Answering Your Coronavirus Questions: Masks, Ventilators And Making Choices
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On Friday, the Centers for Disease Control and Prevention said it now recommends that people in the U.S. wear cloth or fabric face coverings when entering public spaces.
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On this broadcast of The National Conversation, we'll give you the latest on efforts in the U.S. to stop the coronavirus. We'll also answer your questions about masks, ventilators and some of the difficult choices everyone is making these days.
Copyright 2024 NPR. To see more, visit https://www.npr.org.
On this broadcast of The National Conversation, we look at efforts in the U.S. to stop the coronavirus and answer questions about masks, ventilators and some of the difficult choices we're all facing.
Transcript
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PRESIDENT DONALD TRUMP: We're going to have a rough week. We're going to have maybe a rough little more than a week. But there's tremendous light at the end of that tunnel.
ARI SHAPIRO, HOST:
President Trump tells Americans to brace for a surge in COVID-19 cases. The U.S. death toll is now over 10,000. It's Monday, April 6, and this is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED.
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SHAPIRO: I'm Ari Shapiro. Coming up, we'll answer your questions about how the coronavirus will affect the future.
PHIL ORLESKI: Is there anyone compiling a lessons learned report that will help us prepare for the next?
ANDREW MCBRIDE: Is there a possibility this pandemic will continue beyond 2020?
SHAPIRO: Also, how should you take care of your cloth face covering?
LAUREL: Can I sterilize them by hand-washing or other methods? Also, can surgical masks be sterilized and reused or just reused after a waiting period?
SHAPIRO: We're answering your questions about COVID-19 this hour. Want to ask our experts something? Go to npr.org/nationalconversation. First, these headlines.
This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED. I'm Ari Shapiro. And each night, we're here to answer your questions.
LO: Hi. My name's Lo (ph).
ORLESKI: My name's Phil Orleski (ph).
AARON OLSHEVSKY: My name is Aaron Olshevsky (ph).
MCBRIDE: I'm Andrew McBride (ph) from Bellingham, Wash.
LO: My question is about ventilators.
ORLESKI: And I want to know...
OLSHEVSKY: I was wondering...
UNIDENTIFIED PERSON: My question is...
MCBRIDE: Is there a possibility this pandemic will continue beyond 2020?
ORLESKI: ...Is there anyone compiling a lessons learned report?
LAUREL: Can surgical masks be sterilized and reused?
SUSAN: Is there any way using a CPAP could be useful when a ventilator is not available?
ORLESKI: Thank you.
LO: Thank you.
OLSHEVSKY: Thank you.
SHAPIRO: We have NPR journalists and outside experts here to offer solid facts and correct some of the misinformation that is floating around. And today, we've got answers about the latest efforts in the U.S. to stop the virus, how you should handle the new instruction to cover your face in public and how ventilators fit into the medical treatment for this disease. Send us your questions about all these topics and more at npr.org/nationalconversation. On Twitter, use the hashtag #nprconversation.
Each night, we begin THE NATIONAL CONVERSATION by answering the question, what happened today? Well, now more than 10,000 people in the U.S. have died of this disease, and there are more than 360,000 confirmed cases in the country. In New York, hospitalizations, infections and deaths continue but may show a slight flattening of the curve. Six hundred people died in New York yesterday. Governor Andrew Cuomo says the city may have reached a plateau, but the health care system is stretched to the max.
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ANDREW CUOMO: Staying at this level is problematic. And if we are plateauing, it's because social distancing is working.
SHAPIRO: California, Oregon and Washington state are shipping ventilators to New York to help. The morgue in New York City is filling up. Officials there are exploring using a city park for temporary burials. Here in Washington, D.C., President Trump bristled at criticism and tried to paint an upbeat picture.
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TRUMP: Let's win this, and let's get our country open as soon as we can. I think it's going to be sooner than people think. Things are going really well. Again, light at the end of the tunnel.
SHAPIRO: Washington, D.C.'s Mayor Muriel Bowser warns that the nation's capital could be one of the next hot spots.
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MURIEL BOWSER: If we aren't strict in our social distancing, the community spread will continue and we will have more people succumb to illness and perhaps death.
SHAPIRO: South Carolina issued a stay-at-home order tonight. In Wisconsin, Governor Tony Evers issued an executive order to postpone all in-person voting tomorrow, but the state Supreme Court overruled it and ordered the election to go forward tomorrow.
In Britain, Prime Minister Boris Johnson was transferred to intensive care after his symptoms from the virus worsened. He has handed off power to the foreign secretary. Last night, before the prime minister entered the ICU, the Queen of England rallied her nation.
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QUEEN ELIZABETH II: We should take comfort that while we may have more still to endure, better days will return. We will be with our friends again. We will be with our families again. We will meet again.
SHAPIRO: Well, NPR's Ayesha Rascoe is here to answer your questions about the White House response to the pandemic. Welcome back, Ayesha.
