Coronavirus (COVID-19): Press Conference with Rachael Piltch-Loeb, 04/08/21

You’re listening to a press conference from the Harvard School of Public Health with Rachael Piltch-Loeb, Preparedness Fellow in the Division of Policy Translation and Leadership Development. This call was recorded at 12:00 p.m. Eastern Time on Thursday, April 8th.


MODERATOR: Dr. Piltch-Loeb, do you have any opening comments for us?

RACHAEL PILTCH-LOEB:  Sure. Hi, everyone. Thank you for joining today. As Nicole mentioned, my background is in public health, emergency preparedness and risk communication. My work currently focuses largely on the vaccine rollout, as well as issues related to vaccine hesitancy and attempts to improve government communications and efforts related to the vaccine. I’m happy to take questions on any of those related topics, and I’ll do my best to answer anything that is on your mind this afternoon. So I think we can go ahead and get going with the specific questions.

MODERATOR:  Right. Thank you, Dr. Piltch-Loeb. All right. First question.

Q: Yes, hi, thanks for taking our questions today. I was just wondering if you have any insight on what is happening with J&J vaccine supplies? Maine and I noticed a bunch of other states are reporting much lower allocations to the state vaccination program. But I’m also aware that a lot of those doses flow to the federal retail pharmacy program. And those numbers for next week haven’t been announced yet, but the state vaccination program has been announced. But then at the same time, there is that problem with the manufacturing plant in Baltimore. And I guess I’m just wondering if you know what’s going on with the J&J supply.

RACHAEL PILTCH-LOEB:  Sure. So it, of course, varies state to state. But to kind of head off a couple of the things you broke up, brought up excuse me. First, the issues at the Baltimore plant do not affect any of the doses that the federal government is allocating right now. So that while, of course, we’re concerned about that and for future doses, that is unrelated to any supply-related issues or distribution at this point in time, worth being aware of. All the doses that we are currently allocating have come from the plant in Europe. In terms of the allocation that states are taking or getting related to J&J, there are a few different things that may be going on. And again, it probably varies state to state. But just across states, a lot of J&J vaccines have been, as you said, allocated to particular programs and in addition to being allocated to particular populations or homebound groups because it’s one shot, some states are considering how those single doses can be used most effectively for people who perhaps can’t come to a mass vaccination site, a pharmacy or some other location that would require them to come in person to that location, obviously, to get the dose. And so if they’re going to be being delivered kind of in a mobile clinic or for a group that needs to be staying home or as has other limitations, they’re being kind of allocated separately. So that’s why we’re kind of seeing separate allocation of streams of the particular of the J&J vaccine in particular, and why some states perhaps have been critiqued for not using them as quickly as they’ve been receiving them.

Q: OK, but thanks, but I’m wondering if you know about specifically about next week. I know it’s not just me, I was reading news, a bunch of other states or New Jersey and a whole bunch of other states are reporting lower doses next week. Does that mean there was just like a blip in the supply production or are the doses being diverted to pharmacies or other programs? Do you know?

RACHAEL PILTCH-LOEB:  My understanding is the doses are being allocated to a variety of different programs. And so that the dip in particular states may be because of the allocation priority is shifting where J&J could possibly be being used differently to pharmacies or federally qualified or federally oriented programs that are not kind of managed by the state supply. Beyond that, I don’t have any additional specifics I can offer at this point.

Q:  OK, thank you. Can I ask a follow up on a different topic, is that OK?

RACHAEL PILTCH-LOEB:  That is a question for Nicole.

MODERATOR: Oh, absolutely. Please go ahead.

RACHAEL PILTCH-LOEB:  OK, I’m fine with it, of course.

Q:  All right. Thank you. I just didn’t know. And this is not related to vaccines, but last week the US CDC came out with that report showing COVID was the third leading cause of death in the United States. In Maine and a few other states, Hawaii, Vermont, few others, the death rate was much, much lower. And I’m trying to determine how much of that is because of just chance or geography or versus state restrictions, like mask mandates, et cetera.

