The Daily - Where Is This Pandemic Headed?

Episode Date: October 7, 2020

The pandemic has killed more than one million people around the world, at least 210,000 in the United States alone. The illness has infiltrated the White House and infected the president.Today, we offer an update on measures to fight the coronavirus and try to predict the outbreak’s course.Guest: Donald G. McNeil Jr., a science and health reporter for The New York Times.For more information on today’s episode, visit nytimes.com/thedaily Background reading: Fearing a “twindemic” — the onset of both the flu and the coronavirus — health experts are pushing people to get influenza shots.Here’s how to identify the different symptoms of the flu and Covid-19.Donald tells us about his job trying to “cover the future.”

From The New York Times, I'm Michael Barbaro. This is The Daily. Today, an update on the state of the coronavirus in the U.S. I check back in with Times science reporter Donald G. McNeil Jr. It's Wednesday, October 7th. Donald, you recently sent me an email that pretty much stopped me in my tracks because in it, you said that you were optimistic about the course of the pandemic. And that is not a word that I associate with either you or the pandemic. And it immediately made me think that we needed

to talk. Okay. I can explain. I am short-term right now, fall and winter, pessimistic. I think things are going to get worse. But since I've been saying since April or so that this epidemic is not going to be over by Easter, this epidemic is not going to be over by fall, and that the record for making a vaccine is four years, that, you know, the record for making a vaccine is four years, I now have new optimism about how fast I expect vaccines and other interventions to get here and how quickly that will bring the pandemic to an end in the United States. So it sounds like you have a qualified long-term optimism, and I want to get to that. But for now, let's explore your shorter term pessimism by understanding where we are right now in the pandemic, starting with the U.S. What's happened in the U.S. is really, in some ways, one giant wave with geographical distinction.

In the spring, the Northeast was hit very hard. New York City, Boston, some of the other cities. But it was a very concentrated, very intense epidemic. Then there was the big summer wave, which began mostly in the South. It was the Southern states. Meanwhile, you've always had a sort of smoldering thing going on in California, particularly, but also in Oregon and Washington. had a sort of smoldering thing going on in California particularly, but also in Oregon and Washington. The third part of this big, if you like, first wave is now hitting the Midwest, and especially the upper Midwest, Wisconsin, Minnesota, North Dakota, South Dakota, and Utah. And so now they're suffering through it. So if we think of the first wave as this giant body of water sloshing around the country, it's finally reaching all the different crevices and coastlines.

And the latest one is the Midwest, the mountain states, the plains. Yeah. And now things are beginning to tick up again, even in New York City and some places that had really done quite well all through the summer. had really done quite well all through the summer. Good afternoon, everybody. In Brooklyn and Queens, we're having an extraordinary problem, something we haven't seen since the spring.

Well, tell me about that. What is happening in New York City? Because that doesn't so much feel like a first wave encounter. It's not. And what's going on in New York City is very, very much neighborhood by neighborhood. What has become clear is that there are a number of neighborhoods now that have continued to have a high level of coronavirus positivity and that requires stronger action than we've had to take for many months. You know, the mayor and the governor are struggling over whether or not to shut down nine zip

codes in the city. We are all in this together. We have overcome much worse than this challenge, and we will overcome this one as well. Thank you, everyone. And what in your mind explains this second wave in New York City? And I think the reason why so many people care about New York City, and I'm asking about it, is because it seemed like the city had a very good handle on the virus. The city did have a good handle on the virus, and a lot of people were cooperating, wearing masks, and socially distancing. But we've begun to ease off on the restrictions. You know, schools are reopening. There was a plan to let restaurants open indoors as long as they only had 25% of their crowds. And also we've seen a really strong uptick in the Orthodox Jewish and Hasidic neighborhoods in Brooklyn.

