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Guidance Evolves On How To Battle The Coronavirus Outbreak


What more can Americans do to fight a pandemic? For now, we face a brutal, ruthless, relentless question of math. Of more than 320 million Americans, how many are exposed? Of that number, how many get sick? And of that number, how many die? Yesterday at a White House briefing, Dr. Anthony Fauci suggested the implications of that math. To reduce the numbers, many changes in American life would have to remain in place.


ANTHONY FAUCI: When it goes down to essentially no new cases, no deaths at a period of time, I think it makes sense that you're going to have to relax social distancing. But the ultimate game changer in this will be a vaccine.

INSKEEP: How, if at all, can we change the math before then?

Dr. Jeffrey Koplan is with us. He's a former director of the Centers for Disease Control and is now the vice president of Global Health at Emory University in Georgia. Good morning, sir.

JEFFREY KOPLAN: Good morning, Steve.

INSKEEP: The White House now says that if we follow social distancing rules almost perfectly, 100,000 to 240,000 people will die rather than even more people. Does that sound about correct to you?

KOPLAN: There's a lot of modeling going on around this issue, and that number is the one that seems to be common to most of the analyses.

INSKEEP: Although when we start doing the math and we start with 320 million Americans, any of whom are vulnerable to being exposed, it's pretty easy to come up with a death toll that's a lot higher, isn't it?

KOPLAN: It is. That - you know, these are estimates. And there's a - what you might think is the usual course or most likely, and then there's the extremes. And the extremes aren't far away from whatever we're doing. So as Dr. Fauci indicated, we need to take stringent steps in this mitigation approach.

INSKEEP: Florida and Georgia yesterday issued stay-at-home orders, steps that the governors of those states had resisted up until yesterday. How significant is that?

KOPLAN: Very significant. And I think every state should and will need to go in that direction. It's the one tool we have. Both states have - both difficult outbreak conditions currently, and they'll only get worse before they get better.

INSKEEP: I want to ask about the speed with which these stay-at-home orders have been issued. Brian Kemp, the governor of Georgia where you are, this is a quote from the governor of Georgia yesterday. Quote, "those individuals could have been infecting people before they ever felt symptoms." And he went on to say, quote, "we didn't know that until the last 24 hours."

I just have to ask. He's the governor of a very large and prosperous state. He has access to the best health advice. You're right there at Emory University. Could the governor of Georgia plausibly have known before yesterday that it was possible for asymptomatic individuals to spread the disease?

KOPLAN: I think, you know, in the course of an interview much like we're doing now, it's possible to say things that you would be corrected on quickly by your staff or you knew the day before - had a different answer. But the governor is doing the right thing now, for whatever reasons, and has been, I think, an ally in the efforts to get this under control.

INSKEEP: Do you feel that compliance with social distancing rules is where it needs to be, that just from your experience, that enough people around the country seem to be following what states are asking of them?

KOPLAN: Absolutely. If you go where - I'm in Atlanta. And if you go out on the streets, there's no cars out. There's no people walking around. People have heard the message and are applying it. Are there folks who ignore it? Sure, there are always will be. But I think people have heard this message, are concerned, anxious about it and are trying to do whatever they can do to make this situation better. And it's clear that while we're awaiting a vaccine, that's a ways off in terms of whatever it's 12 to 18 months if we're lucky.

So I think that people have heard the message, are trying to do what - the best thing they can do. It is a simple approach but one that's difficult for all of us - to stay inside, to socially distance from family, loved ones, friends for a period of time like this. But it works, and so we need to do it - all of us need to do it.

INSKEEP: The CDC is at least considering whether to recommend masks for everyone, not just medical workers but the general public. What are the implications of that?

KOPLAN: It's a complicated subject. You wouldn't think it would be. It's just something - do you wear a mask, or you don't wear a mask? The key issue is hospital workers and health care providers probably need the masks more than anyone else does. So whatever we do, we have to ensure that there are adequate numbers of hospital masks which are the flimsier, more papery type, less secure masks, even more so, surgical masks which are sturdier and also protect against splashes and spraying but also then, on a separate issue, the N95 respirators. So there are three different types.

We see in China and in other countries in Asia extensive use of masks of different types. It is scientifically unclear the role that - just people walking in the streets or in their homes, what the use of a mask would be. There's great concern that if there's a run on masks by the general population, that it will deprive those that absolutely have to have them - again, the hospital workers, primary care providers, first responders. So that's got to be ensured. And at this time, where it's iffy about our having adequate protective equipment for these people, that needs to be insured even as there might be a recommendation or a certain permission that - to go ahead for regular individuals, when they leave their homes, to don a mask.

INSKEEP: I think you're telling me that if I was thinking of buying a mask, maybe I should hold off and let a medical worker have that because they need it way more. Very briefly, one other question - does a homemade mask actually help with the virus?

KOPLAN: Again, you know, we'd love to be able to quote scientific studies that show what we're doing. But in this case, we don't have it. If that's all you've got, it's better than nothing. And it also reminds you to keep your hands away from your face, nose, ears, eyes.

INSKEEP: Dr. Koplan, thanks very much for the insights.

KOPLAN: Thank you, Steve.

INSKEEP: Dr. Jeffrey Koplan is at Emory University in Georgia. He is a former director of the Centers for Disease Control. Transcript provided by NPR, Copyright NPR.

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