The Pandemic Isn't Over

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Brian Lehrer: It's The Brian Lehrer Show on WNYC. Good morning, everyone. Hope you had a wonderful Easter weekend, Passover weekend, more days of Ramadan, happy tax day today, if it is a happy tax day. We'll be talking about that later in the show. We're going to meet a very interesting former Congressman who some of you know of, some of you don't, he's from Texas, Will Hurd.

He was the only Black Republican in Congress until he left office. He didn't run for reelection in 2020. He sees himself as a political missing link. He embraces the word moderate. He might run for president in 2024, we are told. Will Hurd, later on today's show. Mayor Eric Adams spent Easter week in isolation with COVID-19, as you know. We don't know for sure where he got it, but he was one of the 72 people, all vaccinated, who tested positive after the Gridiron Club Dinner on April 2nd, after which other top Democrats and their appointees got it too, including House Speaker Nancy Pelosi and Attorney General Merrick Garland. You've heard that no doubt.

The event did not require a negative test that day to attend like the State of the Union Address at which nobody got COVID. From isolation, Mayor Adams has continued to be an aggressive interventionist on crime, such as ordering the subways flooded with police officers after the shooting on the N train last Tuesday. Here's the difference between the politics of COVID and the politics of crime. When it comes to public safety these days, many politicians of both parties seem to favor more government intervention not less, more policing, more surveillance, et cetera. They're responding to stats like this.

The gun control group, the Brady Campaign, says 42 people on average are murdered each day with a gun in the United States. That is obviously a problem. When it comes to the pandemic, with over 400 people dying each day right now, and remember it was 2,000 a day just recently at the height of Omicron 1, despite the still high numbers, there's a lot of public pressure for government to intervene less.

Is that a contradiction or a reasonable assessment of the cost and benefits and risks and rewards in each case? This is now a topic of dispute within the field of public health. Last week, for example, we heard on this show from Dr. Leana Wen, a public health expert and physician, former health commissioner of Baltimore, who the right used to hate for advocating aggressive intervention for the first year and more of the pandemic.

She was a major voice for public health measures on CNN and in The Washington Post, as many of you know, but now she's getting excoriated from some people on the left mostly, because she is making the case for recalibrating our risk assessments in light of the availability of vaccines and treatments, pointing out that nobody from the Gridiron Club needed hospitalization or died since they were all vaccinated and saying it's time to leave the decision to take precautions more to individuals and save the government restrictions for emergencies like when hospitals are getting full or new variants cause serious illness in people who are vaccinated, if that were to start happening.

Now, to be clear, this is not about Dr. Wen. She just happened to be a guest last week. The Biden administration is increasingly on this message too, as are governors of both parties. In just a minute, we'll hear another public health professor and advocate who disagrees with the way things are headed. He accuses Democrats, not just Republicans, of practicing what he calls public health apartheid. First, though, to set this up, here's a minute from Dr. Wen's appearance last week. She acknowledged that there is a divide among public health officials and said simply asking how to best avoid COVID is now the wrong question.

Dr. Leana Wen: I think the question to ask though is, what is the price you're willing to pay to avoid getting COVID? Understanding that about 50% of Americans are estimated to have contracted Omicron during this last surge. We're dealing with an even more contagious variant, BA.2, now. It's going to be very, very difficult to avoid. Do you want to keep your kids out of school and out of extracurriculars? Do you want to wear a mask in perpetuity? Maybe the answer is yes in some of these cases, but I think that right now, what we're seeing is quite a steep divide within the public health community.

Whereas in 2020, before we had vaccines, I think all of us were saying, we need to take a lot of precautions because we really want to avoid getting COVID-19. I think there are a lot of us now in public health and medicine who are saying, not that we want to get COVID, but rather that we need to see COVID more like we do the flu. It's not something we want to get, but we're also not going to take such extraordinary precautions that we're not going to be living our lives.

