KOJO NNAMDIIn the wake of George Floyd's death, protesters have gathered across the country, often in packed crowds, doing away with social distancing measures in a mass expression of grief and anger at police brutality. Now, public health officials are warning that these demonstrations could be followed by a surge in coronavirus cases. So, what safety measures can protestors and police take to prevent the spread of the virus? And what do these demonstrations mean in the age of COVID-19?

KOJO NNAMDIJoining us to discuss these issues is Dr. Leana Wen, an emergency physician and professor of public health at George Washington University, formerly serving as Baltimore's health commissioner. Dr. Wen, thank you for joining us.

LEANA WENOf course. Happy to join you, Kojo.

NNAMDILeana Wen, in many of the photos we've seen, demonstrators are wearing masks, but how safe is it to be out protesting during a pandemic?

WENIt's very challenging, Kojo, because we have to acknowledge the reasons why people are protesting and why. All of us are saying that racism is a public health issue. And, of course, those who are the most disproportionately affected by COVID-19 are also people of color. And that is exacerbated on top of underlying health disparities.

WENBut, at the same time, we also know that this is a contagious virus, that it's transmitted from person to person. And so, whenever there are people gathering in large groups, there is going to be an increased rate of transmission. And, on top of that, that states are reopening at the same time, I do think it's almost certain that we will see an uptick in cases in communities all around the country in the coming weeks.

NNAMDIWhat factors can put someone at risk of contracting COVID-19 during these protests?

WENWell, the most important thing is we know this is a virus that's transmitted from person to person. And so, individuals who are in close proximity to one another for long periods of time, who also, in the heat of the moment, may be hugging one another, who may be shouting and expelling more droplets that way, who when they're speaking, may be lowering their mask and expelling droplets into the air. I mean, all of these things increase the rate of transmission.

WENI think what is helping is that these protests are happening outdoors, that many people are wearing masks. And we know that universal mask wearing does reduce the rate of transmission by as much as 50, to even 90 percent. And so I think there are things that we can do that we can encourage protesters to do to protect themselves and others around them.

NNAMDILet's hear from John in Rockville, Maryland. John, you're on the air. Go ahead, please.

JOHNYeah, hello. Thanks for taking my call and all that. Yeah, I'm calling regarding the safety of the protesters. And while everyone is bemoaning the safety of people, with whichever side is shooting or doing what or this or that, the only thing that's been unnecessary, absolutely, has been when the president has given orders that the federal people do teargas or smoke, which I think most medical people would say makes the people who it was directed at, the protesters, breath harder and have a more vulnerable situation to catch a lethal virus. So, all the other things that are happening, one can't really point to, you know. In this situation, it's clearly where the danger is.

NNAMDI(overlapping) Yes. Dr. Wen, can you talk about that? These demonstrators were tear gassed so they could get out of the way from Lafayette Square so the president could go to St. John's Church. What are the health risks involved there?

WENSure. I mean, beyond the health risks normally that one might experience with teargas, you can imagine, I mean, if someone has to be -- if somebody is going through this and they're rubbing their eyes, that, in itself, is a risk factor. Then you have people maybe taking off their masks, and now they're sneezing and coughing in addition. And that expels respiratory droplets, also increasing the rate of transmission. And I would just say, I mean, something else that can be helpful in addition to wearing masks and face coverings, people can use eye protection to prevent injury. That also helps to reduce the impact of teargas, too.

WENOther things, just along the lines of how people can protect themselves, don't share drinks. Bring your own bottle of water. Don't share snacks with others. Bring hand sanitizer. Watch what you're touching. Sometimes there are signs, or bullhorns being passed from one to another. Sanitize afterwards. And really important is don't go if you're feeling sick yourself. Because the last thing that you want is to go when you're already coughing and sneezing. That increases risk to other people around you.

NNAMDICoronavirus is already happening at disproportionate impact on people of color, and, here again, we have a lot of black and brown people taking to the streets in protest of systemic racism and in protest of police brutality. What effect might these mass demonstrations have on the current public health crisis?

WENI mean, I do worry about this. I do worry about the communities that are already disproportionately affected by underlying health disparities. You have COVID-19 on top of that, that's going to exacerbate the health outcomes and worsen the health outcomes of these communities. And then, on top of that, these are also the communities that are going to be affected because of the protests and the uprisings that we're seeing, too.

