COVID-19 Infections On The Rise And Understanding Vaccine Hesitancy In San Diego
Speaker 1: 00:00 The Delta variant is suspected of pushing up COVID rates in San Diego. Speaker 2: 00:05 Well, do you know that Delta cases are increasing here in San Diego based off cases that are sequenced since last week, they've nearly doubled Speaker 1: 00:12 I'm Maureen Cavenaugh with Jade Hyman. This is KPBS midday edition, new numbers show most unvaccinated San Diego and say, they're not getting a COVID shot. Speaker 3: 00:29 They lack confidence in the safety of the vaccine. They're worried about side effects. They're worried that the vaccines development was too rushed and they're uncertain what its longterm impacts might be. Speaker 1: 00:40 California throws another twist into the school masking controversy and a San Diego author at this year's writers' festival talks about the challenges of writing about culture that's ahead on midday edition. After many weeks, seeing daily COVID-19 cases, dip into the double digits, San Diego county health officials announced 355 new cases on Monday. In fact, there have been more than 150 cases reported each day in San Diego since the beginning of July. And the likely culprit is the more contagious Delta variant of the virus. The increased numbers present a test between a new strain of COVID-19 among the un-vaccinated and a hoped for wall of immunity among those vaccinated in San Diego. Joining me is KPBS health reporter, Matt Hoffman, and Matt. Welcome. Hey Maureen, do we know for sure if this increase in COVID cases is due to the Delta variant? We Speaker 2: 01:47 Don't know for sure. Now we do know that Delta cases are increasing here in San Diego based off cases that are sequenced, you know, since last week, they've nearly doubled up from like 54 to like 107. But keep in mind, we talk about sequence cases like, you know, if you or I were to test positive for coronavirus tomorrow, our case might not go to a lab to actually find out what strain of covered that is. They only do a very small percentage. I think statewide this month, it was like 5%, but that does give us a snapshot. And we know that it was around less than 10% we know in the state of California and in the U S that Delta is the dominant variant. Dr. Wilma Wooten did say yesterday that we will probably be seeing that be the dominant strain here in San Diego county. But it sounds like it's not yet, but keep in mind those sequenced cases, there is a lag time, you know, two to four weeks. So the data that we're seeing right now is sort of, you know, a few weeks old, what other factors Speaker 1: 02:35 Could be causing an increase in cases? Speaker 2: 02:38 Well, you know, health officials have said since late June, they seen an overall increase in cases. And, you know, we were averaging for awhile about a hundred cases a day, 75 cases a day that has gone up recently to in the two hundreds. We even had a day where we had 300 cases. Now some of those may be batches that are dropped, but health officials sort of attributed to, you know, more people going out and mixing, you know, the, the big, uh, June 15th, the blueprint was lifted, but the pandemic was not over. So probably a lot more people mixing, but it's sort of hard to say, have we Speaker 1: 03:05 Seen a corresponding increase in hospitalizations and Speaker 2: 03:09 Deaths? The increase in hospitalizations and county health officials presented that at their meeting yesterday, basically from the time period of June 12th, to July 11th, they seen a 46% increase in hospitalizations. Now we're still talking about small numbers. I don't think that there's this worry from health officials that we're necessarily going to overwhelm the hospital system right now, but they haven't seen an increase in intensive care unit admissions. They seem about a 10% increase during that same time. But they do think though that that's a lagging indicator in terms of, you know, if you're in the hospital right now, just in like in a normal bed with coronavirus Smith, that worsens, so to speak, you might have to get put on a ventilator and then eventually go to the intensive care unit. So they expect that to change and they expect ICU admissions to also go up a little bit. Does the Delta Speaker 1: 03:49 Varian pose a threat to people who are fully Speaker 2: 03:51 Vaccinated? There is some good news in terms of there's more and more data coming out that shows that people who are fully vaccinated. So, you know, that's either getting, you know, one dose of the Johnson and Johnson or both doses of the Pfizer and Medina that there is really, really good protection. Now we do know that there's more and more studies coming out that are showing that one shot just doesn't provide that same level of protection drops down significantly in terms of percentage points. So, uh, officials are, are, are really encouraging people to get their second doses. If they haven't. We know that 140,000 San Diego or so have skipped their second doses. Um, and the message that health officials are sort of putting out there is, Hey, you know, you might think you're protected early on in the pandemic. You know, we know that one dose was good against the virus that was out there, but it's mutated a lot. Delta's becoming more dominant and that same protection is not there with just one dose. Now, this Speaker 1: 04:39 Uptick that we're seeing in the number of COVID cases, most likely because of that Delta variant is being called a test case of how much a mutating virus can infiltrate an area with a largely vaccinated public. Can you explain that a Speaker 2: 04:53 Little bit more? Right. So San Diego county health officials, you know, they set a goal of getting 75% of residents, ages 12 and over that's basically everybody who's eligible right now to get 75% of the eligible population vaccinated. Now they have hit that goal. You know, 2.2 million people have gotten at least one dose. Um, you mentioned, you know, there's 1.9 million San Diego are fully vaccinated, but that