DAVID GREENE, HOST:
Why are coronavirus cases so much higher here in the United States than in other countries? Is it slow testing? Well, the White House testing czar admits that it is still taking too long to test. This is assistant secretary at the Health and Human Services Department, Admiral Brett Giroir.
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BRETT GIROIR: We are never going to be happy with testing until we get turnaround times within 24 hours. And I would be happy with point-of-care testing everywhere. We are not there yet. We are doing everything we can to do that.
GREENE: But our next guest says the fundamental issue is not testing. It is not face masks or lockdowns or back-to-school guidelines. It is, fundamentally, trust. Andy Slavitt is a former acting administrator of the Centers for Medicare and Medicaid Services, and he joins me this morning. Thanks for being here.
ANDY SLAVITT: Morning, David.
GREENE: So why do you see this all about trust?
SLAVITT: Well, if we're wondering why, in the U.S., we're not doing as well as other nations are - and to be clear, other nations have really crushed this virus; whether you're talking about Europe or Asia, they really flattened that curve down to almost nothing. And we ask ourselves kind of why is it that we haven't done as well? Those other countries, what are they doing? Mostly, they're using gifts that they were born with - the ability not to spread the virus by not breathing on people, either using a mask or staying home. And the answer is that, in those countries, they are more unified and trusting in what they're saying. And I'll give you a couple of examples of...
GREENE: Sure.
SLAVITT: ...Where we're not doing that in the U.S. So, you know, you take the governor of Texas or Arizona and you see the absolute hell that New York goes through, and you don't trust it, and you don't take the actions that the governor of New York and Connecticut are pleading with you to take. You take great institutions, historically great institutions, like the CDC and the FDA, which historically we look to in times like this to tell us whether a drug is safe or whether it's safe to go to school, and we're not sure if we can trust them any longer.
GREENE: So you're saying...
SLAVITT: Some people say masks work, and some don't.
GREENE: ...It's leaders in states. Like, it's leaders in states like Texas and others who don't trust their counterparts, like, in New York? Or where does the trust deficit really exist here, that you're talking about?
SLAVITT: I think we see it everywhere, David. I think we see it in the presidential briefings and the inability to trust what we hear when the president recommends a drug and we're not sure. We're used to hearing that from the FDA. We're seeing it among ourselves when some people say that we should be wearing masks and we won't. And where this will really come to play out in short order is when we have a vaccine. And will enough Americans trust that this vaccine is safe and effective when they've been hearing from various parties, like the president, that a certain drug is safe or a certain drug is not safe? And there's not one body - the great institutions that we've come to trust as being impenetrable by politics, we're not sure if they are any longer.
GREENE: Who do you hold responsible for this?
SLAVITT: Well, look - some of it is cultural. I mean, you know, I think we were founded on principles of liberty and freedom and distrust of government, and some of that is - makes us who we are. But that also means that we need really good leadership in times like these because we have to do difficult things. Nobody asked for this virus, and we're all going to be inconvenienced by it one way or the other. And so it takes enormous amount of leadership to tell people that we've got to make some sacrifices.
Now, in the scheme of things, four to six to eight weeks of real sacrifice, which is what we're talking about and other countries have done, is not the kind of sacrifice our - we did in World War II or in a 10-year-long depression. But still, it requires a leader who people trust to say, if we do this, we will get through this. And given that there's a incubation period - you don't see the results instantly of your actions - you'd have to trust that what you're being told is going to help.
GREENE: Can I ask one angle of this that seems to take in a somewhat different direction but might be an example of the same thing you're talking about - there was a professor of epidemiology at Yale, Harvey Risch, who said that the much-debated drug hydroxychloroquine - which, obviously, there are a lot of scientists who say that it should not be trusted to be used for COVID - but he suggested, in certain cases and instances, it can be a very reliable treatment. And he said that politics basically poisoned the environment. And Lara Trump, the president's daughter-in-law, basically said it is irresponsible if people are not thinking about hydroxychloroquine in the medical community only because President Trump said it worked. I mean, is that an example of the culture we have right now?
SLAVITT: It's actually a perfect example. Who are we used to telling us that drugs are safe? We have a whole body that's built to do that that we, taxpayers, pay for. It's called the FDA. And the FDA granted an emergency-use authorization on the president's request that this drug be made available. Subsequently, the FDA withdrew that because it felt that the side effects were strong and there was no evidence that it worked. So should Americans really be getting our advice on whether a drug is safe from the president's daughter-in-law or even an opinion piece in Newsweek, or should we be getting it from the institution we've come to rely on? And if we can't get it from the institution we rely on but we get it from political leaders, then all of a sudden trust really breaks down because everybody's going to listen to a different leader.
GREENE: In the few seconds we have left, are you confident that trust in institutions that are very important in this pandemic can be regained and sometime soon?
SLAVITT: I think it's going to take a while to build back. I think we have - you know, none of these institutions have come through this completely unscathed, and the president and others have done their best to make them even less trusted. And I think it's going to take a while to build back. But I don't know how we get there unless we do.
GREENE: Andy Slavitt, former acting administrator of the Centers for Medicare and Medicaid Services, host of the podcast "In The Bubble." Thanks so much.
SLAVITT: Thank you, David. Transcript provided by NPR, Copyright NPR.
