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2022 Local Journalists Workshop
Thursday and Friday, April 7–8, 2022
The State of the World, with CFR President Richard Haass and Ayman Mohyeldin / Don Pollard
The 2022 Local Journalists Workshop is part of CFR's Local Journalists initiative, the goal of which is to help print and broadcast journalists at local outlets across the country link the local issues they cover to national and international trends and events. CFR brought together print, digital, and broadcast journalists from thirty-one states and Washington, DC to CFR's New York headquarters to share best practices and discuss clean energy, immigration, infrastructure, cybersecurity, and public health with CFR fellows and other experts.
The full agenda is available here.
This workshop was made possible in part through the generosity of the John S. and James L. Knight Foundation.
Virtual: The Future of Clean Energy
The Future of Clean Energy
Speakers Nili E.M. Gilbert, Robbie Orvis, Meaghan Parker
FASKIANOS: Good morning, everybody. Welcome. Can I have your attention?
Thank you so much. I'm Irina Faskianos, vice president of the National Program and Outreach here at CFR. Welcome back to the second day of the CFR Local Journalists Workshop. It's great to have you with us. We have journalists from over thirty states joining us, so we appreciate your making the trip—one journalist as far as Honolulu, Hawaii. (Cheers.) Yay.
So, I—we have a very full day planned for you on clean energy, immigration, public health. We have discussion groups in the middle of that. I want to first credit and thank the John S. and James L. Knight Foundation for supporting this workshop. And I know that they support much of the work; this is their mission, to support local journalists. So we thank them, Alberto Ibargüen, for his support. So, we will all thank the Knight Foundation. (Applause.)
It seems a little silly to say this: This meeting is on the record. That's an important fact, so we encourage you to tag us at @CFR_org, hashtag #CFRlocaljournalists. You can have your phones on, but please silence them, so we don't, you know, have pinging and dingings going on during this meeting.
We also have journalists joining us virtually.
So, with that, I'm going to turn this session out, over to Meaghan Parker, the executive director of the Society of Environmental Journalists, to moderate and to contribute her thoughts on the future of clean energy. And she will introduce our distinguished panelists.
So, Meaghan, over to you.
PARKER: Thank you, all. Thank you so much, Irina. Thank you to Council on Foreign Relations for this wonderful, lovely event. And congratulations to the organizers on what I know was a very challenging planning environment.
I'm so excited to be here today, and to do double duty as your moderator and speaker. And I hope my fellow panelists will hold me accountable if I go on too long, because I know we want to make sure to get to your questions. So please, start thinking about them early and often.
I'm going to briefly introduce our panelists, and then talk a little bit about the panel and my thoughts. And then I'm eager to ask them a lot of questions, as they have such tremendous expertise to share.
So first, we have Nili Gilbert, who is the vice chairwoman of Carbon Direct—thank you so much, Nili, for being here—and Robbie Orvis, the senior director of energy policy design at Energy Innovation.
And I'm, as I said, the executive director of the Society of Environmental Journalists, but I started my career actually in the energy industry. And I worked for Pennsylvania Power and Light, which is the regulated gas and electric utility, in their international investments and renewable energy division. And I—when I started there, I really knew nothing about electricity, not a thing. And I think it took me the whole five years I was there to reach that goal that Richard spoke about last night, which was to be able to explain electricity to my mother.
And I think that's, you know, one of the big challenges that we're going to talk about today on this panel, on the future of clean energy, is really reckoning with the fact that our educational system doesn't prepare our audiences, or even our ourselves as journalists, to cover such a complex topic as electricity, as energy, as climate change. And so, how do we as journalists communicate that to our readers—to our mothers?
So, that was one thing that I took from that experience, and I think is critical to being able to make the transition that we need to make. It's just really even grappling with the lack of understanding of these complex systems that we have.
The other thing I learned at that job was how important policy was to the private sector. We worked on this renewable energy strategy, which just went nowhere. This was the early 2000s, and the regulatory environment was just this constant rollercoaster of tax credits that would come and go, and the projects pipeline would similarly rollercoaster along with those. And that was very frustrating. And I know Nili will talk more about the private sector, and its—and its perspective on how it can be a leader, but also needs that regulatory certainty.
So I moved—my next step then was to go into policy. I went to the Woodrow Wilson Center, which is a think tank focused on international affairs, a lot like CFR—although CFR has much better food—(laughter)—by far. But I worked for the environmental change and security program there, which looked at the connections between energy, environment, and national security, how environment and energy can be both a driver of conflict—like we're seeing today, in Ukraine—but also, perhaps, a platform for building cooperation and peace across borders, as it is a shared global system.
And my work there was to help journalists connect what's happening globally to their beats, whether it was topical, or regional, or local. And that's super hard to do, so, you know, a huge kudos to CFR, and to all of you for being here, because it is a major challenge, you know, to have readers who are saying, that's happening thousands of miles away from me today; what does this have to do with my family, my concerns, my—you know, my job, my children? And making that connection is, in a very short, you know, number of words, in a way that your mother can understand—boy, that's a big ask.
And it takes—it takes, really, folks who can help, who can provide that expertise on the—on the timeline of the news, which, you know, has been accelerating year after year after year. How can you get up to speed on these tough, complicated issues, in a timeline that serves your audience and your editor—and convinces your editor, first and foremost, to even accept a pitch? You have to now get through them first, right? They're the gatekeepers.
So, I learned a lot about, you know, the challenges that journalists faced in making those connections through that work. And so, an opportunity came to go over to the staff side on—at SEJ. I loved it. I had been a member of SEJ for a long time; served on the board. And what I—what I found that I wanted to do was help journalists, not only with the topical, you know, challenges of this—of this beat, but also with the very real challenges of the career path. It is a tough—(laughs)—it's a tough career to be in right now. I don't have to tell you guys the struggles that local news outlets across the country are facing. Ayman last night called local journalism the backbone, you know, of our society. Well, that back is breaking, and it—and it has been for ten years.
I just got back from our annual conference in Houston, and, you know, the—what I hear from newsrooms that went from fifty to a hundred people, that are now down to four or five. And, you know, when you're covering schools and crime, and sports—oh, right now, do a climate story on top of all of that? That's huge. And so we work to provide some of those resources, that Climate 101, those real baseline information that helps you—get up to speed quickly, be able to explain it to your editor, how to, you know, pitch it to him, or her, and also how to, of course, explain it, all of this, to your readers, including your mother.
One of the other things that we do, though, of course, is also try to support the production of these stories. They're not cheap, whether it's in terms of time, there's also travel, and data, and other things. We have some small and large grant programs. I'm happy to talk with you guys about that afterwards.
But all that said, this is why I'm so excited about this panel. It's an opportunity to really delve into those—all those pieces of that question: What is the future of clean energy? How do we connect this global, interconnected story to our local readers? And how do you do it sustainably in an—in an industry that is—faces so many very real structural challenges?
So, I'm really excited, though, to hear from our experts, who of course—of course, this is how we do this work, is by getting to ask questions of people who really know—really know their stuff.
So, I wanted to start with Nili and say, how does your work help us get to that transition to net zero? What is the future of clean energy, from your perspective?
GILBERT: Well, thank you so much for those introductory remarks, Meaghan. And thank you to the Council for hosting us, and to all of you for being here today.
My name is Nili Gilbert. I'm the vice chairwoman of Carbon Direct, and I also serve in the leadership group of the Glasgow Financial Alliance for Net Zero as the chair of the advisory panel of technical experts. So for me, it's all net zero, all day long. (Laughs.)
At Carbon Direct, we're really focused on scaling carbon management into the global industry that it needs to be. As all of you know, by 2050, we're going to need to reduce our global carbon emissions as much as we can, and then figure out how to remove the rest. It is the challenge of our times.
We at Carbon Direct are doing two main things: One is we're making investments into the technologies needed to decarbonize heavy industry, including a focus on renewable energy. And also, we advise clients on their own carbon management journeys, everything related to reductions and removals, all supported by a team of about sixty climate scientists across every discipline of carbon management.
So, when I think about the clean and renewable energy transition, a lot of this focus is on future fuels and the future of power: things like green hydrogen, sustainable aviation fuel, and so on. You know, when I—when you think through the evolution of clean energy and the energy transition, where we sit today is quite evolved from where we were back in 2010, where a lot of the focus, or maybe all of the focus, was primarily on things like wind, solar, batteries, electric vehicles. Today, because of the insistence of the logic of net zero, we need to look beyond those areas into the energy transition that will be required to get the whole economy down to net zero.
And the truth is that we won't be able to electrify everything. We can't run everything on wind and solar. And so, when you think about decarbonizing things like aviation, steel production— even the grid, we won't be able to run everything on electricity—this is what pushes us into the demand for future fuels, and moving from just clean, into the broader field of renewable energy.
Some of this is science and technology, so it's a real honor for me to work with so many scientific experts in the field, but at Carbon Direct, we also really focus on the interdisciplinary needs, to be able to achieve these efforts. As you know, of course, we're going to need to continue to advance in innovation, not so much for creating new solutions, but for figuring out how to scale them up and continue to lower the price, but we also need to have expertise in focusing on how policy will support these efforts, and importantly, on how to finance all of it.
So, this is why, across my work, we're looking at bringing in experts from across these fields, who can talk to each other in figuring out how we raise this ambition together as a global community.
PARKER: Nili, just to ask you a quick follow-up, you mentioned, you know, how to finance it. I wonder if you talk a little bit about the Glasgow commitment, and the role of banks and other financial institutions in supporting this transition.
GILBERT: Sure, thanks for asking.
So, the Glasgow Financial Alliance for Net Zero was founded on Earth Day last year, so we're coming up on the one-year anniversary. This is an alliance of over four hundred and fifty financial institutions worldwide, who represent over $130 trillion in capital, everything from banks, asset owners, asset managers, to insurers.
The way that I think about is, when you look at the net-zero transition, we've got to get—we've got to transition every industry, right? I mentioned we've got to do airlines. We've got to do steel, consumer products. Every single industry needs to be decarbonized. But what's really special about finance is that while the financial sector has its own transition plan, it also touches every other sector. So it's almost like the plan of plans, the amalgamation. And so, it's very inspiring to me to think about how we can use the long arm of private finance as a critical tool in solving these global and interconnected problems.
That being said, at GFANZ, as we call it—(laughs)—we acknowledge that it won't be possible for the private sector or private finance to find these solutions alone. We have a significant effort on calls for policy action globally to support private sector and private finance ambitions, in doing what we know that we need to do.
And another area of focus is, of course, on understanding how, as we address this global urgency, we understand how to raise and finance the transition in emerging and developing market countries. It's interesting, when you look at the amount of capital that will need to be invested over the course of the next thirty years to achieve net zero, that two thirds of that capital will need to be invested outside of North America and Europe. So, this means not only working with private sector, working with the public sector and policy initiatives, but finding the right way to collaborate with development finance institutions and philanthropy.
PARKER: Well, if there's one thing journalists are good at, it's following the money. So I think as the money moves through the system, there's some tremendous story ideas in there.
Robbie, I want to ask you a similar question. You know, please tell us about your work and how you're working on the future of clean energy.
ORVIS: Yeah, thanks, Meaghan. And Nili, great opening remarks. And I'll just echo thanks for the invitation to be here today, and for everyone coming.
So my name's Robbie Orvis. I'm the senior director of energy policy design for an energy and climate think tank called Energy Innovation. And we work with policymakers around the world to help understand different climate and energy policy options: how to design those options, what they can actually do to achieve emissions, how they work together, and how they affect the economy in terms of deployment of clean energy, jobs, GDP growth, and health.
And as it turns out, there is generally a need for better assessment and understanding of what different policies will do, and how we will achieve net zero. You know, we have generally kind of the technologies in mind—although as Nili pointed out, a lot of them are still in development, and we need more options. But oftentimes, there's a disconnect between targets—stating net zero— and how a country will get there. And so that's kind of where our focus is.
So, in the U.S., for example, we look a lot at national-level targets or state targets. We actually just put out a report last week for Oregon, looking at its emissions targets, and what current policy will do, and trying to understand, you know, what—how to close that gap. How—what other policies will work to close that gap, and how do we design those policies? And so, you know, we do that work in the U.S. and in China, and India, and all over.
And so, I think, you know, as the net-zero targets have grown, and we see from the IPCC report kind of what's required to keep us at a stable, or minimal level of warming, there's a lot more work that's needed to understand how we get there, and how policies can support the private sector in driving technologies to market.
PARKER: So, I know that your work—you've produced a lot of good data analysis, and—but there's one thing that—and I came away from our most recent annual conference—was just a hunger among journalists for really good data sources, and really good analysis, particularly ones that they can access quickly and grasp quickly—which, you know, is easy if you're a data nerd all the day—all the time. But again, if you're trying to cover multiple beats, it can be hard.
Can you tell us a little bit more about that kind of resources that you have that would be helpful for local journalists, particularly at state level?
ORVIS: Yeah. And you're right, it's a challenge, even for us, to find state-level data often. Sometimes, the reports aren't public; sometimes, who wants to read a 300-page report to pull out a few numbers?
But so, one thing my organization does is we have an open-source tool called the energy policy simulator. We are developing it for all—not every state, but forty-eight contiguous states, given data restrictions. But that tool is available online, it's easy to use, and it contains a whole bunch of data for states—where emissions are today; where they're going; what different policies can do. And we go to great lengths to document where that data is coming from, so that it becomes a resource to folks, like everyone here and others, to try and better understand state emissions and policy trajectories.
We also—you know, we try and include information that provides resources to those data sets. It varies a lot from state to state, what you can find. There's actually a lot of national data for states as well. But I think that tools like ours, or there's some other groups that put out similar tools—there's another research group called Rhodium. They have a state tool that has a lot of information on state emissions. Trying to better aggregate those and to improve the way in which data is presented, you know, it's hard if it's just very detailed and lots and lots of numbers. But, you know, we put a big focus on visualization of data as well, to try and help tell that story and explain that story, of what we need to do on clean energy and climate.
PARKER: That's so important to have those visuals, I know, and particularly for folks being able to grasp such complex things. But they are—they can be costly on the news sites, so it's great to have resources like your work for that.
I'm going to ask one or two questions up here, but please make sure you're thinking of your questions for the panel. We'll get to those shortly. We've talked about the transition that's needed and that is, you know, underway. What some folks have really focused on, though, is who are going to be the winners and losers in this transition? How can we make sure that it is a just transition, and that folks who have been traditionally overlooked, or not at the table, aren't left out in this transition, aren't left behind? Certainly, in Houston at our conference, we heard loud and clear from community members, from local environmental activists, that, you know the same—that in the same way that the—our energy system left their neighborhoods, you know, some of the most polluted in the country, they fear being left out of the solutions to the climate challenge, as they continue to bear the worst of its impacts, in terms of flooding and other things.
So, how do we—how, through your work, are you helping to ensure that this transition will be a just one for all of us?
GILBERT: Thank you so much for asking this question. The just transition permeates across all of the work that I do, and which I described earlier. And one of the reasons for that is because when you think about it, we're not likely to be able to have any transition at all, if it's not a just transition. There are a lot of reasons for that, one of which is—as you just said, Meaghan—a lot of the solutions that need to come forward, need to come forward in the frontline communities that have been most disadvantaged by the harms of the climate disaster. And so, we need to go in—bring the solutions to where the problems are.
Another reason is, because of the long-term political will that we'll need to maintain, to be able to complete this transition over time, we need votes. And so if people feel like this transition is evolving in a way that doesn't include them, or in a way that they don't trust or understand, we may not maintain the mandate to be able to get the work done. And we see that in the debates that we have going on in our Congress right now.
When I think about climate justice, it touches many topics. We have the long-term environmental justice movement, that grows out of the civil rights movement here in the U.S., that looks at the intersection of race and climate equity. There's actually a broad field at the intersection of gender and climate. I sit in a group of women leaders in climate finance who are developing databases to be able to better understand that aspect. There's the just transition in jobs. President Biden often says, when I think about climate change, I think about jobs, right? We're going to have to build a whole new green economy. We're going to need to have labor training. We also need to think about making sure that the new jobs are where displaced workers will be. And so, it—we need to make sure that we have place-based justice in how the transition evolves.
The just transition also includes equity issues between the Global North and the Global South. As I already mentioned, there is a great deal of investment and effort that we need to make, to bring along emerging countries in the climate transition.
And then, when—right now, at the top of our news flow is the energy crisis, and the way that we think about the just transition and the evolution of energy prices. It's important that we find the right balance of an orderly transition, so that we avoid the type of price volatility for things like gasoline, that first of all, will decrease political will for the transition to continue, but actually, if we don't have an orderly transition, the volatility that we'll see in the future, in terms of prices, will be even worse, and always accrue most harmfully to the poorest in our communities.
PARKER: Thank you, Nili.
Robbie, tell us a little bit about how—what you're seeing, in terms of the policy environment around the just transition.
ORVIS: Yeah, so we don't have a great track record in the U.S. of having inclusive climate and energy policy design. And I think we've seen the impacts of that, both in terms of disengagement and the loss of that mandate to go ahead and pass policy in climate and energy. And of course, we've seen disproportionate impacts in terms of uptake of clean energy. You know, look no further than the uptake of really expensive Teslas in California, that aren't affordable to a lot of folks.
I do think we're starting to see the beginning of a trend of policy that is designed to be inclusive from the start, and that's really key. And I was just speaking with someone last night about the Climate and Equitable Jobs Act in Illinois, which is a great example of how smart, equitable climate and energy policy can be designed. And that legislation from the start included outreach to communities, listening—a really key focus on listening to communities that are on those front lines, getting their feedback, and then designing the legislation with the needs of those communities in mind. So there's targeted investments in green banks and training for small businesses in the communities that have been, you know, the least invested in, historically.
You know, Build Back Better, or its second incarnation—which we hopefully will see soon—that has a lot of funding tied to communities that, you know, to your point, Nili, are not—need to be orderly transitioned, in order to have an equitable growth for those communities. So there's a lot of funding set aside for communities that are near coal plants or coal mines that are being closed, or auto factories that are going to be transitioned or closed.
So we're starting to see that. We need a lot more of it if we're going to be successful and be able to transition the economy and rebuild the economy to be a green economy. But I'm hopeful that some of those recent legislative pieces can serve as a—as a learning point for other states and communities.
PARKER: Yeah, to me, this is a treasure trove of story ideas at the local level, and a way to bring this global transition, you know, to your readers at those—at those household issues that I—that they care about, how it affects them and their livelihoods, their jobs, their communities, especially if you look at the funding that's flowing through—and again, there's a whole bunch of accountability—great accountability stories that can be done to make sure that that money really is going to the communities that need it most, and that those projects are being implemented in the best—not only with the best of intentions, but with the best of results. So, I think there's, just, you know, incredible stories there.