RACHAEL PILTCH-LOEB:  Yeah, it’s a great question and it’s really difficult to unpack. But I can offer a few suggestions or reasons that I think that the death rate was less in particular locations. I think first we need to think about the population itself that was impacted. So we know that it was elderly and nursing home residents, perhaps, or particular populations who were dying at higher rates, much higher rates of COVID-19. So we have to think about, you know, what’s the distribution of people in Maine, Vermont, Hawaii, places where we saw lower death rates? What’s the distribution of people who would fall into those groups who may have even been kind of in the pool to be kind of at that highest risk of death from COVID? So the numbers and the rates in that population group are potentially a lot lower than in some other states where the kind of population distribution looks a little bit different, as well as the number of nursing home or long term care facilities or locations where we were seeing these much higher rates of death in comparison to general population groups. So one factor is kind of population distributions that were existing in those locations. That’s not the only thing going on. You know, in part in Maine, in or I’m more familiar with Vermont and a little bit with Hawaii. But the early action to curb the spread of the virus, even prior to the situation, kind of being out of control. You know, Vermont, for example, was taking public health action, even though their case counts and numbers were not necessarily increasing at the same rate we were seeing in other states. That early intervention to reduce the spread of the virus and kind of prevent people from even encountering the virus prior to those numbers, really being kind of continuing to go up and up, likely had an impact on reducing the likelihood that somebody who was at high risk for COVID would come into contact with the virus or and then obviously have a severe infection and die from it. So we have kind of a population distribution as a factor. We have early intervention of public health measures as a second factor. And then we have kind of this notion that the early intervention is kind of connected to the idea that the virus also possibly didn’t reach kind of some of those more at risk populations in the same way that it did in other locations. So, again, we know that people living in particular kind of congregate settings or in multigenerational housing were dying at increased rates from COVID-19. And those facilities may have just been largely spared. A higher proportion of those facilities may have been spared in some of those locations, which is why we’re here, in particular seeing the death rates be lower. So I think it’s a variety, a confluence of factors, but those are three that come to mind.

Q:  OK, thanks a lot.


MODERATOR: Next question, David Bienick from WCVB.

Q: Doctor, thank you very much for talking to us today. I wanted to get your hot reaction to some news we’re just getting that Walmart is expanding its vaccination program to 48 states, including here in Massachusetts. Has Walmart really been a big player in other states? And do you think this will help, given that perhaps Walmart has a different clientele than some of the CVS, Walgreens and other places that have been distributing up until now?

RACHAEL PILTCH-LOEB:  Yeah, I think it’s an exciting development, as you’re suggesting. It’s important for stores or pharmacies, various private sector companies that are frequented by a variety of different folks, some clientele who may have higher rates of hesitancy than others. You know, their involvement is likely in the presence of kind of a vaccination clinic at a store that people are already comfortable going to can only help to increase our rates of vaccination. So it’s hard to say the scale of how big a player Walmart has been in the success of vaccine rollout in other states. But it’s exciting to see that they’re on board and in a larger partnership. The vaccine rollout approach needs to be multipronged, right? We need those large-scale mass vaccination clinics. We need the pharmacies. We need to be at a place where primary care and physicians can be delivering the vaccine. Basically, we want the vaccine to be in places that people already feel comfortable going. And we need to be bringing vaccine to people. And Walmart, being a big player that’s on board, can only help to improve that.

Q: And in a kind of a 30,000-foot question about vaccine hesitancy, we’ve seen some of the poll numbers shifting that people of color are less hesitant to get the vaccine now. But there seems to be a solid block of resistance among I think it’s Republican men that seem to be the hardest not to crack, for lack of a better expression. Have governments been, do they need to refocus their public outreach campaigns to given that the fact that the population of hesitant people is perhaps shifting?

RACHAEL PILTCH-LOEB:  Yeah, it’s an excellent point. So we’ve seen vaccine hesitancy in a variety of different subgroups. I’ve seen fairly high rates among evangelical Christians, as you’re mentioning, Republican men. We know the various communities of color have previously had high levels of vaccine hesitancy. I think one of the key things to keep in mind is that there are really varied reasons why people are vaccine hesitant. So, yes, we should think about revamping or expanding the kind of public health communication strategy, but that really requires us to understand what’s the root cause of why they’re hesitant. And it’s going to be pretty different for a Republican man. Whatever other intersectionality is that person has and somebody who is perhaps a member of a community of color or a particular religious group, though, there may be some intersection between the evangelical Christian group and the Republican group. So, for example, is it fear that they are anti-vaccine or vaccine hesitant because they don’t like the idea of government compelling them to get a medical intervention? Is it because they don’t trust the science or development of the vaccine? What is that root issue? Because it’s really hard to address hesitancy if we don’t address the underlying question, concern or reason for skepticism. So absolutely, we need to be looking into this in more detail. But it’s not a simple “let’s target the existing message to that population”. It’s what is the message and what is the root cause of the concern?

