Speaker 1: As the new Delta variant of the coronavirus spreads around the world and countries face an uptick in infections. Health officials are warning us that the pandemic is not over, even if we're vaccinated. So now what joining me now to make sense of all of this is Andy Peko. He is a professor of microbiology at the Johns Hopkins Bloomberg school of public health. Andy, thank you for joining us today. Oh,
Speaker 2: My pleasure to [00:00:30] be here.
Speaker 1: So I have to start, why is this new Delta variant of the coronavirus? Why has it got everyone so worried?
Speaker 2: Um, it's spreading more efficiently in the population. It seems to be causing more disease across a number of age groups. Um, and it seems to be escaping some of the immunity that our vaccines are able to, uh, generate against the virus. So all three of those things are properties. This variant [00:01:00] has show and just by its spread throughout well, initially India, and now the us, you can see that it really is a virus that seems to be optimized for infecting humans. So
Speaker 1: Let's go back to a bit of the microbiology basics, if you will. Um, how do virus variants work what's happening kind of on a really microscopic in terms of the mutations that cause them to be so dangerous for humans?
Speaker 2: Well, first it's important to note that viruses [00:01:30] mutate all the time and SARS two mutates at a fairly regular level. Um, what is different about SARS two is when you have lots and lots of people getting infected and making lots and lots of virus, there's just more chance that the virus can mutate across its whole genome. And every once in a while these random mutations give the virus, what's called a fitness advantage, meaning it allows the virus to [00:02:00] do something a little bit better, which allows it spread in the population, uh, and become the dominant virus. And what we've seen with Delta is that, uh, it has done exactly that.
Speaker 1: So would it be fair to say the fact that, uh, so many people out in the community are still UN vaccinated, that this virus is getting into those people and getting a better chance to mutate and creating these issues and causing more problems?
Speaker 2: That's the beginning of the issue? [00:02:30] Um, if you allow the virus to replicate, then you allow it to accumulate these mutations. Um, so replication in UN vaccinated people is allowing the virus to generate a whole panel of variants. And then those variants are allowed the opportunity to spread in the population, sometimes infect vaccinated people. And that's how the virus is then sort of selected to be better at infecting humans.
Speaker 1: And so these new variants are, they [00:03:00] infecting our bodies in the same way. Why do they have more serious health implications when it comes to infection?
Speaker 2: There's still a lot that we don't know about that, but I can start with the things that we do know many of the variants, um, are able to, to the cells within your respiratory tract, more efficiently than the early strains of SARS. COVID two. Um, some of them can also act faster, [00:03:30] meaning that it's a shorter amount of time between when the virus binds to your cell versus when the virus starts to replicate inside your so they bind faster, they start replicating faster. And now we're seeing variants that are starting to avoid some of the immune responses that we know can protect us from infection. So all three of those things are contributing to the extra spread of this virus in the population. And
Speaker 1: So is the, the Delta [00:04:00] variant, the Delta variants, obviously more dangerous than the variants that we saw last year. Is that the case, even for people who are vaccinated
Speaker 2: Well, the good news, if there is a good news about this is that vaccination is still working against the Delta variant. Um, it's a different type of SAR, two. It, it seems to be able to infect some vaccinated people and it's able to infect them and make them sick. But when you look at the most important [00:04:30] thing that vaccines do, and that's protect from severe disease and death, vaccines are still working against the Delta variant. So I view Delta as of virus that is starting to move towards really being a major problem with us with prospective vaccination, but vaccines are still our best weapon against the virus, as long as we use them effectively and extensively. So
Speaker 1: We're hearing a bit that people who have been vaccinated are [00:05:00] still capable of transmitting the virus to other people without actually getting infected themselves. What's happening in the body for that to happen. Is it a case that they've got a higher viral load or that it's maybe just getting into their nose and not all the way into their body, what's actually happening there? Well,
Speaker 2: When you get vaccinated, um, two things can happen. One is you can generate a enough of, of this immunity to keep you from getting infected. Uh, now that happens very rarely because that takes an awful [00:05:30] lot of immunity to keep you from being infected at all, where most vaccines work is that once you get exposed to the virus, your immune ramps up much, much faster than if you've never seen the virus before. So you can control the infection very, very rapidly. And this is where we think Delta is getting around some of the immunity in the, in vaccinated people, because it binds to cells faster, [00:06:00] it replicates faster, and therefore it may be able to really swamp your immune system initially, um, and therefore establish itself in vaccinated people, something that other variants couldn't do again, the good news is your immune response for remembers and ramps up and eventually gets to a level where you can control the virus, but it may be that our vaccines work better against previous variants than they are working against Delta, uh, in terms of preventing [00:06:30] symptomatic disease, those milder forms of disease.
