Communications. Several staff here have worked really hard to pull this together. Emma colebrand among the foremost who have made this to believe. He was Travis Hopkins and clifford johnson, special thanks to them. And lastly, were just thrilled that we could bring this collection of great talent and Close Friends together for this conversation, and Susan Glasser has agreed to host for today. So susan, thank you so much. And over to you. Well, thank you so much, steve. And thank you not only to everyone who is joining us, but to this incredible allstar panel of experts that we have with us today. I cant think of a group that in my as a citizen and not just as an observeobserver, i hope y help provide us somedy fintive answers, recognizing were in a world where we couldnt have predicted what we would be talking about this week, even two weeks ago. No one will hold you to it, but i want to thank the panelists in advance for their expertise and insights today. Let me do a quick introduction of everybody, so our guests can understand what an allstar lineup this is. Just the order im seeing people on my zoom screen, i dont know if it looks different to you where youre sitting, but we are joined today by peggy hamberg, maybe raise you hand, peggy. Shes the former secretary of the National Academy of medicine. Of course, she was the head of the fda from 2009 to 2015. And before that, was the former commissioner of the new York City Department of health and mental hygiene. So she brings deep expertise on the ground and at the federal level to us today. Thank you so much, peggy, for joining us. Next, we have julie, who is right now the executive Vice President and chief patent officer for merck. Patient. That makes more sense. And before that, she was the director of the u. S. Centers for Disease Control and prevention, from 2002 to 2009. Shes recently described herself as a vaccine optimist. So im sure well have a conversation about what exactly that means. I for one am looking for optimism and a moment in time that hasnt been optimistic. So thank you, julie, for everything you bring to this conversation today. Steve morrison, youve already heard from him, senior Vice President and director of Global Health policy center. He has directed several different high level commissions, and brings a deep background and expertise to the question of what america had done to get ready for a Global Pandemic, and now, of course, what it is doing when it is experiencing one. And then we are also joined today by the ceo of the Chicago Community trust. Before that, she was a longtime ceo of care. Deep expertise in international Global Health. And spent 20 years working with the cdc on hiv aids, as well as with the bill and me linda gates foundation. So were delighted youre with us today, as well. Theres almost an overwhelming number of ways i could jump in and start this conversation. But i feel like its important to actually begin with a little bit level setting as far as where everyone in this distinguished group thinks we are today in terms of the pandemic. Because you hear a lot of numbers thrown around. You hear a lot of, you know, is it a spike, are we at the end of the first wave, the beginning of a second wave. You know, what is your best effort to describe the moment that were in as far as this. So im going to quickly ask each of the panelists to give me their best version of what we are experiencing right now. Just to frame that a little bit, right before this, i saw someone quoting a conversation they recently had with a friend of theirs saying im a little confused. America is reopening, what exactly is different now than it was two months ago when we were closing down . You know, the nurses response was simple and really quite chilling. She said nothing is different, really, except that we have a hospital bed to offer you when you become sick from all the reopenings. So i offer that in the spirit of really hoping to understand from each of you. Peggy, why dont you start us off on that. Thank you. Clearly, this is the most catastrophic Infectious Disease threat of our lifetime and the century. And i think we are still in the early days. You know, we have gotten through some very, very challenging times, places like new york state and my old stopping ground, new york city, are really showing dramatic declines in the burden of disease and the same is true in other hot spots across the country. But were seeing other places with numbers going up, and were seeing conditions that will clearly make it possible for infections to continue to spread, people continue to get sick, and all of the risks and concerns that we have been living will persist. You know, we dont know what the summer will look like in terms of, you know, all the discussions around, will there be seasonal waning, whatever. But this is a completely novel virus in terms of our human experience. You know, it is clear that there are many Vulnerable People that will continue to see infections. People talk arnbout will there a second wave . We arent out of a first wave yet. But were seeing such huge mobilization from the Scientific Community and we can take courage from that. We will be seeing, i think, some meaningful treatments, not magic bullets. But things that will make a difference in our management of this disease. And i hope jowly is right in her optimism about vaccines, and we may have a vaccine or multiple vaccines that are safe and effective and can make a difference in really preventing this ongoing pandemic and protecting not just this country, but the world. Julie, do you agree were still in the first wave, as it were . I see this exactly the way peggy described. You have to step back and realize that with rare exception, at least 90 of people are still vulnerable to this virus. So what were really doing is conducting a very large social experiment. We have proven that social distancing and lockdown actually does slow spread, and protects our Health Care Surge capability. And now with various degrees of relief from that lockdown, were on erving what happens. And i think were experimenting with the calibration. How much openness can we tolerate before we see a very rapid return to the upflow of the curb that we saw when the virus first arrived . And we have some sobering news about that. I think in places that are demonstrating more flexibility, less social distancing and things, were seeing more cases. In some cases that may have some of the requirements, were seeing many citizens continue to wear masks and avoid crowds. So essentially the top down decisions about what needs to happen, havent necessarily changed the way individual people are behaving. So theres a lot of vary buiiab and uncertainty about where this is going to go. I am not optimistic about the consequences of reducing social distancing. I think we need to be very cautious before we fully return to any kind of sort of business as usual approach. And i will just qualify the vaccine optimism a bit, cautiously optimistic is the best way to characterize it. I say that because there are 130 vaccines in progress. The collaboration is enormous. The investment is enormous. But in addition, we know from animal coronaviruses that these vaccines of a family are something that you can create successful vaccines to. So i think the science is on our side, but that doesnt say anything about the speed, safety, dur build aability and other criteria that have to come into play before we can have something to count on before we have the population immunity against this pandemic. Theres a distinction between your optimism, tempered as it, is on the vaccine versus the situation with the virus as it is right now without a vaccine. Let me just quickly ask you before we go to steve, you hear a lot of things thrown around in terms of timetables and the like when it comes to vaccines. Help us understand what you think is the way we should hear those things. We hear the president of the United States saying its just going to be october now, conveniently before the election, is the latest date that hes been throwing around. Is there any possibility of that . I think its important to understand that there are some early potential candidates that are moving very quickly into the more advanced phases of the clinical trials. If were extremely fortunate, those vaccine also have the desired properties to make them good vaccines for widespread use. But its not just enough to get an antibody response. We need to have an antibody response thats protective. We need to have one thats broad enough so that minor variations in the virus are not going to attenuate the effectiveness of the vaccine. We need one thats durable, so we dont have to get it periodically. Ideally we should have a vaccine that only requires one dose, just from a logistics perspective, when youre thinking about global immunization. But we need a vaccine thats safe enough to be used in broad populations of people, Young Children potentially infants, elderly people, we have to be very mindful that this is likely to end up in a situation where we have more than one vaccine, and that well be learning how to use them in the most effective way in the target populations where they make sense. All of that is a tall order. Although we can compress the time line by doing things in parallel and not in theory, we cant short cut safety. I think thats one of the things that Everyone Needs to be paying attention to, and im relieved in admiring colleagues that are on the front lines of this right now, because we are finding ways to work with the regulatory agencies and make sure the safety data is accessed. But at the same time, doing a lot of other things in parallel to shorten what is normally a fairly prolonged timeline. Having said all that, just experience from merck, bringing the ebola virus vaccine across the finish line, which we really went into clinical studies of it in phase three in 2014 and took until 2019 to get the vaccine fully licensed. We were doing everything we could to move that vaccine through the process quickly. But it takes time. You cant always predict what the manufacturing productivity is going to be like or how the vaccine is going to behave in reallife circumstances. So a little scientific humility is also an important component of the communication here. So somewhere between five months and five years. And well hope its closer to five months. Ev steve, i want to get your sort of sense of where you would say our Baseline Assessment is right now, and then we can go bigger. A couple of quick points. We crossed the 2 million mark of cases in america out of a global total of 7. 3, and adding about 20,000 per day. Weve lost 112,000 people to this disease, out of 410,000 globally. Were losing 800 to 1,000 a day. And 14 states today that have reopened that are seeing accelerated infection rates that are at the highest in the sevenday cycle, the highest they have experienced. So its a dangerous situation, and obviously it raises the question did they was the reopening premature, at least in those states and where does it go and what actions need to be taken . Oregon has postponed the next phase of reopening, but it begs the question of, where do you go from here . Were seeing in this rebound period quite aggressive spread in rural areas. Rural areas that are very poorly prepared for this. The second point is the complexity of this disease. Were discovering that it attacks the vascular system, kidney, weve seen in children this frightening syndrome, kawasaki syndrome. So were coming to terms with the dangerous and complex nature of this. Its posing a huge burden on those that are poor and people of color and those marginalized. Its striking them with an impact that is far more ferocious than what the rest of the population is experiencing. These are people who live in poverty. People who are living close to one another. Who are in jobs that have special exposure of risk, and people with underlying conditions. On the vaccine, i would just say that were seeing exceptional collaboration across governments, industry, foundations, international bodies, which is very encouraging. When we look at the moment where we need to manufacture and distribute between 5 and 7 billion people, that is enormous undertaking and very expensive. The ranges are between 25 and 65 billion in order to meet that requirement. Thats a daunting challenge. Thank you. Thank you so much for your patience. You know, has anyone said anything that strikes you as wildly off at