Hi, everyone, I'm Katie Kuric, and this is next question. I recently had a conversation over zoom with CDC director Dr Rochelle Willinski. Now, I know everyone out there has COVID fatigue, duh, and you're probably really sick of even hearing about it. But the scary fact is almost people are still dying of COVID every day. So when is our long national, really international nightmare going to end? What is the state of play? Right now? That's how I began our conversation, right, So, first of all, I recognize everyone's tired. I recognize everybody wants to be out of this. I certainly want to be out of this, and and I'm with everyone. I'm in that if we sort of look at where we are today, UM cases are coming down from om Coon. They have been at record highs, but those cases are coming down, and they're coming down almost as swiftly as they went up. UM. Certainly, if we look at individual cities, we've seen them come down. As a lagging indicator, we have seen hospitalizations high, but those two are starting to come down. And then finally that our death rates UM are high, UM higher than we had seen in some other peaks UM, so around twenty three hundred a day. UM. So that is where we are right now. I certainly don't like to see our death counts as high as they are. Those continue to be tragic um with every single family they they touch. What I can't say though, is over time we have now are mounting more and more immunity in the population, the substrate of the population. As we get more and more people vaccinated, more and more people boosted, and people who are encountering disease who will get some background immunity from that. We have now background immunity, more background immunity in the population. And we also have a lot more tools than we used to. If you think, you know, you say year three in this pandemic, and that's where we are. But we also now have vaccines, we have a menu of therapeutics, we have more testing options, and so we're working now to you best utilize those tools in the context of what may lie ahead. You know, I get confused because we keep hearing that the omicron variant is less legal and yet, as you mentioned, twenty three hundred deaths a day, and that's the highest in nearly a year. So can you just explain how those two ideas can coexist. Yeah. I think that's a really important question. So milder does not mean mild, and I think mild can come in two different kinds of ways. For every single person that gets sick, if you were to get sick with O macron compared to delta, you might be less likely to end up in the hospital. However, or if we have three or four times the number of cases because of how transmissible OH macron is, we still end up with lots of people in the hospital and again lots of deaths. So it is this interplay between the absolute number of cases that you have and that each case for case may be less lethal, but because we have so many more, we still have challenges both in our hospitals and with our deaths. I know there have been breakthrough cases, but does the vaccine still seem to protect people from severe illness? And can you quantify the percentage of deaths from OH macron among the vaccinated population. Yeah. So here, here's what we know is that because of O macron two things have happened. One, you need more protection, more immune protection from O macron then you have with prior variants. And to just when O macron hit many people who have been previously vaccinated with their primary series, we're starting to wane in that protection, So people who are more than six months out of their primary series might have protection in the fifty pcent range in terms of severe disease presenting to an emergency department. However, with that booster shot, we can bolster that protection from that fifty to fifty five range all the way up to eight with that booster shot, which is why right now we're really encouraging people to get boosted. Here's what we know about what's in the hospital. The vast majority of people who are in the hospital continue to be people who are unvaccinated. We're also seeing people who are in the hospital who might have been vaccinated, but either they were vaccinated and not boosted, or they are people who might be less likely to have mounted a really good immune response to the vaccine, people who are older, people who are more immuno compromised. Latest data from the CDC on Friday demonstrated you are sixty eight times more likely to die from O. Macron um compared if you're unvaccinated compared to if you're boosted. Dr Lyndsky this may sound like a selfish question, but I think a lot of people maybe in my boat. I'm sixty five, I was boosted in November. Am I going to need a second booster or a fourth shot? Yeah? Right now, those data are really starting to emerge in terms of waning from your booster dose. UM. Certainly, we've seen in some countries Israel, for the most part, have been starting to think about and have been boosting their UM. They're older populations, they're more vulnerable populations. We haven't yet seen a lot of data on the waning protection from boosters in the context of Oh Macron, and those data are just forthcoming right now from the c d C. We are not recommending yet a boost an other booster dose. I know that you say milder doesn't necessarily mean mild yet. In an open letter to Governor Newsom for UCSF, doctors including the Director of COVID Response, are calling on state leaders to acknowledge the transition of COVID to an endemic disease and lift most masking policies for school aged