 All right. Good afternoon, everybody. All right. Today, we have a very special session planned for you. We have a special guest, Secretary Kathleen Sebelius. Kathleen was, yeah, the Secretary of Health and Human Services. During the H1N1 pandemic while I was serving as Secretary of DHS, prior to that, she was a two-term governor of Kansas as a Democrat, which is quite a feat. And prior to that was the insurance commissioner for the state of Kansas. And so she has graced us with her presence today for which we're very grateful. Professor Sargent is going to be our interlocutor. And we have the questions that you all submitted prior to class. But with that, I'm going to turn the program over to him. Great. Thank you. Now, just a quick note on the process for today. Because today's event is being streamed to an external audience, I'm going to pose the questions for the first hour using the questions that you as a group submitted in advance of the class. But once that hour has expired, then I think we can circulate the microphone and you can pose impromptu questions. But we're going to start out by talking really about the experience of the H1N1 pandemic of 2009, and then we'll sort of broaden out to reflect upon lessons learned for COVID-19. So I'm going to put my first question to Secretary Sebelius, but I hope Secretary Napolitano may also chime in. And I'd like to ask you to transport us back to April 2009. Now, you've just been sworn in as Secretary of HHS. I think you were the last Cabinet appointee to be confirmed. And now you're facing a pandemic that has begun, sort of even before your Senate confirmation has been completed. How do you get a handle on the situation? So what are the first steps that you decide to take in response? Well, nice to be here with all of you. Nice to be here at Berkeley. And thank you to Professor Sarjan for inviting me and my good friend Janet. I was a governor in Kansas and had been nominated for HHS as the second choice of President Obama. He nominated Tom Daschle, and part of the way through that confirmation process, former Senator Daschle withdrew his name, so I became the second nominee. And as was just said, was the last to be confirmed in the Cabinet. I was in my office on April 28th as governor in Kansas. And we had a plan. The Senate was going to begin that day to talk about my nomination. I hoped to be confirmed. And then when confirmed, I planned to resign, have my lieutenant governor sworn in, get on an airplane with my husband and fly to Washington a day or two later. And I got a call at about 10 o'clock in the morning from somebody in the White House saying, the President has a plane in the air. It will land in Topeka at Forbes Airfield at noon. You need to be on that plane. And I began to explain to the person on the other side, well, that wasn't going to happen because I was governor and I hadn't resigned and I didn't have a job in Washington. And they interrupted me immediately and said, the President has a plane in the air. It will land. You are to be on the plane. And it was my first reminder that I now had a boss again. And so indeed I got on the plane. And about halfway across the country, I was called to say the Senate did confirm you. When we landed, I scrambled. I didn't have any idea. When we landed, a person who I barely knew met me at the plane, I said, where are we going? They said, we're going to the White House. You're going to get sworn in at the White House. The President's waiting for you. Well, it turns out that the President doesn't have the authority to swear anybody in. So he had to find somebody who had that authority. And he stood and held the Bible and I got sworn in. And then he said to me, I have to leave because I'm going to reception for new cabinet members. You're going to the Situation Room where Janet Napolitano, your friend is already hosting a call with the Canadian Health Minister and the Mexican Health Minister and the head of WHO. And so that's how my day started. This was about six o'clock at night. By the time somebody showed me where the Situation Room was and I participated in this couple of hour call. And then everybody got up and left the room. I said, I called my best friend from college where I had gone in Washington and said, are you and your husband still up? She said, yeah, where are you? I said, well, I'm at the White House now, but I just became a cabinet member and I'd like to go woo-hoo with somebody and maybe I could come over to your house. So it started very quickly. It was very much underway. Janet, I knew we had served together as governors. We were friends. I was thrilled that she was there. And what quickly became evident was that President Obama had in Palatano as head of Department of Homeland Security do sort of the all of government approach and lead that edge of the effort and I was in charge of the health side of the effort. So we were working on a vaccine. We were looking at a major vaccination program. We were in charge of the CDC putting out guidance. None of us had ever been through a pandemic before, including the President of the United States. So this was all kind of learned as you go with a fire hose pointed at you and people were panicking and just to give you a snapshot at that time, while the ultimate results of H1N1 turned out to be not as dire as everyone had feared, what was really terrifying was first it was a strain of the flu that people hadn't seen before and hadn't seen in years and secondly, a much younger population was dying. There were teachers who had died being exposed in class with no underlying health condition and kids who had died. That is a very unusual death toll for a flu which usually hits older Americans and people with underlying health conditions. So this was really sending shock waves through the country and there was no vaccine. So we scrambled but Secretary Napolitano had begun to mobilize an effort across government and I was able to step in and kind of join a train that was racing down the tracks at that point. Great, thank you. So we actually have a