1 00:00:03,720 --> 00:00:09,039 Speaker 1: Welcome to Prognosis. I'm Laura Carlson. It's day sixty eight 2 00:00:09,160 --> 00:00:14,160 Speaker 1: since coronavirus was declared a global pandemic, our main story 3 00:00:14,920 --> 00:00:19,000 Speaker 1: in discussions about reopening regions for business, there's been talk 4 00:00:19,160 --> 00:00:25,560 Speaker 1: of two big prerequisites, testing and contact tracing. Today we're 5 00:00:25,560 --> 00:00:28,360 Speaker 1: going to talk about the nitty gritty of that second one, 6 00:00:29,160 --> 00:00:33,840 Speaker 1: how hard contact tracing actually is, and how one country 7 00:00:34,440 --> 00:00:41,080 Speaker 1: is getting it right. But first, here's what happened today. 8 00:00:45,840 --> 00:00:51,080 Speaker 1: An experimental vaccine is showing promising results in a small 9 00:00:51,120 --> 00:00:54,200 Speaker 1: study of a drug made by the biotech firm Moderna. 10 00:00:54,960 --> 00:00:58,440 Speaker 1: Patients immune systems were triggered to create a response to 11 00:00:58,560 --> 00:01:02,840 Speaker 1: fight off the virus. The news is reason for cautious 12 00:01:02,840 --> 00:01:06,800 Speaker 1: optimism that the global efforts to combat the pandemic will 13 00:01:06,840 --> 00:01:11,120 Speaker 1: eventually succeed. The results are just a sample from the 14 00:01:11,160 --> 00:01:14,759 Speaker 1: initial study, and the small study is designed to look 15 00:01:14,800 --> 00:01:19,520 Speaker 1: at how safe it is to inject the drug into volunteers, 16 00:01:19,560 --> 00:01:23,759 Speaker 1: but the study does suggest there are no major safety worries. 17 00:01:24,560 --> 00:01:28,080 Speaker 1: That's a key hurdle to clear, since a vaccine would 18 00:01:28,120 --> 00:01:33,080 Speaker 1: be given to millions of otherwise healthy people. Moderna is 19 00:01:33,120 --> 00:01:36,080 Speaker 1: moving ahead with plans for a larger test to determine 20 00:01:36,080 --> 00:01:38,800 Speaker 1: the right dose, as well as a phase three test 21 00:01:38,959 --> 00:01:44,200 Speaker 1: with many thousands of patients. China will make its coronavirus 22 00:01:44,280 --> 00:01:49,080 Speaker 1: vaccine a global public good once one is available, according 23 00:01:49,120 --> 00:01:53,160 Speaker 1: to President Jane Payne, g spoke to the World Health 24 00:01:53,280 --> 00:01:58,000 Speaker 1: Organization's governing body. As concerns grow that countries will put 25 00:01:58,040 --> 00:02:01,760 Speaker 1: their own interests first in the quest to stem the virus, 26 00:02:02,960 --> 00:02:05,520 Speaker 1: the w h O was pushing a proposal that aims 27 00:02:05,560 --> 00:02:09,680 Speaker 1: to ensure broad access to COVID nineteen treatments and vaccines 28 00:02:10,320 --> 00:02:16,680 Speaker 1: while offering an appropriate reward to creators. Also in China, 29 00:02:17,000 --> 00:02:20,200 Speaker 1: some one and eight million people in the countries northeast 30 00:02:20,400 --> 00:02:24,120 Speaker 1: are being forced back into lockdown. A new and growing 31 00:02:24,160 --> 00:02:27,400 Speaker 1: cluster of infections there has caused a backslide and the 32 00:02:27,560 --> 00:02:31,720 Speaker 1: nation's return to normal in an abrupt reversal of the 33 00:02:31,760 --> 00:02:36,200 Speaker 1: reopening across the country. Cities in Jilin Province have caught 34 00:02:36,200 --> 00:02:40,520 Speaker 1: off trains and buses, shot schools, and quarantine tens of 35 00:02:40,560 --> 00:02:44,720 Speaker 1: thousands of people. While the cluster of thirty four infections 36 00:02:44,840 --> 00:02:47,760 Speaker 1: isn't growing as quickly as the outbreak in Wuhan that 37 00:02:47,880 --> 00:02:52,400 Speaker 1: started the global pandemic last December, China's swift and powerful 38 00:02:52,440 --> 00:02:58,760 Speaker 1: reaction