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Brian Lehrer: It's The Brian Lehrer Show on WNYC. Good morning, everyone. If you haven't heard, Mayor Eric Adams yesterday officially raised New York City's COVID threat level from medium to high alert. That's the official term, "high alert." The number of new cases has been rising again ever since the end of March, so of hospitalizations and deaths. According to The New York Times COVID Tracker, 29 people in New York State died of COVID-19 yesterday. That's up from single digits per day in late March.

Back in January, though, at the peak of the first Omicron wave, more than 200 people a day were dying in New York State. 29 is not bad compared to that, but that's 29 people a day multiply that out by every day and how bad that is. The hospitalization numbers follow a similar pattern. In January, peak of Omicron 1, around 13,000 New Yorkers were hospitalized with COVID at any one time. That fell all the way down to around 1,000 in March. Now, it's approaching 3,000.

The hospitalized and the dying continue to be disproportionately unvaccinated too. According to the New York City Health Department, the high-alert status means people should wear high-quality masks in public settings. Both indoors and outdoors, they say. The city did not return to an indoor mask mandate for restaurants or schools or anything else, nor to a vaccine mandate for indoor adult venues like restaurants and gyms if they didn't have them a week ago.

In fact, despite knowing this was coming, Mayor Adams' one-vaccine requirement change in the last week was to remove the vaccine mandate for New York City high school prompts. The high-alert status also comes with a city government advisory that people should consider avoiding crowded indoor events, but they put no new limits on such gatherings, leaving it to individuals and institutions, and no new protections for workers. The mayor did announce more distribution of masks at public schools and other venues and more distribution of free tests.

Now, we'll ask, who does this way of approaching a high-alert period protect and who does it leave vulnerable? We know that your immune status affects how risky this is for you, and so does your socioeconomic status. Essential workers who can't work from home offices, for example, are disproportionately lower-income and people of color. That's who tend to have to work in the crowded indoor spaces that the city advises other people to avoid voluntarily.

There's no more pandemic unemployment insurance either to help such workers take the city's advice to remain safe without going broke. The same goes for those who live in crowded or multi-generational households out of economic necessity. With me now, with all that as a starting point, Dr. Uché Blackstock, emergency medicine physician and founder and CEO of the group Advancing Health Equity, which helps equip healthcare organizations and startups with the tools and strategies to provide equitable care. Dr. Blackstock, always good to have you on. Welcome back to WNYC.

Dr. Uché Blackstock: Hi, Brian. Thank you so much for having me. I'm excited to be back to speaking with you.

Brian: First, how do you see the overall curve of this latest Omicron wave? As I laid out, we're not nearly at the numbers of January, but we're going in the wrong direction. Are we headed back to a January-level spike?

Dr. Blackstock: Brian, I would say that we don't have a good sense of the true state of the pandemic, right? We have a lot of different misleading factors. For example, the fact that the community levels are based mostly on hospitalization and hospital capacity, the fact that there's no infrastructure for reporting at-home results. I think that we are one severely underestimating the number of COVID cases that are out there.

Some people have been saying it could be by 5 or 10 times as high as what we do know the cases to be. We do have a more contagious variant. While Omicron has this narrative that it's milder, we know by now that because it's more contagious, especially the BA.2 subvariants, it'll end up infecting a larger volume of people increasing the risk for people to be hospitalized and then die.

Brian: Let me follow up on what you just said about probably underestimating the real toll that it's taking. I didn't even give a cases number in my intro because of what you said. There are so many at-home tests right now that don't get reported to authorities that the number of cases would surely be much less than are being reported. Hospitalizations and deaths, they can't be too misleading or can they?

Dr. Blackstock: Well, no. They're misleading in the fact that they're lagging indicators, right? We know for people, often, it'd be two to three weeks after they're infected for rates to go up. Then for deaths, it's a lag. I could say it's a lagging-lagging indicator. It can be six to eight weeks for deaths to increase. I think we can have a mixed picture right now. It's we're at that point we've been at many times during the pandemic where we're like, "Okay, we see an increase in cases. We're seeing a slight uptick in hospitalizations."

Deaths are either stable or declining, but that could be from because-- again, that's being the lagging-lagging indicator. I would say that, hopefully, we won't get to where we've been before, but it's still unclear. We still don't know because we still have many people who have not been fully vaccinated. A fraction of those have been boosted. I think that there's also a lot of variation according to region as well. We know the Northeast is highly vaccinated, but the Southeast is not. I think only time will tell. I hate almost saying that because the fact is that we've lifted all precautions, and so it's almost like watching a trainwreck in a way and not being able to do anything about it.

