the fight against coronavirus in the u.s. and globally with epidemiologist dr. chris bieber of the bloomberg school of public health. and purdue university president mitch daniels on the new civics literacy requirement for its undergraduates and challenges facing higher education overall. watch c-span "washington journal," live at 7 a.m. eastern thursday morning. be sure to join the discussion with your phone calls, facebook comments, text messages, and tweets. >> coming up thursday, commerce secretary gina rolando testifies on president biden's 2020 budget request and a house appropriations subcommittee hearing. that is live at 2 p.m. eastern on c-span. at 9 a.m. on c-span 2, members of the facebook oversight board talk to axios about their decision to keep former president donald trump banned from using facebook.

then at 1 p.m., another hearing on the president's 2022 budget request with energy secretary jennifer granholm testifying. >> our next guest is vivian ho. professor ho is health economics chair at rice university james baker institute. and director of the baker institute for public policy. good morning and welcome to washington journal. guest: thank you very much. host: the field of health economics, what is that cover? guest: it covers a lot of things. we think about economics as resource allocation, scarce resources, health economics is about the issue in the health sector, it is different from what we think about a natural competitive market because you add the large participation of government, plus more than half of the consumers have health insurance, so you have a lot of additional actors on top of that in terms of adverse election, a

large government programs like medicare and medicaid. host: we will talk about your report, but broadly about the health economic impact of the past year, the covid-19 pandemic. we look specifically at one of your reports released at the end of 2020, december 16th, state restrictions on -- in the, 19 death rate. the baker institute, they are at rice university, why did you undertake this study? guest: this is a study that is different from the other ones that i have been doing it. i have done an interview with wallethub early in the pandemic, i would say april, when they were asking experts for advice on how to open up safely. one of the people who had read my report in houston as a strategic consultant named michael seleka -- michael and he

constructed the data you see in this report in a way most economists would not think of and he had the graph and he showed them to a doctor and the doctor said, you need to get this out. he contacted me out of the blue and said, look at these graphs. i thought they were striking that i thought i had to put a report out on them. host: one of the graphs, one of the figures you looked at with the correlation between states that lockdown and the death rate in the seven day average death rate and this -- define for us what we are seeing in this line that goes through the end of november i believe as it rises. what are we saying in terms of states that are lockdown and the death rate? guest: wallethub, the first time they measured the openness of every state to economy, they did

similar reports nine different times through october, but the lines are essentially the same. for example, you take the state of openness of each state on may 5 and you correlate that, that is an index that runs from 0 to 100 and you correlate that with the daily death per million on every single day observed through early march through, i believe, we ended up in november. and you look at the correlation between the openness in states and that deli -- daily deaths per million due to coronavirus and would you find is that early on, the states that were more open had lower death rates and at first, that sounds strange, but when you think about it, the governors were responding to the

amount of the current -- consequence of coronavirus they were seeing in their own localities. new york had extremely high death rates at the start of the pandemic and so had little openness. they locked down severely. at the start, you see that the most open states had the lower death rates, but that is -- that correlation starts to reverse around may and it turns out by july, you are at a correlation of 0 and after that, there is a positive correlation that you will see in the graph. in other words, there becomes a point in time where those early restrictions actually lead to lower death rates and those lower death rates left out away from july all the way through the end of october. it seems that at first, it is the number of deaths driving the

lockdowns, eventually, both early lockdowns lead to saved lives several months further down the road. host: did your research and find out, such as the sturgis motorcycle rally, but there were others, incidents that states did not lockdown at these incidents happened that caused a spike in the debt curve in that state. -- death curve in that state. guest: we did this all un-funded. we did not have the resources to track those incidents. my guess is that you would see them if he started looking more closely at the graphs for the different states. host: for the conclusions your report came to on the reporting of the state lockdowns and death rates, say, by shutting down large portions of the economy, lockdowns were accompanied by the failure of many businesses and a massive increase in