this point, or are you also a believer that were at a risky moment as far as the first wave goes . Yeah, no, i would totally agree with everything everybody has said. You know, i think we are one of the things that is so scary about this is that we both, you know, dont have the tools and dont have anything historically really that we can look to, to give us a road map. I think the newness of this, the fact that we are still evolving in our knowledge and that we have such limited tools makes this very difficult and dangerous times. Added to that is the fact that i think in many ways we are weaker as a nation in our ability to come together around this. You know, the fact that we are seeing states do very Different Things that may or may not go along with what is the best Public Health guidance at a time when we really need to have a much more i think harmonized response is very i think very scary. I also think that, you know, the challenge some of the challenges that steve laid out in terms of populations that are impacting, one of the things that is so different about this is that this is the first time weve had a Public Health crisis that also caused an economic crisis at the same time. And if we think about the ramifications of what the economic crisis has done, who its most impacted, we really have this kind of double jeopardy that i think were dealing with. So it is difficult and challenging waters to wade through when we just dont have any real road map that gives us answers. You framed up so many of the issues that we really need to talk about further today. You know, just to name a few of them, this sort of very unequal impact in outcome that has been an aspect oh f this. Of course, which may be accelerated or emphasized even more with the combination of the economic as well as the Public Health aspect of it. The other thing i think that you flagged thats very hard to talk about in a Public Health setting, but clearly we need to, in the Political Polarization and the radically different approaches, you know, you might have had that no matter what. But i was making a list before this conversation of the number of different manifestations on concrete actions being taken as an individual and at the government level. I wanted to ask everyone about that. You know, its mask wearing is one example, where it is more politicized here in the United States than perhaps anywhere else. And you can literally overlay peoples political affiliations with whether they are taking this Public Health advice. Number two, the authority of the very people who are on this panel has been sort of turned into a partisan issue in a way that is quite striking. Actually, there was a very interesting number that i saw in a new piece in the atlantic that suggested that at the beginning of this crisis, both democrats and republicans, you know, had similarly high view of authority and that their willingness to listen to Public Health experts, thats changed pretty significantly after months of it being under assault. And now you have a far, far higher number of republicans who no longer believe in the credibility or will take the advice of Public Health professionals. And number three, just in terms of ways in which were seeing this political divisions in our country exacerbating and complicating the ability to have a national response, not only do we have states taking different approaches to reopening, but you have very different views, depending on peoples political beliefs about what the correct next steps are. So helene, ill ask you and then go back to the others. Sit too late to correct for that . Is there any way that we can stop the polarization from further hindering a disease thats already claimed 115,000 american lives . Or do we have to accept that from a Public Health stand point as a reality of this coronavirus at this point . You know, i think the horse is out of the barn, so to speak, to a certain exextent. It has become taken out of the Public Health realm in many ways, in the realm of knowledge and science, and i think has been politicized. That said, i think there are continue to be voices that try very hard to get people refocused on this as a Public Health issue. And i think all of us in our own way, and why im glad were having this discussion, need to keep thinking about whats the Public Health imperative. How do we get people thinking about lives being lost and all the Collateral Damage that goes along with it . You know, i think it was julie who said that were living through a natural experiment. Perhaps that will also open up peoples eyes. You hate to think we have to see more deaths, but when you start seeing spikes and increases in places that opened up early, you know, and we know that the all of the social distancing and all the rest of the Public Health guidance really did make a difference, perhaps that will start opening peoples eyes and take this out of the political realm and put it back into the Public Health realm where it blo belongs. Julie referred to lets have some scientific humility here. Do you think, peggy, helene is right that there are any ways to address this poet llarization. Its an assault on the credibility of science and questioning of its validity as shaping decisions for the public Going Forward. You know, has this surprised you . Do you have any construction thoughts how it might be addressed Going Forward . Well, as you laid out all of the issues in just how divisive our nation is at the moment, you know, it just fills me with a wave of great sadness. Because as this Global Pandemic was unfolding, i think if theres anything that will help us to unify the nation, to help us pull together, and to help really renew trust and the importance of science and evidence and the Critical Role of Public Health. I thought this would be it. And instead, as you know, we have seen just a tremendous amount of politicalization of issues. And actions, as well. I do think that the public is still listening. I found it, you know, quite extraordinary overall. It wasnt perfect, but the way people adopted the tenants of social distancing, learned about the nature of this virus, and what was needed to control it. You know, understood about the notion of flattening the kufb. And understood that their own