COLD OPEN)
On Plugged In…
Going back to school …
and dealing with coronavirus.
The pandemic forced …
more than a billion children …
out of schools in March …
and into an array …
of education options …
Including none at all.
Now, the challenges ahead …
From kindergarten to college …
To keep students, teachers …
And parents …
Safe and healthy.
My interview …
with the Director …
of the U.S. Centers …
for Disease Control …
Dr. Robert Redfield …
on how best …
to re-open schools …
and the measures …
we need to take …
to reduce the spread …
of COVID 19.
On Plugged In …
Coronavirus: Back to School.
---END OPEN ---
[GRETA OC]
Hello and welcome to Plugged In.
I’m Greta Van Susteren …
reporting from my home …
in Washington DC.
2020’s extended …
summer vacation …
is coming to an end …
with many questions …
about how students …
will go back to school …
amid the coronavirus pandemic.
((VO))
Schools have re-opened …
in parts of Thailand …
and Malaysia.
But a spike in cases …
in Hong Kong …
closed schools there …
shortly after re-opening.
Going back to school …
in South Africa …
means signing …
a letter of consent …
with squirts of hand sanitizer.
In Brazil ---
children wear facemasks …
and shields …
while keeping their distance.
Opening schools is key …
for economic recovery …
providing necessary childcare …
to allow parents …
to go back to work.
[[ON CAM]]
In the United States …
public school systems …
colleges and universities …
are scrambling to determine …
the right balance …
between classroom ...
and distance learning.
In just a few minutes …
I will discuss …
best practices for …
going back to school …
with Dr. Robert Redfield …
the director …
of the Centers …
for Disease Control …
America’s health protection agency.
First, VOA White House …
Correspondent …
Patsy Widakuswara (WEE-duh-koot-swara)…
on the social …
economic and political …
pressures to re-open schools.
[[PKG]]
((NARRATOR))
In the state of New Hampshire...a school using ski lifts for a graduation ceremony to help maintain social distancing – just one of the creative measures American schools have taken during the pandemic.
But beyond pomp and circumstance...Americans schools may soon reopen for a new school year.
((NARRATOR))
President Trump is demanding that it happen on time - in August or September.
((President Donald Trump))
“We're very much going to put pressure on governors and everybody else to open the schools."
((NARRATOR))
Schools are part of the president’s larger plan to resume normal economic function as he eyes his reelection bid in November. Children back in school would allow parents to go back to their workplaces.
The more than 50 million children who attend school in the U.S. did so online after the pandemic hit and before their summer vacations.
The American Academy of Pediatrics has recommended they return to school – in some form -- to keep them from falling behind – a recommendation supported by infectious disease experts.
((Radio track: Including William Schaffner, a professor of infectious diseases at the Vanderbilt University School of Medicine))
((William Schaffner, Vanderbilt University School of Medicine)) ((Zoom))
“Most of us agree that we have to open up our schools again this fall, but we'll see exactly how to do it. Doing it carefully, is very important.
((NARRATOR))
But according to a research by the American Enterprise Institute, only 20% of parents feel safe sending their children back to a school building. Republican parents are twice as likely as Democrats to feel OK doing so.
Mixed messaging from federal and state officials on precautions such as masks, have contributed to parents’ anxiety.
((Radio track: John Bailey is from the American Enterprise Institute))
((John Bailey, American Enterprise Institute)) ((Zoom))
“Reopening of schools isn't just purely a decision that's made by governors and superintendents or principals and teachers. It's a decision that parents have to participate in as well, they have to trust that the schools are putting in place the protections that are going to keep their kids safe. And the problem is when you have conflicting guidance, it creates this untenable situation for parents who try to make a decision with varying types of conflicting guidance on whether or not a school should do X, Y or Z.”
((NARRATOR))
While the coronavirus rarely causes illness in children, there is concern they may transmit the virus to family members like they do with the flu.
((Radio track: William Schaffner of Vanderbilt University School of Medicine))
((William Schaffner, Vanderbilt University School of Medicine)) ((Zoom))
“We don't know that yet about the COVID virus. Does it really infect the children and they can transmit it or is it very difficult for this virus to infect children? Those studies are still underway.”
((NARRATOR))
Beyond the $13 billion allocated in April to help schools and universities move to online learning, it’s unclear whether the federal government plans to provide additional funding to safely reopen schools.
((Patsy Widakuswara, VOA News.))
[[GRETA OC]]
It is estimated …
that it will cost …
an average sized …
U.S. school district …
nearly 1.8 million dollars …
to re-open.
[[GRAPHIC]]
Included in that price tag …
nearly 40-thousand dollars …
for hand sanitizers …
148-thousand for …
disposable facemasks …
for students who forget …
or don’t bring one …
from home …
And 448-thousand dollars …
To hire people …
To clean and disinfect …
Schools and buses.
[[ON CAM]]
The Centers …
for Disease Control ...
is the U.S. government agency …
focused on protecting …
public health.
It has published a checklist …
for schools to use …
to prepare to re-open.
Among the CDC’s considerations …
staggering student arrival …
and departure times ...
Installing physical barriers …
when social distancing …
is difficult.
And keep doors and windows …
open as often as possible …
for fresh air to circulate.
Dr. Robert Redfield …
is the director of …
the CDC.
He has been involved …
in research and care …
of viral infections …
for more than 30 years.
We talked about …
what it’s going to take …
to get students …
back to school.
[[SOT- REDFIELD PART 1]]
GRETA: Alright, let me turn to schools which a huge issue here in this country, is that what's, how do you figure out whether to open schools, not to open schools? We have got public health, we've got the economy, we've got school we got this this tough balance, and I guess for a starter question, do kids transmit to kids?
DR. REDFIELD: you know, right now we don't have a lot of evidence that kids are a critical component of what we call the transmission cycle of this virus.
GRETA: and that would include to adults too?
DR. REDFIELD: yeah, unlike flu, where we know that, you know, childhood school transmission of flu can really see outbreaks in the community. We really don't have that evidence or we don't have it in our household studies that we've done where we've looked at who's bringing the virus into the household, it's usually the adult that's bringing the virus into the household.
