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TRANSCRIPT

Jane Coaston: It’s Wednesday, May 20th, I’m Jane Coaston, and this is What a Day, the show celebrating Louisiana Republican Senator Bill Cassidy’s new career as a big ol’ hater. Since he lost his primary last weekend, Cassidy has said he would vote against funding President Donald Trump’s ballroom and voted to support Democrats’ resolution to limit Trump’s war powers. Hate, hate, hate. [music breakk] On today’s show [mumbles incoherently] Oh, sorry, you couldn’t follow that? That was me trying to talk over the sound of the White House ballroom construction and Trump makes an endorsement Republicans did not ask for. But let’s start with America’s public health system and what it is and isn’t equipped to handle right now. The World Health Organization met on Tuesday in Geneva, Switzerland, to discuss a deadly outbreak of Ebola in the Democratic Republic of the Congo and Uganda. According to the WHO, the outbreak, which has killed more than 130 people and infected more than 500, could last for months. And those numbers could be much, much higher than what officials have been able to determine. Trump is also concerned about Ebola. Well, as concerned as he gets about things that don’t involve him personally. Here he is on Monday. 

[clip of unknown news journalist] Should Americans be concerned about Ebola? 

[clip of President Donald Trump] Yeah. I’m concerned about everything but certainly am. I think that you know it’s been confined right now to Africa and but it’s something that has had a breakout. 

Jane Coaston: The Ebola outbreak comes in the midst of another outbreak you’ve probably heard a lot about, hantavirus. It’s part of a family of extremely dangerous viruses that are primarily spread by rats and mice. It also infected 11 people on what became one of the worst sightseeing cruises ever. Three people died, and now many of the ship’s passengers are in quarantine. And with all this going on in public health, you might be wondering, hey, who is running the Centers for Disease Control and Prevention? And who is the Surgeon General of the United States? The answer to both? No one who has been confirmed by the Senate. So what is going on with the American public health system right now? To find out, I spoke to Apoorva Mandavilli. She’s a science and global health reporter at the New York Times. Apoorva, welcome to What a Day. 

Apoorva Mandavilli: Thanks for having me. 

Jane Coaston: Since Trump took office, the U.S. Public health apparatus has been decimated. There’s a lot of leadership missing in the CDC, including the head of the CDC. We still don’t have a surgeon general. How is the U.S. Public health system operating right now compared to two years ago? 

Apoorva Mandavilli: Not very well. They are doing okay in that the CDC does have a lot of staff scientists who’ve been there a long time, who know what they’re doing, and they can still sort of keep the ship moving, but not having a permanent head of the CDC who can lobby for the agency, who can liaise with the White House and with the Health Secretary Robert F. Kennedy Jr. That’s a real disservice to the agency and they also have lost hundreds and hundreds of employees who would be useful in certain situations like in infectious disease outbreaks. And so they are not doing as well as they could be. 

Jane Coaston: So something about the US public health system that is a little different from some other countries, it’s decentralized Can you explain quickly how all of these agencies work together and what happens when there are budget cuts or these big cuts of scientists and just missing officials? What does it look like when it’s supposed to work and what does it look like right now when it is not working well?

Apoorva Mandavilli: So I think one thing people don’t realize about the CDC is that most of the CDC’s budget actually goes immediately out the door to states and local health departments. The CDC doesn’t keep that money. And so when you cut the CDC’s budget, you’re actually cutting the budget for American’s public health services all across the country. And in fact, often it’s the red states who are really dependent on federal funding that are going to suffer the most. So I’ve spoken to officials at state health departments in places like Alabama and Mississippi who talk about how much harder it is for them to do their job because they’ve had to fire a lot of their own people because of the funding cuts that they’ve experienced. 

Jane Coaston: Of course, this is the Trump administration, so more changes to the public health system are on the way. He recently nominated new candidates for both CDC director and surgeon general. Who are they? 

Apoorva Mandavilli: Well, so we know very little about them because neither of them seems to have been particularly well known before they were nominated. Um. Nicole Saphier, who’s the current nominee for Surgeon General is a Fox News commentator, but she’s a radiologist. And when my colleagues reached out to some radiologists to ask about her, they were told that those folks had never heard of her. So she’s probably best known in her commentator role. We do know a lot about what she thinks about various things because she’s been in this role and she’s said various things about you know vaccines, about um you know Tylenol and autism, the connection that President Trump had tried to make. We know that, for example, she does seem to support some childhood vaccines and thinks that measles vaccine is important, but she also is a big proponent of the idea of you know, medical freedom and people being able to choose, at least for some vaccines, like hepatitis B, that they should be able to decide. And so she’s somewhere in the middle, I would say, seems more pro-vaccine and more into the idea of immunization on a broad scale than a lot of people that have been associated with Mr. Kennedy before. Um. 

