A Commonsense Approach to COVID-19

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Katrina Trinko: Joining us today are Doug Badger, a senior fellow in health policy at The Heritage Foundation, and Dr. Kevin Pham, a visiting policy analyst at The Heritage Foundation. Doug and Kevin, thanks for joining us.

Kevin Pham: Thanks so much for having us.

Doug Badger: Thank you, Kate.

Trinko: So, there’s so much to get into on the coronavirus front, but let’s start with Thanksgiving.

California, rather infamously, has said that Thanksgiving gatherings should be limited to three households, should be held outdoors, and shouldn’t last more than two hours.

Oregon’s governor, Kate Brown, has suggested that neighbors call the police if they see people violating her rules about COVID-19 during this time period, and one of those rules is that no more than six people can be indoors at any given time.

On the flip side, though, we’re seeing memes online spread with messages like, “Well, if you have a big Thanksgiving, get ready for small funerals at Christmas.”

So, what factors should people consider as they decide what to do on Thanksgiving, and what would you say matters most? And what is the media over-hyping? Doug, let’s start with you on this one.

Badger: Sure. And Kevin can speak more effectively to the medical aspects. There’s no question that we’re seeing a big increase in cases right now. It’s not unique to the United States, certainly, but it is something that is concerning.

And I would say in particular, for people who have older relatives or who are older themselves, they would think very carefully about going to large indoor gatherings at this point, or even family gatherings, because of the risk of COVID.

Obviously, this is one of these diseases that, in some ways, fortunately, is serious and life-threatening predominantly for older people. I mean, 80% of the deaths are among people 65 and older, 95% are among people 55 and older. And so there are people at heightened risk, and certainly with respect to the nursing home population, it’s even higher.

So I would try to make smart decisions, and particularly taking age and chronic illness into account. You don’t want to expose someone you love to an infection that could result in a very serious illness.

Pham: Right. And I want to add too that it’s not just that there’s a diseases that’s about that could seriously affect our older Americans or our elders, because that’s true with many diseases, especially influenza is particularly deadly.

What’s different about COVID is that it’s extremely infectious, extremely contagious, and so if one person gets it, they’ll be able to transmit it fairly readily.

And the problem that we’re most concerned about, the whole reason why we’re asking everyone to wear masks where they can’t isolate for a distance from other people, is because there’s a short period of time where you’re not showing any symptoms and you’re able to transmit the disease.

That seems to be when most of the transmission is occurring, because if you’re not sick, then you’re out about, you’re in the society, and you’re in the community interacting with other people.

And so because of that, infections are able to get around very far in society very quickly, and we need to be wary about that and understand that that’s why we’re asking everyone to be so careful.

After that, then yeah, it’s extremely important to be aware of who’s in your circle, in your orbit, in your community, and in your family.

If you have someone who is 85 years or older and you’re interacting with them on a daily basis or even regularly every week, or something like that, then you have to be extra careful with your own health because of the contagiousness. You don’t want to be an accidental vector for getting the virus there.

That having been said, what I’m doing with Thanksgiving is I’m not going home to visit family, who includes a lot of older relatives. I’m having what’s called a Friendsgiving and having a couple of people over for lunch on Thanksgiving Day. And we’re all at the lowest age group.

So there are ways to do this carefully and it’s just up to all of us to take responsibility for our own health and the health of those around us.

Trinko: As we look ahead to Christmas, to Hanukkah, New Years, one of the complicating factors is that not only do we have to juggle the risks with indoor gatherings, but many Americans must travel to be with their loved ones.

So what is the impact of people taking planes, mingling in airports, or mingling in roadside stops if they’re driving? Is this something that could potentially exacerbate the spread of COVID in a serious way? Kevin, let’s start with you on this one.

Pham: The answer to that is certainly it can. Any place that you have a hub of travel or hub of people, people who are coming together where you can’t necessarily keep some kind of distance between yourself and a stranger, you don’t know what their health status is. So, any time that happens, you stand the risk of an infection without you knowing about it.

So, that so far has been a theoretical concern. Hopefully we won’t see that materialize into something more practical. But air travel thus far has not been linked to any outbreaks, so it does seem like we can do this safely.

It’s just, again, it’s incumbent on everyone to take those precautions, and I think masking indoors is going to play a very important part, especially in the airports, especially in the airplanes.

