In the Bubble with Andy Slavitt: Our Shot

Breaking COVID News (with Dan Diamond)

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Andy turns the tables on award-winning Washington Post journalist Dan Diamond, who has covered health care policy (and Andy) since the Obama administration, and asks him about COVID and the media. Andy and Dan talk about what it’s like reporting on the Biden administration after covering the Trump administration, if Andy considers himself a member of the media, and Andy’s appearance as Dan’s debut guest on his old podcast Pulse Check. Keep an ear out for the moments where the two of them slip back into their more familiar roles, Dan as interviewer and Andy as interviewee.

Keep up with Andy on Twitter @ASlavitt and Instagram @andyslavitt.

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Andy Slavitt, Dan Diamond

Andy Slavitt  00:18

Welcome to IN THE BUBBLE. This is Andy Slavitt, your host, thank you for joining me today. We are entering a completely new phase of the pandemic, at least. So says the government of Sweden, Denmark, and Norway, and other European countries who have decided that now’s the time to lift all restrictions, indoor gathering large events, vaccination requirements, masking of any sort in their countries. And that’s going to be effective the beginning of this month. Now, it really is a new phase as the pandemic, it doesn’t necessarily mean that it’s borne out by science one way or the other. I think it’s too early to know what sort of threat they’re going to face in their country from COVID-19 current variants or new variants. But it does reflect countries I think, who have been several who have been leaning this way along, saying, you know, the burden is no longer there on our health care system. And because it’s no longer there in the health care system, we are going to essentially remove all the things that we were doing to keep people safe during big waves and move them out big waves. And you might wonder, well, is this where the United States is heading? There’s one major difference between what’s gone on those countries and what’s going on in the United States. Those countries have greater than 75, in some cases, 80% of the population fully vaccinated, fully vaccinated thinks they’re defining as at least two doses.

Andy Slavitt  01:57

And so they feel like that gives them a level of like protection and blanket coverage, along with the fact that they’re not seeing any variants for a while, or at the moment. And that gives them the logical sense that, hey, they will not be putting a burden on their healthcare system. Whether right or not, can’t possibly know, they can’t possibly know. But it does represent a pretty big difference with the United States, the WHO set a goal that sometime in the middle of this year, I believe, by July, we would have, every country have 70% of its population fully vaccinated. And there’ll be a lot of countries that won’t surprise you too many of them are that will not meet that goal. A lot of them are in Africa. Some of them are nations that have big challenges with vaccinations like Egypt. And some of them are poor countries like Bangladesh, Pakistan, and Ethiopia. That also includes the United States. The United States is one of these 100 odd nations that is not on track, to have its vaccination to meet those vaccination levels. That is a big difference between what’s going on the US and other countries. A lot of vaccinations, a lot of people been vaccinated, but a lot of people still haven’t. And our ability to handle another wave is going to be directly related to that and the ability of our hospitals to handle that. It’s no secret that our hospitals were very busy over the Omicron wave with people who are largely unvaccinated, we run that risk again. So look, nobody can tell the future. Nobody can tell whether what the policymakers in Sweden and Denmark and knows what they’re doing are wise or foolish. In retrospect, maybe they’ll look like geniuses or like idiots. What I think is important is that when cases go up, we not get overly concerned. And when cases drop, we don’t overly drop our guard, things are never quite as bad, or never quite as good as kind of that sentiment would give us. And I think while everyone’s in the mood to drop as many things as possible, get back to life.

Andy Slavitt  04:24

I would encourage that; I would encourage getting back to life as much as possible. But I would also suggest that we all remember that each time these waves come, we have sort of not anticipated the next surprise so don’t live in fear. Don’t live in expectation. But also understand that this is not over. Things have to play out. And we have the tools to manage situations well but we have to use them. And in this country. If we don’t vaccinate and boost, then when waves come they’re gonna hit us hard. than they are in countries like Sweden, and other parts of the world, very difficult to know the right answers here. But important to lay out a sense of what these different scenarios are. I think it’ll be very difficult for countries like Sweden and Denmark, to reimpose restrictions after what they’re doing and saying today, maybe I’m wrong. But I think it’s going to be very difficult. And once they put the public in that frame of mind and saying we’re in a quote unquote, new phase, people expect that that’s what’s going to happen from then on. So as long as they’re if they are prepared to adjust, then I think taking off restrictions, or at least some of the ones that they’ve suggested, makes a lot of sense. Some of them may cause you to scratch your head. And we’ll listen to what public health experts around the world say about them. But interesting, new phase, whether the new phases in people’s patients level, or the new phases in government, changing how they respond to whether the new phase is actually in the way the bug is working. can’t say for sure. Probably not necessarily all that related. Really interesting conversation on the show today that we’re bringing you. Sit back and relax and listen or clicking your pace on your treadmill, or your peloton or whatever you’re doing when you listen to the podcast.

Andy Slavitt  06:21

So Dan Diamond, Dan Diamond is a Washington Post reporter and is a guy that is broken, I’d say many if not the lion’s share of the big pandemic stories, starting in the Trump years, going into the Biden years, he is kind of the probably, in a short time become someone whose coverage has become very scrupulous and analytical of how of our pandemic response and he’s gonna give us a sense today of what it’s been like to cover the pandemic in these two administrations, a bit of a retrospective on comparison of policy responses, you’re gonna hear us get into it a bit, scrap it up a bit. He’s a reporter that used to cover me. And I challenged him on a few things that I think he could have done better. He challenges me on a few things and did better. And it’s a really enjoyable conversation. I think it provides some insight into how the information that happens in Washington gets to you. And I think provides a good new perspective. Very interesting. Hope you enjoy the conversation. Let me bring on Dan. Dan is the national health reporter for The Washington Post. He did win a big award. He’ll talk about that because he loves to brag. He doesn’t, but here’s Dan

Andy Slavitt  07:45

Well, hey, you finally made it onto the real. The real show, you made it to IN THE BUBBLE.

