Axios (2018) s04e04 Episode Script

National Institutes of Health BETHESDA, MD Dr.
Collins, you're an important fellow in an important line of work.
I'm gonna keep my mask on, I'll shout through mine so that you can hear me, but you can take yours off if you're okay with that.
So we can hear you better.
Is that the rule? That works.
Awesome.
AXIOS WHAT MATTERS 1.
COVID-19 checkup / an interview with Dr.
Francis Collins Dr.
Francis Collins is the director of the National Institutes of Health (NIH), a position he has held for almost 12 years.
He oversees 27 agencies and a budget of $40 billion.
He is also Dr.
Anthony Fauci's boss.
Thank you so much for making the time to Axios and welcoming us onto the National Institutes of Health.
You said something at an award ceremony last year which really struck me.
"Of all the developments that caused me concern over the past two years, none is greater than the growing disregard of maintaining a high standard of objective truth.
" Could you maybe tell me where did that come from? I'm a scientist.
Science only can be considered reliable if it has a very high standard for what is actually proven, what is true.
To the extent that we start to substitute our hopes, beliefs, feelings for scientific results then we start to get into trouble.
Did misinformation make the pandemic worse? The main concern about how this has been made worse is about mask wearing.
The evidence was pretty compelling by last March or April that uniform wearing of masks would reduce transmission of this disease.
A mask is nothing more than a life-saving medical device, and yet it got categorized in all sorts of other ways that were not factual, not scientific, and frankly dangerous.
And I think you could make a case that tens of thousands of people died as a result.
You are now working for your third president.
- Joe Biden visited last week.
- He did.
How was that? What'd you talk about? We took him to the vaccine research center, to the very place where a lot of the experiments were done that showed that this new approach for a vaccine, so-called messenger RNA, could work.
President Biden approaches mask wearing in a very different way than his predecessor, President Trump.
Did that come up at all? It did indirectly.
When he came out to give his speech again, in an auditorium where we only had 40 people in a place that would hold a thousand so that everybody could be distanced.
But he kept his mask on for the speech because he thought that was an important message to send.
Were you frustrated when President Trump took kind of a long journey to wearing masks in public? Let's say 2020 was a difficult year for this whole issue about mask wearing.
It became a pitched battle and that people became really quite passionate about refusing masks as a demonstration of their defense of their personal freedom is just unimaginable a few years ago.
But that was not a fight between the government and the citizens.
Members of Congress were acting the same way as far as mask wearing.
It's so disappointing that such behaviors could be chosen intentionally by people who have access to real public health information and yet would decide not to put on the mask in order to make some other kind of statement perhaps with some sense that they're immune from the consequences.
Tens of millions of people have been vaccinated for COVID-19.
How surprised and impressed are you by that? It was utterly stunning that you could go from early January 2020 and first learning about this virus and to have the vaccines designed, as they were here at NIH in two days, and to have within 63 days the first phase 1 trial in human volunteers getting underway.
Tony Fauci and I would sit around in August and talk about, "Well, what are your hopes about how good this vaccine might be on a very wonderful outcome?" "Well, maybe 60%, maybe 70% efficacy.
" FDA would have taken 50%.
And we got 95%? Wow.
Why? Is it better to be lucky than good? Or are we that smart now? It was really good science.
It was this strategy using messenger RNA.
This is a template for future vaccines.
We haven't solved one thing with that.
Give me some optimism about what that might mean for future science.
We are poised to take on all kinds of other potential infectious diseases in a fashion that will be faster and apparently more effective than what we used to do.
So, yeah, look out, next pandemic.
We're ready for you.
The health crisis that exists beneath the pandemic, what have we missed as far as mental health screening, cancer diagnoses, all these things that were put on the backburner because of COVID-19? I have concerns about the way in which the rest of our health care system has been put in a terrible position for the last year by the pandemic.
A particular deep heartache is what's happened with the opioid crisis in the United States.
When you look at the numbers of what has happened in terms of deaths from opioids and from stimulants like methamphetamine it is the other great tragedy of 2020.
Is it possible that the long-tail effects of COVID, these other epidemics, become even greater than COVID itself? I think we are going to see a delayed uptick in other kinds of morbidity and mortality from conditions that were neglected because of COVID.
On top of that, if you want to talk about a long tail, we have this other uncertainty about whether COVID itself is going to leave us with a significant number of people who don't get completely better, the so-called "long-hauler syndrome," which NIH is pursuing with great vigor right now to try to understand who's vulnerable to this.
