There’s a lot of misinformation about the coronavirus floating around out there. Myths and outright lies are the currency of hucksters and global pandemics are feeding season for the unscrupulous. We need real experts now more than ever. Yesterday, that expert was Dr. Peter Hotez — who skyped into the Joe Rogan podcast.
Say what you will about Rogan, he has a massive audience and has often used his platform to highlight what actual scientists say about health, vaccines, fitness, and nutrition (he has also, according to many, given far too big a platform to crackpots). Dr. Hotez is legit, though. He works at Baylor College of Medicine and Texas Children’s Hospital and has devoted his life to studying tropical diseases, vaccines, and finding cures to things like the coronavirus. He’s a no-nonsense expert whose goal right now is to get real information to as many people as possible.
We thought we’d parse some of the most important highlights from Rogan’s chat with Dr. Hotez. The doc himself prefaces all of this with a big disclaimer, “Anything I say today, I might look like the biggest idiot tomorrow or next week.” It’s important to remember that this is a brand new virus that we’ve never seen before. “We’re learning new things about this virus every day,” Dr. Hotez makes clear. In reality, it’s only been four months since we’ve known about COVID-19 — also called SARS-CoV-2 or just SARS-2 or coronavirus 2 — and that’s how long we’ve had to learn about it. Dr. Hotez points out that it took over a year to learn almost everything about SARS-1.
How Did We Get Here?
“The truth is, we knew this was coming,” Dr. Hotez says plainly. “We had a heads up before last year because this is now our third major coronavirus disaster of the 21st century.”
Dr. Hotez then goes to break down how SARS-1 in 2003 that spread from China to Canada and beyond. Then he briefly touches on the MERS coronavirus EMC/2012 epidemic. Both coronaviruses started in bats. In the case of SARS-1, it was from bats via civets from wet markets in China. In the case of MERS, it was an Egyptian Tomb Bat that someone was keeping in their home.
According to Dr. Hotez, the medical community has been working on a coronavirus vaccine for over a decade.
What’s The Difference Between SARS-1, MERS, and COVID-19 (or SARS-2)?
Dr. Hotez says that “both SARS-1 and MERS made you so sick and had such a high fatality rate, that anybody who got it was almost immediately hospitalized … and basically out of the community.”
The difference with COVID-19 and what makes it so toxic, the doctor explains, is that there’s a “big group of people walking around and spreading the disease” unknowingly. And that can be devastating for people with maladies like high blood pressure, lung issues, diabetes, other health issues, or simply advanced age.
How Much More Lethal Is COVID-19 Than The Seasonal Flu?
The doc says it’s five to ten times more deadly as far as they now know. When the subject comes up again later, he revises that to “four to ten times” more lethal. According to Hotez, anywhere from 12,000 to 50,000 Americans die from the flu yearly and the “vast majority of those people die because they didn’t get a flu shot.”
With COVID-19 four to ten times more deadly than the common seasonal flu and if we’re able to contain this virus, that’s still anywhere from 48,000 to 500,000 deaths comparatively.
The point Dr. Hotez is trying to get across is that a lot of Americans are likely going to die from this. He hopes it’s closer to the low end but we just don’t know right now. Per Dr. Hotez, “again, those are models based on assumptions and with a new virus pathogen it’s hard to get all the assumptions right.”
Are Only Old People Getting Sick and Dying?
Plainly, no. “The Center for Disease Control came out with this very chilling document a few weeks ago showing that a third of the very sick people in the hospital are under the age of 44.”
Dr. Hotez points out that 30 percent of hospitalizations have been people between the ages of 20 and 44. He then points out that when the disease hit European populations, it started hitting younger populations for “reasons unknown” at the moment.
Is The Virus Mutating?
Dr. Hotez points out the “host component.” That is, the virus seems to be attacking younger populations in Europe and the U.S. (which is heavily populated by European descendants). “Everything we know so far about what happens with the virus is from China. And, it turns out, the Chinese have some genetic differences to Europeans.”
