• The U.S. is currently seeing over 100,000 new COVID cases each day on average. It’s the highest number since this February, with hospitalizations and deaths up as well. We spoke to epidemiologist and former Detroit health commissioner Dr. Abdul El-Sayed about the state of the pandemic, and whether we should feel like we’re moving backwards. We asked him about the return to in-person classes, what we can learn about the Delta variant from its course in other countries, vaccine verification in public spaces, and more.
• And in headlines: fires continue to rage on in Greece, Cuomo’s top aide resigns, and the future of billboards in space.

Transcript

Gideon Resnick: It’s Tuesday, August 10th. I’m Gideon Resnick.

Dr. Abdul El-Sayed: And I’m Dr. Abdul El-Sayed, and this is What A Day, where we’re holding our climate change stress in our necks and are currently unable to turn our heads.

Gideon Resnick: Yeah, I am immobilized above the shoulders at the moment, but I plan to attempt a turn tomorrow.

Dr. Abdul El-Sayed: Man, I’m a doctor and that’s, that’s not normal. Godspeed.

Gideon Resnick: Thank you. It could be, it could be ugly. We’ll see.

Dr. Abdul El-Sayed: On today’s show, what Senate Democrats want to spend $3.5 trillion on, plus something no one asked for: a company might be putting up billboards in space.

Gideon Resnick: Indeed, I did not ask for that. But first, because we have you with us today, Abdul, as the host of the amazing podcast America Dissected and much, much more, this gives us another good chance to get your expert advice and knowledge about where we stand at this moment in the pandemic.

Dr. Abdul El-Sayed: I just thought you had me here for my winning personality and good looks, but it’s a podcast so, I should have known better.

Gideon Resnick: Exactly. Exactly. You know, those are added benefits that we take as well every time we ask you back, but let’s talk about this. So the numbers are not painting a good picture right now. We’ve been averaging over 100,000 new COVID cases a day. That is the highest number since February, which was around the winter surge. Hospitalizations are also nearing those February numbers that we saw, and deaths are up as well. Now, the Delta variant is driving all of this, as are areas of the country with comparatively lower vaccination rates than we have overall. So in many ways, these increasing numbers make it feel as though we are moving backwards, but we were talking earlier and you were saying it’s not quite as simple as that. Why not?

Dr. Abdul El-Sayed: Yeah, look, I know that when you’re following the momentum on this, it feels like we’re just on our way back and we’d all been promised this hot vax summer and we were all going to have a fantastic August, and now the new CDC guidelines with recommending masks for vaccinated people makes us feel like we’re all going backwards. But I want to just to offer some clarification and maybe, maybe some silver lining in the clouds. Just because the evidence from Provincetown—which is an outbreak that the CDC used to make those recommendations—suggests that vaccinated people can, in fact, pass on COVID, it doesn’t mean that they usually do. There’s another study out of Singapore that looked at how long vaccinated people have virus in their nasal pharynx—that space based behind their nose where they can pass it on from—and they found that they cleared a lot faster than unvaccinated people, which suggests that they’re less likely overall to pass it on. And that, you know, you can tell just by looking at the map of where COVID-19 is spreading fastest, it tends to be spreading fastest in places where people are unvaccinated. And so I know that this feels like we’re moving backwards, but I do want to offer folks some levity here as we watch these numbers go up that, in fact, there are very important things we can do to protect ourselves. Yes, if you’re vaccinated in a place with substantial spread, you should be wearing a mask. But most importantly, if you’re not vaccinated, you should get vaccinated. I have a feeling I’m going to end most of the answers to your questions with that point. And if you are vaccinated and you got folks that you know who are not, have an empathic, thoughtful listening-first conversation, that hopefully gets them one step closer to doing the right thing for themselves and for the rest of us.

Gideon Resnick: Yeah, I think that’s great advice. But let’s stick with Delta for a second here. So the variant is accounting for over 93% of new cases in the US right now. That is a really steep rise. That indicates how transmissible it is. But you’ve also been watching the Delta case rates in India and the U.K. Both of them were hit earlier by it. So what is the story that those numbers in those countries are telling us so far?

