Consider This from NPR - New York City, U.S. Epicenter, Braces For Peak

Episode Date: March 24, 2020

Governor Andrew Cuomo said the pandemic could peak in New York in the next 14-21 days — around the same time President Trump said he'd love to "open" the economy. Plus why the aviation and other transportation industries are lining up for federal bailout money, and a theory about why the virus might be so good at spreading. More links: Find and support your local public radio station here. NPR's Allison Aubrey reports on how to clean surfaces inside your home.Listen to Atlantic journalist Ed Yong on 'Short Wave' on Apple Podcasts, Spotify, or at npr.org. Listen to 'Wow In The World' on Apple Podcasts, Spotify, or at npr.org. This 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

There are now more than 51,000 confirmed cases of COVID-19 in the United States. That is according to Johns Hopkins University. Over 500 people have died. And the epicenter in this country is New York City, where Governor Andrew Cuomo said the number of confirmed cases is doubling every three days. The rate of infection is going up. It is spiking. The apex is higher than we thought, and the apex is sooner than we thought. That is a bad combination of facts. In New York, Cuomo says that means cases could peak, potentially overwhelming hospitals,

in the next two to three weeks, which is exactly when the president said he would like to relax social distancing, and quote, open the country. I'd love to have it open by Easter. Okay, I would love to have it open by Easter. I will tell you that right now. It is worth saying that it's governors, not the president, who are issuing the shutdown orders. Coming up, the science behind why the coronavirus is so good at spreading.

I'm Kelly McEvers. This is Coronavirus Daily from NPR. It is Tuesday, March 24th. So as we are recording this, we are watching for lawmakers to announce a deal on an economic rescue package. It might have even happened by the time you hear this. Your local public radio station will have all the latest news, and we've got a story coming up about one reason the deal has been so hard to negotiate. But first, let's start by talking about what this means in our homes, right now. A study last week from the New England Journal of Medicine said

the virus can survive for up to 72 hours on stainless steel and plastic surfaces and on cardboard up to 24 hours. Jamie Lloyd-Smith of UCLA was one of the authors of the study. We're talking about potentially days of infectivity on some of these surfaces. Which bolsters the official advice from public health officials to avoid touching surfaces outside your home. We're still working out how much is it by human-human transmission and how much is it by surface. Dr. Deborah Birx is the response coordinator for the White House Coronavirus Task Force. This is why those fundamental guidelines were put out that says don't expose yourself to

surfaces outside the home. In other words, it is possible to transfer the virus from a doorknob outside your home to a doorknob inside your home, which is why the CDC recommends cleaning frequently touched surfaces. We have a link to a big write-up from NPR's Alison Aubrey with more information about this and tips on how to clean the surfaces in your home that is in the episode notes. The impact of this virus on the transportation industry, from your local bus service to the major airlines, is one reason this federal bailout we've been talking about will be so huge. It also helps explain why negotiations over the bailout have been so difficult. The airline industry is being crushed.

Tens of thousands of workers could be laid off without a bailout. There are also reports that all passenger flights across the U.S. could be temporarily shut down. But as NPR's David Shaper reports, many remember the 2009 bailout, which left workers behind. This is a surreal time to be working inside of an airport. This is shocking that the speed at which this has completely changed our lives. Sarah Nelson heads the Association of Flight Attendants, the union representing 50,000

flight attendants at 20 different airlines. When we get to the plane, the first thing we're checking is do we have the masks and gloves? Do we have the hand sanitizer? Do we have the sani wipes to be able to wipe things down? Nelson says many flight attendants already are taking pay cuts because they're working fewer flights and now they're facing possible layoffs or furloughs. This is our life now. We're thinking about that and then we're walking through empty airports and wondering how long this can last. The airlines say not long before the industry is crippled. Many in Congress agree that airlines need federal help, but the sticking point is what form and what strings are attached. Unions don't want a

repeat of previous bailouts where Congress helped airlines, but several still filed for bankruptcy and cut jobs, wages, and pensions. After the recession, when passengers and profits returned, airlines pumped the extra cash into executive bonuses and buying back stock to boost shareholder value instead of building up reserves. California Democratic Congresswoman Barbara Lee. Any bailout for the airline industry has got to focus on the workers, not the executives. President Trump agrees that a bailout bill should include restrictions on stock buybacks and bonuses. Airlines now agree, but say they want half of the $50 billion in aid to be direct cash grants. Republicans

largely want to restrict the aid to loans. Some Democrats propose some direct cash payments if used strictly to pay workers. But it's still not clear what, if anything, would go to baggage handlers, wheelchair attendants, and others who work for contractors at the nation's airports. The airline just laid me off a few days ago. Lorica Fifi is a passenger service agent at New York's JFK Airport. I have seven kids to take care of and no one is hiring at the moment. How am I going to manage? Some in Congress are pushing for increased support and health care for these hourly contract workers. And lots of other industries have their hands out for the government money.

