Dr. James Galloway is a former assistant U.S. Surgeon General, a cardiovascular medical doctor and a public health expert. He served as a Senior Federal Official on Health for Pandemic Influenza and Bioterrorism for the Department of Homeland Security and as the Director of the Office of Health System Collaboration for the Centers for Disease Control and Prevention, integrating clinical care and public health at a national level. Dr. Galloway is a Tucson resident who has been monitoring the global impacts of the COVID-19 Coronavirus outbreak, and governments' responses to them. This interview has been edited for clarity.
What steps could the Trump Administration have taken earlier to respond to the COVID-19 pandemic?
On January 9, an outbreak of an "unidentified and possibly new" viral disease in central China was reported and was sending alarms across Asia. Shortly afterwards, Taiwan and Hong Kong and South Korea were contemplating quarantine zones and scanning travelers from China for signs of fever or pneumonia. And then on January 21, they locked down Wuhan, the city in China. In late January, multiple articles came out from well-known scientific experts, saying that we needed aggressive interventions. That was late January. And it was on March 11 when Trump gave his first speech acknowledging the seriousness of the Coronavirus. Unfortunately, early on there were a lot of denials and statements of things like "we're on top of it" and "it's totally under control," which put our government as well as our population at ease when things really should have been ramping up. Things that could have been done earlier are things like accepting the World Health Organization's offer for testing kits, or organizing and directing individuals, doctors and hospitals about how and where to get the tests for patients. Providing leadership to the states, counties and localities as CDC usually does early on in a situation like this, and allowing states to use the testing kits they had developed without federal approval, which was just done a few days ago. So those are a few things that could have been done, but the issues remain that there is a tremendous lack of available testing kits, despite statements that they were available to all.
Going forward, how can national governments work with disease experts and healthcare experts to effectively respond to this rapidly changing situation?
There's several critically important aspects of this. Unmuzzling the experts, allowing the scientist to help guide from their perspectives as we move forward, collaborating among states, local counties and local municipalities with a leadership that allows for uniform implementation of appropriate rules and regulations and guidelines, and collaboration across the globe with other nations and with the World Health Organization in a meaningful way to gather the expertise, as well as the information from our global partners.
What makes COVID-19 different from the common cold or the flu?
It's very infectious, but most importantly, it has a higher mortality rate. The mortality rate that's been published is around 3 percent. That's likely elevated above what we'll see because the people who've been tested were the really sick ones, so the mortality rate would be higher. If we were able to test everyone, more than likely, the mortality rate may be down as low as 1 percent, but that's still 10 times the mortality rate for the flu, which is 0.1 percent. So if you combine the contagiousness with the mortality rate, it makes it a much greater challenge to control and with the potential for much more devastating results.
Do you think other countries are taking the right steps by doing total lockdowns to prevent the spread?
It depends on the situation. The response needs to be graded depending on the severity of the disease in the population. In places that have low rates, no it's probably not appropriate. In places that have high rates, like Italy does, it's very appropriate, because they're overrunning their healthcare system, and so the idea of flattening the curve, that critically important idea to minimize the exposure of individuals so that we can maintain our integrity as a healthcare system is incredibly important.
Do you think the U.S. should be preparing to do the same?
I think that it depends on the severity of increase, but if we find ourselves where we are maxing out our medical treatment opportunities, then we have to do what we have to do to save lives and maintain order within the U.S.
Is it a positive sign that the number of new cases in China is decreasing? Can we look to them as an example for how to get past this pandemic?
China, being the autocratic government that it is, was able to impose very strict rules quite early and were able to contain the outbreak pretty effectively. That's why they're seeing the downturn already and within the United States, we hope that we'll be able to make a similar type of reduction in the number of cases within six weeks to a few months. I do think that with the interventions over time, we will be able to see a decrease and it's also likely that this will continue to be a flu-like disease that many of us will have antibodies to in the future that won't be near as severe. The issue right now is that no one has antibodies to it so it's extremely contagious.
Anything else you'd like to add?
One, I think it's critically important that we maintain our healthcare workers. I think that we haven't been as successful in protecting them as we should be, and they're our critical lifeline. We need to make sure that the nurses, the techs, the doctors, PAs, nurse practitioners, have adequate supplies to be able to protect themselves as they protect us and treat us. Secondly, I think that regardless of what's happened up to this point, it's now up to us as a nation of Americans to fight this disease and to combat this pandemic. We must follow the CDC guidelines. And we will overcome this, there will be casualties, but we will indeed get through this. ■