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In the Bubble with Andy Slavitt: Our Shot
All Podcasts Should You Get Another COVID Booster Now? (with FDA’s Peter Marks)

Should You Get Another COVID Booster Now? (with FDA’s Peter Marks)

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Description

Andy talks with Dr. Peter Marks about the FDA’s authorization of a fourth round of vaccines for those 50 and older. As the director of the Center for Biologics Evaluation and Research at the Food and Drug Administration, Marks is the man most responsible for our vaccines and the speed at which they were developed. Andy gets the inside scoop from him to help answer questions from listeners about boosters, such as: Who should get another shot? Should you mix and match? And when will we see vaccines for kids under 5?

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Transcript

SPEAKERS

Andy Slavitt, Bradley Whitford, Pres. Joe Biden, Peter Marks

Andy Slavitt  00:18

Welcome to IN THE BUBBLE. This is your host, Andy Slavitt. Today’s episode is should I get a booster? Well, really? Should you get a booster? And should I get a booster? There’s new direction out from the FDA and the CDC. And we’re going to address the question with the person in charge of reviewing the data and evaluating that decision. Peter marks of the FDA. Peter Marks, by the way, is the whole reason we even have vaccines today. And so with Peter, we’re going directly to the source to ask your questions. Peter is absolutely incredible. And you all sent us hundreds of questions. The team did a fantastic job distilling those questions down to a couple common topics, all of which I think I’m going to get a chance to ask to Peter, that’s my job anyway. So stick hold me to it. But I think we’ll be able to get almost everything that you wanted to do answered in the courts have this time with Peter A. Little bit more about Peter in a minute. President Biden addressed the country on Wednesday, to talk about where do we go next in the COVID fight. One thing he talks about is a new resource that we will have available to us to get the information and the supplies, we need vaccines, tests therapies, to stay safe during the pandemic.

Pres. Joe Biden 

Today, I’m announcing the launch of covid.gov, a one stop shop, where anyone in America can find what they need to navigate the virus free vaccines and boosters, free at home test, high quality masks. And for the latest information about the level of COVID-19 spread in your community, you can get that immediately. Now, you’ll also be able to find our new test to treat locations, which I announced to my State of the Union address. These are pharmacies and other places in your neighborhood where you can get tested. And if you’re positive, you can get lifesaving treatments all in one stop. We’ve already stood up 2000 tested sites, test and treat sites across the country. We have nearly 200 sites just to serve military families and veterans communities as well. We’ve done, what we’ve done throughout the pandemic, we’ve insured these locations are the hardest hit hardest to reach communities as well. The bottom line, no longer will Americans have to scour the internet to find vaccines, treatments, test or masks. It’s all there. And just go visit covid.gov.

Andy Slavitt  03:03

Okay, so like many of you probably picked up my phone, and I got on the site to see what I could find I searched near me and I’ll tell you what I saw. I found all of the closest locations to get vaccinated and make an appointment. Great. So how to get free masks? There were 12 right near me where I could go, literally get a test. And as soon as I got the test, if I tested positive, I could get a prescription and get the drug. Pretty cool. So 180 places where I could just get a prescription for it. So 12, where I could get the treatment, 180 where I could get the prescription, and the ability to order more free tests. So all that was good. You could also search in your area to see how much COVID is prevalent. So you kind of get a feel whether you should wear masks or not. I mean, this is the age of government giving us tools, moving away from the ease of government mandating, some will like that, some will not, be that as it may. It’s a good tool. It’s a good tool. And for what it’s worth, I built or oversaw the building of some of these tools when I was in the White House. So good work, everybody, a team. But if you like free masks, free tests, free vaccines and boosters, which have been free throughout the pandemic, the President did remind us that the only reason those things are free is because Congress has funded them.

Pres. Joe Biden  04:29

Congress, we need to secure additional supply now. We can’t wait as we find ourselves in the midst of another surge to act, it will be too late. And we also need this this funding to continue our efforts to vaccinate the world with commitments we made is critical to our ability to protect against new variants. There’s no wall you can build high enough to keep out a virus. Congress needs to act now, please.

Andy Slavitt

Now seem like correct me on this. But I think we broke some of the news when we had Jeff Zients on that we were 93% through the funds that Congress has allocated, come back and talk about the funding in a minute. But the President did me a personal favor next, by really introducing the topic of today’s show during his speech.