There's also the opportunity to really engage communities that have not gotten the attention or coverage that they have deserved over the years, and engage them not only as readers or as subjects of the story, but as partners. I'm sure many of your news outlets have been looking for ways to engage the community, to really reinforce that relationship between local news, whether that's events, or other types of platforms. And this topic, this—the transition, and how it's going to affect the local economy and local jobs and the local environment, is a great platform for those community engagements. And we see that in a lot of our members that are covering environmental justice stories at the local level, that the readers really resonate, because you know, it's the most local of stories. It's about the water that they drink, the air that they're breathing, and the food on their table. You can't get more local than that, right?
So, yeah, it's going to be a very challenging transition for everyone, but I think for local journalists, there's a tremendous side benefit of some tremendous stories out of it.
One thing, though, that I took away from my time at the Wilson Center too, though, is that, you know, the best of intentions can have unintended negative consequences. And we looked a lot at where climate mitigation and adaptation projects—you know, in particular in fragile states and countries—how they might exacerbate existing tensions to, you know, unintentionally spur conflicts.
And sometimes, pointing those things out doesn't make you a lot of fans, right? You're a little bit of a skunk at the picnic—(laughs)—you know, saying, wait, this is for the good of the people, of everyone. They say, well, you know, if you don't really understand the context that you're working in, you know, you can—it can have some negative ripple effects.
And I think we're seeing that today in Ukraine, right, and how the global interconnected energy system that has really benefited the European economy is now having some serious intersections with the conflict and the geopolitical scenario there.
So, I wanted to turn to our panelists to reflect on how this clean energy and the Ukraine conflict, how can—how can our journalists here understand those connections, and also, you know, localize that, again, for their readers? Nili?
GILBERT: Well, of course, when we talk about the Ukraine crisis, I always want to start by acknowledging the human cost and suffering there, while in my day job, I spend a lot of time thinking about how this situation is affecting the energy transition—and as a result, the climate transition that we have ahead of us.
The discomforting news is that in the near term, we are seeing an increase in fossil fuel use in Europe because of an increased reliance on coal, as Russian gas and oil are being used less, which means more emissions. So, a delay in what we had expected in terms of peak emissions there.
But what I see is that there may be—while there may be kind of a hump, an increase in the short term because of this crisis, that we can also see an accelerated slope downward after that, because of the simultaneous urgency for the renewable transition, also to be able to advance energy security.
And so, as a matter of fact, when I was talking earlier about green hydrogen, we're seeing a lot of positive tailwinds for the hydrogen production cycle in Europe, coming out of this. For one thing, we had predicted that cost parity for hydrogen would come around 2030, relative to its dirtier alternatives. But as the cost of natural gas now rises—and oil—the cost for hydrogen solutions relatively becomes more attractive. So, Goldman Sachs recently put out a report about the energy transition in Russia-Ukraine, and is forecasting a four-times increase in demand for hydrogen in Europe over the coming period, from—between now and 2050. So, that's good news.
And then I would also want to talk about this sense—sometimes you hear this sense that we have trade-offs, that it's kind of a zero-sum game in terms of how we get the energy transition done. And I think that that's probably a false perception. The truth is that we're going to have to increase investments in everything. We are going to have to invest a bit more in traditional energy, especially in being able to clean it up and develop it in a more renewable way, through solutions like carbon capture and storage. While at the same time, we're also going to have to dramatically expand our investments in clean fuels.
And so, it's not so much a zero-sum game, thinking about how we divide up the same sized pie, it's really a vision for how we work together to expand this pie of investment supply and demand dramatically over the course of the coming decades.
PARKER: Thank you.
Robbie, how about you? How do you see the—this global situation with Ukraine, and its impact on the energy system? How is that going to affect policy in this country going forward?
ORVIS: Yeah.
Well, I think, you know, most Americans are directly seeing this at the pump. It comes as no surprise to anyone in this room. And that's what a lot of people are talking about, is how, you know, the crisis is leading to an increase in oil prices, which is translating into higher prices at the pump.
And I think—it's moments like these, and where we've come in terms of bringing down the cost of technology, that really bring to light some of the benefits of the clean energy transition. We cannot drill our way out of the current situation. For one, we've seen oil producers don't really want to produce more, even though there's a clear, you know, economic case for them to do so with high prices.
The other thing is that if you look back, we're paying the same amount for oil today that we paid in 2016, that we paid in 2005, so the oil markets are global. They're going to always be affected by the actions of other large oil-producing countries, whether it's Russia, or Saudi Arabia, or more broadly, OPEC. And so there's just very limited potential for oil, in particular, for the U.S., to have a really meaningful long-term impact, significant impact, on prices.
And the good news is we now have, and are growing options for, alternatives to gasoline vehicles. We have electric cars. There aren't enough on the market today; we still need costs to come down further—though it's expected to happen. Price parity for gasoline and electric cars is expected in the next five to ten years. But we have alternatives. And we also know that today, driving an electric car is much cheaper than driving a gasoline car.
So, I think this moment is highlighting the fact that there is an alternative technology solution, that's good for the climate, and that can insulate consumers from, you know, the price volatility that's inherent in a global market, like the oil market. And it's—you know, this won't be the last time this happens. It's bound to happen; it happens every ten to fifteen years. And so if we can use this moment to help catalyze the transition to clean vehicles, it can be a moment where we really accelerate things, to Nili's point. And just to build on that, I mean, we've already seen, as you suggested, the EU kind of ramping up policy to move faster, even though in the short term, we have this increase.
So, it's—we're at this very odd moment where prices are high, but we're seeing in kind of the future, on the horizon, maybe we can use this as a moment to accelerate with a mix of policy and technology prices.
PARKER: I'll just build on that, and also a question that came up last night about solutions journalism—which is something that in the environment space, has been growing quite rapidly, as well—this is an opportunity to do stories about the solutions that are out there.
And I know that covering solutions can be a hard sell to your editor. You know, it's a—you know, that sounds like an advertisement. You're just repeating a press release that somebody sent you about their new, you know, silver bullet that's going to solve the climate crisis. But the Solutions Journalism Network—which, if you guys aren't familiar with, please check them out—has developed a toolkit that helps you do a real solid reported story on a solution, that can acknowledge both the ways that it works and raise question about where the gaps might be, or—and that is something that, of course, journalism—journalists can do very well, is investigate, OK, how real is this, you know, proposal? What will it solve? Where might it fall short? And that's a real story. That's not an advertisement.
I think one of the challenges around solutions journalism, of course, is that it's an easy story to delay. You can say, well, it's not time-sensitive; you know, where is the news hook? But a situation like we're faced right now globally could be that hook for saying, how do you take these global prices and really look locally? Where are the companies, or businesses, or innovators in your community, that are developing solutions, or that are working towards some of these alternatives to our current energy system, and really frame it as a—as a feature that delves into the positives and the challenges of that solution.
There's also a technique—because, you know, I know—I know that conflict, problems, those drive clicks. And you know, if you're—if you're measured by clicks, like so many people in ad-supported media are, you know, you can use that technique of sort of the problem sandwich, right, frame it as the problem; introduce the solution as part of the story. That's another way around it. But definitely, there's some great tips from the Solutions Journalism Network out there.
Well, now it's time for your questions. And I'm really, really eager to hear—and I'm—we started in the back yesterday, so I'm going to start in the front this time, right here with my colleague Deb Krol, from Society of Environmental Journalists in Arizona.
Q: So, I need to stand, or—OK, good. Hi. Debra Krol, indigenous affairs reporter with the Arizona Republic. Thank you, Meaghan, for letting me ask the first question.
And yes, it's a thorny one. We all know that, you know, building this new renewable energy grid is going to require a lot of material, like copper, lithium, cobalt, nickel. And utility grid solar plants are eating up hundreds and thousands of acres of formerly undisturbed lands. A lot of environmentalists and tribal people are already seeing the effects of, especially, hard-rock mining on water availability, water quality, the effects that mining has on lands, you know, with the tailings, and the—and the toxic materials left over. And you were talking earlier about trade-offs, but how can—how can things like ESG investments, or other such policies or programs, be put into place so that rural residents and indigenous peoples don't have to pay the price for renewable energy?
PARKER: Nili, would you like to go first?
GILBERT: Thank you, Deb, for raising this question. And you're right, it's a thorny one, and a critical one.
So, first of all, it's very important, increasingly, that we include communities in decision-making processes about how these solutions are advanced—learning from their experiences, learning from their wisdom in how we create plans and involving their concerns in how we advance solutions. And so, you talked about ESG. Sometimes when it comes to ESG, people look at it in silos. Like, we'll say, oh, we need to do the climate transition, and this is all about energy and greenhouse gas emissions. And also, over here, we need to think about justice and social issues, as though they're separate. From here forward, we need to have more integrated assessments, where we're taking account of a combined vision of how we achieve our social goals, our environmental goals, and how we think about leadership within it—that's what the G, governance, means to me, is leadership and people. And there's a big piece about diversity in there as well. We need to do these all at the same time, something that folks call multi-solving.
And the supply chain crisis that you mention is significant. We should expect to see deglobalization of supply chains, which means that the reliance on the voices of our indigenous communities here in the U.S., in thinking about the way forward for how we identify and mine or gather resources, will become only more important from here on out.
ORVIS: I'll just add—completely agree with all of that, and the need for inclusivity in policy from the start.
I think also, this is why we need strong standards for industry. I mean, to your point, we can't have this growth—whether it's mining or deployment of renewable energy—that—where the developers don't take the steps that are necessary to clean up after themselves, and to make sure they're not leaving a large impact in the community. And I think standards have a strong place there on the industry, particularly for these industries that are going to grow a lot in the coming years.
PARKER: One resource I'd recommend is CERES, the Coalition for Environmentally Responsible Economies. I think I got that right. But they do a benchmarking report of, you know, the top companies in the U.S. along a number of ESG criteria, that I found very helpful in terms of looking at, comparing progress across—but there are a number of different international systems, of course, in place on those criteria.
But I think, you know, it can be hard to drill down to the very local conversations and conflicting needs. And that's where, as local journalists, you can really help find those stories that folks at the—at the national and the global levels cannot, and really connect, you know, up to those—to those bigger tracking and performance benchmarks, by looking at what's happening in the local community meeting, in the town hall, and what people are actually saying, not just, you know, what's being reported in the—in the 10-K.
OK, who's next? Right up front, here.
Q: Hi, Sam Wong (sp) from New York metro area, just a freelance journalist.
I've got two questions. One, I wanted to piggyback off of the first question, and just, like, drill down on that, on mining. What are the available or developing technologies for making mining minimally polluting, in terms of, like, water and earth, and not just the greenhouse part?
And the second, less related question that I was thinking of is, is there a risk that's not negligible that, like, physics—to put it brusquely, physics does not cooperate with our goals on increasing the reliability of carbon capture and renewable energy storage technology?
PARKER: So, clean mining, if such a thing exists, and what's the—are you asking, for in terms of carbon capture, the—
Q: Carbon capture and storage, like—
PARKER: —right, the actual success rates? The—
Q: Like, there's goals, right? Like, by 2050, we want, like, something that can capture this much carbon per day, or something.
PARKER: Right, will that work. Those are both very good questions.
GILBERT: I can take your second question, not being an expert in sustainable mining—(laughs)—and both of your questions are tough and important.
So, sometimes, when it comes to the climate transition and the energy transition, we want to start at 2050, or even 2030, and say—and anchor on those ambitions. And what that can cause us to become distracted from at scale is getting it right today. And so for me, the heart of ambition is in quality and technical integrity, which is why, as I said, I'm so honored to work with so many climate scientists at Carbon Direct. Some of the work that we have to do today is about focusing on the highest standards before we scale.
And so the answer to your question is, it depends—like, so much of this depends on us and what we do today, and how we do it today, which is why the importance of the role of journalists is so important in parsing the good from the bad. Neither can we say, no, we're not going to do carbon capture and storage, because there's no—there's no path to limit global warming significantly below two degrees without it, across any major scientific study. Neither can we say, no, we're not going to do it, nor can we say, let's go full bore, with loosey-goosey standards and practices right now. We have to find that in between, and take responsibility for scaling the right action, the right technologies, and the right practices, in the right places.
PARKER: Robbie?
ORVIS: Well said. I also sadly am not a sustainable mining expert. So I unfortunately can't help much on the first question.
GILBERT: You've stumped us. (Laughs.)
I think that's right. I think a lot of things have to go right. You know, we have to get the clean energy deployed. We have to bring down costs for some of the new technologies, including carbon capture. We have to be able to deploy all of that. We have to overcome supply chain constraints and deployment constraints. So carbon capture is a—is a piece of the puzzle. We're going to need it. We have, you know, we also need to deploy like crazy solar and wind and other clean-energy technologies, electric vehicles, electric trucks, hydrogen trucks.
So, I agree with Nili. It's important to understand what we have to kind of get going on today, whether that's deploying or investing in R&D, and setting the standards up to ensure that that technology's available when we need it, but to not get distracted by, you know, what studies say we might need in ten or twenty or thirty years, and to focus on today, investing in the R&D and the commercialization and deployment, so that in the future, we're ready to do that, and we have an array of options.
PARKER: I'm not an expert on this either, but we did publish something in our SEJournal around mining, so I can follow up with you.
And that's a great resource. We have tip sheets on just about every topic and backgrounders, from a reporter's perspective, on just about any topic.
One thing I'll just add on that is that, you know, it's—there's the environmental impacts on mining, but there's also—going to our conversation, the social impacts of mining. And if you don't take those into account, you know, it's not going to be sustainable or clean mining, either. So, you know, as you look at, you know, where lithium and these other, you know, battery inputs are coming from, you know, oftentimes, they're fragile countries with internal conflicts, in marginalized communities that have been left out. And you know, if they're not engaged in the project, it's not going to be a sustainable solution from the get go. So even from the non-technical side, it's incredibly important.
So, thank you. Those are great questions, but it also goes to the challenges of a technical field. You know, we'd need about twenty people—(laughter)—on the panel to be able to provide that expertise. But I know where you can find those experts.
Alright, next question, right here on the side. Thank you.
Q: Hi, good morning. Michael Puente with WBEZ out of Chicago.
We obviously cover everything that's happening in Chicago. And Illinois, it's a very kind of progressive state when it comes to emissions, and reducing carbon emissions, and future renewable energy.
But we also cover our neighboring states, like Wisconsin and Indiana. Indiana, for example, doesn't seem to be as committed to renewable energy, and protecting legacy things like coal. How difficult is it, though, in our country, not to have a unified sort of message and strategy moving forward, for our energy future, when, depending on what state you live in, some of those commitments aren't there, or it's different?
PARKER: Robbie, would you like to go first?
ORVIS: Sure, yeah.
Great point, and one of the reasons why we really could benefit from climate legislation, and one of many reasons I hope we are—Congress is able to get something across the line.
You know, there's a role for federal standards as well. So the Environmental Protection Agency has federal standards that can help with some of that. But I think for me, one thing that gives me a bit of optimism is states that are increasingly protecting coal or fossil fuel interests, it's going to get very economically challenging to do that, as the cost of clean energy declines and more of it is deployed.
There's already multiple states—you know, Ohio, West Virginia, Indiana—that are now having to contemplate legislation to provide, you know, taxpayer money to keep these plants online, because they're not economic in the markets they're in to do that.
And that is a broad trend we see with clean energy technologies, thanks in part to all of the R&D and investment of the private sector over the past ten to twenty years, and policy that's helped to deploy and commercialize those technologies.
You know, the transition is coming. Half the coal fleet has retired already, through a mix of standards, but also just through market prices, through the falling price of gas and clean energy. And so I think that that position is going to be increasingly untenable, and put those states at a real disadvantage. And so I hope that there's enough wherewithal from legislators and regulators in those states to realize that, and understand that for the benefit of their own citizens, that is not a long-term position that can be held.
PARKER: Nili, from the private sector's position—and since they work, you know, most companies work across state lines, what is the sort of top asks, you would say, you know, in terms of nationalizing the policy environment for companies?
GILBERT: Well, when you think about companies that are working nationwide and worldwide, they will increasingly have to vote with their feet in where and how they're doing business up and down their supply chain, in order to meet their own climate goals, their own net-zero goals.
So sometimes—I was on a call recently and a woman said to me, well, what about the fact that it's only these huge multinational corporations that are setting net-zero targets, but not small- and medium-sized enterprises in my state and my region? And I said, well, but the companies in your state and region are suppliers to these huge multinational corporations, and we have what we call Scope 1, Scope 2, and Scope 3 emissions. Scope 3 emissions accounts for the emissions in your supply chain. And so increasingly, there will be pressure on the companies also in your region to be able to do business with others outside.
And actually, we see the same thing at a global level, not just national, where people say to me, well—everyone says to everyone—why can't we have a global price on carbon? We have a local price on carbon in my country, or in my state. But increasingly, you see countries talking about things like carbon border adjustment taxes, that push—they export national policies to become international.
Or Germany, in its presidency of the G-7 this summer, will talk about the concept of country clubs, so kind of bringing together coalitions of the willing, to be able to set policy in kind. For example, here we sit in New York, which is part of a regional carbon pricing regime. And so, even those who wish that they could sit outside of the borders of this movement will eventually be crowded in, because of the way that all of the private sector is interconnected at the end of the day. None of us can operate alone without customers or suppliers.
ORVIS: Can I—
PARKER: Oh, go ahead.
ORVIS: I just want to add, great point. And another—like, another great example is that California, under the Clean Air Act, can set its own standards for cars. And then other states can follow suit, if they want. Well, a lot of auto manufacturers said, we're not going to make—we're not going to make two different sets of cars. We're going to meet the stricter standard.
So if we get some momentum—and there's multiple areas in which this is happening. Cars is one; trucks is another. A lot of states, including New York, have adopted the clean trucks rule that California pioneered—so if you get enough market momentum, it's—you know, you get the more unified market that pulls the laggards in.
PARKER: Yeah, I'd say I was at a conference recently. Reuters Sustainable Business has been running some events that focus on some of these questions at the state and national, global levels. And the Scope 3 emissions is a big focus of companies and that's really getting deep into the supply chain, and if there's one thing we've learned from the pandemic it's how important the supply chain is, so I think, you know, even if you say, well, we don't have these kind of companies in our local community, you probably have a supplier, right, who's being asked to report up their supply chain because they're part of that Scope 3. Reuters' sustainable business summit is happening two weeks from now here. If you're interested, I'm happy to let you know how to get the press pass for that.
Let's go over this side—who is over here? Yes, the lady right here.
Q: Hi, Debbie Abrams Kaplan from New Jersey. I am a freelance journalist.
So I have a question probably for Nili about jobs. So it's one thing to say that, you know, the coal miners can now become solar power installers, but it's another thing to make a much broader scope of training, job training, for everyone from accountants who need to figure out how to account for net-zero to supply chain and procurement people who need to understand how those decisions impact a company's net-zero goal, to real estate people who are looking at the impact of their buildings, which can, my understanding, is about 40 percent of some of the carbon emissions come from the buildings, the building environment.
So I was wondering if you could talk about that process of getting people trained for the broader scope of what needs to happen in climate change, because it's not just little pockets of labor that needs to convert what they're doing, it's a whole environmental ecosystem change and we're already having labor issues in the country and being able to have that kind of broader training, it's not a one and done, take a class and you're done; you need a lot of experience in order to do it and you need to be able to see what's happening, and it's very much of a—maybe not a newer area but a much bigger focus in recent years, and with the goals there's going to be a lot of need globally for this.