Brian: I did see in that New York Times COVID Tracker that as you just indicate, the number of deaths per day nationally is less than it was two weeks ago. In New York, the curve for week after week has been steadily up since March. From a health equity standpoint, who's most vulnerable or most likely to die or be hospitalized in the current wave?

Dr. Blackstock: Right, and just like in the intro, Brian, you mentioned people who are immunocompromised, people who are elderly, and then, obviously, mostly low-wage workers. We have data that throughout the pandemic, low-wage workers are disproportionately infected because they're not able to be at home or work from home, one. Two, we still don't have workplace standards regarding COVID.

I would hopefully expect by now that we would have some sort of standards around indoor ventilation, air ventilation, and filtration. How can you even politicize that ventilation? How could you politicize that? We don't really have any workplace standards, so I really would say that those three groups, people who are immunocompromised, people who are elderly, and low-wage workers are the groups we really need to be concerned about because either their immune systems cannot protect them even if they are boosted.

We are seeing even an increase in deaths among people who are vaccinated. I know that citizens see that vaccines don't work, right? Now, we have more people who are vaccinated, but the fact is that so many more people are getting infected that we're seeing an increase in deaths. I do think that those are the three groups we need to worry about. Unfortunately, this shift led by the Biden administration from collective response to shifting more on to the individual.

My sister actually wrote an op-ed with one of her colleagues in The Washington Post recently about this, but this idea that it's up to the individual to keep themselves safe puts an unfair burden on those groups, on immunocompromised, on the elderly, on low-wage workers, especially when there is still unequal access to the "tools." Everyone doesn't have access to Paxlovid. Everyone doesn't have access to testing either right now. We know that a large number of mass vaccine testing sites have closed over the last few months. If you don't have equal access to the tools, then it's really unfair to lift all the precautions like we have.

Brian: Can you go further into that? Who doesn't have access to Paxlovid if they get diagnosed with COVID and they're in a group where that would be prescribed?

Dr. Blackstock: Sure, I think even the Biden administration has admitted that their Test to Treat program has not been the success that it was supposed to be. Even Dr. Ashish Jha, who mentioned actually early this morning in a Twitter thread that they're going to be talking about some new initiatives to increase access, but you need to have access to a health-- Well, one, you need access to testing.

We've actually already seen in terms of testing, so I mentioned testing sites are closing. There actually are racial inequities on who is rapid testing or who is utilizing rapid testing. That tells me that, yes, even though people may be able to go to a website and order them, are we missing something around communicating to people the importance of these rapid tests, how to use them? Then also there's a digital device, so people may not have access to log onto a website to order tests. That's also one issue that I think we really haven't thought about. Then you need access to a healthcare provider.

We know that there are disproportionate access to health care based on certain communities, people of color, low-income communities. You need access to a healthcare provider to write a prescription for a Paxlovid. There are these multiple steps that you need, testing, access to provider, to get the Paxlovid. I think there are some cities like New York City, which seems to be doing actually a great job in terms of decreasing the barriers [clears throat] to access the Paxlovid, but that is not universal. Definitely, I don't think that's the standard across the country.

Brian: We see cases and hospitalizations and deaths going one way. We see policy going the other way. We see the disparities in who's vulnerable to the worst outcomes. Are there elements of the policy response by the city to get even more specific about this that you're okay with and elements that you're critical of right now?

Dr. Blackstock: [laughs] This is the thing, Brian. I have to say this. I feel like once precautions were lifted, once mask mandates were lifted, once vaccine requirements were lifted, it's really difficult just in terms of human psychology to go back and say, "Hey, we're reinstating these policies," especially without clear messaging. I think the messaging should have been, "Things are better now. For now, we are going to consider lifting mask policies given this is the current transmission level or this is the current hospitalization rate, but we are going to reinstate it based on such and such criteria."

That wasn't done. I think now, especially mask policies and vaccine policies have been lifted, really, the horse is out of the barn. Essentially, there's no going back, I think, for political reasons, I think for, obviously, economic reasons. I think that has done a disservice to how this pandemic has been managed. I do think that this idea of getting things back to normal, first of all, things will never be the normal that we knew.

I think we need to accept that, but what we need to really think about is, how do we function in a way, knowing that we are going to be living with COVID to minimize infections, to minimize hospitalization, death, and essentially human suffering? Yes, people want to go out and have a good time, but I think there are ways that we can still consider doing that but having some of these policies still in place.