Q: Thank you very much.


MODERATOR: Next question.

Q: Hi there and thank you for taking the time today. So this a question about state allocations. With nearly half of new infections being found in only five states, the idea has been floated that these states should have more vaccine allotment. So what is your take on this?

RACHAEL PILTCH-LOEB:  Yes, so it’s a great question and it’s something that we’ve been thinking about a lot. So the reality is that the vaccine is one way. Getting vaccinated, after your second dose or even two weeks after your first dose. We’re already seeing that there is a significant decrease in rates of COVID. So the idea being, I realize that you will likely know this, but the 30 foot view is if we allocate more vaccine to states where there are increasing number of infections, we more rapidly can reduce the likelihood that that kind of outbreak is going to continue to spread because the virus will have fewer people to infect if more people have been vaccinated. And one way to increase the number of people who have been vaccinated is to make sure the states have enough doses to keep vaccinating people. So the concept is that the federal government by the administration should be allocating doses to where we are seeing an increasing number of cases. And that, frankly, could make a lot of sense. So the reality is that if states are currently using their entire vaccine supply and are waiting on more to vaccinate people and are seeing this large scale outbreak happening like in Michigan, and I know New Jersey is having a similar issue, increased supply would be well served in these locations. There are other states where there are a variety of vaccine appointments that are available and that are kind of going unused. And so the supply could potentially be reallocated from states where there seems to be sufficient supply at the moment for, say, one to two weeks and recalibrated after that. So this doesn’t need to be a forever shift in approach, but it could be something that is considered so that the federal approach can be a little bit more nimble to recognizing where there is an increasing outbreak. Now, it’s important to also recognize that, yes, we see that there are five states where they are that are accounting for nearly half of the new cases of COVID. We also know though, that doesn’t necessarily mean that the outbreak is actually decreasing in other places. We know that testing has also gone down in a variety of other states, and we know that a variety of other states are exemplifying their pandemic fatigue in other ways and are perhaps less conscientious about looking for the virus, tracking where it is and who it’s impacting. So there may very well be cases that we are unaware of, significant number of cases, and the pandemic is still continuing to spread, kind of unchecked and untracked. And we still need to be giving the vaccine in places where we’re not seeing kind of that growing level of new cases, because the reality is that the virus doesn’t know state borders at all. And the vaccine is still incredibly important, even in places where there is not a large-scale growing outbreak like in these five states that were worth mentioning. So I guess the key takeaway is, yes, that strategy makes sense, especially when there are not kind of an abundance of we seem to have the supply. The strategy makes sense when we have the supply to do so. That being said, the second kind of key takeaway is we know that the pandemic is still going on even in places that are doing less testing where we may not be seeing the number of cases because we’re not looking for the number of cases by testing people in those locations. And the vaccine distribution is still incredibly important in all of those places.

Q: I’m so glad you mentioned supply, because that’s what my next question was going to be about. So I hear a lot about how we need to vaccinate as quickly as possible to avoid the emergence of new variants. But is that realistically possible that we can produce and administer enough vaccine to outrun the emergence of those new variants here in the US, or is that just kind of like a pipe dream?

