Answering Your Coronavirus Questions: Medicine, Social Distancing And Mental Health
NPR
Tuesday, April 7, 2020
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On this broadcast of The National Conversation, we'll answer your questions about a medication some are suggesting could help coronavirus patients, social distancing and how to care for your mental health right now.
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On this broadcast of The National Conversation, we'll answer your questions about a medication that some suggest may help patients, social distancing and how to care for your mental health.
Transcript
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PRESIDENT DONALD TRUMP: We're seeing tremendous evidence that African Americans are affected at a far greater percentage than other citizens of our country.
SCOTT SIMON, HOST:
COVID-19 has hit some groups harder than others. It's Tuesday, April 7. And it's THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED from NPR News.
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SIMON: I'm Scott Simon. Coming up, to shop or not to shop?
KATHERINE: Should I avoid buying things online that I don't absolutely need?
SIMON: Our reporters and experts have answers to your questions about COVID-19 all hour, from social distancing to taking care of your mental health.
UNIDENTIFIED PERSON #1: How can you feel less lonely when you're supposed to be alone?
SIMON: You can send us your questions by going to npr.org/nationalconversation or you can ask using the hashtag #nprconversation. But first, we have the news.
This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED. I'm Scott Simon. Good to be with you. We're here each night to answer your questions. We have NPR journalists and outside experts here to offer solid facts and to try to correct some of the misinformation that's floating around. Today, we've got answers about the latest efforts in the U.S. to try to stop the virus. We got many questions about a medication that some suggest could help coronavirus patients. Plus, your questions about social distancing and how to care for your mental health right now. You can send us your questions about all these topics and more at npr.org/nationalconversation. On Twitter, you can use the hashtag #nprconversation.
Each night, we begin THE NATIONAL CONVERSATION by answering the question, what happened today? New York reported hospitalizations dropped, but there were 731 deaths since Monday, and that's a new high. Here's Governor Andrew Cuomo.
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ANDREW CUOMO: Behind every one of those numbers is an individual, is a family, is a mother, is a father, is a sister, is a brother. So a lot of pain.
SIMON: Governor John Bel Edwards said that new data shows the coronavirus is having a disproportionate toll on African Americans in Louisiana.
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JOHN BEL EDWARDS: Disturbingly, this information's going to show you that slightly more than 70% of all the deaths in Louisiana are of African Americans.
SIMON: President Trump said that this early picture of the national data also shows African Americans being hit much harder by the virus.
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TRUMP: It's not good. I don't like it. And we're going to have some very good statistics, Tony, I think over the next couple of days.
SIMON: The acting secretary of the U.S. Navy resigned today. He'd come under criticism for how he handled the dismissal of a commander of an aircraft carrier who'd raised alarms publicly about a coronavirus outbreak on his ship. And in Israel, Prime Minister Benjamin Netanyahu said that no one will be able to leave their homes tomorrow night. The government is trying to prevent large gatherings for Passover celebrations. Around the world, there are 1.4 million confirmed infections and more than 82,000 deaths.
NPR's Scott Horsley, our chief economics correspondent, joins us now to answer your questions about the White House briefing and more. Scott, thanks for being with us.
SCOTT HORSLEY, BYLINE: Good to be with you.
SIMON: During the White House briefing, one of the key phrases from public health officials was stabilization in areas with outbreaks. What's that mean exactly?
HORSLEY: Well, as you mentioned, this was another difficult day in New York with a record 731 deaths. But we know there is a long lag time with the coronavirus, and the people who died in New York in the last day or so may well have been infected before we even began our national experiment in social distancing.
What health professionals were talking about in the briefing is they are beginning to see signs that experiment is working. And in particular, they pointed to the West Coast, where some of the first stay-at-home orders were issued. Washington state and California have seen encouraging results. In fact, California health officials now feel comfortable enough with where they are that they've actually sacrificed some of their precious ventilators, donating them to other states that are now coping with steeper infection curves.
SIMON: Scott, millions of Americans, of course, still waiting for benefits from the relief passage - package that Congress passed. We have lots of questions, apparently, on that topic. And let me get you to listen to this one from Mary (ph).
