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Johns Hopkins doctor on hydroxychloroquine, coronavirus asymptomatic carriers

Medical Director at Johns Hopkins Hospital's Biocontainment Unit Dr. Brian Garibaldi joins Yahoo Finance’s Seana Smith to discuss the latest coronavirus developments, as U.S. cases top 400,000.

Video Transcript

SEANA SMITH: I want to turn to the latest developments on the coronavirus, and more than 1.4 million cases now worldwide. And here in the US, the US continues to lead, just in terms of the number of cases, those tapping 400,000 at this point. For more on this, I want to bring in Dr. Brian Garibaldi, medical director at Johns Hopkins Biocontainment Unit.

And Dr. Garibaldi, thanks so much for taking the time. I know you're in the hospital right now. You have been extremely busy, so we really appreciate you giving us some perspective at this point. But let's start just in terms of where we stand with containing this virus.

We had Dr. Fauci out today saying that the outbreak could begin to turn around after a bad week for deaths. He was talking about this week. Where do you think we stand in our efforts to contain the virus?

BRIAN GARIBALDI: Yeah, I think it's really hard to say. You know, we have so many different areas of the country that are in different phases of sort of the surge that we're all expecting. We're in the middle of it here in Maryland, where we're starting to see a rise in the number of cases locally. And we've had to, our hospital, open an additional three to four airborne ICUs and four additional airborne units to take care of the patients that we're seeing.

So I think we're a couple of weeks behind New York, but we're really hopeful that, you know, the great work that people in the community have been doing, socially distance and to try to minimize contact with other people to prevent spread, we're hoping that we're going to see those benefits in the next couple of weeks.

SEANA SMITH: And doctor, what has it been like caring for these patients, being on the frontlines at this point? Just in terms of the safety equipment that you need, are you able to get access to enough masks or enough ventilators for some of the patients that you're seeing?

BRIAN GARIBALDI: So you know, our hospital is one of-- we're a regional treatment center for Ebola and other special pathogens. And so we've really been thinking about these issues for years. And we have an incredible supply chain, incredible infrastructure, and amazing incident command team and wonderful infection control services here. And we have so far been able to allocate the resources that we have effectively.

And I think by and large, the mood on the frontlines is hopeful. We all feel safe in what we're doing. You know, I've been doing this with a lot of providers for almost a month now. And we're starting to have discharges from the hospital. We're getting people out of the ICU. So I think while we're all worried about what we might see coming forward, we're starting to see some positive outcomes for the patients that we are taking care of. And I think we're really kind of holding onto that to get us through.

SEANA SMITH: Brian, do you have access to enough testing at this point? Do you think enough progress has been made on that front, or is it still a major issue at this point?

BRIAN GARIBALDI: Yeah, so it's certainly a major issue. We have built internal testing capacities right now, so we are able to test about 1,000 patients a day. And that's-- we're actually at the point now where we can start offering those testing services even beyond the patients that are coming to our health system and into our testing centers. We're hopefully going to be able to start expanding that capability to other sites throughout the city and the region.

But certainly, I think there are pockets, and not everyone is still able to get a test if they need it. And what we'd love to be able to start doing-- and hopefully, this will come online soon-- is starting to test people's antibody levels against the virus so we can really understand how much asymptomatic individuals are actually out there and really be able to start making sure that we're safe here as the health care workforce, protecting ourselves, protecting our families, protecting our patients who don't have coronavirus have to be in the hospital. So I think we want more testing, and we're continuing to bring it online.

SEANA SMITH: You know, the other point that has been a huge focus, obviously, has been treatment. Now there's been kind of conflicting headlines coming across, just in terms of the effectiveness of hydroxychloroquine, whether or not that is safe to use at this point. I was reading through some of the notes that you sent over. And it turns out you were actually the subject in a hydroxychloroquine trial. Tell me what was that like and just what your thoughts are on potentially using that as a treatment at this point.

BRIAN GARIBALDI: Yeah, so the reason-- so I signed up for a trial that is looking at people who have potentially been exposed to coronavirus, so it was focusing on folks who had contact with patients, but also health care workers who were taking care of patients, even if they were wearing personal protective equipment.

And the reason I signed up for that trial is I think we really need to create data around the use of this medication. There's a lot of off-label use of hydroxychloroquine with very limited evidence about its efficacy. And I think people are underestimating the potential for harm.

This is a disease that we've never before seen in the human population. And while hydroxychloroquine is safe for most people, we have no idea what the effects could be on patients who have this virus. And the only way we're going to answer that is through a clinical trial.

So as we're ramping up trials across the country and the world to test this in a randomized controlled fashion on patients who are infected, I really felt it was my responsibility to help create some data about whether or not this medicine has a use either in prophylaxis or in preventing sick patients from getting sicker. [INAUDIBLE]

SEANA SMITH: Dr. Garibaldi, I have one more quick question, just in terms of the effectiveness of masks. So we have Los Angeles saying that everyone needs to wear a mask at this point. Do you think that's a good idea? Should more cities be following this type of order?

BRIAN GARIBALDI: Well, you know, I think it's potentially a double-edged sword, right? I mean, obviously, if someone is sick and we are worried about how many patients may have asymptomatic infection that potentially could spread that to other people, if that person is wearing a mask, it's going to decrease the likelihood of them spilling droplets and potentially infecting someone else.

Obviously, the people who are at the highest risk are the folks on the frontlines who are taking care of patients, and so making sure that medical grade masks, particularly in the N95 respirators that we need in these units, I think those need to be prioritized for health care workers.

And I think once we start getting out some more of this epidemiologic data about how much asymptomatic transmission is actually happening in the community, then we'll have a better sense are masks helpful or not. I think as long as we're not diverting medical masks away from health care providers and frontline responders, I think it's OK to wear a mask in public. But we have to make sure we prioritize where the medical grade masks are going.

SEANA SMITH: Dr. Brian Garibaldi, I know you're extremely busy. Thanks again for taking the time to talk to us.

BRIAN GARIBALDI: Thanks for having me.