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New Coronavirus Outbreaks: Is It The 2nd Wave?


We are winning the fight against the invisible enemy, so says Vice President Mike Pence writing about the coronavirus in an opinion piece for The Wall Street Journal. Pence, who also chairs the White House coronavirus task force, makes this statement as new daily cases are rising throughout the country. Do those infections represent a second wave or a crest of the first wave, or is something else happening with coronavirus? Questions to put to Amesh Adalja - he's with the Johns Hopkins Center for Health Security, also an infectious disease doctor.


AMESH ADALJA: Thanks for having me.

KELLY: Are we looking at a second wave of the virus?

ADALJA: I think it's less important to try and number the waves but realize that we have not gotten control of this virus in many parts of the country, and we're going to see successive waves that are not really synchronous appear in different states, on different timescales and going to be challenging to control. And that's what we're seeing right now.

KELLY: When you say not gotten control and maybe looking at successive waves, does that suggest, in your view, we are still in the midst of a first wave?

ADALJA: Yes. The first wave hasn't completely ended. And many states that fared well earlier in the spring didn't really get hit that hard, and now they are seeing increasing intensity of spread. Places like Arizona, for example, are really high on our radar because the percent positivity of tests is going up there, and their ICUs are getting filled with patients. And while I don't think they'll go to the crisis levels of New York, I think it's going to be very challenging. And this is what we're going to have to contend with as we move forward in this pandemic without a vaccine.

KELLY: So understand that there are a lot of numbers to keep track of when we're trying to weigh where we are with this virus. Fact-check that statement by Mike Pence for us. He says we are winning the fight against the invisible enemy. Are we?

ADALJA: We have not won this fight yet, and I think we were losing very badly in January and February and March. And only now have we actually started to fight in earnest, and we can't declare victory yet. The only time we're going to be able to declare victory is when there is a vaccine and the population is vaccinated. So this is a long battle, and it's not going to be an easy one.

KELLY: What do these numbers tell us now about where things might stand come autumn, come early winter when it cools down again and epidemiologists have warned that the numbers might get worse instead of better?

ADALJA: We know that other coronaviruses have this seasonality, where they decrease their spread in the summer and increase it in the winter months. And that's going to be a real phenomenon we have to contend with when it gets to the fall, especially because influenza will definitely be something that we're contending with. And we have to prepare our hospitals to be able to deal with an onslaught of patients that might occur if this intensifies its transmission. And we want to make sure that they have adequate personal protective equipment, mechanical ventilators, ICU bed space, diagnostic testing and that our contact tracers and our public health departments are adequately resourced. I think that all of that has to be in place, and we should be taking this time, especially in places where they're not being hit hard, to make sure that this is all in place as we move into the fall.

KELLY: One other point to fact check in the Vice President's Op-Ed. He writes, and I'll quote, "we are well on our way to having a viable vaccine by fall." Is that true?

ADALJA: We definitely are moving at rapid speed to get a vaccine faster than we've moved with any other vaccine development program and there...

KELLY: But by fall?

ADALJA: So the issue is that vaccine development is something we have to think about in years, not in months. I don't think that we can wed ourselves to some date in the fall or even the winter. I think we have to think about probably a two-year timeline, and I wouldn't give people a false sense of security. I think everybody's optimistic about a vaccine, but I don't think that this is something that we should think about having in the fall - maybe some batches in the winter and more batches probably in months to come after that.

KELLY: So we just have 30 or 40 seconds left, but I wonder if you would give us some hope. What is the most optimistic way to look at where the situation stands?

ADALJA: We're in a much better place in June 2020 than we were in March 2020. We have diagnostic testing at a place where it should have been months and months ago where we're doing about a half a million tests per day. That testing is very seamless and easy. We have antivirals that have gotten emergency use authorization like remdesivir.

KELLY: Right.

ADALJA: We've got clinical trials going all over. And we're getting better at treating these patients. And we have contact tracing in place in many parts of the country, so we are much better than we were before.

KELLY: That is Dr. Amesh Adalja of the Johns Hopkins Center for Health Security.

Thank you so much.

ADALJA: Thank you.

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