unemployment. while the entire country was affected, low income and middle income workers have been as proportionately impacted. why have those workers been disproportionately impacted? guest: when you look at our lower income workers, a lot of them are in the service sectors, the ones working in restaurants and bars, working at our movie theaters, at our baseball and football stadiums. those were the people who had the frontline jobs that disappeared. other people had fought my jobs and stayed, but lower income workers did not have jobs that were amenable to work from home. host: to go back to graph and tell us about the graph in terms of the relationship between a state of short openness and unemployment. guest: right. what we did see is when you look at the severity of the lockdown, the severity of the lockdown is

associated with a higher unemployment rates down the line. now, i do want to caution people in terms of interpreting some of these numbers because what we do not know is how much of that lockdown, how much of the effect of the lockdown is the true state regulation that led to the increase in unemployment and how much of it is due to greater fear in the local population, which then would lead governors to feel that they are more -- have more leeway in imposing a large lockdown, but that greater fear can also can lead people to decide to behave safely. i think there is a high likelihood that that increased fear was what drove the economic

activity that boosted unemployment rates rather than necessarily the actual government intervention. host: we are talking about the cost and impact of color lockdowns across the country. our guest is professor vivian ho, health and economics chair at rice university and one of the researchers and writers looking at the same issue. we welcome your calls and comments, (202) 748-8000 for democrats. (202) 748-8001 for republicans. and independents and all others, (202) 748-8002. what do you see in -- are some of the most effective ways that states have used lockdown their states? guest: wallethub ranks the highest score for producing openness of the state to restaurants and bars and those

are situations where people are indoors, not wearing masks, potentially close to each other, so that is the highest chance of respiratory droplets being exchange with someone infected. but you have -- that is one of the more striking things, there is disagreement in terms of what happens in terms of opening schools, statewide. schools that have excellent ventilation and a lot of room to space out students will be in better shape than some of our schools here in lower income areas of houston that do not have modern day ventilation, but there are other things in terms of guidance for assisted living homes and nursing homes that could be quite effective. that was early on in the pandemic and we now know that we have gotten more vaccines to those locations, so the story has changed there. host: what are some of the unintended consequences of the lockdowns?

guest: some of the unintended consequences, it is interesting that it has been only recently that the cbc has relaxed its -- the cdc has relaxed its guidance on wearing masks outdoors and i remember having great concern, we needed to have those protests regarding the death of george floyd early on in the pandemic, but there were a lot of researchers that were concerned about what that would mean in terms of the spread of the virus, but interestingly, there have been other studies of that and when you looked at the timing of the protests a different cities, you did not see a correlation between that and an increase in the spread of the virus. there's a lot of outdoor things that probably could have done safely and we shut down completely. you know, we shut down the entire baseball season completely. and maybe we could have figured out how to do that in a safe

manner so we could have had some economic activity that would have kept people going. host: i want to ask you about education and this question come from an opinion piece in the wall street journal. you pay a high price for covid protection says the opinion writers. the cost include reduced schooling, reduced economic activity, increased substance abuse, more suicide, more loneliness, delayed cancer diagnosis, delayed child vaccinations, increased anxiety, lower wage growth, travel restrictions, reduced entertainment choices, and reduced opportunity for building friendships. in a 2020 study for -- they estimate that the loss to lifetime income for individual students will be 6% -- assuming schools will be closed for the equivalent of 77% a year. do you think that loss of income and that gap in education will be something that lingers quite

a bit for a kid coming out of secondary and high school in particular? guest: yeah, i think the greatest concern is the increase in inequality in educational attainment. some of the data is showing that the higher income -- children in higher income families and middle income families that can stay at home and had excellent access to internet, internet access, they did just fine and some of them preferred staying at home, which i found interesting. it is lower income students, when you do not have wi-fi, you do not have the computers and technology and you do not have the assistance to figure out all of this, i think there were some families, and there were a lot of nonprofit organizations in school districts that stepped up to try to get this to work, thank goodness they did. they cannot take care of everybody, there were students who did not tune in to school at all and we have lost them.

