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Brian Lehrer: Brian Lehrer on WNYC and back with us now, Jessica Malaty Rivera, infectious disease epidemiologist, and science communication lead at the COVID Tracking Project, the one-year volunteer effort launched from The Atlantic magazine that so many news organizations and other Americans have relied on during the pandemic. As it happens, they did their final day of data collection yesterday, so we'll talk about some of the latest data and what happens next, and listeners, as we've been doing on the show for this entire year of COVID, we can take some questions on the phones, today.

Our topics will be vaccines and variants, openings and closings, and the new CDC guidelines on what vaccinated people can do. If you have a vaccine or variants or openings and closings question, with a lot of moving parts and all those things right now that I know we're all trying to understand, our call-in lines are open at 646-435-7280, 646-435-7280.

Just to be clear, that is not the same as our membership drive line. We will never ask you for a donation when you call to talk about content. Again, it's our call-in line for Jessica Malaty Rivera from the COVID Tracking Project, 646-435-7280. If you want to ask a question, 646-435-7280, and Jessica, thanks for coming on again, and congratulations on what the COVID Tracking Project has been able to accomplish.

Jessica Malaty Rivera: Thank you, Brian. Thank you, I appreciate it.

Brian: Let me start here, movie theaters reopened in New York City over the weekend. We did a cal-in on that for people who went back to the movies in the city this weekend. They've been opened many other places for a while with capacity limits. Is there any good data on COVID spread in movie theaters?

Jessica: There's plenty of data that shows that COVID does spread quite effectively in closed indoor settings, so that is still technically considered a high-risk setting. I would say I would only recommend doing something like that if you were fully vaccinated and you know that the people that you were going with are fully vaccinated. I'm going to always err on the conservative side here, but indoor activity has always been considered, based on the data, a high-risk setting.

Brian: The CDC released data the other day, I saw, indicating cases and death rates have gone up in places where mask mandates were lifted and indoor dining, in particular, was allowed. Do you have any numbers that would describe how much or how much certainty there is to that conclusion?

Jessica: That's a really hard confirming conclusion to make on those two events. We have seen though, just on smaller studies and studies from different local public health departments, that when you do see mask usage decreasing, you do see transmission increasing. On a state level though, we are seeing overall cases are declining and deaths are declining, but it is now not the time to start to take that for granted and therefore justify taking away mask mandates and increasing capacity limits.

Brian: I'm looking at an AP story. Tell me if this is breaking news, just this morning, the way it looks to me like it is. It says, "Fully vaccinated Americans can gather with other vaccinated people indoors without wearing a mask or social distancing, according to long-awaited guidance from federal health officials." Is that correct?

Jessica: That is correct. Just about 30 minutes ago, the CDC director announced new post-vaccination guidelines during the White House coronavirus briefing. They basically listed about four or five things that can now be done by people who are fully vaccinated, including gathering indoors in private homes or in other settings, with a small group, without masking or distancing, assuming everybody is fully vaccinated.

They also said that vaccinated Americans don't need to quarantine or get tested after a known exposure. Vaccinated people still should continue to wear masks and maintain social distance and other precautions in public. They should still avoid, like we mentioned earlier, large gatherings, indoor gatherings, in which you don't know the potential capacity limits there. The emphasis is on small gatherings with known people who are vaccinated.

Brian: That's very reassuring to hear this from the CDC, with more and more people getting vaccinated but what about the variants? I thought there's a lot of uncertainty about whether the variants evade the vaccinations, and whether people who are vaccinated and don't feel sick can spread the variants or still acquire and then spread the disease, even though they don't have symptoms.

Jessica: Yes. The variants are still of concern. There are variants of interest and variants of concern. Right now, we're seeing a lot of variants of interest circulating in the US and I think that a lot of the headlines are still causing more panic than necessary. We chatted about this a little bit last time, that increased transmissibility doesn't mean that the viruses are evading things like masks, or hand-washing, or even physical distancing. It might mean that your infectious window's a bit longer. It might mean that it could evade vaccines, but not fully.