MARY: I'm from Long Island, N.Y., living in Ireland for the past three years. I earn a very small income - under 5,000 - for rental property. Will I qualify for the COVID-19 personal payment, as I do not qualify for any aid here?
SIMON: Scott, what's your judgment?
HORSLEY: Mary should be eligible for that payment. The question is how will she receive it? I'm guessing if her income is under 5,000, she may not have filed a U.S. tax return for the last couple years. If that's the case, she may need to somehow communicate her bank information to the government so that they can expedite the payment without the delays that would be involved in sending a paper check overseas. If she has filed a tax return, she's good. Likewise, if she's receiving Social Security benefits by direct deposit, she should be in good shape as well.
SIMON: Wren (ph) in San Francisco has a question about how some people will get that relief payment.
WREN: I understand the $1,200 we are getting is an advance tax credit and that it will be deducted from our 2020 tax return. But what if you don't typically receive a tax refund? Will you now owe an extra $1,200 next year when you pay your taxes?
SIMON: Scott, what do we know about that?
HORSLEY: No. They're calling this an advance tax credit, but don't think of it as an advance on next year's refund. It's sort of an extra special bonus. So even if Wren is not otherwise eligible for a refund next year, Wren would not be in a position to have to pay this money back.
SIMON: Howard (ph) in Woodland, Calif., has a question about Social Security and the payments.
WREN: I understand the $1,200 we are getting is an advance tax credit and that it will be deducted from our 2020 tax return.
SIMON: I think we've got the - we're replaying that. Let's go to Howard in Woodland, Calif.
DOUGLAS: In the stimulus package, there is money set aside for small-business loans to pay their employees. Where do you apply for those loans?
SIMON: That, apparently, is Douglas (ph) in Austin. My apologies for any mix-up. Scott Horsley, any advice for Douglas?
HORSLEY: So Douglas should be able to apply for these loans at any FDIC-insured bank. They started processing those loan applications last Friday. Now, there have been some hiccups. There's been, as you can imagine, lots of small-business interest in those loans. Already, they have awarded some 70 billion of the $354 billion that Congress set aside for that. They are ramping up, though. Big banks and small banks are getting their act together and beginning to process those loans. And today, the administration said it's going to go back to Congress and ask for another $250 billion to help small businesses get through this rough patch.
SIMON: Scott, a lot of conversation going on in this country about the supply chain and how many workers it takes to keep things going - food in the store, medications in the pharmacy. Here's a question here from - about that from Katherine (ph) in Philadelphia.
KATHERINE: Should I avoid buying things online that I don't absolutely need? Am I taxing companies and the Postal Service unnecessarily, or am I helping the economy?
SIMON: Good question. Are we jeopardizing the people who are helping to enhance our lives at the moment?
HORSLEY: It is a good question. I think Katherine's obviously thoughtful about this. We - I do know that Amazon, for example, is prioritizing the delivery of essential items, like medical supplies. So Katherine doesn't have to worry that, you know, a scented candle or some other discretionary item is going to take up space on the delivery truck that would otherwise go for a box of N95 face masks.
It's also true that a lot of smaller merchants are very grateful right now for online purchases, especially at a time when their brick-and-mortar stores might be closed to the public. So I think you are safe to order discretionary items with a clean conscience. But it is a good question that Katherine poses and probably a good reminder for all of us that we do need to think about how our shopping, along with our other activities, might be affecting the bigger distribution network during this heavily taxed time.
SIMON: All right. NPR's Scott Horsley, chief economics correspondent, thanks so much for being with us.
HORSLEY: It's my pleasure, Scott.
SIMON: And we also have NPR science correspondent Jon Hamilton joining us now. Jon, thanks so much for being with us.
JON HAMILTON, BYLINE: My pleasure.
SIMON: President Trump today, among others, talked about how the early data appears to show the virus is disproportionately affecting African Americans in the United States. There are a number of factors that may contribute. What's the current reasoning on why this happens to be the case?
HAMILTON: Well, it's really hard to know what's going on, at least at this point. There have been some real differences in deaths, but the data are preliminary. They're only from a few cities. What it shows is that there really is a reason to be concerned.
