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Doctor on COVID-19: ‘We're clearly not rounding a corner'

Assistant Professor in Department of Health Policy and Management at the Harvard Global Health Institute Dr. Tom Tsai joins Yahoo Finance’s Zack Guzman to discuss the U.S. coronavirus cases reaching new highs to over 77,000 in one day.

Video Transcript

ZACK GUZMAN: A swelling case count nationally in terms of new daily cases of coronavirus-- more than 77,000 new cases were reported for the day, up from the prior record of 75,000 back in July. And unlike last time, we are seeing a lot of hot spots across the country, not just limited to a few states, like we saw in the prior peak. So joining us now to break that down with us is Dr. Tom Tsai, assistant professor in the Department of Health Policy and Management at the Harvard Global Health Institute.

And Doctor Tsai, I appreciate you coming back on with us. First up, just your reaction, because we've been seeing this case count rise over the last few days. We are seeing hospitalizations now rise, as well. We saw the death count rising, too. So how worried are you about this next wave here? And how do you see this playing out now?

TOM TSAI: First, Zack, thank you for having me on. I am very deeply worried by what the numbers are telling us-- over 70,000 new cases, over 1,000 deaths a day. And just today we are launching a view on our risk level dashboard for COVID-19 on globalepidemics.org that really shows that this really is a 1-2 punch. And we are showing what the number of cases are like across the country, not by just counties and states, but by the level of congressional districts, so the 435 congressional districts in the country, to let our legislators know how severe the pandemic is in their own backyards.

And what the data tell us are two things. There are now over 21 states that are hot spots, with over 25 per 100,000 new cases. And second, on a congressional district level, there are over 1 in 5 congressional districts are hot spots and over 7 in 10 are now in the orange or red level, so with accelerated growth. So this is a wildfire once again.

ZACK GUZMAN: And unsurprisingly, obviously, if things are getting that bad, it was a question-- a main focus of the debate last night, the last presidential debate between President Trump and Democratic nominee Joe Biden. I just want to highlight exactly what President Trump was sharing in terms of his thoughts on where this goes from here. He largely stuck to his talking point there in saying that we rounding the final corner here. Here's what he had to say.

DONALD TRUMP: More and more people are getting better. We have a problem that's a worldwide problem. It will go away, and as I say, we're rounding the turn. We're rounding the corner. It's going away.

ZACK GUZMAN: I mean, obviously yesterday we kind of highlighted that the outcomes in terms of hospitalized patients has improved, which has kind of contributed to the fact that we haven't seen deaths necessarily track the swelling case count like we saw back earlier in the pandemic. But to his point that we are rounding the corner, how would you assess that in terms of what you're seeing play out now?

TOM TSAI: We're clearly not rounding the corner. While our ability to treat COVID-19 has improved and hospitals are more prepared this time around, what's fanning the wildfire is that the number of cases keep growing. And there are very real concerns that hospitals, especially in our rural areas that are seeing the outbreaks in the upper Midwest and the West, rural parts of the South, are-- and they already are overwhelmed.

So the numbers are tell a totally different story, that we are not rounding the corner, that the cases are actually increasing. Hospitalizations are increasing. Admissions to intensive care units are increasing. And unfortunately, deaths are starting to increase, as well. And as we know, that death is a lagging indicator. And the next couple of weeks may bear an even more grim picture on the true consequences of the out-of-control infection from the last several months.

ZACK GUZMAN: Yeah, it generally lags the hospitalization rate and net hospitalizations. And we've already seen that rising rather quickly here over the last couple of days. But I want to focus in, too, on those treatments-- the treatment options you mentioned there, because President Trump's been pretty outspoken, going as far as calling the antibody cocktail that he received there a "cure."

Also, as I noted off the top, we did see Gilead Sciences get remdesivir, their anti-viral treatment, approved finally, the first drug in terms of being that all outright approval from the FDA as an option for doctors to help patients here. So when you kind of go through all those treatment options, what would you assess in terms of having those now approved to kind of judge how far along we are in helping patients battle this?

