April 1, 2020 • 19 mins
As COVID-19 testing capabilities ramp up and companies are coming up with new tests, why does it still take so long to get results? First, it is a multi-step process… once a sample is taken, it needs to travel to a lab, then it needs to be processed. And different circumstances in processing will lead to different turnaround times. Julie Appleby, senior correspondent at Kaiser Health News, joins us for the steps involved in testing and new ones on the way.
Next, we hear a lot about confirmed cases of coronavirus. The U.S. has the most confirmed cases in the world right now, but unfortunately, that metric does little for us in the way of tracking how fast it is spreading due to uneven testing. Instead, some suggest we track the rate of hospitalizations and other factors. Faye Flam, columnist at Bloomberg News, joins us for why we still need a lot more data to find out true rates of infection and spread.
Finally, coronavirus is forcing pregnant women to make tough choices. There are many hospitals with such tight restrictions that in some cases a woman’s partner might not even be allowed into the delivery room. Women are having to resort to FaceTime to have their partners present, and it could be falling to nurses to provide supportive care and camerawork. Laura Kusisto, reporter at the WSJ, joins us for more.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
It's Wednesday, April one. I'm Oscar Ramirez in Los Angeles
and this is the daily dive. As COVID nineteen testing
capabilities ramp up and companies are coming up with new tests,
why does it still take so long to get results? First,
it is a multi step process. Once a sample is taken,
(00:21):
it needs to travel to a lab, then it needs
to be processed, and different circumstances and processing will lead
to different turnaround times. Julie Appleby, senior correspondent at Kaiser
Health News, joins us for the steps involved in testing
and new ones on the way. Next, we hear a
lot about confirmed cases of coronavirus. The US has the
most confirmed cases in the world right now, but unfortunately
(00:43):
that metric does little for us in the way of
tracking how fast it is spreading due to uneven testing. Instead,
some suggest we tracked the rate of hospitalizations and other factors.
They flam calumnist at Bloomberg News joins us for why
we still need a lot more data to find out
true rates of infection and spread. Finally, coronavirus is forcing
pregnant women to make tough choices. There are many hospitals
(01:05):
with such tight restrictions that in some cases a woman's
partner might not even be allowed into the delivery room.
Women are having to resort to face time to have
their partners present, and it could be falling to nurses
to provide supportive care and camera work. Laura Casisto, reporter
for The Wall Street Journal, joins us for more. It's
news without the noise. Let's dive in. The FDA authorized
(01:30):
the new test developed by Abbot LAPS that delivers lightning
fast results and as little as five minutes. It's a
whole new ball. Joining us now was Julie Appleby, senior
correspondent at Kaiser Health News. Thanks for joining us, Julie,
thanks for having me. A lot has been made about
testing throughout this whole coronavirus pandemic right now, as everybody
(01:52):
is clamoring to get tested, we're seeing serious backlogs on this.
Still it still takes a long time, despite a bunch
of new tests coming out, besides new companies working on
tests saying that you know, we can get results in uh,
you know, as little as minutes to a few hours,
there's still a lot of steps that are involved in
all of this, and that's why things are taking so long.
(02:12):
So Julie, tell us a little bit about this. Take
us behind the scenes at what this testing looks like, right,
And it does take a long time, as we've seen,
people are being told, you know, you have to wait
five or six or seven days in some cases to
get a test. So why is that? So let's back
up a little bit. We had some problems initially when
the first CDC test came out. Those were resolved. More
and more labs now have approval to run these tests,
(02:35):
and larger labs on the hospital labs, ETCeteras that are
and as you mentioned, we're starting to see some quicker tests,
but it still takes some time. There's a number of
steps in the process. Like first you get your nose
swabs right with one of these things, and they put
that swab in a little tube and they send it
off to the lab and the lab then has to
do some pretty sophisticated analysis of the sample right to
(02:57):
figure out do you have COVID or not and that
and real quick. That's the first step, actually getting swapped
and then sending it to a lab. That could take
up to a day depending on where the lab is,
how far it is from where you got tested. That's correct.
You've got to think about transit time. There's about a
day lag there. Now, there are some places that are
doing testing on site, So if you're at a large
academic medical center, chances are they might have their own
(03:20):
testing capability at depth center, but they're probably limiting the
testing too in patients and to their hospital staff. So
the reason they can get a result back a little
quicker there is because they just do it in house,
so they don't have that transit time. But even when
they do it in house, there's a bunch of steps
that have to be done. They have to put them
in a machine. Generally, there's there's some manual work that
(03:40):
the technician does. They have to extract some R and
A and amplify the DNA and there's all this science
kind of stuff. Some of it's done manually, but a
lot of places, these big commercial labs have these machines
that run them automatically, so they're faster. They can process
more samples at a time in a piece i road.