GILBERT: Thank you. Thank you for your question.
So there's a number of pillars to this; one of the pillars will be policy and so I'll let Robbie talk a little bit about the policy piece. I actually think that the concept that you're raising has the potential to be an equalizing force because the new green labor force is yet to be built and so it creates the opportunity for a kind of leveling of the playing field, and that builds back into what we were saying earlier about the just transition, not only nationally but globally. We have the chance to include lots of new folks in the vision for the economy that's to come.
When you think about net-zero commitments and net-zero transition, from the outside maybe it sounds like a lot of climate math—(laughs)—carbon math, and it is, but a lot of it is also a lot of organizational transformation, so in the private sector I'm honored to sit with a lot of companies as they move from making their net-zero pledges into targets and action, and much of it is what you're saying; it actually has to do with how are we going to retrain the workforce, how do we motivate the workforce to want to be retrained, especially if it's a national company that also has offices in Indiana and Wisconsin? How do we motivate the workforce to want to be retrained? How do we do this retraining? How do we support the investment in it? And so from the inside, oftentimes, this climate movement and climate transition work looks not just like carbon math but also a lot like people and leadership. And that is the work. And this also pertains to place-based initiatives. It's not just this kind of like conceptual "we need more solar engineers." It's like, how do we transition coal miners in West Virginia into the future of green labor and what kinds of jobs are we going to be able to put there?
ORVIS: Yeah, on the policy side, you know, I keep coming back to this legislation in Illinois, but, you know, to Nili's point, we can't just say, you know, we're going to transition these people from one job to another. We need to know what those communities need, what are the challenges they're seeing on the ground, and to invite their voices early and often into the policymaking process so that their concerns are heard and solutions to those concerns are integrated into the policy options that we're putting out there. So inclusive and equitable policy design is going to be essential to get this right and to not leave those communities behind.
I think also, just to give another example, some of the funding in Build Back Better is earmarked for communities with coal mine closures or with coal plant closures or with auto plant closures, so there are—you know, that's not enough just setting aside money. We need the job training and again to hear from those communities, but an increasing trend towards doing that is positive and we're seeing that, but it's going to be key to making sure the jobs are there and that those communities are brought along in advance and that we can have that equalizing that is possible now as we rebuild the economy and create millions and millions of new jobs.
PARKER: Thank you. Let's go right—let's stay on this side to the back table, lady right there in the back.
Q: Hi. Eric Mercado with Los Angeles Magazine.
And I have a seemingly simple question about oil, and as most people know, the U.S. imports a lot of oil; however, we also export it. And as a carbon idiot, I'm just wondering, that doesn't seem to make much sense. So how do you explain that?
MR. ORVIS: I can jump in on that. OK, so the oil market is global and it's not run by a single government. It's private companies who might have contracts but more generally who will go out and whoever will pay them the most for their oil—and also not all oil is equal; it has different chemical properties. One thing I've learned from the current oil crisis is that there's a bunch of refineries on the East Coast that need a special kind of oil that really only Russia or Venezuela has been able to provide historically, and that's part of the reason why it's been challenging to just have a substitute for that. But generally speaking, oil producers will sell on the market to whomever they can get the most money from and so that might mean that they have an existing contract or that someone somewhere else in the world needs their specific type of oil and will buy it, or will buy some type of derivative of that oil, whether it's gasoline or diesel or something that's less finished. Unfinished oils is a category. And so that is why—you know, even though we could produce more in the U.S., technically, it may not stay here and we don't keep all of our oil domestically. The combination of the private sector leading that and the different types of oils and the oil market being a global market where trade happens is why the oil market looks the way it does, which I completely admit is very confusing—(laughs)—doesn't make a whole lot of sense on paper.
PARKER: That's probably the best explanation—(laughs)—I've heard of the oil market. (Laughs.)
Q: So there used to be a law not that long ago that forbade the United States from exporting oil. That law was repealed in Congress and typically the type of oil that United States exports is a light condensate, which is a special kind of oil that is used for specific purposes. So one barrel of oil is not the same as another barrel of oil; they vary—sulfur content, all sorts of different properties, and so that's why it is.
PARKER: Similarly with coal, there's different kinds of coal in different parts of the country that people use different kinds of coal. It speaks to the need to—when you're looking for experts—and first of all, there's no such thing as a carbon idiot. (Laughs.) I understand it can be challenging but we're all, you know, again, at the same level where our educational system doesn't prepare us for this level of complexity. But it means you need to find the right expert. I was often asked at the Wilson Center about, you know, what was happening with—where was oil price going to go? Was it going to go up or going to go down? And I was like, first of all, if I knew that I wouldn't be sitting here—(laughter)—at this think tank, I would be on a private jet somewhere. And second, I worked in electricity, not oil. You know, they're connected but they're not the same, so you definitely need to make sure you're looking for, you know, the right technical expert who can give you a really good explanation like Robbie did.
Nili, do you want to add anything about the markets and how they work in the energy system that—they're not always the most efficient?
GILBERT: The only thing that I would add to this great discussion is that it's interesting to think about the United States doesn't have a national oil company the way that some other countries do, and so our oil market is privatized and, for that reason, more fragmented, which leads to the dynamics that Robbie described, but to point out that in another country that has a national oil company that you might see more kind of orderly series of flows than what—as you would imagine than what we have here.
PARKER: Lady in the back. All the way—yes.
Q: Hi. I'm Maria Recio. I write from Washington for the Austin American-Statesman, and before I wrote for Austin I spent many years writing for the Fort Worth Star-Telegram, north Texas.
Fort Worth is, of course, the epicenter of fracking, and that's what I wanted to ask you about. Fracking has been responsible for really energy independence, in many ways, for the United States. I mean, there was a huge surge because of this phenomenon. Yet, we have the downside, which is what we're talking about today, is on the environmental side. So how do you see the future of fracking?
PARKER: Robbie, do you want to start?
ORVIS: Really great question, and I think there's a lot of discussion right now around what role natural gas generally—which is the part of fracking I'm going to run with here and leave the oil part behind—plays. I think that the energy security issues in Europe—I think most people are probably aware but Europe gets a lot of its natural gas from Russia; a lot of revenue to the Russian government comes from Russian gas that's sold to Europe, and so there's a real interest in ending that; we've seen sanctions to do that. So the U.S., Biden administration has already redirected some of its natural gas that it's exporting, and just to make sure we're all on the same page, you need special terminals to export natural gas and import it; they're very expensive to build, they can be quite polluting, but that is the way the U.S. has grown and other countries have grown the international trade of natural gas. Natural gas used to be very, very limited in terms of international trade.
So I think the question is, what happens in the next ten to fifteen years as we try and provide the European Union with some energy security? I think we're likely to see an increase in natural gas production. Just reading what the administration has put out, there's an interest in increasing the number of export terminals and the amount of natural gas, liquefied natural gas that we're exporting. In the long run, if we're to achieve our decarbonization targets, there's not a role for it. If you look at the IEA, International Energy Agency, report from last year on a 1.5 climate future says actually we shouldn't be investing in any more oil and gas today anywhere in the world, or coal, for that matter. So if globally we're going to be on a track to do that, there's not a great long-term future for natural gas.
I think, especially in light of the crisis in Europe, we're likely to see some increase. And I think one interesting thing will be to also see what happens to natural gas prices in the U.S. We've been—to your point, you know, fracking has delivered really cheap natural gas to the U.S., which has helped decarbonize the power sector, it's helped keep, you know, building energy costs low to heat, and it's helped U.S. industry stay really competitive globally because we have really cheap natural gas. What happens if we start exporting a lot more and the supply doesn't keep up with that? And I also wonder if the same issues we're seeing with oil drilling now and kind of the refusal of the private sector to increase drilling might spill over into natural gas and what that might mean for prices and U.S. competitiveness globally in the future. That was a lot—(laughs)—to unpack there, so—Nili, what do you think?
GILBERT: I think it's interesting to think about the grand march of progress over time and the story, the character of natural gas in that tale. You know, the pioneers of fracking felt that they were themselves advancing progress, where gas is cleaner than coal and oil, where, as you mentioned, fracking in the U.S. advanced our energy independence and, you know, we see the energy security that comes from it, and so the early vision for fracking also had its positive attributes. Today we talk about gas as a transition fuel. There was a big debate in the EU when they were working on their sustainability taxonomy about whether to include natural gas as a transition fuel among fuels that could be considered cleaner as part of the sustainable transition, and I think that that envelope is being pushed very strongly right now. What we need to think about when we think about natural gas as a transition fuel is how to produce it more cleanly, really to focus in on methane, methane leakages, using advanced technologies to identify as well as stave those off.
I was asking our chief scientist at Carbon Direct, Dr. Julio Friedmann, about all these new LNG terminals, because one thing that's very sensitive to us in the climate transition community is investments in new, long-term CAPEX for old energy, and so it's hard to see all of these new terminals go up and I was asking, what is the likelihood that what's being built today for natural gas could be transitioned into hydrogen terminals in the future, and what he said is, based upon the current technologies, that it's probably never going to be cost-competitive to transfer these new LNG terminals into green hydrogen facilities, but that they could be transitioned over time into gray hydrogen, which is still pretty dirty, or blue hydrogen, which, with the proper technology, can be considered much cleaner and a beneficial transition fuel going forward. And so all of this is—as I was saying to the other question, we can't snap our fingers and end up where we need to be in 2050, and even when we get to 2050 we'll have a whole new wish list of things that we're going to have to do then—(laughs)—and so all of it is kind of like thinking through step by step how the process unfolds and kind of hones us into where we need to end up. And I think that natural gas is going to continue to be a critical part of that story.
PARKER: Well, unfortunately, we've run out of questions. I'll just add on to the last thing—you know, twenty years ago at the electricity company we—you couldn't—they couldn't give away, literally couldn't give away nuclear plants, you know? Nuclear was done. People were paying other companies to take them off their hands. Then nuclear came back, right? So it is a cycle. You will see, you know, this continual process of not always moving in one direction; some of it will come back around again.
Thank you so much. Please join me in thanking our panelists. (Applause.) Thank you both very much. Thank you. And there's now a break until 10—sorry, 11:15. You can ask more questions during the break. Sorry we couldn't get to everyone's. Thank you all.
Immigration and the Economy
Speakers Angela M. Banks, Chad Sparber, Alexandra Starr
Presider Shannon K. O'Neil
O'NEIL: Great. Well, good morning everyone. I'm glad to hear all the voices as we were walking in. Everybody is engaged here.
So this panel is about "Immigration and the Economy," so a big subject to cover.
I am Shannon O'Neil. I am vice president for Studies here at the Council on Foreign Relations as well the Nelson and David Rockefeller Senior Fellow for Latin American Studies, so I have looked at some of these immigration issues, particularly the countries where at least some of these immigrants are coming from.
I have here with us an excellent panel—lots of expertise from different points of view. You all have their bios in your pockets so I will not go over them in detail, but I will just give you a heads-up of who's who up here.
We have Chad Sparber. He is the W. Bradford Wiley Chair in International Economics at Colgate University and, as you can guess from that title, he looks a lot at the economics of immigration here in the United States and perhaps elsewhere around the world as well.
Next I have Angela Banks. She is the Charles J. Merriam Distinguished Professor Law at the Sandra Day O'Connor College of Law at Arizona State University. She, obviously, looks at it from a legal perspective. And I just want to highlight she had a book that came out last year. It is titled Reimagining Civic Education in the Age of Mass Migration.
And then finally—last but not least—we have Alexandra Starr. She is one of our own. She is a senior editor here at Foreign Affairs of the Council on Foreign Relations, but she has had a long and illustrious career of twenty years of covering issues of immigration for all kinds of outlets, so has looked at these issues—like you all do— as a reporter on the ground in the U.S.
We will begin up here; we'll have a conversation for about half an hour, and then I'm going to open it up to all of you and to your questions. So, please, as we go along, think about what you would like to ask any and all of them that would help you in the work that you do when you leave here today after CFR.
So to start our conversation, I want to start—not surprisingly I guess—at the U.S. southern border because this has been a focus of U.S. politics, and I dare say will be an increasing focus as we get towards the midterms coming up in the fall. And there has been a sense—or at least a narrative that is out there that since Biden came into office over a year ago, the numbers of migrants that are crossing the U.S. southern border has been on the rise and has been at, you know, significant highs. And indeed, if you look at the February CBP numbers—the Customs and Border Patrol numbers—there were 160,000 what they call encounters with migrants at the border, which does seem like a high number.
But before we get all worried about that, I would like us first to turn to Alex, and Alex, could you put those numbers in a little bit of historical perspective? So are these trends—are we at all-time highs? Is this something that has been happening over time? And who is it that is showing up at the border today compared to perhaps in the past?
STARR: That's a big question.
O'NEIL: I know. (Laughter.) That's why I turned to you first. (Laughter.)
STARR: First, I want to say how thrilled I am to be in a room of working journalists. I know we are an endangered species these days, and I know the kind of hard work you guys put in under tough circumstances. And I'm thrilled to welcome you here. And I look forward to talking to you in greater detail at our breakout lunch.
So, to Shannon's question, why don't we just—I could start in the 1920s but—(laughs)—that's a long time ago. So let's go to, say, the 1970s and '80s when the Mexican economy was in a tailspin, and we saw more Mexicans coming across the border. A lot of that migration was circular; people would work seasonal jobs and then go back home. The border was patrolled extremely loosely, particularly compared to today.
By 1986, there were roughly, I believe, three million undocumented Mexicans living in the United States, and that was the last year we had comprehensive immigration reform. And that happened under President Ronald Reagan, and roughly 2.7 million migrants were able to become U.S. citizens.
I mean—(laughs)—it's funny to look at some of the talk around that legislation because the idea was somehow that solved the issue. I mean, it was paired with more patrolling along the border and, for the first time, there were theoretically penalties for employers who employed undocumented migrants for jobs. Of course, what ended up happening is, in the late 1990s, we had a big economic boom, and the numbers of particularly Mexican workers and, you know, people in the United States swelled. I believe by 2003, there were 11 million undocumented Mexicans in the United States.
Now, since then, the numbers decreased in the 2010s, in part because of demographic changes in Mexico. People were having fewer children, the economy was on the upswing. What we started to see is more migrants from Central American countries; in particular, El Salvador, Honduras, and Guatemala. That has not abated, and now that the Mexican economy is in a swoon again, we're seeing more single Mexican men coming over to the United States, and now we're seeing Cubans, Venezuelans, and Nicaraguans. All three of those countries have horrific leadership and—I mean, people are desperate to get out. And so we should not expect, under any circumstances, for those immigration flows to abate, irrespective of what the U.S. government does.
So, yeah, the numbers are high, and I believe they are going to increase.
O'NEIL: So you teased out there, if I'm right, some of the drivers of this, so talk a little bit about, if you would, what is driving either overall migration and/or from particular countries—if you would just lay that out for us.
STARR: Sure. Well, part of the issue was that after the border was—god, no, like there are parts of it that really look like a military state—migrants no longer do that circular route, right? They're stuck. And so, in a lot of cases then they've sent for their families to join them.
Also, once—I've seen this in the Honduran community, for example—once someone makes it here, right, and makes enough money to send money home, and then their cousin, or their younger brother, or their mother wants to come, they are in a position to take out a big enough loan to pay the smuggler who brought them over to make the trip. So having people here then creates more venues for broader parts of that community to join them. And you know as well as I, like, the situation in El Salvador is bad—(laughs)—and the situation in Honduras—I mean, it might—there's a new president in Honduras. Some people are a little bit optimistic, but things are not going to change overnight.
Guatemala—what's interesting to me in reporting on the Guatemalan community is people there are not so—in my experience, people there are not so nervous about being killed; it's that there is this enormous underclass in Guatemala that just—it's not uncommon for people to leave school in the second grade. You know, if they want any kind of future, they have to leave. And once they see people come to the United States and have a modicum of success, that is going to bring more—you know, encourage more people to make the trip themselves.
O'NEIL: Great. Angela, let me bring you in because, you know, as Alex was saying, we have the push of, you know, terrible economic conditions, no possibility there. We have the pull of the U.S. economy, which has been doing fairly well, as well as the communities here where they have someone to come to. But another issue that Alex touched on here is how desperate and also some other issues, you know—worried about their safety, about violence, about other issues.
So, you know, one other thing that we have seen, especially in the Central American community, but others, is coming not just for economic opportunity but also for asylum. Now I know you are an expert in this, and first I want to ask you, as I was looking at some of the numbers of asylum, as I read it, we have 1.5 million asylum cases pending in the United States. Does that seem like a reasonable number? And if not, why do we have so many pending?
BANKS: Right, so that's a great question, and part of it is just the significant backlog we have throughout our immigration system right now. Things are terribly backlogged across the board. And so one of the places where we see this very significantly is in asylum cases. And so, just as a quick backdrop—because I think one of the things that you mentioned that I think is really important is to think about the different reasons that people are migrating, and thinking about historically why do we have such high numbers in different categories. So just to back up—because one of things you mentioned was sort of the importance of the 1970s and seeing those numbers increase there—one of the really important things I think to think through is U.S. economic structure—and I'm sure you will take much more about this—but also then people fleeing, seeking protection and a better life. And so the United States for many years had something called the Bracero Program which was problematic in a lot of ways in terms of the way workers were treated, but it did provide a formal legal pathway for workers to come to the United States to do sort of low-wage work, particularly in the agricultural sector.
The 1965 immigration reforms were sort of heralded as getting rid of a lot of the sort of racial and ethnic barriers to immigration that existed within the U.S. immigration system, but one of the things that it did do was create numerical limitations on the number of people that could migrate from the Western Hemisphere. Pre-1965 we didn't have limits on Western Hemisphere migration. And also what happened was the Bracero Program ended, and there was no other temporary worker—robust temporary worker program implemented. And so what you saw was significant like—in effect, people who had been here working in the Bracero Program, all of a sudden when that law was passed, become unauthorized migrants in the United States because there is no longer a legal pathway for them to be here. And we just see that being exacerbated over time. So a lot of people who are looking to come for low-wage work that would provide a pathway for economic mobility for their families no longer exist.
Then we move to people who are just fleeing terrible situations. Their physical safety is in danger. And under asylum law, if you have a fear of being—a well-founded fear of persecution or past persecution on account of race, religion, political opinion, membership in a particular social group or nationality, you can seek asylum in the United States. And one of the major ways that you seek asylum is that your present yourself at the border, and you say, I'd like to seek asylum. You don't have to have a visa. You don't have to have gotten permission to enter the United States. It's perfectly lawful to just show up and say, I'd like to seek asylum.
What that means is that you get a lot of people coming to the border to say, I'd like to seek asylum, and then those cases have to be adjudicated. And there has just been a significant backlog in getting those cases adjudicated by immigration judges to determine whether or not the individuals who are seeking asylum qualify under that sort of legal definition of who gets asylum.
