Is the Pandemic Getting Better… Or Worse?

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S1: Here are a few of the early clues I got that the al-Muqrin wave was going to look different. First, I’d get on Zoom for a meeting and someone in that meeting would be phoning in from an hours long coronavirus testing line. Then I’d walk out my door and I’d run smack into these lines myself at the urgent care center, down the block or at the little tense that started popping up on the sidewalk. And then these emails started trickling in from school. There were one or two cases, they said. Then there were a dozen cases. Then 19. Pretty soon, the teachers started calling in sick. These interruptions, you’ve probably noticed them. One in 10 flights were canceled this past weekend. Sure, there was snow, but pilots were getting Covid too.

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S2: It’s funny. Mary Right before we started doing this, I got a text message from my dad, who was trying to fly back and not sure he’ll be able to.

S1: Diane Dimond reports on health care. Over at The Washington Post.

S2: The shutdown of basic parts of our society because so many people are getting sick with al-Muqrin, this was what folks worried about some weeks ago, and I think that’s come to pass for Dan.

S1: The deja vu right now is real.

S2: It is Groundhog Day. I mean, it’s been Groundhog Day for nearly two years. There have been moments of joy, but we just can’t get to them consistently.

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S1: I mean, I think it’s easy to look at these disruptions and think we’re careening into a fresh Covid crisis. Is that how you see it?

S2: I do think crisis is right in some frames, but I guess the hope is that this is a crisis that will pass. Just like there were earlier waves that we got through. This one might be short and brutish. But the good thing is the short part, and I don’t think we’ll know it’s over until it’s been some months and we can finally finally relax and say the pandemic’s in the rearview.

S1: Today on the show, how to ride out the latest wave, I’m Mary Harris. You’re listening to what next? Stick around. Can we do a little new wave 101 where you just walk me through exactly what we know about this wave, because if you if you look at the line graph, it is really shocking to see those infection levels go up like us cases up 200 percent and that might not even account for everyone because people are doing at home tests.

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S2: Yeah, I mean, at the Post, at The Washington Post, we do try and track this and we use a rolling seven day average Mary because we’re trying to iron out the hiccups some days. States aren’t all reporting other days. States are reporting data that’s been backed up for a few days. So you get these big swings and at the post, our seven day rolling average a month ago was about 100000 cases per day. As you and I are talking now, it’s about 500000 cases per day. So that’s that’s a 400 percent increase. And you’re right, it doesn’t count people who are taking at home tests and not reporting them. It doesn’t count all the people who want to get tested and can’t find them. So we know that the true numbers are even bigger. And then these other numbers, hospitalizations, the seven day hospitalization rate is nearly double there, about 100000 people in the hospital right now. Deaths are basically the same, and that’s both a good and a bad thing. It’s good because all of these cases haven’t immediately translated to significantly more death and pain. On the other hand, it’s possible that we will see in the weeks to come there’s a lagging nature of Covid, where people who are getting sick now were getting hospitalized now will end up dying later.

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S1: Do we know that this is all Omicron at this point?

S2: It’s not all a mccarren and it depends where you are in the country. Parts of the U.S., we’re still dealing with a serious delta wave. This previous variant that was proven to be not only fast moving but reasonably severe, pretty severe. I was in the Midwest a few days ago, and hospitals there say they are still seeing many patients coming in because of Delta.

S1: And are they testing? They’re trying to sort out who’s Omicron? Who isn’t?