reflects its fear of a second wave. Finally, in Florida, 39 00:02:59,280 --> 00:03:01,800 Speaker 1: one of severn world u S states where businesses are 40 00:03:01,840 --> 00:03:05,600 Speaker 1: starting to reopen, the state reported a larger than average 41 00:03:05,639 --> 00:03:10,600 Speaker 1: increase in new infections. Florida is expanding its reopening today 42 00:03:10,720 --> 00:03:14,880 Speaker 1: to include Miami Dade and Broward, the two most populous 43 00:03:15,000 --> 00:03:20,079 Speaker 1: and hardest hit counties. Elsewhere, Governor Rohn de Santis is 44 00:03:20,200 --> 00:03:25,120 Speaker 1: loosening restrictions further. Retailers and restaurants will be allowed to 45 00:03:25,160 --> 00:03:30,320 Speaker 1: have customers inside at fifty capacity, up from in the 46 00:03:30,360 --> 00:03:38,320 Speaker 1: initial phase of reopening. And now our main story. As 47 00:03:38,360 --> 00:03:41,040 Speaker 1: countries around the world try to figure out how to 48 00:03:41,120 --> 00:03:45,000 Speaker 1: live with the virus, a very old public health strategy 49 00:03:45,040 --> 00:03:51,520 Speaker 1: is on everybody's mind. Contact tracing. This is the laborious 50 00:03:51,560 --> 00:03:56,480 Speaker 1: process of tracking down everybody that a coronavirus patient might 51 00:03:56,560 --> 00:04:02,560 Speaker 1: have infected. It's tedious and time consuming, but irreplaceable if 52 00:04:02,600 --> 00:04:06,680 Speaker 1: you want to stop a disease from spreading. The World 53 00:04:06,680 --> 00:04:11,480 Speaker 1: Health Organization has specifically praised one country for its contact 54 00:04:11,560 --> 00:04:16,400 Speaker 1: tracing practices, Germany. The country has about a quarter of 55 00:04:16,440 --> 00:04:20,920 Speaker 1: the deaths of neighboring France. Despite a more flexible lockdown. 56 00:04:21,760 --> 00:04:26,279 Speaker 1: Last weekend, it continued its cautious move towards pandemic normalcy 57 00:04:26,600 --> 00:04:32,120 Speaker 1: by letting restaurants reopen. Bloomberg reporter Naomi Kraski takes us 58 00:04:32,160 --> 00:04:35,560 Speaker 1: to Wurtzburg, a region about an hour east of Frankfurt, 59 00:04:35,880 --> 00:04:39,520 Speaker 1: to see what Germany is getting right about contact tracing 60 00:04:41,720 --> 00:04:51,000 Speaker 1: m okay. Our story starts with Joachim Lazar. Infections were 61 00:04:51,040 --> 00:04:54,400 Speaker 1: never his specialty. Joakim, who was thirty nine years old, 62 00:04:54,520 --> 00:04:57,440 Speaker 1: is a social worker, not a doctor. But when the 63 00:04:57,440 --> 00:05:02,159 Speaker 1: new coronavirus swept into Wurtzburg, Germany, in early March, he 64 00:05:02,240 --> 00:05:04,920 Speaker 1: found himself in the thick of the war against it. 65 00:05:05,680 --> 00:05:10,200 Speaker 1: He's one of the city's contact tracers. It's like detective work. 66 00:05:10,680 --> 00:05:14,680 Speaker 1: When someone in Wurtzburg tests positive for the virus, Letzariic 67 00:05:14,839 --> 00:05:18,640 Speaker 1: interviews them to uncover any trail of illness they might 68 00:05:18,680 --> 00:05:21,719 Speaker 1: have left in their wake. Under that, I'm a kind 69 00:05:23,440 --> 00:05:26,719 Speaker 1: you can't make any mistakes. You have to ask things like, 70 00:05:27,000 --> 00:05:30,960 Speaker 1: for example, whether they're living in a small apartment, are 71 00:05:31,000 --> 00:05:34,080 Speaker 1: you living with your partner and children? Is your grandmother 72 00:05:34,160 --> 00:05:37,280 Speaker 1: also living there? Is it a large family? And then 73 00:05:37,320 --> 00:05:40,240 Speaker 1: at work, did you take part in a meeting. Did 74 00:05:40,279 --> 00:05:43,039 Speaker 1: you smoke a cigarette with someone on your break? Do 75 00:05:43,160 --> 00:05:46,560 Speaker 1: you work at a hospital? For