COVID: What comes next - With Dr. Ashish Jha

By: COVID: What comes next - With Dr. Ashish Jha
  • Summary

  • Long before COVID, Dr. Ashish Jha was an internationally respected expert on pandemic response and preparedness. In September 2020, Jha left his position as faculty director of the Harvard Global Health Institute and became dean of the Brown University School of Public Health. Jha is a regular contributor to CBS News, ABC News, The New York Times, The Washington Post, NPR, CNN, MSNBC, TODAY, and other media outlets.  

    Every week here, Jha, a practicing physician and scientist, will analyze events of the previous several days and offer his assessment and guidance for what lies ahead for the U.S. and the world. This exclusive podcast is hosted by G. Wayne Miller, healthcare reporter with the Providence Journal and the USA TODAY NETWORK. 

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Episodes
  • Welcome to Episode 41 of “COVID: What comes next,” an exclusive weekly Providence Journal/USA TODAY NETWORK podcast featuring Dr. Ashish Jha, dean of the Brown University School of Public Health and an internationally respected expert on pandemic response and preparedness
    Jan 21 2022

    PROVIDENCE – The numbers indicate that the latest COVID surge has peaked, according to pandemic expert Dr. Ashish Jha, and while the next couple of weeks “are the critical time,” the nation as a whole can expect a better February than this January, when the Delta and omicron variants have combined to deal a coast-to-coast punishing blow. 

    Looking further ahead, Jha foresees the likely emergence of more variants but maintains that the country has the tools needed to protect health. And Jha, dean of Brown University’s School of Public Health, said most experts believe COVID will become “a seasonal virus” enabling people to move mindsets away from the crisis mode of the last nearly two years and into a less stressful mentaility. 

    “So here we are on January 20th recording this and the good news is that the national surge has peaked,” Jha said Thursday during recording of the latest “COVID: What Comes Next” podcast. “I think the peak number was probably sometime in the last couple of days and we are going to see what I hope is a rapid decline down.” 

    Geographical differences remain, however, Jha said. 

    “Let me put some caveats on it,” he said. “Some places like Rhode Island probably peaked about a week ago. But lots of other places in America have not peaked yet… But nationally, I think we have peaked and we are starting our descent. To be clear, there are a lot of infections ahead. If you think about a peak, you're going to get as many people infected on the downturn as you did on the way up.   

    “So if you've not gotten infected yet, consider yourself lucky and be really careful for the next couple of weeks because I think the next couple of weeks are the critical time. My guess is after that it's going to really get down to pretty low numbers… the good news is we can see the end of this surge in front of us.” 

    Jha said now is the time to prepare for possible new variants. 

    “Once we get out of this surge and life begins to return more to a normal phase with low infection numbers and high vaccination rates, especially here in New England, we’ve got to start preparing like crazy for the next surge,” Jha said. “I don't know if it's going to come. I don't know when it's going to come. I don't know what the variant will be. I don't know where it'll begin, just like none of us predicted omicron specifically.” 

    But, the physician said, “we should assume that we're going to have more variants… so when it hits we're going to be ready to go. There's a whole series of things that need to be done: Plenty of testing, plenty of masks, making sure that we continue plugging away on vaccinations. All these things will help us be ready.” 

    Jha does not expect COVID to disappear, but with the passage of time, its presence will be experienced differently, he asserted. 

    “Most of us believe this will eventually become much more of a seasonal virus,” Jha said. “I don't know that we're ready to quite declare victory and call it a seasonal virus yet, and so for the next year or two I suspect we're going to have to continue managing this in a very aggressive way and knowing that we can get outbreaks at any time. 

    “That said, that shouldn't scare people. We have to do a mental shift away from thinking about this as an acute pandemic -- where ‘my God, it dominates our lives, my God we've got to think about COVID and talk about COVID all the time' -- toward a new mental model where, ‘yeah, it's around; yeah, it's going to be a problem; yeah, we need to deal with it, but we have all the tools and it's not going to disrupt our lives the same way.’ ” 

     

     

    This is the 41st episode of the “COVID: What Comes Next” podcast, begun in October 2020 and available exclusively from The Providence Journal and the USA TODAY NETWORK. It is hosted by Providence Journal health reporter G. Wayne Miller, who has covered the pandemic since January 2020.