Dan Diamond  07:51

I’ve made it inside the bubble. Yeah. So it seems like a safe place to be in the middle of the pandemic.

Andy Slavitt  07:56

Yeah, the whole idea is just forget that you’re here. You’ve been covering HHS and the White House and health care in Washington for how long now?

Dan Diamond  08:09

It’s been about six years of full time reporting on the administration. Before that I was in healthcare consulting, I wrote on the side, but it’s a very different line of work when you’re just parachuting into right opinion columns versus daily beat reporting on the administration.

Andy Slavitt  08:25

Well, and you broke some really big story and got a lot of notoriety. Or you became well known for some of the nice stories you broke for Politico, and then more in the Washington Post, you know, there was a, there was a story, which ultimately, was part of leading to the resignation of the first house secretary in the Trump administration, about his use of airplanes. And I know he spent months and months and months on that, and it ended up being a pretty, pretty big story. And it was, I think, part of what ultimately led to him being replaced.

Dan Diamond  08:59

Yeah, that that story, Andy, for me, it was like getting a master’s in journalism. So I came in to Politico in early 2016, where I took over the healthcare newsletter, that Politico head. Spent a lot of my time reading the remarks and tweets of a CMS administrator named Andy Slavitt. But by 2017, I was finally starting to figure out how to actually break stories and my colleague Rajan proton, had gotten this tip that Tom Price, the first health secretary under President Trump had been flying everywhere, on charter jets, I mean, not just across the country, but trips up and down the East Coast that you could do by car or train. So we did work for a long time on that story. And part of the process was we were just trying to get proof, we were trying to get details. It’s one thing to be told a rumor, it’s another thing to get it to a place where you can actually safely report it and it led us to some interesting places, including camping out in airports, trying to catch him in the act. But that story was also informative because I’d never really up until that point, worked day in and day out with the senior editors at politico, I never broken news that the world kind of adjusted around and it was informative and also addictive. It became for me the kind of reporting that I really wanted to do.

Andy Slavitt  10:18

Trying to suss people out, look for scandals, and so forth.

Dan Diamond  10:22

There were a lot in the Trump administration, but it’s kind of less about scandals, and more about just revealing things, revealing things that people might not otherwise want known. And in that case, I think it was, it was enlightening about how the Trump administration was doing its business.

Andy Slavitt  10:36

That’s really interesting to think about, kind of this, use your phrase addicted. Because I think there was some addiction, like during the Trump administration, I feel like there was some addiction, not just to your part, but sort of across the board, I’d like the stuff that was routinely coming out of the White House, or the departments or the administration, good or bad. It was just super interesting stuff. I mean, it was like, it was like more, more like unusual things happening, then it’s happened in a long time and as a reporter, and look, Trump even said, on occasion, some words to the effect of hate CNN, you know, you guys are addicted to me, Hey, media, you know, I’m making bank for you guys. Because covering me is a lot more lucrative than covering anybody else. And you may say, you don’t like me, but you need me. I mean, there was some weird dependency it seemed to be like on and covering his behavior. That almost I don’t know, it almost had an effect of, of making it look like it was sort of mutual, it was sort of some kind of an enjoyable in some sense.

Dan Diamond  11:53

What’s interesting, there clearly was a symbiosis between people interested in following government news because of Donald Trump, and the amount of coverage that was then produced. So you can see it in the subscription numbers and the ratings. And I mean, it’s I can’t argue that there was a lot of interest in what the Trump administration did. I do know that the coverage we did, leading up to the Trump administration, and after the Trump administration continues to be pretty much the same. I mean, there was more, it was different, and then the nature of what was being reported, but I’m still scrutinizing the health secretary, you know, I’m still writing tough stories about what we’re doing nationally on the federal level in Congress on health care. So the approach hasn’t really changed, but the amount of stuff has, and the amount of impact times feeling like world changing dramatic things that were coming from the Trump administration that’s clearly gone.

Andy Slavitt  12:49

Here’s the part that I only get into with you. I’m like, how do you write a tough story about Biden, in the Biden administration? When the kind of the very nature of what you’re challenging, it seems a bit different, and I don’t want to put words in your mouth, so you can tell me how you see it. But, you know, we get one administration where it wasn’t always clear that, that the President had the best of intentions, that he was out for the public good when talked about the pandemic, when managing the pandemic, that he was in denial that he wasn’t looking for information to come out that he was trying to cover the stories. And then you know, you covering Biden, people, I don’t think are generally worried about his Biden lying to us 50 times a day, or is he working he’s hardest to get things done. And they may be worried about, you know, did we nail the response? Are there things we could be doing better, and so forth? But when you write a hard story about the boat, they kind of both come off kind of very much the same as if the same that headline looks equally as concerning. When it feels like a totally different ballgame. How do you manage that?

Dan Diamond  14:01

Well, I think first we should just acknowledge that if I’m going to talk about the Biden administration, one of us and it wasn’t me. I was a member of the Biden administration for some time.

Andy Slavitt  14:10

So you think I’m biased?

Dan Diamond  14:12

Well, I think we have very different perspectives.

Andy Slavitt  14:16

Let’s hear yours.

