Announcer this is Washington Week. Funding is provided by for 25 years Consumer Cellular has been offering no contract wireless plans designed to help people do more of whaty like. Our u. S. Based Customer Service team can help find a plan that fits you. To learn more, visit consumercellular. Tv. Announcer additional funding is provided by the estate of arnold adams and koo and Patricia Yuen through then yue foundation, committed to bridging cultural diffeurnces inommunities, the corporation for public broadcasting and by contributions to your pbs station from viewers like you. Thank you. Once again, from washington, moderator robert costa. Robert good evening. And welcome to week. We hope you enjoyed thanksgiving. We also know it wasnt easy. The coronavirus pandemic remains a burden and a threat. Families cant gather. Millions are isolated and truggling. Haveied. So our question tonight, for this special reporis whats next . Joining us to provide answers and insights are three of the best journalists on this story. They have been covering different aspects of the crisis. Fareed zarekia, host of fareed zarekia g. P. S. On cnn. A Washington Post columnist anduthor of lessons for a postpandemic world. Health policy reporter for the Washington Post. And sarah kliff, an Investigative Reporter for the New York Times covering the american heah care system. Lets begin with dr anthony fauci, the nations top epidemiologist who spoke with me earlier this week. He was upbeat about vaccines, but he warnedin thatr could be bleak. Now what were seeing, almost the entire map of the country is lighting up with the dark colors which indicate increased test positivity and the slope is like that which means that if in fact youre in a situation when you do the things that are incre risk, the travel, the congregant setng, not wearing masks, the chances are that you will see a surge super imposed upon a surge. Robert that made me sit up. A surge superimposed upon a surge. Yasmeen, when you listen to dr. Fauci, and when you talk to Health Officials, what do you hear what is keeping them up at night . Yasmeen i think, you know, the biggest concern is that there really isnt a federal respons right now at this time where at the worst point in the crisis that weve been. In the sprin you saw this national shutdown, a bit more crisis is actually worse now than it was then. You know, theres this hug fear thats been playing out, you know, that federal response could not wait until over on january 20. Biden takes you cant just let the crisis pread unchecked for those 10 week and thats essentially what were seeing happen. You see states taking different steps. You know, to try to control some states being more willing than others to take dramatic steps. But right now, youre not seeing a lot of federal leadership. There isnt a lot of federal messing about what do. You know, theres obviously huge concern abou travel and gettogethers and whats that is going to mean for a sge or uptick after ward when were already at 170,000, 1,000 cases today. And that these Smaller Health care centers and hospitals are not getting the help and reso robert sarah, you Cover Health Care workent and pat so out in the coury, what is their reality rightow . Sarah i think theres a lot of really tir Health Care Workers who have been fighting this day in and day out across the country. And really the fear right now that i hear expressed by Public Health officials, by Hospital Executives, is that what we could see in the next few weeks is Something Like what happened in new york city in march and april. Just this huge surge,or need more staff and more ventilators, for more hospital rooms. What had happened in new york the rest of the country could help s othetes sent ventilators, travel nurses came to new york city. But the real fear at seems to keep these workers and Public Health officials up at night is that surge is going to come at so many places across the bcountry, that there won those resources to place to another. And i think its certainly true. We stepped up our production of p. P. Theres more masks. And more ventilators, too. But the real linchpin is the people. Theres o py so manyple in the u. S. Who know how to operate a ventilator, who know howhio treat disease. And thats the thing that keeps the Health Workers and Hospital Executives i talk to quite worried and alarmed is they might not have the staff to treat patientshen the surge gets much worse in their area. Let me read a line from your terrific book. You write, quote, nations have createds mechanid institutions to cooperate and some of common problems. But in the end, extremists walk alone. This is a global crisis, but which challenges are uniquely american . Fareed you know, the paradox of a pandemic that by definition its global, it forces countries to become somewhat more isolated. You know, you cut off or you limit travel. You have to put your own house in orderca in the ame case, i think the are two principal challenges. O were going beyond trump for a moment. One is the crazy quilt patchwork of center, state and local authonity. Thed states does not have one