Holidays, Covid Vaccines, Boosters & Testing

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Brian Lehrer: It's The Brian Lehrer Show on WNYC. Good morning, everyone. Here we are with less than a week to go before Thanksgiving. It's understandable if you're confused about what kinds of family gatherings are COVID safe for what kinds of family members, and specifically the role of COVID testing before joining other people who you don't live with. We mentioned this briefly on yesterday's show, and we'll expand on it for today's and especially to clarify. Here's Mayor Bill de Blasio speaking yesterday morning.

Mayor Bill de Blasio: Get tested before you attend major gatherings or family gatherings. Get tested because you'll know you're safe.

Brian Lehrer: Mayor de Blasio, yesterday. Dr. Fauci was also on TV yesterday and didn't mention anything about testing, but this also raises anew the issue of the role of testing generally, in combination with vaccines, in the pursuit to get back to a pre-pandemic normal level of safety and activity and whether public policy has maybe de-emphasized testing too much as they rightly try to get everyone vaccinated first. There's also the breaking news this morning, if you haven't heard it yet it's just an hour or so old, that the FDA has just recommended approval of the Pfizer and Moderna booster shots for all adults, and some mixed messages that I've seen about whether a last-minute booster just before the holiday helps protect yourself or others right away. So we'll try to clear that up too.

Back with us now, I'm very happy to have Dr. Daniel Griffin, MD, Ph.D., infectious disease clinician and researcher at Columbia University, Chief of Infectious Disease for the ProHEALTH system, and President of the group Parasites Without Borders, which doesn't sound like a good thing, but I'm sure it is. Dr. Griffin, we always learned a lot when you come on. Welcome back to WNYC.

Dr. Daniel Griffin: Thank you, Brian. I'm going to have to give up a few jobs so there's less intro, we can get more content covered.

Brian Lehrer: Exactly, but now you're going to have to explain Parasites Without Borders. What is that?

Dr. Daniel Griffin: I appreciate that. Parasites Without Borders is a not for profit that was founded with the motto of getting knowledge to the people in places that need it the most. We provide a number of educational resources, videos, books, and actually support a lot of organizations and go out there into the field. Parasiteswithoutborders.com is our website, and every week we post full-length articles that we think are important in understanding COVID. Our sister organization, MicrobeTV, we do a lot of podcasts trying to keep people up to speed. This is the one time my children are proud of me, they actually listened to it on the International Space Station.

Brian Lehrer: Wow, that's a good place. You have children on the International Space Station, is that what you just said?

Dr. Daniel Griffin: No, that's the only time my children are ever impressed. You know the children roll their eyes? Just one time they don't. One time they light up and say, "Really?"

Brian Lehrer: Got it. That's really without borders. You heard the mayor of New York City there, should everyone get tested before their Thanksgiving gatherings?

Dr. Daniel Griffin: My motto is never miss an opportunity to test. Testing is really a tremendous way of decreasing risks around the holidays. I know we've put a lot of emphasis on vaccines, but we do know vaccinated people are less likely to get infected, they can get infected. Vaccinated people are less likely to spread but they can. If you're having a get-together, and there's at-risk vulnerable individuals, which there will be across the turkey table throughout America, if you're getting together with your parents, with your grandparents, throwing in those tests can really decrease risk.

To go into just the mechanics of this, if you can do two tests, that's better than one. If you do a test on Wednesday morning, you do another test on Thursday morning, you're really going to reduce your risk of showing up at that family gathering being contagious, being transmissible.

Brian Lehrer: Let's talk about this idea of multiple tests. I've heard advice that it's best to get a PCR test in enough time before Thanksgiving because those take a few days to come back, and then a rapid test on the day of. Other people only mentioned the rapid tests. I think that's probably what you were referring to just now when you said a test Wednesday and a test Thursday. Are the rapid tests alone enough in your opinion?

Dr. Daniel Griffin: I'm going to say yes, and I'm going to go into the details of what I mean by that.