Brian Lehrer: Such extraordinary precautions that we're not going to be living our lives. A minute of Dr. Leana Wen on the show last week after writing her Washington Post column called The Gridiron Club Outbreak Shows What Living With COVID-19 Looks Like. With us now, with a different point of view is Gregg Gonsalves, Yale epidemiology professor, co-director of the Global Health Justice Partnership, and public health correspondent for The Nation. His latest article is called Laughing Ourselves To Death At The Gridiron Dinner. Thanks for coming on, Professor Gonzalves. Welcome back to WNYC.

Gregg Gonsalves: Thanks, Brian, for having me.

Brian Lehrer: Dr. Wen's article in The Washington Post was called The Gridiron Club Outbreak Shows What Living With COVID-19 Looks Like, your article in The Nation is called Laughing Ourselves To Death At The Gridiron Dinner. Why laughing ourselves to death?

Gregg Gonsalves: First of all, I want to tilt it to strawman arguments. Dr. Wen is suggesting that we want to go into some Redux of 2020 with us all being at home, schools closed, wearing masks into perpetuity. What Dr. Wen is suggesting is unilateral disarmament against the virus. She even said in her Washington Post piece that she didn't think it was any responsibility of the hotel in D.C. to protect their customers and the people at the event last week.

Didn't need to be wearing masks, but we could have asked people to pretest, before they came to the event. We could have inspected the ventilation, not had people at long narrow tables. Dr. Wen is basically tilting it to strawman and suggesting that anybody who suggests we should really keep investing in pandemic mitigation, is somehow living in a fantasy land.

Brian Lehrer: Although, even that, the way you lay it out, that would've been a private decision on the part of the hotel that would not have been a government mandate. That's the direction Democratic politicians as well as Republican politicians are headed, right?

Gregg Gonsalves: Actually not. Most of what we do in public health is not mandated. It's community guided and community level decisions that we do together. The fact that we recommend to businesses across the country that they should invest in remodeling their ventilation and that there's some federal support left to do so, to say that if you're going to a party or if you're going to an event, perhaps you should rapid test. It's not a mandate. It's asking people to invoke common sense.

Dr. Wen and what I call COVID nihilists are saying, don't worry about it. It doesn't matter if you get COVID, everybody's going to get it anyway. That is what she said in her broadcast with you last week. The point is we had 200,000 people die in December, January, February, March of this past winter--

Brian Lehrer: Per day.

Gregg Gonsalves: What?

Brian Lehrer: Oh, 200,000. I'm sorry, it was 2,000 per day. Sorry, I heard the wrong number. You said 200,000 this winter. Got you.

Gregg Gonsalves: Died. The idea that Omicron is mild or that everybody's going to get it and it'll all be okay, is beyond fudging the truth. In fact, there are plenty of people who remain vulnerable to this disease. People who are immunocompromised, people who are vulnerable in other ways. What I point you towards is another piece in The Washington Post that came out over the weekend, which was really about the tale of two pandemics. There are people like Dr. Wen and others who have access to many resources.

I'm sure they have a closet full of rapid tests, access to Paxlovid if they get sick, know who to call to get N95 masks. Then there's a whole bunch of people around the country who are far away from sites where they could get access to treatment and testing. We've just run out of money for the uninsured program to get people testing, vaccination, and treatments. We only just barely were able to extend the public health emergency for 90 days to make sure that people didn't get kicked off Medicaid [unintelligible 00:09:30]

I am not suggesting that we should mask forever, I'm not suggesting that we should even consider trying to spend all our energies on mask mandates. I'm talking about a comprehensive response tailored to the times. The times are not that the pandemic is over, that the worst is behind us. There's great uncertainty about what's going to happen next with BA.2 or what happens this fall. People like Katherine Wu and others, who write for The Atlantic suggested that we are basically not taking reasonable precautions to keep ourselves safe for the rest of 2022 into 2023.

Brian Lehrer: On the concept of Laughing Ourselves to Death, and I realize you maybe even didn't write that headline, the people who write the articles aren't necessarily writing the headlines, but using that word, even sarcastically, is it misleading? Because despite that overall death rate, which is ongoing and which is completely unacceptable, one of Dr. Wen's main points was about the Gridiron Dinner itself. It should be seen primarily as proof that vaccines are effective.

