MS. ABUTALEB: Welcome to Washington Post Live. I’m Yasmeen Abutaleb.

Today's guest is Andy Slavitt. He resigned from the White House last week as a COVID-19 senior advisor, and this week, he's out with is new book, "Preventable." Before we dive into his book today, we're going to get his take on the country being almost fully reopened, variants, anti-vaxxers, and his son who is a COVID long hauler.

Andy, thank you so much for joining us today.

MR. SLAVITT: It's great to be with you, Yasmeen.

MS. ABUTALEB: So, before we dive into your new book, I think there are a lot of questions about the variants and especially the Delta variant. Prime Minister Boris Johnson of the UK postponed the UK's reopening plans by about a month because of concerns over the Delta variant. Is that of concern to you, and how do you think that factors into how we think about the reopening in the U.S.?

MR. SLAVITT: Well, the parts of our country that have high levels of vaccination should be in really good shape, and if you've been vaccinated, I don't think you should have a lot of worries about the Delta variant. The vaccines are showing themselves to be highly effective so far against the Delta variants.

If you're living in a part of the country where there is a low degree of vaccination or if you yourself are not vaccinated, you're clearly vulnerable because this is basically COVID-19 on steroids. It grows. It spreads easier. It goes faster. You need less exposure to get it, and so you are facing an even starker choice about whether or not to get vaccinated and protect yourself or be more exposed to this variant. And, you know, I think if there--I know there are people out there still making the decision about whether to get vaccinated, but it's a great opportunity to be able to talk to their doctor and make that decision.

MS. ABUTALEB: That's a great point because, fortunately, we know the vaccines are very effective against this variant, but on Sunday, the former FDA Commissioner, Dr. Scott Gottlieb, said the Delta variant could become the dominant strain in the U.S., which could lead to new outbreaks in the fall. So, given the UK's decision, how big of a concern is that for you, and what do you think Americans should be aware of? Do you think it could become the dominant strain in the next couple of months?

MR. SLAVITT: Well, it looks like it will be, and as long as we have a dominant strain that the vaccine is highly effective on, then for those who are getting vaccinated, we should feel good about it. But this is a vaccine that will become more dominant. Thankfully, the spike protein is one that we will be able to reach with our highly effective vaccines.

So, I think we can expect in the fall that if you're in a community, say, in the Southeast where penetration rates of vaccines are lower and there are things like indoor weddings and other things, you will see outbreaks, unless we get more and more people vaccinated, and I think by then, we should have good news out of the FDA about the Pfizer and soon the Moderna vaccine being fully approved. And when that happens, I hope to see many more people continue the road to vaccination.

MS. ABUTALEB: I know there's a lot of encouraging news on vaccines and how effective they are against the various variants that have emerged, like you noted, but right now, we basically have an honor system in place for the vaccine. What can or should employers and maybe information employees do as people return to work, and is there a way that we could know who's vaccinated and who's not?

MR. SLAVITT: Well, you know, one employer I talked to recently before I left the White House said they weren't requiring vaccinations among their employees, but what they were doing was saying that if you don't get vaccinated, you need to get tested. You need to get tested two or three times a week.

So, there's a lot of different approaches, and I think each employer is going to decide what's right for them. I think some employers, just like some universities, will end up requiring vaccination. Some employers won't but will say if you don't get vaccinated, you need to wear a mask, or some will say you'll need to show a negative test, and maybe that will only happen for a temporary period of time while there is spread. When the spread is very, very low, when the spread gets lower, I think those practices probably will go away.

MS. ABUTALEB: Well, one thing that I think--we want to understand how you think companies should think about reopening and getting people back in the office. The Biden administration lifted restrictions on the number of federal employees who could return to work while still maintaining some flexible telework policies. I mean, how should we think about that, and how should we think about the rest of us who are going to return to the office soon and how people should be thinking about returning? Because right now, it looks like the country is pretty mixed in terms of people who do want to return and don't.

