Let’s take a little walk down Vaccine Memory Lane.  Do you remember how it felt when you got access to the first Covid vaccine in late 2020/early 2021? Julie remembers DRESSING UP to go and get her vaccine. (She wore a turkey hat with little Santa hats on its feet since it was close to the holidays).

Now, do you remember last winter’s TRIPLEDEMIC??

How can we avoid the same situation this year? What are the options and recommendations for folks for prevention of flu, COVID, and RSV?

Today we have invited our doctor friend and expert in Infectious Diseases to explain the viral landscape in the US in the autumn of 2023. After today’s episode you will feel empowered to make your personal vaccine choices based on your risk factors, epidemiologic evidence, and straight-from-the-source data-backed recommendations from CHICAGO’S FAUCI HIMSELF!!

Welcome, Dr. Rob Citronberg!

You may remember Dr. Citronberg from our previous episode about Monkeypox, Covid and Polio posted almost exactly a year ago! 

• Dr. Citronberg is the Executive Medical Director of Infectious Disease and Prevention at Advocate Aurora Health
• MD from University of Connecticut, IM Residency and ID Fellowship at RUSH
• Trusted news source as Infectious Disease expert (catch him regularly on ABC Chicago!)
• Julie was afraid of him when she was a resident (til she did an ID rotation then they were besties)

"Get your COVID vaccine when you can, don't worry too much about timing it perfectly. It's a step towards getting back to a normal life, protecting ourselves and our loved ones." - Rob Citronberg, MD

In this episode, you will be able to:

• Find out how vaccinations stand as the frontline defense against COVID-19, Flu, and RSV.
• Understand the significance of safeguarding pregnant people and infants through planned vaccinations.
• Find out how to create memorable and safe holiday gatherings during pandemic times.
• Learn to access the most credible and valuable health and public information from respected medical experts.
• Decide which vaccines this fall/winter are most important for you based on your individual risk factors.
• Determine whether masking in public makes sense for you.

Key moments in this episode include:

00:00:00 - Introduction,

00:02:16 - Vaccine Landscape,

00:07:43 - Variants and Vaccines,

00:10:10 - Impact of Prior Pandemic Restrictions,

00:11:48 - RSV Overview,

00:12:42 - Vaccine Recommendations,

00:14:22 - The Importance of COVID-19 Vaccines,

00:16:01 - Transition to Annual COVID Shots vs "Boosters",

00:17:46 - Targeting High-Risk Populations,

00:22:52 - RSV Vaccines for Infants and Pregnant People,

00:28:07 - Challenges with Vaccination Uptake,

00:29:17 - Monoclonal Antibodies as a Game Changer,

00:32:14 - Preventing Serious Illnesses in Newborns,

00:34:13 - Continued Interest in Vaccine Research,

00:37:06 - School Safety and Recommendations,

00:42:52 - "Work Culture and Changing Attitudes",

00:43:48 - "Changing Attitudes in the Medical Field",

00:45:20 - "Shift towards Work-Life Balance",

00:46:08 - "Handling Holiday Plans during the Pandemic",

00:51:17 - "Effects of Masks and Mask Mandates",

00:56:50 - Importance of Listening to Credentialed Experts,

00:57:29 - Recommended Source: Your Local Epidemiologist,

00:58:15 - Keeping a Low Profile,

00:59:18 - Call to Action: Share the Podcast,

01:00:15 - Importance of Vaccination,

Dr. Citronberg recommends the following resources if you want to learn more about vaccines this fall:

The CDC website, specifically their pages about vaccine recommendations.

Johns Hopkins University of Medicine Coronavirus Resource Center.

Your Local Epidemiologist Substack by Katelyn Jetelina PhD, MPH.

The New York Times - their coverage of vaccines has been well-presented and evidence-based.

For more episodes, limited edition merch, or to become a Friend of Your Doctor Friends (and more), follow this link!

• This includes the famous "Advice from the last generation of doctors that inhaled lead" shirt that Julie wears in this episode :)

Also, CHECK OUT AMAZING HEALTH PODCASTS on The Health Podcast Network

Find us at:

Website: yourdoctorfriendspodcast.com 

Email: yourdoctorfriendspodcast@gmail.com 

Call the DOCLINE on 312-380-5005 and leave us a message. We will listen and maybe even respond/play it on the show!

