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- Hello and welcome to Crosscut Northwest Newsmakers.

I'm your host Monica Guzman and the countdown is on.

In just eight short days, the State of Washington is set to officially reopen from the long dramatic and traumatic shutdowns of the COVID-19 pandemic.

Public health has been a roller coaster for all of us the past year and change and you and I, we're gonna have to unlearn a few things and learn a few others.

Here to help us make sense of all the changes and their implications for our own lives is none other than State Secretary of Health, Dr. Umair Shah.

He's joining me in studio, oh yes, he's actually here in the studio, sharing airspace with me and we are going to cover a lot of stuff so stick around.

But first I wanna thank all of you for joining us on this lovely June morning and invite you to lean in and ask Dr. Shah your own questions.

You can submit one anytime during our conversation using the comment section on your right.

And we'll be moderating the chat today and we'll make sure that your submission is in the running for our Q and A toward the end of the show.

Should also be sharing articles and resources in the comments so be sure to check those out.

I also wanna give a big thanks to Waldron for sponsoring this series and share this message on their behalf.

Waldron is proud to support Crosscut, a forum for dialogue that increases knowledge, understanding and compassion.

Waldron funds and volunteers to ensure strong, independent public media that informs and inspires our community.

Dr. Shah was appointed Washington Secretary of Health just six months ago in December of 2020.

He comes to us from Houston, Texas, where he served as Executive Director and Local Health Authority for Harris County Public Health in the third largest county in the nation.

And he holds leadership positions with some places you've probably heard of the CDC, the National Academies of Sciences Engineering and Medicine.

We'll be talking with Dr. Shah about what we're learning and unlearning as the State gets ready to reopen with over 50% of our population fully vaccinated but lots of disparities county to county.

So there's a lot to get to, what should we make of masks, guidelines for businesses and all those variants.

Finally, we're gonna ask Dr. Shah to give us a dose of information on what's safe when it comes to unvaccinated kids, big events, travel, vulnerable groups, the works.

Dr. Umair Shah, welcome to Northwest Newsmakers in studio, eek!

- And we're vaccinated so we can be without... - That's right.

And I, Oh, you know, I didn't have my mask.

I was gonna wave around as prop.

- Got mine right here.

- You got yours.

- Great to be here.

Thanks for having me.

- Thank you so much for joining us.

So for over a year, we've learned that things like this, being indoor with other folks not in our household is bad, is unsafe.

Now we're unlearning all of that in this transition.

This is actually the first time by the way that Crosscut's had an interviewer and speaker in the same room in doors.

So your household, it's your wife, your three children, your mother, when you're out in the world right now, going to the grocery store, you know, parks, maybe seeing friends, what still makes you nervous?

- Well, you know, I think there're, for every household it's different.

In our household, my wife is a dentist.

She's a healthcare provider, I'm obviously a healthcare provider.

So we have two healthcare providers on the one hand and we have three children.

And our three kids are under the age of eligibility for vaccines, 11, seven, and four.

So they cannot get vaccinated.

The two of us were vaccinated, mom, she's vaccinated.

And in fact that was really hard for us because the whole pandemic, we knew that when we were out and about we were potentially bringing something back that we needed to cocoon her, protect, you know, grandma because we were worried about her from whatever was going on outside.

So what worries us now is that she's vaccinated, the two of us are vaccinated and we have three children who are not able to get vaccinated.

So it's this really strange place for all parents, because parents who are vaccinated, they, you know, they're were feeling like, Hey, we're protected, which is what vaccines do.

But you still have to remember your kids.

And if your kids are not vaccinated, you've got to still be thinking about perhaps that you're back to the fall of last year for the kids to make sure that they are wearing their masks, washing their hands and making sure you're not in crowded places because ultimately they can also still get COVID-19.

So it's this, that's what worries us.

Is this dichotomy of where we're protected but also thinking about who may not be.

- Right, so do you think that because, I have two kids under the age of 12 as well, so you do have to behave differently when you know that you have unvaccinated folks in your household even though, you know, children, maybe, you know, it's not as infectious.

We haven't seen as much sort of harm but even so families have to pay attention.

- Well, and the other thing I think he brought this up which is, so we're vaccinated, but guess what?

We are modeling the behaviors for our kids.

So our four year old if he sees mom and dad without a mask on what's the first thing he's gonna do?

- Does he take it right off?

He does?

Yeah.

- So we have to keep ours on in front of our kids because we wanna make sure that our kids are, that we're modeling the behaviors so they're also doing those things.

So I think that's the other thing we have to remember is that kids really take a lot of cues from their parents and adults around them.

And we've got to do what we can to make sure that they're doing.

The healthy choice is the right choice or the default choice.

- So switching gears a bit.

Nationally states like Mississippi and Alabama are very low on vaccination rate of their population.

Here in Washington we're in the top 10 nationwide but there's still this big gap between the most and least vaccinated counties.

And it's been getting wider unfortunately.

It goes all the way from San Juan County where 76% of people 12 and over are vaccinated to Garfield county where just 29% of eligible folks are.

So I know the State's tried all kinds of incentives to persuade folks in some counties to get their vaccine.

What's working best?

How do you know?

And then maybe more difficult, how are you confronting that big divide we're seeing in the public's distrust of government?

- Well, that's the, that's the big question.

- That's a tough one.

- That's the tough one.

You know, first of all, let me say Governor has been fantastic.

He has said, look, whatever we need to do to help people understand why vaccines are the road forward, the path forward, let's do that.

And you've talked about the lottery and the incentives, you know, X boxes, all sorts of other things.

