Transcript: Lessons Learned about COVID-19 | Jun 24, 2020

Steve sits in the studio. He's slim, clean-shaven, in his fifties, with short curly brown hair. He's wearing a blue suit and shirt, and a checked blue tie.

A caption on screen reads "Lessons learned about COVID-19. @spaikin, @theagenda."

Steve says FOR ALL OF US, THIS PANDEMIC HAS MEANT A STEEP LEARNING CURVE. FOR MEDICAL EXPERTS AND RESEARCHERS - WELL, IF EVER THEIR WORK WAS MORE IN THE SPOTLIGHT, IT'S HARD TO THINK OF WHEN THAT WOULD HAVE BEEN. AS ALMOST ALL OF ONTARIO IS NOW REOPENING AND WE'RE TRYING TO LEARN TO LIVE WITH COVID-19 IN OUR MIDST, WE WELCOME DR. ISAAC BOGOCH FOR THE LATEST. HE IS AN INFECTIOUS DISEASES PHYSICIAN AT THE UNIVERSITY HEALTH NETWORK AND A SCIENTIST BASED OUT OF THE UNIVERSITY OF TORONTO. DR. BORGOCH, IT'S GOOD TO SEE YOU AGAIN. HOW ARE YOU MANAGING SO FAR?

Isaac says NOT TOO BAD. THANKS FOR HAVING ME BACK ON.

Steve says NOT AT ALL. IT'S GOOD TO SEE YOU. LET'S START WITH THE OBVIOUS. ALMOST ALL OF ONTARIO IS MOVING INTO STAGE 2 WITH THE EXCEPTION OF WINDSOR ESSEX IN SOUTHWESTERN ONTARIO. WHAT IS YOUR ADVICE TO THE PEOPLE WHO WILL NO DOUBT START FLOCKING TO PATIOS, TO HAIR SALONS, TO MANI-PEDI PLACES, ET CETERA.

The caption changes to "Isaac Bogoch. University Health Network."

Isaac says IT'S NICE TO HAVE NEW FOUND FREEDOMS AND WHERE WE CAN LIFT PUBLIC HEALTH RESTRICTIONS, WE HAVE TO REMEMBER WE'RE STILL IN A PANDEMIC. OUTSIDE OUR BORDERS, THE WORLD IS GETTING WORSE, NOT BETTER. WE KNOW HOW CONTAGIOUS THIS INFECTION IS. IT IS NOT GONE IN CANADA, IT IS NOT GONE IN ONTARIO, AND WE HAVE TO BE VIGILANT AND ADHERE TO THE TRIED AND TESTED HEALTH MEASURES THAT WORK: PHYSICAL DISTANCING, HAND HYGIENE, PUTTING ON A MASK WHEN YOU'RE IN AN INDOOR ENVIRONMENT. IT'S AS SIMPLE AS THAT. IF WE CAN ADHERE TO THOSE MEASURES, WE CAN DO WELL WITH THIS GRADUAL REOPENING AND THIS STAGED REOPENING WILL PREVENT US AND OTHERS FROM GETTING THIS INFECTION IF WE DO THAT.

Steve says MASKS INDOORS, YES. WHAT ABOUT MASKS OUTDOORS ON PATIOS WHERE I KNOW THE ESTABLISHMENTS ARE GOING TO TRY TO ESTABLISH PHYSICAL DISTANCING PROTOCOLS, BUT IT'S GOING TO BE TRICKY.

The caption changes to "Isaac Bogoch. University of Toronto. @BogochIsaac."

