WEBVTT - Failing the test 

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<v Speaker 1>I think the next forty days will probably be the

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<v Speaker 1>forty worst days of the pandemic. It's really bad at

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<v Speaker 1>this point. I mean hundreds of thousands of Americans getting

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<v Speaker 1>infected every day, of two to three thousand people dying

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<v Speaker 1>every day. If we had widespread testing available, this would

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<v Speaker 1>make a huge difference. But we don't, and so we're

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<v Speaker 1>still stock and you're going to see more hospitals basically

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<v Speaker 1>say we can't take care of anybody else, not just

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<v Speaker 1>we can't take care of COVID patients, we just can't

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<v Speaker 1>take care of anybody else. It's gonna be awful, and

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<v Speaker 1>it's gonna be a very challenging months. Six weeks ahead.

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<v Speaker 1>This week, we watched as the first Americans received the

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<v Speaker 1>COVID vaccine, heroic health care workers who have been on

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<v Speaker 1>the front lines of this fight for months. It was

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<v Speaker 1>emotional and extraordinary, and it is something we should be

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<v Speaker 1>very excited about. But at the same time, we cannot

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<v Speaker 1>forget that most of us will not be getting this

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<v Speaker 1>vaccine four months, and we cannot lose sight of the

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<v Speaker 1>crisis at hand, because the spread of COVID has never

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<v Speaker 1>been worse. For almost nine months now, I have been

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<v Speaker 1>reporting on COVID, covering it every day, the stories of

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<v Speaker 1>healthcare workers, families, business owners, teachers. I thought I understood

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<v Speaker 1>the chaos of this moment, but a few weeks ago

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<v Speaker 1>I realized I didn't. I became one of the more

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<v Speaker 1>than sixteen million Americans who have contracted the virus SORTD

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<v Speaker 1>my family, and the experience of getting COVID made it

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<v Speaker 1>even more clear to me that we have failed and

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<v Speaker 1>continue to fail in some very key ways, namely testing

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<v Speaker 1>and tracing. I'm Stephanie Rule, MSNBC Anchor, NBC News Senior correspondent,

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<v Speaker 1>and this is Modern Rules, a podcast from NBC Think

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<v Speaker 1>and I heart radio. On this podcast, We're not gonna

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<v Speaker 1>waste your time. We're interested in getting straight to the point,

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<v Speaker 1>and then we're gonna leave you with some time to think.

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<v Speaker 1>And today we are looking at why the US is

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<v Speaker 1>failing the COVID test and how we can use the

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<v Speaker 1>tools we have at our disposal right now to maybe

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<v Speaker 1>get things under control. And I've got the perfect guest

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<v Speaker 1>here to help us try and make sense of it.

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<v Speaker 1>Dr she'sh Ja. He's the dean of Brown University School

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<v Speaker 1>of Public Health, and he has been a crucial voice

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<v Speaker 1>of science and reason throughout this pandemic. Dr Jah, thank

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<v Speaker 1>you for joining us. I want to start with COVID

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<v Speaker 1>nineteen tests. Can you explain to us what kind of

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<v Speaker 1>tests are available in the United States, the pros, the cons,

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<v Speaker 1>because I'm going to tell you when my husband woke

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<v Speaker 1>up with a scratchy throat and not feeling that well,

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<v Speaker 1>I foolishly thought let's run out and get a test.

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<v Speaker 1>There's no such thing as let's go out and get

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<v Speaker 1>a test. Zephanie, thank you so much for having me

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<v Speaker 1>on it. And this is a question that confuses people

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<v Speaker 1>still nine ten months into this pandemic. Right now, if

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<v Speaker 1>you want to think about a test to diagnose whether

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<v Speaker 1>you have the virus or not, you have two choices.

