On Plugged In... the United States.. taking steps to reopen its struggling economy, Around the world.. other nations are doing the same... From China.. where the outbreak began.. to Italy and Spain... But with cases of COVID-19... still rising around the globe... health experts are warning about a second wave of the vicious virus. What will a post coronavirus world look like? On Plugged In… the Coronavirus Crisis: The New Normal. ((Greta)) Hello and welcome to Plugged In. I’m Greta Van Susteren coming to you from my home in Washington, DC. While the global death toll from corona virus climbs past 200-thousand, some countries are planning to ease “stay-at-home" restrictions. Among them Europe’s hardest hit countries France, Italy and Spain. And in China - where the corona virus outbreak began, some students are going back to school. Here in the United States - home to the most confirmed cases and deaths some parts of the country are starting to “re-open", hoping to revive a spiraling economy. VOA’s Brian Padden reports on America’s search to balance health and the economy. ((US Prepares to Reopen - Brian Padden)) ((NARRATOR)) Gyms, hair salons, and dine-in restaurants are among the non-essential businesses that have re-opened in the southern U.S. state of Georgia - the first state to take expansive steps to restart the local economy. Yet these businesses are required to maintain social distance guidelines, sanitize the premises and screen employees for coronavirus symptoms such as fever. ((Shannon Stafford, Owner, New Era Hair Studio)) "We are checking temperatures, we make sure that clients fill out a questionnaire before we perform any type of services on them, making sure that the hands are washed.” ((NARRATOR)) But Georgia’s coronavirus infection rate is still rising. And public health experts warn that trying to ease the economic pain caused by the shutdown too early, risks a more severe outbreak of the deadly virus. ((Dr. Jason Farley, Epidemiologist, Johns Hopkins University)) “We are, as we open up the economy, exposing immunologically naïve people, meaning no antibody, no history of the virus, to the virus and ultimately may lead into a circumstance where we will lose lives” ((NARRATOR)) Protests have erupted across the country by Americans who want to get back to work. Yet opinion polls show strong public support for restrictions on businesses and large gatherings to contain the outbreak, until effective treatment or a vaccine is developed. President Donald Trump has left it to the states to decide when to restart economic activities. On Monday, he announced new guidelines to help businesses safely reopen and to increase testing capacity nationwide. ((President Donald Trump)) “Ensuring the health of our economy is vital to ensuring the health of our nation. These goals work in tandem. They work side by side.” ((NARRATOR)) Some other states are also allowing certain businesses to reopen, as widespread job losses and gaps in government unemployment assistance leave many without enough money to pay for food and rent. But it may be a slow process, say experts. ((Dr. William Schaffner, Infectious Diseases Professor, Vanderbilt University Medical Center.)) “We might have to do this gradually to see whether we can handle it or whether we suddenly get a new surge in cases of COVID. And it's going to be a delicate balancing act.” ((NARRATOR)) In New York, which has been the epicenter of the U.S. outbreak, Governor Andrew Cuomo said the state is developing a phased plan to open based on guidelines from the Centers for Disease Control. First, states must see a sustained period of decreasing COVID-19 cases, followed by increased testing and risk evaluation. ((New York Governor Andrew Cuomo)) "Then we're going to leave two weeks between phases so we can monitor the effect of what we just did. Taking action. Monitor it.” ((NARRATOR)) Even as some businesses begin to reopen, virus outbreaks have forced others to shut down. A surge of coronavirus infections in the meatpacking industry has closed some plants, disrupting the supply chain which could lead to food shortages and higher prices. ((Brian Padden, VOA News Washington)) ((Greta)) Steps are being taken in parts of Europe to find the right balance to ease social distancing. Italy’s prime minister’s plan to reopen his nation are being met with skepticism in a country with Europe’s largest death toll. In Germany - Chancellor Angela Merkel warning that her country is on “thin ice” as shops open again. And Britain’s Prime Minister Boris Johnson is back on the job after a bout with COVID-19 says the UK is at “the moment of maximum risk” urging the British to remain locked down at home. More now from VOA’s Henry Ridgwell in London. ((Europe Lockdown easing – Henry Ridgwell)) ((NARRATOR)) In Rome - a tentative ray of light after two long months of lockdown. Some bookshops have been allowed to reopen. ((Alberto Volponi, Shopper )) “I've actually come here to buy some stuff for the grandchildren. When I see them, we'll have a party.” ((NARRATOR)) The celebrations remain on hold. Rome marked 2,773 years since its founding but the birthday party was postponed. Italy is still recording hundreds of deaths a day, and most of the economy is still shut down. The World Health Organization urged Europe to show caution. ((Tedros Adhanom Ghebreyesus, WHO