News Brief: COVID-19 Tests, Hospital Capacity, Coronavirus Lockdowns
STEVE INSKEEP, HOST:
How many Americans are infected with the coronavirus?
RACHEL MARTIN, HOST:
It is the most basic question, and yet it's really the hardest to understand the answer to. From the early days of the outbreak, a shortage of tests has made the illness hard to track. The president now says a million people have been tested and that more tests are on the way.
INSKEEP: Let's check those statements against the demand for tests across this country. NPR health correspondent Rob Stein is on the line. Rob, good morning.
ROB STEIN, BYLINE: Good morning, Steve.
INSKEEP: One million is a lot of tests. But is it enough tests?
STEIN: Well, you know, officials also say there are now about 100,000 tests being done each day. But it's still probably not enough, even though those numbers do reflect the fact that after this botched rollout of testing that left the U.S. scrambling to play catch-up, coronavirus testing has finally started to increase, you know, big time.
But some experts say a country as big as the U.S. needs to be doing, like, hundreds of thousands of tests a day to really have a chance to beat back the virus. And we're certainly still hearing lots of complaints from doctors and patients around the country who are still really desperate for tests.
INSKEEP: Will a test that the president showed off yesterday help at all?
STEIN: You know, a lot of people are calling this new fast test - it's a five-minute test - a game changer. Here's FDA Commissioner Stephen Hahn, who was at the White House task force briefing yesterday.
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STEPHEN HAHN: The test that gives you a result where you're getting care. This is truly a patient-centered approach, whether it's the doctor's office, a hospital, an emergency room, urgent care center or a drive-by testing site. Just like tests for flu or strep, where you go to the doctors and you get the test done, you can get an answer within minutes of having this test done.
STEIN: You know, and in addition to being quick and easy, the test comes with everything that's needed to do it - the swabs and all the chemicals, the stuff that's been starting to run short around the country. The company that makes it is promising to deliver 50,000 of these tests a day starting tomorrow. So if that really happens, it certainly would be a big boost.
But still, you know, alone, it's probably not going to get the U.S. where it needs to be right away. And, you know, as we keep saying, testing is really key to winning this battle. If we can't test enough, we don't know where the virus is hiding and spreading. And you can't begin to beat it back.
INSKEEP: Well, let's remember, in the absence of widespread enough testing, people are being told to stay home by the millions, sheltering in place, if that's the appropriate term. Is there evidence that all of that effort is paying off?
STEIN: You know, we have started to see some clues that these tough strategies may be starting to pay off, you know, like, the first hints of what could be a slowdown in Seattle. But New York is still under siege. And cases are rising fast in cities from coast to coast, you know, places like Boston, Philadelphia, Miami, Detroit, New Orleans, LA. So we're probably going to have to live with these shutdowns for quite some time to keep trying to slow the virus down, to give hospitals as much time as possible to save as many sick people as possible and maybe come up with some kind of phase strategy for eventually reopening the country.
That would need enough testing, combined with intense efforts to keep the virus from exploding in other places or erupting again where we thought we had it under control. So, you know, the other thing to remember is this might just be the first wave of the virus. So the hope is that scientists can find effective drugs and a vaccine to protect people who haven't gotten infected.
INSKEEP: Rob, as you know very well, the president has already made it clear that he is going to allow social distancing guidelines, national guidelines, to extend beyond the original 15 days. They're at least going through April 30, if not longer. But will the guidelines change as the details come out today?
STEIN: You know, that will be interesting to see - if the White House lays out some kind of coherent, long-term strategy for accomplishing all that so the country really can start to eventually, safely return to some kind of normalcy.
INSKEEP: Rob, thanks for the update.
STEIN: You bet, Steve.
INSKEEP: That's NPR health correspondent Rob Stein.
Mayors and governors across this country say they need more.
MARTIN: More bed space, more protective gear for medical workers, more ventilators, more tests. States are working to ramp up capacity at their hospitals as more cities see their COVID-19 cases just multiplying. So are hospitals ready for the peak in cases that is coming?
INSKEEP: NPR's Leila Fadel joins us now from California. Hi there, Leila.
LEILA FADEL, BYLINE: Hi.
INSKEEP: How are hospitals working to increase their capacity?
FADEL: So governors and other local officials are asking for federal help, some of which has arrived or is arriving in hot spots, the epicenter being New York, but also places like Louisiana, California, Michigan, Washington state. They're purchasing gloves, masks, face shields, tests and, of course, are scrounging for as many ventilators as they can find...
FADEL: ...The California governor yesterday even asking people to donate broken ventilators so manufacturers can fix them and hospitals can use them. In places like Michigan, the governor has said some hospitals could be in dire straits by the end of the week, even with the some 112,000 masks the state has gotten from the national stockpile. And I should note that in states like California, there's hope that early stay-at-home orders may mitigate the same level of surge we're seeing in New York.
Meanwhile, these states are working to boost bed capacity at existing hospitals, building field hospitals with federal help, converting places like convention centers, even dorm rooms, to medical facilities. Yesterday, the White House said it was further easing restrictions on where health care can be provided during this crisis, places like those dorm rooms.
