ROCHESTER, Minn. -- A self-described "medical detective," Dr. Michael Osterholm, author of the 2017 book "Deadliest Enemy: Our War Against Killer Germs," director of the Center for Infectious Disease Research and Policy at the University of Minnesota and former state epidemiologist at the Minnesota Department of Health, is suddenly one the most in-demand experts on coronavirus.
Gov. Tim Walz on Friday cited Osterholm's reasoning in deciding against closing schools, and a recent interview Osterholm offered to podcaster Joe Rogan is currently approaching 8 million views in just three days.
"We conservatively estimate," he told The Joe Rogan Experience of the outbreak, "that this could require 48 million hospitalizations, and over 480,000 deaths over the next 3-7 months."
Osterholm talked with Forum News Service on Friday. This is an edited version of the interview:
Question: It seems like Minnesota Department of Health Commissioner Dr. Jan Malcolm made a distinction between going to the mall or grocery store, and going to a movie, gym those kind of places. Would you be willing to speak about the practical side of these new recommendations to avoid crowds?
Osterholm: Well, I think we're all adjusting to what "practical" means. This is not going to be like a Minneapolis blizzard, where we're sheltering in place for a couple of days. At this point, we're talking about something that I call a coronavirus winter, with a long season ahead of us. We have months and months to go. So one of things we have to think about is, how will we do that? That's going to be a challenge. A lot of people in the last few days have made a decision about what to do with regard to events, large meetings, schools, etc. I think every one one of them has a good intention of trying to protect their families, their clients, their coworkers.
But what they haven't thought about is what it means if they make the decision to do this now, when we don't have a documented case of community transmission in Minnesota -- and I think it's happening but we just don't have it documented yet -- but the question is then, how do you unring a bell? If you put this into place, how do you in August, September, or whatever, say OK, we're no longer going to do this anymore. Because if you didn't start with criteria, it makes it pretty hard to base it on criteria for ending it. That's why I was so pleased to see the comments about school. I think the governor and the health department have it exactly right.
Question: Meaning, in your opinion, there's going to be an impact on healthcare workers if we close the schools?
Osterholm: We still had an absence of clear evidence in what (closing schools) would mean in terms of reducing the overall impact of the disease. We know with influenza, kids are little viral reactors. They pick it up, they amplify it, and that's an important observation. We don't know if that's the case with kids (and coronavirus). We know they can get infected. We know that they don't have a lot of clinical illness. The role they play in transmission is not clear. There is a real downside to (closing schools). If we lose 20 percent of our nurses or any of the occupational areas we have in healthcare, this could add a really devastating impact on our delivery of healthcare during the middle of this pandemic situation.
Question: I've heard statements that if you do the math, America potentially runs out of hospital beds by May 10. Do you put any stock into these kind of predictions?
Osterholm: I think we're going to have real challenges in our healthcare system. We are operating on fumes right now, in a regular time period. I think the healthcare systems are doing as well as they possibly can, given the realities of modern day health financing. I wrote in my book back in 2017 that we were ill-prepared in our health system, and that we need to get better prepared. Well, ironically in 2020 we're in worse shape today than we were in 2017.
Question: If you had your way, if there was aggressive funding to take this head-on, would we be building temporary hospitals right now?
Osterholm: Well, you have to have the equipment to put in them, and we don't even have the equipment to put in them. We don't have the ventilators. And you can't invent them. The production of those take time. They're manufacturing as many N95 respirators as they possibly can. The suppliers are running 100% of the time. It's just that we never stockpiled anything. We all counted on just-in-time use. Suddenly when they put in an order of 50,000 rather than 5,000, all that capacity becomes terribly inadequate for the need. And no amount of money is going to change that.
Question: What are you personally avoiding in your activities in your life, in terms of the types of events you go to and you don't?
Osterholm: One of the nice things about working 22 hours in your day, is that you don't have to worry about having events in your day.
Question: But what would you say if you were trying to advise people who are wondering if they can go to movies or restaurants?
Osterholm: I may be sitting next to you in a restaurant, and I don't know that tomorrow morning I'm going to come down with the symptoms of this, and I'm infectious today. So you may get infected by just sitting next to me in a restaurant. I don't think that's a very common event right now. So I would tell people, you know, not to go to restaurants if you were older, in your mid-60s, and had an underlying health condition like COPD (chronic obstructive pulmonary disease), asthma, immune deficiency, high blood pressure, kidney disease, I'd say maybe you want to avoid those restaurants right now. I can say with certainty there will be a time in the not-to-distant future where you will definitely want to avoid them, when we see increased community-wide transmission. Which we will see. We will see it. It will happen.
Question: When do we get to that "unring the bell" point and we can call off the recommendations to avoid events? Is it when we develop herd immunity -- when a large enough percentage of us get the illness?
Osterholm: That's exactly it. It's the point where enough people have gotten the virus that it knocks the rates down a lot. But we pay a heck of a price to get there. Several groups have estimated that between 20 and 60% of the population could very well get infected.
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