individual actions and those of their families mattered not only to their own safety, health and wellbeing, but also for the Broader Community and the public at large. But i do take some heart in that. Whats happening now, though, as steve noted is dangerous, where the best possible science and understanding from Public Health about what you need in terms of declines in cases, hospitalizations and deaths, strategies for continuing social distancing, mask wearing, hygiene, et cetera, while you go back into more public settings. That is not being followed as states open up. Of course, the issues that were seeing around distrust of scientific information, Public Health leaders, and the insertion of poll tigitics into activities of some of our important Public Health agencies really is a signal of enormous concern for us. But i guess i do i do feel that as others have voted, you know, this virus is going to continue to do its deadly work. And sit a formidable foe. We cant wish it away, we cant invoke political ideologies or media spin to change what will unfold. So we have to really monitor and learn as we go in ways that will be hard. Because we may need to pull back as oregon is doing from some of the opening up, as the numbers and the burden on the Health Care Systems demonstrates itself. I think we lost you, peggy. So julie, speaking of the sort of credibility issues that surround things, i think a lot of people would love your insights into what you think has been happening with the cdc over the last few months. You know, most people thought that was the agency that would be front and center in any sort of pandemic. I think today is the first time theyre holding a Briefing Since march. They seem to have been systematically sidelined. But its an agency you were at, so how can you understand what role is the cdc playing right now . And how should we understand why it appears to have been sidelined . I would just like to respond to the broader question first. And you know, from where i sit, i think on a global basis, peop people crave leadership. Theyre looking at that from the w. H. O. So any time theres a misstep or something that does not go the way they hope it would, theres a lot of confidence. People are craving schedule leadership. Theyre looking for it from their state and local officials, as well. And that need for leadership is a root cause for a lot of the challenges were having in being able to effectively manage this. So when there suspeisnt unifie leadership, individual leaders will take action and make decisions. But they wont necessarily be the right decisions, and theyre far less likely to be the right decisions that theyre not listening to their scientific advisers. Is so that leadership vacuum is swi something were all watching. Im in a business environment, so the question were asking is, what kind of leadership can we provide . We have a strong stake in the consequences of this pandemic. Our employees are at refk. Our businesses are at risk and our longterm success is at risk. For those of us in the b biopharmaceuticals, how can Business Leaders help fill in the gap in this partisan environment to provide the kind of leadership. As far as i know, that does not check peoples voter Ridge Administration card before it decides who to check. So we need somebody who can be broader than the political process, to be able to create examples of appropriate policies for employees or policies collectively or advice and thought leadership as policies are being crafted. I think thats going to become increasingly important as we go into the election. With respect to the cdc, obviously my point of view, and helene may want to comment further, but i know the scientists who are leading this effort. They are basically the same scientists who were there when i was at the cdc. These are the same scientists that led to numerous outbreak investigations. There are some surround sound issues you made reference to, but i think the ability of our entire Public Health system, to be able to respond to a crisis like this, requires that people keep their eye on the prize over long arcs of time. This brings me back to something that csis has been working on that we operate in our preparedness to remain an inflection between crisis and complacenc complacency. So it revs one the emergency p supplementals, and that relaxes as the money gets used for other purposes in between. So the same longterm commitment to continue wously improving our preparedness. I think cdc and their Public Health system at the local and state levels pay a big price for that, and were seeing that play out right now. Steve, President Trump has said there was no pandemic playbook, and that he inherited a mess and we just werent ready for this at all. Is it a case of institutional and bureaucratic failure or would you does it look more like a political or social one . Theres an excellent point about the ebb and flow of budgets, which predates this current administration. Can you unmute . Sorry about that. The commission that julie referenced, the Csis Commission on strengthening america, helps security which julie cochairs and peggy is a member of that. We spent a long time looking at this cycle of crisis and comply san si and what was required. One of the alarming things was the decision taken by john bolton in the spring of 18, to dismantle the senior director within the white house charged with leading the effort and being vigilant and exercising a level of coordination and discipline across a fragmented field, and relating to also those outside interests. That dismantling of capacity left us very vulnerable going into this. President trump, i think there were other things going on that this was seep as a distraction or seen as unwanted competition, this pandemic in terms of the reelection campaign. Impeachment was unfolding. So there was not a will at the top to seize on the first disclosures, which started december 31st. The president didnt even begin to address this until january 18th. Even then it was not taken seriously. So there were questions of Political Choice and priorization at that level. But the institutional capacities had been weakened. What were seeing is that 2800 Public Health jurisdictions in this downry are woefully