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Description

Some passengers ripped off their masks in jubilee while others froze in horror when airlines across the country announced mid-flight that a Florida judge had struck down the CDC’s travel mask mandate last week. What does this ruling mean for air travel and daily commutes on public transit? Andy speaks with epidemiologist Katelyn Jetelina about why you should keep your mask on and how to minimize your risk while traveling amid unmasked passengers. And global health law professor Lawrence Gostin explains what could happen if the justice department’s appeal makes it to the Supreme Court.

Keep up with Andy on Twitter @ASlavitt.

Follow Katelyn Jetelina @dr_kkjetelina and Lawrence Gostin @LawrenceGostin.

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Check out these resources from today’s episode: 

• Check out Katelyn’s thorough explanation of SARS-CoV-2 transmission on planes: https://yourlocalepidemiologist.substack.com/p/sars-cov-2-transmission-on-planes?s=r
• Find out why Lawrence and other legal experts say Judge Kathryn Kimball Mizelle misunderstood public health law: https://www.npr.org/sections/health-shots/2022/04/19/1093641691/mask-mandate-judge-public-health-sanitation
• Find vaccines, masks, testing, treatments, and other resources in your community here: https://www.covid.gov/
• Order Andy’s book, Preventable: The Inside Story of How Leadership Failures, Politics, and Selfishness Doomed the U.S. Coronavirus Response: https://us.macmillan.com/books/9781250770165

Stay up to date with us on Twitter, Facebook, and Instagram at @LemonadaMedia.

For additional resources, information, and a transcript of the episode, visit lemonadamedia.com/show/inthebubble.

Transcript

SPEAKERS

Larry Gostin, Kyle, Katelyn Jetelina, Jackie, Kathryn Barnes, Andy Slavitt

Andy Slavitt  00:18

Welcome to IN THE BUBBLE. This is your host, Andy Slavitt. It is Monday, April 25th. A great show today, we are going to talk about the major topic on everyone’s mind and provide some clarity. We’re going to talk about the last major barrier to come down in fighting the pandemic, really the most visible one, which is the removal of the mask mandate for travel, air, bus train, otherwise interstate travel. It’s very confusing for people. And so we’re going to have both a kind of legal interpretation of what’s going on. And since it went through the judicial processes, this was not a decision made by public health experts, But a lone judge, we’re also going to get into what does the science say about traveling without a mass mandate, and mostly what to do if you’re traveling, if you’re concerned, because we’ve great conversations, I’ve been talking to the White House all week about this, to legal experts, to health experts, I want to thank those folks who helped us who did not appear on the show, I would just brought you two amazing guests. I’ll get to them in a moment. And it’s a great conversation. Clarity amidst the chaos. I want to talk about this whole idea of getting back to normal. My first question when I hear that is, what is this normal we’re talking about? In some ways things haven’t felt normal for a long time. But also normal, like when I was a kid growing up in the 1970s. Normal was driving a gas guzzling car, and you’re leaving it as idling as long as you wanted. throwing trash anywhere you wanted. There were literally no garbage cans, anywhere. You run the water as long as you wanted, you could pollute. And we were never taught things that are very fundamental now like how to appreciate people’s differences, where they come from age, gender, sex, orientation, all those things were just started, not part of what you learned about that was that normal back then. Look, I understand people who don’t want to feel restricted by rules and regulations that prevent them from living their lives, who want their kids to get back to school, who want to get back to work, who want to see their family and their friends, I totally get that, I’m an advocate for enjoying your life and bringing joy back to your life as much as possible. So long as you’re not putting other people at risk. That’s the only rule. Otherwise, have at it. But sometimes when I hear people say normal, I hear an entitlement to have things back like they were. Well, the reality is no one owes us that entitlement. You know, we aren’t old, a world without viruses. Many, many periods of our history have had there been big plagues. We’re not owed a world without climate change. We’re not owed a world without hate. We don’t owe any of these things, we work with them. We earn them. So we adjust our normal to the times.

Andy Slavitt  03:22

If you have a pandemic the last two years, well then your normal adjust, f the pandemic lasts five years, normal adjusts. What happens when our normal doesn’t adjust? Well, then we have what happened in the HIV-AIDS crisis. People die while others look away because they refuse to adjust their normal. We learned during this pandemic; how many things happen in this world that could be improved. How people of color are completely mistreated by the health care system and lack access to care more than White people. We’ve learned there’s so many kids that need school, just to get a decent lunch. We’ve learned how many people depend on one another, for a better life, how we all depend on one another. We’ve seen how people with disabilities or who are immunocompromised, who are just older, can participate in the basic things, unless we all take some precautions. The old normal wasn’t great for everybody. Just like everyone is nostalgic for the 1960s and 1970s. You know who hates the old normal by the way? The planet the planet hates the old normal just hates it. So, look, we can and we should respond to what we see. We should learn that sometimes we have to suck it up for other people. These moments of empathy we experienced during the early stage of the pandemic when we worried that we couldn’t see a doctor, if we got sick, when we worried about dying, if we got sick when we hated feeling isolated, when we were scared that the world forgot about us.

