Welcome to the next chapter of the pandemic

Make Me Smart February 21, 2023 transcript

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Kai Ryssdal 

I’m here. I’m here

Kimberly Adams 

Oh just wanted to make sure.

Kai Ryssdal 

Hi everybody else Kai Ryssdal. Welcome back to make me smart, where none of us is as smart as all of us.

Kimberly Adams 

And I’m Kimberly Adams, thank you for joining us on this Tuesday for our weekly deep dive. Today, we are going to get into the end of the national COVID-19 public health emergency. And what that means in practice, because it definitely feels like we’re about to enter sort of a new chapter of the pandemic.

Kai Ryssdal 

What happened was that last week somebody wrote in with a question about what it meant that the public health emergency was ending and Kimberly and I, you know, we gave it the good old college try, but this is one of those where you need an actual expert. So we have called one. Dr. Celine Gounder is an epidemiologist, also an editor at large for public health at Kaiser Health News. Dr. Gounder, welcome back to the podcast.

Dr. Celine Gounder 

It’s great to be here.

Kai Ryssdal 

So the public health emergency is ending, that means a pandemic is over, right? We can all go about our day?

Dr. Celine Gounder 

I wish the pandemic were over. But um, no, it does not mean the pandemic is over. But rather that certain government responses to the pandemic are coming to an end.

Kimberly Adams 

We still have hundreds of people dying every day from COVID-19 in the US. Probably more from related diseases. And that’s twice the number of deaths per day more or less than during a bad flu season. And people are still getting sick. So why is this the time to end the public health emergency?

Dr. Celine Gounder 

Well, I think some of this is related to political will and how long Congress and others were willing to fund specific responses to COVID, and the desire to continue those responses. So for example, like making vaccines available for free testing at home available for free, etc. While the supplies that the government has purchased will continue to be for free, there won’t be additional purchases. And so some of those measures will be coming to an end.

Kai Ryssdal 

Do you expect then that, and this is kind of a broad brush, but that public health as regards COVID will get worse because some of these programs are ending?

Dr. Celine Gounder 

Oh, there’s no question, you’re going to see disparities. According to age, according to race, according to income, geography. You’re going to see disparities with respect to COVID widen. And so you’re going to see certain populations be at higher risk for exposure, higher risk for infection, higher risk for severe severe disease and death.

Kai Ryssdal 

That seems not great, because that’s where we were when this thing started, right? Communities of color, lower income communities, first responders and people in what were then called “essential occupations.” They all suffered disproportionately to the rest of us.

Dr. Celine Gounder 

Well, that’s what it means to commercialize the COVID response. What that means is you’re taking it from the government to the commercial sector, and then it’s really who can pay. And so we know in this country, people have different abilities to pay. And so your health care in general is determined by whether you can pay or not. And COVID is going to be transitioning to that as well.

Kimberly Adams 

So that’s the part related to direct COVID care. But the public health emergency also has some consequences for other kinds of health care as well right?

Dr. Celine Gounder 

So a major one, and I think what people are going to notice, first and very significantly in their day to day lives is Medicaid. Some 15 million people stand to lose their Medicaid coverage on April 1. So during the COVID, public health emergency people who signed up for Medicaid had to be kept on it, regardless of what happened to their income in the interim. And so you have a lot of people who are going to roll off Medicaid and who may not be able to afford other types of health insurance.

Kai Ryssdal 

This is a little sideways, but do you think we got our money’s worth out of all the money that the government spent on The public health part of this. Forget the PPP program and forget support to Main Street and Wall Street. Talk to me about public health spending. Did we do it right?

Dr. Celine Gounder 

I think a major problem was money didn’t get down to the public health departments quickly enough. Some public health departments are only now receiving some of those emergency funds. And so, you know, what do you suppose to do with that, when you’ve already been through the worst of it? So there’s been some reluctance when the finally, finally the money gets there, to then make use of it and hire people, for example, because then how long can they stay on the payroll? You’re just gonna have to let them go in a couple months. So, you know, I think the system for getting money to the ground needs to be a whole lot faster than it is.

Kimberly Adams 

You mentioned this, and I’ve heard versions of it that, you know, we’re finally through the worst of it. And you know, thank goodness for vaccines, and for people eventually getting access to masks and testing and things like that. And then in the State of the Union, President Biden said that COVID no longer controls our lives. But I mean, with this national emergency coming to an end, how do you think it’s going to affect the way that people think about the pandemic?

