Former White House COVID Coordinator Dr. Jha: Debate About Boosters for Young People Is OK

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Mark ( 00:05 ):
COVID - 19 related hospitalizations in the US are up over 40% and there's a new sub variant. On average,
54 Americans are still dying each day from COVID. A former top advisor to President Biden says with
some simple steps, none of this should be a concern to most of us
Dr. Ashish Jha ( 00:22 ):
Keeping up getting your annual COVID shot. If you're a high risk person, it may mean two shots, but
basically making sure you're up - to - date on your vaccines. Single most important thing. One of the things
that we have found consistently in the last year and a half is if you're up - to - date on your vaccines, your
chances of ending up in the hospital or dying are dramatically low.
Margaret ( 00:43 ):
Our guest today is Dr. Ashish Jha, the former White House COVID - 19 coordinator. Now back in his role
as the dean of the Brown University School of Public Health.
Dr. Ashish Jha ( 00:52 ):
I think everybody over the age of 50 and maybe even people under 50 though is not authorized for that.
But everybody over the age of 50, if you get COVID, you should get assessed for treatment. And my view
is most people should be getting treatment.
Margaret ( 01:05 ):
And this is Conversations on Healthcare.
Mark ( 01:16 ):
Dr. Jha, welcome back to Conversations on Healthcare.
Dr. Ashish Jha ( 01:19 ):
Thank you for having me back. I'm excited to be back.
Mark ( 01:21 ):
Yeah, and it's your fifth time on our program and we always learn a lot from your insights. You recently
wrote in the Boston Globe that most of us can finally ignore COVID. Wonder if you could go over for our
listeners the basic steps that can help all of us indeed ignore COVID?
Dr. Ashish Jha ( 01:39 ):
Yeah, and I think the purpose of that was to say that I often get asked, "Do we have to learn to live with
COVID?" And I say, "Look, we've been living with COVID for three and a half years." The question in my
mind isn't, do we have to live with COVID or not? The question is, how do you live with COVID safe? How
do you live with COVID, while continue to do the things that are important to you?
( 01:59 ):
And number one on that list is keeping up with your immunity. Look, the bottom line is the reason
COVID was a problem, a massive problem in 2020 was because none of us had immunity to the virus.
Keeping up, getting your annual COVID shot. If you're a high risk person, it may mean two shots, but
basically making sure you're up - to - date on your vaccines. Single most important thing. One of the things

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that we have found consistently in the last year and a half is if you're up - to - date on your vaccines, your
chances of ending up in the hospital or dying are dramatically low.
( 02:31 ):
The second thing, which we didn't have available two years ago but we do now, is really effective
treatments. And I believe we should be using more of these, not less. Paxlovid, everybody of course
knows about, there's IV remdesivir, there are other options coming down the pike, but right now I think
everybody over the age of 50 and maybe even people under 50, though it's not authorized for that. But
everybody over the age of 50, if you get COVID, you should get assessed for treatment, and my view is
most people should be getting treatment. If people do those two things, keep up on the immunity, get
treated when you get infected, COVID need not be a substantial disruption, and there's no reason to
think it's going to land you in the hospital or worse.
( 03:16 ):
Obviously, there are other important things, mark, that people can do in highest risk situations,
especially when cases are up. Wearing a high quality mask can reduce your risk of infection. I think more
systemically, we've got to continue plugging away at improving indoor air quality, can talk more about
that. So, it is not that there are not other things to be done, but making sure you're up on your
immunity, making sure you're getting treated to me, those are the cornerstones of ensuring that COVID
does not become a [inaudible 00:03:44].

Margaret ( 03:44 ):
Well, Dr. Jha, all good and valuable advice. I'd like to just highlight one element of it. You spoke about
the importance of treatment and that treatments like Paxlovid are remarkable at preventing serious
illness and their safety is proven. I think you've done a lot to help increase its use, but I noted a study
that found patients with COVID - 19 who were Black were 36% less likely than white patients to be
treated with Paxlovid. Patients who were Hispanic, 30% less likely than non - Hispanic patients to receive
it. What do we do to ensure that people get the treatment they need regardless of race or ethnicity?

