WHO’s Vaccine Advisory Leader Discusses Global Readiness to Manage Pandemic: SAGE Chair Dr. Alejandro Cravioto

Dr. Alejandro Cravioto

[Music]

Marianne O’Hare : Welcome to Conversations on Health Care with Mark Masselli and
Margaret Flinter, a show where we speak to the top thought leaders
in health innovation, health policy, care delivery, and the great minds
who are shaping the hea lth ca re of the future.

This week , Mark and Margaret speak with Dr. Alejandro Cravioto ,
Chair of SAGE, t he Strategic A dvi sory Group of E xperts on
Immunization . R eporting directly t o the World Health Organization,
SAGE just issued an emergency authorization for g lo bal distribution of
the Pfizer V accine for COVID - 19. Dr. Cravioto talks about the need for
more scaled up production and distribution of approved vaccines and
the need to ensure that distribution of vaccines is fair and equitable
around the world.

Lori R obertson also checks in, the Managing Editor of F act C heck.org ,
who looks at misstatements spoken about health policy in the public
domain, separating the fake from the facts . And we end with a bright
idea that's improving health and wellbeing in everyday l ives.

If you have comments, please email us at [email protected] , or find
us on Facebook, Twitter, or wherever you listen to podcast , and y ou
can also he a r us by ask ing Alexa to play the program. Now stay tuned
for our interview with Dr. Alejandro Cravioto here on Conversations
on Health Care .

[Music]

Mark Masselli: We are speaking today with Dr. Alejandro Cravioto , Chair of SAGE at
the World Health Organization, the Strategic Advisory Group of
Experts on Immunizati on , the principal advisory group at the WHO on
vaccines and immunizations, which just gave emergency authorization
for the Pfizer COVID - 19 vaccine for global distribution.

Margaret Flinter: Dr. Cravioto has worked to advance nutritional protocols for child ren
all around the world. He served as D ean of the Medical School of the
National Autonomous University in Mexico City. And he's been the
Executive Director o f the International Center for Diarrheal Disease
Research in Bangladesh. Dr. Cravioto , w elcome to Conversations on
Health Care .

Dr. Cravioto : Thank you very much.

Mark Masselli: You know, the world has entered this second year of the COVID - 19
pandemic a nd no one , including the World Health Organization , could
know how far this emerging pathogen would r each when it first
began. But we're at this turning point . Your team at SAGE just issued a
green light for the global distr ibution of the Pfizer COVID - 19 V accine.
And I wonder if you could tell our listeners about the recent

Dr. Alejandro Cravioto

emergency authoriza tion of this particular vaccine , which had already
been approved for use in several countries. But what criteria did your
team at SAGE consider before making your recommendation?

Dr. Cravioto : Every time we have a vaccine to evaluate, it has to be a vaccine that
has a lready gone through the whole regulatory process. That means
FDA or the E MA in Europe , or where the vaccine was produced, how it
is produced. Now what the WHO does is look at the vaccine in the
same way , in two ways. One, it goes through what is called a
p requalification, which allows countries that don't have a regulatory
authority of themselves , to use that as a way of saying this is a safe
vaccine to use in our population. Or , it allows the UN agencies ,
UNICEF and others , GAVI, to buy the vaccine , to pur chase the vaccine
that is available.

So , on the other hand, for the policy part, in 1999, the Director
G eneral decided to create a group of experts that would look at all the
issues related to vaccines and immunization . The idea that 15 of us
that represen t the world geographically and also have a total gender
balance , that means half of men , half women , look at the evidence
that was handed in to the regulatory authorities, not only the
qualities of the vaccine, but h ow the vaccine should be used. V accine
i s not useful unless it goes in to somebody , orally or injected .

