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Pandemic Will Get Worse Before It Gets Better: Johns Hopkins

Oct.06 -- Dr. Amesh Adalja of the Johns Hopkins University Center for Health Security, says the coronavirus pandemic will get worse before it gets better. He speaks on "Bloomberg Surveillance." The Bloomberg School of Public Health is supported by Michael R. Bloomberg, founder and majority owner of Bloomberg LP, the parent company of Bloomberg News.

Video Transcript

- What does immunity mean in a virus?

AMESH ADALJA: What immunity refers to is the ability to fend off further attacks of whatever pathogen you're talking about. And usually with an infectious disease, after you've been infected there is a period of time when you've developed antibodies where you are impervious to further infection with that same pathogen. The president will likely be immune for some period of time after he recovers.

That immunity will last maybe several months to a year, and it may not be completely that it protects him from reinfection but prevents him from getting severe disease. We're still learning what immunity means here, but in general we're seeing that trend followed with this coronavirus.

- Dr. Adalja, as President Trump and his entire circle battle the virus, we're seeing a similar trend around the country and frankly around the world-- Europe also fighting a number of hotspots with the virus spreading faster now. How bad is it? I mean, are we on a tipping point for something substantially more significant than perhaps medical professionals have been expecting for a second wave?

AMESH ADALJA: No, I think it is going to get worse before it gets better with this virus. There is a weather change going on in the northern hemisphere where people are going to be doing more activities indoors, and we know that the virus spreads more efficiently indoors than outdoors. We also have a lot of complacency going on because this has been 10 months now since the virus has been discovered, and people are getting more lax with their habits in terms of social distancing and facial coverings.

So I do think that we are still going to continue to see more hotspots flare. We're hearing about hospitals in Wisconsin that are under stress. I think this is the new normal. I think, you know, as a country and maybe as a world, we really failed in general at controlling this pandemic. So it is going to be something that we're going to be contending with for several months in the future.

- Doctor, I'd love your thoughts on localized restrictions. In New York City right now, I believe it's about nine ZIP codes that seem to be the problem areas, and the nine ZIP codes are going to have local restrictions. Doctor, how effective are local restrictions, when-- Let's think about it, just in terms of common sense. If you're an individual, you can still leave that area and go somewhere else and do what you need to do somewhere else.

AMESH ADALJA: Yeah, it's very challenging for local restrictions within a city to be something enforceable or something that people are going to obey because what you can end up doing then is paradoxically suppose you shut all nonessential businesses in one of those ZIP codes. Then everybody is going to go to the next ZIP code over, and now you have more people that are infected, tracking that virus into another area that hadn't been affected. So you have to be very careful about this.

In general, we want targeted and precision-guided public health, but you have to make sure you're looking at it in the long term and realizing what the negative consequences are or the unintended consequences might be. What I think needs to happen in those ZIP codes is we really have to get more testing. We have to get much more public health involvement in trying to convince those people to change their behavior, to wear face coverings, to not have gatherings.

- Doctor, you are on the NCAA COVID committee. Your Carnegie Mellon is not playing football, and down the hill, Pittsburgh will play Boston College this weekend. Who's right?

AMESH ADALJA: Well, I think that what's happened is the Division I schools have the ability to do some modicum of testing which they think can counterbalance the risk of infection. So I think that this is something that we've debated with throughout the pandemic about sports. Schools like Carnegie Mellon, where football is not important-- where I went. I didn't even-- I never went to a Carnegie Mellon football game. I can't even name a Carnegie Mellon football player. I think it's probably a wise choice for them because it's not something that they really are important.

It's important for them for Pitt. It is kind of in the lifeblood there, so they're trying to find ways to mitigate it. Obviously you can't get the risk down to zero. You have to be prepared that they're going to have cases, that they're going to have to put people in isolation. All of that is going to happen with these games. All you can do is try and give people the best tools to reduce the risk, reduce the harm.

But many of these Division I football schools basically are going to go forward anyway with the antigen test as one way to minimize risk. But it's not going to be zero, and it is going to be a disruptive football season this year. And at least we're not having fans so far in the stadiums, so that's not created a mass-gathering effect, although that may be changing in the next couple of days as well.