O'NEIL: Let me ask you, when I look at the immigration at the southern border the last four-plus years, many were seeking asylum, and you also saw an influx of children—not just adults—coming, too.
The other thing is when I look—at least the numbers coming from Central America, most of those cases are not successful.
BANKS: Yeah. Sure.
O'NEIL: So could you talk a little bit about why they aren't? Is it because actually they're coming for these economic reasons so they don't, you know, qualify, or is it—why are we not seeing successful cases? And is it different than, say, people seeking asylum from other places around the world?
BANKS: That's a really great question. So I sort of gave you the very broad definition of—experience persecution—well-founded fear of persecution or experienced past persecution. And the way the law thinks about persecution, it doesn't encompass every sort of terrible thing that people experience in the world. And so, for example, people who are—this is a—well, so, for example, if your home country was devastated as a result of a natural disaster, that is not going to give rise to meeting the definition of persecution. If you are a victim of generalized violence—so perhaps there is armed conflict at—well, sort of gang conflict, et cetera, and you have not been targeted because of your race, religion, nationality, membership in a particular social group, et cetera, then you are not going to qualify for asylum.
So part of the challenge is that a lot of the terrible conditions that people are fleeing, they are not sort of targeted victims on account of one of those five grounds, and therefore their asylum case may not be successful.
O'NEIL: So for instance, in El Salvador, place where there are gangs that rule various neighborhoods, it's a hard case to make because that is not the state supposedly; that is a gang.
BANKS: And that's another great point. So another piece of this is that it generally has to be—the persecution has to be attributed to the state, and in recent years we've had some new legal precedent clarifying what constitutes state action in this context and making it much harder for individuals who are victims of private violence—so domestic violence, gang violence—to be successful in their asylum claims. And so that is another reason why it is harder for those individuals to be successful in seeking asylum.
O'NEIL: Last question while we're just focused on this to sort of parse it out a bit—so Central America, since it's generalized violence or non-state violence, but severe—quite strong actors but not the state—would you expect—we're seeing for instance hundreds if not thousands of Ukrainians show up at the border just in the last few weeks. We have seen—as Alex was saying—Nicaraguans, Venezuelans, Cubans, Haitians. Where do you see, in terms of this seeking asylum, which ones—which groups would you—or nationalities would you expect to be more successful or not, and why?
BANKS: So what's interesting is that our asylum law grows out of World War II and sort of the idea of never again. And so it is a very sort of state-centric, wartime understanding of persecution. And so in many ways Ukraine fits that definition—or that idea of people fleeing. You know, they would be targeted because of their nationality, and so that fits much more tightly in our understanding of—or the legal definition of what would constitute asylum depending on what's happening. So, you know, for example, membership in a particular social group is a very vague concept—(laughs)—that has been defined by the courts and by immigration judges over the years, and so there are ways in which people have been able to use that category to find protection for individuals. For example, victims of domestic violence have been able to construct a particular social group that they are a member of and the state not being—providing protection or support for them, that being a viable claim for asylum.
And so I think, depending on what exactly is going on for the people who are fleeing in Cuba, and Venezuela, and other places, there might be ways that membership in a particular social group can be utilized to create successful pathways for asylum. But just in terms of our traditional sort of understanding, individuals fleeing the armed conflict in the Ukraine are sort of the classic examples of persecution.
O'NEIL: Great. Chad, let me turn to you, and let's talk about when these immigrants get here—whether they come through—(laughter)—asylum channels, whether they come seeking economic opportunity, whether they are here, you know, authorized or unauthorized—you know, with or without visas or green cards and the like. And so, you know, as I look out there, sort of three—I'm generalizing here—but sort of three narratives about immigration and the U.S. economy. And so one of those narratives is that immigrants steal jobs, right? Immigrant is bad for the U.S. economy and particularly bad for particular sectors and types of workers in the U.S. economy.
Another narrative is, well, you know, the MIT graduates, and the Elon Musks, and Sergey Brins of the world, that's OK if they come, but we don't want the gardeners or the, you know, people who work in the restaurants and the like—that that takes jobs, that there's sort of a difference in here. And then there is another argument that is out there that actually immigration benefits the economy broadly but also benefits the economy on a microeconomic level much more than it hurts.
So I guess one is, as you look at these different narratives, where do you fall out? (Laughter.) And give a little description why that is the case and the others are not right.
SPARBER: That's a good question. Briefly, the third—(laughter)—narrative is the one that I fall into, although I empathize with the other kind of perspectives.
I should maybe first say that one of the interesting differences between us on this panel is that as you focus on the immigrant experience, I focus on that much less and am really interested in how immigrants affect Americans and the American economy.
So let's start with that empathy bit. So if you know a little bit of Intro to Econ, you might have this understanding of the world where, like, OK, an immigrant comes in, they're going to work. That's an increase in supply. Whenever you see supply increase, the prices should come down somehow. That means immigrants come in, my wages are going to fall, right? And so that's kind of the thing that motivates a lot of anti-immigrant sentiment that people have, right? They don't want immigrants stealing their jobs or reducing their wage opportunities and that sort of thing. And I respect that.
The problem is I think that narrative is wrong; that effectively that Intro to Econ story is too simple for understanding these really complex labor markets. There are a lot of reasons for that. The one that I tend to focus on, I guess in layman's terms, is that immigrants do jobs that Americans don't want to do. You mentioned gardeners; fine. I would also mention economists—(laughter)—and so it's an important bit, though, because I should say that there's a—there are little bit of difference between whether we talk about workers with high school education or less versus markets where we're talking about workers that have some college experience or more. There are differences between those two markets but also similarities. And, in simple terms, we do have different—we specialize in different kinds of skills that then lead us to specialize in different kinds of jobs. And so when immigrants come into the country it kind of creates an opportunity for a native-born worker to respond by moving into maybe higher-paying jobs, managerial jobs, and that sort of thing.
So I don't want to drone on too much, so I should probably pause here and say what more—(laughter)—if anything would you like to know?
O'NEIL: So let me ask—let me ask you about one study that you had done—
SPARBER: OK.
O'NEIL: —and in this study, you know—we get the sense that, OK, you know, Americans generally speaking are in kind of the middle skill area.
O'NEIL: All right? And we get—we need the—you know, we need the economists, I guess—(laughter)—and the other—engineers and the like, and then we need, you know, those who will come in and, you know, do other things, and do the manual labor, you know, that many people don't aspire to or aspire that their children will do those jobs. But one of your studies you showed that those that come in with STEM qualifications or, you know, those engineers and others with those skills, that in the study that you looked at they not only didn't displace Americans with those skills, but they actually raised the wages of Americans—native-born Americans who had high school or less.
So explain a little bit about what your findings were and how that happened, right? Why would that happen?
SPARBER: So there are a lot of moving parts here, and the first thing, I think, to understand is just, as you kind of say, that when we're talking about highly educated immigrants, they have this comparative advantage or specialization in science, technology, engineering, and mathematics. There are a lot of reasons for that. Some of it is immigration policy—the ways that our laws are written—but some of it is like math is a universal language that goes across borders pretty well, OK?
Well, one of the important things about understanding our STEM workforce is that these are the people who are really responsible for advancing our technological frontier, for generating long-term productivity growth. We were joking aside, like Zoom—I don't really like it—(laughter)—but Zoom was really helpful in, you know, connecting with family during COVID, helping us work more than we otherwise would have been able to. Zoom was a technology that was invented by an immigrant here in the United States, right? And so these kind of, you know, technological discoveries or whatever, they have these wide ranging applications that benefit all of us; you know, a lot of positive spillovers if you like. So that's one way.
Other ways I would cite just briefly is that immigrants start a lot of businesses—kind of across the board—that hire lots and lots of workers. They also do a lot of local consumption, so there's like a multiplier effect there where one STEM immigrant moves in, you get 2.5 jobs that are created, and service industry things that, you know, support those workers. So that's, I guess, in a nutshell some of the ways in which, yeah, high-skilled immigrants coming in benefit everybody.
O'NEIL: Are there nuances to this that—you know, overall it's a benefit. Are there nuances here where there—I mean, is it all a positive-sum game? If you get immigrants that come in then everybody—all boats are lifted, or is there some nuance there to think about as well as you think about communities that may have a large number of immigrants or may be thinking about trying to attract immigrants or not?
SPARBER: So the nuance is exceptionally important, OK? So economists, we talk in generalities a lot, you know—it's typical behavior, OK. And so a story that I might tell is that, oh, immigrants at the low-education end have a comparative advantage in manual skills, labor skills, whatever. So suppose you are a native-born American construction worker, and an immigrant moves in. You might rationally respond to that by becoming a foreman or a construction manager, and that will pay a higher wage, and you really benefit from this, OK? This is the sort of, maybe, typical behavior that I might characterize as like, well, this is why immigration is good for the economy, OK? Well, what if you don't respond, right? What if—like you've been an American-born construction worker for the last thirty years, right? That person, when they say that immigration has hurt their labor market opportunities, they're not lying, right, like—and so there are these sort of distributional concerns that we should be worried about.
Now from a policy perspective, I don't think the right answer is, ah, therefore we should close our borders. I think the right policy thing is, well, if you're concerned about these distributional aspects you could redistribute some of the benefits from immigration from the winners to the losers, or what have you. But that nuance can be lost when we're getting "immigration is good," "immigration is bad." No, there are a lot of finer points, and I think it's important that we maintain empathy for those who have been adversely affected.
O'NEIL: Given that we're trying to build empathy—
O'NEIL: —I want to turn our conversation—before we open it up to broader questions—to a little bit about how one reports on this story, or what are the stories to tell and how would you go about telling it well. And so I want to start on the policy side, so I'm going to turn to you, Angela, and I think there is a consensus up here on the panel—I'm daring to guess—and perhaps a consensus in the room that the idea of a comprehensive immigration reform is dead—(laughter). Anyone who used to champion it a decade ago is gone from Congress or has changed their mind in terms of where they stand. And it is such an issue that it seems hard to imagine that we could—you know, it's hard to get a lot of—anything through our Congress, but this in particular seems like a third rail.
But that, to me, doesn't say that the immigration policy story is dead, and there may be other things that can be done, that will be done either by the president, by the executive branch, perhaps by Congress, perhaps by local governments.
So I want to turn to you, Angela. As you think about the policy space and the legal space, what is out there that's coming down the pike in the next months or couple of years that you are watching and that you think needs to be told?
BANKS: Yeah, so I think one—so Supreme Court—so thinking about not only did we get a historic confirmation for a new Supreme Court justice yesterday, immigration's on the docket this year. And so the Migration (sic; Migrant) Protection Protocols—the Supreme Court agreed to take cert on this case—I can't remember—maybe a month or so ago. And so this was really dealing with the process, the procedures that are going to be used for asylum seekers in the future.
So the Migration (sic; Migrant) Protection Protocol is a program that is implemented as a result of a provision within the Immigration and Nationality Act that allows the United States to say individuals who seek asylum by crossing the southern border or the northern border can be sent back to that country—so basically to Mexico—(laughs)—and wait there for their asylum case to be adjudicated. And the way this works is that the individual would sort of approach the border, say they are seeking asylum, be initially processed, then be returned to Mexico. And then they would be given a date on which they'd have a hearing before an immigration judge. They would then—Customs and Border Patrol would pick them up at a marked location, bring them into the United States for their hearing, and then return them back to Mexico.
There has been a lot of controversy around this program because of the experience that the migrants were having while in Mexico. Again, these are not Mexican citizens; these are individuals who are traveling generally through Central America to—so they, you know, don't have sort of family connections in Mexico. Communities were being developed that were then being targeted for violent crime, et cetera. The Biden administration terminated the program. Texas and—I'm blanking on the second state—sued to say that that was a violation of the administrative protection—so I won't get into the legal—(laughter)—the legal claims, but that it violated administrative law, and also violated the terms of the immigration statute. And so both the district court and the Fifth Circuit said that the Biden administration was wrong in the way that it terminated the program, and the Supreme Court is going to decide this.
So this really has implications for thinking about—as we see more individuals from the Ukraine and others are using the southern border as a way to enter the United States to seek asylum, what is that process going to look like? Are we going to require individuals to return to Mexico and wait in Mexico? Is that going to be part of the process? Is that going to be a disincentive for individuals or—et cetera. So I think that's one issue to keep an eye on.
Another is thinking about what sort of maybe smaller areas could we see immigration reform happen. So, you know, again, pathway to citizenship is very popular in the public for DACA recipients. Are there ways in which a pathway to citizenship will be offered or somehow something could be created, even through Congress, for smaller populations? So instead of the unauthorized migrant population as a whole, could something be crafted for DACA recipients? In light of the pandemic and extensive support for essential workers, and recognizing how many immigrants and particularly undocumented workers were essential workers, might there be appetite for a pathway to citizenship for essential workers?
Things like that I think are things to keep an eye on—sort of the smaller populations that there might be work for, and then also thinking about executive action as another pathway to provide protection—if not a pathway to citizenship, something like DACA that at least provides work authorization and/or protection from deportation.
O'NEIL: Chad, let me go to the economic side. As you think about—with this audience here, they want to tell the economic story. What are those stories that you think are the most interesting ones, or perhaps get this nuance that you were talking about? And how do you go about doing it? How would you go about doing it? Or when you study and you do the economics of it, how do you go about doing it?
SPARBER: I should be careful; I'm a little weird. (Laughter.) I love data! Personal human interest stories? Come on! (Laughter.)
So, OK, let me tell you some of the stories that are kind of exciting or interesting to me in ways that—it's the unintended consequences of policy that kind of go, oh, ha, I wouldn't have thought about that.
So I'll give you an example. So kind of in the Biden administration we had this Secure Communities policy that led to a lot of deportations of illegal immigrants, most of them—
O'NEIL: So explain the Secure Communities—for those who don't live in secure communities. (Laughter.)
SPARBER: Leave. (Laughs.)
BANKS: Well, I was going to say these are programs whereby the federal government partnered with state and local law enforcement officials so that individuals who essentially were getting processed by state and local officials, the federal government would be notified of that to be able to know if people's immigration—people who were unauthorized migrants were being caught up in the local law enforcement sector. So what happened was—some people refer to this as sort of low-hanging fruit—which was that unauthorized migrants were identified because of their interactions with local and state law enforcement, and then got deported when they were not significant threats to public safety or anything else.
O'NEIL: And just the opposite would have been sanctuary cities.
BANKS: Exactly.
O'NEIL: And that refused to share this information. So if you get stopped at a stop light, your information wouldn't be run.
SPARBER: And so this had some predicted effects, right, like it led to a lot of deportations. Even people who weren't arrested, a lot of them went home or left the labor market because—out of fear of being caught. These are all the intended effects of the policy. Whether you liked those effects or not, they were predictable.
The surprise—and this is—I'm citing evidence by East, and Velasquez, and Heinz (sp), and some others—I can give you that later maybe. (Laughter.) I've got to cite my sources. (Laughter.)
So, you know, these immigrants—they supplied a lot of services like household services, cleaning services, childcare, food services and so forth. And when they left and those services were less available, what did we see? Well, we found—or they—these other authors found that college-educated women with young—with young children—so Americans with children who are less than five years old—younger than five years old, they ended up leaving the labor force as well, right? And so this is an unintended consequence. Do you want your immigration policy to have this effect of making it more burdensome for women with young children to work? And presumably no, that's not something that we wanted when we passed this policy. So those kinds of things are interesting to me, you know, in telling a story to an audience that they might not have thought about otherwise.
O'NEIL: Let me ask you—I mean, right now we're seeing, you know, an incredibly tight labor market and lots of stories about, you know, not being able to find workers, you know, or wages going up in, you know, good ways in some places, unionization happening, there's a lot of, you know, worker power. Where does migration fit into this story or not fit into this story as you think about either why we got to the place we are or perhaps what happens afterward?
SPARBER: It's an excellent question. OK, so one thing—so I loved Alex's opening talk, and there is one little bit that I would clarify a little bit in that we've seen an upward trajectory of immigration—a lot of immigration flows—but COVID killed that, right? And so there's some evidence right now that the foreign-born working-age population in the United States right now is 2 million below where it would have been without COVID, OK, so that we're missing 2 million foreign workers in the working-age population that we otherwise would have had, OK? So that's a lot, and when you look at, say, like from an industry perspective on, you know, the industries that were very dependent upon foreign workers, a lot of those industries are the ones that are having a very difficult time finding employees right now, the ones that have a lot of job vacancies, so things like hospitality and food services as primary examples, and even with higher wages and so on and so forth. So—somehow I thought that was an answer to the question—(laughter)—you were asking. So like in this current environment—immigration and what our economy can absorb or cannot absorb, I think there is a lot of room for—you know, like if more immigrants were to come in, I think that we'd have a lot of workers there.
O'NEIL: Alex, let me go to you and—it's great to have the data, and we want to have the data, and that's important, but to translate that for non-economists you need—(laughter)—you need, stories, right? So how do—how do you find the stories? How do you—how do you report a story that brings an immigration issue to life?
STARR: I'm really interested in hearing everyone's—(laughs)—thoughts about that, but I'll just talk from my own personal perspective.
I have found—I just did a big story for Mother Jones about my alma mater, which is purported to be one of the most diverse high schools in the country. And there I followed three undocumented teenagers from Central America. The process of reporting that story—I don't know how much you guy report in schools, but you know there is this whole hierarchy and bureaucracy you have to negotiate. But I do find teachers—you know, people who have frontline experience with families and kids—to be super helpful, and obviously—like in New York there is a plethora of organizations—advocacy organizations. What I found—and very understandably—they will sort of cherry-pick stories for us—(laughs)—and I think some of these advocates are just extraordinary, and I try to just keep in touch with them.
And actually, probably the piece I've done that had the biggest impact ended up being about African teenagers who were trafficked to the United States to play basketball. And the reason I found about it is I was reporting on DACA, and I had worked with this organization, African Legal Services, in the city, and they were like, you know, this kid just came in the other day. He was in Mississippi for eight months and now he's homeless. And then it turned out this guy had brought in more than two thousand of these children to do this, and they were all over the country. So as you guys know, oftentimes it's establishing those connections to those groups.
But one thing I do want to say is I feel like this work is going to be so important in the months ahead. We are going to see more people at the border. We're going to hear lots of words like "tsunami," and "wave," and "crisis." I think it's really—the work journalists do to get people to understand that these are people at the end of the day and not just raw numbers is going to be so important, particularly as we enter the mid-term season. And I think the demagoguery we're going to see around this is going to be off the charts. So the extent to which we can get out there, and meet people, and tell their stories in an unvarnished way—I mean, I don't think we do anyone any favors—and look, I've been as guilty of this as anyone, like when I was at NPR I did a series of stories about DACA recipients, and I did a series on kids who were in medical school. They are phenomenal, but there are 128 of them nationally, right—(laughs)—like that is not—it's OK; not everyone has to be a superstar, you know. We're complex people, and I think the extent to which we tell these stories and show these people's humanity and, you know, the reasons that they are migrating—it is not always because someone put a gun to the head of their mother, you know. But, you know, sometimes, like, as I mentioned, the Guatemalan kids I spoke with—they're just desperate for an opportunity.
