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As the novel coronavirus pandemic wears on, debate is brewing over how long the associated shutdowns should last. The New York Times’ Donald McNeil has covered epidemics for close to two decades and reported recently on why American society could continue to be disrupted by COVID-19 for the next two years. He joins Judy Woodruff to discuss the epidemiological and medical realities of COVID-19.
As officials around the country are considering how to reopen their communities, there's great concern and debate brewing over how long shutdowns should last and whether reopening too soon could be dangerous.
Donald McNeil reported extensively on these questions for The New York Times in a piece that explored how society could be profoundly affected and disrupted for the next two years. He's been covering epidemics for close to two decades for The Times, and he joins me now.
Donald McNeil, thank you so much for joining us.
You do open your piece quoting scientists as saying, this could last for sometime.
Why? What do they base that on?
Well, you know, basically, they say that the notion that we're all going to be out of this in two or three months, and that football stadiums are going to be open in the fall and we will be all out together, is a fantasy, that, right now, somewhere north of 300 million Americans are still uninfected and vulnerable to the virus.
If we all go out again, things will look good for two or three weeks, and then suddenly the infections will begin to tick up, and then the emergency rooms will fill, and we will be back on our way towards two million dead, which we were when the lockdown started.
So that can't happen. And we won't really get out of this until we have either a vaccine or a prophylactic pill that will let us out.
And the vaccine.
We are told, what is it, Dr. Fauci says a year, a year-and-a-half. What do the scientists you talk to say about that, why it takes so long?
Well, they say, look, a year or 18 months is really optimistic.
The record for making a vaccine in this country is the mumps vaccine, which was made in back the '50s, and it took four years. We — now, things have set up in modern times. We actually have vaccine can — that part has sped up. You can make a vaccine candidate very quickly.
You can't speed up the immune system. You still have to do the tests in people.
And coronaviruses have problems. They have a tendency to create a thing call antibody-dependent enhancement when other vaccines have been made, which means the vaccine can actually make you more likely to get the disease, rather than less, which would be a disaster.
So you have to test carefully against that. And then there's the production problem. Most vaccines are made in batches of five to 10 million doses, because we have about four million babies born in this country every year. But if we need a vaccine that every American has to take, that's either 300 million or 600 million doses, if you need two shots.
So that's a whole different order of magnitude in vaccine production and getting the factories working to do that.
A huge, almost an unimaginable amount.
What about treatment? You mentioned medicines. What about treatment for the coronavirus? Could that make a difference in how people respond?
And we're in the clinical trials now. And those are going to take probably at least a couple more months, depending on how many people get enrolled in the trials and how they go.
Most of the medicines we know something about tend to help people who are already hospitalized and in trouble, rather than being something that you could pop and take as a pill, like you can the PrEP for HIV.
So we're not — I mean, there's been information from the White House that the hydroxychloroquine will work as a preventative. Nobody really thinks that. It might help people who are likely to crash, because it's an immune system suppressant, but it's not an antiviral.
And most of the antivirals we know about are — they're not Lazarus drugs. They don't save you. We're not seeing anything like that, the way antibiotics used to make people come back from near death.
So, it may be a long time before we have a pill that's prophylactic. And then, again, we have to make 300 million doses per day, make it as ubiquitous as aspirin. So that will take a while too.
And what about testing, Donald McNeil. There's so much discussion about that now, about how there's just not the capacity for testing that is needed.
But how much does that matter to getting — getting us even close to back to normal?
It matters enormously.
I mean, when Dr. Fauci says something like the virus will tell us, what he means is, we have to get a stable platform of the same number of tests being done all across the country every day. And then you — and they have to be rapid too. You can't have it three, four days, go out to state labs.
And then you want it — you watch that level of testing to see how many positives and negatives you get once you have got a base. And different people have different estimates as to how many tests we need.
I mean, I heard one estimate 750,000 per day. I heard another estimate from Harvard that came out today that they think five to 10 million per day, per day, in order to understand across the country where the virus is rising or falling, so that you would know, hey, we have got a hot spot here, we're going to have to go into something more like a lockdown in order to get those people out of the path of the virus.
So, you're going to need a lot of tests in order able to be spot that.
And so, when people say, well, once we begin to say we're part of the way to normal, how much worry is there that we're going to see a resurgence of this?
This is not a virus that's just going to go away, is it?
And nobody really believes the virus is going to fade in the summer either. It's spreading in India. It's spreading in Brazil. It's spreading in the Philippines. It's spreading very aptly in hot weather countries.
And that's typical with viruses, that if they have victims they have never seen before, the temperature doesn't really make a big difference.
The worry is that, as we're in lockdown, we may be the hammer and the dance. The hammer has come down, and now we sort of dance out of lockdown for a little while, but then realize, uh-oh, we're getting infections, and that will mean deaths rise again, so we go back into lockdown. And then wait a little while, it'll drop.
And on the epidemiological models, it looks like a row of shark's teeth, where you see deaths rising, and then deaths following, and then deaths rising and deaths falling. And that could go on until we have a vaccine, which might be take two or three years.
So a lot of things might happen. Some people might deliberately decide to infect themselves to get out, young, healthy people. That will be a very risky thing to do.
But people may just get really, really fed up of being in lockdown, while the rest of the world is out having fun and taking their jobs. So there will be a lot of psychological changes in this country over the next couple of years.
And do we ever get back to a pre-COVID normal, if we can remember what that was like?
Hopefully. Hopefully, there will be a vaccine, ultimately. And that will — once we're all protected, we're back to the where we are with flu shots and measles shots and everything else. Life will go back on again.
And maybe life will become better. This will have — this is like going through a war. And in the postwar periods after World War I and World War II, people's attitude towards lives changed. They wanted the League of Nations. They wanted the United Nations. They — income equality changed.
Life was, for people who lived through that generation, often, they recognized it was more precious. It was like living through the Blitz. People began to know what was important in life and what wasn't.
But that's sort of how I stay hopeful through all this. But we're not there yet. And we got to go through some pain before then.
But that's something we can at least hang on to, even as we — as we realize the reality of this.
Donald McNeil with "The New York Times," thank you so much.
Thank you for inviting me.
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