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Decades of evidence based science wiped out in a matter of years.

As the Trump administration works overtime to dismantle the nation's public health infrastructure.

Tonight, Washington's secretary of health is here to talk about the West Coast Health Alliance and other steps being taken to try to keep actual science in public health, at least locally.

Health Secretary Dennis Worsham is next on northwest.

Now.

Music few things have changed the course of human history more than safe and effective vaccines and all the other advances made by the science of public health, which includes things like sanitation, clean water and a robust program of taxpayer funded research.

But somehow, being anti-science became part of the far right's anti-government, anti-democratic and anti-social playbook that spread and metastasized into national policy.

Standing against the attacks on settled science are the blue states here on the West Coast.

Let me be clear.

The progressive left by no means holds the keys to effective governance in this country.

But on this issue, they're the only group representing the vast majority of Americans who understand and support things like vaccinations.

Into this absolute mess walks Washington Secretary of Health Dennis Worsham.

Dennis, thanks so much for coming to northwest now.

Great to have a conversation about the state of the science in public health.

And also, one of the big things that you're tasked with now, which is kind of spreading the message of public health in an era where a lot of the things one would think we took for granted, maybe we don't necessarily anymore.

Let's start out with a little bio.

How do you find yourself in the Secretary's role?

Talk a little about, about your history in public health and how you landed here.

Yeah.

Well thank you, Tom, it's great to be here with you.

And thank you for helping us get our message out about public health.

It's a topic.

Of course I'm near.

And dear to my heart.

I've been in the governmental public health space in the state of Washington for about 32 years.

Grew up in eastern Washington, a little farming town called Buffalo, and, wasn't sure what I wanted to do when I grew up and, went to school at Eastern Washington University, where I studied in health services administration.

And, during that time, as I was getting ready to graduate, also came out as a gay man, and we were in the middle of the HIV crisis and really felt, I wanted to do something and give back to the community in which I was coming out.

And so, during that time there was a position open over in Snohomish County for an HIV Aids educator position to really get out and really educate folks and really hopefully interrupt transmission.

So I applied and that's really began my public health career in the 1990s.

I've done a variety of things.

I've stayed in that space, up in Sonoma County for about 12 years and, working around the HIV epidemic, at the time, you know, it was such an, a powerful time.

There wasn't medications that were effective at the time, and people were dying pretty rapidly.

I often tell the story that we would start every Monday.

Staff meeting, reading the names of people who died that week.

And, you know, every time we read a name, it just recommitted me and, to the mission of public health, which was really is about prevention, education and, really getting to longevity and healthy life and well-being.

So I, became really deeply fascinated and committed, to that journey, stayed there for about 12 years, ended up down in King County doing a different infectious disease at the time, tuberculosis, which has a totally different population and impacts in those areas, was in stock and worked there in infectious diseases for a while, moved into policy work, down in King County for a period of time.

First, policy out the gate, was menu labeling.

So when you go to Starbucks and see your calorie counts, that was my first stop policy out the gate.

Moved into administration, became, a deputy director down there or chief of staff role.

Came down to the Department of Health.

For Inslee's first years under secretary, we spent as a deputy secretary of health, went back to King County over infectious diseases.

Covid hits.

And it was just another crazy time in public health.

Much like, you know, the first time I went, just a different type of disease.

But, greater impact in those particular areas ended up in the director role, in King County, through the Covid response.

But back to Snohomish County, as a director, of their department and now, been in the secretary role here for the state of Washington for the last four months.

A big part of your job really sounds like you've you've seen some of these peaks, and they're not positive peaks, but large events in the public health space that constitute crisis.

Do you think that you think we're heading into another one?

Yeah, I do, it's a very different type of crisis, unfortunately, one that's easily preventable.

But it's around the political, and the divisiveness of ideology and misinformation that's out there around vaccine, vaccine preventable diseases.

We're already seeing as, you know, increases in measles across the United States.