I was really struck by what Dr. Anthony Fauci, who spoke after the president, said. You know, he did not outright confirm the president's suggestion that coronavirus is somehow infecting more African Americans than other people. That's just not clear. What he did was talk about the long history of health disparities that have affected African Americans. He also noted that there are a number of underlying health problems, like diabetes and high blood pressure, that are more prevalent in black Americans. And what that means is that among African Americans, there is reason to think that their risk of dying if they do get the virus is significantly greater.
SIMON: Let me follow up. People who are poor, people who haven't had a lot of medical care in their lives are more vulnerable now during the coronavirus. Is that fair to say?
HAMILTON: Absolutely. It's - the thing that's clearest is that, you know, if age - with age, your risk increases, and also with what they call underlying health problems. So all of these things - high blood pressure, diabetes, heart problems - all those greatly increase your risk of dying. And so if you're talking about a group where those problems are more prevalent, there is real reason to be worried.
SIMON: Lots of questions from listeners about the spread of the disease. Let's listen to one.
ANNA NICHOLAS: This is Anna Nicholas (ph) from Portland, Ore. Experts are saying there's no natural human immunity to COVID-19, so how is it that some people exposed, who don't already have antibodies, do not become sick? How can someone not be immune if they're able to spread the virus without ever manifesting symptoms?
SIMON: We're coming to the end of the segment. Is there a simple answer to that, Jon Hamilton, or do we have to discover it?
HAMILTON: Simple answer is that it's just not clear. I mean, with coronavirus, what seems to be the case is that there are very few people who don't have symptoms and still spread the virus, but there are a few.
SIMON: OK. Thanks very much, NPR's Jon Hamilton.
You can hear much more of our extensive coverage if you download the NPR One app. You can go to the Explore tab and click on The Coronavirus Outbreak for a curated stream of stories. If you have questions, that's why we're here. Go to npr.org/nationalconversation. Reach us on Twitter with the hashtag #nprconversation.
A lot of talk about whether or not there's medication to treat coronavirus patients. We have answers on that right after this.
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SIMON: This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED from NPR News.
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SIMON: This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED. I'm Scott Simon. Over 82,000 people in the world have died from the coronavirus to date. The global medical community, of course, has been working around-the-clock to try to make a vaccine. While COVID-19 cases increase by the thousands, the use of various medications has been widely debated.
You've submitted so many questions on this topic, and we have some answers. We're joined now by Dr. Jinoos Yazdany, a rheumatologist from the University of California, San Francisco, and NPR science correspondent Joe Palca. Dr. Yazdany, let me apologize in advance if I mispronounced your name. I'll try and do better next time. Let me ask both you and Joe Palca first. One drug we've been hearing a lot about, of course, is hydroxychloroquine. Before we go into answering questions, what is it?
JOE PALCA, BYLINE: Well, Scott, this was a drug that was originally developed I think around World War II as an alternative to quinine to treat malaria. And then at some point, people noticed that it had an interesting and positive effect on patients with rheumatoid arthritis, so it was used for that for a while. It seems to have some impact on the immune system.
And then at some point again, people decided to try it, since they were trying a lot of things, as a therapy for this new coronavirus. And the first evidence was that from testing it in the laboratory, it looked fairly promising, but these were just cells, of course. So then they tried it in people, and there was some limited success in China, a small study, and there was some limited studied success in France. And it suddenly caught on. Now, why we're talking about it - well, I think that has a lot to do with our president, who's been relentlessly pushing it and saying how confident he is that it'll be helpful.
SIMON: With that, I'll introduce our first question from David (ph) in Houston.
DAVID: I was wondering why Trump and his administration are pushing hydrochloroquine (ph) when infectious disease expert Dr. Anthony Fauci has argued against its effectiveness in the fight against COVID-19.
SIMON: Dr. Yazdany, thanks again for being with us. What do doctors, scientists, health care workers say about this?