I talked to pathology lab at mid Star Medical or
in Georgetown here in Washington, d C. And they can
(04:02):
run nine three samples at a time in their machine
and they can run about three of those cycles a day. Okay,
so that's why they do it in the house at
this hospital, but they're kind of limited in the number
they can do. Whereas if you go to a test
site and they might send it off to a large
commercial lab, that's they can process twenty or thirty thousand
of these a day, so that might be faster, but
(04:25):
then you've got to transit time and they've got a
big backlog. So these are all the reasons why it
can take a number of days to get results back
in some cases, and in other cases you might get
an answer back sooner. And one of the other difficulties
is that there's so many people that want to get tested.
They want to have peace of mind to know whether
they do not have it, or they want confirmation if
(04:46):
they're getting they have some type of symptoms. They want
to know they have it so they can know what
to do. And in a lot of these places, it's
like almost a sign like no Watkins welcome kind of thing,
because you know, some of these sites have to you
have to follow a line. Basically, you know, somebody coming
off the street just can't get their tests and get
it done. They need to prioritize these things to healthcare workers,
(05:07):
to people that really have bad symptoms and are in
hot need hospitalization. And that's true. That's because we don't
have enough test in the United States right now. They're
working on ramping that up. As you mentioned, We've we've
got some new test kits out there starting to go
out that that can get results back quicker, and those
are expected to be sort of point of care. When
you walk in your doctor's office or the emergency room,
you might be able to get a result back in
(05:28):
five to thirteen minutes. But that just got approved, you know,
Friday night, and they're they're going to start shipping them.
They're hoping to ship fifty thousand of them a day.
But there's a lot of people like you mentioned that
just want that peace of mind or you know, if
you've got it, you really need to isolate yourself and
so it's good to know do you have it or not.
But we're not there yet. Yeah, the test that you
were just talking about that we can get the one
that just kind of got to prove this past Friday,
(05:50):
the President was talking about that one. Um, you know,
just trying to get people hope really that you know,
you can get tested and get a result very quickly,
but even that still needs to get ramped up. Those
little test kits need to be made and sent out,
and there's a lot of stuff that goes into it,
and and we're hearing a lot about shortages specifically with
healthcare workers with personal protective equipment, masks, all that stuff,
(06:12):
but these testing kits also suffer from some of those shortages.
The chemical agency using those kits, the swabs to get
the samples. There's a lot of things that are in
short supply right now, and all of that needs to
get ramped at. That's correct, and that's why some of
these groups are the big lab testing groups, and some
of those are saying, let's limit the testing right now
and to these high priority people because there are these
(06:34):
shortages and asks kind of backing up manufacturing in some cases.
I spoke with a manufacturer who was, you know, working
on making sure he could get all the right little
chemicals to put in it and and the swabs and
that kind of thing. And he has multiple suppliers, but
he's on the phone working this thing to make sure
that happens. And there's just a big demand for these
products right now, you keep hearing it a lot. We're
all in this together. We have to practice the social distancing.
(06:56):
There's a bit of patients that goes into this that
unfortunate a lot of people don't have because you know,
you hear scary words like pandemic and whatnot, and people
are legitimately concerned. So but it is kind of this
patience that we have to practice with all of this
as well. Right and more and more of these are
getting approved. I mean, just in a couple of days
since I wrote my story, there's been a couple more
tests approved under these emergency use authorizations by the f
(07:19):
d A, So more tests are coming on the market.
There's another entire kind of tests which tries to figure
out if you have immunity, if you already had the disease,
and those are gonna we're gonna start hearing more about those.
They're not available widely here in the United States yet,
but other countries are working on that, getting folks tested
to figure out, Hey, maybe it's safe for you to
go back to work. You've had the disease, you presumably
(07:40):
have immunity now. Julie appleby Senior correspondent at Kaiser Health News.
Thank you very much for joining us. Thanks for having me.
There are some people who think it's likely that well
before the first kind firmed cases showed up here, there
(08:01):
may have been people that weren't particularly sick that just
showed up here, and the disease was already spreading quietly
well before those first cases showed up in January. Joining
us now was Faye Flam science journalists and opinion columnists
at Bloomberg News. Thanks for joining us, Faith Hey, thanks
for having me. Since this whole coronavirus pandemic really got
started in the United States, we've kind of been obsessed
(08:24):
with tracking it, seeing the total number of confirmed cases,
but it's really hard to base it on that. We
know that numbers keep going up as more testing occurs,
but even then, you know, we don't really have quote
unquote real time numbers because some of these testings could
take a week for results to come through a couple
of days, so it's really tough to gauge how all
(08:45):
of this is going. So this notion that confirmed cases
the metric is really hard to go buy on that.
