start simply, explained the title. and the reasons you wrote the book. you talk a little bit at the beginning of the book. >> cap great professor i'm going to callso you larry so thank you it's an opportunity to be with you again. we have had a long career together with pandemics in the making of the most vulnerable are served for the help we take that message here in this country. i call that silent invasion to really raise the alert that despite the capacity we had not been diagnosing truly diagnosing respiratory diseases ever in this country. i was confronted that in africa in 1998 where hebert was treated as malaria than something else and then do something else. maybe it was for tuberculosis t may be hiv. we did not what was specifically harming the people in africa. we work with the private sector and now he could diagnose hi tv and malaria no matter where you live for the farther scent of the road or in a metropolitan area. and to come back to the united states and find out that 90 -- 95 -- 99% of fluids diagnose presumptively. we were only surveying for symptoms of respiratory diseases and making assumptions about what people were infected with. i found that really shocking in this day and age. something appropriate for the 20th century not the 21st century. i really wanted to alert americans we could still suffer silent invasion this virus came to us silently because we were not testing order comment respiratory diseases are. if you don't knowon it's flow yu don't know if it's not flow. it's really a call to action for laboratory diagnosis of all of our respiratory diseases so we knew what is here and we know what is i coming. i think even today the viruses silently moving around our communities. we are not adequately making it visible to the american people. >> i want to dig in a little bit more as we go along about your remarkable career. hiv canri be malaria. and also a bullock, h1n1 and influenza. sars one, so i want to get into that rich history i know that you have had in your leading the public health response in america globally for such a long time. the idea of silent invasion, you make another point quite forcefully in the book about the silence of asymptomatic spread. when you talk a lot about the idea that someone has the flu they have symptoms. you can have a lot of spread before their symptoms are rising. can you talk a little bit about that part of the silence? >> thank you. this virus and many age groups is invisible. and very visible in a group of age groups. and people with comorbidities end up having severe disease and dying. so if you do not see it and you do not see it coming then you miss all of the tools that we have to utilize them so that americans cannot only survive but thrive. i use silent invasion because i come out of a family of a lot of scientists big science-fiction fans. sonc i wanted to give voice to those of you who love science fiction. this was it not science-fiction but i think in a way many of these science-fiction books have been talking about pandemics and global spread for very long time. and societies were not ready. am hoping that's why there is an appendix at the end with clearoc legislative fixes that need to occur. i feel like even today with all of the tools we have we remain vulnerable to silent invasion community by community. we are not picking up the asymptomatic spread. >> i love the science-fiction. when i grew up i wasn't science-fiction my favorite book was the micro hunters. the early story of people that are looking into anthrax and tb. it fascinated me at thee time. so one of the things you said you wrote the book four, you said you were writing it not to condemn, not to commend but to recommend. i want to get at the very end of our interview, debbie the idea what is your blueprint for the future? but let me take you back now. i want to go back to the beginning. both to the early days but also to something you said early on that you are compelled to accept the job knowing who donald trump was. talked a little bit about why when you got the call you were reluctant but you answered that call. >> well, global public health people who have known me for decades know that when i see an injustice, when i see in an equity when i see that results in people's lives being altered it is something i am compelled to address. and so in january i can see this virus coming. obviously i was responsible for sub-saharan africa and asia i was very worried about everyone we serve their community by community. i looked at the data myself and i was late, this is going to be serious. my first step was to go to the white house to the african bureau the national security council. and say to them i need to have an emergency meeting with all the african diplomats. and so before the end of january we've got all the african diplomats in thein indian treaty room. i am going through why i am t concerned but have doctor fauci talk, doctor redfield talk about what we're doing domestically so that africa could know and cable back to their countries two things, that we need to rapidly develop tools and that they can tell their ministries to utilize the capacity we built over the last two decades. and i won them to know our resources were available to them immediately. try to get africa and asia and how to route these are dollars for testing. let them know the depth of my concern. and i am assuming the same thing is happening in the united states. but then i o just watched i was over an africa mode most of february. i'm watching i'm watching the nightly news. i am watching the reports of the press conferences keep talking about the risk being low. that we only have a handful of casesoi. then werecl going to close to china. but we are going to let all come back. her only going to screen my symptoms. i was like the virus is everywhere. i did have a friend in the white house who is the husband who i knew quite w well. i felt like they were not acting. i