9 May 2020

Donald McNeil: US facing a dystopian Covid future

From Saturday Morning, 8:10 am on 9 May 2020

The New York Times health and science correspondent has defended New Zealand’s strong response to Covid-19 over criticism its measures may have been too economically harsh.

Donald McNeil told Kim Hill those putting economic interests above the lives of the vulnerable, including their family members, were cold-blooded and that health should be the priority.

NEW YORK, USA - APRIL 12: An amazon delivery person, with a face mask, crosses a street on Park Avenue, remaining nearly empty due to coronavirus (COVID-19) pandemic in New York City, United States, on April 12, 2020. Tayfun Coskun / Anadolu Agency

Photo: 2020 Anadolu Agency

New Zealand was to be congratulated for quickly and decisively containing the virus and for choreographing a slow ‘dance’ out of lockdown - in stark contrast to the United State’s response.

He said the US now faced a dark and somewhat dystopian future, with economic opportunities for those with acquired immunity, leading to people deliberately expose themselves to the virus to get an "immunity passport" back into the workplace, gambling with their lives.

Australia and Iceland have somewhat flattened the Covid-19 curve without going to the extremes of New Zealand. Australia has 6948 reported infections and 97 deaths. Iceland, with a population of 360,000 has a reported 1802 cases and 10 deaths. Some politicians have suggested this showed New Zealand has been guilty of an overreaction.

“You have to choose, how many people do you want to die. What’s more important to you?

“I’ve had arguments on the air with people who basically say that … the economy is more important to me than my father’s life and I think really, how cold-blooded can you be? And how does your father feel about that?

“We can tolerate a certain amount of lockdown if it’s done well. It doesn’t have to last for ever and the economy will revive. But coming out of lockdown also has to be done carefully and intelligently enough, rather than willy-nilly, so that you don’t get a whole set of deaths happening again.

“People can work, there are certain circumstances where people can work under safer conditions and this isn’t endless. It isn’t like the 100-year war, or like the Blitz in London, where we didn’t know if the Germans were going to run out of bombers, or whether or not they were going to invade.

“We know this will end in 18 months, which is the optimistic view when a vaccine arrives, maybe two years, but if we acknowledge that it ends we can plan accordingly and try to minimise the number of deaths.

“Unless you’re that person who says ‘it only affects the weak and I’m not one of the weak’. But we’re all weak… I’m not with the camp that says ‘let’s rush out there and crank it up again and let it blow through.”

He said US President Donald Trump had failed to respond to the virus, initially denying it was serious. When medical experts sounded the alarm and the US stock market lost 500 points, he said those experts were effectively silenced.

The US death toll leads the world as it approaches 80,000. McNeil said America was now further divided between two classes – those who have been infected with Covid-19 and those who had not.

With some scientists proposing ‘immunity passports’ to fast track people back to work, he said there was now a temptation among many to self-infect.

“I know young people who are very tempted and there have been people who’ve done Covid parties to deliberately get infected because they’re tired of lockdown and tired of being out of work.

“They think their chances of having a mild case are pretty good and statistically their chances are pretty good but it’s no guarantee… That’s the chances people are taking.”

He suggested the US Government could facilitate this approach, especially for the military.

“These are different times, so you need to think differently than we normally do,” he said.

‘I think the government ought to recognise that this is happening and do what it can to protect people. And the military may have to go in that direction. We don’t have to be in a position where our military are completely vulnerable… We could do it unit by unit in small numbers so you have treatments and ventilators standing by for those who crash.”

With states and cities across the US preparing to come out of lockdown, the prospects for the near future remains gloomy. Ultimate hope lies in a vaccine.

Donald McNeil

Donald McNeil Photo: supplied

“I think it will end with a vaccine. I think it may be blunted along the way with convalescent plasma and then maybe we’ve be able to make monoclonal antibodies and maybe we’ll find some sort of pill that will slow it down the chances of it getting worse. I think the end point was going to be a vaccine, but we don’t know when that’s going to arrive.

“We’re speeding everything up faster than before. But the fastest we’ve ever made a vaccine anywhere in the world is  a mumps vaccine and that took four years back in the 1950s. I don’t think it will do that, we’re doing great with the candidate vaccines right now, but viruses have a tendency to create antibody dependent enhancement, where the vaccine actually makes the problem worse rather than better, makes you more likely to get it and that would be a disaster, so we have to do the safety testing to make sure we haven’t made that mistake before we give it to millions of people and that takes time.”

Scientists are currently testing whether convalescent plasma can improve the chance of recovery for people with the most severe disease and whether it can help keep people who are moderately sick from getting sicker.

Monoclonal antibodies are laboratory-produced molecules engineered to serve as substitute antibodies that can restore, enhance or mimic the immune system's attack on Covid-19. The technology has been used to produced ZMapp, a drug unsuccessfully used to treat Ebola, but which has had some success when given to Covid-19 sufferers.

 “It’s not fast-moving technology, but it is a way so that we might be able to save people. We might even be able to use it defensively to protect first-responders, doctors and nurses,” McNeil said.

New Zealand’s response had aligned closely to a strategy famously penned by expert Tomas Pueyo, published, and New Zealand had followed that strategy.

“He predicted what would have to happen actually by looking at what had happened in China, that when you realise your deaths are soaring and they’re going to run into millions, the only way to stop it is to bring down the hammer, is to lock everybody in their homes as much as possible until the death rate comes back down to pretty close where it was before ideally and you have control of the situation and then you begin to dance out of lockdown." McNeil said.

“You have to sort of see what steps you can do so that you can come out and see your economy started again without starting that spike up to million deaths again and so it might be we come out wearing masks or it might keep the schools closed down…

"If deaths, rates increase you need to go back into hiding again.

“You do this in a series and dances and lockdowns, until either we reach herd immunity because so many people have died and there’s nobody left to infect, or you get it the nice way, through a vaccine.”