Isaac says IT SURE IS. YOU KNOW, THERE'S THE PUBLIC HEALTH ANGLE AND THEN THERE'S THE SCIENCE ANGLE. FROM THE SCIENCE ANGLE, I THINK THIS IS A FASCINATING AREA TO DISCUSS BECAUSE IT'S NOT ENTIRELY CLEAR WHAT THE DEGREE OF TRANSMISSION IS IN OUTDOOR ENVIRONMENTS. CERTAINLY IN ONTARIO WE'VE HAD A FEW HIGH-PROFILE EVENTS. WE'VE HAD THE TRINITY BELLWOODS EVENT SEVERAL WEEKS AGO NOW AND IT DOESN'T REALLY LOOK LIKE THAT CONTRIBUTED TO ANY BUMP IN CASES. CERTAINLY WE'VE SEEN BLACK LIVES MATTER AND MANY PROTESTS THROUGHOUT CANADA AND THE UNITED STATES. WE SAW VARYING DEGREES OF MASK USE, VARYING DEGREES OF PHYSICAL DISTANCING IN THESE PROTESTS THAT INVOLVED THOUSANDS AND THOUSANDS OF PEOPLE, AND TO DATE, KEY WORD TO DATE, WE HAVEN'T SEEN A BIG INCREASE IN CASES THERE. CERTAINLY THERE WAS A SCENE FROM CHERRY BEACH IN TORONTO FROM THIS PAST WEEKEND WITH BIG CROWDS AND THOSE SETTINGS, WAY TOO SOON TO KNOW IF THERE'S ANY TRANSMISSION FROM THOSE SETTINGS. THE KEY POINT HERE IS THAT IT'S NOT ENTIRELY CLEAR WHAT THE ROLE IS OF MASKS IN OUTDOOR SETTINGS. THAT'S FROM A SCIENTIFIC STANDPOINT. FROM A PUBLIC HEALTH STANDPOINT, MAINTAIN PHYSICAL DISTANCING, PUT ON A MASK. I WONDER IF THAT'S GOING TO CHANGE WHEN WE LOOK AT DATA FROM OUTDOOR ENVIRONMENTS AND I'M CURIOUS TO SEE SOME OF THE SCIENCE AND EPIDEMIOLOGY EVOLVE ON THAT FRONT.

Steve says ONE THING WE CERTAINLY DO KNOW IS SOME OTHER JURISDICTIONS, BE THEY PROVINCES, STATES, COUNTRIES, SOME WHICH HAVE RECENTLY REOPENED IN A BIGGER WAY HAVE SEEN THEIR CASES SPIKE UP A LOT AND NOW SOME OF THEM I GATHER ARE HAVING TO RETRENCH AND TELL PEOPLE, WHOOPS, YOU BETTER GET BACK TO WHERE WE ONCE WERE, WHICH POLITICALLY IS A VERY TOUGH THING TO DO. TALK TO US ABOUT THE PROVINCE OF ONTARIO. IF, HEAVEN FORBID, AS WE REOPEN, CASES START TO SPIKE AGAIN, WHAT NUMBERS... RIGHT? WE'VE BEEN LESS THAN 200 A DAY OR AROUND 200 A DAY FOR, I DON'T KNOW, EIGHT OF THE LAST TEN DAYS, SOMETHING LIKE THAT. WHAT NUMBERS WOULD NECESSITATE OUR CLOSING UP A LITTLE BIT MORE AGAIN?

Isaac says WELL, I THINK HERE'S WHAT'S GOING TO HAPPEN. IT'S NOT UNEXPECTED. IN FACT, LET ME SAY THAT A DIFFERENT WAY. IT'S EXPECTED TO SEE SPIKES IN CASES OR OUTBREAKS IN CASES. THIS IS HOW THIS INFECTION MANIFESTS ITSELF. IT'S PATCHY. WE'VE HEARD THIS TERM, THIS 20-80 RULE WHERE 20 percent OF PEOPLE ARE RESPONSIBLE FOR ABOUT 80 percent OF INFECTIONS. THERE'S GOING TO BE POCKETS AND SMALL OUTBREAKS OF THIS INFECTION. WE'VE SEEN THIS GLOBALLY AND WE WILL SEE THIS IN ONTARIO AND WE'VE ALREADY SEEN IT THROUGHOUT CANADA WHERE THERE'S GOING TO BE A CASE HERE, A CASE THERE, A SMALL OUTBREAK HERE, AND ESSENTIALLY WE'RE GOING TO BE PLAYING WACK A MOLE TRYING TO QUELL THESE OUTBREAKS AS THEY POP UP. THAT IS EXPECTED. NOW, IF WE DON'T HAVE SYSTEMS, LIKE EARLY DETECTION SYSTEMS OR WE DON'T HAVE THE CAPACITY TO RAPIDLY RESPOND TO THOSE AND QUELL THOSE OUTBREAKS AND THEY SORT OF SNOWBALL INTO A MUCH LARGER OUTBREAK, OBVIOUSLY THAT'S A HUGE PROBLEM. IN A SITUATION LIKE THAT, I THINK IT'S VERY LIKELY THAT WE'LL SEE REIMPOSITION OF THESE PUBLIC HEALTH RESTRICTIONS. WE'VE SEEN THIS IN PLACES THAT HAVE DONE THIS RIGHT. SO IN GERMANY, IN SOUTH KOREA, IN JAPAN, IN MANY OF THESE PLACES, THEY HAVE... WHO HAVE MANAGED THIS INFECTION VERY WELL, THEY'VE HAD OUTBREAKS, EXPECTEDLY. THEY HAVE SUCCESSFULLY QUELLED THOSE OUTBREAKS. I THINK IT'S IMPORTANT, THAT LISTENING TO THESE PUBLIC HEALTH RESTRICTIONS IS NOT A ONE-WAY PATH FORWARD. THERE'S GOING TO BE EBBS AND FLOWS AND CERTAIN AREAS MIGHT NEED TO CLAMP BACK DOWN AND LIFT BACK UP AS WE CONTEND WITH THIS VIRUS IN THE PRE-VACCINE ERA. IT'S GOING TO BE CHALLENGING. IT'S GOING TO BE CHALLENGING. I THINK THAT'S AN EXTREMELY IMPORTANT PART OF THE COMMUNICATION THAT SOMETIMES GETS LOST AS EVERYONE GETS EXCITED TO GO HAVE A DRINK ON A PATIO OR GET THEIR HAIR CUT. THIS ISN'T OVER YET. WE STILL HAVE A PANDEMIC AND THIS IS STILL AFFECTING US IN ONTARIO AND ELSEWHERE IN CANADA.

