Tanja Lewis: Hello and welcome to COVID, Quickly, a Scientific American Podcast series!
Josh Fischmann: This is your fast track update on the COVID pandemic. We bring you up to date with the latest science behind the most pressing questions about the virus and disease. We demystify the research and help you understand what it really means.
Lewis: I am Tanya Lewis.
Fishman: I am Josh Fischmann.
Lewis: And were Scientific American‘s senior health editor. Today we are talking about clinics for long distance COVID patients …
Fishman: The rise of the Delta variant and what you can do about it …
Lewis: And the use of barber shops to bring vaccines to communities that need them most.
Lewis: At the start of the pandemic, there were some reports of people with strange symptoms, such as fatigue and memory problems, that persisted long after their acute infection. Now these “long-distance drivers” get special help.
Fishman: More and more data is being published about COVID over a long period of time: serious physical and psychological effects that can last six months after the first infection. The latest study appeared in Nature Medicine last week. Researchers looked at the medical records of a few hundred people in Bergen, Norway. That was almost everyone in town who was diagnosed with COVID for several months in 2020. A total of 61 percent of the group had symptoms six months after the initial infection.
Her most common problem was fatigue, followed by difficulty concentrating, smell or taste disorders, memory problems, and shortness of breath. Two remarkable things about this patient. One of them was that many had only a mild or moderate case of COVID at the beginning. The other was that many were young, between the ages of 16 and 30. Other studies have reported a similar cluster of symptoms, like one from University of Washington researchers who found that around 30 percent of people with COVID had these persistent problems.
Lewis: Do doctors know what is causing these problems?
Fishman: That is still a mystery. Some people have organ damage related to the viral infection, but others do not. Doctors are trying to figure out how to treat them. SciAm employee Melba Newsome wrote this week about new COVID recovery clinics treating the entire patient rather than having people run from a pulmonologist to a neurologist to an immunologist. Patients say the coordinated care helps and they feel more hopeful as they are being taken seriously and not dismissed as a crankcase. The NIH takes it seriously too and spends about a billion dollars studying the disease. It now has an official jaw breaker with a name: Post Acute Sequelae of SARS-CoV-2 infection.
However, Melba notes that a racial imbalance is looming in these clinics. Most of the people named there are white. But people of color are more likely to get COVID. Barriers to entry, such as the lack of health insurance, are therefore likely to keep many people who need them out of care. It’s another stress that adds to the health inequality that is already hurting people in the pandemic.
Fishman: Let’s talk about the delta variant. It is common in more than 70 countries and is now the dominant variant in the United States. How concerned should we be?
Lewis: The delta variant is definitely a cause for concern – especially for those who have not been vaccinated. It is already causing another surge in the UK, where it accounts for the vast majority of cases. And a company that tracks virus sequences in the US estimates that this variant now makes up about 40% of the cases here – making it more than twice as common as the most common alpha variant in the past.
As you noted earlier, research from the UK suggests that Delta is at least 40 percent more transmissible than Alpha and almost twice as likely to result in hospitalizations. However, the data on whether or not it actually causes more serious illness is somewhat unclear – so far it has not resulted in a large increase in hospital admissions or deaths in the UK
Yet it is spreading widely in the United States, where only about half the population is vaccinated (much less in some areas). Experts say there likely won’t be another devastating nationwide spike like last winter, but it will likely flare up in states where fewer people have been vaccinated, like Alabama or Mississippi. And the risk could increase in places where hotter temperatures force people to spend time in air-conditioned indoor spaces where the coronavirus can easily spread.
Fishman: That sounds pretty dark. What can we do against it?
Lewis: The good news is that the vaccines are working. Additional data from the UK shows that two doses of the Pfizer vaccine were 96 percent effective in preventing hospitalization and two doses of the AstraZeneca vaccine were 92 percent effective. But you need both vaccinations – a single dose of AstraZeneca only prevented 71 percent hospitalization, and a dose of both vaccines only prevented about 34 percent of infection. We don’t yet know how well the Johnson & Johnson vaccine works against the Delta variant, but it probably offers some protection.
Meanwhile, the World Health Organization is urging even vaccinated people to continue wearing masks and practicing social distancing just to be on the safe side given the viruses still circulating. However, the CDC hasn’t changed its guidelines – it still says that vaccinated people don’t have to mask themselves unless they want to. But since Delta is so transferable, it can’t hurt to be on the safe side.
Lewis: There are still many people who are skeptical about vaccination – sometimes for valid reasons. Now some efforts are trying to build trust by reaching people in their neighborhood.
Fishman: The rate of COVID vaccinations among people of color lags behind that of white people. Access barriers are one reason, but also negative experiences with the medical profession that arouse suspicion. Black-run barbershops and hair salons could possibly counter that, says Stephen Thomas, who heads the University of Maryland’s Center for Health Equity. For the past 15 years, Thomas has researched the trust hairdressers and stylists have in their communities and says it’s a strong thing. He trained these people to educate their clients about ways to prevent diseases like diabetes.
Now this expertise is helping with COVID vaccines. Thomas’ group is part of a White House “Shots At The Shop” campaign. Hairdressers and stylists are trained to talk to people about the benefits of vaccines versus the risks and build long-lasting relationships. These conversations that can arise from snipping and combing are not lectures. And they are not magic and do not convince all doubters. But they affect many people.
Some stores become pop-up vaccination sites with local health clinics that solve access problems by bringing free vaccines to the neighborhood. Thomas project is called The Health Advocates In-Reach and Research. That stands for HAIR, of course.
Lewis: Now you are up to date. Thanks for joining us.
Fishman: Come back in two weeks for the next episode of COVID, Quickly! And on SciAm.com you will find current and detailed COVID news.
[The above text is a transcript of this podcast.]