1 00:00:03,760 --> 00:00:08,800 Speaker 1: Welcome to Prognosis. I'm Laura Carlson. It's day one and 2 00:00:08,880 --> 00:00:14,760 Speaker 1: ninety six since coronavirus was declared a global pandemic. Today's 3 00:00:14,800 --> 00:00:19,680 Speaker 1: main story. We're now learning that having had COVID nineteen 4 00:00:20,360 --> 00:00:24,600 Speaker 1: doesn't mean you can't get it again. We'll discuss what 5 00:00:24,640 --> 00:00:28,520 Speaker 1: that means for stopping the outbreak spread and for the 6 00:00:28,560 --> 00:00:34,159 Speaker 1: development of a vaccine. But first, here's what happened in 7 00:00:34,320 --> 00:00:51,600 Speaker 1: virus news today. COVID nineteen could wipe out an estimated 8 00:00:51,840 --> 00:00:56,680 Speaker 1: five hundred million jobs globally. That's a bigger hit to 9 00:00:56,720 --> 00:01:01,880 Speaker 1: the labor market than economists anticipated. According to the International 10 00:01:02,160 --> 00:01:07,160 Speaker 1: Labor Organization, the i l O also predicts a much 11 00:01:07,360 --> 00:01:12,080 Speaker 1: slower recovery. At the end of this year. The i 12 00:01:12,440 --> 00:01:16,360 Speaker 1: l O said that global working hours were seventeen percent 13 00:01:16,480 --> 00:01:21,440 Speaker 1: lower than the end of equivalent to almost five hundred 14 00:01:21,480 --> 00:01:27,360 Speaker 1: million jobs. That's up from four hundred million projected in June. 15 00:01:30,360 --> 00:01:34,240 Speaker 1: Johnson and Johnson has begun dosing up to sixty thousand 16 00:01:34,400 --> 00:01:39,280 Speaker 1: volunteers in a study of its COVID nineteen vaccine. It's 17 00:01:39,319 --> 00:01:43,000 Speaker 1: the first big US trial of an inoculation that may 18 00:01:43,160 --> 00:01:48,240 Speaker 1: only require one shot. J and J is the fourth 19 00:01:48,320 --> 00:01:52,120 Speaker 1: vaccine maker to move its candidate into late stage human 20 00:01:52,200 --> 00:01:57,240 Speaker 1: studies in the US. If enrollment goes as expected, the 21 00:01:57,320 --> 00:02:00,120 Speaker 1: trial could yield results as soon as the end of 22 00:02:00,160 --> 00:02:04,840 Speaker 1: the year, allowing the company to seek emergency authorization early 23 00:02:05,000 --> 00:02:10,680 Speaker 1: next year if it proves effective. Finally, the Trump administration 24 00:02:10,840 --> 00:02:14,519 Speaker 1: has shifted billions of dollars away from public health programs 25 00:02:14,680 --> 00:02:18,560 Speaker 1: for testing and mask funds into its Operation Warp Speed 26 00:02:18,639 --> 00:02:23,560 Speaker 1: vaccine effort. It's a sign the US government is increasing 27 00:02:23,600 --> 00:02:28,840 Speaker 1: its focus on a medical solution to the pandemic. The transfers, 28 00:02:29,080 --> 00:02:32,840 Speaker 1: disclosed in the government audit reported by Bloomberg News and 29 00:02:33,000 --> 00:02:36,880 Speaker 1: described by Congressional Aids, have increased the budget of the 30 00:02:36,880 --> 00:02:40,920 Speaker 1: Warp Speed program to as much as eighteen billion dollars, 31 00:02:41,600 --> 00:02:45,520 Speaker 1: much larger than the ten billion dollar figure the administration 32 00:02:45,720 --> 00:02:56,919 Speaker 1: has routinely cited in public and now for today's main story, 33 00:02:58,240 --> 00:03:01,280 Speaker 1: scientists in Hong Kong were ar died last month. What 34 00:03:01,520 --> 00:03:06,480 Speaker 1: many Headlong suspected could happen. Someone who had recovered from 35 00:03:06,520 --> 00:03:12,480 Speaker 1: COVID nineteen caught the coronavirus again. Since then, about a 36 00:03:12,520 --> 00:03:17,560 Speaker 1: dozen cases of reinfection have been reported worldwide. These cases 37 00:03:17,600 --> 00:03:22,360 Speaker 1: demonstrate that a natural infection doesn't lead to lasting protection, 38 00:03:22,919 --> 00:03:26,640 Speaker 1: and that the pandemic could persist in the human population. 