Director-General)) “Easing restrictions is not the end of epidemic in any country.” ((NARRATOR)) Elsewhere elements of normal life are returning. Germany is allowing small shops to re-open. In Prague, outdoor markets are back in business. In Norway, nursery schools are welcoming pupils – friends reunited. ((Doctor Peter Drobac, University of Oxford)) “Now in countries that were very effective in flattening the curve, like Austria, Czech Republic and Norway, there are very few ongoing new cases, you know, tens to maybe about 100 per day. Certainly in those countries measures to begin easing social distancing are appropriate. Other places like Germany that have had a high number of infections, but a low number of deaths, but with really strong capacity, I think are also in positions to do this.” ((NARRATOR)) In Britain, the lockdown remains in place – with the country on course to be the worst-hit in Europe. ((Doctor Peter Drobac, University of Oxford)) “We’re maybe just barely past the peak It's still at a plateu so it’s really going to be several weeks before we see enough of a sustained decline in transmission caused by the current lockdown that it would really be safe in my opinion to begin opening again.” ((NARRATOR)) Global work on a vaccine continues at an unprecedented pace. But it will be several months or longer before anything is available on a large scale. In the meantime, scientists say the easing of the lockdown in countries like Germany offers important lessons. ((Doctor Peter Drobac, University of Oxford)) “First, that you've had a sustained decrease in the number of new infections at least two weeks going down. Second, that your health system can cope and that you're no longer relying on emergency measures like temporary hospitals. And then finally it’s really important to be able to move back to a containment strategy, you need to be able to have very widespread testing capacity in place so that you can test everybody with symptoms, and you need to have tracing capacity.” ((NARRATOR)) Testing, and contact tracing – finding and isolating those who have come into contact with an infected individual – are methods employed successfully in countries like South Korea and Vietnam. Scientists say this is the key to opening up shuttered Western societies. Brick by brick, parts of Europe are nervously taking down the defensive wall. The coming weeks will reveal if this cautious step toward normality is justified – or if scenes like this will signal the start of a second wave of COVID-19 infections. ((Henry Ridgwell, for VOA News, London.)) ((Greta)) An expected “second wave” of the virus has infectious disease experts racing to understand how the virus works. Researchers at the University of Southern California are partnering with the Los Angeles County Department of Public Health to examine the results of county-wide antibody tests. They’re trying to find out why some people are better equipped to ward off infections than others. I spoke with Dr. Paul Simon, chief science officer and co-leader of the study to find out how antibodies might help in the battle against coronavirus. ((Greta Interviews Sr. Paul Simon)) PS: It was designed to be as representative of the county adult population as possible, and our interest was in getting a more comprehensive understanding of the epidemic here in Los Angeles County. As you probably know, our statistics on reported cases of COVID are quite limited because many persons in the past were unable to get testing, even if they have severe symptoms, and so the advantage of the antibody test is that it allows us to identify persons who've ever been infected with a virus because it's measuring antibody to the virus. GVS: So, how do you do this? as I understand it the FDA has only approved a certain number of tests or studies. So how are you actually going about getting this information? PS: So we were able to use some donated test kits. A distributor in Minnesota provided those to us; the manufacturer's information on the test kits indicated they were pretty accurate. We then had the test kits also evaluated up at Stanford University and there again they got good results on accuracy. We worked with a marketing research firm the LRW group, which provided pro bono support. And they used some of their proprietary databases to reach out to individuals via email or telephone to invite them to participate in a survey about COVID. And then, once they had completed the survey we offered them the antibody test. And that was done at six different drive thru locations in Los Angeles County. About a fourth of the people who completed the survey also asked for the antibody testing. And the advantage of that I think is we could compare the characteristics of people who were tested versus those that weren't interested in being tested. GVS: alright, is it- just so I understand the mechanics of it -is it a pinprick, I mean how do we actually do this? PS: Sure, it's a relatively easy test to do, it's a it's a finger stick, just a drop of blood is collected and then it's, it's put into a little pipette that is put into the little test kit, and you get a result, a color change that indicates whether antibody is present or not within about 15 to 20 minutes. Because we had pretty rapid flow through at the test sites, we didn't provide results there at the sites. We