• COVID cases and hospitalizations are on the rise in the U.S., and experts are closely monitoring a new variant nicknamed “Pirola.” Plus, there might be a new, updated vaccine as early as next week. We’re joined by Dr. Abdul El-Sayed, host of Crooked’s America Dissected, to talk about the latest uptick and what to expect in the coming months.

Show Notes:

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TRANSCRIPT

Juanita Tolliver: It’s Tuesday, September 5th. I’m Juanita Tolliver.

Priyanka Aribindi: And I’m Priyanka Aribindi. And this is What A Day where we’d be happy to get new COVID shots every year as long as we get a lollipop every single time. 

Juanita Tolliver: But the good stuff only, right? Tootsie Pops, Sour Patch Kids Lollipops. You know. 

Priyanka Aribindi: All we’re saying is no dum dums. That’s a no go. 

Juanita Tolliver: Hold up. Dum dums has a root beer float flavor that I love. So I’ll take your dum dums. 

Priyanka Aribindi: No. No justice for dum dums. [laughter] [music break]

Juanita Tolliver: On today’s show, we’re going to break format and do a whole episode focused on the latest on the coronavirus. Yes. It never went away. And in fact, it’s back on the upswing right now. We recently saw a rise in COVID cases and hospitalizations in the late summer and in a two week period ending on August 12th, hospitalizations increased by 24%. And as we head into fall and winter, experts are warning about even more possible spread. Plus, there might even be a new updated vaccine as early as next week. 

Priyanka Aribindi: Okay, updated vaccine. Not bad news at all. 

Juanita Tolliver: Major plus. 

Priyanka Aribindi: Happy to hear it. 

Juanita Tolliver: Yeah. 

Priyanka Aribindi: But I got to say, when we talk about possible upswings, especially later in the year, it’s really giving throwbacks to some pretty dark days. So not happy to hear that. It’s very hard to believe that the virus first upended everyone’s lives three years ago feels honestly like a different life, and we are still learning how to navigate this so-called new normal. And COVID 19, as you said, still very much here. Thankfully, we are now better equipped to deal with the virus from vaccines and treatments to prevention and overall knowledge. But we’re still experiencing upticks and new variants, and millions of people are still dealing with long COVID. 

Juanita Tolliver: Yeah, there’s a lot going on. And contrary to popular belief, we don’t have all the answers. I mean, I’d like to, but clearly not in this situation. So here’s where we turn to Dr. Abdul El-Sayed. He’s a physician and epidemiologist and host of Crooked’s America Dissected. So he knows a thing or two about the coronavirus. And he joined us last week to bring us up to speed on the latest COVID news. Here’s our conversation. 

Priyanka Aribindi: So here in the US, we are experiencing a late summer uptick in COVID cases and hospitalizations. Can you walk us through the latest wave of COVID cases? Who is getting sick and where are these outbreaks happening? 

Dr. Abdul El-Sayed: I’m going to put a little asterisk on what I’m about to say by saying that the degree to which we have consistent data right now versus the kind of data that we’d had in the past is quite limited simply because so much of our data about cases came from reported PCR testing. And now when you think about when people are getting COVID, they’re not getting PCR tests, they’re taking rapid antigen tests at home. 

Priyanka Aribindi: Right. 

Dr. Abdul El-Sayed: And I don’t know about you, but I’ve never reported a rapid antigen test. So. 

Priyanka Aribindi: Same. 

Dr. Abdul El-Sayed: We actually don’t know that much. But what we do know is that we’re seeing an uptick across the globe actually, internationally, a relative increase in cases that has yielded a small increase in hospitalizations in some locales. And a lot of this is to be expected. And so, you know, folks need to understand that the endgame here was always going to be that this was going to be a seasonal disease, that it was going to start spreading again right around right now, which uh you got a lot more congregated settings, I can tell you in Michigan it’s starting to get a little bit more chilly, spending less time outside. All of the things that tend to drive transmission are increasing. So we’re seeing a bit of bump and that was to be expected. 

Priyanka Aribindi: How does this summer uptick compare to past summer surges of COVID? 

Dr. Abdul El-Sayed: You know, it’s hard to compare because we’re not really talking about apples to apples anymore. 

Priyanka Aribindi: Sure. 