Dan Diamond  14:18

This is why I wanted to come on in the bubble to get battered around. The tables have turned. I think there are a couple ways of answering your question first. The headline and abstract. It’s hard to judge almost any story I think an abstract this has come up over and over again where the Washington Post where I work now, we might write a tough story like I wrote about Surgeon General Vivek Murthy, going through confirmation last year, and that he had more financial entanglements than a Surgeon General nominee usually would. Now I wrote many stories about Trump administration nominees who had their own entanglements. But out of context, people see the one story I wrote about a Surgeon General nominee. And it somehow becomes equivalent to all the stories that we’ve done in the past. How can we never do this with the Trump administration? When the truth is, we probably did much more, because those nominees had many financial entanglements or other complications. So I think it can be hard in looking at any individual story to really get the full picture. And maybe we are doing some tough stories on the Biden administration. But I think in bulk, there are probably lots more tough stories on all the excesses of the Trump administration. So that’s one way I would answer the question. I think another way is to try and put in context when there is an excess or a mistake. So I covered political interference and the Trump administration, I think I found some pretty hard and fast examples of the administration officials trying to meddle with reports that were going out, or change the message or prevent experts from going on TV. In the case of the Biden administration, there have been disputes, and we’ve written about them, but they are a different order of dispute. And I think if you look at the language and how they’re contextualized, there would be a difference in that coverage.

Andy Slavitt  16:16

Yeah, yeah. I think that’s the part. And I’m not really so much in the frame of mind of saying, Don’t criticize Biden administration, how could you criticize them when Trump was worse, is really more trying to understand how you as a reporter, and other media in general, bounces back from a situation where, like, we put to this way, like every administration, at least, that I’ve been a part of things, they get bad coverage, only one administration doesn’t think you should be allowed to actually have a free press. So to me, it’s like you know, across the board. If President Biden came out tomorrow and said, hey, there is no pandemic, we don’t need to do any more testing, testing is just gets us in trouble. By the way, take some kind of smoke and mirrors thing, don’t worry about the vaccine. Because he hasn’t done that when he does something that is, you know, doesn’t see all the consequences of the Omicron wave coming. Or it doesn’t hate every element of his plan, which you wrote about, you know, if you have to write about that in a way, which, you know, doesn’t let anybody off the hook for not hitting their goals. But also, I imagine it’s got to feel totally different than when you’re trying to describe somebody who’s literally trying to prevent the events from unfolding from being told as they’re being unfolded.

Dan Diamond  17:41

You know, I was having a conversation with someone with knowledge of Biden Administration Health Strategy the other day, and I will say this to you on your podcasts, I’ll say it on NPR, if they stick a microphone in from my face, I’d say it on Fox News. It feels fundamentally different to cover this administration. And this administration has behaved very differently when it is encountered similar conflicts. So for example, I don’t think it’s a secret to say that the federal health bureaucracy at times annoyed officials in the Biden administration, you can challenge me if you like, you know, better than me. But there were times that the White House wanted to get things done, say on booster shots, and ran into resistance inside the bureaucracy. The Trump administration also ran into […].

Andy Slavitt  18:25

By bureaucracy meaning like CDC?

Dan Diamond  18:27

Right, CDC-FDA officials who mean well, and had their concerns about, say, the booster shot plan, and were worried that the Biden administration was circumventing what these regulators wanted to do. So I think any administration is going to run into challenges in the bureaucracy and get upset about them. The difference to me is that the Trump administration, it’s like being I think the analogy or metaphor I used was, it’s like getting into traffic on the expressway. We all hate it. But the Trump administration, you know, got a bulldozer and tried to drive over all the traffic, the Biden administration grumbles about it and maybe tries to figure out a way around, but it’s much more conventional. And it makes for, in some ways, a less interesting story that’s not going to grab headlines, but it’s also the way that government should probably be working. The government should not be trying to rewrite retroactively CDC reports like what happened in Trump, so I try and make sure, Andy, when I’m covering, as well as talking about the coverage to draw that line.

Andy Slavitt  19:30

Sure. So what you’re saying is in effect, it’s like you talk to someone in the Biden administration says, boy, I’m frustrated that this is where the CDC is, but this is where the CDC is, and we have to deal with it. Versus in Trump administration, where they effectively said CDC is here, and then you saw action. So they’re trying to change them and hire people behind the scenes to change their messages from under them in a kind of cloak and dagger kind of way.

Dan Diamond  19:54

Right. I mean, the Trump administration said in public and a lot in private, that people at CDC and FDA where the so-called deep state, they were trying to undermine President Trump’s reelection. They made it a battle and a war inside the administration. I mean, we weren’t just fighting the pandemic, the government was fighting itself, the Biden administration for all of its stumbles is much more aligned on the overall goal and the overall mission.

Andy Slavitt  20:48

Part of what I wonder, and this is, this is a bit as a partisan for sure. So, it’s fair to point that out, is how we keep ourselves as a country from having a short memory. So I, you know, I read all these one year retrospectives on the first year of the Biden administration, and all of the things I wonder, like, okay, now can we write the one your retrospective on what it feels like not to be lied to have the press be lied have a constant xenophobia, have a constant racism, have, you know, all of these things that like, were really, for someone like me, and maybe a lot of other people just disturbing in their own right, like, and to me, like, it’s not even about the policy, somebody about the policy decision, I think, you know, trying to get rid of the ACA trying to get rid of Medicaid, like, I felt like there were all these existential battles. But even if you put those aside and just stick to the lying, trying to get rid of journalism, trying to undermine voting, trying to undermine democracy, and, you know, short of every single story you write about the Biden administration leaving literally half of this space. But, this isn’t as bad as when someone was trying to steal your country, which of course you can’t do. The question, in my mind is like, how do we rescue ourselves from the short memory. Because you know, it’s not like you can write a story or like you have written a story which says, hey, this stuff is whole by orders of magnitudes different than what we were dealing with last year. Or maybe you can?