Brian Lehrer: A test cannot predict the future, and that's one of the challenges with the resulting delays with PCR. If you get a test and it's negative on Monday, doesn't really tell us what's going to happen Thursday because there is this incubation period. If you get a test Wednesday morning, and it's an antigen test, the reason we're saying test again the next day is that you may still be in an incubation period, you're exposed, there's not enough virus that we can pick it up yet. The day that a person is contagious, that day those antigen tests are positive. Let's say you get a PCR on Wednesday, PCRs can pick up a incubating, a growing infection a little bit sooner than those antigen tests, but if it's a delay of three or four days, by the time you find out it might be Friday morning, and you might realize you've already exposed your family and friends.

Brian Lehrer: When you say antigen test, that's the same as saying the same day rapid tests. What does antigen mean?

Dr. Daniel Griffin: We have two ways of testing for the virus that causes COVID-19. One is looking for the genetic material, that's our PCR test. The other is looking for the viral proteins, that's the antigen. Maybe we should call them viral protein test. Those are rapid 15-minute resulting tests. More tests the better, because the test can't predict the future. That's why even if you had a negative PCR on Monday, I still want people to think about doing a rapid test on Thursday.

Brian Lehrer: Listeners, we can take your questions for Dr. Daniel Griffin about COVID testing as a tool for Thanksgiving Family Safety, and more broadly going forward, which we will get into as we try to get more back to pre-pandemic normal in a variety of ways. For Dr. Daniel Griffin, 212-433-WNYC. 212-433-9692. Maybe if you want to throw in a question about parasites and space stations or something like that, but mostly COVID testing for Thanksgiving and generally. 212-433-WNYC. 212-433-9692, or tweet a question @BrianLehrer. Dr. Griffin, how available as well as how accurate are at-home rapid tests now so you don't have to go to a medical setting somewhere Thanksgiving morning?

Dr. Daniel Griffin: Fortunately, they've become more available. I remember the initial before the uptake, and they were everywhere. Suddenly they were off the shelves, now they seem to be back out there again, but go ahead, track them down, get your test, be ready now. You don't want to try to run out next week when everyone's listened to the Brian Lehrer show and they've embraced rapid testing and they start leaving the shelves again. How accurate are they? I think that's really an important question. They are very accurate during that period of time when a person is able to spread the virus to others.

That's either two days before infection or symptom onset. Two days before you start getting that runny nose, sore throat, about 7 to 10 days afterwards, when you're still not fully recovered. That's when those antigen tests are 98% better at picking it up. The other side, though, I think this is important if a person is asymptomatic, also during those high levels of virus, when there's a lot of the virus protein around, those antigen tests are going to work really well. The sensitivity of these tests is based upon how much virus there is, not necessarily based on whether or not you have symptoms. I think that's really the critical thing.

Think about these tests as being really good during that period of time. If you test someone who's already recovered, is no longer able to spread it to others, you still might get a PCR test, but you might be over-diagnosing, and that's really not what we're talking about here that keep you from safe.

Brian Lehrer: That's really interesting, and I think really useful for a lot of people because I think that the common lay assumption is the PCR tests are better, period. The rapid test or antigen tests are good to have as a tool but less accurate, but you're really telling us maybe in lay terms that rapid tests may be the best for measuring your infectiousness at the moment, which would be the most important thing going into crowds like on Thanksgiving Day.

Dr. Daniel Griffin: I think that's really critical Brian Lehrer. If you think about it, the person comes in, they're feeling a little bit crummy. Were they feeling crummy four weeks ago, that might have been the time they were spreading COVID. You may still pick up that infection from four weeks ago with that PCR because it's just so darn sensitive. The question I think people are asking right now is, "Can I get together with my family and friends?" Antigen tests are great test for asking and answering that question.

Brian Lehrer: Are there different kinds of rapid or antigen tests that are better or worse at accuracy, whether that's different brands? I don't know if you get into naming brands and anything.

