August 25, 2023 • 23 mins
COVID's back on the scene, as more and more people start to test positive while we make our way out of the summer months. There are so many questions out there about where we go from here with the virus: do we get a new booster or wait? Should we be masking? What's going on with long COVID? Dr. Shira Doron, Chief Infection Control Officer over at Tufts Medical Center, joins Nichole this week to answer questions and offer her insight.
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Episode Transcript
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(00:07):
From WBZ News Radio in Boston.This is New England Weekend where each week
we come together we talk about allthe topics important to you and the place
where you live. It's so goodto be back with you again this week.
I'm Nicole Davis. I've noticed overthe past few weeks, going through
social media like Facebook and Instagram andall that stuff, that more of my
acquaintances and friends have been coming downwith COVID. Some of them didn't even
(00:30):
realize they were sick, but kindof felt a bit off and took a
test and boom, they have COVID. Combine this with the headlines of a
new variant to potential surge in themaking. People are talking about it.
We're coming into the fall. There'sso much to take in. So I
said, all right, it istime to reach out to the experts,
because that's what we do here onthe show. Let's get the rundown of
what's actually happening here and what weshould focus on to stay safe and healthy.
(00:54):
So let's do it now. DoctorShia Drone is the chief infection control
officer over at Toughs Medicine. Shehas really been on top of this virus
and all the science behind it sincethe start of this whole pandemic. So
doctor Drona, I really appreciate yourtime. I've got to say, honestly,
the summer has been so nice becausethe wastewater levels were low and you
(01:15):
really didn't have to worry about maskingso much or any kind of spike.
But it really does seem like,yeah, that trend might be changing.
Well, yeah, so COVID isnever going away, and so this kind
of up and down shape of thecase curve is what we can expect for
the rest of time. Now,when cases go up, inevitably you will
(01:40):
always have some degree of hospitalizations goup. One of the reasons is that,
you know, even with the largeamount of community immunity that we have
where most people now get a mildinfection, they're always going to be those
highly vulnerable people, people who arefrail, medically complex, who even before
(02:05):
COVID, even a mild respiratory infectioncould tip them over the edge and they
needed hospitalization. And we have thisdata very clearly outlined in the state of
Massachusetts, and it's based on researchthat they did with collaborators at the BA.
What we know is that of thepeople who are hospitalized with a positive
COVID test, Only a small ishproportion of those are actually being treated for
(02:30):
severe COVID. So there's always goingto be those people in the hospital who
are there for a completely other reasontest positive because they had some mild symptoms,
are there for a completely other otherreason and have no symptoms but we're
tested, you know. And thenthere are those who are there due to
COVID, but it is in severeCOVID, and so you know, we
are seeing that number covering now betweenonly twenty five to thirty percent in Massachusetts
(02:54):
have actually been treated for severe COVIDwho are in the hospital right now,
So some of our numbers are actuallymuch better than they ever were, while
at the same time we are seeingthis uptick. But I wouldn't call it
a wave, I wouldn't call ita surge. And I just looked at
the National Biobot Wastewater COVID data rightbefore getting on this call with you,
(03:17):
and the numbers are really going inthe right direction, so they're turning around
and going back down. So thiswas really a pretty minor bump in the
road. All of my appendages arecrossed right now, hoping that that stays
that way because you know, evenanecdotally, I know a lot of my
friends have come down with COVID overthe past couple of weeks, and you
know, a lot of them havesaid to me, we're not doctors for
(03:38):
what it's worth, like you,but they said, Wow, I really
thought it would be like September,October, November before we had to break
out the masks again and had todeal with this. It's sort of like
a summer COVID, not a surge. But you know what I'm saying,
So, do we expect this tohappen in the summertime or a little bit
later? Yeah, I mean,COVID has not yet settled into a seasonal
(04:00):
matter where it affects us mostly oronly in the fall and winter months.
You know, we've even seen somepretty big surges in the summer in the
South. And I think one ofthe problems right now is that we're still
kind of always tempted to attribute upsand downs of cases to human behavior,
(04:24):
and so we'll say, oh,well, it's going to be worse in
the winter because we're going to beinside more, but it's going to be
worse in the South in the summerbecause they're inside more because it's really hot
outside, and you know it's goingto be worse after holidays because of travel.
And in the end, I thinkit's really just going to go up
and down and up and down,probably driven more by the fact that when
(04:46):
you have more cases, you generatea bunch of immunity that lasts for some
number of months and then wanes.And as new variants emerge which evade that
immunity, that plays role as wellto some extent. Those things working together,
though, are unpredictable and I thinkare driven very little by human behavior.
