wasserman. watching c-span's washington journal live at 7:00 eastern monday morning. be sure to join the discussion with your phone calls, facebook comments, text messages, and tweets. >> you are watching c-span, your unfiltered view of government. c-span was created by america's cable television companies in 1979. today, we are brought to you by these television companies who provide c-span to viewers as a public service. washington journal continues. host: joining us now is andrew pekosz from the john hopkins -- johns hopkins bloomberg school of public health. thank you for joining us. let's get some of your take first on the washington post story today. it talks about you tatian's that

are out there now, adding urgency to the vaccination effort. they write that the road to herd immunity looks longer. the emergence of more transmissible, potentially vaccine evading variants threatens to make 2021 feel too much like 2020. what do use the out there right now -- you see out there right now? guest: the term variant is a broad term that characterizes viruses that appear to be doing two things. they appear to be getting better at infecting our respiratory tract. the second thing they are doing is they appear to be getting mutations that are preventing some of the antibodies that can be induced by vaccination or infection from binding to new variants. these two things happening at the same time are the concern.

we do not want anything to derail our vaccination campaign. these new variants and their ability are things we are going to have to consider as we go forward. host: are variants in a case like this surprising and how does the medical community tackle these strains? >> viruses always mutate. this particular coronavirus mutates at a slower rate than many other viruses. it is not surprising that these mutations have occurred. scientists have been monitoring this -- for this for a long period because we assume to something like this would happen. this convergence of mutations that appears to increase transmission and evade immune responses is something that was a bit unexpected. the fact that these were occurring globally -- some of

these viruses are being generated in different places. some are spreading from other places. it seems like there has been a incredible increase of activity over the past two or three months with this virus, and that is what is really getting this virus even more on our radar screens of it was not before. host: phone numbers on the bottom of our screen for our guests. he is andrew pekosz with johns hopkins. we are talking covid-19 variants, vaccine development. numbers will be split regionally. eastern and central time zone, call (202) 748-8000. mountain and pacific, (202) 748-8001. separate, third line for medical professionals this morning, (202) 748-8002. our guest is educated at rutgers and has a phd from the university pennsylvania.

he is a overall addressed. broaden the conversation for a moment or two. what else are you seeing in terms of vaccine development and its response to these variants? guest: there are problems with vaccine rollout. if you think about the vaccine itself, in the u.s. in particular, we are fortunate to have two vaccines showing good responses. the pfizer and moderna vaccine seem to be inducing strong immune responses, in many cases stronger than what we see in people infected with the virus. that is good because the stronger the immune response you have, the less likely it is that the virus can evade that and the better protected you will be from infection. two new vaccines are coming down the pipeline, one from johnson & johnson.

the johnson & johnson vaccine is particularly interesting because it is one-shot immunization and that vaccine does not need that cold that the moderna and pfizer vaccines have. the johnson & johnson vaccine may help increase the rate at which we vaccinate because there are less constraints in distributing the vaccine and storing that vaccine before it needs to be used. i see a lot of good things from the vaccine standpoint that will happen over the next few weeks. host: you refer to problems with the rolling out of the vaccine. how many people need to get vaccinated for it to start making a broad difference to turn things around? host: there are 2 -- guest: there are two answers to that appearing we could immunize highly vulnerable populations, the elderly, health-care workers getting in contact with this virus at high rates, we could

almost immediately see a downturn in the number of severe cases of covid-19 and hospitalizations from infection. there is interesting data from israel that shows exactly that. the vaccine campaign was robust and the almost immediately saw a downturn in the number of hospitalizations from covid-19. if we are talking about the general population, different numbers have been discussed, but i think you want to get around 75% of the adult population immunized before you can see a significant downturn in terms of numbers of cases that are out there. it is not black or white. as we get more vaccines into people, case numbers go down slowly. it is that 75% number many are targeting to achieve before fall 2021 to make sure we immunize

