KELLY MCEVERS, HOST:
Before this week is over, COVID-19 is expected to kill more than 2,000 people a day in the United States. New York City is considering temporary mass burials in a city park. So where do we go from here?
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PRESIDENT DONALD TRUMP: We're starting to see light at the end of the tunnel. And hopefully, in the not-too-distant future, we'll be very proud of the job we all did.
MCEVERS: Even as the number of people dying keeps going up and the situation seems to get worse and worse, if social distancing continues in places where it's happening and ramps up in places where it's not, White House officials said Sunday, we might see the curve bending.
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ANTHONY FAUCI: What you're hearing about potential light at the end of the tunnel doesn't take away from the fact that tomorrow, the next day, it's going to look really bad.
MCEVERS: The thing to remember, Dr. Anthony Fauci says, is that when we see these big spikes in the number of people dying, that's actually about two and a half weeks after those people got infected.
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FAUCI: So we've got to make sure we realize we're always talking about a two-and-a-half-week lag.
MCEVERS: Coming up, what we know about how many people could be carriers without symptoms and what it looks like to recover after you've been sick with COVID-19. This is CORONAVIRUS DAILY from NPR. I'm Kelly McEvers. It's Monday, April 6.
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MCEVERS: So first, we're going to talk about masks - or, more technically, face coverings - and why we should be wearing them. In short, it's because a lot of us might be carrying this virus without even knowing it. And if that's the case, a mask is less about you and more about the people around you.
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HARVEY FINEBERG: The main reason actually isn't only to protect ourselves. In fact, it probably doesn't actually afford that much protection to the wearer.
MCEVERS: Dr. Harvey Fineberg chairs an infectious disease committee of the National Academies of Science. He's been advising the White House on the pandemic, and he said on Morning Edition that a face covering might help slow the spread of those tiny, disease-carrying droplets that come out of our mouth when we talk or breathe.
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FINEBERG: If all of us have these masks in front of our mouth and nose, we are less likely to emit these particles that could infect someone else. That's why if all of us adopted this practice, it would be one more step to reduce the spread.
MCEVERS: That spread is thought to be driven in part by people who have no symptoms but who can still carry the virus. And so one big question is, how many of us are that kind of carrier? Turns out it could be a lot.
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FAUCI: It's somewhere between 25 and 50%. And trust me; that is a estimate. I don't have any scientific data yet to say that. You know...
MCEVERS: Dr. Anthony Fauci on Sunday. Of course, data on how many people have the virus can only come from widespread testing. The United States still doesn't have enough tests for that. There is another test coming to see if you've already had the virus.
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DEBORAH BIRX: The peace of mind that would come from knowing you already were infected, you have the antibody, you're safe from reinfection 99.9% of the time...
MCEVERS: Last week Dr. Deborah Birx said it looks like people with antibodies might have immunity from this virus, but it's still not known how long that immunity would last. For now, universities and private labs are working to scale up those antibody tests.
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FAUCI: Then we can answer the questions in a scientifically sound way. Right now we're just guessing.
TRUMP: And we've made great progress with the antibody testing.
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MCEVERS: Of course, one way to know you have definitely had the virus is if you get sick. More than 275,000 people around the world already have gotten sick and then gotten better. NPR's Allison Aubrey has been reporting on what that recovery looks like. Here she is on Morning Edition with host Noel King.
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ALLISON AUBREY: Recovery likely depends on a lot of factors - age, what risk factors and chronic conditions people had before they got infected with the virus. I've spoken to several doctors who've had COVID and are now recovered. They're back to work. One is ER doctor Rosny Daniel. He works at UC San Francisco. He told me the first few days of his illness, he had aches, chills, a fever. He felt wiped out. Then he started to feel better.
ROSNY DANIEL: My symptoms improved for probably four or five days, and I felt fine. And the scary thing is symptoms came back on day seven for me. So at that time, I started having some trouble breathing. I am asthmatic. I also have type 1 diabetes. So it was kind of scary to develop that fever and trouble breathing a week into the illness.
NOEL KING: That is scary because he has those underlying conditions that we hear are so dangerous with...
AUBREY: That's right.
KING: ...COVID-19. What happened to him next?
AUBREY: Well, he did get better. He used his inhalers for the asthma. He was put on an antibiotic in the event that he had a secondary bacterial infection in his lungs. And he says within several days, he began to feel better. Generally speaking, people with chronic heart or lung disease appear to be at higher risk, especially older people. But the CDC says there's not enough information to determine specific risks tied to each condition.
KING: OK. I want to ask you a question that has been circulating in my family and friend group a lot over the past couple of days. For people who have gotten it and then recovered, how do they know when they're not contagious anymore, when they can go back out into the world?
AUBREY: The guidance from the CDC is as follows. People can stop isolating themselves when they've been fever-free for 72 hours - so three days after the fever ends. And this is without the use of any fever-reducing medicine. They should also see improvement in symptoms such as cough. And this should be at least seven days from the onset of their initial symptoms. As more testing comes online, a negative test result would also inform the decision. But, you know, it's worth noting right now the CDC says this is all based on limited information. So this guidance could change as they learn more.
KING: Do scientists know yet if a person can get reinfected or if - once you get it, are you immune?