(05:09):
I mean, look, influenza hasbeen around for a century plus at
this point. What we used toknow is the Spanish flu. It's still
every year we have to go getour flu shots. We still have to
get our COVID shots. We talkabout these variants, this latest one that's
been kind of moving in over thepast a few weeks. What do we
know about it so far? Well, there are two variants that are getting
a lot of attention right now.So one is EG five, which became
(05:34):
noteworthy because it reached predominance on anational level, except that it's not very
hard to reach predominance when you havelots and lots of variants, soup mishmash
of variants out there. It onlygot to seventeen percent, but that was
predominant, and it is not predominantyet in our region in the northeast.
(05:59):
So how much you know. Inthe past we often said, well,
it really a variant really needs toreach fifty percent predominance to have an impact
on cases, to increase cases,But who knows if that's true. I
mean, we don't know that,and so how much is that impacting this
current little uptick that we've been goingthrough. We also have our eye on
(06:20):
a sub variant that's an offshoot ofBA two, which we haven't really seen
since twenty since twenty twenty two,and it's of interest because it has a
lot of mutations compared to currently circulatingvariants, over thirty mutations, and it's
been detected in a few countries.It's it's started out being noted in Denmark,
(06:45):
Israel, and the US, andnow it's been detected in the UK
and a couple other places in smallnumbers so far, but it bears watching.
It wouldn't be expected to be thecause of any uptick that we see,
right now, but it's definitely somethingto keep an eye. And then
I think about the vaccines too,because in just a matter of weeks,
as far as I remember, we'resupposed to be getting a whole new crop
(07:06):
of vaccines. And when you're apharmaceutical company like Maderna or Fizer or whatever,
I would imagine it takes several monthsto go plan out for the fall
vaccine, you know, like theflu shot, and then you're working toward
one variant and then all of asudden another one comes up and knocks on
the door and says, hey,well, I'm going to be the fall
variant. Now. I mean that'sgoing to be really complicated for people who
(07:28):
are working on these vaccines to tryand keep us safe. Yeah, I
mean there are two issues there interms of predictions. You know, one
is that the variant that's going togo into the vaccine needs to be chosen
in June to be ready in September, and you know it's true of flu.
Two, you always know that whatcould be around October, November and
(07:48):
through the rest of the season.If you're that your fall shot is supposed
to last, you for is probablynot going to be What's predominant in June.
Sure. And then the other issuewith COVID NLI flu is that we're
still sort of banking on trying tomatch the flu campaign in that the CDC
is planning to recommend a fall COVIDbooster, except that, as I said,
(08:11):
we really don't have a seasonal patternthat we can rely on, and
it's not necessarily going to be thecase that COVID is going to be worst
in the fall and winter. Butit has been so complicated the way we've
done it up until now, withyou know, how many boosters am I
supposed to have, and when amI supposed to have it, and how
(08:33):
long between my last one and howlong between my last infection, And so
I do command the FDA and theCDC for trying to simplify it by matching
the approach to the approach that theytake with the flu. Everybody just get
a fall booster, Yeah, butit might not work as well. If
the flu campaign does well, youcould have all the vaccines you want,
but it doesn't matter if people don'tget them. And I was thinking,
(08:56):
right before I came to talk withyou, I took a look at how
many people got the boosters. Lastyear, I think it was less than
twenty percent of Americans actually went togo get the booster, and seniors obviously
the most high risk of people herein the United States, less than I
believe half of them got it.So why are people holding off on doing
this? Are we all just likesuper wiped with the situation and over it,
(09:18):
or like, is there conspiracy theoriesthat are really getting to people?
I mean, why do we Whyare people holding off on getting these boosters
that could really help us stay healthy. Well, some of it is simply
confusion, people not knowing that itwas time to get another booster just because
of all of the messages about okay, another one and it's time to get
(09:39):
another one. And so I thinkthat is a really important reason for this
simplification plan, so that the processthat people are very familiar with I get
an annual flusha we can apply tothe COVID vaccine. Of course, we
have all of the problems that we'vealways had with misinformation and disinformation and vaccine
(10:03):
and hesitancy, and then on topof that, we do have another unique
issue with the COVID vaccine, whichis that it is not actually totally clear
yet who stands to benefit the mostfrom repeated vaccination because the protection against severe
disease, hospitalization, and death isactually very strong and long lasting, even
(10:26):
for people that just got two orthree or two in an infection, whereas
the additional protection that you get fromthe booster, which helps to prevent even
mild infection, is really short lived. And so, you know, it
will remains to be seen with usexactly what the CDC will recommend next month
in terms of who should get thefall booster. Is that everyone over the
(10:48):
age of six months as they dida year ago, or will they follow
in the footsteps of many other countries, many European countries specifically, where they
actually recommend it for a targeted audienceand maybe will actually get better uptake in
the targeted audience when people really feellike, Okay, you know this is
more kind of well thought out interms of what the evidence really shows,
(11:13):
and then physicians can really get behindthat evidence and recommend it more strongly.
