Coronavirus Antibodies; Tennessee's Approach To Testing Anyone : Consider This from NPR Most people infected with the coronavirus develop antibodies in response. NPR's Richard Harris reports that scientists are trying to figure out if that means people who've been exposed are immune from reinfection and, if so, for how long.

The Labor Department reported 20.5 million jobs were lost in April, putting the jobless rate at its highest level since the Great Depression.

Health care workers are among those hard hit by the economy. Many are losing work as hospitals struggle financially due to a decrease in non-emergency visits and procedures.

Only a few states have enough tests to ensure safe reopening. One of them, Tennessee, has taken a unique approach to testing: Its state government pays for every single test, no questions asked.

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This episode was recorded and published as part of this podcast's former 'Coronavirus Daily' format.
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Antibodies And Immunity; Why Even Health Care Workers Are Losing Jobs

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Antibodies And Immunity; Why Even Health Care Workers Are Losing Jobs

Antibodies And Immunity; Why Even Health Care Workers Are Losing Jobs

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KELLY MCEVERS, HOST:

Every week for the last month, we've been hearing about millions of Americans filing for unemployment. But not everyone who has lost a job qualifies for those benefits, so today we get a more clear picture of the economy. The Labor Department's monthly report revealed 20 million jobs were erased by the pandemic just in the last month.

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MCEVERS: That's an unemployment rate of almost 15%, the highest since the Great Depression.

KEVIN HASSETT: The next jobs report is going to look worse than this one in terms of - at least, the unemployment rate is going to probably go up to around 20%.

MCEVERS: White House economic adviser Kevin Hassett said it is not over.

HASSETT: I think we're definitely going to be looking at least one more month of just, you know, catastrophically and tragically bad data.

MCEVERS: Coming up - why even people in the health care industry are losing their jobs and the one state where anyone who wants a test can get one. This is CORONAVIRUS DAILY from NPR. I'm Kelly McEvers. It's Friday, May 8.

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MCEVERS: Most people who get sick with COVID-19 produce antibodies. That is one thing we know. But do those antibodies mean you're immune for life, like with chickenpox or measles? Or can you get sick again, like with the common cold?

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JEFFREY SHAMAN: This, to me, is one of the big unanswered questions that we have because it really says, what is the full exit strategy to this? And how long are we going to be contending with it?

MCEVERS: Jeffrey Shaman at Columbia University says the best case is that people who develop antibodies to the novel coronavirus will be done with it for good. But he's not betting on that. Coronaviruses, he says...

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SHAMAN: They're very common, and so people seem to get them quite often. And our evidence suggests that those antibodies are not conferring protection.

MCEVERS: One possibility is that people who had mild cases of COVID-19 won't be immune, but people with more severe cases will be. But at this point, that's just a hunch. Another variable - not all antibodies are protective. Some can actually make an illness worse. And even if it turns out antibodies protect you, that doesn't mean the people around you are safe.

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KARI NADEAU: Because you might be immune; you might have protected yourself against the virus, but it still might be in your body, and you're giving it to others.

MCEVERS: Dr. Kari Nadeau at Stanford is examining blood samples from hundreds of people who have recovered from COVID-19. If people can still spread the disease after they've recovered, it would have massive implications for how we go back to work or visit our parents or grandparents. And all this depends on the accuracy of the antibody blood tests that are starting to flood the market. Is a positive test really positive? Does it signal long-lasting immunity?

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NADEAU: We can never say you're fully protected until we get enough numbers. But right now, we're working hard to get the numbers we need to be able to see what constitutes protection and what does not.

MCEVERS: Kari Nadeau and Jeffrey Shaman talked to NPR science correspondent Richard Harris. There's a link to more of his reporting on antibodies in our episode notes.

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MCEVERS: You might think health care is the one industry where jobs are safe right now. But doctor visits are being canceled. Emergency room visits are down. Non-Surgical procedures are on hold. And all this means that more than 1.4 million health care workers lost their jobs in April.

