#102 - Michael Osterholm, Ph.D.: COVID-19—Lessons learned, challenges ahead, and reasons for optimism and concern

Mar 31, 2020

Michael Osterholm, Director of the Center for Infectious Disease Research and Policy at the University of Minnesota, shares invaluable insights on COVID-19. He discusses the true case fatality rate and how factors like obesity influence outcomes. Michael highlights the importance of immunity and cautions about supply chain issues affecting vaccines and testing. He also reflects on future protection strategies for healthcare workers and the long-term health implications for COVID survivors. His perspective balances optimism with the challenges still ahead.

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INSIGHT

Challenges in Determining CFR

Calculating the true Case Fatality Rate (CFR) is challenging due to underreporting of deaths and infections.
Comorbidities like obesity and smoking heavily influence CFR, varying across countries.

INSIGHT

US Vulnerability to COVID-19

The United States' high prevalence of comorbidities like obesity and renal disease may lead to higher CFR.
The lack of widespread long-term care facilities in China versus the U.S. creates differing vulnerabilities.

ADVICE

Strategies to Limit Deaths

Suppress transmission and maintain a functioning healthcare system to limit deaths below 100,000.
Prioritize essential workers and address supply chain issues, especially critical drug shortages.

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In this episode, Michael Osterholm, Director of the Center for Infectious Disease Research and Policy at the University of Minnesota and author of Deadliest Enemy: Our War Against Killer Germs, provides an overview on the COVID-19 pandemic in regards to what has happened to date, what we've learned about how the disease spreads, and his optimism and pessimism about what potentially lies ahead. Michael gives his take on the true case fatality rate, why it differs around the world, and which underlying conditions, such as obesity, impact risk of severe illness and death. We also discuss the outlook regarding vaccines, repurposed drugs/antivirals for treatment, and Michael's growing concern about supply chain limitations with respect to drugs, vaccines, n95 masks, and testing kits. We discuss:

Recapping the brief history of COVID-19 and what potentially lies ahead [2:15];
Some positive news about immunity and reinfection [10:45];
Case fatality rate—The challenge in finding the true rate, difference by country, and the impact of age, underlying conditions, and obesity [13:00];
What has to be true for less than 100,000 Americans to die from COVID-19? [24:30];
How do we best protect healthcare workers? [29:45];
Concerns about testing capability—Reagent shortfall and a supply chain problem [39:30];
Vaccines and antivirals—The outlook, timing, and challenges [47:45];
Long term health of survivors of COVID-19 [56:45];
The impact of comorbidities—Diabetes, obesity, and immunosuppressed patients [59:30];
Understanding R0 and how the disease spreads [1:01:30];
The challenge of forecasting with so many unknown [1:08:00];
What explains the difference in cases and fatalities in different parts of the world? [1:14:30];
Repurposed drugs/antivirals being considered for treatment options—any optimism? [1:16:45];
A parting message from Michael about what lies ahead [1:18:30]; and
More.

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