Speaker 1: All right. So knowing that these new variants are maybe a bit better at infecting us and they've, uh, mutated to be more damaging to us, is it a case that our old protections aren't going to be as effective anymore? Things like hand washing masking, social distancing. I remember last year, it was all about not touching your face. Some of us were washing our groceries. We all felt a little bit insane with it all. So some of these old protections are not going to be enough [00:07:00] anymore.
Speaker 2: The same protections can work against the Delta variant. We just have to make sure that we're relying on multiple protections, especially now that here in the us, there's so much of that virus circulating. Uh, so what do I mean by that, um, vaccine work, but when there's a lot of virus in your community and you have a lot of chances to be exposed to the virus, um, you just increase your risk of getting infected. And since not all back since [00:07:30] all vaccines are not a hundred percent effective, um, if you know that there's spread of the virus in the community, it just makes sense to do something else besides getting vaccinated, to limit your chances of getting exposed. And that's where a mask comes in as another good thing to do that will help lower your chances of getting exposed. Social distancing is another good thing that is in place. Um, particularly if you know, you're going into a scenario like going inside, um, where you know that the viruses can [00:08:00] spread more easily.
Speaker 1: So in terms of the public health response from, you know, governments, uh, private companies, schools, big institutions like that, do they need to start changing the way they think about approaching this pandemic? Do they need to sort of get a new war strategy? Well,
Speaker 2: I think dealing with the pandemic us back to, um, a normal economy really begins and ends with the vaccine. Uh, there's uh, so much data out there about the safety [00:08:30] and efficacy of the vaccine, even against Delta variant, that I think everybody needs to incorporate vaccination into their plans to try to get back to, to normal. Um, companies should be utilizing vaccinations as an incentive to get people back into the office. Um, we should be using vaccination and getting, uh, people vaccinated to take part at indoor events. Um, the fall is gonna be a time where we're really worried about another wave of virus, because [00:09:00] we're gonna be all moving indoor and putting the virus in conditions where it's easier for the virus to spread. So anything we can do right now to sort of push the vaccine and get people get vaccinated will be good.
Speaker 1: So I don't mean to pivot our conversation to something even scarier, but we've been talking about Delta, this new variant that is, is, uh, potentially more harmful. It's got a higher transmissibility. So what about these new variants that I'm starting to hear about? Now? [00:09:30] I was reading about Lambda. I was reading about AOTA. It's sort of a Greek alphabet of new variants that could come to threaten us. How much of a risk are these new variants we're starting to hear about? And is there a possibility that one, you know, super variant that's highly evolved and perfectly mutated into becoming a, you know, uh, our worst enemy. Is it possible that we could face something even worse than that?
Speaker 2: The, the number of variants that are out there, um, all represent viruses that have [00:10:00] either the potential or have to some degree shown the ability to spread more efficiently in the population cause more disease or evade immunity. Um, many of them haven't done what Delta and what alpha before it has done, which the big jump to the global stage and really circumnavigate the globe. So many of the other variants that you hear about right now, uh, for the average person really shouldn't be any major concern, um, [00:10:30] variants, what, whatever their Greek name, um, are all susceptible to the induced by vaccination. So for the average person, a variant is all, you have to worry about the details of which one is circulating is not as critical at this point in time for our scientists. It's very, very critical because each of these variants has a different combination of mutations and it's increased seeing the variety of viruses [00:11:00] that are out there. And we as scientists really need to keep track of these variants because each one represents a different kind of combination of mutations, a different potential for the virus to evolve. And so, um, every time you hear the word variants, a scientist become busier and busier, even though in some ways the pandemic is starting to be getting under control through the use of vaccines.
Speaker 1: I wa I wanna think about going forward and what life can start to look like for us, because as the Northern hemisphere [00:11:30] hits summer, a lot of people finally felt they were able to dust off the cobwebs, get out there. And you know, now that they're vaccinated, get back to some semblance of normality. And I think the talk of variance has really, uh, you know, burst that balloon for a lot of us. So I wanna start with kids and school. The return to school is a huge question. Is it safe to be going back to school? Should we be planning a return to school? And if so, uh, what should parents and schools be thinking about in terms of [00:12:00] mitigating the risk
Speaker 2: For kids? There are a combination of tools that need to be put into place. Simple things like paying attention to airflow systems in classrooms, making sure or that, um, teachers, um, staff, um, everybody around the students is vaccinated forming a bit of a barrier that prevents the virus to get into those populations. Making sure that that families of children going to elementary schools have all been told about the benefits and the need [00:12:30] for them to get vaccinated, to again, protect their children, it and protect the schools. There are lots of ways that we can build the barriers up to allow our kids to go back into school. We've learned an awful lot about this virus since it's, and since the beginning of the pandemic. And I think we are at a stage where we can open up school safety. It's just gonna require a few things to be put in place and importantly, to be followed because if we loosen our restrictions, if we don't pay good attention to these things, [00:13:00] we're setting ourselves up for, uh, outbreaks in our schools. And that's the last thing in the world. Any of us want. So
Speaker 1: Let's pivot to adults, uh, those who can get vaccinated, obviously the first step is to go out and get the vaccine. But in terms of, uh, life returning to normal for adults, are we, should we be thinking about things like returning to work returning to college? Uh, what can vaccinated adults safely do right now?