39 00:03:27,840 --> 00:03:32,000 Speaker 1: Bloomberg New Senior editor Jason Gale talked to health experts 40 00:03:32,080 --> 00:03:35,320 Speaker 1: about what this means for our ability to stop the 41 00:03:35,400 --> 00:03:45,120 Speaker 1: virus and to produce an effective immunization. Anecdotes of people 42 00:03:45,120 --> 00:03:48,320 Speaker 1: being infected by the coronavirus twice have appeared in the 43 00:03:48,320 --> 00:03:51,960 Speaker 1: media since at least February, but these cases went proven. 44 00:03:52,520 --> 00:03:56,760 Speaker 1: To demonstrate reinfection, scientists have to isolate the microbial culprit 45 00:03:56,800 --> 00:04:00,240 Speaker 1: at each time, check it's genetic, think a print, show 46 00:04:00,280 --> 00:04:04,000 Speaker 1: that each infection was caused by a different virus. Scientists 47 00:04:04,000 --> 00:04:06,880 Speaker 1: in Hong Kong reported the first confirmed reinfection almost a 48 00:04:06,880 --> 00:04:10,640 Speaker 1: month ago. I asked an infectious diseases physician, he's worked 49 00:04:10,640 --> 00:04:13,720 Speaker 1: on a lot of outbreaks, how we should interpret that finding. 50 00:04:14,600 --> 00:04:18,800 Speaker 1: I'm Dr Tom friedan president and chief executive officer of 51 00:04:18,960 --> 00:04:23,000 Speaker 1: Resolved Saved Lives and former director of both the Centers 52 00:04:23,000 --> 00:04:26,080 Speaker 1: for Disease Control and Prevention and Commissioner of the New 53 00:04:26,160 --> 00:04:29,840 Speaker 1: York City Health Department. Well, first, we're continuing to learn 54 00:04:29,880 --> 00:04:35,000 Speaker 1: more every day, but it's clear now that reinfection can happen, 55 00:04:35,520 --> 00:04:39,840 Speaker 1: how often it happens, and what the implications are for 56 00:04:39,960 --> 00:04:46,320 Speaker 1: both natural infection and vaccine induced immunity really are still unclear. 57 00:04:47,200 --> 00:04:50,320 Speaker 1: Reinfections have now been confirmed in Asia, Europe, and North 58 00:04:50,360 --> 00:04:53,839 Speaker 1: and South America. That all up, these cases probably number 59 00:04:54,000 --> 00:05:00,040 Speaker 1: less than a dozen, which is reassuring. Right, globally we 60 00:05:00,200 --> 00:05:02,960 Speaker 1: certainly had more than a hundred million infections. Now if 61 00:05:02,960 --> 00:05:05,479 Speaker 1: we haven't seen a lot of reinfection, it must be rare, 62 00:05:06,000 --> 00:05:07,960 Speaker 1: or you can say, you know, we're really not looking 63 00:05:08,320 --> 00:05:11,320 Speaker 1: and until we look, we're not going to find. I 64 00:05:11,360 --> 00:05:14,240 Speaker 1: think most of us believe that there is some level 65 00:05:14,320 --> 00:05:17,600 Speaker 1: of immunity for some period of time in some people, 66 00:05:17,920 --> 00:05:22,159 Speaker 1: but those are very vague qualifiers is some ten percent 67 00:05:22,320 --> 00:05:25,520 Speaker 1: or eighty percent, and really until we get better dead 68 00:05:25,560 --> 00:05:32,520 Speaker 1: and we won't know. This first case reported by doctors 69 00:05:32,560 --> 00:05:34,719 Speaker 1: at the University of Hong Kong occurred in at thirty 70 00:05:34,720 --> 00:05:36,920 Speaker 1: three year old nine t worker who had a mild 71 00:05:36,920 --> 00:05:40,000 Speaker 1: case of COVID nineteen in March last month. He was 72 00:05:40,160 --> 00:05:42,760 Speaker 1: screened for the coronavirus at the airport after we return 73 00:05:42,800 --> 00:05:45,039 Speaker 1: from a works trip to Europe. The man didn't have 74 00:05:45,040 --> 00:05:48,160 Speaker 1: any symptoms, so it was no doubt a surprise when 75 00:05:48,160 --> 00:05:50,640 Speaker 1: the test came