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'From a safety point of view, a national roadmap' is required to reopen U.S. economy, says Mayo Clinic vaccinologist

Mayo Clinic vaccinologist Dr. Gregory Poland joins The Final Round to discuss how the federal government's response to the COVID-19 outbreak, and what steps are necessary to ensure a safe recovery throughout the United States.

Video Transcript

MYLES UDLAND: All right, let's turn now to the coronavirus and the latest Jared mentioned, or Jen mentioned, rather, that news last night from Stat about Gilead's Remdesivir treatment possibly being a solution here, but Gilead themselves cautioning that we are a very long way from that really being anything.

So thinking about the medical side, where we are with the vaccine and other treatments, I want to bring in Dr. Gregory Poland with the Mayo Clinic now for more. So Dr. Poland, thanks for joining in. As an outsider who wants to know where we stand, what have we learned in your world about coronavirus and how we need to go about treating it and finding a vaccine for it, just in the last 40 days here in the US since it went from maybe an off the radar concern to obviously the thing that is dominating American life?

GREGORY POLAND: Yeah. Great question. You know, just 14 weeks ago, this canvas that we call COVID-19 was blank. And it's shocking how much we've filled in just in 14 weeks. We know the genetic structure of the virus.

We've initiated trials with plasma derived therapies, a host of antivirals, other drugs. Two phase 1 vaccine trials have started. We know a lot about the pathophysiology age structure, even the receptor that this virus uses. So we've learned a lot. Having said that, there is a long way to go yet particularly when we talk about a vaccine.

MYLES UDLAND: And I guess, Dr. Poland, in your view, is a vaccine the only thing that will get us back to having something like a normal daily life here in the western world? I mean, is it a treatment that could get us there, or is a vaccine which, you know, estimates range 12, 24, 36 months away, is that really what we as concerned citizens should be patient for at this point?

GREGORY POLAND: Yeah, I think so. You know, when you talk about normalcy and how would we actually do it, so how would we protect, say, 350 million people in the US, particularly if it took two doses?

Well, we're talking about a vaccine that optimistically, under the most favorable conditions, probably wouldn't be available for 18, 24 months, something like that. I do think that that's going to be the long term answer. There are bridge therapies, though, as I mentioned, like plasma and antivirals.

JEN ROGERS: One thing that I still don't understand, and maybe it's because nobody does, is the antibody issue. I think there's been a lot of excitement about that, that especially those of us that are in New York City, maybe people have been exposed. Maybe we already have antibodies, and then the WHO warning today that there's no evidence if antibody tests can show coronavirus immunity. What do you think people should be thinking about antibodies and antibody testing at this point?

GREGORY POLAND: You know, just to clarify what WHO meant is, we don't know what level of antibody might protect you and for how long. The other problem in some of these tests is what's called cross-reactivity. In other words, is it detecting antibody to SARS CoV 2, or is it detecting antibody to the four seasonal coronaviruses that circulate every year and cause about 30% of the colds that we humans develop?

The durability problem is a real issue. In SARS, the initial SARS outbreak in 2002, antibodies could be detected for about two to three years. By six years, they were gone. MERS, short term. Even the seasonal coronaviruses, that immunity last months to maybe a few years at best.

DAN ROBERTS: Dr. Poland, Dan Roberts here. While we have you and with your medical expertise, I would also be curious on your take about the different timelines now because the latest is we're hearing buzzings about reopening certain economies, but it looks likely to be state by state.

And President Trump had initially said, before the tweets today at least, that he would leave it up to the states and the different governors. And some states are talking about reopening their economies before others. And the reaction I've seen to that is people saying, gosh, well, with the inconsistencies there, that seems kind of dangerous.

Like, OK, this state is saying that you don't have to stay at home anymore, but someone can work in New York and then drive home to New Jersey and go to a local grocery store in New Jersey where things are still closed, et cetera, et cetera. I mean, what do you make of that? Does that seem possible, plausible, safe to reopen in a staggered order, or really, should America be doing things more kind of consistently, one schedule that all the states agree on?

GREGORY POLAND: Yeah, you know, there's the tension, isn't there, between states' rights and their ability to do that, versus national rights and the safety of a population. From the safety point of view, a national road map is really what we need. And set minimum standards maybe based on local epidemiology. You could vary somewhat around that.

But look, reopening depends on us knowing that cases have fallen. The testing is widely available, that we can do can contact tracing. And most importantly-- you guys are in New York-- that we have hospital capacity if there were to be a resurgence of disease. You don't want to reopen and suddenly find 14 days later, the way Japan did, is, oh my gosh, we've got a major problem here and surge demand the medical system again.

MELODY HAHM: Dr. Poland, you've said in a recent interview that [AUDIO OUT] seven to 10 year [AUDIO OUT] a billion dollars in investment.

GREGORY POLAND: Could you repeat the question? I'm unable to hear you.

MELODY HAHM: Sorry. Better-- [AUDIO OUT]

MYLES UDLAND: All right, Melody, I think we lost you there. Dr. Poland, I just want to finish by, you know, as we're talking here with you, I think I reflect the sentiment of the group, which is that I feel maybe a little bit more pessimistic than I had previously. Or it kind of comes and goes in waves here as someone who is at home and we're trying to make the best of it. We're doing this show remotely.

Things are OK for now, but it is hard to think about six, nine, 12 more months of life like this. I guess, as you discuss this process with your colleagues, what is your mood like right now in terms of what we've done, what we can do, and what steps are likely and feasible for the country to take in the months ahead?

GREGORY POLAND: Yeah, it's a great question because one of the scenarios that could happen is that we see a recurrence of this in our fall, winter time. Right now, it's starting to happen in the southern hemisphere, which is their fall and winter time. If they have bad case loads, likely, we're going to see it again this coming fall for us.

What do we do, push the pause button again? I think what we've got to do is be smart. Number one priority is we need testing. We've got to have that capacity, figure out who is likely to be immune, take our lowest risk people-- that is young people-- allow them to get back to work, get back into school. Watch and wait and do this in a logical phase order so that you can phase back out if needed.

MYLES UDLAND: All right, Dr. Gregory Poland, vaccinologist with the Mayo Clinic, really appreciate you joining us on this.

GREGORY POLAND: My pleasure. Be safe.

MYLES UDLAND: Yep, take care.