(Disclaimer: we will not answer specific medical questions or offer medical advice. Consult your healthcare professional with any and all personal health questions.)

Connect with us:

@your_doctor_friends (IG)

@yourdoctorfriendspodcast1013 (YouTube)

@JeremyAllandMD (IG, FB, Twitter)

@JuliaBrueneMD (IG)

@HealthPodNet (IG)

Fall Virus Preview - Rob Citronberg

===

And I took pictures and I like asked the vaccine person if I could, if they could be in my picture, , and I put it on social media. I was so

And I was like, oh. And then I called back and it was just the flu vaccine and I was like, Ugh. . It reminds me like of being excited when your favorite band is opening up ticket sales for their new tour. Like when are they coming to my town? Like when can I see 'em?

Welcome to your doctor Friends, the show that teaches you to sniff out the garbage and answers all the questions that you wish you could call or text your doctor friend. My name's Julie Bruny. And I'm Jeremy Allen. And we are two physicians who work at a nationally ranked practice and take care of some of the world's greatest athletes.

We know that you have questions and we want to help. We wanna be your doctor friends.

So happy your Dr. Ver to Dr. Berg. Um, briefly. Dr. Berg is the Executive Medical Director of Infectious Disease and Prevention at Advocate Aurora Health. He got his MD from the University of Connecticut. He did an internal medicine re residency and, uh, infectious disease fellowship at, uh, the big green mothership herself, rush, which is me and Jeremy's alma mater.

Um, he's a very trusted news source as an infectious disease specialist. And, um, I was afraid of him when I was a resident, but then I did my infectious disease rotation and now we are best friends for life. So, Rob, Dr. Citrin Berg, welcome back to the pod

People go back in and the viruses come out to play. So we we're gonna bring back our virus expert to just give us fall previews, uh, uh, every single year.

And I think what's the most important thing about that too is that while there are some patients who are being hospitalized for it, the need for critical care is really, really low. Um, only occasional patients need to be in the ICU, which is, as you know, a big problem. The huge change from how it once was

so COVID levels are higher There's actually some evidence that the current wave of COVID is peaking Already started early finish early may come back later There's really been minimal flu activity only a little bit in the southern u.

s Again, it tends to start in the south and move up more towards the north. So I would say in the next Six weeks or so. We'll probably see some flu activity and rsv is Around a little bit. It's nothing like it was last year. We had a lot of interseasonal RSV in the summertime. There are some sporadic cases right now, but I wouldn't say we're seeing a surge of RSV at all.

So overall, I would say the temperature is pretty cool. But we're always keeping an eye on it. Things can change week to week. I

And those are like pretty much hospitalized patients. Um, everybody else does home tests. So we have no idea. with the true number of COVID cases. It's probably a lot more than is reported because people are doing home tests. So it's actually harder to track COVID cases. I think COVID hospitalizations is easier to

track and is a reasonable surrogate for the number of cases. You know, there's some interest in looking at wastewater surveillance for COVID activity, which I think gets mixed reviews about how accurate it is, but it probably gives you some idea if there's COVID circulating. Pretty hard to pinpoint a number of cases though. Hospitalizations, yes. Cases, no. But, Influenza and RSV are pretty easy.

And I feel like there just hasn't been a huge update to. Like, what's the next Greek alphabet letter that's coming out? Are we just not able to find these? 'cause we're not testing? Is there another new variant coming? Does it not matter if there are new variants? Where are we at with that

So,

So, I think we're all sensitized to COVID. We hear about COVID and we shudder, but,

um, I think there's, uh, too much to worry about. I think we just are, uh, rational, uh, about it and, um, try to get on with our lives best we can. But that's really what's circulating right now. Uh, and, uh, you know, in a few weeks it might change, but those are pretty much the three strains that, that we were seeing.

Do you, do you feel like it's all that different than it was last year or, I mean, I know you already kind of explained that, so this might be a little esoteric.

And so that, to me, that, that told me is that, yeah, masks actually be. do something.

Masks and handwashing really work, but I think it's hard to pin a cause and effect on ultimate seasonal patterns because there's so many variables

that go into when these viruses emerge. Like, for example, last summer we saw a ton of RSV like in the summertime.

