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Brian Lehrer: It's The Brian Lehrer Show on WNYC. Good Friday morning, everyone. Here is the New York backdrop against which Mayor Adams lifted the workplace vaccine mandate for professional athletes and other performers yesterday. Over the last two weeks, according to The New York Times COVID tracker, the number of new COVID cases per day in New York state has gone up by 44%. Thank you, Omicron variant BA.2.

The number of new cases among New York City public school students has doubled compared to a month ago according to the education news website, Chalkbeat, and its crunching of the data. We'll see if the new spike in cases produces a new spike in serious cases and deaths, but for the moment, the news about serious disease is very good around here. The Times' COVID tracker says the number of people hospitalized with COVID is now 30% less than it was two weeks ago in New York state, ICU beds in use for COVID patients also down 30% compared to two weeks ago, and the number of people dying from it is 50% less than two weeks ago.

Just 10 people died statewide from COVID yesterday according to the Times' tracker. At the peak of Omicron in January, more than 200 New Yorkers were dying per day. Also, right now, Pfizer and Moderna are seeking government approval for fourth vaccine doses for people. Germany's health minister today called for fourth doses for all people over 70 in that country with underlying conditions. At the other end of life, Moderna has now released clinical trial results for children as young as six months old. There is a lot to talk about.

We'll get a bicoastal view as joining me now is Dr. Monica Gandhi, MD and with a master's in public health to boot, an infectious diseases specialist and professor of medicine at the University of California, San Francisco. San Francisco has been a national leader in policies to fight COVID throughout the pandemic, as I think we can say has been New York. Dr. Gandhi, before you've even said a word, you've gone above and beyond for us doing this segment at 7:00 in the morning Pacific time. Thank you and welcome to WNYC.

Dr. Monica Gandhi: Thank you very much.

Brian Lehrer: Let me start with the big new controversy in New York City and get your San Francisco take. New York City has a vaccine requirement for all employees who go to work in-person at any workplace, private sector included. Here is a clip of what Mayor Adams said to a heckler just a few weeks ago, when the heckler said, "Lift the vaccine mandate on Kyrie Irving," the unvaccinated star of the Brooklyn Nets. Listen.

Mayor Adams: Thank you very much.

[applause]

Mayor Adams: You're right, sir. Thank you. Listen. You're right. Kyrie can play tomorrow. Get vaccinated.

Brian Lehrer: "Kyrie can play tomorrow. Get vaccinated." That was then. Yesterday, he lifted that vaccine mandate just for professional athletes and performers. This had a lot to do with Kyrie Irving and his Nets approaching the playoffs and baseball season coming. Other unvaccinated people, however, who've been fired from their jobs for not being vaccinated, including 1400 municipal workers are understandably furious at the double standard.[00:03:00]

The New York Times reports this morning that the executives from these wealthy New York sports franchises lobbied the mayor hard for the win he gave them yesterday. The owner of the Mets contributed $150 million to a political action committee tied to Adams. Dr. Gandhi, my question to you is about the underlying policy. New York is the only city in the country, as far as I know, to have a private sector vaccine mandate at all. I wonder, has that ever been considered in San Francisco or elsewhere in the US that you know of?

Dr. Monica Gandhi: San Francisco did have vaccine passports and vaccine mandates for healthcare workers, and then some private employers chose to do vaccine mandates. At this point in time, however--

Brian Lehrer: Those were some private employers doing it on their own. I just want to make that distinction.

Dr. Monica Gandhi: Right. That's really fair. Then, actually, at the beginning, San Francisco did have city employees-- it was actually the first place along with New York that had city employees have to have a vaccine mandate. It is true that New York and San Francisco paralleled each other in that way. One issue though, is that at this point in the pandemic, and I just wrote a piece in [unintelligible 00:05:06] CNN about this. We had to decide what's divisive and what's not divisive and what makes sense.

