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To Slow The Spread Of Coronavirus, Experts Turn To Mitigation


The coronavirus is a pandemic. That's the conclusion of the World Health Organization. Infections are on the rise in many countries, and that is triggering more global disruptions. Last night, President Trump announced a 30-day ban on foreign nationals traveling to the United States from most countries in Europe.

NPR health correspondent Rob Stein joins us now to help us understand the latest developments. Hi, Rob.

ROB STEIN, BYLINE: Hey there, Rachel.

MARTIN: Let's start with the president's travel ban. Is this going to reduce the spread of coronavirus?

STEIN: You know, Rachel, most public health experts I've talked to say, look, the virus is already here, so banning Europeans is unlikely to do much good. And it actually could make things worse, you know, by diverting resources from what's really needed, which is stopping the spread here. That's got to be the top priority right now.

MARTIN: All right. What about the WHO now calling the coronavirus a pandemic? What are the implications of that?

STEIN: You know, it shows how worried the WHO is about - that things are getting worse. The WHO has hesitated to use the word pandemic. They were worried that it might make things seem hopeless. So officials are really stressing that there's still lots that can be done to fight this virus.

MARTIN: All right. So what's the latest with that fight in this country?

STEIN: You know, there's still a lot of frustration with the federal response, especially about testing. But the government has started giving cities and counties fighting outbreaks specific advice about what to do - you know, recommending things like telework and protecting nursing homes and canceling large gatherings.

And that's really where things are heading. There's a big shift in strategy going on right now towards what experts called mitigation, which is actually basically keeping people apart to try to slow the spread of the virus. That's what will save lives. You know, to try to get a sense of the shift in the nation's strategy, let's just listen to Anthony Fauci from the White House Coronavirus Task Force.


ANTHONY FAUCI: As a nation, we can't be doing the kinds of things we were doing a few months ago.

STEIN: When the coronavirus first hit the U.S., disease detectives swooped in to try to stop the germ from spreading - isolating sick people, tracking down and quarantining everyone they had contact with to try to contain the virus, to stop it from spreading. But increasingly across the nation, experts worry that's not enough anymore.

MARC LIPSITCH: It's clearly too late to contain it in much of the country.

STEIN: Marc Lipsitch is a Harvard epidemiologist. He says the long delay in testing let the virus get a foothold in this country. So it's probably already spread much more than we realize, and that's likely to accelerate in the coming weeks.

LIPSITCH: It's unsustainable, in an exponentially growing epidemic, to keep increasing the efforts to trace individual cases.

STEIN: Because understaffed and underfunded public health departments are getting overwhelmed trying to track down and monitor everyone - so while testing is still really important, public health experts are increasingly also calling for what's called mitigation to slow the spread of the virus - get people to work from home, close schools, cancel big events.

LIPSITCH: I'm extremely worried that we are just letting transmission continue. By sitting and sort of living business as usual, we are just wasting time as the epidemic grows. The time to act is now.

STEIN: Because if too many places wait too long, it will be too late. Here's Anthony Fauci again testifying before Congress.


FAUCI: It's the old metaphor that - the Wayne Gretzky approach. You know, you skate not to where the puck is but to where the puck is going to be. If we don't do very serious mitigation now, what's going to happen is that we're going to be weeks behind, and the horse is going to be out of the barn.

STEIN: So more and more communities are shifting their tactics. Sacramento County stopped quarantining everyone who had contact with someone who was infected. Instead, Peter Beilenson says, people should monitor themselves. And vulnerable people, like the elderly, should minimize their exposure.

PETER BEILENSON: So for example, avoiding malls - if they have to go to a grocery store, go off hours and buy two or three weeks of groceries at a time so they don't have to go back and expose themselves.

STEIN: Jeffrey Engel of the Council of State and Territorial Epidemiologists says there's probably no one-size-fits-all strategy. Sacramento is going ahead with its St. Patrick's Day parade while other cities have put off theirs.

JEFFREY ENGEL: It's happening community by community. So I think we're going to see this patchwork approach across the United States.

STEIN: Other experts agree that makes sense. Thomas Inglesby heads the Johns Hopkins Center for Health Security.

THOMAS INGLESBY: It's not black or white. I think that there are places where we can potentially identify a chain of transmission and isolate that group and try to stop the chain of transmission in that place. But I think there are other parts of the country or other cases where that's not going to be possible. I don't think we should give up on the former, but we just have to acknowledge the latter.

STEIN: So you know, Rachel, it's clear that we've got to get ready for a lot more disruptions in our daily life unfortunately.

MARTIN: Right. Thanks so much, Rob. NPR's Rob Stein. Transcript provided by NPR, Copyright NPR.

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