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<v Speaker 1>An anagen test and a PCR test. Most of the

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<v Speaker 1>tests we've used over the last nine months are these

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<v Speaker 1>PCR tests. They're really good. They pick up almost anybody

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<v Speaker 1>who's infected. They have to be running a major lab

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<v Speaker 1>and they can be turned around in twenty four hours,

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<v Speaker 1>but sometimes they take a week to come back. Let's

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<v Speaker 1>talk about that other kind of test, the anergine tests.

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<v Speaker 1>The test, Yeah, that's the rapid test, cheap ten to

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<v Speaker 1>fifteen bucks a test as opposed to HUD. For that

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<v Speaker 1>PCR test, you should be able to get a result

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<v Speaker 1>in fifteen minutes. So you're thinking cheap and fast. What's

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<v Speaker 1>wrong with this story? Um, it's a little less sensitive,

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<v Speaker 1>So let me explain what that means. The PCR test

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<v Speaker 1>will pick up somebody with the infection up to weeks

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<v Speaker 1>after they've been infected. The anergin test is really a

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<v Speaker 1>test for infectiousness. So if you are in that period

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<v Speaker 1>of time where you're spreading the virus and lots of people,

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<v Speaker 1>the anergin tests will be positive. But there are other times,

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<v Speaker 1>let's say later in the disease course, where you may

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<v Speaker 1>not have a lot of virus. You're still infected, but

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<v Speaker 1>the level of virus you have is very low because

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<v Speaker 1>you're on the tail end of your illness. The nigen

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<v Speaker 1>tests will then turn negatives. It's just not gonna be

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<v Speaker 1>as good at taking those people up. Could there have

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<v Speaker 1>been a scenario where people would have gotten antigen tests

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<v Speaker 1>to their homes and if they woke up saying, maybe

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<v Speaker 1>I was exposed, maybe I don't feel great, you can

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<v Speaker 1>take your tests immediately and that would dictate whether or

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<v Speaker 1>not you leave your house that day, absolutely, and for

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<v Speaker 1>that the anergen test is really good. We've had this

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<v Speaker 1>technology since May, and we should have had billions of

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<v Speaker 1>these tests widely available so people could test themselves all

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<v Speaker 1>the time. You wake up, you have a sore throat,

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<v Speaker 1>you could go to a CBS, pick up a ten

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<v Speaker 1>dollar tests and test yourself. We just never made those investments.

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<v Speaker 1>Remember how the disease spreads. Majority of people who are

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<v Speaker 1>spreading the disease have no symptoms at all. If you

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<v Speaker 1>could test yourself, what that would do is it would

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<v Speaker 1>take people who are infected out of commission. They wouldn't

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<v Speaker 1>be spreading it to others. So there's very good data

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<v Speaker 1>now that if we had those tests available the level

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<v Speaker 1>of infection in the community would go way down. But

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<v Speaker 1>also you could start implementing those tests in schools, in

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<v Speaker 1>business and that would make a big difference. And here's

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<v Speaker 1>the big issue. We still don't have a plan. Test

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<v Speaker 1>can take a week just to come back in, which time,

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<v Speaker 1>if you're out and about, you're spreading the virus. If

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<v Speaker 1>you haven't, they tell you to isolate. But unless you

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<v Speaker 1>have a place to isolate and a supportive job or family,

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<v Speaker 1>many many people can't afford to follow the guidelines when

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<v Speaker 1>you think you may have exposure to COVID nineteen. Do

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<v Speaker 1>we in the United States of America actually have the

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<v Speaker 1>choice to say, here are my nearby testing facilities. This

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<v Speaker 1>is where I can get a PCR test, and the

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<v Speaker 1>turnaround time is x. You could get results in a day,

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<v Speaker 1>but many, many, many are five, six, seven days. Why

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<v Speaker 1>would that be? Basically, there are two major lab testing companies,

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<v Speaker 1>Lab Corps in Quest Diagnostics. When they get backed up,

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<v Speaker 1>everything gets to lay. Let's say go to your doctor's office,

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<v Speaker 1>you got a fever, you got a sore throat, you

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<v Speaker 1>got a swab. It gets sent off to a lab.