I think it's important to put those stories into the public sphere, and I'm really excited to see what you guys do in the months ahead.
O'NEIL: Well, that's a good segue to open it up to all of you. So I would like to ask for questions. We will do as we have done—and I think you did last night, and you did so this morning—I will point to you. I will ask you to name who you are and your affiliation, and then ask your question for the panelists.
So let me start right back there, sir.
Q: Hello, my name is Charles Robinson. I'm with Maryland Public Television.
I'm going to be little parochial because I am from Maryland, and we do have crabs—(laughter)—a lot of them, but they are very expensive these days. And one of the reasons why they are expensive is because of the H-B2 (sic; H-2B) visas. Last year, 66,000 of those visas were vetted. We got less than ten thousand of them. Now I'm not saying that the people who process these crabs aren't making money because they are making a whole lot of money because I know when I pay for crab at my local seafood place, it's like forty-two bucks a pint.
I want to know, first and foremost, is this a way to get—I know it's being exploited by a lot of employers. I also want to know—because most of these women who come to Maryland are from the Eastern Shore and are from Mexico. I know the same occurs in place like North Carolina, Florida, and other states around the country.
Are we usurping what the traditional path for migrant labor coming into the United States—are we exploiting it, and where are these visas going?
O'NEIL: Great, who wants to take that—sort of talk about these, you know, non-immigration visas, the sort of work visas that come. Do you want to—do you want to talk about the economic facts or the—
BANKS: The economics? No.
O'NEIL: And do you want to—or you—either way. You guys decide. (Laughter.)
SPARBER: I'd rather start with policy. (Laughter.)
BANKS: Well, I think one of the things you are highlighting—I mean, this is one of the most complicated aspects of immigration policy are temporary workers. There has not been a lot of appetite to sort of have significant temporary worker programs that employers feel are useful and productive. So one of the problems with the H-2A and H-2B programs is that employers feel that they are just cumbersome to utilize, and that the amount of—like when they know what their workforce needs are, the program is not flexible enough or respond quickly enough to get them the workers when they feel that they need them in a timely manner.
And so there just, I think, a lot of hesitancy to actually utilize the programs that exist, so your question about sort of where are the workers going, you know, that have been approved, part of the problem is that I think for some employers they just feel like by the time they get approved it's too late or, you know, their season for when they needed the workers has passed. And so this is one of the reasons why we see more unauthorized workers being hired to do that kind of work because of the—sort of the timeframe that they can get access to that work.
I think, you know, sort of the really negative history we had with the Bracero program is one of the challenges to a more robust temporary worker program, but also to the fact that there's just a narrative around the fact that that is really going to displace U.S. workers.
And so going back to sort of thinking about the stories that you can tell and how to think about reporting this, I think one of the really important factors is to talk about sort of how complicated—and I know this not easy—(laughs)—but short stories—but the fact of the matter is, as sort of you talk about is, it's just so much more complicated—I mean, the story that wages went down because immigrant workers were available doesn't also address the ways in which a lot of industries have undergone significant structural changes over the years, and that as a result of those structural changes, their margins for profit have been reduced. And where they feel they can make that up is in labor. And so then they are looking for where can we find lower labor costs. And so it's not just a matter of immigrant workers being available or unauthorized workers being available, but that the structures of the industry have shifted. And so when those stories aren't told or that aspect of the story isn't told, it's easy to just point the blame on the unauthorized workers.
SPARBER: Yeah, I get the—I get the different visa and status groups kind of mixed up. I know, kind of stereotypically, a lot of people will think about, like, agricultural work, seasonal work, and what visas are available for that, and then they forget that there are things like dairy where—that's not seasonal. Or they'll forget about hospitality, which is seasonal but non-agricultural. And I think a lot of the decrease in visa processing that we saw in the last year or two was COVID, I think, right? It was, you know, trying to—at least ostensibly about trying to prevent the spread of disease, but also continuation of the general anti-immigrant policy.
I guess—I guess maybe one of the central lessons that I do want to convey to you is that immigrants and natives don't compete against each other for jobs in a way that a lot of immigrant opponents fear, all right? The job that you are describing is not one in which there are very many—I assume—native-born workers working in it. And so if you prevent foreign-born workers from coming in and working there, people are going to notice, not in their wages but in the expenses of the products that they would like to buy.
O'NEIL: Question? We'll go right here.
Q: Hi. Karen Campbell, WTHR from Indianapolis, Indiana.
Like so many other news outlets, we're focused in what's happening in Russia and Ukraine, and in terms of our viewers, it seems that they are more accepting of people fleeing their homes in Ukraine, coming to Indianapolis, finding a better way of life—there are fundraisers, there's ways to help them—as opposed to focusing on any other nationality; say when we talk about those in Mexico wanting to come because they are fleeing their homes, too, for persecution, whatever.
How can we make viewers, listeners, readers understand that, in a sense, it is the same. But again, you get that pushback when we focus on the Mexico border. Where do you see the future of immigration going in terms of that, in terms of economics, how it's going to impact the U.S? I know you said it's going to continue for some time, it's going to grow, but when we focus on what's happening now with Ukraine versus any other nationality, why is there such, I guess, a disconnect with viewers when—
STARR: I want to take this one. (Laughter.)
O'NEIL: I was going to give it to you. (Laughter.)
STARR: Oh, good. That's an excellent question, right, and it's something that I've been hearing a lot in immigration circles. I don't know how—if many of you know of the group Define American, but they have a segment on their website where they talk about best practices for journalists covering immigration, which I thought was very smart and helpful.
Look, there's a lot of racism behind all this, let's be honest. I mean, no one's talking about the surge at the Polish border, right? And I think in some ways this has been a moment of reflection for a lot of journalists. The people who are fleeing Ukraine, a lot of them are middle class, and they're White, right? So I—the reasons I—we haven't talked about this so much—and who knows what's going to happen—but at this point it seems like the administration is going to attempt to lift Title 42.
And I do feel like you should be the one to— (laughter)—
BANKS: I should have mentioned that earlier, but yes—(laughs)—
STARR: But we don't—I mean, basically it was something on the books from 1949 that the Trump administration pulled out and said, ha, because of COVID, no one is coming; it's a public health crisis. There were exceptions made for unaccompanied migrants—sorry, teenage migrants, so that was—when I was following these families, insanely one of the Honduran families sent for their 13-year-old and their 8-year-old to join them because the grandmother had died, and they were alone, and they were without any kind of supervision. And I was like, oh, my god, they are going to get turned back. You are spending money you don't have to bring them over. And then in November of that year, the district court judge said, you've got to stop turning away underage kids. So by like some miracle these children came.
Anyway, Title 42, if it's lifted—apparently CPB, some of their forecasts are—at the high end, we could see half a million people at the border in a month. That's going to get a lot of attention. And so who knows what will happen. Again, this is not all set in stone, but this is where I think the role of journalists is going to be so important. Let's talk to those people and find out why they are coming, right? Let's explain what they went through to come over here.
I mean, one story that I don't think gets a lot of attention is—it's so sad, these people who sell their homes back in Central America to come and then get turned back. They are out $15,000 or, you know, they're in debt for—and no way of paying it back. You know, there are all kinds of—I think a lot of aspects of that migrant experience is shrouded in secrecy, and one way to cultivate more empathy or get people to sort of understand like all of these people are leaving for a reason—people don't just pick up and make that horrific journey just because they feel like it—can potentially engender more understanding for the—about the forces that drive them over and what these people need once they are here.
BANKS: And I'll just add quickly that Title—so they did lift Title 42, and part of what was interesting was that, as Ukrainians were starting to use the southern border to seek asylum, the secretary of Homeland Security issued a memo saying, oh, by the way, don't forget; you can make case-by-case analyses of each of the cases, so Ukrainians were getting through despite Title 42 whereas Central Americans—except for unaccompanied children—were not getting through. Now, mind you, there had been long-term advocacy to revoke Title 42 and so that eventually came to—the Biden administration finally did that.
But the other piece I would add to this idea about, you know, how do you more sort of universalize some of these stories is also thinking about—because AI think one of the differences is between the sort of perception of Ukrainians coming—you know, fleeing the Russian invasion—is also the sense of what is going to be the impact of a large number of Ukrainians in the United States versus what's the impact of a large number of Haitians in the United States.
So we all remember what was happening—I think it was in the fall—when the Haitian immigrants were—or Haitian migrants were at the southern border. I mean, we saw CPB on horseback with whips. That's not how the Ukrainian refugees are being received.
And so I don't—I think part of it is about this understanding of why people are coming, but I think the other part of it is what people think the impact of these populations in the United States are, you know. We have seen a lot of mobilizing around the idea of a minority country happening within the next twenty years, you know, and so what does it mean to see large numbers of migrants of color coming to the United States versus a number of White migrants coming to the United States. I think the concerns that people have about the shifting demographics in the United States can't be ignored here.
STARR: Can I—
O'NEIL: I was going to jump to you and say if five hundred thousand Ukrainians come or five hundred thousand Haitians come, what's the economic effect? What is the answer to that question?
SPARBER: (Laughs.)
O'NEIL: Or what would your speculation be? (Laughter.)
SPARBER: You know, so five hundred thousand is a huge number.
O'NEIL: It is; I'm throwing out a big number.
SPARBER: But I—you know, if you are unfamiliar with the Mariel Boatlift, I recommend that you read up on it. So the Mariel Boatlift—I think it was 1980—a wave of about 125,000 Cubans, largely less educated Cubans, basically arriving in Miami. And so like if you would think that immigrants take job opportunities from Americans, like that is where you would expect to see it. That is where you would expect to see the wage losses.
In 1990, David Card, who won the Nobel Prize this last October, you know, he had this very famous paper in 1990 saying, no, don't see it; don't see wage losses. And that's actually the beginning of economists starting to question whether these basic Intro to Econ models hold water and, you know, just an explosion of research. So, you know, if it's like the Mariel Boatlift, then, you know, maybe everything is OK.
But can I ask—(laughs)—I want to ask a clumsy legal question because this issue about the Haitian migrants came up, as you said, and one of the things that—part of the narrative of that Haitian event was, well, maybe these are not actually asylum seekers, refugees; that they are actually economic migrants because they had been displaced from Haiti into South American countries and had lived there for a year or two before migrating to the United States.
And I feel like—whether it's U.S. law or European law, there is some sort of principle of initial settlement or something; like, you fled violence. That's what we want from a humanitarian perspective. Anything beyond that is, oh, no, that's a different category. Am I full of it now, or is this part of the story we should actually—
BANKS: No, and so what's interesting is that there are certain—so the EU actually has sort—and I'm blanking on the name of the policy right now—but it's this idea that you have to seek asylum in the first country of safety that you reach.
AUDIENCE MEMBER: The Dublin agreement.
BANKS: I'm sorry? The Dublin agreement. And so the United States, actually under the Trump administration has similarly tried to implement a similar agreement with certain Central American countries. So the idea was that—and I'm—you know, so that individuals would essentially have to seek asylum in one of the Central American countries that would prevent them from continuing on to the United States to seek asylum in the United States. We also have a similar agreement with Canada, so certain individuals have to seek asylum in the United States; they cannot go through the United States and then seek asylum in Canada.
And so one of the challenges with these policies is whether or not that sort of first country of safety that you arrive in has a robust and effective asylum process because one of the concerns is that if you are in a country that doesn't have a robust legal system or a fair and accessible legal system, then your opportunity to effectively seek asylum is not very good. And so that is one of the concerns that has come up with like where do you have to seek asylum first.
And I think the question is less about whether or not people are successful asylum applicants, but how do we treat people who are saying that they are seeking asylum because we have a legal process to make the determination as to whether or not somebody is entitled to asylum. That decision, under our legal system, is not made by border patrol. They conduct a credible fear interview to see is somebody should then proceed into the asylum process or if they have no credible fear and so they should be returned. But that isn't what was happening. And so the question is why weren't the procedures followed that we have, and instead, why are we having people on horseback with whips—as opposed to just use the process we have.
O'NEIL: Great. All right, a lot of questions—(laughter)—the woman right here.
Q: Hi. Kate Redmond from KVNF Radio in Paonia, Colorado, which is in western Colorado where the temperature is rising at twice the rate of anywhere else in the United States.
Our economy would not run without H-2A guest workers, and the Hispanic Affairs Project is an advocacy program there that is advancing this work to go work with the consulate of the workers' country of origin to streamline the application process and ensure that exploitation doesn't happen at the point.
Why aren't we doing this more? We're a global society, and we have access to consulates and embassies in other countries.
O'NEIL: OK, why don't we work with other governments to ease this process, particularly in temporary workers? Any thoughts?
STARR: I do have a couple of thoughts. We just published a piece by Ana Raquel Minian at Foreign Affairs, which was excellent. She is a professor at Stanford.
And we do coordinate with governments, but often it's so that people don't arrive, right? So she has done a lot of—she is Mexican, and she has done a lot of research into—you've probably seen now, right, like the United States has more or less told Mexico just make sure Central Americans don't get here, OK? Do what you have to do. That apparently has a long history. They did that in the 1980s when there were all those civil wars in Central America, and apparently there are documents where Secretary of State Schulz tells them, we'll be nicer to your Mexicans; just make sure the Central Americans don't make it to the border, OK?
And Mexico—particularly Vepla (ph) had a vested interested in making sure that particularly working-age men made it across the border because—I mean, look, they have a lot—(laughs)—problems, and Shannon can go into the details of the problems of the Mexican economy, but it was in a free fall, and that is sort of an escape valve for the government, right. They're going to have to answer harder questions about how things are run if people can't feed themselves.
You know what's interesting, too—I have seen certain consulates, like the Honduran consulate—during COVID they were very active across the country, sometimes handing out free food, providing COVID tests. They—you know, their number one source of income is remittances. They want people to stay here and stay healthy. I know, it sounds so crass and awful, right—(laughs)—and it doesn't really speak to what you were talking about, but it's interesting to me, as a reporter, seeing how governments are active, but in a very self-interested way.
BANKS: And was just going to add that I think it depends on the community's perspective of these workers—
STARR: Yes.
BANKS: —so I think when there is broader understanding that these workers are valuable and necessary to the community, then there is going to be more willingness to find ways to make it work. And I don't think that's true across the country.
O'NEIL: Right. And let me go—right there in the middle, please. Yeah, go ahead—with the striped shirt.
Wait for a microphone and introduce yourself.
Q: Hi, hello. So my name is Jordan Cole (sp). I am a current graduate student at the Columbia University's journalism school, so I know we have in common in that aspect.
STARR: Hi. (Laughs.)
Q: And also, Liz Robbins—I spoke to her like very recently as well, so she—
STARR: Great!
Q: —yeah, so she—I'm also the president of the national Hispanic journalism group, so I'm half Colombian and half Dominican from Miami, worked at the Herald, was a breaking news reporter before coming here to Colombia.
But my question was pretty simple. I've—again, my experience has always been like short piece, like fast, like short-term type of writing, but it was interesting. Last semester I took Keith Gessen, so I did the long-form-piece magazine writing. But I encountered a source, right, and it was undocumented, born in Uganda, came here to the U.S. when he was three. He is now a medical researcher at Colombia. So he has—and again, there's a lot of gaps to fill, but my question is fairly simple.
It's like the approach. How, as a reporter—because there's a lot of discrepancies that come with these types of stories, and a lot of people—you know, there's not, like, a handbook, right, to like get it, often correct, but how do you take into account the leniency, and the sensitivity, and the relevance, you know—like what's happening?
I'm Hispanic, but I was born here, but I know, you know, like personally I can—I know communities and things like that, and I talk to them, and I interact with them. But as a reporter—and this could be to you specifically, but your—how do you approach it with sensitivity and—you know, like your story with Mother Jones, too—like I was reading a little bit about it, but, yeah, what was that like, and that process, and—yeah.
STARR: That's great question and I feel like we could all, like, have a group talk—(laughs)—right; that way, just go for the rest of the day.
Also, just so everyone knows, when he mentioned Liz Robbins, she is the director of outreach for journalists at Define American. And I think they do give talks in addition to the material that they have online, so it's worth checking them out.
She's great. She's a former reporter at the New York Times. She covered immigrants in the city.
So I think the short answer it's a—it requires a tremendous amount of patience. The extent to which I can embed in someone's life in a way that I'm making sacrifices for them versus them for me—so I give rides when I can. This poor kid in Northern Virginia—I mean, it was like a fifteen-minute ride to her place of work, and it would take her an hour and a half because she had to take two buses. Me giving her a ride? You know, it gave me fifteen, twenty minutes with her uninterrupted, and she was grateful for it. I would walk to and from homes with people.
It's also—in terms of letting people say what they need to say on their own timeline, right? That's something that I had to learn the hard way. When I first started out, I'm kind of like, let's get to it, right? (Laughs.) And no one wants to be treated that way, right? We don't like it if someone said, tell us about the worst experience of your life, you know, and I'm going to put on a tape recorder while you do it. A lot of it is—and then sussing out, right? This is such an overused metaphor, but dating a little bit, right? Like sometimes it's just not going to work. You know, the person is too traumatized, or they're being told by other people not to talk to you, and I always assume at least one person will drop out. And invariably that will happen. And at first I would find it just, like—(laughs)—it felt like being dumped a little bit, right? (Laughing.) You're like we spent so much time together, how can—
But I will say when you—I know—(laughs)—but I will say that, in the grander scope of things—I've been doing this for a long time—all of that time becomes meaningful because it provide context that you bring to your stories, right? And, yeah, I think those are the major things I would say, and I'm happy to talk with you separately. And I'm thrilled you are at Columbia, and Keith is an incredible writer; you know, soak up every minute of it because opportunities like that don't come along often.
O'NEIL: Right here in the front.
Q: Thank you. David Martin Davies, Texas Public Radio.
So I have spent a lot of time on the southern border—like decades—and everything we're hearing about the—it's a war zone, it's a crisis, this is a danger to America, how do we, as reporters try to put that in context and bring down the temperature of the rhetoric where, I mean, that is not actually what is happening, but we have politicians who say that over and over again? Fox News showing the pictures, and that's what the rest of America believes, but that's not the reality.
STARR: I think it—look, you—god, you are really—(laughter)—you are in that zone, right? I think there your work is so important, right? It's talking to these people about the journey that they've made, the hopes they have; also, oftentimes the communities that they have waiting for them, right? It's pretty rare, particularly—I've focused a lot on undocumented minors—for them just to cross the border with no connections here. And giving people a sense of like—this is a perennial story that is incredibly sad; like, these are kids who have been separated from their parents for like a decade or more in a lot of cases—like, what is that like?
I think the extent to which we put a human face on numbers, and we should be careful—to the extent to which editors will let us—be careful in using words like surge and tsunami—
Q: Invasion.
STARR: Invasion, right? We could go on and on.
There I think like the work of journalists in telling stories is going to be so incredibly important. I look forward to looking at your stuff.
BANKS: And I might just add I think the other piece of it that's really important is highlighting the stories of these border communities over time, so the idea that, you know, the people who have been living in this space and who theoretically should be worried about the invasion, that they have a different perspective.
