Speaker 1: Hey, before we start the show, we have a quick
Speaker 1: favor to ask you. As many places in America enter
Speaker 1: their second month of social distancing, questions are coming up
Speaker 1: about what's okay? Can you drive to another town to
Speaker 1: see your mom from a distance if you never get
Speaker 1: out of the car. What about taking a bike ride
Speaker 1: with a friend two days six ft away? Daily life
Speaker 1: now involves a lot of confusing risk calculations. So what
Speaker 1: social distancing ethics and etiquette argue you wondering about? We
Speaker 1: want to know. Leave us a voicemail with your question
Speaker 1: at six four six three two four three four zero.
Speaker 1: We'll answer some of your questions and we may use
Speaker 1: your voice on a future show. And now today's show,
Speaker 1: it's day forty two since coronavirus was declared a global pandemic.
Speaker 1: Our main story, patients who are seriously ill from diseases
Speaker 1: besides COVID nineteen are finding themselves in a strange limbo.
Speaker 1: Getting treatment in hospitals is riskier than ever, and doctors
Speaker 1: are forced to delay procedures without knowing for sure whether
Speaker 1: patients will suffer long term harm. But first, here's what
Speaker 1: happened today. New York is building a tracing Army to
Speaker 1: attract the origin of individual coronavirus cases, according to Governor
Speaker 1: Andrew Cuomo at his daily press conference today, the governor
Speaker 1: said that doing this kind of so called contact tracing
Speaker 1: will reduce the spread and let the state focus on
Speaker 1: reopening UH. And we've been talking about testing, tracing and
Speaker 1: then isolating UH and that is going to be the
Speaker 1: key going forward. That's how you are educated and have
Speaker 1: some data points as you're working your way through this
Speaker 1: reopening calibration. And we set as a goal yesterday to
Speaker 1: double the number of state tests, to go from twenty
Speaker 1: thousand on average to that almost at the state would
Speaker 1: work with Connecticut and New Jersey on the initiative. Former
Speaker 1: New York City Mayor Michael Bloomberg volunteered to help the
Speaker 1: state implement the program and will donate ten million dollars
Speaker 1: to the effort. Michael Bloomberg is the founder and majority
Speaker 1: owner of Bloomberg LP, the parent company of Bloomberg News.
Speaker 1: New evidence suggests the new coronavirus may have been spreading
Speaker 1: in the US earlier than previously thought. In California, to
Speaker 1: Santa Clara, residents who died in early February were infected
Speaker 1: with the virus. According to the Counties Public Health Department,
Speaker 1: the first death on February six was twenty days earlier
Speaker 1: than what was previously believed to be the first US fatality,
Speaker 1: and it came three weeks before health officials identified the
Speaker 1: first infection that didn't have a known tie to other cases.
Speaker 1: The deaths were also weeks before cities and states started
Speaker 1: implementing widespread social distancing measures. At the time, US attempts
Speaker 1: to track the virus were limited, Tests were scarce, and
Speaker 1: the criteria for who could be tested was tightly limited.
Speaker 1: It's not the only thing the US may have gotten
Speaker 1: wrong about the spread of the virus. The Trump administration's
Speaker 1: projections for how many in the country will die from
Speaker 1: the coronavirus maybe short by about a hundred thousand. According
Speaker 1: to the American Civil Liberties Union, that's because it hasn't
Speaker 1: fully accounted for the high prison population in the country.
Speaker 1: Models that account for the hundreds of thousands of incarcerated
Speaker 1: people suggest there will be many more deaths than projected
Speaker 1: unless inmate populations are rapidly reduced. The A C. L.
Speaker 1: You said, and how Speaker Nancy Pelosi said, the House
Speaker 1: will pass the emergency four hundred and eighty four billion
Speaker 1: dollar relief package tomorrow, giving small companies quick access to
Speaker 1: additional loans. Pelosi also said on Bloomberg Television that a
Speaker 1: major package of aid for state and local government will
Speaker 1: be in the next stimulus legislation considered by Congress. That
Speaker 1: sets up a conflict with Senate Majority Leader Mitch McConnell,
Speaker 1: who was urging a slowdown in dolling out federal help.