Andy Slavitt  05:13

That’s what we’re supposed to respond to, in my view, I know we want to brush that feeling far away, because it didn’t feel good. But it’s that feeling that many people have every day. And we got a taste of it. So look, normal changes, normal evolves. Normal should improve, should improve the way we take care of ourselves and take care of others. So keep that in mind as you think about everything we’re talking about when you hear about people who are feeling just as itch to get back. And look, you may disagree with me, that’s totally fine. That’s just my point of view. So let’s bring on our guests. They’re terrific guests. They’re going to help us understand what’s going on in this very complex and ever evolving story about this court case, how it evolved, how it happened, what’s going to happen next there. And then what does the data tell us about what is actually safe to do when we travel? Say for us, say for others. The first person I’ll introduce is you’ll hear Larry Gostin. Larry is a lawyer and expert in global health law at Georgetown. He’s the director of the WHO Collaborating Center on public health law and human rights. He’s also been advising the White House on this topic. And then a familiar voice. Katelyn Jetelina, who is your local epidemiologist, she’s been on the show a couple times. She is amazing. She’s got a very systematic and thorough breakdown of what air travel and other kinds of transport. The issues are from a public health perspective. Anyway, if you want to stick around for after this interview, we’ve got a very special feature that some of you might be interested in, I am going to bring on the new production team. And we’re going to talk about some of the changes coming to in the bubble in the near term with this amazing new team. So if you liked the show, and listen and are interested, after this amazing interview, stick around and meet the new team with me, I think you’ll have a good time.

Andy Slavitt  07:35

So Larry, welcome to the show. Katelyn Jetelina, who I think at some point in the near future will probably be our most frequent guest on IN THE BUBBLE. She is your local epidemiologist, and she’s freaking amazing. Can we see frickin on the show? I think I can. Welcome to both of you. And let me start with you, Larry, what was your reaction when you heard about this district court’s ruling coming out of Florida last week?

Larry Gostin 

Well, jaw dropping, I suppose is the best way to do that. We’ve been masking on air transit and trains and, and buses now for over a year. And I literally couldn’t imagine a more ruinous way to end the COVID era transit masking in America than by a single federal judge in Florida. And I know it’s you know, it may not be fair, but she you know, she was appointed by President Trump after he lost the election. The American Bar Association had rated her unqualified and she was ratified in the Senate by a party line vote. And I have to say that that her opinion reflects that. I mean, to me, if there’s one central star, one basic thing is that CDC has powers to prevent the interstate and international transmission of infectious diseases and particularly on airlines. And so if they can’t require masking on airlines and international flights, or interstate flights, I don’t know what CDC could do.

Andy Slavitt  09:23

So I talked to the White House a couple days ago, about their decision, and you did too, and I know that there was some debate for a couple of days. Whether or not the Justice Department was going to appeal to retrace the steps that they said they would appeal if the CDC felt that was necessary. The CDC after a couple days, said it is necessary. The White House Counsel believes that the White House has a very, very good case. Talk about tricking me if you put it aside, you know that this is going to also likely go to a very partisan appellate court put that aside for a second and talk about the merits of the law here. How clear is the law? And what does it exactly say? It’s called the

Larry Gostin  10:09

It’s called the Public Health Services Act. It was enacted in 1944. And it gives the secretary for HHS who’s then now a delegated that to the CDC to take any measure that it deems necessary to prevent the introduction, or transmission of an infectious disease across state lines or international borders. And then it goes on to list a number of things that as examples, and it includes, this judge famously focused on it sanitation and other things. It doesn’t mention masks, because it was impossible, in 1944, to imagine that we would have an aerosolized, spread, and you would need masks, but it says, or any other measure that CDC deems necessary.

Andy Slavitt 

So sanitation was listed just as an example, if it really seemed to cite it as an analysis of whether or not this was sanitation or not, correct?

Larry Gostin 

They did. And that was foolish, because it was just one of many things. I mean, this judge […] as well, in our opinion, sets, you know, something that really is very much, you know, feeding into the COVID culture wars, you know, which is basically, you know, CDC can’t just yank people out of their seats if they’re unmasked or, or pull them away from the bus stop. And then she went on to say that, you know, it’s not as if CDC has the power to detain or quarantine. Well, in fact, the regulations under which CDC operates and has since 1944, are actually called the quarantine regulations. And CDC has been quarantining for smallpox, Ebola, tuberculosis, and now COVID, for many, many years, and if you can isolate or quarantine or detain somebody, sure, you can, surely you can do something that’s the lessor, which is just simply asking somebody to wear a mask. So I think the idea of sanitation is bogus. And, you know, it’s very much the idea, well, CDC can clean the plane, but they can’t make me as an individual do anything. And we’ve just lost Andy, the tradition of the common good in America, you know, looking out for one another.

Andy Slavitt  12:49

Well, I want to come back to talk about the implications of this appeal, because it feels very high stakes and in the courts, that’s gonna go to and, you know, particularly as we look at, you know, what happens if we have a more severe outbreak? What are the powers of the CDC? What happens if we have an Ebola outbreak in the future? All of those are questions I think we should get to. But I think the other thing that’s quite very much on people’s mind, Caitlin, is people who have been flying, or need to fly the safety for them. Maybe you can start with what you thought when you first heard the ruling. And then you put out I think, a very thorough analysis discussion of what is known about the safety of flying in different circumstances. And then let’s get into that and help educate people as to whether or not it is indeed safe to fly what the science tells us.

