States reopening during COVID-19 outbreak 'should worry everybody': Fmr. CDC Official

Chief Medical Officer at Osmosis & Former Center for Disease Control and Prevention Epidemic Intelligence Officer Dr. Rishi Desai joins Yahoo Finance’s Seana Smith to discuss the FDA's latest decision to ban faulty masks after failed tests.

Video Transcript

SEANA SMITH: Welcome back Yahoo Finance's live market coverage. Now, the FDA has pulled its approval for more than 60 mask manufacturers in China. Now, this comes after tests last month showed that the masks did not meet standards. "On The Move" highlights that challenge officials are facing as they try to meet demand for protective equipment here in the US.

And for more on that, I want to bring in Dr. Rishi Desai, chief medical officer at Osmosis and also a former CDC epidemic intelligence officer. We also still have Anjalee Khemlani joining us here. And Dr. Desai, let's start with that-- the latest news, the FDA no longer approving these 60 mask manufacturers out of China. Just talk to us of what are your thoughts on this, and how does this complicate the US's efforts to get those masks to the frontline workers?

RISHI DESAI: Yeah, it's great that they, you know, pulled them back. They obviously should have done that weeks ago. And I think that gap of a few weeks is extremely disconcerting, right? Because now you're a health care worker on the frontlines. You get a mask, and you think to yourself, is this even going to save me? Is this actually approved? And so I think it was a big disappointment. Unfortunately, the agencies have to work much, much better with one another because the reports were there a few weeks ago.

SEANA SMITH: We were just talking to Rhode Island's secretary of commerce in the last block, and we are talking about the fact that the state is beginning to reopen its economy tomorrow. Testing, he mentioned-- he said that they had the highest per capita when it comes to testing, but it's still severely less than what many health officials are advising at this point. There was a Harvard study out recently saying that we need to be testing across the nation at least 5 million a day. We're nowhere near that number. Does the fact that states are beginning to reopen their economies at this point, does this worry you?

RISHI DESAI: Oh, absolutely. It should worry everybody. I mean, you know, it's extremely hard to shut down a country or a state. You know what's harder? Trying to do it twice. We don't have a backup plan. Rhode Island doesn't have an effective backup plan if this doesn't work. You know, it's going to be near impossible to shut down again.

So delaying, you know, through Mother's Day, delaying through Memorial Day when you know people are going to get together is important because when they hear, we're opening up, they don't hear the fine print of oh, just five people should get together and oh, we should still socially distance when we can. They just hear, we're opening up again.

And so it's very scary that they're doing this because yes, they have good testing per capita, although not as good as, as you just said, experts say it needs to be at. But there's also some key caveats. For example, what's the testing turnaround? It doesn't really matter if I do a test and I find out five days from now what my result is. For those five days, I've been spreading it. I've been getting other people sick. So what's the median time to getting a turnaround?

Are you counting all tests? What if you test one person four times? Is that really four times the testing? Not really, that's the same person getting tested over and over again.

So you can't just count tests. You have to count people tested. And a lot of these things seem like little nuances, but this is how we're, in some areas, inflating our testing data and making it seem better than it is when we need to count people tested and quick turnaround. Those are the only tests that really count.

SEANA SMITH: So Dr. Desai, testing is obviously very important when we begin to think about states rolling back some of their restrictions. But what else do you need to see in order for you to think that, hey, now it's OK, that we should start rolling back some of these restrictions?

RISHI DESAI: Yeah, I'm all in favor of making sure we can de-isolate when it's safe. Let's just be clear on that. I want to get out of my house just like everybody. And so number one, yeah, you need to have good testing data. We have to have reliable data that the median time of turnaround is fast. We have to make sure it's people, not just testing, so just validate that piece.

But third, that cases have to be coming down, not just flattening. And so if you look at that data, is it really, really coming down to the point where you feel comfortable that your contact tracers and the testing is going to be good enough to kind of mop up the rest? That's got to be there. And then finally, N95s-- I mean, we have to make sure that our health care teams on the frontlines aren't still scrambling and recycling N95s, that they have what they need.

SEANA SMITH: Dr. Desai, you spent time at the CDC, so I want to get your thoughts on the report that we got out earlier this week, the fact that the Trump administration rejected the CDC's guidelines for reopening, asked for some revisions to that. Just what are your thoughts on that, and does this send a confusing signal to the American public?

RISHI DESAI: I don't think it's confusing. I think it's extremely disappointing. I mean, you have a team of scientists working around the clock to create really thoughtful guidelines. And when they get rejected, that's just disappointing. What the heck are we doing? You know, we need to make sure we have scientists up front leading the charge and working with economists and politicians together to figure out the right path forward. But when you just outright reject something that's that carefully thought through, that's really, really disappointing.

ANJALEE KHEMLANI: Dr. Desai, this is Anjalee here. When you're looking at also, you know, what it means to go forward and move forward in this reopening, going back to that, one of the things you've looked at is the treatment cocktail. I know that Dr. Fauci has also, you know, referenced that that is going to be the solution, that the results from Remdesivir alone are not good enough, necessarily, to build that confidence.

What are the things that are being targeted? Because simultaneously, you know, we're looking at these treatments. But at the same time, you know, right in that report, it says not enough is still known about this virus to really know how to attack it. So how do you go about, you know, deciding what parts of it to attack?

RISHI DESAI: So one of the things that's being done is looking at combination therapy, and you kind of alluded to that, is what are the different things we can do to attack the virus all at once? And it's going to look like, at the end of the day, much more like treating HIV where it's a cocktail, rather than one single medication. Already, people use steroids. They use plasma therapy. They use certain antivirals. And so, you know, right now, there is a paper that you kind of alluded to that basically shows that using Remdesivir with Lopinavir and Ritonavir together is much more effective and safe in vitro. So the next step here is a clinical trial where you see if this works in actual people.

SEANA SMITH: Dr. Desai, what would the timeline for that be?

RISHI DESAI: Yeah, great question. So starting a clinical trial is on the order of, let's say, a few months. Actually carrying it all the way through is going to be, let's say, six months. So you're still looking at a number of months before this is done. A lot of these trials can start to enroll people that are very, very critically ill on a compassionate care basis as well.

So you might see this used in a combination where a person is very sick, they have no alternative, and they're using multiple medications. And then we get some data out on that and say, like, hey, how did it work in a very, very sick patient? A lot of these medications have already been used, so we know that they're safe from that standpoint, but they haven't necessarily been used together. So that's kind of the new thing.

ANJALEE KHEMLANI: And speaking of that timeline, months, We know that even though those drugs are known to be safe, in general, we're seeing just a very compressed timeline for all the trials. What should we be careful about when it comes to that, and should we be concerned about, you know, these fall timelines that we're seeing?

RISHI DESAI: Yeah, you should be. I mean, the big thing is there's a lot of pressure on showing that these things do have efficacy. And the fact is, you want to make sure that we're not jumping to a conclusion that something works when it doesn't. These medications also have side effects. They also have other adverse effects, especially when they're used together.

So we have to be really thoughtful about what are the biases involved in trying to make sure that something proves that it's effective, just to say we have a winner when, in fact, it's actually not that effective. We saw that already with other medications like hydroxychloroquine where initially, there's a lot of excitement, and later, people thought, well actually, maybe it's not as exciting as it seems.

SEANA SMITH: Dr. Rishi Desai, chief medical officer at Osmosis. Thanks so much for taking the time to rejoin us.

RISHI DESAI: Thank you.