still means that there's, you know, more than a million San Diego, whether if they just, you know, don't want to get vaccinated or they're not eligible yet in terms of their, their minors, who haven't gotten their COVID vaccination. And we know that Delta does spreads so fast, it really just kind of takes over these communities. So there is a worry there that this Delta variant will spread very, very quickly in terms of those who are in vaccinated. And are we seeing Speaker 1: 05:36 Pockets of resistance Speaker 2: 05:38 That health officials are worried about? It was posed to the county health officials during a last minute briefing that they called last week when they did say that they are seeing the lowest vaccination rates, um, out in the east county and then rural parts of north county. I've been speaking Speaker 1: 05:51 With KPBS health reporter, Matt Hoffman, Speaker 2: 05:54 Matt. Thank you. Thanks Maureen. More on San Speaker 1: 05:57 County's polling results on vaccine. Hesitancy is coming up next. Speaker 4: 06:15 San Diego is seeing the largest number of COVID cases since April as the Delta variant becomes the dominant strain. Doctors are now getting a glimpse of what happens when restrictions are eased and people congregate while a pandemic is still ongoing, but with eight and 10 adults reporting, they are vaccinated. Why are we still seeing a rise in cases, a new survey suggest there are still too many people unlikely to get vaccinated despite being able to do so. David met president of FM three research who conducted the survey and Dr. Bob Gillespie, a sharp physician and the medical director of the San Diego black nurses association joins us. Welcome Speaker 2: 06:54 To you both. Thank you very much. Pleasure to be here. David, what Speaker 4: 06:58 Were your top line findings from the survey? Speaker 3: 07:00 We surveyed, uh, several thousand adult residents of San Diego county. And while we found that 80%, uh, were vaccinated said they had an easy time getting vaccinated and a lot of confidence in the health benefits that it would provide about one in five adults. Tell us that not only are they not vaccinated yet, but a majority of them say they have no intention of getting vaccinated. And for most of them, what we found was they're relatively unconcerned about the risks of getting COVID. Um, they, uh, believe it would be easy to get vaccinated if they chose to do so. They don't see any particular logistical hurdles to get past, but they lack confidence in the safety of the vaccine. They're worried about side effects. They're worried that the vaccines development was too rushed and they're uncertain what its longterm impacts might be. And for all those reasons, as well as the fact that they're not worried about getting COVID themselves, uh, right now they just don't feel an urgency to get vaccinated. Dr. Speaker 4: 07:56 Gillespie, if those who are vaccine hesitant, don't get the vaccine. What can that mean for the community as a whole? Speaker 2: 08:03 Well, first all with Jade, I think we should take a moment to take a step back and pat ourselves on the back. And the point being that if you look at historically, what we've done with flu vaccines has been in the range of 45, 50%. Even though this year, we had 55% because of the concerns that were out there for us to be at the numbers that we are now, that is very encouraging. That being said, um, we do have more work to do, and there can be obviously those who are not being vaccinated, the biggest concern is for them, for those people not getting vaccinated are at the highest risk. There are other issues such as the Delta, variant and other variants that can occur. If we don't have everyone back sedated, Speaker 4: 08:47 And then what can be done then to encourage those who are vaccine hesitant to get the vaccine? Speaker 2: 08:53 Well, I think we have to focus on, first of all, the 20% of people who are unvaccinated, who still feel, they're very likely to get vaccinated. And I looked at the survey and that's encouraging. So we still have that group. We have to focus on. If you look at the county data and you see those over 65, who've been vaccinated as well, over 90%. So the highest risk people have been vaccinated. We now have to focus on our young folks. If you look at the highest group that have not been vaccinated, those between the ages of 12 and 39. So we have to focus on that group. We have to talk about a condition called long haulers or long COBIT and the impact of that condition for not death, but long-term conditions and issues that can occur. If these people aren't vaccinated, focus on how this can impact their lives. And Speaker 4: 09:43 David, the survey looked at vaccine hesitancy by a number of demographics, including ethnicity. What did you find there? Uh, first, Speaker 3: 09:51 I just want to follow up on something Dr. Gillespie raised, which is an important point, which is those who are currently un-vaccinated can really be divided into two groups. Those who are vaccine hesitant, and those who are vaccine resistant, the first group that hesitant, uh, largely younger San Diego ones are people who haven't had a chance to get vaccinated yet may not feel a lot of urgency about it, but they're open to it. And if we tell them it's free, it's administered by healthcare professionals. It's been thoroughly tested. Uh, they ought to be, uh, persuadable and they ought to be, uh, willing to get vaccinated. And the survey data suggests that, but there is another group, those who are resistant who say that they will not get vaccinated, uh, and they are much more resistant to that kind of information. And it's likely going to be harder to get them, to be willing, to take the vaccine. Speaker 3: 10:41 Now, in terms of demographically, who they are, the profile right now of those who are most resistant tends to be older, whiter, more affluent, and more highly educated than the rest of the county's population as a whole. And that's a shift from what we saw in some research at the