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May 17, 2021
What A Day
What To Know About The New CDC Guidance with Dr. Abdul El-Sayed

In This Episode

  • Since the Centers for Disease Control announced their new relaxed guidance for mask-wearing for vaccinated people, there have been numerous questions about what was behind the decision, how it will affect mask hesitancy, how businesses will respond, and more. To discuss these questions, we’re joined by Dr. Abdul El-Sayed, an epidemiologist, physician, and former health commissioner of Detroit.
  • And in headlines: Israel conducts its deadliest airstrike in Gaza, a California gubernatorial candidate is tight with a bear, and a tiger that was at large in Houston has been found.

 

Transcript

 

Gideon Resnick: It’s Monday, May 17th.

 

Dr. Abdul El-Sayed: I’m Dr. Abdul El-Sayed in for Akilah Hughes.

 

Gideon Resnick: And I’m Gideon Resnick, and this is What A Day where we hope the IRS accepts tax returns that are written in crayon.

 

Dr. Abdul El-Sayed: I just stole one of my daughter’s scented magic markers—cinnamon—to mix things up.

 

Gideon Resnick: Yeah, you know, they have boring jobs and we want to give them a treat—that’s, that’s just what it is. On today’s show, Dr. Abdul El-Sayed joins us yet again. It is always a pleasure to have you, my friend. Welcome back.

 

Dr. Abdul El-Sayed: The privilege is always mine. And I have to say, now that I’ve done this two weeks in a row on Mondays, I just feel like Monday’s my day. And, you know, I know the folks would rather listen to Akilah, but like, you know, I feel like I, you know, Monday’s mine. And Akilah we can we can have a whole conversation about it.

 

Gideon Resnick: I’m not wading into this fight, but I look forward to its resolution peacefully, obviously. He is an epidemiologist, physician and former Detroit health commissioner, as you know. Plus, he’s the host of America Dissected, where the latest episode is actually all about the CDC’s new relaxation on mask wearing for vaccinated people. So let’s get right into that. Were you expecting an announcement like this from the CDC at this point in the vaccination campaign?

 

Dr. Abdul El-Sayed: Gideon, when I tell you that nobody, and I mean nobody saw this coming, I am not exaggerating. Just last week, in fact, Dr. Fauci was talking about people having to wear masks regularly every winter. So we went from seasonal masking, to no masking. And so that’s about as big of an about face as you’ll ever see from an institution like the CDC.

 

Gideon Resnick: Yeah, I’m glad I wasn’t the only one that was sort of caught off guard by it. And to that point, CDC Director Dr. Rochelle Walensky reportedly approved of this decision to actually update the guidance before the announcement that we all got, and before her testimony to the Senate. She tried to address how this all came to be on the Sunday shows yesterday. And here she is on ABC’s This Week, talking about the recent science from the past two weeks on the effectiveness of the vaccine.

 

[clip of CDC Director Rochelle Walensky] Some of that science was really evolving as late as last Thursday. And one of the public, one of the papers, the largest paper, was published from the CDC just the day before yesterday. So we were actively reviewing that science during the past week. We were making decisions and moving, and our subject matter experts were working just as I was testifying in front of Congress. And those, that was what was happening. I told the American people I’d deliver the science as soon as we had it.

 

Gideon Resnick: So to that point, what do you think of how this all came to be?

 

Dr. Abdul El-Sayed: Well, to Dr. Walensky point, the paper that she’s referencing is a 33-site study that was published on Friday actually, the day after these new guidelines had been, had been issued. And it is new science, but the evidence had been accumulating for some time. And I’ll be honest, it’s kind of just the latest in a series of communication missteps around how we get the science out into the public. And communicating science is really hard. And sometimes the thing about it is that new science can come out that fundamentally changes our directions. But because of the fact that this has been an accumulating consensus with time, I would have loved to see some foreshadowing from the CDC. In particular, given that they had been really slow to meet the science in this moment, and so to go from where we had been just a week ago, to where we are now, when the speed that we’ve had it, without any foreshadowing, I think it’s caused a lot of whiplash for folks and it tends to shake a bit of trust in the institutions that people need most right now.

 

Gideon Resnick: Yeah, I think whiplash is a great word for everything in the last couple of days. And, you know, all the federal health officials are saying there was no outside pressure that was involved. We understand that this was based on the science that they had, as Walensky was describing as you were just talking about, but are they not under any kind of pressure to provide more incentives to get people vaccinated at this point?

