Published on Feb 11, 2021

Video Transcript

[MUSIC PLAYING] JOHN WHYTE, MD, MPH: Welcome, everyone. You're watching Coronavirus in Context. I'm Dr. John Whyte, chief medical officer at WebMD.

The president has talked about we need to address the COVID pandemic and vaccination as a war-time operation. That's how serious it is. So to help provide some insights, I've asked a general, the former Supreme Allied Commander at NATO, General Wesley Clark.

General Clark, thanks for joining me.

GEN. WESLEY K. CLARK, US ARMY (RET): John, thanks. Good to be with you.

JOHN WHYTE, MD, MPH: Here we had Operation Warp Speed, which was great in terms of developing vaccines. But then when it came time to vaccination, it's really been a failure, hasn't it?

GEN. WESLEY K. CLARK, US ARMY (RET): Well, the thing about it is, that wasn't their mandate. They were limited by the policies they were given.

I actually spoke to General Gus Perna, who was the head of Warp Speed, about it. And we exchanged emails, I talked to his team. And when I mentioned the problem of a distribution and then knowing who's been vaccinated, and then being able to certify that you've been vaccinated so you can safely open restaurants and theaters and football games and so forth, he said, not our problem. Policy issue. Just a technical issue, but we're not doing that. All we're trying to do is get the vaccine to the states.

But then, John, we talked to the states. And each state had to submit to the Centers for Disease Control its plan. I reviewed many of these draft plans. And they were pretty rough. It was like, we're going to give them to pharmacies, and we're going to then enter the data.

The states are almost invariably overwhelmed.

JOHN WHYTE, MD, MPH: And under-resourced. Let's be honest. They're under-resourced.

GEN. WESLEY K. CLARK, US ARMY (RET): There's not enough people. The IT systems, or the information technology systems they have, are connected to the reporting system for the CDC, but they're not designed to give to the public or to the business community or to the airlines any assurance that people have been vaccinated.

And so there's-- what we tried to explain to Operation Warp Speed, is you need a closed loop system. You track the vaccine, deliver it to the states, watch where it goes in the states, watch who gets it, have something on their phone where they can explain, hey, I got vaccinated.

JOHN WHYTE, MD, MPH: Why is that so hard? Why don't we have it?

GEN. WESLEY K. CLARK, US ARMY (RET): It's-- you know, because it wasn't looked at strategically. It wasn't looked at systematically.

And John, when all this happened, there were some of us who had some experience and thought about national strategy and biological warfare and so forth. We knew that you had to look at the problem from the largest possible perspective.

So the first thing to do, you had-- the first thing you had to do was stop the killing and the dying. So the first thing you should have invested in, actually, was therapeutics. You should have looked at all the existing medicines out there and said, well, can any of these be repurposed? Would any of them have an effect on the virus?

And of course, President Trump shot a couple of ideas out. But there was not a systematic evaluation.

Now that is in the Biden plan.

JOHN WHYTE, MD, MPH: But what about people who say, it's a pandemic, General Clark. We don't have time to do all these studies. Let's just get it out there? That is what happened, to some degree.

GEN. WESLEY K. CLARK, US ARMY (RET): If we had time to develop vaccines, which normally take three or four years, we'd push those out in nine months. We had plenty of time.

And there was a lot of international private effort devoted to trying to find therapeutic drugs. But it wasn't systematized. Instead, the federal government pushed the money to the vaccine makers. That's good. And that was part of what should have been done.

But just as we were saying with Operation Warp Speed, it wasn't done systematically. It wasn't thought through strategically.

Just imagine today if you had the therapeutic drugs, you would be treating people who are in the hospital coming in there, and you'd still be vaccinating people. But the crisis of the pandemic wouldn't be there. You wouldn't have kids losing their parents and grandparents. You wouldn't have the panic that's out there.