down't positive. The fact that he was 76 00:05:50,760 --> 00:05:54,920 Speaker 1: infected without symptoms suggested to some scientists that his memory 77 00:05:54,920 --> 00:05:59,279 Speaker 1: immune response prevented any symptomatic disease. In other words, that 78 00:05:59,480 --> 00:06:03,080 Speaker 1: natural infection protected him from getting the cough soil throughout 79 00:06:03,160 --> 00:06:06,000 Speaker 1: favor and headache he experienced four and a half months earlier, 80 00:06:06,360 --> 00:06:10,360 Speaker 1: but it didn't prevent him being infected again. I asked Tom, 81 00:06:10,480 --> 00:06:13,320 Speaker 1: is this what we might expect from a subsequent infection 82 00:06:13,680 --> 00:06:17,360 Speaker 1: with the Sasko et virus. Well, one theory is that 83 00:06:17,600 --> 00:06:21,320 Speaker 1: you're not likely to get severe disease twice. There is 84 00:06:21,480 --> 00:06:24,479 Speaker 1: a reported case of someone who had mild disease the 85 00:06:24,520 --> 00:06:28,640 Speaker 1: first time and then moderately severe disease the second time, 86 00:06:28,920 --> 00:06:32,480 Speaker 1: and someone else who had moderately severe disease the first 87 00:06:32,520 --> 00:06:36,360 Speaker 1: time and mild disease the second time. And the theory 88 00:06:36,440 --> 00:06:40,479 Speaker 1: here is that it's the more severe disease that's more 89 00:06:40,560 --> 00:06:45,080 Speaker 1: likely to result in protective antibodies. We know that there 90 00:06:45,080 --> 00:06:47,280 Speaker 1: are some people who have very mild disease who don't 91 00:06:47,320 --> 00:06:51,000 Speaker 1: seem to mount an antibody response, and that may correlate 92 00:06:51,120 --> 00:06:54,159 Speaker 1: with being able to get infected again. It also seems 93 00:06:54,160 --> 00:06:58,080 Speaker 1: antibodies don't always stick around that long. Last Thursday, researches 94 00:06:58,160 --> 00:07:00,840 Speaker 1: at the Vanderbilt University Medical Center published a study in 95 00:07:00,880 --> 00:07:03,320 Speaker 1: which they found more than half of the health care 96 00:07:03,360 --> 00:07:05,960 Speaker 1: workers who have been infected with sansko vie too and 97 00:07:06,000 --> 00:07:10,280 Speaker 1: had detectable antibodies in early April didn't have detectable antibodies 98 00:07:10,520 --> 00:07:13,680 Speaker 1: two months later. The researchers said they didn't know whether 99 00:07:13,840 --> 00:07:17,080 Speaker 1: the decline and antibodies increases risk of reinfection and disease. 100 00:07:17,640 --> 00:07:20,480 Speaker 1: It's at least helping us understand what the limitations of 101 00:07:20,520 --> 00:07:25,760 Speaker 1: immunity against COVID nineteen might be. I think it's unlikely 102 00:07:25,840 --> 00:07:31,160 Speaker 1: that immunity to COVID is going to be as dramatically 103 00:07:31,200 --> 00:07:35,000 Speaker 1: effective as to say, immunity to measles is. If you 104 00:07:35,080 --> 00:07:39,240 Speaker 1: get measles naturally once in your life, you will in 105 00:07:39,320 --> 00:07:43,880 Speaker 1: all likelihood never get it again. In contrast, if you 106 00:07:43,960 --> 00:07:48,400 Speaker 1: get influenza or malaria or lots of other conditions, you 107 00:07:48,480 --> 00:07:52,679 Speaker 1: may get them again, but perhaps less Seriously, we really 108 00:07:52,720 --> 00:07:57,160 Speaker 1: don't know at this point enough about COVID. But what 109 00:07:57,560 --> 00:08:03,720 Speaker 1: has emerged is that um certain antibodies known as neutralizing antibodies, 110 00:08:03,800 --> 00:08:08,240 Speaker 1: do appear that they may be protective and that's why 111 00:08:08,640 --> 00:08:12,680 Speaker 1: we're hopeful that vaccination may be possible, But until that's proven, 112 00:08:13,440 --> 00:08:21,280 Speaker 