Virginia Hospital Center set up a collection spot in Arlington for people to get tested for COVID-19.

Virginia Hospital Center set up a collection spot in Arlington for people to get tested for COVID-19.

As infections accelerate and more local governments issue stay-at-home orders, the World Health Organization is warning that the United States could be the next epicenter of the coronavirus pandemic.

In the Washington region, as more testing rolls out, positive COVID-19 cases are increasing exponentially. In Maryland and D.C., all non-essential businesses have been shuttered. And in Virginia, schools are closed for the rest of the year.

So, what’s next? How do we keep ourselves and our loved ones safe? And what do we do if we get sick?

In this time of uncertainty, we look to medical professionals for guidance. Emergency physician and public health expert Dr. Leana Wen joins us in a weekly segment to share her expertise and answer the essential questions.

Produced by Julie Depenbrock

Guests

  • Dr. Leana Wen Emergency Physician, Visiting Professor, George Washington School of Public Health

CDC Coronavirus

Coronavirus Disease 2019 (COVID-19)

Coronavirus disease 2019 (COVID-19) is a virus (more specifically, a coronavirus) identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China.

Transcript

  • 12:00:02

    KOJO NNAMDIYou're tuned in to The Kojo Nnamdi Show on WAMU 88.5. Welcome. As infections accelerate and more local governments issue stay-at-home orders, the World Health Organization is warning that the United States could be the next epicenter of the coronavirus pandemic. So what's next? How do we keep ourselves and our loved ones safe? And if we get sick, what do we do? Joining us is Dr. Leana Wen. She is an Emergency Physician and Professor of Public Health at George Washington University. She formerly served as Baltimore's Health Commissioner. She joins us by phone from Baltimore. Leana Wen, thank you so much for joining us.

  • 12:00:41

    DR. LEANA WENHappy to be with you again, Kojo.

  • 12:00:43

    NNAMDIDr. Wen, what's the latest news on the spread of coronavirus?

  • 12:00:47

    WENWell, since we last spoke a week ago, the numbers have been escalating across the country. We are seeing thousands of new cases every day. We've reached some very disturbing landmarks of having more than a 100 deaths in a single 24 hour period, and unfortunately we do have widespread outbreaks in multiple parts of the country, and we still don't yet know exactly what is true extent of community spread not only in these areas, these epicenters of outbreaks, but also throughout the country.

  • 12:01:28

    NNAMDIWhen we look at the number of cases for D.C., Maryland and Virginia, which as of this Wednesday hovers over 800, how representative is that figure of the number of people truly infected?

  • 12:01:42

    WENThat's a great question and that's exactly the question that we should be asking. The problem is we have no idea what the answer is. Now no doubt that number that you just mentioned, Kojo, is a significant underestimate of the true number of cases. But we don't know how much higher that number actually should be. Of course we've had -- we've talked about this before and it's all over the media about the significant problems with testing capacity in this country. And there are a number of reasons for this that we can get into, but the fact is that we simply don't have enough tests.

  • 12:02:15

    WENWe're currently testing patients who are not only symptomatic, but are hospitalized and acutely ill. But we are not testing all those who may have mild or no symptoms, which some studies are beginning to show could be the majority of people, who have coronavirus could have mild or no symptoms. We're not testing them. And so these asymptomatic or mildly symptomatic people are likely to be the ones that are transmitting COVID-19 throughout our communities. And unless we have much better testing and surveillance capacity, we have no idea the true numbers. And therefore, are in the dark when we're trying to plan our public health strategy.

  • 12:02:57

    NNAMDILeana Wen, hospitals and states are scrambling for the medical equipment needed to battle the coronavirus. That includes N95 masks, gowns and ventilators. What's happening right now in the market for medical supplies?

  • 12:03:12

    WENThis is truly shocking, Kojo, and I actually can't believe that we're having this discussion, because it was just two months ago that we saw some horrific images coming out of China. We saw these images of nurses, who were having to use their masks for multiple days at a time until they were so soggy that they wouldn't work. We saw doctors who were trying to cut their own gowns out of garbage bags. And I don't think any of us thought that this could be the reality here in the U.S. just two months later, but that's what's happening.

  • 12:03:45

    WENI mean, my colleagues are begging over social media for people to go to their local home improvement stores and try to buy masks. I mean, it just can't be happening that the least we could do -- the least we could do for our frontline providers, who are putting their lives on the line every day, the least that we could do is to give them the equipment that they need in order to care for patients. And frankly this is not only unethical. But it's also just not good for the future of our workforce because if we run out of masks and gowns and goggles and supplies to protect our first responders and our healthcare workers, we're going to run out of healthcare workers. And it's just an untenable situation to be in.