The arbitrariness of some of our rules where wealthy people can get out of a rule and poor people can't get out of a rule, where children, I believe in New York, cannot get into museums without showing their vaccine card and a member of a sports team can. This kind of arbitrary aspect of our COVID policies are creating divisiveness. What I really think needs to happen at this point is that we have the vaccines. We've had them for more than a year. We know that they're amazing at preventing severe disease, but they don't actually block all transmission.

That's just a function of essentially our antibodies coming down, the new variants. Mandates are increasingly being dropped in multiple municipalities. It makes sense to me to heal the divisiveness and not have mandates for either masks or vaccines at this point, but essentially, strongly recommend, we can even have testing if people don't want to get vaccinated. This is getting profoundly divisive and I've been watching what's going on in New York.

Brian Lehrer: You are saying it's time to lift all vaccine and mask mandates on anyone. Do I hear you correctly?

Dr. Monica Gandhi: I wrote this piece that essentially said, "What are the two biggest policies that are creating divisiveness?" I actually didn't say vaccine mandates in the piece. I said vaccine passports and mask mandates, because what's happened with mask mandates is that half the country has been doing this for a year and half the country's been doing something else. When the CDC put in their new mask guidance on February 24th, to me, it made sense because they actually said, "We recommend masking. The city of San Francisco is recommending masking, but it becomes a personal choice."

Going back to vaccines, the point of vaccines were to prevent severe disease. At this point in the pandemic, there are people who we can't seem to encourage enough to get the vaccine. There are other ways to say, "Okay, you need to get tested. You need to maybe wear a mask at work." The firing of people because of not getting vaccinated, I have found a very harsh punishment.

Brian Lehrer: It's certainly divisive, but has it protected public health? It was just a few weeks ago that 2,000 Americans every day were dying of COVID in the Omicron wave. Now, it's down to about 800 Americans every day. That's still an unbelievable toll if you spread it out over the year at this current what's considered a low rate. Do we just pull the foot off the gas pedal of protecting public health because it's politically divisive?

Dr. Monica Gandhi: No, not at all. I'm essentially saying that there are other ways to enforce vaccination requirements, which are, if you're not going to get vaccinated, then you'll test, you'll mask. You'll do something else. We absolutely have to encourage vaccinations. In fact, it is New York City's high rate of vaccination, San Francisco's high rate of vaccination, and increasingly, if you look at other countries beyond us, anyone who has an 80% rate of vaccination or above has weathered Omicron so much better than we did in different places. Delta, better than we did. It was an incredibly important technique at the beginning of the pandemic.

At this point, if people will not get vaccinated, there are other ways to enforce ways for people to be safe around them like [inaudible 00:08:51] and masking. [inaudible 00:08:54]

Brian Lehrer: The test or vaccine mandate. The testing mandate was the first thing that went away. The original version of it in New York was if you're going to enter a restaurant or some other public place, you either have to show proof of vaccination or a negative COVID test within the last day or within the last three days. The testing requirement, as an alternative, was the first thing to fall away. That's because Mayor de Blasio wanted to focus on incentivizing everybody to get vaccinated because that's the longer term strategy against COVID. The testing alternative has already gone away here as I think almost everywhere. You're saying that could come back?

Dr. Monica Gandhi: Here in San Francisco, we have also dropped vaccine passports, but vaccine mandates have not been dropped.

Brian Lehrer: What's the difference?

Dr. Monica Gandhi: The difference is this, you can go into a restaurant here and not show proof of vaccination and that's a recent change in the last three weeks. If you go to work, again, city employees have to be vaccinated. If you go to work and you've chosen not to be vaccinated, you have to test and mask. It's vaccine mandates with testing.

Brian Lehrer: Interesting. That distinction that you just made is between public employees and private sector employees.

Dr. Monica Gandhi: Our city employees have to be vaccinated in the city of San Francisco, not [unintelligible 00:10:34]

Brian Lehrer: You're not the mayor of San Francisco, so I'm not holding you responsible for this, but why make a distinction as a matter of policy between private sector and public sector workers, if they all deserve equal protection and the public deserves equal protection from them?

