Today, Explained - You’re vaxxed. You test positive. Don’t panic.

Episode Date: May 25, 2021

Nine New York Yankees tested positive for Covid-19, even though they were all vaccinated. Vox’s Brian Resnick says it’s proof the system is working, just as New York City is opening back up. Transcript at vox.com/todayexplained. Support Today, Explained by making a financial contribution to Vox! bit.ly/givepodcasts. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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Visit connectsontario.ca. Brian Resnick, science, Vox, son of Long Island. What's your favorite baseball team? Oh, I kind of hate baseball. Perfect. Yeah. Like, when I go watch a baseball game, I'm kind of rooting for the clock. So, like, both teams have to, like, play the fastest game possible.

You can at least root for the hot dogs or the seventh inning stretch or something. Come on. Oh, yeah. But we can get this done in an hour. You know, all that stuff. Anyway. What's going on with the Yankees, Brian? Several members of the Yankees organizations have been infected. It's eight staff members and one player.

They've all tested positive for the coronavirus, despite having been vaccinated earlier with the Johnson & Johnson vaccine. Like a ground ball slipping through the infield, breakthrough cases when fully vaccinated people get COVID are supposed to be rare. But now nine members of the New York Yankees, including shortstop Gleyber Torres, have tested positive for the virus in the last week. And it's important to mention here that just all but one of these people didn't have any of the symptoms of COVID-19. They just tested positive on a test. Okay, so everyone here was vaccinated with that J&J vaccine. They still had nine cases on the team. What's going on here? Is this an efficacy issue, Brian? So we know from the clinical trials of all the vaccines, the J&J, the one from Pfizer, the one from Moderna, that none of that people who have been vaccinated could get infected in some ways.

But, you know, there's still a lot to break down there, too. You know, when we talk about immunity, like immunity doesn't mean just one thing. There's a lot of different levels of what protection means when it comes to being vaccinated. So at the biggest level, and this is what was assessed in the clinical trials, was just protection against disease. So protection against having symptoms of COVID-19,

and everything worse that comes from it. Protection against hospitalization, protection against death. But there's also another level of protection, and that's just protection against infection. So you could very well be infected with COVID-19, the virus could be in your body, but you never get symptoms. You never feel sick. You don't even know you have COVID at all. And what researchers have learned more recently, we didn't know this a few months ago, that these vaccines are really effective at preventing infection. And that gives them more confidence to say, well, people aren't getting infected, so they're not transmitting the virus. You're very likely to be like this dead end in a chain of viral transmission if

you've been vaccinated. This case is interesting because it kind of makes you think about like, what is the thing that the vaccines are doing? If these people who have been infected aren't showing symptoms, like they're probably not infecting other people as well. It means their bodies are clearing out this virus really quickly, that these people did not get sick is showing that the vaccine is working. And it could also be, the Yankees are tested often, a part of their regimen of playing professional baseball. And these tests are very sensitive for COVID. Yes, when you are vaccinated, the virus can get inside you. It can start replicating. But your body is primed to fight, and you might not even notice that you've been infected. You might not be even able to pass it

on to anyone else because there's just such a low level of virus in your body. But have you technically been infected? Yes. But the vaccine is also working. It's doing its job. It's preventing you from getting sick, and it's making it less likely for you to spread the COVID to someone else. And they call these infections breakthrough infections, right? Because they've broken through the vaccine? Yeah. So these are breakthrough infections. And again, like infection is the biggest word we can use here. It's like the biggest tent. Like, you can be infected and not feel sick, you know, which is different than getting the COVID-19 disease. Do all vaccinations come with breakthrough infections? Well, no vaccination is perfect, but an example that has been given to me a few times is the measles vaccine isn't perfect, is not 100% effective.

