What A Day - Ask Delta Questions, Get Delta Answers with Dr. Joshua Sharfstein

Episode Date: July 23, 2021

The U.S. is at another pivotal point in the pandemic, with loosening restrictions and the rapidly spreading Delta variant leading to a concerning rise in cases, and less than half of the population fully vaccinated. We talked to Dr. Joshua Sharfstein, Johns Hopkins University’s Vice Dean for Public Health Practice and Community Engagement, about the current state of the pandemic in the country.And in headlines: Biden plans to sanction Cuban officials for human rights abuses, Mississippi attempts to overturn Roe v. Wade, and NASA researchers map the inside of Mars.Show Notes:Nature: “How the Delta variant achieves its ultrafast spread” – https://go.nature.com/3BHosgOFor a transcript of this episode, please visit crooked.com/whataday

It's Friday, July 23rd. I'm Akilah Hughes. And I'm Gideon Resnick, and this is What A Day, where we are calling on the FCC to clamp down on misinformation by temporarily shutting off the internet. Yeah, you know, keep hospitals and stuff on, but the rest of us could use a break. I will use the internet downage as a chance to learn Spanish. I plan on taking a nap. Don't

bother me. Yeah, realistically, that's probably what I'm going to do. On today's show, the White House issues sanctions on Cuba after the country's recent crackdown on protesters. Plus, NASA researchers have given us our first ever look into the hot center of Mars. But first, the fast spreading Delta variant has health officials sounding more urgent than just a few weeks ago. We are yet at another pivotal moment in this pandemic, with cases rising again and some hospitals reaching their capacity in some areas. That was CDC Director Dr. Rochelle Walensky during a briefing yesterday. Yeah, and this reflects how things have changed in the U.S. just since July 4th. That was the day the White House was hoping to symbolically mark our collective independence from COVID based on the progress of vaccinations.

But less than half of the country has been fully vaccinated and slightly less than 70% of adults have received one dose, which was a goal the president hoped to reach on July 4th. Right. Cases have jumped rapidly in the U.S. also, with the two-week average spiking over 170 percent, and there are projections that it's going to get a lot worse. Hospitalizations and deaths are also increasing, but to a lesser degree in places where more of the population is vaccinated. And Dr. Walensky said that the Delta variant makes up more than 83 percent of identified cases in the country, and here's more of what she said yesterday. The Delta variant is more aggressive and much more transmissible than previously circulating strains. It is one of the most infectious respiratory viruses we know of and that I have seen in my 20-year career. Yeah. Wow. And here's another startling fact, Tequila, that I found that we can link to in our show notes. There is data suggesting people infected with Delta can carry up to 1,000 times more virus in their nasal passages than with the original strain.

That is a huge number. And we're also seeing this week that local officials all over the country are grappling with instituting or reinstituting masking requirements for everyone. Although for now, the CDC has not updated their overall guidance, though some say, me obviously, that they should come out with stronger guidelines in the face of these rising cases. Yeah, so we wanted to get you some expert advice and information since, as Walensky said, America is at another pivotal moment in this pandemic. We have with us again, Dr. Joshua Sharpstein. He's the Vice Dean for Public Health Practice and Community Engagement at Johns Hopkins University. Dr. Sharfstein, thank you for being on WOD. Thanks for having me.

What are some of the biggest factors that have led to what kind of feels like a dramatic change in terms of how health officials are talking about the pandemic in just a few weeks? We have the Delta variant now in the United States, not just the occasional case of Delta variant, but four in five cases now are Delta variant. There are more than 250 deaths a day. That appears to be rising again. There's a 35% increase week over week in hospitalization. So this is not the direction we want to see things heading. It's leading people to take a look at the situation we're in and what could happen and how it could get worse. When it actually comes to masks, the CDC just this past May advised that

fully vaccinated Americans could go without them in most settings. And that's because transmission was significantly lower and daily vaccination rates were a lot higher, as we both know. But with where we're at now at this point, was that decision by the CDC too soon? I have my opinion about it. And also, is reinstituting mask mandates the way to go now? Is that even a possibility? Well, I think there was some misunderstanding at the time about that CDC statement. I think the CDC statement that people who are vaccinated have an extraordinarily low risk of getting sick, even if they're unmasked, is true.

But people interpreted that to mean it's okay to get rid of mask mandates in all settings, and a lot of states immediately dropped them. I do think that people got rid of mask requirements a little early and may need to put them back, irrespective of how good the vaccine may be in preventing cases of the virus. I feel vindicated in that, you know, you're a professional and you know what you're talking about. And I've been saying it. So just for the people listening, I was right.

Well, I think the analogy that I used at the time was that it may well be the case if there's some self-driving car that can make it through the intersection without causing an accident, even if the light is red. But if a lot of the car is still the driver's driving, it doesn't make sense to take down all the streetlights. Right. And I guess the alternative to that in terms of public spaces, specifically public indoor spaces, would have been this determination as to who is vaccinated and unvaccinated in those settings, because I think that's what we're left with not knowing at this moment. Is that the way to go everywhere? Is that an alternative, perhaps better way than trying to enforce masks again? I don't think it's a blanket answer because, for example, there are some places that you really want everyone to have access to. You wouldn't do something like that at the Department of Motor Vehicles.