The other thing that we know is that children, really, one of the things that's unique about this virus is it can go anything from nothing, no symptoms, all the way to make you critically ill and need to be intubated. The spectrum of illness, as Tony says, as I say is really the largest we've ever seen--
GRETA: --does damage on different organs and might be your heart and my lungs--
DR. REDFIELD: --very large and as you said, it's got some interesting complications with causing coagulopathies and problem with different organs. When we look at kids in general, and individuals under the age of 45, pretty much in the absence of significant medical conditions, this is really an asymptomatic illness. We've looked at the individuals under 18, we've had 52, I think, individuals under 18 that have died, many of which have other comorbidities, out of the first say, 118,000 that we've looked at. So if you look at that, the risk of mortality for individuals under 18 right now is about point one per 100,000, or about 1 in a million with the data that we have right now. As opposed to those people that are over 75, where the risk is really much, much greater, about 3,000 per 100,000.
GRETA: so do you feel comfortable opening schools and even if --you feel absolutely?
DR. REDFIELD: Absolutely.
GRETA: You feel absolutely, comfortable?
DR. REDFIELD: What I feel is this. It has to be done safely. My biggest concern about opening schools is making sure we protect the vulnerable, that we're protecting the teachers, and we're protecting the children that are vulnerable. I would argue that the public health risk, because I don't think it's public health versus opening schools. I think it's public health versus public health. I think the public health risks to K through 12, if continuing to have these schools closed is real. whether it's the absence of mental health services for the 7.1 million kids who get their mental health service in school, whether it's in nutritional services that some of the kids get, whether it's the fact that this is where most of our mandatory reporting for sexual abuse and child abuse is, whether it's the impact of socialization, whether it's really a lot of kids just learn better face to face.
So when I look at the relative risk of say death of covid among kids and compare that to the relative risk of flu, you're far more likely as a child to die from flu. And that's even in an environment where we have a vaccine that if you took, you wouldn't have been at risk. So, I think it really is time.
Now each jurisdiction is going to have to work through it. They're going to have to figure out exactly, you know, we've given guidance. And that's just what it is it's guidance. I've said its guidance to help facilitate the opening of schools. And I don’t want to see it be as a guidance that's a rationale to keep schools closed. And we'll work with the school districts on how to take our guidance and operationalize it in a practical way to get these schools open. But yes, I think it is, from strictly a public health point of view, I'm not going to get into the larger debate but from public health point of view, I think it is extremely important that we open these schools. The vigilance though, it has to be there, is to make sure we're protecting the vulnerable teachers, making sure we have alternatives for children that are vulnerable because of their medical conditions. But I think we can do this in a very thoughtful safe way.
[[GRETA OC]]
More from Dr. Redfield …
About developing new treatments …
and a vaccine …
For COVID ...
Ahead in the show.
First …
among the consequences …
of the world’s focus …
on coronavirus …
are many people …
are not being treated …
for any number …
of medical conditions.
VOA Medical Correspondent …
Carol Pearson …
reports the impact …
is felt most …
by women and children.
[[PKG]]
((NARRATOR)) ((VIDEO: ID: tag:reuters.com,2020:newsml_WDCM3GXGZ:2; HEALTH-CORONAVIRUS/KENYA-AMBULANCES; Free ambulances to the rescue for mothers after dark;
:11 moon rising; 1:27 - 1:59 ambulance sequence))
It's nighttime in Nairobi and a pregnant woman is in labor. An ambulance service started by health workers takes her to the hospital. When the government imposed a curfew to contain the coronavirus pandemic, doctors noticed an increase in deaths of women giving birth alone, at home, so they moved into action to save women's lives.
((radio: Richard Namu is an emergency response operator))
((Richard Namu, Emergency Response Operator))
"Maternity-related cases has gone higher. On average we are doing two calls per night."
((NARRATOR))
What's happening in Nairobi is happening worldwide, even in rich countries. A U.N. report shows that health services are being taken away from women, children under the age of 5 and adolescents in order to fight the coronavirus pandemic. The consequences are devastating.
((Mandatory CG: ZOOM))
((Dr. Nicholas Alipui, UN Report Panel Member)) ((Alipui interview 6:55 - 7:30))
((Radio: Dr. Nicholas Alipui is an expert on child and maternal health who contributed to the study))
"Initial estimates are projecting that we will see a major impact on under 5 mortality rates, mortality rates for newborns, for maternal mortality. The numbers of malnourished children, children who are exposed to abuse and violence, critical loss of access to women's health, etc., so, the estimates are quite dire."
((NARRATOR)) ((video: children, schools, vaccine vials, women and children))
The report estimates that nearly 400 million children are going hungry because they are missing meals at schools that are closed. Thirteen million children are missing vaccinations. Some parents are afraid to take their children to get their shots and some countries have a shortage of vaccines.
((Radio: Dr. Alipui says if this continues, we could see global outbreaks of preventable disease.))
((Dr. Nicholas Alipui, UN Report Panel Member)) ((Alipui interview 12: - 12:44))
"The risk of a new and renewed outbreak of measles, polio and all these other infectious diseases, is actually real, and it's something that we need to be prepared for."
((NARRATOR)) ((women and girls; pregnant women, women in labor, ))
The report also finds that women and girls worldwide are experiencing higher rates of abuse, increased pregnancies, less access to reproductive services, and along with that, more mothers are dying from complications of childbirth.
Dr. Alipui says a vaccine, once developed, will end the COVID-19 crisis, but rich countries, he says, will have to help the poorer countries strengthen their health systems, because the pandemic will leave the poor even more destitute than before.
((Carol Pearson, VOA News Washington))
[[GRETA oc]]
It will likely take …
A medical breakthrough …
To get school …
the economy …
and so much of everyday life …
back to some sort of normal.
I asked …
the director …
of the U.S. Centers …
for Disease Control …
Dr. Robert Redfield …
where we stand …
on developing a vaccine …
and other treatments …
for coronavirus.
[[SOT – REDFIELD PART 2]]
GRETA: Now, I want to talk about vaccines, where we are. But before that, since we have so many hotspots in the world, is that people obviously are worried about vaccines, but they're also worried in the short time about treatments. And it seems to me that the one that's that seems to have the most faith, at least in the public domain right now might be, is Remdesivir, which was developed for Ebola. Am I right, that that sort of is the leading contender but we're always looking for more and better?
