>> THANKS SO MUCH FOR JOINING US ONCE AGAIN ON NEXT UP.

RAY AND I ARE INTERVIEWING ANOTHER COMMUNITY LEADER.

AS YOU KNOW, COVID HAS BEEN AROUND LONG ENOUGH THAT THERE'S NOW A STUDY EXAMINING THE HEALTH EFFECTS OF REINFECTION AND OUR NEXT GUEST IS THE LEADER OF THAT STUDY.

HE'S DR. ZIYAD AL-ALY, DIRECTOR OF THE CLINICAL EPIDEMIOLOGY CENTER AT WASHINGTON UNIVERSITY HERE IN ST. LOUIS AND THE CHIEF OF RESEARCH AND DEVELOPMENT AT THE V.A.

DR. AL-ALY, THANK YOU FOR JOINING US ON NEXT UP.

>> THANK YOU FOR HAVING ME.

>> YOU'VE BEEN IN THE WASHINGTON POST, NPR, CNN, ALL OVER THE NEWS.

PEOPLE ARE WONDERING ABOUT REINFECTION.

YOU'RE THE GUY WHO'S DONE THE EXHAUSTIVE STUDY AND I THINK IF I COULD JUST GIVE A QUICK SUMMARY, IT'S THAT IF YOU GET REINFECTED, THAT'S NOT A TRIVIAL MATTER ACCORDING TO YOUR FINDINGS.

>> WELL, ABSOLUTELY NOT A TRIVIALAL MATTER.

WHAT WE'VE DONE HERE IS WE'VE ANALYZED DATA ON ABOUT 40,000 PEOPLE WHO HAD REINFECTION, MEANING MORE THAN ONE INFECTION, AND COMPARED THAT DATA, THE OUTCOMES TO PEOPLE WITH ONLY ONE INFECTION.

WHAT WE FOUND IS THAT PEOPLE WHO HAVE REINFECTION HAD A MUCH HIGHER RISK OF HEALTH OUTCOMES IN THE FIRST 30 DAYS AFTER THE INFECTION AND ALSO IN THE LONG HAUL.

SO REINFECTION ABSOLUTELY CONTRIBUTES ADDITIONAL RISKS OF HEALTH OUTCOMES, BOTH IN THE ACUTE PHASE, THE FIRST 30 DAYS AFTER YOU GET COVID-19 OR REINFECTED WITH COVID-19, AND ALSO IN THE LONG HAUL.

>> THAT IS SUCH AN INTERESTING FINDING BECAUSE I THINK A LOT OF PEOPLE FEEL -- LET ME ASK YOU, PUT IT IN THE FORM OF A QUESTION, DR. AL-ALY.

DO PEOPLE FALSELY HAVE A SENSE OF SECURITY THAT THEY ARE SOMEHOW MORE IMMUNE BECAUSE THEY WERE INFECTED ONCE?

>> ABSOLUTELY TRUE.

THIS IS ACTUALLY WHAT LED TO US THE STUDY BECAUSE IT'S HARD TO SEE PATIENTS COMING BACK, HEY DOCK, I'M VACCINATED, I'M BOOSTED, AND THEY ALSO GOT COVID.

THEY HAVE THIS AIR OF INVINCIBILITY WITH THEM.

I GOT COVID BEFORE, I GOT VACCINATED AND TWO DOSES OF BOOSTER, SO I HAVE HYPERIMMUNITY.

SOME PEOPLE REFER TO IT AS SUPER IMMUNITY.

IT'S GOING TO PROTECT ME 100%.

SO THEY HAVE THIS AIR OF SUPERIORITY AROUND THEM AND WE STARTED ASKING THE QUESTION, IT DOES REALLY MATTER FOR THEM IF THEY GOT REINFECTED, DOES REINFECTION IN THESE SPACES ADD RISK OR SHOULD SHE GO THE EXTRA MILE AND CONTINUE TO PROTECT THEMSELVES TO REDUCE THE RISK OF REINFECTION.

AND WHAT WE FOUND IS ABSOLUTELY YES.

REINFECTION ADDS RISK AND PEOPLE SHOULD DO THEIR BEST TO TRY TO CONTINUE TO PROTECT THEMSELVES.

>> IF I COULD FOLLOW UP REAL QUICKLY.

IS THERE ANY -- I MEAN, MESSAGE RECEIVED LOUD AND CLEAR.

IS THERE ANY ADDED IMMUNITY, JUST IN TERMS OF IMMUNITY, TO SOMEONE WHO HAD A VACCINE PLUS GETTING COVID, WE UNDERSTAND THE OUTCOME, BUT DO THEY HAVE ANY MORE PROTECTION AT ALL THAN SOMEBODY THAT JUST GOT THE VACCINE?

>> CERTAINLY PRIOR IMMUNITY, WHETHER IT'S VACCINE DERIVED OR ACTUALLY FROM A PRIOR VIRUS CONFERS SOME PROTECTION.

IT'S NOT ZERO AT ALL, BUT STILL IT'S BETTER TO NOT GET HIT BY A BUS THAN HAVING A MILDER HIT.

