Transcript

 

Derek Smith:

Hello and welcome to Baylor Connections, a conversation series with the people shaping our future. Each week, we go in depth with Baylor leaders, professors, and more, discussing important topics in higher education, research and student life. I'm Derek Smith and our guest today is Dr. Peter Hotez. It's a special interview on the program today is Dr. Peter Hotez, Dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston and co-director of the center for vaccine development at Texas Children's Hospital is interviewed by Dr. Lee Nordt, Dean of the college of arts and sciences at Baylor. Dr. Hotez is an international expert in tropical diseases, vaccine development and more, and he has a special relationship with Baylor, which you'll learn as Dean Lee Nordt visits with Dr. Peter Hotez on Baylor Connections.

Lee Nordt:

Thank you, Dr. Hotez, Peter, for taking time from your busy schedule to join us virtually at the campus of Baylor University in Waco, Texas. I say busy schedule Dr. Hotez because you have been a regular on national cable and news TV networks for the past couple of months, participating on panels related to the COVID-19 pandemic. In addition to what some of your listeners have been hearing from you on those venues, in this podcast, I would like to also explore a little bit more about you and your work, and maybe as a bit more of an introduction to our listeners, Dr. Hotez is an MD PhD, the Dean of the School of Tropical Medicine at Baylor College of Medicine where he serves as the co chair of the COVID-19 task force. He holds many positions there related to pediatrics and neurology. And what some of you, our listeners may not know is that Dr. Hotez is also a faculty member at Baylor University as a university professor where he holds a joint appointment in the department of biology and the college of arts and sciences. So my first question for you, Dr. Hotez, and some of our listeners may not know about you is that you are passionate about undergraduate education and particularly related to Baylor undergraduate students. And this kind of runs counter to the stereotype that a lot of people have about scientists working in a secluded research lab not wanting to be bothered. Where does this passion come from regarding undergraduate education and in particularly Baylor students?

Peter Hotez:

Well, thanks Dean Nordt, Lee, one of the first things that we did when we came down to Texas and Houston and the Texas Medical Center and Baylor College of Medicine is look around and say hey, where all the undergraduates? And what was really interesting is shortly after we arrived, we started getting emails from some of the Baylor university undergraduates had heard about arrival. They were doing a lot of work abroad in some cases part of their Christian mission work, but a huge amount of interest in global health because they were doing projects, Baylor projects in Tanzania, in Asia, all across Latin America, of course, central America, South America. So we were just very touched by their enthusiasm and we started having one off contacts and finally he got in touch with Rich Sanker and you, Lee, at Baylor University, and we've hit the ground running in terms of building out undergraduate programs. We built out a summer tropical disease Institute for the Baylor university undergraduate spring 2025 Baylor University undergrads to our National School of Tropical Medicine every summer every summer and our faculty really look forward to that. And I love visiting the Waco campus. There's something, I know I don't have to explain this to you, but we just felt that there was something unique about the Baylor University undergraduates, not only being smart and capable, like a lot of undergraduates are at different institutions, but this passion to do good, this passion to fix the world. That was something that really resonated with us. And so we try to work with Baylor University undergraduates every chance we get either bringing them into our laboratories, providing career advice, coming to Waco to teach. It's been something really special and for us, one of the best parts of moving to Texas.

Lee Nordt:

Well, the feeling is mutual, that is for sure. And the internship program in particular has been of great benefit to our undergraduate students and the experiences that they received there. Maybe extending a little bit on that topic, You've always had a passion for helping the underprivileged, especially children and in developing countries, which is probably why in part you went into pediatrics. But I'm just curious from a personal standpoint, where did that passion come from?

Peter Hotez:

Well, ever since I was a young person, ever since I was an adolescent, I actually had this passion for studying parasitic disease, tropical diseases. And I was an undergraduate at Yale working in a lab on molecular parasitology, which was then a new science and wanted to do an MD and PhD and went to Rockefeller University and Cornell. And that's where I became really enamored with the idea of making vaccines for parasitic diseases with the dream of running my own lab and becoming a professor working on parasitic disease vaccines. And I still do that. And partnered with me for the last 20 years is Dr. Maria Elena Bottazzi, my science partner for the last 20 years who is also a Baylor University professor. And that's been fabulous and we now have new vaccines moving into the clinic or in the clinic for schistosomiasis and hookworm and Chagas disease. But then the other piece that I did not anticipate was really having a big role in public engagement and explaining science to public audiences. And I just somehow found the voice and just have this ability to explain complicated concepts to audiences without a science background. So that's been really exciting and I feel really privileged to be able to do this since we've had COVID-19 because one of the things that we began a decade ago was a project on coronavirus vaccines, even though we're not virologists, because we've been adept at scaling up production of parasitic disease vaccines. And then about a decade ago, we began a coronavirus vaccine program. Not because we're virologists, but we had began partnering with this outstanding group at the New York Blood Center. They had a great concept for making effective and safe coronavirus vaccines, and they were orphaned because nobody cared about coronaviruses back then. So we began scaling this up and now we have developed vaccines for SARS and Mayors and now moving towards COVID-19. And then of course, beginning in January, people suddenly became interested in coronavirus vaccines again.

Lee Nordt:

So along those lines, one of your frustrations has been conducting research for the discovery of therapeutics or vaccines for active childhood diseases, particularly in developing countries. And so this has slowed your progress I think, maybe even for finding a vaccine for the coronavirus, something that you were working on I know as recently as a couple of years ago. Exactly what is the challenge in research or maybe getting resources for these particular diseases and for these areas?

Peter Hotez:

Well, the problem of course is we're making vaccines that the big pharmaceutical companies won't make or can't make, because they're typically for diseases of the world's poorest people, diseases such as hookworm and schistosomiasis and Chagas disease. And so we're always struggling to find resources to develop our vaccines. And this is one of the reasons why we're so grateful to be at Texas Children's at Baylor College of Medicine, as well as Baylor University because we get a lot of support to help us and fill the gaps where the grants don't. Because it's hard to do it entirely on typical NIH grants. So we get a lot of private philanthropic. And for the COVID-19 vaccine, that one was supported by the national institutes of health. And that's been really a blessing and now we've got one of our vaccines ready to move into clinical trials.

Lee Nordt:

Oh, that's great. I'm curious, this is a very complicated matter. I'm curious and I'm sure our listeners are too, about how you think this might play out in the short and longer term with the current pandemic. Not an entirely fair question, it's very complicated. How do you see this at least maybe big picture, a pandemic like this playing out?

Peter Hotez:

Well, you know, there's a few things that are happening. One of the things that's really heartbreaking for us is as bad as things are in the United States it's now moving into South America in a big way and it's devastating Brazil. So I think the number of deaths in Brazil could easily exceed those in the United States. And it's not just Brazil, we're seeing this potentially in Bolivia and other South American countries. I'm worried about Venezuela, where there's been this depleted healthcare infrastructure. And then in the United States, I think it hasn't gone away. We've been really good about social distancing here in Texas, way ahead of things when we saw how bad things are in New York city, we looked at this and said, we don't want that to happen here in the state of Texas. So we enacted a very aggressive social distancing program. And we did it just in time because we know the extent of your epidemic relates to how long transmission goes on before you interrupt it. So it probably went on for at least six weeks before it was halted in New York through social distancing. So we did it much sooner here in Texas and avoided all the devastation that we saw with all the patients in the intensive care units. Problem now is we have the models coming out of Seattle, you've heard about Institute for Health metrics and evaluation model and the models out of Philadelphia say we should have kept that social distancing going on until the middle of June and nobody was prepared to do that. So we are opening up faster, because if we had waited until June, you could have gone back to then what's called containment mode that is prevented, gone back to one new case per million residents per day. And we know that the existing public health infrastructure can manage that. But in the case of we haven't done that, and so now we're starting to see an uptick in the number of cases. And we don't know what's going to happen. I mean, some of the models coming out of the University of Pennsylvania show a pretty steep rod as we advance later in the summer. So I am concerned about that. So it's really going to be important to implement a proper public health system that's commensurate with efforts to open up the economy in order to ensure that we can sustain that economic development.

Lee Nordt:

Yeah, on the vaccine front, there's a lot of difference of opinion on timeline across which one might be developed. I don't know what your thoughts are on that. I mean, they range anywhere from when it's working together collectively a remarkably quick timeline to some taking what they think is a more realistic approach of years.

