"The Second Wave Is Going To Be Much, Much Worse" (w/ Dr. Dena Grayson and Pedro da Costa)
PEDRO DA COSTA: Welcome to Real Vision to the interview. I'm Pedro DaCosta. I'm really excited to be joined today by Dr. Dena Grayson. I spend my life interviewing financial and economic experts. But they all tell me we need to listen to the doctors now so. I'm really pleased to have her. She's not only a medical doctor, she's also a biochemist. And she's, importantly for our purposes today, an expert in viral pandemic threats of which we are all living a nightmarish one today. So thank you so much for joining me, Dr. Grayson. DR DENA GRAYSON: Well, thanks so much for having me, Pedro. PEDRO DA COSTA: First of all, how are you doing? What are things like in Florida, as your governor toys with reopening? And how is your family doing? DR DENA GRAYSON: Well, thanks for asking. We've got all 5 kids in the house. So [LAUGHS] times where the lockdown life is hectic, as I think most Americans are experiencing. And both my husband and I work from home now. And so it makes for tight quarters. But luckily everyone's healthy and doing well. I'm a native Floridian. So I do love my state. But there is a reason there's something called #Florida. And I think that Governor DeSantis, unfortunately, is embodying that a bit. So thus far where we live in central Florida, in the Orlando area, there have been a number of cases. And there's good local leadership that is very unlikely to reopen, as the governor, of course, has announced that the state will reopen. Now, having said that, I will say that Governor DeSantis did recognize that there is still an ongoing hot zone in South Florida, namely in the Miami Broward County Palm Beach areas with a number of cases still going on. And I do think that does underscore that when we think about these lockdowns, when we think about these surges of waves of infection, a wave isn't static. It doesn't just stay in 1 place. It moves. And not every place is the same. So there are some areas of the country potentially where you could think about starting to relax some of the lockdowns. But, again, you've really got to think about testing, testing, testing. And we all know where are those tests? We're still just ridiculously short on testing. PEDRO DA COSTA: So if we could take a step back, our viewers. As you know, are primarily financially focused. And I just wondered if what if you could tell us a little bit about your background and the research that you've done. And why you've become such a hot commodity. And it was so hard to get you on the show. DR DENA GRAYSON: [LAUGHS] Well, thank you for that, Pedro. And again, I'm really excited to be here, my friend. And so my background-- I have 2 doctorates. I'm a medical doctor. I have a PhD in biochemistry. And really relevant to the ongoing coronavirus pandemic, I spent nearly a decade developing medicines to treat these viral pandemic threat-- what we call broad spectrum antivirals. So when you think about antibiotics for bacteria, we have these antibiotics that can hit and kill a lot of different bugs. But no such thing, at least, to date has existed for viruses where you could have 1 drug that could treat many bugs. So starting actually a decade ago, I started working in the biotech world to develop new medicines, actually set up and led a collaboration-- multiple collaborations with the Department of Defense and the National Institutes of Health most relevantly on a drug called galidesivir which is a drug that's being developed by BioCryst. Now, galidesivir was really the first in that same class of drugs as remdesivir that's everyone's hearing about, as well as another-- PEDRO DA COSTA: That boost in the stock market recently, right? DR DENA GRAYSON: [LAUGHS] Yeah. Boy, which we'll talk a bit about that, I'm sure, about the relative utility of these drugs. And there's another drug called favipiravir, which is approved in Japan for the treatment of influenza. So essentially how these drugs work is they block the ability of RNA viruses to make RNA copies, RNA to RNA-- something that humans can't do. So when you're developing a medicine that's really a great drug target, because we're not going to hit anything in the humans. So there's sort of a safety window, if you will. So the nice thing about these drugs, these antivirals is there is that idea that you could have that 1 drug that could hit many bugs that have that same RNA-to-RNA copying. And that appears to be the case for remdesivir. Galidesivir, the drug that I mentioned, is now in clinical testing for the deadly coronavirus actually in Brazil. And then favipiravir has also been studied. At least some data has been released from China. So I think that all 3 of these drugs-- and certainly remdesivir everyone's talking about-- there are some early data that certainly that look promising. But, I mean, these drugs are not going to be the be all, end all. This does not mean we can just relax. Everything is going to be Kool and the Gang. And we can go back to normal. PEDRO DA COSTA: So before I even ask you about the vaccine potential in stage, I want to ask you about where you think we are in this pandemic in terms of the global cycle-- how far it might go-- the potential for a second wave. Are we halfway there, a tenth of the way there? Are we past the worst? Where are we? DR DENA GRAYSON: Well, we're past the beginning of the beginning. I knew in December that a pandemic was coming and then, at least, certainly based on the information I was hearing from China. But you have to take that not with the grain of salt, but like a bucket of salt. But by mid January it was very, very clear that this coronavirus checked every box