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Recall when the first COVID vaccines came out in early 2021. It turned from a scientific problem to a logistics problem, how to distribute millions of doses to Americans clamoring to get them. It fell to  the Federal Drive with Tom Temin’s next guest to coordinate the setup of 39 mass vaccination centers, and 1600 smaller centers all across the country. For this work, he’s a finalist in this year’s Service to America Medals program. He’s also the region nine administrator of the Federal Emergency Management Agency (FEMA), Robert Fenton.

Interview transcript:

Tom Temin: And we should say that at the moment, you’re actually not the regional nine administrator. But you have a new task at the White House for monkeypox. Tell us what’s going on there.

Robert Fenton: Yeah, Tom. So I’ve been detailed over to the White House, President Biden asked me to come in and lead the nation’s response to monkeypox. And in that effort, I’m coordinating across not only federal agencies, primarily HHS, but to state and local agencies to help coordinate the containment control of monkeypox.

Tom Temin: Once again, you’re close to the White House, close to the center of action. Does it feel a little bit like a replay of what happened during COVID? Or maybe not quite as pressured?

Robert Fenton: Yeah, well, I mean, I think in all these events, there’s obviously pressure. There is the need to coordinate across all levels of government to help people that are in need. And all these events, people need help from the government. And so to do that, effectively, efficiently, is what I try to do in these situations.

Tom Temin: I never heard of monkeypox until this came out. Is this something for which there is a vaccine at this point? Pardon my ignorance, but I I’d never heard of it.

Robert Fenton: Yeah, no, appreciate the question. So much different than COVID. And many people’s last memory is COVID. And so they link viruses together. And this is very different. Where there is a vaccine that exists, it takes a little longer to test as testing is through swabs and you have to go to your doctor and and it’s a very painful virus that ends up lesions and rashes on you. So go get tested to prevent it. Getting vaccinated is the key. And then there is medication that if you do get it that you can take.

Tom Temin: Sounds almost like shingles.

Robert Fenton: It very similar, very painful. Yes.

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Tom Temin: Right. And the vaccine for it, that’s no picnic, but it does keep it from coming in. So let’s get back to when you were doing the work on behalf of COVID, or the COVID distribution of vaccines. Tell us how it worked, the vaccines came out? And then how did that get translated into 39 mass vaccination centers?

Robert Fenton: Yes, well, let me first start off with I couldn’t have done it without a great team of civil servants from FEMA, and FEMA is not a large organization. But a group of individuals that are dedicated and all year put the priority of Americans ahead of their own as they respond to disasters throughout our country. And so this was one that that staff was all in on. They knew that the vaccine had just rolled out, that we just went through a change of administration, as you remember a little bit of a rocky change. I came in as the acting administrator for FEMA. And the first charge the President gave me was, you know, let’s vaccinate all of America, especially those most at risk. And as I partnered with HHS to do that one of the key underlying elements of this administration that exist, and I’m doing today with monkeypox is really looking at equity, and how do we make sure that there’s equity in the services we provide? So what I did was coordinate a whole of government approach, use existing systems like the national incident management system, and brought in multiple federal agencies to work with states and local governments to set the sights up across the country.

Tom Temin: And describe these sites. I guess I saw them on television, because by the time I got a vaccine, you could just go into CVS and get it. But yeah, early on, there were traffic and cones, and big tents, and so forth. And local police had to be involved just for the, if nothing else, for traffic control. So give us a sense of how they were set up and who was actually operating them.

Robert Fenton: Yeah, we set up very large sites to very small sites, each  playing a critical role. And we  partnered with stadiums across the country, sometimes NFL, sometimes big parking lots,ed partner with Chicago Bulls in Chicago, in their stadium, and set up these sites across the country. The first ones were in California, and then set them up across the country. These are mass sites, using Department of Defense military personnel, USDA, DHS, HHS, VA to help vaccinate large numbers of individuals coming through they were able to go through in vehicles or foot traffic. And then what we did is we used kind of a hub and spoke approach because it became clearly evident to us pretty quickly that if we really going to reach the equity part of the population, we need to go ahead and provide services to where they’re at. Not just expect them to be able to to meet us. And I think that’s one of the things that I’ve learned over the years and doing this is that sometimes the government, we set our systems up to help the majority of people, but recognizing that maybe the most in need, the people that can’t get through tonour services are the people we have to go reach out to. And so by having these mobile vaccination sites, we were able to partner with community-based organizations, with church organizations, and really get just trusted agents. Because as you remember, early on, there was not a high degree of confidence in the vaccine.  And so what we had to do is go to trusted agents, where we put on mobile efforts to go to individuals to get them vaccinated.

