1 00:00:15,356 --> 00:00:22,916 Speaker 1: Pushkin from Pushkin Industries. This is Deep Background, the show 2 00:00:22,916 --> 00:00:26,236 Speaker 1: where we explored the stories behind the stories in the news. 3 00:00:26,836 --> 00:00:28,876 Speaker 1: And if I sound a little different on this episode, 4 00:00:29,036 --> 00:00:32,876 Speaker 1: it's because, in deference to Corona norms, I'm actually recording 5 00:00:32,916 --> 00:00:36,996 Speaker 1: it myself without the aid of our excellent sound engineers. 6 00:00:38,436 --> 00:00:41,196 Speaker 1: Right now, I think the most immediate question on my mind, 7 00:00:41,236 --> 00:00:43,636 Speaker 1: and it may be on your mind too, is how 8 00:00:43,676 --> 00:00:46,436 Speaker 1: do I know if my symptoms were those of one 9 00:00:46,476 --> 00:00:51,236 Speaker 1: of my loved ones actually correspond to coronavirus. There's tons 10 00:00:51,236 --> 00:00:53,796 Speaker 1: of information going around on the Internet, and it's a 11 00:00:53,836 --> 00:00:58,196 Speaker 1: little hard to know what's reliable and what isn't. I 12 00:00:58,236 --> 00:01:00,516 Speaker 1: thought it would be useful to talk to a frontline 13 00:01:00,596 --> 00:01:04,836 Speaker 1: primary care physician who's actually in charge of programs where 14 00:01:04,916 --> 00:01:08,076 Speaker 1: lots and lots of doctors are seeing patients who are 15 00:01:08,116 --> 00:01:13,276 Speaker 1: presenting with coronavirus. So I called doctor Rebecca Berman, the 16 00:01:13,356 --> 00:01:17,556 Speaker 1: program director at the University of California, San Francisco's Internal 17 00:01:17,596 --> 00:01:21,596 Speaker 1: Medicine Residency program. That means she's the person in charge 18 00:01:21,596 --> 00:01:24,636 Speaker 1: of training the actual doctors who are going to become 19 00:01:25,156 --> 00:01:29,316 Speaker 1: residents in internal medicine. An internal medicine means in a hospital, 20 00:01:29,636 --> 00:01:34,196 Speaker 1: the main job of seeing patients. I asked Rebecca about 21 00:01:34,196 --> 00:01:38,156 Speaker 1: how we should be thinking about symptoms, which symptoms actually 22 00:01:38,196 --> 00:01:40,156 Speaker 1: tell us that we should go to the hospital, what 23 00:01:40,196 --> 00:01:42,156 Speaker 1: we should do if we're not going to the hospital, 24 00:01:42,476 --> 00:01:47,756 Speaker 1: and how preparedness is going inside UCSF. Rebecca, you are 25 00:01:47,836 --> 00:01:52,836 Speaker 1: literally on the front lines facing the current coronavirus situation. 26 00:01:53,516 --> 00:01:56,836 Speaker 1: I wonder if you could start us off by telling 27 00:01:56,916 --> 00:02:01,716 Speaker 1: us how you and your physicians in your training program 28 00:02:01,756 --> 00:02:05,716 Speaker 1: are doing the first line diagnosis. When someone comes in 29 00:02:05,756 --> 00:02:08,796 Speaker 1: to the hospital and says, I'm feeling lousy, I think 30 00:02:08,796 --> 00:02:12,476 Speaker 1: I have coronavirus. What algorithm are you guys using? Well, 31 00:02:12,516 --> 00:02:15,276 Speaker 1: I think something that's challenging about coronavirus is that for 32 00:02:15,356 --> 00:02:18,636 Speaker 1: a lot of people, they functionally have cold symptoms. So 33 00:02:18,676 --> 00:02:21,356 Speaker 1: we're all kind of worried. I have chronic allergies, and 34 00:02:21,396 --> 00:02:24,116 Speaker 1: it makes me worried constantly, like is this running nose 35 00:02:24,156 --> 00:02:27,116 Speaker 1: different than the normal running nose that I always have? 36 00:02:27,716 --> 00:02:30,916 Speaker 1: And so I think for us in the hospital, the 37 00:02:30,996 --> 00:02:33,396 Speaker 1: things we're most worried about, and the people were actually 38 00:02:33,436 --> 00:02:36,236 Speaker 1: testing are those who seem sick, those who are having 39 00:02:36,276 --> 00:02:41,236 Speaker 1: shortness of breath or fever. The presenting symptoms can just 40 00:02:41,276 --> 00:02:43,916 Speaker 1: be cough and running nose, and then some people is asymptomatic. 41 00:02:43,956 --> 00:02:46,716 Speaker 1: So we're also seeing our primary care clinics kind of 42 00:02:46,756 --> 00:02:49,356 Speaker 1: flooded with people who are worried and want testing. But 43 00:02:49,476 --> 00:02:52,156 Speaker 1: right now, given the limited number of test kits that 44 00:02:52,196 --> 00:02:55,636 Speaker 1: we have, we're trying to encourage people not to come 45 00:02:55,636 --> 00:03:01,196 Speaker 1: in if they aren't actively feeling feverish and short of breath, 46 00:03:01,676 --> 00:03:06,556 Speaker 1: because simply testing someone who's not that sick but symptomatic 47 00:03:06,636 --> 00:03:08,356 Speaker 1: is going to result in the same treatment, which is 48 00:03:08,356 --> 00:03:11,396 Speaker 1: to tell them to self quarantine at home for fourteen days. 49 00:03:11,756 --> 00:03:13,836 Speaker 1: It is really hard for people to be stuck at 50 00:03:13,876 --> 00:03:16,276 Speaker 1: home right now, although frankly here in San Francisco most 51 00:03:16,276 --> 00:03:19,116 Speaker 1: people are stuck at home right now, but that is 52 00:03:19,156 --> 00:03:21,996 Speaker 1: what we are doing. In terms of diagnosis. At this point, 53 00:03:22,076 --> 00:03:25,196 Speaker 1: we are trying to triage. We have a COVID nineteen 54 00:03:25,396 --> 00:03:28,596 Speaker 1: infectious disease doctor on call at all times, and we 55 00:03:28,716 --> 00:03:32,796 Speaker 1: run cases by them in order to choose who needs testing. 56 00:03:33,796 --> 00:03:36,916 Speaker 1: I completely understand that from the hospital's perspective, you don't 57 00:03:36,916 --> 00:03:39,516 Speaker 1: want to be flooded with people who might be positive 58 00:03:39,996 --> 00:03:42,796 Speaker 1: but can't at present be treated, So it makes sense 59 00:03:42,836 --> 00:03:46,236 Speaker 1: to say only come in if you have the shortness 60 00:03:46,316 --> 00:03:49,716 Speaker 1: of breath and the fever. In terms of people's own 61 00:03:49,756 --> 00:03:52,356 Speaker 1: self diagnosis at home, though, however, there's sort of like 62 00:03:52,636 --> 00:03:56,836 Speaker 1: a plethora of information out there, much of it surely inaccurate. 