[music]

Melissa Harris-Perry: Welcome to The Takeaway, I'm Melissa Harris-Perry. The weather outside is frightful. Heavy snow, high winds, frigid temperatures, and icy roads are creating dangerous conditions across much of the country.

For holiday travelers who made it over the river and through the woods before the bomb cyclone whipped through, it means heading indoors, sealing up drafts under doors and windows and huddling together. Conditions which could fuel the tripledemic of RSV, Flu, and COVID already taking a toll on our communities. While some experts are saying the peak of RSV may be past us, the flu and COVID are surging.

In this season of sickness, an increased demand for many over-the-counter medications has triggered shortages in some parts of the country. Some of you told us how the tripledemic is affecting you.

Caller: I live outside of Salt Lake City, Utah. My family just had a battle with RSV and COVID at our home and we definitely struggled to find enough children's Tylenol and infant Tylenol. They're different actually. I had to hit up quite a few stores and ended up going at midnight. The night after I got back from the hospital with my daughter who had been in for oxygen treatment because she had RSV. I finally found the Walgreens that had like four left of the liquid Tylenol.

Melissa Harris-Perry: When there ain't no medicine and there's a surge in illness and the policies that were enacted to protect the public have largely disappeared, what does it all mean for our ability to act both now and in the phase of future public health crises? Joining me now is Gregg Gonzalez, the Nation's public health correspondent, co-director of the Global Health Justice Partnership, and associate professor of epidemiology at Yale School of Public Health. Gregg, welcome back to The Takeaway.

Gregg Gonsalves: Thanks for having me again.

Melissa Harris-Perry: Give me a sense. Should we be expecting this tripledemic to get worse before it gets better or are we on the downside of these infections?

Gregg Gonsalves: It depends which of the [unintelligible 00:02:18] pathogens we're talking about. There's some suggestion that RSV cases have peaked potentially in the United States although there's some variation by region. We had an early onset of a flu season with a particularly steep slope of increases of cases. It's hard to tell if it's going to plateau or is it going to peak over the next few weeks. And COVID is starting to inch up. You could see after Thanksgiving, the deaths [unintelligible 00:02:42] consistently be over 400 deaths per day at least when you look at The New York Times website. I think there's some expectation that there'll be another increase as we pass through the Christmas and New Year's season. As you said, people huddle together and togetherness with families will probably see a couple more 100 deaths per day above what we're seeing in December.

Melissa Harris-Perry: Help me to understand the current mortality and morbidity associated with COVID. Are the categories of people most vulnerable throughout the pandemic, the same categories? Are we still seeing death primarily among the elderly, among those with preexisting conditions or has that shifted at all?

Gregg Gonsalves: A couple of things. This is not March or April 2020. We have a lot more things at our disposal to buffer us against the worst ravages as COVID-19. In particular, the vaccines, [unintelligible 00:03:35] as [unintelligible 00:03:38] in certain populations, it does seem to have an important effect, particularly in people at high risk and are elderly. We're not in a situation where we're seeing thousands of deaths per day that we saw at the peak of the epidemic or even last year during our Omicron first wave. We're still seeing 300-400 people die per day. COVID will end up being the third leading cause of death in the United States for three years running. There's been a little dip in that and it's only down at six when I looked up the data for October.

It really means it's a major killer in the United States. We also have the largest per capita COVID deaths and excess deaths compared to our G7 Peers. Other countries that are economically similar to us. We're seeing a high level of mortality in the United States that we've seemed to accepted over the past few months. That being said as The New York Times and others have reported, we're seeing more and more people who are vaccinated ending up in the hospital and getting sick, particularly among our elderly.

The vaccine is an important part of keeping people healthy and safe but the new variants are particularly good at evading immune responses. We're seeing people who are vaccinated also ending up in the hospital and among those 400 per day who are losing their lives to this virus. We also know that the latest variants are able to evade some of the monoclonal antibody therapies that we use. It's the best of times, it's the worst of times in certain ways.

Melissa Harris-Perry: I want to dig into two different parts that you've given us here. One is this question of the tools we have for protection and for fighting back. Then the other is about the idea of American deaths versus global. Let's start at that second. We have maybe the highest among G7, but what we're seeing right now in China-- Can you talk about this reversal of the zero COVID policy and of how deaths are being accounted for and what this might mean?

Gregg Gonsalves: A catastrophe is unfolding in China right now. They've gone from a zero COVID policy to almost "let it rip" strategy. The projections are that millions and millions of people are going to become infected. We're going to see a million or more deaths over the next weeks in China. This is extraordinary. They didn't use the time wisely during their strict lockdowns to vaccinate people and get them boosted. Relied on their own vaccine, which is not as powerful against serious disease and hospitalization, and death. They are incredibly vulnerable to this virus right now because of the choices that were made.

What happens in China doesn't stay in China. There are a couple of things to think about. One is, with all these infections pouring out of China, we're going to see definitely upticks in neighboring countries. More people infected means more variants. Not saying that they're going to come from China, but the point is we need less infections across the globe than more infections across the globe. This is just a bolus dose of new infections that we're going to see in the millions in China.

The other thing is your caller and the person who spoke at the beginning of the segment about shortages in medicines is tied to China as well. China's an important part of our global supply chain in terms of generic medicines and active pharmaceutical ingredients for other manufacturers around the world. The disruption in China, due to this massive unfolding of the pandemic there is going to have knock-on effects that have nothing to do with the direct effects of the virus.