We never see it. We're not seeing it this year. And in some years we have early influenza. Last year we had a very early flu season. This year is not. And it's all right. Could it be related to Um, Patterns of, of masking? Yeah. I, I guess it could, but it could also just be the natural variations that we see in these virals, in the viruses.

Like who's the most vulnerable people and what kind of illness does it typically cause?

right? So, uh, RSV is an interesting virus. It can actually cause very severe infection in the lungs, bronchiolitis, um, and it's particularly bad in infants. Sometimes in premature kids, premature

infants, or even older babies who have some chronic conditions. And we also see it in adults too, but typically older adults. Those also with chronic lung disease, frequently in nursing home residents. Uh, so, so kind of older, frail people. Uh, clearly the biggest focus is on the babies. But definitely we, we do see RSV infection every year in some of our seniors as well.

Um, 'cause I like them as a source. Um, but I'm just gonna go.

the New York Times. We'll, we'll see.

Um, they also mentioned that the full recommendations won't be available until the F D A authorizes these shots and that the C D C, um, reviews the new data. Is that this came out yesterday. Rob, what are your thoughts about that?

about FDA signing off on the new COVID vaccines from the three manufacturers.

After FDA, it goes to CDC, ACIP for really the formal recommendations for who should get it. And then after that, typically within a few days after that, you should be able to get it at a retail pharmacy or even in your clinic. You know, most of the clinics, like our clinics, they just take longer. to get the vaccine.

But really with once within a few days

after CDC signs off on it, you should be able to get it in the retail pharmacy. And we are recommending that people get the covid vaccine this year in large part because it is updated. It covers strains that that prior vaccines didn't. And also, you know, people haven't been vaccinated a long time, like a year and a half, two years. They stopped getting boosters, you know, only a very small percentage of people were getting boosters. So, um, we do recommend the vaccine for most people. Can I say everybody should get it? No, I think it's clearly, um, very advantageous for people who are older, elderly, chronically ill. The ones who were, if they get COVID could die from

it. But I think the argument's a little murkier for young, healthy people, particularly kids. You know, there's a lot of, uh, concern, especially in young males about getting myocarditis in the vaccine, even though... Um, the rates are extremely low. It's, it is a measurable rate. And the question is really what's the risk benefit ratio in that population.

So, uh, and, and uptake in that population and also in little kids has been really, really low.

A lot of parents just don't want to expose their kids to vaccines. We're still going to recommend it. But the way I look at it is I want to, I want to get my target populations first, which are elderly, chronically ill. Those are the ones I want to prioritize. I'm not going to preach to everybody. Oh my God, you got to go run out and get the vaccine tomorrow. But I am going to do that to people who I think are at risk for severe illness. So, um, and you know who you are. If you're one of those people, you've heard

it now for the last three plus years, those are the people that we're really going to try to target with our efforts.

Um, for one thing, I think we're going to do away with the term booster, which is something that's kind of long overdue. It's really just trying to do is roll this into an annual COVID shot. Like you get your flu shot, like you get your RSV shot,

forget about primary series, forget about boosters.

I think those terms are pretty much gone. Uh, but I know in the last couple of months, I've heard from a lot of people who are getting those exact messages in their pharmacies. Like, should I get the booster now? And the answer for most people is no. We've been advising people over the last couple of months, you know, wait for the new one.

There's really no advantage to getting the older one now. Um, it's going to probably disappear

from the shelves in a couple of weeks anyway. So we've been advising pretty much everybody to just wait till mid September, which is coming up soon, to get the new vaccine.

Should I wait and delay and get it closer to that time?

do recommend that with like flu shots, for example, you try to time it so that it's not too early, not too late. And with the COVID vaccine, I would say, just get it when you can, when it's available. Uh, and don't worry about timing it so much. And if it, you know, if you get it towards the end of September, That should provide adequate protection for Thanksgiving time, Christmas

time.

and that takes a while. So, that takes a while, takes a little

while to get the vaccine.

So, usually run a couple weeks

behind the time we can get in a retail pharmacy.

