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Emory University Epidemiologist On The Future Of COVID-19

LULU GARCIA-NAVARRO, HOST:

This week, at some point, we will reach a grim new milestone - 200,000 Americans dead from COVID-19. And yet alarm about the disease seems to be diminishing among some. A new poll in Wisconsin by the Marquette Law School finds 38% of respondents say they are not very worried or not worried at all by the virus - this as journalist Bob Woodward released tapes of President Trump revealing that the president purposefully downplayed the coronavirus in public while early on privately acknowledging how lethal it is.

(SOUNDBITE OF ARCHIVED RECORDING)

PRESIDENT DONALD TRUMP: It's also more deadly than your - you know, your - even your strenuous flus. This is deadly stuff.

GARCIA-NAVARRO: More on the political fallout from those comments in a moment. We begin this hour with our next guest, who says there may be reasons for hope. Carlos del Rio is an epidemiologist with Emory University in Atlanta, and he joins us now.

CARLOS DEL RIO: Happy to be with you, Lulu.

GARCIA-NAVARRO: You are cautiously optimistic. Why?

DEL RIO: Well, I think we're beginning to see in many parts of the country, including here in Georgia, a decrease in the number of cases. On a national level, we've seen over the last two weeks a 13- to 15% decrease in number of cases. We are seeing, also, some places where the cases are increasing. I worry mostly right now about North and South Dakota. But in general, we see in the U.S., you know, 10 states where the cases were high and are now coming down. And that's good to see.

GARCIA-NAVARRO: Testing, though, has also gone down. Could that not be a product of the fact that testing has slowed down instead of actual infection rates going down?

DEL RIO: It certainly could. But I don't think testing has gone down as much as cases have. And at the end of the day, we are seeing other indicators coming down - most importantly, the number of people hospitalized. And I really think looking at who gets in the hospital and what happens to hospitalizations - it's a very good indicator of really the severity of disease.

GARCIA-NAVARRO: We have seen the number of deaths slowing. But that has happened in other countries, only to see the numbers surge again. Is that a concern?

DEL RIO: Well, it's very interesting because the decrease in the deaths has not been as significant so far as a decrease in cases that we've seen in this country. You're seeing close to a thousand deaths per day in this country, and that hasn't changed much. And I think part of it is that we're not having one epidemic, right? We're having multiple epidemics. So for example, in the Northeast, deaths have really plummeted. But here in the South, they almost are staying stable, and some other places are actually going up.

The other thing that we've seen, Lulu, is an increase in cases among young people, and a lot of it is related to college towns. And as a result of that - you know, young people get infected, but they don't get as sick, and therefore they don't die. So part of the issue is that the epidemiology that we have today is very different than the epidemiology we had back in March or April.

GARCIA-NAVARRO: Bearing all that in mind, we are still closing in on 200,000 deaths in this country. The United States has been the epicenter globally of this pandemic. What has been the biggest failure so far, in your view?

DEL RIO: You know, I think we've had a failure of leadership. And the administration essentially gave it to the states and said, let's each state do its own strategy. This lack of coordination, lack of a national strategy, has really hurt us because you have states making very different recommendations.

And the White House coronavirus task force, honestly, when they put the recommendations of how to open, they were very clear on what needed to be done. There were very clear metrics that you had to follow to open. And many states just essentially chose to ignore those recommendations. So we really have not had a national strategy, and we're paying the consequences of that.

GARCIA-NAVARRO: I'd like to ask you where you see the science right now. Have we gotten better at treating COVID-19? What have we learned?

DEL RIO: One thing that has been particularly successful, I would say, is the scientific response. And again, I'm biased because I am one of the scientists. But I would tell you the way internationally there's been coordination and scientific response, the way pharmaceutical companies have worked together in unprecedented ways - it's really something that I think we need to be all proud of.

You know, think about - we went from describing a new virus and posting the genetic sequence of a new virus to having a vaccine delivered into a human in 62 days. That is absolutely amazing. Never, ever before had something like that happened. You know, we have major vaccines. There are three or four vaccines now in phase three trials, so they're in the trials for efficacy.

We're really moving at incredible speed, and that is a result of leadership. And I think, you know, Operation Warp Speed and many other things that have been done have actually been examples of what needs to happen when we think about other diseases like cancer, for example.

GARCIA-NAVARRO: And yet, one of the great tragedies and scandals of this pandemic is how it is disproportionately impacting communities of color. Do you see any improvement there?

DEL RIO: You know, unfortunately, I don't. And I think that the disparities that we're seeing in this pandemic are not new. We have had enormous health care disparities in this country that we have not addressed. And my hope is that as a result of this pandemic, we are going to begin to look at what we need to do to improve the racial and ethnic disparities that have been so - just unacceptable in this pandemic.

GARCIA-NAVARRO: So, Dr. Del Rio, how do you see this pandemic ending and when?

DEL RIO: Well, first of all, I would like to make it very clear that a vaccine is going to be important, but it's not going to be the endgame. People are talking about having a vaccine that has an efficacy of 50%. So that means, you know, you give it to a hundred people - half of them are protected. Half of them are not protected. And that's in the best of circumstances.

So we need to continue incorporating the non-pharmacological measures of masking and social distancing and hand-washing together with a vaccine. We will eventually get to enough people infected and enough people vaccinated that then you will get to herd immunity. But that's not going to happen, in my mind, before, you know, a year, year and a half from now. So my goal is by Christmas of 2021, we will be on our way out.

GARCIA-NAVARRO: Epidemiologist Carlos del Rio of Emory University.

Thank you very much.

DEL RIO: Happy to be with you. Transcript provided by NPR, Copyright NPR.