Doctor: Just a 'matter of time' before another COVID-19 surge

Dr. Murtaza Akhter, University of Arizona College of Medicine-Phoenix Emergency Physician discusses the state of the coronavirus pandemic with Yahoo Finance.

Video Transcript

- Let's bring in Dr. Murtaza Akhter. He's a University of Arizona College of Medicine Phoenix emergency physician. And Dr. Akhter, it's great to see you again. Just your thoughts on the fact that the FDA panel did back booster shots, Moderna booster shots for high-risk adult or at-risk adults, and also those 65 and older. And then, of course, like [INAUDIBLE] just saying, we have J&J under consideration tomorrow, and then, of course, the mix and matching question, as well.

MURTAZA AKHTER: Seana, good to be back. All great questions. We know that boosters seem to increase the antibody response. And at least looking at some of the countries, the booster shots also decrease the rate of severe sickness and hospitalization.

The main debate has been what timing is best. And that's the reason the FDA has been having these meetings and debates. That's the reason that, right now, the boosters are mainly for those above 65 and those in high-risk situations, not necessarily for everyone. But the data keep being churned out, both in other countries, as well as in our own. And I think it is interesting to note that it seems to be more effective of a response if you've had the J&J vaccine before to get one of the mRNA ones now. It makes sort of sense physiologically, but the data seem to bear that out, as well.

- What about, for instance, with Pfizer? We keep getting these studies that would indicate, on one hand, its ability to prevent infection, whether you've already been vaccinated or had-- well, if you've been vaccinated-- decreases [INAUDIBLE] time, thereby the booster becomes a point, but it doesn't necessarily decrease the ability to keep you from getting severe disease. Help us understand why prevention is not the same as preventing the severity.

MURTAZA AKHTER: So I would say it does prevent you from getting severe disease. It doesn't necessarily have as massive of an effect of preventing infection per se. Now, it does, but it's not the 95% we were hearing early when the vaccines were first coming out. Especially the Delta variant, even if you're vaccinated, you still have a reasonable chance of getting infected. Far less so than if you're not vaccinated, but the most important effect is the severe disease part. And by severe disease, we usually mean people are sick enough to be hospitalized.

And so vaccinated people, [INAUDIBLE] Pfizer-BioNTech or [INAUDIBLE] Moderna or even J&J, but especially the mRNA ones, people who have had the full dose of vaccinations are much, much less likely to get severe disease or be hospitalized from it. So that still holds up, and it's going to continue to hold up. The boosters are trying to increase that even more. But there's no denying that a full dose of vaccination definitely decreases severe disease. There's no doubt about that.

- And doctor, we heard from the president earlier when he was addressing the nation, touting the fact that we are starting to see a decline in the number of cases, the national average here over the last several weeks. I guess what's your assessment just of where we stand right now in this pandemic as we do head into some of those colder months, which makes us a little bit nervous about what that means for the potential spread of the virus over the winter months?

MURTAZA AKHTER: Seana, I didn't think I was going to be back on with you last summer. I thought we would have beaten this by now, especially once the vaccines came out. It's crazy that it's still here. If you look at the numbers in certain states and nationally, it's almost as if, yeah, we've gotten better than before, but we're not even quite at the level that we were at since the surge we had in the summer.

And my concern is, with the holidays coming up-- and by holidays, I mean Thanksgiving and Christmas-- we know people are going to congregate. They did last year, even before the vaccines were out. They're definitely going to this year. And it's just a matter of time before we have another surge. Not to sound pessimistic, I know people think I'm a Negative Nancy or whatever the phrase may be, but as much as it looks like it's getting better now, it's just a matter of time before we have another spike. It's definitely going to happen after the holidays.

- With that in mind, though, we have experienced now where people congregate in tightly confined spaces and we don't get superspreader events. I'm talking about airplanes. Now, I realize they have circulation systems and HEPA filters, but what could we do on the ground that might not be that expensive to replicate that kind of protection? Or would it be too expensive?

MURTAZA AKHTER: Well, the other thing airplanes have beyond the great ventilation is the FAA mask mandate. Anytime you're on a flight, they will always tell you they are bound to have you wear a mask, to not make their jobs any harder, and if you do, you'll be banned from the flight. There is very few things on the ground that are like that, where if you're caught not wearing a mask, and especially repeatedly doing so, that you're banned from that institution.

So if we had a similar situation, which is very hard to do, especially in small congregate indoor settings, then I think it would be a lot more effective. Remember, other countries were able to do it, right? Even before the vaccine, other countries had beaten COVID. And they had done it by distancing and masking. And we just refused to do that. And the reason airplanes aren't as much of a hotbed is because they have good ventilation, for one, but two, they have the mask mandates. It's pretty simple. You don't need to run a great experiment. It's already been run. If we had something like that on the ground, I think we'd be very effective at preventing transmission.

- And doctor, just your reaction to the school year, because that was a big concern when we last spoke a couple of months ago, just what we're going to see play out in the number of cases. Yes, we are seeing the number of pediatric cases continue to be at elevated levels, but is this school year going better than you were expecting to see?

MURTAZA AKHTER: Well, it depends where you look. There are certain states that clearly took the pandemic seriously. And if you look at the schoolchildren there, where they have implemented measures, including good ventilation, a lot of them are masking, in those states, there seems to be almost no community spread. If you look at other states, it seems like every other day there's a school district that's closing. So it depends on what snapshot in time [INAUDIBLE] looking at. The data are variable depending on where you are.

I do think we need to be careful of our children, of course. The fact that some people are taking lackadaisically-- even though, I'll admit, kids are less likely to get severe disease than adults are, even though that's the case, to just say, eh, they're kids, whatever, you wouldn't say that about other diseases that are serious, so why say about this one? But there are definitely school districts in certain states, especially, that have pulled this off successfully. There are ways of doing it. And so what I would say is I wouldn't be concerned in general, but if you're living in a state in which they seem to disregard all the science, well, I'd be concerned not just about COVID but about your children's education, too. And maybe that's going a bit beyond my expertise, but [INAUDIBLE] truth.

- Dr. Murtaza Akhter, we always appreciate you sharing your opinion. Thanks so much for taking the time to join us. University of Arizona College of Medicine Phoenix emergency physician.

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