DR. REDFIELD: Well it's the important first step. I mean Remdesivir is an important step, what has been shown and proven now to actually have improvement. It can lower the length of stay in individuals in intensive care, and a very special subgroup, if it started at the right time, it does appear to actually decrease mortality. Important advancement that's out now.
GRETA: And is that because it's sort of like Tamiflu to the flu? It reduces the viral load so if you have less viruses in your system you're less likely get so sick?
DR. REDFIELD: It clearly is antiviral. that's how it works. Its challenge is once you've already, when this virus causes infection in your body, it gets to a stage that actually what's really causing disease for you is not the virus, but your body's response to it, the inflammation. So when you're in that inflammation phase, Remdesivir isn’t going to work so much. That's when you heard the recent data about steroids. Steroids work helping save lives when you're in the inflammation phase. Remdesivir helps when you're in the viral replication phase.
GRETA: which is why then the popularity of Dexamethasone, which is the steroid that's been around forever. So that it tells your body, your immune system, quit inflaming.
DR. REDFIELD: Yeah, quit inflaming. It tells you a lot about the pathogenesis, when Tony and I saw that data come out about Dexamethasone, we immediately said, you know, ‘okay confirms our suspicions in the pathogenesis that when we see patients starting getting better. And then all of a sudden they crash, very rapidly on say, day 9,10,11- that's really their body causing a pro-inflammatory response in their lungs, causing pulmonary insufficiency. Steroids work there.
10:18 Now there's other therapies that are coming on the line right now, they're under evaluation. Taking the serum plasma from people that have convalesced infection. And right now there's a large trial over 30,000 people that have been receiving the plasma of individuals that have recovered, to see if that can provide antibodies that will provide benefit to those individuals.
GRETA: Hydroxychloroquine is another drug we've heard a lot about. In the beginning it was given a lot of attention, then people backed off, then you hear a little bit more about it. What is sort of the current state of affairs with hydroxychloroquine? And is it prophylactic, or is it a treatment once you have it?
DR. REDFIELD: Yeah, I think the key here is looking at the controlled clinical trials. And as you know, you have some that clearly have not shown benefit yet --a recent one announced in Detroit where there was some benefit earlier on. This sort of falls into the range right now, until the data is definitive, of what I call clinical judgment. You know I'm a physician an internist in infectious disease. And I think each individual clinician makes a decision with their patient about their own circumstance, whether they try to use some of these drugs that are approved for another indication. But, you know, Tony Fauci and I would say, we think that this drug really needs to be evaluated by rigorous clinical trials to see what its role is ultimately, therapeutically.
GRETA: and I should add that, that's been used for malaria so at least it is safe from that perspective for-
DR. REDFIELD: and used for lupus, yes for lupus it's a drug we know the safety profile very well.
GRETA: Scientists always look, as you say, you know you're very careful and you want studies and you want trials and I got that. But if you are sick, and you have coronavirus and you have placed in front of you Remdesivir, convalescent plasma, or hydroxychloroquine. Which one are you going to grab right now realizing that, you know, six months from now your answer, maybe in a month now, would be different -which one are you going to grab?
DR. REDFIELD: It depends on where I am. if I'm in the hospital and all of a sudden I'm starting to, we call it desaturate, meaning my ability to oxygenate my blood is starting to not work the way it's supposed to. I hope that the physicians in there will be able to put me on Remdesivir at this point in time.
GRETA: so okay but it may change even an hour or two.
DR. REDFIELD: I hope that we're going to hear about convalescent serum and monoclonal antibodies in the next eight weeks. and we're going to have a bigger portfolio.
GRETA: Now the vaccine, I read there's something like 160 170 places around the world right now, looking at a vaccine for the big race it's like the race to the moon almost. Is that right, a number of places around the world looking at it?
Dr. REDFIELD: but yeah this is the big one. This is clearly, I want to remind people, I mean this is, this is the key. Biomedical innovation. When I started in my practice of medicine with HIV my patients had a 10 month survival. Now they can live a natural lifetime. Science is going to solve this problem, Okay?
But we're in a race right now because clearly this virus has the potential to particularly cost the life of those of us that are vulnerable, that have multiple precondition medical conditions. We've seen obviously in our nursing homes, we've seen individuals over the age of 75. And this virus is clearly not --- it's here with us right now. We had hoped that it would dissipate over the summer, we didn't see that.
So we're getting ready for the virus in the fall to be complicated with the flu virus at the same time, which is going to be a difficult time for us where we have both. and so racing to try to make sure we can get an effective vaccine to begin to protect the vulnerable, protect those individuals that are first responders and then ultimately protect the American public, and then the rest of the world is really a goal and when they use the term Operation Warp Speed, this is really a highly accelerated program, not to undermine scientific integrity, not to cut short to safety.
What really has been cut out of the process that usually takes multiple years is the decisions to invest in the product at the time it goes into a phase three trials, as if it works, to produce it , 100 million doses. At the end of the day we may have a lot of souvenirs, from the different vaccines that we bought ahead of time. But the reality is, if one or more of these vaccines work, the moment we know it works, the FDA knows it works. There'll be 100 million doses of that particular vaccine available to the American people we won't have that delay.
[[GRETA OC]]
More of our conversation …
in a moment.
First, some background …
on Dr. Robert Redfield …
who has been …
on the frontlines ….
of public health …
for more than 30 years …
particularly in the areas …
of viral infections …
and H-I-V.
[[PKG]]
((VO))
Robert Ray Redfield is the current Director…
Of the Centers for Disease Control in Atlanta, Georgia…
And head administrator
At the Agency for Toxic Substances and Disease.
At 69 - Dr. Redfield has been on the frontlines of public health and research for over three decades…
Particularly in the areas of viral infections, and HIV.
He was founding director of the department of retroviral research in the US Military’s HIV Research Program…
And he served as Chief of Infectious Diseases at the University of Maryland’s School of Medicine.
Dr. Redfield has made a number of important contributions to our scientific understanding of HIV.
That includes the potential for viral transmission among heterosexual couples…
Which has helped reduce some of the social stigma once associated with HIV-AIDS.
