Speaker 1: Pushkin from Pushkin Industries. This is Deep Background, the show
Speaker 1: where we explored the stories behind the stories in the news.
Speaker 1: And if I sound a little different on this episode,
Speaker 1: it's because, in deference to Corona norms, I'm actually recording
Speaker 1: it myself without the aid of our excellent sound engineers.
Speaker 1: Right now, I think the most immediate question on my mind,
Speaker 1: and it may be on your mind too, is how
Speaker 1: do I know if my symptoms were those of one
Speaker 1: of my loved ones actually correspond to coronavirus. There's tons
Speaker 1: of information going around on the Internet, and it's a
Speaker 1: little hard to know what's reliable and what isn't. I
Speaker 1: thought it would be useful to talk to a frontline
Speaker 1: primary care physician who's actually in charge of programs where
Speaker 1: lots and lots of doctors are seeing patients who are
Speaker 1: presenting with coronavirus. So I called doctor Rebecca Berman, the
Speaker 1: program director at the University of California, San Francisco's Internal
Speaker 1: Medicine Residency program. That means she's the person in charge
Speaker 1: of training the actual doctors who are going to become
Speaker 1: residents in internal medicine. An internal medicine means in a hospital,
Speaker 1: the main job of seeing patients. I asked Rebecca about
Speaker 1: how we should be thinking about symptoms, which symptoms actually
Speaker 1: tell us that we should go to the hospital, what
Speaker 1: we should do if we're not going to the hospital,
Speaker 1: and how preparedness is going inside UCSF. Rebecca, you are
Speaker 1: literally on the front lines facing the current coronavirus situation.
Speaker 1: I wonder if you could start us off by telling
Speaker 1: us how you and your physicians in your training program
Speaker 1: are doing the first line diagnosis. When someone comes in
Speaker 1: to the hospital and says, I'm feeling lousy, I think
Speaker 1: I have coronavirus. What algorithm are you guys using? Well,
Speaker 1: I think something that's challenging about coronavirus is that for
Speaker 1: a lot of people, they functionally have cold symptoms. So
Speaker 1: we're all kind of worried. I have chronic allergies, and
Speaker 1: it makes me worried constantly, like is this running nose
Speaker 1: different than the normal running nose that I always have?
Speaker 1: And so I think for us in the hospital, the
Speaker 1: things we're most worried about, and the people were actually
Speaker 1: testing are those who seem sick, those who are having
Speaker 1: shortness of breath or fever. The presenting symptoms can just
Speaker 1: be cough and running nose, and then some people is asymptomatic.
Speaker 1: So we're also seeing our primary care clinics kind of
Speaker 1: flooded with people who are worried and want testing. But
Speaker 1: right now, given the limited number of test kits that
Speaker 1: we have, we're trying to encourage people not to come
Speaker 1: in if they aren't actively feeling feverish and short of breath,
Speaker 1: because simply testing someone who's not that sick but symptomatic
Speaker 1: is going to result in the same treatment, which is
Speaker 1: to tell them to self quarantine at home for fourteen days.
Speaker 1: It is really hard for people to be stuck at
Speaker 1: home right now, although frankly here in San Francisco most
Speaker 1: people are stuck at home right now, but that is
Speaker 1: what we are doing. In terms of diagnosis. At this point,
Speaker 1: we are trying to triage. We have a COVID nineteen
Speaker 1: infectious disease doctor on call at all times, and we
Speaker 1: run cases by them in order to choose who needs testing.
Speaker 1: I completely understand that from the hospital's perspective, you don't
Speaker 1: want to be flooded with people who might be positive
Speaker 1: but can't at present be treated, So it makes sense
Speaker 1: to say only come in if you have the shortness
Speaker 1: of breath and the fever. In terms of people's own
Speaker 1: self diagnosis at home, though, however, there's sort of like
Speaker 1: a plethora of information out there, much of it surely inaccurate.
Speaker 1: And I've heard all kinds of things, you know, people saying, well,
Speaker 1: you know, if you have a running nose, that's not it,
Speaker 1: and others saying, well, if you have a sore throat,
Speaker 1: that's it, but if you're coughing, that's not it. I mean,
Speaker 1: I guess what I'm wondering is, first, just at the
Speaker 1: very basic level of the sis, is this all ridiculous?