end of last year, where it was some of those younger residents and communities of color that were a little bit more hesitant about the vaccine. Those ethnic differences seem to have a diminished overall. And at this point, those who are resistant to the vaccine are more likely to be white than they are members of communities of color, uh, David. Speaker 4: 11:16 But when you look at it from an ethnicity lens, based on the percentage of those who have, and haven't gotten the vaccine, white people have the highest rate of getting the vaccine. Can you explain how that works? Speaker 3: 11:26 Sure. So 83% of whites say that they've been vaccinated, 80% of respondents of color have that's a relatively small difference and it's around the survey's margin of error. But when we look at those who express the greatest resistance to getting vaccinated, who say they are not at all likely to get vaccinated, they are much more disproportionately white. And I think what some of that has to do with unfortunately is partisanship. Um, we have seen that, uh, among white Republicans and other survey data, there is more resistance to taking the vaccine. Um, whereas whites who identify as democratic are more likely to get vaccinated and have higher rates of vaccination so far. So I think what we're seeing now is that the set of white adult residents of the county who are unvaccinated, uh, may differ in that way, ideologically, that may be influencing their willingness to get vaccinated. Speaker 4: 12:20 Dr. Gillespie, when this pandemic first started, the narrative was that people of color were more hesitant to get the vaccine. You've been a part of, of a lot of community-based vaccination efforts. What's your reaction to these findings from the Speaker 2: 12:33 Survey? I think the survey is excellent and it provides a lot of information, but remember also when you have a larger pool of people who've already been vaccinated, that is, if you already have a large pool of whites who have been vaccinated, then you are pretty much, and especially in an influent group that knows how to get to the information, get the vaccine done. You have a much smaller pool of people to pull from meaning that that group would have gotten vaccinated because they would have had the means to do it. When you look at African-Americans, there had been some access issues. There've been some other issues that have been going on. So we have a larger pool to deal with with, to still encourage that group to move forward. And I think some of the data may be skewed because of that, because I still see how's it in people for reasons that we can talk about including concerns about the long-term effects of the vaccine, concerns about how quickly it was developed and things that's still out there. Speaker 2: 13:28 And I talked to people every day about that, but many of those people, once you give them the facts, you go over how the vaccine was developed. You go through the side effect profiles, you look at the issues related to clots or pericarditis that have come up. You can explain the importance of use of getting the vaccine and that the risk of having a problem is much less than the, um, the facts that the large benefit that you get for getting the vaccine. So I think it's a population that still has some that are racially divided and hesitant based on mistrust and other factors. But I would agree it's not nearly as much as we initially thought. Um, early on, Speaker 4: 14:09 And David, Dr. Gillespie mentioned the long-term effects of the vaccine being one reason that people say they are vaccine hesitant. What are some of the other reasons that you saw with your survey? Speaker 3: 14:20 Well, the primary concerns that people raised were, uh, concerns about the long-term effects, concerns about immediate side effects that they might experience. And in particular, uh, some of the respondents seem to be aware of some of the challenges faced relating to the J and J vaccine. Um, although the problems have arisen in a very small, uh, group of, of, uh, people in studies, um, they have gotten a fair amount of publicity. And so that's something that the respondents were aware of. Um, but it really was those concerns, uh, that seemed to be the biggest obstacle. It was not a belief that it was hard to get the vaccine hard, to get an appointment hard, to find a place to schedule it. It was not some of the more outlandish claims that we've heard about, about the sort of the motivations behind vaccination or, or what some of its other effects might be. And so, as, as Dr. Gillespie said very carefully, going through with people, be evidence that has been gathered, the incredible effectiveness that the vaccine has had so far, um, ought to help to allay some of those fears and concerns, and hopefully make people more comfortable with getting vaccinated. Speaker 4: 15:28 Dr. Gillespie hearing that. Uh, what would you like for people to know about those concerned with Maxine side effects? Speaker 2: 15:35 I think David alluded to the point, if you look at those who have had side effects that are real concerning side effects, you had a small group of patients, women between ages 18 to 48 that developed this issue of clotting. Or you may have all heard about this whole thing with TTP, which is a very serious condition, but it occurred in a very small percentage of people, somewhere in the line of one in a million and some very small number. And the same with pericarditis inflammation of the heart occurred in a small number of younger male, primarily patients who all recovered from this, that I know of, no one had had any long-term effects from that. So educating folks on these are short-term issues and that when you get the vaccine and you have a reaction that that's a normal reaction, that is when you have the muscle aches, et cetera, that your body getting ready to defend itself, if challenged with the actual virus. Speaker 2: 16:29 So we have to get those messages out. And I want to, again, point out it's important to talk about