Consider This from NPR - New White House Guidance for When States Can Move To Reopen

Episode Date: April 16, 2020

The White House Thursday offered a blueprint for states to re-open. It starts with a decline in confirmed cases of COVID-19 and includes extensive testing that does not yet exist. Johns Hopkins epidemiologist Jennifer Nuzzo told NPR's Rachel Martin that the lack of testing means the outbreak is still largely unpredictable. In the past four weeks, 22 million people have filed for unemployment, nearly wiping out all the job gains since the Great Recession. A group of volunteer EMTs in New Jersey is on the front lines of the coronavirus outbreak.Plus, after seven months in space, astronaut Jennifer Mier returns to a very different reality on Earth.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

Ten straight years of job growth, the longest stretch in U.S. history, has been wiped out in just four weeks. More than 22 million people have filed for unemployment benefits. When somebody's the president of the United States, the authority is total. And that's the way it's got to be. The authority is total. It's total. It's total. And the governor's know that. The governor's know that. The governor's know that.

That was earlier this week. But at the White House Thursday, the president backed down and told governors they can take their time in reopening their states. Coming up, why that will not be simple. And one quarantine that has probably lasted longer than yours. This is Coronavirus Daily from NPR. I'm Kelly McEvers. Today is Thursday, April 16th.

Don't worry, we double-checked. This message comes from WISE, the app for doing things in other currencies. Send, spend, or receive money internationally, and always get the real-time mid-market exchange rate with no hidden fees. Download the Wise app today or visit wise.com. T's and C's apply. The new White House guidance does not lay out a timetable

for states to end their stay-at-home policies. It's more of a blueprint they should use to make that call on their own. That, by the way, is a win for public health officials. The guidance says there are a few key things states should do before moving to reopen. There needs to be a downward trajectory in the number of confirmed cases. There needs to be enough hospital capacity to treat everyone who needs help. States need to be able to do extensive contact tracing. And there needs to be testing. A lot more testing. We've rapidly developed the most expansive and accurate testing system in the world.

That was President Trump on Wednesday. And have completed more than 3.3 million tests. But 3.3 million tests is still a very small fraction of the total number of people in this country. And testing labs report that an alarming shortage of supplies is holding them back. And that is why we don't know how many cases are out there or whether things have actually started to peak. I have a really hard time using the word peak to describe where we are now. Epidemiologist Jennifer Nozzo is a senior scholar at the Johns Hopkins Center for Health Security,

and she told Morning Edition host Rachel Martin that while it's true the rate of growth in the U.S. is slowing, that does not mean we are turning a corner. And that's because the fact that it's slowing is largely due to efforts in a few states to reduce the new cases that occur through social distancing. And how much of this has to do with the fact that we don't have universal testing at this point? Well, that's another important point. So when we're looking at the number of cases reported each day, that's just people who've been tested. We know that in much of the country, many people who are sick are not

able to be tested. So those numbers aren't even being included. So I would feel more confident to say that we are seeing a sustained decline in cases if, despite increasing numbers of people tested, the case numbers continue to fall. What would it mean for our public health response if the country were past the peak? What would start to happen? What should happen? Right. So we would first have to believe that the case declines are real. We might want to think about what measures we can release, but we have to be prepared to deal with the rise in cases that will inevitably occur when we do that.

And so that means we need to be able to test all the new cases that occur, isolate them, figure out who they may have exposed before they became a case, trace those contacts, monitor those contacts, and if they become sick, test them. So that's a whole lot of work that requires a whole lot of resources that we don't yet have. And so I think even talking about releasing measures is quite premature, not until we are able to test more and do more. Members of the White House Task Force, including Vice President Mike Pence, Dr. Deborah Birx, have referenced states that have low numbers of cases. Does that mean those places have escaped the worst effects of the pandemic?

Right. So low numbers of cases don't really tell us much. In fact, there are many communities in the country that have small numbers of cases, but they're also small populations. And while the big cities are probably dominating the headlines and we're seeing some good progress in big cities, there are actually parts of the countries where the case numbers are rising. And I'm actually particularly worried about those places because often it's occurring in places that have fewer healthcare resources. And if they don't have enough healthcare resources, we're going to see really severe outcomes if their hospitals get overwhelmed with even a small number of cases. Well, Ashley, can you just define the risk if we start to return to normal or opening businesses,

starting to open the economy too soon? Right. So I think it's important for everyone to realize that the social distancing measures that we're doing right now are absolutely essential. They're needed to stop that rapid growth in cases that we saw about a month ago. But they're not a cure. They're a pause button. As soon as we begin to release, we should expect to see a rise in cases. And unless we have a plan to deal with them, we could find ourselves right back where we started, which I think will feel very, very frustrating to a lot of people if they have to go through this all over again. Johns Hopkins epidemiologist Jennifer Nozzo

talking to NPR host Rachel Martin. In New Jersey, there is a surge of COVID-19. More than 4,000 people were diagnosed in just one day there this week. All told, more than 3,000 people have died in the state. TNEC is at the state's epicenter. The infection rate there is higher than in New York City. WNYC's Karen Yee has this story about the Teaneck Volunteer Ambulance Corps. Okay, you're on your way. Oh, all right. Do you want to take it or do you want me to take it? A call comes in just a few minutes after I walk into the EMT headquarters.

