Answering Your Coronavirus Questions: How The Virus Spreads, Disinfecting Your Home On this broadcast of The National Conversation, a doctor on the front line addresses some of your common questions. We'll also take a look at how to best disinfect your home and food.

Answering Your Coronavirus Questions: How The Virus Spreads, Disinfecting Your Home

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MITCH MCCONNELL: Colleagues, it's past time - past time - to get this done for the country.


Congress is working to secure more relief funding for small businesses. It's Monday, April 20. And this is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED from NPR News.


SHAPIRO: I'm Ari Shapiro. Coming up, we'll answer your questions about government assistance and COVID-19...

CESAR: I am a small-business owner that sells snacks, like chips and candy. Due to the virus, I haven't opened my shop for over two months. Is there a government program that I can apply for some type of help?

SHAPIRO: ...And the best ways to protect yourself against the virus.

BETH HOUSE: Does the bacteria which causes coronavirus remain on bar soap after hand-washing? And should we be using liquid soap instead?

SHAPIRO: Plus, the questions we've been asked the most since we started this program five weeks ago. To join in, go to Now, these headlines.

This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED. I'm Ari Shapiro. Each night, we're here to answer your questions.

CESAR: Hi. My name is Cesar (ph), and I am from Los Angeles.

NATALIE LECANCHEK: My name is Natalie Lecanchek (ph).

RACHEL BEST: This is Rachel Best (ph). I am in Madison, Wis.

UNIDENTIFIED PERSON #1: I bought bleach, and, apparently, it's not a disinfectant.

CESAR: Due to the virus, I haven't opened my shop for over two months.

UNIDENTIFIED PERSON #2: I was a productive member of society before COVID-19.

UNIDENTIFIED PERSON #3: I have a family member who is fighting cancer, so for their safety, I've been keeping my distance from them.

LECANCHEK: What is being done to track the health of all those who were turned away because they did not qualify for a test?

MIKE MCCOOD: Am I able to disrupt the virus using heat or cold?

UNIDENTIFIED PERSON #3: Thank you so much.

BEST: Thank you.

SHAPIRO: Tonight, we have NPR journalists and outside experts on hand to offer solid facts, tell you what we know and correct some of the misinformation that is floating around. And when we don't know something, we'll tell you that, too. Send us your questions about the pandemic and the way we live now at On Twitter, use the hashtag #nprconversation.

Each night, we begin by answering the question, what happened today? Well, today, President Trump said he will restock the Strategic Petroleum Reserve as the price of crude oil went below $0 a barrel and into negative territory.


PRESIDENT DONALD TRUMP: We're looking to put as much as 75 million barrels into the reserves themselves. That would top it out.

SHAPIRO: The pandemic has destroyed demand for oil, and energy companies say they are running out of places to store the extra fuel. Governor Andrew Cuomo said New York will remain closed until testing ramps up. He said federal money is needed for that. And he also suggested that the money could fund hazard pay for front-line workers.


ANDREW CUOMO: You know what? Thanks is nice. But also, recognition of their efforts and their sacrifice is also appropriate.

SHAPIRO: Overseas, the death toll in France passed 20,000, and the World Health Organization issued a stern warning.


TEDROS ADHANOM GHEBREYESUS: Trust us. The worst is yet ahead of us. Let's prevent this tragedy.

SHAPIRO: In Washington, Congress is scrambling to strike a deal on a new relief bill that would give the Paycheck Protection Program more cash for small businesses. Here's Senate Majority Leader Mitch McConnell.


MCCONNELL: Colleagues, it's past time - past time - to get this done for the country.

SHAPIRO: Joining us now is NPR political and economics reporter Danielle Kurtzleben. Hi, Danielle.


SHAPIRO: Let's start with that new small-business rescue package. It's still being debated on Capitol Hill, as we just heard. Part of this debate is over adding another $370 billion to emergency small-business loans and grants after that fund ran out less than two weeks after it started. What's the holdup? And how is the money going to be allocated?

KURTZLEBEN: Right, so let's start with that first part of your question. As far as the holdup, I mean, you had some disagreement between Republicans and Democrats. They had agreed, yes, the program definitely needs more money. They hadn't agreed on how to do it. Republicans just wanted to inject more money now and fast. Now, Democrats had a couple of conditions. They wanted to set aside money for state and local governments also in this package, aside from the small-business stuff, but also to set aside some small-business money for smaller banks to help it get to lower-income areas, minority businesses, some of whom really had trouble getting into this program. So...


