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December 24, 2021 29 mins

Ryan Gorman hosts an iHeartRadio nationwide special featuring Dr. Adi Rosario, a scientist, and lieutenant in the U.S. Public Health Services, serving in the office of the U.S. Surgeon General. Dr. Rosario provides the latest information on the Omicron variant and explains why vaccines and booster shots are vital for preventing severe illness from COVID-19. Dr. Kelly Sanders, Technical Lead of the Pandemic Response Initiative at the UCSF Institute of Global Health Sciences, also checks in to talk about the impact of COVID-19 on children and to assess our country’s response to the pandemic. 

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Episode Transcript

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Speaker 1 (00:00):
Welcome to I Heart Radio Communities, a public affair special
focusing on the biggest issues impacting you this week. Here's
Ryan Gorman. Thanks for joining us here on iHeart Radio Communities.
I'm Ryan Gorman, and we have some important conversations lined
up for you coming up in a moment. I'm gonna
talk to a scientist and lieutenant working in the Office
of the U S. Surgeon General about the latest on

the O macron variant, and then I'll check in with
Dr Kelly Sanders, technical lead of the Pandemic Response Initiative
at the u c s F Institute of Global Health Sciences,
about how kids have been impacted by the pandemic. Right now,
to get things started, I'm joined by Dr A. D. Rosario,
a scientist and lieutenant in the U S Public Health
Services serving in the Office of the U S Surgeon General.

Dr Rosario, thanks so much for joining me, and I
think the place to begin would be with the topic
on everyone's mind, the O macron variant. What's different about
this variant compared to what we've seen previously from this virus. Well,
thank you for having me, and yes, the only cron
variant is on everybody's mind giving it to the latest
UM and developing quickly. UM. So what we could share

with the audience is, UM, what what's most concerning about
the only cron is that it has shown high uh
high transference, so it's very it's far more contagious than
what we've seen before. UM. However, the bright side is that, UM,
we have the protection that we would need against it

with you know, the the vaccination options that we have
out there in the booster shots and now the pediatric
population having access to it as well. So this is
why I think there were comments made that yes, it
is something to be aware of, Yes there's something it
is something to be concerned about, but it's not anything

UM to necessarily panic over because it is nothing for
you know, outside of the norm of what we currently
have to help contain. This one thing that seems pretty
notable about this variant. We're seeing case counts rise and
we're seeing a lot of people who have been fully
vaccinated get infected with this O macron variant. Luckily, the

infections are not severe. But is that something that those
who have been vaccinated should expect a higher probability this
time around that they may in fact it infected with
this omicron variant. No, it really isn't any um, the
percentage isn't any necessarily, uh gets bagically higher. And as

you said, you know those that have the vaccines already
and the boosters UM, you know you could get it
the same way that covid has um been around in
a way that you know, if you were following the percussions,
you had been vaccinated already with the first rounds that
were available, you know, people were still um contracting the

virus UM. But similar to the influenza vaccine as an example,
it's not that it makes you completely impenetrable through the virus.
It is how your body is able to manage the
symptoms thereafter. It really really drastically reduces uh, the dangerous

aspects um the parts that are a bit of a
gamble with this virus, which is you just don't know
how your body um physiologically is going to respond to it.
So the vaccines are applicable just as much to the
omicron variant as they as it has been to the
prior variants, in keeping your body that much more capable

and able to overcome the virus far more easily than
if you were unvaccinated. I'm joined right now by Dr
Adi Rosario, a scientist and lieutenant in the U s.
Public Health Services serving in the Office of the Surgeon General.
You have a lot of Americans who are making their
appointments to get their boosters shots. And I've got two

questions here. One, what kind of protection does one shot
of the Johnson Johnson vaccine or two shots of the
fives or Maderna vaccines provide against the macron variant? And
when you get your booster how long untild that fully
kicks in two weeks? So the first the initial dose UM,

you are considered fully vaccinated after two weeks from receiving UM.
The second dose, if it was the two shots administer
administration vaccine UM, if after the Johnson and Johnson one shot,
it would be two weeks after that as well. The booster, again,
you know, maximizes UM your ability to fight it, as

over time the effectiveness of the original vaccine would wane,
So the booster keeps you at the kind of the
original level of UM protect as when you receive the
first two. And now the bigger question that that we're
hearing these days is how often are we gonna have

to get boosters. Is it just this one? Is there
now going to be a timeline that we have to
be mindful of and you know when is it exactly
that it wanes. So this is something that is still
very much developing. So we are learning as we go,
and it is really really impressive how far we've come
so quickly in being able to counteract this virus with

the rate of the suspectings have been developed. So that's
not a bit of information that um I could offer
right at the moment, but it is something that you know,
as information scientifically becomes known of the effectiveness of the
booster and the intervals that boosters might be needed. Um
that's definitely going to become available to the American public.

