Without Resources, Vaccine Rollout Could 'Fall At The Last Hurdle,' Journalist Warns

TERRY GROSS, HOST:

This is FRESH AIR. I'm Terry Gross.

It's astonishing that scientists were able to develop vaccines for a virus that wasn't even identified a year ago. This week, American health care workers started getting the first COVID vaccine to be approved in the U.S. Also this week, the FDA approved a new rapid test that you can take at home and get results in about 20 minutes.

My guest, Ed Yong, has a new article in The Atlantic about the science that led to developing COVID vaccines in record time, the flawed science that helped lead to misguided policies and the lessons that can be applied to future pandemics. He's been covering this pandemic since it began, writing about nearly every aspect, including how the virus is spread, what the government got wrong, the long-haulers who have symptoms lasting for months and the mental health of the doctors and nurses caring for patients. Yong is a staff writer at The Atlantic, where he covers science. His new article is titled "How Science Beat the Virus - And What It Lost In The Process." I spoke with him yesterday.

Ed Yong, welcome back to FRESH AIR. Let's talk about the new vaccines. They use a form of vaccine that's been in the works for a while, but it hasn't been used by the public before. It's only been used in experiments. Is that cause for concern? Should people feel like guinea pigs because this hasn't been publicly used before, this type of vaccine?

ED YONG: I don't think that they should. There has been a long process of development for mRNA vaccines that go well beyond this year, and that's partly why these vaccines could be made in such short order. And, you know, I'm pretty confident, looking at the clinical trials that have already been done for the Pfizer and Moderna vaccines, that they didn't skimp on any of the necessary steps for testing - things like safety and efficacy. You know, things were quick, but corners don't seem to have been cut. And there's nothing about the biology of these vaccines that's concerning.

So these vaccines use mRNA, which is the genetic material of the virus. They use a sliver of that genetic material and inject it into the body. The body then uses that material sort of as an instruction booklet to reconstruct a very small and noninfectious portion of the virus, a protein called the spike protein, which sits on its surface and which it uses to interact with our cells. That little fragment of the spike is then used by the immune system to prepare adequate defenses in case the actual virus should make its way into us. None of that, really, is cause for concern.

You know, there's - we're not dealing with anything infectious. We're not dealing with anything particularly dangerous. And - you know, and as I've said, the - this technology has been developed and refined for many years and has - you know, this - if anything, this year is the year in which mRNA vaccines have proved their worth, and that's a really good thing. That's a really encouraging thing - not just because of COVID-19. These vaccines are designed to be customizable. So most traditional vaccines have to be bespoke. Like, you have a new pathogen, and you have to - whenever you get a new pathogen, you have to design an entirely new vaccine to counter it.

And this one-bug, one-drug approach is very laborious and very time consuming. But mRNA vaccines should be very easy to tweak to whatever new virus emerges. You just take that virus' genetic material, slot it into these existing vaccines, and you're off to the races. So the fact that they're working this time, the fact that we have one approved, possibly two in the near future, means it sort of heralds an age where we should be able to develop vaccines against new emerging diseases much more quickly than we have ever done in the past.

GROSS: So here's a piece of, like, great news. Like, this is strange, great news - that the Trump administration's ineptitude in managing the spread of the virus makes it easier to gauge the performance of a new vaccine. Would you explain that?

YONG: Yeah. So it's a bit counterintuitive, but the final phase 3 trials, the biggest ones that really establish whether a vaccine is effective or not, those compare people who have been vaccinated and people who haven't been to see whether they end up developing symptoms of COVID-19. Now, that comparison is much easier to make in a situation where the virus is running out of control because you just have a much higher rate of infections whirring along in the population.

In a country like, say, New Zealand or South Korea that has controlled the pandemic, it's almost impossible to do these kinds of studies. And this, weirdly, has contributed to the fast pace of development. Just the fact that so many Americans have been infected over the last several months means that it was much quicker to reach the end - the projected endpoints of these trials.

GROSS: It is remarkable that we have vaccines in record time, and part of what made that possible was the sharing of information, which you write about in your article. And the sharing of information starts with China, that shared the genetic makeup of the virus as soon as they were able to figure out what the genetic makeup was. Why did China - why did Chinese scientists share it, and how did that help scientists around the world?