So for some people that we know the motivation is going to be fiscal, financial, something of that nature, other people the motivation is simply, I wanna protect myself, I wanna protect my family.

I wanna get out of this pandemic.

Let's move forward.

I've been saying for the last several weeks that I'm worried about this tale of two societies.

Those who are vaccinated, thereby they're protected, they take their mask off, they do all sorts of things and they're okay.

And those who are not vaccinated, not protected, seeing others doing those things who are not thinking that they need to do those things, still taking the mask off and going through with their daily activities, but getting in trouble.

And our data are showing that that unvaccinated people for ages 45 and up are 15 to 20 times more likely to be hospitalized than vaccinated people.

That's a big issue.

So vaccines work, they're safe, they're effective.

But like you said, there's this, this disparate way of looking at the world.

As a doc, as a physician, as a doctor, I look at it as, look, vaccines are absolutely gonna help protect me, my family and the community but there are people out there that are having questions about that.

- So how are you confronting that?

What do you think might be the, you know, a strategy to establish more trust there?

- I think the issue is that there are lots of strategies.

Some are incentives.

Some are about trying to encourage people to talk to, you know, their doctor or talk to their clergy or talk to somebody that they care about.

Others are to actually have people who are vaccinated themselves to be the champion.

So you've been vaccinated.

You were vaccinated months ago.

So you are somebody who can be a champion to people that are around you.

There are some people that the end of the day that got vaccinated early and are getting vaccinated now that they are already in the camp I'm gonna get vaccinated.

There are other people that have decided I'm not gonna get vaccinated.

I don't care what you say, what you do, I'm not doing it.

But there is a group of people that are in the middle and that's our job is to try to do whatever we can to help with good information, outreach, working with our local health departments, our partners on the ground, getting into those systems.

And this is where I think doctors and nurses and healthcare providers have an incredibly important role.

So when you have a doctor or a nurse saying, look, get vaccinated.

96% of doctors, according to the American Medical Association, have gotten vaccinated.

Why?

Because we know it works and we wanna protect ourselves.

So if you don't have that kind of information and trust then it becomes really hard.

So we want people to talk to each other about good information, the right information and hopefully they make the right choice.

- So give us a sense of the results in terms of the incentives, the X-Box as you mentioned, what really is working?

Which of those programs are you're pointing to saying, hey, hey, hey, more of this!

- All of the above, you know, and this is why it's hard because it is hard to know from a statewide level what's happening in terms of specific this action related to this, this result.

But you know, the one thing that we did notice is that after the governor announced with the lottery and the incentives that we were seeing, the week before, we were seeing that the numbers were declining we started to see that flattening or to actually stay stable, which means likely was gonna continue to go down but it, it stayed stable.

Now we're hoping that it remains stable or starts to go up.

That's the kind of information that really helps us determine what are the things that are incentivizing people.

But ultimately this is about, this is about this political divide, you know, at the end of the day, unfortunately, that's come in this country.

You know, I've been for 20 years, a doctor in the emergency department setting at the VA hospital.

Taking care of our nation's veterans in Houston.

- [Monica] And you were in Texas, right?

- In Texas, right.

- [Monica] There's a different culture there as well.

- In a very, it's been politically charged and, you know, red and blue and all sorts of things.

And I never had a situation where I went to my patients and said, look, you've got, your blood pressure Mr. Jones is really high.

I'm gonna give you IV X medication.

I'm gonna bring your medication down.

And that patient looked at me, Mr. Jones said, doc, you know what, don't give it to me.

I don't want it.

Not because I don't believe in the med because I've heard something out there that that blood pressure medicine, isn't what I need.

That's what vaccines are, is that we have somehow politicized something very simple but it's been just the way this pandemic has rolled out which has been unfortunate.

- So in Washington, those areas that might stay more unvaccinated for a longer period of time.

How is the state planning to deal with, you know, flare ups that happen in those areas maybe into the foreseeable future as they, you know, as they come up?

- Well, the first thing is we're doing everything we can to work with those local jurisdictions and do everything we can in those communities to get the word out.

Look, there vaccines available in our state right now down the street from you.

They're free, they're safe, they're effective, they're accessible.

There are people, and Monica, I think this is the hard part, right?

People around the world, there are many people in many countries that they would do everything they could to get a vaccine today.

Here we have America, the land of the free, the land of opportunity, the land of research, - [Monica] Vaccines, free in your grocery store.

- Vaccines, they're right there.

And we can't get people, some people, let's be clear, millions of people and a good portion of Washingtonians have gotten vaccines.

So I don't want it to be that not anybody but vast majority.

- [Monica] And particularly high in Cape County and Seattle.

- That's right.

Absolutely.

But the issue is that people who are not, and my concern is that as we start moving down, especially when we start to get to fall and we get back into winter, now you're gonna see those flare ups like you're talking about.

That means we're gonna have to continue to bring resources, to try to help with those communities where you've got flareups clusters.

And this is where the variants become concerning because when you have people that are unvaccinated together that's when you have more chances of variants being homegrown.

And that's also a concern.

So here we are, we've got a chance and an opportunity but we've got to do everything we can to avail ourselves.

- And we'll get to variants in a bit because there's all these Greek letters to kind of parse through.

But first let's be super clear about what exactly happens when the state reopens, the plan is June 30th, with masks, the size of gatherings, the work.

So let's start with folks who've been vaccinated like you and me, what are the big changes for us in our lives after June 30th?

- Well, for the most part for us that we are going to be able to do things outside of some specific settings.

Let's say for example, in a healthcare setting or if you're on public transit, you know, like for example a flight somewhere.