KURTZLEBEN: ...As of late this afternoon, here's where the money is supposed to be allocated. Of course, this could change. So this package includes $310 billion for that Paycheck Protection Program you mentioned. That would be on top of the 350 billion that has just run out. That would include 60 billion for those smaller banks. And it would also include - there would be another 60 billion on top of all of that for another Small Business Administration loan program for small businesses. That's a program called EIDL, E-I-D-L, that had existed before the CARES Act passed.

SHAPIRO: OK. So many of our listeners have questions about this, so let's get to as many as we have time for. First, here's Cesar from Los Angeles.

CESAR: I'm a small-business owner that sells snacks, like chips and candy. Due to the virus, I haven't opened my shop for over two months. Once I open, I will have to dispose many of my products due to expiration and best by date no longer good. Is there a government program that I can apply for some type of help?

SHAPIRO: Danielle, what advice would you give to Cesar?

KURTZLEBEN: OK, so there are a few programs he can apply to for some kind of help. Let's start with that PPP program that you and I already have both already mentioned. Now, those loans are forgivable on certain conditions. They have to be used on only particular things, and primarily payroll, in order to be forgiven. Now, it sounds - if I'm understanding his question right, it sounds like Cesar is asking if he can use the money for inventory for...


KURTZLEBEN: ...The materials in his business. Now, that is not among the forgivable categories that the Small Business Administration has laid out. Now, he could still use the money on that. It just wouldn't be forgiven. And, I mean, these loans, even if you don't get them forgiven, they have an interest rate of 1%. That's pretty low. If you're a business owner, you might decide that's a good deal anyway.


KURTZLEBEN: But on top of that - yeah, absolutely. On top of that, there are a few other things he could try. There are the Economic Injury Disaster Loans, EIDL loans. Those are administered directly through the Small Business Administration. Now, of course, those have run out of money, as has the PPP, so if he wants to apply, he's going to have to wait or the program will have to wait until it gets more money.


KURTZLEBEN: The one other thing I would say is...


KURTZLEBEN: ...The Federal Reserve is putting out a program called the Main Street Lending Facility. It's not finalized yet, but that is supposed to help small and medium-sized businesses as well.

SHAPIRO: So much still in the works. Let's go to another...


SHAPIRO: ...Listener from Los Angeles. This is Amy (ph). And she has two questions. Let's take them one at a time.

AMY: NPR has reported that the 349 billion Paycheck Protection Program to boost small businesses during the coronavirus economic crisis has run out of money. What does this mean for small businesses that are, A, in the process of applying for PPP loans, B, whose banks have indicated that the loan was, quote, "approved but not yet funded"?

SHAPIRO: Interesting question. That first wave of funding that ran out - if somebody was already approved under it, are they first in line for the second wave? How does this work?

KURTZLEBEN: There's some ambiguity here. Now here's what I can tell you. To her first question, if you're in the process of applying for a PPP loan, what that likely means is that your bank, your financial institution - whatever - is accepting applications and putting you in a queue. But that queue is dependent upon SBA getting more money from Congress, so that's going to have to wait. Because, to be clear, SBA is not accepting new applications right now. They're waiting. And also, many banks are not accepting applications themselves. Only some are.

But to her second question, what does it mean if your bank has said you're approved? Now, once a bank has approved your loan and finalized it with the SBA, your bank has 10 days to get you the money. Now, given backlogs, it might take a little longer. But it is possible to be approved and still be waiting on your money. So it's possible it's still in the works. It's also possible to misunderstand it and to have your application in, your bank is fine with it, but the SBA hasn't approved it, in which case you still need to wait on that money.

SHAPIRO: All right. Now, there's actually another part of her question. Let's listen to her follow-up here.

AMY: What agency or committee of Congress is monitoring whether the PPP funds are properly allocated? I ask this in light of reports from Reuters that companies with greater than 500 employees have received funds.

SHAPIRO: Yeah, there's been a lot of this reporting about big companies. I mean, Shake Shack returned $10 million that it got from this fund, saying it was going to let it go to restaurants that need it more. So how would you answer that question?

KURTZLEBEN: I mean, one thing is that, I mean, SBA is really poring over the paperwork when people send it in to look at, OK, how are you spending the money? Who's getting the money - that sort of thing. But, no, listen; this is an important question in Washington right now. Amid all of this debate on Capitol Hill over exactly where the money is going, how it's going, there is a lot of push and pull back-and-forth among lawmakers about increased oversight. Perhaps there should be more people watching where these hundreds of billions of dollars are going. So I think we're going to have to wait that out.

SHAPIRO: All right. Well, if you have a question for NPR's Danielle Kurtzleben about the virus and its impact globally, including the economic impact, send it to us at or share it on Twitter using the hashtag #nprconversation. Our next question comes from Jennifer (ph) in Vancouver, Wash. Let's listen.

