Transcript of Meidas Health, Episode 15: Dr. Demetre Daskalakis Speaks Out After CDC Resignation

Hello, Midas-Midi. Welcome to September. Really, really impressive momentum that we had here over the last 14 episodes. We just had Dr. Susan Crusty of the American Academy of Pediatrics on to talk about all things back to school and to really give evidence-based information, remember, she said to go to healthychildren. Org if you had questions for all the parents out there with all the confusion. If you have questions on what vaccines to get your child or if there's basic fundamental issues that might arise when it comes to getting the flu vaccine, questions about the COVID vaccine, RSV. She went through all of that in episode 14, especially in the back half. I highly encourage you to listen to that. It's completely free. Also, immunize. Org. If you have questions and you're an adult or if you have a loved one that might be older, she recommend that we go there to get trusted resources that are easily navigable. So please do do that. And just as a reminder, Midas Health is not just trying to be another podcast. We're trying to leverage the massive audience of the Midas Touch Network to provide you a space to interact and to hear from the nation's best healthcare leaders, because unfortunately, a lot of them are no longer at the very top of the federal government.

And so that's exactly why I'm so thrilled to have Dr. Dimitri Dascalakis here for episode 15. He's a big-time healthcare leader for our country. I've admired him for a very long time. I really, frankly, consider him as somebody to just emulate in terms of impact at scale, and especially as a physician trying to have impact at scale and trying to reach as many people as possible. Dr. Dimitri Dascalakis is the very definition of that. You're going to see that really shine through in our conversation. But without further ado, I really want to maximize our time here with Dr. Dimitri. We've agreed that we're just going to use first names here. Dimitri, thanks so much for joining my Health.

Thanks, Ben. That is an introduction that my mom would love. So thank you so much for that.

Well, here we are, Labor Day, quite literally Labor Day. So thank you for joining us on a holiday. Last week was quite the week for you. I wanted to see how are you doing?

I'm doing fine. I think it was quite a week. It's a whirlwind, I think, going from leadership at CDC to trying to be a voice for raising a red flag for what's going wrong with public health in a very immediate way. It's been a lot, but I think I'm doing well for the most part. There's a lot of emotions, lots of feels.

Do you feel safe? I know that you gave it really, I just thought, a series of incredible interviews on broadcast TV, a resignation letter that I thought, I'm still getting pings about. It really resonated. But I'm wondering, just in this environment, personal safety-wise, any issues there?

I've been in a national view before I'm talking about some very complex issues that have made some folks decide that it's appropriate to target me either in digital or other media. I think that's happening now. When I wrote that resignation letter, I knew it was going to happen because it happened before. Do I feel safe? I'm looking over my shoulder a lot, I've got to tell you. But I think that this is the mission. I have to do It was I decided that if I was going to resign, I could either send a letter that says I resigned or send a letter that actually says why I resigned, and then really share the details. Again, the voices from inside are different than the voices from the outside. And there's one moment in time when you go from the inside government to out, where you're able to give a very specific point of view that could potentially affect some important change.

For our listeners who may not have tracked your career as closely as I have, although it's been, as you point out, Dimitri, a career filled with moments in the national spotlight in a really positive way, having incredible impact. I do want to take some time just going through your background, what It led you ultimately to this high post at the CDC. Infectious disease doctor, trained in National Brigham for fellowship, multiple stints in public service. I was wondering if you could take our listeners through your journey. How did you end up leading the National Center for Immunizations and Respiratory Diseases?

Sure. I'll take your way back. Everybody should get their kids a doctor's kit if you want them to be a doctor because that's what made me want to be a doctor. So shout out to the doctor's kit. So all my life, I wanted to be a doctor. I had no idea what that meant. My parents were immigrants. They came from Greece. My dad worked in restaurants, and my mom was an executive assistant. But they really helped mentor me into a place where I was able to go to undergrad to Columbia University, where I moved there in 1991 to New York City and immediately started doing things in the HIV space. I decided to volunteer and go to high schools and talk about safer sex and all of the things. It became clear to me that I wanted to do something that would work in HIV space. It was punctuated by my last year at Columbia when I helped put on a large display of the AIDS Memorial quilt. I I had friends who passed away. I used to go out in New York City in nightlife. I was a young kid in New York. I would meet people, they would disappear into Bellevue or St.

