What Does the Delta Variant Change?

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Brian Lehrer: It's The Brian Lehrer Show on WNYC. Good morning again, everyone. Back with us now is Dr. Leana Wen who has given us so much good information about COVID during the whole pandemic. Dr. Wen will do double duty today, helping us understand the revised CDC recommendations for schools and for vaccinated adults, as well as unvaccinated people. We'll talk about her own new book about her own life from childhood through the pandemic called Lifelines: A Doctor's Journey in Public Health and it takes on controversies in public health as well.

One thing about the new CDC guidelines as background before we start, they are based, in part, on a big outbreak over the last month in Provincetown, Massachusetts on Cape Cod. Maybe you've been hearing about this, about 900 people infected, stemming originally from Fourth of July weekend tourist crowds. 74% of the infected people were vaccinated. 79% of those vaccinated cases were symptomatic. Now the good news, only seven hospitalizations out of 900 cases and a nice round number, zero deaths.

Dr. Leana Wen is an emergency medicine physician, George Washington University professor, and CNN and Washington Post medical contributor. Again, her book is called Lifelines: A Doctor's Journey in Public Health. Dr. Wen, thank you for everything so far during this period and welcome back to WNYC.

Dr. Leana Wen: Thank you, Brian. It's a pleasure to join you. Thank you for all the work that you're doing to help to educate people about what is going on with COVID-19.

Brian Lehrer: Let's start on the news and then we'll talk about the book. About Provincetown, what's actually the bigger news here, the spread among so many vaccinated people or the zero deaths and only seven hospitalizations out of 900 cases?

Dr. Leana Wen: I think that people are really drawing the wrong lesson from what is happening or with the outbreak investigation in Provincetown. The correct lesson first is to say that the vaccines worked. If we did not have the vaccines, imagine the thousands of people who would have gotten infected, the many dozens, if not hundreds, of people who could have ended up in the hospitals, and the individuals who would have died.

The benefit of the vaccines is that it prevents serious illness, it prevents hospitalizations and deaths. The vaccines in this case did exactly what they were supposed to do. The other issue that I think is illustrated in this is now we do know that you can have breakthrough infections. With the Delta variant, if you're fully vaccinated, there is a chance that you could become infected with COVID-19 and there's a chance that if you were infected, you could transmit it to others.

The takeaway here is not that the vaccines don't work, it's that it matters if you are vaccinated, whether people around you are vaccinated or not, as in, if you're vaccinated, think of the vaccine as a really good raincoat. If you are in a drizzle, it's fine, but if you are now in the midst of thunderstorms, where there's a lot of rain around you, the raincoat isn't going to protect you fully.

I think the takeaway here is that we need to stop having this live and let live attitude of, "Well, if I'm vaccinated, who cares if the people around me are vaccinated?" No, it matters to you. For example, in my case, I live at home with two young children who are too young to be vaccinated. If I'm around unvaccinated people who could have COVID-19 all day, chances are much higher that I may become a carrier to infect my children.

I think that is the bigger lesson here that we need indoor mask mandates again, in areas of the country with high coronavirus transmission, not because of the vaccinated, but because of the unvaccinated. The honor code that the CDC was relying on before just never worked. It was never going to work. I was opposed to it from the very beginning for this reason. Now we're seeing, for the first time, since February, the CDC reported over 100,000 new daily cases in the US, and this is a major issue, and the issue is not because there's something wrong with the vaccines, it's because so many people did not get the vaccines.

Brian Lehrer: Hospitalizations are rising nationally and deaths are rising nationally, although not as much as last winter when there was a similar number of total cases being reported. How do you explain that?

Dr. Leana Wen: That, again, is the benefit of the vaccines. We know that older individuals, individuals with chronic medical conditions, people residing in nursing homes, these were the groups that were hit the hardest with hospitalizations and deaths, while this is also the group with the highest rate of vaccinations. I think this is great that-- and again, the benefit of the vaccines, that we have prevented serious illness but we still have less than half of the US, less than half of the US is fully vaccinated.

This is a major problem. We are nowhere near anything approaching herd immunity. Also consider that now that we have the Delta variant, which is the most contagious yet, we actually need to have a higher threshold of herd immunity than before. The task that we have ahead of us becomes even harder. I think we really need to make it clear, the problem is not those who have gotten vaccinated. If you are vaccinated, your chance of being a carrier to others is much decreased. You are not a public health threat.

