COVID-19 Vaccine Q&A with Brian Thomas Fletcher, MD

The following is a transcript of a 1/28 conversation between John Busby, managing director of The Senior List, and Dr. Brian Thomas Fletcher, a physician of emergency medicine. Portions of this conversation have been abridged or altered for clarity.

John Busby: I think I speak for everyone here when I say thank you to Dr. Fletcher, your colleagues, and all of the frontline workers who are keeping us safe and treating us during this time. To start, I’d like to ask you to summarize what life has been like at the hospital over the last 12 months.

Dr. Brian Thomas Fletcher: First of all, let me say you’re welcome. It’s actually our pleasure as emergency room personnel to help people during this pandemic. This is what we’ve trained for, and I don’t know of one colleague––from nurse to technician––who says that they would not have done this had they known a pandemic was coming. This is what we’ve trained for.

With that said, I’ll never forget when this first hit, and everyone in the ER was like, Is this a pandemic that’s coming? Then the world was kind of shocked by northern Italy when people in that region started to get very sick. That’s when we realized that this is not a nothing burger, and it was on the way here. So we were really frightened at first, to be honest with you, but we were happy to help. The way we understand COVID now is far different than our initial understanding.

I knew physicians and colleagues who moved out into the garages because they were so afraid of bringing it home to their loved ones. At that point, we didn’t know if it was strictly airborne or if it was on your shoes, your clothes, your scrubs. We didn’t know how you brought it home, whether masks were really protective. Since then, we’ve learned a lot, so what I also want to say is thank you to everybody who’s doing your part social distancing and mask-wearing. These are all proven methods to decrease transmission, and we’ll talk about this later, but we’re getting a lot better in terms of transmission in the United States as we know more and do our part.

JB: How would you describe the state of COVID in the U.S?

BTF: The state of COVID in the United States is very regional. There are some areas of the U.S that are horrific. Everyone recalls in the beginning how New York City was the epicenter of the pandemic, and people––for lack of a better term––were dropping like flies. They sort of got it under control, and then it was spreading in different pockets, mostly urban areas. Currently, in Los Angeles, they call us the New New York right now because we’re having the highest rates of transmission and death.

A lot of this has to do with travel and the holidays, quite frankly, because a lot of people would take it on an airplane and travel somewhere without knowing they were positive. The tricky part about COVID is that you don’t register as a positive test until you have probably a minimum of
four to five days of being infected, unlike the flu, where you get infected and register a positive test in about 24 to 48 hours. So people would think that they’re negative for almost a week, hop on a plane, and basically spread COVID all over the place without knowing that they even had it.

Because many people are completely asymptomatic, especially younger ones, they have no idea that they have it. We have no symptoms, so we’re spreading it everywhere without even knowing, and most young people aren’t even getting tested because they don’t see a need or. They feel fine; they don’t know anyone who has it.

JB: I’m gonna kind of cut to the chase on the vaccine, but let me just ask the first question. Dr. Fletcher, have you been vaccinated?

BTF: I have received dose one of the Moderna vaccine. In a few days, I’m supposed to receive the second dose.

JB: Did it hurt?

BTF: I think what you’re asking is, Did I have a reaction to it? And the answer is yes, though mine was more on the moderate side. I got a low-grade fever for a day: aches and chills. I took off the next day, but that’s quite frankly how I knew the vaccine was working. When I went to bed, the symptoms waned. By the next day, I was completely fine, certainly much better and milder than getting COVID.

JB: I follow you on Facebook and Instagram. One of the things you have historically done every flu season is remind everyone to get a flu shot. This is even before COVID. Why did you feel the need to do that, and what is the overall role of vaccines in your mind?

BTF: The overall role of vaccines is to protect the population, in addition to individuals at large.
Working in an emergency department, it’s sort of like an epidemiological cluster of what’s happening in the community. So unlike other very specific branches of medicine––for instance, I don’t know pediatrics or gynecology––where you’re dealing with a very specific subset, we deal with a sort of microcosm of whatever community we’re in. So I see things like the flu.

I do see the importance of vaccines because they protect everyone else, including yourself. That’s the concept of herd immunity. If you know there are 100 people in a certain community and 90+ percent of them are vaccinated, then the other 10 percent don’t have much to worry about. Typically, the other thing that you need to know about vaccines is that you can still get whatever disease it is if you have the vaccine, but typically the vaccine makes that disease progress or process much less pathologic, meaning I tested positive for the flu one year, even though I had the flu vaccine and get it every year. But my case of the flu was actually fairly mild. I think I had a fever of 101 for a day, body aches, and then I was fine. But I was flu positive, so it doesn’t prevent you from getting the disease in all cases. However, in almost all cases, it will make the disease much less severe if you get vaccinated, which is actually true of COVID.

