Celine Gounder, a former member of the Biden-Harris Transition COVID-19 Advisory Board, currently works as a clinical assistant professor of medicine and infectious diseases at New York University.
Gounder received her bachelor’s degree in molecular biology from Princeton University, her Masters of Science in epidemiology from Johns Hopkins Bloomberg School of Public Health and her doctorate of medicine from the University of Washington.
In a discussion surrounding COVID-19 and the public’s divide on the vaccine, Gounder said it’s important to note where Black Americans, indigenous Americans, rural Americans and right-wing partisan Americans fall in the conversation surrounding vaccination.
For Black Americans and indigenous Americans specifically, the hesitation stems from a long history of medical mistreatment, according to Gounder.
“These are the people who have been enslaved, who were subjected to different second-class medical treatment if you would even call it that in many cases,” she said. “More broadly, when you talk about a government and a society that was not set up for you and produced a vaccine, why on earth would you trust that it was for you.”
But for rural Americans and right-wing partisan Americans, Gounder said it’s a direct reflection on an extremely politicized pandemic. “And the other piece is that you have a very libertarian personal responsibility, ‘don’t tell me what to do’ kind of perspective among these two groups,” she said.
With the vaccine becoming eligible to the public in December 2020 and the Biden administration pushing to vaccinate Americans, Gounder virtually joined a classroom of Morgan State students to answer questions about COVID and clarify some of the misconceptions surrounding the vaccine.
The following responses have been edited for clarity.
Where in respect to COVID-19 would you say the American populace stands right now?
The good news is that cases are decreasing, hospitalizations and deaths are decreasing. We saw a big surge that was related to the socializing people did with family and friends over Thanksgiving and Christmas and New Year’s.
The unfortunate fact about this infection is that the people we love and trust the most are most likely to infect us and are most likely to be infected. We aren’t as guarded around the people we really care about, we’re less likely to wear a mask around family and friends.
The other good news is that we have two highly effective vaccines that have been granted emergency-use authorizations by the FDA here in the United States. The Pfizer vaccine, the Moderna vaccine are both fairly equivalent in terms of technology. The performance in clinical trials is almost exactly the same.
The bad news is the emergence of these new variant strains. This is what happens when the virus mutates and it can become fitter. Meaning, maybe it replicates better or it’s able to infect us more easily. There are three main variants of concern, and the CDC had modeled that by the end of March, the UK variant is going to be the dominant variant and take over here in the United States. So, I really do anticipate a surge in cases and hospitalizations and deaths again in late March and April.
People are skeptical about taking the vaccine for various reasons. Can you explain in layman’s terms what the vaccine does and are there any plans in place to try and change the American people’s minds to take the vaccine?
Vaccines are like a recipe being delivered to your cells that tells the cells how to make what is called the spike protein. You are not given the virus, you are just giving the instructions to make the protein and your cells actually make the protein themselves. And because that is what coats the virus, you’re teaching your immune system what the virus looks like. So, your immune system now knows, ‘okay this is what the spike protein looks like.’ If this enters the body, it will respond much more quickly than if it has to figure out that was a foreign invader.
So, when you have an infection, it is a race between the infection and your immune system. If the infection is faster, you get sicker and die. If your immune system is faster, it can really nip things in the bud and you may never even realize you had anything.
So vaccines give your immune system a leg up in the race where it doesn’t need time to think about it and respond—it already knows.
Has there been any conversation on how not to let future pandemics or epidemics impact the Black community as it did in this pandemic?
There has been massive underinvestment in public health across the board, whether it’s our information tech system, or labs, or our people. We have lost about 50,000 to 60,000 public health workers across the country, some of them let go.
We need to be investing the money in the tech systems that would allow a person to be registered, take down their name, age, race, gender, occupation and address including zip code. We need to collect data on the race of people being vaccinated.
We would need about 250,000 new hires across the country to do the work. That is a big investment but that is the kind of work that needs to happen if you really want to prevent something like this from happening and the health disparities that occur during this kind of pandemic.
If you have been vaccinated and you are exposed to someone who has the virus, do you need to quarantine?
Once you are fourteen days out from being fully vaccinated, which gives your immune system time to gear up, you should be considered protected enough that you don’t have to quarantine.
Knowing that a vaccine goes through many stages before being deemed safe and effective, have these vaccines gone through each necessary phase?
This is how we sped up the approval process. Typically, we do phase one, then phase two, then phase three. But they did them in parallel.
They did phase one and then started phase two at the same time. Then they overlapped phase three and started it in the middle of phase two. So, that is why they were able to speed up sort of the studies and approval process. So yes, they have gone through all the normal phases.
Do you think double masking will become a normal thing or is it just while cases are rising?
The big thing driving double masking is the rise of the more infectious variants. We started to see the UK variant in October and it has spread to the U.S. But because it is more contagious, your masking needs to be even better.
I think things will change once everybody is vaccinated but depending on whether the vaccines remain effective against these mutant variants, that will determine how long we have to mask and what kind of mask. Masks are not going away anytime soon.
What are your thoughts about fully reopening colleges in the fall?
In terms of reopening school, it really depends on the age. Kindergarten through 8th grade is very different from 8th through 12th grade and college-age. Above the 12th grade, the biology is more like an adult at that age. Whereas 8th grade and below, the biology in terms of the virus is more of a child. The risk of transmitting to adults is actually very low for kindergarten through 8th grade as long as everybody is masking and doing basic safety stuff.
For older kids and young adults, it’s a very different thing. The places that have largely been able to reopen have been depending on testing. And most of them are testing students once a week, maybe twice a week, in addition to having kids wear masks and having their own rooms if resources allow.
Come this fall, I think we may be at the point where enough kids or enough college students are able to get vaccinated where you may be able to go back to in-person learning. You may still have to wear a mask, but I think we may get to that point in the fall.
Would it be ethical for institutions to insist on vaccines as a point of the reentering process?
Two things have to happen before vaccines can be mandated. The first is, there needs to be enough supply to access everybody who wants the vaccine and we are not there yet. You cannot mandate when we just do not have enough for everybody.
The second thing is the way the vaccines are out there now under emergency authorization. They will be getting full approval before long, it is just a slightly different FDA step and I do not think there’s going to be any issue with them getting the full approval. But administratively, you cannot mandate until full FDA approval is in place.
Brianna Taylor contributed to this article