Um I would um anticipate that though that the way
that the influencea shops work, you know how we have
to take that annually to keep your body, um you know,
readied and colectible with the way that influence the shift
here to here and the end of you know, the
more the more contagious strains. There's a good chance that

we may see that in in the COVID situation, A
couple of communities that I know you focused very intensely
on throughout the course of this pandemic the Asian American
Native Hawaiian Pacific Islander communities. What can you tell us
about how they've navigated and been impacted by COVID nineteen.

You know, historically in the API population, as in other
minority communities, there is a sense of distrust, um and
mistrust that that's the population of communities have with the
government and any you know, information, any um, anything that

the government kind of stands behind. So there's we've definitely
encountered that sense of mistrust link ring. Even though it's um,
you know, with all the information, all the data, all
the outreach, all the educational resources that are available, UM,
it's still important to to engage with the community and
ensure it with every possible opportunity that that information and

that data and that knowledge and those those facts are
able to penetrate the community more deeply. UM. There's a
lot of uh, you know, myths, um that are difficult
to miss the spell because there's a lot of you know,
this community is tight knit and they trust each other.

The community trust each other, So it's myths and the
such are circulating in the community among the population that
will be heard and that will be entertained. So the
important thing is to keep sharing the data, sharing the science,
the evidence UM, showing the numbers of the effectiveness and
how the benefits far out way any risks. UM. It's

really critical to continue to share that information and transmit
it to the you know, all the minority communities, UM.
But in particular that you're referring to the a p
I I'm joining right now by Dr A. D. Rosario,
scientist and lieutenant in the U s. Public Health Services
serving in the Office of the Surgeon General. So we've
been dealing with this pandemic for a long time now,

and it's really worn on a lot of people in
a lot of different ways. How difficult is it to
keep up this public health messaging trying to get Americans
to take certain precautions With all of that being the case,
people just being burnt out on this pandemic at this point,
right UM, I could refer and I agree with you,

I think it's taken a toll on all of us
in one way or another, as individuals, as families of
communities UM, as you know, globally as well as naturally.
But the same way that there are things that we
have to contend with as a people. UM, you know,
referring back to the influenza vaccine. You know, that's something

that every year we are reminded of. Every year there
is UM you know, information that you know, readministered across
the nation to remind you, to encourage you, to let
you know where it's available. UM, it's it's we're going
to have to at least stay on that trajectory currently

with UM, you know, the COVID efforts for vaccines and
for preventiveness. You know, part of the issue is with
with the O macron, you know, referring back to that
variant and all the other variants and the possible variants
to come. That has to do with the fact that
there's still segments of the population that remain unvaccinated, and

that's the space where these variants uh evolve out of.
So it's still UM. As fatigued and exhausted as we
may be. UM. As much as we wanted to see
it all go away and life go back to a
pre COVID world, we're not at that point yet, and
we still have to exert effort to the best of
our ability. UM, you know, to encourage those that haven't

yet been vaccinated to you know, make sure that they
receive the correct information to spell the myth, you know,
offer encouragement, offer the reminders of the value of the vaccine,
and and that that is really our best ticket to
get back to life as we remember it that we
UM nostalgically want to get back to. So that's that's

really right now, UM, slowing down is the effort is
not going to is not yet an option final question
for you. We may in fact be in for a
rough couple of weeks here with this omicron variant spreading
as rapidly as it is across the country. But is
there some optimism for two? Because of all the tools
that we have in our toolbox now, the vaccines, some

more treatments coming online, all of that, should we be
opt to mystic about the new year when it comes
to this pandemic. Absolutely, I would say that it is
definitely optimistic. There's really no way around that. Um. You know.
In fact, as of December twenty, it's just over sixty
of people you know, age five and up in the
US have been fully vaccinated. So that's already two out

of every three eligible persons that has that sense of relief,
that has that peace of mind, that knows that they're
protected from serious illness, hospitalizations, and death, and that they're
doing their part to protect the next person. Um. We
already know that these COVID vaccines work. We've had, you know,
a stark decline in the cases, um, you know, referring

