What are the likely origins of the virus?
What structural problems have inhibited the US response?
And how serious is CCP virus in the US? What’s in store for the near future?
In this episode, we sit down with Dr. Steven Hatfill, a physician, virologist, bio-weapons expert, and an adjunct professor of emergency medicine at George Washington University Medical Center. He has studied the Ebola, Marburg, and Monkeypox viruses at the US Army Institute for Infectious Diseases, and he is the co-author of the prescient book on pandemics, “Three Seconds Until Midnight.”
This is American Thought Leaders 🇺🇸, and I’m Jan Jekielek.
Jan Jekielek: Dr. Steven Hatfill, so wonderful to have you on American Thought Leaders.
Dr. Steven Hatfill: Nice to be here with you Jan.
Mr. Jekielek: So, Dr. Hatfill, you’re an expert in disaster planning and epidemic response and a whole range of issues, you’ve written this book, “Three Seconds Until Midnight,” which predicts what we’re seeing right now with coronavirus—although you were expecting it to be influenza. Why don’t you tell me how you knew, when you published this book in November, what was going to happen.
Dr. Steven Hatfill: We spent about 10 years looking at this. … The United States didn’t have a plan really for any pandemic respiratory virus until 2005, when George Bush put one into place. It was a preliminary plan, there was a lot of fanfare about it. But it was the first time somebody had outlined what the various segments of the federal government were going to do. And Health and Human Services had within weeks, taken this and put some meat on the bones and gave it a body. And that plan was a very careful delineation on what the federal government was responsible for, what the states were responsible for, and what the mayors of our towns and cities, our local authorities, were responsible for. And it outlined it in extreme detail. … There were checklists. There were everything.
Dr. Hatfill: The federal government has kept its task to the American people. It is met and it is doing all of its responsibilities. There were some snags starting out, but this is moving at a speed we have not seen since World War II, with regards to industrial mobilization. The states partially did what they were supposed to do. Some states were better than others. Some states were excellent. But that is to take items from the national stockpile and distribute it to the local authorities, to modify any rules regarding volunteer liability, the use of alternate care sites, modified standards of care for the state in a severe pandemic—these types of things. And then, unfortunately, most of the local authorities did very little, some did very well, but the majority failed. They didn’t stockpile, they didn’t make plans to have a surge medical capability. That is, increased [inventory], of beds, of healthcare personnel, this type of thing. There was no stockpiling of critical basic items and an inventory to control that stockpile. They took federal money to help them but nothing seemed to get done.
And this whole concept of emerging disease became more prominent. This started in the mid 90s. When we started to see all these infections previously unknown to medical science, and it started to occur with an increasing frequency. A lot of us thought we were imagining this until a few seminal papers came out that went back historically and looked over the last hundred years. And it turns out, it’s not the fact we were getting better at identifying new diseases. New infectious diseases were indeed jumping from animals into man with an increasing frequency. And right now, some scientists are predicting anywhere from 10 to 40 new pathogenic animal viruses are going to jump into man over the next 20 years. We have no idea how lethal these new agents will be. You have to sort of plan for the worst. And if it doesn’t occur, be pleasantly surprised.
When the SARS epidemic in 2003 made its way through the world, it really wasn’t anything anyone was expecting. Our social distancing measures and control measures were able to quickly keep it under control. By this, I mean case contact tracing. So you have a patient, they fit a clinical definition. You go by and you quarantine to everyone they’ve had close contact with for so many days and this really did it… Singapore did an excellent job. Hong Kong as well, of getting this firmly under control. That was our warning, we needed to improve our surveillance. We needed to improve our surveillance above what the WHO was doing.
Now as a signature country to the WHO you are required to inform the WHO if any new, unusual disease outbreaks occur. This is an international health regulation—an IHR. Unfortunately, a lot of countries aren’t doing this, or they try to minimize it or hide it. We missed critical, critical days in preparing for this thing. And this happened in SARS. This was kept undercover for several weeks. And it’s happened with the outbreak in China. Once the virus gains access to the international air traffic system, passenger traffic, and then it disseminates, as we’ve seen, very, very widely.