S2: Well, they are testing, but it’s hard to do it in the moment so you can look back and do this genomic sequencing. And there are hospitals that I’ve talked to Houston Methodist and Texas, which has done this really comprehensive tracking of OK. This week we had 15 percent of patients were al-Muqrin. This week we have 30 percent this week, 50 percent and I’m saying weeks, but really it was a matter of days. I’m a Karen moved very, very quickly and it’s up over 90 percent of the cases now at this hospital system in Texas. But it’s also hard to know if you’re in the emergency room or you’re in the ICU. You’ve got this patient presenting with Covid who might need immediate help. You can’t tell if that person’s crown or that person’s delta, and that makes a real difference when you’re trying to figure out which treatments to administer. Because some things that work for Delta don’t work for Akron, and there’s a limited supply of these things. Like what? Oh, like the monoclonal antibodies, which which essentially you’re infusing. You’re giving someone antibodies immediately to fight off these infections. But the monoclonal antibody treatments that we’ve had for some time now, most of them don’t work for Macron. So if a patient showing up and needs monoclonal antibodies, it’s kind of a twofer. If you give an arm Akron patient these antibodies, you’re not making any difference in fighting on Macron, and you’re losing the opportunity to give it to someone who has a delta infection.

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S1: Oof, we’ve talked about how this wave seems to be milder. Can we talk a little bit about the evidence for that? Like, I was reading about a study on Syrian hamsters who were very impacted by earlier variants of this virus, but seem less impacted by Omicron. Why is that? What do we know?

S2: Well, you know, I haven’t interviewed the hamsters myself, so I’m just going off the the reviews and recap secondary source. I’m sure they have a lot to say if I can ever get them off the wheel. But the early lab data and then the real world evidence suggests that Macron is less severe for a couple of reasons. One, the ability to infect the lungs appears to be significantly less with this variant. And that’s important because Covid has led to pneumonia. It’s led to people having respiratory failure for two years and just a horrible, painful way to land in the hospital and in many cases, die.

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S1: And sometimes people survive the virus, but then their lungs are just ravaged, and that becomes the real issue. Right?

S2: And I have to admit, Mary like that has been one of my biggest fears. It can be a life altering condition for a long, long time. And that silver lining that al-Muqrin is less bad for lungs. I think that that is one of the best pieces of news about this variant in a wave of relatively depressing news of seeing these infections go up.

S1: Do we know if it’s milder just for people who have been vaccinated? It or vaccinated and boosted or whether it’s milder for anyone who encounters this new variant.

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S2: There’s evidence that it seems to be somewhat milder than previous variants for everybody. But mild is such a fraught word here because if you get an arm around infection and I’ve spoken to people who were vaccinated, who were boosted, who are young and healthy, and they get al-Muqrin and they’re laid up in bed for days and it’s the worst sickness cold that they’ve had, certainly in the past couple of years and in some cases, one of the worst colds they ever remember having. And then they still feel bad for days or potentially weeks to come. So a Macron is no picnic, and that’s for people with protection. People who aren’t vaccinated, who don’t have previous infections and don’t have some immunity built in to fend off a Macron. It may be somewhat easier than Delta, but that doesn’t mean that it’s going to be so easy that they’re not landing in the hospital. I feel like

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S1: the fact that this wave is both milder and crushingly large is confusing for a lot of people. Like over the Christmas break, a friend texted me that she felt like it was inevitable that she and her kids were going to get sick, and it seemed silly to take a ton of precautions. I’m wondering what you would say to someone who is struggling with those kinds of feelings right now.

S2: I share them when I first heard about Macron. I remember saying to my wife, This is the variant that’s going to get us. It seems inevitable that I’m going to be exposed to how Macron, in fact, I’m sure I’ve been exposed to people with Macron the past number of days because I went traveling for Christmas. So I’ve tried to land in the place of. I will take some risks, but not as many risks as I was taking in the weeks leading up to Macron. And that’s where I feel comfortable. But I think that individual risk calculation continues to be a defining feature of the pandemic for everybody.

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S1: Yeah, I normally think of you as a health policy guy, but I was kind of surprised that with this latest wave, you stepped into this different role like you’ve been posting on Facebook with these really popular posts where you’ve just laid out, like, here’s what I’m doing, here’s what I know it’s new for you.