  • 12:04:30

    WENNow I'm very concerned about this as you can tell. But I'm also concerned that we're not making progress in securing these supplies. The president has said that he can authorize the Defense Production Act and that's what we need. We can't just have states and local jurisdictions and hospitals bidding each other or trying to outbid each other in the open market for these supplies. We need to have a national coordinated effort to secure these supplies in much larger numbers than we currently have. And that's what the president has the ability to do. And we need to ensure that that happens because otherwise our healthcare system is absolutely going to collapse.

  • 12:05:12

    NNAMDIAnd that's exactly what Mark in Silver Spring wants to talk about. Mark, you're on the air. Go ahead, please.

  • 12:05:17

    MARKYes. Good afternoon, Dr. Wen. First I want to wish you good luck. I saw you on PBS and you mentioned you're about to deliver. So wish you all the best. The president has called this a war -- so I guess he's the commander in chief, and is there a war room that is tracking the following, what resources are being sent, by what methods, how many are being sent, to what destinations, within what time period, for what purposes? Trust me Eisenhower knew the answer to these questions on Normandy. Does the president -- going to level with us to tell us the answers to these questions?

  • 12:06:07

    NNAMDIWhat do you know, Dr. Wen?

  • 12:06:10

    WENWell, first I appreciate Mark's kind sentiments, but to his question, that's exactly right. We need a war time mobilization. We need supplies. We need hospital capacity. We need people. We need staffing in order to treat our patients. We need to go to where the need is and we need to have the data to back up what we're doing and to be able to track. That's not happening on the federal level.

  • 12:06:38

    WENWe've seen state and local officials really step up where the federal government has not been. And I applaud these state and local officials and individuals for stepping up and doing whatever they can. But frankly if this is, in fact, a war and it is, -- I mean, this is the worst pandemic, the worst public healthcare crisis that we have seen since 1918-1919, the flu pandemic then -- if this is in fact an all-out war, then we need the federal government to be leading this efforts with exactly the kind of things that Mark is saying, which so far we have not seen.

  • 12:07:14

    NNAMDIWe got a tweet from whatbot who doesn't seem to be as enthusiastic about local operations. "One of the biggest questions I have is why the roll out of testing in D.C. has been so slow. We had a confirmed case of community transmission on March 5. But on the following weekend we only tested 11 people." Were there just not any tests, Dr. Wen? Local hospitals are braising for these grueling weeks and months to come. How are they preparing for the surge in COVID-19 patients? Whatbot doesn't seem to have a lot of confidence.

  • 12:07:46

    WENWell, that has to do with the supplies that are coming from the federal level. What happened initially was that the CDC had sent out tests to local jurisdictions that had a problem with that particular test. And then they were able to deliver more tests, and also got local public health laboratories and academic centers and private laboratories to start producing these tests. More issues came up in that -- because people have been asking, well, why don't we just tests from South Korea? Why don't we just get tests from other places that do have them?

  • 12:08:20

    WENWell, the problem is that it's not just about the physical test. Then we started running out of swabs to physically get the test. And then we ran out of reagents to process them in the lab. And now that we are getting more swabs and reagents the problem is that there isn't enough personal protective equipment, the masks and gowns that we talked about for providers to be wearing to administer these tests.

  • 12:08:44

    WENAnd the guidance is coming out that we should be saving this protective equipment for patients, who are really ill. And that's why people are not getting tested more. So all of this I say to paint a picture that we have been consistently behind. Instead of anticipating what's going to come, we've been reacting to what's happened and it's playing whack a mole, because every time you solve one problem there's a next problem, a next supply chain problem, a next shortage issue. Our hospitals are trying their best, but they really need the support, because otherwise you can imagine they're spending all of their time worrying about supplies and protecting their healthcare workers instead of devoting all their attention as they should be to treating patients.

  • 12:09:25

    NNAMDISpeaking of supplies, Sara in Woodbridge, Virginia might be able to offer some small assistance. Sara, you're on the air. Go ahead, please.

  • 12:09:33

    SARAHi. Good morning. My name is Sara. So my husband and I we ordered 600 masks from China. So we received 600. So I would like to donate 200 for, you know, the lady she was speaking that they're having problems, and so what's the best phone number I can call and then all that.

  • 12:09:55

    NNAMDIShe would like to donate masks that she and her husband got from China. Dr. Wen, any recommendations as to where she should send them?

  • 12:10:04

    WENI very much appreciate that she is -- that's she's offering, and I know that -- by the way, I should say thank you to all those who are out there. There has been an outpouring of support for healthcare professionals from people who want to do their part, who want to participate in donations or helping to create masks through 3D printers and through other innovative methods. I would say, first thing is check with your local state or in this case District health department and see if there's something that they would need.

