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monica gandhi twitter

The Effect of BQ.1 and BQ.1.1 on COVID-19 TreatmentI'm Dr Monica Gandhi associate chief of,the divis

ExchangeCME

Updated on Jan 18,2023

The Effect of BQ.1 and BQ.1.1 on COVID-19 Treatment

I'm Dr Monica Gandhi associate chief of,the division of HIV infectious disease,and Global medicine at UCSF and today,we're going to be discussing the effects,of the bq1 and BQ 1.1 subvariance on,covid treatments so this is the latest,data from the CDC and you can see at,this point that the prevalence of,subvariance around the country is really,growing in terms of bq1 and BQ 1.1,prevalence in fact only about 11 percent,of strains are ba5 and over 40 percent,are bq1 baq BQ 1.1 with a smattering of,ba275 and xbb and when we think about,the lineage of the emerging subvariants,of Omicron really think of ba2 as being,kind of the parent and then that's,divided into ba45 and the offshoots of,ba45 are ba7 bq1 bq11 and then another,major family is the ba-275 and its,offshoot is xbb this is really to say,that all these subvariants of Omicron,are emerging they're more transmissible,and their impacts on the monoclonal,antibodies that we can use so in terms,of the monoclonal antibodies,unfortunately we really have a sort of,increasingly lost them as these,mutations have emerged in the spike,protein that render our old monoclonal,antibodies pretty pretty useless and in,fact on November 30th bem televomab or,beb was sort of taken away in terms of,its eua status because the subvariance,of bq1 bq11 xbb which are now dominant,in our country really beb does not work,against them,and then what about the prophylaxis,agent of tixa give themab and silgavimab,I'll know I'll refer to that as tix sill,well essentially in vitro if you look at,these subvariants that are dominant this,particular tick sill monoclonal antibody,for prophylaxis does not work against,these emerging subvariants so here this,really shows you on this slide what are,the remaining treatments that we have,for covid-19 in the face of these,subvariants that are predominant and,actually we do absolutely have three,options uh the first is essentially the,protease inhibitor so this is,normatravir with retonovir they are,administered separately and this is,really a bid or twice a day regimen for,five days unless the glomerular,filtration rate is below 30 in which,case you want to give it once a day this,five-day course of this protease,inhibitor is not Disturbed perturbed by,this of variance it still works very,well this is an oral treatment for,outpatient treatment the second is ramde,severe ramdasavir we do given the,inpatient setting but it's also been,approved for outpatient treatment,for all of the emerging subvariants,absolutely works and we can give this,down to very low kilograms essentially,we have to change the dose obviously if,someone is between 3 and 40 kilograms is,indicated here or above 40 kilograms and,this is an outpatient therapy but given,as an infusion and then the third is,monoperavir and this is a nucleoside,analog that is also effective against,the subvariant one thing to say about,all of these is the protease inhibitor,really and the monoperative drug have,both been studied in randomized,controlled trials in those who are,unvaccinated at risk for severe disease,and the um and they showed very high,rates of prevention of hospitalization,and death actually 89 protection from,hospitalization and death,for a normatrovir and retinovir and for,mold a pair of it was 30 reduction in,hospitalization and death the data that,we have among vaccinated patients are,really from large observational,databases and at least for the protease,inhibitor those over 65 benefit the most,in a large Israeli study published in,the New England Journal of Medicine,likely doesn't at least for those less,than 65 in the panoramic UK study,doesn't seem to improve hospitalizations,and death for those who are vaccinated,so I'll just say in my own practice the,loss of the baptolivumab eua on November,30th has affected the way that we think,about treatment we are very fortunate to,have three remaining treatments used for,outpatients though beb was very useful,because it could be given as a very,rapid push but essentially we're moving,now more to giving out the protease,inhibitor the nucleoside analog paxilvid,and appear very respectively and we,definitely have restarted our outpatient,infusion of remdessavir especially for,those younger patients since the two,oral medications are not approved for,younger so it has affected us but we,still have options left thank you so,much for joining me today and for more,information on covid-19 treatments,please visit the series landing page at,exchangecme.com and the latest updates,on kova 19 subscribe to exchange cme's,YouTube channel and check back regularly,thank you so much