JENNIFER: I have a question. If you get a Paycheck Protection Program, PPP, loan, what can you use that money on - unemployment, health insurance, federal taxes, garnishments? How about the IRA Roth plan match?

SHAPIRO: OK, Danielle, you mentioned that in order to get it reimbursed, it needs to go to payroll. But can it be used for other things as well?

KURTZLEBEN: It can. I mean, first of all, 75% of it has to go to payroll. But what payroll means is pretty broad. In the guidance that the SBA and Treasury have put out, they have said, yeah, you can use it to repay what people would get from salary, wages, tips, that sort of thing. But you can also use it on benefits, like vacation, sick leave, health care, retirement. There are a lot of places that this money can go. Now, one very important point here is that it can mean slightly different things if you're a sole proprietor than if you're an employee. If you own your own business, you're going to want to talk to your accountant or lawyer about exactly what that means.

SHAPIRO: Finally, just in our last minute or so, we have a question from Erica (ph) in Richmond, Calif., who writes, what help is there for small businesses that are sole proprietor? My friend is a hairstylist and runs his own business with no employees. The help I've been hearing about goes to businesses to keep employees. What program is there for sole proprietors, she asks. What advice would you give Erica?

KURTZLEBEN: Well, she can - her friend can apply for the PPP. That is also for sole proprietors. Now, one unfortunate thing for sole proprietors is that the program opened later for self-employed, independent contractors - those types of people - than for bigger businesses. So they did have to wait a week longer to get in, so that created some road bumps for them and put them in the queue later. So those people are probably going to be waiting even more for Congress to approve more money. Aside from that, there's the other usual SBA programs. And check with your state and local governments. They might have programs, too.

SHAPIRO: NPR's Danielle Kurtzleben, you have provided us so much helpful information. I really appreciate it. Thanks a lot.

KURTZLEBEN: Thank you, Ari.

SHAPIRO: And you can hear much more of our extensive coverage when you download the NPR One app. Go to the Explore tab and click on The Coronavirus Outbreak for a curated stream of stories. If you have questions, we want to help. Go to Or on Twitter, use the hashtag #nprconversation. Up next, your questions about disinfecting your home and the things in it.





OK, we know the best way to avoid getting sick is to stay home as much as you can. If you're one of the lucky people who can do your job from home, that's great. But even then, most of us have to interact with the outside world somehow. We go out for important errands or get groceries and food from the outside. Many of you have asked us about how to disinfect the things that could've been exposed to the coronavirus. So joining us now to answer those questions on the topic, we have Joshua Santarpia. He studies microorganisms, like the coronavirus, in the air. He's a researcher at the University of Nebraska Medical Center. Thanks for joining us.

JOSHUA SANTARPIA: Yeah, thank you.

SHAPIRO: There is so much that we're still learning about how the coronavirus spreads. This question comes to us from listener Steven Vining (ph) of Dayton, Ohio.

STEVEN VINING: NPR cited early research in March indicating the COVID-19 virus is viable for 24 hours on porous surfaces and up to three days on hard surfaces. Is there recent confirmation of or updates on those results?

SHAPIRO: Close listener there. Has the scientific guidance changed, or is our understanding still that 24 hours is, more or less, the lifespan of this virus on a surface like that?

SANTARPIA: So there hasn't been anything new since that time. A couple of caveats to that particular study. That was done with virus in cell culture media, which isn't what comes out of you when you cough or sneeze or breathe or whatever. And so there may be some variation on that, more or less, but it's in a different kind of particle, I guess. Further, I think that there's some ongoing work - a colleague of mine is actually working on this now - looking at factors like sunlight and like higher temperatures and humidities that might actually change the way this virus survives on surfaces as well...

SHAPIRO: That actually - I was going to say that segues perfectly into our next question, which is about whether temperatures have an impact on the virus. So forgive me for interrupting, but let's listen to this question...

SANTARPIA: No, you're fine.

SHAPIRO: ...From Mike (ph).

MCCOOD: Hi. This is Mike McCood (ph) from Frederick, Md. How does temperature affect the viability of the coronavirus? Will putting groceries in the refrigerator or freezer deactivate the virus?

SHAPIRO: He's just teeing you right up there (laughter). You were about to say?

SANTARPIA: I know. It's great. So I'd say - so based on what we know right now, I would say that higher temperatures and higher humidities are probably worse for this virus than the cold. Just for a little perspective, you know, we keep the culture samples in refrigerators to help preserve their viability. So I wouldn't rely on your refrigerator to kill anything. But certainly, hotter temperatures and more humid conditions are likely to be - likely to more quickly inactivate the virus.

