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Brian Lehrer: It's The Brian Lehrer Show on WNYC. Good morning, everyone, and we'll dive right in today with some Tripledemic reporting and Tripledemic advice with COVID, RSV, and the flu all spiking right now. The COVID numbers nationally from the New York Times COVID Tracker show deaths, which had dropped below 300 a day before Thanksgiving are now back up close to 500 a day. Cases, hospitalizations, ICU admissions, and test positivity rates, all those common metrics are all substantially up as well, not as bad as last year at this time, but bad enough.

Now, at this time last year, by way of comparison, when Omicron was new the average number of COVID deaths per day was around 1300. Now it's 468, so not as bad, but bad enough, and The Times Tracker says cases are three times higher among people not fully vaccinated than those who are, the death rate is six times higher among me unvaccinated. Locally, one striking stat is that there are about as many New Yorkers hospitalized with COVID now as last December on this same date, around 4,000 New Yorkers hospitalized statewide.

Nassau County leads the way on that with 49 people per 100,000 hospitalized. Every other county in the state, including the five boroughs of New York City, is in the twenties or below hospitalized per 100,000. Again, it's 49 in Nassau County. New Jersey's new cases per day are up about 55% compared to two weeks ago with Somerset and Hunterdon Counties reporting the biggest spikes about 70 New Jerseyans have died from COVID in the last week, about 420 New Yorkers. Now comes the question of what to do about it.

Governments and most school systems are largely done with vaccine and masking mandates, you know that? Eric Adams is still demanding full-time in-person attendance by city workers as well. No hybrid if you're in the city workforce. Officials are recommending more consistent masking on mass transit to be sure and in indoor crowded spaces generally, but that's about all, recommending. Here's New York City Health Commissioner, Dr. Ashwin Vasan on All Things Considered yesterday.

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Dr. Ashwin Vasan: When you're in public crowded settings like subways or schools or elevators or crowded stores, or you're doing your holiday shopping, it makes sense to wear a mask when you're going in and out of stores.

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Brian Lehrer: It makes sense is about as far as the government will go. He's the New York City Health Commissioner, Dr. Ashwin Vasan. Last December, around this time, how quickly we forget Mayor de Blasio was imposing a vaccine mandate for almost all indoor public spaces. Remember that? In fairness, last December, at this time, the US was seeing around 120,000 new cases a day.

Right now it's around 65,000 a day according to The Times, but it is still rising. With us now, Jessica Malaty Rivera, infectious disease epidemiologist and research fellow at Boston Children's Hospital and The Johns Hopkins Center for Health Security, senior advisor at Pandemic Prevention Initiative Infectious as well, and as a COVID information communicator, she has more than 400,000 followers on Instagram.

The posts at the top of her feed include a picture of a guy in a green Christmas suit with an arrow pointing to his left arm, and the caption says, "the best way to spread Christmas cheer is getting a flu shot right here." Another post is a cartoon about protecting yourself from COVID in crowded spaces outdoors. Wait, it can spread outdoors? And in what she calls fleeting encounters indoors. We'll get into those. Jessica, thanks for coming on with us. Welcome back to WNYC.

Jessica Malaty Rivera: Thanks, Brian. Thanks for having me.

Brian Lehrer: We'll get into flu and RSV as we go, but on COVID, to start out, I gave some comparative stats to last winter's original Omicron spike. How would you describe the current moment nationally?

Jessica Malaty Rivera: It's important to remember that the COVID data that we have is a severe undercount. I know I've probably said that phrase a lot of times, even when data was richer than it is today, but as far as states reporting daily cases, tests that are coming back positive, those numbers are very unreliable because the cadence of reporting has dramatically decreased, and even with the CDC, the reporting of that is happening at a much slower rate than it's happened at previous times in the pandemic. Even still, when you see these numbers very high, it is alarming knowing that it is an undercount.

You're right in that you said compared to Omicron, it seems lower, but at the same time we're not seeing all of it. There's a huge shift in how testing is happening as well in the United States, you're seeing a lot more use of at-home testing, and unfortunately, that data doesn't make it into these charts. That data often just ends up in trash bins and homes across America because there isn't a system to self-report a positive case from an [unintelligible 00:05:43].

Brian Lehrer: That's why, in the intro, I was leaning more on hospitalization rates and death numbers. It's hard to undercount those, right?

Jessica Malaty Rivera: It is, but at the same time too, if you're going to be comparing some statistics right now, flu hospitalization has actually overtaken COVID for the first time.

Brian Lehrer: Really?

Jessica Malaty Rivera: Yes, it has. We're quite alarmed by the rate of flu. In fact, I've seen some comparisons say that we haven't seen something like this since the 2009 H1N1 pandemic. We knew that this would happen. We were bracing for impact when we saw data from the southern hemisphere about how flu had hit places like Australia and New Zealand. It's not too shocking, but knowing that mitigation, like masking is hard to come by, it is expected that you would see such high hospitalization rates because there's not a lot of people wearing masks.

Brian Lehrer: Let's talk about flu for a second and certainly we're going to get into mask, we're going to get into vaccines. We'll get into RSV, but I did look at the CDC's flu tracker for New York City as an example, and if I'm reading the graph right, it shows 17,000 positive flu tests already this season compared to just 8,000 for the next highest entire flu season a few years ago in terms of recent years.

Again, if I'm reading that chart right, it's not as clear to me as The Times COVID Tracker on COVID. We are seeing a very bad flu season this year. Again, just that New York City number, according to the CDC chart as I'm reading it, 17,000 positive flu tests already this season in New York City, 8,000 for the entire flu season in the most recent most next highest year, about three years ago.

Jessica Malaty Rivera: No, you're reading that right. There are things that we call seasonal baseline and an epidemic threshold, which is what we would expect every year. Flu has been, as people remember, quite mild the last few years, in part due to the benefits of COVID mitigation and its effect on another respiratory virus like influenza, but this year we're seeing rates much higher than the seasonal baseline and much higher than that epidemic threshold. In fact, we saw some staggering numbers at the end of November, which kicks off flu season of more positive cases of flu in one week ever recorded in the United States.

Brian Lehrer: Wow, and yet, again, if I'm reading these graphs it's still really low in terms of number of cases compared to COVID. If we have 17,000 positive flu tests so far in New York City, we're having that about every few days in New York City, 17,000 with respect to total COVID cases.

Jessica Malaty Rivera: Yes, but the problem there is that it's never just one disease, especially as we think about this "Tripledemic." Looking at any of these case counts in isolation isn't going to really give you the right picture of what hospitals are looking like because it's a combination of influenza, COVID, RSV, pneumonia-related infections, and as a result, you're seeing a just incredible burden on hospitalizations. Some estimates saying 4x as they are usually this time of year.

Brian Lehrer: 4x?

Jessica Malaty Rivera: Yes, four times as high.

Brian Lehrer: Four times what typical for December?

Jessica Malaty Rivera: Right. Hospitalizations per 100,000 in the last few years, what we're seeing right now at this early point in December has been four times what we have seen around this time usually.

Brian Lehrer: Well, we remember in the original COVID wave, one of the biggest reasons for the early lockdowns and then mask mandates was that the hospital beds were filling up, and we wanted to avoid-

Jessica Malaty Rivera: That's exactly right.

Brian Lehrer: -avoid the dire scenario of not being able to treat really sick people because there were no beds. Are we approaching or exceeding that threshold anywhere now?

Jessica Malaty Rivera: We really are, and I think, at the risk of repeating myself again, the same priority as we had early on in the pandemic of flattening the curve or protecting our healthcare infrastructure, it remains today because we're seeing these overlapping surges, these hospital beds filling up. What makes that a very concerning trend is that we are pretty early into the winter months.

We still have many more months of the flu season ahead of us. If it's already difficult right now to triage patients who need care in ERs, it's going to make it very difficult to rationale the amount of beds we have, the ICU positions we have, the ventilators that are needed because there are just so many people who are requiring respiratory support in emergency care.

