‘It’s hard to tell if we ever exited phase one' of COVID-19 wave: Doctor

Infectious Disease Physician & Candidate for Massachusetts Congress Dr. Robbie Goldstein joins Yahoo Finance’s Kristin Myers to discuss the outlook on the risks for colleges reopening amid a surge of coronavirus cases in certain states.

Video Transcript

KRISTIN MYERS: And on the coronavirus front, because that's what we're going to be starting the show today, the number of cases has now crossed 4.7 million. And for anyone keeping score, that number was at 4.6 million yesterday. So we are seeing big leaps and bounds in the number of cases there.

Dr. Fauci actually reiterated what Dr. Deborah Birx had said just a couple days ago, that sentiment that the virus is now in, quote, a new phase. The virus is now hitting the islands of Hawaii and Puerto Rico. These are areas that essentially had very low case counts. They are now seeing some of their highest weekly averages.

And on the flip side, the states that we've been talking about a lot-- Arizona, Texas, Florida, for example-- that have really been leading the charge in those surges in the coronavirus cases, we're actually now seeing those cases plateau. So let's keep it going on coronavirus. As I said, those cases are continuing to surge across the country in the islands, but also in areas, rural areas in the Midwest and the West. And in Massachusetts, some experts are actually saying that they need to roll back on reopening.

So for more on this, we are joined now by Dr. Robbie Goldstein. He's an infectious disease physician, and also a congressional candidate for Massachusetts. Dr. Goldstein, thank you so much for joining us.

So I want to start on the news from your state about rolling back those reopenings. I couldn't help but think maybe this is something that we should actually be seeing across the country. I mean, what do you make of that decision? And do you think more states should be taking it on?

ROBBIE GOLDSTEIN: Well, thanks for having me on. And it is actually very clear here in Massachusetts, we did a great job really early on in this pandemic of making sure that people could work from home, making sure that education was happening at home. And we saw a dramatic decrease in the number of cases. We flattened the curve, right? We did exactly what we had to do.

And now we are seeing this slow and steady uptick in cases day after day after day. And it does feel as if there needs to be some intervention to sort of move backwards in a phase, to go from where we are in phase three back into phase two, and consider closing down some of the things that we have reopened-- gyms, casinos, some of the entertainment industry that has opened up. If we're seeing that here in Massachusetts, it is likely that that also has to be done all across this country, certainly using the data state-by-state to help guide which industries should be open, which businesses should be open.

KRISTIN MYERS: So I want to ask you specifically about Boston. That city had been pretty hard hit. It's also a huge college town. I'm going to give a shout out to Zack Guzman. I know he's watching, because he went to school at Harvard. So I will give him a shout out as well in Cambridge.

Do you foresee a big spike there if all of those universities reopen? Do you think that they might actually have to do what the state is doing and revert on that decision to reopen the universities and schools?

ROBBIE GOLDSTEIN: I do think it's a conversation that we have to be had-- we have to have right now. I mean, we know in Massachusetts, we know in Boston in particular, that every end of August, beginning of September, we have this enormous increase in the number of people who come into the city, mostly students, coming from certainly all across Massachusetts, but really all across the world. And when that happens, when we have that huge influx of folks coming in, it is going to be really hard to make sure that we stay on top of this virus.

Many schools in Boston and across Massachusetts have been day-by-day adjusting what they're going to do on campus, thinking through how you can bring people and put them in a dorm room, how you can bring people and have them all go to the same dining hall, how they can go to different classes throughout the day and keep it safe. I suspect that we're going to see changes in those regulations up until the day that freshmen arrive on campus for their first day of orientation. And it's going to keep changing all throughout the fall semester.

KRISTIN MYERS: So, as I mentioned in your introduction, Doctor, you're running for Congress in the 8th District of Massachusetts. But as a doctor and as now someone entering the political arena, I mean, what do you make of the moves that we've been seeing from government officials, from Congress, White House itself when it comes to our response as a country, but even more on a local, state, and city level in the response to the coronavirus?

