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Brian Lehrer: It's The Brian Lehrer Show on WNYC. Good morning, everyone. How much shutting down is the right response to the record coronavirus deaths and hospital demand that we're seeing right now? How much does it hurt when Democratic Party politicians don't practice what they preach about not traveling and avoiding crowds? What's the right order for distribution of the coronavirus vaccine. How should public health officials deal with the weirdly opposite challenges of telling some people they can't get vaccinated yet and convincing others to take the shots at all, if they're opposed to it?

These latest pandemic challenges come as the daily national death rate from the virus top 3000 people a day, the last few days for the first time, since the pandemic began. Think about it. That happens to be about the same number of people who were killed on 9/11. We're now experiencing a 9/11 every day in terms of Americans getting killed. Unlike 9/11, this is no surprise attack, right?

We know the enemy and the sacrifices that are needed to stop the slaughter. We're at a moment when patriotism meets public health. Are enough of us capable of enlisting in the army of personal responsibility and smart public policy to ward off the worst of this attack? With me now is Dr. Dara Kass, emergency medicine physician at Columbia University Medical Center and Yahoo News medical contributor. Dr. Kass, thanks for joining us again, welcome back to WNYC.

Dr. Kass: It's pleasure, Brian, always.

Brian: Let me start with the new wave of closings that are being ordered and this idea of patriotism meeting public health. Joe Biden said yesterday he would ask the country to wear masks when in the company of people outside their households for his first 100 days in office as president, and that could make a significant difference. I don't know if many more people will do it than are doing it today, just based on that, given the polarization around the issue, but do you think that could make a significant difference?

Dr. Kass: I know that if it works, it makes a huge difference. We know masks work for stopping the spread of this virus, not just for the person who may be infected from spreading it, but also the person wearing the mask from getting it. We have data that shows that if you are wearing a mask and somebody around you, for example, coughs near you, or has the virus, you are both less likely to get the virus and less likely to get a severe form of the virus. Any more mask-wearing that we can get anywhere in America will absolutely improve our fight against this virus or decrease our transmission and decrease our hospitalizations and death rate. Yes, absolutely.

Brian: Biden is not contemplating and national mask mandate and it seems to me that even the local mandates are mostly unenforceable. Could appealing to people left and right as a matter of patriotism, have a place alongside shutdowns of things and stay at home orders?

Dr. Kass: Absolutely. I think that one of the things we're seeing from the President-elect and I think a lot of the governors that have tried to enforce mandate statewide with the best intentions is that even mandates are only as good as enforcement and if you can't enforce things, then it's like a piece of paper without any [unintelligible 00:03:22], and so political will or, more importantly, public health will and community engagement is critically important as any of the recommendations or mandates we put out.

I am optimistic that although I can't see the President-elect putting in a federal mask mandate across all states, he can enforce it on federal property. He can enforce it for interstate travel. He can model this behavior and encourage bipartisan support from the Senate and Congress to show that mask-wearing on federal property is mandated, but also that the senators and governors from both parties should be modeling the behavior at their state level.

Brian: Let me get your reaction to what California is doing now, because this has implications for everywhere as cases and hospital bed shortages and deaths continue to rise. California is ordering things closed, like they haven't since the spring. For certain areas of the state, at least, where ICU bed availability has dropped below 15%, that's their threshold, including no outdoor dining and roping off playgrounds.

In LA, they don't even want people walking or bicycling with people not from their own households for the next few weeks from what I've read. What's your opinion about closing outdoor things since experience seems to show being outdoors is very protective in general, against spreading or catching the virus?

Dr. Kass: I think what's happening in California, and remember the metric they're using to start all this is critical hospital capacity, we're seeing an exponential spread of this virus in every single state basically and the hospital capacity we know is going to continue to get crunched. There's a lag once hospitalizations start at this level from the time that people can get discharged from hospital, because this disease has such a prolonged and unpredictable course, once you reach that critical level.

I think that what they're really doing is going back to a state home order and it's because every single infection runs the risk of taking another one of those ICU beds. We saw obviously in New York when we had our surge in March and April, we were able to flex up to a huge number of ICU beds, converting all of our ambulatory care centers, a lot of our recovery rooms into ICUs, but really very few other areas of America have that capacity.

