Las Vegas epidemiologist weighs in on how long closures will last

By Kelcie Grega

Monday, March 23, 2020 | 2 a.m.

Just one week ago, coronavirus was not known to be circulating widely in Nevada, and most of the valley was still operating business as usual.

Since then, 126 cases have been confirmed in Clark County, two people have died, and Gov. Steve Sisolak ordered that all nonessential businesses close for 30 days, leaving Las Vegans wondering just how long the shutdowns will last and how far coronavirus will spread.

“If at the end of the 30 days the situation has gotten much, much worse, then obviously we'll have to extend it,” said Dr. Brian Labus of the UNLV School of Public Health. “If we get closer to 30 days and everything is better, we’ll look at how to modify it. It’s a place to start, but obviously because we don’t know how this will play out, it’s hard to say exactly how many days it will be and whether or not it will be enough.”

Some experts around the world say the virus will likely be circulating for the next year or two, and until a vaccine is developed — which could take at least 18 months — there needs to be some level of social distancing for the long haul.

Labus, who served as Southern Nevada Health District’s senior epidemiologist for 15 years, compared suppressing coronavirus to suppressing a fire — if you don’t completely put it out, it will inevitably flare back up.

“If Vegas manages to get everything under control, but one of the states around us doesn’t, it could easily restart an outbreak here,” he said. “We have to look nationally and worldwide to decide how best to keep this from flaring back up.”

That said, it’s nearly impossible to predict how the virus will progress not only in Las Vegas, but the entire country. Viruses tend to affect each region differently; the way the illness occurs in Las Vegas is going to be different than in China or Italy or even New York City.

“We have to have flexibility. There is no one size fits all because every community is different from other places in the world,” Labus said. “If you look at us compared to Italy, Italy [has an] older [population], and if you look at the governments in China and South Korea and Italy, those are all different structures of wealth.”

There is also no other pandemic of this scope to draw comparisons from except for the Spanish flu, which infected almost 27% of the world population, killing at least 50 million people, said Dr. Michael Gardner, vice dean of clinical affairs at UNLV School of Medicine.

He added that the high mortality rate of health care workers at that time is an important lesson — we need to protect the individuals on the front lines, making sure they receive priority on medical supplies and care because they are our first line of defense.

Even with those lessons, the Spanish flu happened more than 100 years ago, before doctors even knew what viruses were, Labus said.

“They couldn’t do the testing that we could do now,” he added. “The world was also connected differently so you could actually watch the virus in 1918 move across the country from city to city over the course of a couple weeks. Here, with a well-connected population around the world, it spreads very differently.”

It’s also still not clear how immunity works once someone does recover from COVID-19.

“Usually at the very least, you get several months of protection after an illness because if your immune system didn’t work at all, you would never recover,” Labus said. “The problem is right now we don’t know if recovery will provide long-term immunity or not.”

Working with these unknowns is part of the territory when you study viruses, Labus said, and the most honest answer he can give to questions related COVID-19 is “I don’t know.”

No matter how unprecedented, it’s unfortunately something that doesn’t surprise those in the epidemiology field.

“We always knew it was a remote possibility, but it was still in the realm of things that could happen,” Labus said.

In preparation for such an event, Southern Nevada Health District ran pandemic drills in the past that included what to do if the city is quarantined and how to get ventilators from the Centers for Disease Control and Prevention’s Strategic National Stockpile, but having to live this scenario is a completely different story.

"You can't fully practice something like this ... but we've worked through things to see what gaps are there in the system to fill them," Labus said.

The most important thing people can do right now is listen to the governor and "Stay home for Nevada."

“We’ve canceled all these events, we’ve told people to work from home, but if you look at the streets, there are still lots of people going about their day-to-day lives,” Labus said. “It’s important to look at these things as not just a risk to yourselves, but a risk to the community.”