AILSA CHANG, HOST:
Donald Trump is still president for 68 more days. Two of those days are Thanksgiving and Christmas, holidays that may tempt people around the country to come together at exactly the worst time - when the coronavirus pandemic looks less like isolated hotspots and more like a map engulfed in flames.
And so President-elect Biden will likely take office in the middle of a COVID-19 catastrophe. To prepare for that challenge, he has appointed a transition COVID-19 advisory board. It's a panel of outside experts who will provide scientific expertise to inform his administration's response to the pandemic. Atul Gawande is on that board. He's a practicing surgeon at Brigham and Women's Hospital and a professor at the Harvard Chan School of Public Health. Welcome.
ATUL GAWANDE: Thank you.
CHANG: Well, right now the Trump administration is refusing to participate in a transition to the Biden administration. So tell me; how much can Biden actually do before inauguration?
GAWANDE: Well, it's limited. It's important that we're messaging and that he's messaging that, you know, we know what to do. Here's the big picture, right? This week we learned about the results of the Pfizer vaccine and its likely great effectiveness. That puts a light at the end of the tunnel. We see the light at the end of the tunnel. Now we need to pull together to get our country through that tunnel, saving all the lives and jobs that we can.
CHANG: Right.
GAWANDE: And look; it makes a difference that we've been denied access to the agencies and to actually starting formally a transition with the Trump administration. Doing that work now can make a big difference.
CHANG: Is your board indeed confronting zero cooperation from the Trump administration right now?
GAWANDE: Yes, in a word. We do not have access to talking to the agencies, to Dr. Fauci, to people who have information about what the status is of mask supplies and glove supplies, what the threat assessments are, what the distribution plans for vaccines are. That will be important and very much in the national interest to be able to work together on that.
CHANG: What do you think - once Biden is in office, what is the one step that would make the biggest difference right away, in your view?
GAWANDE: He's been very clear that on Day 1, it's to begin working with the states to institute mask mandates nationwide. We already see clear evidence that the states that have done that have dramatically lower case rates. The estimates are that this would be more than 130,000 lives saved within a period of four to five months. You know, it's never too late to save 140,000 lives.
CHANG: How much of a difference will that make? - because at this point, a lot of the people who are not wearing masks are just skeptical of public health guidance in general whether or not there's a mandate.
GAWANDE: Absolutely. We're in a situation where some of the basics that make people safe have been politicized. But I don't want to get that exaggerated. Eighty percent of people have indicated they wear a mask outside the home. Seventy-four percent of Republicans do. So we just have to stop politicizing this.
When someone refuses to wear a mask in a store or at a family gathering indoors, they're hurting everyone's freedom, and they're putting them in danger. And it's pushing people away from our stores and hurting jobs. This is not political. And I think when we get started from January 20, we'll see that the temperature gets turned down. I can't tell you the number of leaders that I speak to across lines who know this is the right way to go. And it's just that we have to pull the rest of our population along with us.
CHANG: But beyond how much this pandemic has become politicized, a lot of states are saying that they're seeing a lot of the spread being linked to private indoor gatherings like dinner parties, game nights, slumber parties. And if that's where transmission is happening, what can the government do to stop that?
GAWANDE: Look; I think it's so hard. I'm exhausted. You know, our families are exhausted. Today I was just talking with my wife about what we're going to do for Christmas. I have elderly in-laws. My mother has a serious illness. And we had been all thinking, you know, we're going to figure out a way to do it, and we'll all fly and connect together. And you know what? We can't. This is where we are.
One in 400 of us tested positive last week, just in the last week. It's probably three times that many who actually have the virus. So that means in these gatherings, there's a very high likelihood that someone is infected and doesn't know it. We have to recognize that that is exactly how the virus spreads. And we have to take the steps, such as wearing a mask, being outdoors. It's really hard to do that when you see lots of other people not doing it and see the virus continuing to spread, but it is what we're going to have to do. And I think it'll be easier as we get a committed leadership nationally who are backing taking these measures.
CHANG: So what does the end of this pandemic look like to you at this point? Paint a picture for me.
GAWANDE: Well, I think there's a couple of possibilities. One is we truly eradicate this disease. It's also possible that we come to live with this disease at a much lower level where, sort of like the flu, most people get vaccinated, we have good treatments and that we're able to severely limit the damage and just get back to normal. You know, I can see a year from now being in a place where we really do have the holidays again.
CHANG: When it comes to vaccines, though, there have been several recent polls that show an alarming percentage of people who are saying they will not get a vaccine if and when one becomes available. What then - if a large number of people simply refuse to get vaccinated?
GAWANDE: I'll be honest. I'm not at all alarmed about that. I'm much more alarmed who gets them. And the initial allocations of vaccine will get to 10 to 20 million people out of 350 million people. It's not enough to get to all of the first responders and at-risk health workers, let alone nursing home population.
So my big concern is that there's going to be such clamoring for the vaccine that that will become a source of great dispute and anger. And we have to distribute fairly and enable people most at risk to get the vaccine, and we're just going to have to take time to get there. You know, if we come down to 20% who don't take the vaccine, we're just in a much better world where it'll be nowhere near the kind of sickness and deaths that we've seen.
CHANG: Atul Gawande is a member of President-elect Biden's Transition COVID-19 Advisory Board. Thank you very much for joining us today.
GAWANDE: Thank you. Transcript provided by NPR, Copyright NPR.