Vox Senior Correspondent German Lopez joins Matt and Dara to discuss what went — and is still going — wrong with vaccine distribution, as well as to talk through some new research about the effects of implementing eviction moratoria on the spread of Covid-19.
"What Biden can do to fix America's Covid-19 vaccine mess" by German Lopez, Vox (Jan. 22, 2021)
"'We crushed it': How did West Virginia become a national leader in Covid vaccination?" by Laura Strickler and Lisa Cavazuti, NBC News (Jan. 31, 2021)
Matt Yglesias (@mattyglesias), Slowboring.com
Dara Lind (@DLind), Immigration Reporter, ProPublica
German Lopez (@germanrlopez), Senior Correspondent, VoxCredits:
Erikk Geannikis, Editor and Producer
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This is an unofficial transcript meant for reference. Accuracy is not guaranteed.
Support for this episode comes from Clickup. We lose an average of three hours every day, switching between all our work apps, but you can get them back with Clickup a flexible platform that brings all your essential tools into one place where you can prioritize tasks: collaborate on docs chat with your team and track goals, so companies like uber and web flow use clickup is their mission control Center, replacing every other app that we're using before click up even guarantees to help you save one day a week and get more done. It's completely customizable, it's free forever! So try click up today and click up dot com, the weeds. I only had like
one friend in the class, and she knew how to ski. If she was not patient enough to, let me do the bunny slopes and on the
one and only time on the next up from the bunny slopes. Not only did I not stop at the end of the slope, but I hit the ski lodge. Oh wow, that's not good
experience. When I say I hit the ski lodge, only my skis hit the ski lodge. At that point, I was on my back with my knees like under me: yeah. If I don't ski anymore, you can
welcome to another, so the needs on the box media Potass network I met my place- is here with Hamas Lopez Pro public, as their land
we're gonna talk today about vaccines, which we would have had a little bit. A few
weeks ago, but we know a bit more now. The situation has changed. A bit more. The rollout seems seems to be going a little bit faster than was,
as previously, but still well behind the kind of optimistic operation warp speed forecasts that we had
had last fall, and here I mean been You'Ve- been writing about this year. But what's going on
why. Why is this so much slower than they said it was going to be so I would say it's going a little better than it was worth
around one point: three million vaccinations a day which is decent pace, not not what a lot of people would like, but a decent pace
I think so, for what we've seen for most of the past few weeks are problems like the last mile, the distribution chain, essentially, which is where vaccines had to go from
to arms. We've seen all sorts of problems in that regard from they're, not being
staff to actually vaccinate people from my storage breaking down from like terrible dislike legists basic logistics planning like over scheduling long lines. It seems like there's just a lot of problems going on in this last.
Part of the chain, and I can actually be easy to think like ok, so there's there's all these problems going on is. Is there really one big factor I would have asked? Experts are safe, said it's kind of like like look. There aren't fifty bad state governments in the? U S,
like that is not how it works. It's just the lack of federal support.
Made it so easy for states to Macedonia,
and since the U S is a big country like a big, diverse country, there are going to be lots of different problems happening at one
when no one has enough resources for this, and I just resources butts
like guide and support. Like a really seems, I got the Trump administration in many ways and even do the basics on this, and that's really what were or seeing the results of like K, interrogate that illiterate
so differently. Ministration didn't deliver a lot of resources and guidance and support
but at the same time, if you're the governor of I don't know what island
You know, like you, can see coming right like it's it's August September, its act,
or there's a news story that Pfizer has these good results, we're waiting for the FDA? Like you, you are aware that you haven't been given these federal resources and
It seems like there's an opportunity to do something.
Like today. The garbage is not being picked up on my block, even though it's my garbage day because it's snowing and they need the department of Public works to plow the streets and, like
fair enough right, like there's no federal resources available to the streets like the city
gotta figure it out
Why is this an insurmountable problem? Why I want to say legs
while some of it is on states, you can't just write them off, but this is I mean, like
for months. States have been trying to plan for this, but the same thing I heard like time and
again as like look. This is the biggest vaccination campaign in. U S, history like its it,
just a massive roll out like we're trying to vaccinate three hundred million people in the span of months, so it was always going to be pretty difficult to do and if you do anything to make that even harder is,
it's gonna be a really difficult challenge. I'm not trying to exclude excuse states by any means, I think I mean and in terms of covert in general. I think there are,
plenty of mistakes made by, I think
me, it's just, I think of this,
If this is a world where the Trump administration had not actively lobbied against more support for states which they did, we ve seen these reports that they actively lobbied against more money for saves. If this is a world were like
The trumpet ministers was consistently providing guidance there.
And I would then I think we re I've been in a much better place by now.
Other thing I think to consider is states were already overwhelmed because they were dealing with the biggest surge of covered period over the winter,
and so the same public health agencies that were now in charge of like doing vaccines were also dealing with like making sure their hospitals and get jammed up end like
How do you get enough corona virus testing out there, and can you still do contact racing at all? So I think
those things combined again. I again I say that if forgive states, but it makes it seem more reasonable and, and it really puts it on the federal government
yeah I mean honestly her mom we can talk about. This is like the largest vaccination campaign in US history. I've found over the last few days when I'm thinking
is that I have to reset my expectations. A little bit like the rule out
new, you, no federal state partnership supported me.
To be like individually tailored stuff, like even the healthier doktor of rule out
had a substantial number of problems in its first weeks. Unlike yes, that was like a notable you know: government failure on
some levels, but it's just true that new complicated things don't go. Super smoothly, initially jump in the differences that lake
vaccines are going to expire if not a are going to spoil, if not stored at a particular temperature, which, in the case of a first round of vaccines to go live, is super low. Like super technical freezers required
love, and also not necessarily something that would be known to a great degree of confidence in advance during
Casting processes, they're still working the technical specs out and be that they will be
I have not used within a certain amount of time, and so the you get a period forbade attesting on vaccines and for political reasons.
