As the worldwide coronavirus vaccine rollout continues, questions remain about efficacy, virus variants, and how to reopen the country and our schools safely.
On LA Times Today, Spectrum News 1 anchor Lisa McRee talked with Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, who continues his role advising the government through everchanging COVID best practices. She also asked him some questions from LA Times Today viewers.
On the topic of variants, another dangerous strain from the UK has just been identified, along with the original UK variant, the South African variant, and the Brazilian variant.
“Getting variants evolving is not unexpected because this is an RNA virus. They tend to mutate, and most of the time, mutations have no functional impact on the virus, but every once in a while, it does. Particularly, the UK variant and the South African variant do have an impact on the function of the virus. For example, the UK variant transmits much more readily, which accounted for the spread in the UK. There is also some evidence that it makes more serious disease. The thing that we are most concerned about is what the impact is on the protection that is supported by the monoclonal antibodies in the vaccine. In other words, does it escape the protection of the vaccine? Thus far, things look pretty good, at least regarding the UK variant, because there does not seem to be any negative impact on the effectiveness of the vaccines we are using in the United States, the Moderna mRNA and the Pfizer mRNA,” said Dr. Fauci.
However, Dr. Fauci said the South African variant is more problematic.
“The South African variant somewhat diminishes the efficacy of the vaccine, but it does not bring it below a critical level. In other words, the vaccine still works, not necessarily from preventing symptomatic infection, but definitely to prevent severe disease leading to hospitalizations and death. So that is the reason we are taking it very seriously," he said.
The vaccine shortage in Los Angeles County has been a massive issue. Some vaccination sites were forced to close because of a shortage of doses. The question on a lot of Southern California residents are now asking — when will the vaccine supply will be more stable?
“We were expecting a greater number of doses from Johnson & Johnson, and it looks like even though it is a good vaccine, that we are not going to have a substantial number of doses until we get into April and May. I was not anticipating that we would have this much of a problem with the number of doses of the J&J. Right now, in some places, it is complicated to get a vaccine because of this discrepancy between supply and demand,” said Dr. Fauci.
While hospitalizations and deaths have gone down, scientists have been predicting another spring surge. However, Dr. Fauci said it is in our power to prevent a wave from happening.
“I do not think we should accept the inevitability of there being another surge. We can prevent that by very carefully adhering to the public health measures that we speak about all the time. Like universal masking, doing physical distancing, by avoiding congregate settings — particularly indoors — that, plus the rollout of more vaccines, I believe we can avoid and avert what would be a threat of a spring surge," he said.
Dr. Fauci also answered several questions that LA Times Today viewers submitted via Twitter.
Well, there are so many ways that you can mitigate against the children getting infected. The CDC a couple of days ago, came out with their very detailed guidelines for keeping children in school, and getting them back to school. Obviously, we are going to have to vaccinate children, ultimately, but you do not want to wait until the children get vaccinated to send them back to school. Adults, mainly the teachers, will be able to get vaccinated, but even that should not be a “sine qua non,” where you have to vaccinate every teacher before getting children back to school. If you follow various mitigation methods like wearing a mask, physical distancing, cleaning surfaces, contact tracing, and making sure there is enough ventilation, that goes a long way to protecting the children, the teachers, and other education personnel.
Theoretically, you can. What the original studies that prove the 94% to 95% efficacy of the Moderna and the Pfizer candidate showed in their primary endpoint, which was preventing clinically recognizable disease, we do not know yet whether it prevents asymptomatic infections. So, it is conceivable and theoretically possible that you can get infected, but because you are vaccinated, you do not get sick. In other words, the vaccine worked, but it did not protect you from infection which means, you can have virus in your nasal fairings that you can shed and infect someone else. That is why we tell people that even though they are vaccinated, they should still wear a mask because they might be shedding virus that could infect others.
That remains to be seen because there has been a requirement for vaccination in certain circumstances in our country. For example, as a physician who still sees patients, if I want to see patients across the street at the NIH hospital, I have to get vaccinated every year with Influenza. So that is a requirement. I would imagine there might be some requirements for vaccination at some time. There are none now, but I can foresee under certain circumstances such as the situation that I am in as a healthcare provider that you might require people getting vaccinated.
We hope we can contain this particular outbreak in all of its ramifications throughout the world, in a way that does not have the recycling of various versions of the virus so that you have to address it differently each year. It remains to be seen; it is an open question.
I think that we cannot become complacent, and we have to address the situation with the variants. But things should get better, particularly as more and more people get vaccinated. We should see a dramatic diminution, a continuation of the diminution in new infections per day that we are currently experiencing. So, I hope that if all things go well, it will get better as months go by. And, hopefully, by the time we enter 2022, we will have a degree of normality that will approximate the kind of normality we are used to.”
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