governme that is handling the pandemic. It has 9,000oughly separate units of government that have to coordate ami have r standards and travel and things like that. And that has prougd a problem. The secd is more cultural. There is within americas d. N. A. A certain kind of antistatism, the kind of dont tread on me philosophy. And so eces hard to get people to observe quarantines, mask wearing, you know, the c. D. C. Has advised dont travel during thanksgiving or dont large gatherings. Its very hard, that rubs against the culture of the country. Both challenges exist f other countries. But they are in some senses secially american and it certainly true that weve been especially bad at dealing with them. Robert yasmeen, what is the outlook on vaccines this week . What are they watching for at the f. D. A. . Yasmeen well, i think one of the rare signs of positive news been these three very promising vaccine candidates that have reported their first results. So, you know, at the f. D. A. , there is an Advisory Committee meeting scheduled to review the data on pfizers vaccine on december 10. I think a lot of people are hoping that appear eme authorization for that vacks onan emergency authoriza for that vaccine comes shortly after that meeting. And the Moderna Vaccine and astrazenaca, it will be the same process. The f. D. A. Reviewing the data to see, you know, if it warrants an emergency authorization which is not the same as a full approval which takes more time. But basically is an assessment that the benefits of the vaccine outweigh any potential risks. N the middle of a public robert but sarah, is the system you cover ready to effectively disibute vaccines in the coming months . Sarah you know, that makes me think of the question you asked fareed. And when i think of the American Experience with coronavirus, one of the unique challenges we ha is this incredibly Fragmented Health Care system where we dont n ha ional helt care system like many of our peer countries. Ng we have compeealth insurance plans and some private plans and some public. And this who patchwork of providers. And it will be a challenge get the vaccine out through that system. If you think of all the different places where americans get their vaccines right now, sometimes at the doctor office. Sometimes at a pharmacy. Sometimes through the workplace. Were going to have to figure out how to distribute it and distribute it in an equitable way to make sure that the people who really need this vacce get it first. So thats the next large hurdle deal with. Public Health Officials are quite eager to deal with. They want to get this vaccine outo people. W buthave a system that is not set up because there are so many different players. You wuld have placre the lack of communication makes it a bit more challenging to distribute a vaccine in our country compared to some of our peers. Robert fareed, beyond tha efficiency point, will there be much Public Confidence in cche es to get the nation out of this crisis . Youve spoken to bill gates in recent days about this tic. Fareed yeah. Look, its a huge pblem. And let me pose what will be a real challenge if it right now, donald trump is provaccine because he sees it as being something that hes spearheaded. And he helped f operation warp speed. En ew months, the b bidens vaccine and at which point ifonald trump becomes an antivackser and i started this program well but t biden administrati screwed it up and dont get vaccinated, remember, he still has a huge number ofeople who support who hang on his every word. That massively secomplica the scenario. But let me sum up about this, i think that its worthg point out these vaccines have been developed faster than any vaccines that we know of. This is an extraordinaryen achiev and probably going to he seven or eight of these. If you think about the first phase of the health crisis, was a Public Health response, wh the United States basically botched. The second phase is going to be therapies and vaccines which is largely ava p sector response. I would suspect the United States will overperform or outperform on that metric in terms ofroduction even in terms of distribution. The key issue is going to be the one yo asked which is public trust and over there, as i say theost worrying variable is donald trump. And hes not the only guy. As i point out in my book, this ole wave of populist leaders who scorn expertise works scorn scientific knowledge, they could hey could have a second act with the because that will be a place preeminently where you need to trust experts. About this week and you have written about this in recent days and how the president h railed against the socalled medical deep state, his term. So while i spoke to dr. Fauci and youre talking to him in a other other officials who is actually in charge right now inside the federal esponse . That no one is really in charge. Inside the federal response. The white house has really not paid a lot of attention to the Coronavirus Response for weeks now preceding the election. You know, weve spoken with several officials, both litical and healthfficials, who said the White