Airplanes have special filtration systems, but they really rely on [a] person’s respiration staying close to that person and then being filtered out. So that’s going to be important.

And the other thing too, which would be very helpful, is if people tried to make an effort to get themselves tested before traveling. If you test, you test negative, then it’s going to be a lot safer.

Now, there’s the outside chance that you’ll have a false negative, but if everyone’s testing, then you’ll be able to catch, probably, the majority of cases. And if people who test positive decide not to travel, then there’s going to be a lot less COVID-19 traveling around the country.

Trinko: So on similar lines, what metrics should lawmakers and individuals deciding about risk-level comfort be looking at when they are considering the state of COVID-19 in their area? Doug, what do you think?

Badger: Well, I’m going to challenge the question, Kate, before. But I think the theme that both Kevin and I are sounding is that people need to be taking responsibility for themselves and they need to be making smart decisions. The decisions you make are highly dependent on facts and circumstances.

As Kevin said, for him, getting together with some friends on Thanksgiving all in the younger age group is a very safe alternative. For an older guy like me, my wife and I are going to have one couple over. We’re in Florida, we’re going to eat outdoors and we’re going to take extra precautions.

One of the real errors, I think, that has been present in our former policy on COVID from the beginning has been this command and control in which people are told to be confined—businesses, and churches, and schools are shuttered.

What happens from that is, some people understandably react negatively to that and are maybe more likely to take a defiant posture that maybe takes the illness a little too lightly.

We’re adults. OK? We need to make decisions for ourselves. We need to make informed decisions. So if anything, I would say that the way public policy [has] been done on COVID too often has focused on confining people and limiting their liberties rather than helping them get informed and making good decisions about their own conduct.

Trinko: Well, I think that’s a great point. So let me rephrase the question a little bit, and this is why I love working with Doug, he always calls me out. No. I’ve heard conservatives online have sometimes debated like, “Is it the number of cases that matters or the number of deaths that matters?”

Then of course we see media reports, which, for someone like me who’s not a data analyst, it’s hard to know. Like, this many cases per 100,000, is this bad or is this to be expected?

So as an individual, when you’re making your decisions, what are the numbers you should be looking at to get an accurate sense of how bad it is in your area?

Badger: Well, I think the first thing I’d look at would be my driver’s license, and depending on my date of birth, I would have a pretty good idea of what my risks of serious illness are.

The second, as Kevin notes, for those who aren’t in a particularly high-risk group, they have to think about the folks with whom they come in contact on a regular basis, and be concerned, as he says, that you don’t become a vector of the disease for someone for whom it is very serious.

Obviously, if you’re in a community where there is a widespread outbreak, and you mentioned a few things, obviously, number of cases, number of deaths, and all that’s in your local newspaper, and you’ll probably see pretty easily, again, from the local news, without having to go to specialized websites, what’s going on in your hospitals.

If you’re seeing a situation in which hospitals are getting crowded, death rates are rising, and your case levels are much higher than they were, say, over the summer or last spring, then you’re probably in an area where you should be taking some extra precautions.

Trinko: So, per your earlier point, Doug, states and localities across the country are really replaying the spring. We’re seeing lockdowns happen in L.A., New Mexico’s having some, and I expect there’ll be more announced in upcoming weeks.

What did we learn this spring about lockdowns and whether they work or not? And specifically, because these lockdowns really dramatically differ from each other, they focus on different things and shut down different businesses and places, are there particular lockdown measures that are more or less effective?

Kevin, let’s start with you on this one.

Pham: Sure, and I think I’ll answer this question, but I think Doug’s going to have a better answer, or at least a more in-depth answer. But from my perspective, with the lockdowns in spring, … there’s a couple things that we can learn from it.

No. 1 is that it did what it was intended to do as it was originally intended, which was to flatten the curve.

If you look at the curve in the number of cases and in deaths, they hit a peak in April. The cases peaked early April, and then deaths peaked mid-April. After that, the whole curve scalped.

You know, we didn’t just flatten the curve. We sliced the top off it, essentially, which was a good thing. It did come at a tremendous cost to our economy. But it did, as I said, what it was originally intended to do.

But the sort of mission of flatten the curve became to crush COVID in America, and that’s really an unrealistic goal, even when we have a vaccine. Then it’s going to take a little bit of time for that to get out to the broad community.