S2: I was driven to do that because I was seeing a lot of misinformation about Macron. Mary I mean, the confusion over, is it mild? Is that inevitable? Does it matter if you get on Macron? I mean, you told

S1: folks brace for a positive test result. Expect hospitals to be overburdened and think twice about taking risks for the next month or so. And I was struck when I was reading this by the difference between what you were saying and how you were saying it and what. The government, like the CDC was saying, because before the holidays, the CDC was not saying that much. Since then, they’ve ramped up messaging a bit, but it was a real contrast to me and I wonder if that struck you too.

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S2: And I know it struck some folks in the government because a federal official messaged me and said, I need to get the CDC to do what you’re doing on Facebook. But but it’s it’s a challenge of public health agencies don’t want to alarm. They want to inform. They want to encourage good practices. They want to share information. And realistically, I, in individual health reporter, have a lot more flexibility with what I say than whatever government agency.

S1: But over the last week or two, the CDC has released some guidance that I think has confused people certainly generated a lot of controversy. It’s basically guidance that’s shortening isolation time after infection with Covid and saying once symptoms of resolved people can go back into the world while wearing a mask, a good mask, even if they don’t have a negative test result. And I think a lot of people heard that and they just thought, this is nuts. Like, Is this based on science? I mean, these guidelines, are they based on science? Do we know why they made these new recommendations?

S2: They are based on a mix of factors science in part, but also economic considerations. Real Real-World impact. The new guidance has been confusing. It’s been frustrating to lots of health workers I’ve spoken to with AMA crime it. It does move faster through the population. Through your system, you develop symptoms faster, generally by the third day opposed to Delta, which was more like four or five days earlier, Covid variants took even longer. So it does move up this timeline. And yes, to make that change abruptly has left not only workers confused, but other folks in the government confused. CDC sometimes is is making these decisions in ways that. Come as a surprise, even to other senior officials.

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S1: So is that a CDC problem like they messed up their process or is this just how it goes sometimes?

S2: I think CDC has stumbled over its communication for a couple of years in this pandemic. During the Trump administration, they stumbled in part because the Trump administration kept stepping on what CDC was trying to do, trying to influence which CDC was saying. That was obviously bad. The Biden administration in many ways has over corrected. They’ve tried to let CDC have such a free hand that as a result, the White House keeps getting surprised because it’s it’s letting CDC do its thing. There’s probably a happy medium that the government has not figured out yet.

S1: We’ll be right back. Diane Dimond says the thing to keep in mind right now is that even if al-Muqrin is less severe than previous Covid surges, the fact that it’s more contagious means Americans are still in a difficult spot. A strain that’s less deadly but more catching means your mortality rate could still go up. And the people who are going to bear the brunt of all that are the health care workers. Dan wanted to see how they were coping. You went to Mayo Clinic, right?

S2: Yeah, yeah. I was at Mayo Clinic last week.

S1: They and a number of other hospitals took out a full page ad in a newspaper, basically begging folks to get vaccinated and take precautions. Why did they feel the need to do that?

S2: So they took out an ad, hospitals in Cleveland took out an ad. Hospitals in the Chicago, Wisconsin, area have taken out ads. I mean, this is not just a Minnesota thing. This is a real problem across the Midwest, where the Delta variant appears to still be landing people in hospitals. And now Akron is layering on top of that a new wave of demand. Hospitals are putting off procedures. They are canceling scheduled surgeries. If you’re an ambulance and this isn’t just in the Midwest, it’s around the country. If you’re an ambulance with an emergency patient, you might be shopping around trying to find a hospital that will take you because so many beds are taken up right now. And also, so many workers at hospitals are having their own arm around infections. They’re they’re not coming in to work. Some of the shortage fears are overblown. Mary There was a claim that circulated last month in the Atlantic magazine and elsewhere that one in five health workers had quit the industry during the pandemic. That does not appear to be true. But even if just one in 25 workers has left over the past year and wasn’t replaced. That means more work for the remaining twenty four, and that gets more noticeable when you’re already burned out when you’re swamped with new patients. And when four or five of your colleagues are out sick with immigrant.