Dr. Abdul El-Sayed: Well, first, I just want to explain to folks why Delta is so much more transmissible. It’s because basically it’s the biological equivalent of being stickier. It takes less virus to be able to stick to someone’s nasal pharynx and start spreading and it sticks to our nasal pharynxes longer. And so for that reason, it’s a lot more transmissible than garden variety SARS-CoV-2 that we’ve been dealing with. But here’s the thing, because of that transmissibility, the case increases look explosive. We’re watching this huge spike take shape right now, similar to what we watched in India in April and May, and what we watch in the U.K. in May and June. But what’s also good news is that as fast as Delta can spread, we’re also seeing that the cases fall off rather quickly relative to other variants that we dealt with and so it doesn’t necessarily mean that come autumn, we’re going to be having an awful time of it. But it does mean that the things that we can do right now to protect ourselves, we’ve got to do, because we don’t want to get past this spike and have lost people that we know and love along the way. The most important thing that folks can do is get a vaccine.

Gideon Resnick: Yes, exactly right. Let’s talk about breakthrough infections. That is sort of a topic du jour for good-faith reasons, bad-faith reasons. They do seem to be increasing, but the refrain that we keep hearing from the CDC is that almost all of these cases are not leading to hospitalizations or deaths. But Dr. Eric Topol of Scripps Research wrote about the lack of available data that we have on breakthroughs so our information might not be fully accurate and up to date. We’re going to link to the piece that he wrote in our show notes. But are we kind of in the dark about the extent of these cases that are happening in the U.S.?

Dr. Abdul El-Sayed: He’s right, we are, but for a very good reason. And that’s because in vaccinated people, people who are infected, who have those breakthrough infections, are most likely to have asymptomatic disease, meaning they don’t even know that they have it. And though that may be a bad thing for our accounting, it does remind us that these vaccines are extremely safe and effective, regardless what the risk of breakthrough cases are. And we know that breakthrough cases are really quite rare given what we’ve seen in the maps of where COVID is spreading fastest. And so I know that to understand it, I want folks to understand that when you think about the rate of breakthroughs, a rate is a fraction and you remember the numerator, which is the top number and the denominator, which is the bottom number. Because the infection is so much more likely to be asymptomatic, a lot of folks who could be having breakthrough infections just don’t get tested. We don’t really have a very good denominator for that number simply because so many people who could have got a breakthrough infection just don’t get tested.

Gideon Resnick: Right. And let’s talk now about a population that is largely not able to be vaccinated at this point, that is children. They made up about 15% of new cases reported in that week that span the end of July and into early August. That’s according to the American Academy of Pediatrics. How concerning is that for you and also for other parents as schools are set to resume soon and some actually have already?

Dr. Abdul El-Sayed: I want to explain why that is. We’re conditioned from 2020 to to to think of COVID-19 as a disease of the elderly. Remember, we were doing all we could to protect our seniors, in fact, going without even basic hugs from our grandparents for that reason. But now that we have vaccines on board, the people who are most likely to be fully vaccinated are older folks and therefore substantially more protected, and younger folks tend to be foregoing it. Now, it’s worst of all among children who cannot be vaccinated, children under the age of 12, and as a father of a three year old, I’m really quite concerned. And I’m particularly concerned given the fact that a lot of red state governors have decided to turn masks into yet again another political football when it comes to masking in schools. And they have banned mask mandates in schools in a situation where we’re watching case rates increase among children. And what’s sad is that they’ve basically turned our kids into red meat that they’re trying to throw to their base, and the cost of that is going to be children getting sick, children being hospitalized, and even potentially children dying unnecessarily, because somebody wanted to make a political stand out of something as simple as a piece of cloth that you can put on your face. And we’ve got to do all we can to protect our children, and also immunocompromised people who can’t be vaccinated right now. I know for a lot of folks, when they think about the renewed mask guidance for vaccinated people, they ask, why should I have to wear a mask when I did the right thing and I got vaccinated? Why should I have to wear a mask to protect somebody who’s not doing the right thing and not getting vaccinated? And when you think those thoughts, I understand, but don’t forget that a lot of those unvaccinated people include our children who just can’t be vaccinated. And so let’s do the right thing to protect them.

