S1: Welcome in San Diego , it's Jade Hindman. On today's show , several states , including California , are banding together to issue public health guidance amid rising Covid cases and turmoil at the CDC. This is KPBS Midday Edition. Connecting our communities through conversation. So a summer Covid wave is spreading across California. At the end of August , just over 12% of tests statewide came back positive. That's double the rate of positive tests at the end of July. In San Diego County , we're seeing a similar increase , with nearly 13% of tests coming back positive. Meanwhile , in the headlines just this morning , several state governors are banding together to issue public health guidance amid turmoil at the CDC , while Florida plans to end all vaccine mandates across the state. Joining me live to talk about this is Rebecca Fielding Miller. She's an associate professor of public health at UC San Diego , though not speaking on behalf of UCSD. Professor , welcome.
S2: Thanks for having me.
S1: So glad to have you here. And so many things to talk about. Um , let's let's first start with this West Coast Health Alliance. So the governors of Oregon , Washington and California are going to start coordinating public health guidelines separate from the CDC.
S2: And so what has been happening is , is really quite sad that their work is being politicized and weaponized to a degree that's even putting them at physical risk. So I think it's honestly a tragedy the way the CDC is being dismantled. And I think this regional alliance is one of the few structural ways that we have to to counterbalance that and make sure people can still get evidence based advice from a reputable public health agency. Yeah.
S1: Yeah. And you mentioned evidence based. So talk a bit about how might California's public health guidance differ from what the CDC is advising here. Yeah.
S2: Yeah. So I think , you know , one of the things that people might not realize is happening right now is a lot of , um , science research recommendations. They now have to go through this level of political review where it's not scientists giving their advice based on their expertise and the data. It's political appointees with very little experience or knowledge , um , kind of mangling the numbers to say what they want. Um , and that is sad because we want to be able to trust recommendations. So while that is happening , um , people still need a place to get accurate information. And I think having these states that have not been really ideologically co-opted , um , for political gain , um , being able to make these um , uh , generalized recommendations is , is probably going to help us quite a bit. Yeah.
S1: Yeah. Uh , just curious , I mean , how much power do states have to issue health guidance ? Um , you know , especially when it conflicts with the federal guidelines.
S2: So historically , the CDC really has functioned as an advisory board. Um , they don't really make. They certainly don't make law. They make guidelines. And because people could trust the science coming out of the CDC , it was a good idea to follow those guidelines. Um , but in the US , public health is really state by state and to a certain degree. County by county. So state's have quite a bit of control over what they do and don't recommend , um , an advice for , uh , what people should and should not do. Mm.
S1: Mm. You know , uh , the other bit of breaking news today is Florida planning to eliminate all vaccine mandates for children. That's according to the state surgeon general , who has likened vaccine mandates to slavery. Um , what do you make of that ? And the president , it could set and also the broader health implications there.
S2: Yeah , there's a lot to unpack there. And people are going to be writing dissertations about that little sentence for a while. Yeah. Um , I think it's sad. I think if you look at , um , actual real data , um , the vaccine revolution has been , I mean , really a miracle in the way that it has saved lives , saved children's lives. Um , I think , you know , every parent loves their child. We would all do anything to keep our kids safe. Um , and I think it's a real tragedy the way these political appointees with , again , no experience , no knowledge and a history of creating harm , um , with these false stories and other places that they are advancing their careers by peddling lies to scare parents in ways that will kill children. I think that's awful. Yeah.
S1: Yeah. Well , back to this. The Covid guidance here. Last week , the FDA approved the next round of Covid vaccines , but they put restrictions on who can get them. Now the shots are reserved for those 65 plus or who have some serious health problems.
S2: And I think we all remember , like the summer of 2020 , um , without them. Um , but they also make it a little bit less likely that you're going to transmit. Not completely unlikely , because it's not a perfect vaccine , but they protect you and they protect other people. So what restricting them does is it just makes it harder to get. And so individuals are going to find these a little bit harder or more confusing to access , which is a shame for their individual health. But the fewer people who are accessing vaccines , the easier it's going to be for these viruses to bump around and make people more sick. So there's there's a big population impact in addition to our our ability to protect our own individual health. Right.
S1: Right. And then there's that concern of over long Covid , um , and how vaccines typically lessen the risk of , of having long Covid , right. Yes.
S2: Yes. That's correct. Vaccines are good for so many reasons. They're very safe. Um , and they , they lessen the risk of hospitalization , of death , of long Covid. And although they're not perfect , any chance you can get to reduce your risk of getting the virus also reduces your risk of transmitting the virus , which is a genuinely life saving thing to do for other people. Hmm.
S1: Hmm. Well , I do want to dig into this current Covid wave that we are seeing.
