May 7th 2020

Democracy Now!

As President Trump starts to reopen the country, Pulitzer Prize-winning science writer Laurie Garrett predicts the pandemic will last at least 36 months. Meanwhile, a top government vaccine specialist says he was forced from his job after he resisted the administration’s promotion of untested treatments for COVID-19. Garrett predicted the pandemic. In an extended interview, she discusses what’s next.

Transcript

This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: This is Democracy Now!, democracynow.org, The Quarantine Report. I’m Amy Goodman in New York City, the epicenter of the pandemic. Joining me, my co-host Juan González, from his home in New Brunswick, New Jersey, the state with the second-highest number of reported infections, next to New York. Hi, Juan.

JUAN GONZÁLEZ: Hi, Amy. And welcome to all of our listeners and viewers across the country and around the world.

AMY GOODMAN: Well, as a new report indicates the coronavirus death toll could reach 3,000 deaths a day by June 1st — that’s a 9/11 every day — President Trump said Tuesday he’s winding down the coronavirus task force, claiming there’s been tremendous amount of progress in fighting the pandemic, which has already claimed more than 71,000 lives in the United States alone, with nearly 1.2 million confirmed cases.

PRESIDENT DONALD TRUMP: Thanks to the profound commitment of our citizens, we’ve flattened the curve, and countless American lives have been saved. Our country is now in the next stage of the battle: a very safe, phased and gradual reopening. It’s a reopening of our country. Who would have ever thought we were going to be saying that? A reopening. Reopening.

AMY GOODMAN: President Trump made the remarks during a trip to Arizona, where he toured a Honeywell Aerospace plant that’s now producing N95 face masks. Trump wore safety glasses but no mask during the tour, ignoring a sign in the factory ordering everyone inside to wear a facial covering. A reporter asked him why he was winding down the task force now, despite an expected spike of deaths into the fall.

PRESIDENT DONALD TRUMP: Well, because we can’t keep our country closed for the next five years. You know, you could say there might be a recurrence, and there might be. And, you know, most doctors or some doctors say that it will happen. And it’ll be a flame, and we’re going to put the flame out. We’ve learned a lot. You know, we’ve learned a lot about the coronavirus. We’ve learned a lot about this hidden enemy. It’s a dangerous enemy. It’s a bad enemy. … And we’re saying that people that are over 60, 65, but over 60 — we’re even saying, sort of, “Stay back for a while. We recommend you staying back for a while.” At the same time, with young children and children, we’d like to see the schools open early next season and on time.

AMY GOODMAN: Vice President Mike Pence said the task force is expected to disband by the end of May. This comes as the White House has blocked Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, the chief coronavirus doctor at the White House, from testifying in front of a House committee. The Institute for Health Metrics and Evaluation at the University of Washington estimates there will be nearly 135,000 deaths in the U.S. by the beginning of August.

Well, for more, we’re joined by Laurie Garrett, former senior fellow for global health at the Council on Foreign Relations, Pulitzer Prize-winning science writer, author of several books, including Ebola: Story of an Outbreak and The Coming Plague: Newly Emerging Diseases in a World Out of Balance, as well as Betrayal of Trust: The Collapse of Global Public Health.

So, Laurie, if you can go through what is happening now? Just as the president insists on opening the country, he is disbanding the coronavirus task force, when you would think you would need it more than ever if you wanted to see any kind of successful, cautious opening?

LAURIE GARRETT: Well, you just summarized it, Amy. I mean, I don’t know what I can add to that. We’re on the ascent. At least two different models, including one a government model, predict that we’re almost going to double the size of our death toll between now and the end of June. Yet the president has decided, you know, “Let’s roll up the tent, bring in the circus act. Come on, everybody.”

JUAN GONZÁLEZ: Laurie, I wanted to ask you — the death toll. The United States has about 4% of the world’s population, yet it has, with all the money spent on healthcare in this country, 25% of — more than 25% of the deaths worldwide. And in recent days, it’s gone as high as one-third of all the deaths in the world are occurring right here in the U.S. from COVID-19.

LAURIE GARRETT: Yeah.

JUAN GONZÁLEZ: What’s your sense of the reason for that?

LAURIE GARRETT: Well, it’s very obvious that we have a patchwork response. We don’t have a unified, national response to the virus. We don’t have any uniform standards, no guidances. The CDC is virtually mum, numbed and silenced. And we’re operating as if every local mayor, every local governor has equal capacity to make appropriate choices and decide how to best fight this disease. And that’s, of course, ludicrous.