Dr. Monica Gandhi: Our vaccine laws in the United States have really stemmed from the beginning, prior to the 1900s. You're absolutely right that we have precedent and we can enforce vaccine mandates. The issue in the United States is that private employers can have that choice to do that with their private employees and public sectors in general have not mandated in many cities except for cities like San Francisco, New York City, and in the State of California.

All of our state employees are mandated to be vaccinated or test regularly and mask. What you've done is you've created a situation where it's uncomfortable not to be vaccinated, it is difficult not to be vaccinated, there are rules not to be vaccinated, but the firing of employees has not been executed in the same way.

Brian Lehrer: Listeners, I see you're not being shy about calling in, those of you who already have us on our speed dial. For everyone else, your COVID question is welcome here for Dr. Monica Gandhi from UC San Francisco on vaccine or mask mandates for athletes, performers, the public-at-large or just the workers, the need for second boosters, which we're going to get into or vaccines for kids under five, which we're going to get into or anything related at 212-433-WNYC, 212-433-9692. Let's take a phone call right now. Jane in Manhattan, you're on WNYC. Hello, Jane.

Jane: Good morning to you, Brian, and your special guest. Thank you very much for all these conversations. It's critical. I did call you yesterday, but I wasn't able to get on, so that's why I guess I'm first online.

Brian Lehrer: We didn't really have a record of that. Our software isn't that sophisticated, but I'm glad you're [crosstalk]

Jane: Yes, I spoke to the young lady. In any case, the mayor has made his decision. It's such a contradiction here. I'm a senior with immunocompromised situation severe. We have helpless little children who have severe compromised situation, plus a person like me, a senior, who has immunocompromised situation. This is so wrong. I feel like the mayor was paid off because last week and the week before, he did say that he was not going to be bending the rules for these people in the sports arenas like Kyrie Irving that started this whole mess.

Brian Lehrer: We played that clip.

Jane: He said that. Now he's contradicting himself. The second thing is, which is why I believe that he was paid off, you must make all decisions about us, the immunocompromised people. I'm one of these few. I'm terrified. I follow all the rules because of my immunocompromised situation. I follow all the rules and [unintelligible 00:13:49] All the little children that have their parents are doing that. Why should these groups of people be excepted?

There should be no exceptions around the world because everyone around the world, if we were all doing everything as we're supposed to do, as CDC and epidemiologist says and medical doctor says and the CDC's department says, we would not still be in this position. We would be able to be walking around without a mask and being able to live just a less fearful life about viruses. Here comes another one right now.

Brian Lehrer: Here comes another one. We're going to ask doctor Gandhi about BA.2.

Jane: Right now. Exactly.

Brian Lehrer: Jane, thank you very much. I'm glad you got in today. Let's go. Well, there's really two questions from Jane, if we want to split them up. One is, what do you make of BA.2? Let's do that one second. She's talking about herself and other people who are significantly enough immunocompromised that they don't feel safe by the dropping of all these requirements for other people. Do you have thoughts as an MD and as a public health person about how to protect the immunocompromised in the new environment where the rules are coming off?

Dr. Monica Gandhi: Yes. I think that when you look [inaudible 00:15:10] emergency COVID preparedness plan, I think what got missed is that there absolutely has to be protection for immunocompromised individuals and the President's plan accounted for that, which is the part two of that plan, which is essentially the test and treat program. Anyone who is immunocompromised while the virus is still circulating should have access and get monoclonal antibodies that last six months, that protect you from COVID-19, that's called Evusheld. Then the second is that anyone who is immunocompromised should be first in line for what are called oral antivirals Paxlovid, Molnupiravir.

