What Will We Tell Our Kids, with Chelsea Clinton

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Today, Andy and Chelsea Clinton talk about the role of the US in the world as Trump diverges from other world leaders in going it alone in the face of this global pandemic. They also discuss what their parents taught them about America and what they’re telling their own kids. Then, Andy calls author and historian Steven Johnson to put COVID-19 into a global, historical context.

Show Notes 

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[00:38] Jacinda Ardern: I do just want to prepare everyone that because of the lag with Covid-1, the time from someone having contact with someone who has it, catching it themselves, then being symptomatic and being tested and positive, is a number of days before all of that happens. So we won’t see the positive benefits of all of the effort you’re about to put in for self-isolation for a lot – for a few days. Quite a number of days, I’d say at least 10 days. So don’t be disheartened. Our numbers are going to go up, and the modeling I’ve seen suggests that they will go up quite considerably. We’ll see quite a steep rise until we start to, we hope, see the effects of what we’re doing with self-isolation having a positive impact. So don’t be disheartened when you see that. Don’t be disheartened when you see the ongoing increase because of that lag. 


[01:32] Jacinda Ardern: All of the efforts that we’re putting in should eventually show, if we all follow the rules. Until then, do check in on your neighbors, do especially check in on those who may be elderly, give them a call, see what their needs are. And if you can help them go out and grab their essentials and pop them on the front door for them, just remembering the way we can keep them safe is by keeping our distance. Remember, stay at home, break the chain, and you’ll save lives. And it’s as simple as that. That’s everyone’s job for the next four months. 


[02:09] Andy Slavitt: Hi. Welcome to In the Bubble. This is Andy Slavitt. The voice you just heard was New Zealand’s Prime Minister, Jacinda Ardern, from the beginning of the onset of coronavirus. And you heard her essentially in her pajamas talking to the country as she was putting her kids to bed. And as the story now goes, New Zealand had a very effective communication program and lockdown. And while at that point in time she sounded a little bit trepidatious about what lies ahead, a few short weeks later, this is the message we heard. 


[02:45] Jacinda Ardern: There is no widespread undetected community transmission in New Zealand. We have won that battle, but we must remain vigilant.


[02:52] Andy Slavitt: So today on the show, Zach and I are excited to have Chelsea Clinton. Many may not know that Chelsea has real leadership and background in public health. In addition to a lot of the other things she does. And we are going to talk about the kind of messaging that comes out of leaders at a moment like this, and how much it matters. As well as whether or not we should be thinking about coronavirus not just as an American issue, which is how I will admit I often talk about it, but as a global issue, and what responsibilities the U.S. has in that regard. I want to cover a couple of other things. First, today, a group of about 20 healthcare leaders and I launched an op-ed in the USA Today with a new movement called #OpenSafely. Let me just tell you a little bit about the reason why we did this. I think the narrative that is starting to shape the country is one that is that we are increasingly divided again. And I know that going into the crisis with the pandemic, it felt like a very divisive country. I, for one, really appreciated the fact that Americans unified in such important ways during the early stages of the crisis. And, you know, I suppose it’s only natural that there’s some reversion. But, you know, it’s my belief that we aren’t really as divided as we are portrayed on TV, with the marching and the protests. In fact, you know, marching and protesting, generally speaking, are not always a bad sign. But there are a lot of people not out there marching and protesting. You know, some of the data shows that like 90 percent of people still do not want to be in groups of 10 or more, and do want it to socially distance. So I don’t know. I think the country is more united than the popular press portrays it. 


[04:41] Zach Slavitt: Yeah, well, like any opinion where there’s a more radical group of people, their — despite being the minority — going to be the loudest group of people because they’re different in opinion than the majority people. Which causes a disconnect between the amount of people who actually feel a certain way, whether it’s about opening up the country or something else, and how many people actually feel that way. Simply because they’re the people who are going out and protesting and making their voices heard.


[05:17] Andy Slavitt: Yeah, kind of hard to protest when you’re staying home, isn’t it? So this initiative we launched today, it’s co-led by someone named Mark McClellan and I. Mark served in George W. Bush administration, both as the FDA director as well as the CMS administrator. And we’ve got about 20 other people from both parties essentially laying out what the majority of Americans believe. I’ve not heard anybody say that they don’t believe that they want this country to be closed longer than it needs to be. I have not heard anybody say that they would like there to be a greater loss of life than needs to be. I think Americans all want the same thing. We want to prevent the loss of life. And if we open, we want to open in a safe way. And this piece that we put out details what it is we believe opening safely means, and what are the things that we think can open when, and what governors should watch for. And it’s amazing the uniformity, if you look at this piece, I hope that you’ll find that you agree with the majority of things in it. And that I think the majority of people in the country do agree with this. But sometimes, as you just said, Zach like nobody states the majority opinion because it’s less interesting. 


[06:24] Zach Slavitt: Yeah. So this is basically like the sequel to #StayHome?


