Melissa Harris-Perry: You're listening to The Takeaway. I'm Melissa Harris-Perry. On Tuesday, Texas governor, Greg Abbott, tested positive for COVID-19. The perennially maskless chief executive of the lone star state is fully vaccinated, asymptomatic, and expected to be just fine in short order. Which is great news because we have lost far too many people to this pandemic.

In fact, my husband is in Texas right now for a family funeral because the coronavirus has claimed yet another one of our loved ones. That the governor's positive status is unlikely to lead to a negative outcome is evidence of the effectiveness of available vaccines, but it might be hard to hear that message on a day when the Biden administration is expected to announce that most vaccinated Americans will need booster shots.

You can just cue the conspiratorial social media posts about the failure of the vaccine, which by the way, is not what a suggested booster shot means. Confusion and misinformation continue to swirl even as more than 900,000 new cases reported in the US last week show the result of a highly contagious Delta variant. Oh, yes, school has restarted in much of the country. Kids under the age of 12 are still not eligible to receive the vaccine, which accounts for the dramatic spike in pediatric COVID infections in recent weeks.

Since my seven-year-old will be in a second-grade classroom in just six days, I knew it was time to get a little expert guidance on how this whole global pandemic situation is progressing. Here to help is Dr. Bhakti Hansoti, an associate professor of emergency medicine and international health at Johns Hopkins University and Bloomberg School of Public Health. Dr. Bhakti Hansoti, welcome back to The Takeaway.

Dr. Bhakti Hansoti: Thank you so much for having me. Happy to be here.

Melissa Harris-Perry: We had a bit of a chat before going on air. I know that you are also the parent of even younger children, those who won't even be eligible for the next round of vaccine, but I got to tell you, just on a personal point of privilege, I want to start with this. When do we think that vaccines for five to 11-year-olds will become available?

Dr. Bhakti Hansoti: Very, very soon. I was hoping for the first week of September to be receiving the FDA EUA notification, but very, very soon. The studies have been completed. The trials have been done. There's a lot of data to comb through, but all indications that there will be approval and vaccines will be forthcoming shortly.

Melissa Harris-Perry: In the meantime, we know that Delta is more contagious. We know pediatric cases are up, but is Delta also more deadly?

Dr. Bhakti Hansoti: We are not seeing that Delta is more deadly. There's conflicting data. Studies from United Kingdom, Scotland specifically, compared alpha to Delta. What they showed was that patients with Delta were significantly more likely to be hospitalized, but they did not show significant increases in deaths. In the United and the United States right now, when you look at the COVID 19 statistics available online, what you can see, we have our [inaudible 00:03:08] of cases.

We have a [inaudible 00:03:09] of hospitalizations, but we're not seeing that same uptake in death. That could be due to lag time. It could be that the population that's unvaccinated is younger and has less likely to have comorbidities, but it could be a product of the Delta virus, which requires hospitalization, supplemental therapies, but may not be as likely to result in death.

Melissa Harris-Perry: Is it possible that we've gotten better at treating COVID over the past 18 months?

Dr. Bhakti Hansoti: Absolutely. We know so much more about how to manage these patients adequately. We have many more therapies now that are [inaudible 00:03:47] to preventing progression of disease that are now available to individuals of mild to moderate illness. Stop them from getting sick, like stop them from getting to the ICU. I think doctors are also more confident in the COVID-19 patient and what works and what doesn't work.

Melissa Harris-Perry: Now, as my daughter prepares to go back into the classroom as a student and I have prepared to go back into the classroom face-to-face for the first time in a year and a half as a teacher, honestly, I'm trying not to just be mad all the time about folks who are not vaccinated. I was also reminded as I was prepping around politics, teaching politics, that fear actually isn't very good at motivating action.

It only really motivates inaction. I'm wondering, is there a joyful, hopeful way of getting people to want the vaccine?

Dr. Bhakti Hansoti: Sure. We know that children thrive through social interactions. We know this. There is evidence and science behind this. We also know that nothing is full-proof when it comes to COVID-19. It is a deadly virus. However, we have seen previously from our experience late spring last year that we can make schools as safe as possible. There's well established strategies such as masking, keeping children in social pods, routine testing, and routine symptom screening.

We know that these strategies have been effective. We're lucky that when your child goes back to school in September, the weather will be still good. They can have many outdoor classroom opportunities. I have hope that we can do this. We just need to adapt the way we do business.