Steve says SURE, BUT EVERYBODY IS LOOKING TO METRICS TO SEE, NOW THAT WE'RE IN STAGE 2, OKAY, WHEN DO WE GET TO THINK ABOUT STAGE 3? AND IF WE'RE AROUND 200 CASES A DAY, 200 NEW CASES A DAY, PEOPLE HAVE GOTTEN PRETTY ENCOURAGED ABOUT THAT. THAT'S PRETTY GOOD. IF, AS WE REOPEN, WE GET UP TO SAY 400 CASES OR 500 CASES A DAY WITH REOPENING, WOULD THE ADVICE FROM YOU THEREFORE BE: SORRY, NOT GOING TO STAGE 3 UNTIL WE GET THEM LOWER?

Isaac says OH, ABSOLUTELY, ABSOLUTELY. IF THERE'S HIGH DEGREES OF SUSTAINED COMMUNITY TRANSMISSION, FIRST OF ALL, THERE'S NO WAY THAT I THINK THE PROVINCE WILL MOVE TO STAGE 3. SECONDLY, THEY'LL PROBABLY GO FROM STAGE 2 BACK TO STAGE 1. JUST LIKE WE REOPENED IN A REGIONAL MANNER, I WOULD BET THAT THEY WOULD CLOSE OR SHUT BACK DOWN IN A REGIONAL MANNER AS WELL. OF COURSE, IF THERE WAS A LARGE PROVINCIAL ISSUE OR IF THERE WAS WIDESPREAD DISEASE TRANSMISSION, THEN THEY MAY OPT TO TAKE A PROVINCE-WIDE APPROACH. BUT I DON'T THINK THERE'S GOING TO BE A FIRM NUMBER. I DON'T THINK YOU'RE GOING TO SEE ONE METRIC THAT'S GOING TO BE DRIVING THIS. THIS WILL LIKELY BE A COMBINATION OF METRICS TO PAINT A MORE HOLISTIC PICTURE OF WHAT IS ACTUALLY HAPPENING, WHAT IS THE REASON BEHIND THOSE NUMBERS AND WHAT'S DRIVING THE OUTBREAK. SO CERTAINLY, FOR EXAMPLE, YOU CAN HAVE A VERY FOCAL OUTBREAK, FOR EXAMPLE, IN A MEAT-PACKING PLANT OR A CONGREGATE SETTING AND THERE'S LITTLE SPILLOVER OUTSIDE OF THAT IF IT'S JUMPED ON RIGHT AWAY AND THERE'S CAREFUL CONTACT TRACING AND ISOLATION OF CONTACTS AND THOSE AFFECTED AND YOU MIGHT NOT HAVE TO REIMPOSE BECAUSE OF A FOCAL OUTBREAK. THAT REALLY ONLY WORKS IF YOU JUMP ON THOSE OUTBREAKS QUICKLY. I THINK IT'S VERY HARD TO PICK A SINGLE NUMBER OR A SINGLE METRIC TO DRIVE A PUBLIC HEALTH POLICY AND THEY WILL BE LOOKING FOR A MORE HOLISTIC APPROACH INTO WHAT'S HAPPENING IN ORDER TO EITHER HE LIFT OR REIMPOSE PUBLIC HEALTH RESTRICTIONS.

