COVID-19: Straight Talk about Testing, Potential Cures, & Reopening the Economy

“It’s just not what I expected. I thought there would be some sort of, we did all these tabletop, in my job, you do all these tabletop meetings where you go through, like, a pretend pandemic, and you sorta figure out where the weaknesses are and where the strengths are. And in every one of those, there’s a centralized governmental, organized facility for distributing supplies, distributing resources, and like, a couple weeks in, the Defense Production Act kicks in, and everybody starts getting their stuff, and we’re just not seeing that. And I don’t understand why the cries from the front line of, this is not enough, I don’t have enough, there are a lot of places that are re-using N95s, which is, I don’t think, a great idea. And I don’t understand why those are not being heard in a way that has resulted in mobilizing America like America can mobilize. I just don’t get it.”

“So there’s, like, a new vision about these drugs every week as we learn more. At first it was Kaletra, a medication used to treat patients with HIV. And that was tried a lot in China and Italy without as much success as people had hoped there would be. Then there was remdesivir, which we are using. And remdesivir actually looks pretty good. And we’re part of the remdesivir trial, and many of our patients are being put onto that trial and are getting remdesivir if they qualify for it, if they qualify for the trial.”

“Oh, I’m hoping it’ll come sooner than later. But I think a year is really short for a vaccine. Flu, I know H1N1 in 2009 had a vaccine sooner, but that’s because it’s just another kind of flu, and we have a system, it’s a whole, like, method set up and ready to run every year for influenza vaccines so you can just harness it and make another flu vaccine. And you know how to do it. But that’s not true for this. And so we’ll probably have a vaccine to try in the late winter, maybe, I heard maybe a little earlier. I don’t know. I think it’s not for certain that that vaccine’s gonna work. There’s gonna be a lot of candidate vaccines out there.”

“And we are trying to figure out a model that will help us understand how to be more precise about what needs to stay closed and what needs to happen, what places shouldn’t be open and what places should be open in order to maximize the benefit for the economy while minimizing the health impact. And I think we need a better tool than just a sledgehammer to, like, close everything all at once. I think that’s really obvious. But we also need more epidemiologic data in order to inform those models. And we don’t have it without widespread testing and without sort of a better understanding of the mortality in the US and what happens, and how much, what really does overwhelm our health system. And then being able to rationally distribute ventilators and supplies so that they’re where they need to be, and healthcare workers so that they’re where they need to be at the right time to enhance our ability to take care of these patients.”

”I think as long as the restaurants are being careful and not allowing sick people to work, I think that’s a key piece. You gotta make sure that people are not sick. I think using fabric masks like the CDC is now recommending is actually really important for that because it helps keep your respiratory secretions, your droplets that you make every time you talk and breathe, off of whatever you’re doing, like the computer that’s in front of me, or the shared workspace if you’re going to an essential workplace. And so that’s the sort of thing that will help protect people and make food safe. Hot food is, heat is deadly to coronavirus. And so hot food, I think, is actually pretty safe.

“But the real benefit of those fabric masks is that they help hold your droplets in the mask. They’re actually much better at that than they are at filtering out other people’s droplets. But if everybody is wearing one, then it’s not so much about protecting me. I’m not wearing the mask to protect me. It does provide about 50 to 70% of the protection of a traditional surgical mask, so it’s not nothing. But it’s really I’m wearing it about to protect other people. So when I put that mask on my face, if I get sick in two days because, I don’t think I’m gonna get sick in two days, but what if I do? And I go to the grocery store today and I’m picking out which produce I want, and some of my respiratory droplets are landing on that produce. If I’m wearing my fabric mask, that’s not gonna happen. And so no one’s going to be able to pick up a few viruses from my produce that I’ve picked over in a couple of days.”