  • 12:10:39

    WENEvery jurisdiction has different needs. You can also call your local university hospital and see if that's something -- if they might make use of your donations that way. I know that there are quite a number of websites that are out there. There's a website called ppelink, something else called maskmatch, and a number of other volunteer websites. But I think the best thing to do right now is to call your local health department and also to ask your local hospitals. I am quite certain that they would appreciate the offers. And I would that more people will donate their masks, because we don't want people to be saving hundreds of masks in their basement when there are healthcare workers that can be using them today.

  • 12:11:19

    NNAMDIThank you for your call, Sara. Here is Irwin in German Town. Irwin, you're on the air. Go ahead, please.

  • 12:11:26

    IRWINWell, thank you very much. As I understand there are a few key symptoms that are related to the coronavirus infection. I'm wondering if there's any value in individual persons monitoring their own temperature to look for a spike in temperature as a possible indicator of infection. Also I think it would give people a sense of involvement in this fight we have against the enemy we're all facing.

  • 12:11:57

    NNAMDIDr. Wen, if you can hold your response to that question for a little while. We're going to take a short break, but when we come back, I'll ask you to respond. I'm Kojo Nnamdi.

  • 12:12:21

    NNAMDIWelcome back. We're taking any and all of your questions about coronavirus with Dr. Leana Wen, an Emergency Physician and Professor of Public Health at George Washington University. She formerly served as Baltimore's Health Commissioner. Dr. Wen, when we took that break there was a question from Irwin about people monitoring their own temperatures, etcetera.

  • 12:12:42

    WENWell, I appreciate the sentiment that Irwin expressed at the end of his question, which is about, hey, how can we all become involved. Now that we're staying at home, let's take a more active role in this. And I want to address that part first if I may, because I really appreciate that. And I think that all of us -- this is one example of where all of us are in this together. That what helps you with your health also helps your family and your loved ones. It also helps the community. We should all be trying to stay healthy.

  • 12:13:12

    WENRemember that COVID-19 is a respiratory virus that transmits from person to person. So everything that we can do to break that chain of transmission is what we should be doing. If the virus -- if we have no person to person contact with people outside of our immediate family then we are in essence stopping that virus transmission. So I just emphasize to everyone the importance of that physical distancing, the social distancing that we keep on talking about. As crazy as this sounds, because some people are saying, well, what good am I doing sitting at home in my couch? But staying at home is the single most important thing that we can do to protect ourselves and each other and our families. So I think Irwin in staying home is doing exactly the right thing for those around him.

  • 12:13:58

    WENNow the question about monitoring your own symptoms is an interesting one, because so many people with COVID-19 don't have symptoms or have mild symptoms. I mean, I don't think that it's wrong to monitor your own symptoms and know your own body. But monitoring your symptoms in itself is not going to be what's effective in preventing the spread of this virus. That said if you do start feeling feverish, have a cough and shortness of breath, these common symptoms of COVID-19, you might have COVID-19. It's important to call your doctor at that point. But do not show up to the ER unless you are acutely ill and need emergency medical services.

  • 12:14:40

    NNAMDIYou may have answered Dana's question in Fairfax. But I'll let Dana respond. Dana, go ahead, please.

  • 12:14:47

    DANAHello. Thank you for taking my call. I am currently one of those people with mild symptoms and I am at home. I have contacted my doctor and I've also got family on the frontlines right now. And I know they're very scared. I'm wondering is there a way for people, who are showing symptoms such as myself who are not eligible for being tested to get mapped so that there are -- so that at least doctors and health departments know where there may be cases mapping these cases. And also just trying to keep track of it even if it's not that serious, I guess.

  • 12:15:33

    NNAMDIDr. Wen.

  • 12:15:35

    WENIt's a really good question. And it's something that perhaps when there is more capacity we should think about this. I mean, actually what would be ideal right now is if we're not in this situation. Is if we do have enough tests to test those who have mild symptoms and their family members so that we can actually understand is this COVID-19 or not because there are other respiratory illnesses, the cold, the flu that may mimic the symptoms of COVID-19 too. And without testing we have no idea if what the caller is experiencing is coronavirus or something else. That's what we should be getting to.

  • 12:16:16

    WENIn the absence of that at this point around the country we are experiencing such a problem with hospital overcapacity that we really have to quickly pivot to treating those who are the sickest, those who need intensive care, those who need hospital care. And so while it would be ideal to get to what the caller is asking for, at this point we do have to make this pivot in order to save lives. But then realizing that what we ultimately need is better testing so that we can understand what is happening in the community.

  • 12:16:50

    NNAMDIThank you very much for you call, Dana. And good luck to you. Our president often seems at odds with the scientific community when it comes to enacting virus policy. Is the pandemic response becoming a partisan political issue?

  • 12:17:07

    WENWell, I hope that it's not. I think your listeners will have to judge for themselves as to whether they think that it is. I am very concerned about some of the comments that have been made in recent days. The most recent comments about how we should be rolling back the social distancing and other public health measures very soon.