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<v Speaker 1>That lab sends it to some processing place. Machine are

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<v Speaker 1>starting to break down, workers are becoming a short supply,

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<v Speaker 1>and your sample could sit for three days, four days.

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<v Speaker 1>That's just the reality of where we are. Had we

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<v Speaker 1>had an operation warp speed for testing, where do you

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<v Speaker 1>think we'd be right now? Oh? I think if we

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<v Speaker 1>had an operation warp speed for testing the way we

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<v Speaker 1>did for vaccines, we would have widespread testing available. You

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<v Speaker 1>could wake up in the morning and you could test

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<v Speaker 1>yourself at home before you went to school, before you

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<v Speaker 1>went to work. And if we had really made the

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<v Speaker 1>kind of investments that we needed to, and these would

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<v Speaker 1>not have cost us that much money. I believe all

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<v Speaker 1>the schools would be open, most businesses would be open,

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<v Speaker 1>the level of infections in the community that would be

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<v Speaker 1>much much lower, our hospitals would not be overwhelmed, and

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<v Speaker 1>we'd have far fewer debts. I'm thrilled that we did

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<v Speaker 1>operation works feed for vaccines. I love it. I think

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<v Speaker 1>it was exactly the right thing to do, But that

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<v Speaker 1>didn't prevent us from doing an operational warp speed for treatments,

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<v Speaker 1>for testing, for protective equipment to protect our doctors and nurses.

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<v Speaker 1>Like there's no rule that said you only get to

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<v Speaker 1>do one operation warp speed, like we needed four different things.

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<v Speaker 1>The government chose to do one and ignore the other three.

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<v Speaker 1>And I have to tell you that I'm not convinced

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<v Speaker 1>that if we hadn't done the vaccine that the Trump

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<v Speaker 1>administration would have then put more money on testing. So

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<v Speaker 1>I am like glad they put investments in vaccines, because

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<v Speaker 1>if they hadn't, they would have put investments in nothing.

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<v Speaker 1>Vaccines are great, but they are not the end all

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<v Speaker 1>be all. They will not make the pandemic go away.

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<v Speaker 1>They'll certainly end the horrible nets will take a long time,

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<v Speaker 1>but the disease will not be gone forever, and we

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<v Speaker 1>will need to continue to deal with it, and testing

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<v Speaker 1>will be a really important part of that. We'll be

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<v Speaker 1>back after the break. I want to talk about contact tracing.

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<v Speaker 1>We had no known exposure in my family, and I

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<v Speaker 1>contact traced to myself. I called the people who we

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<v Speaker 1>had seen. I called a big box store with my

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<v Speaker 1>receipt and I was like, so my husband was there

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<v Speaker 1>at four pm. That big box story called had no

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<v Speaker 1>interest in taking my call. There's no way they wrote

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<v Speaker 1>any of it down. But it wasn't just me. I

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<v Speaker 1>wasn't contacted by the state of New Jersey. And that's

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<v Speaker 1>where we were. We talked so much about the importance

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<v Speaker 1>of contact tracing. Thousands of people were hired, they were trained,

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<v Speaker 1>they were to be the contact tracers. Are we even

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<v Speaker 1>doing it? No? I mean some states are doing a

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<v Speaker 1>little bit, and a little bit is better than zero.

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<v Speaker 1>But we never built up the contact tracing infrastructure, partly

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<v Speaker 1>because it would cost money. Again, this is the place

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<v Speaker 1>where like our government, our federal government, our Congress has

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<v Speaker 1>just fallen down on the job. When you look at

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<v Speaker 1>other countries and how they are doing testing and tracing,

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<v Speaker 1>is there one that you can point to that you

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<v Speaker 1>would say they're doing it right. The classic model that

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<v Speaker 1>we all point to is South Korea. South Korea is

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<v Speaker 1>unbelievable because they did such a good job with testing

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<v Speaker 1>and tracing. They were able to open up nightclubs. Somebody

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<v Speaker 1>with a some thematic disease went to like six nightclubs

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<v Speaker 1>in one evening. What an amazing evening, right, But unfortunately,

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<v Speaker 1>like he infected like eighty people that one evening. Within

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<v Speaker 1>five days, South Korea had tested like forty thousand people,

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<v Speaker 1>not just everybody who was at one of those nightclubs,

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<v Speaker 1>but all of their contacts and their contacts and contacts

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<v Speaker 1>and isolated everybody and shut that outbreak down within five days.

