PANDEMIC WAVES OF ATTACK ACROSS THE U.S.

ONLY OPTION TO CONTROL SPREAD RIGHT NOW IS SOCIAL DISTANCING, SAYS INFECTIOUS DISEASE TRANSMISSION EXPERT PITZER

SAYS WE MAY GET INTO PATTERN OF HAVING REPEATED NEED FOR DISTANCING UNTIL ENOUGH PEOPLE HAVE IMMUNITY  

PITZER: VACCINE IS ULTIMATELY NECESSARY TO CONTROL COVID-19 IN THE LONG RUN

Federal and state officials say that large pandemics usually happen in three waves. COVID-19 is already in its third wave in the U.S. as it makes its way across major cities. First came cases on the West Coast, in Washington state. Next, New York City. Then onto Detroit, New Orleans, Chicago and Atlanta. With COVID-19 case numbers climbing and millions sheltered in their homes to slow the spread — many are asking the obvious question: How long will this last? Virginia Pitzer, who is an expert in infectious disease transmission, joins us to help answer that question.

Aired on April 7, 2020. 

TRANSCRIPT

WELCOME TO 'METRO FOCUS' I'M JACK FORD.

SINCE THE WORLD IS BESIEGED WITH THE CORONAVIRUS WE STRUGGLE WITH WHEN MIGHT IT END, HOW MIGHT IT END, ANSWERS TO THESE QUESTIONS ARE COMPLEX AND ALLUSIVE, SO WE HAVE DONE WHAT WE ALWAYS DO, WHICH IS TURN TO SCIENCE TO HELP US IN THIS STRUGGLE.

WE'RE DELIGHTED TODAY TO HAVE JOINING US ONE SUCH SCIENTIST WHO HAS DEVOTED HER PROFESSIONAL LIFE TO THESE TYPES OF JURISSUE RESEARCH WRITINGS, WE'RE DELIGHTED TO HAVE AN ASSOCIATE YALT PROFESSOR AT SCHOOL OF HEALTH AND AN EXPERT ON THE DYNAMICS INFECTIOUS DISEASE TRANSITION.

THANK YOU FOR JOINING US.

THANK YOU FOR HAVING ME.

LET ME START WITH THE OVERARCHING QUESTION, WHICH IS THE WHEN QUESTION.

WE HEARD SPECULATIONS OF WEEKS, MONTHS, EVEN YEARS SHALL AND WE HAVE TO UNDERSTAND THERE'S SO MANY VARIABLES INVOLVED HERE BUT GIVEN THE RESEARCH THAT YOU'VE DONE OVER THE YEAR AND LOOKING AT THE SCIENTIFIC MODELS THAT YOU'VE SEEN WHAT'S THE BEST SENSE OF PROBABILITIES OF THE TIME PARAMETERS THAT YOU CAN OFFER FOR US?

I THINK THAT WITH THE CURRENT WAVE OF CASES THAT'S OCCURRING RIGHT NOW THAT WE'RE PROBABLY LIKELY TO SEE A PEAK OCCURRING AT LEAST IN PLACES LIKE NEW YORK AND CONNECTICUT AND THE PLACES WHERE THE DISEASE IS REALLY SPREADING, KIND OF A LOT RIGHT NOW, IT SEEMS LIKE SOME OF THE SOCIAL DISTANCING MEASURES THAT HAVE BEEN PUT INTO PLACE ARE STARTING TO HAVE SOME AFBLGT AND THAT WE MAY SEE A PEAK OCCURRING IN SOME CASES IN THE NEXT FEW WEEKS BUT WHEN IT COMES TO THE WIDER QUESTION OF WHEN THIS MIGHT PEAK ACROSS THE U.S., I THINK A LOT OF IT DEPENDS ON WHAT CONTROL MEASURES ARE PUT INTO PLACE, HOW QUICKLY THEY MAY HAVE AN AFBLGFECT AS AND HOW IMMUNITY COMES INTO PLAY TO LIMIT TRANSMISSION.