[06:30] Andy Slavitt: It kind of is. It’s kind of like the movie sequel to #StayHome, which is #OpenSafely. If you agree and believe it, then it’s a hashtag that we think you can use. And I think it sends a message to our political leaders, yes, we want to open, but we don’t want to rush it so that we open so fast that we have to close down again, or that there’s needless loss of life. We launched the #StayHome campaign in the middle of March. It’s now two months later almost exactly, and we’re launching this campaign. 


[07:00] Zach Slavitt: And do you feel #StayHome was a success? 


[07:02] Andy Slavitt: I do. I do. I mean, you know, we invested quite a bit of effort and even a little bit of money behind it in communities like New Orleans, Washington, D.C. and other areas where we really wanted to prevent an unnecessary death toll. I mean, we had millions and millions of views. I think #StayHome has become kind of a rallying cry. Look, we still think people should stay home when they can, but we do know that it’s impossible not to step forward in a step-wise, smart way. And as much as we’d like to say that there’s no risk in taking some of these steps, there is a little bit of risk. But we think there’s intelligent ways to get there if we’re going to do it. And let’s face it, we’re gonna learn. I mean, we’re gonna learn what activities are healthy and safe and which ones aren’t. I think everybody should be cautious in the meantime. But, you know, we may learn that there’s a lot of things like doing things outdoors, for example, that are safe and that people should be doing so long as they don’t do them in large numbers. 


[07:58] Andy Slavitt: Do you want to give us a fact, Zach?


[07:59] Zach Slavitt: Yeah, I got one right here. So this is from CNN. And it’s basically just saying that the Moderna coronavirus vaccine trial, which is one of the eight current vaccine trials worldwide that are on the human trial aspect of this. And they have gotten some early results. So there’s three different levels of human testing that each vaccine has to go through. And so they just completed the first one, or at least part of it. And they’ve revealed that the participants who were given the vaccine so far have shown the same antibodies or more than people who had previously had the virus, which as we know from one of my previous facts, it is largely believed that there is some period of immunity from antibodies. And so if you take these together, a large enough portion of the world having some temporary at least immunity would effectively suffocate the virus by not allowing it to infect people. And it would go away.


[09:09] Andy Slavitt: Great. So that’s a promising fact. The only commentary I would add is we’re probably going to see lots of news on vaccines. Some will be positive, some will look like it’s stepping back. So I would probably advise people not to get too excited about the good news, or too frustrated about the bad news. So now we’re going to go to our conversation with Chelsea Clinton. It’s a rare opportunity to talk to Chelsea. I think as you’ll learn, she’s working on some great and really important things. So here it is. 


[09:43] Andy Slavitt: Paint a picture. Give us the imagery of where you are right now. You’re in your apartment. You’re on a phone. You’ve have three kids. Are they around? What’s the atmospherics of life for Chelsea Clinton like these days? 


[09:55] Chelsea Clinton: Well, my two older kids, although they’re not really that old, they’re five and a half. And as my son Aiden proudly declared this morning, he is one month from being four, but they are hopefully on their last session of what they call computer school, to distinguish it from a real school. And right before I hopped with the phone with you, I was breastfeeding Jasper, our nine-month-old. And hopefully he’s going to remain quiet. But if you hear any things that sound like a baby, you are hearing a baby. That’s Jasper. 


[10:30] Chelsea Clinton: So we are incredibly grateful to be healthy and safe. My husband and I have a number of family members who are on the frontlines as doctors and nurses, so we’re deeply aware of our loved ones and also our friends and praying every day for their safety. And Andy, as we’ve talked about before, I live, as I think many of us do in this place of extraordinary gratitude for our health and safety. And I hope and fear for our loved ones. And then just incredible anger. I’m just so angry. All the time. Every day, you know. I try not to be angry while I’m breastfeeding, but kind of absent that, or when I’m with my older kids, I’m just so angry all the time over the multiple failures of leadership over the last months and all that co-exists every day. 


[11:23] Andy Slavitt: Right. I wonder if I’m saving my anger for later. Not that I don’t feel at times, but I find it hard to sustain it and not drive myself up the wall. So I’m probably suppressing it and trying to be busy and productive and hopeful. And sometimes I’m hopeful when I feel hopeful. Sometimes I’m hopeful to make myself feel hopeful, if you know what I mean.


[11:46] Chelsea Clinton: I’ve thought about this a lot before this Covid crisis, and now even more so with Jim Kim, one of the founders of Partners in Health and then the president of World Bank, who has been a real leader in helping Partners in Health partner with the state of Massachusetts, kind of on really the first effort at scale in this country of building a contact-tracing response, because we know the only way we’ll really be able to safely reopen, with “safely” kind of being an important part of that, is to have, you know, robust testing infrastructure, contact-tracing infrastructure. Ideally also helping people kind of isolate with dignity and the support that they need. And Jim said something years ago, which I gather he has said now a number of times that optimism is a moral choice. And I think about that a lot, because as angry as I am, I also wake up every day and choose to be optimistic that we can emerge hopefully healthier and everything that that entails. Because otherwise, I think kind of anger, just at least for me, I think would only lend itself to gross depression every day. So I try to have optimism alongside my anger. 


