One Year Later, What We Know About COVID-19

Speaker 1: 00:00 Today a retrospective on our pandemic year, Speaker 2: 00:05 Trying to catch up with everything what's going on in the heat. Speaker 1: 00:12 I'm Maureen Cavenaugh with Jade Heinemann. This is KPBS midday. Speaker 2: 00:16 Sure. Speaker 1: 00:24 Stories from the people and the communities that have suffered most. Speaker 3: 00:28 This whole thing has been very unfair. Um, we've seen so much trauma and so much death and so much tragedy, but it has not been evenly distributed. Speaker 1: 00:38 And what this year has taught us about the virus and about ourselves, join us for our special report on pandemic life. One year on that's ahead on midday edition, Speaker 1: 01:01 It's been just over a year since the COVID-19 pandemic was officially declared a year of anxiety, hardship, confusion, and loss a year like no other. We were told we were all in this together, but some communities suffered more than others. Many people untouched by the virus were hurt by its fallout, seeing their businesses and jobs evaporate. Now that there's a glimmer of light at the end of this long dark tunnel. We're marking this anniversary with a look back and a look forward. As we begin our series pandemic life one year on first up KPBS reporter Matt Hoffman turns back the clock to last March. Speaker 4: 01:45 This time a year ago, pandemic hysteria was gripping the nation. The death toll was rising in New York city. While in San Diego store shelves were out of cleaning supplies, items like toilet paper and water became hard to find. And gun stores. We're seeing record sales to people like Daniel, Frank of alcohol. Speaker 2: 02:02 We're getting crazy over this Corona virus. And I want to be able to protect myself and protect my family. Speaker 4: 02:08 There weren't even a hundred confirmed cases here get, but San Diego is we're already familiar with the virus a month before in February. Hundreds of evacuees were flown in from Wu Han, China and quarantined at MTAs Miramar that included Frank Wu Sinsky and his three-year-old daughter Annabel. Speaker 3: 02:26 I understand what's going, you know why mom's not here Speaker 4: 02:29 Within days of the first evacuees arriving San Diego County supervisor, Nathan Fletcher declared a crisis on February 14th Speaker 3: 02:36 Today, acting out of an abundance of caution. The County of San Diego is taking an administrative action by declaring both a local emergency and a public health emergency Speaker 4: 02:47 On March 9th County, public health officer Dr. Wilma boudin announced the first positive test for San Diego County resident. Speaker 2: 02:53 We will not go into details about the case except to say that the case is a female in her. This San Speaker 5: 03:00 Diego County resident is hospitalized and doing well Speaker 4: 03:03 At the same time, numbers were rising statewide. Speaker 5: 03:07 We now have six individuals, uh, that have passed away Speaker 4: 03:10 On March 15th. The governor would issue a first of its kind order. Speaker 5: 03:14 We are calling for the home isolation of all seniors in the state of California. Speaker 4: 03:19 Newsome also took aggressive measures that day to begin mitigating the viruses spread. Speaker 5: 03:23 We are directing that all bars, nightclubs, wineries, brew, pubs, and the like, uh, be closed in the state of California. We believe that this is a non-essential function. Speaker 4: 03:36 Indoor capacity at restaurants was cut in half and social distancing measures put into place. By this time, San Diego was feeling the financial impacts of COVID 19 major conferences at the San Diego convention center were canceling. Schools were closing then San Diego state students, including freshmen, chase contraband, or sent home from their dorms. It's absolutely nuts Speaker 5: 03:56 That they give us a some 40 hours notice to get out of here Speaker 4: 03:59 On March 19th. All Californians were ordered to stay Speaker 5: 04:02 At home. Let's bend the curve together. Let's not regret. Let's not dream of regretting. Go back say, well, you know, we coulda woulda Speaker 4: 04:10 Then on March 22nd, the pandemic took a deadly turn here. Speaker 5: 04:14 We will be reporting our first death, uh, for the County of San Diego, Speaker 4: 04:19 The county's chief medical officer, Dr. Nikki. [inaudible] had this message that day Speaker 5: 04:24 Without alarming, but with dry dyed realism, we are still in the eye of the storm. And we are asking you not to board up your windows, but to board up yourselves at home, please, Speaker 4: 04:37 A day after the first death in response to crowds at beaches and parks, then San Diego mayor Kevin Faulkner took action. Speaker 5: 04:43 Now I am directing city of San Diego staff to move forward with the closure of all parks, beaches, boardwalks bays, city lakes, and trails Speaker 4: 04:54 Springs. We're not required in San Diego County until a local order went into effect on May 1st, Speaker 5: 04:58 There are 64,000 Americans who have died in the last two months. The danger that's presented is real, and you can't reopen an economy. If you don't have a handle on your public health situation. Speaker 4: 05:11 At first, it was hard to track the viruses spread samples had to be sent to the CDC lab in Atlanta for confirmation and early on, you needed to be showing symptoms or have a doctor's referral to