That you're gonna be able to not have your mask on and you're gonna be safe and protected and you're gonna be able to go on with your life.

Those who are unvaccinated are still going to be required, at least when they're out in public doing things and not necessarily in outdoor settings like in a park where nobody is around, but when they're in a situation, especially around other people, that's when we're gonna say you have to have your mask on.

This is gonna be a really challenging time because there is going to be a period of time where people are gonna be confused.

- Well, right.

It's the honor system, right?

It's not like there's enforcement out there too much of this.

- We want people to do the right thing.

And this is where it's becoming hard, right?

Because I go into a grocery store and I'm vaccinated, I can easily take my mask off and walk around.

I choose to keep my mask on.

Why?

one, because my kids are oftentimes with us.

- [Monica] Modeling.

- So I wanna model it.

But number two is that I also wanna do everything I can to promote that, if there's anybody else in that store that is not vaccinated, I want to not let that person feel like someone is shaming them or that they can't wear their mask.

So out of solidarity, out of being in some community, I keep my mask on.

But that doesn't mean that I can't, I could take it off in many instances and be fine.

In fact, my chance of being able to do anything with spreading to others is really nil, right?

So at this point, that's what we can do.

But the problem is that it becomes confusing to others who are not vaccinated or others who are concerned about those around them, who may not be vaccinated.

- Right, so let's say I own a business that hosted lots of folks in doors before the pandemic, a restaurant with a packed bar and maybe a stage, right, on weekends.

What changes for me?

How should businesses approach that curtain between June 29th and June 30th?

- Yeah, so I think one of the biggest things you're gonna see is that those restrictions will lift, that you're not gonna see those restrictions that are gonna be in place related to what you can or cannot do when it comes to going into those businesses.

But if a business decides that they wanna continue to have those requirements in place we're not going to stop them and say you can't.

But again, it's not that it's required to be put in place.

Now, when it comes to big stadiums or things of that nature there are gonna be additional stipulations and rules that are gonna come out related to what people can do in those establishments or in those settings.

And then finally, when it's a business, and this is where labor and industry comes in, they're gonna update their rules as well.

So a whole host of things are happening behind the scenes.

The bottom line is, get vaccinated.

Get vaccinated.

Get those numbers up, do everything we can so we don't have these kinds of conversations.

We've got a week or 10 days where we can still get vaccines in and hopefully beat our June 30th date.

But again, it's gonna be up to all of us.

- Right, so just to be clear, if you're vaccinated and you don't wanna model for kids maybe that you don't have you really could just take that mask and put it away.

- You could.

I mean, I'm always gonna recommend take it with you because of, you know, situation where you might be in a crowded situation.

I'll be honest, - [Monica] And businesses that are going to require it anyway.

- That's right.

And it may be a situation where, and this has happened to me, where somebody is coughing around me.

It's likely not COVID honestly, it may be something else, but, put this on.

Let's put this on.

And, you know, it's really, I think you talked about this, about learning behavior, unlearning behavior.

I really call it relearning behavior.

It's really that we have been so thoughtful about how do we protect ourselves?

How do we protect those around us?

And this is really an opportunity for us to continue to do that.

Is to protect ourselves, protect those around us.

But how do we do that?

We do that by remembering those basic things that our parents taught us when we were younger wash your hands, cover your cough.

You know, don't sneeze out in public, don't.

You know, these are basic things that we were always taught.

And as doctors, that's what we tell our patients.

- Yeah.

- But this is a time when people were actually paying attention.

- Right, we're gonna carry this around with us for years.

- Flu season nobody, for the most part people weren't, same messages, you know, wash your hands, cover your cough.

If you're sick, don't go to work.

Don't send your kids to school if they're sick, but people weren't heading those messages for all these years.

Here we have a pandemic, now we hope that people are gonna still keep some of those behaviors because ultimately it's not just about COVID, it's about protecting yourself from a whole host of other kinds of illnesses.

- So coming at this from another direction, I'm gonna ask you what I refer to as the, you're sure about this question.

And I'm gonna ask it using the exact words.

Yes.

Get ready.

The exact words of one of our readers because you can hear the incredulity in the question and in a way I think that I'd like you to respond to that.

So the reader says, how on earth can it be safe for everyone to unmask so quickly when so many people have not been vaccinated.

Vaccinations are not a hundred percent safe and virulent new strains are emerging.

- Yeah.

And so, you know, this is a, it's a number of probabilities, right?

You start to look at what is the likelihood or the possibility of me getting infected, right?

So if more people are vaccinated around me I have less likelihood.

If I'm vaccinated, I have less likelihood, right?

So now you start to have this addition of less likelihood, less likelihood, now you have a real, very unlikely chance that you're gonna get an illness.

Now, is it possible that you can have a breakthrough?

Yes.

Is it possible you have a variant that will now knock through all of our vaccine efforts?

Yes.

These are not a hundred percent.

Nothing is a hundred percent in life.

You know what, there are antibiotics that I have prescribed to my patients.

I have prescribed to my patient and I said, this is gonna work.

And they're, doc, are you sure?

Pretty sure it's gonna work.

Let's do.

And they've come back two weeks later and say, it didn't work.

And we tried something and, there is nothing in medicine that's a hundred percent, but we do the best we can.

These vaccines are 94, 95% effective.

We should be able to use those vaccines to be able to help ourselves.

- So break it down for us then one level deeper.

Considering all of that, right.

What made this the moment then?

I know you've been talking with the governor, you know, lots of folks around the timing of reopening.

How much of it is public health?

How much of it is the economic health of our State and how much of it is just navigating a complicated, you know, social and political reality where the world's been shut in for so long?

