Johns Hopkins doctor: We have a long way to go before things return to normal

Johns Hopkins Biocontainment Unit Medical Director Dr. Brian Garibaldi joins Yahoo Finance’s Seana Smith to discuss the outlook on hydroxychloroquine and possible treatments for the coronavirus, as U.S. cases surpass 800,000.

Video Transcript

SEANA SMITH: Getting to the latest on the coronavirus outbreak, the number of cases worldwide topping 2.6 million. And here in the US, that number has risen past 830,000. Now, for more on this, I want to bring in Dr. Brian Garibaldi, Johns Hopkins Biocontainment Unit Medical Director. And Dr. Garibaldi, thanks so much for taking the time to join us this afternoon and to rejoin the show. We always love having you on.

I first want to talk to you about the latest when it comes to treatments, because there was news yesterday and it's what many in the medical field and also just across the country are focusing on. And that's the fact that the NIH panel led by Dr. Fauci, that they're saying that there is insufficient evidence about many drugs that have been considered possible remedies for coronavirus patients.

Now, this is including some that President Trump has advocated for in the past, one of them being hydroxychloroquine. I know that you signed up for a trial for people that had potentially been exposed to the virus. But I want to get your thoughts just on where we stand on possible treatments or potential remedies for coronavirus at this point.

BRIAN GARIBALDI: Yeah, so I think this is a really important issue, and I think it's true right now we don't have any known treatments for this virus, other than supportive care for someone who becomes ill enough to come to the hospital. And I think the newer studies that have been coming out have suggested that, for medications like hydroxychloroquine, particularly if combined with azithromycin, which is another antibiotic anti-inflammatory, can actually cause more harm than good, potentially.

And I think it raises the important point that the only way we're going to find out how to use these medications effectively is in the form of a clinical trial. And I know we're all faced this tension every day as physicians. We want to do something for the patient in front of them, but sometimes giving an off-label medication can do more harm than good. And we need to take a step back and say, all right, we're going to support you through this, we're going to offer you clinical trials enrollment when possible, but these other medicines, we don't know if they work, and they could potentially be dangerous.

SEANA SMITH: And I want to get your thoughts just on the containment measures that have taken place so far, how effective that they have been. It's interesting, we had New York Governor Andrew Cuomo, he was out this morning saying that New York is working with New Jersey and also Connecticut to launch a nation-- this is what he calls it-- a nation-leading contact tracing program. Now, he's doing this with Johns Hopkins' help. How effective do you think this will be just to help contain the virus?

BRIAN GARIBALDI: Well, I think it's going to be a critical point or a critical step in any community or area that wants to start trying to limit some of our physical isolation strategies. And the reason for that is, if-- we need to be able-- if we're going to start allowing people to go back to more business as usual, we need to be able to test widely so we understand where there might be pockets of disease.

And we also need, when we find someone who has the infection, we need to be able to actually trace who they've been in contact with, and if we want to do this effectively, quarantine or isolate those potential people until we know that they don't have the virus. And I think the worry is that if we open up too soon, as some states are starting to do, there's no way we're going to be able to do that effectively in Florida or Georgia.

There are simply too many cases every day. We'll never be able to know who is infected because we can't test enough and we don't have enough public health workers to be able to track people, even using technology like smartphone geolocation applications and things of that nature. So I think we're all really worried about opening up too soon and what that's going to mean for our ability to try to limit the spread of this infection.

SEANA SMITH: So it sounds like you think that these discussions that are happening, specifically down in Georgia, the fact that they will be opening up extremely soon, that's a huge public health care risk, then, at this point.

BRIAN GARIBALDI: Yeah, I think we're all really, really worried. I mean, you know, I have folks, colleagues who work down in that area, and I think they've been stressed, they've been taxed. And we're all worried about what capacity is going to be able to handle in terms of new infections if we go back to business as usual too soon. And I think, you know, business as usual is a-- we don't know what the new normal is going to be, and I think it's going to be unlikely that we can get back to where we were in January until we have a vaccine.

You know, all these trials that are ongoing for therapeutics, this is really a Band-Aid. We need a vaccine or we need to get to the point where we have herd immunity. And that's not going to happen unless, by some estimates, we have 60% or 70% of the population in the US that's been infected. And we're nowhere near that, thankfully, but I think we have a long way to go before we can really start thinking about getting back to business as usual.

SEANA SMITH: Dr. Garibaldi, I want to go off the point that you raised earlier about testing, and how testing has continued to be a major issue. And you were saying that we need this and we need to test widely right now just to get our grasp, just to get a handle on how widespread the virus is at this point. How do we escalate this? What do we need to do to address the testing shortage in the US?

BRIAN GARIBALDI: Yeah, you know, I think there's been a lot of issues related to, obviously, the initial, you know, hiccups that we had in getting an appropriate test out, the initial reliance on the CDC as being the only site in the US that was testing for the first several weeks of the outbreak. You know, I think it's-- governors and states and local health departments have been doing their best to build testing capacity in their own areas, but I think the idea of trying to partner together to have more of a regional approach to testing I think makes sense.

And I think it's really-- it's highlighted the-- how fragmented our supply chains are. You know, there are some areas that can get the cotton swabs that they need, but they can't get the reagents for the test, or there's some folks that have the reagents, but they don't have the devices. So I think it's really highlighted how fragmented our health care supply chains, if not just for testing, but also for, potentially, therapeutics.

SEANA SMITH: And I also want to get your thoughts on the story that was out this morning just about the fact that the first deaths in California, they occurred much earlier than what was initially reported, and they actually took place in early February, which is about three weeks earlier than what authorities had initially realized. So we talk about the lack of testing, talk about the differing reporting standards. How does that mask the extent of the contagion at this point?

BRIAN GARIBALDI: Well, I think it just reminds us, as we all suspected, that this was circulating in the US, you know, probably in January, right? And we just didn't ramp up testing capability. We still are not at a level of understanding how many people are truly infected, how many people are asymptomatic or have mild symptoms, how many people, you know, over the last two months, were in the hospital with a presumptive diagnosis of something else, but actually had COVID-19 as either their main diagnosis or maybe something that was contributing to whatever their problem was. So I don't think it changes our response right now, it just reminds us that this was probably here for a while before we picked up on it.

SEANA SMITH: Now, Dr. Garibaldi, last time we spoke, I asked you what the feeling was on the front lines, and you told me that the mood was very hopeful. Is that still the case? What is the mood at this point?

BRIAN GARIBALDI: Yeah, no, I think, you know, our teams at Johns Hopkins and the folks that I've been in touch with nationwide, I think we're all still hopeful that we're-- you know, we've done a good job taking care of the patients that we've seen in front of us. I think we're all starting to be a little bit worried when we hear talk about going back to business as usual. You know, I know we're tired, we're taxed, some areas of the country more so than others. And if we have another wave, or as people are starting to talk about it, if this now gets coupled with flu season next year, I mean, we still haven't built capacity beyond these surge beds that we've created.

And so if we're not careful about how we stage relaxing some of these restrictions that have led to a slowing of the infection rate, we're going to be in a lot of trouble, and we're going to be right back to the panic that we had a month ago when we were talking about running out of ventilators, running out of hospital beds. Those conditions don't change. We don't-- you know, if we go back to business as usual, we're going to be right back where we were in that panic state a month ago.

SEANA SMITH: All right, Dr. Brian Garibaldi, so much great information there. Again, we really appreciate you taking the time to join us on the show. We know you're very busy. So thanks so much for all you're doing at this point.

BRIAN GARIBALDI: Always a pleasure. Thanks for having me.