Vincent's, never to be heard from again. But I did that AIDS, the display of the AIDS Memorial quilt. I met people who were mourning people that they lost and also people who were coming so sick. It was amazing they could walk in the door. I had this moment on College Walk where I said, I don't want anyone to ever have this happen again. No more death and dying, no more suffering from this, whatever I can do. That really became my guiding star, my North Star, to be able to go into that. Then go to med school. Nyu, that was great, was mentored by some great infectious disease doctors that let me see some clinical things that became very important to me in the HIV space. Did my residency at Beth Israel Decanes, surrounded by leaders in infectious diseases. I'm going to shout out Bob Molaring, who was one of my very early mentors, who just is a legend in infectious diseases. Then I did the Unthinkable, which was to leave the Beth Israel Decanes system. For those in Boston knows that that's high treason. Not really. I moved over to Mass General in the Brigham, where I did Infectious Diseases, and again got to work with some of the brightest and the best scientists and clinical folks.

When that happened, I was working in a lab for a while doing basic science immunology. Tom Frieden, another person you may know, came on my radio because we had radios then. The radio, he talked about there was a case of HIV, multidrug resistant, and fast progression in New York in a gay man. I was like, What am I still doing here? I need to go back. I reached out to New York City to my friend Judy Aberg, who brought me back as faculty at Bellevue. Then instantly, I started doing things that were public health things. I started I was doing testing in commercial sex venues for HIV. I started post-exposure prophylaxis programs, so taking pills after an HIV exposure to prevent it. There wasn't prep, so I did surveys about prep. I all of a sudden was doing public health and didn't know it. I got the opportunity to get my master's of public health at Harvard after a family donated money to NYU to build a doctor's career, or some doctor's career, to make sure that no one died like their son. It resonated to my moment on college walk. I got my MPH, and then my first job out of the gate was to be the head of HIV prevention for New York City.

There, I got an influx of the things that you need, political will and resources, as well as really strong science to be able to implement some really significant programming that pushed the HIV epidemic down in New York City in a rapid way, faster than expected, and to a place that is enviable across the world. Did a good job there, enough where they made me the Deputy Commissioner for disease control in New York City. I remember when I was interviewed for it, they said, You're going to be the Chief of Infectious Diseases for New York City. Every now and then, you'll do an emergency response. Then subsequently, I was in an emergency response the entire time. So measles, outbreak in Brooklyn, legionella outbreaks all over the city. Then ultimately COVID-19, where I was incident manager of a lot of events, stayed there and then was recruited to CDC to be the head of HIV prevention, managed to stay in that. Actually, I was hired by Robert field during the first Trump administration. I worked there for about three months and then got pulled back into the COVID space, where I worked in the Vaccine Task Force, got back to HIV briefly.

Then Mpox brought me to the White House, where I led, I think, what is considered one of the most successful infectious disease responses in the last couple of decades. That went great. After that, came back to CDC to work for National for Immunization and Respiratory Diseases, which is the home to vaccine programs around the country, as well as a place where the smartest scientists work that the entire world looks toward for vaccine-preventable diseases. That brings me to today where I had to resign because it was getting weaponized.

I want to say for our listeners, the first time I actually was on a call with Dimitri was during his tenure at the White House, overseeing the Mpox response. I was saying this before we We officially began the podcast, how, as he notes, he oversaw one of the greatest public health responses to a crisis in my lifetime, certainly. But Dimitri, you'll remember this. There was moments where on those calls, you guys had to talk through the nuances of how to vaccinate, and whether it was a SUPQ or I. It was just even the nuances of the angle in which-A little complicated. It was really complicated. There was a lot of complications there, but you cut through that in a way that... I try to emulate my own life when it comes to health and communication. But you did something that is, I think, incredibly hard to do. You don't necessarily get trained to do it in medical school. You either learn it or you don't. Some of it is just natural, some of it is hard to learn. But you did an amazing job. For our listeners here, everything that Dr. Dimitri just pointed out, that's a lot of hard work.