In addition to his research…
Dr. Redfield oversaw an extensive clinical program – that treated more than 5000 HIV patients in the Baltimore/Washington, D.C. community.
In 2005, Dr. Redfield was appointed to President George W. Bush’s Advisory Council on HIV/AIDS.
And in January this year, he was named one of the key members of President Donald Trump’s coronavirus task force.
[[SOT- REDFIELD PART 3]]
GRETA: Would you go to a big event, enclosed, like a concert, a rally, or a political convention or a church, without a mask? And would you go to one with one if everyone's wearing a mask?
DR. REDFIELD: Yeah, and that's the key here, and I think it's an important point for me to emphasize. The key is the mask. If we all, if this whole nation, really decided to make the personal responsibility and sacrifice like many of our ancestors had to do in World War One and World War Two--- if we just all did one thing, we all just decided for the next 4-6-8 weeks we're going to wear masks, all of us. This outbreak would really come to a halt. I mean the mass really do work. You can seem them in WAR today from CDC coming out about hair salonists that were infected, but they wore a mask and they were, they didn't see any transmission. We have household contact studies coming out that the households, or someone was infected in the household, but they all usde the social distancing, masks, hand washings, we didn't see transmission if they didn't do that, we saw over 70% transmission. So one of the things I can say for sure-- face coverings and masks really work. I tell people, we're not defenseless against this virus. We have one of the most powerful weapons in the world--
((CROSSTALK))
GRETA: Even the mask-
DR. REDFIELD: you can see, little mask. I have another one that's a little more, you know, stylish.
GRETA: I have an N- 95, I have a bunch of those--
DR. REDFIELD: This little ditzy mask. All right, this is a powerful weapon against this virus, alright, and if we all did this, Right? And we wash our hands. And we have vigilance about closing operations that promote irresponsible behavior. I'm a big advocate of closing bars right now. Because I think people that spent too much time in bars are not social distancing and not wearing their mask and they're not optimizing what I'm asking them to do is to be part of the solution. But we could actually bring this down. We could, we could defeat this enemy, if everyone just made a commitment for the next four or 5,6,7,8 weeks to really be vigilant about wearing a mask. We know this now works. I wish I knew it worked six months ago, I didn't know it works.
GRETA: Why didn’t we know six months ago?
DR. REDFIELD: we didn't have the data. Again, CDC, unfortunately, and fortunately- is not an opinion organization. It's an organization that is science-based data driven. We've got to get the science and data. You'll see, we're coming out with an M&W today, I have an editorial today in JAMA the American Medical Journal, American Medical Association again, about the importance of the fact that the masks work. So wear a mask. Wash your hands. All right. Don't decide right now-- particularly the millennials and the Generation X, you know, take a take a break from the bars right now. And I don't want people to close the bar just to go in their home and have a big gathering in their home, okay, please? You know I don't want that either. I really want people to take this seriously. I had hoped that the summer was going to be easier for us. It's clearly not. we don't know this virus, I think the thing that I keep trying to repeat when people ask me what do you predict? The fact is I can't predict. I don't know this virus, I know flu.
GRETA: Let me ask you one last question and it's because we have a large African audience here-- is that a colleague, former colleague of yours, Dr. Robert Gallo, talked to me about bridge vaccines and the live polio vaccine which we don't use here in the United States and haven't since 1997, but was used in Africa as well as the TB vaccine as a temporary sort of bridge vaccine and as I understand it, it doesn't deal directly with coronavirus but it tells your immune system to do something special in the short run, so you don't get the coronavirus. Is there any new, do you have any thought on this bridge vaccine because it's cheap, it's 12 cents a dose?
DR. REDFIELD: Well I think it's a great idea, I told Bob this myself. I mean it's actually based on an observation that was made by colleagues of his parents in Russia, the Soviet Union many years ago where they received the polio vaccine during an influenza epidemic. And it was observed that the people that had been the vaccine recipients didn't get severe flu.
GRETA: Are we seeing that in Africa where they're using this particular polio vaccine is there, are they having a less incidents of COVID-19?
DR. REDFIELD: it's really important because you point out some of the some of the sideline tragedies of this pandemic. Because one of the things that's happened in Africa is these immunization programs have been curtailed. So right now most African children are not going to die from coronavirus, I told you it's not that pathogenic. But over 120 millions haven't gotten their measles vaccine. and measles kills. All right, so I do believe the idea that Bob's talked about, viral interference where you give a live RNA product, and that product replicates. It may teach the cells to develop some defense mechanisms when another RNA virus comes in, that it makes it so that RNA virus can’t commit its lifecycle. Very recently something with similar said about BCG too-- that live product, to see if that does it.
So I'm an advocate. I know our people are looking at those individuals that are getting polio vaccine now, and are getting measles vaccine, what are we seeing difference about the occurrence of coronavirus but I think it's, he's an innovative scientist for more than 60 years. I think it's something that warrants being pursued.
GRETA: And the last thing is that you can't get the virus if you don't come in contact with it.
DR. REDFIELD: can’t get the virus--
GRETA: It’s impossible to get it if you don't come in contact with it. That's an important point, I mean people are afraid of it, but if you wear your masks, you stay far away, you don't come near the virus, you're not getting it.
REDFIELD: So I want to come back to that, that while people worry, and I have 11 grandkids. You know, I have one grandchild with cystic fibrosis--- I think people need to have enormous comfort that they've got a lot of power to prevent this virus from entering themselves, the vulnerable people they love, and their children. It's just a change in--
You know, a lot of people didn't think the American Society was going to adapt to masks. You know, but the fact is, from my travel when I was in North Carolina yesterday, I didn’t see a single person in the airport, or on the airplane or in in Mecklenburg area that I was walking, actually, that wasn't wearing a mask. I think it's-- the people are getting it. And I just want to make sure that we reinforce that, that this is a powerful weapon. If we do this, we can get this outbreak under control.
[[GRETA OC]]
That is all the time we have.
My thanks to…
CDC Director …
Dr. Robert Redfield…
for sharing his insight…
on the coronavirus pandemic.
For more on this story…
and the latest news…
from around the globe…
please visit our website…
at VOANews.com.
And follow me on Twitter @Greta.
Thank you for being Plugged In.