We're still seeing protective value from all of the vaccines against the variants. I find that the Johnson & Johnson data is particularly encouraging because those trials happened as variants were circulating. I think the next, we're at this critical stage in the pandemic where it's a race between the vaccines and the variants. I think that the next four to six weeks can be very telling, for the next four to six months, if we can surpass the variant circulation by increasing vaccinations.

Brian: Julie in Brooklyn, you're on WNYC with Jessica Malaty Rivera from the COVID Tracking Project. Hi, Julie.

Julie: Hi. My question is about vaccines for pregnant people, and I had COVID last March, and I still have antibodies. I recently tested positive. I'm wondering if you have any specific thoughts on people with antibodies who are pregnant getting vaccinated, and if there would be a difference among the vaccines in that case.

Brian: Thank you, and congratulations as your baby becomes the latest to make his or her radio debut on The Brian Lehrer Show. What's your baby's name?

Julian: Well, this is Ezra.

Brian: Okay. Ezra on The Brian Lehrer Show. Maybe Julie's watching somebody else's baby. She asked a very interesting question, of course, Jessica, and it was also interesting to me that she still got antibodies from having COVID a year ago.

Jessica: Yes. One of the things that is still being investigated is people's antibody levels from natural infection. What we do know is that it varies. There are some people who can have prolonged antibody protection, and there's some people where it fades pretty quickly. Again, what we're seeing from natural infection versus vaccination is a different kind of protective immune response. Typically, with vaccinations, it triggers those longer-lasting T-cells, and B-cells, and those memory cells that give you that robust protection for a longer period of time.

I will say that I was very encouraged to see that ACIP, the Advisory Committee for Immunization Practices, just had a meeting on the 1st of March about pregnancies and vaccinations, and they showed really encouraging data about the safety and efficacy, and the protective value of these vaccines for pregnant people. Based on the data and based on the consensus between a number of bodies who speak to things on pregnancy and lactation, it seems like the evidence is pretty clear that vaccines are safe and provide protective long-lasting protection for people who are pregnant and lactating.

Brian: Luisa in Morningside Heights, you're on WNYC. Hi, Luisa.

Luisa: Hi, how are you. I also have a child in the background, so you'll have to excuse some outbursts.

Brian: You can name check your child if you want.

Luisa: This, I have Bridget right in front of me. She's a few days away from turning two. Do you want to say hi, Bridget?

Bridget: Yes.

Luisa: I don't know if you heard that. Okay, perfect.

Brian: You're a good kid, Bridget, I could tell. Go ahead, Luisa.

Luisa: Thank you. I have a question about the long-term outlook, not just summer, not just next year, but people are still in very tiny pockets, getting the bubonic plague, which is obviously not a concern for the general population, but once we achieve herd immunity and most people aren't getting COVID-19, it's still going to be out there and still causing a big problem for the unfortunate people who get it. Is that correct? I'm wondering if you can calm my fears a bit.

Jessica: I think the comparison to bubonic plague should actually calm your fears even more. The bubonic plague is very easily treated with antibiotics. It happens because it's endemic in a number of places all over the world, and even here in the US. It doesn't present a serious risk to the general public. There are some whisperings of could COVID-19 become endemic itself, meaning it circulates every year, like how H1N1 after the pandemic has become a circulating influenza virus and that could happen.

I think that as we create herd immunity through mass vaccination, as we get past the disruption of a pandemic, it could be a virus that we continue to deal with, but it just won't be as destabilizing to the public health, public infrastructure, et cetera.

Luisa: Perfect. Thank you. I'm going to run just because I still have a child, but thank you. Have a good one.

Brian: Luisa, thank you very much, and Bridget, thank you. Question about Texas lifting its mask mandate and all capacity restrictions on everything. I saw your COVID Tracking Project graph on hospitalizations in Texas this year. They peaked in January at nearly 500 people per million hospitalized. It's gone steadily down since then to less than half that. Today, if I'm reading your chart correctly, a little over 200 per million. Since Texas already had fewer restrictions than many other states, is that an indication that this life and death experiment they're about to undertake might work out?

