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Heading into Christmas 'we’ll see a spike on top of a spike': Doctor on COVID spread

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Dr. Michael Saag, Associate Dean for Global Health at University of Alabama at Birmingham joins Yahoo Finance Live to discuss the surge in coronavirus cases across the U.S. and share his thoughts on a national mask mandate.

Video Transcript

- I want to back up and highlight the latest headlines that we are seeing play out on the coronavirus front here, as well, because as crazy as it is, all this enthusiasm in the marketplace for these new publicly traded companies is coming as cases continue to set records and hospitalizations surge across the country, including the state of Alabama, largely seeing the same theme there. Authorities reporting about 14,000 new cases a week through middle and late November there. That's been the trend across a lot of states here.

But want to bring on our next guest, who's been seeing that play out firsthand. Dr. Michael Saag is Associate Dean for Global Health at the University of Alabama at Birmingham, and he joins us once again. And Dr. Saag, I opened with the Alabama statistics there because it raises a lot of the concerns that we're having nationally here, that these cases are going to continue to rise due to the lag in what we saw play out during the Thanksgiving break. Potentially also going to be double-bookended here with the next break at Christmas. So talk to me about where you think we're at right now in this winter surge.

DR. MICHAEL SAAG: Yeah, in the long run, we're all excited because the vaccine's coming, and that's incredible news. It's really a miracle. And by the summer, I think we'll be coming out of the woods completely.

But in the meantime, we're headed for some pretty dark days, Zach. I'm really concerned about it because as you mentioned, there's a spike that's happening right now, right after Thanksgiving, and as we go into Christmas, there's going to be a spike on top of a spike. And what I'm concerned about, besides the obvious number of people that get sick and need hospitalization, is how will our health care system withhold, or how will it get through this onslaught of cases?

And so the concern we've talked about early on. We talked about ventilators, we talked about beds. Right now, the thing I'm most concerned about is the human resources.

Our folks are getting exhausted, and as the beds fill, some of our staff are getting sick, and we're having to fill in. I don't know what it's going to look like, but it doesn't feel good for January. That's going to be a tough month for all of us all across the country.

- And Doctor, we heard President-elect Joe Biden say that he plans to impose a national federal mask mandate on day one of his administration. Considering just how quickly these numbers are going up right now in terms of case counts, hospitalizations, death rates, how effective do you think a national mask mandate can be in trying to at least flatten the curve, if not bring down some of the numbers?

DR. MICHAEL SAAG: We actually need that mask mandate yesterday. So to all folks who are listening to us or watching, we should be wearing masks all the time now. My advice-- stay at home unless you absolutely have to go out. If you're in a group of 10 people, in most areas of the country, the probability that 1 of the 10 people are infected that you're around is 50%. 50% that 1 out of 10 people in a grouping are infected with COVID if you were to randomly put them together.

That means that we need to avoid crowds completely. We need to find a way over the holidays to downsize in a big way-- not have more than four or five people in your home if you can help it. And ideally, do it through other mediums-- Zoom or Skype or FaceTime or something.

But try to stay away from others because we're seeing a lot of the cases now being transmitted in the home. Somebody goes out, they're in a large crowd, people in that crowd aren't wearing masks, they bring it home, and then a lot of people in the family will then get sick about five to seven days later. So we all really need to buckle down and do all the things we know to do. When Biden takes office on January 20th, that's right in the heart of the big problems that we're going to be seeing. We should be doing those things right now if we can.

- And you think about the timeline of all this, too, and how many of those things that you would have hoped wouldn't have happened kind of did, when we think about all of these things playing out to see changes now coming, as you said, in the worst part of all this. But a lot of that, I think, has been overlooked when we think about testing and how that may have helped earlier on.

And now, as we see cases continue to rise here, I mean, how important is that when you try and assess the failures that would have helped address the pandemic earlier on, and how we still aren't where we're at when it comes to PPE and the expectations there to boost that? But also testing and trying to prevent what you're talking about, and, kind of, the younger people going back home and perhaps bringing cases, as well, if they can't get tested or have to wait, in some cases, up to four or five days to get results.

DR. MICHAEL SAAG: Right. I think the testing is much more widely available than it was. The problem with testing is that those rapid tests [AUDIO OUT] don't help with an asymptomatic person too much. It'll miss about 30%, 40%, maybe as much as 50% of the cases. So we really can't rely on that as giving us-- you know, we get a test or a negative, we feel great, we don't have it. Well, that's not necessarily true.

I think what happened, Zach, is that back in April when we all took this collectively very seriously, we shut down, we did all the things we knew to do, and the curve stayed flat. Then we relaxed because we said, look at that, our businesses failed. All the words that we heard about a surge didn't happen.

And so people, now that we're saying we need to do these things, don't understand too much that that preventative measure that we did in April actually did work. But in people's minds, they said, well, it never happened, so therefore, we didn't need it. Actually, we need it now, and we need to pull those things together. We can't test our way out of this at this point. The community spread is too great, and we have so many people who were infected in our midst, that we can't really avoid it.

So, again, stay home. If you do go out, wear a mask. Avoid large crowds and keep distance from other people. We've been saying it over and over.

- Well, Dr. Saag, I mean, if you do say that testing's too late here to kind of prevent, I guess, this next surge, we had you on before Thanksgiving and caught a lot of flack. I know you didn't want to force the issue, but you said it wasn't too early to start thinking about canceling Thanksgiving. You joked that you sounded like a Thanksgiving Scrooge. Now that we're approaching Christmas here, is it time for families to consider canceling some Christmas vacations or canceling family gatherings around that holiday, as well?

Yeah, I'm feeling like a Dickens novel character, for sure. And I'm not sure if I'm the ghost of Christmas past, but I think I for sure am the ghost of Christmas present because we really should-- I don't want to use the word "cancel." Let's just say scale it back, and in some cases, maybe cancel.

But keep it very small. Keep it to just immediate family, and use other media. It's just one year. Imagine the world right now if we didn't have the hope of a vaccine. What if those trials had failed? What if the vaccine didn't work?

Then put that into context of what we're about to experience in January, and that going on seemingly forever. It wouldn't be, but that's a horrible thought. But instead, we have hope. We've got a vaccine. So let's get through these next three months. Just sacrifice a little bit, and do the things we need to do to get through this, and we'll all be better off for it.

- Yeah, some important contacts there. Doctor, I want to get back to what you said about the capacity concerns right now in hospitals, because there are a number of reports out there about concerns about PPE yet again. We experienced that back in March and April. Now there appears to be concerns that the stockpiling on the federal level, as well as the local level, certainly wasn't enough to withstand this recent surge. What are you hearing from hospitals on the ground there right now? And do they have enough to be able to treat everybody, whether that is ventilators, a mask-- basic PPE that's necessary?

DR. MICHAEL SAAG: Yeah, infectious diseases, all epidemics, are local, and in the case of supply of PPE, it's also local. So it's variable across the country. In our case at our hospital, we're OK for now. We do a lot of recycling, but I'm not sure every hospital has that capability. In other words, we have these N95 masks that we can process and use 10 times before we have to discard them, but not everybody has that luxury.

So I am concerned about that. It's just the pressure that this surge on top of the surge places on our health care system cannot be overstated. It is a big deal. And what we can do as citizens is do our part and all the things that we talked about earlier.

- Dr. Michael Saag, always some good takeaways. We really appreciate your time. Associate Dean of Global Health at University of Alabama at Birmingham.

DR. MICHAEL SAAG: Good to be with you.