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Brian Lehrer: It's the Brian Lehrer show on WNYC. Good morning, everyone. Let me begin today with praise for The Atlantic Magazine which has done deep and sophisticated reporting on COVID since the beginning and continues to explore the science and the impact on our lives in important and importantly, nuanced ways. Currently, they have two different articles up that I've been looking at, one with nuance takes on the differences between the different vaccines and one called Don't Be Surprised When Vaccinated People Get Infected: Post-Immunization cases sometimes called 'breakthroughs' are very rare and very expected.

Let me be clear as we're about to talk to the writer of that article. These articles are not anti-vax in any way, they clearly describe the overwhelming evidence that getting your shots is central to finding our way back to something like normal. If anything, these articles are another kind of inoculation against sensationalist media reports that are likely to come any day when some breakthrough infections occur that will launch stupid debates about whether vaccination is worth it.

The Atlantic is, I would say, a few articles ahead of that possible curve which hopefully will prevent it from doing much damage, but it also offers some guidance on how to live your life after vaccination which can still be a little different from before the pandemic, especially if you're one of those people more at risk of a serious case. For example, they quote a virologist at Mount Sinai saying, "Vaccination is like an umbrella in the rain, very good protection against getting wet, but not the only thing you need depending on the severity of the storm."

With me now is Katherine Wu, science reporter for The Atlantic. She previously was a science writer for The New York Times, some of you might know. She completed her PhD in microbiology and immunobiology at Harvard in 2018. She is the 2020 winner of the Evert Clark/Seth Payne Award for young science journalists. Again, her most recent article is called, Don't Be Surprised When Vaccinated People Get Infected: Post-immunization cases sometimes called 'breakthroughs' are very rare and very expected. Katherine, thanks for coming on today. Welcome to w NYC.

Katherine Wu: Hi, thanks for having me back. It's good to be here.

Brian: Can we inoculate people by focusing first on the very rare part of your subhead, how rare are they?

Katherine: That's actually a really tricky question to answer. If you start to look on a state by state basis, which is really the only place that data is available right now, we're seeing reports of a handful of cases among hundreds of thousands of people that have been vaccinated, but I really don't want people to start dividing immediately and think that we have a good sense of the rates. Not all of these cases are going to be noticed knowing that we're tracking infections which may or may not have symptoms. There's a lot of people getting infected, they may never know it. If we look on a nationwide scale, the CDC is starting to collect those numbers, but they haven't yet unveiled their national database.

What we do know is that based on clinical trial data for Moderna and Pfizer and Johnson &Johnson, these vaccines do an amazing job of reducing the number of cases of symptomatic disease. It's a little squishy when we're talking about asymptomatic infections, but the important thing to know is that if we are talking about like a 95% efficacy, for example, that does not mean that 5% of the people who get vaccinated are going to be infected. It means we're reducing the number of post-vaccination cases by 95%. It totally depends on how much virus is around and ideally, the virus is not having a chance to infect every single person that's getting vaccinated.

Brian: You write that some coronavirus infections will continue to occur and the goal of vaccination is not eradication but a détente, your word, in which humans and virus co-exist with a risk of disease at a tolerable low. Katherine, that's different, isn't it, from the way we tend to think of our childhood vaccinations. We don't live in a detente with polio, polio basically does not exist in this country anymore. Why is this different from that?

Katherine: That's a great question. I think there's a couple of things to consider here. When we think about the vaccines that we've developed against other viruses or really any other pathogen, I'm talking bacteria here as well, it's pretty hard to eradicate a pathogen, a disease. We've really only done it once with smallpox and vaccination certainly did help there, but we know that this past year has just been overtaken with this new virus.

It has overwhelmed the population that has never seen it before, that makes it really, really easy for this virus to spread. It's tough because the vaccines came at a point where so much of the world was infected, so much of the virus had a chance to circulate around and so much of the population remained vulnerable. The vaccines are really a good way for us to help end the pandemic in combination with other strategies that stop help the viruses spread. But vaccines by themselves, it would be really hard to launch this campaign and say, "We're going to eradicate this disease, end of story.

