Science Vs - Coronavirus: What Should You Do Now?

Episode Date: March 16, 2020

The coronavirus pandemic is here, and in the U.S., this is starting to get very real. We talk to people in South Korea and Italy to see what life has been like for them. And we find out what the problem was with America’s tests — are they fixed now? And now that social distancing is on everyone’s mind, do we have evidence that it will really “flatten the curve”? We speak to public health expert Prof. Josh Sharfstein, virologist Prof. Vincent Racaniello, and epidemiologist Prof. Elizabeth Radin. UPDATE 3/17/20: An earlier version of this episode said that Hong Kong had zero deaths, but according to figures on Friday from WHO 4 people died. We've updated the episode. Here’s a link to our transcript: https://bit.ly/2QmpJUf  Selected references: A look at what’s happening in Italy: https://bit.ly/3d56AA4 Josh’s paper on the testing debacle: https://bit.ly/2x3oT84  How different cities reacted to the 1918 flu pandemic: https://bit.ly/2waLYWk  This episode was produced by Wendy Zukerman, Michelle Dang, Meryl Horn, Sinduja Srinivasan, and Rose Rimler. We’re edited by Blythe Terrell and Caitlin Kenney. Fact checking by Lexi Krupp. Mix and sound design by Sam Bair. Music written by Peter Leonard, Emma Munger, and Bobby Lord. A big thanks to all the researchers we got in touch with for this episode, including Dr Neeltje van Doremalen, Prof. Nigel McMillan, Prof. Jeffrey Shaman, and Prof. Stephen Morse.   And special thanks to Salvatore Incontro, Gabriella Doob, the Zukerman family and Joseph Lavelle Wilson. Learn more about your ad choices. Visit podcastchoices.com/adchoices

All right, so this is Wendy here from Science Versus. I am now working from home, and my package of food for the pandemic has just arrived. All right, let's open it up. Wow. That's a lot of cans of chickpeas. Even though we've been reporting on this for months now, I still can't believe it's here.

How dumb am I? Yeah, so we are in the middle of a coronavirus pandemic. The World Health Organization has officially called this a pandemic. Over 100 countries now have confirmed cases and life for millions of us is changing really fast. Attention has shifted away from China a bit to the US and Europe as the virus is taking hold there. In countries like Spain, France and Italy, new strict rules have just been brought in to keep people away from each other. Italy has been hit particularly hard by the virus. Fabio Gaeta in Milan told us what was happening around him.

You are only allowed to go out with a kind of document in which you have to state why you are going out. Wait, you're not allowed to leave the house without a document? Yes. Fabio's job in the manufacturing industry means that he can still go to work. But other than that, he's only allowed

to go to the supermarket and the pharmacy. And police are patrolling the streets. If they stop you, they will ask you, for example, where you live. And based on the location, they can assess if you are really going to the supermarket. And so they can fine you with up to 200 euros. Oh, wow. Did you ever sort of imagine this would happen? Honestly, no. You have always the impression that this is stuff that happens in other parts of the world, never in the efficient Western culture.

But in this case, we are, I think, all of us discovering a very fragile, you know, how many weeks will pass until we will get to our normal life. That's the question. I know. It's so hard to know. Like, I'm looking at my office home set up, which is, like, we're at at my, like, my office home set up, which is, like, we're at the beginning, right? We're not even close to the end.

This is the beginning. I hope for you that I'm wrong, but I think that it's the beginning. I mean, it started like this also in Italy, with politicians saying that it was not a problem. Only a few people. No worries. But in the end, it was not like this. So I really hope for you that this is not the case. But it could be.

And over here in the US, things are changing every day. Just today, the president made recommendations for all Americans. He said for the next 15 days... My administration is recommending that all Americans, including the young and healthy, work to engage in schooling from home when possible, avoid gathering in groups of more than 10 people, avoid discretionary travel,

and avoid eating and drinking at bars, restaurants, and public food courts. And earlier, Trump announced a 30-day travel ban from Europe and declared a national state of emergency. Sporting events like the Boston Marathon have been postponed. Broadway went dark. Disneyland is shuttered. Schools are being shut down across the country and bars and businesses were told to close.