[12:57] Andy Slavitt: Yes. So you remind me of maybe it was after the shooting in Charlottesville when Obama was speaking. You know, we hear him talk about the arc of the moral universe is long, it bends towards justice, that he would frequently say, particularly when it was hard to believe, when you were headed the wrong direction. And your father also was able to communicate in ways when he was president that helped people going through hard times see that things could be overcome, maybe in part because of his biography of his own life. 


[13:30] Chelsea Clinton: I think one of the things that President Obama did so brilliantly was helping us collectively — individually, but especially collectively– feel like it was our responsibility to bend it towards justice. That this wasn’t just going to happen. We couldn’t rely on inertia. We could collectively bend it toward justice. I think one of the things that’s so painful, Andy, now is to see kind of on Twitter here, our current president either deride the human suffering around Covid as trumped up, no pun intended, or “fake news.” Or yesterday congratulating himself on an extraordinary amount of progress, I think he said on Twitter, as we crossed the threshold of 90,000 Americans that we have counted, and we know that that’s a desperate undercount, but 90,000 Americans we have counted having died of Covid-19. Hundreds of thousands of more recovering, but with long tails to their recovery. So just the fact that he can’t even muster a pretense of compassion and empathy still is mind- and heart-boggling to me. 


[14:40] Andy Slavitt: And we’ve done no mourning. I mean, I remember how much we mourned 9/11, the victims and the tragedy. I think about how the processes for grief allow you to be human and to be optimistic even, in the face of the really sad and awful things that life brings you. And I feel like we’ve almost stopped having that expectation that somebody will stand up and speak to and for the entire country, not just the people that may be in their voting block. To me, once this thing became largely an African-American/nursing home kind of thing that you could easily categorize off, I feel like the rhetoric changed for the worse to some degree to, oh, this is manageable. This is other people. And not really looking at this the way that we would if we valued the dignity of every life the same.


[15:39] Andy Slavitt: I think that that’s exactly correct. I mean, I think we see the ugly truth of that, of our racism, on kind of proud and loud display at the protests for reopening. And also kind of in people, you know, saying the quiet parts out loud. Like the story in The Washington Post this morning where a number of people across town in Georgia were interviewed. And, you know, you had people in the article saying blithely, well, once it became clear that effectively, like I wasn’t in that demographic, why should I be bothered? And also the callous disregard for our elderly. I certainly was raised to have respect and even deference to not only my grandparents, but to people who had lived longer than me. The collision of the racism that has always been part of American life and certainly has been re-energized and amplified under this administration that we see so painfully refracted in this Covid crisis, along with the ways in which we’re now treating and talking about and disregarding our elderly. And when you have elected officials talking about how well you know, it’s OK if grandparents have to die. Or I would sacrifice myself if I were a grandparent. This isn’t the country that I want to live in. I want to live in a radically different country. And I think this goes back to the optimism point. I believe that it’s possible. I believe that we can prove that it’s possible if we make it so.


[17:13] Andy Slavitt: I do believe there is a strong silent majority that is quite unified. And that if we look on cable TV and see, you know, the number of people, however many it is, marching on the capitol with semi-automatic weapons, that’s, of course, going to be interesting to cover. I still look at the polls, which show me that 92 percent of Americans believe we should still be socially distancing, 92 percent of Americans don’t feel comfortable being in crowds of more than 10 people. And so they want to be led. And they’re actually quite unified. I actually think the differences between the governors’ policies are actually much smaller than they’re made out to be, both Democrats and Republicans. 


[17:54] Andy Slavitt: And so I don’t know a person in this country that wants another unnecessary death. And I don’t know a person, this country that wants a small business owner to have their store not open as soon as safely possible. You know, we’re not going out protesting and marching, but that the vast majority of people are far larger, in my view, than the people that are out there saying, I don’t want to wear a mask. That stuff will get on Twitter. Someone goes to a store without a mask and raises a big deal on Twitter. But the truth is, I think that’s a vast minority of people.


[18:22] Chelsea Clinton: I agree with you. I mean, thankfully, that is what the polls do bear out really pretty uniformly across the country. And I agree with what you said about governors, with some painfully glaring exceptions to the contrary. Listening to you, though, I think about how — that was, Jasper, if you just heard that in the background. I think that one of the challenges in the reopen safely kind of goes back, though, to the absence of not only humanity, compassion, decency at the top, but also the failure to communicate clearly. And public health and the economy are not two ends of a spectrum. But I think that because it’s been framed that way for all sorts of politically convenient and expedient reasons, it does kind of cry out even more for clear communication. There was a wonderful New Yorker article about the response early on and now sustained in Washington state quotes a number of people effectively saying, look, we realize that communication about the crisis wasn’t secondary to the management of the crisis. It was fundamental to management of the crisis. And so part of what has to be so core to how we talk about reopening safely is to be able to talk about it in a clear way that people really understand why they’re still being asked to change their behaviors from a few months ago. And also to be candid with people, Andy, that we may have to shut down again. China today closed a huge swath of the country. Over 100 million people in China are confronting the cessation again of schools and businesses being closed and are being asked to shelter at home because of a Covid outbreak in northeast China. So we just have to be clear, candid, transparent with people, but not frame it in this public health or economy.