And you know, I have so many students in my class who are from border towns, and they talk about that, you know, sort of the way it gets talked about, they're like that just wasn't my experience. That's not how I—that's not how I lived, what my life was like in a border town, and talking about the fluidity and, you know, the ways in which that this is—you know, has been a way of life for generations, and that it is not scary. And to the extent that people get those stories, it's something to at least counterbalance the, you know, invasion stories.
O'NEIL: I just want to add one thing—break my rules as moderator. I totally agree with that, and I actually think the stories—when I have gone down to the border and border towns, and spoken there, you know, the fact that Main Street is full of stores and not empty; the fact that tax bases are up because people are out shopping—like who are the owners of that store, of the florist, of the deli, other places, and what are their stories, and how do they make that community much more rich, right? The good side of immigration I think sometimes doesn't get told, especially—you know, those that are reporting on Texas but not from Texas.
SPARBER: And so I just like to look at the border in two different ways; I mean, it's where two countries are set apart, but it's also where two different countries come together. And if we can, not focus on the conflict, but on the shared stories.
O'NEIL: Yeah, exactly.
Next question—we go right here in front.
Q: I'm Bryan Horwath with the Las Vegas Sun newspaper.
So I think what the missing link is here—and I'd—you know, whoever wants to comment on this; I guess maybe it's more for Alexandra—but I'm sorry to say that there's millions of people in this country who aren't ever going to read anything in Mother Jones. (Laughter.) They're not ever going to read anything in the New York Times.
STARR: Right.
Q: And I don't know what the answer is there. So you're talking about humanizing people and being able to present stories. There is a huge part of the population that immediately is going to shut that out. How do we—how does anybody reach those people? That's a huge population.
SPARBER: I don't know—can I—(laughs)—
O'NEIL: Yeah, no, no—(laughter)—
SPARBER: (Laughs)—I wanted to talk but now I'm—(laughter)—all right. So, you know, we talk about political divides in the country, right, and I think that when a lot of people who want immigration reform are doing so from, say, a social justice perspective, or diversity, equity, inclusion perspective, that those are terms that don't fly with the median voter that you need to get on your side, right?
And so—you know, I think citing the stories that we've talked about here—you know, cracked crabs in Maryland or, you know, the economic activity in Paonia—I mean, these are stories that I think appeal to centrists, center-right people who can kind of relate to like, yeah, you know, like, these people are helping me get what I want, right? I mean, voters—insofar that voters are self-interested, that story is really, really important. And so I guess I would say go for that angle.
BANKS: And I know the report will have more to say on this, but I just want to add to the recognizing—even though they may not pick up a story in Mother Jones, to your point, the public is not as anti-immigrant, I think, as sometimes we are told because when different policies are sort of tested and there are surveys, there's often much broader support than you might here if you listen to Fox News.
And so I guess I would also just say that group of people who are just sort of the heck no, never, is much smaller than we actually, I think, sometimes think. And so there is a broader group of people who are open. And to your point, like the stories that are open—that there is—there is space for people who are sort of in the middle and unsure, even though there are a group of people who may never want to support any of this and will never see immigrants as human. But they are small—they are not the majority.
O'NEIL: I wonder if your stories are somewhere the place to start because as you find in your research economically, it's a pretty good deal in a lot of different categories, and so maybe that's sometimes the place to start because it has come down to the pocketbook.
SPARBER: It is, and when I talk to like kind of regular non-academic folks like about, oh, immigration's good, you know, what are their hang-ups. Well, you know, they'll cite the Reagan amnesty and they say, we were promised amnesty once and never again, right? And so, you know, for that person, a pathway to citizenship—excluding DACA—that's off the table. Are you willing to compromise, right? And so yeah, I mean, I think that there are areas where compromise is possible, and areas where, yeah, it's still going to be divisive.
O'NEIL: Time for one more question. Let me go right here—with the mask, please.
Q: Hi, I'm Sheri McWhirter. I write for MLive in Michigan.
And this question is a little more economic rather than the personal stories of immigration. We hear a lot about inflation lately. It's off the charts. What would inflation be like if we had those 2 million workers that aren't here because of COVID; if we had the workers here who hadn't been turned away because of government programs? What might it look like now for the everyday person in America going to the grocery store dealing with inflation?
SPARBER: There's a paper—maybe it's about a decade old—by Patricia Cortes where she looks at what happens to the prices of goods and services that are predominantly provided by immigrants. And so we've said—I've mentioned before, like childcare, health care—or maybe I didn't say health care—(laughs)—but childcare, food service, construction work, and that sort of thing, and that, yeah, immigration that flows into those sectors reduce prices of those goods and services. So, at least in certain sectors, yes, if we had the 2 million more immigrants that were missing, I think that you would see less price pressure in those sectors.
Q: Thanks. (Off mic.) (Laughter.)
SPARBER: Very well could. I don't think gas prices are going to be affected by—(laughter)—otherwise, yeah.
O'NEIL: But our crab would be less. (Laughter.)
SPARBER: But our crab would be cheaper, yes.
O'NEIL: OK, for our next trip to Maryland.
We have come to the end of our time. We now have a break for about a half an hour but will be back here for table topics at 1:00 p.m.
And I would imagine—I know I didn't get to all of the questions, there were a lot of hands—but I imagine people here would be happy to take those questions one on one.
But for now, please join me in thanking the panel. (Applause.)
Public Health Communication
Speakers Thomas J. Bollyky, Leana S. Wen, Farah Yousry
Presider Carla Anne Robbins
ROBBINS: Thank you so much, Irina. And just want to establish that Irina and the extraordinary local journalists people do all of the work for the—I just—I just do the crash research, and it's wonderful to see so many people from the webinars and actually get to see you guys. And this has been a great conference, so thank you so much.
So this is the final meeting of the day, and the other seminars have been so great. But the bar is really high so I'm feeling very nervous. But this one is on public health communication, and you all have the bios for our experts hero so and they are extraordinary, but I'm just going to go through it really, really fast.
We have on Zoom with us Dr. Leana Wen, who's an emergency physician and professor of health policy management at George Washington University Milken Institute, and she writes a column in the Washington Post. If you don't read it, I recommend it.
And then we have Professor Tom Bollyky, who is the director of the Global Health Program and senior fellow for global health economics and development here at CFR and he's also an adjunct professor of law at Georgetown, and he—is it ThinkGlobalHealth? Which is very recommended.
And Farah Yousry, who is our colleague as a reporter. She's a health equity reporter for NPR member station WFYI and Side Effects Public Health Media—Public Media. She's a health reporting collaborative of local NPR stations across the Midwest. She previously worked with the BBC World Service and as a journalist in Egypt during the Arab Spring.
So welcome, everybody. So you guys know the drill here. We're going to talk up here for a while and then we're going to throw it open to you guys.
So, Dr. Wen, can I call you Leana? Is that OK?
WEN: Absolutely—
ROBBINS: Let's start with you.
WEN: —since I'm not there in person with you, which I'm very sorry that I'm not. But yes, absolutely.
ROBBINS: OK. Well, we really appreciate your being with us. So I've—you know, I've covered wars. I'm a reasonably courageous person, not overwhelmingly courageous. I got into this room last night and I didn't have a mask on and I was a little nervous.
Can we start out where are we in the pandemic in the U.S. and where do you think we're headed in the coming months? Tom had a mask on when he was walking in here and he took it off. Are you nervous? Where are we going in this?
And I just saw in the Times this morning, they said there was a spike in Washington and New York. So can you just start with a little level setting? Tell us where we are and where you think we're going.
WEN: Sure. I'd be happy to do that, and I also wanted to preface everything by saying that I suspect that there will be people, potentially, our other panelists that—also probably some of you will quite strongly disagree with what I'm about to say. And so—and I mean this for my comments to be the beginning—the opening salvo of our conversation. I would love to have a discussion about that, and the reason I put it out there is right now there are—if you talk to ten different public health experts you're going to get very different answers about where we are in the pandemic.
That's very different from—think back to 2020. Virtually all of us in medicine and public health were saying one thing, and it was like that throughout most of 2021 where we were really emphasizing, for example, the importance of vaccination.
Now, in 2022, I think there's a lot of disagreement over exactly this great question, this level-setting question that you're asking, and the reason is this. I think we can objectively look at the numbers, right. We can look at the numbers and say that we have a lower number of cases that we've had, basically, throughout the entire pandemic.
We're experiencing a clear lull when it comes to hospitalizations. Our case numbers are also low. They may be artificially low, sure, because people are doing home tests. Not everything is being reported. But, at the same time, they were artificially low throughout other parts of the pandemic when we didn't have sufficient testing, too.
I am hopeful that because of the combination of vaccination as well as the fact that about 50 percent of Americans are estimated to have gotten Omicron during the last wave, that that together makes it such that we have enough immunity that we're able to successfully decouple infections from hospitalizations.
So when I look at the numbers, yes, it is true that we're seeing an uptick in cases in New York City. In D.C., the cases are doubling. Probably we're going to see an upsurge in the days and weeks to come. But I'm hopeful that our hospitals are not going to become overwhelmed as they were before because of the combination of immunity and vaccination.
Where we are, and you hadn't mentioned this about the events that were occurring, the outbreak that seems to have been associated with the Gridiron dinner as an example from last weekend, I just wrote a Post op-ed yesterday about how that's our new normal, and just because we see potential super spreader events doesn't mean that they should be canceled and I believe that's the case because we have tools in a way that we did not two years ago or even one year ago.
Vaccines and boosters protect you very well against severe disease. High-quality masking, even one-way masks, can protect you well. Rapid same-day testing, if you wanted additional level of protection, can help do that, and, of course, we also have many more treatments that we did before.
So all of that together make it such that, I believe, we should let individuals choose as to what level of risk they want to take. I think it's equally reasonable for somebody to say, I want to still be cautious. I want to mask in all indoor events and not go to crowded indoor settings where—you know, where masks are not required.
I think it's equally reasonable for somebody else to say, I'm fine with all aspects of pre-pandemic normal. I'm going to travel. I'm going to go to restaurants. I'm going to go to indoor gyms. I'm not going to worry about COVID anymore. I think both are equally reasonable.
That's why I'm more optimistic about the pandemic than I had been at any moment prior, although I'm certain that others might disagree.
ROBBINS: So can the physician heal thyself? If you were here with us, would you be wearing a mask?
WEN: No, I would not, and, in fact, I was in New York City last week attending an event that did not have required vaccination or testing. and it was over two hundred people and I did not have a mask on the entire time.
ROBBINS: Interesting.
So, Tom, you were wearing a mask when you walked up here so you are from a slightly different take on this. So just wanted to ask you about that very quickly, and then I did want to turn to the international, if you can give us a level set on where we are internationally, because I suspect it's very different from what Leana was talking about domestically.
BOLLYKY: Great. So you want me to do both, taking them?
ROBBINS: Yeah.
BOLLYKY: All right. Well, let's start with the—Leana's point. I agree with the fundamentals. The pandemic has shifted quite some time ago in this country where we moved from an environment where it was—there were people seriously talking about the possibility of achieving herd immunity and preventing people from, effectively, ever getting infected.
That moment, if it ever existed, has passed a long time ago. We are really trying at this point to delay infection and to reduce severe outcomes. That's been true for some time. The question is what steps do we need to do to undertake that and is it data driven.
So in terms of delaying, it is just what Leana suggested. We are trying to delay infection to the point where people have adequate access to tools to avoid severe outcomes from that. I think the challenge that we have now is we still have relatively large pockets of people that aren't vaccinated.
For myself, I do—if I'm in a crowded public place and near other people I do wear a mask currently. I have a(n) unvaccinated child and that is, really, for me, the driving factor of trying to delay infection for that child, even though statistically on a population basis the risk for a(n) almost 5-year-old are still low. The costs of me wearing a mask in a crowded place is nothing, and from that standpoint I don't view it as a great cost.
I do think it is, to some degree, an individual choice, which has been true in the pandemic of what your risk budget is and where you're going to spend it in terms of protecting yourselves. I do think there are still people getting—having severe outcomes from the pandemic because they're immuno-compromised and we need to make sure we're doing what we can to protect those people.
What I think is less certain—and this is the last thing I'll say on the domestic side—is what our ability is to ratchet up and ratchet down protections because I think what most people have suggested is that this is—we should do what Denmark has done, ultimately, and look at potential indicators as a way of moving up and down the scale of nonpharmaceutical interventions to protect ourselves.
I'm not sure we have that opportunity in the U.S. Going around New York last night, people are pretty done. Other than people working in settings, I saw no one wearing a mask anywhere and I'm not sure there's any coming back from that no matter what happens in this current surge. So I do worry a little bit about where we might be going.
Let's talk on the global side. Global side, we are in a situation where the pandemic has shifted dramatically and policy is not keeping up. I'm going to mention three indicators of that.
First, on global vaccination, the target that is still motivating all our international action is that every country should vaccinate 70 percent of its population. We just did a paper in Nature that came out maybe a week ago that did an updated estimate. Nearly a hundred countries are going to miss that target. That's four out of five countries on the African continent. Most countries in Central America, the Middle East, seventeen high income countries will also miss that target.
For low income countries and countries in Africa, only 14 percent of the population—this is true for both of those groups—only 14 percent of the population has received a single vaccination. So we're not close to this—to that target at all.
However, the goals of vaccination or the public health goals have shifted a bit. As I suggested before when we were talking about the domestic context, we're not likely to achieve herd immunity or protection from high population coverage from vaccination alone.
This is really about preventing severe outcomes, which means we should be really prioritizing fully vaccinating the most vulnerable, and we're not seeing the investments to make that happen.
All right. So that's the first thing I would mention where we have a shift in the global situation. The goals haven't kept up.
The second is on funding. Donor governments, like the United States, are still talking about prioritizing international response to the pandemic. In terms of what we're seeing in terms of funding and action, that has not been true for a while.
So USAID requested 19 billion (dollars) to pursue global vaccination to help this targeting of most vulnerable populations. The White House, ultimately, requested 5 billion (dollars) from Congress. Congress, as you probably—most of you know, recently appropriated nothing for the global intervention. The U.S. still has its target donating 1.2 billion vaccines globally. We've only delivered on about 40 percent of that and about half of those doses have just gone to five countries and not the countries that are the least vaccinated. So they've gotten to Bangladesh, Pakistan, Indonesia, the Philippines, and Vietnam, countries, in many cases, that are actually fairly highly vaccinated but have some broader strategic benefits to the U.S.
We're not alone. Europe has also only delivered around—European Union has also delivered on, roughly, only 40 percent of its promises of vaccine donations, China about 14 percent.
So you're seeing that shift, and for a lot of recipient countries they are turning away donations at this point because there's no money attached to deliver them. So they need to do what we did in this country, which is mobilize a big global effort to try to get the vaccinations in a place where they're convenient for people to access and they're not seeing any of that funding. So that has really restricted it.
Last thing where you're seeing this disconnect between policy and the underlying situation is China. The big story moving forward, of course, is we're starting to see a rapid increase of cases in China. Shanghai, on Friday, reported the highest case count in a single day, twenty-one thousand that they've had so far. They're still only reporting five deaths per day.
That's implausible in terms of what's happening in this situation, but the projections that you're seeing for China is that by July we could see a wave where they're having three times the number of deaths, as India experienced in its Delta wave so as many as six hundred thousand per month.
That's, in part, because when you look at age, what—the limited data that is out there on age-specific vaccination rates, China has a very similar problem as Hong Kong territory itself had, which is you see under vaccination in older populations. One estimate came out in February that estimated 18 million people eighty and older in China had yet to be vaccinated at that point.
They also had vaccines that are less protective than the ones they use here. They're trying to increase access to mRNA vaccines, which are more effective, but that has been slow.
We are not seeing either from the government itself or from the international response people getting ready for what's coming in China in terms of a potential wave and that's a concern, I would say, as well. And I'll stop there.
ROBBINS: That's great. Thank you.
So, Farah, so I've always learned so much from the questions I've asked when I'm out interviewing people, and I'm jealous of you because you get to go out and talk to people.
YOUSRY: Best part of the job.
ROBBINS: It's a great part of the job. So what are people asking you right now about the pandemic?
YOUSRY: Yeah. So most of the questions we have been receiving throughout the pandemic have been about, you know, where can I find certain resources—early on in the pandemic—you know, what's the guidance because, you know, there's been mixed messages throughout the pandemic about so many things, you know, including vaccinations, you know, how can we stay safe, how can we keep our kids safe, do we keep schools open, you know, keep them open, and so on.
So many questions revolved around, you know, clarifying, what are the, you know, current rules, what do we—who do we follow, what do we do, you know, where can we get our vaccines, where—right now, where can we get our treatments.
So we know there are antiviral treatments or antivirals, but not everyone knows about—you know, about their existence. In fact, during our editorial meeting, we were speaking amongst each other and some of the editors had no idea that, you know, those antivirals and how they work, you know, the fact that they're free and they're available, you know, in many big hospitals as well as pharmacies, and so people don't know how to get those treatments.
And the result of that that we're seeing, you know, less than 2 percent of the stock that we have of those oral antivirals, which have been, you know, shown to be effective—Paxlovid, for instance, cuts the risk of death or hospitalization by as much as 89 percent—and so we've seen less than 2 percent of the stock that's available right now being used. The rest of it is sitting on shelves.
You know, I spoke with a federally qualified health center in Indiana. It was the only health center serving underserved communities, you know, uninsured and so on, and they were the only center that got the treatments and they used less than 25 percent of it.
So, clearly, there's a mismatch between, you know, the resources available and the communication we're putting out there making people aware of—you know, of these things and how can they get them and what are the steps?
And so, like, looking back at the stories that have done well, they were mainly about explainers, you know, assistance to, like, where to get certain resources and so on. So yeah, I mean, these are the same things people are asking us about so far.
ROBBINS: And how much of that has to do with just lack of access and information and how much of it has to do with mistrust in information?
YOUSRY: Oh, yeah. Absolutely. I mean, mistrust is one thing. It's also—you know, barriers to access is another big issue. You know, we've seen that there is a disparity in terms of, you know, who is able to get those treatments and who is not, and that's been a big problem.
You know, there's studies on monoclonal antibodies, for example, that have been available for a while now. A CDC study found that Black and brown communities were way less likely to get those treatments, which are outpatient treatments given to people, you know, who are not severely sick, who don't have to be hospitalized.
But then when the same study looked at patients who are hospitalized—so they're severely sick, they had to be in the hospital—they found that there was almost no racial disparity, which goes to show you that some communities do not seek care except when they're extremely sick. They have to go to the hospital and so then they get the treatment they need. And so, again, we're not doing enough to reach these communities to inspire trust, to inform them and to, you know, facilitate, like, the problems or the barriers that are keeping them from getting those vaccines.
And, you know, also state health departments have a big role and that's where local journalists, you know, come in play. So I asked several state health departments across the Midwest whether they are tracking who is getting those treatments and who is not, and states like Indiana, Ohio, said they have no idea who is getting those treatments and who is not because they're not asking providers to report such information, whether by demographic or race, ethnicity information. And so if we don't know where the gaps are, how are we going to solve them, you know?
