--:-- Sean Rameswaram: It's happening again. A friend got it. I think I got it at the Giants game. Then a neighbor. For the fourth time! Then a colleague. Good luck with that Daily News podcast, y'all, but I'm out. And another colleague. I've got the bug, formerly known as the novel coronavirus. And another colleague. For the first time. Then Dr. Jill Biden got it. Like so many of you, I'm left asking, how do I keep my family safe? COVID seems to be everywhere again. There's a new variant, but there are also some fresh vaccines. A health advisory panel is deciding whether the updated COVID-19 boosters from Pfizer, BioNTech, and Moderna should be available to people as young as five years of age or only groups deemed high risk.
--:-- Sean Rameswaram: On Today Explained, we're going to deliver some news you can use, whether you're still scared of it, totally over it, or somewhere in between. Support for Today Explained comes from BetterHelp.
--:-- Sean Rameswaram: Let me tell you a true story. Last weekend, I got an email from a listener who wanted to discuss their problems with me. And I said, look, I don't think that this is about me personally. At least I hope it's not. Why don't you try BetterHelp.com slash Explained. Absolute truth. As the largest online therapy provider in the world, BetterHelp can provide access to mental health professionals with a diverse variety of expertise. Find the one with BetterHelp. The one is not me, guys. Our listeners get 10% off their first month at BetterHelp.com. That's BetterHelp.com. slash explained.
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--:-- Sean Rameswaram: I don't know who needs to hear this, but y'all, COVID is bad. I have COVID. I got caught in a summer search. And I got COVID again for the fourth time. It really sucks I'm 30 for weeks and I've been having bad body aches. I am a nurse, y'all. A pediatric nurse. And we have been getting some COVID. And school hasn't really even started yet. Anyone else notice that, like, all the kids at school have COVID? I caught COVID on the way back from Grand Cayman. First week was, it was pretty bad. I had really bad mouth sores. I was super tired. I had a fever.
--:-- Sean Rameswaram: Today Explained is the show. My name is Sean Ramas-Vurm. I'm here with Karen Landman, who writes about science and health for Vox and happens to be a trained epidemiologist.
--:-- Karen Landman: Hi, Sean.
--:-- Sean Rameswaram: Karen, am I crazy or do a lot of people have COVID again?
--:-- Karen Landman: OK, both can be true, first of all. But no, a lot of people do have COVID again. It does seem that almost everybody I know either has COVID or recently has COVID. My parents had COVID. I had COVID in August. Lots of people on our work slack are out with COVID. A lot of people have COVID right now. It's everywhere. What is going on?
--:-- Karen Landman: Well, we had a wave earlier this year. Phase three of America's so-called triple-demic tonight sweeping the nation with a vengeance and pushing hospitals to a brutal new breaking point. Immunity waned and variants continue to evolve. and I think there are just now enough variants that can capitalize on the waning immunity and not enough immunity to really fight them off. And so we're seeing a lot of people now susceptible to COVID reinfection, and that's what's happening.
--:-- Sean Rameswaram: And anyone who pays casual attention to COVID knows that there's a new variant, but it sounds like you're saying this isn't all just the new variant. There's a bunch of variants out there. Almost none of this is the new variant that has gotten the most attention lately. It's kind of a mix of variants that have been emerging over the course of the last few months.
--:-- Karen Landman: You might have heard Eris. You know, Eris is that Greek goddess related to dissonance and strife. And I hope Eris doesn't cause that much dissonance and strife. The EG5 variant, you might have heard Fornax, you might have heard, you know, other XBB. Are you just naming Elon Musk's kids with Grimes?
--:-- Sean Rameswaram: The AE is like pronounced ash. Yeah. And then A12 is my contribution. I guess the point is, there's not like one variant dominating the scene right now. And the ones that are causing a lot of infections are not the one that has gotten the most media attention of late.
--:-- Karen Landman: With all these variants afoot, did people change their behaviors this summer? Not so far as I can tell. No one's testing that I know until they get sick. And even then, like, people have run out of those free home tests. A lot of people either cannot afford or cannot find other tests in grocery stores and pharmacies. So nobody's testing unless they absolutely have to and if they're lucky enough to still have tests hanging around.