Yeah, focus it toward those patientsthat really could use it. And that's
actually a really good answer to thequestion I was going to ask you,
because I mean, we are hearingabout these new cases and people might think,
oh my god, like the vaccinesaren't out for another month or two,
and I want to make sure thatI'm safe and I want to get
my booster. But the booster that'sout right now isn't for these new vaccines
(11:37):
or for these new variants. Whatis your advice? Yeah, I mean
at this point, with the newbooster coming out in a matter of weeks
and being better targeted to more recentvariants, including being based on XBB,
which is still one of the predominantsub variants of omicrons circulating. Even though
cases are in in optic really casesare and hospitalizations still quite low compared to
(12:01):
most other times of the pandemic,just not compared to you know, a
month ago. I would say betterto wait and be able to get that
newer one, because typically when theCDC says you can go ahead and get
a new booster, they often sayas long as it's been some number of
months since your last one, andsay you would you would disqualify yourself from
(12:22):
the new one if you win,go on now. Yeah, that's true,
that makes sense. We don't wantto do that. So really,
another person I talked with recently wastalking about the masking situation. I know
that personally, I have been maskingmore in stores. You know, when
you run into the grocery store orCBS or whatever, or in crowded areas,
do you think that this is thetime to bring the masks back?
And if so, are we talkingjust a surgical mask or grab a kN
(12:46):
ninety five or something like that.So again I'll go back to that,
although cases have been on an upswing, overall, it's still quite low compared
to most other times throughout the pandemic. We are not in US surge or
even what I would call a wave. But anybody should feel that they can
put on a mask whenever they feellike they don't want to get COVID.
(13:09):
And and certainly, you know,the more high risk you are, the
more you stand to benefit from wearingthat mask. And then if you are
going to wear that mask to protectyourself, you should wear the highest quality
and most well fitting mask that youcan tolerate for long periods of time,
because of course it won't do anythingif you have to keep pulling it down
or taking it off because you can'tbreathe. And you know, there are
(13:31):
a lot of people that say theycan wear an in ninety five fitted in
ninety five all day long, andthen there are a lot of people that
can't, and you know there's areason for that. They are very uncomfortable.
So I would say yes, ifyou want to avoid COVID, either
because you are high risk, yourrisk of first, you have a wedding
(13:52):
coming up that you don't want tomess. There are many reasons why you
might want to put a mask on. Cases are higher than they where a
month ago. I respect that decision. I personally am not trying to outrun
COVID because I know I can't andI'm not putting one on to go to
the store. That makes sense.And I'm curious if you think that the
(14:13):
medical industry, you know, peoplein the medical field. Do you think
that the governor or do you thinkthat even the president is going to say,
look, medical professionals, even you'llhave to wear a mask throughout the
winter months and then during the springand summer you won't have to mask again,
especially because we have these high riskpeople who might be coming in.
What are your thoughts on that?Yeah, you know, in terms of
(14:35):
who makes those rules, I don'texpect that to come from the White House
or the governor. It could besomething driven by state departments of public health.
It is likely to be something that'sdecided at the local institutional level,
given that each healthcare facility and hospitalare so different, it is such a
(14:56):
controversial topic, and you know,the answer to that question is so tied
up in a number of different nuancedissues. How much a purely asymptomatic transmission
really happens between two people having ahealthcare type interaction. How much do those
(15:18):
masks disrupt effective safe communication between apatient and their healthcare provider, you know,
And how does one define those thresholdsfor reimplementing universal or targeted masking.
(15:39):
It's really really tricky, yeah itis. And nobody's really always going to
be happy. That's just the waythis whole pandemic has made that very clear.
Nobody's really going to be happy there. And look, you know,
at the end of the day,we're all just exhausted anyway. We are
all just done with COVID. Maybethere's somebody out there who's not done with
COVID, and if you are,like, kudos to you. But I
know, like ninety nine I'm pointnine nine percent of us, we're all
(16:02):
just over this but like you saidright in the beginning of our interview,
it's not like COVID is going away, So we have to think about this
stuff. It's it's not, butit is becoming one of many respiratory viruses,
respiratory pathogens that we have always livedwith, and we we do need
to slowly be putting it into thatcontext, and in many ways we already
(16:27):
have. There's no longer recommendation forbroad asymptomatic testing, there's no longer a
recommendation for quarantining after exposure, eventhough vaccinated people can get COVID after exposure.
