- As we look forward out of the COVID-19 pandemic,
governors in some states are already talking
about reopening some businesses, and a few states
have already started reopening.
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[electric razor buzzing]
- Social distancing must continue,
but our economic shutdown cannot.
- South Carolina's business is business.
People wanna work, they need to work.
- We will allow gyms, fitness centers, bowling alleys
to reopen their doors.
- But rushing to reopen too early
could lead to a deadlier second wave.
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The first and the biggest mistake we can make
is ending physical distancing too early.
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If we rush to reopen, it could lead
to the uncontrolled spread of the virus all over again.
It won't be safe to reopen until we see a dramatic decline
in the number of cases.
There isn't a magic number in terms of how big
that decline in cases needs to be,
and different countries are handling that differently.
The White House is saying that states should be looking
for a decline in cases for 14 straight days,
because that's the virus' incubation period.
But China didn't allow cities like Wuhan and Nanjing
and others to reopen until intense surveillance
detected zero new cases for 14 days.
Overall, a second wave in China seems
to be pretty minimal at the moment.
Here in the states and in some countries in Europe,
the virus is still reaching its peak.
We're still waiting to see an overall decline in cases
in the states, signaling that the virus spread
is slowing, and that the potential
for future outbreaks won't overwhelm hospitals.
It will take several more stages
until we return to some kind of normal.
Some experts predict that we could see some level
of physical distancing continue for years.
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The next big mistake would be not preparing hospitals
for another surge.
We've seen this happen in the past.
Take the 1918 Spanish flu pandemic
that killed an estimated 50 million people, and many
of those didn't die in the first wave of the pandemic.
They were killed in the second and third waves.
Given that another surge of COVID-19 is likely,
we need to make sure that hospitals have three things.
The first is medicines that are proven to treat this virus.
Right now, in some cases, doctors
are using experimental treatments, but we need antivirals
that specifically target this new coronavirus.
Second, we need the right amounts
of personal protective equipment, or PPE,
for first responders and our healthcare workers
so that we're not seeing a situation like we are now
in this first wave, where people are having
to reuse PPE, or having to use expired masks.
It's so important that our front line healthcare workers
have that protective equipment to make sure they're safe
while caring for others and to limit the spread
of the virus through healthcare facilities.
And third, we need to make sure that hospitals
have sufficient resources and equipment.
That means everything from enough beds, enough staff,
and ventilators to treat the sickest patients.
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The third critical mistake would be
to reopen without ramping up testing dramatically.
The need for accurate, widely available,
and quick turnaround testing could
be the most important factor in reopening the country.
Without accurate testing, we just have no idea
of how far and wide this virus has spread,
and also it means we can't diagnose people quickly
and treat them appropriately.
This is especially important, given as many
as one in four people who has the disease
doesn't show any symptoms, and in that context
of asymptomatic spread, it means we need
to continue testing, even as the number of cases declines.
And we may need to test people multiple times.
One of the challenges of this new virus
is we don't know how long immunity lasts for,
or what the likelihood of reinfection might be.
So far we've tested four million americans,
and are running between 130,000 to 160,000 tests a day,
but we should be running 500,000 to 700,000 tests a day.
But ramping up testing to this extent
could cost billions of dollars.
Add to that the challenge that you're asking lab technicians
to suddenly do many, many more tests on top
of their existing work, so you're taking away resources
from other areas in the healthcare field.
And at the exact same time, the entire world
is also demanding access to these resources.
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The next big mistake we could make
is letting the virus spread without tracking it,
so basically not doing contact tracing.
Contact tracing is where we find each person
who has the disease, find out when they were contagious,
and then trace their steps to find out where they went
and who they had contact with while they were infectious,
and then you have to follow up with each and every one
of those contacts to make sure
they're quarantined or isolated as necessary.
It's an old school public health technique,
but let me tell you, contact tracing
has been the cornerstone
of every major infectious disease epidemic investigation.
A lot of contact tracing is leg work.
You're following up with people, finding out where they went
and who they may have exposed,
but there are new tools that can help.
Apple and Google are working on contact tracing technology
for smartphone, but keep in mind,
as important as contact tracing is,
it really has to work hand-in-hand with widespread testing.
Without knowing who's been infected,
we can't monitor the spread.
[tense music]
And finally, we need to stop
repeating the panic-neglect cycle.
The panic-neglect cycle is what we so often see
in public health where we all freak out
during the crisis, and then soon after,
we forget about it and act like nothing bad happened.
The aftermath of the 2002/2003 SARS pandemic
is a perfect example of this panic-neglect cycle.
A possible vaccine for SARS was being developed,
but then it was abandoned by funders
as the disease tapered off, so then we ended up
with a half-developed SARS vaccine
that was forgotten about in laboratory freezers.
The panic-neglect cycle, especially that panic part of it,
also leads to what we call exceptionalism,
where we target much of our funding and energy
on one disease, but at the cost of other pressing diseases.
I'm hearing of some people losing jobs
at other medical organizations, for example,
those working on dementia, because they're
losing funding during this pandemic.
But dementia's not going anywhere, and so we need
to make sure that we don't lose focus
of all those other diseases that cause so many problems.
Also, ebola is not still fully under control,
and so even though it's not making headlines right now,
we can't take our eye off the ball.
And I really hate that after all the panicking,
we fall into this neglect mode,
because it's really not a matter
of if we'll go through this again,
it's a matter of when will we go through this again,
and we need to be prepared for it,
and we need to learn from this
so that we don't keep repeating our mistakes.
Thank you so much for watching.
Keep dropping your comments here
and contacting me on social media.
Stay home and stay safe, everyone.
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