Dr. Stefano M. Bertozzi ’77, M.D., Ph.D., is dean emeritus and professor of health policy and management at the UC Berkeley School of Public Health. Previously, he directed the HIV and tuberculosis programs at the Bill and Melinda Gates Foundation and was director of the WHO Global Program on AIDS.
Many thanks to Dr. Bertozzi for sharing his perspective and insights about the current pandemic and his opinions about the path forward.
Did the world’s approach to AIDS in any way inform the way we’re approaching COVID-19?
The U.S. led the global response to HIV—from here (CDC, USAID, NIH, US military...) and from WHO (the first three leaders were Americans and Peter Piot trained here). However, we are now at the back of the pack. We have the worst epidemic now. We have managed this worse than all of our peers. We had our first case at the same time South Korea did. If our response had been as effective as theirs has been, 60,000 more Americans would be alive today. We still have problems with access to testing. We have not ramped up a contact tracing/isolation/quarantine system. It is sad to see how much worse we have done than countries with far fewer resources—human and financial. That said, the world was better prepared thanks to HIV—and perhaps even more so thanks to SARS.
For you, what are the most puzzling variables about COVID-19?
In terms of the data, there are still lots of unknowns. We understand poorly how lethal this virus is. This is mostly because there is inadequate information about how many people who have mild disease or are asymptomatic are actually infected with the virus.
What do you think are the criteria that should guide the U.S. in determining when it is safe to reopen?
We need to have the infrastructure to quickly identify (test) and isolate new infections and quarantine their contacts—I describe it as effective whack-a-mole. If you can shut down mini outbreaks then the rest of society can operate more normally. However "more" is the operative word. I don't think that we'll be going to concerts until we have a highly effective treatment or vaccine—or a very long time passes and most people have been infected.
If you could be successful in developing one innovation that addresses the COVID-19 crisis, what would it address?
In the near term, an effective treatment, ideally a small molecule that can be massively scaled up very quickly. In the medium-term, an effective vaccine. In the longer-term a strengthened national and global infrastructure to handle the next epidemic so that this doesn't happen again the next time a virus jumps from an animal to human.