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Why the American Approach Is Failing

2020-03-24

So far, the United States has been losing the battle against the pandemic, with a patchwork of inconsistent measures across the country proving unequal to halting the spread of the virus. Today, we ask: What will it take to change the course of the crisis?

Guest: Donald G. McNeil Jr., a science and health reporter for The New York Times. For more information on today’s episode, visit nytimes.com/thedaily.

Background reading:

This is an unofficial transcript meant for reference. Accuracy is not guaranteed.
From the New York Times. Unlike other borrow, this daily today. So far, the EU it states is losing the battle against the corner virus damage. Macneil Junior on what it would take to turn the corner. It's Tuesday March twenty fourth. Donald. It is both for twenty on Monday
where are we in this pandemic in the United States? How would you characterize it at this moment? I would say it's wildly out of control, but we have not recognised it yet certainly wildly out of control in New York State at the centre and the U S is now clearly New York with more than twelve thousand cases. Most of them here in New York City, wash to the state of Washington, has the second highest number, with almost one thousand cases than than theirs. California, we have the third highest Number- Northern California. In South Florida we saw pictures of. Do me. World people aerial photos of beaches in Florida jammed with people there are still so many Americans did Donald
I understand they are spreading the virus statement we ve just begun to do tests really. We ve got forty two thousand positive cases. We ve got five hundred and thirty In this you know some people said this is like a war and it's as if your army Been marching forward, enemy has been shooting at you for two to three weeks. Now and nobody has yet look down to see whether or not their bleeding, but very soon, we will see how many people have been hit, because you know get sick within four five six, seven days of getting infected. But usually you dont need, hospitalization if you're gonna need hospitalization until about ten days, two weeks in its known as the second week
and some people crash, even if they thought they were starting to get better. So we're we're facing something like that. Lot of people are sick. Huge numbers of people are about to fall seriously ill, but it just happened. Get what I want to talk about, what the? U S, government and states have done so far. How would you describe what has been done to try to mitigate this? It's a giant patchwork across the country. This is a moment. We need to make tough decisions. This is a moment where we need some straight talk and we need to tell people the truth You see the ban, California in ordering people to stay inside their houses. Are we going to put out an executive order today, New York State on Pause New York requesting that people stands either houses and closing down all non essential. Businesses a stay at home order for all of Ohio.
Oh hi, oh and Louisiana. Today, I'm issuing a stay at home order for the entire state of Louisiana moving in the same direction, which will become effective tomorrow, Monday March, twenty third, at five p m, the federal government has recommended no gatherings of more than ten people, some states are enforcing that even more harshly than like California. Other states are setting their own policies right in his patchy and ink. As this approach may be. There is beginning to be real flow back to this government mandated social distance and shutting down our society, given that it is putting people out of work, is causing businesses The president has said yes to the past few hours sooner. We cannot let the cure be worse than the problem itself. We're not gonna let the queue every worse than the problem. He doesn't want to cure to be worse than the this itself. So I want to understand why Pursuing this approach rather
a variety of alternatives, and, let's start with the south korean approach right, not closing all businesses not closing off Trials, focusing instead on aggressively tracking the sick and testing as many people as possible, as seems to be working right. So why can't we do that here? Why isn't there, A viable alternative to shutting things down. Well, we could do that here, If we had a time machine and we could travel back in time to about January twentieth because January fifteenth is where we know one of the first cases arrived in the United States and started spreading. That was the case in Washington, the idea that we could try to start down now when we have over forty thousand cases in five hundred this, it's just utterly impossible is like most anything that South Korea faced them in South Korea. They were doing this kind of crack down when they first saw cases
having before there was a single death, so we're just behind the April on that kind of thinking and mostly they had small scattered cases than they had this gigantic explosion inside one church? I think it was more than five hundred cases inside the church They managed to do contact tracing on two hundred and ten thousand members of that church was annulled just gave up contact tracing today, while just knowing that data have the test to do it. Meaning tracing those who are in contact with somebody who is tested, positive tracing everybody who was contract with somebody who is tested positive? Not only everybody live in contact with, since they knew they were infected, but everybody even forty, eight hours before that. So not only is it Who led to follow the south korean model, you're saying as an alternative in the? U S, we just don't have the capacity or their resources to follow it. Correct. Ok, so we can dispense with that another
possible alternative to the shunning. Everything down is isolating the most vulnerable in them. Work and society to the current fire, so the elderly, the The three existing conditions underline medical problems, rather than asking everyone to isolate in some form or another, and in that scenario Most Americans would be treated as we treat most Americans during the regular fleeces and right Take some precautions, be careful but dont fundamentally alter your life and there are doc. Those who seem to be advocating for this isolate the most of all, while scenario in one of our colleagues colonists Tom Free, gave voice to their views over the weekend and since President Trump is interested in this kind of a concept. What do the experts at you have taught you say about them? body of that. This was an idea that was floated for a while in the Netherlands and was
loaded for a while in the UK and dropped because they realised that it was ridiculous. Why is it really goes one? How do you only isolate the elderly, elderly people in this country very often liver? There found elderly people need services which people deliver to them in their houses, or they go to community centres, or to their relative houses for services, they absolutely need from everything from food to company. How do you isolate the vulnerable? How do you ice? everybody whose obese in this country, when you mention, because many have diabetes, and diabetes is one of the conditions that Is you more susceptible to dying of this disease?. Everybody, who's, got high blood pressure, not all high blood pressure, but uncontrolled high blood pressure, which a lot of people do in this country is more susceptible to this.
