Behind the Mask — ‘Vaccine Joy’ and the Future of COVID

This blog post highlighting Episodes 55, 71, and 80as well as Bonus Episode 2of the Epidemic podcast is sponsored by RubiconMD.

“It gave me a sense of freedom I had kind of forgotten existed,” said one Epidemic listener about the COVID vaccine in a voicemail for the Just Human Productions team. 

“It felt amazing, you know, to touch somebody else,” said another. 

“We got the call and I was like, ‘OMG really?! I gotta go! I got a vaccine appointment! Bye!’” recalled a third listener. 

These voicemails, which are woven into Episode 80 of Epidemic, capture the “vaccine joy” so many have experienced upon receiving their shots. With immunization has come the possibility of a return to normalcy and, for many, the prospect of safe reunions with family and friends. 

Vaccine joy has taken the collective effort of so many people—from doctors and scientists, to essential workers, to everyone who has complied with public health guidance. Mask wearing, social distancing, and sheltering in place have all been crucial steps in slowing the spread of COVID thus far; and despite the easing of pandemic regulations, COVID safety measures remain essential to ensure the health and well-being of all.

How is the coronavirus transmitted? 

On Episode 55, Dr. Céline Gounder, along with Kim Prather and Linsey Marr—coauthors of an article in the journal Science about airborne transmission of the coronavirus—explain how the virus moves. Coronavirus particles travel through the air in droplets and aerosols—“tiny bits of solids and liquids that get released into the air when you sneeze, sing, or even just talk normally,” as Gounder explains––and can be inhaled by others. Though public health recommendations were originally based on the assumption that heavy droplets—“mini-cannonballs,” as Prather describes them—accounted for most of the spread, later research showed that lighter aerosols are more important to transmission. 

“I wanted to know what airborne meant,” says Roxanne Khamsi, a science journalist, on a bonus episode released in March 2020, early in the pandemic. On this episode, Khamsi, along with Lydia Bourouiba, an MIT professor whose lab studies the fluid dynamics of disease transmission, explain how effective public health guidance demands a thorough understanding of the movement of coronavirus particles. Bourouiba explains the “false dichotomy” of distinctions between droplets and aerosols, and how original social-distancing recommendations did not fully take into account that droplets and aerosols can actually become gaseous, enabling them to move further. 

Taking into account how the coronavirus is transmitted, Bourouiba explains that guidelines such as “six feet apart” may not be sufficient, while Prather and Marr assert that masks are critical to slowing the spread of the virus.

What is the science behind mask wearing? How has mask wearing helped to ease the pandemic?

On Episode 55, Marr explains how masks protect both the people wearing them and those nearby. “For the larger aerosols… the cloth masks block even up to 80 percent” of particles, says Marr. And for particles of two microns or larger, that blockage rate increases. “So that reduction is going to make a big difference in how many viruses are out there in the air that other people could be exposed to.”

Though masks are most effective in protecting those around the people wearing them—rather than the mask-wearers themselves—Marr says that if everyone wears masks, “there’s a multiplier effect.” Especially in indoor environments, with little ventilation, masks have proved critical to slowing the spread of the virus. Although face coverings are no longer required in many public settings for those who have been vaccinated, new guidance from the World Health Organization suggests that masks are still a good safety measure for those who have been vaccinated, given the increased transmissibility of the Delta SARS-CoV-2 variant. 

Is COVID here to stay? If so, what does that mean for the future?

“I don’t think that herd immunity is a possibility for SARS-CoV-2,” says Jennie Lavine, a postdoctoral epidemiologist and infectious-disease researcher at Emory University, on Episode 71 of Epidemic. “I think there’s going to be a different kind of equilibrium that we reach in the future where humans and SARS-CoV-2 coexist in a much milder, more benign way.”

Even with the existence of an effective vaccine, many scientists believe that COVID is here to stay. “If I had to put money on it, I think it’s more likely that this virus will be persisting in human populations for as long as I’m alive,” says Jeffrey Shaman, a professor of environmental health sciences at Columbia University’s Mailman School of Public Health.

For example, OC43—a very mild coronavirus and one of four circulating endemic coronaviruses—has infected most people many times. It’s generally experienced as a common cold. Following the SARS outbreak in 2003, researchers began to look into the history of mild coronaviruses like OC43. Some believe that OC43 may have caused the “Russian” flu pandemic of the late 1800s. While at the time, OC43 often caused extreme symptoms in those it infected, it now just causes the common cold. Many predict that SARS-CoV-2 may have a similar future. 

On Episode 71, Angela Rasmussen, a virologist at the Vaccine and Infectious Disease Organization at the University of Saskatchewan, says, “I think that it’s pretty unlikely that we’re going to eliminate [the coronavirus], at least in the short term. Because there are still many, many people worldwide who have never had SARS-CoV-2 and are still susceptible to it.” 

The Pfizer, Moderna, Johnson & Johnson, and Novavax COVID vaccines are highly effective in protecting against severe disease, hospitalization, and death from COVID, and in preventing transmission of SARS-CoV-2 infection. However, as the SARS-CoV-2 virus mutates and becomes more transmissible, the proportion of the population that needs to be vaccinated to achieve herd immunity increases, making elimination an increasingly elusive goal. 

Why might safety measures, like mask wearing, remain vital despite the significant decrease in cases?

If we are unable to eliminate SARS-CoV-2 through herd immunity, the virus will become endemic. “An endemic pathogen is something that is just present in the community,” explains Shaman on Episode 71. “In the strictest sense, it’s something that’s there all the time and constantly being transmitted.” With OC43, people often get reinfected within the span of a year, and the same may eventually be true for SARS-CoV-2.

Reinfection after vaccination—what we call breakthrough infections—may not be a big issue if subsequent infections typically cause much milder disease. However, researchers are still learning about the long-term consequences of COVID, including milder cases of COVID and breakthrough infections. For this reason, many experts recommend that people continue wearing masks as a public health precaution so long as SARS-CoV-2 is still spreading in their community. As Gounder says, “The OC43 coronavirus may have gone from pandemic to common cold… but that took over 100 years. That’s time none of us have.”

On this second World Mask Week, recognizing and communicating the importance of COVID safety measures is critical. We may be strides ahead of where we were a year ago in defeating COVID, but lasting gains will take ongoing collective adherence to public health guidance. 

“Although the focus of healthcare is gradually shifting away from the COVID-19 pandemic since there are more vaccinated individuals, we must not overlook or ignore the rise of the Delta SARS-CoV-2 variant. In honor of World Mask Week, this episode shares the importance of how and why masks are a valuable safety measure even for those who have been vaccinated.” — Gil Addo, CEO/Co-Founder of RubiconMD

About RubiconMD

Launched in 2013, RubiconMD advances its mission to democratize medical expertise by connecting primary care clinicians to top specialists. Through its digital platform, RubiconMD enables the remote exchange of insights between clinicians that eliminates unnecessary referrals and services, reduces patient wait time and travel burdens, and allows primary care to practice at the top of their license. For more information, please visit  www.rubiconmd.com.

About Just Human Productions

Just Human Productions launched in 2017 to democratize public health knowledge. By translating complex science and policy concepts into engaging, accessible, and actionable solutions, Just Human Productions generates “citizen scientists” across its worldwide audience. To access our full suite of free, multimedia digital resources—including docuseries podcasts, weekly articles, illustrated guides, infographics, and short videos—visit www.justhumanproductions.org