these other conditions, such as long COVID, which a long haul this condition, which I have several patients now who are young and can't get back to work. So these are things that young people we have to point to. We used to use the argument. You could infect your older grandmother or your mother and father. But now the answer to that, when I say that is they're all vaccinated, we don't have to worry about them as much. So I still want to focus on directly how it would impact these young folks. And lastly, it's really important to make sure that 140,000 people who are overdue for their second vaccines, that they get that second shot and point out the importance that it's a two shot vaccine, unless it's J and J. And when you have to get that second shot to be fully protected, Speaker 4: 17:18 I've been speaking with David mats, president of FM three research who conducted the survey and Dr. Bob Gillespie, a sharp physician and the medical director of the San Diego black nurses association. Thank you both for joining Speaker 2: 17:31 Us today. Thank you. Thank you. Speaker 1: 17:40 This is KPBS midday edition. I'm worrying Kevin Hall with Jade Heinemann for many in the public Afghanistan was America's back burner, far away, often overshadowed by war in Iraq. As us troops continue pulling out the survivors of a fiery helicopter crash. 15 years ago that killed 10 soldiers say time does not heal all wounds. KPBS, military reporter, Steve Walsh has the story Speaker 5: 18:10 Just to know Donahoe was 24 years old. When he enlisted in the army, he had already graduated college. His parents, pat and Pam still have his pickup truck out front. They drove it home to San Diego after visiting him at Fort drum just before he deployed to Afghanistan. In 2006, Speaker 6: 18:27 Came out to dinner at his favorite Chinese restaurant, which he loved. And that was the last time we saw him live. Speaker 5: 18:34 It's been 15 years since Justin died in a fiery helicopter crash on a mountain side in Kunar province, along with nine other soldiers, Speaker 6: 18:44 Fathers aren't supposed to bury children. There is no closure for that. There is a, a internal kernel of you that is still filled with grief. Speaker 5: 18:59 Justin Odonto was a cavalry scout with the 10th mountain division. His platoon was on a mountain at night near the Pakistani border. One of Justin's platoon mates, Nick Pelosi says the landing zone was only large enough for the giant Chinooks rear wheels to touch down on the third, try the rear rotors struck a tree top, Speaker 2: 19:19 And it just tumbled and exploded. It was a mass mass carnage. Basically Speaker 5: 19:30 They had been in the field for weeks. Part of operation mountain lion. The goal was to retake territory captured by Al-Qaeda and the Taliban. Speaker 2: 19:39 It was so hot that we couldn't get down in there. So we're yelling if you're hurt and you're still alive, you know, move or make a sound something. And we'll, we're going to come down and get you in the Speaker 5: 19:52 Morning. The survivors came down to recover. The bodies Polozi was injured after he was knocked out of the helicopter during an earlier attempt to land. I mean, it was about nine 11. And Speaker 2: 20:03 At this point, I don't really know. I don't really know what that's about. Polozi left Speaker 5: 20:08 The army after that first 18 month deployment. He's now living on a farm in upstate New York, near where he grew up. Speaker 2: 20:15 The damage that comes from this stuff is unbelievable. You know, none of these families are ever going to be the same after this. Speaker 5: 20:31 Justin left one last voicemail before heading into the mountains in Afghanistan, just to tell his parents, he was okay, that were a military family. Justin's father spent his career in the Navy. His brother, Kyle is a Navy pilot Donahoe. His mother, Pam, some days are harder than others. Speaker 6: 20:50 I don't, I don't agree with the war because I think a lot of people got killed. A lot of boys got killed for no reason. We didn't win anything for anyone. You know, why were we there? I don't know. Or Speaker 5: 21:09 The O'Donnell house sat around the same dining room table where army officers sat to tell them the findings of the crash nearly 15 years ago, Speaker 6: 21:17 All of a sudden done helicopter, still Christ. And our son still died. Speaker 5: 21:22 The army rule, the crash and accident. I heavily redacted copy of the crash reports is two sergeants told their leadership that they considered the night landing high risk and didn't understand why it was being attempted. Regardless. The effective end of the war in Afghanistan doesn't offer any solace to the O'Donnell hosts Speaker 6: 21:40 With the rest of your, your life. And you don't forget, you don't ignore you. Don't let it slide by. I have a compartment in me that's Justin Speaker 5: 21:51 America has never had a conflict that stretched on for so long that the parents of fallen soldiers were still watching the war on TV long after their children had died. As the Afghan war finally comes to an end, Pam and pedo Donahoe are moving forward without moving on. Speaker 1: 22:12 Joining me is KPBS, military reporters, Steve Walsh, and Steve welcome. Speaker 6: 22:17 I'm Maureen. Speaker 1: 22:18 Now the sacrifice of this family in the Afghan war is part of two decades of us casualties in that country. More than 2300 us military personnel have been killed. And yet, as you say, this has been America's burner war. Why do you think that is? Speaker 2: 22:37 Well, you can make the case that Afghanistan stopped being at the forefront of public attention, right after the invasion of Iraq. In 2003, you look at all the publicity surrounding the departure over the last few weeks. You know, I'm watching this a bit more closely, so I can see some of the benchmarks as the us starts to pull out. You know, we have a largely left Afghanistan already, but you're not really seeing, um, these stories making, you know, the top headlines, uh, you know, some of