The Daily - What We’ve Learned About the Coronavirus

Episode Date: June 15, 2020

States are reopening. Parks are crowded. Restaurants are filling, again, with diners. But is this dangerous? Six months into the pandemic, we reflect on what we’ve learned about the virus — and ask how that knowledge should chart the course forward. Guest: Donald G. McNeil Jr., a science and health reporter for The New York Times. For more information on today’s episode, visit nytimes.com/thedaily Background reading: As New York businesses reopened, Gov. Andrew Cuomo warned that a second wave of infections was almost inevitable if residents did not abide by social-distancing rules. “It will come,” he said. “And once it comes, it’s too late.” Restrictions are easing across the United States, but Arizona, Florida and Texas are reporting their highest case numbers yet. As of Saturday, coronavirus cases were climbing in 22 states.

Donald, the pandemic feels different in the U.S. than it did two weeks ago, three weeks ago, a month ago. It feels, and these are highly qualitative words, and I know you're probably rolling your eyes, it feels less desperate, and it feels a little less urgent. And I'm not even quite sure why that is. So what do you make of that? I mean, does that mean we've gotten complacent? What do you make of that? I mean, does that mean we've gotten complacent? Yeah, I think some parts of the country are not afraid yet.

They see this as something that happened to the other, to urban New Yorkers, to blacks and Hispanics in the big cities far away. But I also see that even in New York, it's a combination of, well, we survived the first wave and it didn't get me or the people I knew who got it survived. And boy, am I bored and frustrated and locked down and I want my job back and I want my hanging out with my friends back. And I think we have gotten used to the idea of death, of absorbing a lot of death. From The New York Times, I'm Michael Barbaro. This is The Daily. Today. My colleague, Donald G. McNeil Jr., returns with an update on the state of the coronavirus and what we've learned about the virus six months into the pandemic. It's Monday, June 15th.

Don, the last time that we spoke to you was in mid-April, when the death toll from the coronavirus in the U.S. was nearing 40,000. And various states at that time were beginning the process of opening back up. Slowly, but opening back up. Where is the pandemic now? Okay. Well, there are 113,000 dead in the U.S. the last time I looked. Basically, every state has reopened to some extent in different ways with different phases. In about 21 of those states, cases are going up, as was feared. Hospitalizations are going up. So I would see this as a very worrying situation.

Well, given that, I mean, in terms of how the United States is managing the virus and its spread, are we doing better now than we were many, many weeks ago when we spoke? Are we doing worse? I think we're doing considerably worse in that now we know what the danger is, and yet we're still getting enormous number of infections. Now, the places that were hit hard in the first wave, which is New York and the Northeast, but also places far away from that, like New Orleans, Seattle, and California, they are mostly coming down. They got seriously scared. They had intense lockdowns that lasted relatively long. They are wearing masks. They are practicing social distancing.

And cases are coming down in those states. In states where there wasn't a big first wave of the virus, where they were more upset by the economic effects of the lockdown, lots of people out of work, lots of people suffering, lots of people frustrated in their houses, those are where the cases in general are going up. Places like Texas, places like North and South Carolina, places like Arizona. And that's dangerous

because they're coming out of lockdown and opening society and encouraging people to be in greater contact with each other at a time when the cases are already on the upswing. So you're not flattening the curve, you're allowing the curve to spike up again. So is it fair to say at this point in the pandemic, the cities and the states that were hardest hit at the beginning seem to have enforced the strongest lockdowns, and therefore the virus infection rates seem to be going down there,

whereas states that weren't hit as hard at the beginning and perhaps didn't respond as forcefully are now experiencing an uptick in infections instead. Yes, in general, that's correct. So, Donald, now that we have lived with this virus for about half a year, I want to turn to the things that we have learned about it and that we didn't know when we first started talking to you. And I wonder if we can start with transmission.