You know you're not going to say we are going to you in the first days, only take twenty percent of the capacity of vaccines that we think the ultimate
get so that we can make sure that all sites have the proper storage that they have proper procedures in place that they have the personnel etcetera. Like that's not you. Can
all of the police
medical issues that are coming up now. Indeed, the distributional questions of who is getting vaccines. Who was getting prioritized? You know who has the law?
Travel easily to go to sites where
vaccines are would have been so much worse. If you had a situation where the government was explicitly saying we're not taking all the vaccines, we can get our hands on at the very first jump. So I do kind of wonder you know
how much of this in particular would have been planned for in advance and to what extent is this kind of just
To what extent was it always going to be this rough? I mean I
say that it was always going to be pretty rough. To begin with, this is a big country doing trying to do a very big thing and kind to this point. There are very few countries executing this
which kind of land to the point that this is difficult. Like one country that has been doing really well as Israel, which not, coincidentally, is small and pretty dense. But I would say that the other side of this is
states were planning for this and that's good, but you also to plan like four things going wrong, and
at stake where you start lay really having to dig into details,
having to run simulations simulations of what you're going to do, having to do like the
Extra extra work like you need a surplus.
Okay, if this fridge breaks down, what are we going
to make sure those doses are used, and maybe that requires a backup fridge made
requires. Suddenly, surging staff, both those things, require more money right
those those are things that lake are going to be really difficult to pull off. If you have just have limited resources, so I think that's kind.
The issue here is when you're planning for such a big supply chain. I've actually talk to a bunch of supply chain experts about this, because this is
like I want to know how you do this some of this stuff sound basic, but the essence of it is you want to
make sure that when something goes wrong
your lease prepared to address that problem to some degree like you might not know what the problem is, but you have
like logistics and set up in place to do it. A lot of places just didn't do that
because they have the resources- maybe just poor planning our leadership, but that that's what's goin wrong when we make of this July, obviously like one of the big priorities everywhere, as far as
I know, is to try to go to nursing homes.
With such a high share of of the deaths, have been happening, and what did I
ed right is that, where
Virginia is the only state that didn't sign up for some kind of like CVS Run effort
to go do this, and then they seem to be popping up with the fastest through point I bought
I don't even know what branch of Sea vs it is that you would contract with this, the like I've been to see the s kind of slow like is. Is it really a did outsourcing this to companies that,
probably don't like, have a clear incentive to actually do it that efficiently cause a problem here,
I mean that certainly is a part of it. The Trump administration recommended partnering with a major pharmacy chains and West Virginia basically said now. Look will do with like local, like local pharmacies, and I think that's interesting as it turns out. These local pharmacies have a lot of partnerships already with local nursing homes, which sought exactly shocking but leg. That seems to be their advantages. Lake, because they already have this pre established
our second go ahead and actually distributive vaccines, but I think what this really speaks. Essentially, this broader thing of of like adaptability and flexibility, west region,
was not like. We are only going to stick to these two pharmacies, we're going to use which ever pharmacies can get the vaccine out facets, and this is something that I think is really tripped up. The. U S in general is when you look at
whether its guidelines are criteria were using to actual and who can actually qualify for a vaccine, whether you're thinking about like where a vaccine is being distributed.
We have a lot of like inflexibility in terms of like deciding
who can actually get a vaccine where they can do it in and what not? And I think I need this.
The process you want to make us easy and a straightforward as possible, and in many cases where just not doing that yeah, it's really can be hard because we're so used to mature policy making processes when we think about
and of major government efforts that lake. It seems sensible to say well, of course, we're going to have the maximum pool of resources available to us and therefore our problems are problems of trio's right, like, of course, we're going to be able to get as many vaccines into arms as we want to. So. The question is: whose arms do we priorities
vaccines in into like when you are creating a new thing. That's not necessarily the case. It's like very this is
maybe the most attenuated immigration analogy I ve ever done
This shows I'm sorry but late. One of them
lessons the last twenty years and immigration enforcement is once you have the technical capacity that in theory you could be. You know that in theory
no of more unauthorized immigrants than you have. The physical capacity should report. That's where it starts to become a question of you know: do you ramp up that fiscal capacity?
Do you start deciding that, even though some one is known to you, you're not going to go after them, and that's that wouldn't have been possible twenty years ago? And similarly it's not. You can't make the kind of mature trial decisions if you're still trying to get kind of the technical universe of being able to
connect with people as want you. I thought I found you looking locally at DC and what they're doing that the M the concept of prioritization, I think, like encompasses several different universe
since read so there's this one universe in which dc- and I think most states are prioritizing senior citizens over non seniors and with that
means is that there are some vaccines available on a kind of first come first served basis, but there are more people coming than can be
served. So the saying, if your under sixty five, you can't get it so over sixty five as a priority. Another thing that's happening is they are. Might my son is in school for the first time in ten months today,
they are trying to get schools back up and running, so they are prioritizing vaccinations of teachers, but that's different. The inn
Do you see, at least it's not, that the teachers are now like in the priority group, and they can
sign up it's. There is a special facility at Dunbar, high school set up for people who work in the DE cps system and they can go there and get.
Vaccinate right and then suddenly, you're seeing within those two windows is that these divergent problems
right like surely there are some senior citizens who are reluctant or hesitant to get the vaccine, but in the aggregate every time they open up appointments like it sells icon, cakes and, as you know, there are books in twenty minutes. But with the teacher
is because they ve created. I guess I would call it like deep
adaptation of teachers like they have a vaccine for every school staffer like they're waiting for them. They have a dedicated facility.