Speaker 1: I mean, is it? In the end, the full range
Speaker 1: of cold like symptoms could be indicators of COVID nineteen. Well,
Speaker 1: I think what's hard is in most people, cough is
Speaker 1: the presenting symptom, often a dry cough, but sometimes productive.
Speaker 1: It's true that running nose makes it less likely, but
Speaker 1: it doesn't rule it out. So about fifteen percent of
Speaker 1: people with coronavirus are going to have runny nose. So
Speaker 1: if you have a running nose, it can make you
Speaker 1: feel a little better, but it doesn't mean definitely you
Speaker 1: do not have it. The guidelines that are health occupational
Speaker 1: health is giving us to help us as healthcare workers
Speaker 1: know when not to come in. Are saying, if you
Speaker 1: have two of those symptoms like sore throat and cough
Speaker 1: or cough and runny nose, and they're getting worse over
Speaker 1: two days, than you should stay home. And so I
Speaker 1: think using those guidelines more widely as a wise one.
Speaker 1: I think, did you say fifteen percent of the people
Speaker 1: who are positive for the virus do have a running nose.
Speaker 1: So the running nose is not a guarante. It's not
Speaker 1: necessary an indicator that you have it, but it's certainly
Speaker 1: not a reason to think you don't have it exactly.
Speaker 1: Then what about the sore throat? Where does the sore
Speaker 1: throat fall in? Sore throats also are seen in less
Speaker 1: than fifteen percent of patients, and similarly, GI symptoms like
Speaker 1: nausere vomiting, or diarrhea are seen in a low percentage
Speaker 1: of patients. So it's really a combination of different elements
Speaker 1: that give you clinically an indication that you're probably looking
Speaker 1: at a corona case, with kauf being the most significant
Speaker 1: and fever the next most significant, and then the things
Speaker 1: like running nose or sore throat they don't have a
Speaker 1: huge indicating effect. But their absence also doesn't tell you much.
Speaker 1: If it's fifteen or twenty percent of the people have
Speaker 1: that symptom, then the fact that they're not there doesn't
Speaker 1: tell you very much. If they are there, it might
Speaker 1: be indicative as well. I guess. I guess if they
Speaker 1: are there, it's like a little reassuring, but it's not
Speaker 1: a slam dunk. So I think the advice that if
Speaker 1: you're not feeling well, stay home and isolate is a
Speaker 1: good one. And what about the core takeaway question, which
Speaker 1: is I'm at home. I think I have these symptoms.
Speaker 1: I have a fever, it's not terrible, but I don't
Speaker 1: have shortness of breath. And I have let's say, a
Speaker 1: serious cough. Should I come in or should I just
Speaker 1: self isolate? Right away? I would say you should self isolate.
Speaker 1: If you have underlying medical problems like diabetes, or you're immunocompromised,
Speaker 1: or you're pregnant, certainly call your physician. But the last
Speaker 1: thing you want to do is come to a hospital
Speaker 1: where they're going to be other patients who have this
Speaker 1: walking around. You would rather stay at home. So I
Speaker 1: think our biggest fear is that the health system is
Speaker 1: going to be overwhelmed by what we call the worried well,
Speaker 1: people who are relatively asymptomatic or have minor symptoms of
Speaker 1: this disease, who are worried and come in when they
Speaker 1: don't need to, and in this instance, well would just
Speaker 1: mean well enough that they don't have to be admitted,
Speaker 1: because maybe the worried well in this case actually will
Speaker 1: have coronavirus, but they're well enough to stay home. So
Speaker 1: in that sense, they're they're the worried well. They're not
Speaker 1: they're not the irrationally worried well. Under these just then
Speaker 1: not intensely sick. Perhaps we should call them the worried
Speaker 1: mildly sick. That's not as catchy as the worried well,
Speaker 1: but it sounds helpful. So for the rest of us
Speaker 1: will try not to enter the category of the worried
Speaker 1: mildly sick. But those people at this point should stay
Speaker 1: home so as not to overwhelm the system. And when
Speaker 1: you start to feel genuinely sick, that's the time to
Speaker 1: go in correct. So that brings me to the really
Speaker 1: fascinating point that you brought up, that I deflected us
Speaker 1: from because I wanted to know whether we have we
Speaker 1: all hell, we know whether we have the virus, which
Speaker 1: is the idea that is part of your triage. You'd
Speaker 1: have to deal with the fact that we just don't
Speaker 1: have enough tests. And I want to ask you about
Speaker 1: this because you know, one of the forms of criticism
Speaker 1: that one hears of us prepared in this here is well, gee,
Speaker 1: they're just not enough tests here, and there are more
Speaker 1: tests available in other countries and we should have been
Speaker 1: better prepared there. And that seems plausible to me. But
Speaker 1: I've heard a counter argument as well that said something like, well, look,
Speaker 1: if ultimately it could be between forty and seventy percent
Speaker 1: of adults who get this, testing isn't really what's significant
Speaker 1: at this point. And what's more, if we don't have
Speaker 1: a treatment for most people except that they're very, very
Speaker 1: sick and we put them on a ventilator, the testing
Speaker 1: isn't really the key. The lack of tests isn't really
Speaker 1: our problem here, and we should just be more focused
Speaker 1: on the broader public health response. Do you have a
Speaker 1: much more informed view on that debate than I have.
