democracynow--2020-04-23--"The Virus Is Still Out There": Infectious Disease Expert Warns Against Reopening States Too Soon

This is a rush transcript .
Copy may not be in its final form .
AMY GOODMAN : Well , we are broadcasting from New York City , where the COVID-19 death toll has passed 15,000 .
The number of daily deaths has finally begun to decrease , after more than a month of strict social distancing .
Officials warn there is still a long road ahead for New York ’ s recovery .
Increased testing will be critical as New York City and other localities look to slowly reopen certain parts of society .
New York Governor Andrew Cuomo @ @ @ @ @ @ @ Tuesday to discuss federal aid for expanding testing capacity , and said the president committed to helping New York state double both its COVID-19 and antibody tests to 40,000 a day .
But Wednesday , Senate Majority Leader Mitch McConnell said he ’ s against giving states more federal aid in future pandemic legislation , suggesting states should instead consider filing for bankruptcy .
Governor Cuomo called the statement “ one of the saddest , really dumb comments of all time , ” unquote .
This all comes as the governors in Georgia @ @ @ @ @ @ @ to reopen parks , beaches and nonessential businesses despite the strong objections of public health officials .
Last weekend , President Trump encouraged far-right anti-quarantine protesters — many of them openly brandishing assault rifles — tweeting they should “ liberate ” Michigan , Minnesota and Virginia .
But on Tuesday , Trump said he disagreed strongly with Georgia Republican Governor Brian Kemp ’ s decision to reopen businesses .
AMY GOODMAN : Meanwhile , the head of the Centers for Disease Control and Prevention has warned a second wave of the coronavirus could @ @ @ @ @ @ @ even more devastating results .
For more , we ’ re joined by Dr. Syra Madad , an infectious disease specialist , special pathogens expert , here in New York City .
She was recently featured in the Netflix docuseries Pandemic , which premiered in January .
Welcome to Democracy Now !
, Dr. Madad .
It ’ s great to have you with us .
Why don ’ t we start off with what seems to be , to the shock of many , this controversial issue of testing ?
How is @ @ @ @ @ @ @ we are still at the point where just last week a 92-year-old woman , the mother of our co-host Juan González , went to a top hospital in New Jersey , 92 years old with COVID symptoms , and she was told she could not be tested ?
Only when they finally agreed to admit her did they say , well , then they had to do a COVID test to decide which wing to put her in .
But that is one of many , many examples , the lack of access @ @ @ @ @ @ @ all over the country , have to tests .
Why is testing so important ?
DR. SYRA MADAD : It ’ s a great question .
Everyone ’ s asking that : Why testing is so important ?
And I ’ m sure many people keep hearing about , you know , ramping up testing .
And the reason why testing is so important , not only to know that you actually are infected with coronavirus disease , while probably clinical management won ’ t change much , unless you ’ re in @ @ @ @ @ @ @ , but it ’ s also extremely important to know you ’ re positive , so that way we can isolate you , and so you don ’ t start new chains of transmission .
And unfortunately , here in the United States , we ’ ve almost seen a — hit a plateau when it comes to testing .
We ’ re not really increasing the number of testing being done yet , for a number of different reasons .
One big one is because of the whole supply chain aspect , @ @ @ @ @ @ @ the reagents and the swabs that are needed to actually conduct the testing .
A lot of states actually have the infrastructure to do the testing , but really it ’ s relying on the supplies itself , that unfortunately is just not there yet .
And so we really need to make sure we have widespread testing and a good infrastructure in place .
That way , we can test anybody that needs it .
So , you know , if you ’ re symptomatic , even if you ’ re asymptomatic @ @ @ @ @ @ @ we have a test available to be able to see whether you have coronavirus disease , because the biggest thing is we want to make sure that you ’ re able to isolate yourself so you don ’ t start these new chains of transmission and infect additional people .
This is , you know , a very highly transmissible virus that ’ s proven to be quite lethal , if you will .
So we need to really make sure that we have these systems in place in order for us to @ @ @ @ @ @ @ will .
NERMEEN SHAIKH : And , Dr. Madad , could you explain what the different kinds of tests are that are being carried out ?
Are they all the same across the board ?
What , for example , is the distinction , the difference , between an antibody test and a test to determine whether you have COVID-19 right now ?
Are they the same ?
And you talked about the problem with supply chains .
Where is the material being produced for these tests ?
And is there any likelihood @ @ @ @ @ @ @ and continue to be 'til they 're needed ?
DR. SYRA MADAD : So , in terms of testing , there is an antigen test that looks for acute infection , meaning if you ’ re actually infected with coronavirus disease , it actually looks for the virus itself through molecular assay .
And then the other test is the antibody test , or the serology test , that actually looks to see if you had the infection previously and have developed an immune response .
It ’ s actually looking at the @ @ @ @ @ @ @ there is two very distinct means .
One could be used for diagnostic purposes , if you will , the antigen test .
The antibody test is something that is relatively new , and I would highly caution anybody using the serology test right now to make any type of decision .
And the reason why I say that is because the assays that are being used for serology tests , so the serology test itself , the blood that is drawn and tested , is very hard to interpret the information .
@ @ @ @ @ @ @ ’ re getting a lot of false positives , false negatives .
It doesn ’ t seem to be — depending on the type of test you ’ re using , you know , a lot of these are not validated and not going through a quality control measure .
We can ’ t see if they ’ re providing true results .
And the other big issue when it comes to serology is — and I think it ’ s very important for people to state — we just don ’ t @ @ @ @ @ @ @ .
There ’ s still a lot of the science that we do not know .
We don ’ t know about the pathophysiology of coronavirus disease .
And so , even if , for example , you may have a positive antibody test , what does that mean ?
Does it mean that you are actually immune to coronavirus disease , you can ’ t get reinfected ?
We don ’ t know that .
We don ’ t know how much — you know , the titer level that you need @ @ @ @ @ @ @ actually don ’ t know that .
There needs to be a lot more data on that .
And on top of that , we also don ’ t know the risk , as I mentioned , of reinfection .
And so , these are things that I think we need to be very public about .
This is the science that we don ’ t know , that we hope to know in the future .
It ’ s not there yet .
This is a puzzle that is missing a number @ @ @ @ @ @ @ we want to rely on seroprevalence and conducting serosurveys and seeing how many people are actually immune , we really need to take that with a grain of salt , because , again , we don ’ t know a lot .
AMY GOODMAN : So , Dr. Syra Madad , I wanted to ask you about this possibility of how you open the country — what President Trump is pushing so hard for , has been saying that these gun-toting activists around the country who are demanding their states open , are @ @ @ @ @ @ @ plan would be .
I wanted to ask what you think of the Rockefeller Foundation plan that ’ s just put out there .
Paul Romer , the Nobel Prize-winning economist , has recently said some very interesting things .
I mean , they ’ re calling for 30 million tests a day in the United States , so that people — a day in the United States .
He ’ s calling for a day .
The report , I think , is calling for 30 million tests a week .
He @ @ @ @ @ @ @ I think he compared it to that the U.S. makes something like 350 million cans of soda a day — why can ’ t we do 30 million a day ?
The report itself , though , calling for 30 million a week .
We are so far from any of that .
I think that would clearly go to the issue of the Defense Production Act , President Trump demanding that companies start to convert to making these tests .
Trump has been extremely resistant to this idea of mass testing .
@ @ @ @ @ @ @ country without having to shut it down right away because there ’ s another mass outbreak , because workers come together who are both positive and those that weren ’ t exposed ?
DR. SYRA MADAD : You ’ re absolutely right .
And I think the best way to really show the American public , you know , what situation we ’ re in is look at where we ’ re at right now , right ?
One of the reasons why we ’ re seeing a decrease in the number of @ @ @ @ @ @ @ , if you ’ re at least in the state of New York , is because of our collective actions , doing what we call social distancing , physically distancing ourselves .
And the reason why we ’ re doing that is because we want to obviously make sure that , you know , we ’ re not going out , we ’ re not coming in contact with the virus .
Right ?
So , the endgame is , the whole goal is making sure we don ’ t come in contact @ @ @ @ @ @ @ come in contact with the virus , then , obviously , you can get infected .
And right now no one has , really , immunity to this virus , because this is brand new , unless , obviously , you ’ re already going through active infection right now .
And so , the virus is still out there .
And one of the reasons why we ’ ve been able to decrease the number of cases is because of social distancing .
If you take that away , that very effective @ @ @ @ @ @ @ re going to be in the same position that we were back in January , back in February , back in March , because nothing has changed between now and then .