The President is thinking about a plan, which I think is amazing, a test and treat program through pharmacies, where there's a very quick test, turnaround to get the medication and it protects you from severe disease and death, Paxlovid, by 89% even if you're unvaccinated. For the vaccinated and immunocompromised, this will also be incredibly protective. The treatments are a profoundly important part of our program, along with vaccinations. Essentially, again, I believe in vaccine mandates, but the point is, whether you fire, whether you create arbitrary rules or not, is what's at play here. There are other ways to keep people safe in the workplace if you require testing and masking of those around them.

Brian Lehrer: The availability of treatments is one of the arguments for loosening restrictions. However, I think a lot of people say these treatments are being underutilized and that federal funding is ending for testing and for treatments, spelling problems for the uninsured and immunocompromised. Correct?

Dr. Monica Gandhi: This absolutely is an incredibly disturbing point that you just made that Congress has been asked for $22.5 billion to actually fund the President's preparedness plan that will require treatment to be made available for uninsured and vulnerable. This funding needs to be maintained. This funding needs to be given for the President's plan. In no way did he say we're giving up on COVID. He actually had an incredibly, I think, distinct and clear four point plan to continue with COVID management, but it needs funding.

Brian Lehrer: If all the treatments have to be taken within about five to seven days of first symptoms, who should get them? Should relatively healthy people be requesting them if they're knowledgeable enough and their doctors are resourceful enough to request them and get them even if vaccinated or does it depend on their age or comorbidities? What would you say about that in a treatment shortage world, if you agree we have a treatment shortage world?

Dr. Monica Gandhi: We actually have the treatments. You're right. We're not accessing them enough. There are two distinct treatments. One is monoclonal antibodies that, at least a long acting monoclonal antibody, is actually a preventative. Your caller that just called, should talk to her doctor about something called Evusheld, which will protect her for six months.

Then there are treatments, the oral antivirals, you're right, have to be started within five days of getting symptoms to really be protective. They've only been studied in those who are unvaccinated at high risk of severe disease, but there is no reason to think that vaccinated people who are immunocompromised, these won't work for. There's an ongoing study of these populations. Everyone getting them, and this is going to relate to our question of the fourth booster, doesn't actually make sense because the purpose of both vaccines and treatments are to protect us against severe disease.

If we don't make that mind shift where we think that we can prevent all infections, unfortunately, it's not the nature of the virus. It can't be eradicated. BA.2 is yet the latest. It can't be eradicated, not because it's our fault, but because of the viral properties. What we have to focus on now is protecting people from why we noticed COVID to begin with, which was severe disease, that's both with the fourth booster and these medications, so no, it would not be for everyone who's healthy and gets a mild infection and can fight off that [crosstalk]

Brian Lehrer: Even though I said there's a shortage, to be very clear, there's the shortage of them being used.

Dr. Monica Gandhi: That's right, yes.

Brian Lehrer: NPR reported the other day about how these pills are sitting on pharmacy shelves. If they're not in short supply, then why shouldn't anybody who gets COVID, who's in some kind of high-risk group, even maybe just over 65, take it?

Dr. Monica Gandhi: Well, we don't have the studies that if you're fully vaccinated and you're healthy and over 65, that they will help you, but you're absolutely right in a way. There's no reason to think they wouldn't, but we genuinely don't have those studies. It is really people who have only been studied in unvaccinated severe disease, and two ongoing trials of unvaccinated and at risk for just standard risk and then the third study ongoing, only immunocompromised who are at risk for severe disease. That's called EPIC-PEP. It's just a matter of, usually, if they're not approved for an indication, we don't use them.

Brian Lehrer: Well, I want to make one correction. I think I said before that the owner of the Mets, Steve Cohen, had donated $150 million to a Eric Adams political action committee. I got my decimal point wrong. It was $1.5 million. That's a lot less than $150 million, but it's also still a lot of money, probably that reduction in that number that I just stated is not going to be enough to assuage Duke in Jersey city who's calling in. Duke, you're on WNYC. Hello there.

