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Nancy Solomon: Thanks for sticking with us on The Takeaway. I'm Nancy Solomon, in for Melissa Harris-Perry. Over the past seven days, New York City has reported a 15% positivity rate for COVID-19, the highest it's been since January. Across the country, hospitalizations for COVID-19 have risen to their highest levels since March. This rise in cases is being driven by the new BA.5 variant, which now accounts for about 65% of all COVID infections in the US.

On Tuesday, White House COVID-19 Response Coordinator Dr. Ashish Jha took a measured tone when talking about a briefing on BA.5.

Dr. Ashish Jha: BA.5 is something we're closely monitoring, and most importantly, we know how to manage it. We have all the capabilities we need to protect the American people, vaccines and boosters, treatments, tests, masks, ventilation, and so much more.

Nancy Solomon: But not everyone is actually following that guidance. To help us understand the stage of the pandemic, I'm joined by Celine Gounder. Dr. Gounder is a Senior Fellow at the Kaiser Family Foundation, a Clinical Associate Professor of Medicine and Infectious Diseases at New York University's Grossman School of Medicine, and a former member of the Biden-Harris Transition COVID-19 Advisory Board. Thanks for being here, Dr. Gounder.

Dr. Celine Gounder: Thanks, Nancy. It's great to be here.

Nancy Solomon: Tell us how BA.5 compares to previous variants and why the rates are so high right now.

Dr. Gounder: The most important characteristic of BA.5 is that it is more immune evading. In other words, it's better at dodging our immune responses, our antibodies. That's because it looks so different from earlier forms of the virus. Our immune systems are good at recognizing those older variants but less good at recognizing all of the different Omicron subvariants.

Nancy Solomon: On a scale of 1 to 10, how concerning is this wave and why?

Dr. Gounder: Well, if you are not vaccinated, I would be concerned. What we're seeing is that, in particular in counties across the country that have lower vaccination rates, say in the 30s to 60s percent fully vaccinated, those are the counties that are seeing the biggest increases in hospitalizations. Now, New York City has a pretty good vaccination rate, but there are a significant proportion of New Yorkers who are still not vaccinated. That's the group that is ending up in the hospital with BA.5.

Nancy Solomon: Are there a lot of people who are testing positive but not getting sick? I mean, is there a silver lining in this as well?

Dr. Gounder: That's right. We are seeing a huge increase in cases. If you look at maps of community transmission right now, the country is red, it is on fire with transmission, so your risk of getting COVID right now is quite high if you're going around unmasked in indoor public places, but the vaccines are working. They are doing their job of keeping people from getting severely ill, but that's not to say that a relatively mild case of COVID that does not land you in the hospital. It's not pleasant still. Patients or people will experience fevers, chills, extreme fatigue, muscle aches and the like. If you don't want to be coming down sick, it does require you to take some additional steps beyond getting fully vaccinated.

Nancy Solomon: Dr. Gounder, there are new boosters coming, right? When are they coming and when should people get boosted?

Dr. Gounder: Well, if you are over age 50, you are eligible for a booster now, so a second booster dose. If you are over the age of 12 and you have an immunocompromising condition, you are eligible for a second booster dose now. We are going to be seeing updated vaccines that are matched to the BA.4, BA.5 subvariants, coming out probably in October and more widely available in November.

It's really important to understand that just because you get a booster now does not prevent you from getting that updated booster later. That will not preclude you from getting that other booster later so don't try to hedge your bets here or game this out. If you're eligible for a booster now, get that booster now because that is what's going to protect you from what is circulating now and keep you out of the hospital now.

Nancy Solomon: Ever since the pandemic began, cities and states across the country have been trying to get back to a so-called normal. Businesses are back and municipalities are reducing their expenditure of resources. For example, in New York City, Mayor Eric Adams's administration closed half of its free public COVID-19 testing sites since February. What do you make of these efforts to "Get back to normal"?

Dr. Gounder: Well, we may want to get back to normal, we may want to go back to pre-2019 life and behavior, the fact is we're not going to be able to go back to that world because COVID is now with us indefinitely, so it really comes down to how much risk we're willing to take on and what we're willing to do to reduce our risk. I think for different people, that's going to look different.

I think for some people, minimizing their risk of getting any kind of infection is going to be a priority, perhaps because they have underlying medical conditions or are older and so are more cautious. Maybe they just cannot afford to take time off work and so we're going to be more cautious, but I do think we are moving towards this place where it is going to be more tailored by the individual what they're willing to do.

Nancy Solomon: What are you currently seeing in the hospital where you work?

Dr. Gounder: We are seeing an increase across New York City of hospitalizations related to COVID that is being driven by the BA.4 and BA.5 variants. I think the good news is fewer people are ending up in the ICU than we saw with previous waves. That's also a reflection of people having at least some degree of immunity largely from vaccination but to some degree prior infection that's preventing them from getting so sick that they end up in the ICU.

Nancy Solomon: There are some reports that re-infection increases the risk of long COVID. Are you seeing that, or do you have any information about that?

Dr. Gounder: Yes, that's based on a study of veterans in the VA system, those were almost all men, much older as you can imagine. The VA population had a lot more underlying medical conditions, more likely to smoke and the like. I think you have to be very cautious about generalizing the findings in that study to the general population. I think we're waiting to see that replicated, those same findings replicated in other studies with different populations, but what that study did show is that with each subsequent infection, people were more and more likely to develop long COVID.

Nancy Solomon: Dr. Celine Gounder, Senior Fellow at the Kaiser Family Foundation and Clinical Associate Professor of Medicine and Infectious Diseases at New York University's Grossman School of Medicine, thanks for helping us out today.

Dr. Gounder: My pleasure.

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