JINOOS YAZDANY: It's a great question from David. Some very small, poorly controlled or uncontrolled studies from France and China demonstrated that hydroxychloroquine may have benefit. But the studies really had serious methodologic flaws when we reviewed them carefully. And therefore, you know, this evidence should be considered inconclusive at this time. The bottom line is that the treatment is experimental, and we need randomized, well-controlled trials to know if hydroxychloroquine is useful at all to treat COVID-19.
SIMON: Another question from Ellen (ph) in Poughkeepsie, N.Y.
ELLEN: I've been taking hydrochloroquine (ph) for 10 years for rheumatoid arthritis. Does this afford me any protection from the virus?
SIMON: Dr. Yazdany, any evidence?
YAZDANY: So we don't have any evidence at this time that people with rheumatoid arthritis or lupus taking hydroxychloroquine are protected from COVID-19. In fact, data that we've collected over the last few weeks suggests that people with these conditions are getting infected. I'm, therefore, telling my patients not to let their guard down. They should continue to follow strict social distancing if they can.
SIMON: Nancy (ph) in California has a question that kind of grows out of that. She writes, I'm concerned that the interest in the drug as a possible treatment for coronavirus will restrict the availability of the drug for legitimate uses. Are you concerned about that, Doctor, for you and your patients?
YAZDANY: I am concerned about drug shortages. And we're hearing about them from patients all over the country. This can be a serious problem because interruptions in treatments can lead to autoimmune disease flare-ups. And so I'm recommending that my patients call different pharmacies in their area, including mail-order pharmacies, if they're running into shortages.
SIMON: If you have a question, by the way, for Dr. Yazdany and NPR's Joe Palca, you can send it to us at npr.org/nationalconversation or share it on social media using the hashtag #nprconversation.
Lots of questions also about Advil and ibuprofen. Here's Jordan (ph) from Sacramento.
JORDAN: Should I avoid taking ibuprofen right now during this pandemic? I work inside a medical center in Sacramento. We haven't experienced a surge of COVID patients yet, but we are preparing for it if it does come. I've heard that taking ibuprofen feeds coronavirus. Is that true?
SIMON: Dr. Yazdany, does it?
YAZDANY: So, Jordan, at this time, there's no evidence that ibuprofen is harmful. Now, this concern initially arose because the SARS coronavirus, too, the virus that causes COVID-19, binds to our cells via a receptor called ACE2. And this receptor is increased in ibuprofen - by ibuprofen in animal experiments, and so there was really a hypothetical concern that this might worsen infection in humans. However, we can't extrapolate those animal experiments to humans, and we don't have any data to this effect in humans.
SIMON: What about Tylenol?
YAZDANY: Tylenol is safe to take, and it might even be a better choice for older patients because it has a better safety profile for people that have underlying conditions like kidney disease.
SIMON: Next question is about food supplements - Paul (ph) in New York.
PAUL: I understand the immune response can be one of the causes for lung or other organ failure. Is it dangerous to take too many immunity supplements, including zinc, vitamin C?
SIMON: Dr. Yazdany, is the immune response partly responsible for organ failure? What do we know about food supplements under these circumstances?
YAZDANY: So they - the immune response can actually cause serious problems in the later stages of COVID-19, so it's a legitimate concern. We don't know if supplements help a COVID-19 infection. And usually, supplements taken at low or recommended doses are safe. But I would avoid taking megadoses of these vitamins. Vitamin C and zinc can cause nausea or other gastrointestinal symptoms. And high doses of vitamins like vitamin D can cause even more serious problems like high blood calcium levels. And so I would recommend caution.
SIMON: Sharon (ph) from Texas asks, have patients who got seasonal flu shot get well quicker or have fewer symptoms? What about those who got a pneumonia shot? Let me ask you, Dr. Yazdany, any correlation?
YAZDANY: An excellent question, Sharon. Vaccinations against flu and pneumonia can be helpful. And that's primarily because they decrease the risk of having a simultaneous infection with COVID-19. We have been seeing reports of patients who are co-infected with viruses like flu and COVID-19, and we worry that this will lead to a more severe disease course.
SIMON: Dr. Jinoos Yazdany is a rheumatologist at the University of California, San Francisco. Thanks for being with us. And NPR science...