Steve says LET ME ASK YOU ABOUT THE BORDER. WE KNOW THE AMERICAN AND CANADIAN OFFICIALS HAVE AGREED TO KEEP THE BORDER CLOSED THROUGH MUCH OF JULY. AT ONE POINT SHOULD WE START TO RECONSIDER THAT AND LOOK AT POTENTIALLY REOPENING THAT BORDER?

Isaac says IT'S HARD TO KNOW. BUT CLEARLY IT'S NOT NOW. WHEN WE LOOK SOUTH OF THE BORDER AND WE SEE THINGS GETTING PRETTY BAD IN MANY OF THE STATES. SO I KEEP TRACK OF THIS EVERY DAY, BUT THERE'S SEVERAL STATES THAT ARE GETTING WORSE AND WORSE AND WORSE AND PLACES LIKE FLORIDA, TEXAS, ARIZONA, SOUTHERN CALIFORNIA ARE SHOWING VERY HIGH NUMBERS OF NEW CASES PER DAY, AND WE'RE STARTING TO SEE HEALTH CARE SYSTEMS STRETCHED BEYOND CAPACITY AND SADLY THE ARROWS MAY BE POINTING TOWARD WHAT WAS SEEN IN NEW YORK SEVERAL MONTHS AGO WHERE THE HEALTH CARE SYSTEM WAS STRETCHED BEYOND CAPACITY. IT'S GOING TO BE HARD TO RIGHT THAT SHIP. EVEN IF THEY TOOK EVERY STEP NECESSARY, EVEN IF THEY TOOK THE MOST EXTREME STEP LIKE IMPOSED A LOCKDOWN THERE, IT WOULD STILL TAKE A WHILE TO RIGHT THAT SHIP. AND WE KNOW THAT MANY OF THOSE PLACES ARE NOT TAKING EXTREME MEASURES TO GET THIS UNDER CONTROL AND WE'RE WATCHING THESE CURVES SHOOT UP WITH... SOME OF THESE PLACES HAVE EXPONENTIAL GROWTH OF COVID-19. IT'S REALLY UPSETTING TO WATCH. SHORT STORY LONG, I DON'T THINK THEY'RE GOING TO BE OPENING THE BORDER ANY TIME SOON AND I THINK THAT'S THE RIGHT MOVE. IT'S HARD TO KNOW WHAT THE EXACT NUMBER IS FOR WHEN THEY'D WANT TO REOPEN THE BORDER. BUT EVEN IF THE BORDER STARTS TO GET REOPENED, WE'LL STILL NEED MEASURES TO TRACK PEOPLE THAT COME INTO CANADA TO ENSURE THAT THEY'RE NOT IMPORTING THIS INFECTION. WE'VE DONE SO MUCH HARD WORK HERE AND IT WOULD BE TERRIBLE TO UNDO IT IF WE IMPORT A LOT OF THESE INFECTIONS.

Steve says LET'S COME BACK TO THE ISSUE OF MASKS FOR A SECOND. YOU'VE TOLD US WHEN IT MAKES SENSE TO WEAR MASKS AND YOU'VE TOLD US THAT THE JURY IS OUT WHEN IT COMES TO OUTDOORS. IT CAN'T BE A BAD THING TO PUT A MASK ON WHEN YOU THINK YOU'RE GOING TO BE NEAR OTHER PEOPLE, RIGHT? WE KNOW THAT MUCH. DO YOU THINK THE PROVINCE OF ONTARIO OUGHT TO BE BUYING LITERALLY MILLIONS OF MASKS AND DISTRIBUTING THEM TO THE POPULATION FOR FREE?