WENAnd this is the reason why we need to all take additional steps ourselves to protect one another. But I think our civil institutions, our government institutions also need to be targeting resources to communities that are the hardest-hit. We need to have widespread testing that's available in communities. We need to make sure that health care is available free, and that people do not have to be worried about losing their jobs if they're ill.

WENI think there are acute -- this is one of these things that we in medicine call acute on chronic, that there are underlying problems that are then exacerbated by acute conditions. And we need both short term actions, as well as long term attention to these underlying disparities, including, again, calling out that racism, is also a public health issue.

NNAMDIWe're talking with Dr. Leana Wen. She's an emergency physician and professor of public health at George Washington University about protesting -- mass protests during a pandemic. Here is Katy in Fairfax, Virginia. Katy, your turn.

KATYHi. It's so good to be on the show. So, I am a protestor. I've been going into D.C. And so one of the first things that I do is I always keep hand sanitizer with me. I also have an old N95 mask that I've had for a while that I've used at other protests, where I haven't needed it. But what I've been doing since we've been getting tear-gassed, is I keep several bandanas with me, and then each time we get tear-gassed, I change out the bandana for a fresh one. And I keep the bandana in a plastic bag, just like a Walmart bag.

KATYAnd every time we get tear-gassed, I just have to take my bandana off and put it in the bag. And I take the bag home with me, instead of throwing it in the trash in case there are people experiencing homelessness in the District that go through the trashcans looking for food. So, I highly recommend that everyone bring multiple bandanas with them, in addition to a mask, if they're planning on protesting.

NNAMDIDr. Wen, good safety practices?

WENI mean, I think it's always good practice, in general, to just be aware of what you're doing with your face. I think, so often, people put on a mask and assume that they're safe. But then that mask slips off, then they scratch themselves underneath the mask, the mask gets wet, and you can spread germs that way too. So, I think bringing additional bandanas is a good idea, but, in general, even better is just knowing that we need to do things differently in the middle of a pandemic.

WENI'm not saying don't go and protest for what you believe in, but rather, when you go, do your best to think of the fact that we're still in the middle of a pandemic. So, even things like social distancing, which I realize is very difficult to do in the middle of a protest, but one thing that can be helpful is go with a small group of people and think of them as your buddy system. Think of the small group as the people that you're going to be in close proximity with, but that having that small group ideally keeps some distance between yourselves and others.

WENEven things like that, just being aware of where you are and who you're around and what's on your face and what you're touching, all these individual steps are helpful to reducing your overall risk.

NNAMDIKaty, thank you very much for your call. Dr. Wen, what do you recommend for people who are still weighting whether they feel safe enough to go out and exercise their First Amendment rights?

WENI mean, this is really hard, and I think people need to follow their own conscience while thinking about their own risk, too. And knowing that there really cannot be judgment on those who choose not to go because they are weighing their own individual health risk, too.

WENYou know, there are individuals who are older, with chronic medical illnesses, who may be caregivers of those who are being compromised, who may decide that at this moment there is a substantial risk if they do go, and that there are other ways for them also to be helping. Or, as I mentioned, if you're feeling sick yourself and you have a fever, you have a cough, you're sneezing, it's actually not safe for you to go and be around others, because you can infect others.

WENAnd so I think there are other ways for you to be assisting as well, donating to George Floyd's memorial fund, supporting organizations working on the ground, helping protesters too with paying for their legal fees and bailout funds. I mean, there are other ways to help to support in the cause. And, again, everybody should weigh their individual risk factors and where they are right now, without judgment for why they may choose to go or not go.

NNAMDIBarbara emails: please ask Dr. Wen to comment or remind us that masks basically protect others more than ourselves. And if we want protection from others, our masks should be multilayered.

WENWell, another way of thinking about it, I think, is that masks protect all of us if we all use them. So, yes, it is true, that the individual mask that you are wearing protects the others around you if you do expel respiratory droplets. If you are an asymptomatic carrier of COVID-19 and you're coughing or sneezing, you're coughing and sneezing now into your mask instead of into the air. So, that protects others around you.

WENBut if everyone, or nearly everyone is wearing masks, that reduces the rate of transmission for everyone in that area by as much as 50 to 90 percent. Now, imagine if there were a medication that everyone could be taking ahead of going to these protests that reduced everyone's rate of transmission by 50 to 90 percent. We would all do that. And I think we should be thinking about masks in that same light.

NNAMDIHere, now, is Starr in Washington, D.C. Starr, you're on the air. Go ahead, please.

