Health & Fitness

Fauci says virus circumstances "by no means obtained the place we needed to go" as a result of the demise toll was 130,000

michael barbaro

I am Michael Barbaro from the New York Times. This is "The Daily".

(Music)

Today: With infection rates breaking new records in the US this weekend on July 4th, there are four new insights into the virus from my colleague, science reporter Donald G. McNeil Jr. It's Monday July 6th.

Let me start, Donald, and say happy July 4th.

Donald G. Mcneil Jr.

Thank you.

michael barbaro

How did you spend it

Donald G. Mcneil Jr.

On Saturday morning I played softball – socially distant softball.

michael barbaro

Soft ball?

Donald G. Mcneil Jr.

Yes.

michael barbaro

In New York City?

Donald G. Mcneil Jr.

In New York City. Yes, Riverside Park. And then last night we went to a friend's backyard on Long Island for dinner, where we were all sitting together as a couple but six feet apart, and took turns and went to the table to get dinner and sat down and had a really good time.

michael barbaro

I have to imagine that even a socially distant meal with you is challenging because I think I would feel quite seen and judged given your role.

Donald G. Mcneil Jr.

Why?

(Laughter) Donald G. Mcneil Jr.

I mean, I tend to say a lot about people six feet, six feet, six feet.

michael barbaro

See?

Donald G. Mcneil Jr.

Because masks give people a false sense of security. I mean, it's a big thing on the softball field that people put on both masks and sit next to each other in the dugout and put together the order of strikes and the like. And I would go, no! Air escapes from the side of your masks. And you don't always wear masks. Sometimes you wear it as a kind of Captain Ahab's blue beard under your chin. So it is better to stay a meter apart. That way, if your mask –

michael barbaro

Do you remember a few seconds when you asked me why it could be difficult to have one?

Donald G. Mcneil Jr.

(Laughs)

michael barbaro

– a meal with you?

Donald G. Mcneil Jr.

Well. (LAUGH)

michael barbaro

Ask and –

Donald G. Mcneil Jr.

All right, touche, touche.

michael barbaro

Everything you've just described naturally happens in New York, where the infection rate has generally decreased or at least stabilized. So let's talk about the state of the pandemic in the rest of the country. I wonder if you can give us a quick status update this weekend on July 4th.

Donald G. Mcneil Jr.

OK. I think there are 39 countries where cases are now appearing. And it's hardest in the south and west. Texas, Florida, Arizona, California, a number of other states. And that was exactly what was predicted in May when the states debated the opening until Memorial Day. All public health experts said if you open up as your case numbers increase, they will continue to increase and increase even faster. And now we see that.

In Houston, for example, doctors who knew the situation in New York say that what happens there looks like what happened in New York in early April. Finding new beds, finding ventilators, many patients who were sick, patients who had oxygen. Not as many die yet, but with people who have oxygen and respirators, they may find themselves having to park refrigerated vehicles behind hospitals to hold the bodies, as they did in New York.

michael barbaro

So Donald, correct me if I'm wrong. I think there are about 50,000 infections a day in the US right now. Dr. Anthony Fauci said we could get up to 100,000. And if so, how do we expect the number of deaths to start in the US? I assume that this will make up for it.

Donald G. Mcneil Jr.

Yes, it will catch up. I mean, but there is no reason to assume that 100,000 is the upper limit. It all depends on how much social distancing we practice. I mean, that's the dance. And do you close bars and restaurants? Do you open or close schools? Do you wear masks How much attention do people pay to the instructions you give them? How much do you practice good social distancing? This has a very strong impact on the spread rate of the virus.

michael barbaro

In light of these big questions about how we are coping with the rest of this pandemic, you have reported a lot on the latest findings and findings about the virus that will be very helpful in how we answer these questions. And we would like to discuss this with you. So where should we start?

(Music) Donald G. Mcneil Jr.

Some of these findings are really more theories with some evidence to support them. And with some there is some trust. So we should probably start with something that doctors put a fair amount of trust in.

michael barbaro

And what is that?

Donald G. Mcneil Jr.

When all of this started, we thought of lung disease, respiratory disease, because in the first cases we heard about, people got pneumonia. And of course that reminded us that the model for this disease was the 1918 influenza epidemic. However, we learn that this coronavirus is very different from an influenza virus.

The influenza viruses attach to receptors in the lungs and in the airways. This enters the body through the airways, through the lungs. But it really sticks to the inside of your blood vessels. And that makes it a vascular disease, a blood vessel disease.

michael barbaro

And what does it mean that such a virus is a vascular disease, a blood vessel disease and not just a respiratory disease?

Donald G. Mcneil Jr.

It means that it affects every organ in the body that contains many fine blood vessels, and not just organs.