Lots of the teachers. I'm hearing at school support staff in general, not just teachers aren't going right
and so one issue there having with throughput is they want to maintain the policy that
vaccines are available for all the school staff, but while many school staffers are clamoring to get the vaccine, many others aren't and then there's like a different group of people who are over sixty five clamoring for
seen they can't get it, and I think the language of prioritization is
the logistics are complicated, but also the language is confusing people, because people are
oh I'm in a priority group, but I can't get a vaccine
because you're, not unlike the really good prior right like there, is a group of people for whom, if you want a vaccine, you can go get it and they are having a problem actually like delivering
everybody there. I'm begin there's a different group where it's like yeah you're on the list, but but it's really hard to do, and I mean I don't know ready, there's reasons to sort of target. Sub groups like this and healthcare workers is the big one. Every
We have a similar thing, but Eve clearly slows down your throughput right, like you create a bottleneck, were you say: ok
you, wanna get everybody who works in this hospital a shot and not everybody who works in hospital, wants a shot. The lots of people who don't work in the hospital,
and you're not given him away as easily as you could, because you're too,
lying to me like that
like they don't want a big outbreak among teachers in the school system, which seems reasonable to me,
but like also, I wish the school staff would get vaccinated
I mean it seems like, like, I think, you're gonna see more of this as time goes by,
Just in terms of like that, the growing problem over time is going to be vaccine hesitancy and I think how you balance
moving along the priority list. You separate yourself, and that is going to be just something that loud and local and state officials has had to figure out but
I'm I'm. I wouldn't curious there how much like aggressively, following through with teachers and like actually pushing them to get back scenario, because
because what we ve seen in like Asian and Africa Income
is where they do like big vaccine efforts for Time Alex suffer like Polio and what not it's not enough
just like set up a vaccine side and ask people to come in. You have to like very aggressively bother people essentially
I call them tax them and what I am curious if there actually doing that with teachers, because that would probably help a bit once all the whole problem.
I just want to show you know, like my school's patio, like put a thing together, we got doctor you know
come come and talk to people I mean I just know that the public health officials are feeling like pulled in multiple different directions, because you have
while saying you know so, you have teachers union being like no, no like weak.
And opened the schools. Like you haven't vaccinated body, you have the Deasey PS officials who are like
we gotta get these vaccines done like we're, opening the schools we? We will need win our arbitration case right with the union to to win that,
sorry, to say that the vaccine is is is going well
but then you have all these other people write. The seniors
I mean I was stereotyped them as like White College, educated seniors, who are like gnashing reef.
Shown their web browser all day. Knowing why can't I get the vaccine right and
the city and the media, like everybody, wants them to do all of these things simultaneously. Right like they want them to fix the hesitancy issue in the school system to solve. You have like a big problem for pain.
Students they also want them to like deliver vaccines to the people who do want the vaccines
they don't want the Washington Post to keep publishing these info graphics that show that their only vaccinated people in the rich white neighbourhoods and thereby
crying different things right. They like set up extra appointments in the lower incomes, zip codes and things like that, but it
that doesn't solve the hesitancy issue, which requires a lot of spade work, but I think it's hard to invest in that spadework when there are so many people clamouring for a vaccine,
they can't get. Rightly, when you do a polio eradication programme, like the premise is that, like you, ve already hit like the low hanging targets
as it now is like all right, like we gotta get out there into the rural villages. The logistics are hard. We need to do
the community work. But, like that's the point of the programme, but here this
like lots of red, like I would love a vaccine, you know, and it's it's a challenge to like do both of these things simultaneously yeah, I mean, I think, to be the other part of this that the equity part, the appended lands TAT man is
super important, because it's another way in which the conversation about prioritization is being intended in a different way from the weights. Getting herds,
when you say we are going to make vaccines available to these categories of people
also making them available at these places, and those two may not perfectly map on to each other. I e there might be a lot of educated upper middle class white people who are in
roots aren't getting as many vaccines as they have people willing to take the like we're
distributing the vaccines, isn't a strict limitation on who can get them, especially when a lot when people have been you know not walking around their neighborhood the time they have to get online to get a vaccine appointment anyway. The lift involved in all I have to go to a different part of town. To get this thing. That is the most important thing I can do to stop myself and getting the corona virus, and that is why the changed my life, like that's, not a big obstacle and so bringing this is in a lot of cases, a digital divide, problem right where you have, for one thing, a cohort of people who are less likely to feel comfortable using the internet on their own. That's true, you know even of higher income people higher educational, the people who are of a certain age there, often in a meeting with children,
or neighbours or something to help them get set up, but especially in places in neighborhoods, where you don't have any, were used to using the internet for work, because no working blue collar jobs, you'll have people who are sitting in front of computers all day. It's not that surprising that those people aren't is able to get the slots that are available in their neighbourhood and so
You can see a world where a lot of the vaccine rule out took the form of hey. Let's make sure that we have an Ipad out that we have available
well at lake, see VS is in lower income neighborhoods, so that people can easily sign a perplexing appointments in the air and they know that that is a place for aid and straightforwardly do that. Unlike that's, not what happened. Instead, we have a situation where a lot of people.
Will they have to be their own internet detectives and, by definition,
the folks who can marshal those resources are going to be the ones getting the flow, but I want to pivot this a little bit because
One thing that has happened over the past month is that this, these throughput problems, I think, have been getting less severe weather. I mean people continue to struggle with
bite, but there's a glove, more vaccinations per day happening than was five or six weeks ago.
So we're, starting to run up against the question of like how much vaccines can you make,
and were beginning to hear sort of glimmers of work on this swayed. So one idea is going to use the defence production act. To get this a like to do.
