In the Bubble with Andy Slavitt: Our Shot

Why Texas’s Bullying of Trans Kids Matters to Everyone (with Admiral Rachel Levine)

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While states like Texas and Florida target LGBTQ+ youth and families, Andy digs into the top issues affecting our nation’s health with Admiral Rachel Levine, a pediatrician currently serving as Assistant Secretary for Health. Dr. Levine, who is the nation’s first openly transgender four-star officer, discusses her commitment to finding solutions to improve youth mental health, the opioid epidemic, and health equity. She and Andy also reflect on the profound difference one supportive adult can make for an LGBTQ+ young person.

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Andy Slavitt, Rachel Levine

Andy Slavitt  00:18

Welcome to IN THE BUBBLE. This is your host, Andy Slavitt. As of Monday, March 28, we have an extremely powerful show. I want you to stop and think about the question of what do you do when you see a bully. I know that as a kid, I didn’t always act as I should, as ways that would have made me proud of myself as I would like to be. When you’re unsure of yourself in your own standing, you don’t want to call yourself out to the bullies, less you become the next victim. And so many of us want to fight bullies in only the safest ways possible. And I suspect that many of us have some experience with bullying of some sort either being bullied ourselves as kids or as adults. Seeing the bully and feeling helpless around them, maybe having our kids bullied, which is a really helpless feeling. Maybe even have a painful memory of at one time bullying somebody that you regret. It’s not something it’s adults we think about as frequently. But I will tell you, it is one thing now that gets my blood boiling is this whole idea of seeing someone bullied. Bullies have the power for making you feel helpless, self-conscious, unsupported. And basically that someone has basically taken over the proper rules of civility in society, and in bringing their own form of lawless justice. And so you wonder kind of where the authorities, where somebody’s gonna step in and see this wrong that’s happening. But what if that bully is society itself? What if that bully is the state government that you live in? What if they’re bullying you? So what do you do when you’re in a state, as in Texas, right now, or Florida, which is mixing together frankly, I’m just going to call it as I see it a brew of ignorance, politics in hate, and points them at our own children. Alright, so we’re gonna get into this topic today with Dr. Rachel Levine. Rachel was the Secretary of Health in Pennsylvania. She led the pandemic response there, by all accounts, to rave reviews, which is hard to do in this pandemic. She is a pediatrician, and is now the Assistant Secretary for Health, essentially, the person in the government whose portfolio is the health of the nation, our health. We’re going to begin by talking about our nation’s health. Quickly honing in on how we define it. You might have thought that the surgeon general Vivek Murthy played that role. This is actually the Surgeon General’s boss. Rachel is also the first transgender Senate confirmed official in our history. Rachel is also the first four-star officer in the US government who’s transgender.

Andy Slavitt  04:40

Now, you’ll hear in this conversation, Rachel isn’t going to shy away from being a symbol to transgender youth into the LGBTQ plus community. You will hear that but she plays a far more expansive role. And part of that role is systematically standing Up to the bullies of all types with a force and if that bullying is misinformation, if that bullying is something which is not consistent with what’s good for the health of all of us measured in physical, mental, other tolls, Rachel is clearly and systematically and forcefully calling this out. This is a show about clinical and social and very reasonable thinking as it stands up against, basically, someone who is spewing hate and using politics and demagoguery. And it’s a very hard tricky thing to do to stand up to a bully like Paxton. And we talk about, like the best methods for doing it, and how do you get there emotionally, etc. But the thing that is most profound about this conversation is, when Rachel says, look, in many respects, we all have a choice, we can either be the bully, or the evidence shows that when it comes to a kid, particularly an LGBTQ plus, kid, all they need, as a starter is one caring adult, one caring adult who recognizes them, who understands them, who appreciates them, and who supports them. That one caring adult makes a massive difference, not conceptually But by research, by clinical evidence, you and me as a caring adult, actually are a silver bullet in some kid’s life. So when we choose not to be that caring adult, but when we choose to, I don’t know other people, or make them less than human, make them doubt who they are, make them doubt their choices, and they’re a kid who are still fully forming their identity. That’s a really bad choice. And it leads to really bad consequences, it leads to really bad consequences. And we’re going to talk in this episode about some of those consequences, we’re going to talk about how that can sometimes lead to suicide. So if that’s a topic that you’d rather not hear about, again, it I just want you to be aware, it’s not, I don’t believe we touched on it in any kind of irresponsible way. effect. I’m pretty confident in that. But I just want you to be aware of that going in. And look, if you are a parent of a kid who has been bullied or is being bullied. Look at what Rachel Levine has become. Look at this role model. Listen to this person. And if you think appropriate, have your children listen to this very inspiring woman, this role model, this four-star admiral who is serving the country, and is the antidote to the Paxson’s, the Abbott’s, the DeSantis’ of the world, those who would use politics and ignorance and hate to victimize kids. That’s what the show is about today. It is one I hope you enjoy as one I hope you get something out of this one, a conversation I really loved.