- I think all of that, right?

I think it's public health, the information is that we have fought, this is our fourth wave.

We fought that wave.

The numbers were getting better and they've continued to get better and we've had more and more people getting vaccinated.

So we know that even if you have an increase in something, it's gonna likely be contained, it's gonna be a cluster, but it's not gonna be a huge cluster because vast majority of people around you, hopefully will be vaccinated, right?

This is where the counties where you have a lower vaccination rate concerns us, right.

But the other issue is that there are impacts to health and wellbeing, including from the economy and from our mental health and being shut in or feeling like you can't move forward.

And then you're seeing what's happening across the country in other states, other states that are reopening.

So I think that June 30th is actually a really good, smart time for us to reopen.

Hopefully we can even get there a day or two earlier, a few days 'cause we hit the 70%.

We're not quite there.

- Yeah.

And what is that exact metrics, 70% of?

- Yeah, so it's one or more dose for those who are age 16 years of age, right?

- Okay, that's how... - So at least one dose for 16 years of age or above.

And that is that we're at 68% essentially.

- Okay.

So we could in theory hit that earlier.

- So we're close, right, but still quite a few people, 2% is quite a few people of our population estimate.

So it really is going to be up to us.

So if you know somebody that's down the street from you hasn't gotten vaccinated, go to their house, Hey, get vaccinated.

Drive them to an appointment, make an appointment for them, do something to get them vaccinated, help them get vaccinated.

We can all help each other get vaccinated.

But ultimately, why is this so important?

When we get that number of 70% does the work stop, Monica?

No.

We have to keep trying to help people understand that vaccines protect you, protect you from this horrible virus.

And a year, year and a half ago, all of us would have been doing anything we could to get something to get us out of this pandemic and here's our path out of it.

So let's protect ourselves.

- So now's a good time then to talk about those virulent new strains.

So we've got, let's see, the alpha variant making up more than 50% of the cases in our state.

We've got the Delta variant that's been spreading globally in recent weeks and months.

And then Dr. Scott Linquist who's with the State says, that it's the gamma variant that worries him.

It's more infectious and it's the fastest rising variant in the State.

Although, again, it's sort of, for those who are unvaccinated that it's more a concern and that's 16% of COVID cases, the gamma variants.

So we've been worried about a lot of things this past year and change what that is worth worrying about when it comes to variants and what's not worth worrying about?

Can we make that distinction for our viewers?

- Sure.

So, they're, viruses mutate, right?

They change, they morph.

They take a different form.

Why do they do that?

Because that's how they continue to infect people, right?

They find a little way.

- [Monica] Life finds a way.

- Yeah.

And I always find it, I've been calling this COVID-19, the virus itself a super squirly virus that's broken every rule in the playbook.

That's been my descriptor about this virus since March, April of last year.

And this virus finds a way, it mutates.

So what are variants?

Variants are those mutations that's essentially the virus has found a different form.

Now, if it's a variant not of concern, so there can be variants it's a small little bit of a shift.

It doesn't really do much in terms of infection, transmission or to get people sick, no big deal.

But it's when it's a VOC, a variant of concern, and you referred to some of those like P117, and you know, you all think about, - So many names.

- The Delta variant, P1, and all sorts of.

So you start to see these different variants.

What we want people to do is one focus on what you can do.

So there's a theoretical concern.

You're hearing it all over the globe.

You know, there was a variant that was first identified in, in the UK or South Africa or Brazil or India, et cetera, et cetera, et cetera.

There are, by the way, variants that we have in our State that were identified in California.

So, right?

So there're domestic variants.

There are international variants but we're a global community.

Eventually variants will spread.

What we don't know though is how much they'll spread.

And so what people should be focused on is what can you do to protect yourself?

What can you do?

Get vaccinated, right?

What else can you do?

Well, you know, be careful around others.

If you see somebody coughing and, you know, sneezing and things of that nature, you know, maybe that's when you put your mask on but be careful of those kinds of settings.

Don't worry as much about what all these variants are out there.

Let us do that piece of worrying for you.

- And by us, you mean?

- Public health community, the doctors, the nurses, the healthcare community, let us do our job to continue to monitor what's happening but you do what you need to do which is to get vaccinated and really ultimately make sure that you're having those good health hygiene habits that are gonna keep you and the people around you protected.

- This is actually an excellent segue to my next question.

So once reopening hits, businesses, employers, venues, everyone, as you said, can set up their own rules about mask wearing and the like, do you support requiring proof of vaccination to participate in indoor events like concerts and sporting events?

- You know, I think it depends.

You know, I do think that there is a utility of that if you're worried about a community where you don't have as much vaccine, you know, if you've got not as much vaccine penetration and you know, as you know in a lot of communities, including King County, for example, there's been just a lot of really strong efforts and I have to give a lot of credit to, you know, King County and public health Seattle, King County and city of Seattle for all the efforts that they have done within King County to be able to vaccinate as many people as possible.

When you go into other places, you don't have as much vaccine penetration.

Now you start to wonder if there is a, an event or an activity, are people gonna get into trouble?

It's a numbers game, right?

Because ultimately when you have more people in more crowded situations and they're not vaccinated, then you're still back to where you were several, several months ago.

But the chances are less and less likely that it's gonna spread to other people because people are vaccinated and they're protecting themselves and cocooning, if you will, around others.

So I do think that, in my book, I'm always about incentives.

I'm always about encouraging.

I'm not as much about requirements.

I don't feel that that's the way to go unless you absolutely get in trouble.

