New Model Projects 72,000+ U.S. Deaths by Early August; Fauci: COVID-19 Vaccine "Doable" by January if Things Fall Into Place; Sweden Does Not Require Social Distancing as Death Toll Climbs
COOPER: Welcome back to our CNN global town hall, the latest coronavirus modeling is showing an increase in the estimated deaths nation wide to just over 72 thousand by early August. Those numbers, which of course are only projections are from the institute of health metrics and valuation at the University of Washington -- they've been cited by the White House coronavirus task force. Dr. Chris Murray is the director of the institute and joins us now. Dr. Murray, thanks for being with us, your newest model increases the predicted number of deaths by thousands. What specifically has made the number take up?</s>DR CHRISTOPHER MURRAY, DIRECTOR, INSTITUTE OF HEALTH METRICS AND EVALUATION, UNIVERSITY OF WASHINGTON: Well, the number has gone up because we've seen these protracted peaks in some places. It took a while for New York, for example, to come off the peak of this, now fortunately it's on it's way down. We've seen that phenomenon in a number of places, we've seen states adding presumptive deaths to their death counts -- not all states are doing that. So, we're in this sort of funny zone where we've got the confirmed deaths and then some states adding in quite a large number of presumptive deaths where people couldn't get tested before they passed away. And so, we're seeing quite a lot of fluctuation in the numbers that's contributing and remember that our -- the increased numbers there are still assuming what's not going to happen -- namely that people would've kept to social distancing through the end of May. We're working hard to factor in how that's going to bump up the numbers as we expect to see some longer and resurgent epidemics in some states.</s>COOPER: Yes, there's no doubt as people lessen the social distancing the deaths will go up.</s>MURRAY: That's certainly what we're expecting to see, we're trying to figure out, because our model's driven in a large part by changes in mobility, so we've traced the changes of the social distancing mandates into changes in mobility and how that translates into fewer deaths, less cases, less transmission. And now coming out of that where we're seeing already some increases in mobility in some of the cell phone data, the question is how quickly will people change their behaviour and how quickly will they go back to having more contact, more contact means more transmission and sadly eventually more death.</s>GUPTA: So, just to be clear this increase in numbers then does not account for these re-openings? Because we know that they're coming and some have already come, but you say that numbers have gone up to spite that. So, they're definitely going to go up even more, you're predicting?</s>MURRAY: The numbers are up despite that, we are really hard at work trying to translate these changes in the mandates into what that's going to mean. And the reason that's harder than you might think is we know mobility's a driver of transmission, but at the same time we're seeing states ramping up their testing and if the more you test, the more you find infectious individuals or even asymptomatic individuals and get them to isolate, the more you can tamp down transmission. So these two opposing effects and the goods news is the US has doubled testing in the last week, not equally in all states, but we've got to try and figure out how the balance of those two forces will play out, but certainly our numbers are going to go up once we take that all into account.</s>COOPER: When you look at the data, I mean, are the flatter, longer peaks, is that unique to the United States or has that happened around the world?</s>MURRAY: You know, it's happening in different places in the world. You know, if you can go to two adjacent places in Italy -- you know, Liguria and Lombardia -- and one of them had a pretty up and down sort of pattern -- you know, the down swing was really quick like Madrid was in Spain. And then, you know, an adjacent region has this long- protracted peak and a very slow decline. And nobody's really come up with a great explanation for who gets the long-protracted peak and who's lucky enough to have the quick decline -- must be related to, at some level to, you know, behavior and social distancing. But we're having a hard time predicting in advance where that's going to happen.</s>GUPTA: Many of the models I look at, Dr. Murray, don't extend out a few days or a few weeks. Yours goes to August. I'm curious, how did you pick August? And what are your expectations after that?</s>MURRAY: You know, August just started when we started off this effort and we were talking to the hospitals that we were primarily trying to help plan for the surge. And we said, "So, what time frame do you want some planning numbers for?"</s>GUPTA: I see.