CDC's Schuchat offers her post-summer COVID-19 predictions

Anne Schuchat, M.D., of the Centers for Disease Control and Prevention (CDC) spoke with with JAMA Editor-in-Chief Howard Bauchner about the evolution of CDC guidance and latest developments in the COVID-19 pandemic on May 1. (JAMA)

Speculation around epidemiology—specifically, how COVID-19 will play out over the next few months—has recently taken on an intensity more typically found in sports gambling. 

So, naturally, this was the focus of one of the first questions for Centers for Disease Control and Prevention Principal (CDC) Deputy Director Anne Schuchat, M.D., during a recent online chat centered around her predictions for September. 

That is, after all, the beginning of the school year, often seen as the unofficial start of flu season, when health officials have warned we may begin seeing a resurgence in the spread of the novel coronavirus.  

"What we do this summer is going to be critical," Schuchat said. "The more we intensify the testing and expand the public health capacity, and assure that our hospital capacity and material to support the hospitals is adequate or has excess, the better we're going to be in the fall."

She was speaking with Journal of the American Medical Association Editor-in-Chief Howard Bauchner, M.D., about the novel coronavirus. Bauchner regularly hosts filmed interviews with guests from around the medical community. Throughout the COVID-19 crisis, he's had a number of interviews with top officials including the National Institute of Allergy and Infectious Diseases Director Anthony Fauci, M.D.

Part of the key will be focusing on doing well with certain interventions such as flu vaccines that are known to work, Schuchat told Bauchner. The CDC is already recommending vaccine companies produce more influenza vaccine for the upcoming season because demand is expected to be high.

RELATED: CDC promises clinicians more information on caring for coronavirus patients

"If schools don't reopen or schools are at partial attendance and there's more online, and not the recesses and assemblies that bring the kids in close quarters, maybe it won't take off right at the same time the influenza pandemic did," Schuchat said. "We're trying to balance the safety and the health with the aspects that are really destructive about the social distancing that we've had to go through.

"We want to see as much flexibility, but we really don't want to get into that point where the health care system is overwhelmed or the public health system can't keep up with things," Schuchat said. "For clinicians, for your patients, it's really important for everyone 6 months and older to get a flu vaccine this year."

Among the top questions being fielded by doctors is also the ability for patients not just to get tested for COVID-19, but to get antibody testing—or serology tests—to learn whether they've had the illness.

Part of the motivation is to know whether that individual has gained immunity, she told Bauchner. Serology testing will be very helpful, but Schuchat cautioned it has many limitations.

For instance, at the population level, antibody testing can offer a look at how much of the population has gotten COVID-19 compared the number of patients that have been diagnosed with the virus. Early antibody testing in New York found the overall percentage of the population that has gotten COVID-19 appears to be only about 15% higher than the percentage of diagnosed cases. 

RELATED: CDC's Schuchat: While coronavirus spreading faster than SARS, it could be less severe

But at the individual level? Much more needs to be learned, she said. 

"Each of us wants to know: Did I already have this infection? Do I have to worry about it?" she said. There area few problems with that, she said. Some of the antibody measurements at the individual level may not be specific enough to show a definitive positive.  

"The other thing is the durability of the antibody: 'Is the yes that I got in the antibody testing mean that I'm immune and I'm never going to get this infection?'" Schuchat said. "We don't know yet because we don't know if the antibody that's specific against this virus is long-lasting and the key to protection. We hope it is. It probably is. But we don't know for sure and we don't know for sure enough to say for ... a health care worker, 'You don't need to wear an N-95 if you're in contact with a person who has COVID-19.'"

That might become more clear in the coming months, but for now, scientists don't know the answer. 

"There's a huge thirst to understand everything we can because, of course, we want a vaccine, understanding the immunology will help us understand whether these vaccines are going to work for not," she said. "The experience the nation has been through already, the more we understand how much of the population really is still clearly susceptible because there is no antibody, that will help us understand just how much we need to hunker down."