So, this concept of emerging disease, we were expecting something like this to happen. And it was necessary to go back over the respiratory pandemic plan, and make an assessment of the bottlenecks, what needed to be done, how can we approve it, all the way from surveillance of new events to the major megacity region responses and we tried to offer some solutions to get the ball rolling. But there didn’t seem to be a lot of interest at the time.
Mr. Jekielek: Let’s talk about China first. Is it certain that the virus originated in China?
Dr. Hatfill: As certain as it can be. In the southern part of China, there’s a lot of bats. And coronaviruses have been isolated from these bats. There’s I think they’re up to 400 different coronaviruses out there. These serve as your reference samples, so when you do have an outbreak, it makes it fairly easy to find one of these bat coronaviruses that it closely matches. And then, as with any emerging disease, the virus by itself in its natural environment may not be enough to jump into man. There’s a learning phase that the virus has to go through to adapt to human biochemistry. And this can often be done by passage through a second species of mammal.
One of the current thoughts is that this had passed from horseshoe bats into the pangolin. The pangolin is kind of a creepy little animal. It’s an anteater type thing with long claws. It’s a mammal, but it has scales all over the outside of its body. And a real long tail, it likes to roll into a round ball if it feels threatened. Well, these are considered a delicacy in some parts of the world and they’re actually endangered animals.
In Asian countries, the people like their food very fresh. So grandma will go shopping in the morning. And they’ll kill the item right then and there, at the live market, and then bring it home and it’s consumed virtually the same day. This is a tradition. And the live markets are where you have a lot of different animal species crammed into cages next to each other. And of course, viruses can traffic from any of the sick animals to other species. And they make a species jump into something else. …The golden rule I use if you find the same virus in more than two species of mammal, then that virus is a risk for jumping into man and becoming very efficient at person-to-person transmission.
Mr. Jekielek: There’s been a lot of rumors that this could have been some sort of vaccine research that escaped from the nearby P4 bio lab in Wuhan or possibly even a bioweapon. You’re it sounds to me like you’re saying it most likely originated in this wet market.
Dr. Hatfill: No, it didn’t originate in the wet market. I personally think it originated further south. You capture these animals to eat, you have to transport them to market. All these different species go in the back of a truck. We know that the virus did have a genetic change while it was at the market. The biosafety level four lab is kilometers away from this wet market. It’s not like next door or anything—it’s clear across town. … And you only keep very small quantities of this stuff around in tiny tiny little plastic vials that are kept in liquid nitrogen. The research is done very carefully. Nothing gets out of that place.
Any of those labs there, everything is sterilized before it comes out or treated. You’re in an encapsulating suit so your chances of catching something are almost zero. And should you tear your suit or something like this, there’s a whole protocol you go through. You go into quarantine for many days. So the chances of it coming from something like that out of the laboratory into a humid environment with lots of moisture in the air… these things don’t survive very long as an aerosol, they decay fairly quickly. Outdoors, they decay very quickly. The ultraviolet light damages them, oxygen in the atmosphere. … Like when you put salt on a slug when you were a kid and they shrivel up, it exerts forces that tear the virus apart, or try to tear the virus apart.
So when you look at the genome of the virus, it doesn’t look like it’s been tampered with in any way intentionally. And we can follow these mutations all the way back to the first recognized case, which was a long ways away from [Wuhan]. And then from there to the cases, and even there now, you can see the different clades, the ones that went to Europe, the ones that went to North America, the ones that spread further through Asia. And you can follow all this stuff like a detective. So the chance of this being an accident and or an intentional event… Is anything possible? Well, essentially anything is possible. But the chances of this are about the square root of zero.
Mr. Jekielek: Dr. Hatfill, you mentioned earlier that the Chinese Communist Party wasn’t very forthcoming with information. I’m wondering if you could trace that for me and also what the costs of that were.