that is the Biden administration. They're not looking for that mission accomplished moment. They're more interested. It seems to not Telegraph their moves so they can avoid a confrontation with the Taliban. On the way out. Speaker 1: 23:21 One of the soldiers you spoke to in your feature says the war used to be about nine 11, then he didn't know what it was about. And that questioning about the purpose of the war is shared by Justin's parents. Wasn't it? Speaker 2: 23:34 Yeah. Justin's mother, especially. She really didn't understand why we had been there for so long and had the most difficult time in trying to explain that, um, his father had very similar, had a very similar viewpoint, even though he's, uh, he had a military career himself in the Navy and was a civilian contractor. In fact, he even did a crash investigations as part of his job, so he could understand what had happened to his son, but it's, you know, it's especially hard to explain the more after, um, the seal team killed Osama bin Laden back in 2011, there's just a sense that nothing really changed. Long-term, you know, we honored the sacrifice that these men and women made for our country and for their comrades. But overall, the goal seemed kind of murky Speaker 1: 24:23 This week. The top general in Afghanistan stepped down and that's apparently a signal of the end of the war. Can you tell us about that? Speaker 2: 24:31 Oh yeah. Monday general Austin Miller stepped down as the commander of the American led forces in Afghanistan. They had a change of command ceremony in Cabo, which effectively ended the us war in Afghanistan after 20 years. You know, we have largely left already except for a small forest, which remains mainly to protect the embassy in our residual forest. That's basically handing off control to Turkish forces, but you know, after 20 years, this is, this is not the top story this week, even though, you know, for the most part, the war is over and, and don't expect any big homecoming parades. This will most likely be a very quiet end to America's longest war. Speaker 1: 25:11 And since the war in Afghanistan lasted a generation, I wonder if the end of the war is having as big an impact as you might think it would on camp Pendleton. You know, so many young Marines were barely born when this war started. Speaker 2: 25:27 I'm always told that, you know, the Marines are, um, are the youngest fighting force. So most of the people who fought in Iraq in Afghanistan, um, they're either at the very end of their careers or they've they've left long ago, I've been told by a us Marine headquarters that there are no Marines who are part of the remaining troops. So that means no one from camp Pendleton or, or 29 palms are left on the ground. So, you know, I'm going to be sitting down with members of the dark horse battalion, which spent seven months in, in Helmand province in Afghanistan. They will go down as having the highest number of casualties of any American unit during this war, you know, 34 Marines lost limbs, and they're living with the legacy of this conflict and, and there'll be living with it for the rest of their lives. Their injuries though, did drive a revolution in prosthetics. So I'm, I'm really actually looking forward to sitting down with them and talking with them and, you know, really getting a sense from them of what, uh, what their understanding is of the war. Speaker 1: 26:29 The U S okay is gone, but our stated enemy, the Taliban remains is the Taliban part of a new Afghan government. Speaker 2: 26:39 Well, you know, we, we forget that talks are still ongoing with U S and the Taliban and the Afghan government it's been described as a slow growing, even by optimists. Um, you know, many observers say the Taliban is just waiting for the U S departure. They've already taken wide swaths of the country. The Biden administration said that they, uh, they're confident that the Afghan government will hold it's, uh, at least at the population centers around Cabo. But, you know, we'll see when you spoke Speaker 1: 27:08 With Justin's family, the Donna hos, did you get the sense that they were glad the Afghan war is finally over Speaker 2: 27:16 Well for them and for everyone else who lost a loved one in that more, it does not bring back back their son or daughter, you know, it doesn't bring back their son or any of the people who died in that crash that day back in 2006, Justin's dad talks about there being no such thing as closure. When you lose a son, it was clear that they, uh, they haven't been able to describe the purpose behind this war for a very long time. Um, they seem relieved that it's over, but it, it really, it doesn't really end the pain that they will take with them for the rest of their lives. I've Speaker 1: 27:53 Been speaking with KPBS, military reporter, Steve Walsh, and Steve, thank you. Thanks, Maureen Speaker 4: 28:06 Fornia has softened its COVID masking guidelines for the upcoming school year. The change comes after the state originally advised that students who refuse to wear masks would be barred from campuses while face mask will be required. Indoors, social distancing will no longer be mandated within the state's public schools. The change in guidelines, further complicates how parents in schools approach the health and safety of children in classroom settings, especially as cases of the Delta variant continue to rise across San Diego. Joining me now with more is Dr. Robert Schooley and infectious disease specialist at UC San Diego health. Dr. Schooley welcome back to the program. Speaker 2: 28:46 Thank you very much. Good afternoon. So Speaker 4: 28:48 First question here, uh, is there a consensus within the medical community as to how parents should approach the health and safety of their children in the classroom? Speaker 2: 28:58 We know that children can be infected, that they are less likely to become ill than adults, but some do become quite ill. And there have been some deaths and some long-term side effects and some children who are