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What We Now Know About COVID Prevention and Treatment: A Podcast with Monica Gandhi
Monica Gandhi - The Motivation We Need Now
“We’re in a Transition Phase”: Dr. Monica Gandhi on Vaccine Safety & Why You Still Need a Mask
IS THE END IN SIGHT FOR PANDEMIC?
The End Of The Pandemic (w/Dr. Monica Gandhi)
Immunity Is The Only Way Through A Pandemic (w/Dr. Monica Gandhi)
Dr. Monica Gandhi on COVID-19 developments

What We Now Know About COVID Prevention and Treatment: A Podcast with Monica Gandhi

the jerry pal podcast is brought to you,by archstone foundation artstone,foundation improving the health and,well-being of older californians and,their caregivers and supported by,listeners like you many of whom have,donated on the jerry pal fundraising,site which you can find at,www.jarrypal.org,big blue button,or through reviews stars on your,favorite podcasting app big thank you,welcome to the jr pal podcast this is,eric widara this is alex smith and alex,this is going to be our second of our,coming back to some of our old covid,guests,um who do we have with us today we're,delighted to welcome back monica gandhi,who tweets at monica gandhi nine and is,an infectious disease doctor and,professor of medicine at ucsf welcome,back to the jared pal podcast monica,thank you for having me,uh i i want to say too the last time i,talked i had you on monica um,my son and my wife were huge monica,gandhi fans my son for this one wanted,to,make a sign that we love monica gandhi i,think um you have really done an amazing,job for the last two years kind of,parsing out the science of covid kind of,where we are,where we're going and,despite a lot of negativity on some of,these social media platforms i've never,seen you go into a negative space or,attacking people,so really uh,very honored to have you on here,really excited to be here all right,before we start talking about covid in,older adults and those with serious,illness,do you have a song request for alex,you know i always like the beatles and i,feel like it's really perky to think,about penny lane i feel like i'm,tripping down something like just,flowers and,so that's my request anyway all right,great here's a little penny lane,in penny lane there is a barber showing,photographs of every hat he's had the,pleasure to have known,and all the people that come and go,stop and say hello,on the corner is a banker with a motor,car,the little children laugh at him behind,his back,and the banker never wears a mac,in the pouring rain,very strange penny lane is in my ears,and in my eyes,and alex um i always thought that was a,light tuned reminisce thing about,i didn't think we were gonna go there,okay we're gonna go there so you're,running around i to our listeners if you,google,penny lane meaning you will see,something that you probably,will regret seeing and you can never,unsee there is sort of a hidden um,sexual,innuendos,references to this song that does seem,like a cheery song about the suburbs,that you know paul mccartney was being,very cheeky and uh yeah sliding some,words in there and references um yeah,the banker never whacked there's a mac,in the pouring rain i'll never think,about that line the same way again,but monica as we were discussing a song,for this podcast we were trying to come,up with something and we mentioned this,one and i suggested yesterday by the,beatles because you're a big beatles fan,and you said no that's too depressing,that's not where we are but maka i am,depressed,i read this twitter thread by andy,slavitt okay who was you know like,former,um head of uh medicare medicaid under,obama former biden white house senior,advisor host of,uh the in the bubble uh podcast,um and he may 20th he was like oh boy,here's what we are here's where we are,globally like in china right they have,these lockdowns and they've tried the,zero covered policy it's not going to,continue to work we're going to have a,massive outbreak in china their vaccines,aren't as effective who knows what's,going on in north korea it could be,terrible there,but we have very little information,almost no information and in south,africa we're continually seeing new,variants emerge,and like let's think about our tools,right the vaccines they try and develop,in vaccine against omicron well we're,way beyond omicron now and in south,africa we saw people who are,infected with the uh omicron they get,reinfected with the new variants they,get reinfected with yet other variants i,think those are just going to keep,sweeping around the world every year,three times a year we can't keep up we,can't you know we can't make vaccines,fast enough,who knows what sort of viruses are going,to come out of china north korea and,south africa,i'm,concerned i'm worried i'm anxious,talk me out of it yeah i i totally get,it and um i think twitter is also a,place where,people you know kind of think in their,head and and it's it's who they are as,individuals so i think let's look at,this sweeping view of infectious,diseases which is how i've approached,this pandemic throughout because unlike,um many others i just happen to love,infectious diseases went into it wanted,to be an infectious disease doctor when,i was 10 read about infectious diseases,like read the history of um think about,it deeply like i'm just into it and what,got you interested in when you were 10,well um because i just like i i learned,about worms and i liked worms when i was,ten like a little nematodes i'm really,just into,parasites nematodes,fungi ba