Isaac says I DO. I THINK THAT'S A GREAT IDEA. I THINK THERE'S OTHER PLACES THAT HAVE DONE THIS AND HAVE DONE THIS SUCCESSFULLY,IEN A MACRO LEVEL, SO YOU'RE SEEING THIS DONE, FOR EXAMPLE, IN PLACES LIKE ALBERTA. AND THEN ON A MORE MICRO LEVEL, YOU'RE SEEING THIS DONE SUCCESSFULLY. THERE ARE SEVERAL LARGE GROCERY CHAINS, FOR EXAMPLE, WHEN YOU WALK IN THE FRONT DOOR, THEY HAVE SOMEONE STANDING THERE WITH A BOX OF MASKS, THEY HAVE THESE TONGS, THEY SORT OF PUT THE TONGS IN, HAND YOU A MASK, AND YOU EITHER PUT IT ON OR YOU DON'T PUT IT ON. OF COURSE, MY BIAS IS, PUT IT ON! YOU'RE GOING INSIDE. YOU'RE GOING TO BE AROUND OTHER PEOPLE. PUT A DAMN MASK ON. IT'S NOT THAT HARD. BUT IF YOU WATCH THESE SETTINGS WHEN PEOPLE ARE NORMALIZING IT AND MAKING IT CONVENIENT AND PASSING IT OUT, IT'S REMARKABLE HOW MANY PEOPLE ACTUALLY PUT A MASK ON. I THINK IT'S A TERRIFIC INITIATIVE. SO IF WE MAKE THESE AVAILABLE, IF WE HAND THEM OUT, IF WE NORMALIZE THIS BEHAVIOUR, ESPECIALLY IN SETTINGS WHERE YOU REALLY SHOULD BE WEARING ONE, I'M ALL FOR IT. I THINK THAT WOULD BE GREAT. WHEN WE THINK ABOUT INTERVENTIONS AND THE COSTS OF DIFFERENT INTERVENTIONS AND THE BANG YOU GET FOR THE BUCK, THIS IS PROBABLY ONE OF THE MORE COST EFFECTIVE AND REASONABLE INTERVENTIONS. AGAIN, YOU'VE GOT TO THINK ABOUT WHERE YOU'RE GOING TO BE DOING SOMETHING LIKE THIS, RIGHT? ONTARIO IS A HUGE PLACE, AND OF COURSE WE SHOULD ENCOURAGE THIS EVERYWHERE, BUT IF YOU'RE REALLY GOING TO BE A STICKLER, YOU START THIS IN THE HIGHER IMPACTED REGIONS LIKE PEEL, TORONTO, WINDSOR ESSEX. THAT'S WHERE I'D FOCUS THE ATTENTION NOW AND THEN YOU CAN SORT OF SPREAD TO OTHER PLACES AFTER THAT.

Steve says THERE IS A DEBATE AS TO WHETHER OR NOT THE GOVERNMENT OF ONTARIO OUGHT TO PASS A LAW FORCING PEOPLE TO WEAR MASKS WHEN THEY'RE INDOORS. WHAT'S YOUR TAKE ON THAT?

