The following is a lightly edited transcript of the February 27 episode of The Daily Blast podcast. Listen to it here.
Greg Sargent: This is The Daily Blast from The New Republic, produced and presented by the DSR network. I’m your host, Greg Sargent.
In West Texas, an unvaccinated school-aged child just died of measles. This is the first reported death that’s related to the frightening recent outbreak of the disease, which has been spreading in Texas and now into New Mexico. All this came up at President Trump’s cabinet meeting on Wednesday afternoon. What happened was really troubling. Elon Musk, apparently a de facto member of the cabinet, cavalierly admitted that his cuts had briefly closed down Ebola prevention. Health and Human Services Secretary Robert F. Kennedy Jr. said that these types of measles outbreaks are not unusual, something critics immediately jumped on. Today, we’re talking to Stephanie Psaki, a former senior HHS and White House official under President Biden who specializes in pandemic response. We’re going to get into how serious this measles outbreak has become, and how big a threat having people like Musk and RFK overseeing public health really is. Thanks for coming on, Stephanie.
Stephanie Psaki: Thanks for having me, Greg.
Sargent: Let’s start with the comic relief. Well, maybe this isn’t really that funny. Here’s Elon Musk, who somehow got invited to a cabinet meeting, talking about DOGE.
Elon Musk (audio voiceover): And I should say, we will make mistakes. We won’t be perfect, but when we make a mistake, we’ll fix it very quickly. So for example with USAID, one of the things we accidentally cancelled very briefly was Ebola prevention. I think we all want Ebola prevention, so we restored the Ebola prevention immediately and there was no interruption.
Sargent: Stephanie, you’d think that this would give these guys pause, that it would be an occasion to ask themselves whether it’s a bad idea to have Musk’s team rummaging through governmental data and crucial programs. Your thoughts?
Psaki: Well, I’m guessing that’s probably not the example they would have preferred for him to have given in that moment. It seemed a bit off the cuff. I hope it does give us pause. I hope it gives Americans pause. Ebola is something that is pretty salient for Americans, and when they hear about something like flipping a switch of turning off Ebola prevention—which I think is a very simplified way of describing it—they should be concerned, particularly when there are ongoing Ebola and Marburg and unknown outbreaks happening in multiple countries right now.
Sargent: And we have a measles outbreak in the United States. This poor kid was unvaccinated. Many of the cases of measles that we’re now seeing are in other unvaccinated kids. Can you talk a little bit about what we know about the outbreak at this point?
Psaki: As a parent of two young children, I should say there are many children who are not vaccinated or not fully vaccinated against measles—not because their parents don’t intend to get them vaccinated but because you’re not fully vaccinated until you’re ages four to six. So children usually get their first dose around the age of one and their second dose of the measles vaccine around the ages of four to six. That’s when they’re fully vaccinated, which means that children who are not fully vaccinated can also be at risk even if their parents want to protect them with vaccination.
That said, in this case, the outbreak originated, as I understand it, from what CDC has shared in a community that is under-vaccinated, including children who are old enough to be vaccinated. It’s not particularly surprising. Measles is the most infectious disease that we know about in the world, that exists in the world. So it takes advantage of cracks in the system. In the public health community, we think about measles as the canary in the coal mine. When you have breakdowns in your public health system, one of the first things you’ll see is measles outbreaks because it’s just so, so contagious.
Sargent: Yes. We’re seeing a lot of alarm among public health professionals on social media and so forth. And it’s being exacerbated by the wanton and indiscriminate hacking away at government that Musk is doing right now. People are getting laid off all over the place in places like CDC, the NIH; medical researchers are getting pushed out. Putting it all together, it seems like there’s absolutely no serious concern on the part of the very highest people in our government right now about what you’re saying, which is that this measles outbreak is signaling a problem with our public health apparatus. Is there any indication that you see that they’re taking that idea seriously?
