Dr. Gottlieb, welcome back to Washington Post Live.
DR. GOTTLIEB: Thanks a lot. Thanks for having me.
MS. ABUTALEB: So I want to dive into your new book, but I think we need to start with some breaking news we just had in the last five minutes, which is that the CDC’s advisory committee made its decision on who is eligible for a booster. It differs a bit from the FDA’s recommendation, which they had made earlier--or the FDA’s approval, which it had made earlier this week. So can you just give us your thoughts on that and give us a sense of who’s going to be eligible under this advisory committee recommendation?
DR. GOTTLIEB: Well, it differs a lot from the FDA recommendation. They firmly rejected the FDA’s advisory panel and what they put forward. And I think part of the challenge is that this is very hard to interpret. So getting at your underlying question of who’s going to be eligible for a booster shot under the recommendation just made by the CDC, I think a lot of people are going to have a challenging time interpreting it. Very clearly the CDC sent a message that they think those above the age of 65 should be eligible regardless of their underlying medical condition. For people below the age of 65, it gets a little bit more confusing. Those ages 50 to 65, the recommendation seems to suggest that the booster should be available to those with underlying medical conditions. When you’re looking below that age, it’s a little bit unclear. They rejected the recommendation from the FDA that people be offered boosters based on occupational risks. So those who work in certain occupations with their heightened risk of exposure to COVID seem to be eligible under the recommendation made by CDC, but it doesn’t--it doesn’t seem to be the case here. And for people ages 18 to 49, the suggested that those individuals should be eligible for boosters subject to a separate determination of risk benefit, which seems to imply that they should consult their physicians.
And so where you end up with this kind of a recommendation is that a 30-year-old or a 25-year-old who might have asthma or some other underlying medical condition that could put them at some heightened risk for COVID, could be eligible for a booster under this guidance, but a 64-year-old who lives in an assisted living facility or a group home wouldn’t be if they didn’t have an underlying medical condition. So it’s a little bit confusing. I think it’s going to be challenging to fully implement this guidance if, in fact, the CDC accepts the recommendation from the advisory panel.
And it hearkens back to the early days of when the vaccines were first authorized last December, when the CDC put out a schedule of who they thought should be eligible for vaccines. That was very granular, very specific, and ended up slowing the administration of vaccines. States ultimately moved away from the CDC guidance and started to administer vaccines just on the basis of age, vaccinating first their oldest populations. The governor here in Connecticut, where I live, certainly did that. And it actually facilitated getting the vaccines distributed more quickly. So it was only when the states started to move away from the CDC guidance that they were actually able to deliver the vaccines more quickly. I think the same thing may happen here, that the CDC’s guidance is ultimately so granular and it’s going to be challenging to interpret and implement that it may actually slow the administration of boosters to those who the CDC deemed eligible.
Final point I will just make is that this guidance from ACIP, from the CDC’s advisory committee, is just that. It’s guidance. It goes to the CDC’s senior management, and ultimately, it’s going to be the decision of the CDC director whether or not they take this guidance or, you know, subject it to some further evaluation and issue something that’s slightly different.
MS. ABUTALEB: And I want to ask you really quickly before we move on, how unusual is it for the CDC to differ this much from the FDA in its recommendation?
DR. GOTTLIEB: Yeah, there were certainly past cases where the CDC would differ from the FDA and actually would sometimes cause chagrin within the FDA when CDC would narrow the recommendations being made by FDA. And this happens sometimes in the context of vaccines as well. I can’t remember a precedent where the CDC’s advisory panel differed this starkly from the FDA’s recommendation, however. I think that this is far more explicit than what I remember in the past. Usually in the past it was on the margins of the FDA’s decisions, where CDC would sometimes have disagreements. This is a very explicit deviation from the FDA’s recommendation.
I mean, the FDA, very clearly the advisory panel wanted to scope in people 18 and above who are at risk from severe COVID because of occupational exposure, which would include all the healthcare providers in the nation. And I think that was one of the reasons why FDA ultimately came down where they did, because they felt that the healthcare providers, many of whom were vaccinated last December and January, should be eligible for boosters. Under the CDC’s recommendation, if it is in fact put into effect, a healthcare provider wouldn’t be eligible for a booster unless they have an underlying medical condition and qualify because of their underlying health condition. Notwithstanding the fact that a lot of healthcare providers that I’m aware of are already getting boosters, I think a lot of healthcare providers will continue to do that. Under this guidance, they wouldn’t be eligible unless they have a medical problem.
