New Orleans a hot spot; is Houston next?
With the coronavirus outbreak, vaccine researcher Peter Hotez’s gift for explaining science to the general public has made him a familiar bow-tied presence on the national news.
His lab is developing a COVID-19 vaccine. An M.D. and Ph.D., he’s a professor and dean of the National School of Tropical Medicine at Baylor College of Medicine, and co-director of the Texas Children’s Hospital Center for Vaccine Development.
This week, from his home office, he discussed what COVID-19’s explosive growth in New Orleans might mean for Houston.
You’ve been worried about New Orleans. Judging from the numbers we’re seeing coming out of Louisiana, it’s possible that their hospital system could melt down. What are you thinking?
I’m thinking that things have not gone well in New York. We’re seeing hospital systems being overrun. We’re hearing stories of 500 or more coded patients coming into Columbia, Presbyterian, New York Hospital, the big flagship teaching hospitals, daily. And we’re hearing Gov. Andrew Cuomo telling us that they just cannot manage the surge. There are too many ICU patients for them to manage. This is the nightmare scenario that we all worried about.
Then you have the health care workers getting sick, so they’re getting taken off the workforce. Many of them are my former medical students, so I’m very upset and very worried about what’s going on in New York.
Now the question is, is New York a one-off thing, or do we now expect this to pop up in other cities? This week, we started seeing a big, sharp uptick in Louisiana, and when I look at the map, most of the cases are in New Orleans or New Orleans’ suburbs. So I’m concerned that New Orleans may be one of the next dominoes to fall.
We also heard from the mayor of Atlanta that their ICUs are filling up. So I’m wondering if the epidemic is taking a Southern twist or a Southern turn.
Are there other problems with cities like New Orleans that could make things worse — like poverty?
I’ve spent my life working on interventions — vaccines — for poverty-related diseases. There is a depth and breadth of poverty on the Gulf Coast that I’d never seen before I moved from Connecticut to Houston. The people are wonderful, but it is heartbreaking to see the severity of poverty here.
The question is, is that the population that’s getting affected by COVID-19? Now, why would I think that? One of the reasons New York is getting hit so hard is because of extreme population density. And what you see among the poor, in places like New Orleans and Atlanta, is they also live in areas of extreme population density, so practicing social distancing is problematic.
I’m worried that in the South, COVID-19 is taking a different turn or twist, that it’s predominantly affecting underrepresented minorities, especially African Americans living in extreme poverty.
Do I have evidence for that? No, … all I have to go on are the observations I’ve just been making, together with some of the news reports I’m seeing. But I think this is something that we need to get our arms around very quickly.
We’ve heard that COVID-19 is more deadly when it’s combined with underlying conditions. Is that more likely with people who are living in poverty? Absolutely. And especially African Americans living in poverty. We know that they suffer from higher rates of hypertension, heart disease, diabetes — all the known risk factors for COVID-19. So I worry this is a toxic mix. I think this is going to be an important new dimension to look at.
What sorts of effects do you think an outbreak in New Orleans would have on Houston?
Since Katrina hit in New Orleans, the cities have been linked to the hip. We root for each other: If the Texans aren’t advancing to the Super Bowl, I’m rooting for the Saints. If you’ve ever taken that Megabus between New Orleans and Houston, you know that everybody’s got family in the other place.
That affection and love between the two cities is great, but it also means that if you have all those individuals leaving New Orleans coming to Houston, there’s the potential to spread COVID-19 into our community. That’s one reason why we’ve implemented pretty severe socialdistancing measures. That may help us a lot.
We’ve been hearing a lot about the shortage of equipment, such as ventilators. If there are outbreaks simultaneously in multiple cities, does that mean that we can’t move those ventilators around?
Until these last few weeks, I never even gave thought to the fact that ventilators could move around. This is a new idea. It’s being discussed with New York City right now. The governor of New York, Andrew Cuomo, says he needs 30,000 ventilators, and he’s only getting 400. So would other cities be willing to share? We may have look at some type of rationing.
The other thing that I’m worried about is, if it’s building up in New Orleans and building up in Atlanta, is Houston the next shoe to drop or the next domino to fall? I don’t know. I think there’s a real possibility.
We’ve been hearing a lot about the difficulties of density in New York. Houston and Atlanta are both more sprawling cities. Can we expect lower rates of spread?
Yeah, that’s a huge question. I think it’s not a coincidence that this disease is in New York and San Francisco and Seattle. These are very dense cities, and in Houston, we don’t have that. Maybe that’s going to work to our advantage.