Detroit's Former Health Director Dr. Abdul El-Sayed joins Yahoo Finance’s Seana Smith to discuss the latest coronavirus developments, as Detroit becomes a hotspot for the outbreak in the U.S.

Video Transcript

SEANA SMITH: Now, let's get to the latest on the coronavirus. Worldwide, number of cases topping 1 and 1/2 million at this point. Right here in the US, the number of cases are now more than 432,000. The US death toll continues to climb, with nearly 15,000 deaths right now.

But there is a little glimmer of hope in some of these numbers. There are signs emerging that the new coronavirus cases may be leveling off for now in some cities. And for more on this, I want to bring in Dr. Abdul El-Sayed, a epidemiologist and the former health director of Detroit.

And Dr. El-Sayed, thanks so much for joining me this afternoon. I want to start off just focusing in on Detroit and what we're seeing in the city there. It is one of the worst coronavirus outbreaks in the country at this point. From your time as the health director of the city, and from what you know in terms of the containment efforts right now, where does this city stand in trying to contain the virus?

DR. ABDUL EL-SAYED: Well, folks are doing all that they can to try and contain it. That means everything from building up an alternative location for medical care, a sort of MASH unit, so to speak, and then also trying to get out testing access to folks in rolling out some of these fast result testing. That being said, you know, when we talk about an epidemic, I really want to step back and just make sure folks understand that it's not just about the pathogen, in this case the coronavirus that causes COVID-19. But it's also about the host and the environment.

And for right now, when you think about why it is that Detroit is getting pummeled so hard, why it is that so tragically African-Americans are suffering this disease far worse, it's because you've seen the environment, our society pummeling the hosts for a very long time, whether it's lack of access to stable housing, lack of access to high-quality food, lack of access to good education, or the fact that so many people are choosing between going out and earning an $11 wage, for example, working in the back of the kitchen to save their livelihood, versus staying home to save their lives. That is an impossible choice that too many people face. And so we're seeing that happen to folks. And we've got a responsibility to understand why it's happening and what we need to do about it.

SEANA SMITH: Yeah, when we talk about why it's happening, I mean, it's interesting. When we even discuss the fact that there's still a shortage of tests out there. So the number of confirmed cases is likely far lower than the number of actual cases that could be out there at this point, particularly in lower-income areas. Do you think it's fair to say that we're underestimating the burden that this disease is having on the lower-income communities and minorities at this point?

DR. ABDUL EL-SAYED: Almost definitely. You know, you think about the high probability of what a disease case looks like for somebody who's affected. They get sick, but their sickness never rises to the level where they need hospital care.

And so they stay home. They never get a test. We don't know about it. And in that circumstance, right, we know that folks are living in housing with other folks, and they're exposing them. And so the majority of cases don't actually get counted.

What we're seeing is largely driven by the serious case count that we see and, of course, the death count, which also may be an underestimate simply because there's a difference in what you classify as a COVID-related death and otherwise. And so this is a far bigger burden than what we're measuring. And we have to understand why it is still moving so fast, because a lot of the transmission of this case-- of this disease just goes uncounted and, therefore, under-observed.

SEANA SMITH: Yeah, Dr. El-Sayed, I mean, when there are so many more cases likely to be out there than the ones that we know confirmed at this point, the fact that we're still seeing testing shortages really almost across the board at this point, what do you think that tells us, just in terms of our timeline of this? I mean, how long do you expect it to be until we hit a peak here in the US?

DR. ABDUL EL-SAYED: Well, Seana, I'll tell you, based on the best available modeling that's driven by evidence, we're looking at a peak coming sometime in the next two weeks. At the same time, however, once we get past that peak, it doesn't mean that we're out of the woods. In order for us to really be able to tamp this pandemic down and make sure that there's not a resurge in cases and another wave, we're still going to need mass testing capacity, because what happens next is what's called contact tracing.

We want to know who is exposed, identify the people they may have exposed, and, ideally, get them all testing so that either we isolate them if, in fact, they have the disease or a test hasn't resulted yet, or allow them to go about their lives. And so even when we let off with social distancing-- and we're not there yet. But even when we let off of social distancing, we need something to be able to make sure that this doesn't start spreading again and we get yet another peak.

