Content note: Some medical model discussion of weight with regards to health issues.

We spoke with epidemiologist Dr. Rene Najera about pandemic best practices and misinformation at the end of 2020, just as the first COVID vaccines were launching. It’s now mid-2022, the pandemic is still with us, and yet solid guidelines for COVID safety can still seem confusing. So we went back to  Dr. Najera for updated insights and advice. Here’s what he has to say about vaccines, masks, and trusted sources for COVID information—and why he doesn’t like to use the word “booster.”

Thinking Person’s Guide to Autism (TPGA): Thanks so much for having this conversation. I’m actually doing this at the request of the Autistic Self Advocacy Network, which wanted to get more good information out there for our community.

We talked to you at the end of 2020, just as the first COVID vaccine were rolling out. What are some COVID vaccine wins since then?

Rene Najera, a Mexican American man with short black hair and a face mask. He is standing inside his office door, and his arms are folded.
Rene Najera, a Mexican American man with short black hair and a face mask. He is standing inside his office door, and his arms are folded.

Dr. Rene Najera: Wins, oh my goodness they’re out there. Before the vaccine came out, I wrote a blog post called Vaccine Distribution Is Not Going to Be Equitable Is It?, based on just the history of vaccines. [chuckles] Distribution always has been inequitable: The rich and powerful, or other people in the privileged positions in society get them first, or have the option to get them first. The COVID vaccine was no different.

I think that one of the wins is that the unequal distribution of vaccines was recognized very quickly by those of us in public health—not just in the terms of people who were skeptical of the vaccines, but in the people who wanted the vaccines, but were not able to get them because of just the structure of public health and the marriage of public health and healthcare organizations. We worked hard to get the word out as loudly and as much as we could of “You’re not being equitable, you’re not being equitable.” A lot of work was done.

We were also lucky in a sense that the Trump administration did not continue to be in place, because although they did put in a lot of money (or facilitated that a lot of money be put) into the development of the vaccines, they were standing in the way in many ways of the vaccine being distributed. Either by design, or just on purpose they were not allowing the vaccine to be widely distributed. Not only that but they were kind of agreeing with a lot of scientific vaccine misinformation that was floating out there.

We get the Biden administration a year into the vaccine.  The vaccine rollout is starting in earnest. One of the things that was different [with the Biden administration] is that we in public health have more access to the president and the White House or the decision-makers and the executive branch. That allows for better organizing and better strategizing as to where the vaccines are going to go, and how to distribute them.

There was misinformation from the bully pulpit that was the presidency, and people listen to the president, whoever that person happens to be. [In the new administration] the misinformation cooled off, and people started taking the vaccines. We saw in the older age groups, regardless of their political leanings, get the vaccine at a very high rate. That was a win because you saw the number of deaths in that group, which was having the highest rate of deaths, you saw that number decline.

There’s no other explanation for that decline other than the vaccine, because [after we had the vaccines] we get the Delta wave and then we get the Omicron wave and you see it, that it, the, the older population who were vaccinated and then got the third dose. (I don’t like to refer to it as a booster, it’s a third dose, and there are plenty of vaccines that have multiple doses.) They’re more protected, but at the same time we have the continued relentless attack on science and public health from certain people with a lot of social media followers and big bullhorns, and that continues.

The win is that we seem to have gotten control of the deaths from COVID-19 and the population’s most at-risk older adults, people with predisposing conditions, et cetera. The problem is that we continue to have an issue where a portion of the population is not vaccinated or not immune and we seem to have given up. We seem to just have people saying, “Okay, no more masks.” Even at the federal level we see people not masking even though the number of cases and the number of deaths is nowhere as low we had last July, which was right after the alpha wave, the initial wave. The rate bottomed down really nicely—and then Delta came along.

