Future Tense and Rebecca Katz, director of the Center for Global Health Science and Security at Georgetown University Medical Center, were supposed to host a screening of the 2011 film Contagion on March 24. But we had to cancel, for obvious reasons. Instead, we moved the conversation online by having Katz host an Ask Me Anything on Reddit. On Wednesday, she answered questions about what’s real and what’s not in Contagion, the international response to the novel coronavirus, and more.
Katz teaches courses on global health diplomacy, global health security, and emerging infectious diseases. Since 2007, much of her work has been on the domestic and global implementation of the International Health Regulations as well as global governance of public health emergencies, and from 2004 to 2019, she was a consultant to the Department of State, working on issues related to the Biological Weapons Convention, pandemic influenza and disease surveillance.
Some highlights from her Ask Me Anything appear below. The transcript has been lightly edited.
On the movie Contagion
OutrageousCondition6: Do you recommend people watch Contagion if they haven’t already? And beyond entertainment, what valid takeaways does it provide for us these days?
Katz: It is a good movie, so recommend watching for entertainment. I also think there are some aspects of it that are very educational (love that Kate Winslet explains R0), and there are some parts that feel very relevant to today (sitting in a coffee shop and realizing all of the opportunities for virus transmission). But there are some parts that are very much Hollywood—like self-injecting an experimental vaccine. Also, the movie was based on a virus that had a much higher case fatality rate than COVID.
Jglloyd220: In the film Contagion, researchers find that the pathogen mutates as it spreads through the population. Is it something that scientists are concerned about with the new coronavirus as well?
Katz: So far this coronavirus has been pretty stable. There was some research published around two different strains of the virus, though, and that is being more thoroughly investigated.
On the U.S. and international responses
OutrageousCondition6: If you were fully in charge of the U.S. response, what’s the first thing you’d do?
Katz: Started the response in early January!
DawnBRK: Welcome to Reddit AMA, Dr. Katz. My question is: Why aren’t U.S. hospitals releasing clearer statistics of the deaths (age group, if they had pre-existing condition or not) in order to calm some people down? I feel like so many people are freaking out in fear, when they should be able to understand that self-isolation is a matter of precaution, to avoid mass infection of those in risk-groups.
Side note: Hah, just watched Contagion two days ago. :)
Katz: The public health and medical community is indeed sharing information. Data should be reported to CDC. CDC is releasing some of this (not all—which I, too, take issue with). And clinicians are publishing academic papers as fast as possible (and putting prepublication papers online as preprints).
Velken: I remember reading about COVID-19 back in early January when it was still “pneumonia of unknown origin.” Are there concrete steps the WHO or even individual countries can take to improve upon disease surveillance and international broadcasting/reporting?
Katz: China reported these cases to the WHO in late December.
There will no doubt be arguments for a long time re: whether they could have reported earlier. But they reported the end of December, and the WHO declared a Public Health Emergency of International Concern at the end of January.
Are there steps we can take to improve capacity for surveillance and reporting? Absolutely. Under the International Health Regulations, countries are obligated to develop core capacities to prevent, detect, report and respond to public health emergencies. Many countries, however, have not had the resources to build and sustain these core capacities. The global community knows how to provide technical guidance, but requires financial resources (and national level commitment) to put these capacities in place.
nmsmith1br: What are your thoughts about the relatively low number of cases in Africa and what can be learned from Africa about COVID 19?
Unfortunately, I fear that there are probably many unreported cases in Africa.
But what can we learn? Senegal has developed a rapid test for COVID, Nigeria is involved in aggressive contact tracing. Africa CDC is working closely with nations to help them prepare.
lisa_lionheart84: Having spent so much of your career on disease surveillance and public health emergencies, what has surprised the most you about 1) governmental response worldwide and 2) public response to COVID-19? Does this seem like previous outbreaks/pandemics, just on a different scale?
Katz: There are a lot of things that I’m finding pretty surreal right now. I think one of the things that has surprised me is decision makers not taking this seriously enough early on. I’m also struggling with trying to convince the general public that they need to take action … now. I found it very distressing to see so many people out at bars Saturday night. This is dangerous. For you. For your parents and definitely for your grandparents. We haven’t seen anything at this scale in ~100 years.
muserudita: Is our current administration taking and implementing your expert advice about managing this public health crisis?
Katz: The current administration is drawing upon its internal U.S. government experts, but also using the National Academies for advice.
zorastersab: Why are there such large differences between different countries’ tests in terms of both deployment and the rapidness with which results are found? Do you know if there has been any tangible ramp up of production for both testing and treatment (i.e., ventilators)? I understand the U.S. turned down WHO tests, but I’m still confused why some places have “rapid” tests and others don’t.
Katz: I’m pretty confused, too. We should be in a much better place right now re: testing.
My understanding is that testing has ramped up, but it is still difficult to get a test for everyone who wants/needs one and the results take way too long.