Dan Diamond  22:16

Well, I can answer that two ways. First, at the end of the Trump administration, one of my last stories of Politico before joining the post was how Trump had warped HHS. So it was about all these ways that the Trump administration had changed the functions of this health department in ways not for the better. So it was a moment to take stock. But I also think, Andy, we were in the middle of a pandemic, a presidential transition, and very quickly, the attention did switch to okay, what is next? So there was some Trump retrospective, maybe there would have been more if there had been kind of more time to reflect. But I will also say this, advice that I got years ago was to the effect of personal advice. You know, you can blame your parents up until the age of 30. But after that, your decisions are on you. And I feel sort of that to uncovering the government, you can always blame the last guy to a point, but then it’s on the current team.

Andy Slavitt  23:09

I’m not even in this saying we need to blame them now. I’m saying come election time. I hope people don’t forget, like what that was like, and that if they’re frustrated with any element of the current administration, you know, we’re microscope is our current challenges. But  they’re very, very different from the existential ones we had before. I mean, just to hear, you know, Trump out saying that he would strongly consider pardoning the January six, he calls them demonstrators or protesters or what have you. You know, he’s thankful he’s reminding us of like, oh, yeah, that was that. That was cool. And that was happening. And that was that cool that he took that attitude? And then maybe it’s a maybe he will remind us who he is. But, I do think like, I do remember when the post and Bezos and a lot of the reporters, they’re like, during the Trump administration really amped up its coverage in a way to hold government accountable. You know, the kind of tagline at some point moved to democracy dies in darkness.

Dan Diamond  24:18

Because on the blanket behind me, actually.

Andy Slavitt  24:21

Yeah, awesome. Well, it felt like that the media was really, really doing its job in a way that we really needed. And, of course, you know, now, in this administration, I do think the same kind of things are true. Like, I do think, you know, when we see media stories when I was inside, that were critical, or were you know, you did ask yourself, did we miss something? Or is there something we’re not getting it or something we’re not seeing? And if you see enough of it, it does provide, I would call it good pressure. To ask yourself, boy, something we’re doing is not resonating. You know, what is it and but I, and I think that’s the way probably it had been at least that’s how I experienced it during the Obama years as well, that there’s a really valid role to play for the relationship between the media and the administration and just not supposed to be cozy. You’re supposed to call folks out. But you know, then everyone’s got their own perception of who’s being fair and what’s being fair and nobody thought thing. Nobody claimed things were more unfair than Trump, right? He thought he was being picked on to no end. And maybe that’s just always in the eye of the beholder.

Dan Diamond  24:58

What I would say is this, it was clarifying during the Trump administration, if you remember the press covering the government, what the stakes were, what the focus was, in a way that, for me, help focus my coverage. I knew what I had to do every day and especially when the pandemic had. It’s a little harder in the Biden administration for a bunch of reasons. One, the pandemic at this later stage is a more complicated issue to cover. And second, the response is not as focused out of the White House. I mean, during the Trump administration, the way that President Trump put himself at the center of the response, whether it was speaking at the White House podium, and often miss speaking or offering misinformation. President Biden doesn’t do that. He’s in a very different role with respect to the national strategy. So I think, Andy, some of it was, because Trump made himself the government so often, he was the decider, for better and for worse, that meant that the reporting often ended up being Trump focused. There were stories and during the first year of the pandemic, I remember a few that sometimes when I thought too far, they looked for conflicts, they made problems out of the fact that someone affiliated with Trump might have had an idea. And then it became a story that wasn’t really backed up by the facts.

Andy Slavitt  27:01

Yeah. And I felt that that there are certain reporters, you and I’ve even talked about her a couple of more, who were I felt so addicted to that level of controversy that they were writing things about the Biden administration. They were like looking for gotchas. And I remember like one reporter wrote, why won’t the Biden ministration use the word wave? And we were like, we’re like, because cases are declining and flat.

Dan Diamond  27:30

I do think it’s fair to say that there are reporters who have looked for ways to hold the Biden administration accountable. And that’s a good goal, we should hold the government accountable. At times, I think, maybe a hangover effect from the Trump administration is being too cynical, when just the facts are sometimes what they are.

Andy Slavitt  27:51

Right. I wrote, I put something on Twitter yesterday about how the FDA has been criticized for not rapidly approving rapid tests, many of which did not have a lot of data behind them. People say they’re too slow. And I’m speaking a broader point that if they make a decision around kids zero to five, as their as they’re about to, to do something aggressive, that, you know, if you’re FDA, you’re in a situation where almost no matter what you decide, you’re going to be considered, there’s going too fast or too slow for some people. And someone wrote, you know, someone wrote on Twitter reporter Slavitt just said the quiet part out loud about FDA, as if it is if there was some scandal and what I was saying about the FDA not approving rapid tests enough. So I feel like there’s a combination of whether it’s the Trump years or social media or whatever, people looked at edge up controversy. When you know, there’s nothing controversial, because I was clearly just putting it out myself.

Dan Diamond  29:01

So I’m curious how you see your role in all this, because you were a person who, at the beginning of 2021, you are what we would call principle. You were someone speaking to the press, you are shaping policy. Now you’re on the outside. I mean, are you a member of the media now? Is that how you describe yourself?