Dr. Celine Gounder 

I don’t know. I think a lot of people have already put COVID in the rearview mirror. I think some people had as soon as vaccines rolled out. And so I don’t know that it’s going to have a huge impact on public perception. But I do think big picture, we have wanted to forget about this as quickly as possible. And we’re not really learning the lessons from the pandemic and preparing to do better next time,

Kai Ryssdal 

Wait, say more about the lessons?

Dr. Celine Gounder 

Well, there’s certain things we could be doing to make ourselves more resilient, whether it’s to the next pandemic, or just to other public health crises. We are in a place where frankly, I don’t think enough people will be willing to mask or get vaccinated if we are hit by another big outbreak, you know, does not necessarily have to be COVID. And in the meantime, we’re seeing restrictions on public health powers. Whether public health jurisdiction can isolate and quarantine somebody. You know, I don’t think you would want somebody with Ebola walking around in the middle of town. And that person can’t be isolated, but some jurisdictions are moving in that direction. You also have pretty extreme legislation being proposed, for example, in Idaho, to make it a felony to vaccinate somebody for COVID. And so you’re taking away really basic public health tools. And if we’re hit by another public health crisis, maybe it’s the flu h5n1 avian flu one day, will we even have the tools to address it? I don’t know.

Kimberly Adams 

I’m still kind of stuck on this idea of people moving on from the pandemic, and many people already have I was on trains and planes this weekend. And I wear a mask in those settings, but not all settings. And lots of people weren’t wearing masks in those settings. But then there’s a huge portion of the population that doesn’t have the option to move on, you know, people with disabilities or that are immunocompromised or groups who who have been vulnerable and more vulnerable this whole time. I mean, what signal does the end of the public health emergency send to those folks?

Dr. Celine Gounder 

Well, I think it signals that the rest of us don’t really care honestly about their lives or their health, and that it’s up to them to fend for themselves. There are certainly things we could be doing that would benefit ourselves as well as others who are at highest risk and that don’t require individual action, which I think we have forgotten about. So what are some of those things? Well, one would be improving indoor air quality. So improving ventilation, air filtration, improving the standards, the minimum requirements, which would benefit all of us, not just in terms of COVID, but other viral respiratory infections, asthma attacks, and a number of other things. Paid sick and family medical leave, which would allow people to stay home if they are maybe their child or another another loved one is sick so that people aren’t spreading illness, at work or at school. And finally, health insurance. And this goes back to what I was saying about Medicaid and a lot of folks losing Medicaid coverage. If you don’t have health care coverage, it’s really hard to access testing and treatment, even during normal times, much less during a public health emergency.

Kai Ryssdal 

You remember like a year ago, there was all this talk about well, any day now the WHO is gonna say it’s endemic, it’s no longer a pandemic and we can start treating it as part of our daily lives. I wonder if it’s already de facto that and we’ve all just said, certainly in this country, “Yeah, I’m not dealing with it. Let’s just move on.”

Dr. Celine Gounder 

Yeah, I mean, I think people have misunderstood what endemic means. I think they saw “E-N-D”, that must be the end. That’s not what endemic means. It really means that it’s a more stable, predictable level of disease transmission. And I don’t know that we’ve gotten there yet. We don’t yet know, is this going to be seasonal? Are we going to continue to see Summer and Winter waves? Even the flu has epidemic seasons, where some years it’s really out of proportion to what we were expecting. And so from an epidemiological perspective, I think it’ll be a while yet before we’ve really exited the pandemic phase.

Kai Ryssdal 

Given that you’re the medical professional in conversation here, what’s your own level of concern?

Dr. Celine Gounder 

Well, I’ve been vaccinated four times now. So vaccinated and boosted. I feel very well protected myself in terms of my own personal risk. But do I still mask when I’m on the subway or when I’m shopping at the grocery store? Yeah, and it’s not inconvenient to do. And it’s an easy way just to avoid getting sick. I don’t really like being sick. So you know, who, who likes having the sniffles and a runny nose?

Kai Ryssdal 

Nobody. Nobody. That’s Dr. Celine Gounder. She’s an epidemiologist, also editor at large for public health at Kaiser Health News. Dr. Gounder, thanks for your time, I really appreciate you.

Kimberly Adams 

Yeah thanks.

Dr. Celine Gounder 

My pleasure.

Kimberly Adams 

It’s such an interesting balance, you know, and I was very aware of my choices in various settings over the weekend as I was traveling, and I was in some crowded spaces and in restaurants and, you know, in a crowded place with lots of people, and I’m wearing a mask, but then in a crowded restaurant with lots of people, and I’m not wearing a mask. And you know, it’s like “does it matter.”