get a test. Speaker 5: 05:22 So this is the swab it's going in your nose. It's only going to go in about an inch to the mid-level here Speaker 4: 05:27 Until early may. When state sponsored testing sites were opening up in San Diego for the general Speaker 5: 05:32 Public, okay. In your eyes might get a little watery. Speaker 4: 05:36 As summer came cases, Rose and officials warn that we were heading in the wrong direction as parts of the economy began reopening, but it would still be months before the healthcare system saw its biggest test yet with holiday related surgeries and hospitalizations, Speaker 5: 05:49 No know people are hurting out there. And we know they're tired of the pandemic. You know, we're tired. Speaker 4: 05:54 That was script's health CEO, Chris van Gorder in when the pandemic Speaker 6: 05:58 Pushed the healthcare system to the brink, Matt Hoffman, KPBS news, the staggering loss of life rocked by COVID-19 has been unavoidable over the past year in San Diego County alone, nearly 3,500 have perished from a virus that's claimed the lives of more than 56,000 statewide. Perhaps the most significant impact of the global pandemic has been how we deal with grief and loss and how familiar these feelings have become to so many. Today we share a personal story of loss. Jojo regale is the long-time partner of beloved San Diego blues musician, Tom cat, Courtney, who tragically passed away earlier this year due to complications from the virus, Courtney at Texas transplant, who was a fixture of the San Diego music scene for decades, met regale at one of his performances. The two became an inseparable team as she became his agent and keyboard is Joe Joe regale joined us by phone to share her thoughts and reflections on a year of change and tragedy Jojo. Welcome. Hi, how are you? Good. Thank you. You know, first, I just want to know how have you been doing, Speaker 7: 07:27 I'm still trying to, uh, trying to catch up with everything what's going on. It's tough. You know, every scene is done, Tom passed away and I'm still in denial. And I still cannot believe that, uh, Sam isn't as bad in the impact of Colby is very strong. And people think that the Colby is a joke, but it's true. You know, in my experience, having somebody getting that COVID, it is unbelievable. You know, you can be with them, um, when the time needs, you know, you can beat them and, and it's, it's like, you can even talk to them in the phone. And for me, you know, that's the hardest decision I have to make when they call. They told me that, uh, he's not gonna make it no more. You know? Speaker 6: 08:18 I mean, talk to me about the pandemic a bit, if you can. What were your thoughts when this pandemic first began? And when did you and Tom cat realize that this was something serious? Speaker 7: 08:28 When we got both got sick, you know, around December, um, feminized, not feeling good. And I keep telling Tom, Sam, let's go and have you checked? And he say, that's okay, no time. I was telling him we need to go and have the test. So we finally, our, we decided to go and one of the clinic here and then he's, uh, running out of breath already. And I was selling, I was telling him, you know, um, I think, uh, we need, uh, um, I have to go call nine one one and he say, no, I'm I'm okay. Uh, I just need a rest. No, I told him no, I'm going to call nine one one. So he's before Christmas it's in and out in the hospital already Speaker 6: 09:11 About a Tomcat though. I know he was a prolific performer. And I can imagine that the closing of music venues due to COVID must have been hard on him. Speaker 7: 09:22 Very hard. The last time he play, he play at proud. Mary is end of February. He just turned 91. And when all the clubs closed down and he started staying home, I know that he's going down because he loves his music. He don't care if he got paid more or he got paid less, as long as the play just music. And he see that people is having fun. That's all the moderates for him. You know, music for him is his life. Speaker 6: 09:53 There was a significant outpouring of affection from the community following his passing. Was that a small comfort in what was no doubt? A very difficult time. Speaker 7: 10:03 Yes. You know, uh, you know, I think everybody, you know, who supported him and I cannot believe I got flowers. People sending me flowers here. I got calls. I got messages that I don't even know. These people that I don't even know where to thank them. You know, the support that I'm getting is unbelievable. And I can thank them enough before I'm doubting, you know, I was, I was standing, um, why you stay here in San Diego? Because you know, it's like the way they, they treated him, it's unfair because he's been here for 40 years, 50 years playing loose. And he got recognized just recently, he got the best hit, uh, become a blue, uh, best blues band. And then he, they gave him a another award and things like that, but it's kind of late, but he in, you know, for him, it's not being recognized. Speaker 7: 11:03 It's like once you see people jumping and having fun, when he played that's, that's, that's, that's what you want, you know, but he loves in Jericho. This is where he wants to leave. But the support that I got when he passed away, you know, I feel bad thinking that San Diego will never recognize him, but I'm mistaken, you know, because a lot of support that I got from these people that I don't even know that I guess Tom don't even realize how, how these people love him. You know? And I, I know that he knows that now. Speaker 6: 11:38 Well, we thank you. And, and, uh, we, we to miss Tom cat Speaker 8: 11:53 [inaudible] Speaker 3: 11:58 Yeah. Speaker 1: 12:02 Not all communities have been hit equally hard by the COVID-19 pandemic in San Diego, a map and a list of zip codes tells the story by far the most COVID cases and serious illness have been in predominantly Latino neighborhoods. 