In fact, you probably should just get them in different arms. There's actually, interestingly, recent studies that show your immune response to the COVID vaccine may be better if you get it in the same arm that you got your last COVID shot in. So if you can remember which arm you got that one in, say, well, maybe, maybe put the COVID shot in that arm.

So

Um, no. I will think, I'll, I'll try to plan something really good. Last time I wore your doctor friend's shirt, so maybe I'll wear another

So go, go purchase some Um, back on track. So we basically just touched on influenza. I mean, there's really not much to talk about with flu, I don't think, Rob, I mean influenza. So the annual flu vaccine is recommended for everyone. Six months and older, but you know, it's most important for adults, ages 65 plus, although 65 isn't some magic number that makes you frail,

Um, but you know, and then people under five with weak immune systems. Anything else that you would add on about

Just so it's something you do every, every September you get your COVID vaccine and you get your flu vaccine. But I think people at this point have pretty much decided whether or not they're going to get their flu shot every year.

I don't think we're going to change too many minds.

very very early flu seasons in the southern hemisphere We saw an early flu season here as well, too But there's so many variables we can make predictions, but I think they're really just educated guesses

In terms of what's actually gonna happen. Anyone's Anyone's guess.

And then again, on August 21st, the F d a, um, approved the use of Pfizer's vaccine, uh, vaccine, a svo, which sounds like a scary robot for pregnant people as a way to protect infants from the virus. So this vaccine is given the last weeks of p pregnancy and this would provide maternal antibodies that travel across the placenta.

Um, and it's expected to prevent severe respiratory illnesses in infants up to six months after exiting intrauterine life. Um, and then a brisbo and another R S V vaccine, a Rex V, which doesn't sound like anything interesting to me, are not yet approved for most Americans younger. 60. Does that sound accurate to you, Dr.

Berg?

antibody, but we're kind of treating it like a vaccine. I think that's okay because it fits into the, the, vaccine mold, right? It's, it's similar to a vaccine. My colleagues in, in pediatrics are super excited about this. They think this is actually a real game changer for pediatric RSV. Um, the studies look great. It's actually been, I've been really recommended for every single baby, uh, in this country. And that's. That's pretty impressive. So I think that there is a potential for this to be really a game changer for pediatric RSV You know that the maternal vaccine is interesting because it's it's gonna be a little tricky because it has to be given Between 32 and 36 weeks of pregnancy, which you know for people getting prenatal care you can do it But there's sometimes other things going on or things to do and It, I think it's going to be a little more challenging, a little more problematic to get a big uptake on that vaccine, especially I would say a lot of moms, if they had a choice of getting the vaccine themselves in the last trimester of pregnancy, or having the baby get the RSV monoclonal antibody, I think they'll choose the latter. Because they're still concerned about taking vaccines while you're pregnant, even though they... appear to be extremely safe. I think there's just there. I believe that there's going to be this. My prediction is there's going to be relatively low uptake of the vaccine in moms, but very high uptake of the product in, in kids, the, of the

monoclonal antibody.

clear. what the benefit of it would be. So I just, my prediction is that there'll be a lot of, a lot of interest in the product for, um, for babies, but not so much in the vaccine for moms.

But we'll see. And then for adults, 16 over that both, both of the vaccine, the true vaccines have been approved for adults over 60

in this country. Again, I think the uptake is going to be relatively low for one thing. I think that people are all vaccined out. And again, I, you know, I could certainly say to everybody, like, listen, you should get the vaccine.

It's recommended that you get it. The truth is, I'm going to prioritize, I'm going to prioritize that RSV vaccine for people I think are most likely to get sick from RSV. And those are clearly older adults, those with, elderly adults, chronic lung disease, immunocompromised, etc. The ones who might get really sick from it.

Those are the ones I'm going to push the hardest for.

You know, I might say, to everybody else over 60. Yeah, you get the vaccine. If I had to rank the vaccines of the three vaccines, I'd probably rank RSV third in terms of priority. And it's not that it's unimportant, but I think that the benefit for universal vaccination is going to be greatest for influenza or greater for influenza and COVID than it is for universal vaccination for RSV,

just because. Really? Anybody can get COVID, anybody can get influenza, but not anybody can get

So, you know, hopefully, I think the concept of understanding that that had to be done during certain weeks and people were okay with that. And I think we're gonna rely probably a lot on our obstetricians and the, and the, the, you know, the nice relationship they have with their patients, right? That, that the trust level between them, that, that this is gonna be something that will protect you, but maybe even, maybe more importantly, your baby in those first few months when they don't have antibodies.

for sure. But I would just say that your experience, Jeremy probably was prior to COVID

since COVID. MMR. It's crazy. Polio. It's crazy that parents don't want to have their kids vaccinated.

