COVID-19 is 'running rampant in poorer communities': Fmr. CDC official

Former Center for Disease Control and Prevention Epidemic Intelligence Officer & Chief Medical Officer at Osmosi Dr. Rishi Desai joins Yahoo Finance's Zack Guzman to discuss the latest coronavirus developments as U.S. cases top 4.6 million.

Video Transcript

ZACK GUZMAN: From states of Florida, Texas, California, and Arizona, Texas delaying a little bit of his reporting as we await some updates to the tracking software here across the country. But when we think about what we should be watching, obviously it's very important to dig into what's happening across the country beyond those states.

And for more on that, I want to bring in our first guest today. Dr. Rishi Desai is Chief Medical Officer at Osmosis and a former Center for Disease Control and Prevention Epidemic Intelligence Officer as well. Dr. Desai, good to be chatting with you again. I want to start with a couple of the updates that we're getting on the back half, not just case counts, but also what's happening on the research front.

Drugmaker Eli Lilly seeing shares rise about 1.5% today. As the drug maker said earlier, it's beginning its late-stage trial to study whether one of its experimental antibody treatments can actually prevent the spread of the virus in some of the more susceptible communities we've seen, including nursing homes.

So we're getting that, as well some other updates globally on the vaccine front. So where do you put us at right now, as we continue to try and make progress on some of these silver bullet type of, I guess, treatments out there?

RISHI DESAI: I think you nailed it in terms of how people are thinking about these things, as silver bullets. I think that the fact is that vaccine trials, you know, the first phase that we've passed, and in many cases Phase 2, has kind of been skipped over, because the government has allowed that. Those two phases really take on the order of months, and you're looking at kind of 100 or 200 total individuals that are getting the vaccine.

Now we're entering Phase 3, which is on the order of thousands, tens of thousands of individuals that are going to be getting the vaccine to see how it does. And so now we're really going to get a chance to see, is it safe? How well does it work? So that's what we're entering right now.

On the other front, the monoclonal antibodies, that's a great part of the treatments. We can see that maybe being given to health care workers and other folks to kind of bridge them and give them a short-lasting immunity. It doesn't save you for years.

But certainly for a few months, it can help you out. And of course, all of these things are expensive. So whenever you can do something that's cheaper, like wearing a mask to prevent it altogether, that's ideal. But right now, that's where we are in terms of treatments.

ZACK GUZMAN: Yeah, and it's always good to kind of back up and think about what all this means and what we're trying to do with the vaccine, right, when we think about herd immunity and how many people out there are getting infected. And really, I guess, that becomes the question, is of how effective some of these treatments are going to be, when you think about trying to establish herd immunity out there.

So maybe just, I guess, give an easier explanation on that front, and what we're hoping for, and what investors should actually be watching for when we think about how effective these treatments might be.

RISHI DESAI: Yeah, absolutely. So vaccines are not 100% effective. Let me just say that again. They're not 100% effective. They are some percent effective. And so let's just assume, for the moment, to do the math, that it's 75% effective at preventing you from getting seriously ill. Of course, that's the goal, right? You might get mild illness, but we don't want people getting seriously ill.

And that's really one number, 75%. Then you got to multiply it by how many people actually take the vaccine. So let's say 2/3 of America signs up to take the vaccine, that's 75% times 66%, so really, we're sitting at 50%. So that would be kind of the minimum needed to hit to what we call herd immunity. It's not going to happen through natural infection because, of course, right now, we're roughly seeing 10% of America, maybe even less in some areas.

And it's already crippling us. There's no way we're going to get there naturally, so getting there through vaccine is really the only way there. And I think that that means that both those numbers better look good. So the data has got to show that it's 75% effective or more, and we've got to convince 2/3 or more of Americans to take this.

ZACK GUZMAN: Yeah, which is interesting too, since the FDA threshold has been set at 50% effectiveness so far. And obviously, we'll see where these candidates come in as we as we get these late-stage trial data coming out later on.

But when we think about that, back here in the US, I don't want to get too far ahead of what we should be looking at on the vaccine front the fall, because obviously we're dealing with a lot before then, especially schools opening up. And we did hear from Dr. Deborah Birx, the task force, Coronavirus Task Force Chair here, warning that the US is moving to a new phase.

And of course, we're seeing cases kind of spread from those worrying states to more rural areas now. And when we think about schools opening up, I mean, if you get an outbreak in some of these communities that aren't necessarily as prepared for something like this than a big city like New York, obviously there are larger concerns on that front.

Dr. Fauci also warning about the fact that kids ages 10 to 19 it can spread this disease just as effectively as adults. I mean, what's your take on how all of this might be coming at a bad time, as the US prepares for flu season in the fall and winter? What do you think about schools reopening now and what that could mean for the stresses on our health care system here?