And we just think that these things are going to continue in these trends are going to continue here in the state of Washington as well.

Now you have a measles tracker up on the websites, right?

I mean, this is something you're actively kind of like back in the day with Aids, where you're you're looking at the data.

Yeah, we are we we are monitoring this thing of a couple reasons.

You know, measles is one of the most infectious diseases that are out there.

Highly contagious.

And, and it's really important, that we interrupt it quickly or we'll have a widespread, situation for people who are unvaccinated.

Around measles.

We have seen that double in the last year here in the state of Washington.

Luckily, we've had no deaths.

But, as you know, throughout the country, we've seen huge numbers of measles outbreaks and, have seen deaths for the first time in over ten years.

So we're really concerned about this trend.

And, and what's feeding it is, the misinformation and the effectiveness of vaccines.

Speaking of misinformation, and I would add parenthetically, you know, we've seen measles outbreaks before in the state of Washington.

I remember very specifically ten years ago going down to southwest Washington, where there was a US out there.

And here we are again in the past few days, CDC updated its website.

That implies a link between autism and childhood vaccines that has been completely debunked by actual science over the years.

One is that dangerous?

And two, how does it flow?

I know you don't run the medical piece of of Washington state, but how does it flow into public health, into your space?

Yeah, well, you know, you're absolutely right.

That information has been debunked over and over again.

And even the people who did the original research on that have come out very strongly and saying, there is no, direct ties to autism and, and vaccine and, this misinformation is reckless.

It, it confuses people.

It delays, action.

And it makes kids more vulnerable, in particular in these particular areas.

So yes, it is really, concerning to us, as you have watched in the media and through social media and a variety of other, venues, a number of medical communities, providers, public health and professionals have come out strongly, against these statements.

And described them include including the American pediatrics of medicine.

Little devil's advocate question here to Secretary Kennedy, have any redeeming qualities in terms of maybe thinking a little less dogmatically about the medical system?

Who's paying for what?

How do we look at I agree, and you got to come to the right conclusions, but is there anything that he's talking about where he says, you know, let's let's be a little skeptical.

Let's look for new information.

Let's not just, you know, take the company line all the time.

I would take vaccines out of that discussion but don't make any sense.

Yeah.

You know, there are some things I'm hopeful for, you know, as as the saying goes, the devil's in the details.

And so, you know, we start with broad, broad statements around health and well-being.

He's had an interest in really around chronic conditions and chronic diseases.

And how do we address those on on the surface, we agree that, leading causes of death like diabetes, heart disease, are things that we should be very concerned about and lean into.

We'll see what the policies in the practice they have not aligned so far.

To, actually aligned to what the science says are the best approaches.

So we're, we're, you know, we're watching, monitoring and, and of course, our truth is always on the science side rather than on the rhetoric.

So we're open to the conversations.

We just got to see where they land.

Let's talk about science for a moment.

How is it and why is it, in your estimation, politically speaking, did the right come to a place where science got thrown out the window?

To some degree, science is what brought us the space program and a lot of things I would think the right would be be proud of, you know, American progress and capitalism and all of those things.

But in the health sciences, for some reason, it got singled out and pushed to the side.

You've been in this game for so long, why do you think that is and why did it resonate?

Yeah, it's a it's a good question.

Of course, I can understand this myself because I think that's going to be our best effects and really having the conversations.

I do feel where the change happened was during Covid.

You know, I have to think, in my public health practice, public health was, you know, no matter when the polling happened, was the trusted voice within government around health information.

CDC has always been that gold mark.

The science and where it's at.

I think, when Covid happened, we saw some political rhetoric, really take place during during that time frame.

And I do feel that was the change.

I think about a time, before Covid, you probably heard this term a million times, as we would say, let's use the public health approach.

Even people who weren't in public health would say, let's use a public health approach, because it was such a trusted, mechanism of doing it, doing that work.

I think when we got into Covid, there was a lot of misinformation.

It became very politicized.

It became very economically challenging, and I feel like there was some ideology that stepped into that place.