[20:19] If you are hungry for a national leader to give you a message, go listen to Angela Merkel, or go listen to Jacinda Ardern in New Zealand, who we had playing at the beginning of this show. And I mean, I’ve said — I’m not the first one to say — gosh, if we’d only had a woman as president, there seems to be a thread of being able to manage this crisis that’s been fairly consistent.


[20:44] Chelsea Clinton: I certainly think Angela Merkel and Jacinda Ardern and others, many of whom are women, do show us the counterfactual of what is possible when you have competent and compassionate, also, I think humble leadership. And even Angela Merkel, who herself is a scientist, has been very candid about listening to the epidemiologists, virologists, experts that she’s really surrounded herself with in the last couple of months. And I do think, again, this shows us that elections matter. 


[21:18] Andy Slavitt: We have a running joke here in the Slavitt bubble that Lana has a crush on Justin Trudeau and I have a crush on Jacinda. It shows how geeky and lame we must be that like our crushes our non-movie stars, they’re political figures who we admire. You can laugh at us. Go ahead, Chelsea. 


[21:33] Chelsea Clinton: I have a massive girl-crush on Angela Merkel. I mean, I adore Jacinda Ardern, too, from afar. I mean, I don’t know either of them, but I just have been so impressed with especially how Angela Merkel has talked about the science. And I think she’s done a masterful job, as you have Arden and others in helping people understand not only what they’re being asked to do, but why they’re being asked to do.


[21:57] Andy Slavitt: You said two things that were kind of a little bit buried in there that I want to call out. One of them is in public health, and this is where your expertise, for those of you don’t know, Chelsea wrote a book called Governing Global Health: Who Runs the World and Why, that communication and message is response. It’s not like an overlay, how you respond, but it’s part of the book of a good response is public messaging. And Trump wasn’t the only one that got it wrong, by the way, I think the mayor of New York didn’t get it quite right. At first, I think he’s better now. But listen to the scientists, listen to your public health commissioners. They know what to do in these situations. And time is so valuable that if you get it wrong for as long as we got it wrong, you pay dearly. Because when you’ve got something that spreads exponentially, even a week or two is tens of thousands of lives at the wrong time. And so I think maybe the most important thing for people to hear right now is that we will zigzag a little bit, even with the best leadership. Even with Merkel, even with states like California or Washington state, there will be more cases. Hopefully there won’t be big outbreaks. Hopefully they’ll be small. And if you watch the bouncing ball every day, you’re like, we thought they were great and now they failed. But the measure of success and failure is actually how quickly you can respond and minimize and contain. Not whether you have cases or not. 


[23:21] Chelsea Clinton: Absolutely. I mean, I think that it’s really important for our leaders to be really clear and candid that we are likely going to be for many months, and likely years, until we have a vaccine, until we have a raft of antivirals that are able to treat Covid and the attendant symptoms and syndromes in a period of opening and closing. And I do think what you said is so important that the measure of success is how well prepared are we so that when there is an outbreak, it doesn’t spread, and we are able to respond effectively and efficiently to save lives. There’s an adage in public health that outbreaks are inevitable, but epidemics are not. And I think that that should be true if all these things that we know need to happen, happen. It’s just so sad to me, Andy, that the U.S. has totally ceded our leadership role in public health when kind of it was the U.S. who really led, alongside at times the Soviet Union, the effort to eradicate smallpox. It has been the U.S. that has really been leading for the push to eradicate polio. That after kind of initial obstruction and an absence of leadership on AIDS, that the U.S. was leading, that the U.S. was the lead in responding to Ebola, to MERS and other global threats even in the last few years. And we are just absent. And if not absent, just angry. Instead of being kind of part of the solution and trying to save lives around the world, which I would hope the Trump administration recognized to help save lives here at home.


[27:29] Andy Slavitt: You and I were talking a couple weeks ago about the WHO. You gave me a great primer on what the World Health Organization actually does and what our funding goes for. Which it turns out isn’t super straightforward to be able to tell on your own. And I’m wondering if you could just give like the one minute thumbnail sketch of like the two or three big priorities the U.S. funds. Because as we sit here today, the U.S. is now saying that they’re going to cut off all funding for the World Health Organization as some sort of punishment to China. So what would we be actually cutting off?


[28:04] Chelsea Clinton: It’s hard to have this conversation in a kind of one-minute way because there’s a two-year budget cycle, we don’t totally know the exact distributions, and for those of us who care about kind of precision. It’s hard. But in the last budget cycle of 2019, we provided about 15 percent of its funding and that funding went to everything from the global effort to eradicate polio, to what was called the contingency fund for emergencies, which was really important in helping the Democratic Republic of Congo respond to its recent Ebola outbreak. We help fund the work around the international health regulations, the IHR, which is kind of the mandated reporting on things like plague and yellow fever and also newer threats like Covid. We also don’t fund the things that the United States has never signed up for. So we don’t find any part of the WHO’s work on monitoring compliance with the Convention on Tobacco Control, because we’re one of the few countries in the world that has never signed up to the global effort to help eradicate tobacco use. So it is in some ways, I would think, kind of tailor-made. And I don’t agree with this, because I believe the U.S. and member states should actually be contributing more money to the WHO that isn’t earmarked, but the vast majority of funds we contribute are earmarked. So it should ideally be tailor-made for the Trump administration, like it’s not funding things that it probably doesn’t support like tobacco control. It’s not funding things that probably I know it doesn’t support, like the efforts to move away from breastfeeding substitutes for women for whom it is really important to breastfeed their children around the world. All of these things that, you know, the Trump administration doesn’t support, wouldn’t support. We’re not funding it anyway. 