There's a long days. I think you probably don't think as you're in the midst of it that you're going to end up where you just ended up, high post at the CDC leading a really important center. But when you reflect back on the last week, the decision to put the resignation letter out there, take us through that because there's a lot there. Also, before I do want to do a little tee up here for that resignation letter, I encourage all our listeners to go Google Dr. Dimitri Dascalakis' resignation letter to read it. It's very easily discoverable on the internet. But you talk about conflict with RFK's leadership, undermining public health, ideological bias in science, concerns for an increase in vaccine-preventable diseases, risks toward national security because of being less prepared for the next bio crisis. There was a lot there. I'm wondering your decisions. What went into your mind before you wrote it and what made you think, Gosh, I got to write it?

I'll start by saying, I'll take us back more than the week and take us back to the beginning of Secretary Kennedy He's stint at HHS. I'm a career government person, and what we thrive on is being like AI. Our brains get trained on the information that we get so that we can actually generate messaging that really is based on what that training and that input is doing. When Kennedy came, I was like, This is great, because now we're going to hear from him at his HHS welcome talk, and that's the first time I'm going to hear what he actually thinks now, as opposed to my impression of him before, which was definitely influenced by my experience leading the measles outbreak in Brooklyn, where I saw some of his sentiment toward vaccine come through. I really did that. I'm going in there open-minded. I had everyone cancel their meetings in my center so we could listen to his speech. I had note takers avidly taking notes so that we could take what he said and say, How could we train that AI brain of our own? How could we train ourselves to be able to figure out how the things that we think are clinically and scientifically important, how we can meld that into the vision of what the secretary is expressing?

When I'm hearing you say this in the pre-prep for his comments, it sounds like you guys were open and willing to be perhaps proven wrong if you had pre-existing a sense of what he might say. It sounds like you were open to a positive outcome here that maybe he was going to surprise you.

A hundred %. I was thrilled when he got on stage at that HHS meeting and said, I'm not coming with preconceived notions, though you may heard here that I have some. You should not come with preconceived notions either. We were like, Shazam, that's the thing. That's what we need to hear. Everyone was like, Okay, we can work with that. I think also we heard the words gold standard science, and we're like, yes, science, since we felt that folks were trying to get away from it. We heard radical transparency, and we're like, yes, all of this is a yes. We have had conversations based on that transcript and other things we saw about how we could really plug in our stuff into that vision. We all started there. Then when we saw that the words and the actions didn't really correlate, we started to feel not so good about that. For me, as I saw that unfold, my question was always, Where is my line? What's going to happen where I'm like, I can't be here anymore? Again, I'm a doctor. I took the Hippocratic oath. I really do believe in that if I feel like I'm about to do harm, then it's really not a thing that I can do.

I was really close and continue to be close with Dr. Dan Hauere and Dr. Dan Jernigan. We We definitely... My letter, which has been sometimes criticized for being long, sorry, I had lots to say. That letter- That's why we have AI. Yeah, right. I should have summarized. I had prepared it and really had been chronicling the things that got me close to my line. Then a couple of things happened. The first for me was the document that guides what's going to happen at the Advisory Committee for Immunization Practices, the work group, that small group that creates recommendations that go to the bigger meeting for discussion. We gave loads of feedback, lawyers gave loads of feedback. Then ultimately, what came back was this document that it wasn't about what they wanted to talk about in the meeting. Everyone was great with that, but it was more about the fact that they wanted to say that they wanted to remove CDC scientific bias from the work group, which is weird because I think that we have the most disimpassioned scientists who are the least biased. They made it clear that That the work group, that the members of CDC staff weren't actually reporting to the director anymore, that they were really beholden to a vision of the work group chair.

