In the Bubble: On the Frontlines

What the US Can Learn from Israel’s Vaccine Rollout (with Ronit Calderon-Margalit)

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Dr. Bob calls up Hebrew University epidemiologist Ronit Calderon-Margalit to learn more about Israel’s best-in-the-world COVID-19 vaccine rollout. They cover how Israel did it, what the process of getting back to “normal” looks like now, and what lessons we can learn from their success. Plus, how the vaccines have held up against the so-called UK variant.

 

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Transcript

SPEAKERS

Dr. Ronit Calderon Margalit, Dr. Bob Wachter

Dr. Bob Wachter  00:08

Welcome to IN THE BUBBLE. I’m Dr. Bob Wachter. The tiny country of Israel is providing us some amazing insights into our own future. Because they’re about four to six weeks ahead of us in terms of the proportion of their population that they have managed to vaccinate. They have vaccinated nearly everyone over age 65 in the country of Israel, and a large proportion of the rest of the adult population. And so by looking at Israel, we may get a sense of what the future may hold for us here in the United States and other countries in the in the world. One of the things that they are showing us is how well the vaccines work in real life.

Dr. Bob Wachter

You might ask, why do we need to know that we’ve seen how well they worked in the clinical trials, but it frequently occurs in healthcare and in medicine, that results that you see in the very controlled environment of a clinical trial do not hold when you roll them out into a real population. But the results from Israel are really, really encouraging. And you’ll hear about that, from our speaker. You’ll also hear about whether a broad scale of vaccination changes the world, how are people feeling? How have people changed in their behavior? And some of the answers to that are pretty surprising. You’ll hear about the state of vaccine hesitancy in Israel, it’s apparently alive and well there. Israel does not mirror the United States, although there are lots of similarities.

Dr. Bob Wachter 

They have some special populations that pose different kinds of questions, including an ultra-religious population in Israel that sometimes has its own standards and some of its own rules, the Israeli-Arab population, and of course, the population of the Palestinians. And we will talk about that as well. One of the most fascinating things that’s going on in Israel is not just the fact that they are well ahead of the rest of the world in vaccinations, but they are doing something that we’ve begun talking about in the US and elsewhere, and I think will become a dominant thread of the conversation in the next couple months.

Dr. Bob Wachter  02:16

And that is the idea of vaccine or immunity passports in Israel, they call it the Green Badge System. And the government is mandating that people who want to get into certain places, show evidence they’ve been vaccinated, even there that is controversial. It’s just rolling out now. And we’ll talk about how they’re thinking about doing that some of the logistics of how to make that work and what the national debate about that is. And just like we’re learning about vaccinating the whole population in Israel, we’ll also learn from them, what it’s like to roll out that that kind of system, I do think it’s gonna be one of the most interesting phenomenon for us to watch here in the United States over the next few months.

Dr. Bob Wachter 

So a lot to learn from Israel. And we are lucky today to talk to Ronit Calderon Margalit, who is a professor of epidemiology at Hadassah Hebrew University Braun School of Public Health, and has emerged as one of the key spokespeople for the Israeli experience. We thought it would be worthwhile talking to Dr. Calderon Margalit to help us understand what’s actually happening on the ground in Israel, and help us understand what may be in our future. So let us ring up Professor Ronit Calderon Margalit.

Dr. Bob Wachter

So Ronit, thank you for being on with us today.

Dr. Ronit Calderon Margalit

Thank you for having me. It’s a real pleasure.

Dr. Bob Wachter 

Same. Tell us how it feels to be there in Israel now. Are people more optimistic? Are people dancing on the streets are people particularly older populations that are now it sounds like almost fully vaccinated? How does life feel now compared to how it felt a month or two ago?