 

Dr. Abdul El-Sayed: You’re absolutely right. The evidence has been on its way for some time. And this decision from the CDC is certainly evidence-driven. At the same time, there’s a much wider berth for policy than the evidence itself. Right? One—two experts can look at the same evidence and come to very different policy recommendations from that evidence. And what you’re seeing here is the CDC moving from a very conservative approach to the evidence, to really going all the way in terms of engaging with the degree to which you are stripping down the kinds of pandemic-related protections that we’ve all become very accustomed to over the past year and a half. That being said, the point that you made about incentives is really critical. The biggest, most challenging problem in public health right now is how do you get the vaccine holdouts to finally decide to go on and get vaccinated.

 

Gideon Resnick: Right.

 

Dr. Abdul El-Sayed: And this is about creating an incentive for those folks. If they can go maskless, well, then they may have an incentive to do that. And I think the part that’s not being said here, is that while the CDC is not going to be engaging in any vaccine verification, because they have created this step where only vaccinated people are allowed to go maskless, there has to be some sort of vaccine verification. And I think relying upon a lot of private institutions, whether it’s an employer or a restaurant or a theme park or an event that you might want to go to—those, they’re riding on those institutions to start putting up vaccine verification barriers for people who are choosing to go unvaccinated, and that those institutions collectively are going to be putting forward that incentive. But of course, it could backfire.

 

Gideon Resnick: Yeah, yeah, you’re a 100% right. And we started to see a little bit of what the response looked like to this. So a number of major retailers like Walmart began dropping mass mandates based on a sort of honor system, I guess that’s how it’s going to be there. Others are sort of on the fence, or they’re keeping their mandates for now. What is the impact of that, if there are just different sets of rules in different kinds of settings for people?

 

Dr. Abdul El-Sayed: Well, Gideon, this is exactly how these kinds of policies can backfire. Let’s not forget, there are a lot of people who still can’t be vaccinated. I think about my own daughter. She’s three years old. And we went out to an outdoor market over the weekend and I had to sit down with her and tell her, look, I know in the past everybody’s been masking, but, you know, there are going to be a lot of people who are not wearing their masks because they’ve had vaccines. And she said, well, I’ve had a shot. And you’re like: well, you haven’t had a shot for this.

 

Gideon Resnick: right.

 

Dr. Abdul El-Sayed: And it reminds you that there are people who can’t get these vaccines and we have a responsibility to protect them. And so if you are going by the honor system, it does create a circumstance where you have people who may be transmitting this virus because they are unvaccinated, circling among other folks who who are also unvaccinated, and that can create a real problem. And so it really is critical that we think about folks who remain unvaccinated or for whom the vaccines are not yet approved, or for whom the vaccines are just not as effective because they may have immunodeficiencies for other reasons. And I think that we have a responsibility to make sure that we are following these kinds of CDC guidelines that may create space for transmission, following them to the tee, at least.

 

Gideon Resnick: Yeah, and let’s just get to the brass tacks here. Abdul, you are vaccinated, what are you going to be doing about wearing a mask yourself? Like, walk me through a couple of different scenarios.

 

Dr. Abdul El-Sayed: Yeah. So let’s say I’m not with my three year old daughter for whom I’m trying to model good behavior. If I’m outdoors, I’m going to go without my mask. There’s really good evidence that has achieved consensus at this point that the risk of getting a transmission, particularly if you’re vaccinated, outdoors, is minimal. Indoors I would likely still be wearing my mask just because I think it is important to sustain that norm right now, simply because in a lot of communities, the vaccination rates are still quite low, and out of respect for people who need to wear their mask. And because I know that there are folks who are going to try and bully folks who continue to wear their mask indoors. Now, if I’m with my daughter, I’m probably going to be wearing a mask in all the places that she needs to wear a mask. I think I’d be a little bit more comfortable if we were outdoors. I’d be less comfortable if we are in a really, really busy, bustling space. And if I’m going to ask her to wear her mask, I’m going to wear my mask just because I think that’s what being a good dad is about.

 

Gideon Resnick: Yeah, that is great advice, I think, for everybody to sort of figure out what they are doing in their daily lives. And this is all part of a conversation about, you know, how officials have communicated guidance during the pandemic. And this also came up in tomorrow’s new episode of America Dissected as well, where you interviewed Dr. Sanjay Gupta. So let’s listen to a clip from that.

