Consider This from NPR - New Shots and a New Era for COVID

Episode Date: September 12, 2023

Right now it seems like people all around us are testing positive for COVID. But for the most part, they are not getting seriously ill. The Food and Drug Administration just approved a new booster. And on Tuesday advisers to the CDC recommended it for everyone six months and older.With a new variant and a new booster, how should we think about the pandemic in this moment? Email us at [e-mail] more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

This message comes from Indiana University. Indiana University performs breakthrough research every year, making discoveries that improve human health, combat climate change, and move society forward. More at iu.edu forward. As President Joe Biden was preparing for his trip to a summit in India last week, a speed bump popped up that a lot of families have had to deal with lately. I can tell you that the First lady is experiencing mild symptoms and will remain in Delaware for the week. First Lady Jill Biden tested positive for COVID-19. And like many of us, President Biden faced the question, should he cancel his own plans

and isolate? Unlike the rest of us, he had a press secretary on hand to answer. Here was a reporter's exchange with Corrine Jean-Pierre after the first lady's diagnosis. The person of Biden does test positive for COVID in the coming days. We can assume he's not going to travel to India. I'm just not going to get a tie to the hookles. I'm really not. There's no updates to his schedule. That's where we are right now. He tested negative last night. He tested negative today. That's what matters. Right now, it seems like people all around us are testing positive for COVID. But for the most part, they're not getting seriously ill. The Food and Drug Administration just approved a new booster.

And on Tuesday, advisers to the CDC recommended it for everyone six months and older. Many doctors say the new booster offers important protection, like former White House COVID-19 response coordinator Ashish Jha. The data so far suggests that the new COVID vaccine should be really quite effective against even the new emerging variants that we have seen come up in the last few weeks. So I'm actually quite optimistic this new vaccine is going to be protective. And he says that even goes for people who think they might not need it. For younger, healthy people, I say, look, getting the vaccine will reduce your risk of being out of school or being out of work for a while. It reduces how much you transmit it. There are a lot of good reasons to get your annual COVID shot.

I understand that, you know, it's been a long pandemic and people want to move on. The best way to move on is just to get your annual COVID shot and know that that's going to provide a good amount of protection. Consider this. With a new variant and a new booster, how should we think about the pandemic in this moment? From NPR, I'm Ari Shapiro. It's Tuesday, September 12th. This message comes from Indiana University. Indiana University is committed to moving the world forward, working to tackle some of society's biggest challenges. IU makes bold investments in the future of bioscience and cybersecurity, cultivates visionary work in the arts and humanities, and prepares students to become global citizens by teaching more languages than any other university in the country.

Indiana University, nine campuses, one purpose. Creating tomorrow today. More at iu.edu. It's Consider This from NPR. Through the ups and downs of this pandemic, we've turned to epidemiologists and public health professionals to help us understand where we are in a given moment. Like in fall of 2021, when Americans were wondering whether it was safe to go to family gatherings when not everybody was vaccinated. I love us to be in a place where COVID was receded as a part of our lives and we were back to 2019. But I think it's increasingly clear that that's not likely to happen. That was Dr. Robert Wachter, professor and chair of the Department of Medicine at the University of California, San Francisco. This is going to be with us for the foreseeable future. And we're going to be on this roller coaster where cases go up and then they come down and then they go up again. Well, now two years

later, the cases seem to be going up again. And with a new booster just becoming available, we got back in touch with Dr. Wachter to ask how he thinks we should be approaching the pandemic right now. Worse than we were a month or two and substantially better than we've been at most times in the last three or four years. So this is definitely an uptick. The virus is going to come and go and probably will do that forever. There's more virus around now than there was a couple of months ago, but it still is nowhere near the kinds of surges that slammed us in the past few years. Just anecdotally, for me, it seems like everyone from family members to co-workers is getting a diagnosis and not being debilitated by it. Is that what the science bears out to? Yeah, I got my first case of COVID two

months ago. That's a pretty common story. The science says that the fact that we essentially have 100% population immunity, you cannot find anyone now who has neither been vaccinated nor been infected. And in most people, they've gotten both. So the virus doesn't find any humans anymore that have zero immunity. That's obviously very different than 2020. And what that means is that when it strikes humans, and it still is giving a lot of people COVID, the cases tend to be substantially milder than they were before. There are still people dying of COVID, but the chances of getting super sick, going to the hospital and dying are much, much lower than

they were a couple of years ago. And so now there's this updated booster. Doctors have been saying for years that getting a COVID vaccine might become an annual routine like a flu shot. Is that where we've landed at this point? I think so. It's complicated because it's a little bit of four-dimensional chess that you've got to play. The boosters do four different things

