‘Someone, somewhere in the U.S. is getting overwhelmed’ with the rising numbers of covid cases: UC Davis Health

Dr. David Lubarsky, UC Davis Health CEO, joins The Final Round to discuss the rise of new coronavirus cases worldwide, recent news coming out on the vaccine race, and how hospitals are preparing for a new surge.

Video Transcript

SEANA SMITH: Welcome back to "The Final Round." The daily COVID-19 case count is at its highest that it's been throughout the pandemic with nearly 84,000 new cases reported each day over the past couple of days. The hospitalization rate is also on the rise. We've had four days in a row of more than 40,000 COVID patients in hospitals.

So for more on this, we want to bring in Dr. David Lubarsky. He is the UC Davis Health CEO. And we also have our very own Anjalee Khemlani joining the conversation. And Dr. Lubarsky, thanks so much for joining us. It's great to have you on the program. We know it's a very busy time for you.

And I'm just curious-- just, let's start, I guess, this conversation out with, you're a hospital network, so you're on the front lines of this pandemic. We're seeing record number of cases, like I was just saying. How prepared are you to deal with a potential surge that we could see now, and really, what could come over the next couple of months?

DAVID LUBARSKY: Well, I'm happy to say that we're very well prepared for a surge that might come, as are all of my colleagues in this area. As a matter of fact, we're cooperating and we speak every few weeks just to make sure that no one hospital is overwhelmed.

However, I am very concerned by these rising numbers because whether we are overwhelmed or not, someone, somewhere in the United States is getting overwhelmed already. We see that on the news. And the rates of the cases and the explosion in certain areas where they don't have multiple hospitals in a city, those are the ones I think right now that are most at risk.

And those are real people's lives at risk for not getting appropriate care not only for COVID-19, but for other preexisting conditions that require care. And there, frankly, won't be any room at the hospital for them.

SEANA SMITH: Yeah, Dr. Lubarsky, it's so-- it's such a regional story, I think at this point, just in terms of the capacity and the ability to handle the breakouts in terms of what we're seeing. But that hospitalization rate continues to climb. We've had four days, like I said, in a row of more than 40,000 COVID patients in hospitals.

Hospitals are also facing this other question. Because they either need to decide to go ahead or put on hold elective procedures. And we just had the story in "The Wall Street Journal" earlier this week that hospitals are pushing that offer as long as they can. They want to continue to do the elective procedures. I'm curious just at what point do you make the decision to stop the elective surgeries?

DAVID LUBARSKY: Right, well, see, we're an academic medical center, and we do pretty complex stuff. There's very little that's truly elective. I mean-- and when you think about, well, what's elective, sure, when you get your screening colonoscopy, that's elective. You get a mammogram, that's elective.

When it's elective for tomorrow or maybe 30 days from now, it's not elective to wait six months and put off a cancer screening. When you have somebody who has really bad lung disease and you needed to check up on whether or not their medication is performing the way that you expect and that they're being able to live their life to the fullest, sure, it's elective to see that patient. But it isn't elective to wait three months while they may be deteriorating.

So we need to stop talking about elective healthcare. Almost all of it is essential. It's just a matter of how long can you put off essential healthcare. And now that we're, well, eight months into the COVID crisis here, that's long enough. So we have to figure out how to take care of all the people in the United States, those with COVID and those without COVID, no matter what happens this flu season.

ANJALEE KHEMLANI: Dr. Lubarsky, one of the things that is going to definitely help with getting more people in the door is going to be that back scene. I wonder-- I know that California is looking at having that independent panel. And your hospital's very involved with the Pfizer trial. What is your sense, as it stands right now, about the conversation about the results?

Is an independent-- based on what's recently unfolded with the FDA committing to these more stringent guidelines and really pushing back a little bit on the political pressure, do you still hold the idea that there should be an independent panel?

DAVID LUBARSKY: Well, I think the independent panel is just a way to reassure the public and reassure our patients that we're doing exactly the right thing for them. And there has been all this talk in the media about whether or not there is political pressure to push this vaccine through without sufficient safety safeguards.