The lead of the work group for COVID-19 has a pinned tweet that says, The evidence is clear. We should stop giving people COVID vaccines. Call me crazy, but we've seen that COVID vaccine helped end the pandemic. All of the data in the world, except for some sources that maybe these folks are citing that are not demonstrated to be valid sources, that the COVID vaccine is safe. There's always a risk for a vaccine. Nothing is zero risk. But overall, it's a safe vaccine. Definitely, there could be some side effects. Again, there's been a severe side effects. There are folks who myocarditis, which is inflammation of the heart. But that hasn't really been seen for a while, and it was really related to a very specific time where people were getting doses close together. Anyway, so that meant to me that there was no way that my scientists that were working within CDC were going to be able to create science that was not contaminated by the ideology since the ideologs were the one that were driving the conversation in in a way that was unprecedented. That was my first line. The second was when we started to hear that Susan was potentially Susan Monarez, who was the director of CDC, the congressionally approved director of CDC, confirmed.

When we heard that she was probably going to leave or be removed, we were going back to the time before we had a director But months and months of having no scientific leadership, where we were just getting these top-down recommendations with no ability to input. We never briefed the secretary once. Not one NCIrd, no one from my center ever had briefed him. Ever, ever. Not me, not anyone. We were getting all this top-down stuff with no evidence backing it. We were like, Great, we have scientific leadership. We're going to be okay. Then that got pushed aside, which meant that, imminently, we were coming to all these decisions and that there was all that could happen from my perspective was harm, no good. That's my line.

You led the National Center for Immunization and Respiratory Diseases. That was the post that you held. We're having this conversation on Labor Day, day after a conversation that we just had with President of the American Academy of Pediatrics, Dr. Susan Cresley. What I find just hard to keep up, but My wife's a pediatrician, I'm a pulmonologist, and vaccines are what we do in our clinical lives in a variety of different ways. I was talking to Dr. Cresley, and it was amazing to me that here is an organization, the AAP, that is now stepping into this void that is seemingly being created in a very rapid period of time. It just seems like this is all happening so quickly. Can you speak to what what this means now for our listeners who represent a product swap in the general public? Because Dr. Crust, it was trying her darndest to represent 79 other medical societies and put good information out there. I linked towards the end to a few websites, and it all felt... It just felt tragic, and it felt like no one podcast or entity is going to be able to fill the shoes of what we've lost.

And what we've lost here is incredible expertise and servant leadership like you and your colleagues. I'm just wondering, what do you think this all means? Where are we headed?

Yeah, Ben, I'm going to take it from high up to low down. Please. What this means is that there is going to be a clear effort to limit access to vaccines. It's not going to be about improving the ability or for people to choose, it's going to be about the inability to access vaccines. There may be bottles on the shelf, right? There may be bottles, needles, whatever on the shelf that vaccine exists. But this is undermining two things. It's undermining access from the perspective of coverage, and I'll talk about that in a second, but it's also undermining trust and confidence in vaccines. This chaos, all of this noise creates an issue. Folks can't process all of this. What happens with all the different pieces coming in in the way that it's coming is that you're like, Well, I don't know who to believe. I applaud the medical organizations that are trying to say, Look, we are your trusted providers. By the way, they are the trusted providers. I mean, the secretary said, Don't take his medical advice. I agree, don't take his medical advice. He is not an expert, nor has he listened to experts.

