Peter Hotez has spent his career studying infectious diseases that others weren’t paying attention to, developing vaccines that “no one else will make.” Four years ago, Hotez and a team of Texas scientists developed a vaccine that he now believes could have protected against the new coronavirus, which has killed tens of thousands of people around the world. But they couldn’t find funding to begin testing on humans, so it languished in a freezer. Now Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston and co-director of the Texas Children’s Hospital Center for Vaccine Development, is warning the public and government officials about the new coronavirus, while working to develop and test vaccines.
Hotez spoke with the Observer about the United States’ coronavirus response and the need to invest in public health much, much earlier.
Texas Observer: How are you holding up?
Peter Hotez: Well, it’s exciting and scary at the same time. And exhausting. I’m beyond sleep deprived.
It’s a difficult time, but it’s an important time. We’ve developed a vaccine, so we’re trying to get through all the complexities of getting a vaccine into clinical trials. And we’re trying to develop the first global vaccine for places like India and Africa and Latin America as well. So that’s a huge undertaking. It’s always very challenging to move vaccines for the poor or for health disparities, where there’s no traditional financial market, into clinical trials.
You were working on a vaccine in 2016 that would have been helpful now, but there wasn’t funding. Can you tell me more about that?
I’ve talked about it so much, I don’t think I can talk about it again. But let’s just say we are moving forward now on two vaccines. One for this new COVID-19. But the other, a previous vaccine for the original SARS, SARS-1, is already manufactured, so we’re trying to see if we can move that into clinical trials, because we think it will protect against COVID-19 as well.
What’s the timeline on both of those?
Well, Dr. [Anthony] Fauci [director for infectious diseases at the National Institutes of Health] says a year to 18 months. I think that’s a pretty accelerated timeline. It could be longer. It could be two years. For Ebola, it took five years to do all the clinical testing and get everything through. So it’s hard to accelerate that down to the level that he’s talking about. But we’re going to try.
I keep thinking about something a county official told me about battling Zika on the Texas-Mexico border: that there’s reticence to invest in public health because you don’t see the value on its face. What has COVID-19 underlined about the way the United States invests in public health, and lessons learned for the future?
The lesson learned is we have to stop thinking of this as public health, we have to start thinking of it as critical to the security of our nation. It’s every bit as critical as having a military. Look what this virus has done to our economy. It’s reversed all of the gains we’ve had over the past four or five years in the course of weeks. And not only that, it’s caused the population to question the abilities of our elected leaders. So these neglected and emerging infections are highly destabilizing, both in economic terms and political terms.
Global infectious disease threats are so intimately tied to social and physical determinants and to the stability of a nation. We need to recognize this, and we’re going to have to invest. Because we couldn’t get a few million dollars invested in a coronavirus vaccine, the program that we started 10 years ago, we’re looking at a multi-trillion-dollar hit to the economy.
Why was the United States so ill-prepared to deal with this?
I don’t know. I think we’ll have to do an investigation to figure out why testing could not get scaled up. Or why we allowed our first wave of hospitals to get so overrun so quickly in New York and New Orleans. Because we knew what was coming, right? The Chinese gave us a heads up. And then we saw it again in Italy. We saw what was going to happen.
We knew that this virus rips through nursing homes and kills people. And that’s what it did in Washington state. It’s done it again in New Jersey and now in New Orleans. That’s why I went and testified to Congress, calling this virus the “angel of death.” I didn’t want to be so provocative, but I felt I had to do it to wake people up.
So I’m just a bit puzzled. We had all of this warning ahead of time. And the Chinese isolated the virus, they sequenced the virus, they found how the virus binds to the receptor. We had pretty much all of the information we needed to know to fight this epidemic. And yet we didn’t do it. I don’t understand it.
What do you make of the different demographic information we’re seeing—from China, Italy, the United States—on who the virus affects the most?
In China, it was all individuals over the age of 70 that had 10 to 20 percent mortality, and those with underlying conditions like diabetes and hypertension. And we found that in Korea. But then in Italy, we started seeing a lot of young adults getting very sick. We don’t know why. And, unfortunately, the virus seems to have gone by the Italian playbook here. So now the [Centers for Disease Control and Prevention] finds that about a third of hospitalized individuals are between the ages of 20 and 40. That’s another thing I’ve been trying to raise awareness about.
How have Texas officials done so far on handling the pandemic, and what are you watching closely here?
The fact that now it’s hitting New Orleans is very concerning, because we’ve got a pretty tight link with Houston after [Hurricane] Katrina. Everyone’s got family in each place. So I think that’s a risk, potentially, for bringing the virus here. And you know, Texas is an international hub.
The only two things that [Texas] may have going for it is that the cities are not very dense compared to cities in the Northeast. That may work in our favor. We don’t know about climate effects; there’s some suggestion that warm climate may cause some seasonality. But of course, the epidemic is still going on in New Orleans.
Things are changing extremely quickly. But right now, what’s the most important thing that needs to happen for us to get this under control?
Well, remember that without a vaccine, we’re using 14th-century methods, which is what quarantine is, or social distancing. That’s really all we have at this point.
That’s the only known effective measure. It prevents the surge in hospitalized cases that’s directly linked to mortality. The reason why mortality rates are so high in Wuhan and in northern Italy is because the ICUs were getting so overwhelmed, they couldn’t take care of the patients. The only way to stop that is, one, making certain you’re ready for the surge. But also practicing social distancing before those numbers start to arise. The worst situation because you’re not testing is what happened in New Orleans, where you first found out about it when patients started showing up in the ICU. When that happens, by then it’s over.
We’ve talked before about your call to scientists to speak out more, like you do. How does that fit into what we’re seeing now, with state and federal officials making statements that are against the guidance of public health experts?
I think it’s really important that people hear from scientists, because we don’t hear from scientists. We’re invisible. My media career tends to spike every time there’s a major pandemic threat. If you were to graph it out over time, it would look like an EKG with peaks around Ebola and Zika and now this. And then I sort of disappear for a while.
I do it because I think it’s really important to explain complicated concepts in straightforward language, and it’s something I really love doing. And I do it in a way that I think I can avoid getting baited too much by the local politics. That’s why I’m committed to going on MSNBC, Fox News, and CNN. I think it’s really important to show that you’re not politically motivated, that you want to do what’s best in the interest of public health and security.
It must be frustrating.
Well, I’ve devoted my whole life to something called neglected diseases. So I’m used to being frustrated.
This interview has been edited for length and clarity.
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