Dr. Ashish Jha ( 04:22 ):
Yeah, this is a fantastic question, Margaret. Let me tell you how we thought about this when I was at the
White House and how I think about it now. Look, in 2022, that study that you mentioned, I think is a CDC
study or published in the MMWR, looked at the first half of 2022. In that time period, we did a lot of
work to dramatically increase access to Paxlovid. And one of the things we found out and not surprising
is that when it started increasing initially, much of that increase was happening in communities, in more
privileged communities, in wider communities and wealthier communities. And that data became
obvious, apparent to us. And even before this study came out, we said, "We have a problem here we've
got to address." And so, we actually put in a lot of policy efforts to try to improve access to these
therapies.
( 05:13 ):
So right now, 98% of counties, communities have a place where these treatments are available, but it's
not just about availability. One of the things we realized there were a lot of Americans who didn't have a
primary care physician, African - Americans, Latinos more likely to not have. So, we really substantially
built out our test to treat programs where if you test at home and you're positive, you don't need to go
see a primary care doctor. There are other mechanisms. We work with FDA to expand pharmacists
prescribing because we know in a lot of communities of color, it's a pharmacist who often functions as a
primary care. So, there was a lot of work done after the study came out to try to expand access.

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( 05:55 ):
Final point on this, we have a long history of disparities in healthcare in our country across every single
topic. So, it is not surprising to see that pop up here. The job is not to write it off and say, "Well, we
always have disparities. We can't do anything." It's to use data like this to drive action to close that gap
and make sure that everybody's getting access to treatments.

Margaret ( 06:19 ):
Dr. Jha, if I can before we move on, I think we'll talk in a little bit about what happens after the vaccines
are not as available. A big piece of Paxlovid, at least in community health centers, was the drugs were
delivered to us. They could be dispensed at the point of care. Thoughts about how that might be
continued in the future?

Dr. Ashish Jha ( 06:39 ):
Yeah, it's a very good question. Look, one of the things that made this much easier was that the US
government had bought the Paxlovid and we could send it directly to community health centers,
actually did a whole series of phone calls with HRSA and community health centers to make sure that
these drugs were available. By the way, the ending of the public health emergency doesn't make that go
away. There's still a national stockpile of medicines, and I know that HHS is negotiating with the
companies to figure out how do we make sure that certainly in communities of color, underserved
communities, that we are able to continue doing that?
( 07:12 ):
And then we have something called the Bridge Access Program we created, which was also to make sure
that uninsured people can get these drugs and get vaccines through other means, not just through
community health centers. So, I actually saw all of what we were able to do as something I want to keep,
not just in emergency phase, but even as we pull out of the emergency phase, making sure that access
remains.

Mark ( 07:33 ):
Well, I know one thing you're very proud of is the stocking of the national stockpile, which is very
important, but I want to get back to that op - ed that appeared because there were quite a few letters,
and you probably saw them to the editor?

Dr. Ashish Jha ( 07:47 ):
I did, I did.

Mark ( 07:48 ):
Writers pushed back on what they thought was a rosy outlook. One wrote that, "By downplaying the
prevalence in debilitating outcomes of even moderate long COVID, that you are signing thousands of
people up for misery and despair," with which that individual lives with every day. I'm wondering if you
want to respond to that because I know you're quite aware of all the issues around the impact long
COVID.
( 08:14 ):

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We actually had Dr. Horowitz from NYU, who's leading up the long COVID trial right now, really trying to
get some more insight onto that. But I'd love to hear your thoughts about the people who are really
significantly impacted by COVID.