I trust the pediatricians. I trust the obstetrics and gynecology folks. I trust the medical doctors. I imagine that there's more coming. But here's the facts. If the government, if the ACIP, if the Advisory Committee on Immunization Practices decides to somehow constrain who is able to get one vaccine or another for a reason that's not based in data? There may be reasons. There may be like, Oh, you shouldn't give this vaccine to X, Y, or Z because the risk and the benefit, it doesn't make sense. But for vaccines where the risk and benefit does, if there is some ACIP recommendation that somehow makes it hard for someone to get vaccine or says, This vaccine shouldn't be given to a 6-12-year-old, that's probably not going to happen with COVID. But if that ACIP says that, yes, AAP and all the other organizations can say, We call That's inaccurate. That's not right. That's a false recommendation. But if the recommendation is an ACIP recommendation that gets signed by whoever it is, I guess a speechwriter, O'Neill or the secretary, That then gets codified as a recommendation from CDC and HHS. That recommendation triggers vaccine coverage in insurance. If that says, Do not give to 6-12-year-olds, that means that that vaccine may no longer be comforted by insurance.

Let me give you one more very scary thing, which people don't know, but hopefully I can express it in as clear a way as possible. There is a program called Vaccines for Children. It is the program that is the safety net program that gets vaccines to kids who are uninsured or uninsurable who can't afford it or who are on Medicaid. Over 50% of kids in the United States get their vaccines through the Vaccines for Children program. If the ACIP says this vaccine should not be given to 6 months old to 12 year olds, the VFC won't buy it.

I see.

That means that those kids will not get vaccine.

It was really... Thank you for that. It was illuminating just to look the data on 6 months to 23 months of age children that are those in that age group, otherwise healthy. As the AAP was pointing out, that's a high-risk group still for ending up in the hospital, even if they don't have an underlying condition. To your point, what I think it's lost, I'm wondering your view on this. I think this level of detail, all it takes is you having 60 seconds to lay it out for us, and it's clear. But it strikes me that a lot of these decisions are being made with perhaps the expectation that the general public won't grock what's actually happening. I look at some of the decisions that were made on the FDA. The FDA label changes the COVID vaccine, and many people, and we did a lot of segments on broadcast for it, and I got a lot of feedback saying, Vin, I didn't realize that this means my pharmacists cannot potentially do what they've what I'm doing for the last five and a half years. That's right. It's amazing that through line that there's complexity and policy that if people understood that right below the headline, what this means for them, which, again, This is why you're so good at what you do.

Do you think that's what's missing here is the lack of accountability because there's a lack of a through line?

A hundred %. But I feel like the role of us, I'm going to speak for Deb and Dan, right now, we can point at the thing and say, This is the thing that you need to look at. I think there needs to be more voices of folks that understand the policy nuances that are able to say something. I'm a simple guy. Cvs and Walgreens say that they're not going to be able to vaccinate in some states, and in other states, they say you're going to need a prescription. If you look at our data, sorry, the data, That's sad, right? The data at CDC, what you'll see is that the majority of COVID-19 vaccination for adults happen in pharmacies. That's going to be not so good for your seniors who definitely are at risk for COVID-19 complications. If they're going to need to find a prescription or their state doesn't carry it in the pharmacy, that's a problem. Rural America Oh, no. Right? Right. Your best access is going to be a pharmacy. So yes, some of the pharmacies that have a doctor's office affiliated, you may be able to get that prescription. But are you also going to get to reach for a doctor's visit to be able to get the prescription and get the vaccine versus just go do the whole thing and be done.

So this has ramifications that mean that people won't have access to vaccine. So that's the I think it's not about we don't want this to be a mandate. We don't want there to be this thing where you're like, that ACIP is releasing something that says you must vaccinate X, Y, or Z for something. It doesn't say that. It just says, Recommended for some population with some parameter, and then physicians and patients and other clinicians, including pharmacists, are able to make decisions. The way that we're going, there is going to be a clear decrease in access for vaccines, and that is going to look like people unable to get the vaccines that they want. I think that that's going to be highly problematic, and depending Depending on what happens with these infections, COVID-19 specifically, there may be potentially some pretty significant human toll if children and older adults end up getting hospitalized, going to the ICU or worse outcomes.

