Consider This from NPR - Q & A: Masks, Unemployment Aid, And Recovering From COVID-19

Episode Date: April 11, 2020

Public health experts and NPR journalists answer listener questions on 'The National Conversation with All Things Considered,' NPR's nightly radio show about the coronavirus crisis. Excerpted here:- Dr. Abraar Karan on wearing masks- Dr. Lucy McBride on what to do if someone is recovering from the coronavirus at home- NPR's Scott Horsley on unemployment relief and how to get itWe'll return with a regular episode of Coronavirus Daily on Monday. 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

Hey, I'm Kelly McEvers, and this is Coronavirus Daily from NPR. There are a lot of questions that experts just can't answer yet about the coronavirus. But there are also a lot of questions they can answer. Today, we have some of those answers. Our colleagues at the National Conversation with All Things Considered, that's a radio show, have been talking to NPR journalists and public health experts to answer questions that are sent in by listeners. And that's what you're about to hear. Later in the episode, they'll talk about face masks and unemployment benefits. But first, we'll talk about this. There are nearly 500,000 confirmed coronavirus cases in the United States.

And of course, that doesn't include people who feel sick at home, who are wondering if it's just seasonal allergies or if they've been infected too. Dr. Lucy McBride is a physician practicing internal medicine in Washington, D.C., and she talked to Weekend All Things Considered host Michelle Martin about the symptoms of COVID-19 and how to take care of yourself at home. And they started with this question from Jason in Seattle. I know that there's evidence that some people never get symptoms, but it would seem incredibly useful to be able to self-diagnose mild symptoms to know that one should completely self-quarantine in that case. What are some examples of mild symptoms associated with mild cases of COVID-19? How about that, Dr. McBride? Can you tell us some of the

first symptoms of the virus? And do you, can I just ask you, do you even use the term mild yourself medically or first symptoms? What's the most used? Is mild symptoms okay? Mild symptoms is perfectly fine. And it's actually a lovely word given that some symptoms are not so mild, but most people do have mild symptoms. The symptoms that we're talking about are sore throat, runny nose, fatigue, a light cough. The challenge is, as Jason is alluding to, that these symptoms mimic a lot of other illnesses and even allergies that we're seeing with the pollen season. So it can be very confusing to patients. One thing I might suggest to Jason is to check the CDC website. They have a nice

symptom checker, but it's obviously not a substitute for talking with your personal physician to help tease out what you're dealing with at home. Our next question is from Anna in Fairbanks, Alaska. Let's listen. Are there preventive measures that can be taken at home during the initial days of illness to prevent the virus from moving to the lower airways? For example, after a surgery, you may be encouraged to walk, use a spirometer, and sit upright in bed to prevent pneumonia. Would similar actions be helpful during the onset of the virus? First, Dr. McBride, tell me what a spirometer is, because I do not know, and then you can tell us what measures you recommend. A spirometer is a plastic device that people use to help inspire and to get a full breath of air and to basically exercise their lungs.

And so it's something that we'll use in pneumonia patients or asthma patients. In the case of coronavirus, when people are dealing with the virus at home, the key is really to let your immune system do its thing, to let your body fight the virus. There is no targeted treatment for coronavirus, as you thing, to let your body fight the virus. There is no targeted treatment for coronavirus, as you know, for people with mild symptoms at home. And so time is the tincture and Tylenol for aches and fever. And the key is also maintaining your general health. So hydrating, eating regular meals, walking around when you can, and staying quarantined, of course. Solsham from State College, Pennsylvania is wondering about hospitalization. And here's

this question. What kind of treatments or care are being given to COVID-19 patients in a hospital other than the extreme treatment of being on a respirator? In other words, if I were at home sick with the virus, and I don't want to be on a respirator, what benefit is there to go into the hospital? And I'm really glad for this question because how exactly does home care differentiate from hospital care? And at what point is it absolutely necessary to seek medical help? Again, this is where it's crucial to have a relationship with a primary doctor who can help you know when it's time to go to the hospital. What the hospital can do is a couple of things. One, supportive care. First, making a diagnosis and understanding what we're dealing with. Is this a diagnosis of coronavirus or is this something else? Is it a pneumonia or is it a