It was a vax mandate event and none of the 70 people who got COVID who were there are known to have died, or even gotten hospitalized including 82-year-old Nancy Pelosi, 61-year-old Eric Adams with his history of prediabetes and high blood pressure or anyone else. Your reaction to that argument?

Gregg Gonsalves: Let's put it this way. The people at that dinner have the resources to get the best of the best in medical care and preventive care. I will bet you $100 that all of them have been boosted twice, or at least boosted. Now, let's talk about how many Americans across the country are boosted with COVID vaccines, about 30%. To extrapolate from the Gridiron Dinner and the heady reaches of the Washington elite to the 70% of Americans who are not boosted.

70% of Americans are not boosted, and therefore more vulnerable to the variants than you and I. I assume we're boosted, and you may even be boosted twice. The point is, extrapolating from the heady reaches of those people who were at the Gridiron Club to the general American public, which is under-protected from COVID-19 because they have not gotten boosters, makes Dr. Wen's statements almost cavalier.

If you were not boosted, would you have gone to the Gridiron Dinner? Probably not, but everybody there was. Yet some people got sick. Suppose somebody's antibody levels or their vaccine did wane, supposedly happened to live with somebody who was immunocompromised, and happened to bring a breakthrough infection home to them. The idea that getting sick with COVID is no big deal, is an idea that I think is both wrong in fact, and wrong in policy. Remember [crosstalk]

Brian Lehrer: Just to stay on the Gridiron Dinner as symbolic of the larger thing, and hearing very much what you're saying, the people who attended the dinner were the privileged who were probably vaccine boosted and maybe double boosted, vulnerable downstream for them were perhaps their immunocompromised family members or others they might come in contact with. Also workers at the Gridiron Club who aren't in that privileged class, we haven't talked about them yet. I'm sure you would include them.

What would your standard be for any event like that that includes a lot of people in the same room. Then that generalizes too, like when Dr. Wen says living our lives, that generalizes to ordinary people having their weddings with, let's say, sometimes a few hundred people.

Gregg Gonsalves: I have shockingly gone out to dinner unmasked over the past month or so since the Omicron wave is lulled. What do I use? I use rapid tests to give me some sense of security that I'm not shedding copious amounts of virus at any given moment.

Brian Lehrer: Each time before you go to a restaurant?

Gregg Gonsalves: If I'm going to be in a place where I do not know people's vaccine status, and they don't know mine, I use rapid tests. Until like a few months ago, we were saying we should do this. That it was an important thing to do. People like Michael [unintelligible 00:14:08] and others were saying, "Rapid testing was a way to manage your risk." That's one way. Right?

Brian Lehrer: Right. If we could scale the rapid tests to be available for every time you go out to a restaurant.

Gregg Gonsalves: Hello. [chuckles] If you go to any other country in the industrialized world, they've done a much better job at getting rapid tests out to their citizens. Anybody who just traveled to Europe over the past six months knows that they're much more plentiful, accessible supply than they are in the United States. I'm not suggesting that people should avoid their wedding, should avoid indoor gatherings, I'm saying take reasonable precautions.

The idea that you have no responsibility to take precautions, because you're adjudicating your own personal risk and making your own personal choice, and that extends to the venue that you're in, is basically saying we're all in this for ourselves. We're all in this alone. I'm saying you can do simple things. You could have had pre-event testing. Guess what? At the White House Correspondents' Dinner in the next few days, there is pre-event testing.

You could have decided, "Maybe we should do this in a semi outdoor setting." We could have not had a brass band singing [unintelligible 00:15:16] which is going to spew respiratory droplets and aerosols into the air. There's many the things we can do to make our events safer. The idea that we can put it all behind us and do nothing is what Dr. Wen is advocating, and I don't think it makes any sense.