Peter Hotez:

Yeah. Lee, there's a lot of misinformation out there. And unfortunately there's not been a good communication strategy coming out of the White House, at least not yet. And I've been making that strong recommendation that we need to communicate better. But what's clear is that the first vaccines, they're not going to enter phase three trials until later this summer, maybe in July. And there's going to be several others after that. Hopefully ours will be one of them, but it'll take a year in those phase three clinical trials to collect enough information from patients both for safety and efficacy before anybody would feel comfortable licensing a vaccine. So despite what you're hearing and all the bluster, we're probably looking at the third quarter of 2021 at the earliest before some of these vaccines roll out. And even that would be a world land speed record. That would be the fastest anyone's ever done it. But you know, what's happening is you've got the bio techs and the pharma companies sending press releases to their shareholders, saying vaccine within weeks or months, that's not going to happen. And this operation speed Star Trek metaphors are not helpful either. But the reality is these vaccines will be adequately tested for both safety and efficacy and there may be a couple of dozen vaccines tested before it's all over. And you need that, I mean, the actual technical feat of making a COVID-19 vaccine is not complicated. It involves making an immune response to the spike protein of the virus, and you've seen what the virus looks like with those spikes emanating out of it and that's what docks with the host tissues. You make a type of antibody response and those neutralizing antibodies you'll make a coronavirus vaccine. It's kind of an old school problem in virus and virus vaccines. So I'm pretty confident we will have one. Exactly which technology is the best to do it remains to be seen. We're doing it through recombinant protein approach. Others are using DNA or RNA vaccines. There's rVSV-vectored vaccines. But we'll know over the course of the next one to two years which ones are the best to which ones can roll out. So the key is trying to find a way to maintain the nation's economy and health infrastructure over this period. And also recognizing that a vaccine itself is not a panacea, that in the sense that many of the first vaccines that roll out may even be partially protective. So it's not as if you're going to see the vaccine released and solves all your problems and you can go back to normal again. We'll still have to maintain, a vaccine is more likely, at least the first ones may be partially protective, and that may be why we're going to probably have to continue. It's not going to replace all the existing healthcare infrastructure we're putting in place. It will be used as a companion technology.

Lee Nordt:

Okay. Very good. Let me ask a broader question. We have a large number of journalism, communication majors, public relations majors. What is the one thing about the current pandemic that is not being reported enough or not being reported accurately by the media? Now you may have touched on some of this, but it was a nice segue.

Peter Hotez:

Well, the media has been so ubiquitous now. You can't turn on any of the cable news channels without hearing COVID-19 24 seven these days. So there's a lot of information. I think the important pieces of this that need to be better understood is that we've just experienced an initial wave of the infection, but we're not out of this. We were able to enact social distancing and you've heard this term flatten the curve, so we reduced the big surge on the intensive care units and the hospital beds, but the virus is still with us. And as we relax social distancing, the number of cases will go up. And I think that the piece that needs to be better articulated is this is the time now to really expand our public health infrastructure, meaning to expand our testing capabilities, our contact tracing, and expand the number of people hired for contact tracing. I think the other big thing that we're not really hearing about is this concept of syndromic surveillance, because the testing is still relatively modest, especially here in Texas, that doesn't rank high as States go nationally. And syndromic surveillance is a system where you can detect local areas of people, significant numbers of people getting fever and cough and respiratory symptoms, which this time of year, more likely than not would be due to COVID-19 more than anything else. And there are different ways to do this through an app based system. And there are several out there from Kinsa, which is a West coast from KMSA, there's Google, there's Apple, and I've been pushing hard to get all the great engineers that we have in the state of Texas, State of Texas has some of the finest engineers in the country, getting those together to really plan out a system of syndromic surveillance tied to an alert system so we can know if there are areas that are unsafe to be out and about. And I think that would be a good way to manage our way through the epidemic. And also getting local models. We don't have very granular epidemiologic models to chart a roadmap for most of our cities in Texas. We have one in Dallas that came out of UT Southwestern. We have one in Austin that came out of the University of Texas, Austin. I doubt very much we have anything for Waco, we don't even have anything for Houston, really. So I think those are the two things that I've been pushing hard, that syndromic surveillance technology, which I think would be really helpful and getting more granular maps so we know where this thing is going.

Lee Nordt:

Okay. Maybe the silver lining down the road, we will have a better, hopefully, public health system. We're getting a little close on time here, but I want to ask you one more question here on vaccines. I heard you in one of your television appearances that even if vaccine is developed, because of the anti-vaccine movement that's spreading your costs across the country, there are a lot of people that will not take the vaccine anyway. And along those lines, you published a book a couple of years ago, Vaccines Did Not Cause Rachel's Autism. Who is Rachel and what does she have to do with the anti-vaccine movement and how that might relate to the current pandemic?