The concern is those who have yet to be vaccinated, who have the choice of being unvaccinated. I actually think that we really need to change this dynamic around so that vaccination becomes the easy default convenient choice, rather than, what's happened with the honor code, is that people can be unvaccinated and go about public life the same as before. That's the problem.

Brian Lehrer: People are calling in already with questions. We can take some of your calls for Dr. Wen at 646-435-7280 with the Provincetown story and the new CDC guidelines for masking even among vaccinated people and for schools for this fall. 646-435-7280 or you can tweet a question @BrianLehrer. I want to ask a couple of P-town-related things and then move on to some larger picture things.

One is that the spread in Provincetown, we should say, seems to be from indoor contact, even though it was Fourth of July weekend. July 4th was a rainy weekend on Cape Cod and people were spending a lot of time indoors from what I've read, in small, poorly ventilated bars and restaurants. It was basically an indoor phenomenon in unmasked situations. Despite it being a July 4th weekend phenomenon, people's first impression might be, "This took place on the beach, what?" Do you have any reason to believe that Delta spreads outdoors more than other variants based on this though?

Dr. Leana Wen: We know that the Delta variant is the most contagious of the lot but there's nothing to suggest that if you are walking outside and someone around you has COVID, that somehow you're going to get COVID from that casual interaction. No one is recommending outdoor masking for just everyday use. I do think that we need to be very careful about indoor, poorly ventilated settings, especially ones in which people are engaging in for long periods of time.

Again, I really don't want us to draw the wrong lessons from what happened in Barnstable County, in the Provincetown outbreak because, by all accounts, there were individuals who were spending, as you were saying, Brian, a lot of time indoors in cramped settings. We're not talking about casual interactions and people going shopping in a well-ventilated grocery store. I don't want people who are vaccinated to now be panicking and thinking, "Oh my goodness, I now need to hunker down and not see anyone again."

I really want the lesson to be that we need to be thinking about our own risk here. The way that I would process this is think about your own medical risk and the medical risk of those in your household. If you're healthy, everybody else, your household is also vaccinated, the risk to you is still very low because even if you have a breakthrough infection, you're not going to get very sick, chances are.

On the other hand, if you live at home with someone who is unvaccinated or immunocompromised, you should take additional precautions. For example, for me, because I have two young children, my husband and I will mask in indoor crowded settings, when we're in the grocery store, when we're at church, but we are not going to be masking outdoors.

If we have people coming to visit us, we're happy to have visitors who are fully vaccinated, but if the visitor told us that they were just at a rave or something with thousands and thousands of people, we might want them to quarantine and get tested prior to coming to visit our children.

Brian Lehrer: Tell us more about that. How much should the new data change the behavior of vaccinated people in their homes and for, let's say, their vacation plans the rest of this summer? What the CDC was saying back in May, I guess, was, "Okay, if you're vaccinated and even if you're a much older person, you can now have friends who are also vaccinated in your home and you can hang out without masks. Is that different now?

Also, what about bigger groups? Like one situation I've heard of, a group of 10 college friends, all vaccinated, renting a house for a summer vacation. Now is that safe anymore? Here's, again, the way that I would think about it. If you are a healthy person or a generally healthy person, and you do not live at home with somebody who has severe immunocompromise or is unvaccinated, I think you should be able to go about doing all the things that you just talked about. I think you should definitely be able to get together with people for dinner, go out to restaurants, and basically, I don't think much should change for you if you are a generally healthy and fully vaccinated individual.

On the other hand, if you live at home with someone who is more vulnerable because they're not vaccinated, or they don't have the full protection because of immunocompromise, I do think that you should cut risk. Nothing at this point is risk-free but think about how can you reduce that risk as much as possible.

For me and for my husband, again, we'll wear masks in indoor crowded settings. We will have people over to our house who are fully vaccinated, and who we believe are generally lower-risk individuals. Again, if somebody frequent spars every night, and if they just went to a really large indoor event, we're probably not going to have that person over indoors, we'll see them outdoors.

Brian Lehrer: When you define higher risk groups, what about an 85-year-old who's vaccinated, who started getting together with their grandchildren again, only in the spring, after a long gap, now what?