44% of those who have lost their lives to COVID in San Diego County are Latino. And the bulk of the jobs lost during the shutdown have been in the hospitality and service industries occupied by a largely Latino workforce. The pandemic has been an awful experience for everyone, but for many Latino families and communities, it has been devastating. Joining me is Dr. Christian Ramers the assistant medical director with family health centers. Dr. Ramers is Cuban American and works in many predominantly Latino communities in San Diego County. Dr. Ramers welcome to the show. Speaker 3: 12:53 Thank you for having me, Maureen Speaker 1: 12:55 Latinos make up 34% of the San Diego population. 55% of the COVID positive cases in the County have been Latino. What does a statistic like that tell you? Speaker 3: 13:07 Well, Maureen, I think it's a classic example of a health disparity. You know, if things, if all things were equal for all people, we would have representation of diseases and problems by the proportion that that population makes up in the population. So, um, the fact that there is a much higher case rate hospitalization rate and death rate, as you've outlined at the beginning here, just shows us that there's some inequity, there's some disparity going on. Um, and I think now that we're aware of this, it's time to really look at the underlying causes, Speaker 1: 13:38 You know, over the past year, we've heard that on equal health care and resources before COVID made the Latino population, especially vulnerable to this pandemic, would you agree? Speaker 3: 13:50 I would agree. And I think it's a very complicated thing to put your finger on. We, we in medicine and public health called us the social determinants of health, and it's not just one thing. It's really, uh, a whole conglomeration of many different factors, language ability, education, nutrition, transportation, and poverty itself, all these things that really stack the deck against these populations and make things more likely in terms of COVID infections, COVID hospitalizations and deaths. Speaker 1: 14:19 We've heard a lot about intergenerational living conditions, especially in the Latino community. How much of an impact do you think that had, Speaker 3: 14:27 You know, I've seen in my own anecdotal experience that it has a major impact. I've seen many families where, you know, perhaps an essential worker brings the infection home because they are expected to be at work and may or may not have adequate personal protective equipment. And then very soon it travels to the spouses, the siblings and the parents, unfortunately, who are mobile, more vulnerable. So absolutely has had an impact on, on those and, and really probably tips that, uh, that death number, because when we have grandparents living with younger essential workers, that's a really high risk situation in terms of transmission and death from COVID. Speaker 1: 15:03 And you make the point that when people were told to work from home, that was impossible for workers in service industries, here's Nancy Maldonado, she's CEO of the Chicano Federation, Speaker 9: 15:15 The consequences and the fear of having to choose between going to work and providing for your family and knowing that you are increasing the risk of them being exposed to a potentially deadly virus, the impact that that has on so many families across the, and Diego, I can't even imagine Speaker 1: 15:33 Dr. Ramers, how did people still going to work affect the number of COVID cases among Latinos? Speaker 3: 15:39 Well, I certainly saw this exact situation that Nancy described play out over and over again in the COVID patients that I've helped treat in the last year. And it is an impossible decision. Um, many of my patients really had no choice, but to go to work for their own paycheck, to put food on the table, but also because they were told to do so by their bosses and they didn't have any sick leave. Uh, some of them even were told to go to work, even though they had symptoms and we're clearly potentially, um, spreading the disease, whether or not they had personal protective equipment. So what I think this reveals again, is we can look at the numbers and we can understand that, but, but we should really look beneath the numbers and look at the structural inequities that have really been at play here really for decades, um, to, to give us these results Speaker 1: 16:25 Along those lines of looking beneath the numbers. Can you give us an idea of the kinds of situations Latino families faced when they came to family health centers over the past year? Speaker 3: 16:35 Yeah, I'm reminded of a particular patient who, um, worked at a sandwich shop and again, was told to continue to come to work whether she wanted to or not was, it was really frightened to talk about her symptoms to her boss. And in the end, when she even showed up at work with a