STARRThank you very much for taking my call. I just wanted to suggest that people be sure to take a small carton of milk with them and some rags. That has been used around the world to fight against teargas. I also have a concern. I'm a senior, and aside from other serious things, rubber bullets, there's a serious concern with older people or people who have underlying conditions about being confined in holding cells, or even in buses for long -- you know, for any period of time, because that gives you more exposure, of course, to being infected with the virus.

STARRAnd there's been a pattern around the country of people being arrested on nonviolent offenses, which is not supposed to be happening, but on very minor things, and being hauled into the city jails, held for long hours and risking infection and possible death or permanent injuries.

NNAMDIThank you for making those points. Two questions, Dr. Wen. What is the usefulness of milk to fight off the effects of teargas, and do you think these protest may lead to a second wave of coronavirus outbreaks in this region?

WENYeah. So, there are anecdotal reports of milk being helpful. I would say if you are exposed to teargas, the important things to do, first of all, try to get out of that area quickly, because the longer you're exposed to teargas means more problems for you and effects for you. Rinse your eyes and your face with water as much as you can. And don't rub your face, because the active part of the teargas is not the gas itself. It's the powder that binds to the skin. So, you could be making it worse by rubbing your face.

WENRemove your contacts and also throw them away. I mean, again, milk and other things that have been used, like baking soda in water, they're helpful to wash people who have been gassed, but actually just water, spraying people with water may be the most helpful, especially because you don't want milk that's not sterile, that hasn't been refrigerated, because there could be additional germs that are carried that way.

WENSo, to your point -- your second point, Kojo, about increase, or could there be a second wave.

NNAMDIYes.

WENI mean, it is possible, because this is a virus that transmits from person to person. And large gatherings, like protests, could result in higher rates of infection. And that's something that, again, is happening on top of reopenings that are happening in every state. And so we do need to watch for that. And this could very well be the case in the next few weeks.

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

RAYYeah, I just wanted to comment. I was down at the Lincoln Memorial today, and I ran across about seven people protesting. Not one of them was wearing a mask (unintelligible). And not to be funny or anything, but it seems to me the last thing they are even worried about is COVID-19. It's like five or six down on the list of all the nonsense we've had to put up with. And, I mean, there were kids. And, like I said, they were all between the ages of, like, 32 to 25. So, I'll take whatever it is off the air, if you'd like.

NNAMDI(overlapping) Well, we have to assume that the reason they're protesting is because one of their major concerns is systemic racism. But the fact that they were protesting without masks could be an indication that they are not maybe as concerned as they should be about the spreading of the coronavirus. Dr. Wen?

WENI mean, I do understand where people are coming from in this. I mean, when the existential threat is there about racism and police brutality, that perhaps they're not thinking about this pandemic that's another type of threat in their lives. I mean, I would just say, on our end, this is a time again that we're all in this together. And just as we should all be fighting police brutality and systemic racism together, we should also be fighting this pandemic together, too, recognizing that the impasse of this pandemic are going to be on the same communities that are also suffering, unfortunately, because of systemic racism. So, we really should each do our part, yes, to exercise our First Amendment rights but also to try to do our best to protect one another from COVID-19.

NNAMDIYou served as Baltimore's health commissioner during the uprisings that occurred in the aftermath of Freddie Gray's death. Did any public health issues arise during those protests?

WENYes, and I'm glad you asked about this, Kojo, because we are talking so much about the effects of COVID or the effect on COVID, and that is important to talk about. But after the uprisings in 2015, there were over a dozen pharmacies that were burned down, looted or closed. And hundreds, if not thousands of people couldn't access their prescription medications. People called us because their corner stores were closed, and now they couldn't get access to fresh food, or any types of groceries or Ensure or other supplies.

WENAnd I think we have to remember that those who are the most vulnerable are those who are the most affected by these protests, too, and that it's also our responsibility as local officials, as civil society to help to provide those needed resources for individuals who are the hardest-hit. So, as we work towards long terms change, there are short term actions that we also have to be taking to protect those who are the most vulnerable, as well.

NNAMDIIn your most recent column for the Washington Post, Dr. Wen, you wrote about reaching the grim milestone of 100,000 deaths in the United States from COVID-19. How do we prevent the next 100,000?

WENWell, we need to look at the lessons that we learned. We learned, for example, that early, aggressive action, bold action is what saves lives. There was a study done in Columbia University that found that had we implemented social distancing a week earlier, we could've saved 36,000 lives here in the U.S. And the question is, what are we going to learn for next time?