YAZDANY: Thank you.
SIMON: ...NPR science correspondent Joe Palca. If you have questions for us about small businesses or child care, please let us know. You can send us your questions to npr.org/nationalconversation. Or on social media, you can use the hashtag #nprconversation.
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SIMON: You are listening to THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED from NPR News.
This is THE NATIONAL CONVERSATION FROM ALL THINGS CONSIDERED. I'm Scott Simon. Coming up, your questions about what's safe to do when you're trying to socially distance.
UNIDENTIFIED PERSON #2: They just opened up a drive-through testing center at the building in front of our neighborhood. Is it still safe for families to walk in the neighborhood being that close to a testing center?
SIMON: Now the news.
This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED. I'm Scott Simon. The U.S. is now several weeks into a different way of living. It is nearly impossible to imagine several months ago. Over 300 million Americans are now under orders to stay home. When people do leave their homes, they're told to stay at least 6 feet from each other. Friendships and relationships are on hold or only taking place digitally. Adjusting to this new reality has been confusing for many people, and you've submitted lots of questions about this. Here to try and answer those questions is Celine Grounder (ph). She's a professor at New York University, where she's an epidemiologist and infectious disease specialist. And we're also joined by NPR science correspondent Jon Hamilton. Welcome back to both of you.
HAMILTON: Hi.
CELINE GOUNDER: Thank you.
SIMON: Jon, let's start with a basic question we got from a listener who asks, after mass self-isolation and quarantine, why is the number of cases still increasing?
HAMILTON: Yeah. I mean, it does seem to be - right? - even - it doesn't look good right now. And there are a couple of reasons why things are actually better than they may appear. One of them has to do with testing, right? So we're testing many, many more people than we were a few weeks ago. When you do more tests, you find more cases, so it can look like the number of infections is rising even if it's not.
And another reason we aren't seeing great improvement yet or don't seem to be is that there is this big delay between when people change their behavior and then when you see a decline in the number of new infections and deaths. So you've got the incubation period, the time between exposure and symptoms. That can be 14 days with coronavirus. Then there's the disease itself, which can take weeks to run its course. So what all that means is that even dramatic changes in behavior can take a month or more to show up in the statistics.
SIMON: Dr. Grounder (ph), another question about social distancing and what it can or can't accomplish. Keri Maine (ph) of California sent this to us.
KERI MAINE: Given that the virus is so widespread, couldn't we consider the idea of isolating the most vulnerable population, which is the elderly and those with underlying health conditions, and let the general population mostly resume normal activity?
SIMON: Dr. Gounder, before you reply to this very important question, my apologies, Dr. Gounder, please.
GOUNDER: So very good question, and there are two reasons why that does not make sense. So the first one is that young and healthy people are at risk for very severe complications from this. About 20% of the patients we're seeing in intensive care units on ventilators in New York City right now are those young and previously healthy people. So they are at risk for very severe complications.
And then secondly, they are contributing. Even if they have no symptoms or very mild symptoms, they're contributing to onward spread of the disease in the community. And so in other words, they're bringing it home to you, the parents, to you, the grandparents. And so unless you completely lock them down, which is what you're arguing against, you know, they are going to be infecting others. And so that's exactly what we're trying to prevent here.
SIMON: Jon Hamilton, let me turn to you. Based on your reporting, what experts have told you, what we've seen in other countries, what conditions would have to be met in this country before some social distancing measures might be relaxed?
HAMILTON: Well, I mean, obviously, there's no precise answer to that question. But, I mean, obviously, at a minimum, you need to have the number of new infections falling, not rising. That would be a good start. And it probably is useful to look at some of these other countries, like South Korea. You know, right now, that country is finding fewer than 100 new cases a day, so, like, all the measures they put in place have really paid off. And I think that is the kind of clear signal that the U.S. would like to see before it relaxes any of the measures to slow down coronavirus.
SIMON: Dr. Gounder, I hope this doesn't put you on the spot. You're - absolutely possible to say we have no idea. Any sense of when that might be?