So what I'd like to do is say, okay, June 30th we reopen, maybe sooner, but June 30th, we reopen, let's also, and we're gonna continue to monitor what's happening with the data, let's monitor what's happening as well.

Let's keep getting people vaccinated.

Let's make sure people are doing the right things.

Don't get into trouble.

Don't go out and do some things that are, you know are going to be, you know, not good health behaviors and then turn around and let's see where we continue to be.

And if we start to see more variants, we start to see increases in cases, clusters that are not small clusters but huge community-wide clusters.

Well, maybe we need to have different conversations but right now I really wanna move towards that incentives and doing everything we can to get people to do the right thing.

- So some real talk about what we're seeing out in the world.

Apparently you're only slightly more likely to catch COVID from contaminated surfaces than you are to be struck by lightning.

So digital menus, shut down water fountains, clean and dirty pen cups at the register.

At what point is all that just, and this is the term that's been floating around, hygiene theater that we should close the curtain on?

- That's a gray one, you know.

What do you think about that one?

- I mean, I don't know, clean and dirty pen cups, it's probably not the hardest thing to do.

I've gotten pretty used to taking my phone out and scanning the QR code but there's always a voice in my mind going, do I have to do this?

Like, is this forever?

Are we just always gonna do this?

- Well, you know, I think the other thing we have to remember is a lot has changed, right?

Because of this pandemic, we are now seeing, like you said, menus with QR codes, you know, we're seeing using virtual and technologies that we never thought.

You know people working remotely that we never thought was going to happen in the degree that it's happened.

Some of those behaviors and some of those changes will likely last for a longer period of time than we think.

Not because the pandemic is still putting people at risk for that.

But because we have found, we as human beings, we as society members, we found a different way and we've adapted to it.

And some of us, I'm not saying it's me necessarily.

Some of us may like that, right?

We like the fact that we're doing virtual.

We like the fact that we're, you know, using a pen cup that says sterile or clean and a pen cup that says this is where your dirty pen goes.

Some people will like that, but there are gonna be other places where it probably is that it's time to think about what truly is going to make people safe.

It's about vaccinations.

It's about doing those things when you have your mask on versus really the surface.

The surface is probably not as much at risk, but I do think that hand sanitizers, that is what I would love to see more of.

- Because that helps with all health, right.

I mean all the germs and everything.

- Even if I touched the pen, that Jimmy right before me touched, right.

And Jimmy, you know, like I'm at a restaurant - Where has Jimmy been?

- Jimmy signed before me, and that pen comes over to me and I saw at the next table, Jimmy was coughing on the pen and doing it.

And the pen comes to me.

And even if I use the pen to sign, Monica, as long as I put the pen away and I use my hand, I'm good.

So I would love to see the ability for people to be, to see those hand sanitizers remain somewhere.

You know, I would hate to see that you go to a restaurant and you can't look for it, or you got to go run to the restroom to wash your hand.

Wouldn't it be great if you continue to at least have the option of having the hand sanitizer.

- So don't put away those dispensers businesses, it looks like we're, - That's what I'm talking about.

- We're gonna keep those around for a while.

- So, there are some things that we've learned that hopefully will be good.

Hopefully we'll sustain and hopefully will remain because guess where I'm coming from on this?

I'm a healthcare provider.

I'm ultimately a doctor, I believe in health.

That's my role.

Not just as secretary of health, not just in public health but that's why I went into my career was because I wanted to save lives.

I wanted to help people with their health.

So if you're gonna ask me the question about hand sanitizer in a restaurant, I'm gonna say, yeah, I want that option.

I would love when my four year old goes out of that restaurant and I say, Cheyenne, his name, Hey Cheyenne, guess what you should and I have the option and I squirt and he puts his, gleefully puts his hand underneath the hand sanitizer and he does this and he's got his mask on.

He can barely see and he walks out, but he's got this.

And he is now, whatever he touched, which I can't watch the whole time.

I know that he is protected.

I want that as a parent.

And I want that as a doctor, but am I gonna require that everybody have their hand sanitizers sitting there?

I'm not, but I'm saying that it's the right thing to do.

So let's do those things.

- So at this point, Dr. Shah, we're going to play a little game called is it safe.

I'm gonna give you some scenarios that a lot of our viewers I'm sure find themselves in learning and unlearning life, right.

Coming up to the reopening.

And I'd like you to give us your take on how safe it is with an eye, hopefully toward how comfortable you would be personally doing it.

So here we go, ready?

- Fair enough.

- All right, here we go.

- Do I get a rapid-fire?

- Yes, sure.

Oh my gosh.

Well, we'll see, 'cause some of them will probably take some context but you know what I just realized before we do that a reminder to all of you watching that we will be doing a Q and A in a few minutes with Dr. Shah.

So if you haven't gotten your questions in, please do.

Okay, here we go, are you ready?

I'm gonna wait for you to put your mug down.

- I am.

- All right.

- Okay.

Let me straighten up here.

Okay, all right, now we're ready.

- Is it safe to let our young kids play with other young kids outside without masks when they are under 12 and can not be vaccinated?

- Is it safe or unsafe?

So if this is a binary yes or no, the answer is going to be, it's safe, but not fully.

- [Monica] Okay.

What does that mean?

- And what that means is that, look, I've got again, my two kids were playing soccer.

You know, they're on their Thursday evening soccer practice.

They had their masks on because there is, it is not unsafe.

It is not safe.

It's somewhere in between.

It's still a risk activity but it's not a riskiest activity.

But when you get to the point with under 12, here's the concern, right?

Under 12, they're not vaccinated.

And so now you can get transmission between the kids.

And you also know that kids, as you said earlier can actually get severe illness.