That's going to be the end of the pandemic." I think what a lot of experts are saying now is that the most reasonable next goal is to get us to a point where we can end the pandemic, where we're no longer in a global crisis and the disease is spreading unchecked. This is beaten back to the point where people can resume a somewhat normal life and maybe only bothers us fairly infrequently, possibly even on an annual basis like a flu virus might.

Brian: This gets us to the question of personal behavioral choices, especially for people who might be in more vulnerable categories, older people, or people with certain underlying conditions. We're going to get to the umbrella analogy here, you quote Viviana Simon, a virologist at Mount Sinai with her umbrella in the rain analogy, if it's drizzling, the umbrella by itself is probably enough. If it's a windy maelstrom, the umbrella alone might not be enough or in the case of the virus, if there's a lot of it blowing around and you're in a crowded space, you might still want to think about avoiding that kind of thing?

Katherine: One thing to clarify, I actually did not take that metaphor from Viviana, though she did have some wonderful other metaphors about how this all works. There were some really great analogies here and I think the best way to think about this is the vaccine is a tool, but it's a static tool in this really dynamic landscape. We have to consider a few things on both sides. When we think about the number of people who might be infected even with the backdrop of vaccination going around, you have to consider what's going on on the virus side.

With the umbrella analogy, that's the weather, the conditions of the rain. Is it just a drizzle if there's not much virus around or are we dealing with a really steady downpour, has the virus changed in some way that might make it easier to evade some of the antibodies that vaccinated people might mount against it. Is the quality of the raindrops changing? Are we're dealing with hail now? Then there's also the person underneath the umbrella, some people might feel like, "Oh, I really, really, really don't like getting wet or I get sick really easily when the weather changes." Those people might be more vulnerable even if they're using the exact same umbrella as someone else.

There's just so many things to consider that it's really hard to paint with a broad brush and say, "We're handing out the same tool to everyone, an umbrella or a vaccine and it's going to work exactly the same way." If a few people get just very, very slightly wet in this analogy, maybe they're getting infected but they're not feeling symptoms or at least severe symptoms, that's a huge, huge win. I think that is clearly what the vaccines are doing at this point.

Brian: You write that the circumstances of exposure to any version of the coronavirus, meaning any variant, can make a difference. If vaccinated people are spending time with groups of unvaccinated people in places where the virus is running rampant, I guess that's the hailstorm, that still raises their chances of getting sick because large doses of the virus can overwhelm the sturdiest of immune defenses if given the chance.

I get the other part of the answer that you just gave, if people get a little sick from it, okay, it's like a lot of other illnesses that go around in the world, the goal is preventing hospitalizations and deaths, but can you describe the science of that hail storm? Like if I'm a vaccinated person in a room with one COVID positive person, that's safer than being in a room with 10, is it literally a dose-response curve?

Katherine: I think the data on this is still emerging, but based on what we know of other pathogens and really what we've seen in terms of the epidemiology of this disease so far, that does seem likely. I think that's the same risk calculation you would ask unvaccinated people to make, that it's more concerning to mingle with a lot of other people whose infection status you don't know, especially if people aren't wearing masks or the ventilation is really poor.

That's going to be more risky than being in a room with a single other person who is like 20 some feet away from you. It's very hard to do those ones of really clear-cut dosing experiments because often that involves doing what's called a challenge where we actually are dosing people or animals with different amounts of the virus and seeing what happens to them. It is very possible. I think the idea to think about here is vaccine is a risk lower, it turns your risk downwards. It does not obliterate risk, it does not surround people with an impenetrable barrier, it's lowering your risk, which means your risk is not zero. That means a couple of things, one, you can lower your risk further by adopting other strategies like masking and distancing.

It also means if people are starting from a different point. Like, if you're exposed to a ton of a virus, the vaccine can only lower your risk so much, it's not going to drive everyone's risk of getting infected down to like 2.7%. Of course, I'm making that number up. Everyone is starting from a different baseline. People are in different contexts, and that's going to be different. The upshot from this is even if you're vaccinated, that is not a free pass to tear off your mask and expose yourself to a ton of the virus, you're not in a risk zero situation. Do not go out and I think probably mingle with people who you know might be sick.

