Holiday health update: A check on COVID, flu and mpox

S1: Welcome back to Kpbs midday Edition. I'm Jade Hindman. Over the last few years , a lot of us have added one more item to our holiday to do list , and that is how to minimize the spread of illness , most notably Covid. As we get set to reunite with family and friends for the upcoming holidays , we wanted to get a temperature check on where things stand with not only coronavirus , but also other viruses like the flu. Who else to talk about that then ? Dr. Eric Topol , he is the director of the Scripps Research Translational Institute in La Jolla. Dr. Topol , so good to talk to you again.

S2: Same here. Jade. Always good to have a chance to have a conversation with you.

S1: Yes , yes. So we've become familiar with Covid surges over the past couple of years , particularly around the winter holidays.

S2: It's it's toward the lower side. There is a concern out there that the virus is made a detour from where it was evolving to a whole different path. And we've seen in countries in Europe , Iceland and places where this so-called Gen1 variant has taken off very quickly. And this is building on that variant we were very worried about a couple of months ago that had 50 new mutations in it , and at the time that was dismissed because we weren't seeing it get legs. But right now it seems like it is. So it's too early to say right now things are good that what I would do , though , is to stay protected. If you haven't had a booster this XB one five booster , it would be a good time to get one. About 90% of the people in the country have had it. It's about the same as the first booster a year ago , but we need a lot more people , particularly those who are advanced age or have a lot of coexisting conditions , immunocompromised , more people who really would benefit from the booster should go out and get it , because we might be seeing some significant trouble in the in the next several weeks.

S1: And well , I am glad though , at least for the moment , things are low.

S2: But yeah , I mean , when I think about traveling to places that indoor gatherings , large groups , cold weather inducing , that I think more of the risk. And so that's another reason to get a booster , is you're going to be going to places and you're going to especially going to be in groups that are large places where the ventilation is not good. This is where , you know , keeping the antenna up for risk , because that is definitely a chance to have a reinfection if you've already had Covid or a new one , if somehow you've been spared. In.

S3: In.

S1: Last year , we heard a lot about the possibility of a triple demic of Covid , flu and RSV.

S2: But it's just still the beginning of that season , if you will. So we don't know if it's going to fare as better than last year or somewhat worse. But right now it doesn't look , you know , particularly troublesome. Again , not a reason not to get a flu shot. Right. But still it isn't looking like it's going to be a bad flu season. RSV is the one that has definitely been on the rise and that of the triple demic. That one is still a concern. Hopefully we're seeing a plateau right now in the country. It's not as bad here in San Diego as it is , particularly in the northeast. Again , going back to that temperature differential and seasonality aspect. But yeah , and we and we do have ways to prevent RSV in older adults and antibodies and in babies and vaccines that are available. So that's something to keep an eye on. Of of the three right now RSV is actually the one that's most problematic. Right.

S3: Right.

S1: So lots of preventative advancements being made. Another ongoing piece though of the Covid puzzle is long Covid. And there seems to be more research coming out on its effects.

S2: We have so many millions of Americans that are suffering and significantly disabled. There was a report this week in the New York Times that showed the big spike in disability related to long Covid that's occurred. And although the the chance of getting long Covid now with a with a reinfection or a new infection is lower than it used to be because our immunity has been built up over time. This is a dreadful situation since we have no treatment. So what we've done really well in these years is understanding the different mechanisms by which the virus can lead to sustained and really problematic adverse outcomes , not just symptoms , but affecting many different of the body systems , including the nervous system and the heart and kidney and others. So this is a problem we don't have a treatment for. So , you know , we make just great progress on understanding mechanism. But we still are wanting desperately for effective treatments. We know how to prevent it. Just obviously if you never get Covid or you don't have a reinfection and you not had Covid , that's the only prevention we have. But also things like metformin , Paxlovid have shown some evidence that they help prevent long Covid. But treatment is a different story. And it's very frustrating that we haven't seen anything proving a treatment that validated to help. Our.

S3: Our.

S1: Doctors at this point , even able to spot when someone is suffering long Covid.

S2: Another good one , Jay , because that's the other deficiency. It's not as bad as not having a treatment , but having a biomarker or a blood test , which we don't have for long Covid there's many that have been proposed , like antibodies is directed against oneself , certain cellular markers and other inflammatory substances , but none of them are practically available. None of them have gotten to a scale at test , we hope , you know , in the months ahead , certainly sometime next year , that there will be a blood test that would be helpful not only to make the diagnosis , but also if you institute a treatment to use that test to see whether or not it's really working. So that's another missing link in the long Covid story.

