‘The Pandemic Will End’

This is the final installment of our Q&A with President Biden COVID Task Force advisor, UCSF's Dr. Eric Goosby.

Synapse: And finally, the question that probably everybody wants to know the answer to: Do you think this pandemic will ever end? And if so, how do you think it will end?

Dr. Goosby: I do think that it will end.

The rate of mutation with the number of cases that we have in the United States is at its highest point ever. If the cases were lower, there would be fewer mutations occurring spontaneously.

Way up here with the cases, we are continuing to churn mutants. That’s what viruses do. They’re constantly looking for an advantage in an environmental difference or in a change in the way that they enter and metabolize within the environment — something that gives them a reproductive advantage.

Either they can attach more efficiently to cells that they infect, or they don’t kill the cells they infect, they live in them longer, and propagate better.

Or when they are released as little baby viruses, they have some trophic advantage to other cells in the body that again gives them a survival advantage.

That is going on with every virus every time it divides. It divides every six hours, so four times a day, you’re having each population go through F1, F2, F3, F4, giving you each time an opportunity to create a new mutation that may or may not have an advantage to the virus.

The other mutative gradient that could occur is that they become less virulent. They don’t attach as well.

And they mutate themselves out of a threat. That’s what happened to H1N1 in 2009. That’s what happened to SARS in 2003.

We don’t know how to predict which way it’ll go, and it could go that way today, you know, in the mutation that occurs. So that’s always a possibility — that we can favor a strain that is less infective to humans, and that dominates in the United States.

It has to have some advantage, but maybe not an infectivity advantage. So that’s the other thought.

Singapore and Hong Kong jumped on it and contained it, and they also demonstrated that they’ve been able to maintain it. So, we have models.

We are not in the place where we can fully realize the power of contact tracing in containing an outbreak, but we’ll get back to that as the total numbers drop.

A sincere thank you and heartfelt appreciation to Dr. Goosby for sharing his thoughts on the COVID-19 advisory board and coronavirus pandemic.