Okay. I remember you telling me back in February, the main modes of transmission are droplets. You cough or sneeze near me, I catch the virus from you. The other was the virus living on surfaces. And I would touch that surface, I might touch my eye, I would get infected. What have we learned about the actual levels of transmission from these two? Did one of them turn out to be a much bigger vector than the other? Those two are still vectors, although surfaces may be a little

less important than we feared. But the really important thing we've learned is that there is aerosol transmission. Little tiny, tiny droplets, the kind that hang in the air inside a room for hours, can hold enough virus to transmit this disease. And we emit those droplets not just through coughing or sneezing, but just through talking, especially loud talking, through laughing, through singing. You know, we're unaware of this fine mist of droplets that comes out of our mouth at all times. You're only sort of aware of it if you're in the front row at a theater and you realize the actors are sort of spitting on you. But actually, if you

and I were to sit three or four feet apart and we're talking and joking and laughing, we would actually be spreading a cloud of a very fine mist of droplets at each other. So we're learning that transmission, particularly in indoor spaces where there is no wind, is probably a major spreader of this because everybody's vulnerable to it. Okay. So staying on this idea of what we've learned, asymptomatic carriers. What have we learned about people who may not even know they have the virus? They don't show any symptoms,

but they may be spreading it. How much has our understanding changed about how important asymptomatic carriers are in this pandemic? It has changed a lot. The initial estimates out of China were that there were very few asymptomatic carriers are in this pandemic? It has changed a lot. The initial estimates out of China were that there were very few asymptomatic carriers, like 1%. That has turned out to probably be quite wrong. The CDC estimates that the number of asymptomatic carriers is about one third. Wow. Right.

And that changes a lot about how we handle this disease. What do you mean? Well, okay. So temperature checks probably aren't very useful because- You're asymptomatic. One of the symptoms you feel is fever. If you don't feel fever, you can still spread the disease. So you're going to have to detect the disease through testing

rather than through saying, hey, we got a lot of sick people around here. Because one third of your people are not going to be sick, but they're still spreading the disease. So if you wanted to open up your office, you know, to people, like I said, fever checks wouldn't work. You'd actually have to test everybody. You'd have to test them frequently and you'd have to be able to get the results back very quickly because you don't want somebody who's asymptomatic working in the office for two or three days while you're waiting for the results of the test to come back. And how possible is that kind of testing? I mean, what you're proposing is every workplace

having some sort of mandatory testing system to weed out people who may have the virus, and especially those who may be asymptomatically infected. Yeah, I mean, there's a lot of thinking about testing. In the beginning of the, when we only had, you know, 10,000, 20,000 tests, we were only testing people who were sick, who had symptoms. It was very hard to get a test. Now we've reached a point where we're on track to get to a million a day, I think. When you reach that level, you can use testing for surveillance. That is, you sort of look around the country and say, where do we have hotspots? Now, probably to do that right, we need like five million tests a day.

That's what a Harvard study suggested. And it means testing in New York City, but also testing in Winnemucca, Nevada and every place else, because you want to know wherever the virus is popping up. You want to spot it and you want to test not just the sick, but a broad spectrum of people. You know, maybe one day you test all the third graders in the county or something like that. And another day you test everybody in nursing homes and things like that. Now that's at the 5 million test level. If you go up, there was a Nobel Prize winning economist at NYU who proposed that if we had 30 million tests a day,

we could literally use this as a way to completely reopen the economy. And that would mean everybody who's in contact with other people in an office would have to be tested every day, and we'd need rapid results. And it would cost, he figured, about $1.5 billion per week. But he said, you know what? That's a whole lot less than lockdown has been costing us. We could completely reopen the economy if we could test 30 million people a day, and we'd save money by having the whole economy go again. Now, the logistics of doing that is wildly unimaginable. The proposal from the NYU economist has been put in the crazy ideas box for now. And yet people who really study this stuff think of it as, wow, crazy, but good. So what are you going to do? You know, it depends

on what people are willing to commit money to do. Okay. And for those who have had the virus and have recovered, of which there are hundreds of thousands of people, what are we learning about immunity? We know that people have antibodies. We know they have IgG antibodies, which are the ones that appear later and usually indicate immunity. So we know that people turn up positive on antibody tests. And, you know, top experts are saying we think we can assume they're immune to the disease, but we're not sure yet because we don't really know what level of antibodies you need in order to be immune. So nobody's saying, okay, that's it. You've passed one test. You're immune. That's what people would like to think.

I know all sorts of people ask me, should I get an antibody test? And I keep saying, sure, if it's going to make you feel better, get an antibody test. But don't assume you're immune just because you've got a positive. You probably are, but we don't know that yet. It's still too early. So recalling our very last conversation in which we talked about the idea that there might be kind of two classes of people in this pandemic, the immune and the susceptible. We are not yet at a place of our understanding of the coronavirus where anyone is truly considered immune and therefore sort of invulnerable and able to wander the world differently than the rest of us. Scientifically speaking, no, we're not there yet. But practically speaking, a lot of people, even doctors I know who've been infected and have recovered, are behaving as if they're immune.