Dr. Daniel Griffin: I think if I named brands, I get some kind of a kickback. The FDA is really good. Recently was a story where they found out that when the manufacturers were having issues with the test, and immediately those get pulled back off the market. All of the ones that are currently out there are very easy to use, very sensitive, they are also very accurate. If you get a positive test people worry about, "I'm getting too many false positives with the antigen test." They're actually as good as the PCR test, maybe, as I'm going to say, maybe a little bit better about getting a positive test that doesn't mean what you think it means.

I am a personal fan, I will say, of the Bynex Now. I like the boxes with the two tests in there, it encourages that double testing that I'm talking about. Very user-friendly tests, but they're all very user friendly. Use it the first time and now you're a pro.

Brian Lehrer: Here's a question from a listener by a Twitter, it says, "At least eight of our guests to a very big Thanksgiving will be in their 20s. What is the least expensive way for them to test or test twice? Home tests in DR," I'm not sure if that means Dominican Republic or what that refers to. "Home test in DR cost $23, a lot for them. Thank you."

Dr. Daniel Griffin: That is a lot. Everyone's got to make decisions. I do. I think many of us wish the tests were less expensive. From a public health standpoint, it actually would make sense to make them as inexpensive as some countries, like the UK and France, where they're basically free, Germany where they're a couple of dollars each. If money is an issue, which, unfortunately, I don't think we're going to suddenly jump in and make these $1 a test in the next week, you may want to do just that one test right before you all get-together.

Fortunately, people in your 20s are going to be at lower risk but also think about weight, medical comorbidities, make these decisions. I wish it wasn't just $23 because when we fall through and someone gets infected, someone ends up in the hospital, that's going to cost a lot more than $23 to test.

Brian Lehrer: How well are they covered by insurance?

Dr. Daniel Griffin: Most of these rapid tests, right, the ones that we're buying over the counter, this is money out of your pocket. There still are situations where you can go to one of these urgent care centers and those have all ramped up drive-throughs. Other really ease of getting through, a lot of times those are actually going to be covered by your health insurance. Sometimes it can be cheaper for an individual to go to one of the city MDS or a ProHEALTH or go-health and get that rapid test.

Brian Lehrer: Felipe in Huntington, you're on WNYC. Hi Felipe.

Felipe: How are you, Brian? The situation is my wife, my daughter and I are all vaccinated. I have a 15-year-old daughter in my house. I also have a nine-year-old and a two-year-old, they're not vaccinated. Two days ago, my 15-year-old lost her sense of taste and smell and we took her to the urgent care, she came back positive for COVID 19. The thing after that is, we're a bit confused with the protocol for going forward. We contacted the schools and the schools told us to do a 10-day quarantine period. The doctor told us a five-day quarantine period. We went ahead and we had a couple of parties going on at the house, we canceled. Most people came back to us and told us, "We're vaccinated. You don't have to cancel." People's assumptions is that because they're vaccinated, they're not immune.

Brian Lehrer: Or they're not susceptible.

Felipe: Then even worse, people were like, "Well, look, we're vaccinated so we don't really care if you come to the meetings or not. We know that you're still able to transmit it anyway. Yes, you may be vaccinated, but you're going to bring it to somebody else who may not be."

Brian Lehrer: Dr. Griffin, what do you recommend for Felipe?

Dr. Daniel Griffin: Felipe, this is a little complicated. I'm going to give you the rules and we'll talk a little bit about what's the science behind the rules. We've got these two terms, a quarantine, and isolation. Isolation for the infected, that's how I get people to remember that. As I talked about, when you are infected, from that day, the onset of symptoms or that first positive test, you are potentially able to spread to others for the next 10 days. The CDC and all the states across the board, isolation for the infected, that's 10 days. Your child who tested positive, there's going to be 10 days that we think that that individual can spread to others.

Then we get into quarantine and this gets a little more complicated because a person who's vaccinated is at less risk of getting infected and less risk of spreading it to others, less but still there. They have certain rules. A fully vaccinated person does not necessarily have to quarantine. They can continue to go about their day. It is recommended that they wear a mask indoors and round others for the next 14 days, and this is 14 days that really the clock doesn't start until the end of your exposure to that isolating person. That's 10 plus 14, you're wearing a mask, you're being extra careful. Five to seven days after the initial exposure, another five to seven days after the end exposure.