So I think In the current climate, uh, it's going to be more challenging. I'm hopeful that we'll make progress. And

I'm sure the obstetricians are going to be on board. But, um, you know, they had to basically beg their pregnant patients to get a COVID vaccine. Some don't want to get a flu vaccine. Many don't want to, even though we know the risk of influenza and pregnancy is low.

You know, getting severely ill or dying is very hot, is much higher than in other populations. So, um, I, I think it will be really interesting to see, you know, now that we're kind of post COVID or post, post pandemic,

what the interest is going to be in new vaccines.

And so any, I, I agree with your pediatrician friends that this could be a huge game changer to have something that potentially could decrease the likelihood of somebody that age getting an illness.

right? He's giving passive, you know, a vaccine, you're creating active immunization. This is passive immunization, same concept, but I think the words are important. And maybe one way you can sell this is say, Hey, this is not a vaccine.

Right. This is just, we're giving you antibodies to help protect the baby. Uh, and I think that actually might be a good selling point by saying it's not a vaccine.

Was there like a specific timeframe in which, okay. Because I'm wondering if that's part of the reason one, Rob, you were saying because it's a new vaccine for pregnant people too. It's like you have to get it between this weird little time window and it's also like the time window where they're also probably the most uncomfortable , you know?

It's not like a, it's more of just like a, are you willing to do it? And I, again, I think, you know, my, my wife got those vaccines. I got the vaccine. I wasn't pregnant when it did, and if I, if my daughter was pregnant right now and, and was going through it through this period of time, I certainly would recommend getting, especially that R S V vaccine, probably the flu vaccine as you've already mentioned.

Just because again, I mean, anything you can do to prevent your child from having a serious illness after they're born is just, it's unbelievable.

They look like they can't breathe. It's goop everywhere. It's, it, it's, it's a disaster. And so that's scary. And if, if you can prevent that from happening, it's

And I think that's really exciting.

true, but that technology is amazing. It's, it's nothing short of miraculous that vaccines using that technology.

Um, could be developed for COVID in such a short period of time. mRNA vaccines actually were really invented, uh, for the purpose of, of oncology vaccines, cancer vaccines.

And it just so happened that when COVID came around, they said, Hey, maybe we can use this as a COVID vaccine. Uh, So I think the people who are interested in studying and making the vaccines, nothing's going to stop them because of scientific intellectual curiosity and ability to produce a great product. You know, I guess what it comes down to is, is how many are they going to sell? That may in the end determine how many, you know, how much they're going to, how much research they're going to do to develop these, these products. But, um, I think there's still tremendous interest in the scientific community. For vaccine research and new products, it's exciting, right? Because you, you know, for example, for RSV, this is the first time ever we have vaccines that prevent RSV infection. That's

a tremendous accomplishment.

uh, what, you know, the, the trolls and the naysayers. And, you know, every time a young athlete dies on the basketball court. Like, look at Twitter, there's like a thousand, got the

jab, got the jab, got the jab, and it's completely irresponsible, but it's so easy to disseminate this information now that, um, it's, it's, you know, it's troubling, but I think the scientists and what's actually, who actually look at science, um, Still are very, very interested in developing vaccines, not only for the illnesses we have now, but for new ones as well.

just that was even before COVID, right? It's like how. You know, experts being an expert doesn't mean anything anymore because some fool could just put a comment on Twitter like so, you know, I went to four years of medical school, five years of postgraduate training.

This is my 30th year of practice and infectious

diseases. Yeah, I'm forced to match wits with some troll who does a 10 minute Google search while drinking their morning coffee

because we have equal opportunity on the airways, right? So it's maddening for for us is as physicians to try to deal with this.

But you know, the best we could do is is try our best and educate our patients and. Not worry about the rest of it, but it's, it's hard.