TOM TSAI: Yeah, unfortunately remdesivir is not a game-changer. The data has actually been very mixed across trials. Both the United States and the WHO, the World Health Organization, released results from one of the largest trials across 400 hospitals around the world. And that just showed very-- well, actually, no effect from improving mortality or decreasing the length of stay.

The trials in the US did show some benefit from remdesivir in decreasing the duration of symptoms and this hospital stay for individuals with more mild cases of COVID-19. I think remdesivir is an incremental improvement, but it is not a game-changer. And really what needs to be relied on to suppress a pandemic is our public health strategies. This is why we need Congress to pass the funding for testing and contact tracing. We need to continue our efforts around masking and physical distancing, because as we can just look to our hospitals, they're becoming more and more busy every single day with more COVID patients.

ZACK GUZMAN: Yeah, that's a good point to raise, too, because every time we talk about cases going up, you hear some people not wanting to admit that, focusing on increased testing. And while that might be true here, we are seeing the test positivity rate increase, well on its way back up to where we saw it back in July, as well.

But my question to you that I want to pose here about what happens over the next couple months is one that we were discussing yesterday in terms of the risks around the holidays when it comes to intergenerational homes or celebrations there, because a lot of people are going to be traveling back home, perhaps endangering elder grandparents here. So talk to me about that and how important testing becomes, and whether or not we're even there in terms of helping families try and protect those loved ones as we approach the holidays.

TOM TSAI: Yeah, Zack, that's a great question, and on the minds of families across the country, and children, as well, with Halloween coming up and then Thanksgiving and Christmas. And we want to spend time with our families. The pandemic has led to a lot of fatigue. But as the numbers tell us, the cases are increasing. The danger of COVID-19 being transmitted-- and we see that from our risk level dashboard. The community level transmission is still increasing.

And because we still don't have adequate testing, we don't know if-- ourselves may be asymptomatic, or our loved ones and family members may be. So there is a very real risk of COVID-19 cases being spread through family gatherings and through indoor gatherings. And I think what some of the contact tracing data have revealed over the last few weeks is that people have been more vigilant when out in public or out at work in wearing masks, but they let their guard down when they're back home with your friends and neighbors. And that's a real worry as we look towards the holidays, is we can't let our guard down, especially around the ones that we care about the most.

And that's why we need testing and testing to screen asymptomatic individuals, so we can interact with our family members safely. This is a moment of decision, a moral decision for our country to decide on, is what vision of family and values and social interaction do we have around the holidays? Is it one of individuals locked down because we don't have enough tests? Or is it one that we can actually embrace it going forward?

ZACK GUZMAN: Well, that was my kind of last point here, because I'm not sure how testing is up by you in Cambridge who are-- the luxury-- I talked to a lot of friends who are still there at Harvard-- able to go in and get those tests. But here in New York, there's still long waits. I mean, when you look around the country right now, especially in those rural areas that we haven't really discussed in terms of the case count now in North Dakota, South Dakota-- some of these rural areas, it doesn't sound like testing is where it should be, considering we had months to plan here.

TOM TSAI: It's absolutely not, Zack. And we've been stuck about a million tests per day. And the technologies are here. There's antigen tests. But what we need is the will and the ability to make it affordable and accessible. Right now, funding for the testing is still very tied to a reactive medical diagnostic framework of needing it to be performed by clinicians, ordered by clinicians and paid by insurance companies.

We have to make-- push the tests out into the communities and have a proactive approach. So we have to get the noses to the swabs and the swabs to the noses. And that's really what's-- it's a different way of thinking about testing. We've been talking about it for months now. But this is the time to act. And you know, the election is really a seminal moment in deciding which way we're going to go with our testing strategy, and really, our public health strategy around COVID-19.

ZACK GUZMAN: Well, Dr. Tom Tsai, I know you're very busy tracking all this. And I appreciate you taking the time to come on and chat it with us today. Thanks again and be well.

TOM TSAI: Great. Good to be with you, Zack.