On Plugged In…  Corona virus casualties …  continue to mount.     More than one million cases…  worldwide …  with thousands dying …  each day.    As scientists scramble …  in search of a cure..  frontline health workers  worry about their  personal protective equipment    ((Dr. Calvin Sun, NYC Emergency Physician)) “Because when we get sick, who's going to be around to take care of you?” Is the world getting closer...  to finding a cure?  What are we learning about  this virus?  And how are different countries…  responding to this unprecedented…  global health crisis?    On Plugged in –  the Corona virus Crisis;  Cures and Care.  (Greta) Hello and welcome to Plugged In.  I’m Greta Van Susteren coming to you from my home in Washington DC.    Around the globe more than 1.2 million people have been infected with the virus that causes COVID-19.  Among them: world leaders, actors, musicians, medical professionals and first responders.    Social distancing is having an impact - slowing infection and death rates in some parts of the world.    While a vaccine cure is about a year away - caring for those now with coronavirus is an uphill struggle.    VOA’s Brian Padden tells about efforts to adapt existing drugs to battle the pandemic.  (Search for a Cure, Brian Padden reports) Older malaria drugs, chloroquine and hydroxychloroquine, are being used on a trial basis to try to kill off the coronavirus in early stages of infection.     ((Dr. Hana Akselrod, George Washington University School of Medicine))     “This drug interferes with the virus’s ability to enter the host cell, and makes the cell less hospitable to the virus. And if the virus is not infecting the cell, it would not be as effective at reproducing and creating more copies of itself.”    ((NARRATOR))  This is a drug combination that President Donald Trump called a “game changer” - but scientists caution more study is needed to verify results and warn these drugs are potentially toxic.    Another drug called remdesivir that proved ineffective to treat Ebola patients shows promise against the coronavirus. It also prevents the virus from entering the host cell and reproducing.     Among drugs being tested to treat  the coronavirus symptoms is a rheumatoid arthritis medication called Kevzara. This drug relieves the life threatening congestion in the lungs by reducing the body’s immune response that is causing inflammation as it tries to fight the infection.    ((Dr. Hana Akselrod, George Washington University School of Medicine))   “It interferes with an important part of the inflammatory cascade, which is part of the body's defense mechanism in response to an overwhelming infection.”  ((NARRATOR))  Large scale trials of these drugs are underway to test their effectiveness and determine possible side effects that could be worse than the cure.    Convalescent plasma trials have also begun in the U.S. to treat seriously ill coronavirus patient. This involves extracting antibodies from blood plasma of coronavirus patients that have fully recovered, and injecting them into ill patients.    ((Dr. Shmuel Shoham, Johns Hopkins University School of Medicine))  “What we're doing is this low tech, old style solution of taking it from people, just like people did before antibiotics were invented.”     ((NARRATOR))  However doctors involved in past plasma transfers say it was not effective on the seriously ill and recommend it more for prevention and early treatment.     Infectious disease experts say finding an effective coronavirus treatment could take months while developing a vaccine to prevent infection could take more than a year. ((Brian Padden, VOA News Washington))    (Greta) Here in the United States at the University of Pittsburgh, medical scientists believe they have developed an effective vaccine. I spoke to the team’s leader - Dr. Louis Falo about their research and when a vaccine might become available. (Greta interview with Dr. Louis Falo) LF: So essentially this vaccine is made out of a small fragment of protein from the virus with the goal of developing an antibody response against that part of the virus, with the hopes that that will prevent that virus from entering the cells and therefore avoid the disease. GVS: How is it actually applied to the human? LF: Right, so it's delivered by a novel delivery platform that is known as a microneedle array. So the best way to think of a microneedle array is almost like a Band-Aid, except that it has hundreds of very small needles. These needles are about the width of a human hair and about the length of a half a millimeter or so.That needle can pierce the outer layers of the skin. When we put the Band-Aid patch, Band-Aid type patch on and then once it's in the skin it has the unique property of being able to dissolve rapidly. So it dissolves rapidly and releases the antigen. GVS: Are you saying could I actually feel it if it were on my finger? LF: So it would feel a little bit like Velcro if you rubbed your finger against it. The good news is there's no pain or bleeding when this is actually applied to the skin because the needles are short enough to avoid nerves and blood vessels. GVS: I've done a little research. And one of the things that when what you're doing. I keep reading about something called spike protein. What is that? LF: OK. So this vaccine specifically targets a protein from the spike protein from the spike protein of the virus. The spike protein is a critical protein for viral function. What