And so, you can drive from one county to another, from one state to another — completely different policies being executed. And they’re all competing. They’re competing to get their economies going. They’re competing to get masks. They’re competing to get PPEs, medicines, healthcare workers, ambulances, burial details. It’s insane. We’ve pitted each component of America against each other for resources, for policy, for response. And now the president has raised the stake and said, “And for your economy.”

AMY GOODMAN: So, Laurie, if you could start at the beginning? We see countries like Taiwan, which is right next to China, which dealt with this with extremely few deaths, immediately seeing the need of the supply chain and making sure there was protective — there was personal protective equipment, there was gear, there was testing, right from the beginning. President Trump continually repeats that he was the one, against all advice, that instituted a travel ban against China very early on. But doesn’t that undercut his very case for preparedness, that if he understood early on what this was about, why he didn’t, at the same time, or before — I mean, Dr. Bright has been saying he was warning of this way before — why he didn’t immediately gear up the testing, gear up the making of the protective gear, like other countries did? Take us back to the beginning and talk about what has happened, from the beginning, that led to this catastrophe in this country.

LAURIE GARRETT: Well, Amy, for those of us that went through the SARS epidemic — and I was in China during the SARS epidemic, and Hong Kong — the warning signs were obvious, and they were obvious in that window of time, roughly about three or four days before Christmas going all the way through to New Year’s Eve. It was very obvious that a terrible epidemic was unfolding, that it looked like SARS or it was similar to SARS, that healthcare workers were panicking. The social media all over Wuhan was full of fear and rumors and all the signals that, you know, those of us that follow China have come to accept are the signals that something is out of control in that country.

And if I could see it, sitting here in my living room or my office and just monitoring what’s available on the internet — if I could see that this was happening, then certainly the CIA was seeing it, the Defense Intelligence Agency was seeing it, and a whole variety of other intelligence operations within the United States government were aware of it. And we know, in fact, they were trying to brief the White House. They were directly briefing the president. But he was ignoring it, and he had other things on his mind, including the impeachment trial. And so, that was unfolding on this side, a kind of “let’s just ignore it.”

And on the Chinese side, what was unfolding was a deliberate cover-up, that extended out until January 20th. So you had about six to eight weeks of transmission of this virus going on in Hubei province and Wuhan, and it was basically being lied about. And they were reporting false figures to WHO. They were distorting the information about it to the world and to the rest of China, until Xi Jinping really ordered transparency. And that was on January 19th. So you saw this huge jump in the reported number of cases between January 19th and January 20th, a tenfold increase, because all of a sudden, you know, “OK, bring all those hidden files out of the shelves and tell the world the truth, or some semblance of the truth.”

And we institute our travel ban as a primary tactic to deal with this imminent plague, and it becomes the only policy, really, that Trump is willing to settle for. And it fits nicely with an overarching policy he has vis-à-vis China in terms of tariffs, reducing their trade with the United States, holding their feet to the fire for our economic relationships. So, saying, “OK, no more flights from Wuhan, no more flights from China,” was a comfort zone for the president. It fit.

As this unfolds and countries around the world are doing battle with the genuine outbreak, again, there is a sort of shrug on this side of the oceans, sort of, “Well, you know, it’s not coming here. That’s over there. It’s not us.” Of course, inside the government, every agency that’s responsible for such things has their hair on fire, saying, “This is actually an imminent threat. We need to get prepared. We should be doing X, Y and Z, but it’s being ignored.”

Now, the countries you named, Amy and Juan, are countries that had been through SARS. So, Taiwan, Hong Kong, Singapore, South Korea, Vietnam, these countries all said, “OK, we’ve seen this bad guy before, and we know this is what you’ve got to do when a coronavirus comes in the front door.” And they took very, very strong steps very immediately, and they activated all the networks that they had created after their SARS experience in 2003, or the MERS experience in the case of South Korea in 2015, and they said, “All right, let’s get ready. This is how we respond.” And response included testing, contact tracing, placing people under quarantine, just aggressively bringing it — keeping it small. Don’t let it spread outwards.

