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What Does COVID-19 Modeling Show, And How Can U.S. Lessen The Pain?


April begins with an acknowledgement of reality. President Trump says the first part of this month will be, quote, "one of the roughest two or three weeks we've ever had." U.S. government projections say the coronavirus has spread far enough that the less-bad scenario includes 100,000 to 200,000 deaths.


A big change from what the president has said in the past. The virus spread during months when the president said the United States would soon have zero cases. He told a campaign rally that he was the victim of a hoax. In February, he repeatedly minimized the importance of the pandemic.


PRESIDENT DONALD TRUMP: You know, you do certain things that you do when you have the flu. I mean, view this the same as the flu.

INSKEEP: As recently as last week, the president spent days urging the nation to return to normal.


TRUMP: I would love to have the country opened up and just raring to go by Easter.

INSKEEP: Easter is April 12, a date that White House computer modeling places within the period of peak deaths.

MARTIN: And then last evening, President Trump tried to leave the impression that he has understood the severity of the crisis from the beginning.


TRUMP: I mean, I've had many friends - business people, people with great, actually, common sense - they said, why don't we ride it out? A lot of people have said, a lot of people have thought about it - ride it out. Don't do anything. Just ride it out. And think of it as the flu. But it's not the flu; it's vicious.

MARTIN: So what does the modeling actually show, and how much can the U.S. do to minimize the inevitable pain? With us now, NPR global health correspondent Nurith Aizenman. Also, we've got NPR White House correspondent Ayesha Rascoe. Good morning to you both.


NURITH AIZENMAN, BYLINE: Good morning, Rachel.

MARTIN: Nurith, I want to start with you. The president's saying the next couple of weeks are going to be some of the most difficult the country has ever had to face. What are you hearing right now from health professionals, from the scientists?

AIZENMAN: Well, so the bottom line - the models that the White House is relying on say so many people in the U.S. are already infected with coronavirus that not only is drastic action needed, it's going to take a while for those measures to slow down; the process of, you know, one person passing the disease to another and then onto another.

And so what these models predict is, over the next two weeks, every day there will be more hospitalizations, more deaths, until the U.S. hits the peak of this wave. And by the time this is all suppressed, between 100,000 to 240,000 people in the U.S. will have died.

MARTIN: Ayesha, let's talk a little bit more about how the president is presenting this. Let's play a clip. This is from the beginning of his press conference yesterday.


TRUMP: Our country is in the midst of a great national trial, unlike any we have ever faced before.

MARTIN: But as we pointed out a moment ago, Ayesha, the president himself spent many, many weeks downplaying this virus.

RASCOE: Yes, President Trump's messaging has been all over the place during this crisis. Just two weeks ago, he was sounding really somber when he announced the first 15-day guidelines. But then last week, he started pulling back, saying the cure might be worse than the disease, and we have to get the economy moving again. He was comparing the virus to the flu, as we said, and to deaths from car accidents. And now his tune is changing again.

So in this moment, he's saying he wants people to be prepared. But a real question is does he stick with this position going forward, and can people expect that this is what the administration is going to be saying and that this is what they're going to stick with?

MARTIN: Right. And that's a challenge for people like Dr. Anthony Fauci, Deborah Birx, people who are trying to be consistent in messaging the importance of social distancing and to get people to take this seriously. I mean, Nurith, what does the modeling suggest about when things are going to get better?

AIZENMAN: You know, while the president said we're in for two or three weeks of pain, this is not just two or three weeks. Several more weeks after the peak, the number of new deaths each day will still be high; it's just that every day it will be slightly lower than it was the day before. And of course, by the end of it, even with full mitigation, the administration says if the models are right, there will still be that minimum 100,000-person death toll.

Here's Dr. Anthony Fauci, who's on the White House coronavirus task force.


ANTHONY FAUCI: As sobering a number as that is, we should be prepared for it. Is it going to be that much? I hope not. And I think the more we push on the mitigation, the less likelihood it will be that number.

