(Gay Courter, Quarantined American) “We never thought we would end up in the Twilight Zone.” On Plugged In… A quarantine patient…  tells us…  the high cost of isolation…  in the age of corona virus.    ((Scott Kelly))  “It's all our responsibilities to get through this …"    And a veteran astronaut…  who set the record…  for the longest mission in space…  shares his experience…  on how to survive…  social distancing…    How much…   has your life changed?    And when might …  Things return to normal?    Plugged In...  Brings you the latest…  from our team of reporters…  around the globe...    On…  “The 2020 Coronavirus Crisis.”      (Greta)  Hello and welcome to Plugged In. I’m Greta Van Susteren, coming to you from my home in Washington DC.    By now, you already know this is not a drill. This is our new reality. And like you I’m staying away from large crowds, I’m staying indoors more often than I would like and washing my hands frequently, very frequently.    We don’t know exactly how long our lives will stay this way but we do know that in some countries the number of Corona virus cases is starting to flatten. Fewer cases are being reported in China, where the virus was first detected.  And some good news in South Korea - health officials there say infections have been falling for two weeks.    Now, that is not the case in the United States, which now has the unfortunate distinction of leading the world with the largest number of confirmed cases.     I spoke with Dr. Leana Wen, emergency physician and former health commissioner for the city of Baltimore. To find out what she has learned about the coronavirus pandemic.  (Greta interviews Dr. Leana Wen) GVS: Doctor, thank you very much for joining me. LW: Happy to be with you again, Greta. Thank you GVS: Doctor, there's a lot of attention in the United States and I imagine worldwide on chloroquine and possibly the Z-Pak, the antibiotic, and now we see that some of it is going to be tested in New York. What are your thoughts on this? LW: Well I'm glad that there are potential treatments that are being tested. But we also have to follow the clinical protocols that exist. We have scientific protocols that follow medical guidance, legal and ethical guidance for a reason. And just because this is the time of a pandemic, we can't skip steps because we have to ensure both efficacy and safety of these medications. GVS: No drug is perfect, I understand that, but what make this one a little bit different and obviously we non-medical people are eager for anything and I realized that basically when you get desperate you're trying anything, but this this chloroquine is an anti-malaria drug that has some side effects but it's been around forever so it seems it's a little safer, or more reliable at least in terms of, you know how it impacts the person? LW: There are other antiviral medications that are also being tested too. And I think it's important for these medications to all go through a standard process. Now of course I understand that patients want to have the right treatments and really want to have the treatments down, but there is a process, and if we don't go through that process we could potentially cause more harm. One of the things that's been happening and one of my concerns, is - the President has been saying a lot of things about these medications, and that's actually caused a run on these drugs. and there are patients who take hydroxychloroquine for rheumatoid arthritis, for lupus, and now they cannot get these medications. And so we just have to be aware of the unintended side effects that we may be causing when we start promoting treatments that are not yet proven, which I definitely agree we need to go through the treatments, the trials to test them. But in the meantime, I do urge caution, GVS: Now from a public health standpoint, covid-19 appears to be more infectious than the flu, and that it has a higher mortality rate. Am I correct on both those? LW: Yes you are. And this is why it is so important for us to focus on prevention. Because Covid-19 so far looks like it has the mortality rate that is 10 to 30 times greater than the flu. And because no one has been exposed to this disease before it's a new disease. That's why it is spreading in our communities, exponentially. And so without a proven treatment at this point, without a vaccine, the only thing that we have is prevention to try to prevent person to person, transmission. And that's why these social distancing measures, the physical separation measures of having no gatherings and not being outside our immediate family household unit, are so critical. GVS: If you go in for a test on day one, and you test negative and then the next day, you're not going to get tested, but you could get it the next day, and he would be without any symptoms, and you could be infectious. Is that right? LW: That's correct, that just because you have a negative test one day, doesn't mean that you don't have Covid-19, and it certainly doesn't mean that you're not going to contract Covid-19 in the future. So that is one of the limitations of testing. Although at the moment, we really have huge limitations because even patients who have symptoms, who are ill, are not able to access testing in many parts of the