Brian: Listeners, your question's welcome. I see some of you are starting to call in already. We have some lines still open, though. I'll give out the number for Atlantic Magazine science writer Katherine Wu, on the rare cases of vaccinated people getting COVID, the implications for precautions vaccinated people should take, and the risk of media blowing these rare cases out of proportion when they occur, and delivering exactly the wrong message when these rare cases do occur. 646-435-7280. 646-435-7280. Anyone listening now who got COVID, two weeks or more after your last shot, or anyone with questions 646-435-7280. Or you can tweet @BrianLehrer.

One thing that the umbrella analogy and your description of how being around a lot of people that might be passing around virus in the same place at the same time got me thinking about, should this give people pause about mass transit? Lots of people in a bus or a train car, who we don't know who they are, that density is coming back with a decent percentage of unvaccinated people likely to be present in any individual case.

Katherine: Yes, it's a great question. I think people are really anxious to get back to traveling after a year of being told not to. I think that still is the guidance. The most recent change from the CDC is telling people who have been vaccinated that they can interact with each other in small groups, maybe start to form small pods, or start visiting single groups of unvaccinated people on a limited basis. In general, experts are still saying, "Don't do unnecessary travel, really still try to avoid crowds."

We're still figuring out exactly the extent to which vaccines can block people's ability to carry the virus asymptomatically and their ability to be able to transmit the virus to other people, especially who might be unvaccinated. I think until we figure more of that out and until we have more of the population vaccinated, it's still ideal to avoid travel when possible. Of course, we also do want to keep people's mental health and livelihoods in mind if travel is indeed essential. There have been a lot of ways to make that safer, people are traveling with masks. Some people are testing before and after travel, airlines are starting to recommend that.

Some controversial policies now coming into place about, should vaccinated people be greenlit to fly? Still taking precautions, of course, but then there are some really serious equity issues to think about there.

Brian: We should point out that on the other hand from the CDC guidelines, there are smart people like Dr. Leana Wen from the Washington Post and CNN, and the former Baltimore Health Commissioner. Many of our listeners know Dr. Wen, she comes on here a lot, who says the CDC guidelines are too timid. Vaccinated people should be told it's okay to fly, which the CDC still recommends against as you were just describing. She wrote, "The risk of infection during air travel is already very low and all passengers are masked. Surely that risk is even lower for vaccinated people. Why can't the CDC say that vaccinated people can travel without having to quarantine or get tested."

In fact, she writes, "I think it could go further and encourage those fully vaccinated to travel. The CDC can specify that they should still be careful once they get to their destination. Don't go to parties with people of unknown vaccination status, for example, but it's fine to visit extended family, go to beaches and parks and tour cultural sites while wearing masks in public places." Is either position, Dr. Wen's, or the CDC's more consistent with what your many scientists' sources told you for this article, if you went there?

Katherine: Yes, I think people are still very divided on this. It's totally understandable. This is something that we are all figuring out. It's not just about the data that we're seeing from clinical trials and the data just kind of emerging on a country-by-country basis. You do have to keep people's behavior in mind. We have to keep their mental health in mind. I completely respect people who are falling on both sides of the advice here. I'd say like a very slight majority of the people that I've been talking to have still been fairly conservative about traveling while vaccinated or the behavioral changes people are making while vaccinated.

I think one really important thing to consider here is the protection that the vaccine offers builds up somewhat slowly over time, it's not instantaneous, it's not happening the moment the needle goes into your arm. Most of the vaccines that are still being distributed in this country are still being administered into doses based several weeks apart and it's really a couple weeks after that the CDC considers you to be fully vaccinated. Really, the weeks after that your immunity is still building up accumulating slowly over time. Several weeks after that last dose, you're probably even more protected than you were at the two-week mark.

I think people just need to figure out how to very slowly adjust their behavior, and really keep up to date with the latest guidance, the CDC has really indicated that this guidance will keep evolving. We're just figuring out at what pace that's going to happen and how people are going to react in the meantime.