Melissa Harris-Perry: All right, you all, we have to take a break. More of this conversation in just a moment. [silence] We're still with Gregg Gonsalves, the Nation's public health correspondent and associate professor of epidemiology at Yale School of Public Health. Gregg, you just said something about the choices that were made in the context here of thinking about how China did and did not use its time during the severe lockdowns. Can you talk to me about the choices that have been made in the US around maybe less the question of what vaccine we're using or what treatment, but public health protection policies from masking to strategic closures? The politics of that now, if we were to see a spillover another March of 2020 moment, are we capable of responding sufficiently, adequately? Did we use our time well?

Gregg Gonsalves: I would say not so much. Unfortunately, there's been a political imperative over the past year or more to downplay anything but vaccination and treatment with [unintelligible 00:08:33] as the core of our response to the pandemic. Now, there's two things going on here. One is the Congress is not interested in spending any more money on the pandemic. The coffers are dry in terms of spending, making new, huge investments in pandemic control in the United States. That being said, we do not need the White House saying that "If you're vaccinated and have access to [unintelligible 00:08:56], the rest is noise."

The point is that we're seeing these increases in three respiratory diseases right now that are overwhelming pediatric infectious disease units, et cetera, that have been all over the paper. We need to use all tools at our disposal. Masks had become the cultural taboo for people on the left and the right but even outside of the context of mandating them in public settings, which might be good to do during a surge as we're entering into.

You could have some full-throated endorsement of this simple intervention by the President all the way on down. To be fair, better late than never, there's some suggestion from the CDC Director and others that in certain places around the country it may be time to don a mask again this season, and several cities around the country have made those recommendations on their own. As the President said a few months ago, we're starting to act as if the pandemic is over. We're not using everything at our disposal. We've backtracked to think of ourselves as a [unintelligible 00:10:01] nation, that's a whole--

We're dealing with vaccination as our primary goal but only about 14% of Americans have the by mail and boosters. Even with that, we're still on the backfoot, and that, again leads us into the situation where we're at the top of the leaderboard in terms of excess deaths and per capita COVID mortality around the G7. We're just not using all tools at our disposal because politicians now think of all of this is politically toxic for them. It's as if Ron DeSantis has gotten into everybody's heads and we're reacting to the worst instincts about how to deal with public health.

Melissa Harris-Perry: Indeed, you just named [unintelligible 00:10:39] Ron DeSantis, and coming out of Florida is a group of so-called health freedom activists opposed to COVID protocols. Several were recently elected to the Board of Sarasota public hospital, and it has thrown the hospital board meetings into chaos. I want to take a listen here to one of the activists who spoke at the board meeting in late November.

Activist: It is blatantly obvious that there is a more sinister scheme at hand and this hospital is one of the countless hospitals to become a victim at the hands of government overreach.

Melissa Harris-Perry: Some of these activists are upset that certain kinds of medicines that have been indicated not to have any effect, but that they weren't administered, others are saying the hospital inflated COVID deaths for profit, which is a false conspiracy theory. How concerned are you about this cultural war just raging within public health institutions?

Gregg Gonsalves: One is, let's look on the bright side. There's plenty of wonderful public health people around the country that are working day and night to keep all of us safe.

Also, among our clinicians, and folks in hospitals and clinics. There's a rising anti-science, anti-public health movement, and Florida is ground zero for it, but we see it all over the place. You can even say almost the entire Republican Party has sort of going hook, line, and sinker for this kind of antagonism towards basic public health practice but again, there's a weird reaction to it from the Democrats and the Biden administration as if they don't want to go head-on and challenge Ron DeSantis in all of what's happening.

They're backing off on public health protections themselves, not from a conspiracy-minded angle, but from an idea that it's toxic for a whole set of Americans. Why lose any political capital in trying to add features to a pandemic response that people don't want to do?

Melissa Harris-Perry: People are going to be getting together with their families over these next week or so. Are there ways that we can protect ourselves and our loved ones?

Gregg Gonsalves: It's interesting when you read Times, or The Washington Post, or other newspapers, you'll see that in their advice to house sections, they say do what we should all be doing and have been doing for the past three years. If you're about to go see your family and friends, get a rapid test, make sure that the morning you leave for someone's house that you are rapid test-negative. If you're in a warm part of the country, try to do your events and you're socializing outdoors.

If you can wear a mask in certain situations, if you're doing some sort of public celebrating, try to do that. If you can get some sort of ventilation in your socializing or celebration space, portable air filtration, do that as well. We're not helpless, all right. Make sure you're vaccinated but use rapid tests as a way to manage your risk and your risk to others. Masking and ventilation is key ways to do that as well.

Melissa Harris-Perry: Gregg Gonsalves is public health correspondent for The Nation. He's also co-director of the Global Health Justice Partnership and associate professor of epidemiology at the Yale School of Public Health. Gregg, thanks for your time, and be safe this holiday season.

Gregg Gonsalves: You too and thanks for having me again.

[music]

Copyright © 2023 New York Public Radio. All rights reserved. Visit our website terms of use at www.wnyc.org for further information.

New York Public Radio transcripts are created on a rush deadline, often by contractors. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of New York Public Radio’s programming is the audio record.