I get mixed feelings about where we are with this. I had my daughter vaccinated. We’re thankful for that, but she is in a school district where a lot of the parents at her daycare have been very, very vocal and very mean about her being vaccinated and not understanding where we come from—both my wife as a physician assistant and me as an epidemiologist. They think that we’re the wacky ones and it’s yet we’re the subject matter experts. If anybody’s gonna know what this could do to a child or what could happen if they give it to their grandparents, it’s us. The parents, even knowing that, they don’t believe us. It’s because they have been fed a lot of misinformation.

TPGA: That’s so distressing. I’m so sorry. It’s very strange to hear about that. For me personally, we live in San Mateo County in California, which I believe is one of the highest vaxxed counties in the country. We don’t see a lot of misinformation, but also, at the same time are seeing what you are seeing, which is that the indoor masking guidelines are being dropped again, and that is really distressing.

For instance, my youngest child is one of the the minority at his school still wearing masks, and he is worried about peer pressure, but so far he’s bucking it. But that’s more about his personality. I mean, somebody with a less fiesty personality, I’m sure, would probably succumb to peer pressure. The thing that worries me, and I would really like to get your take on this, is it seems to me that the science says there’s a direct link between the relaxing of the indoor masking guidelines and the Delta and the Omicron spikes. Is what happened, or is it a coincidence?

Dr. Rene Najera: Yes, it is [what happened]. We’re going to be doing this dance for a while now. You see the rates of disease climbing in parts of Europe where the indoor mask mandates were dropped or relaxed, and then the latest surveillance report of the wastewater system in the US is showing increases in several sites throughout the country, which usually precedes by about a week or two, a general increase in cases.

We’re waiting for it, it’s coming and so, yes, it’s just one of those things that society does this all the time, right? We, we get uncomfortable for a few months, weeks, years—depending on the situation—and we try to adjust, and we kind of are okay with ourselves. Even if somebody suffers for it. You see that all the time or again, we’re repeating the same playbook.

One of the things that I tell the people I advise in public health is, “Sure, go ahead and relax the mask mandates. Do it, but be prepared to apologize to the people who will lose loved ones.” I always get this look of like, “Huh? Why so pessimistic?” Well, because it’s happened over and over again. You might say, somebody will say, “Oh, I’m sorry for your loss,” but they’ll never take personal responsibility for having relaxed the mask mandates or having changed their mind about vaccination requirements.

This morning I stopped at a coffee shop that I always stopped at, and everybody was unmasked, whereas yesterday or day before yesterday, everybody had their mask on. I asked, and it was because, “Oh, the boss said we don’t need to wear them anymore.” I said, “Well, what changed from day before yesterday?” They said, “Well, the boss said so.” Epidemiologically speaking, nothing had changed. They’re very crowded with customers and amongst themselves.

While they are otherwise healthy population, young folks, I’m sure that just statistically speaking, one of them will have some situation that might complicate matters, whatever that is. It’s going to happen, and you guys are on your own. Sorry about that, it’s very frustrating as somebody who advocates for equity and for public health in general, that this happens.

TPGA: Well, I really share your frustration, especially because, so many people in my life, like my autistic son, literally cannot wear a mask. We’ve been very restricted since the beginning of the pandemic. He hasn’t been insides places like grocery stores for two years, except for maybe the week before the Delta variant hit, when we were all so optimistic (at least those of us who were following public health research) and—

[Dr. Najera: laughter]

TPGA: Where so many of us were thinking, “Now that the vaccine worked we can actually go into a grocery store!” But otherwise we have mostly not been in indoor spaces where there is any kind of risk.

It’s so frustrating because we were just visiting grandparents—on a road trip, of course, because we’re not taking planes or any public transportation. We went by a coffee shop, same as you. Nobody was wearing masks, and it was so strange to see that, especially because what they will do is they will post signs that say, “You only have to wear a mask if you’re not vaccinated.”

Well, we’re still wearing masks, which makes it seem like we’re anti-vaxxers, which has been so ironic because of course, anti-vaxxers aren’t going to go by the honor system

So I wanted to ask you, would it be possible for people like my son to be safe in a herd immunity-type scenario? Kind of like we do with vaccines? With people who can wear masks during COVID times wearing them, and the small amount of people who legitimately can’t wear them, like my son and other disabled people,not wearing them? So that they could still participate in society? If you see an ideal scenario like that being possible, if people were compliant.

