Let's Talk UNLV

0:00:00
Well, Danielle, welcome to Let's Talk UNLV.

0:00:12
Thank you for having me.

0:00:13
Thank you for being co-host. Keith just gave me the boot. So what's going on with you? What's new?

0:00:18
So far, just excited to be settling into a new city. I've been here for a little over six months now, so I've been spending a lot of time being with my roommates and friends And pretty much eating because that's all you could do nowadays. Okay, you came from where?

0:00:33
San Diego all right, San Diego beautiful beautiful area. I'm also from California, so I visited San Diego many many times so what's your favorite spot to eat in Las Vegas that you've been here? Oh, man so far

0:00:46
I'm a big brunch person. I really like hash house a go-go, but you can only eat there so many times before you tap out So yeah so far That's the first thing that comes to mind, but I've tried a lot of other restaurants that are escaping me at the moment But how have you been pretty good last night? I went to top of the world which is

0:01:06
top of the price. Beautiful ambiance, scenic view, very good service, but it was a good night out. It was my partner's birthday and so it was deserving that we went.

0:01:13
Worth the price. Right. But I couldn't help but notice that

0:01:18
really, really empty. And I think we were maybe, you know, 20 guests out of a place that seats 400. And I don't know if that was because of the virus, or it was just too pricey. But either way, it was a good outing. But nevertheless, we're glad to have Brian Labus.

0:01:36
Back again.

0:01:37
Brian, back again. Back again, yes. You're right. From the Department of Epidemiology and Biostatistics in the School of Public Health. He probably is our most invited guest. Yep, he definitely is. Yeah, this is his third time. I had to track it. No, probably more than that. Probably five or six, I would probably say. Yeah, exactly. Actually, Dr. Rogers, I did have you back. You said, well, we could always use some more COVID updates. So that's right. That's right. Okay, so my biggest question, Brian, is okay, I had my booster in October. Is it time yet? Is it time for another booster? Well, the CDC and FDA have not

0:02:32
recommended an additional booster right now because we still don't know if a booster is necessary, if it's helpful, and if so, what the ideal timing is. The problem is we have to wait and see what happens over time, and there's no way to do that other than wait. So, if you had yours back in October, you were about three months past that, and we know you typically have strong immunity for three months. That's the cutoff we use, 90 days, if we're talking about somebody who got infected, that they are not likely to get infected again in those 90 days. So you're still in that period where you have a strong response to the booster. We'll just have to figure out what's next, but unfortunately, we have to kind of wait to see the population experience before we can make that next recommendation.

0:03:13
So I'm curious, did you ever expect that we would still be in this situation from, you know, a scientist's point of view, researcher? Did you ever think that we would be in this situation still? Well, when everything first started,

0:03:27
I didn't think we would see much more beyond the outbreak we saw in China. I thought it was going to take the same path that we saw with SARS and MERS and a number of other viruses, just like Ebola and everything else that we've seen. The fact that it went to a pandemic was kind of unexpected. It was always a possibility, but it was one of those things that wasn't the most likely scenario. But then when it happens, the question is how do you get past it? And the likely scenario for that is it's something that's going to be with us for a long time. This is not something where we're gonna get sick and two weeks later, everyone's gonna feel better and we're gonna look back and say, oh, that was an interesting period. This is something that will probably be around the rest of our lives.

0:04:06
Wow. I don't know how to feel about that, but I was taken aback by that news.

0:04:11
Well, let me say this. Being around the rest of our lives and having a pandemic for the rest of our lives are two different things. Right. At some point. But what's going to happen at some point is that we're going to reach some state of equilibrium with the virus. There's a balance that we reach with every virus where we describe it as endemic. It's kind of always there in the background. It flares up every once in a while and then goes back to the background. We are at the point now where we hopefully are gonna start heading in that direction. We're just not in that endemic phase yet. And so there will be a point where COVID is something that we deal with, but not as a pandemic. We deal with it like the flu or measles or other vaccine preventable diseases that are out there that are always there. And we always kind of have to keep our guard up, but we're not dealing with them every single day like we are with COVID.

