Front Burner - The End of COVID?

Episode Date: May 29, 2023

COVID-19 disrupted almost everything about our lives when it struck. Now, as the WHO says the global emergency over the novel virus is over, how dangerous is the virus and what will it be like to live with it into the future? Helen Branswell is a world-respected reporter who has spent her career writing about infectious disease and global health. She writes for STAT News and takes us through the latest science. For transcripts of this series, please visit: https://www.cbc.ca/radio/frontburner/transcripts

In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization, empowering Canada's entrepreneurs through angel investment and industry connections. This is a CBC Podcast. Hi, I'm Alex Panetta. It came in with a bang, but the global emergency over the COVID-19 pandemic is exiting with barely a whimper. When it started, it changed almost every aspect of our lives. Now, you might not even have noticed that the WHO has said the global emergency is over.

The World Health Organization announcing COVID-19 is no longer qualified as a global emergency. For more than a year, the pandemic has been on a downward trend. This trend has allowed most countries to return to life as we knew it before COVID-19. Well, you know, I think for some people, this is going to seem very arbitrary and accelerated that the emergency part of this pandemic is coming to an end. For other people, they're going to say, hey, look, months ago, maybe even a year ago, I was sort of through this. months ago, maybe even a year ago, I was sort of through this. So, if it's the end of the emergency, what does the future hold as we learn to live with COVID?

And, three years later, with many of us a little worse for wear, what have we even learned from this whole ordeal? Helen Branswell is an old colleague and friend, and now a senior writer in Boston for Stat News covering infectious disease and global health. Hi, Helen. Great to be chatting with you again. Alex, so nice to hear your voice. Great. So the emergency is over, but COVID, the disease, is not over. What do we know about how many people a day COVID is still killing? Oh, well, you know, I don't know that we have good numbers globally. I was just checking the

WHO site and, you know, they said in the week of May 15th, there were just under 2,000 deaths, which was a fairly substantial drop from the week before. But, you know, at this point, globally, numbers are quite soft. Some countries are still gathering fairly decent data and some countries are not. So you really can't say a lot about that other than that things are much better than they were. I looked as well at the CDC site for, you know, what was happening in the United States and was stunned to see that in the week ending May 30th, only 281 Americans died from COVID.

And I think the U.S. numbers are pretty strong. And that's just, I mean, it actually, to be honest, brought a tear to my eye because it felt like forever that, you know, the numbers had been in the thousands and, um, that's actually the lowest number since the start of the pandemic. So, so that's good news. Amazing. And I want to ask you about vaccinations. Uh, is it just about everyone been vaccinated worldwide? I mean, by everyone, I mean the vast majority. Wondering what that looks like around the world right now. affluent countries have had four or five, even six doses of vaccine. So clearly not everybody around the world has been vaccinated. But there are kind of two ways at this point to get protected

against the worst of this virus. One is by vaccination and another is by being infected. And it stands to reason that most people on the globe would either have been vaccinated, been infected, or, you know, some combination of the two at this point. So it's killing very few people right now. Almost everyone's either been vaccinated or has had it. So after, you know, three years of data now, what do we know about how COVID affects a relatively healthy vaccinated person? At this point, it feels like for people who have had several doses of vaccine, that it can be a very nasty infection. You know, I had it last November for the first time. For me, it was super mild. I only tested myself because my throat felt a little bit scratchy and it, you know, for the whole duration of it, it was super mild. I only tested myself because my throat felt a little bit scratchy.

And for the whole duration of it, it felt like I had a cold coming on as opposed to anything worse than that. But I know people who were down for the count for 10 days, which sounds very much like influenza. So it clearly isn't sending people to emergency rooms in droves as it was before. I think for most people it is some version of a cold or a bad flu. So yeah, you mentioned the flu. I mean, none of us ever wants to get the flu, but severely immunocompromised people, very elderly people, people caring for a newborn, they can live in fear of catching a cold or the flu. Others don't. So I want to ask you about those two groups of people. How worried should people be if they do have a robust

immune system? I think you've indicated that they probably don't have a lot to be worried about, but versus people who actually do or are immunocompromised, how worried should those people be? You know, I think the reality is this virus is here to stay. We're all going to catch it multiple times over our lifetime. And I think that, you know, for people who have been vaccinated or previously infected or both, the chances are that, you know, you may have few symptoms, you may have fairly robust symptoms, but you're probably going to be fine. There is the question still of long COVID. I think the risk is lower in people who have been vaccinated. And also, I think with subsequent infections, I think the risk is also lower. But that is still part of the equation

