Just before COVID-19 exploded in New York, Gothamist interviewed Dr. Ian Lipkin, a preeminent epidemiologist at Columbia University who is known as the "master virus hunter" for his decades-long work tracking infectious diseases, including West Nile virus and SARS. His credits also include being the consultant for the eerily prescient Steven Soderbergh movie Contagion. The last time we spoke, Lipkin had just returned from China after working with that country's scientists on investigating the outbreaks. Since that time, he has been busy in his own lab testing therapeutic treatment for COVID-19 as well as working on developing a rapid test. He has also served as a testing adviser for New York City, part of a team of experts who spearheaded the opening last month of a new coronavirus testing laboratory in Manhattan that seeks to process around 20,000 daily diagnostic tests.
As New York attempts to fend off a second wave of coronavirus, we reached out again to the scientist to get his latest thoughts on the state of the pandemic.
What has been the biggest surprise to you about the trajectory of the virus since we last spoke?
I’ve been more surprised by the trajectory of the way humans in general have responded to the virus. On the plus side, the rapid pace of scientific discovery has led to improvements in testing, drugs and vaccines, and the courage and generosity of those on the front lines, from health care to food services. On the other, there have been a rise of false prophets pushing drugs that do not work like hydroxychloroquine, dangerous strategies such as attempting to achieve herd immunity through infection, and profiteering from sales of critical supplies at inflated prices.
What are your thoughts on the prospect of a second wave in NYC? Is it truly inevitable? Are the clusters we are seeing now in portions of Brooklyn and Queens evidence that it's already happening?
Whether we call it a second wave or not, I am deeply concerned by the increasing numbers of people with infection and disease. We can minimize morbidity, mortality, as well as social and economic damage by engaging constructively and compassionately with leaders of the affected communities. I am eager to join such efforts.
Do you follow the state and city's daily numbers on the virus? Are there certain data that you’d like to see them publish?
There is always room for improvement in surveillance. Nonetheless, I think the state and the city are currently doing a good job of reporting what they know.
How confident are you in the ability of local governments to contain small outbreaks and prevent wider spread? Based on the lockdown policies you’ve seen enacted here and in Europe, are there certain measures that inspire more confidence than others?
If everyone wears a mask and practices physical distancing we can contain the virus and avoid a lockdown.
How successful do you think government and public health officials in NY have been in communicating the threat of the virus? How can they fight misinformation and pandemic fatigue?
State and local leadership were slower out the gate in February and March than I’d hoped but are now on track. It’s difficult to promote public health initiatives when the federal government undercuts their messaging. I think we could and should recruit more New Yorkers to help—athletes, actors, business leaders, and faith-based groups as well as people like you and me. Early in the pandemic, we released a series of public service announcements from the cast of the movie Contagion that were well received.
You were part of a team that advised the city on expanding its testing capability through a new coronavirus testing lab. How much more testing do you project the city would need in the coming months, especially if we do see a resurgence?
Testing is critical to containment of this virus because people can transmit the virus without knowing that they are infected. For surveillance purposes, a city the size of New York should be able to test at least 150,000 people every day (10% of the New York City population over the course of a week). This is a similar strategy to what we use at Columbia University where a 10% random sample of our community is tested every week.
Are there rapid and cheaper tests in development right now that can be a game changer?
I anticipate that we will have accurate, rapid, portable tests for infection within 6-12 months. This will allow us to resume some limited in-person events like theater, music, dance, and sports. I don't think we will be able eliminate masks and physical distancing until the entire population has been vaccinated.
How hopeful are you about a vaccine coming out early next year? The New York Times has reported that the vaccine rollout process will likely be chaotic and frustrating, and that the first set of vaccines will likely not be that effective. Do you agree? When do you predict life will return to normal?
Barring an unforeseen complication, we appear to be on track for the first vaccines to come on line in early 2021. They may vary in performance; however, I don’t know the effectiveness of the first set of vaccines or how smooth the rollout process will be. I do agree that during the course of the rollout, some people will be frustrated by lack of early access. An additional challenge will be to persuade people to take the vaccine. It is critically important that we complete the phased trials needed to ensure that the vaccines we offer will be safe and effective.
As an expert on viruses, what is your day-to-day comfort level of resuming activities in New York City? Have you tried indoor dining? Would you recommend sending children back to school? Should people feel comfortable going to the polls next month?
I wear a mask in public and physically distance myself. I prefer the term physical distancing to social distancing because one can interact socially without risking virus transmission. I don’t yet dine indoors, but have been talking with friends who own restaurants about how this could be safely done. It’s difficult to make a generic comment about schools because the risk is dependent on compliance as well as the physical environment. As far as the election goes, this one may be the most important election of my lifetime. I intend to vote in person.
Can you share what you and your team are working on right now?
I am privileged to work with a large team of talented scientists. On the COVID front, we are completing a randomized trial of convalescent plasma in Brazil, building rapid tests for detecting the virus and neutralizing antibodies to the virus, and supporting colleagues who need help in testing drugs and doing surveillance. We have large programs in understanding the roots of ME/CFS and Gulf War Illness that will dovetail with studies of COVID survivors who have crushing fatigue and cognitive dysfunction. We recently received partial support for GIDEoN, an international network devoted to supporting capacity building worldwide for pandemic response and prevention. It will also provide infrastructure for clinical trials of diagnostics, drugs, and vaccines.
Last, but not least, I’m helping Contagion screenwriter Scott Z. Burns and Steven Soderbergh write and produce a new set of public service announcements that will address the importance of vaccines in ending the pandemic.