--:-- Sean Rameswaram: Very few people that I know are masking. You know, I've done a bunch of traveling recently and I saw scant people either in the airport or on the airplane masking in crowded public spaces. I will occasionally see somebody masking and occasionally mask myself. But, you know, that's the exception rather than the rule.
--:-- Karen Landman: There have been a couple of polls recently about how concerned people are about coronavirus. And I think the last I saw, there was a Gallup poll from sometime in the middle of summer, maybe June or July, that said that maybe 18 percent of Americans are currently either somewhat or very concerned about coronavirus, which is almost at their all time low.
--:-- Sean Rameswaram: So, it sounds like people have sort of given up here. How about our governments be it city state federal? I mean we talked about this before but as promised in May our government is no longer funding testing treatment and most of the other things that enabled a lot of COVID protections to happen on an individual level.
--:-- Karen Landman: The pandemic is over. We still have a problem with COVID. We're still doing a lot of work on it. But the pandemic is over. Unless your insurance is great at covering those things or you are fine with paying out of pocket for those things, the personal protections are kind of gone. And the sort of more institutional-wide types of protections like closing schools or the things that private companies or agencies could do to reduce spread, like reverting back to a more liberal work-from-home policy at certain workplaces. You know, those kinds of things are on the whole, really, we're just not seeing that happening.
--:-- Sean Rameswaram: In most places, we're not seeing huge demand to have that happen. I mean, we are seeing in hospitals a lot of those health care facilities go back to masking. And that's different. Health care is, by nature, a much riskier environment for the people who move around in it. So that seems like it would be sort of the first thing that I would expect to see change is more enforcement of protective measures in hospitals. But we're really just not seeing that at all on a society-wide level.
--:-- Karen Landman: So it sounds like people have given up. It sounds like governments have given up. Where does that leave tracking this virus in a moment where you've got multiple surging variants?
--:-- Sean Rameswaram: Yeah, I mean, it's not a new thing. But the CDC has switched to tracking basically hospitalizations and deaths, which, as we know, are kind of late indicators of viral trends and wastewater. And, you know, there are various places to look at wastewater trends. And inside this fridge, they have samples from millions of people from across the Bay Area, stretching from Gilroy to San Francisco. You see here San Jose, Palo Alto. You see over there Stanford.
--:-- Karen Landman: I actually look at something called Biobot, which is a little bit easier to understand than CDC's read of this. It's the best real time idea that we can get of what the virus is doing. It's also not perfect in many, many ways, but it's good. And hospitalizations, you know, usually lag infections by a few weeks. deaths by much longer, you know, weeks to sometimes even more than a month.
--:-- Sean Rameswaram: But we haven't scaled up our public data gathering and communication in response to a rise in cases. You've got people not caring, governments not caring, not enough data tracking, and a surge of variants. What do we know about this new one, Parola? Ideal if you're the virus, right? Yeah. Great news for Parola. Right. Great news for viruses that want to spread undetected.
--:-- Karen Landman: Parola is, just to be clear, it's not an official name. But the variant that it is intended to refer to is the BA-286 variant. So I'm just going to keep calling it Parola because nobody is going to know what I'm talking about if I say BA-286.
--:-- Sean Rameswaram: Who came up with this name if not official? Who came up with a casual name like Parola?
--:-- Karen Landman: Oh, just a bunch of dudes on the internet.
--:-- Sean Rameswaram: We're ranking girls. You think this is such a good idea? I need the algorithm. All right. I need the algorithm.
--:-- Karen Landman: But in any case, it got a lot of attention up front because it looked really different from its ancestors. And it took the kind of genetic leap that Omicron had taken. And I think because of that and because the leap appeared to be in sort of places on the coronavirus genome that have portended concern in the past, There was a lot of concern that this was going to be, you know, a real mover and shaker in terms of causing a lot of bad disease and spreading really easily.
