On Tuesday afternoon, the U.S. government recommended that almost every American begin taking a new annual vaccine for Covid, a milestone in the nation’s three-year battle against the virus.
Apoorva Mandavilli, a science and global health reporter for The New York Times, explains why the era of booster shots is now over and how to navigate this latest uptick in infections.
Guest: Apoorva Mandavilli, a science and global health reporter for The New York Times.
Background reading:
- The C.D.C. recommended all Americans aged 6 months and older should get at least one dose of new Covid vaccines.
- Covid continues to rise, but experts remain optimistic.
For more information on today’s episode, visit nytimes.com/thedaily. Transcripts of each episode will be made available by the next workday.
This is an unofficial transcript meant for reference. Accuracy is not guaranteed.
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The new york times, I'm michael of our own
Is it a on tuesday afternoon, the? U S, government recommended that almost everyone-
again begin taking on new vaccine for covert a milestone in the nations
You're a long battle against the virus. I spoke with my colleague approval
the view about why the era of booster shots is now and how exactly
we're supposed to navigate this latest uptick in infections. In what too many feels like a post covert war, the it's Wednesday september, thirteenth, a approval, we're talking to you just about an hour after the centers for disease control and prevention, does something
don't do all that much of these days, which has no publicly way and on covered all these many months after telling us that cover is no longer a national emergency. So tell us exactly what the cdc just did, what they did. Today's then certain refrained how we think about the kind of ass vaccine. We used to have all these boosters and doses to keep track of, and they recommended a single shot, but everyone should get. The idea is that you're gonna continue to get
good vaccines? But you should really think about this, like the flu vaccine you're going to get one dose every fall and that's gonna be for everybody, not this many doses for this group and that many doses for the other group in this very confusing male launch they had before it was a confusing march, does not just mean thinking man. It was confusing to me too, and I write about this tough. I think everybody had trouble.
Bring out how many doses they'd had and what they were due for next and whether they really needed it and what the cost benefit analysis were, and so today, what we have is a much more simple model shares this maxine. The we're going to have every year like we do with the flu vaccine. It'll now be a part of our regular healthcare, and everyone should go, get it
it will become part of the ritual of getting a vaccine, and I have to imagine
and a big reason why the cdc is pushing. This is not just because the previous regime was confusing, but because the previous system wasn't really getting people to take a vaccine. It's a bit of both. I think not many people got the last booster. You know Pfizer actually thought something like one hundred million doses of the booster would be administered this year, just as an example, and actually only about twelve million doses were in the first six months of the year. That's a tiny fraction is a tiny fraction and gives you a sense of how few people really were interested in getting the vaccine. The numbers were the best for people who really need it. You know older adults really did go out and get it about half got. It
but if you think about adults as a whole, fewer than one in five americans got it and that's just not a very high number well. So what should we know about this new vaccine, this new annual coven shot and how it differs from past shots, the ones that we have talked about thought of as boosters for a while? We were getting the vaccine that was intended to protect us from the original version of the virus that came through in early two thousand and twenty, and we got several doses of that and then the most recent vaccine that we all got- or at least I got the fda- tried to sort of hedge, their bets by having part of that, but also part of the AMO cron variant, and so they were trying to sort of protect us against both, and you know before we were
reactor. We had wave after wave and we were just rolling out the vaccine as needed, and this was much more intentionally. You know in june the FDA decided okay, this is what we're gonna. Do we're going to pick the variant that is the most dominant and we're going to design the vaccine to protect us from that variant. So it was all a bit less rushed and frantic
it used to be got it. So it's a little bit more anticipatory. It is- and this is
very familiar process for our federal health officials. They know how to do this because they do this every year for the flu vaccine, except for the flu they make that very dim in the spring after they ve seen what the fluted in the southern hemisphere, sometimes that vaccines are being a good match for what we actually seeing the fall. Sometimes it's not, but usually even when it's not a grade match you end up getting sick for fewer days. You may not get quite as sick and threats to usually worth getting it and nuts. I think that the hope for the covert vaccine to is that, even if they pick a variant and drawn and everything changes by the fall, you'd still get some amount of protection from getting the vaccine and would be better than nothing right and you carving,
hinted at this, but I'm assuming nothing changes here with the function of a cobra vaccine. The idea is that the vaccine will necessarily prevent you from getting covered its design, above all, to make a covert infection. My other that's absolutely right. I think many of the vaccines that we had in the past few years have not been great at preventing infections. I think now we should really just expect these vaccines to protect us from ending up in the hospital.