This may be an ongoing infection that becomes endemic to the US.
I think the long-haulers no longer have active viral infection.
The infection did something to them.
Maybe it reset their immune system in a way that is destructive for their health.
Maybe it was because of all those little clots this virus likes to create that clotted places that really matter, like your lungs or even your brain and gave you this brain fog.
On top of that, we may need to redesign our vaccines to come up with a booster approach so that people can continue to be immune when immunity is imperfect.
You've been very generous with your time.
Thank you.
I gotta ask: What's it like being Dr.
Fauci's boss? It's wonderful bein' able to work with Tony Fauci.
And, yes, we laugh about the fact that I'm his boss.
Were you ever jealous when Brad Pitt's playing him on Saturday Night Live? I thought it was great.
I'm not expecting to have that experience myself, but I love it that Tony is getting this kind of visibility and credibility.
He deserves it.
2.
Every step you take / the CEO of Fitbit San Francisco, CA - Hey Ina.
How's it goin'? - Hey James.
Good to see you.
Good to take these off.
When the pandemic started, I thought that sales and usage of things like Fitbit might just drop as people didn't want to know how inactive they were no one going anywhere.
That didn't necessarily turn out to be the case, did it? I think after the first few weeks of shock for everybody, people became super, super concerned about their health and fitness.
And the other thing that a lot of people don't realize is your actual device and others, some of the fitness rings out there, are used to try and predict or detect early whether somebody has COVID.
I don't think you started out trying to track diseases, did you? No, that was pretty unexpected, although about a year ago we had been working with Scripps Research on using wearable data to help detect early signs of influenza.
And what we found is this algorithm was able to for 50% of the cases detect signs of COVID-19 about one to two days before people even reported symptoms, which doesn't sound like a lot but it's pretty profound in the sense that if you could tell people one to two days before they should start self-quarantining, that could have a pretty meaningful impact on the spread of the disease.
And what are some of the biometric indicators that that are used to kind of show you have COVID? Heart rate, heart rate variability, respiration rate were three key metrics that we are looking at.
But our watches and devices actually detect a lot more, like skin temperature SpO2 levels, et cetera.
Do you think of these newest products as medical devices? They definitely require the scrutiny and approval of a medical device.
But the biggest distinction from let's say a Fitbit and a medical device is really the work and thought we put into making it into something that people want to wear all the time, 24/7.
Because you could have the greatest technology in the world, but if you're not wearing it, it's not gonna help save your life.
Obviously though the risks and the things that you have to worry about is this is a ton of data and it's very personal.
How do you make sure that whether it's an employer or an insurance company they're not using that data in other ways? We created what's called an employee bill of rights that enshrines things like the fact that we will never share data with your employer unless it's with very specific opt-in consent.
And we've turned down business when institutions don't want to work and agree to that bill of rights.
You're being acquired by Google.
You're a part of Google.
When you guys first started having talks with Google about this, did you have concerns? There was a promise that the data that was being collected would never be used for the purposes of advertising.
So even being part of a company that makes money from advertising, you feel confident that our data's safe? I do.
I do.
And the thing is my data lives on Fitbit.
I have almost 14 years of data on Fitbit.
I want it to be private.
I want it to be secure.
How do you feel about the culture within Google? Historically the tech industry creates things that are much more appealing to men than they are to women.
There's this crude term that's been thrown around in the consumer electronics and tech industry where creating products and marketing to women was just a matter of, like, "pink it and shrink it.
" I actually really hate that line.
But I think when we launched our cycle tracking feature, there was a lot of thought put into it.
Even in what the name should be.
Should it be female health tracking? Period tracking? Cycle tracking? There's one school of thought that, when it comes to machine learning and artificial intelligence, the more data, the better.
Inevitably, a society that collects the most data, like China, is going to win.
Do you think it has to play out that way? No.
Obviously more data helps the development of algorithms.
But on the other side, unless you're highly coercive the most acceptance of technology like this will come if consumers trust how you use that data.
I appreciate all the time that you've spent, James Park, CEO of the Google unit of Fitbit.
Thank you so much.
Thank you for having me.
3.
Report card / Pres.
American Federation of Teachers More than 50 million students are enrolled in U.
S.
public schools.
A survey found only 24% are attending in-person classes full-time.