So in that sense, what we do is to review the evidence. And for that
we create what we call a ‘ working group ’. To extend the expertise of
the 15 of us, we invite others to participate also , sel ecting people
from all over the world , in these working groups. And in this case, we
have a wonderful one , of 26 people from around the world who have
been helping us three times a week . And this group has been looking
at three areas. One is the evidence , o ne is how the vaccine should be
prioritized for use , and the other one helps us with the modeling . H ow
do we actually try to see how this vaccine will work through this
mathematical modeling that allows us to predict a bit how these
things would work.

Mar garet Flinter: Well Dr. Cravioto ,I think we're really curious . T his was such an intense
race to develop a viable vaccine , and truly i t does sound like a very
cooperative venture , a nd yet we know we had scientists working all
over the world, just on the bas ic science to develop the vaccine. W as
there that level of collaboration in the scientific community about the
actual dev elopment of the vaccine as well , and how does the World
Health Organization help facilitate that, since this is obviously also a
huge b usiness proposition for these companies ?

Dr. Cravioto : I think here, what we have to see, and we see that very much in
vaccines , is a public - private partnership. In many cases, we have
vaccines that are very good, but there's no commercial value in them.
N ow, somebody might decide to produce it because it has public

Dr. Alejandro Cravioto

good , b ut that doesn't necessarily happen with all the vaccines that
are actually created. So we have wh at we call this ‘ valley of death ’ .
T hat means the vaccine just gets lost, because no one i s willing to pu t
up the money. If you look at Warp S peed, the program in the US to
speed up the process of vaccine, what they put their money in was
not the development of the vaccine , that was done by Pfizer , by
M oderna , by AstraZeneca, by each one of the companies. W hat the
US put the money for was to create, at the same time that the vaccine
was being developed , a factory to produce it.

Now, normally, that is, two - three years after the vaccine has been
approved, after it has gone through SAGE and every s ingle committee.
T hen somebody puts up the investment to create the whole area to
produce it. This is what has been incredible with these vaccines that
we have, not knowing that the vaccine would actually work, hav e
invested the money to put up a factory t o produce it. So as you saw in
the US, the FDA approved the vaccine one day, and the next day it
was rolling out of the factory where it was being produced , long
before the whole process of approval started.

The other is that we can shorten the time of the se long trials that we
do , without affecting the safety or the efficacy of the vaccine. And
that's something we really need to learn to do it more quickly. We
have a wonderful vaccine for tuberculosis that is in development , a nd
the prediction is that we w on't have the product until probably 2028 -
2030 b ecause of all these issues related to the development, and the
testing , and the production of a vaccine, which might be of great help
to the world, and needs to be moved in a faster way.

Mark Masselli: You kn ow, we recently had Dr. Paul O ffit join us . He serves on the
c ommittee a dvis ing the United States for vaccine approval and, like
you, they had to mine trial data very thoroughly before they made
their recommendation. And yet , there are a number of other va ccines
in the queue, one from AstraZeneca, another from Russia, China,
India . Each has its own configuration , and I'm wondering if you could
talk to us about your access to this data to these emerging vaccines.
What are you doing at Sage to monitor safety an d efficacy?

Dr. Cravioto : Well, SAGE has always work ed very openly with the producers, both
the ones that are established in the higher income countries, but also
the ones that are housed in the lower or middle income countries.
And now we have large pro ducers, especially in India and in China,
that have come online, which have been very helpful to have a much
wider amount of types of vaccines. So what we do is, this is a
voluntary process, any company that wants to come to us , or to WHO ,
with the data, t he dossier , like t hey hand it in to the FDA or the E MA ,
does it . And then it goes through the process , as you have seen with
these new ones of looking at the data , a nd when the whole thing is

Dr. Alejandro Cravioto

completed, then it comes to SAGE for review , a nd then we decide
whether the vaccine has all the characteristics needed to make a
recommendation. Our recommendations go to the Director G eneral
of the organization , who then if he agrees, approves them, and then
they're disseminated both through the World Health Organizat ion and
through other systems.