SHAPIRO: You're actually teeing up our next question pretty well here (laughter). I promise we didn't give you a preview. But here. This one comes from Jane (ph). Let's listen.

JANE ROSEMOND: Hello. This is Jane Rosemond (ph). And I'm calling from North Carolina. I'd like to know if time in a hot car on a hot day will inactivate the coronavirus. For example, if you leave something, like shoes, masks or clothing, in your car when it's parked for a while, will the virus be inactivated?

SHAPIRO: Is that a good tactic?

SANTARPIA: I mean, so technically, that's probably true, right? I mean, even based on the previous study, you can leave things around for long enough and it'll die. And probably the heat will make that - will shorten that time. However, like, none of us could tell you how long that would take...


SANTARPIA: ...Or how long it would take for it to be safe.

SHAPIRO: We got similar questions about whether steam or UV light or other things could kill the virus. Are there any things we might not think of that science has shown might be promising?

SANTARPIA: I mean, so lots of things are actually not that good for microorganisms. And, for instance, the coronavirus being an envelope virus, it's not among the more robust microorganisms that we tend to work with. Envelope viruses are typically unstable. But this particular coronavirus and some of its cousins are actually more stable, I think, than your average envelope virus.

SHAPIRO: All right, let's go to...

SANTARPIA: So things like...

SHAPIRO: Sorry. Go ahead - yeah.

SANTARPIA: I was going to say things like UV are bad for virtually every microorganism, bacteria and viruses alike, but is very wavelength-dependent.

SHAPIRO: OK. Well, if you want to ask Joshua a question about the coronavirus' ability to survive, send it to us at or ask on Twitter with the hashtag #nprconversation. Let's go to our next caller.

NANCY WONG: Hello. This is Nancy Wong (ph). I'm calling from Reno, Nev. Everyone says to wash hands with soap and water to protect from COVID-19 because it breaks phospholipids. What about other cleaning products that are technically not soap, like facial bars, dishwashing liquid, a teaspoon of bleach in a quart of water? And if the bathroom ran out of soap, would a long, brisk hand-washing with water be better than nothing?

SHAPIRO: What would you say about those non-soap cleansers? Are they useful?

SANTARPIA: So, I mean, basically, it's surfactants that break the envelope. So you can use anything like...

SHAPIRO: I'm not familiar with that word surfactants. What is that?

SANTARPIA: I mean, I guess most of us call it soap (laughter).

SHAPIRO: OK (laughter).

SANTARPIA: But it's - and so it's - you know, I think when you think about - when people think about soap, they think about actual hand soap or something like that. But, really, like, all kinds of - you know, there are all kinds of other surfactants used for other things. And, you know, like, dish soap would be very effective. Certainly bleach - you know, like, a 10% bleach solution is going to be quite a big sledgehammer for killing this virus, but I'm not sure how much of that you want to put on your hands...

SHAPIRO: (Laughter) Right. Fair enough.

SANTARPIA: ...For any period of time. You know, and the last part of that question, you know, certainly mechanical removal is better than no removal at all. So if you don't have...

SHAPIRO: You mean just rubbing your hands together underwater even if there is no soap that you could use?

SANTARPIA: Yeah, 'cause at least you're still taking away some of - you know, removing some of it. And, of course, everyone knows hand sanitizer now these days, at least with 70% alcohol.

SHAPIRO: Right. We have a question from Beth House (ph) of Woodland, Calif., about whether the type of soap matters.

HOUSE: Does the bacteria which causes coronavirus remain on bar soap after hand-washing? And should we be using liquid soap instead?

SHAPIRO: Does the virus remain on a bar of soap? Should you worry about picking it up after someone else?

SANTARPIA: I wouldn't think so, I mean, for the same reasons that we just talked about, where surfactants destroy - can help destroy the envelope virus. The same thing would apply, right? Even if there was a virus that wasn't quite broken up, I think as soon as you started washing your hands, the likelihood is that it would be immersed and you would have a disruption.

SHAPIRO: And we've got another question here about fabrics. Let's listen to this.

SARAH WELTON: Hi. This is Sarah Welton (ph) calling from Jackson County, Mich. Is there a safe way to wash fabrics? What should I do about clothing and bedding that might've been exposed to the virus?

SHAPIRO: We've heard about health care workers coming home and throwing their clothing directly in the washing machine. What guidance can you give us here?

SANTARPIA: Yeah, I think that's a pretty fair approach. We really don't know. In fact, I've been asked a lot lately by the health care workers at our hospital about what they might be taking home. And the best advice I can give is to, one, be very careful. You don't want to - you know, especially with something like bedding, you don't want to, you know, unintentionally aerosolize some of the virus that might still be on there. So, you know, if you carefully remove it and put it in the washing machine, hot water and soap, again, should be fine.