63 00:03:56,836 --> 00:03:59,556 Speaker 1: And I've heard all kinds of things, you know, people saying, well, 64 00:03:59,556 --> 00:04:01,676 Speaker 1: you know, if you have a running nose, that's not it, 65 00:04:01,756 --> 00:04:03,756 Speaker 1: and others saying, well, if you have a sore throat, 66 00:04:03,796 --> 00:04:05,676 Speaker 1: that's it, but if you're coughing, that's not it. I mean, 67 00:04:05,836 --> 00:04:07,836 Speaker 1: I guess what I'm wondering is, first, just at the 68 00:04:07,916 --> 00:04:11,036 Speaker 1: very basic level of the sis, is this all ridiculous? 69 00:04:11,036 --> 00:04:13,236 Speaker 1: I mean, is it? In the end, the full range 70 00:04:13,236 --> 00:04:17,396 Speaker 1: of cold like symptoms could be indicators of COVID nineteen. Well, 71 00:04:17,436 --> 00:04:20,796 Speaker 1: I think what's hard is in most people, cough is 72 00:04:20,796 --> 00:04:24,396 Speaker 1: the presenting symptom, often a dry cough, but sometimes productive. 73 00:04:24,796 --> 00:04:27,276 Speaker 1: It's true that running nose makes it less likely, but 74 00:04:27,316 --> 00:04:29,636 Speaker 1: it doesn't rule it out. So about fifteen percent of 75 00:04:29,676 --> 00:04:34,076 Speaker 1: people with coronavirus are going to have runny nose. So 76 00:04:34,396 --> 00:04:35,956 Speaker 1: if you have a running nose, it can make you 77 00:04:35,956 --> 00:04:38,116 Speaker 1: feel a little better, but it doesn't mean definitely you 78 00:04:38,156 --> 00:04:41,996 Speaker 1: do not have it. The guidelines that are health occupational 79 00:04:41,996 --> 00:04:45,276 Speaker 1: health is giving us to help us as healthcare workers 80 00:04:45,276 --> 00:04:47,036 Speaker 1: know when not to come in. Are saying, if you 81 00:04:47,036 --> 00:04:49,676 Speaker 1: have two of those symptoms like sore throat and cough 82 00:04:49,836 --> 00:04:54,116 Speaker 1: or cough and runny nose, and they're getting worse over 83 00:04:54,236 --> 00:04:57,116 Speaker 1: two days, than you should stay home. And so I 84 00:04:57,156 --> 00:04:59,876 Speaker 1: think using those guidelines more widely as a wise one. 85 00:04:59,956 --> 00:05:02,636 Speaker 1: I think, did you say fifteen percent of the people 86 00:05:03,116 --> 00:05:06,916 Speaker 1: who are positive for the virus do have a running nose. 87 00:05:06,916 --> 00:05:08,516 Speaker 1: So the running nose is not a guarante. It's not 88 00:05:08,756 --> 00:05:11,076 Speaker 1: necessary an indicator that you have it, but it's certainly 89 00:05:11,076 --> 00:05:13,356 Speaker 1: not a reason to think you don't have it exactly. 90 00:05:13,396 --> 00:05:15,356 Speaker 1: Then what about the sore throat? Where does the sore 91 00:05:15,396 --> 00:05:19,076 Speaker 1: throat fall in? Sore throats also are seen in less 92 00:05:19,076 --> 00:05:23,156 Speaker 1: than fifteen percent of patients, and similarly, GI symptoms like 93 00:05:23,236 --> 00:05:26,836 Speaker 1: nausere vomiting, or diarrhea are seen in a low percentage 94 00:05:26,836 --> 00:05:30,756 Speaker 1: of patients. So it's really a combination of different elements 95 00:05:30,756 --> 00:05:34,116 Speaker 1: that give you clinically an indication that you're probably looking 96 00:05:34,116 --> 00:05:38,196 Speaker 1: at a corona case, with kauf being the most significant 97 00:05:38,516 --> 00:05:41,836 Speaker 1: and fever the next most significant, and then the things 98 00:05:41,916 --> 00:05:44,996 Speaker 1: like running nose or sore throat they don't have a 99 00:05:45,076 --> 00:05:47,956 Speaker 1: huge indicating effect. But their absence also doesn't tell you much. 100 00:05:48,036 --> 00:05:50,076 Speaker 1: If it's fifteen or twenty percent of the people have 101 00:05:50,116 --> 00:05:51,756 Speaker 1: that symptom, then the fact that they're not there doesn't 102 00:05:51,756 --> 00:05:54,196 Speaker 1: tell you very much. If they are there, it might 103 00:05:54,236 --> 00:05:56,596 Speaker 1: be indicative as well. I guess. I guess if they 104 00:05:56,596 --> 00:05:58,636 Speaker 1: are there, it's like a little reassuring, but it's not 105 00:05:58,676 --> 00:06:01,956 Speaker 1: a slam dunk. So I think the advice that if 106 00:06:01,956 --> 00:06:04,636 Speaker 1: you're not feeling well, stay home and isolate is a 107 00:06:04,636 --> 00:06:08,516 Speaker 1: good one. And what about the core takeaway question, which 108 00:06:08,596 --> 00:06:11,756 Speaker 1: is I'm at home. I think I have these symptoms. 109 00:06:11,796 --> 00:06:14,596 Speaker 1: I have a fever, it's not terrible, but I don't 110 00:06:14,596 --> 00:06:17,236 Speaker 1: have shortness of breath. And I have let's say, a 111 00:06:17,596 --> 00:06:21,236 Speaker 1: serious cough. Should I come in or should I just 112 00:06:21,516 --> 00:06:25,716 Speaker 1: self isolate? Right away? I would say you should self isolate. 