RACHAEL PILTCH-LOEB:  Yeah, so it’s a good question. The speed in which kind of viruses evolve. So I’ll back up. We know that there are always going to be variants of a virus. It’s natural for viruses to evolve over time. The fact that we are seeing variants isn’t in and of itself newsworthy from my perspective. What is the big question mark is can the vaccines address those variants? And are the variants more infectious, more deadly? What are the kind of factors associated with those variants? So far, we have good news that it seems like the vaccine works for the variants that we’re seeing, the variant that was originally from the UK, the South African variant, et cetera. The vaccines we have are currently able to work towards those variants. That may not always be the case. And we don’t know because it depends in what ways the virus changes in the new variant. So it’s not a pipedream to say that we need to vaccinate people before they come in contact with these variants. It’s absolutely possible to think that we will have kind of sufficient supply to vaccinate the majority of the adult population over the next few months. I mean, we are going at an incredible pace. Three million people are getting vaccinated a day. That’s fantastic. And we’re up to nearly 40 percent of the population having received one dose is also fantastic. I think that we will continue, though, to see pockets of the population that have vaccine hesitancy or that can’t get the vaccine for a variety of reasons. We know that kids are a long way away from getting from being considered eligible for the vaccine. And so what we want to do is get as many people who are able to be vaccinated, vaccinated as quickly as possible so that we reduce the likelihood that we come in contact with a variant that the vaccine doesn’t work for. And so why we say its kind of a race against time, a race against the variants is because we don’t always know how the virus is going to evolve, how it’s going to vary in those variants, so to speak. And what we want to do is get as many people vaccinated with this kind of working vaccine as quickly as possible to kind of reduce that opportunity that we come into contact with a new variant.

Q: Thank you.


MODERATOR: Next question.

Q: Hello, can you hear me?


Q:  Great, thanks so much. I appreciate your time and I appreciate that you’ve made yourself available for these conversations. Forgive me for the question if you’ve already covered it, but if we can briefly just say what the five states are that are driving more than half of the number of new cases. If I’ve got that correct, it’s Michigan, New Jersey and who else?

RACHAEL PILTCH-LOEB:  Yep, it’s Michigan. Let me see if I can remember off the top of my head. Michigan, New Jersey, New York. And I think it was for Florida and Pennsylvania, Michigan, New Jersey, Florida, Pennsylvania, New York, and I think it’s close to half. I’m not as we can get new numbers, it’s somewhere between 40 and 50 percent of the new cases that are being tracked on a daily, weekly basis.

Q:  I think this has been difficult for me and others to pin down as we slice and dice this data so many different ways. But are we able to say that younger people are driving that upward trend in those five states? Do we see the age distribution working out that way?

RACHAEL PILTCH-LOEB:  Yes. So it’s a really good question. And I think slicing and dicing the data is a good way to describe it. So, yes, we are seeing the number of cases. There’s a high number of cases in younger populations. So the new cases are allocated to younger age groups, especially in comparison to earlier phases of the pandemic. That in and of itself is not particularly surprising because we have to think about who has gotten the vaccine so far. Right? Three quarters of 75 and older have been vaccinated in the majority of the country. So we wouldn’t expect to be seeing new cases there. We also are likely doing a lot less testing in that group. Right? This kind of goes hand in hand. The group that’s getting vaccinated are less likely, frankly, to have new cases of COVID. They’re also less likely to be being tested for the virus because they are now protected by having had the vaccine. So we’re looking for the virus in groups that are less likely to have had the vaccine. And inherently, that means we’re looking at younger adults. So, yes, I think the answer is we’re seeing the number of cases in younger adults, younger age groups. But it also has to do with how we are testing them and the fact that they haven’t been vaccine eligible over the last few weeks.

Q:  OK, that makes sense. Thank you and apologies. That, I think is my dog. He doesn’t really bark, but he said I didn’t even know that you were going to start talking. So a follow up question to this. You said kids are a long way off from getting a vaccine, but there’s already tensions there around acceptance of the vaccine. And we can kind of already see where this is going in the sense that Michigan, for example, had a court case that ruled in favor of parents who didn’t want their children being tested for contact sports. Right? There’s just a resistance here to some sports. You can’t wear a mask. And there was resistance for parents to allow for their child to be tested because if their child tested positive, then that means that they would be able to participate sports. So what should the messaging? You know, I always think about this is like we’re a little behind here, but where do you think the messaging should go, you know, moving forward in terms of making sure that younger people are receiving vaccine and that group has the same level of penetration in terms of vaccine usage as other groups?