Dr. Rene Najera: Yes, that would be the safest, right? We really dropped a ball in public health in that we were talking about safety as a binary, when it really is a gradient. The safest thing for a child who cannot wear a mask due to whatever condition, whatever the case it may be, it’s for everybody else to be vaccinated and masked. It is just like vaccination. If a child cannot get a vaccine they’re better off cocooned by people who are vaccinated. The safer is for people to be vaccinated, even if they’re not masked and then the least safest for people, unmasked, unvaccinated, and within six feet of you at all times.

That is the thing that again, human nature, we don’t seem to think of the consequences beyond our own. We take off our mask, not knowing if somebody who is unmasked next to me, might not be able to wear one, might not have the resources even to have one, right? We think of them as being fairly cheap, but they’re not, if you really think about it. Especially the ones that really work well, the N95 respirators. We don’t think beyond that.

One of the reasons why my daughter got vaccinated is because we had a conversation with her healthcare provider and we said, “Look, both my wife and I are exposed continuously through our work. She goes to daycare. The last thing we want to do is to get her exposed and infected and her giving it to somebody at daycare who then goes on to have a complication or gives it to someone else.” We want to stop the contagion.

My daughter has been incredibly good at wearing her mask since age two. She has completely adapted to it. Now she’s the only one wearing it at her daycare. She’s the one chastising others who are not wearing a mask, which is hilarious. She will not be told to take off her mask.

TPGA: [laughs] Whose kid is she, I wonder?

Dr. Rene Najera: Yes, I know right. We got her vaccinated because that is the safest thing for her. She wears her mask, I would say 90% of the time—like any other child she forgets sometimes that she needs to put it on—and she’s vaccinated.

We did it not only for her, but we also did it because my wife works in the emergency department and she sees the people coming in, who then would, unfortunately, pass away. I see it in the outbreaks that I investigate and the people that I have met. Then in my own family, we have people who unfortunately passed away. We wear the masks, but we’re in the minority. And that is a very tough pill to swallow as a public health practitioner: That we humans care, but we then forget to care about others, and then that’s when others get hurt.

I’m sure that my physician, for example, gets frustrated with me when I come in and I step on the scale because I am overweight and I understand that that is a risk factor and I need to do something about it, and Lord knows I try. [chuckles] I’m sure there’s frustration there. It’s just like the frustration that I feel.

We can talk about the mitigating factors for something like being overweight versus something like COVID. I like to think that it’s easier to avoid COVID than to avoid from the readily available fast food and empty calories and the need for candy when you’re having a long, stressful day, [chuckles] but we forget, right? We just forget that. The other thing, being overweight is not infectious. [laughs]

We forget, and you see it in the school systems that are fighting over masks where parents are saying, “I don’t want my child to wear a mask.” Well, what about the child who is immune-compromised? We have more of those children, because we have made great strides with things like HIV, AIDS and  cancer, and many people are no longer confined to a hospital for treatment. We have very, very “normal” looking people—if there’s such a thing as normal—who are walking around and they’re living their lives while infected with HIV and you never know when that takes a turn for the worst, and you don’t want to be the one who gives them an infection, but we forget.

We are in this situation now where we are relaxing everything. Last year the CDC relaxed a mask mandate, and went on the honor system. 99% of us in public health disagreed with that decision, but it was the politics of the President, having people over at the White House who were vaccinated and why are they still masking if the vaccines work? They wanted to say that the vaccines work, so they took away the mask requirement and that is something that people who know much more about vaccines than I do, like Dr. Paul Offit have said, we made vaccines to be this miracle thing, but while they prevent disease, they may not prevent infection.