MS. ABUTALEB: So this whole booster debate has been fairly unusual from the start. And one of the complicating factors here is that the WHO has adamantly opposed the use of boosters in wealthy countries that have pretty high vaccination rates. They say those doses should go to the rest of the world. What do you make of that? Is it a zero-sum game? The U.S. has recently announced that it’s going to double its donation of Pfizer doses globally. So I think the metric is that for every booster given here, there will be three doses given globally. So I mean, what do you think of that argument? Do you think that’s a valid concern? Or do you think it’s more complicated than that?
DR. GOTTLIEB: Well, I think the challenge around the global distribution of vaccines, especially in austere environments in low- and middle-income countries, is going to be a challenge of getting the vaccines distributed. It’s not going to be a supply issue going forward. There’s going to be a lot of supply entering the market, and I can break that down. But I don’t believe it is a zero-sum game. The bottom line is the Biden administration has purchased 200 million doses of Pfizer vaccine and 200 million doses of Moderna vaccine, and those doses are going to be used within the United States. And if they’re not used, they’re going to be stockpiled as a matter of our own national security. I suspect that the administration is going to want to have access to enough vaccine to revaccinate the entire population should something unexpected happen, should a new variant emerge where you have to quickly revaccinate the population.
So a dose used here in the United States isn’t a dose that isn’t going to be used overseas. We have now distributed 6 billion doses globally, collectively across all the companies. If you just break down with the Western manufacturers, Pfizer has committed to produce about 4 billion doses over the next 12 months. Moderna has said they’ll produce 3 billion. J&J is producing hundreds of millions of doses, and they’re going to be ramping up their supply. AstraZeneca is producing billions of doses. And the Serum Institute in India is going to be producing billions of doses. The Chinese manufacturers are, the Russians are as well. And Sanofi is going to enter this market at some point, I believe, and has capacity to produce a tremendous amount of vaccine. You know, collectively there’s going to be between 10 and 15 billion doses produced over the next 12 months. Six billion have already been distributed, 380 million here in the United States. Most of the Western world has been largely vaccinated. There’s obviously pockets of under vaccination in all the Western countries, but a lot of doses have already been administered.
And so, you know, this isn’t going to be a supply issue going forward. The global population is 7.6 billion, I believe. We’ve distributed 6 billion doses already. Obviously, that’s not 6 billion people vaccinated. But the difficult part is going to be getting into countries where you don’t have the cold chain storage, you don’t have the same logistics, and also convincing people to take this vaccine. We’ve seen vaccine hesitancy here in the United States and in other European countries. There’s going to be a lot of hesitancy across the world, especially when you try to put a Western vaccine into some of these markets. So it’s going to be hard to get people to take the vaccine. It’s going to be hard to distribute the vaccine. We’ve seen challenges just with the Polio eradication program, how difficult it can be.
So I don’t know that there is enough focus and dialogue around the distribution issues. The WHO seems to be fixated on the supply issues and browbeating Western manufacturers in the United States. I don’t see as much action on the part of the WHO actually putting resources into these countries to get the logistics in place to distribute the vaccine. That’s where we’re going to have to pour enormous amounts of money because of the challenge in doing that.
MS. ABUTALEB: And I want to move on to your book. But just real quick before I move on, I want to ask, do you think that the CDC advisory committee decision was the right one? Do you think it’s too complicated or that more people are going to need boosters than are allowed under these definitions?
DR. GOTTLIEB: Hey, look, I think the CDC’s Management and the CDC’s director need to take a hard look at the advice that came out of the advisory panel and take it under close consideration against the consideration of what is going to be practical and what is going to yield a regime that can actually be implemented. If there’s too much difficulty actually implementing the campaign, it’s going to forestall access, and it’s going to hurt worse the people who already face obstacles getting access to care. But if you require, you know, a doctor’s intervention, that’s going to put impediments in the way of people who, you know, already face obstacles getting access to care.
