Let's Talk: The Latest on Monkeypox and Covid with Dr. Brian Labus, Assistant Professor, School of Public Health andMaster's of Public Health Internship Program Coordinator

Keith Rogers 0:06
All right. Welcome to another segment of less talk UNLV podcast with co host Keith and Tanya. Tanya, how was your weekend?

Unknown Speaker 0:14
I'm eventful in a word. I spent most of the weekend just chillin. Order and then and catching up on all my Ben shows.

Keith Rogers 0:23
What are you watching?

Unknown Speaker 0:25
Oh, so many things. I finally got through insecure. Yay. It was awesome. I'm kind of sad that it's gone. I'm currently watching Westworld.

Keith Rogers 0:34
Oh, that's good. I think they coming up with the new season four. Right. I have a I thought I saw some promos about a new season of Westworld. But yeah, Westworld is I really enjoyed it.

Unknown Speaker 0:45
mess with your mind. Make me look at technology different now.

Keith Rogers 0:48
Yeah, for the weekend, I ended up traveling to California, like four in the morning to Whoa, yeah. So the wife and I was going to pick up a few things. So yeah, we were in California and drove back the same day. So I was exhausted the weekend. But you know, it's interesting. On the flight, you know, my wife and I like what were our masks that were no one has masks. So you know, if you're not flying frequently, you don't you lose sight of what was happening. So this segment is really timely to help me make sure I'm still exercising the appropriate level of care to myself and family in terms of staying safe. So we're pleased to welcome to the show today, our guest Dr. Brian labourers. He is an assistant professor in the School of Public Health. And His research focuses on communicable disease surveillance and his currently studying the use of social media to identify restaurants associated with increased risk of causing foodborne illness. Brian, welcome to the show. You're a veteran, you've you've probably been our most frequent guests, since we started the podcast. So I guess we don't even have to go through you know how you your origin story to UNLV. I think our guests may be familiar with, we're just sort of dive right in, you know, today's podcast focus is going to be just, you know, doing COVID updates, and just talking about monkey pox. And just hearing from you sort of what was happening in those two spaces. So we'll just start with, can you just share with us the latest news or discoveries in regard to COVID-19?

Unknown Speaker 2:18
Well, right now, we're actually in a really good place for COVID. In southern Nevada, we are at the lowest level we've seen since the beginning of the pandemic, we've had some weeks where there weren't any deaths, which is really kind of a milestone to get to that point where we've gone through the worst of it now and are kind of coming out the other end at a point where we're in more of a balance with the virus and hasn't gone away. But it's more like the things that we deal with on a regular basis, rather than some brand new passages and that we have to deal with that. That initial phase of kind of figuring each other out.

Unknown Speaker 2:49
That's wonderful. So, you know, I sort of got used to being a superhero all messed up in the streets. So can you help me figure out how to live my best life? By telling me what are the latest goals for protecting people from COVID outbreak?

Unknown Speaker 3:04
Because we're at a low level, the CDC recommendation is not that everybody wears masks, if you have underlying health conditions that put you at high risk, you still may want to wear a mask, you know, if you're undergoing chemotherapy, or have things that deplete your immune system, of course, you're going to take individual steps to protect yourself. But in general, throughout most of the US right now, we're at a level where masks are not recommended. Now that can always change, we can have a new variant things can increase. But right now, it's kind of just the common sense things you need to do to protect yourself from respiratory diseases in general, if you're sick, stay home, get vaccinated appropriately for COVID and flu is flu seasons coming up, wash your hands, cover your cough, do all that stuff that we've talked about for years. And COVID is just another one of the pathogens we have to deal with.

Unknown Speaker 3:50
Oh, no, I'm losing my secret identity.

Keith Rogers 3:54
So Brian, I hear you say I have to change my COVID face. Now when I see people at the airport and on planes and you know, I have to sort of change myself a little bit. Watch your watch what your transmit Yes, you know, you know, but I still have my mask on. But today won't see all the facial expressions I've given them but

Unknown Speaker 4:15
we've been used to it for the last couple of years. And you're used to seeing people in airports and on airplanes wearing the masks and all that. But that's changed. Some people are still doing it. But it's really a change in the mindset. It took us a while to get comfortable wearing masks. For a lot of people, it's going to take quite a bit of time to get comfortable not wearing a mask every single day. But if you're more comfortable doing it, there's no reason you can't.