underfinanced and understaffed. That traces back to the 20082009 great recession. So right now youre working in chicago, but you spent a long time in the forefront of International Health and global Public Health responses. I wanted to ask just a quick question before you turn back to whats happening here in the United States, about the International Cooperation or lack stlof right now. And how important thats going to be once there are treatments or vaccines available. You know, have we already settled upon essentially a series of individualistic and highly nationalistic approaches to this . Is it still possible to imagine a more collective and international approach. And also just quickly what do you make of the withdrawal from the w. H. O. And how consequence shall is that, and where does that come from . And we only have 25 minutes . I just want to make sure we talk about it. So i think theres so many ways to unpack that. And, you know, first and foe foremost, Global Cooperation is essential when you have a Global Pandemic. You know, this has been an example, again, where i think the lack of National Leadership within the United States has a real impact on the rest of the world. We are seen as the national the international Public Health leaders. You know, the relationship between cdc and w. H. O. Has been vital for every other Global Pandemic. So i think the fact that not only at a National Level but now interNational Level, were not coordinated in the way we should be, leaves the whole world, i think, very vulnerable. Particularly things like defunding the w. H. O. When the u. S. Is the largest contributor, and the u. S. Collaboration is so critical. Its just wrong and wrong headed. I think we will play the price for that. The fact that the u. S. Isnt entering into this with the spirit of global collaboration that were used to, has just meant that people are nations are starting to go into their own camps a t a time when we need this kind of global collaboration. A lot of discussions have gone on about when we have a vaccine. Depending on which country is the one to first develop a vaccine, are we going to worry about how we get a vaccine for our own population and not think about the most ration nat wal w vaccine contribution. Theres a lot in there, but the big message is global collaboration is more important than ever, and were seeing a retreat from that. And if you look at the Global Health successes, theyve all been successes because of that global collaboration, including making sure the w. H. O. Is able to play its leadership role in coming together around addressing the issue. So challenging times. Do you think, you know twhashwhat are some consequences of the u. S. Withdrawal from a more international approach to this, and the w. H. O. . What specifically ways should we look for that to affect the course of the pandemic . Well, i think as helene was so el quebloquently laying out,e only as safe in this country as other countries are prepared and capable of responding. We need to share information. We need to share lessons learned. We need to be able to harness the best in science and technology, wherever it is, in a collaborative way, to help build the medical countermeasure tools we need as a public good. So w. H. O. Is the only entity that exists in the world that has membership from almost every country in the world. They have rich and poor, north and south, sophisticated and still, you know, developing economies. They provide a lot of guidance and standards. They represent an opportunity to convene, to develop Important Research agendas or how were going to really try to develop the diagnostics, drugs and vaccines that we need. They enable countries to have access to important information. And even regulatory review of certain critical products. And most importantly, looking forward in terms of our continuing vulnerabilities of Infectious Disease threats and other global, catastrophic threats, the ability to have eyes and ears around the world for early recognition of an emerging problem and rapid dissemination of information about the nature of the threat and strategy to address it is critically important. You know, i think that as helene said, although i might say it stronger, its just wrongheaded what the u. S. Is proposing to do. Luckily, we havent actually implemented that decision yet. But its reckless in the midst of a Global Pandemic to pull out from an entity thats usually important to our nation, but hugely important to helping, you know, build a safer, more secure world. Were talking about sort of social, political, economic faultlines and fissures that are exacerbated. Weve seen that here in the United States in the very unequal consequences so far of the coronavirus. Internationally as well, obviously one fissure thats being exaggerated in part for political reasons is the china u. S. Sort of rift were seeing. I want to ask, just aschina u. S rift that were seeing. I want to ask as a medical and scientific matter, i want to ask you about that. Is there, to both of you, is there anything putting aside the rhetoric and it is quite striking how political that has become in our american context. Yesterday i was watching the president s event in dallas and he said, you know, i call it the chinese virus and it was a laugh line. People started laughing and applauding. And i thought, wow, thats probably a pretty risky place for us all to be in. But putting that aside, what i want to ask you, julie, is, is there anything to it from the point of view of science both in terms of how much would you lay concern or blame at the feet of the chinese for the timetable on which they informed the rest of the world about this, you know, and what are the consequences of what appears to be not sufficient scientific cooperation at this point. How can you help us understand that. I have a different perspective than some people because i was leading the cdc during sars when it first merged in 2003. In that outbreak there was a substantial delay in notification and global alerting. The virus emerged in november and we were not aware of it until march. And so that was long enough for the virus to basically have already globalized and set off hot spots in a number of other countries. By comparison to