Furthermore, Dr. Hotez laments that “who knows what happens?” when the virus runs through South America, South Asia, and Sub-Saharan Africa.
What About The Talk Of Avoiding Ibruprofen?
Dr. Hotez bluntly says, “There’s not a lot of evidence to say your symptoms will get worse with ibuprofen.” Basically, the doctor says that it’s mostly “internet buzz” spreading a rumor and the WHO has put out a paper saying there’s really no science behind the claim.
Are Certain Blood Types More Susceptible To The Virus?
“This is actually well-known in the infectious disease literature,” says Dr. Hotez.
Dr. Hotez points out that it’s already established that a long list of diseases, viruses, bacteria, and infections can behave very differently depending on a person’s blood type. In the doctor’s words, “host’s genetics influences things quite a bit.”
What’s Going On In Germany?
Compared to Italy which has a ten percent mortality rate despite a similar amount of cases, Germany has a less than one percent mortality rate. The doctor believes it’s all a matter of the German system not being overwhelmed. “In Germany, so far, we think it’s been a combination of things.” He goes on to point out that there are more younger people getting corona in Germany with minor symptoms and that the hospital system was ready and better managed.
(I can attest to this. As I experienced firsthand, Germany was keeping people home who showed mild symptoms and not letting them flood into hospitals for the last six weeks.)
However, Dr. Hotez points out that Germany is shifting quickly. The virus has now entered the eldercare system and Germany is starting to build pop-up hospitals to deal with a surge in cases. “They’re worried now too,” Hotez says.
Why Is New Orleans Experiencing Such A High Mortality Rate?
“What happened there is they kept Mardi Gras open,” Dr. Hotez says bluntly. “A large number of people are getting infected.”
Hotez points out that, like Italy, this overwhelmed the health system. But there’s more to it than that he says.
“There’s lots of people living in extreme poverty [in New Orleans]. And poverty is very linked to diabetes and hypertension. And we know diabetes and hypertension is a big risk factor for death.” Hotez says it’s like New Orleans is getting hit twice. Once due to the overwhelmed medical system and once again due to the poverty rate among the African American population with diabetes and hypertension plaguing that community.
Dr. Hotez ends by mentioning that authorities in Houston, Texas are very worried about the warning signs they’re seeing in New Orleans as their demographics are very similar.
Do Smoking And Vaping Exacerbate The Virus?
“Smoking actually up-regulates the receptor in the lungs that virus responds to,” according to the doctor. Translation: That means smoking is creating more receptors in the lungs for the virus to bind to, thus accelerating the virus’s growth and severity.
With Vaping, it’s less clear. While there are a lot of young people who vape getting put on ventilators, there just haven’t been enough studies on vaping, in general, to know the effects when coupled with COVID-19, according to Hotez.
What About Chloroquine?
Chloroquine is an anti-malarial that is also used as an anti-inflammatory in the treatment of lupus and other autoimmune issues. Dr. Hotez breaks down why it’s getting press right now.
“We know that this drug can block the replication of the virus in the test tube.” (Emphasis ours) “Second, we know this drug reduces inflammation,” the doctor says. We know COVID-19 causes inflammation in the lungs as the virus takes hold. An anti-inflammatory as a treatment tracks.
According to Dr. Hotez, the whole thing is based on a very small study in France where a scientist combined chloroquine with azithromycin and found positive results in patients with COVID. “The problem was it was a very tiny study,” Dr. Hotez points out.
People have been touting this as a miracle cure but Dr. Hotez isn’t so sure until we do massive and widespread studies to see if it really works. He’s speaking from a place of knowledge. Evidently ten years ago, they found that chloroquine worked wonders in the test tube against influenza and then didn’t have any effect on the population. “It didn’t pan out,” the doctor laments.
He does say that clinical trials are scaling up and that “there’s a lot of ‘off-label’ use” of chloroquine right now. Still, he says that the evidence is “not strong.” Again, that’s now. This could change.