We still don ’ t have enough testing .
And we still don ’ t have , you know , a testing — a treatment option yet .
And then we have clinical trials still in the pipeline .
People are actually getting very confused , I think , in terms of when we ’ re talking about all these different @ @ @ @ @ @ @ when I ’ ve been talking to them , they think these are cures .
These are not cures .
There is no cure for coronavirus disease .
There are a number of different treatments that are in clinical stages .
How effective and safe they are , that ’ s still something that ’ s being explored .
And so , nothing has changed .
And if we are to reopen the economy , being in the same position that we ’ re going to put ourselves in , we ’ re @ @ @ @ @ @ @ cases .
And as we ’ ve seen with history — right ?
— a lot of people have been comparing this to the 1918 Spanish flu — the second wave was much higher and much more severe than the first one .
And so , if we ’ re going to let history repeat ourself , I think we just need to make sure that we ’ re prepared for it .
And unfortunately , we are not .
And I think the other thing we need to also think about is @ @ @ @ @ @ @ do we define the word “ safe , ” because that ’ s — you know , living with COVID-19 is going to be our new normal , so we need to make sure what amount of risk are we able to take , if at all .
And what does that word “ safe ” actually mean ?
We ’ re not going to really be safe .
As long as that virus is out there and lingering , we ’ re not going to be safe .
So we need to @ @ @ @ @ @ @ really to protect everybody .
NERMEEN SHAIKH : Dr. Madad , that ’ s a very good point that you make about how essential social distancing is , given where we are now with both testing and clinical trials for drugs .
Could you give us some sense , because obviously the costs of social distancing and the impossibility of social distancing in a large part of the world , the developing world , in particular , and in poorer — among poorer communities everywhere , where it ’ s simply not possible @ @ @ @ @ @ @ what — how far are we along in clinical trials ?
And are there any alternatives at all to social distancing at the moment or in the foreseeable future , the near future ?
DR. SYRA MADAD : So , any of these potential treatments that are being studied , they ’ re not going to be a silver bullet .
And what I mean by that is they ’ re not going to be 100 % .
We still are waiting on the data for a number of these different pharmaceutical interventions @ @ @ @ @ @ @ seeing some come out right now .
For example , you know , hydroxychloroquine , you ’ re seeing whether it ’ s safe and effective , and in fact the data is showing otherwise , that it actually is not effective .
And then you ’ re seeing other studies come out with remdesivir , that is showing — that is looking promising .
But again , you know , when you ’ re doing these clinical trials , you really need to go through the proper channels and making sure that @ @ @ @ @ @ @ a longer period of time .
And that ’ s obviously not happening right now .
These are very quick , short studies .
And so , I think , in the coming weeks to months , we ’ ll probably get some more information in terms of the various clinical trials that are out there around the world , not just here in the United States .
And so , you know , it seems as if we ’ ll — AMY GOODMAN : Do you want to weigh in on this @ @ @ @ @ @ @ Dr .
Bright right now ?
I mean , President Trump , the Trump administration , fires the person in charge of vaccines in the government , who has been fighting hard to coordinate all these kind of tests you ’ re talking about , clearly opposed to , you know , prescribing hydroxychloroquine or chloroquine without the proper studies , and now being taken out as he resists President Trump ’ s drug of choice , which hasn ’ t even been adequately tested .
DR. SYRA MADAD : You know , @ @ @ @ @ @ @ saying from the get-go .
We really need to let science speak , and we really need to look at the facts .
We need to follow the facts .
There is , obviously , a lot that we don ’ t know , and we need to be very clear about that .
And we need to make sure people understand .
When we don ’ t know something , we ’ re providing that information ; when we do know something , we can provide that information .
And , you @ @ @ @ @ @ @ and having these types of actions and reactions is very unfortunate , because , really , it ’ s showing the credibility of the administration in and of itself .
And this is a very pressing time , and a lot of lives are on the line .
And we really need to make sure that we ’ re following the facts .
And so we want to make sure that we are having experts be able to be at the table and drive these conversations .
AMY GOODMAN : We want to @ @ @ @ @ @ @ we ’ re going to come back to Dr. Syra Madad , infectious disease specialist , special pathogens expert , here in New York City and for New York City .
We ’ ll be back with Dr. Madad in a minute .
AMY GOODMAN : “ Oh , What a World 2.0 ” by Kacey Musgraves .
She reworked her song from 2018 and released it Wednesday on the 50th anniversary of Earth Day .
This is Democracy Now !
, democracynow.org , The Quarantine Report .
I ’ m Amy Goodman @ @ @ @ @ @ @ re both in the epicenter of the pandemic , as we continue to look at the path ahead for this pandemic , how we respond , how we consider when to reopen , with Dr. Syra Madad , infectious disease specialist , special pathogens expert .
Dr. Madad , if you could talk about your own personal experience ?
Did you test positive for COVID-19 ?
DR. SYRA MADAD : Well , I did .
I did test positive for COVID-19 .
Certainly , I think anyone getting that type of test result @ @ @ @ @ @ @ , you know , if you have loved ones at home , those that are even in the high-risk category , which , for me , I do .
It was something that , you know , when I got the test result , wasn ’ t surprising , really , unfortunately , given the circumstances and being out there .
But I was able to quickly isolate myself .
And luckily , everybody in my household was able to recover .
One of the symptoms that I had was the loss of @ @ @ @ @ @ @ had that for quite a few weeks .
And just , actually , as of recently , I was able to get my full taste and smell back and be able to enjoy , for example , my cup of coffee .
But , you know , with the coronavirus disease , the spectrum of illness is so wide and variable .
You have people that are asymptomatic .
You have those that have mild signs and symptoms of the disease .
And then you have those that are more severe and critical @ @ @ @ @ @ @ .
You know , right now we know there are certain aspects that put those in the high-risk category , but you ’ re also seeing very young , healthy individuals fall anywhere on that spectrum .
So , again , don ’ t know a whole lot about this disease , but we ’ re hopeful that as the days and hours and weeks progress , that we can learn more through , you know , factual means .
And when I say “ factual means , ” you ’ re seeing @ @ @ @ @ @ @ a lot of things being published , not going through peer review .
So , I caution anybody that ’ s going through a lot of — in reading a lot about this , making sure that you ’ re reading peer-reviewed information , things that actually have been going — AMY GOODMAN : Before we talk about that kind of information , just your own is so important for people to see someone who has recovered from COVID-19 .
You have three kids , right ?
Your last child , you just @ @ @ @ @ @ @ you talk about the kind of decisions you had to make when you tested positive , and what it means to isolate for a mom like you and a new mother ?
DR. SYRA MADAD : So , you know , as you mentioned , I actually delivered in January my youngest .
My baby girl turned 3 months most recently .
And I ’ m a breast-feeding mother , 100 % .
So , it was certainly difficult , you know , to be able to isolate myself from my children , @ @ @ @ @ @ @ after I had gotten my test results , because from what we know , you can actually spread the virus before actually being symptomatic .
So everybody was already exposed in our household .
And as I mentioned , luckily , everybody recovered .
But , for me , as soon as I became symptomatic , I did isolate myself for a period of time , until I was afebrile for at least 72 hours .
Certainly had a big impact on my family .
Luckily , I have a great support system @ @ @ @ @ @ @ the kids .
But at the same time , I knew he obviously had it , as well .
But I was symptomatic .
Then — AMY GOODMAN : He had it , too ?
He was positive , as well ?
DR. SYRA MADAD : He had it , too , yeah .
He was symptomatic first , and then I became symptomatic .
And so , when I did , I was able to isolate myself , and he was not symptomatic during that time .
But , you know , @ @ @ @ @ @ @ if you will .
And luckily , they actually had very mild signs and symptoms .
We didn ’ t get them tested .
The only person that actually did get tested is myself , as a person working in a healthcare system .
And my in-laws , actually , both high-risk , one actually on hospice care , he actually did also get tested and did get tested positive .
But we ’ re very lucky that everybody was able to recover .
NERMEEN SHAIKH : Dr. Madad , you mentioned that @ @ @ @ @ @ @ with COVID-19 .
And obviously , we ’ re all just learning about how this disease , this virus , spreads .
But is there anything that can predict how severe the illness will be in people who get it ?
DR. SYRA MADAD : That ’ s an excellent question .
And what we ’ re seeing right now is , while we know this virus can infect anybody and anyone , if you will , regardless of your age , regardless of your health status — you know , this is @ @ @ @ @ @ @ know , we know that it ’ s ubiquitous .
