Answering Your Coronavirus Questions: New Symptoms, Economy And Virtual Celebrations On this broadcast of The National Conversation, we answer your questions about the economy, mental health and new symptoms of COVID-19. We'll also look at how people are celebrating big life events.

Answering Your Coronavirus Questions: New Symptoms, Economy And Virtual Celebrations

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ARI SHAPIRO, HOST:

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

DAN: Hi. This is Dan (ph) from San Antonio.

SARAH PASCOE: My name is Sarah Pascoe (ph).

DENISE: Denise (ph) from Greenville.

CHARLES VAN DEVENTER: Hi. This is Charles Van Deventer (ph).

HOLLY HANSON: I'm Holly Hanson (ph). I'm calling from South Hadley, Mass. My question has to do with blood.

AMARI JEREMIAH: What's the best way to support someone who's tested positive for the coronavirus?

JESSIE: I worry about how my life will be when things return to, quote-unquote, "normal."

VAN DEVENTER: I had COVID-19 last month, and my sense of smell and taste were way, way off, and they still are.

PASCOE: As the virus mutates, will the symptoms change with it? Thank you.

HANSON: Thanks so much.

SHAPIRO: NPR journalists and outside experts are on hand tonight to offer solid facts, tell you what we know and correct some of the misinformation that's 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 npr.org/nationalconversation. On Twitter, use the hashtag #nprconversation.

Each night, we begin by answering the question, what happened today? More than 58,000 people in the U.S. have now died of the coronavirus. That's higher than the American death toll from the Vietnam War. There are more than a million confirmed cases in this country. The U.S. has a third of all COVID-19 infections in the world.

President Trump said he will invoke the Defense Production Act to keep meat processors open.

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PRESIDENT DONALD TRUMP: That'll solve any liability problems where they have certain liability problems. And we'll be in very good shape. We're working with Tyson, which is one of the big companies in that world.

SHAPIRO: The Navy's Blue Angels and the Air Force's Thunderbirds roared over New York, Newark, Trenton and Philadelphia today.

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SHAPIRO: That flyover was a salute to health care workers fighting the pandemic.

Dr. Anthony Fauci warned in an interview with The Economic Club of Washington that the virus could return in the fall.

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ANTHONY FAUCI: In my mind, it's inevitable that we will have a return of the virus, or maybe it never even went away.

SHAPIRO: Treasury Secretary Steven Mnuchin told CNBC companies that got more than $2 million in small-business loans would face audits and those that weren't eligible for the relief funds could be subject to criminal liability.

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STEVEN MNUCHIN: I never expected in a million years that the Los Angeles Lakers - which I'm a big fan of the team, but I'm not a big fan of the fact that they took a $4.6 million loan. I think that's outrageous, and I'm glad they've returned it.

SHAPIRO: Well, joining us now to answer your questions about the economics of this story, we have NPR chief economics correspondent Scott Horsley once again. Good to have you back, Scott.

SCOTT HORSLEY, BYLINE: Good to be with you, Ari.

SHAPIRO: First, just bring us up to speed on the new funds for small-business loans. Earlier in the week, we heard that the processing system broke down. Are banks now processing applications?

HORSLEY: Yes, they are. But, you know, the banks all expected this new batch of money to go fast, and so they had dozens or hundreds of applications all teed up to go at 10:30 yesterday morning when the pipeline was supposed to reopen. And it turned out the Small Business Administration's computer network is less Alaska oil pipeline and more drinking straw. So it's been something of a bottleneck. They did process about $50 billion worth of loans in the first 24 hours, we're told, but it's been a challenge, and a frustrating one, for a lot of bankers and their would-be borrower customers.

SHAPIRO: And the Small Business Administration says it's going to impose a maximum dollar amount for individual lenders - these are the banks - at $60 billion per lender. Explain why they're doing this. Is it just to get more banks in the game of giving out loans? How is that going to help consumers?

HORSLEY: Pretty much. I mean, you heard the frustration there from Treasury Secretary Mnuchin and irritation certainly among a lot of Americans that big companies got money that was intended for small businesses and complaints that big banks were, in some cases, favoring their preferred customers. So this was an effort by the SBA and the Treasury to sort of spread out that business. Congress also did a part. They earmarked a chunk of this new $320 billion to be distributed via community banks. That $60 billion cutoff meant no single bank could corner more than about 9% of the total program. But, frankly, none of the even the biggest banks were likely to come close to that, anyway.

SHAPIRO: OK. Well, a lot of listeners have questions about this, so let's get to them. The first one comes from Jeff (ph) in Michigan.

