WEBVTT - Curing Social Distance Fatigue 0:00:07.560 --> 0:00:12.879 Welcome to Prognosis. I'm Laura Carlson. It's day seventy two 0:00:13.080 --> 0:00:17.360 since coronavirus was declared a global pandemic our main story. 0:00:18.400 --> 0:00:21.720 When lockdown measures went into effect in countries around the world, 0:00:22.239 --> 0:00:25.239 many expected to be trapped at home for a few weeks, 0:00:26.280 --> 0:00:30.320 but months into the pandemic, people are now looking for 0:00:30.360 --> 0:00:34.760 a way to make social distancings sustainable while tentatively returning 0:00:34.800 --> 0:00:38.320 to some of their old activities. State and local governments 0:00:38.360 --> 0:00:41.440 are having a hard time helping people navigate those gray 0:00:41.520 --> 0:00:48.479 areas because there are few clear answers. But first, here's 0:00:48.520 --> 0:00:59.800 what happened today. Yet another study is showing the dangers 0:00:59.840 --> 0:01:03.800 of antimillaria drugs touted by US President Donald Trump for 0:01:03.880 --> 0:01:08.880 treating COVID nineteen. Hydroxy chloroquine and chloroquine were linked to 0:01:08.920 --> 0:01:12.800 an increased risk of death and heart ailments. The drugs 0:01:12.840 --> 0:01:16.360 don't benefit patients with the coronavirus, either alone or in 0:01:16.440 --> 0:01:20.000 combination with other drugs, according to a study published today 0:01:20.240 --> 0:01:24.760 by the Lancet Medical Journal. Trump's endorsement has led many 0:01:24.800 --> 0:01:28.800 people to take the medications without scientific proof of their benefit. 0:01:29.640 --> 0:01:34.560 An experimental vaccine developed by Chinese company Cancino Biologics is 0:01:34.600 --> 0:01:38.240 showing promise. An early study shows that the vaccine was 0:01:38.360 --> 0:01:42.800 safe and generated an immune response. That's according to another 0:01:42.840 --> 0:01:46.840 report out today from The Lancet. The researchers from the 0:01:46.880 --> 0:01:52.000 Beijing Institute of Biotechnology and other organizations said further study 0:01:52.080 --> 0:01:57.480 is needed to show its effectiveness against the virus. And finally, 0:01:57.960 --> 0:02:02.200 coronavirus is having another direct health effect, this one on 0:02:02.440 --> 0:02:06.600 very small children. The pandemic has kept parents from taking 0:02:06.600 --> 0:02:10.959 their children to routine doctor visits. That means, according to 0:02:11.000 --> 0:02:14.720 the world's top health agencies, that more than eighty million 0:02:14.880 --> 0:02:17.680 children under the age of one are at risk of 0:02:17.760 --> 0:02:24.280 life threatening diseases like polio and measles. That's because routine 0:02:24.360 --> 0:02:28.280 vaccinations of children have been substantially hindered in at least 0:02:28.560 --> 0:02:31.840 sixty eight countries, according to data from the World Health 0:02:31.919 --> 0:02:38.239 Organization UNICEF and other organizations. The agencies called on countries 0:02:38.320 --> 0:02:43.440 to resume campaigns against vaccine preventable diseases and made recommendations 0:02:43.560 --> 0:02:54.800 on how to safely deliver shots. Amid the pandemic and 0:02:54.919 --> 0:03:02.040 now our main story, there's a growing public health argument 0:03:02.120 --> 0:03:05.160 about how people should calculate risk when it comes to 0:03:05.200 --> 0:03:08.960 social distancing. Many U S States are now lifting stay 0:03:08.960 --> 0:03:12.280 at home restrictions. Summer is around the corner, and people 0:03:12.360 --> 0:03:14.800 in the third month of what many hoped would be 0:03:14.840 --> 0:03:18.880 a week's long disruption are desperate to visit friends and 0:03:18.919 --> 0:03:22.959 get outside. That means we will be socializing a lot 0:03:23.040 --> 0:03:27.040 more