But at the same time , there are these health disparities and social determinants that may put you at even high risk for having a worser outcome .
And we ’ re actually seeing some of this play out .
So , for example , you ’ re seeing a higher rate of infection in the African-American community .
You ’ re seeing a high rate of infection in the Latino community .
And I think when you look at some of the @ @ @ @ @ @ @ re also looking at the socioeconomic status and some of those variables that actually may put them at higher risk because of the type of work that they ’ re doing , for example , as essential workers , also looking at their living conditions , living in close quarters .
I think it was by no accident that one of the first hospitals that was overwhelmed in New York City was Elmhurst Hospital .
The reason for that is that particular area and that ZIP code is one of the most diverse @ @ @ @ @ @ @ and you have a lot of families living together in close corridors .
And so , when we talked about social distancing , and as we mentioned actually earlier , you know , some people don ’ t have the privilege of actually socially distancing themselves , because there are so many people living in their household .
And so , because of that , you can spread the virus much more easily and quickly .
And we ’ re seeing a lot of that play out .
AMY GOODMAN : And can @ @ @ @ @ @ @ ?
Not really new among the docs all over the country .
I had gotten this random text last week : It ’ s not about the pneumonia , it ’ s about the blood clots .
And I wanted to read to you from a Washington Post piece , “ A mysterious blood-clotting complication is killing coronavirus patients.
” It says , “ Increasingly , doctors also are reporting bizarre , unsettling cases that don ’ t seem to follow any of the textbooks they ’ ve trained on .
They describe @ @ @ @ @ @ @ so low that they would normally be unconscious or near death — talking and swiping on their phones .
Asymptomatic pregnant women suddenly in cardiac arrest .
Patients who by all conventional measures seem to have mild disease deteriorating within minutes and dying at home.
” And they ’ re saying it seems to be this issue of blood clots .
In fact , the first person now , who ’ s believed to be weeks before we really believed , a 57-year-old woman in California , who was in very good shape @ @ @ @ @ @ @ like she also died in this way , of sudden maybe cardiac arrest , and people didn ’ t identify it as coronavirus in the beginning of February .
What about this blood clotting issue ?
DR. SYRA MADAD : It certainly is an issue .
And from what we ’ re seeing , you know , what hospitals are reporting , it is becoming — and I wouldn ’ t say “ becoming ” — it does seem to be a common issue .
But what we ’ re also seeing is @ @ @ @ @ @ @ folks may think that COVID-19 is more implicated with the lungs , we ’ re actually seeing a number of different organs within the body actually in distress and having various manifestations .
So you ’ re seeing issues with kidneys and heart and brain and liver .
And so , the way that it can manifest is obviously very different , and it depends on the individual , their immunoresponse and the body response .
But what we also don ’ t know is the sequelae .
And what I mean by @ @ @ @ @ @ @ .
And this is something — as I mentioned , it ’ s a new virus .
It ’ s only about 4 or 5 months old .
And we ’ re learning a lot about it , and a lot we don ’ t know .
And everyone is really learning at the same time .
We ’ re relying on each other to be transparent and show data and share some of the case studies that we ’ re seeing , that may help others that are obviously treating individuals with @ @ @ @ @ @ @ I think a good example would be , for example , Zika .
You know , Zika was relatively something that a healthcare system did not experience that in the magnitude that we did a few years ago .
And you saw , obviously , children being born with microcephaly and having other issues .
Those individuals , those children , are still being studied long-term to actually look at the full effect of Zika .
And you ’ re still seeing data come out .
And similarly with COVID-19 , this being @ @ @ @ @ @ @ , it ’ s going to take years for us to actually see the long-term effects , because we need to follow these individuals for their entire lifetime to actually see , you know , does it have additional effects on them , not just during the acute stage when they ’ re actually infected and in the hospital , but also once they get discharged .
Is it going to have any effect on their health , moving forward ?
And really , that ’ s a question that we don ’ @ @ @ @ @ @ @ NERMEEN SHAIKH : And , Dr. Madad , very quickly , before we conclude , as I ’ m sure you know , many people are relying on the development of a vaccine , even if it will take from 12 to 18 months .
But you ’ ve said that even a vaccine won ’ t be a silver bullet , as you said .
Why is that ?
And what about your concerns about certain people perhaps not getting the vaccine even once it ’ s available ?
Why would people @ @ @ @ @ @ @ Well , first , I think when we say 12 to 18 months , you know , that is an optimistic timeline .
Is it realistic ?
I don ’ t think it is very realistic , knowing that developing a vaccine actually takes years and years .
And we really need to be very careful in making sure that we ’ re having a safe and effective vaccine to actually administer to the American public and globally .
And I think once we do have a vaccine that is safe and proven @ @ @ @ @ @ @ whenever that will be , we ’ re going to have to jump through additional hurdles , like those that are hesitant to actually get vaccinated .
You know , as you may be aware , the anti-vax movement is vast .
It actually is one of the biggest — one of the biggest global health problems that we have in the world .
So we need to make sure that even once we have a vaccine available , people are actually able and less reluctant to actually get vaccinated .
But even @ @ @ @ @ @ @ vaccines are manufactured , not everybody is going to get the vaccine at the same time .
There are going to be — there ’ s going to be a short supply .
And to get everyone vaccinated will take years .
You know , we ’ re a very , very large country with many individuals .
And to be able to vaccinate everybody that is eligible to get vaccinated will take at least a year or two , or maybe even longer .
And so we need to really face the @ @ @ @ @ @ @ we ’ re at , and we know that there ’ s going to be additional hurdles once that vaccine is available .
And so , this whole notion of herd immunity , and so on and so forth , we really need to give it a lot more thought .
AMY GOODMAN : Well , we want to thank you so much , Dr. Syra Madad , infectious disease specialist , special pathogens expert , featured in the first episode of this remarkable series that came out on Netflix called Pandemic , @ @ @ @ @ @ @ right at the beginning .
And , Dr. Madad , we ’ re so thankful that you and your family now are safe , are healthy , and we just hope that for the rest of the country and the world .
We also have this breaking news : The Labor Department has just reported another 4.4 million people , U.S. citizens , filed for unemployment claims over the last week , bringing the total over the past five weeks to over 26 million .
That doesn ’ t even include the millions @ @ @ @ @ @ @ who have lost their jobs due to the pandemic , and those who tried to apply but weren ’ t able to .
When we come back , we speak to another doctor , a global health expert , about the efforts to stop the daily spread of COVID-19 with contact tracing in Massachusetts — following those who have been in contact with those who have COVID-19 .
Stay with us .
AMY GOODMAN : “ He Will See You Through , ” sung and written by Rhiannon Giddens , with Francesco Turrisi @ @ @ @ @ @ @ in two different places — as part of the Humanity in Concert series .

This is a rush transcript. Copy may not be in its final form.
AMY GOODMAN: Well, we are broadcasting from New York City, where the COVID-19 death toll has passed 15,000. The number of daily deaths has finally begun to decrease, after more than a month of strict social distancing. Officials warn there is still a long road ahead for New York’s recovery. Increased testing will be critical as New York City and other localities look to slowly reopen certain parts of society.
New York Governor Andrew Cuomo met with President Trump in Washington on Tuesday to discuss federal aid for expanding testing capacity, and said the president committed to helping New York state double both its COVID-19 and antibody tests to 40,000 a day. But Wednesday, Senate Majority Leader Mitch McConnell said he’s against giving states more federal aid in future pandemic legislation, suggesting states should instead consider filing for bankruptcy. Governor Cuomo called the statement “one of the saddest, really dumb comments of all time,” unquote.
This all comes as the governors in Georgia, Tennessee and South Carolina are preparing to reopen parks, beaches and nonessential businesses despite the strong objections of public health officials. Last weekend, President Trump encouraged far-right anti-quarantine protesters — many of them openly brandishing assault rifles — tweeting they should “liberate” Michigan, Minnesota and Virginia. But on Tuesday, Trump said he disagreed strongly with Georgia Republican Governor Brian Kemp’s decision to reopen businesses.
PRESIDENT DONALD TRUMP: The spas and the beauty parlors and barber shops, tattoo parlors, I love ’em, but they can wait a little bit longer, just a little bit, not much, because safety has to predominate. We have to have that. So, I told the governor, very simply, that I disagree with his decision, but he has to do what he thinks is right.
AMY GOODMAN: Meanwhile, the head of the Centers for Disease Control and Prevention has warned a second wave of the coronavirus could hit the U.S. in the winter with even more devastating results.