Dr. Hatfill: From what I understand, there were alarmed cab drivers sending tweets to each other. The cab drivers are very smart people who have a pulse on the city at any one time. The Chinese media swooped down on these guys and did whatever they did so that they’d stop talking about it. There’s possibilities this may have actually been occurring in November. A few people think maybe it was October over there. It’s possible with any virus to get a subclinical infection. In other words, you’ve been exposed to enough of the virus that you make antibodies that activate your immune system, but you don’t become overly ill. And as we’ve learned over the last 50 years, each pathogen has its own critical, minimum infective dose. And if you’re exposed to a number of viruses below that minimal infective dose, then you tend to develop an immunity and your body handles them. Above the minimally infective dose, …[you’ll] go on to develop the actual disease.
This could have been lurking around for a long time without anyone aware of it, without people really becoming overly sick or dying of something else, or misdiagnosis. Remember we had a flu epidemic going on as well. And there was a [Type] B influenza strain involved, which was pretty rough on humans. So how many of these flu strains got misdiagnosed or improperly diagnosed when it was actually a coronavirus infection? So that could have happened as well. Whatever it is, we lost valuable time.
Mr. Jekielek: On January 14, the WHO, based on data that it had been given by the Chinese regime, announced that there was a very limited human-to-human transmission of coronavirus. What do you make of that announcement?
Dr. Hatfill: Personally, I looked at it with some degree of suspicion. If it was using the same receptor as SARS, that was sort of a background model. And because of the original SARS problem with China in 2003, it was best to be pessimistic about what they were announcing. And time would tell. And time did tell. From the time in the wet market, this virus seemed to be transmitting more readily to humans and from human-to-human. So, in that case, and [considering] the level of the population that really weren’t showing overt symptoms, then it (human-to-human transmission) falls into the realm of possibility, and this should have been communicated.
That said, the Chinese moved with remarkable urgency and speed to develop a rapid PCR diagnostic test, a DNA-based test. The viral RNA is changed to DNA and it’s amplified and labeled. And you can have results within a few hours. They also took apart the blueprints of the virus in pain-staking detail. They really, really moved with speed with that. And that allowed him to do the PCR testing. So we thought, “Okay, well, we’re not going to get alarmed yet.” We were worried about the population densities of Wuhan. And the potential for it to spread.
But, people were sort of sitting and watching this. And then it exploded. So, that’s sort of the timeline, that period of concern. There should have been a request for assistance early, when you could see that this was going to ramp up. And things like border closures are still debatable measures in the scientific literature, but they certainly proved their value this time. It was just a very slow response, and I’m still not sure I trust their fatality figures and their total number of infections. I think those are artificially low. When this thing was developing, and you saw the different graphs come up and plateau—theirs were a little too perfect.
Mr. Jekielek: There have been some papers saying that if we had known weeks earlier, infection would have been reduced dramatically.
Dr. Hatfill: Well, there’s some data that dates back to 1918 to the great influenza pandemic that arguably killed 100 million people. It came around in three waves. The first wave was infectious, but not a lot of deaths. And then the second wave came through, and there was a significant increase in mortality. And they didn’t know about viruses in 1918. They knew there was something that couldn’t be seen with a microscope. But the concept of the virus really hadn’t taken the forefront in medicine. That took until after World War II, [after] the electronic microscopes was developed, so we could actually see these infectious agents.
When you don’t have a vaccine, and when you don’t have a drug that’s effective at treating it, your only recourse is the thousand-year-old technique of social distancing. Don’t get too close to anyone. And case contact tracing, quarantining the people that were around the original case, and quarantining the people that were around the people that were around them. … And there’s a very, very narrow window where these measures become effective.
Let’s say for one person in a modern-day you may have 70 or more chances to transmit your infection to someone else during a normal working day. Public health authorities have to track down, identify, find, interview, and if there’s a test, test or home quarantine them for a little bit. You can see how this quickly gets out of control. You just simply don’t have the number of health care workers to do this. And you’re forced to lock everybody down. This is what happened. So every day is precious to get countermeasures ready.
