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The World Health Organization announced this week the highest number of new COVID-19 cases in a single day since the pandemic began: 106,000.
In the U.S., deaths from the disease reached at least 95,000 with at least 15 states still showing increases. But there are bright spots, too: a promising vaccine, antibody and other drug trials, at least 15 states with decreasing cases and fledgling attempts to open the economy.
Dr. Sanjay Gupta, CNN's chief medical correspondent, says more testing is going to reflect the increasing number of cases in some states, “but not entirely.”
“I think what we're seeing here is actually more people also becoming infected,” he says. “This is a snapshot in time from probably two or three weeks ago between the time people are exposed to the time that they get tested, the time they may develop symptoms, if they're going to develop symptoms. There's a lag time.”
While Gupta admits the pandemic is an “awful situation” that the world is all dealing with together, he is hopeful that we will come out on the other side.
“As a doctor, I'm operating all week in the hospital, and I take care of patients who suddenly find out they have a medical problem that's significant, and it's the only thing in their lives they can think about,” he says. “I mean, we're dealing with this as a world right now. We are going to get through it. It's going to take time.”
On coronavirus antibodies and immunity
“I will go out on a limb and say that as a general rule, when people become infected and then they recover, they should have antibodies in their blood and that antibodies should provide some level of protection. What we don't know is how long or how strong that protection is. So if you take the situation of the USS Roosevelt and those sailors, were the tests which, you know, sometimes have a high rate of false negatives, as we know, showing a negative result when in fact they were positive? Sometimes when people test positive, again, it's not necessarily that they have active virus. It just could be remnants of virus.
“We don't know for sure, but I think we should not deviate from what we've known scientifically for some time, that there should be some level of protection. We just don't know how long or how strong. Now, one point I think is very fundamental is that when you look at a vaccine trial, in addition to looking for antibodies, you're also looking for efficacy. That's a principle called neutralizing antibodies. And what we've shown now in some of these trials very early is that there is evidence of neutralizing antibody effect. That's significant. We haven't even found that after 40 years with HIV vaccines.”
On the promising vaccine being tested by Moderna
“There's two things. One is that had it not shown antibodies, that would have been definitive. We would have known that it didn't work. As we've said with HIV vaccine trials for 40 years didn't work. Here now you at least have proof of concept. Is it going to work in larger groups of people? These are young, healthy people for the most part. Will it work in older people? Will it last that long? In essence, this is still a chance that even if it works scientifically, it may not work practically in the population.”
On why some people develop severe cases of COVID-19 and others do not
“I've spent a lot of time looking at the various routes of entry … of this virus into the human body. And the study that came out looking at what's called the ACE2 receptors said basically there's fewer of those in children as compared to adults. That's one route of entry. We do know that kids, even if they're not getting sick, can still be harboring the virus and still spread the virus. It's a concerning point because it's going to dictate a lot of policy with regard to schools and things like that in the fall.
“When people get very sick and if they die, it can really be for a few different reasons. In people with weakened immune systems, it can be that the virus just was able to replicate unchecked and eventually overwhelm the body. In people who are otherwise healthy, it could be that their body is sort of overreacting to the virus. Think of it almost like an anaphylactic reaction with an allergy. And in that case, it's the inflammation itself, this cytokine storm, that basically is causing people to get very sick and die.”
On the Columbia University study showing implementing social distancing one week earlier could have saved about 36,000 lives
“That does also assume that as states locked down earlier, that people would have been on board. You remember in the early days, people were hearing about this, but I think in the early days, people really weren't taking it very seriously. And I think it wasn't until the NBA announced they were suspending the season that a lot of people [started to take it seriously].
“But there's two points, really. One is that we're not through with this pandemic, unfortunately. And I hate saying it ... come fall, we may be sort of looking at some of these same decision matrix views again. Are we going to do it early enough? I think that people [should] remember the study coming out of Columbia and Jeffrey Shaman's work at that time because I think it's going to be important to not lose that lesson.
“You remember that South Korea, which is admittedly a much smaller country — one-sixth, one-seventh, the population of the United States — had their first patient diagnosed on the same day as we had our first patient diagnosed in the United States. The total number of infected is around 11,000 and the total number of people who have died is under 300. Not under 3,000, under 300. Why? Because they acted early. They tested with an existing test, the World Health Organization test, which we had access to as well. And they did implement some of these movement restrictions as well early. It can be done. And we should keep that lesson in mind because we may be dealing with this for some time to come.”
On the importance of following Centers for Disease Control and Prevention guidelines for reopening
“I mean, there is a virus circulating. It's a contagious virus. I mean, that hasn't changed. CDC, thankfully, has now ... 60 pages of guidelines. You're going to have to approach it differently than in the past, as everyone knows. Be prepared. Don't blow this off and read those guidelines.
“It seems to be primarily person-to-person contact. So it's the distance, but it's also duration. You'd be six feet away from somebody for two hours, that's worse than being six feet away from someone for five minutes. There's also the type of activity that's going on. So there's lots of different considerations. I like the way [former CDC director Dr. Tom Frieden] put it. We should get to the point where you have to decide, are you going to take an umbrella to work that day or not based on all the various data that you can take in?”
On why it’s important to continue social distancing and other measures to stop the spread
“It's just very hard to say, 'Hey, look, I don't want to go through the treatment. I just want to get better.' That's just not the way that it works. You can't abandon treatment partway through and then get upset that we're not getting better. What I would say is that right now, the idea of how we behave is not only a potential risk for ourselves, but for the people that we love. I think about it every time I come home from the hospital. Do I have the virus? Could I potentially be infecting my three little girls? That is just [the] time period in which we live. We will get through it. We've seen countries get through it. It's like saying, 'I got patients who have gotten through the therapy. Let me introduce you to these patients. It might make you feel better.’ Not right this second, but at least you see that light at the end of the tunnel. We'll get there. We just got to make sure we do it right.”
This segment aired on May 21, 2020.
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