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Expert on COVID-19 outbreak: "We're over the worst" in most places

Senior Scholar at the Johns Hopkins Center for Health Security Dr. Amesh Adalja joins Yahoo Finance’s Seana Smith to discuss the latest coronavirus developments as some states push to reopen their economies.

Video Transcript

SEANA SMITH: All right, let's turn our focus a little bit and talk about the latest when it comes to coronavirus. Now, states are scaling back their stay-at-home measures, as more than half the nation's governors relax their coronavirus restrictions this week. Now, Texas, today, is reopening its economy with restaurants and retail stores among those businesses allowed to reopen their doors.

So for more on this, I want to bring in Dr. Amesh Adalja, senior scholar at Johns Hopkins Center for Health Security. And Dr. Adalja, it's great to see you, again. Thanks for taking the time to rejoin us. Since we last spoke-- we last spoke just around six weeks ago, so clearly we have seen a lot of developments in the coronavirus outbreak. So let's just start broad. What do you think of the progress that's been made in containing the outbreak since the last time we spoke?

AMESH ADALJA: Well, I think we're in a different place. We really went through some very dark days in March, especially in hotspots like New York City, where there was real concern that the hospital capacity might be exceeded and that they might have to change standards of care. I think we're over the worst of that in most places. And you're seeing that reflected in the fact that many governors are now starting to loosen the economic restrictions.

We're learning that what happened in New York City wasn't necessarily extrapolable to other parts of the country. But we still want to keep an eye on things. Because we know when we decrease social distancing, cases are going to go up. We want to make sure that our hospitals, our health departments are able to handle those cases and not exceed health capacity.

And I do think that there is much more recognition now of the cost of these economic shutdowns and what that did to people's lives. And I think we're being much more nuanced and better about it now than we were back in March.

SEANA SMITH: You know, that's interesting. So Dr. Adalja, then, do you think that in some of these states, now that they are reopening-- we've already seen some states, like Georgia, now be reopened for just over a week. From a public health standpoint, do you think an economic reopening can be done-- can be responsibly managed at this point?

AMESH ADALJA: I definitely think it can be responsibly managed. But you have to do this in specific geographic areas, looking at the dynamics of the infection there, meaning, what does your health department look like? Do they have the ability to do case contact tracing? Do you have access to diagnostic tests? Have your hospitals built capacity, meaning, do they have enough personal protective equipment? Do they have mechanical ventilators? Are they ready to go back to work at normal operations?

And if all of that's in place, you can start to peel things back. Obviously, certain types of events, like mass gatherings, are going to be really difficult to have for any time before a vaccine is available, because a number of cases that could occur in one of those is enough to really put anybody into crisis. But I do think you're going to see some reawakening of the economy. And I think it's long overdue in some parts of the country that really didn't get hit very hard.

SEANA SMITH: Well, and some parts of the country that didn't get hit pretty hard, like Michigan, for example-- Michigan's governor just signed an executive order extending the shutdown through May in her state. So as a doctor, when you're trying to evaluate which states should do this, which states should refrain, I guess, how do you convince people that an extension of some of these lockdown orders is the right way to go?

AMESH ADALJA: Well, you have to really look at what's going on with the outbreak. So if you're in a place where the percent positive of tests that you're doing, if there's still a very high level of positive tests where you're still hearing about hospitals having the majority of their ICU patients being COVID-19 patients, then I think you really are in a different place than a place where I'm sitting in Pittsburgh right now, where most of the hospitals are quite empty. We passed our peak a while ago. We're doing pretty-- pretty good with testing and our health department being able to do contact tracing.

So this isn't going to be a "one size fits all" type of policy. It's going to be really based upon what's going on in that area. And I think that's what we're going to see-- that some states are ready. Some counties within states are ready. Some are not. And I think you're going to have to look at it that way for the time being.

SEANA SMITH: Dr. Adalja, when we talk about how long this could last, there was an interesting report that caught our attention. It was from the Center for Infectious Disease Research and Policy at the University of Minnesota. And what they found was that the pandemic is likely to last as long as two years, and it won't be controlled until about 2/3 of the world's population is immune. What do you think of that statement? And what do you think of that timeline?

AMESH ADALJA: I do think that's a pretty good estimate of what we're facing. Remember, we have a community-spreading respiratory virus. It's not going to go anywhere until there is a vaccine and until we get enough people immunized that we have some level of herd immunity. So we have to be prepared to live with this.

And the whole metric that we have to look at is we don't want to go back to where we were in March in New York City. So we want to make sure that we have enough control of this virus that hospital capacity isn't exceeded. And beyond that, then it's going to really be a risk-- a risk tolerance issue for many people. And there are going to be older individuals, those with other medical conditions, that are going to have to be much more careful with social distancing. And there are going to be other people who are going to be out in the community, and they're going to have to learn to live with this risk.

Because this really hasn't been about trying to decrease the number of cases forever. This was trying to set reset, basically, so that we could get to a place where we could decant our hospitals, make sure capacity was OK, get testing in place, get our health departments in order, and then basically kind of go back as close as we could to normal, because that's what flattening the curve was about-- really buying us time so these cases occur over a longer period of time.

SEANA SMITH: Yeah, Dr. Adalja, I also want to get your thoughts just on where we stand for treatment. So we know that Gilead had their results from their remdesivir trial, and it looked pretty positive. That got people pretty excited. Lots of people were talking about the fact that this is a breakthrough when it comes to possible treatments. Do you think this helps blaze a trail for other drugs that are in the pipeline to potentially treat coronavirus?

AMESH ADALJA: I do think it is. It sets a good precedent. We now have a compound that is active. It decreases the time needed to improve from your condition. It's not a miracle drug. It's not-- it's not that's-- in that category. But it is something that's very encouraging. And hopefully, this will get emergency use authorization from the Food and Drug Administration, and we'll start seeing it used in hospitalized patients.

And it will give people encouragement that you can make treatments for this. And hopefully, we will see a whole plethora of new treatments starting to be developed going through clinical trials. And there's so many clinical trials right now that I can't keep track of them all. And I think that's a good thing, because the more countermeasures we have against this, the less of a threat it becomes, the easier it is to get back to some sense of normalcy.

SEANA SMITH: Dr. Amesh Adalja of Johns Hopkins, thanks so much again for taking the time to join us.

AMESH ADALJA: Thanks for having me.