MR. SLAVITT: Yeah. Look, I think we're used to thinking of COVID-19 as this sort of existential threat with a lot of unknowns and a lot of anxieties, and that is how we've been feeling for the last year and a half. I think we're moving to a place, though, where we can start to move COVID-19 into the bucket of all the rest of the challenges that we deal with every day that are manageable, and making manageable means that you'll want to be alert to if, for example, you live in a community that has a high degree of COVID or there's a new outbreak. You'll want to be aware of when seasonally there are people, particularly older people or people who are at risk, who may be exposed, and so our practices will probably adjust a little bit, just as they do with other things that we view as manageable risks in our lives.

I think what we'll feel, a bit of a shock at first going back to the office, taking off your mask if you've been wearing a mask and so forth. Over time, I think we'll start to blend and blend in, and people will decide what they're comfortable with. Some people will feel like they can go to a crowded stadium and not be worried. Other people will want to go and sit in a vaccinated section, which my son and I did at a recent basketball game. So, over time, I think there will be all kinds of nuances.

But mentally, we should be adjusting ourselves to a place where even with the new variant, if you've been vaccinated, you are extraordinarily protected. Ninety-eight, 99-plus percent of the people that are being hospitalized and dying with COVID have not been vaccinated. So, if you've been vaccinated and you've been past a several-week point, going back into the office, going back to a restaurant, going back to all these things, while they may seem strange at first are actually quite safe.

MS. ABUTALEB: I'm curious what it felt like in that vaccinated section of the basketball game, because you're right. It's going to be a huge adjustment for people to not view it as the sort of deadly threat.

I know that you just resigned last week, but what advice would you leave the Biden administration with in terms of how to navigate this next phase of the pandemic and the advice you would give to states, especially because states are in such different phases of reopening in their vaccination campaigns?

MR. SLAVITT: Sure. Well, my resignation was planned from the start. I was in as a short-term government employee for 130 days, which was the same amount of time that Ron Klain was in for the Ebola response, and our view was at the end of 130 days, we're either going to be in a much better place or we're going to be in real trouble. And we weren't going to let that happen.

So, it was wonderful service, and I think a lot of the systems are set up for success. The team is terrific. I wouldn't rather have anybody focusing on this, and the president is in a very clear way, in a very compassionate way, leading on this issue.

The next phase of this work is going to be a couple things. One is it's going to continue to vaccinate the people in the country that haven't been vaccinated, and I think that will happen over time, and that will happen locally. It will happen in local communities and conversations, but it will happen.

Second is we've got to do the job to vaccinate the globe. The G7, this last week, was a powerful beginning for that, and the commitment that the U.S. made to purchase and donate 500 million vaccines around the world is the kind of leadership that's needed to get it done. We're going to need over the course of 2022 to be vaccinating billions of billions of people.

And then third, there are other breakthrough opportunities. Antivirals to me is a very important development, and we have global trials ongoing. It will be very important for us to get through those and see if we have an antiviral, which will be another game changer at making COVID even more manageable.

MS. ABUTALEB: Well, one of the goals that you were working on up until you left--and I know this is the goal that the administration is working towards now--is having 70 percent of adults have their first shot by the 4th of July, and there is a risk that the administration doesn't meet that goal, given you're now in the phase of this where you're trying to convince people who maybe don't want to get vaccinated to get vaccinated. So, do you think the administration can meet this goal, and what were some of the biggest hurdles that you saw that the country is going to have to overcome to meet some of these goals?

MR. SLAVITT: I would characterize it as a national goal for our country, more than an administration goal. I think the president would like to see people step up to that level because we'll be safer if we do it.

I think we'll be very close to 70 percent by July 4th, and then I think we won't stop. I think we'll keep going, and I suspect that over time, we'll be well above 70 percent.

But it's really important that community by community, that 70 percent will look different. That could be 90 percent in the Northeast, and it could be 40 or 50 percent in some communities in the South. If we don't want to have a divided country and we have a president who really wants to bring people together, it makes this not about politics. Hopefully, we can overcome some of that regionalization, and hopefully, we can begin to vaccinate more and more people.

I think the big challenge right now with the people who have decided not to get vaccinated really fall into two categories, and neither of them are people that I consider to be anti-vaccine. Yes, there are people that are anti-vaccine. They're a small and vocal group, but the two larger groups are, one, people under 40 and particularly people under 30 to whom they're not anti-vaccine in any way. It's just COVID-19 doesn't for them feel like a big enough threat to get moving and do it. It's just about making it more convenient, making it more accessible.

