Your coronavirus questions, answered (Part II)

[Sound of a news broadcast]

Sean Rameswaram: It's Friday, March 27, 2020, and Bojo has come down with COVID-19. I'm Sean Rameswaram, and this is your coronavirus update from Today Explained. The United Kingdom's Prime Minister Boris Johnson has tested positive. He says he has mild symptoms and will continue to lead the kingdom while in self-isolation.

[Sound of a news broadcast continues in the background]

Sean Rameswaram: In Italy, almost 1,000 people have died as a result of COVID-19 in a single day. That's the highest daily death toll yet and brings Italy's national death toll close to 10,000, higher than anywhere else in the world. Only a few people have died at this point in South Africa, but there's been a surge in confirmed cases there. It's now the center of the pandemic on the African continent with more than 1,000 cases. The government ordered most of South Africa's 59 million people to stay at home for the next three weeks. It's the biggest stay-at-home order on the continent. But it's the United States that now has the most confirmed COVID-19 cases in the world. Almost 100,000 people here are known to be infected. The actual number of confirmed cases, again, is surely much higher than that.

[Sound of a news broadcast fades out]

Sean Rameswaram: According to CNN, Michigan is seeing a huge surge in cases from something like 300 last week to something like 3,000 confirmed cases this week. Cities and states around the country are still struggling with critical shortages of medical supplies and protective equipment for health care workers. The president now appears to be pushing for American industry to make ventilators, at least on Twitter. He tweeted earlier today, General Motors must immediately open their stupidly abandoned Lordstown plant in Ohio or some other plant and start making ventilators now. Ford, get going on ventilators fast at General Motors at Ford. There were a lot of all caps moments peppered throughout there. He seems like he's handling this well, but it's not all negative. Millions of people across the United Kingdom took to their balconies and doorsteps and car horns on Thursday to applaud in unison the work of the National Health Service. And you too can show your appreciation for your healthcare, sanitation, grocery store, and delivery workers, restaurant workers, everyone. I'm sure every little bit helps.

[Sound of a news broadcast returns]

Sean Rameswaram: If you've got questions about the coronavirus pandemic, we'll try and answer them. Tweet at today underscore explained or at Ramas Firm, email today explained at vox.com or call 202-688-5944. Keep in touch, but please don't touch. Support for Today Explained comes from the FIFA World Cup of all things. The FIFA World Cup 26 is coming to North America next summer. It is the ultimate celebration of sports and culture. You can get closer to the beautiful game with a hospitality package, closer to the action, the best seats, the best suites, closer to match day and that world-class food and that world-class entertainment, closer to the experience of a lifetime. Book a hospitality package at fifaworldcup.com slash hospitality.

[Sound of a news broadcast fades out]

Sean Rameswaram: This message is brought to you by Apple Card. Each Apple product, like the iPhone, is thoughtfully designed by skilled designers. The titanium Apple Card is no different. It's laser-etched, has no numbers, and it earns you daily cash on everything you buy, including 3% back on everything at Apple. Apply for Apple Card on your iPhone in minutes. Subject to credit approval, Apple Card is issued by Goldman Sachs Bank USA, Salt Lake City Branch. Terms and more at AppleCard.com.

[Sound of a news broadcast returns]

Sean Rameswaram: Last Friday, we tried something new on Today Explained. We opened up the show to your questions. We talked about TP and about sex and how to help others during this crisis. Today, we thought we'd try it again because your questions keep coming via Twitter, via email, and our nifty new listener voicemail line. Hi, my name is Grace. I'm calling in from San Francisco, California. My question is, why are so many people not paying attention to the shelter-in-place warning? I went to the Dolores Park, one of the big parks in the city yesterday, to do like a quick yoga and like hit class off of this app on my phone that I downloaded. So I wasn't just stuck inside all day. And I noticed that while there were a lot of people doing something similar or going outside for walks, there also seemed to be a good number of people still, you know, hanging out in big groups and not maintaining that social distancing. What are those people thinking?