Kai Ryssdal 

Totally. And you rationalize it a little bit, and you’re like, “Well, you know, it’d be okay.” Yeah, it’s hard.

Kimberly Adams 

So I mean, the way I’ve been kind of wrapping my brain around it is sort of a reduction of risk, right? And so, if the risk is never going to be zero, how can I reduce the risk the most? You know, if I see that I’m in an elevator with an older person, I’m putting on a mask, probably, just to be careful. But I suppose not all vulnerabilities are visible. So that’s probably not great, either. Anyway, who knows?

Kai Ryssdal 

Send us your thoughts would you? On the end of the public health emergency that’s coming up. In May, what does your three we’re going on your four by the way, of this pandemic? What does it look like where you are? How you feeling about it? Are you masking? Are you not? What are you doing? Let us know 508-827-6278. 508-U-B-SMART. Email us at makemesmart@marketplace.org That works too. We’re coming right back.

Kai Ryssdal 

We’re back. We’re back. We’re back. We’re back. We’re back. We’re back. Holy cow. Let’s do some news.

Kimberly Adams 

I’ll go first, just because mine is quick. And following up on everything we just heard, the Kaiser Family Foundation, which is sort of the umbrella group the Kaiser Health News is under, has a really good guide with details of all the different health things are going to that are going to change with the end of the COVID Health Emergency just in case you want to hear more on sort of the details of all that. The other story I wanted to talk about is this big Supreme Court case. I know everybody’s talking about it this week. But this Gonzalez versus Google really does have the potential to overturn how the internet works. This is the idea that search engines and web platforms should be somewhat responsible for the results that they’re algorithms serve up to people. In case you haven’t heard. I’m going to read here from SCOTUS blog. “The question comes to the court in a lawsuit filed by the family of Nohemi Gonzalez, a 23 year old American woman who was killed in a 2015 ISIS attack. They brought their lawsuit under the anti-Terrorism Act, arguing that Google which owns YouTube, aided ISIS is recruitment by allowing ISIS to post videos on YouTube that incited violence and sought to recruit potential ISIS members and by recommending ISIS videos to users through its platforms.” Obviously, section 230, which is kind of the underpinning of the internet that says “platforms aren’t responsible for what people post on them” is the crux of this and whether or not section 230 goes too far or has been interpreted too broadly. And I have to say, I talked to Chuck Grassley about this, I think it was last year, and there are a lot of Republicans in Congress that would love to see section 230 go away. And they think it is way too broad and gives platforms too much protection, which is kind of interesting, because you also hear complaints from the GOP, that Republic that sorry, that platforms get to go too far when it comes to censorship.

Kai Ryssdal 

Totally, it’s, I have no clue how this case is going to turn out. I’m desperately interested to find out though, because it’s gonna have huge consequences. Huge. Huge, huge, huge. Okay, so here’s mine. I just want to you know, we talked about this a little bit with Dr. Gounder up in the first part of the program, but there are still 300 and something people in this country dying every single day of COVID. And that doesn’t get enough press. I was flipping through the New York Times this morning, just randomly and knowing that we were gonna do this episode, and the chart that the Times has every day, and many other newspapers do the same thing of continuing COVID infections and vaccinations and all this jazz, it caught my eye. And honestly, most days, I just kind of skim right by it. But according to The New York Times, and this is data, I don’t actually know the source of their data. But I will take the New York Times’s word for it. Hang on a minute, let me click on the “about this data” thing will you? State and local health agencies, okay, US Department of Health and Human Services. So it’s government data. 378 people, on average, are dying every single day in this country of COVID. And that’s a lot of people. That’s a lot of people. And, and we should just think about that. And yes, I know, we just did a whole 20 minutes with Dr. Gounder. But anyway, so. And here’s the other part. Go ahead. Sorry. Go ahead.

Kimberly Adams 

Well, I mean, and just looking at some of those other numbers, more than 28,000 people hospitalized, more than 3000 and ICUs. Like these are serious health consequences.

Kai Ryssdal 

Yeah. Did I mentioned this the other day? I know it talked about the menopause piece in here at times, there was a piece in The Atlantic by Jen total total turnier. This has nothing to do a menopause by Jen Senior, about her long COVID experience.

Kimberly Adams 

No

Kai Ryssdal 

Horrific, absolutely terrible. Scary as all get out, we’ll put it on the show page. Really, really scary. Holy cow.