Unknown Speaker 4:37
Okay, so is there anything new we should know about how to protect ourselves other than masks are recommended. If you have underlying health conditions, you really should consider wearing a mask again and watch your face in public because now people can see you. Is there anything else that we should be doing?

Unknown Speaker 4:55
Well, we've also had a big change with the vaccine. Two or three weeks ago we approved a A new vaccine that has an updated strain that matches basically what's circulating, so it better matches the Omicron strains that have been out there recently, which means the vaccine that's out there now that you can get your booster. No matter what age you are, no matter how many boosters you've had, you can get this booster that will provide extra protection against this particular strain and hopefully keep you from getting infected or getting really sick if you do get infected.

Keith Rogers 5:24
And could you dispel rumors that may be circulating in terms of when you do get the booster? How long was it effective?

Unknown Speaker 5:33
Well, we don't know exactly, we don't have an exact amount of time, we know that over time your antibodies wanes, so you're having less protection as time goes on. But that doesn't mean it's no protection. It's the same thing we saw with the earlier vaccine, you first have this additional protection, where it really keeps you from even getting sick. And as those antibodies weighed, it may not prevent you from getting sick. But it makes a huge difference in hospitalizations, serious disease and death. So you may still get sick, but you're not going to be in the hospital because of it. And so right there, it's still effective, even though it doesn't prevent those infections. We know that after a natural infection, you have strong antibodies for at least 90 days. They last longer than that, but it kind of varies from person to person. This is something we're going to be talking about over time, it may be that COVID shots become an annual shot just like getting a flu shot. So you go in and you get both shots, and you're protected for the next year.

Keith Rogers 6:29
So I hear you saying it actually going, you recommend that we go and get the the updated the most recent booster.

Unknown Speaker 6:38
Absolutely. So no matter how many boosters you've gotten, even if you're under 50, where you're only eligible for one booster, you are eligible for this new booster across all agents. So this is a good time of year to go in, you can get the COVID shot and the flu shot at the same time I went and got mine last last week, I got two needles in the same arm, my arm was sore the next day, but that was it just because I got a shot. But you can get your flu shot your COVID shot now and it will provide you better protection going into the cold and flu season that's coming up here.

Keith Rogers 7:06
And then and I may have missed it if you share. So I apologize for the redundant question. But did you like what are the booster you can go down to what age now to receive the booster? And secondly, do you have to have had the original vaccine to be eligible for the booster?

Unknown Speaker 7:24
Well, basically what we've done is replaced the original vaccine with these new booster doses. So I think if you weren't vaccinated at all, you would probably just get the series using this new new booster strain. Essentially, we have different vaccines available all the way down to very young kids. So it's pretty much available across all age ranges. It's not like before where you had to be 18 or over or anything like that. So elementary school all the way through, older adults can get it and if you go in basically your medical provider or pharmacist will be able to tell you which dose you need. And what the schedule is because it comes down to your individual situation and, and which shots you've had already. The there's different doses we use for different ages and different manufacturers have different age cut offs and things like that. So they'll be able to help you figure that out and get the appropriate shot for you.

Unknown Speaker 8:16
That's really good information and information I wasn't really aware of. So even though we're sort of at a low at this moment, that doesn't mean that we should get complacent. We should still take our boosters and make sure that we do everything we can to be safe and to protect each other's what I hear you saying?

Unknown Speaker 8:32
Absolutely. It's kind of like your flu shot right now there isn't flu circulating in Southern Nevada, but we know it's just around the corner. So now's the time to get your shot before it's here. It's the same thing with COVID. The numbers are low. But we know COVID is still circulating, and we could see an increase in our community. So the best time to get vaccinated is before we see that increase, it's going to provide you the most protection against whatever's coming next.

Unknown Speaker 8:54
Wonderful. So I have a question about not too much. Well, yes, a question. So 2020 has plenty 20 and the 2020s have been like low level ridiculous. And there's a new player on the block whose name is monkeypox. So could you please provide us with an overview of what monkey pox is and where the heck it came from.