Brian Lehrer: Now, listeners, we can take any Tripledemic questions for infectious disease epidemiologists, Jessica Malaty Rivera on COVID or Flu or RSV right now, 212-433-WNYC. I'd be especially interested in hearing from people who work in hospitals since what's happening there is such an important indicator of what kind of moment we're in right now, as well as, of course, concern for the individuals you're helping to care for.

Are the beds filling up hospital employees 212-433-WNYC? Do you have staffing shortages, which I keep hearing is a part of the problem? What else would you like to report if you work in a hospital, help us report this story, or anyone else may call to with any related questions. 212-433-WNYC, 212-433-9692 or tweet your comment or question @BrianLehrer.

Jessica, I mentioned in the intro The Times COVID Tracker stat of not fully vaccinated people dying from COVID at six times the rate of vaccinated people, but I'm not sure what they're counting as fully vaccinated at this point. Do you know what that comparison might be for people who only got the initial shots and not the subsequent boosters or the latest bivalent omicron-specific one in terms of risk of death?

Jessica Malaty Rivera: It's a great question. Unfortunately, the definition for fully vaccinated has not evolved from completing the primary series. If that's the -- We're talking about the mRNA vaccines, for example, you're talking about those two doses as being fully vaccinated. The language of being up-to-date is what's being used for those who have received their boosters, and that includes monovalent boosters, which have now been replaced by bivalent boosters, but that's not reflected as fully vaccinated.

There's fully vaccinated and then there's with a booster, and with a booster is what we would consider up-to-date. Unfortunately, when you are comparing those who are fully vaccinated, looking at booster rates will tell you that the booster rates are not very high, especially for bivalent. You're still actually comparing this to those who just completed the primary series.

Brian Lehrer: Which is more important, in your opinion, to slowing transmission now? I could see that is between masking and being vaccinated. I could see an argument for masking being more important because it reduces transmission and face-to-face contacts. The vaccines from everything we always hear are excellent at protecting against severe cases, but maybe not so much, maybe a little disappointing actually at stopping transmission. Is masking the more important variable for slowing the spread right now?

Jessica Malaty Rivera: I don't like to rank the mitigation, to be honest. I will say masking is a critical aspect of preventing transmission, especially because it is intended to create a physical barrier to stop respiratory droplets from spreading from person to person, but it really is the cocktail of things. It's the masking, it's the distancing, it's the hand hygiene, it's the getting up-to-date with your boosters.

There's been a lot of unfortunate debate about what the boosters actually do or what the vaccines actually do, and folks claiming that these vaccines don't actually prevent transmission. The reality is when you have more people boosted, more people up to date on vaccines, you are going to reduce the rate of transmission in the community overall because they'll be less people sick in general. Overall, it's intended to prevent you from having a severe illness, but it's hard to really rank them because if all of them are high, then you do see the benefits at the community level.

Brian Lehrer: Daniel in Queens, you're on WNYC with infectious diseases epidemiologist, Jessica Malaty Rivera. Hi, Daniel.

Daniel: Hi, good morning. My question is if any of the common colds, I know some of the variants are in the coronavirus family. I'm not sure if the other forms of the common cold are in the influenza family, but if they are, and you caught any of these colds, would that give you some cross-immunity or resistance to either COVID or the flu? If there's any vitamins or supplements that help boost your immune system for odd of those?

Brian Lehrer: Daniel, thank you for both those questions. Jessica?

Jessica Malaty Rivera: Great question. Unfortunately, the common cold is not the same virus as the virus that causes COVID-19, so it is in the same family of viruses. Coronaviruses are often the causes for common colds, but SARS-CoV-2 is a specific coronavirus that causes COVID-19, and then we have all the sub-variants of that SARS-CoV-2 virus. As far as cross-immunity, we're not seeing that because, again, influenza and coronavirus are two different families, and SARS-CoV-2 is a unique type of coronavirus. As far as supplements are not going to provide absolute protection, and overdosing or megadosing on vitamins, it's certainly not advised.