for a pandemic threat. So why? It's extremely contagious. It can cause serious illness or death in otherwise healthy people as we're seeing. I mean, we're seeing people in their 30s dying of strokes, of heart attacks. It's a very bizarre virus. And then, lastly, of course, there really are certainly no vaccines. And until yesterday, there were no proven treatments for this deadly virus. So that's why it's so dangerous. And as far as where we are, we haven't even ended the first wave. The number of new cases in the United States has plateaued. But unlike other countries if you look at Western Europe-- or, again, I don't want to look at China so much because, really, who knows what the real numbers are. But other countries, as well, in general, what we've seen is that there's this peak. But then the number of new cases starts to decline. And we're really not seeing that yet here in the United States. So will there be another wave? I would at this point say there's going to be another surge on top of what is already existing, which is 20,000-plus new cases each day. Now, my expectation-- and I've been saying this for many months since January, Pedro-- is that I do believe that this coronavirus is likely to come in waves. I predicted that the Southern Hemisphere would become a new hot zone when their flu season starts. And guess what's happening? Of course, we're seeing Brazil and Ecuador just light up, unfortunately. And that's because these coronaviruses, like influenza, these respiratory viruses, they tend to spread a lot more easily when-- so as we are here and exiting our winter, which is our flu season, the conditions are less favorable for this virus to spread. Now, that doesn't mean it doesn't spread. As we're seeing, we're still seeing new cases. It just means it's a little more difficult for this virus to spread. But this virus is extremely, extremely contagious. So what I think will happen as we head into fall and especially as we're loosening these lockdowns, which I think we're going to see even over the summer some miniwaves, if you will, in places that start lightening up on these lockdowns-- but I do think that come the fall, this virus is going to boomerang back from the Southern Hemisphere. And I think the second wave is going to be much, much worse-- very similar to what we saw with the 1918 great pandemic with the influenza pandemic where 80% of the people who died in the United States during that pandemic died in the second wave of infections. And unfortunately, I think that's what we're looking at, unless we have a vaccine, unless we continue these really rigorous lockdowns. I mean, we don't have a lot to protect ourselves. PEDRO DA COSTA: But of personal history, it turns out we found out during this process that my great grandfather died in his 20s of the Spanish so-called Spanish flu all the way down in Rio de Janeiro in 1918. So-- DR DENA GRAYSON: Wow. PEDRO DA COSTA: That's how global and everywhere it was. So to your point, how did these countries' health systems in places like Brazil and Ecuador, how did they hold up? If we're already rickety up here, what happens in places and also in African nations that are starting to get hit as well? DR DENA GRAYSON: Well, I think starting with Africa, that's been 1 of my great fears. I mean, there literally is in many places, forget health care for a moment. We have people that are living in places where they cannot even wash their hands, which we know. Look, soap and water-- soap is this virus's kryptonite. It's 1 of our best defenses. So that's why when people think, oh, gosh, just wash your hands. OK, roll my eyes. No, really, washing your hands is, it will destroy this virus on your hands, so really, really critical. So then on top of that, we have places that have extreme poverty, no access to health care-- not even little access to health care-- no health care, no testing. So what really is happening in sub-Saharan Africa? I don't think we really know. I mean, until unfortunately. And tragically we start seeing dead bodies lining the streets. I don't think we are going to know. And certainly what we're seeing in South America is harrowing. I mean, Ecuador only has hundreds of reported deaths. But we know that the real death toll is much, much higher because of the people being buried. Same with Brazil. I mean, Brazil is a disaster. And unfortunately, as you know, that Brazilian president just recently after record number of deaths-- well over 450 deaths in a single day-- he's just like, well, so what. What do you want me to do about it? Unfortunately he's been a denier. He's been a pandemic denier. And now the Brazilian people are paying. And gosh, you know the system in Brazil. The health care infrastructure, it was rickety at best and certainly in parts of the country-- PEDRO DA COSTA: Not be distant in places. DR DENA GRAYSON: Yeah, and especially in these cities-- the city right near the Amazon where the system already was overwhelmed. And now, you have people that are just if you need a ventilator, and there's no ventilator, you could die. And so it's harrowing. So as bad as this has been in the United States-- and this virus is exposing every single weakness and flaw in our health care system in every single country. So you see certain countries, like Germany, which has an excellent health care system, they've been able to manage this virus. And actually their mortality rate has been relatively low. Even within Europe, compare that to the UK-- not as good of a health care system, right? Now we look at the United States. Who are the people really dying in the United States? Well, it's people of color-- people that are lower socioeconomic status that don't