coronavirus pneumonia? Is this the flu? And then the hospital can offer access to treatments like oxygen and other medications that are now being investigated for coronavirus treatment in the most severely ill patients. Mary in Ohio has a question about pneumonia. She writes, it sounds like folks who are pretty sick, like with pneumonia, are nevertheless told to stay home and take care of themselves. How should senior citizens prepare for this? And I'm going to amend this question, if you don't mind, Dr. McBride, to say people who live alone. Right. It's one of the more terrifying situations for my older patients, particularly when they live alone, because they feel, some of them feel like they're being told by media and things they're

hearing on the internet that they're supposed to stay home no matter what. That's absolutely not true. The hospital is there for you with open arms if you need to be there. But again, I'll go back to my refrain that it's important to have a doctor to help you understand what is going on and how sick you are, how likely is it that you can treat your symptoms at home, or how urgent is it to get you to emergency care? The beautiful thing about this shift recently in medical care to telemedicine by necessity is that doctors are now able to reach people more than ever in their homes by TV screen, by remote access. So hopefully in the future, we'll be seeing more access to doctors by virtue of telemedicine. Up next, we have Pat from New Mexico.

What should you do to prepare a room for self-quarantine? I only have construction masks and gloves from home improvement projects. And what about disinfecting the room afterwards? Dr. McBride, what do you say? So there's nothing you really need to do to prepare to quarantine an ill patient. The key is that they have a comfortable bed, access to water, and that they have a mask and gloves to use when they absolutely need to go outside of that sort of safe, sealed off space. But there's nothing you have to do to really prepare to be sick in a quarantine space. After someone is sick, that's when you need to make sure that the room is virus free as possible.

The nice thing that we are seeing in more and more data that's coming out is that the virus doesn't actually live on fabric like bedsheets for very long. And it lives more on metal and soft plastics like doorknobs and elevator buttons and apartment buildings than it does on sheets. So in reality, you could actually just have the person convalesce and recirculate in the house when they're well, and then let the virus die in the room for a day, day and a half, and then it might be fine. You might want to Clorox it just for a safe measure, but that's all that you need to do. Our next question is from Laura in Olympia, Washington, and she's wondering about allergies. I often have a spring cold triggered by allergies, but I've had a dry cough for almost a month now.

It was pretty infrequent, but it's getting more frequent and more chesty in the last week. I don't have a fever or any other obvious symptom. Is this allergies, bronchitis, or could this be a case of COVID-19 that has taken a while to manifest? Dr. McBride, I'm betting you're hearing this from, you're in Washington, D.C., which is known for its beautiful, you know, flowers, but also horrendous pollen at this time of year. So I am betting you are getting this question all over the place from your patients. You're absolutely right. I'm talking to patients every day about this exact question.

It's probably the most common question I'm getting. And the first thing is not to panic because a lot of people are suffering from allergies, and people are often familiar with their seasonal allergy symptoms. That said, I'm telling people that they need to presume this is coronavirus because it's so prevalent in the community, and there's such a high risk of community spread. Call a doctor. Call your doctor. Yeah, so call your doctor. That was Dr. Lucy McBride talking to Michelle Martin. 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 CDC now recommends that all Americans wear cloth face coverings in public. And a lot of people sent in questions about when to use them and how to make them. So Dr. Abrar Karan, a global health expert and physician at Harvard Medical School, answered some of those questions with All Things Considered host Ari Shapiro. I think a lot of listeners are feeling confused about the guidance on this. Let's hear from somebody who's trying to sort this out. This question comes from Phil in Providence, Rhode Island. So my question is regarding whether or not are we supposed to be wearing masks? First, we're being told we should only be wearing masks if we're showing symptoms or if we're sick. Then we're being told that we should be wearing masks all the time regardless. And now we're supposed to

be making our own masks at home. I'm really confused and lost. I think Phil is not the only one who's confused and lost. There's been really conflicting guidance over time. Help us sort it out. Yeah, I can understand how this could be very confusing to a lot of people. And one thing that was mentioned in the question was, you know, initially there was a thought that we are focusing on people who have symptoms. As we get further data, we're now thinking a little bit more about people who are in a pre-symptomatic state, so people who before they actually develop symptoms are harboring virus and could be transmitting it to other people. And so the idea with trying to have more people cover their face and their nose is to blunt transmission in that way,

particularly when you're not showing symptoms. So I think that is what drove this push towards having more people wearing masks. So it's less about preventing the disease from getting into the mask wearer and more about preventing it from getting out from the mask wearer. Is that right? You know, that's definitely a good way to think of it. I think partly because, as you know, in the healthcare setting, right, there's a lot of conversation about wearing face masks versus N95s. And these have a dual function, right? One is to make sure that we aren't transmitting and the other is to make sure we aren't getting infected as health care workers. Whereas for these more general cloth mask recommendations that have now come out from the CDC, the idea is at a population level trying to prevent transmission as much as

possible. Okay, now, as you point out, the CDC is saying, save the N95 masks for the professionals, which has led to a lot of people making their own masks. And I know you're a global health expert, not an origami expert. So I'm not going to ask you to tell us how to fold your own mask. But we did get this question about home crafting from Aaron in Washington. If you want to make a mask out of materials you already have at home, what's the best material to use? As a doctor, I don't know if they taught you this in medical school, but what insight can you give us? No, yeah, so certainly not something we learned in medical school, but I've been doing some reading on this topic. You know, it's something that a lot of us are thinking about. So some of the data is suggesting perhaps using a high-quality, quote, quilter's cotton.

So this is something that they've looked at a little bit in terms of what people might be able to use, but I wouldn't be the person to tell you what is and isn't quilter's cotton. So this is something that they've looked at a little bit in terms of what people might be able to use, but I wouldn't be the person to tell you what is and isn't quilters cotton. So quilters cotton, whatever that is. I also hear cotton sheets are good. Yeah. You know, the trouble with a lot of this stuff is we don't have studies in the real world to really say if this is going to work or not. A lot of this is theoretical, hoping that this would be another aspect that could help lung transmission. But, you know, one of the keys to this is really to make sure that that doesn't change the things we're doing in terms of social distancing, like keeping six feet apart,

washing your hands. So one of the things from our side as public health practitioners is we don't want people to think masks are now an excuse to not be doing the other things that are important. Yeah. We got a lot of questions about reusing masks. Here's one from Laurel, not far from you in Somerville, Massachusetts. I want to wear a cloth mask when I'm out in public, but I can't really run the washing machine every day. Can I sterilize them by hand washing or other methods? Also, can surgical masks be sterilized and reused or just reused after a waiting period?

What advice would you give, Laurel? Yeah, that's a great question. So the guidance from the CDC and from other experts is certainly that you should be washing the cloth. So if you wash the cloth, it should be clearing the virus off there. In your washing machine with soap, if you wash it with hand soap, you know, under the sink. What we know is cleaning works pretty well. A lot of the studies in major medical journals have shown that when you actually are cleaning off surfaces, it does remove the virus. So I'd say to really focus on cleaning those clots, don't reuse them. And when you are taking the mask off, make sure you're not touching your nose and your face inadvertently. That's another pretty important thing. So that's what I would say to that.

You know, an artist friend made me a reversible fabric mask, and I was telling a doctor this, who said you can't reverse it unless you wash it first. But if the goal of the mask is to keep an asymptomatic me from spreading my germs to other people, does it matter whether there's a clean side and a dirty side? It absolutely does matter, because you're wearing a mask not knowing if you're infected or not. You know, you should be social distancing, you should be staying at home, but let's say you had to go to the grocery store or

something like that, right? Theoretically, if you were to touch something and then touch the outside of your mask, you could be spreading fomites and other germs and materials. So it's better to be careful and it's better to be washing it as much as you can. We also heard from some listeners who are skeptical that a face covering will work. Here's Mary Ellen Schmidt of Bloomington, Illinois. I only go to the store as needed. I don't talk to people and I'm not sneezing or coughing. I don't think a mask will help even if I could find one. What are your thoughts? Yeah, it's a great question. I think that the key that she's saying here is that she's not leaving the house that much. She's just going to the store as needed.