JB: Okay, Dr. Fletcher. I’m going to start asking some questions from the audience. So the first one here is from California.

Since COVID is so bad here, I don’t understand why Governor Newsom is opening things up. Also, I got my first shot of Moderna and only had a sore arm and a slight headache. I’ve been told the side effects for the second shot are worse and have a friend who experienced that. What causes this?

BTF: So your question is two parts, and I’ll take the first one. I’m going to punt it a little bit because it’s really politically charged. I don’t have a good answer as to why we are opening restaurants and some gyms and salons. For my friends in politics, I feel like the question is one of balancing the economy versus safety.

The most recent study of outdoor dining in Los Angeles said it was responsible for about four percent of transmission, so not very much. With that said, four percent means a lot to you if that’s your grandmother who catches it and dies. So again, I don’t have a good answer as to why they’re doing that other than to say that they feel like it’s balancing out.

Now, in terms of the reaction that you’re getting, what happens is you get a reaction because you get the vaccine that means your body is building antibodies. I’m sure we’ve all heard this before. Someone gets the flu vaccine, and they say they will no longer get it because it gave them the flu. No, it didn’t; it’s a dead virus, not a zombie. What ended up happening was your body is reacting to it. You probably got swollen lymph nodes, and your body is building up antibodies to the flu because they see the dead flu inside of you. That’s the same thing that’s happening with COVID.

Let me also say that if you don’t get that reaction, it doesn’t mean that you’re not building up antibodies. Most people get an inflammatory reaction where they get small lymph nodes, fevers, and chills, which means it’s working. As far as people getting the second shot with worse side effects, this tends to be anecdotal. I hear that a lot too. I don’t think anybody really knows why that’s the case. The news reports seem to play that up a lot because it’s kind of a sexy story, but that’s only about 20 percent of cases, so the vast majority of people don’t really have a reaction. The vaccine still works very well. It’s over 95 percent effective.

JB: I’m going to move on to the next question. So there are a bunch of vaccine manufacturers that have been approved. There’s Moderna, Pfizer, and I believe Johnson and Johnson might have one approved in the coming weeks.

Is one vaccine better than the other, and can we pick which vaccine we get?

BTF: The answer is maybe. What ends up happening is the efficacy of the vaccines are based on the data that the company is providing to us. So far, the only vaccines available are Moderna and Pfizer, and they’re using a technology called mRNA, which I’ll talk about in one second. These vaccines are reported to be about 95 percent effective after two doses. That’s great.
Most people don’t know this, but for a vaccine to be approved by the FDA, it only needs to prove about 50-55 percent effectiveness, so 95 percent is fantastic.

The other vaccines that are coming out from Johnson and Johnson, as well as AstraZeneca, use a different type of technology. Let me just briefly talk about this now because it’ll make a lot more sense. On every cell in your body or virus or fungus––or whatever cell in existence––there are proteins on the surface that identify as that cell or particle. For example, your lung cells have proteins all over that identify it as a lung cell, and your body says, That’s a lung cell! A measles virus has proteins all over the surface where your body says, Hey! That’s measles! The same is true of COVID

The COVID virus has proteins on the outside where your body says that’s COVID. What mRNA does is it creates the protein on the surface, not the virus itself, which is why it’s so safe. It creates the protein on the surface that identifies it as COVID. When your body sees that, your immune system says, Hey, that protein is something we need to attack. What ends up happening is if COVID ever gets inside of your body, your immune system recognizes that protein––also called the spike protein––and attacks it, killing whatever it’s attached to. That protein is only found on COVID. It is not found on your lung cells; it is not found on your brain cells, your liver, anywhere else in your body. It’s a completely foreign substance, and that’s why the vaccine is both safe and effective.

JB: Speaking of multiple vaccines, there’s the Pfizer vaccine; there’s a Moderna vaccine. They’re based on the same technology, so can you mix them? Can you get dose one of Pfizer and dose two of Moderna?

BTF: No, it doesn’t really work that way. I couldn’t exactly tell you about how they’re specifically different, but they were designed to be different. The truth is they haven’t tested whether you can mix the two. I suspect it probably might have some benefit or might work to some extent, but because that wasn’t studied, I wouldn’t really do that. The other thing is whether or not you have the option to pick one. Depending on whatever site you go to, they’re just loaded with either Moderna or Pfizer. You really want to get your second dose to be the same one as the first one that you got.

