Consider This from NPR - From Air Travel to Hospital Treatment, We're Still Learning About The Virus

Episode Date: October 21, 2020

Francis Collins, director of the National Institutes of Health, told NPR this week that he's "guardedly optimistic" about the prospects of a coronavirus vaccine being approved by the end of the year.In the meantime, scientists are still learning new things about the coronavirus. NPR's Geoff Brumfiel reports on improvements in medical treatment for COVID-19 patients, and NPR's Michaeleen Doucleff explains new research on air travel. In participating regions, you'll also hear a local news segment that will help you make sense of what's going on in your community.Email us at [e-mail] more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

States are getting ready for a vaccine. That means they have to buy gloves and syringes. They have to stand up data systems to track who's getting it and possibly to remind those people to come back for second doses. And they have to figure out how to store massive amounts of a vaccine, possibly in very cold temperatures. We are working to procure dry ice or the capability to manufacture our own dry ice. Molly Howell is immunization

manager for the state of North Dakota, where they're also stocking up on freezers. It's a part of her state's vaccine distribution plan. Each state recently submitted its own plan to the CDC for review. We've kind of described it as framing up a house. Chris Ayersman is the director of infectious disease for Minnesota's health department. So we're going to keep adding to it, obviously, as we get more and more information. But right now, we've kind of just built a frame. Information like how many doses of vaccine will be available, how much funding might come from the federal government, or which vaccines will actually be approved.

I think it continues to be absolutely breathtaking the pace that has been achieved here, recognizing that most vaccine development in the past has been a matter of multiple years. Dr. Francis Collins, director of the National Institutes of Health, told NPR this week that two of the four U.S. vaccine trials have nearly completed the final phase of large-scale human testing. The next step after that, submitting to the government for approval. Hopefully, he says, that could happen by the end of the year, setting the stage for distribution in 2021. The fact that we knew about this virus and its particular genome sequence in January, and we now have four phase three trials in the United States.

It's pretty amazing. Consider this. It's been about 10 months since the first case showed up in the U.S., and with cases now reaching their highest level since July, we're still learning a lot about the coronavirus. From NPR, I'm Adi Cornish. It's Wednesday, October 21st. and bring their faith to the voting booth. Subscribe and listen to Voting Catholic wherever you get your podcasts. This message comes from NPR sponsor, The Representation Project, with The Great American Lie, a new documentary that explores how the American dream became out of reach for so many

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Kalia is a critical care physician at Northwestern Hospital in Chicago. Her patient was an older woman. She was very sick, and Gates and her team needed to put a tube in her throat to help her breathe. It's not that we didn't know what we were doing. We absolutely knew 100% what we were doing, but there was that unknown element there. There were a lot of unknowns. Was the procedure the best thing she could do for this patient? Was it safe for her and her colleagues to do it? Fast forward to today, Gates has seen a lot of COVID patients. She feels much more confident. Six plus months into this, we kind of have a rhythm.

And so it has become kind of an everyday standard patient for us at this point in time. That's true for a lot of physicians, and it's translated into better results for COVID-19 patients. Two studies soon to be published show that hospitalized patients in the US and UK are much less likely to die from the virus

than they were at the start of the pandemic. Here's NPR's Jeff Brumfield. All over the world, physicians have been finding their rhythm with this virus. They've systematized care using checklists. They've learned which drugs work best, and so it might seem obvious that they're saving more lives. But Leora Horwitz, a doctor who studies population health at New York University's Grossman School of Medicine, says it's not so clear. Because while death rates have dropped, the people getting infected today are healthier than those who were infected in March. The people who are getting hospitalized now tend to be much younger and tend to be less frail than people who were hospitalized in the early days of the epidemic. So have death rates dropped due to what doctors are doing, or is it the change in who's getting sick?