  • 12:17:31

    NNAMDIPresident also says he wants us, the country, opened up by Easter April 12.

  • 12:17:37

    WENI mean, I think all of us would love for that to happen. We would love to not be in the situation that we are in now. We have this extraordinary situation that we're in, that none of us I think could have imagined three months ago, six months ago or even three to six weeks ago. But we have to do the responsible thing in order to saves lives. I mean, when we look at what's happening in the epicenter in New York, in Seattle, in California, in Massachusetts, in other areas that are experiencing big spikes, we're seeing hospitals were patients are already on the verge of not getting the care that they need, not only the COVID-19 patients, but other patients who also need emergency care and intensive care.

  • 12:18:18

    WENWe're seeing these healthcare providers, who have no supplies. We're seeing lack of testing all throughout. And I mention all of this because it feels like right now we're -- we have this forest fire that's burning. We have no idea how much this fire is going to burn for or what the extent is going to be. And to talk about, well, we should be building this house in the middle of this plot, when we don't even know how many lives this fire is going to take that doesn't feel like the responsible thing to do.

  • 12:18:45

    WENAnd in fact, that messaging I'm worried gets muddled, because we should have a unified national message to stay at home, to save lives, to focus on doing the things that we can do to take this really seriously. We see leaders in other countries around the world, the UK prime minister. We saw the Chancellor of Germany. We've seen so many other leaders of other countries state unequivocally what that message should be and how the decisions should be driven by data, science and evidence. And that's how it should be in the United States of America too.

  • 12:19:21

    NNAMDIWhat would be the fallout if we simply discontinued these social distancing measures after just a few weeks?

  • 12:19:29

    WENPeople would die. That's clear because we have modeling from many different epidemiologists about what will happen. We're talking about potentially up to a couple million people who are going to get infected within a short amount of time. And if we have a fatality rate of even one percent, that's about tens of thousands of people, potentially hundreds of thousands of people who are going to die.

  • 12:19:54

    WENNow we've talked before about this concept of flattening the curve that even if we have the same number of infections, if we can spread out the number of severe illnesses over a course of months rather than have everybody become sick all at once within a few weeks then we give the hospital system a chance to catch up and for patients to be treated when they become ill. But if everyone becomes sick at the same time our hospitals will quickly become over capacity. And we will not have the ability to treat patients and doctors and nurses will have to make choices about who lives or dies, and unfortunately we will have many people who will die. And that is what will happen if we roll back these restrictions without data and knowing that the cost of inaction is going to be people's lives.

  • 12:20:42

    NNAMDIIn D.C. and Maryland all non-essential businesses have been shuttered and in Virginia schools are now closed through the end of the academic year. Are these measures enough to what you characterize as flatten the curve?

  • 12:20:56

    WENThese measures are really important, but we have to remember that first of all they were rolled out over time. Initially there were less restrictive guidelines. And then they became more and more restrictive. And so that what you described has been relatively recent. The other issue too is that while some people, many people have been taking these guidelines very seriously, I also worry that many people have not.

  • 12:21:25

    WENThere are the so-called young invincibles, who think that perhaps they are not the ones who are the most targeted by COVID-19 and are still hanging out together. Kids are still going to birthday parties and celebrations, which really defeats the purpose of all these other social distancing measures that we have. Now I understand that these are really challenging measures to follow. And that our kids are bored and we have cabin fever, and this is not normal how we're living right now.

  • 12:21:59

    WENBut the cost of doing things differently is that many more people are going to die. And so if it's anything that people will take away from this it's the following. My colleagues in medicine have been posting on social media this sign, which to me just brings tears to my eyes. And the sign, "I stayed at work for you. Please stay at home for me."

  • 12:22:25

    NNAMDIWow. Yep, that is touching indeed. Here now is Terry in Silver Spring. Terry, you're on the air. Go ahead, please.

  • 12:22:34

    TERRYHi, there. Well, I just wanted to tell you that I'm 81 years old. I have had a DNR around my neck for the last 15 or 20 years. I feel very strongly about the concept of death and dying. And I sent a note to my kids yesterday. They all are aware, but I sent a note to them telling them should I contract the COVID-19 and should I go into respiratory distress I do not want any of the equipment used on me, not the respirators, not the masks, not anything. Just let me go. I'm ready. It's okay. They know how I feel.

  • 12:23:18

    TERRYAnd I have to say, my daughter told me this morning that it relieved a lot of the issues that she might have had such as survivor guilt because it was my decision not theirs. And they support me absolutely. They agree with me. Save all those masks and respirators and all that other stuff for young people, for children and for young parents, who have children not an old lady.

  • 12:23:51

    NNAMDIBut, Dr. Wen, what if Terri simply survives?