Brian: Listeners, your calls are welcome for Dr. Uché Blackstock on New York City and COVID high alert officially as of yesterday, but with no new rules on the medicine of it or the policy of it or anything related. 212-433-WNYC, 212-433-9692, or tweet @BrianLehrer. I read the interview with you in Education Week in March in which you said it's unconscionable, you used that word, to leave protection to individuals rather than pursuing a collective public health approach. Public health is about public health. That was in Education Week. You talked about your own kids. What would you be doing now or recommending if you were the health commissioner with respect to schools?

Dr. Blackstock: Oh, pardon me, Brian. I would say that we would definitely have to have clear criteria that's communicated to the public about when we would reinstate mask rules. I hate using "mandates" because people hear mandates and they think

it's scary. Reinstate mask policies about a certain level. When we would lift them, I do think right now, the city is at a high level, which means that there's a high level of transmission and that there's increasing hospitalization. The recommendation is that in public indoor places, you should be wearing a mask. It's confusing to me and, actually, I would just say it doesn't make sense to me that we are not reinstating masks in schools at this point.

Brian: By way of a little recent history, just to remind people because things are so compressed, it's so dense in our world today that we can forget what happened just a few months ago when Omicron was on the way in, in December of last year. It's just a few months ago. Mayor de Blasio ramped up his so-called "Key to the City" policy, which required vaccines for basically anybody working in person in the city, including in the private sector, that also required vaccination for schoolchildren taking part in extracurricular activities considered high-risk, though not to simply attend school.

Mayor Adams has rolled back the vaccine requirement for patrons of indoor businesses but kept it in place for workers, except for performers and professional athletes. The mask mandate for kids over five in schools was lifted too. This is a kind of head-spinning rollercoaster, all these details coming and going, right?

Dr. Blackstock: Yes, Brian, it's super confusing. What I will say is, yes, I think we are at a different stage in the pandemic for a number of reasons. More contagious variants. Actually, Brian, I've got COVID a few weeks ago after going two-plus years [chuckles] trying to dodge it. Actually, we got it because we went traveling. While we were abroad, they lifted the mask mandate for planes. While we were masked, majority of people on our flight were not and so--

Brian: You think you got COVID on the plane?

Dr. Blackstock: I think one of my children got COVID on the plane because the way that I timed it, it was a day that we traveled. Then he ended up infecting a few other family members, including me. I have to say that if I had known that the travel mask mandate was going to be lifted while we were traveling, I probably would not have made that trip, but it was lifted so suddenly. There was no notice or anything. When we got to the airport, no one was wearing a mask. No one's wearing a mask on the flight, so it was almost inevitable.

Brian: We're going to take a short break. We'll continue with Dr. Blackstock in a minute. I definitely want to ask you what you think about the fourth dose or second boosters for different people. We have a lot of calls coming in, so a lot more to talk about regarding New York City now officially in COVID high-alert status and other related things. Stay tuned.

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Brian: Brian Lehrer on WNYC as we talk with Dr. Uché Blackstock, emergency medicine physician and founder and CEO of the group Advancing Health Equity. On this day after Mayor Adams declared high-alert status for COVID-19 spreading as

quickly as it is now, hospitalizations and deaths going up as they are in New York City. Let's take a phone call. Here's Kylie in Northern Virginia, you're on WNYC. Hi, Kylie.

Kylie: Good morning. How are you both doing?

Brian: Doing all right.

Dr. Blackstock: Good, how are you?

Kylie: Good, thank you. I have one really, hopefully, an easy question. When we say vaccinated these days, what do we mean? Does that mean that you've been boosted in the proper time? What does it mean that somebody is "vaccinated" these days? The second question on this whole issue of equity, I can't wrap my mind around why the government hasn't really implemented COVID FMLA. This comes out as a two-pronged approach. Number one, with the return to work and I've actually discussed this with my employer.

Brian: That's just so people know the initials, FMLA, Family and Medical Leave Act?

Kylie: Yes, thank you. Because if we're doing a return-to-work and there's no coverage for me as an employee if I get COVID or if I'm exposed to COVID and, therefore, I have to quarantine if I have to use my PTO. This is very privileged. I acknowledge that. If I had to use my PTO to cover that, then that becomes a problem.