enough people to prevent another outbreak like we saw last year. host: a call in for andrew pekosz. larry is calling for minnesota on the independent line. good morning. caller: good morning. i have a question. do you remember when ebola took off in africa? guest: absolutely. caller: ok. do you remember the procedure they used to control ebola? guest: there were multiple ones, so i'm not sure which one you're referring to. caller: do you remember the word quarantine? host: why don't you keep going and make your larger point? caller: ebola, they quarantine everybody to keep it from

spreading. the chinese did not and neither did the cdc. they sent everybody home who was sick and told them there was no medication to help them. it seems opposite of what they did during ebola. my point is, if ebola comes back to the united states, are we going to listen to vouching again? -- fauci again? guest: there are a few things that are different. the important thing about the covid-19 outbreak was, from the beginning, people showing symptoms were suggested to go home and quarantine, and we were monitoring for people showing symptoms. what we did not know at the beginning was there was such a large percentage of the population that were getting infected and showing mild or no symptoms. it is really that population that drove the spread of the virus into -- globally.

so the public health interventions that work for ebola, finding people showing symptoms, quarantining them, and identifying people that came in contact with them do not work as effectively against covid-19 because of those large numbers of cases where people are not showing symptoms. that is why we want to have social distancing and mass wearing to try to prevent the transmission from people showing low amounts of symptoms or no symptoms at all. host: we will get to more calls. we are not doing party affiliations for this segment. it is eastern and central. that is one number. mounted and pacific, that is another number. we will put phone numbers on the bottom of the screen and get more calls in in a moment. that last caller mentioning dr. fauci. here's dr. fauci talking about some of the questions surrounding the new variant at

the white house news conference last week. [video clip] >> the variations do have clinical consequences. as you can see, even though the long-range effect in the sense of severe disease is still handled reasonably well by the vaccines, this is a wake-up call to all of us that we will be dealing, as the virus uses its devices to evade pressure, that we will continue to see the evolution of mutants. that means we as a government, companies, all of us there in this together will have to be nimble to adjust readily to make versions of the vaccine that are specifically directed toward whatever mutation is actually prevalent at any given time.

finally, this all tells us that it is an incentive to do what we have been saying all along, to vaccinate as many people as we can as quickly as we possibly can because mutations occur because the virus has a playing field to mutate. if you stop that and stop the replication, viruses cannot mutate if they do not replicate. that is the reason to continue to do what we are doing, intensify our ability and implementation to vaccinate as many people as possible as quickly as possible. host: anything you want to respond to that from dr. fauci? guest: dr. fauci is correct. what we are seeing is the results from the novavax and j&j

clinical trials were showing some of these variants were still being protected by the vaccine, but it was not as efficient as the protection against the older strains. the older strains were seeing 80% to 90% effectiveness of vaccines against them. that dropped to 50% to 60% against newer variants. that is not a bad thing. we understand viruses are evading some immune responses but that is telling us the vaccine is still working against variants. we really need to do now is continue to get ahead of this virus, come up with ways we can generate booster vaccines that might allow more specific control these variants, and work that into our vaccination program along with vaccines currently being rolled out host: -- rolled out. host: nikki is in texas. caller: it has taken me almost a year now to finally get a hold of myself of masks that say they

are n95. i am excited about that because i have not been trusting the cloth masks and things like that . they did not seem to be appropriate or adequate. i have two questions. with all the variants, it seems like it is important now that we stop the spread. why is and the seat -- why isn't the cdc and others advocating more forcefully for the use of the n95 masks? now that i have these masks, i am concerned about aerosolized particles entering through the eyes. i wondered if you could recommend what kind of eyewear would be adequate to protect against aerosol particles entering through the eyes. guest: let's start from the last part.