WENWe need to set up the surveillance systems in place, so that we can detect an outbreak before it becomes an epidemic. Ideally, we can prevent a cluster of infections from even becoming an outbreak in the first place. These are the types of tangible things that we have learned. And, I mean, we could say, look, the first time we didn't know, but now we have no excuse.

WENWe know we need to take early action. We know we need clear, consistent messaging. We know we need a national, coordinated strategy. We know we need to increase testing, contact tracing. We know that we need to prepare for a surge that may come, and not run out of masks and personal protective equipment and leave our health care workers to fend for themselves once again. And it's shame on us once, that we didn't do it the first time and we've lost 100,000 lives, but we need to prevent the next 100,000. And this time there are no excuses. We know what to do.

NNAMDIHere now is Lisa, in Washington, D.C. Lisa, you're on the air. Go ahead, please.

LISAThank you. Hi. I'm calling from (unintelligible) in Baltimore. And I just wanted to (unintelligible) that drugstores were burned down during the uprising. I just want to make a comment that there's no grocery stores in that neighborhood. That neighborhood is a food desert neighborhood. These people are grocery shopping at drugstores, not for fresh vegetables or fruit, but shelved items. That community only had a drugstore, just like (unintelligible). What's your comment on that, Doctor, about fresh food and water, milk and, you know, fresh items?

NNAMDIDr. Wen, food deserts.

WENYes. I mean, yeah, I'm so glad that you brought up this point, because, in Baltimore, just like across the country, we see huge disparities when it comes to something like access to food. One in three African-Americans in Baltimore live in a food desert, compared to one in 10 or more whites. And that's another reason why, when we look at rates of cardiovascular disease, hypertension, diabetes, you see disparate health outcomes, because there are disparate resources that are there for people in our communities.

WENAnd it's so true, that the local corner store may be the only place that someone is getting any food of any kind. And so when that corner store burns down, and also people face huge issues with transportation, it just would not be realistic to tell someone, take two buses and walk 12 blocks in order to access your groceries.

WENAnd so these and the other problems, the other health effects that we are going to see from these protests, and I hope that there is, again, attention to them, that people need medications, they need food. That so many of the things that some of us may take for granted because we have cars and live in neighborhoods with grocery stores. These are things we take for granted, but need to ensure that they're there as we work towards a more equitable society longer term.

NNAMDIIndeed, over the weekend, you tweeted, quoting here, "racism is a public health issue, so we have two major public health issues staring us down." Where do we go from here?

WENI think part of it is acknowledging that we are in the midst of overlapping crises, health, economic, societal crises. It also involves acknowledging the fact that racism is a public health issue and therefore requires public health solutions, too. And I think we also then need to start somewhere with the solutions. So often, the problems that we face, like racism or like health care or a pandemic, seems to be so big and there are so many contributing factors, I think it's important for us to start somewhere and do what we can, recognizing that it's a small step, but inaction can no longer be an answer.

NNAMDIWe only have about 30 seconds left, but Nick emails: please don't only address the role of the protestors. Law enforcement are also people who may be carrying the coronavirus, and they're not always wearing masks and keeping their distance, either. Dr. Wen.

WENThey should also be. This is about all of us, in this together. Our individual actions affect one another. And, again, thinking of that COVID-19 and the effects of racial injustice affect the same population disproportionately. And it's incumbent on all of us to do our part.

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

WENThank you, Kojo.

NNAMDIDr. Wen is an emergency physician and professor of public health at George Washington University. She formerly served as Baltimore's health commissioner. Today's show was produced by Julie Depenbrock, Monna Kashfi and Lauren Markoe. Join us for the next Kojo in Your Virtual Community on racial disparities during the pandemic. We'll explore how the coronavirus has hit people of color especially hard, and what people are trying to do to lessen the health care inequality. The program starts at 7:30 p.m. on Tuesday, June 9th. It's free, but you need to register at kojoshow.org.

NNAMDIWe didn't want to go today before noting the passing of former Washington Wizard Wes Unseld. He was actually a member of the Washington Bullets, as the team was called, in those days. He passed at 74 years old. He was a phenomenon on the court, one of only two players in NBA history to win both Rookie of the Year and the MVP awards in the same season. Our condolences to Wes Unseld's family.

NNAMDIComing up tomorrow, the state of crime in Maryland, plus middle school students speak out about how gun violence has touched their lives. That's all coming up tomorrow, at noon. Until then, thank you for listening, and stay safe. I'm Kojo Nnamdi.