In an ideal environment, this would be available in pharmacies. It would be subject to self-attestation. Patients could self-identify when they’re eligible. That’s how they approach the booster campaign for people who are moderately and severely immunocompromised. It was self-attestation at the pharmacy. If they do anything more complicated than that--and the CDC’s recommendations, they would certainly seem to suggest that they’re going to have to if they want to fully implement what the advisory committee recommended--then that’s going to ultimately slow access to the booster shots, in some cases to--from those who need it the most.
MS. ABUTALEB: So like I promised, I want to move on to your book. So you start by talking about how, you know, you were one of the first people to understand the threat this possibly posed even when we really didn’t understand what exactly was happening in China in January 2020. And you write about alerting the White House through the then-Domestic Policy Council Director Joe Grogan. How did you feel your message was received both by Joe Grogan and by the administration more broadly?
DR. GOTTLIEB: Yeah, it’s hard to know how it was received more broadly. I mean, early on I had a lot of dialogue with the White House, and including with the president, with President Trump at the time and with the vice president. I had some weekly calls with the vice president for a period of time. So I certainly think the White House and certain elements of the White House were very focused on this threat early, and this is back in sort of the March timeframe, March/April timeframe.
Joe took it seriously. After that phone call that I had with him--I called him Martin Luther King Day weekend--it was right after the number of cases being reported in Wuhan had gone from 50 to 200, which I found deeply concerning.
And the other thing I found very concerning about that report that came out that night was that all 200 of the cases, or most of them, were being identified as having severe pneumonia. It’s very unusual that you have a viral pneumonia, a viral pathogen that only presents as severe pneumonia in that many people. I mean, SARS-1 was certainly that case. It presented as severe illness in those who got afflicted with it, but it didn’t spread so easily. And this seemed to spread easily, and it seemed to be causing severe pneumonia. What it suggested to me was that there might be hundreds, if not thousands of cases behind that and what we were identifying in Wuhan and up until that point was just the tip of the iceberg. So that seemed very concerning. Two hundred cases of severe pneumonia suggested a much larger outbreak was underway.
So I called Joe that morning--it was a Saturday, as I recall--and suggested that he reach out to HHS and just try to get a briefing together with HHS to make sure that CDC and FDA were coordinating--and the other offices for that matter, BARDA as well--because it was going to take a lot of coordination, in my view, between the different health agencies to try to mount an appropriate response. He reached out immediately to HHS, sent emails requesting a briefing for that Monday. And that was the day that Secretary Azar first called President Trump to brief him on the unfolding situation. So after Joe had sent those emails, the secretary reached out to the president. I don’t know that they were connected. But that’s the sequence of events. And that’s when President Trump was reached on the golf course by Secretary Azar, which you reported on The Washington Post, that conversation and how it went.
But Joe was on top of this. So was Matt Pottinger at the time. Had some dialogue with him. There were elements in the White House that I think were deeply concerned by the situation that was unfolding.
MS. ABUTALEB: And the failings of the pandemic and the pandemic response, especially last year, have been well-documented, and your book is distinctly not that. It’s not a political book. It’s about more systemic failings. So I know this is a loaded question because this is what your entire book addresses, but what are some of the biggest reasons you think the U.S. was so unprepared given that there were warnings over at least three administrations that a pandemic was inevitable?
DR. GOTTLIEB: Yeah, we--I think we had this illusion that we had prepared adequately for a pandemic because of the plan that had gone into place trying to prep for a flu pandemic. And part of the problem was that this wasn’t influenza, and I don’t think we appreciated the ways that a coronavirus pandemic would differ than an influenza pandemic. And part of the problem is that the plans that we had put in place for an influenza pandemic weren’t adequate even if we had been struck with a flu. I think that a lot of the things we did were sort of a technocratic illusion. The stockpile wasn’t adequately stocked. We stockpiled the wrong things. I didn’t think--we didn’t appreciate that in a setting of a global pandemic, if we were struck with a pandemic, everyone else would be struck with the same--the same viral pathogen and they’d all be tugging on the same supply chains at the same time. So you’d have shortages of elements of the supply chain that you didn’t anticipate. So, you know, we didn’t anticipate that we’d run out of nasal swabs and PPE and reagents to run diagnostic tests, because no one recognized that global supply chains would be closed in the setting of a global public health emergency. And so part of the problem is that we just didn’t prep right and we didn’t prep for the right pathogen.
