Consider This from NPR - Testing, Reopening Schools, Vaccines: Fauci And Others Testify

Episode Date: May 12, 2020

In a Senate committee hearing on Tuesday, Chair Lamar Alexander of Tennessee asked Dr. Anthony Fauci whether coronavirus treatments or a vaccine could be developed in time to allow college students to return to school in the fall. Fauci said that "would be a bridge too far." There's a full recap of today's hearing on The NPR Politics Podcast. listen on Apple Podcasts, Spotify and NPR One.New York is trying to build what could become one of the largest contact tracing programs for COVID-19. Starting this month, public health officials there are looking to hire as many as 17,000 investigators.Nursing homes account for nearly half of COVID-19 deaths in some states. NPR's Ina Jaffe reports on why nursing homes have been so vulnerable to the virus and what could be done to improve them in the future.Plus, a professional musician sidelined by the coronavirus becomes a one-man marching band for his neighborhood.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

This week, the president said the United States had prevailed. We have met the moment and we have prevailed. On testing. We certainly have done a great job on testing and testing is a big, is a very big, important function. But in a Senate hearing today, a top Trump administration official suggested. So by September. There's still a lot of work to do.

We project that our nation will be capable of performing at least 40 to 50 million tests per month if needed at that time. Last week, the U.S. conducted around 2 million tests. And while the government pledges more money to help states with testing, many are still very far short of where experts say they need to be. Coming up, Dr. Anthony Fauci on returning to work and school and what one state is doing to hire an army of contact tracers. This is Coronavirus Daily from NPR. I'm Kelly McEvers. It is Tuesday, May 12th.

Tuesday's Senate hearing was a little different. The Committee on Health, Education, Labor and Pensions will please come to order. Top officials, including Dr. Anthony Fauci. Thank you very much, Mr. Chairman, Ranking Member Murray. The committee's chair, Senator Lamar Alexander. Thank you, Dr. Fauci. Dr. Redfield. And CDC Director Robert Redfield. Good morning, Chairman Alexander and ranking members.

We're all in different locations on video. The subject of the hearing was safely getting back to work and getting back to school. I don't have an easy answer to that. I just don't. School in the fall, Fauci said, is a really tough call. There are so many factors. The lost time and kids' development, the nutrition and safety they get at school, and the burden on parents who might still have to work even if their kids are at home. It's very difficult of the unintended consequences of trying to do something

that broadly is important for the public health and the risk of having a return or a resurgence of an outbreak and the unintended deleterious consequences of having children out of school. There's also new evidence that some kids can get really sick from the coronavirus. So Fauci said some schools might be able to return in the fall, but depending on the outbreak at the time, others might not. So I would imagine that situations regarding school will be very different in one region versus another, so that it's not going to be universally or homogeneous. I don't have a good explanation.

On a potential vaccine, Fauci said hoping for one by fall is wishful thinking. But multiple vaccines are being fast-tracked. He says this is called at-risk development. Which means we'll be investigating considerable resources and developing doses even before we know any given candidate or candidates work. Of course, until there is a vaccine, businesses and workplaces will have to figure out how to operate safely in all kinds of different circumstances. The White House reportedly has been holding back

detailed CDC guidance for how to do that. Clearly, we have generated a series of guidances, as you know. CDC Director Robert Redfield told Senator Chris Murphy of Connecticut the guidance was still being reviewed. But we're reopening in Connecticut in five days, in 10 days. I mean, this guidance isn't going to be useful to us in two weeks. So is it this week? Is it next week? When are we going to get this expertise from the federal government? The other thing I will just say is that the CDC stands by to give technical assistance.

The guidance, he said, would be out soon. Soon isn't terribly helpful. Thank you, Mr. Chairman. But maybe the most important message at the hearing was one Anthony Fauci has repeated over and over. My word has been, and I've been very consistent in this. Reopening without the right precautions in place is a big risk. My concern is that we will start to see little spikes that might turn into outbreaks. So therefore, I have been being very clear. Our colleagues over at the NPR Politics Podcast have a breakdown of the entire hearing.

You can get a link to that in our episode notes. Public health officials in New York plan to hire as many as 17,000 people to be contact tracers. These workers are essential to contain the virus as, hopefully, infections there continue to decline. It would be one of the biggest contact tracing programs in the country, and the people doing it will have their work cut out for them. Here's NPR's Hansi Le Wong in New York City. After more than two months of COVID-19 ravaging New York and killing around 27,000 people in the state, public health workers are preparing to make a lot of phone calls that start like this. I'm an official from the Department of Health. I understand that you have a positive test for coronavirus. Dr. Kelly Henning is an epidemiologist who leads the public health program at former New York City Mayor Mike Bloomberg's Charitable Foundation, which says it's committing more than $10 million to New York

State's new contact tracing efforts. You know, if we don't start the contact tracing work, we're going to have to shelter in place for longer periods. And I think that's something that most people are not wanting to do, obviously. And so the idea is to try to open as safely as possible. And to do that, officials with New York State's program say they need to call people who test positive for the coronavirus, if they can get tested, as well as people with whom they're in close contact from two days before symptoms start to show and until the patient is isolated. Close contacts include anyone who, for at least 15 minutes, was within six feet of a person who tests positive. If they've been in high-risk locations like nursing homes or homeless shelters or other places where there's very high risk,

it allows public health to really zero in on those locations. The key to contact tracing is to collect information from people who may be infected as soon as possible. That's especially important with a coronavirus because some people who have it don't have symptoms. New York Governor Andrew Cuomo says his state's health department is trying to build up an army. The estimate so far is you need 30 contact tracers for every 100,000 people.