1: that's just the theory. There's a possibility that immune protection 113 00:08:21,360 --> 00:08:25,120 Speaker 1: against the coronavirus might be cumulative. The more times are 114 00:08:25,120 --> 00:08:28,440 Speaker 1: immune system says the virus, the better and faster it 115 00:08:28,480 --> 00:08:31,680 Speaker 1: could be in awarding it. Tom says, we don't know 116 00:08:31,760 --> 00:08:35,680 Speaker 1: that for sure, though. Well, there's something called an anamnastic response, 117 00:08:36,080 --> 00:08:39,600 Speaker 1: where when someone is exposed again and again to a 118 00:08:39,640 --> 00:08:44,520 Speaker 1: pathogen it strengthens their immune system. That's one theory, but 119 00:08:44,640 --> 00:08:47,800 Speaker 1: we really don't know what the reality is with COVID. 120 00:08:47,880 --> 00:08:50,880 Speaker 1: What we do know is that there's a wide variety 121 00:08:50,920 --> 00:08:54,760 Speaker 1: of illness. Some people get infected and it's quite mild. 122 00:08:55,080 --> 00:08:57,760 Speaker 1: Other people will get infected and they can get severely 123 00:08:57,800 --> 00:09:01,640 Speaker 1: ill or died, and we're not sure what the difference is. 124 00:09:03,160 --> 00:09:05,920 Speaker 1: One of the key questions around reinfection is whether someone 125 00:09:05,920 --> 00:09:09,280 Speaker 1: who has called the virus again is capable of transmitting it. 126 00:09:09,880 --> 00:09:12,920 Speaker 1: Some pointed to one example that indicated someone could be 127 00:09:12,960 --> 00:09:17,080 Speaker 1: infectious and another example that suggested they might not be. 128 00:09:18,240 --> 00:09:21,640 Speaker 1: At this point, um there are theories but no proof. 129 00:09:22,160 --> 00:09:24,640 Speaker 1: For example, someone who has had a mild infection before 130 00:09:24,840 --> 00:09:28,079 Speaker 1: has very little immunity may behave just the same as 131 00:09:28,120 --> 00:09:31,199 Speaker 1: someone who is infected for the first time. In contrast, 132 00:09:31,280 --> 00:09:34,320 Speaker 1: someone who was very ill and has a high level 133 00:09:34,360 --> 00:09:38,320 Speaker 1: of neutralizing antibody may indeed reduce their viral load and 134 00:09:38,400 --> 00:09:41,480 Speaker 1: be less infectious. It's something that we need to figure out. 135 00:09:42,559 --> 00:09:45,560 Speaker 1: So what do these reinfections mean for our ability to 136 00:09:45,640 --> 00:09:48,960 Speaker 1: reach herd immunity where the virus is potential to spread 137 00:09:49,360 --> 00:09:51,959 Speaker 1: is mitigated by a high level of immune protection in 138 00:09:52,000 --> 00:09:57,359 Speaker 1: the community, all bets are off still um the likelihood 139 00:09:57,520 --> 00:10:02,360 Speaker 1: is that herd immunity is going to involve well over 140 00:10:02,520 --> 00:10:07,319 Speaker 1: half of the population getting infected, but there's still many unknowns, 141 00:10:07,360 --> 00:10:09,959 Speaker 1: And one thing that's important to keep in mind is 142 00:10:10,000 --> 00:10:13,480 Speaker 1: that herd immunity is not a dichotomy. It's not her 143 00:10:13,559 --> 00:10:17,320 Speaker 1: immunity on off. The more people who are immune in 144 00:10:17,360 --> 00:10:22,720 Speaker 1: a community to slower the virus spreads. What is certainly 145 00:10:22,760 --> 00:10:26,319 Speaker 1: the case is that in all likelihood, getting to herd 146 00:10:26,440 --> 00:10:31,199 Speaker 1: immunity for COVID in the US would require an infection 147 00:10:31,320 --> 00:10:37,040 Speaker 1: rate of something like currently we're at about we have 148 00:10:37,120 --> 00:10:40,839 Speaker 1: two d thousand deaths, So in all likelihood, getting to 149 00:10:41,040 --> 00:10:44,960 Speaker 1: herd immunity in the US would involve another six hundred 150 00:10:45,040 --> 00:10:49,720 Speaker 1: thousand deaths. We're talking about more than almost any war 151 00:10:49,960 --> 00:11:00,600 Speaker 1: in US history. When does all this slave vaccine for COVID? 