RACHAEL PILTCH-LOEB:  Yeah, it’s an excellent question. And it’s probably the next frontier. We’ve had so many frontiers, but in a rising kind of issue that we’re going to see. So I guess there’s two things. One is we have kind of a vaccine hesitancy or confusion. I think already in kind of the youngest adult group, maybe that eighteen to twenty-four Gen Z, whatever, whatever gen people are these days where we have already not kind of communicated why, if at all, it’s important for that group to be getting the vaccine. And we’re seeing, for example, colleges requiring that that people be vaccinated prior to coming back. And so that’s right where that age group is, where, yes, they’re considered technically adults, they may still be very likely to be influenced by their parents, especially if they are attending in that group that may be attending college or considering it. And we’re going to be encountering these issues whereby the vaccine is an expectation for them to participate in particular activities. This kind of concept that the vaccine is required in the same way that a meningitis shot is or an MMR vaccine or whatever it is. So we have that group and then we have minors, right. People who are under 18, younger children where the vaccine currently is still being tested and developed. You know, the trials are ongoing for kids. And we know there’s kind of a few different things, I guess, to consider or two different kind of buckets of messaging, depending on the role in which parents are going to play in the agents or the level of agency of the individual to be getting vaccinated. I think that they’re so going back to what I was saying before, vaccine hesitancy is such a constellation of different beliefs that people have, right? There is fear around potential side effects or long-term consequences of the vaccine. There is perception that government should not be telling individuals what to do around a vaccine, meaning shouldn’t be compelling them to get it in any way, shape or form, that private businesses shouldn’t be using it as an expectation for people to come in or to participate, etc., As you were already pointing out, relating to the testing. So I think that the messaging needs to be both at the individual and the community level, meaning the vaccine: it protects you from COVID-19 even as the potentially rare kind of outcome that a younger person would get COVID-19 have a severe infection or die from it is preventable. So even if it’s unlikely, it’s preventable if we get the vaccine, if you get the vaccine. And so there are individual-level benefits to the person. But there’s also those community-level benefits, meaning, you know, if you get the vaccine, you can participate in life in a different way. You can hug your grandparents and your parents, and you can kind of engage in activities that perhaps you didn’t or other people around you didn’t feel comfortable doing previously. So I think we need to be highlighting both the individual and community level benefits. That’s very general, though. Beyond that, we really need to be having conversations about those underlying issues. And so similar to another question that some somebody else brought up is kind of, you know, there are different groups who vaccine are hesitant or we’ve seen kind of changes in who’s hesitant. And that’s a reflection of kind of growing differences in sentiment around why people are hesitant. So I think we’re seeing an increase in hesitancy among people who do not think that this should be the government shouldn’t be involved in this space. And we’re seeing a decrease in hesitancy among people who perhaps have mistrust in medicine or didn’t feel like the information was out there for them to access because we have done a relatively good job or are doing a better job of reaching kind of community leaders, religious figures, et cetera, who have who can be kind of public health community partners in that space. And I think similarly, when we talk about young adults and we think about kind of older minors, we need to also be thinking about who the right risk communicators are to reach those groups. So it’s our content which should focus on individual and community benefit. It’s our approach which needs to identify the underlying kind of vaccine hesitancy, beliefs and concerns. And then it’s our messengers. So Instagram influencers, teachers, coaches, people who can be kind of public health community partners who are already familiar to the audiences we’re trying to reach.

Q: Thank you for answering that, I appreciate it. Nicole, can I ask one more quick question, please?

MODERATOR: Yes, please do.

Q:  Thank you. I want to talk about vaccine passports.

RACHAEL PILTCH-LOEB:  You cut out there for a second. I just heard you want to talk about vaccine passports. I apologize. Might be my connection.

Q:  No, that’s OK. I want to talk about vaccine actually passports. I want to ask the question, like, what are they good for? But really, what application do they work best?

