Short Wave - A Science Reporter And A 'Mild' Case Of Breakthrough COVID

Episode Date: September 27, 2021

Will Stone is a science reporter for NPR. He's been reporting about the pandemic for a while now, so he knows the risks of a breakthrough infection, is vaccinated, and follows COVID guidelines as they change. Nonetheless, he got COVID - and today on the show, Will shares what he learned about his breakthrough infection, and what he wish he'd known before his "mild" case.For more of Will's reporting, check out "I Got A 'Mild' Breakthrough Case. Here's What I Wish I'd Known"(https://www.npr.org/sections/health-shots/2021/09/12/1036356773/i-got-a-mild-breakthrough-case-heres-what-i-wish-id-known)You can follow Will on Twitter @WStoneReports and Rhitu @RhituC. Email Short Wave at [e-mail]. See pcm.adswizz.com for information about our collection and use of personal data for sponsorship and to manage your podcast sponsorship preferences.NPR Privacy Policy

You're listening to Shortwave from NPR. Hey there, Shortwavers. I'm Reed Through Chatterjee here. And today we're going to talk about breakthrough infections. Now, it's a relatively new phrase that's become really, really familiar in the past few months of the pandemic. While COVID vaccinations are saving lives, they're keeping people out of the hospital. They don't quite offer complete protection against infection. And so the virus, particularly the new Delta variant, can and is breaking through. And it's happened to some of us here at NPR, including one of my colleagues, science reporter and editor Wohlstone.

Hi, Will. Hi, Ritu. So, Will, tell me what it felt like, your breakthrough infection. It was rough. It was definitely right up there with some of the worst colds, the worst bouts of flu I've ever had. It started with this overwhelming fatigue and a sore throat. And I thought, oh, maybe I'm just tired, worn down, maybe a sinus infection. then I got a horrible headache, started to spike a fever, which eventually got all the way up to about 103 degrees.

I'd wake up in the night, drenched in sweat, aching all over, and I even lost my sense of smell and taste. So it was five really, really bad days. So, well, being the true reporter that you are, once you were feeling better, you decided to dive into what we do and what we don't know about these infections. That's right. Okay, so today on the show, we'll talk to us about what he's learned about breakthrough infections and what he wishes he had known before he got sick. You're listening to Shortwave, the Daily Science podcast from NPR. So first, I'm really glad you're here.

How are you feeling? And do you have your sense of taste and smell back? I'm feeling much better. Thankfully, I have my smell and my taste back. And I'm just around back to my baseline health. But it took really several weeks. until I got all my energy back. Well, I'm glad you fully recovered.

And I'm curious, do you know where and how you might have gotten sick? Not exactly, but I had been traveling in the days before I got sick. And like a lot of us, I had loosened up on my COVID precautions after getting vaccinated in the spring. And in late July, I flew from Seattle to the East Coast to see my family. And I went to a wedding with other people who were vaccinated. But I also stayed at a hotel. I ate indoors at restaurants. I hung around the city, went to the gym. So quite a few places, Reto, where I could have caught the virus. And did you suspect it was COVID right away? And when did you find out? Well, I wasn't sure at first, but I decided to get tested because I was concerned. And actually, it was a bit confusing. My first two test results were negative. These were both rapid antigen tests. So these are those fast. over-the-counter tests that are very convenient and a lot of people are doing them,

except they're not as accurate. And even the nurse reminded me of this after I got my second negative result when I looked at her kind of confused because I thought I might be getting COVID. She said, don't hang your hat on this negative result, act like you do have COVID. And she took another sample and sent it to the lab for a PCR test instead. And sure enough, a few days later, that did come back positive. Now, you were fully vaccinated, right? I'm wondering, were you surprised that you still got infected and sick? I was surprised. Clearly, I'm a reporter who has been covering COVID, so I knew that breakthrough cases can happen, but I was not prepared for this, especially that my breakthrough case is what doctors would consider mild. All that means is basically you don't need oxygen or you don't have to go to the hospital. Here's how doctors,

Robert Wachter describes it. He's at the University of California, San Francisco. You know, you can have a temperature of 103 and be completely laid up in bed for a week. And all of your bones can hurt and your brain isn't working well. And that's called mild. And it puts in the same category that and the person that, you know, that felt a little crummy for half a day and then went on with their life. So clearly that's a very wide range of illness. Obviously, I'm very lucky, right? Many Americans got sick before the vaccine was even available. Sure.

Much of the world still doesn't have access. Because I knew I was vaccinated, my risk of getting hospitalized was very slim, and I'm also in my early 30s, so that also makes me less of a high risk. But another reassuring thing I learned in my reporting afterwards is that it seems like people don't stay sick as long when they have a symptomatic breakthrough infection that's compared to people who are unvaccinated. This is what Dr. Francesca Toriani at the University of California, San Diego, told me. What we can say is probably you would have gotten much sicker if you had not been vaccinated.

