The latest wave of the coronavirus pandemic appears to be subsiding, but people still have lots of questions about the virus. There may, for instance, be a new subvariant responsible for an increasing number of cases here in Massachusetts and the United States at large. Edgar B. Herwick III, the man behind GBH's Curiosity Desk, joined All Things Considered host Arun Rath to answer some audience questions about the virus and this stage of the pandemic. This transcript has been edited for clarity and length.
Arun Rath: We have some questions which you have gathered for us. Our first question comes from Eileen Hardy in Wellesley, who asks: Is omicron the dominant strain in Massachusetts now? And what happened to delta?
Herwick: Well, let's start with part one of that question, and that answer is a simple yes, omicron is the dominant strain, and when I say dominant, I mean really dominant. Essentially, 100% of the cases in Massachusetts and across the country right now are omicron cases. There is no delta, there is no other [variant]. This is according to numbers from the CDC. They compile this weekly.
Now, about 35% of those omicron cases across the country are that variant that we've been hearing about: omicron BA.2, that subvariant. But that number is even higher here in New England, where the estimate is that it's at least about 55% of the cases that are the BA.2 variant of omicron.
I spoke with Dr. Katherine Gergen Barnett, who's the vice chair of family medicine at Boston Medical Center, a little bit more about BA.2. Now, she noted doctors and medical professionals are watching how things have been playing out with BA.2 in the U.K. because for much of this pandemic, as you know, what's happened there has often been what happens here — only it happens there first. So she says the subvariant does appear to be even more transmissible than the original omicron.
But she also said there's some good news: "We're still seeing that the vaccines and booster shots work well against this variant BA.2 in terms of keeping people out of the hospital and getting severely ill."
Rath: And then what about the second part of Eileen's question? Where did delta go?
Herwick: Simply put, it was outcompeted by omicron. Omicron did a better job of infecting people, and that left delta with nobody to infect. So as I said before, right now it looks like there is no delta, that it's gone. But of course, scientists, doctors, they are very careful to avoid absolutes with this kind of thing.
Here's Shira Doron, who's an infectious disease physician and the hospital epidemiologist at Tufts Medical Center: "So is it gone like beta, for example, which just went away? Or could it very well be hiding in an animal reservoir? Could it very well be existing in some chronic infection in an immunocompromised individual and mutating to become a new subvariant of delta? It could."
Rath: So Edgar, question number two was sent in to the Curiosity Desk by Jason Clark and Dedham, who wants to know: Will people who don't think they ever got COVID ever know if they had it at some point? And I wondering the same thing myself,
Herwick: Yeah, so am I. And in fact, you know, I spoke with a number of doctors as I was researching these questions and all of them when I asked that said, "Yeah, that's a great question. A lot of people want to know that."
The short answer is that while it is technically possible, for all practical purposes ... well, here's Dr. Doron again: "If you want to know if you had COVID in February 2019, there's no way to know that. At least, there's no way to go to your doctor and get an order for something that will tell you that."
Now, there are a few challenges on this front in terms of finding out, like looking back and finding out if you had it right. The key is the antibodies. And so one, the antibody tests that we have, we know, have fairly high rates of false positives and false negatives. Then we know that antibodies wane over time. And then we also have to be able to distinguish between antibodies that were happening because you got vaccinated versus you got infected, right? So everybody that I spoke with said that, in theory, if it became important that we know [whether you were ever infected], it's very probable that we would be able to do this to look back and say, yes, you had it or no, you've never had it.
But for now, Dr. Gergen Barnett says that the efforts, as they should be, are not on looking back, but on other fronts: "What matters is how do we walk forward and how do we make sure that future variants of COVID-19 don't impact our communities in the same way that these initial waves have, and that we can actually make this endemic, where it's predictable in terms of where it's going to be and when it's going to be and how many people it will infect."
Rath: So for people like Jason and myself who are wondering if we ever got it, it's going to remain an idle curiosity.
Herwick: Exactly, at least for now. That's right.
Rath: Our final question is from Joan in Rhode Island, who asks: Considering the difference in efficacy compared to mRNA vaccines, will individuals who received the Johnson and Johnson vaccine plus an mRNA booster, require an additional booster, possibly sooner than those who received three doses of mRNA vaccine?
Herwick: Yeah, so [that's] a little bit of a complicated question, but essentially, you know, it's if I got mRNA for all three of mine versus just being boosted with mRNA, am I in better shape?
For an answer here, I spoke with Dr. Paul Biddinger, chief preparedness and continuity officer for Mass General Brigham. Here's what he had to say: "It looks like probably the duration of protection once you've had an mRNA booster is about the same no matter what you had as your initial series. So if you had mRNA in the beginning and you got an mRNA booster, or you got the Johnson and Johnson and mRNA booster, it's likely that your degree of protection or your longevity of protection is about the same."
So, no, Biddinger says that if boosters are recommended again, it's not likely they'll be recommended sooner if you started with a J and J shot, for example.
Now, he also said that we need to draw a distinction between efficacy in terms of preventing infection and in terms of preventing, say, severe disease, hospitalization and death. Here's Biddinger with more: "The complexity of this is that it seems pretty clear that people's antibody response wanes over time after they've had a booster, and somewhere it's probably about three to six month window. The good news is that protection against severe disease — meaning you're going to get hospitalized or you're at risk of dying — still is pretty low, it's really pretty good. And so we still need more time. We need more data. But ultimately, getting vaccinated, getting boosted is phenomenal protection."
Biddinger also points out that at this point in the pandemic, we also have a lot of therapeutic treatment that we didn't earlier, and we're getting better at understanding all the details of how they effectively work. So especially for higher-risk folks, that's another level of protection against the worst outcomes.
Now, all of the doctors I spoke with noted that there may be more boosters coming in the future, so don't be surprised if those recommendations do eventually come. And they all went out of their way to again stress the importance — as we've been hearing since the very beginning of vaccines — is that that the best thing you can do is get vaccinated, get boosted as we continue to battle COVID.
Rath: Edgar, it's always good talking with you. And this is just especially good, useful answers. Thank you.
Herwick: Thank you, Arun, and my thanks to all of those listeners who reached out with their questions. We can't do the Curiosity Desk without them, so thanks. And keep them coming.
If there is something you've been itching to know more about, email The Curiosity Desk and Edgar might just look into it for you. For more from The Curiosity Desk, follow Edgar B. Herwick III on Twitter and subscribe to the GBH News YouTube Channel.