Brian Lehrer: A related thought on the other side is that the people winding up dead and in the hospital from COVID are overwhelmingly now the people who refuse to be vaccinated. If we assume that there's real access to vaccines, and I know that's still an issue to some degree, but if we presume that the people getting serious COVID are now overwhelmingly the people who are just declining to be vaccinated or wear masks themselves, should everyone else have to mask and distance forever to protect those people from themselves?

Gregg Gonsalves: Basically, should we throw smokers out of the lifeboat, should we have thrown people during the AIDs epidemic who had sex out of the lifeboat? The point is, we treat everybody the same in public health and clinical medicine. There are not those who are guilty, or those who are innocent in terms of their chance to get disease. Yes, I understand that there are many people who don't want to get vaccinated, there are some who have not gotten around to it for many other reasons, but the idea that we say, "You know what, you didn't get vaccinated, so tough luck. It's up to you to protect yourself and you didn't, so tough luck that you ended up in the ICU."

We could say that about many, many people who have lung cancer. We can talk to people who developed HIV in the early epidemic because a condom broke. We can talk about lots of ways in which we blame people for their own infections, their own health status, but that's not what we do in public health. That's not what we do in medicine. The idea is to do no harm in medicine, and the idea is if there are those who we are willing to cast away, to dispose of, who are we?

What does it tell us about us? This goes from people who are maybe Trump supporters who haven't gotten vaccinated, or to people who work three to four jobs who just don't have access to healthcare and have not been able to figure out how to get a vaccine either. I'm not ready to throw anybody off the lifeboat because of a decision they made about their own lives. I would like to see them vaccinated. I'd like to see all Americans vaccinated, but the point is, we have 30% of Americans boosted. If that's the bar for back to normal, back to 2019, I think we're really setting our sights pretty, pretty low in terms of what we can do as a country.

Brian Lehrer: My guest is Yale epidemiology professor, Gregg Gonsalves, who is also co-director of the Global Health Justice Partnership and public health correspondent for The Nation. His latest article in The Nation is called Laughing Ourselves to Death at the Gridiron Dinner. We can take some phone calls and tweets for him. Professor Gonsalves, you may not be surprised to know that this is one of the segments where before I even gave out the phone number and invited people to call in, our lines are full.

For those of you who don't have us on speed dial, it's 212 433 WNYC, 433 9692, or tweet @BrianLehrer. I do want to play a couple of more clips of Dr. Wen from last week's show just to lay out the other side of the conversation that's taking place, but I want to read you two tweets that have already come in on different sides of this, and get your reaction to the intensity of feeling on both sides, and how people who make these arguments are being discounted.

I don't know who these tweeters are, so I don't know who they're in the tank for or whatever, but maybe nobody. One of them says, "Dr. Wen is not a public health expert. She does not have an MPH. Her approach is apparently eugenics. Please do not support her." That's really rough on that side. Then on the other side, somebody writes, "Can Brian Lehrer sink any lower than having Gregg the fear-monger on? This has got to be a new low for him." This says something about the intensity of feeling and accusation among people who presumably legitimately care about public health and doing the right thing for society. Is this an unusual position for you to be in, with respect to other people in your field?

Gregg Gonsalves: I cut my teeth on the AIDS epidemic. I remember when gay men, people who use drugs, were being suggested by William F. Buckley to be tattooed on their buttocks or their upper forearms to protect ordinary Americans from contagion. If you want to talk about the way people were treated over the course of history in epidemics, we have a long, long, long story to tell.

I don't think Dr. Wen is eugenicist and I'm not a fear-monger. The point is that the pandemic isn't over. There are reasonable precautions we can take to protect ourselves and our families that allow us to resume many normal activities, but the point that it's all about private choice and personal risk, is not what public health is about. Take away the questions of mandates, but think about what you would do for your neighbor.

Suppose your neighbor is a 80-year-old diabetic, who's had trouble with getting a good response to the vaccine, or you have an under-five-year-old child at home who you just gave birth to two months ago. You would want to make sure that your neighbor and your child were safe. You do that by saying, "You know what, I'm going to do what I need to do to protect my family, my friends, and my community." That's all I'm saying.