--:-- Sean Rameswaram: Scientists continue to be a little more concerned about this one, even though that case count is still very low. And that's because there are so many mutations and many of them are in the spike protein. So it could make it more difficult for our immune system to recognize it.
--:-- Karen Landman: Are people dying, Karen? I mean, it sounds like the people in your life who've gotten this didn't die, and I'm pretty sure none of the people in my life who got it died. But are people dying?
--:-- Karen Landman: Yeah, so we have seen an uptick in both hospitalizations and deaths with this latest rise in cases. And that's not a huge surprise. You know, we know that COVID is going to be a player in driving respiratory illnesses the way the flu is a player, the way RSV is a player. RSV is a common cold virus that can be associated with severe disease in young children and older adults.
--:-- Sean Rameswaram: Yes, we have seen a rise in hospitalizations and deaths associated with COVID over this time. Most people are going to have a mild illness, but this is real. I spoke with one doc who is a hospital epidemiologist at Tufts Medical Center in Boston. And she said that in her hospital since May, there had been maybe, I don't know, between zero and two people hospitalized with COVID at any given moment. And that's now up to six. And yes, she said some of those people have an infection with COVID that is sort of incidental to their hospitalization, meaning like they came in with a broken hip, but it also turns out they have COVID.
--:-- Karen Landman: So, you know, it may not be the cause of their hospitalization, but there are people who are admitted to her hospital for COVID right now. And they're not in the ICU, so they're not as sick uniformly as the same number of people might have been earlier in the pandemic, but they're hospitalized. So it's real.
--:-- Sean Rameswaram: More with Dr. Karen Landman in a minute on Today Explained. Support for Today Explained comes from Chime.
--:-- Sean Rameswaram: Nobody likes fees and complicated banking, says Chime. And Chime gets that, says Chime. Chime is a financial technology company that says they understand that every dollar counts. So when you set up direct deposit through Chime, they say you get access to fee-free features, such as free overdraft coverage, getting paid up to two days early with direct deposit, so much more.
--:-- Karen Landman: Chime says with qualifying direct deposits, you can be eligible for free overdraft, up to $200 on debit card purchases and cash withdrawals. Plus they say you don't need to worry about monthly fees or maintenance fees. You can work on your financial goals through Chime today. You can open an account in two minutes at chime slash explained. That's chime slash explained.
--:-- Sean Rameswaram: Chime feels like progress. Chime is a financial technology company, not a bank. Banking services and debit card provided by the Bank or Bank N.A. or Stride Bank N.A. Members FDIC. Spot me eligibility requirements and overdraft limits apply. Timing depends on submission of payment file. Fees apply at out-of-network ATMs. Bank ranking and number of ATMs according to U.S. News and World Report 2023. Chime checking account required. Not all journalism is the same. Take The Guardian.
--:-- Karen Landman: Our coverage has something unique. Fierce independence. Nobody owns us or tells us what we can and can't say. So we're free to report the whole picture. We connect what's happening in Washington to the rest of the globe. Expose corruption wherever we find it. And give fresh perspective on everything. From wellness and soccer to culture, the climate and more.
--:-- Sean Rameswaram: Read, watch, and listen to The Guardian for free at theguardian.com. Today Explained is back with Dr. Karen Landman from Vox. Karen, it sounds like the new variant isn't a huge deal, but surging COVID certainly is a problem. People die. People get really sick. Is this just a cycle that we're in? Is this just the latest cycle of the cycle?
--:-- Karen Landman: I think we need to zoom out for a second. We're still talking about this using the language of the early pandemic and this is a fundamentally different time with a fundamentally different virus and a fundamentally different global population.
--:-- Sean Rameswaram: Like I'm not picking on you but you use the word surge which a lot of people still use to talk about rising cases of COVID and it implies something right it implies that there's an overwhelming wave that maybe we can't cope with. And that's simply not happening with COVID anymore.
--:-- Karen Landman: We can cope with the waves now. There are more people in the hospital. There are more people dying now. But I'm not sure that anybody would look at the numbers now and call this a surge. I mean, I think, yeah, you'd call it an increase, you might call it a wave. But even the language that we're using is just dramatic, right?