Brian: It's good that scientists disagree. [chuckles] This is the difference between science and politics. In politics, everybody has to line up with their party's position, in science, because data is complex and implications for behavior might be open to interpretation that scientists disagree with each other about where the line is, where those gray areas are, what to do with uncertainties in the data. It's a good thing that scientists are honest enough to disagree with each other a little bit. Jane, a nurse in Rockland County, you're on WNYC. Hi, Jane, thank you for calling in.

Jane: Thank you for having me. I'm really confused about what's going on with me. I've been on the front lines working in hospitals here in Rockland County since before we had a name for COVID, from the very beginning, nurses all around me were getting it and I felt like somehow I had some immunity. I was one of the first in line to get the Moderna vaccine and about a month after I had the second dose, I started getting symptoms. I didn't believe it could be COVID, so I just thought it was allergies or something else, and finally, just to rule it out, I got tested last week, and I'm positive.

It's really strange to me that, after being so in the middle of it after I was vaccinated, I got it. I just find all this news going on now is so confusing, because for me, at least the vaccine didn't protect me and it makes me nervous that people who are vaccinated are going back to pre-COVID life.

Brian: May I ask how severe your case is?

Jane: It's not. I know it's not severe. I had the headache, no smell or taste. Looking back, it's obvious. I haven't had fever, and I haven't had any respiratory issues. Thank God.

Brian: Do you happen to know if it's a particular variant?

Jane: They don't check. I spoke to the Department of Health, they don't check. I thought that was interesting also because I thought they were doing statistics on it. At this point, it's so rare what happened to me. The lab doesn't check. I don't know.

Brian: Katherine Wu, here is a breakthrough case. If Jane has got her story right, which we can't verify, but Jane sounds credible. It's consistent with your article. Do you want to ask her anything or what were you thinking as you hear Jane's story?

Katherine: First of all, thank you Jane for sharing this. Thank you for all the work you've done this past year. I think one other question I had was when did you start feeling sick after your second dose? Do you know the timing of the difference there?

Jane: It was like four weeks after and I kept up the N95 at work and the shield. I kept up social distancing and all of that. It was definitely after that.

Katherine: A couple things come to mind for me. I feel like infection with the virus can seem a little bit chancy sometimes though I wouldn't read too much into that you didn't get infected last year, but it seems like you got infected recently. It doesn't [unintelligible 00:20:44] even more than two weeks out from your last shot, you tested positive. You don't have to answer this if you don't want to, but unless you had already mentioned this, it sounds like you shouldn't have- I guess I will ask it, do you have any underlying medical conditions that could change your ability to respond to the vaccine? That is one other thing that could impact your ability to respond.

Jane: No.

Brian: You're saying an underlying medical condition could have reduced the effectiveness of the vaccine.

Katherine: For some people who are taking immunosuppressive drugs, who are recovering from cancer, a bunch of conditions, those can impact vaccine effectiveness, but we also know that even among healthy adults, very, very healthy adults who are able to mount great immune responses to all kinds of pathogens. There is a huge, huge, huge range in the number of antibodies you will mount to the specific virus and the way that your body just reacts.

That doesn't mean anything is wrong with the body. It's just different people are a little bit different. Everyone's immune system is tailored a little bit differently. This one felt like it was a break the case and those things are going to happen. I don't want that to [unintelligible 00:22:02] anyone. This is really still in the extreme minority. It's really comforting to me that you have not had severe symptoms so far and I hope that continues to be the case and that your symptoms will resolve quickly.

We can't notice for sure, but it is possible that if you hadn't gotten the vaccine, you could have faired much worse. I think that's one thing that researchers are concerned about. It's obviously hard to prove on a case-by-case basis, but it seems like based on what the trials showed us, people were getting far less sick when they were vaccinated compared to people who were not. [crosstalk]

Brian: Jane, thank you so much for sharing your story with us. I'm sure it took some courage to call in and say this on the air. Thank you very, very much. I hope you continue to do well. I think you're making a very important point. Of course, we can't know in an individual person's case, one case, but that the trials for the vaccines found 95% efficacy. That still means some cases, but what they found that the media keeps rightly emphasizing is zero cases of hospitalization and zero cases of death among vaccinated people. This would still be consistent with the important findings of the trials.