0:04:57
Okay, understood. So, okay, that's a little bit more reassuring. But as far as, as of late, we've just continued to have different variants that are arising. So one of my questions for you, just out of pure curiosity. Is there potential for a new variant to arise that's more dangerous than the last? Like I know the Delta was pretty severe and then now we're on the Omicron, which is the symptoms seem to be more mild but very much more contagious.

0:05:36
So variants are always going to happen. There is no way to stop variants from happening because that is the natural process of a virus multiplying. Basically, when a virus copies itself, sometimes it makes typos. And those typos often mean nothing. They'll mean nothing or they'll actually do something that damages the virus so it won't spread. Every once in a while, though, we get a typo that gives the virus some sort of advantage. It may be that it allows it to spread more easily. It may be that it stays under the radar so your immune system won't find it or something like that. There's all sorts of ways that that change can be a benefit to the virus, and if that new change allows it to spread more easily, it will become the dominant strain. The more people that are infected, the more variants that have the potential to show up because it happens when the virus multiplies. So if we're not seeing a lot of cases, you're going to have fewer variants emerge just because it has fewer opportunities. There's really no way to avoid it, though. This is something we deal with every single year with the flu. The question is, what are those variants going to mean? We really don't have a way to predict what that is, but all we can do is kind of sequence and figure out what's going on and decide what the best course of action is. Now one thing to keep in mind, if the virus has a-say a new variant comes out that has a higher death rate. A higher death rate isn't necessarily a benefit to the virus. So say there's a new COVID strain that kills everybody that's infected. Well, that's not really an advantage because that happens a month down the road and long after people have been infected. So there's no pressure for that to hang around. It's really the pressure that allows the virus to spread more easily is what's driving any of those mutations. If it's a higher or lower death rate, higher or lower hospitalization rate, more or less of their symptoms, those things are kind of just along for the ride and they just happen because they go along with the ability of that virus to spread more easily.

0:07:26
So I caught COVID first of the year

0:07:28
and I had mild symptoms.

0:07:30
Congratulations.

0:07:30
I know, I know. But I was able to work remotely and I just experienced mainly fatigue and just some body chills. But I'm telling you, Brian, I think that I got it at the gym. I recall maybe hours later feeling just kind of clammy and I thought it was just because I walked outside and didn't have the warmest of jackets on. But now looking back, I think that's probably the most likely case where I caught it. I'm terrified to go back to the gym and the home workouts, they're just not as effective. So am I right? Should I not go back to the gym at this time or is it too early? What do you think? Well first of all, since you have

0:08:15
the disease naturally, you're not going to get infected again for at least 90 days or so. So you can do whatever you want right now. 90 days of freedom. But I would also say that it probably wasn't the gym. If you went to the gym earlier in the day, the timing doesn't work out. Because on average, it takes about five days from when you're exposed to when you have symptoms. So it may have been the gym several days prior to that, but it wasn't the gym that day. It's one of those things where when we get sick, we always look at what happened right before. We have this with foodborne illness all the time. You go to eat somewhere and an hour later you're sick. And I get a test result that says, oh, you have this disease that takes 10 days to show up. I can tell you that, I can explain it to you, but in your mind, whatever you were throwing up is what you think caused the illness. It's the same thing here. The last thing you did before you got sick was go to the gym. The gym didn't cause it, but there's that connection in your mind where it's hard to get over that because that's the last thing you did. It probably wasn't the gym, no, unless you got it at the gym several days prior.

0:09:16
Wow. Okay.

0:09:18
Well, LVAC, I'm coming back.

0:09:21
At least for 90 days.