--:-- Sean Rameswaram: I don't think experts ever really expected COVID to go away. So I think what's happening is that the virus is kind of stumbling toward endemicity. And this is what that looks like. We see cases rise. We see cases fall. We see cases rise again. We see cases fall again. And every time cases rise, we can notice that we can attend to that. We certainly should be looking for signs that it may turn into something that's difficult for us to cope with, either on a personal or an institutional level.
--:-- Karen Landman: But I don't think we need to assume anymore that every time COVID goes up, we're going to see hospitals get packed, we're going to see waves of people dying, we're going to see a lot of unexpected stuff.
--:-- Sean Rameswaram: When you talk about endomicity, are we talking about COVID becoming more like the flu? Is that what we're talking about? It becoming an endemic and not a pandemic?
--:-- Karen Landman: Seasonality is a little complicated here because, you know, there is such a thing as a cold and flu season. It's usually fall and winter in the Northern Hemisphere. COVID doesn't seem to vary seasonally. It doesn't rise reliably in the fall and winter and then go down again in the summertime, right? We sometimes see bumps in the summertime and it just, it seems to more vary on an every few months kind of schedule.
--:-- Sean Rameswaram: And a growing number of experts think that that is because of immunity and because of the duration of human immunity to this particular virus. It's not easily pegged to big events, big holidays, big changes in weather or other sort of seasonal things that drive whether we're indoors or outdoors.
--:-- Karen Landman: It is still driven by human behavior. I don't want to say that, like, if everybody were to mask and everybody were to stay inside, respiratory viruses, including COVID, wouldn't all suddenly drop. They would. But in a world where most of us are out and about, very few of us are masking and taking a lot of precautions, our institutions are not taking really big precautions. In this environment, seeing these things wax and wane the way they are really suggests that the way human immunity comes and goes is a bigger driver of their spread right now than our behavior is.
--:-- Sean Rameswaram: So there aren't COVID seasons, but flu seasons remain, and one seems to be around the corner. And of course, getting COVID during flu season is more risky for you and perhaps those around you, especially if they're immunocompromised.
--:-- Karen Landman: So help us understand right now what people can do if they get it. Let's do some news you can use. Like, does testing still work? Are all these variants still getting picked up on the old test-a-roo?
--:-- Karen Landman: Oh, absolutely. So yeah, we should definitely still try to prevent spreading it as best we can. So that means if you're getting sick, good idea to mask up around people and stay out of circulation as best you can. And, you know, we should try to prevent spreading it. If you think you might be able to get Paxlovid or might benefit from Paxlovid, test. Paxlovid is the first pill that can help treat COVID after you've been infected. If someone is COVID positive, it can reduce their risk of both hospitalization and death by a lot.
--:-- Sean Rameswaram: But yeah, I think generally, if you're getting sick, try not to pass it on to other people. And that might mean masking. It might mean keeping a distance. It might mean staying home from that birthday party that you were going to go to. But I think it doesn't mean shutting down your life the way we shut down our lives earlier in the pandemic.
--:-- Karen Landman: It also means you should get a vaccine. Like the vaccine is going to help prevent you from getting sicker than you might otherwise get in the next few months. It may not prevent you entirely from getting infected. It probably won't prevent you entirely from getting infected. But if you get infected, you won't be as sick. That's good. And you probably will be less likely to pass it on. And that's also good.
--:-- Sean Rameswaram: And the vaccines are still good? Are they updated for the Parolas of the world?
--:-- Karen Landman: So, yeah, the FDA already this week has approved these new vaccines. The Centers for Disease Control and Prevention has given the go ahead for Americans to get the newest vaccine. My colleague Rachel DeRose has written a great story on Vox that answers a lot of the questions about it.
--:-- Rachel DeRose: Hi, it's Rachel here. Last night, the CDC announced that they're recommending the newest COVID vaccine for everyone six months or older. This vaccine targets a specific sub-variant, and at the time that the CDC announced that they wanted a vaccine to target the sub it was the dominant variant That not the case anymore but the dominant variants right now are descendants of this XBB line And so it seems like this current new vaccine will be effective against the most prevalent variants in the U.S. at the moment.