Jane Coaston: Uh. Can you tell me a little bit about this new the potential CDC Director?

Apoorva Mandavilli: Yeah, so Erica Schwartz was a um Coast Guard in the Coast Guard for many years. She was a doctor. Again, in the public health world, no one I know seems to have heard of her. They all think she has great credentials. They’re excited about the fact that she’s an MD. She has studied you know biotechnology. She’s studied law. She seems to a very broad background. She did serve in the first Trump administration. She was in charge of some of the uh the testing during the early in the pandemic. And I’ve spoken to Trump administration officials from that term who said she was great um and that she seemed to really think very you know carefully about things and that when she didn’t think something was right, she did seem to speak up. At the same time, some public health experts I’ve talked to point out that you know she was in the military overall and that in certain circumstances, she may just be inclined to carry out orders that come from above because that’s what happens in the military in general. And so um it’s not clear exactly how she would serve. And you know she has really been a mystery to me because I know a lot of people in the public health world and to encounter someone that no one seems to have really had much interaction with is is pretty rare. 

Jane Coaston: We were talking earlier about you know what what these institutions are supposed to be doing, are supposed to look like when there’s an emergency, and we are in the midst of two potential emergencies. Over the weekend, the World Health Organization declared the outbreak of the Ebola virus in central Africa a global health emergency. It’s especially concerning because it’s a strain for which there is no treatment nor is there a vaccine. We’ve also been hearing a lot about Hantavirus, which hasn’t been a part of the global health conversation. And people are very worried. But as you know, last year Trump pulled out of the World Health Organization. How does that decision affect our ability and the world’s ability to fight global threats moving forward? 

Apoorva Mandavilli: It makes it a lot harder, not just for us, but for everybody else. So when the US withdrew from the World Health Organization, and it also rejected something called the International Health Regulations, which is this legal framework that binds countries together and obligates them to report outbreaks, so when the U.S. is not part of those things, it means that we don’t hear about outbreaks and everybody else does. To give you an example with the Hantavirus outbreak, there were officials from the world health organization, from the European CDC and from the Dutch Health Ministry on board the ship, investigating what had happened, but nobody from the CDC was there, and we didn’t find out about it and did not start our response till almost a month after the first patient had died. And everyone I talked to who has been involved in these kinds of outbreaks before talks about how when the US is in the room, they’re the leaders. They make everybody move faster. They coordinate. They make things happen and that was not the case this time. And we’re also seeing that play out with Ebola, again. May 5th is when the WHO found out. CDC has said they found out on May 14th, nine days in an outbreak that moves this quickly is just an eternity. 

Jane Coaston: Right, especially in a disease with a 50% fatality rate. Let’s set aside these global threats, which is hard to do, but we’ll do it. How would you rate the preparedness of our current public health system in America? 

Apoorva Mandavilli: We have lost a lot of the things we need to be ready for a pandemic. So when there is even a hint of a threat, we used to have several people whose entire job it was to coordinate responses. So we had somebody in the White House that a role that Congress had created. We had an entire office of pandemic preparedness that also Congress had created. Those things are not filled right now. Those are all vacant. We also don’t have a lot of the infectious disease experts that the CDC would normally have. There are fewer people that the CDC has in country offices, you know, all across the world, especially in places like Africa, who would be able to contain an outbreak or at least tell us about it very quickly if it happened. We completely lost USAID, the U.S. Agency for International Development, which funded much of the surveillance that we used to have to detect outbreaks really early. And when there was an outbreak, USAID was what would go in and coordinate and make sure that you know people had the right kind of protective gear. They had um the right kind of lab equipment. They would help pay for transport of lab samples. They would train health workers. None of that is happening right now in quite the same way. Some of it is happening because there are other organizations involved, the WHO, the European CDC. They’re trying to do their best. And even the US agencies are providing some support. But none of this is happening at the scale or the speed that we would need to really get on top of an outbreak before it becomes a pandemic.  

Jane Coaston: Apoorva, thank you so much for joining me. 

Apoorva Mandavilli: Thanks for having me. 

Jane Coaston: That was my conversation with Apoorva Mandavilli, science and global health reporter at the New York Times. Don’t worry, there is news that will not fill you with existential terror coming up. Unless you’re a big John Cornyn fan. If you like the show, make sure to subscribe, leave a five-star review on Spotify and Apple Podcasts, watch us on YouTube, and share with your friends. More to come after some ads. [music break]

[AD BREAK]

Jane Coaston: Here’s what else we’re following today. 

[sung] Headlines.

[clip of President Donald Trump] We will have to have a safe country. We have to have a great country. We have to make sure that Iran doesn’t get a nuclear weapon. All of the things that you see me fighting for so hard. 