YONG: Yeah...

GROSS: And I should mention that - I should just mention here that the backdrop for all of this was President Trump blaming China for everything having to do with the virus.

YONG: Right. And I think what this tells us is that below the level of, you know, political bombast of Trump and his counterparts, of China and America squaring off against each other's geopolitical powers, there is also the level of scientists cooperating with each other across international borders. And, you know, Chinese scientists were very, very quick to release the - to upload the full sequence genome of this virus in early January. And that gave scientists elsewhere in the world the knowledge that they needed to immediately start development of these mRNA vaccines that have - that, you know - one of which has been recently approved. I think that's a testament to, you know, one of the ideal ways in which science could work, in which it transcends international disputes and in which knowledge is shared around the world.

GROSS: And you talk about how Britain was able to draw on its national health system to do a large study called Recovery that had, like, 17,600 COVID patients across 176 institutions, and that no study is more - done more to shape the treatment of COVID. What were the studies that this project developed, and how did that help?

YONG: So Recovery is notable because it was a huge trial that looked at a number of possible COVID-19 treatments - things like dexamethasone, a steroid which does seem to help the most critically ill patients; and hydroxychloroquine, a much-hyped antimalarial drug which doesn't seem to do anything for COVID-19. A lot of attempts to test whether different drugs and treatments work against this disease were very, very badly done. A lot of these trials were very small; too small to produce statistically solid results. Some trials lacked a control group - a group of people who'd receive a placebo or standard medical care and who provide a baseline against which you can judge how effective a new treatment actually is. So many of these studies were incredibly wasteful. They were just too sloppy to actually tell us much of anything about how to treat this disease. RECOVERY really stands out because of its size, because of its coordinated nature. You know, it spanned 176 different institutions across the U.K. And it took a long and unfortunate amount of time for the U.S. to catch up to that kind of coordinated, careful, efficient effort.

GROSS: The sloppy studies that - the sloppy research studies that you referred to, did those lead to misguided policies?

YONG: In some cases, sure. You know, there has been a huge amount of doubt about how to actually treat people with COVID. Of course, hydroxychloroquine was the subject of months of controversy and in many cases, still is. It didn't help that Trump himself touted the drug without much evidence and continued to do so even as evidence of its ineffectiveness started to mount. But this has just been a generic problem with the entire pandemic writ large; that a huge number of studies were done about COVID-19 because the pandemic gripped the world's attention at a time when many scientists had their standard modes of research disrupted. And so thousands, maybe even hundreds of thousands of researchers pivoted to studying this disease. And, you know, a lot of them did amazing work. I hope we can talk about that. But there was a lot of sloppy work done, too, by people who strayed into academic fields that they had no expertise in and who overconfidently and arrogantly published papers without the requisite careful checks and balances. And that - a lot of that work reached international attention because everyone was so clamoring for more information about COVID-19.

GROSS: Let's take a short break here, and then we'll talk some more. If you're just joining us, my guest is Ed Yong, a staff writer at The Atlantic where he covers science. He's been writing about the pandemic since it started. His latest article is titled "How Science Beat The Virus And What It Lost In The Process." We'll talk more after a short break. This is FRESH AIR.

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GROSS: This is FRESH AIR. Let's get back to my interview with Ed Yong, a science writer for The Atlantic. His new article is titled "How Science Beat The Virus And What It Lost In The Process." One of the things that contributed to scientists being able to develop vaccines so quickly is that scientists shared information from around the world. And they shared it in relatively new ways. Can you compare the more traditional way that research was dealt with and shared and the peer review process compared to how research was shared regarding COVID?

YONG: Sure. And to be clear, I'm not entirely sure that this specifically contributed to the speed of vaccine development, but it definitely contributed to the speed at which we understood - we learned more about the virus. You know, so traditionally, academia works very slowly. People do experiments, write them up. They send their papers to a journal that sends them out to other scientists who then review the work. This process is very slow. It can take several months, which is obviously not what you want when a fast-spreading pandemic is moving around the world. But for - in recent years, biomedical scientists have been making use of preprint servers; places where researchers can put up early versions of their papers before they've been reviewed by others so that their results can be discussed and built upon.

