vaccine. be sure to join the discussion with your phone calls, facebook host: this is the washington journal for april 18. those of the four countries listed as the most direct threat to the united states during the next year. that was done by the director of national intelligence. concerns from these countries range from military and way pins -- weapons capability to cybersecurity. you will see more of the report and we will ask you to give us what you think the biggest geopolitical threat facing the united states.

if you are military active or retired, call us at (202) 748-8000. if you are the member of a military family, (202) 748-8001. all others, (202) 748-8002. if you want to text us pure thoughts, (202) 748-8003. you can post on twitter or our facebook page. it was on april 9 the director of national intelligence posted this report. taking a look at these countries, the top countries that are most concerning as threats to the united states. russia, china, north korea, iran. the dni appeared in a senate hearing, talking about those countries and the threats they pose. that hearing is still available at c-span. >> there is an array of threats we are facing the coming year.

beginning with those coming from a key state actors and starting with china, and i'm paralyzed -- an unparalleled priority. china increasingly is a near peer competitor, challenging the united states and mobile -- multiple areas. china is approaching its strength and can compel neighbors to acquiesce to beijing's desires. it also has cyber capabilities and can cause localized issues inside the united states. while china has a formidable challenge to the u.s. global affairs, it's economic, environmental, demographic vulnerabilities complicate its

ability to manage the transition. with respect to russia, moscow will continue to employ a variety of tactics to undermine u.s. influence. russia does not want to conflict, they believe that washington is seeking to weaken russia. moscow will use tools to pursue its objectives, including arm sales. it will employ new weapons and cyber capabilities to threaten the united states and its allies. it will have malign influence campaigns to undermine our global standing. russia is becoming increasingly adept at leveraging its technical prowess to develop asymmetric options in the military and cyber spheres.

turning to iran, they want to project power in neighboring states and minimize threats to regional stability. iraq will be a key battleground. ironic will pursue a military presence. for its part, north korea is making destabilizing actions to reshape its security environment and will drive wedges between the united states and its allies. this could be the resumption of inner, -- ballistic missile testing. talking about findings from the report filed by her organization and her office, taking a look at top geopolitical threats. the hill highlighting the story, saying that she faced sharp questions about those assessments. you can find that story at the hill. the hearing is available on our

website, c-span.org here is how you can call us. (202) 748-8000 four active and retired military members. (202) 748-8001 four military families. (202) 748-8002 for all others . if you want to text us, (202) 748-8003. you can tweet us.

there is a section committed to china and the top concerns the u.s. as for that country, including beijing being a shift and using the economic measures against beijing since 2018 as an effort to contain china. china is touting its success on the pandemic as evidence the superiority of its system. beijing is combating its growing military power with economic and diplomatic clout to preserve the ccp. china was also the topic of ted cruz on the senate floor. he talked about china and why he feels it is a threat. >> china is in my judgment the

greatest long-term geopolitical threat to the united states for the next century. presidents in both parties have believed for decades the united states could somehow turn china from a phone to a friend. -- foe to a friend. instead, the opposite has happened. the united states can't sever all commerce with one of the biggest economies on the planet. we must recognize china for the threat it poses to our national security. to counter the threat that china poses, we should do four things. number one, attacked ourselves from chinese espionage and interference. number two, we should insulate the supply lines of our critical

resources from china, including ringing them back to the united states. -- bringing them back to the united states. we should insulate all commerce from enabling the chinese commonest party human rights abuses, including their pattern of torture and murder and genocide. number four, we should vigorously compete to secure our interests. host: as far as threats are concerned, what is the top of your list? good morning. caller: thank you, good morning. it's good to speak with you. i think we need to support our neighbors in the vicinity in north and south america. in addition to trying to have diplomacy with these four

countries, especially china and russia. north korea is a loose cannon. iran, we need to get back into that nuclear agreement. it was napoleon that said don't interrupt your enemy when he is making a mistake. host: do you view them as threats or concerns? caller: i think it's more of a concern. the threat of it is over -- over exaggerated. i think trump pushed everybody away. he made enemies out of everybody, even in pan-american. biden is trying. i found -- host: you said it was exaggerated.

caller: does china have ships at our doorstep? when was the last time iran attacked anybody? host: that is mark in massachusetts. we will hear next from john in new york. go ahead. you are next. caller: i would like to address the issue with china. i think if you go back in history and time and look at the culture of the country, as far back as chairman mao winning the civil war in china, the violence in the revolution, you have a history of the ccp. human rights violations like tiananmen square.

they've always been a hostile nation, hostile to the interests of the united states. they've been building up their military. the thing that bothers me the most and it's been evident for the last four decades, how these globalist corporate leaders have moved out of the country and have gone into china. you can include things like the nba, major league baseball, it's a feeding frenzy for the business community. we know what's going to happen. we've seen the chinese take our intellectual property. apply it to their military. displace us as a primitive power in the pacific. what's going to happen is when

we recover from the coronavirus, you've got 600,000 people that have died. these people are going to go back to china and it's going to be business as usual. host: you can find the dni report. when it comes specifically to china, highlights include the china indian border. the border areas have the most lethal escalation in decades. the south china sea, they will have rival and use law-enforcement platforms to signal southeastern countries that china has control over contested areas. beijing will press taiwan to move toward unification and condemn u.s. taiwan engagement.

geopolitical threats and what you think might be the largest one. vicki is in idaho. good morning. you are next. caller: our biggest threat is the partnership with the private sector that our government entered into in order to participate in the global economy where other countries allow business groups which are monopolies, cartels of business groups. they weakened our government and strengthened the multinational corporations in such a way that our government has become a tool for the multinational

corporations. we don't have a government for the people of the united states. we have a government for business. host: when you say it has weakened the government, what example would you give? caller: it's not business activity. it's the business relationship, the partnership. our government makes decisions in the interest of business, not in the interest of the people of the country. host: what's an example of that? what would you say is an example of what you are saying? caller: the pacific northwest economic region, a partnership between five american states and british columbia with businesses and full member partners.

that is the business side partner of the asia-pacific economic cooperation organization. host: that is vicki giving her examples. let's hear from george in louisiana. caller: hello. my concern is with afghanistan and the withdrawal of our troops from afghanistan. my concern is with the allies we have, the afghani allies we have not being protected after we withdraw and being slaughtered i the taliban. that's my concern. host: are you concerned about

what happens after the troops leave? caller: i'm concerned about that as well. that is a political problem. i am concerned that the taliban is going to take advantage of not being any protection for our allies who have supported us for the last 20 years. it seems immoral for us to not protect our allies from the slaughter that will take place. host: that is george in louisiana. he cites afghanistan in light of the decision to remove troops i september 11. that decision was announced last week. >> i believe our presence in afghanistan should be focused on the reason we went in the first

place, to ensure afghanistan would not be used for a base from which to attack our homeland. we accomplished that objective. we said we would follow osama bin laden to the gates of hell. that's exactly what we did. we got him. it took us close to 10 years to put the commitment into form. that's exactly what happened. some of bin laden -- osama bin laden is gone. that was 10 years ago. we deliver justice a decade ago and we've stayed in afghanistan for a decade since then. the reasons become increasingly unclear. even as the terrorist threat that we went to fight evolved. over the past 20 years, the threat has become more

dispersed, metastasizing around the globe. al qaeda in the arabian peninsula, isis is attempting to create a caliphate in syria and iraq. with the terror threat in many places, keeping thousands of troops grounded in one country at the cost of billions each year makes little sense to me. we cannot continue the cycle of extending or expanding our military presence in afghanistan, hoping to create ideal conditions for the withdrawal and expecting a different result. i am now the fourth united states president to preside over troops in afghanistan. two republicans, two democrats.

i will not pass this responsibility onto a fifth. host: president biden talking about the troop pullout. others have been listed. you can call and respond to that. (202) 748-8000 four active and retired military. (202) 748-8001 for military families. (202) 748-8002 for all others. several people texting us.

let's hear from danvers, massachusetts. good morning. caller: i think that my concern with regard to china is if we turn them into an enemy of the state, we risk losing our supply chain and a lot of the ties that we do with commerce. we owe the money. they could call the note. we are at a greater risk than if we would have tried to make them one of our biggest allies and ensure we deal with some of the political footballs such as information, intellectual property theft with regard to

excelling the laws against them for patent infringement at the u.n. level. i think it's a mistake not to try to make them an ally. the two of us working together would ensure the piece of the world. host: how do you think the u.s. goes about making them an ally while still protecting u.s. interests? caller: for years, we have been convinced that china has been a threat. i have yet to see any specific evidence that says which technology they stole from us. it has become a very big political football. in the end, when we make them an ally, we will be much better off. you see them expanding their

interests around the globe. i hate to see what happened with the last administration where we have people who believe asians are the problem when in fact the existential threat has been germany putting eight target on china in 2003 -- a target on china in 2003. the people have been lied to about the status of our relationship with that country. they came to our aid in 2003. in the end, some people in the media are to blame to some extent. host: that is doreen in massachusetts. caller: hello? host: you are on. caller: the major problem is we

are going to need our troops at home. what's going on at home in america is more concerning. the socialist democratic party is upsetting america so much. we are going to need troops on our own border and around the capital. we have to be prepared. america is in its own up people right now. we can't be concerned with the rest of the world. host: no other countries top the lists? caller: if we are not the most concern, the others don't matter. we no longer can do that. host: you listed iran, why is that a concern? caller: the nuclear weapons. you could be sure they are going to go after israel. it could end up being a nuclear war.

that could be the start of a major global problem. what are we going to do without our troops? host: if you go to the new york times, a piece taking a look at uranium.

that's the new york times, you can find the story about that. the attack at that one nuclear site last week, the washington post following up on who was behind that. this is the headline.