Jessica: No, unfortunately I don't think that these metrics are a license to change policies that honestly, I mean, mask wearing is really the bare minimum when it comes to disease prevention. I understand if you're trying to get your economy back on track and change things like capacity limits, that's a different conversation, but to remove mask mandates to be completely frank, is quite senseless, because it's not disruptive to things like the economy or even to individual life.

I think it's maybe burdensome and annoying to folks, but we know that masks prevent transmission. We are, like I mentioned earlier, at this critical crossroads with the pandemic where we can't let the variants outpace our vaccinations. We really need to keep transmission down and vaccinations up so that we can get that edge. I think the next four to six weeks are going to be very telling. Texas's numbers have dramatically gone down, as you said, since January, but they still have over 4,000 people, almost 5,000 people hospitalized right now.

Their 7-day average for hospitalizations is about 163. That's not nothing. We are still seeing cases each day in the 50,000-plus range. That's why we need to be very careful because we've seen this dip and plateau before. It's preceded other spikes and we just can't risk a fourth surge right now, not where the end is truly insight.

Brian: Do you know the comparative hospitalization or death rates for Texas versus New York or more versus less restrictive states in general?

Jessica: New York has a similar number of people who are currently hospitalized in their seven-day average for cases. For hospitalizations per million is just a little bit north of that, about 246, but again, it's very difficult to use a single metric to compare two states because it requires a number of metrics to get that full context of everything going on. Their populations are different. The density's different, even the vaccination pace and distribution is different.

It's very difficult to just go apples to apples here, and because of that, I think that we need to, as a country, stand together and be very vigilant and determined to get across this finish line by maintaining these public health measures. Even today, in the CDC's post-vaccination guidelines, made it very clear, even the vaccination green lights that you're getting does not eliminate the things that we need to continue doing, because those things do prevent transmission and we really need to work on that.

Brian: Sig in Manhattan, you're on WNYC. Hello, Sig.

Sig: Hi, Brian. Long-time fan, first-time caller. I had heard from a good friend, the usual friend of a friend, that there was some evidence that delaying the second dose could actually increase the effectiveness of the vaccine. Is that true or partially true?

Jessica: There are all kinds of studies being done on what it means to pace the vaccine doses differently based on availability. What the decisions that are made right now per the CDC and FDA guidelines are based on the data that we have from the clinical trials. As we know, from the clinical trials, that optimal antibody response and peak immune response happens as it's properly dosed, which is 21 to 28 days between dose one and two for Moderna and Pfizer.

I think that as distributions change, and maybe they'll look into it even further, but I do think that they will alleviate some of the burden of having to make those decisions now that we have a single dose Johnson & Johnson vaccine that's already in distribution now.

Brian: You're ending the COVID Tracking Project, with yesterday having been the last day of data collection. Before you go, why now with so much uncertainty and specific things to keep track of as you've been describing, as we manage our way out of this?

Jessica: It's a great question and I will say that the work is not entirely done. We still have a number of things that we plan on publishing as far as analysis in the next couple of months, but in many ways this is a bittersweet and triumphant moment for us. Because finally, we can look at CDC data as quite reliable for their cases and HHS data for hospitalizations is extremely reliable.

These are things that we'd been hoping for for an entire year, and we have expected them to happen much sooner, but the fact that it's happening now, it seems like it's the right time. We do feel confident that we are leaving the public in good hands. We're not disappearing. We still have plenty of things to write and say over the next few months, but in many ways, we're reminding folks that this is the job of the federal government, and we are delighted to finally point people to those federal sources for these data streams.

Brian: I know people in our listening audience have very much appreciated your clarity when you've come on. I guess that's why you're what they call the science communication lead at the COVID Tracking Project in addition to being an infectious disease epidemiologist. Thanks for breaking the good news this morning that the CDC now says vaccinated people can hang out with other vaccinated people with no mask or social distancing, and for answering so many listener questions, Jessica, thanks a lot.

Jessica: Thank you, Brian. I appreciate it.

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