having the virus enter through your eyes has not been shown to be a major route of transmission. we do know things as simple as safety glasses, sometimes regular glasses. in the hospital, we have used face shields and we use those things as a second set of barriers in addition to a mask to continue to lower the amount of potential exposure one gets. she brings up a good point. there is no one perfect way to keep yourself healthy from infection. what we are trying to build here are layered approaches. so you put a mask on, you keep social distancing, you avoid crowds, wash your hands. those things each contribute to our protection from infection. no one of them by themselves is 100%. even the n95 masks, studies have shown that if you do not wear

the 95 masks effectively, you will not do that added protection that the n95 masks gives you over a regular cloth facial covering. the important thing is, if you have an n95 masks, make sure you know how to wear it correctly. we have a test we do to make sure people are buying the right mask and wearing it correctly. it is multiple approaches, no one thing that will protect you from infection. it is that layered approach of several things that will cumulatively allow you to protect yourself from infection. host: the new york times has a double page spread for folks wanting to learn more about what to expect when it is time to roll up your sleeve. they do a lot of q&a, from where do i go to sign up for a shot to when i can start going to movies again. what are the most important things people should be thinking

about? we just talked about masks, washing hands. what else should they be thinking about? guest: the vaccine is one to be one more layer of protection that we are rolling out in the population. for the first few months, you would not expect too many more changes from what we are doing in terms of our regular approaches in public health intervention. vaccination of the general population is low, we are going to ask people to maintain almost -- public health interventions like social distancing, limiting meetings, limiting large gatherings. we are going to try to make sure that, as people roll out the vaccine, we have that as another layer of protection. i'm hoping by the time we get to the summer case numbers go down. we will start to see public health interventions start to be eased a bit. the goal will be to get to 70

percent of the adult -- population vaccinated by december to make sure when we get into the fall -- september to make sure we get into the fall we do not have a repeat of last fall and winter. host: paul is calling from england. caller: is it enough to have just one injection? will every country have vaccinations? at the moment, some countries cannot get any. host: how would you describe conditions in? the u.k. right now? -- in the u.k. right now?

i am sure caller: -- caller: i am sure that will get sorted eventually. it is doing well in this country and fingers crossed that we get even better. guest: as more vaccines come out, they will be under different schedules. the j&j vaccine will only take one dose. our infrastructure in terms of medical record-keeping and new things put in place to monitor for vaccine -- vaccinations will keep track of who gets what vaccine. the issue of equity in terms of who gets the vaccine, how vaccine is distributed, that is a difficult question. it is outside my area of expertise. we have to remember this is a global pandemic. immunizing 100% of one country is not going to reduce the threat as much as trying to make

sure we are minimizing the virus globally in all countries. we have to think about our vaccination level as something that has to occur everywhere. if we leave any part of the globe smoldering with the virus to mutate, that will eventually come back to be a problem for all of us. the global vaccination program has to be considered as we are generating vaccines. host: to georgia now, or scott is on the line. caller: i read an article this morning in the washington post on all the mutations. they made the point that actually when these mutations happen your vaccination rate has to go off. supposedly, as it mutates, it loses its verrilli tea or whatever, meaning the severity.

so far, that has not happened and it makes me wonder -- here's a question. the longer the virus is in the system, does it mutate more because it has more time? or is it a shorter lasting virus, meaning it blows through a whole population and never mutates? is that a positive? or if -- the longer the game is played, does it mutate more and possibly avoid the vaccine and all that? do you have to go back to the drawing board and come up with another vaccine? host: interesting question there. guest: it is not how long the pandemic is going. it is about the number of cases and whether the virus is then allowed to mutate or replicate completely. when you have a high number of

cases, there is more likelihood that the virus will mutate. it is more likely it will mutate in a place that might give it an advantage. by lowering the number of cases, that is how you can limit the chance of mutations from occurring. it is not about how long we have been with the pandemic. it is trying to keep the number of cases down because that will limit the chance of the virus to mutate in these particular sites. we tend to think of viruses and humanize them, but viruses are not smart. they have no intelligence. they mutate randomly across every gene they have. it is only by chance that they can mutate once in a while in an area that gives them an advantage. by dropping the number of cases, we can limit the chance, the probability, that a mutation will occur in one of these areas that will give the virus and