Andy Slavitt  08:39

Well, thank you for joining.

Rachel Levine 

My pleasure. I’m

Andy Slavitt 

Very pleased to be here. You are the Assistant Secretary for Health for the nation. Tell us a little something about the health of the nation. And how do you define it? How do you measure it? I mean, look, longevity, inequality, crime, the level of tolerance, violence, bullying, the state of our public dialogue, how do you think about the state of our nation’s health?

Rachel Levine 

Well, there are many measures that we can use to evaluate the state of our nation’s health. And I think that it’s important, of course, to have a holistic view of health. So that would include physical health, but as well as mental health. And I think that we are continuing to have significant challenges. Of course, we’re having challenges with COVID-19, although we’re doing much better right now, or having decreasing case counts and decreasing number of hospitalizations and deaths. But the mental health challenges that we’re seeing in our nation are significant. And the President highlighted that during his State of the Union address. So and you have alluded to health equity. Health Equity is a very important measure of the state of our health of our nation. So we have lots of challenges ahead of us.

Andy Slavitt 

So with all of those issues, how do you pick your priority He’s because you can’t solve them all. And yet it feels like I get the same sense that you do that we have a set of challenges, that they’re not superficial challenges that many of them feel structural, in deep and complex. And we talked about the origins of the mental health crisis, we could probably go on for a long, long time, we talked about the origins of inequality, and violence and lack of tolerance and all the things that I think prevent us all, as many of us as possible for living as long and healthy and fulfilled life as possible. It’d be really complex to where do you start? And how do you decide which issues are the most important ones for you to focus on?

Rachel Levine  10:41

Sure. Well, there are a number of answers to that question. Of course, my priorities as the Assistant Secretary for Health will align with Secretary […] priorities, and that aligns with the White House priorities. And I think that we really need to deal with the challenges that are right in front of us. So that remains COVID-19. Again, we have made so much progress in the last year in terms of our safe and effective immunizations, in terms of expanded testing capability, in terms of the therapeutics, and it’s very comforting that the numbers are going down. But we have to be prepared for challenges in the future, especially if we start to see new variants that might significantly impact our nation and the world. But mental health has really risen to one of the biggest challenges that we face. And the President again, highlighted that during the State of the Union, and Secretary viscera, and I and many others in HHS are, are going on the road talking about the mental health challenges that face us. And that includes our youth and Vice Admiral Murthy, our Surgeon General highlighted that within an advisory last year, and I have gone on now on several different trips, one with the second gentleman one with the secretary. And then we just recently came back from Seattle and visiting Seattle Children’s Hospital, talking about youth mental health difficulties as well as a federally qualified health center. So we have, you know, challenges with our youth and that have been exacerbated by the COVID 19 pandemic that we have to address. And of course, there’s overdoses, we’ve seen more overdoses now than we saw previously due to synthetic fentanyl compounds, as well as other synthetic compounds such as methamphetamine. So those challenges are right there before us. And we’re going to work together across HHS and the administration to address them.

Andy Slavitt  12:38

So I think if parents are listening to this, I know a lot of parents are in whether they have kids that have either even severe mental illness or depression or anxiety, or addiction challenges. The thing that we hear the most and I’m sure you do as well, is they don’t know where to start, they don’t know how to enter the system, in a way that that helps them in my view is that the stigma that’s the most harmful type of stigma is self-stigma. When kids who feel like I can’t be treated, because there’s something wrong with me, and that deepens the mental health challenges. And so I feel like these are the things that are occurring in society for whatever reason they’re occurring, but our inability to address them just magnifies the problem. Because we don’t have, you know, they there’s no logical front door for most parents. If you go to the average emergency room, you won’t find a mental health specialist. If you go to the average school, you won’t find a mental health counselor of any sort. So, are there big structural things we can do?