Dr. Abdul El-Sayed: We’re in a moment now where right around 97% of the population has been exposed to COVID 19. So the degree to which there are people who are super susceptible to getting infected is quite low because all of us have some immune reaction to this virus, unless, of course, we are immunosuppressed. And so we are kind of out of the phase in which you would expect very rapid growth unless, of course, the virus itself makes a huge evolutionary leap, which may in fact be the case. To finish that thought here, because I don’t want to leave you on that cliffhanger, right now we are seeing far slower growth. Case spread is still really quite low. Hospitalization rates are really quite low. So this is not the summer of 2020 or the summer of 2021 or even the summer of 2022. 

Juanita Tolliver: Let’s break down the variants that are circulating. In August, COVID variant Eris became the dominant variant in the U.S. and now there’s a new variant called Pirola that’s being closely monitored. What should we know about these new variants, especially for those who are vaccinated or had COVID recently? 

Dr. Abdul El-Sayed: We should know that the person who is naming them has a great imagination. [laughter] The other thing we should know is that when it comes to Eris or EG.5, this is an Omicron sub variant, meaning it is a cousin of a cousin of a cousin of a cousin of the original Omicron, which of course devastated us in 2021. But it’s really quite similar. And the good news about any Omicron sub variant is, of course, that the major jump in exposure that I talked about earlier was because of Omicron. So almost everybody has some Omicron exposure, meaning that most of us have pretty high immunity to Omicron and its sub variants, which Eris is. But Eris right now accounts for about 17% of all cases in the United States, and it is leading the increase in cases and the small bump in hospitalizations, which we talked about. But remember, this is just a more optimized version of Omicron, optimized to the level of immunity that we have in the population. This new one, Pirola or BA.2.86, which you can imagine why we need imaginative naming here. 

Juanita Tolliver: Because I mean, for me, yes. 

Priyanka Aribindi: Right. [laughter]

Dr. Abdul El-Sayed: Yeah yeah like Star Wars, right? Nobody wants to call whatever droid–

Juanita Tolliver: R2D2. 

Dr. Abdul El-Sayed: –by it’s number name. Right like–

Juanita Tolliver: Yeah, all of that, all of that.

Dr. Abdul El-Sayed: We got to give it an actual name. So Pirola in this case is a really interesting sub variant because the evolutionary leap between original Omicron and Pirola is about as big as the evolutionary leap between original Wuhan type COVID or SARS-CoV-2 to Omicron. So this is a big, big jump. But here’s the thing. It’s been observed now in about 20 countries, and it’s being observed in wastewater. But the number of positive cases that we’ve identified who are symptomatic is really, really low, which suggests to us that the sub variant may actually be less virulent, meaning causes less actual illness than some of the others. The jury’s still out, but just based on this early evidence, that would be what you would surmise, while very, very transmissible, uh may actually be less virulent. That being said, we still don’t know. It’s really too early to tell. 

Juanita Tolliver: Right now as you talked about the evolution of the Pirola variant specifically, I had very large eyes. [laughter] They got wide in that moment because alarm bells are going off in my head, like sure, less harmful in terms of symptoms as the studies are shown to date. But of course there’s still more to learn. But I’m also thinking like if it’s spreading that much faster, how much are these new variants going to contribute to another surge this upcoming fall and winter like it seems to be a big driver there, no? 

Dr. Abdul El-Sayed: You know, we really just don’t know. And the nature of what a surge means can be defined in two different ways. One is how many people get infected with COVID, but the other, which I would argue is probably more important and what people worry more about is how many people come down with symptoms of COVID 19. 

Juanita Tolliver: Okay. 

Dr. Abdul El-Sayed: So if we’re in the situation where this Pirola sub variant has identified an opportunity to spread like wildfire, but doesn’t make that many people sick, it does not necessarily mean that we’re up against a really, really tough COVID season. And so right now, you know, time will tell. There are three questions I want people to always think about when we’re talking about a new sub variant. The first is, is it more transmissible? The second is, is it more immune evasive? Meaning, can it move past, can it juke past our current immunity? And then the third is, does it make people sicker? And, you know, if the answer to one and two are high, but the answer to number three, does it make people sick or is low, then at that point, when we think about what it means to have a surge, it may just change the way we we think about it. 

Priyanka Aribindi: Got it. So definitely a thing we’ll be keeping an eye on. I know you’ve touched on this a little bit. The last time you joined us back in May, you mentioned that the end of the COVID public health emergency declaration changed how data is tracked and reported along with consumer behavior. People how they test and how it’s changed, how can we track these variants accurately now? Will we ever be able to? 

Dr. Abdul El-Sayed: When we talked about this at the beginning of the interview, I said we were comparing apples to oranges here. And the reason that that’s a problem is because we have vastly decommissioned a lot of the infrastructure around keeping tight minute to minute, hour to hour tabs on COVID infection rates. 

