Speaker 1: (00:00)
The push to distribute booster doses of the COVID-19 vaccine continues across the country. And just recently, Dr. Anthony Fowchee recommended the overwhelming majority of Americans should receive an additional dose. And with many families gathering again for the Thanksgiving holiday tomorrow health officials continue to press Americans to keep their guard up and take every precaution to prevent a deadly winter surge. Joining the program now with a look ahead is Dr. Eric Topol director of the Scripps research translational Institute in LA Jolla. Dr. Topol, welcome back to the program.
Speaker 2: (00:35)
Thanks Jay. Great to be with you again,
Speaker 1: (00:37)
Our definition of fully vaccinated has changed somewhat given me addition of booster doses into our vaccine regimen. Uh, will we continue to need boosters as the pandemic goes on?
Speaker 2: (00:49)
Absolutely. We should consider fully vaccinated is three shots. That is the booster shot. When a person reaches six months, all these vaccines have significant waning. So by five or six months, a lot of that initial protection, which was terrific. 95% efficacy is faded. That is, it can get down to 60% or 70%, which is a big dropdown from 95%. So that's why it's imperative that everyone who's gotten the first two shots goes ahead and keeps that protection level as high as it can be. It is restored fully to at least 95%, which is terrific. And it may last for quite a long time.
Speaker 1: (01:30)
The deadlines for many San Diego vaccine mandates are approaching. What role do workplace mandates play in the fight against COVID-19?
Speaker 2: (01:38)
You know, it's really unfortunate. We had to go to this mandate route because you would have thought if you follow the science, these vaccines that have been given in billions of people, that we would all want to get them and all be protected, but because of all the anti-vaccine and science, that's why the mandates became inevitable here, and we need to accelerate them. We need to get everyone vaccinated in order to deal with Delta, which is a hyper contagious virus stream. We need to get 90% of this country's population vaccine we're at 59%. We're so far short and we're in attrition because a lot of people that are had gotten early vaccinated have now gotten past six months and have had some declined protection. So we've got to get moving mandates work. They are really working well. And it's just so sad. We had to resort
Speaker 1: (02:26)
The CDC has seemingly moved away from herd immunity, even as a tangible goal.
Speaker 2: (02:32)
Well, we've got, we're not going to get population level immunity. When we have 90 some thousand cases a day that are new and we're going up, the only way we could get to where we need to be as containment, which would be a few thousand cases a day in this so-called endemic state. So we get out of the pandemic. We go endemic, that's the goal no longer are we thinking we can squash zero. COVID no place really in the world can do that because it's such a hyper contagious strain and it could get worse. That is the virus could still evolve. So our goal is containment and we're going in the wrong direction right now. And unfortunately, we'll see the effects of that in California and San Diego as well.
Speaker 1: (03:13)
What haven't COVID vaccines been able to reliably block transmission?
Speaker 2: (03:18)
Well, they do block transmission in some respect. So first of all, before Delta, they had a great role in blocking transmission. Mo most of the transmission was reduced substantially with Delta, even in household contacts, which is a high risk zone for transmission spread. That is, uh, there's reduction, but it isn't as much as it was in prior strain to the virus. But if you prevent infections, you prevent spread. And that's the greatest contribution of the vaccines they prevent the darn infection to start with. And so that is why in Israel and in the UK, and now in Belgium, we're seeing the use of boosters on top of the initial vaccinations are blocking, spread, blocking new cases. And so that is really vital information that we're not incorporating in this country.
Speaker 1: (04:10)
What's the FDA status of the Merc antiviral COVID pill. And when can consumers expect it to hit the market. And do we know if it's safe to use with vaccines
Speaker 2: (04:20)
Hearing by the FDA is going to be next week and the publication of the trial is coming also next week. So we'll see more data. Uh, it certainly looked good. That is, there was about a 50% reduction in death or hospitalization. And the Pfizer drug similarly looks quite good as a pill that's taken for five days early in the course of, uh COVID. So it will work. There shouldn't be any reason why people who are vaccinated wouldn't benefit if they get COVID. But the key is to prevent COVID in the first place, but the pills are going to help us as give us yet another dimension of, uh, a powerful way to block the progression of the virus. Once someone has become infected, it does rely on getting tested early and we still don't have the best scenario for getting rapid testing, but that's something that will be necessary for the pills to work well.
Speaker 1: (05:12)
And several countries across the globe have recently re-instituted lockdowns and the world health organization is warning of a surge in deaths over the winter months is the same to be expected here in the United States.