Rachel Levine 

So, you are correct. I mean, we faced mental health challenges with youth before the pandemic and in my field in academic medicine. Before I entered public service, I was at the Penn State College of Medicine and Pediatrics and Adolescent Medicine. And what I did is he troubled young people, troubled teens and young adults with eating disorders such as Anorexia nervosa, and Bulimia nervosa, as well as related other behavioral health challenges such as depression and anxiety and others. But they have all been exacerbated during the COVID 19 pandemic, that the challenges of social isolation, the challenges of not being in school of learning loss, so many different challenges that our youth have faced and our families have faced over the last two years is that those youth mental health challenges have gotten worse. And so we are working at HHS across the different divisions to make this better. So I’m very pleased to co-chair the Health Disparities Council with Assistant Secretary Delphin Rittman, my colleague at Samsa and We have different subcommittees and one of those specifically is about youth mental health is another on workforce, another on that integration between physical health and mental health at all different levels. And so we are working to create those open doors that you’ve been discussing. For a parent right now. You know, I think a good place to start would be their pediatrician, or their family physician if they have one, but most people do, if they don’t, then potentially a community health center, or, you know, every county has a mental health office. And so that would be another place to start. And so every county, the United States has a mental health office that they can contact if they and often with hotlines that they can contact and of course, Assistant Secretary, Delphin Rittman, is working for SAMSA to put out the 988 Suicide Hotline nationally, later on this year. So we are working on more resources.

Andy Slavitt 

Do you want to spend a second on 988 because it’s a great thing that the President announced during the State of the Union address, and I’m not sure if everyone caught it.

Rachel Levine  16:04

Sure. So we are working on a three-digit national hotline for suicide and this would be for youth, this would be for adults, this would be for seniors, that people can call and they will be directed to local resources to help them so it’s going to be sort of nationally run, but locally implemented. And it’s quite a task that that Dr. Delphin Rittman is working on, but they’re up to that challenge. And I think it’s going to be really successful. Also, you know, for teens, teens don’t often call now, that’s for people like you and me, Andy.

Andy Slavitt 

What’s calling, what does that mean?

Rachel Levine 

What does that mean for you to talk to a teenager so they text to they might be online and do chats or things. So they’re going to have to, they’re going to build in text lines as well that young people might access and be able to get support and help at their local level. So it is a tremendous effort and a national program. And I think it’s going to be a real service to our nation, for people in pain, people that are suffering, that they’ll be able to reach out and get health.

Andy Slavitt 

Yeah, it’s great. It’s simple. And this front door, I think it giving people an entry point, will hopefully allow people to act more quickly, more reasonably and not feel that sense of stigma. I want to jump into an area that is hot right now. It’s a hot place where politics and the what’s best clinically, are running right smack into each other. And that’s the idea of gender affirming care. So first of all, I think you’ve got some expertise here. You’re a pediatrician. You’re the country’s Senior Public Health Officer. Sure you also happen to be transgender; you might be considered to have some expertise. First of all, maybe I should say that the Attorney General of Texas has labeled gender affirming care as child abuse. I’m not I’m not I’m not inserting words in his mouth. That’s what Paxton, General Paxton said, the governor is called for parents to be quote turned in for allowing it. First of all, can you just to inform us what gender affirming care actually is?

Rachel Levine  18:44

Sure. So you know, we see young people who are transgender or gender diverse. And you are correct. I do have expertise in this area in my field of pediatrics and specifically adolescent medicine. And I have been involved in academic medicine at Mount Sinai and then Penn State for most of my career, and actually saw children, teens and young adults for gender affirming care. And there are standards of care to assess trans and gender diverse youth. They are established by the World Professional Association for Transgender Health WPATH. There’s a US arm called USPATH and their standards of care. The last edition was in 2011, and there’s going to be a new addition published right in 2022, updating those standards of care and then there are medical articles based upon that. So this is a medical field. There is research done on that there’s evidence based that to inform the standards of care and then much of the care for youth is provided at, for example, our expert Children’s Hospital. So I’ve been able to visit some of those clinics and at Nationwide Children’s Hospital in Columbus, Ohio, I visited one a great clinic in Seattle Children’s Hospital in Seattle yesterday. I know there’s a great clinic at Children’s Hospital, Philadelphia, DC children’s. And so it involves a multidisciplinary team with a psychologist to help the young person and their family, and then medical care to implement these standards of care for gender affirmation. It is by no means child abuse and any insinuation that it is child abuse really is very politically motivated, it is egregious that this is, you know, provided by experts at either at LGBT Q health centers or children’s hospitals. And it’s very carefully done to support and affirm and empower the young person and their family.