You want to test yourself because vaccinated people can get asymptomatic infections, but vaccinated people can continue to go out, do the things that they want to do. Now, an unvaccinated person, there's actually different rules. The CDC has a14 days from last contact. Certain states shorten that, like New York says for the unvaccinated 10 days without a testing option. Some states, and this is not New York, they allow you to test out a little sooner. Think about continued exposure to the infected, isolating person for 10 days forward. Then the clock starts.

If you're in New York State, it's another 10 days if you're unvaccinated. In certain states, you can shorten that to seven if you get a negative test in those last couple of days. Complicated navigating this, this is one of those things that hopefully this helps.

Brian Lehrer: It sounds like depending on the timeline of the story, Felipe told us they may have to cancel Thanksgiving.

Dr. Daniel Griffin: Thanksgiving is going to be tough. The group of you, Felipe, that are already together and getting exposed, maybe this is just going to be a small Thanksgiving for everyone. You really don't want to bring someone who's vulnerable into that setting because not only the individual, your child who's infected right now, but there's the risk that this is going to end up spreading to someone else. Then you would put someone at risk. Gosh, timing is terrible.

Brian Lehrer: Felipe, I hope that's helpful, even though it's a little complicated and probably not great news about your Thanksgiving. Thanks for checking in with us and please call again. We're going to take a short break right here. We have many other calls and tweets coming in. I want to ask you when we come back about the Jen Psaki White House press secretary PCR test saga or a sequence in her own experience when she got COVID. I want to get into the bigger scheme of things if you think testing has been de-emphasized too much in the vaccine era as an additional tool to help people get back to the office safely and back to other things. A lot of your personal questions still about testing and Thanksgiving weekend and bigger picture stuff too with Dr. Daniel Griffin. Stay with us. Brian Lehrer on WNYC.

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Brian Lehrer: Brian Lehrer on WNYC. As we talk about COVID testing for Thanksgiving and beyond with Dr. Daniel Griffin. Griffin, MD. PhD., infectious disease clinician, and researcher at Columbia University, Chief of Infectious Disease for the ProHEALTH system, and president of the group that sounds like it's a bad thing, but it's really a good thing Parasites without Borders. Dr. Griffin, the Jen Psaki, White House press secretary Jen Psaki PCR test experience, what do we learn from this? She had an exposure a few weeks ago, on a Tuesday, then said she tested negative on Wednesday, Thursday, Friday, and Saturday, but then tested positive on Sunday. What does that tell us about the true meaning of a single PCR test?

Dr. Daniel Griffin: Brian, this is a great story. I think it goes back to what I repeatedly tell people, that a test cannot predict the future. I think we use the pregnancy test on a prior show where we talked about getting your daughter tested before they go off to college. That's not going to predict the future. When you get exposed to someone who is infected who has COVID, there is an incubation period. There may be a tiny amount of virus that actually gets into your nose and to your upper airways, but it's going to take days before that virus actually replicates to the point where we can detect it, where we know that you're going to go on to get sick.

This is a perfect example. Now with the Delta variant, that period of time to exposure to that first positive test is about four days. The day after exposure, it's going to be negative. The second day, it's going to be negative. The third day, it's probably still going to be negative. It's not till the fourth or fifth day that you start to see that positive test. The thing about PCRs, as we've talked about, they may pick it up a day before the antigen tests pick it up, but you're probably still not contagious. It's when the antigen test turns positive that you start to be contagious, when symptoms come on that you start to be contagious. Some people have symptoms a little bit before they're contagious.

Often people can be contagious for a day or two before those symptoms. That's why don't just trust one test. That's why we talk about people who've been exposed getting a test five to seven days afterwards. That's that sweet spot for determining whether or not you got infected from that exposure.