S1: You're listening to Kpbs Midday Edition. I'm Jade Hindman , speaking with Dr. Eric Topol to talk about the current state of viruses this holiday season. Dr. Topol , another infectious disease that's been a reoccurrence recently in San Diego , is impacts. The county reported 11 new cases last month , and more cases have been reported in the past two weeks.

S4:

S2: Problem amidst the pandemic. You know , we have a vaccine and , you know , we had it under wrap to some degree. And now , as you mentioned , we got some recrudescence of this. So , you know , we know the things that work. We just got to use them. It's just like everything else , you know , all these conditions we've been talking about these infectious diseases. We actually have ways to prevent it. We have , you know , good ways. We just don't use them. And they are not just the vaccines but the non pharmacologic the non vaccine interventions.

S1: And I'd like to turn to discussing the vaccines for these various viruses. First the newest Covid vaccine. I've heard that that not as many people are getting that one correct.

S2: Well that was the case as of a couple of days ago. Okay. But the update from the government is that we're right on the same as we were a year ago. That isn't great , though. I mean , it's , you know , 19% of the people who would be eligible have gone ahead , but it isn't as bad as you might have projected because there's such terrible pandemic fatigue. People are just so fed up. People are just thinking the pandemic is over. Well , you know , maybe the rip roaring side of the pandemic is over , but it's still endemic and still could get significant in the times ahead. So the I do think that , you know , the uptake is low , but it's actually the new data suggests that it's at least about the same as it was a year ago. So some of us were worried it would even be substantially worse. It isn't worse at this point.

S1:

S2: The flu vaccine appears to be more effective than it has been in a number of years , and the number of people taking it is substantially higher than the updated booster vaccine. So , you know , that may be one of the reasons why flu seems to be at least so far in check. But the matchup of the vaccine with the circulating variant does appear to be improved compared to some of the years where it seemed to to be a pretty significant gap.

S1: And , you know , many doctors offices are offering Covid and flu vaccines at the same time.

S2: I went ahead and did it separately. You know , I did the flu vaccine and then about ten days later , I hit the. The reason I did that is I think the data to show that it's fine to give both the same at the same time. It's okay. But I wouldn't say it's definitive and I want to get the max. If I'm going to go get a shot , I want to get the max immunity built. I don't want to have any kind of competition for the target , but it's fine for convenience to do that. I'm a stickler for kind of hard data , and I have to say , you know , having a few hundred people looking at their antibody response , it isn't convincing to me. And if it isn't too much of a hassle , I actually think it's good to go separately.

S1:

S2: In light of that , it's out there and it can get people who are older pretty significantly ill. That should be contemplated. Um , and I think the pregnancy vaccine and also the antibody against RSV , prophylactic preventive antibody , those things should be considered as well. So we have some good tools we've never had before Jade against RSV. And you know , a lot of the people out there don't have enough respect for respiratory syncytial virus and that it can cause of an illness that's very serious , like flu. You know , perhaps not as bad as Covid at full force , but it leads to a significant number of hospitalizations and deaths in this country , particularly in in newborns and in people of advanced age. You know , you start getting over 70 , 75 years age. You start to see , you know , RSV impact. It's not trivial at all. So getting those vaccines in the right people and use of the antibody is something to keep in mind.

S1: Finally , I mean , aside from the vaccines we spoke about , what are some things we should be keeping in mind as we make our holiday plans this year ? Start to mingle with friends and family when it comes to our health.

S2: Well , Thanksgiving's not too far away. And right now , you know , at least here in San Diego , we're in a relatively good state. So , you know , it doesn't mean you should let down. But at least you know , we're not probably in the next week or ten days , you know , going to see some big jump in the circulating virus. On the other hand , I think all bets are off by in towards the end of December because things are in flux. If this variant that we're seeing in Europe light up , if it starts to become a one that can induce a lot of hospitalizations , especially then by the end of December , we could start seeing that here. So we got to always keep up with the latest evolution of this virus. It's not done with us yet , but at least for now , at least through Thanksgiving and the good part of the early part of December , we're in pretty good shape. But , you know , whenever you are out there , you know , if you can stay away from large crowds indoors , especially in places that are indoors , not well ventilated , you know , not with the good filtration of air when you're in public transportation , airports , on flights , you know , don't give up on the things that we know work.

S1: I've been speaking with Dr. Eric Topol of the Scripps Research Translational Institute in La Jolla. Dr. Topol , as always , thank you so much for your insight.

S2: Thank you. Jade.