YOUR AREA HAS BEEN THE IMPACT OF INTERVENTION ON THE SPREAD OF DISEASES, WITH THAT AS YOUR BACKGROUND WHAT FACTORS WILL SPECIFICALLY IMPACT THE -- THIS PANDEMIC, AND WHAT IT MIGHT COME TO AN END?

I THINK THERE'S A NUMBER OF DIFFERENT FACTORS THAT REALLY KIND OF COME INTO PLAY.

PART OF WHAT WE'RE DOING NOW AND REALLY I THINK THE ONLY OPTION THAT WE HAVE NOW FOR CONTROLLING THE SPREAD OF THE SARS CORONAVIRUS IS TO INSTITUTE THESE SOCIAL DISTANCING MEASURES THAT REALLY ARE INTENDED TO PREVENT PEOPLE FROM CONTACTING OTHER PEOPLE, LIMITING THE NUMBER OF CONTACTS PEOPLE HAVE, SUCH THAT THEY'RE NOT SPREADING IT AS WIDELY WITHIN THE POPULATION.

AS THE NUMBERS START TO GO DOWN AND WE GET MORE OF A HANDLE ON TRANSMISSION THAT'S OCCURRING, INCREASING OUR TESTING CAPACITY SUCH THAT WE CAN IDENTIFY CASES AS EARLY AS POSSIBLE, MAKE SURE THOSE INDIVIDUALS, WHETHER THEY'RE HAVING SEVERE SIYMPSYMP OR NOT, ARE ISOLATED, STAYING HOME, NOT CONTACTING OTHER PEOPLE, AND THAT THE PEOPLE THEY'VE COME INTO CONTACT WITH STAY HOME, BECAUSE THEY COULD POTENTIALLY BE SPREADING IT WITHOUT KNOWING IF THEY ARE INFECTED.

TO SOME THAT MIGHT SOUND COUNTER INTUITIVE.

YOU SAY AS THE NUMBERS GO DOWN IT'S IMPORTANT WE INCREASE TESTING.

WHY IS THAT SO, JUST EMPHASIZE THE SIGNIFICANCE OF THAT.

I THINK WE NEED TO BE TESTING A LOT MORE NOW, BUT I THINK THAT THE FIRST WAY TO REALLY GET THINGS UNDER CONTROL IS JUST TO CLAMP DOWN AS HARD AS POSSIBLE ON EVERYONE TO LIMIT TRANSMISSION JUST BECAUSE A LOT OF THE CASES THAT ARE CONSIDERING TODAY ARE REALLY REFLECTING TRANSMISSION THAT OCCURRED ONE OR TWO WEEKS AGO SO IT IS A BIT DIFFICULT TO GO BACK NOW TO THE CASES OCCURRING NOW TO SAY WHO WAS IT YOU WERE IN CONTACT WITH ONE OR TWO WEEKS AGO WHEN YOU MAY HAVE FIRST STARTED TO EXPERIENCE SYMPTOMS CAN OR EVEN BEFORE YOU STARTED TO EXPERIENCE SYMPTOMS, THERE'S SOME EVIDENCE PEOPLE WILL STILL BE INFERKS -- INFECTIOUS WITH THIS VIRUS.

I THINK BECAUSE THE INFECTION SEEMS QUITE WIDESPREAD AT THE MOMENT SOME OF THE MORE AGGRESSIVE SOCIAL DISTANCING MEASURES ARE REALLY NEEDED.

ONE OF THE QUESTIONS IS AS WE START TO RELAX STRICT SOCIAL DISTANCING MEASURES CAN WE THEN KEEP IT UNDER CONTROL WITH THE TARGETING TESTING, QUARANTINE CONTACT SITUATION..