fever was, was told to just keep on working. Uh, she ended up having a moderate case of COVID and then also had a transmission within her own household. So it's the same story that we've seen play out over and over again in our County. It just, it's not a real fair distribution of the disease. So the one feeling that's that's, um, staying with me after a year of dealing with this is this whole thing has been very unfair. Um, we've seen so much trauma and so much death and so much tragedy, but it has not been evenly distributed, Speaker 1: 17:23 You know, following up on your idea of this pandemic being unfair and its distribution of grief and loss. It's also being unfair when it comes to how vaccines are being distributed. Although Latinos make up 55% of cases here in San Diego, apparently they only make up 18% of vaccinations. So what do you think needs to be done there? Speaker 3: 17:47 And I'm glad you brought that up. There has been a couple of analyses looking at vaccine rates by zip code compared to case rates by zip code. And again, you just see a very striking disparity in the numbers. The top three zip codes in terms of vaccination receipts are LA Jolla Del Mar and Cornado. And then you have other places in the South Bay, which have clearly been more impacted, much lower down on the list. And you can start by explaining well that's because of the phases and that's because initially we vaccinated those above age 65 and those who are healthcare workers, and that's fine. But I would ask everyone to look a little bit deeper and ask, well, why are the retirees in San Diego, predominantly white? And why are the healthcare workers predominantly white? And why don't we have a healthcare workforce that represents the demographics of our County a little bit better? So we're getting there, there's a lot of outreach being done. The County has placed vaccination sites in the South Bay. There are things like project save that are reserving spots for people from the hardest hit neighborhoods. And certainly at family health centers, we are doing the best we can to outreach to all of our patients. It just takes extra effort to push back against decades of structural inequity Speaker 1: 18:55 Kinds of extra resources. Do you think the Latino community will need to truly recover from this pandemic? Speaker 3: 19:01 Well, this gets a little out of my expertise in terms of making policy, but I think starting with really basic worker protections and sick leave is something that really would have helped, uh, helped allow people to protect themselves to not be forced to come into their essential worker jobs. Um, things like that. Um, obviously access to healthcare, access to information, uh, in their preferred language. I think those are all things that are going to help going forward. Speaker 1: 19:25 I have been speaking with Dr. Christian Ramers, he's the assistant medical director with family health centers, Dr. Ramos. Thanks a lot. Thank you so much for the interest Speaker 10: 19:41 [inaudible] Speaker 1: 19:43 You're listening to KPBS midday edition. I'm Maureen Cavenaugh with Jade Heinemann today. We bring you a special program pandemic life. One year on recognizing the impact the COVID-19 virus has had on the lives of all San Diego ones. Baking bread became a popular pastime for many during this pandemic year, it relieved, boredom made up for absent bakery, goods and field homes with a comforting Roma. But for some, it became an anchor in the storm author Murray V Sullivan sometimes bait as she received calls from hospitals, anxious to use her tagalo Filipino interpreter skills to communicate with COVID patients in a short story about one soul wrenching call Sullivan, right? Speaker 10: 20:30 I see her shrink into her pillow breathless at the thought of her remaining days. One are folding into the other slipping away into a solitary end tears fall on the dough. As I call it into a bond, even her God cannot help her. Now her short story Speaker 1: 20:48 Pandemic bread is part of San Diego's Decameron project, and it's a pleasure to welcome. [inaudible] welcome to the program. Speaker 10: 20:56 Thank you for having me Marie. Speaker 1: 20:59 Now, how did baking bread get involved in your work as a translator during the pandemic? Speaker 10: 21:05 I've always cooked or baked when I run into like writer's block, because I feel like I need to be creating something. If it's not words on a page, at least it's food on a plate. So, um, when the pandemic hit and I started getting all of these distressing calls, obviously I was to distress myself to continue writing. So I will turn to baking. It became kind of this routine where I would bake something. And obviously there are only two of us in the household and that's too much sugar for us. So we would make a habit of walking to these people's houses in Kensington or in North park and just giving them half of whatever I need. And you know, that way we kind of continued with our sense of community, were able to socially distance and get outside of the house and, you know, be with people, even though we couldn't really be indoors with them. Speaker 1: 22:00 Did the calls from hospitals frequently involve elderly Filipino patients as it does in the short story? Speaker 10: 22:07 Yeah, for the most part, um, because, uh, the elderly ones tend to be the first generation immigrants. And even though they, many