0:09:22
Yeah, I was gonna say,

0:09:23
I'm sure Dr. Watson was in there, you know,

0:09:25
for the last month or so, so it has to be the gym. I do wanna know, how do scientists decipher when a new variant has arrived? Because I've always, all of a sudden it was Delta and then it was this Omarion or Omaricon variant. What is the science behind that? So we are always looking for new variants. Okay. We do this by taking a

0:09:53
subset of all the people who are infected and testing their viruses by sequencing them. So rather than just run a test that says, yes, you're infected, we actually sequence it out. We're doing some of that work here on campus. We do it at our state lab. Nevada actually does a really good job of the sequencing, doing a lot more of it per capita than most other states do. But we take a sample of all the viruses, and we look for the genetic code. And we look to see if there are differences in the genetic code. Now, you can find little differences here and there. The question is, do they mean anything? And that's the other part of it. We have to look and see which things are starting to circulate in the community then. So if it's just one person with this brand new variant, it probably doesn't mean anything. All of a sudden we start to see that same variant over and over again, we know that it's spreading more easily in the community. Because we can look and say there's a change, the question is, does that change actually matter when it gets into a population? And that's kind of the trickier part of it. The sequencing is easy, but knowing when that change is important is the other challenge. And the World Health Organization gets together and looks at those things, and that's when we have variants of interest, variants of concern. We have different levels of those variants, and we have to decide are these ones now that we're worried about? There are variants showing up. There were a bunch of variants between Delta and Omicron. We skipped a couple letters in there just because the names would have been a little awkward. For example, we weren't going to use a variant new because it sounds like N-E-W, and that would have been confusing. And so there are variants showing up all the time, though. The question is, are they important enough to get a name, and are they a new thing that's going to circulate?

0:11:32
Okay.

0:11:33
So I'm curious, how have you adapted your classes? I mean, I don't know if your students are stoked about learning about this or they're just like, you know, I'm just tired of it all. But what things have you done to still engage your students but also be mindful of their own concerns and health? What have you done?

0:11:52
Well, I'm probably not a good example because I'm one of the few people on campus that was teaching this stuff before these things were interesting. I teach infectious disease epidemiology. I talk about how disease spreads in a population, how we control things. I've been talking about isolation and quarantine and how we use it. The vaccination for 15 years I've been teaching my class. So for me, it's basically given me real world examples to use in saying, okay, this is why we do these things. And this is how it works in the population. All these social media posts you saw that claim this are wrong and here's why. So it's given me a lot of really good examples about what to teach in the classroom because this is what I do. It's not like I teach a math class or an English class where COVID is not part of the schedule. My first class in 2020, I was looking back at my old notes and the first day I taught that semester, COVID had just showed up. I spent an hour going over all the data from COVID and all the stuff that we could find from the news and talking about what we knew about it. So it's been a great real world learning experience for my students. It really hasn't changed how I go about teaching, it just gives me more examples.

0:12:59
Okay, that's interesting.

0:13:01
Do you have, you mentioned that students will bring up like a post or something they've seen online that's inaccurate. Do you have any examples that come to mind because there's a ton of information out there on social media and a lot of it needs to be taken with a grain of salt so it'd be

