WHO walks back coronavirus asymptomatic transmission claim

Yale Professor of Medicine and Director of the Yale New Haven Hospital Center for Outcomes Research and Evaluation Dr. Harlan Krumholz joins Yahoo Finance’s Heidi Chung to discuss the WHO's latest comments on asymptomatic COVID-19 carriers.

Video Transcript

HEIDI CHUNG: For more on COVID-19, I do want to bring in our next guest Dr. Harlan Krumholz, who is a Yale professor of medicine and director of the Yale New Haven Hospital Center for Outcomes, Research, and Evaluation. Doctor, I first want to get your thoughts and reaction to what we just heard from Anjalee's interview with Dr. Fauci just in terms of testing here in the US and that getting better than a couple months ago.

HARLAN KRUMHOLZ: Well, you know, I have a lot of admiration for Dr. Fauci and I agree fully that things are a lot better than they have been. But I'm not satisfied that they're as good as they need to be. We need better tests, we need tests with fewer false negatives, they need to be more widely distributed. And importantly, we need to figure out how we're going to pay for them. I know that in Connecticut, there's a lot of concern about who's going to pay for all these tests.

So we were in the beginning in a moment where we needed to have more supply. And as that supply is increasing, we need to also be understanding how that's going to be paid for and how people are going to get access to it. We also need to change a mindset. The mindset needs to change where we need to be doing a lot more testing. There are places that actually have capacity that's unused.

So we need to be able to say, who are we getting into testing, how are we getting frontline providers, people who are in a position where they're interacting with the public to be sure that we are testing and that we're also testing asymptomatic as well as symptomatic people. That we're focusing on really understanding the spread of the virus and working hard to break this chain of transmission.

So I fully agree-- we've got a lot more testing than we've had. We have a ways to go. We want to see saliva tests. We want to see easier testing and better testing, but we're better than where we were. But we also need to be understanding the finances, who's paying for the testing, and we need to be able to be mobilized so we're actually now doing the testing. So the test availability is just one part. The other part is getting the public to be tested.

HEIDI CHUNG: And doctor, you mentioned asymptomatic. And on that front, yesterday, the World Health Organization saying that actual transmission of COVID-19 through people that are asymptomatic is, quote, "rare, " but then today, the WHO taking back those comments a little bit, walking it back, saying that these are very complex issues, and so much is still unknown. So I want to get your thoughts on what the WHO is trying to say here in its messaging.

HARLAN KRUMHOLZ: Yeah, so this was a soundbite that got amplified and I think widely misunderstood that they began to walk back today. So the message yesterday was that it's not really being spread by asymptomatic people. We need to focus on people who are symptomatic. But that was a small comment within the context of a press conference, where somebody commented that they thought it was very rare that asymptomatic people spread it.

I think there was a lack of appreciation for just how powerful those words might be and how they might be interpreted globally. Immediately, I think experts stood up and said, we really don't know when in fact, people who are asymptomatic are shedding virus. And there's a concern that they are a major vector. They're a major means by which the virus gets spread. And that could be occurring among children, among young adults, people who aren't affected very much by the virus, but in fact, are ones that are out in the public interacting, and could be the ones who are then infecting other people.

And I think as that was being recognized and as that feedback was coming back to WHO, they said, well, wait a minute, that's not what we meant. We think there's been a misunderstanding, a miscommunication. And I think there was a large scale admission that in fact, the science if anything, is suggesting that there's a large number of people who are either presymptomatic-- they're infected but they haven't yet developed symptoms-- or people who will never develop symptoms, but in fact, are carrying the virus and are likely to be infectious. Whether they are the main means by which people get infected or whether or not they are contributing means there's a large number of them.

And so we have a lot more to do to understand this. But we certainly want to-- would not want to send the message that if you don't have symptoms, you're not possibly able to infect other people. Right now, the conventional wisdom among experts is that that is a major means by which the virus could spread. That's why this virus is so sneaky. That's why it's so hard to eradicate. Because there are many people who don't know they're spreading the virus who have it. And so that's why we're focusing on masks and protection and testing-- because of that-- precisely because of that.