Isaac says I'D BE VERY WARY ABOUT THAT AS OF TODAY. OF COURSE, THINGS CAN CHANGE. BUT AS OF TODAY, I'D BE KIND OF LEERY OF SOMETHING LIKE THAT. IF YOU'RE GOING TO MANDATE IT, THEN YOU'VE GOT TO THINK ABOUT SEVERAL OTHER THINGS: ONE, ENFORCEMENT. HOW ARE YOU GOING TO ENFORCE IT? ARE YOU GOING TO FINE PEOPLE FOR NOT WEARING A MASK? WE KNOW HOW WELL THAT PLAYED OUT FROM A PUBLIC PERCEPTION AND TRUST IN PUBLIC HEALTH STANDPOINT IN TORONTO WHEN TICKETING OFFICERS WERE GIVING PEOPLE 800 dollar TICKETS FOR WALKING THROUGH A PARK. THAT ACTUALLY WAS EXTREMELY DETRIMENTAL TO PEOPLE HAVING TRUST IN THE SYSTEM AND BUYING IN. YOU CAN THINK ABOUT ENFORCING IT BUT YOU'VE GOT TO REALLY THINK ABOUT HOW YOU'RE GOING TO ENFORCE IT. IF YOU'RE NOT ENFORCING IT, IF IT'S A FINGER-WAG OR PROVIDING EDUCATION FOR MASK-WEARING, THEN THAT'S NOT A MANDATE. THAT'S A STRONG RECOMMENDATION, WHICH WE ALREADY HAVE. THE NEXT THING YOU'VE GOT TO THINK ABOUT IS EQUITY. IF YOU'RE GOING TO MANDATE THEM, YOU HAVE TO) FREE. YOU CAN'T RESTRICT PEOPLE FROM INTERACTING WITH THE WORLD AROUND THEM BECAUSE THEY DON'T HAVE THE FINANCIAL MEANS OR THE CAPACITY TO BUY OR PRODUCE A MASK FOR THEMSELVES. YOU JUST CAN'T... THERE'S A HUGE EQUITY ISSUE HERE. IF YOU'RE GOING TO MANDATE IT, YOU GIVE THEM OUT FOR FREE. THE THIRD THING IS GEOGRAPHY. WHEN I THINK ABOUT GEOGRAPHY, I THINK ABOUT MICRO GEOGRAPHY. WHERE ARE YOU GOING TO MANDATE THESE? YOU HAVE TO BE SMART. IF YOU'RE GOING TO MANDATE THEM, THEN MANDATE THEM IN THE APPROPRIATE SETTINGS. FOR EXAMPLE, INDOOR SETTINGS. ARE YOU GOING TO START TO MANDATE THESE IN OUTDOOR SETTINGS? IT GETS A LITTLE QUESTIONABLE IN THAT REGARD. WHEN WE THINK ABOUT GEOGRAPHY, I THINK ABOUT GEOGRAPHY ON A MACRO LEVEL SETTING. ONTARIO IS A HUGE PLACE. WE LOOK AT SOME PLACES IN ONTARIO WHERE THERE'S DISEASE TRANSMISSION, FOR EXAMPLE PEEL, TORONTO, WINDSOR ESSEX, AND THEN YOU LOOK AT OTHER PLACES WHERE THERE'S LITTLE TO KNOW DISEASE TRANSMISSION. KENORA, TIMMINS, THUNDER BAY. IT'S A LOT EASIER TO TELL PEOPLE TO PUT ON A MASK WHEN YOU'RE IN A HIGH-BURDEN AREA. BUT IMAGINE THE CHALLENGES YOU'RE GOING TO HAVE FORCING PEOPLE TO WEAR A MASK THAT GET ON A BUS IN KENORA, ONTARIO, OR IN NORTH BAY. I THINK PEOPLE HAVE TO THINK OUTSIDE OF DOWNTOWN TORONTO, AND THERE'S A LOT OF SORT OF DOWNTOWN TORONTO CENTRES WHEN YOU HEAR ABOUT POLICIES LIKE THIS. THESE ARE JUST THINGS TO CONSIDER. THERE ARE ALTERNATIVE APPROACHES. NOW, LOOK. IF THERE'S A HUGE OUTBREAK AND IT'S WIDESPREAD THROUGHOUT ONTARIO, WE MAY GET TO THAT POINT WHERE MANDATING IT IS GOING TO BE THE RIGHT MOVE. BUT, LIKE, AS OF TODAY, I JUST DON'T THINK IT'S THE RIGHT MOVE. I APPRECIATE THAT THERE'S TREMENDOUS STRONG OPINIONS ON THIS, TO SAY THE LEAST. I ALSO APPRECIATE THAT WE'RE NOT THE UNITED STATES. AS POLITICIZED AS THIS ISSUE HAS BECOME, WE ARE NOT THE UNITED STATES, WHERE I THINK THAT MASK DEBATE IS RATHER DISGUSTING WHERE IT'S BASICALLY DEVOLVED INTO IF YOU'RE A DEMOCRATIC YOU WEAR A MASK AND YOU'RE A REPUBLICAN, YOU DON'T. THIS IS INSANE! THIS IS INSANE! LET'S KEEP IT CANADIAN, LET'S KEEP IT LOGICAL AND HAVE MEANINGFUL DEBATE ON THIS ISSUE. PERSONALLY AT THIS POINT IN TIME, I DON'T THINK MANDATING THEM IS THE RIGHT THING.

Steve says WE'RE A LITTLE OVER A MINUTE TO GO HERE. I HAVE A BIT OF AN ODD QUESTION TO ASK YOU FOR OUR FINAL QUESTION HERE, WHICH IS: WHAT DO YOU STILL NOT KNOW ABOUT THIS THAT YOU WISH YOU DID?