A patient is in cardiac arrest, likely COVID positive. We were dispatched to a report of a patient not breathing. It's in a nursing home, which has had a number of cases. Captain Jacob Finkelstein is coming off an overnight shift, but you wouldn't be able to tell. He's calm and steady, leading an all-volunteer brigade in the epicenter of the state's outbreak. He's only 24 years old.

Ambulance 74 is arriving. He says the calls are getting more intense. Difficulty breathing, respiratory distress, cardiac arrest, and more people are dying at home. We don't stay at the nursing home very long. By the time we get there, the patient is dead. It's not the first death of the morning. It is my third of the day, and it's like 10 o'clock now. So that's pretty crazy for us. You know, we

normally see probably less than one week and we're seeing like three, four, five, six a day right now. The EMTs are getting twice the usual number of calls at a time when half the volunteers are out sick or on quarantine. Others are worried they'll bring the virus home. The Teaneck Volunteer Ambulance Corps receives some funding from the town and runs on donations. Other volunteer squads aren't responding to calls these days. It's too much of a risk for their members. Some crews have run out of supplies, leaving it up to hospitals or paid EMTs to respond. In Teaneck, they make do with any personal protective equipment they can get. A family in town found a YouTube video on how to make homemade face shields. So the lady said she would make as many as she can a day with her kids.

Another call comes in. A man is having difficulty breathing. We rush him to the hospital, passing refrigerated trucks out front for the overflow of bodies. We're coming in with an 80-year-old male, COVID positive. refrigerated trucks out front for the overflow of bodies. Worried about exposing his family, Finkelstein moved into another apartment where he's been living for the last three weeks. Other members say they've brought the virus home or tested positive themselves, like 20-year-old Bobby Alexu. He's newly freed from his quarantine after coming down with a mild case. It's his first day back. Just don't tell his parents. Oh, they don't know I'm here. I'm like, oh, I just gotta, I'm just going over to do some food shopping. You know, I'll be back in like an hour. I'm not allowed to be down here. As soon

as this whole thing kicked off, they were like, they were like, no more going to TNEC for any calls at all. He says there are just too many calls, and he wants to help. That's great, Bob. They'll never know about it now. Oh, oops. Good thing they don't watch the news. A few minutes later... I owe you. The laughs are short-lived. The mood in the room changes in an instant.

Okay, in rep. Suit up. What you got? COVID positive, difficulty breathing. We're on a quiet residential street. A woman in her 50s is struggling to breathe when she's carried out of the basement and placed on a stretcher. Her family watches from the lawn. They have to stay behind. In the ambulance, the patient is alert, but then suddenly she goes into cardiac arrest. At the hospital, Alexu wheels her inside as a paramedic performs chest compressions.

He eventually comes back to the ambulance and shakes his head. The woman has passed away. It's just hard to see anyone in pain. 21-year-old Joe Horowitz also responded to the call, his last for the night. This was a particularly difficult call, and things like this happen. I think it's the frequency with which it's happening that makes it a little more difficult. By the end of the night, the station is empty except for one volunteer. And then that familiar ring comes again.

WNYC's Karen Yee in Teaneck, New Jersey. For a lot of us in the U.S., it's the fourth week of social distancing. Jennifer Meir has been isolated for a bit longer. Right now we are packing up and we will be home on Friday after seven months. Today's actually my 203rd day in space. She talked to NPR's morning edition from the International Space Station. I believe we actually are just passing by

the southeastern corner of Australia. She'll come back to Earth this week. And she knows she's not the first person to watch a big history-making event unfold from space. But this one is just something that is affecting the entire planet. There really isn't anybody that's not affected by this except for us for now. And so that has just been very odd and surreal for us to experience. Back home, she will have to quarantine for at least a week. Being in space can make your immune system weaker. What does she miss about Earth?

Actually, I haven't really missed anything. I think for me, this is my first space flight, something I've been thinking about literally my entire life since I was five years old. But of course, elements of nature are the one thing that I think will feel even more amazing once I come back. The feeling of the warmth of the sunlight on your skin, the smell of the trees in the forest, that is something that I am really looking forward to. Jennifer Meir talking to NPR's David Green. For more on the coronavirus, you can stay up to date on your local public radio station, also on NPR.org. We will be back tomorrow. I'm Kelly McEvers.