On the virus itself
eriee: Is there any reliable information you’ve seen as to whether or not otherwise asymptomatic people have any decrease in lung capacity? (Basically, I know the hold-your-breath-for-10-seconds thing going around was nonsense, but would otherwise healthy individuals with Covid-19 have any way to measure their own health given most don’t qualify for tests.) Also, thanks!
Katz: To my knowledge, there is no way for the general population to know if they are asymptomatic or not. Which means, if you have an elderly or at-risk person in your family, please be very careful and maybe just connect with them virtually.
tnssr: Can COVID-19 be classified as an airborne virus at this time?
Katz: My understanding is that a recent study has shown that the droplets can be suspended for an increased amount of time, particularly in certain health care settings/result from specific medical procedures, but I do not believe it should be classified as airborne at this time.
Mimi108: There have been conflicting reports as to how long SARS-Cov-2 lasts in the air, and on certain objects. I read some articles saying hours in the air, and 9 days on certain objects at room temperature. Then I read other articles saying it lasts half an hour in the air, and 3 days on certain objects. I’m wondering if you perhaps have an idea on what the averages are for the air and on objects, or if this is something that is still being looked at?
Katz: The latest study I have seen (by authors from NIH, CDC, and Princeton) show that it lasts on surfaces up to 3 days. (less time on cardboard and copper, more time on plastics and steel)
nmsmith1br: I’ve recently read that over time it is estimated that 40 percent to 70 percent of the U.S. population will be infected with the virus. Is this a virus that is a one-and-done per individual or is it possible to contract COVID 19 multiple times?
Katz: There are multiple models out there for how much of the population may become infected. These range from 10 percent to over 80 percent. These estimates, though, are directly related to how many social distancing measures are put in place and for how long.
It appears that earlier reports of “re-infection” were really just people having a very long course of disease (or period of time when they are still testing positive). I think everyone is hoping that people who recover develop a natural immunity, but we are still waiting for additional scientific studies to confirm this, as well as to confirm how long such immunity might last. This will be critical information for the response.
Unusual-Trash: How is the development of the vaccine against COVID-19? Is development being effective?
Katz: Vaccine development is happening at lightning speed. There is already a candidate that started Phase 1 trials this week. Know, though, that it is a long process to get through clinical trials and we are still probably about a year to 18 months out.
abh1972: Hello Dr. Katz, I was told the coronavirus would peak in mid-June. Can you confirm that based on your research/models? Thanks.
Katz: It is pretty hard to tell when the peak will be, as we are still seeing new social-distancing measures implemented. My best guess, though, is that we may see a peak sometime between late May and mid-July.
Advice for people who are unsure of what to do
Diablooo: What do you think people with non-coronavirus issues should do about going to the doctor? Should they avoid it and wait it out or go like normal?
Katz: Depends on what the issue is. If it is not a critical appointment, consider postponing. In fact, many providers are changing their hours or postponing noncritical procedures/appointments themselves. But, clearly if it is a necessary appointment (like dialysis) you should keep it.
Your provider will no doubt have new processes in place to keep people as safe as possible.
Also, note that a lot of providers are moving to telemedicine, if possible.
KingKaos420: Am I really safe in my home? Will self-quarantining guarantee I don’t catch it?
Katz: After a full 14 days, if you have totally quarantined yourself, and have not developed symptoms, you should be confident that you are virus free. But after those 14 days, are you re-exposing yourself?
On how people can help
zaboomafoo89: What’s the easiest way to donate supplies to hospitals right now? What kind of supplies will hospitals take? Do masks, gloves, etc., need to be unopened to be donated? Are there other kinds of contributions or donations we should be thinking about right now? Blood or plasma? Food?
Katz: If you have supplies, I’m sure hospitals would be very thankful. I’m not sure what normal procedures are for donating supplies, but I do know that many hospitals and health care providers across the country do not have sufficient numbers of masks There are also calls out right now for donating blood, particularly in more hard-hit areas of the country, as there are severe shortages.
mtaylorcreative: Hi Rebecca, thanks for giving your time. Can you suggest some ways we can help our local doctors, nurses and health care providers? Is there anything regular citizens can do for them during this time?
Katz: What a great question. Acknowledge that they are the front line responders. They are putting their health and well-being at risk every day to fight this pandemic. They may be tired. They may really love a nice meal—or maybe delivery to the hospital. They may be trying to figure out how to provide childcare for their families. But ask them directly!
On what we can expect in the future
CraftyCustard0: Hello. I am filled with anxiety. When can TV shows and other parts of normal life resume? When do you think social distancing will end?
Dr. Katz: Honestly, it may be a while. But it will be OK. There will not be any major disruptions in the food supply. Or water. Or electricity. These sectors are doing the best they can to provide critical services.
And we will hopefully see some of the best of humanity—communities doing everything in their power to provide support to each other.
I also fully expect to see some new ideas, interventions and technologies I’ve never even dreamed of. One of the few good things happening right now is that many smart people from many disciplines and sectors of society are now focused on COVID. I imagine we are going to see things our (pretty small professional community) had never even dreamed of.
Boom12356: Is this the end of humanity?
Dr. Katz: no :-)