Psaki: Having been in the White House, one of the challenges is that when you avert a crisis, you get no credit for averting a crisis. Americans often are not fully aware of the many, many crises that are being averted not just by the federal government but actually more often by state and local governments. And there were, of course, measles outbreaks in the past, but the way that these measles outbreaks are being handled and the scope of the outbreaks are a symptom of some of our systems starting to break down. Those systems include trust in vaccination—and we’ve seen a decline in trust among Americans toward vaccination in the last few years, especially in the wake of the Covid pandemic. So this didn’t just happen a month ago. It’s been happening over time. And what we’re starting to see in different spaces are some of these outbreaks.
Sargent: Well, as it turns out, the people who have done the most to undermine trust in our public health system are now running it. The kid who died of measles came up at Trump’s cabinet meeting. A reporter asked Trump about it, and then Trump turned to RFK Jr. to get him to answer. Listen to this.
Donald Trump (audio voiceover): Bobby, do you want to speak on this?
Robert F. Kennedy Jr. (audio voiceover): We’re following the measles epidemic everyday. I think there’s 124 people who have contracted measles at this point, mainly in Gaines County, Texas; mainly, I’m told, in the Mennonite community. There are 2 people who have died. We’re watching it, and there are about 20 people hospitalized mainly for quarantine. We’re watching it; we put out a post on it yesterday and we’re going to continue to follow it. Incidentally, there have been four measles outbreaks this year. In this country last year, there were 16. So it’s not unusual, you have measles outbreaks every year.
Sargent: Stephanie, there’s a lot to unpack there. First, is it true that this is not unusual?
Psaki: It’s true that there were measles outbreaks last year and the year before. Although, if you look at the numbers even from 2024, they were much higher than 2023—so we’re going in the wrong direction. We should also keep in mind that we’re now about two months into the calendar year, so we shouldn’t be comparing what has happened already in 2025 to what happened throughout the entire year in 2024. Yes, it happens. I think we should be very concerned that we’re about a third of the way in 2025 toward the numbers that we got to in 2024.
We think of measles as the canary in the coal mine because it is the most contagious disease. There is also a very, very effective vaccine against measles, and it is very dangerous for children who are unvaccinated. So any death in a child is a massive failure of the public health system. That is a collective failure. I’m not saying it’s RFK Jr.’s failure, but it is a failure of the public health system; it is a failure of leadership. There should not be a child dying of measles in the U.S., or frankly anywhere in the world, because we have such an effective vaccine and we know how dangerous it is.
To cast that aside as technically it’s true that there have been measles outbreaks in the past and there will be measles outbreaks, it’s a major problem for our public health system. It is very much the responsibility of the secretary of HHS to get this outbreak under control, and to make sure that we don’t see additional outbreaks and certainly that we don’t see additional deaths in children.
Sargent: Should he be saying it’s not unusual?
Psaki: There are a lot of things that RFK Jr. has said that I would not say and would not recommend for a secretary of HHS (laughs). I don’t know that he’s taking advice from me on that. I think he should be very concerned, and I think he should be telling his team that they should be on the ground working with CDC in Texas and New Mexico and in other states in getting this under control and surging any support they need immediately. And frankly, I think both he and President Trump should be expressing empathy and regret for what is happening because a child died of something that is preventable.
Sargent: Speaking of Trump, I want to point out that Trump himself didn’t really speak at any length about this. Looking at this from the perspective of public health, shouldn’t a president want to go out of his way to personally reassure the nation at a time like this? Tell people what’s being done, tell people the government is on top of everything and understands the threat? As you said, RFK should be saying really vociferously, We’re surging resources, we’re doing this, we’re doing that, we’re doing the other thing. He basically said, We’re just monitoring it, it’s not unusual, although he said they’re taking it seriously. And here, Trump doesn’t even use his own bully pulpit to address it. We know Trump doesn’t take pandemics and disease seriously. Are we already seeing that here?
Psaki: If you look at how the meeting started, it started with Elon Musk speaking at the top about DOGE and the cuts that are being made across the government. That clearly is the headline that they are looking to have coming out of the meeting, and that’s what President Trump seems to be very focused on. The challenge is that there are downsides. There are reasons that these services were in place—and when you start to cut them and remove them, you are increasingly going to see crises that happen, emerge, are exacerbated because of those cuts.