Gideon Resnick: Right. And you mentioned, you know, what could actually happen to kids if they do get COVID. There were a number of recent stories that talked about some children facing short-term symptomatic effects of COVID, sometimes severe, but also symptoms associated with long COVID that we have heard about in some adults. Are we seeing more serious cases that are involving children because transmission is so high, or is there something about Delta’s physiological impact specifically that’s different?

Dr. Abdul El-Sayed: Well, we definitely know that kids are more likely to get sick now simply because they’re unvaccinated and Delta is so sticky that it is far more transmissible. But we don’t know whether or not it actually is more virulent, it actually causes worse symptoms. But what we are seeing is more and more kids winding up sick and potentially even in the hospital. Now, here’s the thing I want folks to appreciate about this is that, you know, a lot of people say I don’t want to be a guinea pig for some vaccine, but if we choose not to vaccinate, if we allow this virus to continue to spread unabated among us, what we’re basically doing is turning our children into guinea pigs for the virus. And I don’t really want to know whether or not it’s so much more deadly among children because I don’t want kids to be getting sick in the first place and there’s something we can do to protect them. And unfortunately, right now, we’re not doing those things and so we’re seeing kids get sick and we’re learning what some of the short and long-term consequences of infection with the Delta variant can be in our children.

Gideon Resnick: Right. Why would you want to find out if you don’t need to find out? Exactly. I also want to talk a little bit about what we’re doing for public spaces now. On the new episode of America Society that is out today, you’re also talking about vaccine verification for places like offices, restaurants—that being sort of the right way to go here. It’s going to go into effect in New York City next week. There are more and more places that are requiring vaccinations, including just yesterday for the US military. The FDA is also close to getting a full approval to some of the vaccines as soon as next month. How much could all of those things I just mentioned be factors in bumping up vaccination rates across the country?

Dr. Abdul El-Sayed: Look, in France, when they announced a national vaccine verification program to require vaccines among people who are entering restaurants or bars or government buildings, they saw in the next day nearly two million people sign up to get their vaccine. Yeah, we know that one of the most important things we can do to get people vaccinated is to make it easier to be vaccinated and a little bit harder to be unvaccinated. And I think it’s really important that we start pursuing that kind of public policy right now, because in the end, those folks who are remaining unvaccinated are, in fact, free riding on the rest of us who’ve done what we needed to do to protect ourselves in other people. And so I think this kind of policy makes sense, both in the microscale when it comes to making sure that people are paying their fair share into a system that is protecting them, doing what they need to do to protect themselves, to get vaccinated, rather than free riding on the rest of us. And it works in larger scale in terms of making it easier to be vaccinated and a little bit harder to be unvaccinated, so that, so as to make sure more people are getting their vaccine and doing what it takes to finally, finally, hopefully see the light at the end of the tunnel on this thing.

Gideon Resnick: And one last question here. We talked about this in the past. I like to ask you what activities you are most comfortable with doing in public. The last time I asked was before we knew more about Delta and the world that we’re living in right now. So what are you most comfortable doing at this moment, with or without masks?

Dr. Abdul El-Sayed: You know, I really like sunbathing by myself, but, um.

Gideon Resnick: Easy.