I mean, it affects the lungs, which is the filter through which the air gets into the blood, and you have a lot of small, fine blood vessels that surround the little bags at the ends of your breathing tubes. It attacks the kidneys as this is the filter where urine comes out of the blood. So you have very fine networks of blood vessels there. It attacks the intestines because you have a network of blood vessels in your intestines that feed food into your body. It attacks the brain because you have many fine blood vessels in the brain. It does not attack the nerve cells in the brain that make up most of the brain. It does not attack the muscle cells in the heart. But it attacks the blood vessels that go through all of these other parts.

And when they do autopsies, they find thousands of tiny little blood clots all over their bodies. We have a lot of people who have strokes. And if these blood clots clog blood vessels in small areas of the brain, dementia or disorientation can result. And then, in children, when you have “covid toes” in teenagers and young adults, these are the small capillaries in your hands and feet that get blocked and get this inflamed, painful, red or purple toe and finger syndrome. It is therefore more complicated to deal with an illness that can be transmitted to every organ in the body.

michael barbaro

How is this new knowledge about the corona virus changing the way we approach the pandemic?

Donald G. Mcneil Jr.

In the past, the main thing to look for when looking for a problem is blood oxygen levels. Because you assume that your problem will be pneumonia. However, if you find that the problem can be kidney and heart damage, do a completely different set of blood tests.

michael barbaro

So you're saying that doctors who previously diagnosed Covid-19 with a number of well-established symptoms must now extend this set of symptoms quite a bit. Because it turns out that this is vascular and not respiratory.

Donald G. Mcneil Jr.

Yes that's right. This means that practically everyone who comes to a doctor's office sick may suffer from the coronavirus. If you experience symptoms of a stroke, it may be Covid. If you experience symptoms of a heart attack, it may be Covid. If they come in with arthritis in their feet, it could be Covid Toe.

And because we often don't have enough tests or it takes a long time to get the test results, the patient is really at a disadvantage. Because if you don't know that your patient has coronavirus, the symptom he is now experiencing may worsen and spread to other organs. So the problem in your toes could literally spread to your kidneys or brain. And you want to know that this patient has an illness that can spread throughout the body.

michael barbaro

In other words, more tests and quick tests become more imperative once we learn that so many symptoms can actually be a sign of Covid-19.

Donald G. Mcneil Jr.

Absolutely.

michael barbaro

OK. What is the next big new insight into the corona virus?

Donald G. Mcneil Jr.

Well, people always ask, does the virus mutate? Will it be different? And the answer is yes. This virus always mutates. It makes a mutation about every two weeks.

michael barbaro

Impressive.

Donald G. Mcneil Jr.

The question is whether one of these mutations is important. And most of them are not. Most of them do not change the function of the virus at all. But there was a mutation that has become the subject of great interest. We know with certainty that there are two common clades of the virus, the Wuhan strain and the other, the Italian strain or sometimes a European strain. Now the Wuhan variety is obviously the original one. This is where the virus started. But it was about Asia. Then it went to Iran. Then it went to Italy. And in Italy this mutation probably took place sometime in February. Now the virus has definitely not made it more dangerous, deadly, and likely to kill you. But it seems to have made it more transferable.

michael barbaro

How?

Donald G. Mcneil Jr.

Well, it seems that it transfers five to ten times easier between people. Well, that's controversial. However, work was done in cells in the laboratory where they were infected with the two different strains. And the mutation in the Italian strain seems to make the tips on the outside of the virus – the tips of the corona – more stable. Can infect better. And so they seem to be five to ten times better able to infect cells than the old Wuhan version.

michael barbaro

The strain of this virus, which has a better tip – the Italian strain – and is therefore more transmissible, displaces the previous strain because it only does a better and more effective job in infecting people.

Donald G. Mcneil Jr.

Yes that's right. It is the natural progression of a virus. It is the way they go.

michael barbaro

What do you think?

Donald G. Mcneil Jr.

Well, viruses tend to become less lethal and communicable to these hosts as many hosts become infected. For example, if I have the virus and it mutates in me and it turns into a more lethal strain, I now have two strains. And I'm passing this virus on to two people. The person who gets the more lethal burden is more likely to go home, go to bed, and die. While the person who gets the less lethal, more transferable burden goes to a disco and infects 40 people.

And if you do this enough times in the course of the virus, the virus will naturally move towards the more communicable, less deadly virus, as this virus will spread whenever it receives this type of fork.

