WEBVTT - The Virus Trackers 0:00:03.720 --> 0:00:09.039 Welcome to Prognosis. I'm Laura Carlson. It's day sixty eight 0:00:09.160 --> 0:00:14.160 since coronavirus was declared a global pandemic, our main story 0:00:14.920 --> 0:00:19.000 in discussions about reopening regions for business, there's been talk 0:00:19.160 --> 0:00:25.560 of two big prerequisites, testing and contact tracing. Today we're 0:00:25.560 --> 0:00:28.360 going to talk about the nitty gritty of that second one, 0:00:29.160 --> 0:00:33.840 how hard contact tracing actually is, and how one country 0:00:34.440 --> 0:00:41.080 is getting it right. But first, here's what happened today. 0:00:45.840 --> 0:00:51.080 An experimental vaccine is showing promising results in a small 0:00:51.120 --> 0:00:54.200 study of a drug made by the biotech firm Moderna. 0:00:54.960 --> 0:00:58.440 Patients immune systems were triggered to create a response to 0:00:58.560 --> 0:01:02.840 fight off the virus. The news is reason for cautious 0:01:02.840 --> 0:01:06.800 optimism that the global efforts to combat the pandemic will 0:01:06.840 --> 0:01:11.120 eventually succeed. The results are just a sample from the 0:01:11.160 --> 0:01:14.759 initial study, and the small study is designed to look 0:01:14.800 --> 0:01:19.520 at how safe it is to inject the drug into volunteers, 0:01:19.560 --> 0:01:23.759 but the study does suggest there are no major safety worries. 0:01:24.560 --> 0:01:28.080 That's a key hurdle to clear, since a vaccine would 0:01:28.120 --> 0:01:33.080 be given to millions of otherwise healthy people. Moderna is 0:01:33.120 --> 0:01:36.080 moving ahead with plans for a larger test to determine 0:01:36.080 --> 0:01:38.800 the right dose, as well as a phase three test 0:01:38.959 --> 0:01:44.200 with many thousands of patients. China will make its coronavirus 0:01:44.280 --> 0:01:49.080 vaccine a global public good once one is available, according 0:01:49.120 --> 0:01:53.160 to President Jane Payne, g spoke to the World Health 0:01:53.280 --> 0:01:58.000 Organization's governing body. As concerns grow that countries will put 0:01:58.040 --> 0:02:01.760 their own interests first in the quest to stem the virus, 0:02:02.960 --> 0:02:05.520 the w h O was pushing a proposal that aims 0:02:05.560 --> 0:02:09.680 to ensure broad access to COVID nineteen treatments and vaccines 0:02:10.320 --> 0:02:16.680 while offering an appropriate reward to creators. Also in China, 0:02:17.000 --> 0:02:20.200 some one and eight million people in the countries northeast 0:02:20.400 --> 0:02:24.120 are being forced back into lockdown. A new and growing 0:02:24.160 --> 0:02:27.400 cluster of infections there has caused a backslide and the 0:02:27.560 --> 0:02:31.720 nation's return to normal in an abrupt reversal of the 0:02:31.760 --> 0:02:36.200 reopening across the country. Cities in Jilin Province have caught 0:02:36.200 --> 0:02:40.520 off trains and buses, shot schools, and quarantine tens of 0:02:40.560 --> 0:02:44.720 thousands of people. While the cluster of thirty four infections 0:02:44.840 --> 0:02:47.760 isn't growing as quickly as the outbreak in Wuhan that 0:02:47.880 --> 0:02:52.400 started the global pandemic last December, China's swift and powerful 0:02:52.440 --> 0:02:58.760 reaction reflects its fear of a second wave. Finally, in Florida, 0:02:59.280 --> 0:03:01.800 one of severn world u S states where businesses are 0:03:01.840 --> 0:03:05.600 starting to reopen, the state reported a larger than average 0:03:05.639 --> 0:03:10.600 increase in new infections. Florida is expanding its reopening today 0:03:10.720 --> 0:03:14.880 to include Miami Dade and Broward, the two most populous 0:03:15.000 --> 0:03:20.079 and hardest hit counties. Elsewhere, Governor Rohn de Santis is 0:03:20.200 --> 0:03:25.120 loosening restrictions further. Retailers and restaurants will be allowed to 0:03:25.160 --> 0:03:30.320 have customers inside at fifty capacity, up from in the 0:03:30.360 --> 0:03:38.320 initial phase of reopening. And now our main story. As 0:03:38.360 --> 0:03:41.040 countries around the world try to figure out how to 0:03:41.120 --> 0:03:45.000 live with the virus, a very old public health strategy 0:03:45.040 --> 0:03:51.520 is on everybody's mind. Contact tracing. This is the laborious 0:03:51.560 --> 0:03:56.480 process of tracking down everybody that a coronavirus patient might 0:03:56.560 --> 0:04:02.560 have infected. It's tedious and time consuming, but irreplaceable if 0:04:02.600 --> 0:04:06.680 you want to stop a disease from spreading. The World 0:04:06.680 --> 0:04:11.480 Health Organization has specifically praised one country for its contact 0:04:11.560 --> 0:04:16.400 tracing practices, Germany. The country has about a quarter of 0:04:16.440 --> 0:04:20.920 the deaths of neighboring France. Despite a more flexible lockdown. 0:04:21.760 --> 0:04:26.279 Last weekend, it continued its cautious move towards pandemic normalcy 0:04:26.600 --> 0:04:32.120 by letting restaurants reopen. Bloomberg reporter Naomi Kraski takes us 0:04:32.160 --> 0:04:35.560 to Wurtzburg, a region about an hour east of Frankfurt, 0:04:35.880 --> 0:04:39.520 to see what Germany is getting right about contact tracing 0:04:41.720 --> 0:04:51.000 m okay. Our story starts with Joachim Lazar. Infections were 0:04:51.040 --> 0:04:54.400 never his specialty. Joakim, who was thirty nine years old, 0:04:54.520 --> 0:04:57.440 is a social worker, not a doctor. But when the 0:04:57.440 --> 0:05:02.159 new coronavirus swept into Wurtzburg, Germany, in early March, he 0:05:02.240 --> 0:05:04.920 found himself in the thick of the war against it. 0:05:05.680 --> 0:05:10.200 He's one of the city's contact tracers. It's like detective work. 0:05:10.680 --> 0:05:14.680 When someone in Wurtzburg tests positive for the virus, Letzariic 0:05:14.839 --> 0:05:18.640 interviews them to uncover any trail of illness they might 0:05:18.680 --> 0:05:21.719 have left in their wake. Under that, I'm a kind 0:05:23.440 --> 0:05:26.719 you can't make any mistakes. You have to ask things like, 0:05:27.000 --> 0:05:30.960 for example, whether they're living in a small apartment, are 0:05:31.000 --> 0:05:34.080 you living with your partner and children? Is your grandmother 0:05:34.160 --> 0:05:37.280 also living there? Is it a large family? And then 0:05:37.320 --> 0:05:40.240 at work, did you take part in a meeting. Did 0:05:40.279 --> 0:05:43.039 you smoke a cigarette with someone on your break? Do 0:05:43.160 --> 0:05:46.560 you work at a hospital? For us, everything is important 0:05:46.960 --> 0:05:51.040 and you have to follow up very carefully. Unlike the US, 0:05:51.480 --> 0:05:55.359 UK and most other countries, Germany never gave up on 0:05:55.440 --> 0:05:59.640 contact tracing, even as infection is ballooned. Thanks to some 0:05:59.760 --> 0:06:03.360 of the world's toughest privacy laws, the country's three hundred 0:06:03.360 --> 0:06:06.719 and seventy five local health authorities could not rely on 0:06:06.800 --> 0:06:11.679 digital surveillance for help. Instead, they recruited everyone from medical 0:06:11.680 --> 0:06:16.599 students to firefighters. These contact tracers spend untold hours on 0:06:16.640 --> 0:06:20.200 the phone. Together with a lot of testing and the 0:06:20.320 --> 0:06:23.320 luck of having the German outbreak spread first and younger 0:06:23.360 --> 0:06:26.960 and healthier people, contact tracers are one of the big 0:06:27.000 --> 0:06:30.880 reasons why Germany has about one third as many coronavirus 0:06:30.880 --> 0:06:38.320 deaths per capita as the US. Mike Ryan, executive director 0:06:38.320 --> 0:06:43.360 of the who's Emergencies Program, recently praised Germany's testing and tracing. 0:06:44.040 --> 0:06:46.200 He said it puts the country in a good position 0:06:46.279 --> 0:06:49.800 to suppress the new infection clusters that inevitably will pop 0:06:49.920 --> 0:06:52.800 up as it emerges from lockdown, and he had a 0:06:52.880 --> 0:06:55.320 warning for those that are not putting in the same effort. 