The Daily - Most of Us Have Had Covid

Episode Date: April 28, 2022

This week, the Centers for Disease Control and Prevention released new data that showed around 60 percent of Americans — more than half of adults and three quarters of children — have now been infected with the coronavirus. But herd immunity looks likely to remain elusive, and many people are still at high risk from Covid-19.What do the C.D.C. figures mean for immunity in the United States, and for the future of the pandemic?Guest: Apoorva Mandavilli, a science and global health reporter for The New York Times.Want more from The Daily? For one big idea on the news each week from our team, subscribe to our newsletter. Background reading: Sixty percent of Americans, including 75 percent of children, had been infected with the coronavirus by February — another remarkable milestone in a pandemic that continues to confound expectations.For more information on today’s episode, visit nytimes.com/thedaily. Transcripts of each episode will be made available by the next workday. 

From The New York Times, I'm Sabrina Tavernisi. This is The Daily. Today, more than half of all Americans and three-quarters of all children have now been infected with COVID. My colleague, Apoorva Mondavilli, on what that means for immunity and for the future of COVID. My colleague, Apoorva Mondavilli, on what that means for immunity and for the future of COVID. It's Thursday, April 28th. So, Apoorva, I have to tell you that Michael was supposed to be the one having this conversation with you, but he has COVID. So you have me.

He told me that it was okay for me to tell you. I mean, I've had it now, so we're in good company. Exactly. In fact, I remember the last time you and I did an episode, you were just coming out of your sickness with COVID. That's right. And I think actually now I'm starting to hear all kinds of people around me getting COVID who didn't get it in the winter. And I'm sure you are too. So many, so many. So this is our question for you, Apoorva, is, you know, it seems like at this point, everybody in my life has COVID. And I know you've been doing some reporting on just how many Americans have been infected. Tell me about that. So this week, the CDC released new data saying that three in five Americans, so that's 60% of Americans, have had COVID at some point.

60%. That's a lot. I think that's why it feels like everybody you know has had COVID because most of them have. And that exact percentage varies by age. So if you actually think about kids 0 to 17, 75% of them have apparently already been infected. Wow. Three quarters of all children. Yep. And you know, when you think about those numbers, it sort of makes sense, right? Many kids have not been vaccinated, even if a vaccine is available to them. One in four of kids five to 11 have been vaccinated. And for kids under five, a vaccine isn't even available. Right. And, you know, in general, kids are also more social than adults.

They have more social contacts, you know, teachers, other students than, you know, older people who may be very careful. And also in this country, a lot of older people are vaccinated. So those two things, I think, add up to kids being at much more exposed to the virus than older adults. So how did they find that? How did they measure it? The CDC has actually been looking at people's blood samples for evidence of infection since very early in the pandemic. So what they've been doing is when somebody goes in for a routine blood test or for some specific reason, not COVID, they've just gone into a Quest lab or someplace like that to get their blood tested. Quest Lab or someplace like that to get their blood tested. CDC has been looking at those blood samples to sort of get a general idea of what percent of the population seems to already have some evidence of having been infected. And Apoorva, when you say evidence of infection, what do you mean?

They're looking for immune molecules, you know, antibodies that the body produces when you have a viral infection that's specific to this particular coronavirus. You know, you make antibodies when you're infected or when you're vaccinated, and they're different kinds. So they're looking for the kind of antibody that you would have if you were infected. And what time period is this measuring? This particular study is looking at September through February.

And what's really striking is when they looked at September to December, the numbers were about half of what they were by February. So there was so much that happened between December and February. And we know what that was. It was Omicron. That's right. That was when the Omicron wave really hit in the United States. I remember that around Christmastime and then January. Right.

And a lot of people were done with the pandemic. A lot of people didn't really want to deal with it anymore. So there were fewer precautions. We had this insanely contagious variant. You remember those graphs where, you know, the number of infections just kept going up and up and up. And that's what was happening. Apoorva, giving these pretty striking numbers, does that mean that we have finally arrived in the United States at this holy grail of herd immunity? No, we have not. Somehow I knew you were going to say that. Not only have we not arrived there, I hate to say this, but we're probably never going to get there. Why not? Herd immunity is this goal that people talked about, you know, very early in the pandemic

when we didn't really know what kind of virus this was. We didn't know enough about it yet. And it's a very difficult place to get to. If you think about, you know, measles, we have this incredibly powerful vaccine for measles and 95% of the population is vaccinated with that. And then that's it. You don't really care about measles very much except for like the odd outbreak here and there. For the coronavirus, everything is different. We have many more versions of this virus that we've seen. We have nowhere near that