They're reasonably confident that they're immune. Okay. I mean, they shouldn't let down their guard, A, because it's not smart, and B, because that's a bad example, but they probably worry a whole lot less than they did before. Now, we do not know how long immunity lasts, and that's going to be another great big question. And we can't know that until some months or years have passed because this virus has only been around since November.

So probably the immunity is going to last a few years, but we don't know that yet either. These are all unknowns. Immunology is complicated. And given everything you just said, under the current circumstances, where will the United States be by the fall when it comes to death? I'm very worried about the fall for several reasons, which I can go into if you want to. Please. Okay. We know the virus transmits indoors. And when it gets cold, people aren't going to be able to eat outdoors again. They're going to want to get into warm spaces. So the possibility for transmission is really high. We also know, not just from 1918, but from Michael Osterholm at Minnesota has looked at eight influenza epidemics since,

I think it's 1763. And in each one of them, no matter what time of year the virus first hit, winter, spring, summer, or fall, it faded and then came back several months later in a much more lethal wave. And that was the phenomenon in 1918. There was a brief but scary breakout in Haskell County, Kansas in army camps and stuff. And then the disease mostly disappeared from the United States, seems to have mostly gone overseas and hit the troops in the trenches in Europe. And then in the fall and winter, it came roaring back. And a third of the deaths took place in a little tiny period between September and December 1918. So I'm very worried that something like that could

happen this fall and winter and that we're not mentally prepared for it. So the infection and death rate for the next few months quite likely will not be representative of what this virus is capable of. And the fall and the winter may be very, very different and much scarier. That's possible. And that's what a lot of top public health people are worried about, that we will have transmission. I mean, we're still seeing 20,000 new infections per day, and we're at about a little under 1,000 new deaths per day. And that's been consistent for a couple of months now. And this might be a strange question, but is that a good number or a bad number?

That's a terrible number. I mean, 1,000 deaths a day from this? 20,000 new infections a day? I mean, that's not an epidemic you have under control. You know, we don't talk about it that way, but that's a rapidly spreading epidemic. Now, we may become complacent about that. We may sort of accept that as the new

norm. And that may lull us into a sense of complacency when fall arrives. And that's a worry. And that's why I'm so eager for, you know, treatment or vaccine to hurry up, hurry up, hurry up. And where are we in that vaccine process now? There's 150 or so vaccine candidates being looked at around the world. In the United States, we have designated different candidates for warp speed, meaning testing the vaccines,

but simultaneously paying companies to build factories to make them so that all the ones that turn out to be both safe and effective will have hopefully millions of doses ready to roll immediately. Because one of the big roadblocks to getting vaccine is not just testing the vaccine to make sure it works, but then suddenly producing 300 million to 600 million doses for this country, depending on if you need one or two doses, and seven plus billion

doses for the world. So you want to get a head start on the production as much as you can. And so we're doing that with a number of candidates, and we've never seen anything like this before. Does all that encourage you to think that we might have a vaccine much faster than we've ever had a vaccine before? I remember you telling me that the fastest we've ever really had a vaccine in production and available to people from start to finish is close to four years. Yes, that was the month's vaccine, and the record is four years. But I think we're doing things very, very differently this time.

We've got, you know, multiple candidates, and some of those vaccines, if what we're being told is correct, are actually going into production even as we speak. So that's very encouraging to me. are actually going into production even as we speak. Wow. So that's very encouraging to me. But things go wrong when you test vaccines. You get surprises you didn't expect. And so let's hope multiple things don't go wrong. We'll be right back.

So, Don, we have talked about the risk of many different activities in this moment of the pandemic. different activities in this moment of the pandemic. We have not talked about something that has been going on for several weeks now in the United States, which are large-scale protests and demonstrations since the police killing of George Floyd. And I wonder what your sense is about the risk involved in those protests of spreading the virus. in those protests of spreading the virus? Well, I don't worry when there are crowds outdoors, spaced six feet apart and wearing masks. I do worry when people are jammed up against each other,

either confronting a police line or on a dais while they're making speeches or something like that. I worry about anybody who's pushed into the back of a police van. I worry about people who've been in cells together. I worry about the funeral ceremonies, which all took place indoors. You know, these are all potential super spreader situations. And have we yet seen any uptick in transmission from the U.S.? I know it may take several weeks for us to determine that, but have we? I mean, if we have spikes here, it's going to be very hard to say, oh, that spike came from the protest. Because, you know, how do you do contact

