- Dr. Ashish Jhadean of the Brown University School of Public Health.
As the “very exciting” rollout of the COVID-19 vaccine distribution gets underway in the United States, Dr. Ashish Jha, dean of the Brown University School of Public Health, says the country is still experiencing “astronomical” numbers of new infections and deaths. “We’ve just had a federal government that has given up on any efforts to try and control the pandemic,” he says. “What we have to do is get through the next few months with basic public health measures until vaccines become widely available and widely adopted. Until that time, there is no reason to let up whatsoever.”
AMY GOODMAN: This is Democracy Now!, democracynow.org, The Quarantine Report. I’m Amy Goodman, with Nermeen Shaikh.
The United States has once again shattered global records for daily coronavirus cases and deaths, with nearly a quarter-million infections reported on Wednesday alone. More than 3,600 Americans died of COVID-19 Wednesday, by far the worst one-day death toll for any nation since the start of the pandemic.
This comes as Politico reports former Trump appointee Paul Alexander repeatedly urged officials at the Department of Health and Human Services to deliberately allow tens of millions of Americans to become infected with coronavirus, promoting a widely discredited approach of herd immunity through natural infection.
In one email to top health officials, Alexander wrote, quote, “Infants, kids, teens, young people, young adults, middle aged with no conditions etc. have zero to little risk … so we use them to develop herd … we want them infected,” Alexander said.
The approach has been condemned by the World Health Organization as highly unethical, with disease experts saying it could result in the deaths of millions of people.
This comes as Trump’s ally, the former New Jersey governor, Chris Christie, is urging Americans to wear masks, citing his hospitalization with COVID-19 in October after a superspreader event at the White House. Christie spoke in a video posted to his Twitter account.
CHRIS CHRISTIE: You know, lying in isolation in ICU for seven days, I thought about how wrong I was to remove my mask at the White House. Today, I think about how wrong it is to let mask-wearing divide us, especially as we now know you’re twice as likely to get COVID-19 if you don’t wear a mask, because if you don’t do the right thing, we could all end up on the wrong side of history.
AMY GOODMAN: While he was hospitalized with COVID-19 in New Jersey, the former Governor Chris Christie was treated with a monoclonal antibody therapy produced by Eli Lilly, a promising drug that’s in extremely short supply. Christie’s VIP treatment came after he reportedly turned down a chance to participate in a clinical trial for a separate antibody drug, produced by Regeneron, because he was unwilling to accept the chance that he could receive a placebo.
To discuss all of this and more, we’re joined by Dr. Ashish Jha. He’s dean of the Brown University School of Public Health, former director of Harvard University’s Global Health Institute.
Welcome back to Democracy Now!, Dr. Jha. All over this country, I mean, all of the corporate media, you see the celebrations of people getting that vaccine in their arm, the idea that the pandemic is over. But at the same time, in that split screen, the numbers are going up astronomically, not only for this country, the wealthiest country in the world. We have the worst numbers in the world. Can you talk about why it does matter that people still wear masks and will probably have to for a very long time — the very reason your son says you’re boring on television, because you keep saying the same thing?
DR. ASHISH JHA: Yes. Good morning, and thank you for having me on. I am a little boring on television, because I have a certain set of messages, based on public health, of where we are. But let’s talk about where we are as a country.
You know, look, so, first of all, the vaccine news is very exciting. It is worth celebrating. It’s terrific. But it does come at the same time that we are seeing just astronomical numbers of infections and deaths. We’ve crossed 300,000 deaths. We are going across 400,000 deaths probably around the time of the inauguration. And the question is: When does this stop?
And there are two reasons that have gotten us here, right? I mean, first and foremost is, we’ve just had a federal government that has given up on any efforts to try to control the pandemic. We haven’t heard from the president about it. Scott Atlas, who is a very big believer in letting the infection spread widely, was running the show out of the White House until very, very recently. So we’ve had that failure.
And then, the second is the political division that all of this has created, that has undermined mask-wearing. The idea that wearing a mask is a political statement is absurd.
So, that’s where we are. And what we have to do is get through the next few months with basic public health measures, until vaccines become widely available and widely adopted. Until that time, there is no reason to let up whatsoever.
NERMEEN SHAIKH: And, Dr. Jha, could you explain what we know so far about asymptomatic spread from people who have been vaccinated, and when you expect to hear more? There hasn’t been very much released, because there isn’t enough known, about how much people can spread the virus even if they have been vaccinated.
DR. ASHISH JHA: Yeah. So, this is a critical issue, because if people can still spread after vaccination, then we don’t get the sort of population immunity benefits of the vaccine. Until a few days ago, we had really no data whatsoever. But a few days ago, in the release of data that came from the FDA from the — sorry, from the Moderna vaccine, what we see is, after one dose, spread of asymptomatic virus sort of drops by about two-thirds. I suspect it’s even more after the second dose. But we don’t have that data. So we’re still sorting it out, but I am becoming more optimistic that we are going to see a substantial decline in asymptomatic spread among people who have been vaccinated.
