A candid assessment of where we are now with the corona virus
On 7-15-20, Dr. Ali Khan, epidemiologist and the dean of the College of Public Health at the University of Nebraska Medical Center, was interviewed on Democracy Now!. As Amy Goodman indicated in her introduction, Dr. Khan is the former director of the Office of Public Health Preparedness and Response at the CDC and the author, with William Patrick, of The Next Pandemic: On the Front Lines Against Humankind’s Gravest Dangers, a book published in 2016 that looks at how the world’s public health community responded to outbreaks of the most dangerous infectious diseases over the past quarter of a century.
Dr. Khan told Goodman that the US response to Covid-19 has been “without a doubt, is the greatest public health failure in our nation’s history, and it just continues to be in freefall. We peaked at about 30,000 cases in mid-April, and then squandered two months of lockdown and economic collapse by failing to get the disease contained. Now we’re up to 60,000 cases a day. That’s completely out of step with Europe, Oceania, and East Asia. All of those countries have not only just contained their outbreaks, resumed their economies, and started back schools, but some have just gone all out and said, ‘We’re going to zero.’ New Zealand and some other countries have eliminated the disease. China, with 1.4 billion people, has gone nine days without a domestic case. We’re clearly the outlier with this uncontrolled, failed response here in the United States.
When Goodman asked what the US is doing wrong, he said, “We don’t have a national strategy based on the four principles that everybody else has used to get rid of this outbreak. The first principle to contain this outbreak is leadership: integrated, whole-of-government leadership on the national, state, and local levels. We still don’t have that. We can’t agree on so many things that are important. The second part is, get down community transmission. And this is the role of government, to make sure we’re testing and tracing. Nobody is talking about that anymore – isolating cases quickly, finding those contacts – nor does anybody talk about the metrics around that. The third thing is community engagement. And that’s our role, right? Wear a mask. Wash your hands. Social distance. And the fourth thing is, do what you can to make sure that people who are hospitalized are more likely to survive. And the one drug we know that does that right now is dexamethasone.
GOODMAN: Dr. Khan, you’re the former head of the CDC’s Office of Public Health Preparedness and Response, which included overseeing the Strategic National Stockpile on emergency medical supplies. Can you account for, many months into this pandemic, the United States continuing to have a shortage of tests and masks?
ALI KHAN: I have no explanation for that. I have said I could have grown polypropylene trees by this time for nasal swabs, given the ingenuity of Americans and our biomedical complex to create material, personal protective equipment, to conduct tests. I have no explanation for that. I can say, though, that we have enough testing in the United States currently, if we used it correctly and we got a timely result back and didn’t have to wait a week for the result. This goes back to strategy. We don’t have the right strategy in the United States to get this disease contained. And if we did, we wouldn’t be worried about personal protective equipment. South Korea today has 40 cases. Right? They’re not worried about personal protective equipment. So we’re worried about these things because we can’t contain the disease and not willing to do the hard things, not willing to strip politics out of this, base it on the science and get this disease under control.
JUAN GONZÁLEZ: Dr. Khan, I wanted to ask you about the role of Anthony Fauci in terms of the handling of this disease, because, on the one hand, we see the Trump administration trying to undermine his credibility these days as he increasingly comes into conflict with what the president wants to do, but, on the other hand, there are some legitimate questions. Your assessment of how Dr. Fauci has handled the crisis?
ALI KHAN: This isn’t really about Dr. Fauci. This is about CDC, our nation’s public health agency. We need to see it get its role back of educating the American people, providing the necessary data, and getting us back into containment. There’s no doubt that there were missteps made by our public health agencies and public health professionals. But what we need now is for the talent we’ve always had at CDC to be back at the forefront talking about public health issues. That’s where our public health expertise resides.
JUAN GONZÁLEZ: How optimistic are you about the development of a vaccine?
ALI KHAN: I am optimistic; however, the road to an uncertain vaccine is paved in death. Right now we have about 60,000 cases a day, so basically 600 to a thousand new deaths every day. We can’t wait for a vaccine. And other countries have gotten their diseases contained and eliminated without a vaccine. So, yes, I would love a vaccine, but there’s lots of data that makes it problematic. Immunity may be short-lived. We’ve never had vaccines based on these technologies. But, like everybody else, I’m optimistic. I hope there’s a vaccine. But we don’t need a vaccine today so that we don’t kill another 600 to a thousand people tomorrow. We have the tools.
AMY GOODMAN: Can you talk, Dr. Ali Khan, about what it would mean if the president of the United States simply put on a mask on a regular basis? Trump seeing a mask as weakness – only this past weekend, you saw him for a minute wearing a mask, and he said, well, he was in a hospital? The significance of what this would mean at the federal level? Then you see it go down to the state level – his biggest allies, DeSantis, the governor Florida, for the first time donning a mask. In Arizona – we’re going to speak with the mayor of Tucson today…Governor Ducey, a recent death in Arizona of a Mexican-American man. His daughter said, ‘I say that the governor and the president have blood on their hands.’ Do you feel the same way, Dr. Khan?
ALI KHAN: I believe all of government has blood on its hands…136,000 deaths, preventable deaths, a tragedy, especially since most of the rest of the world has contained this disease, and some have even eliminated it. But what you saw in countries that were successful was that each and every politician, regardless of their party, followed the science. So, everybody said, ‘Wear masks.’ No controversy. Everybody wore a mask. We need to see that here right now at every political level. Wear a mask. That’s one of the four strategies that will get us out of this mess. We need everybody to be wearing a mask at this point.
AMY GOODMAN: Let me ask you about some of the recent studies out of China, Germany and Britain, suggesting that people who have had COVID-19 begin losing their antibodies in just a few months. So, even if there was a vaccine, the significance of this, Dr. Khan, and also of the younger people that we are seeing get sick and die all over the country?
ALI KHAN: Two great questions. Yes, if your immunity is short-lived, that makes finding a vaccine chasing a rainbows to some extent. Again: we don’t need a vaccine to get out of this mess. We can get this outbreak under control. As far as young people are concerned, without a doubt, we see less severe disease. However, young people also can get sick, get hospitalized, die. We’re now learning that about 50% of all people who get infected with this disease are left with some sort of heart abnormality. So, even if you don’t die, there can be long-term complications.
JUAN GONZÁLEZ: And, Dr. Khan, speaking of young people, your sense of how various states and school districts around the nation are handling the issue of the reopening of public schools?
ALI KHAN: I’ll be very honest with you. As a pediatrician, as a father, as a public health professional, we need kids back in school for numerous reasons. But we have to do it safely. And we know we can do this. You know, I just did a review of over 15 countries that were able to safely get kids back in school. But that’s based not just on the safety measures we take and wearing masks and everything else that the kids need to do. It’s based on dropping community transmission. Unless you have approximately 25 cases per million population per day, you can’t reopen schools. So, drop your community transmission. Work with the local health department. Make sure they have the support they need to test and trace everybody. This is what we need to do to get our kids back in school.