have that same access to health care and also live in more crowded areas, have to take public transit, greater risk to get the virus. We're seeing the same thing happen now, unfortunately, in other countries. PEDRO DA COSTA: And presumably, a lot of lower income Americans have to continue to work their jobs. They're not able to work from home and maybe lack access to adequate health care. DR DENA GRAYSON: You nailed it. That's exactly right. And if you look in the areas of this country-- for example, in New York, there was a study that was done looking at the subway line zip codes where the highest rate of infection were occurring in the city, as well as in the outer boroughs all out to Long Island. And you could actually see a heat map along the subway line. So the people that are taking the subway-- they're getting on these crowded cars. I mean, that is a literal dream for a cauldron for this virus to spread-- a crowded subway car. You cannot dream up a more nightmarish scenario. I mean, everyone knows you go to subway car. This air is stale. That's right. You're breathing other people's air. That means you're also breathing their germs. PEDRO DA COSTA: How would you rate the American response? How much of this was avoidable? We can talk a little bit about your political background. You do come from a political place. You've run for office. And so I'd love to talk about your politics. But before we get to that, how much of what we're suffering is because of a deficient response as opposed to just what was naturally going to happen, especially given that other countries are suffering some of the same patterns, including places like Italy and Spain that maybe have better health systems? DR DENA GRAYSON: Well, I give the administration a grade of an F. They have handled this extremely poorly. I would look at a country like Australia, New Zealand, OK. They have done a fantastic job of really preparing for this virus. Now, they did have a slight advantage of being in the Southern hemisphere. So they're just entering their flu season. But they have been very aggressive. And if you look at the governments in Australia-- right wing government versus New Zealand left wing government-- but, yet, they're following the scientists. What we had here-- and, again, I warned of this. Experts like me were screaming from the rooftops for testing, including Trump's own former FDA commissioner, Scott Gottlieb. He and I are on opposite ends of the political spectrum. He wrote an editorial in The Wall Street Journal in late January screaming for testing. And I was cheering from the rooftops. I mean, he and I follow each other on Twitter. We are-- PEDRO DA COSTA: He's been pretty amazing on this. I've watched him on CNBC and other places. I mean, he's been on point, yeah. DR DENA GRAYSON: He's generally been on point, although he was very opposed to lockdowns. I will say that. I wrote an op-ed in The Boston Globe in early March calling for widespread massive lockdowns in the United States. And had we locked down when I called for it, 90%-- 90% of the deaths could have been prevented. That is tens of thousands of American lives. So what happened? Is Mr. Trump the only person to blame? No, but the buck stops with him. He was a denier. He repeatedly lied to the American people. I am promising you, this is not politics. And I'll come back to that because I've criticized a very prominent person on the left as well. This is about public health. I mean, I am a physician, scientist, expert in viral pandemic threats, first and foremost. And I'm going to follow the evidence. And it was very, very clear that this virus was spreading like wildfire across our country completely undetected. I mean, once you see that first case, that means there's hundreds if not thousands of cases, because, as we know, many people are asymptomatic-- up to 60%. Then you have to get sick enough to actually go to the hospital. Well, I mean, if you get the flu, do you go to the hospital? No. Most people have a relatively self-contained illness. They stay at home. Then the hospital has to recognize, this isn't like flu. Then there has to be a test available. So you think about all those steps. And then we finally had that first case identified in Washington state. How many hundreds if not thousands of people were infected? We that's the case in New York. First case identified-- experts think that there were probably 10,000 people infected in the state of New York. So that's the problem. We had denial, denial, denial. Oh, there's only 15 cases. Like a miracle, it's soon going to be 0, right? No. We're now over a million cases. And the dead bodies are piling up. And we know that the real death toll is much higher, likely double what was being reported. So, I mean, we had an opportunity to act. These viruses-- think of like a snowball going downhill. And the later you act, you are dead, dead, dead. This virus is winning. Now, these lockdowns have helped. They're a very crude tool. And no one wants to lockdown. I don't want to lockdown. My kids don't want to lock down. No one wants to. And the problem, though, is, Pedro, is the later you act, the less effective it is. And actually the more radical and aggressive you have to be in these lockdowns, and the longer they have to last. And we're seeing that now. PEDRO DA COSTA: So where are we now in that balance in terms of the economic toll? We're watching jobless claims just surge. We're going to have what is likely to be, not just a recession, and, perhaps, a depression on our hands. Is there a trade-off between economic activity and public health? Or do people really have to feel safe about their ability to go out without extreme risk before