my experience, i was impressed with how fast we knew there was a virus and had the genome and could initiative some of the protocols for developing testing and ultimately countermeasures. I also will say that from a Public Health perspective, the china cdc is an extraordinary organization. They have outstanding Public Health scientists at the china cdc. My predecessor published support peopletopeople relationship with the china cdc that i perpetuated. We signed a memorandum of understanding and every other year we would visit each others agencies. So the cdc Center Leaders and i went to china. We helped inaugurate their new campus with their new laboratories. We conducted a flu pandemic conference by linking in in an Emergency Operations center there to the various provinces in china. All of this came in the aftermath of sars because china did not want to be caught unprepared for another emerging Infectious Diseases. During that time, the scientific cooperation was as good as it gets between two countries, the exchange, the training, the collaborations and, you know, its shocking to me right now to see that change. I dont understand the per sip tense of it or the politics of it entirely. I think its a terrible loss. And it is that kind of sciencetoscience engagement that helps overcome some of the political differences that divide us and creates common ground. When were dealing with a Global Pandemic, were all in this together and no one is safe until everyone is safe. So the loss of that conduit of exchange and Public Health sharing, basically, is something that i hope we can remedy quick because it leaves us in a tremendously disadvantaged place. Whats going to happen when the next virus emerges . What will be the consequence of this divide that weve created now . Steve, do you see us as, you know, and other countries pursuing especially a nationalism at the expense of internationalism Going Forward in dealing with this coronavirus or future ones . What is the lasting damage, what are specific ripple effects from the w. H. O. Plow and this rift at the scientific level that im more scared about having heard julies answer. Thank you. You know, the dismantling of the relationship between ourselves and china on science started earlier. We dismantled our presence in beijing a couple of years ago. Weve been involved. We hosted the u. S. china summit when secretary price was head of hhs in the fall of 17 and it was remarkable. These were decadeslong relationships. We had the vice premier, four ministers and all the chief agency heads from china in the room and it was remarkable to see the Human Interaction with the american counterparts who had been working with these folks for decades. Thats pretty much gone at this moment in time and will have to be resurrected. The problem is the unraveling of the u. S. china relationship. Health is no exception. Its been swept into this. And the china hawks have played a huge role in that. Were now in an arms race for a vaccine and the drive to sort of have the narrative that the whether u. S. Or china emerges first will give it the key to reopening the economy and dominating the world, well that logic and spirit is the opposite of what helene was talking about in terms of and julie about the need for collaboration, allocation, equity, transparency in the way that these the vaccines are going to be produced and allocated. We need to have a chorus of agreement around dedicating vaccines to the Health Workers in every country and those who are most have you bevulnerable. If we have no dialogue going on between the u. S. And china on these matters, its going to set us back normallenormously. We have the act accelerator on the vaccine and is driven by the gates foundation, the eu, w. H. O. And a number of other players that is pushing out those norms around equity, fairness, full access and transparency in the allocation of the vaccine. But the u. S. Has boycotted those sessions and has not been a member. China appeared at one of the pledging conferences but has been pretty much on the margin. We need to pull them into this type of effort. Thank you. And if i could just jump in for one second, u. S. And china scientists are still trying very hard to Work Together around covid19 and other issues. But, you know, this governmental attitude is also creating a Chilling Effect from what have been very productive scientific collaborations outside of government as well and really preceding covid19 there was a lot of pressure on even chineseamerican scientists in this country and suspicion about the work they were doing and the nature of any collaborations that they might have with chinese scientists, if they had come from china and trained in state here, whatever. And weve seen some very unfortunate defunding of grants that involved collaborative work in china. And the breakdown of the work between critical Public Health agencies that julie was describing. I had a similar experience with the fda where we worked closely with the chinese fda and it was very, very important, because a large percentage of medical supplies used in this country actually come in whole or in part from china. Having that transparency, that collaborative working relationship and being able to actually help them improve their Regulatory Oversight to better ensure the quality of goods that americans depended on here, was very, very beneficial and one really does worry about the near and longterm impacts on science, health care and beyond of, you know, the political cold war that seems to be under way. So i realize we dont have that much longer so i want to bring you back here to even a slightly more whats happening right now conversation even compared with whats going to happen this fall. Helene, you are in chicago. Youre leading a foundation. Tell us what youre seeing on the ground, in particular over the last few weeks as you have this convergence of the ending of the lockdowns and people reemerging. You have the extraordinary outpouring of protests and discussion and dialogue over race at the exact same time that just the scale of the disparity between how covid19 is hitting different communities has become apparent. Tell us a little bit about what the experience is in chicago and what conclusions you draw