Dr. Marc Siegel: In coronavirus fight, here’s what CDC director says about what's ahead and second wave

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America wasn’t prepared to deal with the novel coronavirus pandemic, Centers for Diseases Control and Prevention Director Dr. Robert Redfield acknowledged to me in a recent interview. But he is doing everything possible to fight the virus now.

There are many reasons for this lack of preparedness, including the Chinese government’s refusal to provide accurate, reliable and timely medical information about the pandemic that began in the Chinese city of Wuhan. This led U.S. experts to badly underestimate the severity and spread of the new respiratory disease COVID-19 that is caused by the new coronavirus.

We could have predicted the wrongful conduct by the Chinese government by the way that government suppressed information regarding another somewhat similar disease – Severe Acute Respiratory Syndrome (SARS) – back in 2003.

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In addition, the U.S. failed to complete work on a SARS vaccine early in this century because that disease was far less widespread than COVID-19 is today and didn’t persist.

Had we developed a vaccine to protect people against the SARS-CoV-1 virus, it would have put us in a better position to build on that discovery and more quickly come up with a desperately needed vaccine to protect the people of the world against the coronavirus we are now battling, SARS-CoV-2.

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In fact, pandemic preparedness in general in the U.S. has been largely inadequate.

When the coronavirus pandemic first began to take hold in our country early this year we didn’t have state-of-the-art testing in place. We were soon overwhelmed with undiagnosed cases spreading through our communities.

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Redfield – a longtime virologist and a key member of President Trump’s Coronavirus Task Force – is determined to learn from the current pandemic to fight it as effectively as possible. He wants to prepare for a possible surge in COVID-19 in the fall, when he expects to have a full array of diagnostic testing available.

“The antibody testing, I think it's really important,” Redfield told me in an interview for SiriusXM’s “Doctor Radio” program last week. People with antibodies to a virus have been infected by the virus. The antibodies indicate immunity in the cases of other viral infections, but the virus that causes COVID-19 is so new we can’t be sure at this point how much protection antibodies will confer.

We're starting fairly large surveys now across the country,” Redfield told me. “We started with New York and Washington, which can expand to 10 states and 20 blood donation stations across the country. So we'll have a pretty good idea of what the extent of … asymptomatic infection was.”

Redfield said that the increasing amount of surveillance data will be useful in terms of not just American confidence, but also “as we get into next season ... to modify some of our health delivery systems that will be more COVID-specific. Maybe staffed by COVID-immune providers.”

Redfield agreed that testing for the coronavirus – a hot-button issue – is front and center in our ability as a society to recover from COVID-19, especially in the absence of a vaccine.

“You got to be real-time, right in the field, be able to do the contacts real-time,” Redfield said. “That's going to be fundamental to our public health enhanced capacity that we're going to need to open this country back up.”

Redfield said he and other medical experts were taken by surprise by how contagious this new coronavirus is. He said “it is the most infectious respiratory virus I’ve seen in my lifetime.”

Nevertheless, Redfield refused to blame Chinese scientists for the ferocious rapidity of the spread of COVID-19. He revealed an early and extensive set of interactions with his CDC counterpart in China beginning in early January.

Redfield said that although the initial Chinese assessments were inaccurate, “it's a testament to them that within a short period of time, as you know, they identified a new coronavirus, which they basically almost immediately shared online, which … allowed us to develop the diagnostic test.”

But while he had kind words for Chinese scientists and physicians, Redfield said he was very disappointed by the continued denial by the Chinese government of his “direct offer to send a large team to help … answer critical questions. Is there human being transmission? What's the R0 (the expected number of new cases of disease generated by each case)? Really get a handle on it.”

“As scientist to scientist, everybody was on board to help facilitate that, but as it escalated its way up the political structure, that offer for me to send the team … just didn't get approval at the higher levels of government in China,” Redfield said.

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So what can we now expect going forward?

Redfield believes that there is a lot of evidence “that this virus is going to be seasonal,” and he is looking to see how the virus performs in the Southern Hemisphere now, as autumn is starting there, to predict how it may do in the U.S. this coming fall.

I agree with this approach. It’s how we study other seasonal viruses, including the flu.

“I think we're definitely going to have a second wave” of COVID-19, Redfield said. “This virus is so infectious that I'm not sure …we are going to contain it to the level we want to. But ... we've got six months now to get really prepared. And ... we need the American public to stay with us.”

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“We're stabilized,” Redfield added. “We're almost at the peak. I think the cases will drop fast, but what we don't need is to have a secondary bump in June or July because certain areas of the nation relaxed their mitigation strategies too quickly, and now we're back with another major metropolitan area like New York with significant outbreak – say in Miami, or Phoenix, or San Diego.”

Redfield is one of many dedicated and talented medical experts prepared to learn from past mistakes and not let up in an all-out war on the novel coronavirus virus until we finally defeat it with a vaccine. We all need to stay the course along with them.

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