am sending him all of these messages and data about how severe i think this is going tob be. he is taking it to the task force but he is tell me they're not listening. i might please tell them again. i am pushing out these messages and he is calling me and think you need to come back and help. but of course my commitment was to the people i was serving. and frankly i knew about the white house. i frankly knew how i would be perceived even though i was a civil servant and had nothing to do with trump political machine, i knew if i went into the white house to help that all of their perceptions about the president would also become their perceptions of me. because most people p in america did not know me. overseas people know me but not in america. >> and we all know you here for sure here in the field. >> kept saying no. i could just see the tsunami cominghe. i felt like the diamond princess with such a real example to me about how america was misjudgint this pandemic by only testing symptomatic people. i'm not testing the crew on that diamond princess. only looking for symptoms for the crew was much younger. i did the virus was spreading through the crew. i just felt like we were not utilizing all of what i had learned others had worked globally pandemic after pandemic to bring that knowledge base to the united states. so finally out of frustration i answer the call and came back. >> looking back and seeing what president trump did in downplaying, or going to get into that you talk a lot about that in the book about flulike illness, low risk other kinds of issues like bleach and so forth. what do you think, when you think back to thosese early day, how do you reflect on it? the reason i don't regret it is because i know what happened upon my arrival. those people who know me, no it doesn't matter who is president. i work with presidents across ntthe world. i don't care who is president. i don't care who is prime minister. i don't care who is minister of healthm. i t believe i can assemble the right dated to convince them to do the right thing. i had seen that happen throughout my career. i saw africanic presidents finay let us address the lgbt community to people who inject drugs. people who were innon prison. to do the right thing to prevent hiv and to prevent and t treat o those who need treatment. i believed working with so many with the right data i could convince the president and the vice president this was serious. until i arrived with my list. i was really happy that first week that immediately when i said to the vice president, here is a list of people to immediately call to the white house. we have to have our developers make test. not just pcr' test but antigen tests and antibody test. got to have it immediately. you got to get them all here. by wednesday they were all there. and so there is a lot of action that first week. both on pushing therapeutics, pushing vaccines,et pushing testing taking much more seriously. obviously i knew a lot of them for nearly a decade. and they helped me. they sent me their data. they were about two weeks ahead of us. and i usehe that data for the european travel ban the 15 days to slow the spread and the 30 days to slow the spread. when history is written see the first wave compared to many other countries much more contained many other waves subsequently. i think as a company we reacted seriously in this three -- four weeks and then we didn't. that was very disconcerting to me. i talked in the book how the president got very different analyses and really that unraveled the data was correct. >> for me in reading the book the one thing that comes across is your love of data. and your frustration when it is not there. when it is not accurate. when it is not comprehensive. that really came through. before i kind of i go on also a little bit about the early days in china. i want cannot help but ask you didn't really feature in the book but you talk a lot about africa. probably the one american in the nation that knows africa and its interception with disease more than anyone else, what do you make of how covid would has transpired and africa? were thinking it would be cataclysmic and wanting that early on. and yet there is some evidence there's less severe disease. maybe that is a reporting issue. maybe that is an issue of simply having a younger population. what is your take on africa and covid ed? >> that is a brilliant question. it intrigues me and intrigues me today. certainly some of it is testing and reporting. we cannot hide severe covid disease. and you cannot hide most of the covid deaths. i said that across this country to many governors and mayors. there will be a full accounting state-by-state county by county by what actually happened. in africa they're blessed by three things that were really critical. across the main part of africa most people know around the equator going north and south from east to west africa that median age is between 15 and 14. 50% of their population is younger than 14. we know from data now this virus was very selective in general for the elderly.di if you look at the continents that includes north africa's a very different situation. i can talk about that separately. africa is a consonant has left 9% of their population over 65 we have about 20%. the other piece of it a lot of the individuals in the '90s in the earlier popular forney thousands millions and millions of people.e it emptied out the change as a community the ability for people in africa to thrive despite it tried tb andch malaria. the other second is comorbidities as compared to the united states much less obesity. that's why few look around libya, south e africa, botswana where they do have older individuals. where they do have more comorbidities. you see fatality rate from covered. and so the younger generation, the last comorbidities certainly underreporting. when you look at excess deaths you do not see thehe same level and excess