great opportunity here to get the other side of this story and to ask Secretary Napolitano to reflect upon the experience of having to manage a global pandemic without a confirmed Secretary of HHS. How did that go? I kept looking around going. So the Secretary of DHS, you know, in the event of a pandemic is responsible for the all of government organization as HHS takes the lead on all the health related matters. And so we were just beginning to figure out what it is we were dealing with. We knew it was a new type of flu. We knew we didn't have a vaccine. And we knew that it was impacting young kids. In fact, the first case in the United States was a young child in California who was diagnosed in March of 2009. And when I think back, we were a brand new administration. You know, the president didn't get sworn in until January the 20th. Most of us were still finding out where the Xerox machine was and who had what email address. And when the White House called, did you have to take that call? Or did anybody who worked within that whole complex simply lob calls saying we're from the White House? And should you assume that that meant they were calling for the president himself? So we were brand new. But we were able to figure out a few things relatively quickly. One is that we needed to communicate clearly and concisely with the public about what we knew and what we didn't know. And so we began a battle rhythm of having regular press events. Initially we held them up at the Department of Homeland Security. And I would be there and we would invite other cabinet members to stand with me. And we began a constant litany of you need to sneeze into your elbow. You need to wash your hands thoroughly. You need to practice to the extent you can social distancing. But it was those kind of very basic public health messages that we just kept repeating and repeating and repeating. Even as we began doing the science and getting the vaccine, I'm going to let Kathleen talk about the whole issue with vaccines and what we discovered at that time about vaccine in the United States. So it was a matter of kind of shepherding my fellow cabinet members. It was a matter of as clear as we could make it communications plan, which as I said required us to say what we didn't know as much as what we did know. And then putting ourselves in the hands of the scientists. And I would just follow that up by saying we worked for a president who really believed to his core that the science had to be followed and made that clear. And every time there would be a deviation or a battle with the politicos wanting to move in one direction, he would come back to that. And I think it was one of the most courageous acts that I've ever seen because he really didn't know where that would lead us or exactly what the result would be and there were possibilities that you would have millions of children dying across the country or a terrible result that could topple his very new presidency. But over and over again the communication of tell them what you know and tell them what you don't know and say it again and say it again really came from him and he believed that to his core and followed that at every step along the way. You want to talk about doing a full Ginsburg? So how many, you all are infinitely younger than we are. So how many of you have heard the term full Ginsburg and know what that means? One. So Ginsburg was Monica Lewinsky's lawyer. And she's about to be famous all over again. But there was a Sunday morning routine where there were five talk shows on Sunday morning that ran back to back to back to back. And it turned out that Mr. Ginsburg was the first person ever to do all five shows in person on a Sunday. And so that became known as the full Ginsburg. It got from station to station to station now. Some of them are pre-taped and some of them are this and some of them are that. But Janet and I think the second week I was there, along with Rich Besser who is, he was headed, acting head of the CDC at that point, but is about a six foot five inch doctor who curled himself into a little ball and was able to get into the very back of an SUV while the two of us rode in the regular seats. And we managed to do the full Ginsburg, I think the first Sunday in May, which was quite a feat. And we kept telling people during the full Ginsburg, you got to wash your hands thoroughly, you got to sneeze into your elbow, et cetera. Let me ask you both, before we come back to the question about vaccines, let me ask you both to reflect upon the ways in which your experience, very recent experience, in your case, Secretary Sebelius, as state governors, shaped your sort of engagement with federal pandemic response and just to provide some context for the question. One of sort of the key themes that we've stressed over the course of this semester has been the necessity for cooperation between levels of government, state, local, and federal in order to affect sort of effective security policy. So did you find that your experience running states was a sort of source of insight, even advantage when it sort of came your turn to manage the federal government's response? Well, I think having been a governor certainly helped. It helped in all kinds of ways. The rhythm is somewhat the same. You're in a cabinet. We as governors had cabinets. You work with the legislative process to get budgets done and bills passed. And I think all of us, I certainly had, and I know Janet had other ones, but had dealt with disasters within our own state. I hadn't ever had a pandemic, but we'd had natural, you know, tornadoes wiping out a whole town or fires that destroyed areas. So you had to mobilize resources, set up a kind of command post. There were health issues related. There were medical issues related. In the case of our tornado response, we had to set up a temporary morgue. I mean, things that you knew to mobilize state resources to share those with local citizens. And so that opportunity was helpful. This was clearly at a very, very different level. And I would say that, you