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Looking Back On The Pandemic's Start And Forward To When It May End

STEVE INSKEEP, HOST:

The Johns Hopkins coronavirus tally finds the United States just below 400,000 deaths as of this morning - 400,000 dead. That's like eliminating the entire population of New Orleans or the whole population of Tulsa, Okla. It is roughly equivalent to every single person in Arlington, Texas, and close to every person in Minneapolis. We reach that number of 400,000 almost exactly one year after the first case of coronavirus was identified in the United States. NPR's Allison Aubrey has joined us live every Monday throughout the pandemic to talk things through. Allison, good morning once again.

ALLISON AUBREY, BYLINE: Good morning, Steve.

INSKEEP: I got to tell you it was pretty hard when the numbers were a lot lower to imagine we would ever be at this point.

AUBREY: You know, that's right. We went from the confirmation of the first case almost a year ago to the virus quickly spiraling out of control. Steve, you might remember this. I'm going to play some archival tape from one of our segments early on.

(SOUNDBITE OF ARCHIVED NPR BROADCAST)

INSKEEP: Something just happened to the document on the computer screen in front of me. Just a moment ago, it said there were 31,000 coronavirus cases confirmed in the United States. And then, in an instant, the number changed as our editor made it 35,000 coronavirus cases.

AUBREY: And here we are a year later, with about 24 million documented cases in the U.S. - around the globe, 95 million cases and over 2 million people dead from the virus.

INSKEEP: Yeah, we looked forward to far lower numbers than we're at now and found them horrifying. I remember, you know, before this really spread across the United States, Allison, I remember thinking it was going to be something like - I don't know - the Ebola virus of a few years ago or an earlier SARS outbreak in Asia, which...

AUBREY: Right.

INSKEEP: ...You know, would be scary, but it would largely be contained somewhere else. It was hard to imagine the wave that hit the United States.

AUBREY: You know, I think a lot of people thought that, Steve. I mean, the moment that stands out for me was in February when Nancy Messonnier of the CDC spoke to reporters, and she said, look. I told my own children at breakfast this morning, we need to prepare for a disruption to our lives. She said, it could be severe disruption. And I was thinking, whoa, what does this mean? I mean, up until that moment, the threat seemed very distant.

INSKEEP: Yeah, and then the stock market plunged. The president said, don't worry. Everything would be fine. People did worry. The country began to shut down. And ever since then, we've been on a learning curve, I think it's fair to say. So what are some of the things we've discovered over the past year about the virus and how to fight it?

AUBREY: You know, the first thing is just how it spreads. I mean, we've been in a race against this virus, and the virus has been winning. I spoke to Carlos del Rio. He's an infectious disease doctor at Emory University. You know, he says part of this can be explained by a factor that we were unaware of a year ago, and that's the level of asymptomatic spread - people being infectious without realizing it.

CARLOS DEL RIO: The Achilles heel of this virus and the advantage this virus has is this asymptomatic transmission. You can be infected and asymptomatic and still be transmitting it. So just because you feel fine doesn't mean that you're not infected. That's a huge lesson.

AUBREY: And it really helps explain how the virus got a foothold and how it came to circulate so widely.

INSKEEP: Yeah, I can remember prominent people, including members of Congress, saying, well, I'm not wearing a mask because I'm not sick...

AUBREY: Right.

INSKEEP: ...Looking past asymptomatic spread. Now, we did learn about masks. And we should note that officials were skeptical that a mask would make any difference, at first, for ordinary people on the street, as opposed to hospital personnel, but then they came to think masks were vital for everybody. So what has the evidence actually shown over the months since then?

AUBREY: You know, despite the politicization here, there is a lot of evidence that they help. Consider this one. I mean, thousands of Americans have been surveyed in every state every month, asking to what extent they adhere to social distancing and masking. One scientist behind this project, David Lazer of Northeastern University, told me what they have found is striking.

DAVID LAZER: What we can say from our study is that the states that, through the early fall, were least adherent to social distancing measures and mask-wearing were the earliest states to be hit hard.

AUBREY: In this winter surge...

INSKEEP: Yeah, it's like a state-by-state national experiment, and now we have results.

AUBREY: That's right. I mean, and later this week, President-elect Joe Biden plans to sign an executive action to, you know, mandate masks on federal property and in interstate travel.

INSKEEP: What have we learned, Allison, about how the virus affects people who do get it?

AUBREY: You know, most people recover fully, but up to 10% of people have lingering symptoms. You've heard them called long-haulers, and people sick enough to be hospitalized tend to fare a lot worse. I spoke to Dr. Emily Brigham about this. She's a co-director at the Johns Hopkins Post-Acute COVID clinic. We spoke about a new study out of China that finds, six months post-COVID, about 76% of hospitalized patients have at least one symptom that still persists.

EMILY BRIGHAM: This is not a surprise. The most common symptom six months out within the study was reported as fatigue or muscle weakness, which I would say is commensurate with some of our experience at Johns Hopkins.

AUBREY: They also see patients with shortness of breath and lots of other symptoms. You know, it's just another indicator, Steve, of the toll of this virus and the urgency to get people vaccinated.

INSKEEP: Does that lead to another lesson learned? It doesn't have to take five or 10 or 15 years to develop a vaccine.

AUBREY: That's right. As NIH Director Francis Collins wrote recently, developing this vaccine in 10 months, a process that normally takes eight years, is truly unprecedented. But there are major challenges we're seeing, given this chaotic rollout in these initial weeks. I spoke to physician Joshua Sharfstein about this. He's now a contender for the top FDA post in the Biden administration. He says there's been a lack of coordination and funding.

JOSHUA SHARFSTEIN: Really, the public health system has been trying to do this with one arm tied behind its back.

AUBREY: You know, the rescue package Congress passed last month will help. Biden will ask for more. And Dr. Anthony Fauci said yesterday that the goal of giving 100 million doses in the first 100 days of the Biden administration is absolutely a doable thing, he said. He says two additional vaccines, including the one-dose Johnson & Johnson vaccine, will be evaluated in the next couple of weeks by the FDA.

INSKEEP: Where do we stand right now in terms of vaccinations?

AUBREY: You know, upwards of 12 million doses have been administered, and the pace is really picking up. I got a virtual tour by FaceTime of the vaccination site at Gillette Stadium outside Boston. That's the home of the New England Patriots. They'll be able to scale up to about 5,000 shots a day there. Rodrigo Martinez of CIC Health showed me around the clinic.

RODRIGO MARTINEZ: It's a really big space. And you can see over here, here's where they get vaccinated in any of these stations. And afterwards, they can actually walk into the stadium and take a photo and send through social media that they got vaccinated at Gillette Stadium.

AUBREY: And at a time when scientists are concerned about new, more contagious strains, scaling up vaccinations quickly is critical.

INSKEEP: So when will the pandemic be under control?

AUBREY: You know, I spoke to Ali Mokdad at the Institute for Health Metrics and Evaluation. And he says, really, the latest modeling is very encouraging. He says if everybody keeps doing our part, we can have, quote, "a good summer."

INSKEEP: OK, we'll look forward to that. Allison, thanks so much for your work.

AUBREY: Thank you, Steve.

INSKEEP: That's NPR's Allison Aubrey.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.

Allison Aubrey is a correspondent for NPR News, where her stories can be heard on Morning Edition and All Things Considered. She's also a contributor to the PBS NewsHour and is one of the hosts of NPR's Life Kit.