ROBBINS: Just really quickly. I mean, are they not asking that because they're just not asking it or are they saying, well, for HIPAA reasons we can't ask these questions or—
YOUSRY: Oh, no. No. Yeah. No, I mean, they're not requiring them to ask. So the federal government provides states with those treatments, OK, and then leaves it up to each state to allocate those treatments in whatever way they see fit.
ROBBINS: So no one's checking up on their—on whether or not they're living up to some sort of equity standard or something?
YOUSRY: Yeah. I mean, the federal government said that 15 percent of the entire stock of treatments that they have of Paxlovid, for instance, will go to federally qualified health centers, which are the centers that, you know, serve uninsured people, low income people, and so on.
The rest of it—the 85 percent—are left up to the states how to distribute them. But then the federal government doesn't require states to report, you know, who's getting them, and then the state, in turn, is not requiring, you know, pharmacies or hospitals to report such information. And so there are gaps and I think local journalists need to ask, like, OK, how do we know that we are centering equity in the process, especially when the supplies are still so limited, you know? So they're limited but there's also courses of the drug sitting on the shelf. So it's, like—you know?
ROBBINS: So, Leana, certainly, there are particular communities that are more mistrustful of the medical system. But in my experience, just from what I read and just from talking to people, there's just a general mistrust that exists of—from beginning to end of the system of the government and how it's managed COVID, and part of it, I suppose, began with the Trump administration and mistrust.
I mean, everyone used to think of the CDC as, like, Caesar's wife. You know, they were the most trusted of institutions out there. When I would write about cyber I would say, well, we need a cyber CDC out there, some institution that everybody trusted. But you can't even use that image anymore for the CDC because no one seems to trust the CDC.
How much of this is just because we have an unreasonable expectation for science and we expected everyone to know everything about the virus and how much of it is that they blew the communication strategy, and how much of it can they get back now if they just had a better communication strategy?
WEN: It's a great question. I don't know the answer, right. I mean, I don't know how much because it's difficult to look back in hindsight. But I'll name some of the things that I think went wrong and things that, as you were saying, looking forward, how could we do better.
First is—and I'll name three things. But in my—I always think in threes, but then I end up maybe having a fourth. So bear with me for a moment.
The first is communicating change. We always said, look, this is a pandemic. Things are quickly evolving. But I think there has been this really unfortunate narrative that's come up from all sides of the political spectrum that somehow change means that you're flip flopping when actually if something has changed—let's say the scientific guidance has changed or circumstances have changed—then you would expect that your guidance would change as well.
I mean, I'm a physician and so I think about this for—in a clinical analogy, right. If a patient is getting cancer treatment and a new chemotherapy drug came out, you would hope that your doctor would tell you about it. That's not—you're not flip flopping. Your doctor is not flip flopping. They're communicating a change in science.
Or what if your cancer responded really well to this treatment and unexpectedly well or unexpectedly poorly? You would expect that then the guidance for what you do next should change.
And so I think keeping—communicating that things have changed. I mean, I was kind of surprised that there were liberal commentators and conservative commentators alike yesterday talking about the Gridiron Club outbreak and saying, well, how come, you know, when—how come nobody's jumping on this the way that they jumped on the Rose Garden ceremony that was this big super spreader event, you remember, back during the Trump administration.
The reason is it was a timing issue. The Rose Garden ceremony happened September 26th, 2020, before we had vaccines. The Gridiron event happened last week when we have widely available vaccines, lots of treatments, even if they may not be as accessible.
Still, we have a lot more tools than we did September of 2020. So we cannot—you know, we all have to do a better job of putting things to context by talking about change over time. That's the first.
Second is I think lack of transparency about the rationale. Look at the CDC's change in isolation guidance back in December. I think a lot of people were very confused when they said it was because we have new science. But their science showed that after five days, 31 percent of people were still infectious, were still testing positive.
And so if your reason for changing the guidance from ten days to five days of isolation is the science has changed, people would be, like, but I don't understand. Are you saying it's OK when 31 percent of people are still testing positive and are actively infectious, versus—and I don't know that this is the real reason but I have heard—I'm sure you've heard, too—that one of the reasons driving the CDC's changing guidance at that time was lack of health care workers, facing a critical shortage of people just because people were—everybody was getting sick from Omicron. If they had said instead, we can't sustain our critical infrastructure, we don't have enough food service workers, we don't have enough, you know, flight attendants, we don't have enough nurses. That's why we're changing the isolation guidelines from ten days to five days and then after five days you could go to work but with a mask—if they had said the real reason—and, again, I don't know that this is the real reason but if they had explained the rationale as a practical matter versus a scientific—it's because the science has changed—I think that that could have helped a lot when it comes to actually building trust.
And then the third thing that I'll say here, too, is I think there is a real problem with scientists, including CDC and others, not accepting nuance, that two things can be true at once. It is true that masks reduce the risk of transmission of virus. But it can also be true that masks, especially for younger children and children with disabilities, may have some harm, especially masks in perpetuity.
I mean, I think we can—let's be intellectually honest and say that two things can be true, or it can both be true that there is natural immunity, right. You do have some level of immunity after recovery from infection and also true that vaccines, in addition to having COVID, will give you an even better level of immunity. Don't deny one and say—and try to make it clear cut when actually it's both.
You know, when we don't have acknowledgement of natural immunity, a lot of people who understand that it's real—it's a real thing—will say, well, I don't trust anything else that you say because you're not giving truthful advice here.
And so I think that we need to be a lot more nuanced in our guidance and be honest that things are complicated and that it's OK for us to acknowledge that complexity.
ROBBINS: So you're—and I just want to do this quickly because I want to go back to Tom and to Farah—but that's just—everything you said is so fabulous but it's—you can direct this at officials, you can direct this at politicians, but you can also direct this to us as writers, and you're a writer as well as being a doctor.
I mean, how do you—and complexity is a hard thing for politicians and it's also a hard thing for writers. I mean, how do you write nuance into a news story like that? How do you say when—particularly, when political leaders aren't doing it, rather than it being a gotcha story that says they're not being nuanced for us, and because so many of these things need explanation?
WEN: I mean, I would answer this and say that it's particularly true at this point in the pandemic. Earlier on—for example, should people get vaccinated in the first place? I don't actually think that there's much nuance there. I mean, there is—you should get vaccinated.
I mean, the evidence is so straightforward. Or very early on in the pandemic should we do masking and social distancing? Yes, because we want to flatten the curve, avoid our hospitals from getting crushed. We don't know much about the virus. We have no other tools at our disposal, right. There wasn't much nuance there.
But right now, for example, the question about second boosters, there's a lot of nuance. Not everybody needs a second booster, and I think we need to be honest about how much we know and how much we don't know. And I think it's—and also there's a lot of disagreement now about should restrictions remain, should people go back to normal, should they not.
I think there are—now that the medical and public health establishment is very much divided on these questions, you'll be able to find experts from all sides of this and I think it's important to highlight all their voices.
ROBBINS: Great. Thank you.
YOUSRY: And I want to add also, you know, because the pandemic has been this moment of time where everyone's going through the same thing all over the world and so there's been an influx of, you know, research and studies coming from all across the globe, you know, and some of that are preprint study. So they're nonpeer-reviewed studies, and then those studies, you know, show up online. They show up on, like, your news feed, your grandma's WhatsApp group and, you know, or your uncle's TikTok and so on.
And then, you know, some groups like those who are opposed to vaccines, for example, use these and interpret them and misinterpret them and, you know, have all of these messages that then sow mistrust in the—you know, the guidance of the CDC. And, you know, like, this—journalists are caught in the crossfire. You know, we report on the studies and then people blame us for, you know, changing, like, whatever—like, the true science.
And so the problem when—you know, like Dr. Wen was saying, science is contentious by nature. You know, it's all about questioning, and then when a preprint study is out there and there are, you know, problems with the data, then it's either retracted, removed, or corrected. But then people see it in two—one of two ways.
Either they say, yeah, the scientific process is working, peer review is working, data is being filtered out, but then there's another group who say, you know, legitimate scientific information is being withdrawn or, like, you know, removed for political reasons or, you know.
And so I feel like part of our job as journalists is to make this distinction very clear, to report on that and, you know, enough so that our local communities understand, like, what's the difference between a study that's been peer reviewed and a preprint study.
ROBBINS: And it's hard because, I think, you know, people sociologically expect medicine to give them clear answers in a way that—you know, you—and you go to a lawyer and you say to a lawyer, I have my question. Lawyer says, come back in a week, and no one says, oh, my God, the lawyer doesn't know what they're talking about. You go to a doctor, expect an answer, and that's sort of an unfair expectation but I think that happens with medicine, in a way.
YOUSRY: Yeah. And, I mean, the example Dr. Wen gave about masks and kids, so I remember, like, it was a very heated, you know, debate here in the U.S., you know, with schools and school board meetings, you know, seeing all of this chaos.
But at the same time, we had the U.K.—like, the British government say that we're not requiring masks for kids. So we made it a very partisan issue here in the U.S. when it didn't need to be.
You know, if we were just clear about, you know, how science is naturally contentious and then the CDC being transparent about their, you know, motives when they're saying—not motives but, like, their reasoning behind, you know, certain guidance, I think that would have helped a lot.
ROBBINS: So, Tom, this is something that really follows on with this. This failure that we—to do more internationally to live up to our commitment, and it's not just us but, you know, we do have a leadership role and we're pretty rich, is this a failure not just of morality but is it also something that's going to come back and bite us? Because we kept hearing that, you know, that if we don't control the virus overseas it's just going to get worse for us eventually. I like that argument because I thought it would make us do more. But is it true?
BOLLYKY: So a couple things. One, I wanted to respond a little bit on the events thing. So I think the challenge is—and this goes on both sides—are we making database decisions where we're announcing prior what our metrics are and what our motivations are, and this has been true for the CDC.
Where I think they've been hurt the most is when you read their guidance you feel like there's something happening in the background that isn't reflected in the guidance that's influencing the decision, whether it's the availability of tests or, in some cases, perhaps at different points in the pandemic, some political concerns.
So, for me—and I have not followed the details of the Gridiron event at all and Leana definitely knows more about that event than I do—but I think it's a—it can be a false choice between holding events like that and holding them in ways that might reduce the risks.
So my understanding of that event is that they neither required vaccination nor tests beforehand. Is that not true?
WEN: They required vaccinations but not tests.
BOLLYKY: Yeah. So at this point, vaccinations aren't particularly effective against—they don't offer sterilized immunity. So it really—the safest thing you could do for an event like that is to require both. I also think, particularly for something like a Gridiron event where we're not talking about an event that needs to happen—
ROBBINS: Oh, come on. (Laughter.) It's so much fun.
BOLLYKY: It is fun. But that's sort of the point. There are going to be some people that may be infected. There may be people like Nancy Pelosi, who are a high risk, that, I think, there are benefits to doing modest things and being cautious, in part because I think in the United States we are not going to be able to ratchet up—that, I think, it pays to be a little bit cautious, from my perspective.
Again, using that event as an example because I have not been following this closely at all. So I'd defer to Leana on that.
In terms of the broader conversation on the international setting, I think the big choice we have in this pandemic, whether we see global engagement as a matter of charity or we see it as national security, and I think we have shifted some time ago to seeing it fundamentally as a matter of charity.
And if that's the case, that's going to be—make it a second order issue in this country. We were slow to start donating vaccines. We didn't have to be. We were slow to invest in ramping up global production of vaccines. We didn't have to be.
There was a perception that, fundamentally, if we were able to prioritize our domestic response that would be the key to protecting us, even though many of the variants which have caused us so much trouble in this country, of course, emerged from under vaccinated settings abroad.
Will it matter, moving forward, that we're under vaccinating? Certainly, vaccinating more does remain important for all the humanitarian perspectives. It gives us more control in terms of that ability to ratchet up and down protections in other settings. The vaccines aren't that effective at preventing infection.
So the more infections that happen you do have a risk still of variants emerging, and I want to be honest about that, and there are also some very under vaccinated settings where you're going to see some amount of spread, and that's not going to change overnight.
So it's, certainly—I do think it makes us safer and it has a humanitarian perspective. But I also would encourage us to take the longer view on that in the sense that we're having this conversation now about countries joining together to make investments in preventing the next pandemic from happening so we don't have to go through all this again.
We really want to rely on low and middle income countries to help us in that crisis, and what is the incentive for them to join in those systems if they have no sense that they will benefit from any vaccines that might emerge or any countermeasures. So it's not just about responding to this crisis. It's about responding to the next one.
But we have every reason to see this more as—more than just a matter of charity and a matter of national security as well.
ROBBINS: Well, I want to throw it open to our colleagues here because I'm sure everybody has a lot of questions. So if you could just raise your hand and identify yourself, and we've got mics here and we will do that. Yeah, please.
Q: Hi. Thank you for this. I'm Megan Kamerick. I'm the news director at KUNM public radio in Albuquerque.
I'm struggling with the idea of this large shift that's taken place to making your own personal decisions and informing yourself, and at least in my state we used to have a public press conference every week, go through the numbers. They issued the cases every day. I'm sure I am not alone. Now it's once a week. You got to go to the website, dig through the data. Plus, we have more home testing that's not necessarily reported.
My point is it seems really hard to gauge and make a personally responsible decision, and there's also the factor that I know is still emerging scientifically of long COVID that, apparently, can emerge in people who weren't even that sick, and I think we really don't know yet what the impact of that's going to be.
So I just—I hear you, you know, saying, well, you just have to make an informed decision. I decided I don't have to mask, whatever. But that seems hard for us to ask our readers and listeners to do. We are trying to give them the best information we can. Anyway, if you could talk about that.
ROBBINS: Leana, do you want to take that?
WEN: I do, and I want to, first, acknowledge that you're right. I mean, you're absolutely right. It's very difficult to give people specific numbers to make these decision points. I mean, you mentioned the issue, for example, about long COVID.
We, literally, don't know what is the prevalence of long COVID because there's no clear agreed upon definition for long COVID. If you're considering long COVID to be any kind of residual symptoms after sixty days, it could be 30 percent of people have long COVID.
But I don't actually think that's what most people mean, right. They don't mean, do I still have some shortness of breath after sixty days. They're saying, do I have debilitating headaches and such severe fatigue, as some of my patients do, that I can no longer work and I can no longer function and take care of my children.
I think that's what they're—I think that's what people are really concerned about. We don't have those clear numbers, though, and so I see your point that it has become very difficult to make those individual decisions without very specific data.
But I want to address three related points here. I think in threes. One is a state of emergency cannot last forever. We are already two years into the pandemic and, frankly, if you keep on telling people that it's a five-alarm fire they're not going to pay attention anymore.
That's what's happened. We've seen poll after poll that individuals have, basically, started tuning out and are going back to their pre-pandemic normal anyway. So that's the first thing. Public health has to meet people where they are.
The second is there has been a very clear shift by the Biden administration. I think it's been more gradual but maybe it feels more sudden about this shift from government responsibility to individual responsibility, and I think it happened at the point that people have recognized that we can't do mandates forever.
You know, at the point where numbers started to drop, where people are resuming their lives anyway, and also we have a lot more tools at our disposal, the conversation has shifted from, well, everybody need to wear masks because that's required to you have to decide whether you want to wear a mask.
And I understand that making that decision is difficult and so that brings me to my third point. Ultimately, the question to ask—I think that people should be asking is what is the price you are willing to pay to continue avoiding COVID-19, and I'll tell you how my family thought about this. Like Tom, I have two unvaccinated children. I have a 4-year-old and a daughter who just turned two. She was born in the pandemic.
For most of the pandemic, up until December—very specific—up until December of 2021, so this last year, my husband and I were extremely careful. We did not want to infect our children and we thought, you know, a vaccine could be on the horizon for our children.
But then guess what? A few things happened. We found out that a vaccine was not anywhere on the horizon, right. We still don't have a vaccine authorized for children under five and even if one is authorized it's probably going to be a three-dose vaccine taken quite a bit of time apart. It probably is not going to be super effective. So that's the first thing with our kids.
Second is Omicron came out. Not only is Omicron less dangerous by itself to the individual but also it's so contagious that it's almost impossible if not impossible to avoid and, therefore, the price we would have to pay to keep on trying to avoid Omicron for our children was so high that we're not willing to stop sending our 4-year-old to preschool. We're not willing to stop sending our 2-year-old to daycare. We're not willing to deprive them of summer camp. I mean, we're not willing to keep on doing that indefinitely.
And so I think that was a very specific point for us. Other people may have a different decision point about when they have to decide the price they're going to pay to avoid COVID is just too high.
ROBBINS: Thank you for that. Thank you.
Q: Hi. I'm Camalot Todd. I cover mental health—(comes on mic)—I cover mental health for Spectrum News through Report for America.
I actually have two questions. So, one, how did the politicization—oh, God, that was rough—of the pandemic impact public policy and public health policy?
And, two, what we've seen with this pandemic is a surge of mental health needs. So one out of every five hundred kids is a COVID orphan. You've seen more suicides, more deaths of despair, and even more homelessness, unemployment, and long-term kind of mental and behavioral aspects of this pandemic.
What are some public policy efforts, public health efforts, to address that as well?
ROBBINS: Farah, you want to talk a little bit about the—
YOUSRY: I mean, I—I don't know. Like, I don't have an intelligent answer for that. I mean, I have access to the same data as she was referring. I would refer to Dr. Wen.
ROBBINS: OK. Tom, do you want to take—
BOLLYKY: I'll just weigh in on the first issue. Well, I'll weigh in a little bit on both. But on the issue of polarization, I think it had an enormous impact. So we did a study in Lancet maybe six weeks ago that looked at the epidemiological mystery of this pandemic, which is why you saw such—we've seen such big cross-country differences in infections and infection fatality ratios.
Countries right next to one another will have differences that are twofold. You don't see it following the pattern of many other infectious diseases in terms of the countries that have been disproportionately affected.
So we looked at all the things that you might think. We looked at health care capacity, pandemic preparedness metrics. We looked at regime types of democracies versus autocracies, populism, economic inequality—really, the whole gamut, and what really does appear to have made a difference, at least on the infection side, is trust—trust in government and trust in one another, and it made a large difference.
And what I would suggest there is any pandemic with a contagious virus, particularly prior to a vaccine, the most effective thing you can do to protect people is to convince them to take measures to protect themselves. That's, effectively, what we've been talking about here today is people's adoption of protective behaviors and when they should have them.
That has, undoubtedly, been influenced by the polarization of—in this country and particularly around advice that was emerging from government. That started early. It has, unfortunately, snowballed and affected, particularly, confidence in national level health sources.
On the mental health piece, I think this is a huge story and one thing that I don't think—to throw a plug for state and local officials—that we're seeing enough reporting on is where the money has gone that was dedicated for pandemic recovery and where it is being spent, because some of that was meant to be spent very much on these types of programs.
And the reporting is very anecdotal, but you hear stories about funding going to all sort—whether it's tax cuts or buying—or more needed things but not pandemic related, like schoolbooks. We're not seeing enough of that.
