With the COVID-19 outbreak, vaccine researcher Peter Hotez has become one of the country’s most reassuring presences on cable news: a scientist with a rare ability to explain the complex, fast-changing science of the coronavirus.
His lab is developing a COVID-19 vaccine . An M.D. and Ph.D., he’s a professor and dean of the National School of Tropical Medicine at Baylor College of Medicine, and co-director of the Texas Children’s Hospital Center for Vaccine Development.
Since early March — before community spread was discovered in Houston — he’s talked with us about the virus, the effect it could have on the U.S. and Houston , and his fears about the outbreak in New Orleans .
This week, he discussed the potential dangers of in-person religious services in Texas; the latest coronavirus models for the state; and promising new data that shows that social distancing is working.
Yesterday, Texas Gov. Greg Abbott extended the stay-at-home orders to the rest of the state of Texas. But at the same time he overrode Harris County’s stay-at-home order for churches and other religious institutions. He said that they are essential, and that they do not have to abide by the limits of 10 people per gathering. What are your thoughts on that?
Hopefully most pastors and religious leaders in Harris County and the adjoining counties — Fort Bend, etc. — will encourage their parishioners to stay at home and conduct services via Skype or some other remote means. We’ve realized that for this epidemic, church services do create risks for transmission.
The most extreme example was what happened in South Korea, where the entire devastating epidemic was ignited through a single church group. I think it’s really important that that we don’t have any aggregations of significant numbers of people because this is how this virus works. It’s highly transmissible — much more transmissible than influenza.
Any kind of congregation of more than 10 or a dozen people puts us at great risk.
What are your thoughts about the coronavirus in the Houston area right now?
I think we’re still in the early stages of the epidemic in Houston. We’re starting to see an increase in the number of diagnosed cases.
The actual numbers are not so alarming. But the fact that we’re only now gearing up for testing means that still probably the majority of cases are not being accounted for. So any increase that you’re seeing in in actual numbers of cases is probably not completely reflective of what’s going on in the city. That’s Concern Number One.
Concern Number Two is that we’re now seeing epidemics of COVID-19 in other southern cities, most notably New Orleans, which next to New York probably has the worst COVID-19 problem in America. Undoubtedly, a lot of that was because of keeping Mardi Gras open. One of the lessons learned from that is, we don’t want to wait until cases show up in the ICU to know you have a COVID-19 problem. That’s a recipe for ensuring that hospital systems get overwhelmed.
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On the plus side, the Texas Medical Center, the world’s largest medical center, gives us much more capacity than New Orleans. In Italy and Spain, we saw that when hospital systems become overwhelmed, that’s when the mortality also skyrockets. In Spain and Italy, that’s why they have a 10% mortality rate. Hopefully we can avoid that.
Right now we haven’t seen any specific models or projections for Houston, but Institute for Health Metrics and Evaluation has put out estimates for the state of Texas. That’s one of the things that I’ve been speaking about with the mayor and other city officials. It estimates that the peak for the state of Texas will happen around May 5, and potentially with around 6,000 deaths for the state of Texas.
Of course, models are only as good as their inputs. We know we still are in a steep learning curve about this virus. The inputs are not robust.
But from the best estimates we have, if we’re looking at a major second peak [in fall], that strongly indicates that we should at least be conservative and keep social distancing aggressively in place, at least for the month of April, and then reassess to see whether those models are panning out.
Why does it take so long to tell whether social distancing is working?
We actually now have data from various cities that tells us that social distancing is having an effect. These are some syndromic surveillance technologies that that use an app connected to a thermometer that have 150,000 data points per day for people recording their their body temperatures.
That data is not specific for COVID-19. But as influenza cases start to go down, it becomes more relevant to this coronavirus. What we’re seeing is in cities like Miami and Santa Clara, Calif., is that social distancing has brought down the number of COVID-19 cases.
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It is our first evidence that this seems to be working — and also for what we hope for in Texas and for Harris County: that social distancing is preventative.
What other things should Houstonians keep an eye on?
Staying home is a tall order for people whose wages depend on physically showing up to work. It’s a huge hardship, and it’s devastating for many families. Hopefully, some of the economic stimulus packages coming down from Washington will help.
But I don’t see we have much choice. We don’t have a vaccine in hand, and we don’t have adequate preventative technologies other than social distancing. It’s the one thing we can do to keep ourselves safe.
How are you doing personally?
I’m speaking to you from my home office, where I’m doing social distancing. It’s a back room with Astros T-shirts blocking light from the window, and my cat comes in to sleep and look bored. But my wife, Ann, has helped me set up something in here that resembles an office that will look credible when I’m interviewed on cable news networks.
Is there anything else that you want Houston to know?
All of this is fluid. This is a new virus and new pathogen, and there’s nothing like a new virus or pathogen to make you look stupid. Whatever I’m saying, I may have to do a lot of backpedaling in a couple of days. We’re trying to make our best estimates, given the data that we have at the time.
Dr. Anthony Fauci, director of the National Institute of Allergies and Infectious Diseases, said it best: The virus makes the rules. We don’t make the rules.