And so it happened in 1918. The virus started extremely deadly. It blew through an enormous section of the population, probably 60 to 70 percent of all people in the world. And then it disappeared for a while. Then it appeared in pigs and was a swine virus for a while. And when enough people were born who had never had the virus, it reappeared in people. But it reappeared as the seasonal H1N1 flu, which we know every year as one of the seasonal rivers. But that became less deadly and more transferable. And basically all viruses do that. And we could start to see the first signs that this is happening with this virus.

michael barbaro

If I'm in Texas or Arizona right now and test positive for Covid-19, it's very likely that I got the Italian mutation of this virus, right? And that means I will probably pass it on to someone else and not have the worst symptoms. Does this partially explain why infection rates are rising so quickly in the United States?

Donald G. Mcneil Jr.

Well, infection rates in the United States are increasing rapidly due to human behavior rather than changes in the virus. I think it is desirable to think that this virus is not dangerous. It is really dangerous and highly transferable.

michael barbaro

However, as the Italian version of the virus spreads more effectively, this suggests that the virus is better able to do what it was designed to do, infecting many, many people.

Donald G. Mcneil Jr.

Yes. But I mean, the Italian version versus the Wuhan version is not a dead end. There will be a lot more mutations. It changes every two weeks. There may be other mutations in the virus that are found to be important. And we can call this the Texas variety or the California variety or whatever.

But we don't know them yet. There is great disagreement among scientists as to whether it is really transferable or not. And there is no agreement about it – not even really thinking that it is less dangerous. That remains to be seen.

(Music) Michael Barbara

We'll be right back.

So Donald, what's the next big new understanding we have for the virus at this point?

Donald G. Mcneil Jr.

Well, there is always more evidence that you are much safer outdoors than indoors. There is a study in China that examined 318 transmission clusters. And only one case involved transmission outdoors. And that was between two neighbors who had a long conversation with each other. And recently there was another study from Japan, which indicates that your chances of getting the virus indoors are 20 times higher than outdoors.

michael barbaro

And what do these studies find out why this is exactly the case? I think we all understand that if you are outside the virus, the virus will only disperse and become more diffuse. Is it as complicated as it is?

Donald G. Mcneil Jr.

Well, there's always a bit of wind outside. Moisture also drops droplets from the air. But mostly it's the wind. And when people speak only a few feet apart, especially when they speak loudly or when they laugh or when they sing or scream or do something like that, clear that kind of invisible mist from tiny tiny droplets that spurt out from your mouth and somehow hangs around your head. But it also drifts towards the other person. And so you sit in the other's droplet cloud. And these tiny tiny droplets, even if you don't feel the other person actually spitting on your face, these droplet clouds can contain enough viruses to spread the disease from one person to another.

And inside, if no windows are open, it can drift more or less at head level through the room and pass one person after the other at a cocktail party or in such a bar. And each person inhales a little of this droplet cloud until the disease has spread to 20, 30, 40 people. While the breeze simply blows it away outdoors. It is therefore safe to stand outdoors one meter away even without a mask.

michael barbaro

This is the idea that the virus is aerosolized. And you say that this poses a very great danger indoors. Outdoors, because of the wind, not nearly as much.

Donald G. Mcneil Jr.

Yes that's right.

michael barbaro

So, if it is less risky to be outdoors, and this has now been clinically shown, I wonder if that explains something that you mentioned in the previous conversation, namely that you weren't too afraid that these protests would take place everywhere the United States has about race and policing that it would be a major source of infection. And is that because they performed outdoors? And is it so far that they have not led to a significant increase in infections?

Donald G. Mcneil Jr.

In the cities where most of the protests took place, we did not see a large increase in infections. So it looks like they haven't done too much transmission. That doesn't mean that everything is safe just because it's outside. The important thing is how far apart people are when they are outdoors. So it's not safe to sit next to someone else in front of a stage at Mount Rushmore where the chairs are tied together with a zipper. Masks or no masks, you still really want to try to keep six feet apart.

michael barbaro

Donald, a few moments ago you mentioned the danger of being inside because this aerosolized virus mist is not a big danger outdoors. But I want to linger a moment on this question of the interior. Because the more we think about it, the more this aerosol mist seems to make any indoor activity inherently dangerous. I wonder if that's an accurate assessment.

Donald G. Mcneil Jr.

Yes. I mean, at funerals, in choir practice, at birthday parties, in bars, and in business meetings, we saw the transmission of viruses to a large number of people. Virtually any type of indoor climate you can imagine, there were super spreader events. There may be ways to make interiors safer. There will be no way to make them completely safe.

And all this talk about what is safe to do indoors brings us to the really important question, which is the most important interior that we want to make functional again, namely schools. Can children go to school safely? And again the science is not yet fixed. However, there is growing evidence that it may be safe or fairly safe to open schools in the fall, especially for very young children.

There is growing evidence that children are not major carriers of the virus in adults. Denmark opened its schools in April. I haven't seen a big surge in the cases. Finland opened its schools in May. I haven't seen a big surge in the cases. Even from the beginning, the Chinese in China almost never saw a case in which the child, especially the youngest child, had introduced the virus into the family every time they looked at clusters in families. Usually it was parents who infected the children, not the other way around.