Meanwhile, many people in the US still don't know if they're sick with this virus or not. And that's because it's been really difficult to get tested. And experts, like our old pal Anthony Fauci, are saying we should expect more and more cases. We will see more cases and things will get worse than they are right now. So what can we do now to stop this?

As we've been following what's going on around the world and here in the US, two big things have been swirling around. The first is about testing. The US seems to have really bungled this from the start. So what's happening here? And how can you know if you have this coronavirus? The second thing is social distancing. We're hearing that we need to be

avoiding other people, but how far do we really need to take this? Science vs Coronavirus Part 3, Rise of the Machines is coming up just after the break. Welcome back. Right now in the US, there's been a ton of talking and arguing about testing for the coronavirus. Or rather, not testing. The testing thing, we obviously screwed that up royally as a country.

Why don't we have a test? Tell us the truth about testing. And our man on the ground, Anthony Fauci, has had to acknowledge to Congress... That is a failing. A failing, yes. It is a failing. Let's admit it. We're hearing all these reports of people who are sick,

who think they have this virus, but can't get tested. The situation in the US is actually such a mess that it's often not clear how to get a test or even how many people have been tested. The best stats that we could find were saying that it's probably around 40,000. And people are pointing to other countries and saying, look how far ahead they are on this.

For example, South Korea. They had their first reported case on January 20th, right around the same time that the US had theirs. Since then, South Korea has tested more than a quarter of a million people. One of them is Grace Moon, a Korean-American who moved to Seoul eight months ago. She had a really nasty cough and went to get tested. And she told us, look, it's not perfect there. She had to go to a

booth outside a hospital to get tested. But she actually had to wait there for hours next to a bunch of people who could have been sick. When I went there, I was just so scared. I was like, wow, I'm going to get coronavirus by just being here, by going to the hospital, because people around me were like coughing. And so I remember I just tried to stay like in the corner. Finally, it was her turn to get tested. And Grace said that part was quick it was just I think five minutes like they the first part was just two people in the suits they just asked me like what are your symptoms like why are you here today um in the in the suits as in quarantine suits yes the quarantine suits everyone there was wearing quarantine suits. You go into this narrow space that closes. And they kind of like shoved this piece, this long stick up my nose. Oh my gosh, it hurt.

I was crying. But yeah, it was very fast. And then they took my information. I paid. I can't remember how much I paid, but it was definitely under $30. I think within 24 hours, I got my results via text. Via text. It was like, hey, these are your results.

Your results are negative. So that's South Korea. But here in the US, it's very different, which is a big problem. And that's partly because symptoms of the coronavirus are really vague. A lot of people who have it will get a fever and a cough, maybe fatigue or shortness of breath. But really, these tests are key to knowing if you have this virus or not. So to find out why this has been so hard to work out in the US, we called up Josh Sharfstein. Josh is a professor at Johns Hopkins,

and he used to be the secretary of the Maryland Health Department. Last week, he wrote a paper about what went wrong in the US. And Josh told us... It really shouldn't be that challenging from a scientific perspective to stand up. But back in early Feb, the CDC sent out a bunch of tests and they didn't stand up. You see, these tests are supposed to just be detecting bits of this virus's genetic code.

But instead, the tests were picking up other stuff as well, confusing that for the virus. Scientists realised this pretty quickly in quality control and then knew they had a problem. The test didn't work as intended and the state labs, many of them had to send it back. So the test was a lemon? I would say that would probably be a fair statement. That was producer Rose Rimler. So some of the initial CDC tests, they were bung. That problem was pretty easy to fix.

Unfortunately, there was another problem. Even if it had worked, I think we would still be complaining about not enough tests. Not enough tests. Now, that happened, partly, because the CDC were the only folks that were allowed to make these tests at first. So weeks went by with these little trickle of tests from the CDC were the only folks that were allowed to make these tests at first. So weeks went by with these little trickle of tests from the CDC. That was until the regulations loosened, letting companies and universities make the tests too. By then, the coronavirus had already moved fast.

Josh says that what we were missing in those first weeks was a sense of urgency. If you go back to the beginning, mid to late January, you know, the general sentiment was this may not affect the United States that much. And on one hand, there were some good reasons for thinking this. Some other epidemics like SARS and Ebola, they didn't gain traction in the US. But still, this positive poly attitude, we'll be all right here in the US. But still, this positive Polly attitude, we'll be alright here in the US, it needed to change faster than it did. I've been really surprised that the US bungled this so badly.