This is when the local authorities start taking their final inventory, making sure they have what they need just in case it gets over here. Looking at the projections from the disease experts, looking at the case histories of the patients in China, we knew we would need some ventilators if it got over here. How many? So having the infrastructure in place takes planning. Our major cities have had 15 years to pre-plan for an event like this. They were told by some of the top scientists in the world that this is going to happen. We’re living under population densities that are unnatural. In fact, no other large species of mammal has ever achieved these population densities before. We’re all living in a biological experiment. Public health in the 21st century has to be ranked up there with national defense. This is a strategic issue.
There are very few things that can interrupt a nation from making goods and providing services and national defense to its people other than an infectious disease pandemic. So this has to be treated as part of national defense. We have a president that realized that about a year ago, before this even started. The president realized that we had lost our vaccine manufacturing capability—that businesses that had taken it overseas to China. He had signed legislation to bring not only that capability back to the United States, but to use the latest technologies, cell culture methods, and have the ability to quickly make a new vaccine should a new pathogen appear. And I applaud him for the foresight.
The federal government has been stockpiling partially as a result of biological warfare defense, but dual-use for a pandemic. The government’s been stockpiling items since the early 2000s. It’s a strategic national stockpile, just for events like this. [Stockpiling so] that it could disseminate to the States, and the states could disseminate it to the local authorities. But there’s not a ventilator for every person in the United States. That’s crazy. So it has to be a rehearsal system…have your sites for alternate hospitals, pre-identify buildings of opportunity. You don’t have to use army 10 hospitals. High schools have cafeterias that make very good alternate care centers.
But you have to handle this medical surge. And if you can successfully do that and keep it below the maximum amount your doctors, nurses, and health care system can handle, then you’re free to work on all the other things that go along with a pandemic. And the local authorities have been running since day one. And I’m sorry, I don’t want to be overly critical, but I can’t see where some [localities] have done anything to prepare. And then you ask the federal government to bail you out.
Federal government’s stockpiled. They’re rapidly working as fast as they can towards a vaccine, or rapidly working towards drug therapy. In fact, most of our drug manufacturing is in China. We’re rapidly trying to get that back as a nation, an endogenous capability, at least for our critical drugs. … I’ve never seen things happen this quick in my life, especially with the government. So it’s absolutely phenomenal what’s been going on. People aren’t aware of this. It’s the cities that aren’t prepared. Or they have strange plans or revelations… but the [federal] government can’t do everything for everybody. There are limits.
Mr. Jekielek: The administration has been criticized actually for being too slow to realize the severity. Your thoughts?
Dr. Hatfill: Too slow? I’ve never seen things move so quick in my life. My mouth hangs open out of amazement at how fast the federal government has responded to this. I’m also thrilled how US manufacturing has responded. You know, our companies are coming forward. “What can I do? What can I make? How can I help?” It’s just phenomenal. It brings your American spirit back in a huge fashion.
But this virus is moving very quickly. Modern air travel has ensured modern transportation, not just air. In the old days, [in] 1918, if you wanted to go a long distance, you took a long-distance train, which took a couple days or you took a steam. The aircraft hadn’t been invented. In fact, Charles Lindbergh didn’t make his flight till about 9 years, 12 years later. So travel was very slow and still this influenza A strain in 1918, managed to circle the world within about three months. This virus has done the same thing.
So you have to pre-plan you have to take this seriously. And pre-planning doesn’t mean sitting around a long table with everybody drinking coffee and doing a little paper thing. You have to drive the routes. How long does it take? How many miles and how much gasoline does it take to get from the airfield? To the warehousing and the time? How much does it take to get to this hospital and to that hospital? If these hospitals start to fill up, where are available buildings I can use and turn these into alternate care sites to take the strain off? Because we have normal people, uninfected, going to a hospital every day. A lot of these surgeries had to be postponed. It doesn’t stop the accidents from happening and the necessity for emergency care for just day to day living. So the idea is to try to keep these hospitals functional. While we still handle this tremendous surge of very sick patients. And keep in mind, most of the patients of this disease get better. They live.