JEFF: Has any reputable study been done to assess the health consequences of a recession, depression and the deeper financial consequences of illness, loss of life due to COVID-19 so that we can do an apples-to-apples comparison of the state of the economy versus the impact of COVID-19 and understand the full risk of the choices that politicians and us all face?

SHAPIRO: That's an interesting way of looking at it. People have talked about weighing the economic cost against the health cost, but Jeff is pointing out that the two are related.

HORSLEY: Right. You know, I have not seen any, as he says, reputable studies. I've certainly heard some politicians, including President Trump, who suggest that there are not only economic but health risks associated with keeping much of the economy shut down, and that has to be weighed against the economic benefit of limiting the spread of the coronavirus. We may see some folks try to put a sharp pencil on that at some point. Right now, I think, though, the case is being made more by politicians, mostly on the right, than by public health officials.

SHAPIRO: And, of course, all of this costs money, and that raises this question from Denise in Greenville, S.C., wondering about the deficit.

DENISE: My question is, while the recent stimulus checks were helpful, I'm wondering where all of this money is coming from and how we're going to pay it back. With a current deficit of over $4 trillion, will the burden again fall upon the middle-class Americans?

SHAPIRO: Scott, how is this going to be made up?

HORSLEY: You know, so far, the money is, frankly, coming out of thin air. The Federal Reserve has bought more debt from the government than the Treasury has issued since this all started. So you could really say that the Fed is running its, effectively, printing presses to put up this money. There may come a reckoning at some point, but you could say the same for really all the deficit spending we've been engaged in over the years, much of it a lot less urgent than what the government is trying to do in those circumstances in keeping businesses and families afloat during the crisis.

SHAPIRO: And at least for the moment, there doesn't seem to be much political resistance to that at all.

HORSLEY: No. Really, I mean, it's been pretty bipartisan. There's - you're starting to hear a little bit of maybe that's enough, maybe we should tap the brakes now. But there's been a tremendous willingness to spend big and spend fast.

SHAPIRO: All right. Well, if you have an economics question for NPR's Scott Horsley, send it to us at npr.org/nationalconversation or share it on social media using the hashtag #nprconversation. And our next question comes from Amy (ph) in Santa Clara, Calif.

AMY: I have a question about contact tracing. I keep hearing about the army of people needed to ramp up contact tracing to the necessary level. Is this something that could be done by some of the millions of newly unemployed Americans? Thanks so much.

SHAPIRO: Scott, does that seem viable - the workforce of people who've lost their jobs to do contact tracing?

HORSLEY: Well, fortunately, Ari, our colleague Selena Simmons-Duffin addressed this very question this morning on Morning Edition. She's been reaching out to all 50 states. She heard back from about 41 of them. What she found is that they are planning to hire some 36,000 contact tracers, up from about 7,000 on the government's payroll now. Some experts say they will ultimately need five to 10 times that many.

And Selena asked if this was an opportunity that might be taken advantage of by some of those newly unemployed people. What she heard was you don't need a degree in epidemiology to be a contact tracer. You do, however, need some empathy, and you need the ability to win the trust both of the people who are infected with the coronavirus and the people they've come in contact with.

SHAPIRO: You know, many countries have taken the strict lockdown approach that the U.S. has taken, or even stricter, but not all. And Joanna (ph) in Palm Beach County, Fla., wonders whether the U.S. might consider a less strict approach.

JOANNA: Why are we not considering a more sustainable approach, like Sweden, where we allow the economy to remain active, albeit with social distancing and protective measures in place? Then we would quarantine only those who are elderly and at the greatest risk and allow low-risk and asymptomatic patients to work through the virus and hopefully obtain a level of herd immunity, especially since a vaccine is likely months, if not a year, away.

SHAPIRO: Scott, I know you're not a medical professional, but, you know, restaurants and malls and schools are still open in Sweden. From an economic perspective, what kind of a difference does this make?

HORSLEY: Well, it makes a big difference. Now, I should say Sweden is kind of the outlier here, not the United States, but it's a reasonable question. And, in fact, you know, Georgia's aggressive effort now to open up may be in some ways approximating the Swedish experiment. Our federal system allows the states to serve as laboratories of democracy, so that's what we're going to see now is an experiment. Now, some Georgia residents don't like the idea of being lab rats here, and they're not playing along with the experiment, but we'll see how it goes.

SHAPIRO: And a lot of listeners are wondering about what happens as some of these states do start to open up. This question comes from Dan in San Antonio.