I feel disappointed in the response the country has had. Do you feel that way? I think it's enormously frustrating. I think just the situation we're in is frustrating. I think surprised and disappointed would describe a lot of people about this. And all these testing problems had consequences because while we were waiting to get more tests, the coronavirus kept spreading.

We didn't know the people who had it. We couldn't isolate them. And so they stayed out there, infecting more and more people. And meanwhile, we are kind of in the dark about infection rates all across the US. Okay, so what is happening now? Well, on Sunday, the government said that it's basically going to throw a bunch of stuff at this problem. The Trump administration says that it's working with 2,000 labs to get tests made,

and it says that testing centres will be soon set up across the country. It's still not clear how many people will be able to get tested, though, or how soon. One official said that they'll be testing tens of thousands of people or hundreds of thousands of people a week. Let's wait and see. Now, because it's currently really difficult to get tested, we're in this position. If you have symptoms, any symptoms of coronavirus, coughing, fever, You need to stay away from other people. Isolate yourself, just in case.

And we know this sucks. Now, I totally appreciate that is enormously frustrating position to be in. Like if you're sick and you're wondering whether you have something and you can't find out, that is enormously frustrating. Josh says that soon, or soonish, he thinks that this testing situation will be sorted. That even then, there will be one more thing to keep in mind. These tests aren't perfect.

And one place where they're not super accurate is early on in your infection. If there's not enough viral bits in your body, the test won't pick it up. And it could tell you, congrats, you're fine, no coronavirus, when actually that's wrong. And I would worry in that case about people feeling like if they're negative that, you know, they're good to go.

Don't wave your negative test in the air and say, huzzah, I'm fine. That's exactly right. And there is a real risk of that. People feel like say, huzzah, I'm fine. That's exactly right. And there's a real risk of that. People feel like not only huzzah, I'm fine, but now I can go bowling or to the big party or whatever. I love that you picked bowling as if this pandemic was set in the 90s. I'm dating myself. So bottom line, the tests were and are a big mess

and the US still has not cracked it. But Josh says that tests aren't the only trick up our sleeve when it comes to stopping this pandemic. I think that we shouldn't play a game of just waiting for tests. Everybody should be thinking about what they can do. And one big thing is avoiding other people, even if you feel fine. It's called social distancing. So will it work?

And if we really want to slow down this pandemic, exactly how much of a hermit do I have to be? That's coming up after the break. Welcome back. We've just talked about how testing for the coronavirus is still a struggle in the US. And that means we don't have a good idea of who is infected. Worse still, according to a big report from the World Health Organization, on average, people infected are walking around for five to six days before they start showing

symptoms. That's almost a week. And even though it doesn't look like this virus is super contagious compared to, say, measles, we are living in a world where basically any of us could potentially be infected. So what should we do? Well, one idea has been getting a lot of attention. The buzzphrase of the moment is social distancing. That means avoiding group gatherings, plus crowded subways and buses.

Illinois, Ohio and Massachusetts closing all bars and restaurants. New York, it has the look and the feel of a ghost town. Boo! Look, it's not exactly a ghost town. Things are quieter though. So, how far should we be taking this social distancing? And will it work? Hello. Hi, hi, hi. Hi. Sorry, I was having some technical difficulty.

Oh, that shouldn't be with all your gimlet money. Ah, that gimlet money. Down the drain with the stock market. This is Professor Vincent Racaniello, a virologist at Columbia University in New York. And ever since the outbreak, Vincent has been talking to other scientists across the country about this coronavirus for his podcast, This Week in Virology. Basically, Vincent is the perfect person to ask, does social distancing actually work? Absolutely.

There will be fewer infections and fewer serious infections. That's the key here. Vincent says that from what we can tell with this new coronavirus, for every infected person, on average, they're spreading this to around two more people. So those two people, on average, will spread it to four people, who spread it to eight people. Now, the idea with social distancing is that if we could slow that down so that maybe each infected person only spreads this to one person or no one, then it could lower the total number of people who become infected. This is actually what happened in the 1918 flu pandemic, the Spanish flu.