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SHAWN REED: Basically, if our volumes don't pick up, then we have to really look at how we're staffed. We're trying to avoid layoffs, and we're trying to keep people working.

MCEVERS: Shawn Reed (ph), an ER nurse in Washington state, says her hospital has scaled back ER staffing to the bare minimum. And they're asking some nurses to cut back on hours, take furloughs.

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REED: And so when I look at, like, a nurse that we've only had for, you know, maybe a year two who's pregnant with her third child and I know that she's going to need hours now, I'm willing to fall on that sword to make sure that she can get hours.

MCEVERS: But Reed says she can't afford to do that long-term. NPR's Leila Fadel and reporter Will Stone in Seattle talked to Morning Edition host Noel King about how hospital workers across the country are dealing with this.

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NOEL KING: Will, I remember when this pandemic started just a couple of months ago, and the anxiety then was that hospitals just would not have enough doctors and nurses. Is that still a concern, or has that completely changed?

WILL STONE: Actually in many places, that narrative has flipped. Some have said, hey, we were on the frontlines sometimes in risky situations without enough masks or protective gear. And now we're worried about our jobs and paying our rent. Rozetta Ludwigsen (ph) is a nurse who works at a small hospital north of Seattle. She's gone from working a 40-hour week to only a few days a month. She's in her mid-60s. And actually, before this pandemic hit, she was hoping to retire in the coming year.

ROZETTA LUDWIGSEN: I don't know if I'm going to have to stay another year. That's not something I wanted to do. The longer I work, the more I fear that I'm going to end up with something. And I'm not going to enjoy my retirement, so (laughter)...

KING: So we have two groups of people here. We have people dealing with the trauma of being laid off, and we have people who are still working. Leila, for the people who are still working, what does this mean for them?

LEILA FADEL: Well, basically less staffing means nurses in ERs, ICUs - they're taking on all kinds of extra tasks to make up for those layoffs or furloughs. In one Detroit area hospital, I spoke to Fatima Hashem (ph). She's an ER nurse. She works with COVID-19 patients every day, so she's helping treat them. She's FaceTiming their families. She's being their support system. And now, because some of the cleaning and maintenance people have been laid off...

FATIMA HASHEM: We are going in and cleaning these rooms up, you know, getting them ready for the next patient.

FADEL: So that means she's changing sheets, sweeping, taking out trash. And Hashem says the people who worked as patient advocates or in guest relations are also mostly gone, so she's arranging rides for patients through insurance, bringing people coffee. One nurse I spoke to in California, Amy Erb (ph), describes her and other nurses' jobs in the midst of layoffs and reduced hours like this.

AMY ERB: We're being nurses. We're being environmental services. We're phlebotomists drawing labs. We're being, you know, social workers. We're being psychologists. We're taking all of this on and, you know, we do that to some extent every day, but it's been very much exacerbated by this crisis.

KING: You know, Leila, we've seen so much support for health care workers - people calling them heroes, people sending them food and, when they can, equipment. When you talk to these folks, are they telling you that that's helpful?

FADEL: Well, I mean, people - they love the support of handmade signs, the food deliveries, the applause, but they're also really frustrated. This is a terrifying time for health care workers. One nurse I spoke to in the Detroit area says she spent the first month of this pandemic crying every night because she was scared because of the shortage of protective gear. But she was also grieving because she's working with patients who are really sick or dying alone because of COVID-19. And now she's worried about her job, so they want more. They want protective gear and job security.

KING: So if we pull back here, Will, I guess the big question is, is there any fix?

STONE: Things are already changing in some places as hospitals ease into elective procedures again. That will bring in money and get some people back to work. Congress has also come up with some funding, but industry groups say that's still not enough. Even in New York City, where the hospitals were swamped, the situation is calming down. And one head ER doctor there says some hospitals are now looking at their finances and wondering if they can stay afloat.

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MCEVERS: Reporters Will Stone and Leila Fadel with Morning Edition host Noel King.

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MCEVERS: To reopen businesses, states need both testing and contact tracing on a massive scale. This is what we know. We also know you can't have one without the other, but only a handful of states have enough tests. One of them is Tennessee. And that's because the state simply decided to pay for every single person who wants a test. Here's Blake Farmer of member station WPLN in Nashville.