So you could have been sick for a longer period of time, could have had worse symptoms if you hadn't been vaccinated. Exactly. Actually, one study found the time spent in bed sick was about 60% lower with breakthroughs when compared to people who were unvaccinated. Also, breakthrough cases tend to have fewer symptoms. And even the symptoms are a bit different. For example, the top five symptoms with a breakthrough case can include sneezing and a headache. And you're less likely to spike a fever or deal with persistent cough, which are much more common with unvaccinated people. So, well, what did you learn about the risks of spreading it to others if you have a breakthrough? Unfortunately, you can. And this is especially true with the Delta variant. Remember, Delta is more than two times as contagious. as that original strain of the virus, and it can build up quickly in your upper respiratory tract. This is what Robert Darnell, a physician scientist at the Rockefeller University, told me recently.

Even in fully vaccinated asymptomatic individuals, they can have enough virus to transmit it. What we know about Delta is that is very good at replicating, attaching, inserting itself into cells because of the different mutations that are present. Now, to be clear, there's a lot we still do not know about how infectious vaccinated people are. And it's still the case that unvaccinated people are the major source of new infections in the U.S. And just because there's a lot of virus in the nose of a vaccinated person at one moment in time, you know, that doesn't necessarily mean they spread it as well as someone who would be unvaccinated. And in fact, it does appear that the amount of virus in the nose decreases faster in people who are vaccinated.

So there would be infectious for a shorter period of time? Right, exactly. Okay, so, I mean, taking all this information in, I mean, what do I as an individual do with that information if I have a breakthrough? Yeah, I think the bottom line is you should act like you have COVID. That's what I did, even before I had my positive test back. I started wearing a mask and I started isolating myself in the house from my father, who I was staying with. And I'm really glad I did because he didn't get sick. No one else got sick. And I would say it's

also a good idea to get tested if you are exposed to someone who has COVID-19, even if you've been vaccinated. And that's just to make sure, you know, you're not putting others at risk whether or not they're vaccinated. And do we know how often these breakthroughs are happening and why we're hearing of more cases now? In the spring, these breakthroughs used to be quite rare. And I think it's clear the rise of Delta over the summer has changed the odds. Dr. Eric Topol at the Scripps Research Translational Institute in La Jolla, California, he says breakthroughs are clearly happening more these days. It's a totally different ballgame in this Delta phase. And of course, the longer we're in it, the more we have the problem. But, you know, I think the chance of having a symptomatic infection

has gone up, you know, substantially. So here's the thing. We don't have great data on breakthroughs in the U.S. It's not being tracked all that well. But our best numbers from the CDC show that the risk of getting infected if you're vaccinated is five times lower than if you're unvaccinated in the U.S. And the risk of hospitalization is more than 10 times lower. Different studies that try to pinpoint how well the vaccines are working against preventing any breakthrough cases during this Delta surge, and they're still doing pretty well. There are probably several different reasons that breakthroughs are happening more. Some of it may be. waning immunity from the vaccines, especially in older people.

Some of it could be the Delta variant itself, and some of it could simply be our collective behavior. Right. I mean, the U.S. relaxed a bunch of public health measures, right, like masking and social distancing over the summer. Yeah. I mean, all of these are probably at play. People aren't wearing masks as much.

And that is coming together with these other factors to result in more breakthroughs. Okay. So knowing what you know now and having had a breakthrough case, what would you have done differently? Well, looking back, I do wish I had taken more precautions. I would have still taken the trip to see my family and to go to the wedding because people were vaccinated. But in general, I wish I would have been more diligent with wearing a mask, especially a better

one like an N95. And I really would have avoided many of the other things that raised my risk. So that means spending all that time indoors in public places, eating and whatnot. But it's a hard question. I spoke to Dr. Preeti Malani about how vaccinated people should think about risk. She's at the University of Michigan. My hope is that people who are fully vaccinated should really feel like this risk is manageable. What I am seeing in the hospital and what other hospitals are seeing in this area are some breakthrough cases,

but they tend to be overwhelmingly in people who have underlying health conditions. If I talk about what I suggest to my own parents is, feel good about spending time with your friends, have a small dinner party, but make sure everyone's vaccinated. I think it made me realize that we are in a moment where many of us, including myself, are having to do a bit of a reset of our expectations. I would say, you know, it's not like you should go back to a total lockdown mindset if you're vaccinated. And none of the experts I spoke to thought that was a good idea. But it is about trying to lower your risk, at least for now, because the U.S. is still in the middle of a very big surge.

It's averaging more than 140,000 coronavirus infections a day. And right now, your chances of coming into contact with the virus is much higher than it was earlier in the year. But it won't always be that way. And as things change and improve, people will be able to adjust their behavior and feel even more comfortable again. Right. And the more we're cautious now, I'm assuming the faster we will get to that point where things are better. Definitely. Well, well, thank you so much. I'm glad you're feeling better and thank you for bringing your reporting and your own personal story to the podcast. Really appreciate it. Thanks for having me, read too. It was a pleasure. This episode was produced by Thomas Liu, edited by Giselle Grayson and fact-checked by Indy Kara.