0:13:20
great to hear. Well the stuff I wind up discussing the most is some of the technical details related to say masks or vaccination. Let's use vaccination as an example. Students will see things in the news, people make a claim that vaccinations caused a bunch of deaths and they found it because of the BEARS system. And I explained, well, here's what the BEARS system actually is. It's not designed as the final answer. It's a surveillance system to look for problems and it all requires investigation. So anytime you see somebody out there saying, well, look how many adverse events were reported in BEARS, to me that really doesn't mean anything. But I have to teach my students what the system is and how it's actually going to be used and how that data can be used to mean something rather than just taking it at face value. So that's kind of the sort of thing that I have to deal with my students. They're not looking for the general thing. They want detailed answers because this is the career they've chosen and they need to understand what these systems really are and what they mean when they're going to go out and use them. So this whole thing has become polarizing and politics is so involved in this. How do you teach your students to just follow the science and to not look at their political motivations or opinions? Is that something that you've had the privilege of kind of walking students through so they can really see this for the work and the science that, and the public health concern that it is? One of the things I teach my students is that public health really sits at the intersection of science and politics. I can say this is the scientific recommendation and we can approach it just as scientists and take emotion out of it. My students tend to have a science background, so that's not a difficult message to get across. What's difficult to get them to understand is how to function within a political world. So I'm very much supporting vaccination everywhere I go, but I know I don't always have the right audiences for that. How do you deal with people who are completely opposed to you? How do you pick your battles? How do you decide what things are the most important for our community? And how do you decide which things you kind of have to say, okay, we can't do this right now just because the climate is not appropriate, so I need to take a different approach. If you get a job working in epidemiology, you're gonna deal with this all the time. You're going to have elected officials that are making decisions for the agency ultimately, and you're trying to influence those decisions in the right direction. And you really have to learn how to function within that political environment, whether you agree with it or not. You may have elected officials who are completely in line with everything you believe, or you may have elected officials who are the exact opposite. In either case, though, you have to do something to protect the community and you have to learn to work with people who don't see the world the same way that you do.

0:16:07
Well, speaking of politics, so something I've been noticing, I don't know if you even have an opinion on this. I don't because I'm somewhat of a rule follower, but when I...

0:16:16
I have an opinion on everything. Okay, perfect.

0:16:20
Well, so I've been noticing like either at restaurants or grocery stores, there'll be a couple of people who go in without a mask and if they're asked to put on a mask, they throw a fit. They're like, this is absurd, this is ridiculous, when is this going to end? They can't force us to do this. It's very political to them. What would be your opinion on that and maybe even your advice to people who are really refusing to wear masks?

0:16:47
Well, it's a difficult situation, especially for business owners, and it's unfortunate that they're the ones that sit between the government and the person who doesn't want to put on the mask. That's just the reality of things, though. There's certain rules that are in place, and people don't always like them. Some people are always going to disagree with what you have to say, and those people may have the same opinions about speed limits or anything like that. It's just sometimes they'll follow the rules, other times they won't. It depends on the enforcement piece of it. But those are the rules that are in place. We don't get to choose which rules we follow. They are the rules. And if you don't like the rules, there's a process by which to change them. If I want to see those things happen differently, you vote. You change your elected official. You make your voice heard and you try and change things. But just because you don't like something doesn't mean we're going to change the rules to accommodate you. And that's the thing that I think has been difficult in this. People want things their own way because they say, it's all about me. Well, when you're talking about infectious diseases, it's not about me. It's about a community. If it were just about you, then we wouldn't have infectious diseases. Things don't spread from person to person if it's just about you. But everything I do is looking at that group level. And sometimes you have to do things that you don't like to protect everybody, which ultimately comes around to protect you. But it puts some business owners in a very, very difficult position of fighting with their customers or even putting their employees' safety at risk. And so it's a very difficult thing to try and implement. When I see something like that, my thoughts are, well, how do we change the system to try and make that required? Is there something we can do that would make it easier for business people? Are the mask mandates still necessary? And every time I look at that, yes, they are. But is there some way to change things to make this less of a problem? And that's kind of the way I wind up looking at it every time I see somebody pitching a sit at a restaurant or something like this. Is there something I could do to change the rules so that this is not going to put a restaurant owner at risk?

0:18:43
So I'm curious, when I go to the stores,

0:18:45
I mean, you see the shelves are not getting restocked and there's still concerns that there could be another shutdown. Do you see that on the horizon? Or, you know, we're just not where we were a year ago with this disease and some people are vaccinated and the booster is available. It's now being available to children. Do you see that on the horizon that there could potentially be another shutdown? If, you know- I do not see another shutdown. The governor has said that is off the table.

