KOJO NNAMDIYou're tuned in to The Kojo Nnamdi Show on WAMU 88.5. Welcome. Later in the broadcast, Graphic Novelist Raina Telgemeier joins Kojo For Kids. But first, the insurrection on the National's Capitol may have pulled attention away from the coronavirus, but the pandemic is still shattering records. On Thursday, for the first time, more than 4,000 people died of COVID-19 in the United States. Joining us to discuss all of this is Dr. Leana Wen, an emergency physician, a public health professor and a columnist for The Washington Post. Dr. Wen, thank you for joining us.

DR. LEANA WENAlways glad to join you, Kojo.

NNAMDILeana Wen, it seems like every time you join our program, we're talking about another grim milestone. Amid the mayhem that insurrectionists sowed in our Capitol, the pandemic was largely forgotten. How did you respond to the news that day and the fact that this virus plaguing the nation was once again -- for a while, anyway -- put on the collective backburner?

WENWell, I mean, we have now been living with this pandemic here in the U.S. for 10 months. And pandemic fatigue is really real. I think a lot of people would rather forget about the virus and think about other really important things in our lives. The problem, though, is that the virus has not forgotten about us. And I am speaking to more and more people and more and more patients and people who have gotten infected with coronavirus, even though they've been so careful. And I think we need to remember that the level of virus in our community is higher than ever. And what that means is activities that were once relatively safe are now higher-risk. And we really all need to be on guard, even more than we were before. I mean, we've now surpassed more than 4,000 deaths in a single day, more than 300,000 new daily infections. We need to be using an abundance of caution and not let down our guard.

NNAMDISome experts are warning that the storming of the Capitol could be another super-spreader event, among those who crowded together mask-less. Many also noticed that Trump supporters stayed in hotels in large groups across the region. What do you think? Could this be a super-spreader event?

WENYes. And not only could it have been on super-spreader event. We could be talking about multiple super-spreader events as a result of this. I mean, we had cases of people coming from all over the country who were gathering. And as we saw through the footage, clearly not wearing masks or physical distancing, who are flouting social distancing guidelines. And it stands to reason that if they were flouting guidelines while they were together in these violent mobs, they probably were not following guidelines wherever they were coming from and where they're going to, as well. And I hope these individuals, I'm not sure that they will. But I hope that these individuals are quarantining once they get back to their home locations. I certainly hope that all those lawmakers who are forced to be in enclosed spaces for prolonged periods of time with others who refuse to wear masks, I hope that they're also quarantining for at least seven days, and then getting tested or quarantining for 10 days, because I really -- the last thing that we need is for more cases to be around for us to further tax our overburdened health systems.

NNAMDIIndeed. Another disturbing piece of news we learned yesterday, lawmakers who hunkered down together for safety during last week's insurrection may themselves have been exposed to the virus, because they were hunkered down in a room with some Republican lawmakers who simply wouldn't wear masks and refused to wear masks when offered.

WENRight. And, I mean, I really have no words for individuals who refuse to wear masks even in enclosed spaces were people don't have a choice about being there. I mean, mask-wearing at this point has gotten so politicized in a way that's incredibly -- I don't know another word for it but just disappointing and tragic. I mean, we should see it no differently than the laws that we have to prevent drunk-driving, because this is not about you. You can make a choice about your health, sure. But not wearing a mask around others in small indoor enclosed spaces within inadequate ventilation is a public health threat to those individuals, too.

NNAMDIHere is a plaintive tweet from a listener: Why aren't we just locking down and paying people to stay home? I'm exhausted. I got the first bit of time off in months. I'm just a humble hospice social worker. But I have been tasked with keeping the mental health of my coworkers up and helping families grieve. We can't keep doing this to citizens. Most of us agree that this is serious. But we're forced into bad situations because we need to eat and house ourselves. We are forced to risk our lives because we have families we need to provide for. This, according to our listener, is simply just cruelty. How would you advise that listener, Dr. Wen?

WENI mean, I really feel for the listener. And I think there are so many people in this situation who don't have the ability to physical distance, who cannot stay home to work, which is a privilege that certainly a lot of people, a lot of essential workers do not have. I talked to my colleagues around the country. I grew up in Los Angeles and my colleagues, my friends who are working in L.A. area hospitals are -- every time they go into the hospital and see all the people who cannot even be seen. I mean, there are ambulances that are lined up for six-seven hours and patients cannot come into the ER to be seen, now they walk out and see that there are birthday parties, retirement parties, indoor game nights, all these things that are happening that are fueling the spread. And I think it is incredibly frustrating. Look, we have to acknowledge that this pandemic fatigue is real. But we also have to remember that hospitals are the last line of defense.