To start, over the next few weeks, hundreds of contact tracers with the state's program may be deployed to call around New York after they undergo online training that includes a video of actors showing how a contact tracing interview might play out. Since you were around someone who tested positive and there's a possibility that you're positive too, we strongly recommend that you quarantine yourself. So I'm just back to staying at home alone without going anywhere?

Yeah, that's right. New York City is providing free hotel rooms to anyone who tests positive and cannot self-isolate at home for two weeks. Still, contact tracing has raised concerns about privacy. Sarah Braunstein, who's a director with the city's health department, says investigators with the city's own local efforts for COVID-19 would only share limited information with people who may have been in close contact with a person who tests positive. We would never mention a name. It would be someone you know or someone you were in close contact with tested positive for coronavirus and you may have been

potentially exposed. Bronstein says for now, New York City's contact tracers will not be using smartphones to try to track people's exact locations. They're planning to rely mainly on humans. So far, the city has received 7,000 applications for 1,000 contact tracing jobs, including from Shalini Dan Hormelus. I am a student from Brooklyn College. I am studying health and nutrition science. Hormelus says she used to make dozens of phone calls a day as a case manager for Haitian immigrant students enrolled in New York City schools.

And that, she says, could come in handy. The thing is, you have to build trust. Because sometimes people don't want to share information with you like that. For public health officials in New York, though, it's information they say they're counting on as they prepare for a possible second wave of the coronavirus. NPR's Hansi Lo Wang. According to some estimates, as many as a third of the people who have died from COVID-19 across the country are either residents or staff in nursing

homes. And in some states, that rate is far higher. What's worse, these numbers are probably low. Not all states report data on nursing home deaths and causes. And the federal government is just beginning to track it. NPR's Ina Jaffe reports that in spite of these high mortality rates, a lot of nursing homes still have no plans in place to control infections. She talked to host Steve Inskeep on Morning Edition. Failure to have a plan for controlling infection is the most commonly cited deficiency in nursing homes nationwide.

Even before the pandemic, almost 388,000 nursing home residents died of infections every year. And even after the pandemic, government inspections found that more than a third of the facilities still had trouble following proper hand-washing procedures, and a quarter didn't use protective gear correctly. How would the nursing homes get away with that when so many people are dying? You know, for nursing homes, there's not much of a price to pay for these lapses. The fines are usually small.

It can just be the cost of doing business. And sometimes all the nursing homes have to do is give the government a written plan to show how they'll fix the problem. Critics of nursing homes say it's also a matter of staffing. There aren't enough people to do all the work and do it safely. There are no federal minimums for staff, and many states don't have them either. And since most nursing homes are for-profit businesses, the simplest way to cut costs is to keep the staff small. When you talk to experts, what do you hear about what nursing homes should be doing? Well, the thing I hear most often is that if you want to control

infection, nursing homes should be smaller and everyone should have a private room and bath. But that would affect the bottom line. Currently, many facilities have two or three or even four residents sharing a room and bathroom. Other suggestions range from how to make the inspection process more effective, to changes in design and architecture, to organizing facilities in a way that would respect the dignity of residents. Why would people not be pressing facilities to do more or to do better? First, I should say that there are nursing homes that do do a good job. I've been in some.

But until we suddenly need one of these facilities for a family member, we never think about them. They're not something we picture ourselves, a place we picture ourselves living. I spoke to Dr. Louise Aronson. She's a geriatrician and the author of Elderhood, which is just named a Pulitzer Prize finalist. And she thinks that these conditions show that we don't value older lives. As a society, we claim to have family values, and yet we outsource care of key members of our families, the people who gave birth to us and raised us and our parents and our grandparents. And then we pay people a paltry wage to do work that is so hard we don't want to do it ourselves. You know, that said, not everyone has a choice about moving a loved one to a nursing home. So these facilities are providing a profoundly important service. Advocates are hoping that with all the attention on nursing homes now,

maybe they'll finally get the scrutiny and support they deserve. And PR's Ina Jaffe talking to Morning Edition host Steve Enskeep. Zach Hickman is a professional bass player who was supposed to be on tour when the pandemic hit. Now he's at home in Watertown, Massachusetts. Walking the streets of his neighborhood with a big brass instrument decorated like the Loch Ness Monster. We always had the dragon. This is the Loch Ness. This is Nessie, the world's only Loch Ness Monster sousaphone. Reporter Bruce Gellerman of member station WBUR caught up with him there.

It's a sousaphone. Yeah. It's not a tuba. They're very closely related, but this is a sousaphone. Every day, Zach marches down the middle of the street. In the middle of the day, neighbors stare out the windows or watch from porches. I try to do a parade every day for my neighbors. It's to help break up all the monotony, you know.

So I do a couple hours a day, maybe 90 minutes, a couple hours a day. Awesome. Thank you so much. I appreciate it. He calls it a parade of one. For more news from NPR, you can stay up to date on your local public radio station and on NPR.org. I'm Kelly McEvers. We'll be back with more tomorrow.