AYESHA RASCOE, BYLINE: Thanks for having me.
SHAPIRO: It was a long briefing tonight. And after the president left, the medical experts at the White House expressed some optimism. Tell us about that.
RASCOE: Yes. So it didn't happen until close to the end of the second hour of the briefing, but Dr. Anthony Fauci pointed to numbers that - pointed to the numbers that Governor Cuomo had mentioned, the plateau in hospitalizations, ICU admissions. And he said those are the kind of good signs that you look for. Fauci said it shows that we need to keep up the social distancing. And Dr. Deborah Birx said if we keep it up, there is potential that there will be fewer deaths than the government projected last week. But she listed more than 10 metro areas that continue to be concerning. So even with the - kind of the optimism, there's still a lot of caution coming from both Birx and Fauci about what happens next.
SHAPIRO: So the sacrifices people have been making do seem to be having a positive impact. Now, earlier in the briefing, President Trump had some very tense exchanges with reporters over the number of tests that have been administrated, that have been given out. What did the White House say was the reason for the lack of testing?
RASCOE: So, yeah, President Trump was angry about a new inspector general report that was a snapshot of what conditions were like for hospitals in mid-to-late March. And the president has been and continues to be super defensive when it comes to criticism about his administration's response to the pandemic. But task force officials did acknowledge today that things were backed up at that point. They say, though, that things have improved, and that is true both on testing and supplies. But while testing has expanded, there are still reports of problems on the ground.
SHAPIRO: All right, we have a lot of questions coming in. Here's one from a listener in Oregon.
ORLESKI: Hi. My name's Phil Orleski. And I want to know - it's known that President Trump disbanded a federal office that was in charge of long-term planning for pandemics. Has there been any analysis of what impact this has had or may have had on our current situation? Also, is there anyone compiling a lessons learned report that will help us prepare for the next?
SHAPIRO: That question looking backwards and forwards. Ayesha, what can you tell us?
RASCOE: So regarding that office, it's not really clear. There has been a lot of controversy about this former federal office. Some former Trump administration officials say that the expertise was not lost when that office was disbanded, but Dr. Fauci did say, you know, earlier that it would've been nice if it was still around.
In terms of lessons learned, there have been some calls for review after this is over. And agencies like FEMA usually do what's known as an after-action report when any type of big event like this happens. So that may be coming down the pike. Democrats in Congress have created a select committee, but it's more looking at how aid money is spent than necessarily investigating what led up to this. So right now, it doesn't look like there is a specific plan for a commission or anything like that. That could change.
SHAPIRO: All right. NPR White House reporter Ayesha Rascoe, thanks a lot.
RASCOE: Thank you.
SHAPIRO: And NPR science correspondent Jon Hamilton is also on the line with us now. Hi, Jon.
JON HAMILTON, BYLINE: Hi.
SHAPIRO: To return to that issue of testing, the White House says there are 125,000 coronavirus tests being done each day. When you talk with public health experts about what they would like to see, how do the numbers compare?
HAMILTON: Well, I don't think they have, like, a magic number of the right number of tests, but, you know, there are a couple of ways you can tell when the number of tests is catching up with the number of cases you have. And one indicator is whether people who have symptoms that could be coronavirus - whether these people are still having trouble getting tested. And if you look at the U.S., this seems to vary a lot by where you live. So you have some areas, labs actually have the capacity to test more people than they're being asked to. But you have other areas where even people with pretty bad symptoms are saying it's still hard to get a test.
So another indicator is how many tests are coming back positive. Right now, I think nationally, about 15% of people who get tested are found to actually be infected. And the public health community is saying that probably means you need to be testing a bit more widely than we are right now. And even more concerning, you'd like to see the percentage of positive tests come down over time as we do more tests - more and more tests. And we haven't seen that happen yet.
SHAPIRO: OK. Well, we have a lot of questions from listeners about how long people can spread this disease. Let's listen to this one.
LAUREN: I'm Lauren (ph). As I understand it, if someone is infected with COVID-19, they will either become sick in 14 days or will become a silent spreader. If someone is a silent spreader, how long will they be contagious for?
SHAPIRO: We've heard a lot about the fear that asymptomatic people will spread this disease. How long can they do that?
HAMILTON: Right. I mean, there's not a great answer to that question yet. I should say it is clear that most people who get infected are not what you would call the silent spreader. It's not a common thing. And there's really strong evidence that it's people who do have symptoms who are most likely to infect other people. And even more recently, we found that, you know, people can be contagious before they develop symptoms, so, in fact, they aren't truly asymptomatic or a so-called silent spreader.
That said, there are people who seem to never get sick but do seem to be able to infect other people for some period of time, and we just don't know how long that is. The Centers for Disease Control and Prevention says people seem to stop being contagious within a couple or three days after their fever goes away. So it seems unlikely that other people are contagious for, say, weeks or months, but we just don't know.
