The Daily Beast Podcast - Could There Be a Non-Vaccine COVID Cure?

Episode Date: September 17, 2021

Dr. Scott Gottlieb, author of ‘Uncontrolled Spread’ and a member of Pfizer’s Board of Directors, updates Molly Jong-Fast on the status of “COVID pills” and child-approved vaccinations in the works, Eric Boehlert, founder and editor of press run.media, calls out the media’s obsession with Trump's voters and not Biden’s, and The 19th editor Emily Ramshaw paints a grim picture of the “abortion tourism” set to ramp up in states around Texas. If you haven't heard, every single week The New Abnormal does a special bonus episode for Beast Inside, the Daily Beast’s membership program. where Sometimes we interview Senators like Cory Booker or the folks who explain our world in media like Jim Acosta or Soledad O’Brien. Sometimes we just have fun and talk to our favorite comedians and actors like Busy Phillips or Billy Eichner and sometimes its just discussing the fuckery. You can get all of our episodes in your favorite podcast app of choice by becoming a Beast Inside member where you’ll support The Beast’s fearless journalism. Plus! You’ll also get full access to podcasts and articles. To become a member head to newabnormal.thedailybeast.com Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Hi, I'm Molly Jong-Fast and welcome to The Daily Beast, The New Abnormal. I'm a left-wing pundit and an editor-at-large at The Daily Beast. We're here to have fun, sharp conversations with some of the smartest people in media, politics, and science that help make what's happening in the country and the world clearer. Our world has been turned up to down. On the new abnormal, we'll talk about the people who got us into this mess and figure out how to get ourselves out of it. And I'm producer Jesse Kennan. I'm here to make sure things don't go too far off the rails.

Today we have a great episode with Dr. Scott Gottlieb, who's going to talk to us about the latest on the coronavirus and vaccine rollout. Then we'll talk to Emily Ramshaw of the 19th about the assaults on women's rights to choose in America and some great analysis on what's next in that fight. But first, we have founder and editor of press run. Dot Media, Eric Bollard. Welcome, Eric, to the new abnormal. Thanks for having me.

So let's talk about the California recall election. He won by a gazillion trillion. This is a mathematically accurate count here. And yet, punditland, Soliza is soliciting. What the fuck? Why is the media so broken? Oh, my gosh. That's my whole job.

But to answer your question, I'm not, you know, they get married to this narrative, right? So the press had some, for them, they had some good polls over the summer from California. Oh, you know, Newsom's only up by eight. He's only up by 10. Wow. This could be a Trump earthquake. You know, everyone, you know, Trump is, you know, dominates our politics. And Larry Elder is going to, you know, move that forward. And so there was a lot of breathless coverage over the summer. But by the end, it became pretty clear that, you know, Newsom was going to win by like at least 10 points. Right. But, you know, they love the Dems and Disarray storyline, and they love that Republicans are always super savvy. And Larry Elder lost, I don't know, what did he lose by gazillion points, 25 points? I mean, two to one or something. In the Los Angeles Times yesterday said, you know, he's a rising star in the Republican Party. Now, I have a decent memory. And I remember when Hillary Clinton won by three million votes, the same, the same punditland told her to, quote, go away,

quote. So if you're a Democratic woman, woman, and you win, you know, you're supposed to go away. If you're a Republican man and you lose by 25 points, your future looks bright. Well, and it's interesting because it's like Larry Elder, right, there was no, the way the right in worked was. And I think I want to talk about this for a minute because there was a lot of pundant stupidity on both sides, on two different issues. So the way the right in worked was there was the first question you were supposed to answer no, right? Do you want to recall Newsom? And then the second question was you could vote for a panoply of lunatics. And Democrats didn't run anyone.

So, you know, actually the way it worked out was two to one voters voted for no one over Larry Elder. So it's not even like Larry Elder lost. He lost to nothing. Yeah, no, that's a good point. And there was lots, again, back to the summer, lots of hand-wringing, oh, the Democrats should have put a name in there. They're going to regret it and things like that. Yeah. And there was also lots of bad pundry.

Well, you know, Newsom got lucky because, you know, he ran against Larry Elder, you know, he's an AM talk show host. Boy, if Newsom had run against someone, you know, respectable and popular and more mainstream in California, boy, that would have been trouble. That would have been a real test for Democrats. Here's the flaw in that. Larry Elder perfectly represents the Republican Party today. And so, yes. And also the idea that California has, like, Democrats that aren't Devin Nunes. Right. The California Republicans are a fucking clown show. Yeah. I mean, the party barely exists in California. We saw it from that recall campaign and in these kind of joke rallies that Elder was, I mean, there was no get out to vote. There was nothing resembling a national campaign for the Republican Party because there is no Republican Party in the state of California, basically. And but yeah, I mean, Larry Elder is, you know, a nut job. And that's where the Republican Party is. This, this mythical creature, you know, this mythical popular centrist Republican that could have given Newsom a run for his money. The press says, oh, boy, you know, if he had faced a different candidate, he would have been in trouble. I don't buy it. And then just real quick, I saw something on, you know, Twitter this morning saying, well, okay, so the Democrats won, you know, this kind of begrudging acknowledgement of a landslide. win. And then they say, well, it doesn't really matter because it's, you know, it's California, and they're already vaccinated. So this really isn't a referendum on being vaccinated. And the point is

the Republican Party picked this fight in California. They got demolished. So you can't then turn around and say, well, it doesn't really matter because it's California. It was their idea to get in the rain. And they got to, and they got knocked out. So I have this theory that the smartest thing the Republican Party ever did was convinced the media that it was liberal. Oh, gosh. Not so much convinced, but put the fear of God that they were liberal. Right. So every day the Beltway press kind of gets up and says, how can we prove we're not liberal? You know, how can we prove we're going to be tough on Democrats? And honestly, you know, we just saw that with that orgy of Afghanistan coverage. I mean, that was just a godsend for the press, which wanted to say to Republicans, oh, you thought we were tough on Trump.

Watch us. Watch this. Watch this 19 days of coverage. The liberal media thing, I mean, it started with Spiro Agnew. It's been incredibly powerful, and the press falls for it all the time. I was reading a headline today that said, Dan Crenshaw is building a youth army. Yeah. And I was like, he's like in bed with the far right. I was like, that's not a youth army. I was like, that's like terrifying. And it struck me like the way that Republicans are covered, right?