So Fay, you wrote an article talking about other things
to look at for how fast this could be spreading.
I was in touch with some epidemiology sense statisticians and
people that are really trying to get handle on these numbers.
And the numbers of confirmed cases, which are the ones
(09:08):
that everybody's obsessed with, are kind of a mix that's
hard to sort out of increases in the numbers of
people who actually are infected and the number of people
who are getting tests. The actual number of infected people
is unknown at this point and won't be knowable until
we can do different kinds of testing. But the death
rate is a real number, but that is lagging behind.
(09:29):
So what we're trying to do is figure out how
many more people are likely to dye and how do
we keep more people from dying. So one of the
things people are hoping to get better handle on is
the number of people that enter the hospital. That that's
a really meaningful number because it can give us a
lot of information about how this pandemic is growing. And
you look at places like China, obviously where this kind
(09:50):
of started. They have a population of one point five
billion people. They have about any thousand cases, and that
just seems so small compared to the amount of people
and we know there's a lot of people that don't
have the same type of symptoms, not as severe symptoms,
so there's people that could have had it there was
a minor cold for them and never got tested, never
went to a hospital, So it's hard to go with
(10:12):
the confirmed cases for anything like that. So beyond hospitalizations
and death rates, what else could we be looking at.
One of the things that may happen. We may be
able to do random sampling, which has been done in
a couple of plays. It was done in a small
town in Italy where you just get a random group
of people are perfectly healthy. You just take a sample
and then test everybody and then you can see how
(10:35):
widespread the virus is. Another thing that we should be
able to do fairly soon as auntibody testing, and that's
really important because it tells you the number of people
that have been infected. So the antibodies don't show up
right away, but they stay with you afterwards, so we
can find out how far this has actually already been spreading.
There's some people who think it's likely that well before
(10:57):
the first confirmed cases showed up here, there may have
been people that weren't particularly sick that just showed up here,
and the disease was already spreading quietly well before those
first cases showed up in January. There's constantly things being
written up about this, and there was somebody that was
kind of saying, could that December cough have been some
of this? And the real fact is that we just
(11:19):
don't know at this point. We kind of have to
get well beyond this so we can look at all
the data that we've gathered and really put the picture together.
The other thing that a lot of people keep talking
about our age and pre existing conditions. We know that
the most vulnerable group is older people, but it might
not necessarily just be just because they're old. It really
(11:39):
looks like it has a lot more to do with
these pre existing conditions. I talked to Stanford epidemiologist Steve Goodman,
who has been taking a very close look at this,
and what he told me was, you know, once you
get the data by age and by pre existing conditions,
then you can start to tease apart these things, because
a lot of the pre existing conditions that seem to
(12:00):
put people at higher risk are things that also increase
with age. But age might not be the relevant thing.
It might be the pre existing conditions for what we
really need to keep our eye on, and that would
mean the people that really need to be careful and
the people we need to protect her a little different
from the people we thought. And he has since gotten
some data. Actually talked with him since the story ran,
and he said that it confirms what he suspected that
(12:22):
the pre existing conditions are the more important factor here.
So with all of this, I mean, it's tough. We
want to know how this is happening, and with the
way the news cycle isn't everything we're getting so much
all the time. Every day there's some type of new
thing that we're either learning about the virus itself or
how it's been traveling. It's really tough to kind of
comprehend all of that. And the unfortunate part is that
(12:44):
we're going through it right now, so we won't be
able to know until at least we hit the peak
of cases here in the United States, maybe so we
can start looking back at some of the data, and
that's really the stuff that we're gonna have to pay
attention to. We won't know if all of these lockdowns
and social distance seeing are that effective until after we
at least hit the peaks of this thing. I think
(13:05):
that we have to be patient, though I also feel
optimistic that our country scientists are going to make a
lot of progress in the next two or three weeks
and understanding what we have on our hands. So right now,
Steve Goodman said it was like building an airplane in
the air that it feels a little like we're just
in the dark. But they are gathering data and they
(13:26):
are trying to understand all of these facets of this disease.
I think once they start to get a handle on
it will have a more focused strategy for moving forward,
say flam Science journalists and opinion calumnists at Bloomberg News,
thank you very much for joining us. Hey, thanks for
having me. She went to her obstetrician's office and they said,
(13:55):
it kind of looks like you might be starting to
go into labor. You should probably go to the hospital.
