Dr. Céline Gounder

you can have differences of opinion as to whether you should mandate masking or vaccination or whether schools should be closed in the context of a pandemic. But you should start at least with a common understanding of what the science is. What we saw, Jay Bhattacharya, who's nominated to head the NIH,

you can have differences of opinion as to whether you should mandate masking or vaccination or whether schools should be closed in the context of a pandemic. But you should start at least with a common understanding of what the science is. What we saw, Jay Bhattacharya, who's nominated to head the NIH,

And some of his colleagues, Marty Macri, who's now nominated to run the FDA, they came up with estimates of what they thought the infection and death rates for COVID, their estimates were really flawed and very small compared to, very low compared to what actually played out.

And some of his colleagues, Marty Macri, who's now nominated to run the FDA, they came up with estimates of what they thought the infection and death rates for COVID, their estimates were really flawed and very small compared to, very low compared to what actually played out.

And so we do need to start with people who understand how to make these estimates, who understand how to advise us and say, you know, these are the trade-offs. You with your values, your politics, your partisanship may make different choices, but at least start with that basic level of understanding.

And so we do need to start with people who understand how to make these estimates, who understand how to advise us and say, you know, these are the trade-offs. You with your values, your politics, your partisanship may make different choices, but at least start with that basic level of understanding.

And I think that's also what's scary because we may have another pandemic on our hands before too long. Unfortunately, we in this country have not been managing the H5N1, bird flu situation as well as we could. And that is putting us at risk for a pandemic sooner than later. So these questions are really quite pressing and imminent.

And I think that's also what's scary because we may have another pandemic on our hands before too long. Unfortunately, we in this country have not been managing the H5N1, bird flu situation as well as we could. And that is putting us at risk for a pandemic sooner than later. So these questions are really quite pressing and imminent.

Well, one of the things that I think was made very clear during the COVID pandemic is we've very much underinvested in public health. Some of the areas of real need are our data systems. When we were dealing with public health departments faxing their data into the CDC, to Debbie Birx's team at the White House, that is not something where you can get real-time data, quality data,

Well, one of the things that I think was made very clear during the COVID pandemic is we've very much underinvested in public health. Some of the areas of real need are our data systems. When we were dealing with public health departments faxing their data into the CDC, to Debbie Birx's team at the White House, that is not something where you can get real-time data, quality data,

Part of the challenge here is, and this is something a lot of people don't understand still, is that public health powers reside at the state level. There's only so much the federal government can do. Yes, the federal government provides funding, technical expertise, advice, guidelines, but they're not the ones actually that institute mandates, requirements, or do the boots on the ground work.

Part of the challenge here is, and this is something a lot of people don't understand still, is that public health powers reside at the state level. There's only so much the federal government can do. Yes, the federal government provides funding, technical expertise, advice, guidelines, but they're not the ones actually that institute mandates, requirements, or do the boots on the ground work.

And so this creates issues in terms of how well health departments are funded at the state level. Do they have the capacity and funding from their state legislatures to do what's needed, including the data modernization issues? And then do they report that to the CDC? So they can choose not to report. They can choose to report only certain things.

And so this creates issues in terms of how well health departments are funded at the state level. Do they have the capacity and funding from their state legislatures to do what's needed, including the data modernization issues? And then do they report that to the CDC? So they can choose not to report. They can choose to report only certain things.

The CDC has some levers it can use, tying some of that reporting to funding. But in general, they're not usually too aggressive with that because of the potential harms of withholding funding.

The CDC has some levers it can use, tying some of that reporting to funding. But in general, they're not usually too aggressive with that because of the potential harms of withholding funding.

Yeah, so the Constitution does not provide public health powers to the federal government. Again, the federal government has the right to tax and spend, to regulate interstate commerce. But that's really the limits on federal powers. And all of the other federal powers really derive from those, too. So if you're somebody who's concerned about public health,

Yeah, so the Constitution does not provide public health powers to the federal government. Again, the federal government has the right to tax and spend, to regulate interstate commerce. But that's really the limits on federal powers. And all of the other federal powers really derive from those, too. So if you're somebody who's concerned about public health,

Yes, you should pay attention to national politics, but it really is at the state level and to some degree the local level that you can have the most impact. So that's where I would say pay attention to what's happening in the state legislature, what your local health department is doing. At the state level, we've seen increasingly public health powers eroded.

Yes, you should pay attention to national politics, but it really is at the state level and to some degree the local level that you can have the most impact. So that's where I would say pay attention to what's happening in the state legislature, what your local health department is doing. At the state level, we've seen increasingly public health powers eroded.