You know, the press has not, and this frankly, for me, goes back to the Obama years. The press just does not want to acknowledge how radical and dangerous the Republican Party has become. And my gosh, that was obviously put on steroids for the Trump years. and we're still, you know, seeing it. You know, the press interviewed these Trump voters in Ohio diners for four years, right? And you never got the hint that they were going to stage an insurrection. And you never got a hint they were going to lob death threats at local school board members. So they never, they, this glowing Trump voter coverage, they never pulled back the curtain

to show the kind of the rot that was driving the Trump vote. movement. And to your point, here we are now where, you know, these congressmen are basically, I don't know, trying to come up with street armies and stuff. We're in such a dangerous time, and the press still wants to treat the Republican Party as kind of the center-right mainstream entity, and they're not, they're anti-democratic and they're authoritarian and they're scary. I feel like one of the ways that the press is really allowing the Republicans to see modal saying too is that none of them are pressing any elected Republicans on that Donald Trump is for three weeks saying that the January 6th or insurrection was a righteous act and that charges

need to be dropped and no one is pushing any Republican electeds for a response to that. Yeah, I think honestly, I think the press kind of stopped asking Republicans about Trump lawbreaking and Trump criminality and Trump corruption. I don't know if I had to guess like the summer of 2018. I mean, they kind of tried to follow them around the halls of Congress to ask about, you know, racist tweets. And they never got any answers. So they just, now they just give them a pass, like you said. And it's certainly true, you know, as Trump's out of power. I think the Republican Party feels less necessity to respond to anything Trump does because they can kind of shrug their shoulders. Everyone knows he's driving the bus. And everybody knows, you know, he's still railing against, you know,

free and fair elections. He's trying, as you say, he's trying to turn, you know, these insurrectionists into martyrs. And yeah, and the Republican Party just gets just gets a pass. But my gosh, you know, you know, if Biden looks sideways at somebody, you know, every member of Congress has to, you know, issue a formal statement or something. Yeah, I have to say like the watch gate when, you know, he checked his watch at the funeral, right. I mean, you have Trump, meanwhile, saying things like, you know,

blundering and they're, you know, barely showing up. Do you think that the media has learned anything from covering Trump? Very, very little. And I just wrote a piece this week. I mean, what was the preview of the California loss? Oh, it was rigged. Oh, you know, they were going to be stolen votes. Oh, and the New York Times did a story on it as they had to because it's news. And they, and just as they did during the Trump years, they burned through the sosaurus in order to not to say lies, in order to not call these people psychopaths, you know, falsehoods, you know, allegation on and on. They did that for four years for Trump. They just kind of gave him an open field. We're not going to call you a liar. We're not going to call you a psychopath.

We're not going to question your mental stability. And they're still not doing that with him. But now with the Republican Party, you know, they launched this campaign to attack the integrity of the California recall vote. It turns out they lost by so many votes. They had no option. Yeah, they tried, but they were like, oh, fuck it. Well, just concede. I mean, maybe if he lost by 11, 12 votes, they could have given it a run. But we saw the same timid, passive language who, I mean, nobody uses falsehood. Nobody uses, you know, the kind of the stilted language. And it's so obvious what they're trying to do. They don't want to offend Republicans. They don't want to call them liars when they're liars. Well, I also think,

they don't under, you know, modern, there is no handbook for normal media under autocracy, right? There's no, I mean, most autocracies don't have, most autocratic regimes don't have a free and fair press. That's a good point. You know, Trump came in, you know, and he just blew up everything in terms of protocols in the belt way, you know, in terms of how he dealt with bureaucracies, who he fired, the corruption, the criminality. And he blew everything. up. He was the most radical player in American politics. And as you kind of point out, the press didn't really change the way it did business. You know, they still tried to cover this maniac through the prison. And I've said this before, but there were days, you know, he would say something outrageous

and do something dangerous. And you'd read the coverage, you would think Mitt Romney were president or John McCain were president. You know, just kind of, oh, this is what's happening. Yeah, this is what he did. But your point is a good one. I mean, go to Hungary, go to Poland, go to these countries. You're right. They do not have a free and fair press, free press, because authoritarian's slowly choke it to death. And that's the process that Trump began,

and that's the process a lot of people on the right would like to continue. Yeah. So let's talk, speaking of free and fair press, let's talk about the unfree and unfair propaganda network. They're just hired a man who I actually, I mean, I know he doesn't, but had I not been sort of, you know, in the business of reading all this stuff, I would have assumed that Pierce Morgan already worked for Fox News. I mean, he's been on there so many times. You know, he took a, well, but he, you know, he got a paycheck for CNN, which in retrospect,

looks incredibly embarrassing. And then he went back home and he, you know, he kicked around the right wing media in London for a while. And I guess, yeah, Fox News is bringing him back because, I don't know. I mean, the guy just seems like a waste of space. But, you know, they have so much money laying around. I guess they're going to, I don't know if they're going to give him his own show. I don't know what they're going to do. But look, he's the perfect piece, you know, the aggrieved white man.

I guess he's buddies with Murdoch. Murdoch gave him his big break. So, yeah, you know, it's, ugh. The thing I feel like when we talk about Fox News, because it has so much power, we never talk about how shockingly low rent the organization really is, you know, misspelled chiron, you know, like today they had polling where it didn't add up to 100. You know, like, I mean, the people who work there are really fucking idiots. Yeah, yeah, I was going to say, they're not really getting the best and the brightest.

I mean, you eliminate from the pool, you know, most people who want to be a part of serious journalism. So in terms of the people go to work there, you know, it's the people from, you know, the young Republican clubs and who are trying to put their college newspaper out of business. And so, yeah, look, the whole thing as a talk show, this charade for years, particularly in the Beltway press, oh, well, there's a news side to Fox News. And we're, you know, Brett Bear is a serious person. And, you know, we're going to, but, oh, okay, they do opinion. The whole thing is garbage. and the whole thing should be blown up. And I said a year ago,

I wish the Biden White House would just kick him out of the White House briefing room. They don't belong there. I know it would be, you know, a firestorm. But in my perfect world, they wouldn't be able to show up for those briefings. I never understood, like, why she's bothering to talk to Ducey's son, you know, Pete Ducey or whatever his name is. I mean, like, why even fucking bother? Like, these are not serious people.

