Science Vs - Coronavirus: Shots! Shots! Shots!

Episode Date: December 3, 2020

There’s a ton of hoopla over these new coronavirus vaccines. But given that they’ve been produced at warp speed — can we trust them? We also find out what’s going on with “long haulers.” How common is it to be sick for months from Covid-19? Plus, fresh new science about why some young people land in the hospital. We talk to Dr. Katy Stephenson, Dr. Alexander Hoischen, Dr. Jeffrey Siegelman, and Prof. Tim Spector.  Link to transcript: https://bit.ly/37vYvT3 This episode was produced by Rose Rimler, NickDelRose, and Wendy Zukerman with help from Michelle Dang, and Hannah Harris Green. We’re edited by Blythe Terrell with help from Caitlin Kenney. Fact checking by Diane Kelly. Mix and sound design by Peter Leonard. Music written by Peter Leonard, Marcus Bagala, Emma Munger, and Bobby Lord. Thanks to everyone we got in touch with for this episode including Dr. Cleo Anastassopoulou, Dr. Cas van der Made, Prof. Joel Ray, Dr. Nicholas Tatonetti, Michael Zietz, Prof. Torben Barrington, Dr. Emma Pierson, Professor Peter Wark, Dr. Jennifer Dan, Dr. Natalie Lambert, Dr. Benjamin Abramoff and others. And special thanks to the Zukerman family and Joseph Lavelle Wilson. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Hi, I'm Wendy Zuckerman, and you're listening to Science Versus from Gimlet. This is the show that pits facts against finally some light at the end of the tunnel. A sign of hope in a year that's been filled with doubt and desperation. There's been some very exciting news about a vaccine on the horizon. Pfizer announced that their coronavirus vaccine is more than 90% effective. Now it's showing it's 95% effective. We're hearing that clinical trials have been super successful and it's all go, go, go, go, go.

People in the UK can start getting the Pfizer vaccine early next week. The first Americans could be vaccinated against COVID-19 as soon as December 11th. But before we pop the champagne... Happy Vaccine Day. ..there's been some questions about these vaccines, like AstraZeneca's. These are thousands of people who got the wrong dosage.

That in itself is a huge problem. So what do we know about how well these vaccines really work? And can we trust that they're safe, despite being churned out at warp speed? That's one thing we're finding out today. Plus, we're finally getting answers about why some super healthy people land in the hospital or stay sick for months and months after getting COVID.

These so-called long haulers living a nightmare every day. So what is going on here? While a lot of us have been sitting at home on our butts watching that chess show on Netflix, scientists have been toiling away. And they have learned so much more about this virus. And we're going to tell you all about it on today's show. When it comes to the coronavirus, there's a lot of... Living a nightmare every day.

But then there's brand new science. Coming up. Oh, handsome. Who knew you could give yourself the ick? That's why Bumble is changing how you start conversations. You can now make the first move or not. With opening moves, you simply choose a question to be automatically sent to your matches. Then sit back and let your matches start the chat. Download Bumble and try it for yourself. Metrolinks and Crosslinks are reminding everyone to be careful as Eglinton Crosstown LRT train testing is in progress.

Please be alert as trains can pass at any time on the tracks. Remember to follow all traffic signals, be careful along our tracks, and only make left turns where it's safe to do so. Be alert, be aware, and stay safe. What does the AI revolution mean for jobs, for getting things done? Who are the people creating this technology and what do they think? I'm Rana El-Khelyoubi, an AI scientist, entrepreneur, investor, and now host of the new podcast, Pioneers of AI. Think of it as your guide for all things AI, with the most human issues at the center.

Join me every Wednesday for Pioneers of AI. And don't forget to subscribe wherever you tune in. Welcome back. Today, we are taking on the latest and greatest science about the coronavirus, starting with these vaccines. There have been some super optimistic headlines saying that the vaccines are looking great, with Pfizer and Moderna's being around 95% effective. That is wild.

Like, the flu vaccine is only around 50% effective. And yet these coronavirus vaccines, they've been whipped up so fast. So can we really trust these numbers? And will these vaccines end the pandemic? Hello. Hello. Hello, hello. Okay, it's recording.

This is Katie Stevenson, a doctor who does vaccine development at Harvard. And we called her up to get a gut check on these coronavirus vaccines that we're hearing about. And she told us to start with, let's find out exactly how they got these impressive sounding numbers. So let's take Pfizer. Can you walk us through like how they got that number 95%? So the way it works is that you enroll, I mean, in their case, it was about 40,000 people. 43,661 people, to be precise. Everyone gets two jabs a few weeks apart.

