With the coronavirus outbreak, vaccine researcher Peter Hotez’s gift for explaining science to the general public has made him a familiar bow-tied presence on the national news.

His lab is developing a COVID-19 vaccine . An M.D. and Ph.D., he’s a professor and dean of the National School of Tropical Medicine at Baylor College of Medicine, and co-director of the Texas Children’s Hospital Center for Vaccine Development.

Since early March — before community spread was discovered in Houston — he’s talked with us about the virus, the effect it could have on the U.S. and Houston, and about his own life in these strange times.

This week, from his home office, he discussed what COVID-19’s explosive growth in New Orleans might mean for Houston; his own highs and lows; and his lab’s continuing struggle to pay for research on a coronavirus vaccine.

You’ve been worried about New Orleans. Judging from the numbers we're seeing coming out of Louisiana, it’s possible that their hospital system could melt down. What are you thinking?

I'm thinking that things have not gone well in New York. We're seeing hospital systems being overrun. We're hearing stories of 500 or more coded patients coming into Columbia, Presbyterian, New York Hospital, the big flagship teaching hospitals, daily. And we're hearing Gov. Andrew Cuomo telling us that they just cannot manage the surge. There are too many ICU patients for them to manage. This is the nightmare scenario that we all worried about.

Then you have the healthcare workers getting sick, so they're getting taken off the workforce. Many of them are my former medical students, so I'm very upset and very worried about what's going on in New York.

Now the question is, is New York a one-off thing, or do we now expect this to pop up in other cities? This week, we started seeing a big sharp uptick in Louisiana, and when I look at the map, most of the cases are in New Orleans or New Orleans and their suburbs. So I'm concerned that New Orleans may be one of the next dominoes to fall.

We also heard from the mayor of Atlanta that their ICUs are filling up. So I'm wondering if the epidemic is taking a Southern twist or a Southern turn.

Are there other problems with cities like New Orleans that could make things worse — like poverty?

I’ve spent my life working on interventions — vaccines — for poverty-related diseases. There is a depth and breadth of poverty on the Gulf Coast that I'd never seen before I moved from Connecticut to Houston. The people are wonderful, but it is heartbreaking to see the severity of poverty here.

The question is, is that the population that's getting affected by COVID-19? Now, why would I think that? One of the reasons New York is getting hit so hard is because of extreme population density. And what you see among the poor, in places like New Orleans and Atlanta, is they also live in areas of extreme population density, so practicing social distancing is problematic.

I'm worried that that in the South, COVID-19 is taking a different turn or twist, that it's predominantly affecting underrepresented minorities, especially African-Americans living in extreme poverty.

Do I have evidence for that? No, I mean, all I have to go on are the observations I've just been making, together with some of the news reports I'm seeing. But I think this is something that we need to get our arms around very quickly.

How do you do that? Well, it would be nice if we could get the locations of COVID-19 cases by ZIP code, because we have detailed demographics of the economic levels by ZIP code.

We've heard that COVID-19 is more deadly when it's combined with underlying conditions. Is that a lot more likely with people who are living in poverty?

Absolutely. And especially African Americans living in poverty. We know that they suffer from higher rates of hypertension, heart disease, diabetes — all the known risk factors for COVID-19. So I worry this is a toxic mix. I think this is going to be an important new dimension to look at.

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What sorts of effects do you think an outbreak in New Orleans would have on Houston?

Since Katrina hit in New Orleans, the cities have been linked to the hip. We root for each other: If the Texans aren't advancing to the Super Bowl, I'm rooting for the Saints. If you've ever taken that Megabus between New Orleans and Houston, you know that everybody's got family in the other place.

That affection and love between the two cities is great, but it also means that if you have all those individuals leaving New Orleans coming to Houston, there's the potential to spread COVID-19 into our community. That’s one reason why we've implemented pretty severe social distancing measures. That may help us a lot.

We've been hearing a lot about the shortage of equipment such as ventilators. If there are outbreaks simultaneously in multiple cities, does that mean that we can't move those ventilators around?

Until these last few weeks, I never even gave thought to the fact that ventilators could move around. This is a new idea. It’s being discussed with New York City right now: The governor of New York, Andrew Cuomo says he needs 30,000 ventilators, and he's only getting 400. So would other cities be willing to share? We may have look at some type of rationing.

The other thing that I'm worried about is, if it's building up in New Orleans and building up in Atlanta, is Houston the next shoe to drop or the next domino to fall? I don't know. I think there's a real possibility.

We're blessed with the greatest medical center in the world: Texas Medical Center, where I work. The leaders of the TMC have been meeting on a regular basis, having those discussions daily.

