Georgia Public Broadcasting’s new series What You Need To Know: Coronavirus provides succinct, fact-based information to help you get through the coronavirus pandemic with your health and sanity intact. 

On Second Thought host Virginia Prescott speaks with Dr. Carlos Del Rio, the executive associate dean for Emory University School of Medicine at Grady Health System, about the need for more action to stop coronavirus from spreading. 





Georgia’s benefits to stop the virus

This is a fast-moving epidemic and as a fast-moving epidemic, it also requires fast and bold moving actions. This is the time, it's an unprecedented time, but I'm also confident that we—and I'm focusing here locally— we have in this city, in this state, unique resources. We have always said Atlanta is a public health capital of the world. We have the care, we have the Carter Center, we have academic and research institutions like Emory University, Georgia Tech, like Georgia State, Morehouse. We have a lot. We have incredible companies. We have Fortune 500 companies, Home Depot, UPS, Delta that are all headquartered here in Atlanta. So we have the intellectual and the and the economic capital to do the right thing right now. So, therefore, I am very confident that we will get it right here in the state of Georgia.

Well, you tweeted yourself and you amplified the tweets of others, opinions of others, saying that Georgia is nearing the point of no return of containing the virus. So what needs to be done now?

I think we need several things. And again, I'm going to say Georgia. But the reality is if Georgia does this and the rest of the nation doesn't do it, it's not going to do us any good. We really need federal bold action. But if we're just going to focus here in Georgia, I mean, every governor— the problem is public health is run at the state level and not at the federal level and not at the federal level. So the federal government can make recommendations, but cannot issue executive orders to change things. Well, the states are the ones in charge of public health, and that's why we're seeing states take action individually. Now we need all the states in unison to do the same thing. And what do we need? We need to stay at home.

I'm calling this Operation: Stay at Home. We need everybody to stay home for the next 15 to 30 days. Let's leave it at 15. This virus transmission is about between 5 and 14 days. For the next two weeks, stay at home. And during that time, what we will achieve is two things. Number one, stop future transmissions, because we already have plenty of cases as we are, but we need to stop future transmissions. And I tell you why that is important. With the way this virus reproduces, one infected person today results in approximately two and a half infected persons in five days. But that results in 406 infected persons in 30 days. If we're able to decrease contact of that one infected person today with other individuals by 75%—I'm not talking about 100%; 75% in five days—that will result in less than one infection and in 30 days, we will only have two and a half to three new infections. So if you do the right thing, instead of in 30 days having 400 infections, you have three infections. That is huge. The number one thing we achieve is we achieve future transmissions.

Number two, that buys us some time to scale up testing. By scaling up testing, we'll be able to really— and I'm talking about being able as a country to start testing 50,000 to 100,000 people a day, really, to find who's infected. We don't have any idea where those infected individuals are. But if we truly scale up testing, we will be able to find infected individuals. And what we do is we take those infected individuals and we put them in isolation so they don't infect other people. And the third thing we do during that time is we shore up our healthcare system. We make sure we have the appropriate PPE. We have the appropriate ICU, bed supply, et cetera so we don't get overwhelmed. By doing those things, we're actually doing what's called "flattening the curve." We're preventing an onslaught of patients to come to our hospitals that would actually make our healthcare system collapse. So those are the things that need to happen.

Well, these are terms that have been discussed a lot publicly and privately in the last couple of weeks, flattening the curve. But do you think people are taking it seriously enough? I mean, there are people fluttering Washington, D.C. for the Cherry Blossom Festival and people that are still on the beach.

People are not taking it seriously and that's why we need leadership. This is when we need national leadership and local leaders to stand up and religious leaders. I'm not seeing the religious leaders out there. I'm not seeing the different leaders, the sports leaders in the community. Where are the leaders saying, "This is what we need to do"? Where are people when we need them? I mean, where do we have our business leaders, our spokespeople out there in the news and everywhere? It is not just us, the public health experts and the medical experts. We need the leaders in the business community. We need the leaders in the religious community, in every single aspect of the political community to come out there and say, "This is what we're going to do.” And I have confidence that if we do it, we will stop this virus.