unfortunate enough to become infected. We know that many of the same things that have worked in adults to prevent transmission masking, trying to avoid large numbers of people in Dortch endorsed together, maximizing ventilation work in children as well. So until vaccinations become widely available for children under the age of 12, we're going to have to rely on some of the behavioral interventions to keep children as safe as possible. Where does Speaker 4: 29:35 The state's revised guidance sit with what the CDC is currently recommending? Speaker 2: 29:41 Basically being consistent with the CDC guidelines, which is that people who are unvaccinated shouldn't wear masks indoors, the CDC is recommending that K through 12 students also remain masked in the fall term, mainly because most of them will not have been vaccinated by the time fall arrives. Since the studies of vaccines in younger children will be ongoing. So the state's, uh, recommendations are quite consistent with that. Uh, I hope that as, uh, the vaccines are found to be safe and effective in children, that we can extend the same protection to them that we have to the adult population and make, uh, schools also a place for the virus. Isn't welcome. In the meantime, Speaker 4: 30:20 There's been a nationwide spike in the number of reported COVID cases over the last week. Is there any worry that this kind of spike could extend to school campuses once the fall semester starts Speaker 2: 30:31 Up? Well, we know that respiratory viruses do increase in their, um, incidents, the new cases, um, in other words, uh, increase in fall and early winter as people come in doors. And that certainly happened last year with, uh, this particular virus. There's no reason to think that it won't. And we have layered on top of that this new Delta variant, which is circulating, uh, and a substantial sub segment of the us population that has not yet been vaccinated. So I think we're going to continue to see in the fall kind of a dual epidemic, one epidemic will be of unvaccinated people and they will end up in the ICU. Uh, and many of them will die. We will also have cases of much less severe disease, more flu like illness, uh, so-called breakthrough cases and people have been vaccinated, but very few of them will end up in the hospital. Uh, and we will have cases of people who have been vaccinated, who are infected, but don't become symptomatic. Uh, the schools will be part of this, uh, children because they're younger will be less likely to come severely ill. Uh, but we should be careful about our children. And again, when they're in situations where there are large numbers of others, present, masking really makes a lot of sense, uh, until they become vaccinated. And that's the reason the K through 12 recommendation remains in place. Speaker 4: 31:42 And given that that's the case, you know, given the current surge of Delta variant cases, then should students and teachers alike be wearing masks in the classroom, regardless of vaccination Speaker 2: 31:53 Status, I think in the fall, that makes a lot of sense. So there will be children over the age of 12 who have been vaccinated. The problem is that when you're in a school, you don't know who's vaccinated and who's not in a elementary and high school. And until vaccination percentages are much higher than they are now, uh, it's just much more reasonable to have everyone be masked, uh, until we get to a higher level of vaccination. So what Speaker 4: 32:17 Do we know about the transmission of COVID-19 in the classroom? Speaker 2: 32:22 It has occurred. We know that when people have looked though in the last year before vaccines became widely available, most of the transmissions occurred, uh, when people became infected and their families or in the community and came to the classroom rather than the classrooms being, uh, incubators for infections that then spread into the, into the population. There's no reason to believe that the virus can't be transmitted in classrooms. And again, that's why masking is recommended and what particularly important in the fall, if the current, uh, increase, uh, in new cases, uh, continues to, um, to accelerate. Here's the question. Speaker 4: 32:56 Do you have any sense on if the virus has been able to mutate among those breakthrough cases? We Speaker 2: 33:02 Don't yet. Um, there are some data emerging that most of the breakthrough cases are variants, but it's also true that most of the cases in the community now have become barons. Uh, so, uh, although the data aren't definitive, I think you would see an over-representation of Varian cases in the breakthroughs, and we'll continue to have that happen. But again, people who have been vaccinated are much more likely to have either an infection that has no symptoms or an infection with mild flu like symptoms. And I think one thing that people should, we've seen a fair number of people who just think they have the sniffles or the flu, and continue to go to work and school, and then suddenly realize when they get tested, that what they really had was COVID. I think people should be aware that those who've been vaccinated in particular can have what people think are the sniffles or the flu that turned out actually to be COVID cases. And so if you have symptoms like that, you should not go to work and you should not go to school and you should be tested for COVID. Uh, because, uh, right now that's more likely than another viral infection. Let me ask you this. Speaker 4: 33:59 Is it accurate? Cause we hear this so often that the virus is able to mutate because so many people are not vaccinated. Is that an accurate statement? It Speaker 2: 34:08 Is this virus like other RNA viruses and those include HIV and hepatitis C or viruses that are out in influenza as well. These viruses were able to stick around the human population because they have as one of their toolkits, the plan to make mistakes when they copied themselves. So that each new generation of virus is slightly different from the one