Hantavirus is not COVID. The real problem is the communication void.
The absence of federal health leadership is fueling public fear far beyond what the science warrants.
Jessica Dean: And Dr. Céline Gounder joins us now. She’s an infectious disease specialist and epidemiologist. Doctor, you’ve also written extensively on the hantavirus. Thank you so much for being here with us to talk through all of this. Rafael just went through kind of where things are. What is your assessment of how effective the response has been so far to contain this outbreak?
Dr. Céline Gounder: I think my biggest concern has been the lack of communication to the American public. We as clinicians did not receive a health alert until Friday afternoon. It seems to have been timed with the, uh, plans around the 17 Americans being returned home. But I think the American public had a lot of questions leading up to that as to how are these Americans going to be quarantined, what is the testing protocol?
And I think because of that absence of leadership and communication, that raised a lot of questions. People are understandably very scared coming out of the COVID pandemic and asking themselves, “Is this a replay of what we saw in 2020?”
Jessica Dean: Yeah, and to that end I want you as the medical professional to lay this out for people.
How concerned should the general public be?
Dr. Céline Gounder: Yeah, the risk to the general public remains really low. I think of it this way. COVID was a wildfire. It spread through the air. People who did not have symptoms could still infect other people, and the entire world was fuel for the COVID virus. Hantavirus is like a wet log in a stone fireplace.
It requires direct, sustained contact with a sick person. The virus infects deep lung tissue, so it doesn’t get coughed or breathed out in large enough amounts to cross a room. Hantavirus is not a new virus. This is a virus we’ve been studying for decades, and infectious disease specialists understand how this virus moves the way, say, an engineer or electrician might understand how electrical current moves through a wire.
So the material here, the virus here, determines the outcome, and every data point from the outbreak so far is consistent with what the science would predict.
Jessica Dean: And so now we have these 17 Americans who are being flown to this quarantine center in Nebraska where our understanding is they’re going to be evaluated, and from that it will be determined if they will be able to then, uh, go home and be monitored for, for some 42 days or if they’ll stay there in Nebraska.
From the outside looking in, I think a lot of people go, “Wait a minute, shouldn’t they just stay at the outbreak center in Nebraska?” Would you help people understand that process?
Dr. Céline Gounder: Yeah, so they’re assessing the level of exposure. So how much contact, how close of contact, how intense of contact did they each have with known hantavirus cases?
And this is in fact identical to what was done for Ebola back in the 2014 to 2016 epidemic in West Africa. I was an Ebola aid worker. When I landed at Newark Airport, they gave us thermometers and cell phones and diaries to log our symptoms, to check in. And then depending on our level of exposure, we were quarantined differently.
So my level of exposure was I had no known contact with somebody with Ebola without wearing protective equipment, so my level of risk was very low. And I could quarantine at home, which I did for three weeks. And so it’s a similar kind of stratification of risk and determining what level of quarantine is needed accordingly.
Jessica Dean: And what will it be like once. I mean, you kind of just went through what it was like for you, but they’re going to an actual facility in Nebraska. How might that be different?
Dr. Céline Gounder: Well, it depends. So some of them, the low-risk people would be allowed to quarantine at home, which was my experience.
For those who are being kept at the National Quarantine Center, so this is the only federally funded quarantine center in the United States, they have experience with this kind of thing. They handled the quarantine of the COVID passengers on the cruise ship early in 2020. People may remember.
I think people are having flashbacks to that moment. But this center handled that quarantine, and they have practice doing that. The advantage here is hantavirus is actually a far less contagious, infectious virus. So the stakes in that respect are lower, and the other thing that’s really important here is for people who are high risk for developing severe hantavirus disease, they need to be near a medical center that has the capacity for ECMO, which is the heart and lung bypass machine, because when they develop that kind of severe disease, that’s the only thing that can save them.
And so this is actually very much in their interest if they’re at higher risk for infection.
Jessica Dean: And I heard you at the top of our conversation talking about the lack of communication, what you perceive as a lack of or it could be better communication. How else would you evaluate the CDC response to all of this?
Dr. Céline Gounder: Well, we have not heard from the HHS secretary. We have not heard... We, in fact, don’t have a confirmed CDC director. We finally heard from the acting director, Jay Bhattacharya, who’s wearing two hats, in fact. He’s also the NIH director. We heard from him today on Jake Tapper’s show. We don’t have a confirmed surgeon general.
The FDA commissioner has just been fired. We really have a massive void of leadership at the very top to communicate with the American public, and I think we should be having daily situation updates for the American public to understand not only what is the risk to us, but also what is being done to address the situation aboard the cruise ship.
Jessica Dean: All right. More to come. Dr. Céline Gounder, great to have you on. Thank you so much.