Kinds of byles that Madeira uses for their vaccines, and one of them has like a less wasteful, syringe and sinking at six shots out of it, but it is only five some. So that's one one thing there they're going with it looks like
There's going to be an application to the FDA from Madeira to like stuff there vials with more
more more vaccine, and I dont totally understand how this works, but like apparently their current regulatory approval says they can put five or six dose
worth in the vile, but they believe they can fit ten
well like see how regulators go with that.
These kind of issues seem to me, like their increasingly gonna, become the key topic.
And if we want to vaccinate, everybody here eventually wanted vaccinate people in Tibet.
In countries like the
the world needs a lot of vaccines, but it seems
oddly like mysterious to me. What's, let's go
non with us like. You would think that
The ceo would say like I would love to make.
Three million doses a day, but to do that, you gotta give me
you know six billion dollars in an elephant and like a painting of giraffe? And you know them,
Congress would go. Do it right. I mean this is like the the uncontroversial aspect of like the coded relief bill. Is that, like
want some money for vaccinations. Am congressional republicans seem open to that idea, but it's not what what do we need? I mean I think they're there
like notably last transparency around us, especially when you compare to leg covert testing last year
it's a covert. Testing was screwed up in a lot of ways in the: U S particularly early on, but we like knew what was going wrong in alone:
these cases like it was swabs. It was regions, it was like machines with with vaccines. It's been, I think, much more difficult to pin down. I think part of it might be that we have been stuck would like these other problems that aren't route necessarily supply related to the vaccine. For the past few weeks. A lot of light, the reporting and attention is gone to other stuff. But I do wonder
it's. A drug companies are too scared to, like maybe not scared, as, moreover, by just worried about sharing like what exactly they might be running low on cause, it's like proprietary or whatever it may be, but in general
and you you are seeing like, but I think we,
there's a seesaw where, on one side, you have like these supply concerns and the other. Basically, the Tuff we've seen the past few weeks, like all these logistical like last mile things and we're going to probably bounce back and forth between that in the next few months and right now, I think we're getting close to that supply
constrained- and I agree mad like I'm. Somebody is doing a lot of reporting on this and has still not very clear to me exactly what is going wrong. Even in Europe you're getting reports that lake their delivering waste, your vaccines and expected is, and the companies aren't really providing a clear explanation.
As to why, but I'm in spite of the mysteries. It says it's working on it, but it just wondering like why, like what? What is an even like, why is this happening but like? Why were they more prepared for this,
Was it a it's like the divine administration last week set its ordering enough facts
for three hundred million Americans who, for the orders only added up for to undermine America and its eyes, and they knew how many people are in a hurry like that? This was not some sort of.
Mystery. A few weeks ago, like why weren't people on top of this already understand that, like the federal german ordering stuff works, weird, but lake still like this, it seems like
some balls have been dropped somewhere along the lines and nobody's really explaining why I
before everybody else, it ass theirs. I do like two things that people who work
pharmaceutical, say about this, they don't like totally explain it, but I want to acknowledge that I know that
say this one is vaccines, are complex biological products so
Not at all? I don't know exactly what they put out or know. It's like. It's not like a table and the
is that the process is the product is a thing that they say, I'm so dead, because these are
logical products? Small differences in the production climate can ruin it right,
you know like it has to be very sterile, has to be very pure everything has
be done just so so
Apparently, the manufacturing is very prone to being thrown off against.
Nicky I saw by this to be like totally satisfactory a we do? Three million
vaccinations per day during full season. And if you ve ever read like a smart health persons article about flu vaccinations, they will tell you that not many people even get them. It's definitely not like a huge
national focus, I'm so like it is possible to produce vaccines at a larger scale. Even if it's hard company, six
we do it all the time and so
to her months point like its confusing you read like
ass rosetta is not delivering as much as they thought they would too. The European Union
and then you keep waiting for the paragraph in the story where they're going to be like, because this net didn't work and
A fly got, it unites us. What actually happened?
and it's weird and reporters don't like to do like what we're doing here this like. I don't know stuff
is a gear assigned to write the story about production shortfalls. So you like right everything. You know all about production shortfalls and as a reader, you can be frustrated because,
like the real story is that the company has not explained it, and the government is also not explained it, and we would like to know I mean I wonder how much of this is. It seems really hard to talk about the questions of vaccines apply without acknowledging that we still don't have one hundred percent certainty
how many vaccines are going to be approved for mass distribution and by whom, and when the like that,
not only is a question going forward. You know a lot of the more optimistic assumptions,
wow vaccine availability assume they were going to have stuff coming
on line now. That is not currently available for getting effort for going into arms in the west, but also retrospectively as we think about like or
in a world where Moderna isn't one hundred percent certain that they're done to get their vaccine approved. To what extent does it even make sense to invest in you know all of these second order production and supply chain questions, as if you, in a bit
they may not be reputable to any other vaccine, much less any other product. On the assumption,
something will happen, that you're not sure about it does seem that the regulatory uncertainty might be a factor here that you think, maybe you can't go and go back in time and change the atom. Maybe that isn't the lever you want to pull, but it doesn't seem not unreasonable to me that you can't scale up from. Maybe we have some vaccines getting approve, maybe we dont you? Ok, they needed to be entirely ready. Yesterday I mean that the one
I would say to push back on. That, though, is we knew that modern and Pfizer like their vaccines or moving along and trials pretty quickly like weeks months in advance, so like you could have started like making some headway on this
I don't know I mean it is true. The vaccines are complex processes complex, but at the same time, lake we knew this was come,
like maybe you can like prepare for the worst, and maybe you don't have to do.