Dr. Ashish Jha ( 08:33 ):
Yeah, absolutely. So, let me be crisp and clear on this. And by the way, I talk about long COVID in the
piece. I think some people might've just missed that, but long COVID is a real problem, and what we
know is that a small percentage of people who get COVID end up really significantly impacted that goes
well beyond that acute illness. They end up weeks or months later, and a small number of people even
years later, are very, very profoundly affected by [inaudible 00:09:02].
( 09:02 ):
Now, what I say is a few things. First, we've seen this with other viruses too. This is not a phenomenon
only of COVID. We've seen this with influenza, we've seen this with other infections. It probably happens
a bit more with COVID, and I say probably because we don't know for sure, but it may be more of a
problem. The second thing is there is absolutely clear data that if you have been up - to - date on your
vaccines, the risk of that significant long - term debilitating long COVID gets cut substantially 50%, 60%,
maybe more.
( 09:33 ):
So, there is no doubt about it that vaccines help prevent ... and by the way, if you think about how long
COVID happens and how it works, it makes all the sense in the world that immunologic training through
vaccines is going to reduce that. And obviously, the people who've been living with it for several years, a
lot of them got infected before the vaccines are available. But no doubt keeping up - to - date. There is a
little bit of evidence that getting treated also reduces your risk of long COVID by about 40%. There's one
study on that topic. We need more data. So my point in all that, Mark, is there are things people can do
to reduce their risk.
( 10:08 ):
Now what about the people who already have it? That's a group that needs treatment and it needs
support. One of the things we worked on quite substantially when I was inside the administration was
laying out a whole federal plan for how we were going to support people with long COVID, how they
were going to get ... how we make sure that they get access to disability care, that disability insurance,
or payments where that's appropriate, that CMS is doing everything it can to create medical code so
physicians can code for it. It is just there's a lot of work to be done here.
( 10:40 ):
And then last but not least, is a RECOVER study from NIH that is literally spending billions of dollars to try
to both better understand long COVID and treat it. Is that all enough? No, I think we got to continue
doing more. I'm very supportive of more work in this area. I just think we have to be thoughtful on this.
( 10:57 ):
Last point. There are a lot of people who I think want to call anytime anybody has any persistent
symptoms a few weeks later, as long COVID. We've got to define this thing carefully because it does no
service to people who are really suffering to lump everybody in. We've got to focus on the people who
are really suffering substantially and figure out how to support them and help.

Margaret ( 11:20 ):

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Well, summer is wrapping up, falls right around the corner. That means flu season is here, flu vaccine
season is here. And maybe the number one question we're hearing is, should we be waiting to get the
COVID vaccine? Is there a new version that's going to be out that will be more effective? What's the
process and the knowledge on where things stand right now in terms of what people should do this fall
in terms of getting the vaccine?

Dr. Ashish Jha ( 11:47 ):
Yeah, it's a great question. First of all, the advice is a little different if you're over 60 versus under 60.
Remember, there are three viruses now, respiratory viruses that we deal with, that during the winter kill
a lot of people. COVID, flu, RSV .for people over 60. We have a highly effective RSV vaccine, first time
ever. We're going to have a flu vaccine as we always do, and we are going to have a new COVID vaccine.
( 12:11 ):
Look, I always want to be data - driven on these things. My full expectation is that the new vaccine from
COVID, on COVID XBB.15 vaccine, will provide a substantially greater degree of protection than what's
out there already in terms of vaccines. Let's see what the data shows. We will see some data in the
upcoming weeks. It'll certainly drive how FDA makes these decisions. Let's see what FDA says. Let's see
what CDC says and recommendations should follow the data.
( 12:38 ):
So, my view is most likely, I think about my elderly parents, they're in their 80s, most likely they're going
to get a flu vaccine, a COVID vaccine, and an RSV vaccine. They're probably going to get them all
together on the same day. They're not going to be very happy. They're going to be a little miserable for
24 hours, but it's going to provide a very high degree of protection for them throughout the holidays
and the winter season. And for people under 60 like me, assuming that the data on COVID vaccines
bears out as I expect to, I'll probably get a COVID vaccine and a flu vaccine, be good for me, good for my
family, prevents and slows spread as well. So, it's good for everybody else around me. That's going to be
the recommendation. Two shots if you're under 60, three if you're over, but let's see where the data
land and then really make a decision based on that.

Mark ( 12:38 ):
You know, I'm wondering -

Margaret ( 13:24 ):
And thanks for that. Shout out on RSV vaccine as well, which people haven't been hearing as much
about that one.

Mark ( 13:30 ):
I'm wondering, as you think past your service in the White House, there are enormous amount of large
crisis that the country's facing, certainly the behavioral health crisis, opioid, we've got environmental
issues to deal with. Life expectancy has been shortened. How are you conceptually putting all that
together as you think about back in your role now of framing up some responses and what are you
seeing out there that gives you some encouragement that these things are being addressed?

Dr. Ashish Jha ( 14:01 ):