Speaker 1: I mean, to me, there's two different questions, like having
Speaker 1: limited testing is extremely stressful on the health system. It
Speaker 1: actually means we can't test doctors who have been exposed,
Speaker 1: or if we test them, how do we know that
Speaker 1: those tests are correct should they really come back to
Speaker 1: the frontline. So from a workforce perspective, that's very stressful.
Speaker 1: In my ideal world, we would have so many tests
Speaker 1: available that we could swab everyone who comes into the
Speaker 1: hospital every few days and make sure that they are
Speaker 1: being protected and that they're not bringing any virus into
Speaker 1: the hospital. So I do think that there's two different questions.
Speaker 1: One is does your average person at home where we
Speaker 1: can't actually really treat it, is it important for us
Speaker 1: to have that diagnosis versus this second question of healthcare workers.
Speaker 1: And then I think the other problem with not having
Speaker 1: widespread testing. Part of the reason Korea's numbers look so
Speaker 1: great in terms of their number of people who have
Speaker 1: gotten very, very sick is that they've done widespread testing,
Speaker 1: So they're testing a whole bunch of asymptomatic people. They
Speaker 1: have a much better sense of what the denominator is
Speaker 1: of how many people have this virus compared to how
Speaker 1: many gets sick. Here, we're only testing a small portion
Speaker 1: of people, which means that we don't really know what
Speaker 1: percentage of people get very sick from this. It seems
Speaker 1: that it's about three percent of people, but again, we
Speaker 1: just don't know because we have no idea how widely
Speaker 1: spread this is. So to me, I mean defunding our
Speaker 1: pandemic response was a tremendously large error of leadership. And
Speaker 1: I'm grateful to our state and local governments who are
Speaker 1: really trying to step in in this moment. But it
Speaker 1: would be better if testing were more widely available. Rebecca,
Speaker 1: I understand that it's tentative, but tell me again, what
Speaker 1: was that three percent number? That's the number of people
Speaker 1: whom you think of at present who are exposed who
Speaker 1: are getting very sick, or is it the number of
Speaker 1: people who have the coronavirus who are getting very sick?
Speaker 1: I think between two and three percent is the number
Speaker 1: being bandied about of the number of people who will
Speaker 1: die who get the virus. Right. I've heard that number
Speaker 1: as well, and based I think it's largely based on
Speaker 1: the Wuhan statistics, right. Correct. Now, let's move on to
Speaker 1: what happens when you're treating a patient. The patient comes
Speaker 1: in the patient is symptomatic enough for you to give
Speaker 1: them a test. Let's say you determine their positive for coronavirus,
Speaker 1: but they're not so sick that they need to be
Speaker 1: admitted to the hospital, so you send them home into
Speaker 1: effectively self quarantine. Correct, Correct? And what is that supposed
Speaker 1: to mean in real practical terms? I think a lot
Speaker 1: of listeners out there are wondering. We hear this phrase
Speaker 1: self quarantine or I guess in that case, self isolation,
Speaker 1: but we don't really know how much exposure to other
Speaker 1: humans that entails. I mean, is it literally meant to
Speaker 1: be lock yourself in your room and do not see
Speaker 1: the other people who live in your house, if there
Speaker 1: are any I mean, in an ideal world, yes, right,
Speaker 1: it's ideally have your own room, in your own bathroom,
Speaker 1: and have someone like leave food at the door that
Speaker 1: you then open the door and get the food and
Speaker 1: shut it, recognizing that for some people that's not going
Speaker 1: to be possible. But you know, there was a case
Speaker 1: in Asia of a family of nine who, like one
Speaker 1: of them was on isolation and they all shared hotpot
Speaker 1: and they all got coronavirus. And so certainly I think
Speaker 1: trying to really isolate, I mean, luckily we all have computers.