A larger part of the problem and what I get into in a lot of detail in the book is that we didn’t have the right infrastructure here in the United States to mount an effective response. There was this perception that CDC was going to be able to mount a logistical capacity to respond to a national public health threat of this magnitude. It was going to be able to develop and deploy a diagnostic test that scaled. It was going to be able to develop a national vaccine campaign that was going to be able to engineer the manufacture of the equipment that we needed and the drugs that we needed, that it was going to be able to collect data and do real-time analytics and serve as guidance to policymakers and individuals in how they can reduce their individual risk, that was going to be able to able to collect data to even ascertain how this was spreading, what the geographic and social compartments of spread were, and how we can reduce the contagion. It couldn’t do any of those things. It’s a very retrospective organization, a high science organization that’s used to taking a lot of time to do very exquisite scientific work, but it’s not--it’s not a FEMA, it’s not a DOD. It doesn’t have the logistical capacity to respond in a way that’s needed in a moment of crisis.
And there wasn’t--what happened was, there wasn’t a recognition of what those limitations were until very late, and then they finally augmented the CDC’s response. And CDC also didn’t try to self-organize or raise its hand and say, hey, guys, we really don’t have this. We’re not the right organization to be doing these things. They plodded on trying to accomplish the tasks that were being handed to them and didn’t really have the ball.
MS. ABUTALEB: And do you think that the shortcomings of CDC and the agency not being structured to deal with a health crisis like this was the main systemic shortcoming that the U.S. faced, or are there others that you think are equally important to pay attention to, and how do we address them?
DR. GOTTLIEB: Yeah, look, I think that there were multiple failings at all different levels. The CDC--the weakness of the CDC was certainly one of them. I think we had underfunded public health departments, so we really didn’t have a distributed system that we could rely on. We had underfunded the public health labs, so we didn’t have a first line of defense to try to get in place a sentinel surveillance program. We didn’t have an adequate infrastructure for conducting clinical trials in a setting of a public health crisis.
The UK, the British were able to stand up their recovery trial, which was able to run practical clinical trials in a setting of a public health emergency like this. So they were able to get quick answers on what therapeutics were and weren’t working. We didn’t have that. We didn’t have an infrastructure to do that, and so we weren’t able to execute clinical trials quickly. And some of the most important clinical trials, like the ones involving the monoclonal antibody drugs, the Regeneron and Lilly antibody drug, weren’t able to enroll. Patients weren’t enrolling in those trials. So the most important therapeutics ended up being delayed to getting to the market because we simply couldn’t enroll the clinical trials.
So there were--there were failings up and down in terms of our response. I think one of the biggest underappreciated shortcomings was just our ability to collect information and do analysis that can form decision-making. Early on, CDC couldn’t even tell us how many people were being hospitalized for COVID. They were facing their hospitalization data on a small sample that they collected from 1,000 of the nation’s 6,000 hospitals, and then they were modeling how many people were being hospitalized each day for COVID based on that small sample set. But that small sample set wasn’t representative of the country. The virus was spreading early on in a highly regionalized basis. So if they missed an entire region where the virus was spreading, they might be undercounting how many hospitalizations were occurring. Based on their sample set, the entire northern half of California wasn’t included. And so when CDC was saying that there were 2,000 or 3,000 people hospitalized for COVID, they didn’t actually know that. It was an estimate based on a model.
And then when it came time to actually ship drugs to hospitals when Remdesivir became available and they had to ship those doses to hospitals, the CDC wasn’t able to tell HHS which hospitals actually had patients hospitalized for COVID because they didn’t have that data. That data should have been able to be collected. And ultimately, the HHS took over the task of collecting that information and was able to collect granular information on exactly how many people were being hospitalized each day. We should have had an infrastructure in place to do that.
But again, the culture of CDC is that they collect data feeds--these very bespoke data feeds--that’s only collected for CDC. So they have their own unique data feeds. They’re not collecting data out of health records or other kinds of accessible troves of information. And they’re used to taking these data feeds which are just a sample of the population and doing modeling work to actually arrive at an estimate. That’s how we estimate how many people are hospitalized for flu each year or die from flu each year. It’s not a point estimate. We don’t actually know how many people die of flu each year. It’s based on a model that CDC does that’s derived from a small sample set. And so that’s not a really appropriate way to get at important pertinent public health information where you need point estimates in the setting of a crisis and yet we relied on those systems.