House CoronavirusTask Force Meetings at this point are a little more than political theater. So you have the agencies that have very clear work to dth f. D. A. On reviewing and authorizing these vaccines, distributing personal protective equipment, preparing when youre talking about the entire federal response that really should out of the white house, there isnt really a leader there. And i think you can t seet in the conflictingessages you get from people. You have people liker. Fauci, you know, really sounding the alarm for these last several weeks about the direction were headed in. You have the, presideu know, sort of barely acknowledging the rising infection ath toll. And then, you know, all manner of officials in bween. You got the secretary of and human services, alex azar, reiterating basic Public Healths tepeaking about their vaccine progress. But you arent seeing a coordinated centralized federal response. And i think thats reflected in the messages messages you see depending on whos giving it a that robert sarah, i want to come back to your beat for a moment. In terms of testing and treatment, what are the costs of thi pandemic . Sarah so for patients, they are supposed to be free. There are some rules that congress passe this spring that are meant to make coronavirus testing free and with good reason. We dont want people to be o afraa medical bill and not get tested when they thk they might have coronhairus. So means no copayments, no deductibles, a special fund to cover tests for those who are uninsured. Unfortunately, what ive been finding in my reporting is that many patients are facing costs. Andca sometimes quite signi costs for their coronavirus tests. You know, in rare ces over 1,000 for a test they expected to be free. And i think this really reflects the way that our healthare system worin. And a the fragmentation. I talked to Insurance Companies that have tried to impleme these rules. But the coding is quite complex. Sometimesroviders will tack on extra services. Patients werent aware were being added. And theyll get billed for those things beyond theirro virus test. So right now, were having millions of coronavirus teersts ev single month. And unfortunately, you are seeing some patients get medical bills. I think the other side of th b aware of is that you have patients who are uninsured or patients who have gotten a surprise medical bille past. And they might be a little bit nervous to get a coronavecus testse they dont think they can afford it. Ive talked to some people who faced steep costs for flu tests, for example. And nowre nervous to get a coronavirus test. So its a unique elent of the pandemic in the United States that you have this medical billing side that is goinbeg to n element that makes it harder to control the pandemic here versus in othe cntries. Robert those are challenges for President Trump but also for preside welect biden is putting together a strategy. However, for weeks, the president refuse to sign off on the transition. Finally, on monday, the head of the General Services administration inf that he could begin the process. Yasmeen, whatsour aessment of biden and how he will handle the pandemic . Yasmeen i think he made pretty clear as soon as he was declared the winner of the electi you saw him two days task force Transition Task us force which was made up entirely of doctors and health experts. So, you know, i thin signal right out of the gate that this was going to be a r scienceleponse. He was going to follow the advice of scientists. Youaw him appoint ron klain, chief of staff who was the ebola czar for the Obama Administration in 2014 and was generally praed for the way he coordinated across the federal government to manage the ebola response. You see thathis is going to be the top priority for the Biden Administration when they me in front and center. You know, the biden team has also signaled that they will put the c. D. C. Front and Center Including career officials who were cast aside in the Trmp Administration for, you know, straying from the message of the Trump Administration wanted to convey. So hes trying to signal in that way that he ca muffing lar fedal response. Theyre going to try to help the states as they can. Is they are going inherit an o enormous crisis. Cases are already at almost 200,000 a day. Its hard to predict where they will be by the time they take over. So it is gng to be an ormous challenge that theyre going to inherit. Robert fareed, what would you add here about president elect biden . Fareed i think biden has exactly the right instincts. He has very good people around him. But i think that one of the understand is that the United States really failed at every level. Its not just President Trump. Trump, you can blame him for a lot of things. And i think he deserves that blame. But its been a broader systemic failure. One of the things i talk about in my book you look around the arled the ces did well that figured out how to get government right and how to get to a crisis like this. Sponse so, for example, taiwan, which really gets the gold medal for this, figured out how to do not just testing