Katelyn Jetelina 

Yeah, so my initial reaction to the ruling, unfortunately, I wasn’t too shocked masks have been politicized throughout this entire pandemic, while other public health mitigation measures have not like testing or ventilation. So I guess I was, of course, incredibly disappointed, but not necessarily surprised when you start learning a little more about the judge and the background, like Larry was saying, but you know, I so the next question is, is it safe to fly? Well, we know that airplanes have incredibly great ventilation and filtration, they circulate the air about 10 times per hour in a hospital, it’s about six times per hour, so we get a lot of circulation. And during that ventilation, it’s also filtrated. as well. There’s two problems though, is that one, you have to get to the plane and you have to wait for that filtration system to turn on which it’s not during the boarding process. It’s not even during taxing it’s usually turned on when wheels up in the air and then the other thing is that filtration and ventilation help a lot with the aerosols. So when we transmit the virus there’s we transmit droplets on a spectrum very, very small, which is aerosol on their, you know, airborne to very, very big, which is droplets that can travel up to six feet. But because they’re heavy, they fall to the ground. Now filtration and ventilation help with the smaller ones that are airborne. But once we start getting into those bigger droplets, filtration and ventilation don’t help with those. That’s where really masks come in. And this is especially true with if you’re within about two rows of the index case or the infected case on an airplane. We have a lot of examples of transmission on planes, particularly before masks were implemented widely. I think I saw about 10 or 12 or 18 studies about this. The other thing, and of course, putting on my public health hat is the concern is yeah, you may have, you know, 13 cases get infected on an airplane. Why is that such a big deal. The problem is that those 13 people then go out into their communities, and not just one community, but communities all around the nation and around the world. And so there’s onward transmission. And we’ve seen that very famously in an Ireland flight back in 2020. And so the, you know, masks work, they match, they work really well, they work well with layered protection, and I think it’s just not an entirely terrible inconvenience to wear a mask to ensure good health.

 

Andy Slavitt  17:10

So, let’s pinpoint the science that I think you did a great job of laying out what to do what to kind of see sequentially. First of all, obviously, there’s the airport. And, you know, I suppose the airport is in a whole lot different than a restaurant or any other situation where there is a risk, there are crowds. But then again, you know, at this point in time, whether we like it or not many other places, restaurants and stadiums, etc. Also don’t require masks. So it’s a risk, but it’s exact same type of risk where we’ve started to get used to taking.

Katelyn Jetelina 

Yeah, I would, I guess half agree with you..

Andy Slavitt 

That means you have disagreed with me.

Katelyn Jetelina 

I think that, the unique part about airports is that you’re mixing all types of communities in there. So right now we have a significant hotspot up in the northeast, like New York, now that person could easily go travel to a low hotspot, like in Texas, surprisingly, right now, and start mixing there. And so you start getting this mix of communities within one space, that, you know, usually if you go to a concert, they’re all the same people from the same county.

Andy Slavitt  18:25

So harder to analyze the baseline level of spread when you’re in an airport than it is in your local community. That’s a great point. That’s a great point. So that’s the rest, there’s the onboarding and off boarding of the plane part. And then there’s this question of, if you’re sitting near someone who is asymptomatic, but shedding COVID. I’d like to assume that people who have symptoms don’t fly and go out in public. I wish I wish; I wish that I could be confident of that. I think we all know that that’s less than true. But be that as it may, if someone’s coughing or sneezing or sick, you can see them. But there’s also this potential that you’re sitting there someone who got these, as we’ve talked about these ballistic droplets that can’t be filtered out, and you’re within a row or two. We talk about that in terms of likelihood that that’s happened. I saw a study in one hospital in San Francisco, which showed that of the asymptomatic people that were tested for COVID, about 2%, tested positive. And I don’t know if that’s representative, if that’s low, if that’s high at any given moment. But it strikes me that if you’re on a plane with 25 rows in it, that means that there’s going to be you know, one every, you know, two eight or 10 rows, there’s gonna be likely to be somebody with COVID Who doesn’t know it, if that’s the baseline level. That’s not massively comforting.

Katelyn Jetelina 

I know it’s not so yeah, you’re right. So if there’s, so San Francisco right now has a relatively very low I will say asymptomatic test positivity rate. So it’s about 2% of people are asymptomatic, so they’re positive and they don’t know it. Now, if we have a plane of 200 people, that means the probability of someone getting on the plane from San Francisco, that’s asymptomatic, not knowing they’re infectious, the probability is about 98%, there’s going to be someone on that plane. If there’s only 100 people on that flight, it goes down to about 86%. And that’s the low bar. So we’re pretty confident when you’re on a flight, at least one person on there is going to be positive, then it’s a matter of, you know, Russian Roulette, basically, is, are you close to them? Or are you not? And it’s impossible to tell. And so the value of wearing a mask for that two-hour, 5-hour, 12-hour flight, I think is worth it.

