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As COVID-19 Cases Spike, Epidemiologist Warns “The Road to an Uncertain Vaccine Is Paved in Death”

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As the U.S. reports its highest one-day spike in infections and 11 states report record hospitalizations, the Trump administration is demanding states stop sending COVID patient data to the CDC, which then releases it to the public. We speak with Dr. Ali Khan, epidemiologist and the dean of the College of Public Health at the University of Nebraska Medical Center, about the Trump administration’s handling of the crisis and his hopes for a vaccine. “The road to an uncertain vaccine is paved in death,” notes Dr. Khan. He is the former director of the CDC’s Office of Public Health Preparedness and Response, where he oversaw the Strategic National Stockpile. We also ask him about the ongoing shortages of masks and tests.

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This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: Well, we’re moving in on records being set every day. Coronavirus cases worldwide have soared by more than 1 million in just five days. The World Health Organization is warning the pandemic is raging out of control in North and South America and that the outbreak will continue to worsen if governments don’t take basic public health precautions.

TEDROS ADHANOM GHEBREYESUS: If the basics aren’t followed, there is only one way this pandemic is going to go: It’s going to get worse and worse and worse.

AMY GOODMAN: Here in the United States, more than 67,000 new cases of the coronavirus were reported Tuesday alone, marking the highest one-day spike so far, and at least 11 states reported record hospitalizations. More than 136,000 people in the country have now died from the disease.

During a webinar with The Journal of the American Medical Association, the director of the U.S. Centers for Disease Control and Prevention, Dr. Robert Redfield, made a dire prediction.

DR. ROBERT REDFIELD: I do think the fall and the winter of 2020 and 2021 are going to be probably one of the most difficult times that we’ve experienced in American public health.

AMY GOODMAN: This comes as the Trump administration has ordered hospitals to bypass the Centers of Disease Control when they send COVID-19 patient data. Starting today, instead of the usual process of sending the data to the CDC, which then releases it to the public, states have been told to send it directly to a Department of Health and Human Services system that The New York Times reports is, quote, “not open to the public, which could affect the work of scores of researchers, modelers, and health officials who rely on CDC data to make projections and crucial decisions.”

For more, we’re joined by Dr. Ali Khan, epidemiologist and the dean of the College of Public Health at the University of Nebraska Medical Center. He’s the former director of the Office of Public Health Preparedness and Response at the CDC. He’s also author, with William Patrick, of The Next Pandemic: On the Front Lines Against Humankind’s Gravest Dangers, a book that looks at how the world’s public health community responded to outbreaks of the most dangerous infectious diseases over the past quarter of a century.

Dr. Khan, welcome to Democracy Now! It’s great to have you with us. Let’s start with that new directive that no longer are hospitals to send their information on COVID-19 patient data to the CDC, but instead to bypass the CDC. Can you talk about the significance of this?

DR. ALI KHAN: Good morning, Amy, and thank you for the opportunity.

I think that story is a little bit more nuanced. So, the type of data that’s going to the assistant secretary for preparedness and response is capacity and utilization data in terms of how many hospital beds are being used, how many ICU beds are being used. And that data has always traditionally gone to ASPR and not gone to CDC. What we’re not seeing is that public health data is being rerouted to CDC — rerouted from CDC. So, that story about where that specific bit of data is going may be a little bit nuanced, because it’s always gone to the assistant secretary for preparedness and response in the past.

AMY GOODMAN: But the stuff that’s being bypassed from the CDC, the significance of the public not then being able to see it?

DR. ALI KHAN: Now, that would be an issue if the data is no longer available to the public. If you read the original memo, which I did, this was all about streamlining data to a single — capacity data and utilization data, so how many hospital beds are being used, how many tests are being performed in hospitals, to one site, so that multiple federal agencies are not asking hospitals for the exact same thing. This is what hospitals have asked for. They do not want to send data to multiple federal agencies. They want to send it to one place, that is then shared everywhere else. So, as long as the — the real test is, “Is this data still available to the American public?” — is the real test.

JUAN GONZÁLEZ: Dr. Khan, there have been some issues or some criticisms about the CDC data in terms of the fact that there’s always at least a week lag time between the time that the agency gets the information and the time it’s released. Do you have concerns, given the fast-moving nature of this pandemic, that there is a need for the CDC to be able to make data available more quickly?

DR. ALI KHAN: Oh, absolutely. This has been an issue from day one of this outbreak, which is a timely data and transparency of data. Countries that have managed this outbreak well — South Korea, for example, Singapore — all of their data is completely available to the public, and they’re very timely in getting that data, and they use good metrics for how their response is going. And the U.S. has never adopted that strategy to the current day.