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<v Speaker 1>That's how you do it, and what that means is

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<v Speaker 1>their economy has barely suffered. In other countries, it's not

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<v Speaker 1>about following the guidelines. There are punitive consequences. You test positive.

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<v Speaker 1>You are checking into a COVID hotel for fourteen days.

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<v Speaker 1>Like it or not. There's no decisions to be made here.

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<v Speaker 1>It's about goodwill, being honest and decision making. Do you

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<v Speaker 1>think the majority of the American people actually know what

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<v Speaker 1>the CDC guidelines are. I don't think that what we

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<v Speaker 1>need is like harsh mandates on this stuff. What we

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<v Speaker 1>need is support. But the point is there are ways

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<v Speaker 1>of allowing the right thing to be done by people,

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<v Speaker 1>right because I think most people want to do the

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<v Speaker 1>right thing. If you push them and say, well, you

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<v Speaker 1>have a choice, do the right thing or put food

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<v Speaker 1>on the table for your kids, well, people can put

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<v Speaker 1>food on the table for their kids. Don't force people

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<v Speaker 1>into those choices. And the only way we could have

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<v Speaker 1>done this is if we had an active government trying

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<v Speaker 1>to help the American people do the right thing. We

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<v Speaker 1>just did. To your point, we're not offering any incentive

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<v Speaker 1>to those who can't afford to quarantine, who maybe have

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<v Speaker 1>mild symptoms and are out there living their lives and

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<v Speaker 1>going to work, or people who are simply defiant and

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<v Speaker 1>choose not to. Why wouldn't we do that. I have

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<v Speaker 1>to say that the failure of Congress to act after

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<v Speaker 1>the first couple of actions that took, the failure for

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<v Speaker 1>it to act over the summer the fall even now

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<v Speaker 1>is baffling to me. It is the most phenomenal, pennywise,

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<v Speaker 1>pound foolish thing I have ever seen. This pandemic has

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<v Speaker 1>cost our three about sixteen trillion dollars with a capital T,

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<v Speaker 1>and Congress is fighting about a couple hundred billion dollars

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<v Speaker 1>money that would go to the pockets of the American

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<v Speaker 1>people and would help them through a difficult time like

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<v Speaker 1>this is such a no brainer. Imagine if in World

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<v Speaker 1>War two Congress said, you know what, We're just not

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<v Speaker 1>going to fund the war effort. Good luck people. That

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<v Speaker 1>would have been a disaster, right, it would have been

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<v Speaker 1>a disaster. Not thankfully Congress did not do that. But

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<v Speaker 1>essentially after May Congress said we're just not going to

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<v Speaker 1>fund the effort to fight COVID, good luck people, But

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<v Speaker 1>we're going to spend the money, mountains more of it

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<v Speaker 1>for years to come. This is the result of the

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<v Speaker 1>federal government just completely throwing in the towel about two

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<v Speaker 1>months ago and saying we're just not even gonna bother

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<v Speaker 1>trying anymore. Then, seeing that we've botched testing and tracing

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<v Speaker 1>so badly, are you concerned that we're not going to

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<v Speaker 1>get the implementation of or distribution of this vaccine right?