SHAPIRO: So much that we still don't know about this disease. We have this question here from Charles (ph) in Georgia asking, does the virus travel in blood? Is it immune to iodine? Explain why iodine would be relevant here.
HAMILTON: Well, I mean, iodine has been used in the medical world for a long time to kill viruses and anything else. You know, it's often Betadine. They put it on your skin before they're going to give you a shot to kill off any pathogens that are there. So iodine is really good at killing just about any virus on your skin or your surface, but I don't think I would drink it.
SHAPIRO: (Laughter) Let's take this question next about how long the pandemic might last.
MCBRIDE: I'm Andrew McBride from Bellingham, Wash. I've read that the 1918 pandemic lasted from January 1918 to December 1920 and that there were waves of infections. Is there a possibility this pandemic will continue beyond 2020?
SHAPIRO: Of course, everybody's hoping for a vaccine or a good treatment. If that doesn't come along, is it possible, Jon, that this could continue for more than a year?
HAMILTON: I think everybody in the public health community believes that, yes, it entirely possibly could continue for more than a year. And already, you have the public health community planning for that possibility. You know, if you look at other pandemics, you often see that they go in waves. It's not just a one-and-done kind of thing. So it's quite possible that what we're seeing now is a first wave that might pass, and but there might be a second or third one, something that could hit us later this year or next year.
And, of course, one of the places I think people really are looking closely at is China, where we first saw this outbreak. And the question there is, are they going to see a second wave? What's going to happen? That will probably give us a better idea of what's going to happen to us.
SHAPIRO: A somber note to end this part of the conversation on. NPR science correspondent Jon Hamilton, thank you.
HAMILTON: You're welcome.
SHAPIRO: And you can hear much more of our extensive coverage when you download the NPR One app. Go to the Explore tab and click on The Coronavirus Outbreak for a curated stream of stories. And if you have questions, we want to help. Go to npr.org/nationalconversation or reach us on Twitter with the hashtag #nprconversation. Up next, you have a lot of questions about masks. We've got answers, right after this. You're listening to THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED from NPR News.
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SHAPIRO: This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED. I'm Ari Shapiro.
It's time for Americans to start wearing masks in public, or, more specifically, cloth face coverings. Ever since the federal government gave that new guidance on Friday, you have flooded our inbox with questions about masks - where to get them, when to use them, how to make them. Doctor Abraar Karan is a global health expert and physician at Harvard Medical School who is with us once again, this time to answer your mask questions. Good to have you back.
ABRAAR KARAN: Hey. Good to be here, Ari.
SHAPIRO: I think a lot of listeners are feeling confused about the guidance on this. Let's hear from somebody who's trying to sort this out. This question comes from Phil (ph) in Providence, R.I.
PHIL: So my question is regarding whether or not are we supposed to be wearing masks. First we're being told we should only be wearing masks if we're showing symptoms or if we're sick. Then we're being told that we should be wearing masks all the time, regardless. And now we're supposed to be making our own masks at home. I'm really confused and lost.
SHAPIRO: I think Phil is not the only one who's confused and lost. There's been really conflicting guidance over time. Help us sort it out.
KARAN: Yeah. You know, it's - I can understand how this could be very confusing to a lot of people. And one thing that was mentioned in the question was, you know, initially, there was a thought that we were focusing on people who have symptoms. As we get further data, we're now thinking a little bit more about people who are in a pre-symptomatic stage, so people who, before they actually develop symptoms, are harboring virus and could be transmitting it to other people. And so the idea with trying to have more people cover their face and their nose is to blunt transmission that way, particularly when you're not showing symptoms. So I think that is what drove this push towards having more people wearing masks.
SHAPIRO: So it's less about preventing the disease from getting into the mask wearer and more about preventing it from getting out from the mask wearer. Is that right?
KARAN: You know, that's definitely a good way to think of it. I think partly because, as you know, in the health care setting - right? - there's a lot of conversation about wearing face masks versus N95s. And these have a dual function, right? One is to make sure that we aren't transmitting, and the other is to make sure we aren't getting infected as health care workers, whereas for these more general cloth mask recommendations that have now come out from the CDC, the idea is, at a population level, trying to prevent transmission as much as possible.
SHAPIRO: OK. Now as you point out, the CDC is saying save the N95 masks for the professionals, which has led to a lot of people making their own masks. And I know you're a global health expert, not an origami expert, so I'm not going to ask you to tell us how to fold your own mask. But we did get this question about home crafting from Aaron (ph) in Washington.
OLSHEVSKY: If you want to make a mask out of materials you already have at home, what's the best material to use?
SHAPIRO: Well, as a doctor, I don't know if they taught you this in medical school, but what insight can you give us?
KARAN: No, yeah. So certainly not something we learned in medical school, but I've been doing some reading on this topic. You know, it's something that a lot of us are thinking about. So some of the data suggesting perhaps using a high-quality quilter's cotton. So this is something that they've looked at a little bit in terms of what people might be able to use. But I wouldn't be the person to tell you what is and isn't quilter's cotton, so...