The point is that we have in the Northeast where I live, BA.2 is rampaging across the northeastern states, yet many people are doubly boosted or singularly boosted in this part of the world, but there are maps of the state of Massachusetts recently that showed that there's great variety of vaccination uptake, even across places in the Northeast. The point is, let's see what we can do reasonably in this new era of the pandemic to protect ourselves, our families, and our communities.

This is not talking about a return to 2020. This is not talking about any Wuhan-style lockdown. We're talking about basic reasonable protections that we took for granted just a few months ago, at the beginning of the Omicron surge. What were people looking for? They were looking for rapid tests, they were looking to know their status. Many people were looking for N95 masks. We had long conversations about ventilation, and now we're talking about access to [unintelligible 00:22:14] another treatment to deal with the people who are at the highest risk, who might come down with COVID.

The point is that Dr. Wen is not a eugenicist. I'm not a fear-monger. I do think her version of public health based on private choice and private assessment of risk is really out of the mainstream of public health thinking. We don't talk about public health as something we do alone. Public health is what we do together. It's everything we think about in our lives, to clean the water that we drink, the fact that I can go get some take-out food for lunch and not get salmonella is public health.

The fact that we can walk into restaurants now and not leave with smoke-filled clothes is public health. They're things we do together and to collapse it all to about adjudication of private risk and personal choice when your risk and my risk is very different from somebody else's in another community or another part of this country, is really elevating our personal lifestyle or personal lifestyle choices into public policy. That's where I think she's wrong.

Brian Lehrer: We'll continue in a minute with Gregg Gonsalves, stay with us.

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Brian Lehrer: Brian Lehrer on WNYC, as we continue with Gregg Gonsalves, Yale epidemiology professor, co-director of the Global Health Justice Partnership, Public Health Correspondent for The Nation, his latest article was called Laughing Ourselves to Death at the Gridiron Dinner. I asked Dr. Wen on last week's show if the current status quo is acceptable to her with 500 deaths a day right now, 2,000 deaths a day when Omicron was higher in the winter, that would mean hundreds of thousands of COVID deaths every year, as long as we reopen as much as we have now, and now that COVID seems permanently with us. That's what endemic means. Here's part of her answer to that question about how many deaths per day is acceptable.

Dr. Leana Wen: If we want to get that number below 600 deaths, let's pick a number, let's say it's 100 deaths or 50 deaths, there's going to be a heavy toll on society. How much do we want to impose additional restrictions, including continuing lockdowns in order to get to that point? It's a very difficult question and not one that I have the answer to, but I think we do need to think very seriously about the trade-offs for every intervention.

Brian Lehrer: What are some of the biggest trade-offs? Dr. Wen said they are not just public health versus "normal life" but a holistic view of public health. Here she is on that.

Dr. Leana Wen: I think at some point we also have to accept that good health is not just the absence of COVID-19. There are studies coming out, for example, that show even in 2020, the number of people dying from alcohol-related diseases for people under the age of 65, that actually exceeded the number of people dying from COVID.

The number of overdose deaths has been climbing, cancer screenings, routine cancer screenings, especially colonoscopies have fallen off the charts, routine childhood immunizations have fallen off the charts. We need to also pay attention to issues that are not just COVID because I don't think that avoiding COVID infection is the be-all and end-all of good health.

Brian Lehrer: Professor Gonsalves, your reaction to that as an arguably more holistic public health view of what behavior mandates produce at this point?

Gregg Gonsalves: A couple of things. Dr. Wen invoked the idea in the specter of continuing lockdowns. Can we seriously get real? Most of our mitigation efforts have really fallen away over the past year or so. The reason we're having this discussion is because many of us are pushing back and saying, "Maybe we went a little too far." Invoking that we have some continuing lockdown mentality in the US is-- if you want to talk about fear-mongering and overstatement, it's an exaggeration to say so.

