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'We can’t predict the future, but we can take our best shot at it': Q&A with 'Colorado's Dr. Fauci'

One local doctor earned a nickname after helping create the models that leaders like Governor Polis are using to make big decisions - like reopening the state.

DENVER — The man Gov. Jared Polis referred to as "Colorado's Dr. Fauci" said the COVID-19 model he helped create shows a spike in cases in late July, but one that is more manageable due to prior social distancing measures put into place.

"I think that it could be bigger than what we just saw, but coming more slowly because of the management," said Dr. Jonathan Samet, dean of the University of Colorado Anschutz Medical Campus' Colorado School of Public Health.

Polis discussed the modeling work Samet and his team are working on at a Monday news conference, where he also outlined the state's transition from a stay-at-home order to a safer-at-home order.

That transition is set to occur April 27, after which some nonessential businesses will reopen with strict precautions in place. It's based on models that show the impact social distancing has on curbing the spread of the novel coronavirus, COVID-19.

RELATED: Colorado moving to 'safer-at-home' status; here's what we know so far

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"The modeling work is incredibly important," Polis said in the Monday update. "It's informing all of the decisions that we're making in state and county health departments."

Samet sat down with 9NEWS to explain the models and to answer questions about why — while the state is lifting the stay-at-home order next week — social distancing will affect our lives for months to come. 

Editor's note: Responses have been edited for context and clarity.

9NEWS: How did you become involved in creating the models that are guiding decision making in Colorado?  

Samet: I came to this job by way of a longtime interest in public health and epidemiology. My clinical background is actually internal medicine and pulmonary disease, although I left that clinical part of my life quite some time ago. I went into doing full-time public health because I was interested in having as broad an impact as possible.

Credit: KUSA
Dr. Jonathan Samet explains the all-important models that are guiding the state in coronavirus times.

The modeling began with recognition that there was a need for a group to do work that could guide the state as it made some really challenging decisions. I was able to identify a very talented group across the Anschutz campus from the Colorado School of Public Health, University of Colorado Boulder and Colorado State University.

That team has been working very hard to produce results that we hope will guide decision making in Colorado. We’ve been at this for a very busy month.  

What has the work looked like over the last month and how is it changing? 

Samet: When we got started, we were really worried about how high the peak [in cases] would go, how fast it would get there, and how to keep the peak at a level that would not overwhelm the state's healthcare system.

We were trying to avoid becoming the place that did not have enough ventilators for people. We succeeded.

That was of course achieved with the measures implemented like the stay-at-home order throughout March. Within the last week, we began to see the first signs that all the changes we've been making in our lives have had an impact. We see that indication that the curve is bending. Case numbers are going down.

As the month continued, we then began to say, 'What are we seeing for the downturn? When are we going to see it? How do we keep that curve trending down?'

Now, with this month ending, we’re turning our work toward future scenarios for what we can anticipate as social distancing measures are reduced. 

The new model you created shows the impact social distancing can have on the number of future cases. Why is this model so important? 

Samet: Of course, we can’t predict the future, but we can take our best shot at it, which is what the models do. You’re referring to a plot that shows how the case curve will look over the next months running into the fall. 

The important message from that curve is we have to do everything we can. We don’t have to socially distance as much as we are now if we have successful case identification and isolation, if we are using masks well, and if we ask those who are more vulnerable to continue to protect themselves as much as they can.

Those are about to be individual choices and decisions. The right one — to protect yourself and your family — is to stay distanced. 

Credit: KUSA
The line is the 2,000 ICU beds available in the state. Our goal is to stay below that line.

Do you believe that a 20% difference in social distancing could make that significant of an impact on how many new cases arise?  

Samet: Again, models are just representations of how we think the world works. But the models are quite clear that there is a level of social distancing that we have to maintain to keep our healthcare system from being overwhelmed.

Just look at the difference between 45%, 55% and 65%. It’s a striking difference in the height of the peaks. I think the message is quite clear, in fact.

What’s the difference between 65% social distancing and 45% in practical terms? Will we feel freer? 

Samet: I think some of us will feel the difference. But the populations who are vulnerable need to protect themselves. They may not feel the difference as much. If you look at Colorado, the figures are clear — most of the deaths are in people over 60 years of age. So there are groups who will need to follow the governor’s 'safe-at-home' guidance more strictly.

If social distancing decreases significantly, even to 45% from the 75% the state is at now, there would likely be a resurgence of COVID-19 cases as early as June.

Even in a best case scenario, the model shows a second wave of cases somewhere around late July. How would that predicted wave compare to the wave we just experienced? 

Samet: I think that it could be bigger than what we just saw but coming more slowly because of the management. So perhaps the number of people affected is the same or larger, but it would be in a fashion that doesn't peak quite so quickly, making it more manageable.

The model assumes there is also expanded testing in the state. What happens to the curve if you take the increased testing out of the equation?

Samet: Not surprisingly — it would come quicker and go higher.

The model goes all the way out to November. Is it fair to say that we’ll see a disruption of life for several months to come?

Samet: I'm afraid I’m going to have to agree with that...yes. That's because we’re still mostly not immune to the virus. 

So, what did the social distancing do? It protected us from becoming infected. But we’re nowhere near the point of so-called ‘herd immunity,’ which means enough of us have been infected so that the virus can’t propagate itself. And we don’t have a vaccine. 

That leads us to advise keeping a sustainable amount of social distancing for some time to keep us all protected.

Is tourism possible while maintaining 65% social distancing in the state?

Samet: Great question. I can’t give you a clear answer, but I think the way we would have to do it is one that maintains social distancing. What that means is it would be a different form of tourism. People could not come here and sit in crowded bars and restaurants, for example.

But in the summer, we can certainly go out and enjoy Colorado’s outdoors without having to be close to one another. So, I think some kinds of tourism can work.

Do you agree with the decision to end the stay-at-home order in Colorado on April 27?

Samet: I think we have to start at some point moving forward. 

I think the timing now is reasonable. I think the models would say now versus two weeks from now, versus four weeks from now — it’s probably not going to have a very large difference.

We know that changing the way we live on April 27 — it’ll take awhile for us to understand the consequence. We have to watch very, very carefully.

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