New Antibody Study Suggests As Many As One In Five New Yorkers May Have Had COVID-19
GOV. ANDREW CUOMO (D-NY): Anecdotally, we were hearing it was roughly this high. But what it shows is it is more widespread, Anderson, and it also, I think, reinforces the point that the virus got here a lot earlier than any of the experts told us it was here. It's about 14 percent statewide have antibodies, which means they've been infected, about 20 percent of New York City, just think about that, 20 percent of New York City. So, it is significantly more widespread than most people had imagined. And I think it confirms the point that it spread faster, and it got here earlier, than we originally believed.</s>ANDERSON COOPER, CNN HOST: So, moving forward, when you think about testing, is there a - is antibody testing a priority in terms of the overall picture of testing? Or is it, you know, the other forms of testing that are out there?</s>A. CUOMO: Well, you have antibody testing, and you have diagnostic testing, right, positive or negative. The antibody testing, I think, is important for a couple of reasons. Number one, when a person tests positive for the antibody, then you can have that person donate blood for the convalescent plasma, which is probably one of the best therapeutics that we're looking at right now. But also, that is the indicator of the infection spread, right? So, as you are talking about reopening, and the weather is getting warmer, and more people are coming out, just because of circumstance, or they just - they can't stay in anymore, or you start to reopen businesses, the gauge to see what's happening is the gauge of the spread of the infection. Is the infection gaining ground? The antibody test is that answer. So, we did a baseline survey now, do that every three or four days, watch that infection rate, is it going up or is it going down, and that's the guidepost to calibrate the activity level.</s>DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Governor Cuomo, you know, it's interesting, it's one of those situations if you knew then, what you know now, if we knew that this had been spreading more widely, and earlier, right now, the first confirmed infection, I think, was March 1st in New York. But I think, undoubtedly, it was earlier than that now, based on all the data that we're seeing. Should anything, have been done differently then, in terms of tackling this at that time?</s>A. CUOMO: Well look, you know, global pandemic, the words have been used for many years, Doctor. But we've never actually lived through it. So, I don't think that this country - country was ready for it. I don't even think our experts were ready for it. You know, in retrospect, it seems so simple, right? China has a virus last November, last December. The virus can get on a plane, can go to Europe, can come to New York, can be anywhere in 24 hours. What made anyone think it was going to stay in China last November and last December? And then, we're taking actions in March. What happened to January and February? You know, when you look back at it, it seems to be so plain and so obvious. The President has talked - spoken about the World Health Organization, and what they should have done. But I think we have to take a hard look. Where were the experts, the organizations, the International watchdogs, who should be watching for something like this, because obviously we missed it. March, we're taking actions in March. I have the first case in March. But the data is now saying it may have been here in January, may have been here in February. And if you look at the infection rate of 20 percent in New York, it makes it hard to believe that this has just been a few weeks.</s>GUPTA: Right. I mean - I mean part of the reason that I ask obviously is because there was a travel ban from China at the end of January and, as you know, from - from Europe, sort of middle of March and, you know, again, if we only knew then what we know now. But - but it seemed like the virus was already spreading here at that point. I mean, do you think that those - those travel bans, in retrospect, made a difference?</s>A. CUOMO: Well, in retrospect, close the door on China, yes, that makes sense. But it had already left China. What made anyone think it was going to stay in China in November and December? It got on a plane. It went to Europe. It went to in Italy. It went to the Lombardy district, where you have a lot of Chinese workers, and then it was in Europe. The strain in New York came from Europe.</s>GUPTA: Right.</s>A. CUOMO: It didn't come from China. Close the door on China, the virus is already out. You know, it's closing the barn door when the horse is gone.</s>COOPER: Yes.</s>A. CUOMO: And when you think back, I mean I don't do public health, but I'm not even a doctor, Doctor. But November, December, what made anyone think the - the virus was still going to be isolated only in China after two months?</s>GUPTA: Yes.</s>COOPER: Yes.</s>A. CUOMO: Makes no sense.</s>COOPER: The - there have been concerns obviously about the reliability of antibody tests in the market. I know the New York State Health Commissioner said the test your State developed is reliable enough to determine immunity and can - and can be used to send someone back into the workforce. Do you think he's right? And is that how one of the ways you plan to use this test, moving forward?</s>A. CUOMO: Yes. Well Anderson, if I didn't think he right - was right, he wouldn't be my Health Commissioner, right?