</s>MURRAY: And the response we got back was, "Four months." That's the way they were thinking about it. So, we said, "OK, we'll try to -- we'll do forecast out to August." We haven't changed that farther going out because there is so much uncertainty about what will seasonality and temperature do to transmission. And then, on the other hand, we're also being asked by a lot of groups to make forecasts of when there may be a resurgence in the fall.</s>GUPTA: Right.</s>MURRAY: So, we'll get there. We'll come up -- we'll extend our forecast window into the fall, but first priority for us is to really capture what's happening now in the country and the relaxation of social distancing and the warmer weather and how that all plays out as well as the rise in testing.</s>GUPTA: Got it.</s>COOPER: You know, it's interesting because we've obviously been talking to you throughout this. And, I mean, I remember when the modeling that -- your projections to August were, I think, like, 61,000. And I feel that was, like, several weeks ago. And correct me if I'm wrong because this is just from memory. And then there was better social distancing in southern states in some of your modeling.</s>MURRAY: Yes.</s>COOPER: So, when I saw that, you know, the death toll had actually, basically, you know -- was coming close to what you projected for end of August already -- is that just the longer -- that the peaks had been longer? Is that or is it that social distancing hasn't been followed as much as you had anticipated?</s>MURRAY: You know, our approach to forecasting -- I think we've talked about it before, Anderson -- is really very data driven. It's like weather forecasting. So, we're trying to forecast the path of a hurricane. And so, our models adapt to what we're seeing in the data. They're not sort of like a theoretical stand about what we think the epidemic will be. And so, we've seen a number of swings happening. So, we started off at about 80,000 deaths with a wide range -- you know, 35 to about 150,000. And then we saw as you mentioned, that mobility metrics suggested that the south was doing a better job than we originally thought. That brought the numbers down. And then you had this very long-protracted terrible epidemic in New York --</s>COOPER: Yes.</s>MURRAY: -- where New York stayed at the peak with you know, thousands of deaths a day at the peak that really racked up the death toll. And we've seen protracted peaks much smaller. But even here in Washington state, we stayed at the peak longer than we expected to see mostly for hospitalizations, a little bit for death. Put all those together, you're getting these changes and then the new thing that's happening on top of that is this presumptive deaths that were missed -</s>COOPER: Yes.</s>MURRAY: -- in nursing homes and elder care facilities. So, people are back-reporting. They're sort of rewriting the history by telling us about deaths that the states missed in the past.</s>COOPER: Yes.</s>MURRAY: And, you know, our net forecast for the country is the balance of all this new information feeding in on a daily basis.</s>COOPER: Well, Dr. Murray, we appreciate your expertise as always. Thanks so much.</s>MURRAY: Happy to be here. Thank you, Anderson.</s>COOPER: Quick reminder, at the bottom of your screen you'll see our social media scroll shows some of the questions that you're sending us. You can tweet us your questions with the hashtag #CNNTownHall or leave a comment on the CNN Facebook page. Back now with Sanjay. And also, I want to bring in a veteran of many of our Town Halls -- Dr. Leana Wen, a visiting professor at the George Washington University School of Public Health, also Baltimore's former Health Commissioner. So, Dr. Wen, with this latest coronavirus modeling showing an increase in the estimated deaths nationwide and as they are going to now incorporate the ending of social distancing, it's likely to go up, does it concern you that so many states are relaxing their orders?</s>DR. LEANA WEN, VISITING PROFESSOR, GEORGE WASHINGTON UNIVERSITY: Yes, it does. I mean, I'm worried for three reasons. One is that the numbers are going up, as you were saying, Anderson. And also, we don't know the true numbers because of under-testing.</s>GUPTA: Right.</s>WEN: Second is we have lack of capabilities. We just don't have the public health infrastructure to do the tracing and quarantining that we need. And third, I'm not sure that the American people are ready for another wave of -- not only resurgence of deaths, but also for another wave of shut downs if necessary. So, I hope that all those who can will continue to shelter in place, stay at home and those who have to go out should take additional precautions like wearing a mask, washing our hands and trying to stay six feet apart, because we can all do our part to continue to protect each other and our loved ones.</s>COOPER: All right. Let's get some viewer questions. Sanjay, Andrew in New Jersey sent in this question which reads "Why was a vaccine never finished during the original SARS or MERS outbreak?" And then there is a follow-up about -- well, let's answer that one first.