SHAPIRO: So quilter's cotton, whatever that is. I also hear cotton sheets are good.
KARAN: Yeah. You know, the trouble with a lot of this stuff is we don't have studies in the real world to really say if this is going to work or not, right? So this is - a lot of this is theoretical, hoping that this would be another aspect that could help blunt transmission. But, you know, one of the keys to this is really to make sure that that doesn't change the things we're doing in terms of social distancing, like keeping 6 feet apart...
SHAPIRO: Right.
KARAN: ...You know, washing your hands. So one of the things from our side is, as public health practitioners, we don't want people to think masks are now an excuse to not be doing the other things that are important.
SHAPIRO: Yeah. We got a lot of questions about reusing masks. Here's one from Laurel (ph) not far from you in Somerville, Mass.
LAUREL: I want to wear a cloth mask when I'm out in public, but I can't really run the washing machine every day. Can I sterilize them by hand-washing or other methods? Also, can surgical masks be sterilized and reused or just reused after a waiting period?
SHAPIRO: What advice would you give Laurel?
KARAN: Yeah. Another great question. So the guidance from the CDC and from some other experts is certainly that you should be washing the cloth. So if you wash the cloth, it's said it should be clearing the virus off there in your washing machine with soap. If you wash it with hand soap, you know, under the sink - what we know is cleaning works pretty well. A lot of the studies in major medical journals have shown that when you actually are cleaning off surfaces, it does remove the virus. So I'd say to really focus on cleaning those cloths. Don't reuse them. And when you are taking the mask off, make sure you're not touching your nose and your face inadvertently. That's another pretty important thing. So that's what I would say to that.
SHAPIRO: You know, an artist friend made me a reversible fabric mask, and I was telling a doctor this who said you can't reverse it unless you wash it first. But if the goal of the mask is to keep an asymptomatic me from spreading my germs to other people, does it matter whether there's a clean side and a dirty side?
KARAN: It absolutely does matter because you're wearing a mask not knowing if you're infected or not. You're now - you know, you should be social distancing. You should be staying at home. But let's say you had to go to the grocery store or something like that, right? Theoretically, if you were to touch something and then touch the outside of your mask, you could be spreading fomites and, you know, germs and materials. So it's better to be careful, and it's better to be washing it as much as you can.
SHAPIRO: All right. If you have a question for Dr. Abraar Karan, send it to us at npr.org/nationalconversation or share it on Twitter using the hashtag #nprconversation.
We also heard from some listeners who are skeptical that a face covering will work. Here's Mary Ellen Schmidt (ph) of Bloomington, Ill.
MARY ELLEN SCHMIDT: I only go to the store as needed. I don't talk to people. And I'm not sneezing or coughing. I don't think a mask will help even if I could find one. What are your thoughts?
SHAPIRO: Well, what would you say, Dr. Karan?
KARAN: Yeah. So, you know, again, it's a great question. I think the key that she's saying here is that she's not leaving the house that much. She's just going to the store as needed. And this is just another added protection to help blunt transmission. But, you know, the keys, again, are social distancing. Don't get close - too close to other people. Wash your hands. The mask is - a mask is something that's trying to add to that. And again, we just don't have the studies to know for sure how much that's going to impact transmission, but, you know, that's what we know.
SHAPIRO: Seems like these are all ways of reducing risk. And even if no single step is going to get us to 100% risk reduction, each little bit at least can't hurt. Is that the working principle here?
KARAN: That's the working principle. And, you know, the concern is one where sometimes new interventions can change how people perceive their risk. So we don't want people to wear a mask and now think their risk is much lower, and then they may go do other things that actually put them at higher risk again.
SHAPIRO: Right.
KARAN: So that's part of it. And the other part is that these things can be harmful in certain ways, right? So if you, in the process of wearing your mask, are now actually touching your face more when you're taking your mask off, you could've potentially just exposed yourself. You need to be very careful, even with things like putting masks on, cleaning masks and all those things. And those are things that we do in the health care setting. You know, those are all things we think about regularly when we're putting our masks on or taking them off.
SHAPIRO: OK. We've just got a minute left, but we've got a question here that I think a lot of people have thought to themselves, if not asked out loud, which is, if you're passing someone on the street and you have the instinct to hold your breath or exhale rather than inhale, does that actually make any difference?
KARAN: Well, you know, it's really sustained - when you have sort of sustained contact with somebody for some period of time that you're going to be most likely to transmit. So if you just pass them very quickly, it's less likely.
SHAPIRO: Dr. Abraar Karan of Harvard Medical School, also assisting with the virus response in Massachusetts, thank you for your work with them, and thank you for your help answering these questions with us.
KARAN: Thanks so much.