A SECOND INFECTION MIGHT BE MILDER THAN A FIRST INFECTION, BUT IT STILL CONTRIBUTES ADDITIONAL RISK AND IN SOME PEOPLE, IF THEY DODGED A BULLET AND DID NOT GET LONG COVID IN THE VERY FIRST INFECTION OR DID THE NO GET HOSPITALIZED OR DIE FROM THE VERY FIRST INFECTION, THAT'S NOT NECESSARILY THE CASE THAT THEY DODGE THE BULLET AGAIN WITH A SECOND INFECTION.

REALLY EVERY INFECTION WE FEEL IS ALMOST LIKE ROLLING IS DICE AGAIN.

MAYBE MILDER, YOU MIGHT GET MILDER INFECTION NOW, BUT YOU'RE STILL TAKING YOUR CHANCES AGAIN.

SO THE MESSAGE IS ABSOLUTELY, ABSOLUTELY, IF IT'S -- FOR PEOPLE TO TRY TO PROTECT THEMSELVES FROM BEING REINFECTED WITH SARS-CoV-2 OR WITH COVID-19.

>> AND YET IF YOU TAKE A LOOK AT THE NUMBERS RIGHT NOW, A LOT OF PEOPLE ARE TESTING POSITIVE FOR COVID-19.

THEY'RE GETTING INFECTED FOR THE FIRST TIME AND GETTING REINFECTED AND THE NUMBERS ARE PROBABLY LIAR BECAUSE MOST PEOPLE ARE TAKING THE DES PROBABLY HIGHER BECAUSE MOST ARE PROBABLY TAKING THE TEST AT HOME AND NOT REPORTING TO THE COUNTY.

YOU GO AROUND AND YOU FINE A LOT OF PEOPLE HAVE IT.

YET THE HOSPITALIZATIONS ARE NOT THAT HIGH.

WE HAD ABOUT 160,000 OF PEOPLE IN THE HOSPITALS WITH COVID IN JANUARY.

IT'S DOWN TO THE 30,000s RIGHT NOW, CORRECT?

>> THAT'S TRUE.

WE KNOW A LOT OF PEOPLE ARE GETTING REINFECTED, BUT LUCKILY, FORTUNATELY, THE NUMBER OF HOSPITALIZATIONS HAS NOT INCREASED DRAMATICALLY COMMENSURATE WITH THE NUMBER OF REINFECTION.

THAT'S A GOOD SIGN THAT THE NATURAL IMMUNITY THAT PEOPLE HAVE BILL UP FROM THE OMICRON SURGE AND THE NUMBER OF PEOPLE WHO ARE VACCINATED AND BOOSTED IS PROTECTING THE POPULATION IN GENERAL, BUT THAT PUSHES US INTO A SENSE OF COMPLACENCY OR NOT A BIG DEAL.

IT'S STILL A BIG DEAL.

GETTING REINFECTED ABSOLUTELY STILL A BIG DEAL.

WHILE ON AVERAGE THE NUMBER OF HOSPITALIZATIONS IS NOT SKYROCKETING FOR THE REASONS I JUST OUTLINED O AN INDIVIDUAL CASE BY CASE BASIS, IF YOU DODGED A BUT BLFR, IT DOES NOT MEAN NECESSARILY YOU'RE GOING TO DODGE THE BULLET AGAIN AND REALLY TO MINIMIZE ONE'S RISK AND THE RISK TO YOUR FAMILY AND PEOPLE AROUND YOU, IT'S ABSOLUTELY BETTER TO CONTINUE TO PROTECT YOURSELF AND REDUCE YOUR RISK OF REINFECTION.

>> IF I COULD JUMP IN REAL QUICKLY, I LOOKED AT THE STATS FOR THE CITY OF ST. LOUIS TODAY, AND AS OF TODAY, SINCE THE BEGINNING OF COVID, NOT ONE PERSON UNDER 19 HAS DIED OF COVID ACCORDING TO THE CITY'S WEBSITE AS OF JULY 13th, ACTUALLY.

THEY DIDN'T UPDATE IT FOR THE 14th.

SO MY QUESTION IS, I KNOW A LOT OF PEOPLE ARE TALKING ABOUT YOU HAVE TO BE CAREFUL, ESPECIALLY WATCH THE KIDS AND IF YOU'RE UNDER 5, YOU CAN GET THE VACCINATION RIGHT NOW, BUT HOW DANGEROUS IS THIS TO THE YOUNGSTERS OF OUR COUNTRY WHERE IN THE CITY OF ST. LOUIS, NOT ONE DEATH FOR SOMEONE UNDER 19 YEARS OLD?

>> SO YOU KNOW, YOUNGER PEOPLE, YOU KNOW, KIDS IN GENERAL WEATHER THE INFECTION MUCH BETTER THAN OLDER ADULTS AND ADULTS IN THEIR 80s AND 90s FOR SURE.

SO THE YOUNGER YOU ARE, THE MORE ABLE -- YOUR IMMUNE SYSTEM IS ABLE TO ADAPT THE INFECTIOUS AND DEAL WITH IT IN A BETTER WAY.

