CAMBRIDGE, Mass. — For a veteran epidemiologist, an authority on homeland security, and a global health reporter, the outbreak of the novel coronavirus is the type of emergency they had long anticipated. But now that it is here, the three experts said Friday, they still couldn’t help but feel the monumentality of what they were watching unfold.

“It’s the most daunting virus that we’ve contended with in half a century or more,” Michael Mina, an epidemiologist at Harvard’s T.H. Chan School of Public Health, said at a panel discussion Friday at Harvard’s Kennedy School of Government.

Helen Branswell, STAT’s infectious diseases and public health reporter, has covered emerging pathogens since the 2003 SARS outbreak.

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But with the new coronavirus, Branswell said during the panel, “It’s bizarre but I find myself startled. Having written about the possibility of something like this for years, I still find myself really startled that it’s happening, and I don’t know why that is.”

She compared the circumstances now to the summer of 2014, when Ebola was racing through West Africa and the world didn’t seem to have a plan to stop it. “Except that I never worried then about Ebola spreading in the city I lived in,” she said. “It’s different now.”

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As the panel was occurring, the Cambridge-based drug company Biogen said that top executives had been at a meeting at a Boston hotel last week that was also attended by eight people who later tested positive for the coronavirus, which causes a disease that authorities have named Covid-19. The company asked many employees to work from home for the next two weeks.

chairs at virus coronavirus forum
Photo by Martha Stewart Photo by Martha Stewart

In introducing the Harvard panel, Mark Gearan, director of the Kennedy School’s Institute of Politics, which hosted the event, directed students and others at Harvard to new travel policies the university issued on Friday, just before the panel started. They included a ban on university-related international travel and “non-essential” university-related domestic air travel, and discourage personal international travel. “We strongly discourage any non-essential meetings or events of 100 people or more,” the email to the campus read. (Institute of Politics staff members also put more than the usual space between chairs in the audience.)

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Panel moderator Rick Berke, STAT’s executive editor, asked the crowd of roughly 100 people if any of them had considered not coming to the event. A few raised their hands.

“Do I think that this is a bad idea?” Mina said when asked if the panel should be held. “I think we’re hitting the time in the course of this epidemic where we might consider that this should be one of the last types of events like this.”

Here are some highlights from the event.

Why this virus is different

The spread of the new coronavirus has been compared to influenza, which also causes a respiratory illness. But, as the panelists pointed out, there are no drugs or vaccines yet for treating or preventing the virus, known as SARS-CoV-2, as there are for flu. In addition, we are exposed to different flu strains throughout our lives, which help us build immunity. No one had immunity to this new virus.

“We have an entirely susceptible population,” Mina said. “The potential for this to burn through a population very quickly is very high without extraordinary measures.”

As researchers race to study the virus, they are finding that it does not seem to be infecting great numbers of children, or at least making them very sick. (Experts around the globe are still trying to figure out just how broadly the infection has spread, given that many mild cases are likely to be missed.) But it is causing serious harm to older people and those with underlying diseases or weakened immune systems.

“This virus, on the one hand, there’s a saving grace that it doesn’t seem to be impacting our young, and that is amazing,” Mina said. “But the mortality rate among people who are getting infected above 80 years old is 15-plus%.”

How to mentally prepare for this pandemic

If you plan for the disruptions that the response to the pandemic could require, it will seem less unexpected when schools are canceled or you’re told to work from home, advised panelist Juliette Kayyem, the faculty chair of the Kennedy School’s homeland security program and a former homeland security official at the state and federal level.

“Get your head around this is practical,” she said. “It’s here, there are going to be massive disruptions to our social fabric in terms of your day to day. All of you have a part in stopping the spread of this … but we have to treat this as part of the plan. We’re at that stage now.”

Unlike with a natural disaster or terrorist attack, “we don’t have a boom moment,” she said, and the virus was more slow rolling. “When do you activate?” she said. “That’s sort of the challenge right now.”

Kayyem, who worked in the Obama administration, also made the point that the response will be a patchwork. Some schools will close, others will remain open.