children. What's your response to that? Yeah, Um, well, I'll go back to we all want to be in a place where we are not living in a crisis situation. In my mind, one of the places we have to look out first is how are our hospitals doing. Um. Can our hospitals take care of not just the COVID patients that are in there, but can they manage the routine medical care that should that comes in every single day? Our motor vehicle accidents, are our heart attacks, are strokes? And how are they doing? Because that is one of the indicators, a barometer, if you will, that I look at to a can we start um getting back out of this crisis mode? And I would say all of us are looking forward to that and want to sort of get to that place, But in so many parts of the country we are not there yet. We are still seeing hospital capacities that are overwhelmed and not able to do so. And so that is a place that we all want to be and that we're all aiming for, preparing for, and yet we're not there quite yet. Let's shoun there be certain regulations or recommendations or restrictions depending on the region you're living in and the circumstances that are happening in that area. Absolutely, and in fact, we do at CDC have a map stratified by county. Actually, that looks at how every individual county is doing in terms of cases per hundred thousand. We look at both hospitalizations as well as death counts, and right now those cases are still across the country um over every county, nearly every county in the country is read. It is those cases that actually help us inform when people can and should be able to take off their masks um And so we do do that at the jurisdictional level because as you know very much, many of these is we're a very big country. We're uneven with regard to how our cases are, how our vaccination rates are, how our hospitals are doing. But right now I will remind people, you know, O Macron hit us with a lot of cases, and so right now we're not quite ready to do that more with Dr Rochelle Willinsky in just a moment, I'm almost afraid to ask this, but an Overcrons sub variant b A two has already been found in nearly fifty countries. So what do we know about this variant? How concerned should we be? Right? Really important questions? So be a too is what they call a sub lineage A sister of m B A one, which is the most prominent UM O macron sublineage we have, so most of what we have here in the United States, over ninety point five percent of all macron is O macron, and the large majority of that, the vast majority of that is the B A one sublineage. UM. Now we started to dedect this be a too sublineage. We have seen it in some areas UM in Denmark and in UM in the UK, well Denmark and India, where it's become more dominant. In the UK it's still less than one percent. We're starting to learn more and more about it. We haven't yet seen any more severe disease from it, and it does look like our current vaccines will work about as well as they did as they do against the O macron itself. It might be a little bit more transmissible, which may be the reason we're seeing more and more of it in certain countries. Here in the United States. We've detected it, we've actually known about it here in the United States since mid December. We haven't yet seen it ratchet up in terms of seeing more and more of it. We have a handful of cases here and we're continuing to follow it very carefully. So this one doesn't seem to be of grave concerned. I mean, how worried are you, Dr Wilynsky? Every day you're going to hear about a much more serious variant. I don't need to be a DEBBI downer, but are we going to have to be on a constant state of alert that that an even deadlier variant maybe right around the corner. So that is our job is to be on a constant state of alert. That's our job at CDC. But really I think the important thing is to be alert and prepared and not yet necessarily to panic, right because we know that our vaccines right now it looks like are working against oh Macron, not quite as well as they did against um against Delta, but they are working well, especially if you get boosted. And our job is to follow these variants. We do know as long as we have circulating virus, we have the potential for variants. But what the long term goal is is to be able to manage these variants and to not have a crisis every time we have a variant, but to be able to live in the context of the potential variants that might emerge, and that means that our testing is working, our therapeutics are working, and our vaccines are continually working and up to date. So will this be the new normal something we just live with and manage with annual shots that hopefully can combat whatever strain comes along. Um. I don't want to pretend that I'm content with where we are right now as being a new normal. We are coming down from a pretty robust surge, and so that I don't think is a new normal place. I envision a new normal place UM where our hospitals can manage, where our workforce is back, UM, where we might have to combat many surges, um, but that we have the tools, the tests, that therapeutics, the vaccines that work. Jury is still out as to whether and how often we will need to have those vaccines. It may be that we need them annually. It maybe just like you roll up your sleep for your flu shot every year, you roll up your sleep for your COVID shot every year. And we still have more science to learn from in order to see if that's where we're going to be. Even if it's endemic, it could still be quite dangerous. Yeah. UM, what