Lab 036: Shoot Your Shot - A COVID Update

I can't believe it's the last episode.

I can't either.

It feels like the start of this semester was like twenty years ago, but then also yesterday.

No sense of time here. We've covered quite a few things this semester, but the thread that has been just tying it all together has been COVID nineteen.

Exactly.

Every single episode has been COVID adjacent because everything has been touched by this pandemic.

Absolutely, back in February, we did not know it would be like this.

No, you know, I wasn't ready.

It was maybe the first week of February when we interviewed doctor Kismikia Corbett at the NIH and we saw everybody ramping up their efforts, working late, and we felt confident. We felt like the infrastructure was there. Based on what we saw, we said, surely the CDC will screen people. That's nothing new, That's what they're supposed to do, right, And that's where we left season two.

Yeah, and imagine, to our souprise, everything went completely left after that.

And some of you guys reached out. You said, hey, have really changed since your last episode. When are you gonna do something different? When are you gonna tell people what's going on. So here we are.

I'm TT and I'm Zachiah and from Spotify. This is Dope Labs. Coronavirus has been like a pressure cooker on all things, all of the cracks in the foundation, all of the deficiencies in our infrastructures. It was brought to light because of the pandemic, things that we probably may have never found out in our lifetime or in this generation. Coronavirus said, here it is. I'm trying to light on it right now.

Today's episode is a coronavirus update. Is about the advances in science and the public health plans to help communicate those advances.

And what we want to do in this episode is better understand what has happened since COVID began, specifically from a science communication perspective.

Everybody became an expert. There's information everywhere, people are making their own graphics, all kinds of things. It's hard to know what to believe. And so what we want to do is do a hard reset to say here's where we are and here's what's coming next. So let's jump into the recitation. What do we know?

I think one thing that we do know is that we are experiencing another spike in COVID cases, so people being admitted into the hospital and deaths are all on the rise right now.

Yeah, and it's really interesting. If you look at a map, the Midwest is being hit particularly hard, Wisconsin, North and South Dakota, Minnesota, Iowa, Nebraska, the whole area is dark red.

In the US, there have been over twelve million COVID cases and two hundred and fifty seven thousand, sixteen deaths.

The vaccines are here and things are happening. On November thirtieth, Moderna submitted an application to the FDA for authorization of this COVID nineteen vaccine, and then another committee just decided healthcare workers and nursing home residents will be the first people to get the coronavirus vaccines. Yeah, that's very true.

And some folks are excited and some folks are not so excited about the vaccine rollout.

So with that, what do we want to know?

What do we need to know about these new vaccines that are going to be available what seems like very soon.

And you know, this is one of the first urgent worldwide rollout of a vaccine, and I think people need to understand this is not going to be like a free for all, Right, how is this going to be distributed?

Back in twenty nineteen, we talked about vaccine hesitancy in one of our episodes. So, when it comes to vaccines and getting vaccinated, there's like three flavors. There are people who are all the way on one end of the spectrum, and they will not get a vaccination regardless of the circumstance.

There's no way you can convince them.

Then you have people who will get the vaccine as soon as it's available. But then you have this huge chunk in the middle of people who are vaccine hesitant. I want to know how that has changed with the coronavirus. I'd imagine that people are feeling a little bit different about being vaccinated themselves for COVID.

Yeah. I think that's a really good point vaccine hesitancy as it relates to coronavirus, vaccine hesitancy broadly, and has the game plan changed since twenty nineteen for combating vaccine hesitancy?

And then I guess the question that I think everyone has now that we've all experienced a pandemic, will there be another pandemic like COVID? Nineteen and what have we learned that can get us through a pandemic better the next time?

All right, let's jump into the dissection.

Our guests today are doctor Rue, Polly Lamay, and Molly Sour.

I'm Rue Poly Lamay. I am a Associate scientist at the Johns Hopkins Bloomberg School of Public Health, and I am in three departments Department of International Health, Epidemiology, and Health Behavior in Society.

I'm Mollie Sower and I'm a research associate at the International Vaccine Access Center and the Department of International Health, also at the Johns Hopkins Bloomberg School of Public Health.

Doctor LeMay is a repeat guest. We had her back on Lab four, Protect Your Neck, which was all about vaccines.

Yes, and she told us all about how vaccines work and what happens when you take a vaccine. The vaccine is basically like a movie trailer. It's a preview of the viruses to come so you can recognize it when it actually comes. So it just prepped your body and says, hey, be on a lookout for this dude that's going to show up or who might show up.