So we learned that it can do it, but I think what’s more important here is what we didn’t learn. We didn’t learn, apparently, that these things are not sustainable over the long run.

I think part of what’s responsible for the current rise in cases is that people are tired of being told not to do this, not to do that, and they’re seeing the differential enforcement of these rules.

People can’t go to a funeral with all their loved ones, but we’re having these massive public funerals in multiple cities for people who are held in high esteem by certain political groups.

When people are seeing that, then they realize that the people who are making the rules, the policymakers, they’re not taking their own rules seriously. And they’re not our kings, so why should we follow their rules?

That’s having a major impact on how seriously people are taking this disease. Yeah. What we have not learned from these lockdowns is making the situation worse, in my opinion.

Trinko: Doug, did you want to speak to the lockdowns?

Badger: Yeah. I think Kevin summed it up.

You know, it warrants remembering we didn’t have tests partly because the [Centers for Disease Control and Prevention] test didn’t work, and partly because the [Food and Drug Administration] and the [Centers for Medicare and Medicaid Services] wouldn’t allow alternative testing.

So suddenly we found ourselves with people showing up in New York hospitals and particularly elsewhere in the Northeast with this dread disease. And we began to get this idea that, “Wow. This thing is spreading much farther and much more quickly than we thought.”

And the lockdowns were, as Kevin said, a reasonable response. But certainly national lockdowns of indefinite duration aren’t sustainable, and it’s just not going to happen.

Again, I would say it is conceivable that we will get areas where perhaps hospitals might be overrun or their capacity heavily taxed, where it might be, on a localized episodic basis, a lockdown may be part of a broader strategy to preserve hospital capacity.

But lockdowns are an expedient, and somewhere along the way they were sort of repackaged as a solution. They’re not a solution. They’re not a solution here, and they haven’t been anywhere else in the world.

Any country that’s been successful at combating the pandemic has either not used lockdowns, or if they’ve used them they’ve used them only as an adjunct to more effective policy interventions.

Trinko: There’s been good news on the vaccine front in recent weeks with trial results indicating that the vaccines for COVID-19 largely work. So let’s start first with the practicalities.

What do we know about when the vaccine might start being available? And how many folks do we need to get vaccinated to get herd immunity? Doug, let’s start with you on this one.

Badger: Alrighty. I’m going to have a short answer, which is, Kevin.

Pham: Happy to help. With herd immunity we’re still not 100% sure about what percent of the population needs to be immune to this virus. I do say immune because the people who have been infected and have recovered, they’re going to count toward this herd immunity.

We’ve been under the assumption that it’s going to take about 60% to 70% of people being immune for us to achieve herd immunity with COVID-19. With other diseases it can be as low as like 50%. But since COVID-19 spreads so fast, you’re going to need a larger percentage of people who will be immune.

It’s a little bit hard to track who has been infected because there seems to be a very large number of completely asymptomatic cases. So we could actually be a little bit closer than we thought.

But anyways, that being said, we’re looking at about 60% of people being immune. That’s sort of the goal here, and that’s a large number of people.

We’re talking about 330-plus million people in this country, and so the rollout of the vaccine is going to be really important. It’s going to be targeted, which all of the COVID precautions, all of the COVID measures that we should have been taking, they should always have been targeted.

So I think the rollout of the vaccine, the plans that they’re going to have for it, is one of the bright spots in the pandemic response in America.

It’s going to first go out to those at risk and those who work with those at risk. So nursing home workers, and then first responders, and then slowly over time—I can’t really give it a timetable because I don’t know how long it’s going to take. This is more a logistical concern. …

But over time then, the vaccine will be made available to the broader public. And once that starts happening, it’s going to take a couple months. And then you’ll have a large number of people who are vaccinated.

Obviously, in some communities, it’ll be easier to get more vaccines out, and in other communities, it’s going to take a little bit longer. But when it starts getting out into the community for anyone who wants it, then we should be seeing cases start to plummet. And along with cases, hospitalizations and deaths should start to plummet after that.

Trinko: So, polling shows that many Americans are nervous about taking a vaccine, one that’s so new that we don’t have any long-term testing of. Kevin, what do you think about the risks of the vaccines? And how should Americans face how they decide whether to take it or not?

Pham: I’ll start by saying that as soon as one is available to me, I am going to get it. People have challenged me and said, “You first.” I will say, “Gladly, I will raise my arm to get a vaccine.”