I would say is I would like to be in a place where we are endemic at relatively low rates of disease, where we have low rates of disease, high rates of vaccination, high rates of protection, and certainly low level of death. I also want to remind people that even with a vaccination, even for those um, even with vaccination, we have the capacity. Now we have new therapeutics and and even more science that continues to evolve, and some of those therapeutics can also, as I say, take the fangs out of this and really lead to less severe disease. So we have a lot of tools in the toolbox and working now to scale those up to make sure that everyone has access to them. Children under five still aren't able to get the vaccine, as you know, and I get this question constantly on social media. When will we see that approved? And does that give you pause? It all the idea of vaccinating children under five. You know the companies are working towards the timeline for children under five. I can't tell you exactly when that will be with a date certain, and I know parents are really anxious. Um when it happens through the f d A process through to the c d C process, I can tell you, Um, it won't happen with me at the helmet CDC unless all of that due diligence is done such that I would be comfortable allvaccinating any child that I would have that's under the age of five, so that I can that I can say. What I can say is we really need to work to vaccinate all those who are around our children under five, because we have seen time and time again that in households where you have two and three people vaccinated, you surround them, you you cocoon children under five um that they are less likely to get disease. And right now, you know, we have about fifty two per cent of our teenagers who have received their primary series, about twenty percent of our children between the ages of five to eleven. So we have a lot of work to do, and I would encourage parents to get their children who are eligible vaccinated so that we can really protect those who aren't eligible yet. A lot of people on social media also wanted me to ask you about the troubling cases of long COVID. Is the CDC collecting data on this. Many of those folks feel that they've been sort of abandoned by the medical establishment. Yeah, so we have a lot of studies that are ongoing at CDC, both a surveillance level as well as UM through electronic health records, and i AGE actually has quite a bit of funding to look at the manifestations and disease of long COVID and to try and understand how we intervene with long COVID. So there are many resources. The one thing I do want to say here, and I think it's really important, is that UM, you know, COVID hit UM disproportionately across the United States, and we've seen that. We've seen that in more vulnerable populations, We've seen that in racial and ethnic minority communities and UM. Because of that, that will have implications on who gets long COVID, and so I think we have a responsibility to make sure that those patients who were hardest hit by the original wave of waves of COVID nineteen that we worked to provide them resources, access to medical care. UM for those who have received long who have long covid UM. We don't have a lot of data yet on O macron and long covid UM because we certainly just certainly hasn't been with us enough. But we're talking to our international community. Those who have had COVID before US, South Africa, UK O, Macron before US South Africa and UK so that we can have sort of an earlier window as to what's happening there, and then we of course will continue those studies here. We'll be right back. I know this is a politically charged question, but it's still unclear how this virus started. No animal host has been found, and there are many critics who believe that this could have come from a lab in luhan On and it's somehow being covered up. What's your response to that, UM, you, I think it's an important question. Um. We may not be able to get to the bottom of that question. What I can say is that we have known many prior coronavirus, and I don't have insight into the truth behind that question. I think it it would be helpful historically and scientifically to know and understand it. I think we should do everything we can scientifically to understand it. I also know that historically coronavirus is whether they be stars or mirs, have traditionally come from an animal zooonotic source. So we have history that suggested the capacity to jump UM, but that is not just definitive for this virus, so you wouldn't rule out the possibility. I haven't had enough window into the science to to be able to say, and I don't know that we will ever be able to discern it. Tragically, it's been baptism by fire for you. Welcome to the world of being a public figure, Dr Willinsky. And there's been a lot of criticism of the CDC's public messaging. Looking back, what would you have done differently or what do you think the missteps might have been? Yeah, I think a lot about this. Um. First, let me say, UM, I came out and said I was going to lead with the science, and that is what I have done, and it has been my north star. I came from the bedside UM when I joined the CDC, and it is you know, the patients, every single one of them as individuals and collectively in public health, that drive how I make decisions. Um, that science during a pandemic is fast moving, and sometimes that science is gray, and you have to make decisions when you don't have all the perfect science that you would like