Worse like this is just basic stuff, like companies do when launching products is like, like you play
four things going wrong and then make sure you have things in place to make sure those those things are smooth out as quickly as possible and to me just
not seem like that has been done at any step. The chain I mean the Trump Administration was like actively resisting doing any of this,
and then one of the most ridiculous courts we ve heard in the past year from them, and we heard a lot of stuff was em like characterizing. More support for the states is like a federal court. Unquote invasion like this is where that a ministry.
And was coming from so in that sense it is not surprising that a lot of the stuff just didn't get done, but I think we're like still suffering the consequences,
that we still have a lot of answers, but it just doesn't seem like us going as the should. Also it. You know on
on production side staff? What they did there has been frustrating me is that
of the reporting on the face three clinical trials.
Made. It seem like there was a boy
huge amount of doubt as to what the outcome of the trials would be, but from what I've heard from people who worked on vaccine development in the past is not. Nor did the phased. Retrial is pointless
or that you can just skip it, but then is actually very rare for a vaccine to fail at that stage in the process that, if you are at a gambler right,
if you have a vaccine and it succeeded in animal trials, its exceeding lab tests,
asked phase one safety tests. It demonstrated a phase to antibiotic response. It would be quite surprising for into flunk the phase three trial at not to say it never happens, but dead like it's a distinct minority of
the cases and they do it because you know they don't want to just inject people with vaccine and hope for the best they they want to have scientific knowledge about it, but
you could, with simple downside risks have started acting like the Pfizer Medina vaccines. We're gonna be a thing. You know when they started the face
try right, you would have run a maybe fifteen twenty percent chance that they would flunk there, but the expected value there is still pretty good web. We didn't actually need to like wait around until MID November and then say: ok now we're gonna start thinking about. Do we have enough files right because, like you, you can get all that stuff. You can ask them like. What's it was your supply, lest you know what what
spoil vials, you can stack in warehouses, Cyprus, a reason they should be shortages of that, and it was a very sort of you- know, penny wise pound foolish kind of approach that was taken to sort of at completely ignored
stick about this, and very you know, I mean it's very Donald Trump that he was so focused in the summer and fall on the vaccine, approval
like that, was his alternative to doing any hard work about anything, a non from suitable interventions, but it turns out the vaccine. Approval itself doesn't like magically fix anything. It's just this whole other raft of hard
work and you know, being motto: maniacal focused on vaccination wouldn't have been the worst idea in the world
like you didn't wanna put in time answer
of any aspect of this
a way he's lucky. Like he's, gonna go down to his grave, telling himself that had Pfizer put out their press release a week earlier, he would have one and that they really screwed him, but like he wasn't
doing everything on the vaccine friend any more than he wasn't anything else and like that's what we saw over the course of December and January that, like work had not been put in to addressing any of these issues, I mean one of the things that have you. I've read some of the report. I like how operation warp soon came to be, and it was like the most haphazard shit
like the federal government. I was basically as arduous the Secretary of Health and Human services, just kind of like pitching it to the Trump Administration to like save his career, because he was under trouble for failing on other aspects of covert, and then it is kind of like fell together.
Some of the vice presidents team was unhappy whether because they felt that was undermining their authority like the public side of this was like. This is a wonderful project by the Trump administration. Trump is really involved in it, and why not, and apparently just internally from bit based on their party, was nothing like that
and they really just puts like this- I did. I just backs up what bad as saying that lake. It's that these things were not like. There was really not that much focus, despite what they tried to put out to the press on actually getting off this right. So I mean the question that
is. It is, and I know that the Vine White House not a little left about you- know the initial reaction to their kind of million doses at a table causes they felt that the press was annulled,
and usually hitting them for it being too modest and too ambitious, which you folks that's what happens when you treat the press is a model of people are going to have different reactions to it
I am the de Rossa. We ve also been getting mixed messages from them on exactly how much they inherited in terms of an infrastructure that they can use right
Is, on the one hand, there was a message being sent out that, like we got absolutely nothing,
the Trump administration. We really have to start from scratch.
The other hand, the way that anti poverty is talking about this, the way that they're going about logistically.
Learning does make it seem like are able to really hit the road.
Running and a lot of ways that imply that there has been some in that they are not just starting from zero. So
What is your estimate of whether the Biden administration is gonna, be able to start doing what it wants to as quickly as it wants to? I mean
I would say that that is not that there were literally starting from zero, but there certainly wasn't as much work as you would have hoped. I think one thing you where you can see this is you can just look at bindings plans and if you look at the plans heap almost nothing that he is proposing
is like radical or new, or anything I mean one of his things was like we're. Gonna get FEMA to build some vaccination centres starting tomorrow and like that
like literally tomorrow, just what he said and it's the sake,
yeah what? Why wasn't that happening already like this seems like a very obvious thing, and you look through the plants and their they're. Just ideas like this, it's stuff that you would expect the federal government to do it. To me that, like you, might have expected, just like President Mitt Romney to do like, but but like even that basic stuff was going to go out, so it's just to say like when that's the stuff, that's making it in the proposals. After the bond administration has had time to study what operation World seed was doing it. I think it lends credibility to the fact that this this really was not.
Handle it as well, as I mean not surprisingly, but not as well as it should have been. You know one thing that I do think we're going to start bumping up against is that
nobody really should have prioritized putting a covert transition team together. He as like a task force that is co chairs any
brought back the former surgeon, general and all this kind of stuff, but he is not appointed a FDA commissioner, and in a practical sense, like the idea, is a very important institution for rigour
both food and drugs and use of all this stuff right so like can we
aims. The vials, though, can we change how much stuff we put in a virus? Can we get new factory certified, like others, have runs
HU, the FDA up, the idea obviously doesn't like hot functioning just because it doesn't african.