one should be thinking about. You asked about people who are immunocompromised. I was listening recently to a meeting of the Advisory committee on immunization practices which advises the cdc on on how vaccines should be used and uh somebody on the acip is um has a clinic for people who is severely immunocompromised and she was saying that finally they're starting to see some change there that it isn't quite as bad for immunocompromised people, but it's still, you know, somebody who's recently gone through chemotherapy, for instance, you really wouldn't want them catching COVID. So for that group of people, the risk is still higher than it is for people with healthy immune systems.

for people with healthy immune systems. Okay, so given everything we've just discussed, the decline and the lethality of this virus, the fact that it appears to be endemic and that people are going to be getting it over the course of their lives, I want to talk about living with this thing. So there are people who are still masking in public or sending kids to school with masks. Some have no doubt adopted the practice of doing that when they feel under the weather. Others seem to do it as kind of an ongoing response to the threat of COVID. So I want to ask you whether masking, distancing, but masking specifically, is that a reasonable precaution to be taking at this point? First of all, you know, it's not my call. People have to decide for themselves, I think at

this point, what their comfort level is. And if they want to continue to mask, I don't think anyone should give them a hard time about it. I certainly do wear masks on public transit when I go into a crowded store and on a plane. I would still wear a mask, although people tell me the air quality on planes is still pretty good. But I still do. Whether I will forever, I don't know. But, and certainly as we go into the summer and transmission appears to be, you know, fairly low right now, I think one might think about being able to be a little bit freer on that kind of thing. If transmission rates started to pick up again, I, you know, I, the reality is some people are done with masks and they're not going to put them on again. I, you know, I, the reality is some people are done with masks, and they're not going to put

them on again. And I think there are people who are going to have a hard time taking them off. But I don't know about you, I haven't had a cold in, in three and a half years. And I don't mind that. So, you know, it doesn't seem to me to be a huge difficulty to put on a mask from time to time. But at this point, I think it's really to each their own. This is a debate we've been having in my own household, my spouse and I. I mean, I've been in the non-mask wearing camp for quite a while now, well, since last year, and my spouse being more inclined to wear masks. And neither of us has had COVID yet, but you're right. Once the mask comes off, the colds start to become a bit more frequent.

But the one argument you hear, and this is part of our own conversation at home, about wearing a mask is long COVID. And that's the heart of what people fear now. I want to ask you about that. What's the latest science on how sick a long COVID is making people and how long it lasts? I think, you know, there's still a lot of questions about long COVID in terms of, is it one thing? Is it multiple things? How do you explain how some people remain really profoundly affected for quite a long period of time? In other people, it seems to resolve itself within a few months, which is long enough for sure, but a different thing than somebody who might have been infected in 2020 and is still suffering from it.

2020 and is still suffering from it. You know, I think the evidence points to less of it at this point than when what we saw before the Omicron wave and less of it in people who've been vaccinated. But, you know, hopefully the people who have long COVID will recover at a point and hopefully we'll see less of it going forward. But we still don't have great answers, I think, about what's going on there. And certainly it's something you'd rather not encounter if you could help it. In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization. Empowering Canada's entrepreneurs through angel investment and industry connections. people I speak to, 50% of them do not know their own household income. That's not a typo, 50%. That's because money is confusing. In my new book and podcast, Money for Couples, I help you and

your partner create a financial vision together. To listen to this podcast, just search for Money for Couples. So I want to look forward while looking backward at lessons learned. Three years on and counting, things are more or less back to how they were before the pandemic, but our healthcare systems were bursting at the seams. And I know you live in the US now, but the United States healthcare system buckled, so did Canada's. Some mental health professionals say there's been an increasingly visible mental health crisis. Kids did Canada's. Some mental health professionals say there's been an increasingly visible mental health crisis. Kids have been affected. You've seen an effect on academic performance with schools having closed. So I'm just wondering if you had to look at a lesson or

two that you've personally drawn from this pandemic, things that we might want to apply to the next one. What are these lessons that you think we've learned or should learn? Beware of hubris. I think that, you know, a lot of high income countries had done pandemic planning in the past 20 years, you know, in response to concerns about bird flu, in response to the 2003 SARS outbreak. They had pandemic plans. They had contracts for vaccine. But when the excrement hit the fan, those plans turned out not to be as useful, I think, in some cases, as their planners would have hoped.