Then the flip side is, for people who don't have childcare, who don't have the luxury of having a pay cut if they can't go to work, then knowing your status, knowing whether or not you have COVID really means very little and there's nothing you could do about it either way. To me, the solution to that is to re-implement COVID FMLA so that if you have COVID or if your kid has COVID or your agent-parent has COVID, you can stay home, therefore, not spreading it. Those are my two questions/comments.

Brian: Thank you. Dr. Blackstock, and I can just hear the heads nodding out there, "Me too, me too."

Dr. Blackstock: [chuckles] Right, so, first, for vaccinated, vaccinated means that you've had your two doses of mRNA vaccine, and boosted means that you've had at least one booster, one third dose of that vaccine. That's what that means. Then in terms of the COVID FMLA, the comment that the caller made, obviously, I totally agree with this. The fact is, is that the United States does not have the social safety nets, have the workplace protections needed to really help keep people healthy, right?

When we talked earlier about low-wage workers, many of them work in jobs with no paid sick leave. Even if they have a mild illness, if they're out for 7 to 11 days, that's 7 to 11 days of pay that they're losing. I've always said that this pandemic, there's no stronger argument in this pandemic for a single-payer universal health care for paid sick leave, paid family leave. All of that is just so incredibly important. Those are

items that other countries provide for their patients, other high-income countries. The United States continues to be an outlier in terms of not protecting workers and families.

Brian: A friend of mine was just telling me about her sister, who's staying home all this week with her COVID-positive kids using PTO, paid time-off vacation days, using their vacation days to stay home with her COVID-positive kids.

Dr. Blackstock: Exactly.

Brian: Isn't this government provision for that?

Dr. Blackstock: Right. Brian, I want to say, a lot of times, people compare the US to European countries, but European countries have socialized medicine, right? They have these other provisions that keep society safe and healthy. The fact that we have a certain number of hospitalizations here and deaths here in cases is very different than what's happening in Europe because of that safety net.

Brian: Let's go further into what the federal government is or isn't doing. They are stuck in gridlock over new funding to fight the pandemic. Congress stuck in gridlock over that. The Republicans won't support it. The Democrats want it. Does this mean though in practice that tests and treatments and vaccines will be any less available or cost anything to lower-income people if they're currently free?

Dr. Blackstock: Brian, I think, ultimately, what's going to depend on is what's happening on a local and state level. I think certain states, probably the ones that are more progressive, are going to be able to provide testing and vaccines and therapeutics to people who are uninsured at no cost. For people who are insured, they may end up actually having a cost. Even though your insurance company may end up paying for the vaccines and therapeutics and testing, their premiums may end up going up, increasing in the long run because of that without congressional funding.

Brian: I did see the government is making a third round of tests by mail available for free. Anyone can sign up online to get eight more at-home test kits mailed to us. Not everybody's going to know about that. Not everybody's going to have the wherewithal or the internet access as you were saying before, but I still thought it was worth saying that out loud because a lot of people don't know third round of tests by mail available for free from the federal government.

Dr. Blackstock: Brian, I have to say, I was shocked because I actually saw an article actually from NPR. I saw an NPR article that announced it, I think, about two days ago. I said, "Why wasn't there an announcement by the government?" Why wasn't there a briefing saying, "Everyone, you are eligible for a third round of tests"? Now, this time, we're increasing it from four tests to eight tests per household. The communication is absolutely horrible. I do feel like at the very minimum, they should be offering these rapid tests to households at the very minimum, considering our current situation.

Brian: By the way, the website for that is covidtests.gov. Covidtests.gov. Hopefully, easy enough to remember. Vanessa in Bayside, you're on WNYC with Dr. Uché Blackstock. Hi, Vanessa.

Vanessa: Hi. Oh, my gosh, I'm totally fangirling right now. I listen to the show every day. I'm so glad to be on.

Brian: Glad you're on.

Vanessa: I just wanted to ask the doctor if her child was masked on the plane though, her child that contracted COVID she believes was on the plane, or the child was under two years old because my husband and I will be flying for a wedding. While our six-month-old will be staying here, we're obviously going to mask on a plane, but we're nervous about the travel and coming back and possibly bringing something to the baby.

Dr. Blackstock: My children are both over five and they were both masked on the plane. One thing about planes for people to understand is that being on the plane itself is actually relatively safer than the boarding process and deep cleaning when the air circulation is turned off at those time points. Often what I recommend for people if you're on the plane to direct the-- What do you call it? There's the air vent above the seats. Direct it towards your face. That's one recommendation. The challenge, obviously, is with deep cleaning and boarding, where people are just in the jetway, indoor space, crowded, right next to each other. That's where the risk happens, unfortunately.