Brian Lehrer: Sonia in Rye you're on WNYC with Dr. Griffin. Hi Sonia.

Sonia: Good morning Brian. Good morning Dr. Griffin, and thank you so much for this very well-timed public service that you guys are doing this morning. I just wanted to quickly make two points. I wanted to get Dr. Griffin's take on what seems to be going on in Europe. We have family arriving from Germany for Thanksgiving and in addition to the testing that they have to do to enter the US, they are very used to these rapid tests almost daily in their lives. The government provides them for free. Some stores require them to be taken before you even enter the store. They take them to go to the office. I'm just wondering if you think that's something we might be seeing here?

Then I did have a quick question about PCR tests and how months later you can still get a positive even though you're long recovered. Thank you so much for this sort of segment.

Brian Lehrer: Sonia thank you so much. Dr. Griffin, why don't you take her PCR test question first and then we'll use her Germany frequency of rapid testing question to launch into what we might change in the United States.

Dr. Daniel Griffin: The PCR, that's a great place to start. I think that really echoes what I've suggested already, that the PCR tests can be too sensitive. They could be picking up someone who's no longer contagious, who maybe still has some remnant RNA. We're not sure if this is remnant RNA that the body just hasn't cleared or if there's a low level of viral persistence that we're picking up here, still trying to sort that out, but we certainly have people who continue to test positive for a month, two months, three months out. I actually had a patient myself over 100 days, still positive. Back when we were really strict about needing negative PCRs for things that was really a problem for them going to work, doing all the other things. Those PCRs can continue to be positive well past the period of time when a person is infectious.

Brian Lehrer: Now on her question about what they do in Germany and how we might learn from it here, in the bigger scheme of things, do you think testing has been deemphasized too much in the United States in the vaccine era? It's not that long ago that when entertainment venues first began to reopen in the spring, the option was proof of vaccination or proof of a negative test within 72 hours. That's become solely a vaccine requirement in most places even though we know by now that, as the caller said, vaccines present serious illness better than they prevent spread. It was the previous caller Filipe at Huntington who said that. Do we need more testing again of people who don't feel sick as a routine measure to go to work, to go to clubs, with cases rising again in most states right now?

Dr. Daniel Griffin: Brian I do think we've deemphasized testing. This has come up several times. we have a program for Netflix, Amazon Prime, Lionsgate, where several times it keeps coming up. Why are we testing everyone before they're face-to-face in these closed spaces with poor ventilation? Everyone's getting vaccinated. I think the thing that's really clear is that individuals who are vaccinated can still get infected. They actually still, if they're older, if they have health issues, they still can actually get quite sick. We've had I think we're up to about 8,000 deaths in the vaccinated. Getting vaccinated does not completely end this pandemic.

Now we're talking about getting together with families, Thanksgiving. As you may have noticed, I didn't say, "If you're vaccinated don't worry about testing.' I'm assuming that people are getting vaccinated, I'm hoping people are getting vaccinated but I'm still encouraging that tests be added to that. The tests should be less expensive and more accessible and it is so much of a wiser and cost-effective approach to prevent COVID with testing than it is to pay on the back end when people end up infected.

Brian Lehrer: What would you recommend? She mentioned workplaces, people getting rapid tests routinely in Germany, if that's the case, to go to work on a regular basis. Depending on the setting obviously, but do you think we should be doing that more here? Again, the conversation is generally should employers mandate vaccination.

Dr. Daniel Griffin: The testing actually a lot of our large companies in the US actually are incorporating testing. Some of these are the multinationals that are familiar with it from having offices in the UK and other parts of the world. I say, my honorary cousin Peter Gates who I sail with, he works at a large financial institution and part of his employment is they sent him this big box and he tests every other day. He's supposed to test the days that he ends up in the office, now everyone's doing a back and forth. A lot of these things make sense because it's expensive to get COVID. You're missing work. You might end up in the hospital, you might end up being sick for more than just that two weeks. I think that this makes a lot of sense.