Now, this is a development that I think has both good and bad sides to it. The good side is that it allows science to operate at a much faster pace. And we saw that in the pandemic. We saw, you know, preprints being openly and rapidly discussed, dissected, built upon. But at a time when a lot of overconfident and inexperienced people are diving into the field, you see a lot of bad work, a lot of sloppy preprints. And a lot of those got massive media attention because we journalists were looking for them to a greater degree than we had ever done before. So, you know, it's - there are both good and bad sides to this, I think. You know, if you want science to operate at a much faster pace than it normally does, then you're also going to see both good and bad work getting out into the world at a much faster pace.

GROSS: Something that you think we did not conduct enough research into is schools and how the virus spreads and operates in children. And, you know, we see that the school and college policies have been so inconsistent from one school to the other, from one city to another. And schools and colleges were opening and closing and opening and closing. And it was all very confusing. And parents and children were kind of caught in the middle not knowing what to prepare for. What kind of research do you think could have been done that was not?

YONG: So, you know, there's a couple of things there. I think that the disruptive and discordant policies are reflective of America's very disparate attempts to deal with the virus and the fact there was no single, coordinated and effective national strategy.

But to the rest of your question, there are just basic aspects of how the virus moves between children, to what extent children and schools, more generally, contribute to the spread of the pandemic that are still being argued over, you know, by very seasoned veteran experts in this space. And I think partly that comes - that stems from a lack of clear, coordinated, large-scale research efforts. You know, there simply wasn't a - certainly in this country - a study of the size and scope that would offer really solid answers to these questions. A lot of the ones that were done were small and piecemeal.

And I think that reflects our biases, you know, as a society and biases among the research enterprise. Like, biomedical scientists - you know, we have this biomedical bias. We want drugs and vaccines, and a lot of biomedical researchers focus on sickness as an acute event, like just a battle between a person and a virus, you know, that leads to perhaps death or recovery. But a lot of social scientists think about long-term consequences. They understand that if you take children out of school for a year, maybe longer, you're really going to set them up for problems much further down in their lives and in their careers.

So it should have been obvious to everyone that - even in March, that without a vaccine ready by the fall, we would need to face questions about whether schools would reopen. And this was a major area of research that needed investment. But when Congress awarded billions of research to the NIH to study COVID, none of that went down to the National Institute of Child Health and Human Development, which focuses on these kinds of issues. You know, that institute did do some studies, but it didn't benefit from that massive congressional bolus of money, and that's a tragedy, I think. It reflects where our priorities lie and where they are - and areas that are being neglected.

GROSS: I want to ask you about another new development and that's monoclonal antibody therapy, which was recently approved by the FDA for emergency use. What is it, and what will it be used for?

YONG: So when a person gets infected by the virus, their immune system eventually develops antibodies, which are small molecules that glom onto the surface of the virus and stop it from infecting cells. Monoclonal antibodies, these treatments that you're mentioning, are basically ways of providing those antibodies without your immune system having to do the work. So you're injecting people with premade antibodies that are meant to recognize and gum up the virus.

There have been some really promising results for these antibodies and especially in the context of preventing, you know, infections from progressing to severe disease. And that absolutely is something that we need. It is a win in that there are very, very few other treatments that really seem to work for COVID-19, you know, beyond just basic medical care. We have things like dexamethasone, a steroid, and possibly, arguably some others. But it's very slim pickings. So having extra tools in our arsenal is certainly a good thing.

GROSS: So this would be used for people who are already sick, but not so sick that they have to be hospitalized. This might prevent them from having the disease progress.

YONG: Right. That is the ideal use case, that you would use these to keep people out of hospital. Now, a couple of caveats here. There are not a huge number of doses of these things available. So, you know, we're not - I would just really caution listeners against thinking that we are going to use drugs and - whether we are going to use drugs and treatments to end the pandemic. I don't think that's ever really been the case. These things tend to have incremental benefits over and above standard medical care.

What we need and what we've always needed have been good public health. You know, we've spoken a lot in this interview about drugs and vaccines, and while those are great, a lot of the things that have really made a difference - and should have been more of a difference this year - have been things like masking, physical distancing, testing, contact tracing. Those are the things that we don't, as a country, invest nearly enough in, and yet they have been our main defenses against COVID-19 for almost all of 2020.

