michael barbaro

From The New York Times, I’m Michael Barbaro. This is “The Daily.”

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Today: Global health officials are singling out China and South Korea for the success of their efforts to contain the coronavirus. Donald G. McNeil, Jr. on what those countries are getting right and what everybody else can learn from them. It’s Thursday, March 12.

donald g. mcneil, jr.

OK. All right, first of all, do you have a fever or a cough?

robert jimison

I do not have a fever or a cough.

donald g. mcneil, jr.

OK.

robert jimison

I am healthy.

donald g. mcneil, jr.

Here, help yourself.

robert jimison

Thank you.

donald g. mcneil, jr.

Do you need me to clip on a microphone or you want this?

robert jimison

No, no, no, no.

donald g. mcneil, jr.

OK.

[sounds of spritzing and wiping down the studio]

michael barbaro

So can I just start by asking you about what I understand was a rather aggressive studio sanitation regiment that you applied?

donald g. mcneil, jr.

Me, just now?

michael barbaro

Yeah.

donald g. mcneil, jr.

[LAUGHS] Somebody ratted on me, I see. Yeah, I have a little spray bottle of hydrogen peroxide that I keep on my desk —

michael barbaro

Who doesn’t?

donald g. mcneil, jr.

Yeah, and I sprayed down the surface of this desk here before I put my elbows on it. I also carry Purell in my pocket. And I wear one glove now, so I look like kind of an aging, completely unfunky, white Michael Jackson imitator. And I disinfect the glove as soon as I get a chance to.

michael barbaro

Well, we appreciate the fact that you are keeping our studio so clean. So I wonder, Donald, if you could tell me about this news conference on Wednesday afternoon. What happens?

archived recording (dr. tedros adhanom ghebreyesus) Thank you, thank you, Tarik. Good afternoon, everybody.

donald g. mcneil, jr.

So this was the World Health Organization, the W.H.O., which is part of the United Nations. And they held their regular Monday, Wednesday, Friday meeting on the coronavirus epidemic, a press conference.

archived recording (dr. tedros adhanom ghebreyesus) In the past two weeks, the number of cases of Covid-19 outside China has increased thirteenfold. And the number of affected countries has tripled.

donald g. mcneil, jr.

It started off with the director general, Dr. Tedros, enunciating the new figures for the world, as he does every one of these.

archived recording (dr. tedros adhanom ghebreyesus) There are now more than 118,000 cases in 114 countries. And 4,291 people have lost their lives.

donald g. mcneil, jr.

And then he went into the big news —

archived recording (dr. tedros adhanom ghebreyesus) We have therefore made the assessment that Covid-19 can be characterized as a pandemic.

donald g. mcneil, jr.

— which is that the W.H.O. is declaring this a global pandemic.

archived recording (dr. tedros adhanom ghebreyesus) Pandemic is not a word to use lightly or carelessly.

donald g. mcneil, jr.

The W.H.O. has resisted using the word, even though it’s clear the disease has spread all over the world. Because they were afraid if they said it, then countries would say, OK, we’re throwing up our hands, it’s hopeless, we’re not going to be able to fight it.

archived recording (dr. tedros adhanom ghebreyesus) W.H.O. has been assessing this outbreak around the clock. And we are deeply concerned, both by the alarming levels of spread and severity, and by the alarming levels of inaction.

donald g. mcneil, jr.

I think they chose to use it this time because they believe that many countries are not moving rapidly enough, are not preparing, are not taking seriously enough. It doesn’t actually change anything in the world, but it raises the level of attention. And they’re ringing the alarm bell even louder and goading people to move faster.

michael barbaro

Right, because I’ve had a sense, and I think you have to, that this has been a pandemic for quite some time. And so this moment feels a little bit like the weatherman coming out and telling you it’s raining, even though you’ve been outside, soaked in the rain, for hours.

donald g. mcneil, jr.

Yeah, that’s right.

archived recording (dr. tedros adhanom ghebreyesus) All countries must strike a fine balance between protecting health, minimizing economic and social disruption, and respecting human rights.

donald g. mcneil, jr.

But they want it emphasized that although this is the first pandemic ever caused by a coronavirus, they also believe this is the first pandemic that can be brought under control.

archived recording (dr. tedros adhanom ghebreyesus) More than 90 percent of cases are in just four countries. And two of those, China and the Republic of Korea, have significantly declining epidemics.

donald g. mcneil, jr.