On Plugged In…
Going back to school …
and dealing with coronavirus.
The pandemic forced …
more than a billion children …
out of schools in March …
and into an array …
of education options …
Including none at all.
Now, the challenges ahead …
From kindergarten to college …
To keep students, teachers …
And parents …
Safe and healthy.
My interview …
with the Director …
of the U.S. Centers …
for Disease Control …
Dr. Robert Redfield …
on how best …
to re-open schools …
and the measures …
we need to take …
to reduce the spread …
of COVID 19.
On Plugged In …
Coronavirus: Back to School.
---END OPEN ---
[GRETA OC]
Hello and welcome to Plugged In.
I’m Greta Van Susteren …
reporting from my home …
in Washington DC.
2020’s extended …
summer vacation …
is coming to an end …
with many questions …
about how students …
will go back to school …
amid the coronavirus pandemic.
((VO))
Schools have re-opened …
in parts of Thailand …
and Malaysia.
But a spike in cases …
in Hong Kong …
closed schools there …
shortly after re-opening.
Going back to school …
in South Africa …
means signing …
a letter of consent …
with squirts of hand sanitizer.
In Brazil ---
children wear facemasks …
and shields …
while keeping their distance.
Opening schools is key …
for economic recovery …
providing necessary childcare …
to allow parents …
to go back to work.
[[ON CAM]]
In the United States …
public school systems …
colleges and universities …
are scrambling to determine …
the right balance …
between classroom ...
and distance learning.
In just a few minutes …
I will discuss …
best practices for …
going back to school …
with Dr. Robert Redfield …
the director …
of the Centers …
for Disease Control …
America’s health protection agency.
First, VOA White House …
Correspondent …
Patsy Widakuswara (WEE-duh-koot-swara)…
on the social …
economic and political …
pressures to re-open schools.
[[PKG]]
((NARRATOR))
In the state of New Hampshire...a school using ski lifts for a graduation ceremony to help maintain social distancing – just one of the creative measures American schools have taken during the pandemic.
But beyond pomp and circumstance...Americans schools may soon reopen for a new school year.
((NARRATOR))
President Trump is demanding that it happen on time - in August or September.
((President Donald Trump))
“We're very much going to put pressure on governors and everybody else to open the schools."
((NARRATOR))
Schools are part of the president’s larger plan to resume normal economic function as he eyes his reelection bid in November. Children back in school would allow parents to go back to their workplaces.
The more than 50 million children who attend school in the U.S. did so online after the pandemic hit and before their summer vacations.
The American Academy of Pediatrics has recommended they return to school – in some form -- to keep them from falling behind – a recommendation supported by infectious disease experts.
((Radio track: Including William Schaffner, a professor of infectious diseases at the Vanderbilt University School of Medicine))
((William Schaffner, Vanderbilt University School of Medicine)) ((Zoom))
“Most of us agree that we have to open up our schools again this fall, but we'll see exactly how to do it. Doing it carefully, is very important.
((NARRATOR))
But according to a research by the American Enterprise Institute, only 20% of parents feel safe sending their children back to a school building. Republican parents are twice as likely as Democrats to feel OK doing so.
Mixed messaging from federal and state officials on precautions such as masks, have contributed to parents’ anxiety.
((Radio track: John Bailey is from the American Enterprise Institute))
((John Bailey, American Enterprise Institute)) ((Zoom))
“Reopening of schools isn't just purely a decision that's made by governors and superintendents or principals and teachers. It's a decision that parents have to participate in as well, they have to trust that the schools are putting in place the protections that are going to keep their kids safe. And the problem is when you have conflicting guidance, it creates this untenable situation for parents who try to make a decision with varying types of conflicting guidance on whether or not a school should do X, Y or Z.”
((NARRATOR))
While the coronavirus rarely causes illness in children, there is concern they may transmit the virus to family members like they do with the flu.
((Radio track: William Schaffner of Vanderbilt University School of Medicine))
((William Schaffner, Vanderbilt University School of Medicine)) ((Zoom))
“We don't know that yet about the COVID virus. Does it really infect the children and they can transmit it or is it very difficult for this virus to infect children? Those studies are still underway.”
((NARRATOR))
Beyond the $13 billion allocated in April to help schools and universities move to online learning, it’s unclear whether the federal government plans to provide additional funding to safely reopen schools.
((Patsy Widakuswara, VOA News.))
[[GRETA OC]]
It is estimated …
that it will cost …
an average sized …
U.S. school district …
nearly 1.8 million dollars …
to re-open.
[[GRAPHIC]]
Included in that price tag …
nearly 40-thousand dollars …
for hand sanitizers …
148-thousand for …
disposable facemasks …
for students who forget …
or don’t bring one …
from home …
And 448-thousand dollars …
To hire people …
To clean and disinfect …
Schools and buses.
[[ON CAM]]
The Centers …
for Disease Control ...
is the U.S. government agency …
focused on protecting …
public health.
It has published a checklist …
for schools to use …
to prepare to re-open.
Among the CDC’s considerations …
staggering student arrival …
and departure times ...
Installing physical barriers …
when social distancing …
is difficult.
And keep doors and windows …
open as often as possible …
for fresh air to circulate.
Dr. Robert Redfield …
is the director of …
the CDC.
He has been involved …
in research and care …
of viral infections …
for more than 30 years.
We talked about …
what it’s going to take …
to get students …
back to school.
[[SOT- REDFIELD PART 1]]
GRETA: Alright, let me turn to schools which a huge issue here in this country, is that what's, how do you figure out whether to open schools, not to open schools? We have got public health, we've got the economy, we've got school we got this this tough balance, and I guess for a starter question, do kids transmit to kids?
DR. REDFIELD: you know, right now we don't have a lot of evidence that kids are a critical component of what we call the transmission cycle of this virus.
GRETA: and that would include to adults too?
DR. REDFIELD: yeah, unlike flu, where we know that, you know, childhood school transmission of flu can really see outbreaks in the community. We really don't have that evidence or we don't have it in our household studies that we've done where we've looked at who's bringing the virus into the household, it's usually the adult that's bringing the virus into the household.