I think that, although this does feel draconian in a lot of ways, very dramatic, because they are taking even the safest gatherings and stopping those, I think it's really for the fear that if somebody needs an ICU bed and is critically ill, there will be no place to put them and that itself, that unnecessary death, the idea that somebody would have nowhere to go is the bar that they're hitting against to say, "We now have to close basically every place that the virus could spread, even if it's a very, very low risk."

Brian: Is there data on this? Is the virus spreading in playgrounds and is the virus spreading in social gatherings that people have with social distancing and masks outdoors?

Dr. Kass: No. I think that that's exactly what I think. I think, like I said, it is as far as they can go to short of saying, "Stay home and do not leave your home." I think that they are unsure how far they have to go to stop this ICU spread, the risk of losing their beds. I do think it's a bit far, but I also know that when you're looking down the pike of having to tell people that there is no place for them.

If they're in an ambulance and trying to come to the hospital, you start to look to as many places as you can spread even one case of this virus and so I think we're in a very difficult place and the decisions become very difficult to make and the better people aren't following the other guidances, the more likely those parks and outdoor dining will get to be opened again very, very soon.

Brian: Maybe they just figure, like, if you give people an inch, they'll take a mile, [crosstalk] but listeners coronavirus questions welcome here for Dr. Dara Kass from the Columbia University Medical Center and a Yahoo News medical contributor, 646-435-7280 or tell us how much you are going back to the precautions you took in the spring. Nobody wants to close in again that much, but we see what's happening all over the country. How much should public policy go back there? How much are you going back there personally? 646-435-7280.

Also, listeners. How will you decide if you'll get a vaccine, as soon as it's available to you? We're going to get into vaccines as well with Dr. Kass. Again, any questions for Dr. Kass, emergency medicine doctor at the Columbia University Medical Center and Yahoo News medical contributor, 646-435-7280, 646-435-7280. How damaging is it in your opinion as a doctor that liberal Democratic politicians keep getting caught in virus behavior hypocrisy? You've probably seen these stories.

Governor Gavin Newsom eating with 12 people at a fancy restaurant in California and having to apologize. Governor Andrew Cuomo planning to have some people over for Thanksgiving, from other households, in his family but other households, and canceling that when he got called out. The mayor of Denver told his city not to travel for Thanksgiving, but then flew out of state himself. He got caught in apologized.

The mayor of Austin attended a wedding with 20 people while he had a 10-person capacity rule in effect. Then he flew to Mexico for a vacation and posted a video from there telling people not to travel. That mayor issued a public apology too. All liberal Democrats who've all been at odds with the President's more or less a fair public policy. How damaging is it to the effort to get people to comply?

Dr. Kass: Look, I think it's damaging and I think that these are not both sides. Each of these leaders made a bad choice and they made a bad choice amongst the other choices that they're making and I'm not excusing it, but I think that we make choices every single day and when you're a leader, you just don't have the room to make bad choices. Governor Cuomo having his mother over when asking people not to have elderly people in their homes or a Governor Adler, going to an Island and posting a video saying, stay home, while he's at an Island, these are poor form choices and they are bad example.

They are not however deliberate flouting of public health response like we're seeing at the White House when they're having 40 unmasked Christmas parties, while the CDC is saying, don't gather with people outside of your house. I want to make sure that, although it is true that we should not be seeing these bad choices be not as publicized but exist, because it is important that our leaders lead by example, across the board. I don't want to deteriorate is this idea that it is now even on both sides. We have governors like Ron DeSantis in Florida, that is saying not just he won't put in a state mandate for masks, but he won't even support any communities or cities having their own mask mandate.

It's very important that we keep our eyes straight ahead and say, each of these leaders has made a mistake. They have apologized, but remember that every day we make choices around the spread of this virus and these are hard choices. When your mother-in-law, like mine did, asks you to come over Thanksgiving and you try to convince her not to, but she comes, and she knows the risks at some point, you have to somehow acknowledge that that is the choice somebody is making for their own life. We have to continue to try to make better choices every single day, but it just reinforces to me how difficult so many of these choices are that we are making every single day and why we are so exhausted from these choices.