And they believe that because China and South Korea appear to be bringing the epidemic under control.

archived recording (dr. tedros adhanom ghebreyesus) We’re in this together to do the right things with calm and protect the citizens of the world. It’s doable. I thank you.

michael barbaro

Right. And I watched this news conference. And I noticed that the people overseeing this news conference singled those countries out for praise. But I wonder if that means that they were scolding other countries by omission.

donald g. mcneil, jr.

In effect, yes. Other countries for not taking it seriously enough and not moving aggressively enough. But they didn’t name any countries. And when they were asked to name the countries, Mike Ryan, who’s the head of the emergencies program said —

archived recording (dr. mike ryan) The W.H.O. doesn’t interact in public debate or criticize our member states in public. The answer to that question is you know who you are.

michael barbaro

OK, so with all that in mind, let’s talk about the different approaches that governments around the world are taking, some of which were referred to during this news conference. And since the W.H.O. leadership started with China on Wednesday during this news conference, let’s start there as well. Why do you think China is being praised here?

donald g. mcneil, jr.

China has cut its epidemic from over 3,500 new cases a day in late January to only 24 new cases yesterday.

michael barbaro

Wow, that’s pretty extraordinary.

donald g. mcneil, jr.

It’s stunning. No one thought it could be done. Public health experts, to me, say if they can keep the cases down as they let millions of people in China out of their houses and back into factories and subways and restaurants, if they can keep it up, then they have, you know, captured the wind. They’ve done something that nobody else has ever done before.

michael barbaro

And so how did they do it?

donald g. mcneil, jr.

Really aggressive measures. Some people call them brutal and draconian. The W.H.O. calls them aggressive. So the testing regimen there is nothing like ours. You do not go to your doctor’s office and ask for a test. They have set up fever clinics all over the place, attached to hospitals. There, you are met in a separate part of the hospital, maybe even in a parking lot, by doctors completely garbed head-to-toe in personal protective gear. They take your temperature. They ask you some questions to see what your symptoms are, if you’ve gotten some reason to think you’re exposed. And then they quickly to a white blood cell count on you. And, if they have it, a flu test. And those are two ways to eliminate the possibility that you have either flu or a bacterial pneumonia. If you’re still a suspect case, then they whip you into a CT machine.

michael barbaro

A CAT scan?

donald g. mcneil, jr.

A CAT scan. In this country, CAT scans take half an hour to an hour. The portable CAT scanners they were using, they were doing 200 scans a day on some of them.

michael barbaro

Wow, so this is all industrially scaled?

donald g. mcneil, jr.

Absolutely, it is industrial diagnosis. Then, if you were still a suspect case, whether they had the answer then or whether they wouldn’t have the answer until the next day, you still stayed with them. They found some place to put you up.

michael barbaro

So this is a no chances approach, in which anyone who might have the virus is not really given a chance to go home, to go back to the office and perhaps transmit it to somebody else. They’re just eliminating all those possibilities.

donald g. mcneil, jr.

Correct, there is no home quarantine in China. Not for people who are known to be infected or suspected to be infected, because they realized it wasn’t working. So when you see those pictures of the giant gymnasiums in the stadiums with beds in them, those were separate isolation areas for suspect cases who were kept away from the confirmed but mild cases. And you had gymnasiums for men, gymnasiums for women — I mean, these are really not gymnasiums but hospitals — and those for kids. And they separated kids from their families. And mom and dad were not allowed to visit.

michael barbaro

Wow.

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michael barbaro

So, why is it so important and effective that home isolation has been eliminated in China? Because that feels somehow pivotal to this all.

donald g. mcneil, jr.

75 percent to 80 percent of all the infections in China were within family clusters. So they knew that if you got people out of the family before they infected everybody else in the family, you could cut your caseloads.

michael barbaro

So it sounds from what you’re saying, like the most distinctive element of the Chinese approach is not that curtains are being dropped around entire regions of China — although that has gotten a lot of attention — but instead the procedures and restrictions and isolating tactics within those cordoned off districts that the Chinese government has pursued.

donald g. mcneil, jr.

That’s part of it. The other important part is they are looking incredibly aggressively for cases. So everywhere you go, your temperature is taken. Every building you walk into, every train station, every bus station. Even trying to get into your own apartment building, there’ll be a committee there from the apartment building committee who will take your temperature before you go home. And if you’ve got a temperature, you are immediately told to report to one of the fever clinics. So they’re catching everybody with fever.

michael barbaro

Wow. So that is China. And the portrait you have painted is of a incredibly aggressive approach. The next country that was praised by the W.H.O. on Wednesday was South Korea. What has been their approach and how does it contrast with China?

donald g. mcneil, jr.