We're getting really seriously sick or dying from it. So now I want to better understand what the scene
he has said about who should get this vaccine, how
broad or narrow. Their guidance is for age groups, populations and so on. Actually, really simple: now they said everybody was older than six months should get at least one
dose of this vaccine. That's what I just brought as a recommendation can possibly be I'm curious how that compares with the breath of the government's recommendation for the flu vaccine. It's exactly the same as for the flu vaccine, and I think that's another hope that by
at the same as the flu- it will make things very simple for people to remember and understand right, given these very broad recommendations on I'll ask a few logistical questions about this new facts,
I mean now that it's supposed to be an annual shot when exactly on the calendar. Are people supposed to get this vaccine? What's the specific window of time, you should get it when you're actually likely to get it whenever it's most convenient, for you is what I hear from the experts, because they're so worried that if you try to give a very specific window, people will just not go. If you can go multiple times. They recommend that you get the covert shot when covert is looking like a problem, and you get the flu shot sometime in october, because flu usually peaks much later than covert, got it, but if you don't think you're going to actually get to the
clinic multiple times, then you should get both as soon as you can. Whenever you have time, I once heard about the reality that these recommendations from the cdc arrive at a moment in our relationship with covered that fuels- worse, contextual, rising, which is that despite the government telling us that the danger has really past cases are actually rising right now, I just had to deal with an affection and my own family. Several people on the daily team have recently been infected. I should say not by me and yet our access to hard data on case numbers is very different than has been in the past. So it's a strange time to try to wrap your head around thing so give us the official lay of the land. It is a confusing time because,
before it was very clear that cove it was dangerous, they were rising cases, they were rising oscillations and debts. We knew exactly where we stood and where the cases were going up now,
As you pointed out, we don't actually have great data. The cdc is not reporting numbers of infections any more, so we don't have a great idea of whether and how much cases are going up. We kind of have a sense that they're going up because we see it in things like wastewater and, as you said, you hear about people around you getting sick. What we don't know the exact numbers and when you say wastewater, just to be clear. This is the idea that sewage is tested periodically by municipalities and that's how local governments can often determine that coven seems to have been growing in a particular place right and it's not a very quantitative way, doesn't give you a really clear idea of how much virus there is. But you get a general sense. You can see that it's going up. You can see that maybe it's about the same level as it was last year at some time, but if they're, not exact numbers,
We just don't really have a clear picture of cases. We have better data for hospitalizations and deaths and we can see from that that those are going up, they've been going up since july, but the actual numbers are a lot lower than they were in previous years. So hospitalizations are about half the number. They were at the same period last year and one fifth, the number in two thousand and twenty one. That's also you know there are deaths. There are six hundred or so deaths every week, which is not nothing, but they are lower a lot lower than they were in august. Twenty twenty two: when there were three thousand people per week dying,
and fourteen thousand per week in august, twenty twenty one. So there is a risk level that is significantly lower than in the past me. Fourteen thousand deaths a week verses six hundred per week is things only twenty three times less lethality as meaningful tat is meaningful, but when you compare to something like the flu, it still worse than the flow it's just
better than it was in the really horrific delta period. So we ve come a long way but cold. It is still a pretty significant threat and it still among the leading causes of death in the country and it's worse than flu, which we take seriously a rear right. What is the annual death?
it's from the flu compared to what based on the numbers we expect this year to be the death rate from coded. So deaths from flu vary a lot based on how bad the strain is at any given year, but there was just a modeling estimate for kovac. That said, even if everybody goes out and gets the vaccine and the variant is really sensitive to the vaccine and you know be respond very well. We could still see something like forty six thousand deaths from coven and that's a very bad flu year and, let's not forget, there's also respiratory syncytial virus, which is a third respiratory threat, especially for older people and kids, write better known as rsv right.
as we that's the third virus that we had to deal with last year, member there was the triple dynamic and we had people in hospitals for months and months, because there was covert, there was flew, and then there was our as we there were all these things circulating right, and you know not
but he may worry about those things. A lot of people don't have to worry about our speeds, really a risk for older people and kids and a lot of young people probably dont, think very much about the flu or get the flu vaccine but cold. It is a little bit different. We're just learning that if you get infected with the carnivores, you don't even have to get very sick. You could still have a lot of long term health problems in a long covert, long term damage on the hard, for example. So it's not just like the flu, and I understand that that's a bit of a confusing
I heard ox: the government is telling us go get the vaccine, but other than that, I know it's not really a problem. There is no data for us to make our decisions and yet or some hot supposed to try to figure out how to help ourselves how to protect ourselves in so we all have to come up with our own ways of fear.