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S1: And I guess it’s not just quitting either. It’s also the fact that people are out sick, like you said. People are just stretched and that has its own impact on how well they’re able to care for patients.

S2: Oh yeah. We don’t have a national report on total procedures delayed for reasons of cover. That’s just not something that’s tracked. But it is clear that hospitals are dealing with real shortages, that that data is shared and the number of hospitals that are reporting a critical staff shortage to the federal government that I believe is at its highest level of the pandemic on par with where we were a year ago, which was seen as the worst part of the pandemic to this point.

S1: I’ve heard that scientists are now saying al-Muqrin could peak as soon as this month. How will we know that this latest surge is making a turn?

S2: We’ll see it in the data. We’ve seen the huge explosion in micron cases overseas in South Africa. We then saw the U-turn where it very quickly began to fall, too. So hopefully we’ll see something like that in America. I’m a little pessimistic that it will be as fast only in that the US, it’s so much bigger than South Africa. It’s so much bigger than the UK. And even if Macron is hitting everywhere, it still is going to take longer to make its way through this country than it did in a smaller place like South Africa.

S1: I want to ask about. Weather scientists you’re talking to are talking about a micron as a way that a pandemic could end. This seems to be a virus that is taking over Delta yet milder. Maybe this is how a pandemic fades away, where the virus evolves enough that it becomes something that’s less of a threat. Our doctors, you’re talking to thinking about it that way? Or do they not want to say that out loud?

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S2: They’re thinking about it, and some are definitely saying it out loud that that is the hope, right? That this tough on micron wave is going to pass and leave us with more immunity across the population. al-Muqrin is challenging us because of its mutations, and it is evading the antibodies that would have been able to latch on and block earlier forms of Covid. But it does appear that if you are infected with Micron, you are left with no more protection against whatever next variant comes, including potentially Delta as this earlier variant. So that that is the hope that if it’s going to tear through the population, if some people are going to have serious symptoms where many people have relatively mild symptoms, now there’s this new coat of armor around the world. And this is not our first bout with coronavirus. There have been coronaviruses plaguing the world for years, but we know them as common colds. There is a theory Mary that those coronaviruses that circulate the world now that maybe they were pandemic strains once upon a time, centuries ago and humanity evolved to have enough immune protection that when you get infected with one of these old coronaviruses, you might feel lousy for a day or two. You might might have the sniffles. But could that be where Covid eventually heads if we have enough general immunity and we have other treatments to defang it? Absolutely. So that is still the the hope above all hopes.

S1: I wonder if part of the reason you’re optimistic is because of where we are with treatments like there are a number of treatments coming down the pipeline, including monoclonal antibodies that could protect people for maybe six months ago, that seemed to be about ready to come out in the next few months. Does that also make you think, OK, maybe we’re getting some traction here.

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S2: I’m excited about the new. Interventions, I also am cautious because they’re coming generally in short supply. So the one that folks are most excited about is this Pfizer antiviral that’s called a game changer because it appears to keep lots of people out of the hospital when you give it early in the course of infection. The challenges there’s a lot of Pfizer pill to go around right now. Tens of thousands of doses were distributed across the country last month at a time when millions of people are getting sick. It just takes a long time to ramp this stuff up. It’s not in January of 2022, unfortunately.

S1: Diane Dimond, thank you so much

S2: for your time. Mary, thank you so much for having me back on what next?

S1: Diane Dimond is a reporter over at The Washington Post who covers health policy, politics and the pandemic. And that’s our show. What next is produced by Carmel Delshad Mary Wilson, Danielle Hewitt and Elaina Schwartz. We are led by Alison Benedict and Alicia Montgomery. And I’m Mary Harris. You can track me down on Twitter. I’m at Mary desk. But if you don’t want to do that, you can always just stick in this feed. I’ll be here bright and early tomorrow morning.

S3: Catch it on.