NOEL KING, HOST:
To get your head around, it's the population of Scottsdale, Ariz. You could fill the Staples Center in Los Angeles 12 times over and still not get to 250,000. And every number is a person who had a life, who had friends or kids or siblings or parents. As of last night, 250,000 are dead. Now, back in March, Dr. Anthony Fauci predicted it could get this bad. And at the time, a lot of us thought it just seemed impossible.
RACHEL MARTIN, HOST:
And yet here we are. NPR's health correspondent Rob Stein is with us. Rob, I mean, the scale of the loss of life is hard to understand. I mean, Noel tried to help us grapple with it. Can you take it further and help us put this into perspective?
ROB STEIN, BYLINE: Yeah. So, Rachel, each of these new terrible milestones is so big, they can start to feel incomprehensible. So I've been struggling to find a way to put such a stunning toll into some kind of context. It's hard. And it's getting close to the 291,000 Americans who died in four years of combat during World War II. I talked about this with Dr. Howard Markel. He's a medical historian at the University of Michigan.
HOWARD MARKEL: There has been no experience in American history in the last century that has caused this much carnage - no war, no natural disaster and no infectious disease pandemic, with the exception of the 1918, 1919 flu pandemic. This is something quite different, I think, of the American experience.
STEIN: And, you know, Rachel, the CDC says the 1918 flu killed about 675,000 people in the United States. And the official death toll from the coronavirus is believed to be a gross underestimate. The true total is probably already tens of thousands of deaths higher. And then there are so many other people who survived but suffered horrible illness, many of whom are still recovering and may never fully recover.
MARTIN: Right. And as you note, haven't even been captured in this data. So, I mean, what has been the reaction to this? You've been talking to doctors, epidemiologists, public health experts about this pandemic for months. What do they say about this point?
STEIN: Well, you know, they're just heartbroken by this and frustrated. You know, when 100,000 lives were lost in May, they hoped it would be a wake-up call. And when 200,000 lives were lost in September, they hoped it would finally set off alarms like, you know, a declaration of war or something. And now here we are. Let's listen to Dr. Carlos Del Rio. He's an infectious disease expert at Emory University.
CARLOS DEL RIO: Just none of us thought it would happen. And it just makes me incredibly sad because those are not numbers. Those are people. Those are persons. They have names. They have families. They have friends. And the death toll is just staggering.
STEIN: And, you know, one of the most frightening things about this is if you look at what's happening, the worst could be yet to come for this country.
MARTIN: I mean, let's talk about that. What are the predictions?
STEIN: It's just terrifying, Rachel. The virus is running rampant from coast to coast. More than 150,000 new infections are now being reported every day. More than 1,200 new deaths are being reported day after day. It's like several jumbo jets crashing every day. The U.S. could easily be plummeting towards a death toll rivaling or even surpassing the terrible 1918 flu. Here's Dr. Ashish Jha. He's the dean of the Brown University School of Public Health.
ASHISH JHA: We're in the darkest days of this pandemic, and I think the next two months will be very, very difficult. I'm really hopeful we don't get to 500,000 deaths. It would start rivaling the kind of suffering and death we saw with the 1918 flu. And a century later, with all of the tools that we have in front of us, that would be truly just shocking and awful and unacceptable. It's not where we should be as a country.
STEIN: So doctors like Jha are literally pleading with people to do what needs to be done and protect themselves and those around them, especially as we head into the holidays so more of us can be thankful for our health on this Thanksgiving.
MARTIN: NPR health correspondent Rob Stein. Thank you, Rob.
STEIN: You bet, Rachel.
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MARTIN: Public schools in New York City are going all virtual starting today.
KING: Yeah. The mayor made the announcement yesterday. He was very direct. He said the city's COVID infection rate has passed 3%, and that's the threshold at which schools have to be closed.
MARTIN: NPR's Anya Kamenetz is with us now to talk about this latest development. Hi, Anya.
ANYA KAMENETZ, BYLINE: Hi, Rachel.
MARTIN: So, I mean, New York City was one of the worst places in the country for COVID early on. Then things seemed to get better. And then, you know, the schools were open, and now they are not. So what led to the change?
KAMENETZ: Well, it's been a bit of a saga. Mayor Bill de Blasio had previously set this threshold of the 3% positivity rate on tests in order for schools to close if they hit that number. We'd been edging closer over this past weekend. And then yesterday, parents, journalists were waiting for several hours until the announcement finally came down in the late afternoon. Now, 3% positivity, Rachel, compared to some places in the country, that's pretty low. It's a pretty stringent standard. New York is doing better than some neighbors, but the mayor and the chancellor said, you know, they're hoping to offset the second wave of the virus from becoming even bigger.
MARTIN: And we should just say it's not 3% positivity in schools at all. It's 3% in the city, right?
KAMENETZ: That's right. So this is a citywide number. The rate inside the schools is much, much lower.
MARTIN: Right. So what are public health officials saying about the decision to close the schools?
