( Yuki Iwamura / AP Photo )
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Brian Lehrer: It's The Brian Lehrer Show on WNYC. Good morning, everyone. Who's ready for a second COVID booster? The Food and Drug Administration and the Centers for Disease Control authorized them yesterday, as you probably heard by now, for anyone over 50 and people over 12 with compromised immune systems. This is for people who got your first boosters at least four months ago. Now the CDC and FDA didn't recommend getting boosted, but will now allow it based on the data they were working with. We'll try to pick those two things apart, but for example, a third of people over 50 have underlying conditions that put them at risk for serious disease.
The New York Times says that was apparently a big enough percentage to authorize for the whole group of over 50s. A not yet peer-reviewed study from Israel of people over 60 years old found that the death rate from COVID for once boosted people was about 1 in 1,000. For twice boosted people, it was more than 3 times lower, closer to 1 in 3,500, much less risk. This is coming as the case numbers from the Omicron sub-variant BA.2 are making double-digit percentage leaps in this country. Percentage leaps, though, from very low numbers of cases. The CDC announced yesterday that it is now the dominant version of the virus in the United States.
In New York State, The New York Times COVID tracker says the average number of new cases per day over the last 2 weeks is now 65% higher than it was before that, but the average number of deaths per day in New York is still declining so far down about a third from 2 weeks ago to just 12 deaths a day statewide. What does it all mean and should you get boosted again if you're over 50? To talk about this and other COVID news, we are joined by Dr. Daniel Griffin, infectious disease clinician and researcher at Columbia and chief of the division of Infectious Disease at the ProHEALTH medical group on Long Island. Hi, Dr. Griffin, thanks for coming on. Welcome back to WNYC.
Dr. Daniel Griffin: Oh, good morning, Brian. Good morning, everyone.
Brian Lehrer: What does it mean that the FDA is authorizing but not recommending this fourth shot of either the Pfizer or Moderna vaccine?
Dr. Daniel Griffin: I think the way you put it is actually perfect there, Brian, because this is something I've been getting a lot of emails, a lot of texts, a lot of calls. I've been telling everyone just listen to you this morning, and hopefully, we'll get everyone all the information they need. [laughs] Hopefully, this is going to help me in my- [crosstalk]
Brian Lehrer: Then when 1,000 people call your office, you can just send them the link to the podcast.
Dr. Daniel Griffin: Now, you can get this out to, what, a million people that listen to you. That's exactly what happened here is the US FDA said it's okay to get that fourth dose, but they didn't say that we're encouraging, we're recommending. We'll probably go a little bit into the details about who should get that fourth dose. I'm going to say it's reasonable for certain people to think about it, but it's also not everyone needs to run out and do this. Their authorization's pretty broad. It really was. First, off the bat, anyone 50 years of age and older, 4 months after they got that first booster, you can go ahead and do that. Then they also talked about special populations.
I think we should probably first talk about what is the study that got everyone so, I will say, concerned, and should you really be concerned, and who should think about a fourth booster? It was this study that was posted as a pre-print, so it hasn't been peer-reviewed, suggesting that there was a mortality benefit to that fourth shot, but having looked at that study- [crosstalk]
Brian Lehrer: That's the Israel study that I mentioned in the intro, right?
Dr. Daniel Griffin: Exactly. Second booster vaccine and COVID 19 mortality in adults 60 to 100 years old. It's an interesting study. You look at the top line results and it looks compelling until you start to look at this study, which is significantly flawed, I'm going to say upfront. Really, what they did is they said, "We're going to open up eligibility to a fourth shot. We're going to look at who goes and gets that fourth shot. We're going to look at who decided not to." First off you realize that basically wealthier Israelites were getting that fourth shot. People lower socioeconomic status, more Arabs, more orthodox populations decided against it, did not go with that fourth shot.
They're really comparing two different populations when they talk about the mortality, and 40 days follow-ups are very short. Nothing terribly compelling or earth-shattering here. It does bring us back to the fact that not everyone has the same ability to respond to vaccines. If you're an older individual, if you're not able to avoid high-risk situations, if you have other things going on, other medical problems, then back to those pharmaceutical commercials that maybe we remember, have a discussion with your doctor, find out if that fourth shot is right for you.