let's go to earl. earl is in indiana. he comes from a military family. caller: thank you for letting me talk. i really believe looking at the shape the countries and, we are headed for a one world government. we have so much turmoil. the bible tells you you will have wars and rumors of war. there is no getting out of it. we've got prophecy from the bible. i believe it says they will riot in the streets. a mother will be against daughter. look at what we've got in this country. host: since we are talking about geopolitical threats, is there a country that stands out as more of a concern? caller: i would say china and russia. they gave trump hell for talking

to vladimir putin. they have proved all this crap they had on trump wasn't true. get rid of the fbi. they are not even investigating. host: you said china, what about russia? caller: i believe russia wants power. any country wants power. they are going to do everything they can against us. that's nature. that's human nature. people are greedy. host: that is earl in indiana giving thoughts on geopolitical threats. he listed china and russia. you may add others to the list if you wish. if you want to call, you can do

so on these lines. if you are active or retired military, (202) 748-8000. if you are part of a military family, (202) 748-8001. our line for others, (202) 748-8002 is how you do that. you can text us at (202) 748-8003. twitter is available as well, as well as facebook. for those who calling, make sure you turn down your television. oklahoma city, oklahoma, this is otis. caller: i believe it's russia hands down. they have been doing a job on us. we have some political leaders who are pushing vladimir putin's

lies, doing his dirty work with all of this fake news. russia is starting to pull this country apart. i know they are over there laughing at us. the things we believe are unbelievable. we have political leaders who are thinking about lies. vladimir putin is a genius. host: why is it a threat to the country? caller: because of his interference with the election. he did a wonderful job this time around. we can't have that. we are one nation. we need to start to focus on that. china is an issue. i believe russia is putting wedges between us. host: that is otis in oklahoma

city. when it comes to russia, the washington post reporting that the kremlin said friday it would expel 10 u.s. diplomats, including the fbi director in response to u.s. sanctions. the expected measures deepen the strains between the two countries. when it comes to afghanistan, vanity fair highlights recent statements by lindsey graham. this is the headline. here is more from senator graham

last week. >> al qaeda and isis are going to benefit very quickly from this decision. i feel like i need to tell the american people why it is in our interest to keep a few thousand troops over there until conditions are right. if we leave afghanistan under the path charted by president biden, the government will teary rate and people will go back to their corners. the taliban will grain -- gain strength. the central government will lose its ability to manage the country. the net work named to be a terrorist organization will reign in the east. they will reconstitute and form militias in the north. in the west, the iranians will have major influence.

what do we lose? we lose that insurance policy against another 9/11. we lose listening posts in the backyard of some of those radical movements in the world. afghanistan has been a platform we can monitor what's going on. we lose all of that. what do we gain it? we gain the idea the war is now over. joe biden ended the longest war in american history. you have not ended the war, you have extended it. host: roy ads on twitter:

host: if you want to post, you can post on our twitter. we have separated the lines. a retired military member, this is rob from new york. caller: i think the biggest threat is the biden administration for their open borders. we've got an old man that can't finish a sentence on his own. host: when it comes to specific geopolitical threats, why the southern border? caller: we have no real media

except c-span. you guys won't put mike lindell on. host: that's not the topic. you highlighted the southern border. caller: it's wide open. they've got kids coming here. the cartels are running the border. host: how is that a geopolitical threat? caller: the biden administration. half the country knows the election was stolen. host: ok. that's rob giving us his take on geopolitical threats. you can do the same. if you want to call us on the lines, you can do that. if you want to take a look at that. as far as other things, a piece in the washington post by george w. bush, talking about

immigration, he offers this, a couple of ways to make changes to the immigration process. he says in the piece:

host: the thoughts from the former president, george w. bush in the washington post. he and the congress of the time made an effort on immigration reform. we will hear from james in maryland. you are next up. good morning, james. caller: i believe it's mexico, guatemala, honduras, bolivia. the amount of drugs that are being brought to this country, it's just amazing that we are subsidizing our own mis. by letting -- own demise. we have to take care of a lot of them. they take money and we need to do something about these drug cartels.

that's my point. host: why are the cartels a top concern? caller: right here in virginia, about five days ago they killed two guys because they tried to rob a cartel stash house. it's a secret war that's going on. they are too dangerous to be in this country. we are not doing enough about it. host: that is james giving his thoughts from marilyn. when it comes to china -- maryland. when it comes to china, the chinese government and the u.s. government saying they will work together when it comes to climate change. some listing that is a

geopolitical threat. on friday, the chinese president said china is committed to climate goals. more to that story in the washington post. let's hear from retired military person from and a soda. -- minnesota. caller: the biggest threat is the biden administration. your previous collar -- hello? host: go ahead.

caller: i consider this administration to be a threat because your previous collar said what he's been doing to this country regarding immigration, the budgets they are passing it it's crazy. host: how is it a geopolitical threat? caller: you kind of cut him off. he said allowing these people coming in from the southern border, we have a pandemic going on. that's a threat right there. host: ok. that is terry in minnesota. one of those threats the dni director talked about at the hearing last week which you can still find on c-span, potential threats against the united

states. this is a portion of that. >> we are refining our efforts to disrupt terrorist threats to the homeland. it's in a way that contends with the diverse nature around the world. we have identified them from overseas. they are primarily from al qaeda and isis. within that, if you look at the primary from al qaeda, it's in the region where affiliates operate. the most concerning threat to us comes from somalia and syria and yemen. those are the key areas you see for al qaeda. the primary threat from isis comes from iraq and syria. they continue to foment eroding

security gaps to create conditions for seizing territory. in afghanistan, we've talked about other scenarios, years of sustained counterterrorism has degraded the ability of al qaeda and isis to attack u.s. interest. neither group is currently positioned to conduct attacks on the west. they could reconstitute. that is the current situation. host: that was from a hearing last week. you can find more on the website c-span.org. you can go to our website to find more from that hearing. from new jersey, we will hear from janice. go ahead. caller: the biggest political threat here is the biden

administration and all of the leftovers from the obama. we need fresh people. we need to bring back the restraints of destroying all the things the prior administration had worked on. host: this is geopolitical threats. what would you put on that list? caller: china. russia will always be there. china is our threat. they are waiting to take over the world. everything we buy is china related. they are responsible for the pandemic. they will not ever change their attitude. our present administration is feeding right into china. we do not want to be a socialistic country. they are going to have to take all the money from the american

people. we are paying the taxes. we don't need all the stimulus. our country, the current administration is the threat. host: to china specifically, how is it a threat to the united states. caller: china has billions of people. we have 350 million people. we are not destroying our climate. they have people that have to wear masks for a decade. they are not doing what they should do to prevent this from happening. they are a dictator. they have no common decency. what about the people in concentration camps? what about the people -- they

took over hong kong. they are a threat to us. everything you buy is made in china. host: let's hear from marianne in tennessee. caller: i believe our biggest geopolitical threat facing the united states is mar-a-lago. host: how do you make that case? caller: we have an election coming up in a few years. i don't believe we need the same people in office. host: how is that a geopolitical threat? caller: within the country, the past administration tore the country apart. it thank you very much. host: gary is in iowa. hello. caller: people are missing the

point. when you talk geopolitical, it's not about our politics in america. it is what is happening overseas. everyone wants to blame the past administration or this administration. china right now, they just signed a pact with iran for cheap oil for the next 10 years. russia has been probing our alaskan and western front for the past six months. you are talking about china with their south pacific area, the problems they're having with japan, that whole waterway. they could take that over and there would be no more shipping

through that area. the biggest threat is china. they will eventually take us over. that is what's going to happen. host: when you say take over, what do you mean by that? caller: they created the virus to weaken the western hemisphere. look what happened. we shut everything down. we lost millions of jobs. everyone is -- just look at the average person. everybody is scared to go out. host: how do you view that as a takeover? caller: you weaken society. then it's easier to come in with your ideals. since most of the people in

america count on the government to pay for their things, whatever the government is going to say, they are going to do. they are reliant on the money from the government. host: gary in iowa, a member of a military family. we have a line for military and military families. china was on the topics of the president last week when he held that meeting with the japanese prime minister, he talked about areas of concern in the pacific and highlighted china and north korea. >> we affirmed our ironclad support for u.s. japanese alliance and for our shared security. we committed to working together , to take on the challenges from china and on issues like the east china sea. as well as north korea, to

ensure a free and open indo pacific. japan and the united states are too strong democracies in the region. they are committed to advancing our shared values, including human rights and the rule of law. we are going to work together to prove that democracies can still compete and win in the 21st century. we can deliver for our people in the face of a rapidly changing world. host: more of that is available on our website c-span.org. you can find that in all the other things that have taken place at the website, c-span.org . rest in california says -- russ in california says:

if you want to textus, -- text us, (202) 748-8003 is how you do that. the white house first announced it would retain the historically low cap on refugee resettlement's.

if you want to see more of that, the washington post is how you can look at that. from new york, mike is on our line for others. caller: the biggest geopolitical threat to me is the gentleman in office right now. two reasons why. you've got his son who is tied up with russia and china. you've got camellia who can't take an assignment. he did it. host: how did they prove those points as geopolitical threats?

caller: the worst person you could have in their is the leader of our nation. just like yesterday. host: how does this prove a geopolitical threat? caller: he is so far left. host: ok. let's hear from dan in massachusetts. caller: thank you for having me on. our biggest threat is our own government -- host: how exactly is that a geopolitical threat? caller: our own government and the multinational corporations in our country. when we were younger, what we

saw is a lot of companies outsourcing jobs to china to get their goods manufactured. that's what we saw a long time ago when we were kids. i'm probably about the same age as you. we saw this all over. now what we are looking at are the same corporations looking at china as customers. they have a lot more people than we do. that's a lot more potential customers for these corporations. the government that doesn't get elected, they are sitting there. they are there now. host: if it's corporate based, what is the threat? caller: the threat is these

corporations now, their allegiance is the bottom line. their allegiance is getting more business, more market share. they don't have a specific allegiance to the united states. even though there are bills that treat them like citizens. they don't have an allegiance to our country. these companies are selling out to get more business in china. you see it happening. they have a better relationship with china. what's happening here at home, these companies are turning into political things. it is undermining the united states of america. host: let's hear from radley in virginia, military family. caller: this is bradley.

thank you for taking my call. the biggest geopolitical threat would have to be canada. take a look at the price of maple syrup. it's got up to $20 per leader. there nationalize health system has us envious or disgusted that we have to pay outrageous rates for comparable care. their parliament system has 105 senators. we only have 100. poor california. host: what is the threat? caller: there's not one, actually. i just find this question comical. mass hysteria is the biggest threat facing most nations in this day and age. we have so much access to news. host: i will highlight the

report that we started off with from the director of national intelligence. why do you call it mass hysteria? caller: naturally, there are always going to be competitors in the world economically. however, as an example from our last two presidential elections, people can easily get outraged by a lot of regurgitated information. host: our line for others in virginia, go ahead. caller: good morning. for me, china is a competitor and not a threat.

