‘The medical community has learnt a lot’ and are ‘better prepared’ for the next phase: doctor

Dr. Tom Tsai, Harvard Global Health Institute, joins The Final Round to discuss his thoughts on the latest developments with the coronavirus and the vaccine race as new cases continue to spike across the globe.

Video Transcript

SEANA SMITH: So I want to bring in Dr. Tom Tsai. He's assistant professor in the Department of Health Policy and Management at the Harvard Global Health Institute. Dr. Tsai, it's great to have you back on the program.

More than 20 states, like I said in my intro there, recording record numbers of new cases over the last couple of days. We have 40 states seeing a week over week increase. How big of a second wave do you think we'll likely see, given these numbers at this point?

TOM TSAI: Seana, great to be with you back on the show. The numbers are very concerning and definitely heading the wrong direction. We're seeing over 14 states now that are considered hotspots at a risk level dashboard, meaning greater than 25,000 or 100,000 new cases. And now the US is seeing over 50,000 cases per day consistently, despite testing approximately over a million tests per day.

It's hard to tell where this wave is going to end up, but it's definitely continuing to grow. And this is the second wave that a lot of epidemiologists and public health experts have been warning about for the last several months as we head into fall and winter. And more individuals are in indoor settings, where there is a higher risk for COVID-19 transmissions. So still early days for the second wave, but the numbers are already very concerning.

SEANA SMITH: And Dr. Tsai, I wanted to ask you about that, just because as the weather gets colder, I think there's questions out there just in terms of how much more at risk you are when you're with other people indoors. How much greater are the odds of catching the virus indoors?

TOM TSAI: Right, the transmission for COVID-19 isn't really driven by the weather directly. It's really about the risk of the airborne transmission. So if you are closer to an individual for a longer duration of contact, so meaning within six feet for greater than 15 minutes. And those situations are more likely to happen as the weather gets colder and people are indoors more frequently.

Also concern with the holidays coming up over the next few months that there is a occasion for social gatherings indoors that kind of pose risk as well. So the risk is definitely higher because of the airborne transmission in indoor settings, because of the risk of the respiratory transmission.

ANJALEE KHEMLANI: Dr. Tsai, Anjalee here. We seem to know a lot more about the virus, whether you're talking about how to treat it, how to determine a patient's severity, et cetera. Does that help when we're talking about facing the second wave? And could we anticipate a sort of an easier process for hospitals and health systems? Or should the country be bracing for a repeat of April?

TOM TSAI: I think we should sort of hope for the best, but prepare for the worst. And but the data have already shown that there are already improvements in our ability to manage COVID-19. The situation that is playing out now in the Midwest is different than the situation that we were seeing in New York and Boston back in March and April.

We've learned a lot about the protocols for managing the critically ill patients with COVID-19 in terms of ventilator settings. There are some newer medications and treatment regimens that are available, Remdesivir, and some of the steroid treatments as well. So we've made some progress in terms of our ability to treat COVID-19.

And our ability to plan for surge capacity is also improved, as we've learned over the last several months. So, you know, the pandemic is still very serious. And there's still a lot of individuals at risk for adverse outcomes from a clinical standpoint. But the medical community and the hospitals have learned a lot over the last several months and I think are better prepared heading into the fall and winter.

AKIKO FUJITA: And Dr. Tsai, we've really started to see the case numbers ramp up in Europe, particularly in countries like France, as well as Spain. And I am curious what you see differently in terms of the situation there.

If you look at schools, for example, they didn't close as much as they did in the US. What do you attribute this spike that we're seeing in Europe to right now? And how are conditions different than what we've been seeing play out here in the US?

TOM TSAI: What the lesson from Europe and France and Spain has taught us is the importance of the public health measures. There are no shortcuts to the pandemic. Bars and restaurants were opening in Madrid back in June, and we're seeing the consequences of that play out now in October.

In some research that we've done in collaboration with Google Health, we looked at that the relationship between the changes in people's mobility with the decline in cases. And it's a roughly one-to-one correlation. So approximately a 10% decrease in mobility relates to about 12% decrease in the growth of COVID-19.

So again, the armamentarium is still very much the same. Even when the vaccine comes, it's not going to be 100% effective. So we still have to rely on masking, good physical distancing, testing, and contact tracing. The difference now is we have better information. And hopefully, we've learned from the last few months we can then offer better targeted interventions.

ANDY SERWER: Doctor, just have a brief second here left. But I wanted to ask you about the work that the Broad Institute has done, which is the joint venture between Harvard and MIT, with regard to testing. How has that endeavor gone? And how important is it?

TOM TSAI: Andy, that's a great question. It's an incredible resource for Boston, where I am, and most of the northeast. In fact, the testing that we have through Brigham and Women's Hospital, where I work, through Harvard University, where I work, is all being administered through the Broad Institute. And it's also being scaled across the country.

So the assurance testing alliances, establishing contracts between employers to take the technology from Broad Institute, and offer that to employers and municipalities and schools all across the country. So in the lack of federal response, the private sector and the academic sector has really stepped up. And I think the next phase we'll see is how to scale up these early efforts at testing.