S2: And also in many ways , it's just a really new virus and we're still learning about it. And so that's it's sort of a it's a surprisingly tricky question. Certainly as some of it is behavioral kids are going back to school. Um , they are sneezing and being filthy at one another , which I say with love as a parent of a small child. Um , people are traveling in the summer. They are sharing airplanes with one another. Airplanes are a great place to exchange a lot of air with a lot of people for a long time , and therefore a fabulous place to wear a mask. So there's definitely some behavioral , um , things happening. Um , we know that the variants keep evolving , and so there's probably some element of changes in variants , but it's genuinely hard to say at this point. Um , what is going to shake out as standard and why ? And what's still just noise , so to speak. Yeah.
S1: Yeah.
S2: Um , uh , so San Diego County does , um , track , and I think we again , it's it's so hard to say , um , because we it's just very hard to compare. Um , I think we are not terribly off from where we were last year , but unfortunately , one of the things that changed recently was changes in federal funding is we used to have really cutting edge wastewater surveillance that let us say very precisely where we were in comparison. And that has stopped. And so it's it's sort of comparing apples and oranges to compare test positivity from year to year , when what we would really want to be able to do is wastewater surveillance or sort of better , more rigorous data collection. Hmm.
S1: Hmm.
S2: I am not an MD or a bench scientist. And it is it is such um , it is , it is such a an alphabet soup of Greek variants. Yeah. Um , I think what people need to know about this constant evolving of variance is really from a practical standpoint , your rapid tests still work. Um , there is no evidence that the effectiveness of them or the accuracy of them changes by variant. And the vaccine , especially the updated vaccine , is still effective. So we do kind of see this constant churn of new variants. And some of that is also because we are just doing more real time , um , genomic surveillance than we have ever done with any other disease. Um , but but I think from a practical standpoint for people wanting to be able to protect their own health and the people around them , the vaccine is still effective and your antigen tests are still accurate. Hmm.
S1: Hmm. You know , I want to circle back to data collection because , um , federal data is also so important to this and understanding what's happening locally.
S2: Um , I think we have seen data manipulation , um , happening in the CDC. Um , we have seen that we're not really allowed to speak to disaggregated data anymore , which is to say , um , there are a lot of political hoops to jump through if you want to say that , um , uh , vaccination rates are lower in Hispanic communities or Covid mortality is higher in , um , LGBT communities. So I think the scientists remain as trustworthy , if not more so. But I do have concerns , um , a little bit about manipulation of previous data and removal of previous data , but also about what we will be allowed to collect and know moving forward. Hmm.
S1: Hmm. And bigger picture here. What do you think the consequence will be to public health policy ? Um.
S2: Policy is an interesting question , and I will give you my optimistic answer. I think that we are already , I hope , seeing a backlash to some of these. Really ? Um. uh , really deadly , um , policies that are coming out of Health and Human services and their political leadership. Um , I hope that backlash is beginning , and I hope with that is coming and understanding that the things that are for ideological purposes being dismantled are important. Um , and so my my profound hope is that as we move forward , as we begin a rebuilding of public health phase someday , that people realize that these things that have been defunded and dismantled matter , and they are things that we need to deeply invest in. So , um , when the CDC or the National Institutes of Health say we can't study health equity anymore. Um , we can't , you know , create policies that are differentially targeted for the communities that need them. I hope we can acknowledge that that is important and that this is where we really need to pour resources. Um , so my my optimistic hope is that there is going to be a public health rebuilding phase when we truly recognize how important some of these um , currently prioritized topics are , and that our political leadership really has the courage that they have now , um , to continue investing in these areas that are so important. Hmm.
S1: Hmm. Well , before we go , I mean , given all that is happening. What are you telling your friends and family members to do right now in terms of precautions ? Yeah.
S2: So I actually just went camping with some really wonderful friends this weekend , and and we had a policy. Everybody took a Covid test before we got together. And that was because , you know , everybody has like a different health. Everybody lives with different people. And we wanted to all feel just completely free and easy singing with one another , talking with one another , being in confined spaces. So I think it is , um , just really a A very loving act to do these things that might feel silly for a moment like , hey , would you guys mind taking a test before you come over ? Especially if there's somebody in you home , in your home you want to protect ? Um , I absolutely wear masks when I travel and I encourage everybody to mask when I travel. You will never catch me maskless on an airplane again. That's gross. Um , and so I think vaccination masking and and knowing your status is , as individuals , one of the best things that we can do and genuinely , um , speaking to your representatives at the federal and state level , because people can't bootstrap their way into , um , public health , it is it is a societal choice we have to make to keep everybody safe. Um , and we shouldn't , as individuals have to rely on masks and tests. We should have , um , communities and societies that are built to keep everybody healthy.
S1: Finally , some solid advice. I've been speaking with Rebecca Fielding Miller. She's an associate professor of public health at UC San Diego. Professor , thank you so much. As always.
S2: Thank you. It was a pleasure. Sort of.
S1: That's our show for today. I'm your host , Jade Hindman. Thanks for tuning in to Midday Edition. Be sure to have a great day on purpose , everyone.