the economy can take off again? DR DENA GRAYSON: Well, I think we should have the billionaires go out first. I mean, they're the ones screaming to reopen, right? But are they putting their lives on the line? Are they going to be that restaurant worker? Are they going to be those bartenders, baristas, and food servers? Right, those are the people that are on the front lines. PEDRO DA COSTA: Well, Mike Pence was out there without a mask in the middle of a hospital. Maybe that's a faith-based approach. DR DENA GRAYSON: [LAUGHS] Well, I think 1 misnomer about these masks-- the mask really protect others from you. Just putting a little mask on probably is not protecting you very much. But it's just decreasing the amount of germs that you're spewing out to the others. So the fact that he was going into a hospital without wearing a mask. He's like, well, I had a coronavirus test. Well, when was that test, right? When was that test? Was it 3 days ago? You can be infected now. So totally irresponsible. And where are we now? We're in a place still, Pedro. And, again, this goes back to failure of the Trump administration. We don't have testing. We don't have enough testing to test the people who are suspected of having coronavirus who are sick. I mean, day after day after day, we hear credible reports. This teacher that just died in New York, right? She begged for testing. 30 years old. She's dead. She couldn't get a test, and she died. She died. We're seeing that over and over and over again. So when I hear this nonsense-- anybody who wants a test can get a test-- well, maybe the billionaires can get a test. Well, maybe an NBA player can get a test. Maybe a tiger at a zoo can get a test. But my friend's mom can't get a test. A teacher can't get a test. And, again, we want to reopen. I think there's this assumption that people are going to say, yay, run out in the streets and run out to the clubs. There will be some people that will do that. But people will die because of this. So I don't think that people really understand that we are now looking at a new normal that is going to exist for, not and just until a vaccine is quote, unquote, "available," but until we've achieved that herd immunity. And in order to open up more, we could do it if, number 1, we get new infections. The Chinese would say you have to have 0 infections for a month before you reopen. And then you have to test, test, test, test, test. And you got to test every day. You've got to test every frontline worker. In China, you want to go in onto a bus-- you've got a fever-- off you go to fever clinic. OK, you want to go into a mall, you're going to get tested. They're not going to let you go anywhere. And that, I mean, not to mention the apps and the phone and intrusion to personal privacy, we're just nowhere there. And the CDC-- they utterly failed. Now, this is under Trump. So it's not just his fault. But they squandered 6, 7 weeks where WHO has test kits. Why didn't we get those? PEDRO DA COSTA: Can I ask you about the doctors around Donald Trump, because I have mixed feelings about Dr. Fauci and Dr. Birx, as they stand there legitimizing some of his pronouncements just by their appearance. What do you make of their role in toeing that line? DR DENA GRAYSON: Dr. Fauci and Dr. Birx I think are 2 different characters, right? So I think Dr. Fauci-- look, the guy has been around, not forever, but seemingly forever. He's survived multiple administrations on the left, on the right. I think our country does need him. He truly is a world-class expert in virology and in viral pandemics. I think that he I think has done much less of this legitimizing. I understand what you're saying of him standing there. But you watch his facial expressions. You can see him just visibly wince. And then when he's asked the question, he will-- PEDRO DA COSTA: He walks it back, yeah. DR DENA GRAYSON: He will say no, this is actually not true. And he'll say it in front of Trump which is really important. Birx, on the other hand, very different. I find her quite the Trump apologist. I will say, though, that whole video when Trump was espousing the use of disinfectants to cleanse the lungs-- OK, now, we've had people overdose on disinfectants. Just what world are we living in, Pedro? I mean, really. And you saw that tweet out, that video of her. And I said, this is what Stockholm syndrome looks like. I mean, it looked like a hostage video. It was stunning. And I'm watching her face. And I'm thinking, her facial expressions are exactly what I'm feeling. I'm an emoji girl. You know that. And I'm kind of by for a reason, this is how I am. I'm very emotive. And I'm watching that just going, he said what? Oh, my god. Like, ah. And you could see her just sitting there like-- and then she starts looking down, like, oh, my god, oh, my god, oh, my god. But, yet, then she will go out on these shows and said, well, he didn't really mean that. Yeah, he did. Yeah, he did. So they're very, very different people. And I don't know Dr. Birx personally. I don't know what's going through her head. And so I can't comment on her motives. But certainly Dr. Fauci I think is somebody that we really need. And that's why you see the right wing with these hashtags, Fire Fauci. There's a reason, because they know he's speaking truth. And he's speaking truth right in front of Trump. And he's trying to do in a very delicate way that's science-based. So overall, I think he's doing a good job. And we need him. Has he made some mistakes? Yes, but I think that people have to understand when somebody says to an expert like Dr. Fauci, is this really a threat? He said not right now. But people say, oh, he said it's not a threat. No, what