allowed people to access an online portal where they could get their result within 24 hours. GVS: If you have the antibodies, it is presumed you have some level of immunity but is there any way to determine whether that immunity is for a week, a month, a year lifetime? PS: We don't know the answer to that yet, that's certainly a very important question. there's a lot of research being done to better understand it. but we were very clear in the instructions to the participants, and in the debriefing materials they received when they got their test result that having an antibody doesn't necessarily mean you're protected. We hope there's some protection, based on what we know about other infections. Generally the presence of antibody indicates some level of protection but that's not universal. GVS: Alright, but the the antibodies for COVID are different than the antibodies for the flu? PS: Exactly, so-- GVS: and you can identify that right? PS: Yes. Yeah, so the antibody that we were testing for was specific to the coronavirus. And so basically what we found is about 4% of adults in our study tested positive for the antibody. And so if you apply that to the general county population, if you assume that our sample is perfectly representative of our adult population, that would translate to about 300,000 persons who had the infection at some point in the past. Now there's been a lot of debate about whether our sample was truly representative or not. There's concern for example that maybe the people in our study again were at higher risk of infection and therefore our estimates are inflated. And, you know, we can't argue with that concern. We did the best we could to make sure our sample is representative. I think it's relatively accurate. but you know there'll be other studies done with different methodologies to, you know, to see whether there's consistency in the findings. GVS: I think the first case confirmed in the United States was sometime in almost late January, about January 19 or so. but do you have any reason to believe that this virus had come here much earlier? PS: It would not surprise me if it was here earlier. And I, after having done this study now, I've been inundated with emails from from people, describing illnesses going all the way back to December that sounds very much like COVID. We can't be sure. Again, it some in some ways mimics influenza, but given how much global travel there is and the fact that Los Angeles is such a destination, people coming and going, it would not surprise me that the virus was, was present here as far back as December. GVS: Is there anything for the study that that stunned you? Well, the numbers are stunning. And I think it really made clear to me that there may be a large pool of folks that have very mild illness, even no symptoms, with the infection. I think that's good news for people, but it does make our disease control efforts very challenging. when you have a large pool of persons that have no symptoms, but nonetheless have the virus, could be shedding the virus, could be spreading it, it makes disease control very challenging and I think it just is gonna force us I think to consider very carefully strategies moving forward because this is going to be with us for a while. Do the Five – Help stop coronavirus: Hands - wash them often. Elbow – cough into it. Face – don’t touch it. Feet – Stay more than 3 feet (1 meter) apart. Feel Sick? Stay at home. Do the five – help stop coronavirus. ((GRETA)) As we deal with the potentially prolonged impacts of this pandemic, US health officials have now expanded the list of COVID-19 symptoms, adding sore throat , loss of smell, headaches, muscle pain , and chills as possible signs of infection. But doctors are also urging the Trump administration to collect data on populations at greatest risk from COVID-19. Data collected so far shows the disease is killing African-Americans at an alarmingly higher rate than the rest of the US population. More from VOA Health reporter Carol Pearson. ((At Higher Risk – Carol Pearson)) ((NARRATOR)) There's an old saying that when white America gets a cold, black America gets pneumonia. That's never been more true than with the coronavirus. ((Dr. Taison Bell, University of Virginia)) "There are several states that have released some of these data that have shown that African Americans are having higher rates of hospitalization, higher rates of death when they do go to the hospital." ((NARRATOR)) )) In Louisiana, African Americans make up a third of the population and account for 70% of the deaths. Similar disparities exists in other states too. In New York City, Hispanic people make up 29% of the population but account for 34% of the city’s deaths from Covid-19, according to the city's own data. African Americans, Hispanic Americans and other minorities generally have lower incomes than their white counterparts, many of them are essential workers, they often can't afford health care. ((Dr. Eliseo Pérez-Stable, National Institutes of Health)) "We know that blacks have more hypertension, more heart failure. We know that both Latinos and African Americans have more asthma and more severe asthma. And we know that all race ethnic minority groups have higher rates of diabetes by significant and often double what the white population does. These are the three major