0:12:00.520 --> 0:12:04.600
<v Speaker 1>The Biden team very much understands that effective distribution of

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<v Speaker 1>the vaccine is the whole ball game for them in

0:12:07.559 --> 0:12:11.079
<v Speaker 1>the short run for getting economy going again. I think

0:12:11.080 --> 0:12:13.040
<v Speaker 1>the Biden team is gonna be putting a lot of

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<v Speaker 1>very good people into making sure that the vaccine distribution

0:12:15.640 --> 0:12:18.400
<v Speaker 1>continues to go well, that we get that last smile,

0:12:18.440 --> 0:12:20.400
<v Speaker 1>we get vaccines into people's arms. So I guess I

0:12:20.440 --> 0:12:23.800
<v Speaker 1>remain reasonably optimistic that a good team is coming and

0:12:23.880 --> 0:12:26.360
<v Speaker 1>they understand the importance of getting this right. We've seen

0:12:26.600 --> 0:12:30.520
<v Speaker 1>the President got the best possible medical care and experimental

0:12:30.559 --> 0:12:34.520
<v Speaker 1>drugs that works. His close advisor Rudy Giuliani, same thing.

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<v Speaker 1>Do you think a lot of rich people are going

0:12:36.360 --> 0:12:38.800
<v Speaker 1>to cut side deals and get the vaccine before anybody else?

0:12:38.880 --> 0:12:41.720
<v Speaker 1>They're getting better treatment than everyone else. Because here's the thing.

0:12:42.000 --> 0:12:46.640
<v Speaker 1>I had a frustrating process getting tested, but it wasn't crippling,

0:12:47.240 --> 0:12:49.120
<v Speaker 1>and if I didn't have the privilege that I have,

0:12:49.480 --> 0:12:52.160
<v Speaker 1>it would be way worse. So I can tell you

0:12:52.520 --> 0:12:56.040
<v Speaker 1>testing is for the privileged. Will the vaccine be for

0:12:56.080 --> 0:12:59.360
<v Speaker 1>the privileged? I think in the first past, it's gonna

0:12:59.360 --> 0:13:01.280
<v Speaker 1>be very very hard for people to cut in line,

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<v Speaker 1>and I think that's gonna be very tightly controlled. I

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<v Speaker 1>am very worried about what happens after that, because I'm

0:13:07.440 --> 0:13:11.840
<v Speaker 1>already hearing stories of concierge practices who are trying to

0:13:11.840 --> 0:13:14.520
<v Speaker 1>figure out how to get some for their business travelers.

0:13:14.559 --> 0:13:16.920
<v Speaker 1>The finance guy who wants to start being able to

0:13:16.920 --> 0:13:20.360
<v Speaker 1>fly to Hong Kong again and needs to be vaccinated. Look,

0:13:20.400 --> 0:13:22.200
<v Speaker 1>it's fine go to Hong Kong, but you should not

0:13:22.240 --> 0:13:24.760
<v Speaker 1>be able to cut in line on the vaccine. This

0:13:24.800 --> 0:13:26.640
<v Speaker 1>is one of the big jobs that the Biden administration

0:13:26.679 --> 0:13:28.880
<v Speaker 1>has is to make sure that we don't do this,

0:13:29.000 --> 0:13:30.600
<v Speaker 1>because it will be I mean, if you think about

0:13:30.640 --> 0:13:34.000
<v Speaker 1>who has been so disproportionately affected in this pandemic, it's

0:13:34.040 --> 0:13:37.160
<v Speaker 1>been the black community, the Latino community, the Native American community,

0:13:37.760 --> 0:13:40.880
<v Speaker 1>It's been horror people. But I do think there is

0:13:40.920 --> 0:13:43.160
<v Speaker 1>going to be a real effort to make sure we

0:13:43.240 --> 0:13:46.600
<v Speaker 1>don't do that. I'm also a realist. I'm sure there

0:13:46.600 --> 0:13:49.559
<v Speaker 1>will be some cutting in line, because that's just the reality.