It tends not to be that way, but it can happen.

So if I'm the parent and I've got my child, I'm gonna say to my kid, Hey, put your mask on around other kids.

- And is that what your kids do?

You direct them to do that?

- That's what my kids do.

That's what my kids do.

So my kids will have, if they go into a setting where there are and by the way, I should point this out.

It's not just my wife and I, this is the kids doing it.

They don't feel comfortable when they go into a setting with strangers, parents or adults, or even kids, other kids that they don't know, they'll have their mask on.

In fact, I may at times say, wait, just take your mask down just, you know, they could see your face.

No, we're gonna keep it on.

Like, whoa.

So, it is, you know, if it's outdoors, obviously we know indoors is less safe than outdoors.

Outdoors is safer, but there are instances where you could have a situation where that would be a possibility of transmission.

Is it the highest risk?

No.

Is it completely zero risk?

No.

So it's somewhere in between.

It's likely safer, but you wanna be careful because again, kids are unvaccinated, they're around each other and you could get into trouble.

So just keep that in mind.

- So quick aside, before we go to our next one.

When can our kids get vaccinated?

What do we know?

- Well, you know, it's funny because I just had a colleague in DC just text me a couple of days ago because she had her child who was part of the trials, a four year old part of the trials for phase three trials for vaccine and was indicating that it's actually six months of age that they're already starting this trial.

They've already started, they're in the works.

We're hoping, we were hoping they would be done by the time school would start.

So we, remember that would be, it's not just by September.

It would almost you'd wanna back it up to August so you could, it's not gonna happen.

- It's not gonna happen by school start.

- No, no.

But it's gonna likely be sometime in the next few months that we'll see that.

There are gonna be a couple of things that we're gonna see.

One, we're gonna see vaccines for likely all the way down to six months of age, one that.

Number two, you're gonna see at some point the question about boosters and that's gonna come up as well.

Booster in two different ways.

One, booster for those who are, like you and I maybe had vaccinated early in the process and at some point we're gonna have waning vaccine immunity.

The second is that we may see boosters because of the variants, that it may be at some point that we find that our vaccines are less effective.

And we've got to do a booster to help people through that.

Those are probably the three things that are up ahead, childhood vaccinations, six months of age or above, right?

So that everybody's six months age to seniors can be vaccinated.

Number two, boosters for waning immunity, boosters for variants.

Let's hope the last two will be far off but let's hope the first one about kids is gonna be sooner.

- Yeah, for sure.

Okay.

A little bit faster on these next, is it safe.

Let's see if we can get through them.

- Okay.

- This one, Oh man.

Is it safe to hug an unvaccinated friend if you are vaccinated?

- So if you're vaccinated, you're protected.

You're safe, you're protected.

That's the whole reason why we're saying get vaccinated.

Now, if you're gonna have a long embrace and they're unvaccinated, you might wanna think about that, right?

But honestly, you're protected.

I mean, that's the reason to get vaccinated is you're protected.

And now the issue is that the person who's unvaccinated, my concern isn't that they're hugging you vaccinated person.

My concern is that they're hugging everyone around them, including unvaccinated people.

So if they're hugging Monica, because Monica is vaccinated, that's one thing.

But if they're hut hugging me and I happen not to be vaccinated, and they're not distinguishing Monica versus me, they're just equal opportunity huggers.

That gets them in trouble.

- Is it safe to go to a big wedding out of state in an area where less than half of folks are fully vaccinated?

- I would say no, I would say no.

But again it also depends on your vaccine status.

If you're vaccinated, yes, I do think that you're protected.

But if you're unvaccinated, first of all, you shouldn't, you shouldn't go to any large gathering if you're unvaccinated, you shouldn't get on a, hopefully on a plane even, those kinds of things.

But if you are vaccinated going to a large gathering again, your vaccine is your protection.

- So even in areas of the country that are, that have very low vaccination rates, vaccinated folks shouldn't even really consider that, you're protected no matter what.

Is that the guideline?

- You're protected, that's your cone of protection, you're protected, right.

Cause you don't know who who's gonna be around you or not.

That's the whole point of getting vaccinated is that you're protecting yourself.

So if you're not vaccinated right now, right?

You know, let's say you told me, Hey, you know, Hey doc Shah, I was vaccinated and you weren't, and you and I are just kind of doing our thing here.

I take my mask off.

I trust you.

You tell me you're vaccinated and you decide to cough on me and I'm protected, but that's what the vaccine does.

So I think that's what people are forgetting is that the vaccine actually protects you.

Now, do you feel more comfortable, it may be that in certain settings you will psychologically feel less comfortable not having a situation around you where people are less vaccinated and those are the numbers that you're around.

So I think people should take that discretion in mind.

- Well, we are now gonna move to our reader questions.

I am hoping that we can talk too about folks who are immunocompromised and all of that but it's possible that this will come up.

So let's see from Kathleen Cronin, what does a vaccine being 94% effective mean?

Does it mean that 94% of all the people will be okay or I will be okay 94% of the time if I'm exposed?

- Yeah, I think the what we have to remember is that 94 or 95%, let's just say 95%.

It means that what you're really doing is you're saying that this gives you a reduction of risk that it's a 95% advantage that you're gonna be able to beat that virus.

Does that mean it's a hundred percent?

No.

You still have the ability to have breakthroughs.

You have the ability to have somebody who's going to to be able to get, and this is why we say we're not a hundred percent fail-proof right.

But at the same time, that's what it does.

Is it makes you feel comfortable that you're protected from this virus which is what the vaccine does.