Brian: There's also, I think, a matter of what lesson we should take from these hypocritical Democratic Party politicians, because when I watch Fox, they point out the hypocrisy, which is fair and they should, but then they shrug as if, to say, "You see? Those control freak elected officials Shouldn't be asking us, regular people, to be making sacrifices that they won't make themselves. We shouldn't have to do this." That's the implication. When the real message should be, "Those politicians are hypocrites. We should all be taking preventive behaviors." I'm curious if you see the damage in those terms?

Dr. Kass: I definitely see the damage and this is the problem we're living with right now is that, like you said, if you give people an inch, they take a mile. If they see one crack in the system, they then take the whole house down. The problem with this virus and the transmission is that every decision matters. If you're with a friend in a car and you're both wearing masks that is better than being in front of the car and being unmasked. If we saw a politician in a car with people, unmasked, that would be a poor decision that would have repercussions going forward.

I totally agree that you have to be on your best game all the time if you're in a position of leadership as far as decision-making for this virus, because it gives fodder for anybody willing to undermine the system. Once they see one crack, they will take the entire structure down.

Brian: Let's take a phone call. Chris in Manhattan, you're on WNYC with Dr. Dara Kass. Hi, Chris.

Chris: Oh, hi. Hi, Brian. Hi, Dr. Kass. Thank you very much for having this conversation. I'm an essential worker. I started my essential work in December of 2019, perfect time. I did get sick in March. I was tested positive around May or June for antibodies. Yes, I got a vested interest in this and honestly, I think about the vaccine, like I think about so many things, opportunity, education, these are things that have been compromised.

They were supposed to be for everybody and it was supposed to be a fair shot. Vaccines, when there's not enough, our first instinct to say, "Yes, let's make it fair," but it shouldn't be fair because we have superspreaders. We have wealthy entitled people, put any other filter on that as you want and they're the ones spreading. Why, when they get it after flouting the rules, should we not find them and then say you have to take the vaccine because you're a problem and everybody around you is a problem?

Brian: You're identifying too. Chris, thank you very much, and you're identifying, Dr. Kass, he's identifying what I called at the top, this weirdly opposite challenge or set of challenges, pair of challenges of telling some people that they can't get vaccinated yet and convincing others to take the shots at all, if they're opposed to it. What a funny position to be in.

Dr. Kass: Yes. I think that the vaccination campaign-- You have two issues with the vaccine rollout. You have both an operational system that is overwhelming. You have a very unstable vaccine, that's going to be required a very interesting storage and it's two shots and there are some side effects and so there's a huge list operationally to delivering this vaccine. There's going to be a very deliberate rollout of who can get it when and how.

While you also have to keep everyone in the background excited about getting the vaccine, you have to address their anxieties about vaccine, both for their community and for themselves personally and their families. You have to remind them that when they-- you have to match when they're ready to get the vaccine when it's available to them. Because if you've actually dispelled those anxieties and they're ready to go, but it's not ready for them for the next two months, then you have to re-engage them again, as it gets closer.

These two campaigns, this operational campaign, and this public messaging and trust campaign has to be done very deliberately and actually completely intertwined in a way that we've never done before. Certainly not since post-World War II, anything of this scale. That's going to require public and private partnerships, community leaderships, faith leaders, private industry, public health, all together, working to really address this pandemic's end.

Brian: Will you get an early vaccine if you're eligible early as a healthcare provider? Because if you're an emergency room doc, I think you're going to be in the first wave.

Dr. Kass: I am actually. I would get it live in-person as soon as humanly possible. Absolutely, I think that it is really exciting that our technology and our innovation and our federal support has gotten us this vaccine as quickly. There's a lot of reasons why it happened this way, but I think that if we can all be examples to our communities of believing that we can be part of the solution, part of this newly immune army of people that can help protect the citizens that are further down the line, then yes, absolutely. I'll get it early.

