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Is COVID-19 Spread By Talking? That And Other Questions Are Answered

NOEL KING, HOST:

Medical experts and the Trump administration are warning us to be ready for a hard week ahead. Jerome Adams, the surgeon general, says it will be a Pearl Harbor moment for the country. And yesterday, Dr. Deborah Birx of the White House Coronavirus Task Force said three hot spots - Detroit, New York and Louisiana - will probably hit their peak in the next five to six days.

I'm on Skype now with Dr. Harvey Fineberg, who has advised the administration on this pandemic. He is the chair of the National Academies' Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats. Good morning, Dr. Fineberg.

HARVEY FINEBERG: Good morning, Noel. It's good to be with you.

KING: Good to have you here.

I want to start by asking you a question that the administration asked you. And that is whether the coronavirus, COVID-19, can be spread by talking. There has been a lot of confusion over this. Can it spread that way?

FINEBERG: The short answer is yes. The COVID virus, like any respiratory virus, can be spread in three ways. One is by large droplets. You know when someone is shouting in your face or talking at you or laughing and you feel the spray? That's large droplet. The second is tiny droplets. And of course, these droplets have a whole spectrum in size. But when they get small enough, they actually form what scientists call a bioaerosol, meaning that they're so tiny, they can float in the air. They don't even drop to the ground.

Now, when you talk, you produce quite a few intermediate sized that go out for a while and then do fall to the ground. But some of us, by talking or even breathing, produce a fair number of these tiny bioaerosol particles. And those, effectively, can float around for a while. Now, what's important is that that is a problem mainly in closed spaces, like patient care rooms. And that's why it is so important for our health care professionals to have that personal protective equipment - the goggles as well as the masks. When you're outdoors and you keep your social distance, that bioaerosol is dispersed in this great outdoor air, and there's no real danger from that. But...

KING: So Dr. Fineberg...

FINEBERG: Yeah.

KING: ...Who should be wearing a mask and when? We've been very slow to this, in this country, to a kind of firm answer. What would your firm answer be?

FINEBERG: My answer, right now is that it would be prudent for all of us, when we're out and about, to wear a face covering. The main reason, actually, isn't only to protect ourselves. In fact, it probably doesn't actually afford that much protection to the wearer. But if all of us have these masks in front of our mouth and nose, we are less likely to emit these particles that could infect someone else. And because this virus can be infectious while someone is asymptomatic or presymptomatic, you could feel perfectly well, be out and about spreading the virus unwittingly. That's why if all of us adopted this practice of wearing a face mask, it would be one more step to reduce the spread. It does not substitute for social distancing, physical distancing, hand-washing. But if we add that on top, it's another way to slow the spread.

KING: It can only help.

You've written about how important it is to find people who have been infected, who have recovered and who are possibly immune. Why are those people so important? How do they help in the fight against this virus?

FINEBERG: Those parts of the world that have been most successful in dealing with the COVID-19 have had physical distancing, yes, but they've done much more. They've tested widely. They've identified every individual - symptomatic - who has the disease and tested enough of the contacts to get people even in this presymptomatic phase.

If you separate the people who are infected - that's called isolation - and then you separate those who are the contacts for a period of time - that's called quarantine - from the rest of the population, you have a much faster way of containing this virus and preventing its spread from one person to another. The only way we're going to stop the virus is by preventing spread from person to person. And these are added measures that accomplish that goal.

KING: Because you've advised the administration, I want to ask you this question. President Trump has said that a drug called hydroxychloroquine should be used to treat the virus. He says there's nothing to lose. Is he right?

FINEBERG: Not exactly. Hydroxychloroquine is relatively safe, but it can have some cardiovascular side effects. In general, health professionals understand that a drug that could work also might not work. And if you are in a desperate situation, yes, you might apply a variety of experimental treatments.

For me personally, plasma from patients who have recovered - who have antibody - is a kind of experimental treatment now that would qualify for that kind of emergency use. With hydroxychloroquine, we'll know soon enough whether it does or does not have a net benefit for patients with COVID. But that requires a controlled clinical trial. It's the only way to know. And honestly, it's much better, for me, if the president has said, we'll know soon whether hydroxychloroquine is, in fact, worth using.

KING: Dr. Harvey Fineberg was the president of the former Institute of Medicine. Dr. Fineberg, thank you so much for your time this morning.

FINEBERG: It's my pleasure. Transcript provided by NPR, Copyright NPR.

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