Andy Slavitt  20:52

So far, Larry, does this make you want to fly more make you fly […]

Larry Gostin

Those data, I never, never really would have imagined that it’s so it’s so basically we’re saying is just about a certainty that if you’re on a plane, someone else, there’s got COVID, and they don’t even know it. So that’s what you know, this is I’ve always said that SARS-CoV-2 is the most widely virus that I’ve seen, because it’s asymptomatic. It’s aerosolized. It keeps changing form. It can evade, you know, immune protection. It’s got all of those characteristics. And, you know, maybe, you know, that’s really why we need CDC to have the kind of powers and flexibility, you know, to be able to act.

Andy Slavitt

Yeah, I mean, look, I think we could all find really valid things to criticize the CDC for to say the CDC could do better at, and I’m sure all three of us have, you know, it’s hard to be in the position they’re in and get it right every time. But boy, the question is, would I rather have an entity that studies data and employs scientists are living, or a 34-year-old judge, who’s never heard a case before, and writes a flowery prose make this decision? It’s not a close call. I mean, you know, this is sort of what a society means. Not to be on my soapbox. But you know, we are living in a society with laws. And the presence of laws or regulations doesn’t mean we don’t have freedom, it means we actually have the freedom to prosper and flourish, because the laws are there to protect us. And look, I don’t mind the debate. I don’t mind. The people hate masks, I don’t mind. You know, all of that is just sort of part of the society. But at the end of the day, the people who call the balls and strikes need to be the people that we trust in society to make these decisions, not just on my behalf, but on our behalf.

Larry Gostin  22:57

Yeah. You know, I mean, there’s been some discussion of, you know, what is public health? You know, and I’ve been in public health for a long, long time. And I think the best definition was one that the National Academy of Sciences put out, I was actually on the committee that drafted it, you know, and it’s what we do collectively, as a society to assure the conditions for people to be safe and healthy. And that’s not an individual responsibility. And what we’ve seen during COVID is more and more, you know, protect yourself. You know, it’s the individual, rather than the collective.

Andy Slavitt 

And let me let me give you the push back. Let me give you the push back, Larry, you public health people have gone too far. There’s no limits. And there’s no accountability for when you’re wrong.

Larry Gostin 

There should be limits and there should be accountability. That’s why just taking a leaf out of last conversation I, I disagree. I disagreed with you half and in what you said there, because basically, you’d said it’s an easy call, you know, basically, would you trust a judge or would you trust a scientist will or a group of scientists? And of course, the obvious answer is I I’d much rather that the CDC make the decision. On the other hand, CDC does have to operate under the rule of law. When it acts, it needs to have a clear legal basis for acting. I think it does have that clear legal basis. You know, if you think back to some of the other things that have happened during COVID, I mean, one of them went up to the Supreme Court twice, which was the housing eviction moratorium. Now, I supported the housing eviction moratorium for CDC, very, very strongly. But I always said that it was on the edge of CDC’s authority that CDC doesn’t have the right to just reach into a state and regulate a building a business or an individual. That’s a state matter. And the Supreme Court and this is almost deja vu all over again. Because if you remember the housing eviction moratorium was going to expire, just like this mask mandate was, and it went to the Supreme Court, Supreme Court upheld the eviction moratorium but told the Biden administration, don’t test me. And Supreme Court, then just a couple of weeks later, struck it down. And forevermore, that tool is out of CDC’s toolbox. So we do want the rule of law. In this case, we’re not on the edge of CDCs authority. We’re smack dab in the middle of it.

Andy Slavitt 

Well, I think you just hit your credibility by disagreeing with me halfway. And look, the fact that you vote to screw up halfway means collectively, you 100% Disagree with me. So that’s how the math works, Katelyn?

Katelyn Jetelina  26:02

Yeah, exactly.

Andy Slavitt 

So let’s talk about other modes of transportation, Katelyn, that may not have such great either filtration or ventilation systems. There’s people, more people have to take the bus to work at the train to work than get on an airplane every day. And many people have to take the bus or train to school. Not all those people can be vaccinated. Some are under five. Some are immunocompromised, where the vaccines just aren’t as effective. So maybe you could talk a little bit about what people in those situations should be doing.

Katelyn Jetelina

Yeah, that’s right, you know, a lot of this debate is around airplane travel. But I think what’s mainly lost is this is all public transportation, including buses, and subways and trains, which actually have really terrible ventilation and filtration systems compared to a plane. New York health officials came out saying that their subways do have decent air filtration and ventilation, which is great news, I am a little more worried about buses, actually, I’m very worried about buses, one person infected on a bus exhales and about 45 seconds later, everyone’s inhaling that. So buses is a concern. And the reason for this is because of the whole aspect of health equity, that you know, blacks and Hispanics are two times more likely to take a subway or a bus compared to whites. And they have to get to work to they have no choice. And so you start getting this revolving door around disproportionate transmission. So disproportionate hospitalizations and then disproportionate does something that we’ve continued to see throughout the pandemic. And so that is where most of my concern actually lies. And so what people should do riding on subways, riding on buses, they should wear a mask, you know, in a good mask, I’m talking about an N95 and K94. They do a good job protecting the wear. And so I would certainly strongly suggest that they continue doing that on other public transport.

Andy Slavitt  28:20

So let’s talk about masks. Because it’s one of the things that we can control. Now, originally back in 2020, I think we were all trained on this idea that I wear a mask to protect you wear a mask to protect me. And that’s how this worked. update us on whether or not that’s really true anymore. How would you state it today?