Priyanka Aribindi: Right. 

Dr. Abdul El-Sayed: But as long as you’re comparing apples to apples or oranges to oranges, you’re probably okay. 

Priyanka Aribindi: Okay. 

Dr. Abdul El-Sayed: So even if we’re not keeping minute to minute data, even if we’re keeping decent day to day data, which is what our current decommissioned infrastructure looks like or even week to week data, as long as we’re comparing where we were and where we are relative to the same basic infrastructure, then we still can get pretty good information about whether or not COVID is spreading, where it’s spreading and who it’s affecting. The worry I have, though, is that if this starts to spread really fast, recommissioning a lot of that infrastructure may come too late. And that really is the concern I have among others. 

Juanita Tolliver: All right y’all, we’re going to take a short break for ads, but when we come back, we’ll talk about vaccines because there might be new ones on the way. [music break]

[AD BREAK]

Juanita Tolliver: We’re back with Dr. Abdul El-Sayed, host of Crooked’s America Dissected, talking about his favorite thing, COVID. Let’s chat about vaccines now. So CDC advisers are scheduled to meet next week to discuss updated shots. What do we know about these vaccines and will they tackle the variants, Eris and Pirola? Let’s go a little deeper there. 

Dr. Abdul El-Sayed: They’re likely to have reactivity against Eris, given that uh Eris is an Omicron sub variant, a distant cousin to XBB, which was the main variant they were designing against. When it comes to Pirola, we just don’t know. It is too soon to tell and we’re going to be learning a lot more about that reactivity in due time. But you know, the hard part about this is is that it’s a moving target. You know, what we we often do is we will look at what the main variants in Australia were when Australia was having its rough season in their winter, our summer, and then design against where we think it’s going based on that. But again, when you’re talking about a virus that can mutate as fast as SARS-CoV-2 can, it is a moving target. And so we think that um they may not have hit a bullseye given how fast, you know, Pirola’s come on the scene. But um we’ll be learning a lot more about whether or not there is reactivity against Pirola and about where the virus will be moving yeah as we hit later into the fall and into the winter. 

Priyanka Aribindi: When could we expect new vaccinations to become available to the public? And do you have any advice quite yet on, you know, how to schedule them, when to stagger? I know we also want to get the flu vaccine come, you know, fall winter. So how should we be thinking about that? 

Dr. Abdul El-Sayed: They should be available within one to two weeks of the CDC’s and FDA’s issued guidance. And so I recommend folks get their vaccine as soon as possible. There is no reason to stagger. I know a lot of folks may choose to do that, particularly if you’re someone who may experience, you know, a mild reaction to getting a flu or a Covid vaccine. When I say reaction, I mean symptoms that are your immune system remembering what it’s supposed to be immune to. And don’t forget what a vaccine is. It’s sort of like a biological be on the lookout call if you ever watch any of those cheesy dramas. It’s you introducing one of those like mug shots, in effect, like watch out for this thing. And so your immune system gets all rough and ready when it sees that thing. And that can cause some of the symptoms that people can experience. But honestly, there’s no difference in efficacy if folks stagger or they take them at the same time. And so the recommendation is if you’re just going to go in, I’ll tell you what I’m going to do. I’m going to go in and I’m going to be like, give me Covid in the right arm, give me flu in the left arm, and I’ll be good to go. And I don’t have to come see you again. 

Priyanka Aribindi: Exactly. 

Dr. Abdul El-Sayed: That’s my recommendation, folks, because the truth of the matter is, we’re all busy people. We all can figure out reasons why not to get stabbed by metal in the arm. And so if you don’t just get it all done at one time, then sometimes people will just be like, Yeah, I got that one. But, you know, I got busy and you find out that you’re in January uh and you haven’t gotten your vaccine yet. 

Priyanka Aribindi: Right. 

Dr. Abdul El-Sayed: So my recommendation is just get them done at the same time and then you’re good to go. 

Priyanka Aribindi: Got it. An important follow up for you. These vaccines used to be free for most people, at least covered under insurance. What is the expectation now? You know, are people going to be out a somewhat significant amount of money to get this vaccination? 

Dr. Abdul El-Sayed: You know, Priyanka, for a moment there, for like a three year period, we did this crazy thing in America where we realized that we could provide a basic critical piece of health care to everyone. 

Priyanka Aribindi: Crazy. 

Dr. Abdul El-Sayed: That was free at the point of care. And guess what? Millions upon millions upon millions of people took advantage of that thing and were all the healthier for it. 

Priyanka Aribindi: Yup. 

