Episode Transcript
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Speaker 1 (00:00):
I think the next forty days will probably be the
forty worst days of the pandemic. It's really bad at
this point. I mean hundreds of thousands of Americans getting
infected every day, of two to three thousand people dying
every day. If we had widespread testing available, this would
make a huge difference. But we don't, and so we're
still stock and you're going to see more hospitals basically
say we can't take care of anybody else, not just
(00:22):
we can't take care of COVID patients, we just can't
take care of anybody else. It's gonna be awful, and
it's gonna be a very challenging months. Six weeks ahead.
This week, we watched as the first Americans received the
COVID vaccine, heroic health care workers who have been on
the front lines of this fight for months. It was
emotional and extraordinary, and it is something we should be
(00:44):
very excited about. But at the same time, we cannot
forget that most of us will not be getting this
vaccine four months, and we cannot lose sight of the
crisis at hand, because the spread of COVID has never
been worse. For almost nine months now, I have been
reporting on COVID, covering it every day, the stories of
healthcare workers, families, business owners, teachers. I thought I understood
(01:08):
the chaos of this moment, but a few weeks ago
I realized I didn't. I became one of the more
than sixteen million Americans who have contracted the virus SORTD
my family, and the experience of getting COVID made it
even more clear to me that we have failed and
continue to fail in some very key ways, namely testing
(01:29):
and tracing. I'm Stephanie Rule, MSNBC Anchor, NBC News Senior correspondent,
and this is Modern Rules, a podcast from NBC Think
and I heart radio. On this podcast, We're not gonna
waste your time. We're interested in getting straight to the point,
(01:51):
and then we're gonna leave you with some time to think.
And today we are looking at why the US is
failing the COVID test and how we can use the
tools we have at our disposal right now to maybe
get things under control. And I've got the perfect guest
here to help us try and make sense of it.
Dr she'sh Ja. He's the dean of Brown University School
(02:12):
of Public Health, and he has been a crucial voice
of science and reason throughout this pandemic. Dr Jah, thank
you for joining us. I want to start with COVID
nineteen tests. Can you explain to us what kind of
tests are available in the United States, the pros, the cons,
because I'm going to tell you when my husband woke
(02:32):
up with a scratchy throat and not feeling that well,
I foolishly thought let's run out and get a test.
There's no such thing as let's go out and get
a test. Zephanie, thank you so much for having me
on it. And this is a question that confuses people
still nine ten months into this pandemic. Right now, if
you want to think about a test to diagnose whether
(02:53):
you have the virus or not, you have two choices.
An anagen test and a PCR test. Most of the
tests we've used over the last nine months are these
PCR tests. They're really good. They pick up almost anybody
who's infected. They have to be running a major lab
and they can be turned around in twenty four hours,
but sometimes they take a week to come back. Let's
(03:15):
talk about that other kind of test, the anergine tests.
The test, Yeah, that's the rapid test, cheap ten to
fifteen bucks a test as opposed to HUD. For that
PCR test, you should be able to get a result
in fifteen minutes. So you're thinking cheap and fast. What's
wrong with this story? Um, it's a little less sensitive,
So let me explain what that means. The PCR test
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will pick up somebody with the infection up to weeks
after they've been infected. The anergin test is really a
test for infectiousness. So if you are in that period
of time where you're spreading the virus and lots of people,
the anergin tests will be positive. But there are other times,
let's say later in the disease course, where you may
not have a lot of virus. You're still infected, but
(03:57):
the level of virus you have is very low because
you're on the tail end of your illness. The nigen
tests will then turn negatives. It's just not gonna be
as good at taking those people up. Could there have
been a scenario where people would have gotten antigen tests
to their homes and if they woke up saying, maybe
I was exposed, maybe I don't feel great, you can
take your tests immediately and that would dictate whether or
(04:18):
not you leave your house that day, absolutely, and for
that the anergen test is really good. We've had this
technology since May, and we should have had billions of
these tests widely available so people could test themselves all
the time. You wake up, you have a sore throat,
you could go to a CBS, pick up a ten
dollar tests and test yourself. We just never made those investments.