DAN: With all the talk of reopening the economy, what specific steps has anyone taken to bolster medical supply inventories or rest our health care system or enhance the health care system? And what else has been done to fortify the supply chain or feed small business or float people's incomes in case there's another wave? Thanks.

SHAPIRO: Has the country done much to prepare for a potential second wave if the economy reopens?

HORSLEY: Well, I know we're building a lot of ventilators, Ari, and a lot of them will be ready for a second wave even though they weren't ready for the first wave. Certainly, a lot of home crafters have been cranking out face masks. Where we are still lacking, of course, is in testing, even though it's been acknowledged for a long time now that that is critical to getting and staying ahead of an infectious disease.

And I don't see yet, in response to Dan's question, that we've really built a much stronger safety net for households or small businesses if, in fact, we have to go through, say, a second round of stay-at-home orders maybe this fall. It's conceivable that lawmakers could authorize something like that quickly now that they sort of know the route. But I don't know that we've done anything yet to overcome the challenges of, say, distributing another round of unemployment benefits or another round of stimulus payments.

SHAPIRO: Let's end with this question from Sonny (ph) in Asheville, N.C., who writes, what'll happen if a month from now, the economy is still shut down but some people don't qualify for unemployment compensation and also don't have any continuing relief payments available? These relief payments are helpful, but they only last so long, Scott.

HORSLEY: That's a good question, Sonny, because, as we've heard, it's going to be a lengthy process to reopen the economy. And the issue is not so much a month from now but, really, two or three months from now. You know, the small-business loans for those companies that are lucky enough to get one through the Small Business Administration, they're designed to sustain payrolls for about eight weeks. The expanded unemployment benefits that Congress authorized, they're set to run through the end of July. So the cushion here is more than a month, but it's not indefinite. And there could be trouble if employers don't stay afloat that long or if we get a big second wave of infections requiring another shutdown.

SHAPIRO: NPR chief economics correspondent Scott Horsley, thanks for answering all these questions again.

HORSLEY: It's good to be with you, Ari.

SHAPIRO: Up next, your questions about mental health and the cost of self-isolation, specifically on the most vulnerable. This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED from NPR News.

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SHAPIRO: This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED. I'm Ari Shapiro.

Every day, we understand more about the toll COVID-19 takes on our bodies. It's harder to know the effect of the disease on our mental health. NPR's Patti Neighmond has been looking into this, and she's here to answer your questions about it. Hi, Patti.

PATTI NEIGHMOND, BYLINE: Hi.

SHAPIRO: We've heard from so many listeners who are concerned about their children. Let's start off with Craig (ph) in Spokane, Wash.

CRAIG: I have a soon-to-be 12-year-old daughter who will spend her birthday in relative isolation. She is an only child, and the loneliness is clearly getting to her. She talks to her friends over the computer, but it's not the same. Are there best practices for helping children dealing with this level of loneliness? Are there lasting psychological effects on children, especially those without siblings, if this goes on for a prolonged period of time?

SHAPIRO: That's so tough to be 12 and an only child and not be able to see your friends. We are going to have much more about virtual celebrations later in the program. But on the question of loneliness and mental health, Patti, do you have any advice for Craig and others who are worried about their kids?

NEIGHMOND: Well, definitely, this is a first for all of us. It's definitely new territory. And I have to say we don't know whether long periods of isolation will have a lasting psychological impact, but we do know that a solid, loving, supportive environment at home helps children cope with all sorts of adversities, even those like this that are really, really challenging. So try to keep the conversations going. Take long walks, bike rides. Talk. And, remember; social connections with friends are also critical, as you mentioned, Ari. Of course, it's not the same thing as being in person, but video chats and Zoom sessions can be fun. And importantly for this age group, they're stimulating intellectually and emotionally.

So for the birthday itself, I did talk to one psychologist who suggested a Zoom party where each child performs their talent - it could be singing or stand-up comedy; kids this age love to show off what they can do well - and, of course, a happy birthday song or two with balloons and streamers, if possible.

SHAPIRO: All right. More on that later in the hour. But we heard from another listener who says that social distancing has actually been good for her mental health. This is Jessie (ph) in San Diego.

JESSIE: As someone with a history of mental health struggles, it feels like for the first time in my life, I'm living an environment that caters well to my needs. I've had plenty of time for arts and crafts, exercise, adequately eating well, all the things I'm supposed to be doing to maintain a stable mental health, so I worry about how my life will be when things return to, quote-unquote, "normal." So I wonder if anyone else with mental health struggles or disabilities is feeling this way as well.

SHAPIRO: That's so interesting. Patti, have you heard this from other people you've spoken with?

