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News Brief: Social Distancing, COVID-19 Modeling, New York Deaths

Mar 30, 2020
Originally published on March 30, 2020 6:16 am
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DAVID GREENE, HOST:

It looks like we better get used to social distancing.

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PRESIDENT DONALD TRUMP: The better you do, the faster this whole nightmare will end. Therefore, we will be extending our guidelines to April 30.

RACHEL MARTIN, HOST:

That was President Trump speaking in the Rose Garden yesterday. He announced that he is extending the nationwide social distancing guidelines beyond the original 15 days. This was a big shift from just a couple days ago when the president said that he hoped to get people back to work by Easter, which is April 12.

GREENE: That's right. Let's bring in NPR White House correspondent Tamara Keith. Tam, big change in tone from the president week to week during this crisis. What is contributing to him shifting now to saying that we've got to stay at this for some time?

TAMARA KEITH, BYLINE: Yeah, those 15 days have been a journey. President Trump started out resolute about the public health need to shut everything down, but he was also watching stocks tank and unemployment spike. And he was hearing from friends in the business community, conservative economists, seeing people on Fox News talking about this. By early last week, he was saying the cure shouldn't be worse than the disease and talking about sort of a grand reopening with churches packed by Easter - which, to be clear, public health experts warned would be a terrible mistake.

GREENE: Right.

KEITH: But no sooner did Trump say that than the ground began shifting beneath him again. He saw images on TV of a New York hospital in the same Queens borough where he grew up overwhelmed by patients, a refrigerator truck parked outside for bodies of the deceased. You know, a little more than a month ago, President Trump predicted the number of U.S. cases would get down to near zero. Last night at his press conference, he was saying 100,000 American deaths would be a success.

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TRUMP: If we could hold that down, as we're saying, to 100,000 - that's a horrible number, maybe even less - but to 100,000 so we have between 100,000 and 200,000, we altogether have done a very good job.

KEITH: And that's how you get to President Trump saying last night that nothing would be worse than declaring victory before a victory is won.

GREENE: I mean, it's just stunning that 100,000 deaths in the United States would be a best-case scenario. I mean, how does the administration get to that number?

KEITH: Immunologist Anthony Fauci, one of the top advisers on this crisis; Dr. Deborah Birx, the White House coronavirus task force coordinator - they reviewed a dozen models about how this epidemic could progress. They made their own projections. And you know, for much of last week, they had resisted publicly talking about specific numbers. But that changed yesterday. Here's Dr. Fauci.

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ANTHONY FAUCI: Dr. Birx and I spent a considerable amount of time going over all the data, why we felt this was a best choice of us. And the president accepted it.

KEITH: And I'm told that seeing that modeling likely proved decisive in President Trump's move to extend this shutdown for another month.

GREENE: But I mean, we still don't know where this is going - even experts, right? I mean - so we might keep getting a message from the top that could evolve.

KEITH: As we have for the course of this whole thing. You know, over the next couple of days, President Trump says that the coronavirus task force will finalize plans for a path forward and provide a summary of their strategy as well as the supporting data.

GREENE: All right. That's NPR White House correspondent Tamara Keith. Tam, thank you.

KEITH: You're welcome.

MARTIN: All right. So as Tamara just noted, President Trump says extending the social distancing guidelines is based on these new models that could help predict how the outbreak will play out in the U.S.

GREENE: Right. And let's bring NPR global health correspondent Nurith Aizenman, who's been looking at some of those models. Hi, Nurith.

NURITH AIZENMAN, BYLINE: Hi, David.

GREENE: Can we just start with that number that's still sticking in my mind? I mean, the president almost sounding like keeping this to 100,000 deaths should be a relief to us. Can you just put that in perspective?

AIZENMAN: Yeah. Look; if the U.S. had mounted a more aggressive response sooner, earlier in the year when the first cases started popping up - if there had been enough testing capacity to pick up on those cases and act instead of allowing all this undetected transmission to go on for weeks, then maybe the death toll would have been projected far lower than 100,000. But at this point, the U.S. already has tens of thousands of cases. So the models tell us probably the best that can be hoped for is to keep the death toll to about 100,000 people. That 2.2 million number of deaths that officials have said the U.S. is avoiding - that was from an older model based on what would happen if no action was taken.

GREENE: Well, let's talk about this new modeling. What exactly are officials looking at, and what is it telling them?

AIZENMAN: At the press conference, Dr. Birx said that she and her team had put together internally that modeling and they're going to be revealing details of it tomorrow. But she also said that, by coincidence, it's very similar to a model that researchers at the University of Washington released late last week. And what those researchers are saying is, OK, right now, this large number of people in the U.S. have already been infected with the coronavirus. And that means that no matter what, some of them are going to pass the virus on to some number of additional people who will then pass it on to some number of others. And the key question is - how many others?

So this model takes into account the dates when various states put in their stay-at-home rules that really slow the spread, you know, by cutting down on how much face-to-face interaction people have. And the researchers modeled if those rules are kept in place through June 1, what will this inevitable wave of infections look like? When will the largest number of people flood into the hospitals?