Duke: Hi, Brian, how are you?

Brian Lehrer: Good. What'd you got for us today, Duke?

Duke: Okay. I think my position is totally opposite to the first caller, Jane, and I totally respect Jane and I feel like the vaccines have been proven, it saves lives, and if you are a person who is compromised in any way with your health, you need to be vaccinated. However, those of us who are young and healthy, who don't want to do that, should also have the option, should have the option to not be pressured into having to do it. I don't want to inject anything into my body. It's that simple. I've never even gotten a flu vaccine, so I will never ever get the vaccine. In terms of Mayor Adams--

Brian Lehrer: I hope you never get polio, by the way.

Duke: I don't think that's an issue right now, Brian, but anyway--

Brian Lehrer: It's because everybody got vaccinated, but go ahead.

Duke: Okay, well, that's your position, Brian. There are other doctors-- let's not get into science because we'll go down a rabbit hole, but in terms of Mayor Adams, he's totally lost my respect. This situation shows how easily he can be compromised and swayed to do something. That's not a sign of a good leader. Let's not forget, less than two weeks ago, almost 1400 people lost their jobs. Their lives have been totally turned upside down.

Brian Lehrer: That's right, City workers, 1400 of them.

Duke: I want the listeners to think. 1400, that's a lot of people, lost their livelihood because of some stupid mandate. Now, I feel very strongly about this because the science is clear. Your guest, Dr. Gandhi, just said a moment ago, that vaccines do not stop transmission.

Brian Lehrer: Let me go back to that, and Duke, I appreciate your call. Thank you very much for that call. Good thing for Mayor Adams that Duke lives in Jersey City, but Dr. Gandhi, on the point that he was just making that you said, and you did say vaccines don't stop transmission. I think the science shows that they still reduce the likelihood of transmission.

Dr. Monica Gandhi: They do.

Brian Lehrer: You tell me, you are the MD and the master of public health combo, if a vaccinated population reduces total serious disease among everybody. How would you actually put that? Because if the way Duke heard you is accurate, then it really does weaken the case for a vaccine mandate because then it does just become a matter of protecting yourself or not.

Dr. Monica Gandhi: Yes, they do reduce transmission, but they don't block transmission. What do I mean by that? You're about 11 times less likely to get infected with COVID at all if you're vaccinated. By definition, you can't infect another person if you don't get infected at all. Unfortunately, when you do get infected, your viral loads in your nose are not that much lower. They are lower, but they're not that much lower such that you can't infect another person. That is the reason to drop vaccine passports and why that's been done essentially worldwide.

It's a fair point that increasingly our vaccines don't cause what's called sterilizing immunity where we completely cannot transmit to others. It has been the main decision point in dropping vaccine mandates. Again, there are other ways to keep people safe, as opposed to firing and I think it's the arbitrary aspect of one group who's more wealthy and another group who's less wealthy that's creating consternation in your city.

Brian Lehrer: What do you make of the number so far from Omicron BA.2? By way of background, I mentioned some of this in the introduction, but that was almost a half-hour ago now. We're seeing cases go up at a high rate, but from a very low starting point, we're not seeing deaths or hospitalizations increase yet, which is really the test, but this keeps being in the news. White house press secretary, Jen Psaki, announced this week she has COVID, so did Hillary Clinton and Barack Obama just recently too.

These are Democrats who believe COVID is real and don't carry ivermectin with them. The prime minister of Ireland got it in DC last week after meeting briefly with Biden. The president has tested negative, but it's circling him and I'm raising these public figure examples, doctor, only to say the pandemic is not over and a new wave is upon us. We saw hospitalizations and deaths spike again with Omicron 1, even though that was said to be less severe on average, there were so many cases. What's the policy response and how quickly to Omicron 2 in your opinion?