us, everything is important 76 00:05:46,960 --> 00:05:51,040 Speaker 1: and you have to follow up very carefully. Unlike the US, 77 00:05:51,480 --> 00:05:55,359 Speaker 1: UK and most other countries, Germany never gave up on 78 00:05:55,440 --> 00:05:59,640 Speaker 1: contact tracing, even as infection is ballooned. Thanks to some 79 00:05:59,760 --> 00:06:03,360 Speaker 1: of the world's toughest privacy laws, the country's three hundred 80 00:06:03,360 --> 00:06:06,719 Speaker 1: and seventy five local health authorities could not rely on 81 00:06:06,800 --> 00:06:11,679 Speaker 1: digital surveillance for help. Instead, they recruited everyone from medical 82 00:06:11,680 --> 00:06:16,599 Speaker 1: students to firefighters. These contact tracers spend untold hours on 83 00:06:16,640 --> 00:06:20,200 Speaker 1: the phone. Together with a lot of testing and the 84 00:06:20,320 --> 00:06:23,320 Speaker 1: luck of having the German outbreak spread first and younger 85 00:06:23,360 --> 00:06:26,960 Speaker 1: and healthier people, contact tracers are one of the big 86 00:06:27,000 --> 00:06:30,880 Speaker 1: reasons why Germany has about one third as many coronavirus 87 00:06:30,880 --> 00:06:38,320 Speaker 1: deaths per capita as the US. Mike Ryan, executive director 88 00:06:38,320 --> 00:06:43,360 Speaker 1: of the who's Emergencies Program, recently praised Germany's testing and tracing. 89 00:06:44,040 --> 00:06:46,200 Speaker 1: He said it puts the country in a good position 90 00:06:46,279 --> 00:06:49,800 Speaker 1: to suppress the new infection clusters that inevitably will pop 91 00:06:49,920 --> 00:06:52,800 Speaker 1: up as it emerges from lockdown, and he had a 92 00:06:52,880 --> 00:06:55,320 Speaker 1: warning for those that are not putting in the same effort. 93 00:06:56,120 --> 00:06:59,560 Speaker 1: Shoving your eyes and I'm trying to drive through this 94 00:06:59,720 --> 00:07:03,360 Speaker 1: blind is about as silly an equation as I've seen, 95 00:07:04,080 --> 00:07:07,279 Speaker 1: And I'm really concerned that certain countries are saving serves 96 00:07:07,360 --> 00:07:10,280 Speaker 1: up for some seriously blind driving over the next few months. 97 00:07:11,480 --> 00:07:14,240 Speaker 1: U S States are putting together their own armies of 98 00:07:14,320 --> 00:07:18,520 Speaker 1: contact tracers right now, but they're starting late in the game. 99 00:07:19,200 --> 00:07:21,520 Speaker 1: By all accounts, the country will need more than one 100 00:07:21,600 --> 00:07:25,239 Speaker 1: hundred thousand people like litz Artic, at a total cost 101 00:07:25,320 --> 00:07:29,280 Speaker 1: in the billions. Utzburg is a case study for why 102 00:07:29,400 --> 00:07:33,520 Speaker 1: that would be a worthwhile investment. Its first two virus 103 00:07:33,640 --> 00:07:36,720 Speaker 1: cases emerged on March fourth, in people who had just 104 00:07:36,920 --> 00:07:41,560 Speaker 1: returned from Italy. Infections mushroomed from there a young couple, 105 00:07:42,160 --> 00:07:44,200 Speaker 1: a student and teacher who had been on a trip 106 00:07:44,280 --> 00:07:48,640 Speaker 1: to the Alps, a handful of other school children. Most worryingly, 107 00:07:49,040 --> 00:07:52,760 Speaker 1: the virus emerged in a local nursing home. On March twelve. 108 00:07:53,320 --> 00:07:56,720 Speaker 1: An eighty three year old resident of that facility became 109 00:07:56,800 --> 00:08:00,600 Speaker 1: the coronavirus is first victim in Bavaria and among the 110 00:08:00,720 --> 00:08:05,040 Speaker 1: first in Germany. The health authority staff were already making 111 00:08:05,120 --> 00:08:09,200 Speaker 1: calls begin at the beginning. There were actually only a 112 00:08:09,280 --> 00:08:12,960 Speaker 1: few people doing the investigating, and then because the numbers 113 00:08:13,000 --> 00:08:16,760 Speaker 1: were rising so high, we all started doing nothing but tracing. 