know, the H1N1 began in Mexico and then kind of traveled north. So the North America was really the epicenter when you think of Wuhan, China being the potential epicenter of the outbreak of the pandemic. I mean, we were really in North America of the epicenter and it began to spread globally. We had wonderful partners. The Mexican Health Ministry and the Mexican government did a truly amazing job, I think, kind of standing up, giving very transparent information and taking a huge economic hit in Mexico. I mean, they shut down beaches. They shut down travel. They relied heavily on sources of income that they just cut off immediately trying to stem this outbreak because nobody knew. And they shared information very openly with both the United States and with Canada. So none of us had, I mean, I at least had never had an international crisis like that that happened in Kansas. But there were some parts of the puzzle that at least were more understandable and that you have to make quick decisions that you don't necessarily know. You got to gather the best possible information you can and then make a call because not acting is not an option. And I think that's one thing that you learn in a disaster at a state level. You can't just stop and say, oh, let me go back to class. I need to read that next chapter of the book. Let me think about this a while. I'll go back. I mean, you have to just keep moving and you're going to probably make some mistakes, but then you correct them and move on. You can't let the perfect be the enemy of the good to use the cliche. And you need to quickly understand what tools you do have at your disposal. Who do you have amongst the staff who may have some knowledge? What are some outside resources that you can draw upon? And then I can't emphasize enough how important communication is with the public because if you get the communication part wrong, your crisis management will lack credibility. It's really interesting for those of you who may look at medical issues or be interested in medicine in any way. Epidemiology has a couple of core principles, but one of the core principles for epidemiology is communication, is clear, concise, accurate communication on a regular basis and that's considered as important as documentation of what you're dealing with of demonstrating a pattern of looking at certain aspects and I would say one of the differences, dramatic differences between 09 outbreak and what happened in 2020 particularly was that the communication was inconsistent, often inaccurate and contradictory in 2020 and I think ours frustrated people because we didn't try to make things up or spin it or tell them. As Janet said, you learned how to sneeze over and over and over again because that's really all we had to share until we could share something else, but that was done pretty accurately and everybody was on that same page including the President of the United States who stuck to the script. Terrific. So let's sort of focus on the question of how the federal government connected with other governments to manage the effects of the pandemic. I would like to hear more about the Mexican angle which seems to strike some interesting contrasts with the role of China in relation to the COVID pandemic. So more on that aspect would be really interesting but also it would be interesting to hear more about how the federal government interacted with state governments. I am struggling to recollect any instances of sort of adversarial confrontation between the federal government and any state government in 2009 which of course again is very different from the pattern that we saw in 2020 in which the federal government recurrently found itself at logaheads with state governments think liberate Michigan. So I don't know if perhaps Janet if you want to address the international dimension and then we could ask Secretary Sebelius to reflect upon how relations with the state governments were managed. I think Kathleen talked about the WHO but in terms of Mexico that I had had quite a bit of experience working with the national government in Mexico both at the federal level and at the state level the state of Sonora because Arizona was a border state and we had a huge Arizona-Mexico commission and I had been there to Mexico City several times to meet with then President Fox and so forth. And frankly I was not surprised at the cooperation that we got with Mexico on something like this, a pandemic that they would see their interests fully aligned with the interests of the United States and of Canada and actually view this as almost a continental problem as opposed to just a national problem for them. And so one of the first meetings we convened in the Situation Room was with Mexico and Canada to make sure that we were all seeing the same things sharing information, saying the same things, etc. Well as Janet said, the WHO, the World Health Organization is the umbrella group in charge of coordinating assets for health. Everyone has a delegation. It's much like the UN for health issues and so delegations come and meet. There's an annual meeting, there are ongoing committees and they were really very actively involved in helping to coordinate this effort and begin to look out for the outbreaks in other places around the globe and eventually H1N1 did spread and they're very interested in equitable vaccine distribution and getting assets up and running and monitoring results. So that was very key. The head of the World Health Organization when we had this outbreak was a woman named Margaret Chan who had been the leader in China during the bird flu outbreak. So she was very familiar with pandemics and how really frightening they can be and she had mobilized resources, country-wide resources to help shut down that outbreak in China with the avian flu and really probably saved millions of lives by quick action. So she was well suited to now lead this global effort. I think that in terms of the relationship with states and federal governments, the way disasters typically work is ideally a disaster doesn't happen