We still, though, do fivedays of isolation, and at some
point that's going to go away.We don't do asymptomatic hospital admission testing or
(16:52):
pre procedure testing. So you know, there are things that we've that we've
changed to go to treat COVID morelike the respitray viruses. There are things
that we've still maintained that are uniqueto COVID, But slowly but surely,
it is becoming more and more likethe respiraty viruses that we are familiar with
and live with. In fact,the infection fatality rate, which is what
(17:15):
percentage of people that get COVID dieof COVID that crossed. The infection fatality
rate of flew over a year agofor all age groups. But there's still
more death from COVID because there's moreCOVID. So you know, there will
come a time when those numbers,you know, start to look like the
(17:37):
numbers that were unfortunately familiar with otherrespiratory viruses. We will never get rid
of any of them. They willalways cause disease. It's up to people
like me and scientists working in labsto keep it at the forefront of our
minds, even if other people wantto put it at the back of their
minds, to remember to you know, maintain capacity or surges, to maintain
(18:00):
capacity, to treat more people,to test more people, to vaccinate more
people as we need to, andto develop better strategies, mostly in terms
of prevention and treatment. Yeah,I mean in scientists like you have been
working and doctors really the medical communityfor the past three and a half years.
You have been working so hard tokeep all of us healthy and safe.
(18:22):
And I know it's been a reallycontroversial time at points, and you
know there's been a lot of vitriolatimes, but at the end of the
day, How is the medical industryrecovering from this? Because I know a
lot of people burned out, alot of physicians and nurses. They were
just like, forget this, We'redone, I can't do this anymore.
And it was a really traumatic timefor the first year and a half of
(18:42):
COVID, especially the height of thepandemic. How are you seeing that your
fellow doctors and your fellow clinicians arerecovering from all this. It was a
really traumatic time, and you know, there's already people rewriting history and saying
that what happened and what we liveddidn't happen. You know, we did
(19:03):
have patients who were critically ill inplaces that weren't designed for patients, who
were critically ill in places that weren'tdesigned for patients. We did have a
shortage of ventilators. We did haverefrigerated trucks, you know, outside the
hospital for bodies. Those things reallydid happen, and many healthcare workers were
(19:25):
quite traumatized by it. Many haveleft healthcare. The result is that we
are operating in some situations with lessstaff than we would like to do the
things that we would like to do. Although We maintain a very high level
of care everywhere, but it's tiring. We still are reeling from the fact
(19:47):
that we ran out of personal protectiveequipment, we ran out of supplies,
you know, the supply chain wasbroken, and we couldn't get some basic
things take care of patients during theheight of the first surge in particular,
and so there are people that arenever going to return to healthcare, while
(20:08):
other people have been invigorated, youknow, to do more and do better
and continue to help people and savelives and to really step up those preparations
for what might be coming next.Sure, and then I think about long
COVID too, because we're now aboutthree and a half, we're getting into
(20:29):
four years past the start of thepandemic. We're learning as we go when
it comes to COVID on all levels. Here, what have we been learning
lately about the effects of long COVID. Yeah, it's so hard because there's
there's something that really prevents effective researchon long COVID, and that is in
ability to define it. And ifyou can't define it in a reliable way
(20:55):
that identifies those who have it andleads out those who don't have it,
then it's so hard to study it. If you can't find that cohort of
people to do the tests on tofigure out what's causing it, then you
can't figure out what's causing it.And the problem is that some of the
symptoms are so they and common toso many different conditions. So if you
(21:18):
ask ten people in the room,if you if they have fatigue, there
many you know, nine of themmight say right, even though some of
them have never had COVID. Andin fact, a recent study from the
CDC last week showed that the rateof certain long term symptoms was actually the
same between people who had tested positiveand those who had had viral syndromes and
(21:41):
tested negative for COVID. And sopart of it is also that all respiratory
viruses can have post viral conditions associatedwith them. And again because there was
so much COVID, there was somuch long COVID or long respiratory virus.
But it may really be a respiraortyvirus phenomenon in general, which is also
(22:02):
worthy of study and figuring out howto prevent and treat. So here we
are we have some good news inthat long COVID is becoming less common as
our population becomes more immune. Wehave some good news in that many people
who had long term symptoms, whetherthe last or three months or a year
or two years, are finding thatthey do resolve. But we still have
(22:25):
a great need for research in thephase of this problem where that research is
really really difficult. Yeah, it'sgoing to be some time before we really
figure this thing out. But youknow, thankfully we have people like you
doing their best to keep us informedbecause I think that sometimes we just need
somebody in the know to say,Okay, this is scary, this is
kind of weird, but we're goingto be all right, you know.
(22:47):
And I'm heartened by the fact thatthere does really seem to be a dedication
from federal officials the White House tocontinue to put a great deal of funding
towards this issue. Yeah for sure. All right, Well, doctor Jerome,
this has been really helpful information aswe make our way into the fall,
and you know, FLU and RSBare going to do their thing,
but knowing about COVID on top ofit, this has been really great.
(23:10):
So thank you for your time andthank you for all your expertise for the
past few years as we've made ourway through COVID. Thanks for having me.