[Sound of a news broadcast fades out]

Sean Rameswaram: Yeah, I think a lot of people probably think that they're invincible. We called Eleanor Cummins for an answer. She's a science journalist based in New York City. I also live really near a park. I live right on Prospect Park in Brooklyn. And I've been taking daily walks, which has been so great for my mental health. I imagine a lot of the people you're seeing are younger adults who have probably heard, based on data coming out of China, that younger people aren't as susceptible to the coronavirus, that this is really a disease that affects people 60 and older. But, you know, there's new data coming out that suggests that in the United States, 38% of people hospitalized with the coronavirus are under the age of 55.

[Sound of a news broadcast returns]

Eleanor Cummins: And they probably also are experiencing some, you know, basic human psychology, right? Like the optimism bias, which is this idea that's really pervasive that you are the exception to the rule. So things that happen to other people that are terrible won't happen to you. That's really hard to battle. And even more so when the president's saying the cure can't be worse than the problem, while maybe your governor or your mayor is saying shelter in place, lock it down. These are mixed messages. Mixed messages have definitely been a big problem with the coronavirus. So a lot of state and local officials have been really clear on this threat from the beginning. But a lot of people are following the national discourse and they're hearing messages from President Trump and the White House that have kind of consistently underplayed the severity of this illness.

[Sound of a news broadcast fades out]

Eleanor Cummins: And so I think that that has been a real contributor to people sort of taking this a little bit more casually than they should be. And a lot of people have been pretty upset about what they see as an impingement upon their freedom and their liberty. And that is, you know, a completely valid response to some of this. This is something that most people in the United States have never experienced in their lifetimes. But that being said, what we're dealing with here is not a sort of traditional, personally held set of morals or ethics. What we're dealing with is public health ethics, which is a completely different paradigm for thinking through these problems.

[Sound of a news broadcast returns]

Eleanor Cummins: So if I say, you know, I have the right to do these things, this is about my personal liberty, a public health ethicist would say, well, I have the right to not be infected by you. And that's sort of the paradigm that we have to think through is the risk we pose to each other and the rights of other people, not just our personal rights. Eleanor Cummins wrote about why people aren't social distancing for Vox. Her piece is titled, I'll Do What I Want, Why the People Ignoring Social Distancing Orders Just Won't Listen. You can find it at Vox.com. She also writes a newsletter about death called The Pine Overcoat. You can find a link at her website, EleanorCummins.com.

[Sound of a news broadcast fades out]

Sean Rameswaram: Many of you wrote in with medical questions. And while we're not in the business of giving medical advice, check local listings for a medical professional, we did find a doctor with answers to some of your more technical questions. My name's Dr. Jason Farley. I'm a professor at the Johns Hopkins University School of Nursing and a nurse practitioner in the Johns Hopkins University School of Medicine. First up, an email from John. What are the differences in people that allow some to walk around asymptomatically and lay others flat out on the floor?

[Sound of a news broadcast returns]

Dr. Jason Farley: In all honesty, we don't actually know what makes some people, even young people, develop symptoms and others do not at this point. We have a lot of theories and a lot of hypotheses. First and foremost, we believe that children are exposed to multiple coronaviruses routinely, particularly when they're in around a lot of other children in daycare and school-like settings. So with coronavirus being one of the viruses that cause the common cold, it is possible that repeated exposures have provided some level of protection for our youngest kids. We also think that that might have some level of protection for younger adults.

[Sound of a news broadcast fades out]

Dr. Jason Farley: Also, we do know that as we age, our immune system is less responsive. And so you add older age and a slightly less well-functioning immune system with medical comorbidity like heart disease or respiratory disease. And you've set the stage for the perfect storm. Another listener, Kendra, emailed to ask about obesity. She wrote, I'm wondering if obesity is likely to cause complications in young or otherwise healthy individuals who contract the coronavirus. Both Italy and China have relatively low obesity rates as compared to most of the U.S., and I'm wondering if that could lead to a higher death toll for Americans.