But I would love to see more reporting and that's a great state and local story in terms of how your locality has been doing that, and there's not a lot of transparency on it. And Leana may have more to add on these topics.
YOUSRY: I would say also that the politicization of the pandemic has played out, at least from my perspective as a journalist—so I find that some public health officials like state public health departments are reluctant to give, like, in-person interviews or phone interviews just because they don't want to be caught in the crossfire, you know, of, like, political debates and so on, and that makes our job harder as journalists.
On the other side also, I was reporting a story on Ivermectin hashtag. If you know, you know. I'm not going to explain that anymore. (Laughter.) But so some scientists have been receiving death threats, you know, when they retract their study or when they put out a study that says, oh, Ivermectin isn't exactly effective.
And so there was a survey done by Nature and they found that a big number of scientists are choosing not to communicate on social media anymore just because, you know, it's too pricey of a risk to pay. You know, it's not worth it. And so who will fill this void? Probably people who have, you know, malintent, misinformation, and so on. So it's a big problem.
ROBBINS: Really scary. Leana?
WEN: Yeah. I wanted to fill in on the mental health and substance use, which is a closely related issue, and just mention, for example, a—there's been a lot of work done on this, but let me cite a recent JAMA article that, I think, didn't get the press that it really needs to.
It was an NIH study that looked at alcohol-related deaths in 2020, the first year of the pandemic, compared to the year before, and they found that it rose from seventy-nine thousand to more than ninety-nine thousand. That's an increase of more than 25 percent in a year.
The rates increased across all age groups but especially for people thirty-five to forty-four, up nearly 40 percent in that group. In twenty-five to thirty-four years old it was up 37 percent. And here's the kicker—for people under sixty-five, alcohol-related deaths exceeded the number of deaths from COVID-19 in 2020. OK. That's just for alcohol-related deaths.
Overdose deaths are also through the roof, right. They are escalating. The question about the diseases of despair, I mean, there is so much else that—you know, I am not one to blame the lockdowns. I think, initially, we needed to have those very restrictive measures, those blunt tools, because we had nothing else.
But we also have to recognize that social isolation contributes to a lot of the lack of well-being that we're seeing. There are huge treatment gaps when it comes to mental health and substance use that were there prior to the pandemic. But then we also have the issue that recovery depends on relationships and we have just thrown all of that, all these networks that were so crucial, out the window.
So I hope that, going forward, we can think about good health as being not just the absence of COVID because people have put off—we can talk about cancer deaths. People have put off their mammograms, the colonoscopies.
People are not optimizing their diabetes and hypertension because they've been scared of COVID or because they've had other social factors disrupted in their lives. All these things are going to have, over time, a much worse impact than actually COVID itself.
Again, not to say that we shouldn't have had those measures in the beginning but, rather, that there are many people who are overestimating their risk from COVID right now and perhaps it would be better for them to be going back to the gym or going out to dinner with their friends because there are actually mental health and physical health benefits of these other social activities as well.
This actually ties into the politicizing part of the question as well, and I want to mention that, you know, as a former local health official, I'm in contact with many of my counterparts in local and state health departments. There are a lot of the concerns that the other panelists raised about personal threats.
But I will say one of the other concerns is that there are knock-on effects of COVID because COVID, unfortunately, has become so polarized and seen as a part of the partisan culture wars, right. We wish that were not the case. I wish that we could see it as simply a public health issue. But that's not the case, right. It has been politicized. It is what it is.
As a result, we need to recognize the reality and work from there. Well, you have states that because of COVID vaccine mandates are now saying that they want to remove childhood immunization mandates of all kinds. That's terrible. Or because politicians hate masks and, therefore, they want to ban the use of masks even for things like multi-drug-resistant tuberculosis in the future, I mean, how—what is that?
And so I think because of how COVID has gotten so politicized, I actually think that backing away from COVID may actually have an increased benefit to protecting public health for the long run. I know that's controversial but I want to throw that out there.
ROBBINS: Leana, can I ask you, really, quick question here, which is putting on your hat as a former health commissioner for a city? Is the data that we look at nationally available on a city level, I mean, things like alcohol deaths and in which we can compare pre-COVID, post-COVID, on a city and local level, county levels?
WEN: Yes. So state health departments, generally, should have those data. The office of the chief medical examiner—I mean, this is going to be different for every place—but there will be reports from the medical examiner. The state may compile the records separately.
They will be available. Now, I think one of the challenges is there is a long lag to reporting those data and those data may also look different depending on what part of the country you're in. But those data are available. There just might be a significant lag of time.
ROBBINS: And, Farah, what sort of—how are you finding that sort of data?
YOUSRY: Yeah. I mean, so many of this data is on, like, the local health department's website. If I don't find that I go to—so while I'm reporting locally, I would use federal data on the CDC website, HHS or HRSA, and so on. They do have, like, data divided by states and so sometimes I look at that.
I just also want to throw this at some of the local journalists. So there are some tools like a tool called SciLine. So it's a nonprofit that, yeah, they—basically, you tell them what story you're covering, you know, what questions or, like, what kind of discussion you want to have and what kind of experts you want to talk to and then tell them your deadline and they usually refer back to you with, like, a number of, you know, Ph.D.s. And then, of course, you vet your—like, the sources, and then you can schedule with one of the experts, and it usually saves time on the front end. Have used them in a couple of stories and it came handy, especially when it's, like, a tight deadline.
ROBBINS: Tom, any other suggestions on if people want to take something, like, a national story like that and make it more relevant locally and being able to crunch numbers, in particular?
BOLLYKY: I find the data really spotty. I mean, I agree with what Leana said. Every state should have this. Many—some major cities should have this. Lots don't, necessarily, at least not in a timely way, and that's an area of investment that we need to see in the future is more in health informatics and in data and that's something that CDC has emphasized needs to change, moving forward. I think that it does.
One thing I want to talk a little bit, though, about, something that Leana raised. I agree with most of it. The one thing where I would quibble with I don't think we should look to COVID protections for excusing governors who want to get rid of mandates for pediatric vaccinations or as an excuse for anti-science measures like removing masks for multi-drug resistance tuberculosis. It, frankly, gives those politicians too much credit.
They are, in those instances, doing this because they see a political angle for it and I think it's our job as people who write on policy or report to take them to task for it because they're doing it from an opportunistic perspective. And I don't think it has any bearing on, necessarily, of—how their state has experienced and they're finding an audience for it.
I do completely agree with Leana, that I worry deeply that the polarization that we've seen around COVID has spread to other areas and one thing we've worried about for a long time is that you would see polarization around vaccination in general, which has not historically actually been true, or you've had pockets—I don't love the term vaccine hesitant but just for the sake of argument where you have pockets of that across the political spectrum. It has started to shift and that is something to worry and continue to engage on.
But I don't think we should give politicians a pass for these measures that are happening because I don't think it's a rational response. It's a political opportunistic response.
ROBBINS: We have a question from Zoom.
OPERATOR: We'll take the next question from Liz Llorente.
Q: Hello.
ROBBINS: Hi, Liz.
Q: Hi. OK. Just want to make sure you could hear me. Liz Llorente. I am a lead health writer for NJ Advance Media.
And, first, I want to say that I'm so glad that my colleague previously mentioned long COVID because I think that is one of the next major stories and the story about the—in the coverage of the pandemic and which I feel I don't hear enough about from political leaders and others.
And I just, you know, wanted to ask about that, because I know—and it's true that the data—the definition is—it's still elusive and there's not a real agreement as to what it is. But it's definitely a problem. Between—about 30 percent—up to 30 percent of the 100 million Americans who've gotten COVID are believed to have had or are still experiencing some form of long COVID.
And the Biden administration this week announced an initiative aimed at studying it and coming up for—coming up with treatments for it. And I just—I wanted to ask, how much of a concern do you think this is right now? Keeping in mind, of course, that we're trying to understand it. You know, and someone said about the whole pandemic, it's like, you know, we're trying to fly a plane as we're building it. So how much of a concern do you see long COVID being?
ROBBINS: Thanks. Leana, you want to take that? Because you've—
WEN: Sure. I mean, I've been writing about this and talking about this. I see patients with long COVID. I talk to people about the risk of long COVID. I certainly acknowledge that it's very real and of great concern. There are also studies coming out, for example, that show not necessarily the definition of long COVID, but that getting COVID can increase your risk of cardiovascular disease, your chance of getting diabetes, your chance of having maybe permanent neurological issues. And so it's really complex, right?
At the same time, I think there's something else that we have to address. And actually, I just wrote a newsletter column specifically about this for the Post, which is, in our thinking about the risk of long COVID we also have to think about the risk of COVID. As in, when we consider for Omicron—so Trevor Bedford has estimated that about 50 percent of people—of Americans got Omicron in this last wave. Other estimates are that 45 percent got Omicron. In any case, no matter if it's 45 percent, or 50 percent, or higher, a lot of people got Omicron between—or, got COVID between December and March.
When you look at the number of people who got COVID overall, it's going to be much higher than just 50 percent of Americans. Maybe it's 70 percent of Americans or higher even who have gotten COVID already. I think it's kind of a travesty that we don't have the numbers of people who have long COVID from that. I mean, if we had that many people who had COVID, don't we know the numbers already? But that's a separate question.
My point here is if so many people already had COVID, then to try to avoid it is extremely hard. And therefore, I actually don't think the question to ask is, what are the long-term consequences of long COVID, because it might take us years to find out. Other viral diseases are associated with long-term consequences too. And we're still finding out about what is the long-term consequence of EBV, or what about Lyme's disease? I mean, there are other things that cause long-term illness—long-term symptoms too.
I don't think we can wait until we have final data on treatment, which we need to get, or prevalence, which we need to get, to think about how do we conceptualize it for ourselves? And I guess the way that I'm thinking about long COVID is not what is the risk of long COVID but what is it going to take for me to avoid COVID? And I think that is what I mentioned about the price to pay.
ROBBINS: You've had your hand up for a long time.
Q: Patrick Clark with Patrick Clark with DPLR and KTVI in St. Louis.
And I'm curious, we're now getting to go back into schools. And I feel that I hear from a lot of teachers about developmental delays in these children from the past two years of this. And I'm curious, maybe this is a question for you, Thomas, or Dr. Wen, or anyone, about Spanish flu of 1918. Can you—is it comparable? Was there the same thing that existed in society then? Can you look at that? And how far behind are children?
BOLLYKY: Yeah. It's a great question. From a historical perspective I haven't seen the educational studies. Maybe Leana—
YOUSRY: That would be very interesting to look at. I don't know, but I'd love to hear—like, to read something about that.
BOLLYKY: Deaths-wise, we're still a long ways off in terms of the overall toll. Even if you look at excess mortality from COVID-19, the most recent estimate—reliable estimate that I've seen is eighteen million globally. That's a high number. And obviously, you know, as I mentioned before, China may change that figure significantly if things go wrong. But that's still a long ways away from some of the estimates around 1918-1919 flu.
Educationally I think this is the big story, both globally and domestically. The long-term consequences of the pandemic really are going to be seen in education. So, you know, studies have looked at do you see big shifts. We worried early on that we would see significant decreases in vaccinations globally or broader healthcare services provided for HIV, or malaria, or TB. And the reduction actually was relatively modest over the pandemic, is the current estimate.
The area where we really saw a devastating effect was education, where ultimately you had 1.2 billion schoolchildren spend time out of school. And in low- and middle-income countries, just to take that for a second, they tended to be out for longer. There is—and we talked a bit about the investment to catch up on this. You're not seeing the funding go into that space. There is not getting that time back. It has all the mental health implications that were referenced before. But you're going to see a significant diminishment in human capital.
And then you'll see the same degradation around economic and social inequity here in the United States for poorer children who suffered most from that. And that's on the mental health side, educational side, and, in some cases, from nutritionally from the means they would have otherwise received at school. And we should—this is where that money should be going, that we were talking about, on the state and local level. And you're not—at least, it doesn't appear to be happening in the way that we had hoped it might.
YOUSRY: Yeah. I mean, if we take anything from the pandemic, I feel, as reporters, the focus on, like, the funding for public health is huge. There is—like, later you see data show that 30 to 40 percent of those who died from COVID had diabetes. And so what have public health departments been doing to eradicate this epidemic of diabetes we have around the country, you know? That's one thing.
Another thing, like, a JAMA article, like, they were looking at the factors that contributed to increased death rates in certain communities. And so they compared rural and urban areas and they found one common factor between them. That if you do not have internet access, you're much more likely to die from COVID. And so investments in infrastructure, in public health departments, these are the big stories that we need to pay more attention to, put more emphasis on, and take from the pandemic moving forward.
Q: Hi, there. I'm Sheri McWhirter. I'm a reporter for MLive in Michigan.
And I wanted to see if I could get you to talk a little bit more about that price to pay that I've heard you mention. I'm sure it's the same in other parts of the country, but in Michigan public health workers have had quite a price to pay. A lot of death threats, needing security guards to follow them home. And they quit—a lot of them have quit. And there's the worry that they'll be replaced by people who are either not qualified or are only marginally qualified, and that they'll be political appointees into positions of public health. What is that going to mean for the long-term health of all of us? You know, public health does a lot more than just tell us about COVID, you know? Low-income people do their well-child visits at their health departments, you know? They get their dentistry done at their health department. If unqualified people are in charge of local level health decisions and monitoring, what's the cost?
YOUSRY: I mean, it's not just public health workers, like you mentioned. It's also school boards. So I've spoken with many school board members who are quitting their jobs because of death threats and, you know, attacks—physical attacks on them. And so this goes back to the point that Dr. Wen was making, you know, the fact that the more COVID is lingering, the more polarization is happening, and it's affecting everything, you know, from school boards to, you know, public health officials who take care of, you know, the local health and, you know, wellness of our kids at school, and so on. So, yeah, it's a big concern.
WEN: Can I add here that here's—again, people will disagree with this statement, and by saying this I also very much acknowledge the great point that Tom made earlier that I'm not trying to excuse bad behavior, right? I'm not trying to excuse the behavior of people who are threatening public health officials or politicians who are trying to stand in the way of public health for their own political gain. I'm not saying that's a good thing. I think it's shameful. And I think it's great that all of you as journalists are calling them out for this, and people are calling them out for this.
I am also, though, a public health pragmatist. I ran an agency that, to the questioner's point, was exactly what you were saying. We oversaw senior centers. We oversaw maternal and child health. We oversaw opioids. We oversaw mental health. We oversaw direct services, and family planning, and dental health care for individuals and families who can't pay, who otherwise can't get access to care. I'm really worried that all those other things are now going to be affected because COVID has gotten so politicized.
And so I think in areas such as in areas where their health department is really suffering from this weight of politics due to COVID, I think they should pivot away from COVID. I think they should double down on the issues that have broad bipartisan support. For example, fighting the opioid epidemic, addressing homelessness in areas where that has bipartisan or nonpartisan support. I mean, maternal and child health. I mean, there are so many areas that have broader support. Let's pivot away from COVID in these areas.
Final point I'll make, because you were asking about this question of who's going to pay the price. I think so many people had to pay the price, right? I mean, it's teachers and educators, as was mentioned, doctors, and nurses, and pharmacists. It's parents who have all suffered during this time, individuals who've lost their loved ones. I mean, my point here isn't that, oh, we have to put the onus on certain individuals and make public health officials suffer more, but rather that I think it's unfair to say to individuals who have done everything right, who are vaccinated when they got vaccinated, boosted when they were told get boosted. They wore masks when it was required.
It's really difficult to tell them: You have to keep paying the price for this ongoing pandemic. And your children are going to have to stay masked in perpetuity and not have normal—a normal life. I think it's very difficult to say that. And that's why my—that's why I—even though I've been critical of some of the Biden administration's actions around COVID in the past, I really support their move from government mandates to individuals choosing whether they want to keep on paying the price or not.
ROBBINS: You were writing down notes. Do you have something to say there?
BOLLYKY: Yeah, no, no, no. Well, a couple things. So I agree in terms of more investment in public health, in particular in the areas where there's consensus. Unfortunately, the lack of underinvestment in public health predates this pandemic. And you saw officials leaving beforehand. What I will say is, in terms of the survey data for declining trust, is actually been less in health officials—I mean, even CDC still does better than a lot of agencies that it did before—and more on state governors, had the largest decline in trusted sources of health information. So what I would say is I think I'd be—for me, at least, be careful in assigning the polarization happening in this country to COVID as opposed to COVID being a symptom of the polarization that we have in this country. And I think we should disaggregate those two.
In addition to worrying about what's happening with public health officials, which I worry a great deal about, I also worry about the medical profession and the departure of nurses and what we've seen in that space. Because, you know, again, in that same Lancet study we looked at adjustments of death rates for factors, like you mentioned before, around diabetes, or age, or obesity. Things that aren't immediately controllable in a pandemic. And the U.S., particularly when you make those adjustments, actually does pretty well on infection—on fatalities. Better than a lot of high-income countries and certainly better than many countries around the world.
And it's, frankly, a credit to our nurses and doctors. When you watch Contagion, or movies like this, the story is that people are going to line up to get vaccinated and nurses are going to walk off the job because they're going to be nervous about going to work in the midst of the pandemic. And the reality is we saw the opposite, where everybody kept going to work, those systems held up. And I think it's important to make the investments to make sure that we're able to do so in the future.
ROBBINS: So, Farah, you're expert on the one-minute hit. (Laughs.) Given what you do for a living. But COVID fatigue. Everybody's COVID fatigued. Readers are COVID fatigued. Tell me a story that makes you excited. (Laughter.)
YOUSRY: A story that makes me excited? (Laughs.) Like, in general? Or a story I worked on? Being here makes me excited. Like, I haven't been to an event like this for so long.
ROBBINS: A story on public health right now that you're working on.
YOUSRY: I mean, I'm working on a project on sickle cell disease. And, you know, for me, sickle cell disease is, like, the poster child of health inequity, just because it's a disease that affects mainly people of African descent. And so you can see clearly, if you compare sickle cell disease to a disease like cystic fibrosis, for example. So cystic fibrosis has a third the number of patients, but it receives 11 times the funding, the federal dollars, just because it's mostly, you know, affecting white patients. And so there are so many disparities in this realm and I'm so excited about this project I'm working on right now. (Laughs.) I don't know if that's the answer you wanted. (Laughs.)
ROBBINS: I wanted to—I wanted to end on an excited note.
Thank you. Thank you for Dr.—thank you to Dr. Leana Wen, thank you to Tom Bollyky, thank you so much to Farah Yousry. And thank you so much to all—to all of the lovely journalists. This has been an extraordinary workshop. And I just really wanted to thank Irina Faskianos and her extraordinary team for pulling it together. It's just been an extraordinary time, to everybody for doing this. (Applause.)
We, here at CFR—and the "we" is very advised because I'm just a part-timer—we are here to answer your questions and to work with you because we know that the extraordinary work you're doing as journalists is just so fundamental to our democracy. So thank you. We're here to answer your questions. Join our webinar, because it's great to have you do this. And come, there's a reception on your way out the door. So thank you so much. (Applause.)
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