Consider This from NPR - CDC Guidelines Change As Omicron Cases Cause Disruptions

Episode Date: December 28, 2021

The Centers for Disease Control and Prevention announced this week that people who test positive for COVID-19 but remain asymptotic can cut their quarantine time in half, from ten days to five. This shift comes in part due to major disruptions causes by rising Omicron cases, with hospitals and airlines in particular struggling to stay fully staffed. This moment in the pandemic feels a little like living in a contradiction. Cases are rising, yet guidance on certain restrictions is loosening. Hospitals are filling up, yet many infections are mild. Prof. Gaurav Suri, computational neuroscientist at San Francisco State, and Dr. Leana Wen, emergency physician and public health professor at George Washington University, discuss how to live with the threat of Omicron right now. 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]. Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

One number we've gotten used to seeing during the pandemic is 10, as in 10 days, the minimum time someone should quarantine after they test positive. Now that's changed. If you're infected and without symptoms, then you have five days of isolation and then you could go back out into society with a mask worn consistently. That's Dr. Anthony Fauci on MSNBC describing new guidance from the Centers for Disease Control and Prevention, guidance which cuts the length of isolation time for asymptomatic cases in half. The chances of virus being shedded in the first five days is much greater than in the second five days following infection. And while Fauci says science supports the shift, the motives behind it also have to do with the economy. We don't want to get into a situation where so many people are out from their jobs,

many of which are essential jobs to keep society running smoothly. So the decision on the part of the CDC is a really prudent and good decision. I'm really happy to see the CDC make this change. Dr. Ashish Jha, dean of Brown University's School of Public Health. Imagine the person who feels totally well, hourly wage worker, who misses getting paid if they don't go to work. Asking them to test themselves and then isolate for 10 days when they feel well is a huge burden. Jha told NPR that we've known for a while people are most contagious the few days before and after symptoms appear. He says shortening the time of isolation for people who feel well might actually mean more people will follow CDC guidance.

My hope is that this will actually create an incentive for more people to get tested and more people to follow isolation guidelines because it's easier to do and it's more consistent with the science. This guidance comes as rising Omicron cases are straining hospitals and leading to thousands of canceled flights. And Dr. Jha says he is not bothered if that was in part the reason for a decision like this. Functional society, a functional health system is part of public health. Consider this. This moment of the pandemic feels a little like we're living a contradiction. Cases are rising, yet guidance on certain restrictions is loosening. Hospitals are packed, yet many infections are mild. Coming up, we'll talk about how to navigate it all.

From NPR, I'm Mary Louise Kelly. It's Tuesday, December 28th. This message comes from WISE, the app for doing things in other currencies. Send, spend, or receive money internationally, and always get the real-time mid-market exchange rate with no hidden fees. Download the WISE app today, or visit WISE.com. T's and C's apply. It's Consider This from NPR. Now, here's a take on the Omicron variant that may surprise you. First, keep in mind, health officials still don't know as much as they would like to about severity and spread. But based on what he's seen so far, Dr. David Nabarro of the World Health Organization says, compared to Delta, Omicron appears to be the lesser of two evils. Absolutely. You know, when these kinds of pandemics are evolving, the general pattern that is expected is that the virus becomes more transmissible and less serious over time. And Nabarro told NPR that according to the health officials he consults,

Omicron is a step on the journey towards humanity being able to coexist with this virus. And that in the end, the COVID should become not more serious than the common cold. Now, we have to admit, predictions about what happens next with COVID have not had a stellar track record over the last two years. But Naboru is hopeful the pandemic could cease to become a serious issue in many parts of the world by the end of 2022. We're not at the end, but we are moving in that direction. In some countries, that will be reached before others. And it will be helped, for example, by having vaccines, which make people much less likely to become seriously ill. And so I think we're moving in that direction.

Okay, let's return now to the present, where the Omicron variant is a very real threat that we are all living with. But because the situation seems to be changing so fast, it's hard to figure out which activities are safe on a given day. So we wanted to check back in with Dr. Lina Nguyen and Gaurav Suri. Dr. Nguyen is an emergency physician, and Suri studies how humans make decisions at San Francisco State University. Welcome back. Great to join you. Dr. Nguyen, let's start by reintroducing a strategy you advocated when you were on the show a year ago. This was a strategy for making decisions that you called a risk budget. The idea

of being what? Well, the idea is that we should think about risk as being cumulative. And so if a lot of people may have this misunderstanding that if they're doing one thing that's risky when it comes to COVID, that they might as well let down their guard and do everything else. When actually, it's quite the opposite that when you choose one thing that's of high value to you, perhaps you should actually be reducing the other aspects of risk in your life. Gaurav, Siri, let's turn to how our brains are trying to make sense of it all. I mean,

I am talking to you today, vaccinated, boosted in such a better place than a year ago. And yet we're all being asked to mask up again and to test again. How are our brains processing what risks to take? Right. One of the biggest misconceptions about decision making is that we pursue value exclusively. Value and rationality and utility maximizing is one component of our decisions, but emotions, habits certainly enter into the picture. I think it's good to acknowledge the exhaustion that people, many people are feeling and to try to incorporate that and not force this about, oh, this makes sense. And of course, I'm going to do this because that usually leads to decisions that don't hold over time. Which sounds like a really reasonable approach.