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BLAKE FARMER: Testing has become so plentiful in Tennessee that people like Christine Garner are invited to just stop by the local high school and get swabbed.

CHRISTINE GARNER: I'm just, like, hypersensitive to any change in my body at all. I think a lot of people are.

FARMER: Garner helps refinance mortgages around Nashville and still interacts with customers face to face, so she wanted some assurance she wasn't a carrier, at least at this point. All she had to do was wait a few hours in her minivan. Her husband and her kids also got tested. In almost any other state, they wouldn't even qualify for a test. But almost no other state has as much testing capacity to spare as Tennessee. Dr. Lisa Piercey is the state health commissioner. She gives a lot of credit to private commercial labs.

LISA PIERCEY: We've called on almost all of them to say, hey, we need you to ramp up because you're about to get a flood of tests. And that's exactly what we've given them.

FARMER: Private labs are processing tests in lots of states, but about a month ago, Tennessee decided to guarantee payment. The state doesn't even try to bill insurance companies. It just pays the labs directly about $100 a test. And money is a good motivator. Take Aegis Sciences, which decided to go all in on the coronavirus market. CEO Frank Basile says he's already doubled capacity to 7,000 tests a day.

FRANK BASILE: Clearly, it's beneficial for the lab companies, like us, to receive the assurance of payment. And it gives us the confidence to put the effort and the capital in to make this happen.

FARMER: Those tax dollars are well-spent, says Dr. Ashish Jha of the Harvard Global Health Institute. He's been tracking testing capacity by state. Jha says Tennessee's spending could more than pay for itself since you need lots of testing to safely reopen businesses.

ASHISH JHA: If the state says, we'll just pay everybody $100 every time you do a test, that strikes me as very smart policy.

FARMER: The Tennessee Department of Health doesn't know exactly how much it's on the hook for yet. It's a tab that now grows by millions of dollars a week. The state's also hoping the federal government will reimburse the cost at some point. All this testing capacity is just what states need, says Dr. Kelly Moore. She's a pandemic consultant and previously worked for the Tennessee health department.

KELLY MOORE: If these highly motivated, worried well people coming out for free tests are not taking up scarce resources we need for someone else, then it's definitely not a problem to test them.

FARMER: Virtually no one is being turned away. But at some of the free mass-testing events, 99% of the tests have come back negative, which sounds great. But Moore says it could prompt the state to reopen too quickly.

MOORE: We can't draw conclusions about what's going on in the whole community based on this self-selected group of people who are so motivated, they come out to get tested.

FARMER: And Tennessee has started using its testing muscle in a more strategic way. Everyone who lives or works in nursing homes and prisons is getting tested this week.

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MCEVERS: WPLN's Blake Farmer - his story is part of NPR's partnership with Nashville Public Radio and Kaiser Health News.

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MCEVERS: Before we go, we are going to address the serious problem of glasses plus face masks equals fogging. Turns out to solve it, you just need basic dish soap and water.

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JOSEPH ALLEN: The best type of dish soap to use is the original type of Dawn dish soap. If you use anything that says, for sensitive skin, or has some sort of lotion in it, don't use that. That'll actually just get stuck on the lenses and smear it even more. You just use a single drop on both sides of the lenses, rub it in with your fingers, and then go ahead and rinse off.

MCEVERS: Optometrist Joseph Allen says shaving cream works too. Allen talked to NPR's All Things Considered. For more on the coronavirus, you can stay up to date with all the news on your local public radio station. And tomorrow, we'll have another episode from NPR's National Conversation with experts and NPR journalists answering questions from listeners about the pandemic. If you have a question, send it to NPR.org/nationalconversation or tweet with the #NPRconversation. This podcast is produced by Gabriela Saldivia, Anne Li and Brent Baughman and edited by Beth Donovan. For questions and feedback on the show, you can write to us at coronavirusdaily@npr.org.

I'm Kelly McEvers.

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