JUAN GONZÁLEZ: And speaking about other countries, what’s your concern about the U.S. response to the pandemic compared to some other countries, like South Korea or New Zealand?

DR. ALI KHAN: That’s an excellent question. So, this, without a doubt, is the greatest public health failure in our nation’s history, and it just continues to be in freefall. So, we peaked at about 30,000 cases in mid-April, and then we squandered two months of lockdown and economic collapse by failing to get our disease contained, and now we’re up to 60,000 cases a day. I mean, that’s completely out of step with the rest of Europe, with Oceania and East Asia.

So, many — all those countries have not only just contained their outbreaks, resumed their economies, started back schools, but some countries have just gone all out and said, “We’re going to zero.” So, New Zealand has eliminated disease. Right? A number of other countries have eliminated disease. China, with 1.4 billion people, has gone nine days without a domestic case. So China is going for elimination, too. So, we are clearly the outlier with this uncontrolled response here in the United States — failed response here in the United States.

AMY GOODMAN: Dr. Ali Khan, what is the U.S. doing wrong?

DR. ALI KHAN: So, it starts — goes right back. So, you know, in the early days, I said it was lack of imagination. So, you know, the U.S. had sort of been sucker-punched by this outbreak. But at this point, it’s very clear: We don’t have a national strategy based on the four principles that everybody else has used to get rid of this outbreak. Simple four principles, right?

So, the first principle to contain this outbreak is leadership. So that’s integrated, whole-of-government leadership from the local, state to national level. We still don’t have that. We can’t agree on so many things that are important.

The second part is, get down community transmission. And this is the role of government, to make sure we’re testing and tracing. Nobody is talking about that anymore — isolating cases quickly, finding those contacts — nor does anybody talk about the metrics around that.

The third thing is community engagement. And that’s our role, right? Wear a mask. Please, wear a mask. Wash your hands. Social distance.

And the fourth thing is, do what you can to make sure that people who are hospitalized are more likely to survive. And the one drug we know that does that right now is dexamethasone.

So, those are four simple principles, a national strategy, four principles. We can get our disease contained like so many other countries all over the world.

AMY GOODMAN: Dr. Khan, you’re the former head of the CDC’s Office of Public Health Preparedness and Response, which included overseeing the Strategic National Stockpile on emergency medical supplies. Can you account for, many months into this pandemic, the United States continuing to have a shortage of tests and masks?

DR. ALI KHAN: I have no explanation for that. I have said I could have grown polypropylene trees by this time for nasal swabs, given the ingenuity of Americans and our biomedical complex to create these material, personal protective equipment, to contain tests — make tests. So I really have no explanation for that.

I can say, though, that we have enough testing in the United States currently, if we used it correctly and we got a timely result back and didn’t have to wait a week for the result. So, really, this goes back to strategy. We do not have the right strategy in the United States to get this disease contained. And if we did, we wouldn’t be worried about personal protective equipment, right? South Korea today had 40 cases. Right? They’re not worried about personal protective equipment. So we’re worried about these things because we can’t contain the disease and not willing to do the hard things, not willing to take — strip politics out of this, base it on the science and get this disease under control.

JUAN GONZÁLEZ: Dr. Khan, I wanted to ask you about the role of Anthony Fauci in terms of the handling of this disease, because, on the one hand, we see the reality that the Trump administration is trying to undermine his credibility these days as he increasingly comes into conflict with what the president wants to do, but, on the other hand, there are some legitimate questions. And in the early parts of the pandemic, Dr. Fauci did urge people not to wear masks. Now, he didn’t couch it by saying there’s a shortage.

DR. ALI KHAN: There wasn’t a shortage.

JUAN GONZÁLEZ: But at that time, most people in Asian countries were wearing masks, widespread use among the population. Your assessment of how Dr. Fauci has handled the crisis?

DR. ALI KHAN: So, really, this isn’t about Dr. Fauci, right? This is about CDC, which is our nation’s public health agency. And we need to see our nation’s public health agency get their role back, to educate the American people, to provide the necessary data and get us back into containment.

And there’s no doubt that there were missteps made by our public health agencies and public health professionals. Masks is a good example — the lack of a strategy that couldn’t tell the difference between flu and a SARS virus, you know, the lack of testing. So, there was invariably — there were a lot of missteps.

However, what we need now is, we need that talent we’ve always had at CDC back at the forefront talking about public health issues. That’s where our public health expertise resides. It resides at CDC, not at the NIH, not at ASPR, not at whatever. It resides at CDC. We need to hear CDC’s voice, bring those wonderful, amazing people, the greatest public health agency in the world, back to the forefront and help us contain this disease.