What we also want to see as part of what we review is how is this
vaccine going to be used . W ith the Pf izer vaccine , o ur biggest problem
was how are we going to maintain a cold - chain to be able to keep the
vaccine safe, which requires a - 70 temperature . But we have done this
in the past . W e have vaccinated over 300,000 people in the
Democratic Republic of Congo against Ebola using a vaccine that also
requires a - 70 temperature to keep it alive. So we have done it before.
And i n my own country when people say well how are we going to
handle these ? R esearch centers have - 70 freezers , so they len t them
to us to set up vaccine centers where we now move the people to
them , instead of moving the vaccine towards them.

So all these thi ngs have the proposal that a vaccine should be used
effectively, not get lost in the way, because that is what really
decreases its efficacy. In the case of the vaccines for COVID, w e have
seen the Pfizer dossier , we have looked at M oderna and we have had
close to five or six long sessions with the producers , with a working
group. They have presented the data . We have made questions to
them, they have answered the questions. So we now have a
confidence o f the information that we're handling, to be able to m ake
the recommendations for these other vaccines , as we have done for
the Pfizer .

Margaret Flinter: Wow! s uch great progress. And I know, because of all the work that
you've done with the World Health Organization , and internationally,
you're concerned wit h making sure that we use the vaccines
effectively, but also with using them equitably around the globe and
making sure that it's not the wealthier nations that disproportionately
take the vaccines than the less advantaged countries. Y ou have
COVAX as part of the World Health Organization, which addresses this
issue of vaccine nationalism , a nd we really welcome you telling us a
little more about that.

Dr. Cravioto : This is a wonderful initi ative, mainly based o n the whole idea of the
Global Alliance, what w e call GAVI. GAVI is a system of input of money
from private funders, the Gates Foundation, others, and
g overnments , who actually come together to make sure that
countries that have less income, are also capable of having a good
vaccination program. Over t he years, GAVI ha s supported countries in
Africa, Latin America, in Asia, that have allowed them to create
efficient and really well - organized vaccination services, and have had

Dr. Alejandro Cravioto

the ability to incorporate new vaccines, some of them very expensive
ones, lik e the ones we use aga inst R otavirus, which causes diarrhea,
or against pneumococcal disease, which causes pneumonia , and
infections in the ear, and infections in the brain. So in that sense, now,
using that principle, what GAVI did was to make a proposal o f
expanding that and creating this fund with the money coming in from
all different sources, which now has close to $ 3 billion , to be able
then , once the vaccines become available, to make sure that the
poorer countries have access to these vaccines withou t cost , the
middle income countr ies have a way of sharing costs that would also
make them cheap , the vaccines, because they're buying huge
amounts , a nd then, of course, having enough supply to be able to
make sure that all these different groups have acces s.

The other part is the humanitarian part . We have a large number of
communities that are displaced . We have areas of high conflict . We
have the whole problem in Yemen, which is very, very dramatic. And
of course, we want to make sure that those countries and those
groups of people also have access to these vaccines. In the case of the
COVID , one in differen ce to others, the companies have decided to
minimize their cost and have only a replacement of these basic costs
without actually making a profit, whic h is highly laudable them ,
because this is not the moment to make business, this is a moment to
have the world make something different.

And in that sense, what we're waiting now is for all these other
vaccines, like you were saying the ones produced in Ru ssia , or in
China, to be able to come up with their information so that we can
see them in the same way, make sure that they are safe, and then
make the same type of recommendations in that sense. Now , we are
being overtaken by events . Countries are doing their own bilaterals to
buy vaccine because they have a pressure from their communities to
immunize them. But in a sense, what we feel is that we are taking
care that everybody should have at least a chance to be able to share
in this product and not just the countries that have the resources to
do it.