Trinko: I think we’re going to have to try to figure out how to do a Facebook Live of you taking the vaccine, Kevin.

Pham: I’d be happy to do it. But if and when that happens—or when that happens, I should say. When I get vaccinated. What I would say to those who are hesitant about it is, I completely understand.

This is the fastest a vaccine’s ever made it all the way through the trial process and … most of that is because of the government action in underwriting all the risk it takes in developing a new drug.

So, the safety precautions have not been shortchanged. They’re going through all three phases of pre-market trials, clinical trials.

And in order to participate in Operation Warp Speed, which all of these have done, all the candidates have done so far, they all require at least 30,000 participants and a median follow-up time of two months, which isn’t as long-term as some people would like, but we do have a decent amount of follow-up information.

Not quite a year yet, but the first people started taking the vaccines … over the summer, so we have several months of long-term data. We have all these people who have received the vaccines.

And none of these vaccines have had a strong enough reaction except for one: AstraZeneca vaccine. None of these have had a strong enough reaction that would cause a halt in the testing. And these are over 30,000-plus across all three of the current front-runners of the vaccines. And I think we’re talking at least 200,000 participants.

So, any of these three vaccines are probably going to be very safe. And I had mentioned that they stopped the AstraZeneca trials for a little bit, but after an investigation, they had determined that it wasn’t caused by the vaccine, and so they continued on again. And AstraZeneca just completed certain endpoints. And they’re going to be sticking EUA soon as well—an emergency use authorization.

So, there’s a lot of safety data behind these things. Obviously, no one’s had one of these vaccines for longer than a year, so I do understand people’s concerns, but I think those concerns are going to be very small. The chance of something [happening] is going to be very far outside of a normal range. And, once again, once the vaccine gets authorized, I’m going to take it.

Katrina Trinko: Great. So, on the policy front, we’ve seen that lawmakers are not hesitant to take action, but are there particular actions they should be taking, or areas they should focus on? Doug, I’m going to turn this one over to you.

Badger: Thank you. Yeah, I would talk about three things that I think are essential. The first is nursing home safety. We are seeing an increase in cases in nursing homes. That is very, very concerning.

Forty percent of deaths associated with COVID have been among nursing home residents. And an increase in cases among the frail elderly and congregate settings is very, very concerning.

I’ll let Kevin talk. Kevin’s laid out some specific policy prescriptions that the government should follow in protecting nursing home residents.

The second, and the thing that is very, very important is that the FDA approve home rapid tests that don’t require laboratory analysis. Let us test ourselves. The FDA’s reluctant to do it.

They did approve one home test recently, which is great. Unfortunately, it still requires a prescription. Costs around 50 bucks. That’s simply not conducive to the kind of broad, widespread screening, where we get to learn our COVID status on a very fast basis and we get to repeat that test multiple times.

There are tests that have been developed that cost about a dollar each. They’re just paper strips, and you take a saliva sample and you get the results in 15 minutes or so. These cost about a dollar to produce.

We could have 10 or 20 million tests performed every day. And we could be testing kids in school, each twice a week. People could test themselves in their homes before going to family gatherings. But unfortunately, the FDA hasn’t approved them.

Dr. [Anthony] Fauci, last week, of all people, in an interview said that if he could do one thing on testing, it would be flooding the zone with tests, and in particular tests that you can do at home.

I certainly hope the FDA will find its way in time for Christmas to allow this kind of widespread testing to go on. Once people know what their status is, they can take much more intelligent precautions than what we’re doing right now.

And the third thing, as I mentioned, is to provide temporary isolation facilities people could voluntarily use.

The hotel industry has been clobbered by this, by the pandemic and the shutdowns and the reluctance to travel, that they would make excellent facilities for people.

If they don’t want to go home and expose their family to the infection, they know they’ve got a positive test, give them a place to go to recover without exposing other people to the infection.

If we can identify people who are infected and separate them from the uninfected, we can do what lockdowns can’t do, which is actually begin to push back and reverse the course of the pandemic.

Pham: I think that kind of voluntary isolation quarters, that would be a really great thing for the society at large.

But if we can’t do that broadly, speaking of nursing homes, we should at least be able to do that for nursing home workers. If they’re on, for instance, on service for two weeks at a time or so, maybe we can house them in a dormitory, test them first and then keep them isolated there. Can’t go out. They’ll have their food come to them.