113 00:06:25,756 --> 00:06:31,276 Speaker 1: If you have underlying medical problems like diabetes, or you're immunocompromised, 114 00:06:31,356 --> 00:06:34,596 Speaker 1: or you're pregnant, certainly call your physician. But the last 115 00:06:34,596 --> 00:06:36,196 Speaker 1: thing you want to do is come to a hospital 116 00:06:36,196 --> 00:06:38,836 Speaker 1: where they're going to be other patients who have this 117 00:06:39,356 --> 00:06:43,276 Speaker 1: walking around. You would rather stay at home. So I 118 00:06:43,276 --> 00:06:45,436 Speaker 1: think our biggest fear is that the health system is 119 00:06:45,436 --> 00:06:48,276 Speaker 1: going to be overwhelmed by what we call the worried well, 120 00:06:48,356 --> 00:06:51,556 Speaker 1: people who are relatively asymptomatic or have minor symptoms of 121 00:06:51,596 --> 00:06:54,036 Speaker 1: this disease, who are worried and come in when they 122 00:06:54,076 --> 00:06:57,116 Speaker 1: don't need to, and in this instance, well would just 123 00:06:57,196 --> 00:06:58,996 Speaker 1: mean well enough that they don't have to be admitted, 124 00:06:58,996 --> 00:07:01,036 Speaker 1: because maybe the worried well in this case actually will 125 00:07:01,076 --> 00:07:04,556 Speaker 1: have coronavirus, but they're well enough to stay home. So 126 00:07:04,596 --> 00:07:06,516 Speaker 1: in that sense, they're they're the worried well. They're not 127 00:07:06,556 --> 00:07:09,556 Speaker 1: they're not the irrationally worried well. Under these just then 128 00:07:09,676 --> 00:07:13,236 Speaker 1: not intensely sick. Perhaps we should call them the worried 129 00:07:13,316 --> 00:07:16,716 Speaker 1: mildly sick. That's not as catchy as the worried well, 130 00:07:16,716 --> 00:07:19,436 Speaker 1: but it sounds helpful. So for the rest of us 131 00:07:19,436 --> 00:07:21,596 Speaker 1: will try not to enter the category of the worried 132 00:07:21,716 --> 00:07:25,036 Speaker 1: mildly sick. But those people at this point should stay 133 00:07:25,076 --> 00:07:28,716 Speaker 1: home so as not to overwhelm the system. And when 134 00:07:28,716 --> 00:07:31,916 Speaker 1: you start to feel genuinely sick, that's the time to 135 00:07:32,316 --> 00:07:36,196 Speaker 1: go in correct. So that brings me to the really 136 00:07:36,276 --> 00:07:38,676 Speaker 1: fascinating point that you brought up, that I deflected us 137 00:07:38,676 --> 00:07:40,556 Speaker 1: from because I wanted to know whether we have we 138 00:07:40,596 --> 00:07:43,236 Speaker 1: all hell, we know whether we have the virus, which 139 00:07:43,316 --> 00:07:45,956 Speaker 1: is the idea that is part of your triage. You'd 140 00:07:45,956 --> 00:07:47,996 Speaker 1: have to deal with the fact that we just don't 141 00:07:47,996 --> 00:07:50,436 Speaker 1: have enough tests. And I want to ask you about 142 00:07:50,436 --> 00:07:53,116 Speaker 1: this because you know, one of the forms of criticism 143 00:07:53,116 --> 00:07:57,156 Speaker 1: that one hears of us prepared in this here is well, gee, 144 00:07:57,156 --> 00:07:58,796 Speaker 1: they're just not enough tests here, and there are more 145 00:07:58,836 --> 00:08:00,996 Speaker 1: tests available in other countries and we should have been 146 00:08:01,156 --> 00:08:03,596 Speaker 1: better prepared there. And that seems plausible to me. But 147 00:08:03,636 --> 00:08:07,756 Speaker 1: I've heard a counter argument as well that said something like, well, look, 148 00:08:07,876 --> 00:08:10,476 Speaker 1: if ultimately it could be between forty and seventy percent 149 00:08:10,476 --> 00:08:13,916 Speaker 1: of adults who get this, testing isn't really what's significant 150 00:08:13,916 --> 00:08:15,236 Speaker 1: at this point. And what's more, if we don't have 151 00:08:15,316 --> 00:08:17,956 Speaker 1: a treatment for most people except that they're very, very 152 00:08:17,956 --> 00:08:20,796 Speaker 1: sick and we put them on a ventilator, the testing 153 00:08:20,956 --> 00:08:23,596 Speaker 1: isn't really the key. The lack of tests isn't really 154 00:08:23,596 --> 00:08:25,276 Speaker 1: our problem here, and we should just be more focused 155 00:08:25,276 --> 00:08:27,996 Speaker 1: on the broader public health response. Do you have a 156 00:08:28,116 --> 00:08:30,156 Speaker 1: much more informed view on that debate than I have. 157 00:08:30,556 --> 00:08:33,916 Speaker 1: I mean, to me, there's two different questions, like having 158 00:08:33,996 --> 00:08:37,436 Speaker 1: limited testing is extremely stressful on the health system. It 159 00:08:37,436 --> 00:08:42,236 Speaker 1: actually means we can't test doctors who have been exposed, 160 00:08:42,716 --> 00:08:44,276 Speaker 1: or if we test them, how do we know that 161 00:08:44,316 --> 00:08:46,356 Speaker 1: those tests are correct should they really come back to 162 00:08:46,396 --> 00:08:49,716 Speaker 1: the frontline. So from a workforce perspective, that's very stressful. 163 00:08:49,996 --> 00:08:52,116 Speaker 1: In my ideal world, we would have so many tests 164 00:08:52,156 --> 00:08:55,156 Speaker 1: available that we could swab everyone who comes into the 165 00:08:55,196 --> 00:08:58,836 Speaker 1: hospital every few days and make sure that they are 166 00:08:58,876 --> 00:09:01,356 Speaker 1: being protected and that they're not bringing any virus into 167 00:09:01,396 --> 00:09:05,196 Speaker 1: the hospital. So I do think that there's two different questions. 168 00:09:05,196 --> 00:09:08,596 Speaker 1: One is does your average person at home where we 169 00:09:08,676 --> 00:09:11,156 Speaker 1: can't actually really treat it, is it important for us 170 00:09:11,196 --> 00:09:16,116 Speaker 1: to have that diagnosis versus this second question of healthcare workers. 171 00:09:16,356 --> 00:09:18,436 Speaker 1: And then I think the other problem with not having 172 00:09:18,476 --> 00:09:21,156 Speaker 1: widespread testing. Part of the reason Korea's numbers look so 173 00:09:21,236 --> 00:09:24,196 Speaker 1: great in terms of their number of people who have 174 00:09:24,316 --> 00:09:28,236 Speaker 1: gotten very, very sick is that they've done widespread testing, 175 00:09:28,276 --> 00:09:30,556 Speaker 1: So they're testing a whole bunch of asymptomatic people. They 176 00:09:30,556 --> 00:09:32,916 Speaker 1: have a much better sense of what the denominator is 177 00:09:32,916 --> 00:09:35,636 Speaker 1: of how many people have this virus compared to how 178 00:09:35,636 --> 00:09:38,756 Speaker 1: many gets sick. Here, we're only testing a small portion 179 00:09:38,796 --> 00:09:42,076 Speaker 1: of people, which means that we don't really know what 180 00:09:42,196 --> 00:09:45,956 Speaker 1: percentage of people get