0:06:56.120 --> 0:06:59.560 Shoving your eyes and I'm trying to drive through this 0:06:59.720 --> 0:07:03.360 blind is about as silly an equation as I've seen, 0:07:04.080 --> 0:07:07.279 And I'm really concerned that certain countries are saving serves 0:07:07.360 --> 0:07:10.280 up for some seriously blind driving over the next few months. 0:07:11.480 --> 0:07:14.240 U S States are putting together their own armies of 0:07:14.320 --> 0:07:18.520 contact tracers right now, but they're starting late in the game. 0:07:19.200 --> 0:07:21.520 By all accounts, the country will need more than one 0:07:21.600 --> 0:07:25.239 hundred thousand people like litz Artic, at a total cost 0:07:25.320 --> 0:07:29.280 in the billions. Utzburg is a case study for why 0:07:29.400 --> 0:07:33.520 that would be a worthwhile investment. Its first two virus 0:07:33.640 --> 0:07:36.720 cases emerged on March fourth, in people who had just 0:07:36.920 --> 0:07:41.560 returned from Italy. Infections mushroomed from there a young couple, 0:07:42.160 --> 0:07:44.200 a student and teacher who had been on a trip 0:07:44.280 --> 0:07:48.640 to the Alps, a handful of other school children. Most worryingly, 0:07:49.040 --> 0:07:52.760 the virus emerged in a local nursing home. On March twelve. 0:07:53.320 --> 0:07:56.720 An eighty three year old resident of that facility became 0:07:56.800 --> 0:08:00.600 the coronavirus is first victim in Bavaria and among the 0:08:00.720 --> 0:08:05.040 first in Germany. The health authority staff were already making 0:08:05.120 --> 0:08:09.200 calls begin at the beginning. There were actually only a 0:08:09.280 --> 0:08:12.960 few people doing the investigating, and then because the numbers 0:08:13.000 --> 0:08:16.760 were rising so high, we all started doing nothing but tracing. 0:08:17.040 --> 0:08:19.800 At first, it was like playing a public health version 0:08:20.040 --> 0:08:23.760 of Whackamore, Lazark and the other contact tracers to get 0:08:23.800 --> 0:08:27.600 their day's cases. During an early morning meeting, the positive 0:08:29.000 --> 0:08:31.880 the positive tests went to the tracing team, and then 0:08:31.960 --> 0:08:34.719 the tracing team would get to the phone. Because these 0:08:34.840 --> 0:08:38.480 people had been tested, we had their contact detests and 0:08:38.600 --> 0:08:41.120 in the conversations. The first order of business was to 0:08:41.200 --> 0:08:45.000 inform to inform people that they've had a positive test, 0:08:45.200 --> 0:08:48.079 and then to inform them about what that means to them. 0:08:48.880 --> 0:08:51.920 We had to tell them to isolate. People who test 0:08:51.960 --> 0:08:55.079 positive aren't allowed to leave the house. But then another 0:08:55.160 --> 0:08:58.280 big piece, something that is very important to me, is 0:08:58.360 --> 0:09:06.680 to give them information and try. They used a simple 0:09:06.800 --> 0:09:11.719 definition for contacts, everyone with whom an infected person was 0:09:11.880 --> 0:09:15.840 face to face for more than fifteen minutes starting two 0:09:15.960 --> 0:09:20.240 days before their symptoms began. These contacts also have to 0:09:20.320 --> 0:09:23.400 be called, told to quarantine and asked to track their 0:09:23.480 --> 0:09:27.120 health and write down any encounters, even something as fleeting 0:09:27.200 --> 0:09:30.200 as a package delivery person coming to the door. If 0:09:30.240 --> 0:09:34.000 they developed symptoms, they're tested, and for those who test positive, 0:09:34.320 --> 0:09:37.079 a tracer goes back to the beginning to investigate that 0:09:37.280 --> 0:09:41.280 person's contact chain. In the early weeks, the case is 0:09:41.360 --> 0:09:46.120 piled up. On March twenty, when Bavarian Premier Marcus Suder 0:09:46.240 --> 0:09:50.480 put the state into lockdown, Fittzburg had fifty four new infections. 0:09:51.320 --> 0:09:55.040 By early April. Ltzarik and his colleagues were working flat out. 0:09:55.679 --> 0:09:58.640 He soon found himself leading a team of other tracers. 