Peter Hotez:

Well, when you hear so many Americans clamoring for a COVID-19 vaccine, you'd think if there was ever a time when the anti-vaccine movement will go into retreat or in hiding, this would be the time. But unfortunately, some things have happened to actually reenergize it. One of the things that if you look at the central tenants of the anti-vaccine movement, one, they claim vaccines cause autism. Second, they claim vaccines are not safe, they're rushed. Or there's this cozy relationship between the pharma companies and the US government. And rightly I spent a lot of time diffusing the autism arguments, and they've come to Baylor University in Waco a couple of times to give talks to the students about that and wrote this book about my daughter, because I'm a vaccine scientist and the parent of an adult daughter with Autism, called vaccines do not cause autism. And then the other pieces I try to fold into that explaining why they're adequately tested for safety, why we don't have to worry about cozy relationships between pharma and the government, et cetera. But then the White House comes out with this science fiction term, operational warp speed. It plays right into the hands of the anti-vaccine movement. And then the pharma company started putting out these irresponsible press releases, we'll have a vaccine weeks and months when they know it's not true. And then now we're hearing about conflicts of interest between some of the companies and that that's been going on. So this thing has really re energized the anti-vaccine movement in a big way. And Reuters came out with a survey a week or two ago showing that around 25% of Americans would not take a COVID-19 vaccine, even if it were made available. And then the Associated Press, the AP, just came out saying half of Americans won't take the COVID-19 vaccine. To the point where we want a vaccine to do to things. One, we want to prevent people from getting sick and going to the hospital or into ICU's, to mitigate against disease. But also you want to induce a certain amount of herd immunity so that the whole community gets protected to the point where we could stop transmission, which is one of the ways the Measles vaccine works. But now we're working with a group at city university of New York, a modeling group, to actually show that enough Americans may choose not to get vaccinated where we won't achieve our second goal of herd immunity. And that would be really tragic. And this is one of the reasons why it's so important to work with universities like Baylor University, where you have schools that go beyond the biomedical model, schools of law and business and social sciences, the medical humanities program, these kinds of things are so important because we now realize that just making a piece of technology, a vaccine, is important, but that's not going to solve it on their own. We're going to need to bring in social scientists and people from medical humanities, anthropology, sociology, psychology. Otherwise, these problems have become so complex and touch all aspects of the society. These are why we needs colleges of arts and sciences, Lee.

Lee Nordt:

Okay. Thank you. Maybe in closing, let me ask you one more question. Most universities, including Baylor University, is aiming to return to campus this Fall. What advice would you give us in our return, safely returning to campus during a pandemic? And I know it's complicated so maybe one or two words about that.

Peter Hotez:

Well, it is complicated and we're now going to start this interesting dialogue between Baylor College of Medicine and Baylor University to see how we can be helpful because our group is developing vaccines, but we now at Baylor College of Medicine have ramped up a lot of diagnostic testing capability. So how can we use that to help in a very practical way at a university like Baylor University, whether it's through the testing, the contact tracing and syndromic surveillance. Can BCM help BU in a very substantial way to address this? We don't have the answers yet, but it's something now that's being discussed at a very high level with your provost and university president. And I think Baylor University can do it better than most places. And I have a good feeling that the students, we can do this in a way to give the students a lot of comfort, knowing that they're being taken care of and they'll be safe in the fall semester.

Lee Nordt:

Well, Dr. Hotez, we really appreciate your time and we definitely want to continue that strong relationship between you and Baylor University. And so again, thank you very much for your time on this edition of Baylor Connections.

Peter Hotez:

Well, thank you so much, Lee, and again, so grateful for all you've done for us and our link with the college of arts and sciences at Baylor University, really all of Baylor University has been very special and important to us. And quite honestly, we don't think we would be nearly as successful in very important things that we're doing like developing COVID-19 vaccines if it weren't for our association with BU.

Derek Smith:

That is Dr. Peter Hotez, Dean of the National School of Tropical Medicine at Baylor College of Medicine and university professor at Baylor University being interviewed today by Dean Lee Nordt, Dean of the college of arts and sciences at Baylor. Thanks so much to Dr. Hotez and Dr. Nordt, and thanks for joining us today on Baylor Connections. I'm Derek Smith reminding you that you can hear this and other programs online, baylor.edu/connections.