Dr. Leana Wen advises that you should think of your COVID-19 vaccine like a very good raincoat: If it's drizzling or you're in a rainstorm? You're well-protected. "But if you're going in and out of thunderstorms every single day and now there's a hurricane — at some point you're going to get wet," she says.
That's one of the reasons why Wen, an emergency medical doctor and former health commissioner of Baltimore, believes the CDC ended masking requirements too abruptly and prematurely in May – especially now that the highly transmissible delta variant is so prevalent in the U.S. She and other public health experts have urged the CDC to revisit their guidance — which the agency is expected to do on Tuesday.
"Unfortunately, we're in a situation now where the vaccinated are having to pay the price for the actions of the unvaccinated ... " she says. Though it's very, very rare for vaccinated people to get seriously ill with COVID-19, breakthrough infections are occurring, she says, "not because the vaccines aren't effective, but rather because of the high levels of unvaccinated and infected people who are surrounding us."
Wen serves as a medical analyst for CNN and a contributing columnist for The Washington Post. In her new memoir, Lifelines: A Doctor's Journey in the Fight for Public Health, she describes the remarkable path that led to her current career.
Wen spent the first few years of her life in Shanghai. During the Cultural Revolution, her father spent time in prison for his work as a dissident. When she was nearly eight, she and her father came to the U.S. to join her mother, who had moved to Utah on a visa to attend grad school.
Her father was able to obtain political asylum in the U.S., but the family had little money and Wen had bad asthma. The family's reliance on Medicaid and the public health care system inspired her to pursue a career in emergency medicine and public health.
Today, she has voiced concerns about the way the CDC and the Biden administration have handled coronavirus communications with the public.
"Public health depends on public trust, "she says. "Public health depends on winning over hearts and minds. It's not enough to just have a good policy, you have to convince people to actually follow it."
Wen believes that most people who have not yet received the COVID-19 vaccine are not completely opposed to vaccines — they are just people who are more concerned about the vaccine than the virus. But vaccine mandates have worked in the past, she says — just look at childhood immunizations and mandatory flu shots for health care workers — and the same approach can work for COVID.
"We really need to be talking about the COVID vaccine the same way that we talk about other vaccinations — which is that it's safe, effective, life-saving and essential for the public's health."
Interview Highlights
On the CDC lifting the mask mandate in May
The CDC was relying on an honor system at a time when many people, unfortunately, were not behaving in the most honorable way.
It was a mistake for them to lift their guidance in May. ... Many of us in public health were very concerned because the CDC was relying on an honor system at a time when many people, unfortunately, were not behaving in the most honorable way. ...
When that guidance was first issued, only 36% of the country was fully vaccinated. And we're actually now seeing the consequence, which is that the unvaccinated began behaving as if they were vaccinated, and we are now seeing massive surges again across the country...
On her hope that the Biden administration will implement vaccine mandates
I don't think that people should have the choice to infect others with a potentially fatal and extremely contagious virus.
I hope that the Biden administration at this point really gets behind vaccine mandates, because we need to acknowledge that what we're doing thus far just isn't working. I don't think that people should have the choice to infect others with a potentially fatal and extremely contagious virus. And I think we, as a society, need to figure out, what are our values? [Does] the value of freedom of choice for some really override the public's health for the most vulnerable? ...
The Biden administration can do a lot when it comes to signaling. For example, they just said yesterday that employees of the V.A. now need to be vaccinated within the next eight weeks. That's a really important signal for all health care institutions and nursing homes.
I think the administration can go even further and say all federal employees will need to be vaccinated. And also that if you go on planes, trains in federal buildings, that you either have to show proof of vaccination or you have to have a recent negative test, something like that will also pave the way for private institutions, including businesses and many more schools and universities, to implement that type of health screening as well.
On how safe you are in an environment where everyone is vaccinated
If everyone around you is fully vaccinated, the chance of them carrying enough virus to infect you is very low. If you're also then fully vaccinated, your chance of contracting COVID from one of these individuals is very low. ... If everyone around you is fully vaccinated, then you do not need masks or distancing in that circumstance.
But I also think that there is this narrative that is not true — and actually quite harmful — that once you are vaccinated, who cares if others around you are vaccinated, too? That's just not true. We know that these vaccines are not 100%. We don't know exactly how well they protect against symptomatic illness ... but let's say that it's 90%, which again, is very good, but it's still not 100%. The more risk you're exposed to, the higher likelihood you have of contracting COVID-19. ... It really matters whether others around you are also vaccinated.
On children returning to school in the fall
Schools can be some of the safest places for children from a COVID-19 transmission standpoint if mitigation measures are followed. ... Indoor masking is absolutely critical, improving ventilation as much as possible, and also having regular testing — I do think that it's possible for schools to come back safely in person. But these measures have to be in place. ... There are at least eight states and counting that have actually forbidden schools from mandating masks. That's a really substantial problem. And I hope that parents in those circumstances will still choose to ask for their children to be masked as much as possible to protect them and others around them.
On the anti-Asian hate and discrimination she's experienced
Every time I am on air, I will receive actually quite a few messages that specifically tie me to the Chinese Communist Party — which is ludicrous because my family left on political asylum from China — or that will blame me and "my people" for the coronavirus. And of course, there are many, many messages telling me to go back to my own country. ...
There are so many Asian American people who have suffered during this pandemic. There are shop owners who have had their shops burned down or graffitied ... by people directly attributing the coronavirus to them. There are people who have been assaulted — nurses, physicians who have been spat upon and assaulted, leaving the hospital by individuals who are, again, attributing the coronavirus to them.
On a formative medical emergency experience when she was young
There was a neighbor child who was just a couple of years younger than me who also had asthma, and he had a very bad asthma attack, and I remember rushing to help him because his grandmother was screaming for help and I knew what to do for asthma. ... His grandmother was too afraid to call for help, and actually, because we didn't get help for him in time, he died. He died in front of me due to this entirely preventable cause. ...
This image is seared on my mind because I kept on thinking: This did not have to happen. His grandmother was just too afraid to call for help because they were undocumented immigrants and she was afraid of the authorities coming in, their family being deported.
And I thought at that time — and I remember having a discussion with my mother about this afterwards — that we're in a society where people's lives are valued differently, depending on where they come from and whether they have the money to pay for care.
On how caring for her mother, who had cancer, informs her approach to medicine
One of my longtime mentors is the late Congressman Elijah Cummings, who used to say ... that your pain is what fuels your passion, that then becomes your purpose. And for me, in dealing with my mother's illness ... I was her caregiver for eight years ... I was a medical student when she was diagnosed and a resident when she died. And having gone through that, I also saw so much of the disconnect that's happening in our medical system. ... So I entered this field, of patient and family advocacy from the perspective of being a clinician, but also being a patient and a family member as well.
Seth Kelley and Sam Briger produced and edited this interview for broadcast. Molly Seavy-Nesper, Beth Novey and Carmel Wroth adapted it for the Web.
Copyright 2021 Fresh Air. To see more, visit Fresh Air.