Brian Lehrer: Listeners, if you have a question about whether you or someone you care about should get a fourth dose, I guess if you started with Johnson & Johnson, it might be a third dose, but a second booster in any case, 212-433-WNYC to talk to Dr. Daniel Griffin this morning. 212-433-9692. Again, 212-433-WNYC, or you can tweet your question @BrianLehrer. How do we know? As an individual, start to pick it apart. If somebody listening right now is 50 years old plus and they heard what you just said and thought, "Well, I don't really know how much my ability to respond longer term to the vaccines I had before persist or wane. I don't really know what all my risk factors are, whatever underlying conditions I might have that may or may not be diagnosed," "I'm 53 years old," or, "I'm 63 years old," or, "I'm 73 years old," start to talk to people about how they can make judgments for themselves as individuals.
Dr. Daniel Griffin: Sure. I think the extremes are going to be easier, not easy, I shouldn't say. As my wife says, if you are-- She asked this morning should she run out and get her booster. She's healthy, ideal body weight, 50 years old, no significant health issues. The right time for her to get that fourth shot is probably going to be next fall. The other extreme though, let's say you're in your 80s and you've got-- carrying extra weight, you've got diabetes, you've got a heart issue, it's been for four to five months since you got that last vaccine, and you're in a situation where you can't keep yourself safe, or you're going to be in situations maybe you're now back in the office, you're around people that maybe are not as careful as you're trying to be, that's a person that maybe it makes sense to get that fourth shot.
We just got encouraging data about how are we doing here in the US, how are those shots doing here in the US. If you look at someone who got those three mRNA doses, you're still looking at a vaccine efficacy of 90% or more keeping folks out of the hospital. That's why I say maybe certain people at higher risk should be thinking about this, but not time for everyone to go charging the mass vaccination sites.
Brian Lehrer: Well, we had a guest who mentioned something similar to what you just said last week. I asked her this question. I'm going to ask you this question because I think this is going to be a determining factor for a lot of people. The effectiveness of the first booster, from what I've read, starts to wane after a few months, in terms of protecting you from getting Omicron or getting COVID at all, you're more susceptible to it a few months after your first booster, but in terms of the protection that it continues to give you against serious disease against hospitalization level disease or worse, persists for longer. Is that your understanding, and what's the science that would back up that conclusion?
Dr. Daniel Griffin: Brian, that is the science. The science with vaccines is that they're really good at preventing severe disease, severe illness. They're not good at keeping you from getting an infection. We always use polio as a perfect example where it's really great at protecting you from ending up with paralysis, but really the injectable poliovirus zero protection against infection at all. Not great against infection. The science behind it is an antibody issue. The antibodies that go up to a high level, they're high on mucosal surfaces, they do have some temporary ability to protect you against infection.
We do care about that during a pandemic. We also care about it because nobody is at low risk of long COVID. We do think vaccines decrease that, but the durability of your vaccines is going to be against severe illness, dying of this, ending up in the hospital, to some degree, staying out of the ER and the urgent care setting. That science is holding up. That's something we've known for decades. I think for a lot of, probably, listeners, this is new. People thought like, "I got the shot. This is going to keep me from getting infected." Really, vaccines are great against disease. They're not so great against infection.
Brian Lehrer: Let's take a phone call. He is Gordon who says he's 70 in Brooklyn. Gordon, you're on WNYC with Dr. Daniel Griffin. Hi, there.
Gordon: Hi. Actually, well, my wife and I are both over 70 by a few years. We both got boosted, got our first booster shots at the beginning of November. Nevertheless, my wife had a positive COVID test and some minor symptoms at the beginning of January. In March, her doctor gave her an antibody test, and her antibodies were very high. The question really is if you had a breakthrough infection, does it make sense? How long should you wait after that since the infection itself acts somewhat like a vaccine?