But you don't see breakout cases of measles because there's just not a lot of measles going around. So there's not a lot of chances for the measles to slip past through those defenses. Also, like in the case of flu, flu vaccines generally aren't very effective. Sometimes they're 40% effective, or it's hard to put an exact number on it because it changes all the time. But, you know, it's very common to get a flu vaccine and then also get the flu. But it also doesn't mean that you don't have any immunity or have any immunity built up. Commonly, when you have a flu vaccine and you get the flu, your flu course is less severe. So you see a lot of flu breakthroughs because there's a lot of flu, but you don't see a lot of measles breakthroughs because there's just not a lot of measles. With the mRNA vaccines, the ones from Moderna and from Pfizer. At the end of April, the CDC reported that, I think at that time there had been 95 million Americans who were fully vaccinated,

and they only had 9,000 around reported cases of breakthrough infection. That being said, is it like a coincidence that all of these Yankees had the Johnson & Johnson vaccine, which I believe of the vaccines we're giving out in the United States is the least efficacious? Yeah, the Johnson & Johnson vaccine in the clinical trials, I think, was somewhere between 60 to 70 percent effective, which for a vaccine is actually really very effective. And the other kind of interesting thing about the Johnson & Johnson vaccine is that its efficacy seems to increase over time. So like two weeks out of being vaccinated versus four weeks out, it seems like you have more protection in four weeks. But it's also a very effective vaccine. And the longer it's been since you've been vaccinated,

you have more protection. So if I'm following what you're implying here, this shouldn't be like an indictment of the Johnson & Johnson vaccine. In fact, it's sort of an endorsement? these kind of super clusters emerge where one person would infect so many other people. And maybe you can look at this scenario as there was a potential cluster emerging, and it just didn't. When you get vaccinated, even in this case where it seems like the vaccines failed, the big point is that you're still, having been vaccinated, so much more likely to be a dead end in viral transmission than if you hadn't been vaccinated. And even though that PCR, that really sensitive test, is detecting a little virus, you still are becoming a dead end in transmission. And I imagine this is comforting to hear for people who might be a little concerned that the CDC recently changed its mask guidelines, saying that fully vaccinated people don't need to wear their masks anymore. Is there any cause for concern here?

I wouldn't be surprised if some people saw these new guidelines from the CDC and were a little confused. But it's important to know here that there is a lot of confusion in how people have been talking about this change of guidelines. But if you read the guidelines and you take them very literally, they are all based in really good science, see how powerfully protective they can be. There's some fear that unvaccinated people might take this as a symbol that the pandemic is over and that they can go out without masks too. But that's not what the guidance says. The guidance says if you have been vaccinated, you have a really high level of protection against COVID. You have a protection from getting it yourself, and you have protection from giving it to somebody else. Yeah, I mean, I just heard on the radio that the new rules at the ballgames in Washington, D.C. are fully vaccinated people don't need to wear a mask, unvaccinated people do.

It seems like a nice idea. I don't really know how easy it'll be to enforce. I don't think they're going to be looking for vaccine cards or anything. Yeah. And the guidelines are lacking in some nuance that some researchers I've been talking to would like to see. So your absolute risk of getting one of these breakout infections or breakthrough infections, should say, is really dependent on what's going on in your community.

Just the more COVID there is around you, the more chances there are for it to wiggle through the crack. I think we see this transition from there being kind of clear set rules in a community to more of everyone has to assess what they're personally comfortable with and assess like their level of risk in any given situation and be proactive and get vaccinated and know that they're not going to necessarily be able to enjoy all the return to normalcy without the vaccination. Even with some sick Yankees, former COVID epicenter New York City is reopening like it's going out of style. How that's going? In a minute on Today Explained. Thank you. PhotoFrame by Wirecutter. AuraFrame's make it easy to share unlimited photos and videos directly from your phone to the frame. When you give an AuraFrame as a gift, you can personalize it, you can preload it with a thoughtful message, maybe your favorite photos. Our colleague Andrew

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free of charge BetMGM operates pursuant to an operating agreement with iGaming Ontario. Melanie, let's have you start by just saying your name and how you want us to identify you on the show. Thanks. I'm Melanie West. I'm a reporter at The Wall Street Journal. Okay. And may I ask where you are? I'm in New York, New York, in my Manhattan apartment. Remind us how bad things got in New York City.