but also tracing and then isolation of the people. You see the thing is to get the infected and the potentially infected so i would hope t what the Biden Administration can do is learn from tain, south by the way, all places that had no lockdowns. Who ran this told me, a iwan lockdown is a sign you have already failed. What you have to do is figure out how do you take the infected, quarantine them, isolate the potentially infected, thats usually in in taiwans case, it was 1 of the population. That allowed the other 99 ulf the pion to live life as normal. And if we re to isola these people and give them hotel service, the cost would be a fraction of a fraction of whati countrys losing economically as a result of tru corona so anything you can spend to have an intelligent and aggressive response would be the right answe one of the things were bad at in america is learning from other countries. We think were exceptional. And we are in certain ways. But itlinds us to the reality that there are some things we do very badly. Ot r countries do well. And it would do to have a little bit of humility and look arou best practices. Robert sarah, congress is de ly divided here in the states. Are you expecting more executive actions next year on issues likeesting rather than legislation . Sarah i think i am. Bu theres only so far that executive action can get you. You can get aarther if you move legislation through congress. And i think you see this, for example, with the issue o masks. Joe biden has spoken positively of a mask mandate. But it does appear that there is federal authority to create Something Like that. You know, i do expect more executive action around a testing strategy. Joe biden has outlined a pretty scomprevens plan for how he wants to increase to 100 month. Tests a the 30 or so million we at right now. But a lot of it is going to be easier to do if you can get the buyin of congress to fund those sort of things and toet the buyinf the american people. I think one of the things youre seeing right now is americans are taking a lot of their cues from their political leaders. D if you have President Trump mocking masks or not talkinge about importance of getting tested, even if the capacity of his supporters not wanting to use those resources. So i think part of it is Getting Congress and getting the buyin of Congressional Republicans would signal to the American Public that both paies feel likehis is important. And this is the right thing to be doing. Robert yasmeen, quickly, whats one thi youre watching as a reporter in the weeks ahead . I yasmeen hink the big thing is whether we see a big spike afterhanksgiving and how states try to manage that. You know, we saw a big spike after memorial day when people felt it asafe to get together and at that points case were at about 20,000 or a 30,000 day. So i think thats the big thing. D then of course how the federal response changes or doesnt change in the coming weeks. Robert and fareed, in just a few second what are you watching . Fareed the georgia races whether biden will be able to spend money or not. At the end of the day, as others areaying, this is all it all becomes much weaker unless you can spend a lot of money fast. Tonight. We must leave it there a little earlier than usual. So you can support your pbs station. Thank you so much to fareed taleb, and meen a we very much appreciate your time. We also appreciate yours and we will keep taking you as close to the news as we can. And check out our next chapter lfof our books series, you can find it on our social media website. About his book. Im stay safe. Sta. And good night from washington. Announcer Corporate Funding for Washington Week is provided by before we talk about your investments, whats new . Well,udrexpsting. Twins. Grandparents. We want to put money for them so change in plans. All right. Lets see what we can adjust. We would be closer to the twins. Change in plans. Ok. Mom, are you painting again . You uld sell these. Let me guess, change in plans . At fidelity, a change in plans is aays part of the plan. Announcer Consumer Cellular. Boeing. Additional funding is provided by t estate of arnold adams and koo and Patricia Yuen through the yuen foundation. Committed to c bridgingtura differences in our communities, the corporation for public broadcasting and by contributions to your pbs station from viewers like you. Thank you. [alastair sooke] in kentposing house was once the setting for one of literature greatest mysteries. Our story begins in 1870, on the 8th of june, rounheabout 6 oclock in t evening, e and onhat particular day Charles Dickens had been hard at work on his latest novel. d worked for 8 hours solid, which was quite unusual for him and that evening, he muhere at gads hill, workiwhich is now a school, he came down to the dining room to have dinnerth his siste, miss hogarth. Almost as soon as he entered he started complaining of a toothac and immediately he collapsed and lost consciousness and never recovered. He died shortly afterwards, and hed never complete his final novel, even though the first three installments had already been published,