NEIGHMOND: Yes, I - actually, I have. I've heard a number of stories from other people who feel relieved not to participate in all the activities that Jessie mentions, like work, social obligations and managing family duties. Interestingly, I'm also hearing about children, particularly those with ADHD, who can now superfocus on their own needs and not on everything the teachers and other peers expect.

And for people with mental health issues, managing stress is really important. You know, the tasks of daily living can be overwhelming, which is why today's social isolation may feel like something of a relief from all that stress. And it's mandated isolation, so people don't feel guilty or ashamed for not taking part in certain activities.

So the psychiatrists that I talked to have - say this may be sort of a good time to reset for people. Figure out what your new normal should look like when this is finally over. And you may want to go back to doing certain essential activities, but perhaps bow out of those other obligations you don't feel comfortable with.

SHAPIRO: That's a really valuable reminder that this isolation is going to have different impacts on different people. Let's take this next question from Matt (ph) in Orange County, Calif.

MATT: My wife and I are expecting our first child at the end of July. I was wondering if there are risks specific to pregnant women, if they're more at risk. Are there risks specific to the baby? And how does this vary along the different stages of pregnancy?

SHAPIRO: We've gotten, actually, a lot of questions from listeners about pregnancy not just about the risk of contracting COVID-19 when giving birth, which is a whole other topic, but on the mental health question. Patti, what have you learned?

NEIGHMOND: Well, stress is a worry with pregnancy. We know it can increase complications. It can increase preterm birth, difficulties bonding once the baby's born. So doctors prefer and hope that pregnant women won't stress out too much about the coronavirus. They suggest relaxation techniques like deep breathing and meditation - things we've heard a lot about.

The good news - there is no evidence yet at all that pregnant women are more severely affected by the disease - by COVID-19. But we do know that during pregnancy, a woman's immune system is weakened, which does increase the risk of infection. Pregnant women are more likely to get the flu, for example, so it's really important at this point for pregnant women to follow the advice we're all getting - avoid crowds, wear a mask when out, wash hands often and avoid touching your face.

As for the baby, early research has not shown that the virus can be transmitted in utero during delivery or through breast milk, so that's good news.

SHAPIRO: All right. Let's - yeah, that is good news. Let's take a question from a younger listener. This is Nathaniel (ph), a senior in high school in Dallas, N.C.

NATHANIEL: Everyone that I can think of that completed high school got a graduation. They got to go to their senior prom if they wanted to. And it's a milestone. And it's kind of hard when you go into your senior year and you have no idea that one day, it's going to just - you're going to have to say your goodbyes. I didn't get to say goodbye to a lot of my friends. They called us one day and said we won't be going back to school.

SHAPIRO: That's so tough. Patti, what would you say to Nathaniel?

NEIGHMOND: Well, first of all, of course, I'd say I am really sorry, Nathaniel. I mean, you are not alone. There are thousands - thousands - of students whose graduations have been canceled, and it's a big loss - no two ways about it. Everyone's worked so hard at school and athletics, extracurriculars, and you want to be recognized for this achievement. Unfortunately for so many of the students today, it will be a virtual recognition.

But there are some things you can do to soften the blow. I talked with psychologists who suggest you plan a celebration for the future, something you'll do when things get somewhat back to normal - perhaps a special trip with best friends or a party at the beach or somewhere special. Start planning now - now. Talk to your friends now. What food do you want to have? What activities, games? What kind of music? Just something you and your friends can look forward to and get excited about today.

SHAPIRO: That's a great suggestion. In our last minute, let's bring in one more question from a listener in Baltimore, Md.

JEREMIAH: So my name's Amari Jeremiah (ph). And I was wondering what's the best way to support someone who's tested positive for the coronavirus? And what are some healthy mental health activities for someone who is in self-quarantine due to the coronavirus?

SHAPIRO: I think a lot of people are going to have this question. Patti, what advice do you have for Amari?

NEIGHMOND: Well, not my advice exactly, but a number of psychologists I spoke with - and, first off, they suggest that for an infected person who's relatively healthy, again, engage them via text, FaceTime, video chat. Social connection is important. Now, if the person is pretty sick, you'll have to take another tact. Ask straight-up what do they need? Can you drop off food, help a child with homework over Skype, pick up a prescription? And, again, stay connected. And in this case, don't necessarily expect a response. They may not have the energy to get back to you, but they will appreciate your caring.

SHAPIRO: Great suggestions from NPR's Patti Neighmond. Thank you.

NEIGHMOND: Thank you.