I think if you're keeping up-to-date with regular and your daily input of vitamin C and vitamin D, that's certainly okay, but there isn't going to be some cocktail of supplements that will absolutely prevent you from getting it. The best protection against influenza is the flu vaccine, and the best protection against COVID is the COVID vaccine in addition to all the other mitigation efforts that we've been encouraging.

Brian Lehrer: Here's an interesting question from a listener tweeting at us that says, "Question for guest. Just curious, if there had never been a COVID pandemic and Americans had never worn masks, what would you be advising right now in light of flu and RSV rates?"

Jessica Malaty Rivera: Great question. A lot of the things that I've been saying for years, including if you're sick, stay home. If you have a fever, stay home, keep your kids home if they're sick, practice good hand hygiene, make sure that you have your flu shot, make sure that you're not traveling if you're sick. Mask wearing is not actually a unique phenomenon to COVID-19. It's been a practice in healthcare settings for a very long time and in many parts of the world. If it was as bad as it is right now, I probably would've considered mask wearind as well. There are many other things that we've been encouraging apart from the COVID-19 pandemic to prevent the transmission of respiratory viruses.

Brian Lehrer: What we mean by fully vaccinated someone writes about their own company, "When we fill out a daily health screening for coming to the office, it's two doses, mRNA seems hopelessly out of date." Writes that person. Nick in Manhattan, a respiratory therapist, you're on WNYC. Hi, Nick, thanks for calling in.

Nick: Hi, Brian. Longtime listener. I just wanted to share our experience working at a major hospital. I'd rather not say the name in Manhattan, it's based on the East side. I'm in pediatrics, and we have seen definitely a big surge. Just to put it in perspective we have an ICU for pediatrics that has 15 beds. During this surge, we've had to double up, and we are now at 25 beds, and we're seeing something like two to three kids a night come in from other hospitals or just walk-ins to the ED that we are treating for RSV.

I would just say one other thing. It just from parent's worry level most of these kids just need base level support. They're not in any kind of critical danger. It's really just about oxygen support and respiratory support, and I feel like this is RSV is no different from any other year. It's just about the numbers.

Brian Lehrer: Thank you for that report, Nick. A little bit reassuring but also pretty troubling. Jessica, what are you thinking?

Jessica Malaty Rivera: Absolutely agree. We're seeing that in the data this pandemic, this flu season especially is hitting the pediatric population quite hard, and we're also dealing with a huge uptick in RSV. I think that there's a lot of confusion as to why this is happening, but one thing that is important to note is that RSV, it's a prolific virus and everybody before they're two will have had RSV once, maybe even twice. When there is an amount of RSV happening in the population, there will always be a subset of that population that does require some hospitalization or some supportive care. In the last few years, because of masking, because kids being out of school, you haven't seen as much RSV transmission.

Right now with not many masks and a lot more kids back in in-person learning and in-person activities, the sheer number of RSV cases for the first time among kids in the pediatric population, especially zero to two, the most vulnerable population has resulted in this huge uptick in RSV hospitalizations. I think a lot of people wonder like, is it a worst version of it? It's a numbers game. It's because we just haven't seen it happening in the last few years because of mitigation. There's a lot of people, a lot of kids who are in hospitals with RSV and or flu.

Brian Lehrer: Thank you for your call, Nick. We're going to continue in a minute with Jessica Malaty Rivera. We have a lot more to do. Our lines are still completely jammed with your calls, with your questions and reports, and tweets coming in. We're going to ask her about the cartoon that I mentioned in the intro at the top of Jessica's Instagram feed about protecting yourself outdoors and a reference to getting COVID from even fleeting encounters, using that phrase indoors.

We'll talk about how to treat RSV as well as flu. You probably know by now how to treat COVID, but flu and RSV actually less talked about in that respect. We have a lot to do as we continue with infectious diseases epidemiologists, Jessica Malaty Rivera. In your calls and tweets, stay with us.

