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Coronavirus Update: The U.S. Health Care Industry Is Challenged By The Pandemic


Nurses and doctors have been at the epicenter of the coronavirus pandemic. And yet even as health care workers fight back against the virus, the health care industry is crumbling around them. Today we learned that of the more than 20 million jobs that vanished last month, nearly 1 1/2 million were in health care.


And despite this dismal news for American workers, we heard a more optimistic message from the president today, who spoke about his belief that the country may soon turn an economic corner.


PRESIDENT DONALD TRUMP: So we're looking at the transition to greatness, and I think it's starting right now.

CHANG: Meanwhile, the virus is inching closer and closer to the president, with another White House aide testing positive today for COVID-19. All right. To talk more about all of this, we're joined now by NPR chief economics correspondent Scott Horsley, science correspondent Nell Greenfieldboyce and White House correspondent Tamara Keith.

Hey to all three of you.




CHANG: All right. Hi. All right. Tam, let's start with you. So what is this new coronavirus case in the White House?

KEITH: So this is the third case at the White House, but this is by far the highest-profile. This is Katie Miller, who is the press secretary for Vice President Mike Pence. She is regularly with the vice president and other senior officials. In fact, she is married to Stephen Miller, a close aide and speechwriter for President Trump.

CHANG: Right. And how did all of this come out?

KEITH: She was tested this morning, and it came back positive. Pence was on his way to Iowa. His plane was on the tarmac. Six people who were on the flight who may have had contact with her were asked to get off and go home, though thankfully, they later all tested negative.

CHANG: OK. Well, I guess the question on everyone's minds is, what does this mean for the safety of the president and the vice president now?

KEITH: The White House says that they are taking every precaution to keep them safe, including testing everyone who comes in close proximity to them, also trying to maintain social distance. But that's nearly impossible on Air Force One...

CHANG: Yeah.

KEITH: ...Or Air Force Two and in a cramped West Wing. You can see that on TV when the president packs the Oval Office with people for photo ops and meetings.

CHANG: Sure.

KEITH: And what the CDC recommends, especially when you can't keep six feet of distance, is to wear masks or cloth face coverings. But White House aides that reporters can see haven't been doing that. Chief of Staff Mark Meadows addressed this today at an event where members of Congress were meeting with the president not wearing masks.


MARK MEADOWS: The mask that you wear is generally to keep other people from being infected. And so as we look at that - and I can tell you the testing protocol is a strong regime. And as it gets close to the president, some of those that serve him will wear a mask in those closer proximities.

KEITH: So what he said is that everyone there had been tested, so they didn't need to wear masks. But just moments earlier, when talking about Katie Miller, President Trump had said testing only goes so far.


TRUMP: She tested positive out of the blue. This is why the whole concept of tests aren't necessarily great. The tests are perfect, but something can happen between a test where it's good and then something happens and all of a sudden - she was tested very recently and tested negative.

KEITH: So the president is downplaying the value of testing at the same time that his chief of staff is emphasizing how important it is to the White House.

CHANG: OK, this is all very confusing. Let's go to Nell on this topic of testing. There is news today - right? - about a new test for COVID-19 that can be done at home, I understand.

GREENFIELDBOYCE: Right, right. So the Food and Drug Administration just approved the first at-home saliva test. There was already one at-home test out there that required you to use a swab to sort of swab your own nose.

CHANG: Right.

GREENFIELDBOYCE: This one, you can spit in a tube, right?

CHANG: That sounds much more comfortable.

GREENFIELDBOYCE: But unlike the more - yeah. But unlike the more rapid testing that the White House is using, this one requires you to actually ship that sample to a laboratory. So getting results back takes a couple of days. It might not be right for everyone, but there it is. It's available.

CHANG: Got it. OK, well, Scott, let's go to the economy now. I mean, today's jobs report was pretty grim. It really brings the economic fallout from the coronavirus into sharp focus. So tell us what you see in it.

HORSLEY: Well, the numbers were every bit as bad as we expected - more than 20 million jobs lost, unemployment soaring to its highest level since 1940. That's the tail end of the Great Depression. Even the Trump administration didn't try to spin this as anything more than a disaster. And as bad as it is, White House economic adviser Kevin Hassett warns there's more to come.


KEVIN HASSETT: The next jobs report is going to look worse than this one in terms of - at least the unemployment rate is going to probably go up to around 20%. I think we're definitely going to be looking at least one more month of just, you know, catastrophically and tragically bad data.

HORSLEY: We're just seeing an economy that's suddenly shifted into reverse as businesses around the country closed their doors in a desperate bid to slow the pandemic.

CHANG: And did you see particular workers or industries that were especially hard-hit?

HORSLEY: You know, everyone's getting beaten up but, certainly, some worse than others. Workers who have only a high school education or less, they're less likely to be able to work from home. Their unemployment rate's up around 17% or higher. Women were also disproportionately affected. About 55% of the jobs lost last month were held by women. That speaks in part to the industries that were most affected - restaurants, retail. But really, whatever industry you look at in this report, you see a big minus sign. Even health care, which is ordinarily a growth industry and pretty recession-proof, lost nearly 1 1/2 million jobs last month, as y'all mentioned, as a lot of hospitals canceled...

CHANG: Yeah.

HORSLEY: ...Elective procedures and doctors and dentists closed their offices.

CHANG: Well, Nell, I mean, it is strange to think about job losses in health care during a pandemic. So what do we actually know about how people are using health care right now for illnesses or injuries other than COVID-19?