in many cases without clear guidelines as to what's 0:03:27.280 --> 0:03:31.600 really risky. As we learn more about how the virus 0:03:31.639 --> 0:03:36.880 spreads and what constitutes risky behavior, messaging from experts will 0:03:36.960 --> 0:03:40.400 have to become a little more nuanced than just stay home, 0:03:40.720 --> 0:03:45.839 stay safe, reports Kristin V. Brown. Here's Kristen with more 0:03:45.880 --> 0:03:48.600 on how we can make social distancing work for the 0:03:48.720 --> 0:03:56.280 long haul. A few weeks ago, I did something that 0:03:56.320 --> 0:04:01.960 broke social distancing rules. I live in Oakland, California, and 0:04:02.000 --> 0:04:05.280 on March seventeen, my county enacted a strict shelter and 0:04:05.320 --> 0:04:09.280 place order That means no hanging out with friends or 0:04:09.320 --> 0:04:11.840 family you don't live with, or spending time outside of 0:04:11.840 --> 0:04:16.480 the house unless it's necessary at all. Like many people, 0:04:16.839 --> 0:04:19.640 I coped by moving my social life to the screen. 0:04:20.680 --> 0:04:23.520 I had lots of Zoom happy hours and Zoom game nights. 0:04:24.000 --> 0:04:26.120 My best friend I would go for runs while chatting 0:04:26.120 --> 0:04:29.480 on the phone. But a few weeks ago I hit 0:04:29.520 --> 0:04:32.279 a wall. I just wanted to have a drink with 0:04:32.320 --> 0:04:36.000 a friend in real life, so I suggested that my 0:04:36.040 --> 0:04:38.120 best friend and I meet for a drink in her backyard. 0:04:39.080 --> 0:04:42.599 We were careful, We stayed six ft apart, weight chips 0:04:42.600 --> 0:04:46.839 from separate bowls. It seemed really low risk, but still 0:04:47.360 --> 0:04:52.600 I felt guilty. Julia Marcus is an epidemiologist at Harvard University. 0:04:53.000 --> 0:04:57.640 She calls what I've been experiencing quarantine fatigue, and she 0:04:57.720 --> 0:05:01.560 says I am far from the only one feeling it today. 0:05:01.680 --> 0:05:05.000 The public health health messaging right now has been um 0:05:05.080 --> 0:05:07.640 stay at home, and of course that is the safest 0:05:07.640 --> 0:05:10.560 option right now, staying at home, either on your own 0:05:10.720 --> 0:05:13.680 or with your family, But it's not sustainable for the 0:05:13.720 --> 0:05:17.080 long term. Julia is among a growing number of people 0:05:17.120 --> 0:05:19.680 in the public health world to think the messaging around 0:05:19.760 --> 0:05:24.240 COVID nineteen needs to change. At the beginning of the pandemic, 0:05:24.600 --> 0:05:26.839 the idea was that we would all hunker down for 0:05:26.880 --> 0:05:29.880 a few weeks or even a few months until the 0:05:29.960 --> 0:05:34.200 virus was more under control. But now we're at an 0:05:34.200 --> 0:05:38.000 inflection point at states reopen. On the one hand, we 0:05:38.040 --> 0:05:40.240 still don't have a vaccine, and the threat of a 0:05:40.240 --> 0:05:43.680 new outbreak of disease is very real. But on the 0:05:43.720 --> 0:05:47.719 other hand, forcing people to continue to exclusively stay inside 0:05:48.240 --> 0:05:53.480 it's unsustainable and taking a real psychological toll. Julius has 0:05:53.520 --> 0:05:55.240 all of this means we need to make a plan 0:05:55.480 --> 0:05:59.039 for the long haul, and now that that's become clear 0:05:59.560 --> 0:06:01.800 that this is a long term proposition, we have to 0:06:01.920 --> 0:06:04.240 rethink how we're going to do this so that we 0:06:04.240 --> 0:06:06.560 can do it in a sustainable way and people can 0:06:06.600 --> 0:06:08.680 live their lives such that they have things to look 0:06:08.720 --> 0:06:11.440 forward to and they have joy, and they're not oppressed 0:06:11.480 --> 0:06:13.520 and isolated. And it's not going to look the way 0:06:13.520 --> 0:06:16.040 it did before. But you know, we have to adjust 0:06:16.040 --> 0:06:20.360 to a new normal that balances people's need for human 0:06:20.480 --> 0:06:24.120 contact with keeping the risk of transmission as low as possible. 