You have people who are getting sick. Yes, it's uncomfortable to be in the hospital. But you're going to recover. That's an entirely different kind of concern than what we have today where we've had over 400,000 Americans die.

JOHN WHYTE, MD, MPH: Should the military be more involved in the dissemination of the vaccine? You know, West Virginia has one of the highest percentages of residents vaccinated. And they early on had the National Guard involved. And now we're talking about FEMA and use of the National Guards. But it's sporadic.

If you were in charge, would you bring the military in? They're good at logistics. They're good at planning.

GEN. WESLEY K. CLARK, US ARMY (RET): No. I'd have the military in there giving the shots. Medics, not your average riflemen or--

JOHN WHYTE, MD, MPH: No. I get that.

GEN. WESLEY K. CLARK, US ARMY (RET): I'm not trained to give a shot. If you gave me a hypodermic needle--

JOHN WHYTE, MD, MPH: I could teach you. I could teach you.

GEN. WESLEY K. CLARK, US ARMY (RET): I don't know how to do it. But there are a lot of trained people in the military who do. And of course, the military hospitals, they have their own issues with COVID.

But you could mobilize the Guard. You can produce medics who are trained in the military. They know how to give a shot.

JOHN WHYTE, MD, MPH: Should we be doing that? Should we be having the National Guard out more to help?

GEN. WESLEY K. CLARK, US ARMY (RET): We absolutely should. But we also have another problem. Is you have to bring everything together. So one of the things is, we're not sure we have enough vaccine yet. We just have ordered 200 million more doses of vaccine.

What were we waiting for? Did we think that every American shouldn't have a couple of doses of vaccine? There's 300 million Americans.

So it seems to me like you should be planning for at least 400, 500, maybe 600 million doses if the vaccine takes two doses. So that's just getting underway.

So really, this is a hard problem to deal with centrally. So the governors need funding. And they need to have access to their own National Guard medics. You may have to put some active duty military out there to assist them. But that's the governors' responsibility to make that call with the funding.

Look, there's even a shortage of hypodermic needles. I got a call last week from a friend said, Walter Reed doesn't have enough hypodermic needles to be able to give the-- Walter Reed, the nation's premier medical military medical facility, doesn't have enough hypodermic needles.

And all over the news it's been pointed out the way the vaccine was packed by Pfizer, if you have the right hypodermic, you can draw six doses from. But if you don't, you only get five. And that's a vaccine that has to be kept very cold.

JOHN WHYTE, MD, MPH: And we should have known that beforehand, in reality. We shouldn't be finding that out.

GEN. WESLEY K. CLARK, US ARMY (RET): It's just, these were the things that should have been all thought through by President Trump's team, and then operation works be given the mission to do it. Attention to detail is really important, John. And we didn't have the attention to detail.

I think we do with the new team that's coming up.

JOHN WHYTE, MD, MPH: I also want to ask you, because you're an expert in national security, and we had an interesting conversation last week about this concept of vaccine nationalism. We're not vaccinating anyone [INAUDIBLE] everyone here. We're not sharing any vaccines with Canada or the developing world.

Does that give us a false sense of security? And is it the wrong approach?

GEN. WESLEY K. CLARK, US ARMY (RET): Well, you know, everything today is about competition between pure competitors. So Russia has its Sputnik vaccine. China has a couple of vaccines, one from Sinovac one from Sinopharm. And they're out there beating the bushes trying to get countries to buy them.

Now the Sinovac vaccine has been rated as only 50% effective. The Sinopharm leadership, for some reason, just recently got replaced. And so there's a lot of turmoil inside China.

But this is vaccine diplomacy. It's competition. Moderna is being manufactured not only here, but overseas. We're waiting for AstraZeneca.

JOHN WHYTE, MD, MPH: But how does vaccinating just the US make us safe?

GEN. WESLEY K. CLARK, US ARMY (RET): It-- absolutely not. You have to go around the whole world. This is like smallpox. It's like polio. You want to eradicate it everywhere.