Cities that reacted fast, closing churches, businesses and schools, they had less infections and it saved lives. One paper estimated that in San Francisco and St. Louis, the strict interventions might have dropped infection rates by a third. And fast forwarding 100 years to this pandemic, a paper just out estimated that after Japan cancelled sports and entertainment events, amongst other things, it did drop their infection rates. So what's happening across the US right now, all the closures and banning big gatherings, it is expected to help. But did we take these actions fast enough? And have we gone far enough? Because the thing we are trying to avoid here is hospitals getting overrun. Because the real issue here, 80% of the infections are mild, 20% are not. And some of those are going

to require hospitalization, and a small fraction are going to require intensive care unit. And the issue is, if we have too many people needing ICU, then at some point we're going to overburden the system. Social distancing slows down the spread of the disease, so that vulnerable people don't get sick and land in the hospital all at once. And then the hospital has to triage and make a decision. And so that's really a problem. And this is exactly the problem in Italy right now.

Their hospitals are overrun. They don't have enough beds. They don't have enough ICU beds. Recommendations are being sent to Italian doctors, telling them that if they need to make a choice, give the beds to younger and healthier people. So Italy, they acted too late. So when did they start social distancing?

Well, after only a few people died, some towns started closing schools as well as businesses and train stations. But Italy's big regional shutdown, when life changed dramatically for people like Fabio, who you met at the beginning of the show, well, that didn't happen until more than 200 people had died of coronavirus. As best as we can tell, about 70 people in the US have died. Now, this is not a perfect comparison.

The outbreaks are different. The US has a much bigger population. But given that we are just now starting to do some serious social distancing measures, not a perfect comparison. The outbreaks are different. The US has a much bigger population. But given that we are just now starting to do some serious social distancing measures, what could this mean for our hospitals? Well, just to take New York State as an example, the governor has said that the state currently has around 3,000 ICU beds and including new coronavirus patients and patients that are already using those ICUs for other things. He says we're 80% full. And he thinks we're not going to have enough beds for this. So unless we can ramp up capacity fast, we can expect our hospitals to get pretty

full soon. And the thing is, other places around the world, they acted much faster. For example, in Hong Kong, within a week of their first case, workers were encouraged to telecommute and they closed schools, libraries, museums, courts and sports centres. Two months later, according to the World Health Organisation, they've had only some 140 confirmed cases and four deaths. Acting Fast worked in other places in Asia too. Which is really remarkable because everyone

listened. They were told to stay home and not travel and they did it. And that's what it takes. It really takes a commitment. Some places in the US have already closed restaurants and bars and with new recommendations, we'll probably start to see a lot more of that. But you can still get a cheeky beer in Australia and many other parts of the world. So what should you do if you live in a place that has coronavirus patients, but where businesses haven't been closed? So this is a time, this is a critical time to start avoiding interacting with other people. All non-essential movement, don't do it. People have asked me, can I go to the restaurant tonight

and meet friends? I would not do that. A student wanted to come see me today and talk, she would have to take the subway. I said, it's better if you don't do that. Let's do a Zoom thing. So as much as you can. Vincent says that working from home is a great idea right now, but he gets it. Not everyone makes a podcast in Brooklyn. Yes, and I understand that some people have to go to work, in which case you have to take precautions. You have to wash your hands when you get to work and make sure you don't touch your face to transmit the infection.

You have to sneeze and cough into your elbow. And if someone is near you who's obviously sick, move away from them if you're on mass transit. So, you know, you can do things that will reduce the likelihood that you'll either get infected or transmit the infection. And this is really important if you're over 60 or if you have a condition like diabetes or heart disease. I have an elderly podcaster here in New Jersey,

and I said to him, stay home. Please don't go out. I don't want you to get sick, because he's 80 and is at risk for serious infection. His grandson typically visits from Brooklyn. I said, don't do that. Just don't do that. It's too much of a risk.

If you do decide to go for a walk or a bike ride, Vincent says it's a good idea to try to keep your distance. Yeah, so six feet is the minimum because the droplets you produce by breathing and coughing, they typically drop to the ground within six feet. Right, and so literally right now, if you're walking down the street and you see someone, should you cross the street?