of them have a rudimentary understanding of English and actually some of them can express themselves in English when you're under duress. It's really hard to think in any other language except your mother tongue. And you really don't want to be bothered because a you're you're in pain or, um, you're worried. And to have to translate that into a second language, it's just more distressful for them. And I find that medical professor professionals, um, have an easier time of it when they're explaining a difficult procedure like, Oh no, we may have to give you oxygen, or we might have to do a colonoscopy. And that all doesn't sound very good in English because there's not a translation, a direct translation in psychology. So they depend on an interpreter to explain in context, what exactly is happening to their bodies. Speaker 1: 23:08 Patients were alone. They were separated from family in the hospital. And I'm wondering, did you feel a special obligation to them because of that? And you're translating, Speaker 10: 23:20 Oh, definitely. When they're speaking to someone in their language, they cling to that voice because for them it is the more reassuring sounds. So towards the end of the call frequently, they'll be calling me at their, which means older sister, which is, you know, a common kind of honorific where like, they, they relate to you on a familiar level. So, and it also implies that they trust you. So they'll call you older. Sisters is true. What they're saying, older sister, does this need to be done? There was this one woman who she was, she was very upset because she kept saying over and over again, why have they tied me down, released me from these ties? And the doctor was like, well, we tied you down because he kept pulling off your oxygen. And if you do that again, you will die. So, you know, in that case, it was really crucial that I explained it to her in a language and in a way that she could understand Speaker 1: 24:13 How has doing this work affected you personally, Speaker 10: 24:17 It's very stressful because why I started baking when I did these calls, because for me, I get very emotional, like many times I've come close to tears or I have been crying. Like in that one story, I actually was crying by the end of the call because I really feel for these people, I, I will never see them. I will never know where they are. I probably will never hear from them again. But I feel that in this one particular moment where everything was so crucial, so fraud, um, for me to have to bear witness to that, um, you know, it's kind of a privilege, but it's also very, it's very hard on you because even if it's a 10 minute call at, sometimes the calls have gone on for as long as an hour, you feel a certain investment. I mean, you can't help it because you're talking to this voice on the phone and they're clinging to your voice and saying, older sister is this true. And you have to convey generally the bad news. So it is, it is stressful. But at the same time, I would rather be doing that than have them try to understand in English what needs to be done because better, they hear it from someone in the language that they are able to grasp than to have someone say we're doing this and this and this, and to have it done with them, without them fully understanding what exactly is going to happen. Speaker 1: 25:45 I've been speaking with Mary V. Sullivan RV. Thank you so much. Speaker 10: 25:49 Oh, thank you so much for having me Maureen, a year ago, Speaker 1: 25:54 We didn't even really know what to call the new virus that had already shut down an entire province in China as a gain traction in the U S we had weeks of mixed messages on wearing masks about wiping off packages and about how contagious or how deadly this virus was. It was the beginning of the learning curve on COVID-19 that is still keeping researchers and scientists busy. One year later over these difficult months, much has been learned about the disease information that has led to the creation of effective vaccines and new treatments, but this viral strain and its host of effects on the human body still has secrets to reveal. Joining me is Dr. Eric Topol. He is founder and director of the Scripps research translational Institute, Dr. Topo. Welcome. Speaker 11: 26:44 Thanks, Maureen. Great to be with you again, Speaker 1: 26:46 When you first heard about this outbreak of novel Corona virus, and especially when it began showing up in the us, what kinds of mistaken assumptions were being made about COVID-19 early on? Speaker 11: 27:00 Well, there were many, but, uh, you know, one thing of course was that, uh, there was not an adequate recognition of this aerosol and re and the thought that it was just liquid droplets. So if we had respected that from the outset, the mask protection would have helped, uh, right from the start. Uh, another one is the assumption that it was just a respiratory virus because in Mohan, there was pneumonia as a primary presentation, but it turns out this virus can do so much more havoc inside the body, uh, in other organs, including the heart and the kidneys, the brain. So there wasn't enough appreciation for the scope of this. And, you know, I think, uh, the biggest problem was that in order to not fly blind, you had to have a rapid testing and had to be scalable. And we still a year later have not gotten that right in this country. And that's really