[30:03] Andy Slavitt: Right. So what I’m hearing you say is there’s sort of a narrow list that has sort of been vetted by both parties over the last few presidencies that includes AIDS and HIV, includes moms and kids. It includes eradicating polio. It includes some of the intelligence to make sure that we see what crops up where.  And we do these on behalf of ourselves and for countries who just don’t have the ability to make that investment and so would be wiping out large parts of their population. So if someone were to have the impression that Trump cutting off funding for the WHO would be hurting China somehow, sounds like that’s not the case. 


[30:43] Chelsea Clinton: It’s just not true. I mean, if the pause turned into a permanent freeze, we would lose, if not completely kind of undermine, our ability to push forward on eradicating polio. I mean, we know even the pause in the polio vaccination campaigns has led to new cases in Niger, in Chad. We hadn’t had a polio case in Niger since 2012. So we know that any pause has catastrophic consequences. And if the Trump administration pulls the hundreds of millions of dollars we contribute over two years to that effort, it will be disastrous. If we pull the money to support the responsive efforts to WHO, like what happens when there’s the next Ebola outbreak in the DRC or elsewhere? If we pull the money that supports kind of their broader HIV/AIDS work with U.N. AIDS and Global Fund, like what happens to the vital coordinating role that WHO plays? And it’s not as if you can pull these funds from WHO and then invest them or give them to another entity that can just go do all of these things that WHO does. That’s just not a plausible scenario. So we wouldn’t only not be punishing China, we would be hurting the world and making us more vulnerable, too. 

[32:08] Andy Slavitt: I think that’s a very compelling case. And so in the interests of just kind of some of the sausage-making for the audience, after Chelsea and I spoke, I called the White House and tried to get a feel for where things were. And really with the sense that I generally have, or the gut instinct I have, that they float these trial balloons. And my assumption was that the president really didn’t know what this funding was going for. But really, I think like the political message, tested it. So then enter Tucker Carlson and Lou Dobbs. Trump apparently had floated the idea of maybe keeping some of the funding for WHO, and apparently Tucker Carlson leaked this. Not quite sure exactly how this happens, since they just read about it. And leaked it to the base. At least I think it sounds like with the idea that the base would come back and tell Trump, as apparently Republicans in the House have told him, that not a penny should go to the WHO, and that that would really help his reelection. Now, I’m not sure if Tucker Carlson is an expert on the WHO, maybe he knows about eradicating polio more than I am aware. But if he does, maybe he doesn’t care.


[33:16] Chelsea Clinton: My only trust in Tucker Carlson, really is — I’m sure that he has criticized me on more than this occasion. But he criticized me for linking child marriage to climate change, even though we actually have lots of evidence that as temperatures rise and weather events become more extreme, women and girls, again, are especially made vulnerable, as is so often the case in crises. And families are more likely to forcibly marry their girls in an effort to give them stability or to kind of remove the burden that they perceive them to be. So that’s really my only experience at least that I’m aware of with Tucker Carlson. But, you know, I just find this all so painful that Tucker Carlson and Lou Dobbs are making any type of American policy. And that, again, kind of America First crowd doesn’t seem to understand that America First is expressed, at least in this administration, often as “America alone,” which just makes us more vulnerable. And I have plenty of criticisms about the WHO historically and contemporaneously. I mean, I was a coauthor on a piece that was deeply critical of its response after the Ebola outbreak five years ago. But I do believe it is indispensable and we cannot just recreate it. And if Tucker Carlson or anyone thinks that we can just stand up a global health entity that somehow defines the globe as starting and ending at America’s borders, like I don’t understand that. It’s not logical or moral or strategic or smart to me.

[34:53] Andy Slavitt: I want to connect this to another passion of yours. When I was growing up — I was born in 1966, so I was growing up in the ‘60s, ‘70s, then went to high school in the ‘80s. The image of America that my parents painted for me was of a flawed but generous and open and kind nation. Their parents, or grandparents, came to the country not that long ago. My grandmother was born in Poland, came through Ellis Island with plenty of trials and tribulations and so forth. And I was raised with an image of this country as being a place that you could do that, you could come. And this vision of this country — it’s not that they were never critical of the country, they were critical of political leaders and critical of big mistakes we’d made. But at the end of the day, I was raised to think of a lot of the goodness that exists here. I’m guessing that’s pretty similar to the way your parents raised you. Now your parents are obviously very well-known people. And so what image of the country did they give you growing up?