  • 12:23:58

    LEANA WENWell, let me just say, for Terri, I appreciate so much that she outlined her goals and made it so clear to everybody else around her. Very different situation, perhaps, but my mother had metastatic breast cancer. And towards the end of her life, she made it very clear to all of her loved ones that she did not want to be resuscitated, if it ever came to that. And that clarity made all the difference in how we then processed her death and our loss. And I do think it is important that we talk to our loved ones, not just during this time, but just in general, that we clarify our own wishes, so that it can better guide their decision making, as well.

  • 12:24:45

    LEANA WENAll that said, I mean, I think it sounds clear that Terri has a particular decision in mind for herself. And that's great. We should respect each person's individual decision. What I have a problem with is when there are many people...

  • 12:24:59

    NNAMDIOnly about 30 seconds left.

  • 12:25:01

    WEN...when there are many people who want to live. And if medical professionals are put in a position of choosing who gets to live and die, that's a major problem, and that's what we need to try to prevent.

  • 12:25:13

    NNAMDITerri, thank you very much for your call, and good luck to you. I'm Kojo Nnamdi.

  • 12:25:37

    NNAMDIWelcome back. We're asking and taking your questions about the coronavirus pandemic. The answer to why I'm broadcasting from home is, well, the coronavirus pandemic. Joining us is Dr. Leana Wen. She's an emergency physician and professor of Public Health at George Washington University. She formerly served as Baltimore's health commissioner. So far, our local leaders have stopped short of issuing a shelter-in-place order. What would that do, exactly, Dr. Wen, and how is it any different from what we are doing right now?

  • 12:26:08

    WENWell, what Governor Hogan has done in Maryland is essentially a shelter-at-home order. It's not called that, but the encouragement to stay at home, the closing of nonessential businesses, it all has the impact of essentially a stay-at -- or a shelter-in-place or stay-at-home order. What I would say to everyone, because we do live in a Democratic society. We don't live in a society like China where these lockdowns are enforced quite as they would be there. What I would say to everyone is, this is our chance to show a sense of collective selflessness.

  • 12:26:47

    WENOur fates are really bound with each other. What is good for me and what's good for my family is also what's good for you and your family, and all of us. And to prevent these horrific choices of somehow deciding who gets to live and die, there's actually something that we can do all together, which is we should honor the sacrifices that people are making for us.

  • 12:27:08

    WENWe should be doing everything we can to stop that chain of transmission, recognizing that if we have even one neighbor come over to our house, and that neighbor has been around 10 other families, and maybe plan on going to 10 more families and we are the -- just think about how you would feel if you are the person that's transmitting a virus to hundreds of people. We should all be acting as if we have coronavirus, and we should be acting as if anyone that we would come into contact with has the virus, meaning that that should be directing our action. By doing that physical distancing, we can stop that chain of transmission. Behave as if you have the virus, and that others around you, too.

  • 12:27:53

    NNAMDIWhat about walking, biking, hiking? Is there a point when these activities become unsafe?

  • 12:27:59

    WENWell, I would encourage everyone to continue as much outdoor exercise, or indoor exercise, if you have a home gym. But if you have access to the outdoors and are able to do so, please continue your outdoor exercise. You can take walks and do anything together with your immediate family, the immediate household that you're living in. And otherwise, stay at least six feet away from others.

  • 12:28:25

    WENSo if you live in a quiet suburban neighborhood or near a trail or something, feel free to walk outside. In fact, I would highly, highly encourage you to do so, which is good for your physical health and mental health. Just stay six feet away from other people.

  • 12:28:39

    NNAMDII've heard debate over playing partner sports like tennis or even badminton. What are your thoughts there?

  • 12:28:45

    WENYou cannot play partner sports, because think about what you are touching while doing that. I don't know how to play tennis while never touching the tennis ball. I just don't think that you could do that. (laugh) And so if you touch the ball and the other person touches that ball and then somebody touches their face in the process, you could be transmitting the virus to each other. So, no partner sports, unless they're members of your family.

  • 12:29:10

    NNAMDIHere's Karen in Springfield, Virginia. Karen, you're on the air. Go ahead, please.

  • 12:29:14

    KARENI've been self-isolating, ever since they told us to start doing that, but occasionally, I do have to go out to the grocery store. So, I'm getting conflicting or confusing information from all the different sources, whether symptoms show up in two days, seven days or 14 days. So, my question is, when I go to the store do I reset that clock every single time, in terms of watching for symptoms?

  • 12:29:41

    NNAMDIDr. Wen?

  • 12:29:42

    WENWell, it's a good question. What you're hearing, Karen, is the incubation period, which is the period between when you get exposed to the virus and when you start showing symptoms. And, actually, you're right, the symptoms -- that incubation period does vary between two to 14 days, with an average of, it appears, five to seven days.