So we had doctor LeMay in Lab four with Protect your Neck. That was the introduction of vaccines. Then we had a chance to talk to doctor Kismikia Corbett who was working at the National Institute of Health, and she was working on the coronavirus vaccine that's actually the Maderna vaccine that's been getting a lot of press lately, and so we wanted our guests to walk us through how we got to a vaccine being ready for public distribution so soon from February to December.

Here in the United States, what we can normally do from an administration perspective is do something called an emergency Use authorization through the FDA, and essentially what that does is that speeds up the process to get some sort of therapeutic to the market.

People are hearing emergency Use authorization, it's easy to think this has been rushed through, and it doesn't help that the administration called this committee Operation Warp Speed.

So what they're doing with the Emergency Use authorization is that they are shortening the process to approve the vaccine so that everybody can get it faster. This pandemic is going on, lots of people are getting sick, lots of people are dying, so there has to be a response to that, like, we can't have the same process that you would normally go through for a full FDA approval.

But in fact, the emergency use authorization allows the FDA to focus more on shepherding this through, right, so devoting more resources here to this process. Whereas normally you have to wait they have a certain amount of time. They can now put everybody on this project. So for some of the rules that used to exist for these medical countermeasures, they might not be so necessary, or there may be some things that you don't actually need, or waiting periods

So the reason that this is important for us when we're talking about this is that we can essentially break the cycle of the pandemic in two ways. Right, people can be exposed to the virus or they get a vaccine. Unfortunately a lot of people have already been exposed to the virus. We can increase her immunity by getting people the vaccine. And so with these two things together, we will be able to fingerish crossed. We will be able

So when we think about controlling the outbreak with the vaccines, and you consider this emergency use authorization, there are a couple of things you want to understand to measure how well a vaccine works.

You've probably heard the term efficacy and heard the term effectiveness. We're throwing around a couple of different terms sort of interchangeably, but there is a bit of a difference that's important to note.

Efficacy is basically how well the vaccine works in the last.

So when we're talking about the information coming out of these clinical trials, these human trials that have been done over the last several months, we're looking at efficacy, which is in a.

Controlled setting where we're setting.

Up specific individuals who are receiving a placebo and the receiving a vaccine.

We are getting a measure of how.

That vaccine is working to prevent infection or prevent disease among those individuals.

The effectiveness of a vaccine is once a vaccine is put out into the population, how well it works in the real world.

When we go into a broader population, we can start to measure effectiveness, which is sort of taking out that controlled component of the environment that we're testing.

It in effectiveness. We can't know that until the vaccine is distributed because there are a couple of other things that we don't consider host factors. So we're the hosts, humans are hosting this virus. When you get infected with coronavirus, are you older, are you younger? Which underline medical conditions have better outcomes after being vaccinated. Do you have a

If other people in your community are more likely to get the vaccine. The effectiveness in your community may be higher, but then in another community it might be lower.

Right, that's basically cocooning. If everybody around you is vaccinated, the virus can't replicate in them and they can't give it to you.

My cousin did this.

We had a Christmas party in Chicago and my cousin had just had a baby. She told us, if you plan on being around the baby, which we all did we're very excited, you have to get a flu shot. So we all got flu shots.

Right, And so what your cousin is doing, She's saying, Hey, my baby can't get a flu shot because the flu shot isn't recommended for anybody under six months, So you guys have to get a flu shot so you won't be a host that brings the flu virus to my child. She was making sure that you guys were creating a cocoon.

So we asked doctor LeMay about the specific vaccines that have been recently developed to combat the coronavirus, What are their efficacy rates and what should we expect.

So in the case of vaccines, the good news is is for both the Pfizer product as well as the Maderna product. Is that when we are seeing these initial numbers right of ninety percent effectiveness ninety five percent effectiveness. To be honest, I think most of us that work in vaccine science these numbers are astonishing.

So the Maderna vaccine has an efficacy rate of ninety four point five percent. The Fiser vaccine has an efficsc rate of ninety five percent. So on November twenty third, Astrazenica announced their vaccine had an average efficacy rate of seventy percent. Remember that's in the lab doing the tests. Moderna came out and said they had a vaccine with an efficacy rate of ninety four point five percent, and then Piser came out and said that they had a

I believe the typical effectiveness for the flu vaccine is somewhere around fifty to sixty percent. Measles is a vaccine that is much higher in the levels of effectiveness and evaccine, but it has to be because we have to have such community conferred among these communities to actually protect people.