For our listeners here, Dr. Dascalackas, you referenced CVS and Walgreens and prescriptions. I've seen some questions come through on social about exactly what you just raised, Dimitri, which is, do you need now a prescription for vaccines. As CVS and Walgreens has reported late last week, ours in 16 states, I believe for CVS, they are actually not right now. They're pausing distribution of the COVID vaccine because it's not clear in the absence of a CDC endorsement of this vaccine from ACIP, which is this committee that you're referencing, they have to formally endorse recommendations for then pharmacists to be able to actually immunize. Do I have that right, and right now that mechanism is lacking.

You're almost 100% right. Just to be clear, ACIP makes a recommendation to the director of CDC, and then the director of CDC endorses it. It's an advisory committee. They do not set policy. That means that when Susan had been there, there was a chance that there was going to be a balanced voice to come up with what recommendations should be. They don't set the policy. They recommend to the director who then signs off. But what you said is right, so that when you have an ACIP recommendation, that is not just a pretty piece of paper. It actually opens the gate to all of the things that need to happen for a vaccine to be covered by insurance. In many states, as you heard, to allow pharmacists to give it. So there's some states where you have to have an ACIP recommended vaccine to be able to give it. And there are other states that say that depending on what the recommendation is, you may need a prescription for it. I just need to give one really good shout out to CVS and Walgreens. This is not because they're not trying. Everybody who hears me, this is not the time to be angry at CVS and Walgreens.

This is the time to question what's happening government that has made the circumstance that these pharmacies are unable to provide a service that is so valuable to their patients. They're not pushing a vaccine on anyone. They're just offering it. I enjoy being reminded about my vaccines from CBS. I don't always take them up on it and from Walgreens, but it's nice to get a reminder. I think that when I go pick up my toothpaste, that may be a great time for me to get vaccinated so I don't have to wait drive to a doctor's office. I think that that's... Americans don't like having inconvenience, and I feel like we're getting to a place now.

Right. No. Thank you for that call out and just elaborating on it, making sure that we have... We want to make sure we're operating with all the correct facts and also helping us understand CES and Walgreens' place here. They are responding to changes in policy the best they can, and that's an important call out. I do want to I was really struck, Dimitri, by a line or something that you were quoted on that the New York Times published, I believe it was today or recently. It was an article about everything that's happening, and it said, The panel, this ACIP panel, may curtail access to several vaccines, which is the statement. Then your quote after that was, It really is transparent that these decisions have all been predestined. I'm curious what you think that means, playing it out. Right now, we've talked about COVID. I saw something between Senator Rand Paul and Senator Bill Cassidy on the hepatitis B vaccine. The latter was defending it. The former was questioning the need for it, the hepatitis B vaccine. For our listeners here, that's something that probably almost all of our listeners have gotten when they were infants.

I'm Are you worried about where we're headed. It seems like that's what you've been signaling directly in the last few days. Where do you think we are headed?

I fear that we are headed to a couple of things. The first is the very overt work to curtail access to vaccine by really calling into question data. I think that the other strategy there that I need to say is also questioning the quality of the data. This is something to watch out for very carefully. I predict that at the ACIP meeting, there are going to be comments on the fact that there's not perfect data. We don't know about the reason for hospitalization for every child in America. We don't know what every underlying condition for every child who's admitted for COVID-19 or every adult admitted for COVID-19. There's going to be something there where they're going to undermine, I think, public health data as well as other data to make the point that it's not gold standard. What everyone needs to know is some of that data is completely unknowable in the United States of America because we do not have a single-payer system with some universal data stream. I cannot know know the underlying conditions of every child based on how our system works today. What I fear is, before we even get to vaccines, is that the strategy will be to undermine the data that is available, which is very high-quality data and has been used for decades to make decisions, if not decades, years, and is also looked at by other countries as very significant data, there is going to be an attempt to undermine the scientists and the science that provide that data.