The people are telling us-- the doctors, the scientists, say, it's going to be really tough, because unlike polio and unlike smallpox, this is a coronavirus. It rapidly mutates. That spike protein that sticks out on the virus is constantly changing. Most of the mutations don't mean anything. But some have had an impact, and apparently they're more contagious.

So we don't even know in the future which vaccines are going to be more effective as these mutations pile up on the spike protein. So there are a lot of medical uncertainties here as we move forward.

So it's not just about being vaccinated. But you're going to need to remember what vaccine you got and when you got it.

JOHN WHYTE, MD, MPH: Well, General Clark, you modernized military during your time. How do we modernize the public health system? What would you do?

GEN. WESLEY K. CLARK, US ARMY (RET): Well, it's a much tougher thing because public health depends on public attitudes. So for the last 30 years, there's been a growing anti-vaccine movement in the United States associated with fears of autism and other things.

So you've got to have a major public information campaign. You've got to really provide the facts out there and the truth. And people have to communicate with it.

So you've got to have people accept the fact that there will be more of these dangerous diseases coming. It's inevitable with global travel and communication and almost 8 billion people in the world. It's inevitable.

Secondly, you've got to be able to track your own record of immunizations, and it's got to be verifiable. You know, when we travel abroad, used to before you could go to Nigeria, you had to get a yellow fever shot. So you go to the drugstore, they give you a yellow fever shot.

Oh yeah. We got it here. They give you a yellow card, just scribbled on there with a date. When you go to Nigeria, they don't know where that card came from. Or they don't have any-- but they trusted it.

Well, we know now from examination that a lot of this is fraudulent. And we've accepted it. And in the United States we've become complacent because we got rid of malaria, tuberculosis, polio, even measles, mumps, chicken pox, the kind of diseases my contemporaries had when we were children. Mostly that's gone.

So you forget about the dangers. So we have to re-sensitize the American people to the needs for public health and the acceptance of the public responsibility, the responsibility of government to provide assistance in public health to its citizens.

JOHN WHYTE, MD, MPH: What keeps you up at night?

GEN. WESLEY K. CLARK, US ARMY (RET): Well, in this case, it's the worry about the vaccines and how we're going to manage the vaccines. We know that these vaccines are targeted on the spike proteins. And we know the spike protein, just like penicillin when it came out, it killed 99.99% of all bacteria in a Petri dish. And people said, ah! We got an antibiotic. It changed medicine.

But over time, that 0.0001% of the surviving bacteria become penicillin-resistant. So we've gone through one antibiotic after another to get antibiotics that will kill these other bacteria. Same challenge and response is behind the mutation of the spike proteins in this [INAUDIBLE]. And they mutate very quickly.

So if one of them becomes more effective at spreading, whether it's more lethal or not, and it challenges the vaccine, and it's the survivor, well, then just by how many people are infected and the spread of that infection, that strain of the virus is going to increase and become more dangerous. I worry about that.

I also worry why we can't apply more common sense. One of my friends in Silicon Valley has his own fund he's put into trying to find a therapeutic. He swears there's a therapeutic called Fluvoxamine, which is an-- it's an antidepressant, actually.

But somehow it interferes with the cytokine storm that the virus creates. And it provides a margin of safety for people--

JOHN WHYTE, MD, MPH: Well, we'll have to see. We've seen a lot about the cytokine storm. And that's why we have a regulator.

I also want to ask you, Dr. Clark, you've worked with our allies for many years throughout your career. Has our role on the world stage been diminished?

GEN. WESLEY K. CLARK, US ARMY (RET): Well, actually, we're in a struggle now. You know, during the Cold War when I was a young officer, we had a principal adversary in the Soviet Union. China had turned inward. It was starving its own people. But it was no big challenge.