Speaker 2: (05:26)
No, I don't think we're going to see any lockdowns in this country, but, uh, we don't even have mass use. I mean, we have no mitigation, so we have a long ways to go with it and scale that out. We're starting to see places in the country, bring back the requirement for mass it's. It's going to become inevitable that as this new fifth wave in the U S gains momentum, it's already started in the Midwest and the north new England states, as it gains momentum throughout the country, we're going to need to get back with masks and up our protection, the colony season, we know from last year with the monster wave, you know, breed spread. And so we're not doing enough to counter that, but we won't need lockdown
Speaker 1: (06:09)
Is COVID seasonal
Speaker 2: (06:10)
Well seasonal, depending on how you interpret, interpret that word when it gets cold colder. As we're seeing in states like Michigan and Minnesota and Vermont, New Hampshire people go indoors, and they're not only people gathering indoors often without mass, but also you have air that's not unified, not without filtration. And so that adds to the spread markedly. And so this was the problem now in Canada, which is colder than the U S colder than the states. I just mentioned. They're doing really well because they use mass plus vaccination. So our problem is we could cope with this change of season and the colder weather, if we were to up our defense mechanisms and we're not using them fully as we should.
Speaker 1: (07:00)
You mentioned long COVID earlier. Do we know if vaccines prevent this form of the disease?
Speaker 2: (07:06)
Well, there's a really good view reviewing the general nature of everything we know about the interaction between vaccines and long covert. And the bottom line is we still don't know that much, but if there is protection from vaccines from long COVID, it's, it's modest. It's not enough people who get COVID after vaccination. That is a breakthrough, have a risk of long COVID, that's substantial. Uh, it's reduced perhaps some, but not nearly as much as we would have hoped. Uh, and so, you know, that's another reason why boosters are important. We have a Washington post, um, essay today, Mike Osterholm and I, uh, about the necessity of boosters, even though the CDC has not urged them for people under age 50, all the data, all the data supports, how is essential that we use the boosters as a critical defense mechanism.
Speaker 1: (07:59)
Are there any variants of concern out there that officials are currently tracking or is Delta still the dominant strain?
Speaker 2: (08:06)
Is it, I mean, we have no new variant that is of a functional significance. Delta is so potent in terms of its transmission capability, that it will take be very difficult for another strain of this virus to overtake it. It is now taken over the entire world and all the sequencing that's being done now, or the virus, there's no meaningful difference. This, this is it. And hopefully we won't have something beyond doubt that we just, this is bad enough. This is really a take. If we had never had dealt that we would be past this pandemic now, but this is what's given us such a grand challenge.
Speaker 1: (08:47)
And you've said before that one of the biggest tools against COVID is testing. What are the major obstacles in getting more widespread testing at this point?
Speaker 2: (08:56)
Well, Jay, I don't understand why this country has not gotten it at his act together for testing in countries that are successful in managing even the Delta weight. They have free tests for everyone, an ample supply that either is mailed, or you can just pick up at a local pharmacy for free. We don't even have the tests here in, in the, in Europe, there's over a hundred rapid tests that are available. We have one not available and expensive. It should be free. It should be available to every household to pick up. And it could be used like for the holiday gatherings. It's perfect that everybody does a rapid test before you gather and do it on a daily basis. You then, you know, you're not infectious. And if your test is positive, you stay away from other people. We're just not using this. And it's unfathomable. And we're still relying on antiquated means that are not these PCR tests that started the pandemic, or is not the answer that just tells us if you've been, if you've had the virus even remnants it, doesn't tell you if you're infectious and there's just no excuse that this country hasn't gotten this right yet. I am just so frustrated about it.
Speaker 1: (10:10)
We are still in a pandemic. We are coming up on, on the holidays here. Is it safe to travel and gather,
Speaker 2: (10:18)
Well, if you've had your booster shot, yes, I'd say it is. But if not, I'd be worried if you're five, six months out. And as far as gathering, I would want to know that everybody I'm gathering with is fully vaccinated, which means if they're past that six month mark, they got a booster. So those are the considerations that I consider now, as far as safety for gathering, I mean, obviously there's going to be lots of gatherings for Thanksgiving and throughout the holiday season, but there are things that we can do to make sure they're safe for everyone.
Speaker 1: (10:50)
All right. I've been speaking with Dr. Eric Topol, director of the Scripps research translational Institute, Dr. Topple, thank you so much for joining
Speaker 2: (10:58)
Us. Thanks for having me, Jay.