SHAPIRO: And you can hear more of our coverage when you download the NPR One app. Go to the Explore tab. Click on The Coronavirus Outbreak. This is THE NATIONAL CONVERSATION FROM ALL THINGS CONSIDERED from NPR News.

This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED. I'm Ari Shapiro.

This week, the CDC updated its list of common COVID-19 symptoms. Beyond the fever and cough, new additions include chills, muscle pain, headache and sore throat. And some people are experiencing more unusual side effects, like swollen toes. To answer your questions about symptoms, Dr. Helen Boucher is here. She is chief of Infectious Diseases at Tufts University Medical Center in Boston. Thanks for joining us.

HELEN BOUCHER: Thanks for having me, Ari.

SHAPIRO: You know, some of these symptoms, like chills, headaches, sore throat, sound a lot like the common cold or flu. So when should somebody with those symptoms start to worry that maybe they have COVID-19?

BOUCHER: Well, you know, it's a great question. And, truly, now that we're in the midst of this epidemic, really anybody who has those type of symptoms - flu-like symptoms - should be thinking that they might have COVID-19.

SHAPIRO: And then I suppose they just call their doctor and ask what the next step should be from there.

BOUCHER: Yeah. Well, it's really important. If you have mild symptoms, like a sore throat, a runny nose, it's important to stay home. Right now, as we're in the shelter-in-place mode, the best thing to do is to stay home and rest. If you get sick enough that you feel like you need medical attention, it's important to call your doctor. And if you get really sick, like you have trouble breathing and you need to call 911, you should let the operator know that you might have COVID so that they can be the most prepared to care for you.

SHAPIRO: OK. Well, let's go to our listener questions about symptoms. And this first one comes from Kathryn (ph) in Stanford, Calif.

KATHRYN: Why do people think that measuring the temperature of a person is a good way to screen if they have COVID or not? Supposedly, there are so many people who are asymptomatic and still carriers.

SHAPIRO: That's a good question. If people can spread the disease before they start showing symptoms, what good does it do to take someone's temperature before they walk into a public place?

BOUCHER: Well, we know that 50% - about half of people - will have a fever when they first become ill with COVID, so we'll catch a good number of folks by looking for their temperature. And we know, also, that if we include a brief symptom check - asking if you have a sore throat, runny nose, a cough - we put that together with the fever, we'll catch a lot of people. And we also know that you're the most contagious when you do have symptoms. So this kind of a method of putting a fever check along with some symptoms has been shown effective in catching a lot of people. It won't catch everybody, and it won't catch the truly asymptomatic. But it can go a long way to helping us in the prevention efforts.

SHAPIRO: All right. Well, our next caller is on the line with us live. And we've granted him anonymity to discuss private medical issues. He's joining us from Massachusetts to tell us his experience with a lesser-known symptom. Thanks for joining us.

UNIDENTIFIED PERSON #1: Hi there.

SHAPIRO: Hi. So I understand you had swollen toes. Is that right?

UNIDENTIFIED PERSON #1: Yes, that's correct. About a few weeks ago, I noticed one of my toes was a little itchy and red, almost as if I had a bug bite. And after a few days, all my toes on that foot were a bit swollen, itchy, red- and purple-colored, especially at night. And I spoke to a doctor, and we thought it might be something like gout or as serious as arthritis, even, until last week, they called me and told me about COVID toes.

SHAPIRO: Wow.

UNIDENTIFIED PERSON #1: Yeah. And later that day, I went for a test that ultimately came back negative, but it seems that we really can't rule out that I had coronavirus...

SHAPIRO: Because some of those negative tests are false negatives.

UNIDENTIFIED PERSON #1: Yeah, absolutely, which was a complete surprise to me. But, yeah. So, you know, I definitely had something - just not totally sure what it was yet.

SHAPIRO: And the symptoms have now subsided. Is that right?

UNIDENTIFIED PERSON #1: They've definitely gone down over the past week. I'd say, like, I still feel some itchiness and there's still some redness and purple color-ness (ph), but definitely not as bad as a week and a half ago when I could hardly walk on the toes.

SHAPIRO: I also just want to be clear. You're in your mid-20s. You're not in the older, more at-risk group. Dr. Boucher, is this something you've ever heard of?

BOUCHER: Well, you know, this entity of COVID toes has been described where patients, usually with some other symptoms, have these kind of funny toes that are kind of red and purple. And, in fact, there are a number of different kind of skin manifestations of COVID disease. I think it's important, you know, for this caller - for you to know that this could be other things as well. And so I think it's important for you to follow up with your doctor so he or she can take a look and make sure that we're not missing something else in addition to the potential that it could be COVID.