Dr. Monica Gandhi: What the CDC has decided and multiple countries are deciding is to act on severe disease, hospitalizations, and deaths, because unfortunately, cases are going to be always with us. I think that's an extremely hard pill to swallow that we can't eradicate COVID-19, but it really isn't the public's fault. There are 29 species of animals that carry COVID. Our immunity is not completely sterilizing as we just discussed and it has a long infectious period. It looks like other viruses. Cases will be among us.

What we have to do is keep on vaccinating our population, keeping our population immune so that our hospitalizations stay low. South Korea has a 90% vaccination rate and they are seeing high BA.1 cases, but their hospitalizations are staying low. Hong Kong, high BA.1 cases, do not have that good vaccination rate and unfortunately is leading the hospitalizations and deaths. It is now going to be--

Brian Lehrer: You're just making a case for a vaccine mandate. How are we going to get everybody vaccinated and keep from overwhelming the hospitals again if we don't keep these mandates in place?

Dr. Monica Gandhi: The vaccine mandate, again, I live in a city where everyone is mandated to be vaccinated, but we didn't fire people, we allowed them to be tested and masked. What you are hitting up against with your last caller is that there has been misinformation about these vaccines. People truly have been confused. They actually think they're dangerous. I wish that had never happened, but that's what happened. I think our only point of disagreement that you and I are having is if someone should be fired or not. I think we have to, again, in our city, we didn't fire people, we allowed them to have other ways to exist at work and keep people safe.

Going back to BA.2, there's no doubt that we are going to see case increases, and in places that were highly vaccinated, you're absolutely right. What you just said is absolutely right. That's where the severe disease stays low.

Brian Lehrer: In that case, let's move on to boosters. You wrote an article on who should get a second booster dose and we see Pfizer and Moderna applying for approval to administer them. We see Germany's health minister just this morning recommending second boosters for anyone over 70 with certain underlying conditions. I don't know if he specified which, but who needs one in your opinion?

Dr. Monica Gandhi: This speaks to how complex our immune system is because essentially what happens is that we create antibodies from a booster and they go up nice and high, but they will, unfortunately, come down after about four months. That's what was shown with the third booster, but luckily, we have baseline cells, which are called T cells and B cells from our vaccines that can produce more antibodies if we see the virus again. There are certain populations who, they're fine just with their T cells and B cells producing more antibodies, taking their time, but there are certain populations that need their boosting to occur because their antibodies should stay high at all times.

Those are the patients that are at risk for severe breakthroughs. A large CDC study showed that those who are immunocompromised or those who are over 75 with four comorbidities were at risk for severe breakthroughs without a booster. We should be thinking about boosting older populations. Germany has decided on 70, I believe UK has decided on 75, Sweden's decided on 70 and Pfizer has applied for an over 65-year-old indication, not all populations. Usually, older people are more at risk for severe breakthroughs and people who are immunocompromised, who are already accepted and approved for the fourth dose.

Brian Lehrer: You're saying over 75, over 70 in some of the European countries with multiple comorbidities. I think you also just said Pfizer is applying for approval for people over 65 in this country, just based on age. In your opinion, in your medical opinion, where should that line be? We have a lot of listeners who are over 65 and pretty healthy who will run right out tomorrow and get a fourth dose if it's authorized. Should they?

Dr. Monica Gandhi: In our system, no one's applying based on comorbidities and it's probably, you also have to simplify the world just like the UK and Germany and Sweden are simplifying the world. It's likely to just be an age cutoff and anyone over 65 is likely going to be able to get it after the FDA puts in their ruling on April 6th. It'll take about three weeks to go through the CDC. Simplicity is best, so something like an older population or those who are immunocompromised are likely to be approved for this vaccine, for the fourth dose.

Brian Lehrer: Then I guess it's up to each individual. Take me one step deeper about how the booster protection Wanes. You said wanes after about four months. I think a lot of our listeners have heard that timeline before, but I think you're saying it's the protection against getting infected at all that wanes, the protection against serious disease lasts much longer than four months. Do we know that?