And she said, well, let me just swing by my
house and pick up my husband first, and they said,
oh no, no, no, no no, your husband is not it's
not going to be allowed to come joining us. Sound
was Laura Casisto, reporter at the Wall Street Journal. Thanks
for joining us, Laura, Thank you. We've previously done a
(14:15):
story on the podcast about life's big moments that are
being upended because of coronavirus, extreme social distancing that we're
having to practice right now, and these big moments in
life just having to be modified postpone canceled all that.
And one of the major things that are happening is
that this is forcing pregnant women and moms to be
(14:35):
to make tough choices. There's some hospitals that have put
rules out where you can't have anybody in the room
with you while you're giving birth, out of an abundance
of caution. But this means that your partner might not
be able to be there at the moment of birth.
Laura tell us a little bit about what's going on. Yeah,
pregnancy is sort of unique in terms of these life moments,
and that it's something where for most people at least,
(14:58):
it's pretty much inevitable that you're going to end up
in a hospital. You know that you're going to have
to interact with the medical system, go to a doctor,
and that is uniquely challenging at this point um and
so hospitals are really grappling with how do they keep
staff safe, how do they keep women safe, but how
do you also kind of try to keep things as
normal as possible for people. Um and hospitals all of
(15:21):
the country have been going back and forth over the
last couple of weeks, uh and and really kind of
restricting and changing their visitor policies. And most now will
certainly not allow you to have you know, your dula
there to coach you, your mom there to take pictures.
But some of them have also UM at points put
in place policies that won't also let you allow you
(15:42):
to have your husband there. Uh and those, as you
would imagine, have had the most stringent pushback from people.
You spoke to a woman who was about to give
birth in the hospital wouldn't allow her husband in there,
so they were calling other hospitals to see if they
could take any last minute patients so that he would
be able to be there at that time. Yeah, this
is just a crazy story. She went to her obstetrician's
(16:03):
office and they said, it kind of looks like you
might be starting to go into labor. You should probably
go to the hospital. And she said, well, let me
just swing by my house and pick up my husband first,
and they said, oh, no, no, no, No No, your husband
is not. It's not going to be allowed to come.
And you can imagine that kind of how emotionally overwhelming
that was for both of them. You know, they really
(16:23):
had very little time to play with and she's learning
just then that her husband's knocking able to come with
her um. So they ended up calling around finding another hospital,
local hospital that would take them. But you know, they
spent you know, sort of this time as she was
going into labor frantically find it, trying to find a
new hospital and having to have this hospital where they
didn't really know anybody. Uh, it worked out okay for them,
(16:45):
but you can just imagine the stress that that would
be put you under. And the rules are going to
be different for each hospital across the country. Obviously New York,
New Jersey, California where they're big hotspots right now, they're
gonna have more restrictions in place. And two hospitals that
you talked about specifically in your piece, we're New York
Presbyterian and Mount sin Night Health System, which we've heard
(17:05):
tons of stories already there at the forefront of taking
in and helping patients that have coronavirus. Right now, So
how are they going about all of this. Yeah, so
it was a crazy roller coaster of a week, uh
for me as a reporter to some degree, but more
than anything for for women who were set to give
birth in the last week. UM. Both Mount Signa and
(17:27):
New York Presbyterian about a week ago came out and
said they weren't going to allow partners to be there
with the women as they were giving birth. UM and
you know, really kind of stuck by that policy, even
though there was quite a bit of public pushback, quite
a bit of pressure, a petition that got over half
a million signatures. Uh. And then over the weekend, New
(17:48):
York State came out and said, we're gonna now mandate
that you have to allow a partner to be there.
So they went and reversed that policy. But uh, it's
going to be I think a challenging issue. I think
that's just a sort of taste of at hospitals around
the country are going to be dealing with as coronavirus
spreads to more places. Because Mount Sinek and your Presbyterian said, look,
we were having you know, people come into the labor
(18:10):
and delivery ward and test positive for coronavirus, and we
just can't put women on the ward and our medical
staff at that kind of risk. So what are people
doing on the other side of this thing that a
lot of times they're doing FaceTime delivery. So honestly, it's
falling to the nurses, the other people, the medical professionals
in the room to have to hold that phone to
(18:31):
be able to do that FaceTime while the mom is
giving birth. And you have a couple of examples where
families were doing just that. The nurses had to help
out and be that support system because others couldn't be there. Yeah,
I and I think this is going to be a
kind of challenge going forward. Is the the strain that
this is going to put on the medical staff to
have to step in where maybe a do la or
(18:54):
a mom, or even a husband or a partner would
have been able to be there to help and support.
You know, there's a photo that ran with my story
of a woman having to take a selfie of her
self right after having given birth to her son because
her husband wasn't there. Um, it's a kind of just
surreal set of circumstances, uh, but one being kind of
(19:15):
dictated by this this unfolding crisis Laura Casisto, reporter at
The Wall Street Journal. Thank you very much for joining us.