Tracking the U.S. response

The federal government’s bungled rollout of testing for SARS-CoV-2, which has limited how many people can get tested for the virus but is now being remedied, did not inspire much confidence in the U.S. response initially. But Kayyem said that as cases are detected in more places, it will largely be on local and state agencies. She described the action as “locally executed, state managed, and federally supported.”

As for how to judge whether the response is working: “The bad thing has happened, it’s coming, it’s here,” she said. “We’re in the response phase. Our measure of success is not containment anymore. Our measure of success now is, will fewer people die or get severely sick because of our efforts?”

It’s not just the government that has a role to play, she said. Universities, the media, and employers need to act responsibly. Individuals also have to get involved, whether it’s staying home if they are not feeling well or making sure they have had the flu shot. After all, if they can avoid getting the flu, that frees up space for health care providers to deal with Covid-19 cases.

Mina said the fragmented U.S. health care system leaves him worried about the cohesion of a response.

“I don’t want to sound defeatist here, but the state of our health care system, the way we have privatized everything about it for the most part, is going to seriously impact our ability,” he said, adding that, “we have no ability to create out of the blue new hospital beds. We can’t even test appropriately.”

“If we can’t figure how to run some PCR instruments because we can’t work together as a society — this is within networks, within hospitals, within the national government, everything — I really am very concerned about this in a way that far exceeds our concerns for other viruses and other pathogens, and the most vulnerable are the elderly.”

What’s happened in China

The response in China, where the virus first emerged and cases quickly exploded, included the unprecedented steps of essentially quarantining tens of millions of people in and around Wuhan, the city at the center of the outbreak. There were concerns about people with other diseases being able to get the care they needed and the trampling of individual liberty. But from a raw epidemiological perspective, global health authorities have argued that such drastic measures gave the world more time to prepare. The interventions in China, they say, delayed the wave of cases in other places around the world.

“I think it was absolutely the right thing,” Mina said. “They truly bought the rest of the world at least a month. The U.S. wasted it, in my opinion, but many countries did not.”

Kayyem agreed about the initial U.S. response.

“When the story is written about U.S. preparedness for this, Chapter 1 will be called ‘Squandered Time.’ Not just on the medical side, but on the preparedness side,” she said. “What were we doing? And now, how do we make up for lost time? It’s not just the kits. It’s why this week we seemed so flat-footed and surprised by things like school closings. School closings were inevitable the second we had the first patients.”

Where this could go from here

Branswell noted that some people, based on both biology and socioeconomics, will be able to weather the outbreak more safely and less disruptively than others.

“I’m very worried right now about vulnerable populations,” she said.

“I’m really concerned about people living in long-term care facilities. If this virus gets into long-term care facilities [as it has in the Seattle area], it will be really bad. I’m worried about people who stay in homeless shelters. I’m worried about people who work in retail. I’m worried about people who don’t have the money to stockpile food because they don’t have extra money. I’m worried about the fact that there isn’t much social cohesion right now. People seem to be really angry at each other a lot and this is a time when we’re really going to need to help each other.”

Planning ahead

Kayyem said that organizers of large events, including the presidential nominating conventions and the Olympics, need to start coming up with Plan Bs. The decisions about whether to actually go with these alternate plans can’t be made yet, but it is crucial to start developing contingencies.

“I cannot tell you when we’re going to activate and when it’s going to impact, but if the parties are not thinking about how you pick your nominee in a different manner, shame on them,” she said about the conventions.

“We don’t know where we will be at that moment,” she added. “I think we need to be comfortable making decisions in week allotments.”

After the event, Harvard officials said they were considering cancelling a full roster of Kennedy School Forums for next week, making Friday’s potentially their last public event at the Kennedy School for quite a while.

Correction: A photo caption in this story previously misspelled Juliette Kayyem’s first name. 

  • I’m Absolutely and profoundly Dismayed by the comments in this area of science … to say this virus has emerged from a particular location / person with no testing to other individual throughout the world seems suspect and negligent at best…. this virus could have been around for months if not years and mistaken for the flu…it’s disheartening that science and history has cautioned us to make these leaping associations withought truly understanding the facts ……. Shame on the media and Experts for casting such pre judgment and sparking fear through the world…

  • I understand how reporters get caught up in sensationalizing the new, uncertain, and possibly harmful to some, but it pains me to hear scientific and medical experts speak with so little balance and so much contradiction in their reported statements. If we know that most people are going to get over their coronavirus colds, why are we talking about how many will have to be hospitalized. Would we propose overwhelming our hospitals with people with colds and flu? The professionals on the panel must also know that a distinct possibility is emerging that COV19 was already preexisting in the U.S. and other populations, and now is only being ascertained with the new test that has been developed and focused on finding it. Cautioned is warranted, but sensationalizing destructive fear is not.