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Yeah. Well, a couple of things. I mean, first is there are very substantial challenges facing human health
both here in the United States and around the world. Obviously, viruses, pandemics are near the top of
that list, but there are other important things that are also near the top of the list that have gotten
much less attention.
( 14:20 ):
You mentioned this, Mark. I think it's worth emphasizing. I think climate change poses one of the most
substantial health challenges in our country and around the world. From heatwaves, to changes in
disease vectors, to displacement, to so many other things, climate change is going to end up having a
very large effect on clinical practice as well as on public health. That needs to be understood better and
we need to start working on mitigation because this is not a problem that's 30 years away. It is a
problem that is now, and we are just now recognizing it as that. So, we've got to do that.
( 14:54 ):
The drop in life expectancy in the United States is unprecedented. It is, we have never seen this kind of a
drop in life expectancy, certainly not in the last hundred years outside of during World War II. And
whereas other high - income countries are starting to turn around, we have not seen that turnaround in
the United States. I think it is for the reasons you have highlighted. Deaths from fentanyl continue to be
shocking and growing. Obviously we've got mental health challenges. I am hopeful that the energy of
responding to COVID can be directed towards these other problems as well. While we continue to deal
with respiratory diseases, we can really bolster public health responses. It's going to be hard and people
are tired and the public health community is exhausted after three and a half years. So, they're really
going to need an infusion of energy resources if we're going to turn these things over.

Mark ( 15:47 ):
And just going back to COVID 2020 and the environmental crisis that we face today, they're both global
problems, right?

Dr. Ashish Jha ( 15:57 ):
They are.

Mark ( 15:57 ):
And they require concerted action across that. Was there anything built in terms of the long - term COVID
response that gives you some hope that the public health community can be aligned in terms of its
response there because it's going to require a global action?

Dr. Ashish Jha ( 16:18 ):
Absolutely. It's a great point. Look, I often say global pandemics require global solutions. Solutions have
to be simultaneously global and local, meaning they have to be contextualized for local context. It's not
the same solution in Providence as it is in rural India. I think we understand that, but at the same time,
it's that coordination that's very important.
( 16:43 ):
I actually am hopeful on this one, Mark. There was so much that ... even in the time that I was at that
White House about 15 months, but before then, there was so much work done to make sure we're
coordinating with our friends in Europe, that we're coordinating with our friends in Asia and elsewhere.
And that practice of coordinating, of talking to each other, of sharing knowledge, sharing data, I think is

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going to translate into how we deal with these other global challenges. So, I am hopeful that one of the
silver linings out of a very tough pandemic will be that we're going to do a much better job coordinating
globally and understanding that you can't solve these problems in one country at a time, especially
when the challenges are truly global.

Margaret ( 17:29 ):
Well, I'm all about silver linings. I like them a lot. And one of the silver linings, it seemed to me was the
greater use and recognition of existing capacity to deliver essential health services regardless of your
ability to pay, sending people to their local pharmacy, independent door chain pharmacy on the corner
for a COVID test and then for a vaccine, certainly was one of them. Expanding a program, I bet you 80%
of parents who bring their kids to the pediatrician don't know that that vaccine is coming under the
Vaccine for Children's program if it's for one of the standard illnesses. And I'm really curious, as a public
health expert, a scientist and a physician, have you tried to use your bully pulpit there to maybe expand
those programs so that these things are just a given part of infrastructure in the United States regardless
of your insurance status?

Dr. Ashish Jha ( 18:24 ):
Yeah, it's a great question, Margaret. I actually want to answer this question in two or three ways and
you'll see how it connects to the question you're asking. I often get asked, and I got asked throughout
the whole pandemic, how do we go back to 2019? What do we need to do? And I always said, "We're
not going back to 2019. I don't want to go back to [inaudible 00:18:44]. 2019 had plenty of problems." I
want to go to a brighter 2023 and a brighter 2020.
( 18:48 ):
And that means looking at what worked well in the pandemic and making sure that we don't dismantle
them when the emergency ends, or that we actually build on those. That's one thought, and then I'll
connect these dots.
( 19:01 ):
The second thought is I have said for a decade, if not longer, that pharmacists are among the most
underutilized healthcare providers we have. They are everywhere. They are trusted. They have a lot of
knowledge. Like every healthcare provider, they have their limits of course, but they are incredibly
knowledgeable, incredibly expert, and we do not use them well enough in our [inaudible 00:19:24].
( 19:24 ):
Okay, start combining some of these ideas and you see, what we did in this pandemic was we leaned
heavily on pharmacies, we leaned heavily on pharmacists. We also leaned heavily on doctors and nurses
to do innovative things. And as we were unwinding the emergency, one of the constant questions we
asked ourselves, we asked the healthcare providers was, which of these things do we want to keep?
Telemedicine, really important. Test to treat programs. Relying on pharmacies for vaccinations and
treatments, especially for people who are uninsured and can't get access because they don't have a
regular primary care physician. A lot of that will stay. And my hope is we will build and expand on those
things because again, the goal is not to go backwards. The goal is to look forward to a future that's much
better than where we were before this pandemic.