Dr. Ronit Calderon Margalit  04:02

So I think that when vaccines came, we always so hopeful that this is the end of it and the end is in sight. However, it doesn’t seem that the government is loosening up and much of the restriction so people vaccinated people still are required to walk with the masks. Not all activities came back. Some of them are, the government is trying to promote vaccines to encourage people to be vaccinated by doing this green passport thing, which means that there will be activities that will be available only to vaccinated people. For example, if you want to go to a gym, if you want to stay in a hotel, hotel in Israel, that would be available only to vaccinated people and not to unvaccinated people.

Dr. Ronit Calderon Margalit

So I think they somewhat a little bit reduced, because you don’t really feel that so much in your daily life in terms of masking of still having some kind of social distancing. But on the other hand, we see these reopening of places and the availability or accessibility to places and events that is reserved to people who are vaccinated. And I think that’s a really encouraged to do that. And I think that our people are very suspicious. I think that’s, I mean, vaccine hesitancy is here as well, especially in young adults.

Dr. Ronit Calderon Margalit 

And I think that comes also with mistrust in the government and the feeling that things are politicized. So we are going to have elections by the end of this month, like three weeks from now. And so some people suspect that all these reopening are not because of, you know, not because of the vaccines or the effectiveness of the vaccines, but just to gain more votes for the government.

Dr. Bob Wachter  06:09

I’m shocked that there’s politics there. We don’t have any of that here. So Israel has become a global exemplar, a model of how to get vaccine distributed quickly. How did it do that?

Dr. Ronit Calderon Margalit 

The truth is a that we were all surprised in a good way. I think what happened, there are several factors that kind of enabled this success of the vaccination rollout. One is that Israel is a very small country, our population is around 9.3 million inhabitants, and in a very crowded countries. So it’s a small, physically small country. In this sense, it’s already something that is beneficial for distribution of vaccine or any other service, then we have our system. So our government is central, we don’t have anything that is federal government, we have one central government, and this government is responsible for the purchase of the vaccines, then our health systems.

Dr. Ronit Calderon Margalit 

So I think we should really well I take pride in our health system, all citizens in Israel are insured under the law, the National Insurance health law, and we get our health supply from one of four HMO. So each one of us is, is insured by one of four health suppliers. And they have really a great system and infrastructure that they can reach everyone or each one of us. So we have this centralized mechanism. It was all computerized. So the Ministry of Health knows about everyone who gets vaccinated.

Dr. Ronit Calderon Margalit  08:04

We got a text message from the Ministry of Health. For me, for example, I was, of course vaccinated in my hospital. And I got a text message from my health plan that they know that I was already vaccinated, and I shouldn’t reach them for the second dose. So that was another part that for every one of us, once we got the first dose, the second dose was already secured when you when we were supposed to get them.

Dr. Bob Wachter

So are you down? I know about 55% or so of people have gotten vaccine for the 45% that have not yet Are they all eligible or you’re still going through priority groups?

Dr. Ronit Calderon Margalit 

So there’s in the larger proportion for those of us 60 were way over the 80%. So among those who are 70 to 79, we are reaching 100% of people vaccinated. The age group with the smallest proportion of vaccinated is 16 to 19 years old. We have about 4.7 million people being vaccinated out of a total population of 9.3 million, but of whom about only 6 million could be vaccinated because they are over the age of 16.

Dr. Bob Wachter 

I say.

Dr. Ronit Calderon Margalit 

So yes, I’m very, I’m very proud. I think it’s amazing.

Dr. Bob Wachter 

It is amazing. People have talked about when a country reaches herd immunity and often talk about two thirds or so. So by that measure, are you close and how are you thinking about that number?

Dr. Ronit Calderon Margalit 

So the issue with herd immunity, it all relates like the general public it all relates to the R Naught, R0. And we thought that the R0 is three and then you need to vaccinate two thirds of the total population. And that could be reached in Israel only if you vaccinate all eligible people because we have a third of the population that is children. However, now that we have, probably all viruses here are related to the B117 variant, the UK variant, the R Naught is probably much higher, then it doesn’t seem that by these simple rules of getting herd immunity by having one minus one over R Naught that we will get to herd immunity in terms of transmission in the community.

