KELLY MCEVERS, HOST:
In the United States, more than 10,000 people will have died from COVID-19 by Monday. That's according to one of the most well-regarded models out there. By the end of next week, 2,500 people could be dying a day, but still there are states where governors have not issued stay-at-home orders.
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ANTHONY FAUCI: If you look at what's going on in this country, I just don't understand why we're not doing that. We really should be.
MCEVERS: Dr. Anthony Fauci on CNN Thursday contradicted a message from the president...
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PRESIDENT DONALD TRUMP: Because states are different. States are different.
MCEVERS: ...From just a day before.
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TRUMP: We have a state in the Midwest or if - Alaska has an example, doesn't have a problem. It's awfully tough to say, close it down. So we have to have a little bit of flexibility. Look.
MCEVERS: Coming up, orders or not, what's becoming clear about who has the ability to stay home and to get tested and a new message, again from public health officials, about masks. This is CORONAVIRUS DAILY from NPR. I'm Kelly McEvers. It's Friday, April 3.
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TRUMP: OK. Thank you very much, everybody.
MCEVERS: The CDC has now officially recommended that you should cover your face when you leave your home with a nonmedical cloth face covering.
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TRUMP: The CDC is recommending that Americans wear a basic cloth or fabric mask that can be either purchased online or simply made at home - probably material that you'd have at home.
MCEVERS: This does not mean the kind of mask that is worn by doctors and nurses and other health care workers.
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TRUMP: Medical protective gear must be reserved for the frontline health care workers who are performing those vital services.
MCEVERS: At the White House, the president seemed anxious to emphasize that this is a recommendation.
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TRUMP: This is voluntary.
MCEVERS: Not a requirement.
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TRUMP: I don't think I'm going to be doing it.
MCEVERS: Which added to the confusion.
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TRUMP: Really, a voluntary thing you can do. You don't have to do it. I'm choosing not to do it. But some people may want to do it, and that's OK. It may be good.
MCEVERS: Earlier in the week officials at the White House said they had been examining this possibility.
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DEBORAH BIRX: There is experiential data when you look at communities that have oftentime (ph) utilized masks in general for personal protection from - when they particularly are themselves sick and have used their mask in public. And we've looked at the rate...
MCEVERS: But scientists don't love experiential data. Dr. Deborah Birx said that simply covering your face when you go outside will not keep you safe.
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BIRX: So we don't want people to feel like, oh, I'm wearing a mask. I'm protected, and I'm protecting others. You may be protecting others, but don't get a false sense of security that that mask is protecting you exclusively from getting infected because there are other ways that you can get infected.
MCEVERS: Mishandling a mask, failing to clean it adequately could even make things worse. A homemade mask, Birx said, should only be used on top of other measures - washing your hands, staying six feet from other people and, of course, staying home when you can.
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MCEVERS: In ordinary times, a vaccine to prevent COVID-19 would be at least a year away. But right now dozens of groups are racing to create one sooner than that. NPR science correspondent Joe Palca talked to All Things Considered host Mary Louise Kelly about what's being done.
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MARY LOUISE KELLY: Well, let's cut to the chase. Where are we? Where does the effort stand to come up with a vaccine?
JOE PALCA: Well, there are a lot of groups trying to find a way to generate protective immune response. For example, there was a paper published in the journal EBioMedicine from a group from the University of Pittsburgh Medical School, and it uses tiny bits of the virus to generate the immune response. But what's cool about this approach is it uses a patch with microneedles made of these viral bits, and those needles are so small that you don't even feel them. So you slap on the patch, wait a few weeks. And you've got immunity if it works.
KELLY: (Laughter) That's the giant if, right? If it works - I mean, how encouraged should we feel?
PALCA: Yeah. You caught that, Mary Louise. That's good. Yes, there's certainly a lot of approaches that aren't going to work when they get tested in clinical trials. But Louis Falo, who is one of the people behind the microneedle-based vaccine, says there's a reason to be optimistic because there are a lot of groups trying a lot of different approaches.