Mark Masselli: We 're speaking with Dr. Alejandro Cravioto , who is C hair of SAGE, the
principal advisory group at the WHO on vaccines and immunizations.
You know d octor, it may be not all around the world, but certainly in
the United States , w e're hearing a lot of people who have sort of
vaccine hesitancy . And you add to that hesitancy the emergence of a
number of variants to the COVID - 19 vaccine. We had the UK variant,
the one in South Africa really causing a number of set of problems.
And I think WHO just convened a meeting of scientists around the
globe to track the COVID variant . Tell us more about it. S hould people
be worried about it? Or is this sor t of a normal Novel Coronavirus
mutation that sort of happ ens all the time? If it's a normal one, could

Dr. Alejandro Cravioto

there be an abnormal one? And how are you tracking all of those?

Dr. Cravioto : I think it's normal for the virus to mutate. And in the case of this one,
which ha d spread so widely, of course, there are many cul tures in
development . Every person who's infected, it's actually in your culture
for the virus, and it has to adapt to a lot of things. One is to adapt to
our own genetics . Some of us are resistant to the virus, because our
genes have that capacity as we a re resistant to the HIV virus, for
example. And it's a small group, but it's also something that we know
happens. In the case of the of the variants, I think the most important
thing of the session, long session, five hours that we had yesterday in
WHO to look into this , was to create an international network of
people looking at these things at the same time, sharing the strains,
sharing the reagents , sharing the information , that would allow us as
we hav e done with I nfluenza, or w e did many years ago with
Salmonella , to be able to have a worldwide recognition of what is
actually happening.

The other is, of course, looking for these variants and seeing how
much they are actually movi ng in a sense of danger. I think they have
to be looked at and they have to be clearly studied to make sure that
we are still in a capacity with our drugs and our vaccines to be able to
curb them, or if they are really something that we really should see,
and control in a different way. So far, all the evidence that we saw
yester day, and the evidence that has been publi shed, doesn't seem to
do that. A lthough the variants are worrying , nobody has actually been
able to prove , one , that they are more capable of causing a more
severe disease, which is something , one, we really don't k now if
they're capable of transmitting from one person to another. More
often, we have the data from the UK , b ut that also has other things at
the same time happening in the country that mask a bit what is
actually happening. And on the other hand, and the re's going to be a
meeting in WHO on Thursday , tomorrow , is that we want the
International Health Regulations to look into this to see if there are
any restrictions about travel l ing or any requirements for travelling.

In that sense I think that everybody's looking at this , a nd as we have
done with the vaccine, it has to be a joint work of every country not
putting restrictions just by itself, but actually thinking about how we
control this issue. The data we have published so far, only comes
about the respo nse of people vaccinated with the Pfizer vaccine,
showing that the antisera that they have , the serum taken from these
volunteers, or these patients, neutralizes , I mean controls the growth
of the variants. So that is good. But they're happening all the ti me .
You have now a new one of people going from Brazil that has a large
Japanese community to Japan, and then bringin g the virus from Brazil
to there. And then I'm sure that if we start studying them, we will see
that happening more frequently. So we need to be aware of the

Dr. Alejandro Cravioto

problem and try to handle it in a more coordinated way than has been
done so far, when these things have been more isolated in their
capacity of being analyzed .

Margaret Flinter: Well Dr. Cravioto , it seems like a very long time ago, Jan uary 2020.
But I remember we, with great pleasure , launched the World Health
Organization International Year of the Nurse and Midwife . And here
we are in 2021 a nd we were so pleased to see that the World Health
Organization named 2021 a s the International Year of Health and Care
Workers in honor of the incredible sacrifice , commitment, heroism of
health care workers all over the globe that have treated patients
during this deadly pandemic , and really with considerable loss of life
in the United States and i n other countries. How do you think we're
doing at getting the vaccine to the frontline workers in countries all
over the globe , as well as the PP E they need to keep themselves safe?
Are we making progress there , a nd is that death toll coming down
around t he country as we move forward around the globe?