Unknown Speaker 9:17
So monkey pox is a viral infection that results in a fever and a rash. It's Think of it like smallpox. In that same family we think of chickenpox the same way chickenpox is actually caused by a completely different virus, but it's the same sort of disease, you get a fever, you get this rash with little pustules all over your body. It's something that we've known about since the 1970s. It's the origin. We don't know exactly where it came from originally, but we know that the population that we find it is rodents in certain parts of Africa. And so it's just a disease that you find in small rodents that are there. We named it monkey pox because it made its way into a population of research monkeys and that's where we first identified it. So it really has nothing to do with monkeys, there are more human cases now than there were monkey cases. It just that's where we found it. So it became a monkey pox and the name just kind of stuck. So it's a viral infection that's spread typically through skin to skin contact. So skin rubbing against other skin, it typically has been happening in this outbreak during sexual contact. So it's not, it's not a sexually transmitted infection, like we think of all the other ones that are out there. But it happens during close physical contact when bodies are rubbing up against each other. So we've seen that type of transmission almost exclusively in this outbreak. And it's largely been among men who have sex with men. So it made its way into some of those social networks. And within the population of men who have sex with men who have a lot of partners, that's where we've seen the outbreak. So it's nothing special about being a man who has sex with men, it's basically people who are having a lot of sex. And it's in the group of men who have sex with men. So that's what we've been dealing with over the past few months. It's very different than COVID, though, because it's not something you're going to come in contact with in your day to day life, you're not going to get it sitting in a classroom, you're not going to get it in a bank or a grocery store or anything like that. Because that's not how it's spread.

Keith Rogers 11:12
And so what I hear you saying it is, it's a low, a low likelihood that it's going to spread, and your normal daily activities,

Unknown Speaker 11:21
I would say it's zero likelihood, you really have to have close physical contact, you have to be rubbing against somebody else's skin. For that to happen, we can see some respiratory transmission, but you have to be face to face for an extended period of time like laying next to somebody in a bed or something like that. It's just not something that spreads easily through the air. And you know, touching a doorknob isn't going to spread it to you or things like that. So it's really that that direct skin to skin contact, you're in typically sexual contact that spreads this disease.

Keith Rogers 11:51
And then if you if you were to have signs and symptoms, like what's the, like, how do you treat it? And how long should you be under care,

Unknown Speaker 12:03
treatment for it, it's, it's a disease that we don't have a lot of clinical experience with. But what we recommend people do is if you think you have this, you obviously have some sort of fever and a rash, talk to your doctor, and they can do the appropriate testing to figure out what it is and decide what needs to be done. There's some different antivirals we've been experimenting with to try and treat it. There also is a vaccine though, which we can give after you've been exposed to hopefully prevent you from getting disease, but we can give it like any other vaccine. If you are a high risk person, you can cut down the probability that you will become infected, if you do come in contact with someone that

Unknown Speaker 12:41
that's good. I was going to ask about precautions, you know, as he talks about skin to skin, are we talking about? Through open wounds? Are we talking about just general contact, and what are some precautions people can take? If they're high risk,

Unknown Speaker 12:55
it's really the the direct skin to skin contact skin rubbing instead of skin, it doesn't have to be broken skin. Because when you get this, you get a rash. So you have little pimple like pustules all over you. And that's what contains the virus. And so if you're touching that you can get the virus from somebody else, the vaccine is the kind of thing that can be given ahead of time. So even if you do have contact, it's going to reduce risk of infection or serious disease. And another thing that we've seen, which has actually been quite effective has been the people who are at highest risk based either on public health messages, or just what they've decided to do have really cut down their number of sexual contacts. So that goes a long way to slowing transmission as well. So when we had a lot of people in the population getting affected, plus a lot get vaccinated, plus those who are in not in those first two groups, reducing their sexual contacts, that's really helping to get the outbreak under control.

Unknown Speaker 13:50
So increased so increased sexual contact means increased risks. So that's something to be mindful of with the transmission. And it sounds like a human version of poison ivy, where you just come into contact with it, and then all of a sudden, it shows up for you

Unknown Speaker 14:06
why that's not a bad way to describe it. It's that sort of thing you've got, it's an infection that somebody else has on their skin, and you get it by rubbing that infected skin. And so a little bit of time after that infection a week or so or two weeks, you'll get the vague symptoms of not feeling well and a fever, and then it'll progress to a rash. And so yeah, it's really it's not quite pleasant it but it's the same idea. You're touching something that's contaminated, basically. But instead of a plant, it's a person who's already infected with it.

