A&M virologist: Hold off on parade
Ben Neuman, one of the world’s top experts on coronaviruses, has been studying the things for 24 years. He’s the Global Health Research Complex Chief Virologist at Texas A&M University. He’s a funny, genial explainer of science — his laugh lights up the podcast version of this interview — but this week, when we started talking about reopening Texas, he got serious fast.
Q: We have loads of questions from Chronicle readers this week. First up: Gov. Greg Abbott is reopening Texas on March 10 and lifting the mask requirement. Should we still wear masks anyway?
A: Should we reopen Texas now? [Laughs.] That’s the bigger question.
Q: Okay: Should we reopen Texas now?
A:
No. That’s the short answer.
We don’t even have an accurate count of how many cases there are. The case numbers are right now artificially low, according to the Texas Department of State Health Services. We know they’re artificially low because the number of deaths was going along at a particular rate, then it went down to zero for that week where everything was frozen, and then it came right back up as if nothing had happened. Normally, with glitches in state data, they collect all the ones that fell through the cracks and dump them all at
once, usually on a Friday night, and then we have a spike of 30,000 cases.
We have not had that yet. We have not corrected from the data fallout basically.
Q: So we can all expect that this Friday? A: Some Friday.
Q: Maybe a month from now?
A: Right. It’ll be really exciting. One line on the graph is gonna go way up.
Q: So that means the COVID numbers in Texas are higher than we think?
A: They’re definitely higher, but nobody knows how high, including the governor — which is why this was a weird time to basically hold the parade for the end of COVID. We’re not quite done yet.
It’s a recipe for social pressure against maskwearing, and Texas has had trouble with mask compliance right from the start, bless them. I don’t think this is going to make anything better.
You’d have to talk to a epidemiologists to figure out how many more people are likely to get infected, and how big the spike is likely to be. Cases are rising to some extent — that’s just places that weren’t able to report starting to report — but it’s really anybody’s guess as to when those cases were logged and how many of them are getting through now.
Q: The governor is emphasizing individual responsibility. Now all the decisions are up to us: We have to be our own epidemiologists and virus experts and assess our own risks. Why do you think that’s not a good idea?
A:
The governor is also putting county judges in the place of your local epidemiologist, when everybody also has some form of a county, local or state Department of Public Health, essentially. There are people whose job it is to know this stuff and to make these decisions, and they are not in the loop on this one. That is a questionable choice, I would say, from a scientific point of view.
As for personal responsibility/personal freedom, the problem is that this is not an individual risk. You can’t get COVID on your own; you have to get it from somebody else. Whether or not you get it depends both on whether you wear a mask and whether they wear a mask. There are cases like one up in Vermont, where one person was wearing a mask, three other people were not wearing masks, and the masked person still caught the virus.
So yeah, in scientific terms, we’re playing fast and loose on this one.
Q: So we shouldn’t relax, shouldn’t change how we’re behaving?
A: Oh, my goodness, no. If anything, Texas is going to be a little more dangerous in terms of COVID in the coming weeks. I would say extra caution is probably warranted. We should certainly be cutting down our potential exposure as far as possible.
I guess we have yet to see how this is going to play out — to what extent people were only going along with mask regulations because the governor said so, as opposed to because it’s an epidemiologically and scientifically sound thing to do, a course of action very well proven in the literature and backed up by lots of tests and mathematics.
Q: So some people have been vaccinated. Does that change the game?
A:
Some have; 7.5 percent have been fully vaccinated at the moment. Every day it’s more — but we’re nowhere near herd immunity.
It’s a good question whether or not we can get to herd immunity. Even if we have vaccine and we convince everyone who is (eligible) to be vaccinated, we still have the problem that very young people aren’t eligible — everybody under 16 isn’t eligible for one vaccine, and under 18 for the others.
That’s a sizable part of the herd that is very definitely catching the virus and is able to spread it. So I don’t think, with the current climate, you would be able to get herd immunity by only vaccinating adults.
We’re waiting on one of the clinical trials to come through so vaccination of children is allowed. So yeah, herd immunity gonna take a while, and
I’m not sure if we’ll get there if vaccinations are the only thing we do to interrupt transmission.
We need to do other take other precautions, too. The scientific outlook would urge caution, rather than less mask-wearing.
Q: If you’re one of the lucky few who are fully vaccinated, how much can you change your life? Should you still be wearing a mask when you’re in public?
A: Yes, definitely — any time you are not in your house with just the people who live all the time in your house. It’s not time to change this yet.
We’re at about a 9 percent test positivity rate right now in Texas. We’re not doing quite as well as Ghana or Belarus. We’re a little better off than Peru.