 

[clip of Dr. Sanjay Gupta] Dr. Fauci actually pointed this out to me, there was some poll that was done that he was a bit disheartened by, but I thought it was instructive. And the poll basically said that the general public is increasingly finding medical people, scientists, arrogant, increasingly arrogant. Which I thought was a, again disheartening but an important note. What does being open to letting people in on the process and saying: we’re not sure yet, but we’re going to act cautious here. What does that do? It’s less didactic, but also perhaps less arrogant. And fundamentally, I think people do appreciate that.

 

Gideon Resnick: Yeah, I think that’s exactly right. So Abdul, what do you think medical professionals should learn about how to talk to patients and the public during a pandemic like this?

 

Dr. Abdul El-Sayed: You know, I think in the past there was a difference in the way that we would speak to patients or loved ones, and the way we’d speak to the public. And I think the pandemic has taught us that, in fact, we have to speak one and the same way to the public as we speak with our patients and our loved ones. And I think there is an approach when you’re listening to a human being who you can look in the eyes that forces you to acknowledge where that person is coming from, and try and meet them where they are to bring them to where you hope that they can come for what’s good for their health.

 

Gideon Resnick: Right.

 

Dr. Abdul El-Sayed: And I think sometimes when it came to the public, we just assumed that there was a certain level of authority that medical professionals had to speak on these things without taking the time to empathize and appreciate where people are. And I think this moment has really changed that, and I think for the better. And I hope that we’re no longer sort of speaking down to people from a place of authority, assuming that, you know, we know best—but rather trying to take the time to listen, understand, and reason with folks and, you know, in sort of open the situation up and help them to make great decisions for themselves by not just telling them what the answer is, but showing them how the answer came about.

 

Gideon Resnick: Yeah, I hope that that is a lesson that’s taken from this. And on a slightly different note, one last thing to talk about in the global fight against COVID, it’s become an issue when it comes to Israel and Palestine. UN officials have warned that the airstrikes on Gaza could actually worsen the pandemic there, as vaccinations and testing slow or halt entirely. So this is a lot to cover, but can you talk about these two crises overlapping?

 

Dr. Abdul El-Sayed: You know, one of the things that we just spent the better part of ten minutes talking about, is how our behaviors affect other people and how their behaviors affect us. And one of the things I hope that we recognize from this pandemic is how interconnected we are. This is a global pandemic. And public health is all about the setup. It’s all about the infrastructure. And when those things are lost or worse, destroyed, it has serious implications for people. And I think the underlying issue here is the dehumanization of people that allows other people to destroy that infrastructure that’s so critical to their health. And it’s sad to see that happening right now in Gaza, but we’ve also seen that before, right? This isn’t the first time we saw that kind of dehumanization by the Israeli government in the decision to vaccinate the public there was a decision not to vaccinate occupied territories.

 

Gideon Resnick: Right.

 

Dr. Abdul El-Sayed: And per international law, there’s a responsibility to provide medical care. And per all of our agreed upon morals, it’s absolutely critical to provide people the means of being able to protect themselves from a global pandemic. But that decision was made, and kept people from getting the vaccines that they so sorely needed. And now in the context of these bombings, we’re seeing the destruction of that same infrastructure that is catching up to be able to vaccinate folks. And so it really reminds us that we have to be in this together, and that core, these morals that allow us to see one another as human beings and to respect the needs that we all share, I think have to be remembered in these moments. Because if not, it doesn’t just hurt the people who are forgetting about it, it hurts us all.

 

Gideon Resnick: Yeah, I think that’s exactly right. Again, always a pleasure to talk to you, you know, we know and love America Dissected, but where else can people find what you are up to? You are up to a lot, my friend.

 

Dr. Abdul El-Sayed: Well, I appreciate that. And it’s always a privilege to be with you. I hope folks will check out my newsletter, The Incision. It’s at Incision.substack.com. I’ll be writing a little bit more about the CDC’s new guidelines in my post on Tuesday. So I hope folks will check it out.

 

Gideon Resnick: Yeah, we will link to it in our show notes. But that is the latest for now.