The first case, I remember this very clearly. March 1st was the first person who was diagnosed as having COVID-19 in New York City. There is no doubt that there will be more cases where we find people who test positive. We said early on, it wasn't a question of if, but when. This is New York. We're a gateway to the world. From that point forward, it was just rapid fire. Every day, a new development. The state accounts for nearly half of the nation's reported cases of COVID-19. New York has become the epicenter of the outbreak in the U.S.

One of the reasons Mayor de Blasio of New York was so hesitant to close the New York public school system was because of the harsh truth about the nation's biggest school system. Far too many kids depend on the schools for two-thirds of their daily meals. In the epicenter of the crisis, New York State, 779 people have died in just the past 24 hours. That is yet another record. And the state now has more confirmed cases than every country outside of the U.S. By May, things had started to reopen in a sense that things were safer. You were able to leave your apartment. People felt comfortable going out on the street, of course.

But a year ago was when you saw these first baby steps towards the return to normalcy in New York City. Although people continue to be deeply and appropriately traumatized by what happened in March and April of 2020. And what does it look like now? Well, it's pretty wild. Just to see the dramatic sort of flip back to where people were, what you might have remembered in 2019, it's wonderful and it's heartbreaking all at the same time. You walk down the street and, you know, 40% of people are wearing their masks outdoors and the rest aren't. You go to a restaurant, hardly anybody's really eating

inside. I went to a restaurant and I was seated with my husband at this two-top table and we were literally six inches from the gutter, which in 2019, had somebody sat me at this table, I would absolutely complain. But now that it's 2021 and we can safely go outside and eat and be with other people, I couldn't have been more delighted to be six inches from the gutter. It's like normal with a twist. New York's reopening, I guess, officially happened sometime last week, about a week ago. But that was moved up considerably, right? How come? So the leadership for New York City, which the mayor is Mayor Bill de Blasio, had targeted July 1st to be the full reopening of New York City. This is when public health officials felt like it would be safe, there would be enough people vaccinated.

New York Governor Andrew Cuomo moved that date of reopening statewide for the state up about six weeks to May 19th. So it's time to readjust the decision made on the science and on the data, right? So today we announced a major reopening of New York State on May 19th. When we talk about reopening in New York, we mean that basically all of the capacity restrictions, except for a few, have been lifted. Some businesses still have to maintain six feet of distance between customers, for example, if you don't know the vaccination status. You also have the capacity to ask people for their vaccination status and to require them to share that with you, as well as any contact tracing data, but it's dependent on the business. The other component of this is the state's decision to follow CDC guidance around masking.

The masks are only required in certain settings. They're required on the subway, for example. They're required if you go into a school or whether you go into a nursing home. But for the most part, if you are a fully vaccinated person, the easing of restrictions mean that you're mostly able to participate in your pre-pandemic life the way that you would have previously. Does it feel real? It sounds real. The reopening is real for me because I'm a fully vaccinated person. The reopening, however, is not real for large swaths of the New York City population. And that could include people who have certain medical conditions that don't allow for them to be vaccinated right now. And it certainly applies to the entire child population. And so for those groups of parents, especially who have small

children, you know, we're navigating a different reality than people who, you know, are operating in households where everyone's fully vaccinated. As has been true the entire pandemic. As has been true the entire pandemic. That's absolutely the case. This Zoom school year could not end soon enough. I was going to ask you what you're most looking forward to in New York City this summer, but it sounds like maybe... The end of Zoom school.