LOUIS FALO: And I think that they will basically feed off of each other. This is going to help us to do these trials both quicker and to find a vaccine that's most effective when we start to be able to compare these different approaches.
KELLY: Joe, let me pick up on one word from that - quicker. What kind of timeframe are we talking about here? Because we keep hearing that it's going to be a year. It's going to be 18 months to get a new vaccine all the way to market.
PALCA: That's absolutely true. It usually does take that long and even, sometimes, longer, unfortunately. But I spoke with Kathleen Neuzil. She's a vaccine developer at the University of Maryland, and she says developing a COVID-19 vaccine could take a lot less time than the usual vaccine.
KATHLEEN NEUZIL: I'm optimistic, I have to say, because I think we've learned a lot from other emerging diseases. And we are capitalizing on those experiences.
PALCA: And she says that in addition to some of the smaller efforts that are going on by players like the University of Pittsburgh Medical Center and some small biotech companies that have some really clever ideas, there are some really big players in the hunt for a vaccine. For example, Johnson and Johnson has a candidate vaccine that they're starting to test, and they're getting ready to make a billion doses of the vaccine. So they're betting that they will have something, and they're scaling up even before they know if it works. So that's pretty encouraging.
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MCEVERS: One thing we know about this virus is that it does not discriminate. The public health response to it is another story. When the virus first hit the U.S., it mostly infected wealthy people - travelers, people flying overseas, going to conferences. The disease is now everywhere. But Blake Farmer of member station WPLN found that treatment varies depending on who you are on the campus of a historically black college in Nashville.
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BLAKE FARMER: Meharry Medical College is staffing some of the drive-through testing centers in Nashville, but this one here on its campus took a long time to open because the school wasn't able to acquire the protective gear they needed.
JAMES HILDRETH: There's no doubt that some institutions have the resources and clout to maybe get these materials faster and easier.
FARMER: Dr. James Hildreth is president of Meharry and an infectious disease specialist. His college is in the historically black heart of Nashville, where there were no screening centers until this week. Across town, Vanderbilt University Medical Center is screening as many as a thousand people a day, primarily in the most affluent areas. Hildreth says that's just proof of a disparity in access to medical care that has long persisted. He says he's seen no overt bias, but if anyone should be prioritized, Hildreth says, it's minority communities, where people already have more risk factors for complications from the coronavirus, like diabetes and lung disease.
HILDRETH: We cannot afford to not have the resources distributed where they need to be because, otherwise, the virus will do great harm in some communities and less in others.
FARMER: In the majority black city of Memphis, a heat map shows where coronavirus testing is taking place. It reveals the most testing is happening in the predominantly white and well-off suburbs. Reverend Earle Fisher has been warning his African American congregation that the response to the pandemic may fall along the city's usual divides.
EARLE FISHER: I pray I'm wrong. I think we are about to witness a inequitable distribution of the medical resources, too.
FARMER: There's already some evidence of that. In Milwaukee, African Americans made up all of the city's first fatalities. Wisconsin Governor Tony Evers says he wants to know why black communities seem to be hit so hard.
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TONY EVERS: It's a crisis within a crisis.
FARMER: Nationwide, it's difficult to know how minority populations are faring because the Centers for Disease Control and Prevention isn't reporting any data on race. Dr. Georges Benjamin has been pushing the CDC to start monitoring race and income in the response to COVID-19. He leads the American Public Health Association.
GEORGES BENJAMIN: We want people to collect the data in an organized, professional, scientific manner and show who's getting it and who's not getting it and recognizing that we may very well see these health inequities.
FARMER: Benjamin says, until he's convinced otherwise, he assumes the usual disparities are at play.
BENJAMIN: Experience has taught all of us, if you're poor, if you're of color, you're going to get services second.
FARMER: Even for those African Americans who are symptomatic, it appears doctors are less likely to refer them for testing. Rubix Life Sciences analyzed recent billing information in several states. They found an African American with a cough and fever was far less likely to be given one of the COVID tests that have been so scarce. That's what worries Dr. Ebony Hilton most - the subjectivity of coronavirus symptoms.