0:06:24.760 --> 0:06:28.280 Julia studies HIV and points to the AIDS epidemic as 0:06:28.279 --> 0:06:32.200 an example of why our COVID nineteen playbook needs to change. 0:06:32.720 --> 0:06:36.920 Asking people to not have sex doesn't work, but advising 0:06:36.960 --> 0:06:39.760 people in ways they can have sex while reducing the 0:06:39.839 --> 0:06:43.800 chances that they'll contract the virus does. She says, New 0:06:43.880 --> 0:06:47.640 York City today is setting a good example, It just 0:06:47.680 --> 0:06:51.400 put out guidelines on sexual health during COVID nineteen. The 0:06:51.440 --> 0:06:54.680 best way to avoid risk, the guidelines say is to 0:06:54.760 --> 0:06:58.320 not have sex, but it does recognize not everyone is 0:06:58.320 --> 0:07:01.040 going to follow that advice and suggest some ways to 0:07:01.160 --> 0:07:05.000 decrease the risk of other scenarios. To health is not 0:07:05.160 --> 0:07:09.200 just prevention of disease transmission, and there are other aspects 0:07:09.360 --> 0:07:12.120 to health that we're going to need to consider. We 0:07:12.160 --> 0:07:14.240 don't want to see an increase in suicide, you know 0:07:14.280 --> 0:07:17.000 what I mean, It's there. There's a lot to balance 0:07:17.080 --> 0:07:20.240 here that I think needs the more holistic approach to 0:07:20.320 --> 0:07:22.840 health if we're going to do this. The other thing 0:07:23.120 --> 0:07:25.680 is that we know more about COVID nineteen than we 0:07:25.720 --> 0:07:28.520 did two months ago. We have a better idea of 0:07:28.560 --> 0:07:32.120 how it spreads and of who is most susceptible to 0:07:32.200 --> 0:07:36.160 getting really sick from it. Marty Marqueri is a public 0:07:36.160 --> 0:07:39.960 health expert at Johns Hopkins. He says he first supported 0:07:39.960 --> 0:07:44.360 sheltering in place in order to reduce the burden on hospitals, 0:07:44.400 --> 0:07:49.680 but things have changed now that we have flatten the 0:07:49.680 --> 0:07:54.080 curve nationally, now that we have data coming in showing 0:07:54.640 --> 0:07:57.680 that it is it has fallen short of some of 0:07:57.680 --> 0:08:03.400 the more dire projections. We need to evolve our strategy, 0:08:04.080 --> 0:08:07.480 and at the same time, the country simply cannot tolerate 0:08:08.120 --> 0:08:12.840 anymore of a harsh shutdown. Marty says that we need 0:08:12.880 --> 0:08:16.360 to customize public health recommendations to better fit what we 0:08:16.480 --> 0:08:20.360 now know about the virus. For example, we now know 0:08:20.680 --> 0:08:23.720 that the virus is much less likely to spread outdoors. 0:08:24.400 --> 0:08:27.040 Most cases seem to come from people who have close 0:08:27.080 --> 0:08:31.160 contact with each other, so have that socially distanced drink 0:08:31.200 --> 0:08:38.599 in the backyard. Some of this thinking has actually already 0:08:38.720 --> 0:08:43.640 made its way into policy. For example, in California, businesses 0:08:43.679 --> 0:08:47.319 can now open up for curbside pickup that will reduce 0:08:47.400 --> 0:08:51.200 contact opportunities, but will also allow life to inch back 0:08:51.280 --> 0:08:55.200 towards normal. Marty says that businesses might even be able 0:08:55.240 --> 0:08:58.920 to just shift to sidewalk shopping. He says, we need 0:08:58.920 --> 0:09:04.439 to completely rethink many aspects of society. We can actually 0:09:04.520 --> 0:09:09.080 fight this thing with a pretty good toolbox of many 0:09:09.120 --> 0:09:14.680 different interventions and have a lot of success. Now