They're not. And I think, you know, 10 years ago, that strategy might have made sense. Oh, I'm going to reach out to the, you know, the Red State reporter and we're going to have a back and forth. But I mean, it's, you know, it's a, it's a, it's a network of racist and insurrectionists. And I don't think they ought to be given the credibility to just to even ask her questions. So one of the things that I wanted to talk to you about, because we, we just talked about the diners. And I think it's really important. There was after the 2016 election, there was endless, and because of stupid fucking J.D. Vance,

we curse here, by the way, in case you're wondering. There were, you know, like, we need to know what the middle of the country is thinking, you know, almost insufferable. I mean, it begot the, you know, serial fabulous Selena Zito and her stories of, like, you know, gas stations. What I want to ask you is I don't see any reporting about women in Texas trying to get abortions. Oh, and that's a great point. In general, you know, where are the Biden voter stories? Right. Where are, why aren't they at flea markets in Baltimore, in Chicago, in San Francisco?

Where is the coalition of voters that brought him together? Look, you know, they invented this for Trump, the Trump voter story, you know, the Beltway. If you had walked into the New York Times in the spring of 2007, you know, 2007 and say, I want to do a story on Barack Obama voters and how much they love him, you would have been laughed out of the meeting. That's not news. But boy, if you were at the New York Times, you knew exactly how to get on page one, which was to, you know, head to a Red County in Ohio. But yeah, so the Biden voter stories don't exist.

And to your point, the women in Texas, all these people who are under attack, what was so ugly about it, it was the unspoken claim that, you know, white middle-aged men voters were the most important voices in American politics. You know, they were the authentic. They were speaking from the heartland. And we know they're speaking for like 32% of the country. You know, the people who don't want to get vaccinated, the people who won't wear masks and all that stuff. But the press, you know, they beat themselves up after Trump won. They felt like they missed the story. And so they went on to these orgies of Trump voter stories. And okay, you made that mistake. So now we have a Democrat. Why don't you like return the favor? Why aren't we constantly getting updates? and in hearing the voices of people of color as well as everyone else who gave 80 million votes. Or, yeah, the most votes in American history. Thank you so much, Eric. This was really great.

I hope you'll come back. Okay, my pleasure. Anytime. Hey, folks, every week we do a special bonus episode for Beast Inside, the Daily Beast membership program. This week, we have Washington Post's opinion columnist Karen Attia, who will talk to us about Texas and the fight for women's rights to choose, as well as editing the late Jamal Khashoggi. To hear this along with all our past bonus episodes

and to gain full access to the Daily Beast fearless journalism head to New Abnormal.com. That's new abnormal. That the dailybeast.com. Dr. Scott Gottlieb is the former commissioner of the FDA and the author of Uncontrolled Spread Why COVID-19 Crushed Us and how we could defeat the next pandemic. Welcome to New Abnormal, Scott Gottlieb.

Thanks for having me. I have a lot of questions I want to ask you. You do serve on the next day. the board of Pfizer, I was in the Pfizer trial. Let's talk about boosters. Someone like me, I'm not in any high risk, but I did get vaccinated very early in the trial. What do you think about the idea of boosters and waning immunity? Well, look, I think we have at this point clear evidence that there's a decline in immune protection, particularly in older individuals, especially in people who were vaccinated a long interval ago. And some of the best data that we're getting on this question is coming out of Israel. It's real-world data

coming out of Israel. We're not doing a good job of collecting and collecting data in the U.S. to answer this question. I think with some of the controversy is around boosters is that the original premise of the vaccines were, was that the vaccines were going to protect you against severe disease and hospitalization. Basically, they were going to prevent people from dying from COVID. And that premise is still fully intact. Even for people, older individuals who were vaccinated a while ago, the vaccines still seem to be very protective against severe disease and hospitalization. But we're seeing a declining effect in this particular older than the symptomatic disease. And the concern is if you continue to see erosion and protection against symptomatic disease in a more vulnerable population, eventually that's going to translate into more people having severe disease and being hospitalized and having bad outcomes.

And it argues for boosters in that population. So my own personal view is I think the data supports the idea of providing boosters for people over a certain age. let's say people over the age of 60 who are more than six months out from being vaccinated, I think that's likely to be where we land somewhere around there. You know, for the younger age groups, I understand why the public health community has more misgivings about providing boosters across the full continuum at this point, given the data that we have. I know that the World Health Organization really, they're kind of pushing that if you can't vaccinate the world, how are you going to give a third shot to wealthy countries?

I feel like the World Health Organization has squandered a lot of its cred. Do you feel like that's what's driving their suggestion against boosters? Or do you think that they really are just being clear-eyed about this? Well, a dose used in the U.S. isn't a dose that would have been used in another country that has difficulty getting access to the vaccine. I mean, you could argue that on a sort of at a political level, if we're focused on this problem of giving boosters, are we going to be focused enough on the other problem? But I think you can do both at the same time, provide for the world and provide for the U.S.

The reality is if we're talking about giving boosters to, you know, an elderly population in the U.S. and maybe even something a little broader, we're talking about 60 million doses, 80 million doses. We're going to have between 10 and 20 billion doses produced over the next 12 months. Pfizer, the company I'm on the border of has said that they'll produce at least 4 billion doses over the next 12 months. They've already committed to donating 2 billion doses. the issue of the global vaccination campaign is very quickly not going to be an issue of supply. It's going to be an issue of distribution and getting vaccine into hard-to-reach areas and also convincing people to take it. I mean, we see vaccine hesitancy here.

It's going to be hard in some markets to convince people to take a Western vaccine. And we've seen how hard it is to eradicate polio and get other vaccines into hard-to-reach settings. So this is not a zero-sum game. And the final point I'll make on this is that right now the Biden administration has purchased 200 million doses from Pfizer and 200 million doses from Rederna for a booster campaign, ostensibly. There is no way that they're going to ship those doses ex-U.S. So they're not going to maintain a reserve of hundreds of millions of doses as a national security matter because they're going to want to hedge against the unknown, unknown, you know,

a new variant coming along the population. So as a matter of national security, the doses that have been sort of secured by the administration are going to be kept by the administration. I read some reporting that said that the Moderna might have, that there may be some benefit to mixing the boosters. Do you, have you seen that? What's your take on that? There's studies way looking at whether or not it's safe to mix the different vaccines, because we know if you start providing boosters, there's going to be deliberate substitution, but there's also going to be a lot of inadvertent substitution.