GROSS: Well, if you're just joining us, my guest is Ed Yong, a staff writer at The Atlantic, where he covers science. His new article is titled "How Science Beat The Virus - And What It Lost In The Process." We'll be back after a short break. I'm Terry Gross, and this is FRESH AIR.

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GROSS: This is FRESH AIR. Let's get back to my interview with Ed Yong, a science writer for The Atlantic. He's been covering the pandemic. His new article is titled "How Science Beat The Virus And What It Lost In The Process."

So President Trump got a monoclonal antibody treatment, and he claims that it cured him of COVID. Do we have evidence that it was the monoclonal antibodies that were effective in his healing?

YONG: I don't think you can ever say for any particular one patient what did the trick, right? So in Trump's case, he had three separate treatments, one of which were those monoclonals. He also had exceptional medical care. Like, pretty much as soon as he was diagnosed or, you know, shortly after he was diagnosed, he was flown to a medical center where he received dedicated attention, which is something that most Americans do not have. And he has also had a life of extreme privilege. And we know that people who have - you know, we know that people from wealthy backgrounds, people - you know, people who've lived lives of privilege start off from a much higher baseline of health than people who've had to struggle, people who've had to deal with poverty and marginalization. So there's a large number of factors that go into whether or not someone like Donald Trump survives their battle - their encounter with COVID-19 beyond just the drugs that they receive, although, you know, probably the drugs were a part of that.

GROSS: Why does top-notch treatment make a difference in how you recover or don't from the virus?

YONG: Right. Because as we said, the drugs that specifically treat COVID-19 are very, very few and far between. And they only make an incremental amount of difference to people's recovery. So say dexamethasone - that's the steroid that helps to save the lives of critically ill patients. You know, it reduces your risk of dying by maybe around 12 percentage points at best in the most severe cases. It's not a panacea. It's not a cure-all like an antibiotic.

A lot of what actually makes a difference are just the basics of medical care, like the savvy of nurses and doctors and respiratory therapists. Like, COVID-19 patients who end up in ICUs are some of the sickest patients that a lot of health care workers have ever treated. You know, they might have eight to 12 intravenous lines going into their heart and other blood vessels pumping in pain meds, sedatives, all kinds of other things, none of which are specifically designed to treat COVID. They're just about keeping that patient alive. And so a lot of that savvy of how to deal with a patient whose body is just crashing is - like, that's the thing that makes a difference.

And we don't guard that resource well enough. Like, the - this third surge, which is pummeling health care facilities across the country, is stretching nurses and doctors and respiratory therapist to the very limit. And the more that happens, the less they're able to make use of all that knowledge that they've learned over the year and the higher death rates are going to become. And I worry that we're still only just starting to see the tip of that happening now.

GROSS: I think what you're describing is also an example of the economic disparities in how COVID is treated.

YONG: Yeah, absolutely. That - you know, this disease has widened every possible inequity that it could find in this society. And it has found plenty, you know, so - just in terms of preventing yourself from infection. A lot of people have been able to stay at home and work from home. Many people had to do so-called essential work. They had to go out and about, exposing themselves and their loved ones and colleagues because they earned low hourly wages that they couldn't afford to skip on.

You know, and then a lot of Americans don't have access to health care at all or receive poorer quality of health care. You know, a lot of people from Black, Latino and other minority groups have long received poorer quality of - and, you know, discriminatory health care. That has led to worse outcomes even before COVID-19. And so it's no surprise that a lot of these folks have also been disproportionately hit by this virus.

GROSS: After you get the vaccine, can you still spread the virus to other people?

YONG: Right. So this is an absolutely crucial question. And we don't know. And the reason we don't know is that the clinical trials that assessed the Pfizer and Moderna vaccine looked really only at their ability to prevent symptomatic disease. So we know that they stop people from developing symptoms very, very effectively; much more effectively than anyone had dared hope for. But we still don't know whether they stop infected people from transmitting.

Now, two things there. If they don't, that is bad news because it means it's going to be much harder to achieve herd immunity, the level in which the virus struggles to find new hosts. And it means that you might get some - it means that there's a risk that vaccinated people lower their guard and could potentially spread the virus to others, which would be a pretty bad scenario.