Pres. Joe Biden  

We know boosters are critical to providing an additional level of protection. That’s why I plan to get my second booster today. Right here after I’m done speaking, if you haven’t gotten your first booster, please don’t wait. Do it today. Those who are 50, and older, as well as those who are immunocompromised can now get it getting more protection than they have from the initial first doses, we have enough supply to give booster shots to those newly eligible individuals. But if Congress fails to act, we won’t have the supply, we need this fall to ensure the shots are available free, easily accessible for all Americans. Even worse, if we need a different vaccine for the future, to combat a new variant, we’re not going to have enough money to purchase it. We cannot allow that to happen.

Andy Slavitt  06:14

So thank you, Mr. President. Appreciate you setting that up next time. Can you mention IN THE BUBBLE? Like I asked you to? Okay. I did call the White House to clarify a point, which is to say they’re talking about how we’re low on funds, which we are, but yet they’re rolling out more vaccines that are coming to us still free. So I wanted to clarify. And what I heard from the White House is there’s enough funding for doses for those of us who are just approved, i.e., people over 50 or over 12, or immunocompromised. But there are not enough. There’s not enough money for doses for people under 50. So if the FDA doesn’t make that approval, and Congress hasn’t passed the funds, well, then we know who to blame. Okay. And blame is just so much fun when you’re mad. So the latest is that Congress is now considering a proposal, of course, as they might at the last minute to fund some COVID approval. But you know, the way Congress doesn’t always have to, like, do some of it, but not all of it. So they feel like they’ve shown their power. And the part that they’re saying they’re not going to fund the practicing they’re not gonna fund is the $5 billion for global vaccinations. But it’s a good thing we’re not seeing any variants appear globally. That’s just a crazy America first dish way to prove a point that sticks a needle right here. What’s that expression, cutting off your nose to spite your face? I don’t know if that applies here. But I thought it was good to say. So we’re gonna introduce Peter Marks now, this is gonna be really fun. And as I introduce him, I thought an interesting way to do that would be to read a passage from the book Preventable, great book. It’s really the most riveting and heartfelt account of the first year of the pandemic, that that’s a quote from me, by the way. By the way, I’m the author of the book. So here’s what I wrote about Peter last year.

Bradley Whitford  08:14

Peter Marks was a Star Trek fan from Brooklyn. He’s a physician with a PhD in cell and molecular biology. After a career in academic medicine, and a stint in the pharmaceutical industry, Marx found his calling as a regulator. Marx is the man at the FDA in charge of approving vaccines and other innovative therapies. On the morning of April 7, while the White House was beginning to figure out how to extract themselves from the pandemic response, Marx was figuring out how to go in deeper, a career civil servant, he wasn’t paying attention to the political jockeying in the administration. He wanted to collapse a multiyear vaccine evaluation process in to months, and had an idea of how to do it. He picked up the phone and called Rick right at the Biomedical Advanced Research and Development Authority, BARDA, one of the men who had been instrumental in BARDA’s investment in new vaccine technologies, together with Anthony Fauci, whose team had worked with the pioneers of this new vaccine technology called messenger RNA or mRNA. They had access to the best expertise and infrastructure for conducting clinical trials. And they came up with a plan that marks dubbed, Operation Warp Speed. The plan would call for assigning specific teams from the NIH, BARDA and the FDA, to work hand in hand with five or six of the most promising vaccine developers and minimize the back and forth customary in the drug approval process. Bright believe that with the right financial support, the government could fund vaccine manufacturing, even while the trials were going on. It was a risky financial bet. But if it worked, it would accelerate a vaccine by six months. Between Marks, Fauci and Bright, they believe they had a chance to get a vaccine to the public inside of a year.

Andy Slavitt  10:15

The voice you heard was not mine, actually, it was Bradley Whitford’s. If you’re my age, you know him from the West Wing. If you’re slightly younger, you probably know him from Get Out. But you hopefully you know his voice, he did a great job reading the book. And of course, you can buy the book, you can buy the audio, you can buy the physical hardcopy of the book if you want to hear more cool stuff like that. But what better intro is there for Peter Marks in that passage, but I should tell you, he is the director of the Center for Biologics Evaluation and Research at the FDA. And he’s the man who is most in charge of approving, evaluating the data and approving vaccines for this country. Let’s bring up Peter.

Andy Slavitt

That is the first intro to you in the book. I hope it’s accurate.

