Hi, I’m Kirk Jowers, and I’m
pleased to host this March 16th episode of COVID-19
with Dr. Russell Osguthorpe. Russ, you’ve been at the
hospital all day. Thank you for taking
the time to do this. You must be exhausted,
but you look pretty good. Thanks. My pleasure. Good to be with you. We’ll start with the graphic
from the World Health Organization. There are now 168,019
confirmed cases, 6,610 deaths, and 148 countries with cases. And is a potentially
significant turning point, there are now more cases
of the virus outside of China than within. The phrase of the days, flatten
the curve, all of these stories seem to rotate
around that phrase. Europe is now the global
epicenter of the virus, according to the
World Health Organization. The Italians remain essentially
under house arrest. Germany is sealing its borders. The Netherlands has ordered
all schools, bars, restaurants, and cafes closed. Similar measures are also in
force in France, the Czech Republic. Austria is prohibiting
gatherings of more than five people. The list goes on and on. What are you seeing, Russ? In Spain, we’ve had a national
lockdown that’s gone into effect. Britain’s health secretary has
recently asked that people over 70 avoid going outside
and stay at home. And Canada recently closed its
borders to everyone except Canadian citizens and
permanent residents. In the United States, the CDC
has recommended gatherings of 50 people or more
be cancelled or postponed. A nd just before we came on, the
White House has further reduced the number to 10, as well as
provided many other guidelines for us to follow. On Sunday, the US Federal
Reserve cut interest rates to essentially zero to try to ward
off another really bad stock day. It didn’t work immediately. US stocks plunged. The Dow tumbles nearly
3,000 points, the worst point drop in history. Businesses are,
of course, affected. Many retailers, including Nike,
Apple, and REI, are temporarily closing their retail stores. In the United
States, following President Trump’s recommendations,
operations of bars and restaurants are being limited, and hotels resorts are
announcing closures. Airlines have slashed their
flight schedules and are asking for government assistance now
in the United States. And there are multiple cruise
ships that are stranded, looking for port. It’s pretty astounding on any
one of these we could focus for a half hour on
the implications and why, but I want to get to, I think,
what is the unique benefit of having you with us is to help
us understand a few things each day. Let’s start with China. Yesterday, it was reported they
had only 20 new cases. Yes. Dramatic downturn from
thousands of new infections a day. So is China largely
past the COVID-19 fears? What can we learn from China—
China’s timeline for the rest of us? There have been a lot of
headlines that and folks talking about China being
through the worst of it. We have seen this dramatic drop
in positives out of Wuhan province in Hubei, and I think that’s very
positive and is largely due to the measures that the public
health sector in China and government have used to flatten
the curve there. And so this is evidence that
social distancing and flattening the
curve actually works. Do we feel like, and now I’m
probably asking for more commentary than facts. But quickly, if—we’re seeing
some reports that China’s easing up on all of the things
they did to flatten the curve because the curve has been
flattened there for the moment, and in the past, when you’ve
dealt with things like this, do we expect it to stay down as
China—like, okay one down? Or is it going
to happen again there? That’s a great question. I would say that because
Coronavirus or COVID-19 is new, we don’t really know what’s
going to happen next. But, you asked me because of
what’s happened in the past with pandemics. The most applicable, for me,
would be what happened in 2009 with the H1N1 pandemic. With that pandemic, there were
measures that were instituted worldwide to try and slow the
spread of the virus, nothing to the scale that like
we have done with COVID-19, but we tried to
limit the spread of H1N1. And it worked. But instead of this nice,
kind of, flat curve that we see idealized in so many graphs, in 2009, H1N1, most countries
experienced multiple peaks of illness throughout the year. I’m not sure if that’s what
will happen in China. But if you’re asking for
my opinion, based on the fact that a large—well the whole
earth’s population is susceptible—for the most part—
to this virus, I would expect there to be
multiple outbreaks of the virus throughout the year, and that as we both Institute
and then relax social distancing or public health
measures to slow the spread of the virus, when we relax, the virus will kind of flare, and we will see secondary
outbreaks of the virus, even in populations where we’ve
seen a decrease. But that’s my opinion. I’m not sure
if everyone shares it. But we’ve we saw
that with 2009 H1N1. It’s comparing apples
and oranges, but it’s the best we’ve got. Well, on that front, some of
the big medical news over the weekend is that infected people without
symptoms might be driving the spread of Coronavirus
more than we realized. What do we know there? Well, there are limited reports
coming out of virology labs, suggesting that people who
become infected can shed the virus before they get symptoms
of the virus, and that becomes problematic
because if we can spread the virus—so shedding and spreading
are not the same thing. All right. But if you can spread the virus
or infect others, if your ability to transmit the virus
occurs before you have symptoms of the virus, then social distancing
is not as effective. However, we know from China,
based on what they’ve done, that social
distancing is working. So I believe that you are most
effective at spreading the virus when you
are most symptomatic. And these reports of being able
to spread the virus when you are asymptomatic are real. We need to digest
them and understand them. But right now, I think the
lion’s share of spreading of the virus is occurring when
people are symptomatic. Small amounts of transmission
of the virus will occur, potentially before you’re
symptomatic and after your symptoms have resolved, but for the most part, it’s
going to be right in the middle, when you have that
fever and cough and shortness of breath. Big question is will the
prevalence of the Coronavirus naturally dissipate once the
weather gets warmer, and a side question is can it
even thrive in warm, hot weather? I’ve seen those reports. I’m not so certain that warm
weather will decrease the spread of the virus. What may decrease the spread of
the virus is the fact that many of our institutions like school
will close in the summertime, and we’ll see smaller groups of
people coming together all the time instead of groups or
classrooms of 30, we’ll be at home and roughly
playing in smaller groups, less than 10—for
example—all summer long. In 2009, we saw a summertime
outbreak of illness, and it went against the grain
of our normal influenza outbreak that we normally
experience every winter in both the southern and
northern hemispheres, but I don’t know the
answer to your question, Kirk. I would say that we hope that
warmer weather will decrease transmissibility because the
virus is an enveloped virus, and if the virus lands on a
surface and it’s really hot in the middle of the summer, that
the virus will immediately “die” and not be
able to infect others. But we don’t know yet, and
we’ll find out as time moves on. The second question is—in an
earlier episode you’d mentioned that there’s not yet a medical
cure for COVID-19, as a novel coronavirus. But are there home remedies
available that can cure or prevent the virus? No. Right now, to the best of
our understanding, there are not any methods of
curing COVID-19, or treating COVID-19, other than
social distancing and preventing yourself from
getting infected. It is important to remember
that most people who get infected, even after we’ve
started looking at the outbreaks that have occurred
in Asia, we are seeing that most folks
who get infected have mild disease. Like most coughs and colds,
there are not real, proven remedies to treat Coronavirus. Thank you. And finally, you mentioned some
new research finding on kids and COVID-19. What are you learning there? Yeah, we’re learning that, in a
study that is in preprint for children out of the
Chinese outbreak, we saw that kids were
definitely infected with the virus and that they could
transmit the virus, but the vast, vast vast
majority of them have mild disease and that person-to-
person transmission was effective in children. And those are really good
epidemiologic points for us to understand about Coronavirus, which indicate that social
distancing works at helping to slow the spread of the virus. Well, thank you so much. Any final advice for today? No. Try and combat panic with
information and kindness to one another. Take care of each other,
and be kind to one another. We’ll have to be patient
as we go through this. It’s probably, as we’ve heard
from other world leaders, going to get worse
before it gets better. And that means that we just
need to take care of each other as we go through it. Thanks everyone. We’ll see you tomorrow