Consider This from NPR - A Drug Could Speed Up Recovery; The Economy Declines

Episode Date: April 29, 2020

Results from a trial involving more than a thousand hospital patients showed the drug Remdesivir could speed up recovery from COVID-19 and possibly also reduce deaths. Wednesday morning's first quarter gross domestic product report shows that the economy shrank last quarter at a rate not seen since the fall of 2008. New findings suggest a link between COVID-19 and life-threatening blood clots that cause strokes in all age groups. Republican Gov. Charlie Baker of Massachusetts talks about how his state is trying to lead the charge in contact tracing, and how leadership during a pandemic is uniquely challenging. Plus, in New Orleans, Brass-a-Holics bandleader Winston "Trombone" Turner wanted to honor the deceased of COVID-19 like they would have been ordinarily — with music. So, he picked up his horn and called a few friends to record a performance of "I'll Fly Away," a celebratory song played at almost every traditional New Orleans funeral. Find and support your local public radio stationSign up for 'The New Normal' newsletterThis episode was recorded and published as part of this podcast's former 'Coronavirus Daily' format.Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

News about the economy today was not good. Turns out, last quarter, the economy shrank at a rate we haven't seen since the fall of 2008. And last quarter includes just two weeks of widespread social distancing. The next quarter is expected to be worse. But there is promising news about a new drug that could treat COVID-19. Some of the numbers may change a little, but the conclusion will not change. Coming up, how Massachusetts is getting ready to do massive contact tracing and the emerging link between COVID-19 and blood clots that's leading to strokes among young people.

This is Coronavirus Daily from NPR. I'm Kelly McEvers. It's Wednesday, April 29th. Okay, finally, some good news. It's preliminary and it needs more study, but results from a trial involving more than a thousand hospital patients have showed that the drug remdesivir could speed up recovery from COVID-19 and possibly could also reduce deaths. Dr. Anthony Fauci described the results of the trial at a White House event on Wednesday. The data shows that remdesivir has a clear-cut, significant, positive effect in diminishing the time to recovery. It was 11 days compared to 15 days.

And the difference between 11 and 15 days might not sound like a lot, but Fauci said when it comes from a well-conducted trial, it's meaningful. Although a 31% improvement doesn't seem like a knockout 100%, it is a very important proof of concept because what it has proven is that a drug can block this virus. The news was good enough that Fauci said testing in hospital patients should be expanded. Whenever you have clear-cut evidence that a drug works, you have an ethical obligation to immediately let the people who are in

the placebo group know so that they could have access. For Fauci, all of this brings him back. When I was looking at this data with our team the other night, it was reminiscent of 34 years ago in 1986 when we were struggling for drugs for HIV, and we had nothing. The first drugs to treat AIDS were not a cure-all. The early results were modest. But they opened the door to life-saving treatments. And that's the kind of potential he sees in this trial. And I can guarantee you, as more people, more companies,

more investigators get involved, it's going to get better and better. Medical evidence so far shows young people usually get relatively mild cases of COVID-19. But NPR's John Hamilton reports on new findings that suggest a link between COVID-19 and life-threatening blood clots. Clots that cause strokes that do not discriminate by age. When the coronavirus arrived in New York, hospital emergency rooms began to see some unusual stroke patients. Dr. Jay Mako directs the Cerebrovascular Center at Mount Sinai. We had a young woman in her early 30s who came in with a profound stroke, the kind of stroke that leaves someone permanently paralyzed and possibly unable to survive. A stroke caused by a clot. The young woman had none of the usual risk factors for stroke, but she tested positive for the virus that causes COVID-19. So Mako and

other doctors began to compare notes. Speaking with the ICU doctors and the pulmonary doctors, they were seeing clots in the lungs. Speaking Speaking with the ICU doctors and the pulmonary doctors, they were seeing clots in the lungs. Speaking with the renal doctors and the dialysis doctors, they were seeing clots in the renal arteries, causing kidney injury. Mako and a group of doctors thought it was time to sound the alarm. So they described five stroke patients in a letter that appears today in the New England Journal of Medicine. These were five patients in their 30s and 40s who did not have the typical risk factor profile, but did have the SARS-CoV-2 virus. The letter supports something other doctors have observed since the pandemic began in China. COVID-19 seems to produce

blood clots, a lot of them. Dr. Craig Coopersmith is the interim director of the critical care center at Emory University in Atlanta. Patients who are in the intensive care unit for other diseases are at risk of having clots, but nothing like the levels that we're seeing in COVID-19. Coopersmith says he hasn't seen the sort of stroke patients reported in New York, young people without risk factors. But he says clotting problems are affecting a significant minority of patients in the ICU, and that includes people on dialysis, which he finds surprising. Patients on dialysis in the intensive care unit with COVID, patients on that are on blood thinners, and the dialysis

machines almost never clot. And we were finding that the machines were clotting two or three or four times a day. Blood thinners do reduce clotting, and other drugs can often dissolve a clot before it causes major damage. But Coopersmith says all of these drugs can cause bleeding, so patients have to be watched closely. We have literally five different teams in the hospital specifically and only looking at blood clotting just because of this, just in COVID. It's still not clear precisely how COVID-19 is causing blood clots. It could be from the infection itself or the immune system's response to the virus. But Dr. Tiffany Osborne of Washington University in St. Louis says doctors are beginning to figure out what's happening. What we're seeing that contributes to our understanding

of that are lab values that are off the wall. For example, doctors are seeing crazy high levels of a protein fragment called D-dimer. This suggests that the body is trying to break down clots. Patients also have high levels of thrombin, which is involved in clot formation. And Osborne says the evidence that COVID-19 is causing clots in lots of places would explain an odd symptom that she and other doctors have seen. You have areas that start to become purple on the hands and on the feet. We think it probably has to do with these blood clots that are going to the extremities. Doctors are still relying on anecdotal evidence to treat clots in COVID patients, But Osborne says that's better than no evidence at all.