</s>COOPER: Fair enough!</s>A. CUOMO: He's a great doctor. I understand the questions about the antibody test. For our baseline survey, what we used it for today, for a snapshot, even if it's plus or minus a couple of points it's still - still a snapshot, and it's still educational.</s>COOPER: And that wasn't frontline workers, right?</s>A. CUOMO: The antibody test--</s>COOPER: That - that was people - you said that it was people who--</s>A. CUOMO: No.</s>COOPER: --had stayed home, essentially.</s>A. CUOMO: Yes. This - the random survey was just random people, literally outside on the street, grocery stores, et cetera. Normally, you would use the antibody test along with the diagnostic test. So, you'd have a backup. You would know if the person was positive or negative today, and the antibody test would say whether or not they had it, which could speak to immunity. But I would even take all of these things with a grain of salt because nobody will really say to you directly "If you have the antibodies, you are immune." You know, they have a little caveat there that says "We think." So, all of this is relatively new.</s>GUPTA: I think you sort of talked about this, Governor, but I just want to be clear on this. If someone has had the infection, and they've recovered, such as your brother, such as our colleague, Chris, what is the guidance for them, in terms of how they should behave going forward? There's a still - still a lot we don't know, as you mentioned, about immunity, how long it might last, how strong it is. So, what - what do you tell them with - with the amount of information we have now?</s>A. CUOMO: Well we say we test them again to see if they test negative. Until they test negative, Doctor, we don't say that they - they are quote-unquote over the Coronavirus officially, until they test negative. Then, what we just discussed, theoretically, they have the antibodies, and some will say they're immune from the - from the virus. But I can't get a straight answer, or an answer I would rely on, to say how long they are immune or if that immunity is 100 percent. But I think it's fair to say they have some immunity towards the virus. But I would be cautious about saying it was absolute.</s>COOPER: You've talked about testing, contact tracing being the bridge to - to eventually reopening or some sort of getting back to whatever it's going to be the new - the new normal. You announced a partnership with - with former New York City Mayor, Michael Bloomberg develop - implement a program to test for the virus, do contact tracing. I know you've said Bloomberg is designing the program. Can you fill us in at all on what it would look like, what the timeline may be to get it up and running, and what kind of, you know, numbers of people we're talking about for contact tracing?</s>A. CUOMO: Yes. Everyone says we're in uncharted waters, right? And we're now going on the next leg of the journey, which is the reopening leg. And even if it's not reopening, in a State like New York, which has a significant number still, the weather's going to get warmer, people are going to come out of their homes. Period! So, you're in these unchartered waters, the one thing you can take is you can take soundings, right? You can find - measure the depth of the water as you go along. And to me, that's what testing is. Test every three days, every four days, and watch that infection rate. Is it going up or is it going down? If it starts to go up, you have a problem. That's testing. Tracing is then every time you find a positive, put on the detectives, the Disease Detectives, and trace the contacts of that person. Who did you go for a walk with? Who did you have over the house? And just trace all those contacts, find the positives, isolate the positives, so they can't spread the disease, which is one of the ways you reduce the spread of the disease. Place like New York with so many, we have 250,000 people who tested positive, how do you begin to trace all those contacts, where one person can immediately trace down to 10, 20 people? You're going to need an army of tracers, literally thousands of people, who do this. That has to be ramped up. It's never been done before. That has to be put in place. And that's what Mike Bloomberg has volunteered to help us do, put it together, train them, and do it on a Tri-state basis, because if you're in New York, that's Connecticut, that's New Jersey, that's Long Island. And no one jurisdiction can do it. So, it's a very challenging task. I worked with Mike when he was Mayor. I was Governor at that time. And he is a great - great public servant. He's also gone through this in his - in his own business with China closing and opening, and then in Europe closing and opening. So, he's had experience on all sorts of dimensions of this problem, and he offered to help, and he's a great talent, and we need help from great talents.</s>COOPER: So, you don't know how big that army of tracers is going to be, at this point?</s>A. CUOMO: It will be in the thousands when all is said and done.</s>COOPER: OK.</s>GUPTA: Governor, I got to ask about this medication, hydroxychloroquine, which I think everybody knows this name now because there's been a lot of news about it. There's a clinical trial that's been ongoing in New York. We know some of that data has been presented to the FDA. Is there - is there anything that you can tell us about some of the data that we've heard from other places, including the VA, was it didn't look like it actually made a difference really. What can you tell us?