KOJO NNAMDIYou're tuned in to The Kojo Nnamdi Show on WAMU 88.5. I'm broadcasting from home. So welcome. Later in the broadcast prima ballerina Julie Kent joins us for our weekly Kojo for Kids show. But first millions of COVID-19 cases have been confirmed worldwide with more than 25,000 cases and counting here in the Washington region. And still so many questions remain. Have we reached the peak? Why isn't there more testing? How are hospitals in the Washington region coping? When will it be safe to reopen local schools and businesses? And how long is all of this going to last?

KOJO NNAMDIToday it's your turn. If you have questions or comments, give us a call. Joining me now is 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, thank you for joining us.

DR. LEANA WENIt's great to be with you, again, Kojo. Thank you.

NNAMDIFirst I want to congratulate you. You gave birth to a baby girl, Isabel, earlier this month. We're all happy that you and the baby are healthy. And that you are back with us. So congratulations.

WENThank you very much. We're also very grateful to be home and hunkering down at home, and everyone is healthy.

NNAMDIPregnancy can sometimes be a frightening if rewarding and remarkable experience on its own, but what was it like going to hospital and giving birth during a pandemic?

WENYeah, so this is my second child. I gave birth to my son two and a half years ago in the same hospital. And my experience this time was 100 percent different from what it was last time. You're right, Kojo, that pregnancy itself is filled with many unknowns and many challenges, many uncertainties. But I remember last time that my thoughts were dominated with how is breastfeeding going to be? And what kind of car seat am I going to buy? And this time our policies -- the hospital policies changed dramatically in the few weeks before I gave birth.

WENAnd actually I was afraid that I might not have my husband with me during labor and delivery. As it turns out, our hospital did still allow for one visitor for the beginning of life and for the end of life, but limited visitors -- actually restricted visitors for everything else. And I thought so much about the other patients were there for strokes and emergency surgery and how frightening it must be to have no one there with you during that time.

WENAnd I think also the other thing that was so different this time was the fear that everyone had about possibly infecting other people or being infected ourselves if we in fact are asymptomatic carries or if our doctors and nurses around us are asymptomatic carriers themselves. And that's just such a different thought than we might have ever had going into a system where we need healthcare.

NNAMDIIndeed you wrote in The Washington Post that that sadly is the deeper shift at work in our healthcare system. COVID-19 is forcing a change in the provider patient relationship and creating a tension that must be navigated with empathy by caregivers and patients alike. Is that what you found during your hospitalization?

WENYes. I found myself worrying about my providers that perhaps they had been exposed themselves and maybe carrying COVID-19. A doctor and a nurse on that OBY floor had just tested positive and a number of others were quarantined. And I thought, well what if my providers could give me COVID-19 without realizing it. And then I remember as I was holding my nurses hand when I was delivering my child I also thought, oh my goodness, what if I myself am a carrier?

WENAnd I found myself worrying about both for and about my providers, and knowing that they themselves are also frontline providers in this fight. And seeing how much they also had to ration their personal protective equipment. I mean, they were all given one mask, just one mask to wear the entire week. And I thought so much about what it meant for them and their families. For them to be on the frontlines and potentially carrying this back to their loved ones too.

NNAMDIThis is something we're all struggling with in some way being fearful of one another, of the virus we and anyone we may encounter may be carrying. How do you navigate the space safely and as you say with empathy?

WENI think part of it is knowing that we are in this very uncertain time. For all of us, I mean, it's good to make a plan, but know that that plan is subject to change. I mean, we may have to go for a medical visit. Well, know that who may come with you or not will change. We may become sick ourselves or have a loved one who falls ill. Well, we should think about who will care for that person. How will the rest of our family cope in these times?

WENAnd I think just recognizing that these are hugely uncertain times that we're in and everyone is making tremendous sacrifices, but that means that we must each do what we can. For those of us who are able to stay home, please do so. Please continue to shelter-in-place. Please continue to do social distancing because that's the one thing we can do to protect ourselves and our loved ones, and those who are not able to social distance, because frankly it's a privilege to do so.

WENWe are also giving them the best change, frankly, of survival and of avoiding illness if we each do our part.

NNAMDIWe got a tweet from Julie who says, "Is it protective against the respiratory effects of coronavirus to get the pneumonia vaccine?" Dr. Wen.