tracing on everybody else who was in a crowd of 10,000 people with you? You know, it's easy to do contact tracing on your family and your co-workers at the office. It's very hard to do contact tracing on a whole crowd of strangers. So we won't necessarily know when people fall ill that they got infected at the protest march. I mean, each individual person may say, well, the only time I've been in association with a lot of other people is when I was at the protest march. But for some epidemiologists to put all those stories together as those people turn up in hospitals or as their grandmothers turn up in hospitals is going to be very difficult. So we may not see the signal we would expect to see, if that makes sense. I'm curious, you know, reflecting on everything that you have just told us, I'm curious how you are operating now in the world, knowing everything you now know,

six months into this pandemic, what your routines are, what your precautions are. I mean, are you taking the subway? Are you always wearing a mask? Are you going to any kind of office? I'm working from home. I'm working a lot. I'm lucky in that I'm not out of work. But my girlfriend and a lot of other people I know who are out of work are pent up and frustrated

and angry, and some are really worried about their income. I always wear a mask when I am indoors with other people, as in the grocery store or pharmacy. I avoid going indoors with other people basically at all costs. If I were riding the subway, I would definitely wear a mask. I'm not riding the subway. I'm very worried about what's going to happen in New York City when a lot of people have to go back to work. Because right now, we've got near gridlock on the FDR drive and stuff sometimes because a lot more people are in cars because they're afraid to go into the subway. But at some point, we're going to have to go back into the subway. And frankly, I think the MTA ought to take the windows off the buses

and subways. I know it's crazy, and I know it's going to be cold in winter and hot and air conditioned in summer, but that's the way to get breeze blowing through enclosed spaces. And if we want to go back into our offices, we're going to have to find a way to have breeze blowing through enclosed spaces so that the virus does not hang in the air. We're going to have to rethink our workplaces or stay out of them because they're going to be too dangerous until we have a vaccine. Do you intend to return to an office anytime soon? No.

I'm 66 years old. I'm in a, you know, I'm reasonably healthy, but I'm also in a higher risk group. So I think me being in an office with a lot of members of the daily team breathing on the microphones or whatever would be dangerous for me right now. So, no. And I'm sad that I, you know, I have not seen my granddaughter except on video. She was born on the 4th. Mazel tov. Thank you. Thank you. And, you know, and I intend not to hold her until I'm vaccinated

or immune. You know, my daughter, the apple did not fall far from the tree and she's just as determined as I am that we should play by the rules on that, I think. So, you know, it's sad, but it's, I'm taking the long view. This increases the chances that both Darrow, that's her name, Darrow Maeve McNeil-Kay, and I will make it to her high school graduation. So that's the plan. And if I have to sacrifice a little bit of seeing her right now, you know, okay, I'll make that sacrifice for both of us. Well, we wish both of you the best, and we're really grateful for your time. And thank you very much.

Thank you for letting me on again. The Times reports that as infections rise in 22 American states, officials there are facing a choice. Accept the increase as the cost of reopening their economies, or slow the reopening process and even impose new restrictions, however unpopular they may be. In an interview published on Sunday, Dr. Anthony Fauci, a White House advisor on the pandemic, said that waves of infections would likely spike and fall for months, and that he did not expect the U.S. to return to normal for another year. We'll be right back.

Here's what else you need to know today. The chief of police in Atlanta resigned over the weekend after an officer she oversees killed a 27-year-old Black man, Rayshard Brooks. Before he was shot to death, Brooks had failed a sobriety test, run from the police, and grabbed a taser from an arresting officer, a sequence of events that Atlanta's mayor, Keisha Lance Bottoms, said did not warrant his death. While there may be debate as to whether this was an appropriate use of deadly force, I firmly believe that there is a clear distinction between what you can do and what you should do. I do not believe that this was a justified use of deadly force. I do not believe that this was a justified use of deadly force. Bonhams immediately ordered that the officer who had killed Brooks be fired.

And the Times reports that protests over the death of George Floyd have been held in more than 2,000 U.S. cities and towns across all 50 states over the past three weeks. The protests, the Times found, defied traditional demographic fault lines, occurring not just in Democratic strongholds, but in rural, conservative, and majority-white communities. Murder! Black lives! Murder! Black lives! Murder! Black lives! The protests continued over the weekend,

from Brooklyn to the small town of Houghton, Louisiana. That's it for The Daily. I'm Michael Barbaro. See you tomorrow.