You have seen extraordinary efforts made in China, in Taiwan, in Singapore. They've actually flattened the curve or even turned around the transmission or let's say, put COVID- 19 on its heels temporarily. But that took extraordinary efforts and those are efforts that, I think, people in the United States, with our dedication and commitment to individual liberty, resist, especially government action.

Well, then we need to start looking for where we're going to bury our dead, okay? I mean, that's a decision we have to take. You know, it's a decision between life and death. This is not a decision about anything else. I mean, this could result in, you know, if you have a third of the U.S. population infected—which is a pretty reasonable estimate—that's 100 million people plus infected. If you have a mortality of 1%—which is pretty low right now— we're running about 3.5% in the US. But let's say the mortality was 1 percent. That's a million people dead in the next year. If we're ready for that, then, you know, I'm all in favor of your individual liberties, but just start finding where you're gonna bury your people because quite frankly, this is not a joke.

Well, we know that and we know that, of course, governors are now begging the federal government for assistance with equipment. Where do you think Georgia's hospitals are in terms of readiness for an influx of patients?

Nobody's ready. Nobody's ready in Georgia, in California, across the nation. We're not ready because we simply cannot take this tsunami of patients happening. That's why we're talking about flattening the curve. If we can spread those patients over time, we're gonna do a better job.

Let me talk a little bit about the nature of this spread. We know, of course, it can be rampant, but as we saw on the Diamond Princess cruise ship, it's the cluster effect. It is family members. It is colleagues. Is there some hope in that clusters themselves can be contained?

Yes, by testing. The moment we start wrapping up testing, then you can find somebody infected and you can quickly get to their contacts. But right now, we're in the dark. We're not testing enough people. But in order to ramp up testing, we have to stop the transmissions from ongoing. We need to stop transmissions now. I mean, I cannot stress to you how much buying some time is going to be critical in the response. The federal government did this. When the federal government said "We're gonna go on a 14 day slow down. Stay at home." If people have followed the advice that was given a week ago, we would be in a very different place. But the reality is we haven't.

Well, one of my colleagues obtained a letter from the hospital administration of the Phoebe Putney Memorial in Albany. It was a letter to staff saying hospital staff are being told to return to work if they’re coronavirus-positive but asymptomatic. Now, I'm unclear if this is just in COVID-19 areas or in the hospital in general. This has gotten locals very shaken up. Might this be an acceptable practice of separating doctors who may be symptomatic or other healthcare workers?

I haven't seen the letter, so I cannot comment, but I can tell you as we have more and more infected health care workers, if they stay home, you're not going to have healthcare workers. So you better have healthcare workers that are infected coming around, taking care of others. Then saying everybody infected is going to stay home. So again, that's the challenge we're facing, right? This is a battle. And if your soldiers are getting injured, are you going to leave them home or are you going to, you know, have them come to the frontlines? They'll put on a mask and continue working. I mean, this is the desperate situation and this is what people need to understand. This is going to get— And I feel bad for Putney Memorial Hospital. They're in dire straits and they're under siege and we need to wake up. Do you want your local hospital to become under siege? Then just continue doing and paying no attention.

So you said something about leadership. Now, we have been hearing an awful lot from politicians about this. Are we hearing from enough scientists, do you think?

I think we're hearing from enough scientists, but I think, again, everybody is being a little too timid and everybody's not necessarily—I mean, I respect Dr. Fauci a lot. They're doing a lot. They're trying to do a lot. But it's just not simple. It's just not the pill that you need to take. I compare this to chemotherapy. I mean, this is a cancer, right? This is a bad disease and you need to take chemotherapy. And the medicine you need to take is pretty rough. It's not going to be simple. So we need to tell people the truth and say, "Look, this is gonna be rough, but also we can get this over with." I want to be realistic, but also optimistic. We are going to get over this, but we all have to do it together.

Well, the administration is now saying it's taking 15 days and is going to reassess that social distancing, those guidelines and strictures. What do you think?

They give guidelines, but we haven't executed. We need execution.

Dr. Del Rio’s immediate appeal to the nation

My immediate appeal to a nation is take action now. Stay at home. The president said it very well last week. Stay at home and save lives. We have to take that seriously. Stay at home and save lives.