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Monica Gandhi - The Motivation We Need Now

all right we're rolling i'm back video,plenary session i'm joined by the great,monica gandhi everyone loves to get your,input monica,thanks so much for doing this podcast,yet again thank you thank you for having,me,you're on the media circuit a little bit,a little bit,well i wanted to ask you you know you've,been one of the great voices of optimism,and one of the things you've been,talking about lately is,optimism towards ending or peeling back,restrictions,i wonder if you might take people,through how do you think about this when,might we do that and what are the,triggers for it,yes i think this is a great question and,i'm really interested in talking about,this because,we've had a complicated relationship,with restrictions,not actually because people are,not don't think that kova 19 is real or,or,you know it was a hoax but because it,has severely caused,lots of other things like collateral,damage and children not being in school,and other health problems and so it is,important to figure out okay what are,the metrics,of when we end restrictions restrictions,being reduced capacity,um masking and distancing,and and also have people backing into in,person,and i think that we there are actually,very clear metrics that we can come up,with,uh on that so for example this is just,one example it doesn't have to be this,way,but i wrote with ashish john sierra,in a washington post open about like,this particular metric that we said okay,end it all end it all mass and,distancing when,you're at five hospitalizations over a,hundred thousand people,and that why do we come up with that,actually during influenza it's 20 to 40.,uh hospitalizations hundred thousand so,it's actually way less than that but we,really went back and forth on that and,we said well,two things one is that influence in the,hospital,is not as deadly as coping in the,hospital more people go on to die from,covert in the hospital if they get to,the point of hospitalization,and the second was that these vaccines,are so much more effective than flu,vaccines right so we came up with this,five right and you know california is at,five,like any minute now we were at six uh,per 100 000 hospitalizations um,yesterday,so so yeah i think that's one idea well,no that's a great idea and one of the,things,and 40 vaccination rate though i mean of,course it's in the setting of,vaccinations so,it's like 40 first dose with that and i,said,yeah i see but the one thing i want to,draw attention to what it isn't,is it isn't about pcr positivity right,it is about,um bad outcomes from stars cove too and,and and then the other thing to just,point out is that the the threshold of,vaccination you propose,i think probably where we're we're past,it,we're at 50 first dose in the united,states but that's not true,everywhere we're at like 65 first dose,in our city san francisco,um about 45.6 right now in in michigan,okay so it's varying all over and then,that's an average,and i don't you know we said that,because at the time we were hoping that,40 was that inflection point when cases,come down,yes i actually think that depends on the,natural immunity of the population the,inflection point may be,higher for places that don't have,natural immunity but at any rate you'll,know because,why would you know that the,hospitalizations have gone down so to,that degree,right and you're right it's not about,pcr positive cases i mean that was,always a,flawed concept to use pcr for a test,because it's so so sensitive,so very low viral loads in the nose will,amplify,and then if you get a qualitative answer,yes no it will look like it's yes even,when you have very low viral loads and,you can't transmit it,which is why many of us for so long have,been saying,either don't use pcr use a rapid antigen,test that gives you a viral load that's,more on par with infection,i said or if you're going to use pcr,tell us how many times the pcr machine,had to spend how many cycles,yes to get to,to that number because if you cycle a,lot you have to spend,42 cycles well it's actually probably,more like yeah,thirty five thirty five is that it's,indeed,right but when you see some of these,test results at 42 cycles you don't know,what that means,well i do know what it means i think,it's so low in your virus that it,in your nose that it's dead right it's,essentially low in non-infectious viral,load but because of this yes no,question that you get on a report yes no,it looks like you have to isolate looks,like you have to quarantine,and that that is just a truism of a test,i see,and i guess if one were to stand back,you would say that the philosophical,principle that you're going to defend is,this idea that at some point,combination of people have been,vaccinated combination of outcomes are,looking good,we have to define that before we get,there and agree on it,and then get rid of the restrictions at,that point yes and and the fact that,that will exist,just psychologically yes will make,people better off motivating yes it's

