August 12, 2020 – We are in a war against COVID-19, and this fall could be one of the worst from a public health campaign that the US has ever opposed, says CDC Director Robert Redfield, MD.
The emerging coronavirus pandemic, combined with the flu season, could create the “worst case scenario” that “we have ever had,” he said during an interview on “Coronavirus in Context,” a video series hosted by John Whyte , MD, WebMD’s Chief Medical Officer.
Redfield also said the agency’s efforts to understand the virus were hampered by a lack of cooperation from China. He reached out to China’s CDC director George Gao on January 3 to see if the agency could work with health officials in Wuhan to better understand the outbreak. But he never received an invitation, Redfield said.
“I think if we could have come in at that moment, we would probably have learned faster than we learned here,” Redfield said.
Now that autumn is approaching, the severity of the outbreak will depend on Americans who follow CDC guidelines to prevent the spread of COVID-19: wear face masks, stay 6 feet away from others, wash hands frequently with soap and warm water, and be wise about many meetings.
“I ask some of America not to do it – we have to do it all,” Redfield said. This is one of those interventions where 95% to 99% of people have to do it to work, he said.
When asked what Thanksgiving’s pandemic might look like, Redfield recalled the opening of Charles Dickens’ classic novel A story of two cities.
“It depends on how the American people choose to react,” he said. ‘It really is the worst of times as well as the best of times, depending on the American public. I’m optimistic. ”
The same precautionary measures could reduce the transmission of the flu. Globally, the flu is at “lower levels than expected for this time of year,” the World Health Organization reported in its latest flu update. Hand hygiene and social distance have played a role, says the WHO.
Redfield asked Americans to add a fifth precaution to their fall-to-do list: Get a flu vaccine. Last year, about 47% of Americans got one, he said. This year, the CDC aims at 65% compliance. The annual flu season is also hampering hospital resources, and the pandemic will punish them even more. Redfield said the CDC has purchased millions of extra doses to distribute this fall to reduce the number of cases.
“Please do not neglect this important achievement of American medicine,” he said. “This is a year that I’m asking people to think really deeply about getting the flu vaccine.”
Optimism About a COVID vaccine
Redfield said he was “very cautiously optimistic” about having a coronavirus vaccine before the end of the year. Six candidates for vaccine are ‘extremely fast forward’, he said. Three vaccines began with Phase III clinical trials 2 weeks ago. He expects a fourth stage to begin the final stage of tears. The final results of these tests may be available at the end of October or the beginning of November.
“No one can predict scientific success, but we think from a scientific threshold, developing a COVID vaccine is not as complex as … an HIV vaccine,” he said. “I am very optimistic that we will have one or more faxes available.”
The Phase III test subjects are still recruiting tens of thousands of participants, which Redfield expects to be ready by the end of September. Unlike other typical clinical studies, the COVID-19 studies accept elderly patients and people with chronic conditions such as diabetes or heart disease. Children have so far not been included in trials – that will require a follow-up trial later, he said – but researchers are concentrating on adults who have the highest risks of serious illness.
“There will have to be follow-up trials for children under 18,” he said. “But clearly there is currently a comprehensive trial that can accept the people who are most at risk because of comorbidities and age or at risk because of their jobs.”
COVID-19 Still highly infected
Redfield highlighted the fact that “we do not know this virus very well.” SARS-CoV-2, the virus that causes COVID-19, is different from other coronaviruses such as SARS or MERS which do not spread as quickly among humans.
At the beginning of the pandemic, the first cases in the US appeared to be spread among family members who had close contact with each other. But because the cases were widespread in communities across the country, CDC experts began to fully understand how fast the virus went.
“The thing that surprised us the most was how infectious this virus is,” Redfield said.
The other “critical feature” of this new coronavirus is the large volume of spread by people under the age of 50 who have the virus but show no symptoms, he said. More than 5 million cases have been reported in the US, and the CDC estimates that the spread of infection was several times higher. More than 20 million people are likely to have contracted the virus between March and May, he said.
The U.S. has so far recorded more than 160,000 coronavirus deaths, and COVID-19 will end this year as one of the leading causes of death, Redfield said. In April and May, about 20% of deaths in the U.S. were caused by pneumonia, the flu, and COVID-like diseases. Mortality rates are declining, he said, because the disease has been diagnosed earlier and doctors have learned how patients in hospitals can be better managed.
For the rest of 2020, the key is to focus on the steps people can take to reduce the effects of the coronavirus, he said.
“Eventually, this virus will have its day,” he said. “It will either infect a majority of the world’s population, or we will have a biological countermeasure that will become an effective vaccine.”
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