Yeah. An optimistic plan laid out today for the biggest public education system in the country, New York City's 1.1 million students ending remote learning in the fall. How many people are testing positive in New York City at this point? The positivity rate, which is looked at over a seven-day average, is pretty remarkable. Across New York City, it's 1.13 percent, and the average number of reported cases is 405. The two metrics that you look for with a reopening, what I was told by epidemiologists and public health experts is, are we going to overrun the hospitals and are we going to have a mass death situation? And based on the number of people who are vaccinated right now and based on the number of people testing positive, you aren't going to get those two scenarios. And so with those two metrics met,

or rather those two pieces of the puzzle solved, we won't have a mass death and we won't have an overrun of the hospitals. You can reopen. Now, where are we in terms of vaccination? So in New York City, 60% of adults have had at least one dose. 51% of adults are fully vaccinated in the state. The number of adults that have had one dose is 63%. And the number of people who have completed their COVID-19 vaccinations is almost 55%. So you've got at least half of the state and the city fully vaccinated. That's among the adult population. So that's pretty good. Else know, elsewhere in the country, it's a little bit of a different picture. You have some states through the South who are having, that are sitting on quite a bit of vaccine. Among those states are Alabama, Mississippi, Georgia, West Virginia, and Arkansas. Those states are at a different

point than New York is or New Jersey is in terms of their vaccination campaigns. And do New Yorkers feel good about reopening because a good number of people are vaccinated? I mean, I think that's a mixed picture, right? What I think you see is people themselves trying to figure it out. When is it appropriate to wear a mask? Do I feel comfortable on the street? There's plenty of places where it's still mandated. When you're in the restaurant, it depends on which restaurant you're in. Do you feel comfortable

sitting outside? Do you feel comfortable sitting inside? I think there's a lot of psychological pieces to this that are going to be figured out in the next coming weeks and months. Certainly. What our reporting at the Journal has shown very consistently over the last couple of months is we don't know until two or three weeks from now whether the decisions that have been made at this moment are good decisions, right? Three weeks time, we may find that there's a spike or an increase in cases in COVID-19. And as the governor has said, and as the mayor of New York City has said,

if that's the case, you might start to see some restrictions back in place. I imagine one thing that makes this scarier for New Yorkers is the fact that the reopening of the city means probably a flood of tourism, right? Part of what brings tourism to New York City is Broadway. Broadway will reopen in September. The last full season for Broadway resulted $1.8 billion in gross receipts.

It adds almost $15 billion to the economy and nearly 100,000 jobs. That's a huge component of tourism in New York City. It looks like the city predicts that there will be about 36 million visitors to New York City in 2021. If you compare that to 2019, we had 66 million visitors, which was at that point a record. So yes, we may be seeing more tourists in New York City, but you're still going to have capacity restrictions in many places. For example, I was recently on the High Line, which is this very popular outdoor park in Manhattan, and it's timed entry. And so back in 2019 on Mother's Day weekend, that place would have been packed elbow to elbow.

And when I went this most recent Mother's Day with my family, it was like the early days of the High Line. They're just, it was nice. It was comfortable. You weren't following people in single file. You weren't trying to, you know, like maneuver your way around people. It was a very leisurely time. And so while that makes a really lovely visit to the High Line, you know, it comes at the cost, of course, right? We know what the cost in New York City was to even get to this place where

we can get back to some level of normalcy. You know, it's thousands of people dying. It's thousands of hospitalizations. It's the closure of untold numbers of businesses. It's the loss of so many things that make living in New York City so great. N-Y-C What is it about you? You're big, you're loud Melanie West covers health in New York City for The Wall Street Journal. Brian Resnick, who you heard from earlier in the show, is a science reporter here at Vox. You can hear him on the podcast Unexplainable. I'm Sean Romsferum. This one is

today explained. The show is made by Emily Sen, Miles Bryan, Will Reed, Koff, Mujzadi, Halima Shah, and Victoria Chamberlain. It's edited by Matthew Collette, engineered by Afim Shapiro. Today, he had some help from Paul Mounsey. Last week, he had some help from Christian Ayala. Laura Bullard's our fact checker. Today, she had some help from Kieran. Music from Breakmaster Cylinder. But sometimes, they get help from Noam Hassenfeld. Amin al-Saadi's our supervising producer.

Liz Kelly Nelson is Vox's VIP of audio. Jillian Weinberger's her deputy. Today Explained is part of the Vox Media Podcast Network. Keep in touch via email todayexplained at vox.com. NYC The shadows at sundown The roofs that scrape the sky NYC The rich and the rundown The Big Parade