common risk factors that have been identified." ((NARRATOR)) Social distancing prevents disease, but it's impossible for people with low incomes. ((Dr. Eliseo Pérez-Stable, National Institutes of Health)) ((9:49 - 10:16)) "How can you tell a single mom with three kids to self-isolate if they've [had an exposure? Let's say they work as a nurse's aide at a hospital., and, oh you've been exposed. You have to go self-isolate. Well, you can't self-isolate. You have to take care of children. You can't self-isolate in a household where there's three rooms and there's eight people living there." ((NARRATOR)) In order to survive this virus, your body has to be healthy enough to fight it. Getting the disease is like getting a punch. ((Dr. Taison Bell, University of Virginia)) "And if your body is not in top shape, then that means that you are less likely to be able to tolerate that punch. So if you have diabetes, which is relatively suppressive for your immune system, when you get infections, you're more likely to have worse outcomes. If you have heart disease coming into it, your heart needs to pick up as rates deliver more blood and nutrients. If you have an infection, if you're not able to do that, so well then you're going to have worse outcomes." ((NARRATOR)) Dr. Taison Bell says now that political leaders are aware of this situation, data can be collected and policies changed. Dr. Eliseo Pérez-Stable says change will not come fast. He says these health disparities have existed for a long time, and activists, politicians and minorities need to prepare to run a marathon instead of a sprint. ((Carol Pearson, VOA News, Washington)) ((Greta)) Like any marathon race, it takes perseverance to get to the finish line. And what will it look like once we get there? For many the forced lockdown and social distancing has been stressful. And according to the U.S Centers for Disease Control stress during this period can include increased use of alcohol, tobacco and other drugs. Plugged In’s Mil Arcega spoke with Dr. Gail Saltz about managing the life change we are all experiencing.   ((Mil Arcega Interviews Dr. Gail Saltz)) GS: Loneliness is definitely a big issue with all of this social distancing. We know that loneliness, which was already a growing public health issue causes anxiety and depression. We know that the suicide rate was already going up before this pandemic I think there are a lot of concerns, not just because of the fear of illness and the social distancing but because also - the economic loss that's gone on for so many people that there is a lot of concern about a rise in substance use and abuse. A rise in the suicide rate, a rise in the divorce rate which for example you see in China as people came out of social distancing. There was definitely a peak in that. We're already seeing a rise in domestic abuse and violence of various kinds, so you know when you stress a group like this in this kind of severe way you do see a rise in all kinds of mental health issues. MA: Dr. Saltz, as we speak some states, some countries around the world are already moving forward with their plans to reopen their economies, get people back to work – barring the potential health consequences of such a move - what will a return to normal look like? GS: Yeah, I think that transitions are difficult for many people, even if it's a transition back to something that you want, even if it's a change that you want. Transitions can be hard. And because - you have to look at it this way: we have made the biggest national change in behavior that we probably almost ever done to get people to stay inside and not go to work and stay socially isolated. It's, it's unbelievable. And it was probably primarily driven by fear. Fear is a big driver. In this case, that was a good thing, but the problem is that once the fear has set in to motivate everybody so much - for some people, particularly people who tend to be anxious or tend to be concerned about health issues - coming out of that will be difficult. So there's going to be people that are afraid to go back to work, that are afraid to socially interact with others. There’s going to be children, afraid to go back to school because we put the fear into them to get them to change their behavior and going back - they might have thoughts of you know, this is dangerous and I don't feel safe. Even if we reach a point where rationally, it is safe. And so there may be people that need help, you know, along the way, to be able to re-digest the idea that it's safe, and especially because there will not be 100% certainty that it is safe, right? We know for a long time coming, that this virus will be around, and even though the odds may drop significantly that one could contract it because of the number of people that are no longer infected or because we have some testing that we're doing, etc. Still, we can't promise people right? There will be uncertainty. And uncertainty for some people, that's hard to accept, and they have fear and that may make it difficult to go back and transition back. But for other people, not so much, they'll be delighted. 