JB: If I have an underlying condition like an autoimmune disease, does the COVID vaccine interfere with that? Also, for COVID vaccine takers who have illnesses that have not been studied––such as someone who’s on chemo with cancer––is it advisable to get tested after the second vaccine dose to see if someone has the requisite antibodies?

Does the COVID vaccine interfere with underlying conditions?

BTF: That is sort of a complex question. I’ll answer it as best as I can. What I think you’re saying is why does someone with an autoimmune disorder really need to get the COVID vaccine? By definition, an autoimmune disorder means your immune system isn’t quite up to snuff. In some instances, you’re not able to fight off diseases as well as other people. The same is true of other chronic diseases like kidney disease or cancer.

Think of it this way; your immune system is already too taxed. It’s too busy fighting off other things. Let’s say you have an army of cancer cells, and you have your immune system saying we need to fight that cancer. Then all of a sudden, COVID comes in, and your immune system is like––Oh crud, now we have to do that too. So the best thing to do is to get a vaccine so that COVID is already taken care of.

With normal, healthy younger people, you can sort of always assume that you’re going to get the 95 percent response, but in people with advanced autoimmune diseases or immune systems that are already fighting other diseases, it’s probably a good idea to see if you can get it checked. You can actually measure the level of immunoglobulins; that’s what they’re called in your bloodstream. This is what we found out with things like measles, mumps, and rubella. Your body never really sees it anymore, so it doesn’t produce as many of those immunoglobulins.

A lot of people have to get a booster shot. I actually did because my immune system said we don’t really need measles immunoglobulins. But then I went to go work in a hospital, and they said I had to get a booster shot. The vast majority of people don’t need to check how much of an immune response they have, but someone on the extremes of whether or not they’re able to fight it probably should get it checked

JB: If you have an autoimmune issue, could the COVID vaccine make it worse?

Does the COVID vaccine worsen autoimmune conditions?

BTF: No, it couldn’t really because they act in different ways. The COVID vaccine is activating a different part of your immune system. Your immune system is incredibly complex and is made up of many parts–– T lymphocytes, B lymphocytes, immunoglobulins. Essentially, what the COVID vaccine does is it activates a completely different part of your immune system to attack COVID and COVID only. So it doesn’t hurt your ability to fight other diseases, and it doesn’t affect other diseases that you already have. In terms of an autoimmune disease, it doesn’t work that way. It’s totally safe.

JB: If somebody already has had COVID-19 and recovered, do you still recommend them getting vaccinated?

If I already had COVID, should I still get vaccinated?

BTF: One million percent, and here’s why. When people get COVID, they develop antibodies,
and what we have found out is––for some unknown reason––the antibodies disappear over time. Although it doesn’t happen very often, a person can get COVID more than once, and that’s well documented. Your antibodies do disappear, which is why you want to get the COVID vaccine, to keep your immune system pumping out those antibodies. They do disappear, so you definitely want to get the vaccine again.

JB: Do you anticipate that people will have annual vaccines for COVID, similar to what we might have for the flu?

BTF: Well, we don’t know. The truth is probably not because what happens is the way these are designed is they activate the part of your immune system called your memory cells, which is like measles, mumps, and rubella. Your body is constantly producing them, and they’re floating around your bloodstream and every organ: your brain, your blood, your liver, your bone marrow. Sentinel cells––they’re just looking for COVID all the time, and they keep replicating themselves. That’s the theory behind the immune response, so you probably don’t have to do that. The reason you get a flu shot every year is because the flu mutates so rapidly. The CDC says: We think these are going to be the strains that you’re going to get this year.

We’re hearing about all these crazy mutations that are happening with COVID, and the truth is I don’t have a great answer for you about that yet because those mutations aren’t widespread enough. That said, I have a funny feeling we’re actually going to have to have booster shots. In fact, Moderna is already creating a booster shot for some of the new mutations. We’ll have to wait and see.

I am not yet that afraid of the mutations. It’s a very sexy news story to talk about, but there are already over four thousand mutations of COVID alone. We’re hearing about the ones that are causing a little concern that seem to indicate that it spreads more rapidly. But two things: it doesn’t seem to be more deadly, and number two is that the vaccines seem to work against them pretty well. The Moderna vaccine––they’re sort of tweaking, changing little bits here and there. It’s not a completely new vaccine at all.