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You're here on WNYC as we're getting triple demic reporting and triple demic advice from Jessica Malaty Rivera, Infectious Disease epidemiologist and research fellow at Boston Children's Hospital and the Johns Hopkins Center for Health Security. She's a senior advisor at the Pandemic Prevention Initiative as well and very prominent on Instagram as a public health information communicator.

She has more than 400,000 followers on Instagram. Jessica, I mentioned in the intro at the top of the hour, the cartoon at the top of your Instagram feed that I guess you forwarded. I don't think you made this about protecting yourself outdoors and masking for even brief trips into indoor or public spaces because people are getting it from even fleeting encounters. I'm curious about both of those things, on fleeting encounters and using that phrase, we used to be told you need maybe 10 minutes, 15 minutes, 20 minutes of a close encounter with an infected person to likely become infected yourself with COVID. Is it less than that with the current variants?

Jessica Malaty Rivera: The data has shown that has changed as the virus has evolved earlier reporting with SARS-CoV-2 showed that a confirmed exposure was usually prolonged period of time, usually unmasked indoors to qualify as a likely vulnerability for somebody to get COVID-19, and that has changed. The omicron sub-variants are very infectious and outdoor transmission has been reported.

It's sometimes very difficult to understand the rate at which that's happening because outdoor environments have a very few controls to understanding who is with who and in what direction people were facing. It has been reported and as a result, it's encouraged that if you're in large groups to wear a mask. I mean, there has been reports of infections happening in outdoor concerts, at outdoor venues, at amusement parks with people reporting that they got COVID and they were never indoors without a mask.

We know that it's happening. I don't say this to cause panic or fear, we just know that masks do work. My rule for my risk tolerance is that if I'm ever in a place where there's just too many people around me, whether inside or outside, I'm going to keep a mask under protect myself.

Brian Lehrer: What about with all the immunity that so many people now have whether from vaccines or infection or a combination? Does that fleeting encounter transmission get reduced?

Jessica Malaty Rivera: Well, that's the problem right now that we're dealing with some of the sub-variants is that reinfection rates can happen pretty soon after an infection. There have been reports of it happening after 30 days, after 60 days and you just don't want to be getting it multiple times. It's not comfortable. It's very disruptive to you and your family. Because of that, I don't think that we can assume the 90 days protection that we did earlier on, because again, the virus has changed a bit. I don't advise anybody to just live mask-free high risk after a COVID infection because you can be reinfected in a relatively short period of time.

Brian Lehrer: I want to give credit, by the way, on that cartoon on your Instagram feed that we were referring to. I think it comes originally from someone named Malaka Gharib, who's actually the editor of NPR's Life Kit Podcast. That was from Malaka Gharib

Jessica Malaty Rivera: That's correct. It's a great infographic.

Brian Lehrer: Credit where credit is due. Ilia in Michigan, you're on WNYC with Jessica Malaty Rivera. Hi, Ilia.

Ilia: Hi, Brian. This is Ilia from Metuchen. I long time was very--

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Brian Lehrer: Oh, Metuchen, I'm sorry. I had it as Michigan. I want to apologize, Metuchen.

Ilia: No worries. We love our little town. I wanted to know, ask Jessica whether there is any immunity that you have and how long it lasts from having an RSV. I'm actually currently and my kid are under the weather with it. If you have the RSV early in the season, how long would you immunity last? How likely are you to get it again and again?

Jessica Malaty Rivera: That is such a good question that I asked my own pediatrician the same question last week. I didn't get a straightforward answer because, unfortunately, respiratory viruses whether they're RSV or not, with kids in preschool and elementary school age will get between 8 to 10 respiratory viruses in a school year. They don't always test for one virus or the other because the care for the viruses is the same.

They want to make sure that the kids are hydrated, they want to make sure that they're having wet diapers, are properly peeing. They want to make sure that they're managing fever and other symptoms, that they're not vomiting to the point of projectile vomiting. It's the same standard of care for RSV, flu, or COVID for instance. Because of that, she couldn't really say because it could be in a few months and it could be a different virus that would be managed the same way in a few months.

