#106 - Amesh Adalja, M.D.: Comparing COVID-19 to past pandemics, preparing for the future, and reasons for optimism

Apr 13, 2020

Amesh Adalja, M.D., is a seasoned expert in infectious disease and pandemic preparedness. He compares COVID-19 to past pandemics like the Spanish flu, discussing its origins and the potential for seasonal recurrence. Amesh sheds light on early modeling errors and critiques government responses during the pandemic. He highlights the importance of effective testing and offers reasons for cautious optimism about future pandemic preparedness. His insights underscore the need for continued engagement and learning from our experiences.

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INSIGHT

Adalja's Expertise

Dr. Amesh Adalja has dedicated his career to pandemic preparedness and emerging infectious diseases.
His expertise has allowed him to offer unique perspectives on the current pandemic.

INSIGHT

Early Pandemic Signals

Early reports from China were misleading, downplaying human-to-human transmission.
The first Lancet paper, revealing a case with no market link, confirmed Adalja's suspicions of a wider spread.

INSIGHT

COVID-19 vs. Past Pandemics

COVID-19, like past pandemics (1957, 1968), spreads through respiratory routes with similar symptoms.
It's crucial to remember COVID-19 deaths are in addition to existing flu deaths, not a replacement.

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In this episode, infectious disease and pandemic preparedness expert, Amesh Adalja, M.D., puts the current pandemic into context against previous coronaviruses as well as past influenza pandemics. Amesh also provides his interpretation of the evolving metrics which have contributed to big variations in modeling predictions, whether this will be a seasonally recurring virus, and perhaps most importantly—how we can be better prepared for the inevitable future novel virus. Finally, Amesh explains where he sees positive trends which give him reasons for optimism.

We discuss:

Amesh’s background in infectious disease [2:40];
When did the virus actually reach the US? And when did Amesh realize it would pose a real threat to the US? [4:00];
Comparing and contrasting COVID-19 to previous pandemics like the Asian flu of 1958 and the Spanish flu of 1918 [8:00];
Will COVID-19 be a recurring seasonal virus every year? [14:00];
Will a future vaccine be specific to this COVID-19 or will it also cover previous coronaviruses as well? [15:15];
What does Amesh think might be the true case fatality rate of SARS-CoV-2? [16:15];
Why did early models over predict infections and deaths by order of millions? [18:30];
Role of government—How does Amesh view the role of local versus central government in dealing with a future pandemic? [21:50];
What went wrong with testing and how could we have utilized it more effectively? [25:15];
Future pandemic preparedness—why Amesh is cautiously optimistic [27:30];
Should there be different policies and restrictions for places like New York City compared to less populated and less affected places across the US? [30:15];
Why mass gatherings might be disproportionately driving the spread of the virus [32:30];
Learning from HKU1, a lesser-known novel coronavirus from 2005 [34:00];
Thoughts on Sweden’s herd immunity approach [36:10];
The efficacy of masks being worn in public and what role they will play as restrictions are slowly lifted [37:20];
What are some positive trends and signs of optimism? [39:15]; and
More.

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