Hotez: Trump’s goal to relax coronavirus precautions by Easter unrealistic

BY DAVID MEDINA

President Trump may want to phase out 15-day self-isolating guidelines and open up the country by Easter, but a prominent epidemiologist who’s testified before Congress says that’s unlikely.

Peter Hotez discussed the threat to global security posed by the COVID-19 pandemic and answered viewers’ questions March 26 during a one-hour webinar.

“I don’t see how that happens given that the infection will still be climbing in New York and even looking worse than it does now” said Peter Hotez, a fellow in disease and poverty at Rice’s Baker Institute for Public Policy’s Center for Health and Biosciences and dean of the National School of Tropical Medicine at Baylor College of Medicine. “I would say let’s give it another month and let’s reassess. That’s what you have to do. Build some time into it and don’t hold yourself to deadlines that are not supported by the data, and by data I mean seeing the rise of the new urban areas getting picked off by the virus.”

Hotez discussed the threat to global security posed by the COVID-19 pandemic and answered viewers’ questions March 26 during a one-hour webinar moderated by Kirstin Matthews, a fellow in science and technology policy at the Baker Institute.

The pandemic has taken a new turn in the United States, Hotez said: In China, COVID-19 was severely affecting older adults, but in this country people between the ages of 20 and 40 are also suffering from the disease.

“That is an important message to get out, because too often it is pitched as a disease of older individuals,” he said. “Those young adults who are still going out to bars and spring break, that’s not going to fly, for a number of those people are going to get sick.”

Another troublesome development is the “urbanizing” of the disease, Hotez said. COVID-19 is spreading rapidly in major cities such as New Orleans and Detroit and disproportionally affecting the poor.

“One thing these cities have in common is high levels of poverty,” he said. “Now there is a new face of COVID-19 and that is health disparities. It’s affecting people living in poverty in crowded conditions and underrepresented minorities. We are having trouble trying to figure out which city it will hit next.”

Hotez, whose lab is trying to develop a low-cost vaccine, believes the combination of social distancing and warmer weather may slow the transmission of the disease by this summer. “And then the question is will the disease disappear the way Zika and SARS (viruses) did, or will it come back in the fall? That’s important to know because we are developing a vaccine for future years under the assumption that it is coming back,” he said.

Hotez said developing a vaccine will take a year to 18 months, and that’s being optimistic. Testing a vaccine for efficacy and safety takes at least a year. “To accelerate the development of the vaccine to a year or 18 months is really ambitious,” he said. “There’s no track record for that.”

Chloroquine, the drug President Trump has been promoting in the fight against COVID-19, may stand a chance, Hotez believes. The antimalaria drug has been around for a long time, he said, and in test tubes it does inhibit the replication of the virus. A few clinical tests in France and China are giving a hint it might be effective, he said, but a new test out of Shanghai  indicated that it didn’t work.

“I would say (its effectiveness) is less than 50-50, but not zero,” Hotez said.

As for testing for the disease, Hotez said the United States is “doing very badly.” But he added that the testing today is better than last week and the week before, and through a lot of effort, the testing is getting where it should be. “But we should have been further ahead than we are now,” he said.

Without adequate testing, the health care system runs the risk of being overloaded, he said. “We really have to ramp up in terms of testing because if people are showing up in the ICU with severe infections, then you have already lost because that means that there are so many patients that we have missed,” he said. “And I’m afraid that is what is happening in New York right now. We are seeing a big surge that is going to overrun the health care system.”

Hotez explained that this is the third coronavirus outbreak of the 21st century. SARS emerged in southern China in 2003 and MERS began in 2012, and now there is COVID-19, which started in Wuhan, China, where 80,000 have been affected.

“We learned a lot from that epidemic, in part because the Chinese were putting up a lot of information in (the websites) bioRxiv and medRxiv,” he said. “And that’s important because there has been a lot of criticism of the Chinese for not being transparent. We learned pretty quickly how they isolated the virus, identified the virus, the genetic coding of the virus and that it is a host receptor to the lungs.”

The medical community in this country learned that COVID-19 was a serious viral infection, but it wasn’t as lethal as the Ebola virus, which has a 50% mortality rate. COVID-19 has a 4% mortality rate, which is 10 to 20 times higher than influenza. The disease is also highly transmissible; it has a reproductive number of four, which means that a single individual can infect an average of two to four people, compared to one or two for the seasonal flu.

“It is not the most transmissible virus we have ever seen, such as the measles, which has a reproductive number of 12 to 18,” Hotez said. “And it’s not the most lethal. But it’s pretty high in both categories and that combination has created a pretty toxic mix, so that you have a lot of people walking in the streets transmitting the virus.”

The virus is especially hazardous to people over 70 with underlying health problems such as diabetes, heart conditions and renal issues. “And now we’re seeing many young adults become seriously ill and hospitalized,” Hotez said. “It’s also affecting health care workers.

“We need to do something about this or else it’s lights out, because our health care systems are going to be overrun,” he said.

David Medina is director of Multicultural Community Relations in Rice’s Office of Public Affairs.