Andy Slavitt  20:54

So you know, one of the things that I find interesting in being in healthcare as long as I have, and I’m probably older than you, no, you’re actually a little bit older than me.

Rachel Levine 

I think I’m older than you, Andy.

Andy Slavitt 

I think you win, you definitely win in the wisdom front window, there’s no doubt about that. But one thing that I’ve kind of what I’ve learned in health care, and whether the issue think about how all the clinical and social pieces interact is we all want silver bullets, and there’s no silver bullet for most anything. So something really interested me and I think that’s somewhat related to this topic, and I’m wondering if you can comment on it. suicidality among teens, is obviously a very high and a very high level, it’s a very big problem among LGBTQ plus kids, it’s even higher. And among trans kids, it’s even higher, still really startling, and sad numbers. So it does turn out, however, that there is one simple intervention, the research shows dramatically reduces suicides in this population. And the reason I talk about silver bullets is because I never ever find, well, there’s one thing that actually helps. And that one thing, according to the research that I’ve seen, is that if you call people by their correct pronoun and name, it has a significant impact on their mental health and reduces suicides, that, that one simple act is for people in their lives that adult in their lives, recognizing who someone is, makes it transformative different. Is that evidence you’ve seen as well?

Rachel Levine  22:35

Yes. So for trans youth and gender diverse youth the ability to talk to somebody to ability to be who they are, and to be affirmed as that really can be quite powerful in terms of helping them with some of the challenges that they face. So I want to point out so you are entirely correct, is that yes, suicidality. Suicidal thoughts and attempts are significant problems among youth. And we just talked about the new 988 hotline, which can be used by text as well. And we do need to work on improving the health care services for youth in the workforce for that as well. But LGBTQI plus you do have increased risks of mental health issues such as depression and anxiety and suicidal thoughts and behavior. But I want to emphasize there’s nothing inherent with being lesbian, gay, bisexual, transgender, queer, questioning, intersex, etc. Plus, that would predispose somebody towards those mental health issues. It is the bullying that young people face, that is the harassment it is the discrimination and intolerance that they face, then they may face that at home, or they may face it in their school or their community, or even, you know, the type of statements and bills that we hear in different states that predisposes them that seem that triggers those thoughts and feelings. So that is why it’s so important to infer them and to empower them. The other thing last word I’d like to say is that in addition to what you talked about, actually one supportive adult, one supportive adult, you know, hopefully a parent but it might not be a parent, it might be a teacher, it might be a someone else at school, it might be a faith leader, might be a neighbor or a friend or a another relative, but one supportive adult can make all the difference in terms of those mental health issues, which is why the quote unquote don’t say gay bill in Florida is so challenging because not infrequently that might be a teacher or school personnel who is that one person that supports that young person that can make all the difference for their behavioral and mental health? And so we all need to, to work together to again in power Are these vulnerable young people not to limit their access to sports or other activities, not to limit their access to affirming care, and not limit their ability to talk to the teachers.

Andy Slavitt 

So you make exactly the right point, I think, which is, there’s plenty of hard stuff in this world that happens to us because life can be hard. But these are things we’re doing to each other. Bullying people, making them feel excluded. When you when you, when every one of us, I just remind me how every one of us has the option to be that one caring adult, any one of us, if I hear you correctly. And so it’s a choice we’re making. And I just think about how punishing it must be to have political dialogue about it around and over you, your kid, lizard, Florida, you’re in Texas, even if your whatever state you’re in the fact that there is a state of your country doing this, that it’s just got to be maddening. And I and I know that we can all imagine it day generations from now, when that’s no longer the case that the fight is being fought now, so that people and future generations don’t have to live with that. But we also see the impacts of people around us and we can we can see measurably in harming people’s lives. I’ve listened to you, Admiral, and you’ve remained very calm, clear. Talking about academic studies, not taking the bait not getting angry, not yelling, not getting on cable TV and in screaming about this. How do you do that at one level? I think I still admire that response. On another level, I wonder like, how the hell do you keep from losing your mind?