--:-- Sean Rameswaram: The previous booster was a bivalent shot, which means it was targeting the original COVID strain as well as the Omicron COVID strain. This is a monovalent shot, which is far more similar to what we were being vaccinated with when vaccines first rolled out, the first set of vaccines we ever got against COVID.
--:-- Karen Landman: The purpose of the COVID vaccine remains to prevent severe infection and hospitalization. It doesn't necessarily protect against mild infection or infection.
--:-- Sean Rameswaram: Are we still learning things about COVID-19, Karen?
--:-- Karen Landman: Oh my God, we're learning so many things about COVID-19, Sean. But what we're learning on a scientific level, I think, I'm not sure it's translating the way I would love to see it translate into society at large.
--:-- Sean Rameswaram: I mean, you know, some of the interesting things that we're learning are actually about how much less at risk most people are for bad complications from coronavirus and from COVID infection than our behaviors would suggest.
--:-- Karen Landman: I mean, we are still acting as though a COVID infection is a newsflash, as though it is, you know, a reason to shut down our lives and isolate ourselves in the, you know, in the really difficult ways that we were doing very early in this pandemic where we had no tools and we have tools now.
--:-- Sean Rameswaram: You know, everybody is getting COVID now and almost everybody is recovering from it now. with no problems. It's not, I mean, yes, we're still seeing a little bit of new cases of long COVID come after repeat infections, but I think the numbers are so, so, so much lower than the headlines would have you think.
--:-- Karen Landman: And the level of alarm remains really high when people get infected. Hospitalization, death, even long COVID are now much, much less common as endpoints to infection than they were a few years ago. A lot more likely now is that you get infected, you get sick, you know, you have a mild to moderate illness, and you miss a bunch of important life things. You know, you curtail travel, you curtail other social activities that might be important to you.
--:-- Sean Rameswaram: If I am in my early 20s, which unfortunately I am not, or maybe fortunately, I don't know. If I were in my early 20s, which for better or worse, I am not. Same. And if I were on like day five of a COVID infection and I'm feeling fine and we were all gathering in a bar or, you know, going to the park, if it were early 2021, no question, right? I would stay home. I would tell everybody. I would not participate. I would wait until day 10 and then I would test and test and test. And if I were negative, then I would start seeing people.
--:-- Karen Landman: Now, day five, I'm feeling fine. I'm probably not shedding virus anymore. You can go out. You can and you should go out. We can and should return to a semblance of normal life.
--:-- Sean Rameswaram: The fact that we're, we are still, there's so many people still shouting that we should not be returning to normal life in any kind of way. And that we shouldn't be using the tools that we have out there to help us returning to normal life. It's a really unhelpful mindset if you want to get people to ever take you seriously again.
--:-- Karen Landman: Because we are going to have to, at some point, respond in a more concerned way to another pathogen. But right now, COVID is no longer that pathogen. And we are allowed to evolve our strategies at the same time that the virus is evolving its strategies. And we really need to. Otherwise, we really endanger our ability to be effective public health communicators and authorities in the future.
--:-- Sean Rameswaram: Read Karen Landman and Rachel DeRose at Vox.com. This episode of Today Explained was a joint effort produced by Siona Petros and John Aarons. We were edited by Amina Alsadi, mixed by David Herman, and fact-checked by Laura Bullard with help from Amanda Llewellyn.
--:-- Sean Rameswaram: The rest of the team here is comprised of Halima Shah, Abishai Artsy, Hadi Mawagdi, Miles Bryan, Victoria Chamberlain, Rob Byers, Patrick Boyd, and my co-host Noelle King.
--:-- Sean Rameswaram: Our managing editor is Matthew Collette. Our executive producer is Miranda Kennedy. And we occasionally use music by Breakmaster Cylinder. Today Explained is distributed on the radio by WNYC. The show is part of Vox Which is totally free. Thanks in part to contributions from our listeners. You can become a listener who contributes at vox.com slash give.
--:-- Sean Rameswaram: Thank you. Thank you.