country, it's only in the US, if you are extremely ill, and are hospitalized, or you're a healthcare worker and you have symptoms - only those categories get prioritized for testing. And there are so many patients who are told, because we don't have enough tests, and because it's not going to change treatment at this point. You should go home and self-isolate, which is the right course of care for them. But you can imagine what that does for someone who may be living with young children or elderly parents and just don't know if they have the disease or not. And also, it really confuses the picture from an epidemiological standpoint, because we really don't know. We have the epicenters that look like epicenters or the next epicenter for the outbreak, but are there many others that are out there in the waiting? We just don't know because we lack those data. GVS: I think it's important to emphasize that if you don't get near the virus you can't get it. And that's why we're talking about the social distancing. I mean if you never go near anybody who has the virus, you don’t go near any surface where the virus has been deposited in some form and lasted, you can't get the virus, right? LW: Greta that's, that's exactly right. And this is why we stress social distancing so much. This is a virus that lives only as long as it can be transmitted from person to person. So theoretically, if we're able to pause the world for 14 days, and no one is in contact with anyone else, the virus will die out, because those who are already infected will become ill and show their infections and those who are not are not going to get infected. If you can stop that chain of transmission, you stop the existence of this virus. Now of course we can't hit pause on the entire world. But we can do as much as we can. And that's why that social distancing is so important because if we don't do that, our healthcare system is going to become overwhelmed as we're seeing in New York and other places now. GVS: You know, a shout out to the health care workers, some of them are getting it, we have seen doctors die, but every time I know a family member goes off to care, or a health care worker goes off to the hospital to care for someone, naturally the family worries and worries about the health of the healthcare worker and it's pressure on them. LW: That's right and I just I think it's so heartbreaking to see my colleagues - they are doctors and nurses and respiratory therapists who are putting their lives on the line every day - to see them, begging for something that really should just be what's available. I mean, we're seeing healthcare workers who are using the same mask, day after day, when we know that's not safe. We're seeing healthcare workers plead for goggles and trying to make a rain poncho into a gown. And that's happening here in the US. I mean, we would never send our soldiers into war, without armor, and it would be crazy to do this. GVS: Doctor, when you talk about the masks though, and if the virus only lives a certain period of time on a material on a surface --cannot the mask be reused after a couple days if it's put off someplace and you put outside or someplace where it can, where that virus can die It can't thrive? LW: In theory. But you also have to keep in mind the materials that these masks are made from. It's possible that when they become damp, they no longer work to block out the virus anymore. Now, I do think it's it, we should try, we should do studies, and we need to figure out what can be effective what these masks can be effective or how they can be effective if they're sterilized in a particular way. But the way to try it out, is not to put healthcare workers lives in danger and see if they become infected. You do a trial. And I think what's been so disconcerting to healthcare workers is from the very beginning, we have very strict guidelines that you need an N-95 respiratory mask and you change that after every patient encounter. Then when those begin running low we're told, we can have a surgical mask, but you have to throw them out after every encounter. Then we're told, actually you can reuse these things if you really have to, and it just makes us wonder, we know this is not based on science and medical standards, we know that this kind of rationing is happening, only because we don't have supplies. But if this is not safe for the healthcare worker, we will become infected, and then we will infect other people, our family members but also other patients. And if we run out of masks, we're going to run out of doctors and nurses, and healthcare providers, and frankly it's just it's ethically the wrong thing to do. And it's the wrong thing to do to try to control a pandemic GVS: There’s a global race to come up with the vaccine. They're hoping that it can be done as early as early 2021. Does that seem possible to you? LW: To get the vaccine - all phases of the vaccine trial and then to produce the vaccine and to get it into people's hands so that it can be used broadly, that takes at least a year. More likely, at least a year and a half. So early 2021 would be very optimistic. Perhaps that's when a vaccine can be developed and ready for mass production, but for it to actually reach people and to be able to protect people from from covid-19, a better estimate would be a year and a half. Do the Five - Help stop Covid-19: 1: Hands, wash them often. 