114 00:08:17,040 --> 00:08:19,800 Speaker 1: At first, it was like playing a public health version 115 00:08:20,040 --> 00:08:23,760 Speaker 1: of Whackamore, Lazark and the other contact tracers to get 116 00:08:23,800 --> 00:08:27,600 Speaker 1: their day's cases. During an early morning meeting, the positive 117 00:08:29,000 --> 00:08:31,880 Speaker 1: the positive tests went to the tracing team, and then 118 00:08:31,960 --> 00:08:34,719 Speaker 1: the tracing team would get to the phone. Because these 119 00:08:34,840 --> 00:08:38,480 Speaker 1: people had been tested, we had their contact detests and 120 00:08:38,600 --> 00:08:41,120 Speaker 1: in the conversations. The first order of business was to 121 00:08:41,200 --> 00:08:45,000 Speaker 1: inform to inform people that they've had a positive test, 122 00:08:45,200 --> 00:08:48,079 Speaker 1: and then to inform them about what that means to them. 123 00:08:48,880 --> 00:08:51,920 Speaker 1: We had to tell them to isolate. People who test 124 00:08:51,960 --> 00:08:55,079 Speaker 1: positive aren't allowed to leave the house. But then another 125 00:08:55,160 --> 00:08:58,280 Speaker 1: big piece, something that is very important to me, is 126 00:08:58,360 --> 00:09:06,680 Speaker 1: to give them information and try. They used a simple 127 00:09:06,800 --> 00:09:11,719 Speaker 1: definition for contacts, everyone with whom an infected person was 128 00:09:11,880 --> 00:09:15,840 Speaker 1: face to face for more than fifteen minutes starting two 129 00:09:15,960 --> 00:09:20,240 Speaker 1: days before their symptoms began. These contacts also have to 130 00:09:20,320 --> 00:09:23,400 Speaker 1: be called, told to quarantine and asked to track their 131 00:09:23,480 --> 00:09:27,120 Speaker 1: health and write down any encounters, even something as fleeting 132 00:09:27,200 --> 00:09:30,200 Speaker 1: as a package delivery person coming to the door. If 133 00:09:30,240 --> 00:09:34,000 Speaker 1: they developed symptoms, they're tested, and for those who test positive, 134 00:09:34,320 --> 00:09:37,079 Speaker 1: a tracer goes back to the beginning to investigate that 135 00:09:37,280 --> 00:09:41,280 Speaker 1: person's contact chain. In the early weeks, the case is 136 00:09:41,360 --> 00:09:46,120 Speaker 1: piled up. On March twenty, when Bavarian Premier Marcus Suder 137 00:09:46,240 --> 00:09:50,480 Speaker 1: put the state into lockdown, Fittzburg had fifty four new infections. 138 00:09:51,320 --> 00:09:55,040 Speaker 1: By early April. Ltzarik and his colleagues were working flat out. 139 00:09:55,679 --> 00:09:58,640 Speaker 1: He soon found himself leading a team of other tracers. 140 00:10:00,080 --> 00:10:03,160 Speaker 1: Then it did happen that we were doing the investigating 141 00:10:03,240 --> 00:10:05,760 Speaker 1: for six or seven days a week and sometimes up 142 00:10:05,800 --> 00:10:09,400 Speaker 1: to fourteen hours a day. They recruited medical students, youth 143 00:10:09,480 --> 00:10:13,319 Speaker 1: welfare officers, and administrators from other agencies to double the 144 00:10:13,440 --> 00:10:16,959 Speaker 1: number of tracers on the phones. Other recruits managed the 145 00:10:17,040 --> 00:10:20,280 Speaker 1: tide of paperwork and data entry. They got a real 146 00:10:20,440 --> 00:10:26,440 Speaker 1: database instead of makeshift Excel spreadsheets, counting everybody, including doctors, 147 00:10:26,520 --> 00:10:29,640 Speaker 1: to manage who goes into and out of quarantine. The 148 00:10:29,760 --> 00:10:33,560 Speaker 1: team swelled more than one hundred people. Let's Ardrek started 149 00:10:33,600 --> 00:10:37,760 Speaker 1: training the new recruits. We look really closely at every 150 00:10:37,840 --> 