(04:40):
Remember how the disease spreads. Majority of people who are
spreading the disease have no symptoms at all. If you
could test yourself, what that would do is it would
take people who are infected out of commission. They wouldn't
be spreading it to others. So there's very good data
now that if we had those tests available the level
of infection in the community would go way down. But
also you could start implementing those tests in schools, in
business and that would make a big difference. And here's
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the big issue. We still don't have a plan. Test
can take a week just to come back in, which time,
if you're out and about, you're spreading the virus. If
you haven't, they tell you to isolate. But unless you
have a place to isolate and a supportive job or family,
many many people can't afford to follow the guidelines when
you think you may have exposure to COVID nineteen. Do
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we in the United States of America actually have the
choice to say, here are my nearby testing facilities. This
is where I can get a PCR test, and the
turnaround time is x. You could get results in a day,
but many, many, many are five, six, seven days. Why
would that be? Basically, there are two major lab testing companies,
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Lab Corps in Quest Diagnostics. When they get backed up,
everything gets to lay. Let's say go to your doctor's office,
you got a fever, you got a sore throat, you
got a swab. It gets sent off to a lab.
That lab sends it to some processing place. Machine are
starting to break down, workers are becoming a short supply,
and your sample could sit for three days, four days.
That's just the reality of where we are. Had we
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had an operation warp speed for testing, where do you
think we'd be right now? Oh? I think if we
had an operation warp speed for testing the way we
did for vaccines, we would have widespread testing available. You
could wake up in the morning and you could test
yourself at home before you went to school, before you
went to work. And if we had really made the
kind of investments that we needed to, and these would
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not have cost us that much money. I believe all
the schools would be open, most businesses would be open,
the level of infections in the community that would be
much much lower, our hospitals would not be overwhelmed, and
we'd have far fewer debts. I'm thrilled that we did
operation works feed for vaccines. I love it. I think
it was exactly the right thing to do, But that
didn't prevent us from doing an operational warp speed for treatments,
(06:50):
for testing, for protective equipment to protect our doctors and nurses.
Like there's no rule that said you only get to
do one operation warp speed, like we needed four different things.
The government chose to do one and ignore the other three.
And I have to tell you that I'm not convinced
that if we hadn't done the vaccine that the Trump
administration would have then put more money on testing. So
(07:11):
I am like glad they put investments in vaccines, because
if they hadn't, they would have put investments in nothing.
Vaccines are great, but they are not the end all
be all. They will not make the pandemic go away.
They'll certainly end the horrible nets will take a long time,
but the disease will not be gone forever, and we
will need to continue to deal with it, and testing
will be a really important part of that. We'll be
(07:34):
back after the break. I want to talk about contact tracing.
We had no known exposure in my family, and I
contact traced to myself. I called the people who we
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had seen. I called a big box store with my
receipt and I was like, so my husband was there
at four pm. That big box story called had no
interest in taking my call. There's no way they wrote
any of it down. But it wasn't just me. I
wasn't contacted by the state of New Jersey. And that's
where we were. We talked so much about the importance
of contact tracing. Thousands of people were hired, they were trained,
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they were to be the contact tracers. Are we even
doing it? No? I mean some states are doing a
little bit, and a little bit is better than zero.
But we never built up the contact tracing infrastructure, partly
because it would cost money. Again, this is the place
where like our government, our federal government, our Congress has
just fallen down on the job. When you look at
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other countries and how they are doing testing and tracing,
is there one that you can point to that you
would say they're doing it right. The classic model that
we all point to is South Korea. South Korea is
unbelievable because they did such a good job with testing
and tracing. They were able to open up nightclubs. Somebody
with a some thematic disease went to like six nightclubs
(09:02):
in one evening. What an amazing evening, right, But unfortunately,
like he infected like eighty people that one evening. Within
five days, South Korea had tested like forty thousand people,
not just everybody who was at one of those nightclubs,
but all of their contacts and their contacts and contacts
and isolated everybody and shut that outbreak down within five days.
(09:27):
That's how you do it, and what that means is
their economy has barely suffered. In other countries, it's not
about following the guidelines. There are punitive consequences. You test positive.
You are checking into a COVID hotel for fourteen days.
Like it or not. There's no decisions to be made here.