So, Randi, let's start big picture here.
President Biden the other day called the lack of in-school education a national emergency.
Do you agree with that characterization? Yes, I do.
Teachers more than probably anyone but kids' parents understand what has been lost by not having in-school learning.
It's not just the issues around not having enough Wi-Fi and hotspots, but it's the lack of social interaction.
It's the loneliness.
It's that the screens have replaced community.
President Biden before he took office, he talked about wanting to get a majority of public schools reopened within the first 100 days of his administration.
Do you believe in 60 days, in two months from now, that a majority of K-through-8 schools in the U.
S.
will be open five days a week? I believe a majority of K-8 schools will be open What does "open" mean? One day a week? An hour? Open for five days? They'll be open five days a week.
The question becomes because of physical distancing and the other mitigation strategies a lot of these schools were overcrowded to begin with.
So will the schools be open five days a week? I hope so.
Will every single child who was there in January '19 be there in April 2021 the same five days a week? Probably not.
But we need to actually have in-person instruction for kids who are in elementary and middle schools.
This is a good goal.
And ultimately, our union and 80% of our members are in favor of this goal and are trying to make it happen.
The basic mitigation strategies you talk about or the CDC is talking about have been relatively consistent for a while now just in general society.
Six feet, wear a mask, et cetera.
Given that those strategies are known, why are there still school districts in America that are completely closed? There's school districts in America that have not had the resources, that have not had the mitigation strategies.
- But six feet isn't a resource issue.
- Yes, it is.
If you were to ask an administrator in a school district about how easy or hard it was to try to reopen in person this year, they'd tell you this was the hardest job they have ever had in their lives.
No, I agree with that.
But why have some succeeded in it and others seem to have failed? You have a combination of a lot of reasons.
The last administration did a really terrible job.
They politicized, as opposed to summoning the will of so many of us, to actually do what they wanted to do.
Very rarely would anybody say that Donald Trump and Randi Weingarten were on the same side of anything.
But if you actually saw what we said last year, we thought it was really important to reopen schools, reopen them safely, reopen them with the resources that we needed.
Let me ask about vaccinations.
Every state has different tiers of who gets vaccinated first.
Do you believe that teachers should be prioritized, particularly vis-a-vis other essential workers? I believe teachers should be prioritized and that if reopening schools in person is the priority that everybody says it is Folks in nursing homes went first.
Health care workers went first.
Should they be ahead of the people in the grocery store? I think that teachers should be prioritized.
Should teachers, grocery store workers, the essential workers basically be in the same bucket and get in the same line together? Or teachers should be above, below? - Teachers should be prioritized.
- I know.
But prioritized over what? There's 3 million teachers in the United States of America.
If we are saying that prioritizing in-person learning is important, the teachers and the bus drivers that are working in places that are reopening should be prioritized.
Would it be appropriate, I guess is the best way to put it, for a district to say to its teachers and other staff, other school staff, "We're gonna reopen.
We want you to come back.
But you need to be vaccinated and vaccines are available for you"? I believe in vaccination.
And the bottom line is this: We live in a very polarized America right now, one that does not discern fact from propaganda very well.
I don't think in this moment you can mandate vaccines.
- Can I ask about that? - I think you can I think you can encourage vaccination.
What I'm pleased about is that teachers are actually clamoring for it.
And a total of 75% really want it.
Let me ask though about that other 25%.
If I'm a parent, and I'm gonna send my kid back in, and my teacher's not vaccinated, and we know that adults are more likely to transmit than our children, is my kid not being put at risk by that teacher's decision and by the administration's decision to let them teach? We don't know if vaccines actually prevent transmission.
But we know you're less likely to get symptomatic, to cough, sneeze, etc.
What we know about except that this disease transmits asymptomatically.
Vaccines actually help you from getting really sick.
Should American parents, teachers, schoolchildren be confident that come September of this year that they're going back to school five days a week? There might still be mitigation strategies and masks, et cetera.
- But they're going to school? - I hope so.
4.
Righting history / three course corrections Axios headquarters ARLINGTON, VA - Hi Mikey.
- Hey Alexi.
- Thank you so much for doing this.
- Sure.
Sorry I'm not there in person.
Alexi, this summer when we had this incredible reckoning, national awakening around Black Lives Matter, something you and I talked about was, "What's really gonna change? Is this gonna last?" Well in a lot of ways this moment feels like a movement.