I'll just say this. I have tremendous faith in the FDA and the CDC. I've been practicing medicine for a long time. And they have been bulwarks of this society. The fact that, unfortunately, there's been some politicization of them is truly unfortunate, because we've always counted on them to do the right thing. I think we can still count on them to do the right thing.

But having said that, the vaccine is not going to fix this problem. We will be wearing masks through the entire flu season. And if you just run the numbers-- and they're very straightforward, right? You need about 60% of people to either be immunized or infected in order to get to herd immunity. We have 330 million people in the US. That means 200 million either need to be effectively vaccinated or have the disease.

Well, the FDA is hoping to get a vaccine that's out there that's only 50% effective. By definition, we'd have to have 10% of the population infected and 100% of the population take the vaccine in order for 50%, right, to be effectively vaccinated. There is no way that is happening.

So not only will it not happen this year, it may not even happen the subsequent year. So we all need to get used to wearing masks, maintaining social distancing, and actually following the guidelines that the CDC has been talking about for a long time. And that doesn't include crowded bars and low ventilated spaces in the winter. Honestly, we know what we need to do in order to keep ourselves safe.

ANJALEE KHEMLANI: Sure, and looking at all the mitigation strategies that our top health officials right in the country have been having constantly talking about and going into next year as well. But what does that mean long term for health?

So I'm looking at, you know, talking about elective surgery, but also telehealth seems to be really coming to the fore here. And this has been a catalyst more than anything. I know that California generally has been a lot better about this. What do you see in terms of greater use of remote monitoring per se and how that all works within the world of insurance?

DAVID LUBARSKY: Right, well, we have a center for health and technology that really focuses on this. And we're one of the most wired academic medical centers in the United States by objective criteria. And we've really seen an explosion of virtual visits of all types and are beginning to experiment with more advanced remote patient monitoring so that we don't have to bring people into the clinic and expose them or our staff to unnecessary interactions.

The whole idea of care by exception, where they'll be-- you'll be attached, basically, to monitors that check on your health, and when things are going awry, your physician will be notified, and there's no more of these routine checkups and visits, that is going to be our future. And I think that this episode of COVID-19 will catapult us into the future about 10 times faster than we expect.

Like almost any other medical center, we were doing about 50 to 100 virtual visits a day. And within a couple of weeks, we were doing more than 1,000. And we stabilized. We've come back a little bit, and we're doing about 600 to 700 a day. But that's a permanent feature now, right? A 6 to 12-fold increase literally in the space of a month, and we've been trying to get people to do virtual visits for a decade.

So that's a silver lining here, is that we're really learning to communicate with our patients in ways that are, frankly, more convenient for them and better for the physicians. It's more efficient use of their time as well.

SEANA SMITH: And Lubarsky, just quickly here, because we only have about a minute left, but I'm just curious. Just as the CEO of UC Davis Health, what do you, what do other health systems CEOs need from the administration? I mean testing, for example, is that where it should be at this point in the pandemic?

DAVID LUBARSKY: No, but we are on the cusp of getting to where we need to be. UC Davis itself is developing a machine previously in a technique previously used for, actually, plant diseases. We have the number one agriculture school in the nation. And we're using that technology to develop rapid, high throughput, extremely low marginal cost testing, down to about $3 in terms of supplies, that we can do on a regular basis.

And the whole idea of these lower sensitivity, high throughput testing is that you quickly discern who might be infectious. You might not know right when they get infected, but you'll know when it's possible for them to transmit the disease.

And through rapid testing that is back the same day, that uses saliva and not these very painful nasal swabs, and that can be deployed in the thousands every day for a single machine, we can get to the point where, basically, we can clear people to be out in public still wearing masks, but relatively safe in pursuing business, economics, and learning.

So we've got to get to that point. We're close to getting to that point. I can't believe that it's still eight months and we have not deployed technologies that are available in Southeast Asia, et cetera. But we're close. And I'm very optimistic about that.

SEANA SMITH: That's good to hear. It's a good way to end the interview. All right, well, Dr. David Lubarsky, UC Davis Health CEO, thanks so much for taking the time. We really appreciate it.

DAVID LUBARSKY: Thank you for having me.