Podcast: Infections, Vaccinations, and Other Questions

James Hamblin answers questions from callers with mild COVID-19 cases.

On this episode of the podcast Social Distance, listeners with mild COVID-19 cases call in with their questions. James Hamblin explains why he thinks the summer could be wonderful. And Maeve Higgins shares nun news from Ireland.

Listen to their conversation here:

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What follows is a transcript of the episode, edited and condensed for clarity:

Maeve Higgins: I’ve been dying to tell you about the latest Irish news. Ireland is under pretty severe lockdown at the moment. You’re not allowed to move from county to county. But some nuns put this video online of them performing an exorcism in Dublin, and they’re not from Dublin.

James Hamblin: Oh, and you’re not allowed to … do exorcisms outside of your locality?

Higgins: I mean, you’re allowed to, but you’re just not allowed to break COVID guidelines to go and do an exorcism.

Hamblin: What happened to them? Are they in trouble?

Higgins: Nothing’s happened to them. The government was already keeping an eye on them. It’s just these two nuns. They’re in a group called the Carmelite Sisters of the Holy Face of Jesus. And they got in trouble just before the Christmas holidays too, because they were selling potions online, so the nuns were, like, known to the authorities and then they broke the COVID rules and came and did an exorcism.

Hamblin: Speaking of religion and COVID, when we talk about people forgoing vaccines, religious exemptions have been a huge thing here in the United States for kids going to school unvaccinated. I’m foreseeing some pretty big debates in the coming months and maybe years about requirements for vaccination and religious beliefs. There’s going to be a lot to unpack there.

Higgins: There is. And Jim, I read your piece about how a COVID-vaccinated summer could be wonderful. And I want to ask you about population-level immunity. You wrote that “no other country has endured so much death and illness. But for all the failures that led to this point, the U.S. does finally seem to be experiencing some protective effects of population-level immunity.” Could you tell me more about that?

Hamblin: The numbers in the U.S. look really promising. Cases are going down really quickly and deaths are plummeting because, among those cases, the high-risk people are being vaccinated or have been vaccinated. Add to that the effects of places that have already been hit really hard, where the virus seemed to be kind of burning out, at least temporarily, on its own.

And you’ve got warm weather on the horizon where people could be outside. It’s a coalescing moment, and I don’t know that it’ll last, but things are looking really promising for the summer. And I’ve been trying to deal with how you genuinely let yourself be pulled forward by the hope and joy in being able to do things that we couldn’t do for a long time, while not getting complacent and declaring things “over” or repeating the same mistakes we’ve been making for the last year.

Higgins: So many people are still catching and experiencing COVID. And we get so many brilliant messages from listeners, so I thought it could be really fun to hear from them today.

Hamblin: Yeah, that would be great. Honestly, the voicemails we get are my favorite part of this whole podcast.

Higgins: The first caller is a 68-year-old in central Pennsylvania. His name is Patrick. And he recently got a mild COVID case and wanted to talk about his immunity—and if and when he needs to schedule a vaccination appointment.

Hamblin: Hello, Patrick. How are you feeling?

Patrick: Not too bad, actually. I had a fairly mild run of this, and the only symptom left over is sort of a foggy-headed lightness. I can give you a pretty concise timeline [of my illness]. In the vaccine rollout here in this area, my wife was entitled to a first shot. She got her first Moderna shot on January 23 and showed her first symptoms of COVID on the 29th. On the 31st, she tested positive and went through a 10-day period where she had mild symptoms. I tested twice negative during that period. On the 13th of February, I started showing symptoms and tested positive on the 14th.

Higgins: You tested positive on Valentine’s Day?

Patrick: I did.

Higgins: And you got it from your wife?

Patrick: (Laughs.) I did.

Higgins: Patrick, I’m sorry. What a gift.

Hamblin: Well, I’m glad you’re both doing okay now. I hope things continue to improve for you. And so you’re specifically wondering about vaccination now, after having gone through this?

Patrick: Yes. For both of us. My wife’s already had her first shot. She’s due for her second. Should she get it? And I actually have an appointment scheduled for March 3 that I haven’t canceled yet. And I’ve heard several things from primary-care doctors. And I’m just curious to see what your take is.

Hamblin: Well, I never want to contradict anyone’s own doctor, because everyone has unique considerations. What’s the gist of what you’re hearing?