he's saying is not right now today when we weren't seeing a lot of cases. But somebody like me reads that, and it's just like attorneys speak, right? Like, oh, I know exactly what he's saying. He's walking that fine line. But tomorrow it's going to be a problem, right? That's really what he was saying. But-- PEDRO DA COSTA: I'm sure Trump's not very happy to see Brad Pitt playing Dr. Fauci on SNL. That's a whole nother-- I wanted to ask you about the medical path that you see forward, because you talked about herd immunity. And so we have different elements. We have the testing. We have the potential treatments. And then we have the vaccine. So I want you to walk me through how this works, because I have so many questions. Like, with the testing, the point that you made about constant testing-- people even talked about a paradox where like, if a certain amount of time has elapsed, then you really have to test again. And then you can never test enough. And then second on the vaccine, right? I wanted to ask you, I can get a flu vaccine and feel good about it. But if I get the flu, I'll probably still be OK. Even if there is a coronavirus vaccine, if there's a small chance that I might get this nasty thing, I probably still won't want to go out. So how is that going to play out? And what are the timelines you have in mind for this stuff? DR DENA GRAYSON: Sure. So let's talk about the vaccine. Then we can talk about testing and sort of the medicines and how this all works, right? So, first of all, there is no guarantee that we'll ever have a vaccine. That is the brutal honest truth. Coronaviruses are weird. They are not influenza. These are different viruses. So there's some good news, bad news with this coronavirus. Unlike flu that mutates pretty rapidly-- and that's why you need a new flu shot every year-- this coronavirus, according to all of the experts that are really on the virology microbiology experts-- they're saying that the good news here is that we're not seeing this coronavirus mutate very much, which is great news, meaning it doesn't look like it's going to change enough so that if we had a vaccine today, it should work for, at least, the foreseeable future. But-- but the problem is it's a coronavirus. And when we look at coronary viruses, in general, there are right now several human coronaviruses that already circulate that cause the common cold, for example. An immunity to those viruses is not great. It doesn't last a long time. So that's the negative side. And I will say that there was 1 study out of China, again, from China. So I take it with a big grain of salt. And it needs to be confirmed. But they looked at people who had been hospitalized with COVID-19, the disease, the illness caused by this deadly coronavirus. And up to 30% of these hospitalized patients who then got better, they had difficulty detecting antibodies in them. So it may well be you have sort of 2 sides of your immunity. 1 is called humoral immunity, which is antibodies. But then you have cell-based immunity, which are cells that go and attack and kill. So it's not really clear how that's going to all pan out. So I just want to caveat that. Now, I was very pleased yesterday that information came out that the Trump administration really is pushing a Manhattan style project, which I think is kind of a bad name, given that this is not a nuclear bomb. We're thinking about-- PEDRO DA COSTA: Same here. DR DENA GRAYSON: Right. But basically-- PEDRO DA COSTA: Marshall has a better ring to it. But-- DR DENA GRAYSON: All right, like, I like it. A Marshall plan. We've got a Marshall plan for vaccines. And this is something I've been calling for quite a while, which is, look-- and I said this several months ago back in early February-- if we want to solve this problem, we have to take that rulebook, throw it out, OK, as far as developing vaccines and medicines. We've got to make sure it's safe, safe, safe-- first do no harm. But otherwise, you throw out that book. So what does that mean? With vaccines, normally what you do is you test. You make a small amount of the vaccines. You first make sure it's safe. Then you see if it's kind of works, meaning if I inject people, do they make antibodies? Then you go to a larger test. Now, I inject people. Is it safe? But also do they get antibodies? But also, do they not get the virus? That's normally how you test a vaccine in clinical trials. Then once you get enough information, then you ramp up production of hundreds of millions of doses. Problem is we can't afford that. So I said, look, what we need to do as a government is we need to get all the top vaccine makers together. We have very limited capacity to actually manufacture vaccines. That's another thing that people don't get, OK, is that it's not like, suddenly it's really easy to make this stuff. It's not. So get them together. And let's pick our top 3 shots on goal and go ahead and start making them now. Now, what's the risk? The risk is we taxpayers are going to lose billions of dollars because 1 or more of these vaccines doesn't work. But the payoff is, if 1 or more works, by the time we have the data saying, yep, this vaccine looks like it works, we already have doses made and ready to go to vaccinate people, because time is our biggest enemy. So if we could do anything to cut those corners, we've got to do it. So I'm actually, again, I applaud the Trump administration. If this is really happening, I think this is great. But I think the key is, then, if the American taxpayers are picking up the risk and picking up the tab for these vaccines, that means these vaccines are going to be freely available because we're paying for it. We paid for it. This is