Peter Marks 

Pretty much.

Andy Slavitt 

They’re late. They’re ladder passages which talk about some of the decisions that you made. And really, thank you for the heroic effort. I think we said in the introduction that we, one of the only reasons we have vaccines right now is because of the really amazing work you did over the last year. So here we are with that introduction. We’re a couple of years more in, we’re now at a at a point in time when last week’s news is the recommendation coming out of CDC for booster shots. And the President made that announcement last week that those 50 or over would qualify for their next booster and if you’re immunocompromised if you’re over 12. Can you just maybe tell us a little bit about how that process worked? Normally there is an FDA committee meeting which this decision was made before that happened. You tell us a little bit about the evidence you reviewed and the measurable benefit you see in another booster?

Peter Marks  12:13

Yeah, no, it’s a great question to ask. We’ve been obviously keeping track of the evidence that has come through on vaccine effectiveness over time. And there was evidence that, particularly in the setting of Omicron, we’ve seen waning of protection against symptomatic disease. But also there’s been a question of whether there’s been waning against more severe forms of disease, including hospitalization and death. And data came out of the United Kingdom, and out of Israel to suggest that there was perhaps indeed waning against more serious outcomes. In terms of the protection offered by the vaccine, the Israelis decided several months ago, to put in place a booster campaign giving a fourth dose of vaccine to people who had a dose their last booster, or that as a first booster at least four months previously. So we looked at the data that came out of Israel in the context of this question of waning protection, and in the context of the uncertainty of where this pandemic may go in the coming months, in particular populations that might be vulnerable. And so that’s the data we looked at. And to summarize, what we saw was that at least some of the studies indicated that a booster could make a big difference. And the one that really essentially made us take note was a study that came out of Israel from a large health maintenance organization, in which over 300,000 people who had received the fourth dose or a second booster dose were compared to a little over 200,000, who had only had three doses, or a first booster. And it seems to show a very significant reduction in death from COVID-19, in fact, about a fivefold reduction. And so that kind of data, plus data on reduction in hospitalization, as well as some evidence that perhaps we might be able to reduce other healthcare utilization, other adverse outcomes led us to take the action.

Andy Slavitt  14:41

So qualitatively, a fivefold reduction in death from people who have had just a third vaccine that had waned, to compare it to people who had the fourth,

Peter Marks 

Right and I should caveat that to say that was an individual’s over 60 years of age, and those that were are judged to be at risk of adverse outcomes from COVID-19. Because of comorbidities

Andy Slavitt 

And is it safe to say that, in general, for people who’ve had just their third dose and not yet their fourth, which is probably very few people have had their fourth, that those death rates are already quite low. This is just getting them lower still.

Peter Marks

That is exactly right. And in fact, you already, you’re a mind reader, because you already got to the point that I was about to make was that one of the really interesting things to come out of this review of the second booster dose, or the fourth dose, however you want to call it was that the first booster dose really made a big difference in everyone who received it across the age spectrum, in providing the kind of durable protection against the serious outcomes hospitalization and death. And so you can really see a step between people who only got the original two doses. That was part of the initial primary series, and those who ended up getting a booster dose in terms of the protection and the duration of that protection that seems to be offered against more serious disease. And in fact, we can see that very clearly from multiple studies during the period of Omicron. Although there were people who were doubly or triply vaccinated, and others two or three doses, who got COVID-19 with Omicron, as the variant, those who got three doses of who had three doses of vaccine generally did not get anything more than a very modest illness and the deaths and hospitalizations were very low.

Andy Slavitt  16:55

Are we concerned that it’s going to wane further, in other words, if you go out further than the four to five to six months, but go into 7-10 months, that curve will continue to decline? They will go for what I believe and was reported on is a 79% benefit against hospitalization to lower and lower and lower and that that’s why it’s important to stay current or do we think it’s plateaued? It’s somewhere there?

Peter Marks 

I think we still believe that there’s probably going to be waning. I don’t think we’ve reached we don’t know for sure. But based on the evidence that we see, we believe there probably is going to be waning.

Andy Slavitt 

The thing that I think I may have, maybe I’m reading between the lines, or maybe I’m looking thinking about earlier reports, but at one point, it felt like there was a stronger recommendation for people who are over 65 or immunocompromised, and talk that for people over 50, it would be available, but it felt like something less of a recommendation is it a recommendation that if you’re between 50 and 65? Is my wife and I happening to be that that you get boosted? Or is it more of an option that we’re making available to people?