Brian Lehrer: Let's take a call from Steve in Suffolk County. Steve you're on WNYC. Hi Steve.

Steve: Hi Brian, first time long time and you're a gem. I'm here in Suffolk County. We don't have access to the amount of testing that your guests is describing. In order to get testing out here we have to be presenting symptoms. Do you guys have any idea where we could get such abundant testing?

Dr. Daniel Griffin: Yes, this is Dan. I'll jump in. We actually have, put on my ProHEALTH hat for a moment, we have ProHEALTH urgent cares and a number of them are out there at Suffolk. You can certainly go in and get tested. A lot of our facilities have convenient drive-through because you're doing it in that setting. A lot of times, I will say most of the time, this is something that will fall under your insurance coverage. To be honest, I put on my UHG hat for a second, it is much less expensive to cover a test than it is to cover a hospitalization. The other side of this is those over the counter tests. Those you can pick up Walmart, CVS, Target, the fancy French store. These you do not need anyone's permission. There's no one standing between you and access to these over the counter tests.

Brian Lehrer: I think you can visit a Target in the French quarter of Ronkonkoma in Suffolk County and some other places. Steve I hope that's helpful. I want to go to the question of booster shots. There's some booster news this morning which is that the FDA has now recommended approval of boosters, the ones from Pfizer and Moderna, for all the adults over 18 in the United States. The CDC is expected to act quickly on that recommendation. We know vaccination is very effective against hospitalization and death. Almost everyone dying or getting hospitalized for COVID was unvaccinated in the first six months after vaccinations began, case pretty much closed on that.

Now there is also the booster question Dr. Fauci said on TV just yesterday that hospitalizations and deaths among fully vaccinated people over 65, meaning with two doses, are rising if they've gone more than six months without a booster or one dose of J&J. How do you see those numbers and the need for universal booster shots?

Dr. Daniel Griffin: I know a lot of people wanted to wait and see and I think that wait and see period has passed. What we do know is that getting that third shot is safe. We are not seeing any safety concerns however you felt after that second shot, that's about what you'll experience with that third shot, so it's safe. People who are over the age of 65, people who have other medical issues, they're not at zero risk of ending up in the hospital and death. Let's be honest, nobody wants to get COVID. No one likes to be sick. Even if all the boosters do is reduce our chance of getting an infection, particularly going into the holiday season, it makes sense to go ahead with the boosters.

Brian Lehrer: In the context of Thanksgiving I've heard two versions in the last few days from respected people. Maybe somebody just got their information wrong or maybe there's actual medical disagreement on this, but I've heard two versions of whether boosters need two weeks after the shot to become fully effective like the original set did or if they are so right away. What can you tell us?

Dr. Daniel Griffin: There's a subtlety there, and I think that's fine. The immune system doesn't suddenly turn on at two weeks, there's a gradual progression after that vaccination. You're going to start to see a ramping up of your T cells at about four days afterwards, you get to really see a ramping up of your B cells and those antibodies about 10 to 14 days afterwards. There's going to be some gradual improvement. The sooner you get the vaccine the sooner you're going to be up to that high level at day 14, but it's a gradual increase.

Brian Lehrer: There are still 1,000 people a day dying from COVID in the United States. That's down from 2,000 a day at the peak of Delta this summer, but a thousand people a day. This is how numb to it we've become, that would be another 365,000 people in the next year. That is still a pandemic emergency, isn't it compared to any infectious disease in the last century since the Spanish flu?

Dr. Daniel Griffin: It is tough because we keep hearing about all the like, "Time to get back to normal," and all the rest, but yet we are living in the midst of an ongoing pandemic with over a thousand people dying a day. We have become numb to that, but think, every one of those thousand individuals. It's someone's mother someone's father, someone's sister someone's brother. This is a tragedy and the way we've moved forward is vaccinations, more testing. Hopefully very soon, in addition to the really powerful monoclonal antibodies, we're going to have oral antivirals.