[Sound of a news broadcast returns]

Dr. Jason Farley: Obesity does put people at greater risk of having cardiovascular and or respiratory health conditions that might increase their risk of a negative outcome with coronavirus. So obesity increases your risk of the diseases that when you get coronavirus, if you have those diseases, ultimately result in a bad outcome. But obesity by itself is not a risk factor for a bad outcome. So let's say you got two adults, both of which are overweight one with who's overweight and has hypertension and maybe another form of cardiovascular disease and or respiratory condition that person at the same weight as someone else who does not have those conditions is at greater risk because of the other conditions that obesity caused not because of obesity itself.

[Sound of a news broadcast fades out]

Dr. Jason Farley: And then one question we've gotten over and over once you get COVID-19 do you have immunity or can you get it again if and when you get over it? Yeah, immunity is one of our most important questions right now. Do you get it? We think you will. How long will it last? We don't actually know, but we're hopeful that it will last, you know, through, you know, potentially up to a year, maybe longer. But what we do believe, as like most respiratory illnesses, is that once you've recovered, you do develop some level of protective antibody. And we're trying to figure out and trying to explore how long that antibody will last.

[Sound of a news broadcast returns]

Dr. Jason Farley: Related, Hunter and Kim both emailed to ask how long you're contagious after you get it. Potential for spread after symptom resolution has been shown. We have a couple of the original patients who came back from Wuhan who developed active symptoms and we know from one of the patients, it was a 17-year-old male. He was positive on his test 14 days from the time his symptoms started. We've also heard from reports of patients who were on the cruise ship whose viral cultures remained positive for weeks, even though their symptoms had resolved. So the question is, is once symptoms resolve, are you developing antibody? Are those antibodies protecting you, right? Or will they show us that you have recovered? That's one thing.

[Sound of a news broadcast fades out]

Dr. Jason Farley: We don't know yet whether or not it will coincide with also not being able to transmit for a certain period of time. So right now, what we would recommend and what we've been suggesting to everyone is that if you become symptomatic, you self-quarantine for a minimum of 14 days. And that's based on the available evidence that we have at this point. Lastly, Stephen emailed to say, I've given blood all my life and I know my O-negative blood is needed, but no one addresses the question of coronavirus in donated blood. I have no symptoms, but like most, I have not been tested and may be positive but asymptomatic. How does American Red Cross ensure the safety of the blood supply?

[Sound of a news broadcast returns]

Dr. Jason Farley: So first and foremost, if you have any symptoms at all, don't donate blood. If you do donate blood and you possibly had coronavirus, it is very unlikely that you would be able to transmit coronavirus. We don't believe coronavirus is a virus that will be transmitted via blood. It is a respiratory virus. On the initial evaluations of patients from Wuhan we found no evidence of virus after symptom onset. Now that's important. No evidence of virus suggests that there would be very low likelihood of transmission in the bloodstream. And after symptom onset would be after someone had developed a fever, cough, and other symptoms of a flu-like illness, which would be something that would screen you out from donating blood anyway.

[Sound of a news broadcast fades out]

Dr. Jason Farley: Finally, we are experiencing a very large shortage of blood throughout the U.S. and around the world. And so we need people to be donating blood who are asymptomatic, fit, and meet normal blood donation criteria. Before we let the doc go, we asked him what the biggest question on his mind has been lately. The principal question is, will we be back to work right now by Easter? The prevailing epidemiology suggests that that is not a realistic timeline. Right now, we are continuing to see cases increase in New York and around the country. And I think in terms of the estimates of when case numbers might peak is all based on modeling. And when we do mathematical modeling to try to make estimates or really good educated guesses of how an epidemic will continue to respond to all the things that we're doing, to try to prevent it, it's hard to know what the assumptions of any model is.

[Sound of a news broadcast returns]

Dr. Jason Farley: But in general, the estimates that I've seen agree with sometime May to June timeline. But it's allergy season. We're moving into the spring. And so many people will be getting upper respiratory symptoms from just general seasonal allergies. And so we also need to be cognizant that there are many reasons why people cough or sneeze that are not coronavirus related. And just everyone take a deep breath and know that testing is coming not only for the virus itself, but also for antibodies to show that we have, you know, overcome the infection and hopefully develop some level of immunity. So I think that will help to allay a lot of people's fears once that testing is available and available widely.