For more, we’re joined by Dr. Syra Madad, an infectious disease specialist, special pathogens expert, here in New York City. She was recently featured in the Netflix docuseries Pandemic, which premiered in January.
Welcome to Democracy Now!, Dr. Madad. It’s great to have you with us. Why don’t we start off with what seems to be, to the shock of many, this controversial issue of testing? How is it possible in the United States that we are still at the point where just last week a 92-year-old woman, the mother of our co-host Juan González, went to a top hospital in New Jersey, 92 years old with COVID symptoms, and she was told she could not be tested? Only when they finally agreed to admit her did they say, well, then they had to do a COVID test to decide which wing to put her in. But that is one of many, many examples, the lack of access that governors, that people in general all over the country, have to tests. Why is testing so important?
DR. SYRA MADAD: It’s a great question. Everyone’s asking that: Why testing is so important? And I’m sure many people keep hearing about, you know, ramping up testing. And the reason why testing is so important, not only to know that you actually are infected with coronavirus disease, while probably clinical management won’t change much, unless you’re in the high-risk group and require additional services, but it’s also extremely important to know you’re positive, so that way we can isolate you, and so you don’t start new chains of transmission.
And unfortunately, here in the United States, we’ve almost seen a — hit a plateau when it comes to testing. We’re not really increasing the number of testing being done yet, for a number of different reasons. One big one is because of the whole supply chain aspect, because there’s not enough of the reagents and the swabs that are needed to actually conduct the testing. A lot of states actually have the infrastructure to do the testing, but really it’s relying on the supplies itself, that unfortunately is just not there yet.
And so we really need to make sure we have widespread testing and a good infrastructure in place. That way, we can test anybody that needs it. So, you know, if you’re symptomatic, even if you’re asymptomatic, we want to make sure that we have a test available to be able to see whether you have coronavirus disease, because the biggest thing is we want to make sure that you’re able to isolate yourself so you don’t start these new chains of transmission and infect additional people. This is, you know, a very highly transmissible virus that’s proven to be quite lethal, if you will. So we need to really make sure that we have these systems in place in order for us to really open back up, if you will.
NERMEEN SHAIKH: And, Dr. Madad, could you explain what the different kinds of tests are that are being carried out? Are they all the same across the board? What, for example, is the distinction, the difference, between an antibody test and a test to determine whether you have COVID-19 right now? Are they the same? And you talked about the problem with supply chains. Where is the material being produced for these tests? And is there any likelihood that their production could be expedited now and continue to be 'til they're needed?
DR. SYRA MADAD: So, in terms of testing, there is an antigen test that looks for acute infection, meaning if you’re actually infected with coronavirus disease, it actually looks for the virus itself through molecular assay. And then the other test is the antibody test, or the serology test, that actually looks to see if you had the infection previously and have developed an immune response. It’s actually looking at the antibodies in your blood. So, there is two very distinct means. One could be used for diagnostic purposes, if you will, the antigen test.
The antibody test is something that is relatively new, and I would highly caution anybody using the serology test right now to make any type of decision. And the reason why I say that is because the assays that are being used for serology tests, so the serology test itself, the blood that is drawn and tested, is very hard to interpret the information. First, the testing itself, you’re getting a lot of false positives, false negatives. It doesn’t seem to be — depending on the type of test you’re using, you know, a lot of these are not validated and not going through a quality control measure. We can’t see if they’re providing true results.
And the other big issue when it comes to serology is — and I think it’s very important for people to state — we just don’t know a whole lot about this virus. There’s still a lot of the science that we do not know. We don’t know about the pathophysiology of coronavirus disease. And so, even if, for example, you may have a positive antibody test, what does that mean? Does it mean that you are actually immune to coronavirus disease, you can’t get reinfected? We don’t know that. We don’t know how much — you know, the titer level that you need that will actually confer immunity. We actually don’t know that. There needs to be a lot more data on that. And on top of that, we also don’t know the risk, as I mentioned, of reinfection. And so, these are things that I think we need to be very public about. This is the science that we don’t know, that we hope to know in the future. It’s not there yet. This is a puzzle that is missing a number of pieces. And so, while we want to rely on seroprevalence and conducting serosurveys and seeing how many people are actually immune, we really need to take that with a grain of salt, because, again, we don’t know a lot.
AMY GOODMAN: So, Dr. Syra Madad, I wanted to ask you about this possibility of how you open the country — what President Trump is pushing so hard for, has been saying that these gun-toting activists around the country who are demanding their states open, are liberating their states — what a rational plan would be. I wanted to ask what you think of the Rockefeller Foundation plan that’s just put out there. Paul Romer, the Nobel Prize-winning economist, has recently said some very interesting things. I mean, they’re calling for 30 million tests a day in the United States, so that people — a day in the United States. He’s calling for a day. The report, I think, is calling for 30 million tests a week. He said it should be a day. I think he compared it to that the U.S. makes something like 350 million cans of soda a day — why can’t we do 30 million a day? The report itself, though, calling for 30 million a week. We are so far from any of that. I think that would clearly go to the issue of the Defense Production Act, President Trump demanding that companies start to convert to making these tests. Trump has been extremely resistant to this idea of mass testing. But how else do you open the country without having to shut it down right away because there’s another mass outbreak, because workers come together who are both positive and those that weren’t exposed?
DR. SYRA MADAD: You’re absolutely right. And I think the best way to really show the American public, you know, what situation we’re in is look at where we’re at right now, right? One of the reasons why we’re seeing a decrease in the number of cases, depending on where you are, if you’re at least in the state of New York, is because of our collective actions, doing what we call social distancing, physically distancing ourselves. And the reason why we’re doing that is because we want to obviously make sure that, you know, we’re not going out, we’re not coming in contact with the virus. Right? So, the endgame is, the whole goal is making sure we don’t come in contact with the virus, because if you come in contact with the virus, then, obviously, you can get infected. And right now no one has, really, immunity to this virus, because this is brand new, unless, obviously, you’re already going through active infection right now. And so, the virus is still out there. And one of the reasons why we’ve been able to decrease the number of cases is because of social distancing.
If you take that away, that very effective public health measure, then we’re going to be in the same position that we were back in January, back in February, back in March, because nothing has changed between now and then. We still don’t have enough testing. And we still don’t have, you know, a testing — a treatment option yet. And then we have clinical trials still in the pipeline. People are actually getting very confused, I think, in terms of when we’re talking about all these different medications. I think some people, when I’ve been talking to them, they think these are cures. These are not cures. There is no cure for coronavirus disease. There are a number of different treatments that are in clinical stages. How effective and safe they are, that’s still something that’s being explored. And so, nothing has changed. And if we are to reopen the economy, being in the same position that we’re going to put ourselves in, we’re obviously going to see a resurgence of cases.
And as we’ve seen with history — right? — a lot of people have been comparing this to the 1918 Spanish flu — the second wave was much higher and much more severe than the first one. And so, if we’re going to let history repeat ourself, I think we just need to make sure that we’re prepared for it. And unfortunately, we are not.
And I think the other thing we need to also think about is how do we define risk and how do we define the word “safe,” because that’s — you know, living with COVID-19 is going to be our new normal, so we need to make sure what amount of risk are we able to take, if at all. And what does that word “safe” actually mean? We’re not going to really be safe. As long as that virus is out there and lingering, we’re not going to be safe. So we need to continue to do various public health measures really to protect everybody.
NERMEEN SHAIKH: Dr. Madad, that’s a very good point that you make about how essential social distancing is, given where we are now with both testing and clinical trials for drugs. Could you give us some sense, because obviously the costs of social distancing and the impossibility of social distancing in a large part of the world, the developing world, in particular, and in poorer — among poorer communities everywhere, where it’s simply not possible to be socially distant from others, what — how far are we along in clinical trials? And are there any alternatives at all to social distancing at the moment or in the foreseeable future, the near future?
DR. SYRA MADAD: So, any of these potential treatments that are being studied, they’re not going to be a silver bullet. And what I mean by that is they’re not going to be 100%. We still are waiting on the data for a number of these different pharmaceutical interventions to come out. You’re seeing some come out right now. For example, you know, hydroxychloroquine, you’re seeing whether it’s safe and effective, and in fact the data is showing otherwise, that it actually is not effective. And then you’re seeing other studies come out with remdesivir, that is showing — that is looking promising.