But I'm not seeing any data or information on what the plan is in terms of surge capacity, or at what point do we have to build new infrastructure, building a tent city or some type or something along those lines, or bringing in the Army Corps of Engineers?

Hopefully, we'll never get to that point. We don’t know.

But we've been pretty aggressive with social distancing. Is that having an impact? That's question one.

Question two: We know coronaviruses and other respiratory viruses often have a seasonal nature to them. So now the weather's warmed up. It's more humid. Might we get a reprieve? Maybe we dodge that bullet because of the warmer weather. We don’t know that for certain, but it will be interesting to see in the coming weeks what happens.

We've been hearing a lot about the difficulties of density in New York. Houston and Atlanta are both more sprawling cities. Can we expect lower rates of spread?

Yeah, that's a huge question. I think it's not a coincidence that this disease is in New York and San Francisco and Seattle. These are very dense cities, and in Houston, we don't have that. Maybe that's going to work to our advantage.

You mentioned that you know people on the front lines in New York. What sorts of stories are you hearing?

I'm getting emails and texts from colleagues and friends. They're worried.

I've been going on CNN, Fox News and MSNBC and debunking this narrative that COVID-19 is only a disease of the old and infirm. That's not the case. The CDC has come out with important data in their morbidity and mortality weekly reports finding that about a third of the hospitalized patients are under the age of 44. That means young people are getting severely affected.

Young physicians, especially residents, who are often in their late 20s or early 30s, are at risk for this infection. And the fact that they don't have adequate protection means that a number of them are going to get sick.

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We know some of them are going to get seriously ill. I’ve been getting quite emotional about this point because I love to mentor medical students at Baylor College of Medicine. I remember match day last year -- getting hugs because someone is going to Bellevue or New York Hospital or Columbia or Mount Sinai and was really excited.

Now, I’m upset about what they're facing.

We've talked before about what recommendations you would give everyday Houstonians at this point in the outbreak, so what are you thinking now? What should we be doing? How should we be living our lives?

I was strongly advocating for shutting down the rodeo and, and doing the social distancing measures. I think these are good decisions made by our city leaders. I think they did the right thing, and they did it in with sufficient time, so I think so it'll make a big impact.

But quality of life is not at its best now for all of us. It’s been especially hard for my special-needs daughter, Rachel, who works at Goodwill for two hours a day. She builds her whole life around that. She gets there an hour early, she talks to people, then she walks home. She's befriended all of the merchants in Montrose. She talks to the person at the frozen yogurt place and the person in the Subway. Now that whole world, her whole social network, has been taken away from from her.

Are you talking from your home right now?

Yes. I’m not going into the lab as much because we're trying to restrict people going in and out.

Our scientists are working on the on the COVID-19 vaccine. They are at it day and night. So we have a team that's there, with special permission because of the unique nature of the project.

Normally I travel a lot. I do a lot of public engagement, getting people to care about neglected diseases, and that's all stopped. It's good to be spending more time with Ann and Rachel. That's actually been a bit of a silver lining.

But there's a lot of emotional stress because my lab is trying to get this vaccine out. So I’m on teleconferences nonstop to move this forward — not only for the science and all of the regulatory hurdles and manufacturing and things like that, but also we don't have the money to do this.

I have highs and lows. Our group is making a vaccine that's urgently needed — that's incredibly satisfying. And I've been blessed to have the opportunity and privilege to talk to the country. I've been on almost every day on Fox News, MSNBC or CNN, and some days on all three networks. Not many people can do that because everything is so politically charged. So being able to speak to the country about science has been incredibly satisfying.

Feeling that responsibility both to talk to the nation and to make vaccines has been draining. My wife is seeing the strain on my face. And I'm seeing it in how I'm conducting my teleconferences. I'm far more emotional than I usually am. I have a reputation for being calming and even-handed, and I've seen flashes of anger that I didn't think I had in me. This epidemic has taught me that I have a limbic system.

Could we back up a bit? With all the federal money flowing into fighting COVID-19, you still don’t have the money your lab needs to work on its vaccine?

We've gotten some. We've got some bridge funding from the National Institute of Allergy and Infectious diseases. And we've been invited to submit proposals to the other agencies, so we're doing that, but those wheels are not turning quickly.

Fortunately, one of the great things about being in Texas is that he philanthropic environment here is extraordinary. You know Texans. There's an attitude in Texas that we shouldn't rely on the federal government, that we're going to take care of it ourselves — and that's actually true. We were on our own during Ebola in 2014, and with Zika in 2016.

And unfortunately, we're pretty much on our own again, I think. But maybe we’ll get through it because we're Texans.

lisa.gray@chron.com

@LisaGray_HouTX