Short Wave - Coronavirus Latest: Testing Challenges And Protecting At-Risk Elderly

Episode Date: March 13, 2020

There's a lot going on with the coronavirus. To keep you up to speed, we'll be doing more regular updates on the latest about the pandemic. Today, NPR science correspondents Jon Hamilton and Nell Greenfieldboyce discuss challenges in testing for the virus and how COVID-19 affects the elderly.Email the show at [e-mail]. See pcm.adswizz.com for information about our collection and use of personal data for sponsorship and to manage your podcast sponsorship preferences.NPR Privacy Policy

You're listening to Shortwave from NPR. Hey, everybody. Emily Kwong here. So obviously, the biggest story in science is the coronavirus and rising cases of its disease COVID-19. In the coming weeks, we're going to cover it a little more with regular updates on the latest news and science. And today, to help us do that, we are lucky to have not one but two colleagues from the NPR Science Desk. Correspondent, Nell Greenfield-Boyce. Hey, Nell. Hi, Emily.

and correspondent John Hamilton. Hey, John. Hi. So coronavirus, it's already impacting American society, and you're each going to focus on one part of the coronavirus story this week. Now, what do you got for us? So one of the things I've been thinking about a lot is who is most at risk of severe illness from this virus. And while there's a lot we don't know about exactly how deadly it is overall, we do know there's some things that we need to do for the most at risk, people to keep them safe. Yes. And John, you were recently in Washington State in Seattle, which is the site of one of the biggest outbreaks in the nation. That's right.

It is where the first U.S. case of coronavirus appeared back in January. Now it has hundreds of cases, dozens of deaths. And, you know, efforts to slow down the coronavirus have really largely shut down the entire Seattle area. It's not quite a ghost town, but it's pretty quiet there. All right. So in this episode, we'll talk about all of that. efforts to get testing for the virus, up and running in Washington State amid the slow rollout of testing kits by the federal government,

and how we can help people who might be the most vulnerable to the virus. Okay, now, before we dive into some of the details from the week, what's the latest on the virus and it's spread? And I should say we're taping on Thursday morning and things are moving pretty fast. They are, they are. I mean, just in the past 24 hours, there have been some pretty dramatic developments. and you can kind of feel a shift in tone as the nation grapples with this. President Trump has this travel ban for visitors from Europe that he unveiled in an Oval Office address. The NBA has suspended its season here in the U.S. in Germany. You've got soccer leagues just playing to empty stadiums.

Even Tom Hanks and his wife announced that they had coronavirus. And so you can see as testing increases, cases across the U.S. are going up. there's this real sense that things are accelerating here and people are paying attention in a new way. Yeah. And we should say that neither of you is actually here in the studio with us right now. Yeah. So I'm feeling sick with the kind of sickness that like normally you might sort of like, you know, take some cold drugs and go to work. But like these days, they say to stay home, so I'm staying home. Well, I'm feeling fine. But because I was around people who might have been exposed to the virus during, you know, the time I was reporting in Seattle, I have been encouraged to stay home for a couple of weeks just to make sure I'm not contagious. Okay. So, Nell, I want to ask you, ooh, I hear a dog.

Yeah, that would be, this is Bella. Bella has come to be apart. Bella has been wanting to be on Shortwave for most of her life. So this was an opportunity and she seized it. So, John, you're in self-quarantine. Now, you're keeping yourself home to make sure you don't get anyone safe. You're both so responsible. Thank you. So, John, we mentioned earlier that Seattle, it's the center of something called a community outbreak. There's a few of those right now in the U.S. Tell us what that means. All it really means is that the virus is spreading in the general population, right? So in Seattle, you know, the first case was brought in from China and then there were a bunch of cases related to a single nursing home. But those are both sort of isolated. Now it's all over the place. So, you know, while I was in there. Seattle, I saw the public health system stop focusing on tracing individual cases, start looking at

clusters of cases, and they are also emphasizing community-wide efforts to slow down the spread. So that's Seattle's response. And tell us a little more of what it all looked like when you were there. Yeah, well, I used to live in the Seattle area. Oh, okay. And I never saw the traffic so light as I did the past 10 days. You know, even at a rush hour on I-5, you know, it was a breeze. And a couple of days ago, I was walking through Seattle's Chinatown, the Pike Place Market. These are both, you know, big tourist areas. And it was strangely quiet. A lot of the restaurants were closed. There were signs explaining that, you know, COVID-19 is the reason. And I should also say people's behavior in Seattle has changed. You know, they keep their distance. They wash their hands.