Out, whether to socialize, whether to go out or not whether to tell people were sick or not. All these questions that we have
What we are willing to live with.
Back.
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So approval I want to spend some time now talking about how we are supposed to navigate this period of calm and not just the vaccines which we ve been talking about, but all of it- and I want to start with a pretty simple question around mass. In my experience, very few people are regularly masking right now that just seemed like a given, I and then it confess I don't carry him. Ask around me a number of people. I know don't either, but I dont walk over it again. So how should I? How should maybe will like me, think about what men are being the rare times that we might want to consider putting a mask back on. This is its of one, because before we used to be able to look at case numbers and decide, ok, the numbers are going up, so I'm gonna put on a mass now now we're having to meet those decisions based on what we are hearing around us, their lot of people who seem to be getting
sake, that number of hospice patients is going up, and then you start to make decisions about specific circumstances. I I totally agree: I don't see the average person returning to any kind of full time asking, but if you know you're going to be in a crowded indoor space, that's usually a good place where mosque in on the subway train or a really crowded bathroom. You know I when I travel, I don't really worry so much about taking my mask off on the plane, because airplanes are great but er
bathrooms. Now I think I will put a mosque. There are really any bathroom hum and any in a crowded indoors space where you think people might be sake like the pharmacy or the hospital where you know people are coming in, who are infected coming to pick up their madge or just see the doctor so really does have to be the sort of circumstance, by circumstance case by case basis, if you're not ok, wearing them. Ass most of the time is interesting. The pharmacy! No europe,
It seems incredibly obvious. Sick people go to pharmacies to get drugs or to get over the counter medicine and it's a very logical place to wear a mask, especially if you're gonna be standing in line to get drugs with other people for a longer time and that's the key thing they're standing in line right, you're spending a lot
time around of sick people. In the same, if you go to any are- and there are a lot of sick people waiting in the emergency room- you're probably want to put on a mosque if you just going in and out quickly, it may not be as important and, of course, if you live with somebody who is a then you're, probably taking more precautions anyway, right anyway, right positive regulation. So
to testing in this moment. As you know, because I know you live in the new york region. A those pop up rapid testing sites, they're gone in my neighborhood
Some seem to have gone out of business. Close shop insurance companies cover less time
now than they did in the past, so alarmist are left with at home tests made by various companies?
how good are those at home test right now, a correctly identifying an infection then defend? You know they all still detect
do variants that are around, but a lot depends on who's doing the test and how carefully they do them. I think the best way to make sure that you are positive or not is to do more than one testino. If you test on consecutive days and you turn out to be negative, then it's more trustworthy than if you just did it once
but you're right that there are a lot of ways to test very easily. Now in new york, actually is sending tests to schools that request them, so kids may still end up getting tested or they miscentes home like they used to, but it's much more difficult to get a sense of whose sick and that's? Why were struggling to figure out? How beat this problem is,
and finally, on testing- and this is admittedly a bit of a delicate matter. I have noticed, there's a growing reluctance to test, even after an exposure or when you wake up with a tickle in your throat, especially of person, isn't really feeling about sick, because there is a cost to testing positive. That folks, just want to avoid missed school for kids, missed work missed whatever and judgments of that aside,
Does that just speak to the reality that in this moment, exposure took cove is
kind of the reality of living in this world. You know I can't really endorse, not testing, because I think you do need to know if you're sick, you know, I I completely understand the societal cost. I have two kids. I know that
If the kid has positive, the kid has to stay home, and then you can go to work or you don't get as much work done, and there are all these sort of ripple effects from that. But you don't want to send the kid to school and start a mini cluster in that class.