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“We’re in a Transition Phase”: Dr. Monica Gandhi on Vaccine Safety & Why You Still Need a Mask

this is democracy now democracynow.org,the quarantine report i'm amy goodman,with nermeen shaikh,u.s health officials have delayed a,decision,on whether to resume the use of johnson,and johnson's coven 19,vaccine after reports of extremely rare,blood clots and six women,between the ages of 18 to 48 who receive,doses this is out of nearly 7 million,johnson and johnson vaccines,administered in the united states,as centers for disease control panel met,wednesday and may continue the pause for,seven to ten days,they also learned of a seventh woman and,man who developed the rare,condition in this video released by the,white house,white house medical advisor dr anthony,fauci explained the reason for the,johnson johnson vaccine pause,a couple of reasons to do that the first,is to investigate this,a bit further and the second is to alert,the clinicians out there,when someone comes in with these types,of symptoms to ask them if they have a,history,of a recent vaccination the people,who've already gotten the vaccine,should not be worried because as i,mentioned this is a very,rare event one in more than a million,individuals the j j vaccine has been,shown in clinical trials,to be highly efficacious what we're,talking about now,has nothing to do with the efficacy of,the vaccine,dr faunchi is set to testify today,before the house select committee that,oversees the government's coronavirus,response along with cdc director dr,rachelle olensky,and dr david kessler biden's chief,science officer for the covet 19,response,this comes as bidens insisted there are,still enough covet 19 vaccines for,everyone in the united states and that,the pause of johnson and johnson,vaccines won't affect immunization,efforts here,this is biden speaking tuesday during a,meeting with members of the,congressional black caucus,i told you all i made sure we have 600,million,doses of the mr not,of either johnson johnson and or,astrazeneca,so there's enough vaccine that is,basically 100,unquestionable for every single solitary,american,to discuss all of this and also what it,means for vaccine access worldwide and,more we're joined by dr monica gandhi,infectious disease physician professor,of medicine at ucsf,that's university of california san,francisco san francisco general hospital,doctor welcome back to democracy now,it's great to have you with,us so let's start off with the johnson,and johnson vaccine,um one of the things that fauci just,said dr fauci said is to alert,clinicians,now what please explain what exactly,happened to these six or seven or eight,people one woman died and we're talking,about young women we don't know if it's,tied to the vaccine,but this whole issue of this rare blood,clot,in the brain and i was also very,interested that he said we want to,alert all clinicians both to report but,also to let them know that what the,standard of care for blood clots is to,um you know give heparin a blood,thinning,medicine but in this case it has an,adverse reaction and you should not do,this,right so essentially like you said this,is very rare,um six women out of 6.8 million doses,given,and perhaps these additional cases it,was i think prudent to just,investigate these we need to see if,there is another reason for the clot we,need to see if there is any association,with any other medications,and um it is true that this particular,syndrome,if linked to the vaccine causes both,blood thinning and blood clots so it's,thrombocytopenia which is low platelets,and also platelets clumping,so it helps us determine what to do if,someone has a headache,these are very rare clots but they are,cerebral venous sinus thrombosis which,means they're in the brain,so you know this is a temporary pause,this had actually happened with the,astrazeneca vaccine that there were,clots,associated with a similar type of,vaccine which is an,adenovirus with a dna inside it and,what the eu decided to do was go ahead,and,proceed with that vaccine but in older,individuals,because the clots weren't seen in,younger individuals that may end up,being what we do here,but right now it's just time to wait and,give a week and,examine it dr gandhi can you say what,the implications of this,pause are what are the communities that,were receiving,uh the johnson and johnson vaccine uh,especially in areas where,it was difficult it's been difficult to,administer,pfizer and moderna because of how,difficult it is to transport them the,conditions,under which they have to be kept as,opposed to,johnson and johnson yes i mean johnson,johnson had advantages,because the issue was it didn't need to,be kept as,cold as the pfizer moderna and it was,one dose,and then you were finished and there,were advantages,for hard-to-reach populations for,minority communities,and specifically worldwide there is an,advantage of using,an agent that is easy to transport,that's just,in a refrigerator and this is a setback,and concerning and i think that,you know astrazeneca again we have a,precedent for this,with a sim