our companies are working with china for cheap labor. china is competing with us. host: how is that a threat to the united states? caller: it's not a threat. it's a competitor because of economic interests. that's what people want. the people want infrastructure, roads, hospitals. they are doing that. our companies, they go overseas for cheap labor. they don't pay the wages here. they want to keep the wages down. russia, they want to weaken our democracy and democracy around the world by hacking our

infrastructure, by doing things around the world. host: you would not put china on that list when it comes to cybersecurity? caller: not as much as russia. china is an economic power. russia is not. china is strong. they have a strong economy. they have more middle-class than we do in this country. host: by the way, the editorial from the new york times takes a look at russian geopolitical politics is in the country itself. alexey navalny's wife has sounded an alarm that the critic's health is rapidly deteriorating.

many supporters are demanding that his doctors be allowed to see and treat him. the decision lies with vladimir putin. host: the new york times with that editorial. if you want to read it there. let's hear from robert in massachusetts on our line for others. caller: the greatest threat is when donald trump first met in helsinki with vladimir putin. they met in that room for two

hours with vladimir putin and not one government agency knows what happened in that room. on top of that -- host: why is that the largest threat? caller: russia is our biggest threat. donald trump worked with putin to fix the election. the fbi told to that. the cia told you that. how could anyone believe the election was stolen? host: we don't have that president anymore. why is that still a threat? caller: donald trump still gets information from the cia and the fbi. vladimir putin might have our nuclear codes. host: that ends this hour of calls on geopolitical threats. thanks to all of you who participated. we have two guests joining us

this morning. we will hear from the former director of the council under the previous president. he discusses the initiative to address the opioid epidemic. pandemic. later on we will hear from the former acting director of the cdc who will discuss the implications of causing the use of the johnson & johnson covid-19 vaccine. those conversations, coming up. washington journal continues. ♪ announcer: watch the trial of derek chauvin, charged in the death of george floyd at 10:00 a.m. eastern on c-span. today, testimony from a use of force expert and former police officer and dr. david fo wler, retired medical chief -- marilyn chief medical examiner. tonight on q&a, a conversation

with the author of the book "the triumph of nancy reagan: the strength and tenacity of the former first lady who helped shape the reagan presidency." >> she had one agenda which was ronald reagan's well-being and success and she had better instincts about people than he did. sort of a better nose for trouble than he did. the people in the administration who understood all this, people like secretary of state george schultz or white house chief of staff treasury secretary really understood that she was a crucial ally to have if you were trying to get ronald reagan on board. announcer: "the triumph of nancy reagan" tonight on q&a.

listen to c-span's podcast the weekly. this week, james clyburn talks about the history of the group and their priorities moving forward. >> stay focused, stay in touch with the dreams and aspirations of the people who look to you for leadership, not necessarily who you may represent. and the only african-american congressman in south carolina but south carolina is a state of over 4 million people and right around 29% of them are african-americans. so although i have one of the seven districts, there are african-americans and all of those districts who look to me to help with the fulfillment of

their dreams and aspirations. the congressional black caucus has that same role to play on a national stage. announcer: find the weekly where you get your podcasts. washington journal continues. host: our guest not only served as a former member of the white house coronavirus task force, he's also a former director of the white house to master policy council under the trump administration. thanks for joining us. guest: thanks for having me. host: can you walk through the responsibilities that you had in that previous administration on guest: guest: both of those fronts? well, i began my time in the trump administration at the office of management and budget as what is called the associate director for health programs. the office of management and budget is one of the best places to work in the federal

government. it is an outstanding group of civil servants, technical aspects on all aspects of the government and i managed the spending and all the regulatory clearances out of the department of health and human services. i managed a budget of $1.3 trillion, cleared every regulation that they issued, significant guidances. i had jurisdiction over that role for cms and fda and other aspects of department of health and human services. i did that for two years and it was a fantastic job, maybe one of the best jobs if not the best job i will ever have in my life. and then the domestic policy advisor, in that role, i had policy responsibilities for basically all of the president's

agenda and the cabinet secretaries and worked very closely with a number of them on issues ranging from homelessness to environmental issues, and your regulatory issues. i was on the state council. criminal justice, drug policy. until covid-19, january, february of 2020, and that increasingly occupied a tremendous amount of my time. i was one of the original members of a task force that left in may, 2020 right around memorial day. host: what prompted you to leave those positions? guest: 3.5 years is a long time. i joined the administration, i had three kids and a fourth kid at the beginning of my service. it is a lot. i worked very hard. i was proud to work hard. my wife and i agreed that i

would not leave anything on the table and i would work very hard because i figured you don't get opportunities like this very often i had promised her two years and when work in the west wing came up, i didn't think i could turn it down. but after a year and a half of that, almost, i was exhausted. to be frank, i really thought that at that point in the covid-19 response, the private sector needed to step up and do a lot more, the government was sort of maxing out on their ability. getting vaccines over the line was the principal issue. that was going to get done whether i was there or not. and i was burnt out. it was time for me to leave. it was time for my family for me to leave.

and i laughed and i didn't look back and it was a big relief to make up the next day at a normal hour and be able to have a cup of coffee and think about what i was going to do that day. host: one of those domestic issues that you highlighted and you have maybe dealt with directly with the ob crisis. there are new figures coming out from the cdc about overdose deaths from october 2019-september of last year, saying that a 29% increase in americans from the previous period suffered, it was a large number in april and may. from the reactions of this report, what do you think is going on with this issue, even though we focused a lot on it, where do you see it going right now? guest: it's a great question. first and foremost i would say

you're talking about every town, every city, just about every family affected in some way by this crisis. we are almost, to your point, year-over-year, at a 30% increase. the data was released provisional. i think that when the next round of data gets released in a few months, we may be over 100,000. the covid-19 shutdowns, the disconnection from care that a lot of people who are struggling with addiction faced. i am a huge proponent of telehealth. but it can't replace in person counseling. we need to fundamentally rethink how we treat addiction in this country.

it was bad before covid-19, it is not going to get better on its own. you look at the push in many states and at the federal level for legalization, which as somebody who trends libertarian, i am somewhat sympathetic to the argument about over incarceration for people with minor drug crimes, i think too many people are being thrown in jail for too long a time and not getting the services they need. but if you legalize more drugs, there is no way you're not going to get more addicts. that is the way it is going to go if we don't fundamentally rethink the way we are free. we need new, in native, nonaddictive painkillers. we also need new treatments to reverse overdoses. narcan will is a great product, but it doesn't work very well against fentanyl. we need opioid reversal agent for fentanyl.

we need to change the way medicaid reimburses for treatment. we need to remove the stigma for addiction and people who have this problem need to be able to get services they need without fear of getting fired at their jobs or ostracized. they need help. and i have viewed the opioid epidemic and crisis as the other side of the coin of the mental health crisis in this country. we need to rethink that as well. we have been on the wrong track for probably 40 years on the mental health treatment. you can't tell me that a number of these mass violent incidents could not have been in many cases avoided if those perpetrators had had some type of intervention before action like that.

this is a continuing, and people don't wake up in the morning and suddenly decide to do something like that. in some cases, they have delusions. regardless of what it is, we need to think about how we treat people with mental illness and on a bipartisan basis figured out how to confront this problem. host: jeff grogan our guest if you want to ask him questions. here is how you can call us. (202) 748-8000 for eastern and central time zones. mountain and pacific, (202) 748-8001. you can text us at [captioning performed by the national captioning institute, --(202) 748-8003. when it comes to approaches, what is the best approach for the federal government? guest: first and foremost, they look like they are trying to

spend more money. fine, we are only getting about one in seven people who need treatment access to treatment now. that is atrocious. that is clearly not enough. it is almost a bottomless pool of demand for addiction services. you need to increase the number of facilities and the spending going to the area. part of that is to reverse a 40, 50 year policy that goes back to the 1960's and prevents medicaid for ash from paying for long-term, in-house treatment, institutionalizing people. there are some people that need to be put into a facility whether they are having an mental health issue or an addiction issue to get long-term stability that would come from in-house treatment. that would help the states, to

be frank. you can do that on a bipartisan basis. you can spend the vast majority of that money by the federal government. the increase in medicaid spending, this would be an area that you could find common ground because crisis is so acute. the next thing we want to do is make sure democrats are pushing on drug pricing efforts. many of these efforts and proposals really would hurt innovation in this country for the level of treatments and the kind of treatments that we need, like i talked about, the new opioids that would not be addictive, the painkillers that would not be addictive, the opioid reversal and overdose reversal agents. if you tinker with this ecosystem which we just sought to splendid effect with vaccine development, if you screw it up,

we could lose a generation of new products that are under development and i'm very worried about the number of proposals being discussed on the democratic side of the aisle on drug pricing because they seem to be focused not on relieving patient cause, but on punishing the pharmaceutical industry that just delivered us a miracle in getting us a number of vaccines that are helping combat the covid-19 pandemic and move society forward. i think there is a whole host of issues that need to be addressed. one thing is not going to do it. i would also point out that this ties in very nicely with biden's effort on equity in health care and eliminating racial disparities. african-americans have even less access to treatment facilities than caucasian americans. in many instances, they get into

treatment years later than whites on average. for decades, african-americans were closing the life expectancy gap, but that gap is starting to widen and it is a little bit unclear as to why. preliminary data indicates that overdose death is a reason why. we have been viewing the opioid overdose epidemic, if you read the media, and there was an article in the new york times yesterday, a brutal story to read about a young man going back to his hometown and the number of overdoses. a predominately white area. that is the type of story you read about. there's a lot going on in the african-american community was overdoses. i think we need to pay attention to it. again, this transcends race, it transcends party.

and i would hope this would be an area that both parties can sit down with an open mind and figure out how to engage. host: this is joe grogan. betty from connecticut, you are on with our guest. caller: good morning. i used to be from virginia, but i am originally from connecticut and i moved back here. but about the opioids. three weeks ago i had a replacement on my right knee. and i would never get addicted to the opioids, but i couldn't even take the opioids that prescribed. but then the itching was so bad that i gave up, i let them know and i went back on iv pros and and i checked with -- ibuprofen and i checked with my doctor and sure, i understand there is a big epidemic and it was pointed

out to me very clearly at the george floyd trial, and i understand it is a big problem. for me, i had the opposite problem. in other words, my body seems to reject a lot of pain medicine and i can take it for a while but then i start itching. host: there is a viewer also off of twitter who adds this, saying the current crisis occurs through legally prescribed drugs. with that and the previous caller, go ahead. guest: to some extent, but not entirely. many people get addicted through legally prescribed opioids and a lot was done during the trump administration to clamp down over-prescribing, taking action against doctors who are over-prescribing, writing letters to doctors who are

overprescribing. changing reimbursement of medicare to prevent overprescribing. there was immunization in the market to prevent these pills from being crushed. and then people moved to heroin which in many cases is cheaper. obviously in that instance if you are buying them on the street they are illegal, but there is a huge market still in this country and you're seeing an hiv outbreak and parts of west virginia right now because hiv, sharing needles is a tragic result of the heroin epidemic. it is not exclusive to legally prescribed opioids by any means. and let's not forget a lot of the stuff is driven by fentanyl.