Dr. Abdul El-Sayed: So I remain comfortable doing that. But let me give you a framework that may be helpful here. Outdoors is still always better than indoors. One way I encourage people to think about this is imagine you are constantly blowing little bubbles from your mouth. Where will those bubbles go? If you were outdoors, they’d be blown away pretty quickly. And if they’re indoors, they stay, just sitting there waiting for them to hit somebody else’s nose or mouth. And that’s exactly what we’re doing all the time, we just can’t see the bubbles. And so outdoors is better than indoors. And the other way to think about it is a mask is the best single thing you can do aside from being vaccinated to protect yourself and others, and so, you know, if you have to ask, wear a mask. And then the last thing I would say is that, you know, the only circumstances outdoors that I’d be a little bit concerned about are, you know, when you’re sort of kind of outdoors. So when you’re in an enclosed space and you’re breathing the same air as the same people for a long period of time, those are circumstances where I would say, you know, you’re probably better off to wear masks. So the masks are the best single thing you can do to protect yourself. If you gotta to ask, wear a mask. Stay outdoors if you’re not going to be wearing a mask. And in the only circumstance I might be worried about out of doors is the circumstance where you’re really tightly packed and you’re not really moving around, there’s not much air flowing. So that’s how I think about it. But if you’re going to be indoors right now, particularly in areas with substantial or high transmission, the recommendation is to wear a mask for a reason, protect yourself and protect others.

Gideon Resnick: Right. Well, thank you for answering all of our COVID questions yet again, Dr. Abdul El-Sayed. There are new episodes of his pod America Dissected that are out every Tuesday. You should already be subscribed so you can listen now wherever you get your podcasts. And that is the latest for now.

Gideon Resnick: It’s Tuesday, WAD squad, and for today’s temp check, we are looking ahead to the second-ever coronavirus Olympics bubble—dark. We’re less than six months off from the 2022 Winter Olympics in Beijing, where coronavirus precautions are expected to be significantly more intense than the ones that were in place this summer in Tokyo. Where residents of Japan were allowed to commute from home to the Olympic bubble, China’s games will be truly walled off. After the events end attendees will either have to leave the country or isolate for several weeks in government quarantine centers before reentering Chinese society. Journalists will interview athletes through plastic walls, and venues are being redesigned so the athletes have almost no contact with referees or spectators, who will also be kept separate from each other. And here is one very evocative detail: the country intends to equip some attendees with armpit thermometers that stick on like Band-Aids and transmit each individual’s temperature. Wow. There is still a lot more to be revealed and we’re obviously a long way out. These things are tentative. But Abdul, what is your take on this early buzz about Beijing 2022.

Dr. Abdul El-Sayed: You know, like I feel like if you’ve got to do all this to have an Olympics, at some point you have to ask whether or not you really ought to have an Olympics. And don’t get me wrong, I loved the Tokyo Olympics. I thought it was fantastic in the way that it highlighted so many really important issues and forced us, I think, as a society to really think about, you know, both how far we’ve come and how far we have yet to go on big issues like mental health. But at this point, this just sounds like a lot. Like I think if I were an athlete at this point, I’d be like, listen, I’m going to take my chances, I’ll wait till 2026. I’ll see y’all somewhere else. But, you know, big questions here. How about you?

Gideon Resnick: I don’t like anything that we just described. Like, I, as an observer, as imagining these participants like you’re saying. I think Tokyo was the kind of yellow flashing lights to maybe be like, hey, I don’t know if these sorts of mass events can really go off without a hitch right now. And if anything, this seems like, you know, that light is continuing or perhaps turning red. It is a little bit tough to have to think about, you know, what would the world be like for the next Olympic cycle for folks? And I understand people are training and all that stuff, but yeah, like once you’re walking around with, you know, Band-Aid thermometers on you, it’s like the magic is a little bit gone I think at that point.

Dr. Abdul El-Sayed: I feel like this is, this gives a whole new definition to the term temp check.

Gideon Resnick: It does.

Dr. Abdul El-Sayed: It’s like actively in your armpit the entire time. Like we’ve really checked our temps in real time.

Gideon Resnick: Right, right. But just like that, we have checked our temps. Soon, I suppose Beijing will be checking the temps of everyone who is there. We’ll be back after some ads.

[ad break]

Gideon Resnick:  Let’s wrap up with some headlines.

[sung] Headlines.