Rachel Levine  26:51

Well, thank you very much. I mean, I think that there are two techniques that I have learned over the years. One is the ability to compartmentalize. And so as a clinician, you know, in my pediatric training, and in my work in pediatric in children’s hospitals, I mean, we see very ill children and young people, and you have to be able to compartmentalize your feelings and to be able to do your work as a physician. And so I have developed the ability to do that. The other is that I’ve developed the ability to sublimate, meaning I take those feelings, and I put it into my work, which is to help people and so that’s what I felt most gratified about my career, again, first in academic medicine and pediatrics and adolescent medicine to help young people and their families, and to teach students how to help people and do clinical research and develop programs to help people. And that’s what I feel so gratified about my role in public service and public health is first in Pennsylvania, and now nationally, to help people with that broader public health perspective with that broader brush with all of the different challenges that we’ve been discussing.

Andy Slavitt 

So it’s, like I feel a level of personal animosity that someone like Paxton when he makes a statement like this, because I feel like it’s hurting people. I just emotionally I feel it. I also probably feel like that’s not the right, public reaction for me to have as I’ve listened to some of the things you’ve said, I think you’ve gone out of your way to be incredibly civil in this conversation. And I mean, it must be exhausting to take on all people who spout prejudice, yet it must be exhausting to not have a strategy and I think you’re taller voice I think makes more people listen, and understand. And I suppose that’s why you do it. But I can’t imagine it’s easy.

Rachel Levine  28:44

So I think that’s a really important point is that I think sometimes many of these of these feelings come from a position of fear is that people fear what they don’t understand what is beyond their experience. And, you know, fear can lead to a lot of negative emotions. And, and so I think that for, for, for many people, these issues of potentially sexual orientation, or certainly gender identity, or just beyond their experience, or they think it’s beyond their experience, and so that people fear what they don’t understand. So my job and my goal is to educate them to be that calm voice talking about these complex issues, so that they can fear less and learn more, and then, you know, develop that sense of tolerance and acceptance. Now, I understand that many of these issues are politically motivated, and I can’t I can’t change that. So I’m going to stay calm and focused, and to continue my work to support the public health of the nation. And that’s what I’m going to continue to do and I’m gonna stay laser focused on that mission.

Andy Slavitt  30:16

You make me wonder something else about how you do your job and how you go through life, you get a lot of really incredible recognition, well deserved. All you have to do is read an article about you. And you know, people will know you’re the first transgender person ever confirmed by the US Senate. There’ll be many more, but there will only be one first. You’re the first transgender four-star officer as the Admiral of the Commissioned Corps. That’s another first is being the first of something exhausting? Is it tiring? Do you get treated like a symbol sometimes? Do you feel like you’re too closely, you’re so closely watched, or expected to behave as this person as opposed to just allowing who you are, like all of us to inform, but not define your agenda.

Rachel Levine 

Not really, I mean, I am honored to have had these privileges, I am honored to have these opportunities. And so with the opportunities I had in Pennsylvania, and now the opportunities that I’ve had, as the Assistant Secretary for Health and as the […] on the Public Health Service Commissioned Corps, my goal is to get back. My goal is to give back and support the LGBTQI plus community. And my goal is to support medical issues and public health issues nationally. And to help people that is always what has driven me and that is what continues to motivate me.

Andy Slavitt 

What are the other things that’s interesting in your perspective, so you’ve had both a state role at a federal role. And there are a lot of places in the pandemic where I think people have understandable levels of confusion when they hear something from the CDC. And then over the course of the last several administration states have been some states have very much been known on their own page, either in Florida saying, hey, we’re gonna do it this way. And not your way or vice versa. When you get the federal government in the last administration, who was saying, hey, it’s all up to the states. So we’ve got this sort of, I think two things going on. One is federalism. And the other is regionalism. And you’re in a perfect person to kind of help discuss, I think this year, like better regionalism is makes a lot of sense in public health. If there is an outbreak in Tennessee, and you’re sitting in Washington State or Oregon, you shouldn’t, you shouldn’t be under the same kind of concerns and restrictions as people in Tennessee, we live in a large geographic country. That certainly makes sense. There’s a federalism component here, though, which I think is really interesting and really tricky, which is that the ability to fight a pandemic, whether it’s something like this or something like Ebola, at some level requires a national level of effort. And because of political views, constitution, whatever, we’re not able to mount one federal response, again, allowing for regional differences, I think is a different matter. But the sort of the structure of government means that a federal government sometimes can’t say, we can only protect people in New York, we can’t protect people in Ohio. So can you think through it or reflect on how the state federal public health infrastructure should be working together? Sure.

