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U.S. Could Be Entering New Phase In Coronavirus Battle


Well, the United States could be entering a new phase in the battle against the coronavirus. More and more cases are being diagnosed in this country, and those numbers may grow as testing for this dangerous new virus ramps up.

Let's bring in NPR health correspondent Rob Stein for the latest. Hi, Rob.

ROB STEIN, BYLINE: Hey there, David.

GREENE: OK. So bring us up to speed - more testing, more numbers and another death in the United States.

STEIN: Yeah. So David, the real hotspot right now is Washington state. Health officials there are coping with what appears to be the first outbreak of coronavirus in this country. It's in a nursing facility near Seattle. Dozens of people are sick, including several who are critically ill. In fact, health officials yesterday revealed one resident had died, a man in his 70s. That marks the second death from the coronavirus in the U.S. The first was reported elsewhere in Washington state on Saturday. At least two schools are closed, and the governor has declared a state of emergency.

GREENE: So Washington state, one place we're certainly watching. But other states are seeing their numbers go up as well, right?

STEIN: Until last week, the only coronavirus cases in the country had some connection to travel overseas. But the first case of someone apparently catching the virus in this country with no connection to any other country was reported in California at the end of last week. Right after that, another case like that was found in California along with similar cases in Oregon and Washington state. So this is no longer a situation of the virus just coming into the country from elsewhere. It's spreading here, too.

GREENE: Well, so what you're describing, Rob, might make it sound like we're suddenly seeing a spread around the country. But that is not exactly what we might be seeing here.

STEIN: Yeah. So what's probably happening is we're finally starting to test widely for the virus in this country. All the testing had been funneled through the CDC in Atlanta before this, but state and local labs finally got the go-ahead to do their own testing. So what may be happening is that we're just starting to discover cases that may have been here for a while and, you know, catching new cases quicker.

I talked to Marc Lipsitch from Harvard about this.

MARC LIPSITCH: I think maybe a metaphor or an analogy is - in your high school play, people run out onstage in the dark and get themselves set. And then the lights start to come up and you start to see what's actually there. Those people didn't just arrive there the second the lights go up.

STEIN: You know, in fact, a genetic analysis of the virus in Washington state came out just yesterday. And that suggests that the virus may have been circulating kind of silently in the state for weeks and hundreds may already be infected.

GREENE: And why wasn't more testing being done sooner, Rob?

STEIN: So one problem is that the first test kits the CDC sent to the local and state labs, it just didn't work. And the CDC finally did fix that problem, letting states start to do their own testing. But the second issue was that the CDC was using very strict criteria for who could be tested. The CDC finally relaxed those criteria. And I talked to Scott Becker about this. He's the executive director of the Association of Public Health Laboratories.

SCOTT BECKER: I certainly do wish that the testing was available sooner. There was this very unfortunate challenge in the production process, and it did put us a few weeks behind.

STEIN: And the worry about that is we could have lost a crucial window to contain the virus and, you know, prevent it from getting a foothold and start to spread undetected. So the CDC is taking a lot of heat for this and a lot of questions about why there was this big delay and - when other countries were testing widely for a while.

GREENE: Which is a huge deal and a lot of questions to answer. But for the moment, it's about tackling this outbreak. So what happens next?

STEIN: Testing is really finally starting to ramp up now. State and local labs should be testing nationwide by the end of this week. And the FDA is now letting lots of other places do testing, like hospitals. So - you know, it wouldn't be surprising if we start finding infections all around the country. And as that happens, you know, it's important to remember that doesn't necessarily mean that the virus is suddenly spreading a lot faster. It could be that we're just finding the spread that's been going on for a while without anyone realizing it.

Here's Marc Lisitch again from Harvard - you know, using that analogy again about stage lights shining a spotlight on the virus.

LIPSITCH: The lights are still quite dim because we haven't done much testing. And as they become brighter, we'll get a better sense of what's already there.

GREENE: All right. So we'll obviously be following that and trying to figure out what is there when it comes to this virus.

NPR health correspondent Rob Stein. Rob, thanks so much.

STEIN: You bet, David. Transcript provided by NPR, Copyright NPR.

Rob Stein is a correspondent and senior editor on NPR's science desk.