What the experts are saying: Part 2 of our biggest takeaways from our COVID-19 webinars

Since the COVID-19 pandemic began, the Buck has been gathering evidence-based opinions and information from top researchers and thinkers about the science aimed at bringing it to an end. What are the biggest takeaways so far? How close are we to getting back to normal? Everyone, from molecular biologists and epidemiologists to clinicians and public health experts, has been remarkably consistent on a few key points. Don’t have time to listen to eleven hour-long conversations? No problem! We’ve assembled the highlights from these webinars in a 4-part series.

Part 2

Public health, personal responsibility

Until there are effective therapeutics and vaccines, we have a collective responsibility to protect ourselves and each other. These goals are not in opposition, but are instead synergistic.

We need contact tracing and testing to get through this, but we’re not there yet

Eric Verdin, President and CEO of the Buck Institute: if a person emerges as positive for COVID-19 we will need to identify everyone who has been interacting with this person in the last two weeks, notify them and isolate them. That’s the only way we will be able to control this virus in the absence of a lockdown. And so it’s been estimated that we’re going to need to hire close to 300,000 people just for the US, alone, to do contact tracing.

Sue Desmond Hellman, Former Chief Executive Officer, Bill & Melinda Gates Foundation: But the problem with testing now is the capacity just isn’t there. So having a test that you get back in eight days, and that’s as if you do have a test. So having the capacity to have the turnaround that’s required is a critical part of testing.

Robert Redfield, Director, Centers for Disease Control and Prevention: The reality is that the need for testing is obviously still there. I think many of us believe we need to get to about 3 to 5 million tests a day to be where we need to be as a nation, so that everyone has readily access or timely result

We’re in this together:

John Newman, Assistant Professor at the Buck and Practicing Geriatrician: Even if you say to yourself, ‘I don’t care if I die. I don’t care if I wind up on a ventilator and wind up not being able to take care of myself. It’s important to me to be with my family. I’ll accept that risk.’ You’re not just accepting it for yourself, you’re accepting that risk on everyone that you’re around, so all of your close family members.  If you’re a young person, but you live with an older relative, your actions are directly affecting your older relative’s risk.

Matt Willis, Marin County Public Health Officer: So I really hope that people recognize that, you know, a gym opening up or a hair salon opening up doesn’t mean it’s safe to do that. It means that you are free to do that.

SDH: First, ‘What am I going to do? What am I going to do to protect myself and my family? How are we going to think about where we travel, where we go, how we work, how our kids get educated?

Some of us are more “in it” than others

Larry Brilliant, Chairman of Ending Pandemics: And let’s not leave this without talking about social equity. I’m from Detroit, Michigan, where a large percentage of the population is African-American. Fifty-six percent of the deaths in parts of Detroit are in African-Americans who comprise less than 30% of the population in that area. Here, in the Bay Area, we’re looking at 30% of the deaths in  African-Americans, compared to 10% of the population. These are round numbers, but they tell the story. Hispanic community, doubly affected. What about the homeless community? What about the nursing homes?

SDH: I’ll tell you, here’s one statistic, that the proportion of coronavirus infections they found in this Mission District among whites, zero. It was like, wow. Wow. And so I think those were some of the early signs that, wow, this inequity is something really profound and needs to be understood. And, now, using that information to take action and protecting people is really important

RR: You know, we’re, obviously, concerned about making sure we can do better for groups that are under-vaccinated historically, particularly in rural America. We’re trying to make sure that we reach out to African-American and Hispanic/Latino populations that are under vaccinated. How do we make sure we can do that? 

MW: in Marin County, our Latinx community makes up maybe 20% of the total, 15% of the total, but they’realmost 70% now of the total cases; in the last two weeks, almost 90% of the cases involve people in that community.

Masks, masks masks! and more!

Warner Greene, Director of the Gladstone Center for HIV Cure Research: Masking is so key given the asymptomatic or pre-symptomatic phase of transmission. The only way that we can block people from spreading the virus to others is through social distancing, which we see is kind of plus-minus, as we’ve opened back up. Masking does work. It really, really works, and we need to be doing that.