Kimberly Adams 

I’ve seen some pretty terrifying threads on what’s left of Twitter about long COVID. And like, people are really truly suffering.

Kai Ryssdal 

Yep. Yep. Anyway, we’ll put this piece up. It’s really terrible. Okay, here’s my other one. So Joe Biden goes to Kyiv over the weekend, competing speeches day today by by Putin and then Biden today in Poland. I just want to just this is I’m going to date myself here. But Putin announces today that he’s pulling out of New START, which is the last remaining Strategic Arms Reduction Treaty between the two nuclear superpowers that defined the Cold War in this country. If you grew up in the 1970s and 80s in the United States, and were of a mind to read the news on this subject. Strategic Arms Reduction was the thing. It was the thing between those two superpowers and now the idea that that whole framework is gone. It’s just kind of wild. It’s just kind of wil.

Kimberly Adams 

It’s mutually assured destruction apparently doesn’t matter anymore.

Kai Ryssdal 

Right and we’re that’s where we’re back to. That’s what we’re back to as a safeguard against nuclear war. Right? There are no Strategic Arms Reduction agreements remaining between two countries. I mean, yes, the Russians were probably cheating on theirs anyway. But come on, man.

Kimberly Adams 

Well that’s what I was gonna ask, like, how, how real were those things at this point? Yes. Because there are all these countries that have nuclear weapons, but don’t formally have nuclear weapons. There are all of these smaller nuclear weapons moving all around the world. And as you said, Russia was probably ignoring it. We’re probably also ignoring it. I mean, really, though.

Kai Ryssdal 

Yeah. Look, that’s a fair question. And and nukes are not a dime a dozen but they cannot be too hard to come by if you want to come by them. But it’s just it’s a marker. It’s a marker of of what I don’t know. But it’s a marker. And it’s just it’s just weird. It made me feel very old. Actually. That’s what he did this morning.

Kimberly Adams 

What’s that doomsday clock?

Kai Ryssdal 

Right, right, right. It’s the Bulletin of the Atomic Scientists. Yeah

Kimberly Adams 

Yeah, I imagine that’s gonna take a couple direct moments in the wrong direction.

Kai Ryssdal 

For sure. For sure

Kimberly Adams 

Well on that happy note. That is it for the news fix. Let’s do the mailbag.

Mailbag 

Hi Kai and Kimberly. This is Godfrey from San Francisco. Jessie from Charleston, South Carolina. And I have a follow up question. It has me thinking and feeling a lot of things.

Kimberly Adams 

Okay, last week, we were talking about pay transparency in the workplace. And we got this from Joey.

Joey 

Hi Kai and Kimberly, this is Joey calling from Twentynine Palms, California. I’ve been in the military now for 10 years, and our pay is publicly accessible on the internet to everyone. You can just Google military pay chart. And if you know someone’s rank and how long they’ve been in the service, then you’re able to see what their base pay is each month. It hasn’t caused any problems with us. But it’s very, very transparent. And I don’t think it would be a problem if the civilian side kind of followed our model.

Kimberly Adams 

I agree with you, Joey. And what’s interesting is a favorite pastime in the dating scene of Washington, DC, is once you find out someone works for the government is to immediately look up how much money they make, because that is publicly available information on multiple websites. Not that I have ever done.

Kai Ryssdal 

That whole city just needs to get out more. Oh, my goodness gracious me.

Kimberly Adams 

It’s a problem. I mean, people are starting to move away from starting conversations with “what do you do”, but they want to ask it you can tell anyway. No, but I mean, like, Joey is exactly right. Like there are plenty of sectors where the, you know, the pay is publicly available. In a lot of union shops, you can see exactly what the wages are for that particular role and what bands are and whatever. And, you know, there there’s plenty of research saying that improves equity,

Kai Ryssdal 

For sure. All right. Here’s one more voicemails from Beryl in Houston.

Beryl 

Kai, thanks for mentioning the wonderful article on menopause from the New York Times. As someone who has averaged eight hot flashes a day for about six years now and sometimes as many as 16 a day, I have often wished men would have hot flashes. So real money would go into researching this. I don’t mean to wish men ill but let’s face it, in the U.S. men’s problems are dealt with in a different more serious fashion. You said you felt this wasn’t your lane, but it is. What affects women usually has some repercussions for men. I appreciate you calling attention to the issue. Maybe if more men took this seriously, so would the medical community. Thanks for trying to make everyone smarter.