I have a safe and healthy weekend. Please join me again next week
for another edition of the show.I'm Nicole Davis from w BZ News Radio
on iHeartRadio.
From WBZ News Radio in Boston.This is New England Weekend where each week
we come together we talk about allthe topics important to you and the place
where you live. It's so goodto be back with you again this week.
I'm Nicole Davis. I've noticed overthe past few weeks, going through
social media like Facebook and Instagram andall that stuff, that more of my
acquaintances and friends have been coming downwith COVID. Some of them didn't even
(00:30):
realize they were sick, but kindof felt a bit off and took a
test and boom, they have COVID. Combine this with the headlines of a
new variant to potential surge in themaking. People are talking about it.
We're coming into the fall. There'sso much to take in. So I
said, all right, it istime to reach out to the experts,
because that's what we do here onthe show. Let's get the rundown of
what's actually happening here and what weshould focus on to stay safe and healthy.
(00:54):
So let's do it now. DoctorShia Drone is the chief infection control
officer over at Toughs Medicine. Shehas really been on top of this virus
and all the science behind it sincethe start of this whole pandemic. So
doctor Drona, I really appreciate yourtime. I've got to say, honestly,
the summer has been so nice becausethe wastewater levels were low and you
(01:15):
really didn't have to worry about maskingso much or any kind of spike.
But it really does seem like,yeah, that trend might be changing.
Well, yeah, so COVID isnever going away, and so this kind
of up and down shape of thecase curve is what we can expect for
the rest of time. Now,when cases go up, inevitably you will
(01:40):
always have some degree of hospitalizations goup. One of the reasons is that,
you know, even with the largeamount of community immunity that we have
where most people now get a mildinfection, they're always going to be those
highly vulnerable people, people who arefrail, medically complex, who even before
(02:05):
COVID, even a mild respiratory infectioncould tip them over the edge and they
needed hospitalization. And we have thisdata very clearly outlined in the state of
Massachusetts, and it's based on researchthat they did with collaborators at the BA.
What we know is that of thepeople who are hospitalized with a positive
COVID test, Only a small ishproportion of those are actually being treated for
(02:30):
severe COVID. So there's always goingto be those people in the hospital who
are there for a completely other reasontest positive because they had some mild symptoms,
are there for a completely other otherreason and have no symptoms but we're
tested, you know. And thenthere are those who are there due to
COVID, but it is in severeCOVID, and so you know, we
are seeing that number covering now betweenonly twenty five to thirty percent in Massachusetts
(02:54):
have actually been treated for severe COVIDwho are in the hospital right now,
So some of our numbers are actuallymuch better than they ever were, while
at the same time we are seeingthis uptick. But I wouldn't call it
a wave, I wouldn't call ita surge. And I just looked at
the National Biobot Wastewater COVID data rightbefore getting on this call with you,
(03:17):
and the numbers are really going inthe right direction, so they're turning around
and going back down. So thiswas really a pretty minor bump in the
road. All of my appendages arecrossed right now, hoping that that stays
that way because you know, evenanecdotally, I know a lot of my
friends have come down with COVID overthe past couple of weeks, and you
know, a lot of them havesaid to me, we're not doctors for
(03:38):
what it's worth, like you,but they said, Wow, I really
thought it would be like September,October, November before we had to break
out the masks again and had todeal with this. It's sort of like
a summer COVID, not a surge. But you know what I'm saying,
So, do we expect this tohappen in the summertime or a little bit
later? Yeah, I mean,COVID has not yet settled into a seasonal
(04:00):
matter where it affects us mostly oronly in the fall and winter months.
You know, we've even seen somepretty big surges in the summer in the
South. And I think one ofthe problems right now is that we're still
kind of always tempted to attribute upsand downs of cases to human behavior,
(04:24):
and so we'll say, oh,well, it's going to be worse in
the winter because we're going to beinside more, but it's going to be
worse in the South in the summerbecause they're inside more because it's really hot
outside, and you know it's goingto be worse after holidays because of travel.
And in the end, I thinkit's really just going to go up
and down and up and down,probably driven more by the fact that when
(04:46):
you have more cases, you generatea bunch of immunity that lasts for some
number of months and then wanes.And as new variants emerge which evade that
immunity, that plays role as wellto some extent. Those things working together,
though, are unpredictable and I thinkare driven very little by human behavior.
(05:09):
I mean, look, influenza hasbeen around for a century plus at
this point. What we used toknow is the Spanish flu. It's still
every year we have to go getour flu shots. We still have to
get our COVID shots. We talkabout these variants, this latest one that's
been kind of moving in over thepast a few weeks. What do we
know about it so far? Well, there are two variants that are getting
a lot of attention right now.So one is EG five, which became
(05:34):
noteworthy because it reached predominance on anational level, except that it's not very
hard to reach predominance when you havelots and lots of variants, soup mishmash
of variants out there. It onlygot to seventeen percent, but that was
predominant, and it is not predominantyet in our region in the northeast.
