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LISTEN: Robert Finberg advises ‘Wear your mask, get the flu shot and protect your neighbors’

Voices of UMassMed podcast features infectious disease expert on latest in COVID-19 pandemic

As coronavirus cases surge and the flu season gets underway across the United States, infectious disease expert Robert W. Finberg, MD, sat down for a Voices of UMassMed interview to provide a snapshot of the COVID-19 pandemic, offer insight into the latest research and urge people to stay vigilant.

“There’s no question that there’s more disease in our communities. It’s not availability of testing,” said Dr. Finberg, the Richard M. Haidack Professor in Medicine and chair and professor of medicine.

Finberg is a leader at the forefront of coronavirus research at UMass Medical School and has studied the flu for much of his career. He said Massachusetts is at a critical moment in the pandemic, as coronavirus cases rose to 148,000 on Oct. 26, up 1,200 cases in a day, according to the Department of Public Health.

“We know that we’ve been testing all along here and we know that our incidence has gone from less than 1 percent to 3 or 4 percent in the last month or so,” said Finberg.

Finberg discussed the latest research into one of the RNA-based coronavirus vaccine candidates that he has been studying, and stressed the importance of the flu vaccine, wearing masks and social distancing.

“The (flu) vaccine is critical and if we can vaccinate enough people, we will have a much milder season. We will have fewer deaths,” he said. “If you don’t wear a mask, you are potentially putting your neighbors at risk, because you can be asymptomatic in carrying either disease.”

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Edited highlights from the Voices of UMassMed podcast interview:

As coronavirus cases are going up in Massachusetts and the United States, how much is attributable to more disease in our communities?
There’s no question that there is more disease in our communities. It’s not availability of testing. I mean, the testing is good. But we know that we’ve been testing all along here. And we know that our incidence has gone from less than 1 percent to maybe 3 or 4 percent in the last month. It is increasing.

For the average person, what data should we pay attention to?
I think that the number of positives and the number of deaths is obviously critically important. And that’s the way you can figure out what the pandemic is doing. From the health care perspective, what we’re concerned about is hospital capacity, because what happened in the surge in March is that we were nearly outstripping the capacity to take care of patients. And obviously, that’s something we’re very focused on, because we want to make sure that we can care for all those who need care.

Are health care providers better suited now to handle a coronavirus surge than in the spring?
Yes, we are clearly much better prepared now than we were in April. And I think there’s a lot less panic. But we want to make certain that we have enough hospital beds and enough ventilators and whatever else we need. I think things will go much better if we do have such a surge.

What advice do you have for people who are exhausted by coronavirus restrictions?
I tell them that I understand how they feel. However, we’re doing this to protect the vulnerable. And I think it’s important that people understand that they are responsible for the elderly, for the sick. It’s important for us as a group, a country, a community, to look after those people.

What advice do you have for people who are looking to travel for the upcoming holidays?
I think one must be careful. One does not want to be in large groups of people indoors, particularly people that are not being masked or social distancing. I don’t think anyone is saying that one shouldn’t visit one’s relatives, however, one must be particularly careful. Wearing masks is important and staying away from coughing on people and exposing them to potentially infectious materials is critical.

UMass Medical School took part in a Phase II/III clinical trial testing whether a messenger RNA vaccine candidate can prevent infection against COVID-19. As the principal investigator of the UMMS trial site, can you provide an overview of that research?
It is a double blind, placebo-based vaccine trial. About 20,000 or more have received the actual vaccine. The Pfizer trial is anticipating finishing the study sometime in November. They are collecting the data right now. In order to find out if it’s effective, they will need a certain number of positive cases. And the hope is that that will happen. There are 12 different vaccine trials in Phase III clinical trials. When we will get enough data to know if it is effective is not clear.

Mass. Gov. Charlie Baker has recruited you to join the state’s coronavirus vaccine advisory group to help prepare for the distribution of the vaccine when it becomes available. Can you share details about that process?
The advisory group submitted to the Mass. Department of Public Health an interim draft. There will be three phases of distribution. The draft report can be found here.

As we approach flu season, why is it critical for people to get vaccinated for influenza?
It is conceivable that one can have both diseases. The last thing you want is to have two different viruses. Also, unfortunately, it’s the same people, people over 65 people who are immunocompromised or have heart or lung disease, who are subject to mortality with flu. A bad flu year in the United States might kill 50,000 people. What we’ve seen with the COVID epidemic right now is the equivalent of something like four bad flu years. Having flu on top of COVID is not going to help anyone and puts a lot of vulnerable people at risk as well. I would urge people to get the flu shot.

Why do you support the state’s policy requiring influenza immunizations for all children 6 months of age or older who are attending childcare, preschool, kindergarten, K-12, and colleges and universities?
I think people tend to dismiss the flu as being like a cold. It’s not. The flu has a mortality rate. Again, that mortality is predominantly in people over 65, but not solely. Young people die of the flu every year; children die of the flu. It is not something that we should take casually. And furthermore, it’s preventable. Effectiveness varies from year to year, but the flu vaccine is generally quite effective. And we’ve gotten better about predicting what strains there are. There are now four different strains in the current vaccine. There’s a higher dose vaccine for people over 65.

When should people get the flu shot?
I would recommend to people that they get the flu vaccine now. The vaccine is critical. If we can vaccinate enough people, we will have a much milder flu season and we will have fewer deaths. I can’t say that there is anything more important that we have to offer in terms of the flu than the vaccine right now.

I think what we need to remind ourselves is how these diseases are spread. They’re spread by the respiratory route, like coughing. People who are coughing are putting other people at risk. If you don’t wear a mask, you are potentially putting your neighbors at risk because we don’t know if you are asymptomatic and carrying influenza or COVID-19. You can be coughing and spreading it around without your knowledge. Also, social distancing, mask wearing, and particularly protecting vulnerable people—particularly the elderly and the immunocompromised is critical.