To find out, Horwitz and her colleagues looked at over 5,000 hospitalizations in the NYU Langone health system between March and August. They adjusted for factors including age and other diseases like diabetes. And what they found was good news. We do find that the death rate has gone down substantially. For all groups, even older patients, 18 points on average. So a patient with a 25% chance of dying in March would have just a 7% chance of dying later in the year. The work will be published online next week in the Journal of Hospital Medicine. I would classify this as a silver lining to what has been quite a hard time for many people. Bilal Mateen is a data science fellow at the Alan Turing Institute in the UK. He has conducted a study of 21,000 hospitalized cases in England,

which found a similarly sharp drop in the death rate. Clearly, there has been something gone on that's improved the risk of individuals who go into these settings with COVID-19. In fact, Horwitz believes it's actually many things that have led to the drop in the death rate. The use of steroids, such as dexamethasone, decisions about when to put patients on oxygen or blood thinners. Each of these choices makes a slight improvement that adds up. All of the above is often the right answer in medicine, and I think that's the case here too. But there is still no cure for this disease. Patients who recover can have long-term side effects, and if hospitals fill again this winter, mortality rates might rise once more.

For all these reasons, Horwitz and Mateen emphasize people still need to wear masks in social distance. I do think this is good news, but it does not make the coronavirus a benign illness. It does not mean that it is not still important to do everything possible to prevent getting it. It doesn't mean that the people who survive, survive without complication. And people will still die. A recent estimate suggests the total death count could reach well over 300,000 Americans by February. That's NPR's Jeff Brumfield. This week, the CDC issued a strong recommendation that masks be worn on trains, subways, buses, taxis, and planes.

Most major airlines have had a mandatory mask policy on flights for months. Now there's new information about how well masks work when we travel, especially in the air. Here's NPR's Michaelene Ducliffe. For months now, health officials in Hong Kong have meticulously tested and tracked all passengers who land in the city, so they know which passengers boarded a plane infected with COVID-19 and whether or not they infected anyone else. David Friedman is an infectious disease doctor at the University of Alabama at Birmingham. He's been analyzing this

data with a specific focus on one airline. Emirates Airlines, where since about April, they've had very, very rigid masking. Emirates not only requires masks, but ensures passengers wear them. Friedman examined the airline's flights to Hong Kong in June and July. What he found is telling. During that time, Emirates had five flights with at least seven infected people on board. And yet on all five flights, no one else on board got infected. Those are flights that, you know, should be high risk and where there was no transmission. On another flight out of Dubai, 27 infected people boarded a single plane for an eight-hour trip. Guess how many other passengers got sick? There appears to have been

two in-flight transmissions. Two. Friedman says that without the masks, he would have expected many more cases. In fact, scientists have not documented one super spreading event on a plane since airlines began to require masks. Together, all this data suggests masks are working. There's encouraging evidence from a number of flights that masking does help greatly, but it would be nice to study it better. You feel like the risk on the plane with masks is low. The circumstantial evidence is that risk is low if you have rigid masking. And that last part is key. To keep the risk low on planes, everyone needs to keep the mask on the entire flight.

Why? Lindsay Marr at Virginia Tech says planes have excellent air ventilation systems, which can remove coronavirus particles from the air about every six minutes. So the only opportunity to breathe in virus that's in the air is if it gets to you the only opportunity to breathe in virus that's in the air is if it gets to you before it goes through that ventilation system. And so that's only going

to happen if you're sitting close to the person who's sick. Because of planes ventilation systems, your risk comes almost entirely from the people sitting around you. That risk is lower when they have on masks. If someone is sick, they could be releasing virus into the air, and the mask blocks that. It prevents the virus from getting out in droplets and aerosols. A mask also reduces how much virus you breathe in, and it stops big drops of spit from hitting your mouth and nose. For these reasons, Mar says, when she flies, she carefully chooses which mask to wear.

If I'm flying, I use my best mask. It has a couple of layers of HEPA filters that remove more than 99% of particles. On the plane, I want the best there is. So if you have access to an N95 mask or even a P100 respirator, use that. Just make sure it fits properly and keep in mind. It doesn't protect your eyes though, so this is where you might want to consider wearing a face shield or goggles or some other kind of eye protection. Also remember to keep surfaces around you clean. Avoid touching your face and be quiet. When we talk, we can emit 10 times more virus particles than when we're silent. Finally, Friedman says, don't forget to wear a mask and socially distance

throughout the whole travel process, including while boarding and exiting the plane. I mean, you can control people getting on. Getting off is just chaos because everybody rushes off the plane. For this reason, Friedman says, he and his wife aren't flying this year. For Thanksgiving. That's NPR's Michaelene Duclef. Additional reporting this episode from our colleagues at NPR's Science Desk, Ping Huang and Selina Simmons-Duffin. It's Consider This from NPR.

I'm Adi Cornish.