Brian: Politico New York has a story today, the quotes an emergency room nurse at Mount Sinai, who says about the feeling among her colleagues, "Thus far, it's been a unanimous "Hell, no. Why are we going to be the Guinea pigs? We're the suicide squad. Isn't it enough, we were stuck on the front lines?" That's just a quote from one nurse, but it is a quote from one nurse at Mount Sinai and about 20% of the 920 physicians pulled by the medical society of the state of New York said they had reservations about getting the vaccine. Do you think that's consistent with your own knowledge of your own colleagues at your own hospital?

Dr. Kass: I think that you getting 20% hesitant means 80% are ready to go, and that is actually what we need to achieve to start seeing some effects in each community, for protection for this virus. We need to acknowledge that people have hesitance about vaccines in general, this vaccine specifically. I also think that once we have new federal leadership and better leadership at the FDA and the CDC that people feel comfortable. are continuing to be de-politicized, that we'll start to see vaccine confidence go up.

I also think that a lot of things about this mRNA vaccine and how it's delivered, why it hasn't been done before, people need to understand what about this makes it probably more safe and effective than anything we've seen before, having to do with the delivery of the vaccine and why this technology hadn't been used. I think it's really about public education, even amongst the healthcare community to feel comfortable that, "No, we're not Guinea pigs as much as we are leaders. The opportunity here is to lead by example, which means that we will get protected early on to protect ourselves and our citizens."

Brian: Sam in Rockland County. You're on WNYC with Dr. Dara Kass. Hi, Sam.

Sam: Oh, it's me. Can you hear me okay?

Brian: I can hear you all the way from Rockland County. Yes, I can.

Sam: I'm taking a walk in the woods by a stream so I didn't know how noisy it is.

Brian: That's great, This could our first walk in the woods by a stream caller.

Sam: Thank you for having me ask my question. I'm a senior. I had a very bad case of this virus six months ago. Thank God I made a nice recovery. I can't get a straight answer as to, "So can I get it again? What do I have to worry about?" I'm going to ask you without giving me a straight answer, shoot from the hip, and tell me what you think my percent chances are of contracting this again. I've been more careful now than I was then. I can't get an answer from anybody.

Brian: Dr. Kass. That must be a lot of people out who've recovered from COVID like this and--

Sam: Shoot from the hip, give your percent chance of what you think I'm going to get. I don't want to hear medical garbage. Just tell me what you think.

Dr. Kass: Okay. We generally don't shoot for the hip when we're giving medical advice, it's contrarian to how we do things. I will tell you that if you have antibodies, which is the part that you haven't told us, if you've gotten checked for antibodies and your body mounted a good antibody response to this virus--

Sam: They said, I had a nice amount of antibodies at that time. This is like five months ago.

Dr. Kass: We are seeing antibodies wane, although I had this virus 10 months ago and I still have antibodies so I'm hopeful that you will as well. It is very unlikely for you to get this virus again. Although obviously, it's a new virus is the problem. The answer is everyone wants, has to do with time, but yet we don't have a lot of that in our back pocket. We don't know a lot about what happens a year out from this virus because it's literally only been around for a year. Unfortunately, people can't give you absolute answers.

What I can tell you is that if you are wearing a mask walking by yourself by the stream, practicing good public health and you have antibodies, it is pretty low, low, low likelihood that you can get this virus again. Again, we're going to find out soon enough if people who have had this virus and have antibodies where they sit on the continuum for vaccination as well, but I would argue that getting vaccinated is another way to protect yourself from ever getting this virus again.

Brian: Okay, but Sam wants to know, assuming he still got a strong antibody response if he were to get tested again today, should he consider himself safe? Can he go on the subway again? Can he go to the theater again? Whatever?

Dr. Kass: We really don't know, Brian, I want to give you the right answer. They haven't proven that you're 100% safe. My answer is, go and wear a mask. That's what I do. This is the decision I make every single day. We need to have better data on what immunity looks like for people that had natural infections versus vaccinations and we don't have it and so I can't give him the right answer. What I can say is, he is probably safe, most likely safe, but there are no guarantees. Sorry.

Brian: I hope that's helpful. This is close to a yes or no answer I think that you can get from an MD and I wouldn't call it medical, what did he call it? I don't know. I think it's a word you can't use on the radio.

