An Epidemiologist on Why We’re All ‘Sitting Ducks’ For the Next Pandemic


Dr. Sandro Galea warns that the U.S. must address the underlying issues that led to the spread of Covid-19

With new cases on the rise, states are grappling with how to safely and effectively reopen the economy, but this has proven to be no easy task. Many of the first states to loosen restrictions, including Texas and Florida, have rolled back their reopening plans to deal with the rise of hospitalizations. On top of this public health crisis, there’s also the economic fallout that could cost the world economy $82 trillion over the next five years — and a reckoning over racial injustice, sparked by the killing of George Floyd in police custody.

Dr. Sandro Galea, an epidemiologist and dean of Boston University’s School of Public Health, warns that the U.S. must deal with all three traumas head-on, or risk facing another pandemic. This includes everything from addressing racial disparities in health care to investing in public health infrastructure. The disease expert, co-author of PAINED Uncomfortable Conversations About the Public’s Health, also settles a question that has come up a lot as more and more Americans plan their summers — is it safer to travel by airplane or car?

Wake-Up Call: What are the best ways to prevent an infection?

Dr. Sandro Galea: Fundamentally being away from people inside — distancing from people when you’re inside. That means staying physically away and protecting yourself from people coughing on you. Like the infection has spread to person to person, so if you keep your distance from other people you’re less likely to get an infection. And principally inside, the evidence is that outside transmission is actually quite unusual.

How effective are face masks?

Face masks protect mostly other people from you, so it is a bit of a social good to wearing face masks. By us all wearing face masks, we are reducing the likelihood of transmitting it to each other.

Are certain vitamins — like D3 or zinc supplements —effective in lowering the risk and help fight Covid -19?

No evidence. In general, being healthy is good for you. It means that you are less likely to get Covid and be sick from Covid but there’s no evidence that certain vitamins make a difference.

What do you make of these coronavirus surges in states like California and Texas? Do you think it will take another complete shutdown to get the number of cases under control?

I don’t know if there’s going to have to be another complete shutdown. I really don’t. I think that as long as we responsible about how we distance; as long as we are responsible around reducing physical contact, I think you can reopen with caution around people being in the same place at the same time inside.

When do you see a return to normal?

What’s normal? I think it’s 2021.

Do you think it will vary? Obviously New York was really hit bad. Now it’s one of the safer places to be. Do you think it’s going to be a region to region thing?

I do. I wouldn’t be surprised if it varies from region to region, but I think in terms of us being normal, meaning that there’s unfettered travel between New York and Florida; New York and California; Boston, Massachusetts, and California —I think that’s going to take until 2021.

What kinds of questions are your own loved ones asking these days?

There’s anxiety around how these things are transmitted and anxiety around what we should be doing and shouldn’t be doing.

The fact that the risk of transmission is harder when you’re outside. I think that should give people a sense that all hope is not lost, that we can reopen judiciously.

The New York Times recently surveyed more than 500 epidemiologists to see when normal activities like getting a haircut or giving a hug will be safe again. What is your opinion on stories where experts rank activities in terms of risk?

I’m not sure people are understanding this notion that there’s this mistake in thinking that we cannot tolerate any risk. It’s not true. We tolerate risk all the time.

We draw lines about what risks we’re willing to accept and risks we’re not willing to accept all the time. So in some respects, there’s nothing different about this. We are drawing a line. We’re saying these are risks we’re willing to take; these are not willing to take. I would like people to understand that you don’t want to be foolish about it. Now that we understand better the dynamics of disease transmission, we should be willing to accept the fact that there is some risk, but we can mitigate that risk by minimizing people being close to one another.

This is a question I have been asking myself — which is safer in terms of risk, traveling by car or plane?

Well probably by car, by yourself is safer from point of view of getting Covid. It’s not safe from a point of view of the risk of dying in a car, which we know as much riskier than it is being in a plane. So you are balancing risks now that being in a plane poses: Is it an acceptable risk? Is a tolerable risk? Probably. I wouldn’t do it just because. But if there’s compelling reasons to travel, I think it’s okay to travel and to wear a mask and to wash your hands.

You wrote your book PAINED before the pandemic broke out. What are some difficult subjects you tackled in the book that are playing out right now, particularly concerning health disparities?

These disparities are exactly what has been underlying, what has happened with Covid. This is what has brought about the massive negative consequences that is Covid. These disparities have been what has characterized the greater risk of Covid among minority populations, people of color, low-income people. They’re also what has created our incapacity to deal with Covid — because it’s not just them, it’s everybody. I’m using the word “them” intentionally — it is everybody.

If some of us are at greater risk of Covid, all of us are at greater risk of Covid. And I hope that what this moment has shown us is that an us-versus-them mentality doesn’t serve us well at all.

What are some silver linings from this pandemic — not only from a health standpoint but a racial and policy standpoint?

The moment we’re in is three different traumas in one, right? One is the pandemic, the other is the economic shock. And another one is a resurfacing —or surfacing — of deeply-seated racial injustices that have been with us for centuries. So all three are important, and I think it would be a mistake for us to ignore any of them.

These issues of systemic racism are not new — people have been writing about these for decades and centuries. So it should be a moment where we actually do have a reckoning and say: Okay, what are the issues, and what should we do to address them? Unless we address that and unless we address the forces that have allowed the pandemic to spread — the lack of investment in public health infrastructure, the underlying poor health of the country — we are sitting ducks for the next pandemic.

This interview has been edited and condensed.

This originally appeared on Medium.