SHAPIRO: Tomorrow on the show, we'll be talking about different medicines that could be used to fight COVID-19. President Trump has promoted the use of hydroxychloroquine. His public health advisers say it's too soon to know if that will work. Send us your questions at npr.org/nationalconversation. Or on Twitter, use the hashtag #nprconversation. This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED from NPR News.
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SHAPIRO: It's THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED. I'm Ari Shapiro. This hour, we'll answer your questions about the links between smoking and the coronavirus.
OLSHEVSKY: Is there any data linking vaping use in an increase in coronavirus complications?
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SHAPIRO: I'm Ari Shapiro. In the U.S. today, there are more than 360,000 confirmed cases of COVID-19. We've been hearing about shortages of critical medical supplies, and the biggest deficit is in the need for ventilators. You've been asking us a lot of questions about how the disease affects the lungs and how ventilators can help. We're going to spend this next part of the program answering as many of them as we can. Joining us now is Dr. Meilan Han, a pulmonologist at the University of Michigan Hospital in Ann Arbor and also NPR science correspondent Jon Hamilton. Good to have you both here.
MEILAN HAN: Thank you.
HAMILTON: Hey, Ari.
SHAPIRO: So before we start answering listener questions, Dr. Han, can you just briefly describe what a ventilator does exactly so that we're all on the same page?
HAN: Yeah, that's a great question. So we first have to think about what our lungs actually do. Our lungs get oxygen in for us, and they get carbon dioxide waste products out for us. So when we think about trying to help out the lungs with a ventilator, we need to do both of those things. We need to get oxygen in and we use that by piping in gases of higher concentration than are in room air. But there's also a mechanical bellows function to the ventilator that helps physically move air in and out to help patients breathe.
SHAPIRO: OK. Well, our first question here comes from Lo (ph) in Oakland, Calif.
LO: I'd like to know what percentage of people who require ventilation go on to actually survive. It's inherently risky, so I just want to know basically hopefully by age breakdown if you could tell us what percentage of people survive after ventilation. Thanks.
SHAPIRO: I think this is not a very encouraging number. Dr. Han, once people are on a ventilator, what are their chances of survival?
HAN: Well, it really depends on the reason they got on the ventilator in the first place. So some things turn around quite quickly. Obviously, the area of concern for tonight is COVID-19. Unfortunately, the numbers are pretty grim. Now, it varies by country and the data that you look at, but perhaps some of the best data that I've seen is coming out of some ICU registries in the U.K. And that data would suggest perhaps as high as 67% of patients that end up requiring a ventilator actually die.
SHAPIRO: Sixty-seven percent do not recover.
HAN: Yes. But having said that, I - you know, the numbers vary widely. Anecdotally, we see some hospitals that are doing better, and I have reasons to be optimistic. You know, we're working really hard at my own home institution at the University of Michigan. And I by far do not want listeners to think that - just because a patient is hospitalized that is not at all necessarily a death sentence, but it obviously is concerning, yeah.
SHAPIRO: Sure. Jon Hamilton, how does this compare to what you've learned in your reporting?
HAMILTON: Well, the study that Dr. Han cited, the U.K. study, was sort of in the middle of the data that's out there. And I should say that this is all pretty preliminary. I wouldn't say any - the definitive trial has not been done yet. But I found, you know, out of China, it could be as low as 15% of people who went on a ventilator survived. And there was a very small study out of Washington state where it was 50%, which is much more encouraging. On the other hand, at the end of the study, a number of the patients were still on the ventilator, so it was like you didn't really know yet what was going to happen.
SHAPIRO: As with so much else about this disease, it just seems like there's so much unknown. It is still so new, and there's so much research to be done. Let's go to another question, this one from Peter (ph) in Albany next to my hometown of Portland, Ore.
PETER: Do those that survive after being on a ventilator recover to the point they can resume a normal life or will they struggle for their remaining years?
SHAPIRO: Dr. Han, what can you tell us about recovery? After people get off a ventilator, the lucky ones who survive, how are their lungs?
HAN: Yeah. So this is another really good question. We have to remember this virus has only been on the Earth a couple of months. So we really do not have long-term data. In fact, the National Institutes of Health is scrambling right now to start getting studies up and running to get this information out. But the limited data that is coming out of Asia suggests that there is lung impairment. This isn't surprising. We see this with other causes of adult respiratory distress syndrome, which is what this is behaving like. Although the good news with ARDS is that many of those patients actually recover farther out, five years out, their lung function, so I think there is reason to be optimistic.
SHAPIRO: Can CAT scans show whether people who come out of this disease having been on a ventilator have damage to their lungs?
HAN: So that's another great question. Data coming out of Asia suggests that there is some some damage at least a little bit out. But the interesting thing going on here in the U.S. is that we actually haven't been getting that many CAT scans, in part because of the difficulty getting the CAT scanners cleaned in between patients. In China, they had many hospitals that were all COVID, so it was OK. But here in the U.S., we're still trying to take care of patients with non-COVID-related problems. And so in many cases, we just don't have a lot of that nice CT imaging data available.