So up and down, I think that there was infrastructure problems with our response that we’re going to have to think of how to create an entity--and I think it’s going to reside within the CDC--but how to create a capacity to actually respond to a public health crisis of this magnitude. And part of it’s going to require looking at these kinds of things through a lens of national security and having in place more of a logistical capability that you would have, for example, a hurricane response. We don’t have that right now for a public health crisis.
MS. ABUTALEB: So I think one thing that a lot of us are sort of struggling to understand is more than 700,000 people have died now, and we’ve surpassed the death toll of the 1918 flu even though in theory we should be much better prepared now. So in March 2020, the Trump administration had projected up to 240,000 deaths with the mitigation measures that they had in place--still in place at the time, which were some of the most aggressive we’ve had throughout the pandemic. Were there points in time in the response where a different response or a more aggressive response would have dramatically reduced the death toll? You talk a lot about solutions and how to prevent against this happening next time. So where do you see some of the opportunities that were missed this time to prevent against such a catastrophic toll?
DR. GOTTLIEB: Yeah, well, when you’re looking at sort of the more systemic woes that I try to, you know, discuss in the book, I think that there were things that we could have learned earlier about this virus that could have helped us respond better. So for example, if were able to ascertain the asymptomatic transmission, if we were able to ascertain that this was spreading primarily through aerosols and in so-called superspreading events--it took us a very long time to come to these conclusions--again, because we weren’t collecting good data and doing good analysis to actually draw out these conclusions. We were wiping down our groceries for far too long under a presumption that this was spreading through contaminated surfaces, when in fact it was spreading through aerosols by putting the wrong person in the wrong place at the wrong time--someone who was pre-symptomatic, who was exuding a lot of aerosols, probably talking loudly or singing in a confined space with poor air circulation. So what are those spaces? Those are bars, they’re restaurants, they’re religious gatherings. So we didn’t--we didn’t understand how it spread, and so we couldn’t actually put out appropriate guidance.
The lack of a diagnostic test early, the instability to scale a diagnostic test and get it distributed not only prevented us from being able to identify the early spread so that we can use tracing and tracking and testing to try to limit the scope of the spread, but it also prevented us from knowing where the virus wasn’t spreading. And so when we actually implemented the population-wide mitigation because we had lost control of the virus, clearly we had to shut down New York. New York’s healthcare system was breached. New Orleans, Chicago, Boston, they were cities that were engulfed with virus. But not every city was engulfed with virus. Remember, this was a highly regionalized epidemic all the way through. There was really only one point where this has been a confluent epidemic. It was last winter, when the whole country was engulfed. But otherwise, it’s been highly regionalized.
And in the early days, during that first wave when New York was overrun with virus, parts of Texas weren’t. Florida wasn’t. Arizona wasn’t. Wyoming wasn’t. But by not being able to ascertain where the virus wasn’t spreading, we had to implement the mitigation nationwide. People in those parts of the country rightly concluded that they probably didn’t need to shut down their own economies. They weren’t at the point where they needed to do that. And so when the virus eventually spread to parts of the South, people down there said, look, we’re not shutting down again. We did it in the spring when you told us to, we didn’t have to, and we’re done with the shutdowns. The political leadership had lost the political capital to be able to implement mitigation when it was needed.
If you go back to the 2005 pandemic plan that was planned around a flu, it talked for the first time about population-wide mitigation, the idea of closing schools, closing restaurants as a way to limit the spread of a pandemic pathogen. But it never anticipated a national shutdown. The mitigation was always anticipated that you would do it on a city-by-city basis. You’d have the equivalent of what they called snow days in that plan, where you’d slow activity as certain cities became engulfed with virus. We couldn’t do that here because we didn’t have a diagnostic test. And that was a failing of multiple agencies. It was a failing of CDC, who bungled the rollout of their own test, BARDA didn’t get engaged to fund the development of the diagnostic early on, and HHS didn’t lead an effort to get the private manufacturers into this game. They made it difficult for the private diagnostic manufacturers to get into the market by putting very onerous IP requirements on them and not giving them access to the viral samples that they could use to design their own tests. So there were multiple, you know, sort of structural features of how we orchestrated this response that made us excessively vulnerable to this spread.