deaths in 2020 and 2021 as you see in the developed world. i think it's really a wake-up call. because like you, larry, we thought pandemic would be horrific and low and low and middle income countries but in the end this pandemic singled out upper and upper middle countries. and there was no natural alliance of those countries. we were all focused on the low and low middle income countries. there were no formal channels to really share information between our european colleagues and the u.s. and central american colleagues. and canada. we thought it was going to be there and it was here. and i think this really opens up a glaring, glaring mistake we all made over the last two or three decades. it's really establishing clear data exchanges amongnd the upper middle income families. >> very, very important points. just very briefly on the early days of china and wuhan, what the president knew, should have known and when. also reflect a little bit about the significant clash between the white house and china on a number of issues. but particularly the lack of early reporting and lack of early reporting in an honest way in terms of transmission. and ultimately lead the president sending a letter to un secretary-general giving a 12 month notice of withdrawal from w.h.o. how did that all unfold in the white house? how did that play into the early days of the u.s. covid response on the global covid response? >> you know, larry i was not here. i could never really understand. so, when i arrived at the white house no one gave me any cia or other cables to suggest there was information coming in through secure channels about how severe this would be. so when i heard the bob woodward interview i was as shocked as america was. because when i arrived and i say nno one, i mean no one in the white house from the nsc to the cia, to the vice president and the president. no one shared with me they had an understanding about the severity. my feeling was they are not takingly this as significantly s i think is going to be. and that is why we have to make these changes. but that was very disconcerting to me too find out that woodward engineers june or july of 2020. i was shocked. and still no one showed me that actually existed. so to this day i have never seen that document that talks about the severity. the reason i knew it was going ngto be severe as you can see on social media the hospitals were getting overwhelmed in january. and at the same time china saying they don't think it's human transmission for advancing the social media post the w.h.o. should have been seeing social media post. they should have gone to the world and said this virus is highly contagious, spreading rapidly, and results in significant illness and those over 70.ha i am still surprised by that. that data was out there. it may not have been coming from china per se. thatse was the whole point of putting w.h.o. representatives in every country. it so you are not always reliant on just what the national reporting was. and after what happened with sars i thought we had learned that lesson collectively as a community. but i think once again that early misleading about human to human transmission i think resulted in a lot of countries making very a poor decisions abt not developing test and not really this as seriously as they should have. >> such an important point. i want to stress one of the points you make. you her doctor birx says she got to the white house and none of our most sophisticated machinery of government the cia, intelligence, national security, white house staff seem to be aware of the seriousness of it. that is a stunning statement. >> i think the nsc was. because matt was trying to get me back here at. [laughter] i don't think the agencies were acting. [inaudible] >> would you include cdc in that? >> you know i do not know the cdc was thinking at that time. but i can tell you they did not prepare the country for a countrywide pandemic. that was evident already in china. what do i mean by that? setting up the data streams you need. bringing in commercialou laboratory developers. it's great they worked on tests for public health lab. but we all know publicea health labs they are not what we call high throughput laboratories. the platforms they made, the tests were in general platforms that could do a handful or less than 100 tests a day. we were going to need millions of tests a day. we had to bring on board our commercial laboratories. until nancy made that comment the end of february i do not know i was worried. >> senior official at cdc. >> yes so when nancy said she was worried that was the end of february. i was in her didn't watch it in our day they had her didn't have. we are incredibly flat-footed as a country. one of your book your first third to a half was about the u.s. response. i want to dig in here but start with the missteps operation warp speed. a testing was a big part of the story. we started talking a little bit about the labs. just expand on that. why was the cdc seemed to be so off based on its testing kits? and also talk about their communication with epidemiologists and others. just take us back to the very, very difficult days in our testing capacities and our test kits w.h.o. had a test cut when her allies like germany or using better test kits. cdc decided to develop its own. tell us a little bit about that story. >> to this day i do not know why itit happened. i got so frustrated after i left in january of 2021 with the covid response. i talked to the laboratories our big commercial laboratories and said to them, what kind of dialogue or you have with the cdc andnd hhs? and how come we did not have these tests? what was going on? what they told me was they were actually calling the cdc in january saying how can we help? how can we help? we can help develop commercial test what you think you're going to need? cdc told them they were not going to need help. i guess for working in resource