Disease Expert: Be 'Cautious' With Reopening, Don't Expect Summer 'Lull'

Meanwhile vaccine developer tells 'Meet the Press' it could know whether close to success by June.
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As the U.S. watches its total known coronavirus infections rise beyond 1.15 million and deaths get close to a staggering 68,000, many are waiting to get back to their jobs, education and normal lives. But an expert at Johns Hopkins warns if the reopening is not performed carefully, it would lead to more deaths and infections.

The doctor also cautioned that according to official counts, most of the infections and deaths have occurred as strict stay-at-home restrictions have still been in place, meaning we're still in a fragile state when it comes to the outbreak.

"I think we need to be going forward very cautiously. I think if you look at the overall country numbers, we’re about 200,000 new cases a week at this point, and in the last month we’ve had something on the order of 60,000 deaths," Dr. Tom Inglesby, director of the Center for Health Security of the Johns Hopkins Bloomberg School of Public Health said on NBC News' "Meet the Press," according to a transcript.

"So, most of the illness and death has occurred over the last 30 days. So, overall, as a country, we still have a long way to go. But the states are in very different places and some states, a small minority of states, are beginning to, to get closer to the White House metrics of two weeks (of) decline. And so, in those places, if they have other capabilities in place, if they’re able to really rapidly isolate and trace the contacts of patients with Covid, if they’re able to diagnose very widely everybody who’s got symptoms of Covid, not just the sick people, but everybody, then those states would be the places where it would be least risky to go ahead and begin to reopen."

Dr. Inglesby's words came as several states were already trying to reopen, and it comes little more than a week after the World Health Organization said it was not certain whether recovering from Covid-19 means immunity to the disease. Information about how many people are infected and have been infected by the novel coronavirus is also under debate.

Later in the day, New York Gov. Andrew Cuomo also spoke to the crisis in his state and the nation, discussing the lingering lack of protective gear, a collaborative effort with other state leaders in the Northeast, and how the virus has affected such daily services as the subway, which is now closed overnight from 1 a.m. to 5.

"The subway service will return when the pandemic ends," said Cuomo. "Public transit, if it is not clean, can serve as a spreader."

In New York, an antibody testing sample has shown that the total infection count was far higher than known, with possibly more than 12% of residents showing some level of antibodies to the virus.

The nation must get a better handle on the number of mild and moderate cases of disease, said Dr. Inglesby. 

"The good news is that we have many, many people who do not get seriously ill with this disease. But the bad news is that we're not capturing those people in terms of numbers for the country and if we don't know who they are, then we can't break their chains of transmission. We can't isolate them, we can't quarantine their contacts, so we need to know much more about the mild and moderate illnesses around the country and that will come with more diagnostic testing."

According to the disease-tracking map by Johns Hopkins, the U.S., which has about a third the known cases globally, has so far tested nearly 7 million people for the disease. But the nation has no idea of the actual total, or who might have had mild cases and not known it. Widespread antibody testing might give a clue to that true picture, and over the weekend, Swiss drug giant Roche RHHBY got an emergency OK from the Food and Drug Administration for its Covid-19 antibody test.

When asked for a timeline of what to expect next, the doctor said, "Well, before we even get to the fall, I am worried that we will have small waves in various places around the country for the coming months. ... Nothing has changed in the underlying dynamics of this virus. If we stop social distancing altogether tomorrow, we would recreate the conditions that existed in the country in February and March."

Then, he said, once fall arrives with no vaccine and the virus competes for bodies to infect with the flu and other viruses, the problem will get worse.

"The flu season will start and at that point, Covid will be mixed with flu and will both be contributing to hospitalizations and ICU beds. And so, we’re going to have two concurrent, large, public health challenges at the same time. So I am worried about the uptake in hospitalization rate and the more people needing intensive care in the fall."

And those expecting a rest from Covid-19 over the summer might be let down.

"I don’t think people should think that there will be a lull, that just because the summer’s coming we’re going to have a lull before the fall. It’d be wonderful if that happens, but I don’t think that we should at all assume that at this point, given the nature of this virus. "

Still, the development of a vaccine could prove a game changer in how quickly the U.S. -- and the rest of the world -- could get back to normal. The promise of such a shot appears possibly closer. Prof. Sir John Bell, Regius Professor of Medicine at Oxford University, said on "Meet the Press" that the vaccine his university is working on has made great progress so far.

"We’ve already started clinical trials, so we’ve already given the vaccine to about a thousand people and we’re going to grow that pretty rapidly. We’ve consolidated the phase one and two programs because we are pretty confident that the vector itself is safe because it’s been used in about 5,000 people already up to now. So that’s allowed us to really accelerate the phase one program and we hope that there would be enough disease that we would get evidence that the vaccine has efficacy by the beginning of June," said Bell. 

But, Bell said, it's too early to know yet the likelihood of success of the vaccine.

This story has been updated.