Thank you so much. That's it for today. Join us
on social media at Daily Dive Pod on both Twitter
(19:36):
and Instagram. Leave us a comment, give us a rating,
and tell us the stories that you're interested in. Follow
us and I Heard Radio, or subscribe wherever you get
your podcast. This episode of The Daily Dive was produced
by Victor Wright and engineered by Tony Sorrentina. I'm Oscar
Ramirez and this was her Daily Dive
It's Wednesday, April one. I'm Oscar Ramirez in Los Angeles
and this is the daily dive. As COVID nineteen testing
capabilities ramp up and companies are coming up with new tests,
why does it still take so long to get results? First,
it is a multi step process. Once a sample is taken,
(00:21):
it needs to travel to a lab, then it needs
to be processed, and different circumstances and processing will lead
to different turnaround times. Julie Appleby, senior correspondent at Kaiser
Health News, joins us for the steps involved in testing
and new ones on the way. Next, we hear a
lot about confirmed cases of coronavirus. The US has the
most confirmed cases in the world right now, but unfortunately
(00:43):
that metric does little for us in the way of
tracking how fast it is spreading due to uneven testing. Instead,
some suggest we tracked the rate of hospitalizations and other factors.
They flam calumnist at Bloomberg News joins us for why
we still need a lot more data to find out
true rates of infection and spread. Finally, coronavirus is forcing
pregnant women to make tough choices. There are many hospitals
(01:05):
with such tight restrictions that in some cases a woman's
partner might not even be allowed into the delivery room.
Women are having to resort to face time to have
their partners present, and it could be falling to nurses
to provide supportive care and camera work. Laura Casisto, reporter
for The Wall Street Journal, joins us for more. It's
news without the noise. Let's dive in. The FDA authorized
(01:30):
the new test developed by Abbot LAPS that delivers lightning
fast results and as little as five minutes. It's a
whole new ball. Joining us now was Julie Appleby, senior
correspondent at Kaiser Health News. Thanks for joining us, Julie,
thanks for having me. A lot has been made about
testing throughout this whole coronavirus pandemic right now, as everybody
(01:52):
is clamoring to get tested, we're seeing serious backlogs on this.
Still it still takes a long time, despite a bunch
of new tests coming out, besides new companies working on
tests saying that you know, we can get results in uh,
you know, as little as minutes to a few hours,
there's still a lot of steps that are involved in
all of this, and that's why things are taking so long.
(02:12):
So Julie, tell us a little bit about this. Take
us behind the scenes at what this testing looks like, right,
And it does take a long time, as we've seen,
people are being told, you know, you have to wait
five or six or seven days in some cases to
get a test. So why is that? So let's back
up a little bit. We had some problems initially when
the first CDC test came out. Those were resolved. More
and more labs now have approval to run these tests,
(02:35):
and larger labs on the hospital labs, ETCeteras that are
and as you mentioned, we're starting to see some quicker tests,
but it still takes some time. There's a number of
steps in the process. Like first you get your nose
swabs right with one of these things, and they put
that swab in a little tube and they send it
off to the lab and the lab then has to
do some pretty sophisticated analysis of the sample right to
(02:57):
figure out do you have COVID or not and that
and real quick. That's the first step, actually getting swapped
and then sending it to a lab. That could take
up to a day depending on where the lab is,
how far it is from where you got tested. That's correct.
You've got to think about transit time. There's about a
day lag there. Now, there are some places that are
doing testing on site, So if you're at a large
academic medical center, chances are they might have their own
(03:20):
testing capability at depth center, but they're probably limiting the
testing too in patients and to their hospital staff. So
the reason they can get a result back a little
quicker there is because they just do it in house,
so they don't have that transit time. But even when
they do it in house, there's a bunch of steps
that have to be done. They have to put them
in a machine. Generally, there's there's some manual work that
(03:40):
the technician does. They have to extract some R and
A and amplify the DNA and there's all this science
kind of stuff. Some of it's done manually, but a
lot of places, these big commercial labs have these machines
that run them automatically, so they're faster. They can process
more samples at a time in a piece i road.
I talked to pathology lab at mid Star Medical or
in Georgetown here in Washington, d C. And they can
(04:02):
run nine three samples at a time in their machine
and they can run about three of those cycles a day. Okay,
so that's why they do it in the house at
this hospital, but they're kind of limited in the number
they can do. Whereas if you go to a test
site and they might send it off to a large
commercial lab, that's they can process twenty or thirty thousand
of these a day, so that might be faster, but
(04:25):
then you've got to transit time and they've got a
big backlog. So these are all the reasons why it
can take a number of days to get results back
in some cases, and in other cases you might get
an answer back sooner. And one of the other difficulties
is that there's so many people that want to get tested.