from that about, you know, this disease Going Forward. Are we doing enough to have targeted interventions, for example, or targeted ways of thinking about different populations given their different experiences so far with the disease . Ill go back to what i was saying earlier about how this is kind of a dual pandemic, if you will. Its both a Public Health crisis as well as an economic criss which we created in order to control the Public Health crisis. Those two keep going hand in hand. And over these last few weeks as we have seen how covid19 has disproportionately impacted communities that were already both healthwise as well as economically vulnerable, in some ways it has exacerbated and highlighted those inequities and it what were seeing is incredible amount of need, desperation and pain that is occurring as a result of those twin impacts. And as we know, as this has rolled it, besides the elderly, which is clearly a very vulnerable population, it has hit black and brown communities the hardest and the economic consequences have been grave. All across the country just like we have in chicago, we have mounted large response funds to be able to just get basics to people, food, shelter, cash so people can pay their bills and not be, you know, kicked out of their homes and apartments, et cetera. And, you know, it really is hard breaking because you realize these same populations were living in very vulnerable situations before and have been just thrown into real sheer desperation. And of course as you mentioned on top of that, we then had this horrific murder that we all had to watch over and over and over again which really i think highlighted in a way that many people had denied that racism is still very much a force in our society. And so, you know, you again have this perfect storm of collision of issues that just bring to the surface many things that we as a nation have not dealt with and i guess my only hope coming out of this is that we have been thrown into such a stark reality around these issues that maybe once and for all we will start thinking about how do we look at these issues of inequity because of structures and policies put in place, can we look at what it takes to shift and come out of this perhaps in a better place coming up with solutions that actually address some of the root causes both to the Health Challenges because as we know a lot of the reasons why black and brown populations are so hard hit have to do with their economic circumstances. Lowwage workers who couldnt make choices about staying home in order to social distance and all of these realities that are both the as we call the social determinates of health, that we have to address if were going to be able to address the challenges of Public Health crises like this as well as the collateral economic damage. I think theres also the fear right now, right, that people have spent the last two weeks since this horrible videotaped murder, many of them in the streets putting their lives potentially even at more risk. I know we dont have numbers yet really that will show us whether theres a new wave of infections as a result of these protests, but im sure that must be a concern for you as well. Yeah, it is a concern. I think that a lot of a lot of these marches and protests have gone to Great Lengths to ask people to continue, you know, safety measures. You see a lot of them and people are wearing masks, trying to social distance. The, you know, but people have ive heard a lot of people weigh the alternatives. You could either worry about whether youre putting yourself at risk for coronavirus and obviously none of us want to do that, or risk not tackling these rootcause issues that have killed people for centuries. And so i think weve got to think about both the immediate, which is how do we keep people safe in the context of this pandemic while we address some of these longer longstanding rootcause issues that have been putting peoples lives at risk for centuries. I know theyre going to pull the zoom plug on us soon. Let me do a lightning round with everybody. Im grateful for all of you for sharing your time and expertise with us. I want to go back to that and ask two quick questions for everybody. Number one, what is a metric that you think we all should be paying attention to that will help us understand over the next few weeks and months where things really are at. So whats a metric that you personally Pay Attention to and then number two, what is the what is the worry that keeps you up at night, you know, about this either something that we dont all understand that we should or a scenario that particularly worries you. Peg g peggy, can you start us off on that . One metric for where we are as a nation is challenging, with respect to covid, hospitalizations and deaths is really, you know, a very concrete measure. Number of cases is unreliable because it depends on testing. Im searching for a broader metric to give some sense of social stability and transformation in light of all of these overlapping epidemics and tragedies that would reflect more what we need for the longer term. My hope is that, you know, we have seen cycles of crisis and complacency in the world of Infectious Disease threats and with respect to racism and Police Brutality and a broad set of inequities in our country. Im hoping that for both of these issues, maybe because of coming together at a time when we are very mindful of our vulnerabilities and our need to come together as a nation and to be the nation we want to be, maybe we actually can and will make sustainable change. And if i call you at 3 00 in the morning and say, like, okay, what are you freaking out about, what would you answer me . Well, i am just i wont do that. Okay. Ill let you go to others. But i think we are still in the middle of a very dangerous situation on many fronts from a disease front and also in terms of how we address in a much more meaningful and Sustainable Way the truths about systemic racism and all of its terrible results in our country. What should we Pay Attention to . How can we screen out all of the noise . I agree with peggy, the most important metrics are hospitalizations and deaths. And i will say the thing that worries me besides concern for my mom and the