Consider This from NPR - New White House COVID Czar: 'Less Fear Is A Good Thing'

Episode Date: June 6, 2022

In the third summer of the pandemic, White House COVID response coordinator Ashish Jha tells NPR it's a good thing that many people feel less afraid of getting sick. But he says the Biden administration still has work to do. One of their latest challenges is managing the vaccine rollout for children under 5, which could begin in weeks — and educating parents and caretakers about the importance of vaccination. NPR's Rob Stein reports on another persistent public health challenge: long COVID. A recent study offers some clues about why many people suffer from symptoms for months. Rob also spoke to Gregory Glenn of Novavax, who you'll hear in this episode discussing the company's new COVID vaccine, which is awaiting FDA authorization.Help NPR improve podcasts by completing a short, anonymous survey at npr.org/podcastsurvey. In participating regions, you'll also hear a local news segment to 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

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And thank you so much. If people are feeling less fearful about COVID these days, that's not necessarily a bad thing. In fact, the Biden administration's new COVID response coordinator, Ashish Jha, told me that has always been the goal. The goal was always to make COVID less disruptive, to make COVID less harmful to the American people. And we've made an incredible amount of progress on that. So I think that's a good thing, by the way, also. That's not a problem. That's a good thing. Two-thirds of Americans are now fully vaccinated, Joss said, and a third are boosted. New treatments are available, like antiviral drugs and monoclonal antibodies. And deaths from COVID-19 are on a

four-month decline. Now, while the virus is still killing around 250 people a day in the U.S., that toll is about as low as it's ever been since the pandemic took hold. In most places, precautions are a thing of the past. Maybe you've been wearing your mask a little less. Maybe you've noticed others taking theirs off. The fact that COVID creates less fear is a good thing. That's always been a goal. And yet, Jha says, we still have a messaging challenge, which is we have to help people understand that COVID is not over. Doesn't mean that it needs to rule our lives the way it did a year ago, but that we need to still take precautions, still make sure we have plenty of vaccines and treatments, continue to do the things that we know will protect Americans.

That's still on the agenda. Consider this. Less fear may be a good thing, but there are still challenges in this third summer of the pandemic. We'll talk to Ashish Jha about one challenge on his agenda, how to get young children vaccinated. Plus, the clues that scientists are uncovering about long COVID. From NPR, I'm Elsa Chang. It's Monday, June 6th. 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, before we talk about vaccines for young kids, let's talk about a new vaccine for everyone. What makes us different is that we actually make the spike protein itself as an almost perfect replicate of what you find on the surface of the virus. Gregory Glenn is president of research and development at Novavax. Novavax is behind a new COVID vaccine that, according to an FDA assessment released this month, appears to be highly effective. And it works differently than mRNA vaccines made by Pfizer and Moderna. Basically, the Novavax shot uses lab-grown viral protein that's mixed into a solution that stimulates an immune response.

It works like, you know, vaccines for other diseases. Here's Gregory Glenn again. Proteins made in a vat, purified, put into a solution, have actually been used for quite a few vaccines very successfully, beginning with hepatitis B decades ago, and flu, shingles vaccine. It follows a tradition of a good way to protect people against infectious disease. Now, some public health experts hope the Novavax shot could sway vaccine holdout since it works more like a quote unquote traditional vaccine. Also, the Novavax shot could be added to the lineup of vaccines available to everyone for booster doses later this year. But first, the FDA would have to authorize it for emergency use.

And advisors to the FDA are meeting this week to make a recommendation to the agency about that vaccine. All right, good afternoon, everybody. I want to take some time today to explain the timeline of what's happening with vaccines for our youngest kids, for kids under five. So a lot of parents and caretakers have a date that they can circle now on their calendar. So we expect that vaccinations will begin in earnest as early as Tuesday, June 21st, and really roll on throughout that week. Just days ago, Dr. Ashish Jha delivered this news at the White House,

that vaccines for young kids are only weeks away. And our expectation is that within weeks, every parent who wants their child to get vaccinated will be able to get an appointment. Jha is in his second month on the job as White House COVID response coordinator. And to do that, he took a break from his day job as dean of Brown University's School of Public Health.

So he knows the public health effort to vaccinate kids is an uphill climb. For instance, kids 5 to 11 had a vaccine authorized for them six months ago. But now only about 30% of that age group is fully vaccinated. So I asked Ashish Jha, will the rates for younger kids be any better? Yeah, so that's a great question. I think we have to continue to do a better job of explaining why vaccines are such an important way of protecting children. There's a lot of misinformation out there about kids and COVID.

And, you know, we have to counter that. And we have to help parents understand that if you want to protect your children moving forward, vaccines represent the best way to do it. Right. But do you feel the administration has failed somewhat with the 5 to 11 age group in getting them vaccinated more fully? No, I think, look, the administration has made these vaccines widely available. I think we have worked with pediatricians and family practitioners. And we've got to do more of that. We've got to keep going. We've got to help parents understand that if in this pandemic, the pandemic is not over, the COVID is still out there, we're going to see other variants. And we want to protect children. And the best way to do it is through vaccines. And what is the plan then to improve

the vaccination rate among not just five to 11 year olds, but also among these younger kids as well? At the end of the day, you know, I'm a parent. And when I think about decisions I make the vaccination rate among not just 5 to 11-year-olds, but also among these younger kids as well. At the end of the day, you know, I'm a parent, and when I think about decisions I make for my kids, I am really guided and shaped by my pediatrician or my kid's pediatrician or family practitioner. So one important part of the plan certainly is to work with trusted medical providers. And the American Academy of Pediatrics has been very strong and very clear on this. I think getting more information out to pediatricians and family practitioners and helping them communicate directly to parents, I think, will also make a really important difference. I am curious, though, do you see these lower vaccination rates among children as it's an issue of mistrust in the vaccines? Or is it more about parents making an informed, deliberate choice?