Those were neighborhoods that were hit really hard in the spring, particularly around Purim, which happened before really there was any notion that the virus was as widespread in the city, was large numbers of people died. There were funerals of important rabbis. At those funerals, nobody wore masks. People were all together, weddings, birthday parties, everything else. Right. And then there was a big wave of deaths. One burial society reported burying seven times as many people as it normally did. They ran out of burial shrouds. And then cases by June seemed to virtually disappear in the Hasidic communities. And the belief kind of grew that, you know, we have achieved herd immunity in those neighborhoods.

that, you know, we have achieved herd immunity in those neighborhoods. So I don't know why, but by September, cases were ticking up again in the Hasidic communities. And we've seen that although nine zip codes in the city are the ones that are being hit hardest, and those all contain big Hasidic communities, it's now actually spreading to about 20 other zip codes in the city. And what is the city doing in response to what's happening in these nine zip codes? Well, they're planning to shut down schools and they're talking about trying to shut down businesses in those areas. And there's now sort of a public tug of war going on between the governor and the mayor over that. So it's not clear. This is all in keeping with the notion

of the hammer and the dance, you know, dance in, dance out. And you dance out into more open behavior, you know, more face-to-face relations with each other until you get a problem, and then you have to dance back in, you know, step away from each other, close down bars and restaurants, have smaller grouping of people. And all through this time, we should be wearing masks.

And there's a lot of resistance to wearing masks, particularly in the Hasidic communities. Mm-hmm. I'm curious what you think about a decision like the one to allow for indoor dining and to a certain degree, indoor shopping, knowing that the city has spikes in certain neighborhoods and that people from those neighborhoods could inevitably end up at one of these restaurants eating indoors. Does that seem wise? Is that just a necessary risk required to keep that industry alive? Well, it's a risk that the city is taking

because the restaurant industry is important to the city's economy and has a fair amount of important to the city's economy and has a fair amount of clout in the city. I personally don't want to eat indoors in a restaurant. I'm okay with eating outdoors. I know it's going to get a little chilly, but I'd rather do that than eat indoors. And I think I know why, but why aren't you comfortable eating indoors at a restaurant at this moment? eating indoors at a restaurant at this moment? Because the virus clearly lingers in the air indoors as it doesn't outdoors. And you have to take off your mask to eat and drink. So what can you do? You can't really protect yourself against it.

I mean, other people may feel differently, but the privilege of eating out in a restaurant is something I can wait on for a few months. I'm cooking fine at home. I'm happy eating outdoors if I have to not eat indoors. I mean, you know, more painful for me is things like I don't want to have a Thanksgiving or a Christmas, you know, big family one indoors. And we're discussing this now. I just think it's dangerous. Even though I trust all my relatives, I've seen, you know, some close calls with relatives and friends of mine.

Oh? Well, for example, my niece in Salt Lake City had a close call and found out that she had been at a party where somebody was infected and found out just after her mother had visited her. And so everybody was behaving fairly carefully, but not perfectly carefully. And then suddenly, bingo, they found out, you know, that one of them was a contact. And other contacts had taken place before that contact tested positive. So, I mean, that's a perfect example of a chain of transmission.

And the goal is to break the chain of transmission. Right, right, right. And I'm sure your niece is going to be thrilled to hear that she is now a public case study. But thanks to your niece, we now understand the situation better. Okay. I'll talk to her about it. We'll see if she ever talked to me again. Right, right.

So, Donald, none of this feels like the basis for optimism, that word you used at the beginning of this conversation. And I think many of us are sadly, like you, thinking about the holidays, thinking about how they're not going to feel normal at all. And if you look at the dashboard the Times has for where the virus is in the U.S. right now, it shows that we have infections on the order of 40,000 a day. And that has been the case now for many weeks, I think even months. And given that, and given what we're seeing in New York and in the mountain states and in the Midwest, do you expect that things are actually

just going to get worse as the weather gets colder and people stay inside, and that we are not in for any kind of relief anytime soon. Yeah, I think things are already getting worse. I mean, we're definitely on an upward trend and it is in a majority of states that we're on an upward trend in. So that's not a good sign.

That makes me pessimistic for the immediate future. It's not a good sign. That makes me pessimistic for the immediate future. But I'm optimistic in my view of when this all ends and we go back to normal. We'll be right back. So Donald, walk us through this optimism you have for the end of the pandemic and what accounts for it and what does that optimism look like? Well, when we talked about vaccines a while ago, I made the point that the fastest the world had ever made a vaccine was four years. Right. That was the mumps vaccine back in the 1960s and thought, OK, that's not encouraging.