NERMEEN SHAIKH: And, Dr. Jha, as you mentioned, a significant number, the vast majority of Americans, would need to be vaccinated before we reach anything like herd immunity. But, of course, vaccine hesitancy remains a problem, though. According to the Kaiser Family Foundation, which just conducted a poll in late November, early December, the number of Americans who are willing to take the vaccine is higher, but it may still not be sufficient. And vaccine hesitancy remains highest among Republicans, according to this poll. Could you talk about your concerns regarding people not taking the vaccine even once it’s available to them?
DR. ASHISH JHA: Yeah, absolutely. So, vaccines only work, and their main benefits come, when a large majority of us take the vaccines. I mean, again, there is some, obviously, individual protection, but it’s really about population protection, community protection, that matters most.
It’s true about, depending on the survey, between, let’s say, 30 and 40% of Americans remain hesitant. I think some of that hesitancy I understand completely. This vaccine has been developed quickly, and Americans have questions about the safety and efficacy of these vaccines. I think some of that will melt away as people see more and more people getting vaccinated, people doing well after the vaccination. I think some of that will get better.
I think the issue around Republicans is concerning because there has been this campaign of misinformation that has tended to stick more to the right-wing media, from hydroxychloroquine to how masks are dangerous and to how the election was stolen, to now there’s a shift towards vaccines somehow being inadequate or dangerous. It’s really troubling. And this is why I’ve been calling on President Trump to get vaccinated on national television. I think that will help a lot. But we also need Republican leaders, conservative leaders to speak up and get vaccinated and talk about the fruits of science that really are available to the American people. I think only through them speaking up will we make progress on this.
And it’s absolutely true we need to get to a large majority of Americans getting vaccinated, if our goal is to return to any semblance of a new normal. If that doesn’t happen, then we will continue to have to have measures that will make life difficult and not where we want to be.
AMY GOODMAN: I mean, what’s amazing about Trump is he wanted to call it, you know, “getting trumped” or the “Trump vaccine,” very proud of Operation Warp Speed and how fast this happened, and yet he is the one pushing the idea that it’s a COVID conspiracy, and so clearly he is conflicted. The Trump vaccine would be solving what problem? Calling it a hoax.
But I want to ask you about, last month, Secretary of Housing and Urban Development Dr. Ben Carson saying he had been desperately ill with COVID-19 but was recovering. Carson said his condition improved at Walter Reed Medical Center after President Trump intervened on his behalf. Carson wrote on Facebook, “President Trump was following my condition and cleared me for the monoclonal antibody therapy that he had previously received, which I am convinced saved my life.”
Now, Carson is just one of a handful of people able to access Regeneron’s therapeutic before the FDA granted the drug emergency use authorization last month. Trump attorney Rudy Giuliani also received the treatment during his battle with coronavirus this month, leading to concerns that those with connections to the White House are getting access to these special treatments largely unattainable to the rest of the population. Then you have Chris Christie, who didn’t participate in the study because he was concerned that, you know, it was very effective, the treatment, and he didn’t want to end up with the placebo. Can you talk about these therapeutics and who gets access to them?
DR. ASHISH JHA: Yeah, absolutely. And all of those examples you brought up are incredibly frustrating in the following way. So, I have been watching the data on monoclonal antibodies. I’m pretty optimistic that they will end up being a really important part of how we treat people who do get infected. What has happened is, these leaders have not followed public health measures, have gotten infected, and then they get access to these therapies that most Americans don’t have. And part of the reason most Americans don’t have them is because we didn’t do an Operation Warp Speed for therapeutics the way we should have.
And so, these people get access to a relatively limited supply of therapies. They get better. And then they go, basically, make the case that COVID is not a big deal. And it’s incredibly destructive, in some ways, because, basically, it creates this impression that COVID is not a big deal. Well, it may not be as big of a deal if you had access to world-class therapies, including things that are not accessible to most of us.
And so, I wish that that cycle would stop. I wish we would have more of these therapies available for everybody. And I think I wish that these individuals would talk about how they’re getting something that most Americans don’t have access to.
NERMEEN SHAIKH: And, Dr. Jha, I wanted to ask you about what the FDA reported yesterday, namely, that the Pfizer vials appear to include as much as — as many as two additional doses per vial. Could you talk about that and that fact that it could increase the vaccine doses available to Americans by 40%?
DR. ASHISH JHA: Yeah. This is a surprise, and a pleasant one at that. Each of these vials is supposedly filled with five doses. And there’s a pretty long history of filling vials a little bit extra to deal with things like spillage or, you know, just that the withdrawing of the vaccine may not be perfect by the pharmacism, so that people always fill up a little extra on these things. And what we’re finding is, at least some pharmacists have reported, that up to two extra doses in a five-vial dose — five-dose vial may be available.