to the A p I community. Hawaii specifically has observed
a very stark drop in COVID nineteen cases among the
specific islanders living there since these vaccines became available. UM.
The great thing also that we haven't seen any long
term side effects yet emerged. UM. And again that the
risk of having COVID itself always outweigh any risks from

possible side effects from the vaccine. So UM, I think
you know everything is looking up. UM. But you know,
referring back to your comment about the fatigue and the exhaustion,
this is not the time to let up our efforts.
This is not the time, um, to become lax about it. UM.
The contrary, what we want to do is see the
elimination of these variants. We want, we don't want to

see these mutations and evolutions of the virus any longer.
So now is a really really good time that with
a lot of care and concern and compassion, we continue
to make sure that the you know, the data, the evidence,
the information continues to um penetrate deeper into our communities,
um into all the minority community's a p I community,

and you know and serve as encouragement as hope as
optimism um in the effectiveness of this vaccine. Dr A. D. Rosario,
a scientist and Lieutenant in the u s Public Health
Services serving in the Office of the Surgeon General. Dr Rozario,
thanks so much for taking a few minutes to come
on and share all that information with us. We appreciate

it absolutely. Thank you so very much. Best to you
and to your audience and your family, and happy holidays,
all right, and happy holidays to you as well. I'm
Ryan Gorman here on her radio Communities and now let
me bring in my next guest. Joining me now, I
have Dr Kelly Sanders, technical lead of the Pandemic Response
Initiative at the u c s F Institute of Global

Health Sciences. She's also focused on pediatrics when it comes
to the pandemic. Dr Sanders, thanks so much for taking
a few minutes to come on the show, and that's
really where I want to focus here, kids and COVID.
Now that we're as far into this pandemic as we are,
what stands out to you about how the virus has
impacted children. It's an absolute pleasure to be here with

you and your listeners today. Thanks for having me. And
I want to highlight really that the impact of the
COVID ninteen pandemic husband multi fat storial for children, and
so I want to start by talking about what we
know about direct impacts and then briefly talk about some
of the indirect ones that we're also seeing. While we

don't really see the same severity and most children that
we see in adults, for example, high hospitalization and mortality rates,
particularly and unvaccinmated older adults, we certainly know that children
can be infected by COVID nineteen and really can suffer
this entire spectrum of disease, from a symptomatic or mild
infections all the way to severe infections that lead to hospitalization.

We've seen thousands of hospitalizations over the course of the
last couple of years and about a little bit over
seven hundred deaths in zero to eighteen year olds from
COVID or its complications, and just to ground us in
some data from the last week. Really, we've seen that
there have been at least a hundred sixty four thousand

new cases amongst children, which is up by thirty one thousand.
Children have a really wide spectrum of symptoms, which makes
it complicated sometimes as a pediatrician to figure out if
we think that a child has COVID all the way
from mild running nose vomiting and diarrhea, sore throating costs,
fever and chest pain, or really no symptoms at all,

And because this looks like other common viral infections, there
are a lot of kids that probably have never gotten tested,
which makes studying the disease in our pediatric population a
little tricky. We also know that long COVID can occur
in children, although race are really difficult to usmate given
there's no firm definition of what long COVID means and

young children can have some difficulty expressing what they're experiencing.
But research studies show that it's somewhere between two percent
and fifty percent, which frankly doesn't help us all that
much given that wide spectrum, but probably is around ten percent.
So briefly, I just want to touch on the really
critical indirect impacts of COVID, so these are just as

important as the direct impacts. And really we know that
there are major educational losses for children who received prolonged
virtual instructions, particularly children of color. And recently the Surgeon
General of the US actually issued an advisory on a
mental health crisis and children in the US. This was
present before the pandemic, but we really have seen an

acute worsening over the last two years. And I'm certainly
saying this reflected in my clinical practice rising rates of anxiety, depression, suicidality,
eating disorders, and children, so this is really impacting them
in very tangible ways. And the last point I wanted
to make is really just about rising poverty rates for families,

which means that many children are experiencing food and security
and lack basic necessities. So really, I mean, the pandemic
has had so many packs on our children, which is
why I'm so glad to be here talking with you today.
Do we know why cases in children for the most part,
tend to be less severe than cases and say older adults,