Dr. Abdul El-Sayed: Now, when it comes to COVID, it’s like the federal government realized that they wanted to end this incredible experiment in providing people free health care. And so. 

Juanita Tolliver: They didn’t want us to get attached Abdul. [laughter]

Priyanka Aribindi: Listen. I already did. I already did. 

Dr. Abdul El-Sayed: I know it’s like, well, if I get a vaccine, what else can I get? How about my insulin? How about my–

Juanita Tolliver: I mean I got a taste. 

Dr. Abdul El-Sayed: –right. [laughing]. 

Juanita Tolliver: I can’t go back. 

Dr. Abdul El-Sayed: At this point, we’ve gone through this process called commercialization, which means that they’re moving to a more market based version. And so what that means is that we’ve got a hodgepodge of coverage, people on Medicare and then people on Medicaid. Those folks will be eligible for free at the point of care, COVID vaccines. If you’re on most private health insurance plans, they’re required to cover any preventive service that is recommended. And obviously, these vaccines are one of those. So they should be free at the point of care for you as well. For under and uninsured people, there are programs that are being supported out of local and state health departments to be able to allay or vastly reduce the cost. But for some of these folks, it’s not necessarily going to be free at the point of care, which is just a pretty terrible thing to think about you know, who ends up getting left out in the cold. Now, you know that’s what it looks like for we the consumers. The reason it’s been done this way is simply about, you know, where money changes hands and why and, you know, how much these vaccine manufacturers can get paid. You know, that’s just the sad thing about our health care system. These are incredible, incredible pieces of technology. It’s incredible that we were able to create these kinds of vaccines this quickly. And that’s because of a major government investment in something that people fundamentally needed. And now you have these corporations that benefited from taxpayer dollars to create these vaccines, on the back end those same taxpayers are being asked to pay rates that are substantially higher. Now, that’s being footed mainly again, by the federal government in the form of Medicaid or Medicare or by health insurance programs. But it does kind of remind you that sometimes we get our goals wrong in American health care, that, you know, the goal of health care should be health and care and not necessarily profit. Like if we want to call it health profit, that’d be a different thing. But that’s not what we call it. And maybe we should actually make it what we call it, or maybe we should call it what it is. And at this point, it’s an opportunity for large corporations who are subsidized by the federal government to make a lot of money off of a piece of technology that was intended to provide for the well-being of the population, which you and I and anybody else listening to this show in the United States of America paid for. So now I’m off my soapbox now. 

Juanita Tolliver: I mean, but I’m going to stay on it a second longer because Big Pharma said they’re not health care, though, like and I think that’s coming through in their reactions even to the Biden administration announcement recently about negotiating prices of other drugs we talk about on the show. Right. Like I think that it’s been consistent, thus the lawsuits. And here we go. Right. Like, I sadly don’t see big Pharma backing down, but one place that could provide more resources is Congress. [laugh] So we know President Biden said he has plans to ask Congress for more funds for more vaccines. But realistically, what needs to happen to get that funding and vaccines widely available to folks across the country again? 

Dr. Abdul El-Sayed: Yeah, Juanita, just while you’re on the soapbox, let me just climb back up on there, [?]. 

Juanita Tolliver: Okay go, go. 

Dr. Abdul El-Sayed: For a moment. Because I love that soapbox. Really lovely. And there’s definitely room for two. 

Priyanka Aribindi: Room for everybody. 

Dr. Abdul El-Sayed: Priyanka, you on the soapbox too, okay, all of us on the soapbox. 

Priyanka Aribindi: Yeah. I’ll join you. I love it up there. 

Dr. Abdul El-Sayed: The CEOs of the top 300 publicly traded health care corporations made a collective $4 billion dollars in 2022. 

Juanita Tolliver: [exhale] Wow. 

Dr. Abdul El-Sayed: So imagine being the CEO of a major pharmaceutical corporation and going hat in hand to the federal government and saying, we want to take your funding to produce these incredible vaccines. And then coming back on the back end when that same federal government is trying to negotiate with you. A simple thing that we do on any market, anybody who believes in capitalism should believe in the ability to bargain. And saying that we’re going to sue you because of a change in public policy that allows you to bargain for just ten drugs. Just ten. 

Juanita Tolliver: Right. 

Dr. Abdul El-Sayed: And they don’t even start until 2026. 

Juanita Tolliver: Right. 