Is anybody whose taken any sort of him you drugs or is fairly recently beyond cancer treatment may be more susceptible to this disease. There's some data: just now that people who vapor maybe more susceptible to developing pneumonia from this disease vapor. Is not something that common among the elderly in this country, so you're saying that too many vulnerable populations traditionally practical, yes So the idea that you can just ice all the most vulnerable people in the. U S is simply wishful thinking. So, given that all I wanna talk through another possible alternatives- that present trump seems to be talking up alive in the past couple of days. Common malaria, drugs, it's been available. So therefore, these safety level, we understand very well- it's been relatively safe, which is the idea
we are close to a treatment to the crowd of virus, something that would lively combated, and me We don't need to shut down societies, also studying those other promising therapies, which is a therapy produced, by Juliet and that would be rims. It's called grim, Deston BAR room desert, and it shows great promise to tell me about. These drugs that present tromp has been referring to and whether he is right to suggest that they might be a solution here. Ok, the drugs, but president from has mentioned over the past week are Cora Quinn and Hydroxyl clerk when which are two versions of the long standing, malaria drugs goes back seventy years and the other drug is called from the severe and drug made by Juliet and it doesn't actually haven't you stay. I think they may have hoped it would work against HIV and it didn't definitely did not work
against a bowler when they tried it now there hoping it works against corona virus, theirs evidence to suggest it does. In those evidence in animal testing to suggested both of these drugs might possibly work those drugs. Had been used in China. But this was by doctors who were desperate, who were based throwing everything they had at patients and some cases where doctors had a certain number of patients who said g these patient, seemed to do better when I gave him a drug that does name the others with some sort of Lazarus like rise from your hospital bed when walk away, smiling miracle drunk, this was a drug. That seems Let these patients have better outcomes, but they weren't able to do for several reasons. Real clinical trials, where you have to groups of patients who are basically exactly equal to each other and have them get the drug and half done. That's what you need in order to be sure that a drug really works
once you licence, or drug and doktor start giving it all over the place. Cork when is already licence, so doctors are giving it in the hopes that it will work And patients are demanding it in the belief that it will work the belief partially spread by the President, and we don't really know how well it works- and these drugs are not completely safe, they shouldn't be especially by children without medical supervision, and you know the fear is it false hopes will be raised and that also people get so excited about it. Some may start taking the drugs to protect themselves out of fear if they manage to get a hold of a bottle and they may end up poisoning their kids. These are bad outcomes, there's a case where the cure is worse than the disease. So beyond the fact, it not yet enough medical evidence that this is a legitimate set of treatments is potentially real medical, risking people starting to take them because they might actually make people sick. Yes,
with all those options basically deemed impractical. That would seem to bring us back to social isolation, but, working because my senses so far in United States. It is not working, though it's not working and that's because we're not doing it right and You know to write the articles. I've been writing recently. I talk to a dozen top experts, not just at the World Health Organization, people who run medical schools, people who have fought pandemics, people who fought a bowler people fought Sars people who fought murders and they say that, if we're going to get a grip on our epidemic, we have to imitate China because we ve got China like spread. We're not going to be able to catch it up with a South Korea like Program and we're going to have to you know to
I'd better than ITALY and around it and we're not on that track. Right now we're going back. We all shop online alight and finding problem Those that work is an easy unless you use honey. The free browser extension backed by pay pal that scans the internet for the best promo code and automatically Ataturk heart, just download honey to your computer shop like normal click, the apply coupons button and watch the prices drop, its one percent, free to use and installs in just a few seconds, get honey for free, a joint honey dot com. Slash daily, that's, join honey dot com
ass, daily, I'm Wendy Door and I'm an editor on the daily for most My adult life, I thought of the New York Times as edge I ain't news machine that spit out news stories all day, long kind of like a vending machine. And I'm embarrassed to say that it wasn't really until I came to work here at the times that I started to think about the reporters behind those news stories and what it takes to get the story. In the first place, sometimes these reporters risked their lives. Sometimes they talk to us. Two in the morning. Sometimes they call us from a war zone and not do they tell us what's happening on the ground wherever they are, but they also give us the context that we need to understand it. If you like hearing these reporters every day, which I know I do the one thing
You can do to support them and the daily is to subscribe to the New York Times if you'd like to do that, go to and why times dot com slash subscribe. So if U S is failing. At social isolation, what would the ideal version of social isolation look like right now? What would it entail? So, in an ideal world, if you could wave a magic wand and everybody in United States freeze in place sitting six feet apart from each other for two weeks. We could stop the epidemic and two weeks if we had enough reliance yapping,
is within two weeks. The virus would die out on every surface that it was people wouldn't be interacting, so they wouldn't transmitted and everybody who has symptoms. The symptoms turn up in two weeks at the most so you'd know who was sick and even for the few asymptomatic acts, you'd be able to find them by doing tests and so could be an epidemic over. You have a lot of people hospitals, but that would be the end of it. Knowing that we don't have a magic wand but which we did, what do we do? What's the playbook for how to keep people away from each other in the United States, given where the viruses as much as possible, we have to say
Everything in places where we know the virus is. That is what China did. They knew the virus was incredibly hot issue Han and the surrounding province, and so they put that entire province on lockdown unfortunate. That means not just stop in all air travel. It means basically stopping all travel. People can't be too They're on buses, people can't be together on planes. People can't be together in cars unless it's just them and they're going to socially isolate together when they get to the end of their journey and stay in place. For Finally, an indefinite amount of time the loose he goose ear. The freeze is the longer it lasts and the longer it's gonna take us together. Economy, started again because.
The loser- it is the more transmission. There is the more transmission there is. The more people end up overcrowding, hospitals, the more people, overcrowd hospitals, the more people die. Ok, so that's transportation and you're suggesting that in many ways we have two further restrict that what about businesses? What about restaurants all over the country did? They need to be shut down. Yes, all of these things, transportation, restaurants, all over the country, schools all over the country where places all over the country bars and restaurants. All over the country and different places are turning in the hot spots. Even as we speak, because people are now try but all over the country and still spreading the virus starting new clusters. The only way to get on top of this disease is to stop the clusters, in this scenario that you're describing what can be open
an acceptable reason for anyone to be out about doctors, nurses, people, work in the healthcare field, police fire, the people who keep the water mains open, then the electrical grid running in Wi Fi, reaching houses and food delivery and medicine delivery. That's the ideal visit. Those are the only people who are allowed out and that keep the country functioning. We need people to freeze in place and we need to make sure they have enough calories and water and medicine to stay alive. You know not that they are worried about how their businesses running how their investments are going, whether another collecting their rents? And we have to do things like tell landlords it. They can't collect their rents, tell banks they can collect their mortgages, the idea to keep the country alive until the virus slows down. It may be impossible, but if you want to try it
use, any sort of social distancing tactic. It has to be much more intense than it is now because we're not slow in the virus it still spreading wildly and this slow down. How would it be enforced in a place like the United States, let say that suddenly every state every mayor locks down, community along the lines of what experts and needs to be done at a freeze this in place. How does it actually get enforced who's in charge?. Of punishing those who violated roaming the streets in making sure it actually happens. Well, I mean, legally, you can do it. Governor and the health commissioner have the power to use the police to enforce these laws in there. As in China. They went to roadblocks everywhere. You couldn't drive down the street without a permit. They D been issued by the government that
I'm an emergency worker. I am allowed to drive down the street, that's what will have to happen if people don't do it voluntarily, and I fully expect that Americans are not going to do this voluntarily, but then we're gonna suffer the concept. So what happens? If we don't do other things that exports are We must do the social isolation the lock down to mean doesnt seem we're headed there. So what happens? If we don't implement any of these measures, if we don't implement these measures? We will have a one in New York and I will harm in Seattle and a war on in south. Order and a war on and wheeling West Virginia and a war on and Billina Montana, and so on, because hospitals will get overwhelmed everywhere and in whew Han in the early weeks of the epidemic,
The death rate was four to six percent little unclear because they were people who could make the hospitals just died at home. But if you go on the South China running post site, you look for the videos were shot, then you'll, see hospitals with people crowded. The card, oars and literally dead bodies lying in the halls met nobody's had time to take away. You'll see nurses and doctors screaming having breakdown screaming and frustration. I can't take it anymore. I can't take it anymore. You will see lines of coffins outside the crematory is just sitting there waiting for their turn to go into the furnace, because there are too many coffins for the flames. The burn faster, I mean we have seen that in move on and we ve seen it in ITALY where they were having the stack coffins on the pews,
The churches have been closed down because there was no place to put the coffins and they couldn't the graves fast enough. So that's it. We're headed for him. A terrific yeah, yeah, yeah and weave I've been looking at the stuff since late January, early February and frightened by it, divisions are nightmarish and see anybody taken seriously, but that's we're headed for it's kind of hard to process this, because what you're suggesting is that a short term, essentially shutdown of much of our life in the EU. Would potentially bring this whole pandemic to an end, and yet there are a lot of practical reasons why that would be very, very hard to imagine, but for those who are very sceptical of it, because I think, as the President said, that they cure maybe worse than the illness, it would seem like a short term version of this would be.
Kind of ideal right, because he would happen that short term. I said if there were a magic wand, You could do a short term shut down. I think for the shut down to be effective, given how lacks Americans are about staying in the shut down, we have gonna have shut down that lasts for months and months. So there's no short term version of us given wait. You s operates, there's no magic wand. There's no fifteen day cure That's pretty depressing because it means that there's almost nothing. We can do right now that the genius out of the bottle, the horses, have left the barn the pandemic. Is too deeply and are system in New York. I think that's true. We dont know exactly how many people have been infected, but we know that it's been incredibly hot with virus out there for a while allow, and yet people are really struggling, because you know they have
had their rock Hudson here. So hey. I know, who's got the disease. So now I believe in it moments people are still you know them Turning to hear about colleagues who are Colleagues were infected and stuff, but that only began for five days ago. People beginning to need to be hospitalized in large numbers is usually ten days and the DES don't usually take place until three to six weeks. So we have a lot more pain in the future Is it possible for other cities in the? U S, smaller cities, maybe even mid side cities, not New York, Nazi, or maybe not LOS Angeles too do these things and spare themselves, and it will take those for the last visions of New York to convince them that this is what type of their way and maybe they'll, take the actions they need to, and maybe they won't
I'm thinking back to the phrase you used to describe the way, the United in handling this right now at a patchwork. Do you think of that, you're going to be ending up in a kind of awful middle place where Many of us are at home. We are isolating in lots of big parts of the country, but it's not enforced significantly enough and uniformly and to have meaningful impact, and so and having them magic wands this. We have the worst version of this, which is, is a lot of social and economic, and still the virus keeps spreading and spreading. Yes, I think that's exactly what's gonna happen, there's gonna going to be a great economic impact, but we're not gonna be able to find the political will or the fear as a people to shut down the spread of the virus. I dont see Us
flattening the curve everybody's our as talked about, maybe some other cities will be able to flattened the curve later to see what's gonna happen in New York, they'll begin to believe that they have to flattened the curve and go in, but then you'll find out how many people were infected in the meantime, And we were going to come out of this is a different nation, a different people if we essentially don't shut down so that the chain of transmissions don't stop. You know we're gonna be looking at hundreds of thousands of dead. I think unless some drug turns out to be a miracle preventive and that's the high hopeful cork when, but we don't really know that yet and we that's not gonna, be have access for a year. So short of that we may have to shelter in place for a year until a vaccine rules out, look, I hope for better,
but I'm not trying to sugar coated. I'm trying to explain what the worst case scenario is, I hope, reach the worst case scenario, but I fear that we, a long way down the road towards it. Well, I wouldn't To say thank you Donald, but it just doesn't seem like that kind of a conversation. Thank you anyway. We appreciate. Thank you. Sorry, I'd love to be proved wrong. On Monday, during his daily briefings the pandemic. President Trump continue to promote medications that have not been widely proven as effective in treating the disease and said that thousand of doses of one of them poor, queen
we to New York City, despite misgivings from federal health officials, America well again and soon be open for business. Very soon, at the same time, the president said that he was eager to quickly and the economic shutdown now in place to halt the spread of the virus, in defiance of advice from his medical advisers, Sarka drawers and built to be shut down. This is not a country that was built for this. It was not built to be shut down all the way back.
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Banning meetings of more than two people and workers wearing citizens to stay in their homes, except for trips, for food or medicine. The way ahead is hard, and it is still true, but many lives will sadly, be lost in the United States, where there are now about forty, two thousand infections federal officials warned virus was spreading at an alarming rate in New York or twenty. Eight percent of tests are coming up positive compared with a nationally Of eight percent so to Allah, my friends and colleagues in New York. This is the group that needs to absolutely social distance and felt isolate at this time. Clearly, the virus had been circulating there for a number of weeks to have this level of penetrates into the general community.
In Congress, Senate Democrats again blocked a newly two trillion dollar stimulus bill, which they argue favours. Corporations over workers in during the republican majority, which Mcconnell who accused the Democrats of seeking to exploit the crisis. They ought to be embarrassed, Mr Programme. In fact, our from some of whom are very popular like this is some juicy political opportunity. This is not just a political opportunity. This is a national emergency, that's it! I'm likeable bottom cinema Vanguard was founded on the simple, but radical idea that initially company can succeed because it puts investors First Vanguard is and owned. You
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Transcript generated on 2020-04-22.