Consider This from NPR - Social Distancing Is Working; Why The Virus Hits Hard In The Second Week

Episode Date: April 8, 2020

New York state saw its highest daily death count today, but Dr. Anthony Fauci says because of mitigation strategies like social distancing, a turnaround may be in sight.Some people who get COVID-19 will experience relief from symptoms, only to crash in the second week. NPR's Geoff Brumfiel reports doctors think they may have found a treatment for these patients. Plus, U.S. states are competing against each other for the same scare medical resources. Scott Horsley's reporting on women losing more jobs than men. Nell Greenfieldboyce's reporting on why men appear to be more likely to die from COVID-19 than women.Video of Fenway Park's organist Josh Kantor.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

Nearly a third of people who rent apartments in this country did not pay rent this month. That's according to new data out today. And tomorrow, on Thursday, a new government report will tell us how many more people are filing for unemployment, beyond the 10 million people we know are already out of work. But the thing is, staying home is working in the fight against this virus. There's no doubt in my mind it's because of the social distancing. And I think people need to understand... Even as more than 3,000 people died from COVID-19 just today, Dr. Anthony Fauci says it looks like the number of deaths will be lower than originally projected.

And that is exactly why social distancing has to continue. So we need to keep pushing on the mitigation strategies because there's no doubt that that's having a positive impact on the dynamics of the outbreak. Coming up, coronavirus spreads to rural America, and so does the fight for medical supplies. Plus, why some COVID-19 patients get really sick after they seem to be getting better. This is Coronavirus Daily from NPR. I'm Kelly McEvers. It's Wednesday, April 8th. It's probably no big surprise that this pandemic is affecting men and women differently.

Most things do. But what is surprising is how. Erica Dabrowski recently lost her job as a front desk clerk in a big Chicago hotel. And if you didn't catch what she was saying, she said that 1,200-room hotel had three rooms occupied. So she filed for unemployment. It's been enough to get by for me, but it's not been great, obviously. And especially the Illinois unemployment benefit obviously is absolutely overwhelmed right now. Women like Erica make up the bulk of workers in restaurants, bars, and hotels. Which is why, of the 700,000 jobs that were eliminated last month, nearly 60% of them were held by women.

When it comes to the actual virus, it's the other way around. One large study that looked at nearly 45,000 COVID-19 cases in China found that the fatality rate was 2.8% for men compared to 1.7% for women. Experts don't know why. They do know that historically, biomedical research has tended to focus on male subjects. There are examples. There are not a lot. And I think part of that is because this has been a grossly understudied area. Sabra Klein at the Johns Hopkins Center for Women's Health, Sex and Gender Differences also says women do seem to mount a greater immune reaction to infections for viruses like HIV and hepatitis C, but there's just not enough data yet. There's more NPR reporting on gender disparities in the pandemic from NPR's Scott Horsley and Nell Greenfield-Boyce in our episode notes. Most people who get COVID-19 get a mild version and then recover.

But others fight through the first week of the disease and maybe even start to feel a little better and then suddenly crash, sometimes badly. Turns out, as NPR's Jeff Brumfield reports, that can have to do with our own immune systems. Right now, the best weapon you have to fight against COVID-19 is your own immune system. The majority of people who get the disease just need to rest while their immune cells seek and destroy the virus. But that army of cells can do collateral damage. And when they deal with infection, they make a lot of toxic molecules. And so those toxic molecules can cause a lot of tissue damage. And when they deal with infection, they make a lot of toxic molecules. And so those toxic molecules can cause a lot of tissue damage. Jessica Hammerman is an immunologist at the Benaroya Research Institute in Seattle. She says the fevers, aches, and pains you feel when you're

sick, that's often a side effect of the immune system's work. And sometimes when the fight is particularly tough, the side effects can get really out of hand. What happens is this. Immune cells have a way of calling in reinforcements using molecules called cytokines. And sometimes, cells just keep producing more and more cytokines. Hammerman imagines it this way. The virus is like a fire breaking out in a large building. The cytokines are like the alarm. It's like the smoke alarm never turns off and you keep having firefighters are coming, coming, coming. Spraying water on the walls, chopping through doors, doing all kinds of damage to the building even if the fire is out. The name for this is a cytokine storm and it can be deadly. In fact, it's believed that cytokine