because the situation at self is imperfect. I think given the curveballs that we've seen through this pandemic, much of what I might have done differently, is to say for now or UM, this could change or you know there there's much that we are continuing to learn because we have had to update our science as we've learned, as in our guidance, as we've learned new science, UM, and so much of that would have been Actually we need to continue to be humble as we learn more and more. A lot of people watching this, are listening to this are thinking, Okay, I mean, you hear about COVID fatigue everywhere. Dr Wilenski, I know you don't have a crystal ball, but when you look at the data that you currently have, when you hear Dr Falk say this will peak in mid February, when realistically do you think we might be able to get back to normal? UM. So let me tell you what I think normal looks like, and that is we talked a little bit about those our hospitals can manage patients coming in. UM. We are in a place where we can start enjoying UH activities that we once knew and loved. UM. I know everybody is interested in taking off their masks, and what I would say is we should manage the expectations that on you know, any given date certain that will be back to normal, because I think we're gonna tiptoe towards normal UM, and we'll increasingly over time, UM, providing that there is not another variant that throws us a curveball, increasingly over time be able to UM start peeling back all of those layers of protection that we have had UM. But I don't think that I think we should manage the expectation that on any given date we will be there. Finally, we ask you one other question, because you've been super generous with your time, but I think this is really important. I know that you believe this public health crisis has really shown a spotlight on the deficiencies and our public health system and how we need to bolster it. What do you think needs to be done so we're better prepared for the next I don't want to say this, but the next public health crisis, whatever that might be. Thank you for asking that question, because we have so much work to do. So over the last decade UM, we have had H one, N one, Ebola, ZEKA, and now COVID, and over that last decade there's an anticipation that we're now eighty thousand people in deficit in our public health workforce. So not only do we need the sheer volume in the number of people, but we need to scale up our workforce, upskill our workforce so that we have in any given community community health workers and genomic epithem neologists. So we have a lot of work to do in scaling up this gil UM and and share volume of people. Public health has to be an attractive place to enter. It's an incredible career UM, It's it's very other oriented and it's just incredible what you can do in public health. Our data systems have been frail, they have been untended to UM. We need to be able to have the pipes connect so that data from one state can easily communicate with data from another, that all can come together at c DC so we can compare different trends so that as you say, our region that's running into a challenge, we would be able to see UM quickly. And then we need to scale up our lab capacity or laboratory capacity at every different at every different jurisdiction and state, so that we have immediate capacity to detect challenges locally where they are. We have a lot of work to do in our public health workforce and in our public health infrastructure. And that's what I'm really trying and working and committed to be able to do um as we're sort of shining a light on where our deficiencies were coming in. It must be heartening for you to hear that applications to medical schools have skyrocketed as a result of this pandemic or increased dramatically. I don't know if skyrocketing is hyperbolic, but it must be heartening to you that many more people are at least applying to medical school, which is good. Is but some of those people need to go into public health when they graduate well, and I was one of them, so um so I do. There is an incredible pathway through medicine to public health. There's an incredible pathway through schools of public health, and really so many different pathways. And yes, it's really encouraging. I love talking to young people who want to who wanna have taken this moment really of this pandemic and said, actually, this is what I want to do now. They were moved by this moment. I was moved in my career by the moment of the HIV epidemic that was that was motivating so many of us to enter medicine at the time, and so um take this moment um and and uh work towards taking that incredible talent of these applicants and moving on towards public out. Dr Rochelle Wilensky. Dr Wilenski, it's really great to talk to you. Thank you so much for doing this this interview. We really appreciate it. Thank you so much for having me. Next Question with Katie Kurik is a production of I Heart Media and Katie Kurk Media. The executive producers Army, Katie Curic, and Courtney Litz. The supervising producer is Lauren Hansen. Associate producers Derek Clements and Adrianna Fasio. The show is edited and mixed by Derrek Clements. For more information about today's episode, or to sign up for my morning newsletter, Wake Up Paul, go to Katie Currek dot com. You can also find me at Katie Curic, on Instagram and all my social media channels. For more podcasts from I heart Radio, visit the I heart Radio app, Apple Podcast, or wherever you listen to your favorite shows.

