PODCAST: Michael Osterholm on the COVID-19 Vaccine Rollout

Solveig Rennan: Welcome to Under-Told: Verbatim. I’m Solveig Rennan for the Under-Told Stories Project. We report from all over the world for PBS NewsHour. We’ve talked to experts and people making a difference in their communities. In this podcast we’re revisiting those under-told stories to share extended interviews we’ve done with changemakers around the world. 

Solveig Rennan: It’s April  2021 –  the COVID-19 pandemic has been omnipresent for more than a year, and vaccines from Moderna, Pfizer and Johnson & Johnson are rolling out across the United States. 

Solveig Rennan: But where you live, who you are and how much time you have on your hands are significant factors into when you might get inoculated. Throughout the pandemic, we’ve reported on essential workers, focusing especially on some of the most overlooked employees – in the U.S. some 50,000 meatpackers have had COVID-19 and about 250 lost their lives. We’ve been checking in on Worthington, Minnesota – home to the JBS pork plant and hundreds of immigrants and refugees who work there. 

Reverend Callahan: If it was not for the immigrant community, this community would just fold up and die. 

Solveig Rennan: Reverend James Callahan preaches alongside Reverend Miguel Praños at the bilingual St. Mary’s Church 

Reverend Callahan: we also put it in the context of what Pope Francis had said, that if you do nothing else in Lent, get the vaccine, because that is the greatest act of charity and love that you can do. 

Solveig Rennan: They got their vaccines on video in early February, hoping their example might convince reluctant parishioners 

Reverend Callahan: When the vaccine started rolling out, people were very, very hesitant about getting the vaccine. Some thought it was too early, that they didn’t think it was enough scientific information, whether it was going to be safer not to get it. There was a second group of people who were afraid that if they got the vaccine, they were going to be turned into immigration. And the third, were just frightened of it because of past situations that they’ve heard of. When the government was doing a vaccination program

Solveig Rennan: For its part, JBS held a vaccine clinic at the plant and provided employees with a hundred dollar incentive to get the single dose J&J shot— that got about 1600 of its 2200 employees vaccinated, but that still leaves many workers vulnerable, both at JBS or at any of the smaller factories and livestock farms in the area. 

Fred de Sam Lazaro: Oh, I am speaking to you from the rectory of a Catholic Church down in Worthington, Minnesota. 

Michael Osterholm: I know right where that is that. 

Solveig Rennan: On March 26, after talking to Reverend Callahan, our correspondent Fred de Sam Lazaro borrowed his wifi signal to speak to epidemiologist Michael Osterholm over Zoom. The director of the Center for Infectious Disease Research and Policy at the University of Minnesota was named to President Biden’s COVID-19 advisory board last year. 

Fred de Sam Lazaro: How important are influencers such as Father Jim in this church who has preached the value of it has put himself on Facebook getting getting himself inoculated? Anybody idea how critical such influencers have been in the vaccine rollout?

Michael Osterholm: We’re really on a journey right now with this vaccine rollout. In the early days, where there wasn’t nearly enough vaccine for everyone that wanted it. We didn’t have to worry about if there were influencers in the community, there was enough interest, there was enough desire, there was enough need to get vaccine. But as we continue our journey, we’re going to hit a period soon, where we’re going to far outstrip the vaccine versus the individual wanting that kind of equation. And it’s going to be a situation with lots of vaccine, and we’re going to have people who are not willing to get vaccinated. This is where the influencers become absolutely as critical as the vaccinators themselves. And so one of the challenges I see right now is we keep putting out numbers and numbers and numbers while people getting vaccinated pretty soon we have to start telling us who’s getting vaccinated. For example, right now in the United States, about 17 million individuals 65 years of age and older have not gotten vaccinated yet. The increase in number of new vaccinees in the past week and 65 year olds or older has been less than 1% increase. So suddenly, Father Jim influencers become absolutely critical in helping us close that gap between those who are most likely to have severe disease, hospitalization and deaths and those that actually get vaccinated.

Fred de Sam Lazaro: This was one of the early hotspots in the pandemic, the Meatpacking industry in general nobles county and Worthington, Minnesota in particular. They had pretty decent uptake from all accounts within the plant at JBS last Friday, and they’re trying to mop up elsewhere, is Worthington and places like it on the way to happily ever after?