JB: I have an allergy to penicillin. Have there been any fatal reactions to the vaccines, and if there have been, how has the patient administered the vaccine?

BTF: The answer is no. There have been––I think––two fatal reactions to the vaccine. Keep in mind that millions of doses around the world have been given. If you’re allergic to penicillin or sulfa antibiotics, there are very specific parts of that antibiotic that you’re allergic to. Penicillin is not remotely structurally or molecularly related to the COVID vaccine. There is zero cross reactivity. So far, we haven’t found anyone really allergic to the COVID vaccine, with the exception of something called anaphylaxis, which you probably heard about.

The best example is when someone gets stung by a bee, and their throat closes up. This is called anaphylaxis, which is why when you get the vaccine, they require a 15 to 20 minute period of observation to make sure this doesn’t happen to you. I happened to see the white house press briefing just this morning about that, and there have been only six anaphylaxis reactions out of about four million doses of the vaccine in the United States. Working in the emergency department, they do have emergency personnel on hand, which is where you can give epinephrine until you can get to the emergency department. I think they said one person died of their throat closing up, but out of about four to six million doses given so far, the odds are pretty slim.

JB: Are there any linking of side effects with the COVID-19 vaccine to people with certain pre-existing conditions like Parkinson’s?

Will the COVID vaccine affect Parkinson’s?

BTF: No, there haven’t been. There are what we call idiosyncratic reactions. I think some of you may remember that some of the trials were halted because somebody got a neurological condition to it. In unpredictable ways, you’ll get someone who has an absolutely crazy reaction to it, like getting paralyzed. There’s no way to predict this. This kind of reaction can happen to every drug. We see people who get these paralysis reactions to not just tick bites but also antibiotics that they get. Sometimes this requires them to be sedated and put in a coma until they can learn to breathe again.

Again, it’s so incredibly rare that it’s not something I would even remotely worry about right now. I think that happened to one person in the UK, and the trial was halted until they discovered it was just one guy, not that this makes it any less bad, but it’s no reason to stop the trials when one person got this.

JB: If someone receives a COVID-19 vaccine, can they transmit the disease to others?

Can someone transmit COVID after being vaccinated?

BTF: I get that question a lot, and it doesn’t make a lot of sense. You think: Well, wait a second. I got the COVID vaccine, and now I killed COVID. How in the world can I transmit it? Your body needs time to actually kill COVID once it gets into your system, so here’s a really great analogy to think about. How can you still transmit it?

Let’s say you’re on a plane. You’re in the middle seat, you’ve been vaccinated, and you’re fine, but the person to your left has COVID, and they don’t know it. The person to your right doesn’t have COVID, and they’re fine. Well, the person to your left could sneeze all over you and put COVID all in your body, and you don’t have a chance to kill it yet because you need at least a few days. Then you sneeze all over that person, so you’re still a vector. You can still transmit active COVID before you kill it, and that’s what you need to know.

However, with the concept of herd immunity, if enough people are vaccinated, then what you hope would happen is if some random person in first-class or way in the back of the plane sneezes, and all three of you happen to breathe in COVID, you kill it before you can transmit it to someone else. Although it’s unlikely, it is still quite possible that you can transmit active COVID before you have a chance to kill it. That’s the best way to think about it.

JB: Can you get the first dose of a vaccine in one state like California and then come up to
Washington, where I live, and get a second dose?

BTF: You can. So you get the CDC vaccination card, and assuming you don’t forget, it has the lot number where you got it. They write it all down for that very reason because the United States is largely a mobile society. They realize that there is a certain window in which you have to get the second dose, so take a picture with your phone, put it in a specific folder, or bring your card with you. If you know you’re gonna be somewhere, make an appointment at that other place.

JB: Is the rapid antigen test better than the PCR test, and are there other types of tests?

Is one COVID test better than others?

BTF: For all intents and purposes, the rapid antigen test is the one that goes in your mouth or in your nose, and that one is uh about 96.7 percent accurate on average. What that is testing for is the actual active virus itself; it’s looking for pieces of the virus. The reason the rapid test is rapid is that it takes about 15 to 30 minutes. The PCR test takes about two to five days, and the reason is because it’s looking for specific DNA sequences. It’s about 99 percent accurate. So you have to decide which one is right for you.

If you need it quickly to go somewhere, and you can’t wait five days, you’re going to have to take the rapid test. A lot of employers require it. Other places like airlines often require the PCR test because it’s a lot more accurate. There are two things that you need to remember about both of these tests. First, the concept of a false negative. When I say the PCR test is 99 percent accurate. That means it’s one percent inaccurate. So if you have a hundred thousand people, you’re going to have one percent of them who think they don’t have it, but they do, which is why it spreads.

