Consider This from NPR - Booster Shots Coming Soon As Delta Overwhelms Some Hospitals

Episode Date: August 17, 2021

Hospitals like the University of Mississippi Medical Center are overwhelmed. Dr. LouAnn Woodward, vice chancellor of the Jackson hospital, told NPR they are nearly out of beds — and treating patients in hallways. Meanwhile, Biden administration health officials are coalescing around a plan that would advise most Americans to get a COVID-19 booster shot eight months after their last dose. A booster is already recommended for immunocompromised people. Here are six things to know if you're immunocompromised and are considering a third shot.If a booster is recommended for most Americans, that means millions of people may soon receive a third shot, while many others have yet to receive a single one. But there are still additional public health measures that could work to help stem the delta surge. NPR's Selena Simmons-Duffin reports.In participating regions, you'll also hear a local news segment that will help you make sense of what's going on in your community.Email us at [e-mail] more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

We've known for a while booster shots are coming. No vaccine, at least not within this category, is going to have an indefinite amount of protection. Dr. Anthony Fauci on the Today Show last week was asked whether it's inevitable that all Americans considered fully vaccinated will eventually need a booster. In answer to your question, it's right. Inevitably, there will be a time when we'll have to give boosts. What we're doing literally on a weekly and monthly basis is following cohorts of patients to determine if, when, and whom should get it. Now, that determination is apparently close. This week, NPR confirmed reports that Biden administration health officials are coalescing around a plan that would advise booster shots for most fully vaccinated Americans eight months after their last dose. The White House says it will announce more details Wednesday

afternoon. Boosters, a source told NPR, could be approved for distribution as soon as next month, and that means that the U.S. could soon be in a situation where many Americans have received three shots and millions more have received none at all. And right now, it's people in the second group who are pushing hospitals in some places to the brink. We're talking about Lakeside Medical Center in Belle Glade. They're at critical levels right now trying to figure out what to do with their extra COVID-19 patients. This week in Florida, a Palm Beach County hospital ran out of ICU beds. And no other hospital in Palm Beach County would take on the extra ICU patients. In Austin, Texas, there was a single ICU bed at a trauma center serving more than 2 million people.

There's one ICU bed available in the Austin trauma service area. And in Jackson, Mississippi, the state's only level one trauma center is racing to open a second field hospital in a parking garage. To relieve pressure on UMC, which has been overwhelmed with a flood of COVID-19 patients. The vice chancellor of that medical center, Luann Woodward, told NPR almost all of its sickest patients are unvaccinated. They're boarding patients in the emergency departments, patients are in the hallways, patients receiving treatments in waiting rooms. It is quite a dire situation for us. Consider this. Booster shots will not help in regions of the country where many people so far have not been vaccinated at all. So what more can be done? Public health experts say there are options. We'll hear what they are next. From NPR, I today or visit wise.com. T's and C's apply.

Over this last year and a half, the world's been through a lot. So on this season of the StoryCorps podcast, we'll hear stories reminding us that even when times are hard, we can still begin again. Listen to our new season wherever you get your podcasts. It's Consider This from NPR. Booster shots. While they may soon be advised for most everyone who's been fully vaccinated, last week, federal health agencies officially recommended them for people with weakened immune systems. Those are people who've been receiving certain cancer treatments, maybe had an organ transplant or have other conditions or take drugs that suppress the immune system.

It's not that the vaccine is losing effectiveness in those people faster. It's that they never really got a very good immune response to begin with. And I think that's the thing that people need to understand to avoid confusion about the durability of response. Anthony Fauci spoke to NPR this past week as the recommendation was being finalized. In these individuals whose immune system is compromised, they never really got up high enough to feel that they were protected. That's the reason why it is so imminent to make sure that we get them boosted so that they would be in a protected zone. Immunocompromised individuals make up almost 3% of adults in the U.S., some 7 million people.

And they may make up an outsized number of severe breakthrough infections. One U.S. study suggested that as many as 44% of vaccinated people who wind up in the hospital with COVID-19 are immunocompromised. But those breakthrough cases are a tiny fraction of total hospitalizations, which are up 20 percent in the last week. The vast majority of those are unvaccinated people, and many are clustered in regions of the country with few other public health measures. Lockdowns are wrong during the course of a pandemic. In Texas, Republican Governor Greg Abbott has moved to ban mask mandates in schools and promised no more government lockdowns or mandates. Everyone already knows what to do. Everyone can voluntarily implement

the mandates that are safest for them, for their families, and for their businesses. In recent days, Abbott has also solicited help from out-of-state health care workers and asked hospitals to delay non-emergency surgeries. Meanwhile, in Florida, We are seeing people testing positive in higher numbers than I think most people anticipated. Republican Governor Ron DeSantis was promoting new availability of monoclonal antibody treatment last week. At the same time, he's been fighting school districts over mask mandates and threatened to withhold salaries of officials who implement them. The governor's political team has also been selling beer koozies and t-shirts with the slogan, Don't Fauci My Florida.