Dr. Kass: He called it medical garbage.

Brian: Oh, medical garbage, that's right. He preferred shoot from the hip. Now we know what people do when they walk in the woods by stream. They listen to The Brian Lehrer Show. I want to ask you a related question to his, about behavior and confidence after getting the vaccine. When they say 90 or 95% effective, can a person find out after they've been vaccinated if they as an individual are in the 90%, or in the 10%? Because I think a lot of vulnerable people will get vaccinated, but then that doesn't mean they'll feel safe to suddenly go on the subway to go to the theater or go to work in an office building. Can people know if the vaccine worked for them?

Dr. Kass: Again, this number hasn't been published yet. What you're asking about is could you measure your body's response to this virus, like what we call viral titers of antibody responses, and know that you have converted to an immune person, which is what we see for a lot of the other vaccines that kids get right? You can tell if your body mounted the response or not. We don't have those numbers yet, although I hope we do soon after the rollout as we see more and more people get vaccinated, and as we know more about how people's bodies respond.

The 94, 95% that we're seeing really has to do with how many people got symptomatic infections who were vaccinated. Certainly, in the Moderna study, they had zero cases of death in their vaccine group. Even if the person got infected, they had a mild case. I think that what I can say is the data that's coming out is so strong, and more importantly, the more people that get vaccinated the less likely that you are to be exposed. Even if you're one of the very few that didn't convert to a robust immune response, if the entire community gets vaccinated, that's where that term herd immunity comes in.

If you have been under-vaccinated or for some reason your body didn't mount the response, that herd immunity then protects you as well. Remember the--

Brian: Yes, [unintelligible 00:23:29] over time.

Dr. Kass: Exactly.

Brian: I'm thinking, you mentioned the word titers, which not everybody knows, but I know that some of the routine vaccines, measles I believe,and some of the others, doctors can do what's called check your titers, which I think means check some mark. Like I know somebody who got them measles titers checked recently, because of a measles outbreak in their community. This is a grown-up, a full-fledged grown-up with kids, and they had the measles vaccine as a small child like most of us get, and they were able to be told that their titers indicate that they're still immune from measles. Will there be something like that for coronavirus vaccine?

Dr. Kass: I expect there will if this vaccine shows to have long-standing immunity. One of the reasons we use titers is to make sure that somebody that's vaccinated at this child does not have to get a booster as an adult. As we learn more about how good these vaccines work, and how long the immunity lasts for, rather than a cycle like the flu virus, where we know that we get vaccines every year, so we don't do titers because we just re vaccinate people. We'll see more of that come through as a way to monitor the response through a community.

I actually remember when I found that I had antibodies that was my first question to the nurse, it was, "I have antibodies. What are my titers?" and my second question was, "What am I supposed to have?" Because exactly that, I was used to seeing those levels from my vaccinations as a child. They didn't have that information. They still don't have it publicly, but I am optimistic that we're going to find those numbers out soon enough.

Brian: Nick in Cleveland, you're on WNYC with Dr. Dara Kass. Hi. Nick.

Nick: Hi, Brian, big fan. I just wanted to ask, my mom's a flight attendant, and she's doing her annual required training. My father is older, he has COPD, and she's going to be coming back tomorrow. He lives in like in-law suite that my grandma used to live in in the back of house. I'm worried about ventilation. I know she wants to quarantine apart from him, just to make sure he's safe. I'm wondering like when it comes to ventilation and everything, what can we do to be safest to protect him.

Dr. Kass: Just to jump into that, so if she's coming back from traveling, and you want to protect them from each other, you're already doing the safest thing, which is to put them in two different spaces for the duration of time. The CDC has now said that you can actually stop a quarantine from exposure for 10 days. If they're apart for 10 days, the ventilation itself doesn't matter as long as they're not in the same space. If they're going to choose to be together, then you would just want to have the windows open and then still be far apart.

Again, if they're wearing masks when they're together, that adds another layer of protection that allows the risk of your mother being an asymptomatic carrier to not get to your father.