0:19:11
I don't think anybody in the country is talking about a shutdown. It might be for a great story to scare people to yell at their politicians or something like that. But it's not true. The things that we're doing the mask, the vaccinations, all those things are there. So we don't have to even consider shutdown. The school district did a brief shutdown, but it wasn't about stopping disease transmission. It was allowing them to get their staff back to work. They had so many sick teachers that they just couldn't operate their schools. And it makes sense to close things down if that's the case. You know, if an entire department at UNLV is sick and we can't offer classes, that's different than us doing some sort of shutdown to try and stop disease transmission. So I don't see a shutdown as actually being very useful in stopping transmission either. People still need to live their lives and the damage that we would cause, you know, people say, well, it's a damage to the economy. It's not just that. If people don't have jobs, they can't afford to live somewhere. And there's a million health issues that come along with that sort of stuff. So there's a lot of negative sides to doing that. Early on, we did a shutdown because it was a new virus that we absolutely did not understand. And it was the pretty thing to do at the time, because of our lack of understanding of what this meant. Now that we understand it better, we don't need to have a shutdown to get this under control.

0:20:33
So, if I'm experiencing symptoms and I have a choice between going to one of these testing sites that are free, you know, be it drive-thru or getting a, you know, test over the counter, is there a difference? Is one better than the other? Or just get tested? It doesn't matter.

0:20:49
Well, it depends why you're getting tested. Even if you test negative, you're still sick and you shouldn't be going to work or school if you're sick. So if you've got a fever and a cough, it could be flu, it could be COVID. In either case, though, you can infect other people. And if testing is going to change your behavior, then that's absolutely useful. You don't have to necessarily get tested, though. If you have a mild illness, you can stay home and stop disease transmission without even knowing what it is. In terms of the tests themselves, the rapid tests are just not as good as the PCR test. The PCRs are gold standard. They do a better job of detecting the virus if it's actually there, so they have what we call a higher sensitivity. So if you're infected, you have a better probability of testing positive on the PCR than a rapid test. You probably are not going to get false positives, but depending on when you've been tested, you can get a false negative. And if you go in too early, you're much more likely to get a false negative. It usually has about the highest sensitivity on about three days after your symptoms have started. So if you go in the day you get sick, you may test positive and that shows you have the disease. If you test negative, it doesn't show that you necessarily are negative. It means maybe you should wait a couple of days and get retested. So it gets a little complicated when telling people when to get tested, but then once you have that positive, you at least know what you have and can take the appropriate steps to stop infecting other people. But you should do that anyway if you're sick.

0:22:12
Yeah, that brought up a question for me because this actually recently happened in our department. Somebody tested positive for COVID and he let us know, and I personally tested right away. Was that pointless or do you have a recommendation? I guess you just say it's kind of hard to decipher when somebody should test?

0:22:33
Well, it's not pointless, but the best time to test is about four or five days after that exposure, but if you do manage to have positive, you at least know that you're incubating, just the chances of finding it that early are very, very low. So it's kind of a waste of your time and a little bit of a waste of the test. It's better to wait a little bit and then you'll have a better answer as to whether you test positive or not. The other thing that I want to say is if you're on campus and you test positive, please go on the website and fill out the form. We have a team that responds to every single case report. We interview people, we find out if there's something we need to do to protect campus, we look to see if there's clusters in a classroom or department or some area on campus, we deal with people in student housing to make sure the students are handled appropriately and that they're not spreading disease but their needs are taken care of. We work with athletics and we work with the academic departments and everyone to provide the best possible protection on campus. And that all starts with those reports that come to us that allow us to do those investigations.

0:23:44
So now that we're able to order, you know, tests and have them shipped, you know, from the Biden administration, is that going to be a game changer?