Mark ( 20:14 ):
I want to try to connect two questions together. One is there's this debate and mystery about how
COVID started. The house select subcommittee on coronavirus pandemic has published a report that

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discusses what it calls the suppression of lab leak hypothesis. And you're quoted as saying it started
when a bat probably infected a human sometime in late 2019 in and around Wuhan. Others say it may
never be known because the date is missing.
( 20:44 ):
And then we recently had Dr. Califf on from the FDA, who's really talking about, he thought the biggest
challenge right now is the misinformation in healthcare is its biggest threat. Those seem to be connected
because we haven't found terra firma from which we can build up in terms of our trust with each other.
And it seems to be that if we're going to solve problems in healthcare, we have to have some trust. And
it seems to be elusive. So, broad set of questions, but what's your contemplation on it?

Dr. Ashish Jha ( 21:29 ):
Yeah, it's actually a very good set of questions. Let me start by talking a little bit about origins, COVID
origins. I think early in 2020, my view was that it was more likely than not a natural origin because that's
where most new infection starts, spillover from animal [inaudible 00:21:50]. But my degree of
confidence then and my degree of confidence now is really low, meaning I don't know. I don't know.
And even when I was at the White House and we spent a lot of time thinking about this and looking at a
lot of data, the short answer, Mark, is I do not know whether this was natural or whether this was lab
leak. What I know is that it is important that we get to the bottom of this.
( 22:15 ):
I still believe, and maybe I'm one of the few people out there who does, I still believe we can get to the
bottom of this, but we need a lot more transparency from Wuhan, from China, about how it all began.
My view is anybody who tells you for sure they know exactly how it started probably is trying to sell you
something. But the bottom line is that this is an area of active inquiry and we need to continue pursuing
this because it's important.
( 22:46 ):
On the issue that Dr. Califf raised, there is no question that until we can come to an agreement on a
basic book of facts, it's hard to figure out exactly where to go on issues and can create a lot of confusion.
( 23:03 ):
Look, when I think about clinical problems, there's clinical debate all the time. Do you want to use this
treatment or do you want to use this treatment? And do you go down this diagnostic path or that
diagnostic path? But whenever I have those debates with my colleagues, we begin with the same set of
facts. No one starts off by saying, "Well, MRIs don't work, or CAT scans are ... " No, we all agree. We
understand what these things do, and then we disagree on interpretation and analysis.
( 23:29 ):
Unfortunately, with this pandemic, we've had a whole bunch of people who I think have spread so much
bad information, that it's actually hard to have reasoned debates. Should a 20 year old get an updated
COVID vaccine? My best read of the literature is that yes, they should. A reasonable person could read
the literature and say, "I don't know if that's true and let's have that debate." But instead, there is all
this nonsense and bad information that's thrown out there around these things that make it very, very
difficult and they cause confusion. And what that does is the public often feels paralyzed and is not able
to make good decisions, and that ends up harming people. So, I think it's really important to get back to
the science and evidence and talk through those issues and do it in a way that's both constructive and
respectful, so it allows us to really move the discussion.

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Margaret ( 24:25 ):
Dr. Jha, as you were leaving the White House, the administration created the Office of Pandemic
Preparedness and Response Policy, to which I think more than a few people probably said, "We don't
have an Office of Pandemic Preparedness." What can you tell us about its mission, and is it up running
and on track in your opinion?

Dr. Ashish Jha ( 24:44 ):
Yeah, I'm happy to talk about OPPR, Office of Pandemic Preparedness and Response. Look, under
President Obama, there was an office created within the National Security Council that was [inaudible
00:24:56] and it was a small office and it was an important office, and that got going. And then under
President Trump, that office actually got taken away. Unfortunately, we didn't have that office when
COVID hit. The thing that President Biden did on the first day that he came into office was got that office
going.
( 25:14 ):
But OPPR is a bit different. OPPR is something that Congress instituted into law and said, "Instead of just
this one small office inside the National Security Council, we need a major presence inside the White
House." And by the way, the president and I and others all agreed that this was a good thing, it's a step
forward.
( 25:34 ):
So, OPPR was codified into law and it got started. I think the official start date of the office was August
8th, but a ton of work went on when I was there, and then after I left to get the office stood up, it has a
new director, a fantastic surgeon from the military named Paul Friedrichs. He's the director of the Office
of Pandemic Preparedness, they're already building out a phenomenal team. I know many of the people,
obviously from my time at the White House and before. So, I am very hopeful that this office is going to
make a really important difference in two ways, both in responding to challenges we have, COVID,
Mpox, flu, others, but also preparing us for future threats because you have to be prepared. You don't
know what Mother Nature is going to throw at you. You don't know what bad actors are going to
[inaudible 00:26:25], and we've got to be ready for this.