storms killed a lot of young and healthy people during the flu pandemic in 1918. Now, Hammerman and other scientists and doctors say they're seeing signs storms are killing people infected with coronavirus. Tests are showing elevated levels of cytokine molecules in the blood of some of the sickest patients, often in the second week when the immune system is ramped up to fight. Some doctors are trying to treat these storms. One is Daniel Griffin, the chief of infectious disease for ProHealthcare Associates, a group of physicians that serves the New York City area. When I spoke to him last week, he had just started using steroids and powerful anti-inflammatory drugs on a handful of patients. The goal was to try and turn down

the immune system's alarm. And he said he was seeing results. Everyone did really well. It was actually, I have to admit, yesterday was a good day. Some patients recovered in a matter of hours. The impact was dramatic. Since then, he's treated dozens of COVID patients. Not all have responded well, but he says overall he thinks it's definitely helping. However, Tobias Hull of Memorial Sloan Kettering in New York City warns that these therapies carry risks. One risk is that the infection could get worse. Remember, the immune system is the best weapon people have to fight COVID-19. Turning off even part of its communications network just when it's in the fight of its life against coronavirus could cause the virus to surge back. Hull says the treatment could

also lead to secondary infections that could be worse than COVID-19 itself. You know, I don't want to be a Debbie Downer, but I think we have to be humble and just not assume that things are going to work. Given the dangers, Hull says, rigorous studies need to be conducted to see who will benefit from the drugs to block cytokine storms. Those studies are already underway. NPR's Jeff Brumfield. So by this point, over 400,000 people have been infected by the coronavirus here in the United States. And more than 13,000 people have died. Almost one-third of those were reported in New York City alone. But COVID-19 is now making its way through rural America, too,

where some places are starting to see the same shortages that urban areas have dealt with for weeks. NPR's Joel Rose reports on the situation in Montana. The market for medical supplies in America has become chaotic. States and hospitals are competing with each other and with the Federal Emergency Management Agency for the same scarce resources. At first, President Trump told governors

to find their own supplies and that, quote, we're not a shipping clerk. Then a few weeks later, the administration launched Project Airbridge to help alleviate the supply crunch. But Montana Governor Steve Bullock, for one, says none of the supplies on those planes are coming his way. If the private market supply chains aren't necessarily working for the states and we're just bidding up prices against one another in a scarcity, I think it makes that much harder for us to do our job. Montana has a relatively low number of coronavirus cases, but it does have a serious outbreak in the Bozeman region. And that drew the attention of Dr. Deborah Birx, the coordinator of the White House Coronavirus Task Force.

There were a few standouts that we were concerned about, which was Vermont, New Hampshire, Idaho, and Montana. These were micro outbreaks that occurred due to ski events and weddings and nursing homes. Emergency responders in Montana say they need half a million and 95 surgical masks. The state asked for 80,000 from the federal government, but only got 10,000. I've gotten five times more supplies of N95 masks from North Dakota than I have from the Strategic National Stockpile. Governor Steve Bullock says the state has been left scrambling to find basic medical supplies elsewhere,

and like many other states, paying exorbitant prices, like for those surgical masks that used to cost a buck apiece. I was happy to bid up to almost five bucks a mask to try to get a supply into Montana. You know, I had one order, it was probably two weeks ago that I was paying six bucks a mask on that ended up canceled. Not only is the marketplace chaotic and pricey, it's also flooded with

opportunistic sellers. Michael Mooney is with Montana Disaster and Emergency Services. It's his job to figure out which companies can actually deliver and which are scams. I've spent the last 13 days in this windowless room trying to vet potential vendors. Companies he's never heard of are cold calling him. Some insist on getting paid up front. Others go for high pressure sales tactics like this. I've got masks on a plane from China right now if you commit right now. Mooney says the state did find two companies it felt good about and placed orders for one million masks. Now they're just hoping those masks make it to Montana. That was NPR's Joel Rose.

There are so many things to miss about normal life right now. And here in the first full week of April, one of those things, for me at least. It's time for the seventh inning stretch. That's the name of the show. And part of it is every day we do a stretch. Is baseball. Relax a bit. Stretch. And have a moment of joy in your day. Luckily, Fenway Park organist Josh Cantor exists, and so does the internet, where every day, from his home, he streams a little show on Facebook called the 7th inning stretch. Don't worry. He takes requests. He talks day from his home, he streams a little show on Facebook called The Seventh Inning Stretch.

He takes requests. He talks a little baseball. And of course, and here's your four bar intro. Check out our episode notes for more on Josh Cantor. For more on the coronavirus, your local public radio station can keep you up to date. This is Coronavirus Daily. I'm Kelly McEvers.