Maybe we can cut that in half. Maybe we can make something in two years. Right now, it's looking like we are going to have some approved vaccines by late December, early January. And if only three out of the eight we have in the works work, we will eventually have enough doses for all Americans. It will take longer. But as far as I can tell, those clinical trials, if you look at the phase one and phase two data,

and you look at the data in monkeys and things like that, they're going pretty well. Mm-hmm. So the biggest basis for your optimism is the fact that you believe we are just months away from an approved vaccine that will, in somewhat short order, be available to Americans. I believe we are probably close to several approved vaccines. And then the challenge is how fast can you make them? And in the beginning, it's gonna be 10 to 20 million doses per month,

but then that will ramp up and we're ultimately gonna need 660 million doses or so. If all the vaccines worked, we would have 800 million doses. And then the question is, will people take them? And although there is skepticism now, I believe people will. And that's something else I can explain.

Well, why don't you explain it? Because I think that's a question we have explored a lot on the show. And in our conversations with colleagues like Jen Hoffman, we have established that there is a considerable amount of skepticism around vaccines in general, and especially this coming set of vaccines because of how much politics has surrounded them. Yeah. And I agree with that skepticism. I mean, if a vaccine is approved before Election Day and it is approved by only one man, I'm Donald J. Trump and I approve this vaccine, then I'm a skeptic and I'm not going to take it. Donald J. Trump and I approve this vaccine, then I'm a skeptic and I'm not going to take it. But when I see vaccines that are okayed by Tony Fauci and Paul Offit and Francis Collins and Peter Hotez and all the vaccine experts that you often see quoted on television,

then I'm going to be one of the first in line to get it. And what'll probably happen, I think, is that a lot of people will be skeptical and then they'll look around at their friends and neighbors who take the vaccine and assuming nothing goes wrong, and that's an assumption, but assuming nothing goes wrong, they'll go, huh, I can avoid this vaccine for me and my kids that I'm somewhat afraid of. And that means I have to homeschool my kids forever, never go to a movie, never get on an airplane, never eat in a restaurant again, or I can accept a vaccine. I think I'll take the vaccine. So you're saying that we may be overestimating the amount of

skepticism in the American public for vaccines, or I guess underestimating people's willingness to try this coming coronavirus vaccine? Not since I was a kid have we faced a disease that we're afraid of for which a vaccine exists. And when I was a kid, that happened with polio, people took the vaccine, even when bad things happened with that vaccine. So you're saying once there is a vaccine for the coronavirus, you expect a similar pattern of usage to unfold? Assuming people are still afraid of the coronavirus, yes. What exactly makes you think that a vaccine will be approved in the coming months? Because I have

listened to the CEOs of the major vaccine companies attempt to downplay some of the rapid timetables that have been offered by the president and say, look, this will not happen in the next couple of weeks. Be patient. I don't expect a vaccine by election day, but lots of experts who are a pretty clear idea of what's going on in these trials do expect one or two or three vaccines approved somewhere around end of the year, beginning of next year. And their reasons for expecting that, they're reasonable. that they're reasonable. By that time, they should have time to both see enough infections in the vaccine trial to make a judgment as to whether or not the vaccine works. And they should also have the vaccine have gone into enough people and waited for at least a couple of months to see if any dangerous side effects emerge. And those are the two things

you're looking for. Does it work? Does it cause dangerous side effects? And if the answer is yes and no, then you've got a winner. And we might have three or four winners by, you know, fairly early next year. So given that vaccine timeline that you just outlined, when do you believe most Americans would get the vaccine and when something approaching normalcy could be achieved? If we have several vaccines and if nothing goes wrong with the multiple manufacturing processes that are being built as we speak, I think there may be enough doses for all Americans to get them by sometime late spring to midsummer of 2021. Which is a whole lot faster than the four-year timetable that you and I had discussed many months ago. Yeah. We started taking this disease seriously in March,

so you could argue that it might last a year and three months or so. Mm-hmm. So beyond the vaccine, which seems crucial to your optimism, clearly, what else gives you optimism? The other intervention that experts have a lot of confidence in is monoclonal antibodies. And remind us what monoclonal antibodies do to the virus. Those are sort of a Superman version of convalescent plasma, because you take the antibodies

from the plasma of survivors and you look for the best ones, the ones that are really good at neutralizing the virus, and you clone those. And then if somebody is already infected and sick, you give them a big dose, hoping that it wipes out all the virus in their bloodstream. And if you want to protect somebody, there's a second way of using it in a sort of ring vaccination form to protect people who are close to someone who's been infected. So if, you know, I had a family of five and I was infected, you could treat me, but also prophylactically vaccinate everybody in my family, hoping that I didn't pass it on to them. And, you know, ring vaccination is how we beat smallpox. Ring vaccination is how we fight Ebola.