limited settings i never turn away help. even if you are not sure you obsolete need it, when people say how can i help? i give them a list. [laughter] you cannot know how bad things hare going to get so you prepae for the worst and hope for the best. but you prepare for the worst. and in my mind because so many people focus on the contamination. in my mind that's not the problem. they made a test low throughput because they firmly believed they would be randomly testing a few samples each of the public health labs. they would track this virus slowly through symptoms. they had symptomatic model of how they're going to prepare and how they had sentinel surveillance around the country all based on symptoms. there's nothing in there about widespread commercial level testing. and i think for those of us who have battled pandemics around the globe we had a leg up. because we know most viruses are invisible. most of the transmission is occurring in an invisible way. >> hiv is a great example of that. >> so early on i had a meetingki with a lot of cdc colleagues. and i was talking to them about how so much of the spread in hiv is asymptomatic. we were not able to change the pandemics course on the .ontinent in finding the asymptomatic virus. in preventing new disease. we heard back there in that meeting as they will back to the cdc in atlantata and said well, she thanks she doesn't understand how viruses are transmitting. she's trying to use a blood-borne model for our respiratory disease. which was not my point at all. my point was you cannot see the virus . yes it's being spread in a different way. but you have to make invisible viruses invisible. they completely discounted what i said because they are like that she has worked on hiv, tb, and ebola. she hasn't work on flu. of course have all worked on liberty work internationally wor' on flute and worried about avian flu. it was that dismissiveness that concern me then. that concerns me now. on the willingness to listen to others ideas. i think cdc is gotten quite insular by being in atlanta. and i do think they have to be much more open to relate looking transparently at the data and let it be dated teach them and get out there assumptions and into a place that is really data-driven. >> the idea at the beginning was a resistance asymptomatic spread was a major factor in the transmission of sars-cov-2 two. >> and larry that continued. that's what was so disconcerting to me. because obviously the fda those of usr who worked with the fda for very, long time understand the limitations of these control panels. usso they have developed a contl panel obviously from symptomatic disease because that is the only thing they were looking for. so the control panel to validate the new test were symptomatic disease. so as late as july i'm trying to convince them in the cdc that the antigen test had been used in the asymptomatic patients. it took an entire 12 months in addition to convince both of them that you t can use antigen tests prior to having symptoms. that really held back states. cms and other payers were not willing to pay for a test the fda and the cdc said could not the text and could not be utilized for definitive diagnosis. so we got in our own way several times. >> the testing was really one of the missteps are supposed to be an understatement. there is some other areas we should discuss. let's think about personal protective equipment and masks. we remember early on with new york hospitals flooded with cases and cases spreading around the world. we ended up with a shortage of personal protective equipment. and also a lot of confusion around the messaging in terms of masking. and what kind of masks. one of the things you said in your book why did we assume the canon 95 respirators people would not wear them they were less comfortable, where is the data? talk about ppe shortages. in other shortages, ventilation, oxygen. and then zero in o on masks. in the early days of masking and really even today. masks have become a flashpoint in the united states. >> really critical important question,re larry. we are vulnerable today to lack of essential medicine. and it was clear, it's clear now there's disruption in the supply chain. we do not make any this essential medicines here. i will never forget admiral coming into task force one day i think it was april or may that all blurs together sometimes and we have the supply shortages. he came in and said i am out of. for those of you who do not know, that is an anesthetic that people use and they have to be on ventilators. so the individual is put into a sleeping state so they do not fight the ventilator. really critically important and we were running out. not only do we not have masks we do not have downs, we did not have gloves, we didn't have ventilatorsnt now we are running out of essential meds for hospital. and none of these things are95 made here except for and 95. and i learned so much about our supply chain and are fabric and the same kind of fabrics that are used for masks are used for gowns. and so people who were making gowns to switch over to masks. then we could get gowns. it should be a national security issue that we do not have capacity in this country to make the essential medicines that we need in a time of crisis. i am hoping that's what it is in the appendix. we have to have congress address this. it is critical for our health and welfare in the future. it will take some time and yes in certain cases we are going to have to pay a little bit more. but in exchange we will not run out. i want to thank the supply chain group. they were under an enormous pressure from me. i have never said this before. i did not really talk about in the book. but, when i came back and found out will have 12000 functional ventilators in the stockpile, 12000 total. until the innovation that camell from our anesthesia colleagues who called us and jerome adams who pointed this out that with the filter change we could use the anesthesia machine. all of this innovation and creativity i also wanted to give voice to that in the book. 