Dr. Bob Wachter  10:41

So let me just try to translate that. So you had thought that getting to two thirds would be enough if the R Naught was three, because most of the virus there now is the UK variant, the R Naught is might be higher than that. And so you may need to vaccinate more than two thirds of people to get to herd immunity. And you basically can’t do that, because there are enough kids that are not eligible for vaccine yet to get there. Is that  that right?

Dr. Ronit Calderon Margalit 

Yeah, so our hope or what we’re waiting for is for the approval of vaccines in children, I think we can get to herd immunity. However, you already see the effect of the vaccines, which is pretty amazing. Because we see the decline in ventilated individuals, we see there was a nice paper on the […] showing the decline in the ratio of those ventilated that are above the age of 70. To those who are under 50, so this decreased by two thirds. And I think that we all relate to the declining morbidity in the community, not to the lockdown that wasn’t in place. concomitantly with the rollout of the vaccines, there was a lockdown. But the lockdown wasn’t very effective, we think and within that what we see as a decreasing in morbidity is thanks to the vaccines.

Dr. Bob Wachter  12:13

So people around the world, including the US are pointing to Israel as the test case of that these vaccines actually work in real life that, you know, we knew they worked in clinical trials and very controlled circumstances. But some of those numbers in Israel are proving that that in a real-world situation, they work really well take us through any other pieces of data that you’ve seen that have given you a sense of how well the vaccines are working in real life?

Dr. Ronit Calderon Margalit

So there are three studies that are observational studies, based on individual level data to come from these health plans. One was just recently published in the New England Journal of Medicine. And I think all of them get to the same ideas that after the first dose between two weeks and three weeks after you have about 50% effectiveness in preventing disease. And then afterwards, like a week after the second dose, the effectiveness gets to more than 90%. So these are very reassuring data. Of course, these are studies they have their own limitations because it’s all observational data and we don’t have active surveillance for disease.

Dr. Ronit Calderon Margalit 

So we can definitely talk about severe cases, hospitalizations, mechanical ventilation of deaths, not so much about transmission  and asymptomatic disease even though the study in the New England Journal of Medicine tried to approach the issue of  asymptomatic disease, but it’s not perfect data. We also did a modeling study. And in this modeling study, we tried to model the expected number of severe cases without vaccinations even when you have an effective lockdown. And we were able to show that given the level of vaccinations in the community, the decrease in severe cases, hospitalized cases came much earlier than one would expect even with an effective lockdown.

Dr. Ronit Calderon Margalit  14:35

So and also in this modeling study, we were able to model the issue of transmissibility of the virus in vaccinated people. And our models were suitable to the what really the real-life scenarios of what really happened only when you assumed that the vaccine prevents at least 50% of transmissibility. So for sure. It reduces transmission. And it reduces, of course, both asymptomatic and symptomatic disease in severe cases. So it’s pretty amazing.

Dr. Bob Wachter 

You mentioned that the UK variant, the B 117, has become quite prevalent there. Have we learned anything about how well the vaccine works against that variant from what you’ve seen in Israel?

Dr. Ronit Calderon Margalit 

The assumption of all studies that were carried out, there is also one study that is a co work of the ministry of health and Pfizer. They all assume that the British prime is the dominant foreign. So whatever you see, whatever effectiveness you see, is, while the dominant variant which is more accountable for more than 80% of the of the cases, that’s why it’s here. So were talking about an effective vaccine, when the British variant is the dominant one.

Dr. Bob Wachter  16:21

Have you seen the other? The South African or the Brazilian variants there yet?

Dr. Ronit Calderon Margalit 

So I didn’t hear about the Brazilian, but I did hear about some cases of the South African variant. And according to some of the reports of the of the Israeli government, it was also in cases that there was no known connection to someone who came back from South Africa. So this is kind of work, it’s worrisome.