very sick from this. It seems 181 00:09:46,076 --> 00:09:48,956 Speaker 1: that it's about three percent of people, but again, we 182 00:09:49,036 --> 00:09:50,836 Speaker 1: just don't know because we have no idea how widely 183 00:09:50,876 --> 00:09:55,516 Speaker 1: spread this is. So to me, I mean defunding our 184 00:09:55,596 --> 00:10:01,676 Speaker 1: pandemic response was a tremendously large error of leadership. And 185 00:10:01,956 --> 00:10:04,756 Speaker 1: I'm grateful to our state and local governments who are 186 00:10:04,796 --> 00:10:07,356 Speaker 1: really trying to step in in this moment. But it 187 00:10:07,396 --> 00:10:12,236 Speaker 1: would be better if testing were more widely available. Rebecca, 188 00:10:12,236 --> 00:10:14,076 Speaker 1: I understand that it's tentative, but tell me again, what 189 00:10:14,156 --> 00:10:16,476 Speaker 1: was that three percent number? That's the number of people 190 00:10:16,636 --> 00:10:20,236 Speaker 1: whom you think of at present who are exposed who 191 00:10:20,236 --> 00:10:21,796 Speaker 1: are getting very sick, or is it the number of 192 00:10:21,836 --> 00:10:23,956 Speaker 1: people who have the coronavirus who are getting very sick? 193 00:10:24,476 --> 00:10:27,716 Speaker 1: I think between two and three percent is the number 194 00:10:27,796 --> 00:10:31,996 Speaker 1: being bandied about of the number of people who will 195 00:10:32,516 --> 00:10:37,276 Speaker 1: die who get the virus. Right. I've heard that number 196 00:10:37,316 --> 00:10:40,076 Speaker 1: as well, and based I think it's largely based on 197 00:10:40,116 --> 00:10:43,876 Speaker 1: the Wuhan statistics, right. Correct. Now, let's move on to 198 00:10:43,916 --> 00:10:47,756 Speaker 1: what happens when you're treating a patient. The patient comes 199 00:10:47,796 --> 00:10:51,836 Speaker 1: in the patient is symptomatic enough for you to give 200 00:10:51,876 --> 00:10:55,916 Speaker 1: them a test. Let's say you determine their positive for coronavirus, 201 00:10:56,156 --> 00:10:58,636 Speaker 1: but they're not so sick that they need to be 202 00:10:58,676 --> 00:11:02,196 Speaker 1: admitted to the hospital, so you send them home into 203 00:11:02,236 --> 00:11:07,356 Speaker 1: effectively self quarantine. Correct, Correct? And what is that supposed 204 00:11:07,396 --> 00:11:09,556 Speaker 1: to mean in real practical terms? I think a lot 205 00:11:09,596 --> 00:11:12,436 Speaker 1: of listeners out there are wondering. We hear this phrase 206 00:11:12,596 --> 00:11:14,796 Speaker 1: self quarantine or I guess in that case, self isolation, 207 00:11:15,276 --> 00:11:18,716 Speaker 1: but we don't really know how much exposure to other 208 00:11:18,796 --> 00:11:20,916 Speaker 1: humans that entails. I mean, is it literally meant to 209 00:11:20,916 --> 00:11:24,116 Speaker 1: be lock yourself in your room and do not see 210 00:11:24,236 --> 00:11:25,876 Speaker 1: the other people who live in your house, if there 211 00:11:25,916 --> 00:11:29,076 Speaker 1: are any I mean, in an ideal world, yes, right, 212 00:11:29,156 --> 00:11:32,596 Speaker 1: it's ideally have your own room, in your own bathroom, 213 00:11:33,236 --> 00:11:36,516 Speaker 1: and have someone like leave food at the door that 214 00:11:36,676 --> 00:11:39,076 Speaker 1: you then open the door and get the food and 215 00:11:39,156 --> 00:11:42,676 Speaker 1: shut it, recognizing that for some people that's not going 216 00:11:42,716 --> 00:11:45,676 Speaker 1: to be possible. But you know, there was a case 217 00:11:46,396 --> 00:11:48,716 Speaker 1: in Asia of a family of nine who, like one 218 00:11:48,716 --> 00:11:51,236 Speaker 1: of them was on isolation and they all shared hotpot 219 00:11:51,316 --> 00:11:55,236 Speaker 1: and they all got coronavirus. And so certainly I think 220 00:11:55,356 --> 00:11:58,916 Speaker 1: trying to really isolate, I mean, luckily we all have computers. 221 00:11:58,916 --> 00:12:01,076 Speaker 1: I would recommend trying to be in a room with 222 00:12:01,116 --> 00:12:03,716 Speaker 1: a computer so you can still have contact with the 223 00:12:03,756 --> 00:12:06,276 Speaker 1: outside world. I'm hearing lots of creative things that people 224 00:12:06,276 --> 00:12:10,236 Speaker 1: are doing, you know, zoom coffee hours, going to art 225 00:12:10,276 --> 00:12:12,756 Speaker 1: galleries online and things, so you don't go bananas. But 226 00:12:12,836 --> 00:12:15,036 Speaker 1: I do think that it's really important for people to 227 00:12:15,556 --> 00:12:18,516 Speaker 1: take this seriously, especially if you live with old people 228 00:12:18,596 --> 00:12:22,556 Speaker 1: or anyone who's immuno compromised. Well, I think probably everybody 229 00:12:22,556 --> 00:12:26,356 Speaker 1: would take it seriously if they had a positive diagnosis. 230 00:12:26,356 --> 00:12:28,956 Speaker 1: The real question, I think is for people who don't 231 00:12:28,956 --> 00:12:32,596 Speaker 1: have that and are just sort of at home under 232 00:12:33,116 --> 00:12:37,076 Speaker 1: self quarantine or because there's a broad shelter in place 233 00:12:37,316 --> 00:12:40,796 Speaker 1: order in effect, the question that is how precise they 234 00:12:40,796 --> 00:12:42,996 Speaker 1: should be. I mean that it's not recommended that those 235 00:12:42,996 --> 00:12:45,876 Speaker 1: people self isolate. That's only if you are confident or 236 00:12:45,916 --> 00:12:49,236 Speaker 1: you think it's a high probability that you have the virus. Right, yes, So, 237 00:12:49,356 --> 00:12:51,956 Speaker 1: just to be clear, Shelter in place is different than 238 00:12:51,996 --> 00:12:54,916 Speaker 1: self isolation. Shelter in place is saying stay in your 239 00:12:54,916 --> 00:12:57,316 Speaker 1: home and share your germs with your family or the 240 00:12:57,356 --> 00:12:59,836 Speaker 1: people that you live with, but don't go outside and 241 00:12:59,876 --> 00:13:02,116 Speaker 1: share it with other people. Sort of keep your germs 242 00:13:02,116 --> 00:13:05,916 Speaker 1: to your little group. It doesn't matter whether it's you 243 00:13:05,996 --> 00:13:08,596 Speaker 1: and your family, or it's you and your roommates or 244 00:13:08,636 --> 00:13:10,516 Speaker 1: the other people who live in a group house with you. 245 00:13:10,756 --> 00:13:12,596 Speaker 1: You're going to share. You're going to share germs with 246 00:13:12,636 --> 00:13:15,156 Speaker 1: those people in an ordinary shelter in place, right, I 247 00:13:15,156 --> 00:13:17,236 Speaker 1: mean the ideas, try to be a little more cognizant, 248 00:13:17,316 --> 00:13:19,996 Speaker 1: don't share spoons and forks and things, and wash your 249 00:13:19,996 --> 00:13:23,716 Speaker 1: hands a lot. But recognizing that it's impossible for people 250 00:13:23,756 --> 00:13:28,236 Speaker 1: to completely isolate. That being said, if you have symptoms, 251 00:13:28,716 --> 00:13:30,996 Speaker 1: act like you have the virus. It doesn't matter whether 252 00:13:31,116 --> 00:13:33,916 Speaker 1: or not you have a positive test. We don't currently 253 00:13:33,916 --> 00:13:37,276 Speaker 1: have testing capacity, So people should take this seriously. If 254 00:13:37,276 --> 00:13:40,396 Speaker 1: you aren't feeling well, isolate yourself from the other people 255 00:13:40,396 --> 00:13:42,756 Speaker 1: that you live with, and how long should you do 256 00:13:42,796 --> 00:13:44,396 Speaker 1: that before? I mean, again, this is something that I 257 00:13:44,476 --> 00:13:47,676 Speaker 1: think has not really fully trickled down to the general 258 00:13:47,716 --> 00:13:49,556 Speaker 1: listener yet. It certainly hasn't to me. So if you 259 00:13:49,636 --> 00:13:53,796 Speaker 1: have flu like symptoms or cold like symptoms and your 260 00:13:53,796 --> 00:13:56,076 Speaker 1: self diagnosis is like, I don't know if I have coronavirus. 261 00:13:56,116 --> 00:13:58,716 Speaker 1: I didn't go to medical school, but I'm feeling lousy. 262 00:13:59,316 --> 00:14:02,956 Speaker 1: Your recommendation is go into self isolation as though you 263 00:14:03,036 --> 00:14:05,436 Speaker 1: had the virus, correct, And the recommendations are to do 264 00:14:05,476 --> 00:14:08,316 Speaker 1: that for fourteen days. I think if you start feeling 265 00:14:08,356 --> 00:14:11,276 Speaker 1: better after it or two, it's probably not coronavirus, and 266 00:14:11,316 --> 00:14:14,916 Speaker 1: so you can feel better about coming out of isolation. 267 00:14:15,036 --> 00:14:18,196 Speaker 1: But you know, better safe than sorry. But is that 268 00:14:18,236 --> 00:14:21,036 Speaker 1: true that if it's coronavirus it's not going to go 269 00:14:21,076 --> 00:14:22,916 Speaker 1: away that quickly. I mean, what if you just had 270 00:14:22,916 --> 00:14:25,636 Speaker 1: a very mild case of coronavirus. I mean, it's a 271 00:14:25,676 --> 00:14:27,636 Speaker 1: great question. I think in the end it's a little 272 00:14:27,676 --> 00:14:29,996 Speaker 1: bit hard to know. But those are the recommendations that 273 00:14:30,036 --> 00:14:32,956 Speaker 1: occupational health is giving us at this time. I think 274 00:14:32,956 --> 00:14:35,636 Speaker 1: what's hard with coronavirus is there are plenty of people 275 00:14:35,636 --> 00:14:38,636 Speaker 1: who are asymptomatic who have coronavirus. So I think that's 276 00:14:38,636 --> 00:14:42,676 Speaker 1: where the overlap of public health and medicine happens. So 277 00:14:43,156 --> 00:14:46,036 Speaker 1: public health is keeping people from spreading it to others. Right, 278 00:14:46,196 --> 00:14:49,876 Speaker 1: most of us are going to get coronavirus and do fine. 279 00:14:50,476 --> 00:14:52,796 Speaker 1: Some people are not going to do fine, and so 280 00:14:52,836 --> 00:14:55,796 Speaker 1: what we're trying to do is protect those people. And 281 00:14:55,876 --> 00:15:00,516 Speaker 1: so my recommendation to the public would be take this seriously, like, 282 00:15:01,036 --> 00:15:05,036 Speaker 1: don't go out with friends, stay at home, really try 283 00:15:05,156 --> 00:15:08,196 Speaker 1: to limit your interactions with other people. I think that's 284 00:15:08,236 --> 00:15:10,676 Speaker 1: just good practice, whether or not you have a cough 285 00:15:10,836 --> 00:15:13,956 Speaker 1: or anything else. We'll be back in just a moment. 286 00:15:24,236 --> 00:15:28,516 Speaker 1: What's the scene like at UCSF at your hospital right now? 287 00:15:28,676 --> 00:15:31,236 Speaker 1: Is it? You know, I'm sure you're preparing like crazy 288 00:15:31,356 --> 00:15:34,396 Speaker 1: for things to get out of hand. Where are things 289 00:15:34,476 --> 00:15:36,996 Speaker 1: right now in that process? I mean, actually we're still 290 00:15:37,036 --> 00:15:40,996 Speaker 1: in the sort of preparing and waiting, the waiting period 291 00:15:41,196 --> 00:15:45,956 Speaker 1: rather than the storm that we worry is coming. So 292 00:15:46,436 --> 00:15:50,396 Speaker 1: you know, the hospital has enacted our disaster plans in 293 00:15:50,476 --> 00:15:54,276 Speaker 1: terms of canceling elective procedures. So if you were supposed 294 00:15:54,276 --> 00:15:56,116 Speaker 1: to get a hip or a knee replacement, we have 295 00:15:57,076 --> 00:16:02,316 Speaker 1: canceled those procedures things like that to create openings for 296 00:16:02,436 --> 00:16:04,836 Speaker 1: patients in case other patients gets sick. It turns out 297 00:16:04,836 --> 00:16:06,276 Speaker 1: a lot of the people who are in the hospital 298 00:16:06,556 --> 00:16:11,476 Speaker 1: are here for somewhat routine electives, and so by stopping 299 00:16:11,476 --> 00:16:13,556 Speaker 1: those procedures, you open up a lot of space within 300 00:16:13,636 --> 00:16:16,916 Speaker 1: the hospital. So actually our censuses are a little bit 301 00:16:17,196 --> 00:16:20,036 