That will then downstream destabilize recommendations, and that means that there will be people who will be using their non-expert expertise to make recommendations about what happens for vaccines. I don't I don't know how to tell people who do operational research how to do modeling about supply chains. I think it's strange that an operational researcher is going to tell us what child to vaccinate. It seems strange. I'm worried that there's going to be first, let's undermine science more and more and more, really call to question the data, not finishing the sentence and saying, this data is imperfect, and there is no perfect data available in the US to make some of these decisions, but it's the data that we use and that's been so valid. That's going to mean decisions are going to be made based on half-truths, win, things that will be called common sense. There's a lot of things that are common sense that are not scientifically true. That's really important. That will then translate into vaccine access problems, insurance not covering. Then subsequently, all of this results in so much noise for people, so much noise that they just won't know where to go or what to trust.

I'll give you one more example, which is there is a thing on the notice that the ACIP meeting is happening, an agenda item that is called Respiratory Syncytial Virus, RSV. Nobody knows what that agenda item is about. It's come from above down to the advisory committee. Scientists at CDC have no idea what's going to be discussed or presented. Therefore, what that means is there's going to be a highly atypical discussion that doesn't include CDC science nor its assessment of other science, to discuss something about RSV, which I predict will try to point at data and say that there's something that was not presented previously by a CIP that would require people to consider not using the monoclonal antibodies that really shut down the RSV season for kids last year. That's going to mean more kids hospitalized in the intensive care unit during the holidays. Parents completely worried out of their minds that those kids are going to be in the intensive care unit. It's going to be about destabilizing data and destabilizing public health because that, I think, is the mission, and the output of that is going to be sick kids.

That is chilling. Yet again, you clarified how they're going to do this. There's a vision, but then how do you execute on it? It's chilling to see that there's that through line. I have to just remark that, and for our listeners here, Dr. Dascalakis and I, as many of you listening in, either no healthcare professionals, you may be a health care professional. What I'm always struck by, just witnessing what's happening, is when you practice medicine, to even be able to practice medicine in some form, as you well know, you have to... It's a gauntlet. Board exams, many Many years in training, many, many years in debt. There's continuing medical education, there's recertifications, there's scrutiny on how you practice by your peers to get recredentialed at a hospital. There's so many steps to make sure that being a professional in healthcare is that there's accountability, that there's quality standards, and you can't do... Bad things can't happen because people are not trained or doing the wrong things. What's stunning to me, especially in this world of patient advocates and all these guardrails and checks and balances, is how quickly it seemingly can all devolve without any accountability.

It's stunning to me that a set of ideologs, as you pointed out, really can impact science. You beautifully said in your resignation letter that there was a distinguishing between ideology and science, or at least historically, and that's been entirely blurred. I'm stunned, though, that in an institution or in the profession of medicine that is replete with accountability and guardrails and standards, things can be undone so quickly. I'm wondering your reaction to that.

I think in general, when you think about public health, there's three things that you need to be effective. You need community engagement, understanding what people need. You need political will and great science. If With that pedestal on which science lives, which is supported by community engagement and by political will is compromised, the science fails. That's what we're seeing. The political will is not to uplift science so that we do best for the community. The political will is political will only. There's nothing that that pedestal is holding up except for individuals, their egos, and their motivations. That's where we are. I think that everything in government, all of the safe checks and balances, I think, exist if you have this social contract that makes sure that folks are approaching things in a way that maintains the best for communities and for people. When the emphasis is not about the people, but about some unseen master or some unseen motivation, you can see exactly what happens. It breaks down. I mean, there's folks who are reviewing data at CDC right now that is focused on the epidemic of chronic disease, specifically autism, who historically had been disallowed from accessing data because of their bad methodology and questionable ethics.

That's happening now because there's political will to let them have full access to CDC data.

Gosh, I could take this in so many different directions. I do want to end on a semi-positive note, if we can, which is to say two questions. As somebody that is in the media space for a part of my life, and especially in health journalism and communications, I feel like I'm speaking to somebody that is an exceptional health communicator across the board. Just communicator, I don't have to qualify it by saying just on matters health. How do you envision the role of media today in covering these stories and in injecting truth into these discussions? Because media can be powerful. I think media can be a force for good if used properly. But I'm wondering your critique of media and things that we should be doing better.