before. So this virus like all RNA viruses will gradually change its genetic makeup, as it goes through the human population and the more people who are infected and the fewer people who are vaccinated, which both increases the likelihood of new infections and allows the virus to replicate at higher levels. In other words, more viral, progeny, more viral children are produced in an unvaccinated person. The more of that that happens, the more likely the virus is to continue to evolve. I've been Speaker 4: 34:58 Speaking with Dr. Robert schooly and infectious disease specialist at UC San Diego health. Dr. Schooley. Thank you so much for joining us. Thank you. Speaker 1: 35:11 As we've been reporting this week on the program, California is in the midst of another drought emergency, but there are still no mandated statewide water restrictions similar to those deployed during the last multi-year drought and the public response to that decision varies depending on where you live. K QED reporter Ezra, David Romero explains 85% Speaker 7: 35:36 Of California is experiencing extreme drought conditions. The last time statewide drought restrictions went into place was 2015 and it was the third drought year. Californians are using 16% less water. And that's why the state is only asking for a 15% voluntary water reduction says Carla Namath director of the California department of water resources. Speaker 2: 35:57 By the end of this year, if we're preparing for another extraordinarily dry year, then we could see California move towards mandatory water reduction, even though reservoir Speaker 7: 36:07 Or levels and dry conditions are dangerously low in some areas on par with a three or four year drought Namath says regional restrictions allow for a targeted approach to reduce Speaker 2: 36:17 Water waste. From a client perspective, I would take the 15% seriously. Noah defin buys a climate scientist at Stanford. We don't have drought relief on the horizon. We can expect these conditions to intensify before there was relief. My fervent hope is that we see some, an early onset to the rainy season. This year, climate Speaker 7: 36:36 Scientists, Daniel Swain says that's hypothetically, Speaker 2: 36:39 Maybe the rains will arrive in September or October this year. That would sure be nice. Speaker 7: 36:43 Swain says that would be contrary to the trend. California is having shorter, rainy seasons, more concentrated in the winter, even with all that California is facing think heat waves, wildfire risk, and lack of rain. UC Davis, water resources expert, Jay London says requiring areas that don't need to conserve as much right now like Los Angeles and San Francisco will Speaker 2: 37:05 Make them less receptive to being told later on when you really need to conserve a lot of water to do so. But for many Speaker 7: 37:13 People who live in places like the San Joaquin valley, where Wells are going dry, the lightwater restrictions feels like a gut punch as Veronica Gotti by co-executive director with the leadership council for justice and account, Speaker 2: 37:26 It's 109 degrees in Fresno today. Imagine having to work outside all day and come home and not being able to shower in your own home. I think it's infuriating and disappointing and sort of feels hopeless. Like have we not learned our lesson here, Speaker 7: 37:43 Advocates for communities through the central valley and the Coachella valley where the drought is making existing inequities worse? Speaker 2: 37:50 Why is the burden on communities and people of color in particular who have the least access to safe water and, and are disproportionately impacted by dry Wells and access to safe drinking water to begin with why is it on our backs and on a community's backs to have to always raise the alarm on these issues. Most vulnerable Speaker 7: 38:11 In mind, faith Kern says it's time to start thinking of drought as a chronic issue, as opposed to an acute idea where we will be saved by rain each year. She's a scientist for the California Institute of water resources. Speaker 2: 38:24 I think the set of actions we might take start to look a little bit different and I don't totally know what those are yet. Maybe those what those voluntary water reductions are permanent. Whether the current Speaker 7: 38:35 Become part of our permanent California way of life is still to be determined. But everyone I spoke with recognizes climate change is stressing the way we currently live. They say solutions for future dry times may mean reinventing the way water is managed beyond just what's needed to get the state through this current drought ear. I'm Sr David [inaudible] Speaker 4: 39:09 KPBS midday edition. I'm Jade Hindman with Maureen Cavenaugh. The San Diego writers festival kicks off on Saturday with virtual events, bringing together local writers and nationally known. And award-winning authors discussions range from the practical, how to find a literary agent to the philosophical, how books can help us through life crises, San Diego author, a Nesha bought to you as debut novel. The rules of arrangement was published just yesterday. She'll be participating in the writer's festival on Saturday as part of a panel on writing about culture and she joins me now. Welcome. Speaker 2: 39:45 Thank you. Thank you so much for having me on, on your Speaker 4: 39:47 Show. Aneesha first. Congratulations on the book. Thank you. Yeah, this is your first published novel. And since we're talking about the writers festival, I wanted to ask, what was your experience like writing the book and getting it published? Speaker 2: 40:02 Um, this is my first piece of long fiction that I've ever written. And, um, I did not realize how lucky I was to find an agent and get a publisher. So I am feeling a lot of gratitude these days. Um, I went through the usual channels of editing and re-editing and, um, the absolutely despairing query process and, um, found my agent worked on the book with her a little more, and then we had a publishing deal. So, um, the usual channels