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Melissa Harris-Perry: A little reminder, just in case being maskless in public, eating out with friends, and shaking hands with strangers has made you forgetful. COVID-19 is still a public health emergency. Indeed on Wednesday, the Biden Administration extended that designation for at least 90 more days. This while we march slowly but steadily toward the painful mark of 1 million deaths in this country due to COVID-19.

Right now many parts of the country are experiencing rising COVID cases. Unlike in some earlier ways of this pandemic, hospitalizations and deaths are actually decreasing. It's a pattern we're seeing in many Northeastern cities. New York City cases have increased approximately 50% over the past two weeks. Even Mayor Eric Adams himself suffered with a mild case of the virus earlier in the week. The City of Philadelphia is experiencing a similar increase, leaving city officials to announce on Monday that they're re-instituting the indoor mask mandate for public spaces beginning on April 18th. Here's Philadelphia Health Commissioner Cheryl Bettigole.

Cheryl Bettigole: If we fail to act now knowing that every previous wave of infections has been followed by a wave of hospitalizations and then a wave of deaths. It will be too late for many of our residents. This is our chance to get ahead of the pandemic to put our masks on until we have more information about the severity of this new variant and to choose to protect each other as we have throughout this pandemic.

Melissa Harris-Perry: Thrown on his first day on the job on Monday, newly appointed White House COVID czar, Dr. Ashish Jha tried to manage fears about another possible surge. Here he is on NPR's All Things Considered.

Ashish Jha: First and foremost, these are decisions that should always be made on a local level. I like that feature of what Philadelphia is doing and they should be driven really by the realities on the ground. I can very much imagine in the weeks and months ahead as you see local cases go up, public health measures get put into place. As infections and hospitalizations fall, public health measures get released. That's a pretty reasonable way to manage a pandemic. I think that's great. I'm happy to see that being done.

Melissa Harris-Perry: This is The Takeaway I'm Melissa Harris-Perry. Let's get to it. With me now is Apoorva Mandavilli, who is the reporter for the New York Times focusing on science and global health. Apoorva, welcome back to The Takeaway.

Apoorva Mandavilli: Thank you. It's nice to be back.

Melissa Harris-Perry: I feel like we've been having this conversation in one version or another which was part of the deep sigh. As we're nearing a million lives lost to COVID in this country, I just want to check in with you about your experience covering this pandemic in recent months and how it may have changed.

Apoorva Mandavilli: I think my coverage has changed with the number of cases. When the cases have been really intense, the coverage has been really intense. Then as the pandemic seems like it's getting better, people lose interest and think the pandemic is over. They stop reading articles and there stopped being really a surge of news even about the virus. It's come in waves. Unfortunately now I think we're again in an uptake. You mentioned that we're seeing an increase in cases, not yet a rise in hospitalizations, and I hope that we'll stay more or less the same but we are actually already seeing an increase in hospitalizations in New York State. Again, we're keeping an eye on things.

Melissa Harris-Perry: Now, clearly this rise in cases came within a few weeks of so many states and localities dropping mask mandates. Is this basically about mask mandates or is there something else going on here that you can tell?

Apoorva Mandavilli: We've seen this virus go in and out in waves that are unpredictable for two years now. Sometimes it seems like it has a seasonality that we are seeing more cases in the winter or in the fall. Last spring, for example, we saw new variants come through. We saw Alpha first and then Delta. It's not completely unexpected that we would see the virus come back. I think it's not entirely because of the mask mandate, but the loss of the masks does mean that the virus has an easier time getting around and finding new hosts.

We know now that the vaccines protection against infection does wear off. Even if you're vaccinated and boosted that's not going to necessarily stop you from getting infected, especially if it's been a while since you got those doses.

Melissa Harris-Perry: Let's talk a little bit about this new variant or in this case subvariant BA.2, which is a subvariant of Omicron. What do we know about it?

Apoorva Mandavilli: We know that it's more contagious than BA.1 which is the variant that really swept through the country over the winter. For a variant that's even more contagious than that one already seems quite surprising. We don't think it's necessarily much more severe than the earlier version of Omicron but we have seen BA.2 really take over entire countries in Europe, really send the cases skyrocketing.

Again, we're seeing it cause some real trouble in China and we're now starting to see it go up in the US as well. In New York in particular there are two new versions of this BA.2 that are troubling some of the state health officials.

Melissa Harris-Perry: You make such a keen point there. We are in a global not a national or a local pandemic. Based on the parts of the world that saw BA.2 one step or one half step sooner than us, what have we seen in those nations relative to what then happens with hospitalizations and mortality?

Apoorva Mandavilli: This is a really interesting phenomenon that we're observing and one that public health experts really predicted which is that, if we vaccinate people in high numbers we may see cases again but we will not necessarily see hospitalizations and deaths. We're seeing that play out in very striking ways across the world. New Zealand did a fantastic job of vaccinating its people, South Korea did a really great job. They both had huge numbers of cases but they did not see an associated increase in deaths, for example.