Peter Marks  18:29

So the CDC, which comes up with more of this type of the piece of the we make things available at FDA. So it’s available, the CDC has made it more of an option that’s available in the 50 to 65 age range. I think that was the reason why we felt it was very reasonable to include the 50 to 65 age ranges, because about a third of people in the United States in that age range have medical comorbidities. And unfortunately, medical comorbidities are often in the eye of the beholder. And in some cases people have them. And they don’t know really realize they have them. In other cases, they may or may not. And by when you have an intervention that has as low an adverse event rate as is associated with the fourth booster doses. Sure. Sorry, should or say fourth doses or second booster doses, sorry, it’s hard to say these booster doses. Right? The safety is excellent. And the idea here is that, you know, it’s sometimes easier to just say, Look, we know that in general with respiratory viruses people over 50 years of age tend to have more problems than people under 50 years. of age, maybe it’s a good idea just to boost everyone here. Yeah, in the event that we have another wave. I’m very, I love modelers, I idol, in fact, it’s like a little hobby of mine. That said, modelers are often wrong. And our job is to try to protect a population that has been battered by COVID-19. And if you think about the population of people, particularly over 65, were one and 100 people are not with us now. Because of COVID-19, specifically, because of COVID-19. And when you think about people with medical comorbidities, it’s a group that really needs to be protected. So if by making things simpler, and saying, if you’re over 50, go out and get a booster, it helps the entire population makes sense to me.

Andy Slavitt  20:52

Sure. Well, the other thing that […] is blurred for another thing, which is, should we be protecting against severe? The so called severe it hospitalization death? Or is it sufficient to say, take a booster if it protects you against getting infected with COVID in the first place, and attitudes among the population are going to differ here, there are some people that are gonna say, I don’t want this thing. I don’t even like getting the flu. I don’t want to get this or I’m worried about long COVID. Or I don’t want to spread it to someone at risk. And so it’s very reasonable for people to say, even if there’s not much of a difference, you know, 50, whatever. And I’m not worried about hospitalization, there’s still a reason for them to do it. But how does the FDA think about the marker that it’s looking for there?

Peter Marks 

So obviously, hospitalization and death are the most serious outcomes that you want to prevent. When we think about vaccines, we often think about prevention of disease from those vaccines, not protection against death, or hospitalization. And the reason for that is that sometimes the disease itself can be associated with problematic things. Not being able to go to work, not being able to prevent yourself from spreading it to someone else. And in this case, for COVID 19, the potential for long COVID or post-acute Coronavirus syndrome, or post-acute COVID-19 syndrome. That’s a concern. And what’s really a concern is what’s unknown about that. We know that even vaccinated people, even though they get it less frequently than unvaccinated people can get post-acute COVID-19 syndrome. And the worry there is that I don’t know, since some of that can be debilitating, probably and debilitating for long periods of time. Why not try to prevent that?

Andy Slavitt  22:56

Sure. Absolutely. And there’ll be people out there that will say, yes, they want to and of course people who don’t just as people do and don’t get vaccinated for the flu. But I think your point is that I hear you say is that the FDA’s job was to make it available, CDC can get into the fine tuning around specific recommendations. There’s a couple, there are a couple of permutations that I wondered if you have the ability to comment and one of them is, you know, we know that this so-called hybrid or layered immunity has been pretty powerful. Which is to say that if you’ve had Omicron and been vaccinated, you’ve got a pretty good protection. Now again, it feels like the warranty that has to do with that statement is we’re not saying go get Omicron, we’re not in Sweden, folks. That was my little take in Sweden. The better question though, is, if you are someone who’s been vaccinated, maybe boosted ones have had Omicron, what are we saying? I know that there’s, I know that we’re officially not saying that that counts. But there’s a lot of people with that question because they want to know if they’re protected sufficiently.

Andy Slavitt 

So I would probably I’ll give you my answer, because there’s no right answer. So my answer is if you’re over 60, you probably want to just not worry about the Omicron. And you might just want to get the vaccine, especially if it’s been a couple of weeks since you had your Omicron. On the other hand, if you’re between 50 and 65, and an otherwise healthy person who’s had three doses and Omicron. That may be one of the people that just says hey, I’ll wait for FDA to come around with another booster.

