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Doctor: COVID-19 variants have 'represented incremental setbacks'

Brigham and Women’s Hospital Emergency Medicine Physician Dr. Jeremy Faust joins Yahoo Finance Live to discuss new COVID-19 variants as vaccine rollouts continue.

Video transcript

ZACK GUZMAN: Welcome back to Yahoo Finance Live. A worrying new COVID variant that was detected by researchers at Texas A&M University, it showed a concerning resemblance to some other variants that we've seen in terms of antibiotic resistance and potentially more severe illness. Experts there say that the strain, dubbed BV1 for the Brazos Valley region where it stems from, shares genetic characteristics with the B117 variant that was first discovered in the UK, which, for a while now, has made up the majority of new infections back here in the US.

And for more on that and all of the other top coronavirus headlines we're watching here, we're joined by Dr. Jeremy Faust, emergency medicine physician at Brigham and Women's Hospital. And Dr. Faust, good to be chatting with you again. It seems like we-- I mean, we talk about variants a lot here. So I know that there's a lot of them for viewers at home to keep track of. But when it comes to what we're hearing about this one particularly down in Texas, how worried are you about maybe some of the things we're learning now?

JEREMY FAUST: Good to see you. I remain kind of similar on the variant question, which is that so far, the variants have represented incremental setbacks, a little bit of breakthrough on mild infections. The B117 variant might have a slight uptick in mortality, certainly more contagious, but not really changing the whole shape of the pandemic, not like a total cataclysmic change. But the thing that worries me is that there are still so many infections that we give the virus an opportunity to mutate. And once in a while, one of those mutations does crop up in a way that can hurt us.

And so what I keep hoping that I won't wake up and read in the next paper is that now I've got one that's 10 times worse or one that hits kids a lot harder. So I keep-- every time I hear a new variant, I think, OK, another incremental setback is potentially upon us. But so far, I haven't seen one that has really just blown the whole thing up and turned this into, you know, the kind of fatality rates you would see with a pathogen like Ebola, for example.

AKIKO FUJITA: To what extent is that risk of new variants coming online elevated when you've got still about half the population that isn't vaccinated? It feels like things really accelerated for the first half. But now you're hearing about supply outpacing demand.

JEREMY FAUST: Well, this is the argument why we need to vaccinate people who are young. There's a prevailing feeling that if you're not an old person, that you don't have to worry about this virus. And then if you got infected, you would just gain natural immunity and move on with your lives. The problem there is just what you're getting at, which is the more people who are not vaccinated, the more infections we have. And infections are where mutations occur. Infections are where variants emerge from. That's the opportunity.

So when I wrote with Angie Rasmussen in "The New York Times" last month or this month, we wrote, look, we really feel like we got to vaccinate the kids as soon as we know that the safety data is there primarily because we don't want to wait around for a variant. So yeah, the way to keep variants from cropping up is to minimize infections. And we do see that the vaccines not only protect against disease, but seem to have a major impact. Not a complete protection, but a major impact on lowering infections as well.

ZACK GUZMAN: That's interesting you bring up the infection rate among children because in Michigan right now, where we know that the spike's pretty bad relative to where we're watching elsewhere in the US, rates of child infections there are now higher than they've been at any point in the pandemic. I'm not sure necessarily how much that might stem from the fact that something else is going on or just the fact that kids aren't getting vaccinated right now.

But when you shift and look at maybe other policies getting put into place right now, we're looking at California's Cal State and UC program also requiring COVID vaccinations for students to return back there in the fall semester. We get into questions about vaccinating and rules like that. What's your take on kind of where you draw the line when it comes to schools putting in policies like that?

JEREMY FAUST: Well, I think every jurisdiction is going to have its own legal challenges. There's going to be-- a lot of that's for the law side of things. But what I would say is that it's not unusual for us-- for organizations to require vaccinations. You can't send your kid to school without proof of vaccination for all the vaccines that we get routinely. Now I grant you, this is an emergency use authorization scheme that we have. It's not an FDA approved. But some people would argue that until these vaccines have full approval, you can't put them in the same bucket. Others have said that that does not apply and that they're good enough and that the public safety interests there make it so that a vaccine mandate in various jurisdictions is not only wise, but legally permissible. But I'll leave that to the legal experts.

What I will say is that the rising number of infections in young people does catch my eye. And I think I've said this before. You take a large number of people, millions and millions of kids, and a very small percentage of them would have serious infections. But that's still a lot of people. And it doesn't escape my notice that, yes, kids have been spared comparatively, thank goodness. But more kids died of COVID last year than usually die of all respiratory diseases combined. So that's something that I think people don't realize, that a very few number of American children die of respiratory illnesses. It's usually under 500. So flu, for example, would be 150 a year. So COVID is actually harder on kids than we realize. And it's worth protecting them against.

AKIKO FUJITA: And doctor, finally, we had heard going into the summer what herd immunity could potentially look like, about 80% of people getting vaccinated. What do you think should be the metric now as we look to the summer months? Is it the case counts on a daily basis? Is it another number? And do you think there should be sort of a universal standard?

JEREMY FAUST: Yeah, this is really challenging. And this is a great example of how do you combine everything we know about epidemiology, virology, and public health to make a policy. And it's difficult. But what I would say is, as vaccination becomes more widespread, I think case counts become less important because there was this sort of COVID denying a year ago or even the past few months, where people say, oh, it's just cases. It's not really illness. They were wrong.

But as we move through the population and vaccinate more people, there's a point there, that at some point, if I get a case of mild COVID, but I don't really notice it, then my case doesn't really matter, as long as I'm not spreading it to others who could be harmed. So for me, a really good metric to watch is hospitalizations. Hospitalizations gives you a pretty good sense of how people are doing in the community. And I'm looking for-- herd immunity is going to be a moving target because natural immunity could wane. We don't know how long the vaccine immunity will last, although I'm pretty optimistic it'll last a while.

So, to me, the way you know you're at a place where you can kind of return to normal is if our rates of flu-like illnesses and COVID-like illnesses, which we track-- if those rates are close to our historical norms, not the norms of the last 15 months or whatever it's been, then I think that's where you know you're really through it. And I want to see a sustained low level of hospitalizations. That's what I'm looking for.

AKIKO FUJITA: Some good context there. Dr. Jeremy Faust, emergency medicine physician at Brigham and Women's Hospital, always good to talk to you.