And that's really where the challenge of information and vaccines, became a hot, a hot topic.

And I think, you know, with Kennedy getting promoted into the platform, he is just took that wave and even wrote it further.

And I think there's some anti-government, a little bit of the anti-government piece flowed into that in terms of government control.

Hey, we're going to lock you here in your house.

We're going to force masks there.

That's right.

The efficacy of which are questionable parental rights.

There's a lot wrapped up into this, too.

That's part of the problem.

It's not just, hey, the science says take a vaccine.

It's been a major advancement in the in the history of humanity.

It's like, no, we got some parental rights in here, people.

We want to, we want to have some exemptions.

What's the status of that?

Washington state?

And are you sympathetic to that at all, or is it?

Listen, folks, here's what the research says.

Let's just do it.

Where are you on this?

Yeah.

You know, it's it's, Of course, I'm on the side of the research side and where the science is at, and, you know, it's I let me talk about Covid for just a moment, that it's a topic I feel like, let's let it go and move forward.

But at the same time, it is what, to your point, has shaped some of the mistrust and information of this particular area.

You know, our job in public health is really to preserve life.

We look at population health, right?

It's like when you go to your doctor, you have a conversation with your doctor.

We understand what's going on for you.

And we make a game plan what's best for you.

In public health, we do the same thing around population health.

And when you've got an infectious disease that is running wild, where people don't have a minute, immunity to to that this particular virus that's at play is then you have to start using non-medical, prevention strategies in order to interrupt that until you have pharmaceuticals or things in place to really do that, which gets into some of the more philosophical and things that are more debatable, is like masks and social distancing.

When there are no vaccines and when there are those places, you have to use non-medical approaches in order to be able to interrupt that virus.

And that's when it gets into a little bit more controversy of where we're at now, of course, with the vaccines that we're talking about like measles, mumps, rubella and those things is we do have effective vaccines that work.

And, and we don't have to do those same levels of non-medical interventions, because we have strong science, we have strong medicines that actually work, to preserve lives in those areas.

So it's a different it's a different virus and a different thing that we're working with at this particular time.

When I think about vaccines, you know, President Trump talks about all the vaccines coming out of the same that and a and a, a round of of 80 shots for childhood, vaccinations, which is just complete bunk that has no basis in fact whatsoever.

With that said, the devil's advocate, again, as a parent who raised a couple of kids and everything, you know, the series is 20 to 30 shots in the first 15 months.

I think for kids it is a lot.

It's a lot of shots.

Do you recognize that and are you at all sympathetic to that with people or what are your thoughts on that?

Yeah.

You know, I think that a variety, it's like who wants it?

Who wants a kid that's crying or uncomfortable or not feeling well?

I think, you know, one, one piece that I want to remind people, I just was at a recent meeting, on the East Coast, and there was a conversation, that really resonated with me with one of our leaders in the public health field and said, history is a truth teller.

And if you go back and you look at history, before we had vaccines, we used to have clinics, in place for kids who were blind because of measles.

Oh, yeah.

And we had children die of, a brain swelling and long term effects because of vaccines.

We had kids with polio who were in braces and had, you know, lived with, complications for a period of life.

History really is a truth teller in these particular areas.

Yes, it's an inconvenience.

And yes, it's an uncomfortable period of time to give a number of vaccines.

But the alternatives are the diseases are much more severe and can cause death or really, some long time permanent damage.

And that's what we're trying to avoid.

So a lot of confusion occurred with what's coming from CDC in terms of recommendation recommendations for Covid shots and the childhood vaccine sequence and all of the things who can keep it straight anymore because, you know, their, their advice and their, their regimen contradicts a lot of what people have become used to.

And I think in response of that to that, we have the West Coast Health Alliance.

So talk a little bit about what that alliance is and what problems it's specifically set out to solve.

Yeah.

So it's a great question.