Dr. Daniel Griffin: This is an excellent question and, boy, we get a lot of this. One of the challenges is what do you do with those antibody tests? We've been told by the FDA, we've been told don't look at those. We don't really know what those mean as far as correlates of protection because we don't really know what those antibodies are doing as far as neutralization, as far as working with the rest of the immune system. It's hard to know that. This is really a lack of knowledge, not necessarily because it's true. We tend to sidestep the infection and look at how many vaccines because we do have better science to guide us there.
You described something we saw quite often this winter, that's why Omicron was able to spread this immunization. We saw people who'd been vaccinated still get infected, but we did see, in general, a significant reduction in severity in that population. You're 70, maybe I'm going to put the question out here, are you the person who needs to get vaccinated living in Brooklyn? You're 70 years old, probably you're someone who would make sense to talk to your clinician and ask. What are your other medical problems? What is your behavior? Are you someone who, maybe me in my Irish heritage, you want to get out there to the bar, get that mask off, get in a big crowded room with a lot of people?
That's a different dynamic than someone who says, "No, I'm happy to limit my risks in my area in Brooklyn." Maybe numbers are down right now. Again, different in different parts of the country, different with different behaviors. Is the timing right for you waiting till the fall, you're doing it as we expect there to be another rise, or do we keep an eye on what's happening with the sub-variant and some of the increases we're seeing locally?
Brian Lehrer: Well, what does your eye on the sub-variant tell us? It looks like the numbers are going up substantially as I said in the intro percentage-wise, but from what had become a pretty low base in the New York area after Omicron had peaked and then declined, hospitalizations and deaths still going down per day in our area, maybe that's just because the Omicron BA.2 cases haven't been around long enough to result in hospitalizations and deaths and a spike in the numbers of those yet. What's your take on the public health consequences of BA.2?
Dr. Daniel Griffin: Well, we certainly are seeing an increase in cases. I think it's underestimated in the numbers because a lot of people that we talk to are doing home testing. When we say, okay, we got down to a low of 1500, maybe we're now up to 3,000 or 4,000 cases. That's a doubling, but it's a doubling from a small number. It's probably higher because a lot of people are testing at home. Just got the numbers today for the ProHEALTH network, and we're about a 3% positivity. That's going in the wrong direction. Numbers are rising. The sub-variant being maybe something that has a fitness advantage, how much of it is--
Boy, we've all taken those masks off and we're not as careful as we used to be. We are hoping that the warm weather gets here ahead of the BA.2 variant rise and gets us in a better place, but, no, numbers are rising. The case numbers out there are higher now than they were a few weeks ago. As far as the world goes, 85% of what we're seeing is BA.2. Here in the US, the majority of cases are now the new BA.2 Omicron stealth variant. I'm glad we started off with vaccines because what makes the Omicron variant mild it's vaccination.
Brian Lehrer: John in Brooklyn, you're on WNYC with Dr. Daniel Griffin. Hi, John.
John: Hi, Brian. Thank you for taking my call. I love your show. My question is I have yet to hear any serious downside. I am 77, and I got the fourth shot yesterday, but I have yet to hear any serious downside, and on the upside, even if you're not hospitalized, my understanding is you can still get long COVID even if your symptoms are initially not serious. Oh, wait, let me turn off the radio.
Brian Lehrer: Yes, John, I got you. I'm going to leave it there and let Dr. Griffin answer your two very good questions. First, let's pick them apart, Doctor, and take them separately. First, what's the downside? You've been talking about people who may or may not need the fourth shot yet, even though they're eligible, but I think John is suggesting, "Well, gee, I'm in the age group, I don't see any downside to it, so I might as well get it."
Dr. Daniel Griffin: Actually, John, you make a great point. You ask an excellent question here. Is there a downside? Is there a safety issue? So far, we are not seeing one. I will say with the pre-print that was put out there, they do make the caveat. They do say, "Hey, we've only looked for about 40 days, so we don't have as much safety data as we would like." These vaccines have ended up being incredibly safe. Is there much of a downside? Is there much of a risk? No. I think that that was behind authorization. This is safe. It's certainly worth considering in certain populations. There's not much of a downside.