much of it is illegal, coming from china, some of it coming through the mexican border and mexico. this problems with meth as well. i am perfectly willing to stipulate that legally prescribed opioids are a problem that we need to think through and as i said, we need new types of painkillers that are not addictive. it sounds like the previous caller was able to kill her pain with ibuprofen. there is a lot of experimental stuff around ibuprofen that is working out very well and i hope we see more promise with ibuprofen being used in surgery and painkilling interventions. host: this is sandra in michigan. though ahead. -- go ahead. caller: what you are not talking about is the law now that is

giving people who are legitimately in severe pain, have been taking pain medications for years, and the doctor cut them off. my best friend was on painkillers for five years, and when the doctor took him off his pain medication, he committed suicide. my sister-in-law had breast cancer surgery, and her doctor only gave her enough pills for 14 days. she really suffered after that because the government wouldn't let her doctor give her any more than that. so it seems like you are hurting the people who really need the pain medication that really take it the right way, who have taken at the right way for years, but are being taken off of it because doctors are afraid of losing their license. people like you never talk about those people.

that suffer because of the law. it isn't right, it is just not right that people go through severe pain and are being taken off of painkillers. it is like you don't care about them. these people who are overdosing are taking medication the wrong way. host: thank you for the comment. we will let the guest respond. guest: well, i do care about it, i care about it very much. there is a role for painkilling medication including for the opioids that in many instances can be addictive. i don't dismiss that. obviously, i have had plenty of family members who have gone through surgery or i have had family members including my father who died of cancer, he was on a tremendous amount of painkillers at the end. i'm very sympathetic to the need for painkillers. but as i've said before, not every painkilling demand needs

to be fulfilled by an addictive opioid. as the previous caller mentioned about ibuprofen. more importantly, we need to be developing new treatments that are not addictive to kill pain. there are a number of interesting things going on on the device side to kill pain. device interventions, to block the neural receptors that transmit pain messages to help people move forward with their lives, and there are a lot of drugs in development that also need new interventions to work on painkillers that are not addictive. and that is going to come from the private sector. we can talk about investment and basic research, it is all very important, but there is no way we should not be encouraging private companies to invest money in this area to develop new treatments that can kill

pain and be nonaddictive, too. host: mr. grogan -- the associated press poll ported divide in the biden demonstration has canceled meetings over a plan for so-called fentanyl analog, adding that they are-generally foreign made drugs. the story adds that the temporary legislation classifies synthetic opioids as a schedule 1 drug, making it easier for prosecutors to build cases against traffickers. the emergency authority authorized in 2018 is that would expire next month. guest: this was an issue that we struggled with in the trump administration as well.

basically, the problem, and actually, i had served on a grand jury at one point in washington, d.c. before or during the obama administration, and you have this bizarre situation where the chemists working for the drug dealers are able to cook up new chemical concoctions that law enforcement hasn't seen before and are not illegal because they aren't schedule. legislators haven't said this product with this chemical makeup is illegal because it is brand-new. and so you would have a situation where people are making new concoctions, getting people high, in many cases overdosing and dying and you can prosecute them.

the idea is to be able to broadly schedule a number of fentanyl analogues in the fentanyl class and call them all illegal to enhance prosecutions. it's not simple, to be fair. i'm not on pathetic what the biden -- i'm not unsympathetic to what the biden administration is going through trying to balance the necessity of fentanyl to be used legitimately for painkilling purposes and the necessity of keeping the stuff off the streets and keeping people alive and prosecuting people who are up to no good. i'm hopeful they will find a way through. i understand they want to ask a lot of questions about the previous policy but there is no question that law enforcement needs more tools and some creative thinking here to be able to prosecute the number of people coming up with new

fentanyl analogues to skirt prosecution and the law. host: let's hear from illinois. caller: good morning. your presentation seems sincere. however, i have seen on the conservative side over the last 30 years that it has not been so sincere in terms of how to solve the suppose it opioid epidemic. i was in law enforcement in calendar -- in california from 1981-2004, and back then junkies did not get the love that they get today. what is the difference? flax, brown, and poor whites were the ones going to the joint for that. now we have developed some sort of illness associated with it. i can guarantee you this. back then as it is now, you will find people addicted to opioids are not just harmless people from the suburbs. by your own admission, most of them are white.

they will become burglars and they are going to steal from you and your house. they are going to steal anyway they can get it and that could also mean violence. so if we are going to be consistent like we did, this epiphany we have had about let's just make it a sickness now has not been consistent. it should be a crime, it is a felony to possess. it should remain that. put those people in the joints -- put a parole record on them and see how well they do in society. i do agree with your sincerity. if you're going to help people with this problem, you help everybody, not just the people who look like you. thank you very much. guest: law enforcement is an important perspective, there is no question, the guys who really understand that better than anybody are the people who are treating addicts on the street with their hands dirty, doing

outreach on the street for people and getting them into care and law enforcement. and this is not something, frankly, that law enforcement is equipped to do. they shouldn't be out there treating people. they need to keep our citizens safe, and they need to keep our streets safe. they shouldn't be out there inundated with so many drug crimes and so many people who are addicts. i don't pretend by any stretch of the imagination to have it all figured out by any means. but i do think that people who are arrested, who hit rock bottom and are engaged in crimes in order to fund their habits as the caller said, they need not only to be punished for their crime, but also to get treatment. in many instances, we've been focusing too much on punishing the crime, throwing them in

jail, and not figuring out how to get these people back into society and being productive. another thing just to keep in consideration here as we consider the biden administration equity agenda playing out, if you are wealthy and you are an addict and you decide your family decides you need treatment and you finally are going to take that step, you have the financial resources. there are some outstanding treatment centers. it doesn't mean you're going to be cured overnight or that you are going to make it to the hunter biden saga which is a great example and should be illustrative as to how difficult it can be regardless of how much money you have to kick your habit. but you've got more margin when you are wealthy. if you are poor and you are an addict, you don't have a lot of margin. that line between needing money to feed your habit and

committing a crime in many cases at the caller said, violent crime, it gets really thin and i do not deny the fact that these people need to be prosecuted, but we also need how to figure out to keep them from getting addicted and figure out how to keep them from committing crimes and get them back to being productive members of society. host: joe grogan is eric asked. also a former member of the white house coronavirus task force in 2020. there was a recent article in bethesda magazine which serves bethesda, maryland highlighting opioid deaths in montgomery county, maryland 26% rise in 2020. one instance as far as rises go is this happening not only in the suburbs, but in urban areas as well.

are we paying more attention to it because it is happening in the suburbs? guest: it is everywhere. there is no question about it that it is everywhere. i think it is a great question about why are we paying more attention to it? i think we were paying attention to it as a society at the beginning of -- the end of the obama administration, breaking into the media, and then donald trump when he was running for president spoke about it a number of times. he got billions of dollars of resources, bipartisan support. we actually saw a decrease in overdose deaths year over year right before covid-19 hit and then covid-19 has blown everything off the front page. everything out of the newspapers as far as health is concerned. i do think the question about, as i mentioned before, this

racial disparities-equity issue is very interesting to watch, because my own anecdotal observations are the media reports around what this is doing in rural america and white america and how this is different than some of the other epidemics that we have confronted, but it is moving into the african-american community and as i said, their life expectancy appears to be declining and it appears to be as a direct result of overdose. i think more attention to your point needs to be paid to what is going on in the african-american community. but it is happening everywhere and is like a balloon. if you clampdown on the pill mill prescribing a lot of the law enforcement activity, they move and they appear to have moved in some instances to southern california where they are seeing an increase in overprescribing.

this absolutely disgusting practice where treatment facilities will get federal dollars to treat people and they seem to be not so interested in getting people on the road to recovery, but actually more excited to have them relapse so they can come back in and be treated again and keep the federal resources flowing. so there is a lot going on here that needs the attention of policymakers and practitioners. host: to that last point, it was in the recently passed covid-19 relief law that the administration set aside some money taking a look at this issue. 1.5 billion dollars overall for the prevention and treatment of substance use disorders. and then it added $30 million specifically toward local addiction services highlighting the spending of this type of money to allow for things like syringe exchange programs. what do you think about that approach?

guest: syringe exchange programs have been controversial for a number of years, back to the 90's when they started. it started in the late 80's, and then hepatitis. i started my career in public service at the department of health and human services working on hiv policy. i ran president bush's advisory council and then i went to the fda and in the private sector i work for gilead sciences for five years which was the number one company in hiv research and revolutionized hiv treatment in this country. there's this debate around needle exchange that it normalizes drug abuse and that we shouldn't just be handing out meals to people. if you look at some of the areas

where they have done needle exchange in the united states or internationally, it certainly hits you emotionally when you go into a part and a bunch of used needles and a group of people who are gathering together to shoot up. i understand the emotional argument. i understand the into a -- intellectual argument against normalizing addiction. however, i think if you designed these the right way, and that is to say, you increased contact between a human being who cares and is devoted to keeping somebody healthy and alive and say ok, i'm going to give you a clean needle or a number of clean needles so that you don't infect yourself with hiv or other people with hiv or hepatitis-c or hepatitis-b or any other number of blood diseases, i'm going to work on

keeping you healthy as i can, and we are going to talk by getting you completely clean. maybe not today, but next time. an increasing contact between people who care and addicts. i think you can pull people out of the cycle. at least, that is what i would hope. you can design a needle exchange program that frankly doesn't do much. you can only have so many needles before you start sharing them anyways if you are a junkie . the critics of the programs would be justified but i think you can design one that is part of an outreach, that can perhaps start to nudge people toward an

understanding that they need to get some help. host: here is matthew in north carolina. you are on with our guest. go ahead. caller: good morning. i grew up in new jersey during the height of the heroin in the 70's. i moved to north carolina in the late 80's and 90's, watched the opioid epidemic come into play by prescription medication. before now, heroin addiction. that i moved to west virginia during the height of the over prescription of medication there and really, totally watch the turnaround. i mean, it was terrible. i moved back to north carolina and now that heroin addiction is very bad. but my point is that the government does and always has subsidized opioid addiction, and

that is just another addiction. it is not another road to recovery, it is just another addiction being subsidized by the government. host: thank you for the question. guest: that is a really good point, very astute observation that needs to be pressed on in a number of areas. first of all, that is an important perspective about the number of places he has lived and witnessed the different types of epidemics and how they have different cycles from prescription drugs to illegal drugs. the first thing i would say before i get to the methadone issue, the federal government subsidized a lot of opioid prescribing for medicare part b. we developed the medicare part b program and there was a wave of

overprescribing of opioids and clearly addictive activity associated with doctors who didn't care and in some cases pharmaceutical companies who didn't care. purdue pharma is in bankruptcy right now. the evidence is very clear that they were completely indifferent. they appeared to be trying to maximize their profits by creating more addicts. there is evidence around consulting firms that were to spit in that. purdue pharma is going to be destroyed, never to rise again based on their activity in this area. advisors in the trump administration did a study that legally prescribed opioids play in getting people addicted and we spent a lot of time clamping

down on preventing doctors from prescribing too many painkillers and also prosecuting them and sending warning letters if we saw activity that was unusual. now, the clinics, it is very interesting what the caller just said, because he is right that methadone and beebe and efrin -- has street value. it has a street value in prisons, too. it is designed to sit under your tongue and it gives you a high and it is addictive. and so is methadone. we need new ones.

