Doctor of COVID-19 vaccine: It’s ‘unlikely’ we’ll see the data before the election
Dr. Jeremy Faust, Emergency Medicine Physician at Brigham and Women’s Hospital joins Yahoo Finance’s Zack Guzman to break down the latest coronavirus developments as cases continue to spike around the U.S.
Video Transcript
ZACK GUZMAN: I want to shift our focus over to the numbers that we're seeing rise here in terms of coronavirus case counts as the pandemic is still an issue, even whether or not we get this stimulus bill here in the short term, because we are seeing a worrying rise in case counts coming out of Europe. And I just want to stress the numbers here because it is increasing beyond what we saw back in March-- overall 140,000 daily cases were reported in Europe. That's about three times the level we're seeing play out here in the US, which is also rising but more linearly compared to the exponential increase we're seeing play out in Europe right now.
So for more on that, I want to bring on our next guest here. Dr. Jeremy Faust is emergency medicine physician over at Brigham and Women's Hospital. And, Dr. Faust, appreciate you coming back on here.
When we look at those numbers, talk to me about how worrying it is when we think about the lockdowns that were put in place and now the return to lockdowns as we see cases continue to rise?
DR. JEREMY FAUST: Great to be back with you, Zack. When we-- let's imagine that this were February and we had this level of cases, if March were to occur and we were to behave as we did in March, we would be in for a world of pain. We would-- it would just be a disaster like we haven't seen before-- 1918 proportions. We've learned a lot, so now we have people wearing masks. The CDC is out there saying if you're going to go on an airplane or a bus, please wear a mask. It's so welcome. It's great news.
But we are basically starting this wave, if you will, from a much higher level of cases than I was hoping. Over the summer, places like Massachusetts, New York, New Jersey that were hit hard initially actually had very, very low transmission. And so you had it sort of creeping up over time, and now we're seeing increases and increases. Well, what I'm worried is that we're squandering that sort of pad, that sort of-- that sort of-- that pad that we could land on and say, OK, we see it coming. Let's slow down. Let's modify our behaviors. Let's try to limit indoor gatherings as much as we can. Because if we don't, we would be looking at another situation where you have these record kinds-- well, we already have record deaths-- but another-- just a period of time where we're really not in control of this crisis.
ZACK GUZMAN: Yeah, that's kind of the worrying thing for me, at least, you know, someone who's not in the medical community but watching the case counts here because you saw a lot of people maybe celebrating the fact that, you know, we were doing better. Or on the flip side, talking about-- people saying, look, you know Europe went into lockdown, and they had this figured out. They did such a better job than we did here in the US on a comparative basis. But now, seeing the cases completely explode past that, people may be rethinking about strategies here and what it might say about what was done here in the US.
And lastly, the idea that just because things are better now doesn't mean things could get worse. So in terms of seeing what's playing out in Europe and what we have ahead of us in the winter months, what are your expectations knowing that this could again tick higher exponentially here back in the US at any moment?
DR. JEREMY FAUST: Well, one of the hardest things is, as you say, you could predict it, and it could go the other way. So actually, the really-- the more important thing that I look at is not necessarily forecasting but now-casting, which is actually hard to do, right? We actually don't test everybody, and there's lags between infection and hospitalization and then serious outcomes like death. So even just studying what's happening in this moment is challenging enough.
And so my concern is that in a moment such as now, where we are seeing increases in hospitalization, increased cases, that we're not really-- really doing much. What I'd like to see from a public-health perspective is leadership to say, OK, here's where we're at with our hospital capacity. We're at x%. If we get to this higher percent or if we get to a certain death rate or if we get to a certain count rate, we're going to do these following things. We're going to have a week where we shut down. Or we're going to say no indoor gatherings.
So it would give people kind of a carrot and a stick-- say, look, we're trying to actually do something here, and here's the goal. When you give someone a goal, they can actually sort of adhere to it. Right now, I feel like everyone is just waiting to see how bad it gets, and then we're going to respond. And I think that's not an optimal situation.