Melissa Harris-Perry: Now, help me to understand a little bit the-- If you're an adult and you are vaccinated, you can still get COVID-19, right? We just know that you're pretty unlikely to get very sick from it. Are you able to then pass it to children who are not vaccinated? I'm just trying to understand all those pieces?

Dr. Bhakti Hansoti: Absolutely. What happens is when you get vaccinated, your immune system gets a kickstart, and it means that you are likely to suppress the virus and stop you from getting sick as quickly as possible. Everybody understands that, but the truth is you'll still have circulating virus, so you may be more likely to be asymptomatic while being infected.

Which means a child who is unvaccinated is susceptible to getting the virus from you. Adults who are vaccinated should still be masking in order to protect their children.

Melissa Harris-Perry: Should they be quarantining? I know that the governor of Texas right now is quarantining. If you get a positive diagnosis, is quarantining still the best?

Dr. Bhakti Hansoti: Absolutely. That's a physical barrier that distances you from vulnerable adults or children from getting the virus.

Melissa Harris-Perry: Early on, we were talking about herd immunity. Where's the herd and where's the immunity here?

Dr. Bhakti Hansoti: Herd immunity is when a significant amount of people have an immune response, so you decrease the likelihood of transmission in the community. Now, herd immunity depends on the number of total people with an immune response already. That can be individuals who have gotten sick from COVID and have natural antibodies or those who have been vaccinated and have antibodies. We're no way near the numbers needed for herd immunity.

Melissa Harris-Perry: What does it mean to say there's going to be a recommendation around booster shots. What does that tell us?

Dr. Bhakti Hansoti: It tells us that basic immunology still is basic immunology 101, that you mount an antibody response when you get vaccinated. Over time, those antibodies will likely wane and that booster shots will be needed to reamplify antibody production. This is how most vaccines work, and this is completely normal and expected.

Melissa Harris-Perry: Do you have a sense of a way to counter what is coming in terms of the misinformation about the idea that booster shots constitute a failure of the vaccine?

Dr. Bhakti Hansoti: Misinformation is really challenging to counter, and that is because it's based on beliefs that are not evidence-based. I think the only way we can counter misinformation is meeting people where they're at with our questions. I have a friend whose young son has a lot of questions about why he should get vaccinated and his fears and concerns, and meeting him where he's at is the only strategy that seems to work.

That is us answering the questions as simply as possible and as transparently as possible. Transparently, what I would say right now is that this is natural, that if your body gets exposed to something that has an aggressive response, over time, that response wanes just because they haven't been re-exposed. A booster shot gives you re-exposure and then reamplifys immune response.

That we knew all along the booster shots would likely be necessary, but it depends on the type of vaccine and the type of individual and how frequent those boosters are and when they're going to be necessary.

Melissa Harris-Perry: I know the work that you're doing is not only domestic but also global. Is it ethical or public health reasonable for Americans to be getting a third shot when so much of the world has not yet gotten a first shot?

Dr. Bhakti Hansoti: I think that's the biggest public health debate that's happening right now. Let's think about it from an epidemiologic perspective. We know that variants of concern emerge when there's high amounts of transmissible virus. We know that unvaccinated individuals are more likely to have transmissible virus. If you have large volumes of individuals who are unvaccinated, then you're going to have new variants of concern emerging.

Where should we put our resources at? Should it be more immunity for those who have some immunity, or is it more beneficial to decrease the amount of circulating virus by getting vaccines to those who are unvaccinated? Now, what's complicated here is not only a lack of resources and the finite supply of vaccines that we have, but it's also the lag time. The second issue that I keep on referring to is that over time, antibodies wane. For me, it's been since January since I've had my shot. I'm now in month number eight. I am likely way more susceptible than I used to be to the Delta variant, and I'm a frontline healthcare worker. Is my immunity at the level of those unvaccinated? Probably not, but what is that difference that we're trying to make up? It's not only an ethical question, but it's an epidemiologic question that requires a lot of complex modeling.

Melissa Harris-Perry: Dr. Bhakti Hansoti, last time that you were with us, now, I really just find your capacity to explain actually very calming in what feels like a storm that just won't stop. Dr. Bhakti Hansoti is an associate professor of emergency medicine and international health at Johns Hopkins University and Bloomberg School of Public Health. Thank you so much for joining us.

Dr. Bhakti Hansoti: Thank you for having me.

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