So you want to make sure that, you know, someone who got Moderna can get Pfizer, or someone who got Pfizer can get Moderna. The NIH is doing a very big study called the Mix and Match study. Results should be out this month. I would expect that to show that it's safe to mix these vaccines. Even if we don't want to do it on a wholesale level, if it happens, people aren't going to have an untoward response. I think in terms of deliberately mixing it, though, I don't really see a strong rationale for that with the MRI vaccines. I think these vaccines are largely interchangeable.

I think the profiles are very similar. They're likely to produce a similar clinical response. I think where you can make a theoretical argument that there could be some advantages when you're talking about mixing the viral vector vaccines like the J&J vaccine with an MRNA vaccine, where there's at least a theoretical argument to be made that the vaccines may be stimulating different components of the immune system. Now, there's no data to guide that, but that's the only place where you can even sort of, in my view, postulate a sensible theoretical argument. With Moderna and Pfizer, I would argue they're comparable vaccines and using them interchangeably isn't going to provide an added advantage. It might not be bad, but it's not going to necessarily be better. Right. No, that makes a lot of sense. I know that there's some reporting that says that there's going to be, like, monoclonal antibody therapy does work well, but it is in a special window and it has to be given in infusions.

I've read reporting that says it seems like there's something else in the works that could truly. COVID that is not a horsy warmer. Can you talk about that? So there are drugs in development that are small molecule inhibitors of viral replication, meaning that there are drugs that could be taken as a pill, much like Tammy flu for influenza, where it will block some component that this virus uses to replicate that could be used either to prevent progression of disease and someone who's diagnosed with COVID. So you get diagnosed, you take it early, and it prevents you from getting really sick, Or depending on the profile of the drug and how safe it is, could be used as a prophylaxis. So if you're exposed to COVID, you could take a pill and it could prevent you or reduce your chances of getting COVID.

The three that are in more advanced development are a drug by Pfizer, the phase three studies, a drug by Merck, which looks very promising, also in phase three studies. And in another one of those drugs, there's the potential that you could have data this year before the end of the year that could show that any one of these drugs is safe and effect. for that purpose. There's other drugs behind these that are also look promising. I think one of them will work. I mean, I think something's going to work because I don't think this coronavirus is such a sort of wily virus that is going to evade our ability to drug it. We're going to be able to drug this target. This virus doesn't replicate through mechanisms that should evade our ability to figure out how to intervene. You know, the question is, is it going to be safe enough that it could be used widely? And then the other question is, can you get the trials done in a timely fashion? Because when you're

dealing with a clinical trial against the backdrop of a population that has pretty high levels of immunity at this point. I mean, 76% of adults over the age of 18 have had at least one dose of vaccine. Of the remaining 24% of people, I would guess half of them probably have had COVID or something close to that. So how do you run a trial to prove that a drug prevents progression of disease and a population now that, frankly, we have a lot of immunity in our population at this point. How do you do that? Some of it's going to have to be done outside the U.S. Right. But for an antiviral, you always want data within your country because different variants circulate in different parts of the world. And it's going to be hard. I think conducting

these trials and being able to demonstrate reduction in progression and prevention of infection is going to require very large, very long trials. And I think that's going to be the impediment that the development program is going to be very large and very long in these cases. I happen to have three teenage children. They have all been vaccinated with great success. So I send them to school in masks vaccinated. And I feel pretty great about the whole thing. But a lot of my friends who have children under 12 do not. What is going on? And I'm more familiar, obviously, with the Pfizer development program. So I'll speak to that. And Pfizer is the furthest along right now. That's, you know, objectively, that's known publicly. They're approved now. Moderna's still not approved, right? Right. So Pfizer is approved for 12 for 16 and above. 12 to 16 is still under an emergency use authorization. And then there's a vaccine in development for ages 5 to 11. And then there's another vaccine development for ages six months to four years. So the vaccine, I'll talk about the vaccine for 5 to 11 because that's the most proximate. That is the same vaccine that's available for adults. And so it's the exact same formulation. It's just in a lower dose. So the dose used for 12 and above is 30 micrograms. The dose, that's being developed for kids age, ages 5 to 11, is going to be 10 micrograms. So one-third the dose. And the reason is because young children typically have very robust immune system. So it doesn't take as much vaccine antigen to induce the same kind of immune response. Pfizer has said publicly

that they will have data from that trial. FDA asked them to do a larger and longer trial. So it's taken a little longer. Right, because there's a greater barrier to entry because they're younger, right? You want to hire assurance of safety, in part because you're dealing with children, you always worry about putting a medical product in a child, in part because, you know, COVID hasn't been as deadly in kids as it is in adults. And so Pfizer has said that they'll have data in September, in sort of the September time frame, end of September, and we'll be in a position to file very quickly with the FDA after that. So maybe within days.

If they file within, you know, let's say early October, FDA has said that the reviewer of the application will be weeks, not months. Now, having been at the FDA, I interpret that to mean probably a review period of four to six weeks. So let's assume a best case scenario of four weeks. You could potentially have a vaccine available. If everything goes well and the data supports it, you could have a vaccine available by the end of October if it takes a little bit longer at some point in mid-November. But I think that's the time frame we're looking at, assuming that the trials go well. They demonstrate that the vaccine is safe and effective for its intended use for children of that age and FDA ultimately agrees with the data set. I'm reading that there's some,

that there seems to be a correlation between type two diabetes and COVID infections. Is that new? Has that been known for a while? There's data that shows that diabetes is one of the risk factors that put someone in a position to potentially have a worse outcome with COVID. So, you know, if you look at sort of the risk factors that create conditions where people are at more at risk of COVID, diabetes is one of them. Obesity is probably the top risk factor. So, you know, it is, correlated with worse outcomes. So I think people who are diabetic, people certainly who are immunocompromised, need to be more vigilant. And, you know, those are people who should consider getting a boost to people, certainly people who are immunocompromised. If you look at where

boosters are authorized right now, it's for people who are moderately or severely immunocompromised. Severely immunocompromise is more clearly defined as someone who's on active immunosuppressies, chemotherapy. Moderately immunocompromise is a broader category of people. And so, you know, it probably would include certain people. Maybe not asthmatics, but being an asthmatic, having a lung condition does set you up for potentially a worse outcome with a respiratory disorder. But someone who has a chronic disease, that's an immune-mediated disease like Crohn's or colitis, that individual could be moderately immunocompromised by virtue of their disease and certainly by what they're taking to treat that disease.