(05:59):
So how much you know. Inthe past we often said, well,
it really a variant really needs toreach fifty percent predominance to have an impact
on cases, to increase cases,But who knows if that's true. I
mean, we don't know that,and so how much is that impacting this
current little uptick that we've been goingthrough. We also have our eye on
(06:20):
a sub variant that's an offshoot ofBA two, which we haven't really seen
since twenty since twenty twenty two,and it's of interest because it has a
lot of mutations compared to currently circulatingvariants, over thirty mutations, and it's
been detected in a few countries.It's it's started out being noted in Denmark,
(06:45):
Israel, and the US, andnow it's been detected in the UK
and a couple other places in smallnumbers so far, but it bears watching.
It wouldn't be expected to be thecause of any uptick that we see,
right now, but it's definitely somethingto keep an eye. And then
I think about the vaccines too,because in just a matter of weeks,
as far as I remember, we'resupposed to be getting a whole new crop
(07:06):
of vaccines. And when you're apharmaceutical company like Maderna or Fizer or whatever,
I would imagine it takes several monthsto go plan out for the fall
vaccine, you know, like theflu shot, and then you're working toward
one variant and then all of asudden another one comes up and knocks on
the door and says, hey,well, I'm going to be the fall
variant. Now. I mean that'sgoing to be really complicated for people who
(07:28):
are working on these vaccines to tryand keep us safe. Yeah, I
mean there are two issues there interms of predictions. You know, one
is that the variant that's going togo into the vaccine needs to be chosen
in June to be ready in September, and you know it's true of flu.
Two, you always know that whatcould be around October, November and
(07:48):
through the rest of the season.If you're that your fall shot is supposed
to last, you for is probablynot going to be What's predominant in June.
Sure. And then the other issuewith COVID NLI flu is that we're
still sort of banking on trying tomatch the flu campaign in that the CDC
is planning to recommend a fall COVIDbooster, except that, as I said,
(08:11):
we really don't have a seasonal patternthat we can rely on, and
it's not necessarily going to be thecase that COVID is going to be worst
in the fall and winter. Butit has been so complicated the way we've
done it up until now, withyou know, how many boosters am I
supposed to have, and when amI supposed to have it, and how
(08:33):
long between my last one and howlong between my last infection, And so
I do command the FDA and theCDC for trying to simplify it by matching
the approach to the approach that theytake with the flu. Everybody just get
a fall booster, Yeah, butit might not work as well. If
the flu campaign does well, youcould have all the vaccines you want,
but it doesn't matter if people don'tget them. And I was thinking,
(08:56):
right before I came to talk withyou, I took a look at how
many people got the boosters. Lastyear, I think it was less than
twenty percent of Americans actually went togo get the booster, and seniors obviously
the most high risk of people herein the United States, less than I
believe half of them got it.So why are people holding off on doing
this? Are we all just likesuper wiped with the situation and over it,
(09:18):
or like, is there conspiracy theoriesthat are really getting to people?
I mean, why do we Whyare people holding off on getting these boosters
that could really help us stay healthy. Well, some of it is simply
confusion, people not knowing that itwas time to get another booster just because
of all of the messages about okay, another one and it's time to get
(09:39):
another one. And so I thinkthat is a really important reason for this
simplification plan, so that the processthat people are very familiar with I get
an annual flusha we can apply tothe COVID vaccine. Of course, we
have all of the problems that we'vealways had with misinformation and disinformation and vaccine
(10:03):
and hesitancy, and then on topof that, we do have another unique
issue with the COVID vaccine, whichis that it is not actually totally clear
yet who stands to benefit the mostfrom repeated vaccination because the protection against severe
disease, hospitalization, and death isactually very strong and long lasting, even
(10:26):
for people that just got two orthree or two in an infection, whereas
the additional protection that you get fromthe booster, which helps to prevent even
mild infection, is really short lived. And so, you know, it
will remains to be seen with usexactly what the CDC will recommend next month
in terms of who should get thefall booster. Is that everyone over the
(10:48):
age of six months as they dida year ago, or will they follow
in the footsteps of many other countries, many European countries specifically, where they
actually recommend it for a targeted audienceand maybe will actually get better uptake in
the targeted audience when people really feellike, Okay, you know this is
more kind of well thought out interms of what the evidence really shows,
(11:13):
and then physicians can really get behindthat evidence and recommend it more strongly.