WENGreat question. So the pneumonia vaccine does not protect you against COVID-19. But it does protect you from getting specific types of pneumonia. So if you are someone, who qualifies for getting that pneumonia vaccine you should definitely do so even though it doesn't protect you against COVID-19 specifically.

NNAMDINow, of course, we'd like to talk about the latest news on coronavirus. What are your thoughts on how the number of cases in our region have increased in the last few weeks? We are now up to more than 25,000 cases in this region? Where are we on the curve so to speak?

WENAnd I should add, Kojo, that though the number that you cited is the number that we know of we know that there is lack of testing in our area as there is across the country such that really the only patients who've been tested are those who have severe illness. People with mild symptoms have been told that they just don't have enough tests. And we also know that many people are asymptomatic and we're not testing them. And so we really don't know how many cases there are in our area. And in fact, the true number is almost certainly to be many times higher than the number that's actually reported.

WENAnd it's because of that -- it's because of the lack of testing that makes predictions very challenging. I hope that we're seeing close to the peak of what it will be in our region. But frankly, we don't know that that's the case, because of lack of testing. Also we are only seeing the positive effects of what we're doing and the flattening of the curve because of our efforts, because of social distancing.

WENSo if social distancing efforts were to be let up in any way we will almost again certainly see an increase in the number of cases again. And so this is the time for us to really bolster our capacity for testing and for contact tracing and doing all these things that are necessary to protect our public's health. It's not time to reopen in a way that's counter to data and evidence.

NNAMDII've seen, Dr. Wen, various projections for when states will reach their peak. How can we ascertain that? Do we know if the Washington region is there yet? Do we know if we're even close?

WENWell, there are various models that have predicted times for when that peak is, but I would just say that the later that our peak hits the better that actually is. We've been talking about the concept of flattening the curve. The idea of flattening the curve is to reduce the rate of transmission so that we don't overwhelm the healthcare system all at once. The more that we're able to spread out the infections over time rather than have them all coming in at the same time, the better it is for our healthcare system. And frankly that's not only good for patients with COVID-19. It's also helpful for everyone, because people will still be needing medical care for heart disease and diabetes and everything else too. And so actually the later that we're able to have our peak hit, the better it is.

WENUnderstanding though that this is not a weather forecast. It's not like looking at a weather forecast for when a hurricane is going to be hitting our region, because what we do today substantially impacts what that pattern is going to look like. The more that we do in terms of social distancing now, the more we're able to reduce the top of the peak and also the more that we can delay that peak from happening. So, again, I would urge for everyone to take the models with a grain a salt and recognize that it's up to each of us to change that trajectory, because what we do outside of the hospital has a huge role to play in what happens within the hospital. And therefore in how many ICU visits there are and how many critical cases and how many deaths there are in our area too.

NNAMDIIs that how we're going to know if the social distancing and stay-at-home orders that have been taken -- is that how we're going to know if they're starting to have any effect?

WENYes. And in fact, we do know that they are working. We have seen the data coming out of states like California and Washington states to know that social distancing has delayed the peak -- the delayed the onset in these areas. In our own area, it's hard to have a counterfactual, right? You don't know what would have happened if you did not take these measures. And in fact that goes to the core of what public health is. There's a saying in public health that public health saved your life today. You just don't know it. Well, there is no face of public health because by definition public health worked if it's invisible.

WENBut in this case the work that everybody is doing every day is actually what's saving lives and I think we should keep that in mind. We should be cautiously optimistic that we are making in roads and that we are saving lives while also recognizing that if we roll back these restrictions we could see a resurgence in the number of infections unless we do so in a very careful and measured way.

NNAMDILuis couldn't stay on the line but wants to know, "I live in an apartment and The Washington Post is delivered every day to my door. What precautions should I take when I bring the newspaper inside?" Luis, I can say I have The Washington Post also delivered to my door every day even though I don't live in an apartment. And what I do is when I take it out of the plastic and throw the plastic away I wash my hands a lot. I don't know what you can say about that, Dr. Wen.

WENI think you're doing exactly the right thing, Kojo. And I would also just say, I'm glad that Luis and others are subscribing to our local papers.

NNAMDIThank you.