How Long Will It Take To Get A Vaccine?
“A year, 18 months, but likely longer. We simply don’t know.” That’s sobering, we know.
What’s Happening With People In Wuhan Testing Positive Again After Recovering?
“We don’t know.” Hotez carries on to say that it’s highly unlikely they’re getting re-infected once they developed anti-bodies but we simply don’t know for sure right now.
Basically, it breaks down to this: It’s really hard to test for respiratory viruses in the first place. That’s also responsible for some of the delays in getting testing off the ground in the first place for COVID-19.
How Important Is Social Distancing?
Dr. Hotez states it simply: “Without a vaccine or other technologies, we have to go back to the 14th century when quarantine was invented.” In short, social distancing is the only tool we have right now to stop the spread of the virus.
The doctor then goes on to break down why we know social distancing works. He says the modeling from the cities in China where they used social distancing have shown “the longer you allowed transmission to go on before you intervened with social distancing and other things, the worse the surge and the worse the epidemic and therefore, as we talked in Italy, the worse the mortality.”
Dr. Hotez cites Wuhan which took six weeks to take measures compared to other cities in South China that only waited a week. The evidence shows that waiting longer led to a massive surge in people showing up at the hospital, overwhelming the system, and leading to much higher death rates in Wuhan.
Hotez also points out that because “things got so fucked up with testing” in the United States that people were transmitting the disease for weeks and we only learned how bad it was by people showing up in emergency rooms already very ill. This tracks with what’s happening in New Orleans, Detroit, New York, and Atlanta right now.
Social distancing is absolutely “paramount,” says Dr. Hotez. “That’s all we got right now.”
When Will This Peak In The U.S.?
Estimates from the experts studying this say by mid-April we’ll hit the peak, according to Dr. Hotez. That’s another two weeks. There’s a big “but” coming, however:
That’s not nationwide. Dr. Hotez points out that the modeling for Texas and Calfornia pin the peak of the viral outbreak in May.
Overall, the numbers show that the “next two months are going to be the crunch time” where numbers are always going up. That’s until June, folks.
The way Dr. Hotez sees it, the April 30th date Trump has assigned is more of a date to reaccess whether we go another month in lockdown or not.
The doctor says, “We hope that by the summer this won’t be a huge problem. But we really don’t know.”
What Don’t We Know?
This is more a collection of things that Dr. Hotez says we don’t know that we’ve compiled in one spot for clarity.
- We don’t know if we can get people to properly social distance to lower the spread for long enough. We don’t have to look far to see how many people still aren’t taking social distancing seriously.
- We don’t know the seasonality of the virus and how severe it might come back in the fall. Dr. Hotez points out that when we enter summer, our off-peak flu season, the southern hemisphere enters winter or their peak flu season.
- We don’t know if that means this could be a year-round thing if travel restrictions are lifted too early.
- We don’t know if this will come back year after year, as the flu does.
Can We Isolate Higher-Risk People To Help Stop The Spread?
Dr. Hotez shoots this down saying that that seems to have been a thought when we believed this was only effecting sick people or the elderly. That’s changed. “Now — as the Centers for Disease Control has been reporting — we’ve had this big flux of young adults getting very sick and in the ICU.”
The doctor also points out that another thing we’ve “only just learned” is that infants are at very high risk with ten percent getting very sick in China in effected areas. News reports of infants dying in Europe and the U.S. have started trickling in.
Dr. Hotez asks, “At what point do you say that pretty much everybody is at risk?”
Is It Possible To Fully Recover From The Lung Scarring COVID-19 Causes?
The doc is very optimistic on this point, especially for the younger population. Otherwise, he says, “I think for older people, they may have some permanent pulmonary deficits.”
But again, Hotez reiterates that “it’s still too early in the epidemic to know” for certain what any lingering effects may be. Hotez points out that it usually takes years and years to fully understand a virus like this. “We’re just trying to buy time,” he says.
Here’s the full clip: