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Coronavirus Remains Persistent And Somewhat Unpredictable

STEVE INSKEEP, HOST:

We have some encouraging signs in the progress of the pandemic. The number of new coronavirus cases has been declining nationwide. A lot of states that were doing badly a month or two ago are doing better now. But we have to keep this in perspective. It's all relative. The daily rate was very, very high this summer, so now it's a little less high. New data show the country is close to reaching a total of 6 million cases. So let's get a status report from NPR's Allison Aubrey, who is covering this. Allison, good morning.

ALLISON AUBREY, BYLINE: Good morning, Steve.

INSKEEP: What's the big picture, as you see it?

AUBREY: You know, big picture, the number of new cases are declining, as you say. We still have about 42,000 cases a day, so that's a lot, right? But it's significantly less than the 60,000 a day we had back in July. Now, about 183,000 people have died. You know, throughout the month of August, it's like a thousand people a day. Public health experts say it's encouraging that hospitalizations are declining. There were declines in many of the hard-hit Sunbelt states, but there's still concern about regions where cases have been on the rise, spots in Midwest, in Kansas, South Dakota and in Iowa where there are many cases at universities there. So, clearly, Steve, this virus is persistent, as we know, and somewhat unpredictable. And there's still a lot of focus on developing treatments and a vaccine, of course.

INSKEEP: Which is something that the FDA commissioner, Stephen Hahn, talked about with the Financial Times, suggesting in this interview published over the weekend the agency may consider - may consider - emergency use authorization for a vaccine before some of the trials are complete. How would that work?

AUBREY: Sure. Well, what Hahn said is that if a vaccine developer were to apply for emergency authorization before the end of so-called phase three testing now, these are the trials with lots of participants who either get the vaccine or a placebo to really test if the vaccine works - that it may be appropriate to make a determination. He said it may not be. He kind of hedged a bit. Presumably, it depends on what the data shows. Now, previously, the president had suggested that the FDA was moving slowly for political reasons so that there would be no vaccine approval before the election, which, of course, Trump would really like. Now, Trump's former FDA commissioner, Scott Gottlieb, was asked about all of this on CBS yesterday. He said he did not think that Hahn could step in and prevent the FDA staff from making decisions using its science-based process.

(SOUNDBITE OF TV SHOW, "FACE THE NATION")

SCOTT GOTTLIEB: The process is rigorous. The process is well established. The agency's put out very clear guidelines on what the approvability of these vaccines is, what the metric is that they're going to use as a basis to approve these vaccines. And what they've said is the vaccines need to be 50% effective in either reducing the incidence of COVID disease or reducing infection, reducing people actually getting infected. I think people can have confidence in that process, and that's what they should be pointing to.

AUBREY: He said it is likely that there will be this phased-in approach to offering the vaccine, so there may be emergency use authorization first for a vaccine that could be given specifically to, say, health care workers or certain high-risk populations. So it will be quite a while, Steve, before a vaccine is available to all of us. In the meantime, many experts say we should continue to test and isolate people who are infected. And increasingly, colleges are attempting to do this, to identify people in real time who are infected and get them away from others.

INSKEEP: Because you mentioned the president's paranoid theory about the FDA working against his election, I was baffled by that. And while you were talking, Allison, I went to look it up just to make sure I wasn't wrong. Stephen Hahn, the FDA commissioner, was appointed to the job by President Trump. This is the person that he's suspecting of conspiring against his election. So that's the vaccine. There's then the question of testing. How important is that in this intermediate phase?

AUBREY: You know, testing is key. If you want to go see grandparents, a test done five days ago is not going to give you the information you need, right? You need to know in real time if you're infected. So there is pressure for more faster tests. Of course, testing has dogged the U.S., right? I think the next development to watch for is approval or potential approval of very fast at-home antigen tests. So these would be tests that you do not need to send away to a lab. You could get the results right in your home, similar to the way a pregnancy test is done. I spoke to Stephen Tang. He's the CEO of OraSure Technologies, which already markets a home test kit for HIV. He hopes to get approval later this fall for his coronavirus test. You basically put some saliva on a stick. You get the results within an hour.

INSKEEP: Wow.

STEPHEN TANG: Our rapid tests are used in home and by physicians as if they were, let's say, pregnancy tests. So there are two lines. One is a control line and one is a test line. And if you have both lines visible, then you are positive for the test.

AUBREY: You know, bottom line, the virus is not going away anytime soon. So increasingly, there's this call for frequent testing.

INSKEEP: Haven't campuses, college campuses, become giant laboratories for this?

AUBREY: Absolutely. And many campuses that have used entry testing, Steve, which is basically testing upon arrival before the semester starts, are finding this to be useful. I mean, it's really resource intensive, but on some of these campuses when they've done entry testing, they've been able to identify on day one people who are infected but perhaps asymptomatic, as many young people are who have the virus, quickly quarantine them or send them home. And many schools have restrictions on visitors and on students' comings and goings and, of course, on big gatherings. You know, this is all hard to enforce, but schools have warned students you break the rules, you may be asked to leave or do your classes online.

INSKEEP: Is it going to be safe to vote this fall?

AUBREY: You know, a team of researchers analyzed what happened in Wisconsin following that state's primary back in April. There were hundreds of thousands of people who turned out to vote waiting in lines, in some places for a few hours. This did not produce a detectable surge in cases there. I spoke to Larry Wein of Stanford University. He's one of the authors of the paper. He points out that many people waited outside outdoors to vote, and many wore masks.

LAWRENCE WEIN: Certainly like in Milwaukee where you're waiting for several hours and they have, you know, 6-foot strips laid out, so I think it's important to ideally encourage people to vote by mail. But if for whatever reason they can't or don't, that voting in person is relatively safe if you take the appropriate measures.

AUBREY: You know, Steve, the bottom line here is the study, which was peer-reviewed and published in the American Journal of Public Health, it concluded that voting in Wisconsin in the primary was a low-risk activity. Now, that doesn't mean zero risk. It doesn't mean that there were no cases linked to Election Day activities. But if you take measures to protect yourself and others, staying masked and socially distanced, it's likely low risk.

INSKEEP: NPR's Allison Aubrey, thanks.

AUBREY: Thank you, Steve.

(SOUNDBITE OF NOVELLER'S "A PINK SUNSET FOR NO ONE") Transcript provided by NPR, Copyright NPR.

Allison Aubrey is a correspondent for NPR News, where her stories can be heard on Morning Edition and All Things Considered. She's also a contributor to the PBS NewsHour and is one of the hosts of NPR's Life Kit.
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