methadone and buprenorphine are better than nothing in many instances, but they are not a solution. they need to be integrated as part of a larger treatment and recovery program, and you can't just say i'm going to replace your heroin with methadone and think that we are going to get more people on the road to recovery. you've got to figure out how to say ok, we will get you off these incredible dangerous drugs and we are going to transition you to something like buprenorphine or methadone and then we are going to do into treatment or we are going to help give you need to move forward. it's incredibly important point and again, it goes back to we need new interventions. we need new ways of treating people to block the cravings for

addiction, to not get people hooked on pain killers the first instance, and when they do, remember, if you have a predilection toward addiction, suppose you were addicted to opioids at one point, it doesn't mean that you don't have a need for painkillers moving forward. if you were addicted at 20 years old and you break your leg at 25, you are going to need painkillers, perhaps. we need new ones that are not addictive and are not going to have relapsing occur. host: what is the best steps for the biden administration to take for this topic in your opinion? 0 guest: first and foremost, they need to work on a bipartisan basis. i've been very discouraged by the difference in president

biden's rhetoric during the campaign, being a and uniting washington, d.c., that was a big part of his selling point in running for president. his rhetoric and actions since he has been in office have been not unifying, not bipartisan, and this is an issue where he can pivot and start to fulfill the promise, promises that he made during the campaign. this is a bipartisan issue that cuts across racial lines, economic strata. he needs to sit down with republicans with an open mind, with his team, and figure out how to intervene. but it needs big thinking. it means fundamentally upending a lot of policies. it means telling democrats in the house of representatives who are focused on punishing pharmaceutical companies instead of relieving patients of their

own co-pays and to dr. bowles and the pain that they are having, because you will screw up the pharmaceutical ecosystem and we will not get the next wave of treatment that we desperately need. host: joe grogan, also the director of the white house master policy council for the trump administration from 2019-2020. thanks for your time, sir. guest: thank host: you for having me. host:we are going to take up a discussion taking a look at vaccines specifically. joining us for that discussion, dr. richard besser. he is the former acting director of the cdc and we will have that conversation with him when washington journal continues. ♪

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bios and committee assignments and also contact information for state governors and the biden administration cabinet. order your copy. every purchase helps support c-span's nonprofit operation. washington journal continues. host: dr. richard besser is the president and ceo of the robert johnson foundation and also the former acting director of the cdc during the obama administration in 2009. thanks for joining us. guest: a real pleasure to be here. host: could you tell a little bit about your work at the foundation and what the foundation is? guest: we are located here in princeton, new jersey and we are the largest philanthropy in the united states focused on improving health and health care in america. more and more, our focus is less around health care itself, but around the conditions in communities that allow people to lead healthy lives. host: because we are going to

talk about the johnson & johnson vaccine, i understand there is a connection between johnson & johnson and the foundation. guest: our foundation was founded in 1972 by money that was donated by rob johnson the second who built the corporation into what it is now. in addition, we own a significant amount of stock in j&j. host: the johnson & johnson vaccine that came into consideration last week because of concerns over quality, explain what happened and do you think that with the right response? guest: first, i do think taking a pause with the right response. when you think about the vaccine that we administer, and i'm a general pediatrician, i administer, over the course of my career, and a lot of vaccine, the approval process they go through requires testing and

tens of thousands of individuals. and when you are testing a vaccine in tens of thousands of people, you're going to be able to detect common side effects, but you are not going to be able to detect something that may occur very, very rarely. once the vaccine has been approved or used, and this vaccine was approved on what is called emergency use authorization, so it is approved during a crisis, it is not a full on approval, once it is approved, you need to monitor and look to see are there any other events that are occurring that could potentially be linked to the vaccine itself? and so you set up systems and in the united states, we have a number of systems to report what are called vaccine-adverse events, and then they are investigated to see if this is something that was just occurring in a timeframe-related to vaccination like someone who had a heart attack and they had

a vaccine last week but it wasn't caused by the vaccine, or was it something that the vaccine could have caused? in these systems of reporting, they detected six cases of a very rare type of blood clot in women who are all younger than 50, within two weeks of having received the j&j vaccine. there is a committee that makes recommendations to the cdc on vaccinations, it is called the advisory committee of immunization practices. they met once, they looked at the initial reports from the cdc and fda and they said we want to see more, we want to understand this further before we make a recommendation in terms of if and how this vaccine should be used again. host: what data does that committee have to look at, and is that data easily available? guest: they are looking at the

case reports. the reports that came in through the system. they are looking to see if there are any possible cases at the state or local level that may have been missed, what is it about these cases that could possibly link them to the vaccine, is there anything different about the individuals who had these reactions from the general public? should the vaccine be used again? if it is being used, what kind of information should have in deciding whether to get that vaccine? what should documentation be for the receipt that vaccine after vaccination that might indicate they are having one of these clots occurring? how should these clots be managed? should the vaccine be available to everyone over age 16 like it is currently, or should it be

restricted? they want to make sure of a couple things, that they have captured all the cases that occurred and the doctors are getting the message of what to look for. this type of clot is a clot that can cause clotting in the main vein that drains the brain. if it is treated the way common clots are treated, it can get worse rather than better. so they want doctors to be aware of this and be aware that the treatment is different than it is for other types of blood clots. host: our guest is with us to answer your question. you can call for the eastern and central time zones. if you want to text us, you can

do so at (202) 748-8003. you can post questions on twitter. because of this pause and if it extends further, what communities are most directly affected as vaccinations are going on across the country? guest: madison going to vary by state -- that is going to vary by state. i am on the new jersey commission for the northeast. states have different plans in terms of how this vaccine was being used and how they plan to use it. what we have been seeing across the nation is that a lot of people were requesting that vaccine, or looking for options to get it because it is one and done. one shot and you are protected, you don't need to go back in three or four weeks for a second dose. that has a number of advantages for public health officials in

terms of getting vaccines to hard-to-reach populations. the pfizer vaccine and the moderna vaccine all have some more challenging requirements in terms of temperature. the j&j vaccine has less of that, it easier to move around at room temperature or refrigerated temperatures. i'm hearing in new jersey that they are going to be able to adapt and this is not going to slow down vaccination. nationwide, what i am hearing from the white house is that we should be able to still reach 3 million doses of vaccine being administered every day. the question is who is going to be getting those vaccines? if you are planning to do a vaccine drive in a church or community center where you might have less access to the cold temperatures for storage, are

you going to have to change your planning? host: there was a poll taken, and the question was how safe do you think the johnson & johnson vaccine is? this is after the suspension announcement. before that, people said 52% safe, 26% unsafe. after that, 37% saying safe, 39% saying unsafe. what does this do to the overall topic of vaccine hesitancy? just the general willingness or hesitancy to take a vaccine. guest: those numbers concern me a lot. especially the pre-numbers. only 52% of people at that point felt that the vaccine was safe, i would have expected that probably applies to all the vaccines that are being administered and reflects a much lower level of confidence in the system that we have in place to approve vaccination. that's very concerning.

i think that all three of these vaccines went through a very rigorous process. when i was watching the process of moving this forward i was looking to see are they cutting corners? is the fda cutting corners and the approval process in terms of what they were looking for? and they didn't. the same advisory committee, a committee of experts that reviews other vaccines reviewed the data on this vaccine. unlike some european countries where they accepted the interpretation from the company. in the united states, the fda reviewed the data independently and that analysis and the company analysis are shared with a committee of experts and that took place here. i watched a lot of those committee hearings and they asked tough questions. at the time the fda said yes, these that seemed approved for emergency use, they are safe and

they are effective, we will continue to monitor them, i felt very confident at that point recommending them to my parents, who are both 91. i recommended them to the parents of my patients. as a pediatrician, most of them are not yet available to my patients, but i will be watching again the approval process at the vaccine comes for kids. and we have to think, what can we do to increase the confidence of the general public in these systems? because they are the most rigorous systems in the world for approval of drugs and vaccines. host: our first call for you comes from linda in connecticut. you are on with our guest dr. richard besser, former head of the cdc and president and ceo of the robert johnson foundation. go ahead. caller: thank you so much. i wanted to ask you a question about the moderna. i took the first -- excuse me --

first of the moderna vaccine and it was given either slightly out of the dose or slightly to the back. in other words, not in that ideal triangle in the deltoid. so i don't know if it actually worked or not. i am getting the second dose this wednesday. i spoke to my doctor and he said well, there might be an antibody test you could take to see if you are fully protected. and all he said as i will try to look into it and i'm wondering, is there an antibody test that you can take to make sure you are fully protected if one of the vaccines was given incorrectly? and if there is, what is it, and when do i take it? guest: right. i would think that administering that first vaccine off-center, you would still get the protective effect from that and you would have a second dose that is coming. but given that vaccines are not

tested in terms of administering them off target, there isn't data to really support that. you are talking to your doctor about level of comfort in terms of whether to assume, whether to count that first dose is not really a dose, or not, the question of antibody testing, there is testing that can be done to determine if you have antibodies. if the first dose was not a ghost dose, will you get the same level of antibodies and will they last as long as if you had gotten two doses administered the way the manufacturer said they are to be administered? but given the number of doses given, i would suspect there are quite a number of doses given that are not given exactly the way they are recommended.