Andy Slavitt  29:20

You know, there’s a real question of over what the media now is. And, you know, in the back in the day, there used to be journalism and reporters, and then there were opinion people. And, you know, that’s gotten blended. Because there are, you know, people who write you know, people who write morning newsletters, like David Leonhard at the New York Times. Is he doing journalism? Is he doing opinion?

Dan Diamond  29:47

I would say he’s doing journalism, but I have an opinion on the journalism he’s doing. My opinion is that at times he’s been too optimistic where he’s featured people who have been historically too optimistic and sometimes wrong experts who don’t have a great track record. But I also think the newsletter is journalism. And I say that as someone who when I was at politico, I was writing a daily newsletter. I was hosting a weekly podcast, and I was doing the accountability journals that we discussed. So I think it’s all journalism, it’s just different kinds.

Andy Slavitt  30:19

But the lines are much broader than they were, say, a decade or two decades or three decades ago. Yes, there are people who write an opinion pages, and there’s people who write for the main part of the newspaper, but there’s a lot of analysis and opinion inside regular journalism these days. And that part of what accounts for that is the fact that there’s different, it takes different forms. And so, you know, I think what David does, is probably more journalism. But I also think he has a point of view. And it’s not hard to see his point of view. And I don’t know that he views his role as to play it down the middle, I view his role is to say, here’s what people aren’t thinking about. And here’s the way to look at things. And here’s the way, and here’s a theory of the case, like he’s aligning up a bunch of facts, whether he ends up being right or wrong, or too optimistic, or too pessimistic, is put that aside, I think he’s lining up a point of view, to say, here’s some really interesting data and facts. And here’s how it comes together. That’s a different way of journalism working. The reason I respond that way is because I’m clearly not a journalist, I’m clearly not someone who is a reporter, and clearly not someone who tries to bring people news.

Andy Slavitt  31:31

There’s other people that do that. But I do think what this is to take to take this podcast is it’s a long form, way of helping people get information. And I don’t claim to be, I don’t claim to have a point of view any less than say David Leonhard does. But I think the idea behind this show, is to take people in my bubble where I get to talk to people like you all the time, I can talk to people like Rochelle Walensky, and Tony Fauci, or other people and say, I’m not gonna have those conversations behind closed doors, you come into my bubble, you can see it for yourself. And we’ll get into a really good conversation about that, generally speaking, insiders have in your times called me like something like the ultimate insider once, and I’m just sort of like, okay, well, my job is to try to open those doors up a little bit, like kick them open. And I don’t tend to like go in and talk to a senator or governor about something that they want me to keep secret. And if it’s in the public interest, not share it. So I feel like I’ve got a platform to share what I think could be helpful to people in topics that I know something about. And so it’s really a forum or a platform to do that hard to define it as journalism. I don’t think that’d be the right thing to call it. It’s probably closer to opinion columnist. You know, I probably read a couple 100 columns in the Washington Post in the USA Today in other places, it’s probably much closer to kind of columnist-ish than it is anything else.

Dan Diamond  33:08

Yeah. I mean, I think from my perspective, I see you with hundreds of 1000s of Twitter followers and a popular podcast, it seems clear to me that you are arguably more influential than a lot of health reporters, there are people who pay closer attention to what you’re saying on COVID, than some of the things that I’m sure I’ve written about in detail. So it’s interesting when we talk about how the Biden administration is being covered, or the messages of the media during the pandemic. You’re part of that ecosystem, too.

Andy Slavitt  33:41

We’ve had this conversation before you’re held to some journalistic standards, that I’m not. So if you hear a rumor, even if you hear it, and believe it, you’ve got to generally, you got to go, correct me if I’m wrong, you’ve got to go verify it with at least two sources, before you report on it.

Dan Diamond  34:01

And even if I verify it with two sources that may still not be reported. I mean, we have a vetting process that’s intense and appropriate. And it also doesn’t just extend to what we’re going to report, if we write something and screw it up. If I tweet something and get a wrong, there’s accountability built in, we will have correction on the story or the Twitter account for the Washington Post would have to say, you know, we screwed up here.

Andy Slavitt  34:28

People who lost their jobs for messing that up or claiming to have done more work than they have. That’s how seriously your profession takes it.

Dan Diamond  34:38

And we should I mean; I should have the fear of God put into me because it’s a massive responsibility to represent the Washington Post or to write a story that might land on the front page. So I hope I’m scared because I need to get it right.

Andy Slavitt  34:50

Well, you’re underneath a big brand. And so if you put something on the front page, and this has happened, notably in the New York Times where there’s just, you know, for whatever reason, you made something up or you did something that violated some ethical rules and how you handled the source. There’s consequences that result when I read the result of that is a good thing. When I read a story, The Washington Post, I believe it. I know enough about now, if there’s an angle or slant or whatever, you know, I may feel like they’ve got that wrong if the head the headline I made I feel representative. I may feel like the story it didn’t need to be written. I may feel like it’s part of the story. There may be a lot of things I feel about it. But put all that aside, most importantly, like it’s not making the paper unless it’s reporting on facts. And so that’s, I think, and there are a lot of places left, I mean, Washington Post, New York Times, certainly there’s others, that we could name plenty of them that do that and stick to that at its core. Whereas if you go over to cable TV, or podcasts or something else, those standards start to erode. And they start to get very different I could get on to Jake Tapper show or, or interested Cooper show or morning, Joe and I could say anything I wanted, without any claim of reference without any facts of that to support me if I chose to. And they let that go on the show, now, and a lot of people would believe it. And they may read it and come back and verify it. It’s a different world.