Katelyn Jetelina

I still think it’s true. I mean, you have the additive effect. If everyone’s wearing a mask, then you have to get it filtered out and then you have to get filtered back and so it’s still works on a population level fantastically. But it does work at an individual level too. And this is particularly true if you again wear a good fitted, filtered mask. And that unfortunately I think has been lost. I think we all got very comfortable with the cloth masks that our neighbors were sewing them in the beginning which was great because we were low on N95s. But we’re at a point now that especially with Omicron being so transmissible and contagious that it’s really necessary to wear a legitimate high filtration mask.

Andy Slavitt

So I was on a plane just the day after the judge’s ruling. The flight attendants and the pilots were not wearing masks. About half of the passengers were wearing masks. I was flying from California to Texas on the way back. One of the flight attendants was wearing a mask and about only 20% of the passengers were wearing masks. And for those that were wearing masks They were I noticed much more casual about when they were eating, pulling their mask down, etc. And so I think what’s really confusing for people is we kind of want the right answer. And if the right answer comes from the President, or a judge or the CDC, it’s too confusing to figure it out for ourselves. But for many people, they equate it not being required for it, that being a good idea. And I think what you’re saying is that if everybody’s wearing a mask, it really does help the most. But that, given the kinds of risks we talked about, say, going back to the airplane, where there’s likely one or two, or maybe three people on the plane that have COVID, you’ve got a system that is very good, but depending on where you’re sitting, and at what time of the plane, you might be exposed, can the addition to the mask, make it? I won’t say 100%? Safe, but can it make it relatively low risk to fly?

Katelyn Jetelina  30:56

Absolutely. Especially, I mean, if you’re boosted, and you have this ventilation system on the plane on and you have a mask on, I mean, you have the best bubble, you’re gonna put around yourself period. When you start taking off those layers, that’s when your risk starts increasing incrementally.

Andy Slavitt

So would you say that if it hadn’t come from a judge, but if this decision had come from the CDC itself, would you have said that is a reasonable decision because people can protect themselves wearing masks?

Katelyn Jetelina

So we knew that this mandate was under question already, before this judge, there was already discussions at the CDC, and they pushed it until May, I think that it probably would have come up in May from the CDC, if things don’t get out of control with this BA2 lineage. And I think that’s okay. But I still would have pushed to wear masks. I mean, I think a mandate, like you said, is different than our individual behaviors. And we should also at the same time, normalize it, there’s this whole behavior aspect to it, as well as if no one else is wearing a mask. And maybe people are getting made fun of by pilots for wearing a mask. And then they weren’t. But I think that there’s this normalization, that will come with time as well.

Andy Slavitt  32:17

I would say I have a little bit of a bone to pick with the airline CEOs here as well, because there was a more responsible way after this ruling for them to respond. And I think what they betrayed was for all the times they’ve been handing out hand sanitizer, and running soft commercials about how they care about our safety and our health. midflight people who had gotten on a plane with one expectation, mid-flight, they made these joyous announcements ripped off their masks, and people were exposed. And I think they could have done something more thoughtful and more reasonable, even if they were going to make this change. And look, let’s be clear, I can tell you what’s going on with the airlines. The airlines care because the flight attendants are really sick and tired of dealing with uncivil loudmouth jerks. And it’s hard to blame them. It’s like anybody on the front line in this pandemic, bears the brunt of this. And it just was made easier when they were told they have to do it. As soon as they were told, you don’t longer have to do it. They couldn’t justify to their flight attendants keeping the mandate a second longer. And I think that’s a betrayal of their passengers. I think it could have been quite reasonable to say, we’re going to take two or three days, we’re going to review the situation, we’re going to make sure our safety protocols are in place. And then at you know, Monday morning or whatever it is, we’re gonna make the following changes or adaption, that I think that would have been a lot better, but as it is, it feels like we basically just hold the public. Nobody cares.

Katelyn Jetelina 

I completely agree. I think that one thing that’s really interesting that I saw was that..

Andy Slavitt 

You 100% agree?

Katelyn Jetelina 

Yeah, no, you know, the flight attendants have been through hell these past two years. Just like as epidemiologist you know, like, I mean, it’s been a long two years and I do empathize with them. One thing I found interesting, though, was a week or two ago that the National Association for flight attendants union didn’t take a stand on masks are not masks because it’s actually not unanimous of what flight attendants want.

Andy Slavitt  34:48

I want to go to another place here, which is as we finish up the application of this appeal. Larry, can you tell us which court this is going to go to the likelihood that ends up with the supreme court. And what a look the president trumpet appointed 233 other judges, federal judges beside this one judge in Florida courts are very conservative, they’re not going to get less conservative in any short amount of time. And by conservative, I don’t necessarily just mean that they’re conservative from a church prudence interpretation. I mean, that they may have political leanings. It’s not going to change anytime soon. Tell us what happens if there’s a bad ruling. And the judge’s ruling is upheld?

Larry Gostin

Yeah, I mean, this is a huge risk, because you can, if you’re the Biden administration, or the CDC, and uh, you can just, you know, you can kind of blow off one, you know, federal district court judge and, you know, Central Florida, it’s quite another thing to disregard the precedent that said, if the 11th circuit upholds that judge’s ruling, and even more so, if the Supreme Court would do it. Now, it depends on what the composition of the circuit court is, but it’s possible that you could get a very conservative 11th Circuit decision.