EBONY HILTON: The person comes in. They're complaining of chest pain. They're complaining of shortness of breath. They have a cough. I can't quantify that.
FARMER: Hilton is an anesthesiologist at the University of Virginia Medical Center. She's also been raising concerns - for example, the way drive-through testing has expanded. She notes, that requires having a car.
HILTON: If you don't get a test, if you die, you're not going to be listed as dying from COVID; you're just going to be dead.
FARMER: Hilton says the country can't afford to overlook race, even during a swiftly moving pandemic.
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MCEVERS: That was Blake Farmer, and that story is part of NPR's partnership with WPLN and Kaiser Health News.
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MCEVERS: There's a new website out there called QuarantineChat, and it's basically an Internet call line that works with a smartphone app to connect people who are stuck in their homes with perfect strangers from all over the world.
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UNIDENTIFIED PERSON #1: Welcome to QuarantineChat. We're about to connect you to someone else somewhere in the world to talk. Please hold while we connect you.
MCEVERS: Gregory Warner from NPR's podcast Rough Translation recently spent some time on the line, and here's what he heard.
UNIDENTIFIED PERSON #2: Hello?
UNIDENTIFIED PERSON #3: Hey. What's going on?
UNIDENTIFIED PERSON #4: Hi. Can you hear me?
UNIDENTIFIED PERSON #2: This really works. It's actually really fun. I think you're my seventh caller? Yeah.
GREGORY WARNER, BYLINE: Why did you join this thing?
UNIDENTIFIED PERSON #5: So that I don't go crazy.
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UNIDENTIFIED PERSON #3: I'm bored. I kind of have nothing to do now.
UNIDENTIFIED PERSON #6: I've been sick for two weeks now. They have me quarantined since last week.
UNIDENTIFIED PERSON #2: I mean, to me, I feel a little bit more isolated because, at this point, I'm too worried to go to, like, the grocery store. I'm scared to pump gas in my car.
UNIDENTIFIED PERSON #5: It's so weird. Usually, technology has made people stay by themselves, but right now we all are facing the same problem and trying to stay more connected than we were before.
UNIDENTIFIED PERSON #7: I think I feel closer to, like, my aunts and uncles and cousins who I may not have reached out to typically, but now I'm saying, hey, how's it going? Just checking in. Do you have everything you need? And I hope that that continues after this.
UNIDENTIFIED PERSON #6: I have an aunt and she's very, very nervous, and she's older. She - you know, and, unfortunately, she lives by herself. I sing to her in German. I sing - (singing in German).
It means, I can't live without you. I love you from the bottom of my heart. I always will.
(Singing in German).
I never want to be without you.
UNIDENTIFIED PERSON #5: I guess this is one of the best conversations I've had (laughter).
WARNER: Oh, yeah?
UNIDENTIFIED PERSON #5: I don't know.
WARNER: Thank you.
UNIDENTIFIED PERSON #5: I'm just tired of people talking about how lonely they are.
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UNIDENTIFIED PERSON #5: But yeah, it's been nice talking to you.
WARNER: That's great. I really appreciate that. It's really fun to talk with you.
UNIDENTIFIED PERSON #5: All right. Take care.
WARNER: OK.
UNIDENTIFIED PERSON #5: Bye.
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MCEVERS: That comes from our friends at Rough Translation. On their latest episode, a story about two people - one who thinks the coronavirus is still a distant threat and one who thinks it's just a matter of time, and those two people are married. We've got a link in our episode notes. You can get more coverage of the coronavirus over the weekend on your local public radio station, and you can sign up for NPR's newsletter, The New Normal, at npr/newsletters (ph).
This podcast is produced by the awesome team of Gabriela Saldivia, Anne Li and Brent Baughman and edited by Beth Donovan. Today's QuarantineChat segment was produced by a Viva de Aviva DeKornfeld. We'll be back on Monday. I'm Kelly McEvers.
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