Hi, everyone, I'm Katie Kuric, and this is next question. I recently had a conversation over zoom with CDC director Dr Rochelle Willinski. Now, I know everyone out there has COVID fatigue, duh, and you're probably really sick of even hearing about it. But the scary fact is almost people are still dying of COVID every day. So when is our long national, really international nightmare going to end? What is the state of play? Right now? That's how I began our conversation, right, So, first of all, I recognize everyone's tired. I recognize everybody wants to be out of this. I certainly want to be out of this, and and I'm with everyone. I'm in that if we sort of look at where we are today, UM cases are coming down from om Coon. They have been at record highs, but those cases are coming down, and they're coming down almost as swiftly as they went up. UM. Certainly, if we look at individual cities, we've seen them come down. As a lagging indicator, we have seen hospitalizations high, but those two are starting to come down. And then finally that our death rates UM are high, UM higher than we had seen in some other peaks UM, so around twenty three hundred a day. UM. So that is where we are right now. I certainly don't like to see our death counts as high as they are. Those continue to be tragic um with every single family they they touch. What I can't say though, is over time we have now are mounting more and more immunity in the population, the substrate of the population. As we get more and more people vaccinated, more and more people boosted, and people who are encountering disease who will get some background immunity from that. We have now background immunity, more background immunity in the population. And we also have a lot more tools than we used to. If you think, you know, you say year three in this pandemic, and that's where we are. But we also now have vaccines, we have a menu of therapeutics, we have more testing options, and so we're working now to you best utilize those tools in the context of what may lie ahead. You know, I get confused because we keep hearing that the omicron variant is less legal and yet, as you mentioned, twenty three hundred deaths a day, and that's the highest in nearly a year. So can you just explain how those two ideas can coexist. Yeah. I think that's a really important question. So milder does not mean mild, and I think mild can come in two different kinds of ways. For every single person that gets sick, if you were to get sick with O macron compared to delta, you might be less likely to end up in the hospital. However, or if we have three or four times the number of cases because of how transmissible OH macron is, we still end up with lots of people in the hospital and again lots of deaths. So it is this interplay between the absolute number of cases that you have and that each case for case may be less lethal, but because we have so many more, we still have challenges both in our hospitals and with our deaths. I know there have been breakthrough cases, but does the vaccine still seem to protect people from severe illness? And can you quantify the percentage of deaths from OH macron among the vaccinated population. Yeah. So here, here's what we know is that because of O macron two things have happened. One, you need more protection, more immune protection from O macron then you have with prior variants. And to just when O macron hit many people who have been previously vaccinated with their primary series, we're starting to wane in that protection, So people who are more than six months out of their primary series might have protection in the fifty pcent range in terms of severe disease presenting to an emergency department. However, with that booster shot, we can bolster that protection from that fifty to fifty five range all the way up to eight with that booster shot, which is why right now we're really encouraging people to get boosted. Here's what we know about what's in the hospital. The vast majority of people who are in the hospital continue to be people who are unvaccinated. We're also seeing people who are in the hospital who might have been vaccinated, but either they were vaccinated and not boosted, or they are people who might be less likely to have mounted a really good immune response to the vaccine, people who are older, people who are more immuno compromised. Latest data from the CDC on Friday demonstrated you are sixty eight times more likely to die from O. Macron um compared if you're unvaccinated compared to if you're boosted. Dr Lyndsky this may sound like a selfish question, but I think a lot of people maybe in my boat. I'm sixty five, I was boosted in November. Am I going to need a second booster or a fourth shot? Yeah? Right now, those data are really starting to emerge in terms of waning from your booster dose. UM. Certainly, we've seen in some countries Israel, for the most part, have been starting to think about and have been boosting their UM. They're older populations, they're more vulnerable populations. We haven't yet seen a lot of data on the waning protection from boosters in the context of Oh Macron, and those data are just forthcoming right now from the c d C. We are not recommending yet a boost an other booster dose. I know that you say milder doesn't necessarily mean mild yet. In an open letter to Governor Newsom for UCSF, doctors including the Director of COVID Response, are calling on state leaders to acknowledge the transition of COVID to an endemic disease and lift most masking policies for school aged