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IS THE END IN SIGHT FOR PANDEMIC?

welcome to issues and insiders today we,address efforts by Health authorities to,accommodate a changing pandemic,environment following assessments by,world leaders in light of retreating,covid-19 tallies for more I have,Professor Kim from Beyonce University,Professor Kim it's good to have you here,good afternoon I also have Professor,Monica Gandhi at the University of,California San Francisco live on the,line Professor Gandhi as always it's a,pleasure,thank you,Professor Kim will start here let's,start off then with your thoughts,regarding the lifting complete lifting,that is in the outdoor mask mandate here,in South Korea even for large events,exceeding 50 people,well uh it's Contin continuously,decreasing in Korea and right now the,daily Italy has already dropped to about,600 cases per million,and this is the same number as a,mid-February,uh 2022 and it's declining in the speed,almost same as Japan so I think the both,countries are facing the end of this ba5,outbreak,and since the mid August the,reproduction number which means how many,patients you infect dropped below 1.0,and,right now it's only 0.82 it's it's also,it's just declining so I'm optimistic,but still there should be no more new,variants coming you're right hopefully,not Dr Gandhi what can you share with us,about the U.S experience with regard to,lifting of the Mask mandate earlier on,so I mean actually outdoor Mass mandates,were dropped in April of 2021 so that,was some time ago and then,um all indoor Mass mandates except in,healthcare settings,have been dropped,um and then even the the health care,settings the CDC just said on Friday,just this week last week that um even,Healthcare settings are dropping Mass,mandates and that's that was true in the,UK about a month ago so we're definitely,in endemic management,um what endemic management has to mean,though we have to remember is that we're,never going to get rid of covid so we're,always going to think about who needs to,a booster who needs Therapeutics it's,never over and that's where these words,are getting confusing endemic is not the,same thing as over right it really isn't,of course Professor Kim there's also,been a bit of talk here in South Korea,regarding the lifting of the indoor mask,mandate for children as a pediatrician,yourself what are your thoughts on this,uh before I talk about that issue you,know we have to know that,recently uh our government announced a,report that the antibody positive rate,is more than,97.3 percent it's very high and more,than half of those are naturally,infected,and if I close into the age group below,10 years of age uh the children's,antibody post rate is more than 80,percent and almost all of them were,naturally infected because they didn't,have any chance to get it vaccinated,so that means you know children's below,10 almost infected by the natural causes,of Kobe 19. and they show mind course,compared to elderly people,so uh now we talk about children mask,wearing uh,if they wear the mask for a very long,time it might have some negative impacts,on development and,socialization especially if the age is,less than two years every age but I,think it now is time is coming to uh let,them go around without mask and it's,going to lead a lot of explanation and,public announcements to prevent,confusions right Professor Ganda did the,lifting of the mosque mandate back in,the U.S lead to any tangible spike in,community Transmissions of covid-19 do,you think,no actually it didn't because it was,very interesting we're very fractured,nation and so the mass mandates were,lifted in some states way before other,states for example California was one of,the last and other states had lifted,them and you still see the same when the,variants come you still see the same,spike in cases and then they go down and,that's likely because people get,infected they get IGA which is the,antibody up in their nose and then,transmission goes down but there was no,preachable difference in that going up,going down in the places with or without,mass mandates after vaccination so,um so February 2022 was essentially when,almost every state stopped indoor Mass,mandates no we haven't seen appreciable,changes even in Planes for example,um which that was stopped also in April,of 2022. right which is of course,reassuring to know then Professor Kim in,line with its claim that the end is in,sight with regard to the pandemic the,World Health Organization has spoken,about six key actions that countries,need to abide by to contain this virus,could you tell us what they are and,which do you believe are of utmost,importance well the four the six tasks,are testing treating vaccinating and,prevent infections happening in public,places and the battling misinformation,seeking a clear Communications,uh yeah it's if we can do all six of,that it's right it's going to be ideal,but let's turn our watch back back to,the beginning of this pandemic there was,a lot of confusion and chaos and,misinformations going aroun

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The End Of The Pandemic (w/Dr. Monica Gandhi)

