Consider This from NPR - Ventilator Shortages; 6.6 Million New Unemployment Claims

Episode Date: April 2, 2020

6.6 million Americans filed for unemployment benefits last week, doubling the record-setting numbers from the week before. The rapid increase has overwhelmed state offices. Ventilators are a scare resource right now. While they are lifesaving for some, NPR's Jon Hamilton reports when it comes to COVID-19, they do not guarantee survival.Plus, how to protect essential workers when ordering delivery and going to the grocery store.Links:The Indicator's episode on scarcity in the emergency room on Apple, Spotify and NPR One.Camila Domonoske's reporting on grocery store worker safety.Find and support your local public radio stationSign up for 'The New Normal' newsletter 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

Just real quick before we start the show, you're listening to this, so that probably means that a clear, calm, and brief update on everything that's going on right now is important to you. And we work hard to do that every weekday. Now we're asking for your help. Please, if you can, go to donate.npr.org daily to find your local public radio station and support it. Everything helps. If you can sign up to be a sustaining member, that's the best. Donate.npr.org slash daily. Also, there's a link in our episode notes. And thanks. 6.6 million Americans filed for unemployment benefits last week. That is a staggering number. And it is a record for the second week in a row.

The week before, over 3 million claims were filed. That means at least 10 million Americans have lost their jobs in just the last two weeks. We have about six days of ventilators in our stockpile. In New York, Governor Andrew Cuomo said his state could run low on ventilators over the next week. If the apex happens within that time frame, if the apex increases, if the apex is longer, we have an issue with ventilators. Coming up, why those ventilators do not guarantee survival, and how we can all help to keep delivery and grocery store workers safe. This is Coronavirus Daily from NPR. I'm Callie McEvers. Today is Thursday, April 2nd.

I was just going to, Joe and Mika, to both of you, that number that we've been looking for just crossed, and you'll forgive me if my jaw is on the ground. U.S. weekly jobless claims total 6.6 million versus 3.1 million expected. 6.6 million people. An impact being felt all across the country right now as we're basically shut down. It is a number never seen before in the history of the Labor Department. These are numbers that we saw over the course of the entire Great Recession. And we don't know how many of these people are going to get back to work and how quickly. Because this happened so fast, the state offices that process unemployment claims have been overwhelmed.

We are currently receiving more calls than we can answer. All agents are busy servicing customers. Please try again later. Gracias. Thank you for calling. Adios. And the backlog of claims is almost certain to grow. You're basically asking people to stay home and not go to work. Lydia Boussour at Oxford Economics says as many as another 10 million people might be laid off. That would be 20 million Americans in a matter of weeks. We wouldn't have think a few weeks ago that something like this would have been possible. There is a little bit of good news, right?

Gig workers, self-employed people, and freelancers are now eligible for unemployment under the Economic Relief Act that passed last week. All that goes to say, if you or someone you know has applied for benefits, it might take some time. For faster service, use UI online at edd.ca.gov forward slash UI underscore online. There are now more than 1 million cases of COVID-19 worldwide.

And in so many ways, the story of this pandemic is scarcity. Not enough tests, not enough masks, not enough hospital beds, and not enough ventilators. Jessica Von Voorhees is an emergency room doctor at New York Presbyterian Methodist Hospital in Brooklyn. And she is seeing all that scarcity firsthand. She talked to Stacey Vanek-Smith on The Indicator. It's NPR's daily podcast about business and the economy. How many ventilators do you guys have? Well, apparently our respiratory therapist

has been gathering vents for a while and like prepping for this. And they were saying we had 55 patients on vents and apparently, you know know we had 70 vents in the hospital 70 vents yeah that's what they said that's like only 15 ventilators left right that's kind of getting that you're getting there right it's like how many i keep waiting for them to call downstairs and be like okay there are four left like you have to choose it just hasn't happened yet and then you have to start picking who the people who really, really most need a ventilator are.

Yeah. And even maybe who to save, right? So like who has the most likelihood of surviving? Because you don't want to put someone on a vent that you think they won't survive. You know, do you save somebody who's younger because they have more years ahead of them? Or do you save somebody who's middle-aged because they have knowledge and experience? That's not a call that you've had to never make. No, never. And you're worried that you might have to start? Yeah, in Italy, they certainly had to make those decisions. Because they didn't, they ran out of ventilators, and they started to just choose younger people or whatever, you know, but they said it's hard, because sometimes you're sort of like these two are a tie. They're very similar. That's a horrible choice to have to make.

I know. That's really, that's, I mean, have you thought about that a lot or? Well, it's really the concept of triage, you know, sorting patients into like more severe and less severe, trying to provide the most good for the greatest number. So I feel like I could actually make those decisions if I had to. And that's a good thing, because you want somebody who could make that decision, right? But do you think that is coming with questions of resources, possibly like ventilators and things like that? Maybe. And they're doing creative things. Like it turns out, you can actually put more than one person on a ventilator, the machine itself is strong enough to give breaths to maybe even three people.

So that's just kind of crazy. Like, I definitely have never seen that done before. But the respiratory therapists were saying that that's possible. And it effectively doubles the number of events that you have. Yeah. Which is crazy. Have you seen a lot of people dying from coronavirus? Yeah.