Michael Osterholm: I don’t know. And no one knows. What we have had happened with this pandemic is a period of almost 10 months, where we were happily on our way to coming to a conclusion that would very easily answer the question you just asked, once we had a vaccine, and once we had a highly successful vaccine, we knew it just be a matter of time before we take care of this pandemic. then along comes November. And it comes the occurrence of these variants, these mutated viruses, that now have the ability to one: be much more infectious, two: cause more serious disease and three: evade the immune protection of both natural infection and the vaccine. The latter group, we’re still trying to understand just how much of that evasion occurs. With the new variant situation. I wish we could say we know that come on a certain date, if X percent of people are vaccinated, we’re home free. I don’t think we can say that. And in particular, one of the challenges we have right now is is that these variants are coming from natural infections, people who are infected and the virus mutates within that individual in the low and middle income countries of the world right now, we’re not looking at getting vaccine to most of those people for years, if ever, given the current plans. Yet those will be the places that these variants, these ones that might evade vaccine protection or even natural infection protection are going to come from. So I’d like to tell you, it’s going to be all over with by summer, we’re gonna have most people vaccinated, most people accept the vaccine, and then it’s back to a new normal. I don’t think we can say that right now. And that’s a real challenge.

Fred de Sam Lazaro: To localize what we’re witnessing right here. Is there any intelligence that you’re aware of that indicate what variants we’re looking at in communities like this?

Michael Osterholm: Well, everywhere in the United States, right now we’re looking at B117. This variant that was first identified in the United Kingdom back in November, is the one that is much more highly infectious anywhere from 50 to 100%, more infectious than the old viruses, it surely is causing much more severe illness. We’re seeing it now 50 to 60% more severe cases. And the one factor that really has changed the equation is prior to B117 being present, we actually saw very limited transmission of the virus in kids, particularly younger kids. This is why I among others felt that we could reopen schools for particularly K through eighth grades, with limited risk to the kids getting infected. Kids are transmitting the virus to their parents or other family members at home or to the teachers. And we proceeded along that course, when B117 emerged in November. In the United Kingdom, it was very clear that young kids were a major source of this virus in the communities. Not that dissimilarly than what we see within influenza, every year, when we work with the outbreaks of influenza about to come, the first place we look for them are in kids. And that is often the event that starts the transmission throughout the community. And while kids are not getting infected any more frequently than adults, right now, they are getting infected at the same rate, which is so different than before. And now they are serving as a major source of transmission. That’s why if you’re looking in the United States today, you can see in many of the states that are seeing these big increases in cases including right here in Minnesota, school aged kids play a huge role in that. And of course, for right now, we don’t have vaccines for them, we likely will by the fall, we’ll hopefully we’ll see a situation we can vaccinate them. So the variant that we have to keep our eyes on right now front and center is B117. With this increased transmission in our communities and seeing that more and more younger individuals are going to be infected and severely ill. You’re on mute again, sorry.

Fred de Sam Lazaro: I’m diverting from our focus on the Meatpacking. But since you make this very interesting point on variants, can you talk a little bit about other things that might lurk, the Brazilian variant, the South African, are those in any way a factor as well?

Michael Osterholm: At this point, we know that the P1 or the variant first found in Brazil, which is of grave concern, because of its ability to evade immune protection, either that or the vaccine, or of natural infection and how much it evades it is still a question. Also, the additional of virus or concern about 1351, which was the one first seen in South Africa, and now also has spread to other locations of the world, we have all of those right here in the United States, but they still constitute a very, very small percentage of the virus activity we see B117 somehow is beating them out. And we’ll have to see over time what happens with what we’re seeing right now in South America, it clearly a major concern with what regard to P1 does, and also just clarifying how much this B117, or the UK variant also contributes. So the whole world of variants right now, I think, leaves many of us are very unsettled as to knowing what the future is going to look like. And again, as I keep emphasizing, the more infections we see, the more likely that new variants and potentially very troublesome variants are going to emerge. I think what most people don’t realize, if you actually look at the case numbers that have occurred throughout the world over the course of the past 14 months, we are about to hit upon the darkest days of the pandemic. I think that within the next month, we’re going to see the numbers occurring globally, far surpassed the numbers that we saw in January of this year globally, which was by many people’s estimation, what they thought would be the peak cases. So we’re still in the middle of this pandemic on a global basis. And that that really is a challenge that I don’t think most people realize a lot of people think we’re just about done, we’re not

Fred de Sam Lazaro: In this population, which is to say of migrant workers, which are now the majority of the population in this general community. The historic population tends to be older seems to be well covered in terms of vaccinations. There was reasonably good uptake in the JBS plant. But there are a whole host of people who work on small farms who are unreached, who work in smaller packing plants, we were unreached and many of them don’t want to be reached in many cases because of documentation concerns. And they’re as, you know, subjected to the rumor mill and the conspiracy theories as anyone else. How critical in your mind is this population and reaching this population with a vaccine in the grand scheme of things, are they critical in intercepting the spread of this virus?