advantage over previous strains. host: a new forecast from the university of washington, best case scenario, close to another 200,000 americans are likely to die between now and may 1. basically, in the next three months on top of the 400,000 plus. your reaction to that figure? explain to what extent these variants, mutations will increase that number. guest: i have not seen the modeling study you are referring to, but certainly people are working really hard at trying to understand how vaccination is going to be balanced by the movement of variants that may be spreading more efficiently the population. vaccinations are taking time. the nature of the vaccinations,

trying to get it out to the most vulnerable populations first, has also contributed to the slow nature of rolling out the vaccine. it is going to take a few weeks before you start to see the effects of vaccination in the population. i would hope as we ramp up the vaccines the number you just said will be reduced as we get more efficient. host: manny is calling from california now. caller: good morning. host: what would you like to say or ask? caller: i am a retired law professor in havana, cuba and california. there is a huge difference between two countries. 1.7 is the number for 100,000 deaths for cuba and here it is

130 per 100,000 deaths from the virus. in the u.s., -- i do not think communist countries like china, vietnam, even north korea are given enough credit for what they have done to combat the virus. host: to what you'd -- do you attribute the difference? caller: i think the cubans are doing it the old-fashioned way, like the chinese, the communist governments, even though they are totalitarian, they seem to have their way of isolating, convincing people to isolate. out here in california, if you are for trump, you do not even wear a mask, that type of thing.

i wanted to see the guest's point as to what are these communist countries doing right and what are we doing wrong. host: thank you for explaining those differences. what is your take, dr. pekosz? guest: i would not just say it is communist countries. there are countries like taiwan, south korea that have done a good job in terms of limiting the number of cases, limiting the spread of the virus by very extensive testing, testing done in a rapid manner. and putting in place public health measures and making sure those public health measures are being followed by members of the general population. you also get a greater buy-in from the population then we have in the united states.

there are examples of countries that have been able to control the numbers of cases. i forgot about new zealand and australia, for instance, as exec was a countries that are not totalitarian -- as examples of countries that are not totalitarian that limit the number of cases. we can do this. it takes a will in the general population itself to do these things effectively. here is a headline from the wall street journal and other places. the cdc is going to require masks on all forms of public track for tatian tuesday, reversing the trump administration policy. how much of a difference will this make? guest: i think it will make a big difference. here at work, as soon as people

start coming up, everybody is supposed to wear masks at all times. a similar situation on public trust for tatian, places where people are coming together and you need multiple lawyers of production. masks will be one of those things. we have to continue having a society that is functioning. people do need public transportation. i have several people in my laboratory that use public transit rotation to get to and from work. anything we can do to increase the level of compliance among the general population in situations where people are coming together is going to be important and limit the number of cases occurring. host: we heard this yesterday. a congressman in massachusetts -- a couple folks.

a representative from covid-19 -- from massachusetts got covid-19 african his second vaccine shot. how can it happen -- after getting his second vaccine shot. how can it happen? guest: the 90 plus percent efficacy with the pfizer and moderna vaccine happens two weeks after your second dose. previous to that, your immunity is being developed. it is not at that level that will get the 90 to 95% efficacy you saw on the study. you will see people who after their first vaccination maybe got infected, people who after their second vaccination, particularly within 10 days of that second vaccination, may have gotten infected as well. some of that is not surprising. overall, there is probably a number of people that get enough immunity to be protected. if you think about immunity from

the vaccine, it is two weeks after the second dose before you reach that level of high protection. previous to that, you've a greater chance of being infected. 95% efficacy means 5% of the population will still get infected after being vaccinated. we expect to see some of those cases. the vast majority of people will be protected. host: in florida now. caller: good morning. i do not know if this is typically the end question you can answer, but at least it will get the word out and maybe something will help. i am a homebound person, 71 years old, multiple things that could cause me to be a severe

case of covid. i have a primary that comes to my house once a month, which is a wonderful program. she says they are not going to get the vaccine until lord knows when. i do not have a computer any longer. getting an appointment and getting to get these two shots are astronomical. i have been out of my home since last february 3 times. so i do not want to ruin that record and get covid because i have to go get the covid vaccine . i am wondering -- when they set up that it is designed for over 65 people to get the vaccine, how does a person like me get on

that line? i feel like maybe next september or something. medically, i need to see my doctors. over the phone does not do a lot. i am very frustrated. i would gladly go to get it, but everything is filled up. if you do have a number you can call, there is nothing available. why can't a doctor that comes to my house get the vaccine for shut-ins? nobody has talked about shut-ins. host: a lot of concern there come out logistical issues, getting to the place to get the shots without getting sick. what would you say?