- Hey, everyone.,Dr. Z, welcome to the show.,Monica Gandhi, infectious disease doctor,and professor at UCF.,Welcome back to the show.,- Nice to see you.,- You need minimal introduction.,You've been on twice, but there is somebody here,who needs an introduction, and that is Frodo.,Can we see Frodo?,(laughing),- Frodo is a little dog that is named,after a hobbit 'cause he has hairy feet.,He has a tie on for you today,and he is really upset by COVID.,And he's just about to throw the Ring in,,'cause we're almost done with COVID.,- You know what? - With these vaccines.,- I would follow him into Mordor.,I would wear seven masks,and I would follow him to Mordor,,mostly 'cause of the fumes, you know?,- He is kinda smelly too.,- Oh, he's so adorable.,So Monica, like we wanted to hang out again,because you are one of the few voices of reason,that is actually also a physician.,So we have tons of PhD epidemiologists,who are painting gloom and doom pictures everywhere.,Well, you know, first it was this.,And then, you know, okay, now we have a vaccine,but you know what, the variants are coming.,So we're probably gonna have to wear seven masks,and stay shut down.,And by the way, don't even think about opening schools.,Why are you thinking about opening schools?,Oh, by the way it's your bad behavior,that caused all this death,,and so we're gonna shame you.,And on top of that, it's never gonna get better.,So expect 2023, before we get back,to a semblance of what will be a new normal,,which will be we'll all be in bubbles.,So get those guys out of the picture,and go with actual physicians who touch patients.,What's your thinking right now?,Where are we in this mess?,- We are just facing like complete dawn,of hope and light and love.,Like it's gonna be so great.,It is getting so great.,So what happened, right?,Like March 11th was the day that the WHO,declared this a worldwide pandemic.,November 9th, we got the first press release,from the first vaccine.,Phase three clinical trial, that fast.,And then we've had seven phase three clinical trials.,So we have seven vaccines,in circulation around the globe that work.,And they work exactly using the same protein,in different ways using that protein,,and they work beautifully, and they all work beautifully,against preventing what even made us notice,on January 31st, 2019 or December 31st, 2019,that something terrible was happening,,which is severe disease.,They all work almost 100% to prevent...,100% for hospitalizations.,And then like in the 90s to prevent you,not even feeling well at home.,So they're amazing.,- And this accomplishment,was against even our better judgment, right?,'cause I mean, we've all been talking,,I've been talking with Offit,,I've been talking with you...,Is this gonna happen?,Like there's so many hurdles that have to be overcome,in order for these vaccines to work.,And we've never had a vaccine against coronavirus and so on.,And there's all the red tape and everything.,Well, they got rid of the red tape.,They did the science, they didn't cut any corners.,They actually just did the science right.,- Yeah, these are peer reviewed fully,,like pages and pages of text.,They did it all right.,- And you've been vaccinated.,- Yes. - As have I.,- Yes. - Yeah.,So and how is your 5G reception now?,(both laughing),Must be really good.,- It is so good,,but I also just wanna like rub my...,Be really close to people-,- No, but if you read the press,,that animal could give you COVID right back, Monica.,- Yeah, and I could give him COVID, but yeah.,- Put a mask on him.,- So we have to understand,that two vaccinated people should be, I mean...,It'd be nice to crawl over this table and be closer.,But this is like, what, three feet?,- It's three feet.,- So we're fully vaccinated.,We cannot get sick and we should be close.,Vaccinated people should be close,and they should spend time together.,They should see each other,as we get to all people being close to that.,- So Monica, I gonna tell something publicly,that I have not said.,This table is new, right?,The last time you were here, I had a six-foot round table.,We were six feet apart.,This table is now about three feet.,And the reason I'm doing that is,,I believe with a 95% efficacy,that two vaccinated people can hang out.,- They could totally hang out.,And remember, it's not 95% efficacy against severe disease.,It's 100% against severe disease.,And then yeah, maybe one person who got the vaccine,will not feel well for a few days,,because it was mild disease.,So that's the amazing thing.,Keep on focusing on preventing,what got us into trouble to begin with.,- And even with variants, you know,,if they're gonna be setting against...,'cause the variance of the new bugaboo, right?,Like, oh, we always knew there was mutations.,That's what coronaviruses do, all viruses do that.,But the thing is if the vaccines are effective,against severe disease, which they are,,even against the Brazilian variant.,- Yes.,I really need to say something

