Dr. Peter Hotez says cases won't peak until first week of May

HOUSTON, Texas (KTRK) -- World renowned infectious disease specialist says the greater Houston region will be seeing a dramatic surge in cases over the next few weeks.

Dr. Peter Hotez, Dean of the National School of Tropical Medicine at Baylor College of Medicine, is working on developing a vaccine for COVID-19. He is also a leading voice as the world fights the pandemic.

Following is a lightly edited version of our conversation with him.

Question: What's your view of the situation in Greater Houston area?

Answer: I think the numbers are starting to go up, we're starting to see an increase in the number of diagnosed cases. The one thing that I'm concerned about is that we're hearing reports of significant numbers of hospitalized patients, as well as ICU patients in the various hospitals of the Texas Medical Center and so, from my perspective, there's a bit of a disconnect between the number of patients we're hearing about in the ICU who's in the TMC versus the number of cases counted because based on past experience.

Question: What's the disparity in the official case count versus the real number of cases?

Answer: We probably have a larger number of patients than we're actually diagnosing. So, I think and that's, that experience is not unique to Houston that's actually become a national trend, but the piece that I'm worried about is that we're replicating in Houston what happened in other southern cities meaning in New Orleans or Atlanta. We're really just learning about the full extent of this epidemic, based on ICU patients showing up.

Question: What can you tell us about the predicted peak at the beginning of May?

Answer: My colleagues at the Institute for Health and at the University of Washington, which are putting out sort of the major transparent estimates of the epidemic, have broke this down by state, and what they're telling me is that the peak of the epidemic in Texas, should be around the beginning of May, and it goes back and forth between May 2 May 5 and May 6, but roughly the first week in May. That means, the fact that we're already seeing patients in the intensive care unit in the Texas Medical Center means most likely we're in for a pretty significant epidemic here in the Greater Houston area.

Question: What does that mean?

Answer: What that means is we really need to enforce the importance of social distancing so Mayor Sylvester Turner and the County Judge Lina Hidalgo have come out with pretty strongly worded statements on the need for social distancing, and it's really important that people maintain that.

Question: Can you talk about our challenges in getting testing, and how we don't have access across all our communities?

Answer: I know the Mayor and the County Judge have worked really hard to expand testing and they're particularly concerned about some of the poor neighborhoods in Houston, because we've seen already from New Orleans and from Atlanta, that it's people who live in poverty where it's tougher to do the social distancing. I'm very worried for places like the Fifth Ward, Acres Home or I'm worried about some things in Northeast Houston. These are the places where I'm concerned that we could see large numbers requiring hospitalization. Another reason I'm worried, is because people who live in poverty often tend to have higher rates of diabetes or hypertension, and we know these are risk factors for severe illness, often requiring a ventilator support.

Question: Do you have you thought about how many fatalities? National projections range from 100,000 to 250,000 deaths?

Answer: We don't really know where that 100,000 - 140,000 number comes from, and until I know the basis for it, I haven't been using it. I've been more focused around what's coming out of it, I mean these two metrics which are telling us around 90,000 deaths over the next few months into the summer. I think that may be a more realistic estimate, and it is still pretty significant. Texas, the projections are roughly around 6000 deaths between now and the beginning of August.

Question: There's a consortium of journalists tracking testing and per million residents and they put Texas up 48 in the country as far as testing per million residents. Does that data surprise you?

Answer: It doesn't surprise me because we've already seen. We know what happens when we don't test adequately, and now we've already seen it in Houston so when we don't test adequately. It means you only find out about your CovID_19 epidemic when significant numbers of patients show up in the ICU and unfortunately that looks like what's now underway, based on what I'm hearing about from the Texas Medical Center. So, we still need to aggressively ramp up for testing, but unfortunately we're going to have to now take on both phases, this epidemic.

At the same time, doing both to testing, expanding testing but also getting ready for that big surge that we're expecting now to hit the Texas Medical Center and, you know, it's the best Medical Center in the world, we've got amazing physicians, nurses and respiratory therapists and other health care professionals, and I'm worried that we could see a situation there that could resemble what we've seen in New York City these last several weeks where hospital systems are getting overwhelmed, healthcare professionals don't feel adequately protected and safe and a number of them are will get sick and, and it's very rough to see, to see, possibly this coming.

Question: What are you doing to protect yourself?

Answer: You know I'm I am minimizing my time outside, you know, I'll go in the early morning or late at night in our Montrose neighborhood when no one's around. My wife and I will take a walk around the block and go outside but that's about it. And I think it's really important that Houstonians adhere to the social distancing.

Question: Should we wear masks outside?

Answer: We're getting mixed messages from the Centers for Disease Control in front of the federal government. And it goes, and it goes something along these lines the masks are not so much protective against you getting the infection, but they may prevent you from transmitting the infection. Right now there's not a strong recommendation to wear masks in part because of the shortage. But, what's true today may be very different tomorrow or next week so it's really important that everyone be mindful and stay close to the news and and have some situational awareness about what's going on, because there are going to be new directives and recommendations, undoubtedly as this thing really ramps up during the month of April in May

Question: What's your final message:

Answer: Things are just starting to gear up now. I know it seems like it's been forever, getting the message is the models are saying right that things will peak in a month, a month from now, so that means there's no question about it. Houstonians are going to be in for very tough time next few weeks, and right now without a vaccine. We're trying to move the vaccine into clinical trials. All we can really do is just do an old fashioned method, a method that was developed in the 14th century, actually, that's when the term quarantine was invented. Social distancing for the next few weeks is the best way to keep you and your family safe.

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