It’s just the intensive care patients require a lot of resources and they’re staying on the ventilators for a good length of time So pre-planning for this type of thing is essential. Without pre-planning, you’ve got to get help from outside. And in this case, that means from the federal government. The blame should go to whoever elected the local authorities. That’s where the problem is.
Mr. Jekielek: I think the specific charge being leveled is that the corona-virus, or CCP Virus as we’re calling it, wasn’t taken seriously enough, early enough.
Dr. Hatfill: Oh, you can sit back and armchair quarterback all you want. I watched this thing develop and people were taking it seriously way back then from the time that was still in China. There were preparations underway. Blame the local authorities. You know, you get what you vote for. And if you don’t have a good leader in times like this, well, you voted for him, blame yourself. Good leaders seek out the most timely information possible. They’re proactive, not reactive. You can’t be reactive in an epidemic and expect that you’re going to keep up with it.
Look at it this way. A pandemic affecting the world is really nothing more than a series of little epidemics in local communities. And if the community can handle their own little epidemic then it’s free to handle all the other things, the worker loss, you know, trash collection, making sure food availability, this type of thing. If you can’t handle your medical surge, or make plans to where you can, then everything overloads, people become scared half to death, and even something that’s manageable begins to look like Armageddon. But you have to do the pre-planning and take it seriously. If you don’t, you’re going to be overloaded. And there are doctors I know personally that expect to get infected and maybe die. And they’re going in there every day.
Mr. Jekielek: I’m actually speaking with you from the heart of the pandemic here near Penn Station in New York City where our studios are. This is where the vast majority of the cases are and the vast majority of the deaths in America right now. The question is, how serious is this here? What should we be thinking here in New York City?
Dr. Hatfill: Panic never solved anything. Plus, we’re Americans, we don’t panic. We deal with it. Okay, panic’s not going to do anything. And it’s pretty hard to eat toilet paper. You make some rational plans. Everybody has good ideas. Nothing wrong with trying to make your ideas known. You move ahead, you gather all the resources you can. And you fight this thing. What else can you do? This will pass, by the way, this is not the Omega Man scenario. There are worse things out there with 50% mortality rates in animal models. These are the ones that are still to come. So this is probably our last warning from Mother Nature.
That we need to give emerging infectious disease the same prominence as we do national defense. There needs to be a centralization for not just local planning efforts, but national planning efforts. We need to be able to model these things in real-time. Right now, nobody knows. I think the mayor of New York just found some extra ventilators he didn’t even know he had. That’s not acceptable. There needs to be resource availability. If the government knew how many ventilators, let’s say New Orleans has, and with good real-time reporting on cases and hospital bed availability, these things can be shoved down there overnight. But it needs a little bit of warning. We need to be able to follow this in real-time, and jump ahead, where we think the next severe situation is going to be, and start funneling resources there early. And we lacked such a system here.
There’s a CDC Emergency Operations Center. But we can do better. We have these things called fusion centers that the military use. If you look at 50 years ago, during the Cold War, we had a fusion center called NORAD (North American Aerospace Defense Command). It took all this disparate data. It tracked satellites manually. And then the radar stations were built and DEW line and all these separate assets, constantly 24/7 tracking things, looking for bombers or missiles … [The data] all fuse down to one board where you could see what was happening at any one time. The military is excellent at doing fusion centers.
Well, we need a pandemic fusion center where we’re taking data from people that are there that are on the ground, verifying that this is seriously a problem. And then we have computer programs now the project where the next casualties will occur, using these centralizing our resources so we can get them from point A to point B.