guest: my own father is homebound. my mother is the primary caregiver and it has been the same situation the caller has been in, barely able to go out over the past few months. my brothers and i have been trying to help in terms of food deliveries and those things. i feel the caller? situation so personally -- the caller's situation so personally. i have been trying to get them onto a vaccination campaign with no success for the reasons the caller mentioned. these are the things that the greater leadership from a centralized federal level -- there are ways we can do this. we have vaccination teams that can do with the caller says, go to individual homes, give people vaccines, and do that in a safe manner. we need to be better logistically at doing that. it is one of the things i think

the new and ministration's pandemic preparedness plan will hopefully speed up and do more efficiently. the problems he caller has brought out, i have heard them in many places. i am hopeful that a few more weeks of organization, better leadership, better guidance from the federal level will help smooth out some of these things. host: craig is in titusville, new jersey. caller: i am an anesthesiologist. host: tell us what the situation is like in new jersey with covid. caller: well, i'm not sure what the situation is at the moment overall. i saw statistics that new jersey leads the country and highest per capita deaths from covid. i have a comment in question.

i would like to give the for all just some statistics. according to the united nations, an additional 270 million people globally have been pushed into starvation as a result of the economic effects of covid. 117 million children globally are not being vaccinated. malaria is projected to double. more americans will die because of the economic effects of the lockdown. according to the cdc, drug overdoses are up. cancer screenings are down. one million cancers are not going to be diagnosed. coronary deaths are up. suicides are up as well as long-term psychological and social effects.

according to a colleague of yours i heard on tv recently, 40 million americans on medicare, 6500 have died of covid. my question is this. to you and dr. fauci and your colleagues, do you believe medically or ethically it is moral and ethical to place over 400 million lives at the direct risk globally -- or is it irrelevant how many hundreds of millions die as long as they do not die from covid? i never hear it discussed, these collateral effects discussed by infectious disease. guest: i will not speak to the numbers being quoted by the caller, but i will say that those types of implications of the pandemic and public health interventions we have put in

place are a major focus of governments and public health departments. it is clear we have to make sure that kids get the vaccines. we have to make sure people get health care that they need to deal with all the medical ailments they have that are going to happen even in the presence or absence of the pandemic. we just have to learn how to do those things safely and more effectively. i think that is also going to be variable in terms of the country you're in and the economic position of that country. i do think those concerns are being addressed here and as with many things with the pandemic, everything is harder to do because of the public health interventions. all you have to do is look at numbers in the u.s. in terms increased number of deaths over the past year during the pandemic that can be directly attributed to infection, and

that number is high. we have to get that under control before we can really start to open the economy and work at a better level for some of the things the caller was talking about. host: onto las vegas now, where mel is on the line. caller: hello. yes, i have a personal question. i am 89 years old. i have macular degeneration now. i get a shot every month. i had bell's palsy. whenever my eyes get dilated, my nerve on the right side of my face gets aggravated and my teeth ache. i am concerned that if i get the shot it is going to aggravate the bell's palsy again. i'm also on a drug because i had a fibroid bypass years ago and

it helps me keep breathing. i am concerned whether i'm doing the right thing or not. i am 89 years old and a little concerned. if you could help me out, i would appreciate it. host: thank you for calling. guest: i do not want to give personal medical advice over the phone because obviously that is not appropriate. i will say the cdc has been considering things you're talking about. all that information is being captured on the cdc website. i would encourage the caller to have a conversation with their health care provider to go over all these things. when it comes to the moderna and pfizer vaccine, many of these types of conditions do not necessarily preclude you from getting the vaccine. it is important to have an in-depth discussion with your