not, hey, price gouge. Do we reimburse these companies for doing work? Of course, of course, just like any other government contract, right? That would be fine. I have no qualms with that. But there's not going to be this price gouging nonsense. We're not going to say, do you have insurance? That will be $100 if you don't. No, no, no, no, no. We're paying for it. We're taking the risk. I think it's actually a really good thing, though, overall. We got to get the vaccine doses. So same things goes with the medicines. And the medicines the way they're used-- they're IV medicines. Remdesivir is IV. Galidesivir-- the drug I worked on is IV. So what that means is like, their utility, it's not when you're critically ill people. Once people are in the ICU, they've got a lot more going on than the virus. Their own immune system is really starting to attack them. So that's a different scenario. That's sort of the horse ran out of the barn but ran off the ranch, OK, where these antivirals are very likely going to show effectiveness. And remdesivir did show effectiveness in a what's called a randomized placebo-controlled trial where you're blinded. The doctors are blinded. Patients are either getting placebo or getting the drug. And then at the end, they had an independent data committee that looked at this, looked at the data. So completely independent of the investigators and of the company. And they said, yep, we see that this drug is working. Very likely where these antivirals will work, Pedro, is earlier in the infection. So people that as soon as they get to the hospital, it's not like they've been sick for 10 days. But they've been sick a couple of days. That's the earlier you can start them, the better. And that should hopefully bring down the mortality rates. But unfortunately it's not really going to help us control how many people get infected because they're IV medicines. It's not like we could use them for what we call post-exposure prophylaxis. A doctor gets exposed. We really got to hook up a doctor with an IV for 5 straight days-- probably not, all right. But where we do have some potential emerging medicines that I think could be really effective is taking sort of a page out of the convalescent plasma notebook. So convalescent plasma is taking the liquid part of the blood from people who have survived the virus, have antibodies and then passively immunizing, if you will, another patient that is now sick with the coronavirus. So that can be helpful. Potentially there's some very preliminary evidence that suggests that this convalescent plasma does have some activity against this deadly coronavirus. And it was shown effective, for example, going back to the 1918 Spanish Flu pandemic that convalescent plasma works. So it's a an old trick. But it can potentially work. Now, the negative is, of course, we can't bleed all the survivors dry. So now what can be done is to actually manufacture those antibodies. So you can actually collect the immune cells from survivors and then get those in the lab and then culture them in a way that you can start manufacturing mass-scale quantities of these antibodies. China has reported that they've already started to make that cell line that can do that. That's a really good breakthrough. We've got companies here in the United States-- biotechs that are really world class with that. I think that's going to be something else that we might see coming down the pipe is sort of like a manufactured version, if you will, these antibodies. That could also be a really helpful tool. But really what we need is that vaccine, as we talked about. And the timeline-- the Trump administration is claiming they're going to try to have this available by the end of this year. If that happens, that would be great for American lives very much so. That would be incredible. I don't want to call it a miracle. But it certainly would be recordbreaking-- I think more likely. And this is what Dr. Fauci has been saying. It's probably more like a year from now, which means we have to go through that second wave without this vaccine, because, again, even if you have the doses available, then you've got to distribute them. Then you've got to vaccinate 100-plus million people. In this country, obviously, over 300 million people. And the Trump administration is not even contemplating having 300-plus million doses available by the end of the year. So I think, unfortunately, it's going to be quite a while. PEDRO DA COSTA: Can we talk about the longer-term view and the success stories as well? So New Zealand basically has declared the elimination of the virus, which seems a little bit bold considering we're a global world. South Korea seems to have done a great job. What do those countries tell us about this new normal? And then on that same topic going back to 1918, Brazilians-- Latin Americans went back to kisses on both cheeks. So did the French. I mean, people forgot that pandemic. So the new normal didn't last forever. Is this one different than that one? DR DENA GRAYSON: Well, I think that we're humans by nature, right? We enjoy that human touch. Most infectious disease docs/experts really despise shaking hands. I would put myself in that category. It's not that I don't enjoy human contact. It's just, viruses love shaking hands. So I'm the type of person. I'll be at a meeting, have to shake hands. And I'm cringing inside but smiling. And then I'll usually excuse myself to go use the restroom. I'm going to go and hit the ladies room-- pardon me-- washing my hands. Then I come back to the meeting. PEDRO DA COSTA: I think we all relate to that now a little bit more. I think you guys knew too much before we did, but yeah. DR DENA