Speaker 1: (00:00)
As predicted the current surge is propelling COVID case numbers to historic highs. The United States opened the week reporting nearly a million new coronavirus infections, the single highest daily count of any country in the world. Since the pandemic started as the highly infectious Omicron variant shows no signs of slowing health officials are having to re think guidance on everything from masking and testing to isolation protocols. Joining us with answers to some of our most pressing COVID questions is Dr. Eric Topel director of the scripts research translational Institute in LA Jolla. Dr. Topel welcome back to the program.
Speaker 2: (00:37)
Thanks Jane. Going to be with you again, Dr.
Speaker 1: (00:39)
Topel. We mentioned just how many cases we're seeing nationally San Diego as well is seeing record highs. Are we currently seeing the peak of this surge?
Speaker 2: (00:49)
Uh, I don't think so. Uh, we have just recently hit in the 90% Countrywide for Aron new cases by sequencing. And that means that we are still growing it's not evenly distributed throughout the country. So we have weeks to go to get through this Armon surge, which is, as you already noted unprecedented.
Speaker 1: (01:12)
When we first heard about the ALN variant, we heard that most people in South Africa showed mild symptoms from infection and that's with much of the population not having access to the vaccines. How is the us faring with hospitalizations in light of these high case numbers? That's a really
Speaker 2: (01:29)
Important question because South Africa is so different with 25% vaccination, but we've seen countries like the UK and Denmark Norway, where there's a very high vaccination rate, notably in Denmark, almost 80% of the population, whereas here in the us, the country overall 62%. And we're a bit better than that here in San Diego. So vaccination is just one part of the story. It's also the age and demographics of the population. There's also prior. COVID how recent in the prior COVID was. So if you put in all these factors, we are not in a great position.
Speaker 1: (02:08)
More children are being hospitalized with COVID than previously. Are those hospitalizations higher among any particular age group of children, such as those under five, who still aren't eligible for the vaccine?
Speaker 2: (02:19)
Yes, there's the, uh, rate in hospitalizations and illness in children and it's alarming. It's the highest it's been in the pandemic. It's a mixture. There are some who are in the age, less than five, where there's no ability to have vaccination. It's not, they're not eligible. And then there's a very low use of vaccination from five all the way through age 17 in this country, relative to what it should be. And so it's mostly UN vaccinated children that are winding up in the hospital. And you know, this is really unfortunate. We are seeing in San Diego, co-infections with the respiratory cial virus RSV. We're also noting that, you know, with the very small airways in infants, young children, there may be a higher liability because Amran tends to be very highly replicated in the upper airway. And whereas adults can handle that, uh, infants and young children. That's a much harder problem to deal
Speaker 1: (03:16)
With given that this is so diff difficult for children under five, particularly to deal with. Do you have any advice for, uh, parents on how to keep their children protected from the virus?
Speaker 2: (03:29)
Right? Well, fortunately, most children are gonna do very well, even, you know, for younger age, less than five without vaccination, the Ry is overall a milder form of the clinical severity, but to protect young children, the best thing we can possibly do is have a family fully vaccinated. And now I'm defining fully as with a booster and that's essential that booster is incredibly important, uh, against and then the others things of course, are the gatherings, the distancing, the high quality masks. It's hard for young children to wear high quality masks, but there are can 90 fours. And if they can use them when they're mixing with other kids and people, that would be great. And
Speaker 1: (04:14)
Speaking of masks, many health officials have said, cloth masks are far less effective against Delta and now Omicron K N 95 masks are recommended. Uh, but how available are they, especially for children who can't get vaccinated, but have to be in school?
Speaker 2: (04:28)
Well, the K N 90 fives and 90 fours are pretty widely available and relatively inexpensive. The N 90 fives are the ones that are really expensive and there probably isn't worth the difference between something that costs less than a dollar versus four or $5 per mask. So the K 94 is for children and 90 fives for adults. They they're, they can be, uh, bought, uh, certainly through the internet and, and other sources and highly recommended well over, uh, cloth masks that just aren't adequately protected. You know, one
Speaker 1: (05:01)
Thing that's certainly been difficult to gain access to our test. Uh, you've been talking about the need for them since the beginning of this pandemic, how is the county doing with making them accessible? You
Speaker 2: (05:11)
Think, well, Jay, this is really disappointing. San Diego county had done pretty well in this pandemic relative to many other places and even, uh, in our state of California, but they've really let recently, and it's much harder to get a test. The demand is overwhelming, the limited supply, and of course the country, our us government hasn't done what we had been begging for them to do, which is to get out free rapid tests to every household, like is occurring in Colorado in certain parts of the country. So those expected, perhaps by the end of the month, we'll start to see rapid tests being distributed Countrywide for free. But the, the supply again is not gonna be at all ample.
Speaker 1: (05:53)
We've seen some revision from the CDC on their guidance for isolation periods. What can you tell us about this? And do you agree with the changes
Speaker 2: (06:01)
Just recently, the CDC, after having said healthcare professionals should have seven days of isolation and then have a rapid test of some type of test before they get back to work, you know, that's negative. Then they came out six days later and said, well, the public, ah, five days don't bother with a test, just wear a mask. I mean, if you're feeling well or your symptoms are resolving, just go back to work with a mask. So this is just profoundly off based because it's not science based. It goes counter the practice in many other countries that have been using rapid tests. You know, it's not, if they just told the truth Jade and said, look, we just don't have enough tests in this country. We can't keep up with the test demand. So we're not recommending tests, but if you can do it, this is the right way to, to use them.
Speaker 2: (06:51)
And instead they said, if your test is, uh, positive, you just isolate for another five days. I mean, basically they didn't tell the truth. The message has been garbled and just horrible. And then they basically said, if it's positive, you know, stay isolated for another five days. Well, that's not the way it should work. You should have ample tests so that, you know, on day six, you test again, it's negative day seven, it's negative. Now you're fine to go. The, the, the, the use of day five and then just going out circulating again without a test is really not good. It's likely promoting spread of the virus.
Speaker 1: (07:26)
Hmm. And with that, the possibility of further variance always remains a concern in this pandemic. What's emerging now. And what's known about them. There
Speaker 2: (07:35)
Has been one variant that was identified in front that gave, um, some composite for concern, but that's been looked at thoroughly and, you know, it's what I call a scary. And hopefully one silver lining of Omicron is that we're gonna build up a lot more of an immunity wall, cuz so many people are getting infected and that should help us, uh, in the next, uh, stage of this pandemic.
Speaker 1: (07:57)
I've been speaking with Dr. Eric Topel director of the scripts research translational Institute. Dr. Topel. Thank you so much for joining us. Thank you.