everywhere at the same time unlike the pandemic that we're experiencing now. It is more often a localized effort and what happens in terms of the precedent and protocol is that the local unit of government, city or county, mobilizes whatever resources they have available and then if those clearly are not going to be enough, call on the state for additional help, additional money, additional resources, manpower, equipment, whatever. If that's not enough, then you see a federal disaster request which means that the level of support needed exceeds what's available within the borders of a state and you need some kind of federal disaster declaration. You often see that in a tornado or a huge flood or a multi-state effort. A national disaster works just the opposite in terms of tiering where the federal government takes the lead and if the outbreak is potentially going to be national in scope, mobilizes the resources and then begins a kind of command and control down through the states. We will purchase vaccine and make the vaccine available to all of you. We will mobilize equipment and make that available to all of you. We will try to equitably distribute assets if there are a limited number of assets and while, Daniel, you might not remember the acrimony, we did have some somewhat acrimonious times with states because vaccine with H1N1, when it was available, wasn't large enough numbers to distribute to everybody simultaneously and you had to make choices and the choices that the scientists made were looking at where the outbreak was most serious and trying to get the distribution there and there were states who loudly complained through their members of Congress that they were being short-shifted and more should go to Maine than to Georgia and there were close to fisticuffs in committee rooms but there wasn't really a question of jurisdiction. It was more we need resources and debate with the federal government were those being accurately distributed. Again, we saw that flipped on its head in 2020 where the federal government, the president at the time and his advisors refused to mobilize the federal resources, did not take ownership of the disaster, did not gather resources and distribute them, basically said to states, you're on your own. Go find your own masks, go find your own PPE, figure out ventilators and the notion somehow that Kansas would be competing with not only California but other entities to try and figure out where in the world to get face masks for medical work. I mean, nobody had ever seen anything like the chaos that involved responding to the COVID experience before because it flipped the experience on its head. The federal government did not use the Defense Production Act, did not use the huge purchasing leverage power that they have with a global marketplace, did not use the distribution, enterprises didn't use the logistics that they have to try and make sure that people had the resources that they needed in the right place at the right time. Essentially just said, you know, figure it out on your own. What did you say the quote from Jared Kushner was, were not shipping clerks? Yeah, yeah. Great, let's pick up the vaccine thread because it would be interesting I think for everybody here to hear more about sort of the point in the story at which the vaccine emerges in 2009 as a plausible solution and how effective is the vaccine, how do you deal with the problems of production that an effective vaccine creates, problems of distribution? Well, I'd say 2009, we were pretty lucky because it was a flu strain, even though people hadn't seen this before. A flu vaccine is made every year and so there's a lot of experience looking at the strain that the virus may take and then finding targets for that virus. So this was very different than the vaccine we have this year which is an entirely new vaccine. There had never been a vaccine for COVID outbreaks before but flu vaccine was a yearly production. So once you could figure out what the strain was from samples in first in Mexico and then Canada and confirmed in the United States, people got to work on taking what is basically a flu basis and flipping it around and targeting it and it turned out again to be a lot of scientific luck. Within about six months there was a very effective vaccine good news, bad news. The United States did not have the capacity, manufacturing capacity to make enough vaccine to vaccinate our population and guess what? The countries that had more capacity than we did logically wanted to first vaccinate their populations and then provide additional vaccine to the United States. So we had contracts in place eventually to purchase vaccine for the whole of country vaccination effort but in many places we were third or fourth in line behind their population and if it was in the EU country they already had other places mobilized. So there was a real production issue and you can't just change other vaccines, need very clean lines and a certain processing that is a much higher degree of lab capacity than most pill makers ever have. So you can't take a normal factory and just flip it over and have it make vaccines. You have to have dedicated lines to do that and one of the results after action, I mean luckily the disease turned out to be not as lethal as was feared but we vaccinated probably 100 million people by the time that was determined and started with kids. I mean this was a whole different ball game where you started with children and pregnant women because they were the most at risk and then we kind of went up the food chain. But the after action report was that we now have enough capacity that new grants were given to firms in the United States and there's now 100% capacity in the United States to produce vaccine which was one of the reasons once a successful vaccine was found for this pandemic we could actually make enough very, very quickly here in the U.S. that we weren't dependent on Germany or Northern Ireland or other areas for manufacturing capacity. So let me ask a question that will not surprise the students who