Right. Well, yeah, because they take immunosuppressive. You have worked in public health and been a doctor and studied this and worked at the FDA. Are you surprised at how quickly the vaccine came together? No, and let me unpack that a little bit. The clinical development, you know, people say the vaccine went very fast. The clinical development was not shortcutted at all. The trials that we did to develop this vaccine were the largest, largest trials ever conducted. against any with any therapeutic. And I think that's a fair statement. You know, the, the Pfizer trial was

45,000 patients. The Moderna trial was 45,000 patients. The biggest trial I remember in my FDA tenure was the rhodovirus vaccine trial, which was 60,000 patients. So a bigger trial, but, you know, combined, Moderna and Pfizer enrolled 90,000 patients. Now, the trial went fast because it enrolled quickly. People wanted to get into it. And it read out quickly because tragically, there was so much virus circulating in the fall that there were a lot of people getting COVID in the placebo arm. What went fast was two other aspects of the development. One was coming up with the vaccine construct. Now, that went quickly. We were able to come up with the vaccine construct. Because it SARS, right? Because we were able to derive it fully synthetically using just the sequence data.

We were at a technological inflection point where we were able to derive a vaccine construct using fully synthetic tools. If this was three years ago, we would have made a vaccine by taking the virus, growing it in cell cultures, inactivating it, cleaving off its surface proteins, putting those proteins in a syringe, and that would have been the vaccine. That's how we make flu vaccine. That's how the Chinese government made their coronavirus vaccines. If this was five years from now, the technologies we used would have been mainstreamed. But we were right at the cusp of technological inflection point. We were able to use sequence data to derive a vaccine construct very quickly. And that's what enabled us to do what we did. And then the other thing that

went fast was we didn't optimize the vaccine for commercial distribution. Why, I mean, by that is, you know, if you remember early on, the Pfizer vaccine needed to be stored at minus 80, and it's two shots instead of one, and it was in a big vial. That's not a commercially attractive vaccine. That's not a vaccine that you're going to deliver at CVS or in a doctor's office. You could have optimized it. You could have taken another six to 12 months and, you know, got it into a single dose vial and made it so that you could store it at room temperature. But we didn't take that time because we knew that this vaccine, first of all, it was a crisis. We had to get it out as quickly as possible.

And we also knew it was going to be distributed at sort of mass distribution points, at least initially. So the idea was get it out as quickly as possible. We'll optimize it later. But the part that matters most to answering the question of, is it safe and effective? There was nothing short about that. So, you know, it was the other things that allowed this to go fast. Yeah, I'm not so worried about it.

It's safe. I mean, everyone I know has gotten and we're all fine. I think the question is more, do you think that you're going to be able to convince these other people, the 30% of the country that is just no go? Yeah, well, a lot of the unvaccinated population right now are children. So we'll take that, set that aside for a moment about parents making a decision to have their children vaccinated. You know, we've vaccinated 76% of the adult population over the age of 18.

I mean, that's remarkable. For an adult vaccine, I mean, we should just recognize what a remarkable public health feat that is. And what a good job, quite frankly, the Biden administration is. done to accelerate vaccination. I think if we just continue, if the Biden administration didn't do anything different from a policy standpoint, but they just continued on their current policies, I think we would have very easily reached 80%. That's a tremendous amount of penetration. And of the remaining 20%, you know, some would have gotten vaccinated over time. And quite frankly, probably a lot

of them have already had COVID. I mean, some people are choosing to go on vaccinate because they know they had COVID. And some people are choosing to go on vaccine because the cavalier about COVID, in which case they were more likely to come into contact with it. So if you've had COVID, that doesn't mean you can't get COVID again. No, but the immunity conferred by prior infection is proving to be more robust and durable than what we would have estimated a year and a half ago. Does that mean if you have had COVID and you get COVID again, you will have less bad COVID?

We see evidence of some breakthrough infections with people who previously had COVID. First of all, let me preface this all by saying we're doing a really bad job of tracking this and answering this question. Really bad job of tracking at this. I agree. So no one knows for sure, right? I mean, CDC has some cohort studies where they're tracking this, but they're selected populations. But generally speaking, we think that the immunity conferred by natural infection is protective. I think with a question becomes more paramount is how long does it last?

We don't know. We're studying the vaccines very closely, so we understand how long, how durable the immunity is. My own guess, based on what I read and people I talk to, is that the immunity conferred by natural infection is protective, but people who are relying on that immunity are eventually going to have to get vaccinated because that immunity is not going to persist in perpetuity. It's probably going to be the case that the immunity from SARS-CoV-2 sits somewhere in between normal coronavirus, seasonal coronavirus, and the other SARS and MERS. With SARS and MERS, the immunity you got was very during. Some people still have immunity 10 years out from being infected with SARS. With a seasonal coronavirus, we get reinfected with that almost every year. The immunity isn't durable.

This is probably going to be somewhere in the middle where, you know, the immunity might persist for a couple of years, but eventually it's going to start to wane and you will need to be vaccinated eventually. Yeah, and you don't want to find out. I mean, it's a, you're really, you're sort of rolling the dice, finding out. The people you've talked to have had their third shot, you know, have they had more symptoms from the vaccine or no? Generally what we've seen in the clinical data, and this is also the data that is coming out of Israel, is that the profile of the third vaccine is consistent with or perhaps better than the profile of the second dose. And so the kind of side effects that you manifest after the second dose is similar to what you would manifest after the third dose and maybe a slightly better side effect profile. And Jay and Jay also has data looking at a booster of their vaccine and they show a good profile with the. additional dose of their vaccine. And we need to remember the J&J vaccine. It looks very good.

I mean, you know, J&J has had challenges manufacturing at scale. They're going to solve for those challenges. They have a partnership with Merck. They're going to be producing this to scale. But that vaccine has proven to be very effective over time. The durability looks very good. So that is another option that we should, you know, factor into how we're going to be vaccine, both in the U.S. and globally. Yeah, it's interesting to me. I mean, especially because if you're trying to go to places like Africa, a vaccine that doesn't need to be refrigerated seems like a much better choice than something that needs to be refrigerated. It needs to be, right? I mean, the J&J is a much more stable on the counter, on the shelf vaccine, right? That's right. I mean,

the cold chain requirements, the modern and the Pfizer vaccine, there has been subsequent stability tests, and I'm more familiar with Pfizer, so I'll speak to that. There's been subsequent, you know, stability tests that show that that can be in a normal freezer, a normal refrigeration for extended periods of time, because we've done the long-term studies to prove that, but still not at the same level of J&J, which can be at room temperature. So the J&J vaccine is still a more room-stable vaccine

that is probably more conducive to distribution in our steer settings. But normal refrigeration and freezers, that isn't such a complex cold chain that you shouldn't be able to supply it in even our steer settings. You should be able to get this vaccine, even the MRA and A vaccines into most parts of the world with a moderate degree of investment in the supply chain.