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    8 mins
  • Welcome to Episode 40 of “COVID: What comes next,” an exclusive weekly Providence Journal/USA TODAY NETWORK podcast featuring Dr. Ashish Jha, dean of the Brown University School of Public Health and an internationally respected expert on pandemic response and preparedness
    Dec 28 2021
    PROVIDENCE – As difficult as COVID-19 has made this December with omicron now the dominant variant, “we are looking toward a month of January when we’re just going to see an extraordinary number of infections across all of the country,” Dr. Ashish Jha, dean of Brown University’s School of Public Health, said on Tuesday.  “As it has been throughout, the pandemic is going to hit different parts of the country at different times,” jha said. “We're seeing pretty substantial increases in the Northeast. We're seeing Florida’s numbers just skyrocket. We're seeing this really in Los Angeles. New York City has been one of the epicenters in the U.S. So we're really seeing this across the country.”  Jha said that while the number of reported new cases has hit record levels, the true numbers are likely even higher.  “I actually think we're way under-counting,” he said. “Because of the holidays, people are not testing. Lot of states are not reporting. So I would argue that right now, we have more people infected in America than at any moment during the entire pandemic, no question about it. In my mind, this is pretty staggering. And we are not anywhere near peak infection.”  According to The New York Times on Monday, 543,415 new cases were reported in the U.S. based on the latest data, with a daily average of 243,099. Rhode Island, according to The Times, had a daily average of 1,382 new cases with a positivity rate of 130 per 100,000, fifth highest in the nation, after Washington, D.C., New York, New Jersey and Puerto Rico.  https://www.nytimes.com/interactive/2021/us/covid-cases.html In Rhode Island, as elsewhere in the nation, the strain on hospitals concerns Jha, who spoke during recording of the latest “COVID: What Comes Next” podcast.  “All of our major hospitals are incredibly stressed largely because of staffing shortages, because of nursing shortages,” Jha said. “So I am very worried about both the cases we saw just before Christmas and what will happen over the Christmas and New Year's holidays in terms of the number of new infections. Even if it turns out that Omicron is milder, which it probably is, there will still be enough new infections to really cause a serious problem.”  https://www.providencejournal.com/story/news/coronavirus/2021/12/11/covid-fourth-wave-rhode-island-hospitals-short-staffed-omicron-ri/6461357001/    Jha and others on many occasions have urged people to get vaccinated and boosted when eligible. Experts also have repeatedly advised people to wear masks in many settings, particularly indoors; limit the size of gatherings; make provisions for proper ventilation, and continue hand-washing. These measures can also help prevent influenza and other diseases.  Isolation after testing positive has also been advised -- and on Monday, the Centers for Disease Control and Prevention issued new guidelines. Among them is shortening the time that infected patients should isolate from ten to five days after a positive result.   https://www.usatoday.com/story/news/health/2021/12/27/omicron-airlines-cancel-flights-covid-updates/9021308002/    Overall, Jha said he agrees with the new guidance.  “I'm in favor of the CDC changes, but I understand that not everybody loves them,” he said.   Looking deeper into 2022 and beyond, Jha said “there is no question in my mind that COVID-19 is going to be with us, probably forever but certainly for a very, very long time.”  The question then becomes, he said, “How do we manage our lives with the virus?”   Similar to “the way we manage our lives with lots of other respiratory viruses” such as flu, which has never disappeared, he said.  “We’ve got to figure out how to really lower the virulence, the way in which this virus gets people sick,” the scientist said.  Progress has already been made, according to Jha.  “Vaccines are going to be our primary tool,” Jha said. “We're also going to have therapies that will lower the severity of the disease, such as monoclonal [antibody therapy], oral pills like PAXLOVID from Pfizer. There will be hopefully others. It's going to become something that we manage and live with.”  https://www.providencejournal.com/story/news/coronavirus/2021/12/12/monoclonal-antibodies-hasbro-childrens-hospital-treat-covid-at-risk-kids/6478053001/   Jha foresees seasonality, just as with flu.  “We'll see surges maybe even in the summer in the south, in the winter in the north, and that will become a feature of this virus,” he said.  But the bottom line, according to the scientist, is that COVID-19 “It will not continue to torture us the way it has so far.”    This is the 40th episode of the “COVID: What Comes Next” podcast, begun in October 2020 and available exclusively from The Providence Journal and the USA TODAY NETWORK. It is hosted by G. Wayne Miller, health reporter for The Providence Journal. 
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    11 mins
  • Welcome to Episode 39 of “COVID: What comes next,” an exclusive weekly Providence Journal/USA TODAY NETWORK podcast featuring Dr. Ashish Jha, dean of the Brown University School of Public Health and an internationally respected expert on pandemic response and preparedness
    Dec 2 2021