i think fortunately, we have a large increase in funds that have done two different school districts around the country and i am wondering how they are going to handle that money if they are going to direct it toward those students who had the educational losses. that would be the most appropriate thing to do, but i am sure they are going to do it. host: bob in logan, utah. the morning, you are on with professor vivian ho. caller: thank you for letting me call in. i would like to know where we are looking to get the herd immunity. they are not seeming to do it. what do you think about if a third had their shots and open

everything up and still people who have many days to do your shots and get -- it costs us money, but anyway, thank you for letting me share my idea. host: vivian ho, any thoughts? guest: i cannot relate to mr. logan's concerns about this issue -- i can relate to mr. logan's concerns about this issue. some are concerned that we will not reach herd immunity. we initially heard that it will be 70% and now i believe that they are talking about 85% because there are concerns about a variant developing that can eventually escape the vaccine. in terms of reopening, in favor of that argument, we know that vaccines are 90%-90 5% of

active, at least the ones in the u.s.. we know from cdc studies that it appears that those who are vaccinated, it is about 90% effective in terms of preventing them from even carrying the virus and transmitting it to others. i see some arguments and the color's argument that most of us are protected, it is not 100%, but it is close and we can open up schools, people with strong immune systems can go about in their daily lives. the negative side of that is when people think about the health care cost, which is what disturbs me because every person who gets covid and requires hospitalization, we are talking about $10,000 -- $10,000 in terms of expenses and potentially higher. when they go to the hospital, it is either the people with their type of health insurance, the insurer will have to raise the premium because of the additional cost or it will be

passed on to the county government and then we will have to pay for it in terms of higher taxes when they are cared for. it is a lot of additional costs that i would like to avoid. it is cheaper to get a vaccine then to deal with a hospitalization. host: we read a story earlier, the headline on washington times, lied and wants 70% of adults to get one passing by july 4. bradley from kentucky. independent line. go ahead. caller: i wanted to thank c-span for having a guest on. we have to understand how catastrophic these lockdowns have been for us. this idea to even do this came from china. a lockdown is not a medical term. it is nowhere in medical history. it is a police term. we have to start asking questions about who the victims of this have been as soon as everyone said it was a bad idea, which statistics seem to fall

now, but once everybody said that, we have to look at the victims, i think the biggest victim has been kids, our kids. they do not have a voice to advocate for them. we have set them back so far and we set them back so hard. another example i was reading about, special education group meeting at our class and it said from the time that they left when the lockdown started the time they came back, one of the individuals have lost their speech ability, which mean they had regressed, their education and social ability had regressed . the individual no longer has the ability to communicate verbally. to amplify that out into the country and this has been a tragic, catastrophic mistake and the more we realize it, the better we learn from it and

think -- and thank you to the guest. host: has states learn anything? -- have states learned anything? have they learned how to do it better next time? guest: i think they have. some of these approaches of closing non-essential businesses , i do not think you needed to do that. if you have a clothing store where there are not that many customers and everyone is wearing a mask, that is perfectly fine to stay open. we have some outbreaks that occurred in grocery stores, but i think that is a small proportion of the total number of outbreaks compared to restaurants and bars, which are much worse. in terms of what the caller is saying, i agree that there are a lot of students that suffered from the pandemic, but you have to weigh that in terms of the findings of the report.

they saved lives many months down the road and so what it turned out, the lockdowns that happened in may where the most effective in terms of saving lives, the lockdowns that have been later on were effective, but not as strong. you have to weigh that against what happened in terms of schools. and in terms of special education, that is a shame in terms of the story that bradley told. we also know -- in texas, it is frustrating because we had a huge problem with the special ed for the last several years and there have been federal oversight saying we need to fix the problem there, but articles coming out this week saying we have not fixed the problem. that is why we need to resources directed, that the federal government has sent to us. host: vivian ho is one of the three authors of the report, the state restrictions and the covid-19 death rate at baker institute. silver spring, maryland. caller: good morning to you and

your guest. i wanted to say first, two comments, one is that i was really suspicious that this virus, whether it was more severe in some places and less in others, but i thought also, efforts were used to get rid of the king, donald trump, so you put us in a mask. to weaken his presidency. nonetheless, i want to address that the mask has been very dangerous because in a mask, it cuts off your blood-oxygen absorption and for children, it is very dangerous to cut off their oxygen to their blood, blood-oxygen absorption and i