THAT'S NOT TO SAY THAT THE YOUNGER KIDS CANNOT FALL SEVERELY ILL AND GET HOSPITALIZED AS A RESULT OF SARS-CoV-2 INFECTION OR COVID-19 OR CANNOT EVEN DIE FROM IT OR ALSO DEVELOP LONG COVID.

SO WHILE THE STATISTICS IN THE CITY OF ST. LOUIS DON'T SHOW IT, IT IS ABSOLUTELY THERE AND THE GENERAL RECOMMENDATION IS FOR KIDS TO BE VACCINATED NOWADAYS AND THAT PROTECTS AGAINST SEVERE DISEASE IN THE ACUTE PHASE AND ALSO REDUCES THE RISK OF LONG HAUL COVID OR LONG COVID.

>> LET'S TALK ABOUT LONG HAUL COVID BECAUSE THE LAST I HEARD, ALMOST BY DEFINITION, IT'S HARD FOR THE MEDICAL PROFESSIONALS, THE HEALTHCARE PROFESSIONALS OR THE PUBLIC HEALTH OFFICIALS TO REALLY BE ABLE TO PREDICT THAT BECAUSE THERE HASN'T BEEN ENOUGH TIME.

GIVEN YOUR EXPERTISE AND THE ADDED INFORMATION YOU'RE GETTING, HOW LONG WILL IT TAKE US TO REALLY UNDERSTAND THE SEVERITY AND THE DANGERS OF LONG COVID?

>> SO WE ALREADY ESTIMATED LONG COVID IS ANYWHERE BETWEEN, YOU KNOW, 4 TO 7% OF PEOPLE WHO HAD COVID-19 IN THE UNITED STATES.

SOME PEOPLE LOOK AT THESE NUMBERS AND SAY THESE OF SINGLE-DIGIT PERCENTAGES, BUT MULTIPLY THAT BY THE NEARLY 200 MILLION PEOPLE WHO HAD COVID-19.

THAT'S MILLIONS AND MILLIONS OF PEOPLE THROUGHOUT THE U.S. WHO HAVE LONG COVID.

WE ALREADY KNOW THIS IS A NATIONAL HEALTH CRISIS AND IT NEEDS TO BE DEALT WITH HEAD-ON.

THERE ARE A LOT OF THINGS THAT WE'VE LEARNED ABOUT LONG COVID OVER THE PAST COUPLE YEARS, BUT A LOT OF THINGS REMAIN TO BE UNDERSTOOD AND REMAIN TO BE LEARNED.

I THINK THERE NEEDS TO BE GREATER REALIZATION ON A NATIONAL LEVEL THAT THIS IS REALLY A SIGNIFICANT PUBLIC HEALTH CRISIS AND WE NEED TO MARTIAL RESOURCES TO MAKE SURE WE UNDERSTAND LONG COVID BETTER AND MOST IMPORTANTLY, WHAT WE HEAR FROM LONG COVID PATIENTS THROUGHOUT THE NATION, NOT ONLY IN ST. LOUIS, BUT EVERYWHERE, THAT THEY'RE REALLY CRYING AND SCREAMING FOR TREATMENTS YESTERDAY, NOT TODAY.

THEY'RE HURTING IN THEIR BED, THEY'RE HURTING AT HOME.

SOME ARE THEM ARE INCAPACITATED WITH EXTREME FATIGUE, DISABLING FATIGUE, OR BRAIN FOG.

THEY LOST THEIR JOB, THEY CANNOT FUNCTION, THEY CAN'T DO THEIR JOB.

THESE PATIENTS ARE CRYING FOR HELP AND NEEDING TREATMENT YESTERDAY, NOT TODAY.

WE NEED A SENSE OF URGENCY TO UNDERSTAND THE PROBLEM WHAT IT IS.

IT IS A NATIONAL HEALTH CRISIS.

THIS IS REALLY THE PANDEMIC AFTER THE PANDEMIC, WHEN SORT OF THIS WHOLE BROUHAHA ABOUT COVID RECEDES AND COVID IS NO LONGER A PANDEMIC AND GOES INTO EPIDEMIC STATE OR SORT OF A MORE CONTROLLED STATE OF INFECTIONS AND, YOU KNOW, EVOLUTION, WE'RE GOING TO BE LEFT WITH THE LEGACY OF COVID AND THAT IS LONG COVID.

AND LONG COVID ARGUABLY IS REALLY THE LEGACY THAT'S GOING TO REMAIN FOR A LONG, LONG TIME.

WHAT WE ALSO KNOW ABOUT LONG COVID RIGHT NOW IS THAT IT'S NOT ONLY BRAIN FOG AND FATIGUE AND THOSE THINGS COULD BE REVERSIBLE WITH TIME, BUT IT ALSO CAN INDUCE STATES OF DIABETES, KIDNEY DISEASE, HEART DISEASE.

THOSE DISEASES ARE MANAGEABLE, BUT THEY'RE NOT CURABLE.

THEY WILL STICK WITH PEOPLE FOR A LIFETIME, SO PEOPLE WILL BE SCARRED FOR A LIFETIME BY THE CONSEQUENCE OF LONG COVID.