SHAPIRO: Is there any reason that COVID-19 would particularly have that effect? Does it have something to do with the blood clotting that we've heard about? I mean, do you have any idea?

BOUCHER: Well, you know, I think that the truth is we don't know. This is still, you know, a very new disease that we're learning about. And you alluded to this observation about the blood clots, which has been made and is a real thing. And I think that's an interesting idea. Certainly, more study's going to be needed before we figure this out with any certainty.

SHAPIRO: I also want to correct myself. I said you were in your mid-20s, but I understand you're actually younger than that. You're in your late teens. And I wonder whether you have a question for Dr. Boucher.

UNIDENTIFIED PERSON #1: I'm just wondering what the process is like for a side effect to become a CDC official symptom.

SHAPIRO: Interesting question. How does that work?

BOUCHER: That's a great question. So part of what the CDC does is they sort of collect the signs and symptoms of a disease by going out and doing the epidemiology. And so when a sign or a symptom becomes so common that it's seen in a high enough percentage of patients, it would make that kind of top 10 list. And so the interesting new - one of the new symptoms is that loss of taste or smell that was mentioned. And that's - you know, we hadn't heard of it three months ago, and now it's been reported with such frequency that it's kind of made this list for us to look at when we screen patients.

SHAPIRO: Well, thank you for calling us with your experience and sharing it with us. I hope your toes and the rest of you feel better as well.

UNIDENTIFIED PERSON #1: Yeah. Thanks for having me.

SHAPIRO: If you have a question for Dr. Boucher, send it to us at npr.org/nationalconversation or share it on Twitter using the hashtag #nprconversation.

And our next question comes from Charles in New York, asking about one of the more common symptoms.

VAN DEVENTER: I had COVID-19 last month, and my sense of smell and taste were way, way off, and they still are. In fact, one day, I drank a half a glass of spoiled milk before I realized. I can't eat many foods because the taste is awful. Does this mean that I still have the virus in my system?

SHAPIRO: Well, that sounds really unpleasant. Dr. Boucher, does it mean he still has the virus in his system? What can you tell Charles?

BOUCHER: Yeah. So, Charles, I'm really sorry to hear that, especially that these symptoms are persisting like this. Typically, they tend to resolve over time, and so I think that's the good news - is that there's every reason to believe that they're going to go away over time. And I think it's not clear at all that this symptom is related to having the virus still in your system. It sounds like the rest of you has gotten better, and that's really a good thing. And we know that most people develop antibodies and seem to have, you know, recovered within about two weeks. So hopefully you're on the mend and this will continue to improve. And I would say if not, I would definitely check in with your doc.

SHAPIRO: You know, I'm just curious. As we talk about the tests and whether they come back positive or negative, our previous caller said he had a test come back negative, but he might've had COVID-19 anyway. Just briefly, how often are these tests inaccurate?

BOUCHER: Well, you know, we're still learning. And the so-called false negative observation has been made. The tests we have for detecting the virus are actually quite good and quite sensitive. But sometimes, the way we do the test, the way we obtain the swab isn't perfect, and that could lead to a false negative test. It's been reported in varying numbers from as low as 10 - 5% or 10%, up to 30% in some series. And so we still have a lot to learn about that.

SHAPIRO: OK, Dr. Boucher, we need to pause for one moment. Stay with us. We're taking your questions about symptoms of COVID-19. It's THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED from NPR News.

All right, our next question comes from a listener in Florida who has been hospitalized twice in the last month with COVID-19 symptoms. Here's what she wants to know.

UNIDENTIFIED PERSON #2: My question is, why would a COVID-19 swab test result come back not detected as opposed to negative?

SHAPIRO: This is interesting. It's related to the false positive or false negative question we were just discussing, but slightly different. What is the difference between not detected and negative?

BOUCHER: Well, not detected gets at exactly what the test is doing. It's attempting to detect the virus. And so if the machine, you know, the instrument was not able to detect the virus, the answer is not detected. It would be the same to you and me as negative, meaning we don't find evidence of the virus present in that sample.

SHAPIRO: OK. Well, our next question is from Holly in Massachusetts, who's wondering about how the virus might be affecting African Americans disproportionately.

HANSON: My question has to do with blood. Sickle cell is a blood condition that affects only people of African descent. Could sickle cell also be a factor in the very high proportion of COVID-19 fatalities that are happening to African Americans? Thanks so much.

SHAPIRO: Of course, there are also other systemic issues that impact African American communities. In addition to and besides that, could sickle cell anemia be a factor, Dr. Boucher?

