YTread Logo
YTread Logo

Mayo Clinic Q&A podcast: COVID-19 update

Mar 16, 2022
Coming soon at Mayo Clinic that you look at new cases per day in the US It's down to 34,000 now with any other infectious disease we would be saying what is happening that we are having so many cases that we have normalized. to this kind of thing and it's still happening about 1300 deaths a day covet 19 cases hospitalizations and deaths are going down in the us vaccinated communities we just won't get rid of this until we get higher levels of vaccination and probably some level of regular boosters welcome everyone to the

mayo

clinic

i'm your host Dr. Helena Gazelka we are recording this

podcast

on Monday March 14, 2022 and we passed a huge milestone last week we passed the two year milestone of the world organization of health declaring

covid

19 a pandemic can you believe it well infection rates and hospitalizations in the United States continue to decline globally.
mayo clinic q a podcast covid 19 update
There are some areas of concern here so give us our earnings 19

update

s and share more on this. it's dr greg poland the

mayo

clinic

is our expert on virology and vaccines thanks for being here greg good morning helena good to see you well great to see you too just realized greg we'll probably launch this maybe on the day patrick's so we probably should have been wearing our green until today. we're doing these

podcast

s a little less often but we might do an extra one if something happens but you're so right when you open you know you're looking at new cases per day in the US it's down to 34,000 with any other infectious disease, we would be saying what's going on, that we have so many cases that we've normalized to this kind of thing and there are still about 1,300 deaths happening every day, which is really important when If you mention other areas of concern, you know that the mass it's starting to come out essentially all over the world and there are two areas we really need to worry about. that mass is off so this is, you know, when you and I last talked, we urged to go slow here, we're in the, you know, if we think of it as a four lap race, we were in three laps and we could see what we expected. be a finish line thing but you keep running and walking you drink you know you're doing the right thing in terms of getting to that finish line um I think the other way when we think about why a potential would be this variant of ba2 um that's happening you know you look at i just look back at some of the data in the us on january 29 only one percent of all our

covid

sequences were ba2 on feb 6 it was 3.6 today it's 12 in new york and new jersey there are 17 that we have to wait to see you well k now it seems to be between 30 and 60 percent more transmissible it does not seem to be more serious I think most of these cases are very mild cases that occur in people that have not been boosted and this is where the risk is unvaccinated people so we should just not get rid of this until we get higher levels of vaccination and probably some level of regular boosters consistent with what we've seen through of all You give the variants and we, as we've consistently seen and as you and I have repeatedly pointed out based on this data that you know there's another really interesting indicator.
mayo clinic q a podcast covid 19 update

More Interesting Facts About,

mayo clinic q a podcast covid 19 update...