I think one of the things that I tried to throw in a little bit before is no one's at risk, no one's at low risk for long COVID. We see that across all groups. That's not necessarily older people with comorbidities. We see that in young, previously healthy. We certainly have children and adolescents suffering from long COVID. No, there does not seem to be any downside to going ahead with this, which is why I think it makes sense.
Brian Lehrer: I saw one pretty scary article about an effect of long COVID. Tell me if you're aware of this and know this to be true that a year after having COVID one's risk of developing diabetes increases by 40%. Now, again these statistics can be misleading. That doesn't mean 40% of people who get Omicron are going to get diabetes. It's much, much, much less than that, but your individual risk of developing diabetes is 40% higher than it would've been if you had not gotten COVID at all. A year later, is that your understanding? Did you see that?
Dr. Daniel Griffin: This is something where I think several people have supported that as a finding. Actually, our group, UnitedHealth Group, I think Ken Cohen and Sarah Daugherty were on a large paper that was put out looking at the millions of people that fall under the UnitedHealth Group umbrella. We are clearly seeing that people who got COVID without the benefit of vaccination ended up with a higher likelihood of a new diagnosis of diabetes over that next year. That is one of the things under that post-acute sequela of COVID we worry about.
We certainly hear a lot about people with the brain fog and the fatigue, and they can't get back to work, but we're seeing higher incidents of diabetes in people that got COVID. We're seeing high incidents of cardiovascular disease, heart attacks, strokes. COVID can really do a job on the body, but the one thing I will point out is this data is all on unvaccinated people. We have yet to see similar outcomes in people that have been vaccinated, and we are very hopeful that the vaccine not only will prevent you from getting COVID, not only prevent you from getting severe disease, but will hopefully decrease your risk of all these many issues that fall under that umbrella.
Brian Lehrer: Are you saying there's enough data now to conclude that vaccination prevents you or greatly reduces your risk of getting long COVID even if you get a breakthrough infection?
Dr. Daniel Griffin: I will say there is data supporting that idea. It does look like people who get vaccinated are at lower risk of getting long COVID. If they do get long COVID, we're seeing a shorter duration and a milder symptom complex and what we've also seen is a number of studies suggesting that even if you get COVID and then get a vaccine afterwards, you may be able to decrease your risk going forward of developing long COVID. Data to support vaccination ahead of time, but also, some data to support the sooner you get that vaccine after getting COVID, the bigger the impact on potentially getting long COVID.
Brian Lehrer: Kirsten in Brooklyn, you're on WNYC with Dr. Daniel Griffin. Hi, Kirsten.
Kristen: Hi, Brian. Big fan. Thank you for taking my call. Dr. Griffin, I wanted to ask, I am not part of the demographic that was eligible for the second booster yet, but I am pregnant. I was wondering if there's any information about whether the second booster can increase immunity even more to the fetus. Right now they've recommended trying to hold off getting your first booster or whatever vaccinations you haven't gotten to your third trimester in the hopes that it passes some immunity to the fetus. I was wondering if there was some information or guidance on that that you had.
Dr. Daniel Griffin: Thank you for asking this question. I think this is a really important topic. A woman who is with a child is at risk themselves for a bad outcome if they get COVID during the pregnancy. We certainly want people who at least have started this series as they go into pregnancy. There's also a risk for the unborn child, an increased risk of losing that child, but then there's also that first six months after the child is born. We do have good data showing that if a woman receives a vaccine or receives a booster during pregnancy, we don't have the degree to know that it has to be that third trimester, but that would make sense with what we know about immunology, but the pregnant woman can actually pass not only antibodies but cellular protection to the child.
That's really in line with most of what we know. Encouraging pregnant women to get that vaccine preferably before you get pregnant for the protection, that third trimester makes sense. Hopefully, a little more than two or three weeks before giving birth so that you get that robust immune response to protect your child for the first six months of life.
Brian Lehrer: Kirsten, I hope that answers your question. When's your due date?
Kristen: I'm due May 30th.