Yeah. I think that media is going to be is really important. I think also leveraging platforms that are not traditional media, like podcasts are great, thinking about other social media. I I think that media, I think, needs to emphasize less the click bait and more like what it means for people. And so that's what I feel like a lot of what I've been doing in the last week has been like, Well, what this means for people is this. I think not taking the bait. I mean, we all take the bait sometimes, but not taking the bait to focus on this person is saying this thing, and let's go for that person. I think that more saying, I'm like, What is this going to actually mean for a kid, their mom and dad, for an older adult? And just using that, what you said to me before, really, take that 60 seconds, that 30 seconds, and I know sometimes it's 20 seconds to somehow message, This is what's happening, and what that means for you is that you're going to have to pay $175 for a vaccine that was free last year. Because I think if people understood I think that they would have a different perspective on getting involved in the noise that is about individuals and personalities and characters and be more like, Well, how do we fix it?

I didn't know that. I feel like that's the thing that I'm getting the most is, I had no idea. I didn't know that. Is that a public health failure, too? Yes, but that involves public health being able to speak, which I think has been something that this HHS This is limited pretty well as well.

Before we let you go, I wanted to get your take on places our listeners, the general public, should be going to to get critical information that I think now, and especially in this chaotic space here, if they have questions about, well, they need a prescription, can their pharmacist prescribe or administer a vaccine? I know it's probably going to be harder to get one-stop shop when it comes to all the questions people have, but where do you go or where would you recommend you go?

I do have a one-stop shop, but it's not the perfect answer because not everybody has a physician or a clinician that looks after their health. But this is a time where I would say that's really important. I think on clinicians, They don't get necessarily wrapped up in all this policy swirl. They know what's the right clinical thing to do, and they look to sources that are valid to be able to figure out what the path forward is for their patients. I think always good to do research. I I think, looking at the AAP, at ACOG, at AMA, at the alphabet soup of professional organizations that serve people. But I think that actually speaking to the provider, talking to the pharmacist, talking to your doctor, talking to whoever in health care you have access to, I think is a great first step. I know this is very operational, silly recommendation, but I see patients, and sometimes you just have to be very straightforward. Call before you go, please, because I don't want people to go to the pharmacy and expect that it's business as usual and all of a sudden have the swirl of chaos that is being created on purpose around them.

Call and say, Hey, I want to get this vaccine. Do you do it? Here's my insurance. Can you run a little test claim to see if it's covered so I know what I'm paying? Just things like that. It's going to be a little bit of extra work, but I think that just a A little bit of precalling, a little bit of prethinking is going to make it less complicated for people.

That's fabulous advice. I'll layer on. I couldn't agree more with speaking to your own, your child's pediatrician, to your medical provider. Best advice I got to say one more thing, Ben.

Everybody who's telling you not to listen to your pediatrician, red flag. It's not okay. Bottom line of all of this is anyone who's It was like, That pediatrician, he's pushing vaccines. No, that pediatrician is pushing health for kids. No one pushes the vaccine. They're going to talk to you about the vaccine, and you can decide if you want to do it or not. But anyone who tries to destabilize what I think is a really imminent relationship between doctor and patient, that's a red flag, warning, something is horribly wrong.

So well said. My wife thanks you as does the AP. Healthychildren. Org, American Academy of Pediatrics, very easily navigable, accessible health information platform, highly recommended, immunized@org for adults. We are graced by your presence. The former head of the National Center for Immunizations and Respiratory Diseases, Dr. Dimitri Dascalakas. Thank you for joining us on a holiday. We're just grateful for your leadership and everything you've done for this country.

Thank you, Vin. Nice talking to you. Thanks so much for having me. Can't get enough Midas? Check out the Midas Plus sub stack for ad-free articles, reports, podcasts, daily recap from Ron Filipkowski, and more. Sign up for free now at midasplus. Com.