0:13:49.640 --> 0:13:52.000
<v Speaker 1>Somebody will figure out how to get stuff on the

0:13:52.000 --> 0:13:55.880
<v Speaker 1>black market, but I am hopeful that most of it

0:13:55.920 --> 0:13:58.400
<v Speaker 1>will be tightly enough control that the right people get

0:13:58.400 --> 0:14:10.559
<v Speaker 1>it first. M H. The reality is that COVID is

0:14:10.600 --> 0:14:13.880
<v Speaker 1>not easy for anyone, but COVID is much easier to

0:14:13.920 --> 0:14:18.120
<v Speaker 1>confront when you've got the benefit of privilege. Throughout the

0:14:18.200 --> 0:14:20.880
<v Speaker 1>last nine months, I have counted my blessings nearly every

0:14:20.960 --> 0:14:25.160
<v Speaker 1>day because I know that my secure home, my family unit,

0:14:25.360 --> 0:14:27.800
<v Speaker 1>and the fact that I can work from home makes

0:14:27.880 --> 0:14:30.120
<v Speaker 1>all the difference in what our new normal looks like.

0:14:30.920 --> 0:14:33.120
<v Speaker 1>But when my family and I contracted the virus, I

0:14:33.160 --> 0:14:38.200
<v Speaker 1>saw firsthand how far that privilege extends. The reality is

0:14:38.520 --> 0:14:41.880
<v Speaker 1>many families and many individuals are put between a rock

0:14:41.960 --> 0:14:44.720
<v Speaker 1>and a hard place, and many of our government leaders

0:14:44.760 --> 0:14:49.080
<v Speaker 1>both sides have completely skirted their responsibility. And I want

0:14:49.080 --> 0:14:52.080
<v Speaker 1>to leave you sometime to think about this. We could

0:14:52.120 --> 0:14:55.920
<v Speaker 1>have done better in basically every aspect of containing this virus,

0:14:56.200 --> 0:15:00.320
<v Speaker 1>particularly when it comes to supporting American families. So as

0:15:00.360 --> 0:15:03.600
<v Speaker 1>a vaccine rolls out and more sophisticated tests are developed,

0:15:03.960 --> 0:15:07.920
<v Speaker 1>how can we make sure vulnerable Americans are not left

0:15:07.960 --> 0:15:11.000
<v Speaker 1>behind again? And how can we change what has been

0:15:11.000 --> 0:15:14.760
<v Speaker 1>a haphazard strategy into our recovery that serves us all.

0:15:18.160 --> 0:15:20.360
<v Speaker 1>Next week we are taking off it is the holiday,

0:15:20.440 --> 0:15:23.720
<v Speaker 1>but I want you to unplug. Please take a week

0:15:24.200 --> 0:15:28.400
<v Speaker 1>to decompress, give yourself a break, have a beautiful holiday,

0:15:28.800 --> 0:15:31.120
<v Speaker 1>and be well. And thank you so much for listening.

0:15:32.520 --> 0:15:35.200
<v Speaker 1>I'm Stephanie Rule and you're listening to Modern Rules, a

0:15:35.320 --> 0:15:41.480
<v Speaker 1>podcast from NBC Think, MSNBC and I Heart Radio. This

0:15:41.560 --> 0:15:44.520
<v Speaker 1>podcast is hosted by me Stephanie Rule. Mike Biette and

0:15:44.560 --> 0:15:48.480
<v Speaker 1>Katrina Norvell are executive producers. Meredith Bennett Smith is Senior

0:15:48.600 --> 0:15:51.960
<v Speaker 1>editor for NBC Think and our editorial lead. The podcast

0:15:52.040 --> 0:15:55.680
<v Speaker 1>is engineered and edited by Josh Fisher. Additional production support

0:15:55.760 --> 0:15:59.200
<v Speaker 1>provided by Charles Herman, Rachel Rosenbaum, and Lauren Wynn and

0:15:59.280 --> 0:16:02.360
<v Speaker 1>special thanks to Katherine Kim are Global head of Digital

0:16:02.400 --> 0:16:05.720
<v Speaker 1>News right here at NBC News and MSNBC. For more

0:16:05.760 --> 0:16:09.400
<v Speaker 1>thought provoking analysis, visit NBC news dot com slash thank