wanted to say that god gave us nostrils so we can inhale oxygen, exhale carbon, so the mask is very bad. if we have a lot of pollution in this country and they are cutting down trees everywhere, trees finds the air, but how do we get good air, we have -- if we have a mask on. that is my only comment. i thank you. host: did your part look at the efficacy of masks in states that relocked down? -- that were locked down? guest: that is an excellent question. we did not look at the efficacy of masks compared to other actions, but they are included in the index. to the extent that they were in the index, they worked to say why. this is a virus that transmitted by respiratory droplets, that is what the scientists have told us at a mask is most effective in preventing that. i agree that it is inconvenient

to wear a mask. i tried jogging and it is really hard. there has been no medical evidence that shows that it leads to a drop in blood oxygen level. even though it is uncomfortable, it does not affect blood oxygen levels and as a matter of fact, there are nuisance -- there are nurses and physicians that won them four months -- that have won them for months. we do not have to wear them outside as long as we are not in close contact with people for a long time who might be carrying the virus. host: allawi, larry on the republican line. good morning. -- larry on the republican line. caller: there were three young children on fox news, which i know is the devil excellent news network, and they were saying

how hard it was -- is the devil's news network, and they were saying how hard it was to get an education and they said it was a 4th, 6th greater and the 4th greater was more concerned -- grader four result and she feels like she has lost a whole year of education and she will not be able to get in a school without going to a junior college first. there was another young lady who was in 6th grade, she was still doing what she considered ok, but her two young brothers who are doing well are both feeling. -- failing. this older generation on generation. secondly, major league baseball and all the players in the dugout's masks whatsoever, watch

professional basketball, all of the high paid people like you and others, you do not have to follow the rules they give us. if you listen to biden, he says one thing and the cdc says another. who do you believe in all of this? host: vivian ho, do you want to respond? guest: there are a lot of important comments. first of all, baseball, outdoors, that is fine. i have not followed their protocols, the nba was extremely careful, so they were doing regular testing and if we had, i am still appalled that we do not have -- michael at harvard had been promoting passage of that-a-state coronavirus, if we had that for the entire population, we would not have -- the nba had all of the resources

to do the testing. in terms of the children, -- in terms of texas, i thought we did a relatively good job in terms of students who have been allowed to come back to school since last fall. it was up to the option of the schools and school districts on how to design this. it has worked pretty well. what i find that fascinating thing about this is that there are still huge numbers of schools, students, and families who have chosen to keep their kids at home because they are still afraid of their children going to school and getting the virus. it is a personal decision and not a decision by the state in terms of forcing those children to stay at home. it is very unfortunate that there are some children who feel left behind, that they feel left behind by the online teaching

system. i have had to do it this year and believe me, it is not fun and i have college students who are more mature than the elementary school students, so i can sympathize with the teachers as well. the biden administration is moving towards having all kids back in prison in the fall and the sooner we get there, -- in a person in the fall. they may start the school year earlier next year and i hope they do that. host: how difficult was it for you to do the research on this and not get pulled into the political arguments on opening and lockdowns and things like that? guest: that is the advantage of working at the baker institute. when secretary baker agreed to lend his name to the institution, he wanted the research to be nonpartisan. what that means is that my colleagues and i, you will hear us if we are talking on a daily

basis, we have people who are extremely liberal, we have people in the center, and we have people who are very conservative. we will talk about that, but we care most about is getting out objective research to the public. because, we have the talents in terms of analyzing complex data, thinking about access to all of the regulatory issues and thinking about them and that is what is important to us. host: there is a headline in the washington beacon which -- some religious gatherings early on in the pandemic caused outbreaks and wound up going, number of cases in the states went up to this supreme court -- supreme court, do you look at that at all? guest: in the wallethub index, i do not believe -- that is a good question. i do not think they assigned a

metric to a religious gatherings. they did say restrictions on large gatherings. i think their notion was that these large church services would have been included in that category. host: is a too general to say that businesses have learned -- is it what are too general to say that businesses have learned lessons to vivid -- to commit -- to pivot. any businesses had to retool what they do because of the pandemic, in general, is that the way businesses look here a year and a month into the pandemic? guest: i think some businesses pivoted quite cleverly in terms of the restaurants. you see in houston, there are many restaurants that have outdoor patios. the quality of the service in terms of their pickup and how

