Are we entering the darkest weeks of the pandemic?

A person wearing PPE and holding a nasal swab in silhouette.
A testing event at Incarnation-Sagrado Corazon Church in Minneapolis in August.
Christine T. Nguyen | MPR News file

Updated: 6:37 p.m.

We could be heading into the darkest weeks of the pandemic. Cases are climbing across the country, and winter is coming. Not only is cold weather driving people indoors, where the odds of transmitting COVID-19 are more likely, evidence suggests the virus itself thrives under low temperatures and dry conditions

Meanwhile, people are weary of taking precautions and growing numb to the virus’s threat. Compared to previous months, more people in October told the market research firm Morning Consult they feel comfortable resuming leisure activities, including dining out and going to the gym.

Each Monday at 9 a.m., MPR News host Kerri Miller delves into the pandemic science and research and takes listener questions. This week, an epidemiologist and an infectious disease doctor joined Miller to discuss how and why the virus is spreading and what this means for Thanksgiving dinner with the family. They also talked about the latest news on vaccines. 

Guests:  

  • Michael Osterholm is an epidemiologist and the director of the Center for Infectious Disease Research and Policy at the University of Minnesota. 

  • Dr. Paul Offit is a pediatrician and director of the Vaccine Education Center at Children's Hospital in Philadelphia. 

Below is an edited transcript of their conversation. To listen to the full conversation, use the audio player above.

How do you break through the weariness about the pandemic that seems to interfere with an appreciation of the threat?

Osterholm: The challenge we have right now is actually more than pandemic fatigue.

Fatigue is a sense of — I believe that the virus is real, I think it's a problem, but, I just at this point feel like I need to go do these things. And so this is the challenge where people are, in fact very aware of the problem and will in some cases actually abide by public health recommendations.

The second group, though, that is growing, has been a real challenges. We have data that suggests that maybe as much as a third of the population are what I call experiencing “pandemic anger.” They don't believe that pandemics real, they think it's going to go away the day after the election, that it's all about some kind of political motivation. And this is the group that not only will not follow public health recommendations, but often intentionally go against them just to demonstrate their independence.

When you put those two together, and you put together the really, truly legitimate concerns we all have for the loneliness, for the distance from family and so forth, this has created a real challenge for us.

We've got conflicting messaging in the political realm. So how important is the kind of leadership to break through this fatigue?

Offit: It's critical. If you asked Donald Trump whether he'd like to be reelected, I think he would say yes. If you asked him — do you think that the state of the economy will mean a lot in terms of your reelection? I think he would say yes. Yet, what he doesn't do is — he doesn't set an example for what we need to be doing for this powerful thing that we have in hand, which is hygienic measures, meaning social distancing, wearing masks and washing hands.

He has these rallies where there are thousands of people all very close together, maybe 90 percent of them aren't wearing masks, and it sends exactly the wrong message. The message should be — I know, this is hard, it's not fun, it is fatigue. But we can get back to work more quickly, we can get back to school more quickly if we do these things. So let's just band together as a country and do these things. And then we can really climb our way out of this. There's no simple way out of this.

But what basically they're doing is just [to] close their eyes as tight as they can, and assume that it's not there, [that] it's all going to go away magically. [It] is exactly the wrong thing to do. It's been really hard to watch this.

Listener question: Has the state given any thought to proactively testing anyone who wants a test to go into a potential small holiday gathering? And what would be the value of testing widely? — Chris from Minneapolis

Osterholm: I think one of the challenges we have with testing, as a method of making it safe for you to go do something, is that it's a one time of view of what's happening.

And I think the White House situation with the Rose Garden reception, in the super spreader event there, demonstrated that testing like that isn't going to stop these from happening. You can't test your way out of this pandemic. It surely can be very helpful. But remember, it's just a snapshot in time.

We can test somebody at time one, and test them 24 hours later, and you have a very different result. And we've seen that over and over again. So it still comes back to — basically what are you doing to make certain that you're not infected from your contacts before you get to that family situation.

And if you can say you've bubbled down for 10 to 14 days, and if you have a negative test, that's great. But just remember that just is at that moment. I think the challenge is most people aren't going to be able to bubble down for 12 to 14 days. And remember, it has to be the entire pod. It can't be just one or two people out of the pod.

And we've seen so many situations, I personally have been involved with far too many family situations where young adult kids came home to see mom and dad or grandpa and grandma. There was a very special event that occurred: a wedding, a funeral, a birthday party, something like that. And then to have the older members of the family become infected a week later, and grandma or grandpa or mom and dad are dead three weeks later. That's the kind of thing that we have to keep people mindful of what the challenges are.

Now if this was going to go on forever, I'd say people are going to say we got to live our lives. We're asking to get through one COVID year, one COVID year holiday season and hopefully next year, it'll be very different with the availability of vaccines. So we're trying to figure out how to get through this year.

What was discussed during last week’s FDA vaccine panel meeting?

Offit: I'm a voting member on the FDA vaccine advisory committee. I think what we're dealing with in a sense is a language problem. So the vaccines that are currently being tested will likely be out by, I think, no later than early next year. But they're not going to be licensed.

None of them will be licensed as vaccines are typically licensed in the United States. Rather, they're going to be permitted for use through this system called “emergency use authorization.”

When people hear that, they think of hydroxychloroquine, which also was permitted for use under the same “emergency use authorization” mechanism, a product that not only didn't work, but was later shown clearly not to work to either treat or prevent the disease and also was dangerous and 1 out of every 10 people who took that drug could suffer a heart arrhythmias.

I think people who see that reasonably can say: Is this going to be the same problem with vaccines? Now the difference is that vaccines, on the other hand, are being tested in massive trials. I mean, the Moderna trial is a 30,000-person trial; the Pfizer trial is a 44,000-person; the [Johnson & Johnson] trial is a 60,000-person trial — that's as big as any vaccine trial. I mean, the human papillomavirus (HPV) vaccine was a 30,000-person trial; the vaccine that I was fortunate to work on at Children's Hospital Philadelphia, the rotavirus vaccine was a 70,000-person trial.

So what's the difference? Why aren't we just licensing these products? The difference is length of time that these vaccines are under study. It's really just going to be months, not years. The human papillomavirus vaccine trial was a seven-year trial; the rotavirus trial was a four-year trial; these are just going to be months.

And the FDA would never license a vaccine that had been tested for that short of a period of time — not only because you don't know really how long it's going to be effective but you don't know whether there's going to be a sort of a serious side-effect problem when you're not looking for a variable for any really significant length of time. So I think that's the difference.

I wish we wouldn't say emergency use authorization, I just wish we would say sort of pandemic level of licensure because that's really closer to what this is.

Listener question: Will getting vaccinated mean I can safely go out again? — Suzanne from Bloomington

Osterholm: If people want to understand about these vaccines and how safe they are, they have to take reassurance that people like Offit are on this these committees, because that's the review. That is really what matters.

We've unfortunately had made the message out there that it's all about the politics and the politics are going to decide this. And in fact, that's not the case at all. I have complete confidence in these reviews that are being done.

In terms of the protection from the vaccine, we'll have to wait and see. We don't know yet how well these vaccines protect, particularly by certain risk groups. We know for example, with influenza vaccine, unfortunately, the very people that we want the vaccines to work the most are in some cases the people for which the vaccine works the least. Now, we still recommend them because some protection is better than no protection.

This is going to be a challenge for us with regard to COVID-19. And we will have to wait and see what the data shows us. If we can get a vaccine that can reduce illness by 60 to 70 percent, that'll be a major step forward in terms of trying to respond to this pandemic.

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