Andy Slavitt  36:15

11th circuit is in Atlanta?

Larry Gostin 

Yeah, the 11th circuit basically has, you know, it includes Florida, Georgia, things like that. And it’s a conservative court, maybe not as conservative, say, the Fifth Circuit that’s become very notorious during COVID years, but quite conservative, we could get an adverse ruling. And then it would go up to the Supreme Court, you know, and the court has been very divided on COVID. And in a […] would kind of tip the fulcrum in favor of some reasonable sanity. But now, he’s not likely to be in the majority. In my view, even this conservative court would probably uphold the mask mandate. If it didn’t, I think it’s just a lawless court. But it the risk is, is that it will so narrow the interpretation of the Public Health Service Act as to really handcuff the CDC going forward, as you said, you know, Andy, if there’s an Ebola or if there’s a new variant, and they need to act decisively, I think they will be really undercut. And that’s a big, big risk that the administration is taking with this court.

Andy Slavitt 

And I think, you know, having talked to the White House, their reasoning, and I think it took them a little bit of debate, but the reasoning is, even if there wasn’t an adverse ruling, whatever they were gonna do, say we get to the fall, and we have a really bad outbreak and the CDC puts in place another, something like a transportation mask mandate, that’s gonna get challenged anyway. It’ll have to go through this again. And that saying that the courts are conservative, is really no reason no justification, not to appeal a case that has a very bad ruling, because that’s not going to change. That’s it. That’s at least what I heard from the West Wing.

Larry Gostin  38:12

In my discussions with the White House, I specifically advise them to appeal. Understanding that it’s a huge political animal legal risk, very huge. But the reason is, is that you do the right thing. And this is just a bad ruling. It’s morally bad, socially bad, and also bad from a legal point of view. And so you do the right thing. And you appeal. Now where we’ll end up with this? I don’t know. But I don’t think we should let this Florida opinion. Stand on challenge. So I agree with you, 100%, Andy.

Andy Slavitt 

100%, well, I’m doing a little bit better. So we’ve got an uncertain outlook. We have, you know, once again, in America, it feels like the last couple of decades. Most things that we’re debating end up in the courts, it feels like the courts have a record of being more and more political or at least unpredictable. And the question is, finally, just where does that leave us? Where does that leave the average person just trying to figure it out and stay safe. The one takeaway Katelyn you’ve given us is a high-quality well-fitting mask that will help in all settings in that on a plane. You know that it has real potential for impact, positive impact, but I think what you’ve also said is, even if it protects you from a public health point of view, we’re going to see more spread and we’re going to see more secondary and tertiary spread. What final advice would you give to people who are really confused by all of this?

Katelyn Jetelina  40:08

The final piece of advice is I’m an epidemiologist, and I’m confused about all of this. And so I empathize. It’s incredibly difficult to navigate this landscape that’s changing. And remember, we have multiple layers. So even if you decide not to wear a mask on a plane, after you’re done traveling and you want to go see someone vulnerable, use an antigen test, try and break those transmission chains with any layer of tools we have. Because we have a lot of effective tools, we just need to leverage them and leverage them at the right time.

Andy Slavitt  40:42

If someone glares at you for looking like an idiot for wearing a mask, what do you do?

Katelyn Jetelina 

Well, I have a pro-vax sweatshirt I wear at the airport and I have my WHO bag that I hold with my computer. So I don’t think that they’re gonna pick a fight with me at the airport.

Andy Slavitt 

Well, I want to just tell people, I’m anti […] if you’re wearing a mask and someone’s side eye you I’m anti-side eye if someone is not wearing a mask for you to side eye them. I just think that whole thing of judging others and knowing where they’re coming from where they stand from his I would say I was in a room in Texas this week. And myself and one other person were the only two people out of about 100 that were wearing a mask. Was it awkward? Yes. That I sent people looking at me finally? Ultimately, did it cost me to take the mask off? No. Because I’m coming home to my wife. And I’m gonna see other people in my life. I don’t want to get; I don’t want to give anybody COVID. And I don’t know those other 98 people are free to do what they want, obviously. But you know, it’s no fun. I’m sure for a lot of people to feel like they’re doing something that takes a little bit of willingness to stand out. But my hope is that that will not be a factor. And then people will do what’s comfortable and protecting them as we figure all this stuff out.

Larry Gostin  42:11

And just show a little bit of decency and compassion to one another.

Andy Slavitt 

A little bit, a little bit of decency, just like you showed to me in the way you kindly disagreed with me. Thank you both so much for coming on. I think you really helped a lot of people make some sense of this.

Katelyn Jetelina

Yeah. Thanks for having me again.

Larry Gostin 

Me too.

Andy Slavitt 

All right, that was a fun conversation. Now for an even funnier conversation. Is fun really a word. We’re gonna ask that question of our new senior producer who’s coming on to the show who’s taken over for Kryssy. Hey, Kyle.

Kyle 

Hi, Andy. Thanks for having me. I believe it’s more fun. By the way. We’re gonna have more fun.