GOUNDER: Oh, no. I have no problem answering that. I'm also an epidemiologist. So there are a number of factors we have to look at here. So not only do you need to see a peak in infections and cases and deaths, you also need to see a number of other things. So first of all, what we see today is reflective of what was happening 14 days ago. So we need to see a sustained reduction in infections and cases and deaths for 14 days because that reflects where we are today.
And in addition to that, there are a few other things we really need to be able to do. We need to be able to test people who have symptoms. We are still not able to do that today. Our testing capacity is really not where it needs to be. We need to be able to trace chains of infection. So what does that mean? We need to be able to say Person A infected persons B and C. Person C infected persons D and E, and so on. And we're nowhere near being able to do that because right now, there is so much infection. It's like a big spaghetti bowl. It's not where you can actually make those connections. So there are a lot of things that need to happen before we can do that safely.
SIMON: So people who want a timetable, they should instead be looking for a number of particular problems to be resolved, and then we can think in terms of 14 days?
GOUNDER: Yeah, I think that's right. And I think the problem right now is you don't have consistent social distancing happening across the country. In fact, cellphone data which looks at, you know, how much people have moved from their home place to other places in the community would indicate that the southeast and the Midwest in particular, people are not staying put. They're not abiding by this, and so they are going to be risks to the rest of the country for basically reinfection, reintroduction of infection. So even if we stay put here in New York City and we go through our peak, these other parts of the country - not only will they have delayed peaks in their own, you know, issues with transmission and disease and death, which I think is terrible because it's preventable, but then they also present risks of reinfection to those of us who've passed our own peaks. You know, and so you're basically playing whack-a-mole where this is going to keep arising all over the country.
SIMON: I want to pass along a question from a listener in Britain who writes, my father's 92, has chronic heart fatigue. He's not going out at the moment and has a few hours care during the week. Can I go and see him if I keep my distance or will I put him at risk?
GOUNDER: So I'm assuming that question's for me. So I...
SIMON: Oh, yes. I beg your pardon, Dr. Gounder. Yeah.
GOUNDER: That's OK. I assume she's saying he has congestive heart disease. And, yes, unfortunately, that is putting him at risk because the people we know who are at the highest risk for the worst complications of COVID-19 are patients who have underlying heart and lung disease. And her father, from what she's saying, has underlying heart disease. So he's one of the people we really need to be most protective of in terms of social distancing.
SIMON: Dr. Celine Gounder and NPR's Jon Hamilton, we have to take a short break, but please stay with us. This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED from NPR News.
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SIMON: Dr. Celine Gounder is a professor at New York University. She is an epidemiologist and infectious disease specialist. She's joining us tonight with NPR science correspondent Jon Hamilton to take your questions about social distancing. Thanks again, both of you, for being with us. Dr. Gounder, Jane Mooney (ph) of Oregon, Wis., has a question about running errands.
JANE MOONEY: I try to go out as little as I can, but I wonder about the number of stops I make. I can't get everything at one place, so I wonder if it's better to grocery shop, pharmacy, hardware, for example - do the trips in one day, or should I make a trip on separate days? Thank you.
SIMON: Dr. Gounder.
GOUNDER: Honestly, I'm not sure that there's that much of a difference. I mean, I might veer toward trying to do it all in one day. But if you think about it, it's really about how infectious are you potentially at that point in time? How many minutes or seconds or hours - whatever you want to measure it by - that you are exposing yourself to other people, and how likely are they to be infected? I suppose to some degree, it depends on if the virus has really hit your community. And if it hasn't hit yet, I would probably veer towards trying to do as many errands as possible before it's really hit but, at the same time, really trying to minimize that to what's really truly essential.
SIMON: Jon Hamilton, I want to throw a question to you that one of our listeners wrote in. A friend is planning to move in with me. She and I both have self-quarantined for 14 days, but what if one of us has the virus and is asymptomatic? How long before you can safely know that we won't infect each other?