Speaker 1: I would recommend trying to be in a room with
Speaker 1: a computer so you can still have contact with the
Speaker 1: outside world. I'm hearing lots of creative things that people
Speaker 1: are doing, you know, zoom coffee hours, going to art
Speaker 1: galleries online and things, so you don't go bananas. But
Speaker 1: I do think that it's really important for people to
Speaker 1: take this seriously, especially if you live with old people
Speaker 1: or anyone who's immuno compromised. Well, I think probably everybody
Speaker 1: would take it seriously if they had a positive diagnosis.
Speaker 1: The real question, I think is for people who don't
Speaker 1: have that and are just sort of at home under
Speaker 1: self quarantine or because there's a broad shelter in place
Speaker 1: order in effect, the question that is how precise they
Speaker 1: should be. I mean that it's not recommended that those
Speaker 1: people self isolate. That's only if you are confident or
Speaker 1: you think it's a high probability that you have the virus. Right, yes, So,
Speaker 1: just to be clear, Shelter in place is different than
Speaker 1: self isolation. Shelter in place is saying stay in your
Speaker 1: home and share your germs with your family or the
Speaker 1: people that you live with, but don't go outside and
Speaker 1: share it with other people. Sort of keep your germs
Speaker 1: to your little group. It doesn't matter whether it's you
Speaker 1: and your family, or it's you and your roommates or
Speaker 1: the other people who live in a group house with you.
Speaker 1: You're going to share. You're going to share germs with
Speaker 1: those people in an ordinary shelter in place, right, I
Speaker 1: mean the ideas, try to be a little more cognizant,
Speaker 1: don't share spoons and forks and things, and wash your
Speaker 1: hands a lot. But recognizing that it's impossible for people
Speaker 1: to completely isolate. That being said, if you have symptoms,
Speaker 1: act like you have the virus. It doesn't matter whether
Speaker 1: or not you have a positive test. We don't currently
Speaker 1: have testing capacity, So people should take this seriously. If
Speaker 1: you aren't feeling well, isolate yourself from the other people
Speaker 1: that you live with, and how long should you do
Speaker 1: that before? I mean, again, this is something that I
Speaker 1: think has not really fully trickled down to the general
Speaker 1: listener yet. It certainly hasn't to me. So if you
Speaker 1: have flu like symptoms or cold like symptoms and your
Speaker 1: self diagnosis is like, I don't know if I have coronavirus.
Speaker 1: I didn't go to medical school, but I'm feeling lousy.
Speaker 1: Your recommendation is go into self isolation as though you
Speaker 1: had the virus, correct, And the recommendations are to do
Speaker 1: that for fourteen days. I think if you start feeling
Speaker 1: better after it or two, it's probably not coronavirus, and
Speaker 1: so you can feel better about coming out of isolation.
Speaker 1: But you know, better safe than sorry. But is that
Speaker 1: true that if it's coronavirus it's not going to go
Speaker 1: away that quickly. I mean, what if you just had
Speaker 1: a very mild case of coronavirus. I mean, it's a
Speaker 1: great question. I think in the end it's a little
Speaker 1: bit hard to know. But those are the recommendations that
Speaker 1: occupational health is giving us at this time. I think
Speaker 1: what's hard with coronavirus is there are plenty of people
Speaker 1: who are asymptomatic who have coronavirus. So I think that's
Speaker 1: where the overlap of public health and medicine happens. So
Speaker 1: public health is keeping people from spreading it to others. Right,
Speaker 1: most of us are going to get coronavirus and do fine.