that is why when vaccines are approved for use in the general public, we will continue to do studies to look at effectiveness. the data from a trial is a best case scenario. sometimes on a vaccine is used in the general population, it will go down a little bit because you are not having the same quality standards in terms of administration. host: this program gets seen worldwide on occasion, particularly sundays. peter joins us from the united kingdom. good morning. caller: good morning. i am wondering if you had seen the report by oxford university researchers which looked at a meta-study of health outcomes from health records in u.s., u.k., and e.u., which found the incidence of cvt's in both mrna

vaccines and adenovirus vaccines. and they found that there were incidents of cvt with mrna vaccines, although a slightly lower level than with the adenovirus vaccine. host: dr. besser, go ahead. guest: cvt is the clot in the brain. i am waiting for that study to be peer-reviewed. it got a lot of press this past week. i would caution people in terms of interpreting a study before it has gone through the scientific review process. if the methods and quality are found to be high, then it is worth talking about. it can be really challenging

when you are looking at a rare event to figure out, is it occurring more frequently than it otherwise would occur? with the j.j. vaccine, what has been seen is six cases of the rare clot in the united states in roughly 7 million people who received the vaccine. even using the number 7 million is challenging since all of the people who developed the were women. the question is, should you use a different denominator, namely one that is just women. and all of the women were younger than 50. should you just be looking at women younger than 50? i think that is appropriate if you are seeing this occur only in a subset of the population. don't to understate the risk while at the same time you don't to overstate the risk. the key thing in terms of trust

is being very transparent, telling people exactly what you know, what you don't know, what you're doing to get answers, so people can make informed decisions. one of the most challenging fans i found -- things i found during the years i was abc news, and i was the chief medical editor there for about eight years, one of the hardest things is talking about the issue of risk because if it is found the risk of this rare clot is one in one million or one in 500,000, that is still significantly less than the risk of having a bad outcome from the disease. and it is also much less than the risk for many risks we are willing to take on every day in our life. it is a real challenge. host: here is how dr. fauci was talking about this on tuesday. he addressed the pause. asked about whether the decision

was premature, here is how he addressed a fat. -- that. [video clip] >> i believe the question was, did we pull the trigger too soon? our fda is internationally known for their capability of making sure we have the safest products out there. that is what i meant when i said abundance of caution. you want to make sure safety is the important issue here. we are totally aware this is a rare event. we want to get this worked out as quickly as we possibly can. that is why we want to hold off for a bit and may go back to it with conditions or maybe not, but we want to leave that up to the fda and cdc to investigate that carefully. so, i don't think it was pulling the trigger too quickly. host: there is dr. fauci's assessment. follow up on that. guest: i agree with him wholeheartedly. if you want people to trust the

system and you are seeing a signal that could indicate some level of concern, even if it is a very small level of concern, you want to take action. you want people to have information to be able to make a decision. i would expect if they feel this is a rare risk of this vaccine that the recommendation would be that people should have a choice in terms of whether they receive this vaccine or one of the other two vaccines. it would be a different situation if this were the only vaccine approved for emergency use in the united states. host: don in new york, go ahead. caller: thank you very much for your service. my daughter is 35 years old. she is expecting at the end of june, so she is considered a geriatric pregnancy given today's world. given the variants, mutants out

there, her pediatrician and gynecologist have suggested to go ahead and get the vaccine to protect herself. but given the current situation with the j&j, do you recommend that at this time? she is scheduled for a vaccine at the end of this week and is really hesitant. if it were to be opened up again, would you still support that? guest: current recommendations regarding pregnant women are that the vaccine should be offered. there should be discussion between a person who is pregnant and their doctor about the risks of covid during pregnancy and the decision. clearly, there are studies that show pregnant women are at increased risk of having severe covid if they get that during pregnancy. one of the other advantages of

getting the covid vaccine during pregnancy is that those protective factors, those antibodies, will be passed on to the baby so that at birth that child will have some antibodies for this that may help reduce the chances the baby could get infection. given that she is scheduled to get a vaccine this week, it clearly would not be the j&j vaccine, so that does not need to be something she is worried about. and this rare complication they are investigating has not been seen with the moderna or pfizer vaccines. host: one of the people responding to the pause was former president donald trump. he said they did a terrible disservice. the results of the vaccine have been extraordinary, but now it's reputation will be permanently challenged. the people who have taken the

vaccine will be up in arms. perhaps all of this was done for politics or the fda's love advisor. guest: one thing that is clear is that people want to get thire health information from experts rather than politicians. what the united states decides to do the j&j vaccine will have implications regarding its use globally. there are incredible disparities in terms of how vaccines have been allocated on a global scale. wealthier nations and particularly the united states have cornered the market on many of these vaccines. there are many countries around the world that have not received any vaccination. the reality is that six women have had a severe caught -- clot.

if you don't take a pause, that raises questions about your system and if you are being upfront with the public. taking a pause let's doctors learn what to do if they encounter a patient that may have symptoms of this. that could be a severe headache. that could be a change in how clearly you are thinking, your vision, pain in your calf or leg, nausea or vomiting, those are some symptoms that have been reported. being able to take a pause and educate so people can be aware is the right thing to do. it could protect lives and hopefully will engender trust in the system. host: our guest is dr. robert

bester who also served as acting director of the cdc for the obama administration in 2009. a related vaccine question coming from a texter. it has been reported people inoculated with the moderna were pfizer vaccine may need a third booster in six months to a year. why is that? guest: i saw a report from the head advisor and wondered if that was more a report for shareholders than anyone else. this is an unknown question. this is something we will have to see over time. the good news is studies so far are showing the protective levels are not falling off. that is looking at six months. the reason we only know after six months is that is as long as the vaccines have been used and they can say the antibodies are

robust and hold up. the reason there may need to be another booster, there are several possible scenarios. one is that the virus continues to change and variants appear that are not covered by the current vaccine. thankfully, the variants circulating right now are all still pretty well covered by these vaccines. but that does not mean in the future that will be the case. if a variants comes that is not well protected and we start to see people getting serious covid disease, then you would think about a booster. another reason you might need a booster is if the protective levels are not long-lasting. as a pediatrician, i give a lot of vaccines. some of them, you give them once or twice and someone is protected their entire lifetime. like the measles, mumps, and rubella vaccine. we give that twice.

we give it at a year and right before a child interest school. and that is. they are good to go the rest of their life. the flu vaccine we give every year. it is too soon to protect what we will have to do with covid. it depends whether this pandemic leads to a condition of ongoing transmission over time, something we call endemic disease where it is always there, maybe higher in the winter and then declines. that is what we see with the flu, coronavirus. there are a lot of diseases that do that. there are other diseases that don't have that same kind of seasonality that we work to try and eliminate or get down to very low levels to keep suppressed. things like measles, chickenpox, where you don't have to think about a seasonal vaccination campaign. too soon to tell on this one. host: in the world of politics,

something played out during a hearing this week featuring dr. fauci. he was sharply questioned by tim jordan about when you crisis will end. i want to play a little bit of the exchange and talk to you about it. [video clip] >> this will end for sure when we get the levels of infection low. it is now at such a high level that there is a major threat. >> over the last year, americans first amendment rights have been completely attacked. your right to go to church, right to assemble, freedom of the press have all been assaulted for a year now. americans have not been able to go to church. even when they go, they are limited in size. you're right to assemble? my goodness. we had a curfew last fall in ohio. had to be in your home at 10:00. in pennsylvania, in your home you had to wear a mask. in vermont, you did not have to

wear a mask in your house because you were not allowed to have people over to your house. your ability to petition your government? for a year, american citizens have not been able to come to their capitol to talk to their representatives. freedom of the press? these pictures? guess what, the press is not allowed in those facilities. the biden administration will not let the press in. freedom of speech? the governor of our third-largest estate meets with physicians, and that video is censored because they dared to disagree with dr. fauci. i want to know, when do americans get their first amendment liberties back? >> i don't think anything was censored because they felt they could not disagree with me. i think you are making this a personal thing, and it is not. >> it is not a personal thing. >> that is exactly what you are doing.

host: there is politics as it played out. where we are at in the country in terms of getting vaccinations and the overall crisis, what did you think about how it played out? guest: there are a number of issues raised. many of them are political. i won't get to that. but i think about public health and issues of freedom, i think as a society what we have agreed to is an individual's freedom ends at the point that what they do impacts on health and safety of those around them. when you think about some of the restrictions put in place, they were to ensure one individual's behavior was not affecting the health of somebody else. when i look back over this past year, it is so clear that every community in america was impacted. but not every community was

impacted as hard as every other community. black, latino, and native americans have been infected and hospitalized, have died, at three or four times the proportion of the population. a large part of that has to do with exposure risks. who in america every day had to go to work in order to pay the bills, put food on the table, and pay their rent? and who might be able to stay home, work remotely, or have the resources and wealth and savings to avoid some of that exposure? somebody who says it is my right to not wear a mask and goes into a store where someone is working, you know, a basic job just to put food on the table, and they are exposed to somebody who decided they want -- don't want to wear a mask, they are putting that other person at risk.

that is where the rights of society, the rights of public health, the rights of government to say if you want to go into that store, you have to wear a mask. and if you don't want to wear a mask, you cannot go into that store. those are things we do as a society to protect each other. one of the biggest challenges in this pandemic is how politicized it became so early. the reason for that was we had political leaders, starting at the white house, who, rather than lifting up and supporting the science-based recommendations of public health, made public health the enemy, rather than seeing public health as the way for sustained reopening in a safe way of our economy. lifted up public health as a barrier to people's economic help. and that is still playing out today. when you look at vaccination in america and who is most relaxed

and dumb -- reluctant to get vaccinated, you see a political divide. white male evangelicals, conservatives, with the highest rates of saying i don't want to get vaccinated. that should not be because viruses do not care about an individual's politics. unless we work to meet everyone's concerns and help people understand a decision to get vaccinated is a personal decision but when you decide to get vaccinated, what you are also doing is saying i want to protect my family, i want to protect my community. i want to make sure everyone in my community is safe and that this pandemic finally reaches its end. host: let's hear from arnold, maryland, this is sue for our guest. caller: i would like to ask you

if the women who had the clotting problem with the j&j vaccine were taking estrogen or birth control pills. remember, back in the 1960's, the first birth control pills were much higher in dosage. there was a clotting risk with them, too. thank you. guest: that is a great question. there is an increased risk of blood clots in women taking oral contraceptive pills. that is a known risk. interestingly, the type of clots in these six women who received the j&j vaccine are very different from the clots you see in people taking hormones. that is one of the reasons for the pause, to let doctors know it is a different type of clot.