>> YOU WERE QUOTED IN THE WASHINGTON POST THIS WEEK BY SAYING THAT RIGHT NOW WE'RE KIND OF IN THE WILD WILD WEST IN THE UNITED STATES WHEN IT COMES TO COVID.

YOU'RE KIND OF ON YOUR OWN.

GOVERNMENT IS NOT DOING MUCH OF ANYTHING.

DON'T EVEN HAVE TO WEAR A MASK ON AN AIRPLANE.

THE TOPICS OF DISCUSSION THESE DAYS ARE UKRAINE AND THE PRICE OF GASOLINE AND COVID IS REALLY ON THE BACK BACK BURNER.

DO YOU THINK THAT OFFICIALS AT THE COUNTY OR STATE OR FEDERAL LEVEL SHOULD BE DOING MORE NOW THAN THEY CURRENTLY ARE?

>> I PERSONALLY THINK THAT THEY DEFINITELY SHOULD BE DOING MORE AND I THINK WE SORT OF TRANSFERRED RESPONSIBILITY OVER THE PAST SEVERAL MONTHS, THE PUBLIC HEALTH RESPONSIBILITY OF PROTECTING PEOPLE, PROTECTING CITIZENS, TO INDIVIDUAL RESPONSIBILITY.

WHAT THAT REALLY DOES IS ALMOST DIVIDES US INTO TWO SEGMENTS OF SOCIETY, THOSE PEOPLE WHO CAN AFFORD TO PROTECT THEMSELVES, CAN AFFORD TO WORK AT HOME, THEY HAVE VIRTUAL JOBS OR THEIR JOBS ARE FLEXIBLE, CAN AFFORD TO WORK FROM HOME OR WEAR A MASK AND DO ALL THOSE PROTECTIONS, AND THOSE PEOPLE WHO ARE NOT.

THE VULNERABLE PEOPLE WHO ARE GOING TO THE GROCERY STORE, EXPOSED TO OTHER PEOPLE AND, YOU KNOW, IMMUNE COMPROMISED, PEOPLE WITH CANCER OR PEOPLE FRANKLY WHO DON'T HAVE JOBS THAT AFFORD THEM THE ABILITY TO REALLY MASK UP AND ALL OF THAT.

AND I THINK THAT'S GOING TO REALLY FURTHER SORT OF CREATE EVEN MORE DISPARITIES THAN WE'VE SEEN WITH COVID-19.

I DO THINK THAT THERE IS A -- IT IS THE RESPONSIBILITY OF PUBLIC HEALTH SYSTEMS TO REALLY PROTECT THE PEOPLE AND WE KNOW THAT THE PANDEMIC IS STILL HERE.

THE PANDEMIC IS NOT OVER YET, BUT YET, WE SORT OF BEHAVE AS IF IT'S ALL BEHIND US AND WE MOVE ON.

NO MASKING MANDATES, NO NOTHING.

THERE'S ZERO PROTECTION RIGHT NOW.

WE TRANSFERRED ALL THAT TO INDIVIDUAL RESPONSIBILITY AND THAT'S REALLY NOT THE OPTIMAL STATE OF BEING.

>> WHEN YOU WENT INTO THIS VALIANT PROFESSION OF EPIDEMIOLOGY, I'M GOING TO GUESS YOU WEREN'T EXPECTING ANYTHING LIKE COVID, RIGHT?

>> OH NO, ABSOLUTELY NOT.

>> DID YOU EVER THINK YOU'D BE DEALING WITH SOMETHING CALLED COVID FATIGUE WHERE EVERYBODY JUST KIND OF WANTS IT TO GO AWAY, EVEN THOUGH IT HASN'T?

>> NO, THAT IS NOT OUR EXPECTATION.

WE ACTUALLY FRANKLY DID NOT THINK THAT THE PANDEMIC IS GOING TO LAST THAT LONG, BUT I ALSO UNDERSTAND IT.

EVEN MYSELF, ALL OF US ARE, QUOTE-UNQUOTE, SICK AND TIRED THEREFORE AND WANT THIS BEHIND US.

SICK AND TIRED OF MASKING, SICK AND TIRED OF THESE LOCKDOWN MEASURES, ETCETERA.

NO ONE WANTS TO GO BACK, BUT WE'RE TRYING TO SAY THE RISK IS STILL HERE.

WE NEED TO FIND INTELLIGENT WAYS OF COPING WITH THE RISK AND MITIGATING IT TO THE EXTENT POSSIBLE IN EFFECTIVE WAYS, SO MASKING IS A VERY SMALL MEASURE THAT PROTECTS A LOT OF PEOPLE AND HAS NO ASSOCIATED COST, YOU KNOW, THAT'S SORT OF RELATED TO IT OR SERIOUS COSTS RELATED TO IT.

SO WE THINK MEASURES LIKE THAT SHOULD BE -- SHOULD BE AT LEAST ADVISED.

MAYBE NOT MANDATED, BUT ADVISED TO TRY TO PROTECT AS MANY PEOPLE AS POSSIBLE.

>> DO YOU ALSO THINK THAT BEFORE THERE'S A MEETING, ALL PARTICIPANTS IN THE MEETING, IF THE MEETING IS IN-PERSON OF COURSE, SHOULD TAKE SOME SORT OF COVID TEST?