Right. But I mean, places like in Africa where you're, you know, you have to travel hundreds of miles. I mean, there are certainly going to be places where it makes more sense. That's right. I mean, that's absolutely right. In a very austere setting where you're, where you're absolutely, you're going to have to travel a long distance and keep it out of refrigeration for an extended period of time, the J&J vaccine could be advantageous in those in those kinds of settings. Do you think now, just for our listeners, If you're a fully vaccinated person, I mean, the way I do it, and I want to know just because I feel like people want to know this. Like, my kids are back at school. They're all vaccinated. They wear masks. We do pretty much normal stuff, except that I try to wear a mask when I'm like inside with a lot of people.

I mean, do you think that's the sort of, that's reasonable? Or do you think that we should be more careful because we live in New York City? I think our behavior should be adjusted based on what our risk tolerance is, you know, what our circumstances are and what the prevalence is. So, you know, in a high prevalence environment, if you're someone who's vulnerable to COVID, even if you're fully vaccinated, or you're someone who has vulnerable people at home, I think you need to be more prudent and more careful in a low prevalence environment. So just, you know, talk about my own circumstance. I'm vaccinated. I feel pretty confident that the vaccine is going to protect me against, you know, severe disease and hospitalization, knock on wood. But I have young kids at home. And they're not vaccinated yet.

they're not older to be vaccinated. My concern is that I become, you know, asymptomatically infected or develop a mild infection, don't recognize. I bring it home and I give it to my kids. And so I'm careful in certain settings still. I'm wearing a mask in certain settings because I don't want to, you know, have that circumstance. And I also self-test a lot. When I go away and I'm in settings where I have some concern, I come home from a business trip or whatever, I'll test myself serially over the course of a couple days. So, you know, I just think you need to judge your own circumstance. most people who are at lower risk from COVID who are fully vaccinated, you know, the risk is probably lower in most parts of the country where prevalence isn't that high. New York right now, prevalence

isn't that high. So I do think that there's an element where people, some people are overestimating the risk and then there's a lot of people underestimating their risks. But that's a very hard thing to get right. And that's why it's very personal to the individual. You could be at low risk and you judge yourself to be at higher risk. And you can't tell a person, no, no, no, you're at low risk. you're doing the wrong things. Right. No, agreed. Will you just tell us about the book? So, you know, the book, Uncontrolled Spread, was an attempt to try to look at the more systemic challenges that led us to be excessively vulnerable to COVID. So I felt that there was a lot of narrative around what went wrong politically. And I touch on some of that in the book. But what I really

tried to do was drilled out and look at the more structural features of government and of our response planning that left us excessively vulnerable to this virus. And it comes down to sort of several domains. One, we didn't have the infrastructure to scale a response like we needed. We couldn't mass-manufactured diagnostic tests and antibody drugs and all the things we needed. We didn't have an institution that really was able to surface real-time information and put out guidance in a sort of continuous fashion. CDC was the organization we relied on, but it has a very retrospective mindset. It doesn't do good real-time analytics. It doesn't surface information that can inform sort of a continuous response. It's not what they historically do. They're

used to being objective, science-based, careful, taking a long time to analyze questions. That's not, they didn't move at the speed of a pandemic. And we didn't have the capacity to gather the kind of information we needed outside the U.S. We were too dependent upon countries, the good graces of other nations, to share information that they didn't want to share. And so we're going to need to build different capabilities. And the bottom line conclusion is we really need to look at public health preparedness through a lens of national security and think differently about how we invest in

public health. Yeah. Oh, so true. Thank you so much for joining us, Dr. Scott Gottlieb. Thanks for having me. Emily Ramshaw is the co-founder and CEO of 19th News. Welcome to the new abnormal, Emily Ramshaw. Thank you. I'm a huge fan, so it's fun for me to get to actually come on myself. Well, we're thrilled to have you. Talk to me about, a little bit about what the 19th is, because not everybody knows, though luckily I do. I'm so glad you do. Yes, so the 19th is the country's first independent nonprofit newsroom at the intersection of gender politics and policy. So we launched just a little over a year ago, born in the pandemic, but our vision really is to use journalism to elevate the voices of women, particularly women of color and of the LGBTQ community in American media.

So really to rewrite the national narrative in a way that centers those voices. And you are in Texas or you're based in Texas? Yeah, pretty timely. I mean, so I, I spent the last 11 years at the Texas Tribune, and I actually started my career as a women's health reporter. And then the 19th is based in Texas, but our journalists are all over the country. One of the things that I've been thinking a lot about, I mean, so you're somewhat modeled on the success that the Texas Tribune has had being a, right, aren't they a nonprofit similar? Yeah, I would say absolutely modeled. I mean, you know, some hybrid between the Texas Tribune and ProPublica and reveal, right, the vision for us is we're a nonprofit, you know, know, member supported, but the journalism comes first.

Right. I wanted to ask you about this because you started your career in women's health. Do you find, because I see as someone who like came, I grew up like in the media, if that makes any sense, because I would always, you know, go on book tours with my mom and stuff. And so I would always see the kind of like ever shrinking book page, how book publicity shrunk and trunk and trunk. And I also have noticed that this sort of, that in some ways they've done away with women's pages, which is probably for the good, but they haven't necessarily replaced it. Absolutely. Yeah. This is really interesting that you say this. There's a parallel here. So I'm the child of two journalists. And my mom started her career in the women's pages of Chicago Today magazine newspaper. And what she really wanted was to be a Washington correspondent. And she had to like beg and plead.