Dr. Abdul El-Sayed: Imagine making that much money off of money that every single dollar spent in health care is a dollar that somebody paid to get care for themselves or their loved ones, every single one of those dollars. And that’s kind of where we are on this. And so while we’re on the soapbox, the question that all of us should be asking is what does it mean for our elected officials in Congress to continue to take contributions from these same corporations. 

Juanita Tolliver: Period. 

Dr. Abdul El-Sayed: Who take all kinds of money from taxpayers and then charge all kinds of money to taxpayers? What does it mean for them to take that money to help get them elected so that they protect the system that continues to allow those pharmaceutical corporations to profiteer off of all of us getting sick? And so, yes, Congress should provide more funds. But more importantly, I actually think Congress would do well to restrict more the capacity for these corporations that we say provide us a critical good, which all of us need to continue to profiteer off of public dollars in the same way that they do. So it’s as much as about funding as it is about regulation. And I think the tough part here is all that funding just goes to feed those coffers even more. 

Juanita Tolliver: 100%. 

Dr. Abdul El-Sayed: I think more importantly, it’s to say we paid for this, so you’re going to keep the price low because already you’re making hand over fist. It’s just the difference between your CEO making an extra five mil in their bonus next year or an extra two mil in your bonus next year. And trust me, these folks aren’t hurting for money. 

Priyanka Aribindi: [sigh] So, listen, a lot of important questions have been asked and answered in today’s interview, but I think this one is arguably the most important of all. With Dr. Fauci retired from public service, what do we call the vaccine if we can’t call it a Fauci ouchi anymore? 

Dr. Abdul El-Sayed: Oh no. 

Priyanka Aribindi: Do you have any, [laugh] do you have any new names? 

Juanita Tolliver: Get creative. 

Priyanka Aribindi: What are what are we calling it. What are we calling it?

Dr. Abdul El-Sayed: Oh, no. [laughter] You know, if you’re going to get two at the same time, can we call it a quick stick?

Juanita Tolliver: Oh. 

Priyanka Aribindi: Oh, okay. 

Juanita Tolliver: I’m into it. I’m into it. 

Priyanka Aribindi: Why not? 

Juanita Tolliver: I accept that. 

Priyanka Aribindi: I mean, that’s what we should be doing. I like it. 

Dr. Abdul El-Sayed: Just go get your quick stick. It’s easy. It’s efficient, I think, to be honest. I’ll just tell you this. Fauci ouchi is the way to go because at the end of the day, even if the man has retired from public service, I think we all owe him a debt of gratitude. And I hope that like decades from now, when our children’s children are getting COVID 19 vaccines, they’re still going to call them Fauci ouchies. [laughter]

Juanita Tolliver: I mean, if it ain’t broke, don’t fix it. [laugh] And on that note. 

Priyanka Aribindi: I like it. 

Juanita Tolliver: Thank you so much for joining us. Abdul. You make science fun. You make COVID fun. 

Priyanka Aribindi: You really do. 

Dr. Abdul El-Sayed: Wow. That is really, truly the greatest compliment anyone has, you’ve made COVID a great experience. 

Juanita Tolliver: Bless. [laughter]

Priyanka Aribindi: That was our conversation with Dr. Abdul El-Sayed, the host of Crooked’s America Dissected. We’ll keep following any developments related to the virus and the upcoming vaccine on the show, but that is the latest for now. 

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Juanita Tolliver: That’s all for today. If you like the show, make sure you subscribe. Leave a review, wear an N95 and you’ll look like 100. 

Priyanka Aribindi: Yes. 

Juanita Tolliver: And tell your friends to listen. [laughter] 

Priyanka Aribindi: And if you’re into reading and not just researching the good lollipops like us, What A Day is also a nightly newsletter. Check it out and subscribe at Crooked.com/subscribe. I’m Priyanka Aribindi. 

Juanita Tolliver: I’m Juanita Tolliver.

[spoken together] And shots, shots, shots, shots, shots, shots! 

Priyanka Aribindi: Yeah, knew you would know. [laughter] The exact tone. The exact rhythm. Yeah duh.

Juanita Tolliver: Of course I would. Here’s the thing. Get all of your shots. 

Priyanka Aribindi: Listen. Couldn’t get that out of my brain. 

Juanita Tolliver: Even if we wanted to. But I hope everybody gets all their shots. 

Priyanka Aribindi: Yes. [laughter] [music break] What A Day is a production of Crooked Media. It’s recorded and mixed by Bill Lancz. Our show’s producer is Itxy Quintanilla. Raven Yamamoto and Natalie Bettendorf are our associate producers and our senior producer is Lita Martinez. Our theme music is by Colin Gilliard and Kashaka. [music break]

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