That being said, I think it is reasonable to assume that based on how well these vaccines seem to prevent symptomatic disease, that they will have some effect, too, on reducing transmission. So a lot of the people I spoke to are variously hopeful or pretty confident that they will have an effect on transmission. But obviously, we don't have that data yet.

And the problem is that the outcome if they don't is worrying enough that I think a lot of people are being very cautious and rightly so and worried about that prospect. But we'll just have to see when new data comes out. But our expectation, I think, should be that they do have at least some effect on reducing transmission.

GROSS: But it sounds like the general opinion in the scientific community is that after you get the vaccine, you should still wear a mask because it's not 100% effective. So you should protect yourself and other people and continue to wear a mask and social distance. Is that right?

YONG: Well, I think that it's a good idea, especially as the vaccines are being rolled out because, you know, the more people get vaccinated, you know, the more things will start to - the more the pandemic will start to slow down. But it's going to take a while, and it's going to take a while for things to get under control. And during that time, it is still important for us to keep on taking the precautions that have mattered this year.

Don't think of the vaccine as a light switch that, you know, the minute it starts going to people's arms, normalcy resumes. It's going to be a slow process. And there are a lot of possible roadblocks in the way in terms of producing the vaccine, distributing it, allocating it. You know, this is basically one - the most complicated vaccination program that the U.S. has ever attempted. And we're attempting it in the middle of a pandemic. A lot of things could go wrong. Some things probably will go wrong. And the more we use protective measures like masks, like distancing, the more we buffer ourselves against glitches in the vaccine rollout process.

GROSS: Let me reintroduce you here. If you're just joining us, my guest is Ed Yong, a staff writer at The Atlantic, where he covers science. He's been writing about the pandemic since it started. His latest article is titled "How Science Beat The Virus - And What It Lost In The Process." We'll talk more after we take a short break. This is FRESH AIR.

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GROSS: This is FRESH AIR. Let's get back to my interview with Ed Yong, a science writer for The Atlantic. His new article is titled "How Science Beat The Virus - And What It Lost In The Process."

Let's talk a little about Project Warp Speed (ph). How much did that contribute to where we are now, having a vaccine that's approved? As we record this on Wednesday, another vaccine seems to be on the verge of being approved. We have new FDA approval of a home rapid-testing kit. So how much credit do you give to Project Warp Speed? And if so, what did they do to contribute to this progress?

YONG: You know, obviously, Operation Warp Speed deserves some credit for what has happened. It's not the only reason at all why we have - you know, why we've had success with vaccines. A lot of that depends on research and investments that were made well before this year, well before COVID-19 was a thing. I think some of the moves that Operation Warp Speed did well were investing in a portfolio. So rather than putting all of our eggs in one basket, like, funding and investing in a lot of different companies to produce different types of vaccines so that we would be guarded against failures in any particular one approach.

You know, there have been also in - I guess, innovations in the logistics of vaccine development. So, you know, a lot of steps that typically happen in series occurred in parallel. One thing I would add, though, is the amount of money that went into Operation Warp Speed was huge, but the amount of money that is being - has been allocated by Congress to actually deploy the vaccines is comparatively miniscule, and that is a problem. Like, they're - I believe that it's just over $300 million. I think it's about $340 million that has been allocated to the states to roll the vaccines out, to get them in people's arms, to do information campaigns. And that is, you know, I do believe, barely 2% of the amount that Operation Warp Speed was funded for. And that is, I think, ludicrous.

Like, you put all this effort into creating these things, and then - what? - do you just assume that they go out to people? I think there has been a certain amount of naivete on the part of the government about, like, what it actually takes to turn vaccines into vaccinations. And unless we do something about that, unless we actually put more funding into this particular area, it's going to be a bit tragic because we're going to have vaccines, but we're going to fall at the last hurdle. And that's one of the things I'm really worried about now - the actual logistics of rolling these things out are very complicated and, at the moment, are severely underfunded.

GROSS: And part of what makes it so complicated is the way-below-zero temperatures that they have to be stored at, like - what? - like 90 degrees below or something like that.

YONG: Yes, it's minus - I mean, so for - the Moderna vaccine requires minus-20, so that's a conventional freezer. The Pfizer vaccine minus-70, so it's an ultracold storage requirement, and you need things like dry ice. That is difficult to do, and it is especially difficult to do in rural areas that are less likely to have these facilities and which have to deal with patients scattered over a much larger catchment area. That is a complication, absolutely. But, you know, so I think - everyone thinks about the facilities, and really, the problem is people. It's always people.