in order to cover Geraldine Ferraro, and then eventually ended up covering White House after White House, covering Hillary Clinton for a time. And she had to just fight tooth and nail in order to prove that she could be out from beyond the women's pages and that women in politics were worthy of full-time coverage. And so, you know, I think fast forward a full generation, I'd been sort of growing up in and around legacy media and what I felt increasingly, particularly around the 2016 election and then in full force in 2020 was that we were not giving women candidates, women of color candidates in particular the do that they deserved. We were infantilizing them. We were talking about them as if, you know, raising questions about likability and electability. Questions that just

were not asked of, you know, cis male, white candidates. And it felt to me in that moment like there needed to be a true investment in coverage that aimed to level the playing field. Yeah, it strikes me as such. And an interesting thing, which I'd love to talk to you about, is who are exciting young female candidates or old female candidates that are on your radar? You know, I mean, there are so many we're paying attention to. I think I'm not in the business of deciding who's exciting or who isn't. We can see who's mobilizing folks. But like, I am most proud actually of some of the coverage that I see us writing out of the states, out of, you know, we had a really great piece with the mayor of Miami-Dade County after the surfside.

collapse, talking about gender played a role in her response to this tragedy. We've been writing about, you know, the lieutenant governor's race out of Virginia that may end up being a pretty seismic when it comes to abortion rights. There are, I'm obsessed with, you know, of course, we love national politics, but I'm really obsessed with what's happening on the ground floor and the women and LGBTQ candidates who we see sort of rising through the ranks and who are going to be the future of or the next generation of their parties leaders. When anyone talks about Texas, I think about Linda Hidalgo and the story of her becoming, she's a judge, but she's an elected judge. She's actually, isn't she sort of the fourth most powerful, one of the more powerful

electeds in the state at this point? I mean, not as powerful as. Yes. I mean, Lena Hidalgo is, you know, Texas is a state where county judges have an enormous amount of power and authority. And obviously, Harris County, which is the home of Houston is enormous, you know, fourth-friest city in America. And so, yes, she's extremely young, extremely promising, and has really an extraordinary political future. But yes, I mean, definitely wields an enormous amount of power on the ground there. Yeah. It's pretty exciting because she doesn't look at all like Governor Greg Abbott, thank God. It really feels like what's really coming up in the war on choice besides the fact that Roe is coming up in October is this Virginia governor.

Can you talk a little bit about it? Absolutely, yes. You know, what we're seeing on the ground here is this, there are two women who really have the potential to play this outsized role in Virginia abortion politics. There's a Democrat, Hala Ayala, who's a lawmaker in the state's House of Delegates. And then there's Winsome Sears, who's a Republican who served in that chamber in the early 2000s. Obviously, Ayala supports abortion access. Sears opposes it.

This obviously is really front and center. You know, there's so much of the national conversation. right now is around what choice is going to look like, what reproductive rights are going to look like around the country in light of what's happened in Texas. And so I think we're going to see, you know, there are all these questions about what elections are going to look like, how women and others are going to mobilize around this particular issue at the ballot box. And so this is one of sort of those early litmus tests that I think a lot of folks are going to be watching. Yeah. It strikes me as really, I mean, it's the sort of, I mean, 2021 is kind of a weirdly terrifying.

and yet sleepy year. Terrifying can be your word. I'm going to play the journalist who's saying there are very strong views on all of these issues. But I think what's most fascinating to me about this moment in history actually is that H word, is history. I mean, I've been in Texas for almost 20 years now. You know, it wasn't that long ago that I was covering Wendy Davis in her pink sneakers on the floor of the Texas legislature in the middle of the night, filibustering, you know, abortion

legislation, we used to think here in Texas that a 20-week abortion ban was pretty seismic. There was so much national attention around it. And then, you know, in sort of feels like the cover of darkness, but in the middle of a pandemic, you know, Texas passes a six-week abortion ban, which we all know really like a two-week abortion ban because, well, pregnant people really don't know they're pregnant until they've been period. The goal is really stopping abortion in the state of Texas. Completely. And I think in this particular case, there's, there is no exception for rape. or incest, which is even, I mean, that's pretty fringe, even given some of the other legislation that XI was trying to pass over the years. And I think, you know, this one sort of came to the fore

and passed and got signed without a lot of national fanfare, whereas some of these other bills that were less restrictive got even more national attention. And so I do think there's a little bit of a sort of undercover of darkness or in the middle of a pandemic that this is really seismic and not enough folks took note until in many ways it was already well on its way to becoming law. Yeah, I'm curious why it's not. I mean, I guess I know, but I just, it strikes me now we have a problem of abortion, which can go. I mean, like, for example, now the Biden DOJ is going to try to sue the state of Texas on this. I mean, it strikes me that this will just go up to the Supreme Court and the pro-life Trumpy Supreme Court will knock it down. I mean, is that,

there any world in which this works? I mean, I was trying to think through the different potential outcomes today. And, you know, I think what we see here is what's going to continue to happen, which is that, all right, so the DOJ is now asking for an injunction. You know, that will come before, you know, a court in Austin, Texas, federal court, you know, which is probably, my hunch is, that's a court that's probably likely to grant the injunction. But then it goes from there to the Fifth Circuit, which is one of the most conservative courts in the country. Depending on what happens there, it ends up almost certainly again in the Supreme Court, whether the Supreme Court has even ruled on this by that point, whether the Mississippi 15-week ban has come up by that point. I mean, you know, in one way or another, this is going to continue to weave its way through the courts. And to be honest, on the ground here in Texas, the damage may already have been done. Like, let's say an injunction is granted. I mean, the reality is we had a story at the 19th this week about the fact that most of these, many of these abortion clinics in Texas already, at least half of their abortion providers have quit. Yeah, that's what I thought. I think I've read that story.

I mean, even folks, you know, people don't even want to perform abortions under six weeks at this point because they're so afraid of getting sued. The doctors that are sticking around to do this are requiring preemptive pledges of legal support from their employers. Their doctors who are flying in from out of state to begin with. It's just, you know, I think it will have already had this ultimate chilling effect whether or not the injunction is put in place. I have a friend who's a friend of Jessie's to Leorre in New Mexico who was telling me that in New Mexico they're preparing to take a lot of the abortions that the women, you know, or they're planning for these women to take, you know, 15-hour bus rides to Albuquerque.

