Dr. Tom Inglesby is the Director of the Center for Health Security of the Johns Hopkins Bloomberg School of Public Health. He has served on committees of the Defense Science Board, the National Academies of Sciences, and the Institute of Medicine, and in an advisory capacity to NIH, BARDA, DHS, and DARPA. In addition to his work in public health policy, he sees patients in a weekly infectious disease clinic.
During the past 20 years, Dr. Inglesby has been my mentor and most trusted advisor on public health preparedness, pandemics and emerging infectious diseases. Whenever you see him on TV, rest assured, his analysis and advice will be nonpartisan, clear, honest, thoughtful and educational.
Dr. Inglesby talked with Chris Wallace about the challenges of reopening schools, the recent spikes in COVID-19 cases, and what you can do to protect your family, friends and community.
WALLACE: This week, the country shattered the record for an increase in coronavirus cases, surging to more than 68,000 new infections in a single day. And we are now seeing more hospitalizations and deaths from cases diagnosed weeks ago.
Joining us once again from Baltimore, Dr. Tom Inglesby, director for the Center of Health Security at Johns Hopkins University.
Doctor, what do you think of the president’s push this week to reopen schools fully, and also his complaint that the CDC guidelines are too tough, too expensive and too impractical?
INGLESBY: Well, I think the first thing to say is that probably all Americans share the goal of opening schools safely as soon as they can be. So I don’t think that’s even a matter of debate in the country. I do think that there are going to be many challenges to opening schools safely and just kind of asserting that just because they want to open safely doesn’t make it so. It’s going to be pretty — pretty difficult for many schools.
States around the country have been preparing for this. So it’s not like nothing has been going on to that effect, but there are still some uncertainties about transmission in schools. As you said earlier, it’s true that many schools have been opened successfully in different parts of the world, but in those places, most of those places, there was much less transmission than is going on now.
WALLACE: Well, let me — let me just ask you, because there have been outbreaks — in some summer camps around the country this summer. Let me go back to the question that I asked Secretary DeVos. Where is the science here? What do we know about the risk of kids getting the illness and what do we know about the risk of kids spreading the illness?
INGLESBY: So, we do know that kids are at much lower risk of serious infections than adults, but not zero. There are — there have been deaths in the United States of children, including tragically at death yesterday in South Carolina of a 5-year-old. So there are serious outcomes in children, but far, far less than adults.
What’s less clear is how efficiently kids will spread the virus in school both to each other and to teachers, adults, and parents. In some places in the world, it seems like that has been relatively uncommon, but there are examples such as in Israel in the last couple of months, there have been a large — there was a large outbreak in schools when they reopened.
And so, I think there still is uncertainty that we’re going to have to live with. We probably won’t know all the answers when we started in the fall but we’ll have to watch very carefully and react to what we find.
WALLACE: What to think of the president and Secretary DeVos’ threat to cut school funding for schools systems that don’t reopen fully?
INGLESBY: Yeah, no, I think issuing an ultimatum for schools opening is the wrong approach. I think guiding schools and helping schools with financial support and encouraging schools to follow CDC guidance and state health department guidance is the right way to go.
I think our incentives are all aligned in the sense that everyone really does want schools to open safely, but mandating it under a very tight timeline such as what happens in Florida this week where they’re required to open schools five days a week in 30 days before the state has really even had a chance to review schools plans seems really like the wrong approach to me.
WALLACE: Let’s step back from schools and look at this whole resurgence of the virus in new parts of the country, especially along the Sun Belt. I want to put up a graph of the wave of cases. Note (ph) at the height of the pandemic this spring, we recorded — this is at the height — 36,000 new cases in a single day. On Friday, we saw 68,000 new cases in a single day.
And I want you to take a look at this chart and the yellow line. You can see that as we were all patting ourselves on the back, we bent the curve of new cases in mid-April and after going down from the peak, the new case increase — it started to plateau. But since mid-June, really for a month now, we have seen that huge spike on the left part of the screen.
Doctor, how serious is this surge in new cases and how do you explain it?
INGLESBY: It’s really serious. I think the country is not in a good place with respect to COVID right now. I think — of course, there are places in the country where there are states doing well, but as you said, across the South and in California and in a variety of other states, we’re having sharp increases in cases, sharp increases in hospitalizations and ventilator use and now increases in deaths.
So I think there are number of explanations and it probably depends on the particular location but in general, I think we don’t have unity of message. We’ve been getting conflicting messages about mask use at the White House level, at — from state governors. We’ve had insufficient attention to indoor large gatherings and too many people are meeting for social gatherings in large numbers.
We’ve got to get back to the basics. Wearing face coverings, six feet apart, telecommuting, avoiding large gatherings and really having a strong central message and in places where they’re having serious hot spots, I think we should be given consideration to stepping back from reopening, moving — moving back a phase.
It doesn’t need to look like exactly like it looked in March or April, I think we should still try to have people going to work. But this idea that we can normalize large social gatherings again, that’s just not right, and we’re going to have to change course or we’re going to continue to see these rises.
WALLACE: Let me talk about another aspect of this surge, and that is what’s happening with not new cases, but deaths. And I want to put up the same chart, but with a focus on a different line. Again, look at the yellow line here. That’s not the new cases, that’s the number of deaths, you can see that that spiked in mid-April, has come down sharply, although there has been an increase in deaths in the last week — more than 800 the last few days.
How much comfort should we take, Doctor, in the decrease in deaths against this huge increase in cases?
INGLESBY: I don’t think we should take any comfort in that number. It’s wonderful that the number of deaths went down to into the 200 for a time, but we’re now back to 800 to 900 deaths a day in the United States. If you compare that to the numbers in Europe, for example, Germany had six deaths yesterday. France had deaths in the teens in the last couple of days.
And there are parts of the world where there are no deaths. Vietnam has had no deaths from coronavirus since the beginning. Thailand has had no deaths in six weeks. New Zealand has had very, very little mortality from this.
So, it is not normal — we should not accept as normal the 800 or 900 deaths that we have in this country. We can do better. We can actually make this disease much, much less serious in this country.
WALLACE: Finally, President Trump wore a mask in public for the first time yesterday during a visit to Walter Reed Medical Center. You talked earlier about the mixed messages coming from Washington, the White House, various levels of government.
Do you think it would have made a difference if President Trump and Vice President Pence had started wearing masks months ago? And what you think of this debate, the argument that wearing a mask is a matter of personal freedom?
INGLESBY: I do think it would have been better to have started wearing masks, demonstrating wearing masks at the highest levels of government a long time ago when CDC came out with the original guidance, but at this point, I think the most important thing is to look forward and to think about what will make the most difference.
And I think that having the president, the vice president, and governors wearing masks when they’re out in public is the right thing to do.
I don’t think we should think about this as a personal choice. We don’t think it’s a personal choice to drive through a neighborhood at 80 miles an hour. We agreed to slow down because we want to protect kids.
The same thing is true here. We want to wear masks to protect our neighbors.