Dr. Leana Wen: I think that people need to think about their own risk tolerance, as well as their values, and understand that risk in this case is additive. I think a lot of grandparents will say it's really, really important for me to see my grandchildren but if that's the case, don't see our grandchildren and then also go to the indoor gym without a mask, and then also go into an indoor crowded bar, see your grandchildren.

Ideally, the safest thing to do, of course, is still to see the grandchildren outdoors. Then also to think about what are the grandchildren doing in terms of their activities? You want to see, are you going to be risk to your grandchildren? Probably not because your risk exposure is pretty low. Are your grandchildren going to be a risk to you? Well, chances are, not really, because you're still well protected because of the vaccine.

If your grandchildren just went away to an indoor camp and spent lots of time with a bunch of people, and some of them may have coronavirus by virtue of being in a hotspot and maybe see the grandchildren outdoors right after they came back from that camp. There's no right or wrong answer, but I think at this point we need to be having hard conversations with people in our lives about what their risk exposure is and then also think for ourselves about what do we value the most and which of those activities do we want to make sure that we bring into our lives, knowing that nothing is zero risk?

Brian Lehrer: Ralph in Astoria, you're on WNYC with Dr. Leana wen. Hi, Ralph.

Ralph: Yes. Thanks for taking my call. You partially answered my question, but it's a travel or vacation question. I'm 68 years old and I took my Moderna vaccine, both of them. I'm looking around to see how long is the effect of the vaccine, because, by the time I return-- I'm scheduled for a trip to Croatia, I'm going to be returning right under the limit of six months. I see between six and eight months. I'm wondering because if I would have to cancel, I wouldn't want to, but I would because I want to be careful.

Brian Lehrer: Ralph, thank you. That raises the question of booster shots after six months, too. Apparently, they're doing it in Israel and I think in France, correct me if I'm wrong, for immunocompromised and older people.

Dr. Leana Wen: I have some criticism of our federal health officials here. One is what we were talking about before, which is, I really think that they botched the messaging with the new CDC guidance, masking guidance, and in fact, with the guidance in May, they should have never relied on the honor code, but now they're confusing vaccinated people about their risks when actually the risk is from unvaccinated people to unvaccinated people.

I also think that they're making a mistake here on boosters. I think what we should be saying to people is that I think we should be allowing individuals to make decisions with their doctors about whether to get boosters at this point. Now, healthy people who got vaccinated really should not be needing boosters right now. However, if you are severely immunocompromised or if you're an older person with chronic medical issues, we do have data coming from Israel that a booster may be something that is advisable, immunity does appear to wane over time.

The Delta variant also, it appears that there is slightly less protection with the vaccines that we have, and so a booster may be advisable for certain groups of people. I think it's not right, frankly, at this point for-- I mean there are individuals who figured out how to get a booster, but their own physician cannot be giving them a booster. They have to go to different pharmacies and really not tell the truth in order to get a booster shot that they need, and so I think that the federal government should change their guidance.

In response to Ralph, though, directly, you should travel. I think that the flights are actually not that high risk. My advice to you is to wear an N95 or KN95 mask when flying, and then really be careful once you get to your destination. Look to see what the infection rates are at the places that you're at. If it looks like there's high infection rate, consider wearing a mask in indoor places, avoid bars and other crowded settings, but I think you should travel and have a good time.

Brian Lehrer: Ralph, I hope that's helpful and I hope there are many beautiful outdoor dining options in lovely Croatia. Anna in Brooklyn, you're on WNYC with Dr. Leana Wen. Hi, Anna.

Anna: Hi, thank you so much for taking my call. I have a question that's a variation on the theme of what you've been talking about. I have a younger daughter who's too young to be vaccinated and an adult daughter who, thankfully, is vaccinated but lives with her boyfriend who is not vaccinated. They've spent some time with his family who are also not vaccinated. I'm just trying to figure out how to navigate my older daughter spending time with my younger daughter, given that she is vaccinated, but is spending time with unvaccinated people. Does that make sense?

Brian Lehrer: Yes. The new definition of a mixed household, Dr. Wen.

Dr. Leana Wen: Right. I think a lot of people are in situations like that. Here's what I would say. One, the easiest of all the scenarios is seeing people outdoors. As far as we know with the Delta variant, it's still going to be very safe for people to see each other outdoors. That should be without question that your kids, your two daughters, can definitely get together outdoors without risk.