[36:04] Chelsea Clinton: I think it is similar one, I mean, toward a more perfect union. I mean, in no way glossing over the work that’s still desperately needed to be done. I didn’t grow up thinking that the civil rights movement or the women’s rights movement were history. Like I grew up with parents who very much believed that work was still ongoing. The first real issue I really remember kind of caring about as a kid, which I’ve thought a lot about actually during this Covid crisis, was around CFCs and moving into a world without acid rain and hopefully toward a more sustainable and a radically different environmental future than the one that we’re currently on. And so I think about this toward a more perfect union and all the work that we have to do and the work that, you know, I’m more aware of now that I was a kid, especially around indigenous rights and remediation and reparations broadly and kind of all these things that are the continuation of what I grew up around that weren’t maybe the concepts or that specific urgencies that were present. But I also grew up with this sense of like to whom much is given, much is expected. You’re never too young or too old to make a difference. I was already a citizen as a kid, even before I could vote. In that sense of kind of, we all had to do our part, however we defined it, whatever that meant. And that there was this kind of big “We.” 


[37:31] Andy Slavitt: You have been so generous with your time. So do you have 10 more minutes or so?


[37:33] Chelsea Clinton: Yeah, I have 10 more minutes and then it’s just either and we will be interrupted by either Jasper needing to eat again or me needing to pump. 


[37:41] Andy Slavitt: All right. We will get it done in 10 minutes, but we will like screech to the curb at 10 minutes. Thank you for sharing you with us today. 


[40:44] Andy Slavitt: This image of kids and what they can understand and becoming citizens — so we talk a little bit about how you see kids growing up now differently. Will they hear the same messages that you and I heard?


[40:59] Chelsea Clinton: Well, they certainly hear different messages. I think a lot about the statistics and the stories behind the statistics of the rise of bullying in our schools, where especially African-American kids and Hispanic kids and transgender kids and girls and differently abled kids experiencing unprecedented levels of bullying. And many of the kids, or even adults, who are bullying them are using the president’s rhetoric, using the president’s words. Not only mainstreaming, but something I’ve been talking about for a while that is just appalling, kind of the president’s ability to mainline hate directly into the veins of our kids. I think we all have a responsibility to try to disrupt that and not only model different behavior, but to intervene and intervene strongly. And for those of us who don’t share those values, to raise our children in ways that are not totally sheltered from it. To talk about it in age appropriate ways to raise our kids to be active citizens and active allies. 


[42:14] Andy Slavitt: Here’s something that confuses me as a parent. Like hate is so intoxicating. And you see how easy it is for the president to marshal hate with his followers. Like it’s so intoxicating. And I also feel like hating the president is also intoxicating. And there’s always been people arguing. But how do you teach kids about what we have in common and not to hate the other side and that there is so much in common and when it’s so not backed up by what they see and experience every day?


[43:19] Chelsea Clinton: I think that’s such an important point for all of us who are citizens, and especially for those of us who are parents to reflect on. I think a few things kind of sprung to my heart and mind listening to you ask this question. I think one about something my mom spoke a lot about in 2016, and I know that she was often kind of made fun over derided for this, but she really thought we needed more love and kindness in our country, especially kind of at the moment in early 2016 when Trump was unleashing an weaponizing so much toxicity. Again, not kind of creating of the racism or misogyny or Islamophobia or anti-Semitism or homophobia or transphobia, ableism — really kind of all these things that have long, long, long, forever kind of been part of our country, but really had weaponized them and amplified them in such painful, destructive ways. I do think we need more love and kindness, and I think that we can talk about that openly with our kids and role-model it for our kids. And for me, part of their being more love and kindness in the world is standing up to the opposite of that and not becoming consumed by the hate. But standing up against child separation at the border, standing up against the kind of callous and cruel and incompetent mismanagement of our Covid-19 crisis. 


[44:40] Andy Slavitt: We have a lot of people who listen to this show with young kids. What are some of the funnest things that you and the kids have been able to do since you and Marc — I know Marc’s been home a lot more — together? What are some of the happy memories you think you’ll take away and some of the just fun things you guys have done together as a family? 


[44:57] Chelsea Clinton: Oh, my gosh. So we’ve played lots of games. Some games that we have played before, like, Uno, and others that are new to us, like Sleeping Queens that a friend recommended that my kids are obsessed with. And Rat-a-Tat Cat. We’ve been doing lots of puzzles. We have built little houses for Charlotte, Aiden and Jasper. Jasper didn’t help build his little house. And for our dog Sauron. Out of all the things that we will recycle but haven’t yet, like paper towel rings and egg cartons and boxes. But that was after the first couple weeks of isolation were big for us like construction projects. So we have really treasured this time all together, but are deeply mindful of the horrors happening around us. So trying to have gratitude for this time together and kind of have the fun and the joy, but certainly not to lose sight of the anger, as we started our conversation, that’ll hopefully help keep propelling me and us forward to try to do whatever we can to make even a little bit of a positive difference. 


[46:21] Chelsea Clinton: Well, thank you. I just want to say what a great role model you are as a citizen, as a parent, as someone who defines our country still by its aspirations, its role in the world. And thanks to Jasper.


[46:38] Andy Slavitt: Thank you, Andy. And I look forward to hopefully talking again soon, offline or online. 