'i think the masking issue illustrates what is fundamentally wrong with us in america at times. because we get so wrapped up in the periphery we don't make the facommonsense judgments one of r friends and family around the world did. an asian new cloth masks works because they had utilize them during sars. to early on with thewe sars-cov2 to we know now cloth masks were highly effective when i mean highly effective 40 -- 50% with the original t variant. we had to rely on data this just happened in october this is a study we should have been doing in january to prove the efficacy of the mask. so when you go out and tell the american people they should wear a cloth masks because it's going to hold their droplets back from getting into the air. but then tell them at the same time it won't prevent droplets from coming in. it is the same piece of cloth on both sides for their telling people to make two ply at a minimum cloth masks. at the same time not telling them it is by directional. that confuses the american people. no one will understand white only works when you breathe out but not breathe in. now we know that you really need a very tight fitting mask. you really do much better if you have the charge fabric layer that is in k and 95. and so now those are available to the public. i think we were not transparent enough with what we knew and what we didn't know. and then make really common sense to the american people. >> early on cdc and w.h.o. were not recommending masks. we really -- this symbol --u masks have become a symbol of covid. they still are. they are still part of what you might call the covid culture wars. : : : your one of your chapterss called 15 to 30 days and that's about the lockdowns. tell us a little bit about that and what went on at the white house. you know. when i >> you know, when i came in that was part of my first week to move us from risk of load to risk of illness of americans extraordinarily high. we were already so far behind. i just want to make it clear you don't do a lockdown unless there is a crisis. and we were in crisis. we could see whatt was happening in italy. i had modeled out the case of fertility rate in italy and their excellent medical care and what they were learning and they still hadta extraordinarily case patella degree. i looked at our case fatality rate in those individuals over 70. if you were 70 and diagnosed with co-good, 30% of those individuals were succumbing to this virus. so we did not have a treatment. we did not know about clotting. we did not have ventilators. and we did not have ppe. we were barely keeping on. i just want to be very clear we were behind in the human capacity needed to treat these patients. we did not have enough human capacity if we had had 25 new york's inner-city greater than 1 million people without a lockdown that is how you end up with literally hundreds of thousands of millions of people dying. that's what the model is that we are saying. i took their input and modeled what would happen if we did what italy did or europe did with a lockdown and that's where by limiting it to 10 - 12 metrogel 100,000 people die in the first surge. if it goes to 25 metros you have about 240,000 american lives lost. it was really modeled by our metros, the city itself in the bedroom communities based on what was happening with spread in newark. i think as a country we prevented a catastrophic event. i mean truly catastrophic. not enough people to care for the sick. no ventilators, no ppe for our nurses and doctors in most of the hospitals. we had 6000 hospitals are probably only 4 - 5 hospitals had to confront the high covid load. that's what america did. america stopped the spread of the first wave from how much damage it could do but we probably were not clear enough to the american people how their proactive behavior changed that course in the first wave. certainly a lot of european countries did worse in the first wave and we did buy a bit i'm talking about a small percentage is, nothing to be really proud about but we could've lost somebody more americans with the footing that we were on because i just want to make it clear we were not preparing for a pandemic in this country. we were preparing for containing the virus in a very small number of americans which failed us. >> for sure. one of the things i was struck by in the book winning e-mail exchange of the high ranking government official and you had said that vaccines would not be enough and we have to rely on behavior change and then the answer back wasst what behaviors and then you decide because all of the things you been telling them about the behaviors that we need to change. they did not seem to get it. we've talked about a lot of the negative things in america. the shortages of essential medicines, ppe, testing, masks, cruise ships, lockdowns. but you also talk about the bright spots. if there were any cavalry america is a triumph of american science. and particularly operation warp speed which i don't think president trump gets enough credit for. and you and also the fact that we have the new messenger rna vaccines that we thought were going to be super effective but are still very good. tell us a little bit about the success that we had in our science community? >> first and foremost i am so grateful to the private sector. the one thing that this white house got right and got right for ppe and testing and got right for therapeutics and vaccines. they believed that the private sector was supported in the technical capacity unleashed in the innovation and creativity in the relationship with biotech and universities and big pharma unleashed the capacity that they would respond in unprecedented ways and they did. the group of that company we had a meeting with the laboratory developer on the fourth of march rolling out