But most industrialized countries with vast resources and health care and testing, like we have available, are doing a much better job of containing this. The testing percentage is the number that really shows you where we’re slipping and where the danger is coming in.
Q: Let’s say that I’ve had my second second dose of vaccine, and have given it time to take full effect. Can I just have a couple of people over for dinner, if everybody stays distant and keep their masks on?
A: I would say yeah. Eat outside. Only take your mask off during the meal. Texas is blessed with warm weather.
Q: What about hugging grandkids if I’m vaccinated?
A: Put your mask on and hug your grandkids. That’s fine.
No.
Q: What about going to a party with 10 people who don’t live in my household?
A:
Q: Even if we’re all masked?
A: If you keep your mask on, and everybody else keeps their mask on, okay. If everybody masks, we’ve figured out that that is pretty good. You can do a lot of things then, and you’re still pretty well protected.
Q: Is the party safer if I double-mask?
It doesn’t hurt anything. A single mask is, like, 95% effective. With the double mask you’re trying to eat up that last 5% of risk.
Q: But I shouldn’t eat the finger foods? Or stand close to other people?
A: I would stand close to them. I think that’s fine if you keep your mask on.
As for the finger foods: You gotta get your little plate of hotdogs, run outside, pump ’em all in, then put the mask on to hide your giant hamster cheeks — that’s fine. [Laughs.] You’d eat disgustingly, but still in a relatively safe way.
Q: We have a lot of questions about the Johnson & Johnson vaccine that we’re about to have available. What do you think of it it? How is it different from the ones that are going into arms right now?
A:
It is different from the ones that are going to arms in the U.S., but it is exactly the same as what’s going into arms in Russia. One of the two parts of the Sputnik V vaccine is exactly the same as the Johnson & Johnson, and the other part is exactly the same as a reasonably successful Chinese vaccine.
And the only way that the Oxford-AstraZeneca vaccine is different is that they have a slightly different shell on the outside of exactly the same gene. So these are things that are very well tried, sort of internationally, globally, broadly. But they’re being proven in this particular formulation produced from these particular steel
vats [laughs] inside the United States, and that’s fine. But from a scientific point of view, it’s not a big surprise.
These vaccines seem to work pretty well. They’re a peg below the level of protection you get with the Moderna, and Pfizer mRNA vaccines. The reason for that is that you can’t put in as much of the adenovirus vaccines into the injections because it’s hard to make them. You have to grow some of the components, and that’s hard: You have to baby them. The problem with growing anything in a cell is that most of the metabolism of the cell has to be directed at keeping that cell alive.
Q: Is the Johnson & Johnson vaccine different for people of different ages?
A: It has very low side effects, about as close to zero as you are going to see. So for that reason, it is possibly ideal in older people and for people who are people who were holding off on vaccination because they were worried about side effects.
This is one that’s going to do a pretty good job. It gets a solid B, whereas the mRNAs get an A.
It has 66 percent efficacy. That doesn’t mean you get a third sick instead of all the way sick. It means that 66 percent of the people are going to be
virus-proof — at least for the first three months, which is all they’ve checked in the studies.
Q: We have a lot of questions from people who have various immune autoimmune diseases, things like Hashimoto’s, celiac disease or rheumatoid arthritis. They’re asking, Do I need to worry about getting a vaccination? Will I send my immune system into hyperdrive?
A: That’s a total askyour-doctor question. But from a scientific perspective, autoimmunity is one of the things that makes COVID-19 much worse. So on average, a vaccine would do more good than harm in a person with certain kinds of autoimmunity. That would be the way I’d view it in terms of cells and stuff.
Q: But nobody is really average, so….
A: This is not guy-onthe-Internet-advice time. It’s time for a doctor who’s seen the charts and knows what’s going on.
Q: What else should we be thinking about? What should we be doing?
A: As a country, we should be testing more. The actual incidence rate of the virus is only something like 2 percent in the worst-hit places. So the fact that 9 or 10 percent of the tests reported in Texas are positive tells you that a lot of people who should be tested are not being tested.
We are now at the stage where there are enough labs that we should be able to saliva test pretty much everybody, pretty much every week. That is within the realm of what is possible without a whole lot of changes. And the sooner we do that, the better.
We should be sequencing more of these strains — as a state, maybe, and as a country, maybe, and as the world. And we should do it faster. Right now it’s about a month from the time that a person gives a sample until its sequence is known. And that person didn’t come in on Day 1, when they caught the virus. They were probably tested about two weeks after they caught it. So you’re a month and a half behind the curve on whatever is going on out there in the world, and we could do better.
The federal government is authorized — I think it’s at least eight — big sequencing sites that will be dotted around the country. And I know other places are applying to be the ninth, 10th, 11th or 12th.
The more the merrier!
This is something where good data is really going to help.