>> WELL, YOU KNOW, EITHER THAT OR AT LEAST SOME LEVEL OF, YOU KNOW, PROOF OF VACCINATION OR -- TO TRY TO REDUCE THE RISK TO THE EXTENT POSSIBLE BECAUSE WE NOW KNOW THAT THE VIRUS IS STILL OUT THERE, PEOPLE ARE -- PEOPLE ARE GETTING REINFECTED, REINFECTION ADDS RISK, IT'S NOT ZERO.

ALL THAT TELLS FEE IF WE ARE SERIOUS ABOUT PROTECTING PEOPLE IN THE LONG RUN AND TRYING TO PROTECT THE HEALTH OF THE PUBLIC, THEN SOME MEASURES NEED TO BE IN PLACE TO TRY TO MAKE SURE WE ACHIEVE THOSE GOALS.

>> AND -- GO AHEAD.

>> I WAS GOING TO SAY, ISN'T THERE A COST TO ALL OF THIS?

IF PEOPLE ARE CONCERNED ABOUT THE PANDEMIC, THAT'S RIGHT IN A TRUE MEDICAL SENSE, BUT I THINK IT WAS THE "NEW YORK TIMES" OR THE "WALL STREET JOURNAL" LAST WEEK THAT SAID THE SALES OF ANTIDEPRESSANTS ARE NOW OR OF THE CHARTS.

THINK I THERE'S A LOW GRADE ANXIETY ACROSS THE LAND RIGHT NOW AND PEOPLE ARE WALKING AWAY WITH ALL THE PROTECTIVE MEASURES OF COVID BECAUSE THEY ASSOCIATE IT WITH A VERY BAD TIME.

>> OH, ABSOLUTELY.

WE'VE ACTUALLY DONE RESEARCH ON MENTAL HEALTH AND PEOPLE WITH COVID AND WE CAME INITIALLY WITH THIS UNDERSTANDING THAT ALL OF US DURING THIS PANDEMIC SUFFERED LOSS OR, YOU KNOW, KNOW NOBODY WHO GOT SICK OR DIED OR ALL OF US IN THIS PANDEMIC WERE UNDER SEVERE STRESS OR SOME SORT OF STRESS.

MAYBE NOT VEER STRESS, BUT SOME SORT OF STRESS.

WE ASKED THE QUESTION IN THE STUDY, DO PEOPLE WHO GET COVID, DO YOU HAVE IT WORSE WITH THE MENTAL HEALTH DISORDERS?

THE ANSWER IS ABSOLUTELY YES.

COMPARED TO EVERYONE ELSE WHO ENDURED THE CONDITIONS OF THE PANDEMIC, THE LOCKDOWN, THINGS ARE CLOSED NO, GYM, NO VISITING FRIENDS, BEING AT HOME, QUARANTINING, ALL THOSE CONDITIONS THAT PEOPLE ENDURED, STILL THE PEOPLE WHO GOT COVID-19, PEOPLE WHO ACTUALLY GOT INFECTED WITH THE VIRUS FARED MUCH, MUCH, MUCH WORSE IN TERMS OF MENTAL HEALTH DISORDERS, ANXIETY, DEPRESSION, SUICIDAL IDEATION, PTSD.

SLEEP PROBLEMS, REALLY SLEEP PROBLEMS TO THE POINT THAT PEOPLE WERE PUTTING THESE PATIENTS ON SLEEP MEDICATIONS, ANTIDEPRESSANTS AND ALSO USE ZORZS.

WE ARE A NATION IN DISTRESS.

WHAT HAPPENED TO US OVER THE PAST TWO YEARS IS NOT A CAKE WALK, ABSOLUTELY NOT A CAKE WALK, SO WE ARE A NATION IN DISTRESS.

WE'RE ALL DISTRESSED.

YOU SEE THAT IN THE NUMBER OF SUICIDES, THE CRAZY ACTS, NUMBER OF ANTIDEPRESSANTS BEING PRESCRIBED, THE SLEEP MEDICATIONS BEING PRESCRIBED.

SO THE METRICS ARE OUT THERE, ABSOLUTELY GLARING AS A SUN, WE'RE A NATION IN DISTRESS.

BUT YOU KNOW MORE IN DISTRESS?

THE PEOPLE WHO GOT COVID-19, THE PEOPLE WHO GOT REINFECTED WHO HAD A HIGHER RISK OF MENTAL HEALTH PROBLEMS.

THE IDEA THERE IS TO STILL PROTECT PEOPLE.

WE DEFINITELY DON'T WANT TO GO BACK TO AN ENVIRONMENT OR A DAY WHERE THERE'S LOCKDOWNS AND QUARANTINES AND FOR GYMS AND PEOPLE ARE LOCKED IN THEIR HOUSES.

NOBODY IS SAYING THAT, BUT SOME REASONABLE MEASURES OF PROTECTION.

EVEN MANDATING OR, YOU KNOW, REQUIRING FOR SURE MASKING, BUT SUGGESTING IT, ADVISING PEOPLE THAT REINFECTION CARRIES RISK, YOU NEED TO KNOW ABOUT IT, MASK UP IF YOU'D LIKE TO.