But not everyone gets the real vaccine. Half of them got a placebo. And no one, not the scientists nor the people in the trial, knows who got what. So everybody has sort of a 50-50 chance of getting one or the other. And then you follow them over time. What you're waiting for is for people to get COVID. For Pfizer's trial, they knew they were good to go once 170 people got sick.

Now, 170, that feels like this weirdly small number. But the math boffins worked out that this was enough cases of COVID to see if there was a significant difference between the group that got the vaccine and one that got the placebo. We rely on our statistical friends to tell us. You can say, you know, I think that's not chance. This is not random that it broke out this way. So once 170 people were sick, Pfizer was like, booyah! Well, I'm sure there was some mixed emotions around it. But anyway, what it meant was that they could now open the envelopes of the sick people in the trial to see, did they get a placebo or the real vaccine?

And what they saw is that 95% of the cases where people got sick were people who got the placebo. And that's how they got the number 95% effective. Moderna's trial worked the same way. Now, we don't have the full data from these trials yet. All of what we know is based on a few press releases, not scientific papers. But Katie told us that, generally speaking, she's not too worried about this. Because in this case, the data has been vetted by a pack of independent nerds.

Leaders in the field, they're usually like our top prestigious professors, and they have no financial conflict of interest. So this data that's coming is not your normal press release data. That I find very reassuring and very believable. So, we can trust these numbers coming out of Pfizer and Moderna. They might change a little once the vaccines are put out into the wilds, but they're working so well for the moment that even if that 95% dropped a little, they'd still be really effective vaccines.

And Katie says that this kind of success, it was not inevitable. Usually vaccines take more than a decade to get to this point. And for some viruses, it's just really, really hard to make a vaccine for them at all. Like with HIV, for more than 30 years, researchers like Katie have been plugging away at this with very little luck. And so this time, Katie was expecting something similar.

Science usually is failure. So whenever there's a vaccine study, you know, we always prepare ourselves emotionally. And that's what we were all doing here too. But this data was just great. I've really enjoyed just seeing all of these like stodgy science types just lose it when they saw this data come through. It's just like giddy, giddy, giddy, like laughing, just like woohoohoo, you know? And even Anthony Fauci, who's had a lot of reasons to be grouchy lately, was excited here, saying these results are extraordinary and beyond expectations. But things haven't run smoothly for all the vaccine trials.

AstraZeneca bungled some stuff early on. They messed up the dosing in one part of their trial. And weirdly, those folks were better protected than the ones who got the right dose. Katie says it's hard to know what's going on there. So for now, let's just look at the people who got the dose that was planned for. Here, AstraZeneca said the vaccine was at least 60% effective, which would still put it on par with the flu shot. So while it's annoying that this all happened, it still looks like this vaccine isn't bong. Okay, so it's looking like, generally speaking, these vaccines are working. But what do we know about how safe they are? They were just made so quickly. Well, when you look at the side effects these companies are reporting,

severe fatigue and muscle pain are the big ones. In Moderna's vaccine, almost one in ten people got hit with this after getting their second shot. One in ten. That's quite a lot. Pfizer's vaccine had the same kinds of side effects, but they were way less common. According to both press releases, the symptoms were short-lived. When we asked the companies exactly what that meant and how long people felt crummy for, they didn't tell us. Pfizer said they're going to release this soon. Still, no one had to go to hospital

because of their symptoms. Usually we would call that pretty safe and well-tolerated because, you know, most people wouldn't mind having an evening in front of the TV, you know, laying low if they would be protected from COVID-19. If you could get the vaccine right now, would you do it? I would do it. Yes, I would. I would definitely take it. So all of this brings up a rather big question. When these vaccines are available, what then?

We kind of have this vision that, ta-da, we're going to get our lives back to normal. But Katie told us, not so fast. For that to happen, we're going to need to get enough people immune to the coronavirus so that it can't keep spreading. To end the pandemic, we need to end the transmission of the virus. And to do that, we need to develop some kind of population-wide immunity. I mean, some people call it herd immunity, but that sounds ridiculous to me.

I like it. It keeps me humble. You know, I am just one of the herd. You're just a cow in the field. Right? That's me right now. From what we know, it's looking like we'll need maybe 70% of people around the world to be fully vaccinated. And that might be hard to do. First, it'll take a while to pump out enough of these vaccines.