00:10:40,520 Speaker 1: single case and we talked together on the team about 151 00:10:40,559 --> 00:10:45,800 Speaker 1: how to proceed. But slowly, social distancing started to reduce 152 00:10:45,880 --> 00:10:49,720 Speaker 1: the number of contacts that had to be traced. On April, 153 00:10:50,720 --> 00:10:54,000 Speaker 1: for the first time, there were no new virus cases 154 00:10:54,160 --> 00:10:58,480 Speaker 1: to distribute in the morning meeting. By May fourteen, the 155 00:10:58,600 --> 00:11:01,800 Speaker 1: team had released more than two thousand, five hundred people 156 00:11:01,920 --> 00:11:05,960 Speaker 1: from quarantine and more than seven hundred of the areas, 157 00:11:06,000 --> 00:11:11,240 Speaker 1: eight hundred and sixty nine virus cases had recovered, fifty 158 00:11:11,360 --> 00:11:16,360 Speaker 1: nine people had died. Wurtzburg is just one small cog 159 00:11:16,520 --> 00:11:20,319 Speaker 1: in the German contact tracing machine. On a federal level, 160 00:11:20,760 --> 00:11:23,680 Speaker 1: Germany has said its aiming for one team of five 161 00:11:23,760 --> 00:11:28,400 Speaker 1: tracers per twenty thou inhabitants, which works out to almost 162 00:11:28,440 --> 00:11:33,640 Speaker 1: twenty one thousand tracers nationwide. There are some challenges, though 163 00:11:33,679 --> 00:11:37,440 Speaker 1: The government has earmarked fifty million euros for a technology update. 164 00:11:37,880 --> 00:11:41,719 Speaker 1: Critics say that's not enough, and a promised app to 165 00:11:41,880 --> 00:11:46,079 Speaker 1: identify potential contacts based on cell phone proximity has yet 166 00:11:46,160 --> 00:11:52,400 Speaker 1: to materialize. As Germany slowly eases restrictions on public life, 167 00:11:52,880 --> 00:11:56,719 Speaker 1: Litzotic and other contact tracers are far from finished with 168 00:11:56,840 --> 00:12:00,800 Speaker 1: their work. The number of German cases has picked up slightly, 169 00:12:01,559 --> 00:12:05,199 Speaker 1: driven by local outbreaks and meatpacking plants and nursing homes. 170 00:12:06,120 --> 00:12:09,959 Speaker 1: Chancellor Angela mercle said last week that health authorities will 171 00:12:09,960 --> 00:12:13,360 Speaker 1: be the deciding point for whether these chains of infections 172 00:12:13,640 --> 00:12:17,040 Speaker 1: can be followed and shut down. I can tell you 173 00:12:17,160 --> 00:12:19,839 Speaker 1: that committed people are working there. They will manage this 174 00:12:20,000 --> 00:12:23,440 Speaker 1: task and we will provide the necessary back up together 175 00:12:23,559 --> 00:12:34,760 Speaker 1: with the States. That was Naomi Krasky in Berlin, And 176 00:12:34,880 --> 00:12:37,920 Speaker 1: that's our show today. For coverage of the outbreak from 177 00:12:37,960 --> 00:12:41,600 Speaker 1: one and twenty bureaus around the world, visit Bloomberg dot 178 00:12:41,679 --> 00:12:46,840 Speaker 1: com slash Coronavirus and if you like the show, please 179 00:12:47,080 --> 00:12:50,000 Speaker 1: leave us a review and a rating on Apple Podcasts 180 00:12:50,160 --> 00:12:53,600 Speaker 1: or Spotify. It's the best way to help more listeners 181 00:12:53,800 --> 00:12:58,040 Speaker 1: find our global reporting. The Prognosis Daily edition is produced 182 00:12:58,080 --> 00:13:02,679 Speaker 1: by Tover Foreheads, Jordan's as Pure, Magnus Henriksson, and me 183 00:13:03,200 --> 00:13:07,280 Speaker 1: Laura Carlson. Today's main story was reported by Naomi Kresky. 184 00:13:08,000 --> 00:13:12,679 Speaker 1: Special thanks to Philip Corn and Karen Matusik. Original music 185 00:13:12,920 --> 00:13:17,720 Speaker 1: by Leo Citrin. Our editors are Francesca Levi and Rick Shine. 186 00:13:18,440 --> 00:13:23,000 Speaker 1: Francesca Levi is Bloomberg's head of podcasts. Thanks for listening.