children. What's your response to that? Yeah, Um, well, I'll go back to we all want to be in a place where we are not living in a crisis situation. In my mind, one of the places we have to look out first is how are our hospitals doing. Um. Can our hospitals take care of not just the COVID patients that are in there, but can they manage the routine medical care that should that comes in every single day? Our motor vehicle accidents, are our heart attacks, are strokes? And how are they doing? Because that is one of the indicators, a barometer, if you will, that I look at to a can we start um getting back out of this crisis mode? And I would say all of us are looking forward to that and want to sort of get to that place, But in so many parts of the country we are not there yet. We are still seeing hospital capacities that are overwhelmed and not able to do so. And so that is a place that we all want to be and that we're all aiming for, preparing for, and yet we're not there quite yet. Let's shoun there be certain regulations or recommendations or restrictions depending on the region you're living in and the circumstances that are happening in that area. Absolutely, and in fact, we do at CDC have a map stratified by county. Actually, that looks at how every individual county is doing in terms of cases per hundred thousand. We look at both hospitalizations as well as death counts, and right now those cases are still across the country um over every county, nearly every county in the country is read. It is those cases that actually help us inform when people can and should be able to take off their masks um And so we do do that at the jurisdictional level because as you know very much, many of these is we're a very big country. We're uneven with regard to how our cases are, how our vaccination rates are, how our hospitals are doing. But right now I will remind people, you know, O Macron hit us with a lot of cases, and so right now we're not quite ready to do that more with Dr Rochelle Willinsky in just a moment, I'm almost afraid to ask this, but an Overcrons sub variant b A two has already been found in nearly fifty countries. So what do we know about this variant? How concerned should we be? Right? Really important questions? So be a too is what they call a sub lineage A sister of m B A one, which is the most prominent UM O macron sublineage we have, so most of what we have here in the United States, over ninety point five percent of all macron is O macron, and the large majority of that, the vast majority of that is the B A one sublineage. UM. Now we started to dedect this be a too sublineage. We have seen it in some areas UM in Denmark and in UM in the UK, well Denmark and India, where it's become more dominant. In the UK it's still less than one percent. We're starting to learn more and more about it. We haven't yet seen any more severe disease from it, and it does look like our current vaccines will work about as well as they did as they do against the O macron itself. It might be a little bit more transmissible, which may be the reason we're seeing more and more of it in certain countries. Here in the United States. We've detected it, we've actually known about it here in the United States since mid December. We haven't yet seen it ratchet up in terms of seeing more and more of it. We have a handful of cases here and we're continuing to follow it very carefully. So this one doesn't seem to be of grave concerned. I mean, how worried are you, Dr Wilynsky? Every day you're going to hear about a much more serious variant. I don't need to be a DEBBI downer, but are we going to have to be on a constant state of alert that that an even deadlier variant maybe right around the corner. So that is our job is to be on a constant state of alert. That's our job at CDC. But really I think the important thing is to be alert and prepared and not yet necessarily to panic, right because we know that our vaccines right now it looks like are working against oh Macron, not quite as well as they did against um against Delta, but they are working well, especially if you get boosted. And our job is to follow these variants. We do know as long as we have circulating virus, we have the potential for variants. But what the long term goal is is to be able to manage these variants and to not have a crisis every time we have a variant, but to be able to live in the context of the potential variants that might emerge, and that means that our testing is working, our therapeutics are working, and our vaccines are continually working and up to date. So will this be the new normal something we just live with and manage with annual shots that hopefully can combat whatever strain comes along. Um. I don't want to pretend that I'm content with where we are right now as being a new normal. We are coming down from a pretty robust surge, and so that I don't think is a new normal place. I envision a new normal place UM where our hospitals can manage, where our workforce is back, UM, where we might have to combat many surges, um, but that we have the tools, the tests, that therapeutics, the vaccines that work. Jury is still out as to whether and how often we will need to have those vaccines. It may be that we need them annually. It maybe just like you roll up your sleep for your flu shot every year, you roll up your sleep for your COVID shot every year. And we still have more science to learn from in order to see if that's where we're going to be. Even if it's endemic, it could still be quite dangerous. Yeah. UM, what