But this was not the response in the United States. And by the time the president wakes up and is presented with two separate sets of studies that have models projecting the scale of what we’re up against, with the possibility of 2 million dead, we’ve already got — the horse is out of the barn, as they say. We’ve already got cases in the United States. And in fact, we’re focused on Seattle area of Washington state and a terrible outbreak in that area, but, indeed, the virus has already seeded all over the United States, and we have a huge epidemic pouring in by then from Europe to the East Coast of the United States. So, all the eyes are on China and blocking travel from China, but, in fact, it’s pouring into New York via mostly European tourists, and we’re being swamped.

JUAN GONZÁLEZ: And, Laurie, I wanted to ask you specifically about that, about this recent report that has identified a COVID-19 case in France as early as December of last year. The issue — you mention all of the epidemics of recent years. There was also West Nile virus. There was H1N1. What about the early-warning systems of the advanced countries? Because, obviously, the advanced countries have now been hit the hardest. The U.K. recently has passed France and Italy in terms of numbers of deaths from COVID-19. What does this say about the early-warning systems of the advanced capitalist countries?

LAURIE GARRETT: Well, we’ve been accustomed, Juan, to thinking of outbreaks as over there, you know, somewhere else. The sort of stereotype of an outbreak was it was occurring in a poor country, probably Africa, and that it was in some remote area, and then it got into a city in a developing country. And this was the model. And the role of the CDC was to fly in and provide advice and help set up testing and do all the things that supposedly we’re supposed to be doing here right now and aren’t.

And we had set up a vast apparatus under the Obama administration that built on things already set up under the Bush administration for training overseas, for building up infrastructures, for rapid disease identification and response. And we had programs for doing that here in the United States. I mean, I have, for example, on my shelf here — excuse me for going out of camera for a moment — this big monster, 2005. This was put together under the Bush administration, and it has blow-by-blow details of how each agency in the United States was supposed to respond if we had a lethal pandemic influenza in America. So we have playbooks. We had multiple playbooks. Every administration was setting them up.

But the Trump administration came in with a very different attitude, and most of the playbooks were thrown out. The agencies and the subsets of departments were dismantled. The whole Obama Global Health Security Initiative, that had been set up to train 194 countries in the world in how to spot and respond to an emerging disease, was all but just completely dismantled. The CDC was cut back by 20%. We can go on and on. You’ve all read the articles now. You all know the scale of this catastrophic lack of preparedness.

And then there comes to the whole point of — you know, a kind of hubris issue. I mean, Italy has been wiped out, just devastated by COVID. It’s not a coincidence it’s Italy, because this is a country where the anti-vaccine movement has been enormous, where members of the government have actually been opposed to vaccination and have called for scientists to go mum and stop telling us what to do. It was caught unawares, unprepared and with a kind of smug attitude that if they kept the immigrants, the riffraff, from Africa and the Middle East out, they wouldn’t face these problems. And we have a similar attitude in much of the rest of Europe, and certainly here in the United States, that always associates the threat of infectious disease with immigration. So, if you’re barring immigration, you’re protecting yourself from disease. And this is ludicrous, you know? The disease got into the United States, it got into Europe, via completely legitimate travelers, tourism, business, a globalized business economy — all things that we promote.

AMY GOODMAN: Laurie, what about this Los Alamos National Lab study? It hasn’t been peer-reviewed, and they admitted this. They said they wanted to get it out early. And this goes to the issue of all those that are developing vaccines around the world. But this Los Alamos report that the coronavirus is actually — what is raging through the United States is not out of China, that it is more virulent, and that it does not lead to, when you get it, having immunity, that you can get it again. Talk about the significance of this, what you understand.

LAURIE GARRETT: Well, regardless of that particular report, we’ve already had plenty of clues and causes for concern about whether or not having COVID provides the individual with protective lifelong immunity or long-lasting immunity. You know, certainly, if you survived measles as a child, you’re highly unlikely, if not nearly impossible, that you’re going to come down with measles as an adult. And if you, on top of having had measles, also got vaccinated, now you’re really truly immune to measles. And that’s why a disease that in my childhood was the number one killer of children under 12 in the world is now vanquished in most of the world, because we’ve created herd immunity through mass immunization.

Now, some early prognosticators in this pandemic tried to convince their governments that the way to go was to allow the virus to sweep across their nation. Sure, some people would die, but, hey, the rest would be herd immune. So you would create a mass population of people immune to future waves of virus coming through.

AMY GOODMAN: Case in point, Britain?