You know, the people who will end up having to deliver a lot of these shots are public health workers. Public health has been notoriously underfunded for a long period of time. And especially, like, at the local level, a lot of health departments are severely understaffed. And a lot of those people have - are utterly exhausted from a year of dealing with this pandemic, dealing with harassment from their communities, dealing with people calling them, you know, fearmongers, accusing them of perpetuating a hoax. And those are the same people who now we're expecting, with still not enough resources, to roll out the most complicated vaccination campaign in history. Like, this is the problem. We always neglect public health until such time as we actually need it and then are shocked when things don't go according to plan.

GROSS: So, you know, one of the things we're learning about now is long-haulers, and that's the word that's used for people who have had COVID and they still have alarming symptoms having to do with so many different things - you know, ranging from, you know, breathing to digestion to, you know, cognitive issues. And we're learning more about long-haulers as time goes on. But what do we know - like, you write that it seems that long-haulers have some disturbances in their autonomic nervous system, and that's the part of the nervous system that kind of operates automatically - you know, like breathing, heart rate, blood pressure, digestion. We don't control that; it happens.

So why - do we know why COVID can affect the autonomic nervous system in such a long-term way?

YONG: So to be clear, I think that that is the case for some long-holders and not all of them. And the - this phenomenon is very, very varied. We're still only at the very start of understanding it, I think. And, you know, in June when I first started reporting on this, many people in health care didn't even know that the phenomenon existed. You know, I talked to patients who had gathered in support groups that numbered in the thousands, and many of them had experiences of trying to seek medical care but being told that they didn't have COVID or that COVID goes away after two weeks unless you get hospitalized.

And I think we understand - I think it's much more widely understood now that a lot of people are going to suffer long-term consequences from their bouts with this virus. A lot of the long-haulers who I've talked to are still experiencing symptoms nine months on. You know, some of them in a few months' time will be looking at their one-year anniversary. I think that some scientists are starting to investigate the wide range of symptoms at play. So, you know, it's - a lot of long-haulers have brain fog, neurological symptoms. A lot have what's called post-exertional malaise, where your body crashes after even mild forms of activity.

But the number of different symptoms is vast, and the mechanisms behind them are also likely to be incredibly diverse. A lot of this will sound very familiar to people with myalgic encephalomyelitis, dysautonomia and a lot of other chronic illnesses. They are - they have a lot in common with what is now being called long COVID. And I think our neglect of those kinds of illnesses for a very long time means that now that long-haulers - now that COVID long-haulers are a recognized and growing group, there's actually very little to offer them in terms of answers.

GROSS: Let me reintroduce you here. If you're just joining us, my guest is Ed Yong, a staff writer at The Atlantic, where he covers science. He's been writing about the pandemic since it started. His latest article is titled "How Science Beat The Virus - And What It Lost In The Process." We'll talk more after a break. This is FRESH AIR.

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GROSS: This is FRESH AIR. Let's get back to my interview with Ed Yong, a science writer for The Atlantic who's been covering the pandemic. His new article is titled "How Science Beat The Virus - And What It Lost In The Process."

So we have the Biden administration preparing to take over. Their policies will be very different than the Trump administration approach to dealing with COVID. What are you expecting from the Biden administration?

YONG: I'm expecting good things. I'm expecting them to, you know, actually try to control the pandemic, which is almost an astonishing thing to say. But we've not had that this year. We've had an administration that has been woefully negligent and that, in some ways, has actually just tried to let this thing rip through the community unchecked. I expect the Biden administration to actually try to control it. A lot of the measures they've talked about in their plans - testing, you know, supporting public health - all of these things are things that experts have been calling for for the entire year, often in vain.

I'm really, really glad to see a lot of seasoned experts on the task force in the administration. You know, Rochelle Walensky has been possibly appointed to - has been picked to lead the CDC. She is a phenomenal scientist and a great communicator. A lot of the people who've been appointed to the COVID task force have a strong focus on health equity, and that's really important. We need people who have - who can maintain a focus on the most vulnerable and the most hard-hit populations.