I would say is I would like to be in a place where we are endemic at relatively low rates of disease, where we have low rates of disease, high rates of vaccination, high rates of protection, and certainly low level of death. I also want to remind people that even with a vaccination, even for those um, even with vaccination, we have the capacity. Now we have new therapeutics and and even more science that continues to evolve, and some of those therapeutics can also, as I say, take the fangs out of this and really lead to less severe disease. So we have a lot of tools in the toolbox and working now to scale those up to make sure that everyone has access to them. Children under five still aren't able to get the vaccine, as you know, and I get this question constantly on social media. When will we see that approved? And does that give you pause? It all the idea of vaccinating children under five. You know the companies are working towards the timeline for children under five. I can't tell you exactly when that will be with a date certain, and I know parents are really anxious. Um when it happens through the f d A process through to the c d C process, I can tell you, Um, it won't happen with me at the helmet CDC unless all of that due diligence is done such that I would be comfortable allvaccinating any child that I would have that's under the age of five, so that I can that I can say. What I can say is we really need to work to vaccinate all those who are around our children under five, because we have seen time and time again that in households where you have two and three people vaccinated, you surround them, you you cocoon children under five um that they are less likely to get disease. And right now, you know, we have about fifty two per cent of our teenagers who have received their primary series, about twenty percent of our children between the ages of five to eleven. So we have a lot of work to do, and I would encourage parents to get their children who are eligible vaccinated so that we can really protect those who aren't eligible yet. A lot of people on social media also wanted me to ask you about the troubling cases of long COVID. Is the CDC collecting data on this. Many of those folks feel that they've been sort of abandoned by the medical establishment. Yeah, so we have a lot of studies that are ongoing at CDC, both a surveillance level as well as UM through electronic health records, and i AGE actually has quite a bit of funding to look at the manifestations and disease of long COVID and to try and understand how we intervene with long COVID. So there are many resources. The one thing I do want to say here, and I think it's really important, is that UM, you know, COVID hit UM disproportionately across the United States, and we've seen that. We've seen that in more vulnerable populations, We've seen that in racial and ethnic minority communities and UM. Because of that, that will have implications on who gets long COVID, and so I think we have a responsibility to make sure that those patients who were hardest hit by the original wave of waves of COVID nineteen that we worked to provide them resources, access to medical care. UM for those who have received long who have long covid UM. We don't have a lot of data yet on O macron and long covid UM because we certainly just certainly hasn't been with us enough. But we're talking to our international community. Those who have had COVID before US, South Africa, UK O, Macron before US South Africa and UK so that we can have sort of an earlier window as to what's happening there, and then we of course will continue those studies here. We'll be right back. I know this is a politically charged question, but it's still unclear how this virus started. No animal host has been found, and there are many critics who believe that this could have come from a lab in luhan On and it's somehow being covered up. What's your response to that, UM, you, I think it's an important question. Um. We may not be able to get to the bottom of that question. What I can say is that we have known many prior coronavirus, and I don't have insight into the truth behind that question. I think it it would be helpful historically and scientifically to know and understand it. I think we should do everything we can scientifically to understand it. I also know that historically coronavirus is whether they be stars or mirs, have traditionally come from an animal zooonotic source. So we have history that suggested the capacity to jump UM, but that is not just definitive for this virus, so you wouldn't rule out the possibility. I haven't had enough window into the science to to be able to say, and I don't know that we will ever be able to discern it. Tragically, it's been baptism by fire for you. Welcome to the world of being a public figure, Dr Willinsky. And there's been a lot of criticism of the CDC's public messaging. Looking back, what would you have done differently or what do you think the missteps might have been? Yeah, I think a lot about this. Um. First, let me say, UM, I came out and said I was going to lead with the science, and that is what I have done, and it has been my north star. I came from the bedside UM when I joined the CDC, and it is you know, the patients, every single one of them as individuals and collectively in public health, that drive how I make decisions. Um, that science during a pandemic is fast moving, and sometimes that science is gray, and you have to make decisions when you don't have all the perfect science that you would