We know that children are great carriers of the flu virus. And they do it because they cough and sneeze like crazy. But if the biggest symptom they get is inflammation instead of coughing and sneezing – and that's the case; Children tend to get moody, inflammatory, and uncomfortable manifestations of the disease rather than what looks like a cold. Then it would make sense that this could be a reason why they are not big broadcasters.

michael barbaro

And what is this new realization that children are less likely to transfer funds to teachers who stand or sit in front of them all day? Does that mean that an adult teacher is pretty safe at school? Or doesn't that mean?

Donald G. Mcneil Jr.

I don't think we know the answer to that yet. I mean schools – you bring a lot of kids together. The schools also bring many adults together. Teachers, staff, parents who pick up the kids, things like that. The schools will under no circumstances be completely safe.

But opening schools is so important to society, much more important than opening restaurants, much more important than opening cinemas. It probably has to be done very carefully. Not just everyone back in the classroom, 30 children in a classroom at all. But it looks like it could be done. And that's really important. Because it is important for the children, for their development, for their nutrition, for their socialization. And it is also important for parents. Parents cannot work again if they are stuck with their children at home. So it is a crucial part of getting the economy going as well as the health of children and parents.

michael barbaro

Of all the insights you shared today, this one seems like the silver lining. Reopening schools can be a somewhat safe undertaking.

Donald G. Mcneil Jr.

Yes. And that would be very good news for us.

michael barbaro

Because if I'm honest, everything else you said sounds pretty bad, doesn't it? I mean it seems to be vascular, not respiratory. So it will be easy to overlook symptoms. It seems that mutations make it more transferable. And because of this aerosolized mist, the interior poses a significant threat to non-children. And when the temperature drops, which will be the case in a few months and tens of millions of us are suddenly stuck in the house, we face major problems.

Donald G. Mcneil Jr.

Yes, and the number of cases per day could well exceed 100,000 if we are not careful. So yes, I think it's mostly bad news.

(laugh)

We are sorry. I hope that the fact that the virus becomes more communicable also means that it becomes less deadly, which would be good news. But it hasn't done that yet. So spreading an already bad virus is not a good thing. No question.

michael barbaro

And all of the things we've just talked about seem to reinforce the need, not just social distancing, but also these government-mandated locks. I mean certain requirements that say don't go to a bar. Don't go to a restaurant. And these become even more urgent when the warm weather gives way to the cold weather.

Donald G. Mcneil Jr.

Yes. We need to recognize that we are in the early stages of this pandemic. I mean, that's the second inning. And there are still more than 120,000 dead. So we dance in, dance out of different forms of blocking. But we have to get to the point where we basically all dance to the same music. If all governors accept the idea that they will react quickly if they have a problem that gets out of control in their state.

And if you do that, you will save the lives of your own citizens. And I think we're starting to see that.

In places like Texas, places like Arizona, places like Florida, the governors have made big turns in the past few weeks. And they get the science that what you do today will only have a good impact in a month from today, because the people who got infected yesterday will be in your hospital in three weeks. So you start to assert yourself.

But we have to come to a kind of general understanding that we don't all have to move in step as a nation, we have to take similar steps at crucial moments to save lives.

(Music) Michael Barbara

Thank you, Donald. We appreciate it.

Donald G. Mcneil Jr.

Thank you. I was happy to be here.

michael barbaro

We'll be right back.

You still need to know the following today:

archived recording (Donald Trump)

In our schools, our newsrooms and even in our boardrooms, there is a new radical left fascism that requires absolute loyalty.

michael barbaro

In two consecutive speeches over the weekend, President Trump delivered harsh attacks on what he described as radical left-wing forces, protesting police brutality and demolishing monuments to America's racist past, and described them as a threat to Americans' values ​​and heritage.

archived recording (Donald Trump)

If you do not speak his language, perform his rituals, recite his mantras and obey his commandments, you will be censored, exiled, blacklisted, persecuted and punished. It won't happen to us.

michael barbaro

The Times reports that speeches outside Mount Rushmore and the White House signaled that Trump would try again to exploit racist and cultural divisions to win reelection.

archived recording (Donald Trump)

I am here as your President to announce to the country and the world that this monument will never be desecrated. These heroes are never blurred. Your inheritance will never be destroyed. Your accomplishments will never be forgotten. And Mount Rushmore will forever be an homage to our ancestors and to our freedom.

michael barbaro

No event forced social distance rules. And both were arrested by public health officials despite the request to be canceled to prevent the spread of the coronavirus.

That was & # 39; s for "The Daily". I’m Michael Barbaro. Until tomorrow.

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