and I'm grateful that it was published. Um, you know, when it was, Speaker 4: 40:39 Mm, and your book is called the rules of arrangement, and it tells the story of 26 year old Zoya Sani who lives in Mumbai. And she has achieved a lot of success in her academic and professional life, but at that a ripe old age, and she's still unmarried, which creates a problem for her family to solve, but it's not necessarily a problem for her at all. Why did you want to write about arranged marriages? Speaker 2: 41:04 Um, I come from a deeply traditional, um, south Asian, um, culture and not getting married or not marrying is just not an option on the table. It isn't something that you speak to your parents about and they'll be like, um, yes. Have you thought it through all right, then we're good to go. This, if you would say something like, I do not want to get married or I just want to have a different life. People would look at you like, oh, I'm, is there something wrong with you? What's what's going. So, um, that's something that I wanted to explore. Um, how you, um, sort of take both the traditional and the modern and, um, create something out of it for yourself. Um, Speaker 4: 41:47 And you know, this is a novel, but it's also a social commentary on beauty standards, colorism, body image, and expectations for south Asian women. What message are you hoping re readers take away from this book? Speaker 2: 42:02 Um, absolutely. There's there's like, um, there are two things that, uh, were foremost in my mind when I was writing this book. One was, um, for women, the women everywhere who've been made to feel less than because of their appearance or weight or skin or anything. I just wanted readers to take away from this book that you are enough, you deserve all the good things. Don't shrink yourself and take all the chances you get. Don't hold yourself back. Um, the second one was, um, as a young person, I grew up with a lot of aunties around me and, um, I ended up, I remember seeing them as sort of, why are you watching over me so much, but as a young person, it is difficult to see someone older, um, as a person rather than just sort of, uh, place, head or figurehead in the family. And I just wanted to bring about the thing that all of the people, whatever they do, there's always a reason behind it. And they are who they are because of what has happened in their life. And that everybody has a story. Speaker 4: 43:04 Hmm. And what you're talking about there is the book's message of compassion. Why is this important to the story? Speaker 2: 43:12 Uh, we often, uh, and you're right. You're absolutely right. And, um, we often go through life. Um, I don't want to say without compassion, but it is very essential in, in the world just to see other people and to know that everything that is coming from them good or bad has a reason behind it. And, um, we just need more compassion in our lives and our world these days. And Speaker 4: 43:38 The rules of arrangement is met for an American audience. And it's largely about a cultural tradition that isn't so common here. So how did you approach writing about this topic when you knew it might be unfamiliar to many people reading it? Speaker 2: 43:52 So, um, I chose a specific kind of narrative of the way the main character speaks, um, simply to make it more relatable. She she's this modern girl who has a career who is doing things with her friends is going out drinking, who also has a boyfriend with benefits. And, um, and I used sort of an irreverent voice, um, to talk about things that are considered, um, not irreverent or almost, um, sacred of very serious topics to basically show what she feels inside her head, what she cannot see out loud, which is also a universal thing. There are of things that we cannot see out loud, but we're thinking them in our heads. So I kind of use that narrative narrative to make it a little more relatable to the audience. Speaker 4: 44:40 And you'll be speaking as part of a panel on Saturday on writing about culture. How do you draw from your own personal experience as an immigrant to San Diego? When you think about writing about culture? Speaker 2: 44:54 Um, I've been in San Diego for about 20 years now. And, um, personally I feel that anything that I do as a south Asian, as an Indian reflects upon my culture. So, um, you know, that always comes into how I'm writing and, um, I simplified some things in the book. Um, certain concepts of say, like arranged marriages, which are so new to this audience and how the family plays a very central role in why arranged marriages are important and why they occur in societies like ours. Um, so, um, and I used, you know, a lot of, um, a little bit of explanation in, uh, within the narrative sort of, um, explain what is going on. And, uh, and our society is very, uh, what do you, what do I say south Asian society is very collective and American society is very individualistic. So, um, it was great to sort of bring those together in a balance in that narrative. Speaker 4: 45:59 And, you know, anytime you're on a panel or you're writing about your culture, um, you are a representation of your culture. Is that ever a heavy weight Speaker 2: 46:09 To carry? Yes, I'd say sometimes it is. Um, it would be a lot more, um, it, it wouldn't be as much if I was living back home, but I've been integrated in, um, you know, San Diego's life, the American way of life for a long time now. So it isn't as much of a burden now as it was before. And, and I've, it's been really enjoyable to be able to introduce some of the culture that I love so much to a new audience. Speaker 4: 46:40 I've been speaking to San Diego author, a Nisha bot, Tia whose debut novel, the rules of arrangement is out. Now, she'll be taking part in a panel discussion on Saturday at 1115 as part of the San Diego writers festival. And you can find more information about the writer's festival and her book on our website and a Nisha. Thank you so much for speaking with me. Thank you so much for having me on your show.