WENIndividuals, the community, they are the first line of defense, and we need to be doing our part to help all those who don't have the privilege of physical distancing.

NNAMDIHere's Michael in Bowie, Maryland. Michael, you're on the air. Go ahead, please.

MICHAELYes. So, I don't understand what's going on here. Most of the people I've noticed when I walk around the neighborhood, they don't wear face masks. They don't social distance. They have adults that don't live in their household visiting them on a regular basis. I don't understand what's going on, what's going on with the people, what's going on through their minds. It's very, very upsetting and tragic, as Dr. Wen was just talking about. So, I'd like an answer. Why are these people doing this? I live in a mostly Democratic neighborhood, so I think it's political. I don't know what it is. And there are a lot of college graduates that live where I live.

NNAMDIDr. Wen, more pandemic fatigue?

WENYeah. I mean, you know, I guess we also need to break down what exactly is happening in Michael's neighborhood, because I think sometimes we look at groups of people, and maybe for those of us who really believe in public health guidelines, maybe we think, "Why is this group gathering?" Well, it may be that -- I don't know if this is the case. But it may be that people are in a pandemic pod with one another. Maybe there are two families that have joined in a pod so they can see one another. They're not taking any risks in other ways. They're seeing one another. Also, when you're walking outdoors, if there's nobody around you, you don't need to be wearing a face mask, because there's literally no one around you. So, I think, you know, -- I think there are -- it's important for us to keep in mind what the rules are, but also to interpret them accordingly, because if we make our rules so strict, then no one can literally follow them. All that said, I do think that it's a big problem.

WENWhat we are seeing around the country -- including in our area here in DMV region -- is that what's fueling this recent surge of infections is informal gatherings. And you and I have talked about this a lot, Kojo. But I really think about this for over the holidays, and, in general, that people are gathering with extended family and friends, letting down their guard, when those interactions are just as risky as interactions with strangers.

NNAMDILeana Wen, President-elect Joe Biden's team has suggested that it intends to release every available dose of the COVID-19 vaccine once the new president takes office. You apparently disagree with this approach. Can you explain why?

WENYeah. So, I think, first of all, that it's wonderful that the president-elect is really focusing on vaccination, saying that this is a top priority. We need that level of urgency. This is a wartime effort that requires that all-hands-on-deck mentality. And so, I think it's great that there's focus on this in the way that there needs to be. I also, though, think two things. First is we need to be solving for the right problem. Right now, we have more than 22 million doses of vaccine that have been distributed to the states. Only six-and-a-half million or so have actually been administered as shots in arms. So, there's a big problem. We need to be fixing that problem, which is the shots in arms. If we just flood the market with supply, there's no guarantee that those will be translated into vaccines in arms. You have to fix that administration problem. Then there is a second issue, which is that the way that these studies were done for the Pfizer and the Moderna study was that there is a second shot that's given three weeks or four weeks after the first shot, depending on whether it's Pfizer or Moderna.

WENNow, I know that the Biden team has said they don't intend to delay that second shot. But we need to be thinking about what happens if the production doesn't come through or if the administration just cannot keep pace, as is the case now. If we cannot guarantee people that they'll receive a second shot in time, that could really fuel vaccine hesitancy. Already, people have a lot of questions about, were there shortcuts taken in the process? And the way that I've been reassuring patients is to say we have not taken any shortcuts in the science. There were no shortcuts taken in the approval process. If now, we're not guaranteeing people that second dose at the time that they're supposed to receive it, by definition, we're taking a shortcut. And I think that that could be really damaging to eroding public trust. And so, again, I think that the focus on speed is really important. But I would also want the Biden team to come out unequivocally to say, "We will guarantee that if you receive the first shot, you will get the second shot at the time that you're supposed to receive it."

NNAMDIHere is Chris, in Washington, D.C. Chris, you're on the air. Go ahead, please.

CHRISHi, Kojo. Long time listener and big fan. It sounds like you kind of addressed my question. But I was curious what the difference is between the Trump administration and Biden administration's rollout. And if we should be optimistic towards that Biden rollout, or if we don't have enough information for that.

NNAMDIDr. Wen.