you can order online has improved. that is where they work well. i find other things, i find target took a while, or walmart. i remember trying to order online from them at the start of the pandemic and the system kept crashing. i felt a whole basket to check out and i could not check out. things have improved. it has taken a lot of time. when you think about medicine, in terms of health care, at the start of the pandemic, all 1% of physicians were telemedicine, and now we are 30%. that is a change that will change health care going into the future. host: nancy in pennsylvania, democrats line. -- caller: good morning. i want to say that reacted in a way that we had to because things were out of hand. we cannot take one business and

say, you do not have very many people, maybe you can stay open. we needed to curb this pandemic and we needed to wear masks and if you say, well, you know, it is not mandatory or it is not necessary, even when it was -- when the outbreaks and hospitals were so full you could not contain, they were out in the halls and things, people did not want to wear masks. and they still -- we do not know who has their shots out there now and their vaccines for covid and who still does not want to wear masks. when the lockdowns happened, they held and what is our it is to wear a mask. come on. come on, america. i think we have to do what we have to do at the time. and the quicker, the better.

it wasn't even quite quick enough and lockdowns did save lives and in pennsylvania here, we are still having in our county, blair county, higher numbers. we are the top again in -- and our hospitals are filling up again. we do not know how long these vaccines are going to last and with people refusing vaccines still, i just say, when we are told to do something for our country to get back to normal, i think it is a good reason to. people in america do not seem to take it serious enough and mask, i cannot be -- believe people complain about that. guest: i agree with nancy's

sentiment. i do not think it is hard to wear a mask given the circumstances of how dangerous this virus is and how it is transmitted through respiratory viruses. i wish the data i had was maybe -- and your willingness to wear a mask. as the caller said, it has become politicized and that is unfortunate. i wrote an op-ed many months ago , fortune magazine had a good article about this about how the top fortune 500 companies stepped up at the beginning. for example, in seattle, cosco make sure that there was a way to get ppe manufactured quickly and get it to the health care providers. all sorts of moves like that. why did our major companies not step up early before the politicians stepped in and say, we need everyone to wear a mask? instead, it has been this case of, oh, we want to make sure our

customers are happy. we -- if we have leadership that is a-political, maybe we would be in a different place. host: republican line. caller: good morning. ms. ho had one concern, the high cost of each covid case. i think she referred to $10,000. that is also my concern. since president biden has stopped the construction of the wall, we have already detected hundreds of cases of covid that have gotten through and our border patrol, they are so overwhelmed and some of these people get out and get sent around throughout the united states and that is a concern of i think every citizen no matter what political party you are affiliated with.

what is ms. ho's concerns about that? guest: so, the border issue as a separate issue which unfortunately, i am not an expert on and i wish my colleague at the baker institute, tony, were here to talk about it. it is a concern in terms of more people coming in who have covid. my understanding from what i have read is that they are being tested. the ones that are running through ice and the formal process are being tested and let's hope that when these other families have an opportunity that they do get testing as well. i have to say, we have not heard about people -- that much about the testing apparatus that i will have to say, it is really good in houston right now. there are places you can schedule online that you can

walk right up and get a test and you get the test results the next day first thing in the morning. to the extent we can make use of that, it is a good thing. let's hope that our government leaders can settle the issue at the border. host: the washington examiner coverage of your baker institute report has a headline that says, studies suggest that lockdown costs have outweighed benefits. do you agree with a headline that that is the gist of your report? guest: i disagree. that was unfortunate the way the washington examiner chose to interpret the report. my co-authors were very concerned about the unemployment consequences of the pandemic and the mental health consequences. i agree that they are significant. but we did not do a full cost-benefit analysis.

we did not put a monetary value to the lives saved. we did not put a monetary value -- we did not even talk about hospitalizations and i mentioned how expensive those are. so it was -- i would have emphasized the might and pretend for some states. it is because of the strict lockdowns in california, closing down disneyland, maybe we do not have did that because orlando is doing well with handling disney world. i do disagree with that interpretation. host: what is next for the baker institute in terms of this area, in terms of your coverage, your reporting, your researching on the effect of lockdowns and measures during the pandemic? guest: before the pandemic, we were worried about high health care costs for consumers because i think that is one of the main reasons why some laypeople in texas are uninsured because health care costs -- why so many

people in texas are uninsured is because of health care costs. we are following closely what were the bailout packages given to health care providers because it is turning out now that many hospitals earned a profit from the pandemic because of the cares act funding that was put through by congress and what we want to do is make sure that we focus carefully on the consolidation that is occurring in the health care industry, the pandemic was very hard on individual physicians. they are being forced to consolidate with large health care systems. that means those large health care systems have tremendous margin a power that will raise health care prices. that is something we are trying to work toward, keeping those prices from going up so much so that health insurance is more affordable to americans. host: let's hear from kate, adrian, michigan. democrats fine.