0:23:50
In some ways, if people use them properly, it can be, but if people just start randomly testing themselves just to test themselves, we're going to waste a lot of tests. So there's an upside that it's more convenient you can do the testing at home will have more people tested but if you're talking at home that data doesn't flow into our public health data system of the same way that things uh... do when they the president commercial lap but you've got a question lab or the people health better you test positive that automatically gets reported to the health department it's a lot trickier when you have people at home because even if some people report that are positive. You don't have any context for it. We just know that we had these people report these positives. We don't know how many negatives there were. We don't know how many people were testing themselves or any of those things. So it's going to change the game, not necessarily in a good way or a bad way, but it's going to be different in terms of the way we look at data.

0:24:41
So we're gonna get you out of here

0:24:42
on these last two questions. One, do you foresee there being an in-person graduation in the spring? And then two, what things are you already looking at for planning purposes for the fall?

0:24:53
For spring graduation, we want to have our graduations in person, we did it in December, and even if we're having this Omicron wave now, if we look at how waves have played out in the past, it's usually about three months or so beginning to end, it kind of climbs up for a month or so, stays up there for two, three, four weeks, and then drops off over another month. That gets us to lower numbers by the end of the semester, hopefully. But we want to have those in-person graduations. So unless something majorly changes, we're going to do everything we can to have those in-person commencements. That's always been the goal. We don't want to go back to some sort of online graduation because that is such an important event. And if we can do it safely, we absolutely want to do that. For the fall, well, we are in week two right now, and so we're trying to keep our heads above water for the spring semester. I would say in another week or two, we're starting to think about what happens next. Right now, it's just in managing things as we get back to campus, because we've spent the last few months making all these plans, and now we have to make sure the plans are actually working. We have a lot more people on campus than we've had previously, and our numbers are up because of Omicron. And so, it's really just looking at where we're at right now. And then we're gonna start to look toward the fall semester, just like we do this time every year. We get through a little bit of the spring semester before we start thinking about enrollment for the fall. The things that are gonna come into play are what happens with a vaccination mandate. The legislative commission did not extend that, but there are other pathways to make that happen. So that's something out of our hands, but if it happens, that'll come into play in the fall, or we'll have to deal with lower vaccination rates on campus. Any changes in the vaccine itself or recommendations, those things will come into play. So unfortunately, a lot of it is waiting to see what other groups do and what the virus does, but those are the things we're going to start to think about for the fall, just like we did a year ago when we were at this exact same point.

0:26:45
All right.

0:26:46
Well, you heard it from Brian. Danielle, what was your takeaway?

0:26:48
My, the main takeaway for me is that if you were unlucky enough to get COVID, once you get over it, you the benefit is that you're pretty much good for 90 days, like you have a guaranteed few months to not worry about contracting it again, I did not know that. And then in addition to that, the waiting five days after exposure to test is very helpful because people have been contracting COVID left and right, and it's not uncommon to come in contact with somebody with COVID nowadays. So it's good to know when to test instead of wasting $20 to $10 on a COVID test that is going to read negative because it's too early.

0:27:34
So I would agree, and I'm going to put that back on the calendar. So looking forward to getting back to my gym regimen. But I'm always impressed by Brian's reassurance that we're good. And this is going to come to an endemic and we'll look back and say, okay, we've handled this. I'm always impressed and he's always saying, here's the science, here's the facts, but let's also look at what we know. We have a lot of successful things that are in place. There's no need for a shutdown. We're gonna be, you know, no major changes for graduation. We hope to have that, and if something else happens, then we'll address that, but we definitely wanna offer those graduations to be in person because the students have worked so hard, and families look forward to those events. And then also looking at the fall. We'll look at the fall plans at the appropriate time, but right now we're going to focus on what we know in

0:28:28
the spring.

0:28:29
I always like having Brian come on because he just gives you that reassurance that we're doing the right things to protect our students and our campus and we're going to follow the science. So I'm always happy to have him because he just reiterates that message. Thank you for tuning in to this week's episode of KUNV 91.5 Jazz Memorial. Thank you for tuning in to this week's episode of KUNV 91.5 Jazz Memorial. That's a wrap!

Transcribed with Cockatoo