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Immunity Is The Only Way Through A Pandemic (w/Dr. Monica Gandhi)

- ZDoggMD.,Dr. Monica Gandhi.,Welcome back.,- Thank you very much.,- Oh my gosh.,- I'm asymptomatic and vaccinated, so here we are.,- Here we are, maskless in Seattle.,- Maskless in--,- Well I mean, in San Carlos.,It's the same difference.,- Yeah, same, same.,Asymptomatic vaccinated.,- Asymptomatic vaccinated.,Okay before we dive into that,,because there's so much I want to talk about with you,,we're gonna, okay,,I'll tell you the things that I'd like to hit.,I want to talk about CDC's messaging and their behavior.,I want to talk about natural immunity.,I want to talk about turning this pandemic,into an endemic cold,,and what's going on in places like say Australia.,- Yes.,- I want to talk about booster shots,,I want to talk about vaccine mandates and passports,,and I want to talk about Mu.,But those are just some of the things.,But before we do all that, we have to back up a second,'cause the last time you and I talked,,we were like variants shmariants,,vaccines are gonna save us, this thing is over.,Okay, were we right or were we wrong?,- I think we were partially right,if vaccines had continued to be uptaken,at a high rate in the United States.,So who was right about that?,The UK, Denmark, Ireland.,Who kept in having good vaccine uptake?,France, Italy.,We will later talk about vaccine passports.,We have to.,But great vaccine uptake,,kept on going, kept on going,,and their society's become more an open and open,,even with Delta.,- So we were right just for the wrong country.,- We are right for the wrong country.,We didn't vaccinate well here.,- We thought the uptake would be higher.,- Yes.,- Now Delta turned out,to be pretty high reproductive number,and spread quite rapidly,,which may have thrown a wrench,in the variant shmariant part of our theory,,except if we had vaccinated many, many, many more people.,What would have been different?,- I think if we'd kept on going at the rate,that every other country was on that trajectory,,right now we would have been without masks or masks for the,,no masks for the vaccinated and masks for the unvaccinated.,We wouldn't have had to take that step back.,- Right.,- And also we kind of made people dig in about,,I mean I definitely think our vaccines,increased after Delta,,but we made some people dig in because they were like,,doesn't it sound like vaccines don't work,'cause of our messaging, so why would I take a vaccine,,and then the third thing that we did is that we made people,feel like this is gonna go on forever,,and actually nothing will go on forever,,but an endemic respiratory virus,that doesn't cause severe illness,is actually a controllable way to live,,and I do think one thing Delta's gonna do,,it's gonna give us a lot of immunity.,Vaccinated people who see it are gonna get an immune boost.,Unvaccinated people are going to see Delta,and they're gonna get immunity.,So in a way it speeds things up.,- Yeah, and you brought up a point,,so this is, I wanted to ask you about this.,The messaging around this vaccine.,We've almost done everything possible to convince people,not to get the vaccine, right?,Like, and I'll tell you,,'cause my audience, they're pretty smart people.,- Yeah.,- Especially the vaccine hesitant people,,because they're asking all the right questions,in the setting of the messaging,they're getting from CDC and others which is,,you know what, these vaccines, first of all,,you're gonna need a booster,,'cause you know, not good enough,,second, you're gonna have to mask again,,we told you not to mask,,but you know what, meh, we were wrong,'cause you can probably still transmit a whole bunch,,so wear a mask.,Now is any of this true, and what do we do wrong?,Tell me what you think about this.,- Okay, so this is what I think.,If we had just kept on a persistent message,like by the way, Iceland did,,which was really consistent about vaccines work,and didn't allow all this hesitation,to come into their voices,,I actually think we would have gotten,a lot more people vaccinated.,I think the messaging that the CDC did set us back,because, okay, so let's talk about two things that they did.,One was transmission.,So on July 27th, ouch, it was such a hard week.,On July 27th they said we're gonna put masks back,for the vaccinated.,We're not actually telling you why.,We'll show you a study in a couple of days.,It'll come out on Friday.,Just trust us.,But vaccinated people transmit as much as unvaccinated,,which seemed like really wrong microbiologically,,because even if your antibodies in your nose,come down a bit since if you had your vaccine in January,,they'll come right back up if they see the virus again,,and also you still have T cells in your nose.,You're doing everything you can to kill that virus.,It may just take a little longer.,So it didn't ever make sense that a vaccinated person,could transmit as well as an unvaccinated person.,And then they showed us the study on Friday, July 30th,,and it was the Provincetown outbreak study,that you've covered, a

