Q&A: Dr. Jerome Adams, Surgeon General

When Jerome Adams was Indiana State Health Commissioner, he enjoyed a reputation as a thoughtful voice on everything from the state’s Ebola preparedness to his work to persuade then-Gov. Mike Pence to adopt a needle exchange to contain an HIV outbreak in Scott County, with both Democrats and Republicans praising his tenure. But as the nation’s 20th surgeon general and a member of the White House Coronavirus Task Force who has been a key surrogate to talk about the virus’s disproportionate impact on communities of color, Adams has endured a more fraught tenure. He was reportedly sidelined after he urged communities of color to “avoid alcohol, tobacco and drugs,” adding, “we need you to do this, if not for yourself, then for your abuela. Do it for your granddaddy. Do it for your Big Mama. Do it for your Pop-Pop.” In recent weeks, Adams has returned to the public eye, and, after a series of DM exchanges that begin back in April when I noted the tension between his Feb. 29 tweet—“Seriously people-STOP BUYING MASKS!”—and what was then the new White House guidance that Americans should, in fact, buy or make their own masks to prevent the spread of COVID-19, he agreed to an interview. Here, we discuss his wife’s cancer recurrence, Indianapolis’ hotspot status, and the Trump administration’s routine falsehoods about the virus.

How have you been surviving the pandemic with your family? Are you guys holding up OK?

We’re hanging in there. I mean, one of the challenges is again, I’ve got a 16, a 14 and a 10-year-old at home. And so we’re dealing with the same things that every other parent is in terms of trying to keep your kids active, trying to keep them engaged, trying to deal with their depression and anxiety, trying to deal with their desires to see their friends, and trying to figure out what to do with them for schooling, because we know there’s real health risk to being out of school; missed vaccinations, increased obesity, increased risk of substance misuse.

I actually do have several close family members who’ve gotten coronavirus. Fortunately, most of them have recovered. Unfortunately, I have a family member, a very close family member right now, who is very sick with coronavirus. So this is something I’ve experienced very personally.

And as you may or may not know, my wife [Lacey] also had a recurrence of her cancer. Her screening was a little bit delayed because of the fact that things were shut down because of COVID-19. In a very real sense, I am feeling both the pains of the virus and the pains of the shutdown.

I’m sorry to hear about your wife. How is she doing?

Well, we’re still trying to figure out what the plan is. This is her third recurrence and so it’s pretty scary for all of us.

But as many people are seeing, there’s the virus, but then life didn’t stop in other ways. I mean, we’ve seen overdoses going up 10 to 20 percent across the country this year. Again, many consequences to the shutdown, which is why I’m so adamant with everyone that we need to understand it’s not reopening versus health. It’s that we need to promote health and my three W’s, washing your hands, wearing a mask, and watching your distance, so that we can reopen and stay open, because that is also good for our health.

Surgeon General Jerome Adams speaks as President Donald Trump and Vice President Mike Pence look on during the daily briefing of the White House Coronavirus Task Force April 10, 2020 at the White House.Photo by Alex Wong/Getty Images

A month ago, you told “Face The Nation” that the country can turn things around in “two or three weeks if everyone does their part.” Why hasn’t that happened? What needs to happen? What does the Trump Administration need to do to make that happen?

Well, one of the things that I think is important is again, helping everyone understand the why. And so I talk about my three W’s, which I’ve already stated, but there’s a fourth W and that’s the will. What we’ve seen around the country is that places that have been able to successfully turn around their trends have had a collective will on the part of the public to do those three W’s, particularly watching their distance, avoiding crowded places, and staying six-feet from others, and wearing masks. I think that is important.

What the administration is doing is they’re really having an all-of-country regional effort. One of the challenges is a lot of the time when the message has come out on a national level, they don’t resonate with people and they’re framed through a political lens. There’s no page in the pandemic playbook for a presidential election and a lot of things are framed through a different lens.

And so what we’re doing very specifically is a lot of regional media direct to consumer, if you will. I’ve been in Baltimore, I’ve been in Miami, I’ve been in Atlanta over the last three weeks, and hot zones, which is a risk to me and my family, quite frankly. But we’re doing it because it’s important that we get there and talk to the people directly. When I get off the phone with you, after my next meeting, then I’m going to have interviews with Nevada, and with Boise, Idaho regional radio. We’re trying to speak directly to the people, help them understand their local stats, and help them understand what they can do to stay safe.