Speaker 1: Some people are not going to do fine, and so
Speaker 1: what we're trying to do is protect those people. And
Speaker 1: so my recommendation to the public would be take this seriously, like,
Speaker 1: don't go out with friends, stay at home, really try
Speaker 1: to limit your interactions with other people. I think that's
Speaker 1: just good practice, whether or not you have a cough
Speaker 1: or anything else. We'll be back in just a moment.
Speaker 1: What's the scene like at UCSF at your hospital right now?
Speaker 1: Is it? You know, I'm sure you're preparing like crazy
Speaker 1: for things to get out of hand. Where are things
Speaker 1: right now in that process? I mean, actually we're still
Speaker 1: in the sort of preparing and waiting, the waiting period
Speaker 1: rather than the storm that we worry is coming. So
Speaker 1: you know, the hospital has enacted our disaster plans in
Speaker 1: terms of canceling elective procedures. So if you were supposed
Speaker 1: to get a hip or a knee replacement, we have
Speaker 1: canceled those procedures things like that to create openings for
Speaker 1: patients in case other patients gets sick. It turns out
Speaker 1: a lot of the people who are in the hospital
Speaker 1: are here for somewhat routine electives, and so by stopping
Speaker 1: those procedures, you open up a lot of space within
Speaker 1: the hospital. So actually our censuses are a little bit
Speaker 1: down right now here at UCSF. At least as of
Speaker 1: last night, we only had two patients in the intensive
Speaker 1: care unit with COVID and none at either of our
Speaker 1: outlying hospitals. So that's great news, and we hope it
Speaker 1: will continue like that, but we worry that it will
Speaker 1: be getting busier. We are upstaffing respiratory urgent care clinics,
Speaker 1: upstaffing our emergency room, and working with across departments to
Speaker 1: upstaff our intensive care units to be ready. I understand
Speaker 1: that at your hospital, then you're postponing surgery that's technically elective.
Speaker 1: Should patients proactively, let's say they're not in San Francisco
Speaker 1: where their hospitals are yet doing the suspension on their own.
Speaker 1: Should patients themselves be trying to judge, Gee, if this
Speaker 1: is elective surgery in the sense that I don't need
Speaker 1: it right away, I should delay it, partly out of
Speaker 1: public service to free up hospital beds, or partly because
Speaker 1: they don't want to be in hospitals because that's where
Speaker 1: sick people are. I think that's reasonable. Frankly, I think
Speaker 1: most hospitals are going to be moving this way, So
Speaker 1: it's more a question of whether you're going to postpone
Speaker 1: your procedure before they start postponing procedures, or whether they'll
Speaker 1: reach out to you. And what about things that the
Speaker 1: hospitals are short on? I mean, are there things where
Speaker 1: ucsfsaid publicly, you know, like we need more ventilators or
Speaker 1: we don't have subsion in protective gear or are you, guys,
Speaker 1: because you're sort of at the front end of this
Speaker 1: and you're also a first class hospital, are you pretty
Speaker 1: well prepared in those regards? I would say both of
Speaker 1: those things. We are well prepared, and we are worried
Speaker 1: about shortages. So we currently have enough protective gear, but
Speaker 1: there is concern that we have, you know, a few
Speaker 1: weeks worth of protective gear on hand. And so another
Speaker 1: public health thing that people can do is not do
Speaker 1: things like hoard and ninety five masks at home. You
Speaker 1: don't need those people who are intibating people with COVID
Speaker 1: need those. You're doing senior administrative work in this moment.
Speaker 1: And so I'm wondering what's the tone like in the meetings?