OFFERING THE PEOPLE THAT OPTION I THINK IS DEFINITELY WISE AND IMPORTANT.

>> WHEN YOU EPIDEMIOLOGISTS TALK AMONG YOURSELVES, HOW HIGH IS THE FRUSTRATION LEVEL, IF YOU CAN COMMENT, WITH THE POLITICIZATION IN ANY RESPECT AND THE CONTINUED INABILITY OF AMERICA AS A NATION, AS A PEOPLE, TO COME TOGETHER SOMEHOW AND NOT HAVE CONFLICT ABOUT THIS?

>> ENORMOUS FRUSTRATION.

WE THINK ONE OF THE REASONS LIKE AMERICA HAS GENERALLY FAILED IN ITS RESPONSE TO THE PANDEMIC IS EXACTLY THE POLITICIZATION OF THIS AND ACTUALLY THE VIRUS DOES NOT KNOW BLUE AND RED.

THE VIRUS IS INDISCRIMINATELY HITTING ALL OF US WHETHER YOU'RE BLUE OR RED, WHICHEVER PARTY YOU BELONG TO OR WAY OF THINKING YOU BELONG TO, THE VIRUS INDISCRIMINATELY HITS ALL OF US.

BUT IT WAS POLITICIZED AND THAT CARRIED THROUGH IN THE PANDEMIC AND AS A RESULT, REALLY HAS CAUSED US TO MOUNT A SUB OPTIMAL PUBLIC HEALTH RESPONSE IN GENERAL.

AFTER ALL, WE'RE TALKING ABOUT THE PANDEMIC AND COVID AND LONG COVID, WE NEED TO REMEMBER THE MILLION PEOPLE WHO DIED AND A LOT OF THEM, MORE THAN 300,000 OF THEM DIDN'T NEED TO DIE IF THEY HAD BEEN VACCINATED.

THAT'S AN IMPORTANT STUDY FOR PEOPLE TO REMEMBER.

CERTAINLY THIS IS A MASSIVE FAILURE OF PUBLIC HEALTH RESPONSE AND CREATES A LOT OF FRUSTRATION.

>> IF SOMEONE IS DOUBLE VACCINATED AND BOOSTED, I'M THINKING OF SOMEONE IF PARTICULAR, SHOULD THAT PERSON WAIT TO THE FALL TO GET A SECOND BOOSTER WHEN PEOPLE START GOING INDOORS MORE OR GET ONE NOW?

GHOO NO, IF THEY QUALIFY FOR ONE NOW, DEPENDING ON THE SCHEDULE WHEN THEY GOT THEIR THIRD DOSE, THAT BOOSTER, IF THEY QUALIFY FOR IT NOW, ABSOLUTELY GET IT NOW.

DON'T WAIT FOR THE FALL.

>> BUT WILL IT COVER ALL THESE NEW SUBVARIANTS?

>> NO, THE CURRENT VACCINES ARE DESIGN FOR THE ORIGINAL STRAIN.

HOWEVER, HOWEVER, IF A PERSON IS DUE FOR A VACCINE NOW AND THEY'VE ACTUALLY IN THE WINDOW WHERE THEY COULD GET REINFECTED, AND THE BEST THING THEY CAN DO FOR THEMSELVES IS TO TRY TO PROTECT THEMSELVES NOW AND NOT WAIT TILL THE FALL.

MAYBE IN FALL WHEN THERE ARE NEW VACCINES AVAILABLE FOR BA.4 AND BA.5, THEY CAN GET ANOTHER DOSE.

BUT SHALL, ABSOLUTELY, IF YOU'RE DUE FOR A VACCINE NOW, DON'T WAIT TILL OCTOBER OR NOVEMBER.

GET IT NOW IN JULY OR AUGUST.

THE NUMBERS ARE SURGING, NUMBERS ARE GOING ON, AND HOSPITALIZATIONS LUCKILY, FORTUNATELY, HAS NOT CLIMBED DRAMATICALLY HIGH NOW, BUT THERE'S NO GUARANTEE THAT ISN'T GOING TO BE THE CASE IF TWO T THREE, FOUR, SIX CAKWEEKS.

SO ABSOLUTELY, IF YOU'RE IN THE WINDOW TO RECEIVE A BOOSTER, ABSOLUTELY GET IT NOW.

>> FOR ALL YOUR EFFORTS AND YOUR PROFESSION, I REALLY THINK -- AND I SPEAK FOR MYSELF.

I THINK THERE'S A LOT OF CONFUSION RIGHT NOW AS TO WHAT THE RULES ARE.

IN OTHER WORDS, I HAD MY FOURTH, IN FACT ONE OF YOUR COLLEAGUES AT WASH-U SHAMED ME ON THE AIR BECAUSE I HADN'T DONE IT, BUT FOR EXAMPLE, FOR KIDS UNDER 18 OR 16, ARE WE TO THE POINT THEY SHOULD HAVE A FOURTH ONE OR JUST A THIRD ONE?

I THINK THERE'S A LOT -- I GUESS -- LET ME MAKE THIS MORE CONCISE.