Yeah, focus it toward those patientsthat really could use it. And that's
actually a really good answer to thequestion I was going to ask you,
because I mean, we are hearingabout these new cases and people might think,
oh my god, like the vaccinesaren't out for another month or two,
and I want to make sure thatI'm safe and I want to get
my booster. But the booster that'sout right now isn't for these new vaccines
(11:37):
or for these new variants. Whatis your advice? Yeah, I mean
at this point, with the newbooster coming out in a matter of weeks
and being better targeted to more recentvariants, including being based on XBB,
which is still one of the predominantsub variants of omicrons circulating. Even though
cases are in in optic really casesare and hospitalizations still quite low compared to
(12:01):
most other times of the pandemic,just not compared to you know, a
month ago. I would say betterto wait and be able to get that
newer one, because typically when theCDC says you can go ahead and get
a new booster, they often sayas long as it's been some number of
months since your last one, andsay you would you would disqualify yourself from
(12:22):
the new one if you win,go on now. Yeah, that's true,
that makes sense. We don't wantto do that. So really,
another person I talked with recently wastalking about the masking situation. I know
that personally, I have been maskingmore in stores. You know, when
you run into the grocery store orCBS or whatever, or in crowded areas,
do you think that this is thetime to bring the masks back?
And if so, are we talkingjust a surgical mask or grab a kN
(12:46):
ninety five or something like that.So again I'll go back to that,
although cases have been on an upswing, overall, it's still quite low compared
to most other times throughout the pandemic. We are not in US surge or
even what I would call a wave. But anybody should feel that they can
put on a mask whenever they feellike they don't want to get COVID.
(13:09):
And and certainly, you know,the more high risk you are, the
more you stand to benefit from wearingthat mask. And then if you are
going to wear that mask to protectyourself, you should wear the highest quality
and most well fitting mask that youcan tolerate for long periods of time,
because of course it won't do anythingif you have to keep pulling it down
or taking it off because you can'tbreathe. And you know, there are
(13:31):
a lot of people that say theycan wear an in ninety five fitted in
ninety five all day long, andthen there are a lot of people that
can't, and you know there's areason for that. They are very uncomfortable.
So I would say yes, ifyou want to avoid COVID, either
because you are high risk, yourrisk of first, you have a wedding
(13:52):
coming up that you don't want tomess. There are many reasons why you
might want to put a mask on. Cases are higher than they where a
month ago. I respect that decision. I personally am not trying to outrun
COVID because I know I can't andI'm not putting one on to go to
the store. That makes sense.And I'm curious if you think that the
(14:13):
medical industry, you know, peoplein the medical field. Do you think
that the governor or do you thinkthat even the president is going to say,
look, medical professionals, even you'llhave to wear a mask throughout the
winter months and then during the springand summer you won't have to mask again,
especially because we have these high riskpeople who might be coming in.
What are your thoughts on that?Yeah, you know, in terms of
(14:35):
who makes those rules, I don'texpect that to come from the White House
or the governor. It could besomething driven by state departments of public health.
It is likely to be something that'sdecided at the local institutional level,
given that each healthcare facility and hospitalare so different, it is such a
(14:56):
controversial topic, and you know,the answer to that question is so tied
up in a number of different nuancedissues. How much a purely asymptomatic transmission
really happens between two people having ahealthcare type interaction. How much do those
(15:18):
masks disrupt effective safe communication between apatient and their healthcare provider, you know,
And how does one define those thresholdsfor reimplementing universal or targeted masking.
(15:39):
It's really really tricky, yeah itis. And nobody's really always going to
be happy. That's just the waythis whole pandemic has made that very clear.
Nobody's really going to be happy there. And look, you know,
at the end of the day,we're all just exhausted anyway. We are
all just done with COVID. Maybethere's somebody out there who's not done with
COVID, and if you are,like, kudos to you. But I
know, like ninety nine I'm pointnine nine percent of us, we're all
(16:02):
just over this but like you saidright in the beginning of our interview,
it's not like COVID is going away, So we have to think about this
stuff. It's it's not, butit is becoming one of many respiratory viruses,
respiratory pathogens that we have always livedwith, and we we do need
to slowly be putting it into thatcontext, and in many ways we already
(16:27):
have. There's no longer recommendation forbroad asymptomatic testing, there's no longer a
recommendation for quarantining after exposure, eventhough vaccinated people can get COVID after exposure.