WENI think it's a great question. And I am optimistic about the Biden team coming in, because they have recognized, first of all, that there is a problem, because there is a major problem. If we had -- the Pfizer vaccine that was authorized a month ago, if you had told us a month ago that this is how the vaccine rollout would be, that we've only gotten less than seven million people actually received the vaccine, that's a major -- that's a major -- it would be shocking. And so, I think acknowledging the problem is a first step. I think something else that went wrong with the Trump administration, as we now know, is that they seemed to have seceded their responsibility after the vaccine is distributed to the states. They have then basically said, "We are washing our hands, once the vaccine is given to the states," versus the Biden team coming in is recognizing that they must be supporting local and state health departments with that last mile, what happens between actually getting the vaccine, setting up vaccine sites, hiring armies of vaccinators, figuring out what to do to actually get the vaccines into arms.

WENAnd so, I'm optimistic. But I think there is a ton of work to do, especially because we are really months behind where we should be because we have not given the support to local health departments the way that they actually have been requesting for months.

NNAMDIWe've got to take a short break. When we come back, we'll continue this conversation. If you have called, stay on the line. If you'd like to, the number is 800-433-8850. Are you an essential worker in the Washington region? We'd like to hear from you. I'm Kojo Nnamdi.

NNAMDIWelcome back to our conversation with Dr. Leana Wen about the coronavirus and COVID-19 epidemic that we're experiencing around the country. Dr. Wen, I would like to expand on one of the things you said. You talked about your colleagues in Los Angeles and hospitals there and the strain they're under. One of the things you have, I think, advocated is that vaccination distribution should not be restricted to hospitals and pharmacies, correct?

WENThat's right. So, hospitals are overwhelmed with taking care of patients in the middle of this coronavirus surge. It really makes no sense that we're tasking the same nurses who are already so overstepped. I mean, many of these hospitals have asked nurses and doctors to volunteer their time to come on their off days to give vaccines to their colleagues. I mean, that's admirable, but come on. I mean, we have to be able to do better than this. You also cannot just rely on pharmacies -- as many as there are -- because we really need a massive effort. We need to be converting stadiums and schools and parks and parking lots, especially outdoors spaces, to do this. We could be doing this. I mean, this is what other countries have setup. And we have done this before when it comes to mass vaccination drives. We can't see this as business as usual. We have to take a totally different approach. This needs to be all-hands-on-deck.

WENA lot of the delay also occurred over the holidays. And I understand that people are tired. But you cannot be tasking the same people who have been running the response all along to also be doing this and doing testing and doing public education. You need to have different people, different workers. And again, all hands on deck, recruiting retired individuals, students, and recognizing, too, that there's a lot of process that can actually be streamlined. If everybody fills out their paperwork in advance, as an example, you don't need to spend time when people show up answering questions. When they show up, they should be lining up, getting the vaccine, and that should be it.

NNAMDIHere's Beverly in Los Angeles, California. Beverly, your turn.

BEVERLYThank you. My concern is that there are any long -- or if there may be any long-term effects of the vaccine.

NNAMDIDr. Wen?

WENSo, this is a very good question, and I think a lot people have questions, given that this type of technology is written as a new, or is said to be a new technology. Although, we have to keep in mind that the development for this mRNA technology for the Pfizer and the Moderna vaccine have actually been in progress for years, for over a decade. So, the short answer is that we don't fully know. We don't know if there are going to be long-term consequences. However, there's no reason for us to believe that there will be long-term consequences. In addition, these vaccines are proven so far to be safe and so highly efficacious, 94 to 95 percent efficacious. We know about the long-term consequences to coronavirus, and so any kind of possible theoretical risk of getting the vaccine is far overshadowed by the huge benefit of getting the vaccine, which is to prevent coronavirus.

NNAMDIThere's a lot of anxiety surrounding a new virus variant, which has now been confirmed in a number of states in the U.S. What do we know about it, and how concerned should we be in our region? Are we seeing cases here?

WENWell, we should be very concerned about this variant, and I think right now we just don't know how prevalent that variant actually is in the U.S. The more we are looking for it and testing for it, the more places it is turning up. I would be very surprised if it's not already here in our region just because of how much travel has been occurring and how prevalent this virus -- the coronavirus is and also how prevalent the virus -- this particular variant appears to be. This variant isn't more virulent, so the individual who gets this variant is not more likely to be hospitalized or to get severely ill or to die. But if it's something that spreads much more easily, many more people are going to end up getting infected, and this could well end up being the dominant strain here in the U.S. So, I think it's certainly something we should keep our eye on, and I think, again, highlights why we need to double-down on these precautions, because this new variant spreads in the same way. It's still a respiratory virus.