Now, if they're getting together indoors, there is going to be risks. Here's how I would think about it. If you are vaccinated, yes, you are very well protected against severe illness, you're also well protected against contracting coronavirus. However, now we know that you can contract coronavirus, and if you do have COVID, you could spread it to others because that was the Provincetown study that the individuals who are fully vaccinated seem to have a high viral load and therefore are able to spread it to others.

Is there a risk with your older daughter and the people that she's surrounding herself with? Yes. Especially because she lives with a boyfriend, as I understand, who's not vaccinated. She is at high risk herself because of her exposures. If I were in your shoes, and again, people have different risk tolerance, that if I were in your shoes, I wouldn't have her be in the same indoor space as my young unvaccinated daughter. I would try to have them together outdoors, and if they are going to be indoors, I would have everybody be masked and have the entire setting be well ventilated.

The difference-- if you wanted to, if your older daughter is going to be spending long periods of time with you, for example, if you're going away on vacation, she could quarantine for three to five days, get a negative test and then come to see you. As in quarantine, as in not see her unvaccinated boyfriend in that family for three to five days, get tested, and then you can go away on vacation together.

Brian Lehrer: Anna, I hope that's helpful. It may not be exactly what you were hoping to hear, but I hope that's helpful. One more P-town question and then we're going to turn the page and talk about your book. It was striking to me how few people needed to be hospitalized, even among the unvaccinated population there who got COVID. Only seven total hospitalizations out of 900 infected people, but a quarter of those cases were among unvaccinated people.

That stands in contrast, to me, with something like what we're seeing in Florida now, which has it about the worst and it's a relatively unvaccinated state and has all those policies against masking and capacity limits and stuff. Florida has 6% of the nation's population, 21% of the new cases, and they have their highest hospitalization rates now and death rates since March. In P-town, were the unvaccinated people, in some way, protected from the most serious illness by the vaccinated people who they might have gotten COVID from?

Dr. Leana Wen: That's an interesting question. I don't know. We also don't have, I don't think, the demographics exactly to be able to do this kind of comparison between the demographics of the individuals. Were they younger, perhaps, with fewer medical illnesses? I don't know, and so it will be hard to speculate. I will say that with the--

Brian Lehrer: It's a younger population, by the way. The P-town, the median age was 40, so maybe it would be very different if the median age was 70.

Dr. Leana Wen: Right, and I do think that there are a couple of other things that we don't know the answer to, but I think what actually helped to contextualize the Provincetown example better. One is, how many people were exposed? Because right now we're missing a denominator. We know the number of people who got infected and it sounds like a lot, but if it actually turns out that thousands and thousands of people were exposed, but many people did not get COVID, that's a really important number.

The other point is we don't really know if you are asymptomatic and vaccinated, but you have a breakthrough infection. Are you able to pass it onto others? Right now, the entire CDC guidance seems to have changed because of this finding that individuals who are vaccinated have a high viral load. What if you are asymptomatic, do you still have enough of a viral load to be able to infect others?

Again, I think we should have indoor mask mandates, but not because of the Provincetown study. I think we should have indoor mask mandates because we can't trust the unvaccinated to be putting on masks. Because we can't trust the honor code, everybody has to put on masks in order to protect the unvaccinated from the unvaccinated.

Brian Lehrer: I did read, by the way, an answer to your-- impartial answer to your denominator question, that there were about 60,000 people in P-town that weekend, so 900 out of 60,000 makes it a different story. We'll continue with Dr. Leana Wen in a minute, stay with us.

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Brian Lehrer: Brian Lehrer on WNYC as we continue with Dr. Leana Wen, Emergency Physician, Public Health Professor at George Washington University, contributing columnist for the Washington Post, and the CNN medical analyst. Previously, she served as Baltimore's Health Commissioner and President of Planned Parenthood among other things, both of which are addressed in her new memoir called Lifelines: A Doctor's Journey in the Fight for Public Health.

Dr. Wen, I see from the book, your family came to America from China when you were young, so your mother could go to school to provide a better life for you and your family. Does your journey into public health start there?

Dr. Leana Wen: It does. Actually, Brian, I'm glad you brought this up from my book because I did not intend to write this book about my own journey at all. Actually, I intended to write lifelines to share the positive, hopeful examples from Baltimore. I was so proud to lead the health departments there, to be the doctor for the city, and I wanted to show, for example, how we fought, what we did around the opioid epidemic, that I issued a blanket prescription that saved more than 3,000 lives in three years.