Speaker 1: I mean, are people managing to sound as calm, cool
Speaker 1: and collected as they sound all the time. I mean,
Speaker 1: I know doctors are all one of the things you
Speaker 1: train people and is to stay calm in situations where
Speaker 1: normal people would be freaking out. Is that sort of
Speaker 1: how it's operating in the meetings. Are there are people
Speaker 1: exaggerating their calmness in order to seem calmer or is
Speaker 1: it sort of business as usual in some sense? It's
Speaker 1: not business as usual in the sense that people are
Speaker 1: really working together in a way that I think is
Speaker 1: actually really admirable. So, you know, UCSF is a big,
Speaker 1: sprawling place with a bureaucracy like any big sprawling institution,
Speaker 1: and I've been really impressed with how things that previously
Speaker 1: would have taken a year to roll out or years
Speaker 1: to roll out or rolling out in days because people
Speaker 1: are really working together. So, for example, telemedicine, we had
Speaker 1: very small percentage of our outpatient visits we're being done
Speaker 1: by video visit. And then a week and a half ago,
Speaker 1: when we had our first sort of disaster planning full
Speaker 1: day retreat, it was decided that telemedicine should convert like
Speaker 1: fifty percent of our ambulatory visits in a matter of days.
Speaker 1: And now we're converting almost one hundred percent of our
Speaker 1: visits to video visits. And that has happened that kind
Speaker 1: of huge change in a complex bureaucracy is usually really
Speaker 1: hard to maneuver, and so I've been super impressed with
Speaker 1: how people are coming together across the organization to make
Speaker 1: these things happen. So every day now within my residency,
Speaker 1: we have a daily planning huddle where we meet for
Speaker 1: thirty minutes and kind of plan out what needs to
Speaker 1: change next. And then in a hospital level, those are happening,
Speaker 1: and then we have a special workforce one where we
Speaker 1: think about how are we going to deploy nurses, what
Speaker 1: do we do with people who are on home furlough,
Speaker 1: how can we help them be useful and help while
Speaker 1: they're in quarantine. So the amount of cross pollination between
Speaker 1: human resources and nursing and the physicians and the administration
Speaker 1: has really been amazing. So I wouldn't say that it
Speaker 1: has been business as usual. I would say it's been
Speaker 1: better than usual. And I think while everyone is stressed,
Speaker 1: people are really working together in a really positive way.
Speaker 1: That's actually extremely heartening and it's exactly what you know.
Speaker 1: You fantasize life is like inside of a big hospital
Speaker 1: and when everyone's preparing for a crisis, But I know
Speaker 1: that in other areas of life, our fantasies of the
Speaker 1: way the planning is supposed to go doesn't always bear
Speaker 1: itself out, So it's nice to hear that that's actually happening.
Speaker 1: Can I ask just a broader question for those of
Speaker 1: us who are not in San Francisco, which is most
Speaker 1: of us right now. San Francisco is presumably a harbinger
Speaker 1: of what it's going to be like for us. So
Speaker 1: what's it like when you get up and come to
Speaker 1: work every day? Given the shelter in place order? How
Speaker 1: many cars are on the road? I mean, I know
Speaker 1: there are lots of people who are exempted from the order,
Speaker 1: people like you healthcare workers, but also the people who
Speaker 1: are doing food service work. And I notice even the
Speaker 1: biotech workers are exempted under the presumably are people on
Speaker 1: the streets, So there are still people on the streets.
Speaker 1: I mean, people are trying to work from home. So
Speaker 1: I'm here at the hospital today and I was in
Speaker 1: clinic yesterday, but the day before I did work from home,
Speaker 1: which I wouldn't usually never do. So I do think
Speaker 1: even amongst the people who are exempted, people are trying
Speaker 1: to kind of honor the idea of self sheltern place
Speaker 1: when they can, but when you go on the street,
Speaker 1: you do still see some people. I mean, it's a city, right,
Speaker 1: So the restaurants still have takeout, you'll see people walk
Speaker 1: up to the door to get it. People love exercise
Speaker 1: in San Francisco, and you are still allowed to go
Speaker 1: out and exercise as long as you keep six feet
Speaker 1: between you and others. And Golden Cape Park was still
Speaker 1: filled with people running and biking yesterday, So it doesn't
Speaker 1: actually feel like a desolate wasteland. It feels like a
Speaker 1: quiet day in the city when there's sort of fewer people,
Speaker 1: a little bit like Boston feels in the summertime when
Speaker 1: all of the college kids leave. Speaking of kids, your
Speaker 1: kids are not college age, But what are you telling
Speaker 1: your kids and how are they how are they relating
Speaker 1: to it all? I mean they're not usual kids. They
Speaker 1: have two physician parents. But nevertheless, I'm curious to know.
