COVID-19 will be ‘ever present’ — even in a post-pandemic world, doctor says

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Johns Hopkins Center for Health Security Senior Scholar Dr. Amesh Adalja joins Yahoo Finance Live to discuss the shortage of COVID-19 tests and the need to get more Americans fully vaccinated.

Video Transcript

BRIAN SOZZI: Some reports out this morning suggest South Africa's Omicron-driven surge in new COVID cases may have peaked. That hopeful news comes as Omicron continues to spread aggressively in many parts of this country. Joining us now is Dr. Amesh Adalja, John Hopkins Center for Health Security's senior scholar.

Doctor, thank you so much for joining us. So we did get a little bit of a sliver of hopeful news this morning. But we still continue to see cases here in this country rise. I mean, is there anything in the data that you track to suggest we may be nearing a peak?

AMESH ADALJA: Nothing so far other than what we've seen in other countries like South Africa, the UK, and Denmark that these waves with Omicron seem to go quicker than Delta waves, and Delta waves one quicker than other waves. And it may have to do with who's getting infected and network effects of that go on in the community and how people change their behavior in response to increased levels of cases.

But I think what we can expect is, the next couple of weeks, we're going to see cases rise. The goal is going to be making sure that hospitals in some parts of the country that are already stressed with Delta have the capacity, have the staffing to be able to operate. And that's going to be the key thing. We're going to see kind of a two-track pandemic, something where the vaccinated basically get their inevitable breakthrough case and then go on with their life, but high-risk unvaccinated individuals may end up impinging on hospital capacity.

JULIE HYMAN: Doctor, there's a lot of confusion out there I think right now about what people should be doing in terms of travel, in terms of testing and when they should be testing, and for how long they should be quarantining. Do you think that public health officials are doing a good enough job right now-- and I speak specifically of the administration-- in terms of communicating? And I think with the understanding, I should say, we all realize that there's still a lot of uncertainty. But the things that we can be certain about, do you think they're doing a good enough job with that messaging?

AMESH ADALJA: No, I think there's been missteps throughout this pandemic with public health communication. I think that's one of the stories of this pandemic is that we could have done a lot better just with better communication to the public, and wouldn't have kind of had the country divided into kind of two different camps if there was better public health communication.

But I do think that what we need to be clear with is, if you're fully-vaccinated-- and you heard the president say this-- you have a different trajectory when it comes to this pandemic because you're protected against what matters, severe disease, hospitalization, and death. And for those people, they can for all intents and purposes, go back to enjoying their life. They can test if they want to minimize the risk. But a lot of this for them is going to be risk calculation because they're inevitably going to get a breakthrough case of Omicron. That's not something that's avoidable.

When it comes to the unvaccinated, the message still has to be, get vaccinated, and get vaccinated quickly because omicron is going to be coming for you. And if you're high risk, you may end up not having a hospital bed if your hospital is already getting crushed with Delta. But I think we've got to teach people how to risk-calculate and really be honest with them that this is a virus that's not magically going into bats, it's going to be endemic. We're always going to have some level of COVID-19 risk.

And the post-pandemic world is not the world of 2019. It's a world in which COVID-19 is ever present. And I think that was something that hadn't been said or articulated much. Yesterday, I think you saw the president finally kind of acknowledge that saying breakthrough infections are going to happen everywhere. That's what we expect, but that's not something to worry about if you're vaccinated because that's what the vaccine was meant to do is make all those breakthrough infections shift towards the milder side of symptoms.

JULIE HYMAN: Yeah. I mean, I think it's more of a question of if you get a breakthrough infection if you're vaccinated, you might not be adversely effective. It's more a question of who you might be adversely affecting, right? And so on that point, Dr. Fauci's recently made comments about that maybe folks don't need to quarantine or don't need to quarantine as long even if they're positive if they've been vaccinated. Does that feel like the right guidance for you? How should people be thinking about quarantining at this point?

AMESH ADALJA: It's absolutely the right guidance because we can't apply a one-size-fits-all isolation period to everybody, especially when you're talking about breakthrough infections where we know that the contagious period is significantly shortened. So what you can do is use rapid tests to be able to determine when you become not contagious. So you can take a rapid test every day or every 12 hours. And when you start becoming negative, you can then end your isolation period. So I think we can go from that 10 days probably down to five days for some people.

And I think that's going to be really important because even though breakthrough infections are mild, the fact that people have to isolate for 10 days is really, really disruptive to their lives, to the economy, to everyone. So once we can get to the point where this becomes guidance that you use tests to end your isolation period or to end your quarantine period, that will be something that everybody will really welcome. And I think there's data to support it. Hospitals are already doing that.

We're hearing about NYU going down to five days. And this is something that I think really has to be part of how we learn to navigate with this virus to make it much more manageable much like other respiratory viruses. If you have the flu, they tell you to stay home until your fever goes away for 24 hours. I think we'll get to a similar point for the vaccinated with COVID-19

BRIAN SOZZI: Doctor, would changing the definition of fully-vaccinated be helpful in getting the pandemic under control?

AMESH ADALJA: I don't think so. I think when it comes to getting the pandemic under control, what we're really trying to do is prevent severe illness, hospitalization, and death. Fully-vaccinated individuals are protected against those metrics. When I work in the hospital and I take care of patients in the intensive care unit, it's not people who lack a booster that are there, it's people who lack first and second doses. So I don't think that there's any way to say that someone who has two doses of the Pfizer or Moderna vaccine or one dose of the J&J vaccine is equivalent to someone who has zero.

And that's what changing the definition of fully-vaccinated would be. I think we should stick with this definitions now, and emphasize booster vaccinations for those at high risk, people above the age of 65, people with high risk conditions that put them at risk for hospitalization. And those who got the J&J vaccine. But keep the definition the same because it really reflects the fact that you're protected against severe disease, especially if you're a healthy person.

JULIE HYMAN: Doctor, it seems like this current wave, that testing is more important that it's than it has ever been because of its level of transmissibility. And yet you can't get tests. What should people do if they can't get a hold of a test right now?

AMESH ADALJA: They have to be innovative and trying I would call around drive to different towns, use online ordering. It's really inexcusable that this is happening now this far in the pandemic in the United States when all of us have been clamoring for better access to testing from the very beginning. I've always said that the original sin of the pandemic has been testing, and it continues to be a sin that the government commits.

What I think people should do is also ask why they're getting tested. If you're fully-vaccinated and you're just doing it for screening, I think there's less value in that situation than if you're exposed or if you have symptoms. So in those situations, if you've been exposed, you probably should be careful until you can get a test. Maybe you're going to have to get a PCR test, but that's a problem as well because the turnaround time might be five days, and it's a completely worthless when you get the result back.

really just a horrible situation. It is another failure that we've seen. And it's, to me, inexcusable because it's not something that was not forecasted. We knew that this was going to be a need especially as people want to get back to their lives and they see testing as a way to do it safely because they can know their status and take protective actions based on whether they're positive or negative.

BRIAN SOZZI: Dr. Amesh Adalja, Johns Hopkins Center for Health Security senior scholar. Good to see you. Thanks so much for making the time this morning. We appreciate it.

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