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