Brian Lehrer: Congratulations in advance. Hope everything goes great.
Kristen: Thank you very much.
Brian Lehrer: Then call back and let your baby make their radio debut, okay?
Kristen: I certainly will.
Brian Lehrer: Okay. Bye-bye. We're going to continue in a minute with Dr. Daniel Griffin the day after the FDA and the CDC authorized second booster shots for people over 50 and people with certain immunocompromised decisions. When we come back, we'll take more of your calls. I'll also ask Dr. Griffin what the latest science is on changing brands or staying with the same brand, a vaccine you got originally. Is there any advantage or disadvantage in terms of the amount of protection you get? Stay with us.
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Brian Lehrer on WNYC as we talk about the authorization of a second booster shot of the COVID vaccine by the FDA and the CDC yesterday with Dr. Daniel Griffin, infectious disease clinician and researcher at Columbia, chief of the division of Infectious Disease for the ProHEALTH medical group, and president of the group Parasites Without Borders. You can also catch his weekly clinical updates on the podcast This Week in Virology. Dr. Griffin, as I previewed before the break, I'm curious if there's any science on any advantage or disadvantage to staying with the same brand of vaccine that people got originally or switching. If you got a certain kind of protection from Pfizer, would you be expanding the spectrum of your protection at all by getting your fourth shot of Moderna?
Dr. Daniel Griffin: We do have science here, which is helpful. The best science is for those folks who maybe started off their series with the Janssen, the J&J shot. We're seeing that the one J&J shot just not as impressive as our other options. Do you get a second Janssen shot, or do you get a second mRNA shot? Really nice data out of the vision network that just came out is early released by the CDC MMWR. Just I'll compare that right off. Let's say you started off with a Janssen and you got a second Janssen shot, about 54% reduction in you ending up going to the ED or ending up going to urgent care, about 67% keeping you out of the hospital, but let's say, instead, you say, "You know what? I'm going to go with one of those mRNA shots. I'm going to get a Mordena or a Pfizer to top off my Janssen."
You're going to jump from a 54% up to a 79% for your ED, UC visit. You're going to jump from that lower number up a 78% at keeping you out of the hospital. Certainly with the J&J at this point, the science is persuasive for recommending that your second shot be an mRNA instead of the Janssen. [crosstalk]
Brian Lehrer: Before you move off the Johnson & Johnson, they didn't even authorize that yesterday. They only authorized Pfizer and Moderna for the additional boosters.
Dr. Daniel Griffin: You are right. Yes, it was just the second booster for either of the mRNA shots. Yes, you are correct. I feel like that would have made a little bit more sense, because this is a little bit more persuasive. You've got someone out there who's just had a Jansen or just a couple of Jansens, it probably makes more sense for them to get thrown an mRNA boost on there.
Brian Lehrer: What about switching between the mRNA brands?
Dr. Daniel Griffin: We are learning that, and this is a little scienty, so I apologize ahead of time, but we always talk about our antibodies as neutralizing as blocking that virus from getting into cells but there's a stock of those antibodies that can pull other cells into the game. We just got some more data basically showing that the different mRNA vaccines may have different abilities to pull other cells into the game, so the neutrophils, the natural killer cells. Nice study that just came out in science, translational medicine, saying that, boy, maybe that Moderna shot is going to give you different ability to pull in those neutrophils and natural killer cells.
It may make a certain amount of sense to mix and match. You got a couple of Pfizers, maybe it's time to throw that Moderna in the mix. You got a couple of Modernas, maybe it makes sense to throw the Pfizer BioNTech in there.
Brian Lehrer: That is to say that neither is better than the other because I had seen a few things along the way, but I don't know how persuasive the science was, that seemed to say the Moderna was a little better than the Pfizer in terms of the amount of protection, and the length, the duration of the protection. True or not true?
Dr. Daniel Griffin: Yes, it's probably true. All my shots have been Moderna. I don't get paid by Moderna, but that could change. I'm okay if you want to send me money. We looked at the big numbers, and this is another one of those studies where you're looking at millions of people across the country, comparing those that got Pfizer, those that got Moderna, so not a randomized placebo-controlled by any means, but it does look like there may be a little bit of advantage to the Moderna as far as all these different endpoints and also maybe as far as durability.