I just move away from them. This six feet, it's kind of a rule of thumb. Studies have found that when you sneeze, droplets can travel even further. But to Vincent, the broader point is that in countries where there is community transmission, so that means that the virus is spreading from person to person within the country, we need to be minimizing contact with other people. And the more cases that are in your area, the more careful you need to be. Though Vincent did hear this story, suggesting that some people didn't get the memo. My friend in Italy told me they were restricting the number of people that could get in a supermarket at any

given time, which in principle is a good idea. However, she said people were queuing up outside by the hundreds. And of course, that's even worse, right? So I think a supermarket, you should just let people go. We reached out to a bunch of scientists, and they all agreed that these were the right steps and they said it was really important. There's not that many times that you'll be able to spend the weekend at home relaxing and binge watching Netflix and call that a public service. And I think this is a rare case where we can. This is Elizabeth Radin, public health professor at Columbia in New York. If we don't social distance and people just keep living their lives as normal, you know, what could happen? I mean, it's sort of we don't really know, but let's not find out. I think if no one practices social distancing,

we can almost guarantee that the spread continues to increase. Something else we need to be doing is washing our hands and disinfecting stuff with things like alcohol. Viruses can stick around on surfaces for hours, sometimes days. So if you touch something that has viral particles on it, you could pick it up. We know this from other coronaviruses like SARS, and a study out just last week into this new virus, it shows that it does the same thing.

But Vincent says that one thing is for sure, it is just too late to be relying on things like travel bans or trying to track every new case. Restricting flights from Europe into the US, that's not the solution. The virus is already here. We need to be stopping the spread within the U.S., it's not the solution. The virus is already here. We need to be stopping the spread within the country. This podcast that I make, Science Versus, we made a fictional pandemic and we published it several months ago, before we knew about coronavirus. And there's this scene where the host, which is me, is working from home, mandated working from home, and where we have the scientist and there's a line in it where the scientist says it's already here which you just said and i just i just like i can't i can't i can't

i just i can't i i'm like i can't believe it it is it is already here but you know people shouldn't panic because this isn't gonna someone asked me yesterday are we we all going to die? No, you're not all going to die. 80% of cases are mild. Most of the deaths are in people over 60. And someone over 60 said, well, that doesn't make me feel any better. I understand that. But only a fraction will die. And that fraction is smaller and smaller if you can get care in a hospital.

That's the key. And we cannot overburden the healthcare system. If we have enough beds for everyone who's sick, we can take care of them. And I gotta ask, Vincent, why are people stocking up on toilet paper? Like, no one needs that much toilet paper, right? I guess people want to have toilet paper, right? Right. I mean, the virus doesn't make you crap. So no, it doesn't give you diarrhea most of the time, as far as we know. I think it's just a hoarding thing. My wife said the milk was gone too. So I don't understand it. Well, my wife bought a 30 pound bag of beans and she said, we're going to just have rice and beans for the next month.

It's fine with me. Yeah. Well, maybe then you will need the toilet paper, I guess. That's right. Look, I know this is new and scary and weird. But for a lot of us, we can do this social distancing thing. And it looks like we just have to. That's Science Versus.

If you want to know more about anything that we mentioned in this podcast, please check out our transcript. It's in the show notes and we have all of our citations there. There's more than 100 of them. So do check it out. Also, Josh Sharfstein, who talked to us about testing, he has a podcast. It's called Public Health On Call.

It's all about the coronavirus. Check it out too. And Vincent's podcast is called This Week in Virology. One more podcast recommendation. Our friends over at The Journal are reporting on this as well and you can check out their work for more. This episode was produced by me, Wendy Zuckerman, Michelle Dang, Meryl Horn, Sindhuja Srinivasan and Rose Rimla.

We're edited by Blythe Terrell and Caitlin Kenny. Fact-checking by Lexi Krupp. Mix and sound design by Sam Baer. Music written by Peter Leonard, Emma Munger and Bobby Lord. A huge thanks to all of the researchers that we got in touch with for this episode, including Dr. Nikla Vandoramalan, Professor Nigel McMillan, Professor Geoffrey Sharman and Professor Stephen Morse. A special thanks to Salvatore Incontro, the Zuckerman family and Joseph Lavelle-Wilson.

I'm Wendy Zuckerman, I'm washing my hands, and I'll back to you next time.