it does is recognizes a receptor on human cells that enables the virus to enter human cells. So think of it as a lock and key. So the key is the spike protein And what we're hoping to do is to make antibodies that block that key. GVS: So you're changing the locks on the house? LF: Exactly. GVS: Is it? Are there any risks with this? LF: So one of the good features of this vaccine is that we deliver very low doses of antigen. It's generally considered to be safe. Until we actually test it in patients, we won't know for sure. Another important feature of the vaccine is it doesn't require what we refer to as the cold chain. So most vaccines require refrigeration from the minute they're made until they actually are in a patient. This on the other hand can be stored at room temperature and so it's very easy to store and distribute and could be used for global vaccine campaigns. GVS: You have said that we have no testing on humans. So tell me where you are with the Food and Drug Administration and the testing. LF: So we're preparing packages of our data and all the background information to submit that for an investigational new drug application. The FDA will evaluate that and let us know when we can start clinical trials. GVS: What made you come up with this? How did you all of a sudden think “we should do this”? LF: So the delivery mechanism is actually a very similar idea as to the smallpox vaccine from years ago. So the smallpox vaccine which some of us actually had, was a drop of fluid that was put on the skin and then scratched in with the needle. So these microneedle arrays are actually a higher-tech way of delivering vaccine into the upper layers the skin just like that smallpox vaccine did. GVS: How optimistic are you about the vaccine itself? LF: So I was very, very fortunate to working with a collaborator, Dr. Gambodo, who is an expert in MERS and SARS vaccines. And so MERS and SARS were precursor infections. And he has done terrific work on both of those, enabling us to take all of that work and build on it. So the re-agents were in place, the assay systems were in place and in those systems, this approach looks very effective. From the studies we've done in the new virus, the new SARS-2 virus, we're very encouraged that it would be just as effective as those previous version vaccines. GVS: You've tested it on mice, is that right? LF: Correct. So we've done studies on mice. GVS: And how successful has it been on the mice? LF: So it's induced. So when we tested this vaccine on mice, we saw a very potent antibody responses that give us hope that we'll see the same thing in patients. GVS: What do you need from the public, the FDA or whatever? We know everyone’s behind everybody trying everything. Are you running into any sort of hurdles at all? LF: So we have seen amazing cooperation at all levels. I mean within the scientific community it's absolutely fantastic. Scientists from different fields are working together at our institution, at other institutions across the country and across the globe. Everyone is sharing information, sharing data. The public universities and private companies are collaborating together. I think it's an unprecedented level of collaboration. Everyone united in a common goal of fighting the virus. So it's been terrific in that respect. COVID-19: Fast Facts. This is a special presentation of Voice of America. 80% of cases are mild. Young and healthy people are at low risk. Ther elderly and people with serious health conditions are at risk of fatality. If you have a cough, fever and shortness of breath, contact a doctor and stay away from other people. For more information, visit the World Health Organization’s website at www.who.int. (Greta) While scientists are learning new about the virus, important lessons area also emerging about the international community's response to this pandemic.     I spoke with Dr. Marcos Espinal from the World Health Organization's regional office for the Americas about the W.H.O.'s progress in helping countries fight the spread of COVID-19.    (Greta interviews Dr. Marcos Espinal) GVS: When did you first hear about COVID-19, the corona virus? ME: Mid December we started hearing that there was, there was something going on in Wuhan that was coming from, you know, a very difficult disease or something unexplained. Yeah. GVS: Did it pique your interest at that time or, or do you always get notices like that, is that something common that you hear of a virus someplace? ME: No, we have mechanisms, you know, to learn about the disease and to know, very quickly through the international hazard regulation mechanism, which is a treaty that all the countries sign to notify to W.H.O. events that are of concern or starting to, to be created in countries. GVS: Do you find that you know there's some criticism that Beijing was not cooperative with W.H.O., or that W.H.O. didn't pressure China into giving information quickly. W.H.O. How do you respond to that? ME: We don't have evidence of that. We think China has collaborated and cooperated with W.H.O. and has informed who and has always opened the doors for W.H.O. to work with, with China. GVS: Did China, allow the CDC for instance in the United States organizations, did they allow CDC to come to China to see what was going on? ME: Well you have to ask CDC for that question. But in terms of W.H.O. -and actually I think there was in the mission, that the first mission we sent there was a scientists