Cruise lines, hotels and resorts are shutting down and laying off workers. Amtrak has lost riders. And so, too, have public transit systems. Stephen Schlickman is a transportation consultant and the former head of Chicago's Regional Transportation Authority. He says with ridership down 50 to 90 percent in many cities, fare revenue has plummeted. And with most bars, restaurants and shops closing down, there's a huge drop off in sales tax revenue. Sales tax is actually probably the largest tax revenue source the transit systems rely on across the country. Congress and the White House agree to give transit agencies $20 billion in aid.

Whether that's enough depends on how long people continue to stay at home. That was NPR's David Shaper. So there are other coronaviruses out there. In fact, if you remember the SARS epidemic, that was a coronavirus. It eventually spread to 26 countries with around 8,000 cases in 2003. But this coronavirus, which causes the disease known as COVID-19, has already affected way more people. So why? Why is it so good at spreading? On a recent episode of Shortwave, NPR's daily science podcast, Atlantic journalist

Ed Yong rounded up some theories. He told host Maddy Sophia it might have to do with the structure of the virus itself. So like all coronaviruses, this one is basically a ball with some spikes sticking out of it. Those spikes are what the virus uses to launch an infection. They bind to a protein called ACE2, which sits on the surface of our cells. And this binding, like a key fitting into a lock, is the first stage of any infection. Now, if we compare the shape of the spike protein on this new coronavirus to that of, say, the original SARS virus from 2003, we see that it sticks to the ACE2 protein much more tightly, much more strongly. And that is likely to influence the course of an infection. So in very broad terms, the stronger the stick,

the less virus you probably need to actually start an infection. And that's really important, right? Because if it doesn't take as much virus to start an infection, it's easier to transmit the virus from person to person. It's what we call an infectious dose. That's right. So basically, this virus is stickier than the virus that caused SARS. That's right.

This virus is better at recognizing and latching on to human cells, we think. So those spikes that the virus is used to attach to our cells, those spikes have to be activated. And that activation happens more readily in this coronavirus than the classic SARS virus. It seems that way.

So the spike consists of two halves, which must first be split apart for the virus to begin infecting a cell. And that split happens with some difficulty with SARS classic, but it seems to occur more readily with this new virus because the two halves can be separated by an enzyme called furin, which is quite widespread in the human body. Right. So much like an avocado, that spike protein is really only ready to do its job once it's split in half. And this coronavirus can make use of a protein in our body that our body is already naturally producing to make that cut for it.

Correct. And thanks for ruining avocados for me. Okay. You monster. So basically that split seems to be happening easier in this coronavirus than in the SARS coronavirus. And that split is really important to activating the infection process. Correct. You also wrote about how this plays into a potential reason why the virus can spread between people before symptoms show up. Talk to me about that.

Right. So in most respiratory viruses, you either get infections in the upper airways, in which case symptoms are milder, but the virus spreads more easily, or you get infections in the lower airways, in which case symptoms are more but the virus spreads more easily or you get infections in the lower airways in which case symptoms are more severe like pneumonia but the virus is harder to transmit. It seems that the new coronavirus can infect both sites so perhaps it infects the upper airways causing mild symptoms and spreading easily before moving down into the lower airways and causing some of

the more severe illnesses we've seen in the worst COVID-19 cases. And maybe the reason it can do all those things is that it relies on this furin enzyme, which is found in lots of different tissues. Now, of course, this is still conjecture, if you look at it, it's a plausible story. It makes sense and it checks out, but it could also be completely wrong. Yeah, this is actually kind of, you know, newer data that's kind of interesting because I think initially we thought, you know, the majority of that infection is in the lower respiratory system, right? That's very similar to SARS.

And now we're starting to get maybe some data that shows that that upper respiratory tract can be infected too. But like you said, this is pretty preliminary stuff. Right. You know, I keep reminding myself that this is a virus that no one knew about. So we're really racing to understand it, even while we're also trying to control it. That was Ed Yong of The Atlantic talking to Maddy Sophia on Shortwave. We have a link to the full episode of that podcast with Ed in our episode notes. And before we go, some advice for how to talk to children about what's going on right now. It's from our friends at Wow in the World.

That's NPR's podcast for curious kids and their parents. And they suggest talking to kids about their role in preventing the spread of this virus. Preschool and elementary-aged kids do understand what it means to be helpful. And kids can be just as helpful as adults right now by staying home, washing their hands, and moving their playdates online. Kids can help their families, their communities, and themselves.

Your kids can hear new episodes of Wow in the World five days a week right now. There's a link on our episode page. And for more news on the coronavirus, you can stay up to date with everything on your local public radio station or on NPR.org. I'm Kelly McEvers. Thanks for listening. We will be back with more tomorrow.