They want to have peace of mind to know whether
they do not have it, or they want confirmation if
(04:46):
they're getting they have some type of symptoms. They want
to know they have it so they can know what
to do. And in a lot of these places, it's
like almost a sign like no Watkins welcome kind of thing,
because you know, some of these sites have to you
have to follow a line. Basically, you know, somebody coming
off the street just can't get their tests and get
it done. They need to prioritize these things to healthcare workers,
(05:07):
to people that really have bad symptoms and are in
hot need hospitalization. And that's true. That's because we don't
have enough test in the United States right now. They're
working on ramping that up. As you mentioned, We've we've
got some new test kits out there starting to go
out that that can get results back quicker, and those
are expected to be sort of point of care. When
you walk in your doctor's office or the emergency room,
you might be able to get a result back in
(05:28):
five to thirteen minutes. But that just got approved, you know,
Friday night, and they're they're going to start shipping them.
They're hoping to ship fifty thousand of them a day.
But there's a lot of people like you mentioned that
just want that peace of mind or you know, if
you've got it, you really need to isolate yourself and
so it's good to know do you have it or not.
But we're not there yet. Yeah, the test that you
were just talking about that we can get the one
that just kind of got to prove this past Friday,
(05:50):
the President was talking about that one. Um, you know,
just trying to get people hope really that you know,
you can get tested and get a result very quickly,
but even that still needs to get ramped up. Those
little test kits need to be made and sent out,
and there's a lot of stuff that goes into it,
and and we're hearing a lot about shortages specifically with
healthcare workers with personal protective equipment, masks, all that stuff,
(06:12):
but these testing kits also suffer from some of those shortages.
The chemical agency using those kits, the swabs to get
the samples. There's a lot of things that are in
short supply right now, and all of that needs to
get ramped at. That's correct, and that's why some of
these groups are the big lab testing groups, and some
of those are saying, let's limit the testing right now
and to these high priority people because there are these
(06:34):
shortages and asks kind of backing up manufacturing in some cases.
I spoke with a manufacturer who was, you know, working
on making sure he could get all the right little
chemicals to put in it and and the swabs and
that kind of thing. And he has multiple suppliers, but
he's on the phone working this thing to make sure
that happens. And there's just a big demand for these
products right now, you keep hearing it a lot. We're
all in this together. We have to practice the social distancing.
(06:56):
There's a bit of patients that goes into this that
unfortunate a lot of people don't have because you know,
you hear scary words like pandemic and whatnot, and people
are legitimately concerned. So but it is kind of this
patience that we have to practice with all of this
as well. Right and more and more of these are
getting approved. I mean, just in a couple of days
since I wrote my story, there's been a couple more
tests approved under these emergency use authorizations by the f
(07:19):
d A, So more tests are coming on the market.
There's another entire kind of tests which tries to figure
out if you have immunity, if you already had the disease,
and those are gonna we're gonna start hearing more about those.
They're not available widely here in the United States yet,
but other countries are working on that, getting folks tested
to figure out, Hey, maybe it's safe for you to
go back to work. You've had the disease, you presumably
(07:40):
have immunity now. Julie appleby Senior correspondent at Kaiser Health News.
Thank you very much for joining us. Thanks for having me.
There are some people who think it's likely that well
before the first kind firmed cases showed up here, there
(08:01):
may have been people that weren't particularly sick that just
showed up here, and the disease was already spreading quietly
well before those first cases showed up in January. Joining
us now was Faye Flam science journalists and opinion columnists
at Bloomberg News. Thanks for joining us, Faith Hey, thanks
for having me. Since this whole coronavirus pandemic really got
started in the United States, we've kind of been obsessed
(08:24):
with tracking it, seeing the total number of confirmed cases,
but it's really hard to base it on that. We
know that numbers keep going up as more testing occurs,
but even then, you know, we don't really have quote
unquote real time numbers because some of these testings could
take a week for results to come through a couple
of days, so it's really tough to gauge how all
(08:45):
of this is going. So this notion that confirmed cases
the metric is really hard to go buy on that.
So Fay, you wrote an article talking about other things
to look at for how fast this could be spreading.
I was in touch with some epidemiology sense statisticians and
people that are really trying to get handle on these numbers.
And the numbers of confirmed cases, which are the ones
(09:08):
that everybody's obsessed with, are kind of a mix that's
hard to sort out of increases in the numbers of
people who actually are infected and the number of people
who are getting tests. The actual number of infected people
is unknown at this point and won't be knowable until
we can do different kinds of testing. But the death
rate is a real number, but that is lagging behind.