percent of people vaccinated. And people keep losing their immunity to this virus in a way that doesn't happen with measles. I mean, we know that even if you've been infected once or you've been vaccinated, you can get infected. You know, that's one of the things that takes herd immunity off the table. People can and probably will get infected more than once. So it's just a much more complicated picture to get to herd immunity with this virus. And now that we've arrived

at these very contagious variants like Omicron, it's just impossible. Okay, so no herd immunity, as you say, but the numbers still mean we have this significant protection, right? I mean, 60% of Americans, that's a lot of people having gotten it. We do. And we also have a lot of people who've been vaccinated. So one way or another, we have a significant proportion of the American population that is protected enough to never need hospitalization or to die from this virus. At least as long as the variants stay somewhat reasonable and don't completely change from what we've seen so far. So speaking of the variant, we know we're starting to see this surge in cases that we're all experiencing from BA2.

Are people who got sick from Omicron before getting sick again now? They shouldn't be. You know, if you've been infected once, you probably won't get reinfected for at least two to three months. And BA2 is really not all that different than BA1, which was the version that circulated in the winter. And so if you've had Omicron already, you're not going to get it again this time anytime soon. So that sounds like more good news. It is, but remember that only 60% of the population seems to have been infected as of

February. So that still means 40% have not. So there will still be people who get infected. They might not get very, very sick, but they might still become sick enough to need to stay home from work. And we saw this winter how disruptive that can be when, you know, healthcare workers and airline pilots and grocery store workers all get so sick that they stay home, the country. And podcasters. And podcasters. So I think it was a signal to us that you don't really need tons and tons of people to end up in the hospital for a wave to be disruptive. And we could still see something like that if the numbers keep going up. who get infected, there could be long-term consequences. You know, we have this very poorly understood syndrome called long COVID, where some number of people who get infected stay sick for a really long time,

have these very lingering symptoms. And, you know, if you're vaccinated, the percentage of people who end up with that gets lower, but it's still not zero. And when you're talking about hundreds of millions of people, even a very small percentage translates to a lot of people who are still feeling ill, a lot of people who need health care, and a lot of people who may not feel well enough to work. Right. You know, you're talking about infection rates as if that's a knowable number. And I guess I'm just curious if we actually do know how many people are getting infected. Because this is really the first wave of COVID in which everybody

has access to a home test, right? So people are just testing at home, not necessarily registering their result. So how do we actually know the infection rate at this point? We don't. We don't actually know how many people are infected or who is infected. When we are talking about these waves that we're seeing, you know, in different parts of the country, we're really talking about trends that we're noticing that the infections are going up, but exactly by how much, I don't think anybody has any idea. But, you know, just knowing that the numbers are going up gives you enough information, enough information to the CDC or to the local government to prepare and to maybe put restrictions back in place. You know, earlier on, many of the administration officials were actually talking

about wanting to prevent infections along with severe illness. But now, you know, more recently, this week even, they are saying that they want to prevent all cases of severe illness, hospitalization, and minimize the number of infections. So infections are a secondary goal now. I mean, is that basically the administration telling us we should all be prepared to get it? I don't know if they're saying that. I think they are still committed to trying to prevent infections. But I have heard some experts say that everybody, all of us, will get it once or twice, simply because this virus is not going anywhere.

And we know now that at least the vaccines that we have so far, and even people who've been infected before, they're not immune to reinfection forever. And Apoorva, do you think we should all be prepared to get it? You know, if we lived in a different world where we had different sorts of societal systems in place to protect people, then I would say, yeah, we could actually have a goal

where we don't get anybody infected, especially people who are high risk. You know, we could really protect everyone. But we don't live in that world. We live in a world where people have stopped wearing masks and don't want to take precautions. And so, yeah, I think anybody who is out and about and mingling with people should expect to get infected at some We'll be right back. We'll be right back. So Apoorva, you said that most of us have gotten COVID and the vast majority of kids have gotten COVID. And if we haven't, we should all be prepared to get COVID. I, by the way, have not gotten COVID.