Tom Temin: We’re speaking with Robert Fenton. He’s a finalist in this year of Service to America Medals program. And in his regular job, region nine Administrator of the Federal Emergency Management Agency. And you’ve been at FEMA a long time, were there lessons learned from prior disaster situations that came to bear in the COVID distribution for vaccines?

Robert Fenton: Yeah, I think there’s a lot of key lessons learned from previous events to this event. It’s about partnership, I think everyone wants to help. And everyone wants to be integrated on that. And how do you build those partnerships across federal, state and local government, working with the highest political leaders in many cases as reaching out to governors, members of Congress, to build those partnerships, whether it be across political lines, all with one priority of helping people and having a whole of America response? And so you really need to integrate everyone into that, and give them a role in doing that to be successful in in these type of missions. And so how do I bring in the community-based organizations? How do I bring in the nonprofits? How do I bring in private sector? And then governmental entities? And how do we all work together in one team, one fight through unity of effort to accomplish that goal. That’s from a leadership standpoint, what I did was really focused on that and how to bring everyone together into one effort to meet this need.

Tom Temin: And as a longtime career civil servant, who now twice has been called up by White Houses to deal with things, what’s your advice for people that do get into that situation, such that they can retain the objectivity and the neutrality they had as public servants, as career people?

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Robert Fenton: Yeah, I would say there’s a couple of key things that I rely on. One is the relationships that you have, through your organization. The team is critical to the success of carrying out the mission of the organization. And so building strong relationships. And maintaining those and having those for this are important. It is really providing clear communication, direction, during these events. And a lot of challenges are sometimes in the communication arena. So how do you communicate effectively as a leader is critical to this and to being able to carry out these missions. And then lastly, I think one of the things  that I do is allow people to go do their job. And I delegate a lot of responsibility down with that clear guidance, and allow those, you know, to use their ability to make decisions, and to be able to carry out the mission. So given a lot of authority and pushing it down and, and letting people use that to respond. One of the things that I had, a leader told me one time is to run a big operation like this, we need to make probably about 1000 to 10,000 decisions today. And I’m not going to make 10,000 decisions a day.  I’ll make three or four. But then the next group down for me, each one of them have to make five or six, and the next group down for them, have to make 10 or 12 decisions. So allowing everyone to participate in the decision-making and have a voice is critical.

Tom Temin: Sounds like when you do get into a White House situation, it’s important to remember where you came from, and not worry about so much where you are now, because that’ll still be there when you’re gone, and you won’t be a part of it anymore.

Robert Fenton: Yeah, that’s true. And, you know, I think there’s some key things that you need to have. And in FEMA, our core values are compassion, respect, integrity, fairness, and those are the things I try to keep with me and keep me grounded, no matter where I’m at in the organization, no matter what job I’m doing.

Tom Temin: And by the way for monkeypox, will this be a mass vaccination situation again? Or is the exposure limited such that everyone in the world doesn’t have to feel like they need to be vaccinated as soon as possible?

Robert Fenton: Yeah, right now in monkey pox. We’re focused on the highest risk population that’s primarily men having sex with men, about 94% of the people affected come into that category. And there’s about 1.6 million people that we’re really focused on based on data we have from PrEP, HIV and other programs. The federal government has to vaccinate those first. Then there’s other groups that potentially could come into this primarily as a sexually transmitted disease, but not only a sexually transmitted disease, so we need to be careful that doesn’t spill over into other populations. And we need to start with vaccinating that most highest risk population first, but then have the capability to increase. Another big important thing here is public education outreach. So we need people have aware of what monkeypox looks like to go in and get tested to get treatment. And then if you’re at risk, get vaccinated ahead of time.

Tom Temin: Robert Fenton is a finalist in this year of Service to America Medals program. He was recently appointed by the White House’s national monkeypox response coordinator.

Robert Fenton: Thanks for having me on today, Tom, and I appreciate being nominated by the sammys for this prestigious award. And congratulations to all those others that got nominated, too.

 

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