Completely agree that we have to take a holistic view of public health, and most of my work is on HIV and substance use and the overdose crisis, but to say that overdoses or reductions in immunizations have resulted in the 1 million deaths we now see with COVID-19 in the United States and to minimize those deaths, is really disgraceful in my mind. She does not need to talk to me about the need to think of public health holistically, not just in the United States, for instance, but abroad. If we want to talk about vaccination, we can talk about the 3% of people who are unboosted in the United States, but the vast majority of people in many places in Sub-Saharan Africa who have no vaccine whatsoever.

The idea that people are just saying, protect yourself from COVID at all costs, it's COVID zero policy versus her more expansive version of public health, is a false dichotomy. As I said, again and again, and I have been trying to get across to your readers, is that there are reasonable precautions we can still take to minimize the death and suffering from COVID-19 over the next year and into the year after that.

The point is, it's not continuing lockdowns versus party like it's 1999, we can do things that are structural, we can do things that are a matter of personal choice, and we can do things to make the places we visit, the places we socialize safer. It's all about harm reduction. I've been talking about this since 2020, when I talked to Michelle Goldberg at The New York Times, is that we need to learn to live with the virus and meet people where they're at, but you also can't tell people what they want to hear. That basically, the risk of COVID is so impossible to avoid, is that you might as well not try, or that COVID impact pales in comparison to car crashes, or overdoses, or the decrease in childhood immunizations, that we shouldn't really care about it.

The point is, Dr. Wen has staked out an extreme position, which is basically, let's go back to normal, and normal meaning, actually resuming most of the things we did in 2019, without any of the easy simple things we could have done to protect ourselves, including at the Gridiron Dinner, using rapid tests, making them more accessible, making sure that we have [unintelligible 00:28:40] ventilations.

Some of this is a discussion that needs to be put at the feet of Congress. The fact that we're talking about $10 billion for COVID relief three years into the pandemic when the White House has asked for far more than that, is the biggest problem of them all. If we had access to more tests, we had more access to funding for improving ventilation in our schools, in our restaurants, in our public buildings, this would be less of a crucial point, but the point is, if you want to say the pandemic is over, that we've turned the corner, that we don't need to worry anymore, it's very hard to go back to Congress and say we have a crisis here that we have to resolve.

Again, this is not about continuing lockdowns at all. It's about taking reasonable precautions over the next year to prepare ourselves for any new wave that comes through and to minimize deaths and suffering across the board. I don't need to be lectured by Dr. Wen on public health. I've worked in it for three years on the front lines, both in the US and across the world.

The point is that we all care about public health, this is the work we do, but I'm not willing to basically tell people that they are expendable. That they're the eggs we need to make an omelet for everybody else's returned to normal because [crosstalk] it's going to be the disabled, the immunocompromised, the people who are underinsured or uninsured in this country who are going to suffer the most while people party on at places like the Gridiron Club and other places. The point is that we're all in this together. Public health is not about what we do alone.

Brian Lehrer: Right. I think where you would agree is that there needs to be a lot of access and better access to things like insurance, testing, treatments, and vaccines. Jean on the Upper West Side of Manhattan, you're on WNYC with Professor Gregg Gonsalves from Yale School of Public Health. Hi, Jean.

Jean: Hi. Brian, I'm noticing a trend that's not insouciant, not caring, it's okay, but fury. I took the Long Island Railroad last week to see-- I go to Long Beach often because my son and my grandchildren are there, and they perform. Half of my train was unmasked. When I asked the conductor about this, she said, "We're afraid." I said, "The Long Island Railroad is afraid." She said, "Yes."

Brian Lehrer: Afraid of what?

Jean: I said, "What are you afraid of?" "We're afraid of assault." If I confront anybody who's not wearing a mask, they might attack me. I think this is new. I haven't seen this kind of anger and I've taken the Long Island Railroad before.

Brian Lehrer: Well, we've seen it during the pandemic throughout in various kind of ways. People wanted to kidnap the Governor of Michigan and all kinds of-- there have been all kinds of assaults that have taken place. Jean, thank you very much. You raise an important point. We're going to follow up on it. Professor Gonsalves, the federal government just extended the mask mandate for public transportation through sometime in May.