GREENFIELDBOYCE: So anecdotally, doctors have been talking about their usual patients just kind of disappearing, you know? Like, where have all the people being treated for other diseases gone?

CHANG: Yeah.

GREENFIELDBOYCE: And then today there was just a report that came out in the New England Journal of Medicine that sort of tried to get at that. And a team of researchers looked at how many people across the United States were being evaluated with a kind of brain imaging that's often used to make treatment decisions for people who come in with symptoms of stroke - you know, a very serious thing. And what the researchers found was a precipitous drop in these stroke evaluations.

So nationwide, there was a 39% decrease. And, you know, what's going on there? I mean, do we think people are having less strokes? No. I mean, one of the researchers is Akash Kansagra, and he's an interventional neuroradiologist at Washington University School of Medicine in St. Louis. And here's what he thinks is going on.

AKASH KANSAGRA: I think the most likely explanation based on this data is that either people are too scared to come to the hospital or that we're seeing the effects of social isolation.

GREENFIELDBOYCE: Because when people are disabled by a stroke, it's often someone else who notices and acts to get them the help they need. But if people are alone, you know, that doesn't happen.

CHANG: Right. I mean, this is really troubling. I mean, clearly, even during a pandemic, it is important to call 911 in an emergency medical situation. But what about non-emergencies - just, like, routine health care? What are you seeing?

GREENFIELDBOYCE: So doctors say that people are not coming to them like they used to. I mean, just take childhood vaccines. So there was another report out today in a medical journal published by the Centers for Disease Control and Prevention, and it said the amount of childhood vaccines ordered by providers plummeted in March as did the numbers of kids getting vaccinated. And the American Academy of Pediatrics is worried that kids are just missing out on vaccines for diseases like measles, meningitis, whooping cough. Today the Academy urged parents to call their pediatricians and get their kids caught up on vaccines because we don't want to be so focused on COVID-19 that kids are left vulnerable to other infectious diseases.

CHANG: And, Scott, back to you - I understand that there is a critical new report out tonight on how the administration has been running the emergency lending program for small businesses. What can you tell us about that?

HORSLEY: That's right. It's an inspector general's report about a program that has been loaning hundreds of billions of dollars to small businesses to try to keep them afloat during this pandemic. The inspector general says the administration has failed to give priority to rural businesses and women- and minority-owned businesses as Congress directed. The report also says the administration added a requirement that the businesses spend three-quarters of the loan money on payroll if they want to have the loan forgiven. But that requirement is not in the law, and that could cause a lot of problems for businesses. This is not the first time we've heard these complaints, but it could carry some extra weight coming from the administration's own internal watchdog.

CHANG: Yeah. Well, looking ahead, I mean, we are starting to see businesses in some parts of the country reopen. And as we mentioned, the president has expressed a lot of optimism about the economy making this big comeback. How much of a turnaround can we expect with these jobs numbers?

HORSLEY: We could see a turnaround, but it's not going to happen overnight. Certainly, the pace of layoffs has declined in recent weeks, but it's going to be a while before employers are ready to start hiring again in large numbers. If there was any flicker of good news in today's report from the Labor Department, it's that a big share of people who lost jobs last month describe their status as temporary. Kevin Hassett, the White House economic adviser, sees that as a good sign.


HASSETT: Almost everyone who's unemployed expects to be reemployed in the next six months. And that, you know, suggests that Americans are doing what Americans do, which is taking a tough hit but remaining optimistic and hopeful.

HORSLEY: Of course, whether people do go back to work in the next six months and keep those jobs will depend in large part on our ability to get and keep the pandemic under control.

CHANG: Right. OK. In the last minute that we have left, I want to go around to each of you right now. Just give me sort of one last thought from each of you about this latest week of this crisis. Nell, let's start with you.

GREENFIELDBOYCE: Oh, boy. More than 76,000 people have already died in the U.S., and there are plenty of places in this country that are still seeing the numbers of new cases rise. So, you know, people may get impatient, but the virus doesn't.

CHANG: All right. Tam, how about you?

KEITH: Yeah. Having two people who work in the White House complex test positive for coronavirus in a matter of days raises questions for everyone about how hard it's going to be to go back to work and keep people safe when they do.

CHANG: And, Scott Horsley, we end with your thought.

HORSLEY: You know, talking this past week with a lot of unemployed people, I was so impressed with their resilience. One young man told me, I'm just trying to not be part of the problem. I think that's a good goal for all of us.

CHANG: Yeah. All right, that was NPR's Scott Horsley, Tamara Keith and Nell Greenfieldboyce.

Thanks to all three of you.

KEITH: You're welcome.

HORSLEY: You're welcome. Transcript provided by NPR, Copyright NPR.

Scott Horsley is NPR's Chief Economics Correspondent. He reports on ups and downs in the national economy as well as fault lines between booming and busting communities.
Tamara Keith has been a White House correspondent for NPR since 2014 and co-hosts the NPR Politics Podcast, the top political news podcast in America. Keith has chronicled the Trump administration from day one, putting this unorthodox presidency in context for NPR listeners, from early morning tweets to executive orders and investigations. She covered the final two years of the Obama presidency, and during the 2016 presidential campaign she was assigned to cover Hillary Clinton. In 2018, Keith was elected to serve on the board of the White House Correspondents' Association.
Nell Greenfieldboyce is a NPR science correspondent.

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