SHAPIRO: All right. Aerobiologist Joshua Santarpia from the University of Nebraska Medical Center, thank you for this guidance today.

SANTARPIA: Yeah. Well, thank you for having me.

SHAPIRO: And tomorrow, we're talking about a range of topics again. If you're a health care worker who has questions about mental health, get in touch with us. Or if you are reconsidering your living will or advance directive because of the coronavirus, go to Or on Twitter, use the hashtag #nprconversation.



It's THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED. I'm Ari Shapiro. Coming up, we answer some of your most frequently asked questions about COVID-19.

BECKY DAVIS: My mom lives in Minnesota, and I haven't seen her since Thanksgiving. How long will it be before I can safely fly to see my mom?

SHAPIRO: Plus, difficult choices we make every day, after these headlines.

This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED. I'm Ari Shapiro. This is the fifth week we have been broadcasting this show, which is about as long as many of you have been working from home and practicing social distancing. You have asked us thousands of questions, and now we're going to answer some of the most common ones, the questions that have come up a lot in the last five weeks.

Dr. Abraar Karan is with us once again. He's an internal medicine physician and clinical fellow at Harvard Medical School. He's also assisting with the epidemic response in Massachusetts. Good to have you back here.

ABRAAR KARAN: Thanks so much, Ari. Good to be here.

SHAPIRO: And we're also joined by NPR's Pien Huang, who reports on global health and development. Nice to have you here as well, Pien.

PIEN HUANG, BYLINE: Hey, Ari. Great to be here.

SHAPIRO: To start, Dr. Karan, I'd like to play two callers who had similar questions. Let's listen.

LECANCHEK: Hi. My name is Natalie Lecanchek, and I'm calling from Queens, N.Y. Is there a plan to move those at the beginning of the virus into a low-level hospital to prevent it from spreading to family members? Most apartments in New York City are small with only one bathroom.

SHAPIRO: And in a similar vein, here's Carolyn Cash (ph) in Tulsa, Okla.

CAROLYN CASH: What, if any, plans are in place for providing additional hospital beds and quarantine centers to help with containing COVID-19?

SHAPIRO: So we're talking here about people who are not so sick that they have to be hospitalized but people who know they have COVID-19 and have no way of isolating from people they live with. What would you suggest?

KARAN: It is a great question, Ari. I've been on service in the emergency room for the last 10 days in our COVID pod, and I have been seeing these stories in almost every single patient I've seen. It's really hard to isolate properly at home. One thing that we've been doing for patients that come in that have, as you mentioned, sort of mild symptoms, are not sick enough to be admitted to the hospital in Boston is sending them to a program called Boston Hope, which is at the convention center here. And they have beds set up for these sort of lower-acuity cases to help them prevent spreading it in their families and in their households. And other cities are doing similar things using hotels, dorm rooms and other spaces that can be repurposed. New York City and San Francisco are examples.

SHAPIRO: That makes a lot of sense since the hotels are not running and the students are not in the dorms.

KARAN: Absolutely.

SHAPIRO: Is there even the capacity to house everyone who is experiencing symptoms but does not need to be hospitalized?

KARAN: Well, you know, it's not that we need to do this with everybody, right? So some people may be able to safely isolate at home, so if you have your own separate room or a separate bathroom, but the vast majority of people won't. And we also will see that people who are, you know, poorer and are living in more crowded housing won't be able to do this, and it's really going to push our health inequities even further. So that's why it's so critical that we provide this space to people that are going to need it the most. But it may not be every single person.

SHAPIRO: OK. Well, another topic that we've heard a lot of questions about is asymptomatic cases. Barbara (ph) in the Bay Area writes, I would like to know more about asymptomatic carriers of the virus. Do these individuals ultimately contract the virus? How do we know they're carriers? Pien Huang, can you answer that for us?

HUANG: Sure, Ari. And like you said, this is something that we've been hearing from a lot of people - a lot of questions about asymptomatic carriers. And I wanted to clarify something quickly in the question. So, first of all, if you are an asymptomatic carrier, you have already contracted the virus. It's just that you're not actually showing any symptoms from it. And some people actually stay asymptomatic and they never actually get sick. But so far, most of the people we've found without symptoms are actually presymptomatic, which means that in a couple days, they end up developing coughs and fevers and other signs that they're sick from COVID-19.