like because the situation at self is imperfect. I think given the curveballs that we've seen through this pandemic, much of what I might have done differently, is to say for now or UM, this could change or you know there there's much that we are continuing to learn because we have had to update our science as we've learned, as in our guidance, as we've learned new science, UM, and so much of that would have been Actually we need to continue to be humble as we learn more and more. A lot of people watching this, are listening to this are thinking, Okay, I mean, you hear about COVID fatigue everywhere. Dr Wilenski, I know you don't have a crystal ball, but when you look at the data that you currently have, when you hear Dr Falk say this will peak in mid February, when realistically do you think we might be able to get back to normal? UM. So let me tell you what I think normal looks like, and that is we talked a little bit about those our hospitals can manage patients coming in. UM. We are in a place where we can start enjoying UH activities that we once knew and loved. UM. I know everybody is interested in taking off their masks, and what I would say is we should manage the expectations that on you know, any given date certain that will be back to normal, because I think we're gonna tiptoe towards normal UM, and we'll increasingly over time, UM, providing that there is not another variant that throws us a curveball, increasingly over time be able to UM start peeling back all of those layers of protection that we have had UM. But I don't think that I think we should manage the expectation that on any given date we will be there. Finally, we ask you one other question, because you've been super generous with your time, but I think this is really important. I know that you believe this public health crisis has really shown a spotlight on the deficiencies and our public health system and how we need to bolster it. What do you think needs to be done so we're better prepared for the next I don't want to say this, but the next public health crisis, whatever that might be. Thank you for asking that question, because we have so much work to do. So over the last decade UM, we have had H one, N one, Ebola, ZEKA, and now COVID, and over that last decade there's an anticipation that we're now eighty thousand people in deficit in our public health workforce. So not only do we need the sheer volume in the number of people, but we need to scale up our workforce, upskill our workforce so that we have in any given community community health workers and genomic epithem neologists. So we have a lot of work to do in scaling up this gil UM and and share volume of people. Public health has to be an attractive place to enter. It's an incredible career UM, It's it's very other oriented and it's just incredible what you can do in public health. Our data systems have been frail, they have been untended to UM. We need to be able to have the pipes connect so that data from one state can easily communicate with data from another, that all can come together at c DC so we can compare different trends so that as you say, our region that's running into a challenge, we would be able to see UM quickly. And then we need to scale up our lab capacity or laboratory capacity at every different at every different jurisdiction and state, so that we have immediate capacity to detect challenges locally where they are. We have a lot of work to do in our public health workforce and in our public health infrastructure. And that's what I'm really trying and working and committed to be able to do um as we're sort of shining a light on where our deficiencies were coming in. It must be heartening for you to hear that applications to medical schools have skyrocketed as a result of this pandemic or increased dramatically. I don't know if skyrocketing is hyperbolic, but it must be heartening to you that many more people are at least applying to medical school, which is good. Is but some of those people need to go into public health when they graduate well, and I was one of them, so um so I do. There is an incredible pathway through medicine to public health. There's an incredible pathway through schools of public health, and really so many different pathways. And yes, it's really encouraging. I love talking to young people who want to who wanna have taken this moment really of this pandemic and said, actually, this is what I want to do now. They were moved by this moment. I was moved in my career by the moment of the HIV epidemic that was that was motivating so many of us to enter medicine at the time, and so um take this moment um and and uh work towards taking that incredible talent of these applicants and moving on towards public out. Dr Rochelle Wilensky. Dr Wilenski, it's really great to talk to you. Thank you so much for doing this this interview. We really appreciate it. Thank you so much for having me. Next Question with Katie Kurik is a production of I Heart Media and Katie Kurk Media. The executive producers Army, Katie Curic, and Courtney Litz. The supervising producer is Lauren Hansen. Associate producers Derek Clements and Adrianna Fasio. The show is edited and mixed by Derrek Clements. For more information about today's episode, or to sign up for my morning newsletter, Wake Up Paul, go to Katie Currek dot com. You can also find me at Katie Curic, on Instagram and all my social media channels. For more podcasts from I heart Radio, visit the I heart Radio app, Apple Podcast, or wherever you listen to your favorite shows.