in my uses of history class last year, which is what sort of earlier cases were you able to look to to inform and guide your pandemic response? One of you, I think Secretary Sebelius mentioned that nobody in the administration had direct experience of managing a pandemic and you actually have to go back several decades probably to the mid-1970s to find the last sort of major pandemic in the U.S. experience before that maybe you have to go all the way back to 1919. Is a serious effort made to grapple with those earlier historical cases or do the challenges in 2009 just seem sufficiently different that the history is sort of not relevant? Well, there hadn't actually been a pandemic I think in about 70 years, which is really a global situation that in the 70s, very similar to 2020. Ford was running for reelection and there was an outbreak of a strain of flu that was quite serious and there was a vaccine developed and they decided that they would mount a national vaccination campaign and that he would be the leader of that and that that was one of the issues that he would highlight in his reelection efforts. And he did just that. He got vaccinated with great fanfare in the White House and had a lot of production and they began this national vaccination effort. What happened relatively quickly was that the vaccine itself began to produce symptoms that later became identified as Guillain-Barre syndrome in a number of patients and it happened frequently enough in the first three or four months that they stopped the vaccination campaign altogether and the virus ended up dying out and more people in the long run had Guillain-Barre syndrome than actually were seriously ill from Guillain-Barre than were from the vaccine. So one of the things President Obama did was gather the principles of that effort. The former head of the CDC, the guy who had been the secretary of health in the White House, the person who had been in the virology department and to say there were six or seven all white men in their 80s at this point who all came to the White House to give basically a history lesson in what went right and what went wrong and clearly things had gone very wrong but the President was very eager to learn how to avoid those mistakes and so they said a couple of very interesting things. They said, first of all, Mr. President, Gerald Ford made a huge mistake taking this ownership into the White House. You don't want to do that. You want the scientists to own it. You want people to listen to the science. You don't want to make this a political issue. You certainly want to be a leader. You but keep it out of the White House. Step number one. Step number two, they said we didn't have any off ramps. Once we decided to go with the vaccine campaign there was no time where we were to evaluate that or measure how widespread the disease was or look at anything else. It was just go full tilt. He said we clearly should have had an off ramp and they said third, Mr. President, you need somebody, not you, but somebody in this administration who is the face of the flu and I was seated right next to the President or Janet is and the President leaned over and put his arm around me and said, see her, this is the face of the flu. And I said, well, I've been caught a lot of things, but never that. But they then talked about the agencies and how the agencies worked and operated and they really didn't regret having gone forward. They did regret not having the ability to stop and I think that was taken very much into account. But the fact that they moved fairly quickly, tried to save lives and there was a really adverse incident and they didn't stop quickly enough once that adverse effect. That's why you see the adverse action reports are often talked about, you know, that the myocardias was found and some younger kids said they paused the testing and they look further and they... because people take that very, very seriously. The last thing you want is the medication to be more toxic than the disease and that can happen, particularly if you're dealing with a whole new vaccine. But that's what happened in 1970. But he was wise enough very quickly to get people together and I think both Janet and I will tell you, I never got a call from the Trump administration. How about you, buddy? Oh, uh-uh, uh-uh. Kind of amazing. I know. Even though I'm the face of the flu, nobody ever asked. So let's push a little bit harder on this sort of theme of politicization. You know, everybody who's lived through COVID-19 understands how politicized this pandemic has been. Was it challenging to resist the politicization of the pandemic in 2009? Or did you just not confront sort of forces that were striving to politicize it? Well, so there were some interesting episodes. So in April of 2009, it may have been early May, there was a cabinet meeting and then as we're leaving the cabinet meeting, Rahm Emanuel, who's the president's, the White House Chief of Staff, points at me like this and he points at Kathleen like this and he points at Arne Duncan, the Secretary of Education like this and he appointed one or two of our, I think Eric Holder, the Attorney General, he says, come in my office. And so we go into his office and we're sitting around a conference table and by now we know that this is a flu that is infecting school-age children at a higher rate than elderly Americans. There have been some deaths in the New York City public schools. We still didn't have a vaccine and Rahm was very strong as only Rahm can be and he wanted us to immediately begin to take more aggressive action because I think he was afraid that the president was not looking presidential enough and so one of the things he wanted Secretary Duncan to do was to order all the nation's schools to close. Now, first of all, this is before Zoom so remote learning is not available. Secondly, if kids aren't in school that means their parents aren't at work and that has economic ramifications and you could just kind of march your way through the domino effects of that but the fundamental question was, as