ROBBIE GOLDSTEIN: One of the biggest concerns I've had about the federal response has been a lack of coordination across all of the states. The president and the administration has really left it up to the states and governors to make some of these decisions, but they don't have the resources they need. We also know that this is a virus that doesn't respect borders.

I'm here in Massachusetts. The virus can just as easily come to us from Rhode Island as it can from New Hampshire. And so there has to be a coordinated federal response that makes sure that all of that contact tracing that has to be done is people shift around, as they go to college in the fall, or as their businesses reopen and they have to maybe travel for work, that there's a coordinated federal response to trace where the virus is going.

KRISTIN MYERS: Now you said in your notes that you have seen this movie before-- rather, we've seen this movie before. So knowing that, what is waiting the United States in the next six months, one year, beyond? I mean, how long can this outbreak continue?

ROBBIE GOLDSTEIN: Well, the short answer there is that this outbreak will continue until we have a safe and effective vaccine that we can get widely distributed across the country so that we can protect as many people as possible from getting infected. But I think we have-- we have a blueprint for what's going to happen over the next six months. And it's these peaks and valleys of infections.

Every time we go to reopen businesses, if we're not doing it by listening to data and following the advice of public health officials, we're going to see local outbreaks that are going to spread to other areas in a particular state or in a particular region. We also know, and it's been very clear, that there is a lag between when we open up business. And about two weeks later, we see that increase in numbers. About two weeks after that, we see an increase in hospitalizations.

And that's been repeated for the past six months. So we've got to keep that in mind as we think about when we should be responding or reacting to changes that we make in business reopenings.

KRISTIN MYERS: So about that point of peaks and valleys, as I had mentioned a little bit earlier, Dr. Deborah Birx had called this, essentially, the second phase of the virus. I am not entirely sure what that means. I don't know if everyone else does at home.

Could you share what that means exactly? And what does that mean going forward for how many cases that we're going to be seeing?

ROBBIE GOLDSTEIN: So we knew that we were going to have this first wave of the infection, the first phase, right? And that's as it spread across the country, we saw this huge peak. And it's what all of us were talking about, how we had to flatten the curve, because there was a potential that that initial wave, when we had no treatment, no diagnostics, we didn't know exactly what we were fighting, and that it could really overwhelm our system. And we expected, as we saw, to see a decrease in the number of infections as we moved out of that first wave, that first phase.

The modeling always suggested to us that once we were to reopen, once we were to begin to open businesses again, we would see a second wave, or a second phase of infections. And many of us thought that that was going to happen around September, October. That's what the modeling was showing us. It's hard to tell if we actually ever exited phase one so that we could enter phase two, or if we're seeing an overlap of phase one and phase two, given the discrepancy in the business reopening policies from state to state.

So I think Dr. Birx is pointing out that we are seeing infections rise in places where they were previously controlled. And that, to us, suggests we're entering the second phase of this.

KRISTIN MYERS: So before I let you go, I want to ask you about contact tracing. Here in New York City, Dr. Barbot actually resigned over a decision on contact tracing, letting the public hospitals handle it. How much of a challenge is it going to be for states and municipalities going forward?

ROBBIE GOLDSTEIN: It's going to be incredibly challenging. It is, first, a very expensive process. It's a very time-consuming process to do contact tracing.

It takes a lot of dedicated experts to figure out who someone maybe came into contact with and what was the risk of transmission. What makes it even more complicated and more challenging with COVID is that so many people are asymptomatic as they spread the virus. And so it's hard for us to create that chain that we want to be able to create as we do the contact tracing.

This is one of those things, when I was talking about that coordinated federal response, we've got to look at this from all across the country, because it's just as easy for someone to, as I said, cross over from New Hampshire into Massachusetts and spread the virus as it is for someone to go from Massachusetts into Rhode Island. And if the states aren't working together, we won't be able to trace appropriately.

KRISTIN MYERS: All right, we'll have to leave that conversation there. Dr. Robbie Goldstein, infectious disease physician and also congressional candidate for Massachusetts' 8th District, thanks so much for joining us.

ROBBIE GOLDSTEIN: Thank you for having me.