  • 12:30:02

    WENHere's what I would say. It's very difficult, I think, to keep on resetting your clock, in this sense. I think there could be a sense of maybe too much self monitoring every time, if you're thinking about, when did I last go to the store? Instead, I would take every precaution you can when you go. First of all, reduce the number of trips you're going to the store by as much as you can. If you're used to going two or three times a week, try to go once every week or once every two or three weeks.

  • 12:30:30

    WENMake sure that you wipe down any hard surfaces, for example, the shopping cart itself, where you push the handle of the shopping cart. Wash your hands a lot. If you don't have access to that, bring hand sanitizer with you. Stay at least six feet away from others. Take those additional precautions, and be really careful of what you touch once you enter your house. Wash your hands a lot. That's the safest thing you can do to prevent yourself from getting the infection in the first place.

  • 12:30:57

    NNAMDIThank you very much for your call, Karen. Jeff emails us: what should people, especially those over 65, do to prepare for the possibility that they might get sick with the virus and have to recover at home? Specifically, what medicine and other things would be good to have on hand for a home treatment? I guess I'd like to add to that, exactly what should we know about the symptoms of coronavirus?

  • 12:31:24

    WENGreat questions. So, the symptoms of coronavirus are -- the most typical symptoms are fever, shortness of breath, cough. Some patients may get some sneezing, overall not feeling well, but actually sneezing, drippy nose are less common with this COVID-19 than it is with the common cold or allergies or other things. Some patients also have body aches and just overall not feeling well. And some may also have atypical symptoms, like abdominal pain. Nausea, vomiting, diarrhea can also present in this fashion, as well.

  • 12:31:59

    WENNow, the treatment for COVID-19, for those who have mild to moderate symptoms that do not require hospital care, we call all of that type of treatment symptomatic treatment, because, as you know, there is no antiviral medication, there is no treatment that is a cure for this disease yet. There are studies in progress, but there is no medication that is a cure for it.

  • 12:32:22

    WENSo, what you do is to manage your symptoms. So, the home treatment would be rest. It would be plenty of fluids. So, I would encourage for everyone to -- we have drinking water but also to have whatever it is that you like to drink. If you like to drink juice or Gatorade or something else, have a lot of fluids around as well. And then medications to reduce fever, so that would be Tylenol and ibuprofen. I would encourage everyone to have Tylenol and ibuprofen at home for that home treatment. And, of course, food, because if you're going to be self isolating at home, have food or have some type of help of someone who can bring you food, even if all they're able to do is to leave it at your door.

  • 12:33:02

    NNAMDIJanet emails: do those of us who have gotten all the pneumonia vaccines have any protection from the coronavirus?

  • 12:33:10

    WENGreat question. I would encourage everyone to have the other vaccines, including those who are eligible, the pneumonia vaccine and, of course, all of us to have the flu vaccine. These vaccines don't protect you from COVID-19, from coronavirus, but they do protect you from these other illnesses. And it is important to note that you could get sick from these other illnesses still, and that could weaken your immune system further. And, of course, those other illnesses also make you ill too. So get those other vaccines knowing that they don't protect you against COVID-19, but do against other illnesses that are also troublesome, as well.

  • 12:33:51

    NNAMDILeana Wen, some doctors are recommending isolation for people who lose their sense of smell and taste, even if they have no other symptoms. Is the loss of smell or taste a marker of infection?

  • 12:34:04

    WENThere are a couple of recent studies that are showing that those could be potential symptoms, too, the loss of smell, taste, etcetera. But, at the moment, I believe that the CDC guidelines -- and they are changing on a quite frequent basis -- but I do not believe that those are the symptoms that you should be looking out for initially to begin to self-isolate. But, that said, it is really important that you speak with your doctor and to follow the recommendations from your doctor, especially as it pertains to your individual health.

  • 12:34:40

    NNAMDIWhat does it mean to be asymptomatic, and how common is that, really?

  • 12:34:44

    WENAsymptomatic means that you don't have symptoms. And I think in this case the question refers to you don't have symptoms, but you are still a carrier of COVID-19, therefore you have the virus and could transmit it to others. Now, there are some studies coming out that are quite alarming in terms of the number of people who are asymptomatic, who do not have symptoms, but carry COVID-19.

  • 12:35:08

    WENThe passengers onboard the Diamond Princess cruise ship, a recent study found that about 50 percent of those who tested positive do not have symptoms. Another study out of China found that 86 percent of people who tested positive for COVID-19 in that study had such mild or no symptoms that they never sought medical care. What that means is these individuals are out there. They're not self-isolating, because they don't know that they have COVID-19.