Andy Slavitt

More fun? Thank you Kyle. Kyle, where did you come from? Why did you join this illustrious show?

Kyle 

Yeah, I’m excited to be here. I’m coming in from Minnesota Public Radio, I’ve been running All Things Considered and Morning Edition.

Andy Slavitt 

Two little shows.

Kyle 

A couple of little shots, a couple of award-winning broadcasts for NPR. And yeah, I spent the last four years mostly focusing on All Things Considered. We were number one in the Twin Cities; I was very proud of that. And so now I’m working with you. And we’re expanding the show out, we’re not going to change it, it’s just going to be more of what you love with Andy, and tackling the topics and things that you’re concerned about, and trying to bring a little calming, a little carrying back into your world. And you know, Andy, you’ve been a staple in our lives for the last couple of years during the pandemic, and you’ve helped all of us get through it. And so I’m here to help you and help the audience get through other issues. Other things, we’re worried about, things like climate change, schooling, teaching our kids, raising our kids in this world today, disinformation, all of those things that you’re worried about in your life. We’re worried about them in our lives. And we’re going to talk to the right people that can tell us what we should be worried about, what we shouldn’t be worried about, and how we’re going to make it better.

Andy Slavitt  44:19

Well, that’s cool. I’m thrilled. I’m thrilled to have you join the show. What other major  changes do you see that you want to tell folks about?

Kyle 

Yeah, the biggest thing that thing I’m most excited about is just more Andy, we’re gonna go three days a week. So you’re used to us being in your feed on Mondays and Wednesdays and now. There’s gonna be a Friday episode every week. So you can take Andy into the weekend, take him home with you. share him with your family, whatever, whatever you want. It’s just going to be more of Andy in our lives, which I think is all what you know, the audience has been clamoring for, we get a lot of feedback, a lot of emails, things people asking for you to talk about things and bring your expertise, and all these other topics. And so we’re answering what the people want. We’re giving you what you want. And that’s more of this show and more of IN THE BUBBLE.

Andy Slavitt

Appreciate that, you know, your news background, Kyle, really will help us, I think, see around corners and try to get people the information that they need or that they will need, shall we bring the rest of the team in.

Kyle 

Yes, please. I’m very excited to introduce Kathryn Barnes and Jackie Harris. So Kathryn’s here first, and she’s joining us out on the West Coast, just like you.

Andy Slavitt 

Hey, Kathryn.

Kathryn Barnes 

Hi. I’m excited to be here. I’m about 100 miles north of you, Andy up in Santa Barbara. And I was working at also public radio, the public radio station KCRW. W in Los Angeles, I think all of us are actually coming from public radio here. And I did kind of a mixture of producing stories about Los Angeles and Southern California, as well as reporting stories. And I’m excited to kind of bring some of the solutions-oriented reporting into the show, and also some more audience engagement. I mean, you have so many followers on Twitter, you have so many listeners to this podcast, I want to help kind of bring their questions and, and feed back into the show more.

Andy Slavitt  46:14

What I really hear you saying is your here for the dad jokes.

Kathryn Barnes 

So many dad jokes. Yes, I you know, I’m across the country from my dad. So I need some dad jokes in my life.

Andy Slavitt 

Oh, that’s nice. Well, it’s great to have you out here, local. And so you’re gonna be you’re gonna give the audience a chance to hear you on the air a bunch, because you do on air reporting. What are some of the areas you’re excited to get into, as you do kind of on your reporting for the in the bubble audience?

Kathryn Barnes 

Well, living in Southern California, climate change is always on my mind with the drought, and you know, wildfires, all these things. So I’m definitely excited to tackle some climate change topics. And more broadly, just, you know, you have this Rolodex of experts that we’re bringing on the show each week. And I want to also bring kind of those real people and get their questions and so that experts can hear from real people, and we can get them their answers.

Andy Slavitt 

That’s great. Well, Kyle, it sounds like a great addition to the team.

Kyle 

Yeah, Kathryn has been killing it so far. And it’s been super excited to have her. And we have Jackie Harris, also joining us out on the East Coast, helping us with the prep and lining up the guests and everything. And she’s been an awesome addition to the team as well.

Andy Slavitt 

What do you think of the show, Jackie?

Jackie 

I think it’s the best thing I’ve ever heard. I heard it the first time and I was like, I gotta line up. I gotta get there now.

Andy Slavitt 

You could tell Jackie’s gonna be our secret weapon.

Jackie

No, but seriously, the first time I one of the first times I heard an episode, it was when Omicron hit. And I was listening to an episode and in the intro, you said here are the four ways this could go, we don’t know yet. But this is how it could go. And I went home to my mom and dad. And they were like, What are we going to do about Omicron? I was like, well, there are four ways that this could go, and I just parroted everything you said, so I’m all about making that news that you can use.

Andy Slavitt  48:03

Well, that’s awesome. We’ll look at anybody that helps me sound better or slightly more intelligent. The prep that you guys have, you know, done, people don’t realize, because it’s called in the bubble, the Andy Slavitt. What a team effort this is. But just since we’ve started working together, I can really feel how we can just get more and better news and information to people.

