on pbs.
John: The United States is
experiencing what's become a
familiar pattern, an uptick in
covid after the holidays and the
big gatherings that accompany
them.
Hospitalizations have risen
eight weeks in a row, though
they're below what they were in
the last post-holiday period a
year ago.
Hot spots have cropped up across
the country as the new dominant
variant jn1 has quickly spread
to account for more than 60
% of cases.
Jessica malaty Rivera is an
infectious disease
epidemiologist at the de
Beaumont foundation, a
philanthropy that promotes
public health.
Was this surge right now in any
way a surprise, or is there
anything unusual about it?
Dr. Rivera: It is not that
unusual.
The virus continues to evolve as
more and more people become
infected, and the virus makes
copies of itself and mutates, it
changes.
It gets better at evading our
immune systems and making people
sick.
What is encouraging is that
because of our hybrid immunity
in the population between
previous infections and
vaccination, not as many people
are becoming seriously ill and
dying, though we are seeing
hospitalizations continue to
increase as more and more people
become infected.
The fact that we are seeing a
surge, though, is not a
surprise.
In fact, it doesn't quite
actually have the same
seasonality as other viruses
like flu, or rsv, where we kind
of see covid come every few
months in these big surges.
John: As an epidemiologist, what
does this suggest to you about
the future of our relationship
with covid?
Dr. Rivera: Yeah, it's a great
question because I think we need
to be preparing ourselves for
living with sars-cov-2, the
virus that causes covid 19,
because it is well-established
in the human population and
among other populations in the
animal kingdom.
And because of that, the odds of
us getting rid of it completely
eliminating and eradicating it
is unlikely.
And so in the same way that we
see flu kind of continue to
reemerge in our community every
year, we'll probably have to be
dealing with covid outbreaks a
couple times a year, maybe 3 or
4 times a year, but the hope is
that between our previous
infections and vaccination, we
will become better at preventing
those serious illnesses and
deaths.
John: You talk about sort of
getting used to living with
covid.
Does that mean we can sort of
forget about it, that we can
sort of be blase about it?
Dr. Rivera: It certainly does
not mean that.
And I think that's a very
important point to raise,
because covid is not quite yet
in the rearview mirror.
Yes, the state of emergency has
ended, but covid-19 is here and
it's here to stay.
And so when I say living with
covid, it means understanding
that people will continue to get
sick.
We need to continue to encourage
all of the mitigation efforts to
reduce infections and severe
illness.
That includes masking, staying
home when you're sick, testing
at the appropriate time,
vaccination when it's updated
and available to folks because
this is going to be part of our
lives.
John: And as you say, the
federal public health emergency
ended in may.
A lot of things went away.
The public campaigns about
masking, about testing, about
getting the vaccinations and
also the tracking also ended.
Is that a handicap to an
epidemiologist like yourself?
Dr. Rivera: It is a severe
handicap.
You know, as an alum of the
covid tracking project, our work
was focused on tracking all of
that data at a very granular
level.
From the state level, we were
tracking testing and cases and
hospitalizations and deaths, and
we did that on a volunteer
basis.
And now, because the emergency
is over, you're not seeing the
kind of funding that we need to
be funding both the CDC and
those state public health
departments to get that granular
data.
We have many resources.
We have some dashboards,
hospitalization data, we have
wastewater surveillance.
But we are a bit like we're
flying blind when it comes to
understanding the full scope of
what's happening with the virus
in our population.
John: And as you say, we don't
have it in the rearview mirror
yet.
But are you concerned that the
public may feel like it's in the
rearview mirror?
Dr. Rivera: I'm very concerned
about that.
I think, you know, it's
difficult to see a lot of people
think about covid as not that
serious, think about masking as
something that was an artifact
of the past.
It is a very, very normal thing
to mask when you're sick, to
mask when other people are
immunocompromised.
It was part of our public health
infrastructure and health care
settings.
So you know, how political it's
become, how contentious it has
become, is quite discouraging
because these things are
effective at helping reduce
harm, which is the basis of
public health.
John: Jessica, we asked our
viewers what they wanted to ask
on this topic.
Rebecca rose in Philadelphia
writes, "Do you think getting
back to 2019 normalcy is
currently in place or possible?"
Dr. Rivera: You know, I would
actually like to pivot the
question a bit, because I think
the conditions of 2019, in the
many years prior to 2019, is how
we got here.
For many, many years, we were
dealing with the defunding and
the de-prioritization of public
health, which is why we were so
unequipped and unprepared for
the impact of sars-cov-2.
And as a result, we are now
reactive.
And instead of being proactive
to something that's
destabilizing.
Destabilizing, I don't want to
go back to 2019.
I want to see a much more
well-funded and much more
prioritized public health
infrastructure in the U.S. And
globally so that we can be
better prepared and better
responding to something as major
as a global pandemic.
John: Laura in New Jersey asks,
"Should we be wearing masks?
Should public places like gyms
report when their instructors
have covid and tell the public?"
Dr. Rivera: I think masks are a
very important part of our Swiss
cheese model of protection,
right?
It's not one thing that's going
to completely eliminate risk.
Risk is subjective and it is
also additive or prevention is
additive.
So will masks help reduce your
risk when you're in very
publicly crowded places like
airports and malls and indoor
theaters?
Yes, it will.
Mandates I don't think are going
to come back anytime soon.
And so as a result, I think it's
a very personal choice.
I encourage mask wearing in high
risk settings.
I personally continue to mask in
high risk settings, and I think
it should be part of our public
health practice moving forward.
John: Jessica malaty Rivera, an
epidemiologist at the de
Beaumont foundation.
Thank you very much.
Dr. Rivera: Thank you for having
me.
♪♪