And we know for sure that at least some people who are presymptomatic can definitely spread the virus. Generally, it's considered for about maybe one to three days before they actually get sick. For example, there's a nursing home in Washington state where they isolated all the people who had symptoms, but the virus actually still spread very quickly through the home. And to researchers, it's a clear sign that it's spreading from people who were presymptomatic.

SHAPIRO: Which indicates why widespread testing is so important. Well, if you have a question for Dr. Abraar Karan or for Pien Huang, send it to us at or share it on Twitter using the hashtag #nprconversation.

And, Pien, we also have gotten a lot of questions over these last five weeks about whether the virus could mutate. Jimmy Schmitz (ph) writes, could the COVID-19 virus and influenza virus merge into a supervirus that could be even more deadly? Setting aside that specific scenario, perhaps, what is the chance that COVID-19 could mutate, merge, transform into a way that makes it even more harmful?

HUANG: Yeah, absolutely. So the thing that the researchers have been saying so far is that they're watching the virus very closely, and it's actually mutating at a, you know, slow and relatively predictable rate, maybe one or two mutations a month. And it's actually pretty stable right now, which is good news for vaccine researchers.

But I did actually want to address Jimmy's scenario directly because I spoke with a couple of researchers who work in coronaviruses. And they said that it's highly, highly unlikely that a COVID-19 virus and a flu virus can merge.

SHAPIRO: OK, not compatible.

HUANG: Because (laughter) they're not compatible. They're super different viruses. One actually told me that coronavirus and flu are as different as humans are to plants.


HUANG: And they actually infect different parts of the cell - yeah, exactly.

SHAPIRO: Thank you for doing that research for us.

HUANG: So the flu - (laughter) it was actually really interesting. The flu, it turns out, it actually replicates in the nucleus. And the coronavirus - that hangs out in the cytoplasm, which is the part of the cell outside of the nucleus, and that's where that replicates. And so even if flu virus and coronavirus get in the same cell, because people can be co-infected with them, they would not actually directly interact with each other, and so they wouldn't recombine.

SHAPIRO: OK. We've also gotten a lot of questions about smoking. Let's listen to this one.

WAI LEE: Hi. My name is Wai Lee (ph), and I'm calling from Antioch, Calif. My question about the pandemic is whether or not the virus itself is carried through cigarette smoke or through the vapors that come out from somebody vaping.

SHAPIRO: OK. The question there was, is the virus carried through cigarette smoke or the vapor that comes out through vaping? Dr. Karan, what can you tell him?

KARAN: Right. So this gets back to how much aerosols are emitted and how many respiratory droplets are going to be spread when you're exhaling forcefully like this. So I think it would be possible. As you're sort of blowing out, you are going to be, you know, blowing out these droplets and other particles. With that being said, I also add that we know the harmful effects of smoking and vaping on the lungs. And so in general, I would advise against this, and especially during a pandemic.

SHAPIRO: And in just a minute or so before we have to take a short break, we have a question here from a listener in the Poconos in Pennsylvania that I think speaks directly to your experience, which is it seems like now the issue is doctors and nurses getting sick. How can hospitals be managed effectively with the continual loss of these workers? I'm sure that's something you think about often.

KARAN: Absolutely. Protecting our front-line workers is so critical. You know, they are putting themselves right in the line of fire to do the best that they can for patients. And so I think, you know, some things that have been done - other doctors from other services have come in to help to cross-cover on some of the COVID floors, as you see in New York. There have actually been doctors flying in from other parts of the country to come help. I've been taking care of just COVID patients for the last several days, as I told you. And the key is wearing personal protective equipment and doing that very carefully. We have people that actually help us, watch when we don and doff to make sure we're doing that to the best of our abilities. And so that's also very important.

SHAPIRO: Right. Dr. Abraar Karan and Pien Huang, stay with us. We're going to take a short break.


SHAPIRO: And if you have questions, we want to help. Go to Or on Twitter, use the hashtag #nprconversation.


SHAPIRO: You're listening to THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED from NPR News. And we're here with NPR's Pien Huang and Dr. Abraar Karan, an internal medicine physician and clinical fellow at Harvard Medical School. And, Pien, we have a question here from Jerry Lame (ph) in San Diego.

JERRY LAME: We can't know what the fatality rate of COVID-19 until we know how many asymptomatic people there are. The assumption seems to be that we'll have to wait to find out until mass testing is possible. But there's another solution - random sampling, like we do for opinion polls. Has anybody done random sampling or are there any plans to do so?

SHAPIRO: That's an interesting question. Pien, have any other countries experimented with this? Are any cities in the U.S. doing it now?