Jane Coaston: Actually, I see you fighting for the construction of that $400 million ballroom you’re standing in front of. Shouting over the sounds of heavy equipment, Trump said he’s giving Iran just days to make progress in negotiations to avoid strikes. He said, quote, “maybe Friday, Saturday, Sunday, something, maybe early next week, a limited period of time.” Sir, you are not scheduling a brunch. Trump covered a lot of ground during that press gaggle. 

[clip of President Donald Trump] I’m going to be putting out an endorsement in a little while in Texas, the great state. 

Jane Coaston: And that he did! Trump endorsed Texas Attorney General Ken Paxton ahead of next week’s runoff in the Republican Senate primary. Trump’s endorsement puts him at odds with his party’s establishment, which pushed for incumbent Senator John Cornyn. The Republican nominee will face Democratic State Representative James Talarico. President Trump’s handpicked candidate, Ed Gallrein, defeated Kentucky Republican Representative Thomas Massie in Tuesday’s primary. Trump sought to unseat Massie after the eight-term representative broke with him on issues like the release of the Epstein files. The president, who had waged a social media campaign against Massie, posted a photo showing him and Gallrein under the words, Ed Gallrein wins, endorsed by President Trump. We’ll discuss the other winners and losers in Tuesdays primary on tomorrow’s show. More than 3,500 stock trades were made on Trump’s behalf in the first quarter, according to government filings. It’s unclear how much Trump made, but the Financial Times estimates that he made hundreds of millions of dollars. Here’s what Maryland Democratic Senator Chris Van Hollen told What a Day when asked about the trades. 

[clip of Senator Chris Van Hollen] This is by far the most corrupt administration in American history. I mean, Donald Trump has literally turned the White House into a pay-to-play casino. And in this latest example, he is making critical decisions that will have a direct impact on the value of the stocks he’s selling. And this is the most blatant example of conflict of interest. That’s putting it very mildly. 

Jane Coaston: There’s currently bipartisan support in Congress to ban stock trading for members of Congress and the president. We’ll see how that goes. 

[clip of Senator Chris Van Hollen] Mr. Attorney General, let me ask you this, are there going to be rules that say that if you’ve assaulted a Capitol Hill police officer or committed a violent crime, you will not be eligible? Why not make that a rule? 

[clip of Attorney General Todd Blanche] I expect that, well, because I’m not one of the commissioners setting up the rules, I expect there will be rules set up. 

[clip of Senator Chris Van Hollen] You’re appointing four of the five members, aren’t you, Mr. Attorney General? 

[clip of Attorney General Todd Blanche] Pardon me? 

Jane Coaston: He’s actually appointing all five members. That was Senator Van Hollen during a Senate Appropriations hearing on Tuesday. He asked Acting Attorney General Todd Blanche some fun questions about Trump’s $1.776 billion anti-weaponization slush fund. During the hearing, Democrats and Republicans both expressed concerns about the obvious pitfalls of a MAGA slush-fund. And it turns out, giving more than a billion dollars to Trump’s backers and allies who claim the Department of Justice has been, quote, “weaponized against them,” isn’t even going over well with conservatives. Both the Wall Street Journal editorial board and the National Review came out against the fund on Tuesday. A judge has ruled that federal agents can no longer make arrests in and around three Manhattan buildings where immigration proceedings occur. The decision on Monday brings an abrupt halt to a Trump administration practice that enabled agents to take into custody people who follow requirements to appear before immigration judges. And that’s the news. [music break]

[AD BREAK]

Jane Coaston: That’s all for today. If you like the show, make sure to subscribe, leave a review, listen to these University of Central Florida students booing their commencement speaker after she praised AI, and tell your friends to listen. 

[clip of Gloria Caulfield] The rise of Artificial Intelligence is the next industrial revolution. [sound of crowd booing]

Jane Coaston: And if you’re into reading, and not just about how a number of universities have had commencement speakers who bring up AI and AI technologies get heavily booed by graduates like me, What a Day is also a nightly newsletter. Check it out and subscribe at Crooked.com/subscribe. I’m Jane Coaston, and when you’re talking to young people you’ve been telling for the last five or so years that AI would destroy their jobs, are you really surprised when they don’t like that? Weird. [music break] What a Day is a production of Crooked Media. Our show is produced by Caitlin Plummer, Emily Fohr, Erica Morrison, and Adriene Hill. Our team includes Hayley Jones, Greg Walters, Matt Berg, Joseph Dutra, Johanna Case, and Desmond Taylor. Our music is by Kyle Murdock and Jordan Cantor. We had help today from the Associated Press. Our production staff is proudly unionized with the Writers Guild of America East.