We keep ourselves in this cycle of national emergency, everybody bound together. Then we adjust as humans do, and then it’s like, “Okay, well, I got mine, sorry about your luck, but I need to get back to normal,” when people cannot define what normal is. [laughs]

TPG)A: Well, directly related to that, we have people in the disability and immunocompromised community who essentially haven’t been outside in two years, and we know the reason that the people who can stay inside are staying inside because the disability community, especially the intellectually disabled community, they, like the old age communities that you talked about before, they have also borne the brunt, disproportionately, of deaths in our country.

It’s just been horrific, mainly because of the way we were scrambling and failing at the beginning of the pandemic to take care of people in congregate care, but also because we also see needless COVID deaths for people like my son, who have complex disability support needs and aren’t able to really necessarily cooperate in the way that medical professionals need them to cooperate in emergency situations. And they get discriminated against when doctors choose who to treat, and sometimes they die as a result. I can’t stop thinking about that. Are there any circumstances under which you see things getting better and people finally being able to leave their home?

Dr. Rene Najera: We assume that, just because a neurotypical [non-autistic] person can adapt to the situation that everybody else can, and that is not the case. We are seeing this in the, I would say, record levels of anxiety, mood disorders, et cetera because we’ve gotten used to the pandemic at a societal level, but at an individual level, some of us have not adapted, and some of us won’t and we need to find a way to do that.

The thing that worries me now with the situation in Ukraine is that we here in the US have very much given, not just Putin and Russia, or other people who want to do us harm, we’ve given them the playbook. Inconvenience us for a few months, and in some cases, inconvenience us for a few days, and we will bend over backwards and do whatever you want us to do.

Take away the internet and see and see how much people will put up with! Are you really willing to sanction the tyrant if it means going without internet for a few days? This pandemic has shown that the general population of the US can only take about two years and that’s it.

You have regimes around the world that are willing to wait it out, and Ukraine is the flashpoint de jure but there are other places around the world that are like, “Okay. Come on, we’ll wait you out, because that’s what we do.” Then people here within the US, whose ideals are a little questionable, they also have the playbook now. “Oh, I’m going to inconvenience you and you will change, I don’t need to use a bomb, I need to just make you uncomfortable for a little bit, and you will change your mind, and so on and so forth.

It’s an interesting time, for sure. I’m a little bit jealous of people who are just now going into epidemiology and public health, because they’re going into it in a very interesting time where a lot of their creativity and their ideas is going to be needed. At the same time I’m also glad that I’m at the position that I am, because I can rely on my own experience from the last 20 years in medicine and public health to understand what’s going on, and make some mistakes, but also take on inequities.

Because of my background, it was so clear to me what was going to happen: We saw it with the polio vaccine rollout, we saw it with the HPV vaccine, and now we’re seeing it again with the COVID vaccine. It’s inequitable, it’s political, it’s societal, religious, et cetera. It happens over and over again, for something that shouldn’t be, something that is just to me, personally, it’s almost like politicizing drinking water. Why would water be a sign of weakness or a sign of strength? I know it’s a need.

I was having a conversation last night with several other vaccine professionals, and one of them mentioned that when you go to the ER with a broken bone, you do not question the safety and efficacy of an x-ray. You don’t debate with with the physicians when you’re there for something very acute and very painful, but somehow for this disease, if you’re not sick, you tend to want to play doctor and criticize them or question them, which is interesting.

It’s just an interesting phenomenon that we’re seeing, social media is amplifying this skepticism, and we also had four years of an administration that waged war on science, and so here we are with the results, it couldn’t have been at a worse time.

TPGA: Thank you. You’ve talked a little bit about how you are protecting your daughter and your family, are there any additional things that you are personally doing to keep you and your family safe?

Dr. Rene Najera: We very much would like to travel and have a vacation, I miss going on vacation but we’re being very diligent about safety. One of the places that seems very attractive is Puerto Rico, because in Puerto Rico, it wasn’t a big deal to put on a mask, stay at home, or get the vaccine. The vaccine was mandated, and so they have one of the highest vaccination rates in the in the country. We’re looking at maybe going there, because they’ve been very good, in my opinion, and in what I hear from friends who live and work in Puerto Rico, about mitigating the impact of COVID-19.