Yeah, I mean, the sort of gross term is like abortion tourism, right? Although this isn't tourism, this is desperation. Yeah. I think there are legal aid funds that are working to provide travel funds. that pregnant people who need abortions can travel out of state. I do think you see states like New Mexico, Colorado, you know, folks that are getting ready to anticipate an influx of people from Texas. I mean, what's really fascinating is you saw, you know, last week or the week prior that Mexico said that, you know, abortion is constitutionally protected. I mean, it's interesting because

you can go to Mexico for an abortion. Right. For a lot of years, you know, women in Mexico were coming north of the border in order to get reproductive health. And it will be, like really fascinating and otherworldly to watch if the sort of tables turn and we're flooding across their border to get reproductive health care. Yeah. I mean, it's certainly likely. It seems very possible. I mean, I think there's already been cross-border reproducing. You know, that's actually pretty common in border communities, whether it's going across to get abortion-inducing medication, for example, counter. That's already been sort of part of the fabric there, but it will be interesting to see if it increases. It's really interesting to me that we have a situation where we have these

medical abortion pills that can work up until 13 weeks. So it is, or maybe even, is it longer than 13? Is it 14, I think? I mean, it used to be, although now the rules in Texas, you know, there's led just, right, onto seven weeks. Yeah. I mean, it's just, it's like the more sort of we've, you know, the more society advances, the more Texas goes back. words. It's been a fascinating place to live and work and cover reproductive health care over the last 18 years that I've done it. It is, I mean, I was, you know, I was talking to my mom about this, a former journalist who's like, you know, she's just stunned that we're still writing the same stories, that a generation apart, it's as if time has stood still in many ways.

Are there reasonable Democrats who might run for governor and lieutenant governor and AG in Texas? Well, again, I'm not weighing in on, you know, whether who's reasonable and who is. Right. But are you seeing candidates come up? I mean, I think what's been really interesting about Texas is that is that over the last, you know, for since I moved to Texas, again, 18 years ago, you've heard you've heard Democrats say, we're on the precipice. We're on the precipice. We're about Texas is turning purple. Texas is going to blue, you know, in the next four. And the last election and look at the makeup of the legislature and the governor's office and, you know, it's lieutenant. And it's like more conservative than it's ever been. And so and I'd also be really. curious to see how Republicans in Texas are thinking about playing the long game as the state changes demographically. I mean, I do think, you know, I think they are gam on the state's growing

Latino population and saying, you know, are those folks who are predisposed to oppose abortion, who we might be able to sort of lay a foundation with? Obviously, we saw in the outcome of the last presidential election, what we saw Cuban Americans, what we saw among voters in Miami, what we saw among voters in South Texas. They are not monolithic by any stretch of the imagination. Demographics are not necessarily destiny here. Right. Certainly true. Thank you so much, Emily. This was great. Please come back. Oh my gosh. My pleasure. Great to be with you. And I'll keep listening. What's crazier than QAnon, more outlandish than Pizza Gate and scarier than a Mexican getaway with Ted Cruz? The answer is what the American right wing has planned next. Be one of the

first to listen to Fever Dreams, new podcasts from The Daily Beast, tracking the conspiracy slingers, orange acolytes, and straight-up grifters pushing to retake power. Every Wednesday hosts Swin Subisang and Will Summer, checking in on the movement of the radical right. Head to the DailyBeast.com slash podcasts or your favorite podcast player to catch the first episode and get subscribed. That's Fever Dreams, which you can subscribe to wherever you get your podcasts.

Jesse Cannon. My John Fast. What's going on? Another day of you having to do fuck that guy. Your favorite activity. My favorite activity. Getting out the rage. So I want to start because I'm very angry.

Yes. That's what I've heard. As opposed to usual. Yesterday, I was watching these four gymnasts talk about the horrendous they were subjected to at the hands of Dr. Larry Nassar. And the many, many ways that the FBI did not help. them when they needed help. But what I want to talk about today is that during this hearing, I don't know if you know this, but Republicans claim to care a lot about sexual abuse for children.

They, in fact, have a crazy conspiracy theory, which called QAnon, which is not just completely nuts. But one of the ways in which they try to play into that theory is say they care about stopping children's sexual abuse. So here's a case of actual sexual abuse, of children. right, a case for Republicans, like, this is what they pretend to care about. Tom Cotton doesn't bother to walk over to the hearing. He zooms from his office. And Josh Hawley doesn't even show up. Okay?

So here's what I'm saying to you. You don't get to pretend to care and then not show up. Like, if you care, you care. And if you don't, you don't. And these women have been subjected to so much. have been through so much trauma and hardship. And it's just horrible. So for that, I say, fuck you, Republican senators who did not show up, you know, Marcia Blackburn, who just called in.

You know, fuck you. If you care about preventing sexual abuse, you know, preventing children sexual abuse, then do it and don't pretend. Jesse, who is your fuck that guy? My fuck that guy is a, you know, it's like a funny thing. like there's often that thing for us nerds is that we know somebody sucks for so long but then they get brought into the national spotlight and that man this week was larry elder a person who's been a vile idiot and like also like some of these conservative talk show hosts they you could be like well you know they at least know how to talk they have some sort of talent this man sucked at his job

anyway like truly was like one of the worst ones at this which is why we often didn't hear about him because he's just bad at it. But so Larry Elder, of course, did the Trumpy thing and claimed that there was going to be mass voter fraud in California and that they were keeping an eye on it. And really, what I really should be directing my fuck that guy too

is that if you are a person with a microphone who is going near anyone who claims there's voter fraud, the words evidence need to be said, show me evidence, show me evidence, show me evidence. Because this has just become a thing that they're just trying to make it so that you've heard this for so long that all elections can be delegitimized. And of course, as we saw, Larry Elder lost by literally the most ridiculous amount

you could lose an election by now. There's still counting votes, obviously, so we don't have an exact number, which is why I'm avoiding it. But right now, he's down about half of what Gavin News is. If you're going to try to pretend that that was voter fraud, fuck you. On that note, we'll wrap this episode of the new abnormal from the Daily Beast. In future episodes, we'll be talking to smart folks from The Daily Beast and beyond from media, culture, politics, and science. We'll help us understand what's happening to our

country and the world. We hope you'll subscribe to us on your favorite podcast app and share the show on social media. Thanks so much for listening, and we'll see you again on the next episode. Want more great listens? Check out our comedy podcast, The Last Laugh, and our star-studed The Daily Beast podcast at thedailybeast.com slash podcasts. If you enjoyed this episode, consider becoming a Daily Beast subscriber. Subscribing is the best way to feed the beast and support all of your podcasts as we cover what might become the darkest timeline. Head to the DailyBeast.com slash membership slash podcast and sign up today.