 

Gideon Resnick: It’s Monday, WAD squad, and for today’s temp check, we are talking about drinking ale for the good of the country. So an English finance firm just published estimates of how much beer every UK resident would need to drink this year to make up for huge pandemic related losses of income among pubs. Here are the mind boggling stats: so each person would have to drink 124 pints of beer or 122 glasses of wine. Alternatively, British people who don’t drink alcohol could eat 976 packets of crisps—aka potato chips for us Americans—or 40 roast dinners. So Abdul, obviously this is an important cause. If you lived in England, how would you choose to fulfill your patriotic duty?

 

Dr. Abdul El-Sayed: Well, I am an epidemiologist and I did do my graduate education in England. And I have to tell you, roast dinner is fantastic. So I would take the roast dinners. There’s this thing called Yorkshire puddings, which are, by the way, not puddings and not pronounced “York-Shire” which I learned based on the look that my English hosts shot me the first time I got to have a roast dinner. But they’re like these little cups made out of Philadelphia dough and they’re filled with gravy, and they’re, they’re delightful.

 

Gideon Resnick: Ooooh.

 

Dr. Abdul El-Sayed: So I’m picking the roast dinners. And if you play it out over a year, right, that’s like, that’s like two out of three weekends, you’re getting a roast dinner.

 

Gideon Resnick: Yeah.

 

Dr. Abdul El-Sayed: So I just think that sounds lovely. And, you know, on top of that, I’m sort of a tee-totaling Muslim guy so the pints and the glasses of wine are sort of off the table, so, you know what? I’m having my roast dinner. How about you?

 

Gideon Resnick: I respect the hell out of that choice and the lovely description of the dinner. I saw a picture of this on the Wikipedia page. They did not use the nicest picture that they could have for this dinner. It was, the beef was looking a little lackluster. So I really, I the, I’ve maybe, I’ve maybe had my mind changed by that response. I was going to say the crisps because I think I want the challenge aspect of this, right, and 976 is an absurd amount of anything. That would be—my math is really bad—but we’re talking between two and three bags a day. So I like the challenge aspect of that myself. I haven’t really thought about the consequences of what would happen afterwards. But if I were going to go for the sensible option here, I think it is the roast dinners. So I might be seeing you a dinner, is what I’m saying.

 

Dr. Abdul El-Sayed: Hey, you know, I would love to have that roast dinner with

 

Gideon Resnick: UK, invite us in to eat all of your roast dinners, please. We will not disappoint you. But just like that, we’ve checked our temps. Stay safe, meet the challenges of the local economy where you live responsibly I guess, [laughs] and we’ll be back after some ads.

 

[ad break]

 

Gideon Resnick: Let’s wrap up with some headlines.

 

[sung] Headlines.

 

Gideon Resnick: Israel conducted its deadliest airstrike in Gaza over the weekend as international pressure for a ceasefire continues to grow. At least 42 Palestinians were killed on Sunday, the highest single-day death toll in Gaza since the violence began last week. The Executive Editor of the Associated Press is calling for an independent investigation after Israel bombed a 12-story tower home to the AP, Al-Jazeera and other foreign news organizations. Israeli Prime Minister Benjamin Netanyahu defended the bombing on CBS’s Face the Nation, claiming that the building housed Hamas operations without providing extra details or evidence. President Biden spoke with Netanyahu and Palestinian National Authority President Mahmoud Abbas over the weekend, reportedly reaffirming his support for Israel. The United States ambassador for the UN said the U.S. was prepared to support a ceasefire if both parties seek it.

 

Dr. Abdul El-Sayed: This is the time that we need American leadership.

 

Gideon Resnick: Yes.

 

Dr. Abdul El-Sayed: And I’d love to see some real leadership out of the administration. Following up with the failed unionization vote at the Amazon warehouse in Bessemer, Alabama this year, employees are now alleging that the company had access to a mailbox where they were encouraged to cast their ballots. At a hearing before the National Labor Relations Board last Friday, a warehouse worker testified that he and others saw Amazon security guards unlocking and going through the mailbox multiple times. It’s possible that they were just looking for Valentine’s. But either way it looks bad. Amazon has claimed that only USPS could access the box. Union leaders criticized the company for pushing to install the mailbox on site, accusing Amazon of using it to surveil workers and implied that the company controlled the mechanics of the election. Amazon is set to testify before the NLRB next week to counter accusations that it illegally interfered with the vote.