BOUCHER: Well, it's a great thought and one that certainly needs to be investigated. The analyses that I've seen so far are pointing more to the issues of health care disparities and other kind of socioeconomic problems that prevent health care access in this particular population. But I think that the potential relationship with the blood disorder is one that's definitely worth investigating.

SHAPIRO: All right. Our next question comes from Anna (ph) in Oregon, who's wondering about who is getting sick.

ANNA: Since the virus took hold in the U.S., we have been hearing about more younger people in their 30s to 50s becoming very ill. Does this mean that the virus is more dangerous for people in these age groups than we initially thought?

SHAPIRO: Do the data reflect that? What do the numbers show us?

BOUCHER: Well, the numbers show us a pretty clear pattern, and that is that whether it's Wuhan or the state of Washington or California or Massachusetts, 80% of people have mild disease, and older people are the ones who get into the most trouble, and older meaning over 70 in most series. So we have not seen evidence that more younger people are getting sick, but we've seen more people getting sick, and with that comes some younger people who get very sick, and I think they're tending to be reported. So I believe that's what we're seeing. And it's certainly significant because we don't want to see anybody getting very, very sick.

SHAPIRO: In our last minute, many listeners have asked whether recovering from a mild case of COVID-19 means they are immune from it going forward. What can you tell them?

BOUCHER: Well, we hope so, but we don't know yet. So we're just beginning to have the availability of tests to look for antibodies. And we have to learn, first, who develops antibodies and when. We believe that most people do by about two weeks after the illness. And then we have to learn whether those antibodies are truly protective and, if so, for how long that protection lasts. So this is the focus of lots of investigation, and it's going to be very important to us as we move forward.

SHAPIRO: Dr. Helen Boucher is chief of Infectious Diseases at Tufts University Medical Center in Boston. Thank you for answering all these questions for us tonight.

BOUCHER: Thank you.

SHAPIRO: And if you have questions, we want to help. Go to npr.org/nationalconversation. On Twitter, use the hashtag #nprconversation.

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SHAPIRO: This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED. I'm Ari Shapiro.

Even as the country is at a near-standstill because of the coronavirus epidemic, babies are being born, students are graduating, people are celebrating birthdays and couples are getting married. We're going to hear from some folks who are finding new ways to celebrate virtually or from a safe social distance. Joining us now to answer your questions is Dahlia El Gazzar. She is an event designer with expertise in technology. Good to have you here.

DAHLIA EL GAZZAR: Hi. How are you?

SHAPIRO: I'm good. You know, it's graduation season right now, and so many students all over the country have had the graduation ceremonies that they've been looking forward to for years canceled. Let's hear from one of them. She's a high school senior.

PASCOE: Hi. My name is Sarah Pascoe. I'm from San Rafael, Calif. And unfortunately, due to COVID-19, in my last semester of high school, I'm missing out on a lot of special events that, normally, seniors get to experience, such as graduation, signing yearbooks and going to prom.

SHAPIRO: So many students feel the same way Sarah does. Dahlia, how can she celebrate an accomplishment like graduating right now? I mean, people all across the country are in this situation.

EL GAZZAR: And my heart goes out to all of them because I remember my high school graduation being a very special time. So my couple of ideas is the graduates have an amazing chance right now to tell their stories in many, many ways. So they either can tell their stories in video and share them together. They can tell their stories in photos, and they can create, like, collages. Those collages can become, you know, photo mosaics digitally and maybe be the - an image of all the photos together that make up the high school mascot, for example. But I think what needs to happen is you have all these blended experiences that are going to happen for celebrations going forward...

SHAPIRO: Yeah.

EL GAZZAR: ...Whether it's for graduations, birthdays, et cetera. But for graduates, this is a perfect time for them to even - you know, I know that Second Life is coming back to life, no pun intended. But, like, even...

SHAPIRO: Have a virtual graduation online.

EL GAZZAR: Have a virtual graduation, where, you know, potentially, they can even have their acceptance speeches together...

SHAPIRO: Right.

EL GAZZAR: ...You know, as well as...

SHAPIRO: Yeah.

EL GAZZAR: But it's also the exchange of stories.

SHAPIRO: Right.

EL GAZZAR: Even on a Zoom-like platform, they can totally graduate together, wear a cap and gown, you know...

SHAPIRO: Yeah.

EL GAZZAR: ...Hold up signs and then take pictures that way, or even, like...

SHAPIRO: All right. Well, spring is not only graduation season. There are so many other celebrations to get to. And, in fact, we have someone on the line who is planning her wedding. And it was supposed to be 250 guests. Now, I understand, it's down to 10 people. This is Sydney (ph) in Harwood, Md. Is that right?