put us in a decided disadvantage. Speaker 1: 28:03 What do we know about the COVID 19 virus that makes it possible for some people to test positive with no symptoms yet other people die from it? Is it something about the virus that makes it able to manifest itself asymptomatically and also deadly in other people? Or is it something about the people who get the virus Speaker 11: 28:26 Right? Well, it turns out there's both sides of this. That is, there are factors in people that set them up more predisposed to having a serious illness. And it's not just clinical factors. You know, that, for example, if they have diabetes and obesity and other, uh, coexisting conditions, we also know some genetic factors that we know, some people have antibodies to interferon, which is our first line defense. So there are factors in people that make them more susceptible, particularly, you know, uh, men, more than women in general and older age because the immune system responds differently as we get older, the term immunosenescence is used there, but there are also virus factors. So as the virus has evolved, it's become apparent that a few variants are of particular concern. One that's, especially in San Diego. Now the UK variant known as [inaudible] and this one is more transmissible. So the virus has changed its behavior and it's at least 50% more infectious and also more illness. So it's never simple, Maureen, it's a combination of things, Speaker 1: 29:46 Right? We have also learned during this year that there are a whole list of COVID complications from blood clots to long-term debilitating illness. Do we know what makes this disease so complex? Speaker 11: 30:03 No there's mysteries. And it's humbling the long COVID story by which some people about 10% or 20%. So it's sizable. When you think of the Denomie or people who have had infections, these are people who go months and even a year now who've never been right. And some of them have very serious disabling symptoms, and we don't understand why certain people are susceptible to long. And COVID, uh, and we have only seen recently that some of these people may be improved by getting vaccinated, which is an exciting advance. Uh, it's only anecdotal right now, but perhaps it will pan out with further study. Speaker 1: 30:45 Let's talk about the vaccines. You know, there's been truly an amazing learning curve in the past year that has resulted in these vaccines. We were told the earliest we could see a successful vaccine would be 18 months, and yet it took less than a year. How is that possible? Speaker 11: 31:03 Well, I actually didn't think it would be possible the average time to get a vaccine from the identification of the, of the bug. The pathogen is eight years. And the fact that this was done in months within the same calendar year. So the sequence of the virus, January 10th and a large scale trial, 75,000 participants in November, uh, in the early part of November, I mean, we're talking about, you know, 10, 11 months. I mean, it's, this is something it's one of the greatest medical science triumphs in history, if not the greatest, because we faced a very serious existential threat, uh, throughout the world here. And that is going to be markedly blunted by the rapidity and the efficacy. I mean, these are the vaccines that were first through the MRN vaccines from, um, visor and Medina, 95% efficacy. We consider that superhuman because we can't get efficacy, you know, as people at that level when we get an infection. So this is extraordinary. It's something that is quickly seeing, uh, in countries where they have been very aggressive with vaccination, like in Israel and the UK. And we're stepping up recently, these vaccines are going to save the day and they're also remarkably safe. Speaker 1: 32:24 Dr. Topo, what do you especially still want to learn about COVID-19? Speaker 11: 32:30 Well, there are many unknowns that are important. Like for example, how long will the vaccines that we take now carry us will be two or three years will be as long as the original SARS in 2003, where people had antibodies, uh, from the natural infection for now 17 years. Uh, I think the long COVID story is really important. The involvement of the heart with COVID is really noteworthy because we've seen some sudden deaths among athletes and, um, you know, it can cause this inflammation of the heart, it C it seems very rare, but it's a serious matter that we have to respect as well. Maureen, there's just so many things that we still have to learn. It's actually remarkable progress that has been made for sure, but there's a long way to go before we say, we fully understand the biology of the virus and the remedies that is better drugs that we could take, uh, when someone had an exposure that would neutralize the virus inactivated right away without having to get an intravenous infusion. So we still have room for better drugs. We hope that the vaccines will be not needing a booster or tweak for the variant. So, you know, it's still in the zone of uncertainty, but my goodness we've made immense progress. Speaker 1: 33:56 I've been speaking with Dr. Eric Topol, founder, and director of the Scripps research translational Institute, Dr. Topol, thank you very much. Speaker 11: 34:04 Uh, thanks so much, Maureen. Speaker 1: 34:18 You're listening to KPBS midday edition. I'm Maureen Kavanaugh with Jade Heinemann today. We