senior members of my own family, i do worry from a business perspective at merck that we provide lifesaving medicines and vaccines. If something happens that we had an outbreak on one of your supply chain lines, it isnt just about the infected and affected employees, it means important, downstream consequences for people who depend on those medicines. Thats a really high priority for all of us and why the rest of us are staying home, because we want to do our part to try to protect the supply. And beyond that, i am very concerned about what is going to happen in the fall when flu season starts. If this thing takes off again the way i think many of us are worried it will, will people be willing to go back into a state where we can once again flatten the curve and i think its going to be a lot harder the second time around. Steve . Thank you, susan. Youve done a masterful job. Thank you so much for doing this. I think the broad pressure weve talked about the other speakers have talked about the measures for hospitalization, deaths. I think one broad measure is whether we are stuck in a cycle of a very chaotic, divisive, violently contested environment or whether we move into a civic dialogue around these reform measures with some vision. Theres there was quick talk and quick turn on the Racial JusticePolice Reform this week on the hill which i found encouraging, actually. I think that the peaceful protests moved that debate into a different place. Well see if that dislodges our dysfunctional and broken political system at the moment. But i would use that as a way of grading. Are we moving towards some kind of unified vision of reform both on the Public Health side but also on the social Racial JusticePolice Reform agenda. In terms of what i worry about, i worry that were already at this very perilous moment. We have a president that fuels and stokes the conflict and chaos and were heading into a season with the virus as well as our electoral season where these tensions are going to magnify. I worry that were not that far away from a breaking point and what might that look like. My feeling is that all of these peaceful protests that emerged, we could if we have another terrible incident or series of incidents, it could reignite the rage and frustration and anger that people have. And we need to show progress in listening to what has happened in a visible and concrete way so that people have confidence that all of this is resulting in some action. Thank you. Thank you. You get the last word, thank you so much. Its hard to add to what all of my brilliant colleagues have said. But i would on what metric i would also just agree that the real measure is how many people are getting seriously sick and dying and so i think thats what is important to keep our eyes on. In terms of the things that keep me awake and i stay awake a lot at night worries, but i worry this could spin back out of control clearly. But i guess my bigger worry is that having gone through all of this that we wont be prepared the next time. This is not the last time were going to face Something Like this. And, you know, the fact that we let our guard down like we did, didnt have Public Health preparedness in place and as julie said, we had a playbook, but we didnt have it up and ready when we needed it. And my hope is for once and for all, we recognize the value of Public Health and Public Health preparedness so when this happens again, we will be prepared. And finally, that we dont lose this moment to really once and for all look at what does it take to make us a fair, just and equal society and look at this moment where there is this much passion and rage. And when i look at the young people who have who are putting themselves at risk as they go out and march because they believe in a better and different world, that we dont miss this opportunity to give that to them. Well, thank you. Thats an optimistic note to end on and i think were all rooting for that. I want to thank you and all the pan panelists and everybody who took time to tune into us. Thanks, and julie, good luck with that vaccine. Thank you. Thank you so much. Thank you, all. Thanks, everyone. Goodbye. With the federal government at work in d. C. And throughout the country, use the congressional directory for Contact Information for members of congress, governors and federal agencies. Order your copy online today at cspanstore. Org. Tonight on American History tv, beginning at 8 00 eastern, a look at the life of dolly madison. Cspan in cooperation with the White House Historical association produced a series on the first ladies, examining their private lives and the public roles they played. It features individual biographies of the woman who served as first lady in over 44 administrations. Watch American History tv tonight and over the weekend on cspan3. The president s from public affairs, available now in paperback and ebook. President s are organized by their ranking from best to worst. And features perspectives into the lives of our nations chief executives and leadership styles. Visit our website, cspan. Org the president s to learn more about each president and historian featured. Order your copy today wherever books and e books are sold. What do you think we can do about that . With Police Reform, protests and the coronavirus continuing to affect the country, watch our live, unfiltered coverage of the governments response with briefings from the white house, congress, governors and mayors updating the situations and from the campaign 2020 trail. Join the conversation every day on our live callin program, washington journal. If you missed any of our live coverage, watch on demand at cspan. Org or listen on the go with the free cspan radio app. Next, Fire Department chiefs from across the country testifying on how theyre responding to the coronavirus pandemic and what concerns they have about staffing, funding, and access to adequate personal protective equipment. The house science, space and Technology Committee is chaired by congresswoman johnson. Were under unusual circumstances today, but pursuant to House Resolution 965, today the committee is moving virtually. This is not how we would prefer to conduct business, but were in the midst of a Global Pandemic and until i am