- So another question, a person saying, I got Pfizer, the Pfizer vaccine, can I get a booster that is not an RNA type?

That kind feels safer to me, they say, is it?

- So first of all, the boosters we don't know how that's going to all roll out.

We don't know if, you know, if somebody has gotten the Pfizer vaccine versus the Moderna vaccine, what's gonna happen related to that.

Most likely you're gonna be able to, you've been protected and there is going to be some ability to get a different kind of booster but we don't know all that information.

Right now, I think the key message get vaccinated.

And then we're gonna have more information on what that means if boosters, if boosters or when boosters are in the mix.

Right now we don't, there's a lot that we don't fully know about boosters.

- All right, so this gets to the folks who are immunocompromised and may still be pretty anxious.

So Jack Mackey asks as a fully vaccinated person also taking immune suppressive medications, what mask precautions must I take as the general public transitions to unmasked daily life?

- Yeah, what I would recommend to him is probably to keep his mask on.

I think he should first of all talk to his health care provider.

That's the key message.

But if I were the doctor and I had a patient who is immunosuppressed, immunocompromised, meaning immunosuppressed on steroids, or because they've got some immune condition, cancer therapy, chemotherapy, et cetera, I would say to my patient, look, keep your mask on.

I know you're vaccinated, but keep your mask on.

At least, especially when you're in instances you're in crowds.

That's what I would recommend to my patients.

But again, it really has to be that individual decision based on what you're talking to about your specific condition along with your healthcare provider.

- And then a good followup to that is, many people asked about being fully vaccinate.

Oh, okay.

Sorry.

People asked about being fully vaccinated and interacting with a fully vaccinated immunocompromised friend, relative.

So what's the advice for the vaccinated person interacting with the immunocompromised friend?

- Well, I think it, I mean, if you're both vaccinated which I think is the instance here, right?

So you're both protected, but you know, it really depends on what that severity of that immunocompromise or immuno severity is.

Be careful, be cautious.

Certainly, you know, be careful about if you have, let's say a cold or some other kinds of symptoms, don't rush into, again, do what we were talking about earlier about hugging and those kinds of more extreme activities.

But again, you're both vaccinated, you should be protected.

But you do wanna have a little bit in the back of your mind about, let me just be careful around my friend or family member who might be immunocompromised just because in general, you just wanna be careful.

- You were talking about how everything is probabilities.

So, maybe we can drill down to that, from Alison Hilfarth, how likely am I to give COVID to someone else if I am fully vaccinated?

So we know it's not zero, what is it?

- It's close to zero.

It's pretty close.

I mean, you know, it's, you know, if you look at this vaccines, look in another way, 95% efficacious or effectiveness, right.

Then you start to say that reduces your risk by a certain percentage and so now you've got a really small probability.

Now you've got the, do you even have COVID?

So there's that piece comes into it.

What are your behaviors around that individual?

So you start to do the numbers and the numbers of probability starts to decrease.

And so I would say it's actually pretty close to zero.

It's not that it's zero, but it's pretty close.

Now, am I going to be able to tell you is 1%, 3%, 2%, 8% I can't tell you exactly but I will tell you it's pretty close to zero because the whole point of the vaccines are that they, at least as far as we know now, now, remember this is the other thing, Monica, we may learn over time that things are evolving and changing.

But right now the best science we have, the best evidence we have is that vaccines are safe.

They're effective.

And guess what?

They markedly protect you and those around you.

So I would say it's actually really close to, in those single digit and close to zero.

- So different contexts of our daily lives coming back.

This question gets to this from Margaret Gormley, do unvaccinated individuals need to be separated from vaccinated in church services?

Is congregational and choir singing safe?

- If they're un-vaccinated well, see, that's the thing.

So like, if this is where, so like congregational and singing and those kinds of things, if you're vaccinated, you're safe 'cause you're not spreading anything, but if you're unvaccinated, now you're potentially spreading something in the mix.

Now it depends on the level of vaccination in that room, right?

So if everybody's vaccinated but one person, let's say one person's not vaccinated and they're singing the loudest and they're doing the loudest amount of, you know, this sort of effort.

But at the same time, they are, everybody else around them is vaccinated.

The chances of doing anything or having any issue is really not there.

- Does it make sense to split in any context the vaccinated from the unvaccinated?

- It does, if you have a set situation or a setting where you have a lot of people that are unvaccinated.

And so if your vaccination rates are up high, now you're gonna be less likely to have a cluster or a bigger cluster.

So if you had a congregational setting where let's say you were in a community where very few people have gotten vaccinated, very few people, that's where you've got to be careful.

Now is it that you can a hundred percent say this is the percentage and this is what's gonna translate into risk.

You can't.

And this is why, what I would hope that the church or the faith-based community is going to do is to say, Hey guys, this is a way for us to protect everybody in this church.

Let's go ahead and all get vaccinated.

So I'm hoping that people will, you know, have a community rally around trying to get vaccinated rather than saying, Hey, separate, don't separate those kinds of things.

I would really rather that everybody be protected.

- We have a few questions about boosters and we've spoken to them a bit, but can you just repeat when you think boosters will be available and who will need to get them?

What do we know about that?

Will they need to be everyone, even if you were fully vaccinated?

- Well, there've been some discussions with our federal partners and nationally there's been a lot of discussion about boosters.

We don't have a good timeline of that.

We are thinking that the immunity from vaccines will, I've been saying about a year of sort of give or take.

And again, it's not full-proof.

So if you're looking at somebody got vaccinated back in December, right?

Our six months of experience in the State of Washington is December of 2020 and now we're at 2021 June, so it's been six months.

We still have six months to go at the outside of that 12 month piece.