Keith Rogers 14:37
And I know you spoke about sort of the low levels for COVID currently in the state. So how would you rate where we stand with monkey pox in terms of, you know, the case number of positive confirmed cases?

Unknown Speaker 14:53
The number of positive monkey pox cases is way lower than anything we've seen with COVID. We're talking about outbreak with With maybe 100,000 cases nationwide or something like that, when we've had over a million deaths nationwide from COVID, alone, it's not even in the same ballpark. So we're really talking about a rare event for most people. Now there are obviously, I risk populations within our community that are experiencing this a little bit differently. But for the average person on campus or in the community, they're not really coming in contact with it. And it's not something they need to be all that concerned about. If you're a man who has sex with men, and you have a lot of, especially one time sexual contacts, your risk is going to be higher. And you have to think about it as part of your overall sexual health. How do you approach your, your sex life so that you don't get a disease like this, but for most people, it's really not something that we need to worry about every single

Unknown Speaker 15:46
day. You know, as we think about monkey monkey pox in the sense as we think about COVID, you know, there's not some fear mongering around it, and some misinformation and some miscommunication. So how do we best provide people with resources in order to get the appropriate information around COVID, and especially around monkeypox, the newest player in the game?

Unknown Speaker 16:09
Well, I think it's the same answer for both it's finding trusted sources of information, just mean that you found on social media is probably not giving the accurate picture of what's happening with COVID or monkeypox, look to your physician, look to your pharmacist look to the local health department or the CDC for the correct information on that. And that can go a long way to dispelling a lot of those rumors and incorrect information that's out there for this disease or any other disease, you know, it's a, it's probably best that you're getting your health advice from health professionals. And not somebody who's known for doing dumb stunts on Instagram, you know, it's you have to think about the source of that information and and look to the people who are the experts in it, that you trust for, for general medical information, you wouldn't look to a social media star for what you should do for heart surgery, it should be the same thing with an infectious disease as well.

Unknown Speaker 17:04
Well, it's a bit disappointing to know that that tick tock that I follow isn't giving me good information.

Keith Rogers 17:12
And I think is reassuring to hear you hear you say that for our UNLV community here on campus primarily that, you know, the current measures that we have in place for, you know, cleaning preventive, all those measures, sort of help keep us even safer from potential spread and that for monkey pox, that's not even an indicator anyway to keep you safe.

Unknown Speaker 17:38
With with monkey pox, we have these discussions as part of the COVID meeting, you know, what else do we have to do to protect people? The answer was really nothing. The only thing that we had to think about is what happens if we have somebody living in the dorm who has monkey pox, making sure that we provide them a space where they're not sharing the room anymore, we use the same kind of protocols we approach with COVID We have to tweak them a little bit because of the spreads a little different, we worry about cleaning a little differently in those spaces. But other than that, there's nothing special we have to do in the classrooms or in any of our campus events to reduce the risk of monkeypox, because it's just not something that's spread through our campus activities.

Unknown Speaker 18:16
So what I hear you saying is, don't panic, get correct information, get credible sources. take necessary precautions pay attention to how many partners you have in the frequency of your sexual engagements. And above all, consider getting a vaccine for monkey pox if you are in part of the high risk population.

Unknown Speaker 18:37
Absolutely. That's that's a great way to sum it up.

Keith Rogers 18:40
Now, Brian, now that you've sort of taken off your superhero, disease surveillance hat, being our disease are for the State and the University. So what are so what are you working on now?

Unknown Speaker 18:57
Well, basically looking for whatever that next outbreak is going to be and thinking about how we can better prepare ourselves to deal with it. Trying to work with students to set up some things to give us the ability to train people to be the next generation of investigators. And that's what I'm really excited about doing next is not just taking what we learned from COVID and stopping there, but taking it and hopefully transforming the way we approach public health in Nevada. So we have people that are ready the first time that that case of a new disease shows up and we get to go through this all over again with whatever's next that happens way often, way more often than people think. And I would love to see us be ready for that.

Keith Rogers 19:36
So who who is an ideal student or candidate to serve on this, this team that you just referenced?