0:10:00.080 --> 0:10:03.160 Then it did happen that we were doing the investigating 0:10:03.240 --> 0:10:05.760 for six or seven days a week and sometimes up 0:10:05.800 --> 0:10:09.400 to fourteen hours a day. They recruited medical students, youth 0:10:09.480 --> 0:10:13.319 welfare officers, and administrators from other agencies to double the 0:10:13.440 --> 0:10:16.959 number of tracers on the phones. Other recruits managed the 0:10:17.040 --> 0:10:20.280 tide of paperwork and data entry. They got a real 0:10:20.440 --> 0:10:26.440 database instead of makeshift Excel spreadsheets, counting everybody, including doctors, 0:10:26.520 --> 0:10:29.640 to manage who goes into and out of quarantine. The 0:10:29.760 --> 0:10:33.560 team swelled more than one hundred people. Let's Ardrek started 0:10:33.600 --> 0:10:37.760 training the new recruits. We look really closely at every 0:10:37.840 --> 0:10:40.520 single case and we talked together on the team about 0:10:40.559 --> 0:10:45.800 how to proceed. But slowly, social distancing started to reduce 0:10:45.880 --> 0:10:49.720 the number of contacts that had to be traced. On April, 0:10:50.720 --> 0:10:54.000 for the first time, there were no new virus cases 0:10:54.160 --> 0:10:58.480 to distribute in the morning meeting. By May fourteen, the 0:10:58.600 --> 0:11:01.800 team had released more than two thousand, five hundred people 0:11:01.920 --> 0:11:05.960 from quarantine and more than seven hundred of the areas, 0:11:06.000 --> 0:11:11.240 eight hundred and sixty nine virus cases had recovered, fifty 0:11:11.360 --> 0:11:16.360 nine people had died. Wurtzburg is just one small cog 0:11:16.520 --> 0:11:20.319 in the German contact tracing machine. On a federal level, 0:11:20.760 --> 0:11:23.680 Germany has said its aiming for one team of five 0:11:23.760 --> 0:11:28.400 tracers per twenty thou inhabitants, which works out to almost 0:11:28.440 --> 0:11:33.640 twenty one thousand tracers nationwide. There are some challenges, though 0:11:33.679 --> 0:11:37.440 The government has earmarked fifty million euros for a technology update. 0:11:37.880 --> 0:11:41.719 Critics say that's not enough, and a promised app to 0:11:41.880 --> 0:11:46.079 identify potential contacts based on cell phone proximity has yet 0:11:46.160 --> 0:11:52.400 to materialize. As Germany slowly eases restrictions on public life, 0:11:52.880 --> 0:11:56.719 Litzotic and other contact tracers are far from finished with 0:11:56.840 --> 0:12:00.800 their work. The number of German cases has picked up slightly, 0:12:01.559 --> 0:12:05.199 driven by local outbreaks and meatpacking plants and nursing homes. 0:12:06.120 --> 0:12:09.959 Chancellor Angela mercle said last week that health authorities will 0:12:09.960 --> 0:12:13.360 be the deciding point for whether these chains of infections 0:12:13.640 --> 0:12:17.040 can be followed and shut down. I can tell you 0:12:17.160 --> 0:12:19.839 that committed people are working there. They will manage this 0:12:20.000 --> 0:12:23.440 task and we will provide the necessary back up together 0:12:23.559 --> 0:12:34.760 with the States. That was Naomi Krasky in Berlin, And 0:12:34.880 --> 0:12:37.920 that's our show today. For coverage of the outbreak from 0:12:37.960 --> 0:12:41.600 one and twenty bureaus around the world, visit Bloomberg dot 0:12:41.679 --> 0:12:46.840 com slash Coronavirus and if you like the show, please 0:12:47.080 --> 0:12:50.000 leave us a review and a rating on Apple Podcasts 0:12:50.160 --> 0:12:53.600 or Spotify. It's the best way to help more listeners 0:12:53.800 --> 0:12:58.040 find our global reporting. The Prognosis Daily edition is produced 0:12:58.080 --> 0:13:02.679 by Tover Foreheads, Jordan's as Pure, Magnus Henriksson, and me 0:13:03.200 --> 0:13:07.280 Laura Carlson. Today's main story was reported by Naomi Kresky. 0:13:08.000 --> 0:13:12.679 Special thanks to Philip Corn and Karen Matusik. Original music 0:13:12.920 --> 0:13:17.720 by Leo Citrin. Our editors are Francesca Levi and Rick Shine. 0:13:18.440 --> 0:13:23.000 Francesca Levi is Bloomberg's head of podcasts. Thanks for listening.