    PROVIDENCE – The omicron variant has been detected in more than two dozen countries, including just this week in the U.S.  

    And this much is certain, says pandemic expert Dr. Ashish Jha: it will continue to spread. 

    Beyond that, Jha asserts, uncertainties at this early stage abound, just as they did when the last major variant, Delta, was first found in India about a year ago. 

    During recording of the latest “COVID: What Comes Next” podcast, Jha, dean of Brown University’s School of Public Health, said he and other scientists are concerned with three major issues as they monitor developments. 

    -- Ease of transmissibility, which the Delta variant has abundantly demonstrated, is one. 

    “There's some data out of South Africa that suggests that it might be spreading very quickly in South Africa, but just because it does there does not mean it's going to spread more easily here,” Jha said. “The short answer is we don't know.” 

    But he added: “If Omicron is as contagious or more contagious than Delta, [most regions] will end up encountering this variant as well.” 

    -- A second issue is severity. 

    “Does it cause more severe disease?” Jha said. “We have no idea. You may have heard stories of somebody who had mild disease, but individual cases, anecdotes, don't tell you the story. We have to look at a lot more data. We don't know if it causes milder disease or more severe disease. Obviously, we all hope it causes more mild disease, but we don't know.” 

    -- A third is evasiveness, “the big issue,” as Jha described it. 

    “Does it break through our vaccines?” Jha said. “We don't have the data, but here's what concerns so many of us: the mutations we see with omicron are in parts of the virus where our vaccines usually work -- the parts of the spike protein where our vaccines work. That's where we're seeing the mutations and that's what's concerning many of us.” 

    Jha expects answers here relatively quickly. 

    “We will get more data in the next week to 10 days,” he said. “We don't have to wait months.” 

    Regarding the three current COVID vaccines – Pfizer, Moderna and Johnson & Johnson – and their potential defense against omicron, Jha was asked: “Is it better to be vaccinated than to be unvaccinated?” 

    “Oh my goodness, not even a close call,” Jha said. “Let's say our vaccines work a little less well. Is there any chance vaccine effectiveness goes to zero, meaning the vaccines atop working completely against omicron? There's essentially no chance in my mind that vaccines will stop working altogether.  

    “So if you've been vaccinated, you'll still have some degree of protection. And most of us believe, [given] our understanding of how boosters work, that if you are fully boosted, you actually will probably have a pretty high degree of protection against Omicron.” 

    Jha’s advice? If you are not vaccinated, do so. And if you are eligible for a booster shot but not yet gotten it, do so. 

    During the podcast, Jha also explained why unvaccinated people who become infected with coronavirus are much more likely than vaccinated people to serve as a sort of haven in which mutations are more likely to occur. The reason, he said, is the more frequently a virus replicates, the greater the chance that one or more replications will carry a mutation. 

     “Vaccinated people most times won't even get infected, so the virus is not going to be multiplying,” Jha said. “Even if you get infected, [the virus] will be there for a much shorter period of time and you're not going to give the virus as much chance to mutate. 

    “No question there's a lot more replication happening among unvaccinated people and replication is the heart of mutations that lead us to” variants such as omnicon. 

    This is the 39th episode of the “COVID: What Comes Next” podcast, begun in October 2020 and available exclusively from The Providence Journal and the USA TODAY NETWORK. It is hosted by G. Wayne Miller, health reporter for The Providence Journal. 

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    12 mins

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