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Melissa Harris-Perry: You're back with The Takeaway. I'm Melissa Harris-Perry. As we get ready for our fourth winter in this pandemic era, we're catching up on the latest development with COVID.

Speaker 2: CDC Director Rochelle Walensky has tested positive for COVID. In this statement, the CDC is saying Dr. Walensky is up to date with her vaccines.

Melissa Harris-Perry: Now, Dr. Walensky tested positive on October 22nd, and it was the second time in one month. She had initially tested positive in early October. With me now to talk about the pandemic and flu season and RSV season that we're entering into is Dr. Bhakti Hansoti, Associate Professor in Emergency Medicine at Johns Hopkins University. Dr. Hansoti, thanks for joining us again.

Dr. Bhakti Hansoti: Thank you very much for having me.

Melissa Harris-Perry: Let's start with Dr. Walensky and this COVID rebound, what do we know about this phenomenon?

Dr. Bhakti Hansoti: First question most people ask us is, is COVID rebound the same as long COVID? And it's absolutely not. COVID rebound is a phenomenon where you have COVID-19, you test positive, and then you get better and you even test negative, but then within five days, a few number of people will test positive again and/or have symptoms again, and that is COVID rebound.

Melissa Harris-Perry: Now, that's happening even under the circumstances of being fully vaccinated and boosted, why?

Dr. Bhakti Hansoti: The vaccines and the boosters and even getting COVID infection, what it does, it gives you protective antibodies and it gives you your own immune response. However, you can still get the virus, and these newer virus subtypes BA.5, BQ.1, there's a lot more letters and numbers out there. They are particularly good at dodging host immunity, and so despite being boosted and vaccinated, people are still getting sick. However, they're not getting as sick, they're faring better, they less likely need hospitalization, and significantly less likely to end up in the ICU.

Melissa Harris-Perry: All right, I almost want to underline that again, because I know that when the CDC director had this COVID and then a rebound, there was at least some discussion of, "See, these vaccines don't work."

Dr. Bhakti Hansoti: No. They absolutely do work. If you look at the data, individuals who are boosted, especially with the new bivalent, which has shown significant efficacy against the newest strains of COVID-19. They absolutely do work and you have a decreased hospitalization by a rate of six times, so you're six times less likely to be hospitalized if you've been fully immunized.

Melissa Harris-Perry: Let's say you're planning to travel for the holidays or have family into your home for the holidays, particularly maybe the Thanksgiving holiday coming up in just a few weeks, what are your recommendations around vaccination for everyone and boosting and what are your recommendations potentially around how to structure those gatherings?

Dr. Bhakti Hansoti: We've done this now for two years, and the same rules of play still apply. If you can protect yourself and the people around you, if you're vaccinated and if you have host immune antibodies, so either get vaccinated, or if you had a recent infection, that also counts. The second is limit the size of your gatherings. The less people, the less likelihood that one person will have asymptomatic COVID or flu or RSV, less likely that the other members of that gathering will get sick. Then the third thing is do invite people that you trust.

Invite people who you can say to, "If you are sick, if you have symptoms, if you don't feel great, let's connect a different way, but you'll be with us in spirit." I think that's what most of us have been doing for the last couple of years anyway, so it's nothing new.

Melissa Harris-Perry: All right, we've talked a little bit about COVID. Let's talk about what's being called the triple-demic. What are the other two parts of this triple-demic?

Dr. Bhakti Hansoti: Absolutely. What a great name, triple-demic. Triple-demic is very simple. It's COVID, it's influenza, which is earlier than we expected, and it's RSV. RSV is a virus that usually affects young children, what we're seeing is that younger children are getting sicker and ending up in the ICU. You have three viruses, all on the verge of increasing case numbers, all happening at the same time, which is causing concern for your health system and the capacity of the hospitals.

Melissa Harris-Perry: Why? What's going on with flu and RSV? Is it actually connected to what's happening with COVID?

Dr. Bhakti Hansoti: I don't think it's connected other than it seems to be happening at the same time. Flu and RSV come around this time of year, every year. Most people right now would have already had their flu shots, but what's happening with the flu, we looked at the Southern Hemisphere, we saw in Australia, because they experience the flu before we do, is that they just had the worst flu season in five years. Which meant they had a lot more cases than normal but also they had a lot more hospitalizations. After people are hospitalized, about 6% to 7% end up in the ICU.

Then RSV is a virus, again, it presents like a common cold, similar presentation, fever, cough, not feeling good, sore throat, but what we're seeing this time around is we're seeing a lot more RSV cases in adults and older children, but we're also seeing that younger children are getting much sicker than we previously expected, with a higher number of pediatric patients ending up in the pediatric ICU, which is obviously problematic.

Melissa Harris-Perry: What can families do to help protect their young children or to help to treat their young children? What should they do if they get an RSV diagnosis or long before that to help to protect?

Dr. Bhakti Hansoti: Absolutely. Let's talk about the RSV diagnosis because that's slightly simpler. If you do get an RSV diagnosis, that means you've seen a healthcare provider because you've been tested in a hospital or in your pediatrician's office. The majority of children, especially those age two and above, will do just fine at home with over-the-counter medications such as Tylenol, ibuprofen. Then the cough is what really upsets children, and the way we deal with that is steamed showers, hot steam, over-the-counter mist, and in some cases, your pediatrician may give you medicines such as albuterol to make the cough better.

You do need to monitor your child's breathing, and if your children are struggling to eat or drink or having difficulty breathing or really just not looking like themselves, they need to go to an emergency department or your pediatrician's office and get evaluated.

How do we protect ourselves? Well, there's similarities with flu, RSV, and COVID in that they present the same way and they're all RNA viruses, but the recipe for protection is also the same. If you are sick, stay at home and avoid getting others sick. Number two, wearing masks. The masks provide a barrier protection against all three viruses. The third, for COVID and the flu, you need to get vaccinated. The flu vaccine is readily available, as is the COVID-19 vaccines and boosters. If you have those vaccines, you're significantly less likely to end up in the hospital.

Melissa Harris-Perry: Far fewer people have opted in thus far to this second round of boosters. What do you think accounts for this discrepancy?

Dr. Bhakti Hansoti: I really think there's a lot of COVID fatigue, and I get that, I'm living it with you. I think there's also this thought that, "Well, I'm probably just fine because I've already had COVID or I'm not one of those people that's going to end up in hospital." The thing is COVID is still unpredictable and what's the big unknown is long COVID. We still recommend people getting boosted as President Biden recently said in a press conference, because it not only protects you from getting hospitalized but it protects the people around you from getting sick, because even if you do get sick, you're likely to be sicker for a smaller period of time with less severe symptoms.

Melissa Harris-Perry: Dr. Bhakti Hansoti is Associate Professor in Emergency Medicine at Johns Hopkins University. Thanks so much for taking the time with us.

Dr. Bhakti Hansoti: Thank you so much for having me.

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