(09:29):
So what we're trying to do is figure out how
many more people are likely to dye and how do
we keep more people from dying. So one of the
things people are hoping to get better handle on is
the number of people that enter the hospital. That that's
a really meaningful number because it can give us a
lot of information about how this pandemic is growing. And
you look at places like China, obviously where this kind
(09:50):
of started. They have a population of one point five
billion people. They have about any thousand cases, and that
just seems so small compared to the amount of people
and we know there's a lot of people that don't
have the same type of symptoms, not as severe symptoms,
so there's people that could have had it there was
a minor cold for them and never got tested, never
went to a hospital, So it's hard to go with
(10:12):
the confirmed cases for anything like that. So beyond hospitalizations
and death rates, what else could we be looking at.
One of the things that may happen. We may be
able to do random sampling, which has been done in
a couple of plays. It was done in a small
town in Italy where you just get a random group
of people are perfectly healthy. You just take a sample
and then test everybody and then you can see how
(10:35):
widespread the virus is. Another thing that we should be
able to do fairly soon as auntibody testing, and that's
really important because it tells you the number of people
that have been infected. So the antibodies don't show up
right away, but they stay with you afterwards, so we
can find out how far this has actually already been spreading.
There's some people who think it's likely that well before
(10:57):
the first confirmed cases showed up here, there may have
been people that weren't particularly sick that just showed up here,
and the disease was already spreading quietly well before those
first cases showed up in January. There's constantly things being
written up about this, and there was somebody that was
kind of saying, could that December cough have been some
of this? And the real fact is that we just
(11:19):
don't know at this point. We kind of have to
get well beyond this so we can look at all
the data that we've gathered and really put the picture together.
The other thing that a lot of people keep talking
about our age and pre existing conditions. We know that
the most vulnerable group is older people, but it might
not necessarily just be just because they're old. It really
(11:39):
looks like it has a lot more to do with
these pre existing conditions. I talked to Stanford epidemiologist Steve Goodman,
who has been taking a very close look at this,
and what he told me was, you know, once you
get the data by age and by pre existing conditions,
then you can start to tease apart these things, because
a lot of the pre existing conditions that seem to
(12:00):
put people at higher risk are things that also increase
with age. But age might not be the relevant thing.
It might be the pre existing conditions for what we
really need to keep our eye on, and that would
mean the people that really need to be careful and
the people we need to protect her a little different
from the people we thought. And he has since gotten
some data. Actually talked with him since the story ran,
and he said that it confirms what he suspected that
(12:22):
the pre existing conditions are the more important factor here.
So with all of this, I mean, it's tough. We
want to know how this is happening, and with the
way the news cycle isn't everything we're getting so much
all the time. Every day there's some type of new
thing that we're either learning about the virus itself or
how it's been traveling. It's really tough to kind of
comprehend all of that. And the unfortunate part is that
(12:44):
we're going through it right now, so we won't be
able to know until at least we hit the peak
of cases here in the United States, maybe so we
can start looking back at some of the data, and
that's really the stuff that we're gonna have to pay
attention to. We won't know if all of these lockdowns
and social distance seeing are that effective until after we
at least hit the peaks of this thing. I think
(13:05):
that we have to be patient, though I also feel
optimistic that our country scientists are going to make a
lot of progress in the next two or three weeks
and understanding what we have on our hands. So right now,
Steve Goodman said it was like building an airplane in
the air that it feels a little like we're just
in the dark. But they are gathering data and they
(13:26):
are trying to understand all of these facets of this disease.
I think once they start to get a handle on
it will have a more focused strategy for moving forward,
say flam Science journalists and opinion calumnists at Bloomberg News,
thank you very much for joining us. Hey, thanks for
having me. She went to her obstetrician's office and they said,
(13:55):
it kind of looks like you might be starting to
go into labor. You should probably go to the hospital.
And she said, well, let me just swing by my
house and pick up my husband first, and they said,
oh no, no, no, no no, your husband is not it's
not going to be allowed to come joining us. Sound
was Laura Casisto, reporter at the Wall Street Journal. Thanks
for joining us, Laura, Thank you. We've previously done a
(14:15):
story on the podcast about life's big moments that are
being upended because of coronavirus, extreme social distancing that we're
having to practice right now, and these big moments in
life just having to be modified postpone canceled all that.
And one of the major things that are happening is
that this is forcing pregnant women and moms to be
(14:35):
to make tough choices. There's some hospitals that have put
rules out where you can't have anybody in the room
with you while you're giving birth, out of an abundance
of caution. But this means that your partner might not
be able to be there at the moment of birth.