Dr. Bob Wachter 

There have been some reports about some tension with the ultra-orthodox in Israel, I think been true all through in terms of other public health behaviors, like masking, but now playing out with, with vaccines. Can you talk about that?

Dr. Ronit Calderon Margalit 

In Israel, we’re looking at mostly into three sectors. So we have what we call the General Sector, which is the majority, and we have the Arab population, which is about 20% of the population. And we have the ultra-orthodox population, which is about 12% of the population. So there was some kind of reluctance of them to be vaccinated. That’s when we know that they also have the highest rates of morbidity in Israel. I think that in a way that is much reduced, otherwise, we wouldn’t get to these high levels of vaccinations throughout the community.

Dr. Ronit Calderon Margalit 

We have even more severe problem with the Arab population, when we see really vaccine hesitancy that is quite surprising. And the surprise comes from the fact that our population is like is excelling, in being vaccinated for all other routine vaccines, so they have the highest rates of vaccinations in childhood vaccines. And nevertheless, now their uptake of the corona vaccine is pretty low. And that’s despite the fact that they have very high rates of morbidity and mortality from Corona.

Dr. Bob Wachter  18:25

What do you think is going on there?

Dr. Ronit Calderon Margalit 

So I think, again, it’s mistrust, it’s miscommunication, I think it was starts and ends with proper communication in different with different sectors. So I’m no expert in communication. But I hear people are saying that the communication in the media or the people that were chosen to, to communicate the vaccines to the population, or to the ultra-orthodox population when doing very good work.

Dr. Bob Wachter 

I want to talk about the green badge system. It’s fascinating. It’s something we’ve talked about that might happen here, although we assume it would be massively controversial. How did it come about there? Do you have a sense of sort of how that decision was made to go with a system like that?

Dr. Ronit Calderon Margalit 

And talks about the green patch, or were started before even the vaccination came here. It was kind of I think, a vision that people had those who will be vaccinated will get more freedom, of mobility of action of doing things or having some cultural events, things that we all miss. So it was discussed before. And once the vaccinations started, the vaccination campaign started, it was clear it was going over there. The recent debate here in Israel. So there are oy vey, just a second, why does it say that? I’m, excuse me.

Dr. Bob Wachter  20:09

Always a little concerning when you hear an Israeli say, Oy vey, that’s a problem. (laughs) You’re okay? Everything okay there?

Dr. Ronit Calderon Margalit 

I think for the time being.

Dr. Bob Wachter 

For the time being, okay. You were saying that the government was discussing the possibility of going to a Green Badge system, and that now that they’ve done it, it’s somewhat controversial.

Dr. Ronit Calderon Margalit 

There are people who are trying to discuss it ethically, and also to talk about, you know, something about too much government power over individual rights. And let’s say, for example, in the university, in the Hebrew University. The management of the university, as declared that their wishes to bring back in person teaching in class teaching in the university. And therefore, they said, they will allow either students who got vaccinated, or those who had PCR test in the previous 72 hours. So it’s basically saying that you all have to be vaccinated. So there is a debate about that, for example, is it tomorrow? Do you limit the rights of certain people? If there are people who maybe cannot be vaccinated? Do you still have to? That’s let’s say, the spirit of things.

Dr. Bob Wachter 

Is there any question that it’s legal? That the government has the right to do that?

Dr. Ronit Calderon Margalit 

Okay, so there are questions about the legality of this. And also nowadays, there is also something that is even taking one step farther. And that is the government is going to pass a law about disclosing names of people who are not vaccinated, for example, to workplaces. I don’t know if it will pass. But that’s the direction that they are leading.

Dr. Bob Wachter  22:19

So how does it work today practically if I want to go to a restaurant or I want to go to a theater, do I have to show somebody something? And what is that thing, if I do? Is that on my phone? Is it a piece of paper?