But again, you know, when you’re doing these clinical trials, you really need to go through the proper channels and making sure that you’re studying these individuals for a longer period of time. And that’s obviously not happening right now. These are very quick, short studies. And so, I think, in the coming weeks to months, we’ll probably get some more information in terms of the various clinical trials that are out there around the world, not just here in the United States. And so, you know, it seems as if we’ll —
AMY GOODMAN: And, Dr. Madad —
DR. SYRA MADAD: Yeah.
AMY GOODMAN: Do you want to weigh in on this huge controversy that’s happening with Dr. Bright right now? I mean, President Trump, the Trump administration, fires the person in charge of vaccines in the government, who has been fighting hard to coordinate all these kind of tests you’re talking about, clearly opposed to, you know, prescribing hydroxychloroquine or chloroquine without the proper studies, and now being taken out as he resists President Trump’s drug of choice, which hasn’t even been adequately tested.
DR. SYRA MADAD: You know, this is something I’ve been saying from the get-go. We really need to let science speak, and we really need to look at the facts. We need to follow the facts. There is, obviously, a lot that we don’t know, and we need to be very clear about that. And we need to make sure people understand. When we don’t know something, we’re providing that information; when we do know something, we can provide that information. And, you know, doing these types of — and having these types of actions and reactions is very unfortunate, because, really, it’s showing the credibility of the administration in and of itself. And this is a very pressing time, and a lot of lives are on the line. And we really need to make sure that we’re following the facts. And so we want to make sure that we are having experts be able to be at the table and drive these conversations.
AMY GOODMAN: We want to go to a break, and then we’re going to come back to Dr. Syra Madad, infectious disease specialist, special pathogens expert, here in New York City and for New York City. We’ll be back with Dr. Madad in a minute.
[break]
AMY GOODMAN: “Oh, What a World 2.0” by Kacey Musgraves. She reworked her song from 2018 and released it Wednesday on the 50th anniversary of Earth Day. This is Democracy Now!, democracynow.org, The Quarantine Report. I’m Amy Goodman, with Nermeen Shaikh. We’re both in the epicenter of the pandemic, as we continue to look at the path ahead for this pandemic, how we respond, how we consider when to reopen, with Dr. Syra Madad, infectious disease specialist, special pathogens expert. Dr. Madad, if you could talk about your own personal experience? Did you test positive for COVID-19?
DR. SYRA MADAD: Well, I did. I did test positive for COVID-19. Certainly, I think anyone getting that type of test result, it is scary, especially knowing, you know, if you have loved ones at home, those that are even in the high-risk category, which, for me, I do. It was something that, you know, when I got the test result, wasn’t surprising, really, unfortunately, given the circumstances and being out there. But I was able to quickly isolate myself. And luckily, everybody in my household was able to recover.
One of the symptoms that I had was the loss of taste and smell. And I actually had that for quite a few weeks. And just, actually, as of recently, I was able to get my full taste and smell back and be able to enjoy, for example, my cup of coffee. But, you know, with the coronavirus disease, the spectrum of illness is so wide and variable. You have people that are asymptomatic. You have those that have mild signs and symptoms of the disease. And then you have those that are more severe and critical, and people falling on those buckets. You know, right now we know there are certain aspects that put those in the high-risk category, but you’re also seeing very young, healthy individuals fall anywhere on that spectrum.
So, again, don’t know a whole lot about this disease, but we’re hopeful that as the days and hours and weeks progress, that we can learn more through, you know, factual means. And when I say “factual means,” you’re seeing a lot of information come out, a lot of things being published, not going through peer review. So, I caution anybody that’s going through a lot of — in reading a lot about this, making sure that you’re reading peer-reviewed information, things that actually have been going —
AMY GOODMAN: Dr. Syra Madad —
DR. SYRA MADAD: Yes.
AMY GOODMAN: Before we talk about that kind of information, just your own is so important for people to see someone who has recovered from COVID-19. You have three kids, right? Your last child, you just gave birth to in January? Can you talk about the kind of decisions you had to make when you tested positive, and what it means to isolate for a mom like you and a new mother?
DR. SYRA MADAD: So, you know, as you mentioned, I actually delivered in January my youngest. My baby girl turned 3 months most recently. And I’m a breast-feeding mother, 100%. So, it was certainly difficult, you know, to be able to isolate myself from my children, knowing I potentially already exposed them, after I had gotten my test results, because from what we know, you can actually spread the virus before actually being symptomatic. So everybody was already exposed in our household. And as I mentioned, luckily, everybody recovered. But, for me, as soon as I became symptomatic, I did isolate myself for a period of time, until I was afebrile for at least 72 hours. Certainly had a big impact on my family. Luckily, I have a great support system. My husband was able to watch the kids. But at the same time, I knew he obviously had it, as well. But I was symptomatic. Then —
AMY GOODMAN: He had it, too? He was positive, as well?
DR. SYRA MADAD: He had it, too, yeah. He was symptomatic first, and then I became symptomatic. And so, when I did, I was able to isolate myself, and he was not symptomatic during that time. But, you know, we had already exposed our children, if you will. And luckily, they actually had very mild signs and symptoms. We didn’t get them tested. The only person that actually did get tested is myself, as a person working in a healthcare system. And my in-laws, actually, both high-risk, one actually on hospice care, he actually did also get tested and did get tested positive. But we’re very lucky that everybody was able to recover.
NERMEEN SHAIKH: Dr. Madad, you mentioned that the spectrum of illness is so wide with COVID-19. And obviously, we’re all just learning about how this disease, this virus, spreads. But is there anything that can predict how severe the illness will be in people who get it?
DR. SYRA MADAD: That’s an excellent question. And what we’re seeing right now is, while we know this virus can infect anybody and anyone, if you will, regardless of your age, regardless of your health status — you know, this is just one of those viruses. You know, we know that it’s ubiquitous. But at the same time, there are these health disparities and social determinants that may put you at even high risk for having a worser outcome. And we’re actually seeing some of this play out. So, for example, you’re seeing a higher rate of infection in the African-American community. You’re seeing a high rate of infection in the Latino community.
And I think when you look at some of the social determinants of health, you’re also looking at the socioeconomic status and some of those variables that actually may put them at higher risk because of the type of work that they’re doing, for example, as essential workers, also looking at their living conditions, living in close quarters. I think it was by no accident that one of the first hospitals that was overwhelmed in New York City was Elmhurst Hospital. The reason for that is that particular area and that ZIP code is one of the most diverse urban areas in the United States, and you have a lot of families living together in close corridors.
And so, when we talked about social distancing, and as we mentioned actually earlier, you know, some people don’t have the privilege of actually socially distancing themselves, because there are so many people living in their household. And so, because of that, you can spread the virus much more easily and quickly. And we’re seeing a lot of that play out.
AMY GOODMAN: And can I ask you about this new observation? Not really new among the docs all over the country. I had gotten this random text last week: It’s not about the pneumonia, it’s about the blood clots. And I wanted to read to you from a Washington Post piece, “A mysterious blood-clotting complication is killing coronavirus patients.” It says, “Increasingly, doctors also are reporting bizarre, unsettling cases that don’t seem to follow any of the textbooks they’ve trained on. They describe patients with startlingly low oxygen levels — so low that they would normally be unconscious or near death — talking and swiping on their phones. Asymptomatic pregnant women suddenly in cardiac arrest. Patients who by all conventional measures seem to have mild disease deteriorating within minutes and dying at home.” And they’re saying it seems to be this issue of blood clots. In fact, the first person now, who’s believed to be weeks before we really believed, a 57-year-old woman in California, who was in very good shape, no preexisting conditions, it looks like she also died in this way, of sudden maybe cardiac arrest, and people didn’t identify it as coronavirus in the beginning of February. What about this blood clotting issue?
DR. SYRA MADAD: It certainly is an issue. And from what we’re seeing, you know, what hospitals are reporting, it is becoming — and I wouldn’t say “becoming” — it does seem to be a common issue. But what we’re also seeing is that, you know, while maybe folks may think that COVID-19 is more implicated with the lungs, we’re actually seeing a number of different organs within the body actually in distress and having various manifestations. So you’re seeing issues with kidneys and heart and brain and liver. And so, the way that it can manifest is obviously very different, and it depends on the individual, their immunoresponse and the body response.
But what we also don’t know is the sequelae. And what I mean by that is the long-term effects of COVID-19. And this is something — as I mentioned, it’s a new virus. It’s only about 4 or 5 months old. And we’re learning a lot about it, and a lot we don’t know. And everyone is really learning at the same time. We’re relying on each other to be transparent and show data and share some of the case studies that we’re seeing, that may help others that are obviously treating individuals with COVID-19.