The other thing that we know is that children, really, one of the things that's unique about this virus is it can go anything from nothing, no symptoms, all the way to make you critically ill and need to be intubated. The spectrum of illness, as Tony says, as I say is really the largest we've ever seen--
GRETA: --does damage on different organs and might be your heart and my lungs--
DR. REDFIELD: --very large and as you said, it's got some interesting complications with causing coagulopathies and problem with different organs. When we look at kids in general, and individuals under the age of 45, pretty much in the absence of significant medical conditions, this is really an asymptomatic illness. We've looked at the individuals under 18, we've had 52, I think, individuals under 18 that have died, many of which have other comorbidities, out of the first say, 118,000 that we've looked at. So if you look at that, the risk of mortality for individuals under 18 right now is about point one per 100,000, or about 1 in a million with the data that we have right now. As opposed to those people that are over 75, where the risk is really much, much greater, about 3,000 per 100,000.
GRETA: so do you feel comfortable opening schools and even if --you feel absolutely?
DR. REDFIELD: Absolutely.
GRETA: You feel absolutely, comfortable?
DR. REDFIELD: What I feel is this. It has to be done safely. My biggest concern about opening schools is making sure we protect the vulnerable, that we're protecting the teachers, and we're protecting the children that are vulnerable. I would argue that the public health risk, because I don't think it's public health versus opening schools. I think it's public health versus public health. I think the public health risks to K through 12, if continuing to have these schools closed is real. whether it's the absence of mental health services for the 7.1 million kids who get their mental health service in school, whether it's in nutritional services that some of the kids get, whether it's the fact that this is where most of our mandatory reporting for sexual abuse and child abuse is, whether it's the impact of socialization, whether it's really a lot of kids just learn better face to face.
So when I look at the relative risk of say death of covid among kids and compare that to the relative risk of flu, you're far more likely as a child to die from flu. And that's even in an environment where we have a vaccine that if you took, you wouldn't have been at risk. So, I think it really is time.
Now each jurisdiction is going to have to work through it. They're going to have to figure out exactly, you know, we've given guidance. And that's just what it is it's guidance. I've said its guidance to help facilitate the opening of schools. And I don’t want to see it be as a guidance that's a rationale to keep schools closed. And we'll work with the school districts on how to take our guidance and operationalize it in a practical way to get these schools open. But yes, I think it is, from strictly a public health point of view, I'm not going to get into the larger debate but from public health point of view, I think it is extremely important that we open these schools. The vigilance though, it has to be there, is to make sure we're protecting the vulnerable teachers, making sure we have alternatives for children that are vulnerable because of their medical conditions. But I think we can do this in a very thoughtful safe way.
[[GRETA OC]]
More from Dr. Redfield …
About developing new treatments …
and a vaccine …
For COVID ...
Ahead in the show.
First …
among the consequences …
of the world’s focus …
on coronavirus …
are many people …
are not being treated …
for any number …
of medical conditions.
VOA Medical Correspondent …
Carol Pearson …
reports the impact …
is felt most …
by women and children.
[[PKG]]
((NARRATOR)) ((VIDEO: ID: tag:reuters.com,2020:newsml_WDCM3GXGZ:2; HEALTH-CORONAVIRUS/KENYA-AMBULANCES; Free ambulances to the rescue for mothers after dark;
:11 moon rising; 1:27 - 1:59 ambulance sequence))
It's nighttime in Nairobi and a pregnant woman is in labor. An ambulance service started by health workers takes her to the hospital. When the government imposed a curfew to contain the coronavirus pandemic, doctors noticed an increase in deaths of women giving birth alone, at home, so they moved into action to save women's lives.
((radio: Richard Namu is an emergency response operator))
((Richard Namu, Emergency Response Operator))
"Maternity-related cases has gone higher. On average we are doing two calls per night."
((NARRATOR))
What's happening in Nairobi is happening worldwide, even in rich countries. A U.N. report shows that health services are being taken away from women, children under the age of 5 and adolescents in order to fight the coronavirus pandemic. The consequences are devastating.
((Mandatory CG: ZOOM))
((Dr. Nicholas Alipui, UN Report Panel Member)) ((Alipui interview 6:55 - 7:30))
((Radio: Dr. Nicholas Alipui is an expert on child and maternal health who contributed to the study))
"Initial estimates are projecting that we will see a major impact on under 5 mortality rates, mortality rates for newborns, for maternal mortality. The numbers of malnourished children, children who are exposed to abuse and violence, critical loss of access to women's health, etc., so, the estimates are quite dire."
((NARRATOR)) ((video: children, schools, vaccine vials, women and children))
The report estimates that nearly 400 million children are going hungry because they are missing meals at schools that are closed. Thirteen million children are missing vaccinations. Some parents are afraid to take their children to get their shots and some countries have a shortage of vaccines.
((Radio: Dr. Alipui says if this continues, we could see global outbreaks of preventable disease.))
((Dr. Nicholas Alipui, UN Report Panel Member)) ((Alipui interview 12: - 12:44))
"The risk of a new and renewed outbreak of measles, polio and all these other infectious diseases, is actually real, and it's something that we need to be prepared for."
((NARRATOR)) ((women and girls; pregnant women, women in labor, ))
The report also finds that women and girls worldwide are experiencing higher rates of abuse, increased pregnancies, less access to reproductive services, and along with that, more mothers are dying from complications of childbirth.
Dr. Alipui says a vaccine, once developed, will end the COVID-19 crisis, but rich countries, he says, will have to help the poorer countries strengthen their health systems, because the pandemic will leave the poor even more destitute than before.
((Carol Pearson, VOA News Washington))
[[GRETA oc]]
It will likely take …
A medical breakthrough …
To get school …
the economy …
and so much of everyday life …
back to some sort of normal.
I asked …
the director …
of the U.S. Centers …
for Disease Control …
Dr. Robert Redfield …
where we stand …
on developing a vaccine …
and other treatments …
for coronavirus.
[[SOT – REDFIELD PART 2]]
GRETA: Now, I want to talk about vaccines, where we are. But before that, since we have so many hotspots in the world, is that people obviously are worried about vaccines, but they're also worried in the short time about treatments. And it seems to me that the one that's that seems to have the most faith, at least in the public domain right now might be, is Remdesivir, which was developed for Ebola. Am I right, that that sort of is the leading contender but we're always looking for more and better?