I wanted to talk about our healthy babies program that reduced infant mortality in our city by 38% in a seven-year period. I wanted to share those examples, but actually, in writing the book, I also realized that my own journey is in itself a journey of public health as well.

My parents and I came to the country just before I turned eight. Despite my parents working multiple jobs, we still really struggled to make ends meet. There were times when my father would go from one job to deliver newspapers, to washing dishes in a restaurant. My mother was getting her degree, and then she eventually ended up becoming a teacher here in the US, but she was also cleaning hotel rooms and working in a video store.

There were times that we experienced homelessness growing up. We depended on Medicaid, we depended on many other safety-net services in public housing and SNAP food stamps. In a way, those services they were our safety net, but that was also an example of how public health was essential to my life early on. It was one thing as a child that I experienced that very much motivated why I went into medicine, specifically to work in the ER, and that was I had a neighbor whose child had severe asthma, I also had asthma. This child was having a really terrible asthma attack. His grandmother was too afraid to call for help because of their immigration status. She was afraid that if she called for medical help, that somehow authorities would come and the family would be deported.

Because of that, this child was struggling to breathe so much, he actually died right in front of me when I was a child myself. I just remember thinking about how, in this country, we don't value health as a fundamental human right, how we see people as having different values, depending on who they are and where they come from. I very much knew that I wanted to enter medicine and specifically to work in the ER, because I never wanted to be in a position where I had to turn someone away because of lack of health insurance, because of ability to pay, or because of their country of origin.

Brian Lehrer: What compelled you to go from working in the ER with patients individually to public health, more of a policy career?

Dr. Leana Wen: It was working in the ER that I actually began to become so frustrated by all the things that health care could not do. I had another patient who had severe asthma and was a boy that I saw with asthma and working in the ER, it's not good when you get to know someone well. Because that should not be the primary place where they got care. This one child came in, I think was about eight years old, who came in all the time. I talk about in Lifelines how I got to know him and his mom and how frustrated I was that the interventions we were providing in the ER were not enough.

As in, we could give him steroids, we could give him inhalers, we could do a nebulizer treatment, we could try different medications, but what was actually triggering his asthma was the conditions in which he was living. He and his mom were in between different shelters, at relatives' homes, a lot of people around them smoked. They lived right near an incinerator.

At some point, they were living in a row house surrounded by other homes that had terrible mold. They were vacant and so even if we remediated or even if they helped with their housing, there was nothing they could do about the housing around them. That those environmental allergens were actually what was triggering his asthma and it just felt so hopeless.

I remember working in the ER that I was, I felt like I always, I could not open Pandora's box. I couldn't even ask the questions because what was I going to do if somebody said to me, "Look, you're telling me to eat healthier food, but I live in a food desert." Which is something, by the way, that one in three African-Americans in Baltimore live in a food desert without easy access to healthy food compared to 1 in 12 whites in Baltimore.

What was I supposed to tell my patient then if they said, "I can't get access to healthy food. All I have near me is a corner store that has dried up old bananas, but really nothing approaching healthy fruits and vegetables." It was at that point working in the ER, that I also realized that all of these issues I wanted to resolve could not be resolved within the four walls of the hospital. That it was actually public health that was the answer.

Brian Lehrer: We had the pandemic expert journalist, Laurie Garrett, on the show recently, and she criticized the fact that doctors who treat patients rather than one, specifically with public health policy careers, like you pivoted to, are being given these top jobs in COVID policy like New York City Health Commissioner and even Director of the CDC. You've done both things, do you have an opinion about that?

Dr. Leana Wen: First, I want to say that the New York City Health Commissioner and I were in residency together. He is wonderful and I think is exactly the person to be in this job because he is not someone who just came from clinical medicine, he also has a very strong background in public health policy. I'll tell you, it was hard for me when I first went from the ER to running Baltimore's Health Department, it was a difficult transition. It's different.

It's different to treat individual patients and then to become the doctor for the city, you deal with different types of issues. That said, I do think that having the clinical background is important. I still practice medicine now and I love the work that I do, and I think it connects me to the realities that my patients are facing every day. I see people who, for example, have not gotten vaccinated. I talk to people about that and I talk to people who are facing all kinds of other challenges in their lives that are not just about health care.

I think there is something distinctive about being a frontline's local or state public health official because you realize, working in these jobs, that, yes, science is really important and public health needs to be based on the science and guided by the science. Public health is not just about the science, public health is also about values, public health is also about understanding politics.