Speaker 1: down right now here at UCSF. At least as of 302 00:16:20,116 --> 00:16:22,516 Speaker 1: last night, we only had two patients in the intensive 303 00:16:22,516 --> 00:16:26,196 Speaker 1: care unit with COVID and none at either of our 304 00:16:26,236 --> 00:16:30,036 Speaker 1: outlying hospitals. So that's great news, and we hope it 305 00:16:30,076 --> 00:16:33,276 Speaker 1: will continue like that, but we worry that it will 306 00:16:33,356 --> 00:16:38,356 Speaker 1: be getting busier. We are upstaffing respiratory urgent care clinics, 307 00:16:38,916 --> 00:16:44,276 Speaker 1: upstaffing our emergency room, and working with across departments to 308 00:16:44,396 --> 00:16:48,556 Speaker 1: upstaff our intensive care units to be ready. I understand 309 00:16:48,596 --> 00:16:54,116 Speaker 1: that at your hospital, then you're postponing surgery that's technically elective. 310 00:16:54,916 --> 00:16:58,316 Speaker 1: Should patients proactively, let's say they're not in San Francisco 311 00:16:58,396 --> 00:17:01,516 Speaker 1: where their hospitals are yet doing the suspension on their own. 312 00:17:02,036 --> 00:17:05,476 Speaker 1: Should patients themselves be trying to judge, Gee, if this 313 00:17:05,556 --> 00:17:08,036 Speaker 1: is elective surgery in the sense that I don't need 314 00:17:08,076 --> 00:17:11,076 Speaker 1: it right away, I should delay it, partly out of 315 00:17:11,076 --> 00:17:13,716 Speaker 1: public service to free up hospital beds, or partly because 316 00:17:13,716 --> 00:17:15,796 Speaker 1: they don't want to be in hospitals because that's where 317 00:17:15,876 --> 00:17:19,636 Speaker 1: sick people are. I think that's reasonable. Frankly, I think 318 00:17:19,716 --> 00:17:22,076 Speaker 1: most hospitals are going to be moving this way, So 319 00:17:22,356 --> 00:17:25,836 Speaker 1: it's more a question of whether you're going to postpone 320 00:17:25,876 --> 00:17:29,076 Speaker 1: your procedure before they start postponing procedures, or whether they'll 321 00:17:29,076 --> 00:17:31,716 Speaker 1: reach out to you. And what about things that the 322 00:17:31,756 --> 00:17:34,036 Speaker 1: hospitals are short on? I mean, are there things where 323 00:17:34,196 --> 00:17:37,356 Speaker 1: ucsfsaid publicly, you know, like we need more ventilators or 324 00:17:37,556 --> 00:17:40,036 Speaker 1: we don't have subsion in protective gear or are you, guys, 325 00:17:40,556 --> 00:17:42,036 Speaker 1: because you're sort of at the front end of this 326 00:17:42,116 --> 00:17:44,916 Speaker 1: and you're also a first class hospital, are you pretty 327 00:17:44,916 --> 00:17:48,076 Speaker 1: well prepared in those regards? I would say both of 328 00:17:48,116 --> 00:17:50,796 Speaker 1: those things. We are well prepared, and we are worried 329 00:17:50,836 --> 00:17:54,156 Speaker 1: about shortages. So we currently have enough protective gear, but 330 00:17:54,236 --> 00:17:56,756 Speaker 1: there is concern that we have, you know, a few 331 00:17:56,796 --> 00:18:01,316 Speaker 1: weeks worth of protective gear on hand. And so another 332 00:18:01,396 --> 00:18:03,596 Speaker 1: public health thing that people can do is not do 333 00:18:03,716 --> 00:18:06,796 Speaker 1: things like hoard and ninety five masks at home. You 334 00:18:06,836 --> 00:18:09,996 Speaker 1: don't need those people who are intibating people with COVID 335 00:18:10,076 --> 00:18:14,596 Speaker 1: need those. You're doing senior administrative work in this moment. 336 00:18:14,876 --> 00:18:18,156 Speaker 1: And so I'm wondering what's the tone like in the meetings? 337 00:18:18,196 --> 00:18:20,596 Speaker 1: I mean, are people managing to sound as calm, cool 338 00:18:20,636 --> 00:18:22,356 Speaker 1: and collected as they sound all the time. I mean, 339 00:18:22,396 --> 00:18:23,916 Speaker 1: I know doctors are all one of the things you 340 00:18:23,956 --> 00:18:26,356 Speaker 1: train people and is to stay calm in situations where 341 00:18:26,476 --> 00:18:28,836 Speaker 1: normal people would be freaking out. Is that sort of 342 00:18:28,876 --> 00:18:31,116 Speaker 1: how it's operating in the meetings. Are there are people 343 00:18:32,196 --> 00:18:35,676 Speaker 1: exaggerating their calmness in order to seem calmer or is 344 00:18:35,676 --> 00:18:38,756 Speaker 1: it sort of business as usual in some sense? It's 345 00:18:38,756 --> 00:18:42,556 Speaker 1: not business as usual in the sense that people are 346 00:18:42,556 --> 00:18:45,036 Speaker 1: really working together in a way that I think is 347 00:18:45,076 --> 00:18:49,116 Speaker 1: actually really admirable. So, you know, UCSF is a big, 348 00:18:49,156 --> 00:18:53,716 Speaker 1: sprawling place with a bureaucracy like any big sprawling institution, 349 00:18:54,076 --> 00:18:57,196 Speaker 1: and I've been really impressed with how things that previously 350 00:18:57,196 --> 00:19:00,116 Speaker 1: would have taken a year to roll out or years 351 00:19:00,156 --> 00:19:03,196 Speaker 1: to roll out or rolling out in days because people 352 00:19:03,236 --> 00:19:08,356 Speaker 1: are really working together. So, for example, telemedicine, we had 353 00:19:09,236 --> 00:19:12,156 Speaker 1: very small percentage of our outpatient visits we're being done 354 00:19:12,156 --> 00:19:15,476 Speaker 1: by video visit. And then a week and a half ago, 355 00:19:15,476 --> 00:19:18,356 Speaker 1: when we had our first sort of disaster planning full 356 00:19:18,436 --> 00:19:22,316 Speaker 1: day retreat, it was decided that telemedicine should convert like 357 00:19:22,396 --> 00:19:25,436 Speaker 1: fifty percent of our ambulatory visits in a matter of days. 358 00:19:25,876 --> 00:19:28,236 Speaker 1: And now we're converting almost one hundred percent of our 359 00:19:28,356 --> 00:19:31,756 Speaker 1: visits to video visits. And that has happened that kind 360 00:19:31,756 --> 00:19:35,876 Speaker 1: of huge change in a complex bureaucracy is usually really 361 00:19:35,876 --> 00:19:38,516 Speaker 1: hard to maneuver, and so I've been super impressed with 362 00:19:38,596 --> 00:19:43,076 Speaker 1: how people are coming together across the organization to make 363 00:19:43,116 --> 00:19:46,556 Speaker 1: these things happen. So every day now within my residency, 364 00:19:46,716 --> 00:19:50,236 Speaker 1: we have a daily planning huddle where we meet for 365 00:19:50,276 --> 00:19:53,476 Speaker 1: thirty minutes and kind of plan out what needs to 366 00:19:53,556 --> 00:19:56,476 Speaker 1: change next. And then in a hospital level, those are happening, 367 00:19:56,516 --> 00:20:00,116 Speaker 1: and then we have a special workforce one where we 368 00:20:00,156 --> 00:20:02,236 Speaker 1: think about how are we going to deploy nurses, what 369 00:20:02,236 --> 00:20:04,996 Speaker 1: do we do with people who are on home furlough, 370 00:20:05,076 --> 00:20:08,036 Speaker 1: how can we help them be useful and help while 371 00:20:08,076 --> 00:20:13,276 Speaker 1: they're in quarantine. So the amount of cross pollination between 372 00:20:13,916 --> 00:20:18,156 Speaker 1: human resources and nursing and the physicians and the administration 373 00:20:18,236 --> 00:20:21,516 Speaker 1: has really been amazing. So I wouldn't say that it 374 00:20:21,596 --> 00:20:23,956 Speaker 1: has been business as usual. I would say it's been 375 00:20:24,396 --> 00:20:28,316 Speaker 1: better than usual. And I think while everyone is stressed, 376 00:20:28,316 --> 00:20:30,676 Speaker 1: people are really working together in a really positive way. 377 00:20:31,916 --> 00:20:35,076 Speaker 1: That's actually extremely heartening and it's exactly what you know. 378 00:20:35,196 --> 00:20:38,476 Speaker 1: You fantasize life is like inside of a big hospital 379 00:20:38,516 --> 00:20:40,916 Speaker 1: and when everyone's preparing for a crisis, But I know 380 00:20:40,996 --> 00:20:43,156 Speaker 1: that in other areas of life, our fantasies of the 381 00:20:43,196 --> 00:20:44,996 Speaker 1: way the planning is supposed to go doesn't always bear 382 00:20:44,996 --> 00:20:47,116 Speaker 1: itself out, So it's nice to hear that that's actually happening. 383 00:20:47,956 --> 00:20:49,876 Speaker 1: Can I ask just a broader question for those of 384 00:20:49,956 --> 00:20:51,756 Speaker 1: us who are not in San Francisco, which is most 385 00:20:51,756 --> 00:20:55,156 Speaker 1: of us right now. San Francisco is presumably a harbinger 386 00:20:55,196 --> 00:20:57,196 Speaker 1: of what it's going to be like for us. So 387 00:20:57,316 --> 00:21:00,036 Speaker 1: what's it like when you get up and come to 388 00:21:00,076 --> 00:21:03,756 Speaker 1: work every day? Given the shelter in place order? How 389 00:21:03,756 --> 00:21:05,196 Speaker 1: many cars are on the road? I mean, I know 390 00:21:05,236 --> 00:21:06,996 Speaker 1: there are lots of people who are exempted from the order, 391 00:21:07,076 --> 00:21:09,476 Speaker 1: people like you healthcare workers, but also the people who 392 00:21:09,476 --> 00:21:11,956 Speaker 1: are doing food service work. And I notice even the 393 00:21:11,996 --> 00:21:15,036 Speaker 1: biotech workers are exempted under the presumably are people on 394 00:21:15,076 --> 00:21:18,556 Speaker 1: the streets, So there are still people on the streets. 395 00:21:18,556 --> 00:21:20,516 Speaker 1: I mean, people are trying to work from home. So 396 00:21:21,276 --> 00:21:23,996 Speaker 1: I'm here at the hospital today and I was in 397 00:21:24,036 --> 00:21:26,636 Speaker 1: clinic yesterday, but the day before I did work from home, 398 00:21:26,676 --> 00:21:29,556 Speaker 1: which I wouldn't usually never do. So I do think 399 00:21:29,596 --> 00:21:31,956 Speaker 1: even amongst the people who are exempted, people are trying 400 00:21:31,956 --> 00:21:35,636 Speaker 1: to kind of honor the idea of self sheltern place 401 00:21:35,676 --> 00:21:38,036 Speaker 1: when they can, but when you go on the street, 402 00:21:38,076 --> 00:21:40,836 Speaker 1: you do still see some people. I mean, it's a city, right, 403 00:21:40,956 --> 00:21:44,556 Speaker 1: So the restaurants still have takeout, you'll see people walk 404 00:21:44,636 --> 00:21:47,516 Speaker 1: up to the door to get it. People love exercise 405 00:21:47,556 --> 00:21:49,476 Speaker 1: in San Francisco, and you are still allowed to go 406 00:21:49,516 --> 00:21:51,676 Speaker 1: out and exercise as long as you keep six feet 407 00:21:51,716 --> 00:21:54,476 Speaker 1: between you and others. And Golden Cape Park was still 408 00:21:54,716 --> 00:21:58,876 Speaker 1: filled with people running and biking yesterday, So it doesn't 409 00:21:58,916 --> 00:22:04,276 Speaker 1: actually feel like a desolate wasteland. It feels like a 410 00:22:04,396 --> 00:22:08,516 Speaker 1: quiet day in the city when there's sort of fewer people, 411 00:22:08,756 --> 00:22:11,396 Speaker 1: a little bit like Boston feels in the summertime when 412 00:22:11,436 --> 00:22:15,356 Speaker 1: all of the college kids leave. Speaking of kids, your 413 00:22:15,396 --> 00:22:18,716 Speaker 1: kids are not college age, But what are you telling 414 00:22:18,756 --> 00:22:21,436 Speaker 1: your kids and how are they how are they relating 415 00:22:21,476 --> 00:22:23,076 Speaker 1: to it all? I mean they're not usual kids. They 416 00:22:23,116 --> 00:22:25,516 Speaker 1: have two physician parents. But nevertheless, I'm curious to know. 417 00:22:26,436 --> 00:22:28,556 Speaker 1: So my kids are little, they're four, six, and eight, 418 00:22:28,596 --> 00:22:32,716 Speaker 1: and we have been pretty consistent in the messaging that 419 00:22:32,756 --> 00:22:35,676 Speaker 1: we're doing all of these things to keep old people safe. 420 00:22:36,476 --> 00:22:39,676 Speaker 1: We really don't want them to worry about themselves, because frankly, 