It’s sort of reminiscent of the NBA bubble situation that they had to protect the NBA workers and the players and everything. If it’s good enough for LeBron James, it’s good enough for my grandma, honestly.

And so, as Doug had mentioned, as we had all been mentioning, all of our focus should be on those who are at the most risk, which is those in nursing homes.

They are confined to a residence and they’re indoors [a lot of the] time and they are full of people who are at the highest risk so that you’re concentrating all the risks in these buildings, so all of your focus should be on protecting them.

Rapid testing should be used. The CMS guidance, I believe, said that workers should be tested once a week. Ideally, you’d be tested before every single shift, but as that’s not necessarily feasible, then keeping them dormed on the premises or something like that would be helpful as well.

But the long story short is there’s only three ways that a case of COVID-19 can get into a nursing home. One is through staff or faculty, as we had been talking about, and two is through visitors. And visitations have been extremely restricted, so I don’t think that’s driving much of the increase in nursing home cases.

And three is by forcing nursing homes to readmit patients with active infections, which thankfully, that’s been stopped now, but that’s been one of the main drivers for deaths and mortalities in the New York area and several other states as well.

Nursing home residents aren’t getting COVID-19 organically. It was coming in. We need to really have strong controls on that access point.

So, this has all been critical, but I do want to highlight something that has been done recently, that is, CMS has decided to cover monoclonal antibody treatments for nursing homes—or for all Medicare beneficiaries, which would include nursing home residents.

This would be a tremendous benefit because the best time to treat COVID-19 is before it becomes a serious infection. And these drugs, these monoclonal antibodies—I believe the president received Regeneron, I believe it was—these things have the most effect when you have a very, or at least a relatively mild illness.

So, if they’re able to get that and they’re already in the facilities, they might be able to run fusion. If they’re able to get that early and get it at cost or get it for without costs, I should say, then, we could be seeing a large impact, a large positive impact on the mortality in nursing home deaths and that’d be a tremendous benefit to what we’re seeing right now.

But long story short, we need to be protecting, we need to be focusing the majority of our efforts on the nursing homes.

Trinko: Kevin, you just mentioned some medical treatments that we have now that we didn’t have at the beginning of this. We talked earlier in this interview about how we now know people 55 and older are at far more risk than those younger, etc.

But more big picture here: We’ve had COVID for, I guess, close to a year now in the U.S. What have we learned? Do you have any thoughts about how many people are being affected by long-term health issues related to COVID?

Pham: We’ve learned quite a bit. One of the most breathtaking things that we’ve learned is that what we were told initially on how to treat COVID-19 was exactly the wrong thing to do.

What we were told from doctors who are treating patients in Italy and in China, we were told to avoid anti-inflammatory drugs and to ventilate early and aggressively.

They were doing their best to try to keep their patients alive. I do not blame them for being wrong about this. They just got a sudden flood of patients and they were doing their best. But that information turned out to be exactly wrong.

You want to spare the ventilators as much as possible because that only makes it worse. It makes it worse because the primary mortality driving factor is an inflammatory process that goes haywire and that is sort of exacerbated by the use of ventilators. So that’s one of the big things that we have learned about this.

Another thing is that we’ve learned that it effects mostly, or the most severe effects of the disease [are] mostly concentrated in those who are older. The risks of mortality start to increase at 50, but it really ramps up once you’re looking at anyone over 65. That’s another thing that we’ve learned.

Other than that, we’ve discovered that some drugs have been particularly helpful. Steroids in particular, old drugs. Dexamethasone, we’ve been using that for years now and it has a real impact on mortality. A couple other, it gets a little bit into the weeds, but we’ve learned how to treat COVID-19 a lot better.

That’s as far as we learned. Things that we had developed are drugs like Regeneron, the Eli Lilly monoclonal antibodies, and we have vaccines online now too.

So there’s a lot of things that we have now that we didn’t have at the beginning. Not to mention, all the tests. We’re routinely breaking testing records daily now. We don’t even talk about it because it happens so frequently. But we’re testing, I think, 1.5 million people, at least we’re recording 1.5 million tests a day this month.

So that gives us a lot more intelligence. It gives us a lot more capacity and capability to respond to an outbreak. So we’re able to do much more with this. Essentially, a case back in March is very different from a case today. Today, you’ll get much better treatment today.