Dan Diamond  36:27

I think that’s something we’ve seen on Fox News, certainly with misinformation during the pandemic. But yeah, I mean, live cable TV, it’s kind of hard to stop a mistake from going out live, there are watchdogs, media matters comes to mind. There are media critics like Erik Wemple, The Post, but it can be very hard to get the same audience that may have heard the original error. I don’t know if this would be helpful. But again, I’ve been a full time beat reporter for six years. So in some ways, I feel like I’ve been through all these wars, I’ve worked around the clock for a couple years. But I’m still relatively new in some ways. And I have my own thinking about how some of these stories come to be, so in this crystallized for me at Politico, because there’s a lot of government reporting. So I basically think of like three different sorts of sources. There’s one sort of source who might come to a reporter like me, that I think of as a patriot, this person has seen something in government go wrong. They’re aware of Secretary Price flying on charter jets. These are people who want only good things to come. And maybe they’ve been stymied and trying to fix it on their own. So eventually, the tip comes to reporters, then, and those sources tend to be great by the way, they might not always be right, but they’re usually coming with best of intentions.

Dan Diamond  37:41

Then there’s like the second category of sources that I think of as I call them, knife biters in my head, these are people, maybe there were 10 people in a meeting in the White House. And the meeting didn’t go their way, or the meeting did go their way, and they want the press to know about it in some capacity. And their information can be good. But it also can be somewhat slanted, there’s usually a reason why they’re coming to me and I get terrified sometimes, Andy, even if there are 10 people in a room, and maybe I talked to three or four of them, I can still get the facts, but I’m getting the facts from the three or four people willing to talk to me. And the six other people might have a very different perspective, right? And then there’s a third group, and this is the group that can be the biggest hit or miss group, I think of them as tourists. Maybe they stumbled on some interesting piece of information. Maybe they’re not in the government, but they’re the doctor to the cabinet secretary and just uncovered some interesting information. And they want reporters to know about it. That stuff can be really interesting and useful, it can also be totally wrong. And in thinking about those three groups, I try and get as much from the people trying to make government work the best. And I’ll hear out anyone who comes with a tip. But I try and be as skeptical as possible, especially when it’s a third group of people who are just sort of parachuting in with something really random.

Andy Slavitt  39:00

Now, that’s interesting. You know, I think I’ve been someone that you probably used to call to verify things or get a perspective when you’re hearing a bunch of things, to see whether it rings true. Occasionally for a quote, but also, I’ve watched you do that, I think part of that diligence process, to say, am I getting this basically right? Am I missing some element of what you know has happened? Do you know this firsthand, or do you know it? Or do you just think it’s secondhand? I’ve watched you kind of process that over time. I don’t think everybody’s had diligent because I think there are some people to whom when that story passes the bar, it’s interesting. I mean, there are there’s a couple of publications, and I will not mention them, but they’ve really look for the salacious stuff. And when if they were to get that call from one or two people in that meeting, you know, in their heads, they’ve gotten that story already written They’re not looking to find out if there’s a greater truth. Or if that’s just a part of it.

Dan Diamond  40:06

I don’t want to pretend that I always get it right. You know, I’ve written hundreds of stories I’ve posted 1000s of tweets, I’m sure there’s someone who’s listening right now, who could say, you know, diamond really screwed the pooch on whatever story, but all I know is that, you know, we’re only as good as our reputation. And if people don’t trust us, if they don’t trust me, they’re not going to read us. And also, importantly, they’re not going to talk to me. So I try and make sure that I’m doing as thorough a job as possible.

Andy Slavitt  40:32

Get the sense that after a while the Trump administration had a ton of leakers?

Dan Diamond  40:38

Yeah, I mean, the way that I thought about it was a gang or like a street brawl, you know, and more and more people just wanted their side out there, not always fully factual, again, like they could be very slanted arguments. But in covering the health department, there were clear divisions of people were on one team and other team. And sometimes you would write stories about the one side, and then the other would come running to you with their kind of response. So it just kept things going in ways that we don’t see in the Biden era.

Andy Slavitt  41:35

You won a very nice award at last year, explain what the award was for?

Dan Diamond  41:46

Sure, I don’t try and dwell on it too much. But it was the Polk award.

Andy Slavitt  41:52

That’s why I asked.

Dan Diamond  41:55

It was the Polk award for investigating political interference during the Trump administration.

Andy Slavitt  42:00

I would say that’s one award that I would hope that nobody could ever win during the Biden administration, or the Obama administration. I mean, I felt like, you know, I mean, I’ve only been to two administrations. And I wouldn’t suggest for a second that we didn’t hope for good media coverage. But I would say that, like, there was never, it was very clean in terms of never doing anything that you would regret, or that would reflect badly on the president. And,  you know, anytime I felt like, there was an ethical question, all you had to do was look up at the president and say, like, is this an ethical decision that I would ever want to make that would get him in any trouble and I think that.

Dan Diamond  42:49

Did you ever feel like there was a political message that trumped the public health policy, especially with the pandemic?