What I would love to see more of are more social scientists on the panel. We know that issues of trust, of communication have been so vital and so missing this year. And we're going to need that going forward in 2021.

GROSS: A lot of people have been ignoring the advice of science - of scientists. And the Trump administration hasn't done a lot to convince people to wear a mask. It's been the opposite. You know, President Trump has mocked reporters for wearing masks. He's asked people around him sometimes to not wear masks. He got COVID. Many people in the Trump administration have gotten COVID.

When you speak to health care workers or you yourself as a journalist, do you get really frustrated when people get really sick, and they've gotten sick in part because they've avoided the advice of scientists? And so by avoiding the advice of scientists, not only have they gotten sick and are facing the personal consequences, they're filling up beds in hospitals and preventing people from - who have followed the advice, who have still gotten sick, to get a hospital bed.

YONG: Yeah. I think that this is a huge source of frustration for health care workers, especially now with this third surge, which, you know, is still at record-breaking heights, which is still filling up hospitals, which, you know, is likely to lead to a huge number of deaths to come. A lot of the people I've spoken to who work in hospitals at the moment describe working incredibly long and grueling shifts, watching patient after patient die, you know, watching the ICUs and their emergency rooms being overrun and then at the end of that, having to drive home past crowded bars and restaurants and gyms, where they know that people are going to be spreading the virus, infecting each other. And then, you know, those people are going to end up in that same hospital in a couple of weeks' time.

I think there is a huge moral injury that that causes. It's part of why health care workers are burning out so badly. The dissonance of trying to - desperately to save people's lives and often failing and then seeing so much of the country take none of the precautions that have been advised so far is really galling. And I don't think that people have truly understood either the costs that that is taking - that it's enacting upon health care workers - or the consequences of that if people just have enough. Like, people are checking out. They're quitting. They're resigning. They're retiring. That's going to leave us in a much worse state after this pandemic is over.

GROSS: What about you? You've been covering the pandemic since it started. And you've not only been covering the science, you've been talking to a lot of people who have had the virus, who still have symptoms. You've spoken to many doctors and nurses who are risking their own lives to take care of others. So you've been the recipient of a lot of tragic news. How is that affecting you?

YONG: It's been difficult. It has been a very difficult year. I don't want to - you know, I'm cautious that we just talked about health care workers, and obviously, you know, they are dealing with things that I am not having to deal with. In many ways, I, you know, I have enjoyed many privileges this year. I still have a job. I've been able to work from home. I myself am not sick. But it has been a burden to report on this, to take so much of this in and to constantly think about it. You know, it is like - it has been like staring directly into the sun for almost a full year now. And I am burnt out.

I think that the difficulty of - I spoke to - earlier this year, I spoke to a woman named Nicollet LeSon (ph) who works on preparedness. And she talked about how people who work in preparedness see tragedy coming well ahead of anyone else. So they're already worried before it happens. They rush to deal with it when it happens. When things calm down, they can see the scars of the period of tragedy. And so they're always looking at, you know, the worst-case scenario straight in the face for a long period of time without respite. And that is, indeed, what it has felt like to cover this pandemic this year.

GROSS: Ed Yong, thank you so much for talking with us. Thank you for your reporting. And I hope you continue to stay safe and healthy.

YONG: Thanks, Terry. You, too.

GROSS: Thank you.

Ed Yong covers science for The Atlantic. His latest article is titled "How Science Beat The Virus And What It Lost In The Process." Our interview was recorded yesterday.

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GROSS: If you'd like to catch up on FRESH AIR interviews you missed, like this week's interview with actor and rapper Riz Ahmed or our two archive interviews with writer John Le Carre, who died last Saturday, check out our podcast. You'll find lots of FRESH AIR interviews.

FRESH AIR's executive producer is Danny Miller. Our technical director and engineer is Audrey Bentham, with assistance today from Charlie Kyer (ph). Our interviews and reviews are produced and edited by Amy Salit, Phyllis Myers, Sam Briger, Lauren Krenzel, Heidi Saman, Therese Madden, Ann Marie Baldonado, Thea Chaloner, Seth Kelley and Kayla Lattimore. Our associate producer of digital media is Molly Seavey-Nesper. Roberta Shorrock directs the show. I'm Terry Gross.

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