Commissioner. There is an acting commissioner there, but sometimes in a public health emergency. You want the regulatory agency to do something different from what is business as usual approach would be, and that's not going to happen when you have a senior career person in there is acting. Commissioner, like I am often critical of how many political pointy is. We we have in american agencies
but like zero, is not the correct number either right. It's like you know that the President of the United States ultimately is accountable to the american people to make a holistic judgment about the relative balance of considerations here and he needs to have a person whose his
agent in these agencies to assess whether its correct or not, you know so, like I read,
story today and they were like wild. The FDA is expected to make a decision in a few weeks, and I dont know you know like. Maybe it really really take some three weeks. Maybe they could do it too?
you know like it's. This is the kind of thing we're like you would want the president to read this article and his newspaper and the like.
But let me call the guy over there like see what's up, but you started can't if you don't have that and it's not because of inattention to the vaccine process
or to covered. In general, there seems to be some genuine indecision between the present his team as to who they should pick their right in the IT sector. They just haven't gotten
onto it yet, and I- and I wonder I mean I think some day we will get the accounting of what that disagreement is about as someone
do they want to bring back an old hand?
They want to bring a new person in because it's a thing people disagree about a lot, but it sort of that the dark matter in a lot of this, because to increase production.
Can you need the regulator to sign off on whatever it is you do you want to be clear about this, because
you know these genre of stories that we got about. President Donald Trump in the vaccine were about the Trump Whitehouse pudding. Undue political pressure on an apolitical agency to Lake skip three no to cuts in scientific corners, and that may have
had an impact on the end of the initial responses to the to the news that vaccines were being introduced is kind of a lake? How can we be confident that this isn't due to political interference and met with yours?
about. Isn't, is not you know, Donald Trump safety
commissioner, you know call
up, some some personal.
Approval desk and saying to skip reading through the rest of the paper and just sign, okay and handed to me when you get them
pillow guy, we are talking about as much as anything is you need someone standing in front of the public to say we
as scientists, are confident that this is the best course of action. If you're going to take extraordinary measures, rates would not like,
may very well be the case. The folks at the FDA think that they could do all of this in a shorter period of time. Then they
then standard operating procedures would have them doing it, but you
a civil servant can't be,
the full guy. If that goes wrong, you can't be the person about whom there's like the Vanity fair article saying you know days, they cut some corners, and this is why this whole thing is it here. This is why they approved a failed vaccine, so
having the political appointee there to say. I have the you container. I have confidence in the scientists at my agency. We are confident that this is the course of action, and I
the person who is going to be taking the success or failure for this this is not the governments promises the administrations, probable
or I mean it, could be the opposite- that inside you need a political pointy to be like. I don't know if this executive is talking about like he's talking,
they tried this Overstepped vials thing in Peru fifty years ago and they all broke. Yet. You know like give or give a recent right union somebody in front of the cameras saying what you are hearing is not the way we can do things exactly because you know is like the civil service spot there. It's not their role to like either depart from standard procedure, be
as its an emergency or too like yell at people and in society there. What they're saying is true, so it's
it's an odd sort of Laguna out there. You know
as I've seen like deputies,
in Treasury secretary- is you now coming in, which is
like I love a good deputies. Students treasure secretary, but like obviously
this is like the issue right now and you need to get people in on all that stuff. At the key
agency is we ve had some good. I think so. My good vibes out of like the CDC as back right, and I feel like that site. That's what the by demonstrations trying to do and it's very helpful likely the covered tracking
jack people say there d be able to wind down because of government
it's actually doing like the basic
Jack staff that you would think, but, like you,
does not have a cdc his trunk pride to, but you also get have an FDA like just because you're in some moment of indecision, I mean you saw this
last year to when they were actually approving the vaccines. And there were like will come back in a few weeks and like look, I have no idea.
What is actually going on in the FDA process. I can't like say exactly what was going wrong, but if the issues
While we have a lot of data to read through, like maybe shifts
staffers over, like. I have to think that when you're dealing with like the worst disease outbreak in a hundred years, you can, like doom alike,
more to speed up the process, and it does seem like that hasn't been happening at every step of the way there hasn't been that focus to it juice Emma some some nights him
against a blessing to break a mindset. Let's talk about our white paper and we feel that you know
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sue. This week's white paper is called housing prepared in the cuban nineteen pandemic, impacts on utility disconnection and eviction, moratoria on infections and debts across. U S counties by a set of five authors, mostly from Duke University and the
People use it, they use a can of counterfactual model, they first look at differences,
in county level, eviction moratoria. I became
is obvious on the assumption that, like it's a lot easier to look at where the virus
actually was at any given time. If you look at the difference between counties in the same state say metropolitan area, then, if you try to compare we're new
work was in March. To wear Montana. Was in March and using that data
build a model that they then have run as a counter factual and end up, estimating that be the difference between policies that limit evictions, whatever,
a moratorium on filing eviction. Notices or whether that's just you know we're gonna put upon the hearings until the pandemic is over at the difference between having those in not creative production infections.
Three point eight percent and eleven percent reduction in debts, which, if you treat those as a kind of whole numbers nationwide, he will end up with some big big numbers. Ah, this is the kind of thing.
That if it were, if this were the only policies which the reflecting would be a massive difference and, in our view, be the biggest policy intervention of the covered pandemic in terms of what we could actually do plausibly
where twenty twenty I'm gonna leave the housing implications. This demand and the public health implications to him on. I just wanna know honestly that what's really striking reading
this paper? Is that this is building on
literature that already exists of the effective covered nineteen, a pen
make that started in the United States like eleven months ago in the most conservative accounting and it's really been- and we ve remarked on this before, but it's been fastened
to see how quickly social science research has been able to generate the exercise in public health. Research have been able to produce not not real time very
those two real time on an academic timeline findings about
how this is working and absolutely no looking at them.