I think the flu vaccine is a perfect comparison to what we know about the coronavirus vaccine. The effectiveness, remember that's in the community. Out in the real world, the effectiveness of the flu vaccine is lower, is fifty to sixty percent. And the reason that kind of changes is because of host factors. So did you get your flu vaccine early? Did you go to Walgreens like they told you to get that flu vaccine? Did you wait too late? But a lot of people are waiting later for the

That is such a great comparison because it really puts into perspective how well this vaccine can work if we all kind of buy into it. But what we know is that not everyone's gonna take the vaccine right. There are a lot of people who are vaccine hesitant. We talked about vaccine hesitancy in the Protect Your Neck episode and the reasons why people are vaccine hesitant, but the reasons for why people don't want to take the COVID vaccine they're different pre COVID.

You know, generally people's concerns fell into four categories when we're talking about hesitancy. So one would be ingredients. People were really concerned about ingredients that are in vaccines. Two would be things related to the schedule, and this is related to children vaccines. People are just concerned about the

That is a really good point. People are like, we've never seen polio before, why do I need to get a polio vaccine? And I think we saw this same type of mentality with I don't know anybody who has coronavirus, why do I need to wear a mask? Exactly now in our post COVID world, we're seeing that same vaccine hesitancy, but for different reasons. One of those is scientific mistrust.

That is such a good point, and Zakiah and I wrote an article in Scientific American about this topic, about why folks are vaccine hesitanting. We'll put a link in the show description and in our show notes. Go check out that article. It's called why so many ers are skeptical of the coronavirus vaccine?

And some of the main points that we hit in that editorial. Doctor LeMay also mentions that she and her other public health communicators that they're considering those same things. The first of these is distrust in information.

I don't know who came up with this name Operation Warp Speed, but it does not convey a sense of like systematic scientific thoroughness with regards to the process. That science has taken a backseat. You could see when administration officials would come up and say something, and then doctor Fauci would come right after and say, well, actually that's not exactly right. So I think it is sowed. I would say this distrust.

Yeah.

I mean, for real, let's call a spade a spade. The administration really fumbled the ball.

If I think about what we were expecting based on our visit to NIH in February, and what we got is like how it started and how it ended up. That's not right, right, that's not right exactly.

Like if you go back and listen to that episode Don't Pass the Corona, we sound very relaxed when we're talking about coronavirus.

We're like, wash your hands, wash your hands, cover your mouth when you cough with your elbow.

We sound very relaxed, like, oh, you know, it'll be fine, everything will be fine. And if we had known what was going on behind the scenes, I'm like, panic, panic, panic.

Well, I think that's the thing, right, and that's what doctor Lamay is saying when she says the science took a backseat because we were there with the scientists who were working on that ninety four point five percent efficacy vaccine in the same building, right, And when we saw that, I said, oh, yes, I have full confidence. Right absolutely, the lab coats on the ground knew what was going on. They knew what needed to happen. They had the right information.

And they were were king honey. We were there late. I was like, it is dinner time. These people are like, okay, let's do one more. I'm like, well more what I'm hungry?

I said, If I see another mini prep, I don't know.

It's time for me to retire to the boudoir.

And so I think seeing that gave us this sense of comfort, and because we knew that potential, it felt even worse to see it all just crumble in execution. And I think that's part of why people still have some of this hesitancy, because even if they trust the science, they don't trust it as administered in the right way or that is not politicized or being held hostage for political motivations, especially in an election year.

And we were looking at tracking of how hesitancy has changed related to COVID from March until about now, and what we have found is that confidence or trust in the vaccine development process have dropped by an average of

That is such a good point.

And I think another reason why folks are feeling unsure about the COVID vaccine is because it's a two dose vaccine, so that means that you would be getting two different injections and that's something that most people are.

Not used to.

And this is changing very quickly. When we wrote that article, it was around fifty percent. Now we're talking two thirds of people, so what sixty seven percent? We need a harder reset. We got to turn some things around very quickly.

This widespread hesitancy around the COVID vaccine has really serious implications. For trying to achieve community protection or herd immunity.

We know that as much as two thirds of the population is already saying they're not going to get a vaccine for the foreseeable future at least. What does that mean for our ability to control the pandemic and to control these things that people are also raising concerns about.

We're going to take a quick break and when we get back, we're going to talk all about what we've learned so far and what the new game plan should be.

So we're back and we're talking vaccine hesitancy and what the new strategies should be. So right before the break, we were talking about the increase or the rise in vaccine hesitancy over the past couple of months.

According to doctor LeMay and Molly, effective communication is all about transparency and empathy.