bring you a special program pandemic life. One year on recognizing the impact the COVID-19 virus has had on the lives of all San Diego ones, Speaker 6: 34:33 Vaccination efforts against COVID-19 ramp up worldwide transmission rates and hospitalizations seem to be trending downward. And while this comes as good news to a believer global health infrastructure, the issue of variant forms of COVID-19 continues to generate concern among health officials across the globe. How do these mutated strains of COVID pop up and how do they complicate our efforts to fight against a global pandemic? Well, joining me today to break down everything you need to know about COVID nineteens variants is Dr. Davy Smith, head of the division of infectious disease and global public health at UC San Diego. Dr. Smith. Welcome. Speaker 11: 35:13 Thanks for having me, Speaker 6: 35:14 Dr. Smith, can you break down exactly how different variants of a virus come into existence? Speaker 11: 35:20 I can try. So we're basically watching viral evolution take place over the past year and a half. We have a new virus that has, uh, trying to make a new home in humans. It was previously pretty happy and bats and had adapted to bats pretty well knew how to infect Speaker 12: 35:38 Them and knew how to spread among them. And now that jumped over to us and at the beginning, it was good enough to get started. So that's what we saw. And now that the virus has been living with us and replicating amongst our population and the more viral replication that occurs within the population, the better it has a chance of adapting to us. And that's exactly what we're seeing. So it's now making what we call variance, meaning mutations that are different than the original strain. And those mutations are basically changing the structure of little parts of the virus to be able to infect us better and to be able to spread better. Speaker 6: 36:13 How many variants of COVID 19 do we currently know about, Speaker 12: 36:17 Well, every mutation probably could be considered a variant, but what we really are interested in what we call our variants of concern, and these are, um, viruses that are mutated from the original strain that we then see spread within a population. And we're looking at hundreds of different types of those variants that are spreading in our population. And some of those that raise to the level of being concerning. So variants of concern, or we're, we're actively tracking around 20 some odd of those. Speaker 6: 36:49 And what do we know about the different variants, those specifically those variants of concern? Speaker 12: 36:54 Yeah. So what we're really interested in is that the virus has a particular protein called a spike protein, and that protein engages in a human mechanism. What's called an ACE two, but it's, it's a little protein that sits on our cell and the virus needs to unlock that protein to get into our cells. And it's different than the one in the bat, but it's close enough to where the original virus could do it. Speaker 6: 37:18 I'm much more deadly or transmissible, um, is that variant? Speaker 12: 37:23 So those two things are, or are not necessarily the same. So there's no reason to think that the virus wants to kill us. So in terms of it being deadly, um, we don't think that evolution really works that way. If anything, the virus doesn't want to kill us at all. It wants to just live happily in us and having to spread it to all the different friends that we have, um, that are close to us. And the longer that it can do it without killing us the better for the virus, but the virus does want to increase transmissibility. So how it does that is it increases the amount of viruses that it produces. So when somebody gets infected, maybe it produces 10 and one person or a hundred and another thousand or 10,000 or 10 billion. But the more that it can produce, if it's off street offspring, the more likely it is to be transmitted to somebody else. Now that's the transmissibility. And we do know that those variants, um, do increase their offsprings. So they have an increase replication rate and that increases infectivity. Now, sometimes the more viruses that are produced within a person means that it can be more pathogenic. Um, and we're still, the jury is still out on that, but, um, people are looking very closely at it. Speaker 6: 38:38 Vaccines offer protection against variant forms of COVID-19. Speaker 12: 38:42 We think so we don't know exactly to what extent that the viral evolution will impact vaccine responses. We do know that the virus is also evolving to be able to get into that a little receptor called ACE two, two, so better to get into us, but it's also evolving away from our human immune responses. So when someone gets infected, they make an antibody. When they get a vaccine, they make an antibody and the virus comes in and it wants to evolve away from those antibodies as well. So we would expect that over time, the viral evolution, these variants will, uh, have decreased susceptibility, or they will, uh, be able to evade our immune responses like antibodies. And this might mean that our first generation of vaccines don't work so well against the new variant. So we'll need to make new vaccines, like second or third generation vaccine. Speaker 6: 39:35 How does the mutation of a virus into a variant form affect your, or affect our ability rather to fight it? Speaker 