Secondly, there are a set of people who still have questions about the vaccine, and they're on the fence. They're not opposed to vaccines overall, but this vaccine, they want to see how people who have been vaccinated respond. They have questions. Maybe the questions are about the longevity or the development process or the fertility or what have you, and we should treat every question as a legitimate question. And we should understand that some people's processes are just going to be longer. For some people, this is a bigger decision that needs to be more considered, and if that's the case, then rushing them isn't the goal. Getting people legitimate information from local sources who they trust versus some dude on Facebook, that should be the goal.

MS. ABUTALEB: I want to jump into your book in just a second, but before that, another topic that's been in the news a lot recently, including in our newspaper, is this question about the origins of the virus, and of course, President Biden has ordered a 90-day review from the intelligence community. Have you seen evidence one way or another that indicates whether this might have been a lab leak versus a natural origin, and do you think that the Biden administration can really get an answer on this? Because as my colleague and I documented, the Trump administration had a number of reviews that ultimately were mostly fruitless.

MR. SLAVITT: We don't know, and what's important is that people may have a bias because there's a narrative they like one way or the other, but we need to get to the bottom of this, and China needs to cooperate. We cannot set a precedent of not having full cooperation and understanding how these things started.

You can paint a picture where this happened in a lab because we know that the virus aerosolizes, and you can imagine a spill or something like that. We don't have any evidence of that whatsoever, but you can imagine that that could be possible. And you could certainly imagine that like most other viruses or all other viruses that there's a zoonotic link.

It's interesting. There is a segment in our book, in the book, in "Preventable," which talks--which has President Trump at the time raising the question, and the way this situation gets explained to him is by someone telling him a bedtime story, which is, I think, quite an interesting part of the book.

But we don't know, and we are going to have to--and by the way, it often takes longer than it should to get to the bottom line on these things, but we have to be very insistent that we get there.

MS. ABUTALEB: Well, speaking of your books, that's what we want to turn to now. You've said that the country has just surpassed 600,000 deaths, which was unfathomable a year ago, even a few months ago. You had said that if Americans had made a little bit more sacrifice that perhaps some of this could have been avoided, and I want to understand a bit better what you mean by that because I think there are a number of people who feel they made a lot of sacrifice. There were months-long periods of isolation. Millions of people lost their jobs. Businesses that had to shutter. So, what were you thinking of when you said that, and could you help us understand? You've said that this death toll could have been avoidable. What was avoidable? What could have been different?

MR. SLAVITT: Yeah. So, first of all, Americans have suffered greatly as have people around the world. Actually, the comment around sacrifice was taken a bit out of context.

I think the thing that I hope we do look at is the fact that as we sit here in 2021, we were a country that decided that in many cases, 70 percent of Americans needed to be essential workers, and that we needed people to do a variety of things in ensuring that we are getting--from everything from getting food out of the ground to driving the trucks to meatpacking plants to delivering groceries to delivering movies, delivering everything else. And we have a large portion of the population that's been very much at risk, and that's largely been something that other countries did not do.

So, as an example, I hope we examine our views towards what should be the policies that set us on the course to collectively looking out for one another versus policies where we have large numbers of people exposed and large numbers of people who are like myself, spend much of the pandemic indoors, in my house, in relative comfort with enough savings to get through the pandemic. I don't call that out in the book as the primary cause, but I do think it's a dialogue that's very important for us to have because we had a lot of conversations about how important the individual liberties are, whether it's to wear a mask or not to wear a mask, et cetera. But we also should have a conversation about what's the collective good here; what are the things that we should be doing for one another.

The bigger issues in the book that, I think, cause us to look at what was preventable are really twofold. One is there is a set of technical things that we just got wrong. We didn't have enough tests. We didn't have a stockpile of protective equipment for people. And then secondly, politically, I think that the Trump leadership committed some, what I called--what are called some "deadly sins" in terms of how it led. A lot of the folks in the book is inside story because I was talking with, at the time, Jared Kushner, Debbie Birx, many other people inside the administration, and I sort of lay out verbatim the conversations and the things that went on behind the scenes that also, I think, show how that was approached.

I think when you paint the whole picture together, you just have to ask yourself, why is it that we did worse than other countries? Why is it that more people died relative to our population? And I think the book tries to not preach that answer but try to lay out some of those things that happened, and I think the lesson has become, I think, pretty clear for us to look at.