So I guess I want to ask then about behavior and how we should live our lives in this current phase, you know, where an infection is pretty likely, right? Let's start with masks. Should I still wear a mask on a plane when it's no longer required? And if everybody sitting around me is not wearing a mask, I mean, should I just skip it? I think that depends so much on your individual risk and it depends on your risk tolerance. And it also depends really on whether you have all the resources to deal with an infection if you do get one. I'm still wearing a mask, even though I do think that I'll be protected for a good bit from infection because I don't know exactly when that will wear off and I certainly don't want to get infected again if I can avoid it. I don't think of wearing a mask as a very big deal. But for people who are immunocompromised or at high risk or who were infected or vaccinated a long time ago, I do think it makes sense to wear a mask whenever you are in any sort of crowded

indoor situation. But is one-way masking effective? It is if you use one of those very powerful masks, like the N95. You know, N95 basically means it's going to keep out 95% of the things that it needs to keep out. So yes, if you wear an N95 mask or something similar, you can actually protect yourself to a pretty large extent. And I think those are much more freely available now than they used to be. So it's a good idea to at least stock some of those. But there's no question that two-way masking is more effective overall. Okay, so let's say you were exposed. Like, I'm pretty sure that I was exposed last week because

I was at a dinner party and there were a couple of people who later tested positive. So how should I be thinking about testing at this point? You know, before testing, I would definitely say also that you should be wearing a mask if you think you were exposed for a while, especially around high-risk people. But if you're just doing home testing with an antigen test, you should test yourself maybe once a day for 10 days to two weeks just to make sure. Wow. So, okay, I'm going to take this home test right after we finish this interview, and then I'm going to keep testing every single day? Well, you know, in your case, you have a good reason to believe that you might be infected. So you could keep using the antigen tests or you could just go get a PCR test and then you'll know for sure.

Okay, but say I have symptoms like sneezing, sore throat. I give myself a home test. It's negative. Am I good to just go about my life just like I have an ordinary cold? Actually, no. And it's a really interesting distinction about Omicron that we're learning more about. So remember earlier in the pandemic, we were told that you're most contagious before the symptoms appear. You were supposed to actually be contagious a day or two before you felt any symptoms. But with Omicron, you could have symptoms for several days before you test positive on a rapid test. A lot of people feel symptoms for a full week before they ever test positive on a rapid test. It's just, yeah, it's completely different. And so you don't want to assume just because you've seen a negative result on an antigen test that you don't have Omicron.

So even if I'm feeling sick and testing negative, that doesn't mean I don't have COVID. I'm feeling sick and testing negative. That doesn't mean I don't have COVID. Exactly. You might be sneezing and coughing and yet not have enough virus in your body to test positive on a rapid test. And that's what happened in my case, for example, where I had symptoms for a week before I tested positive on an antigen test. Right. A lot of people I know are having this, that, you know, they feel sick, they test and test and test, and it's negative, and they go out into the world. It's different,

right? I mean, we didn't expect this because our understanding of how this all plays out was based on earlier versions of the virus, but Omicron is an odd bird. All right, let's say I do test, and it's positive, and I feel sick. Then what do I do? You do what you do when you're sick with anything else. You stay home if you can. You rest and you take it easy and you try not to expose other people. And if you've been vaccinated and boosted, you're going to be fine. You're not going to end up in the hospital unless you have a particularly high risk. If you are worried, you can go to your doctor and ask for an antiviral drug. We have those available now. What are those drugs? So we have a few around and the most effective is probably one

called Paxlovid. And there's a lot of it available in theory across the country. What do you mean in theory? Well, you know, there's plenty of the drug to go around. You know, we've had it around for a few months now and initially supply was the issue. That's not the problem anymore. The problem now is to actually get it. And I'm saying that because the systems that we have to get people a drug like that are really complicated. You have to get a doctor to prescribe it for you. And a lot of Americans don't even have a primary care doctor.

So if they need this drug, they'd have to find a doctor that will prescribe it for them first. And they have to find a doctor who actually knows how all of this works because there are a lot of reports that doctors actually misunderstand the criteria. Some think that, you know, vaccinated people don't qualify. So you actually have to find a doctor who knows what they're doing. And then you have to find a pharmacy to fill that prescription, which also sounds easy to do, but isn't in many places. So if you are, for example, in Pierre, South Dakota, you have to drive a hundred miles just to get to a pharmacy that

has Paxlovid. Whoa. You know, and the Biden administration was trying to make some of this easier. They had this whole test to treat project where you were theoretically supposed to be able to go and get a prescription and have it filled all at the same place. But again, there are lots of places where the access to those is really limited. If you live in Boston or you live in Brooklyn, where I live, there are plenty of locations. But again, if you live in Pierre, you have to drive 200 miles to Minnesota or to North Dakota to get to the closest one. And, you know, we're talking about people having to do all of this in the first five days of symptoms because that's when the drug is effective. Right, so that's a pretty narrow window

and it means a lot of people aren't actually getting this stuff. Exactly. But let's say you're one of the lucky ones and you do get it. What should you expect after you take it? Oh, this is actually a very powerful drug. And in clinical trials,

it seemed to cut down the risk of hospitalization and death by 88%. Oh, wow. But that's why you have to get it also within the first five days of symptoms because you have to get it before the virus has had a chance to do any damage. So I have a provocative question. Let's say I do test positive and I have some symptoms, sore throat, runny nose, but I'm vaccinated.