SHAPIRO: Oh, that's really interesting. If you have a question for Dr. Han or NPR's Jon Hamilton, send it to us at npr.org/nationalconversation or ask us on Twitter using the hashtag #nprconversation. This next question comes from Susan (ph) in Johns Island, S.C. And it's also a medical equipment question. Let's listen.
SUSAN: I have used a CPAP for 15 years for sleep apnea. Is there any way using a CPAP could be useful when a ventilator is not available?
SHAPIRO: Jon, what can you tell us about CPAP machines?
HAMILTON: Well, I can tell you that Susan has just walked into the middle of a very big debate going on right now.
SHAPIRO: Thanks, Susan.
HAMILTON: And, you know, these machines do - you know, people with sleep apnea like Susan use them. They do push air into the lungs. And so in that way, you know, theoretically, they can be helpful. But on the other hand, they are certainly not a ventilator. They are not taking over breathing the way a breathing machine can. So there seems to be a camp that says, well, you know, if you can't get a ventilator, this might help. The other side of that is people are concerned that these machines might cause what they call aerosolization of the virus. So it might contribute to its spread. It might get into the air and make things more dangerous for people around.
SHAPIRO: Dr. Han, I understand that operating a ventilator usually requires a rigorous, specialized training program. Now that demand is so high, are health care workers getting a crash course or are people operating ventilators without proper training or how is that working?
HAN: So that's another really interesting question. You have to remember that taking care of patients in the ICU require massive teams. So it's doctors, nurses, respiratory therapists, techs that all have very high levels of training. So what I'm seeing is that we are shifting - we are redeploying people into new areas that perhaps they haven't worked in. And so we're trying to keep a couple really key experts in the field and kind of have them oversee perhaps a slightly green army underneath them. But that's kind of how our hospitals are operating right now.
SHAPIRO: And how short are you on supplies? Or do you have what you need right now?
HAN: I would say the PPE problem - the personal protective equipment problem - is massive. It's still raging. We do not have enough. And a lot of organizations have been asking central administration for some type of transparent and organized supply chain, so that's still clearly a problem. The ventilator issue really varies from hospital to hospital and state to state. And I think within each state, governors are working hard to shift ventilators from hospitals without a lot of cases to hospitals that really need it most.
SHAPIRO: That is Dr. Meilan Han and also NPR's Jon Hamilton answering your questions about ventilators and the impact of COVID-19 on the lungs. We're going to take a short pause and be right back in just a moment. Stay with us.
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SHAPIRO: And you're listening to THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED from NPR News. We're back with Dr. Meilan Han, a pulmonologist at the University of Michigan Hospital in Ann Arbor, and also NPR science correspondent Jon Hamilton to take more of your questions. Many people have been asking about smoking and vaping. So here are two questions related to that, first from Julie (ph) in Seattle. She writes, much attention has been given to high-risk factors such as diabetes and heart disease. But how much does smoking increase risk of death among those infected? And then along similar lines, here's Aaron from Birmingham, Mich.
OLSHEVSKY: I was wondering, is there any data linking vaping use and an increase in coronavirus complications? Some of the E-liquid must stick around in your lungs after vaping. And I would imagine that oily residue would pose a possible increased breeding ground for the virus or the lung's response to the oil could open a back door for the virus.
SHAPIRO: Dr. Han, what's known about the connection between smoking and vaping and COVID-19?
HAN: So we have a little bit more data about smoking and in particular coming out of China. And what the data suggests is that patients who do smoke are at much higher risk for more progressive and severe forms of the disease. So I would say smoking definitely is a risk factor for having more severe complications. We just have so much less data about vaping. But what we do know is that both vaping and smoking can cause lung inflammation. So my best expert guess or expert opinion on this would be that both potentially could be risk factors for getting more severe lung complications. So my advice for our listeners tonight is that now is an amazing time to think about quitting if you are an active smoker. And, you know, for instance, the American Lung Association, lung.org, has some great resources if people want to look there for advice on quitting.
SHAPIRO: In states where marijuana is legal, I've heard people talk about shifting from smoking it to consuming it through other means. Without endorsing marijuana consumption one way or the other, does that seem like a step that people should be considering?
HAN: I think anything that reduces inhalational injury to the lungs is probably a good thing right now in the era of COVID.
SHAPIRO: Here is another smoking-related question from Leon (ph) in New York.
LEON: I was recently waiting in line to go to the grocery store and a person next to me started smoking and the wind was blowing his smoke into my direction. I was wondering if I could possibly get coronavirus from him smoking and it going into my lungs.
SHAPIRO: OK. So here's something that's coming directly out of someone else's lungs and then the smoke wafts into somebody else's face. Is that a risk?