[46:50] Andy Slavitt: So that was Chelsea Clinton. That’s a voice you don’t get to hear from very often. She doesn’t do a lot of interviews and I feel grateful that she came out with us. She obviously has so much depth to share on this topic of our role in the world, and what we do in these sort of pandemic situations. And I think that sets us up nicely for Segment 3, because Segment 3 is the part of the podcast where I kind of try to stay on a similar theme, but provide a new perspective. And I had a chance to talk with a guy named Steven Johnson earlier in the week. He’s an author and a historian. He has written books about pandemics, he’s written extensively. He has his own podcast called Fighting Coronavirus on Wondery, and he has another podcast called American Innovations. He’s really written some great books, including the one that he and I talked about on this conversation called Ghost Map, about the cities and pandemics that look at cholera in London in 1854. And his latest book is coming out this week on a totally different topic called Enemy of all Mankind: A True Story of Piracy, Power and History’s First Global Manhunt. Hmm, piracy. Maybe they’ll take our minds off the pandemic. 


[48:15] Andy Slavitt: It’s really good currency to know something about pandemics, huh?


[48:19] Steven Johnson: I wish this expertise were timely for some other reason, not the reason we have now. 


[48:25] Andy Slavitt: Tell us what lessons we should be taking from past pandemics?

[48:29] Steven Johnson: Well, I mean, the one that I’ve written about the most, which is the one that’s at the center of Ghost Map, is the 1854 outbreak of cholera in London. And that was slightly different from our current situation. Cholera was a pandemic in the sense that it was a disease that was spreading all around the world. The outbreak in question at the center of that book is a very concentrated one that takes place in Soho in London, where basically 10 percent of the population in the neighborhood dies in about three weeks. So it’s terrifying. But, you know, one of the reasons why I wrote that book, and why I think it’s relevant now is that it’s actually despite the fact that it’s a story on some level that’s, you know, eerily echoing our current situation, in then it’s a story of terror and urban mass death and the dangers of density. But it’s also a story about triumph and the ability to ultimately come up with new ideas and end up solving these problems. 


[49:25] Andy Slavitt: What does that episode tell you that we’re doing wrong or doing right as a country right now? 


[49:30] Steven Johnson: Well, I think one of the key things is that we’re very similar in the sense that, you know, this is 170 years ago, but at this early stage or relatively early stage, in a way, our situation is quite similar to the Victorians in the sense that we really don’t have medical solutions to this problem. So our biggest protection right now is really two things: data and behavior change. Those are the things that we’re able to do. Yes, we have kind of ventilators at the very end of this process, but they’re really you know, we don’t have a vaccine, we don’t have therapeutics yet. And so just as back then, one of the major innovations that really changed the world, and we’re still living with the benefits of this, is this idea that having as close to real-time data about illness and death and being able to map and look at patterns of that, the distribution of deaths and where people are getting sick, to use that as a way of figuring out what we should be doing. That was an incredible invention that needed to happen in the 19th century for us to benefit from it today. You know, the original story is that, at the time, cholera was thought to be in the air. This is the miasma theory back in the day. And everybody thought cholera was something that you breathed in and you were getting because that air was contaminated in some way. But in fact, we now know cholera was caused by contaminants in the drinking water, bacteria in the drinking water. And so it took this pioneering data scientist, physician John Snow, not the guy from Game of Thrones, but the 19th century doctor, to create this map of the outbreak showing that people were getting sick from drinking from this well.


[51:13] Andy Slavitt: So given there were only a couple months in, do you think we have similar significant misunderstandings that over time we will look back and say, gosh, I can’t believe back in May of 20/20, we actually believed that. 


[51:27] Steven Johnson: Yeah, I don’t know. It’s a really interesting question. One of the big issues right now, which is again another parallel, is the connection between density and this outbreak. On the one hand, you can look around New York City and say the fact that we’ve seen such incredible devastation here in the New York metro area, and the fact that New York is by far the densest city in the United States, suggests that there’s some kind of correlation there. On the other hand, at the same time, you look at Hong Kong, or you look at Seoul, and you see these cities that are even more dense in New York. Hong Kong’s bigger than New York City in terms of overall population. And, you know, they’ve had vanishingly small number of deaths. 


[52:07] Andy Slavitt: Well, that makes me wonder how much a role does randomness play — i.e.  uncontrollables. Someone gets on a train, travels somewhere, happens to be a super spreader. I know we want to see these perfectly logical explanations. Oh, this place put in NPIs earlier. I wonder how much we retrofit our logic to the fact pattern as opposed to, in your experience of looking at pandemics, how much of this is a lot of things that are just kind of butterfly effect, difficult to measure? 


[52:36] Steven Johnson: Yeah, I think that that is certainly the case. And New York, you know, had two things going against it in the early days. It was incredibly dense and it’s also a global hub. And so you had those two things kind of stacked up, but you also might have just had some other random things like a heavily kind of centralized Orthodox Jewish community just randomly ends up, you know, getting the virus at an early stage. And there are a lot of super spreader events at that particular point. And you can kind of generalize out from that. You know, the same thing is happening in the comparison with the West Coast at this point. You can look at San Francisco and say they did, you know, a much better job because look at these results. But you also just don’t know whether there was some, you know, chance set of events that happened in New York that didn’t happen in San Francisco, and that makes all the difference when you’re dealing with something that’s a kind of runaway, you know, exponential force like a virus.