So for me, it's kind of like I just have a cold. And theoretically, I could take Paxlovid, make sure I don't get super sick. Can I get on a plane and go on my vacation or go on a business trip like I would have done, you know, before COVID, if I just had a runny nose, I probably would have gotten on a plane. Well, you know, you can't forget that there are people all around you who might actually be much more vulnerable than you are, who might be vaccinated and boosted and still be at risk or might not be vaccinated.

You know, I would say if you can not put other people at risk and stay home, you should. If it's unavoidable, then do everything you can to make sure that you're not going to pass it on to somebody else. So if I wear an N95 the whole time, I am not a monster if I get on the plane? No, you're not a monster. But, you know, it's really just about

weighing costs and benefits for everyone involved, not just yourself, because we do live in a society. So you have to think about what you would be giving up if you didn't go and what somebody else might be giving up if they did go and they were next to you. And, you know, you take all of that into account and you have to make a decision for you. So Apoorva, given everything you've told us, how should we be thinking about this moment in the pandemic? I mean, where are we? You know, that's a very good question. And I think everybody's trying to figure out the answer to that.

We do still have a lot of work left because we have a lot of people who are unvaccinated. We have a lot of people who are high risk and will stay high risk even if they're vaccinated. We have a lot of kids who aren't vaccinated. And a lot of people who have been infected may end up with long COVID, which will be an ongoing issue for years to come. So there's lots of things to still think about. But what I can say in a positive way is that we are in the best place in this pandemic that we've ever been. We've had a lot of people vaccinated. We know now that 60% of Americans seem to have had it and have some immunity.

And we have good antivirals to treat anybody who is at risk. So all of those things look great. So even though we're in the middle of this surge, at least in the Northeast, we're in the best place we've ever been. That's kind of amazing. It is amazing. Considering that case numbers are going up, we are actually in an okay place. But the pandemic's not over. But the pandemic is not over. If the pandemic is a road trip from California to New York, where are we?

I couldn't tell you because we don't have a GPS for this particular virus. We could be in Kansas, we could be in Ohio, we could be in West Virginia. We are getting closer to the East Coast, though, so that's the good news. Apoorva, thank you. Thank you. We'll be right back. Here's what else you need to know today. On Wednesday, Russia cut off natural gas to Poland and Bulgaria, both members of NATO,

the toughest move yet by Vladimir Putin since the war in Ukraine began. The move marked an escalation in the confrontation between U.S.-led allies and Russia, though its immediate impact was likely to be limited. Poland, in Europe's formerly communist east, gets more than 45% of its gas from Russia. Bulgaria gets around 90%. European leaders called the move, quote, blackmail. The shutoff comes a day after the U.S. and its allies pledged to rush more and heavier weapons to Ukraine. And. I read the report, most of it anyway, this morning. I found the contents to be repugnant, at times horrific.

A two-year investigation by the Minnesota Department of Human Rights has concluded that the Minneapolis Police Department, the state's largest police force, routinely engages in racially discriminatory policing, often using needless violence and racist, misogynist slurs. The state investigation, based in part on 700 hours of body camera footage, began just one week after the killing of George Floyd by a Minneapolis police officer in 2020. The inquiry found that the department fails to hold officers accountable for misconduct

and has used fake social media accounts to target Black people, elected officials, and organizations such as the NAACP. There have been so many instances in the past where an investigation has been conducted, findings have been had, recommendations have been given, and then the action ultimately fell short. This time, it needs to be different. Today's episode was produced by Rob Zipko and Stella Tan, with help from Michael Simon Johnson.

It was edited by Rachel Quester and Paige Cowett, contains original music by Dan Powell and Marion Lozano, and was engineered by Chris Wood. Our theme music is by Jim Brumberg and Ben Landsberg of Wonderly. That's it for the daily i'm sabrina tavernisi see you tomorrow