from different, I don't recall the number of partners, but there were several scientists from different partners of W.H.O. in the first mission that went to China. GVS: And what, why did it take so long I'm not being critical I mean I'm just trying to understand a situation, why if W.H.O. learned of this virus in December, mid December maybe, did it not declare a global emergency until the end of January? ME: You have to look at the evidence. You have to also, you cannot only make declarations based on, non-facts. Sometimes you have to look at the evidence you have to, to make sure the facts are right. So, I think, you know, the declaration of public health emergency of international concern, It's something that W.H.O. did very quickly. I mean it could take some time, but that doesn't mean that that it is wrong or is going to prevent more or less cases, you know. because the Chinese were already working and they were already isolating, doing measures to prevent a spread of the disease and so on. But sometimes virus are new and you have to learn on these things. So you have to take into account many different characteristics in order for, for not going in to declare a pandemic immediately. Because otherwise you might be accused of of declaring something that is really, doesn't deserve to be declared. So I think it is important to to look at the evidence, analyze the evidence and that is what W.H.O. did, and went to China and worked with the Chinese to ensure that the situation was the right one and they declared that actually eventually. GVS: In the last 19 or 20 years we've had SARS, MERS and now this has been huge virus global virus, how do you compare and contrast the world response to each of those viruses? ME: You know the key issue here is the countries learned of that: MERS, SARS, ZIKA, for instance, in Latin America, the countries are better prepared because they had an experience of H1N1 and ZIKA . In Asia also they have SARS. So this virus, it's, it's rapidly transmitting is, is highly efficient in infecting people. So, the key issue here is continued strengthening of our public health actions to ensure less cases and less death, and, and, but you know, viruses, this will, it will happen, it will pass. If we implement measures, you know, we will go through these. And hopefully, you know, we today are learning that we're seeing light at the end of the tunnel in Europe cases. Countries are reporting less cases, and less deaths. so so it took three months to China, to do the curve. So, if we look at this, so it looked like, you know, in the future we might be in a better position. GVS: How do you assess the response here in the United States to this? ME: I think the United States is doing its best. It has an excellent public health system. It's doing its best to, to,respond to these epidemic. The governors are doing the best. And you know, while it was issues with testing at the beginning, of respirators now, I think the countries are stepping up to, to ensure that provides all those and, and certainly the United States has the best scientists in the world and the best, one of the best public health systems. So, so, you know, whatever happened in the US, it's also a fact that US has several cities, major hubs, Huge trade economies and things like that. and hopefully you know the peak, it's reached, and we go down. But the key issue is to continue, strengthening our actions, the actions to, to prevent more cases. (Greta) VOA correspondents are deployed around the world and across the United States to report on the impact of the coronavirus pandemic.    To do that they have to put themselves in close proximity to others during this time of social distancing.    Here is how one of our correspondents is coping with the story and also covering it.    (Patsy Widakuswara, VOA White House correspondent)  Hi, I’m Patsy Widakuswara, and like many people who can’t always social distance themselves at work, recently I had to put myself and others in a risky position during this pandemic.     On March 28th, as VOA’s White House correspondent I had to fly with the president on Air Force One from Joint Base Andrews in Maryland, to Norfolk, Naval base in Virginia, where he sent off a naval hospital ship, the USNS Comfort, to assist the state of New York in their COVID-19 relief effort.  The White House had reduced the press pool from the usual 13 to seven people, to accommodate social distancing on the plane, where we were instructed to sit on every other seat.     Obviously I knew that being on a plane at this time was risky and I admit that I was a little nervous. During the screening process for example, I came into close contact with five people, five officers and they were not all wearing masks. I thought about my son, who is 12, who gave me this advice:     ((Abiyoso, Patsy’s Son))  “If people are around you hold your breath or breathe out.”    Aboard Air Force One, I wiped my seat and the boxed meal the crew left for me with disinfectant.     I was stressed, I was sharing this enclosed space with other journalists, White House staff, secret service agents, and the crew, but also because I was radio pool. So a radio pool reporter’s responsibility is to capture and upload broadcast quality audio of every single word that the president says within minutes after he says them. So this is not just my reputation on the line but also my organization’s reputation because other outlets are depending on us.      