But, you know, I think a good example would be, for example, Zika. You know, Zika was relatively something that a healthcare system did not experience that in the magnitude that we did a few years ago. And you saw, obviously, children being born with microcephaly and having other issues. Those individuals, those children, are still being studied long-term to actually look at the full effect of Zika. And you’re still seeing data come out.
And similarly with COVID-19, this being a new virus in and of itself, it’s going to take years for us to actually see the long-term effects, because we need to follow these individuals for their entire lifetime to actually see, you know, does it have additional effects on them, not just during the acute stage when they’re actually infected and in the hospital, but also once they get discharged. Is it going to have any effect on their health, moving forward? And really, that’s a question that we don’t have an answer to yet.
NERMEEN SHAIKH: And, Dr. Madad, very quickly, before we conclude, as I’m sure you know, many people are relying on the development of a vaccine, even if it will take from 12 to 18 months. But you’ve said that even a vaccine won’t be a silver bullet, as you said. Why is that? And what about your concerns about certain people perhaps not getting the vaccine even once it’s available? Why would people do that?
DR. SYRA MADAD: Well, first, I think when we say 12 to 18 months, you know, that is an optimistic timeline. Is it realistic? I don’t think it is very realistic, knowing that developing a vaccine actually takes years and years. And we really need to be very careful in making sure that we’re having a safe and effective vaccine to actually administer to the American public and globally.
And I think once we do have a vaccine that is safe and proven to be safe and effective, and whenever that will be, we’re going to have to jump through additional hurdles, like those that are hesitant to actually get vaccinated. You know, as you may be aware, the anti-vax movement is vast. It actually is one of the biggest — one of the biggest global health problems that we have in the world. So we need to make sure that even once we have a vaccine available, people are actually able and less reluctant to actually get vaccinated. But even on top of that, when these vaccines are manufactured, not everybody is going to get the vaccine at the same time. There are going to be — there’s going to be a short supply. And to get everyone vaccinated will take years. You know, we’re a very, very large country with many individuals. And to be able to vaccinate everybody that is eligible to get vaccinated will take at least a year or two, or maybe even longer. And so we need to really face the facts and know that this is where we’re at, and we know that there’s going to be additional hurdles once that vaccine is available. And so, this whole notion of herd immunity, and so on and so forth, we really need to give it a lot more thought.
AMY GOODMAN: Well, we want to thank you so much, Dr. Syra Madad, infectious disease specialist, special pathogens expert, featured in the first episode of this remarkable series that came out on Netflix called Pandemic, which, unbelievably enough, came out right at the beginning. And, Dr. Madad, we’re so thankful that you and your family now are safe, are healthy, and we just hope that for the rest of the country and the world.
We also have this breaking news: The Labor Department has just reported another 4.4 million people, U.S. citizens, filed for unemployment claims over the last week, bringing the total over the past five weeks to over 26 million. That doesn’t even include the millions of undocumented immigrants living in the U.S. who have lost their jobs due to the pandemic, and those who tried to apply but weren’t able to.
When we come back, we speak to another doctor, a global health expert, about the efforts to stop the daily spread of COVID-19 with contact tracing in Massachusetts — following those who have been in contact with those who have COVID-19. Stay with us.
[break]
AMY GOODMAN: “He Will See You Through,” sung and written by Rhiannon Giddens, with Francesco Turrisi on accordion — they are social distancing in two different places — as part of the Humanity in Concert series.


democracynow--2020-04-23--Headlines for April 23, 2020

Headlines for April 23, 2020

The known death toll from the coronavirus pandemic has topped 184,000 , with the United States continuing to lead the world in confirmed cases and fatalities .
According to Johns Hopkins researchers , 46,785 U.S. residents have died of COVID-19 ; more than 10,000 of the deaths have occurred at nursing homes and other long-term care centers .
In New York , where the death toll from COVID-19 has passed 15,000 , six prisoners have died in state prisons — four of them at the notorious Sing Sing prison north of New York City .
In Chicago , six prisoners @ @ @ @ @ @ @ at the Cook County Jail , where hundreds are sick .
In Ohio , a federal judge has ordered the release or transfer of hundreds of elderly or vulnerable prisoners held at the Elkton prison , where six people have died of COVID-19 .
This comes as the American Civil Liberties warns U.S. models for the spread of coronavirus may be underestimating future deaths by nearly 100,000 unless counties take immediate steps to reduce jail populations .
And the ACLU notes those figures don ’ t even account for state and federal prisons @ @ @ @ @ @ @ warns , “ Unequivocally , keeping people out of jail saves lives — both inside the jail and in the surrounding community .
Lives are at stake .
The time to act is now .
”

The known death toll from the coronavirus pandemic has topped 184,000, with the United States continuing to lead the world in confirmed cases and fatalities. According to Johns Hopkins researchers, 46,785 U.S. residents have died of COVID-19; more than 10,000 of the deaths have occurred at nursing homes and other long-term care centers.
In New York, where the death toll from COVID-19 has passed 15,000, six prisoners have died in state prisons — four of them at the notorious Sing Sing prison north of New York City.
In Chicago, six prisoners and one guard have died of COVID-19 at the Cook County Jail, where hundreds are sick.
In Ohio, a federal judge has ordered the release or transfer of hundreds of elderly or vulnerable prisoners held at the Elkton prison, where six people have died of COVID-19.
This comes as the American Civil Liberties warns U.S. models for the spread of coronavirus may be underestimating future deaths by nearly 100,000 unless counties take immediate steps to reduce jail populations. And the ACLU notes those figures don’t even account for state and federal prisons and immigration detention centers. The ACLU warns, “Unequivocally, keeping people out of jail saves lives — both inside the jail and in the surrounding community. Lives are at stake. The time to act is now.”


democracynow--2020-04-24--"We Don't Have the Capacity to Treat": Palestinian-Canadian Doctor Says Israel Must Lift Gaza Siege

This is a rush transcript .
Copy may not be in its final form .
AMY GOODMAN : This is Democracy Now !
, democracynow.org , The Quarantine Report .
I ’ m Amy Goodman .
We ’ re turning now to Gaza , where fears continue to grow about what a rampant outbreak of the coronavirus might do to the occupied Palestinian territory , already crippled by years of Israeli sanctions .
The Gaza Strip thus far has only reported 17 confirmed cases of COVID-19 , but this week the Israeli army halted testing there after just two days @ @ @ @ @ @ @ the International Committee of the Red Cross donated medical equipment to Gaza hospitals , but its weak medical system remains ill-equipped to serve an influx of patients .
The Red Cross reports Gaza has just 93 ventilators for a population of more than 2 million Palestinians .
This is Gaza Health Ministry official Abdullatif Alhaj .
AMY GOODMAN : Crowded refugee camps in the Occupied Territories are particularly at risk .
This is Um-Shady , a Palestinian woman living at a refugee camp in Gaza with her family , speaking to the BBC @ @ @ @ @ @ @ we ’ re joined by Dr. Tarek Loubani , Palestinian-Canadian doctor , emergency room physician , based in London , Ontario , Canada .
He volunteers in the Gaza Strip , returned from a trip there last month .
Dr. Loubani recently wrote an op-ed in The Washington Post headlined “ Gaza is an open-air prison .
As covid-19 spreads , it ’ s time to lift the siege.
” Dr. Loubani , it ’ s great to have you back on Democracy Now !
Talk about the situation there , before we @ @ @ @ @ @ @ Canada , as you are an emergency room doctor .
What ’ s happening in Gaza ?
DR. TAREK LOUBANI : In the Gaza Strip right now , we see a situation in which , very clearly , we ’ re not able to detect the active cases that are happening and are definitely circulating within the Gaza Strip .
Testing is severely limited .
There are fewer — there have been fewer tests in Gaza so far throughout the entire pandemic than there were in South Korea yesterday .
And so we @ @ @ @ @ @ @ all of the cases that exist .
We know that we don ’ t have the capacity to treat .
And we know that these cases are not just circulating , but are also about to spike in terms of their severity and consequences .
AMY GOODMAN : And talk about the latest news that we have out of Gaza .
But first I want to go to the world-renowned linguist , political dissident Noam Chomsky .
I just had a chance to speak with him a week or two ago from his @ @ @ @ @ @ @ at home in Tucson , Arizona , and asked him what the coronavirus pandemic means for Gaza .
AMY GOODMAN : If you could expand on what Professor Chomsky is saying , Dr. Tarek Loubani ?