This policy interventions as they roll out in the field, and I would love to hear in more detail from you know some of the academic gatekeepers here on what they think
The lessons of this are for once we returned it to postpone them at times. Is you know,
How about a lot of issues that never hit the kind of obvious everybody in the? U S is obsessed with fever pitch the pandemic, has
but the arguably as a true but we're policies are still moving forward at a particular pays, and so you know there can be a gap of in it.
Higher generation of policy is between when you,
think goes out into the field and when you actually find out about its results in an act,
in an interview with academically validated. So I would like to know if you know the operation warp speed that academic,
Labour generation appears to have been working on, has actually been something that could be replicated or some parts of it could be replicated in.
Friend in the world or whether this is actually
does shoddy as the operation works need on the vaccines we just don't know about it yet. Well, you know, there's a
blown roster of scholarship, a bow housing, instability and evictions. Raid
and you can point to sort of evictions as you sort of
events study occurred
as in the lives of the people, and is
always been clear that its very harmful across a wide number of ranges. So
The monetary loss to the landlord of the tenant, not paying rent is obviously real. That's like the whole business is that your tent
have to pay rent, but its small relative to the harm to the tenant of being kicked out, because you know it's, your personal property tends to get destroyed if your evicted from a home of among other kinds of things,
so there's always been a kind of policy conversation as to what should you do about that and
You know a more progressive jurisdictions. The tendency is to adopt very strong regulations that make it hard to evict people even for non payment of ran Tito. You have to give them many months as a whole. Bunch of stuff like that
and it tends to produce some more perverse long term policy consequences, because it means that people don't want to rent to low income, tenants or two tenants who they you don't perceive might be likely to not pay, because it's going to be hard to fix them and there's like an incredible
forest in the literature about the merits of the costs and benefits of of these kind of regulations, and are there better ways you can do it and so there's some kind of like emergency financial assistance programmes were basically interviewed when people money, so they dont get affected this big kind of suffering
that is an interesting thing about the pandemic- is that it inspired governments to largely drop all of their kinds of concerns about this kind of thing, even of republican administration. He'll, be
some pressure from Congress to act on housing instability, but I would have this thing was overwhelming pressure at length. They really just kind of did it to show that they were doing something to the point that the buyer
ministration has actually become concerned about landlords going bankrupt and banks needing to foreclose on the landlords because they are not collecting rent ass, though they don't talk about this. That much but like part of the housing assistance in the fighting plan is to bail out landlords, because there
patent protection is a bit too effective. I saw it as a housing policy measure gives a clear win to stopping people from getting affected and the question is always will what is the cost of that in dynamic term swayed? Because but you go in, there isn't a pandemic. We expect people to move to different cities for different reasons and want to rent departments there. We expect am abused partners to want to move out of their house quickly and we will get a new place to live quickly right and all that kind of stuff gets harder. The sort of more
You increase tenant protections, you make it more difficult for new tenants to gonna get in the game, since people been losing, jobs is not like a ton of hiring does not attach moving. The governments are trying to discourage people from doing most.
That stuff we're in a moment of not caring about the kind of dynamic aspects of the the housing
market. I assume that the more liberal jurisdictions thou. Well, though,
some stickeen us to these ten unpredictable
just because they're not didn't like unheard of ideas or anything of the sort of total suspension you know is, but making it the challenging to keep people out of rental housing is now
like a brand new idea to the policy. Conversation is just an idea that doesn't dumb doesn't
work as well as giving people the
financial resources such that they don't need special eviction protections. I guess what I would say, but it if you don't think too hard about it, it seems cheap.
Right because the financial losses to the landlords are not that large,
and the costs are sort of invisible. I think what want that would sound public health side of this paper that I was a bit sceptical of the,
acts at first because they seemed so large and in general, that that's just makes skeptical interim
yeah yeah. I I don't know that I can vouch for the methodology will. If, if someone wants to do like e mail and explained the strap modeling, I'm happy to hear hear it, but in general I think that counterfactual models like this it just you gotta, take it with the grain of salt, because there is a lot, but basically I'm in
My big questions like I understand the causal chain here is essentially of. If you get evicted, you get back to another house, probably would like a friend, you might be couched surfing and I might happen multiple times
You can see like your exposing yourself to more people, time and time again to covet. I think the thing that makes you a bit
or even knowing that those like it seems to me like,
cities and just places at dead. These moratoriums are probably more likely to have taken covered seriously in general,
and I know this, that these researchers and some of the other studies have been done on this- have tried to control for this, but I'm kind of sceptical. You can fully control for
All that stuff, and I'm wondering, like a bunch of that attack, really is like
The moratorium is a signifier for other policies that are effective in stopping covered, whether that's like lockdown
Social destined say might not even be like
a policy necessarily but just budgets, if you're so
is doing a moratorium on evictions. Maybe you are more likely to as just the jar populace is more likely to mask up yeah. I guess like that. That's that's what
the things that I was wondering while reading this? I don't think the researchers address it, but it is one thing that makes you happy what the numbers over all
Yeah I mean the size of the effect. Their claim here is very, very, very:
art I mean you know a you want to think about. What's the real real counterfactual here right, because you know, I think, if you ask the people at Like American, is due for economic research as like, libertarian kind of and
master? You know whatever people like, they would say. Yes
We shouldn't have done this eviction moratorium but, like we all
you shouldn't have closed bars and restricted. Restaurant. It and read.