And then when the Berlin Wall fell in 1989 and the Soviet Union came apart a year later and the Soviet troops were taken back out of Eastern Germany and those other East European countries and brought to Russia, it was called the year of miracles. The great Spanish writer Gabriel Garcia Marquez told me, he said, it's so boring now. He said, there's only one ideology. And it's yours, meaning the United States.

We thought it was the end of history. But as often happens, there are new challenges.

So there's a resurgent Russia challenging us. And it's using financial means and disinformation, as well as its military, to create chaos in many countries. It's in the Middle East. It's actively engaged in war in Ukraine, for example.

And China has become an economic giant. And they have giant aspirations. They would like to change the international order that we set up at the end of World War II.

We created the UN, the International Monetary Fund, the World Bank. And we did it out of really beneficence. We wanted to help other nations so there'd be no war again.

China looks at those institutions, says, ah, they're American-dominated. Let's do it our way. China. We're the center of the Earth. Let China lead the globe.

And so there's a very strong, systematic, patient, but forceful campaign to reduce the influence and power of the United States by China, as well as by Russia. It goes after the military superiority that we have traditionally had, the dominance in international trade of the dollar, our leadership, and global institutions like the World Bank and International Monetary Fund and the UN, our moral legitimacy on human rights. There are many elements of this. It's a whole of government effort by China.

So there's a new challenge facing America. We can't take for granted America's leadership role in the world. We can be proud of who we are, but we have to engage in the world. We have to look at it as it is and understand that we have to prove ourselves again and again.

JOHN WHYTE, MD, MPH: You have a podcast called The Global Beacon. Tell us about it.

GEN. WESLEY K. CLARK, US ARMY (RET): So we want to look at-- we want to look at the big issues, but also the issues that are behind the news. So we want to take a look at climate change, for example. We want to look at the space race. We called it the space race back when I was a young man when we tried to get to the moon. Well, we won the space race thanks to President Kennedy and NASA.

Now there's a new space race. China wants to put a base on the moon. China wants to go to Mars.

What does that mean for the United States? And what are we doing with it? We want to look at new technologies.

You know, this country is on the verge of a change in its economic foundations. We're trying to shift away from hydrocarbons and move into electric propulsion and renewable energy and storage batteries. And all these technologies are out there. But if they prove more challenging to invest in, and let's say the communications revolution, everybody-- suddenly there was an iPhone. And everybody got one. And everybody loved it. And boom!

But that's a consumer issue. When you're dealing with the fundamentals of things like energy, well, that's different. That's long-term investment, patient money, smart choices in technology. And usually these decisions have to be made-- at least the initial investment decisions-- have to be made by the government because industry doesn't like to take those risks, and finance doesn't like to take those risks.

So we want to talk about some of these technologies. What are some of the opportunities?

When I was a young man, I used to sit in a barbershop and read Popular Science and Popular Mechanics.

JOHN WHYTE, MD, MPH: I remember. I remember.

GEN. WESLEY K. CLARK, US ARMY (RET): Well, you know, according to them, by the year 2000 we should have air cars. We should be flying around. Cities should be like, 100-- everything should be 100-- It didn't happen.

It could still happen. We could still have the space travel. We could still go beyond the moon. We could still have those communications to perhaps other solar systems out there.

So there's a lot of excitement behind that. There's a lot of science out there. These are some of the things we want to explore in Beacon. And we'll also, of course, we'll talk about national security.

JOHN WHYTE, MD, MPH: And to do those things, first we have to get through the COVID pandemic. So I want to thank you for taking the time today to provide your insights and guidance and the strategies we might utilize to have more effective vaccination, as well as address issues of testing. And I want to thank you for your service to America and all that you have done.

General Clark, it's a real honor to speak with you today.

GEN. WESLEY K. CLARK, US ARMY (RET): Thank you very much, John. A real pleasure to be with you. Thank you.

JOHN WHYTE, MD, MPH: And I want to thank you for watching Coronavirus in Context. If you have a question, please feel free to email it to us at [email protected] or post it on social media.