COVID is new. However, what's amazing and awesome about science is that we're learning about it every day, which means we should communicate recommendations as they change. Perfect example that we had to deal with early on was that first the CDC did not recommend the wearing of masks. Right a few months later, the CDC was like, you know,

I think with transparency, it's important for folks to understand that science is ever changing. Every day, the science is changing, and I think part of the reason why folks were kind of like confused, like huh, what is going on is because there is no window into that world to see like, Okay, we learned something new, so now we're going to change the guidance. And I think that that's something that as scientists in the lab, if we pull back this curtain a little bit, there's not anything crazy

I feel like the documentary Totally under Control on Hulu really captured this. I think what we saw was this push and pull. We've talked about it TT on some other people's podcasts about science communication and effective communication and this need to understand this dynamic nature of things changing daily. But that doesn't mesh well with how our leaders speak to our nation, or in smaller buckets, how our governors and mayors speak to the populations. Right, so they want

People have been dealing with us for a really long time. We're looking at communities that have been facing not only the burden of disease, but the economic impacts dealing with missed schooling as.

The education system has been affected. So there's a lot of impacts.

On families and communities and individuals. But there's a light at the end of the tunnel, and we're doing everything we can to help address this.

When we consider empathy and we consider the people who are doing this communication, we also need to hold some folks accountable if we're going to be truly empathetic. Right, there's empathy where you say, oh, I know your kids are at home, but we still need you to work and do all this stuff. But then there is also empathy with action, and empathy with action says stay at

So setting up an infrastructure that is beneficial to all people, not just a few of us.

Right if you say, who has the least individual infrastructure for support? Right, if we ensure that there is infrastructure level support for them, we are building empathy into our systems so you don't have to scramble in the case of a disaster.

Right, I don't want your thoughts in prayers. I need somewhere to live, I need food to eat. Like thoughts and prayers don't really get those things to me. Right, their infrastructure set up. When the power goes out, PEPCO is on the move, honey, Like they know exactly what they're supposed to do. They have protocols and procedures in place to make sure that you will not be without power. We need to keep that same energy when it comes

You've made a really good point. You said, we know this is going to happen. It's happened before. It's happened in smaller scenarios that maybe were just little blips on our news radar because they were controlled really quickly. But there are playbooks for this right And I think another part beyond transparency and empathy is who's giving the message. Because you're more likely to listen to some folks than others.

We're going to have to identify influencers that people trust.

When doctor LeMay says influencers, it's not what you think. She's talking about people that you trust and would listen to when we're talking about things like vaccines, so not Kylie Jenner.

We were talking to someone from the CDC. I was on a different panel, and this poor individual from the CDC was like, why am I not a trusted voice? And I said, the reason you're not a trusted voice is not your fault. It has to do with the fact as how the CDC has reversed guidelines. People think

Even though COVID is a global pandemic, there's been success by approaching communication strategies through a more local lens, focusing on the most effective ways to reach smaller at risk communities.

So we've in Baltimore and in some of the nearby communities, we have looked at ways to leverage social media for different settings. There was a need to engage people and share information from long term care facilities, senior housing where.

Families outside were really concerned.

About what was happening to their family members inside, but there was no way to really be directly engaged. And we knew that Facebook was a tool that they were using on both ends of that kind of telephone line, right, So we were able to work with the city and support them in doing some videos and some engagement using that tool to reach the people who needed the information. So it's really about targeting those strategies and then tailoring

So there's been.

Everything from targeted radio work to share information, to setting up press conferences, to talking to food delivery entities or ways that people are getting some of their basic and leveraging those people to share some of the important health information.

I think that's a really good strategy. At some point I had to turn the news off. I was not watching any more press conferences right but I was getting Uber eats.

I've had a lot of Uber eats. I've eaten a lot of bonshon in the quarantine. If you follow me on Twitter, you know that I've had bon chon, probably.

More than I should have. What have you been getting from overeats?

I'm getting ramen from uber eats, and my goodness, I have been enjoying that. Now you've put a sticky note on the top of that ramen or a flyer that says here's what you should be doing right now, effective I won't see it. I'm gonna see it.

Yes, have every door dash person be handing out a flyer.

And compensate them for doing it.

Exactly if we think.

About making these strides, whether it's general awareness of vaccines, whether it's disputing misinformation and clarifying some missing points, the next step after that information is the action. Yes, and I think that is what feels the most unknown to me. So we know about vaccine hesitancy. Considering what we know, what does this mean for the rollout the delivery of a vaccine?

I think moving forward this idea of how we distribute the vaccine, and more importantly, how we talk about how we're going to distribute it is going to be such a challenge. We're starting with, ideally, those highest risk categories, the people who are most likely to be exposed and to be exposed frequently, and who are going to potentially

This all the time and who we really rely on.