HAMILTON: Yeah. Well, you know, part of the problem when people invoke things like safely is safe is somewhat subjective - right? - and there are degrees of safe. There's no such thing as zero risk with infection or anything else. But if two people have really avoided any possible exposure for 14 days, I mean, that's pretty safe. And, you know, the evidence keeps piling up that very few people spread the virus without developing any symptoms. Of course, if you really want to minimize risk, both people could get tested. I think the gold standard now is - what? - two negative tests a day apart. And if you both did that, I guess you would be about as safe as you could possibly get without being alone.
SIMON: Dr. Gounder, let's turn back to you. Millions of Americans, and not just young people, have roommates, co-living arrangements these days. Laurie (ph) in Davis, Calif., says she lives in a co-housing community where there is a divide among residents about common spaces. And this is the message she left us.
LAURIE: There are those who are more hardcore about not leaving their homes unless absolutely necessary and the softcore folks, I call them (laughter), who feel that it's OK to do more things, like, in the common areas and in general as long as they're very careful and obey the safety rules. Do you have an opinion about is one group right or - I know it's hard to say right or wrong, but how do we resolve the differences?
SIMON: Well, we've got about 20 seconds left, Dr. Gounder.
GOUNDER: To me, it's more of a question of how do you define your household and how do you create the bubble of your household? So you want to have an impermeable bubble. Nothing goes in or out. And so if you can secure that household as such, that would be the way to do it.
SIMON: Dr. Celine Gounder at NYU, thanks very much, and NPR science correspondent Jon Hamilton. If you have questions, you can send them to us at npr.org/nationalconversation or on social media.
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SIMON: This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED. I'm Scott Simon.
In times of stress, it can be helpful to find comfort in others, but one of the ironies of the coronavirus is that all the forms of connection we're used to - close conversations, pats on the back - are potentially dangerous. The best way to stop the virus from spreading, of course, is to be physically alone. A lot of you told us in your questions that you're struggling with that physical distance, so here to try and talk to us about all that is Dr. Sudeepta Varma. Dr. Varma, thanks so much for being with us.
SUDEEPTA VARMA: Thank you, Scott. Thank you for having me tonight.
SIMON: I gather you've studied and dealt with a lot of disasters, including 9/11 and the effects of trauma on people. How is this the same? What's different? What stands out to you now?
VARMA: Yes. So what stands out to me is the fact that, as you pointed out, that we don't have the same methods to relieve our anxiety and to connect us the way that we used to. So typically, after every disaster, you have people getting together, hugging each other, whether reuniting in some form or even grieving together in the cases of loss and death, and people are not dying alone.
And I think that's what makes this so hard is that we don't have the normal - both comfort systems. We don't have the opportunity for oxytocin, which is a neurotransmitter and a hormone that's secreted when we are in close contact with people. And we also don't have the opportunity to be able to distract ourselves in all the normal ways, with entertainment and sports games and all of those things. So this is becoming doubly hard because we don't have all of these usual outlets for ourselves.
SIMON: We've got a question. We'd like you to hear from Laurel (ph) in Somerville, Mass. This kind of tears at me. Here's what she talks about about being alone right now.
LAUREL: It really bothers me that there doesn't seem to be anything useful I can do on my own. I'm also thousands of miles from family, and I'm worried for them but, again, feel unable to do anything to help if something were to go wrong. At least we've all gotten better at talking to one another - lots of Zoom calls.
SIMON: So, Dr. Varma, I mean, I think all of us would understand that, yes, you can talk to your family members and people you're close to, but you can't really help them. How do you handle that?
VARMA: Yes. So first of all, just acknowledging the experience of the helplessness. And we don't want that feeling of helplessness to become so pervasive that it can lead to a depression because that is a common pathway for some people. And I would say that help in whatever way you can. You know, I had a friend of mine. She was sending bottles of water to her parents and setting up carts for Amazon for them or to get grocery deliveries in their neighborhood, even from miles and miles away. And I recognize that that's not necessarily going to be feasible or financially possible for everybody. Even asking your parents - if you have elderly parents or elderly relatives, for the neighbors to check in. And so there are ways to get creative.