Speaker 2: Well, the first thing vaccinated adults can do is, is get [00:13:30] together with other vaccinated adults with very, very little fear of getting the infection. And that's where I think issues of mandates at workplaces for vaccination really come into play if you're coming into work. But you know, that 90% of the people that are vaccinated, that in and of itself gets you to a stage where vaccination protects you as an individual. But at that level of vaccin, you're also helping your entire community of, of coworkers because [00:14:00] you're making it that much more harder for the virus to enter that population. Um, thinking about little things like social distancing doesn't need to be as extreme as it was before, but, you know, maybe we need to get away from shaking hands for the, for, for the next few months so that we can get some face to face time with people, but we don't have to go back to all the things that we were doing previously. I think, um, work weeks that are staggered, having different people come in on different days, [00:14:30] uh, forming hybrid environments, all of those are gonna help limit the number of people that get into an or space during the fall and winter times. And that's also gonna decrease the chance of a virus entering and spreading in that population. I wanna
Speaker 1: Go through a bit of rapid fire with you because I get asked a lot of questions. I'm sure you do as well about what we can do, what we can't do. What's true. What's not, there's a lot of misinformation out there. So go through the basics with me. If I'm vaccinated, can I still spread the virus
Speaker 2: [00:15:00] Very, very low chance of spreading the virus if you're vaccinated,
Speaker 1: Okay. If I'm vaccinated, should I still be wearing a mask right now? Indoors outdoors wear
Speaker 2: A mask. Anytime you th think you're coming in contact with, uh, people who could be infected. So high amounts of spread in your community, put a mask on just to be safe, particularly indoors
Speaker 1: For you. You're you're an expert here. So obviously everyone has different levels of comfort. What can I do as a vaccinated adult? Can I go out and see my friends still? Can I go to restaurants?
Speaker 2: [00:15:30] I think if you know that you're mixing with vaccinated people, you can do all those things. You can go out to restaurants, you can go to the theater. I think if you know that you're going to come into contact with people that aren't vaccinated, a mask is a good thing to put on as a secondary way of making sure you're safe.
Speaker 1: Can I fly on a plane? If I wanna go take a vacation is safe to do right now. Uh,
Speaker 2: Planes are fairly safe in terms of their air system, but you're sitting next to people for long periods of time. So masking up, wouldn't be a bad idea [00:16:00] to get at another layer of protection, to what you already have with the HES, with the planes air system and your own vaccination status.
Speaker 1: And in terms of going back to school, going back to work, these are the, that are safe for us to do in the current environment.
Speaker 2: All of those things will be safe as long as you're, as long as you're vaccinated and a good number of your coworkers or colleagues or students are also vaccinated.
Speaker 1: And one final question, will we have to worry about boosters and is this gonna become something [00:16:30] like our annual flu shot to keep it under control?
Speaker 2: I think in the future, um, we will be able to deal with the severe forms of COVID 19 through vaccination and through antivirals and other treatments that are being developed right now. Uh, we won't eradicate this virus, but we'll be able to control it and treat it like we do measles. Like we do chicken, like we do influenza. It'll be a disease that we can control and not, uh, suffer the severe consequences of [00:17:00] like, we have been over the past 16 months.
Speaker 1: If you look ahead for the next three, six, even 12 months, what does the future look like to you?
Speaker 2: I think we know what it takes to get a vaccine to work against COVID 19. Um, so I think even if the viruses change, we can adapt to that very quickly and keep the vaccines up to date with strains that are circulating and use that as the primary tool, uh, by which to, uh, allow us to get back to normal life. So it really comes down [00:17:30] to, we've learned how the virus is responding to this vaccine. We've learned what it takes to be, uh, to have good vaccinations and to have good coverage of vaccines and populations in the next couple of months, we'll come up with even better treatments so that if you do get ill with COVID 19, you'll have antivirals as well as other therapies to lessen the chance that you're going to develop the very severe disease there. So everything looks like, um, there's a fine path [00:18:00] to controlling this virus in the future that, you know, the timeline in which all of this will come together as really the hard thing to predict.
Speaker 1: Well, I must say I came this interview feeling a bit worried about what you might tell me, uh, that it might be all bad news, but it's really nice to hear that there is hope on the horizon. And I guess the main message continues to be go out and get vaccinated. Thank you so much, Andy. Peko. Thank you for joining us today for
Speaker 2: Now on. Oh, it's been a great pleasure. Thank you for having me.