To continue to help control the pandemic. But as we move down those tiers, it does get a bit more complicated and we start to raise a lot of ethical questions and questions about how people are going to perceive this.

Okay, So Business Insider they put out a chart of what we might be expecting for rollout of the coronavirus vaccine. I'm saying in December of this year to January of twenty twenty one, approved vaccines start to go out to the four priority groups, which is healthcare workers, frontline workers, people over sixty five, and people with pre existing conditions.

At that point.

By this time next year, herd immunity through vaccination could be reached in the US if seventy five percent of people or more get their shots. And we'll have more information about all of these different tiers, who's going to be first, last, and everything in between in our show notes, So make sure you check that out.

We're just so deep in the pandemic and seeing all these numbers rise as we move into the holiday season, it's hard to think about what moving out of it will be. Like I'm ready to move out of it, yes, but it's hard for me to see the clear path to that, right.

And then it.

Also makes me think, what will we do differently if this happens again?

Because it will happen again.

Yeah, that's all we do. We're scientists. That's what you do is how do I optimize this? How do I make it better? What variables stay the same? What variables will we change? I think this was really a wake up call because seeing these multiple waves and spikes, I'm like, behavior is not changing. The model tells us what's going to happen if we don't change these things.

Right, Because I mean even when you think of like pandemics from the past, over one hundred years ago, people weren't traveling the same way, people weren't interacting, like we didn't have this globalization that we do have now, right, which is what facilitated the really rapid spread of the coronavirus. So when I think what fifty years from now or another one hundred years from now, which I do care about those folks. I am one of those people who

Yes, what were there? How different will their lives be?

Can we project and be able to put policies in place in order to facilitate them getting through a pandemic safely?

Or will we have short term memory? Because I see people forgetting what we learned in March and here we are just at the cusp of December.

The sad part is we know that this is not the last in terms of a pandemic. At Hopkins, we have been working on modeling and thinking about this pandemic. We do this exercise every year that essentially do like a simulation, but look at transmission, that look at you different types of pathogens, that look at the reproductive rate,

So what have we learned?

One thing that we have definitely one hundred percent learned is how do we make sure that leaders are transparent and accountable. But for this to work, we have to be better as humans. We cannot go around and just as essentially not say things that are incorrect, be inaccurate, put people at risk because you're trying to put your economic whatever sort of as the priority. And to me, that is the one thing we have learned. This is a great opportunity for us to rehaul the partnership between

That is so beautifully sid right, because it really captures a lot of the things we've been talking about this entire season. It's not just are you sick, but do you have the things you need to keep your risk low to keep you away from possibility of future sickness.

Exactly because what we know is is that the effects of coronavirus is not just oh do you have to go to the hospital, do you stay home? Are you contagious or not? It has trickled down effects on all aspects of our life. We've talked about how it affects us socially, how it affects housing, how it affects our food, infrastructure, all these different things are affected by a virus.

Yeah, affected by this vaccine and our response to it. We failed that test, right, Yes, we failed that test, and we failed it really quickly. And so now we've got to stand up and really say, how do we rebuild without those same disparities, without those same inequities that were in our system and that coronavirus so quickly exposed.

Right, we have to be realistic with ourselves and say, these are the things that we did wrong. How can we do the right thing moving forward? That's it for semester three. I cannot believe we have already finished the third semester.

It went by so fast, and I just have so many more things I want to explore with you. Guys.

We're gonna miss you so much, but make sure that you stay in touch and let us know what you want to hear from us in semester four, and we'll be back as soon as we can can. Stay safe, be positive and stay COVID negative.

Yes, and keep your distance, wear your masks and wear your mask.

That's it for Lab thirty six and semester three. But we have so much more for you to dig into on our website. So head on over to Dope Labs podcast dot com.

On our website you can find a cheat sheet for today's lab, along with a ton of other links and resources in the show notes.

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Too special thanks to our guests experts today Doctor Rupali Lamay and Molly Sour.

Make sure you check out our show notes on Dope labspodcast dot com to find out more about their work and how you can follow them.

Also, we love hearing from you. What did you think about today's lab? Do you have ideas for future labs? Call us at two zero two five six seven seven zero two eight and let us know. You can find us on Twitter and Instagram at Dope Labs podcast, tt is on Twitter at dr Underscore Tsho.

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And Zakiah Wattley. Do you think that works? I think I might have been too flustered when I was saying it. I might need to take it again.

Yeah, try one more time.

Thank you friend, Mam.

Do you hear that?

Do you hear it?

Just?

Oh, great support I have. My eyes are watering. It's just so patient