what is it about children that allows them to again
generally speaking, escape the most severe symptoms from COVID nineteen.
That's such a great question, and I wish I wish
I had a really firm answer for you about that.
We actually don't. There are lots of hypotheses, largely around
how children's immune systems develop and evolve. That is the

foundation for why we just don't see that significant severity.
But we're still even trying to figure out why does
one adult have an asymptomatic infection and other adults have
this really severe infection in older population. So certainly a
lot more research needed there, and many of my colleagues

around the country are looking at that specific um, that
specific question. A lot of parents across the country are
making decisions about whether or not to vaccinate their children.
What would your recommendation be and why would you make
that particular recommendation. Yeah, Ryan, this is such an important question,
and I really want to preface my answer here by

saying that I recognize that parents are trying to do
the safest thing for their children, and we really needed
to start these particular conversations with empathy and understanding and patients.
Pediatricians have been navigating the waters of vaccine concerns, I
would call it for decades, and really we know that

blaming and shaming around vaccination is not helpful and really
being open and honest about the information we have is critical.
So all that said, um, I am completely in line
with the CDC when I say that I absolutely recommend
vaccinating children over the age of five against COVID nineteen.

Clinical trial else show that vaccines are highly effective and
safe for children, and now we have millions of children
who are vaccinated against COVID vaccine over the age of five,
and really it protects your whole family and also helps
to slow the spread of COVID nineteen in our communities.
If I can save one unnecessary child death by doing

this podcast and recommending vaccination, I would be successful here today.
And sometimes that risk calculus is really difficult for parents
given the news about side effects and how rare severe
outcomes are from COVID, But any pediatric death is a
tragedy that we should aim to prevent. The main risk

you really here publicized on the news is myocarditis or
perry charditis, which is inflammation of the heart muscle or
lining of the heart, and this tends to really happen
in older teenage and young adult males and vaccine specifically
vaccine associated myocroditis, because we actually see myocreditis after a

variety of viral infections, but the vaccine one tends to
be very mild, usually only requires Ibprofen or at Bilt
for treatment. And what we saw in the Fiser trials
for children age five to eleven was that there actually
weren't any miocreditis cases. Now, I wouldn't be surprised if
we see some, and certainly it's something that we take

very seriously as pediatricians. I already looked at my schedule
for this thing and see a couple parents I'm gonna
be talking to about this or you, and I just
want to note that I would really be limit not
to mention that for older teenage boys and young adult males,
there's some discussion around spacing the m R and a
vaccine specifically a little bit further out between the two doses,

and Canada has just changed just recommendations around this. So
if you're wondering about this topic, I recommend talking with
your doctors, specifically for older teenage boys. I'm Ryan Gorman,
joined right now by Dr Kelly Sanders, technical lead of
the Pandemic Response Initiative at the u c SF Institute
of Global Health Sciences, For parents who are concerned about

this O macron variant of what it might mean for
their kids, what do we know about how this variant
potentially impacts children? This is the magic question right now.
Had simply put similar to your question around um why
children don't tend to get as it. We actually don't
know yet. We just haven't had enough time to really

track what's happening with O macron, but we have some
signal already, so we know that O macron spreads extremely quickly,
and we have some good information from South Africa and
the UK around this, and so first and foremost I
recommend please be careful and use mitigation strategies through this
holiday season, particular liarly for families with children under the

age of five. There are some reports of increasing numbers
of young hospitalized patients in South Africa, but in my
conversations with my colleagues there, it sounds like many of
those cases are actually children who are admitted for another
reason like a burn or um an accident, who then
test positive when they're coming into the hospital. All that said,

it's really too early to know if they're going to
be an accompanying accompanying site of these moderate or severe
hospitalization cases for hospitalization, but really ensuring that your child
is vaccinated is the best way to prevent bad outcome
even if they do get sick. Let me ask you
about healthcare workers for a moment. What are some of

the biggest issues that they face throughout the course of
this pandemic has been a very trying time for those
on the front lines, and in particular those who are
on the front lines and dealing with children. Absolutely, and
I think there are some different issues here when you
think about adult doctors versus pediatric doctors for all the

reasons we talked about initially, but really health care workers
around the country, and I want to specify that that's
a pretty wide group of people. Doctors, nurses, nurse practitioners, physicians, assistants,
respiratory therapists are aids who work in long term care facilities.
Those are all really critical to our healthcare systems and

