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Infectious Disease Expert Urges 'Humility' As Coronavirus Cases Rebound In Some States

Nine states reported record highs for new coronavirus cases on Tuesday — and Dr. Michael Osterholm says infectious disease experts like himself don’t understand why.

As states across the U.S. relax restrictions on movement and reopen their economies, 20 areas are showing an increase in cases, according to data from The New York Times. But at the same time, 11 states have remained flat for 14 days and 20 areas are seeing substantial decreases.

“Quite honestly, we don’t know what’s going on,” he says. “We’re trying to understand exactly what’s going on, but we don’t.”

Public health and local government need to reduce the number of people coming in close contact in public spaces to address the high level of case spikes seen in states such as Florida, Texas and North Carolina, he says.

Now, intensive care units in these areas are almost overflowing with cases, he says. But at the same time, local officials need to address people living in areas where cases are consistently declining differently.

“We know that one size fits all isn’t going to work in this country,” he says.

Vice President Mike Pence wrote an opinion piece in The Wall Street Journal saying there isn’t a second coronavirus wave and the media has tried to scare the American people throughout the pandemic. Osterholm believes the nation is still in the first wave of the virus because it hasn’t yet gone away for any period of time.

As cases spike in Oklahoma, President Trump is holding a large indoor rally this week in the city of Tulsa. This type of event can lead to a spike in cases two to three weeks later, Osterholm says.

“Across the board, we have to understand in areas where we’re seeing cases increase, large indoor activities don’t make any kind of public health sense,” he says.

A study published this week by a team of researchers at Texas A&M University found face masks dramatically reduce the number of infections. The authors also said other mitigation efforts, including social distancing, are insufficient by themselves.

While Osterholm wears a face mask and recommends others do as well, the data on the effectiveness of masks is lacking. The Texas A&M research and many other studies on masks are “deficient” because they use modeling, he says.

Experts need data on how effective face masks are in preventing transmission and protecting people wearing them, he says.

“We have to tell the public that the number one, two and three things you can do to protect yourself are distance, distance and distance,” he says, “and do not rely on a cloth face covering to protect you or to keep you from transmitting to others.”

The best antibody studies show between 5% to 7% of the country has been infected, similar to other parts of the world, he says. This estimate is far from the 60% to 70% required to slow down transmission by developing herd immunity, he says.

Pence has expressed he thinks a vaccine could come by the fall, but Osterholm disagrees. The U.S. needs to plan to get through the year without a vaccine, he says.

“I do not have any sense that there will be a vaccine yet this year that will be both shown to be effective and safe and available to the public,” he says. “Even having a vaccine sometime next year I think would be considered a modern medical miracle.”

For Osterholm, the lack of understanding of what’s going on with case transmission in the U.S. is a challenge.

Public health epidemiologists spend their lives as “infectious disease medical detectives” to provide the public with certainty, he says. But without understanding why cases are increasing in some places and decreasing in others, Osterholm and other experts aren’t certain themselves.

“I think we all in the public health world have to have real humility right now and just admit we don’t understand exactly what’s happening,” he says, “and that we will do our very best to figure it out, to understand it and to make recommendations about what we need to do to move forward with this pandemic.”

Chris Bentley produced and edited this interview for broadcast with Peter O’DowdAllison Hagan adapted it for the web.

This article was originally published on

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A sign at a shopping mall in Santa Anita, California, reminds people of the mask requirement.(Frederic J. Brown/AFP/Getty Images)
A sign at a shopping mall in Santa Anita, California, reminds people of the mask requirement.(Frederic J. Brown/AFP/Getty Images)