It's about goodwill, being honest and decision making. Do you
(09:49):
think the majority of the American people actually know what
the CDC guidelines are. I don't think that what we
need is like harsh mandates on this stuff. What we
need is support. But the point is there are ways
of allowing the right thing to be done by people,
right because I think most people want to do the
right thing. If you push them and say, well, you
(10:09):
have a choice, do the right thing or put food
on the table for your kids, well, people can put
food on the table for their kids. Don't force people
into those choices. And the only way we could have
done this is if we had an active government trying
to help the American people do the right thing. We
just did. To your point, we're not offering any incentive
to those who can't afford to quarantine, who maybe have
(10:31):
mild symptoms and are out there living their lives and
going to work, or people who are simply defiant and
choose not to. Why wouldn't we do that. I have
to say that the failure of Congress to act after
the first couple of actions that took, the failure for
it to act over the summer the fall even now
is baffling to me. It is the most phenomenal, pennywise,
(10:55):
pound foolish thing I have ever seen. This pandemic has
cost our three about sixteen trillion dollars with a capital T,
and Congress is fighting about a couple hundred billion dollars
money that would go to the pockets of the American
people and would help them through a difficult time like
this is such a no brainer. Imagine if in World
(11:18):
War two Congress said, you know what, We're just not
going to fund the war effort. Good luck people. That
would have been a disaster, right, it would have been
a disaster. Not thankfully Congress did not do that. But
essentially after May Congress said we're just not going to
fund the effort to fight COVID, good luck people, But
we're going to spend the money, mountains more of it
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for years to come. This is the result of the
federal government just completely throwing in the towel about two
months ago and saying we're just not even gonna bother
trying anymore. Then, seeing that we've botched testing and tracing
so badly, are you concerned that we're not going to
get the implementation of or distribution of this vaccine right?
(12:00):
The Biden team very much understands that effective distribution of
the vaccine is the whole ball game for them in
the short run for getting economy going again. I think
the Biden team is gonna be putting a lot of
very good people into making sure that the vaccine distribution
continues to go well, that we get that last smile,
we get vaccines into people's arms. So I guess I
remain reasonably optimistic that a good team is coming and
(12:23):
they understand the importance of getting this right. We've seen
the President got the best possible medical care and experimental
drugs that works. His close advisor Rudy Giuliani, same thing.
Do you think a lot of rich people are going
to cut side deals and get the vaccine before anybody else?
They're getting better treatment than everyone else. Because here's the thing.
I had a frustrating process getting tested, but it wasn't crippling,
(12:47):
and if I didn't have the privilege that I have,
it would be way worse. So I can tell you
testing is for the privileged. Will the vaccine be for
the privileged? I think in the first past, it's gonna
be very very hard for people to cut in line,
and I think that's gonna be very tightly controlled. I
am very worried about what happens after that, because I'm
(13:07):
already hearing stories of concierge practices who are trying to
figure out how to get some for their business travelers.
The finance guy who wants to start being able to
fly to Hong Kong again and needs to be vaccinated. Look,
it's fine go to Hong Kong, but you should not
be able to cut in line on the vaccine. This
is one of the big jobs that the Biden administration
has is to make sure that we don't do this,
(13:29):
because it will be I mean, if you think about
who has been so disproportionately affected in this pandemic, it's
been the black community, the Latino community, the Native American community,
It's been horror people. But I do think there is
going to be a real effort to make sure we
don't do that. I'm also a realist. I'm sure there
will be some cutting in line, because that's just the reality.
(13:49):
Somebody will figure out how to get stuff on the
black market, but I am hopeful that most of it
will be tightly enough control that the right people get
it first. M H. The reality is that COVID is
(14:10):
not easy for anyone, but COVID is much easier to
confront when you've got the benefit of privilege. Throughout the
last nine months, I have counted my blessings nearly every
day because I know that my secure home, my family unit,
and the fact that I can work from home makes
all the difference in what our new normal looks like.
(14:30):
But when my family and I contracted the virus, I
saw firsthand how far that privilege extends. The reality is
many families and many individuals are put between a rock
and a hard place, and many of our government leaders
both sides have completely skirted their responsibility. And I want
to leave you sometime to think about this. We could
(14:52):
have done better in basically every aspect of containing this virus,
particularly when it comes to supporting American families. So as
a vaccine rolls out and more sophisticated tests are developed,
how can we make sure vulnerable Americans are not left
behind again? And how can we change what has been
a haphazard strategy into our recovery that serves us all.
(15:18):
Next week we are taking off it is the holiday,
but I want you to unplug. Please take a week
to decompress, give yourself a break, have a beautiful holiday,
and be well. And thank you so much for listening.
I'm Stephanie Rule and you're listening to Modern Rules, a
podcast from NBC Think, MSNBC and I Heart Radio. This
(15:41):
podcast is hosted by me Stephanie Rule. Mike Biette and
Katrina Norvell are executive producers. Meredith Bennett Smith is Senior
editor for NBC Think and our editorial lead. The podcast
is engineered and edited by Josh Fisher. Additional production support
provided by Charles Herman, Rachel Rosenbaum, and Lauren Wynn and
special thanks to Katherine Kim are Global head of Digital
(16:02):
News right here at NBC News and MSNBC. For more
thought provoking analysis, visit NBC news dot com slash thank