Dr. Ronit Calderon Margalit 

So far, restaurants are still closed for indoor dining, they are supposed to be reopened next week, I think. We already for example, we have a group of students, international students that are going to have a trip to a lab to the southern side of Israel. And that’s where the sleepover. So the hotels already told us that they will not accept people who are not vaccinated, even if they have negative PCR tests, only vaccinated individuals who have the full green badge. So even one of those is not enough, is not sufficient. That is like mandatory in order to stay in the hotel. And that’s the idea.

Dr. Ronit Calderon Margalit 

So I don’t know exactly how it’s going to work. Because we all got all those who got the batch, we have this kind of document that you can download with your name. And then there is also this barcode, but I never saw or up until now. Maybe it will develop in the next week or so. I didn’t see anyone who scans it or I so far I wasn’t asked to present it. If we’re talking personally details. So I have, let’s say my Pilates classes. So now that the classes are going to resume. And already the owner said only those who have the green badge will be allowed to come back to classes.

Dr. Bob Wachter  24:09

So you think it’s likely that you’re going into a Pilates class and at the front door, you’re going to have to scan your barcode on some machine that then opens it up.

Dr. Ronit Calderon Margalit 

I wonder. I’m not sure I’m not sure if she will, if the owner will ask us to really to present it or she will just rely on sincerity. So that’s exactly you know, that’s where we think they rise and fall. Because they say that, for example that to enter shopping malls, you’ll have to show this green badge. I’m very skeptical that you know, the doorman will really go one by one and ask them to present the green badge.

Dr. Bob Wachter 

And is it the government telling the hotel, the shopping center and the Pilates class? You must do this or is it those are private businesses that are making their own choices with the government saying philosophically we think this is a good idea.

Dr. Ronit Calderon Margalit 

No, it’s a kind of the government. That’s what they tell them to do. I don’t know how much they follow up on this compliance on the compliance with their instruction. So it’s really guidelines that they have to do, or else they will be probably they will be closed. I mean, I think that’s the threat. I don’t know if that will ever take it into practice.

Dr. Bob Wachter 

In the United States, given our libertarian streak, if our government did this, people would go ballistic. I think there would be a lot of pushback, a lot of people that think it’s a great idea, and will encourage people to get vaccinated and make people feel safer if they go into events. But there will be it would be a very, very strong pushback, what’s the level of pushback that you’re hearing and seeing in Israel?

Dr. Ronit Calderon Margalit 

So there are plenty of debates, especially on the internet, and you have all these anti vaxxers and people that also come from these individual rights aspects. But generally, I think that people will accept it. And I also believe that all people will be vaccinated because of these incentives.

Dr. Bob Wachter  26:28

So you think it will be a motivator? People will..

Dr. Ronit Calderon Margalit 

For sure.

Dr. Bob Wachter 

People around the fence might choose to do it because of this.

Dr. Ronit Calderon Margalit 

Yeah, for sure. And also, I think that, you know, this vaccine hesitancy once they see that we are reaching almost 5 million people being vaccinated. And, of course, we don’t know about what they will consider as long-term effects. But at least in this short- or medium-term effect, we don’t see much complications and seems very safe. So I think this is reassuring for people. And then they will follow through, either for the sake of having these accessibility to all these normal life occasions and events and activities or because there is a, you know, some kind of social pressure, and then people do what everybody else is doing.

Dr. Bob Wachter

Yeah, that’s true everywhere. Let’s talk about the Palestinians for a second. There’s a lot of debate in the world literature in the you know, on the internet and off the internet about, does Israel have a special obligation to vaccinate the Palestinians? You already mentioned the Israeli-Arabs, but not the Palestinian population. So what is that debate like in Israel today?