But let's just acknowledge the exhaustion that we all feel at this point. I mean, without wanting to depress you two, I went back and listened to our conversation on this program a year ago. Gaurav Suri, you were talking about how important it was that we protect ourselves over, and I quote, these next three or four high-risk months. And Dr. Lina Nguyen, you said, quote, we just have to get through this winter because a vaccine is not far on the horizon. That was November 2020, and here we are. But I want to say one thing, that we are not at the same exact place. We're in a better place. The risks are less than they were before. The new challenge is to acknowledge the risk that exists, acknowledge the exhaustion that

we have, and then adjust to it so that we make it through this coming risky period. I certainly agree with everything that Professor Suri just said. We are at a vastly different place than we were last year at this time. And in fact, I believe that the end of the pandemic is in sight. And by the end of the pandemic, I don't mean that COVID-19 is going to go away. All of us, I think, in science and public health have accepted that it's going to be with us for the foreseeable future, but rather that we're able to turn COVID from an existential emergency into something that we're able to cope with and to live

with for the most part. I do think that the majority of people who are vaccinated, boosted, and generally healthy can make the decision to move on with their lives. And those people can choose to engage in all the things that they did before, with one exception, which is before they see their vulnerable relatives or friends. They might want to reduce their risk, essentially quarantine and then get tested right before seeing that vulnerable person. But I think that a lot of people can go back to life as before. Okay, a number of friends have put this next question to me. So I want to put it to the two of you. And these are by the way, these are vaccinated, boosting, mask wearing,

trying to do the right thing friends who say, I just want to get it. I want to get it over with. If Omicron is so contagious that this is practically inevitable anyway, why not just get sick, get the immunity, would be a bonus, and be done with it? To which each of you say, what? Professor Shuri. Well, I think that exposing oneself to the true consequences of the disease might be dissuading from this notion of I want to get it. I know that this strain is less harmful, less likely to result in very serious illness, particularly for the vaccinated. But it is not consequence free. Dr. Nguyen, how do you think about this, this idea of

if I'm going to get sick, I want to just be done with it? I understand where this is coming from, because people are so exhausted. That said, of course, I agree with Professor Serving that just getting COVID and exposing yourself to it, basically having a chickenpox party, if you will, that's not the best thing that we should be doing. There are real consequences. There's the possibility of long COVID. Also, you have the potential of spreading it to others. In addition, we do have health care systems that are really strained right now, and I'm sure none of us want to contribute to that. How are you two both staying sane in this moment that A feels endless and B feels ever shifting and precarious?

I think it's really hard for me and for my family with our two little kids. The timeline keeps on getting pushed back. Now it looks like for children under the age of five that it may be the second quarter of 2022 that we're able to get a vaccine available for them. And so it's hard. My husband's family is all in South Africa. My husband's mother hasn't met the baby,

my baby who is now 20 months old. And so I'm looking to the future and really believing that 2022 is going to be a much better year because we now have all the science. The science, at least, is in place. Now we just have to ramp up testing, ramp up oral treatments, get vaccines. I mean, we have to do certain things. But at the same time, I believe the science is there. And I do think that 2022 is going to be much better. Do you want to react to that, Gaurav Suri?

I, of course, agree with what Dr. Wen said. And my own family faces many of the same restrictions she alluded to. One added component for me is the emotional aspect of it. So our emotions of exhaustion, disbelief, dismay are real, just as the virus is real. And the virus does not care about our emotions, but we care about our emotions. Acknowledging these, accepting these, and saying, this is the reality of where we are. What do I do? How do I make it forward in this reality while acknowledging how difficult it's been and what needs to be done? Having these internal conversations, practicing acceptance, practicing looking at how I can make my way forward, being internally aware of everything we're feeling,

I think is a useful thing to do. That was Gaurav Suri, computational neuroscientist at San Francisco State, and ER doctor and public health professor at George Washington University, Lena Nguyen. You're listening to Consider This from NPR. I'm Mary Louise Kelly.