And the US government’s done this with the push backs from the CDC, out of the National Stockpile, but we can do even better. We can bring personnel in with these. We’re calling a lot of our inactive reserves and active reserves up for duty. These are highly trained men and women. And there’s a lot of medics who can monitor ventilators. It’s fine someone sends you 300 ventilators but who you’re going to get to run them? [In hospitals], RNs (registered nurses) and nurse practitioners can watch the ventilator and call you if there’s a problem. And so there’s a bit of a surge there. But you’re dealing with in some cases 700% increase in ventilator demand. So you need extra personnel. … And they have to be very brave people because you’re working on a contaminated environment.
Mr. Jekielek: Well, my hat goes off to all of these people working on the front lines, all the healthcare workers, all the military, everybody involved, it’s just incredible to me. I want to ask, how important is social distancing? There are reports that this disproportionately affects older people. How much should younger people worry about this?
Dr. Hatfill: Well, we’re starting to see an increased number of young people with severe infections. Look, social distancing is vital. I’m sitting here, I’m speaking in front of this microphone. [Let’s say] this whole microphone’s contaminated. And then I touch the microphone and then I rub my eye. I’ve just put it in the mucosa of my eye. The eye is constantly making tears and they drain through the nasolacrimal duct. So even if this virus didn’t attack my eye, it’s going to appear inside my nose and most respiratory viruses like the inside of the nose. So I just self inoculated myself. So not only is it important to stay away from that cloud, as you’re speaking, there’s an invisible cloud around you, just from the air coming out of your lungs. So it’s important to stay away from the cloud.
If you touch a surface, wash your hands before you touch your face, your eyes, or the corner of your mouth. Constantly wipe down surfaces in your work environment. Every hour wipe down your keyboard and computer. Practice social distancing, at least six feet apart. … This virus is killed very quickly by anything that contains a significant percentage of alcohol, rubbing alcohol, grain alcohol, it dissolves the fatty envelope that the virus needs to maintain its structure. … We’ve brought things to as much of a halt as we can. But, the people in cases we’re seeing now were infected probably seven days before, at least. So there’s always a lag.
We saw it in Wuhan. Severe draconian social distancing, locking people in their condos. And it was still a number of days before the thing plateaued and started to drop. So we’re running behind. We’re trying to catch up. This country has done the greatest wartime mobilization since World War II. And it’s amazing to watch the patriotism of some of these really well-known companies. It’s just amazing.
Mr. Jekielek: Do you think masks are useful? There’s a lot of discussion and debate about masks right now.
Dr. Hatfill: I can give you the basic lowdown on it. A basic surgical mask—the ones you tie behind your ears—they won’t really protect you. The particles that are going to get through the mask are in a 1-5 micron particle size range. There are a couple good videos on the internet where they’ve had somebody sneeze or cough and they use the reflected light so you can follow all the particles. You cough, most of these particles are large and they fall out of the air fairly quickly within a six foot distance. But there’s a smaller number of 1-5 micron sized particles. These behave essentially as a gas, they stay suspended in the air, the thermal currents off the floor, or the heat. They waft around. Air currents move them around. If you open the doors and windows, they tend to go out.
So that mask will not stop you from inhaling. That will go straight through the surgical mask. You have what we call N 95 masks and N 100 masks. These have a higher filtration capacity. These are the ones that stick out from your face. And they’re capable of filtering 95% of anything out there in that particle size range. Remember you have to have a minimal infective dose to become infected. So this filters out the bulk of that, but it leaves your eyes open. So, is this a factor in transmission now? We don’t know. But it is with other respiratory viruses, including influenza.
Where the regular surgical mask will help is if you’re one of those people that are infected, but it’s still very early, you haven’t had a temperature and you don’t feel bad at all. And you’re going out to the supermarket, but you may still be secreting a bit of live virus into the environment. The surgical mask will help that. It stops you from sending those large particles out into the environment should you cough. Secondly, it reminds you don’t touch your face. Don’t rub your eyes. So yes, there is a role for them. Yeah. But as a protective device for yourself, it can’t be guaranteed. It wasn’t in 1918. And it’s not now. Would you cut your risks down? Yes. Instead of 100 machine guns shooting at you, you only have one. Does that make sense?