Brian: Vanessa, be safe on that trip. Good luck. Call us again. If your kids were masked on the plane and you think they got COVID on the plane anyway, what do you say to listeners who might hear that and throw up their hands and say, "Well, then masking doesn't matter. I'm not going to mask"?

Dr. Blackstock: Well, no. We know that, really, universal masking is most effective, right? When everyone is masking, that's when we really have decrease in transmission. One-way masking, it's just less effective. I think people have to think about these multi-layered strategies and you should still mask. It still is protective to some degree, but it's not as protective as if everyone else is masking. Just for people to know, my children still wear a mask to school. They never stopped wearing a mask to school and that's just because of-- I'm sorry. Go ahead, Brian.

Brian: Oh, I was just curious what percentage of your kid's class since it's voluntary now, I gather, on masking.

Dr. Blackstock: Interesting question because at drop-off, I always look. I would say probably about, definitely, the majority of children in the classroom are masked. Probably about 60% are masked. They go to a very diverse school racially, socioeconomically. It's a New York City public school, obviously, but it's a very diverse class. I was surprised actually that the masking rate wasn't higher. I'm surprised it wasn't close to 100%, but it was definitely the majority of kids wear masks.

Brian: Interesting. You said in that Education Week interview that you thought lower-income kids of color in New York were choosing the remote option when that was available or, really, their parents in most cases were choosing it for them, choosing the remote option at a higher rate than other kids because they didn't trust the school system to actually be acting in their interest. Do you think we've learned anything after that phase?

Dr. Blackstock: Brian, [laughs] I would hope so, but we seem to be making the same mistakes. I honestly think that there was really an opportunity for the DOE really to meet parents where they were and to really acknowledge the concerns that they have. I always talk about this idea of institutional mistrust, that it's really not people who mistrust the institutions, but the institutions have proven themselves untrustworthy for a very long time.

There are different things that you can do with the community to engage them. I always talk about our school principal who held numerous town halls to answer parents' questions, gave very detailed descriptions of how the classrooms would be set up, and air purifiers, windows opening. Anyway, just a lot of details to make us feel more reassured about bringing our children back into the classroom. I know that wasn't done at other schools, but that should be really the standard.

Brian: Staying on the topic of schools, Erica in Brooklyn, you're on WNYC with Dr. Uché Blackstock. Hello, Erica.

Erica: Good morning. Thank you so much. I am calling you from quarantine. I've been home since last Monday when my daughter tested positive for COVID. It turns out about half her sixth-grade class had it, not so surprising given the mask situation. She, fortunately, tested negative and was able to return to school on Monday this week, but I've remained stubbornly positive. Fortunately, I can work from home, so I don't have much to complain about there, except for the fact that I had to rely on very generous friends and whatnot to navigate getting her to school while I'm stuck at home because I am a single parent.

My comment is just to reiterate what others have said. I think it's ridiculous for us to be putting the onus on young kids to make these decisions around masks in schools when this is so obviously a high-risk situation for everybody now. Just to share that frustration and the absurd situation that we're in, I actually had also a question about the recent thing about boosters for kids. My daughter's 11 and she got vaccinated earlier this year.

I was really surprised when the emergency approval came out because it was the same dose for kids between the ages of 5 and 11. As any parent of a young kid knows, most medications for kids change based on their weight. The fact that they have not shown to be as protective doesn't really surprise me much because my daughter is twice as big as a five-year-old. She's turning 12 in the fall, so I'm thinking, it just makes sense to wait till she's 12 and to get her an "adult dose" at that point-

Brian: As a booster.

Erica: -especially now that she's had COVID. Yes, as a booster because the dose is three times as much. I feel like we have some protection in the meantime because of this recent infection, so I'm just curious about the doctor's thoughts on that as a strategy.

Brian: Great question, Erica. Thank you very much.

Dr. Blackstock: Thank you. That's an interesting question. Of course, you know what I'm going to say. I'm going to say I would not wait to get the booster. One of the reasons actually is because we're seeing with the Omicron variant and the subvariants that we really don't develop that much immunity from infection and that we're seeing multiple reinfections within a year-- during a year rather.

It is possible that between now and your daughter's birthday that she would actually get another COVID infection. Of course, we know that increases the risk of COVID complications, of long COVID, of multisystem inflammatory syndrome, and so that's why I would recommend that your daughter gets a booster as scheduled five months after her second dose.