LAURIE GARRETT: Case in point, the U.K., currently Sweden. And it’s often been talked about for the United States. There are certainly people on Wall Street that would prefer we took this herd immunity approach so that businesses could reopen. And we saw the lieutenant governor of Texas say that he thought that all old people should be willing to sacrifice their lives for the sake of the Texas economy — that’s almost a quote. And we’ve seen similar statements from Wilbur Ross and members of the president’s Economic Advisory Council.

Well, the problem is that, increasingly, we’re getting evidence, first of all, of people who can get reinfected. Now, this has been highly controversial. We don’t know. Are they — did they ever really completely clear virus in the first place? In other words, is it like HIV, where the virus seems to be gone from your body, routine testing finds no virus, you feel OK, but actually it’s just retreated into types of cells that are not easily found in blood or saliva tests, so it’s been missed — or nasal tests — and so, in fact, it’s reactivated? So it’s not reinfection, it’s reactivation of latent infection, if you will. Or the tests themselves are lousy, and you just missed it, it was there all along. Or, the third option is, you didn’t develop neutralizing antibody response.

Now, this is a phrase that gets bandied about, but a lot of people don’t really know what it means, including people saying it. So, let’s be really clear. The immune system is a very complex system of defense. It has a cellular system, where there are special cells that find enemies and eat them up, you know, and send messages out signaling to antibodies to come in, which are not cells, which are molecules. And so there’s a cellular response. There’s what’s called an innate response, which is the kind of thing you get when you have hay fever and so on. And then there’s a antibody response.

Now, when you get a good vaccine, what that does is activate your neutralizing antibody response and what’s called memory. So, for the rest of your life, or however long it lasts, you have memory in your immune system. And when this enemy shows up again, your antibodies, that are neutralizing — meaning they latch on and they bring in the whole army of the responding immune system, come in, attack and destroy — is activated.

Well, the problem is, there’s really been quite a lot of controversy and difficulty for many different research teams all around the world in proving that there is neutralizing antibody response to this virus and that it’s long-standing, that it survives for weeks, months, hopefully for many years. Now, that has implications for many things. It has implications meaning individuals can get reinfected. You get COVID, you think you’re fine, now you don’t take precautions — well, maybe that’s not a good idea. And then, secondly, it has implications for vaccine development.

JUAN GONZÁLEZ: Well, Laurie, I wanted to ask you specifically about this whole issue of vaccine development or potential for a cure. The EU is leading an effort to raise about $8 billion for development of a vaccine and treatments, but the U.S. has not offered to be involved. Could you talk about the whole issue of this race now to get a vaccine or a cure, and the attempt to monopolize what would be an incredibly [lucrative], obviously, advance in medical science?

LAURIE GARRETT: Yeah. And I can’t think of any epidemic in my lifetime where the United States has taken the backseat and said, “We’re not part of the world.” Excuse me, dry throat. And here we have a situation where not only is the United States saying, “We’re only protecting America. To hell with the rest of you. We’re not part of the world response. We, in fact, hate WHO. We’re going to pull our money away from the World Health Organization. And when it comes to vaccine development, drug development, well, we’re all about developing for us, not for the world. And we’re all about protecting the patent rights of our pharmaceutical industry and putting our companies first. So, no, we’re not going to engage in any global effort.” And we’re not — even more than not engaged, usually we would be in charge. Usually, the United States is setting the example for the whole world. We’re bringing forces together that don’t normally like each other, and saying, “Look, put your animosities to the side for the sake of this crisis,” and we’re doing everything we can to encourage collaboration between drug companies, collaboration between academic centers and private sector and so on.

Well, this administration is exactly the opposite. So we’re saying to the whole world, “You know, we’re blaming China. They made all this. We think it came out of a Chinese lab.” And with the second most powerful country in the world, instead of collaborating to help bring the epidemic under control, we’re going to do this. And similarly, China is responding back to the United States, saying, “We think it came out of one of your labs, and you deliberately infected China. And we’ve had it with you. We’re going to start cutting you off.”

So, at a moment when a massive-scale collaboration is necessary — and let’s be clear, we’re going to have to vaccinate 7.5 billion human beings. It’ll be the largest vaccination effort ever even imagined, much less executed, in the history of our species. When that is being revved up in Europe, and there’s a desperate desire to see Asian countries, European countries, African countries, Latin American countries all collaborating with a common mission, the United States is saying, “Bye, guys.”