WHERE DO PEOPLE GO TO UNDERSTAND THIS?

>> SO USUALLY THE CDC WEBSITE, BUT FOR YOUNGER FOLKS NOW, IT'S IT'S STILL NOT AUTHORIZED.

THE FDA IS CONSIDERING AND ANYTIME NOW IN THE NEXT FEW DAYS, THEY WILL PROVIDE GUIDANCE FOR VACCINATION FOR THE FOURTH DOSE IN YOUNGER ADULTS.

NOW IT'S APPROVED FOR ONLY OLDER ADULTS AND THAT'S AN IMPORTANT DISTINCTION.

BUT SOON ENOUGH, IN THE NEXT FEW DAYS, EXPECT IT NEXT WEEK, THE FDA WILL GO OUT WITH AN ANNOUNCEMENT TO -- AND SUBSEQUENTLY THE CDC, TO APPROVE THAT FOURTH DOSE IN YOUNGER ADULTS.

>> IF SOMEONE CAN'T REMEMBER MAYBE WHAT THEIR -- THEY LOST TRACK OF MAYBE IN A LARGE FAMILY, CAN PEOPLE FIND OUT, IS THERE A CENTRAL INFORMATION REGISTRY OR IS THERE SOME WAY YOU CAN FIND OUT IF YOU'VE HAD THREE OR FOUR?

>> THEY HAVE THEIR CARDS, RIGHT?

>> THEY HAVE THE CARD, BUT LET'S JUST SAY THE CARD -- >> IS LOST.

>> -- IS LOST.

THERE IS A WAY TO FIND OUT?

>> USUALLY WHERE THEY RECEIVE THEIR VACCINES, THEY HAVE A RECORD.

IF THEY RECEIVE THE STREAK AT WASH-U OR CVS OR ST. LOUIS UNIVERSITY, YOU CAN GO BACK TO WHERE YOU GOT THE VACCINE AND HOPEFULLY IT'S ONE PLACE.

HOPEFUL IT'S WASH-U OR SLU OR THE V.A.

OR CVS.

WE HAVE A LOT -- OH, I LOST MY VACCINE CARD AND I NEED TO FLY.

ACTUALLY BACK WHEN YOU NEEDEDOR CARD TO FLY, THE HEALTHCARE FACILITY WHERE YOU RECEIVE THE VACCINE WOULD BE ABLE TO SUPPLY YOU WITH A REPLACEMENT CARD.

>> THAT HAPPENED TO A COLLEGE STUDENT WHO SHALL REMAIN NAMELESS AND THANKS TO THE MEDICAL CENTER, WE WERE ABLE TO GET ANOTHER CARD.

>> YOU SAY I LOST MY CARD AND I NEED IT, YOU GO BACK TO THE COMPUTER SYSTEM AND REPRODUCE THAT CARD.

THAT'S DOABLE.

>> YOU SAID YOU CONDUCTED AN EXHAUSTIVE STUDY, TENS OF THOUSANDS OF PEOPLE AND YOU LOOK AT REINFECTION.

YOU FOUND OUT THAT GETTING REINFECTED IS NOT A TRIVIAL ISSUE, IT COULD HAVE SERIOUS ISSUES.

DO THE REINFECTIONS AND THE HEALTH PROBLEMS ASSOCIATED WITH IT OCCUR MORE OFTEN WITH PEOPLE WHO MIGHT BE OVERWEIGHT, HAVE DIABETES, HEART ISSUES, AND IF THAT'S THE CASE, SHOULD THERE BE A NATIONAL PROGRAM, AS IF WE DON'T HAVE ENOUGH PROGRAMS ALREADY, BUT SOME EFFORT TO GET PEOPLE IN SHAPE?

AN ANTI-OBESITY PROGRAM FOR KIDS OR LET'S GET IN SHAPE LIKE GEORGE ALLEN AND THE NATIONAL COUNCIL OF FITNESS OR SOMETHING?

>> THIS IS AN IMPORTANT QUESTION.

THIS IS NOT RANDOM.

PEOPLE WHO GET REINFECTED ARE IMMUNE COMPROMISED, HAVE IMMUNE DYSFUNCTION, HAVE CANCER, KIDNEY DISEASE, OBESITY, PEOPLE HAVE SOME LEVEL OF RISK FACTORS THAT PREDISPOSE THEM.

IT'S NOT RANDOM.

THAT'S NOT TO SAY WE DON'T SEE AN 18-YEAR-OLD WHO'S PREVIOUSLY HEALTHY, ATHLETIC, DOING WELL, ON THEIR SECOND OR THIRD INFECTION AND GETTING ILL FROM IT.

THAT'S ABSOLUTELY THE CASE.

WE SEE 20-YEAR-OLD OR 25-YEAR-OLD PEOPLE IN ON A VENTILATOR IN ICU AFTER REINFECTION.

WE'RE NOT SAYING THAT DOESN'T HAPPEN, BUT REINFECTION ABSOLUTELY IS NOT RANDOM.