GRAYSON: Yeah, so I think there's that. I think that we are in this new normal, Pedro, for the next couple of years until we have that herd immunity that we've talked about. So immunity is when you individually are immune to that virus. Now, no one knows if you have test positive for antibodies. Does that really make you immune? My prediction is likely, but it's got to be proven. OK, but no one really knows. Herd immunity is really talking population-wise. So to get to Herd immunity, and why that's so important is, first of all, you have to have enough people that are immune to the virus. So they essentially think of it like, the Heisman trophy with a blockade like this. That virus can't spread very much, because right now this virus is very contagious. Let give you a quick example. People describe this. It looks like r0. It's called r0. That describes the number of new infections from a single infected person. So if I'm infected, how many people on average can I infect. So for influenza, that number is around 1.3, meaning each person who gets infected infects about 1.3 people on average. For this coronavirus, the estimates are somewhere around 3. So the difference between 1.3 and 3-- that doesn't sound like a lot, right? But let's do 10 rounds of infection. That influenza are not a 1.3. That first person infected leads to 14 people infected. That sounds kind of bad but manageable. OK, and we know flu is pretty bad. This coronavirus are not a 3, not 1.3 but 3-- do 10 rounds of infection. That first person leads to 59,000 new cases. PEDRO DA COSTA: Wow. DR DENA GRAYSON: Right. So that's why this idea of testing, testing, testing, testing, physical distancing is so critical, because anything you can do to get that r0 down is once you're below 1, no more outbreak, OK. Germany was down 2.7. They eased their restrictions. Now, they're up 0.97. Once you get above 1, you are, by definition, an outbreak. So as soon as we let our foot off the brake with this deadly virus, it springs back. PEDRO DA COSTA: I had a question from a neighbors-- very relevant, yes. Isn't social distancing the opposite of what you need to get herd immunity? And what are the conflicts there? DR DENA GRAYSON: It is true that as we physically distance, we're essentially what we're doing we're buying time, right? That's the key-- buying time for that vaccine, buying time for new treatments such as remdesivir such as the manufactured antibodies that are mimicking convalescent plasma. But also what we're doing-- and everyone hears about this flattening the curve. So when you flatten the curve, there's only so many hospital beds. Let's say we had a miracle cure. You show up to the hospital. And guess what. You're 100% chance you'll be cured, which is never going to happen. That just never ever happens. But let's assume that we had that like we had this magical silver bullet-- you're cured. Well, if you have this sudden rush, because this virus spreads like wildfire-- literally spreads like wildfire-- we have suddenly have all these people rushing to the hospitals-- there aren't going to be enough doctors, nurses, hospital beds, IV poles. I mean, that's why this flattening the curve truly lowers the mortality is what we're trying to do, right? So hospital systems get overwhelmed, like we saw in northern Italy, that mortality rate skyrockets merely because you just don't have enough ventilators. You don't have enough physicians-- then the health care system. The ambulances can't get there fast enough. They're like, we can't get to the house. And then we have you in the ambulance. Well, there's no place to take you. So that's why the flattening of the curve is so important. And we saw that in Great Britain. Prime Minister Boris Johnson, who he himself, of course, suffered from the coronavirus. And then here in the United States, Mr. Trump, they both espouse this herd immunity, just errant thinking, I guess, if you will. And then they saw the projections coming from the WHO, the World Health Organization's top epidemiologist, who said if you do this, the United States, we were looking at 2 million people dying, not right now very likely, we're very likely right now north of 100,000 people, about double of what's being reported. So this virus is very, very contagious. So I hear that argument a lot. I hear this argument of like, let's just open up. Let's reopen the businesses, like the billionaires want. But even in places that have opened up, you're not hearing reports, like in Georgia, people swarming to those businesses. The restaurants, most people are still getting takeout from what I'm seeing of the public reporting on this. I mean 70-plus percent poll after poll after poll say, listen to the doctors. We're going to listen to the doctors. When the doctors tell us it's Kool and the Gang to go out, then we'll go out because you know what. People don't want to die. And politicians, they can spin. But they can't spin death. PEDRO DA COSTA: Thank you for that. So I want to jump into-- it's section of our interview that we call the intersection-- try to have a little fun in these pandemic times. DR DENA GRAYSON: All right. PEDRO DA COSTA: Just so a little bonus round, and then we'll let you go. I know you're busy. So first question. Is there a person living or dead who you'd like to interview and have a sit down with-- be on the other side of the camera with? DR DENA GRAYSON: Interesting because I'm on this side of the camera. I've not been on your side of the camera. I kind of want to flip that around, right? It seems like that might be even more fun. I would say Elizabeth the I. You have a woman who is a leader 500 years ago, really was a scholar-- very learned, spoke multiple