You've got to ship them, keep them cold. And then you'll run into another problem. Remember, we need to get two shots. Lots of people are pretty wary of just getting one shot of this coronavirus vaccine. And studies of other vaccines have found that when there's two shots, people sometimes just fall off the map after round one. Well, in the real world, people don't come back for their second shot. So that happens all the time. I can almost see you looking at like 13-year-old Wendy and me not getting my HPV second and third shots.

I mean, everybody, right? A large UK study found that with the hepatitis A vaccine, only around 10% of people went back for their second shot. 10%. And even if all this goes great, we may still not have seen the last of this bloody coronavirus. And that's because we don't yet know how long these vaccines are going to protect us for.

The trials have only been going on for a few months. Bottom line, maybe you were thinking that as soon as the vaccine shows up, we'd be done here. It'd be like the rise of Skywalker, the last Star Wars movie. You saw it. Adam Driver was there for some reason. And you thought, story's over. But then we turn around and there's that bloody baby Yoda. This story just keeps on going.

So even with a vaccine, this pandemic is likely to end in fits and starts. And then perhaps you'll find out you've kissed your brother. After the break, we're taking a look at something that's been this huge mystery. Why some people who seem to be super healthy are getting really, really sick from COVID. And what's the chance that that could be you. Welcome back. So something that's been this big question since the beginning of this outbreak is why some young people who seem to be super healthy are landing in hospital and even dying after getting the coronavirus. Well, scientists are finally starting to figure out

what might be lurking under the surface here. Yes, my name is Alexander Heuschen and I work here at the Radboud University Medical Centre in Nijmegen, the Netherlands. Alex is a geneticist and back in April, he heard from a colleague, a doctor working in the ICU. She witnessed that there was a very young man in the intensive care unit needing help for a very severe COVID-19. And she also got to know that he had an equally young brother who was also very severely ill. This was really weird. These brothers were just 29 and 32, super healthy.

They had no business getting this sick from the coronavirus. Getting severe COVID at a very young age is already very rare. And that this happens twice in the same family is indeed extremely rare. Yeah, that immediately rings a bell for genetics to saying, okay, this cannot be just coincidence. Alex thought there must be something hiding in the DNA of these brothers that made them more likely to get sick. But the problem is there are more than 20,000 genes in the human body. So which one might have gone wrong in the brothers? To find out, his team got blood from the patients and sequenced their DNA. He talked to our producer Rose Rimler about it.

So you're sort of looking for the needle in a haystack of this is the bad mutation. That's exactly how it went. And indeed, we look for the needle in the haystack, but we tried to make the haystack smaller and smaller and smaller. To make that haystack smaller, Alex figured that any mutation he found had to be something that both brothers had. And he figured that the suspicious gene probably played a role in the immune system. So he narrowed the search to just those genes. Alex and his student Kaz Vandermade got the genetic info one evening and started looking for the likely suspect. Within two hours, and I still recall that it was at 11pm at night, we identified the TLR7 mutation.

TLR7. The two quickly pulled up as many papers as they could find and read what the devil this gene does. And it turns out that it codes for an important protein that helps to pull the fire alarm when there's a new invader in our body. An invader like a virus. And this alerts other immune cells that there's danger around so that they can fight it. To Alex, this was so striking and made so much sense that we thought, OK, this cannot be a chance finding. And by midnight, it was clear this must be the one. Both of the brothers were actually missing a chunk of that gene,

which Alex figures means that they probably didn't make any of that particular protein. So there was no one around to pull the fire alarm. And that means where a healthy person's body could spot this virus quickly and fight it. This is taking way too long in our patients. So it seems that more N-mei virus can accumulate and making the infection more and more severe. Which probably explains why the brothers got so sick.

They were both on ventilators and more severe. Which probably explains why the brothers got so sick. They were both on ventilators, and one died. Alex reckons maybe one in 10,000 people have a problem with this gene that they don't know about. And this is just the tip of the iceberg when it comes to these genetic mutations. Do we think that there could be other mutations out there that make people susceptible to the coronavirus? Yeah, absolutely. There may be many more genes.