Indianapolis, as you know, has struggled with hotspot status as well. What are you seeing in Indiana, especially as students go back to school? We’ve had a number of schools here shut down after cases have popped up.

Well, first of all, I want to applaud the governor for mandating masks in that state. I think that is appropriate. But as he and I have talked about directly, and I’ve said to everyone across the nation, a mandate alone will be less effective than what you want it to be if you don’t have engagement in education. So I think we need to continue on a national level. The state department and county departments of health there are really working to do the three E’s. One is enforcement, one of education, and one is engagement, helping people understand why they do it, how it benefits them and to normalize the behaviors that we know will be effective.

I actually looked at several Indianapolis news outlets this morning and saw that they’ve had to cite several businesses because they’re packing people in. I think someplace called the Speedrome got a citation from the state department of health recently. And that’s what I say: We need to educate people, and then we need people to cooperate. And what I’m trying to help people understand is we’ve really got two choices. We can either engage in these public health measures and places will be able to open and stay open, or if we don’t all collectively do our part, then we’re going to miss sports. We aren’t going to see the Colts and the Pacers play. We’re not going to have a prom or spring break next year. These things are only possible if we lower background community spread.

I want people to understand that again, it’s not “reopening versus doing what we need to do to drive down the virus.” It’s that we do what we need to do to drive down the virus so that we can reopen and stay open. I hope people are starting to see that and paying attention to the fact that, “Hey, if you reopened, you’re going to be at risk for shutting right back down again, if you don’t do the things to lower disease spread.” We need businesses to cooperate. We need people to cooperate. We need local celebrities and influencers to cooperate and normalize these positive behaviors for the community.

Sure. But another obstacle to fighting this pandemic has at times been the Trump administration itself. The President, his campaign, and people within the Trump Administration continue to make false claims about COVID-19. Why?

Well, all I can tell you is what I am doing on the task force and what the doctors are doing. We actually meet as doctors on the task force regularly. We just had a big huddle yesterday. We give the best advice we can to the vice president and to the president, and then have to put that into a multivariate equation. There’s the economy, there’s people’s liberty and freedom, there’s religion, there’s culture, all these things go into an equation. And all I can tell you is that we are working around the clock as physicians, as scientists, as health officials to give the best possible information we can, not just to the president, but to governors around the country. We’re working directly with governors and mayors.

We hope that information is being taken into account. I know on a federal level, we meet with the vice-president regularly, and that information gets to the president, and so that’s the best I can ask for and hope for. I feel like in many cases, that information is significantly impacting the decisions that are made. That’s what I’m here for, and that’s all I have control over.

In Atlanta earlier this week, you challenged athletes, sports leagues, and influencers to make mask-wearing cool, then issued one to students, too: “To the kids in schools I want you to understand, if you want prom in person next year, if you want to go to spring break, if you want an in-person graduation, then we need you to work together.” Are kids really the problem?

Well, there’s good news and there’s bad news. The good news is that the average age of diagnosis of COVID cases is significantly lower, a decade-and-a-half to two decades lower than what it was in March and in April. And that is why you’re seeing even with more cases than what we had during those times in many places, that the number of deaths is actually lower. We’re protecting the older, the vulnerable better.

But that means that the spread now is occurring amongst younger people. We know that in many cases they feel like they’re invincible. We know that the messaging has been difficult because they are at lower risk for complications, but that doesn’t mean they’re at no risk for complications. And it doesn’t mean that they can’t spread it to their loved ones or to other people. And so I do feel that they are, from statistically speaking, one of the main sources of spread in our communities.

I have a 16, a 14 and a 10-year-old. Of course, this is what kids say, but they tell me I’m the only parent out there who’s not letting their kids go out and have sleepovers, and play together, and do things that we know spread the virus. Again, these kids do need to be part of our efforts to slow the spread of the virus. I know that my kids are more likely to do something because Kylie Jenner, or because LeBron James, or because 2 Chainz says to do it, than because the surgeon general of the United States says to do it. So I want to give people the education, but I need help from everyone else out there to engage these groups who we know are resistant to these health behaviors, so that we can normalize doing the right thing.