Brian Lehrer: Interesting. I know people who as a matter, of course, over the years have tended to get their flu shots in January or so on the theory that it really tends to peak in those later winter months and the immunity from the flu shot wears off, so why not wait until January? I don't know if that advice was ever right, but does it pertain less this year?

Jessica Malaty Rivera: The recommendation has been consistently to get it before the end of October, so before Halloween because typically when you look at the charts over time, Thanksgiving holiday is when you start to see it really take off. It takes a couple of weeks for the vaccine to provide the proper immunity and protection. If you're getting it by the end of October, the hope is that by mid-November before the Thanksgiving holiday, you should be protected.

Brian Lehrer: On treating RSV, here again, is New York City Health Commissioner, Dr. Ashwin Vasan, who spoke with all things considered yesterday.

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Dr. Ashwin Vasan: If you have RSV, the only thing to do is really rest. There's a lot of supportive treatments, obviously, over-the-counter treatments, Tylenol, cough suppressants. Those are all healthy, effective things to do. Staying home and resting is a really important piece.

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Brian Lehrer: Jessica, there is no treatment for RSV in terms of medication like there is for flu or COVID?

Jessica Malaty Rivera: Correct. There's Tamiflu for flu. For COVID, there's things like Paxlovid and monoclonal antibodies. For RSV, it's just supportive care. It's just managing fever with acetaminophen or ibuprofen. Cough medicine is not recommended for kids until they're much older. It's just managing symptoms at home, resting, making sure that they're not going out.

There is encouraging preliminary data coming out that there should be an RSV vaccine soon. There hasn't been one for a long time and there're hoping to have one soon. That I think will be a huge shift in the burden of disease, but right now, that's the only way to care for it.

Brian Lehrer: Again, to the previous caller's question, just to be clear, if a kid or anybody has RSV early in the season, are they pretty much covered with immunity through the rest of the winter?

Jessica Malaty Rivera: No, I can't guarantee that. You can have multiple RSV infections. Again, they don't always test for them, so sometimes they'll say, we'll test or we won't test because the care is not going to change. It's hard to really know. It's not impossible for a kid to get RSV a couple of times in the season.

Brian Lehrer: Kathleen in Redbank, you're on WNYC. Hi, Kathleen.

Kathleen: Hi. I'm curious to know if anyone's explored the possibility that the current COVID test do not respond to the current COVID variants that's going around. I only ask because I had very bad symptoms that seemed COVID to me and the test kept coming up negative, but I'm convinced that I had it. I'm wondering if maybe that's--

Brian Lehrer: Thank you for that question. Actually, it's the first time we brought up testing. Anybody's brought up testing in this whole conversation, Jessica?

Jessica Malaty Rivera: [laughs] The tests still work to the detect omicron and its sub-variance. A lot of times people are testing too early to have enough infectious virus. To turn a positive test, especially if somebody is fully vaccinated and fully boosted because the virus, the vaccine is doing its job with trying to prevent a serious infection and you have a serious infection when you have more virus in your body. But, they are still working. They have not become obsolete.

The chances are that you may have had it, you may not have had it. Symptoms are very similar to flu and to RSV and other respiratory bugs that are going around. Even if you test negative for COVID, it doesn't mean that you didn't have something else. But the tests are still working for covid detection.

Brian Lehrer: Let's talk about public policy. Before you go, I was looking at a COVID story from NBC Los Angeles and it said, LA County will reimpose an indoor mask mandate if the county's virus-related hospitalization numbers reach two thresholds. If the rate of daily hospital admissions tops 10 per hundred thousand residents, they've already topped that. And if the percent of staffed hospital beds occupied by COVID patients tops 10%. I know those stats are a little wonky for most people, but they've reached one, they've not reached the other. It's one example of a major metropolitan area considering reimposing mask mandates, which is more or less not taking place anywhere yet, right?