Patrick: [That I should wait] three months. And the reason given to me is: “because you would have the immunity, and that is the current guideline.” So at least part of that answer has to do with current distribution protocol, I suppose.

Hamblin: So with a lot of diseases, you don’t want to get vaccinated right after you’ve had it, because there can be an increased rate of side effects. If you already have high levels of this acute immune reaction going on, and then you get vaccinated, your body could react more strongly than it would otherwise. We don’t know a lot yet about how that would work with this vaccine, because it’s so new, and I think it’s very reasonable to wait that amount of time.

I doubt that it would be a high-risk thing to go ahead and get it. But I also would expect that you have enough protection, having just been sick, that it would be almost impossible for you to get a serious bout of COVID in that time. You are protected, essentially, at least from severe disease. So I don’t think you can go wrong by waiting that period. I certainly wouldn’t wait a year. I wouldn’t expect the immunity that you’re going to have after this infection lasts extremely long or is going to be 100 percent. We’re not seeing people have reinfection cases really shortly after being sick, so I think that should be reassuring.

Patrick: What about my wife’s case of getting a second shot?

Hamblin: People seem to be pretty well protected after the first dose. The second dose is yet another exposure to this spike protein, which you just naturally got. They’re not exactly comparable, but I expect the effect is similar. It’s like your immune system is doing push ups: Is it better if you do 10 or 20? Sure, do 20 if that makes you stronger, but 10 also is nice. I wish I could be more definitive here. And if there were a serious risk in either direction, I would definitely tell you. But I don’t see one.

Patrick: Thank you both for doing this. I’ve followed this podcast since the beginning, and it’s been quite helpful.

Hamblin: That’s great to hear. It’s been a pleasure to do. And it’s great to hear from you.

Higgins: Okay, Jim, now we’re going to hear from Camie in Idaho.

Hamblin: Hi, Camie. How are you feeling?

Camie: As well as can be expected, I guess, under the circumstances. I definitely don’t have it as bad as many people have had it. So we feel very blessed.

My husband was in quarantine for 10 days. I’m actually in quarantine for 21 days because of underlying health conditions. My doctor just wants to be on the very safe side, which I appreciate. And that started me thinking that, when we’re done with this, what does that mean? Should we be just disinfecting when we recover, just like with any cold or flu? How much of this is sticking to surfaces, and what exactly do we have to clean? It made me think also about when the cruise ships came back and they were finding active, live coronavirus weeks and weeks after.

Hamblin: Are there other people in your household?

Camie: No, it’s just my husband and I, but we have a new grandbaby. We want to go see her, and I don’t want to inadvertently infect her when we go see her eventually.

Hamblin: Absolutely. This has been a point of a lot of confusion over the course of the pandemic. I and most other people making recommendations this time last year were much more about surfaces, about hand hygiene, about sterilizing high-touch surfaces. And then, over the course of the year, it’s really turned out that the virus doesn’t linger very long on surfaces. And when it does, it doesn’t seem to happen in infectious doses. You’re just very unlikely to get enough of a viable virus onto your hand after you touch something and then touch your face and infect yourself.

There are other infections that certainly work that way. But just because you are able to detect some RNA of that virus on, say, a cruise-ship doorknob or something, that doesn’t mean that someone who touched that would get sick. It’s kind of a fine distinction, but we had to play it safe at the time. So we sort of overestimated that and didn’t pay enough attention to air. It seems like surface transmission can happen from touching something, but it would have to be within a very short period. Say, someone came into your office right after you’ve been working at a desk for eight hours and then for some reason had to put their face onto your desk.

Briefly touching a handrail as you went down a staircase and then someone coming by an hour later and using that same handrail—that seems like as close to a zero percent possibility as possible. And so the time period in which the virus is persisting on surfaces at all is short enough that once you and your husband are clear of needing to quarantine, the surfaces in your house should not be expected to contain any lingering virus.

Camie: Should we stay away from the grandbaby, even after my 21 days of quarantining?

Hamblin: If you’re going to see people, stay outdoors, wear a mask, don’t have prolonged close contact unless this person is in your tight bubble and you’re all being really vigilant. But no, there’s no reason to expect that you’re at any increased risk of infecting other people in that period.

Higgins: Camie, thanks so much. And I hope you just feel 100 percent really soon.

Camie: Thank you so much. I so appreciate your help. Wonderful to talk with you.