So let me just a little history here, to bring you up to speed on how it came about, during Covid, as you know, during the first Trump administration, there was a rapid movement to, get a vaccine out across the line from, warp speed.

Vaccines.

We wanted to make sure at the time, of not knowing where the science was going to land, is we set up a West coast.

Practice at that time is what we call ACIp.

It's really the advisory committee around vaccines that the CDC uses.

The FDA approves a vaccine.

ACIp, really does a recommendation of how these vaccines should be used.

CDC adopts it, and we get to go into place.

We decided, during Covid time, we wanted to make sure that there was good science coming in to the vaccines that were brand new, never been, tested before coming into the market is we wanted to make sure they were good.

So a West Coast approach was set up at that time when we saw, Kennedy step into this place and we started to see ACIp being stood down, this, this advisory, to CDC being stood down and reformulated and FDA doing something they had never done before.

FDA usually says, here's a product, it's a safe product.

And then, ACIp makes a recommendation.

And if you remember, around Covid vaccine, FDA came out immediately and said, this is approved for 65 and older.

That's generally not an FDA role.

That's an ACIp role.

And we got concerned about, what was the writing was on the wall and where things were going.

So we decided that we wanted to revisit having our own, West Coast alliance sharing, governance and recommendations that were unified, around vaccine delivery.

So it started out as vaccine in particular, but we decided to make it more broad, and really keep a focus on looking at other things that could come to play like there in our prevention, recommendations like cancer screenings and other things that we're just keeping our eye on to see what's going to happen.

But we wanted to have an umbrella that was big enough and gave us an ability to really point to where the science is, like the Academy of Pediatrics, and Family Medicine and really point to them and lift those up as part of the science, working with the medical community, and making recommendations that were unified.

So a lot of federal money is coming out of the system for Medicaid, which is AppleCare in Washington state, about 16 billion bucks.

You know, eligibility requirements have changed.

The feds want you to see a doctor first.

How are things different in Washington state as a result of the alliance?

And what kind of what's what's the status of accessing a vaccine for me, for Covid and some of those things in Washington state as a result of this, slight separation we've done in state.

Yeah, great.

Great question.

Tom.

So we are again, we have laws on books before us.

So we were, in a good place in the state of Washington.

So, I serve as the secretary of health, under my, leadership, I have what's called a health officer, which we have in our laws the ability to be able to do, actions, as, as a state government under those, medical license.

One of the things that we did is we put a place what's called a standing order or a prescription that was signed off by a doctor.

What happened under the FDA policy, which was so important, was when they made the recommendations for 65 and older.

Anybody who doesn't meet that requirement becomes off label.

And when it becomes off label, it takes a prescription.

If you're under 65, in order to get that vaccine.

Well, we know in some of our rural parts of Washington state, over 60% of the vaccines that are given are given inside of a pharmacy.

A pharmacist cannot give an off label without a prescription in order to give that vaccine.

So it was going to really reduce access in parts of Washington for people who wanted a Covid vaccine.

So what we did is we wrote a standing order or issued a prescription for anybody to go in and allow that pharmacist, to be able to give a vaccine.

If a person chose that, that's what they wanted to do.

That was under 65, and it was an off label process.

So that's one of our outcomes, in assuring access was available to folks in the state of Washington.

Talk a little bit about, the childhood vaccination program.

How do if grandparents or parents are watching this, how do they access that, and is there funding still available for that?

I think if you are 19 or 20 years old, I'd talk a little bit about that.

Yeah.

So we are there are a handful of states, that, that across the United States.

It's, it's a program out of CDC.

It's called, vaccines for children.

And we have gone a step forward, with this.

And we have what's called universal access.

So any child, that is under 19 vaccines are free, and they can go to their medical provider and they can get those vaccines at no cost.

If they have insurance, they'll be billed for those insurance.

But if they have no insurance, there is no cost for those vaccines.

And we have a program that brings those into the state, distributes them throughout our provider community.

And, and so we have access to all vaccines for kids, and those are available at no cost.

