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It was just about six months ago that the first case of COVID-19 was confirmed in the U.S. Since then, the pandemic has exacted an enormous toll in terms of both human lives and economic harm -- with no end in sight. Amna Nawaz marks the moment with two people focused on solving the pandemic: Dr. Rajiv Shah of the Rockefeller Foundation and John Barry of Tulane University School of Public Health.
With the numbers of both infections and deaths related to coronavirus continuing to climb in this country, Amna Nawaz marks a milestone moment with two people focused on ending the pandemic and looking at what needs to be done next.
It was just about six months ago when the very first known case of COVID-19 was confirmed in the United States. Since that time, the toll has been enormous, more than three-and-a-half million people infected.
with two people focused on stopping the pandemic and looking at what needs to be done next.
It was just about six months ago when the very first known case of COVID-19 was confirmed in the United States. Since that time, the toll has been enormous, more than 3.5 million people infected, over 140,000 killed, and millions more have lost jobs and now face an uncertain future.
To look back at how we got where we are over these last six months and where we go next, I'm joined by John Barry. He's a professor at Tulane University School of Public Health and author of "The Great Influenza: The Story of the Deadliest Pandemic in History." Also, Dr. Rajiv Shah, he's president of the Rockefeller Foundation and a former administrator of the U.S. Agency for International Development.
Welcome to you both. Thank you for being here.
And, Dr. Shah, I want to start with you, because the Rockefeller Foundation has just announced a new national COVID testing and tracing action plan. It was an idea, we should say, has been floated from the beginning of the pandemic. You were talking about it in interviews weeks ago.
I think a lot of people find it hard to believe we don't have that kind of plan yet. Why don't we?
Well, we do know that every country in the world that has gotten on top of COVID-19 has done it based on a plan that makes testing effective and ubiquitous for their populations and particularly those in need, and then ties testing and test results to isolation and quarantine efforts that can help reduce the chain of transmission.
I helped lead the Ebola response in 2014 in West Africa. Getting testing times down from eight or nine days to four hours made all the difference in beating back Ebola.
We put a plan out there months ago to get America from about 600,000, 700,000 tests a week up to 30 million. And we today announced a new approach that will help us actually get to 30 million tests a week, which is what we think America desperately needs to avoid and to avert a catastrophe that's even worse than what we're experiencing now this fall.
But we are now six months in. Again, why don't we have this kind of plan yet? What stood in the way?
Well, it takes leadership and coordination at all levels of government, and it takes industry working together with the public sector.
And because we haven't seen that happening as much as we would like, the Rockefeller Foundation pulled together industry groups, scientists, investors, and public health authorities at all levels of government. We work in more than 30 cities around the country.
And what we found is, basically, people need protocols for how to use testing much more aggressively, especially for asymptomatic testing, so that teachers, firefighters, police officers, essential workers, health care service providers, residents in nursing homes are getting regular testing, and we can catch people who don't have symptoms.
That's the big missing piece. And that's the piece that threatens to shut down our economy again this fall, when the flu season hits.
John Barry, you wrote recently, looking back over the last six months — I'm going to read you back your quote.
You said: "Had we done it right the first time, we would be operating at near 100 percent right now."
Hindsight is certainly 20/20. This was a novel virus. So, how can you be sure of that? How do you know that?
Well, every other developed country in the world has done it. They have all done a better job than we have.
Some of them have done probably better than anybody in public health thought was possible. You know, Italy was the epicenter. We're all familiar with the devastation. They are now down to under 200 cases a day.
Compare that to Florida, which I think today was over 13,000 cases a day, Texas over 10, 000 often. It's just impossible to do the kind of testing and tracing that Dr. Shah was just talking about when you have over 10,000 cases in one state.
When you get it down to something like what Italy is doing, what's Germany is doing, what other European countries have done — forget about some of the Asian countries, where the counts are even dramatically less than that — then you can get control of the virus.
We should have, could have, and we still can. We do have an opportunity going forward. But the window is closing rapidly.
Dr. Shah, let me ask you about what John Barry just said, though.
We hear a lot about comparing the U.S. response to other countries. You have led emergency response in other countries. The U.S. is different in culture, in leadership in a lot of ways. Are those fair comparisons?
Well, they're very fair comparisons. And, frankly, they also offer a road map to allow us a way out.
I just want to reiterate what John just said. We have a very short window to act now to avert a real catastrophe this fall. And that catastrophe can only be averted with a major new investment in testing and tracing, the development of protocols, so people without symptoms are getting regular screening tests.
The good news is, there's some new technologies, particularly low-cost, less sensitive, but more frequent and rapid antigen tests that could change the reality in America.
But we need to embrace that new opportunity now and act on it.
John Barry, we should note that, as cases did increase, there were some mitigation steps put into place, not consistently across the entire country.
But, as Dr. Fauci recently pointed out, we never went into a full lockdown across the country. Do you think that could still be ahead?
Well, certainly, I think in hot spots, county by county, that may very well, probably is necessary.
Politically, nationally, that would be difficult. Obviously, we never got the baseline down where it needed to be.
And right now, it is, I think, out of control in several states. And you're not going to get control of it. Even if you get widespread compliance with social distancing, masks, handwashing, staying home when sick and so forth, that is not going to do more than blunt the explosive growth.
It will not, in a short time frame, at any rate, get things down where they need to be. You need to be much more aggressive than that, so that you will have few enough cases that the testing and tracing is possible.
Dr. Shah, it's hard for many people to remember what life was even like six months ago. It has changed so dramatically in so many different ways.
And we can mark the beginning of the pandemic with that first confirmed case on January 20. How do we mark the end?
Well, you know, as we have seen before, the only way you mark the end is when you see the curve bent so low, that then it's really no longer an imminent and immediate threat to everyone around us.
And we have done this before. Frankly, some states have succeeded in this first wave of getting cases down. We have seen other countries, as John mentioned, succeed in getting over the hump.
We ourselves, America led the effort in West Africa to fight back against the Ebola crisis, and won. So, we know how to do this. But it starts with having a data-driven, evidence-based approach. And that requires testing. That requires tracing, and that requires behavior change.
And it has to be top-down and organized. Right now, the federal government has an opportunity. Everyone should have that kind of access to testing, so they can go do their essential work.
And the government could make that possible by putting resources into advanced purchase contracts or using the Defense Production Act to make tens of millions of additional test kits available, especially these new low-cost rapid tests that get you a result in 15, 20 minutes.
So, with that sort of mind-set of, we're all in it together, we will work together, left and right, public and private, that's what it's going to take to win this fight.
It's a phrase we have heard often over the last six months: We're all in it together.
That is Dr. Rajiv Shah of the Rockefeller Foundation and author John Barry.
Thanks so much to you both.
Thank you for having us.
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