Brian Lehrer: To finish the thought, if somebody got Moderna previously, would they be better off staying with Moderna because of that advantage or switching to Pfizer for the fourth shot because they get a different type of protection as you were describing a minute ago?
Dr. Daniel Griffin: Brian, you ask the hard question. The easy question is, if you got a couple of Pfizers, do you throw a Moderna on there? I would say yes. If you got a couple of Modernas, there does look like there's a slight difference in the breath, in the targeting, by adding the Pfizer, but we certainly don't have compelling evidence there. It's reasonable to mix and match at this point.
Brian Lehrer: All right. Here's a question from a listener via Twitter. What about a booster for 5 to 11-year-olds since studies have shown that the first two doses were not very effective? As a follow-up question, that person asks, were the doses too low for kids? First of all, do you accept the premise that the first two doses were not very effective for 5 to 11-year-olds?
Dr. Daniel Griffin: They were not as effective when you look at the numbers, so I think that's a reasonable thing, but we're looking at a reduction in a lower risk group. That is one of the things we're all waiting on. You look at data when we had the earlier variants. Omicron changed things a little bit. There's certainly are a lot of people who would like to be able to have access to that next booster in that population. When we talked about the recent updates, yes, they went across the board with people 50 and up. They talked about second boosters in 12 and up if there were certain immunocompromising conditions. That's still an area that is not really covered by this recent update.
Brian Lehrer: Gail in Queens. You're on WNYC. Hi, Gail.
Gail: Oh, Hi. My question is, excuse me, if you get the fourth booster soon and you have a major wedding in October and you can't get a fifth booster, that seems like a bad situation. Plus I'd like to ask quickly, if somebody is allergic to the Pfizer, should they switch to Moderna?
Dr. Daniel Griffin: Two great questions. I'll pull them apart. I do think, at a certain point, it's a question of timing when my people get that next shot, and I'll use myself as an example. I've gotten three shots already. I would not be surprised if come the fall, it's time for me to get my fourth shot. It may not be a question of do we get fourth shots, but it may really be a question of when's the best timing. You bring up that wedding in October, boy, maybe getting your shot in September makes sense because end of September, early October, you're going to get that protection in time for the wedding, but you're also going to be ready to go for what we anticipate as being another wave, another surge next winter.
The other is the question of if you had a problem with one of the mRNA vaccines, do you switch to the other? They're similar enough. That would be something I'd say talk to your doctor, try to get a sense of what that reaction was and whether or not it makes sense to switch over. That's a little more detailed. That's one of those, I'll say, talk to your doctor about that.
Gail: Thank you.
Brian Lehrer: Thank you. I hope that answers your questions. If there's a fourth booster, it's not a recommendation, it's an authorization but for some people, you're saying you would recommend it. Now, how long do you think this is going to go on where people are going to need boosters if they choose to get them every six months or so?
Dr. Daniel Griffin: Brian, you really hit the nail on the head because this is really the challenge from a public health standpoint. Are we really going to tell people the vaccine efficacy against infection has a durability of about four months? Are we really going to be recommending that every four months for years and years we get people another COVID shot? I just don't know if that's a viable approach. I think at an individual level, there are certain people where you may want to approach it that way. I think that was the difference here between access and recommendation. We're not recommending that everyone get a COVID shot every four months.
We're just saying there are certain people where it may make sense to go ahead and get another dose at this time, and, again, it's not going to be for everyone. It's going to be only for certain individuals where this makes sense because we are anticipating next fall we're probably going to get into a routine of where people get a fall COVID shot along, hopefully, fingers crossed with their flu shot as well. Hopefully, a flu shot that works better than the ones we've been using over the years.
Brian Lehrer: Yes. Let me ask you a couple more BA.2 questions. I keep hearing that Omicron in general causes less severe illness. Is it that more of us have some immunity now and that's why on average it causes less severe illness, or is there evidence that the virus mutations themselves are responsible for fewer hospitalizations and deaths than previous variants?