It's a very short-term extension. What do you think, considering that COVID is going to be with us for a while, I think there's no doubt about that, past May, is that a timid step in your opinion? You can generalize from that, to get it away from you versus Dr. Wen, to how you see the Biden administration, in general, in this respect, which you also write about.

Gregg Gonsalves: A couple of things. One is the fear and the anger that your listener just described is not uncommon. Frankly, many frontline public health workers are quitting their jobs. They've had death threats and threats of violence towards them. We're losing people who we desperately need at the local and state level to protect ourselves, not just from COVID, but from all the public health threats that underpaid, undervalued public health workers across the country do.

The mask mandate, I am sure will be litigated all the way up to the Supreme Court, should the Biden administration try to extend it further than 15 days. The point is that you can use the bully pulpit of the White House, you can use the resources of the White House in a way that gets around some of the desperately anti-public health measures of the GOP and their allies.

On public transportation, we can recommend it, we can make the masks available, and we can make ourselves safer. If nobody wears a mask in a Long Island Railroad car, that's not great, but it's better to have 50% than 100% doing it. We do our best. If we can't rely on a mask mandate in 15 days, why can't we appeal to ourselves as New Yorkers, as Americans, to basically, do not ask what you can do for yourself, but ask what you can do for your country. Where is that collective spirit of national sacrifice rather than don't tread on me, don't tell me to wear a mask on the Long Island Railroad?

Let's take the mask mandate off the table. Let's say, why don't we have the Biden administration saying, "Look, this isn't about returning to normal. It means we're going to have to live with a new kind of normal in which we take care of each other in a way that doesn't depend on the federal government telling you what to do, but exercise your own common sense with the guidance of CDC and our science agencies."

I feel like there's a strong political incentive as we move towards the midterms for the Biden administration based on its pollsters to say that we've turned the corner, that it's all over, that we don't have very much to do collectively as a nation anymore, all the while they're trying to get more money out of the US Congress, but speaking with two narratives. One is that COVID is behind us, and one is that we need to prepare for the future. They can't have it both ways.

We can do much more together as a country. I don't understand why the national sacrifice that we saw across the US in the 20th century from World War II through the other crises we faced like 9/11, why that collective spirit basically is falling by the wayside. Now we're talking about private choice, private risk, and what's good for me and my family than what's good for our communities.

Brian Lehrer: On the private choice, certainly on this show we've spoken many times about refusal to get vaccinated unless you have some medical condition that argues against it is really selfish, that it's a community responsibility to others, same with masking in many circumstances. One of the things that came up on that segment last week was that the one-way protection can be so good that perhaps that doesn't matter as much anymore.

If we are vaxxed to protect us from serious disease and the idea that N95s or their equivalents are very effective to prevent us, whoever is wearing the masks, from getting COVID, just incoming, even if we're dealing with people who are not wearing masks, talking to us or singing at us or playing their French horns at us, that the one-way N95 level masking and vaccines does protect the individual. Do you have an opinion about that as an epidemiologist?

Gregg Gonsalves: Well, a couple of things. It's always compared to what, Brian? Me wearing an N95 or not wearing an N95 in a place where I might come in contact with SARS-CoV-2, I'd make the choice that I'd wear the N95, but you and I wearing an N95 together, if I didn't know your vaccine status, would be even more protection. Let's put it this way. Let's say you're on an Amtrak ride from New York to Miami. Let's say you're in the car overnight with a bunch of people. One of them is my grandmother who just gone through cancer chemotherapy. She's vaccinated, but her immune protection might be waning, and I turned to the person next to me and said, "Would you put on a mask? My grandmother just got out of the hospital. Would that be okay?"

What would your response be? Would it be, "Don't tell me what to do. You're not the boss of me," or would you say, "Sure, I want to protect you. I want to protect your grandmother as well." The point is that one-way masking is good compared to no masking or using a cloth mask or a loose surgical mask rather than an N95, but two-way masking is even better.

Again, I don't want to collapse this just to masking because it's a red meat issue that's been mobilized to basically say-- it's basically saying that continuing lockdowns are equal to mask mandates.