the women who had the clot following j&j had very low levels of platelets. platelets are one of the factors in our blood that help us form clots and stable clots. that is not what you see from someone after being on oral contraceptive pills. it is different here. i don't know if any of these women were taking hormonal contraceptives, but the big lesson is there is no known increase in terms of reactions to these vaccines, any of the vaccines, in women taking oral contraceptives. this is a very different kind of situation. host: dave is an mckinley ville, california. good morning. caller: good morning. whatever happened to common sense in this country. i see people driving around in their car with nobody else in the car wearing masks. i see people vaccinated weeks ago walking around in the open

air with nobody else around wearing masks. i understand michigan is requiring two-year-olds to wear masks. even if these blood clots are related to this vaccine, you are talking about less than one in a million chance of getting a blood clot. your chances are better of being hit by lightning. and yet, they are suspending the administration of this vaccine. it seems like there are two pandemics in this country right now. one of covid and one of lunacy and stupidity. host: that is dave in california. dr. besser? guest: thank you for your comment. i think common sense is really important. as we learn more, i am hoping we will continue to see changes in recommendations.

i was really pleased when cdc put out recommendations for people who were fully vaccinated and said people who are fully vaccinated can gather indoors with other people who are fully vaccinated and not wear masks. those kind of small gatherings are safe. and grandparents who are fully vaccinated can meet and hug their grandchildren who are not fully vaccinated when they are meeting with children in one family. and that travel now for people who are fully vaccinated is a safe thing to do, even though it is not encouraged because of the threat of variants. these things are important. someone wearing a mask driving their car, if there is no one in the car to protect, maybe they put it on so they will remember when they get out of the car and going to the store that they have it on. but common sense is important. appealing to people's love of

family and community and doing the right thing, recognizing we are all in this together, these are all things that are very important to do. host: let's hear from tim in arkansas. hello. caller: good morning, c-span. thank you for taking the call. let's get back into the numbers. give me the revised numbers of the death rate of this virus. it is so small. we were having discussions. is it a bad flu? is it worse? i don't take the flu shot every year and i live. i also would like you to speak about the origins of the china virus and obama and found cheese -- fauci's spending dollars on the development of

the wuhan lab. everything in the election year was political violence up to and including the non-insurrection insurrection on january 6. this is all political violence played out, mapped out, designed by the left. host: you put a lot out there, so we will let our guest respond. guest: the first thing i want to say to everyone watching is please do not refer to this virus as the china virus. this virus, while first identified in china, is covid. whether you call it sars cov 2 or the covid virus, that is how it should be referred to. referring to it as a virus from

one nation is not just the incorrect thing to do, it has cost people their lives. it is causing violence in our country against asian americans. and it does harm. it is not a lot to ask to say that if you are doing something to others cannot do that anymore. and so, a simple thing would be to just refer to this as covid as the rest of the world is doing. in terms of its origin and how it occurred, it is always important when there is a new infectious disease to try and understand how did it evolve. did it come from a laboratory error? you always want to ask the question, was something intentional or was this something that occurred naturally?

given how new infectious diseases have emerged around the world and the tendency for them to emerge in places where people and animal species are in very close contact, in places where animals' natural habitat is disturbed, in situations that increase the chances for viruses to be exchanged between species, it is very plausible this occurred in a market. but that does not mean it also could not have just as easily have occurred through an error in the laboratory. these are important questions to ask and to answer. when i was the acting director of cdc at the start of the h1n1 flu pandemic in 2009, we got those same questions. was this new strain of flu a naturally occurring event or was

it something that could have been deliberate leak constructed and released? it is something scientists looked at and concluded was a natural event. asking the question and trying to get good answers is a good thing to do. host: 3 million deaths worldwide according to johns hopkins. almost 567,000 deaths in the united states due to covid. dr. fauci was asked again about the pause on j&j. i want to play a little bit of what he said moments ago. we will get your reaction to that. [video clip] >> we leave it to the science. we have the experienced fda and cdc people looking at it and monitoring it. there is one case, 2, 3, 4, when we got to six, they said we need to pause to do a couple of things.

examine that hopefully there are not several more out there, to alert physicians to stay heads up for this. we are concerned. it is a very serious complication, although it is extremely rare, you have six cases in close to 7 million people. the other thing about it that is important is you want to let the physicians know who might see women or anybody with this condition that a standard way you would think about treating clots is with the anti-coagulant heparin. that would be contraindicated in this case because heparin could make things worse. there is a twofold reason for doing it. one, to pause and take a look in more detail about it. and two, to make sure physicians treat people appropriately. host: to that last piece as far as physicians approaching it, what is your thinking or comments on that? guest: i agree with everything

he said. you want to make sure if you are a physician and see somebody you think is having one of these clots that you reach out to a blood specialist to help with that management so they are treated accordingly. i wanted to follow on one thing a previous caller said. there are still 70,000 cases of covid occurring every day. and there are still thousands of people losing their life to this disease every week. so, this is not something that is over. what we do right now is individuals, whether we wear our masks and wash our hands and keep apart, whether we get in line when it is our turn to get vaccinated and ensure that everyone has access to the vaccines, these things will matter. they could save thousands of lives and help us get back to

what we all want, which is a full economy, being able to be back with friends and family doing the things we enjoy. we all have a part in getting us there as safely as possible and ensuring everyone has that opportunity to reach that goal. host: one more call for you, dr. bessie. this is from ari in maryland. we are short on time. go ahead. caller: i will keep it short to the personal liberty and freedom. to me, it seems very clear that private property owners, homeowners, business owners, even synagogues and churches, to be able to make decisions about what happens on their own private property. i understand in terms of having a responsibility to others and exposures and going into a store. if the owners of the store request patrons wear masks, agreed, that is the way it.

should be it should not be decided by the government. we have personal liberty and freedom in the government. it should be decided by homeowners, business owners, and people on the property in question. host: thank you. dr. besser, go ahead. guest: i don't have much to say. i appreciate his comment. i think it is the role of government to step in and provide protection when those protections are not provided for them. as a pediatrician and a parent, one of the things i have great concerns about is that there are not vaccines for children. children are at risk. children are involved in transmission. we, as a society, need to take measures to ensure those we are responsible for are protected as well. host: dr. richard besser served as former acting director of the centers for disease control and prevention in the obama administration.

dr. besser, thanks for your time this morning. in light of the vaccination process across the united states and the pandemic upending most of our lives in the past year, we turn to summer and perhaps even thoughts of summer vacation with some of you. we are interested in finding out with more people getting vaccinated if you would feel comfortable taking a vacation this summer, especially if you plan to travel. let us know. eastern and central time (202) 748-8000. let us know. we will take those calls when washingto -- "washington journal" continues. >> sunday, may 2, a live conversation with the author who

writes about politics, religion, moral values, and education. >> it is progress along a particular dimension that feeds back into the larger pattern of decadence because it leads people to spend more time in virtual realities and simulations of reality and retreat from certain kinds of economic activity but also to retreat from family formation, romance, sex, childbearing, which is the aspect of decadence i call stability basically. >>'s latest book is "the decadent society." that is sunday, may 2, at noon eastern on c-span2.

>> c-span is your unfiltered view of government. created by america's cable television companies in 1979, today we are brought to you by these television companies who provide c-span2 viewers as a public service. -- provide c-span to viewers as a public service. >> "washington journal" continues. host: how do you feel about taking a vacation this summer in light of the vaccinations going on across the united states? there was a recent story on cnbc's website about airline executives and how they are thinking about the summer vacation period. borders in much of europe have been closed to u.s. citizens and vice versa because of the pandemic. the airline executives said they did not expect them to open time for the peak summer season.

britton this week eased restrictions allowing retail shops to reopen. france and italy reinstated temporary lockdowns last month. vaccine distribution has been slowed throughout europe. viewers on twitter commenting on this idea of taking a summer vacation, saying we may have to travel to take care of family soon. not looking forward to going to an airport. a couple of polls on the topic. a gallup poll saying the majority of american adults expected disruptions to continue beyond june. the exception was adults 65 and older. 47% expected to last that long -- expect it to last that long.

50% did not feel comfortable they could have a normal summer vacation this year. when it comes to that, we will finish our program asking you what you think about this idea of traveling for summer vacations. if this is something you are comfortable or not comfortable doing, you can tell us why. (202) 748-8000. (202) 748-8001. you can text us your thoughts at (202) 748-8003. you can post your thoughts on twitter as well. dr. fauci again asked about the topic of americans and if they should consider summer travel in light of the pandemic. here is some of what he had to say. [video clip] >> a lot of americans are thinking i have made it to april. i'm going to go through the spring. what about the summer?

virtually everybody in the country has something planned for this summer. and they expect to go forward with those plans or will we still be in lockdown conditions? dr. fauci: it looks like things are going to be improving. we often talk about flattening the curve and coming down. if we see that, and it will be differential in different parts of the country. new york city, the terrible ordeal they have gone through is different from the mountain regions. when you say get back to normal, it will not be a light switch that you turn on and off. it will be differential and gradual depending on where you are and where the burden of infection is. but the bottom line of it all is that we see it is very likely we will progress towards the steps towards normalization as we get to the end of this 30 days. that will be a good time to look and see how quickly we can make

the move to try and normalize. hopefully, by the time we get to the summer, we will have taken many steps in that direction. host: that was dr. fauci recently on the topic. maybe disney world is part of your plans. "wall street journal" had a recent story taking a look at that and saying what that park plans to do. visitors must wear an approved mask. hand sanitizer stations are everywhere. most meals and snacks must be ordered via the app, adding that if you expect to breeze through the lines because of the metoo capacity, -- limited capacity, think again. a lot of travel related topics when it comes to the summer and

pandemic still going on and the vaccination process still going on. we are curious about your plans for the summer. peter in pennsylvania, go ahead. caller: hey joe, how are you -- pedro, how are you? host: i am well, go ahead. caller: my entire family, multigenerational, i am at the top of those generations, we are planning a trip down to the outer banks in june. we are going to be staying in a large home together close to the beach. we will probably be spending most of the time in that home and on the beach. i have no concerns about doing this. we have not all been vaccinated. frankly, we have not mitigated to a significant extent our interactions with each other

over the last year. you could call that irresponsible or whatever, but we have done fine. i contracted covid. one of the results of my experience with covid is the doctor i respect the most, the doctors who care for me, told me on a recent visit i have what everybody wants which is natural immunity. so, i guess that is part of my confidence, that even at 71, i was able to withstand or go through this experience and come out unscathed and really protected. host: would you say to people going on the trip share in your level of confidence or are there varying levels of concern? caller: honestly, we have been

getting together as a family over the last year, probably starting around last easter. i think in a lot of respects, by doing that, we have contributed to each other's mental help for one thing. i don't think enough emphasis is placed on -- we are trying to protect everybody from becoming ill which is a commendable thing to do, but how about all of our children? my grandchildren, my daughters, we have been able to retain that sense of normalcy that i think has benefited all of us. host: ok. that is peter in pennsylvania saying there is a trip planned in his future with his family. you can share that or maybe your hesitancy to take a trip on the phone line. (202) 748-8000 for eastern and central time zones.