MS. ABUTALEB: Well, like you noted, you, of course, had a front-row seat to a lot of this and were talking to a lot of people who were key in the response. Hindsight, of course, is 20/20, and there are some of these bigger questions about collective sacrifice and policies. But given what you know about the response, what would you have done differently? What parts of some of the tragedy that we endured do you think were preventable or avoidable?

MR. SLAVITT: Yeah. So, look, first of all, managing a pandemic is not easy. You're never going to get it perfectly right. You're never going to get everything right, and so we ought to be very forgiving of any political leader that came from a good place, that was of goodwill, and even accept the fact that mistakes were going to be made, because managing a pandemic is hard.

But there are three things that are above and beyond kind of poor management that I think we should be looking at here. One is President Trump's power and penchant to deny the things that he doesn't like and things that doesn't make him look good, and there was a long period of time, as we know, certainly from Bob Woodward's reporting, where there was--where the president continued to deny that this virus was deadly, and here--and going to bed every night, sleeping every night until such time as the NBA and the stock market forced him to address the situation. His power to deny really hurt us. If he had simply said, "Look, we have a problem. I don't have all the answers. We have a problem," people would have been more prepared, and I think that's a deadly sin, to be frank.

The second is the quashing of dissent, and you've done a lot of great reporting about this, and the Post has done a lot of great reporting about this. But in the book, there's a part where Alex Azar wants to say on "Fox and Friends" that things are good, which they really weren't, but he wants to add that things could change rapidly. Not only was that cut, but he was prohibited from going on "Fox and Friends." And not only that, he was prohibited from doing media for 45 days. So, we have a situation where we have a major global pandemic, and the Department of Health and Human Services is cut off from talking to the press and talking to the public by the White House. That's a quashing of a dissent because it didn't fit with the narrative that President Trump wanted, and you can look at that example. You can look at what happened with Nancy Messonnier. You can look at the approach to the FDA or the CDC, but at a time when we didn't really know what was going on and we needed to learn, quashing the dissent of anybody who said I've got a different view is incredibly dangerous and I think was a disservice.

And then finally, I would say--and perhaps this is extra credit, but playing on the divisions in this country so that--look, wearing a mask is hard. Doing any sort of adjusting in people's lives is hard, but what I think the president saw as a populous was that he could turn this into an issue to win favor with his supporters by essentially making it a political issue. And that's much harder to recover from.

I talked to world leaders in other countries, and they said they too have people who don't love wearing masks, and they have people who don't like complying with social distancing protocols, et cetera, because it's very difficult. But at least, he said, for us, it's not a "What color is your jersey?" issue, it's not an identity issue, and in the U.S., you can't even talk about it because people have to essentially decide whether they're going to wear a mask or not based on their political preference. And I think those three things made the pandemic much more difficult than it otherwise would have been.

MS. ABUTALEB: There were, of course, people who felt like wearing a mask or some of these other sacrifices that we needed to make were too much. Do you think that there are sacrifices that people still need to be making right now, and if so, what are some of those?

MR. SLAVITT: Well, look, I think there's legitimate reasons for people to debate any of these questions if they're debating in good faith.

So, my concern is not if people say I hate wearing a mask, I don't want to wear a mask, I don't think it's effective, et cetera. Having a reasonable dialogue with facts, that's what we need as a country, and not everybody is going to agree, and I'm not expecting everybody to agree, but making this an issue where you essentially--your political identity decides that for you is a real mistake. And that hems us in.

Look, I mean, it would be my hope that coming out of this and in the place we're in, we have a dialogue, and we listen to doctors, nurses, people who are on the front lines, people who are most exposed to this, people who died in higher proportions, and understand what we could do better for them.

I felt like if someone is forced to work in a grocery store and forced to see my face as part of that, then I should be forced to wear a mask because they're exposed to people like me all day long. That's just a personal view. It's also a view that a lot of governors shared and some governors didn't, but it is part of a compact to one another to understand that there are people that are out there serving me and putting themselves as risk, and I want to do everything I can for them if they're in that type of situation.