JUAN GONZÁLEZ: And how optimistic are you about the development of a vaccine?

DR. ALI KHAN: I am optimistic; however, the road to an uncertain vaccine is paved in death. Right? So, we talk about 60,000 cases a day. So that’s basically we’re minting 600 to a thousand new death certificates every day. Right? We can’t wait for a vaccine. Right? And other countries have gotten their diseases contained and eliminated without a vaccine. So, yes, I would love a vaccine. There’s lots of data that makes it problematic. Immunity may be short-lived. We’ve never had vaccines based on these technologies. So, as anybody else, I’m optimistic. I hope there’s a vaccine. We don’t need a vaccine today so that we don’t kill another 600 to a thousand people tomorrow. We have the tools.

AMY GOODMAN: Can you talk, Dr. Ali Khan, about what it would mean if the president of the United States simply put on a mask on a regular basis? Trump seeing a mask as weakness — only this past weekend, you saw him for a minute wearing a mask, and he said, well, he was in a hospital? The significance of what this would mean at the federal level? Then you see it go down to the state level, his biggest allies, DeSantis, the governor Florida, for the first time donning a mask. In Arizona — we’re going to go to and speak with the mayor of Tucson today — Governor Ducey, a recent death in Arizona of a Mexican American man. His daughter said, “I say that the governor and the president have blood on their hands.” Do you feel the same way, Dr. Khan?

DR. ALI KHAN: I believe all of government has blood on their hands — 136,000 deaths, preventable deaths, a tragedy. There’s a lot of blood to go around here, Amy, let’s be very honest, you know, if you look at the rest of the world, that’s contained their disease, and some even eliminated. So there’s a lot of blood to go around.

But what you saw in countries that were successful was that each and every politician, regardless of their party, followed the science. So, everybody said, “Wear masks.” No controversy. Everybody wore a mask. They got their disease under control. And we need to see that again right now at every political level — local, state, national. Wear a mask. That’s one of the four strategies that will get us out of this mess. So we need everybody to be wearing a mask at this point.

AMY GOODMAN: Let me ask you about some of the recent studies out of China, Germany and Britain, suggesting that people who have had COVID-19 begin losing their antibodies in just a few months. So, even if there was a vaccine, the significance of this, Dr. Khan, and also of the younger people that we are seeing get sick and die all over the country?

DR. ALI KHAN: So, Amy, two great questions. So, yes, if your immunity is short-lived, that makes this — makes finding a vaccine, we’re chasing rainbows, right? So, again, a reminder: We don’t need a vaccine to get out of this mess. Even today, I’m very hopeful. Public health still works today the way it worked at the end of January. We can get this outbreak under control.

As far as young people are involved, without a doubt, we see less severe disease. However, young people also can get sick. Right? They can also get hospitalized. They also die. We are now learning that about 50% of all people who get infected with this disease have some sort of heart abnormality. So, even if you don’t die, there may be long-term — there are long-term complications of this disease. So we don’t want our young people to get infected, either.

JUAN GONZÁLEZ: And, Dr. Khan, speaking of young people, your sense of how various states and school districts around the nation are handling the issue of the reopening of public schools? What’s your assessment of it? Because, obviously, depending on where you are in the country, there’s very different solutions of whether it’s all remote or partial days of the week in the schools.

DR. ALI KHAN: So, I will be very honest with you. As a pediatrician, as a father, as a public health professional, we need kids back in school. Right? Without a doubt. We need to get kids back in school for numerous reasons.

But we have to get them back safely. And we know we can do this. You know, I just did a review of over 15 countries that were able to safely get kids back in school. But that’s based on not just the safety measures we take and wearing masks and everything else that the kids need to do. It’s based on dropping community transmission. So, I say that unless you have approximately 25 cases per million population per day, you can’t resume schools. Right?

So, if people want to go back to schools, please put on your mask. Right? Drop your community transmission. Work with the local health department. Make sure they have the support they need to test and trace everybody. You know, this is what we all need to do to get our kids back in school. Let’s not put them at risk.

AMY GOODMAN: Dr. Ali Khan, we want to thank you for being with us, epidemiologist, dean of the College of Public Health at the University of Nebraska Medical Center, former director of the CDC’s Office of Public Health Preparedness and Response, where he oversaw the Strategic National Stockpile.

When we come back, we speak with Ohio State professor Amna Akbar. Her new piece, “The Left Is Remaking the World.” Then we’ll speak with the mayor of Tucson. Stay with us.


AMY GOODMAN: “Wintertime” by Norah Jones, ongoing concert series called “Live from the Living Room.”

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