the Attorney General piped up and said is that the president doesn't have the authority to close the nation's schools. That authority is possessed at the local level and so the president can encourage he may even be able to incentivize but he cannot mandate that the schools be closed. That's the closest I ever thought we came to politicization of the response. Well, and I think also a key difference in this instance that Janet is describing is that the scientists did not favor that response. They weren't saying close the schools. In fact, the CDC was saying just the opposite. They said this was a virus that actually was moving fairly slow. You could watch it move. Kansas would have a big outbreak and then it would die down and then Missouri would have a big outbreak to watch this move and their suggestion very strongly was close a school when enough personnel are affected that you can't safely run the school but don't close schools preemptively. First, it won't stop the virus from spreading. Secondly, according to the CDC and public health, you are putting kids more at risk. They'll be roaming around malls. They'll be out. A lot of children rely on schools for food, for safety and you're actually putting them at higher risk out of school than in school. So there was a really key difference. Janet is very diplomatic describing Ram as forceful. He was saying, shut the fucking schools now. They've got to close now. I mean, now pounding on the table the former secretary of education who is the loveliest man in the world I thought was going to have either a heart attack or just throw up on the floor. He turned this color greenish-grey and just was in shock and horror as we all said, it's going to be all right. We're not going to paint. Don't worry about this. This is not going to happen. But yes, that was a very close call and what a lot of us finally said is let's go hand in hand with you, Mr. Chief of Staff and walk into the president's office and we'll have this battle there because I'm with the science. I'm not rewriting the CDC's recommendation. Secretary Duncan is not closing. I mean, you want to have this? Let's go down the hall and have it with him. And he was like, oh no, we don't, never mind. But you could see how in a different situation where there is a tension between the politicians who may want to protect their principal, as they're called. They want the president to look very presidential and they have one point of view and the scientists may have a different point of view and somebody else and that can be testy and difficult to figure out and I think we saw that play out again in the, but what again you saw over and over in the last administration was rewriting the science by the politicos who were put in the office to rewrite the science and that's a very scary place to be in the middle of a pandemic. The other issue that was more in my lane than yours, Kathleen, was there were many who were urging us to shut the ports of entry and shut down the borders to keep the virus from spreading and we had to point out that viruses don't themselves go through a port of entry and are not themselves inspected and that again the economic and trade implications of doing that would be quite severe. Since we were the origin of the virus, it was really hard to shut it out. But we did get some particularly some Republican pushback to that, to those who wanted us to close the international air travel, to close the land ports of entry and so forth. So back in 2009, the Republicans wanted to elevate public health over the economic adverse effects that precautions might have produced. No. I don't think this had anything to do with public health. I think it was politics. I think they wanted to... Not all. Certainly not like it is today. But they wanted to use the H1N1 pandemic to undercut President Obama. Great. So let me ask a slightly different version of the question. And this is a question that a number of students raised in the discussion forum, which is the question of how you manage trade-offs. Because you've both spoken about different kinds of trade-offs that had to be confronted. You know, trade-offs in the arena of child welfare, the modicum of protection against transmission of the virus that might be achieved through closing schools, has to be weighed off against all of the adverse effects that school closures would have on the well-being of children, on child nutrition, on child education, and so on. In the arena of sort of border biosecurity, the trade-offs, the benefits that might be achieved through the closure of borders against the very heavy sort of economic and even geopolitical costs that will be born as a result. So I'm really curious, and I think many of the students are really curious, too, about how you manage those trade-offs. I know you've both spoken of sort of following the guidance of scientists. But scientists are fundamentally specialists, right? And an epidemiologist who's fundamentally concerned with sort of limiting the transmission of a particular virus may not be so attentive to the downside costs that school closure would have on early childhood education or on child nutrition. Those are sort of the domains of other specialists. So what level of government do these sort of competing trade-offs become sort of synthesized into a framework for decision? And is that in the end a technical decision or is it a political decision? Well, I'll take a shot, but I think at the end of the day, it is ultimately the president of the United States and a national crisis that has to be the chief decider and hopefully aggregate all the information and be guided by whatever set of principles he or she is closely adhering to. We actually had a situation where the decisions were kind of opposite of what the decisions needed to be for the COVID outbreak in large part because the virus moved at very different paces. It became apparent that it was receding on its own and we had an effective vaccine. And this virus has taken a very different tact where it was wildly contagious, far more than the...