medical provider to make sure the combination of things are being considered before you make the decision about vaccination. host: what are you seeing around the country in terms of acceptance of getting vaccines? guest: it has been encouraging to see that more people in the country are willing to take the vaccine. i think that is important, that people understand the process. this was a vaccine that was speedily put into the market, but corners were not cut with respect to the safety and efficacy of the vaccines. communicating that effectively to the population is an important thing that needs to continue. i am seeing a lot of people -- i heard even callers today who are wanting to get the vaccine and trying to get it. that is a good thing. we need to encourage that and send the message to people that

we are continuing to monitor safety and efficacy and those things are a primary concern. host: also wanted your take on a new york times story making the point here that 18.5 billion has been spent on vaccines with just a $.2 billion on other therapies, drugs like monoclonal antibodies. vaccines versus other treatments, what is your take on what is going on? guest: in the public health realm, we talk about prevention being more of a critical factor. the emphasis on vaccines is to get the immunity out there to prevent cases. it is not to say there has not been progress on treatments. there has been significant progress. we know the mortality rate from

covid-19 specifically in the u.s. has been dropping as we have gone through this pandemic. it is because the medical community has learned how to treat more severe cases and limit the mortality from severe cases. vaccines are on the other end of the spectrum. they were going to prevent infections and have a trickle effect into severe cases. i agree we need more work on therapies. we need to understand that, in a virus disease, treating early is always going to be better than trying to treat late. we have to focus more on therapies the start early in the infection process that could be more efficient at turning the course of the infection rather than waiting until someone gets so sick that it is a huge medical problem. host: rita is a medical professional as well.

caller: i'm a registered nurse. host: any perspectives from kentucky on covid? caller: the pcr testing that is used for testing people for covid is 90 plus percent shows false positives and numbers are based on that. i'm concerned about that. how does a man-made virus replicate? guest: a couple things. the false positive rate the caller mentioned, that is not true. the pcr test has a low false positive rate. one of the issues with the pcr test is it can tell you you are positive after the period of time you were able to transmit the virus. that has caused confusion in the population because, 10, 11 days post infection, you can still be pcr positive but at that point

you have so little virus in the system -- your system you cannot transmit the virus to anyone else. the test has to be put into its proper perspective but it does not have a false positive rate the way the caller mentioned. host: our last call from north carolina. we read on the screen you had covid at one point. is that correct? what was the experience like for you? caller: me and my family -- fiance had it. she had a hard time with it. i had very few symptoms for a couple days. we have suffered from long systems which are good -- symptoms which are getting better now. when i went to the doctor and had a positive, why didn't they aggressively treat it? all they told us was to -- if we got short of breath, do not come here to the hospital.

am i safe to take a vaccine after having covid? what has happened to the flu and cold? is it because we are wearing masks that they are not rampant? host: before covid -- guest: before covid, my laboratory focus on influenza. it seems like public health interventions put in place to limit covid are having a greater effect on flu, cold, and respiratory viruses. we are not seeing those infections presumably because of public health interventions that we are having. there are three questions there. host: he did have covid at one point and wonders if it is ok to take the vaccine. guest: people in vaccine studies

were in exactly that situation. a number of people had covid when they were enrolled in vaccine studies. getting the vaccine after having covid resulted in strong immune responses. if you had covid, make sure you line up for the vaccine as well guarantee vaccine should help strengthen your immune responses. vaccination gives stronger immune responses than infection, particularly in the case of a caller with a mild case. if you had covid, stolen him for the vaccine when it is your turn to do it because that vaccine will help strengthen your immune responses and get you to a high level of immunity. host: andrew pekosz is an immunologist. thank you for your exp

nurses, teachers and law enforcement. >> mr. speaker, mr. president pro tem, members of the 151st general assembly, members of the cabinet distinguished members of the judiciary in my fellow delaware areas, tha y