AIZENMAN: But again, that's if the model is wrong. You know, Fauci is acknowledging that right now the model is predicting that high death toll, even with full mitigation measures. And also, you know, as we brace for this, it's worth keeping in mind the timing of when illnesses and deaths will peak will actually vary from state to state.

MARTIN: It's so interesting, too, because we've been hearing talk about the peak, you know, as if when we just get on the other side, things are going to get better, but that's not necessarily the case, is it?

AIZENMAN: Exactly.

MARTIN: New York. I mean, New York right now...


MARTIN: I want to pivot to New York because it's experiencing just the worst of the outbreak right now. So as we look to that - because as we start to look to the future, what's the next New York, Nurith? What are you seeing?

AIZENMAN: Well, of course, there's a lot of concern about other places where cases are rising right now, like New Orleans. But I spoke with one of the researchers who created this model that the administration is citing, Dr. Ali Mokdad out of University of Washington's Institute for Health Metrics and Evaluation, and he's particularly worried about a state that isn't projected to peak until about a month from now - Florida.

At the - at Florida's peak, it's projected to see about 136 deaths a day. And Mokdad says that's because Florida is a state with a large share of older people, who are more vulnerable to this virus. Also, it's one of a number of states whose governors have not issued statewide social distancing rules. Georgia, Mississippi, Texas, Nevada - those are others.

MARTIN: So they might not have statewide social distancing rules, but there are nationwide guidelines, right? I mean, the president and his team have extended them until the end of April.

AIZENMAN: Yeah. And I think it's significant that when I asked Mokdad about that, he told me something that the administration has not mentioned about this model that Mokdad's team created and that the White House is relying on, which is that the model does not consider the president's guidelines effective, per se, because they're just guidelines. In states that don't have their own rules, it's not clear how much people are following the president's recommendations. So the model bases its forecast on when each state put in place their strict measures.

And for those states that haven't done that yet, the model assumes they will put in those measures a week from now and that all states will keep these measures in place until June 1. Remember - the president's guidelines right now expire on May 1. And so if states don't do all of that, the death toll would be projected to be even higher.

And interestingly, in Florida, the governor is saying he'll put it in these statewide measures if the president tells him to. But when Trump was asked if he was going to tell Florida's governor to do so, he said, no, you know, I'll leave that to the governor to decide what's best for his state.

MARTIN: Well, it sounds like both of them are punting, right? I mean, Ayesha, the president's saying he's not...

AIZENMAN: (Laughter).

MARTIN: ...Going to instruct the governor of Florida to impose guidelines. As you mentioned, I mean, the president's tone may be more grave. He was asked yesterday whether he downplayed things early and lulled people into a false sense of security. How did he respond to that?

RASCOE: Well, he defended his actions. He said he knew it was going to be bad, but he wanted to give people hope. Here's more from him on that.


TRUMP: This is really easy to be negative about, but I want to give people hope, too. You know, I'm a cheerleader for the country. We're going through the worst thing that the country's probably ever seen.

RASCOE: And as he often does, he talked about that early decision to limit travel from China. And then later from Europe. The issue, though, of course, is not just words; it's whether the administration was really moving quickly enough and is moving quickly enough. And at the briefing, the task force did try to defend that.

MARTIN: Nurith, I want to close with you. I mean, clearly, as a country, we are looking at some very grim weeks ahead. Is there any good news in this moment? Very briefly.

AIZENMAN: California and Washington saw some of the earliest cases but also took some of the earliest social distancing steps, and they have managed to slow down the spread. So this does work.

MARTIN: It does work. OK. NPR's Nurith Aizenman and Ayesha Rascoe. We appreciate it.

RASCOE: Thank you. Transcript provided by NPR, Copyright NPR.

Ayesha Rascoe is a White House correspondent for NPR. She is currently covering her third presidential administration. Rascoe's White House coverage has included a number of high profile foreign trips, including President Trump's 2019 summit with North Korean leader Kim Jong Un in Hanoi, Vietnam, and President Obama's final NATO summit in Warsaw, Poland in 2016. As a part of the White House team, she's also a regular on the NPR Politics Podcast.