Andy Slavitt  42:56

Inside Biden administration? No. I didn’t, actually, the president said to me, in one occasion, I don’t really care how you make me look, just give people the information they need. Like he was desperate, like, I think I what I sensed in him was this desperate sense to help people who were in really scared situations. This was at the beginning of the pandemic. So that sort of light but remember, there were 5000 people a day dying. At one point, there were lots of people who couldn’t get a vaccine who wanted one, I mean, millions and millions of people who were like getting on websites, and couldn’t get a vaccine. And he felt, I think he felt, or at least what I observed that he felt their frustration, didn’t want them to be over promised, didn’t want me to deliver an answer that was too packaged and neat, that people would think was kind of BS. And was like, look, the core job is to tell them the information they need, if they’re not going to be able to get a vaccine for two months. Tell them when, where, how, etc, if they’re not going to get a vaccine for. But if you feel like you got to package up some story that makes it look like we’re doing better than we are, but doesn’t help people. That’s not your aim. So my job I think, was relatively easy. I don’t know how I would have done the job I had to do in terms of going out and doing press three times a week, publicly on TV or, you know, every day with reporters. If I had ended in the Trump administration, where I think people had to be 100%, conscious of the audience of one, and how what you said reflected on them. And I don’t even just mean that talking to the media. But I don’t know how people in the Department of Health and Human Services were able to engage, for example, commercial and academic labs in 2020 when the President was saying, there’s no reason for us to get alarmed by this virus because it’s all a hoax. So I do think that the tone from the top makes a big difference. I felt like I worked for two people who had very clear morality. And maybe they were less clever at spinning things. But that I felt like that trickle down to the way I was supposed to behave.

Dan Diamond  45:19

I think that this idea that President Trump influenced and warped consciously in a time, subconsciously everything that his government was doing, was clear. I mean, the Health Secretary Alex Azar, danced around so many different policies, because he was worried about how the President would react. But just bring it back to the Biden administration. There have been critiques, there have been critiques published, an op-ed in The Washington Post about the Biden administration, meddling on booster shots. Where that was the allegation by some former FDA officials. Do you think there was anything to that?

Andy Slavitt  45:53

Who’s interviewing who here?

Dan Diamond  45:56

I’m much more comfortable asking the question.

Andy Slavitt  45:59

Well, look, there, it would just go back and review what happened. There were two people in the in the FDA who were in the middle of the bureaucracy, who were experts, who had a point of view that was counter to the prevailing point of view at the FDA at the time. And they ended up publishing their point of view. And I thought that was a great thing. Personally, I didn’t agree with what they wrote. But I was so glad that I remind people, we lived in a country where scientists could dissent publicly, even if they were in government roles. And that was should be part of the debate, and that that information should come to light and ultimately would be proven to be right or wrong. Now, it turned out they were wrong about boosters. But they might have been right. And I think I’m glad we live in a country where it wasn’t like a scandal that the two of them could speak out, I thought it was good that they could speak out that they had an outlet to speak out. Now, people I talked to, who were at the FDA and who were in the loop on thing said, these two didn’t have all the data that and they hadn’t had a chance to read all the data from other countries. And therefore, what they were saying, a lot of people were saying at the time they knew was wrong. And so I was outside of the White House at the time, but I can imagine people in the White House who were getting reports, you know, from Israel and other places that were pretty definitive about boosters, being frustrated and saying these two guys are wrong, yet, you know, they were not. They didn’t suppress their right, or their ability to speak out. And I think that that’s a good thing. But should they be frustrated? The two people who were not necessarily seeing the whole picture, were opining publicly in a way that was confusing the public about boosters. Yeah, that’s pretty frustrating.

Dan Diamond  47:53

There was another example that I’ve thought a lot about, we talked about the Biden administration in the press. I don’t think you were at the White House. But over the summer, my colleagues at the Post and I think the Times had a similar story about the rise in breakthrough infections, the Provincetown Massachusetts study, and had leaked presentation from inside the CDC. The White House pushed back hard on that coverage, and said that it was misleading, said that the fear about breakthroughs was overblown, even said that the Washington Post and I think the times were engaging in salacious coverage to try and drive-up interest because our subscriber numbers were going down. What did you make of how the Biden administration handled that moment?

Andy Slavitt  48:37

So it’s a really good question. I don’t really know how they handled it, because I didn’t see that reaction that you did. But I do think this is an interesting moment, because it’s almost like, from 500,000 feet, if you sell the slave to tape down, if you take like 10 years of the pandemic and slow down, that was a moment when we actually knew facts emerged. And those new facts were counter to this narrative prior to Delta, that we all kind of understood, which was that vaccines were going to work in a certain way. So when Delta came and we sort of we learned that scientifically, what happens with a Delta variant is it superpower is how quickly it acts in human body, that it can respond, it can act before the immune response. That the unless you’ve been recently boosted that before your immune response could take off. We had no idea how much durability there was in a vaccine, we knew it would have waned at some point. And then a combination of delta and waning hit us at once in Provincetown may have been one of the first examples, but there were so many confounding things going on right like this is party with people dancing clothes and all this, that if you didn’t get fully grasp the picture. You could look at it and say, hey, well, this is an unusual situation. There’s a lot of people indoors, it’s a super spreader event. And at that point, no interpretation was wrong. And I’d hesitate for us to take too much hindsight bias and say, well, of course, that was right. Nobody really knew what was going on. And we’re trying to figure it out.

Dan Diamond  50:23

So that moment was one where, you know, we talked about the differences between the Biden and Trump administration. That was a moment where I saw fewer differences. And the response was more in line with how the Trump administration would have handled that news. And then there were media folks who took the post and the times to task and said, we were too pessimistic in reporting about breakthroughs. But I think, again, just as we were talking about the booster shots, history is born out that the concern about rising breakthroughs was right, that was a pivot point.

