Consider This from NPR - 5,000,000 Cases And Counting: The U.S. Is Still Failing To Contain The Virus

Episode Date: August 10, 2020

A school district in Georgia learned firsthand last week that the virus is almost impossible to contain — especially without masks and social distancing. A new effort in New York City encourages travelers to self-isolate when they get into town. And public health workers in Texas and California explain that the size of the outbreak makes contact tracing a huge challenge. Find and support your local public radio station.Email us at [e-mail] more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

What happened last week in Paulding County, Georgia, just north of Atlanta, says a lot about where we are right now. A jam-packed high school hallway as students, many of whom are not wearing masks, change classes. You might have seen the photo of this jam-packed hallway that was going around. Students did have the option to sign up for online classes, but space was limited. So some kids ended up on a wait list, but were told they had to come to school in the meantime. People were asking, where was the social distancing, the mask? The district policy was that students were encouraged, but not required, to wear masks.

Superintendent called masks a personal choice. He said there was no way to force students to wear them. A school nurse, Amy Westmoreland, resigned because she said she didn't feel safe going back to school. I had already made my decision to resign prior to that picture coming out. But certainly that validated my decision. And, you know, of course, I was horrified and heartbroken when I did see it. Two students were suspended for sharing the photos of the hallway, then unsuspended after public pressure. And that was just in the first week of school.

Days after these infamous photos showing students shoulder to shoulder in North Paulding High School, the school has now confirmed nine new cases of COVID-19. Now, this week, Monday and Tuesday classes have gone entirely online after six students and three staff members tested positive. With five million cases and counting in the United States, this kind of thing is going to play out again and again as more schools reopen. Coming up, why the scale of this outbreak makes it so hard to contain. This is Consider This from NPR. I'm Kelly McEvers. It's Monday, August 10th. Coming up, why the scale of this outbreak makes it so hard to contain.

This is Consider This from NPR. I'm Kelly McEvers. It's Monday, August 10th. This message comes from NPR sponsor New Belgium Brewing and its flagship beer, Fat Tire Amber Ale. You can't brew great beer without healthy rivers, forests, and soils. That's why Fat Tire Amber Ale is now America's first certified carbon-neutral beer. More at drinksustainably.com. Support for this podcast and the following message come from Integrative Therapeutics, creator of Physician's Elemental Diet, a medical food developed by clinicians for the dietary management of IBS, IBD, and SIBO under the supervision of a physician. In New Zealand right now, it has been more than 100

days since the country had a confirmed case of the virus. And life is pretty much back to normal. Shopping, movies, entertainment, going to bars. That's Colin Peacock with Radio New Zealand. We can dance as close as we like to each other and nightclubs as late as we like. So everything is just fine in that regard. And business is carrying on as normal, apart from the closed down borders. Closing its border to all visitors who aren't New Zealand citizens at a time when the pandemic was just getting started helped New Zealand keep the number of new cases low, which then made contact tracing possible. We work really hard to isolate people that were infected and quarantine the rest of the people in that person's network. That's epidemiologist Brian Cox. And yeah, what he's describing is much easier when you're as isolated as New Zealand.

The country's border is still closed to visitors, and any citizens returning home from abroad have to quarantine for 14 days. Thing is, there is nothing revolutionary about New Zealand's strategy. Keep cases low, test, trace, isolate. In the U.S., our outbreak is just too big and uncoordinated to pull off the New Zealand strategy on a national scale.

So some cities and states are trying it with mixed success. Like New York City. Since June, people coming into New York from other states have been under orders to quarantine for two weeks. Workers have intercepted people at airports, told them to register with the state. And now the mayor is expanding enforcement to bridges, tunnels, trains and bus stations. But New York City's population is about twice that of New Zealand. And that's the least of its challenges.

Fred Mogul with member station WNYC has the story. Attention, please. Amtrak will be firing. At Penn Station, emissaries from Mayor Bill de Blasio greet visiting Floridians and New Yorkers returning home as they get off Amtrak's silver meteor from Miami. So basically, with the new executive order, you have to do a 14-day quarantine just to help keep New Yorkers safe. Some take flyers, some pause to fill out electronic forms, many just walk on by, refusing to make eye contact,

the way New Yorkers often do. Can you fill out your information on this form for me? A woman named Gloria Rebas, back from visiting family in West Palm Beach, says she plans to register her two-week quarantine with the city. City and state health workers have signed up about 400,000 people. But with tens of thousands arriving daily at the city's two big airports alone, that means many are coming into New York and remaining under the radar.

Which is why de Blasio now wants to survey as many surface travelers as possible, too. They'll be reminded that it is required, not optional. They'll be reminded that failure to quarantine is a violation of state law, and it comes with serious penalties. Authorities make calls, send texts, and knock on doors to make sure people are isolating. So far, the state has received 1,700 complaints about possible quarantine violations, but hasn't issued any fines. At Penn Station, Harold Serra says he plans to follow the rules, but doesn't need government monitoring.