Dr. Daniel Griffin: The most compelling science is that what makes Omicron mild is vaccination, is recent prior infection, is immunity when you go into it. Unfortunately, you look at the data out of HK, out of Hong Kong, and the intrinsic severity, particularly with younger individuals who can't have access to vaccines, it's not clear that there's a significant reduction in the intrinsic severity. Maybe you say, oh, instead of a 2% mortality, we have a 1.75. That's not a mild virus. What makes it a mild virus is getting vaccinated.
Brian Lehrer: I did read at one point that the original Omicron seems to reside more in the upper respiratory tract than the lower respiratory tract. If your nose is affected and your throat is affected, that may be very uncomfortable, but that's less life-threatening than if your lungs are affected. Is that a real distinction?
Dr. Daniel Griffin: It may be. The original data came out of the hamster studies. When a person gets into that second week when they have that cytokine storm, that pulmonary phase, that inflammatory thing that gets people in the hospital with oxygen need, that's not so much where the virus is at that time, it's this robust immune response. It may be that that upper airways helps with fitness and transmission, but, no, we're still seeing-- We actually saw more people die during the Omicron surge than we saw died during the Delta surge. Hard to call something mild when it was killing thousands of people a day.
Brian Lehrer: Last question about that. What does more transmissible mean in the case of Omicron BA.2? Does it take less time in a room with an infected person to pick it up yourself, or what's the metric, in behavioral terms, of more transmissible and how to protect yourself against that besides the vaccines and masks?
Dr. Daniel Griffin: Certainly. Transmissible is a tough word for us as scientists because it really takes a long time to tease out what does that mean because it can be related to several factors. Does it mean a person doesn't have to spend as much time around someone who's infected? That would be a case of something more transmissible. Does it mean that that individual is infectious for a longer period of time? That's potentially something we might see. The other, as far as the speed with something spreads, it could be the time from when you're exposed to the time that you're infecting that next person.
We certainly have seen that over time with the different variants. Instead of it taking a week from a person getting exposed to the time they transmit to that next person, it's now down to three or four days. That certainly speeds up the spread. Do the masks still work? The masks still work. Is it still safer outdoors versus indoors? Yes, but all the things we've talked over time, you just have to double up a little on try to be safe because we are seeing increasing numbers again but increasing from a very low low, fortunately.
Brian Lehrer: One more. Jessica in Dutchess County, a physician. Jessica, you're on WNYC with Dr. Daniel Griffin. We've got about 30 seconds for you. Hi, there.
Jessica: Good morning, Dr. Griffin. My question is the following. I'm a physician in Dutchess County. I am forward-facing with COVID patients. I haven't been able to read the full FDA recommendations, but why weren't there any specifics made for those who are at high-risk exposure with regards to the booster?
Dr. Daniel Griffin: All right, Jessica, I'm going to tell you to listen to This Week in Virology. Brian will be listening too, I think, if he's still a fan.
Brian Lehrer: I'm a fan.
Dr. Daniel Griffin: I'll run through this a little in detail. Really, this was really just a access issue. This was not recommendation. There's going to be a big meeting on the 6th of April where there's going to be a whole day discussion on what's going on with boosters and hopefully going to give a little more information. This was really just saying, "Hey, you've got access here," but we did not get a lot of guidance on particular populations like front-facing health care workers.
Brian Lehrer: Jessica, Doctor, thank you very much. Dr. Daniel Griffin, thank you. We always learned a lot when you come on the show. Dr. Daniel Griffin, infectious disease clinician and researcher at Columbia, chief of the division of Infectious Disease for ProHEALLTH Care medical group, and president of Parasites Without Borders, as well as the weekly clinical update person on the podcast. Yes, I am a fan. If you want to wonk out on virology, folks, this is your place, the podcast This Week in Virology. Thanks for coming on, Doctor.
Dr. Daniel Griffin: Oh, thank you. Everyone, be safe out there.
Brian Lehrer: Brian Lehrer on WNYC, much more to come.
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