And , I mean , you have direct experience in Gaza , have been there a number of times .
In fact , you were shot by the Israeli military when you were there , as you were there as a medic helping people in Gaza involved with a nonviolent protest , who were being gunned down @ @ @ @ @ @ @ in Gaza has been terrible for years .
I ’ ve been going there for about a decade .
And one of the things that always shocked me is that each trip I think to myself , “ This can not possibly get worse , ” and then , each trip , it does .
And this was truly one of the worst visits that I had had .
You know , we had some improvement in electricity .
We were up to five or six hours a day of electricity , and @ @ @ @ @ @ @ ’ s so wonderful !
” But in the hospitals , all of our supplies were out , in general , even without anything .
We barely have enough gloves to proceed day to day .
For example , usually I would carry a pair of gloves in my pocket and then only put one when I treat a patient , so that I would spare the other one , and then , with my bare hand , would try to touch maybe areas that weren ’ t as contaminated or sensitive .
@ @ @ @ @ @ @ which something like the coronavirus is bound to keep spreading , and a situation where I understand that there are lots of geopolitical factors that are at play here .
And I just think that what we need right now , if Palestine is this open-air prison , or if Gaza is this open-air prison , is just a moment ’ s parole .
This situation is so severe and so dire that it ’ s not only going to impact on the Gazans — though I think that they should be the @ @ @ @ @ @ @ also going to impact on everybody around .
The virus does not care about the geopolitics .
It will go to Egypt .
It will go to Jordan .
It will go to Israel .
And it will affect all of those populations and make it impossible for them to control their COVID situation .
AMY GOODMAN : So , what has to happen there , Dr. Loubani ?
DR. TAREK LOUBANI : Absolutely the first thing that has to happen is an unrestricted permission for all medical aid , medical supplies and @ @ @ @ @ @ @ number one .
It must happen , effective immediately .
And we have all , within the medical community , not been requesting or demanding that the Israelis do this ; we ’ ve been begging that the Israelis do this .
This is not a situation , I think , in which there can be much pride or ego about it .
This is a situation of absolute catastrophe .
And the Israelis really do , in a big way , hold the keys here .
And so , that ’ s @ @ @ @ @ @ @ them to just stop for a moment with the severity of the siege .
And then , you know what ?
We can go back to status quo once this disaster is addressed .
The second thing , of course , is we can ’ t treat what we can ’ t see .
And so we need those tests to resume immediately , even if there isn ’ t an unrestricted lifting of the siege for medical personnel and medical equipment .
At the very least , the tests have to start @ @ @ @ @ @ @ of course , one of the disasters that ’ s happening right now , there are about 2,000 people in quarantine , but the people who are trying to support them in quarantine don ’ t have any PPE .
And so , the first two cases were people who had come from outside , but the next 15 cases were people who had been in contact with those people , in Gaza .
It ’ s slightly different in the West Bank .
And so we need , really , personal protective @ @ @ @ @ @ @ the Gazans are trying , and people in the West Bank are trying to make their own , as they are elsewhere .
But it ’ s impossible to do that under the current conditions .
AMY GOODMAN : Finally , we only have a few minutes , but I wanted to go where you are right now , to Canada .
You ’ re based in London , Ontario .
You ’ re a Canadian doctor , emergency room physician .
Can you talk about how Canada has approached this , how @ @ @ @ @ @ @ the massive lack of testing and PPE , personal protective gear , for the doctors , the nurses , the custodian , the cleaning staff at all of these hospitals ?
What has it been like in Canada ?
DR. TAREK LOUBANI : Obviously , the situation in Canada is much better than the United States .
And I think we can really chalk that up to a couple of factors .
One of them is the fact that we have for medical care system that will care for anybody , under any @ @ @ @ @ @ @ of care .
Of course we pay for our medical system , but we don ’ t do it when we show up to the hospital .
Nobody asks for a credit card or a bill .
And if people aren ’ t able to pay who aren ’ t covered under the health system , then we take a risk-based approach , and , obviously , for public health , everything is covered .
The other big aspect here is that people , of course , are worried about poverty .
Canada @ @ @ @ @ @ @ not as worried about poverty , because there are some social safety nets .
And so , the real pillars of the response are things like making sure that everybody can access healthcare — well , we have that in Canada ; making sure that everybody can stay away from work and not be worried about ending up on the streets — well , it ’ s not as good as we want it , but we have that , in large part , in Canada .
Canada has many problems , of @ @ @ @ @ @ @ our neighbors in the south , it ’ s obvious that the way in which Canada has set up its system and guaranteed care has reduced the caseload tremendously and is giving us a fighting chance .
AMY GOODMAN : And finally , you just had one of the worst massacres in Canadian history , 22 people dead , it looks like , at this count , in Nova Scotia .
You have this 51-year-old man who posed as a police officer .
Apparently , AP is reporting he had just had a @ @ @ @ @ @ @ this attack .
But so often these mass shootings are related to domestic violence and abuse of women .
Now Prime Minister Trudeau is talking about tightening gun rules in Canada .
If you could just , overall , comment on what this has meant for Canada ?
There will be a news conference today , where they ’ ll be releasing the latest information around this ?
DR. TAREK LOUBANI : I ’ m from the east coast of Canada and still have family there , so this did hit close to @ @ @ @ @ @ @ as an emergency physician , we see the impacts of gunshot wounds , and we see the impacts of domestic violence , as well .
And , of course , in domestic violence situations , having the availability of a gun is a surefire ingredient in the recipe for disaster .
And so , of course , as an emergency physician , I applaud the Canadian government for doing what they can to improve gun control regulations .
I don ’ t know enough about the situation in Nova Scotia to comment very @ @ @ @ @ @ @ with what we see with gun-related violence , it ’ s obvious that even though Canada , again , does a better job than the United States with gun control , there ’ s still some way to go .
And Canadian doctors have called for this in a concerted way over the past few years .
AMY GOODMAN : Dr. Tarek Loubani , we want to thank you for being with us , Palestinian-Canadian doctor , emergency room physician , based in London , Ontario , Canada .
We ’ ll link @ @ @ @ @ @ @ on what ’ s happening in Gaza .
Democracy Now !
is working with as few people on site as possible .
The majority of our amazing team is working from home .
By the way , if you want to get our daily quarantine report , Democracy Now !
’ s daily show and all its reports , in transcript , video and audio podcast form , you can send the word “ democracynow ” — one word — to 66866 .
Text the word “ democracynow ” — one word — @ @ @ @ @ @ @ at democracynow.org .
Democracy Now !
is produced with Renée Feltz , Mike Burke , Deena Guzder , Libby Rainey , Nermeen Shaikh , Carla Wills , Tami Woronoff , Charina Nadura , Sam Alcoff , Tey-Marie Astudillo , John Hamilton , Robby Karran , Hany Massoud , Adriano Contreras , María Taracena .
Our general manager is Julie Crosby .
Special thanks to Becca Staley , Miriam Barnard , Paul Powell , Denis Moynihan .
I ’ m Amy Goodman .

This is a rush transcript. Copy may not be in its final form.
AMY GOODMAN: This is Democracy Now!, democracynow.org, The Quarantine Report. I’m Amy Goodman. We’re turning now to Gaza, where fears continue to grow about what a rampant outbreak of the coronavirus might do to the occupied Palestinian territory, already crippled by years of Israeli sanctions. The Gaza Strip thus far has only reported 17 confirmed cases of COVID-19, but this week the Israeli army halted testing there after just two days of administering tests.
On Thursday, the International Committee of the Red Cross donated medical equipment to Gaza hospitals, but its weak medical system remains ill-equipped to serve an influx of patients. The Red Cross reports Gaza has just 93 ventilators for a population of more than 2 million Palestinians. This is Gaza Health Ministry official Abdullatif Alhaj.
ABDULLATIF ALHAJ: Facing this COVID-19 as a pandemic, Gaza is facing this pandemic with its fragile and overstretched health system due to lots of factors, like the long years of closure and siege, and the poverty and loss of — I mean, shortage of many resources.
AMY GOODMAN: Crowded refugee camps in the Occupied Territories are particularly at risk. This is Um-Shady, a Palestinian woman living at a refugee camp in Gaza with her family, speaking to the BBC.
UM-SHADY: [translated] We know that here in Gaza there are no resources to fight this virus. We’re all in God’s hands here. … People don’t have enough to eat, and there is no work. Had there been any means to work, we would have helped ourselves. But we can’t go out there. I borrowed money to buy food for this week. But next week, I might not be able to borrow anything to feed these kids.