Not ones that I've admitted to the hospital. Like certainly we're seeing people come in in cardiac arrest and not make it. Is it mostly very older people? It's actually been a really broad range. So the patients coming in with coronavirus and needing oxygen, I've seen people in their 30s who have no health problems. So we all know this is a really deadly virus. But I feel like, say, 1% of the population that catches it, which I would say most of the population of New York City is going to catch it at some point. Say 1% of people die. Well, that's a to be coming which is really sad and we all kind of have to emotionally prepare for is the wave of death that's coming there's going to be this

really like big national like bereavement and people should be ready to know I feel like we're still at that friend of a friend phase and eventually it's just going to get closer and closer to home and everyone's going to know someone. We haven't peaked yet. I'm going to be happy when we peak and things start going down because then at least, you know, it can't get any worse. Jessica von Voorhees on The Indicator. You can hear more of that conversation on that podcast and find the link to it in our episode notes.

So as healthcare workers in hard-hit areas stare down the possibility that they could run out of ventilators, it is worth saying those machines can be life-saving for some critically ill patients, but not for all of them. Here's NPR's John Hamilton. The intensive care units at Barnes-Jew Jewish Hospital in St. Louis are filling up with coronavirus patients, and Dr. Tiffany Osborne has been caring for many of those who've been placed on ventilators to keep them alive. It's very concerning to see how many patients who require ventilation do not make it out of the hospital, how many of them die. Osborne is a

critical care specialist at Washington University School of Medicine. She says doctors in China and Europe and elsewhere in the U.S. are reporting death rates from about 50 percent to more than 80 percent. We're not sure how much help ventilators are going to be. They may help keep somebody alive in the short term. We're not sure if it's going to help keep someone alive in the long term. Patients end up on a ventilator when their lungs can no longer deliver enough oxygen to keep the body going. Osborne says it's an extreme measure. We give sedation so that the person goes to sleep and then we provide a paralytic that stops their breathing. Next, they insert a long plastic tube through the trachea and vocal cords. That allows a machine to deliver puffs of highly oxygenated air to the lungs.

The ventilator itself can do damage to the lung tissue based on how much pressure is required to help oxygen get processed by the lungs. And Osborne says coronavirus patients often need dangerously high levels of both pressure and oxygen because their lungs have so much inflammation. Also, ventilators create a path for a wide range of infections to reach the lungs. Dr. Negin Hajizadeh is a pulmonary critical care doctor at Hofstra Northwell School of Medicine in New York. She says ventilators work really well for patients with common forms of pneumonia. We treat patients for several days and then we get the antibiotics into the body and the patient recovers. Unfortunately, with this COVID-associated pneumonia, there are no treatments that we know

work for sure. So Haji Zadeh, who spoke to me from just outside of an intensive care unit, says ventilators are of limited value. We have had several patients between the hospitals across the Northwell Health System that have come off of the breathing machine, but the vast majority are unable to. Hachizade says one reason is that the coronavirus often does a lot more lung damage than, say, the flu. There is fluid and other toxic chemical cytokines, we call them, raging throughout the lung tissue. She says in some patients, the damage is so bad that even ventilation won't help. So they've tried an even more extreme measure called ECMO, which delivers oxygen directly to a patient's bloodstream.

Remember, ECMO-2 is a life-supporting treatment. So it's a bridge while we are allowing the lung to heal itself from a pneumonia. If it can, Dr. Tiffany Osborne says that what doctors are learning about severe coronavirus infections should make it crystal clear why we all need to take steps to keep the virus from spreading. I know that at times it gets frustrating, but it's really important, not just for yourself and your family, but for the other people that you care about to shelter in place until this is over. Osborne should know when she's not at the hospital, she's living in a camper to avoid putting her family at risk. That was NPR's John Hamilton. And before we go, just a couple of notes on food.

The coronavirus is spread primarily through respiratory droplets. And that means if you're getting takeout, the biggest risk to you and to your delivery worker is contact. Many restaurants are taking extra precautions, such as no contact delivery or pickup. And once you have your food, you will want to throw away any packaging. According to the CDC, it is possible to get sick from touching a surface that has the virus on it.

And before you eat, make sure to wash your hands thoroughly and tip your delivery person thoroughly, too. As for the grocery store, we should think of those workers as well. A lot of our customers are coming in in masks, and I appreciate that. And I like to think it's not just for their own health, but it's for ours. Amanda Casaburi works at Kroger near Fort Worth. She talked to NPR's Camila Dominovsky. And she said when she's restocking dry goods,

she is constantly thinking about every surface she touches. My biggest fear is getting sick and passing it to someone else. Kasaburi says she sees some shoppers lingering in the aisles, and that makes her worry. I just wish everyone would take it a little bit more seriously. So she has some strong advice. Bring a list, get in, get out, and go home. For more news on the coronavirus, you can stay up to date on your local public radio station. And if you'd like your news on demand, download the NPR One app.

You will find podcasts and a mix of local, national, and international news. I'm Kelli McEvers. Thanks for listening. We will be back with more tomorrow.