Andy Slavitt  50:54

Yeah, and again, I don’t know that it’s history that is, because it could have gone either way. But I do think there’s some lesson in there that you described, which is, there’s no mileage in administration getting defensive. You know, because if you’re feeling like you have to protect the things you’ve said in the past, during the course of the pandemic, while things are changing, you’re really not doing the job right. And it’s very hard not to feel defensive. At times, when you see bad press coverage. You see something and things aren’t going well. And it is a very human response to be defensive. And what I urge my colleagues in government, all parties at all times to try to do is take a deep breath and get past it and say that, you know, what does this do information telling us? And what is the right to adjust? I think and I think what happened said was, the administration was trying to send a very clear consistent message about vaccines and how important they were, something that came up and took a bite out of that story. And until they saw more evidence, they didn’t want to believe it. They didn’t want to see; they didn’t want to change that narrative about here’s what vaccines do based upon one anecdote. I can’t blame them for that. But it’s also very important that they say, look, there’s a new information, let’s present it.

Andy Slavitt  52:23

And when I was at the White House, what I tried to do is have Dr. Walensky as the country’s aunt and Tony Fauci as the country’s uncle, talk through those things as they came up in a very candid way and say, Look, there’s MMWR on Provincetown. Here’s what happened. Here’s what it means. Here’s what we’re looking at, here’s what we’ll know, here’s the questions were asking, and try to deal with it that way. And if you deal with that way, you keep yourself out of the kind of trouble that you get into when you don’t love the press coverage that’s coming your way, because you’re putting it out there. And you’re putting some context around it. And look, I think that that’s the continued challenging part of your job. I think what difference between being a good reporter probably and being a great reporter, or one of them, is being able to put in perspective and context to what you’re writing, how it relates, or compares to what we saw in the past and how it relates to the changing facts and circumstances on the ground. But as I said, you know, I fully found even when I was a subject of, or when I was at administration, the subject of stories, we did love, generally speaking, they made us better. They’re in the spectrum of things that made us understand ourselves better. And get pushed in the right direction. And I always found that to be better. You covered me when I first came to Washington. I was on your podcast.

Dan Diamond  53:50

I’m Dan diamond host of the new political pulse check podcast, the question that folks in health policy are grappling with every day. How is this industry transforming itself? No one would know better than Andy Slavitt. He runs Medicare and Medicaid. It’s the $1 trillion gorilla shaping all of health care and running point on implementing Obamacare. You were on the first podcast I did a Politico and actually went back and listened. And again, I was just starting out as a full-time reporter, so I was bracing for all these gaffes. But there’s a lot that holds up. You warn that the Obama administration that if it didn’t address drug costs, it would be the defining issue or a defining issue for the next president. I think that came to be in healthcare. You also kept talking about user driven policy design. Do you remember that?

Andy Slavitt  53:53

I think so. Yeah.

Dan Diamond  54:44

That was like your go to Line.

Andy Slavitt  54:46

Seeing us move and seeing CMS moved to an operational stance where we’re rolling up our sleeves means a couple things. One is, it means what a phrase that we’ve coined, called user driven policy design. Right? wherever else I heard you mentioned this now several times, I’m probably the only person who mentioned it. But it’s out, it means something to the people here, which is how can you possibly add a regulation, create a regulation as well-meaning and Stoffels that might be, if you don’t know what it’s like when it’s going to hit the care system, because chances are, it’s a regulation that will set on top of two or three other regulations that were put forward in the last number of years. And it may be that this very noble, thoughtful idea will end up being relegated to the compliance department, some hospital as a cost of doing business, as opposed to something different.

Dan Diamond  55:39

I do remember the feedback I got at politico though, from that early podcast, it was that the conversation was good, but it was too long. And I wasn’t focused enough on trying to break news that I was just chit chatting too much. But it was fun. I liked doing those.

Andy Slavitt  55:55

I mean, I think I’m a mediocre to occasionally decent interviewer. It’s a lot harder than I thought it was. It’s much easier to be interviewed. Because you know what the job is, you know what you need to say.

Dan Diamond  56:08

That’s so interesting, because I prefer the other way. I would much rather be the person asking questions.

Andy Slavitt  56:14

I just have thousands of reps being interviewed and relatively few doing interviews. Plus, maybe I just like to hear my own voice too much.

Dan Diamond  56:26

Thanks again for having me. I appreciate it.

Andy Slavitt  56:28

Thanks for coming on. Okay, thanks, Dan. Wednesday show. We have someone from CDC who is started the new center for forecasting and outbreak analytics. Yes, it’s as exciting as all that it’s the people that are going to help us figure out where the pandemic is going next, Caitlin rivers. I think that’s a pretty exciting new initiative from the government. And then the following week, we’ve got more good guests, including Christian Anderson, who’s an immunologist at Scripps, talking about the new BA2, which is the sort of second virus and then Rochelle Walensky, the head of the CDC, so two CDC shows, we’re gonna rock it. We’ll see you Wednesday.


Thanks for listening to IN THE BUBBLE. Hope you rate us highly. We’re a production of Lemonada Media. Kryssy Pease and Alex McOwen produced the show. Our mix is by Ivan Kuraev and Veronica Rodriguez. Jessica Cordova Kramer and Stephanie Wittels Wachs are the executive producers of the show, we love them dearly. Our theme was composed by Dan Molad and Oliver Hill, and additional music by Ivan Kuraev. You can find out more about our show on social media at @LemonadaMedia. And you can find me at @ASlavitt on Twitter or at @AndySlavitt on Instagram. If you like what you heard today, please tell your friends and please stay safe, share some joy and we will definitely get through this together.

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