South Korea started later than China. Its outbreak was mostly confined in one southern city and mostly, in the beginning, to members of a very large church there. But the infection spread throughout the church like wildfire. And so now, the government is doing contact tracing on more than 200,000 members of that church, trying to find every one of them who’d been exposed. And they’re making sure that everybody who is in contact with those people is in quarantine and calling in with their symptoms. And the minute they have symptoms that indicate they might be infected, they end up going into isolation centers with other infected people. They’re not staying home with their families to infect them. So South Korea is following the China model. And the doctor who’s in charge of it, who is also in charge during their big MERS outbreak a few years ago, told the W.H.O. that he believes they’re taking the heat out of the rising cases. The cases are actually beginning to go down. You know, they’ve been at this much less time than China has, but they’re following the model.

michael barbaro

OK, so Italy was not praised by the W.H.O. But Italy has taken some of the most dramatic actions in Europe, which was closing down much of the country’s North, they said, and restricting movements in and out. So why has that not risen to the level of praiseworthy, do we think, in the eyes the W.H.O.?

donald g. mcneil, jr.

Because Italy is playing catch up. They, like us right now, were refusing to take the threat seriously in the beginning. They wanted to keep, you know, the clubs open into the evenings. They didn’t want to play soccer games without fans in the stands. They didn’t want to shut down movement. And then in the North, they discovered that they had a gigantic outbreak that has now got their intensive care units absolutely full up and a lot of people dying. Italy is now number two in deaths in the world. They got 600 dead out of 10,000 confirmed cases. So they’re in real trouble.

michael barbaro

So basically, they just waited too long.

donald g. mcneil, jr.

They waited too long, and they were resistant to the idea of social distancing. And also, they wanted to try to manage everybody at home, all the mild at home. They didn’t want to isolate cases in centers the way the Chinese did. And now, Italy has gone to the W.H.O. and asked them, tell us how China did it because we’re out of control.

michael barbaro

Italy wants to know how to replicate the success of China now?

donald g. mcneil, jr.

Correct, which means really aggressive measures.

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michael barbaro

We’ll be right back. OK, Donald. Finally, of course, we have the United States. And we now know we’ve had major testing problems in the United States. We talked about those on yesterday’s “Daily.” We have outbreaks and clusters across the country. And my sense is that while a lot of industry and educational institutions and local governments are taking actions to limit exposure and contain the spread, the federal government in the U.S. is not taking the kind of sweeping actions we’re seeing in China, in South Korea, or in Italy. Does that feel right to you?

donald g. mcneil, jr.

It’s absolutely right. I mean, we have been in a completely headless chicken phase of the response for a few weeks now, where we weren’t able to produce tests. Now, we’re in a sort of denial phase, where parts of the government are saying shut down South by Southwest, shut down Comic-Con, cancel March Madness, and things like that. And other people are saying, this is all ridiculous and the panic is overdone. And the guidance from the top is confused. We’re not conveying the sense of the seriousness of the threat. People imagine that they’re just going to be inconvenienced, they’re going to be out of school, it’s going to be a long spring break. This could go on for months if it goes out of control. That’s very difficult for Americans to grasp.

michael barbaro

And Donald, when you think about the federal government in the U.S. and its approach, is it doing any of the things that you and other health leaders have identified as the effective elements of the Chinese approach or the South Korean approach?

donald g. mcneil, jr.

No. We’re not making sure that everyone is diagnosed at a fever clinic, where the doctors are protected and the results are available virtually immediately. We’re not realizing that people who are infected cannot go back to infect the rest of their families. They’re going to have to go into isolation. And we’re not recognizing the fact that you may have to keep a whole lot of people off the streets and out of the way, and find a way to feed them, in order to bring the epidemic under control. Italy is realizing that now. Unfortunately, we are basically right now following the Italian model.

michael barbaro

What do you think it would take to change the American mentality around this and also the federal government’s level of aggression?

donald g. mcneil, jr.

Well, this is really sad, but in every epidemic I’ve ever covered, whether that was AIDS in Africa or Zika here, people don’t believe the disease is going to get them until somebody they know gets it and suffers. What America may need is a Rock Hudson moment.

michael barbaro

Hmm, explain that.

donald g. mcneil, jr.

