COVID-19: An Epidemiologist's View

Special Guests: Dr. Jodie Guest, Phil Smith, Bob Bixby

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On the latest Facing the Future, I was joined by Dr. Jodie Guest, a research professor and epidemiologist at Emory University, Concord Coalition National Field Director Phil Smith and Concord’s Executive Director, Bob Bixby. We discussed COVID-19 data, trends, testing, vaccines and more, as well as the TRUST Act.


[Note: Portions of this week’s Facing the Future can be seen in the video clips posted below.]

Dr. Guest shared the data and trends she is seeing in Georgia and across the country relative to COVID-19.

“Georgia is full-on in our first wave of COVID-19,” she said. “58 percent of the cases in Georgia have occurred in the last four weeks; that is a staggering increase of cases in a very short period of time.”

She also broke down why Georgia is just now experiencing its first wave, while other states have plateaued, decreased or even entered a second wave.

“The United States is 50 different states that are all experiencing 50 different epidemics, and even within each state, there are different outbreaks going on,” said Dr. Guest. “Georgia was later to the game to start, most of the southern states were; so, we’re a little behind timeline-wise.”

There are key statistics that are being tracked during the pandemic, and Dr. Guest looks at all of them.

“You learn different things from each one of them,” she said. “One of the most important and least discussed is the positivity rate of tests.”

She said that testing has not ramped up as quickly as desired and testing has been different in different states.

“In most states, it’s still not the level we would like, but what we want are increasing test numbers with decreasing positive tests,” she said. “You want that positivity rate going down and you want it below four or five percent.”

Dr. Guest added that rates in Georgia and across the country are far above those figures and they vary widely. Many states have positivity rates well in excess of 15 percent and exponential growth in COVID-19 cases.

And there have been some barriers that have slowed down rapid expansion of COVID-19 testing.

“At first it was availability of tests; that was our first stumbling block,” she said. “Additional burdens I have seen … access to insurance, Social Security numbers being required … testing events may not be accessible if you don’t have a car … they need to be during hours that are not work hours, and they typically are during work hours.”

Dr. Guest indicated that the precautions being taken now for COVID-19, such as social distancing and mask wearing, could not only reduce the likelihood of a large second wave but also reduce the impact of cold and flu season.

“The three measures that we are pretty confident will contain a lot of the spread of COVID-19 … are to mask when you are inside and not socially distanced … to wash your hands … and then to be socially distant,” she said. “It’s hard to stay home; there’s no way around that.”

On how we are fairing relative to other nations during the pandemic, Dr. Guest said the U.S. is disproportionately carrying the burden of the disease and identified the country’s state and national infrastructure, response time and culture as significant factors.

“We are 4.2 percent of the world population, and we are currently 27 percent of the cases of COVID-19,” she said.

A large focus has been put on developing a vaccine as quickly as possible to help put COVID-19 behind us, and Dr. Guest said that although “fast-tracking” development can have a negative perception and sound dangerous, that is not the case.

“What fast-tracking a vaccine means is you’re preparing for the next phase before you’ve started the one before,” she said. “So, when you’re starting phase 2, you’re preparing for phase 3 and that means putting infrastructure and economic support in place.”

“You’re moving faster through the setup, but you’re not moving faster through the testing,” Dr. Guest added. “We also didn’t start from scratch.”


Bixby joined the conversation to discuss a proposed plan, included as part of the latest pandemic relief package introduced in the U.S. Senate, called the TRUST Act. .

“The TRUST Act is designed to shore up certain failing trust funds, most notably Social Security … the Medicare Part A trust fund and the highway trust fund,” Bixy said. “The idea was to setup a process to deal with saving these trust funds, and the mechanism chosen is to setup Congressional committees … these are actual lawmakers that can write the laws to implement these plans.”

The bipartisan committees for each trust fund would be required to have a majority supporting a particular reform plan, so long as that majority includes at least two members from each party. But the process outlined in the Act does not prescribe a particular reform path or result. The committees are able to advance on their own to address the sustainability of each qualifying trust fund, but a drawback to such a setup is that policymakers will have to reconcile any plans to ensure they are not competing with each other for the same revenue sources.

“This is not some sort of panacea,” Bixby said. “But it’s a very reasonable proposal … and a good opportunity to enhance the fiscal stability of programs that all Americans like, rely on and have an uncertain fiscal future.”


Hear more on Facing the Future. I host the program each week on WKXL, (N.H.), and it is also available via podcast. Join me and my guests as we discuss issues relating to national fiscal policy with budget experts, industry leaders and elected officials. Past broadcasts are available here. You can subscribe to the podcast on Spotify, iTunes, Google Play Music or with an RSS feed. Follow Facing the Future on Facebook and watch videos from past episodes on The Concord Coalition YouTube channel.

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