AMY GOODMAN: For more, we’re joined by Dr. Tarek Loubani, Palestinian-Canadian doctor, emergency room physician, based in London, Ontario, Canada. He volunteers in the Gaza Strip, returned from a trip there last month. Dr. Loubani recently wrote an op-ed in The Washington Post headlined “Gaza is an open-air prison. As covid-19 spreads, it’s time to lift the siege.”
Dr. Loubani, it’s great to have you back on Democracy Now! Talk about the situation there, before we talk about what’s happening in Canada, as you are an emergency room doctor. What’s happening in Gaza?
DR. TAREK LOUBANI: In the Gaza Strip right now, we see a situation in which, very clearly, we’re not able to detect the active cases that are happening and are definitely circulating within the Gaza Strip. Testing is severely limited. There are fewer — there have been fewer tests in Gaza so far throughout the entire pandemic than there were in South Korea yesterday. And so we know that we don’t see all of the cases that exist. We know that we don’t have the capacity to treat. And we know that these cases are not just circulating, but are also about to spike in terms of their severity and consequences.
AMY GOODMAN: And talk about the latest news that we have out of Gaza. But first I want to go to the world-renowned linguist, political dissident Noam Chomsky. I just had a chance to speak with him a week or two ago from his home, where he’s sheltering at home in Tucson, Arizona, and asked him what the coronavirus pandemic means for Gaza.
NOAM CHOMSKY: International institutions have pointed out that by 2020 — that’s now — Gaza will probably become barely livable. About 95% of the water is totally polluted. The place is a disaster. And Trump has made sure that it will get worse. He withdrew funding from the support systems for Palestinians in Gaza and the West Bank — UNRWA, killed the funding; Palestinian hospitals, killed the funding. And he had a reason. They weren’t praising him enough. They weren’t respectful of the god, so, therefore, we’ll strangle them, even when they’re barely surviving under a harsh and brutal regime.
AMY GOODMAN: If you could expand on what Professor Chomsky is saying, Dr. Tarek Loubani? And, I mean, you have direct experience in Gaza, have been there a number of times. In fact, you were shot by the Israeli military when you were there, as you were there as a medic helping people in Gaza involved with a nonviolent protest, who were being gunned down.
DR. TAREK LOUBANI: The situation in Gaza has been terrible for years. I’ve been going there for about a decade. And one of the things that always shocked me is that each trip I think to myself, “This cannot possibly get worse,” and then, each trip, it does. And this was truly one of the worst visits that I had had.
You know, we had some improvement in electricity. We were up to five or six hours a day of electricity, and people thought, “Wow! That’s so wonderful!” But in the hospitals, all of our supplies were out, in general, even without anything. We barely have enough gloves to proceed day to day. For example, usually I would carry a pair of gloves in my pocket and then only put one when I treat a patient, so that I would spare the other one, and then, with my bare hand, would try to touch maybe areas that weren’t as contaminated or sensitive.
It’s really a situation in which something like the coronavirus is bound to keep spreading, and a situation where I understand that there are lots of geopolitical factors that are at play here. And I just think that what we need right now, if Palestine is this open-air prison, or if Gaza is this open-air prison, is just a moment’s parole. This situation is so severe and so dire that it’s not only going to impact on the Gazans — though I think that they should be the main consideration — but it’s also going to impact on everybody around. The virus does not care about the geopolitics. It will go to Egypt. It will go to Jordan. It will go to Israel. And it will affect all of those populations and make it impossible for them to control their COVID situation.
AMY GOODMAN: So, what has to happen there, Dr. Loubani?
DR. TAREK LOUBANI: Absolutely the first thing that has to happen is an unrestricted permission for all medical aid, medical supplies and medical personnel to enter. That is number one. It must happen, effective immediately. And we have all, within the medical community, not been requesting or demanding that the Israelis do this; we’ve been begging that the Israelis do this. This is not a situation, I think, in which there can be much pride or ego about it. This is a situation of absolute catastrophe. And the Israelis really do, in a big way, hold the keys here. And so, that’s why so many of us are imploring them to just stop for a moment with the severity of the siege. And then, you know what? We can go back to status quo once this disaster is addressed.
The second thing, of course, is we can’t treat what we can’t see. And so we need those tests to resume immediately, even if there isn’t an unrestricted lifting of the siege for medical personnel and medical equipment. At the very least, the tests have to start flowing.
And then, thirdly, of course, one of the disasters that’s happening right now, there are about 2,000 people in quarantine, but the people who are trying to support them in quarantine don’t have any PPE. And so, the first two cases were people who had come from outside, but the next 15 cases were people who had been in contact with those people, in Gaza. It’s slightly different in the West Bank. And so we need, really, personal protective equipment. We’re trying, the Gazans are trying, and people in the West Bank are trying to make their own, as they are elsewhere. But it’s impossible to do that under the current conditions.
AMY GOODMAN: Finally, we only have a few minutes, but I wanted to go where you are right now, to Canada. You’re based in London, Ontario. You’re a Canadian doctor, emergency room physician. Can you talk about how Canada has approached this, how it compares to the United States — the massive lack of testing and PPE, personal protective gear, for the doctors, the nurses, the custodian, the cleaning staff at all of these hospitals? What has it been like in Canada?
DR. TAREK LOUBANI: Obviously, the situation in Canada is much better than the United States. And I think we can really chalk that up to a couple of factors. One of them is the fact that we have for medical care system that will care for anybody, under any condition, without payment at the point of care. Of course we pay for our medical system, but we don’t do it when we show up to the hospital. Nobody asks for a credit card or a bill. And if people aren’t able to pay who aren’t covered under the health system, then we take a risk-based approach, and, obviously, for public health, everything is covered.
The other big aspect here is that people, of course, are worried about poverty. Canada is no panacea, but they are not as worried about poverty, because there are some social safety nets. And so, the real pillars of the response are things like making sure that everybody can access healthcare — well, we have that in Canada; making sure that everybody can stay away from work and not be worried about ending up on the streets — well, it’s not as good as we want it, but we have that, in large part, in Canada. Canada has many problems, of course, but when we look to our neighbors in the south, it’s obvious that the way in which Canada has set up its system and guaranteed care has reduced the caseload tremendously and is giving us a fighting chance.
AMY GOODMAN: And finally, you just had one of the worst massacres in Canadian history, 22 people dead, it looks like, at this count, in Nova Scotia. You have this 51-year-old man who posed as a police officer. Apparently, AP is reporting he had just had a fight with his girlfriend. She survived this attack. But so often these mass shootings are related to domestic violence and abuse of women. Now Prime Minister Trudeau is talking about tightening gun rules in Canada. If you could just, overall, comment on what this has meant for Canada? There will be a news conference today, where they’ll be releasing the latest information around this?
DR. TAREK LOUBANI: I’m from the east coast of Canada and still have family there, so this did hit close to home for me. I think, as an emergency physician, we see the impacts of gunshot wounds, and we see the impacts of domestic violence, as well. And, of course, in domestic violence situations, having the availability of a gun is a surefire ingredient in the recipe for disaster. And so, of course, as an emergency physician, I applaud the Canadian government for doing what they can to improve gun control regulations. I don’t know enough about the situation in Nova Scotia to comment very intelligently, but, in general, with what we see with gun-related violence, it’s obvious that even though Canada, again, does a better job than the United States with gun control, there’s still some way to go. And Canadian doctors have called for this in a concerted way over the past few years.
AMY GOODMAN: Dr. Tarek Loubani, we want to thank you for being with us, Palestinian-Canadian doctor, emergency room physician, based in London, Ontario, Canada. We’ll link to your piece in The Washington Post on what’s happening in Gaza.
Democracy Now! is working with as few people on site as possible. The majority of our amazing team is working from home.
By the way, if you want to get our daily quarantine report, Democracy Now!’s daily show and all its reports, in transcript, video and audio podcast form, you can send the word “democracynow” — one word — to 66866. Text the word “democracynow” — one word — to 66866, or sign up online at democracynow.org.
Democracy Now! is produced with Renée Feltz, Mike Burke, Deena Guzder, Libby Rainey, Nermeen Shaikh, Carla Wills, Tami Woronoff, Charina Nadura, Sam Alcoff, Tey-Marie Astudillo, John Hamilton, Robby Karran, Hany Massoud, Adriano Contreras, María Taracena. Our general manager is Julie Crosby. Special thanks to Becca Staley, Miriam Barnard, Paul Powell, Denis Moynihan. I’m Amy Goodman.