I'll just take a minute to explain this, but in about 650 municipalities that's not an easy word to say in the US, the CDC and local health departments are doing to use a kind word, wastewater surveillance, okay so they actually take them and then test them for the presence of the covid virus and sequence them much more cost effective than trying to do every single individual that lives in that muni cipal area so 650 areas in 28 of those areas, the number of viruses has gone up over 1,000 percent and that's a very sensitive indicator where we see about 7 to 14 days before we start to see a spike in cases again, that has concerned me, we've talked a little bit about this before, but some of those sewage tests in new york city, for example, show some very unusual sequences, the technical name is cryptic, but very unusual sars cov2 sequences that we haven't seen before.
mayo clinic q a podcast covid 19 update
I don't know if they're from animals, they're from humans, but you put all of that together, you put the infection together with the deer, so another animal reservoir of disease, and again, I just urge people to be careful, I think it's too early to tell. take off dough inland areas i think we still need to do the non-pharmaceutical interventions and get vaccinated or boost if not to stay safe and try to buffer this as much as possible i mean 1300 deaths a day and we think well ok , the pandemic is over, imagine if you know what a 747 hold is, let's call it 400 uh people or so if three or maybe four 747s crashed out of the sky every day in the US we would say oh yeah things are better we would be outside of ourselves demanding an explanation so you know we're getting there but let's slowly move towards this idea that we can drop all these precautions and the pandemic is over it's not wise advice right now you were just mentioning vaccines Before, as we often tell me, what about the new vaccines?
mayo clinic q a podcast covid 19 update
What is happening in that field? expect two if not three new vaccines to come before the fda one made by medicago in canada one made by novovacs here in the usa and a third made by a partnership between sanofi and gsk all three are protein vaccines recombinants and I think this mom would appeal to some people who have been hesitant about adenovirus or mrna vector. Sorry mrna virus vaccines uh because they are proteins. A well known platform. the data that I've seen for two of these, the reactogenicity, the side effect profile is very, very mild, so I think this may be a very important factor in getting us to the finish line of people getting immunized and getting boost to prevent infection Speaking of immunizations, greg, i have a very personal interest in seeing two and three year olds get vaccinated with my grandchildren.
What's the latest on children and vaccines? and maybe even a little nuanced with care I think the headlines do a bit of a disservice here so let's break them down into several different groups so for under fives the vaccine didn't do well in pr Taking into account In the results of interest, this is most likely due to the extremely low dose they used, so they were trying to balance in the first study for reactogenicity - you don't want to have a high fever in young children, that's a much more concerning situation. that in older children where you can do a test and rule out things like meningitis and pneumonia it's much more difficult in young children and infants so I think the problem is that the dose is too low so they are redoing the study by adding a third dose to see if that will give them the efficacy that we would like to see happen in the yes I know I also have a grandson I want to see that happen in the 5 to 11 year olds and the 12 to 17 year olds we are saw I'm having almost a little bit of an accelerated phenomenon from what we've seen in adults and that's for these vaccines against this pathogen, the immunity that prevents infection is different to the disease that prevents infection going down and going down moderately fast compared to other v the vaccines we're used to, so let's look at kids ages five to 11 after their second dose and the same with kids ages 12 to 17 after their second dose if you see 90 to 150 days that the efficacy of the vaccine against asymptomatic and symptomatic disease begins to decline to 30 or 60 percent, not the 80 or 90 percent that it was shortly after the second dose, so you know there is more work and reflection to come do about whether even in that age group a booster may be needed or as we get to the second and third generation vaccines, will we be able to do it in two or three doses and be done or will it be something where we get a booster every six to 12 months?
We're still beginning to understand that greg, a little bit earlier, you were talking about greed-related mortality and the incredible number of deaths in the United States and around the world since this pandemic began. I have read something about excess or vicarious deaths related to greed and that we can. be underestimating tire deaths by almost three times do you think about that? No, yeah, I think that's a study you're referring to, it's a truly massive global effort and in that sense, kudos to those researchers and I think that number is likely to vary in different regions, we have a hospital and a public health system that is more likely to pick them up than, say, low-income countries that may not have the same infrastructure, but even in the US Helena, the estimate is that the number of covid-related deaths is probably underestimated by as much as 300,000. which means we haven't had a million, we've probably had over 1.3 million deaths due to greed and this can happen to our listeners who may not understand why that would be.
It's one thing if a patient comes to us with covid pneumonia and ends up dying, that's a pretty clear case, but what if he comes in with a stroke and dies from that stroke and we find out he has coveted pneumonia, well, not? We know this is different than what we knew two years ago or even a year ago now we know that covid induces a hypercoagulable state you are more likely to have kidney damage, stroke, heart attack as a result of covid so which is underestimating that because we don't have a standardized way of saying if you've had covid in the last 30, 60, or 90 days and then say okay, the clinical symptoms you came in with and the disease you have is related, that's kind of hard to do and so those estimates, greg, i was also wondering about the incredible toll this has taken on people's mental health.
Would they be counted in a study like this? mentioning it i hadn't thought to mention it but both in mental health cardiovascular neurological we are seeing side effects actually it's funny because my daughter who is a mental health specialist once said this she said daddy mark my words after this pandemic you're going to see a pandemic of mental health problems and we really have more serious ones and those who were hospitalized, but even those who were not hospitalized new diagnoses mental health hospitalizations because it's your area of ​​specialty helena, I think you'll be interested in it's a 34 36 somewhere about that percentage increase in opioid use disorders, um, and this is all related to the ripple effect of what this pandemic has done, changing lanes just a little bit, what do we know about the neurological side effects of opioid use disorders? vaccine versus neurological effects of a cova-19 diagnosis, yes that is a very good question and some interesting articles have appeared before on this and you know anything that causes a neurological side effect is worrisome let's not cover this up and you and I have pushed for transparency as anyone best knows the data has neurological side effects that have been associated we don't always know if they are caused so I'm using a bit of sc scientific nuance here but associated with these vaccines more so for the in this particular study with the johnson and johnson vaccine about 0.15 percent of people who got that vaccine reported some kind of of neurological side effect for the mrna vaccines was terribly low 0.03 percent what kind of side effects we're talking about, well the cerebral venous thrombosis was a guillain-barre that came out of this study are new seizures, very, very low, but he doesn't want to see any if possible, but then he has to say well, if I don't get vaccinated because I want to avoid that risk, what is the risk that that happen if they covet me?