And you don't know who else is in that kid's family? I think people should still test and should still make every effort to not go out and spread the wires to other people. But I guess I'm asking is: do you need to operate under the assumption that many people
aren't test, isn't edges reality. That is the reality, and I think that's comes back to my. If you want to protect yourself
you may have to rely on your own self to mask, because chances are pretty good that other people around you are not tested. Dont know if their sake or are not telling you that their set right. So let's say you do test, and you just positive in the past that triggered this kind of shot down of life right is like, like everything closed, and we currently, and that does not seem to be the case for a lot of people any more. You know people who does basel. They still take flights for all kinds of.
they get on the planned bride. They still go to parties. I had the experience of notifying a friend pretty recently hey. I preacher. I've been exposed fair war,
do you still want to come over this weekend and the answer was yes. I do I want to see. You wanna see the kids. So how do you think about the new rituals around all of this? Knowing that, in this current surge, people's tolerance for risk is pretty high, but you dont know if the person you are about to meet has a very high tolerance. I think what you did where you informed you
and and let your friend make the decision. That's a great way to deal with it. You know, I think about it like when my kids were little and they would have colds, which was like every day it seemed like, and if you had a social engagement, you'd tell the friend hey my kid is sick. Do you still want me to come over and it's you leave it up to them to decide it's ok with them, rather than you deciding for them. That covert is not a big deal right, so you're suggesting the kind of sick kid model which, if you have a kid,
tend to be kind of automatic. I have Ass a kid. Can I bring them over or you're handed over here you should know. I have a sick kids apply that essentially to covet as a matter of disclosure. Ideally you know people just wouldn't go out at all if they were sick. But realistically, as your saying, if people aren't gonna do that, then I think you at least are obliged to tell people and let them make the decision. Ok, this might be something of a curveball, but I've heard this kind of story from people in my life. They test positive for coded their headed to an outdoors
shall activity, and they tell themselves it's going to be. Ok. Outdoor transmission doesn't happen. This is gonna be safe. This is really improve
to me. We are where we are in this pandemic. I'm gonna to do this. So how should we think about that? Can I wouldn't
go to an outdoor event if it was going to be very crowded. Like a a I dunno taylor, swift concert, but if it's a picnic with a bunch of friends- and you can maintain some distance, we know that outdoor activities generally safe for covert, there's very, very few documented cases of transmission from outdoors. So we
no, you could wear mosque if you wanted to, but really as long as you want to close to somebody outside its probably ok forget here, I want to acknowledge that we have been trying to
habit the mind space of those who have decided that taking a ton of precautions in this moment doesn't make sense for them. But there are, of course those who don't feel that way. They want to be very careful and they want to take a lot of precautions. Perhaps they are amino compromise. Perhaps they live with someone who is emmy, no compromise, or they just want to be careful because they really don't wanna get covered howard.
Supposed to navigate this moment, especially as cases rise and as so many people are not taking these precautions. Right I mean that means it's pretty hard to be a cautious person right now. There are ways that they can
take themselves, and we know this from earlier in the pandemic. I know you are a good maskew avoid socializing with other people, you socialize outdoors. You know you avoid crowded indoor spaces all these things, but it is a little different now, because so few other people are doing these things, and so you know there's a lot of judgment. I mean I've heard from people who are severely amino compromise, we're going to hospitals, even cancer centres, where you think everyone should be masking and they are the only ones wearing a mosque given the start wearing a mosque, it's terrifying for some people. In fact, there was a study recently that said that more people with cancer died during all micron when the cases were mild, then during the previous winter surge, partly because so many fewer people around them were taking precautions, and so the risks to them were higher, which version we might have.
At this moment as well. In other words, when people let down their guard, the risk to those at highest risk is just much higher. It is, and it's also lonelier for them, because everyone around them is doing something entirely different right. Okay, so, given that this may be our last conversation about covert on the daily for a little while I want to ask about the future, not just the near future, but the distant future. So much has
the leech in just the past three years of this virus? There's no better evidence of that. Then the fact
talking about an annual covert showed that were supposed to take along the food shot and the boosters arnold,
part of the conversation. So I'm curious, whether you ve given thought to what this all might look like in five years, maybe even ten years, and will this continued?
a story of less and less risk, do we think and looser and looser approaches to it or not. It's almost impossible to predict what will happen. As you know, we ve had accommodation many times, but we ve been talking this whole time with the idea that word
Keep going in this direction where the virus becomes less and less of a threat, and we all build up more and more immunity and we have fewer hospitalizations and debts and that certainly one,
possibility and one that we all hope for. But there are other possible scenarios. There are possibilities where
maybe we see a variant that comes through the doesn't respond to maxine? Maybe we see a variant, that's incredibly contagious sort of
Google, chrome, watson and through everything into a tailspin. So really the short answer is we hope that this will become like the flu
and something that we only worry about for treatment.
In the year Bobby, just don't know
no problem, as always. Thank you very much
and maybe the new cuvier taxiing is exe.
to be available in pharmacies and clinics
end of the week. I would write back.
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Transcript generated on 2023-09-14.