So it's just sort of a matter of combing through more genomes and finding more of those mutations. Yeah. And those efforts are ongoing. Yes. Scientists have already found more than a dozen genes where mutations might make people more likely to get really sick if they get coronavirus. And knowing about all this, it could help us figure out treatments when these people land in hospital. So for example, the mutation that the brothers had ultimately stopped their bodies from making something called interferon. And the thing is, we have interferon on the shelf. It's actually used as a medicine that people can take. So perhaps it could have helped them.

The Netherlands is now going to screen some people looking for this mutation if they land in hospital with COVID. So we are making some progress on how to help hospitalise people. But just as we whack one mole, COVID gives us another. We're hearing more and more about others getting slammed by this virus in a totally different way. They get sick, and then months later, they still aren't better. They're called long haulers. So meet Jeffrey Siegelman. He's 40, was super healthy, an ER doctor at Emory University School of Medicine in Atlanta. And at the beginning of this pandemic, while lots of doctors were worried about getting sick on the job, Jeff wasn't freaking out. I felt fine going into work. I felt like I could protect myself. I guess I was wrong.

Jeff figured out he was wrong on Monday, the 3rd of August. He woke up with a headache and a fever. I don't get fevers and I don't get headaches. And so this was unusual. Tuesday morning, I had breakfast. I was having some yogurt and I took a couple bites and I was realizing that it should taste like blueberry and instead it tasted of nothing.

Oh no. And that began sort of a frantic chase through our house during that day of anything that could have different flavors. I had my kids and wife bring downstairs for me. Oh, wow. So your whole family is literally like just like ravaging the cupboard being like, what can we give dad? That's right. And so we tasted all sorts of things, nuts and candies and meats and breads. And it turned out that the only thing I could taste was Skittles. Skittles. We have no idea why all he could taste was the rainbow. But after all the fun and games, yeah, Jeff had COVID. Over the next few days, he gets chills, aches, like a typical flu.

He never got sick enough to go to the hospital. But something else happened to Jeff, something he didn't expect. He just didn't get better. And his symptoms changed. The muscle aches and chills turned into fatigue and heart palpitations. Even at rest, I would feel my heart pounding and it would keep me awake at night. The fatigue became much more profound. Really, with any exertion, I would just get wiped and get stuck on the couch for hours, if not a whole day.

Like my battery was drained. My eyelids would have just weights attached to them. Four months later, he still feels like this. He can't even go back to work because he can't concentrate for too long. Says he gets brain fog. And the internet is filled with stories like Jeff's. There are support groups online with thousands of people. Many of them are younger than him.

And their symptoms range from diarrhea to shortness of breath to muscle pain, all things that just won't go away. And I want to know how likely is it that you, or worse, me, could become a Jeff? To find out, I zoomed Tim Spector, a professor of genetic epidemiology at King's College London. Hi, Wendy. Hello. Lovely background. That's the House of Parliament.

Very patriotic. Tim is leading one of the largest studies into long haulers, and it all started a bit by accident. As the pandemic was kicking off in March, Tim worked with a company to make an app so that people with COVID could track their symptoms and researchers like Tim could study them. And this app, it went bonkers.

It turned out that about a million people downloaded it in the first 24 hours. Wow. And it became a sort of overnight sensation, which staggered us. This is basically the Pokemon Go of coronavirus apps. And so about a month into people logging their symptoms, Tim noticed that... Some people just kept on going

and they just kept on recording that they were unwell. And we didn't really know whether that was just an error. They were hypochondriacs. What was going on? Tim was being introduced into the world of Jeffs, long haulers. So after several months of this, Tim figured, aha, okay, right, let's analyse this data. Tim took a slice of people using the app, about 4,000 of them. And first up, he wanted to find out how common it was for people with COVID to stay sick for a long time. And here's

what he found. It turned out that about a month after getting infected, just over one in eight people still felt sick. One in eight. And three months later, one in 50 were still sick, mostly reporting fatigue and headaches. I was surprised there were that many at three months because once you start to do the calculations, knowing how many millions of people are affected with COVID and you say, well, if one in 50 of them are having long-term symptoms, that's hundreds of thousands of people in each country. Yeah, that's a hell of a lot of people. Tim's study isn't published yet. It's currently being peer-reviewed.