AMY GOODMAN: Astounding. You have people like — well, you have countries like Norway who are giving a billion dollars, and, as Juan pointed out, the United States is not giving anything to the vaccine effort. But, Laurie, in an interview you did with The New York Times, headlined “She Predicted the Coronavirus. What Does She Foresee Next?” you said that you see that the pandemic goes on for like 36 months. I think people are cringing all over who are hearing this right now. But if you can say — lay out the scenario. And what exactly does that mean? Do you stay in your home for that amount of time? What would be the most logical, safe reopening, if that can happen, and also dealing with this pandemic? Why do you say 36 months?

LAURIE GARRETT: Well, 36 months is my best-case scenario. Worst case is that it becomes a new permanent feature on the landscape for generations to come.

I think we have to, first of all, put aside this image of a wave, as a uniform tsunami wave coming across — you know, boom, boom, boom, boom, everybody gets hit at once, we all are in lockdown, and then the wave is gone, and now we can come out and hit the beach. It’s not like that. If you haven’t been paying attention, it’s already not a single isolated wave. Parts of the country are starting to get their first cases. Other parts of the country are starting to have a downturn, such as here in New York, where our horrible, horrible epidemic is beginning to come down.

And this is how it’s going to be for months and months to come — sporadic outbreaks here, there, moving towards the Southern Hemisphere, coming back to the Northern Hemisphere, different parts of the world hit at different times. And the movement of humanity is going to be the movement of virus. So, as people come out of not just lockdown in their homes, but out of their countries and back on airplanes, out of sort of trying to operate business via Zoom into business via personal contact, as the supply chains try to restore full-scale operation with globalized distribution, and that means globalized human movement, then we’re going to once again have sporadic outbreaks. So, it’s Italy today. It’s Portugal tomorrow. It’s Albania next week. It’s Rio de Janeiro two weeks later, and so on and so forth. And this is going to go on for a very long time.

Meanwhile, let’s say — my 36-month scenario is if we have very good luck on a vaccine. So, let us pretend that we actually do come up with a very effective vaccine, totally safe, and we have it, through the first stage of development and human testing, before the middle of this summer. And it actually, miraculously, is a vaccine that, number one, can be used in a single dose, no booster required; number two, you don’t have to use syringes, it can be administered nasally, orally or with a patch, so we don’t have to worry about the supply chain on syringes and disposal, safe disposal; number three, it doesn’t need to be refrigerated, so you don’t have to worry about how are you going to use it in countries without electricity and refrigerators; and, number four, it can be mass-produced easily, it’s not terribly difficult to make, there aren’t huge contamination problems, and it’s possible to rev up for production of hundreds of millions of doses right away.

So, then, by the end of 2020, we would be in large-scale clinical trials. By early 2021, if those all miraculously turned out to have no side effects and be just super effective — and we have to figure out how we’re going to determine that something is super effective; you know, you don’t want to deliberately infect people with COVID, so what’s the scheme there? — then, all right, now we have a vaccine. Groovy.

Who has it? Who’s making it? Where are the factories? And who’s going to get it? Well, obviously, it’s going to go to the rich countries first. And it’s going to the country that’s making it first. So, if China beats everybody to the mark, then Chinese will get vaccinated. That’s 1.4 billion people. That’s a lot of doses to manufacture before anybody else in the world gets vaccine. If it’s here, you know, we’re going to make 300 million doses. It’s going to be Americans first. Then we’ll help our Canadian friends, you know? And probably bottom of our list will be Mexico. And this sort of scenario will play out.

But, meanwhile, it’s going to cost money. People are going to want to make a profit off of it. There’s going to be patent disputes. There’s going to be all sorts of international distribution issues that will get in the way. And this epidemic will keep circulating and keep popping up all over the world, and we won’t have a campaign for actually getting 7.5 billion human beings vaccinated. And without vaccinating 7.5 billion human beings, we will continue to have COVID in the world. And if there’s any frailty in this herd immunity and in this vaccine protection that we’ve built, then we’ll have waves of it coming back over and over and over again for years to come. And I see no indication of a mass vaccination campaign coming under gear that would be the largest in the history of humanity, would dwarf what we did with smallpox.

AMY GOODMAN: Well, Laurie Garrett, we want to thank you so much for being with us. We could go on for a long time. And if you were sitting here in the studio, I would have given you some water. But these are socially isolated times. I’m sorry I couldn’t help out. Laurie, thanks so much for being with us, former senior fellow for global health at the Council on Foreign Relations, Pulitzer Prize-winning science writer, author of a number of books. And we thank you so much for being there.

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