</s>A. CUOMO: Yes. We had a number of hospitals in New York that have been testing hydroxychloroquine. They gave it to several hundred patients. They compiled preliminary data. They sent it through the State to the FDA. The FDA has the data. I think from the review that I heard, basically it was not seen as a positive, not seen as a negative, and didn't really have much of an effect on the recovery rate. But I'm not a doctor, Doctor. So, I'm really not qualified to review the data.</s>COOPER: Is that something the FDA's going to release at some point?</s>A. CUOMO: That's - that's up to the FDA, Anderson. I don't know how they work.</s>COOPER: Yes. Governor Cuomo, we appreciate your time, and all your efforts, thank you.</s>GUPTA: Thank you, Sir.</s>A. CUOMO: Thank you. Thank you for having us. Thank you, Doctor. Good to be with you.</s>COOPER: In light of new studies and models, including the one in New York, want to turn next to one of the top researchers of the World Health Organization. As you know, the Organization has come under political fire lately, which is a subject for another time. Tonight, just the facts and the science. With that, joining us now is Maria Van Kerkhove, the Organization's Technical Lead for COVID-19 Response. It is so great to see you again. Thank you so much for - for being with us. We spoke to Governor Cuomo from New York State about what they found in this State, when it comes to antibodies and the population. And I wonder what you make - make of that, how it tracks with other places you've seen?</s>DR. MARIA VAN KERKHOVE, WORLD HEALTH ORGANIZATION TECHNICAL LEAD FOR COVID-19 RESPONSE: So, thanks again for having me. It's a pleasure to be on the show. Yes. So, we are tracking a number of studies right now that are looking at the extent of infection in people. And this is measured through these antibody tests. So essentially, when a person gets infected with this virus, it takes a week to two weeks to develop antibodies, which means that the body is reacting to it, and it means that they've been infected. And these antibody tests will be able to detect people that may have been missed through surveillance systems. And so, what we're seeing from a number of countries, and I just saw an article from The New York Times on the one from New York, but I haven't seen the study itself, that found that's - a proportion of the population, one in five, I think it said, of people in New York have antibodies to COVID-19.</s>COOPER: Right. It was just - it was just under--</s>VAN KERKHOVE: Now, without seeing the study, without--</s>COOPER: It was just under--</s>VAN KERKHOVE: Yes?</s>COOPER: --14 percent statewide. In New York City itself, I think it was like 20 - 21 percent.</s>VAN KERKHOVE: OK. So, what we're doing at WHO is we're tracking these types of studies all over the world. And what we're trying to understand is one, where the studies are being done, how they're being done, so what are the people that they've - they've looked at? Is it - what kind of population, is it a random sample in the - in the general public? Is it a certain type of population like healthcare workers, and then what tests did they use, because not all tests are the same, and then what did they find? And in all of the studies that we are aware of, the seroprevalence, so this is the proportion that has these antibodies, ranges from 2 to 3 percent up to - I've seen one that in Germany, up to 14 percent. So that means, in that population, that proportion has antibodies. That means that proportion was infected. What's interesting about this is that these numbers, this seroprevalence is a lot lower than some of the early models predicted, and may have - that would have suggested that this virus was circulating a lot more and that much more of the population was already infected. So, these studies right now are not actually showing us that.</s>COOPER: And, like you said, I haven't read the complete study yet. But from what I've just been doing on the reporting of it is that the Governor said it was - this was not essential workers. This was people who were non-essential workers, who were basically home, which I guess, you know, would - would make a difference, Sanjay.</s>GUPTA: Yes. No question. I think you want to get a pretty diverse sample to really get an idea of how much penetration this virus has had. If it was only frontline workers, I wouldn't be surprised by high numbers. But the fact that it was mostly not frontline workers, I think makes a - makes a difference. I mean that - that suggests that this is a higher number. This had more spread than we realize. I wonder - I wonder Dr. Van Kerkhove, if I could ask a question about this - this report from Stat today. I'm sure you saw it. It basically was a study from Gilead about Remdesivir, this antiviral medication, lots of interest in this. The World Health Organization put it up on their website for a bit, and then they took it down. But we do - Stat actually published a screenshot. And what it showed was that 237 patients found that Remdesivir was not associated with a difference in clinical improvement, and that the study was terminated prematurely. Gilead, for their part, they says - they say that the study was not significant because they didn't have enough enrollment. But obviously, everybody in the world wants to know what's going on with these medications, Doctor. What - what can you tell us?