That was NPR's John Hamilton. Massachusetts has been hard hit by the coronavirus. It is number three in confirmed cases in the U.S. behind New York and New Jersey. And now Massachusetts Governor Charlie Baker, a Republican, wants to not just slow the spread of the U.S. behind New York and New Jersey. And now Massachusetts Governor Charlie Baker, a Republican, wants to not just slow the spread of the virus, he wants to stop it. And he says the state will do that with contact tracing. That's when public health officials try to call every person who's been in close contact with someone who's tested positive and to help those contacts figure out a plan to quarantine. Baker talked to All Things Considered host Mary Louise Kelly

about how just 850 contact tracers so far have been able to deal with the state's almost 60,000 confirmed cases. There's no question that the slope is big and the hill is high, but the one thing I do know is if you don't start walking up it, you'll never get to the top. And we currently have a plan to hire about 1,000 people to do this by the end of the month. But there were many, many more people who are interested in doing it. And if we need to expand our community of contact tracers, we will.

And the second thing I would say is that we thought when we got into this that the close contact stuff would involve reaching out to as many as 10 people who had been in contact with somebody who tested positive. And because of all the social distancing we've been doing, that number is more like two or three. None of this works if there aren't enough tests, if you don't know who's sick. And I know Massachusetts, you've said, is testing more people than most other states, but I'm sure not as many as you would like. No state has the ability to test as much enough to be where we're ultimately going to need to be. But 35 days ago, we were testing 1,000 people a day. Now we're testing 9,000 or 10,000 people a day, and that's 35 days later. I certainly think we need to do more testing, but I also think we've demonstrated that we have the sort of imagination and creativity to find a way to continue to build on our testing capability. Last thing to ask you is this. You nodded to

that Massachusetts has been hit really hard by the coronavirus. I know you talked about the death of a close friend's mom at a press conference earlier this month. And I wanted to offer my condolences. And Oscar, just ask on a personal note, how are you doing? How are you holding up during this? Well, I never expected to be in the midst of anything like this. I mean, I've dealt with hurricanes and 28 days of snow in a row and tornadoes and gas explosions. We had a horrible natural gas explosion up in Merrimack Valley a couple of years ago, but those were all things I could see. And I had some idea about how they had been dealt with and handled before. There was like a playbook for this stuff.

This is a very different kind of challenge and it's all consuming. Um, you know, my dad's 91 years old. Um, I haven't, I used, I used to have a meal with him once a week. I haven't seen him since February and, um, I was telling people this morning that one of my brothers actually somehow remotely explained to him how to FaceTime on his phone. And he and I FaceTimed on Saturday. It was the first time I'd seen his face in almost two months. And it was really special. And I think this whole thing is insidious in so many ways. And I really hope that we are able through tracing and testing

and some of these other initiatives to really try and turn the tide a bit and make life a little less unnormal for people. That was Charlie Baker, governor of Massachusetts, talking to NPR's Mary Louise Kelly. Louisiana is another state that was hit early and hard by the coronavirus. Every day you wake up, you get some news like, you know, this person, his cousin passed away.

Do you know this person? His dad passed away. Brassaholics bandleader and trombonist Winston Turner talked to NPR's Jazz Night in America about what it's like to live in New Orleans during the pandemic. I've just been waiting for a day in which I don't get that news. That's the real vibe here, you know? When New Orleans issued social distancing guidelines that advised against gatherings of more than 10 people back in mid-March, that included funerals.

One day, Turner got a phone call. A friend's mother had passed away. He said, I don't know what to do, man. I'm feeling it right now. You know, my mom is gone. I can't even have a funeral. I can't even get people in town. If you don't already know this, funerals are a huge part of the culture and history of New Orleans, in particular jazz funerals where there's a brass band and people walking and dancing along behind. And to die in New Orleans and not have a proper jazz funeral

just didn't feel right to Turner. So he called up a few friends with an idea. Let's go somewhere in an open place and let's dress the way we would dress with the respect that we would have if we were bringing them home. And let's play one of the tunes that we normally play when they're coming out of the church. It's just something that resonates in our community.

They filmed and uploaded their tribute so Turner's friend could see it. But the video resonated with other people, too. Here's vocalist Emeka Dibia. It's kind of a celebratory song because this person has gone on to eternal glory. So we celebrate I'll fly away, like one glad morning when this life is over, I'll fly away.

So that's kind of like the highlight of the funeral. NPR's Colin Marshall brought us that story. You can find a link to the video of the performance in our episode notes. And for more news on the coronavirus, your local public radio station can keep you up to date. This is Coronavirus Daily. I'm Kelly McEvers.