Doctor on COVID-19 spike: ‘We need to be worried’

Dr. Kanika Monga, Rheumatologist in Houston, Texas, joins Yahoo Finance’s Akiko Fujita to break down the latest coronavirus developments, as cases across the U.S. continue to spike.

Video Transcript

AKIKO FUJITA: The number of new cases setting a new record. More than 77,000 new infections reported on Thursday alone. 223,000 people have now died of the virus so far. All of this coming even as President Trump insisted things are improving in last night's presidential debate.

DONALD TRUMP: More and more people are getting better. We have a problem that's a worldwide problem. It will go away, and as I say, we're rounding the turn. We're rounding the corner. It's going away.

AKIKO FUJITA: Let's bring in Dr. Kanika Monga. She is a rheumatologist in Houston, Texas. And Dr. Monga, it's great to have you on today. You are in an area that has seen that uptick more recently. You point out the seven-day average of cases has risen more than 40% statewide this month. What did you make of the president's comments yesterday during the debate? Are things moving in the right direction?

KANIKA MONGA: I wish they were. You know, at this point, unfortunately, we are seeing a rise nationwide, in Texas, as you just mentioned, and in Houston. This week alone, you know, on the 21st, they reported 855 new cases per day. And comparing that to last week, the cases were just 497 per day. So I don't think this is rounding the corner. I think we need to be worried. The outlook is bleak unless we continue to take precautions.

AKIKO FUJITA: Let me ask you a question we've been asking a lot of our doctors on the show, which is what you're seeing differently this time around. Houston, of course, saw a big spike in the early part of the pandemic, and now you're seeing another wave of infections. How is it this-- different this time around?

KANIKA MONGA: I think a lot of it's the same. I think we're just learning more about the virus and how to deal with it. I think now we're better at capturing symptoms earlier on, versus waiting until patients have to go through the emergency department or have to be admitted. So I think the difference is, we're just more aware of what the virus contains, and just more aware, as a city or as a state, of what to expect.

But at the same time, you know, what I've seen throughout, whether earlier or now, is when we start gathering and we don't use our mask, cases will go up. And I am seeing people-- even if they're smaller gatherings, people are still meeting. For now they're being more lax on wearing their mask.

AKIKO FUJITA: We did get some good news on the treatment front, the FDA approving Gilead's remdesivir as a treatment. We've heard the president, of course, talk about this, because he was treated with that as well. This argument here that it helps shorten recovery time for hospitalized patients-- how effective do you find this treatment? And what does this mean, ultimately, where you are in your ability to respond to these new upticks?

KANIKA MONGA: You know, whenever there's a drug with potential for the virus, I'm always happy about that. But I do want to make it clear that there's mixed data with this medication. There are some doctors and some studies that have shown that it may decrease the duration of symptoms or the length of symptoms.

But then there's also a big study that was done last week by the WHO that showed there was no change in death associated with COVID-19 when patients were given this medication. So at best the data is mixed.

I don't think this will change much for our patients. At the end of the day, we still don't know what is-- which type of patient would benefit. What is-- You know, a lot of doctors think earlier on-- the earlier on they get the medication, the better. But what is earlier on? You know, what is that window where it may help our patients? We're still unsure about that.

So I don't think it changes much for the patient. Precaution, wearing your mask, being socially distant, and taking your health in your own hands, not waiting for mandates across the city or the state, but being responsible for yourself, for your family, to maintain all precautions to prevent getting the virus in the first place. This medication even though it's approved is not life-changing. This is not a cure. There's no cure for COVID-19 yet.

AKIKO FUJITA: What about the availability of remdesivir? You know, there's--

KANIKA MONGA: Right.

AKIKO FUJITA: You've raised questions about the efficacy in treating, or trying to determine which patients it will be most effective on. But how much access do you have to the actual drug?

KANIKA MONGA: So depending on where you practice-- So I practiced-- You know, a lot of my colleagues have access to it, even before it was approved by the FDA. But I want to realistically say, it's a very expensive drug. It is not going to be easily accessible to our patients. But I think the FDA approving it, definitely it will be easier for-- it may make it a little easier for doctors to access it, especially when patients come in with the earlier symptoms of it.

AKIKO FUJITA: You talked about there being no cure for the virus right now, but we did hear from Dr. Anthony Fauci in an interview earlier today saying that he expects a widespread vaccine several months into 2021. How realistic do you think that timeline is? And does that change anything in terms of your planning over the next few months as you anticipate more and more cases?

KANIKA MONGA: So the vaccination would be a great thing for this pandemic, right? Of course, it's going to be very useful for our patients. But at this point, I think early next year is us being optimistic. I hope it gets-- it's safe and it can get distributed by that time. You know, once we have one approved, even it getting distributed may take some time and a lot of money. So I think at best, it'd be early next year. I don't anticipate one being approved sooner than that.

And yes, I think once we do have one, we would have to wait and see how long does it even provide immunity to our patients. Are there particular patients that get more immunity, other patients that don't really benefit from it at all? So these are things that we're going to have to take into consideration even as the vaccination gets approved.

AKIKO FUJITA: And finally, while we're talking about these new case counts and concerns around the surge nationwide, we have seen that the death rate is not necessarily as high as what we saw early on in the pandemic. Is there a lag here? Are you concerned that number is going to tick higher sort of in conjunction, correlating to these new case counts? Or given what we've learned in the last few months, is there more treatment there, and is that leading to lower death rates?

KANIKA MONGA: So I mean, you know, we're seeing more cases, but we're also seeing an increase in hospitalization this time around. So with an increase in hospitalizations, death is always-- there is a delay. There is a lag. So death rates may also see an increase with that lag, like you mentioned. So I wouldn't be-- I don't think we're out of the woods yet. I think we have to wait and see what the death rates do. With an increase in hospitalizations, I am cautious, and I am worried.

AKIKO FUJITA: Doctor Kanika Monga, rheumatologist in Houston, Texas. It's good to talk to you today.

KANIKA MONGA: Thank you.