ZACK GUZMAN: Yeah, the other big thing that people are watching is progress on the vaccine front there. And I wanted to ask you about that because we have seen a couple of trials paused as patients remain sick. Of course, President Trump on the debate stage back when he was debating Joe Biden had talked about getting a vaccine approved here, tying that to the timing of the election. But considering the fact that we're probably not going to see that phase three trial data even before the election, what does it say about the timeline there? And when he steps to the debate stage again, what might be-- how big of a lie would it be to come out and say that we're going to get a vaccine before the election if we still don't have that data?
DR. JEREMY FAUST: I think we're going to see data soon, whether-- I don't think it's likely to come before the election. I think that the-- Pfizer was looking like it might be first, and a number of us reached out to them and said we want to see safety data. Because as a frontline physician, we're the ones who have to look at our patients and say, look, here's the safety benefit. Here's the safety profile. Here is what it could do for you. And if we don't have-- we can't have that conversation if we only have certain information.
So I think that-- that's not political, that's just a I can't have a medical conversation with a patient without the information. So glad to see that it looks like that-- the FDA adopted this idea that we need a longer tail on the safety data. But I do think that-- look, we have eight or nine vaccines that are in clinical phase three trials. And there are these pauses, like you say, but that's expected.
Right now, the worst news is all for the virus. In us is the best news for the trial. There are so many cases out there. There's so many opportunities for these things to be tested. We don't have to wait around. We have so many cases that we'll see whether the people getting the vaccine or versus getting a placebo are really protected or whether their disease severity is changed. So unfortunately, the fact that the thing is out of control actually might give us answers sooner on the vaccine front.
ZACK GUZMAN: Yeah, and I'm glad you mentioned-- I mean, we don't want to get political when we're talking about a discussion on medicine or the vaccines. But there is an interesting point in terms of a theme that we've discussed in undermining the FDA. We've seen questions about that be raised by critics when we think about the pressure President Trump might be putting on getting a vaccine out quicker rather than later.
Now you also have people criticizing the move by California Governor Gavin Newsom here to say that California is going to want the vaccine that gets approved before that's rolled out in his state. Two things on that front, Dr. Faust, when you think about unnecessarily slowing down the process to get a vaccine out the door and then second, calling a spade a spade here. Does that not also undermine belief that the FDA, or the CDC for that matter, might be doing their jobs to make sure that these things are safe? What do you say?
DR. JEREMY FAUST: It's a really important point. I understand where the governor is coming from in the sense that the FDA has not been reliable. No one's perfect, right? We all make mistakes, and we're learning. That's what science and expertise is about. So I'm not holding them to some unfair standard, I don't think.
But when they've made mistakes that were clear like the hydroxychloroquine story, moving too soon on convalescent plasma, and just the stories we hear about the influence from the White House-- inappropriate. And so that leaves governors in a situation-- and quite frankly, people like me where I say, look, we-- they might approve something, and we'll tell you after that if it's good or bad because we'll have to look at it. So it could delay things, but that's an unforced error that the FDA has created in my opinion. And hopefully that won't take up-- that won't cause sort of a bottleneck.
The other thing to realize is scalability, right? The day that these things are announced isn't the day that there's a dose for every American. And so there's a little bit of time there to say, OK, look, while this gets ramped up let's take a look and see if it's real. Of course, there's momentum. We don't want to push something forward that's really harmful or at least not helpful, but I do think that, you know, the day that there is an announcement won't be the day that you're going to put your arm out and get injected. So there is time for this, and unfortunately as I mentioned, because of this sort of disconnect between reality and politics, we are expecting that we'll have to take a very close look at it and take no one's word on anything.
ZACK GUZMAN: Yeah, and to Governor Gavin Newsom's credit, he says that that policy will not be dependent on who is president come 2021 either, so trying to not play politics there. But Dr. Faust, Dr. Jeremy Faust, emergency medicine physician at Brigham and Women's Hospital. I always appreciate chatting with you, so thanks again and be well.