One of the lessons for me, and I'm going to sound naive even saying this, is that you can't underestimate the impact of politics in a circumstance like this. I am still stunned that the leader of a large country could downplay an event because it wasn't useful for his election chances, and that wouldn't have doomed him. Take a look at some of these charts. I'd love to. We're going to look. Let's look.

And if you look at death. Yeah. It's starting to go up again. Here's one. Well, right here, the United States is lowest in numerous categories. We're lower than the world. Lower than the world? Lower than Europe.

In what? In what? Take a look. Right here. Here's case death. Oh, you're doing death as a proportion of cases. I'm talking about death as a proportion of population. That's where the US is really bad. Much worse than South Korea, Germany, etc.

You can't do that. You have to go back. I mean, given the losses of life in the United States, I'm still surprised that the 2020 election was as tight as it was. But, you know, the political divide in this country is enormous. And it really had a huge impact and still has a huge impact on the steps people are willing to take and the way they conceive of a threat like COVID. So I think going forward, people will have to think about that when they think about how you get people to respond to measures. I mean, certainly I think one of the things we've learned out of this is that there are measures one can take to actually sort of mitigate spread and dampen

transmission as you wait to get vaccine made and into people. But I'm not certain if we had another event like this in the near future that, you know, everyone would agree to do it. Like, I don't know how many people would mask again or agree to social distancing or agree to school closures. I think that's an unknown right now. Well, the politics, I mean, in Canada, too. You saw the truck protests. I Well, the politics in Canada, too. You saw the truck protests. The political divisions happened everywhere. Blaring horns, impassable streets,

all the work of a new movement calling itself Freedom Convoy. Truck drivers demanding an end to COVID-19 vaccine mandates have disrupted major Canadian cities and clogged key U.S.-Canada border crossings. And now copycat protests are spreading around the world. have disrupted major Canadian cities and clogged key U.S.-Canada border crossings. And now copycat protests are spreading around the world. But I guess some of the counter-argument that some of those folks would make, like supporters of the unnamed U.S. politician you alluded to earlier, Donald Trump, would make is, well, global health experts got a lot of things wrong, too.

We were being told to wash our hands at first and not wear a mask. What we worry about is actually the potential negative aspects of wearing masks, where people are not protecting their eyes or other aspects of where the virus could enter your body. And that gives you a false sense of confidence, but also it increases the touching of your face if you think about it. And then we were told to wear a mask and, you know, maybe unrealistic expectations about the vaccines were set. We were told you can't talk about a lab leak for quite a while. So I'm just wondering, what did the global health community, in your opinion, and the public health officials who dealt with this get wrong with COVID, that they might get right with a future virus? Any mistakes made there that you think might be corrected in the future from policymakers?

Okay, so like for starters, you might think of cutting them a bit of slack. It was a brand new virus, you know, it hadn't circulated before. So they were learning as we were learning. And, you know, the notion of whether or not it was spread by hands through fomites as opposed to in the air, that was a pretty reasonable thing to talk about. during cold and flu season, washing your hands a lot is a way to lower your risk of catching, you know, some of the viruses that cause colds and flu-like illnesses. It wasn't unreasonable to suggest people, it's a good idea all the time to wash your hands a lot. So I don't really feel like anybody should be lambasted for that. The mask wearing thing, again, at the beginning of the pandemic, there weren't good data to suggest that people wearing masks, walking

around in public would be protected from contracting a respiratory virus. There hadn't really been studies on stuff like that. And if you remember, at the beginning of the pandemic, a mask was a bunch of different things. A mask was a surgical mask for some people who had their, who could get them, might have been a t-shirt that had been cut up and, you know, attached by straps around the head. I mean, at the beginning, a mask, they weren't all equal. And so you could not know for certain what they would do. That said, I think, you know, some of the messaging around don't mask was really about please don't buy them because there aren't enough for health care workers. And if you take them, health care workers will be unprotected. care workers and if you take them health care workers will be unprotected and maybe being more upfront about that would have been a better thing to do um you know you mentioned the vaccines