Dr. Monica Gandhi: Yes, we really do know that. That's why I'm concerned when people use the word immunity wanes, because it's very non-nuanced. Antibodies wane, which are one part of the immune system, but not T cells, not B cells. This is what's called cellular immunity and they look like they're lasting a long time. For example, there was a large CDC study just a couple of days ago that showed during Omicron, even two doses protected the majority of people in this country from severe disease. Why? Because T cells protect you against severe disease. Then the B cells are aided by the T cells to produce more antibodies.

What is waning for most of us is the ability to protect ourselves from mild disease, which our first line of defense is antibodies in the nasal cavity. The way to prevent all of us from getting mild disease would be to boost the entire population every four months. That isn't logistically feasible. It isn't realistic. Beyond that, I think we have to get away from the concept that vaccines prevent all infection. It's related to a lot of what we talked about earlier in the program. They really are there to protect us against severe disease. The most dastardly thing that can happen with COVID.

Brian Lehrer: Before we run out of time, let me tick off two other things in the news real quickly. One, you tweeted about the Moderna trial on kids as young as six months old. How would you describe the results and what would you recommend?

Dr. Monica Gandhi: It was interesting because essentially the Moderna dose for little children, six months to just under six was 25 micrograms given 28 days apart. That is actually much higher of a dose than Pfizer, which didn't really work very well for the two to four-year-olds. Pfizer is on hold right now for little kids. Okay. Going back to Moderna, it did work in terms of its primary outcome, raising antibodies to protect people. Because this was during Omicron the trial was conducted, what's called the vaccine effectiveness was lower than what people thought. It was 37% and 44%, depending on if you stratified by six months to two years and then two years to six years.

Those antibodies, because we just talked about the immune system, heralds that there was probably creation of cellular immunity because actually if you're going to make antibodies, you're likely to make T and B cells. Even though the protection wasn't amazing against mild disease, not as good as we thought, and there was no severe disease in the population, either in the placebo group or the vaccine group because children are much less at risk for severe disease, I still think it was a success to show that antibodies were up where they needed to be.

Personally, if I had a child under six, I would get them vaccinated. For parents that are weighing the pros and cons of this, again, very safe, which I think was a huge outcome of the trial's 4,200 participants, no myocarditis, no problems with the children. It was, I'll call it a middling success. Let's call it that way.

Brian Lehrer: Middling success on effectiveness, zero side effects. Last question.

Dr. Monica Gandhi: Very good antibody titers. I think that's important.

Brian Lehrer: Along with the rollbacks of various mandates, it may seem like a mixed message. Various places are distributing N95 or KN95 masks for those who want to use them. Do you have numbers on N95 effectiveness? If I'm exposed to a COVID infectious person for the same amount of time with an N95 versus unmasked, everything else being equal, is there a number you can put on my risk reduction?

Dr. Monica Gandhi: Kind of, based on physical science studies. One way masking works, which is why I think that mask recommendations are not dropping for anyone who wants very little exposure to a respiratory pathogen. At least by physical science studies, an N95, if you are wearing it properly, fit-tested, that 95 really does mean it's supposed to block 95% of viral particles, probably with taking off and on, it's going to go down with effectiveness. In general, KN95s, FFP2s, KF94s, N95s and double masks block viral particles from coming in variably between 80% and 95%, again, in physical science studies, which I really think do reflect what's happening to us as an individual.

That one way protect really does work, I think, and I have an older immunocompromised father who is simply not going out in the public indoors without one of these strong masks.

Brian Lehrer: Dr. Monica Gandhi, MD and with a masters in public health and infectious diseases specialist, and professor of medicine at the university of California, San Francisco. San Francisco, like New York, has been a national leader in policies to fight COVID throughout the pandemic. We really appreciate your bicoastal view. Since it's only 7:40 in the morning there, thank you again for doing this yeoman's early call. Now you can have breakfast.

Dr. Monica Gandhi: Thank you.

 

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