DR. REDFIELD: Well it's the important first step. I mean Remdesivir is an important step, what has been shown and proven now to actually have improvement. It can lower the length of stay in individuals in intensive care, and a very special subgroup, if it started at the right time, it does appear to actually decrease mortality. Important advancement that's out now.
GRETA: And is that because it's sort of like Tamiflu to the flu? It reduces the viral load so if you have less viruses in your system you're less likely get so sick?
DR. REDFIELD: It clearly is antiviral. that's how it works. Its challenge is once you've already, when this virus causes infection in your body, it gets to a stage that actually what's really causing disease for you is not the virus, but your body's response to it, the inflammation. So when you're in that inflammation phase, Remdesivir isn’t going to work so much. That's when you heard the recent data about steroids. Steroids work helping save lives when you're in the inflammation phase. Remdesivir helps when you're in the viral replication phase.
GRETA: which is why then the popularity of Dexamethasone, which is the steroid that's been around forever. So that it tells your body, your immune system, quit inflaming.
DR. REDFIELD: Yeah, quit inflaming. It tells you a lot about the pathogenesis, when Tony and I saw that data come out about Dexamethasone, we immediately said, you know, ‘okay confirms our suspicions in the pathogenesis that when we see patients starting getting better. And then all of a sudden they crash, very rapidly on say, day 9,10,11- that's really their body causing a pro-inflammatory response in their lungs, causing pulmonary insufficiency. Steroids work there.
10:18 Now there's other therapies that are coming on the line right now, they're under evaluation. Taking the serum plasma from people that have convalesced infection. And right now there's a large trial over 30,000 people that have been receiving the plasma of individuals that have recovered, to see if that can provide antibodies that will provide benefit to those individuals.
GRETA: Hydroxychloroquine is another drug we've heard a lot about. In the beginning it was given a lot of attention, then people backed off, then you hear a little bit more about it. What is sort of the current state of affairs with hydroxychloroquine? And is it prophylactic, or is it a treatment once you have it?
DR. REDFIELD: Yeah, I think the key here is looking at the controlled clinical trials. And as you know, you have some that clearly have not shown benefit yet --a recent one announced in Detroit where there was some benefit earlier on. This sort of falls into the range right now, until the data is definitive, of what I call clinical judgment. You know I'm a physician an internist in infectious disease. And I think each individual clinician makes a decision with their patient about their own circumstance, whether they try to use some of these drugs that are approved for another indication. But, you know, Tony Fauci and I would say, we think that this drug really needs to be evaluated by rigorous clinical trials to see what its role is ultimately, therapeutically.
GRETA: and I should add that, that's been used for malaria so at least it is safe from that perspective for-
DR. REDFIELD: and used for lupus, yes for lupus it's a drug we know the safety profile very well.
GRETA: Scientists always look, as you say, you know you're very careful and you want studies and you want trials and I got that. But if you are sick, and you have coronavirus and you have placed in front of you Remdesivir, convalescent plasma, or hydroxychloroquine. Which one are you going to grab right now realizing that, you know, six months from now your answer, maybe in a month now, would be different -which one are you going to grab?
DR. REDFIELD: It depends on where I am. if I'm in the hospital and all of a sudden I'm starting to, we call it desaturate, meaning my ability to oxygenate my blood is starting to not work the way it's supposed to. I hope that the physicians in there will be able to put me on Remdesivir at this point in time.
GRETA: so okay but it may change even an hour or two.
DR. REDFIELD: I hope that we're going to hear about convalescent serum and monoclonal antibodies in the next eight weeks. and we're going to have a bigger portfolio.
GRETA: Now the vaccine, I read there's something like 160 170 places around the world right now, looking at a vaccine for the big race it's like the race to the moon almost. Is that right, a number of places around the world looking at it?
Dr. REDFIELD: but yeah this is the big one. This is clearly, I want to remind people, I mean this is, this is the key. Biomedical innovation. When I started in my practice of medicine with HIV my patients had a 10 month survival. Now they can live a natural lifetime. Science is going to solve this problem, Okay?
But we're in a race right now because clearly this virus has the potential to particularly cost the life of those of us that are vulnerable, that have multiple precondition medical conditions. We've seen obviously in our nursing homes, we've seen individuals over the age of 75. And this virus is clearly not --- it's here with us right now. We had hoped that it would dissipate over the summer, we didn't see that.
So we're getting ready for the virus in the fall to be complicated with the flu virus at the same time, which is going to be a difficult time for us where we have both. and so racing to try to make sure we can get an effective vaccine to begin to protect the vulnerable, protect those individuals that are first responders and then ultimately protect the American public, and then the rest of the world is really a goal and when they use the term Operation Warp Speed, this is really a highly accelerated program, not to undermine scientific integrity, not to cut short to safety.
What really has been cut out of the process that usually takes multiple years is the decisions to invest in the product at the time it goes into a phase three trials, as if it works, to produce it , 100 million doses. At the end of the day we may have a lot of souvenirs, from the different vaccines that we bought ahead of time. But the reality is, if one or more of these vaccines work, the moment we know it works, the FDA knows it works. There'll be 100 million doses of that particular vaccine available to the American people we won't have that delay.
[[GRETA OC]]
More of our conversation …
in a moment.
First, some background …
on Dr. Robert Redfield …
who has been …
on the frontlines ….
of public health …
for more than 30 years …
particularly in the areas …
of viral infections …
and H-I-V.
[[PKG]]
((VO))
Robert Ray Redfield is the current Director…
Of the Centers for Disease Control in Atlanta, Georgia…
And head administrator
At the Agency for Toxic Substances and Disease.
At 69 - Dr. Redfield has been on the frontlines of public health and research for over three decades…
Particularly in the areas of viral infections, and HIV.
He was founding director of the department of retroviral research in the US Military’s HIV Research Program…
And he served as Chief of Infectious Diseases at the University of Maryland’s School of Medicine.
Dr. Redfield has made a number of important contributions to our scientific understanding of HIV.
That includes the potential for viral transmission among heterosexual couples…
Which has helped reduce some of the social stigma once associated with HIV-AIDS.