Speaker 1: And now our main story, the waves of coronavirus patients
Speaker 1: flooding hospitals across the country have put an unprecedented strain
Speaker 1: on our healthcare system. But it doesn't mean other diseases
Speaker 1: just go away. The crisis is putting care on hold
Speaker 1: for a lot of people with other serious health conditions
Speaker 1: like cancer. Doctors are delaying procedures and surgeries in order
Speaker 1: to save resources like hospital beds and ventilators for COVID
Speaker 1: nineteen patients and prevent the infection from spreading. But as
Speaker 1: Bloomberg News reporter and Accord explains, doctors are forced to
Speaker 1: make often difficult choices about what constitutes an urgent procedure,
Speaker 1: and experts worry that we're feeding another kind of healthcare
Speaker 1: crisis one with consequences we're only beginning to see. Jenny
Speaker 1: Alstrom has had a type of blood cancer since. Jenny
Speaker 1: is fifty two and lives in Salt Lake City with
Speaker 1: her family. In early April, she needed to see the
Speaker 1: doctor for some tests that would help her understand the
Speaker 1: status of her cancer, but she was worried. I had
Speaker 1: to make this risk benefit analysis. Is it worse for
Speaker 1: me to wait and then how my numbers go up
Speaker 1: and not know what I could be doing about it,
Speaker 1: even if I had to start treatment, or do I
Speaker 1: wait and maybe have a disease that's growing more out
Speaker 1: of control. So I was really holding off on doing
Speaker 1: that just because I didn't want to put myself at risk.
Speaker 1: Jenny did decide to go to the hospital. Her doctor
Speaker 1: recommended a seven am appointment as the safest time to
Speaker 1: go in. She didn't sleep well the night before. I
Speaker 1: woke up really early and I had an in ninety
Speaker 1: five mask, put that on, put my gloves on, and
Speaker 1: went in And the streets are pretty quiet. There was
Speaker 1: no traffic going up to the university, which there usually
Speaker 1: is even at that time of the morning. Jenny says. Now,
Speaker 1: even getting into the hospital to receive care is different
Speaker 1: going into the facility. You know, I walked in, they
Speaker 1: took my temperature. They were taking everyone's temperature that was
Speaker 1: walking in the facility. There were signs everywhere that basically
Speaker 1: there are no visitors or very few visitors, a single visitor.
Speaker 1: And I went up to the floor and I was
Speaker 1: the only patient that I saw on the entire floor.
Speaker 1: No one's getting routine testing right now, no mamograms, no
Speaker 1: stuff you would normally schedule for primitive care or even
Speaker 1: just part of your regular care. They were cleaning off
Speaker 1: all the chairs and surfaces when I got in, and
Speaker 1: there were very few people working in the lab. So
Speaker 1: it's truly changing normal cancer care, and I think that's
Speaker 1: the case for every other disease to Jenny says she's
Speaker 1: glad she went in for the tests. The doctor told
Speaker 1: her she won't have to start treatment immediately, but it's
Speaker 1: not always up to the patient. Hospitals are still doing
Speaker 1: surgeries that are considered emergencies, but in many cases are
Speaker 1: pushing off other kinds of procedures. Those procedures include lots
Speaker 1: of things the average patient wouldn't consider optional, like cancer
Speaker 1: surgeries or a knee replacement. John Hick is an emergency
Speaker 1: medicine doctor in Minneapolis, Minnesota. He says doctors often make
Speaker 1: the decision to delay this kind of care based on
Speaker 1: three things. How much time it will take, how much
Speaker 1: expertise is needed, and what the treatment involves. You know,
Speaker 1: if we needed to take those resources altogether, what's the
Speaker 1: overall investment that we're going to have to make, you know,
Speaker 1: in the patient, And then what are we investing in,
Speaker 1: you know, so kind of cold hard economic terms, what's
Speaker 1: the return on investment here for this particular patient. So
Speaker 1: we have to try to bring the best evidence that
Speaker 1: we can to bear on the situation. But nothing's perfect,
Speaker 1: you know. And I think that's the thing with medicine
Speaker 1: is I used to tell people who wanted a firm answer,
Speaker 1: and I get that all the time. Doctor, you have
Speaker 1: to tell me, you know, I need to know, I
Speaker 1: need to know a hundred percent. And I always say,
Speaker 1: there's nothing that's in medicine. Doctors in the US are
Speaker 1: delaying care for some in order to avoid what happened
Speaker 1: in China and Italy. Hospitals there were overwhelmed by COVID
Speaker 1: nineteen patients. This led doctors to have to make agonizing
Speaker 1: decisions about who to treat and where to put resources.