and unrealistic expectations that was wild i mean when the ve when the first data out of the vaccine trials came out and the mRNA vaccines were shown to be 95 and 94% effective, like I talked to seasoned scientists who started giggling like schoolboys, you know, they were so excited by this. But, you know, in retrospect, that was based on very short follow up. And that makes sense, because they needed to get those vaccines out in a hurry. But, you know, with 20-20 hindsight, it never made sense that a vaccine injected into the arm would give you that high protection on a continuous basis against respiratory pathogens. And I think, you know, like a few caveats attached might have saved everybody. That said, those vaccines don't

prevent all infections and their power to prevent infections wanes pretty quickly, but they really have made enormous difference in terms of whether you're going to have severe disease or a bad flu. And, you know, we were very lucky on the vaccine front. Yeah. With COVID kind of receding as a concern, I'm wondering to what extent you're starting to shift your own focus away from COVID onto this avian flu, H5N1 or other potential viruses. I guess I want to ask you specifically about H5N1. It's killing a lot of birds. The outbreak of the virus known as H5N1 is the biggest in U.S. history. More than 58 million birds across the country have been infected,

and now the virus has spread to other mammals like foxes, minks, and even bears, sparking fears it could mutate and start spreading more easily among humans. How concerned are you about that? So I spent a number of years writing about H5N1 back in the aughts, like right after SARS-1. H5N1 re-emerged in Asia and started killing a lot of domestic poultry. At the time, it was unprecedented. What's happening now is even more unprecedented. And, you know, back then I was really worried that we were in the start of a pandemic effectively. And here we are almost 20 years later. And for part of that intervening time, H5 went effectively quiet.

And now it's back and killing huge numbers of domestic birds, wild birds, endangered bird species, which is really alarming. And also seemingly capable of infecting quite a few mammalian species. Like, you know, you're hearing reports of otters and seals and bears and mink, all sorts of animals that come in contact with dead birds or are fed dead birds and then come down with H5 and in some cases seemingly even are capable of transmitting it amongst themselves. So the evidence on that is not super clear. And I worried, H5 always worries me, but I don't know what it's going to do. And I don't think anybody does. You know, interestingly, while the amount of it out there has, you know, exploded, and it's moving amongst birds all over

the world now in a way that it was not before, human cases are actually far fewer than there were back in the mid-aughts. These days, there are few human cases, and of the human cases, many of them are mild. So I don't know what to make of that. You know, what scientists tell me is that it's very well adapted now, better adapted for birds, which would suggest that it's, you know, it's moved away from us. But I don't think we can assume that it isn't a threat to us.

And I don't think we currently have the capacity to answer the question, will this ever successfully make the jump to people? Yeah, it's not a very satisfying answer because, you know, it's just not known. I want to end on a personal note. Most of us are sick and tired of talking about viruses. You've been doing this for a lot longer than the rest of us. And I'm proud to say I was working with you at the time that you began what eventually culminated in one of the great careers worldwide in health journalism. You mentioned SARS a moment ago, and that's how it started. I was going to ask you,

like, what keeps you so motivated to stay on top of these developments in the virus world and share this stuff with readers that kind of everyone else kind of wants to move on, but you've kept the focus on this? Well, first of all, thanks very much. Those are very kind words. I just, it's an endlessly fascinating field. And it's not all pandemic viruses or things that are going to kill us. Like I had a story today about RSV, which a lot of people who have young children would know about. And it hits, it causes, you know, colds in older kids and adults, but it's very dangerous for little babies and, you know, seniors at the other end of the age spectrum. You know, there are scientists that worked for years trying to

come up with vaccines and other therapies to deal with RSV and haven't managed to. They finally have. And these things are going to be rolling out in, you know, the coming months, probably in time for the next RSV season, which typically begins in late fall, you know, so I was exploring how they might be used and some of the challenges to

getting them to be used. Well, that's something that isn't about a pandemic and, but is information that I'm sure anybody with small children would be interested in knowing. So there are things like that. I'll write about flu season next year. There's antimicrobial resistance,

which is an issue that has enormous repercussions but hasn't been paid enough attention to generally speaking and certainly not since the pandemic started so my niche sounds small but when you realize how much is in it there's always something that is interesting to explore well thank you i don't i don't always and i think most people don't always want to be thinking about this stuff but i always learn from you uh when we uh when I read your work and when uh talking to you about this stuff so thank you well thanks for having me Alex it's been fun that's all for today I'm Alex Bon. Thank you for listening to FrontBurner.