RACHAEL PILTCH-LOEB:  Yeah, so it’s a good question. I think that they work best in a setting where… I’m trying to think about how best to answer this. Vaccine passports work best in a setting where we want to make sure the event doesn’t result in a COVID outbreak or the situation doesn’t potentially lead to viral spread. So, for example, you can imagine why or the introduction, say, of the virus to a place that otherwise doesn’t have it. So it’s not unreasonable. And I already don’t like the term vaccine passports because I think it brings to mind something that already people feel uncomfortable with. And I think we want to break it down into the basically we’re talking about proof of vaccination or of demonstrating that you have a vaccine. And then we can then there’s a separate like what’s the appropriate technology or support to do it. But proof of vaccination, let’s say, it makes some sense. Let’s say you’re an individual going to visit a nursing home or going to a particular event where in theory, nobody else there would possibly have COVID demonstrating that you have a vaccine, really unlikely to be bringing in the virus makes some sense. Similarly, if you’re traveling, let’s say, and you’re going to a country where COVID is not endemic or they are dealing, they’re concerned about the possible introduction of whatever you’re the COVID viruses in the US and want to make sure that it’s unlikely that you have it. Let’s say we’re going to Israel. Israel’s done a really good job of controlling the virus. They don’t want to run the risk that somebody is going to be bringing in a new strain or COVID in general. So you have to show proof of vaccination. Offering those as examples where we can logically see why demonstrating proof of vaccination makes sense. Similarly to attending school or attending college. You want to participate in activity or do something. The school or entity does not want to take on the likelihood that there would be an outbreak in that setting. Proof of vaccination makes sense. When we think about a vaccine passport just to go about kind of our daily life, I think we’re getting into a more complicated calculus of what is the purpose, as you’re suggesting. Meaning there are a variety of things that all of us carry that we all have different health risks and different ways in which we live, et cetera. And we don’t walk around with a card that says, I had to walk around with a card that demonstrates my vaccination record more generally. I’m not sure that COVID is particularly different and different from those other sorts of viruses. So I think that, you know, there are settings where it makes sense and then there are settings where I think it’s still questionable how valuable the passport would be.

Q:  When you say it’s questionable how valuable that passport would be, I think the perspective that I’m seeing, especially in New York, is a pass that gets you into your office, a pass that gets you into a Broadway show, something that you flash at the maître d’ before you show up for dinner. I agree, I do understand that it’s a much different thing if you’re trying to get into a nursing home, but then if you’re trying to get into a restaurant. But I do wonder, like, what is the specific line philosophically that you’re willing to draw on that? Is it a risk to other people? Is it that the risk outweighs the benefits of being able to eat a dinner? If you could just sort of more go to where you’re thinking,

RACHAEL PILTCH-LOEB:  Yeah, I appreciate you pushing. You’re pushing the thinking forward. I think that the value of the passport lies in in its an approach to risk reduction, right? The reality is that people who can show proof of vaccination are far less risk to each other. And so being able to show that proves the vaccination means that participation for everybody else there is safer or less risky, right? We never use the word safe. So that’s where the value kind of lies and it’s particularly important in a setting where we know that there are that COVID is still a risk to a variety of people either who haven’t had the vaccine, don’t want to get the vaccine, can’t get the vaccine, don’t have access to it yet, et cetera. That being said, people who are likely at highest risk for severe COVID-19 hospitalization and death, you know, the oldest adults. People who have been living in nursing homes, if we kind of look at who’s been most adversely impacted, are probably the least likely to be in some of those settings anyways, or which is just this becomes a kind of a trade-off between not a trade-off. A balance between the trying to reduce the risk to as many people in society as possible. And that’s where the argument for vaccine passports is coming in. The more people who are interacting, who have the vaccine and can show that they have been vaccinated, the more additional individuals who can feel comfortable participating, right? The collective is not going to be spreading COVID-19. And so that’s the argument supporting them and their value. And I’m not sure my follow-up answered your question or not, I hope it. I hope it did.

Q:  It did. Thank you so much.

MODERATOR: Next question?

Q:  I thought, why not, I’ll shoot my shot again. So we know the UK variant or B.1.1.7 is now the predominant strain here in the US. So what does that mean for us moving forward?

RACHAEL PILTCH-LOEB:  Yeah, that’s a good question. I’m not sure it means too much more than what we already are doing, if that makes any sense. So we recognize that, yes, that is the strain that, the dominant strain that’s circulating. We think that or we have some evidence that it was more transmissible, possibly more deadly than the prior strain. We also, though, know that the vaccines we currently have are working against that variant. And so I don’t actually think it changes much about our public health calculus at the moment besides the recognition that that is the variant that we’re dealing with and the importance of continuing to track the different variants. So we recognize when there is a change and we possibly need to understand more about what it is about that variant that may shift our approach. I think that one of the things I’m always struck by is that we see headlines about these different variants. But it’s a new variant in and of itself is not necessarily novel. Right? We expect that there’s going to be new variants. So it’s really what I want to know or what I would like to think or how I orient my thinking around this is what is it about that variant that we should be concerned about? And it may not be anything yet, right? So it’s more just the acknowledgment that there are different variants of the virus that we need to be conscious of what those variant characteristics are. And we want to ensure that our vaccines can continue to work for those variants.

