Dr Peter Hotez on Coronavirus: We’re Not Even At the Peak Yet

What's your take on Sweden? And Sweden's the way they're handling this, which is essentially they're giving people the freedom to go to restaurants and bars and they're shutting some things down, but they're quite a bit more open than the rest of the world. And subsequently they're experiencing a spike in cases. Yeah, I mean, the problem again is without a vaccine or other technologies, we have to go back to the 14th century. That's when quarantine was invented. It was when ships would come into the harbor on Croatia and coming from Asia Minor and they were fearful they were bringing plague and they kept the ships for 40 days. That's the word where the word quarantine came from. And that's what we've got right now. So we know social distancing is probably our only hope. And there's a few pieces of evidence for that. I mean, it's real serious social distancing, not going to restaurants and things. My colleague Mark Lipsich, who's a brilliant epidemiologist at Harvard, has been doing a lot of analyses and modeling. And one of the things he's shown is that when he looks at the cities in China, for instance, where they did social distancing and other aggressive measures, and some of them were pretty aggressive that he couldn't even do in the United States, but he showed that the longer you allow transmission to go on before you intervene with social distancing and other things, the worse the surge and the worse the epidemic. And therefore, as we talked about in Italy, the worse the mortality. So for instance, in Wuhan, where he estimates, I forget the exact numbers, I think he found about six weeks of transmission going on before you intervene, then it was lights out. It was a massive surge in hospital systems getting overwhelmed. And a lot of health care workers getting sick. And I want to come back to that point after we finish this, as opposed to in southern China and other places in China where you intervened after a week, then you got, you know, there was the difference between having 2,000 patients in your ICUs across the city versus 20. That's how the dramatic a difference. So that's a lesson we need to learn for the U.S. is it's the only thing we have and to really push hard on the social distancing. And I think it's especially important in the cities because it looks to me like what we're seeing so far in the U.S. is more of an urban slash suburban versus rural divide. We're seeing the big surges in ICU patients more in cities and rural areas. Although Dr. Fauci, I forget, was last night or the other night said don't ignore the rural areas either because we don't know what's going to happen there. So social distancing is absolutely paramount. And unfortunately, what's happening because things got so fucked up with the testing that we've not we've some unfortunately, we've often found out that transmission is going out for several weeks only when a lot of ICU patients started hitting the door. So this is what happened in New Orleans. This is what happened is probably happening in Detroit. The mayor of Atlanta just said, you know, all of a sudden we've had all of these people show up in the eye and the ICU. So that's another lesson learned. We really not only doing the diagnostic testing, but the social distancing is really important. And I've been on calls with the leadership of people in Houston because, you know, you're right, it's it's it's hurting the economy in so many ways. But, you know, if you want to prevent Houston from replicating the New Orleans experience, I've been saying to the to the mayor and everyone else in Houston, this is unfortunately what we're going to have to do. And the models are showing now. The Festick Organ Institute at in Washington, Seattle, Washington, called the Institute for Health Metrics and Evaluation. And it's they've now been looking at this. They do all these amazing things to look at the not only epidemic diseases, but also chronic, non-communicable diseases, diabetes and heart disease and mental health issues. But they've been, you know, all hands on deck at this covid epidemic. And they've just put it out on their website. It's health data dot org. And you go to the covid 19 site. And what they're showing is that they anticipate the peak of this epidemic in the U.S. is going to hit about the middle of April. So we're not even at the peak yet. And so we're another two weeks of this is going to continue to go up. And in some places like in Texas, it's going to be delayed. It's probably going to be around around May 2nd. And I think California was was around there as well. So their numbers say it's going to be the next two months that are going to be the crunch time when it's going to start really going up. And then as we move into later in May, it'll start to go down and maybe really bottom out by by June. Of course, again, it's a model. It's a new virus pathogen. But what I've been saying is, you know, the president yesterday or the day before said, OK, I understand. I said Easter. Now we're going to go to April 30th. And my point is, well, April 30th, things are still going to be peaking in parts of the country. Let's use April 30 as a time to reassess and then make a decision whether we go another month. Let's go a month at a time for now until we know where this is heading.