The point is we can do a lot more besides masking to keep ourselves safe in the next few months and years. Again, let's do this where we meet people where we are at, but don't tell them what they want to hear and say that it's all over and anybody who's afraid of the virus, COVID dead-enders, as David [unintelligible 00:38:01] and others described, are just scaredy cats who don't know how to deal with the risks that we see in all our lives.

The point is, this pandemic is not going away. We may or may not have seen the last variant that's going to give us death rates like we saw over the past several months, but we can do better than we are now, and better than the Biden administration is doing now, better than Dr. Wen thinks we can do together by just taking reasonable precautions, not continuing lockdowns, because that's a specious, false dichotomy that I think is really disruptive and damaging to public health. To say that anything that we've done over the past few months, anything like a lockdown that we saw in Wuhan, for instance, it's just actually preposterous.

Brian Lehrer: Some tweets coming in. I work in the live music industry and every band I know has had to cancel shows or entire tours after catching COVID. People at concerts need to hear the message that masking is mandatory in these large group settings. I think we're starting to move away from that, Professor Gonsalves. Somebody else likes this segment. Says, "Very good segment about COVID and public health with Gregg Gonsalves on why we can't act like public health isn't simply a series of choices about personal risk."

Someone else says, "I think your guest is being unfair to the people he disagrees with and mischaracterizing what good faith clinicians and scientists are saying. Disagreement is fine, but disparaging is unbecoming." On the other hand, somebody says, "A rebuttal today. That's good. She, Dr. Wen, shouldn't have been booked in the first place and definitely shouldn't be booked again." Last one says, can you confirm this? Somebody writes, "Dr. Wen, who I love, just got COVID, she announced yesterday, making her point. I'm not sure whose point that makes if she did get COVID, but maybe it makes hers. Did you hear such an announcement?

Greg Gonsalves: No, I did not hear such an announcement. If she did, I hope she has a brisk recovery and a fast recovery. I hope her family is safe as well.

Brian Lehrer: One last question from Linda in Nassau county, you're on WNYC with Gregg Gonsalves.

Linda: Hi, thank you for taking my call. My daughter who is double-vaxxed and boosted got COVID. Anyway, she had two rapid tests that came back negative, one from home and then one when she went to the doctor then they had the in-depth-- I can't remember the name of it, the more in-depth one, and that came back the next day as positive. It's about six days now, she is feeling better, but it's just interesting. It doesn't give me much faith in the rapid tests where they both came back negative yet she was positive and she said, "Oh no, it's just allergies." I said, "No, you need to go get tested." If it wasn't for me pushing it, she probably wouldn't have went and had the more in-depth one. Then the other thing, how often should we get boosted?

Brian Lehrer: By the way, I'm not seeing any confirmation online of what that person tweeted about Dr. Wen herself announcing she has COVID. Maybe it happened, I'm not seeing it. I just don't want to put anything out as fact that is unconfirmed.

Greg Gonsalves: You should not. In terms of our listener just now, remember, rapid tests pick up whether you're shedding lots of virus, you're spewing lots of virus in your breath and your respiratory aerosols. The PCR test can tell you if there's a virus in general lingering in your body. If you get several negative rapid tests over the course of a week to 10 days where you know you've had COVID, the PCR test could pick up lingering virus for several more days and potentially a couple out beyond a week.

The point is that rapid tests are good at telling you whether you're infectious or not. PCR tests are telling you whether you still have virus residing in your system. They're not contradictory. They do two different jobs. Rapid tests are great for telling you if you're a risk for spreading the virus. PCR is there to tell you that you've cleared the virus or not cleared the virus, if it's in the context of a medical consultation with your doctor.

Brian Lehrer: Gregg Gonsalves, Yale epidemiology professor, co-director of the Global Health Justice Partnership, and public health correspondent for The Nation. His latest article is called Laughing Ourselves to Death at the Gridiron Dinner. Thank you so much for coming on and spending this time with us.

Gregg Gonsalves: Thanks, Brian.

 

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