</s>VAN KERKHOVE: I mean I think you've just highlighted it. Everybody in the world wants to know which drugs, which medications are going to work, which medications are going to save lives, which medications are going to prevent people from who have mild disease to developing severe disease, and go on to die. And I think what you're highlighting is this urgency that we all have to know the results of these studies. There's hundreds of clinical trials that are ongoing right now, and I know you've highlighted this on your show. And what we're trying to do is we're trying to track all of these studies that are ongoing, so that we can have a better understanding of each of these medications that are being evaluated, how they're being evaluated, understand their efficacy, understand their safety, and understand collectively what this actually means. Unfortunately, right now, we don't have any evidence that one works yet. And we're working really hard. And we have the Solidarity Trial that we've launched, which is trying to evaluate this in a clinical trial format. And so, it's critical that these studies get done. It's critical that these studies are done well, so that we can get to this answer that everybody needs.</s>GUPTA: When are we going to get those results, do you think?</s>VAN KERKHOVE: They can't come soon enough. So there's hundreds of clinical trials, as I just mentioned. But what we need is enough of a sample to be able to statistically evaluate the efficacy and the safety. I think we're - I think it will happen soon. You know, as I said, we're tracking all of them. But I think we are, you know, weeks to months away from really knowing this.</s>COOPER: We got a lot of viewer questions sent in, and I want to get to some of those. Beverly in Austin, Texas wants to know, "Is it possible by the time a vaccine is found, the virus will morph and the new vaccine no longer works?"</s>VAN KERKHOVE: So, that's a question, I think, that's what she's asking is if this virus will mutate, if this virus will change, meaning the vaccine - a vaccine that's developed now, based on the virus now, will not be effective.</s>COOPER: Right.</s>VAN KERKHOVE: So, we have - there are more than 10,000 full genome sequences that are available. And there're scientists that are looking at these all - all the time. What we know is that this virus is relatively stable. There are some changes in it. But these are normal changes that you would expect from a virus like this, but nothing that drastically changes it to think that it behaves differently. So, the vaccines that are being developed now, and hopefully, again, this is another situation where we need these to be rapidly accelerated. So, by the time a vaccine is available, we'll be effective against this virus. I think what is important from the first question you asked me, about the serology, yes, it indicates that there's more people that were infected than we may have been detected through the - through the surveillance programs. But it still means that a large proportion of the population is susceptible. And that means that this virus is going to be around--</s>GUPTA: Right.</s>VAN KERKHOVE: --for a long time. So, we need this vaccine to help get us through this.</s>GUPTA: Doctor, let's see if we can get to one more viewer question. Lindy, from Kansas, this is a good question, says "If people are the most contagious before symptoms appear, why do people, businesses, et cetera, use temperature as a measure to determine entrance into an office or an enclosed space?"</s>VAN KERKHOVE: So, that's an interesting question, so let's break that down into two parts. One is about when people are most infectious. So, from the data that - that we've seen that are looking at testing people before they develop symptoms, and through their symptom onset, it appears that most people are infectious, the most infectious, right about the time they develop symptoms. And this is even early, early on in symptoms. We know that they can be infectious before they develop symptoms, a day or two before, but it's really when people are starting to feel unwell. But you have to transmit the virus through respiratory droplets, infected respiratory droplets. The other issue with that question around the - the temperature is that not everyone starts with a temperature. So, the majority of people who do develop COVID-19 disease do have temperature, but it may not be in that first - first few days. So, what's important for people to understand is that you could start out just feeling a little bit unwell, and then you may develop symptoms. The thermal scanners will pick up people who have temperature. But there's lots of reasons why people may have temperature. So, some - some people use those thermal scanners and some don't. But a thermal scanner doesn't mean that you will - you will pick up everybody who has COVID-19.</s>COOPER: Dr. Maria Van Kerkhove, thank you very much. We appreciate it. Coming up next, Chef Jose Andres, on what he's been doing to try to help those left hungry by the layoffs, and lockdowns, and how his remarkable team at World Central Kitchen is making a difference. And later, feeding the spirit and soul, a new song by Alicia Keys, dedicated to the men and women still on the job, feeding people, healing them, helping us all get through this. We'll talk to Alicia Keys, and you'll hear the song as our CNN Global Town Hall continues.