Working at the forefront of the pandemic to keep us safe, the USC pupil Dornsife answers questions about the new coronavirus disease. [7 min read]
Neil Vora is an illness detective.
Doctor and epidemiologist at the US Centers for Disease Control and Prevention, Vora’s focus is on the fight against emerging infectious diseases. Currently stationed at the New York City Department of Health and the New York City Health + Hospital Corporation, Vora is currently leading the city’s contact search effort for COVID-19.
Since the city started preparing for a widespread coronavirus outbreak in mid-January, Vora has held a variety of different roles in the Department of Health response COVID-19. Initially serving as head of clinical operations, he oversaw teams conducting laboratory tests, surveillance, healthcare system support, and communications to suppliers.
More recently, he has been asked to establish and lead the city’s contact tracking effort – a step-by-step approach that he and his team hope will allow them to quickly identify cases and implement control measures to reduce transmission.
“Our hope is that there will be a calculated reopening of New York City. Along with this, we are investigating widespread cases and tracing contacts to make sure we can prevent a huge renaissance of the virus, “says Vora, a USC Renaissance scholar who graduated from USC Dornsife with a double specialization in biology and international relations and a minor in philosophy in 2004.
“I can’t imagine doing anything more rewarding right now than helping New York City,” he said. “We’ve been hit so hard, so being able to return is such a privilege.”
Vora spent much of 2019 working on a measles outbreak in New York – the largest measles outbreak in the country since 2000, when measles was eliminated from the United States – and subsequently deployed in the Democratic Republic of Congo to assist in infection control efforts around the second largest recorded Ebola outbreak in the world. He also worked on the 2014 Ebola outbreak in Liberia and monitored the virus in New York City in 2015, a year before setting up the city’s Zika virus test coordination program.
Ironically, the last time I spoke to Vora in 2018, he told me about a trip he had made to a remote region of Nigeria where he had gone to investigate an annual festival of bats – mammals that are known to carry a series of deadly viruses, including filoviruses (the same group of viruses that includes Ebola), rabies and – as we all know too well – some coronaviruses.
At the time, Vora acknowledged that people sometimes wonder why the U.S.-based CDC worries about what’s going on in a remote region of Nigeria. His response therefore appears particularly prominent now: “Our prospect at the CDC is that a threat to health everywhere is a threat to health everywhere because an infectious disease is only up to a single plane away,” he said. “It is in the interest of the United States to build health security worldwide.”
Here, Vora answers seven questions about the coronavirus and our current answer to it.
What are some of the unexpected ways the virus behaved?
There are so many scientific questions that have not yet been answered on this new virus. In a sense, it behaves similarly to its virus cousins, such as SARS and MERS. At the same time, he also behaved surprisingly.
A striking feature is that there is a transmission of this virus before a person also shows any symptoms. This leads to public health challenges because people can be contagious before coughing or sneezing. This contributes to the spreading capacity of the virus.
We are also witnessing unusual and surprising manifestations of the virus in some cases. We need to learn how it infects the body and how it causes mortality so that we can try to save lives by ensuring that people have the right information to take the measures they need to stay safe.
Scientists infer that coronavirus was passed on from a bat to a human being. What belief, if any, do you give to those who suggest that it comes from a laboratory?
We know from many other viruses: the Marburg virus, which is related to the Ebola virus; Rabies virus; some coronaviruses – that a variety of different viruses originate in animals and particularly bats.
Bats offer many benefits to humans, so we shouldn’t defame them. But humans who interact with bats without the proper protective equipment can suffer health consequences. The way we think this coronavirus emerged is through human interactions with animals, so there may have been a spill
Neil Vora was interviewed by News 12 during an event to promote testing for COVID-19 in New York on July 8. (Photo: courtesy of Neil Vora.)
event from wildlife to humans, or perhaps from wildlife to pets for humans – this is the pattern we have seen before and the genetic sequence of the virus suggests that it is closely related to other bat coronaviruses. All of this is clear evidence that this really has an animal origin.
Where can they get reliable information on COVID-19?
Sometimes there seems to be a disinformation epidemic and this is really harmful. We see misinformation that has been deliberately spread about vaccines. We are also witnessing deliberate attempts to spread misinformation about COVID and this hinders efforts to control this virus. It is really important that people get their information from reliable sources, such as the CDC website, the World Health Organization website or the website of the health department in their city.
Are you surprised that a pandemic of this nature has emerged and what can we do to prevent future events?
Many experts would say that it is not surprising that a new respiratory virus like this has emerged. Evidence suggests that it came from an animal source. Unfortunately, even when we are done with this pandemic – and there will be an end – there will be future threats from new viruses.
We must therefore think about how to build preparation and that ability to respond, and perhaps also to think even further upstream than how to prevent epidemics in the first place.
In particular, I am referring to factors such as how humans interact with animals and the environment. Such interactions put humans in close contact with animal pathogens. In fact, about two thirds of all new infectious diseases come from animal sources. And that’s why I’m saying it’s no surprise that the virus that causes COVID has spilled from one animal to another in humans. Of course, no one could have predicted that it would be exactly this virus and would unfold as it did.
Starting to open up while the number of new cases and deaths is still high, and in some places increasing, are we risking a second wave, perhaps even more deadly?
We need to be prepared for the possibility of the virus returning in a second wave, perhaps even a third. That risk will be there until we have an effective vaccine. If people are not following strong science-based public health recommendations, there is a risk that they can become infected and spread the virus to others.
We have also seen many relapses from other health conditions, such as deteriorating mental health and chronic illnesses that are exacerbated because people have not received the care they need.
No matter how you look at it, this is a really busy time. Much of our lives have been deeply affected.
What do you think New Yorkers have done well to contain and defeat the virus?
I think the New Yorkers did an extraordinary job despite the really difficult circumstances. Our daily number of new cases has been very alarming in the months of March and April, but we have seen decreases since then. This is due to the work done by the New Yorkers together. The New Yorkers physically distanced themselves from each other, chose not to leave the house except for essential reasons and wore their covered faces. These were all basic steps to end that first wave.
Why is global cooperation so important if we are to succeed in the fight against COVID-19?
A threat to health everywhere is a threat to health everywhere. We must work together worldwide to deal with threats of infectious diseases, because viruses don’t care about nationality. Some viruses don’t even care about species. In the end, whether we are two humans in different parts of the world, or whether we are humans and bats, we are all connected on this planet. We have to remember it. “