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COVID-19 'shines a spotlight' on America's shoddy health care system, Dr. Peter Hotez says

Dr. Peter Hotez, co-director of the Center for Vaccine Development at Texas Children’s Hospital and Dean of the National School of Tropical Medicine at Baylor College of Medicine, joins Yahoo Finance to discuss the White House's response to coronavirus.

Video Transcript

- And we we'll shift gears now and turn our attention TO the latest developments on the COVID front. President Biden's top medical advisor Dr. Anthony Fauci says, while the data is early, the new Omicron variant is, quote, "almost certainly not more severe than Delta." So good news there.

But on the flip side, a new study from the epicenter in South Africa reveals the variant could more easily evade immunity from prior infection. And here to help us discuss all this and the debate over rapid test availability is Dr. Peter Hotez, co-director of the Center for Vaccine Development at Texas Children's Hospital and Dean of the National School of Tropical Medicine at Baylor College of Medicine, and Yahoo Finance's medical expert Anjalee Khemlani. Thank you both for being here.

And Doctor, so there is so much data coming in that we're still trying to process. But this new study from South Africa shows immunity protection is estimated to dwindle by half. What are your thoughts on that?

DR. PETER HOTEZ: Well, I think this was kind of expected, that with all of the mutations and the spike protein that individuals who have been infected and recovered, if they don't get vaccinated on top of that, they have kind of tenuous immunity anyway. So even against the Delta variant, individuals who have been infected and recovered but don't get vaccinated are twice as likely to get reinfected with Delta.

Now you superimpose on that all of the spike protein mutations and, not surprisingly, we're seeing a lot of Omicron reinfections in South Africa. And this is how it may play out here in the United States. As Omicron slowly revs up, we're starting to see cases now. It's starting to climb in Europe. It's still a fraction of the Delta cases, but it will increase.

I think what you'll see is, potentially, the two variants each disproportionately affecting certain populations. So Delta especially among the unvaccinated. While Omicron, its selective advantage is that it's going to cause a lot of reinfections among people who are infected and recovered but not vaccinated, or individuals who've gotten two doses of the mRNA vaccine Pfizer or Moderna have waning immunity, have not yet gotten their third booster. I think you're going to see a lot of Omicron cases among those individuals as well.

ANJALEE KHEMLANI: Dr. Hotez, Anjalee here. Great to speak with you again. I want to talk about the impact of Omicron and specifically on testing. That's something that I know you and other experts have been calling for. And we saw Press Secretary Jen Psaki get into a little bit of hot water over her comments yesterday about the at home rapid test reimbursement idea. Listen to what she had to say.

JEN PSAKI: Should we just send one to every American?

- Maybe.

JEN PSAKI: Then what happens if every American has one test? How much does that cost? And then what happens after that?

- All I know is that other countries seem to be making them available in greater quantities for less money.

JEN PSAKI: Well, I think we share the same objective, which is to make them less expensive and more accessible. Every country is going to do that differently. And I was just noting that, again, our tests go through the FDA approval process. That's not the same process that-- it doesn't work that way in every single country.

ANJALEE KHEMLANI: So as you can hear, she's really pushing back on this idea. And when asked about it today, Jeff Lyons did say that the reimbursement idea is really what they're leaning on. So I just wonder, from your perspective, Dr. Hotez, I mean, should we be following other countries when it comes to testing strategy?

DR. PETER HOTEZ: Yeah, I mean, that wasn't Jen Psaki's best moment. I'm a big fan of hers. But on the other hand, the White House didn't give her much to work with, because this points out yet, again, for the hundredth time, COVID-19 shines a spotlight on our health system. And at the end of the day, we do not have a health system. We have something called the Amazon Pharmacy, and the pharmacy chains, and we have hospital systems.

Well, we don't have a health system that the UK has, the European countries have, that Israel has. And now we continue to pay the price for that. So without question, we need to follow the European model. Anyone who can-- let me take a step back. The reason I say that is our health system, if you call it that, cannot tolerate any level of complexity.

It's why we never got diagnostic testing underway. It's why we never got genomic sequencing underway, because we don't have a health system. And so you make things the least bit fussy and everything collapses. And it's the same yet again. No, this is not going to work. You can't buy a kit and then try to start negotiating with third party payers. It's not going to work well.

What we need to do is the European model where anybody with a couple of dollars in their pocket can walk into one of the major pharmacy chains and buy a home testing kit. So Jen Psaki's rhetorical question, what are you supposed to do, give everybody a home testing kit? Well, hell, yeah, that's exactly what we need to do or at least make it for $1 or $2 a dose.

So yet again, it's not going to work well. I don't blame Jen Psaki. She had one hand tied behind her back. And this is a problem. We just have to make things simple, otherwise, it doesn't work.

- You know, Doctor, speaking of accessibility, some folks trying to get that booster may not have access to the same shot they got for their prior two or the one, if they're J&J. What are your thoughts on mixing and matching? There seems to be some early data that suggests it might actually be more potent to mix.

DR. PETER HOTEZ: I think the data-- I think part of the problem with those potency datas, or data, it's based on the fact that it was set up not to maximize looking at the benefit of the J&J vaccine. Because if you look at the curve of the antibody where J&J goes up later, and so that was the first paper.

But I think follow up papers will show a second dose of the J&J is probably going to be as good or may even be better than getting three doses of either the mRNA vaccines because of the strong T cell responses. So here's what I've been saying. The companies have no incentive to collect data on heterologous boost.

So the Pfizer has no incentive for collecting information on what happens if you've got a Moderna boost and vise versa. And the CDC has also underperformed and collecting vaccine effectiveness data. So what that means is-- so let me give you an example. I got two doses of the Pfizer vaccine. I could have gotten anything I wanted for my third immunization. I chose to stick with Pfizer.

Why? Because I know the company will be collecting data and will get a lot more information on elevation and virus neutralizing antibody, will get a lot more information on durability of protection, will get a lot more information on standing up to new variants that emerge.

So my recommendation has been-- and I didn't like the messaging that we did around the mix and matching. We made it seem very random. And the fact is vaccine supply is not an issue. Pretty much anybody can get anything they want at this point. Although it's not true for a lot of other countries.

So to make a long story short, if you got two doses of Pfizer, I'm recommending get your third dose of Pfizer. If you got two doses of Moderna, stick with Moderna. If you got a single dose of J&J, get a second dose of J&J with one possible exception. And that is if you're at higher risk of clotting issues because of the rare cerebral thrombotic events that have been noted with the J&J vaccine, so if you're pregnant, or you're on birth control, you might want to go with something else.

But even that's a very soft call, because when you look at the actual data for cerebral thrombotic events, it was more in the-- it's still a very rare event, but a little higher in the first and the second dose anyway.

- OK, Doctor, we will have to leave it there. Thank you so much for that information. Dr. Peter Hotez, co-director of the Center for Vaccine Development at Texas Children's Hospital and Dean of the National School of Tropical Medicine at Baylor College of Medicine, and Yahoo Finance's Anjalee Khemlani.