Andy Slavitt  24:34

I’m superhuman, superhuman at this point, at least for a little while. Now, when I was a kid, I was told you never wear plaid with polka dots. This is one of the few things I learned as a kid. That’s what you think of as mixing and matching. Nowadays, mixing and matching has a different connotation of course. And I’ve got all these like my wife’s a Moderna person. She wears it proudly. I had Pfizer I was in the federal government with you. And, you know, I plan on getting Pfizer again, she’s played on getting Moderna. Again, a lot of people, though, have written in with questions who said, Should I be mixing and matching? Is there a benefit to mixing and matching one way or the other.

Peter Marks 

So there’s a little bit of data emerging, that perhaps mixing and matching may make sense even for the mRNA vaccines, that perhaps you get a slightly broader range of antibodies, and perhaps better protection. I think those data are still early. I guess my suggestion is not to obsess about that too much. Because probably the more important thing is just to get boosted. If with whatever vaccine you can get boosted with, and not obsess too much about whether it’s the same or a different one, homologous or heterologous than the one that you got last time.

Andy Slavitt  26:07

Did you were plaid and polka dots in the 70s?

Peter Marks 

You know, I have to plead the fifth, my style was so bad that you don’t want to know.

Andy Slavitt 

I’m thinking snappy dresser Star Trek fan? For sure. Did you ever wear the Star Trek uniform to school?

Peter Marks 

No.

Andy Slavitt 

Well, that that is such a relief.

Peter Marks

Nor did I have Dr. Spock ears, I’m sorry, no.

Andy Slavitt 

So I think people are now, if they’re getting into pattern recognition. Had it for months. Now, again, the things tend to spike in the following winter, you made a comment that hey, folks, don’t be surprised if there’s another booster, I think I read you’re saying that summer, come fall winter, after this one. Does this mean that you think we’re probably on a sustainable, asking people to get or allowing people to get vaccinated twice a year for the foreseeable future?

Peter Marks 

No, I actually think, again, I’m going to caveat this with I don’t know, but my for sure. But I think what we’re trying to do is start to normalize dealing with COVID-19, which is that as we move into the fall, predictive modeling, which as I told you could be wrong, says that our greatest risk of another big wave is probably sometime in the period of next October through February, for two or three reasons. One, is that our immunity will have waned by then some, two, it is the season for respiratory viruses, when we tend to go inside and three additional time will have passed whereby more nasty variants of COVID-19 can come up. And that Trifecta may help get us to be in a place at risk. So the concept here is potentially to vaccinate with either a different vaccine possibly, or a combination of two different to protect against two different variants. The ultimate thing trying to protect at the best is we can against whatever might come during some winter wave. Do I know for a fact that we’ll definitely have one? No, I don’t. But I think the idea here is that from a practical standpoint, we could probably go out around the time of influenza vaccine. And because we know we can give influenza vaccines and COVID-19 vaccines at the same time operationally, hopefully get enough of the population boosted so that we really blunt a potential winter wave next year and start to be able to live alongside COVID-19 instead of having it take over our lives.

Andy Slavitt  29:25

Yep. So we should we should have data soon. The tradeoffs with having and how well and Omicron specific vaccine that I know that the mRNA manufacturers have been working on the testing, you think we should have data in time, we know the platform is flexible enough to move quickly. But should we think we should have data in time?

Peter Marks 

I think we’ll have data enough to inform our decision. I think some of that too, will come because I think we understand something about how the different variants and the vaccines against different variants. are likely to protect against other variants. And so that I think will inform the decision. And we’ll be discussing that over the coming weeks, as those decisions have to be made, and will be public about and transparent about how we’re trying to manually come to these decisions.

Andy Slavitt  30:16

The idea of this is, this was my meager understanding that if you went all the way to a new vaccine that worked only against Omicron, and Delta came back or something or another variant came back that had different mutations, you might not be well protected. If you stayed with Delta, the current one we have, there’s some advantages, but obviously, there’s some holes. And then of course, if he did a by valence, you’re doing a little bit less of each. So you know, there’s another question is, is that strong enough? I know you we don’t have data yet. So obviously not asking what the right answer is, but what’s the conceptual way to think about? Is there an effective way to do a Bivalent or Multi-Valent vaccine that could protect against more than a quarter that we don’t quite know about?