And so we're still not out of the woods. The resources that we need we still need. And, in fact, the next phase of dealing with this pandemic is going to require testing, perhaps even more than we need it right now.

SEANA SMITH: Yeah, and I'm wonder-- [INAUDIBLE] from testing to treatment, because there's different timelines out there. And when I was-- when I've been talking to various doctors over the last several weeks, there's different degrees of hope, I guess I would say, just in terms of how fast we could get a possible treatment, how effective it will be. Where do you stand on that, just in terms of the fact that we will get something hopefully relatively soon that will be effective in treating the virus?

DR. ABDUL EL-SAYED: Well, look, there's a lot of research happening right now. We're seeing an unprecedented level of collaboration between scientific communities, not just in our country but across the world. And we do hope there will be a treatment.

But we've got to let the science take its course. The fact of the matter is, is that we have a process in which we understand how a drug goes from being just a drug that in theory may help to something that we know is safe and effective. And that requires randomized controlled trial experimenting.

And that means what you do is you take a group of people. You randomize some to getting the treatment, some to getting a placebo, and then seeing what happens, because at some point, even for medications that we know are safe for people who are dealing with other diseases, they may not be safe, either given the disease process that we're dealing with right now with COVID-19, or at the dosage that we require with COVID-19. And so it's really, really important for us to let the science take its course.

And we're seeing that happen right now. But we've got to make sure we wait for those results, and then we allow our medical communities to use these drugs responsibly. And so I've got a lot of hope that there is a lot of very promising potential treatments in the pipeline. But right now, the science just hasn't been clear that there is a clear treatment, a clear, quote, unquote, "cure" or even a vaccine that is safe and effective against this coronavirus.

SEANA SMITH: And, Dr. El-Sayed, it's been clear just in terms of the strain that this virus has put on our health care system over the last several weeks, in New York City, for example, there's been lots of fear just in terms of running out of potential space, running out of beds. We've seen hospitals almost construct tents outside of where they are located, just in terms of being able to hold the bodies, being able to hold more patients. What do you think this outbreak has showed us about our current health care system?

DR. ABDUL EL-SAYED: That it is generally run for profit, and that a for-profit health system just does not work when we're dealing with a global pandemic. And let me just explain why. If you look at a hospital, which is run as a business in this for-profit health care system, it gets most of its margins on elective procedures.

Of course, when you're facing a global pandemic, you cancel those elective procedures. So now we have hospitals that are both battling COVID-19 in a fight for their lives and also battling bankruptcy because they don't know how they're going to pay their bills tomorrow. Not only that, but every hospital that runs as a business is taught these, quote, unquote, "just in time" procedures in terms of contracting for its supplies.

Just in time is fine when you're trying to reduce your overhead. It's not fine when you're dealing with a global pandemic. And now we're seeing a run on personal protective equipment.

And then beyond that, the bigger moral question is whether or not it's OK that 10% of our population doesn't have health insurance at all. And then another 50% have their health care behind a paywall because their deductible is so high in the context of a global pandemic. You know, the Kaiser Family Foundation calculates tongue-in-cheek this deductible relief day.

And for folks who don't understand what a deductible is, it's the money that you have to pay out before your insurance starts to pay in to pay for your care. Deductible relief day in 2019 was May 19. Right now, we're in April. That means the majority of people who have a deductible are still busy paying it off. And that's a real problem, because people have learned to ignore symptoms like a fever and a dry cough, which by the way, are the symptoms of COVID, but also the symptoms of all of the other flus, and colds, and other diseases that people deal with this time of year.

So people have learned, you know, don't go to the hospital or don't go get care for this because, well, you're going to get hit by a bill on the back end. And that leaves people extremely vulnerable in a moment like this. And so I hope that this is a wake-up call for our country to realize that if we want a health care system that's able to rise to the challenges of a pandemic like this, then we have to rebuild it so that we have the ability to guarantee everybody health care, to guarantee access to the basic resources for our frontline staff who are battling this pandemic, and make sure that our hospitals aren't battling both a pandemic and bankruptcy at the same time.

SEANA SMITH: All right, Dr. Abdul El-Sayed, Detroit's former health director, also epidemiologist. Thanks so much for joining the show this afternoon.

DR. ABDUL EL-SAYED: Thanks for having me, Seana.