Unknown Speaker 19:42
Well, we're still putting all this together. So it's not like I'm hiring people yet. But you want people who are inquisitive by nature, who are quite flexible, because when you respond to an emergency, everything you know today could change and you have to start over from scratch tomorrow and you can't let that bother you have to be able to stop on a dime and change directions quickly. You also want somebody who has skills in different areas, when you put put together a good public health response team. If everyone has the same skills you don't get very far. So you need people with clinical backgrounds, laboratory backgrounds, people who are good at developing databases and doing analysis, people who have experience working with the public or going out and doing restaurant inspections, you need all of those people with the team. So the advice I always give to public health students is figuring out what makes you unique. That's what you can bring to the team. And that's where you're going to help improve things. If you're the same as every other person. Why would I hire you, I want to know that you've got all these extra skills, and it may be something like, well, I worked in a fast food restaurant for a few years, okay, you know, food safety, and other people don't. So there's a lot of things that you as an individual can bring to the table when it comes to responding to a public health emergency.

Unknown Speaker 20:53
I love, love, love the comprehensive nature of the people that you're looking for. I'm also really excited that we're doing prevention versus response. You know, we're responding versus reacting. And we're looking forward to a prevention type model. Because I feel like there's been a lot of whiplash around what's appropriate, what's not appropriate, what's good policy, what's not good policy. So for you guys to develop a system that makes it clear, I think it will go a long way towards, you know, stemming the tide, about misinformation, and also the panic that tends to occur. On a not related note, but I feel like monkeys got a bad deal in here because they weren't even the ones that started it. And somehow it became their thing.

Unknown Speaker 21:38
Well, it's no different than chickenpox. chickenpox has nothing to do with that they get the blame for chickenpox. It is, yeah, it's a human disease. It's just we tend to name things in the populations, we find them. And that winds up being a big issue we had this with, with influenza in 2009. But the new strains came out it was a swine origin virus. So we call it swine flu. And of course, pork prices dropped. It has nothing to do with ticks. But this is this is common when we first identified Hantavirus it was on the Navajo reservation. So it became known as the Navajo food well, it didn't have anything to do with them. AIDS was originally named grid gay related immune disease. And of course, when you start to do that, it stereotypes people and brings all the stigma around it. That's completely incorrect. I think we've learned a lot over code between COVID and this about just what we call them in a lab, it may make perfect sense, the public doesn't see it that way. And I think we need to do a better job of of naming things in a way that aren't going to create those stigmas and cause problems for groups that we don't intend to.

Unknown Speaker 22:39
I couldn't agree more I am. I'm glad that you're working on this team.

Keith Rogers 22:43
And then Brian, we'll get you out of here on this on give you the last word. Is there anything that you wish we had asked you that we didn't ask you or anything that you would like to share in this domain with our listeners?

Unknown Speaker 22:56
Well, I think the question that I get asked a lot is what's next? What's going to happen with all of these diseases? Somebody wants me always to predict, you know, what's going to happen this fall? Will I be able to go on Thanksgiving break and not worry about COVID? And unfortunately, the answer is, we don't know. We can track what's going on. But we're kind of at the mercy of the virus new strains pop up, those new variants are coming out. And that changes the dynamic of the disease. So if nothing changes, we can make some good predictions. But things change constantly. So pay attention to what's going on. And we'll tell you when things are changing. But we really unfortunately, can't predict what's going to be next for we just know that it's going to be here with us for quite some time.

Keith Rogers 23:35
So actually go ahead and commit and buy my football tickets to the game.

Unknown Speaker 23:40
Go support the rebels.

Keith Rogers 23:42
Yes, yes, we are. Three in one. Yes. I'll be I think I'm going to be at the game tomorrow night.

Unknown Speaker 23:49
Okay. tough way to bowl eligible.

Keith Rogers 23:51
Yes. Won't there be dynamic, if we make it to the bowl?

Unknown Speaker 23:54
That would be fabulous. Fabulous. And what I hear you saying is work on them coping skills, man, work on those coping skills so that you can manage all the stress that comes with the not knowing but know that there's good information out there. And there's qualified people to help you to navigate this uncertain medical landscape.

Unknown Speaker 24:15
Absolutely. All right. Well, thank you, Brian. All right. Thanks for having me back. So it's good to be here with

Keith Rogers 24:21
you guys. All right. Well, hopefully we don't need you to come back in this capacity. It could just be a different interview. All right, thanks again.

Dr. Renee Watson 24:36
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Transcribed by https://otter.ai

Let's Talk: The Latest on Monkeypox and Covid with Dr. Brian Labus, Assistant Professor, School of Public Health andMaster's of Public Health Internship Program Coordinator
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