Peter Marks

Yeah, well, that’s exactly what people are doing. They’re modeling you kind of using phylogenetic trees, and trying to see whether a Bivalent vaccine will be better than perhaps a monovalent vaccine, that just gives you better protection against a broader range of, of mutations. Because remember that, really what we’re trying to do for these variances get antibodies against a variety of structural features, just like we’re going to get T-cell receptor responses against structural features. And it could be that a vaccine could be against for who knows, it may turn out that a beta variant vaccine will give very good protection against a variety of others later on, so we would be doing is trying to hedge our bets by finding the vaccine candidate and composition of either a single or multiple, two or three candidates that will protect in against the broadest range of potential things that might come up in the coming season.

Andy Slavitt  32:24

I know we don’t have yet an answer for this. And if there’s nothing to say about it, then totally understood. But I will say got like a dozen questions from parents of kids under five, who are still wondering whether that we have, is there a sense of the just even whether or not we have sufficient data to be able to evaluate that soon? I guess I maybe just broad broadly, what would you say? Is there anything you would say to parents,

Peter Marks 

So I’m going to give you the same answer that I gave yesterday, which is I promise you that before I go on vacation next, we will do something about a vaccine for kids, six and under. This is something where the data are emerging. Right now, I know people, certain sponsors have already made some of the data public. We are in the process of receiving those data at FDA. We as they come in, we are going to be very dutiful, about moving as quickly as we can through evaluating the data as they come in. But we will do a thorough review. And we will think through this very carefully, because as much as we want to get a vaccine out there for kids under six, we know that uptake in the 5- to 11-year-old population has not been great in part because vaccine confidence is not what we’d like it to be. And so we need to make sure that we’ve done our homework, and that when we go out with a vaccine for the youngest children, we’ll be able to say, hey, data look good. The safety is good. The effectiveness is good, you should go out and get your kid vaccinated. And that means making sure that we’ve really looked through the data. And it’s a little complicated because the data for these littlest kids were obtained in many cases when we had multiple different variants kind of moving through, and it makes it a little more challenging. So we will move as fast as we can. And as I said, I’m pretty sure we’re going to get there before I go on my next vacation.

Andy Slavitt  34:31

Good. Good. You talked about moving back to normality. These last couple years have been anything but normal for you and your team. I’m sure you haven’t been able to take many vacations. I’m sure it’s been as stressful as it’s been for everybody else for the team in charge of approving vaccines but more so, do you feel like there’s personally and for your team? Do you feel like you’re able to soon move it back into a normal rhythm, something more routine and I certainly hope so.

Peter Marks 

I really appreciate the question. I think we will, as we come through the summer, my hope is that we will start to move back into the kind of a more normal rhythm of things. We still have a tremendous workload at FDA in our vaccine area because we have the various vaccines which have come through under emergencies authorization, transitioning into biologics license applications. But I’m hoping that as we move over the summer into the fall, things start to become more normal for all of us. Kids going back to school, people going back to work, it might be a little different than they were working previously. But that may also be a good thing.

Andy Slavitt 

Well, Peter, thank you so much for coming IN THE BUBBLE. You have so many fans of the great and high integrity work you’ve done to get these vaccines both quickly and with high integrity and safety.

Peter Marks

Thanks so much for having me today.

Andy Slavitt  36:11

Thank you, Peter Marks. Thank you FDA. I think there’s a lot we take for granted. And think science for what we’re thinking science Peters, kind of one of the people we’re thinking because someone has to do the work. And he does the work, organizes the work makes really ground level decisions that are common sense and based in science. And we’re very lucky, personally of all the people I know in government, there’s going to be very few people that I’m going to rank more highly. On Wednesday show. Amazing show. Coming up Wednesday, Ambassador Marie Yovanovitch. She was the ambassador to Ukraine. You may remember her very dramatic testimony in front of Congress relative to the Trump impeachment process last year, really riveting next week to great shows a panel of doctors who are on the leading edge of long COVID research. You’re gonna want to hear that. And Juliette Kayyem, I am talking about the various I’ll call them disasters, crises, things that we’re facing right now and how we need to get better at responding because let’s face it, we’ve got a few of those things. And we’re gonna talk about that with Julian. I love talking about crises because I think you talked about him, you manage them if you stick your head in the sand, you don’t. And then the show I think we’ve proven scientifically that if we talk about him, we could sleep easier at night. And speaking of which, we’ll talk to you on Wednesday.

CREDITS

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

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