Mark ( 26:26 ):
Well, speaking of things that we have to get ready for, the federal budget is ... The new fiscal year will
start in October. Obviously it looms large in terms of healthcare, and we see that the CDC is facing
substantial cuts, so over a billion dollars. Some would suggest that COVID is behind us and these budgets
can sustain some cuts. What are your general thoughts about what might happen in terms of the fiscal
cliff that we face, and also the impact that the proposed reductions will have on the healthcare system?

Dr. Ashish Jha ( 27:13 ):
Yeah, I'll start off by saying public health has been underfunded for a long time and it is true that more
public health dollars flowed into agencies like CDC during the pandemic, but we saw the cost of an
underfunded public health system. When the outbreak first began, we as a country were not able to
respond effectively because of that lack of [inaudible 00:27:37].
( 27:37 ):
And so again, this is always a question of, do you want to go back to pre - pandemic levels? Well, you
want to go back to pre - pandemic if everything was great. I would argue that public health was

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underfunded and we saw the cost of that cutting public health funding now, because we're no longer in
an emergency, is penny wise pound foolish. It means that we're going to be less prepared for future
challenges. We've talked about all the other health crises we face from fentanyl to mental health, to
others. Public health is going to be less equipped to manage those things.
( 28:11 ):
We've got to modernize our data system that's going to be expensive. There's just a ton of work to do,
and I think beginning by cutting public health, it may save you a small number of bucks up front, it will
cost Americans both in lives and money down the road. So, I think this is generally a very bad idea.
( 28:29 ):
Now, what's actually going to happen, one of the things I learned early in my time at Washington, is my
ability to predict what Congress does is extremely limited. I hope that wiser minds will prevail and we
will not see meaningful cuts to the CDC, but we'll see what happens.

Margaret ( 28:47 ):
Dr. Jha, this is a time of year when we're celebrating in our organization the graduation of our
postgraduate nurse practitioner residents and fellows, our postdoctoral psychology residents, and we
noted that when you joined us all the way back in the spring of 2020, you predicted that the pandemic
would change the training of future health professionals as well as the American healthcare system.
Those were big predictions from your seat at Brown and nationally. Are you seeing the training of future
health professionals change because of the pandemic?

Dr. Ashish Jha ( 29:21 ):
I am, and I think first, there has been a surge of interest, certainly in the early pandemic time period, in
these professions. I think we've seen an unprecedented number of people leaving because they are
burnt out and exhausted after three and a half years. That obviously creates more and more demand for
new healthcare providers. But no question about it, we have to train our healthcare providers
differently, and I think we're seeing that. We have to train them in communications more effectively
than we did. It turns out that communicating with patients is one of the critical, critical things that
healthcare providers, nurse practitioners, physicians, PAs, others need to do effectively. I don't know
that we paid enough attention to that.
( 30:01 ):
One of the big changes that I think comes out of this pandemic is our use of technology, telemedicine,
other types of technology. We got to make sure we're training our healthcare providers to live in a world
where that kind of technology is widespread, widely available. It doesn't replace the doctor, it doesn't
replace the nurse. It supplements them, allows them to be even more effective. But we've got to train
people in those things. So, I actually am very hopeful that we're going to do a better job of training our
providers for the future with all the changes that are going to come out of it.

Mark ( 30:34 ):
Well, thank you Dr. Jha for joining us and for your service to the country. And thank you to our audience
for being here. There's more online about conversations on healthcare, including a way to sign up for
email updates. Our address is chcradio.com. Thank you again, appreciate your time.

Dr. Ashish Jha ( 30:50 ):

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This transcript was exported on Oct 20, 2023 - view latest version here .

Thank you. It was a pleasure being back on with both of you.
Margaret ( 30:57 ):
This copyrighted program is produced by Conversations on Healthcare and cannot be reproduced or
remitted in whole or in part without the express written consent from Community Health Center, Inc.
The views expressed by guests are their own, and they do not necessarily reflect the opinion of
Conversations on Healthcare or its affiliated entities.

Transcript by Rev.com