But the key here is to not feel helpless. And a way that I do that is trying to break down - if we're feeling worried, we have to break down into productive worry, which fuels action, and unproductive worry, which is really kind of like the wheels stuck in the mud. They're spinning, but they're not going anywhere. So ask yourself, is there anything to be done? And if there is, do it. And if not, then you have to let go. And that's where the mental health and the coping element come into play.
SIMON: A question now from someone who was dealing with something rough even before this happened. He went through a breakup. Let's listen.
UNIDENTIFIED PERSON #1: I'm single, and I've just broke up with my girlfriend a few months ago. And now, when I'm sitting in my room alone, I've started to have those flashbacks and anxiety attacks, and I think that my brain is just trying to process that. How can you feel less lonely when you're supposed to be alone?
SIMON: Boy, that's the question for these times, isn't it, Dr. Varma?
VARMA: You know, and I'm - what I'm so struck by hearing is that here, the person that might've been a support system isn't going to be able to be there for you right now, right? And breakups don't follow a linear path necessarily. And what I'm finding is some people are turning back to their ex as a source of support, and they recognize that it's kind of taking them one step back and it may not be helpful in the long run. But I say all is fair in love and war, and we have to - we're in - for some people, they're in the middle of both, negotiating both challenges. But there is a grieving process both in the relationship and then both in the reality and the external world that we're facing loss of freedom, loss of employment, loss of finances. There's multiple losses.
The key is to distract as much as possible and talk to other friends. Get a support system. Resist the urge to get on social media and find out what the ex is doing. And if you think it's healthiest to move forward, resist the urge to go back and ask them to be the support system for you.
SIMON: It's a bad time for people who have addiction problems, isn't it?
VARMA: Yes. You know, and we're finding that a lot of times, people are turning - initially, there were a lot of jokes and memes on the Internet about turning to alcohol and, oh, I got to get my bottle of wine if I'm going to be quarantined. And liquor stores were actually finding that their sales were going up because people were preparing for the times ahead when they were going to be alone. And this is a very well-known coping mechanism for a lot of people. And I think, look; the occasional glass or two of red wine is one thing, but when you're finding that you're not able to cope and that you need to - yeah, you know, we have to find healthier ways. You know, some - there's a SAMHSA Disaster Distress Helpline that I ask people to turn to, and also aa.org, which is Alcoholics Anonymous.
SIMON: Dr. Sue Varma, thanks so much for being with us.
VARMA: Oh, my pleasure. Thank you for having me.
SIMON: But this is a season for renewals. Easter Sunday is this weekend. And this week is, of course, also Passover.
UNIDENTIFIED CHILD #1: (Singing in Hebrew).
SIMON: When young children ask the four questions at Passover Seder dinners all over the world this year, a lot of smiles might follow this ancient query.
UNIDENTIFIED CHILD #1: Why is this night different from all other nights? (Speaking Hebrew).
UNIDENTIFIED CHILD #2: Why is it that on all other nights, we eat leavened bread or matzah and on this night, only matzah?
UNIDENTIFIED CHILD #3: On all other nights, we eat vegetables.
SIMON: A lot of Seder dinners this week and Easter dinners this weekend will have to be small and maybe virtual, with relatives and friends appearing only as faces on phone screens and laptops. At that point in the Seder where a glass of wine is poured and a door is opened so Elijah, the prophet, may enter, people may ask, because a Seder dinner is incomplete without joking, wait; is Elijah wearing a mask? Make sure he washes his hands.
But over centuries, some families have had to celebrate Seder or Easter dinner surreptitiously in some places because of persecution, not pandemic. The occasions can still be celebrations this week to remind us of how people have survived treacherous times in the past and our dinners and services small as we stay at home, expanded as we call out to each other with new technology, can remind us to treasure each other across the table, on the screen from the other side of the world and in our hearts and memories. This spring holiday season, we may discover new ways to be together and cherish all the more the people we wish could be right beside us.
I'm Scott Simon. We're going to be back tomorrow with more of your questions. And if you have a question for us, please go to npr.org/nationalconversation, or you can tweet us with the hashtag #nprconversation.
(SOUNDBITE OF MUSIC)
SIMON: This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED from NPR News. Transcript provided by NPR, Copyright NPR.
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