Jane: That's right. One thing I do think is important to be careful about there I think you had mentioned one of the other recent pieces on the Atlantic, noting that there will not be absolutely zero post-vaccination cases of hospitalization or death from COVID. Very, very, very, very rarely a couple of those cases might happen. Again, the idea is that the number of those cases has been dramatically reduced. We saw none in the trials and we should expect to see very close to none in the real world.

Brian: We'll continue in a minute. Brian Lehrer on WNYC.

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Brian Lehrer on WNYC, with Atlantic Magazine science writer, Katherine Wu, who is looking in the eye in her latest piece, the reality that some vaccinated people, it will be very rare, but some vaccinated people will get COVID-19 and how to deal with that reality. From my standpoint, how the media should not when a few serious cases likely happen blow it up out of proportion and make it an argument for some meaningful debate, "Should we all get vaccinated or shouldn't we bother?"

No. The reason we're having this conversation is partly to reinforce the fact that they are so rare, they're already proving to be so rare enough people have been vaccinated, that when they happen, it does not reduce the argument for everybody getting vaccinated. Yet the science is not 100% and it's good to look at the science and that's what Katherine Wu does in her latest Atlantic magazine article.

I want to ask you about variants. You write that the current vaccine seem to be a bit less effective against some newer versions of the virus. Have you seen any good data on that that you can summarize? I feel like I keep hearing it as something that seems to be happening to some degree, including maybe with the so-called New York variant that is becoming so common around here, but scientists don't have enough data yet to draw conclusions about how much or even definitively yes or no if the variant or other variants challenge the vaccines more. Is there anything more you can tell us as of now that's databased?

Katherine: I'm happy to talk this through and it's a really important question. The first thing to recognize and I noticed that you did say, "Some versions of the virus," which is important. There are going to be a lot of variants of the virus that crop up. Not all of them are going to have the ability to reduce the effectiveness of vaccines. It's just going to be a subset of those that are likely to. The data is all over the place. I think there's two types of data to look out for here.

One is there have been a lot of studies so far, some of which haven't yet been through the whole peer-review process that are showing that when we're looking at antibodies from vaccinated people, with vaccines that were developed against the original version of the virus, those antibodies aren't quite as good at neutralizing some of these new variants. That could be something that is cause for concern. It could mean that in a real setting, when we take it out of a dish and a lab and think about a person who is actually mounting these responses in real-time, maybe they will be slightly less protected.

Again, we're talking about vaccine reducing risk on a spectrum. It's really, really hard to translate what we see in a dish and a lab to what we see in a person. Also, super important to keep in mind that we don't know exactly how many coronavirus-specific antibodies a person needs to actually fight the virus off or stop symptoms from happening. Though the numbers being reported in this study they're all kind of on a trend, a scale, and we don't have definitive numbers to know that, "Oh, this person has 499 antibodies and they're screwed because they don't have 500."

It's definitely not that clear-cut. There's also so much more to the immune response than antibodies. We're also talking about T-cells, which are those super important cells that can kill other cells that have been infected by the virus. Those play a huge role, but those are harder to measure and study. There are fewer studies that are directly looking at vaccine efficacy against the variants where they're actually looking at vaccinated people and how they're fairing against variant one, variant two.

That sort of thing and making direct comparisons. The bit of data that's starting to come out does seem like this trend is right, that some of these variants are a little better at evading some of the immune responses mounted by vaccinated people. Again, it's not complete escape. The bottom line here is there is still no variant that can completely render a vaccine obsolete and it's still far better to be vaccinated than to not be vaccinated at all.

Brian: Pat in Brooklyn, you're on WNYC with Katherine Wu. Hi, Pat.

Pat: Hi Brian. Thank you for taking my call. Ms. Wu, I am fully vaccinated. I'm 70 years old. I live with my parents fully vaccinated. I've been working remotely for a year. We have been called back to the office in a couple of weeks. My supervisor told me yesterday that while she is vaccinated, the third person in our office refuses to get a vaccination. I've been very concerned about-- We share a workstation. What risks do I have or what rights do generally vaccinated employees have against coworkers who refuse to get vaccinated?