Kai Ryssdal 

Yeah, well, thank you for that. I appreciate that. And and I wish more men would pay attention to this stuff.

Kimberly Adams 

There’s some videos on Tiktok, Instagram, whatever your pleasure of have a machine that apparently, and I don’t know if this is real or stunt, that apparently mimics period pain for men? They put sensors on the stomach and you see these dudes like falling out from what is minor to women. And I think about like the level of pain I’ve had from period cramps over the years and like gone to work. I saw a story somewhere a couple like last week about a country that’s starting to have medical leave for women on their periods. Because it’s just like the level of pain that women are walking around dealing with the it’s it’s pretty astonishing sometimes and yeah, you know, if this were taken more seriously and researched in a different way, I think that our lives would be a lot more comfortable shal wee say.

Kai Ryssdal 

Yeah, well, you know, there’s there’s a similar series of videos about pregnancy contractions where they put these electrodes on on men stomachs, and then crank up the the pregnancy contractions that women have in labor. And I’m here to tell you that if men had to bear children, we would die out as a species. We would!

Kimberly Adams 

Okay, well, no good thing. Good thing that evolution or the higher species or higher being or whatever, did not delegate that task to y’all. And actually, before we go, let me throw in one more. This is a tweet that we got from Bob Henderson. He says “disappointed with make me smart team for the morality lesson inferred in your explanation of credit card rewards, your tone markedly shifted to make people who pay off their balances feel like they were oppressing those who do not by driving up rates and fees.” So this is from what was it? Last Wednesday show? What do you want to know Wednesday on credit card rewards. And I was saying that even if you pay off your balance at the end of the month and you don’t end up paying interest and you just get the rewards. Somebody who’s still paying those fees, ends up effectively paying for your rewards. So you’re getting the benefits while someone else is probably paying interest that provides your benefits fine. Now, first of all, I do it too. And so I don’t know how much of a morality lesson it is. But, you know, there are a lot of things about this economy that don’t work very nicely in favor of one group or the other. And we still kind of do it. I also saw something on Discord talking about how it was weird for us to like, say all these bad things about the NFL and then talk about like, Rihanna’s halftime show with great fun. And it’s like, yes, we contain legions. Yeah, there’s a lot of bad stuff. And, you know, I think everybody kind of has to choose, pick and choose their battles and what you’re gonna absorb and what you aren’t. I mean, like, I hear not wanting to feel badly about the choices you make, but you know, they still have consequences.

Kai Ryssdal 

Yeah, for sure. I think that’s totally true.

Kimberly Adams 

Before we go, we are going to leave you with this week’s answer to the make me smart question, which is, “What is something you thought you knew, but later found out you were wrong about.” This week, our producers posed the question to Chat-GPT. And here’s what it had to say.

ChatGPT 

As a machine learning model. I don’t have personal experiences or beliefs. But I can tell you that AI models like me can sometimes make errors or have limitations in their understanding, just like humans. For example, I was trained on text data from the internet. And while I have a large amount of information, there can be inaccuracies or biases in the source material. I can also sometimes misinterpret questions or provide incorrect answers if the information I was trained on is out of date or if the context of the question is unclear.

Kai Ryssdal 

Oh, boy,

Kimberly Adams 

It’s not like we ever have to worry about that do we? Just a note this is… we used a AI text to speech app to record the answer just so we can make it sound nice for the podcast.

Kai Ryssdal 

Holy cow. Holy cow. I wonder if that was before, or after the Kevin Roose article on The Times and Microsoft dialing back on Bing and all that jazz. Very interesting. Very interesting. Let us know what you’ve been worried about lately. If it’s AI, or something else, we are taking your answers to the make me smart question. It is of course 508-827-6278 508-U-B-SMART. The question of course is “what is something you thought you knew, but later found out you were wrong about?” There’s too much to worry about these days.

Kimberly Adams 

Make Me Smart is produced by Courtney Bergsieker. Ellen Rolfes writes our newsletter. Our intern is Antonio Barreras. Today’s program was engineered by Jay Siebold with mixing by Charlton Thorp.

Kai Ryssdal 

Ben Tolliday and Daniel Ramirez composed our theme music. Our acting senior producer is Marissa Cabrera. Bridget Bodnar is the director of podcasts. Francesca Levy is the executive director of Digital and On Demand. Out Vice President and General Manager is Neal Scarbrough. Ex-e-cu-tive Director.

Kimberly Adams 

It’s okay I also said intorn instead of intern. Sometimes we just can’t speak.