INSKEEP: You know, as they ramp up, though, I'm thinking about people. You can throw up a field hospital in days, I suppose. But you can't create a doctor in days.
FADEL: Exactly. And a lot of medical workers don't feel they have the proper gear to protect themselves from the disease. And so if they get infected, then who battles the virus? And in some cases when they speak publicly or bring their own gear, they say they're getting in trouble.
INSKEEP: Getting in trouble for bringing their own gear?
FADEL: Well, bringing their own gear or wearing hospital-issued gear. So take Henryk Nikicicz in El Paso, Texas. He's an anesthesiologist, so he does a lot of intubations. He's 60, has asthma, is prone to upper respiratory infections. And so he was wearing his hospital-issued N95 mask all day in the hospital, including in the hallways. And he says the hospital told him to take off his mask because he was scaring patients. And when he didn't, he says he was taken off the rotation schedule.
HENRYK NIKICICZ: Wearing a mask is one of the basic ways of stopping the spread of the virus. And the right thing to do is to wear a mask. To punish me for wearing the mask is something that I really feel is wrong.
FADEL: So when I asked the University Medical Center of El Paso why he was taken off rotation, a spokesman said insubordination from the company he contracts with. He was told not to wear the N95 mask when he wasn't in the operating room or treating patients. And a few hours after I called the hospital for comment, Nikicicz was put back on the schedule. And his contracting company said, he's a good doctor. He was taken off the schedule because elective surgeries were canceled. And there's been less demand for contractors.
INSKEEP: OK. Are there other hospital workers who say they've been punished for being, in effect, too careful?
FADEL: Right. I heard a similar story from a Dr. Neilly Buckalew in Boise, Idaho. She brought her own fitted N95 mask. She was asked to remove it. And when she didn't, her assignment at the hospital, she says, was terminated.
NEILLY BUCKALEW: There's lots of reason why I'm raising a huge, big stink - because it's wrong, it's unsafe. We'll never stop - we'll never flatten the curve if, you know, hospital systems keep acting this way. And I'm doing this because it's for the benefit of our country and our health care workers.
FADEL: The American Academy of Emergency Medicine says it's also gotten a couple dozen similar formal complaints and hundreds of informal calls.
INSKEEP: OK. Leila, thanks for the reporting, really appreciate it.
FADEL: Thank you.
INSKEEP: That's NPR's Leila Fadel.
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INSKEEP: Massive walls and guard towers separate Palestinians in Gaza from their Israeli neighbors. But they have at least one thing in common.
MARTIN: The coronavirus is on both sides of those barriers. In Gaza, the population is trying to contain the pandemic. Israelis are being told to stay home. Though, the political situation there is very much in motion.
INSKEEP: NPR's Daniel Estrin has an update now from Jerusalem, where he is on lockdown in his apartment. Hi there, Daniel.
DANIEL ESTRIN, BYLINE: Hey, Steve.
INSKEEP: Let's start with Gaza, which has only about 10 confirmed cases, which sounds good. Is it, though?
ESTRIN: Well, it's worrying because Gaza is a unique case. I mean, we're talking about 2 million people living in a small seaside territory. We're talking about crowded conditions. Gaza's blockaded by their neighbors. It has suffered war after war after war with Israel. And its health system is hard-hit. So at the moment, any Palestinian who crosses into Gaza is quarantined. Is it 100% quarantined? Well, there have been reports of families visiting their relatives in quarantine centers.
And there isn't really a full lockdown in Gaza. So - and also, very few people have been tested for the virus. So we don't know if it's already spread. And if it has or if it does, the U.N. is worried the health care system could just collapse. There are - 40% of essential medicines have run out there. There are only about 87 ventilators in Gaza total for 2 million people. And most of those ventilators are already in use.
INSKEEP: Is the West Bank any better?
ESTRIN: Well, there are far more cases in the West Bank - over 100 cases. But Palestinian authorities have imposed lockdowns there even earlier than Israel did, much stricter lockdowns. It's very difficult to move in the West Bank. Palestinians can't drive between cities. And suddenly, the very unpopular Palestinian leadership has gotten popular. Palestinians are rallying around their leadership for their strict measures.
INSKEEP: Well, now, let's talk about Israel, where Prime Minister Benjamin Netanyahu is said to be in quarantine. First, is he OK? And second, what is he doing while there?
ESTRIN: He is OK. He has not tested positive for the virus, but one of his advisers did, so he's quarantined. He announced from his quarantine last night on TV that he's imposing even stricter lockdowns than what is here now. I mean, as of now, there's no more public prayer gatherings allowed, no more weddings.
Israelis are now being told to hold their traditional Passover meal alone at home next week. And you can't leave your house - a few hundred meters away from your house in most cases. Netanyahu, though, has, you could say, benefited from the virus. His corruption trial was delayed. And it looks like he'll actually continue to lead the country. His main political rival has basically folded.
INSKEEP: Meaning that they have agreed - are getting close to agreeing on a unity government that Netanyahu would still be part of?
ESTRIN: That's the idea - that Netanyahu would lead.
INSKEEP: OK. Daniel, thanks so much.
ESTRIN: You're welcome.
INSKEEP: NPR's Daniel Estrin is in Jerusalem.
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