What I do is, we do our research, but again, we’re experts. My mother hasn’t seen my daughter in two years, my father has never met my daughter because the circumstances have not been there for him to travel independently. When we go to crowded settings, we have the mask on even if others don’t, because again, we’re safer, we’re vaccinated, and we’re masked. With gatherings, I haven’t had any of those. We would very much love to, but it’s control over other people and so we’re holding off on that until we’re past whatever wave is coming.

I’m not so sure we’re at the bottom of Omicron. Like I said, there are signs that we’re about to hit another bump.

The other things that we forget, the other things, we’re making sure that our daughter has her shots, she’s about to go into kindergarten, so she’s going to need another series of shots pretty soon. We keep her doctor’s appointments, we keep our doctor’s appointments, checkups, et cetera. We don’t wait, because with my my familial history of cancer, those screenings need to get done, et cetera.

We do the things that need doing: Checkups, dental checkups, I cannot emphasize how important it is to to have dental checkups and I feel really bad for people who can’t afford it. I don’t understand why insurance should be different from dental insurance, but that’s a subject for another day.

Then there’s the mental health aspect of it. I as an epidemiologist, my wife as a physician assistant, we’ve seen some stuff, and so it has become very important for us that just like we go for our dental checkups, we also check in with a mental health professional, and have a chat and make sure that everything is okay because otherwise we tell ourselves, “No, I’m fine. I’m just a little stressed because work was bad.”

So it’s good to have those check-ins, and hear from somebody who can see things from a different perspective, and has the tools to pass on to you to deal with stress and deal with anxiety and deal with sadness and all those things, it’s very important. Again, the same question: Why is mental health insurance or mental health different than medicine, than regular health?

It’s important to do all these things, it’s important to keep up with those checkups, just find other ways to connect. I know that one of the things that friends of mine were saying, “It hurts to not see my people and not be with my people.” I understand, but there are other ways that we can connect and we should, and it might not be as good as being across the table or having a good meal—but you can still talk to friends and you can still relate to them.

One of the things I do is write letters. It means a lot to my friends who read them, and it feels wonderful, pen to paper, and send it the old fashioned way. That is so personal, that is such a great touch and it really does connect to to others. I bring out some of the letters from my grandmother who passed away a while ago, and even though her handwriting is it’s hard to read, it’s a great connection. Finding those other things to help take you away from what’s going on in the world is very important, because you need to take care of your mind as well.

TPGA: I think that’s a really important advice and I’m so glad you’re doing that for yourself. The next thing I wanted to ask is what sources do you recommend for people who are looking for actual consistent COVID guidelines? Because it seems like there’s been a lot of waffling on issues.

Dr. Rene Najera: I know, that is one of the things that I have actually criticized amongst my colleagues and some of them working in policy, because it became very political in the last administration and has remained a little bit politicized in this administration.

While the CDC is a great source of information, it should not be the only source of information and one of the other places where I go is CIDRAP, the Center for Infectious Disease Research and Policy from The University of Minnesota, run by Mike Osterholm. It’s a great resource. He has a top-notch team of epidemiologists and data scientists and policymakers, and their site is very comprehensive. CIDRAP takes what the CDC puts out, and they analyze it, and they put it into context.

Johns Hopkins University, where I went, and George Mason University, where I teach as well, some of the academic institutions, the big ones, you would think they would have a conflict of interest—like, we need students in the classrooms, not online—but they’ve done a really good job as well of getting their network of subject matter experts and putting things into context.Then the second tier I’d check in with is the parent-led organizations or the citizen-led organizations that I trust. Voices for Vaccines,, sites like that, to just check-in and see what they’re seeing and what they’re doing.

But the big two sources for me are CIDRAP and CDC. Unfortunately in that order now; it used to be CDC at the top. I also check in with The Pan American Health Organization for what’s going on in Latin America, because my family is from Mexico. And the World Health Organization (WHO) to see what’s going on in other places.