[53:29] Andy Slavitt: So Zach and I were having this conversation the other day. Where do you think this pandemic will rank? Do you think this will be in history — this will be oh, this is a small thing that was kind of a blip? Do you think this will be talked about as one of the worst things ever? When you go down to the pantheon of past pandemics, how will this fit?

[53:53] Steven Johnson: I think it will certainly rank high in terms of the kind of cultural impact of it. Hopefully, if things continue to progress the way we’re doing, it will not rank all that high in terms of the number of deaths, which are still, despite all the tragedy, very, very low compared to certainly the 1918 pandemic, where a tiny, tiny fraction — some people believe 100 million people died. Hundreds of millions of people probably died of cholera over the 19th century. So the scale of death is likely going to be much smaller, which is good news and a sign of progress, because there are a lot more people on the planet than there were in 1918 or in 1854. 


[54:32] Andy Slavitt: That’s right. I have one final question for you, Steven. I really appreciate your perspective. It’s so unique. It really is a question of the aftermath of this pandemic, and if we can think ahead — I worry, for example, will certain people who have the means turn this into a guarded-gate society, decide, you know what, it’s just not safe to mix and interact. And there’s all kinds of things out there now, including disease, and so we’re going to live a gated-community lifestyle, which may or may not actually mean that it’s technically live in gated communities, but people isolate themselves. Likewise, do people turn more nationalistic — not necessary making a value judgment that all elements of self-sufficiency for a country are bad,  but there is an element we just talked to Chelsea Clinton about. The U.S. has an obligation to play a role as a world leader at this point in time, because not every country can pull their own weight. And you can imagine a pullback. So rather than just be imagined, is there anything that history teaches us about what happens after a global pandemic as people react to it? 


[55:41] Steven Johnson: Yeah, I think there are a couple of things that can be instructive. The first thing that is really important, if you look at the 1854 cholera story, is at that moment in history, London was a very interesting thing because it was the largest city in the world. There were two and a half million people in London and it was twice as large as any other city in the world. No one had ever built a city on that scale. And there were a lot of people who looked at the state of the city and the state of public health, particularly in the city, and said this is not sustainable. Cities are not meant to be this size. And this is inevitably going to crash. And we’re gonna go back to a much smaller-scale living because you can’t cram two million people into one shared community. That just doesn’t make any sense.


[56:22] Steven Johnson: And if you looked at the data at that point, it was actually a kind of a reasonable assumption because people were living much shorter lives in cities. And that changed and it changed precisely because of the invention of a whole suite of public health interventions that made cities actually now the safest places in the world to live. Life expectancy is much longer in big cities now than it is in rural areas. The whole thing got flipped, in part because of the pioneering work of people like John Snow. And so I think that that’s a continuing possibility for us. We’re going to get smarter about the ways in which we deal with epidemics in our cities. And we’re going to learn from this process and we may continue that trend. But if this is the biggest pandemic of the next 20 or 30 years, I don’t think we’re going to see any radical shift in the way that people live. I think that we’ll get through this in a year or two, hopefully, and people will remember what they loved about their lives before and the connected, globalized world that we’re in, and all the advantages that will come back to us and we’ll move on. That’s, I think, the best way to think about it.


[57:24] Andy Slavitt: I really appreciate you coming on and teaching us. 


[57:30] Steven Johnson: Thank you. I appreciate it. Thanks for having me. Thanks for all the good stuff you’re doing.


[57:35] Andy Slavitt: That was Stephen Johnson. That was kinda interesting. Pretty interesting think about whether we should be thinking about this as a country or as a globe. 


[57:48] Zach Slavitt: You know, we have to look at it from both perspectives because obviously the government has responsibility for our own people. But at the same time, we have a responsibility to help other countries. 


[58:01] Andy Slavitt: Very true. Very true. So next week, we’re going to have two great podcasts coming your way. A mini-conversation with Jason Kander, who, if you don’t know Jason Kander, he is a warrior. He is in the great state of Missouri. We’re going to be talking a lot about voting rights and also PTSD and the upcoming election. And then on Wednesday, we are going to have a Lana Slavitt special. We’re going to have Shannon Watts, who is the president of Moms Demand Action. And you’re going to get to hear a lot from Lana on that episode, maybe even more so than me, because we’re both big admirers of Shannon. Thanks for tuning in. And I hope you enjoyed the episodes this week. 


[58:45] Andy Slavitt: In the Bubble is a production of Lemonada Media. Niccole Galteland is our producer and Ivan Kuraev is our editor. Music is by Dan Molad and Oliver Hill. Zach Slavitt is our co-producer and my co-host. You can find out more about our show on social media @LemonadaMedia. And you can find me on social media at @ASlavitt on Twitter, @AndySlavitt on Instagram. If you liked what you heard today, tell your family and friends, but tell them at a distance. For now, stay safe. Share some joy. We’ll get through this together. And #StayHome.


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