WENWhich is so important these days. But that's exactly right. The best thing to do is to take the newspaper out of the plastic. Throw the plastic away. Wash your hands. But also be careful of what you touched in between the plastic and washing your hands. Sometimes we forget that we also touched the door handle and then we touched the faucet. So just remember to also wash those surfaces, because actually the virus lives the longest on hard non-porous surfaces like that.

NNAMDIQuestion I keep hearing from people is how long will this go on? Do we have any insight here?

WENWell, the most conservative measure of how long this will last is until we have a vaccine, which is a year to a year and a half from now. That's a very long time, and I don't mean to suggest that we will all be hunkering in place for a year in a half. But rather that --

NNAMDIHold that thought for a second because we do have to take a short break. When we come back we'll continue this conversation with Dr. Leana Wen. I'm Kojo Nnamdi.

NNAMDIWelcome back. We're taking your questions about the coronavirus pandemic for Dr. Leana Wen, an Emergency Physician and Professor of Public Health at George Washington University. Before we took that break, Dr. Wen, you were responding to the question of how long might this go on.

WENYes. And so I was saying that we should expect some element of social distancing until there is a vaccine or a treatment available. So I don't mean that we are going to be hunkering down for a year to a year and a half, but rather that we should expect perhaps rolling restrictions. Perhaps we will try to reopen schools or try to reopen some businesses. But also recognizing just as other countries have recognized that when these restrictions are loosened there could be a resurgence. And if there is a resurgence then we have to be willing to re-impose these restrictions again. So, again, it will be a time of uncertainty for all us in the next year to year and a half.

NNAMDIHere's Jay in Washington D.C. Jay, you're on the air. Go ahead, please.

JAYYeah. Thank you. Dr. Wen, so my wife and I are in our early 70s. We've been sheltering in place, distancing. Our local family, two little grandchildren that we used to have a day a week at least for our own enjoyment and to give their parents a break, also sheltering and distancing. And everybody's asymptomatic. So after a month now, when can we resume getting back with our grandchildren?

NNAMDIDr. Wen.

WENJay, this is a really great question. And various people have asked it in different ways about what if there are two families or two households that both are sheltering in place is it safe for them to see each other? I mean, in theory, yes, you can see each other. And I certainly understand the desire to see your grandchildren. I myself am faced with the situation now of not being able to share my new baby with anyone else. But I would say that this is a question of risk, because at some point someone in these two households is going to be going out.

WENSomebody is going to be going to get groceries or going to the pharmacy or running errands of some kind. So you have to discuss it with the other family to see if your risk tolerance is such that you could bare that risk. If both families are actually doing everything you can to stay safe, theoretically if you're the only people that you see this will be safe as well. But, again, there is risk every time you introduce one more family one more household into this.

NNAMDIThank you very much for your call, Jay, and good luck to you. Carlos writes on our Facebook page, "I have had four friends test positive and one die. It is hard to grieve at a distance. What resources exist to deal with the mental health needs of our community?" Before you respond, Dr. Wen, allow me to share with Carlos the D.C.'s Department of Behavioral Health Helpline is 1-888-793-4357. Carlos, if you're listening, could you write that down, 1-888-793-4357. And the national lines of mental illness helpline is 202-546-0646. That's 202-546-0646. Anything you'd like to add, Dr. Wen?

WENWell, only to say thank you for sharing these important resources. And, Carlos, I'm very sorry to hear. And I think so many people are in your situation too where the normal things that we do to share our grief with others, the human things that we do to share in these times is not possible. So we look to see what other alternatives we can find including being together with our loved ones over Facetime or Skype, but I think that human connection however we can obtain it is more important than ever.

NNAMDILast time we talked hospitals and states were scrambling for the medical equipment needed to battle COVID-19. That includes N95 masks, gowns and ventilators. What's the latest?

WENIt's better from what I hear from my counterparts all across the country that the supply chain is better. However, we're still faced with the situation of rationing. That these needed personal protective equipment are still being rationed, and even though providers may have enough for this week, they're still looking at next week and the following and not knowing whether they have sufficient supplies for that time.