OK. Rock Hudson was incredibly important to the awareness of AIDS in this country. Here was a man who was one of the most gorgeous leading men of his day. Kissed every woman in Hollywood on the screen. And in 1985, rumors began to spread that maybe he didn’t have liver cancer. He had appeared with Doris Day, his old co-star, in a promo for her series. And he looked gaunt and was barely coherent. And not long after that, he moved to France for treatment. And President Ronald Reagan, who was an old friend of his — they were leading men in Hollywood together — called him at the hospital to check and see how he was doing. And not long after that was the first time Ronald Reagan ever uttered the word “AIDS” in private. Now, it had taken from 1981, when the disease was discovered, until September 1985 for Ronald Reagan to say the word “AIDS.” And for America to realize that there was a disease ravaging the gay community, but it might strike people that they knew and were familiar with and maybe never recognized were gay.

michael barbaro

Like Rock Hudson.

donald g. mcneil, jr.

Like Rock Hudson. And Rock Hudson died in October. And five days later, Congress passed a bill authorizing $220 million to find a cure for AIDS.

michael barbaro

In other words, Rock Hudson was the catalyst for the entire country to realize just how urgently this epidemic — in that case HIV, you’re suggesting now coronavirus — needed to be confronted.

donald g. mcneil, jr.

Yeah. People, unfortunately, do not believe a disease will strike them until it strikes somebody they know and identify with.

michael barbaro

Donald, let’s suppose that there is a Rock Hudson moment in the United States that really galvanizes how the public views the coronavirus and the way the government approaches it. I still have the sense that the reason why China could do what it did is because it’s an authoritarian government. So is what they did possible in a democracy? Can the United States, can Italy accomplish what an authoritarian country like China has done over the past few months?

donald g. mcneil, jr.

It is absolutely much more difficult for a democracy, where people are used to getting their way and telling their leaders what they think to do it. But we’ve done this before when the threat is big enough. When the threat is big enough, America can get organized. Right now, it’s in a lot of denial and finger-pointing.

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There was something that Tedros said in the W.H.O. press conference. That you have to strike a balance between the right to life and human rights, and try to find that balance in your country. And in America, we’re used to enjoying our civil liberties. We don’t live in an authoritarian system. But if what you’re hoping for is life, liberty and the pursuit of happiness, you have to preserve life, or the other two just aren’t there.

michael barbaro

Thank you, Donald.

donald g. mcneil, jr.

You’re welcome.

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archived recording (donald trump) My fellow Americans, tonight I want to speak with you about our nation’s unprecedented response to the coronavirus outbreak that started in China and is now spreading throughout the world. Today, the World Health Organization officially announced that this is a global pandemic.

michael barbaro

In a speech to the nation on Wednesday night, President Trump sought to convey the seriousness of the epidemic, encouraging Americans to take every possible precaution and announcing that he would bar all travel from Europe to the United States, with the exception of the United Kingdom, to limit the spread of the virus.

archived recording (donald trump) To keep new cases from entering our shores, we will be suspending all travel from Europe to the United States for the next 30 days. The new rules will go into effect Friday at midnight. These restrictions will be adjusted subject to conditions on the ground.

michael barbaro

Moments after the speech, one of America’s most famous actors, Tom Hanks, announced that he and his wife Rita have tested positive for the coronavirus. We’ll be right back.

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Here’s what else you need to know today. On Wednesday, Harvey Weinstein was sentenced to 23 years in prison for sex crimes, as the six women who had testified against him during his trial watched from the front row. In a rambling speech, Weinstein expressed remorse, but said he believed that his encounters with the women were consensual. Within hours of the sentencing, prosecutors in Los Angeles said they had begun the process of extraditing Weinstein from New York to face different charges of sexual assault in California. And —

archived recording (bernie sanders) Last night, obviously, was not a good night for our campaign from a delegate point of view. We lost in the largest state up for grabs yesterday, the state of Michigan. We lost in Mississippi, Missouri and Idaho.

michael barbaro

During a news conference in Vermont, Senator Bernie Sanders said he would press ahead with his presidential campaign, despite a series of back-to-back defeats to Joe Biden that have severely narrowed Sanders path to the nomination.

archived recording (bernie sanders) We are winning the generational debate. Our campaign continues to win the vast majority of the votes of younger people. And I am talking about people not just in their 20s, but in their 30s and their 40sm, the younger generation —

michael barbaro

Sanders made both an ideological and generational case for his candidacy, saying that he, not Biden, represented the future of the Democratic Party.

senator bernie sanders

Today, I say to the Democratic establishment, in order to win in the future, you need to win the voters who represent the future of our country. And you must speak to the issues of concern to them.

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michael barbaro