It seems to me that President Trump is very interested in talking about making cuts, saving money in the budget, without talking about the consequences of those cuts. And he’s passing the baton over to his cabinet, who is going to have to deal with the cuts that have been made in terms of crises emerging and the inability to effectively respond to those crises.
Sargent: And don’t we want a president at a time like this to to use his presidential authority to tell the American people that things are being done, that the threat is taken seriously by them? Shouldn’t he want to do that?
Psaki: Look, part of being a leader is saying things that maybe your supporters don’t want to hear in the moment because it’s the right thing to say. So what I would have loved to have heard from him, and from RFK Jr., is to say, We have a safe and effective measles vaccine; measles is very dangerous to children, and you should talk to your pediatrician about your comfort level with getting this vaccine, but I recommend it; I got my own children vaccinated, which I imagine he did. I would love to have heard that from him or from RFK Jr., or for CDC to come out and say that at the leadership level. That’s what leaders should do to protect the American people.
Sargent: That is such an important point. RFK didn’t urge people to vaccinate. We should remember, by the way, that RFK has written that “measles outbreaks have been fabricated to create fear,” which has caused government officials to “inflict unnecessary and risky vaccines on millions of children for the sole purpose of fattening industry profits.” There you have it. He didn’t tell people to vaccinate. He didn’t tell people that the government is surging resources. He didn’t reassure people in any significant way. Neither did Trump. I think that’s highly alarming, no?
Psaki: Absolutely. Again, as a parent, there’s no way that the parents in these communities were anticipating this outcome. The parents of that child did not think that the child was going to die. Parents are trying to make the best possible decisions they can make for their own children, and they are looking to leadership—maybe not in Washington but in their communities—to give them guidance on what’s best for their children. It is terrifying that we have political leadership in Washington that is not willing to just stand up and tell the truth to the American people, even in such an acute situation where children’s lives are at risk. What does it mean in terms of what’s happening when something is less visible and less obvious to the American people? How do we know that we’re being told the truth? How do we know that they’re making decisions, even tough decisions, to protect us now and to protect us in the future?
Sargent: It sure seems clear to me that you’re absolutely right. I want to go back to something you said earlier. I haven’t been monitoring this, maybe you have. Has the CDC been saying what we would ordinarily want in this situation?
Psaki: The CDC, just looking briefly at their website earlier today, has updated information about these outbreaks, the latest on the outbreaks that have happened historically. I don’t think that they had something on their measles page about the child death, but usually they defer to the state and to the family to announce that information when it happens. It does seem that CDC is including up-to-date information on their website. What I would like to see is for the CDC director to be out there and talking about the safety of measles vaccines and calling on Americans to vaccinate their children against measles.
Sargent: So if you step back, here’s what you’ve got. You’ve got Elon Musk, who’s basically now a cabinet member, apparently, rampaging his way through the government, downsizing all sorts of different levels of government that are focused on public health in various ways, medical research, and biological research. You’ve got him “putting USAID through the wood chipper” and calling it all kinds of vicious names—he called it “evil” and “a criminal organization” and said “time for it to die.” USAID isn’t exactly a public health organization in the U.S., but it does a lot for health abroad. You’ve got Elon Musk saying, Oops, I accidentally turned off Ebola prevention.
You’ve got RFK Jr., who has spread anti-vax lunacy about measles in particular, downplaying the measles outbreak that we’re having now. You’ve got Donald Trump not using his bully pulpit to say what he should be saying about it. These are not people who think the state should be involved seriously in protecting public health, right? Isn’t that the big story?
Psaki: Yeah. Also, President Trump was elected by the American people. So the question is: Is this what people were anticipating when they elected him? And is this what they expect and want from him and his administration? We’re very early on. What worries me is the minicrises that we’re seeing right now. The measles outbreak is a crisis, but it’s not an unexpected crisis. There will be unexpected crises. And what worries me is what we are not doing right now to prepare for and anticipate those unexpected, much more difficult crises, and how they will be able to respond and handle those.