I also read something to and maybe I misinterpreted it.

So 70 straight is the MMR vaccine, which we talked about its efficacy earlier.

But is it is it still available?

And you know, is that is there is Medicaid Medicare and or Medicaid still paying for that?

I heard there was some change in the funding for that.

Or is that fall under the program you just talked about?

Yeah.

So if at the end of the program we have so there's a variety of sources that pay for that.

But in the state of Washington, we have universal, care.

So anybody regardless of ability pay, are covered in the state of Washington.

So what keeps you up at night?

What are the other things?

We've talked a lot about vaccines, public health.

It gets into so many things.

You know what I'm telling you.

But you know, public you know, water quality and, patient.

All the things we take for granted in, in, civilization, what are the things are out there on your agenda?

I realize public health from from the medical perspective is number one right now, because what's happening with the feds and CDC, what are some of the other things that are out there on your radar?

If anything?

Yeah.

Let me let me, I'll give you a couple things that are top of mind to me right now.

I'm going to start with one, that we have some responsibility within the state Department, Department of Health.

And, and some of those things are shared.

So, as you know, we have kind of two pillars, I've, I say of our mission within the Department of Health, we, provide the governmental public health space, and really access to good, public health practice.

We also, do a we have a role within the health care space, and we regulate all hospitals, and we provide all licensure for medical professionals.

One of the areas when we talk about, looking at those hospitals that we regulate is assuring that we have access and affordability in those hospitals in the recent case of Medicaid, that you've mentioned, one of our big concern, as we know, 250,000 people will be, lose their Medicaid coverage.

And about another 150 will be priced out of that coverage.

And now with some of the other, if these extensions don't happen at the federal government after December 31st, but another 80,000 people will lose that just because of cost.

In, in the, in the market share.

Right.

You've got a cost piece and also work requirements.

Those are the two things that you see as being the impediments to access.

Well, the bigger part will be is that as I've been out in my first 100 days working with the hospitals, we have a number of critical access hospitals.

We have some hospitals in our rural community that over 60, 65% of their funding comes from Medicaid.

We know that those hospitals are going to be jeopardized in or, in order to stay alive, stay alive and stay practicing, is if they lose their Medicaid funding or lose insurers, is that is just going to be a hard cost.

And we we're really concerned that there could be, you know, the average is better out there in, in some of the, and, and some of the numbers is anywhere from 5 to 14 hospitals could shut down across the state of Washington.

And so, you know, that's a real concern for me is, is part of good health, right, is access to medical care.

And I, you know, as I started this segment is I grew up in a little farming town of fellow.

My parents are still there in their mid 80s.

That hospital hospital's on that list.

If that hospital closed down, the next closest hospital to my parents is an hour away.

So you talk about trying to age in place.

In our communities, access will really become a major issue, with these cuts in the Medicaid cuts that have been, passed in HR one.

So how many hospitals did you say again are in jeopardy in Washington?

The good there's dozens.

Yeah.

There's a there's a there is a range from 5 to 14 that could be impacted by these cuts.

All right, Dennis, thank you.

Good stuff man.

Great conversation.

Yeah.

Thank you so much for the time, Tom.

I really appreciate the time with you this morning to be able to get some of these messages out.

I don't have to sit here and argue the truth of the principles of aviation, the benefits of electricity, or the basic structure of the solar system.

But for some reason, the medical community seems to have to defend a couple of hundred years of advancements in our now fairly solid understandings of human health.

The bottom line science is never perfect.

It evolves like civilization is supposed to.

Might there someday be something better than vaccines?

Sure.

But with that said, what do you hear coming from the Trump administration on public health?

Is in complete contradiction to what the evidence tells us when it comes to things like vaccinations.

I hope this program got you thinking and talking.

You can find this program on the web at kbtc.org, streaming through the PBS app, or listen on Spotify and Apple Podcasts.

That's going to do it for this edition of northwest now.

Until next time, I'm Tom Layson.

Thanks for watching.

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