HUANG: Yeah, that is a really interesting question, and it's actually something that they addressed in today's WHO press conference. And as the listener rightly points out, there just haven't been enough tests to accurately represent how many people have had COVID-19. And so to answer the question, I wanted to distinguish between two types of tests. The first kind is the swab tests that we have right now, the ones that go right up your nose. Those are supposed to tell you whether you have the virus in your body right now. But to determine what our listener is asking for, to determine the actual prevalence, which is how many people have actually had the coronavirus in the past, that's where you have to take blood samples from people to figure out who has fought off the virus and developed antibodies against it.

And so those types of tests are actually getting - actually starting to happen in some places. The WHO is saying that the results so far are actually much lower than people were expecting. So there have been studies in Denmark and Germany that are showing somewhere between 3% and 14% of people are showing up with antibodies. And, actually, there are some results out of Los Angeles today that showed about 4% of the people there were testing positive for antibodies.

But the caveat to all of this is that these are very early results. Nothing's been published yet. So there's a lot we still don't know about the test that they're using, who they're testing and whether these studies can be directly compared to each other.

SHAPIRO: Sure. Dr. Karan, before we have to let you go, you've been with us on this program almost from the beginning over these last five weeks. And being on the front lines, I'm curious what's changed in your experience and what you've seen that's different today.

KARAN: So, you know, from the very beginning, the focus on the front lines has been taking care of patients, doing the best that we can for them and making sure that we address all of their concerns, and also the concerns of family members during a time like this. We're closely looking at clinical trials that are underway for different drugs that may eventually show to be therapeutic, and so that's really key. And also, as you know, vaccine trials are going on to see what vaccine candidates may actually end up being used in the future. But I think ultimately, it comes down to the same thing, providing the best care that we can for our patients in this time.

SHAPIRO: And I know the arc is different in different cities, but where you are in Boston, does it feel like things are leveling off or easing up a little bit?

KARAN: It's tough to say. You know, it's different at different hospitals. And as - one thing that's key to remember is that you're going to have different outbreaks in different cities and different counties and different areas. So what one hospital sees in one part of the state may look very different than what another hospital sees. And that may change over the course of a few weeks. Where I've been working, I've been able to manage the patient load that's coming in.

SHAPIRO: All right. Dr. Abraar Karan is an internal medicine physician and clinical fellow at Harvard Medical School who's also assisting with the epidemic response in Massachusetts. Thanks so much.

KARAN: Thank you.

SHAPIRO: And NPR's Pien Huang covers global health. Great to have you here, too.

HUANG: Thanks, Ari.

SHAPIRO: Send us your questions on Twitter using the hashtag #nprconversation. We'll be right back. This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED from NPR News.


SHAPIRO: This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED. I'm Ari Shapiro. The coronavirus has forced everyone to make difficult choices. And in this part of the program, we're going to be talking about questions where there might not be a clear path. Dr. Abraar Karan is back with us. He's going to provide some answers to your questions. He is an internal medicine physician and clinical fellow at Harvard Medical School, and he's also helping with the epidemic response in Massachusetts. Glad you're still with us, Dr. Karan.

KARAN: Glad to be here.

SHAPIRO: So many people have questions about seeing family. It's so hard for people to be apart from the loved ones who they typically see regularly. This one comes from Becky Davis (ph) in Oakland, Calif.

DAVIS: My mom lives in Minnesota, and I haven't seen her since Thanksgiving. She had been planning to visit me this month, but with the pandemic, of course, that trip has been canceled. I usually don't go this long without seeing her or the other members of my family that live across the country. So my question is how long will it be before I can safely fly to see my mom?

SHAPIRO: Dr. Karan, I'm not sure that anyone knows the answer to that question, but what guidance can you give Becky?

KARAN: That's absolutely right. There really is no easy answer to this other than to say that it's probably not right now unless it's of critical urgency that you need to go see a family member. The key is that you're going to be coming into contact with a lot of people along the way, kind of increasing your chances of being infected or spreading infection. But as we gradually move towards reopening over the next several months, travel and flights will be a key area that we're looking at.

SHAPIRO: OK. Well, staying with this subject of visiting family members, some universities are allowing students to stay in dorms. And for a parent, getting their child back home can be a challenge. Ned Jakol (ph) is in Colorado, and his son goes to college out of state, so he's asking us what the safest bet is for his son to get back home.

NED JAKOL: In early May, I have to get him back here into the home because the semester is over. And I'm wondering if it would be safer for me to drive down and pick him up and bring him back or if I should have him fly back, which would run him through two major airports on the way back.

SHAPIRO: Neither one of those seems risk-free. And we actually have Ned on the line with us now. Thanks for your question, and good to have you here.

JAKOL: Sure. Thanks for having me.

SHAPIRO: Where's your son returning from? Where's he in school right now?