421 00:22:39,756 --> 00:22:41,956 Speaker 1: kids do great in this, which is a parent I 422 00:22:41,996 --> 00:22:46,476 Speaker 1: find really reassuring, and I don't want them worrying about 423 00:22:46,476 --> 00:22:49,076 Speaker 1: me going to the hospital every day. Yeah, that's good. 424 00:22:49,516 --> 00:22:51,636 Speaker 1: By the way, I heard, I heard the siren of 425 00:22:51,676 --> 00:22:54,436 Speaker 1: the background. And you know, ordinarily, when when we're doing 426 00:22:54,476 --> 00:22:57,876 Speaker 1: a podcast, we you know, we stop, we rerecord, we 427 00:22:57,916 --> 00:22:59,996 Speaker 1: don't hear those kinds of sounds. But the truth is 428 00:23:00,036 --> 00:23:02,556 Speaker 1: that that's the actual world where you are. You are 429 00:23:02,596 --> 00:23:05,276 Speaker 1: in the hospital, and those are real sirens, and I 430 00:23:05,276 --> 00:23:07,396 Speaker 1: think it's part of the part of the reality of 431 00:23:07,716 --> 00:23:11,676 Speaker 1: the moment. I just conclude, rebect, because I want to 432 00:23:11,676 --> 00:23:13,276 Speaker 1: be respectful of your time and I want you to 433 00:23:13,316 --> 00:23:16,556 Speaker 1: go back to actually saving people. What is there that 434 00:23:16,596 --> 00:23:19,716 Speaker 1: you think people in the medical profession understand and know 435 00:23:19,876 --> 00:23:23,156 Speaker 1: right now that is not getting communicated to the general public. 436 00:23:23,196 --> 00:23:24,596 Speaker 1: I mean, I asked all the questions that I could 437 00:23:24,596 --> 00:23:27,556 Speaker 1: think of immediate things that you know that the rest 438 00:23:27,556 --> 00:23:30,756 Speaker 1: of us don't know. But I'm wondering, is there something 439 00:23:30,796 --> 00:23:32,476 Speaker 1: else that I should be asking you that I'm not. 440 00:23:32,996 --> 00:23:35,436 Speaker 1: I mean, I think that two things are I would 441 00:23:35,436 --> 00:23:38,156 Speaker 1: really like to see people taking this more seriously. I 442 00:23:38,196 --> 00:23:41,316 Speaker 1: was pretty distressed by seeing pictures of like spring breakers 443 00:23:41,316 --> 00:23:44,836 Speaker 1: in Daytona Beach. If we don't all take this seriously. 444 00:23:44,916 --> 00:23:48,236 Speaker 1: This is going to last much longer, and so my 445 00:23:48,316 --> 00:23:51,316 Speaker 1: hope is that even if your city has not formally 446 00:23:51,356 --> 00:23:53,636 Speaker 1: placed you in shelter and place, that people will take 447 00:23:53,636 --> 00:23:56,756 Speaker 1: this seriously and will start self isolating. Rebecca, I just 448 00:23:56,796 --> 00:23:59,556 Speaker 1: want to thank you for what you're doing now in 449 00:23:59,556 --> 00:24:02,756 Speaker 1: this effort, and for spending time with us, and for 450 00:24:02,796 --> 00:24:06,276 Speaker 1: what you're doing every day even when there's no pandemic 451 00:24:06,356 --> 00:24:09,476 Speaker 1: in the offing, and wish you and your family and 452 00:24:10,236 --> 00:24:13,996 Speaker 1: your residence and staff very well in the challenging time 453 00:24:14,036 --> 00:24:16,676 Speaker 1: to come. Thanks so much. It was nice talking to you. 454 00:24:17,836 --> 00:24:21,676 Speaker 1: I found that a tremendously useful conversation. Doctor Berman really 455 00:24:21,716 --> 00:24:23,596 Speaker 1: told us what we should and shouldn't be worried about. 456 00:24:23,796 --> 00:24:25,836 Speaker 1: And one of the things that I realized is that 457 00:24:25,876 --> 00:24:28,516 Speaker 1: a lot of the information that's circulating out there about 458 00:24:28,516 --> 00:24:31,076 Speaker 1: what symptoms you should or shouldn't be concerned about is 459 00:24:31,116 --> 00:24:34,836 Speaker 1: actually inaccurate, not up to date, and not statistically sound. 460 00:24:35,196 --> 00:24:37,596 Speaker 1: I also realized that there are many many people who 461 00:24:37,676 --> 00:24:40,396 Speaker 1: might be sick and even have corona, who nevertheless probably 462 00:24:40,396 --> 00:24:43,156 Speaker 1: shouldn't go to the hospital if they're not too sick, 463 00:24:43,556 --> 00:24:45,916 Speaker 1: and that I think is a very important takeaway that 464 00:24:45,956 --> 00:24:48,236 Speaker 1: I had not taken on board myself, and I think 465 00:24:48,356 --> 00:24:51,436 Speaker 1: is very valuable for public health purposes. We're going to 466 00:24:51,516 --> 00:24:55,916 Speaker 1: continue covering Corona with new and special episodes to keep 467 00:24:55,956 --> 00:24:59,156 Speaker 1: you up to date on the most important issues behind 468 00:24:59,476 --> 00:25:03,156 Speaker 1: the stories associated with Corona. In the meantime, if you're 469 00:25:03,196 --> 00:25:07,076 Speaker 1: at home, as you probably should be, be well, be safe, 470 00:25:07,356 --> 00:25:14,196 Speaker 1: take care of yourself and of others. Deep Background is 471 00:25:14,236 --> 00:25:17,516 Speaker 1: brought to you by Pushkin Industries. Our producer is Lydia 472 00:25:17,596 --> 00:25:21,356 Speaker 1: gene Coott, with studio recording by Joseph Fridman and mastering 473 00:25:21,396 --> 00:25:26,196 Speaker 1: by Jason Gambrell and Martin Gonzalez. Our showrunner is Sophie McKibben. 474 00:25:26,716 --> 00:25:30,156 Speaker 1: Our theme music is composed by Luis GERA special thanks 475 00:25:30,156 --> 00:25:34,036 Speaker 1: to the Pushkin Brass, Malcolm Godwell, Jacob Weisberg, and Mia Lobel. 476 00:25:34,636 --> 00:25:38,156 Speaker 1: I'm Noah Feld. I also write a column for Bloomberg Opinion, 477 00:25:38,316 --> 00:25:41,396 Speaker 1: which you can find at Bloomberg dot com backslash Feld. 478 00:25:42,156 --> 00:25:45,916 Speaker 1: To discover Bloomberg's original slate of podcasts, go to Bloomberg 479 00:25:45,956 --> 00:25:49,476 Speaker 1: dot com Backslash Podcasts. You can follow me on Twitter 480 00:25:49,676 --> 00:25:52,956 Speaker 1: at Noah Arfeld. This is Deep Background.