Because data does show that these vaccines provide only modest protection for kids. What do you think the issue here is? I think there are a couple of things. One is from the beginning of this pandemic, we have seen a downplaying of COVID in kids, right? You've heard over and over again that somehow COVID is not a big deal. And the way that that has been set up is by saying it's less risky than it is for elderly people. Well, that's always true. Every disease is lower risk for children than it is for the elderly. The real question is, how does COVID compare to other risk children face? And COVID is a real challenge.

And what we know is that the vaccines provide terrific protection against severe illness for kids as well as adults. And I think we have to make that help parents understand that. And I think as we make that case, I think more parents will choose to get their kids vaccinated. Do you think the delay in making the vaccine available for these youngest kids has affected the course of the pandemic in a significant way in this country? What do you think the impact has been? Well, it's certainly for the parents of kids under five. It's been an incredibly frustrating period. I have a lot of friends with kids under five. They have been, I think, frustrated by the delay. But the issue is that when you think about kids

under five, you've got to get the right dosing. You can't just use an adult dose. Obviously, these are smaller humans, and so we want to get the dosing right. You want to make sure that it's safe and effective in this population. And that has all taken time. And I think the companies have worked quickly. I think the FDA has worked quickly. But at the end of the day, we've always wanted to get it right. We thought that was the most important thing. That was Ashish Jha, White House COVID-19 Response Coordinator. Now, another public health challenge as this pandemic enters its third summer is, according to the CDC, as many as one in five people who survive COVID may have symptoms that linger for months or what's known as long COVID. What's more, even as the number of people dying or getting seriously sick dwindles, we're likely undercounting the number of infections out there with more people

using at-home tests. But why some people who survive COVID have symptoms for months or even longer, that's a question scientists are still trying to understand. I spoke to NPR health correspondent Rob Stein about a study with some interesting clues. Okay, so what is this study exactly? You know, just as the pandemic was starting, doctors at the National Institutes of Health started putting hundreds of people under the microscope, combing through their medical records for anything that might predispose them to long COVID, putting them through more than 130 tests, looking for everything from, are their vital organs damaged? Is there any evidence the virus is still hiding in their bodies, causing the ongoing health problems? Have their immune

systems gone haywire, making them sick even though the virus is gone? And today, they published the first round of the results from the first 189 long COVID patients and 120 similar people who never got COVID. The study is in the Annals of Internal Medicine. Okay, I'm so curious. What did the researchers find? Well, the first thing they found was not a surprise. A lot of the COVID patients are still suffering from fatigue, brain fog, headaches, chest pain, and other problems months after first getting sick, more than half. Now, the researchers stress that doesn't mean half of COVID survivors end up with long COVID.

It's probably far lower because, you know, people with these kinds of problems Now, the researchers stress that doesn't mean half of COVID survivors end up with long COVID. It's probably far lower because, you know, people with these kinds of problems are more likely to volunteer for a study like this. But even if the true number is only a fraction of that, that's still a lot of people given how many people have gotten long COVID, have gotten COVID at this point. The second thing they found might sound kind of disappointing and provocative. Here's Dr. Michael Sneller, who leads the project at the NIH. An extensive medical evaluation failed to reveal a cause for these persistent symptoms in most cases. We were not able to find evidence of the virus persisting or hiding out in the body. We also did not find evidence that the immune system was overactive or malfunctioning in a way that would produce injury to major organs in the

body. In other words, despite all the testing, they couldn't find anything that could begin to explain why these people would still be sick. Okay, wait, are they saying that there's really nothing wrong with these people? No, no, no, no, not at all. And that's super important. These long COVID patients clearly are suffering from problems that are having a profound impact on their lives. These researchers just couldn't find anything physically to explain it. They did find that more women and those suffering from anxiety did end up with long COVID, but the researchers stress that doesn't mean their problems are psychological. Here's Dr. Sneller again. I clearly don't want to send the message that this is all not real and in people's heads

and just go home and stop worrying about it. That's not the message. Instead, Sneller hopes his findings will help doctors understand what's not wrong and focus on what might help, like physical and cognitive behavioral therapy. But some worry the findings could send the wrong message. What do you mean? What's the fear? The fear is doctors will dismiss patients, especially when nothing shows up on standard tests.

I talked about this with Dr. David Petrino. He studies and treats long COVID patients at Mount Sinai Hospital in New York. He says the researchers just didn't do enough in-depth testing. We know that invisible illnesses are often psychologized. We know that most people with infection-associated chronic illnesses are constantly first misdiagnosed with anxiety. Regular cookie-cutter testing isn't going to show up anything different in your long COVID patients. We need to look deeper. For his part, Sneller agrees and says he's continuing to study these and other long COVID

patients with more sophisticated tests, and a huge new NIH study is enrolling thousands of patients to try to finally get to the bottom of long COVID. That is NPR's Rob Stein. Thank you, Rob. You're welcome, Elsa. It's Consider This from NPR. I'm Elsa Chang.