We need a national reopening plan, not a state-by-state experiment: Expert

Associate Dean for Global Health at University of Alabama at Birmingham Dr. Michael Saag joins Yahoo Finance’s Kristin Myers and Zack Guzman to discuss the latest developments on the coronavirus, amid a recent uptick of cases in South Korea.

Video Transcript

ZACK GUZMAN: I want to bring on, though, another guest who is able to answer that question, how soon is too soon. That would be Dr. Michael Saag, associate dean for global health at University of Alabama in Birmingham, who joins us yet again. And Dr. Saag, it's good to see you again.

When we look at this, though, I guess you could kind of paint a picture here of some states that reopened before hitting the metrics that even Donald Trump in the White House kind of spelled out here and saying, this is what you should hit. We saw states reopen even before hitting those optimism numbers, if you want to call them that.

And now you've got the other side of Governor Cuomo here actually putting into practice opening up based off of his own metrics here. So what's your take on the way that we're seeing some states kind of just do this the way that they want to do it?

MICHAEL SAAG: Well, let's start with Governor Cuomo, and a tip of the hat to him and the entire government of New York to come together and do this in what I think is the right way. Contrast that with my own state and a lot of other states in the south, where I think actually the political pressure has really been brought to bear, and they're making decisions that I think personally are not what I would do and a little bit unwise.

To be specific, in Alabama, we had an increasing number of cases going into May 1. We relaxed a little bit and said, OK, we can follow this. But the cases continued to rise, and then last Friday, relaxed even further. So I'm very concerned in our state that our cases are going to go up even higher. And that's even more true in Georgia and Texas and a few others.

The question that we all have is what happens if this continual rise of cases goes on, and we're not able to get it back under control quickly enough to protect our health care systems and allow us to bring this back under control? It's a little bit like a nuclear reactor, where you pull the rods and you let it go, but you don't want to get it to the point of meltdown. And that's what we're trying to do here is prevent meltdown, get the economy going, yes, but not at the expense of cases.

ZACK GUZMAN: Well, that's kind of the concern here, too, though, right, because you talk about Georgia, and specifically, we got an interesting look at the data around that state reopening. And the University of Maryland's Transportation Institute pointed out that in the week that Georgia did reopen, it was at more than 10% uptick in visitors to the state of Georgia, mostly coming from Tennessee, Alabama, and your state, South Carolina, and Florida.

So drawing in people from the region here as they reopened, which you would think would feed those upticks in cases. So I mean, I don't know. In your mind, would it be even enough to go back into a lockdown-like scenario here, since the cat's kind of already, at that point, out of the bag?

MICHAEL SAAG: Well, I worry about going back to more of a lockdown situation. And we may have to do it. If you look at what New York has proposed, they're saying we're going to relax, but we're going to keep our eye on the ball. And if we start to see a return, we're going to hit a bit of a failsafe button to get us back under control.

We know how to do this. Look at Korea. Look at South Korea. They've done it the right way. They had the highest number of cases in any country in the world back in February, and a few weeks ago, they were down to zero or single digit numbers per day.

They increased their freedoms a little bit, people walking around with masks, but they noticed in bars and restaurants that they had a brief surge of about 18 or 20 cases, and they went right back down to lockdown in those sectors, which allowed them to continue in other ways. We need to take a page from their playbook.

Finally, what bothers me the most in what I see going on in our country is that we've allowed this to be a state by state experiment. We need a national plan. We need a national policy coming-- if it's not coming from the White House, at least let CDC lead the way. They're a trusted source of information, and so far, they've been a little bit on the sidelines. We need to bring them back full speed, so that we can get our economy going in a safe way.

KRISTIN MYERS: Hey, Dr. Saag, it's Kristin here. So I kind of want to address just medically some of the science behind reopening and the best way to reopen. I've seen a lot of tweets and Facebook posts particularly around how the best way to reopen is to just let everyone out, maybe keep the older folks at home, keep anyone who's immunocompromised at home, and just let everyone else essentially go back to work, go back to, you know, businesses, go out to the parks like they did in, for example Sweden, and that perhaps we could gain some sort of herd immunity that way.

Is there any kind of truth to that, that that might be a good way of going about this? I just keep seeing that a lot, so really just wanted to get your kind of medical opinion on that plan.

MICHAEL SAAG: Well, I'll let the listeners decide if it's good or not. Let me describe what it would look like. For us to get herd immunity, we're going to need, in our country, about 60% to 70% of people who have had the infection. That's about 250 million people. So far, we've got about 1.3. So we've seen what 1.3 million does.

Secondly, we know that this virus is ridiculously contagious, and it can spread like wildfire through areas where people are kind of put together in small spaces. Witness the meatpacking industry or other places. It can explode. And if that happens, if we allow that to happen, not only will it hurt our economy and the sense of people being off work and businesses having to be shut down, but we also, I'm afraid, are going to overwhelm our hospitals, especially in rural areas, which we haven't talked about too much yet.

But rural hospitals were under siege initially. But you can go into Iowa or Nebraska or some of the states that have been dealing with the food industry and the explosion of cases. They're not faring very well. So we have to get this under control and not let it go too quickly. Else, we'll get way behind the eight ball and really be in trouble.

ZACK GUZMAN: You know, and that's, I guess, kind of the main question here, too, right? Even when we were first dealing with outbreaks across multiple states, we were all talking about flattening the curve, and that was the main push, was to make sure that hospital workers would be able to maintain and at least have a fighting chance to deal with all the cases coming in.

But as you move further along here and we talk about maybe, you know, improvements on the vaccine front, Remdesivir looking promising on that front as using a drug to treat patients here, maybe shorten their span of battling COVID-19, on that front, I mean, are we in any better situation here if we do see a double peak in cases, if it does come up in those rural counties now that we have certain things that we know might work?

MICHAEL SAAG: We're in no better shape right now than we were in early March in terms of controlling the infection. Remdesivir is an important glimmer of hope, but there aren't enough vials of medicine, and we're having trouble getting access to it right now. So that's not going to be the savior, if you will. I think a vaccine is quite a ways off. I hope I'm wrong, but I can't plan on it being here by January. I've got to be thinking about the here and now.

The thing that will rescue us to some degree would be a drug like remdesivir, but not an IV formulation like remdesivir is, an oral drug that can be given to patients for, say, a five-day course. Think Tamiflu for influenza. We identify somebody early. We treat them early. We abort the infection, and we shorten their course of illness and avoid hospitalization. Those drugs aren't here yet, and they probably wouldn't even be available to us until about six months from now.

So we've got to keep our public health approach in place. And we have lots of roadmaps. I mentioned South Korea, Israel, Germany, Iceland. A lot of places have done that. What we need, frankly, national leadership from some quarter to coordinate us so that we're working together, as opposed to pulling apart.

ZACK GUZMAN: Yeah, a national leadership that might actually get people to buy into those social distancing measures, even after you come out of lockdown and wearing masks and things like that as well to also help prevent spread of more cases. But Dr. Michael Saag, associate dean for global health at the University of Alabama at Birmingham, thank you so much for joining us again, sir.

MICHAEL SAAG: Thank you.