Now that people are vaccinated, it's a very different story because people who are vaccinated have had a choice to be vaccinated. People who didn't get vaccinated, in many respects, have made that choice, not in 100 percent of the cases but in many respects. I think that goes away a little bit because back then people didn't have a choice to stay safe. Now they've had a choice to stay safe, and they choose not to. It doesn't mean that everybody else needs to adjust around them if they make that choice.

MS. ABUTALEB: You had mentioned when you were talking about your book earlier, the quashing of dissent, scientists not being able to speak freely, people like Nancy Messonnier and several of the other health officials. Now we're seeing a lot of that manifest in some deep disdain for the scientists, including Dr. Fauci who has, of course, become quite a target of the right. What do you make of the demonization of him? And, you know, there's a lot of pulling his words from last year to discredit him. What do you make of what he's had to endure from much of the Republican Party?

MR. SLAVITT: People should be careful about criticizing Dr. Fauci before they really understand what he has done. The last two decades, he had been developing the mRNA platform in response to viruses that we were seeing around the world, and this was basic research investing in foresight on Dr. Fauci's part and people on his team like Barney Graham.

On January 11th, when China put up the genetic sequence for the virus, Fauci and his team downloaded it, sequenced it, and then by the 13th, they had gotten into Moderna to start working on a vaccine.

I don't know what Marsha Blackburn or Tom Cotton were doing on January 11th or January 13th or for the last two decades. I'm sure they were doing valuable things, but we should be grateful to have scientists like that who have the foresight and are doing the things that really have allowed us to get vaccinated or we would have been in a much more difficult situation if we weren't able to access all of that research for all of those years.

I think we ought to be all a little bit careful about overly criticizing people, and it is the easiest sport in the world to go find a statement that someone made, go find fault, go find the place where people are wrong. And oftentimes people do that in a way to make--to show that they're just as smart as the experts. See? The expert got that wrong; therefore, you should listen to me because the expert is no smarter than me. That's a dangerous pattern. It's not a great habit. We have to understand that experts aren't always going to be right, but they ought to be humble. They ought to be modest.

But when the chips are down, you've got to be grateful that you have someone like Tony Fauci in our corner.

MS. ABUTALEB: Well, one other thing I want to ask you about, in your book, you talk about some of the additional time you got to spend with your sons who are home from school with you and your wife at home, and you mentioned last month and have talked a little bit about the fact that your son is a COVID long hauler. I think we'd like to know how he's doing and what you have learned from that experience.

MR. SLAVITT: Yeah. Thanks for asking.

First of all, he is--on the scheme of things, he's going to be fine. He's doing fine. So, I mean, on a scale of one to ten in the seriousness of stuff that happened in life, this is in the one to two category.

Nevertheless, he came to us last--even late last night, and his hands are ice cold, and it's strange. And it feels weird to him, and it makes him a little bit concerned and anxious. It sort of cycles in and out, and it's tachycardia, it's shortness of breath, it's cold hands, it's kind of runny nose, and things like this. And as a parent, your kind of--your go-to move with your kids is everything is going to be okay, right? So, when he asks me, "Dad, how long is this going to last?" you know, you reflexively want to go to your go-to move and say it's going to be fine or it's going to end soon or what have you. It's hard when you don't know. It's hard when you can't as a parent reassure your child.

And so, I would say that in the scheme of things, we've been quite fortunate, but it is a little bit unsettling not to know when his symptoms are going to go away. It does in the back of your mind make you concerned, that you hope that doesn't mean things are going to get worse. But by and large, this isn't the kind of thing that's preventing him from living his life in any way.

MS. ABUTALEB: Well, I'm glad to hear that he's doing better and able to continue living his life. I think that's a big relief.

Well, I think that's, unfortunately, all we have time for, but thank you so much for joining us today and for sharing your insights.

MR. SLAVITT: Well, thank you. It was great to talk to you again.

MS. ABUTALEB: Thanks again for joining us. Coming up tomorrow on Washington Post Live at 9:00 a.m., my colleague, David Ignatius, will interview former national security advisor to President Obama, Ben Rhodes, about President Biden's meeting with Putin today. At 11:00 a.m., we have our "Chasing Cancer" special, and among those guests is National Cancer Institute's director, Net Sharpless.

I'm Yasmeen Abutaleb. Thanks for watching.

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