And then getting to the sort of politics of this, I think that if we had had more collective agreement around a common set of shared principles on how to slow the spread--it wasn’t going to prevent the pandemic; this virus was going to spread--but could we have reduced the scope of the spread, could we have bought ourselves more time and preserved more life until we were able to get to a vaccine? I think we could have if we had agreed early on that there were a common set of principles that we should adopt nationally to try to make the country more impervious to the virus’ continued advance, like wearing masks and high-quality masks, getting high-quality masks to people who were more vulnerable, you know, agreeing that we’re going to limit our social activity and try to, you know, limit the kinds of environments that are conducive to spread. There were just certain things that we could have done that weren’t going to be onerous on society. They were--they were, you know, inconvenient but they would allow activity, business activity, leisure activity to continue on some semblance of normalcy but could limit the scope of the spread of this virus. We couldn’t agree on the easy stuff, and that was a real problem. And we couldn’t get political leadership to align fully behind the easy stuff all the way through.
MS. ABUTALEB: Well, I think one thing you’ve become well known for throughout the pandemic is your predictions. So that’s where I want to end, looking forward a bit. What do you think will happen in the fall and the winter? What do you expect to happen with coronavirus in the fall and winter, especially that, you know, there will be some co-mingling with flu? And I know there’s been some concern that this year or next year could be a more severe flu season since there’s less immunity in the population since last year was much lower flu rates than we’ve seen in some time.
DR. GOTTLIEB: Yeah, we’re in for a very bad flu season. We didn’t put immunity in the population last year. It looks like this may be another year where flu prevalence is lower. It turns out that the mitigation that we’re adopting to try to slow the spread of the coronavirus, while marginally effective against the coronavirus, is very effective--seems to be more effective against flu which spreads primary through droplets and more typically spreads from one person to two people, versus this virus which spreads more from one person to 30 people. I’m of the opinion that this delta wave--barring something unexpected, this delta wave is probably the last major wave of infection that we’re going to have. And what I mean unexpected, I mean a new variant that pierces the immunity that’s offered by vaccines and prior infections. So barring that from happening, on the back end of this delta wave--and I think there’s still parts of the country that are going to be engulfed by this delta infection even as cases plummet in the South and the overall national average comes down because of that--the Midwest is very hot right now. I don’t think the Northeast is impervious to delta spread. But on the backend of this, I think prevalence will decline.
And so we’ll get to a place maybe through the winter where we’re at 20 cases per 100,000 people per day. You know, to give you a basis of comparison, during the peak of the South epidemic, the delta epidemic, they were at about 110 or 120 cases per 100,000 per day. During the nadir in the summer, in June and July when prevalence fell very low, we were at about four or five cases per 100,000 per day nationally.
So, you know, we’ll probably bounce around, around 20 cases per 100,000 people per day. There will be virus around. I think, you know, it will be an environment where a lot of activity is resuming against that backdrop. And then on the backend of this, I think this becomes a more endemic virus.
If there is going to be a new variant, many people think it’s going to be within the delta lineage, so it’s going to be some mutation on this delta variant. There’s actually 20 different delta variants circulating right now. And if we do end up revaccinating the population in the future, I believe--and this is still an open question; there’s still a lot of debate around this--but I believe it’s probably going to be a vaccine that’s based on the delta backbone. Again, barring something unexpected when a new variant comes along, if we come to the conclusion that most of the mutations are going to happen within this delta variant because this is now the dominant strain, you could see in the future vaccines engineered based on a delta backbone. And all of the companies, including the company I’m on the board of, Pfizer, are developing delta variant vaccines--not necessarily to deploy but to have in their back pocket. But this--we’re transitioning from the sort of pandemic phase, at least here in the West, to an endemic phase of this virus, where this becomes a persistent menace that we’re going to have to deal with every fall and winter.
And combined with the flu, getting back to your original point, the combined death and disease caused by COVID alongside flu is going to be too great for us to be complacent about it. We’re going to have to do things differently in society to reduce the cumulative effect of respiratory pathogens in the wintertime.
MS. ABUTALEB: Well, we’re unfortunately out of time. So we’re going to have to leave it here. Dr. Gottlieb, thank you so much for joining us today. It was a fascinating and I think very newsy conversation.
DR. GOTTLIEB: Thanks a lot. Thanks, Yasmeen.
MS. ABUTALEB: To find out more about our upcoming programs, head to WashingtonPostLive.com to register and find more information. I’m Yasmeen Abutaleb. Thanks for watching.
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