Speaker 1: Matthew Winnia is a bioethicist at the University of Colorado.
Speaker 1: He says the situation presents major ethical questions. We're almost
Speaker 1: certainly going to have some people with non COVID disease
Speaker 1: who are harmed as result of delays in the care
Speaker 1: that they receive. There's no perfect way to do this,
Speaker 1: because no matter how you slice up that pie, someone's
Speaker 1: not gonna like how much they got. Many doctors are
Speaker 1: turning to virtual visits with their patients to fill the gap,
Speaker 1: but not everything can be done that way. Jason Fung
Speaker 1: is a kidney specialist based in Toronto, Canada. He says
Speaker 1: he worries that people are staying home even when it
Speaker 1: poses health risks. Many of Fung's patients are elderly and
Speaker 1: have other health problems. They're more vulnerable to COVID nineteen
Speaker 1: and they're afraid of getting it. The other day, I
Speaker 1: admitted a patient who was so scared about COVID that
Speaker 1: they didn't get their blood pressures checked, they didn't get
Speaker 1: it taken care of, and I admitted that patient with
Speaker 1: a stroke. That's not reversible, like they will suffer from that.
Speaker 1: They can't see properly, so they will suffer from that
Speaker 1: for the rest of their life. M bioethicist Matthew Whinia
Speaker 1: says access to medical care has always been an issue
Speaker 1: in our health system. The pandemic has just thrust these
Speaker 1: subjects into even clearer view. But he does see a
Speaker 1: silver lining here. Things like virtual visits are becoming much
Speaker 1: more used and accepted. So there are ways in which
Speaker 1: because of a disaster you develop new ways of thinking
Speaker 1: and new ways of doing things that will then carry
Speaker 1: on afterwards. You know, they're saying that necessity is the
Speaker 1: mother of invention. We're having to invent a lot of
Speaker 1: things right now because we have to, and some of
Speaker 1: those will lead to long term improvements, I hope in
Speaker 1: the health care system. The US is starting to talk
Speaker 1: about reopening states that would include non COVID procedures, but
Speaker 1: until then, patients and doctor will still have to make
Speaker 1: the difficult choices about when and where care happens. And
Speaker 1: that was Emma Court and that's it for our show today.
Speaker 1: For more on the outbreak from one and twenty bureaus
Speaker 1: around the world, visit Bloomberg Dot com slash Coronavirus, and
Speaker 1: one small favor. If you appreciate the show, please leave
Speaker 1: us a review and a rating on Apple Podcasts or Spotify.
Speaker 1: It's the best way to help more listeners find our
Speaker 1: global reporting. The Prognosis Daily edition is hosted by Me
Speaker 1: Laura Carlson. The show was produced by Me, top foreheads
Speaker 1: Jordan Gospore and Magnus Henriksen. Today's main story was reported
Speaker 1: by Emma Court. Original music by Leo Sidrin, and our
Speaker 1: editors are Francesco Leady and Rick sh Francesco Levi is
Speaker 1: Bloomberg's head of Podcasts. Thanks for listening. H