HAN: Well, it's hard to know for sure. We know that this is a respiratory-borne disease and spread by respiratory droplets. I think some of our listeners may have heard the unfortunately extremely tragic story coming out of Skagit Valley where a choir group despite social distancing transmitted coronavirus to quite a few of the choir members. So we do know that things like coughing and deep breathing that might occur during singing certainly do pose some risk for transmission. So I would say there's probably some risk. It may not be as high as other activities. But, again, this is why we're recommending social distancing and masks.
SHAPIRO: That's Dr. Meilan Han, a pulmonologist at University of Michigan Hospital in Ann Arbor. Thanks so much for joining us tonight.
HAN: Thank you.
SHAPIRO: And also answering your question, NPR science correspondent Jon Hamilton. Great to have you back with us as well.
HAMILTON: My pleasure.
SHAPIRO: If you have questions, send them to us at npr.org/nationalconversation, or on social media, use the hashtag #nprconversation.
(SOUNDBITE OF MUSIC)
SHAPIRO: And this is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED from NPR News.
(SOUNDBITE OF MUSIC)
SHAPIRO: This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED. I'm Ari Shapiro. The Internet is flooded with information about the coronavirus, and it can be hard to find sound advice. Sometimes it feels like there are no right answers. Dr. Meilan Han, a pulmonologist at the University of Michigan Hospital in Ann Arbor, is still here with us to help us all think through some of the difficult choices everyone is being forced to make these days. Good to have you here with us, Dr. Han.
HAN: Thank you.
SHAPIRO: Let's dive right in. Our first question comes from Roy (ph) in Tucson, Ariz.
ROY: I am healthy now, but for any of us who may experience symptoms like high temperatures or difficulty breathing and who, like me, live alone, how do we determine before it's too late to act when we should continue to isolate and ride it out versus get ourselves to a hospital because we may need to be on a ventilator or need other interventions?
SHAPIRO: This is such a tough question. We've all heard about people whose symptoms have set in overnight really quickly. Dr. Han, what would you advise somebody like Roy?
HAN: Right. So every city has a local health system with hotlines and so if someone is concerned, the first thing to do is to call your local health system and your hotline. And they're going to ask you a series of questions, and that includes things like, are you short of breath, are you running a fever and do you have a cough? Everyone will have a slightly different threshold for bringing people in for testing depending on access and availability of kits. But the increasing number of those symptoms and particularly if you've been exposed will trigger you to be able hopefully to get access to a test. What I would say is to all of the listeners out there is that probably the most concerning thing and the thing that would ultimately require hospitalization is inability to breathe. So if people are experiencing shortness of breath, that's really the trigger to get in.
SHAPIRO: So I guess the takeaway is consult your doctor, and they will tell you whether or not you should be coming to the hospital or the advice nurse as the case may be.
HAN: Yes, absolutely.
SHAPIRO: Our next question is from Cameron (ph) in Brooklyn.
CAMERON: Are there any tips for jogging outside during this time or should it just be avoided altogether?
SHAPIRO: We've had so many questions along these lines. Another one comes from Amanda (ph) in Minneapolis who writes I'm still confused about whether or not we should be going for walks outside. All reports say the virus can live in the air for up to three hours, so even if I keep a 6-foot distance on a walk, couldn't I potentially be breathing virus-contaminated air along the route? This seems to be a very common concern for people.
HAN: You know, the one good thing and one thing I'm looking forward to about spring is the ability to actually get outside and get some fresh air.
SHAPIRO: I guess it's still pretty cold in Michigan.
HAN: (Laughter) Yes. The good news is that, you know, the likelihood of getting infected really has to do with concentration. And so when you're outside, there's so much air mixing around that even if someone was standing in a spot and coughed, you know, a few minutes ago, the likelihood that a significant amount of virus would land in your lungs to infect you is very low. So, please, everybody, do get out, I would say, and enjoy the sun, walk, run, get your exercise.
SHAPIRO: If you have a question for Dr. Han, send it to us at npr.org/nationalconversation or share it on Twitter using the hashtag #nprconversation. We got this question from Jackie Putnam (ph) on Twitter who asks, any advice for people caring for their adult children with intellectual disabilities or autism if they become ill. My son would be very hard to control if he was alone at the hospital with strangers, she writes.
HAN: You've really touched on a nerve here, and this is something we as health care providers are really, really struggling with. Because of the limited amount of protective equipment and trying to protect visitors and patients, unfortunately we are in a position right now where visitors into the hospital are extremely limited, particularly into the COVID wards. So, you know, I really empathize. And we as health care workers are doing everything we can to bridge those gaps between family and affected loved ones. But this is really hard for everyone right now.
SHAPIRO: Yeah. It sounds like this is one of those situations where there just is not a good answer yet.
HAN: Yeah.
SHAPIRO: We have a question here from Courtney (ph) in Danville, Calif., who asks, as the need for blood is expected to increase, what measures are in place to ensure that we won't have another pandemic of infected blood given to transfusion recipients? The current screening questions aren't accounting for community spread, she writes. What about donating blood?
