STEVE INSKEEP, HOST:
We would like you to know the name of Robbin Hardy. She lived in Baton Rouge, La. She was a pastor, a leader in two churches and spent a lot of time mentoring girls. She was 56 when she died of complications from COVID-19. Her daughter Rachele vowed to continue her work.
(SOUNDBITE OF ARCHIVED NPR BROADCAST)
RACHELE HARDY: I will take one of your biggest passions, which was mentoring teenage girls, to new heights. Thank you for leaving a legacy. I will continue your legacy. I am your legacy.
INSKEEP: Robbin Hardy was one of 125,000 Americans killed so far by coronavirus. And we recall her case as we learn that new cases are surging in many states across the country. Texas, Florida and Arizona have set daily new infection and hospitalization records, and cases are rising in California, too, among other places. So what's going wrong? We've called back Dr. Scott Gottlieb, who headed the Food and Drug Administration for two years in the Trump administration. Good morning, sir.
SCOTT GOTTLIEB: Good morning. How are you?
INSKEEP: We also have Andy Slavitt, who served as director of the Medicare and Medicaid programs under President Obama. Good morning to you.
ANDY SLAVITT: Morning, Steve.
INSKEEP: All right, gentlemen, I just first want to note there are some stunning charts that people have shared in recent days showing that in the European Union, after a big surge of cases, new cases are way down. In the United States, after a big surge of cases, we're heading for an even bigger surge of cases that's going off the charts. Why the difference?
GOTTLIEB: Well, I'll start, if I can. I think the challenge is that we opened against a backdrop of a lot of persistent spread, especially in the South and the Southeast, when those states made decisions to relax restrictions on business activity and social distancing. They really hadn't crushed their virus.
If you look at what happened in Europe, Europe really maintained a lot of the measures that they put in place until they had crushed the epidemic. And in the Northeast and the North, we did that here in the United States. But in other parts of the country, we didn't. So we reopened against a backdrop of a lot of persistent spread. And the cases just continued to build. All that community spread just continued to create new chains of transmission, and now we're seeing the consequences of that.
The outbreaks and the epidemics that we're seeing right now in states like Florida, Georgia, Texas, South Carolina - they didn't happen in the last two weeks. This is chains of transmission that's been building for four to six weeks, and now we're seeing it sort of explode into infernos of epidemics.
INSKEEP: Gentlemen, the president has falsely said repeatedly that this merely reflects more testing. Quote, "When you test, you have a case; when you don't test, you don't have a case." Ron DeSantis, the governor of Florida, has faced his own state's increase in cases by saying it's a testing issue. We've reported that that's false. But the president keeps repeating it, so maybe we need to just get the facts out here. How can you know this increase in cases is real and not just a testing issue?
SLAVITT: Well, one thing you can look at is, are the percentage of the tests that are coming back positive going up or going down? And in all of these states, unfortunately, they're going up. There's also published reports from COVID daily tracker which show the actual increase in tests versus the actual increase in cases. And they're exceeding - cases are exceeding tests by a good amount. So it's good that we're testing more. It's not clear that we're testing enough. But we have - without a doubt have to adopt the interpretation that's most logical, most obvious and, indeed (ph), with the datasets or we're never going to deal with it. And I think the problem we have is that people are too reluctant to admit when there's challenges because they're worried it's going to reflect on them somehow politically. I think we need to get past that and just deal with this for what it is, which is a public health emergency that requires us all to take action.
INSKEEP: Well, gentlemen, I hate to belabor this point, but you're telling me that this is an emergency and that lives are at stake, so I feel it's important to just make very clear about this. You have laid out the stats. These are stats that state and federal officials know. Is it fair to say at this point that anybody who continues leaning hard into the theory that this is just more testing is lying to the public, putting lives in risk, may get people killed?
SLAVITT: Yeah. It's certainly not - it's certainly not the truth. And whether they're lying or just refuse to look at the data, you know, that's for other people to decide. But, you know, the truth is if you don't understand the data, you'll make the wrong decisions. You keep the bars open for too long - you will give the public the wrong information about how important masks are. And most importantly, when we get to the fall, things that we all want to do, like send our kids back to school, are going to be much harder to do if we can't control the case count.
So, you know, it does require a little bit of the society coming together and decide what's important. Is it more important for us to wear masks, or is it more important for us to send our kids to school? Is it more important to invest in contact tracing and testing, or is it more important to decide not to follow kind of the guidance that's out there? And that's going to be a really important set of decisions that we're going to face in the next weeks, if not immediately.
INSKEEP: I'm glad you mentioned contact tracing and testing and so forth, isolating cases when they're found. Back in April, you said that would be the key to a successful strategy. What is making it hard to execute that strategy right now?
GOTTLIEB: Well, what's making it harder is just simply the number of cases we have. When we're reporting 40,000 to 45,000 cases a day, it's exhausting our ability to do contact tracing, especially with the resources that we have available to do that right now. If you figure that we're diagnosing somewhere between 1 in 5 to 1 in 10 cases and we're diagnosing, you know, 45,000 cases a day, that's a substantial amount of actual infection that's going on in the country, and it exhausts our ability to do contact tracing. So that's the biggest challenge right now. We need to get the infection rate down to have those case-based interventions - the tracking and tracing - be successful.
INSKEEP: You also mentioned masks. Is that vital now, especially when we're in this phase when people are economically desperate? Some states have tried to reopen. People probably feel they need to reopen. Is masks maybe the most important thing that people can do?
GOTTLIEB: Well, I'll just say quickly I think masks are the simplest intervention that we can take that can allow us to resume elements of our normal lives without really impeding our activity. You know, we know that if a large percentage of population - one state showed if 60% of people wear masks that are 60% effective, that alone can reduce the transmission rate below one, so you have a shrinking epidemic rather than an expanding epidemic.
INSKEEP: Andy Slavitt?
SLAVITT: Yeah. I think if we told people that they would do exactly what Scott said with a simple 99 cent something over their face and they would only need to do it for a short period of time, it's the greatest bargain of all time. You know, the Czech Republic put on masks early. They had reported 80% mask use, and now they don't even need to wear masks anymore. And the reason is the virus has nowhere to go. The virus is looking for new people to infect, but if it can't get in your mouth, nose or eyes, then it just slowly dies. And if we're willing to do that for a short period of time, there's evidence that - from the counties that have done it that cases go way, way, way down. I recognize some people think it's a sacrifice. I recognize people don't like to be told what to do. But it is the simplest thing to do to help your neighbors and your family.
INSKEEP: Andy Slavitt was director of Medicare and Medicaid under President Obama. Thanks to you.
SLAVITT: Thanks, Steve.
INSKEEP: And also, Dr. Scott Gottlieb was the head of the Food and Drug Administration under President Trump. Good talking with you again.
GOTTLIEB: Thanks for having me. Transcript provided by NPR, Copyright NPR.