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Dr. Monica Gandhi on COVID-19 developments

for more on this dr monica gandhi she's,a procedure professor of medicine at the,university of california in san,francisco thank you for joining us,doctor um,you heard what the white house had to,say,are people listening to this,well,the white house is absolutely right that,we need ongoing funding and i think the,way to think about coven 19 is we're,never going to eradicate it in fact any,elimination strategy has been,unsuccessful because it's in animals,there's multiple reasons what we have to,do is keep our hospitalizations and,deaths low,and we are in a surge of cases,our deaths are actually lower than,they've ever been since march of 2020,but all that takes ongoing work it's,always work who to vaccinate next who,needs a boost who needs treatment and so,they're absolutely right that we need,ongoing 10 billion a year what they're,asking funding to keep things in control,there there are people that i know,that got tested positive for covid with,zero symptoms and here they are walking,around among us having dinner with us uh,maybe even working alongside of all of,us,there's no way you can find all these,folks what's the solution to all this,in fact i do believe shanghai's approach,really,showed that you cannot test everyone,and keep everyone away from all human,beings we have to think of this virus,differently,we have thought or some countries have,thought you can eliminate it you just,can't it's not,only,smallpox has been eradicated worldwide,and it had very particular,characteristics including no animal,reservoirs this has 29 animal reservoirs,the way to deal with this,is is know that it's always with us,which i'm sorry about and,keep boosting,keep vaccinating and keep treatments,ready for to prevent severe disease but,preventing cases preventing mild,infections preventing asymptomatic,infection,we've already seen over two and a half,years we can't do that,and some experts are warning that this,fall there could be another outbreak of,new variants how worried are you about,that,so the one thing that's interesting,about omacron is,it was a variant that,it's getting a little offshoot but,there's not a variant that's totally,different from it,and some evolutionary biologists are,saying that enough of the population in,the world has seen this virus or been,vaccinated that we have enough immunity,that we're going to get little offshoots,for this subvariance but we're not going,to get a whole new bad variant,i'm hopeful about that i actually think,that makes evolutionary sense but the,who is prepared they said if another,worse variant comes we're all going to,need a booster not 80 year olds not 60,year olds not 70 year olds everyone,but,this is the hope there's a stat article,from may 3rd that i'd encourage people,to read about how it's becoming more,like the flu it's changing just a little,bit not like it used to,so i mean i have a personal question to,ask you doctor so when i fly on a plane,or i check in at a hotel or i ride the,bus or a subway,i wear my mask,but it's about half and half,should i wear my mask and,i mean how worried should we should we,be because you said live with it then i,should just take my mask off and kind of,you know what's a reasonable amount to,protect ourselves with,i will tell you at some point,we do have to live with it it's just,never going to go away and the people,have the strongest immunity and again,i'm just doing biology are vaccinated,but also had an infection it's called,hybrid immunity we're seeing cases rise,in places that were most locked down in,this country like here in the bay area,and not in places that had more of that,mix of hybrid immunity so i think it's,inevitable that everyone's going to see,covid i think it's okay to see covert if,you're vaccinated i think it's going to,deepen your immunity and you can't avoid,it forever but if you want to try to,avoid it forever wear that back well,hang,what you just said is is it is something,new that i don't hear a lot of experts,saying,if you are infected and you get the,virus you are saying that some of these,individuals actually have stronger,immunity to protect themselves from say,the next or another variant is that what,you're saying,yes in fact study after study has shown,this so i'm not actually saying anything,new you just have to get the right,immunologist on here but um study after,study has shown this i will give you two,examples i wrote a piece for clinical,infectious disease on march 2nd that you,can read about hybrid immunity the new,england journal had a paper last week,about hybrid immunity what happens if,you're vaccinated and you get the,infection is you get,immunity across the whole virus so if,another variant comes along you have,more broad immunity across the whole,virus and epidemiologically we're seeing,that people have had either infection,and a vaccine or the vaccine,infection hybrid immunity have more,protection than those who've either had,the vaccination or been previously,infected right um,dr mon

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