On the way back from Norfolk, the president came by for an off the record chat. And we huddled around him, again disobeying social distancing guidelines. But off the records are quite rare, and to be honest, for those few minutes I forgot all about the virus, and I cared only that I do my job, something that I am always grateful for, pandemic or not.     So that’s my COVID-19 diaries. Thanks for listening. I hope you and your family stay safe!  (Greta)   Health care workers in the U.S. are sounding the alarm about the ability of America’s medical facilities to contain the coronavirus threat.    Some have taken to Instagram to highlight the risks posed by a shortage of ventilators and personal protective equipment such as N-95 masks.    Calvin Sun is an emergency medicine physician who has worked in most of the emergency rooms in New York City.    He spoke with Plugged In’s Mil Arcega what it is like to work a shift in America’s coronavirus epicenter.    (Mil Arcega interviews Dr. Calvin Sun) CS: We go around and there's patients who died overnight. God knows for how long because they've been admitted to the hospital but the hospitals too full – so they're not going upstairs. And overnight they die quickly, they die suddenly. MA: You were having to re-use your masks even and having to wash your gowns I suppose. You're reusing stuff that should be disposable. CS: Absolutely. The N95 was designed to be disposable in between patient encounters, and we've been using them, reusing them for entire days for multiple patients. But not only that I use my same N95 mask for up to eight days before I was able to find a replacement. My own personal protective equipment as a per diem is cobbled together from different emergency rooms I have the privilege of accessing to, which most of my colleagues, don't - being full time with only one EPR. They’re lacking what that ER lacks, they don’t’ have access to what that ER lacks. So essentially, I’m a modern day Ironman trying to put together this suit right and I'm lucky I can fly around in it. But everyone else should be having access to the same technology. MA: Do you feel like your health is in some danger as a result of the inadequate equipment that you had to deal with initially? CS: Every day. Absolutely. We're running into a burning building – naked, being asked to get our own personal protective equipment and the building is about to collapse and we're trying to get everyone out of this burning building before it falls down on us. And guess what? we're all trapped inside. We heed the call and we we suck it up essentially that's, we're proud of being able to be hardy and scrappy. But to not be adequately protected, there's a balance in which it becomes a moral injury. And we feel that that balance has been tipping against our favor to the point of injustice. And I feel that, fine, you may not have enough resources to fight this fire, but then to ask us to depend on personal donations or to buy our own helmets right when you're sending a soldier into war - there's a certain level in line with which you kind of question like what is right and what is wrong? I don't want to sound entitled. Like we're not entitled, I'm happy with my personal protective equipment, because I have my donations. But why does it have to depend on that? Does it have to depend on it, for a country that claims to be as developed as the United States of America, MA: Are there any positives - is there anything that we can take away from this that might make myself or some of our viewers feel better? CS: The diversity of people coming together from different disciplines to help one another out. I'm finally seeing that now. As I said, we're very scrappy we're also very resourceful and we look out for one another. I have never seen an emergency room where I have volunteer surgeons come in and work for free for 12 hours, helping us move patients to places where they're safer to transfer patients. I've never seen hospital system, share resources in ways of friendship and unilaterally where we all realize we’re on the same team and not competing with one another. COVID-19: Fast Facts. This is a special presentation of Voice of America. Wash your hands with soap and water – before you eat, after using the toilet, after touching anything many other people touch, like a seat on a public bus. Scrub thoroughly for 20 seconds. If you cannot wash your hands, use a hand sanitizer. Taking these steps can prevent not only coronavirus but also colds and flu and other viruses. For more information visit the World Health Organization’s website at www.who.int. (Greta) While government health officials plea for more social distancing to slow the spread of COVID-19, social distancing can be difficult to enforce..    In the Philippines - President Rodrigo Duterte has declared open season on violators suggesting that local police and the Philippine military should be able to shoot people who violate the lockdown.    And in South Africa police were seen enforcing the lockdown - using  a three foot long whip they once used to be used against black South Africans during the height of apartheid (a system of segregation based on race).    South Africa now has the most coronavirus cases on the African continent.  Before this pandemic South Africa was already struggling with tuberculosis and HIV. Health experts are also warning that those who live in poverty and in the country’s overcrowded slums are facing even greater risks.  