Dr. Ronit Calderon Margalit 

Let’s start with a little bit one step earlier. So the Ministry of Health also issued vaccinations, vaccines to people who are working in Israel and foreigners, non-citizens. And then there was the question about the Palestinians, because the Palestinian Authority is not really secluded from Israel, so that we have many people who come into Israel as workers from especially from the West Bank, not so much for Gaza, but for the West Bank. So it was raised with the Ministry of Health and they said that they’re working on a solution on vaccinations to the Palestinian workers who enter Israel. I don’t know the details of this solution. So it wasn’t disclosed, at least to my knowledge.

Dr. Ronit Calderon Margalit  28:45

We as I think, because this is a pandemic, we I mean, every country, we all have this interest that people all over the world will be vaccinated because we have this, we want to go back on planes. We want to travel the world. And for sure, if people won’t be vaccinated in other countries, the virus will stay in the circulation, we will never get out of this mess. Even beyond the humanitarian aspect, solely because of the selfish interest of Israelis. We need to have the Palestinian population vaccinated. There are interactions, many social and family interactions between Arabs in Israel and Palestinian population. There are many workers who come to Israel from the West Bank. So for sure, it’s for our best interest that the Palestinian people will be vaccinated, and that’s beyond anything humanitarian or moral issues.

Dr. Bob Wachter 

And is that where do you think the state of the debate is that people believe that the Palestinians should be vaccinated whether it’s for moral issue For self-interest, or is there, it’s, you know, there’s this conflict and therefore we don’t want to do this.

Dr. Ronit Calderon Margalit 

And I’m certain that all people that are, you know, the professionals, they all agree that it’s our best interest people that passed and will be vaccinated. Yeah. I’m sure about that. And you hear you’ve heard them quite loudly, about, you know, the general population. I don’t know exactly. I can talk on their behalf.

Dr. Bob Wachter 

So maybe, last question. And this probably summarizes everything we’ve just talked about. But in some ways you are looking into the future for us in the United States, you’re a month or two ahead of us. What are the things that you have learned is positive and negative over the last couple of months that you think should help inform the American experience with vaccination?

Dr. Ronit Calderon Margalit 

Well, I think well, everybody can look at us and say that we are safe and sound, I think that’s maybe something to look into about the safety as it is shown in Israel. I think that’s one thing that is really reassuring, then I think when you’re looking to the effectiveness and the way that it reduced morbidity, and specifically the severe morbidity, the hospitalizations, mechanical ventilation and deaths, I think that is really something that should encourage everybody to get vaccinated all over the world. It’s best, of course in the United States. And I think you should you deserve to enjoy the fruits of the science that came from your country. That’s for sure.

Dr. Bob Wachter 

Yeah. Thank you. Yeah, it’s interesting, because I think up until two weeks ago, I would have said, Israel is going to teach us about how to get people vaccinated quickly. And what happens? The green badge is sort of another twist, because I have contended for a couple of months that that will be the dominant question this summer in the United States, should we create incentives for people to get vaccinated, and I think the debate here is gonna be wild about that. So you’re gonna teach us also about how to do that and what it’s going to whether it works. And so what some of the benefits and challenges of that are going to be.

Dr. Ronit Calderon Margalit  32:20

We just started with a reopening. So I think we’ll know more about how it’s working like in the next two weeks.

Dr. Bob Wachter 

Yeah, I’ll check back in because it is fascinating. All right, Ronit, anything I should have asked that I didn’t?

Dr. Ronit Calderon Margalit 

No, I’m so sorry about my English and my accent.

Dr. Bob Wachter 

Your English is perfect, and your accent is charming, so please don’t be sorry about either. And that’s the first “oy vey” I’ve heard on any of my interview. So I really, I really enjoyed that too.

Dr. Ronit Calderon Margalit 

Yeah, I would tell him to come to my kitchen, but it’s really impossible nowadays.