With that said, there’s no perfect test, and you’re going to have even more from the rapid test. I’m not trying to shame anybody who traveled over the holidays, but this is why it spread like crazy over the holidays. People would get tested the day before they get on a plane and go somewhere. If you test on a Tuesday, and somehow you caught COVID on a Monday, your PCR or rapid test is going to be negative because you haven’t created and replicated enough COVID in your body to register a positive test. We call people with positive tests. I cannot count the number of people that I would call and say, By the way, your test was positive. They were like, Whoa, I’m already on the east coast.

That’s how it was spreading like crazy, because the incubation for COVID is so long, which is why it is a pandemic. It takes about five to ten days before your test registers as positive. There’s almost no one in this country that can take the test, wait ten days, and then travel somewhere, which is why everyone’s saying just don’t go anywhere. Skip Thanksgiving this year, skip Christmas, have a Zoom Thanksgiving, so you don’t have an ICU Christmas is the saying that we had.

Because the major travel holidays are now over, we’re seeing a massive decrease in COVID cases, and that, of course, is a good thing. The United States has about a 20 percent reduction in the last seven days alone in COVID cases. Los Angeles has an almost one-third reduction. To be fair, part of that is because people are testing less, but we are definitely seeing less COVID happening because people aren’t traveling as much.

JB: If you are pregnant, or you work as a teacher, should you take the vaccine?

Can pregnant women take the COVID vaccine?

BTF: That is a very loaded, individualized question about what you’re comfortable with. They have not studied pregnant women directly in terms of getting the vaccine. That would be what’s called a prospective study. You get 10 pregnant women to get the vaccine, 10 pregnant women who don’t, and you see what happens. However, they were able to study it retrospectively with the Moderna and the physical vaccines because some women got pregnant in between the two doses. The researchers found that it doesn’t appear to be transmissible, and the fetus appears to be completely fine. I don’t think there’s been any documented evidence of a pregnancy demise because of the vaccine or catching COVID; however, you should not or could not tell a pregnant woman you should get it immediately in all cases. That’s a very individual decision up to the woman and how she views her body and safety

JB: I think you work in Burbank, right Dr. Fletcher? Does your hospital have enough equipment? There’s some curiosity about how you’re able to treat COVID patients.

BTF: We do actually. We live in a capitalistic society, so it’s largely about supply and demand. We didn’t have enough PPE at first because we never had a pandemic, but manufacturers were able to ramp up supplies in terms of the masks and PPE, so we’re not particularly worried about that at this point in our area of the country. I can’t speak to other areas of the country that seem to have shortages, but I can say in my particular hospital in the Los Angeles area, we are not wanting for PPE.

JB: So somebody’s saying they feel like they might have had the virus. They had COVID-like symptoms for over a week. How do they know it was COVID? How do you test for antibodies?

How do I know if I’ve had COVID?

BTF: So there is an actual antibody test. I get that a lot. There are so many people who say, Well I had these symptoms. I had a cough, cold symptoms, and runny nose. I had a friend who had COVID, and I’m certain I had it.

I don’t have a time machine, so what you can do is check and see if they have antibodies in their blood. It’s accurate one way but not the other, meaning if you have antibodies, then you can say you definitely had COVID. But if you don’t have antibodies, we can’t say for sure. As I said, we are discovering that people lose their antibodies, so I can’t say you didn’t have it; I can just say you may have had it, but you also might not have. We’re never going to know.

JB: Can you explain why the mutating screens are described as 70 percent more contagious? Does this mean the spreading is more by droplets, surface contacts, etc?

BTF: It’s getting a little bit complex, but I think most people here are smart enough to understand, so I’ll briefly get into it. The spike protein that attaches to the human cell where the virus sort of gets in is made up of three parts. Think of it like a triangle, and all three angles of the triangle are closed. It’s a little bit harder than you think for it to attach to a human cell. What we have discovered about the mutations: so far are three major ones where one, two, or all three of the angles of the triangle of the spike protein open up. Basically it’s like taking a bigger bite of the human cell to infect, so that’s why it seems to be more infectious.

The way to think about it is the spike protein is just taking now a bigger bite of the human cell to infect. That’s why it’s becoming more infectious. I mean the virus wants to live too, right? So the virus has discovered that if we take a bigger bite, then we’re gonna be able to infect more cells. That’s unfortunate but true.