Michael Osterholm: To date, we estimate that about 50 to 55% of us population is still susceptible to this virus, meaning they’ve not previously been infected and developed immune protection, nor have they been vaccinated. As you can see, right now, the surges that we’re seeing in a number of states tells us that even having that smaller percentage of people vulnerable to this virus still can lead to very large outbreaks. So when you take it to the community level, or the county level, pockets of individuals, 20, 30 40% of the population can still lead to ongoing and major epidemic problems in that community or that county. So it is critical, we try to reach everyone house by house lot by lot as we can. And this is where public health will be at its very best, is trying to identify individuals who don’t want to be identified people who are concerned about the fact that they don’t want government in their lives. But we need to get them vaccinated. So this is where the community has to come together on its own, to help us identify how to do that. And I don’t have any sense that we’re going to get everyone vaccinated. But I think we’re going to see that when we do the community by community efforts, we’re going to do much better over time.

Fred de Sam Lazaro: Okay, and just to dot that i, At what point given all that you’ve talked about the confounding variants, at what point of penetration or vaccine reach and immunity, would you say that we’re at herd immunity? 

Michael Osterholm: You know, I’m one of those today that is challenging the idea that we ever will reach herd immunity. Remember, herd immunity is that concept where enough people are infected or previously vaccinated in your community, and they all have immune protection, such that if I’m infected, and I’m in contact with all of them, if they’ve already been protected, they’re not going to get infected for me. And that begins to then really slow down transmission in the community. The unknowns we have right now is how long does protection last? We’re seeing a number of individuals who are now becoming reinfected after having had a previous infection. We’re seeing surely a number of people who are vaccine failures following vaccination, it’s important to add that that still is a small, small percentage of people getting vaccinated, there should not be a reason to deter you from getting vaccinated. And then if you throw in the variants that are still developing around the world every day, when there are billions of people not covered by vaccines, I don’t think it’s really possible to determine at this point, will we ever reach this herd immunity, this magical number, which I think today, given the increased transmissibility of B117, surely suggest as much higher than potentially even 75%, we may need 90 95% of the population protected? And so with all these unknowns, I don’t think we can answer that question with any scientific certainty. We can only hope that we might one day reach a herd immunity. But we’ve learned a long time ago hope’s not a strategy.

Fred de Sam Lazaro: So learn to live with it and to manage it basically.

Michael Osterholm: That’s it, yeah, I see the long term future with this virus is to learn to live with it and to manage it as effectively as we can.

Fred de Sam Lazaro: You talked about the importance of the public health effort, the door to door, the door knocking campaigns, etc, etc. Are you seeing hopeful signs of a concerted effort in on that frontier?

Michael Osterholm: At this point, we’re seeing only limited efforts on the house by house neighborhood by neighborhood basis, because there’s been such an effort to get out large numbers of doses of vaccine in large clinics, so that we can ramp up the numbers. I for one have been, you might say whispering in Governor’s ears, that at some point is not going to be as successful just to keep coming up with big numbers, as it is to basically get vaccine to those at highest risk for severe disease hospitalizations and deaths. And so I think you’re going to see a transition over the course of the next few weeks. Where are those big Coliseum wide campaigns where we can vaccinate 1000s in a day, which are really important, give way more and more to these efforts by local and state public health officials to reach out to individuals whether they want to be found or not, and to try to get them vaccinated.

Fred de Sam Lazaro: And final question. What do you suspect are the lessons to be learned about or from the experience of the Meatpacking business, the essential workers who work in close quarters in the kind of environments that we that we see over here? Are there any lessons from the way this pandemic has unfolded, that might protect everyone, and our supply chain for meat and for other things?

Michael Osterholm: This pandemic has opened a number of very, very painful doors in our history. I think if you look at whether you’re talking about age, and how many of our cases come from long term care facilities, where we have unfortunately neglected in any real meaningful way to address the issues of of quality of life and quality of care and long term care who works there, how well are they prepared? We’ve seen this with a number of occupational groups based often on race and ethnicity, such as the meatpacking plant, where you see them working shoulder to shoulder, and hour after hour where the transmission of a respiratory pathogen is huge. We’ve seen it along political ideologies and whether or not you really believe this pandemic is real or not, whether you’re experiencing pandemic anger, because you believe that this is all to do about nothing except to try to limit someone’s personal rights. If you see the families that have suffered immeasurably when small businesses have shut down because of the pandemic. And the recommendation is try to limit contact or minimize cases. If you put this all together, I think they’re going to be many lessons are going to come out of what should our society look like going forward in the future. And if we haven’t learned these lessons from this pandemic, I don’t know what is going to teach us that. But we’ve got a lot of work to do, to deal with healing our society, as much as we have to also learn to live with this virus

Solveig Rennan: This episode was hosted and edited by me, Solveig Rennan, and produced by Simeon Lancaster. The interview was conducted by our director Fred de Sam Lazaro.  You can find every Under-Told: Verbatim episode, virtual reality 360 experiences and our entire library of Under-Told news reports from around the world at undertoldstories-dot-org. Under-Told: Verbatim is brought to you by the Under-Told Stories Project based at the University of St. Thomas in Minnesota. As always, thanks for your support