EXPLAIN THE CONCEPT OF IMMUNIZATION AND HOW THAT CAN ENTER INTO THE EQUATION HERE OF WHEN THIS ENTIRE PANDEMIC MIGHT COME TO A CONCLUSION.

YEAH, SO I THINK THAT ONE OF THE REALLY NEED KIND OF IMPORTANT AND SOMEWHAT , YOU KNOW, DISCONCERTING THINGS RIGHT NOW IS THAT AS WE START TO LIFT SOME OF THE STRICTER SOCIAL DISTANCING MEASURES, IT MAY BE THAT WE SEE MORE CASES START TO INCREASE AGAIN BECAUSE NOT ENOUGH PEOPLE HAVE BEEN INFECTED AND NOT EVERYONE'S GOING TO HAVE IMMUNITY TO THE DISEASE.

SO WE MAY GET INTO THIS PATTERN OF HAVING REPEATED NEED FOR SOCIAL DISTANCING UNTIL WE GET TO THE POINT WHERE ENOUGH IMMUNITY HAS BUILT UP INTO THE POPULATION THAT INDIVIDUALS WHO ARE INFECTIOUS ARE MORE LIKELY TO COME INTO CONTACT WITH SOMEONE WHO ALREADY HAS IMMUNITY AND THEY'RE NOT ABLE TO SPREAD IT EFFECTIVELY.

BUT ULTIMATELY I THINK WHAT WILL BE NECESSARY TO REALLY CONTROL THE DISEASE IN THE LONG RUN IS TO DEVELOP A VACCINE AGAINST THE SARS CORONAVIRUS SUCH THAT WE CAN IMPART THAT I AM -- IMMUNITY TO INDIVIDUALS AND PROTECT THEM WITHOUT THE NEED TO HAVE TO ACQUIRE THE VIRUS THEMSELVES.

KWAE HEARD EXPERTS TALK ABOUT THE PROSPECT OF A SECOND WAVE AND PERHAPS EVEN A THIRD WAVE OF THE CORONAVIRUS PANDEMIC THAT WE'RE STRUGGLING WITH NOW.

SO PEOPLE UNDERSTAND, WE'RE NOT TALKING ABOUT PAY WAVE MEANING WORKING FROM THE EAST COAST TO THE WEST COAST, WE'RE TALKING ABOUT A GLOBAL WAVE.

EXPLAIN THAT TO US AND EXPLAIN THE PROSPECTS OF IT.

YEAH, SO, I MEAN, THERE'S A VARIETY OF DIFFERENT REASONS WHY WE MIGHT START TO SEE MULTIPLE WAVES OF CORONAVIRUS HAPPENING.

ONE IS THIS IDEA BEHIND THE LIFTING OF SOCIAL DISTANCING MEASURES AND IF WE DON'T HAVE ENOUGH IMMUNITY IN THE POPULATION, IF WE GOT PAST ONE PEAK OF THE EPIDEMIC IS, KNOCK DOWN INFECTIONS, IF WE DON'T GET RID OF IT COMPLETELY GLOBALLY IT IS POSSIBLE BECAUSE THERE'S NOT ENOUGH IMMUNITY IN THE POPULATION AS THE VIRUS STARTS TO TRANSMIT YOU COULD SEE A SECOND WAVE HAPPENING.

ANOTHER POSSIBILITY IS ANO ANOTHER -- A NUMBER OF RESPIRATORY VIRUSES DON'T TRANSMIT AS WELL IN THE SUMMER, COULD BE IN PART BECAUSE SCHOOL KIDS PLAY A PART SPREADING THE FLU, WE DON'T KNOW THEIR ROLE IN SPREADING THE SARS VIRUS, BUT BECAUSE KIDS ARE NO LONGER IN SCHOOL IN THE SUMMER WE TEND TO SEE A DECREASE IN FLU CASES IN THE SUMMER.