  • 12:35:37

    WENAnd so even though they might not be as infectious, because they're not actively coughing and sneezing onto other people, they're still carrying the virus. And they could be interacting with many other people in their daily lives. And that's why I emphasize again, we should all behave as if we have coronavirus, and think about how we could break that chain of transmission by not interacting with others.

  • 12:35:59

    NNAMDIGot an email from Christine: many in my family are healthcare workers including EMTs, doctors and nurses. People are showing up at doctors' offices for non-emergencies and calling 911 because they are scared. What is your advice to people who want to see a doctor? How do medical workers take care of themselves during this tough time?

  • 12:36:21

    WENWell, people certainly -- I agree with you, that healthcare workers have to take care of themselves first, because otherwise they cannot take care of others. And I just want to talk about, again, the lack of equipment and what that's doing. I mean, I know so many colleagues who are so concerned and so terrified about bringing COVID-19 back to their families, that they are basically self-quarantining, because they're just too scared to even come home. And that's the situation that we're in with the lack of equipment that we have. So, we need to better support our healthcare workers in every way.

  • 12:36:53

    WENBut I would say, to your question about the idea of calling 911, please do not. Please do not go to the ER. Please do not call 911 unless you need urgent emergency medical care. The ERs here and around the country are already becoming overwhelmed. And if you go to the ER or if you call 911 and the paramedics and EMTs take you to the ER, you could be exposing yourself to coronavirus and other infections. If you are actually positive for coronavirus, you're exposing other people. And, also, you're taking up space of people who really need that acute care. Now, if you need acute care, go to the ER or call 911, but don't call if you would've otherwise not called or not gone to the ER if you didn't have concerns about COVID-19.

  • 12:37:44

    NNAMDIHere is Carol Ann in northwest Washington. Carol Ann, you're on the air. Go ahead, please.

  • 12:37:49

    CAROL ANNThank you. I'm a physician, and I've been self-isolating at home to protect my patients and myself from the spread of the virus. And in the lead-in to your show, I heard a comment from Dr. Larry Hogan saying, we don't know what this virus is going to do. And that was broadcast on national news. And, unfortunately, when politicians such as Larry Hogan or the President of the United States give health information to the general public, they have a different agenda from that of physicians. And I'm very grateful to you for Dr. Wen's being on the show, because she's providing factual, unbiased information about what people can best do.

  • 12:38:34

    CAROL ANNI've been whiling away the time watching symposia provided by the University of Michigan School of Public Health, the Harvard TH Chan School of Public Health, and every single presentation that I've watched indicates that we do know how this virus is going to behave. We do know -- thanks to the generosity of Chinese physicians who shared their experience with us -- that severe social distancing will greatly mitigate the spread and the adverse consequences of this virus.

  • 12:39:09

    NNAMDIThank you very much for your call. Care to comment on that, Dr. Wen?

  • 12:39:13

    WENI mean, I would say it's important for us, in a public health emergency, to follow the guidance of public health experts, that, at the end of the day, we need to follow data, the science and what works. And our decisions need to be driven by health and science, not by politics and ideology. That said, we do need the leadership of our political elected officials -- and I hope that they will follow the same songbook as public health experts -- and listen to the guidance of national public health experts like Dr. Anthony Fauci, who has been such an incredible leading voice in these efforts.

  • 12:39:58

    WENAnd, of course, I agree with Carol Ann in what she said about the social distancing measures, that those are our best defense against this virus, because we do not have a vaccine, we do not have a cure. We need to ramp up testing capacity. We need to build up our hospital systems. While we do all those things, what we have that's the most powerful weapon, if you will, is for each of us to protect ourselves and to physically distance ourselves so as to stop the transmission of the virus from person to person.

  • 12:40:28

    NNAMDIElizabeth emailed: I would love to support restaurants by getting takeout, but I'm fearful of eating food prepared by other people. How much of a risk is it, and how can I make takeout safe? And Joanne emails: after returning home from the grocery store, should I be washing the outside of packages, cans, etcetera?

  • 12:40:49

    WENGreat questions. So, one thing about the transmission that I want to clarify is that COVID-19 is a respiratory virus, so it is transmitted through respiratory droplets, not through the fecal, oral route. It's not something that you spread through food itself, as in if somebody in theory prepares food, and they're ill. You're not going to get the illness the same way that you would if somebody had typhoid fever or cholera or something else that spreads through that particular route.

  • 12:41:20

    WENBut I understand the concerns about takeout, because between the time that the food is made to the time that it gets to you, there could be multiple people who are handling that package. So, what you should be concerned about is not the inside food, but actually the package itself. So, what I would recommend is if somebody comes and delivers food to you, or you are getting takeout, come back home, make note of everything that you're touching along the way, while you're coming in. Put your food into a different container -- for example, a bowl or Tupperware or something else and throw away the container, recycle the container that it came in.