Hong Kong which did okay vaccinating its people but had a lot of older people, a lot of vulnerable people unvaccinated, had huge numbers of deaths.

We're seeing this exact thing that experts have explained to us which is especially if you are vulnerable, especially if you fall into certain categories it is so important to stay on top of your vaccinations because this virus is really so much more dangerous for somebody who does not have protection from the vaccines. I think that's something we can also gain some hope from that wherever we have pockets in the country that are highly vaccinated we may not see a horrible peak from now on.

Melissa Harris-Perry: Now, obviously there are still some populations that are actually ineligible for any vaccine, most notably the youngest children. Then there are of course the immunocompromised who may either be unable to take the vaccine or if they they have the vaccine it still may not operate for them in the same way.

Apoorva Mandavilli: I know. It's actually a really sad situation in some ways. I hear from a lot of immunocompromised people who have been very upset at how the country just seems to be moving on from this pandemic as if it's all over because it's not over for them, the vaccines don't work as well for them. As you mentioned, kids under five don't have a vaccine option quite yet. Kids under one especially are at somewhat increased risk from this virus than kids of other ages. For a lot of parents, for a lot of immunocompromised people, for a lot of older people, this virus is still very much a threat and it is still very much scary.

Melissa Harris-Perry: Yet, we've been hearing a lot about the lack of federal funding for this ongoing pandemic. What can you tell us about where that stands?

Apoorva Mandavilli: We are at a stalemate. I think we've seen these two parties disagree over what this pandemic actually means in multiple ways now, over masks, over vaccines, and this latest fight over the budget is another example. Even the public health emergency extension that you mentioned that is another case where the Republican party has felt that extending the public health emergency at this point in time is not really necessary. It's really a philosophical difference and how seriously we need to take this virus.

Unfortunately it means that if we don't get the money that the government needs that means there will be fewer tests, fewer vaccination drives, everything that we need to keep this virus at bay.

Melissa Harris-Perry: What does the Biden administration's extension of the COVID public health emergency for another 90 days, what does it even mean then?

Apoorva Mandavilli: It means that we're buying some more time. It means that people will have access to testing and to drugs for a bit longer because that money does pay for-- The public health emergency does allow for some of that. Behind the scenes, it also means that there is some easier transfer of data between some of the federal agencies. That will all continue for a bit longer because of this extension.

When we drop the public health emergency it really means that we are not thinking of this virus as a big threat anymore. We are really not there. The extension is for 90 days and it's possible that before then we will see BA.2 make another splash that maybe the Republican party will take it more seriously than-- It's really unclear what will happen.

Melissa Harris-Perry: We heard Dr. Jha a bit earlier in his first day, in his new role as COVID czar. He was responding to what's going on in Philadelphia, that decision to return to indoor masking in public spaces. Yet he said these are always decisions that should be made at the level. Again, this is both a national and global pandemic. I guess I was a little taken aback by that notion that all of these decisions should be made locally. Is that a public health perspective or more of a political perspective?

Apoorva Mandavilli: I think it's the combination of both. Certainly, the CDC cannot dictate to localities what they should do. I think in that sense it's appropriate that they're saying the decision should be made at the local level. What we have not seen is really clear guidance from the CDC on exactly when to bring masks back and when to bring precautions back. They have that very confusing calculation of what the community level means. It's really unclear whether that translates to risk in a good way, because if you recall when the CDC first changed its definitions of what a community at a high level means, we went from the map looking red which meant almost all the counties in the United States were considered high risk to almost none of them being high risk.

That definition changed so dramatically that it's really hard to know what the CDC exactly considers high risk now. In some ways it's again appropriate that we're looking at the rate of hospitalizations which is one of the calculations that the CDC now makes to say who's at high risk or which community is at high risk. We know that cases are also a problem, they do stop the economy in its tracks and we really haven't talked enough in this country about lung COVID which is an issue for anybody who is infected. Certainly much less of a risk for people who are vaccinated but not zero.

We seem to be really not taking the risk of infection at all into account when we talk about this virus anymore.

Melissa Harris-Perry: I know in a recent piece you wrote about contracting the virus yourself in March, presumably the first time in the two years you've been covering it. Did you learn anything new based on your own personal experience?

Apoorva Mandavilli: It was the first time and I was surprised it took as long as it did, but what I learned most of all is that it is not trivial. I was sick for about a week and I was okay because I have great childcare options and I can work from home. It really makes you realize how hard this can be for people who don't have all the resources that some of us have.

Melissa Harris-Perry: Indeed and that we are still in this and still marching towards that grim number of 1 million. Apoorva Mandavilli is a reporter for the New York Times focusing on science and global health. Apoorva, we're so happy that you have recovered well. Thank you for your time today.

Apoorva Mandavilli: Thank you so much.

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