does 0:09:14.720 --> 0:09:19.320 that mean that people can resume summer camps and kids 0:09:19.360 --> 0:09:23.840 can play soccer together? It depends on the local viral 0:09:23.920 --> 0:09:28.160 burden in that community. So there's no one size fits 0:09:28.160 --> 0:09:32.040 all strategy, and the strategy needs to evolve. But not 0:09:32.240 --> 0:09:35.360 every region has taken into account what we've learned about 0:09:35.400 --> 0:09:40.280 the virus in deciding how to roll back restrictions. In Alabama, 0:09:40.440 --> 0:09:43.679 for example, restaurants and bars have been allowed to reopen 0:09:43.720 --> 0:09:46.920 with limited seating, even though the state has yet to 0:09:46.920 --> 0:09:51.320 meet White House reopening criteria. The percentage of positive tests 0:09:51.320 --> 0:09:55.120 in the state has increased, causing concern that a second 0:09:55.120 --> 0:09:58.600 wave of the virus may be on the way. Marty 0:09:58.640 --> 0:10:01.560 says public health officials could create a virus threat level 0:10:01.600 --> 0:10:05.200 for every community. This would change as a virus does 0:10:05.480 --> 0:10:08.880 and help people better make their own risk assessments. In 0:10:08.880 --> 0:10:12.040 the United States now with the pandemic, we have numbers 0:10:12.080 --> 0:10:17.160 of cases, hospitalizations, new intubations, and we can create a 0:10:17.280 --> 0:10:23.280 risk level for every locale, which will actually stratify the 0:10:23.400 --> 0:10:30.040 degree of elective activities, be it um, social gathering, sporting events, 0:10:30.160 --> 0:10:34.280 or essential services. And so we can do this. We 0:10:34.360 --> 0:10:38.560 can figure out, hey, in this particular community, the disease 0:10:38.840 --> 0:10:42.880 burden is so low that it's reasonable for young, healthy 0:10:42.920 --> 0:10:47.439 people to essentially do whatever they want in that community. 0:10:47.920 --> 0:10:50.360 In other areas, we can say, look there's still a risk. 0:10:50.679 --> 0:10:52.840 It's not a severe risk, but it's a moderate risk. 0:10:53.360 --> 0:10:58.239 We're going to ask people to limit themselves to activities 0:10:58.280 --> 0:11:03.200 where they can conduct them selves with distancing hygiene masks 0:11:03.520 --> 0:11:07.040 and redesigned business processes. That's very feasible and that's what 0:11:07.080 --> 0:11:10.679 we should be doing. The big message here is that 0:11:10.720 --> 0:11:14.160 now that the virus spread has slowed, public health policy 0:11:14.240 --> 0:11:18.360 requires more of a balancing act. We need to consider 0:11:18.559 --> 0:11:21.839 not just risk of exposure to the virus, but mental health, 0:11:22.000 --> 0:11:28.080 economic well being, access to other kinds of healthcare, and happiness. 0:11:28.120 --> 0:11:49.480 That said, don't count on shaking hands anytime soon. That 0:11:49.840 --> 0:11:53.120 was Kristin V. Brown and that's our show today. For 0:11:53.240 --> 0:11:56.360 coverage of the outbreak from one bureaus around the world, 0:11:56.640 --> 0:12:01.240 visit Bloomberg dot com slash coronavirus and if you like 0:12:01.320 --> 0:12:04.360 the show, please leave us a review and a rating 0:12:04.559 --> 0:12:08.280 on Apple Podcasts or Spotify. It's the best way to 0:12:08.320 --> 0:12:13.040 help more listeners find our global reporting. The Prognosis Daily 0:12:13.200 --> 0:12:17.760 edition is produced by Topher Foreheads Jordan Gospore, Magnus Hendrickson 0:12:17.920 --> 0:12:22.200 and me Laura Carlson. Today's main story was reported by 0:12:22.280 --> 0:12:27.800 Kristin V. Brown. Original music by Leo Sidran. Our editors 0:12:27.800 --> 0:12:32.760 are Francesca Levi and Rick Shine. Francesca Levie is Bloomberg's 0:12:32.800 --> 0:12:35.360 head of podcasts. Thanks for listening.