[Sound of a news broadcast fades out]

Sean Rameswaram: I'm going to take a deep breath now. Dr. Jason Farley is a professor of nursing, an infectious disease-trained nurse epidemiologist, and a nurse practitioner in the Division of Infectious Diseases at the Johns Hopkins School of Nursing and Medicine. More of your questions coming after the break. Support for today's show comes from Adio. What is Adio? Adio is an AI-native customer relationship management system built specifically for the next era of companies. They say it's extremely powerful, adapts to your unique data structures and scales with any business model. According to Adio, Adio takes less than a minute to set up. And within seconds, you will have your email and calendars synced. You'll see all your relationships in a fully-fledged platform, they say, all enriched with that actionable data. And they say you can build AI-powered automations and use its research agent to tackle some of your most complex processes to seize so that you can focus on what matters, building your company. You can join industry leaders such as Flatfile, Replicate, Modal, and so much more. You can go to adio.com slash todayexplained to get 15% off your first year. That's A-T-T-I-O dot com slash todayexplained. We'll see you next time.

[Sound of a news broadcast returns]

Sean Rameswaram: We're back to the show. It's Today Explained. I'm Sean Rameswaram. And last week, I took a walk to a close-by park to talk about social distancing with Vox's science reporter, Brian Resnick. And I promised him we'd do it again. And here we are. Guess who's here? Hey, Sean. We are keeping six feet away, as the song says, but we are also answering questions, starting with a voicemail. Love voicemail. Here we go. Hello, this is Sophia from Bloomington, Indiana. I work in the pharmaceutical manufacturing industry. My question is related to what does essential mean? Who qualifies as essential? I know that healthcare workers and even pharmacies and groceries count. I know that my industry will count. But for me to be able to go to work, it will require a nanny. So is that nanny now an essential person?

[Sound of a news broadcast fades out]

Brian Resnick: Yeah. I mean, you've answered most of your question in your question that grocery stores, pharmacies, healthcare centers, those are all essential workplaces. But actually, this is not necessarily a nationwide technical term. Every area is going to have to decide what its essential workers are. So whether child care providers are essential or not might depend on your area. But I do know a lot of child care centers, daycare centers, have been closed down and have been deemed non-essential. Most states and District of Columbia are considering liquor stores to be essential. But Pennsylvania has not. So it kind of sucks to be in PA right now.

[Sound of a news broadcast returns]

Brian Resnick: And speaking of variation from state to state, Brian, we got a question from Emma in Portland who emailed to ask, shelter in place, stay at home, lockdown. What's the difference? What's allowed? And what should we expect? She also attached a picture of her dog, Scoop, who has been training his whole life for, quote, having me home for days at a time. Can I see the photo of the dog? Scoop I want to see Scoop Here Scoop Oh that a good dog He looks like You know when the dogs are in there like I not sure if I want to be awake right now And you just want to like pet them Only one eye is showing because the other one's knee deep in a comforter. What does Scoop's mom want to know?

[Sound of a news broadcast fades out]

Brian Resnick: Emma in Portland would like to know, shelter in place, stay at home, lockdown. What's the difference? What's allowed? And what should we expect? Okay, this is another one where, at least to my understanding, all these terms are interchangeable. And all these terms might mean something different depending on where you live. But, you know, the thing is the effect is the same. The effect is really think about, like, do I really need to leave the house? Do I really need to go there? And actually, the nice thing about this is a lot of our decisions have now been made for us.

[Sound of a news broadcast returns]

Brian Resnick: Are we going to answer, like, we don't know for every question? Because I feel a little bad. I don't know, Brian. Are we? Or not, we don't know. But there's like, I feel like everyone wants this like beautiful, pristine, we're living in a pandemic. Here, like the terms to know, the things to do. And we're all learning at the same time. And people are hearing slightly different things. But, you know, at the end of the day, the message is the same. Stay home, stay safe, stay healthy.