2: Elbow, cough into it. 3: Face, Don’t touch it. 4: Feet, stay more than 1 meter apart. 5: Feel Sick? Stay home. Do the Five - Help stop Covid-19: (Greta) Among the first Americans to experience just how much coronavirus would change our lives is American author Gay Courter.  In January, she and her husband were quarantined off the coast of Japan with hundreds of others aboard the Diamond Princess Cruise ship.     We spoke to her back in February after they finally got back to the United States but then they were under another quarantine at a military base in Texas.    Just a few days ago I spoke to her again on Skype about how coronavirus has changed her life.    ((Gay Courter Interview))  GC: We were terrified. People were getting sick all around us, ambulances were coming, and it's proven to be even worse than we expected     And they tested in the cabins, that are empty and they're finding that there is some residual COVID virus on the surfaces 17 days later. So that ship was polluted. And we were at risk.   Coming home has been wonderful except that we really are still having nightmares and symptoms of PTSD and we're with some therapy on the phone for that. So we didn’t end up unscathed. It was very scary.     But we're basically staying in. You know, we saw those ambulances carrying people away. We know what happens and how quickly it can happen and that there are people out here that are asymptomatic and passing it on. There's a feeling the children pass along. You know, I'll be walking the dog in the neighborhood I mean they do go outside and I'll push the person is walking towards me away, and I'll say - social distancing.    We live in a very rural county but we already have eight or nine cases, mostly from people traveling and coming home, and one death this week so nobody's immune.    And so quickly our lives have changed. Somebody said something very funny to me about - we changed the time to Daylight Saving Time but we didn't know we were going to end up in the Twilight Zone.    (Greta) Social distancing is not easy. And there are few things that can prepare us for the experience, except maybe a year in space. Which is exactly what American astronaut Scott Kelly did.    In 2015, Kelly broke the world record for the single longest space mission aboard the International Space Station. I spoke with the former fighter pilot and retired astronaut about his experience in space coping with isolation and social distancing.    (Greta interviews Scott Kelly) GVS: Thank you for joining us Captain Kelly. SK: Thanks for having me Greta. GVS: All right, um, I want to talk about quarantine. You had sort of a unique quarantine. How long were you in space, what was the longest period of time? SK: So my longest flight was my last flight, it was 340 days. I launched in March of 2015 and I landed in the following March of 2016. GVS: Okay, people today are now quarantined because of the coronavirus. Many people are feeling like caged animals. We're not 340 some days in and you know, how many thousands of miles away from Earth. But tell me, is, you know, how tough is it to be quarantined in space? SK: Well you know it's not easy being isolated right? And I do understand that this situation can produce some anxiety and stress for people. But there are things you can do to combat that. I flew a six month flight. And that was a really long time. I was actually, when I was in space for six months, towards the end, I was kind of climbing the walls a little bit to get out and get out of there. And you know, I do also recognize that that you know this experience of being isolated in space is not completely analogous to what people experience because everyone's situation is different. But when I flew for a year, for nearly a year, I went into it with this, a different mindset and a different plan for how to deal with that type of isolation. My mindset was that this is my mission it's my job and I think that is similar to what we're all in for today is that it's all our responsibilities to get through this and we need to, you know, work together as a team. GVS: Are you isolated now, self isolate or self quarantine now where you live because of coronavirus? SK: Absolutely. We actually last night went into a you know an official kind of lockdown here in Houston. I actually had an alert, one of those like you know those alerts you get on your cell phone, that basically said, like shelter in place here because of the virus which means we can go to the grocery store, we can go to the drugstore but, you know, that's about it. GVS: Do you have any tips? SK: Yeah, so I got a few tips you know the first one is, you know, I think everyone needs to realize that this is important that we work together on this. This is now our collective mission to to fight this pandemic. You know, unfortunately we don't know when this is going to end so I think everyone needs to have this kind of mindset that this is my life now. It will be over someday and I hope when it is, I'll look back on this experience. And, you know, be proud of my performance and you know how I did, meaning you know the potential