Nick: Well, thank you so much. That was what I was concerned about with the ventilation and that really put my mind at ease. Thanks so much.

Dr. Kass: No problem.

Brian: Thanks you very much. Nick. Part of your own story I've read is that when you got the virus, you actually practiced social distancing within your own household, right?

Dr. Kass: Yes, very much. My husband and I might we had moved our kids out of the house because I was so uncertain about this virus, and I have an immune-compromised child, but we had practice social distancing in our house before I got the virus because I was worried of being an asymptomatic carrier at work. We were sleeping in different bedrooms, we actually were fortunate enough to use different bathrooms and we were not eating together at all.

When I got sick, we lived our life very much like I tell people to which is that I wore an N95 mask in my own house outside of my bedroom. We never ate together, we wipe down surfaces between us. If I went into the kitchen, I wiped down my surface after I left. It's important to practice social distancing at home as best as you can, especially if somebody in your family has this virus.

One of the things I will say is I've heard a lot about people, if they live together and somebody is positive for the virus, then they're getting some advice sometimes, "Well, it doesn't matter, you've all been exposed." I have a problem with that, because every day that you are negative, but exposed is another day you have a chance to not get this virus. If somebody in your family is positive for the virus and is living with you, everything you do to just put some space between that person and anyone that is currently either asymptomatic or negative, helps stop the spread of this virus, which is what we're trying to do.

Brian: Elizabeth, a retired nurse in Brooklyn, you're on WNYC with Dr. Dara Kass. Hi, Elizabeth.

Elizabeth: Hi. Hi, Doc. I just want to say I'm an older person, and I'm a retired public health nurse. I've given vaccinations, and I am pro-vaccination. I'm going to try to ask this question as accurately as I can. I know, nurses and nurses aides, and even doctors here in Brooklyn, who are frontline workers, who are going to be required to take this vaccine as the first people to take it in order to stay on their jobs.

The concern that I have heard expressed is similar to the Mount Sinai nurse and the concern is this was such a quick rollout for this vaccine. Could you speak to what you know about the manufacture and the testing of this vaccine that could tell people who will be the very first people to take it, why you believe it is safe?

Dr. Kass: I will say that the technology they're using is new to us as a vaccine, but it's not a new idea, right? It's something that they've been trying to use, but it's very expensive, and it's unstable to both test and produce. We wouldn't do this level of production for the common cold, does that make sense to you? This is a pandemic--

Elizabeth: Yes, and but you got to say more.

Dr. Kass: What I'm saying is, so this kind of vaccine could have probably been an answer for other viruses as well, but the cost and the difficulty in implementation would have been a barrier against that level of investment. We've seen incredible federal investment. We've seen partnerships with private industry, we've seen everybody stop what they're doing to focus on this right? Which has never happened before.

In addition, we have a pandemic, so the hundreds of thousands of patients that have been enrolled in trials, that have been exposed to this virus, has gone faster because this virus is everywhere. We don't see that with other viruses and other things that need to be vaccinated, because it's not everywhere the same way this virus is. It was the circumstance and the need, that really speed-tracked this vaccine, and these other vaccines to get to the front of the line.

A lot of that has nothing to do-- no standards were changed. I think the way that I tell people that I feel comfortable in the review process, is that they didn't release this data before election day. There was a very specific call to action from the physician and healthcare community to say, please don't let this be politicized. Once we stopped seeing the federal administration put their thumb on the scale of the approval process, and everyone followed the landmarks that they had set out when this started, by numbers of patients, diversity of patients, timelines to be expected, everything seems to be falling into place.

The other thing I will say is, we're seeing multiple countries look at the data separately and come to the same conclusion. Even if there's mistrust in our system, and our FDA looks at the primary data, not an aggregate data, we're seeing the approval happen in the UK, and they will see the vaccine even earlier than we do. We can look to our neighbors around the world and say, "If they're all getting vaccinated and doing okay, and they've looked at the data, and they've approved it, we can start to feel globally more comfortable with this process." But again, that's why people like me that do feel comfortable will have to lead the way and say, "I will get back to needed early and show you that I'm okay."

Brian: I'm curious, Elizabeth, how reassuring was that answer to you?