[Sound of a news broadcast fades out]

Brian Resnick: It's sad because I think I'm about to ask you a question that you won't know the answer to. But here we go. It comes from Noah via email. How are celebrities like Idris Elba and senators getting tested when they are not symptomatic or don't have all the symptoms and seemingly everyone else gets turned away from testing and just told to stay home unless they're getting really, really sick? It does seem that in America, celebrities get what celebrities want.

[Sound of a news broadcast returns]

Brian Resnick: We should add that Idris Elba is not American and probably got tested out in the UK. I have no idea where he is. Also, sorry, no, I don't really know the answer to this question. Do you know who Idris Elba is? Yeah, I do. He was going to be James Bond a thousand times and never was and maybe will be one day. Uptown problems if I ever heard of one, huh? You know, something that we are seeing, which is disconcerting, there is some hoarding going on of medical supplies and doctors even prescribing their families chloroquine, which was that drug that was hyped up by the Trump administration, but there was no evidence behind it to say it works or not. And so, you know, you do see in a situation like this inequalities that arise. And yeah, so is it unfair if some doctors, some dentists can write a prescription for chloroquine for their family when like people with lupus who get this medicine prescribed for them to treat their chronic illness cannot?

[Sound of a news broadcast fades out]

Brian Resnick: So I think like the answer to your question is basically like America is a land of inequalities and certain people will always find ways to take advantage of that. Okay, here's one from Sam Looney, Brian. The last question I'll have for you today. Sam writes, hi, I have a COVID-19 question. I'm a 17-year-old high schooler in Indiana, and my anxiety has been spiking because of this pandemic. How worried should I be about it? How worried should I be for my grandparents who have autoimmune issues?

[Sound of a news broadcast returns]

Brian Resnick: Yeah, anxiety is real. I couldn't tell you how many people I've talked to who aren't usually anxious people who are telling me they're having trouble sleeping, they're feeling like the initial stages of a panic attack. This is all so new for so many people and, you know, scary to not be able to leave your house. Something I've been thinking about is like, I've been at home and my routine is broken. And there's just so many things in my day that were invisible to me. But like there are things that fill you up. But now like they just leave you empty. Like you don't see the familiar faces every day. And so like we know this from psychologists who constantly tell us isolation is a health risk factor. It's a scary thing. But just to know like you're not alone in that anxious space it's weird we're like all alone together and it's hard to really understand you know what this is doing on like at the psychological level to all these people but you know that's if it helps to know you're not alone that's where we'll start.

[Sound of a news broadcast fades out]

Brian Resnick: Can I add something? Yeah, I think you gotta like remember to laugh or stuff like this will really just destroy you and I don't mean to be flip or like reductive of what everyone's going through right now but there was a time not too long ago that the news was really killing me and I stopped laughing and I ended up in the hospital for like a day thinking I maybe had a heart attack and they said like well has your behavior been different in the past few days and I was like yeah like I haven't laughed or smiled in several days and I just think like try and find ways to have the full breadth of human experience, even as you're sheltering at home, even as you worry about your grandparents, even as you maybe are dealing with serious anxiety.

[Sound of a news broadcast returns]

Brian Resnick: Is that okay? I really want to give you a hug right now, even though I can't and I won't. That hug's just going to be all the more sweeter when we get to have it in like six months or or 12 months or hopefully not 18 months. It's in my calendar, July 2022, whenever it is. Sean gets a hug. Thanks, Brian. You're welcome. Brian Resnick is a senior reporter at Vox. The Today Explained team includes Bridget McCarthy, Amna Al-Sadi, Halima Shah, Efeem Shapiro, Jillian Weinberger, and Noam Hassenfeld, who also makes some music for the show here and there. The mysterious Breakmaster Cylinder makes the rest of the music. Cecilia Lay is our fact checker. Liz Nelson is the editorial director of Vox Podcasts, and Today Explained is part of the Vox Media Podcast Network.

[Sound of a news broadcast fades out]

Sean Rameswaram: It is unfairly beautiful out right now. It is. And it's kind of like you almost look like you're trying to independently communicate with a satellite, like holding a microphone in the sky and you have your headphones on. It's a little out of place for this playground. I'm really glad we could do this though. Yeah, yeah, of course.