WENSo this is really -- we are beyond the time for the federal government to kick in the Defense Production Act. And also to have a national coordinated effort. It just does not make sense for states to be bidding against each other for ventilators. For hospitals and states to be fighting against one another and the federal government for masks and gowns for their employees, who are on the frontlines. So it remains a problem even if it's gotten a little bit better since we last spoke, Kojo.

NNAMDIHere now is Vicky in Springfield, Virginia. Vicky, you're on the air. Go ahead, please.

VICKYHi. Thanks for taking my call. There's so little that we're told to do other than social distance and wash our hands. I've heard nothing about the beneficial effects of Vitamin D, higher blood levels of Vitamin D to protect against cytokine storms in the lungs and also since that would explain partly the difference between people with darker skin succumbing more to COVID when it's harder for people with darker skin to manufacture Vitamin D from sunlight and it's protective to have lighter skin. I've heard absolutely nothing. If you could say something about Vitamin D if supplementation would help or what.

NNAMDIDr. Wen.

WENWell, I would only want to give the advice based on what we know from scientific studies. And I'm not aware of scientific studies related to Vitamin D. However, Vicky brings up two important points that I want to highlight. One is that there are things that we can do to improve our own health. And I would encourage for everyone if you're smoking or use e-cigarettes or vape to please stop doing that, because we know that damage to the lungs will predispose you to having more severe effects from COVID-19. Also there are things you can do to optimize your own health. For example, controlling high blood pressure, keeping your diabetes and heart failure and other chronic conditions in as good condition as possible. So I think these are all things that we can do to improve our own health.

WENVicky also did mention an issue related to racial disparities, which I just want to comment on that we know based on what we're seeing from data in multiple states now that African Americans are more likely to die from COVID-19. And these are deep seeded racial disparities that have to do with long standing chronic health conditions and frankly racial inequities and systemic racial injustices that have been present in our healthcare system for a long time. And these issues also need urgent attention.

NNAMDIIndeed we have a segment scheduled on the issue of racial disparities for our broadcast tomorrow. So you may want to join us then. Natasha emails to ask, "I find the reporting on graphics very frustrating. What I'd like to know is what the curve of new cases is by jurisdiction, counties, city? So often the reporting is on total cases or number of deaths. Of course, I realize that so much depends on the level of testing." Dr. Wen.

WENThat's exactly right. I mean, I do agree that that information would be helpful, because then we're able to see the trajectory of cases. Having a daily case count is important so we can know that information, but we need mass testing. We need widespread testing to even know if our data are accurate to begin with.

NNAMDIHere is Michael in Silver Spring, Maryland. Michael, you're on the air. Go ahead, please.

MICHAELHi. I'm curious to know if our experience with SARS and MERS can shed any light on the possible trajectory of COVID-19.

NNAMDIDr. Wen.

WENSARS and MERS are two other coronaviruses that are part of the same family that COVID-19, this new coronavirus is in. And there is -- there are lessons to be learned from SARS and MERS including what some of the Asian countries have learned in combating SARS. That's actually what's made their response to COVID-19 this time so effective, because of all the tracing and other interventions that they have. SARS and MERS, though, are different. They are more fatal than COVID-19. But they are much less transmittable, must less infectious. And so that's why they were able to be contained in a manner that we have not seen possible yet for COVID-19.

WENAgain, this is why COVID-19, this new coronavirus, is so dangerous. It does have very severe effects on people with a fatality rate of at least one percent. It is highly highly transmittable with a very high likelihood of infectivity. Also so many people who have it don't know that they do. And that's the reason why we're taking such extraordinary measures to try to contain this novel disease.

NNAMDIIn the 30 seconds we have left, Dr. Wen, at the individual level what's the best thing we can do to help each other through this crisis?

WENKeep on sheltering in place. I know this sounds difficult and is difficult and it requires so much sacrifice from so many people, but social distancing is working. So for everybody who can, please, keep it up. And know that we're all in this together. Your actions today make a huge difference on protecting everybody else around you.

NNAMDIDr. Leana Wen is an Emergency Physician and a Professor of Public Health at George Washington University. Dr. Wen, thank you so much for joining us.

WENThank you, Kojo.

NNAMDIWe're going to take a short break. When we come back it's especially for kids Julie Kent, the prima ballerina will be joining us. If you're a kid, you can start calling now. I'm Kojo Nnamdi.