Like the argument would be that, like people wouldn't be in danger of losing their home, if we had just like on the full freedom rout and then you know, then I think,
the public health people would say no would have way more deaths in in a scenario like that. But you know
meanwhile we are talking about here. Is the public health impact of this measure, in addition to a bunch of other measure, swayed, not, I think, if you had done like
oh such distancing or mass grew red. If your idea was we're, gonna fix a pandemic within eviction. Moratorium like denizen make sense
Look at all on it on its face swayed the policy rationale was we are deliberately taking steps that are going to hurt people's income and therefore like we need to make sure that they don't lose their there.
Homes and isn't like. Actually, you want to assess to an extent like the holistic package, which obviously deny
work as well, as we had hoped in April,
but does seem to have worked like better than just don't do anything
yeah I mean I should say it like, while I'm skeptical like the overall number here. Obviously, eviction moratoriums have plenty of benefits else.
Where, like regardless of their effects on covered like it and in this particular situation like helping people out economically, is, is this
Maybe, if you had have people crowding into homeless, shelters, yes
I don't know you know like it, I'm not sure exactly how you you would know qualitatively. Like word, people have gone without
and when they try to instrument it because the counties to have different policies but yeah,
I do know that at least anecdotally. The the effect of the moratoria has been so large that, like my mother work
an organisation that provides some rental assistance to families and they are having trouble in their work.
They were for a while having trouble with their grant cycle because they weren't in taking enough families, because families didn't need bread,
assistant silly. There is a certain extent to which the
moratorium may have twins
may actually brought some attention. I think, on the margin, Q, you know housing,
security in pandemic, as a problem in ways that are made me think a little more about the relationship between government
directions and private charity
in ways that might not did might be redundant to each other because government,
action implies as a problem, but I do think that the it's when you worth new worth looking at you know when you re election moratoria expire in various places. Is it consistent with when the virus is fully under control in those places or we're going to have a situation in which places where vaccine penetration is more thorough, lift moratoria and that you know just like the subsiding. The second wave last fall. Let a bunch of places that had never had a second wave to lift restrictions and therefore get the third way are. We would be potentially be looking at a scenario like that in some of the places where,
it might be agents her, look their fingers off the eviction pause and to what one thing I've should also is gonna put scepticism on my scepticism is there is actually
other research showing that slowing down evictions helps people like in a bunch of public health at,
is like in terms of lake reduction of HIV. That does seem to be linked to people knocking affected. So
It's not like this. This. This research field is not unheard of warlike. Stopping evictions helps in public health and help stop disease outbreaks. That's that's actually, not totally novel. So too that there isn't one be surprising if this does have an effect,
question is how big of an effect you I mean. I think it's fair to say that for something that wasn't ostensibly done as a public health measure, it had a massive public health impact,
the question is whether we can say for sure that this was the most important public health intervention at state level learns to me. I mean it,
The thing that I think we're gonna need more research on, ultimately, is you know, like the poverty rate fell during the the
of the Cares ACT which then expired, but the new relief came and we may get even some more and I don't think we yet have a fully clear picture of how the distribution of income sort of shifted and changed during this period. Separate from kind of emergency regulatory
leave measures, because there has obviously been a fair amount of economic hardship associate with with the pandemic.
But in a weird way, where do me this immediate dynamic, so that its like
here's, a story about people who were thrown out of work by the pandemic and what a difficult time they're having accessing unemployment insurance benefits. That's that's news.
Like you can potentially get down on the front page of the newspaper if you're really good quotes and Stuff
we're just on a random day be like here, some people,
all who are marginally attached of labour force and work sporadically, but Cancun many hours and have very poor living conditions. Like that's, not a front page news story right, but the Cares act in an incredible amount to help. People in that situation was the first time that people in that situation had been able to access cash assistance from the federal government asked since
the early, ninety nine knees and nobody has with good reason. People have not wanted to write like welfare, Queen articles about people getting their their pandemics arrival,
send their living standards going up and stuff, but like its clear,
the numbers that there's a set of a diminution in the number of people experiencing
poverty, even as we had the unemployment rate going up and like all kinds of other terrible things, sort of happening right so dense, also gonna play into the eviction dynamics and then to further have that kind of security of tenure. Right that, like your landlord, can't keep you out like that's good way, and I would hope that we can take some
lessons from this about how to create a more a few humane, ass society, because we,
obviously able to afford at a social level, will look back on twenty December this year sucked, but it didn't suck because of a lack of aggregate financial resources. Swayed like its act that I could see my feet.
Molly that you can't do things and Vienna celebrate, dares wedding and and stuff like that, but, like weaken, put back together,
these elements of the emergency safety net in bad times times I mean it's, should be. I, like I, have a friend who act.
Went through one of these experiences where they can afford the rent anymore and ended up moving and with another friend, and that that's actually one of the things I mean we think about this paper bigger
Now he's is an essential work report on quote, and I won
how much that's putting not just himself at risk of cover, but now this other persons living with at risk of covered. So I think just just from that perspective. It makes sense that this policy would work to some degree by like mad and dark
said like there's just there was a lot happening last year and I will just curious curious. Our Sus Alex like how
how's, our researchers can be a big challenge liked of like take upon all these policies into, I saw them to see what effect there having, but particularly in twenty twenty sort, especially challenging. I mean this gets back to earth around last week about the declining crime
right like when you're dealing with something that massive. Yes,
timidly years and years down, the road somebody might be able to pull together like composite study of lake, what effect various things had, but that's not going to be, as you
well as looking at some of the Micro Dynamics Year, because it
Also synthetic at that point that, like you're, dealing with
That has a thousand causes and he should acknowledge that lake.
You're, never going to know exactly what the right path to take clear, then that's rap
thanks thanks Dara Ethics, as always to our answers. For you, sir.
Innocuous and the weeds will be back on Friday.
Transcript generated on 2021-05-13.