I think this is great. And I think what that — and the FDA has basically said people should — pharmacists should feel encouraged to use those extra doses to vaccinate extra people. Obviously, given what limited supply of vaccines we have, given the urgent need to vaccinate as many people as possible, I think this is terrific. And we just have to pay close attention, but I certainly don’t see any downside to doing this.
AMY GOODMAN: I have a very quick double question, and that is the issue of kids and teenagers. The Moderna vaccine apparently is for people aged 18 and above. The Pfizer is age 16 and above. How are kids, from infants to children to teenagers, tested? I mean, how does a parent say, “I’m willing to give up my kid to be tested,” number one? And what do you see happening with these age groups?
And the other goes to the issue of what happens to the tests that are taking place right now, that are so invaluable? When everyone gets injected, you don’t actually follow them in a systematic, scientific way where you can get information, just anecdotal — someone got Bell’s palsy, someone else got a rash. How do these studies continue? Because people aren’t going to want to risk — like Chris Christie, not want to risk getting a placebo.
DR. ASHISH JHA: Yeah. So, there are several issues here, so let’s talk about kids in general and then talk about kind of follow-up studies that need to happen.
You know, the Pfizer vaccine was tested in 16- and 17-year-olds, not in large numbers. So, that’s why, for instance, the FDA vote that happened by the advisory committee, a few people voted no, because they just said there wasn’t enough data on 16- and 17-year-olds. But most people voted yes for even that age group. And the Moderna vaccine has not been yet tested in 16- and 17-year-olds. So, my general take is, certainly when you talk about older teenagers, 16-, 17-year-olds, even 15-year-olds, again, let’s wait for the data, and we should follow the FDA guidance, but I don’t expect big biological differences between older teenagers and young adults.
Where it gets more complicated is in younger children. And what we need, really, there is just the studies to be done. Kids are getting enrolled in clinical trials now, because they’re so far away from being in the front of the line for getting a vaccine that this is a perfectly reasonable time to be testing this in kids. There are always ethical issues of testing things in children. Obviously, you need parental consent. You need to have as much kid consent as possible. These vaccines appear to be very safe overall, so I’m not as worried about it. But I do think, over the next couple of months, we are going to see data coming out about younger children. And that will be very helpful, and it will guide us in the decision-making.
You know, on the other part of your question, Amy, around the issue of kind of post-market surveillance, this idea that: What do we do now that we’re starting to vaccinate people? We can’t follow them in studies. There is a whole mechanism set up so that if people have adverse events, that they will report it to their doctor, and their doctor will then report it into the FDA, that there are very active surveillance programs that exist for people who are getting vaccinated. And there are people conducting studies now of tracking people who have been vaccinated to see how they’re doing. So, I am hopeful that if there are other events, adverse events, that start happening, that we’ll catch them pretty early. I doubt they will, but we should be absolutely tracking this. And there’s a whole set of stuff happening now to make sure that we don’t lose out on all that information about what happens to people after they get vaccinated.
NERMEEN SHAIKH: And, Dr. Jha, you mentioned earlier the importance of the vast majority of Americans getting the vaccine in order to reach anything like herd immunity. Could you talk about that in the global context? We just spoke earlier in the program about a large number of people in the world — in fact, the majority — potentially not getting access to the vaccine ’til 2024 in developing countries.
DR. ASHISH JHA: Yeah, I guess I am, by the way, more optimistic in terms of timeline than that. But I do agree that we are going to see, in much of 2021, a set of countries where most people have been vaccinated and a set of countries where most people have not been vaccinated. And that, I think, is a real problem. It’s certainly an ethical and moral problem. It is also an epidemiological and infectious disease problem, because what we know from this pandemic and every other disease outbreak is that diseases don’t respect borders. So I am very worried about that.
I think we need global leadership here. This is a place where the Trump administration has largely been absent. I know the previous guest discussed COVAX. I think mechanisms like that. I think China and India, as two major producers of vaccines, being able to get billions of doses out. I remain optimistic that much of the world will get vaccinated by sometime in 2022. But I realize I may be more on of the optimistic side than the majority of people. But we’ve got to make the investments to do it. And I think we can.
One of the key things is going to be to see what happens with the AstraZeneca-Oxford vaccine, because that’s the one that has the best possibility for vaccinating billions of people. We haven’t seen the data yet on that, not fully. I hope it ends up being really good data and one that we can use to vaccinate a large chunk of the world.
AMY GOODMAN: Dr. Ashish Jha, we want to thank you for being with us, dean of the Brown University School of Public Health, previously director of Harvard University’s Global Health Institute. We’ll have you back on to talk about so many other issues. This is such a critical time right now.
This is Democracy Now! When we come back, we’re going to look at the stimulus package. Where is it? Stay with us.
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