Brian Lehrer: We're going to do a separate segment on that next week, but you want to give us a quick take on that? COVID treatments, Merck and Pfizer. Now have these antiviral pills to take early on after you've tested positive. Some reports say they can cut hospitalizations and deaths by 90%. Are you using either of those yet in your own practices at Columbia or ProHEALTH?

Dr. Daniel Griffin: Not yet. On November 30th, that's when the FDA advisory committee is going to talk about the Merck product. That's about a 50% reduction. Pfizer, which makes the packs a little bit, that's that 89-90% reduction in people progress in the hospital and death. That's going to get reviewed in December. These are just right there on the horizon.

Brian Lehrer: Alexa in Stamford, you're on WNYC. Hi, Alexa.

Alexa: Hi, how are you this morning? I'm just driving. I'm going to pull over actually. My husband started feeling congested the Tuesday after Halloween and we got him a rapid test, which was negative. Then two days later I had him take other tests while he was still not feeling well, and that was negative. Then the following Monday he still wasn't feeling well. He took another rapid test that was negative and called his doctor thinking that he had a Sinus Infection and he ordered a PCR which came back positive. My husband's fully vaccinated. We thought we were doing the right thing.

It was a mess for a while because I have three children, two are not vaccinated. They both got COVID the day before they were supposed to get vaccinated. We had to retrace all of our steps. It may have been operator error, and I do think the rapid tests, I was hoping at least one of them would come back positive since he was absolutely symptomatic. I just want to put it out there that if you have symptoms and even if your rapid test is negative, maybe you should get a PCR.

Brian Lehrer: Dr. Griffin, what do you think about that?

Dr. Daniel Griffin: I think that that's excellent advice. Remember, if the test doesn't make sense, and I even say this the other side with the PCRs. We've certainly had people, they end up in the hospital. For all the world, I'm looking at a chest X-Ray, the story makes sense. I think they've got COVID, the PCR comes back negative. I'm going to repeat it. Don't trust a test if it doesn't make sense, always be ready to think about getting a second test. Particularly getting a second test that's maybe a slightly different modality. Maybe you did that rapid antigen tase, there are even these rapid molecular tests that you can do, and then there's PCR. If it doesn't make sense and go ahead, get that second test. No test is a 100% sensitive, even our PCRs.

Brian Lehrer: As we wrap this up, Dr. Griffin, I want to come back to one issue that a number of the listeners have raised individually, but I think is really a social issue, a national issue that's going to need more attention. A listener on Twitter pointed out reacting to that caller from Suffolk before, writes, "Nice caller from Suffolk County on Brian Lehrer genuinely wants to know about dearth of testing. Insurance is not covering rapid tests. Why are we minimizing costs associated?" You acknowledged, we acknowledged in the conversation, to a couple of callers and one person who sent in a question via tweet, that these rapid tests, especially if people are going to do them a lot, which is part of what we've been talking about, regarding weaving them into people's regular routines. It's going to cost people a lot of money.

Do you want to say something from a level of advocacy at all about the government requiring insurance companies to cover rapid tests or anything like that?

Dr. Daniel Griffin: Yes. I don't know if Biden listens to your show, but I'm going to put in this plug anyway, maybe Jen Saki will listen. Just think about the amount of money we're spending, right? We just anted another 5 billion up to buy a bunch of the Pfizer medication, the packs loaded. We've anted up $2,000 per dose to get monoclonals out there to people. We've bailed out hospitals to some enormous tune to pay for the average $44,000 per COVID hospitalization. Getting accessible tests to our citizens, that is so much more cost-effective, and also it's a humanitarian thing. It's not just about dollars and cents. It's about preventing people from getting sick. It's about preventing our loved ones from ending up in hospital, or even preventing people from ending up with long COVID where they continue to suffer for months and months,

Brian Lehrer: Dr. Daniel Griffin from Columbia, ProHEALTH, and more. Always great to have you on, so informative. Thank you for answering my questions and listener questions. Happy Thanksgiving to you.

Dr. Daniel Griffin: Thank you, and everyone be safe.

 

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