Mr. Jekielek: Sure. Essentially, it also will provide a social service, so to speak, to help prevent transmission.
Dr. Hatfill: Yes. … Again, it’s relative. If you’re outdoors, and there’s wind, …you’re not crammed all together on a subway or something, your chances of getting infected are much diminished. There’s ultraviolet light during the day, which rapidly kills the virus. The problem is indoors and large groups of people.
So I think they had spring break in Florida this year. And that probably wasn’t a good idea. We’ll see what comes out of that. But you had a large number of people crowded together and they disseminated it all over the East Coast or farther. So, it’s very, very important to avoid large groups. One, from the risk to yourself; and two, if you are infected or have a subclinical infection. We’re not really sure for how long before you have symptoms that you would be infectious to someone else. It looks like maybe a day or so at least. So this is all we have. It’s essential to keep the total figures down to flatten the curve.
It’s essential to keep it to what our local health authorities can handle. Now, when you flatten the curve, you don’t have this huge surge, but you have smaller curves. And it actually goes on for a few months longer rather than getting it over and done with at once. … So moderate numbers of severely medically impaired people can be handled. Overwhelming numbers can’t. So, the idea is to keep it to the level that the local community can handle. You have to plan for it.
Mr. Jekielek: Based on the response that we’re seeing in these large centers and across America now, how long do you expect this to last? And also, you know, are we actually going to flatten the curve?
Dr. Hatfill: The curve will flatten itself, eventually. I don’t see a plateau yet on the general data that’s out there. It looks like we’re still increasing in cases. And some of our 120 largest cities in the nation are starting to have more and more problems. If we had had a couple weeks’ warning from China…that would have given us a couple more weeks. I don’t have a crystal ball.
These things will burn through a community until there’s a certain level of what we call herd immunity. People that have either had the disease and have protective antibodies, or people that have had a very low exposure, didn’t really catch the disease, or had a mild case and have protective antibodies. And this is sort of nature’s way. If you go to the Congo and into some of the African populations and just draw blood from them, you’ll find a surprising percentage of villagers have antibodies to the Ebola virus. But the village has never had a case of Ebola. Well, this is a herd immunity type thing. There’s Ebola in the area and they’d had a subclinical exposure. They didn’t develop over disease. And you see it with all kinds of viruses and all types of different animal populations. So no virus ever killed everyone. The science fiction movies are wrong.
Mr. Jekielek: Recently, the Vice President announced that doctors will be able to prescribe chloroquine or hydroxychloroquine off-label as a treatment for coronavirus symptoms. What are your thoughts?
Dr. Hatfill: I’ve looked at the tissue culture studies. … Chloroquine doesn’t really work on the virus. It works on you. It does make you more resistant to infection. A virus can’t enter a cell and it can’t replicate on its own. It has to enter a living cell and it becomes the perfect parasite. It hijacks the cells’ machinery. All the cell does now is make new viruses until it dies. Well, you need a key to get in. The key for coronavirus is a protein called Ace 2. The virus has little sugar molecules attached to little fingers, which facilitate it getting into the cells. What chloroquine does is it trims off the fingers, making it less effective getting in. It also makes the inside of the vesicle more acidic, dissolving the virus and fatty coating.
…And chloroquine has been around since the ’60s. I was in Africa for years. I remember taking it… The problem is it can have some side effects. If you have irregular heartbeats, you need to be cleared by your doctor. You don’t want to be buying this stuff off the streets. It’s a drug used very commonly for autoimmune diseases like lupus, rheumatoid arthritis, or scleroderma. So it’s available. Some of the hospitals have now brought out protocols for this. Mount Sinai have brought out a protocol. We give you a kind of a double dose for two days to get your blood levels up. And then something to maintain that therapeutic blood level. And we get this going in your lungs and kidneys as coronavirus likes to attack your kidneys as well. There’s a lot of these Ace 2 receptors in your kidneys.