Rachel Levine 

So you know, I mentioned that one of the lessons of the pandemic is that we’re all interconnected. The second is the lesson of the pandemic is the profound importance of public health. So we tend to focus on medical issues and health system and health care issues. But it really has focused the critical importance of public health. And it works best when local public health officials, state public health officials, and federal public health officials are working together, when we collaborate, when we coordinate, and we communicate. And so that is our goal. That is our goal in the administration is to all work together to make sure that the different policies and procedures that we have both have a certain national perspective, but also can be implemented at the local level and have the ability to have local and statewide variation, exactly as you had talked about. Most of the time, we don’t need as much of a national perspective in terms of saying infectious illnesses. We do for flu, but not like nothing has been like the COVID 19 pandemic. I mean, the world has not seen anything like the COVID 19 pandemic in a 102 years, and so is really challenged public health. And so we need sustainable funding for infrastructure, for IT, and data capabilities. We need sustainable funding to make to increase and maintain our public health workforce. But we need to all work together. So, you know, I do have that perspective. I was the Secretary of Health of Pennsylvania, and I was the president of ASTO, which is the Association of State and Territorial Health Officials. And now I’m in this role from a different perspective. But I speak with state and local health officials every week.

Rachel Levine 

What looks different at the federal level that folks in the state didn’t understand? And I’m gonna ask you the reverse question. But as you sit here, what is it that when states look to the federal government, they miss, or they don’t see about the challenges there?

Rachel Levine 

Sure. Well, one of the big differences is when I was the Secretary of Health of Pennsylvania, I would focus in on Pennsylvania, so I would have this national perspective about what’s going on in the rest of the country. But my responsibility was Pennsylvania. And so I would focus in on the on the number of cases in Pennsylvania, I would focus in on the number of hospitalizations, the number of deaths, and, you know, we would look regionally and we would talk with other state health officials in our region, and we would do would have national calls, but my focus was different. And then when I took this position, I had to draw back and not just look at Pennsylvania, but to look at all the regions and to look at the national and even international perspective, in terms of COVID-19 from all of those parameters. I think that in Pennsylvania, we were focused on Pennsylvania data. And, you know, we would share data, but sometimes we would be cautious about sharing data. From the national perspective, I need that data, from all the different states and the local, local health departments so that we can make those national recommendations. So it’s a different perspective, I think all of them are valuable, that that local perspective for local and big city health departments is critical. That perspective from the state is critical. And now the perspective from the federal government is, and then I’d add the international perspective, or because this really is this is a global pandemic. And you know, it really has always had global implications.

Andy Slavitt

I think it sounds like it makes sense when everyone can communicate and is willing to share. What do you do in today, for example, when you have a Surgeon General, I believe it is in Florida, who basically says, we don’t think kids should get vaccinated, and I’m paraphrasing, now, can you pick up the phone and have a conversation and try to meet eye to eye when you have those kind of policy differences?

Rachel Levine 

We can, but we can also, you know, be advocate through to the public and advocate with other public health officials, both in the federal government, but also those state and local health officials that, that we don’t agree with that, that, you know, that we don’t agree with that interpretation and that medical opinion, and we feel that immunizations for children is absolutely critical to protect them to protect their families. We also, you know, work with other stakeholders, for example, you know, I have been a fellow of the American Academy of Pediatrics for about 34 years, and I think we figured out with them that I had been a member of the American Academy of Pediatrics since medical school. So we are now talking 40 years. And the American Academy of Pediatrics really has almost all of the country’s pediatricians I believe about 16,000 or more pediatricians that are members and fellows. And, and, you know, they strongly feel that immunizations for children is extremely important for children’s health and their family’s health as well as the American Academy of Family Physicians, as well as the Children’s Hospital Association and other associations. So, you know, I think that that medical opinion that those immunizations aren’t necessary, is isolated.

Andy Slavitt 

Well, I know you got to get back to your busy agenda. I really appreciate you taking time to come in the bubble, share your wisdom, your values, your perspective and your leadership. Thank you for your service Admiral. Really appreciate you.

Rachel Levine 

Thank you so much. It was real pleasure to be here.

Andy Slavitt 

Okay, on Wednesday, Ken Burns. That is a very cool conversation. Ken Burns, you may know is the amazing documentarian, who sort of chronicling our history. US history, our history. Again, enjoy that. That conversation about long COVID with Tim Kaine, and there may be some personal conversations going on there as well. I hope you will enjoy that. Get through Tuesday. Come back Wednesday. We’ll talk to you then. Thanks.


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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