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. VOA – A free press matters. ((Greta)) Covering this pandemic has its challenges for all reporters - including those covering the White House. Among the precautions - a temperature test for all reporters at the Coronavirus Task Force Briefings. And social distancing in the briefing room is a big adjustment for those covering the President of the United States including VOA White House Bureau Chief Steve Herman. ((Reporter’s Notebook with Steve Herman)) My VOA colleagues and I are usually only in the White House briefing room, asking questions of the president and members of the coronavirus task force, when our turn comes up in the rotation. Some networks have dropped out of the rotation, known as the pool, due to fear of infection, so VOA volunteers as often as possible -- even though that means sitting close enough to several other reporters and the wandering photographers less than the recommended two meters’ distance. So far, three journalists who have spent time in the briefing room have reported coronavirus-like symptoms.  On the days when I am not at the White House, I cover the briefing from this newly configured studio here in my home halfway between the White House and George Washington's Mount Vernon. Here I can ponder that the first U.S. president had to contend with a smallpox epidemic. Yellow fever was a worry in Washington until the end of the 19th century. The Spanish Flu, a century ago, claimed the lives of 3,000 Washingtonians. Now we wait to see if COVID-19 will trump that toll. Steve Herman, VOA News, Alexandria, Virginia ((VOA Video Vignettes)) Thank you to everyone working on the frontlines, keeping all of us safe ((Greta)) May 3rd marks World Press Freedom Day celebrating the fundamental principles of a free press and paying tribute to journalists who practice their profession under difficult circumstances. The coronavirus pandemic adds another layer of difficulty and danger to their important work. VOA is among the most ardent advocates for a free and independent press. Plugged In’s Mil Arcega spoke to Jessica Jerreat, former editor for … the Committee to Protect Journalists and now leads VOA’s Press Freedom Initiative. ((Mil Arcega interview with Jessica Jerreat)) JJ: The press freedom initiative really is an extension of what VOA's work has been for decades. We work in some of the most censored countries, countries where there's just untold restrictions on freedom of information. And through the press freedom initiative, we're just taking a deeper look at what it's like the challenges for reporting in those countries where covering the news can mean being sent threats from governments or powerful interests or being arbitrarily detained just because you report critically about a particular policy or an interest group.    MA: You spoke extensively about Hungary and its current prime minister there, Victor Orban. What's going on in Hungary?   JJ: Well Viktor Orban, he's been trying to consolidate his power and his influence over the media for many years now. And the coronavirus pandemic has really just accelerated that. The Hungarian Parliament last month, voted in a raft of measures that give him increased power. From a press freedom perspective the most troubling of these is that he has implemented a five-year jail term for people accused of false news which is a term that a lot of authoritarian leaders use.  MA: What about the Philippines? What is Rodrigo Duterte trying to do there in light of this pandemic?   JJ: On the plus side with the Philippines, when they installed a lockdown order in one of the biggest provinces in the Philippines, they listed media as an essential service which is a good sign.   MA: Yes   JJ: But to be able to be recognized as a journalist, able to move freely within the sort of quarantine measures, you needed accreditation. And they suddenly limited the amount of accreditation available to journalists. So immediately, journalists in news outlets are competing against each other for how many journalists they can have to go out and report in the field.   MA: Voice of America, the USAGM has a number, has a lot of of reporters, correspondents and stringers all over the globe. How are they faring? JJ: At VOA, I'm impressed at the ability for us to just be able to respond to and report in these countries. At the moment, perhaps one of the biggest areas where we've seen an impact is the Beijing bureau, where the tit for tat political space between Washington and Beijing has had an impact on US news outlets in Beijing. And our bureau there has talked extensively about how some of the ways that they've been able to report the news previously have been impacted, because the news assistance they rely on Chinese nationals to help them get into areas and to make sense of some of the sort of more local issues within China, they're no longer allowed to work for us. So that has impacted and slowed down our work there. But the VOA journalists are very determined, they have strong sort of standing in journalism ethics and the importance of independent news. And so they just push back against these restrictions. They continue to take on the big subjects and to report what's happening in these countries.  ((Greta)) That is all the time we have for this edition of Plugged In.   We will be back next week with a new episode on the crisis.      And for the latest updates, please visit our website: VOANews.com.  And do not forget, you can follow me on Twitter - @Greta.   Thank you for being Plugged In.  We hope to see you again next week!