Certainly starting in the way folks are addressing it in their classrooms but also all the way up to the presidential level.
We have a president who has declared systemic racism as one of the four major crises facing this country.
This is an area where he has real confidence, he can make a real difference.
One place where we think we need to make those changes is in the classroom.
And, Alexi, a hot button issue that I did not see coming: The New York Times' 1619 Project.
You and I and everyone else was taught that the country was founded in 1776.
But 1619 marks the year that African slaves were first brought to Virginia.
It's forcing people to reckon with what Black history and Black enslavement really means for American history.
That's why it was aggressive to say the least when as one of President Trump's last actions he appointed a 1776 Commission on patriotic education.
Then President Biden, as one of his first acts, said, "No, this is counterfactual," abolished it.
Partisan politics are dividing yet another aspect of our lives.
And that's unfortunately even happening with our education system.
You still have Republican state lawmakers who are threatening to withdraw funding from schools and teachers who want to teach the 1619 Project lesson plan in their classrooms.
We visited some leading Black thinkers on both coasts and asked the question, "What's missing?" Not just what we missed but how can we better integrate and more seamlessly integrate the Black history education into the broader American history education experience.
Roxane Gay on teaching the realities of slavery Teachers don't necessarily know a lot about literature about the African American experience because they were educated in the same system that they're educating in.
Students who came out of my school with an understanding of systemic racism were the ones who were interested in social justice issues.
But if a student didn't have that interest, they were not going to leave the school with that sort of education.
The curriculum was never as diverse as it should have been.
I didn't know that it was a problem until I got to college and then beyond and realized, "I have this entire gap in my education.
" I really wish I had learned more about the Middle Passage in my curriculum.
The human cost and the brutality of slavery I don't think was really communicated as effectively as it could've been.
It was people being forced into the cargo holds of ships in vast numbers without adequate food, without water, without air, without light.
Thousands and thousands of people died in that passage, and so much humanity was stripped from Africans as they were brought over.
There's a clear explanation for why things are the way they are.
And if we know that, then we can start to come up with solutions to change the world.
We can draw a direct line from slavery to abolition to Black Lives Matter and police brutality.
You have to sometimes connect the dots for people because people love to say, "Slavery was so long ago," but history is so much more within reach than we could ever I think really understand.
Darren Walker on the legacy of Frederick Douglass The purpose of education in America has always been in part to advance the narrative of this country.
And the narrative of this country is a romanticized idea of our founding.
But what I was not taught was the other side of that narrative, the more dark and ominous and insidious part of our history.
And I think that was intentional.
I wish I had known Frederick Douglass.
I wish I had been introduced to him as a young boy.
He talked about what July 4th meant to him.
That July 4th did not represent independence for African Americans.
Because African Americans were still living with the legacy of slavery and the inherent contradictions and hypocrisy in the idea of Independence Day.
From Frederick Douglass to Langston Hughes to Zora Neale Hurston to James Baldwin, each of them wrote about the contradictions, the hypocrisies of this country from the perspective of their Blackness.
Now, the time has come to right history, R-I-G-H-T, so that as we go forward the history that is written reflects the real America.
Cornel West on the complexity of Martin Luther King, Jr.
My brother and I, Clifton, we were athletes.
We ran track and cross-country.
And we had a track meet.
I had taken a fourth place in the two-mile, and then they made the announcement Martin Luther King had been murdered.
Something died inside of me.
They shoot Brother Martin down, they'll shoot angels down.
And that's a frightening awakening for a young person, let alone a young Black brother in America in 1968.
When you have an exemplar of not perfection but of integrity, of honesty, of decency and someone willing to live and die not just for justice but for a love of others that cannot but be a source of spiritual and moral inspiration.
So he's always been like John Coltrane, the north star in my own sense of who I am.
Martin Luther King Jr.
was against the distractions.
He wanted substance.
He wanted content.
So it is with our curriculum, which means we have to deal with the funk, the mess, the complexity, the subtlety, the humanity of each and every one of us.
Education is really about being unsettled and unnerved and challenged.
If you've got a curriculum that's already tied into low-level schooling rather than high-quality education, even when you bring Black history in, there's not gonna be the rich complexity.
It's not gonna have the nuances and the subtleties that go hand in hand with any people's history.
We're at a pivotal moment.
And the question becomes: Which way do we go? As a people.