I see the headlines on news media, CBC, BBC, CNN et cetera, and sorry CNN and BBC: I trust but verify. I see the headlines, and I see the talking heads, even people with a lot of degrees, but I double-check what they say. I have been disappointed, there are some people who have medical degrees, or doctoral degrees and they still manage to get some things wrong, and it’s human nature to get things wrong but they really should double-check some of the things that they say.

I know that we like to listen a lot to people, parents listen to parents, teens listen to teens, and that is human nature again, but we really should step outside a little bit and get the opinion of experts from multiple sources.

TPGA: Thank you very much, that’s great to hear what sources are reliable. I think one of the things that people don’t understand is that, especially with COVID, with a new disease and emerging responses, the science is going to constantly shift. How do you respond to people who get angry when the guidances change?

Dr. Rene Najera: Well, it’s interesting because those of us who know science knew that this was going to happen. And so when things were changing at the beginning—at first, no need to wear masks, and then all of a sudden, “Oh, no you do need to wear masks,” we were ready for that because we were thinking, “Well, if it turns out that a lot of people were asymptomatic carriers, then we’re going to have to mask everybody because we won’t know who’s sick and who’s not.” That was talked about even beforehand; it’s not a surprising thing and so when I hear somebody say, “Oh, you scientists, you keep changing your mind.” It’s like, “Well, yes, that is how it’s supposed to work, we should not be married to a dogma.” It’s a little frustrating that not everybody paid attention in high school science. [laughs]

Because seriously, that’s where you learn these basic things: Science is always evolving, always changing. You also hear a lot about the Maverick, “Oh, the doctor who, he’s going against the establishment.” Well, and what has happened? What is the outcome? Whereas you have others who have gone with the establishment, and then they change things because they were right.

If you don’t change the scientific establishment in a year, [chuckles] you are not on the right track, and you certainly don’t do it just by yelling, you do it by showing evidence and showing facts. Lately, I’ve been recommending to a lot of parent friends that they really start now with their children who are in fourth or fifth grade in school, with the scientific teaching of their children to protect them from these misunderstanding happening in their lifetime.

If you have a good scientific understanding of how the world works, then you don’t believe things like “the mRNA vaccine will change your DNA,” because the basic science thing is that “No, that’s not how DNA works.” It doesn’t have to be complicated. Just plain old high school chemistry could have told a lot of parents in the ’90s and early 2000s that thimerosal doesn’t cause autism. Just some basic chemistry. We need to do that now, with the young generations, and I’m certainly doing it with our daughter.

Also, I get that not everybody has the privilege of going to a good school system or having the resources to teach or their child. That’s where I think we in public health or we in public service should step in and help those parents with those kind of situations. It is frustrating, as I’ve grown, I’ve been better about not going nuclear at somebody right away—and instead asking questions. So if somebody says that they’re a climate change denier, I say, “Well, when are you buying your next beach front property”? Then they say, “Oh, no, I’ve seen the hurricanes, they’re getting worse.” And I say, “Okay. Well?”

[both laugh]

Dr. Rene Najera: And at that point, we can start to have a conversation. It’s the same thing with vaccines. I don’t know if I told you this story, but one of my aunts, her granddaughter got the MMR vaccine and had a very bad reaction to it.

TPGA: Oh, no.

Dr. Rene Najera: She had necrosis of the injection site. She told me about this and I was worried that this was going to lead to a conversation about how bad vaccines were. I said, “Well, how does that make you feel about the vaccine”? She said, “Oh, she’s getting all her other vaccines. Because imagine if the vaccine did that to her, I can only imagine what the real thing would do to her.”

TPGA: Oh, good, so she understands?

Dr. Rene Najera: Yes, then, I was like, “Oh, you get it right”? This is an aunt who didn’t want the COVID-19 vaccine, not because she was anti-vaccine, she was against the government of Mexico giving her the vaccine. [laughter]

You have that interplay, unfortunately, of people saying,  “I don’t want the Trump vaccine, or I don’t want the Biden vaccine.” We need to stop it with that. The stakes are too serious. Asking questions and having those conversations really helps, instead of immediately exploding.

