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NYC reopening timeline is a ‘disastrous issue’: Doctor

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Dr. Anand Swaminathan, Emergency Medicine Physician in New Jersey, joins Yahoo Finance’s Sibile Marcellus and Alexis Christoforous to discuss the latest on the coronavirus.

Video Transcript

ALEXIS CHRISTOFOROUS: The city that never sleeps will soon fully reopen from the pandemic and do shutdown. New York City Mayor Bill de Blasio says the city will fully reopen on July 1st. Meantime, more than half of US states have seen a significant decline in new coronavirus cases over the past two weeks. Still, the uneven levels of vaccinations across the country point to the challenge of reaching those people who have not yet gotten their shots.

Joining us now to talk about it is Dr. Anand Swaminathan, emergency medicine physician in New Jersey. We're also joined by our healthcare reporter, Anjalee Khemlani. Doctor, thanks so much for being with us. I'm curious what you are seeing there on the ground in terms of vaccinations. Has the pace slowed down? And are you seeing hesitancy to get the vaccine among some groups?

ANAND SWAMINATHAN: The base has definitely slowed down. I mean, we were at a pretty high level. So we've slowed down. But we're still vaccinating a substantial number of people. But I don't think we like to admit it. That was the easy part. The last three months were people who really, really wanted the vaccine and were going to do anything to get it.

Now we're entering the harder phase where we have people a little bit more reluctant. We have plenty of supply, which means that our focus, our biggest challenges have to be on access and demand. In terms of access, what we need to be doing is getting to those communities that are having a low uptake of vaccine and bringing the vaccine to those areas. We have to make it as easy as possible for people to get the vaccine.

And then in terms of demand, let's start educating a little bit more. Let's work with community leaders. And there's a lot of funding that the government has put together. What we need to do is pair with those community leaders and give them that funding and say, you tell us what's going to work in your community to get people vaccinated. We really need to reach out in that way. Instead of telling people what we think is going to work, we need to let them tell us what's going to work.

SIBILE MARCELLUS: So over the past two weeks, we've seen that the number of cases have fallen significantly in about half of the states across the country. So doesn't that indicate that we're doing the right thing by just following their instructions? So if they say, for example, in New York City, the city can be fully reopened on July 1st, shouldn't we just take the mayor at his word?

ANAND SWAMINATHAN: Well, there's a lot of different problems in these equations. The fact that it's falling in half states is great. That means there's half of states where it's not falling substantially. So we have to really kind of understand that part of it. But this is good progress, especially when we thought we were going to get a fourth surge. It was going to be quite large. The fact that rates are declining overall is a good thing. We should be proud of that. But the reason it's declining is because of the public health measures that we have already instituted. It's because of vaccine uptake.

So we can't just eschew those public health recommendations. We can't abandon them. We need to keep to it. This reopening, this false kind of creation of a deadline, that's a disastrous issue. We can't say July 1st, we're going to reopen everything because we don't know what July is going to look like. And setting that artificial timeline makes a problem because either you're back off of that timeline-- people are going to be pretty angry about that-- or you go forward with it when it's not safe.

Instead, what we should be doing is instead of setting a date that we are going to go back to full, what we need to be looking at is, what are the dynamics of transmission? What's the percent positive rate? What's vaccine uptake? Right now, the vaccine uptake in New York City is about 36%. That's far below what we would need to get herd immunity. Now we don't know exactly what the level that we need for vaccines to get herd immunity is. We know it's a lot more than 36%. So yes, July 1st might be fine. But instead of that, we should set guidelines based on what transmission looks like at the time, what the disease looks at the time. And we don't know what July 1st is going to look like.

ALEXIS CHRISTOFOROUS: Do we have Anjalee here? I didn't know if Anjalee wanted to jump in. OK, so then you know what? I'm going to ask you a question, doctor. I heard that we're having an issue trying to get people back for that second dose. I mean, it's a relatively small number, but I think it's still troubling, something like 8% of people who already had the first dose are not going back for-- or have not yet gone back for the second dose. What would your message be to those people?

ANAND SWAMINATHAN: First of all, the message to the people is that the second dose is absolutely 100% necessary for these mRNA vaccines. They're not nearly as effective with a single dose. There's some reduction. We think maybe in the 50% range. But that's not nearly enough. If you get that second dose, wait two weeks after that, we're up to 94%, 95% reduction in cases. So you really need that second dose.

But again, this is about messaging. So when you walk into the vaccine center, everyone who's there, whoever is vaccinating you, should be telling you, this is your first dose. You're going to have to come back in three to four weeks for your second dose, depending on which mRNA vaccine you're getting. And then that second appointment needs to be made on the spot. So the vaccine center that I work in, which is pretty close to where I live, when we give that first shot, they automatically get a text message with their next appointment. So there's nothing for the person to do. It's already booked. They just have to show up on that day. We need to, again, make this as easy as possible.

But then we also have the option of the J&J. For people who think, you know what? Maybe I'm not going to come back for that second dose. I don't want the second dose. Whatever it is-- the J&J is where we should be steering people. So we have some options. But a lot of this is in messaging. There's some studies showing that the vaccinators are not always telling people you have to get a second dose, so we need to reiterate that over and over again.

Every time I give a first dose, I tell people, we'll see you back in three to four weeks for your second dose, depending again on which vaccine I'm giving. And then the center is making that appointment immediately. So these are things that we can do to make this as easy as possible for people. And that's really the phase that we're in at this point. Make it easy for people. Make it a no-brainer to not only get your first dose, but to know exactly when that second dose is.

And then we can also support people by doing things like paid time to get your vaccine, right? So people should not be losing an hour or two of their paycheck because they're going to get a vaccine. That should all be paid for. These are other things that we can do to make it easier for folks.

SIBILE MARCELLUS: And how do you feel about restaurants? A lot of-- for example, in New York City, a lot of diners have been comfortable eating outside. But if the city's fully reopened on July 1st, does that mean that we're going back to crowds inside restaurants? Because it gets hot over the summer. People need air conditioning.

ANAND SWAMINATHAN: Yeah, so I'll tell you, I've been fully vaccinated since January. My wife has been fully vaccinated since February. I still feel a little bit uncomfortable going for an indoor dining. So I have not done indoor dining since last March when the pandemic started. And I think it's going to be hard for people to return to where things were, in some ways. There's a little bit of comfortability. But if you're not vaccinated, I don't think you should be doing indoor dining. And this is not a penalty.

Go get vaccinated so you can do those things. But it's not a safe place. We have tons of data out of the CDC showing that when restaurants reopen for indoor dining, cases spike in areas. So until we get to a low enough level that there isn't really a lot of community transmission, which we are nowhere near at this point, indoor dining isn't safe. I think even as a vaccinated individual, I don't feel very safe doing it. I'm going out to dinner with some friends this Saturday. Everybody is vaccinated. We're still doing the outdoor dining. I think it is the safest thing to do right now.

ALEXIS CHRISTOFOROUS: Actually, doctor, I'm with you. I feel the same way. I'm getting my second shot next week. But I'm of your mindset. Dr. Anand Swaminathan, thanks so much for joining us.