Brian: A couple of follow-ups there. One is, are there a lot of people who had Omicron in the winter now getting Omicron BA.2?

Dr. Blackstock: Oh yes, actually, Apoorva Mandavilli, who's been on your show, a New York Times science writer, she just actually wrote a piece about this about people within a few months getting reinfected again with Omicron, especially recently. Especially with the Omicron variant and subvariants, we're seeing an increase in reinfection because the immunity that you're developing from the Omicron variants is very different from the wild-type variants. You may have some immunity for one or two months, but you're likely to probably get another infection again if you're exposed.

Brian: Another news story from the last day that hooks to Erica's call. The FDA yesterday approved first boosters for kids 5 to 11 years old. The CDC also has to approve it for them to actually become available, but that's expected. Do you recommend boosters for all 5 to 11-year-olds who got the original vaccine?

Dr. Blackstock: Oh yes, definitely, Brian. What I'll say is that, right now, only about 30% of 5 to 11-year-olds are fully vaccinated. I think we need to really do a push in terms of public health messaging and you're talking to pediatricians really to increase those numbers. My kids are going to be getting their boosters next week actually. One is five and one is seven years old. I also just wanted to make a comment about the caller mentioned the difference between the 5-to-11 dose and the 12-and-up dose.

The 5-to-11 dose is a third of the adult dose and it's not based on weight. That's not how vaccines are-- how they're dosed. That's different from other therapeutics. The thought is that maybe because this dose is a third of the adult, maybe that is why it hasn't been as effective in kids. That's why they're recommending this third booster,

which is another dose of a third of the adult dose. I'm sorry that's confusing. Basically, 5 to 11 year old will be getting three doses that are the same.

Brian: Some tweets coming in. Listener writes, "In Nassau County, maybe 5% of elementary school children wearing masks at my daughter's school." Another one, "My four-year-old has to get tested every time she has cold symptoms due to her school policy. Tests must be performed by doctors. The tests are no longer free is my understanding," writes that individual. To that one, is there someplace where anybody can get a free test if they know where to look?

Dr. Blackstock: A free rapid test or PCR?

Brian: PCR.

Dr. Blackstock: Oh, I think nycHealthy, so health and hospitals and the New York City Department of Health. You can still be tested at any of their sites for free. Everyone should know that that's listening.

Brian: Another tweet listener asks, "Are there New York City legal protections for workers with comorbidities that make them more vulnerable to serious illness from COVID if they return to a group office setting with no mask mandate, social distancing, or improved air filtering?" Legal protections.

Dr. Blackstock: I'm not sure, Brian. Yes, that's not within my scope of expertise, but I wonder, have you spoken to any--

Brian: I don't really know the answer to that either. I imagine the Americans with Disabilities Act might kick in at some point. Obviously, that act was not conceived with COVID in mind. I don't know if there have been legal gray areas identified with that. Listener who posts as "vaccinated masks socially distant," that's their Twitter handle. We'll follow up on that and try to get you an answer, but it's not going to be in today's segment.

Let's end with a second booster question that a lot of people have been asking when they call in in recent days, and that is, do you have an opinion about, for people who are going to get the second booster, switching brands for a broader spectrum of protection or some people say the Moderna has just proved itself to be better than the Pfizer over time?

Dr. Blackstock: Brian, there's no hard data looking at the fourth booster and mixing and matching with the fourth booster, but I think that people should feel free to get whichever booster, either Moderna or Pfizer. I would say, yes, Moderna has seemed to have performed a little bit better, I think, because the dosage is higher compared to Pfizer, but I think you can't go wrong either way. I would just love as many people if they're eligible to get boosted.

Brian: Wait, the dosage is not higher relative to Pfizer, right? Isn't the Pfizer like 100 micrograms and the-- Oh, I see. It's 50 micrograms compared to 30, so you're right. The Moderna, even at what they call a half-Moderna dose, is still more micrograms

than-- Are you just recommending Moderna?

Dr. Blackstock: No, I'm saying you can't go wrong either way. If it makes someone feel better to get Moderna, then that's fine, but either choice is fine. Moderna or Pfizer.

Brian: Dr. Uché Blackstock, emergency medicine physician and founder and CEO of the group Advancing Health Equity. Thank you as always. So informative as always. We appreciate it.

Dr. Blackstock: Thank you so much, Brian. It's always an honor to be in conversation with you.

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