HAN: Well, right now, we actually need blood more than ever because people have been afraid to go to donation centers, and we still need the blood for all the sort of usual reasons that we need it.
SHAPIRO: Not COVID related, just the typical demands.
HAN: Not COVID related, exactly. So what we do know is this is a respiratory-transmitted virus, and there's no evidence to actually suggest that it can be transmitted through the blood. We have some experience from related viruses including SARS and MERS, and there was no evidence of blood-borne transmission. So I think we can feel fairly safe about the blood supply from a COVID perspective.
SHAPIRO: That's reassuring. Dr. Han, just in our last minute, I know this is such a stressful time for everyone but particularly for health care workers on the front lines. Is there something that you are doing to help keep moving forward and keep your balance these days?
HAN: (Laughter) You know, I was actually - and I know my friends out there are listening right now. But, you know, I've been reaching out to friends and FaceTiming and texting. And I actually feel in many ways closer to my colleagues than ever. We've been having super frequent calls and everyone has been so supportive. And, you know, all my colleagues at the hospital are stepping up in just amazing ways.
SHAPIRO: I am so glad to hear that. Thank you for the work that you're doing, and thank you for joining us to talk about it.
HAN: All right. Thank you.
SHAPIRO: Dr. Meilan Han, a pulmonologist at the University of Michigan Hospital in Ann Arbor. And tonight, we are going to end our program with something that is making us smile.
(SOUNDBITE OF YOUTUBE VIDEO, "ZOOM SURPRISE: SOME GOOD NEWS WITH JOHN KRASINSKI EP. 2")
JOHN KRASINSKI: Good evening, everyone, and welcome back to SGN. I am John Krasinski.
SHAPIRO: SGN - that is Some Good News, a program on YouTube hosted by John Krasinski. This week, he interviewed a little girl named Aubrey who had been excited to see a performance of "Hamilton" until it was canceled due to the coronavirus.
(SOUNDBITE OF YOUTUBE VIDEO, "ZOOM SURPRISE: SOME GOOD NEWS WITH JOHN KRASINSKI EP. 2")
KRASINSKI: For more on this story, we go now to our heartbreak correspondent, Aubrey.
AUBREY: Hi.
KRASINSKI: I heard you're a big "Hamilton" fan.
AUBREY: Mmm hmm.
KRASINSKI: Scale of one to 10, what do we think? Are we a seven or eight or...
AUBREY: Million.
SHAPIRO: As the two continue chatting, people start popping up on the video chat.
(SOUNDBITE OF YOUTUBE VIDEO, "ZOOM SURPRISE: SOME GOOD NEWS WITH JOHN KRASINSKI EP. 2")
LIN-MANUEL MIRANDA: Hi, Aubrey. How are you?
AUBREY: Good.
MIRANDA: I'm sorry you didn't get to see "Hamilton." I'm so glad to meet you.
(SOUNDBITE OF SONG, "ALEXANDER HAMILTON")
AUBREY: That's my favorite song from "Hamilton."
SHAPIRO: In case you didn't recognize the voice, that is Lin-Manuel Miranda, and he led the original Broadway cast of "Hamilton" serenading Aubrey all from their homes.
(SOUNDBITE OF SONG, "ALEXANDER HAMILTON")
CHRISTOPHER JACKSON: (As George Washington, singing) Something new inside, a voice saying...
UNIDENTIFIED ACTORS: (As characters, singing) Alex, you gotta fend for yourself.
JACKSON: (As George Washington, singing) He started retreatin' and readin' every treatise on the shelf.
LESLIE ODOM JR: (As Aaron Burr, rapping) There would've been nothin' left to do for someone less astute.
SHAPIRO: I want to know how we can make our workplace video calls sound that good.
(SOUNDBITE OF SONG, "ALEXANDER HAMILTON")
ODOM: (As Aaron Burr, rapping) Started workin', clerkin' for his late mother's landlord, tradin' sugar cane and rum and all the things he can't afford. Scammin' for every book he can get his hands on...
SHAPIRO: I'm Ari Shapiro. We will be back tomorrow answering more of your questions. If you have a question for us, go to npr.org/nationalconversation or tweet us with the hashtag #nprconversation.
(SOUNDBITE OF SONG, "ALEXANDER HAMILTON")
UNIDENTIFIED ACTORS: (As characters, singing) In New York, you can be a new man. In New York, you can be a new man. In New York, you can be a new man. In New York, New York...
MIRANDA: (As Alexander Hamilton, singing) Just you wait.
UNIDENTIFIED ACTORS: (As characters, singing) Alexander Hamilton, Alexander Hamilton, we are waiting in the wings for you.
SHAPIRO: This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED from NPR News.
(SOUNDBITE OF SONG, "ALEXANDER HAMILTON")
UNIDENTIFIED ACTORS: (As characters, singing) You never learned to to take your time... Transcript provided by NPR, Copyright NPR.
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