VOA’s Franco Puglisi reports from Johannesburg.    (South Africans at Risk by Franco Puglisi) ((NARRATOR))  South Africa’s overcrowded towns and slums suffer the most from the status of having the world’s highest infection rate for tuberculosis and HIV.      That means millions of poor South Africans have compromised immune systems.    Health experts say the added threat from coronavirus could bring the already-stretched healthcare system to its knees.      ((Dr. Angelique Coetzee, Chairlady, South Africa Medical Association))  “If it’s a community outbreak with only a few people affected and we can contain the virus it will be fine, we would be able to, to manage.  If it is unfortunately an outbreak, let’s say in one of the informal settlements the risk of people there getting seriously ill, would be worse, and those are the people also that we would be that we are afraid of, will have to be hospitalized and I don’t think the system will be able to treat a huge influx of people seriously ill.”    ((NARRATION))  South Africa’s pharmacists are on the front line, dispensing medications and trying to educate on coronavirus prevention.      ((Miss Dara Vucevic, Chief Pharmacist, Mays Pharmacy ))  “I think in the general communities where there is large populations, I don’t know how they would be able to handle it, but I think, I think they have made provisions in the larger hospitals, in the main  centers, I think they have made provisions.”     ((NARRATION))  But South Africa’s epidemiologists worry about the crowded slums, where social distancing is almost impossible.    ((Professor Cheryl Cohen, Co-Head of the Center for Respiratory Diseases at NICD))  “How can the sick person try as much as possible to keep himself separate from other people, for example, by even... if you sharing a room to stay one meter from people?  Because, one meter is the critical distance over which the droplets of the virus can spread.”  ((NARRATION))  For this pandemic, South African authorities are hoping for the best-case scenario– that the country’s lockdown can bring it under control.      Meanwhile, South Africa’s hospitals are preparing for the worst. ((Franco Puglisi, for VOA News, Johannesburg.))  (Greta) Social distancing to flatten the curve of the pandemic is stretching the fabric of society to its limits. Schools are closed, concerts are cancelled and sports are on hold.  Except in South Korea where professional baseball is starting again. VOA’s Bill Gallo reports:  (Getting Your Sports Fix by Bill Gallo) ((NARRATOR))  Spring baseball. Any other time, it wouldn’t be unusual. But right now, this game is anything but typical.    ((William Gallo , VOA News))  “Well it might be weird, but it’s literally true. Behind me is one of the only professional sporting games going on in the entire world. If you look closely, there are no fans here. This is what baseball looks like in Korea during a coronavirus pandemic.”     ((NARRATOR))  The Lotte Giants are playing in front of 27,000 empty seats, due to social distancing guidelines. Instead, the team is broadcasting the games on YouTube, where they’ve been a big hit. About 10 times as many fans have been watching compared to the Giants’ average regular season games last year.   ((Kim Sung Min, Lotte Giants Front Office Employee))  “People want sports right now. People are thirsty for it. Especially baseball fans, they really want baseball fans right now. I’d like to think we’re just helping them out. And we’re just giving them a bit of a fix.”   ((NARRATOR))  Baseball already incorporates social distancing, to an extent. Most fielders stand a dozen meters or more from each other. And there is no sustained physical contact.    Most players also wear masks. And for now, the team is only playing against itself.     ((Adrian Sampson, Lotte Giants Pitcher))  “Washing my hands as often as I can and wearing my mask and just staying clean -- that’s the most important thing for me right now.”   ((NARRATOR))  South Korea is one of the few countries where professional sports could happen at all. The country saw an explosion of coronavirus cases, but was able to quickly put out the biggest fires.  Now, there are flashes of normalcy -- previews of what a post-coronavirus world looks like.    ((Kerry Maher, Lotte Giants Superfan-Turned-Employee))  “I think it desperately needs baseball. We need some distraction. And something spring-like.”  ((NARRATOR))  Springtime baseball: a reminder that happier days could soon be around the corner.  ((Bill Gallo. VOA News. Busan, South Korea.))    (Greta)   Before we go congratulations and thank you to one of our favorite health experts. Recently, Dr. Leana Wen, formerly a city Health Commissioner in the U.S. state of Maryland and a guest right here on Plugged In delivered a healthy baby girl.   She tweeted this picture of mom and dad with new born, meet Isabelle Wen Walker.    Dr. Wen says she and her baby, they’re doing well and looking forward  to meeting the rest of her family.    And since the beginning of the coronavirus outbreak Dr. wren has been a frequent and gracious guest here at Plugged In.   Our congratulations and best wishes to Dr. Wen and family, and a huge thank you from all of us here at Plugged In!  That is all the time we have for this edition of Plugged In.    For the latest coronavirus updates, please visit our website at VOANews.com.   And do not forget - follow me on Twitter @Greta. Thank you for being Plugged In.