So if you had kids who are in elementary or middle school, are you doing anything particular for them kind of going into this virus season? Are you. Any specific recommendations outside of vaccinations?

Um, and, uh, but certainly obviously hand hygiene is always important. It's going to be really interesting to see what happens if there are kind of big COVID surges in the communities, if schools are going to close or not, you know, even temporarily, my guess is that they won't. Um, but well, I just think there's going to be too much backlash against it.

And also remember that, you know, for almost everybody COVID is going to be a mild illness.

These are our, rather than, than having different policies or different ideas for each virus, just have one strategy for all the wintertime viruses that might be beneficial. But, um, school is, you know, obviously it's really important for kids to be in school, but they also have to be healthy. Um, again, if a lot of teachers are getting sick, they may not. Physically be able to be there. So there's a lot of variables and wild cards, but I think we should do everything possible To keep kids in school, but you know, we've got to be safe and and and realistic and rational about it as well, too But it's a different it's a different animal than it was two years

ago And it's it's a much tamer animal than it was two years ago.

And you know, historically over the past couple years, the tendency was, I have to do a test or I have to go get tested and then I have to test to get back in. And I think some of those policies have kind of come down, but in addition, I just think people are like, it's a cold and once the symptoms are better, I'll send my kid back to school.

So I'm not even sure if we would know if there was a, a wave. Is that kind of your pulse of it as well?

And that may be a reasonable, that may be a reasonable approach. I can't say that that's wrong. And. But I think a lot of people are going to do that. Now, the other thing too, is that like I can tell you in our health care system, our employees, there's a return to work policy. Now it's

healthcare and it's, it's different.

You really want to be careful as possible because you don't want to expose patients to contagious diseases. But for example, you know, and I think this is true in every healthcare system. If a nurse, let's say a nurse gets COVID, she has to be out for X number of days. She might have to use her PTO for that.

Um, and. Um, even though she's like feeling fine and what we found is that some people just don't report their symptoms. They don't, they don't test. They don't report their COVID. They come to work. Hopefully if they are sick, you know, we don't want to see them. They're sick, but we know that some people are showing up sick. Hope they wear a mask while they're there. But I think uh, people are essentially trying to skirt that the system for personal gain and You know, it's hard to say. I, I understand why they do it. Um, you can't always, um, endorse it, but I do understand why they're doing it and maybe they're right in the end.

Maybe if this is, you know, what happened before COVID

think about, I, you know, one of my old partners that I used to work with, um, would come to sick, like had like little kids that was like sick all winter with literally, Come to work with a box with a box of Kleenex under her arm and just like cough and sneeze and blow her nose But you know what? Nobody really thought anything about that. It's like that's what you do when you're sick, right? You bring a box of Kleenex to work. Nobody else like well, maybe I should stay home

So we're hopeful that one thing that has come out of this is that people are more responsible in staying away from work when you're sick.

Certainly easy for remote workers to do, but for people who have to go in, like work in a healthcare facility, we're really hopeful that people who are sick Are responsible and probably of all the things they can do the single most effective thing to prevent spread of disease in the hospital Is to not bring it into the hospital

the you

either are working in the hospital Or you're a patient in the hospital, and I remember actually I had an influenza a when I was an intern

I I've never been so sick in my life I you know like a hundred and four fever when I'm on

call at the hospital one night coughing, but that was just the culture then, right?

Like you just tough it out. Like you can't miss, you can't miss work. And so hopefully that has changed. I think with a lot of Gen Zers in the workforce now that's easier because they

don't want to go to work anyway. So,

That we were lazy and everybody else had it. You know? Oh God, you're not gonna have to go through all the stuff that we went through. And it's like, yeah. And we won't lose our minds and and have horrible home lives and never leave the hospital

but you know, some years ago we were interviewing a new person to join our practice and lovely, very smart, very talented came time to offer a contract. And she's like, you know, we gave her a contract. It'd be on call every fourth weekend, et cetera, et cetera. She's like, hold on a second. I really, I want to work like Monday through Thursday. Okay. And I'm like, well, it doesn't really help us right in

our, we need someone to work more than that, you know, and she said something that, that I, I kind of immediately dismissed, but then I thought about it more and she said, I don't want my job to interfere with my life.