Dr. Boris Lushniak who was the former Acting Surgeon General and now the Dean of the University of Maryland School of Public Health likes to say that you can be political, but not partisan. I actually spent a lot of time in Lifelines, my new book, talking about how this applies to the work that I did in Baltimore. That you need to understand how to navigate the politics of a city or a state or federal government, but that doesn't mean that you're ever ideological or partisan, but you have to understand politics and policy.

I do think that the CDC is a great scientific institution, but they really need to have a stronger connection to the realities of people on the ground, including people who have state and local health department experience.

Brian Lehrer: The Kirkus Review of your book says you describe your years in Baltimore in part as one of places where your idealism bumped up against politics necessitating compromise, and that officials too often seem willing to kill a good program rather than eliminate a single feature and that more compromise was needed. Did they describe that accurately?

Dr. Leana Wen: I'm not sure that it's exactly right. Here's the way that I would describe it. I think so often, there are two things that are very frustrating about working in local public health. One is that, by definition, public health works when it's invisible. Where you have prevented something from happening, but because it's invisible, it's really hard to make the case for it when it comes to budget time.

There's the face of a child who was lead poisoned, but what about the face of a child who was not lead poisoned because of the home remediation that you did in time? How do you paint that picture? I ran so many programs that were proven to be effective and yet the budget was stretched and we kept on- I described in the book, these fights about keeping programs going that were so effective.

I mentioned the B'more for Healthy Babies Program that was a partnership with over 150 public and private partners. 38% reduction in infant mortality in seven years, we closed the gap between black and white infant mortality by more than 50% in that time. That program kept on being cut. I ran another program, Safe Streets that's based on the national cure violence model. That's about hiring violence interrupters, people from the communities that they're serving, to stop violence as it's occurring.

I talked in the book about how that program came within weeks of being cut altogether even though there were independent studies that show that it prevented potentially hundreds of shootings every year. I think that is one of the frustrations, but I think the other key frustration also is public health is just not understood. Sometimes people think of it as it's about everything, and so where do you even get started?

I talk a lot in the book about how you have to start somewhere. I think this is the pragmatic aspect is you can't solve every problem. Some people criticize, for example, my Naloxone distribution program and said, "Hey, you're not addressing addiction treatment." We did that too, but first of all, you have to save a life today in order for there to be any chance of a better tomorrow. Getting an opioid antidote or having needle exchange vans, that kid of harm reduction practice is really important to save lives, but that's the pragmatic part.

Brian Lehrer: We're almost end of time. Just briefly on the unhappy chapter of your life as, briefly, President of Planned Parenthood, you write that they wanted you to use the word abortion more in public appearances than you wanted to, is that right?

Dr. Leana Wen: Look, I went to Planned Parenthood because I was very concerned about women's health. The fact that women today are more likely to die in pregnancy than our mothers were, that Black women have three times the mortality during pregnancy than white women. The reason this is occurring is we're not prioritizing women's health.

There is so much healthcare access that we need to be expanding. Women's health is not just about the reproductive system, we have to be treating the whole person. The vision that I wanted to bring to Planned Parenthood, the vision that I carry forward in my work right now is about treating the whole person. Integrating reproductive healthcare, women's healthcare into every aspect of care. My vision for good healthcare is if you're going in for your birth control, you should also be getting a diabetes checkup, you should also be getting your high blood pressure treated, you should also be able to get your mental health issues attended to. It's that vision of holistic whole-person healthcare that I work towards every day in my work.

Brian Lehrer: Dr. Leana Wen, her new book is Lifelines: A Doctor's Journey in the Fight for Public Health. She's got a number of personal appearances coming up in conjunction with the book that you can attend virtually. One that's local to New York is tonight through The Strand. You can go to strandbooks.com/events. If you want to, you can also go to our webpage where we have a list of a whole number of events that Dr. Wen who we've heard so much on this program and has been giving us such good advice and public health analysis about COVID through the whole pandemic. There's one on August 5th, August 7th, August 12th, we've got the whole list in addition to the appearance by The Strand tonight. Again, the book is called Lifelines: A Doctor's Journey in the Fight for Public Health. Dr. Wen, congratulations on the book, and look forward to continuing our conversations.

Dr. Leana Wen: Thank you. Thank you, Brian.

 

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