GENERALLY THE OLDER ADULTS, SICKER INDIVIDUALS, PEOPLE WITH IMMUNE DYSFUNCTION, DIABETES, KIDNEY DISEASE, OBESITY, AND I THINK ONE OF THE REASONS AMERICA GOT HIT HARD BY THE PANDEMIC AND ARGUABLY TO A MUCH BIGGER DEGREE THAN A LOT OF OTHER COUNTRIES, WE WENT INTO THIS PANDEMIC AS A SICK NATION.

WE WENT INTO THIS PANDEMIC WITH VERY HIGH RATES OF DIABETES, VERY HIGH RATES OF OBESITY, VERY HIGH RATES OF CARDIOVASCULAR DISEASE AND WE SIMPLY EAT TOO MUCH AND DON'T EXERCISE AS MUCH.

WE DON'T HAVE PROGRAMS TO MAKE SURE WE ARE A FIT PARTICIPATION.

WE WENT INTO THIS GREAT CHALLENGE, PROBABLY THE BIGGEST CHALLENGE IN THE 21st CENTURY SO FAR, UNFIT, OBESE, EATING TOO MUCH, NOT EXERCISING MUCH WITH HIGH RATES OF DIABETES, HEART DISEASE, SO DEFINITELY IF WE WANT TO DRAW ONE OF THE MAJOR LESSONS OF THIS PANDEMIC, YOU KNOW, HOPEFULLY IT WOULD BE MORE FOCUSED ON PREVENTIVE EFFORTS AND EFFORTS TO REDUCE COMORE DID DISEASES, TRY TO MANAGE PEOPLE'S -- COMORBID DISEASES, MANAGE PEOPLE'S OBESITY, EXERCISE MORE AND LOSE WEIGHT AND PREVENT CARDIOVASCULAR DISEASE, PREVENT KIDNEY DISEASE, AND IF WE'RE FACED WITH ANOTHER CHALLENGE IN 10, 20, 30 -- HOPEFULLY ABSOLUTELY NOT, BUT IF WE'RE FACED WITH A CHALLENGE AGAIN, WE CAN FACE IT WITH A HEALTHIER NATION WOULD LEAD TO BETTER OUTCOMES.

>> IF SOMEONE IN OUR NINE PBS AUDIENCE HAS HAD RE INFECTIINFECTIO INFECT IOINFECTION OR KNOWS A LOVED ONE, FRIEND, PROBABLY HAS HAD ONE, PROBABLY JUST REACHED FOR AN EXTRA GLASS OF WINE IF THEY WERE LISTENING TO THIS, WHAT WOULD YOU SAY THE NEXT THING THEY SHOULD DO IS?

WHAT WOULD YOU RECOMMEND IS WHAT I SHOULD DO TOMORROW?

>> IF PEOPLE GOT REINFECTED AND WE NOW KNOW THANKS TO AMERICAN MEDICINE AND THE WONDERFUL SCIENTIFIC WORK THAT HAS BEEN DONE OVER THE LAST FOR TWO YEARS, WE HAVE ANTIVIRALS.

IF THEY QUALIFY FOR PACKS LOAF INDIVIDUAL, MEANING -- PACKS LOAF INDIVIDUAL, WE KNOW THAT TREATMENT REDUCES THE RISK OF HOSPITALIZATION AND DEATH.

ABSOLUTELY REDUCES THE RISK OF SEVERE DISEASE, BUT MUST BE TAKEN IN THE FIRST FIVE DAYS OF ENCOUNTERING THEIR INFECTION.

LET'S SAY SOMEBODY GOT INFECTED YESTERDAY AND IF THEY'RE FEELING SICK, THEY HAVE FEVER, THEY TEST THEMSELVES AT HOME AND THEY TEST POSITIVE FOR COVID-19, SHE THEY SHOULD BE CALLING THEIR DOCTOR.

CAN I GO TO CVS AND PICK UP THE MEDICATION BECAUSE IF THEY QUALIFY FOR IT, IT CAN REDUCE THEIR RISK OF BEING PUT IN THE HOSPITAL AS A RESULT OF REINFECTION, OR EVEN WORSE, DYING FROM IT AS A RESULT OF REINFECTION.

FOR PEOPLE WHO GOT REINFECTED, HOPEFULLY THEY WON'T GET REINFECTED, BUT FOR PEOPLE WHO ALREADY HAD THAT HAPPEN TO THEY WILL IN THE PAST SEVERAL DAYS, IT'S VERY IMPORTANT TO REACH OUT TO THEIR DOCTOR AS SOON AS POSSIBLE AND INITIATE TREATMENT AS SOON AS POSSIBLE.

>> DR. ZIYAD AL-ALY, THANK YOU VERY MUCH FOR ALL THE GREAT WORK YOU DO AT THE V.A.

HERE IN ST. LOUIS AND AT THE WASH-U MEDICAL SCHOOL AND THANKS FOR JOINING RAY AND ME HERE ON NEXT UP ON NINE PBS.

>> THANK YOU FOR HAVING ME.

>> THANK YOU SO MUCH.

THANKS, EVERYBODY.

THANK YOU VERY MUCH.

>> Announcer: DONNYBROOK IS MADE POSSIBLE BY THE SUPPORT OF THE BETSY AND THOMAS PATTERSON FOUNDATION AND THE MEMBERS OF NINE PBS.