The push to relax social distancing and containment efforts is getting stronger in some parts of the country. People in states like Pennsylvania and Tennessee have begun protesting the limitations even as the number of deaths rises sharply. WGBH Morning Edition host Joe Mathieu spoke with Harvard School of Public Health Professor and epidemiologist Dr. Michael Mina about what we know about the spread of the virus so far, and what loosening restrictions now could mean for the future. The transcript below has been edited for clarity.
Joe Mathieu: Are you worried that letting our guard down now could lead to a second surge?
Dr. Micheal Mina: Absolutely. I think this is a major concern amongst epidemiologists and many policy makers. There is an anticipated anxiety and anxiousness, I think, to let our guard down a bit so that we can get people back to work. But this has to be dealt with in a very organized and carefully thought out fashion so that we don't find ourselves with large outbreaks happening again.
Mathieu: How much of an impact could the actions of Southern states that I mentioned have here in New England?
Mina: Well, I think we would not be likely to see major impacts coming from the Southern states up here if we are keeping social distancing measures — for example, in Massachusetts — similar to what they are at the moment. But if the whole country gets to let their guard down and start to go back to work, then absolutely the virus can start transmitting nationally pretty quickly.
Mathieu: We heard the director of the CDC attempt to clarify his remarks earlier this week about a potential second surge that he was quoted to say could be worse. He clarified that to say that it was because it might coincide with the flu season coming up this winter. Either way, should people be prepared for a second surge no matter what?
Mina: I do think so, yes. We don't know enough about this virus to know if that surge will potentially happen in the summer, fall or at all. But certainly I think that we have to be very aware that this is something that could come back really the moment we start to open back up, and that could very well be in the fall. So we have to have surveillance programs set up before then, and probably before opening up even for the summer, to really ensure that we can capture any outbreaks before they get out of hand.
Mathieu: You mentioned surveillance. Contact tracing is something that we're all learning about here as our state pursues this. It's a labor intensive process. Does it give our state a leg up in handling this?
Mina: It is a very labor intensive process, you're right. It can give our state a leg up. In particular, once we get cases down to a more manageable number, then contact tracing becomes a crucial aspect of epidemic detection and control. But during a time when we have wide-scale transmission and transmission is common, then sometimes contact tracing can actually just be too unrealistic to really be able to keep up with the virus. But putting the plans in place now will be beneficial.
Mathieu: I asked Mayor Walsh this week about whether he should mandate, as opposed to recommend, people wear masks because I still see a lot of people going into stores, for instance, without them, at least here in the city. He said everything is on the table. Is that something you think should be considered at this point?
Mina: I think masks can help. They are harmless to wear and they can potentially stop transmission from somebody in particular who might not know that they are infected. So I do think that that is an appropriate thing to have on the table. Whether it becomes an actual policy becomes a little bit more difficult because then you have to enforce that policy, and that is a tricky thing to do. What do you do to somebody who decides not to wear a mask? So I think as much as we can do, if the public goes along with it willingly without strict policy in place, I think is the more appropriate way to go. But sometimes policy does become necessary.
Mathieu: Have you started, as an epidemiologist, wearing one everywhere you go?
Mina: I don't leave my house too much these days — too much work to do. But yes, I do.
Mathieu: Doctor, we're in the middle of the surge here in Massachusetts. I wonder what we should be looking for as we get into next week for a sense of whether the wave is cresting.
Mina: We should monitor what the case numbers are looking like as we've all been watching these graphs to see cases going up and hopefully coming back down. But more than just the case numbers in terms of the counts on web sites, for example, that people might be able to see, we really want to keep an eye on what's happening in the hospitals, because that is in many ways a better metric of really what's happening with the total number of cases. So if we start to see that the hospitals start to be able to have a little bit less pressure on them in terms of bed space that becomes available, that is something we should really continue to look out for as a metric that we're succeeding in battling this virus.
Mathieu: Should we be impressed that we're not already at capacity — that we haven't had a steeper rise in cases?
Mina: I think that [in] Boston, I can take a look around and I see that people have social distanced, and I think people have across the whole state. We should be proud to have done a good job as a community to really get social distancing in order. That did help reduce the number of cases that we were going to see in the hospital.