the hospitals within two weeks. they worked around-the-clock scum of the abbotts, the rush, the becton dickinson and the hologic came on board, the thermo fisher. these people dropped everything in their entire corporation moved to turning out this high-quality test and not only rapid pcr's but the critical desktop pcr's that were really helpful in our tribal nation and antigen test. we had all of that in a matter of weeks to months that public-private partnership was extraordinary and they went above and beyond in the big testing companies i knew that they could see their equipment because i worked on hiv test. the same equipment. i knew that they could see the data every night. every night they compiled all of the data from that day so i could see with the test positivity rate was in this country because i had no datastream. the private sector did that for me. the private sector realigned their entire supply chain based on data. t i am so proud of them. they took less profit to intraspecific hospitals had what they needed to protect their nurses and doctors to get the patients the drugs that they needed. so i would say this is where the viruses and this is where it is going and cardinal house in mckesson and henry schein and all of the big direct supply companies. they realigned everything and senate based on the data and equity. that was so amazing to me. i wanted the american people to know that we learn how to deal with a pandemic. we need the private sector part of the plan. we need them sitting at the table and we need to know the ramp-up capacity because they did that for us. i just wanted people to be able to see what i saw as a tribal nation. what universities did there were universities that work thet whoe summer of 2022 fully open the following 2020 read all of the people pointing fingers and saying you cannot do this it is not safe. they used the tool of testing and information, just behavioral change information to their students to keep each other safe. those universities and boards of trustees the believed in their students and open fully and they taught me so much it was those universities today, yesterday and all through 2020 who i was tracking their data and the university that tested weekly, had much less community spread among their students. it showed a roadmap of the way through this not limiting studentde activities but ensurig students had weekly testing it totally change the amount of students who were impacted. i think the other thing that universities taught me which is a personally important and why i wanted to get to every state in most universities to sit down with her students and faculty in a administration to go through heather confronting the pandemic. i was so impressed by gen z who understood for many students that was their only bed, their only desk, their only ability to be in college, the only ability to work in those college towns and theyth supported one another and they supported each other's mental health issues and it was so inspirational to me to see what they did, to see what our tribal nation-state, to see what our governors did independent of red or blue or democrat or republican. they answered the call in those days of 2020. america is stronger than what you see in the media because people were really doing the right thing across this country and really helping one another. >> that is a good point the private sector universities and states tribal leaders. i was personally involved a lot in t georgetown so i can attesto the small laboratory of behavior change. we only h a have ten minutes ani have a bunch of things i want to get through. what are the things that'll be easy to skip. send your so global and i'm soie global talk a little bit about our global responsibilities as united states i'm thinking particularly about vaccine and equity in early decisions about prepurchase about our vaccine companies and what that may have played an global scarcity. scarcity is a bigger issue is more vaccine infrastructure. talk a little bit about global vaccine and the other kinds of inequities. i know it is near and dear to your heart. >> it was not just the inequity of the vaccine. it was an equity to access to gloves, masks, access to gowns, access to protective equipment and what was really worrying me was access to therapeutics because we learned a lot about these vaccines but these vaccines are not going to protect countries from infection reinfection and we just have to admit that. that's why i'm excited to look at the subunits because you can change sub unit abdomens and increase the durability of protection from infection from four months to multiple months but right now we should be very clear of who needs to be vaccinated and boosted and we ought to be talking with african countries and her asian colleagues around the world about identifying those individuals with diabetes and hypertension and obesity, asthma, any steroidnt dependenc, cancer treatment and making sure there vaccinated and boosted then we should work around-the-clock to do what we did in pep fire, it was brilliant because it works with a large pharmaceutical company in the large pharmaceutical companies agree to a patent protection waiver that allowed new hiv drugs to be made by nonbranded suppliers expedited the approved by the fda in a parallel mechanism to ensure the safe and effective and allowed us to buy those we were able to bring the best treatments to africa and asia around the globe. that should be happening right now with covid therapeutics. we know how to do it and we know how to distribute it. we need to use the distribution mechanisms that we utilized in pep fire. we can get drugs to the most remote villages we can get paxlovid to the most remote villages. we can get vaccines to the most remote villages. i feel like we are still not taking advantage of everything that we have learned through the decades. i find that there is a pandemic people that look at