I had a few questions for Dr. Tom Inglesby, director of the Johns Hopkins Center for Health Security, an internationally recognized authority on infectious disease and adviser to Maryland leaders on the state’s response to the coronavirus pandemic. We spoke on Thursday as 77,000 new infections were being reported across the nation, the most ever for a single day.
What is your most immediate concern — for the country generally and Maryland specifically?
We have twice the number of cases being diagnosed today as we did at the worst moments of April, and still a substantial number of people dying every day. On average in the last week, we had about 725 people die [from COVID-19] every day in the country.
Fortunately, in Maryland, the numbers of people who have become ill on a daily basis and who are dying have come down steadily over the last two months. But it does seem like the average age of people getting this illness has come down and the percent of positive tests in people below age 40 has gone up in the last few weeks. That says to me younger people may either not be getting good information about how to slow the disease down or making choices that are a higher risk.
While it’s true that young people do far better than people who are older, they still can get seriously ill, still can be hospitalized and, most importantly, they can spread it to people who have underlying conditions or older people. So I think it’s really important for Maryland to be communicating really clearly with everybody, especially with people who may see themselves as lower risk. If they take a chance for themselves, they’re increasing the chance that this disease will continue to spread.
There were 15,000 new cases in one day in Florida, and with a lag time of several days between testing and getting results, that’s 15,000 people possibly spreading the disease.
When we have numbers this high, the strategies that other countries have relied upon are more and more difficult to put in place. Look at New Zealand, Singapore, Iceland or Germany. They rely on testing and contact tracing. If you have 15,000 new cases [in a day], you can’t keep up with that number. The higher the numbers of cases go, the more we see delays in the system. The time it takes to get results gets longer and longer. One of the national goals needs to be to bring that turnaround time down to a day. That needs to be explicitly stated from the top of government. It is unacceptable to have these tests come back seven days later.
Do you think federal mandates would have worked? Many Americans apparently trust neither government nor science on this.
For something that is as specific and valuable as wearing face masks, I think there should have been a direction from the top of federal government for people to be wearing face masks all across the country when they’re in public spaces outside the home. That could have worked, and it’s not too late to try. We still have too much of the country where it’s seen as a personal choice. That’s the wrong way of thinking about this. It’s similar to putting speed limits in neighborhoods. We really require you to drive 25 miles per hour because, if you speed here, you can kill a kid. If you don’t wear a mask, you could infect that person over there, who’s older, and kill them. Most other countries have done this without any controversy.
Should bars be closed?
I don’t think we should have large indoor gatherings open. [Maryland officials] put more restrictions on them. But ... given the rapid reacceleration we’re seeing in a majority of states, I would prefer that our bars and indoor large gatherings were closed until this epidemic is under better control and we see numbers go even lower. It is also very important, for schools and universities to open in the fall, to have a low level of community transmission in the state at the time. This virus is the same virus that’s been here. It is an efficient spreader that basically moves around when people are in close social interaction. Dr. [Anthony] Fauci [director of the National Institute of Allergy and Infectious Diseases] said he thought bars should be closed, and I think that would be wise.
The anti-science, anti-Fauci, anti-face mask sentiment must bother you.
What’s so discouraging, if people think about some of the successes of the United States in the last generation, so much of it has been built on science, technology and innovation. It’s one of our super powers. We know what to do to get control of this pandemic, but we’re among the countries doing most poorly at this point. We can turn that around. We have the power to do that. But we have to pay attention to what science says and public health says, and use our science and technological prowess to get ourselves out of this. It’s what other countries have been doing. They’re wearing face coverings, relying on social distancing, avoiding large gatherings. They have partnerships between political leaders and public health leaders that are very effective; there’s no division or undercutting each other in public.
Dr. Fauci has said we could possibly see a vaccine available by December.
But there could be a lot of illness and death from this disease in the meantime if we keep moving in the direction many states are moving in now. Some people’s hope that this would fade away — that’s obviously not right. We need to grapple with the facts at hand. We can bring this down by doing what other countries have done. Once we do that, it will make it a lot easier for people to reengage the economy and get back to school. But if we let this disease run like it’s running now, all those things are in jeopardy.
Questions and responses have been edited for brevity and clarity.