caller: good morning. -- democrats line. caller: i hope this is not to be off-topic, but does she have any explanation for why there is a high concentration of cases in michigan and i saw an article in the new york times a couple of weeks ago, 8 out of the 10 cities were in michigan for the highest cases per capita, including my very small town, i have never seen my small town in new york times. do you have any idea what might be going on there? guest: i wish i did it. i am very sorry because i have seen the stories. it has to be a combination of unwillingness to get vaccinated as well as people in close quarters and not wearing masks in those types of centers. we did another story, we asked a

large law firm in houston to give us health filing an expedited request to get the case data from the cdc in august and we got the data quickly, 2 million records of case reports if your -- case reports. it is extraordinarily detailed in terms of the exposures each person had in the last 14 days. then, when you open the data set, it is mostly empty. in other words, the data is not filled out. if you were to have the idea -- the data and you had excellent funding for contact tracing and you have done that contact tracing extremely well in five major cities, you would have had better data which you could have gone to the cities in michigan and said, it turns out these types of workplaces are the most high-risk or it is the bar is

causing the problem, or it is traveling. the fact that we do not have that information and we do not have a uniform case report in this country, i think it does not bode well for the next pandemic. host: michigan: fox news, texas and florida reporting fewer covid cases than democratic led michigan, pennsylvania, and new york. professor ho, a rhetorical question on florida, a comment from -- florida that is one of the largest -- many transient workers and visitors. death rates in line with national numbers and current unemployment, how is our response so terrible? guest: texas and florida benefit from having a mild winter. in a lot of cases where people are forced to stay indoors if they want to socialize in michigan, that is not happening in florida and texas. i will also say this, florida

has an extremely large elderly population that pays attention to c-span and other news sources providing information from scientists, so they are behaving safely. they are not going to bars and restaurants. part of this is that part of the population is extremely carefully. i have friends in my neighborhood, if you are walking outdoors, i am on the sidewalk and they moved to the streets -- move to the street. there is a large population that is extra careful. it is easier to do in florida and texas. host: lee in west olive, michigan. caller: hello. everyone is missing the point on all of this. this is a democrat-driven show. all you guys do is reference the new york times and have people like this lady on.

this is ridiculous. the republicans do not believe what cnn, abc, nbc, cbs are all saying. once you figure out that the democrats are in control of our media and brainwashing everybody, the republicans cannot believe anything they say. host: the report is from the baker institute, our guest is professor vivian ho, the health economic chair at the james a. baker institute. >> go to c-span.org/coronavirus for the federal response to the coronavirus pandemic. if you miss our live coverage, it is easy to find the latest briefings. use the interactive gallery of maps to follow the cases in the u.s. and worldwide. go to c-span.org/coronavirus. >> c-span's washington journal.

every day, we take your calls live on the air about the news of the day and we discussed policy issues that impact you. coming up thursday morning, the cost of prescription drugs any the u.s. compared to the rest of the world with the government accountability office. we look at the latest in the fight against the coronavirus in the u.s. and globally with a doctor from the johns hopkins limburg school of public health and the purdue university president. watch c-span's washington journal live at 7:00 eastern thursday morning. be sure to join the discussion with your phone calls, facebook comments, text messages, and tweets. >> this week, we are featuring book tv programs showcasing what is available every weekend on

c-span two. thursday night, we feature best sellers. first, walter isaacson shares the story of jennifer dowd the who received the nobel prize for a method of gene editing. heather mcgee examines the cost of racism for all americans. followed by best-selling author james patterson and army ranger -- and an army ranger who profile men and women who fought in wars going back to vietnam. ♪