Kyle

And I do want to make sure that everyone knows, don’t worry, we’re still going to be your home for COVID News, right? So all the topics is the next wave or variant comes as vaccines get approved, Andy will keep pushing to find out when we’re gonna get kids vaccinated. Five and under, he’s on, you know, it’s right at the forefront of all of our minds. So we’ll still be your home for all of those important conversations. It’s, we’re just with the additional show, augmenting, and expanding what we do so we can cover more topics that you’ll be interested in.

Andy Slavitt 

Yeah. And I think one of the things that was originally at the premise, when we started in the bubble was I get the privilege of having conversations about what’s going on in the world with people who are making the news and who are deeply involved in it. And the idea has a why not just have those conversations, but bring them right onto the show. And try to get them to forget in some senses that they’re even being interviewed. And you can get to get a peek what it’s like in the bubble, if you will, so many puns and meanings to that expression, which by the way, Lana thought of. So I mean, just this idea of getting to find who is it that’s relevant to talk to get them on the phone, and then try to get them on the show.

Kyle 

That’s right. That’s what we’re aiming to do every week and we should also make sure we want to mention our crack engineering squad. James and Noah who we couldn’t do this without they are the backbone of the show, and making sure that all of this comes together to flow into your ears and sound as good as possible.

Andy Slavitt 

We believe that sound so good that those two are great as well. So anyway, that’s the team. You’ll hear from them again? Any parting thoughts from you, Jackie?

Jackie  50:10

It’s been a real pleasure to hear from everybody in response to the show on Twitter as well. And so like Kathryn said, we always want to hear from you and hear what you want to know from the news. So keep that up, and we’ll be listening to.

Andy Slavitt 

That’s great. All right, great. Thank you. Anything else, Kathryn?

Kathryn Barnes 

Just excited to be part of this team.

Andy Slavitt

All right, Kyle, well, looks like we can’t fail now.

Kyle 

I feel like we’re set up for success. It’s, it’s going to be an exciting time. So I’m happy to be here. I know we all are. And yeah, as Jackie said, we want to hear from you. Send us your ideas of what you want to hear Andy talk about or who you want to hear Andy talk to at inthebubble@lemonadamedia.com

Andy Slavitt 

All right, Kyle, let’s talk about what we got on our next couple of shows. But before we do, I want to make sure everybody’s aware of a new podcast. It’s out from Lemonada yet called BEING it is available. When is it available, Kyle?

Kyle 

It launches this Thursday the 28th. And it’s really, it’s a really cool idea. I’m really behind it, I think you’ll like it too. It’s audio reality, right? Reality television for your ears. This season is called BEING trans. And I think it’s really cool. It’s gonna be worth your time, you ride along. As four trans people live their lives out in LA, you get to see how they handle relationships, doctor’s appointments, careers, everything else. It’s just like a reality TV show. But in your ear, you can take it anywhere you want to go with you, and a really intimate chance to learn about these people’s lives.

Andy Slavitt 

That’s great. So Kyle, who do we have coming up on Wednesday’s show?

Kyle 

Actually, I think Andy, that’s your job to tell us.

Andy Slavitt 

Oh, man, I can’t get rid of everything. All right. Well, yeah, that’s right. Wednesday, is show we’re doing on the mRNA platform. Fascinating. I wanted to put an episode up like this for a while. We’ve got a longtime expert who’s been working in the mRNA. Platform. Honestly, there’s some really amazing things that I heard in this conversation, which we just had, that you’re going to, I think really find amazing. Like, we can completely transform how flu vaccines work. We could get vaccines for cancer, when you have good vaccines for things like Alzheimer’s, there either around the corner or around the corner from around the corner. So this is this is a sneaky, excellent episode. And then coming up beyond that, we’re going to have some great episodes. Deborah Birx is going to be on the show. Who else Kyle, you can at least remind me who else I’m missing.

Kyle  52:43

How about the FDA commissioner, he’s coming up on Monday, the second.

Andy Slavitt 

Rob Califf will be on. That’s going to be a big episode we’re going to talk about, among other things, how we get vaccines for kids, zero to five, I talked to Rob yesterday, I told him it is going to be a challenging interview, we’re gonna go at it and he said, I am ready. You have to eat deserves that kind of scrutiny that had been robbed a long time. So all kinds of great episodes. We’re thrilled to bring them to you. We’re thrilled, thrilled, thrilled that you guys all listen to this show and that you continue to come back and you give us feedback, and you make it all really, really worthwhile. So have a great Tuesday, and we’ll talk to you on Wednesday.

Andy Slavitt

Thanks for listening to IN THE BUBBLE. We’re a production of Lemonada Media. Kathryn Barnes, Jackie Harris and Kyle Shiely produced our show, and they’re great. Our mix is by Noah Smith and James Barber, and they’re great, too. Steve Nelson is the vice president of the weekly content, and he’s okay, too. And of course, the ultimate bosses, Jessica Cordova Kramer and Stephanie Wittels Wachs, they executive produced the show, we love them dearly. Our theme was composed by Dan Molad and Oliver Hill, with additional music by Ivan Kuraev. You can find out more about our show on social media at @LemonadaMedia where you’ll also get the transcript of the show. And you can find me at @ASlavitt on Twitter. If you like what you heard today, why don’t you tell your friends to listen as well, and get them to write a review. Thanks so much, talk to you next time.