Brian: Pat, thank you. Bear in mind that Katherine Wu is a science writer, not an office politics expert or even a vaccination and COVID rights writer. Is there anything you can say based on your reporting or other than--? We're probably going to hear a lot of conversations like this in the coming months.

Katherine: Yes, I would say it's a really great question. I do echo your endorsement of my expertise in science, but pretty much nothing else. I think there's a lot of things to consider here. One is, are we moving toward a world in which employers are going to start demanding vaccination status from people? Is that thorny? Does that create a world of haves and have nots? Some people are going to refuse to be vaccinated as it sounds like your coworker did. Others don't yet have access to the vaccine, and what is that going to do in terms of who was able to get paid their salary, or go to the grocery store or go to the movies? It's really tricky.

In terms of your risk in the office, I don't know many details about how big your office is whether people are going to be wearing masks, whether they're going to be plexiglass shields or going to be good ventilation, all those things can reduce the chance of transmission. It is heartening to hear that it sounds like there's only a few people who are going to potentially be in a room or an entire office together. That's encouraging at least and if you all wear masks, that's good. The fact that at least one of your coworkers is vaccinated is a good sign. I think these are conversations that people are going to need to start having.

It also really depends what that unvaccinated person's exposure risk is to others. Are they mingling with a lot of other unvaccinated people? Are they willing to wear masks? I think you being vaccinated is wonderful. That means your risk of getting the virus and getting sick is much lower. You're right, it does throw a slight wrench into how you can move forward in your workspace if there are people around you who are sure that they are not interested in getting vaccinated.

Brian: Pat, thank you for raising that. Yes, these conversations are just beginning, we'll probably touch in our next segment and definitely with Mayor de Blasio on Friday, the fact that he is now calling city workers back to their desks if they have office jobs starting in May. Not all of them all at once, but there's going to be a reaction today from the city workers union, I believe. We will talk about the implications of that. It's supposed to set an example for the private sector.

So many office workers are not coming back. So many companies are not calling their office workers back yet. How much? How quickly? How safe? All of these conversations are just on the precipice of beginning. I want to ask you two quick things before you go. One, you quote Ali Ellebedy an immunologist at Washington University in St. Louis, saying, "The effects of vaccination are best considered along a spectrum."

You were just describing some of that. It's thousands of points on a spectrum, he said, it's not either-or. Here's my question. We hear kids naturally produce lots of antibodies to COVID-19. I think we also know that younger people tend to have stronger side effects from the vaccines because immune response declines with age. It's the immune response that gives you the side effects. Does this mean that the oldest among us who are the most at risk of serious COVID, if they do get infected, are also the least protected by their vaccines, or doesn't it work that way?

Katherine: I want to answer this very carefully because your question is really important and it's an excellent question. I think this is still being figured out. Luckily, if you look at the data from the clinical trials, from Moderna, Pfizer, Johnson & Johnson, and several other vaccines that might soon get clearance here in the US, they did really do a very careful breakdown by age, what was vaccine efficacy by age. By and large, it actually seems like the vaccines do really well in older people. That said, there is a history there is a precedent for there being a lower immune response in older adults. There are vaccines that don't work quite as well in older people. I believe the flu vaccine is one.

That's because the vaccines are getting into people, there really is a little bit less immune material to work with. These people have been alive for a long time, their immune systems have been working very hard as they do what's called immune senescence, they get a little old, they get a little tired. That said, again, vaccination is going to be way better than nothing. I think the data from the trials is really encouraging.

There is a little bit of data to show that the immune response is a little subdued in older people, and that could slightly lower how effective vaccines are in older people, but again, absolutely better than nothing, especially considering how at risk these older individuals are. If they were to actually get infected, the risk of getting seriously sick with COVID is far worse than the vaccine not working quite as well once vaccinated.