RISHI DESAI: Yeah, I mean, I think that the youngest kids, you know, kids under the age of 10 are the group that deserves the most scrutiny in terms of is it safe to get them back in school? Certainly, I know that getting masks on kids very, very young can be hard, but it has to be done in a very safe way.

So if we're going to open schools up it's got to be in-- kind of a few things have to be checked off your checklist. It's got to be in a community where things are relatively stable, where things are looking good, where there's a lot of adequate testing, where there is kind of no capacity hit on hospital beds, where we feel like we could get folks to the hospital if needed.

And then you've got to do it safely with masks, distancing, the desks out, making sure that teachers feel safe, and that maybe you cohort students, and that you do partial day classes. And ultimately, the schools have to decide all that. So I think that it's a real benefit-risk analysis that's got to be done by the schools. And there's no right answer. But I think the biggest advantage or where it's likely to work first, is in the younger kids.

ZACK GUZMAN: Yeah, and I mean, if that's the case, when we think about reopening here, whether you have to do it on a rolling schedule we've seen pitched at some schools, whether or not you just open up for high schools and middle schools, I mean, there's a lot of different ways you can go. And obviously, we've talked about the social benefits that come along with schools.

In some cases, it's really where kids can only get their meals and wouldn't necessarily get them if they don't go to school. So I mean, when you're weighing that, the emotional things on top of it, of development on top of it, what's your take, maybe, I guess on how the medical community should really be looking at this beyond just the health consequences of coronavirus?

RISHI DESAI: Yeah, you know, and I'll put it out there, I'm a pediatrician as well. And I'm also a dad of a three-year-old. So you know, I have a couple of lenses on this. And I think that you're right. There are a lot of different angles on especially the mental health and development of a child. These kids, they develop a lot between ages zero and five.

And so in that kind of very, very tenuous period, you want to make sure they're getting good food, good nutrition, and not feeling toxic stress from a home environment. All those kinds of things matter. And so again, it comes down to making sure that schools are doing it the right way. I think all too often we look at international data and say, hey, it worked over there. Maybe it could work here.

The thing is that America, and we've shown this, has a bit of exceptionalism. And right now, we're exceptional the fact that we don't like to wear masks. And so if we can't even get ourselves to do that, then how do we expect these other settings to be really, really safe? We've got to do it with a lot of scrutiny, a lot of kind of scientific forward thinking.

ZACK GUZMAN: Yeah, the other thing too, and we're going to be talking about this later on in the show, areas that we have been unexceptional would be testing. And we've fallen behind. We obviously started behind a lot of countries here. We've made strides in catching back up.

We've seen testing capacity go from about 100,000 to 700,000 in the last few months here, but a lot of concern still over the lag time in trying to get a test and getting your results back, effectively making getting tested not worth your time if you don't know it until it's seven days after you could be infecting all these people.

So what might need to come forward in terms of our testing capabilities here before you would even be able to say, all right, now it's safe for kids go back to school and/or the parents of all these kids to go back to work as well as the reopening continues?

RISHI DESAI: Yeah, I mean, it's also-- all the points that you just said, I would underline and highlight, because you're exactly right. It's also community driven. So I live in Oakland. I can tell you, East Oakland has a different situation with testing than a rich neighborhood in San Francisco, where folks can probably find a way to get tested and get results pretty quickly.

And so it's really a tale of two cities. And I think what we need to do is recognize that the outbreak is really running rampant in the poorer communities. And those are the areas where testing is just not either happening, or it's happening, and takes days to get the result, so then what's the point in the first place?

ZACK GUZMAN: Yeah, and we talk about what's going on right now in Washington DC. Testing is a big piece of the legislation that could come through here in the fourth round of stimulus or relief, whatever you want to call it. Democrats pushing for more than about $75 billion in terms of testing capacity here, Republicans only a fraction of that.

So I mean, when you think about how much money should actually be dedicated to testing, frontline workers, still issues of PPE out there, not really talked about as much anymore, but still existing, I mean how much weight should be put on government aid continuing, if not getting ramped up, as this continues, and it continues in a way that I think that people don't realize, to your point, are impacting certain communities harder than others?

RISHI DESAI: Yeah, you're exactly right. I mean, it feels like old storylines sometimes get tired out. But the reality still exists. We still don't have a lot of frontline health care workers feeling safe. And now with this second uptick, the other thing I'll point out is that we've got hospitals that are filled to the brim with COVID-19 patients.

And now those patients are getting sent home on increasing liters of oxygen, whereas, you know, you would have admitted a patient, you know, three months ago for now what you're discharging them with.

And so it's a really scary time to be a frontline health care worker, because the PPE is, again, still not available in all places, and the testing is not there as well. So we're definitely not out of the woods. And if anything, we're seeing something that's much worse than we saw back in April right now.