SYDNEY: Yeah, that's correct.

SHAPIRO: OK, so thank you for joining us this evening. And tell us about what your new plan is.

SYDNEY: New plan in light of all of this is to have a 10-person wedding. I'm really fortunate 'cause my family owns a farm, and we have space to be able to do that. So after we have our 10-person ceremony, we have a drive-through plan so people can come and celebrate with us, and we can get to see all the faces that we're having to miss during our 10-person ceremony.

SHAPIRO: That's such a nice idea, a drive-through wedding. Well, congratulations. And, Dahlia, do you have any recommendations or tips for Sydney as she plans this?

EL GAZZAR: I do. Sydney, I would say, like, especially with the drive-through, I think that's fantastic. I would say also have people join you online, if you can, virtually so that you are able to have them come in. I just actually went to a cyber wedding on Zoom, and they were able to dance with each other. Some of the people that were not able to be there in person were sent a goody bag, so, like, they were given, like, certain backgrounds and props so that they felt they were part of your wedding on the farm and had that experience with you but even online, if that makes sense.

SHAPIRO: I love that. And, Sydney, it sounds like you're keeping your spirits up about this, which is really nice to hear.

SYDNEY: I'm doing my best. Hey, there's a lot of other things that could be happening. And I'm fortunate to still be able to get married, so that's the end goal.

SHAPIRO: That's the attitude. Well, congratulations. I hope you have a long and happy life together.

SYDNEY: Thank you so much.

SHAPIRO: Our next caller, Yolanda (ph) in Austin, just got married. And she and her husband decided to invite wedding attendees to watch their ceremony, as you just mentioned, Dahlia, over Zoom.

YOLANDA: They got to see us cut our cake. We had our first dance. It was actually really warm because what we were able to do afterwards was unmute everyone and then, you know, talk to every family that was dialed in because, actually, what we had planned was to have a special moment with our families and to get married - right? - and get started on our life journey together.

SHAPIRO: As beautiful as that is, Yolanda says she does have one regret.

YOLANDA: We did not get a chance to take our dance lessons, so our first dance was just, you know, like prom (laughter).

SHAPIRO: Dance studio was closed. Dahlia, do you have any other tips for folks who are moving their guest list online?

EL GAZZAR: Well, one thing is - also, I'll come back to Zoom because it is an easy platform to use - is, for example, if you still want, like, the table seatings and have different family members on the different tables, you can have that be almost like in breakout rooms on a Zoom platform...

SHAPIRO: Oh, sweet.

EL GAZZAR: ...And have, like, a little facilitator for each table, have little ice breakers as well, so you sort of pretend that you have, like, those round tables with you.

SHAPIRO: That's nice.

EL GAZZAR: And then, you know, Airbnb has online experiences now. So they have dancers that can teach you how to dance. And so maybe you can do that not only for the bride and groom, but do it for everybody that's going to be on - within a wedding. So that's another idea, too.

SHAPIRO: And for the wedding photographer, I guess you just do a screen grab.

EL GAZZAR: Yep.

SHAPIRO: (Laughter) OK. Well, we're also hearing from a lot of listeners who are celebrating birthdays. Earlier in the program, we heard from Craig in Spokane, who was worried his daughter would be spending her 12th birthday mostly in isolation. And for this, we got some advice from Marcy Blum, an event planner who does high-end events and the occasional birthday party. She suggested that the key is to make this day feel special by creating some new traditions.

MARCY BLUM: Something like cake for breakfast, lunch and dinner or cake for breakfast, candy for lunch and a certain song that you sing every time, and just like, OK, today is sort of like topsy-turvy day at camp or something like that, so they know that this is celebrated by the family, so that it's a tradition they look forward to rather than feeling neglected or as if they didn't get to have a real party.

SHAPIRO: Great suggestions. We've only got a few seconds left, but, Dahlia, in a sentence or two, what would you add to this list?

EL GAZZAR: Well, to be cool with your 12-year-old, I would totally do something on TikTok, so stitching challenges together or using Spark AR Studio to create her special birthday filter either on Instagram or on Snapchat.

SHAPIRO: Beautiful suggestions from Dahlia El Gazzar. She's an event designer with expertise in technology. Thanks for joining us tonight.

EL GAZZAR: Thank you.

SHAPIRO: I'm Ari Shapiro. And my co-host Michel Martin will be here tomorrow to answer more of your questions. Send them to us at npr.org/nationalconversation or tweet us with the hashtag #nprconversation.

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