JAKOL: He's in Arizona at Arizona State University, and I'm in Colorado.

SHAPIRO: OK. So, Dr. Karan, help us out here. Safer to travel by car or by air?

KARAN: So great question. Again, it gets into the number of people that you're going to be coming into contact with. That is really what will be driving the chances that you're getting infected by other people. The keys, again, are, you know, social distancing, as we said, of more than 6 feet, probably wearing some kind of protective covering like a cloth mask, cleaning your hands regularly, cleaning surfaces regularly. But, you know, theoretically, if you're in a car where it's just you and your son, you'll probably be in contact with fewer people.

The other key thing to remember, though, is if you've got high-risk people at home and you're now bringing your son home, you know, that is something to consider because he may be - if he's in a college situation, you know, it's possible that he could've been exposed and is not showing symptoms, so something to keep in mind.

SHAPIRO: Ned, can you tell us about what your son's living situation has been? Does he have roommates? Is he in his dorm or living by himself?

JAKOL: He's in a dormitory, but he does have a single room. And currently, campus is largely emptied out, so I don't think he has a lot of contact with people. That does raise another question of wondering if he's asymptomatic. But is it possible to get him tested before we - you know, before he comes back home with the rest of the family?

SHAPIRO: I don't know. Are tests commonly given out to asymptomatic people who just want to make sure they're safe before they go home to visit their family? I'm not sure, Dr. Karan, if you could speak to Arizona specifically given that you're in Massachusetts, but my sense is that that's not widespread in the U.S. right now.

KARAN: Yeah. Hard to comment on the sort of the local strategy over there in Arizona. But, you know, in different circumstances, testing is being expanded to those beyond just those who have symptoms, and part of that's also just to understand, you know, those who - to what degree people that don't have symptoms are actually coming back positive. The other key is serological testing, which will actually help us to understand who's been exposed and who's now developed antibodies and recovered. And that'll be pretty important, especially as we start to think about who is going to be able to kind of head back into society. But there's still a lot to be done.

SHAPIRO: Ned Jakol, thanks for your question. I hope this was helpful.

JAKOL: Yeah, very helpful. Thank you.

SHAPIRO: Dr. Karan, we have a question from Rachel Best in Madison, Wis., who says she and her boyfriend of about six months have both been responsible, isolating themselves separately. At what point is it OK for them to see each other?

KARAN: Yeah, that's a tough question a lot of friends, and even myself have - you know, I've been working in the hospital. I've had to stay away from my own partner. But what I would say is that we should be diligent in sticking to social distancing right now. As we get more testing in place, as we do more serological testing, as I mentioned before, that will help us to understand who's been exposed. But for now, if it's nonessential, I would advise against it.

SHAPIRO: OK. Dr. Abraar Karan, thank you so much for taking these questions tonight.

KARAN: Thanks so much.

SHAPIRO: He is an internal medicine physician and clinical fellow at Harvard Medical School who's also assisting with the epidemic response in Massachusetts.


SHAPIRO: Finally tonight, it's strange what you miss when you haven't seen friends in person for a month or more. The other day, I had an image of being in a crowded bar, beer sloshing onto me from a plastic cup as a crowd pushed in. Never thought I would miss that. Then I saw a tweet from the Swedish pop star Robyn. Let's make a dance floor, she said. And so on Friday afternoon, just before hosting this show, I went to YouTube and watched Robyn work the turntables for an hour or two.


ROBYN: (Singing) We never used to get it right. So, baby, you're right for...

SHAPIRO: It reminded me of something she told me when I interviewed her a couple years ago about her most recent album "Honey." She said music can help people feel good again.


ROBYN: I think music doesn't change the world, but I think music gives people, like, a break, you know, where they can recharge and then maybe change themselves, which is beautiful.

SHAPIRO: Even if, for now, we're just dancing on our own.


ROBYN: (Singing) I'm in the corner watching you kiss her. Oh, oh, oh. I'm right over here. Why can't you see me? Oh, oh, oh. I'm giving it my all, but I'm not the girl you're taking home. Ooh. I keep dancing on my own. I keep dancing on my own. I'm just going to...

SHAPIRO: I'm Ari Shapiro. We'll be back tomorrow to answer more of your questions. We're going to be talking tomorrow about how to get your documents ready in case of a health crisis. So send us your questions at or tweet us with the hashtag #nprconversation.


ROBYN: (Singing) I'm spinning around in circles. I'm in the corner watching you kiss her. Oh, oh, oh. I'm right over here. Why can't you see me? Oh, oh, oh. I'm giving it my all, but I'm not the girl you're taking home. Ooh. I keep...


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