Elizabeth: Somewhat. Can I ask a second question on this?

Dr. Kass: Please, go for it.

Brian: You may.

Elizabeth: Okay, so the first people in hospitals are hospital workers to be vaccinated. I understand there's a 21-day period for the second vaccination. Is there going to be any entity that will be monitoring their reaction to this vaccine in that 21-day period, and afterwards, with the second dose?

Dr. Kass: Yes, so I'm sure of that. There's always monitoring like post distribution of vaccines, and they'll be continued data mining and aggregation of the effects of the vaccine, even just for side effects. Things like headaches, muscle aches, fatigue, that will be published continuously as more and more people get the vaccine, so we can see what it looks like when 100,000 people get it, or 200,000 people get it.

I also want to push back on the idea that there will be a mandatory vaccination for people in the hospital. We actually haven't seen that anywhere that I have seen where that's been published yet. I think that there will be an ease in actually to vaccinations to start just to make sure that there is a community buy-in. Because I do think that the idea that people are hesitant towards mandatory vaccination so early is reasonable, and that we want to make sure that people are feeling that they're coming to this with the best comfort they can. Depending on how many people volunteer to be vaccinated early, we may not have to see mandatory vaccinations in order to protect the health care workforce early on.

Brian: Just tell people they can't have it, then everyone will want it.

Dr. Kass: That's always the way it is, right?

Brian: Right. It's like all these kids who want to go to school now so badly. When in the history of humanity have kids wanted to go to school, rather than, "Can I skip school today?" It's because they can't. Before you go, actually one question on schools, and one question on Trump. Since we were just talking about vaccines and the timing. Does President Trump deserve some credit in your opinion for his operation Warp Speed? We know he's been so counterproductive to encouraging public health behaviors in so many ways during this, preferring his magic bullet approach of hyping vaccines, and hydroxychloroquine, and things like that.

Did his operation Warp Speed program, because he was so focused on the magic bullet, contribute to these various vaccines being ready this fast, or were the pharmaceutical companies had done it like this anyway?

Dr. Kass: The answer is yes, he helped us get here this fast. I will say that with the knowledge that that came with a massive American sacrifice, and I think that we could acknowledge both things at the same time. The unilateral focus on therapeutics and vaccinations with an overwhelming financial support, and the guarantee that we were going to purchase vaccine doses, which gave the industry comfort that they were having less financial risk in the production of these vaccines early on, which is why we can deliver it so quickly, no doubt accelerated the timeline for the delivery of this vaccine to people's arms, assuming it gets approved.

But that must have an asterisk that that choice was made against virtually every single public health measure, that would have prevented an overwhelming number of people dying, including the 3,000 people that died yesterday.

Brian: Lastly on schools, and we have a minute left. We've got everybody's opinion on this, so we'll get yours. In Michigan, Governor Whitmer is now ordering high schools and colleges to halt in-person classes. Here in New York, elementary school classes reopen next Monday, despite the rising positivity rate. Does the data show that little kids spread the virus to their teachers less, and high school and college students spread it more because you can't stop teenagers from social gathering?

Dr. Kass: Right, the answer is yes. The data supports the idea that investing in K through 5, even K through 8 education as in-person learning is safe for teachers and students. That when you get through over the age of 12, middle, high schoolers, and college students that the risk ratio it stops being beneficial necessarily for the spread, and we should focus on, especially since they do so much outside of school work. It's the aggregation and the congregation outside a school of these students that brings the risk back in.

It's not the school environment that's always a risk for spread, it's the fact that these are kids that mobilize themselves separate from their families more. Second graders don't generally go out to the park and hang out with their friends without a mask or supervision. Unfortunately, high schoolers do, so I agree with both the Michigan decision and the New York decision to focus on elementary education for both social-emotional learning, and for academic learning. Absolutely.

Brian: Dr. Dara Kass, emergency physician at the Columbia University Medical Center, and Yahoo News medical contributor. Thanks for so much detailed information and answering so many questions from the callers and from me. We'll keep doing this. Thank you so much.

Dr. Kass: No problem, Brian. Have a good day.

 

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