WENAnd it's still through physical distancing, through mask-wearing, avoiding indoor gatherings that we're able to protect ourselves against this variant, too.

NNAMDIWill the vaccines protect against this virus variant?

WENAt this point, there's no reason for us to believe that the vaccine will not protect against the variant. There have been some preliminary studies done that show that it does appear to be effective against the UK variant. Studies are now ongoing with the South African variant and other variants, too. And so, again, no reason for us to believe that it won't be effective. Although, I do want to caution that viruses mutate all the time. There could well be mutations that arise in the future that render the vaccine less useful, which is why the vaccine may need to evolve, but also, we need to very urgently get the vaccines out to people, because the more it spreads, the more the virus spreads, the more chance there could be mutations that may end up being not only more contagious, but more virulent in the future, too.

NNAMDIHere's Janine in Columbia, Maryland. Janine, your turn.

JANINEHi, Dr. Wen. It's good to hear your voice. Remember, I worked with you at City Hall.

WENI'm so glad to hear your voice.

NNAMDIJanine, go ahead.

JANINEYes. I wanted to ask you, Dr. Wen, keeping in mind that a lot of folks cannot get the vaccine right now if you're not a frontline worker, why isn't there more talk about protocols or things that other doctors are using to -- that are trying to present to the CDC and to the other organizations about things such as Ivermectins? There's a doctor alliance called FLCCC, and a Dr. Paul Marik and a Dr. Pierre Kory that are talking about Ivermectin as way of keeping people possibly out of the hospitals and saving lives. Are you aware of it?

NNAMDIDr. Wen?

WENYeah. So, there have been a number of medications that people have called attention to as potential for early treatment of coronavirus as in you get coronavirus. Maybe you take these medications, and ideally, it prevents you from getting severe illness. However, I think it is important for us to do the rigorous scientific studies, because anecdotes do not replace clinical research. Somebody may have taken a medication, then they did not get severely ill. But we have no idea if they might not have gotten severely ill, anyway, whether this medication had any effect on them in any way. And as listeners may remember, we had a lot of discussion initially about hydroxychloroquine being such a potentially miracle drug that President Trump among others were pushing, but then was not found to actually reduce the rate of hospitalization or severe illness. Ivermectin is in that same category of something that has had some fanfare, but has not been proven in clinical trials.

WENThere have actually been medications that have been -- that have demonstrated efficacy in clinical trials, monoclonal antibodies that are produced by Eli Lilly, by Regeneron. There actually have been some studies to show that infusion of these antibodies may prevent severe illness. But it's still pretty difficult to get those administered, given that you need an infusion. You need to go somewhere for the infusion, and it needs to be done early in the course of your illness. That said, I think we need to do more research into this critical element.

NNAMDIHere's Taylor in Elkton, Maryland. Taylor, you're on the air. Go ahead, please.

TAYLORHi, my husband and I have an upcoming trip planned to one of the major amusement parks in Florida. We've done our research, and we seem really comfortable with their social distancing measures and their masking requirements. Given that the government has even gone so far to include a tax incentive for people to travel, are places like the major theme parks in Florida -- where you're outside most of the day -- okay to be going to? And we do have plans to get tested while we're still in Florida, and then tested again upon our return to Maryland.

NNAMDIDr. Wen?

WENWell, I think that you are doing everything that's responsible. And I have no doubt that when you are on a plane, that you're going to wear a mask and follow all the proper protocols. Look, I think, in general, I am not recommending for people to do non-essential travel. But what I'm really worried about when people are traveling is not they're going to a national park and they're not going to see anyone when they're there. That's not what I'm worried about. I'm worried about people traveling to see their loved ones, bringing coronavirus to a gathering of friends and family, then going back to the home community and spreading it further. If you're traveling just to go somewhere that you can be outdoors and not see other people, I'm much less concerned about that.

NNAMDIDon't have a great deal of time left, but have you received the vaccine, Dr. Wen?

WENSo, I'm a participant in a clinical trial. I've decided to participate in the Johnson & Johnson clinical trial. And so, I have received something. I don't know what it is. But if I were not a participant in the trial, I would have no concerns about getting the Pfizer or the Moderna vaccine.

NNAMDIAnd I'm in a hurry to get it myself. Thank you very much for joining us, Dr. Wen. Dr. Leana Wen is an emergency physician, a public health professor and a columnist for The Washington Post who formerly served as Baltimore's health commissioner. We're going to take a short break. When we come back graphic novelist Raina Telgemeier joins Kojo For Kids. Calls from kids only. I'm Kojo Nnamdi.