GREENE: And that would be the peak. I mean, when would that be? And what would that mean?

AIZENMAN: Yeah. So mid-April, and on that day, it's projected that more than 2,300 people will die. Between 116,000 to 467,000 people will need to be hospitalized. In a lot of places, that need is going to outstrip current ICU capacity. But that's a projection for the country as a whole. The timing of the peak will actually vary from one place to another.

GREENE: Oh, so the geographic will matter here. I mean, so what exactly will the timing look like in different spots?

AIZENMAN: So New York state, which has the bulk of cases right now, is projected to peak in about a week. Louisiana and Michigan are projected to peak in just under two weeks. And then there are states - South Carolina, Virginia, Colorado - that are not projected to peak for about a month. And of course, even after the peak, there will still be many new cases each day. It's just that post-peak, the number of daily new cases will start to diminish until things peter out by June.

GREENE: I mean, I know this is the question everyone wants to ask you. I mean, as this spreads from different parts of the country to other parts of the country, is there a time when we'll be able to say that the outbreak is actually over?

AIZENMAN: Well, I put this question to the lead researcher behind the University of Washington model, Dr. Chris Murray. And he said, no, after this wave is over, the U.S. will not be out of danger because after the first wave of infections, most Americans will not have been infected. People won't have immunity. Let's take a listen.

CHRIS MURRAY: A rough guess is come June, you know, at least 95% of the U.S. will still be susceptible. And that means, of course, it can come right back. And so then, we really need to have a robust strategy in place to not have a second wave.

AIZENMAN: That's his recommendation.

GREENE: Avoiding the second wave will be the next critical step. NPR global health correspondent Nurith Aizenman. Nurith, thanks.

AIZENMAN: Glad to do it.

MARTIN: So we know the number of cases in New York is projected to reach its high point in roughly a week. Already, nearly a thousand people there have died from the coronavirus, which is by far the highest death toll of any state. Meanwhile, the mayor of New York City is warning that they are running low on critical medical supplies.

GREENE: And let's talk about that dire situation in New York with NPR's Joel Rose. Joel, how did we get to this milestone in New York?

JOEL ROSE, BYLINE: Well, New York reported more than 200 deaths from the coronavirus just yesterday alone. And that was the biggest one-day jump that we've seen so far. But that number is likely to look small in the days ahead. Here's a pretty stark assessment from New York Governor Andrew Cuomo.

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ANDREW CUOMO: I don't see how you look at those numbers and conclude anything less than thousands of people will pass away.

GREENE: I mean, we've seen some of the personal accounts from hospitals in New York City, Joel. I mean, how bad is it getting there?

ROSE: Well, the hospitals are under a huge amount of stress, especially in New York City, which now has more than 30,000 confirmed cases. Mayor Bill de Blasio says the city and its hospitals have enough protective equipment on hand for about the next week except for ventilators. De Blasio says the need for ventilator machines is even more acute. Here's de Blasio.

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BILL DE BLASIO: This is a race against time. Yesterday, we sent 1,400 ventilators out to our hospitals. That is a huge step forward, but we have a long, long way to go.

ROSE: New York City is getting help from a wide range of sources. For example, the nonprofit Samaritan's Purse set up a 68-bed temporary hospital in Central Park. FEMA has set up thousands of temporary hospital beds inside the Javits Center. There's the Navy hospital ship we've heard a lot about that is on its way to relieve the pressure on city hospitals. But there is still a concern that all of this may not be enough, that the city's health system is still going to be overwhelmed when the number of critically ill people starts to peak, as we've heard, like in the next week or weeks.

GREENE: Well, Joel, one of the many concerns is that this disease seems to be starting to spread inside correctional facilities. I mean, those are places where it's, like, all but impossible to do social distancing. What do we know about the situation there?

ROSE: Yeah. More than 200 confirmed cases of coronavirus among the staff and inmates in New York City's jails, including the infamous Rikers Island complex. And this is a big concern because public health experts say once the virus gets into an environment like this, it is very, very hard to stop because you can't do social distancing or even really wash your hands adequately. So there's been a lot of pressure to get the jail population down. New York City has released more than 600 inmates so far, according to the mayor. But the city is facing calls to release even more.

GREENE: So the president extends this social distancing guideline through April. I mean, given how bad things are in New York, would it be worse if there wasn't social distancing? Like, is that helping?

ROSE: There is some evidence that it's helping, that the number of confirmed cases is not growing quite as fast as it had been. About a week ago, the number of cases was doubling every two days. Now the number of cases seems to be doubling about every six. But when you look at this curve going forward, there's no way to avoid the idea that we're looking at a couple of very difficult weeks, something we've almost never seen in this country in about a century.

GREENE: That's for sure. NPR's Joel Rose reporting on that situation in New York state. Joel, thanks.

ROSE: Yeah. You're welcome. Transcript provided by NPR, Copyright NPR.