Dr. Abdul El-Sayed: Unprecedented fires in Greece have been raging on for a week now on the country’s second largest island. Over 2,000 people on Evia were forced to go to the shores to be evacuated by boat due to the fires blocking every road off the island. This is just one of many fires currently happening in the country. Greece’s prime minister pledged to compensate everyone affected by the fires and promised a huge reforestation effort. And speaking of the real-time consequences of climate change, the UN’s Intergovernmental Panel on Climate Change dropped their latest environmental report yesterday. The report was described as a, quote, “code red for humanity.” But it also said that the absolute worst-case scenarios can still be avoided if world leaders act fast to drastically curb fossil fuel emissions. We’ll discuss the IPCC s findings more on our show tomorrow with Georgia Tech’s Dr. Kim Cobb, one of the report’s lead authors.

Gideon Resnick: Senate Democrats finally released an outline of their $3.5 trillion anti-poverty and climate plan budget proposal, which offers universal preschool, two free years of community college, expands Medicare and much more. This plan, along with the one trillion dollar bipartisan infrastructure package, puts almost all of Biden’s economic goals into motion. Democrats are seeking to pay for the package with higher taxes on corporations and high-income households. And right now, the outline doesn’t include a measure that increases the government’s debt limit, but it’s possible that may instead be addressed in September after both plans are wrapped up. We’ll keep you updated on the next steps of the budget resolution’s approval.

Dr. Abdul El-Sayed: Mo money, less problems! The man who will eventually handcuff himself to a radiator so he can’t be removed from the governor’s mansion, New York’s Andrew Cuomo, is continuing his slow implosion following an attorney general’s report that said he sexually harassed 11 women. More of Cuomo key allies have resigned, including his top aide, Melissa DeRosa, who first joined his administration in 2013. Per the attorney general’s report, DeRosa previously led an effort to discredit one of Como’s accusers. Also, a part of the effort was Roberta Kaplan, a lawyer and chairwoman of the organization Time’s Up that serves to fight sexual abuse and discrimination at work. Kaplan resigned from Time’s Up yesterday with the organization signaling that they supported her decision. A former executive assistant on Cuomo’s staff went public with her allegations that he groped her repeatedly, in an interview broadcast yesterday. She said this:

[voice clip] What he did to me was a crime. He broke the law.

Gideon Resnick: Awful. When people say space is the final frontier, they mean for large signs advertising personal injury attorneys. Billboards could soon be coming to the cosmos thanks to a new project from Elon Musk’s Space X and a startup called Geometric Energy Corporation, or GEC—not to be confused with a 100 gecs. GEC wants to launch a satellite next year, which will feature a pixilated display screen that people and corporations can rent out. Users will buy space on the screen using cryptocurrency—of course—and ultimately it will appear as a collage featuring the contributions of many different entities at the same time. Of course, the occasional astronaut or Fast and Furious driver in a rocket car could see the space billboard out of their window. But to make sure it gets a wide audience, the satellite will stream itself on YouTube and Twitch using a selfie stick-type extension. OK. If this is some alien’s first encounter with our species, they’ll get the correct impression that we are ignoring our dying planet and putting most of our resources towards influencer marketing.

Dr. Abdul El-Sayed: You know, you think that Geometric Energy Corporation could spend more time thinking about renewable energy on Earth, rather than trying to advertise to nonexistent people in space.

Gideon Resnick: Yeah. Energy is in your name. Prioritize what you’re doing, folks. And those are the headlines.

Gideon Resnick: That is all for today. If you like the show, make sure you subscribe, leave a the review, buy us a pixel on Elon Musk’s space billboard, and tell your friends to listen, and

Dr. Abdul El-Sayed: if you are into reading, and not just Senate budget proposals like me, What A Day is also a nightly newsletter. Check it out and subscribe at Crooked.com/subscribe. I’m Abdul El-Sayed.

Gideon Resnick: I’m Gideon Resnick.

[together] And don’t crash into the space billboard astronauts!

Dr. Abdul El-Sayed: Or billionaires

Gideon Resnick: Yeah. Billionaires. You know, maybe. We’ll see.

Gideon Resnick: What A Day is a production of Crooked Media. It’s recorded and mixed by Charlotte Landes. Sonia Htoon and Jazzi Marine are our associate producers, and Kelly Sadikun is our intern. Our head writer is Jon Millstein, and our executive producers are Leo Duran and me. Our theme music is by Colin Gilliard and Kashaka.