ENVIRONMENT CONDITIONS ARE KNOWN TO AFFECT THE TRANSMISSION OF RESPIRATORY VIRUSES LIKE FLU WHERE FLU DOESN'T TRANSMIT AS WELL WHEN HUMIDITY TENDS TO BE HIGH AS IT IS IN THE SUMMER, SO WE MAY SEE LESS TRANSMISSION IN THE SUMMER PARTLY BECAUSE OF THE ENVIRONMENTAL CONDITIONS AND PARTLY BECAUSE KIDS ARE OUT OF SCHOOL.

AND WHEN KIDS GO BACK IN THE FALL AND ENVIRONMENTAL CONDITIONS BECOME MORE FAVORABLE AGAIN TO THE TRANSMISSION OF THE VIRUS THAT'S ANOTHER REASON WHY WE MIGHT EXPECT TO SEE A SECOND WAVE OF THE VIRUS COMING SOME TIME IN THE FALL OR WINTER MONTHS POSSIBLY.

AND THEN ANOTHER POTENTIAL REASON BEHIND WHY WE TEND TO SEE, SAY, YOU KNOW, MULTIPLE WAVES OF FLU HAS TO DO WITH JUST IMMUNITY WITHIN THE POPULATION.

THE TIME FRAMES ON WHICH WE MAY GAIN IMMUNITY FROM PREVIOUS INFECTION BUT THEN LOSE THAT IMMUNITY OVER THE COURSE OF A YEAR OR MORE.

WE'RE TALKING WITH DR.

VIRGINIA FITTERS, DOCTOR OF MEDICINE AND EXPERT IN SPREADING OF INFECTIOUS DISEASES.

WE TEND TO LOOK FOR COMPARISONS IN OUR LIVES, THIS IS WHAT WE HAVE NOW, THIS IS WHAT WE CAN LEARN FROM WHAT HAPPENED IN THE PAST.

OFTEN TIMES YOU HEAR PEOPLE SAY HERE'S WHAT HAPPENS WITH SARS, HERE'S WHAT HAPPENED WITH MERS, HERE'S WHAT HAPPEN IN 1918.

ARE THERE IN FACT HARD PARALLELS TO WHAT WE'RE EXPERIENCING NOW TO ALLOW US TO MAKE PREDICTIONS IN THE FUTURE?

OR IS THAT NOT AT ALL POSSIBLE?

I THINK THERE ARE POTENTIALLY SOME PARALLELS.

-- THIS VIRUS IS QUITE DIFFERENT FROM THE 2003 SARS EPIDEMIC THAT OCCURS MOSTLY IN ASIA AS WELL AS IN CANADA WHERE WITH THAT VIRUS MOST INDIVIDUALS WHO WERE IN INFECTED ACTUALLY HAD VERY DISTINCT SYMPTOMS AND ENDED UP GETTING VERY SICK AND THEY ALSO DIDN'T SEEM TO TRANSMIT THAT VIRUS UNTIL RELATIVELY LATE IN THEIR COURSE OF ILLNESS, UNTIL THEY WERE PRETTY SICK WITH THE PARTICULAR DISEASE, AND BECAUSE OF THAT, IT WAS RELATIVELY EASIER TO CONTROL THAT SARS VIRUS BECAUSE WE WERE ABLE TO IDENTIFY CASES, ISOLATE CASES, AS WELL AS QUARANTINE WHEREAS WITH THIS VIRUS IT MAY BE THAT UP TO 60% OF INDIVIDUALS NEVER REALLY EXPERIENCE THE SEVERE SYMPTOMS OR THE DISTINCT SYMPTOMS THAT WE ASSOCIATED WITH COVID-19.

AND IT'S ALSO SEEMS LIKELY THAT INDIVIDUALS MAY BE INFECTIOUS WITH THE VIRUS OR THEY START TO EXHIBIT SYMPTOMS SO IT BECOMES MUCH MORE DIFFICULT TO CONTROL THE DISEASE THROUGH THOSE CASE ISOLATION AND QUARANTINE MEASURE THAT'S WERE INSTITUTED WITH SARS.