In addition to his research…
Dr. Redfield oversaw an extensive clinical program – that treated more than 5000 HIV patients in the Baltimore/Washington, D.C. community.
In 2005, Dr. Redfield was appointed to President George W. Bush’s Advisory Council on HIV/AIDS.
And in January this year, he was named one of the key members of President Donald Trump’s coronavirus task force.
[[SOT- REDFIELD PART 3]]
GRETA: Would you go to a big event, enclosed, like a concert, a rally, or a political convention or a church, without a mask? And would you go to one with one if everyone's wearing a mask?
DR. REDFIELD: Yeah, and that's the key here, and I think it's an important point for me to emphasize. The key is the mask. If we all, if this whole nation, really decided to make the personal responsibility and sacrifice like many of our ancestors had to do in World War One and World War Two--- if we just all did one thing, we all just decided for the next 4-6-8 weeks we're going to wear masks, all of us. This outbreak would really come to a halt. I mean the mass really do work. You can seem them in WAR today from CDC coming out about hair salonists that were infected, but they wore a mask and they were, they didn't see any transmission. We have household contact studies coming out that the households, or someone was infected in the household, but they all usde the social distancing, masks, hand washings, we didn't see transmission if they didn't do that, we saw over 70% transmission. So one of the things I can say for sure-- face coverings and masks really work. I tell people, we're not defenseless against this virus. We have one of the most powerful weapons in the world--
((CROSSTALK))
GRETA: Even the mask-
DR. REDFIELD: you can see, little mask. I have another one that's a little more, you know, stylish.
GRETA: I have an N- 95, I have a bunch of those--
DR. REDFIELD: This little ditzy mask. All right, this is a powerful weapon against this virus, alright, and if we all did this, Right? And we wash our hands. And we have vigilance about closing operations that promote irresponsible behavior. I'm a big advocate of closing bars right now. Because I think people that spent too much time in bars are not social distancing and not wearing their mask and they're not optimizing what I'm asking them to do is to be part of the solution. But we could actually bring this down. We could, we could defeat this enemy, if everyone just made a commitment for the next four or 5,6,7,8 weeks to really be vigilant about wearing a mask. We know this now works. I wish I knew it worked six months ago, I didn't know it works.
GRETA: Why didn’t we know six months ago?
DR. REDFIELD: we didn't have the data. Again, CDC, unfortunately, and fortunately- is not an opinion organization. It's an organization that is science-based data driven. We've got to get the science and data. You'll see, we're coming out with an M&W today, I have an editorial today in JAMA the American Medical Journal, American Medical Association again, about the importance of the fact that the masks work. So wear a mask. Wash your hands. All right. Don't decide right now-- particularly the millennials and the Generation X, you know, take a take a break from the bars right now. And I don't want people to close the bar just to go in their home and have a big gathering in their home, okay, please? You know I don't want that either. I really want people to take this seriously. I had hoped that the summer was going to be easier for us. It's clearly not. we don't know this virus, I think the thing that I keep trying to repeat when people ask me what do you predict? The fact is I can't predict. I don't know this virus, I know flu.
GRETA: Let me ask you one last question and it's because we have a large African audience here-- is that a colleague, former colleague of yours, Dr. Robert Gallo, talked to me about bridge vaccines and the live polio vaccine which we don't use here in the United States and haven't since 1997, but was used in Africa as well as the TB vaccine as a temporary sort of bridge vaccine and as I understand it, it doesn't deal directly with coronavirus but it tells your immune system to do something special in the short run, so you don't get the coronavirus. Is there any new, do you have any thought on this bridge vaccine because it's cheap, it's 12 cents a dose?
DR. REDFIELD: Well I think it's a great idea, I told Bob this myself. I mean it's actually based on an observation that was made by colleagues of his parents in Russia, the Soviet Union many years ago where they received the polio vaccine during an influenza epidemic. And it was observed that the people that had been the vaccine recipients didn't get severe flu.
GRETA: Are we seeing that in Africa where they're using this particular polio vaccine is there, are they having a less incidents of COVID-19?
DR. REDFIELD: it's really important because you point out some of the some of the sideline tragedies of this pandemic. Because one of the things that's happened in Africa is these immunization programs have been curtailed. So right now most African children are not going to die from coronavirus, I told you it's not that pathogenic. But over 120 millions haven't gotten their measles vaccine. and measles kills. All right, so I do believe the idea that Bob's talked about, viral interference where you give a live RNA product, and that product replicates. It may teach the cells to develop some defense mechanisms when another RNA virus comes in, that it makes it so that RNA virus can’t commit its lifecycle. Very recently something with similar said about BCG too-- that live product, to see if that does it.
So I'm an advocate. I know our people are looking at those individuals that are getting polio vaccine now, and are getting measles vaccine, what are we seeing difference about the occurrence of coronavirus but I think it's, he's an innovative scientist for more than 60 years. I think it's something that warrants being pursued.
GRETA: And the last thing is that you can't get the virus if you don't come in contact with it.
DR. REDFIELD: can’t get the virus--
GRETA: It’s impossible to get it if you don't come in contact with it. That's an important point, I mean people are afraid of it, but if you wear your masks, you stay far away, you don't come near the virus, you're not getting it.
REDFIELD: So I want to come back to that, that while people worry, and I have 11 grandkids. You know, I have one grandchild with cystic fibrosis--- I think people need to have enormous comfort that they've got a lot of power to prevent this virus from entering themselves, the vulnerable people they love, and their children. It's just a change in--
You know, a lot of people didn't think the American Society was going to adapt to masks. You know, but the fact is, from my travel when I was in North Carolina yesterday, I didn’t see a single person in the airport, or on the airplane or in in Mecklenburg area that I was walking, actually, that wasn't wearing a mask. I think it's-- the people are getting it. And I just want to make sure that we reinforce that, that this is a powerful weapon. If we do this, we can get this outbreak under control.
[[GRETA OC]]
That is all the time we have.
My thanks to…
CDC Director …
Dr. Robert Redfield…
for sharing his insight…
on the coronavirus pandemic.
For more on this story…
and the latest news…
from around the globe…
please visit our website…
at VOANews.com.
And follow me on Twitter @Greta.
Thank you for being Plugged In.