</s>GUPTA: Yes. So, they were started, these vaccines were started and some of the techniques that they used for those vaccines are actually being built upon now. But a couple of things, one is that the other outbreak SARS and MERS, because of some of the strategies we've been talking about we were able to make those epidemics, pandemics sort of really sort of fizzle out. So, a vaccine wasn't as necessary and you know, vaccines cost money. So, as things started to die down in regards to those other infections I think the vaccine plans that guys like Peter Hotez were working on just sort of went away.</s>COOPER: And how similar are those diseases to COVID?</s>GUPTA: Well, so, the coronavirus is the same thing that caused SARS and MERS, a type of coronavirus. So, that part is similar and some of the techniques to use sort of a genetic vaccine, some of that was started -- some of that knowledge was sort of gained back started with SARS back in 2003. So, able to build on it but each vaccine's still going to be different, each pathogens going to be different.</s>COOPER: Dr. Wen, Alex Miller in Connecticut sent in this video, let's take a look.</s>ALEX MILLER, HIGH SCHOOL STUDENT: Hi, my name is Alex, I'm 16 years old and I tested positive for COVID-19 two weeks ago. And since then, I have had small painful bumps on my tongue. So, I was wondering if you knew of any other cases for this symptom or any remedies for this symptom? Also, I haven't lost my sense of taste, thank you.</s>COOPER: Dr. Wen.</s>WEN: Well, as far as I know there is no association that we know of between the bumps on the tongue and COVID-19 although Alex brings up a good point about the loss of smell and taste that even though COVID-19 is a respiratory virus, it is believed to cause these other types of symptoms. So, I would say for Alex specifically about the bumps, if they are causing enough pain and discomfort that he's having trouble eating and drinking he should call his doctor and in the meantime I hope that he recovers well.</s>COOPER: Dr, the CDC actually added new coronavirus symptoms to it's list earlier this week and I want to put them up on the screen just to go over them. It's fever, cough, shortness of breath, chills, repeated shaking with chills, muscle pain, headache, sore throat, loss of taste or smell.</s>WEN: Yes, so what we knew before about the most typical symptoms for COVID-19 were the fever, the cough and shortness of breath. Now it's important that CDC added six more symptoms, because one of the criteria for testing from a lot of places is having these symptoms. So, many of these new symptoms are what you would expect for a viral syndrome -- the chills, the shaking, headache, etcetera, that's what you see for viral syndrome. The one that's different is the loss of smell and taste and again, I think that illustrates that COVID-19 is not just effecting the lungs, it's effecting potentially the nervous system, other parts of the body too and we're learning a lot more as the disease goes on.</s>COOPER: Yes. Sanjay, this next question came in via Twitter with our hash tag CNN Town Hall, it's at the bottom of your screen there reads "As long as you follow social -- hash tag social distancing, is it OK to continue solo outdoor activities like jogging or running? Any other steps to make sure we're safe as we workout?"</s>GUPTA: Yes. No, I think so, that's the key is whether you're inside or you're outside, you want to maintain that physical distance. That's the key in terms of breaking the transmission, that's what we're trying to do here is break that transmission of spread and hopefully start to make the virus die down like other viruses have.</s>COOPER: I can make a tutorial video on how to watch Netflix safely or stream other movies cause that's about the only activity I've been doing. But you made a video Sanjay that shows us the best way of running safely outside. Let's take a look.</s>GUPTA: OK.</s>GUPTA (on camera): Everybody wants to be outside. I want to be outside, people are going stir-crazy inside and it's OK out here for certain. You also want to run and running's OK, the risk of getting the virus while you're running is really, really low, but it's not zero. So, here's a couple of caveats to keep in mind.</s>GUPTA (voice-over): Same rules apply, you want to maintain a physical distance when you're running, just like when you're inside. We hear six feet, according to Lindsay Marr at Virgina Tech, when you run, maybe you make that closer to 10 feet or 12 feet. Why? You're breathing harder, you may be putting more virus into the air. Avoid people as much as possible, maybe you're going to run at odd times, early morning or late at night. Maybe you're going to run different routes, just to sort of mix it up. And let's say you see someone in front of you a few feet. Lindsay says maybe you switch over to the other side of the road at this point because you do want to avoid someone's as she calls it "breath cloud". There's a thing about masks, if you're truly going to be running by yourself, you don't need one. But if there's a chance that you might be sharing a path or a sidewalk with somebody else, then probably have a mask with you. At a minimum, it's a courtesy to let people know that you're taking this seriously and trying to protect them. Keep in mind, if you have any symptoms whatsoever, you should be staying home.