When you have cases that occur in tight clusters, you can use small doses of antibodies, like a vaccine, to vaccinate everybody around every known case. And if you do that right, you can really slow transmission dramatically. So this feels like the next best thing to a vaccine from what you're saying. So where in the development process is monoclonal antibodies at this point? Quite close. They were hoping to have them approved by late August, early September. Trials have gone more slowly than they hoped, but they're pretty close to reaching an end and they might function as a bridge to the day when we get vaccines. So if you ask me why I'm optimistic, it's because I see these big technological advances coming down the

road. They are not coming on the president's schedule for reelection, but they are coming nonetheless. I'm pretty confident in that, and I talk to a lot of experts. in that. And I talked to a lot of experts. So you just mentioned the president. And I think we have to talk about his infection and whether or not that subtracts from your optimism or it amplifies it. And I'm really curious how you have been thinking about that event as you contemplate the end of this pandemic and your growing optimism. I think it has the potential to add to my sense of optimism.

Hmm, why? Well, one, he had a big scare. And for a little while there, he was wearing masks and even advocating wearing masks. Since he tested positive. Yeah. And it's very clear that the virus

spread like wildfire in the anti-mask White House. So a lot of his followers may take a look at the situation and say, huh, maybe I should wear a mask. If that happens, if a few million more Americans start wearing masks, that can make a big difference this fall and winter because we know that masks decrease transmission. But I want to understand your optimism, Donald, because yes, the president did say wear a mask once he got the virus, but he also took real and very public risks once he was diagnosed. He drove around in an SUV, potentially exposing his Secret Service detail very publicly. He returned to the White House quickly and very dramatically removed his mask, which surprised people,

and sent not exactly a wear a mask message. And then in a video that was directed to his supporters and the public, he very much minimized his experience with the virus and said, don't let it dominate your life. Just today, he compared the coronavirus to the flu. And so, does that potentially undermine whatever value there was in saying, wear a mask? Well, look, if you look at what people who are big fans of the president see,

people who are big fans of the president see, they see him not wearing a mask and then getting really slapped by the virus. And the whole White House has been hit hard by the virus. And that in and of itself is a lesson. Even if he says, don't be afraid of the virus, he had to go to the hospital. Chris Christie's in the hospital. Other people around him may have to go to the hospital. We don't know how it's going to turn out for all of those people. So the hard lesson you take away from that is the virus is not a democratic hoax. The virus was a close call for our leader and is infecting other people who followed his lead. And maybe I don't want what happened in the White House to happen in my house. I think a lot of people may take that lesson away. You know, generally I'm optimistic, which is new for me.

which is new for me. Well, on that note, we should be clear that this optimism still entails many, many months of living with the virus. Next spring is not exactly around the corner. It involves potentially

millions more infections. It involves tens of thousands of deaths, more economic hardship. So maybe optimism isn't exactly the right word for it. I'm not sure what the word would be, but it's not exactly ideal. No, it's not ideal. I mean, but once we knew there was going to be a pandemic, we couldn't really have an expectation that everything was going to go duckly. But I hope it's going to be over earlier than I expected. And then we can begin the work of economic recovery and people going back to work, people living life the way we used to before. Right. It's a relative form of optimism.

Yeah. Well, Don, thank you very much. We appreciate it. All right. Thank you for inviting me. On Tuesday afternoon, the U.S. Food and Drug Administration released new, stricter guidelines for companies developing vaccines for the coronavirus, guidelines that were initially blocked by the White House. The guidelines recommend gathering extra data about a vaccine's safety in the final stage of clinical trials, a step that would take more time, but is expected to increase the public's confidence in an eventual vaccine. We'll be right back.

Here's what else you need to know today. On Tuesday, President Trump abruptly ended negotiations with congressional Democrats over an economic relief bill, instructing Republicans to instead focus on confirming his nominee for the Supreme Court. The announcement sent the stock market plunging and means there is no chance that the federal government will deliver assistance to struggling Americans and businesses before the election. And the coronavirus outbreak inside of the White House has spread further. The vice commandant of the Coast Guard,

who had attended a White House event a few days ago, has now tested positive, forcing several members of the Joint Chiefs of Staff to quarantine. And on Tuesday night, Stephen Miller, a senior advisor to the president, said that he too had tested positive. That's it for The Daily. I'm Michael Barbaro. See you tomorrow.