In recent weeks, Florida and Texas combined have accounted for more than 40 percent of new hospitalizations in the country. It's airborne, it's aerosolized, and so we just have to understand that when that's happening, these waves are something that you have to deal with, prevent it with early treatment. But early treatment has not slowed things down in Florida or in Arkansas. For the fifth week in a row, the state has a record number of people in the hospital. Earlier this month, Governor Asa Hutchinson said he regretted signing a bill this year that banned state and local mask mandates. Our cases were at a low point. Everything has changed now. And yes, in hindsight, I wish that had not become law. But it is the law.

Hutchinson is asking his fellow Republicans in the state legislature to undo that law. And there's no indication they will. In fact, they're talking about trying to ban companies in Arkansas from mandating vaccines for employees. Recently, two big firms headquartered there, Tyson Foods and Walmart, did just that. So aside from increasing the vaccination rate and eventually giving booster shots, what more could states struggling through the Delta surge do? Well, turns out plenty. NPR's Selina Simmons-Duffin has been following a group of scientists trying to figure out the perfect recipe for effective public health measures. If you've ever felt confused over the course of the pandemic, trying to keep track of which restrictions were on at a given moment in your community, like still no indoor dining, right?

Masks at the grocery store? No? Then consider this feat. A team of researchers at the University of Pittsburgh and Carnegie Mellon University created a database of every statewide restriction and every time restrictions were lifted in all 50 states plus D.C. since last March. I mean, truly, this was a labor of love. Seema Lakdawalla was one of the project leads. Usually, she studies influenza transmission at the University of Pittsburgh, like lab work.

We're mostly an experimental lab where we do a lot of molecular virology and animal model-based transmission studies. But when she and her staff were home like everyone else in March of 2020, they got curious about what impact these restrictions would have on transmission of the virus. They started scouring state websites for restriction announcements. So we came up with a rubric to say, well, how strong were the interventions based on multiple categories? Masking, gathering size bans, stay-at-home orders, closing non-essential businesses, restaurant and bar closures, restrictions. Then she decided they needed help figuring out what it all meant. So she phoned a friend.

My name is Rebecca Nugent. I am the head of the Department of Statistics and Data Science at Carnegie Mellon University. With the full team assembled, one of the ways they crunched the numbers was to graph out for each state how cases and deaths grew, those curves that show peaks during a surge, and then mark when restrictions were put in place or lifted to show whether restrictions helped to flatten the curves. It turned out... They work. They have an impact. They are contributing to the control of the spread. Granted, timing is really important. The researchers found it was better to put restrictions in early, before a surge had really had a chance to heat up, and then keep them in place for a while. It took about four weeks or so before they started to pay

off. Laktawala explains they also found there seemed to be a sweet spot. When states had several kinds of moderate restrictions in place for long enough, that worked particularly well. Some level of masking, some level of restaurant or bar restrictions, and some level of gathering size bans. Those we think are the critical three. What they couldn't figure out was whether some restrictions are better than others. Like, are restaurant closures more important than limiting the size of gatherings? Because a lot of times the restrictions went into place as a package, so they couldn't tease apart the impact of one versus another.

Melissa McPheeters, an epidemiologist at RTI International who wasn't involved in the research, calls the database this team made a terrific resource, especially since even though there are now highly effective vaccines available, at the moment… We don't have enough people vaccinated and we don't have enough people who can be vaccinated. Think about all the children who aren't eligible yet. And so we need to do combinations of things. That might look like getting vaccinated and masking, keeping gatherings small, good hand washing, good ventilation, and the rest. Because even though Delta is highly contagious and taking off across the country, all of these tools to flatten the curve do still work. That's NPR's Selina Simmons-Duffin. By the way, earlier we spoke about boosters for people with weakened immune systems. And if that's you or someone you know, NPR has a list of things to think about for immunocompromised people considering a booster shot. You can find

a link in our episode notes. It's Consider This from NPR. I'm Adi Cornish.