So I do think that we don't know exactly when the boosters will be coming.

These are the things that we've been talking with our federal partners about.

And there's been talk about in the fall or the winter.

There may be the booster piece that comes in.

I do think at some point we're gonna be looking at annual that there would be a likelihood that we're gonna have, I shouldn't say likely, there's a potential possibility that we're gonna have, - Like the flu shot.

- That's right.

That you're gonna have a flu shot and you'll have also a COVID vaccine shot, booster or something that's gonna be in the formulation.

That's the kind of stuff that we're gonna be looking at.

But right now there's no firm, I haven't seen anything that says, oh, by November 15th you're gonna have booster.

There's nothing like that.

- So another question from Sue Romberg, what if we don't reach 70%, I believe of the first shot, of our population getting the first shot by June 30th?

Will reopening still happen?

I mean, first of all, how likely is that to be the case?

- Yeah, so, you know, we're at 68% and I haven't seen the updated numbers from today.

So hopefully we've inched even further.

And remember, this is 68% of those who have received at least one dose, who are 16 years of age or older.

And so we're very close.

In fact, we've been one of the, as you said, top states in the country.

So the governor made it very clear that by June 30th we are going to be reopening.

We could possibly open sooner if we get to the 70% number, - [Monica] But we're not gonna reopen later.

- We're not going to reopen later, that's right.

I mean, something, the only way I would see a possibility is if in the next nine or 10 days, you know, all of a sudden rates went just completely through the roof and we're like, what happened?

And now you would want our public health officials to say, whoa, whoa, whoa.

But I don't see that happening.

I mean, our rates have been, they've been coming down, they've been flat or coming down for now several weeks.

And so we're looking at that as being the positive, you know, the trend that we're looking for.

Now, does that mean that we're gonna hit 70% before June 30th?

That's the question?

I don't know.

I don't know, because it really depends on everybody else out there and what we're doing to get vaccinated.

- Question from Nancy Spencer, no one really talks about Johnson and Johnson anymore.

What about the folks who got that vaccine?

Because it is less effective, are unmasking rules different for those that got the J and J vaccine?

Interesting.

I am thinking about many younger people I know, she says.

- No, the rules are the same.

And you know, I think there is another piece of this is that look, Johnson and Johnson actually was very effective when it came to preventing severe illness, preventing people from getting hospitalized, which is really ultimately what we're trying to do.

Now, it may be that somebody could get mild illness, but severe, absolutely is very, very effective.

Why is that important?

Because we've been saying, remember even the metric I just talked about 16 and older at least one dose, at least one dose of J and J or at least the first dose of Moderna or Pfizer.

Either count.

And why that's important is that ultimately you are protected.

And that's what we're trying to do is to continue to get people to be protected.

Now, the story of J and J, I was quoted in saying this, you know, nationally, I mean I think it was a missed opportunity.

I mean, J and J really had an opportunity to be this incredible vaccine because we were all in public health excited about a one dose vaccine, right.

- [Monica] One and done.

- You would go to a Mariners game, one dose and you're done.

You go to a Seahawks game, one dose and you're done.

You'd go to populations that it's harder to get back for that second dose and you would be done but it just never materialized like that because of the challenges and the issues that came into the mix, including the pause.

And so I do think that there is unfortunately, the J and J time previously, hopefully, I mean, it's likely passed, but it's possible that there may be more use for it down the road in some other settings.

But if you're, if you received the J and J vaccine you're still protected, it still counts.

- Question from Maria Gutierrez.

What information can an antibody test provide?

What's the need or benefit in getting that test done?

I mean, antibodies are what immunity is made of.

- Yeah, you know, at this point, it's interesting that testing is kind of such an interesting dynamic because, you know, people aren't even thinking about testing anymore.

They're like, oh, I'm good.

You know, it's all about vaccines, but we have to remember that testing remains such an important, at least for public health and the health care setting.

We wanna make sure that if you have sinus issues or cold issues or coughs or sneezes or things like that and you're not sure, go talk to your healthcare provider.

You may very well get tested and hopefully it comes back negative.

So the importance of this is there's antigen testing.

And I won't go into too much of this, but there's antibody testing that a lot of times now people are equating to, I wanna make sure that the vaccine took and I, I got an antibody test and it shows that I've been protected.

It is possible for you to do that.

And that is something that's in the mix but I don't recommend that from a, you know, from a population standpoint.

It just doesn't make sense to go run out and get an antibody test just to show that your vaccine was effective.

But that's what the antibody would show is that you actually have either previously been infected and your body has has now created antibodies to be able to say, Hey, you know, I fought off that infection or you received those antibodies because of the actual vaccine.

And that's what you would measure as well.

- Gotcha.

All right, well, Secretary Shah, this has been a fascinating and I hope helpful conversation.

Thank you for taking the time to join us in studio today and to everyone watching at home, thank you for joining us.

I hope the conversation answered many of the questions you all have.

Before we go, I wanted to tell you about our next Newsmakers event on July 21st.

This one will be a little change of pace for us, something lighter for the summer, a celebration and reflection on the return of live music.

We'll be speaking to photographers who have captured and toured with iconic bands like The Rolling Stones, Bob Marley, Miles Davis, Paul McCartney.

My colleague Mark Baumgarten will step in to host that one.

It should be fantastic and fun.

You can RSVP at crosscut.com/events.

And to all of you who donated today, thank you for your support.

If you'd like to donate, you can do so on the page just below and last but not least to our series sponsor Waldron, our gratitude for helping to make today's event possible.

Thanks everybody.

Have a great rest of your Tuesday.