(202) 748-8001 for mountain and pacific time zones. "i am more comfortable now that i've taken both covid vaccine doses. a little reluctant to fly. my son who has taken both vaccines will be coming from louisiana on memorial day," adding that she cannot wait to see him. this is from sharon in minnesota saying they are permanent changes for her. we will camp and not stay in hotels. travel by car only. maybe an outdoor concert, but never again inside. she added, "too many idiots." from our twitter feed, airports are out of the question for me. those are some of the reactions from twitter and texts. ray in new york, hello.

caller: hello, pedro. this is ray. i'm originally from alaska. i have not been back home since this covid thing started. but i am going up there this summer. i'm going to spend the whole summer out in the bush country fishing. i am going fishing for the summer. i have no concerns with it. some of these people that don't want to take any precautions at certain times i have a problem with. i have had both my vaccinations. i am 70 years old. i am planning to do what i need to do. host: are you going to be around other members of family? will you be by yourself? how many people are involved in this trip? caller: my trip will be me, i think my brother is going to join me and he has been

vaccinated, my nephew who is a guide up there for hunting, i'm going to get with him. i'm going to see a lot of different people. with the fishing, i don't care how many people are in the river. the rivers are usually pretty full. i am going fishing. i have no worry as to the virus at all. host: assuming you are going to fly, you are not concerned about the plane flight either? caller: not at all. just keep the mask on that they require you to, do what the rules they have set, and everything will be good. host: that is ray, alaska his destination as far as the summer vacation is concerned. this is janet and florida saying we usually spend a week in a condo on the beach. while i have been vaccinated, the daughter and son-in-law have not. unless they get vaccinated, i

will skip the vacation. you can make your thoughts on twitter available. realsimple.com highlighted how vacations may look this year saying it all boils down to three words, "vaccine, vaccine, vaccine." now, nearly a year into the pandemic, we are getting antsy about getting back out there pretty much anywhere. newly discovered variants cloud the picture of what is possible. not to mention the task force and current head of the recommend everyone stay put. that is from realsimple.com.

maybe camping is more your speed when it comes to where you are going. "washington journal" highlights the story about vacations saying although national park visitation dropped by 20% overall last year, largely because of spring closures, july to october visitor numbers set records at parks. the outdoors revival has created a boom in demand for recreational vehicle rentals. summer booking volume tripled from the previous summer saying a boutique rental operation expects bookings this year to at least triple from 2020. your thoughts on if you plan to take a vacation this year. john in massachusetts, tell us your thoughts. caller: i am going to be traveling in two weeks to see a concert.

i am not scared of covid-19. i'm not getting a shot. i'm more scared of getting a shot like astrazeneca that killed someone in australia or having blood clots. i had covid. i laid in my bed. host: why a concert? caller: i love music. i'm not scared of it. the lead singer of "government mule" performed in connecticut seven times in november, and nobody got any infections. i saw him every time. he is the hardest working man in music. host: is a concert indoors or outdoors? caller: outdoors at the westville usain bolt -- music bowl. everyone socially distances and has to wear masks.

it is only a certain number of people allowed in accordance with the rules. i am not scared. host: is it reasonable to be socially distanced at a concert? caller: i went to other concerts. there were zero infections spread. they traced everybody. wear your mask walking around. in your square, you are safe, more than six feet away from everybody. it is a great time. i cannot wait to see them again. host: that is john in massachusetts saying a concert as part of his plans. when it comes to cruises, there are questions on whether cruising will still be a thing this summer. "the washington post" says the cdc is facing pressure to modify restrictions.

cruise line associations hoping large ships can return to service by july 1. some cruise lines have eliminated all alaska departures through late june. any 2021 voyage that includes a canadian port. smaller cruise lines have a unique opportunity in alaska this season. cdc restrictions apply only to vessels with more than 250 passengers. that is how the cruising season shakes out when it comes to alaska. alabama, good morning, your next. -- you are next. caller: i have not lived in fear of the pandemic. i have flown twice across the united states. i even flew to england in

december via amsterdam. been around many people. have not had the vaccine. not going to get it. i have had leukemia and stem cell transplants, so i know what it is like to have zero immune system. host: what gives you the confidence to travel? caller: i am just not in fear. i don't understand a lot of christians who are in fear. that is my opinion. that is how i got to spend two years in hospital. i have five children. i was pregnant at the time. i just don't live in fear. i don't take the flu vaccine. i was supposed to get all of my immunizations again. i never did. host: ok. we will hear from darren in michigan. go ahead.

hello? caller: yes. host: you are on. go ahead. caller: i feel what is going on right now, i live in michigan and our governor is getting ready to say that a two-year-old must wear a mask. i don't know if there are many people out there that have traveled with youngsters on planes, trains, or buses. i have. it is very difficult to try to explain to a child, "you have to have this." one, they are very low in transmission and spread. i have not been tested yet to see whether i have the antibodies. and i have not taken the vaccine.

i am healthy. i am at high risk. host: are you traveling this summer? caller: if i do, it will be by car, not by the commercial lines because of the restrictions. i am afraid of paying a price and have a child or someone with me that says i cannot, and i have a legitimate reason not to wear a mask. our freedoms are at risk. we need to be cautious about government control. we are adults. we have families. we trust in god. and we trust we can make informed decisions, loving our neighbor and loving our enemies. host: ok. let's go to eileen in london, kentucky. hello. caller: i bought some tickets

for an indoor concert last year. of course, it was canceled. they moved it a couple of times. the thing is, they will not reimburse you so you are kind of stuck. you have to either go or lose all of that money. i am not sure i am going to go. it will be in september now. host: i am sorry. you may have mentioned this. indoor concert, outdoor concert? caller: it is an indoor concert. host: is the only concern the loss of the ability to go or being indoors? does that concern you? caller: yes, it does concern me being indoors like that. even with a mask. everybody is probably not going to wear them. i think these people really need to reimburse you if you don't want to go because of that.

host: eileen in kentucky talking about concerts. this is a viewer on twitter saying i am taking a short one next month after being fully vaccinated. renting a house with girlfriends who are also vaccinated. she is planning more trips if it is safe to do so. we are asking in the final moments of the show about your vacation plans this summer. if you're going on a vacation or not, you can tell us why. hello. caller: my concern is i am not worried about taking a vacation so much as i am worried about one thing none of the scientists or anybody is talking about on tv. and that is the way the virus is spread in the first place as far

as i am concerned, and that is by cigarette smokers. nobody talks about cigarette smokers spreading the virus. of course, i wear a mask. i also believe that droplets are spread through the air of cigarette smoking, and that is why you cannot get most of them to wear a mask. host: our topic is on vacations. are you going to take one or not? caller: i probably won't because i don't know if i will be traveling anywhere near a cigarette smoker passing the virus through their clothing. host: ok. aaron in jackson, georgia, talking about his concerns when it comes to those who smoke cigarettes. this is from mark stone off of twitter. in the last six month, we have driven to colorado, flown to arizona, flown to florida.

this year, we are flying to colorado and scotland hopefully. we are in our 60's but healthy. you're not going to allow the virus to impact our lives. we wear masks and are vaccinated. twitter is how you can reach out to us when it comes to your plans for summer vacation. if you turn to the "new york times magazine" this morning, a profile when it comes to the governor of new york, andrew cuomo, looking at issues concerning him. that story is in "the new york times magazine" this morning. when it comes to the rnc, "the washington post" profiles the chairwoman of the national -- republican national committee.

the headline says some numbers pressure chairwoman for independence from president trump. the piece says as the republican prepares to meet in dallas, mcdaniel is under increasing pressure from some members to show more independence from the former president, particularly after his mar-a-lago speech. while the former president maintains broad support throughout the party, some of the 168 committee members want to see the party create a modicum of distance from former president trump or at least grapple with the fact the gop lost the white house, senate, and house during his administration and focus on how to improve their fortunes in 20 and 2024. there is one piece of news when

it comes to "the wall street journal" looking at the vaccination process at disney world. this is from laura lippmann. she writes the virus will slowly burn itself out. you are vaccinated. what will you do next? their scheduled to reopen at limited capacity. clearly, my fellow americans crave escapism. it is important. everyone can use some. i'm looking forward to simple pleasures. pedicures, shopping, hot yoga, inviting neighbors over for a drink, visiting my dad, hugging my son for the first time since december 2019.

thrill rides and crowds, none of these make my post-pandemic wish list. one more perspective when asked about the idea of travel this summer, dr. fauci again following up on a question asked on cbs. here is what he had to say. [video clip] >> can you envision a summer where people are going back to beaches, going to baseball games, weddings are happening, reunions are happening? is that in the cards right now? dr. fauci: it can be in the cards. i say that with some caution because, as i said, when we do that, when we pull back and try to open up the country, we have to be prepared that when the infections start to rear their heads again that we have in place a very aggressive and

effective way to identify, isolate, contact trace, and make sure we don't have those spikes we see now. the answer to your question is -- to prevent the resurgence. host: that is it for our program. a lot happening in politics and the derek chauvin trial. coverage continues as closing arguments start on monday. you can tune in to c-span2 to keep track of it and other issues on our website, c-span.org. that is it for our program. another edition of washington journal comes away tomorrow morning. [captions copyright national cable satellite corp. 2021] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. visit ncicap.org] ♪

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