Trinko: … I know it’s a very small percentage, but the COVID patients who say that they’re experiencing long-term effects, what do we know about that?

Pham: We don’t know too terribly much about that because it’s a relatively small percentage. But what I can say is that the severe disease manifestations of COVID-19 include a large inflammatory response, it’s that cytokine storm that we’ve been talking about.

What that is is the body’s natural defense mechanism going into overdrive and it just dumps the zone with these inflammatory mediators …

At that point, though, the virus is probably not too present. It may have been largely destroyed at that point. It will still be present but the body is just trying to find every last instance of the virus and eradicate it, and in doing so, it’s doing a lot of damage to the lungs and to the heart and to any other organ system that’s being affected by the cytokine storm.

So because of that, you can get a lot of scarring all around the body and it would make sense to have long-term lung damage, long-term heart damage, long-term damage to anywhere where the virus has been or has affected downstream. So it’s entirely possible.

It’s why we really have to take this seriously because even if you’re at low risk of death, if you do end up with a severe disease manifestation, then you could come down with long-term damage.

This is one of the other things that we learned too is some of the signs that you look at if you’re trying to determine if you have COVID-19 or not, and it’s better to get treated earlier than it is to get later.

Back at the beginning, people were walking around with mild flu-like symptoms, and then when they finally decide to go or when they finally feel bad enough to check into the ER, then a lot of damage has already been done. So we’re getting people into treatment a lot earlier these days and that’s also a tremendous benefit to people.

Katrina Trinko: So I know we’re coming to the end of our time here, but I did want to just check in with you both about one last question.

I know you’re not media critics, but you are health care professionals. So what do you think of the media coverage of COVID-19? Do you think the media is missing things or having a wrong focus, or do you think they’re doing a good job covering it?

Badger: Well, I’m going to be a media critic here, Kate, and say that I think in many ways the media has misinformed people more than it’s informed people.

It certainly has raised awareness of the disease, which is obviously very, very important. But I also think they’ve taken in many instances an almost partisan viewpoint on this as opposed to one that would more aim at making sure that people understood their risks appropriately and understood how to best reduce their risk, not just of infection, but of serious consequences of infection.

I wish it were different. There’s the whole demonization of [President Donald] Trump and lionization of [New York Gov. Andrew] Cuomo and all of these side things that I suppose get clicks on your website and maybe get eyeballs on your cable station. But they don’t do very much to really help people get a better sense of what they should do in order to best protect themselves and families.

Pham: I will say that the media has been exceptionally unhelpful during this time. My blood pressure raises every time I think about how the media has comported themselves throughout this whole a pandemic.

But just to take a case in point is the matter of masking. Masks are, I think they are a very good, lightweight solution. They don’t cost very much. They’re not a huge burden to people. I think they are a very small thing that can be used and it may have tremendous benefit to society. It may. But we know that masks are not a panacea. We’ve always known that masks are not silver bullets about this.

There was an early drive for the N95 masks because those are the only ones that would actually work to prevent getting infected from a respiratory disease. But we’ve asked people to wear these flimsy little cloth masks.

Which, again, I support that entirely because just a quick justification for masks, this is a respiratory disease, so it makes sense that you put a physical barrier in front of your respiratory orifices, then you’re going to decrease the spread and the velocity of your respirations, which, if there’s a disease on your respirations, it will limit the impact of your infection.

So that’s why it could help. But they’re not going to prevent you from getting sick. If you’re in the middle of a crowd of COVID-19, that flimsy little cloth mask isn’t going to do anything for you.

The media has been treating these masks as if they are a magic COVID-19 talismans that prevent you from getting infected, prevent you from infecting anybody else. If you’re not wearing one, then you clearly want people to die and you’re responsible for all these deaths in America. That’s not helpful rhetoric.

If you want people to wear a mask, you don’t tell them that you’re going to kill people for not wearing a mask. That’s not how it works.

If you’re trying to, if you want to help people, if you want to help the public health situation, then you’re going to try to recruit people to your cause and you don’t do that by telling them that they’re immoral, reckless monsters. That’s not helpful.

That is only a small case in point, as far as my opinion about the media during this time.

Trinko: All right. Well, Doug and Kevin, thanks so much for taking the time to talk with us today.

Pham: Thanks so much for the opportunity.

Badger: Thanks, Kate.

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