JB: When will kids be able to get vaccines, and what’s safe with respect to kids?

When can children get the COVID vaccine?

BTF: So I don’t have a good answer about when kids are going to be able to get the vaccine. That’s actually an industry question about safety and when they’re going to be able to start testing it on children younger than 12. They haven’t done that yet, and I don’t know when they’re going to do that.

For quite some time, we’ve known that children are resilient to this virus. They tend to have almost no symptoms. There have been almost no children who have died, so the issue is children spreading it to grandma and grandpa. Like the pregnancy question, the question is what comfort level do you have with it in terms of your community. It’s very controversial. It has been found through safety measures in schools that transmitting it between children doesn’t seem to happen very much because they’re keeping kids in separate desks, and they’re putting in the plastic partitions, wearing masks.

Still, the teachers union in Chicago, just a few days ago, said they’re not coming back until this is under better control. It’s not the children they’re worried about. I’m actually not really worried about kids. I see positive kids all the time. Mostly, they look great. I only worry about when grandma and grandpa live with the kids who are positive, and grandma and grandpa are 95 years old with autoimmune diseases, diabetes, and high blood pressure with a history of heart attacks.

JB: I’ve heard of a COVID-19 test where you prick your finger, and you can see if you’re positive or negative within minutes by a blood droplet. Is it an accurate form of test?

BTF: That’s not a very accurate test because it depends on how much blood you’re getting, where you are getting it from, and are you doing it right yourself. It’s not really very accurate. The really accurate tests that we have are the nasal and the oral swabs that we’re doing. At the risk of sounding delicate, the Washington Post just discovered that there’s an anal swab that’s really accurate. That’s all I’m gonna say about that because I don’t know anything more than the headline.

Still, the PCR test and the nasal swab are about 97+ percent accurate, so wouldn’t even bother with a different kind of swab or blood test. Most urgent care centers in the United States are equipped to give you a really rapid test available within 24 hours, not because it takes 24 hours but because they’re doing hundreds of tests a day.

JB: After we get both doses, what should we expect? Are we safer to go out, or should we wait until everyone’s been vaccinated?

BTF: That’s sort of a broad question. So there is no solid right or wrong answer. What I will say is 95+ percent of people are gonna build up a really good immune response once they get both doses of the vaccine. When you get that reaction where you’re getting fevers, chills, or aches, that means your body is building up antibodies. We’re discovering it takes about one to two weeks to build up an adequate response.

I can’t tell you not to go anywhere for those one to two weeks while you’re building up a response, but what I can tell you to do is to wear masks and to do your part. If the grocery store is crowded, then go later. If everyone could just quarantine and not go anywhere for two months, there would be no COVID. But society doesn’t work that way, and we’re not going to be fully protected as a society.

Quite frankly, I think COVID is here to stay. Like the flu every year, there’s going to be a certain number of people who get it and probably a certain number of people who die. The question is when does it become a non-pandemic status, and that’s the concept of herd immunity, when we have enough people out there who are vaccinated that it’s not as big of a deal for lack of a better term. What I can tell you is that it’s getting safer and safer. If the current administration is correct that we’re going to have 100 million Americans vaccinated in 100 days. That’s a lofty goal, but that means you can pretty much safely open up things. I predict that life will be back to normal––or very close to normal––around fall because the majority of Americans are supposed to be vaccinated by mid-summer.

JB: Is there any evidence that you can contract COVID through food or drink?

BTF: That’s a tough one because I am not sure anyone’s really studied that. I don’t know if anyone has really studied how long it lasts on surfaces. I remember in the beginning, people were terrified of Amazon because they suspected COVID was on their packages. They kind of did study that, and it does last on plastic surfaces, but it’s very hard to study this because it’s hard to just sit in a grocery store and see who touches what, who has COVID, and then follow that person 10 days later to see if they develop COVID.

So we do know it lasts on surfaces, which is why we tell you to wash your hands and wash everything. But the majority of spread is through respiratory droplets, which is why you wear masks. You don’t share food, and you don’t share utensils, and you certainly don’t share drinks and cups. It’s working.

In those places that aren’t observing social distancing and mask wearing, they’re having much worse rates. The old adage, It could be worse, is very true in this case. It could be a lot worse, but we’re doing socially responsible things. That’s really cutting down on transmission, so everyone, do your part. Be mindful of others in your community, your family––not just yourself–– and we can get this under control.

COVID-19 Vaccine Q&A with Brian Thomas Fletcher, MD

Amie Clark