Q: I asked someone previously if we have the levels of genomic surveillance at the moment to keep a good track of these variants and the answer was no. Are we making progress on that front? Are we better suited now to track them?

RACHAEL PILTCH-LOEB:  I think still no. I think that there is an acknowledgment that we need to be doing more genomic sequencing and tracking. I know that the CDC has acknowledged that and is, I think, putting a foot forward to be doing that. But we see kind of a step behind in tracking the variants and the genomic sequencing. And it’s certainly not being done as widespread or robustly as I think we would like it to be.

Q: OK, thank you.

MODERATOR: Looks like that’s OK, last question for right now, but I always have questions, so I’m going to go ahead. So President Biden has pushed up the eligibility for everybody to April 19th. Do you foresee any issues with that, with the vaccine rollout or is it just everybody can get a vaccine now and you’re still going to have a tough time getting a slot?

RACHAEL PILTCH-LOEB:  Yeah. So I think that that’s a good question. I think that we don’t yet know, I think that there’s already been a challenge, right, related to vaccine appointments, at least in a variety of the locations that I’m familiar with. The systems keep still, keep crashing. The appointments are filled within a certain amount of time, recognizing that there are other states where that’s not an issue. But I know in Massachusetts, for example, when things opened on Monday, there were issues. In New York, there’s been ongoing challenges, though it’s gotten a lot better. So moving up the eligibility in and of itself doesn’t mean that the systems aren’t going to be there or the appointments aren’t going to be there to support it. But we likely will have people who are still needing to make appointments when they can get them a few weeks out. I think that the idea is that if everybody is eligible the eligibility in and of itself is no longer a barrier to entry, meaning that eligibility is not preventing anybody who wants a vaccine from going to get it. And now, in terms of our communication strategy, we can engage with people, all adults, right, who are at the table to have these discussions around vaccine hesitancy. And nobody can say, well, I’m not eligible, so I’m just going to wait till I’m at the end of the line. Well, now it’s the end of the line so let’s have those conversations and get down to kind of the root causes of why somebody may be hesitant. So from that perspective, the outreach risk, communication perspective, the lifting of the eligibility criteria, I think makes means that those strategies can shift a little bit.

MODERATOR: Okay, and you kind of touched on this a little bit. There are some Massachusetts people are still scrambling for slots, but there are other places in the country where people seem to be, I think maybe vaccine hesitancy seems to be a lot more common and that there are there’s been less of a push and more of a decline in vaccine rates. Do you see that as a saturation that everybody who wants the vaccine has gotten one and there’s now getting into the hesitancy? Or what do you think is going on there with some of those decline in vaccination rates?

RACHAEL PILTCH-LOEB:  So I’m not looking at the data at the moment, but one thought I have when I was trying to look at some of the numbers this morning, but I just didn’t flesh it out enough. But in some places where, let’s say mask mandates have been lifted or businesses are open and vaccines are available, but perhaps there’s some vaccine availability and say cases aren’t going up or are being tracked less, I think that there is this perception that the virus is done or gone away. And I think that perception that COVID is less of a risk also means the perception is related to the perception, perhaps, that the vaccine is not needed right now. And so in an ideal world, but we would have had happen is in tandem with certain levels of vaccination, certain declines in the number of new cases, not as a result of a reduction in testing, but as a result of an actual decline. That’s when other public health measures would have been lifted. But we haven’t had that. So I think the perception that the virus was kind of going away on its own or declining on its own preexisted kind of the some of the vaccine rollout. And so I think that it’s not that perhaps means we’ve reached saturation, at least for now, and it’s going to take kind of some more concerted effort to encourage vaccine uptake in places where there is that perception that the virus isn’t as much of an issue or where there’s increased pandemic fatigue. People have already kind of returned to their regular way of life. I think there is we have created this challenge that the vaccine doesn’t seem like it’s necessary or needed in certain locations. And so that’s going to take some public health effort to increase the uptake in some locations.

MODERATOR: Thank you. I don’t know if anybody else has a question out there. Go ahead, raise your hand. Otherwise, we might be all set for today. Looks like it. Dr. Piltch-Loeb, do you have any final thoughts for us before we go?

RACHAEL PILTCH-LOEB:  No, thank you all very much. I appreciate you taking the time and I hope I was able to answer your questions.

This concludes the April 8th press conference.

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