Everyone needs to be together. You know, having a way to prove your vaccination status and if a private business wants to keep people safe to be able to use that information, I think can be reasonable in the right setting. So I think it depends a little bit on the setting. Earlier this week at a town hall, President Biden said that he expects the FDA will give full approval to the vaccines as opposed to where we are now with the emergency use authorization. Let's take a listen. They're not promising me any specific date. We put together over 20 of them, plus others in the field, is that sometime, maybe in the beginning of the school year, at the end of August, beginning of September, October, you'll get a final approval saying the FDA said, no, this is it. It's good. So what would that change mean for mandates and potentially case rates? When it gets licensed, I think more,

there are some people who just want to wait. And they just said, look, I understand there's the track record of 100 million Americans, but I want to see that final stamp of approval. And I think some people will then get vaccinated. I think it probably will have a bigger impact on businesses that are going to feel more comfortable strongly recommending or in some cases requiring people to be vaccinated. And I'm particularly thinking about businesses where the people come in contact with some people who may be at risk for severe COVID. Not just healthcare workers, but maybe nursing home workers or people who are working with older adults. I would expect that more of those companies will say we have an obligation with a fully licensed vaccine for our employees to keep them safe. In the midst of, you know, increasing vaccinations, we've also seen a number of so-called

breakthrough infections. This is where fully vaccinated people have tested positive for COVID. That includes several Olympic athletes, some of the Texas Democrats who flew to D.C. recently. But can you walk us through the science for people who may just casually see these headlines and then perhaps start to get nervous? When these vaccines were approved, and like I said, there were tens of thousands of patients, they did not skimp on the size of the studies at all.

There really wasn't much skimping at all. What the data showed was a dramatic reduction of the chance that you'd get sick at all. And a reduction that was even greater for hospitalization and death. Now, the more virus that's out there, the more people will be in that vaccinated but getting sick group. So it's not surprising with cases rising and the Delta variant more transmissible that we're seeing those cases. But the vaccine, you know, isn't perfect. And it never was.

It wasn't from the original studies. It's just extraordinarily good. And extraordinarily good protection is what people should be wanting now. But sort of keeping with that track, because I, you know, we're all hearing anecdotal evidence about people getting these breakthrough infections. So I'm just curious, if a breakthrough infection happens and a person is asymptomatic, you know, is there a sense of

whether or not there can be sort of long-term implications or long haul symptoms, or are they just totally in the clear? Like I personally am very afraid of getting COVID at all. It's a fair, totally fair question to ask. I don't think we know the full answer to that. But I think based on what we know about how viruses work, it's quite likely that you will not get those long-term effects. So obviously, it's scary, you know, to know that you're infected. You thought you were protected. That's a scary thing to see. But I am not familiar with evidence showing that this is a serious risk for a long term. And just to make it about me a little bit more.

So I had a sore throat this week and had to miss an episode of the show. I think it was just allergies. But a lot of people are coming down with colds and flus and things because we haven't been around each other. Our immune systems are readjusting. But what is your advice to people who might be worried about where that sniffle is coming from? Like, should they go get a COVID test immediately? What should be the sort of protocol if you're not feeling well, but you're not sure if it's COVID? It's totally fine to get a COVID test if it's on your mind. You know, I mean,

you could have done that this week if you wanted. I don't know if you did, but. Would it have been too soon? I heard it has to be five days. No, that's not true. I would say if you have symptoms, it should pick it up. So you do not have to wait. Your girl's good, y'all. No COVID over here then. You know, it's the kind of thing that if it crosses your mind, you might as well get a test. They're very widely available. And obviously, in general, I think if people are feeling sick, they should stay home. That's something from our pre-pandemic lives that we should change. We should stay home. We should keep other people safe in the workplace.

And I think we'll see a lot less transmission of other infectious diseases going forward. We don't really know, you know, how or where all of this goes. But if this is the kind of case threshold that we're at in the summer, what are some of the scenarios that could happen when schools and colleges start opening up again with colder months ahead? Obviously, we've baked in, you know, nearly 50% of the population protected via vaccination. But what is your sense there? What it looks like is that if people aren't wearing masks and the vaccination rate isn't really above 70% of people who are eligible, it's most of the models are predicting a spike in the fall. None of them like last winter bad, but still, you know, thousands of deaths a week bad, which is a lot. And so there is reason for taking this seriously. So that doesn't mean that we're doomed to have that. We don't know exactly what the virus is going to do. And of course, we control our own fate because we don't have to be in the 70% or below group. We can be higher than that. But

this is a serious situation still for the United States. Of course, you know, it's even more serious in other parts of the world at the moment. We probably have a lot of folks that listen who are vaccinated at this stage. They might be talking to people in their family or friends or otherwise who are not. What would be your message for them in those conversations to help convince people and talk to people about getting vaccinated? The instinct sometimes is to get angry or to say, how come you don't see the evidence like I see the evidence? But it first helps to listen and to understand that people are sometimes nervous about things. And you can express that you were nervous about it too, if that's true. One thing that I have started doing is not talking about the what in the evidence, but the who.