SDH: And so the three simple things—keeping your distance, wearing a mask, and washing your hands—remain extremely important, extremely important, no matter where in America you are. Sadly, at the beginning of the epidemic in the US, the Surgeon General, I think in a real wish to preserve masks for healthcare workers, spoke up against masks. So there was a bit of a mixed messages, which was a shame. And then …President Trump doesn’t wear a mask. I mean, that modeling matters a lot, and no matter what party you’re in, having the President show up with a mask would actually be a big deal.

I heard somebody talk about, ‘Okay, you leave your house. You take your keys, your wallet, and your phone, right? Add a fourth thing to the list. You take your keys, your wallet, your phone, your mask.’ I think we need to make it just like in Asia, a cultural norm for a while. And I’m sure we can.

RR: the biggest thing about social distancing is the mask. So I don’t want people to get hung up on six feet. These masks really do work. These face coverings, simple face coverings, really do work in interrupting this transmission.

The short term is not so short term:

EV: I know this is not what anybody wants to hear, but this is the reality of what we’re going to have to deal with in the coming year, year-and-a-half.

JN: This is just the beginning. It’s not the beginning of the end. It’s the end of the beginning that we’re approachingWe now need to kind of dig in for the long haul. …you know, we started off with a sprint and now we’re getting ready for the marathon.

Nevan Krogan, Director of the Quantitative Biosciences Institute at UCSF: My gut feeling is we need to be very vigilant here in the social distancing rules that are put into place, and I think we should still be hunkering down for a lot longer than some of these people are talking about.

And longer term isn’t so much rosier:

Melanie Ott, Director of the Gladstone Institute of Virology: Well, I think if you look at the current frequencies of outbreaks that we have every probably five years, currently, I mean, starting with SARS-1, going to MERS, looking at the Ebola outbreaks, looking at Zika a few years ago, now SARS-CoV-2, I think we can anticipate that this rhythm is going to continue and potentially accelerate.

LB: Looking back from five years from now, I think we’re going to have had two other pandemics by then. Just personally, it’s what I think.

Robert Gallo, Co-founder & Director, Institute of Human Virology at the University of Maryland School of Medicine: So will there be another? Of course, there will be another epidemic or a pandemic. Would I expect it a little more frequently? Well, if you look at the last 50 years, they seem to be more frequent. And the way we’re becoming a smaller globe, yes, I expect it. But I sure don’t know it.

WG: there have been at least three major entries of coronaviruses into the human population since 2003—SARS, MERS and SARS-CoV-2. But it makes its way into the human population with some regularity. So we can anticipate that in the next 10 to 20 years, we’re going to see other potentially pathogenic coronaviruses

You think a pandemic is an excuse to skip exercise, sleeping, and eating well? Think again

EV: Lack of sleep actually has a profound effect on the immune system. Even one bad night can affect your immune system, so get adequate sleep.  Eat nutritional foods, such as vegetables and fruits. So sleep, nutrition, moderate physical activity, which actually might be challenging for many of our listeners. However, in many parts of the country, one is still able to go for a walk, and I’ve argued to try to make this part of your routine. There are profound effects from physical activity and exercise. So those would be my major areas—good nutrition, good sleep, and regular physical activity.

MO: You can nurture yourself and make sure that you are in the best shape ever. But I think, most importantly, to prevent infection, you have to follow the guidelines. You have to wash your hands, you have to wear a mask in public, and you have to keep your distance so that your T cells are as little engaged as possible.

JN:  Well, number one, is try not to get the virus. The best cure for this virus is to not get it in the first place. Everything that’s so important to our health and our lives is exactly the sort of thing that gets curtailed when we’re trying to stop the spread of this virus.

Exercise is a great example. Exercise is the ultimate way to fight aging, so the best way to stay healthy, to stay strong, to stay fit, to keep your mind strong. But how do you exercise if you’re trying to not go out so much, if you can’t go to the gym, if you can’t go to a group yoga class? I think this is a great time to think about how to make your exercise program work for you at home, and work for you in a way that doesn’t put you in contact with too many other people.

Sleeping -- I know a lot of us are pretty anxious these days. It’s hard to get a good night’s sleep. It’s even harder when we’re not as active as normal during the day. But whatever we can do to help ourselves to normalize our schedule and get a good night’s rest is going to be really important for helping our immune system, without using drugs.Aim for natural good sleep. And food -- we also know that a good diet can help your immune system, too.

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Our next set of takeaways will help you understand the research into individual  risk factors for COVID-19 and how to interpret the onslaught of information on potential therapeutics.