And, you know, maybe she's right, maybe maybe we're the ones who were doing it wrong, like by working 80 hour weeks. So maybe there's, there's a lot of truth to that too. So I think that, uh, the pendulum has definitely swung back the other way, maybe a little bit too far. Hopefully it'll come back more to the middle, but there's much, much more attention to this so called work life balance, or we just call it life balance, uh, than there, than there once was.

That's, that's probably a good thing.

I'm Thanksgiving's gonna have 20 people there and I just want be there. And that kind of.

That was absolutely the right advice. I wouldn't say that now. You should have Thanksgiving. You should have Christmas. But really, um, you know, it'd be nice to be up to date on your vaccines. Although, you know, truthfully, the vaccines don't prevent transmission of the virus like they once did

when they first came out. Single most important thing is don't come if you're sick. If you're, you know, you have plans and it's easy, maybe it's easy to not go to Thanksgiving, but you're right. What if you've got a trip you're going on that you paid? It's not, you paid for, it's not refundable. What are you going to do?

Um, I think those are the people a lot of times who just don't say anything about it.

They might be not feeling well, but they're going to go anyway. And I don't know that you're able to stop that behavior. The best you can do is just. Encourage people as best you can, don't show up when you're sick and when you're potentially contagious. Now, the good news is though, um, you know, in the beginning of the pandemic, we, we learned a lot about asymptomatic infection.

So people who had the virus, but didn't have

symptoms could potentially spread it. That's much less of a concern right now because the incubation period, the new strains is much shorter than the original strain. So, you know, the original strains was anywhere from like up to 14 days,

most were like seven to eight.

So, Now, the incubation period is about three days, like

two and a half, three days. So, there's really, that, that potential for being asymptomatically infected is much shorter, right? So, um, that actually poses a lot less risk when you're, you know, you're around that Thanksgiving table,

you know, two years ago or three years ago, there were probably four or five people who actually had COVID but didn't know it because they didn't have symptoms. Because we're in that asymptomatic period. Now, the way the virus is currently, that's much less likely to happen because of the shorter incubation period. So I think that's good news.

positive COVID test. They keep it on their phone.

So they just send that whenever, whenever convenient, right, to get

out something. Oops, positive COVID test.

that's real. I lost it for about five days. And during those five days was when we were having the. The tasting for my daughter's upcoming wedding

and I couldn't go because I couldn't taste I couldn't taste anything so I missed so at the wedding it ended up being a big surprise with some tasted pretty good, but um, it's just more inconvenient than anything, but

um You know, I just, uh, you know, maybe I'll get it again.

Maybe I won't. I don't

know. But I think, I think, people have had it now three times. Um, and each time they have it, they're progressively less sick. I think they're getting less concerned about it. Um, and just considering more like a routine wintertime respiratory virus

and maybe that's okay.

say, you know, Jeremy, I think you're probably going to wear a mask pretty well, but you gotta wear a high quality, well fitting mask

and something like a KN95 or N95 really to, you know, Completely protect yourself and those will or those are extremely effective, but I was over it, you know Whole Foods today and there were probably Maybe a dozen people in the store.

I was walking around. We're wearing masks But only like two of them were actually wearing them properly like

actually real masks over their nose and mouth One guy's got it like on his chin. Somebody else has it on their their mouth, but not their nose And not a high quality mask. So, you know It's so variable. Like if you wear a high quality, well fitting mask, yes, it will protect you and, and that might be a great thing to do if you've got a big event upcoming that you can't miss that will help protect yourself for sure.

It's just harder to talk and I think the human connection was less. And, um, yeah, I, I, there there's something there that, that, that makes it much more difficult with those things involved.

it. Uh, I mean, there's been a lot of study, a lot of science that has shown the adverse effects of wearing masks are clearly true. Listen, they save lives in, in pandemics. There's no doubt about

that, but there is collateral damage to them. I think, especially in babies, like who, who have to see faces, right.

To

learn how to communicate. That's how they see their, their parents smile and, and different facial expressions. That's how they learn. Um, And so I think that it's clearly learning in school is very much, um, uh, uh, hindered by the wearing masks. You can't hear your teacher. Um, the teachers can't hear the kids.