It’s easy in the first month or the first couple of months to make a bunch of campaign promises, that you’re saying you’re delivering on by making cuts, but it is very, very difficult when you are sitting in the White House to keep the American people safe every single day in ways that are not visible to the American people. And I worry about how effectively they are going to do that for the next four years.
Sargent: Do you expect something like the Covid pandemic to come back, or maybe even something worse? And how do you think the response will be? I think there’s reason to believe it could be actually worse this time, right? What are you anticipating? What’s the worst-case scenario here?
Psaki: Oh, boy. The worst-case scenario is probably something none of us could even anticipate, as it has been in the past. But obviously, we’re all paying close attention to bird flu, which has been evolving pretty rapidly in the U.S. The concern is that we’re one or two mutations away from that turning into a pandemic where you see human-to-human transmission. And the more it spreads between cows, and the more cases that we see in humans even though it has not yet spread between humans, the more likely it is that we will see that mutation happen.
That potentially could be much worse than the Covid pandemic was for a number of reasons. One of them being the distrust that we’re seeing in communities around the U.S. that was not there before Covid, at least not at the same level. Also, because many people have said that Covid could have been worse in terms of the health outcomes, it could have had a higher mortality rate, it could have spread even more easily, it could have mutated more quickly, it’s not the worst-case scenario. So we could find ourselves in a bird flu pandemic. We could find ourselves in a deliberate attack from one of our adversaries because the U.S. looks weaker right now.
There are a lot of risks, and that’s just in the biological risk space. There are many other risks, too, that are constantly threatening the U.S. and the American people. Most of the time, we are all able to live our lives and not worry about those threats because we feel confident that we have leadership in place that is tracking those threats, taking them seriously, and taking action. I do not feel confident about that right now. Having been in the White House a couple of months ago and paying close attention to those threats, I’m very worried that (a) best-case scenario, this is a distraction and they’re not able to focus on the most serious threats, and (b) worst-case scenario, they’re just ignoring some of the most serious threats and focusing on things like firing staff who have been loyal civil servants for decades.
Sargent: And if we do see something like the Covid pandemic—that level of seriousness or maybe something worse—do you expect our response to be worse this time than last time?
Psaki: Well, to try to be a bit optimistic, I think the good news is that there are people in the Trump administration and in the Trump orbit who were there for the first year of the Covid pandemic. They lived through it. There are lessons learned from that. think Operation Warp Speed was actually a success in a lot of ways that helped keep Americans safe. So they could make a decision to learn lessons from Covid, not repeat that, do things better. That’s a possible path to take.
Another path to take is to delay recognition of a threat—they’ve already cut staff and cut funding, which puts you on your back foot to begin with—and even to suggest that we don’t need to take mitigation measures because we’re just going to live our lives through a pandemic. If we had an even worse situation with a worse threat or a worse response, we could have many more millions of Americans dying; we could have a pandemic that lasts longer. We were very lucky that we had a vaccine in a year; so we could find ourselves in a situation where we’re waiting multiple years for vaccines or effective treatments. It could be much worse.
The way to prevent that situation is to prepare right now and make investments right now to keep staff in place who know how to anticipate and prepare for those threats, and to work with Congress to make sure that we are making the investments that we need if that threat occurs.
Sargent: At risk of getting out of step with the serious tone you’ve struck here, I’m going to take a flyer and say that having two guys play around with the government like a pair of toddlers knocking over towers of blocks is not what you had in mind when you say that the state should be getting prepared.
Psaki: It is not. It is not. I will say that there are people inside the government at lower levels who have a lot of expertise and would like to take these actions. And hopefully, they will be empowered to do that. There are people there who can do it, and there are certainly civil servants who can do it. But if you get rid of all of them, then you lose that capacity.
Sargent: Right. We will just say now: All of you out there in the government who really want to do the right thing, best of luck to you. We really need you to do that. Stephanie Psaki, thank you so much for coming on with us today.
Psaki: Thanks very much.
Sargent: You’ve been listening to The Daily Blast with me, your host, Greg Sargent. The Daily Blast is a New Republic podcast and is produced by Riley Fessler and the DSR Network.