And I used to do explode! you’ve seen some of my social media postings from me [laughs] years ago, but I’ve gotten better just from understanding and I think just being a little more involved in listening has really helped.

TPGA: I’m glad, your maturity benefits us all.

What is next on the vaccine horizon? Will there another shot be recommended? What can we look forward to?

Dr. Rene Najera: I think we are going to see several waves, not just one, but several. Like happened in 1918 and 1919, during the flu pandemic: There was another severe wave but by that time, like now, Americans were tired and decided to do nothing about it—and that wave caused a lot of death, a lot of cases. In some places more than the original pandemic wave. And they didn’t have the benefit of vaccines or antibiotics a hundred years ago. You want to think about that: 100 years ago, we didn’t have as many vaccines. We certainly didn’t have antibiotics, so we’re lucky now.

And yes, we’re going to see a few more waves. I do believe we’re going to see a recommendation for a fully vaccinated, three doses, a fourth dose for groups that are high risk of complications. I do think we’re going to see other vaccine technologies come online for coronavirus. Right now we only have the RNA vaccine and the one that is a viral vector, the Johnson and Johnson vaccine—but other ones are coming: The subunit vaccines, much like the hepatitis B vaccine. The antigen-only vaccines like the HPV vaccine, those other technologies that can be adapted to this coronavirus, and hopefully, they’ll go to the rest of the world because many variants are coming from the rest of the world that are not nearly as vaccinated as we are, and we need to roll more vaccines out to them.

I’m really hopeful. By seeing the students that I teach, I’m hopeful that there is a generation of very creative, very ambitious, very intelligent, and very mature public health professionals coming up because they matured through this pandemic. They have the advantage of technology to come up with creative ways of solving things, and I see it in their coursework, and I see it in the discussions that I have with them. With all that, you’re going to have 20,000 public health workers at the graduate level every year coming out in the next few years, from this specific group.

TPGA: That’s good news.

Dr Rene Najera: Yes. That is good news. That gives me hope. We’re going to turn it around and there’s always room for hope.

Shannon: That’s so great. Thank you for letting us know that because it’s been hard to hope [laughs] in this scenario. Rene, is there anything I haven’t asked you about that we should know about? [crosstalk] that–

Dr. Rene Najera: One of the things that I recommend to people that tell me how difficult these three years have been, is to look at history, and look at what happened during the Holocaust in Europe and look at the stories of the Jewish people, and how they persevered. More than just WWII, their persecution began way before WWII and they persevered through some unbelievably difficult situations, worse than you can possibly imagine.

To read those stories and to share those stories, to share the stories of other people persecuted around the world and the inconvenience, for lack of a better term, that they had to go through for years.

Maybe even through generations. While acknowledging that, yes, among  your own friends, being away from travel and leisure may be personally difficult, but it really does put into context and it really does make me think about your own place when you see what others have gone through. It does also allow you to find hope. In a lot of those stories as sad as they may be, horrible as they were I find hope because I see they got through it on the other side of that and what came of all that. It gives me hope that these two years, maybe three, will be better on the other side, and it certainly is my hope that I am better and I can be better for the people around me.

TPGA: Thank you, Rene, that’s a really great note to end on, and I’m just very grateful to you and your work, and your expertise and for spending time talking to us about this situation. Especially for so many people in the autistic and disability community who have been having such a tough time. As you’ve said many times, the people who are having some of the tougher times are the people who are the least acknowledged because they are not the majority. 

Dr. Rene Najera: Yes, they’re not the majority and many times they lack people who speak for them. We need to be witnesses for them, and advocate with them. Thank you for that work as well.

TPGA: I hope that we all get to see our loved ones soon because yes, this is—It’s really hard. [laughs]

Rene: Yes. It is, it is.