Fauci: Yes, we expect a second outbreak this fall, but…


You can treat this as a sequel to the last post if you like. Will it really be safe to allow in-person voting in the midst of a second wave of coronavirus?, I asked.

Fauci doesn’t answer that specific question but watch him here and you get the sense that, yes, it might be generally safe. Not completely safe: So long as we lack a vaccine, mass gatherings are a bad idea. But the risk of visiting a polling precinct this fall will be smaller, maybe much smaller, than the risk of visiting one now.

Why? Simple. We’ll have seven more months’ worth of capability in limiting the spread and severity of COVID-19 by then.

The particulars of what he outlines there should be familiar by now. We’ll have greater testing by fall to identify infections quickly; we’ll be able to trace contacts of infected people and isolate them; we’ll have therapeutic drugs, possibly even very early vaccine use for medical providers. Those are the core elements of the Scott Gottlieb plan for reopening America that I wrote about earlier. They’re the same core elements of this Ezekiel Emanuel proposal for getting back to business. There’s no real daylight among epidemiologists on what we need to do to end the lockdowns, restore some degree of normalcy and productivity, and prevent future coronavirus wildfires while we’re waiting for the vaccine. Just follow the South Korean model. Build up testing and surveillance, build up hospital resilience, clear people to return to work who were infected and have since recovered.

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There’s early progress on therapeutics, per another new (and small) Chinese trial of hydroxychloroquine:

All participants were randomized in a parallel-group trial, 31 patients were assigned to receive an additional 5-day HCQ (400 mg/d) treatment, Time to clinical recovery (TTCR), clinical characteristics, and radiological results were assessed at baseline and 5 days after treatment to evaluate the effect of HCQ. Key findings: For the 62 COVID-19 patients, 46.8% (29 of 62) were male and 53.2% (33 of 62) were female, the mean age was 44.7 (15.3) years. No difference in the age and sex distribution between the control group and the HCQ group. But for TTCR, the body temperature recovery time and the cough remission time were significantly shortened in the HCQ treatment group. Besides, a larger proportion of patients with improved pneumonia in the HCQ treatment group (80.6%, 25 of 32) compared with the control group (54.8%, 17 of 32). Notably, all 4 patients progressed to severe illness that occurred in the control group. However, there were 2 patients with mild adverse reactions in the HCQ treatment group. Significance: Among patients with COVID-19, the use of HCQ could significantly shorten TTCR and promote the absorption of pneumonia.

There’s progress on hospital resilience too:

Ford Motor Co said on Monday it will produce 50,000 ventilators over the next 100 days at a plant in Michigan in cooperation with General Electric’s healthcare unit, and can then build 30,000 per month as needed to treat patients afflicted with the coronavirus.

Ford said the simplified ventilator design, which is licensed by GE Healthcare from Florida-based Airon Corp and has been cleared by the Food and Drug Administration, can meet the needs of most COVID-19 patients and relies on air pressure without the need for electricity.

It may not be the case six months from now that no coronavirus patient needs a ventilator but it may well be the case that any coronavirus patient who needs one can get one, which will improve survival rates.

There’s evidence that social distancing is working right now to limit the toll:

We’re now on pace for 750,000 or so tests per week, in line with what Gottlieb recommended as the needed capacity to begin slowly reopening the economy next month or in May.

Meanwhile, there may be political benefits to Trump in having taken the advice of experts and extended the “stay home” guidelines through the end of April. This data, from a Democratic pollster, was circulating over the weekend:

His advisors were nervous that he’d stick with his Easter target date for returning some parts of the country to work, knowing what a fiasco that could have been. Swing voters weren’t thrilled with it either. Right now he’s largely immune from a backlash for any decision he makes that’s in line with expert scientific opinion; if Fauci and other experts believe X, Y, and Z need to be done to spare the country from a public-health catastrophe then Trump can’t fairly be faulted for doing X, Y, and Z, even if the economic consequences are devastating. Medicine is dictating the policy in an unprecedented medical crisis. If Trump breaks from that, though, and goes his own way by encouraging people to go back to work and keep seeding the outbreak before it’s under control, everything that flows from that decision is on him akibe. Deaths that could have been avoided, protracted economic pain in communities struggling to recover — all of it. Democrats would eat him alive. He did the prudent thing by sticking with his advisors in extending the guidelines. It’s not often I get to say that about him.

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