And this is just another added protection to help one transmission. But, you know, the keys, again, are social distancing. Don't get too close to other people. Wash your hands. The mask is something that's trying to add to that. And again, we just don't have the studies to know for sure how much that's going to impact transmission. But that's what we know.

Seems like these are all ways of reducing risk. And even if no single step is going to get us to 100% risk reduction, each little bit at least can't hurt. Is that the working principle here? That's the working principle. And, you know, the concern is one where sometimes new interventions can change how people perceive their risk. So we don't want people to wear a mask and now think their risk is much lower. And then they may go do other things that actually put them at higher risk again. That's part of it. And the other part is that these things can be harmful in certain ways, right? So if you, in the process of wearing your mask, are now actually touching your face more when you're taking your mask off, you could have potentially just exposed yourself. So you need to be very careful, even with things like putting masks on, cleaning masks, and all those things. And those are things that we do in the healthcare setting.

You know, those are all things we think about regularly when we're putting our masks on or take them off. Okay, we've got a question here that I think a lot of people have thought to themselves, if not asked out loud, which is, if you're passing someone on the street, and you have the instinct to hold your breath or exhale rather than inhale, does that actually make any difference? Well, you know, it's really when you have sort of sustained contact with somebody for some period of time that you're going to be most likely to transmit. So if you just pass them very quickly, it's less likely. That's Dr. Abrar Karan talking to Ari Shapiro.

A record number of Americans have lost work because of this pandemic. Nearly 17 million people in just the last three weeks have filed for unemployment benefits. The Federal CARES Act, that's that $2.2 trillion relief package, is supposed to help. NPR's chief economics correspondent Scott Horsley talked to Michelle Martin to answer people's questions about who qualifies for that relief and how actually to get it. And the first listener question came from Howard in California. I actually lost my job just before this back in December, and I've been on unemployment since January. I did get hired at another job, but it was suspended because of this. And so I'm still on unemployment. That unemployment runs out in one month. I want to know, do I qualify for the extension and also the additional benefit?

I bet he's not the only one. Scott, what do you think? who's become unemployed now is eligible for the extra $600 a week that Congress has authorized that runs through the end of July. And that's on top of whatever you're already receiving in unemployment from your home state. What's more, a lot of people who were not previously eligible for unemployment, people who are self-employed or gig workers and so forth, they're also eligible for those $600 a week payments. And that's a really important lifeline as we try to wait out this pandemic. Brianna from Nevada has a question about filing for unemployment. I'm trying to help my boyfriend fill out an unemployment claim. And he received a green card in the 1980s when there was no expiration date given.

And not only do they ask for your alien ID number, which of course he has, but they ask for an expiration date for the card. And everything I put in, 00, 00, 00, nothing is going through. And I've, of course, tried to call the unemployment agency, and I just can't get through. And so I'm really hoping you can help me out. Thank you very much. I just have to tell you, we've been hearing so much, I'm sure you have too, about how hard it is to get through on the phone. Any ideas? Yeah, I wish I had something better to tell Brianna, some magic bullet here. This really sounds like a situation where you are going to somehow have to make contact with a live body at the unemployment office because obviously there's a mismatch between her boyfriend's situation and the way

their computer system is set up. The challenge is the systems are overwhelmed right now. With six and a half million plus people applying last week alone trying to get through, we know that the phone lines have been jammed. We know that the computer systems have been overtaxed. I talked to a man in New York who lost his job on Friday the 13th of March. And at the time, of course, he felt pretty unlucky. But it turned out he was one of the fortunate ones because he got in just ahead of the big wave of layoffs and was able to qualify for unemployment benefits fairly quickly. His fiancee, on the other hand, and some of his co-workers who got their pink slips a week or 10 days later, they're now jostling to get through the system with millions of other people, and they're having to wait longer. The fellow who got through

after the Friday the 13th told me, you know, we're all in the same boat, but we're all in different seats on that boat. And PR's Scott Horsley talking to Michelle Martin. That's it for this weekend. You can join the National Conversation with All Things Considered on the radio Monday through Friday at 9 p.m. Eastern. And of course, none of this happens without you. So thank you for supporting your local public radio station if you can. We will be back on Monday. I'm Kelly McEvers, and this is Coronavirus Daily from NPR.