Brian: To end this way, you end your article, you write, "There's something counterintuitive about breakthrough cases, the more people we vaccinate, the more breakthrough cases there will be in absolute numbers, but the rate at which they appear will also decline." You come back to the umbrella analogy to close, will you do that for us?

Katherine: Sure. The umbrella analogy is, again, this idea that vaccines are giving us a tool for protection against the rain, where the rain is the virus, and we are the people trying to get a little bit less wet, a little bit less infected. As more vaccinations roll out, because that increases the absolute number who are getting vaccinated, that is also going to increase the absolute number who get infected after vaccination. Again, that's going to be a small number and it is not something to worry about unless those numbers for some reason skyrocket and it does not look like they are doing that.

The more people who are vaccinated, that's going to make it a lot harder for the virus to move around and infect people. The rate is really going to go down. It comes back to the idea that the more people who are protected and interacting with that protection, that protection is going to bleed over to the people around you. It's going to help protect people who can't get vaccinated, who haven't yet vaccinated, and we're all going to stay a little bit more dry.

Brian: You know what, Katherine, I'm going to extend this for one more phone call because we just got a call from Tel Aviv. As you know, as many of our listeners know, Israel is the leading example of national successful vaccination with so many people successfully accessing the Pfizer vaccine over there and rates going down of COVID positivity. Let's see what Sandy in Tel Aviv wants to add. Hi, Sandy, you're on WNYC. Hello, from New York.

Sandy: Hi, thanks. I got vaccinated in January. I'm 32, so that's very early in the grand scheme of how things are going in the States. In the last couple of weeks, things have really reopened here. There's this whole green passport program where we show a thing on an app that lets you into indoor restaurants and concerts and all that. Mostly, I've been going with the flow on how the Israeli approach is to this reopening, even though it's reason to be skeptical whether it should be opening this fast, if this is unproven yet, what this has to do with the elections that happened yesterday, et cetera. I'm going back to New York in two weeks and I'm just wondering, how should I adjust?

Should I start to go back and not go, let's say to an indoor museum or restaurant or whatnot because I'm getting being used to a post-vaccination society here? I don't really know how to readapt.

Brian: Wow, again, I don't know if our science writer can actually answer your question. I don't know if your PhD in immunobiology gives you exactly that expertise, Katherine. What would you say to Sandy?

Katherine: [chuckles] Yes, that's a really great question. I do not want to be in the business of telling you how to live your life. I want you to do what is safe and comfortable for you. I think that's going to be jarring. I'll admit I'm not in New York right now, so I don't know exactly what the mood is there. I think it'll be really important to pay attention to local transmission rates, that is a huge driver of how many infections we'll expect, including how many post-vaccination infections, we're going to expect.

If local rates are high, I think that should be a signal for people who are either currently in New York or about to be back in New York, to lie low and try and wait it out for a little bit. It's also all of these gets so tricky because of the variants. If new variants are popping up in New York or spreading in New York, people really, really have to keep tabs. The person we spoke to earlier, Jane, I would love to see what virus she had sequenced because that could really inform people on what's going on in terms of post-vaccination cases.

For you, I think, just keep tabs on the news. See what other people are doing and if you are coming back to friends or family that you are thinking of interacting with, if they're comfortable sharing, ask them if they're vaccinated, ask them if they're fully vaccinated two weeks past second dose. Make sure that you're establishing, sustainable social rules about how often you'll be able to interact, who you'll be interacting with, and if your job or whatever else you're engaged in is expecting you to go back in, set boundaries around what everyone's comfort level is. It's a tough decision, so good luck.

Brian: You mentioned museums and restaurants, Sandy, in one breath, those are very different from each other. You'll start looking I'm sure at different kinds of institutions that you might want to go back to. Nobody's taking off their masks to put art in their mouth like they might be doing with food at a restaurant. The density might Be more easily controlled in a museum and you'll have re-entry and get the lay of the land. I hope that's a little bit helpful. Safe passage back to New York. Thank you for your call. Katherine Wu, science writer for The Atlantic. Thank you for all your time today and your reporting. Thanks a lot.

Katherine: Thanks so much for having me.

 

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