  • 12:41:59

    WENThen wash your hands very carefully, and wash all the surfaces that you touched along the way. It's not practical to not touch anything. I mean, we don't go around life not using our hands, but COVID-19 is not transmitted through your hands. It's transmitted if your hand touches something that has the virus, then you touch your face. So, don't touch your face, and instead wash your hands, and that way, you'll be protecting yourself when you get takeout or other groceries or other packaging.

  • 12:42:25

    NNAMDIHere is Dr. Sue, in Bethesda. Dr. Sue, you're on the air. Go ahead, please.

  • 12:42:30

    DR. SUEHi. Thank you for taking my call. I wanted to ask the opinion about wearing a mask, because we can see that in all the Asian countries like South Korea, Taiwan and China, almost everybody on the street, or even the speakers, are wearing their mask. Those physical barriers, do they help to prevent the saliva or the air drops from spreading around?

  • 12:42:58

    NNAMDIDr. Wen?

  • 12:42:59

    WENIt's a really good question. I have a straightforward answer to this, as of this moment right now, which is, we are so short of marks for healthcare providers, I really hope that people will hear this message and say that, if I have 100 masks stored in my basement somewhere, these masks should be used by healthcare workers who are trying to ration their last mask and putting their own lives in danger to save you. And so, please do not hoard masks. Please donate them to your hospital, local health departments, and so forth, because that's where the need is the greatest.

  • 12:43:38

    NNAMDIThank you very much for your call. For a while, now, Dr. Wen, it feels like we've been in the calm before the storm. How soon before the storm arrives? How much worse is it going to get before it gets better?

  • 12:43:52

    WENIt depends on the part of the country, about whether they still feel like they're the calm before the storm or the storm has already hit. My colleagues in New York will certainly say that the storm has hit, but it's only the beginning. And that's the terrifying part, that we don't know how much worse it's going to get. We know that it's going to get much worse, especially in these epicenters. We know -- based on the trajectory of where they were, where things were in Italy -- we are seeing what's happening now in Spain, we're seeing what's happening in a lot of other countries that are just a few days ahead of us about what's going to come our way.

  • 12:44:29

    WENThe key is can we get enough supplies to those epicenters, while at the same time ramping up testing and doing all the preventive activities that we can in the rest of the country -- including in our areas here in D.C., Virginia and Maryland -- that have not yet seen the peak of the epidemic. We are still in the calm before the storm, but the storm is going to hit us within days. And our actions right now make a big difference. We are not powerless against this virus. I think that's the key takeaway. We are not powerless, but we have a very narrow window of opportunity, and that window is right now.

  • 12:45:05

    WENSo if you're thinking at all about inviting someone over to your house, please think about that, that you are the -- you could help to prevent the virus from spreading. You could prevent this area from having an outbreak the way that we're seeing in so many other countries and in New York. Your actions now make a huge difference in who will survive and who will not in the coming months.

  • 12:45:29

    NNAMDIWorldwide, more than 430,000 people have tested positive for COVID-19. How much do you expect these numbers to increase?

  • 12:45:40

    WENIt would be hard for us to say, exactly, what the true numbers are, first of all. And I think therefore we can't predict how things will go forward. But also, understanding that, how much more that rise is going to be really depends on whether we take seriously these mitigation social distancing measures or whether we don't.

  • 12:46:00

    NNAMDIAnd what do we know about the mortality rate for people who become infected?

  • 12:46:06

    WENThe numbers vary. There were initial studies coming out of China that indicated that the mortality was somewhere between 1 to 3 percent, so 1 to 3 percent -- which, by the way, is much higher than the seasonal flu. So, for anyone who says this is just like the flu, well, this is 10 to 30 times more fatal than the flu. There are some studies coming out of Italy that now show the numbers out of Italy are more like 7 to 8 percent. But there are differences in the populations and differences in the way that these numbers are calculated.

  • 12:46:41

    WENSo, the numbers are still evolving, and we're learning a lot more in this country, too. Interestingly, the initial studies of this country show that --unlike in other places where it seems like it's older adults and predominantly older adults with chronic medical conditions who are affected -- here in this country, quite a lot of young people are getting hospitalized, too, about 20 percent of those who are hospitalized...

  • 12:47:04

    NNAMDIAnd I'm afraid...

  • 12:47:05

    WEN...are under 44. And so it is something that we have to keep in mind, that this is a disease that affects all of us.

  • 12:47:12

    NNAMDIDr. Wen, thank you so much for joining us.

  • 12:47:15

    WENThank you.

  • 12:47:16

    NNAMDIToday's show was produced by Julie Depenbrock. How will the $2 trillion coronavirus bill help Americans with small businesses? We'll ask Senator Mark Warner of Virginia. That all starts tomorrow, at noon. Until then, thank you for listening. I'm Kojo Nnamdi.

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