 

Gideon Resnick: And I’m sure they will be on the up and up. In California, the gubernatorial recall election for Gavin Newsom is delivering on its promise of California-sized hijinks, with one Republican businessman running as the guy who shows up to events with a live bear. Here’s one campaign ad from John Cox based on his campaign’s general theme of wild animals:

 

[John Cox political ad] We need beastly changes in Sacramento. I’ll make them. Recall the beauty. Meet the nicest, smartest beast in California: John Cox.

 

Gideon Resnick: OK, totally normal stuff there. You did hear a 1,000-pound bear roaring in that clip, but what you missed was the visual of Cox strolling next to it and at one point kissing it. Well, after appearing with his captive bear friend at an event in San Diego last week, Cox is under investigation by the city’s Humane Society. They say he may have violated a law that bars individuals from bringing into the city, quote “any lion, tiger, bear, monkey, wolf, cougar, ocelot, wildcat, skunk.” Now, obviously, this is a law liberals created to keep John Cox and/or Ace Ventura from winning elections. Also in funny governor news, Politico reported over the weekend that Matthew McConaughey has been calling influential Texans to discuss his potential run against Governor Greg Abbott in 2022. This despite the fact that he has no known party affiliation, though he did once described himself as a, quote “radical centrist” which, as we know, translates to a hardcore Republican who’s also a celebrity.

 

Dr. Abdul El-Sayed: It’s all about the bare necessities Gideon.

 

Gideon Resnick: [chuckles]

 

Dr. Abdul El-Sayed: Staying on the topic of Texas and also apex predators, a 9-month old tiger that was seen early last week on the streets of Houston has been found and brought to an animal sanctuary. Residents of a Houston neighborhood recorded the tiger facing off with an off-duty police officer. Then the mystery deepened when a man named Victor Cuevas came out of his house, loaded the tiger into his jeep and drove away—presumably to go run for governor of California. The tiger remained at large even after Cuevas was arrested days later on an unrelated murder charge. Unfortunately, he is not one of the good tiger kings. Then on Saturday, the tiger was anonymously delivered to the police with the help of Victor Cuevas’ wife. Details remain murky on whether the Cuevas family actually owns the tiger, but they did care for him since birth so it’s safe to say he’ll remember them always and one day will return to defend them against an even bigger, scarier animal—probably the bear from California. In his new home at a Texas shelter, the tiger will quarantine for 30 days and then may be introduced to other tigers, maskless.

 

Gideon Resnick: Yeah, let him smile at his tiger friends. He deserves it after all of this. And those are the headlines.

 

Gideon Resnick: One more thing before we go: join Crooked’s political director, Shaniqua McClendon, today at 5:00 p.m. Pacific, 8:00 p.m. Eastern, for an exciting virtual town hall with Senator Jeff Merkley and Senator Elizabeth Warren. They will discuss how they’re fighting to end the filibuster and protect our democracy. To watch, go to Facebook.com/crookedmedia.

 

Gideon Resnick: That is, if you like the show, make sure you subscribe, leave a review, leave a wild animal alone, and tell your friends to listen.

 

Dr. Abdul El-Sayed: And if you are in to reading, and not just the nonfiction book Greenlights by Matthew McConaughey like me, What A Day is also a nightly newsletter. Check it out and subscribe at Crooked.com/subscribe. I’m Abdul El-Sayed.

 

Gideon Resnick: I’m Gideon Resnick.

 

[together] And good luck with your roast dinners!

 

Dr. Abdul El-Sayed: Remember Yorkshur, Yorkshur—not York-Shire. It’s also Less-tur (Leicester), not Lie-cest-tur. These are all hard-earned pronunciations.

 

Gideon Resnick: Yeah, you’ve been through a lot to, to get here

 

Dr. Abdul El-Sayed: And all of my friends in the UK: it’s not Ab-dull, it’s Ab-dool.

 

Akilah Hughes What A Day is a production of Crooked Media.

 

Gideon Resnick: It’s recorded and mixed by Charlotte Landes.

 

Akilah Hughes Sonia Htoon and Jazzi Marine are our associate producers.

 

Gideon Resnick: Our head writer is Jon Millstein, and our executive producers are Leo Duran, Akilah Hughes and me.

 

Akilah Hughes Our theme music is by Colin Gilliard and Kashaka.

 

What A Day