And this is where you know we've talked about this over and over again about the wisdom that resides in that balance. The risk of those same neurological side effects occurring if you are coveted and have not been vaccinated, depending on the disease we are analyzing, is 132 to 617 times more likely in the unvaccinated and this is worrying, and we are just starting. g to see papers coming out showing that people who have had covid, even mild covid, which is worrying, are seeing evidence of shrinking brain tissue and degenerative changes now this is of interest to us as researchers because after the influenza pandemic of 1918 was an unusual strain not of covid but of influenza there were neurological side effects that developed in people who got infected some of which went undetected for years afterward and I am very concerned that as these papers come out it will show the long-term effect of covid on the brain, cardiovascular nerves, reproductive health, etc. that we are going to see how to call it a pandemic of complications that will arise in the next few years and people who did not get vaccinated and that are becoming coveted and we can improve that if not prevent that by simply using these vaccines so they are not free of risks let me be very clear and honest no vaccine and I am a vaccinologist is completely freeof risks but you have to balance that against the risk of contracting that disease and the complications that result and the simple headline in the case of neurological problems is that if you choose not to get vaccinated and you get infected, what will happen with these types of highly transmissible variants, your risk for those same neurological side effects is more than 600 times more likely to have another adjunct to the vaccines good for you i want people to be aware because it's heartbreaking when we see these issues and we know this could be prevented ok greg , i have to ask you to put on your thinking cap now we're going to ask listener questions and you know how our listeners yes they challenge i love this first question because i hadn't thought of asking you but it's a great question how does a virus become seasonal And when a new flu variant or strain appears in the southern hemisphere, why don't we see it until October? will it covet to continue as it currently is or will it become seasonal those are good questions are there any others those are really those are really good questions and you know again a gold star for our listeners i'll try to remember that there weren't about three questions involved there so what Why does the flu take a while to arrive?
No one really knows the exact answer to that. We have theories that mainly revolve around the fact that when winter comes you have a variety of respiratory problems. illnesses including flu related to being crowded indoors lower humidity levels lower ambient UV light levels, etc. probably explains that and yet this is fascinating because it has never been seen before in human history a year ago when most of us and the vast majority of us were using mass in part because we had to implement mass mandates, essentially for the first time. time in human history there was zero influenza in the US is that we don't fully understand whether you want the virologic or immunologic rules that govern all endemic media is that there has been enough immunity that it has suppressed one against the reference level endemic is not normal, it just means that we always have a group of susceptible people that allows the transmission of the virus to continue at a lower level.
We are not endemic. no 1300 deaths a day should not be considered normal or endemic and I hope we will continue to see that drop as people get vaccinated and realize these things but I don't want to be the bearer of bad news but I think it's very likely that this summer or fall let's see this spike again because we have enough unvaccinated people and currently enough people who are too young to get vaccinated, so if we continue to see these highly transmissible variants emerge, we'll see surges again. So, greg, one answer to the question of how does it get seasonal was the fact that we're further in in the fall, yeah, yeah, I always understood that kids go back to school, people go back to college, they live close . s yes, so you're in, you know, you materially change the dynamics of people's movement and you're changing environmental environmental conditions, uh, and we think it's that combination of factors that increases respiratory viral illnesses, okay, our next one is question is from a gentleman who is 68 actually i dont know if he is a gentleman so my apologies a person who is 68 and in reasonably good health has retired as a high school principal and since the availability of vaccines has been filling various subs managing positions they are a little concerned this person is a little concerned about working on campus when masks were mandatory and that changed and they no longer require masks this person is overly cautious at their age and would appreciate your input on this if you had To put a label on this, I would say that this individual is a wise and insightful individual and I mean that he or she, by virtue of his age, he is at greater risk of compensation.
Complications of coveting infection plus you're working in a higher risk environment most schools I know of now have removed mass mandates prematurely I think and when you look at that age group whether we're talking about elementary school , high school or college. older students, as opposed to people 65 and older, where immunization rates are over 90 percent in those age groups, you're talking about substantially lower immunization rates, so it's a mature set of conditions for continued transmission of the virus and you know maybe a 12 year old may have moderate to mild illness may or may not have a complication a 68 year old is much more likely to have that side effect so which for that individual i would say make sure you have had your full series of shots get your booster and continue to wear your mask on campus ok thanks greg those are the questions i have in the mail folder today do you have any last thought for us? k the warning that we are seeing a surge in cases in geographic locations and countries that many of us believed had prematurely abandoned mask-wearing and non-pharmaceutical interventions and have truly stopped pushing and encouraging people to get vaccinated i think it's a bug i think it's a bug that will probably come back to haunt us as individuals as communities um as nations so uh i i what can you say but what we've said all along mano space space and vaccines works thanks greg for being here today our pleasure to thank dr greg poland virologist and vaccinologist at mayo clinic for being here to give us our covert 19

update

s i hope you learned something i know i did and we wish each of you a wonderful day mayo clinic q a is a production from the Mayo Clinic News Network and is available wherever you are and subscribe to your favorite podcasts s for a list of all podcasts from the mayo clinic visit newsnetwork.mayoclinic.org then click on the podcasts thanks for listening and feel good we hope you will provide a review of this in other episodes when the option becomes available also comments and questions can be submitted to the Mayo Clinic News Network at mayo.edu

If you have any copyright issue, please Contact