Dr. Cravioto : I think that's an excellent question. First of all, I would say that we're
all in the hands of these people , a nd the only thing we can say is
thank you because they are put ting their life on the line to be able to
keep us safe and treat our relatives and the people who get very sick ,
and thanks to them, many of them come out alive. The second is that
we have had a large number of people dying , a nd that has been a
huge tragedy everywhere that has happened. And I think this just
shows why we decided in SAGE in the first document that we
produced, that looking at the ethics of how these vaccines should be
allocated , t he first group that had to be vaccinated are the frontline
workers that we call the health workers.

That includes not only the doctors and the nurses, it includes the
people who clean the hospitals, who bring the food, who drive the
ambula nces, who are all exposed to this, t he people who take care of
the dead, etc. we call the frontline , and those are the ones that we
feel should be vaccinated first. I think it's something that we need to
do to make sure tha t we keep our health workforce robust, healthy,
and safe in that sense. The problem, as you have seen in the United
States and in othe r countries, is that many health workers are now
reluctant to use the vaccine, because there has been this idea that
they lose a day at work , that they don't feel very well , that they might
have an allergy , a nd that is something that worries us because the y
are our best disseminators of saying that the vaccines are good and
safe in any part of the system. So if they're not convinced, t hen who
can convince the others?

And so we are trying very hard to create all the necessary elements
for them to be assured of the safety of the vaccines, but at the same
time to make them good ambassadors in the sense of why we need

Dr. Alejandro Cravioto

this vaccination. And what we need is information and people that
can be trusted. And on the other hand, with the social media
expanding , as it ha s , th ere are too many people saying the most
outrageous things against the vaccines that people hear , question and
sometimes don't have a good answer back in the sense of saying,
look, this is ru bbish , and don't believe it. Why? Because of this , this ,
this , not because I'm the expert that I know more than you , b ut
because there is this ev idence that comes up. Offit is one of the great
communicators of that, as you probably saw, and he ha s been
working for years in this type of hesitancy problems.

We feel , a s part of the recommendations that we gave, that the
communications part , especially to the communities , has to be very
strong , a nd we have to make sure that the people get the answers
that they need . WHO has created some question and answer pages,
which a re good. Some of them are in more than one language, which
is also very good. The Pan American Health Organization has one in
Spanish because of the amount of people living in this part of the
world who speak that language. So , in a sense I think we are tr ying to
m ove into convincing people that that is something. O ne of the
problems with the Pfizer vaccine is these allergies that t hey can cause
in certain people , and has been something that [audio cut 00:23:40] .
So we have something in the recommendations about that , But on
the other hand, if you have an allergy to a food or to the environment ,
to dust, that is not a reason not to get the vaccine. This is really
allergic reaction , severe ones to either vaccines before , because of
some problem, or people who have allergies to something that can
put them in real danger of having a severe event. So , in that sense we
have that , and at the same time, we have insisted that because of
those allergic responses we need to make sure that in the places
where the vaccin e is given , that we have the treatment for any case
happening in that case, and that is – Yes.

Mark Masselli : Dr Cravioto, y ou know, you have such a great p erch , sort of a global
view of how the world has come together , at least at the scientific
community level , and I'm just wondering, a re you hopeful ? We know
we had SARS and MERS. We've got COVID - 19 . Are we prepared? Or
are there lessons learned from the scientific community of how we
manage not only finishing this crisis but be prepared for the next one ?
And i s somebody modeling up if we're not as good as we should be
modeling up what the best response might be?

Dr. Cravioto : I really thought that after the SARS scare that we had, that we would
be far more prepared for this one. And I'm sorry to say, but that
hasn't happened. I think Bill Gates said the same thing long before
me , that we have been prepared . With the H1N1 in the US, President
Obama created this whole group of a pandemic response, which was
really part of the White House , a nd we ha d groups a ll over the world

Dr. Alejandro Cravioto

looking into this. But this time, I feel that again, we were ill prepared ,
one , to be aware that there was a massive problem coming. And we
can blame anybody for that , it doesn't make any difference. We have
prophets who said somethin g th at is difficult to follow in a sense. And
I think what i t’ s clearly shown is that we need to have a much better
international understanding of what is happening . This team that has
just arrived in China to look into how this whole thing started , it’s
going to be very important. And I'm very glad that the WHO sent
them, a nd of course, the Chinese government accepted to go through
this whole process of understandi ng where were the delays .