I passed a couple of bars that were still open. And you could see people sitting there, but it was every other bar stool. Yeah. Are people trying to get tested for coronavirus in Seattle? Yeah, definitely. I mean, everybody wants to be tested, you know, whether they have symptoms or not. And the problem is it has really taken a while to set up the systems to provide all that testing. And why is that? Well, you know, my colleague Richard Harris has been reporting on that. And one reason he's found is that testing for the coronavirus, it's not that simple. You have to extract viruses from samples that are taken from patients. Then you have to use this device that creates lots of copies of the virus.

Then you need another instrument that looks to see if the virus is a genetic match with the coronavirus. So this is something that a sophisticated lab can do, but a doctor's office really can't. And John, why is testing so important? Well, there are a couple of reasons. It's really important. It's how you pinpoint an outbreak. You need it for contact tracing because you have to know somebody has it to go and look for other people who might have got it from them. And later on, as things spread, it tells you which communities are getting infected. That's sort of the point where Seattle, for instance, is right now within Seattle, what areas is the virus showing up. And finally, it tells you what percentage of people who have symptoms actually have coronavirus.

If that percentage were to go up over time, it would tell you that you're not winning. But the testing is what gives you the clues that allows you to follow the spread, to at least have a trail. Yep. Now, what do you think about that? I think it's interesting because it's a different way of thinking about diagnostic testing than most people normally think about it. Like normally you feel sick. You go to the doctor, and the reason you're getting a test is so, the doctor can determine your treatment, like maybe you have strep throat, and that means you need antibiotics.

But in this case, we have no proven antiviral treatment against this new virus. You know, we don't have a vaccine. All the treatment is basically the same kind of supportive treatment you would give someone with another respiratory virus. So it's a kind of weird situation where the testing that sort of everyone's clamoring for is really of most use for protecting the community and giving public. health workers information about what they need to do on a community-wide basis rather than an individual patient basis. Yeah. And initially, the CDC, it wasn't even permitting private labs and universities to do testing, and that dramatically reduced available capacity for testing. But that's changed recently, right? It has. And now certain labs, so-called high-complexity

labs, they are allowed to run their own tests. But that's not really actually the biggest problem. the biggest problem is setting up this system to collect samples for testing because they have to be sent in for a lab. You know, you don't want people to sort of descend on some doctor's office or a clinic where they might spread the disease, yet you have to test a lot of people really quickly. So one solution I saw in Seattle is what they call drive-through testing. It's something that they've used in Asia. And the idea is that you can get tested for a coronavirus without leaving your car. Wow. And I actually spent a morning watching this happen.

It was in one of these multi-level parking lots, you know, next to a hospital in northwest Seattle. So the morning I was there, a nurse named Jeff Kates would walk up to each car. He was in full protective gear, you know, with the disposable gown, the gloves, a clear plastic face mask. And he would greet each person as they arrived. Hello, my name is Jeff. I'm the employee health nurse here. We're going to be doing your swabs today. So he takes these two swabs, one from each nostril.

Okay, sometimes you lean your head back just a little bit. Okay, one down. So, you know, he collects these samples and seals them up in plastic tubes, and they will be processed by a lab that's only a few miles away. So we're going to be testing for flu, AB, and RSV, then we're also testing for COVID-19. We'll get results back to you as soon as we can. Okay.

Yeah, thank you. I hope you feel better soon. Now, only healthcare workers are being tested this way right now, but it's important because they're the people that are on the front lines of fighting the virus, and so you've got to make sure they're not sick, so they don't take the infection to other staff or patients in the health care system. Also, you know, there has been talk of expanding this kind of drive-through testing to, for instance, first responders who might have been in contact with somebody who had the virus, and eventually even to patients. You know, now, like we mentioned, if you take a community like Washington State, like Seattle, many of the fatalities there were connected to this one place, the Life Care Center in Kirkland.