It's, there's no doubt about it. Um, so I, I think there definitely is collateral damage. And I think that you got to factor that into the equation about masks. You know, they, they do work. You wear a good mask, you wear it the right way. It definitely will work, but it's not without. Side effects, shall we say?

You want to, you know, like, it's just like to, to ban a mask mandate. It's just, it's just. You know, I don't know if it's vengeance, whatever it is, but that's just dumb. Uh, you, you gotta, you gotta look at, at the, what the situation is and why you might need it. You know, that being said, I, I really don't think we'll ever see a mask mandate, municipal mask

mandates. You might see them in businesses, schools, but just a municipal mask, universal mask mandate.

I don't think we'll ever see one again.

That we have a lot more defenses. And I would encourage vaccines. There's all this new stuff with R S V that I p, especially if you're a qualifying person, you should look into. Um, but ultimately I think, you know, take care of yourself. Make sure that you're putting yourself in good situations and not putting other people at risk.

But it seems like it's a rosier outlook. I don't know, I don't remember the tone of our, our, our episode from last year, but the triple demic was a real kick in

And it was not rosy at that time. It was rough, especially for the inpatient pediatric folks.

There's, there's no point. There's, there, there's no utility to do that. What I can do is make sure that all the people that I take care of. Who should be getting the vaccines are getting them and make them accessible. Make sure we're following up with them, make sure they get them. So that's the population that I focus on the ones who actually want to do those things, make it easy for them.

The people who don't want to, they're not going to.

And it's just, I think at some point it just becomes a waste of energy to try to convince somebody to get a vaccine.

New York Times has had a fantastic series on on COVID reporting since the very beginning of the pandemic and really, really good science. I think Uh, reputable sources. As long as it's a reputable source, the, um, um, Johns Hopkins COVID site has a lot of great information. I still use that a lot. Really, really good information.

It's just whatever it is that just ensure that it's reputable, uh, written by people who are credentialed and have, um, or who, who really are experts. I think you can't go wrong.

like, for example, like, um, You're gonna, um, you need a lawyer for something, right? You know, you're gonna actually go to a real lawyer who has like experience. You're not gonna go to some guy who says he's a lawyer and Screws everything up for you, right?

So just pay attention Maybe to bring back that concept of expertise where it really matters.

Um, and again, sometimes it's pretty in depth, so if you are want to nerd out, that's great too. But I, I found her to be a very good follow

and very informative.

no, I just, um, you know, I'm on TV every, probably on every week or two now on

channel seven. I do like a COVID spot.

So, um,

I , I would charge Blue Cross, you know, level four for this, uh, for this episode. But, um, yeah, if you, if this resonates with you and you wanna share this with somebody and you think it would be helpful, please share this episode with someone. Uh, I think it's great. Uh, I do it all the time with the other podcasts that I'm into, whether that's 'cause it's funny or there's a great story.

We wanna be informative. We wanna, we wanna boost the, the, the. Public health information milieu. And we hope we do it in a way that, um, that you guys enjoy. So, so please share this 'cause it means a lot and it matters. Um, and if you wanna buy our merch , go do that because Dave Hylo made it and he is one of the funniest people I know.

In fact, Rob, you didn't get to see it, but this shirt says, advice from the last generations of physicians who inhaled lead

can

Yeah, and Dave is a genius and way funnier than than me. So, um, and then I think my, unless you have anything else to say, Jeremy, I was gonna wrap it up.

Um, you should treat your body like you treat your phone. You know, we, you know, your, your phone tells you you got a, an automatic update. You just say yes to that baby. That's the same thing. That's getting a vaccine, getting a shot. It's not a booster, it's a shot. Get 'em all. Listen to your doctor friends.

the amazing music is credited to Skill Cell with Bay Licensure The podcast is meant for educational and entertainment purposes only The contents of this podcast should not be taken as medical advice to treat any medical condition in either yourself or others Please consult a medical professional for any medical issues that you may be having The contents of this podcast are the opinions of the host only and do not reflect the opinions of their employers or affiliations This entire disclaimer also applies to any guess or contributors to the podcast Under no circumstances shall Dr Julie Bruny or Dr.

Jeremy Allen or any guest to the podcast be responsible for damages arising from use of the podcast