But we did send it out to a bunch of academics. They told us that these results might be a touch high, and that's because Tim's app might not truly reflect everyone who gets COVID. Like, maybe if you're not getting bad symptoms, you're less likely to download a symptom tracking app. But despite that, the researchers that got back to us said that they did generally trust this study. So let's say roughly one in 50 is a Jeff with symptoms lingering more than three months. The next thing that Tim wanted to know is what ups your risk of

being a long hauler? And even though there's a lot of talk online about young people getting this, Tim found that like all crappy things to do with COVID, it's actually more likely to happen to oldies, twice as likely if you're 70 or older. Yeah, I think the early reports were that this was hitting young females, particularly sporty women who were amazingly fit and reported this, you know, inability to get out of bed. People would be much more interested in those dramatic stories than they would in some 70-year-old man who could no longer go for his daily stroll down to the shops with his dog. Yeah, I'm probably not going to click on that headline.

The headline I would click on, though, is about what Tim told me next. It's something that could help us unpack why this is happening in some people's bodies. You see, Tim said that even though long haulers are all getting lumped into this one bucket, that's probably not right. I think our data suggests there's more than one disease here. We found at least two clusters.

That's right. There might be at least two different kinds of long haulers. Behind door number one, you have people with mainly just respiratory symptoms. So think sore throat, shortness of breath and a nasty cough that sticks around. And this suggested to Tim that the virus got into their lungs, caused some damage that the body is still working through. But then you have the more mysterious door number two. Patients with this whole body reaction.

Not just the fever and cough, but you also had stomach problems, you had muscle pains, you had chest pain. And this suggested that something else was going on with these patients. One idea is that their immune system basically went wacko. It spotted the virus, started attacking, and then just didn't let up. It overreacts. They're in some vicious cycle, if you like.

You know, the virus is probably dead by now, but it just keeps getting told that it's still there and it still has to keep fighting it. This can lead to inflammation, which might cause some of these symptoms. And all this isn't unique to COVID. Some other viruses can cause weird immune reactions like this. And once you know that the immune system might be involved here, it could explain one final and curious thing that Tim found. Zooming in on people under 60, he realized that women were more likely than men to become long haulers. And here's a possible reason why. Women's immune systems behave a little

different to men's. We're better at fighting off active infections, but it's a double-edged sword. And the flip side is that we're at risk of having an immune system that gets a bit over-enthusiastic, which might increase our risk of becoming long haulers. So where does all of this leave us? How are we doing when it comes to fighting this coronavirus? Well, vaccines are getting rolled out super soon. And with Pfizer and Moderna,

it's looking like even though there are side effects, for now, these vaccines are working really well. There are a few more question marks around AstraZeneca's, though. Let's wait and see. And when it comes to the nasty side of getting COVID, well, scientists are uncovering genetic quirks in people that might explain why they get really sick and could help with treatments.

We're also hearing about these long haulers, though. They're fairly rare. Maybe one in 50 people who get COVID still have symptoms three months later. And while we do see it in youngsters, it's more common in oldies. And despite lots of things still feeling up in the air here, as our little coronavirus celebrates its first birthday, we can know that we are getting a better handle on this virus.

We are learning its wiles, getting clues as to what makes us vulnerable. And we've taken huge strides in getting us a vaccine. So maybe this time next year, we'll be the ones celebrating. That's Science Versus. Hello. Hey, Rose Rimler, producer at Science Versus. Hi, Wendy, host of Science Versus. How many citations in this week's episode? Okay, I'm checking.

I just got to pull it up. Come on! I'm scrolling, I'm scrolling, it's loading. Okay. 110. 110 coronavirus-filled citations. And if people want to know more and they want to read these citations, where should they go?

They can click on the link in our show notes that will bring them to the transcript, which is available, and all the citations are there. Excellent. Thanks, Rose. Thanks, Wendy. Okay, all right.

Bye. This episode was produced by Rose Rimler, Nick Delrose, and me, Wendy Zuckerman, with help from Michelle Dang and Hannah Harris-Green. We're edited by Blythe Terrell, with help from Caitlin Kenney. Fact-checking by Diane Kelly. Mix and sound design by Peter Leonard. Music written by Peter Leonard, Marcus Begala, Emma Munger and Bobby Lord. A huge thanks to everyone we got in touch with for this episode,

including Dr. Cleo Anastaz Opelu, Dr. Kaz Vandermade, Professor Joel Ray, Dr. Nicholas Tattonetti, Michael Zeitz, Professor Torben Barrington, Dr. Emma Pearson, Professor Peter Wark, Dr Jennifer Dan, Dr Natalie Lambert, Dr Benjamin Abramoff and others. And a special thanks to the Zuckerman family and Joseph LaBelle Wilson. I'm Wendy Zuckerman. I'll back to you next time.