Dr. Bob Wachter 

Well, a special thanks to Ronit Calderon Margalit for I thought, a fascinating discussion, I learned a lot and including, I guess I would have thought the world would have changed more. And yet, in some ways, they’re feeling the same tension that we are here about vaccination. The authorities are being pretty conservative about telling people that their worlds and behavior can change, for understandable reasons. And yet, as we heard last week, here from Caitlin Rivers, and Farzad Mostashari, it can change once you’ve been vaccinated, and we’re trying to get that balance, right. But by not telling people that they have the freedom to now do some things they couldn’t before. We may be discouraging vaccination. So we have to continue to work on that message.

Dr. Bob Wachter 

I was also struck by you know, they are now country whose virus is mostly the UK variant, and that changes the numbers that makes it harder to get to herd immunity. It’s amazing how much of the, of the population they’ve managed to vaccinate. And I continue to believe that the issue of the green badge or whatever we choose to call it the United States, or what are the privileges that come with vaccination will be a dominant thread of ethical and political and legal conversation here in the United States. Probably not in the next month or two. I don’t think that’s a conversation that really starts until everyone has had the opportunity to be vaccinated and may also require that the FDA moves these vaccines from emergency use authorization to full authorization.

Dr. Bob Wachter 

But assuming that those things have happened, there’s enough vaccine let’s say by May and the FDA has blessed these vaccines as being truly approved. I think it’s inevitable that we’re gonna have a really interesting, vigorous and undoubtedly contentious conversation about whether vaccination should be required to open doors to everything from gyms, to theaters to shopping malls. And I’m sure you all have your own thoughts about what’s right and what’s wrong. And I’m I have no doubt we will have some of our in the bubbles where we tackle that issue head on. But I hope you learned something as well, I did. And it was really a fascinating conversation.

Dr. Bob Wachter 

We have more fascinating topics to cover here on IN THE BUBBLE, it seems that there is no end of interesting twists to the saga. We’re going to do an episode that’s a one-year retrospective and looking forward. We’re now a year from the time with that most of us discovered how serious this was one of the correspondents for NPR asked on Twitter the other day, when did you know this was going to be a big deal, for me it was hearing your science reporter Donald McNeil on The Daily right around this time last year, when he was talking about the 1918 Great Influenza, and he said everybody knew someone that died. And that was a moment of chill went down my spine. And I realized this is going to be really, really bad because and in fact, that was pressured because I think pretty much everybody now knows someone who has died. I certainly know several should be a fascinating session where we talk about the key lessons from the past year, and what the next year may hold.

Dr. Bob Wachter 

Speaking of lessons, we’ll have another episode where we talk about COVID. And what we learned from the HIV-AIDS pandemic, which broke across our shores in 1983. I lived through that there are a lot of things that we learned from that experience that have been highly relevant to our experience with COVID. We’re going to talk about two public health experts that live through that as well and have thought deeply about it. One is Gregg Gonsalves from Yale, the other Carlos del Rio from Emory, it should be a really interesting episode. And then we’re gonna do an episode, we’re still putting together the final pieces. But we’re going to talk about how medical training has been transformed during COVID.

Dr. Bob Wachter 

Both the nuts and bolts of medical training, obviously, a lot of it had to go online. But more importantly, if you’re a student, or an educator during this era, what changed in your thinking about training and what do you think the enduring changes in practice may be? And of course, those of us in the training business have to think about that as we train people still lining up that episode. But I know one guest will be my daughter Zoey, who is just enter her fourth year at my own medical school at UCSF and I’ve seen up close and personal how her training was transformed over the course of the year. So we’ll see it through the eyes of a trainee but also through someone in the educator business. So lots of good stuff coming up, never ending fascinating issues, that this pandemic is raising for all of us. So until then stay safe and I look forward to talking to you soon.

CREDITS

We’re a production of Lemonada Media. Kryssy Pease and Alex McOwen produced our show. Our mix is by Ivan Kuraev. Jessica Cordova Kramer and Stephanie Wittels Wachs executive produced the show. 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 @InTheBubblePod. Until next time, stay safe and stay sane. Thanks so much for listening.

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