We still, though, do fivedays of isolation, and at some
point that's going to go away.We don't do asymptomatic hospital admission testing or
(16:52):
pre procedure testing. So you know, there are things that we've that we've
changed to go to treat COVID morelike the respitray viruses. There are things
that we've still maintained that are uniqueto COVID, But slowly but surely,
it is becoming more and more likethe respiraty viruses that we are familiar with
and live with. In fact,the infection fatality rate, which is what
(17:15):
percentage of people that get COVID dieof COVID that crossed. The infection fatality
rate of flew over a year agofor all age groups. But there's still
more death from COVID because there's moreCOVID. So you know, there will
come a time when those numbers,you know, start to look like the
(17:37):
numbers that were unfortunately familiar with otherrespiratory viruses. We will never get rid
of any of them. They willalways cause disease. It's up to people
like me and scientists working in labsto keep it at the forefront of our
minds, even if other people wantto put it at the back of their
minds, to remember to you know, maintain capacity or surges, to maintain
(18:00):
capacity, to treat more people,to test more people, to vaccinate more
people as we need to, andto develop better strategies, mostly in terms
of prevention and treatment. Yeah,I mean in scientists like you have been
working and doctors really the medical communityfor the past three and a half years.
You have been working so hard tokeep all of us healthy and safe.
(18:22):
And I know it's been a reallycontroversial time at points, and you
know there's been a lot of vitriolatimes, but at the end of the
day, How is the medical industryrecovering from this? Because I know a
lot of people burned out, alot of physicians and nurses. They were
just like, forget this, We'redone, I can't do this anymore.
And it was a really traumatic timefor the first year and a half of
(18:42):
COVID, especially the height of thepandemic. How are you seeing that your
fellow doctors and your fellow clinicians arerecovering from all this. It was a
really traumatic time, and you know, there's already people rewriting history and saying
that what happened and what we liveddidn't happen. You know, we did
(19:03):
have patients who were critically ill inplaces that weren't designed for patients, who
were critically ill in places that weren'tdesigned for patients. We did have a
shortage of ventilators. We did haverefrigerated trucks, you know, outside the
hospital for bodies. Those things reallydid happen, and many healthcare workers were
(19:25):
quite traumatized by it. Many haveleft healthcare. The result is that we
are operating in some situations with lessstaff than we would like to do the
things that we would like to do. Although We maintain a very high level
of care everywhere, but it's tiring. We still are reeling from the fact
(19:47):
that we ran out of personal protectiveequipment, we ran out of supplies,
you know, the supply chain wasbroken, and we couldn't get some basic
things take care of patients during theheight of the first surge in particular,
and so there are people that arenever going to return to healthcare, while
(20:08):
other people have been invigorated, youknow, to do more and do better
and continue to help people and savelives and to really step up those preparations
for what might be coming next.Sure, and then I think about long
COVID too, because we're now aboutthree and a half, we're getting into
(20:29):
four years past the start of thepandemic. We're learning as we go when
it comes to COVID on all levels. Here, what have we been learning
lately about the effects of long COVID. Yeah, it's so hard because there's
there's something that really prevents effective researchon long COVID, and that is in
ability to define it. And ifyou can't define it in a reliable way
(20:55):
that identifies those who have it andleads out those who don't have it,
then it's so hard to study it. If you can't find that cohort of
people to do the tests on tofigure out what's causing it, then you
can't figure out what's causing it.And the problem is that some of the
symptoms are so they and common toso many different conditions. So if you
(21:18):
ask ten people in the room,if you if they have fatigue, there
many you know, nine of themmight say right, even though some of
them have never had COVID. Andin fact, a recent study from the
CDC last week showed that the rateof certain long term symptoms was actually the
same between people who had tested positiveand those who had had viral syndromes and
(21:41):
tested negative for COVID. And sopart of it is also that all respiratory
viruses can have post viral conditions associatedwith them. And again because there was
so much COVID, there was somuch long COVID or long respiratory virus.
But it may really be a respiraortyvirus phenomenon in general, which is also
(22:02):
worthy of study and figuring out howto prevent and treat. So here we
are we have some good news inthat long COVID is becoming less common as
our population becomes more immune. Wehave some good news in that many people
who had long term symptoms, whetherthe last or three months or a year
or two years, are finding thatthey do resolve. But we still have
(22:25):
a great need for research in thephase of this problem where that research is
really really difficult. Yeah, it'sgoing to be some time before we really
figure this thing out. But youknow, thankfully we have people like you
doing their best to keep us informedbecause I think that sometimes we just need
somebody in the know to say,Okay, this is scary, this is
kind of weird, but we're goingto be all right, you know.
(22:47):
And I'm heartened by the fact thatthere does really seem to be a dedication
from federal officials the White House tocontinue to put a great deal of funding
towards this issue. Yeah for sure. All right, Well, doctor Jerome,
this has been really helpful information aswe make our way into the fall,
and you know, FLU and RSBare going to do their thing,
but knowing about COVID on top ofit, this has been really great.
(23:10):
So thank you for your time andthank you for all your expertise for the
past few years as we've made ourway through COVID. Thanks for having me.
I have a safe and healthy weekend. Please join me again next week
for another edition of the show.I'm Nicole Davis from w BZ News Radio
on iHeartRadio.
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