Laura tell us a little bit about what's going on. Yeah,
pregnancy is sort of unique in terms of these life moments,
and that it's something where for most people at least,
(14:58):
it's pretty much inevitable that you're going to end up
in a hospital. You know that you're going to have
to interact with the medical system, go to a doctor,
and that is uniquely challenging at this point um and
so hospitals are really grappling with how do they keep
staff safe, how do they keep women safe, but how
do you also kind of try to keep things as
normal as possible for people. Um and hospitals all of
(15:21):
the country have been going back and forth over the
last couple of weeks, uh and and really kind of
restricting and changing their visitor policies. And most now will
certainly not allow you to have you know, your dula
there to coach you, your mom there to take pictures.
But some of them have also UM at points put
in place policies that won't also let you allow you
(15:42):
to have your husband there. Uh and those, as you
would imagine, have had the most stringent pushback from people.
You spoke to a woman who was about to give
birth in the hospital wouldn't allow her husband in there,
so they were calling other hospitals to see if they
could take any last minute patients so that he would
be able to be there at that time. Yeah, this
is just a crazy story. She went to her obstetrician's
(16:03):
office and they said, it kind of looks like you
might be starting to go into labor. You should probably
go to the hospital. And she said, well, let me
just swing by my house and pick up my husband first,
and they said, oh, no, no, no, No No, your husband
is not. It's not going to be allowed to come.
And you can imagine that kind of how emotionally overwhelming
that was for both of them. You know, they really
(16:23):
had very little time to play with and she's learning
just then that her husband's knocking able to come with
her um. So they ended up calling around finding another hospital,
local hospital that would take them. But you know, they
spent you know, sort of this time as she was
going into labor frantically find it, trying to find a
new hospital and having to have this hospital where they
didn't really know anybody. Uh, it worked out okay for them,
(16:45):
but you can just imagine the stress that that would
be put you under. And the rules are going to
be different for each hospital across the country. Obviously New York,
New Jersey, California where they're big hotspots right now, they're
gonna have more restrictions in place. And two hospitals that
you talked about specifically in your piece, we're New York
Presbyterian and Mount sin Night Health System, which we've heard
(17:05):
tons of stories already there at the forefront of taking
in and helping patients that have coronavirus. Right now, So
how are they going about all of this. Yeah, so
it was a crazy roller coaster of a week, uh
for me as a reporter to some degree, but more
than anything for for women who were set to give
birth in the last week. UM. Both Mount Signa and
(17:27):
New York Presbyterian about a week ago came out and
said they weren't going to allow partners to be there
with the women as they were giving birth. UM and
you know, really kind of stuck by that policy, even
though there was quite a bit of public pushback, quite
a bit of pressure, a petition that got over half
a million signatures. Uh. And then over the weekend, New
(17:48):
York State came out and said, we're gonna now mandate
that you have to allow a partner to be there.
So they went and reversed that policy. But uh, it's
going to be I think a challenging issue. I think
that's just a sort of taste of at hospitals around
the country are going to be dealing with as coronavirus
spreads to more places. Because Mount Sinek and your Presbyterian said, look,
we were having you know, people come into the labor
(18:10):
and delivery ward and test positive for coronavirus, and we
just can't put women on the ward and our medical
staff at that kind of risk. So what are people
doing on the other side of this thing that a
lot of times they're doing FaceTime delivery. So honestly, it's
falling to the nurses, the other people, the medical professionals
in the room to have to hold that phone to
(18:31):
be able to do that FaceTime while the mom is
giving birth. And you have a couple of examples where
families were doing just that. The nurses had to help
out and be that support system because others couldn't be there. Yeah,
I and I think this is going to be a
kind of challenge going forward. Is the the strain that
this is going to put on the medical staff to
have to step in where maybe a do la or
(18:54):
a mom, or even a husband or a partner would
have been able to be there to help and support.
You know, there's a photo that ran with my story
of a woman having to take a selfie of her
self right after having given birth to her son because
her husband wasn't there. Um, it's a kind of just
surreal set of circumstances, uh, but one being kind of
(19:15):
dictated by this this unfolding crisis Laura Casisto, reporter at
The Wall Street Journal. Thank you very much for joining us.
Thank you so much. That's it for today. Join us
on social media at Daily Dive Pod on both Twitter
(19:36):
and Instagram. Leave us a comment, give us a rating,
and tell us the stories that you're interested in. Follow
us and I Heard Radio, or subscribe wherever you get
your podcast. This episode of The Daily Dive was produced
by Victor Wright and engineered by Tony Sorrentina. I'm Oscar
Ramirez and this was her Daily Dive
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