And even though there are so many unknowns about this virus, we do know for certain that it seems more deadly for older individuals. Yeah. So the last information I saw was that of the 26 confirmed deaths in King County, Washington, 22 of them were associated with the life care center. So, you know, the people who have died have been older people, you know, in their 70s, 80s, 90s, many times who have preexisting medical. conditions. And I think that that is, you know, a reflection of where this outbreak occurred. But I think it's also a reflection of the fact that this virus seems to be particularly dangerous for older people. Yeah. And then there's the whole group of people who have preexisting health conditions. People in Washington State who died in their 40s and 50s, officials said that some of them had preexisting health conditions. And they were not very specific about what those conditions were. But they have said,

Generally, that those can be sort of underlying chronic diseases. We're talking people with chronic lung disease, chronic cardiac disease, diabetes, people who are immunosuppressed for various reasons. All these people need to be taking special precautions. Yeah, I'll admit, I had a moment this week where I suddenly realized I needed to call my grandma and just say, hey, you're very independent, but maybe you should take some extra care this week. And I didn't want to scare her, but she fits that exact profile of over. 80. Yeah, I think you need to think carefully. You know, if you have an elderly family member, you know, maybe that person shouldn't be going to certain large gatherings that they might otherwise have gone to without thinking. You know, when you look at Seattle and as John described how the place is sort of, you know,

become a little bit of a ghost town, I think you see that people are getting the message and they're willing to, you know, do their part, to work from home, to, you know, cancel gatherings that they were I mean, I think it's getting real for people. And that's certainly been the recommendation of the CDC telling older Americans to stay at home or limit travel. One of the ways people are being encouraged to respond in this moment is social distancing, as you just mentioned. And it's that sort of intentionally taking steps to limit your contact with groups of people. Is that what it is? I mean, it literally means staying away from people.

I mean, you know, just like, for example, you know, the fact that a lot of NPR workers are working from home if they can. I mean, obviously, a lot of people can't work from home, you know, bus drivers, sanitation workers. I mean, some of these things bring up, you know, serious equity issues. That's a whole other set of issues to consider. But, you know, keep in mind, this disease is only like two months old. There's so much about it. We don't even know. And so people are making these sort of generic recommendations and canceling large events and just sort of counseling people to try to change their behavior in very real ways. For weeks now, we've heard from listeners who have heard other people say that

we know the flu has killed more people than the coronavirus. What do you make of that whole statement, that whole comparison between the coronavirus and flu? And why does it seem the coronavirus is getting so much attention? The coronavirus is getting more attention because it's new and it's worse than the flu. We don't know the exact case fatality rate yet, but it's, clearly multiple times greater than that of the flu. The flu, we have antivirals. Like, you can go to your doctor and get a drug that is targeted to the flu. It's even got flu in the name, Tamiflu. We don't have anything like that for this coronavirus. You know, we don't have rapid tests like we do for flu. We don't have a vaccine like we do for flu. So health care systems are familiar with the flu.

They understand its seasonality. They know it's coming. They plan for it. The coronavirus just came out of nowhere. And so it's coming on top of everything else that the hospitals are dealing with. And that is the real reason why people want social distancing to slow the spread of this virus. It's because we're trying to keep the number of cases that require hospitalization low over a greater period of time to keep hospitals from getting slammed. I feel like we ask this every time.

But maybe if you listening to this podcast want to send this episode along to your grandparent or uncle or aunt or cousin who is just incredulous about this whole thing or unsure and wants good information, what would you both, John and Nell recommend that individuals be doing right now? I think the first thing people need to do is assess your own risk. And that's there are two ways. One is, you know, are you in a position where you're coming in contact with people who might have the virus? Are you likely to get infected? But probably more important than that is look at what the risk groups are.

If you are over 80 years old, yes, you need to be really thinking about how to avoid contact. If you're 15 years old, it's probably less a question of protecting your own health and more one of making sure that if you do. get the virus, you don't pass it on to someone else. And no? Well, like me today, if you feel sick, you should stay home. Wash your hands, wash them thoroughly with soap all the time, help people in your community that you feel may need help. I mean, older people who are isolated, you know, if they need help getting grow trees or whatever. I mean, that's the kind of thing you can do for people. But I just really think that as more cases are found through more testing, there will be more and more communities that have, you know, clearly spreading viruses that are not traceable to any known source like a travel or something like that. And, you know, life is going to change for a little while.

It's unavoidable. And people should listen to their local public health officials and follow their advice. Nell Greenfield-Boyce and John Hamilton, their correspondence on the NPR Science Desk. Thank you both for this really solid advice. I hope you feel better soon, Nell, and thanks for coming on the show. Thank you. My pleasure. And if you want to explore Nell and John's recent reporting on the topics that were covered here, today we've got some links in the episode notes.

Like we said, we're going to be doing more regular episodes on the coronavirus for you. So make sure to subscribe to the podcast. So you get those episodes as soon as they're available. And please stay in touch with us. Share your coronavirus questions and stories. Just email the show at Shortwave at npr.org. I'm Emily Kwong. We're back next week with more Shortwave from NPR.