</s>GUPTA (on camera): So, go ahead and do it, I do it, Dr. Fauci does it, it's good for your physical health, I think it's good for your mental health as well.</s>COOPER: So, if you're running near, you know, on a path where there's other people nearby you should you wear a mask?</s>GUPTA: I think so, yes. I think if you're truly not going to come in contact with other people and still able to maintain a safe distance, which you heard maybe closer to 10 or 12 feet because you're breathing harder, then I think it's OK not to wear a mask. I carry one with me if people are going to be around, I think it's a courtesy as well, I mean people are frightened, Anderson, so I think it shows that you're taking this seriously.</s>COOPER: Yes. Dr. Wen, this next question came in via Facebook with our hash tag CNN Town Hall, it's there at the bottom of the screen. The question is "Should we change our clothes after returning home from being in public places like the grocery store?"</s>WEN: With the chance of actually acquiring COVID-19 from your clothes that somebody else may have transmitted virus to those chances are very low. But I would say that if you are a heath care worker, if you're somebody who is around a lot of virus potentially at work, then it makes sense to come home, change your clothes, leave your shoes outside. You can still do so out of an abundance of caution, but the chance of actually acquiring COVID-19 that way are very low.</s>COOPER: All right. Sanjay, yes, your go.</s>GUPTA: And I tell you one thing I've been doing, I don't know if you've been doing this Leana, at the hospital, I actually change my clothes there now so, I go and change into scrubs and then change back to try and reduce the chance of bringing it home.</s>COOPER: Dr. Wen, Carly in Virginia sent in this video, let's take a look.</s>CARLY BUXTON: My son was born two weeks ago during a peak week of this crisis and since then we've been quarantining at home. I expect it will be many months before he's held by anyone outside of the family or before he goes to any public places. My question is this, does spending the first few months of life in an ultra-sterile environment have any lasting impact on a child's immune system? Thank you.</s>COOPER: Dr. Wen.</s>WEN: Well, Carly, I'm in the same boat as you. First of all, congratulations, but I also have a four week old and no-one else has held the four week old other than my immediate family and we're certainly not planning to go to any public places. Look, I wouldn't worry about lack of exposure for now, because actually for newborns they have such limited immunity anyway and we wouldn't want to expose the baby to all kinds of other germs anyway. And this outbreak is going to be over at some point and we will be able to see people again and in the meantime, I would say you can also boost the baby's immunity by breastfeeding if you can, doing a lot of skin-to-skin contact and just enjoying the baby.</s>COOPER: All right. Sanjay, Eric in New York sent in this video, let's take a look.</s>ERIC VIETZ, BANK BRANCH MANAGER: Is it appropriate to compare the infection fatality rate of COVID-19 to the infection fatality rate of the seasonal flu when we have a flu vaccine? What would the infection fatality rate approximately be for the seasonal flu if we had no vaccine?</s>COOPER: Sanjay.</s>GUPTA: That's a really good question and a good point. I mean, what we say is that the fatality rate for those who get infected with the seasonal flu is around point one percent. Now keep in mind though, keep aside the vaccine for a second, because we all have lived on this planet, we all have some immunity to this seasonal flu because there's some variation of the flu changes a bit every year, but we do develop some immunity. And because a lot of people have been exposed, we start to develop some herd immunity to the seasonal flu as well, so those things help us. Then you layer on top of that the vaccine, so again -- but the fatality rate to the question, which is a good question is point one percent for those infected, so in this country, if 30 million people become infected with the seasonal flu which is not that atypical that means 30 thousand people roughly would die of that. So that's -- I think that's the way to sort of think about it.</s>COOPER: All right, Sanjay. Dr. Leana Wen, thank you so much as always. Sanjay, stay with us. Up next, Bill Gates shares his thoughts on testing vaccines and how we successfully reopen the country. And we've got a nice announcement to make ahead, also.