Jessica Malaty Rivera: Correct. I mean, we've seen this happen in a number of jurisdictions. Los Angeles is, it looks like they're holding off on a mask mandate, for now. This has happened before when they say, if it reaches a certain point, we're going to encourage this. I think what ends up happening is it becomes a legal battle because it's very difficult to get mask mandates to be approved. It's more like mask advisories, mask recommendations.

I'll be very interested to see if any other jurisdictions do get away with kind of putting another mandate in their jurisdiction. If places like New York and San Francisco come to mind because they've been the most likely to do so. Right now, everybody's just looking at the data, waiting for a point in which to encourage it. I think that that's actually a little bit misguided. I think that when you see rates this high, which are extremely high, the best thing to do is to encourage wide use of masking

Brian Lehrer: Marie in Woodside, you're on WNYC. Hi, Marie.

Marie: Hi. Let me go off the speaker. Excuse me. I had to go into the emergency room in Elmhurst Hospital this past Thursday and then the Friday before that. Both times they were slammed and the staff told me so, and they were struggling to find beds and make room for enough beds in the emergency room, and they had to keep moving people around. It was insane. People were just going nonstop. Nurses were

Brian Lehrer: Running around and I know somebody personally who had to go to an ER a couple of weeks ago, Jessica and the er that he had been to before said they were full and they were diverting, so he had to go to another hospital. We're in that situation.

Jessica Malaty Rivera: We are.

Brian Lehrer: Do you endorse mandates of any kind at this point? A couple of flashpoints around that in the news, the famous retired general David Petraeus I saw this morning as criticizing congress today for passing a law last week that ends the Armed Forces vaccine Mandate. Locally, in Nassau County, Nassau Community College wanted to reimpose a mask mandate for the current surge, but the anti-man county executive Bruce Blakeman made them back down. Do you advocate on these things one way or another, or are we beyond the mandate point and everybody just has to try to get the message and do what they can because the anti-mandate politics has one?

Jessica Malaty Rivera: I don't think we're beyond that point. Even if my opinion on this is in the minority or in vain, I do think that mandates work. I think that when there are rules in place for public health and enforcement of those rules, you do see a positive effect in the data. It's proven right now with the rate at which we are seeing so many respiratory viruses lead to hospitalizations.

You're not seeing many masks in many places, but if you were, I can guarantee that transmission would be a lot lower for all the respiratory viruses that are causing people to enter ERs and hospital beds. I am in favor of that from a mask standpoint, EV, and even from a vaccine standpoint because we know that both of these tools work, both of these tools are safe and both of these tools when used widely in a population can have a larger community effect.

I think when we start thinking about these things as individuals, unless like a community, it becomes an issue for people being anti or pro, but public health requires everybody's buy-in and that's why I believe it's important to have those rules.

Brian Lehrer: The last question, that's an addendum to that. Is there any data on how effective one-way masking is that is so many of us are traveling in indoor environments where most people are not masking anymore? If the person who just as concerned about their own incoming risk, whereas let's say a well-fitting N-95 or KN-95 mask, how protective is that by itself, even if infected people around them are breathing without masks?

Jessica Malaty Rivera: It's a great question. It is very effective. It's hard to quantify it as how versus two-way masking obviously two-way masking is a lot better. When I fly, I'm always wearing a mask and I'm oftentimes these days a minority on the plane wearing a mask. I have been protected from COVID in situations where I have felt uncomfortable, where I've been around people who are coughing when I've been in close proximity with other unmasked people and I know that it's benefited like at least myself. If I have been, sick with something else, it's protected me from getting others sick. There definitely are benefits to one-way masking. It's ideal with two-way for sure.

Brian Lehrer: Jessica Malaty Rivera, infectious disease epidemiologist from Boston Children's Hospital, Johns Hopkins, the Pandemic Prevention Initiative, and her popular Instagram feed. Thank you so much for coming on with us again. We really appreciate all you know.

Jessica Malaty Rivera: Thank you so much, Brian.

 

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