Yeah, I just do it on my own. I know what I'm doing. I take precautions. Serra's relieved to be back from his long visit with relatives in the Sunshine State. Speaking through a wraparound net gator, he says people down in Florida don't take protecting themselves and their neighbors as seriously as he does. And he's pretty confident he didn't catch anything down there that he's bringing back here. Fred Mogul with NPR member station WNYC. New York City, of course, is not the only place struggling to keep track of who has the virus and where.

Right now, the U.S. only has about 41,000 contact tracers. It's not even half of what public health experts say we need. And people who are doing the job are running into big challenges. Two of those people are Aaliyah Franciscus, an epidemiologist with Harris County Public Health in Houston, and Michael Ogier, deputy director at the Riverside County Department of Public Health in Southern California. They both talked to my colleague, Ari Shapiro. Thank you both for joining us. Thank you for having me, Ari. Thank you, Ari.

Both of your states had a steep increase in COVID-19 cases from June into July. The numbers are now going down a bit. How does the number of contact tracers that you have where you are compare to the number you need? So I can fill this one first. We hired the correct number that we anticipated needing at the beginning of the incline. We did not anticipate it climbing so quickly and so steeply. And then we were not able to get as many as we needed to kind of overcome that hurdle. So that's the outlook in Houston. What about in Southern California? In Riverside, California, in the county,

we had 120 through May. And then when the numbers went increased, we did a whole big influx of new hiring of temporary workers. And we've now in the seven weeks hired 360 contact tracers. The issue is case investigators, because there's so many cases we need to interview first so the contact tracers can call people. And I'll echo that. That's an issue that we're having as well because there's a different level of skill sets that's needed to be an investigator. You're that initial point of contact for these confirmed cases and there's just not enough. So then you bottleneck before you can get to even the contact tracing piece. Let's talk about the issue of trust. When you call people and say, tell me everybody you've had close contact with in the last few days, are they willing to share that information?

They're willing to tell us about their family contacts, who lives in the house, but they're not willing to share their friends, who they saw, the stores they went to. And that's been a huge problem because much of our spread has been through those informal barbecues, get togethers, and other places that these people have been that we are having a hard time tracking down. Yeah, it's the same thing in Harris County. We actually had to, and we created a software system because our regular system could not handle the number of COVID-19 cases that we were getting. And we actually had to add a button that said unwilling to share contacts or unknown batch of contacts. Like they'll say, oh, I went to a party and there were 30 people, but I'm not going to give you their names. When we try and get into the nitty gritty, like, you know, oh, you went to a bar. What bar did you

go to? They won't tell us because then they're afraid we're going to shut that bar down. Do you run into that sort of thing? Like with one in 10 calls, half the calls? I mean, can you quantify it? I would say for Harris County is upwards of 50%. I would say half are very cooperative. Wow. Another 25% are semi-cooperative and the other 25 are absolutely unwilling to share anything. There's so much misinformation being put out right now. So our contact tracers are being, they're being called names. They're being cursed at, derogatory language is being used because there's been these seeds of mistrust thrown

into the community. So when we call, nothing we say can establish that trust where they'll be willing to share information with us. They think that the numbers are inflated. We've heard multiple people say that we're getting paid to make up results. So it's so difficult to combat all of this information, this mistrust that's being put out there. Wow. So we're finding, looking at businesses, most of the businesses will be very cooperative.

But some of the businesses that hire the food processors or the farm workers, they are completely uncooperative and have told their staff who are positive if they cooperate with us, they'll be terminated. So we have two or three businesses that have had major outbreaks that we can't get into at all. And that's been a huge problem. You know, back in the spring, when everyone was talking about how important contact tracing would be to solving this problem, did either of you expect that it would be this tough? We always said that this was the first wave and the first wave never ended. And when mid-May came along with Mother's Day and Memorial Day, Father's Day, we tried to get the word out that this has not gone away, that we still needed to wear masks and keep distancing. But things opened up, people didn't listen. And now we've lost all control that was possible in April and early May. Now we have to

put that genie back in the bottle. Yeah, similar to Harris County. I mean, we do use contact tracing, but it's one tool among many that public health workers utilize. So when so much onus was being placed on the importance of contact tracing, we did agree, but we knew that it was going to have to be a multifaceted approach. It was going to have to be used in conjunction with, you know, shutting down businesses, shutting down restaurants, social distancing, mask wearing. So whenever those measures only lasted a month and they expected contact tracing to basically fill in all those gaps, that was never going to be successful. Aaliyah Franciscus in Harris County, Texas, and Michael Ogier in Riverside County, California,

talking to Ari Shapiro. Additional reporting in this episode from our colleagues at All Things Considered. For more news, download the NPR One app or listen to your local public radio station. Supporting that station makes this podcast possible. I'm Kelly McEvers. We'll be back with more tomorrow.

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