KAMENETZ: It's pretty controversial, Rachel, because, you know, most scientists at this point will tell you that schools, especially elementary schools, have not been found to be significant sources of spread of the virus. And I reported on this recently. And many places in Europe, they've been dealing with the second wave by closing bars and restaurants, sometimes even going to a full lockdown almost, yet schools have stayed open. And you're seeing very few places in the U.S. that are following that model. Here in New York City, indoor dining is still open at 25% capacity. So people on Twitter were saying, well, maybe I'll send my girl - my kids to the bar tomorrow since schools are closed.
MARTIN: Yes. This is what I was seeing on my Twitter feed, too, saying, you know, I can still go to the gym, I can go have a glass of wine, but my kid can't be in school. I mean, what are the parents you're talking to saying?
KAMENETZ: I mean, this is a big, diverse district. It's important to note only about 300,000 of the million students had been going to school in person. There was a shocking statement made yesterday by the chancellor that 60,000 students in the district still do not have devices that they need to participate in remote learning. They're going to be getting paper packets. And, you know, I think whether families are dealing with hybrid or remote, the vast majority are just really worn down by all the changes in plans. And that's really true across the country. I mean, we're seeing districts shut down all over the place. I talked to Daniela Jampel in New York. She started a petition to keep schools open. She's going to be leading a protest later today. She said she feels like the city is taking parents like her for granted.
DANIELA JAMPEL: I think a lot of it is, frankly, like, you're a parent and you love your children, so you'll just figure it out. But there's just no recognition of the insurmountable burden that parents have been under for the last seven or eight months.
KAMENETZ: And she added to that, especially working moms.
MARTIN: Right. NPR's Anya Kamenetz. Anya, thanks. We appreciate it.
KAMENETZ: Oh, thank you, Rachel.
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MARTIN: All right. The nation is gearing up for the largest vaccination effort in its history. Undertaking that is going to be a massive task.
KING: And the Trump administration is betting on a small Connecticut company that says it has a way to get it done. We're expecting an announcement later today that the government is awarding this company alone about $600 million to mass produce a disposable injection device to deliver the vaccine.
MARTIN: We've got NPR's Dina Temple-Raston of our investigations team with us. Dina broke this story. Dina, thanks for being here.
DINA TEMPLE-RASTON, BYLINE: You bet.
MARTIN: OK. So, Dina, explain what this company, ApiJect Systems, is trying to do.
TEMPLE-RASTON: The issue is, is that the vaccines themselves are only the first step, right? And the next step now in this vaccine race is something called fill finish, which is exactly like it sounds. You get a vaccine, you put it in a vial, you get syringes, you distribute it, and then you stick it in someone's arm. But the real concern has been that fill finish is going to break down. And ApiJect says it's the perfect backup plan. It says by January, it'll be able to produce 45 million of its little injection devices with the vaccine inside every month - 45 million of them.
MARTIN: That's amazing. And I understand the idea of being cautious. But explain why there's an assumption that it's going to break down. Why the need for a backup option?
TEMPLE-RASTON: Well, you know, if you remember during the early days of the pandemic, some of the testing supplies were scarce. Remember, some labs had reagents; others didn't. Some had swabs; others didn't. So they don't want to see a repeat of that while we're in the middle of trying to get some 700 million vaccines out. So the thought is that ApiJect can help if suddenly, for example, we run out of glass or there's a syringe shortage because the injection device is self-contained. It's all made here in the U.S. They make this little plastic single-dose device and then they make these little special sort of hypodermic needles that go inside. And that just smooths out the supply chain. And the executive chairman of the ApiJect, Jay Walker, he was the guy behind Priceline. He says it isn't just a COVID solution. This whole ApiJect idea was originally conceived as a way to help developing countries get vaccines.
JAY WALKER: This same technology can also be licensed to pharma companies as well around the world. So this is a breakthrough in how we believe vaccines will be packaged and delivered in the world ahead.
MARTIN: Dina, where are they in the process?
TEMPLE-RASTON: Well, they still need FDA approval. Walker told us that he expects that will happen as a kind of combination deal, that the vaccine in the ApiJect will apply for an emergency use authorization. They just aren't there yet. And they need to do some studies to make sure that the vaccines are stable inside those injection devices, that sort of thing. But if all goes well, they expect they'll be ready in the spring and - if, in fact, they are needed.
MARTIN: I mean, are people optimistic about this? Is there an expectation that it's going to work?
TEMPLE-RASTON: Well, I'd say the experts are still reserving judgment. We talked to Nicole Lurie. She was the assistant secretary for preparedness and response at the Department of Health and Human Services. And she says this isn't a slam dunk.
NICOLE LURIE: What testing has been done to ensure that the materials inside that containers don't interact with the components of the various vaccines?
TEMPLE-RASTON: So I suspect that's what we'll be seeing in the days ahead.
MARTIN: All right. Dina Temple-Raston from NPR's investigations team bringing us this story. Dina, thank you. We appreciate it.
TEMPLE-RASTON: You're welcome.
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