viewers in doing the right thing. And that stuff is important. I mean, keeping connected with your your family that might not be in isolation, with you is absolutely important,. But more than that, I think there are other things that we can do, you know, first of all we need to have a schedule. If you have a schedule if you, you know, look at your situation and decide what's important for you to do. If you can work from home, you know, schedule work, schedule time that you're going to take care of your personal needs. You know, NASA, we call that self-care, whether it's hygiene or, you know, your mental health. Scheduled time for exercise and time to get outside. Interestingly enough, when we're in isolation in space NASA has found that that suppresses our immune systems being in that kind of environment, the stress, the isolation, the lack of sun sunlight is an immune suppressor, which is the last thing we need right now. And also in space, you know bacteria and viruses can grow and spread more quickly for some reason so we also scheduled time to take care of our environment to keep it clean. We have to do that here. So when you come in from the outside, I think it's important for everyone to be very aware of, you know what procedure they go through to make sure they're not bringing this virus into their house, on their hands, on their phone on whatever, and then later spreading it to them themselves. Schedule time for for a hobby, you know something to distract you from, you know what's, what's going on, which is arguably for some people going to be very stressful. Time to sleep - you know, go to sleep at a regular time, get up at a regular time and I think what people will find if they consciously think about this and have a schedule that they follow that the days will go by much quicker. And they will be better prepared to deal with, with the situation and to perform, you know, at a level that we all need to perform at, to get past this. GVS: Do you think.. I think it's particularly hard for people who are feeling the financial pressure. SK: I understand everyone's situation is different. And all I can do is maybe give you know a little bit of advice to people that might help them a little but I do understand that, you know, some people are just living in a dreadful situation where they you know they, they're not supposed to go outside but if they don't go outside, they're not going to have any money to buy food. So what do you do how do you make those choices is very tough. You know, hopefully people will find this experience, no matter how dreadful it might seem, when they look back at it, they say you know at least I did the right thing I made the right choices I took this seriously which is what I think we all have to do. 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. The 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 website at www.who.int. (Greta) As the rest of the world adapts to our changing circumstances, one group that is often overlooked are the people already displaced from our societies.    A new report released by Refugees International says among the most vulnerable are the estimated 70 million refugees around the world, many of whom live in conditions conducive to the uncontrolled spread  of coronavirus.  VOA’s Henry Ridgwell reports.  (Vulnerable Refugees by Henry Ridgwell) (NARRATOR) Across the world health authorities are telling people to stay home; to keep away from other people; to make hygiene a priority. What chance of that in a refugee camp?         ((Prof. Richard Sullivan, Conflict Health Expert, Kings College London))     “Many of these refugees are often packed very tightly into camps. And that makes a big difference to transmission. The access, of course, to water sanitation and hygiene makes a big difference. And also just their general nutritional state. They're in a huge state of stress anyway, which suppresses their immune systems.”          (NARRATOR)     Cox’s Bazar in Bangladesh is home to 900,000 refugees who have fled violence in Myanmar. Knowledge of the Covid-19 virus is varied.         ((Rohingya Refugee (male, in Rohingya) ))     “I forgot the name of the virus. I heard that disease has occurred in different countries, people are dying. So we should clean our hands.”         (NARRATOR)     That good advice is mixed with rumor and misinformation.         ((Rohingya Refugee (female, in Rohingya) ))     “I heard that if you are attacked by the new disease, the hands and feet are disabled. Saliva falls from the mouth. The injured person barks like a dog.”          (NARRATOR)      Camp authorities are trying to screen all visitors and new arrivals.         ((Doctor Kamal Hossain, deputy commissioner of Cox's Bazar))      “We have instructed the foreign aid workers to scan their health condition themselves, and to not bring any new workers from abroad.”    (NARRATOR)     Khanke camp in northern Iraq is home to 15,000 Yazidi refugees. The AMAR Foundation has led Covid-19 awareness programs and advice on preventing transmission.          ((Prof. Richard Sullivan, Conflict Health Expert, Kings College London))     “If Covid gets into a camp, for example, you're going to see quite a spike in the in the death rate, because there's simply going to be no way of keeping them alive until they recover. But of course, many refugees and particularly internally displaced populations live in makeshift camps very far away from any sort of external official help. And those are the ones that are really very, very vulnerable.”    (NARRATOR)     That includes the hundreds of thousands escaping conflict in Syria’s Idlib province – where aid workers are receiving instructions on coping with any outbreak. Thousands of migrants are stuck in makeshift camps on the Turkish-Greek border. Many more live in overcrowded camps on the Greek islands – and aid groups say Europe must evacuate them urgently as the coronavirus threat looms.      Kakuma in Kenya is home to almost 200,000 refugees. One told VOA that “nothing has been done so far in terms of raising awareness in the camp of the coronavirus.”         Many camps are in countries with stretched or under-resourced health systems: Kenya, Bangladesh, Iraq, Lebanon.         (Prof. Kalipso Chalkidou, Global Health, Imperial College London) “They’re already operating at a very high capacity and so the question is, will they be able to redeploy to accommodate people who live in camps?”         (NARRATOR)     Even rich nations are struggling to cope with Covid-19. Any outbreak among refugee communities could have catastrophic consequences.  (Henry Ridgwell, for VOA News, London.)        (Greta) Meantime, the number of confirmed cases is continuing to rise here in the United States.    Dr. Anthony Fauci, the government’s top infectious disease expert says the US death toll could reach 100-thousand with millions infected.    South Korea which has been praised for wide-spread testing for the virus has agreed to provide the United States with badly needed test kits. South Korea’s help comes at a tense time between Washington and Seoul.  VOA’s Bill Gallo is in South Korea’s capital.  (Help from South Korea by Bill Gallo) ((NARRATOR))   South Korea was among the quickest in the world to set up a system of coronavirus tests, including at these drive-thru testing centers.    Now, South Korea is helping other countries, including the United States, which has struggled to make tests widely available.       President Moon Jae-in said South Korea will provide the U.S. as many coronavirus test kits as possible, as long as it has enough to continue testing its own people.        It’s a role reversal for a 70-year-old alliance: South Korea now helping protect Americans in the U.S. mainland.       But hours after asking for help, Trump insisted U.S. coronavirus tests are better, and were made available faster, than South Korean ones.         ((Donald Trump, U.S. President))   “We kept hearing about South Korea. They had a very tough time at the beginning, if you remember. In eight days, we're doing more testing than they've done in eight weeks.”      (Bill Gallo, VOA News) “The U.S.-South Korea relationship has been strained under Trump. In fact, even as he asks for South Korea’s coronavirus help, he’s demanding South Korea pay billions more for the cost of the U.S. military presence here.”      ((NARRATOR))   That fact is not lost on this group of South Koreans who work at U.S. military bases. They are among 4,000 Koreans who will be furloughed when money runs out to pay them.      The head of the Korean workers’ labor union shaved his head in protest.      (Choi Ung-sik, National President USFK Korean Employees Union) “This is how we make a living! So we will continue to protest, using whatever means we can.”         ((NARRATOR))   Neither Moon nor Trump has publicly linked the coronavirus issue to the cost-sharing talks. But many in Seoul privately hope the coronavirus cooperation will help the two allies solve thornier issues.    (Bill Gallo. VOA News, Seoul) 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 things many other people touch, such as seats on a public bus. Scrub thoroughly for 20 seconds. If you cannot wash your hands use a hand sanitizer. Taking these steps can prevent coronavirus but also colds and flu and other viruses. (Greta) Before we go, an update on a story we have been following here on Plugged In. Robert Levinson, the retired FBI agent who was last seen 13 years ago in Iran is believed to have died in Iranian custody.    Levinson’s family posted a statement on Facebook that new information from the US government leads them to conclude that Levinson is dead.    The family declined to comment further but confirmed that Levinson died before the Corona virus pandemic.    Levinson was last seen March 2007while visiting Iran’s Kish Island.  An Associated Press investigation says Levinson was hired by the CIA to gather intelligence on Iran’s nuclear program.    The family repeatedly sought help from the US government which had offered a combined $25 million reward for information on Levinson’s whereabouts. Iran has repeatedly denied involvement in his disappearance    His wife Christine appeared on Plugged In numerous times. She told me she never gave up hope that someone – somewhere knew exactly what happened to her husband.    Our deepest sympathies to the Levinson family.  (Goodbye) 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 don’t forget to follow me on Twitter @Greta.       Thank you for being Plugged In.