It has a useful place until we can get some of the other drugs that are being tested out there and into a tablet form. There’s a couple of things out there that are being looked at. Remdesivir. Unfortunately, we have to give that by an IV but if that can be compounded into a tablet form. I looked at the monkey data for this, absolutely astounding. It appeared to be that effective.
So, chloroquine has a place. Should everybody be taking it prophylactically? No. Should everyone be taken without a doctor’s prescription? No, not at all. You’re going to hurt yourself. I think somebody killed themselves the other day using the tablets to sterilize the fish tank. That is the last thing anyone wants. But should it be made available that a doctor can prescribe it if he thinks it’s warranted? … They should have that choice. I think there was some governor somewhere that said, “Oh, no, we’re gonna outlaw it.” Yeah, well, he doesn’t have that authority. … It’s the physicians that take responsibility. Both moral and legal. Not the governor of a state. How ridiculous.
Some doctors don’t believe in it. Some hospitals have put it in their protocol for use for COVID-19. It’s a common drug. It’s proved over the years to be a safe drug, [though it] does have side effects. If you use it for a long time, it can permanently damage your eyes. … So you can see why it has to be prescribed by a physician.
Mr. Jekielek: Looking at the numbers between Italy, Spain, the US and Germany, it looks like compared to Italy and Spain, the US death rate is a lot lower, but the German death rate is still a lot lower than that of the US. What do you make of these numbers?
Dr. Hatfill: The death rates are not something you want to rely on because you’re taking a percentage of the total number of cases you have in a population. Well, that’s unknown. It’s unknown unless you test every person in the country. You don’t know how many people are infected. So how do you get a percentage out of that? You’re guessing. All these things are guessing.
Mr. Jekielek: What is your advice here to Americans and people around the world?
Dr. Hatfill: We will get through this. We will find a way. It is going to be a bit messy in some areas that haven’t done preparation. … This is probably our last warning before the real thing comes. And that will most probably be a respiratory virus with a 40% or higher mortality. So, we’re learning what’s working, what doesn’t work. We got a lot of work to do and in the future, to get ready for this. It will come. It will. So we need to be ready for it. It is a question of national defense.
Mr. Jekielek: So essentially, you’re saying to take this opportunity to get everything in place both personally and at an institution level at the government level. For whatever else is out there.
Dr. Hatfill: We need to be ready for the other one. And this starts with getting an effective global surveillance system in place. You know, most of the disease outbreaks, you can pick up just through the country’s local media. These can be data mined, automatically, searching the world’s social media for indications of outbreaks of infectious disease.
We’ve had something called ProMed up and running for 20 years now where doctors will report unusual disease outbreaks. The WHO runs on a media data binding system invented by the Canadians. It picked up the 2003 SARS thing several weeks before the Chinese announced it. Well, why not get really good at global surveillance and actually putting boots on the ground at the suspected outbreaks to physically see what’s going on? And linking that into a response system? … Taking the pulse of the world hour by hour for emerging infectious diseases. And responding within hours rather than weeks. This is doable with our technology. Let’s start leveraging this.
Mr. Jekielek: Well, this is a testament to the importance of free and open information. And yet there are countries where that just simply isn’t available because it’s politicized, like in China.
Dr. Hatfill: Yes, the other factor is war zones. You know, Democratic Republic of the Congo is a good example of Ebola. I think they’ve finally got it under control there. But we couldn’t get people in there to determine what was actually happening on the ground. So you need to have some teams able to do things like that, to go into a conflict area and see if there’s an epidemic going, to take samples and learn early on what it is. We do this for nuclear weapons. You have international inspection teams. It’s time for the WHO to do something and get some international disease inspection teams… these international teams should be allowed to immediately go in and confirm. Every week is important with this type of stuff. So, until we have something like that, we have to assume things like this will happen again.
Mr. Jekielek: Well Dr. Hatfill, it’s such a pleasure to speak with you. Thanks for taking the time.
Dr. Hatfill: It’s been my pleasure. Thank you.