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Dr. Larry Brilliant has been on the frontlines in the fight against disease for decades.
The epidemiologist helped eradicate smallpox, and he's also been involved in the battle against polio and blindness. In a 2006 TED Talk, Brilliant described what the pandemic would look like — and he says the coronavirus pandemic has the potential to infect more people than he predicted.
“I think it has the potential for infecting more than a billion people,” he says. “I'm optimistic that for this particular virus, which has a relatively low death rate compared to smallpox and others, that the death rate would be less than that. But as far as its disruption, yes. It's every bit as disruptive as I feared.”
While a vaccine for COVID-19 could take more than a year to develop, Brilliant says he is optimistic that scientists will be able to reduce the virus’s toll with antiviral medications.
“I'm absolutely confident that we will have an antiviral that works, but it'll take us a little while to know which ones work and which ones don't work,” he says. “I talk always about a vaccine, but it is possible and I'm optimistic that we will find an antiviral that not only is curative but is also preventative.”
Brilliant, who worked on the film “Contagion” as senior technical adviser, says the current pandemic won’t be as horrific as the one portrayed in the film.
“The fictional virus that we created in the movie ‘Contagion’ is far worse than [COVID-19],” he says. “We made that movie in order to kind of refute the sentiment in the country after the swine flu of 2008-2009, where people thought, 'Ho hum, if that's what a pandemic is, I'm not worried.' We wanted to kind of rejigger people's sentiments, so they understood what a real pandemic would look like.”
On how antiviral drugs could cure and prevent COVID-19
“We have one now for HIV/AIDS, and we know that Tamiflu would stop an outbreak of certain influenzas. So we know that antivirals can be used as surrogate or pseudo vaccines. It'll be a lot easier to manufacture billions of doses of an antiviral. I'm hoping that we find an antiviral that is not only curative but is preventative. I'm confident of the former. In the next four months, I'm hopeful of the latter.”
On what the federal government should be doing right now
“We've had such a failure of leadership from the federal government. We should be demanding, I guess, that states and counties have plans for the next two years, their own plans. We should have a Manhattan Project for antiviral drugs, a moonshot for [a] vaccine and ventilators, and especially a real thoughtful plan on when we are going to clamp down with social isolation, quarantine. We don't have any of those things. And really, that's what we've always had in the past from the federal government. And I have to tell you, I miss it.
“I don't think it's going to go on with the intensity that it will go on in the next four months. But certainly, it's going to have a long tail. By the way, I just read that nine out of 10 Americans today are doing something to self isolate, to wash their hands. That's something we can be very proud of. And that's to flatten the curve. But when we flatten the curve, we don't reduce the number of cases of the epidemic in its lifetime. But by pacing it, we reduce the number of deaths because we can care for each case better, and we also reduce the number of deaths from heart attacks and trauma and all the other things that we usually take care of all the time. Yes, I think we need a plan for a couple of years. There'll be a very big difference in 12 to 18 months when we have a vaccine. Then it will be a question of vaccinating everybody as quickly as possible and then mopping up all the hotspots in the world with a measles, smallpox, polio type of almost eradication program.
“I urged President Trump to announce three moonshots: one to get antivirals quicker, two, to get respirators and ventilators made cheaper in the United States right now, and three, to work on test kits and to get so many test kits that they're so cheap, they're done at home like home pregnancy tests. If we do this with the power of the federal government, we create a buying consortium so that industry has a price signal that makes them put in the effort to do a Manhattan Project or a moonshot. These three, they would be able to really stem the tide of this epidemic.”
On the argument that the cure could be worse than the disease because of the economic impact
“I understand where that comes from. I mean, it's so hard to think about the empty streets of San Francisco. You watch the stock market and people are unemployed. Three million people applying for [unemployment]. I understand where that comes from. Unfortunately, it isn't our choice. The virus leads us and ... much like a patient who's sick, taking our medicine now will prevent half of the deaths that we expect otherwise. I mean, if you look at what [University of Washington health statistician Chris Murray] said, 85,000 people dying in the next four months. And if you take a look at the models that are coming out of the Imperial College in England, it suggests that it could be as many as to [2 million], [2 and a half million] Americans who die during the course of this disease. If we practice strong isolation techniques, all the things we know we must do, we'll reduce the number of deaths by at least half. That's a huge number of people to trade off for a short burst of quarantine-like effects. The economy is terribly important, but people are first.”
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This segment aired on March 27, 2020.
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