Your "Dumb" COVID Questions, Answered (March ’22 Edition)
Dr. Jeremy Faust gives us a "where are we now" COVID update, explains how our behaviors and the weather both play a role in this pandemic, and helps us decide on the timing of our booster shots...
Things seem to be better on the COVID front, right?
Infections are way down from the Omicron peak.
Mask mandates are being lifted.
And just this week, New York City — known for its caution — stopped requiring restaurants, bars, and gyms to check for proof of vaccination.
But what does it all mean?
By now, you know that whenever I have any questions on the COVID front, I turn to my favorite voice of reason, Dr. Jeremy Faust.
The top ER doc is on the frontlines of the pandemic.
And – important point – he always gives it to me straight.
No sugar coating. No BS.
So, let’s get to it.
WHERE ARE WE NOW?
ALINA CHO: First things first, you're in the ER all the time. Where are we now? Is Omicron behind us?
DR. JEREMY FAUST: So, I [was] on vacation. But my sense is, even when I was just on the tail end of my last group of shifts before I left…
ALINA CHO: Which was when?
DR. JEREMY FAUST: Two weeks ago.
ALINA CHO: Got it.
DR. JEREMY FAUST: It was a huge difference. January was terrible because of the combination of non-COVID care and COVID care. It was just a one-two punch.
Source: 11Alive.com
By the time I left, my most recent shifts, things were much, much better. Because there was less COVID, it made treating COVID and everything else a heck of a lot easier.
ALINA CHO: And to what do you attribute the drop? Did everyone just get it?
DR. JEREMY FAUST: So, this is a whole field of study: waves.
Source: The New York Times
Why do these waves have certain shapes and patterns?
ALINA CHO: Right.
DR. JEREMY FAUST: I firmly believe that there is a feedback loop, such that we hear about cases, we hear about the hospitals [surging], and we cancel our plans. So, in Boston [where I live], for example, we saw a decrease in indoor dining before we reached our peak and I think that helped us.
BEHAVIORS MATTER… SO DOES THE WEATHER
DR. JEREMY FAUST: So, we actually see that our behaviors matter. In Denver, there was like a 30% decrease in indoor dining, and they had very few cases. Versus parts of Arizona, parts of Florida, parts of Texas.
ALINA CHO: San Antonio, for example.
DR. JEREMY FAUST: Yeah. Where in fact dining didn't change at all.
Source: Tampa Bay Times
ALINA CHO: Or in some cases, went up.
DR. JEREMY FAUST: Yes, exactly. In some cases, it went up. And these were places that had a much harder time controlling the outbreak.
ALINA CHO: Of course.
DR. JEREMY FAUST: I also think that weather makes a difference.
I occasionally get this pushback. People say, "Oh no, no, COVID is not seasonal. It's always with us." And I think the answer is that it is such a contagious virus, it can survive and does survive outside of a typical flu and cold season. But I suspect that cold and flu season will continue to be the worst of it. I don't think it's random that the two worst waves we've had so far were in January.
ALINA CHO: Right. Even Pfizer CEO, [Albert Bourla], told me they tracked what happened in 1918 very closely. And what he said to me was the first wave scared everyone, but the second wave killed everyone.
Pfizer Chairman and CEO Albert Bourla and Alina Cho at the Pfizer Labs in Pearl River, NY; Source: Alina Cho
*Watch Alina’s CBS Sunday Morning interview with Dr. Albert Bourla here!*
That's why he said, "We need a vaccine by October.”
DR. JEREMY FAUST: But I also think that this virus is so well adapted to this planet that it can still cause a lot of trouble in the summer. Look at Delta. I mean, Delta, as bad as it was, I wonder, would Delta have been worse if we had it in January?
ALINA CHO: How can we know? But it seems like it would’ve been.
DR. JEREMY FAUST: So, let's just summarize it. There's behavior, there's the weather, and there is our own immunity, which is changing over time as a result of the vaccine and as a result of prior infection.
“WE CAN BOOST OUR WAY OUT OF SURGES”
ALINA CHO: You said in one of your recent newsletters that we can boost our way out of surges. So, what do you mean by that?
DR. JEREMY FAUST: So, what is the point of boosters?
I think that the best and most sustainable use of boosters is to get people their maximum protection against the long-term consequences of severe disease and death. And if the booster gets you to your maximum, then it's an essential thing to receive. People say, "Is it a three-dose series?" And to me, for the 50-plus, the immunocompromised, absolutely.
ALINA CHO: Right.
DR. JEREMY FAUST: But if it's just decreasing infections, which is basically what the booster does for everybody else, then you might not want to waste a booster on a downtime. Right?
ALINA CHO: Interesting.
DR. JEREMY FAUST: You wear a seatbelt when the car's moving.
ALINA CHO: Good point. There has been this suggestion, and I'm curious to get your take on this, that our future, the foreseeable future, might include a yearly COVID shot in the fall or winter, just like we get a flu shot.
DR. JEREMY FAUST: Yeah. It could be yearly. It could be at some other frequency. I think for young, healthy adults, boosting does temporarily decrease your risk of infection. But if you get infected, your risk of consequences is the same because you’re so well protected to begin with. So why not boost people when we sense something is amiss? Because if you raced to get boosted in August or September, and we now know that the booster wore off in terms of infection protection.
ALINA CHO: In four months.
DR. JEREMY FAUST: Then, by February, you're walking around as if you weren’t boosted. And the Israeli data really do show that booster effect is quick because our body is primed.
ALINA CHO: Right.
DR. JEREMY FAUST: And so, if we see in the wastewater, there's a spike on August 1st, then we could have a ton of the population boosted by August 15th or August 30th, and the wave will just be really starting to take off and we'll have far better control.
ALINA CHO: You can blunt the pain.
DR. JEREMY FAUST: Exactly. I think you can shorten these waves by having more days in which we are all protected.
***STAY TUNED for Part Two of Your “Dumb” COVID Questions, Answered tomorrow. ***
Topics we’ll cover with Dr. Jeremy Faust:
Vaccinating the under-five set
Is it too soon to take off our masks?
Is the worst behind us?