I don't think putting blame is going to help anybody , b ut we do need
to have some kind of lessons learned about this, b ecause this is not
the last one. W e are in constant contact with these viruses that come
up , t hese viruses that come mostly from animals and jump into
humans. And we have had HIV, we hav e the Ebola, we have t his one ,
and so all of these are the same type of viruses that start in an animal,
and then suddenly jump into humans, when they can adapt , and then
they spread. H ow much we control led the spread , until now , had
been more successful , b ut with this one, I t hink we were not aware of
its capacity really, to infect this huge amount of people.

And on the other hand, the only thing that we seem to have had in
han d was to tell people stay home, d on't go out , at first. And to be
honest, I mean, I was chatting with a friend of mine who lives alone in
Bangladesh , and she's desperate , because she hasn' t seen her family
for a year. She lives there . She doesn't want to go out . She's scared.
All these things come up , a nd there's no solution for her , except now
to get a va ccine , that is still not available where she is living . So I think
we have to recognize that we need a much better system of control
and awareness tha n we have in place.

The World Health Organization is of course, where we put our money
into doing th is typ e of things , b ut it has to have the response and the
leadership from all the governments that are part of the organization
to be abl e to function properly. And there we have had a very
mismatched response from one government to the next on how to
manage th is . What I do think is that now with the vaccines available, if
we can control this program, we really need to assess how do we
setup a system of awareness and red lights that allow us to be able to
be prepared for this . Because it's amazing that we're now going back
to the experience of a 100 years ago with the I nfluenza epidemic in
1918 , and now this one, I would say we hadn't learned in a 100 years
anything except to wear a mask , or stay at home. Now fortunately, in
this case, we have developed vaccines and it's a magic because some
of them are really novelty vaccines that are going help not only with
this disease but with others. So, in a sense, I think that if we don't
take this chance as lessons learned, I think we're going to be having a

Dr. Alejandro Cravioto

very missed o pportunity of actually doing something different the
next time.

Margaret Flinter : We've been speaking today with Dr. Alejandro Cravioto, the C hair of
SAGE at the World Health Organization. Sage is the principal advisory
group at the World Health Organizati on on vaccines and
immunization. You can learn more about his work on vaccines by
going to who.int/immunization/sage and follow their broader mission
by following them on Twitter @WHO. Dr. Cravioto, we want to thank
you so much for your efforts, your human itarian efforts, your
scientific efforts , making the world a better pla ce , and for joining us
today on Conversations on Health Care.

Dr. Cravioto : Thank you for inviting me , a pleasure to be with you.

[Music]

Mark Masselli: At Conversations on Health Care, we want our audience to be truly in
the know when it comes to the facts about health care reform and
policy. Lori Robertson , is an award - winning journalist , and Managing
Editor of FactCheck.org, a nonpartisan, nonprofit consumer advocate
for voters that a im to reduce the level of deception in U.S. politics.
Lori, what have you got for us this week?

Lori Robertson: Tw o COVID - 19 vaccines are now authorized in the US by the Food and
Drug Administration , o ne vaccine from Pfizer and BioNTech , and
another from M oderna . We'll take a look at how these vaccines work.
Both the Pfizer BioNTech and Moderna vaccines are m RNA vaccines
that require two doses. The vaccines work by triggering an immune
response against the spike protein of the SARS C oV 2 virus. That spike
pr otein sits on the surface of the Coronavirus and is what the virus
uses to enter cells. The vaccines are made of modified messenger RNA
or mRNA, wrapped in a special blend of fatty molecules known as lipid
nanoparticles. The mRNA provides instructions for cells to make their
own spike proteins, prompting the body to generate protective
antibodies and activate T cells. The lipids help deliver the RNA into
cells and prevent it from being degraded too quickly.