and the relevance of those things differ depending on who you are and how old you are and whether you have other medical illnesses. The first thing they do quite reliably is lower the chances you're going to get very sick, go to the hospital and die. And that is most relevant to people who are at risk of those things. And so a 75-year-old is, a 50-year-old who's got a couple of medical comorbidities is, a 25-year-old healthy person, has a very low risk of getting very sick if they get COVID. So the benefit of vaccine there is small for a young healthy person

and much larger the older and sicker you are. But there are other benefits that, to me, tilt the scales to favoring the vaccine and the booster in pretty much everybody. It lowers the chances of getting much everybody. It lowers the chances of getting long COVID. It lowers the chances of getting COVID, but only for a couple of months, but that's meaningful. And if you do get COVID, it reduces the amount of time that you're sick, not by a ton, but by a little bit. So when you factor all of that together, to me, it's an easy decision. So I think about this as a doctor and the benefits versus the

risks of everything we do, like treat high blood pressure, cholesterol. It's an easy decision for an older person or someone with medical comorbidities to get the booster because they are at significant risk of a severe case. And to me, when I talk to my 30-ish year old healthy kids, I recommend they get the booster. I don't think it's a slam dunk for them, but because it lowers the chance of getting long COVID, because it lowers the chance of getting long COVID, because it lowers the chance of getting COVID for a short period of time, and because it will shorten the illness by a little bit, and I consider it really quite, quite safe,

I think the benefits outweigh the risks in pretty much everybody. So it sounds like you're saying everybody ought to get this. It's a good idea. But for certain people, there's an urgency and an importance that might not be true of the general population. I think that's fair. Urgency is a tough word because then you get into the question of timing. And even someone who should get it might actually benefit by waiting a little bit. So for example, I'm over 65. I should get it, but I had COVID two months ago. So the immunity that I got from my infection is still lasting me,

and I will probably not get my COVID booster for another month. So there's some timing issues to play out there. But yes, I think that's a fair way of thinking about it. The higher the risk that you have of a severe case and of dying of COVID, the more important it is for you to get boosted. The younger and healthier you are,

the more it becomes a little bit of a toss-up. But to me, I lean toward the benefits outweighing the risks in pretty much everybody. Do you apply the same kind of risk protection calculus to some of the practices that were so common a couple years ago, from mask wearing to social distancing to outdoor dining? Or is this kind of like cold and flu season where you go out in public, you take your chances, and you live your life? I think it is that whole risk assessment. And the risk assessment is tricky. It's not just the risk to you, but are you living with other vulnerable people? And that has to get factored in too. And then how much COVID is there in the environment? So it's very tricky to sort this out. But yeah, I think that's a fair

way of thinking about it. The same, I think that's a fair way of thinking about it. The same kind of thinking that goes into the importance of getting boosted also goes into your thinking about how careful to be. So if you're an older person who's vulnerable and there's a spike in COVID cases as there is now, it is a time where you should be thinking about masking, thinking about foregoing indoor dining, thinking about taking Paxilivit if you get COVID. Those are things you might say if I'm healthy and 25 years old, even though there's some more COVID around than there was a couple of months ago, I'm not going to be quite as careful. So this kind of drives people a little bit crazy because it really is such a multidimensional and challenging decision.

You know, as I was getting ready for this interview, I wanted to find out if the data bore out my personal experience of everybody's getting COVID these days. And I was reminded the CDC no longer tracks the number of cases. Is that a problem that we don't actually know how many people are getting COVID right now? It is, but it's not the biggest problem that we have. It does make it much more challenging than it was a year ago to figure out the state of COVID. And certainly if you're trying to quantify it, it's become impossible. In the old, old days, by which I mean a year or two ago, you know, you could look at the test positivity rates or the prevalence of COVID in your community. I could look at my own hospital and we tested everybody.

And so you could look at the number of people who felt fine, who were testing positive for COVID and have a pretty good assessment of how much COVID there was. Today, you kind of have to triangulate it from wastewater data, from hospitalizations of people with COVID data. Test positivity rate isn't that helpful, but the trends are helpful. And the fact is today, all of those signals are pointing upwards. And so what we know is there's more COVID now than there was a month ago. Exactly how much more, exactly how many people are getting it, we don't know. But I think for the purposes of most folks' day-to-day decision-making, I don't know that you need that much precision. You need to know that a couple of months ago,

it was really, there was very little COVID in the environment. And today, it's probably two or three times what it was. And does that cross your threshold to going back to masking? Does that cross your threshold to eating outdoors versus indoors? That sort of personal preference meets your own personal risk factors. Dr. Robert Wachter, professor and chair of the Department of Medicine at UCSF. Thanks a lot. My pleasure. Thank you. It's Consider This from NPR.

I'm Ari Shapiro.