Who would you get vaccinated for? I've had people who would stop mid-sentence telling me some piece of misinformation from the internet and they just change and they go, well, if I do it, I would get vaccinated for my mom. And I'd say, well, tell me about your mom. I'd say, well, I live with my mom. She's got diabetes. I don't know whether the vaccine worked for her. And so I think if we think about the reasons people get vaccinated, it's both an intellectual and it's emotional. Some people will see it right away and want to do it. Other people come to think about the people in their lives, that it really would matter for them. Well, Dr. Joshua M. Sharfstein, public health professor at Johns Hopkins University. He's also the co-host of the

podcast Public Health On Call. Thank you so much for taking the time. We really appreciate it. It's a pleasure. And that's the latest for now. We'll be back after some ads. Let's wrap up with some headlines. Headlines. President Biden announced plans to impose sanctions on Cuban officials for their involvement in human rights abuses during the government's response to recent protests on the island. Among those censured were the country's defense minister and a Cuban special forces unit called the quote-unquote Black Berets. The sanctions came a day after Biden's Wednesday night phone call with Democratic Cuban-American activists in Miami who have been demanding action since the July 11th

uprisings, which resulted in hundreds of people being beaten or arrested. The Biden administration's response also includes measures to bring increased internet access to the island and calls for more international pressure on Cuba's government. Yes, and hopefully there will be some pressure on America's government to treat our protesters better. But Mississippi's attorney general asked the Supreme Court to overturn Roe v. Wade yesterday in order to uphold the state's restrictions on abortion cases. Attorney General Lynn Fitch said the case to overrule Roe was, quote, overwhelming, and she urged the justices to sign off on a controversial Mississippi law that bars most abortions after 15 weeks. A.G. Fitch also asked the court to overrule a 1992 abortion rights case, Planned Parenthood

v. Casey, which followed Roe. The court's six to three conservative majority will hear the case this fall. Overturning Roe would likely lead to the prohibition of abortion in 24 states and three territories. Awful, awful. The House voted 407 to 16 yesterday to expand the number of available special immigrant visas for Afghans who helped American troops and diplomats during the 20-year war in Afghanistan. By removing some application requirements, the House moved to increase the visas from 11,000 to 19,000 and allow each visa applicant to include up to four family members. Only Republicans voted against the bill, meaning they've picked an extremely convenient moment to forget how much they typically love war. The move to shorten the wait time for Afghan allies to enter the U.S. is essential, as they are all potential targets of retribution from the Taliban forces in the wake of the U.S.'s

withdrawal from the region. The government managed to do something in space while all the billionaires were distracted. So NASA researchers announced on Thursday they had used seismic recordings from their InSight lander to map the inside of Mars. Sadly, it is not filled with candy and prizes, so I lost that bet, but it does contain a core that is larger and less dense than scientists previously thought, with elements like sulfur, oxygen, and hydrogen comprising a significant portion of its contents. Scientists were able to confirm for the first time that the core of Mars was molten. They said the findings were significant and that they represented the first measurements of Mars's dimensions that could be drawn

from empirical recordings instead of theoretical calculations. The translation here, we now have Mars's real height instead of the height he claims to be on Bumble. Yeah, I got to see the actual profile picture too. I don't believe the one that's on there. Yeah, just be 5'11", you know,

there's no shame in that. And those are the headlines. Two more things before we go. On this week's episode of With Friends Like These, host Anna-Marie Cox is joined by sports writer Alyssa Roenick to discuss Simone Biles and the politics behind gymnastics at the Olympics. Listen to this and other powerful conversations by subscribing to With Friends Like These wherever you get your podcasts. And then, second thing,

have a great weekend and do not freak out when you don't hear us on Monday. We will be back in your ears next Tuesday. That is all for today. If you like the show, make sure you subscribe,

leave a review, match with Mars on Bumble and tell your friends to listen. And if you're into reading and not just the children's menu at restaurants like me, what a day. It's also a nightly newsletter.

Check it out. Subscribe at crooked.com slash subscribe. I'm Akilah Hughes. I'm Gideon Resnick. And please turn off the internet. I'm over it. It's so much. There's so much internet.

Yeah. We had a good run, but it's, it's done. It's over. Yeah. We're all set run, but it's done. It's over. Yeah. We're all set. Mm-hmm.

I don't know. What a Day is a production of Crooked Media. It's recorded and mixed by Charlotte Landis. Sonia Tun and Jazzy Marine are our associate producers. Our head writer is John Milstein, and our executive producers are Leo Duran, Akilah Hughes, and me. Our theme music is by Colin Gillyard and Kashaka.