12: 39:42 Exactly. So if the variant has evolved away from an antibody, so let's say I got a vaccine, or I was infected with SARS COVID two. And I made an antibody. An antibody was really good at killing that virus, but the virus is like, Oh, I, if I change these proteins around then that antibody no longer works. That's exactly how those variants can get around our immune responses, our antibody responses. Speaker 6: 40:07 Do you think that the reality of mutating viruses underscores the importance of vaccination efforts against COVID-19? Speaker 12: 40:15 Yeah. So this is, this is the really important part. So the more that the virus circulates in our population, so it spreads from one person to another person, to another person, or it grows throughout the whole world. The more time it has within us to learn how to better adapt to us. So adapt to getting into our body, adapt to spread between people and our its ability to adapt a way from our immune responses. So the best thing we could do is to reduce the amount of viral circulation in our population. So to do that, that means vaccination is what we have at the moment. So the more of us that get vaccinated, the less that the virus will be able to survive in our community and the less time. And we'll have to figure out how to make new variants of concern Speaker 6: 41:00 As our understanding of COVID-19 changed. As we continue to learn more about it, uh, about its many variants, Speaker 12: 41:08 All the research now on these variants of concern are supercharged. So we were rapidly learning more and more and more. And the way that we're doing it is sequencing as many variants as we can. So as people, um, get tested and we find that they're positive, we take those viral isolates and we sequence those isolates. And then we can track whether or not they had one of these variants of concern, or maybe a new variant that might become a new variant of concern in the future. So Speaker 10: 41:34 Once we started looking for these variants of concern, many laboratories and researchers across the world, really dove deep into sequencing them so we could track them. Speaker 6: 41:45 And before we leave, I want to go back to that question about the virus and if it is more deadly, is it that we have no reason to believe that it's deadly because that's typically not how viruses mutate or is it because that's what research currently says. Speaker 10: 41:58 We, we can see that there's more viruses there. We can see that it's spreading more in our population, but we haven't seen a big fact of more people being hospitalized or dying with these new burials. There are some preliminary reports that say that that might be true with one variant versus another variant. But to be honest, I haven't seen any convincing evidence to say that these new variants are more deadly. Speaker 6: 42:24 I've been speaking with Dr. Davy Smith, head of the division of infectious disease and global public health at UC San Diego. Dr. Smith. Thank you very much. Thank you. The COVID-19 pandemic has turned all our lives upside down, but now as more people get vaccinated every day, there's hope that we can eventually do the things we used to. We talked to people around the community to find out what they're looking forward to. Once the pandemic is over. Here's what some of them had to say. Speaker 10: 42:54 My name is Katherine Garcia. I live in San Diego, California. And the one thing I can't wait to do once the pandemic is over, is going to a concert again and feeling the energy of being in a sweaty crowd, all connected by the music that we love. Hi, my name is Carla Beltran and I live in San Pedro, California. And, um, what I'm most excited about when it comes to this pandemic after it's over is traveling. I love to travel. And, um, I'm looking forward to maybe getting on an airplane and going somewhere far. Um, maybe like to Europe and one of the places I'd really love to visit is skip sermon. So maybe, maybe I'll get to do that after this is all over. Hi, my name is Flores [inaudible] and I live in San Diego, California in the Claremont community area. And what I'd really love to do when this pandemic is over is share a bowl of bright green tea with my friends. And this is something that we haven't had a chance to do since last March. And we've really missed one another. We see each other virtually on zoom, but it's just not the same. Hi, I'm Kevin Davis. I live in North park in San Diego. The first thing I want to do after the pandemic is over, is travel to get out of the house. I like to visit friends and family in Tucson, in Denver, Speaker 13: 44:32 Victoria in British Columbia, New York city, and that area, Washington, DC, and Baltimore in that area. And in Florida, Orlando and Fort Lauderdale. And for fun, I'd like to go to Las Vegas maybe, or to London in England. Speaker 10: 44:49 Hello, my name is Jeanette kuchins. I'm from San Diego and Mira Mesa before COVID nineteens truck. I was traveling a lot, I mean, a lot like three to four times a year, maybe out of the country. And I was dancing a lot when I wasn't traveling, I was dancing or when I'm traveling, I'm dancing. If it's a cruise, I'm dancing in the ship. Um, so after this COVID 19 is done and everyone has been vaccinated. Hopefully enroll safe to go out. I would like to go back to that again, to travel and to dance. That piece was produced by Emelyn Mojave.