Speaker 1: So my kids are little, they're four, six, and eight,
Speaker 1: and we have been pretty consistent in the messaging that
Speaker 1: we're doing all of these things to keep old people safe.
Speaker 1: We really don't want them to worry about themselves, because frankly,
Speaker 1: kids do great in this, which is a parent I
Speaker 1: find really reassuring, and I don't want them worrying about
Speaker 1: me going to the hospital every day. Yeah, that's good.
Speaker 1: By the way, I heard, I heard the siren of
Speaker 1: the background. And you know, ordinarily, when when we're doing
Speaker 1: a podcast, we you know, we stop, we rerecord, we
Speaker 1: don't hear those kinds of sounds. But the truth is
Speaker 1: that that's the actual world where you are. You are
Speaker 1: in the hospital, and those are real sirens, and I
Speaker 1: think it's part of the part of the reality of
Speaker 1: the moment. I just conclude, rebect, because I want to
Speaker 1: be respectful of your time and I want you to
Speaker 1: go back to actually saving people. What is there that
Speaker 1: you think people in the medical profession understand and know
Speaker 1: right now that is not getting communicated to the general public.
Speaker 1: I mean, I asked all the questions that I could
Speaker 1: think of immediate things that you know that the rest
Speaker 1: of us don't know. But I'm wondering, is there something
Speaker 1: else that I should be asking you that I'm not.
Speaker 1: I mean, I think that two things are I would
Speaker 1: really like to see people taking this more seriously. I
Speaker 1: was pretty distressed by seeing pictures of like spring breakers
Speaker 1: in Daytona Beach. If we don't all take this seriously.
Speaker 1: This is going to last much longer, and so my
Speaker 1: hope is that even if your city has not formally
Speaker 1: placed you in shelter and place, that people will take
Speaker 1: this seriously and will start self isolating. Rebecca, I just
Speaker 1: want to thank you for what you're doing now in
Speaker 1: this effort, and for spending time with us, and for
Speaker 1: what you're doing every day even when there's no pandemic
Speaker 1: in the offing, and wish you and your family and
Speaker 1: your residence and staff very well in the challenging time
Speaker 1: to come. Thanks so much. It was nice talking to you.
Speaker 1: I found that a tremendously useful conversation. Doctor Berman really
Speaker 1: told us what we should and shouldn't be worried about.
Speaker 1: And one of the things that I realized is that
Speaker 1: a lot of the information that's circulating out there about
Speaker 1: what symptoms you should or shouldn't be concerned about is
Speaker 1: actually inaccurate, not up to date, and not statistically sound.
Speaker 1: I also realized that there are many many people who
Speaker 1: might be sick and even have corona, who nevertheless probably
Speaker 1: shouldn't go to the hospital if they're not too sick,
Speaker 1: and that I think is a very important takeaway that
Speaker 1: I had not taken on board myself, and I think
Speaker 1: is very valuable for public health purposes. We're going to
Speaker 1: continue covering Corona with new and special episodes to keep
Speaker 1: you up to date on the most important issues behind
Speaker 1: the stories associated with Corona. In the meantime, if you're
Speaker 1: at home, as you probably should be, be well, be safe,
Speaker 1: take care of yourself and of others. Deep Background is
Speaker 1: brought to you by Pushkin Industries. Our producer is Lydia
Speaker 1: gene Coott, with studio recording by Joseph Fridman and mastering
Speaker 1: by Jason Gambrell and Martin Gonzalez. Our showrunner is Sophie McKibben.
Speaker 1: Our theme music is composed by Luis GERA special thanks
Speaker 1: to the Pushkin Brass, Malcolm Godwell, Jacob Weisberg, and Mia Lobel.
Speaker 1: I'm Noah Feld. I also write a column for Bloomberg Opinion,
Speaker 1: which you can find at Bloomberg dot com backslash Feld.
Speaker 1: To discover Bloomberg's original slate of podcasts, go to Bloomberg
Speaker 1: dot com Backslash Podcasts. You can follow me on Twitter
Speaker 1: at Noah Arfeld. This is Deep Background.