Michael Osterholm has been warning for years that the U.S. is not prepared to respond to a pandemic.
The director of the Center for Infectious Disease Research and Policy at the University of Minnesota has been a fixture in media reports since the COVID-19 outbreak turned into a pandemic.
He took time this week to speak with a reporter. The conversation has been lightly edited for clarity and brevity.
What do the latest numbers we are seeing in Minnesota mean to you? We saw a small increase in cases Tuesday (although there was a bigger uptick Wednesday).
The numbers right now could go up or down by 500 percent and it is part of testing phenomena. These small numbers are in a sense just that. You expect variation. It doesn’t tell us anything at all. When the numbers jump by orders of magnitude, then you … know you have something going on.
Minnesota is short on testing supplies. Big problem?
I think it’s a challenge.
What do you think of the state’s response so far?
I think they have done an incredibly good job. I have great respect and appreciation for the Minnesota Department of Health. They are communicating in a very straight-forward manner.
Second of all, they are thinking about the big picture. In other words, what are the issues confronting us right now with this virus? The issue of trying to control it. How do we control it? I think they are looking at that very carefully.
Do you mean things like closing schools and restaurants and social distancing? Are they effective?
I think one of the things we ought to consider is what are we trying to accomplish with these? I think at this point, we have some need for real introspection here. To match up, what we need to do to suppress this virus activity versus what has been recommended.
(Osterholm then noted a recent U.K. study that recommends keeping community mitigation in place until there is a vaccine for the coronavirus. That could take 18 months.)
Does Minnesota have the capacity to treat the number of infections that are likely coming?
We are all in the same COVID virus soup right now. No health care organization in the country is well suited, is well prepared to respond to this in terms of stockpiles of protective equipment.
Will that change?
I don’t think so.
I think the key piece, right now, is health care preparedness. In terms of how are we going to manage the case numbers coming in? That’s going to be important.
Flooding the health care system with a lots of these cases is a challenge. In Minnesota, we don’t have a sense we are there yet.
In places like Seattle and (New York City), they clearly are seeing early increases in cases. Don’t be surprised if you see it taking months literally before case numbers rise around the country, but they will.
What should we be on the lookout for?
If we see increases, orders of magnitude, over a short period of time, there’s substantial transmission in the community. At this point, our whole goal is to keep that curve from going up steeply and from going up high.
A lot of people are worried about the economy. How does economic stress impact overall community health?
This is clearly part of the entire picture. When you put in place social distancing measures, you are counting on the benefit of reducing the number of illnesses that need care.
One thing that has been missed in this discussion is this is likely going to go on for many months. This is not going to be over with by the end of the summer.
We have to ask ourselves not only what can we do, but what can we sustain over time.
COVID-19 has been compared to the Spanish flu pandemic of 1918 that killed 50 million people. Is that a fair comparison?
I think it is. I don’t think (deaths) will be as high as that. What we are seeing is, if this is not altered, if we don’t change the trajectory of cases, we really could see a 1918-like event all over again.
How could have the federal response been better?
We all would have liked to have better testing earlier. At this point, we are pleased that they are looking at this from the standpoint of its real impact. This is a very serious situation.
How does what we are experiencing with COVID-19 compare to what we’ve seen on TV and in movies. “Contagion,” some of which was set in Minnesota, has been trending online.
I can’t recall it. There is no easy and quick vaccine that’s going to show up on this movie script. That’s what is the real challenge.
What’s your advice for everyday folks riding this out?
We are all going through it. As much as the people working on it are dedicated professionals, they’re also humans. This is something that is impacting all of us.
The key message here is: stick with the science. Stick with what we believe is going to have the most impact to reduce the number of deaths.
What should we expect in the coming weeks and months?
I think it could take weeks for some places to see substantial increases. If we are successful in limiting transmission through the mitigation strategies, social distancing, then that should bring the numbers down. We’ll just have to wait and see.
If cases don’t go up right away, that doesn’t mean you are out of the woods. We know with respiratory pathogens like this, you are going to have hotspots in the country, and over time, they will migrate from one area to another.