The Pfizer BioNTech vaccine includes 30 micrograms of mRNA in each
dose . Moderna shot has 100 micrograms. The two vaccines also use a
different mix of lipids. As the Centers for Disease Control and
Prevention has explained , there is no way to catch COVID - 19 from this
type of vaccine because the vaccine is not made of a virus , and
because the mRNA from the vaccine doesn't enter the nucleus , t he
part of the cell that houses DNA, it ‘ does not affect or interact with a
person's DNA , ’ t he CDC said , contrary to some online rumors . The
Moderna vaccine was develop ed in collaboration with the Nati onal
Institutes of Health . R esearchers at the National Institute of Allergy
and Infectious D iseases Vaccine Research Center were already

Dr. Alejandro Cravioto

working with scientists at Moderna on an investigational vaccine to
protect against ME RS, another disease caused by a Corona virus.

As soon as the genetic sequence of SARS C oV 2 became available in
January, the team was able to apply that knowledge to design a
COVID - 19 vaccine . German company BioNTech d esign ed multiple
mRNA vaccine candidate s after the genetic sequence of the virus
became public in January and partnered with Pfizer in March.
According to the results of the Phase III trials, the two vaccines had an
efficacy of 94% or higher, which approximately means your risk of
getting sick from the Corona virus , is cut by 94 % or more if you are
vaccinated. A nd that's my fa c t check for this week. I'm Lori Robertson,
Managing Editor of Fact C heck .org .

[Music]

Margaret Flinter: FactCheck.org is committed to factual accuracy from the country’s
ma jor political players , and is a project of the Annenberg Public Policy
Center at the University of Pennsylvania. If you have a fact that you’d
like check ed , email us at chcradio.com . We’ll have FactCheck.org’s
Lori Robertson check it out for you here on Conversations on Health
Care.

[Music]

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our program , w e then treat t hem at scene, discharge them with
prescriptions as needed, and then we follow up with t hem within 24
hours.

Margaret Flinter: Dr. David M arcozzi , of the University of Maryland Medical C enter ,
says that this community p aramedicine program has a two - pronged
goal , o ne, reducing unnecessary trips to the ER by deli vering right care
at the scene , t w o , bringing a coordinated p aramedicine team
including doctors and nurses into the homes of patients being

Dr. Alejandro Cravioto

released from the hospital to ensure that their recovery is s upported
for better outcomes , t hus greatly reducing the risk of re -
hospitalization.

Dr. David M arcozzi It's eye - opening too, once you understand the challenges when we
discharge a patient , people stay just at home to navigate the
insurance industry , the mu ltiple providers they're supposed to follow
up with , t hen the follow up back to their primary care , and we are
exploring c ould we do this for longer . F or THS , o ur data demonstrates
that the patients who are followed in our program , are admitted to
the hosp ital significantly less , that translate s into lower cost to the
system .

Margaret Flinter: But most importantly he says the patient outco mes are markedly
improved. The Mobile Integrated Healthcare Community -
P aramedic ine P rogram, reducing unnecessary emergen cy room trips ,
now that's a bright idea.

[Music]

Mark Masselli: You've been listening to Conversations on Health Care. I'm Mark
Masselli.

Margaret Flinter: And I'm Margaret Flinter.

Mark Masselli: Peace and Health.

[Music]

Marianne O’Hare: Conversations on Health Care is recorded at WESU at Wesleyan
University, streaming live at www.chcradio.com , iTunes, or wherever
you listen to podcasts. If you have comments, please email us at
[email protected] , or find us on Facebook , or Twitter. We
love hearing from you. This show is brought to you by the Community
Health Center.

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