    • You don’t have all the facts. We have something like 12 million citizens over the age of 60. Unfortunately a large percentage of us will probably get the virus. 80% of those over 60 who get the virus have a severe reaction needing help such as ventilators and intensive care. If only 20% of us get it, we will overwhelm our hospital systems. Then what, do we just leave our friends and family in the streets to die. How about your parents, grandparents, or friends of any age with underlying serious health issues like high blood pressure, asthma, etc are going to die. We will be just like China, South Korea, Italy. This is going to be with us for the next six months to a year because we have lost control and the virus is going to spread everywhere. Watch what is happening in Italy because that is a blueprint for what Is next for us. Just think for a moment. This disease kills people, is highly contagious and there is no treatment if your immune system can’t defeat it.

  • Why is it named Covid-19 as if it was discovered like a new star? Could the Coronavirus be related to “… I saw a star fall from heaven unto the earth: and to him was given the key of the bottomless pit…”

    • Good question. It used to be called “Wuhan Coronavirus” when it first came out. But under a strong guidance of China, WHO decided to change the name to obscure the origins of the virus.

      According to https://www.taiwannews.com.tw/en/index
      a potential vaccine test will begin in May.

    • @Lili I’ve read better fiction in the tabloids. It wasn’t the end during the black death, or 1918 flu (and other similar events in history). It won’t be the end this time around either. Though, I suppose nature does believe in “if at first you don’t succeed try, try, try again.” (Does that count as dark humor?)

    • I can’t do buffets because I see people doing this every damn time I see a buffet line. Disgusting.

  • Before the lock down in Wuhan a Chinese team on the ground rated it @ 4.01 or twice that of SARs. We had it as 360,000 infected in Wuhan before lock down happened.

    A infected person like typhoid mary will appear unsick while still able to transmit. Would be looking at how LVL 4 Lab in Wuhan disposes of its wastes.. possible patient ZERO.

    • The author of “Bully of Asia” – Steven Mosher, states, pertaining to coronavirus orgins:
      “And then there is this little-known fact: Some Chinese researchers are in the habit of selling their laboratory animals to street vendors after they have finished experimenting on them.”

  • I am perplexed at the major responses on this. The fatality rates seem really low and also that seems many cases mild to point of not really noticed. Guess the high contagion factor important, but doesn’t seem all that severe an illness for most of population. So, is it overblown reactions, or something serious about it repressed? Media coverage seems absent facts that real risk is to vunerable groups, old & otherwise sick, most people – not so much.

    • This does not seem to be a serious disease for most people. But it is extremely contagious, and what happened in Washington State shows what will happen in the rest of the country during 2020 – it will get into every nursing home, and it will kill most of the bedridden inmates in those facilities. It will probably do something similar, though not as bad, in every assisted living facility and retirement village in the USA.

    • I’ve read it’s not as contagious as the measles. They don’t believe it’s spreading by air droplets but by actual spittle coming out in a sneeze or cough. And of course it is spread on surfaces commonly touched. Survival instinct should stop people from touching their face; especially over 50 years old. Maybe the over-reaction will stop this disease and current flus and cold viruses dead in their tracks.

  • Hmmm…. don’t get why comments took on such a political theme? Article was not focused on such at all, just some reasonable analysis of some relevant factors.
    Except part about how our polarized and oppositional stances in current society could impact responses. Which seemingly bourne out by angry comment battle.

  • You lost credibility with me at : Tracking the U.S. response
    The federal government’s bungled rollout of testing for SARS-CoV-2. First you give the Obama former administrator a bolster then you kneecap the Trump admin. with a single factoid. No mention on the single best thing the President could do and that was to take the threat seriously early and restrict travel from the hot spots which resulted in a very low infection rate in this country. If you want to be taken seriously give a balanced and truthful account.

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