HEIDI CHUNG: And Doctor, I just want to get your thoughts. Just looking at the infection rate here in the US, a lot of states really pushing along their reopening plans. We had New York City officially announcing it's phase one of reopening yesterday. And New Jersey moments ago lifting its shelter in place orders, as well. But when we take a look at other states that's starting to reopen sooner such as Texas, it's starting to see a large uptick in hospitalizations as a result of the COVID-19 virus. So in that sense, Do you think that this pace of reopening is OK?

HARLAN KRUMHOLZ: So we're-- we're nowhere near through. It's not that we're all of a sudden on the other side of the pandemic and now we can relax. This is a moment for us to see what we can do to reduce risk. Look, we can't stay in suspended animation forever. We can't keep our economy closed forever. But the real question is, what can we do to reduce risk and how can we be smart about it?

So can we re-engage in society, but wear masks? Certainly, that's going to reduce transmission. It makes a lot of sense. The science suggests that it is the right thing to do. Can we avoid very large gatherings of people who not wearing masks and potentially are spreading it to each other? Being outside is probably lower risk than being in enclosed spaces.

We need to be smart about how we're reengaging in society. And I think the geographic locations that aren't putting people in so you're locked up forever, but are allowing them to reemerge into society, allowing society to reopen gingerly, judiciously, with wisdom are going to be the winners in the end. And ones that disregard any of the guidance and are really going out with abandon are the ones placing themselves at risk.

Will they get away with it? I don't think so, but time will tell. But-- but it would seem more prudent to one, allow economy to open up, but do so in ways that maintain the safety. We're not going to decrease the risk to zero. And that shouldn't be our goal. But we can decrease the risk substantially the people if we just take a few wise steps. A lot of testing, masks, and knowing that we really shouldn't be in large unprotected groups together where virus can spread with abandon.

HEIDI CHUNG: And Doctor, I want to get your thoughts on the potential seasonality of this virus. So a lot of people have been talking about the fact that we could see lower numbers of infections in the summer, but then an uptick come fall. And if that coincides with the seasonal influenza, what could that mean for America and the world, I suppose? I want your thoughts on that.

HARLAN KRUMHOLZ: Yeah, this is a really interesting theory. And of course, these viruses, many of them have a seasonality to them, including influenza. And-- and to tell you the truth, even at the best levels of academia, there's still a lot of controversy about what causes this seasonality, the degree to which its behaviors or environment or exposures. But we definitely know that there are many viruses that are seasonal.

We're not sure about this virus, yet, and it's possible that there's a reopening, but we don't see the kind of spikes that we might have expected because in the summer, this is just not as active as it is in the false and spring and winter. And we'll have to see.

I think the most prudent thing, the wisest thing for us to do is to prepare for a fall that could be. We need to have plans in place. We need to be prepared behaviorally and structurally and organizationally. And by the way, we need to make sure our population gets the flu-- flu vaccination. We need to be prepared to ensure that we're not getting a double whammy with the cold virus, with the SARS-CoV-2 virus and with influenza.

So we have to be prepared, geared up. We have to be smart about this. And that means that we have to prepare for a lot of different eventualities. We have to get society geared up. We have to get the public in the right mindset. And again, not to tell them that they have to just stay in their homes. We have to be able to make it so it's safe to go out. But we need to be prepared as a society to say that we want to try to keep people safe as possible.

If we get a second wave, it will be devastating to the economy. So it's not just for people's health, which is probably the most important thing, but it's also for our society as a whole. We have to be prepared to mitigate what could come in the coming months.

HEIDI CHUNG: Doctor, thank you so much. Such good insights. That was Dr. Harlan Krumholz, Yale professor of Medicine.

HARLAN KRUMHOLZ: Thank you.