languages, well-read, and an aberration of her time, of course, not just because she rose to be leader of a world power in a time where women had no rights essentially, but really was learned. I mean, give her father credit. He educated his daughter. As all of his faults, he did educate his daughter very, very well. I think she would've been a very fascinating person to talk to and would have a very interesting world view. PEDRO DA COSTA: So tell me about a book or some books that have changed your world view over the years. And what are you reading right at the moment? DR DENA GRAYSON: Well, I'm reading a fabulous book right now. I'm actually rereading it. And I would strongly recommend it. It's called The Great Pandemic about the 1918 Influenza Pandemic and all the mistakes that were made. And it's a horror show in many ways, right? We're replaying the same movie, the same horror show. And, frankly, we've done it just in over the past 4 or 5 months. We saw the horror show in China. We didn't act in the United States. We saw the horror show in Italy. We didn't act, right? So we're seeing this time after time after time. And now, of course, we're relaxing lockdowns. What's going to happen? Virus is going to surge again. I mean, it's not that hard to predict, honestly. But I find that book-- really, it's tragic to read. And just, look, we humans are doomed to, unfortunately, repeat history. A book for my past-- I studied Russian in college-- a little known fact. [SPEAKING RUSSIAN] I just said, I speak a little bit of Russian still, and I studied in college. So I read a book called The Brothers Karamazov, which was a fabulous book. And I think the part called the Grand Inquisitor for me personally was very eye opening of understanding that really delineating for me as a-- gosh, I think I was 17 when I read the book of that difference between spirituality and religiosity. It was very eye opening and very helpful for me. PEDRO DA COSTA: Great. Some of our guests tied their success to a key breakthrough if you could talk about a tipping point in your career. And maybe tell us a little bit about your role in politics. DR DENA GRAYSON: Ah, goodness. Well, I would say that I've been very fortunate to publish in nature, which is the matron science of the world's most prestigious scientific journals. And I've published not once but twice. And in both cases, it was having the scientific idea and push, push, pushing. In fact, 1 of those publications is related to a drug, this galidesivir drug that's now in clinical testing. So this was a drug I was working with this company, BioCryst, set up a collaboration with the Department of Defense. I've actually been inside of the BSL-4 lab, I mean, inside, inside. These are the bubble labs you hear about, the walls. PEDRO DA COSTA: Big thing. DR DENA GRAYSON: Now, this lab was not hot. As they called it, it was cold. It was decommissioned. They were cleaning it. And you go in this pressure chamber, because it's a negative pressure lab, 18 inches, concrete walls, negative pressure chamber. Then, they lower the pressure. You can feel it your ears. And then you walk into the lab. I've actually seen the monkeys infected with Ebola while looking through the windows in the lab, tested the drug. We were hoping to get government funding, because this is not a drug that biotech can develop. And it's going to be at your local CVS. So unfortunately for a company, they've got to think about, ooh, what can we do to actually make sure that we can fund the developer of this not from our shareholders. And the government does fund things like this. And we were having trouble getting the funding. So I became a lobbyist, which I took criticism for when I ran for Congress because I was a pharmaceutical lobbyist. No, I was trying to get money for a drug to treat Ebola. I started this program 2 years before the big outbreak in Western Africa, because I knew, Pedro, it's not if. It's when these viral pandemics happen. And I saw this. I said, look, planes-- somebody hops on a plane, it's going to be here. And we need broad spectrum antivirals for exactly what we're dealing with today. So I became a lobbyist, went to Congress. In 8 days, I had Republicans, all the key committees lined up. This was before I knew my husband. I just had a friend who was a senior staff member of a named physician, 1 of the named top Republicans in the House, had lunch with him and told him about what I was working on. He's like, oh, it sounds interesting. And then he's like, yeah, I'll make some intros-- sent him an email, didn't hear back from him next day. There was that anthrax scare on the Hill. And so I emailed him. And I said, hey, remember what I said. It's not if. It's when these kinds of things happen. 42 seconds later, I got the email. I'll make the intros. He did. And then I was up to DC that following week of having meetings at, again, 8 days. Took me 2 weeks of meetings. And I got the support that was needed, because these viral threats-- they threaten everybody-- doesn't matter-- Republican, Democrat, white, black, Latino, Asian-- doesn't matter. These viruses don't care. They infect, and they kill. PEDRO DA COSTA: Thank you so much, Dr. Dena Grayson for joining us. That was the interview with Real Vision. I really appreciate your time. DR DENA GRAYSON: Pedro, thanks so much for having me on the show. It's great to see your face. And I look forward hopefully to coming back again soon. PEDRO DA COSTA: That'd be great. Thank you so much. JUSTINE: If you're ready to go beyond the interview, make sure to visit realvision.com where you can try real vision plus for 30 days for just $1. We'll see you next time right here on real vision.