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In order to expand testing access and help stop the spread of the omicron variant, the Biden administration announced this week that it would begin distributing millions of COVID-19 tests and masks to Americans for free. Infectious disease epidemiologist Jessica Malaty Rivera joins for more on the rollout of this plan and its potential impact, the latest public health recommendations, and what the future of COVID-19 may hold.
We've seen a few things come out of the administration recently that we are going to have access to more tests and access to more masks. In a way, a lot of us thought that these responses would happen a couple of years ago. Is this better late than never?
I mean, it's better to happen than never, for sure, but I am one of those people too that lamented the fact that it took this long, particularly because if you look back at the beginning of the pandemic, one of the most obvious failures in our response was that we weren't testing enough and unfortunately, we're still not testing enough. And I think one of the ways in which we could have alleviated some of that testing burden was to provide easy access and free testing to every American.
Where are we falling short? What are the communities that are still not covered by these new policies?
I mean, throughout the pandemic, we've seen a lot of disparities in access to things like testing, proximity to testing facilities, even the ability to have time off work to get tests. There's been a lot of disproportionate burdens on communities of color who may live in testing deserts or vaccine deserts, for that matter. It's also become cost prohibitive. I know that recently to acquire a lot of these at home tests, we've seen price gouging, we've seen shortages and an inability to find them in every drugstore. And so I think that the fact that we didn't prioritize a stockpile and distribution early means that we're kind of in a bottleneck now and having to catch up.
There's this sentiment going around, I don't think it's scientifically accurate that, hey, guess what? This Omicron thing is kind of the best thing that could happen because so many people are going to be getting it that, well, we're going to reach herd immunity. That's not how it works, is it?
You're absolutely right that it's not scientifically accurate. I mean, there is a degree to which people are protected for some time. That time is relative, though it's not standard at all. People's immunity post-infection varies a lot. That variability makes it really difficult for us to understand who's actually protected. Now we do have some data on hybrid immunity, those who've been vaccinated and infected, and those people seem to be faring pretty well against new variants and severe illness in particular. We know that vaccine induced immunity is far superior, but it's much more long lasting. We have recent data that shows that the booster dose has a significant advantage for those who received it against Omicron infection when it has to do with severe infection, hospitalizations and deaths. So that said, we can't specifically rely on the mass amounts of infections to get us to that finish line or herd immunity.
What do we need to do here to try to increase the vaccination rates? Because it seems that we've at best reached a plateau, there's a certain percentage of the population that is still completely opposed to doing this, and I don't know what proportion of the people who are willing to already have it, but it seems like everyone who wants a vaccination might have already gotten one.
That's correct, to a degree, I definitely think that there will be people who will absolutely refuse vaccination till the very end. And my work, especially as somebody who works in science communication and vaccine advocacy, is not necessarily to convince those who are most vehemently opposed, it's to help those who are confused or who are on the fence or who are looking for more information, feel overwhelmed by the decision, feel overwhelmed by the data, and those people are still changing their minds. Those people are still choosing to get their first and second doses as recent as this month, and I'm encouraged by that, so I'm not quite losing hope. But I do think that our lens should be broader, right? I'm not thinking just specifically about the United States, I'm thinking about the whole world here, and there are millions of people across the world who have yet to receive first and second doses, and that's where a lot of the opportunities arise.
The variants that we've seen so far before Omicron were sort of related branches off the same branch, so to speak. This seems different. So does that mean that there could be variants of Omicron that emerge? Given the fact that it's been circulating in this population for a month or more now?
It's possible through the genomic sequencing, you can kind of see a family tree, a origin of how these variants emerged from the original wild type SARS-CoV-2 virus. Omicron did deviate on its own to create its own branch effectively. And so as we continue to have vulnerable populations that are not vaccinated, the vulnerability for the whole world is still continuing because that's when we know those conditions create opportunities for more virus to circulate, more mutations to accumulate. And when you have that, that is an increased risk of variants evolving from that.
There's this hierarchy of masks and not everybody knows about them. But how should we be looking at the type of masks that we're wearing and the situations in which we're wearing them?
Right, so the best public health recommendation has always been to wear the best mask you can in a certain situation. If you only have a cloth mask, is it better to just wear a cloth mask? Absolutely. Any physical barrier is going to be better than nothing, but you want to be having the most layers of protection with the most amount of coverage over your nose bridge and your cheeks to avoid any sort of exposure for yourself and others. And so I think that the distribution of these N95 masks to drugstores around the world from the national stockpile is a step in the right direction, a little bit late as well. But it's in an attempt to have people wearing the most protective PPE in the context of a very transmissible variant, Omicron.
We're going to just wear masks forever?
A lot of us have acquired this muscle memory for it, and I think that knowing now, especially, it's much more known that this is a very common practice in a lot of Asian countries as common courtesy to protect other people if you've got a tickle in your throat. So I think that at least for our family, we've adopted this public health practice of if we're feeling sick, if it's flu season, if we're going to be on a plane or in a crowded place, I might keep some masks in my handbag. Do I think we're going to be wearing them forever? No, but I can't see them fully gone for a lot of folks who've now become pretty accustomed to it as a way to stay safe.
Jessica Malaty-Rivera, thanks so much for joining us.
Thanks for having me.
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