this as this pandemic and the rest of us who have been dealing with pandemics for decades and know how to confront these. they really need to be talking to those individuals and not people within the united states that never confronted a pandemic before. we know how to work with communities and local governments to ensure access. we have significant access in this country right now and it's part of the reason why the red counties, somehow people are thinking if they voted for trump it's like justification for them not doing well. public health does not do politics. we need to be looking at red counties right now and say what is the problem. i'll tell you the problem i was out there there was no healthcare. don't p tell them to go to the primary care physician. there is no primary care physician they are getting the eyecare from walmart, they are getting the healthcare from emergency three hours away address with the access and barriers are in reality get out there and see what they are we should be using data in real-time no one should be dying of covid. let's all agree to that. we take every death and figure out why i happen and fix it. don't publish a study four months later. fix it in real time and make the data transparent and available to every american so they are empowered with the ability to make the decisions dig decrease the risk and the risk of vulnerable family members. i saw this in decades, it p is possible anyone can learn this information you don't have to be a phd and md. it is our job to make it understandable. it is not our job to point the figures and imply that if you voted for trump you're more likely to die of a disease. that is unless if they are in a remote county that is on us. it is so disappointing to me to see it is still politicized even in the media about red and blue counties. that should be a call to action that should be a call to all of us that works in public health to change this. >> i have intentionally not brought president trump into this. i think our listeners have wanted to hear your reflections about that. you talked a little bit about trump administration again. it and other things like the virus goes away and hydroxychloroquine. it must've been very frustrating as a world renowned scientist in public health professional to be in the white house at that time. we only have a minute or two to do what i spent 30 seconds on that and tell us what do you think and hope for for the future? >> frustrating but not impossible. that is the message i want to leave with all of you. you find yourself in situations and people will say things about you and it really doess not matter you are there for one reason serve the american people and no matter howow frustrating i've been frustrated my whole life with hiv and many leaders would tell people if you just took a shower or slap with the virgin. all of thesealnk magical thinki, this is not unusual. pandemics are political and it's our job as public health people to get in there and work every day to do the right thing. some of it iss evident and some of it is an evident. it is not about you it is about what you know and making that translated into saving lives. the whole last chapter over 40 pages, we continue to make missteps in 2021 and now 2022 because redoing pandemic by polling what we think the american people are willing to do. give them the data showed them in real time and they will do the right thing. i don't understand this unwillingness to put all of the data up county by county by age and race and ethnicity. you can blur enough that there is no violation of hipaa we do it every day and gps map every facility where there is a physician and where there is ara nurse practitioner and look how underserved are red counties or we have to fix this. we can but we have to get the right data and utilize it. magical thinking was prominent and the trump administration, i at times it leaves herself into her current administration and we cannot let that happen. i know may is coming and people will say look how low the case counts are but you know what follows may a summer surge in july and august the cost orr something state let's get ready now and do the right thing. >> thank you. a master class i wanted to thank you for your service you talk about the importance of public health, science, data supply chain all of the things that america needs to do. i recommend everybody read thisx book particularly about what we need to do in their hats off to you in deep thanks to you. doctor deborah birx. >> thank you professor. >> weekends on c-span2 are an intellectual feast. every saturday american history tv documents another story. on sunday book tv brings you the latest nonfiction books and authors funding for c-span2 comes from these television companies and more including cops. >> homework can be hard, the squatted in a diner for internet is harder. that's what we provide lower income students access to affordable internet so homework can just be homework. connect to compete. >> along with these television company support c-span2 as a public service c-span has unfiltered coverage of the house, january 6 committee hearing investigating the attack on the capital. go to c-span.org/january 6 our web resource page to watch the latest videos of the hearings, briefings and all of our coverage on the subsequent investigation since january 6, 2021. we will also have reaction for members of congress and the white house as well as journalists and authors talking about the investigation go to c-span.org/january 6 for a fast and easy way to watch when you can see alive. >> the generation grows up as a follow-up to a book that he wrote in 2008 also about the dumbest generation. if you could tell us how you define this cohort of young americans and now not so young americans less young americans that you've written about. i think that would be a helpful place to begin. >> the term is from philippi is referring to pyongyang