Isaac says OH. GOT AN HOUR? SO IN ONE MINUTE, I WOULD SAY THE IMMUNOLOGY OF THIS AND HOW IT CONTRIBUTES TO CREATING A SUCCESSFUL VACCINE. AT THE END OF THE DAY THAT'S OUR WAY OUT OF THE MESS WE'RE IN. IF WE HAVE A GOOD UNDERSTANDING OF THE IMMUNOLOGY AND WE USE THAT TO CREATE A VACCINE GLOBALLY, WE'RE GOOD TO GO. THAT RELIES ON A REALLY GOOD UNDERSTANDING OF HOW THE PATHOGEN INTERACTS WITH THE HOST AND HARNESSING THAT INFORMATION FOR VACCINE CREATION. I THINK THAT IS THE MILLION DOLLAR QUESTION. I THINK WE'LL HAVE SOME VERY GOOD ANSWERS TO THAT IN THE HOPEFULLY MONTHS AHEAD AND I'M FOLLOWING THAT LITERATURE VERY CLOSELY.

Steve says WELL, I WAS GOING TO ASK. I WOULDN'T EXPECT YOU TO KNOW ABOUT THE DOZENS, IF NOT HUNDREDS OF ATTEMPTS AROUND THE WORLD THAT ARE CURRENTLY ONGOING TO FIND A VACCINE, BUT BASED ON WHAT YOU DO KNOW, ANY SENSE OF WHERE WE'RE AT?

Isaac says I'M CAUTIOUSLY OPTIMISTIC. I THINK THERE'S SOME VERY PROMISING TRIALS, AND WATCH FOR THIS OXFORD TRIAL. WE'RE GOING TO HAVE RESULTS OF THAT AVAILABLE PROBABLY IN JULY OR EARLY AUGUST. THIS IS A HUGE CLINICAL STUDY AND IT'S ACTUALLY ANSWERING THE QUESTION: DOES IT WORK OR NOT? I MEAN, IN A POPULATION SETTING. WILL THIS PROVIDE PROTECTION? IF IT DOES, HALLELUJAH. I HOPE THEY MASS PRODUCE IT AND DISTRIBUTE IT AS FAR AS POSSIBLE. IN ADDITION TO THAT... WE'RE GOING TO NEED SEVERAL VACCINES. THERE'S ABOUT 130, 140 IN DEVELOPMENT. MOST OF THEM ARE GOING TO FAIL. IF WE HAVE TWO, THREE, FOUR SUCCESSFUL CANDIDATES THAT CAN BE MASS PRODUCED AND ADMINISTERED WORLD WIDE, WE'LL AT LEAST START TO RETURN TO NORMAL SOON.

Steve says DO WE ASSUME HYDROXYCHLOROQUINE IS NOT PART OF THE SOLUTION?

Isaac says I WOULD SAY THAT'S DEAD IN THE WATER. THERE ARE A FEW UNANSWERED QUESTIONS BUT WE HAVE OTHER TREATMENTS THAT ARE SHOWN TO REALLY HELP. FOR EXAMPLE, THERE'S A REALLY IMPRESSIVE STUDY ON A DRUG CALLED DEXAMETHASONE, IT'S A STEROID, WIDELY AVAILABLE, CHEAP. ANYONE WHO PRACTICES HOSPITAL MEDICINE IS VERY COMFORTABLE USING THAT DRUG AND THERE'S A REALLY GREAT STUDY OUT OF THE U.K. SHOWING THAT IN HOSPITALIZED PATIENTS WHO ARE NEEDING OXYGEN THERAPY FOR THEIR COVID-19 INFECTION, IT REDUCES THE PROBABILITY OF DEATH. PRETTY IMPORTANT METRIC. GREAT DRUG THAT SEEMS TO BE EFFECTIVE, AND YOU CAN BE SURE THAT THAT IS LIKELY CHANGING PRACTICE ALL OVER THE WORLD. I ALSO LIKE THAT THIS IS NOT, YOU KNOW, SOME FANCY SHMANCY HARD TO GET DRUG LIKE REMDEVSVIR.

The caption changes to "Producer: Patricia Kozicka, @TrishKozicka."

Steve says DR. BORGOCH, WE I GUESS APOLOGIZE FOR TAKING YOU AWAY FROM YOUR OFFICIAL DUTIES FOR AS LONG AS WE HAVE. WE'RE GRATEFUL YOU COULD SPEND THIS TIME WITH US. THANKS SO MUCH AND TAKE CARE.

Isaac says HAVE A GREAT DAY.

Watch: Lessons Learned about COVID-19