152 00:11:00,880 --> 00:11:03,720 Speaker 1: Dr Chip School, the professor in the Division of Infectious 153 00:11:03,720 --> 00:11:07,160 Speaker 1: Diseases that you see San Diego School of Medicine, says, 154 00:11:07,400 --> 00:11:09,960 Speaker 1: we have to be careful about going down the AIDS 155 00:11:10,080 --> 00:11:13,760 Speaker 1: vaccine hole. As you remember, we're gonna have an age 156 00:11:13,840 --> 00:11:18,439 Speaker 1: vaccine and we never got one. But we've done pretty 157 00:11:18,480 --> 00:11:21,280 Speaker 1: well with ADS, and we did it with drugs, and 158 00:11:21,320 --> 00:11:24,160 Speaker 1: we did it with behavioral changes, and we may be 159 00:11:24,200 --> 00:11:29,360 Speaker 1: in the same boat with Yeah. I mean, these reinfections 160 00:11:29,840 --> 00:11:33,760 Speaker 1: have to give you pause about thinking that you can 161 00:11:33,800 --> 00:11:35,800 Speaker 1: do better with a vaccine and you can do with 162 00:11:35,880 --> 00:11:40,600 Speaker 1: natural infection. Chip says previous research with vaccines suggests that 163 00:11:40,640 --> 00:11:44,000 Speaker 1: the immunity isn't long and it may not be the 164 00:11:44,160 --> 00:11:48,640 Speaker 1: silver bullet many of us being included, hoping it will be. 165 00:11:49,320 --> 00:11:53,120 Speaker 1: That's why I think it's important to try to UM 166 00:11:53,559 --> 00:11:59,200 Speaker 1: optimize non vaccine interventions UM and get back to business. 167 00:11:59,280 --> 00:12:00,959 Speaker 1: I think we really have to get on with it 168 00:12:01,040 --> 00:12:05,040 Speaker 1: about how to operate in the in the colvid era 169 00:12:05,160 --> 00:12:08,319 Speaker 1: where the virus is kind of gonna be looking over 170 00:12:08,320 --> 00:12:12,400 Speaker 1: our shoulder for a wild to come. There's so much 171 00:12:12,440 --> 00:12:15,560 Speaker 1: we don't know about the coronavirus, including our ability to 172 00:12:15,679 --> 00:12:19,480 Speaker 1: produce a safe, effective and durable immune response with the vaccine, 173 00:12:20,000 --> 00:12:22,280 Speaker 1: But there are things we do know we can do 174 00:12:22,480 --> 00:12:26,360 Speaker 1: to stop the pandemic. While we push ahead with developing vaccines, 175 00:12:26,720 --> 00:12:30,000 Speaker 1: we also have to develop better treatments and keep practicing 176 00:12:30,000 --> 00:12:34,880 Speaker 1: physical distancing, hand washing, mask wearing, and everything else we 177 00:12:34,960 --> 00:12:55,160 Speaker 1: can to prevent infections. That was Jason Gale, and that's 178 00:12:55,160 --> 00:12:57,800 Speaker 1: it for our show today. For coverage of the outbreak 179 00:12:57,800 --> 00:13:01,880 Speaker 1: from one beers around the world, visit Bloomberg dot com 180 00:13:02,080 --> 00:13:06,320 Speaker 1: slash coronavirus and if you like the show, please leave 181 00:13:06,400 --> 00:13:09,880 Speaker 1: us a review and a rating on Apple Podcasts or Spotify. 182 00:13:10,520 --> 00:13:13,120 Speaker 1: It's the best way to help more listeners find our 183 00:13:13,160 --> 00:13:17,720 Speaker 1: global reporting. The Prognosis Daily edition is produced by Toph 184 00:13:17,760 --> 00:13:22,880 Speaker 1: for foreheads Jordan Gaspoure, Magnus Henrickson, and me Laura Carlson. 185 00:13:23,640 --> 00:13:28,320 Speaker 1: Today's main story was reported by Jason Gale. Original music 186 00:13:28,360 --> 00:13:32,839 Speaker 1: by Leo Sedrin. Our editors are Rick Shine and Francesco Levi. 187 00:13:33,600 --> 00:13:38,439 Speaker 1: Francesco Levi is Bloomberg's head of Podcasts. Thanks for listening.