AUBREY: Well, the CDC says the full immune response, including the duration of immunity, is not really fully understood yet. So while there's an assumption that people who've recovered from COVID will have some immunity, ER doc Rosny Daniel says there's also some uncertainty.
DANIEL: I hope I am protected against reinfection, but I don't know that for sure. So I'm treating it as if I don't have immunity. And I wear full protection at all times by our hospital's guidelines to make sure I'm still protecting myself.
AUBREY: Now, I spoke to another physician who is also recovering from COVID. He's a cardiologist at Children's National here in the Washington, D.C., area. His name is Darren Klugman. Now, Klugman says in his case, he did feel poorly for about nine days. He had aches, chills, a fever for a few days. He said he slept a lot, had a real lack of energy. He quarantined himself in his basement away from his family for 14 days. And he says as hard as this pandemic is - I mean, it's brutal with these thousands and thousands of deaths - we also need to be reminded that there are many mild cases.
DARREN KLUGMAN: The majority of people will have a mild to moderate flu-like illness like I had and will do just fine with this. Most importantly, however, is recognizing the symptoms early, isolating oneself and really strictly abiding by the quarantine rules.
AUBREY: He says this is the best way to protect yourself and to stop the spread of the illness.
MCEVERS: NPR's Allison Aubrey talking to Morning Edition host Noel King.
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MCEVERS: The pandemic has changed work for many people, and that change has been especially hard for gig workers - people working for companies like Uber or Instacart. Some companies say they're offering new benefits during the pandemic, but those benefits are not always easy to get. Here's NPR tech correspondent Shannon Bond.
SHANNON BOND: Last month April McGhee and her teenage daughter both started feeling sick - cough, sore throat and fever.
APRIL MCGHEE: She had it worse than I did. Her coughs lasted longer. It was really a concern. It was like a dry, non-productive, hacking cough.
BOND: McGhee really wanted them both to get tested for the coronavirus. But at the emergency room, she was told they weren't sick enough, so they went home and into isolation. A single mom, McGhee makes ends meet by delivering groceries for Instacart and meals for Postmates. McGhee asked Instacart for sick pay under a new policy the company has put in place because of the pandemic, but she was denied.
MCGHEE: They basically laughed me off and said, unless you have the health department or CDC making you stay home on quarantine or a note from the doctor saying that you've been diagnosed with COVID-19, you're out of luck.
BOND: McGhee joined other Instacart workers who walked off the job on Monday. She says the company's policy not only puts her at risk. It encourages people who are sick to keep working and potentially spread the disease.
MCGHEE: They need to remember that we are the buffer zone and keeping us healthy and keeping our population as a buffer zone instead of as a - you know, a typhoid Mary.
BOND: Instacart says it will start distributing masks, hand sanitizer and thermometers to workers in the coming days. Workers for other companies are also running into hurdles getting the help they've been promised. Khadim Diop drives for Uber and Lyft in New York. After he fell ill with fever and sore throat, he got a letter from the city's health department saying he must stay home for 14 days. He showed the letter to the companies to get sick pay. Lyft awarded him $250, a fraction of what he says he typically makes in a week. And Uber...
KHADIM DIOP: A week later or 10 days, they send a letter telling me I'm not qualified for the help.
BOND: After NPR contacted Uber, the company said Diop's claims should not have been rejected. He's now received about $1,700 from Uber to cover the two weeks of work he's missed. That's money he sorely needs to pay his bills.
DIOP: To be honest, right now I'm very broke.
BOND: Uber does not require drivers to get tested for the coronavirus to get paid leave. They can show a doctor's note telling them to isolate to prevent the virus from spreading. But the policy doesn't cover drivers who don't want to get into their cars because they're afraid of getting sick. Steve Gregg (ph) lives in the Bay Area. He stopped driving for Uber about three weeks ago.
STEVE GREGG: I have bad lungs already. I'm borderline diabetic. I have high blood pressure. Like, those three categories alone right there were enough that I was - it's like Russian roulette. That's the term I've been using. It felt like - getting in the car like Russian roulette.
BOND: He showed Uber a note from his doctor explaining his pre-existing conditions, but no luck. Now he's looking elsewhere for help. He's applied for unemployment benefits, which are now available to gig workers.
MCEVERS: That's NPR's Shannon Bond.
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MCEVERS: Let's talk about mental health for a minute. A new poll by the Kaiser Family Foundation found that 45% of adults say this pandemic has affected their mental health. The good news from the team at Life Kit is that increasingly, therapy is available from home.
CRISPIN ROVEN: It looks like every therapist is starting to support online therapy in one way or another.
MCEVERS: Crispin Roven is vice president of product at Psychology Today. He says there are also efforts to make therapy more affordable.
ROVEN: There are therapists that specifically mention discounts or sliding scale applies during this time and are willing to adjust pricing according to financial aid.
MCEVERS: If you have health insurance, be sure to check that you choose a therapist licensed for reimbursement on your plan. There's more advice in the Life Kit episode. You can find a link in our episode notes.
For more news on the coronavirus, stay up to date on your local public radio station, and sign up for our newsletter The New Normal at npr.org/newsletters. We'll be back with more tomorrow. I'm Kelly McEvers.
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