have been stretched to their breaking points countless times over
the course of the last two years. And clinicians and
other health care workers are often labeled as heroes, but really,
let's let's face it. I mean healthcare workers are only
human and resilience is meaning in the face of exhoption

and burnout. I work both in the hospital and in
urgent care, and so I can speak to that setting.
But there's so many issues for adult doctors and e
ers and ICUs who are seeing patients die from COVID nineteen.
For us as pediatricians, it's been a little different, and
we're really seeing that more children are being hospitalized for

very complex mental health issues and delayed diagnoses like cancer.
Clinics for saying patients with chronic conditions like obesity and
high blood pressure. Yes, in children, we have so many
and the rates are dramatically increasing because they haven't necessarily
been managed. Over the last couple of years. We're also

seeing instants and toddlers that are missing routine vaccinations, putting
them at risk for diseases like um the measles, months pertassis,
and that obviously is quite dangerous for the larger populations.
And so we're busy. There is a lot for us
to navigate, and everybody is trying to stay up above water.

Right now, I'm Ryan Gorman joined right now by Dr
Kelly Sanders technical lead to the Pandemic Response initiativity. You
see SF Institute of Global Health Sciences on the topic
of pandemic response. What do you think are some of
the big lessons that we should have learned from what
we've gone through over the past two years, and also

what are some of the things that we should keep
in mind if we were to experience another pandemic when
it comes specifically to our frontline and healthcare workers. Yeah,
that's such an important point, particularly because it's easy to
lose sight of the real goal here, which is better
responding to this one but also preparing for the next one.

And as a country, if we don't work to consue
work to really improve frontline conditions, we risk losing desperately
needed healthcare workers. And this is something that we were
navigating as a country even before the pandemic. Never mind
now when we have a huge attrition rates and are
losing culture workers because of the burnout we were just

talking about. A recent study actually conducted by the Pandemic
Action Network and partners found has some really interesting findings
around um how providers felt prior to the pandemic around
and right at the beginning of the pandemic around warning,
so six of doctors and nurses felt that they did

not have sufficient early warning to really prepare for the
COVID event team pandemic, and even as of summer, this
is such a streaking number to me. More than a
year into the pandemic, thirty two percent did not feel
that they had sufficient access to personal protective equipment or PPE,

and around eight percent agreed that a central platform containing
all professional information related to their roles like nursing protocols,
um treatment protocols for physicians would be valuable. So clearly
we have rooms to improve. The other thing I just
wanted to respond to is in terms of changes that

we can make right now to help our health care workers.
We really need to work on continuing to improve local
vaccination rates, develop new diagnostics and treatment options, and then
to provide more resources for our very stressed public health
system and hospital systems, and then to prepare for the

next pandemic. Well, that is a huge bucket of worms,
and there are many areas for improvement, but just to
name a few, we really need to um enact better
early warning systems, develop measures that prioritize the safety and
security of healthcare workers, and provide more dedicated resources for

rapid response and personal protection. And then, as I was
mentioned before, create this more robust, formalized communication platform for
clinicians to share evolving new information across the country and
I would say across the world. And final question for you,
looking ahead to the new year, with more and more
Americans getting vaccinated, more and more Americans getting boosted with

the treatments, that we have some drugs on the way
that could help with this pandemic, is there reason to
be optimistic that will likely be better than I certainly
hope tho list. And I know that everybody is exhausted
here and we're all just ready to be out of this.

And I think that there are so many really inspiring
new um drugs, the vaccines in the way that we
can adapt vaccines as we need them. It certainly is
clear that we have work to do and we are
not out of this yet, and it's going to be
something that evolves over time, and so I want to

encourage everybody, of course, to keep taking this seriously. But
I really do have a lot of excitement and optimism,
as I said, particularly around the new drugs that are
becoming available and some really great options to ensure that
people aren't dying from COVID nineteen. Dr Kelly Sanders, technical

lead of the Pandemic Response Initiative at the u c
SF Institute of Global Health SCIENCEST. Dr Sanders, thanks so
much for coming on and sharing all of that insight
with us. We really appreciate it. Thank you. It's been
a pleasure, all right. And that's going to do it
for this edition of I Hear Radio Communities. I'm Ryan Gorman.
As we wrap things up, I want to offer a
big thanks to all of our guests and of course

to all of you for listening. We'll be back, same time,
same place, next weekend. Stay safe,
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