AND SIMILARLY WITH MERS MOST INDIVIDUALS WILL BE SYMPTOMATIC WITH THE DISEASE AND IT DOESN'T SPREAD AS EFFICIENTLY AS THIS PARTICULAR VIRUS DOES.

I THINK THE PARALLELS TO THE 1918 FLU IN A LOT OF WAYS ARE MORE APPROPRIATE BUT THAT WAS MORE THAN A SICENTURY AGO NOW, WAS QUITE A DIFFERENT TIME.

SO TO REALLY TRY TO USE THE LESSONS LEARNED DURING 1918 FLU PANDEMIC AND TO APPLY THOSE TODAY, SO MUCH HAS CHANGED WITHIN SOCIETY THAT IT'S A LITTLE BIT HARD TO SAY CAN WE LEARN FROM THOSE LESSONS THAT OCCURRED MORE THAN A CENTURY AGO.

THIS QUICK QUESTION FOR YOU, IF I CAN, ARE WE PERHAPS LOOKING AT SOMETHING HERE THAT MIGHT BECOME A -- A SEASONAL EPISODE IN OUR PANDEMIC OF SEASONAL FLUS, IS THAT A POSSIBILITY HERE?

I THINK IT'S CERTAINLY A POSSIBILITY.

WE KNOW THERE'S OTHER HUMAN CORONAVIRUS WHICH CAUSE SEASONAL ILLNESS WITHIN HUMANS AND CONTINUE TO CIRCULATE KIND OF EVERY YEAR CAUSE -- IT'S ONE OF THE CAUSES OF THE COMMON COLD.

IT'S NOT THE ONLY VIRUS THAT CAUSES THE COMMON COLD BUT IT'S ONE OF THE VIRUSES THAT DOES THAT AND IT'S THOUGHT THAT IMMUNITY TO THOSE VIRUSES ONLY LASTS ON THE ORDER OF AROUND NINE MONTHS OR SO.

SO NOW THAT THIS VIRUS, I THINK, IS WITH US AND HAS SPREAD GLOBALLY, IT'S LIKELY TO BE WITH US FOR A VERY LONG TIME.

WE STILL DON'T REALLY KNOW AND I DON'T THINK WE WILL KNOW FOR A WHILE HOW LODGE LIVED IMMUNITY MAY BE AFTER AN INDIVIDUAL IS INFECTED WITH THE CORONAVIRUS.

AND THAT WILL PLAY A REALLY IMPORTANT ROLE IN DETERMINING KIND OF WHETHER OR NOT WE MAY SEE SEASONAL OUTBREAKS OF THIS IN THE FUTURE.

RIGHT.

WELL, I SAID IN THE BEGINNING WE'RE LOOKING TO OUR SCIENTISTS TO HELP US UNDERSTAND, AND DOCTOR, YOU HAVE DONE A MARVELOUS JOB HELPING US UNDERSTAND.

IT'S A VERY COMPLICATED ISSUE.

I CAN SEE WHY YOU ARE SUCH A GOOD PROFESSOR, YOU DID GOOD JOB EDUCATING US.

THANK YOU SO MUCH FOR JOINING US AND HOPE TO TALK TO YOU AGAIN DOWN THE ROAD.

MEANTIME STAY SAFE.

YEAH, YOU TOO.

BE WELL.

BYE.

Funders

MetroFocus is made possible by James and Merryl Tisch, Sue and Edgar Wachenheim III, the Sylvia A. and Simon B. Poyta Programming Endowment to Fight Anti-Semitism, Bernard and Irene Schwartz, Rosalind P. Walter, Barbara Hope Zuckerberg, Jody and John Arnhold, the Cheryl and Philip Milstein Family, Janet Prindle Seidler, Judy and Josh Weston and the Dr. Robert C. and Tina Sohn Foundation.

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