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Scientists Debate How Coronavirus Spreads, Experts Push For Mask Mandate

DAVID GREENE, HOST:

The number as we begin this new week is 2.9 million - 2.9 million confirmed coronavirus cases in the United States. Almost 130,000 people in this country have died. This holiday weekend, we saw a slight decline in cases nationally, but the virus is circulating widely. There are some incredibly worrisome hotspots. And scientists are now debating whether the virus actually spreads in a different way, not just in droplets but in particles floating in the air. We want to begin with NPR's Allison Aubrey, who has been covering so many facets of this story. Hi, Allison.

ALLISON AUBREY, BYLINE: Good morning, David.

GREENE: So I want to start, if we can, with a fact check.

AUBREY: Sure.

GREENE: President Trump said in a speech over the weekend that 99% of coronavirus cases are, quote, "harmless." Not true. And I just wonder what the response has been from state leaders who are doing the best they can to try and contain this.

AUBREY: Sure. Well, Trump's own FDA commissioner, Stephen Hahn, would not back up the president on this comment. He pointed out the growing number of cases is concern, that this is a rapidly moving epidemic. And keep in mind, David, about 80% of cases are mild. But about 15 to 20% require hospitalization. Three to 5% require ICU care. And New Jersey Governor Phil Murphy pointed to the death toll on NBC.

(SOUNDBITE OF NBC BROADCAST)

PHIL MURPHY: This thing is lethal. New Jersey's paid an enormous price. We've lost over 13,000 confirmed fatalities from COVID-19. We're starting to see a small spikes in reinfection from folks coming back from places like Myrtle Beach and as well as in Florida, other hotspots. To me, it says we need a national strategy, I think, right now. And masking has got to be at the core of that.

AUBREY: So instead of mask policies differing from state to state, the thought is that no matter where you are in the country, there needs to be standard rules.

GREENE: Well, what do infectious disease experts say about that idea?

AUBREY: Well, you know, I've spoken to several infectious disease experts who say that if we had had a national mask mandate as the shelter-in-place restrictions were lifted, we may not be in the situation that we're in now with this continued rise in cases. I spoke to physician Carlos del Rio about this. He's a professor of global health and epidemiology at Emory University. Now, he's a doctor, but he points to an analysis by Goldman Sachs that finds a national mask mandate would be good for the economy, too. It could prevent a 5% decline in the GDP.

CARLOS DEL RIO: You know, we have made this big argument that, oh, it's the economy, or it's public health. No, I think you need healthy people. You need no infections in order to save the economy. They're intimately related. It's not one or the other. So, you know, to me, quite frankly, we're able to put 5% back into the economy. I think most people would do anything for that, right? So I think in my mind, we have to wear masks. We should've had a national mandate to wear masks.

AUBREY: So as you can hear, David, I'd say there is growing support for a national requirement.

GREENE: Well, Allison, stay with us, if you don't mind.

AUBREY: Sure.

GREENE: I want to come back to you. But for the moment, I want to bring in the voice of one mayor from one of the states that has been seeing a steady rise in cases. It's Jeff Collier. He's the mayor of Dauphin Island, which is a narrow strip of beach on the Gulf Coast in Alabama's Mobile County. Mayor, thank you for taking a few minutes for us this morning.

JEFF COLLIER: Glad to be with you.

GREENE: What do you think of masks? Do you think people should be required to wear them in your community?

COLLIER: Well, we've discussed that on more than one occasion, as far as our town council. Mobile proper recently imposed that just before the July 4 holiday. You know, we have tried to be, as we say, part of the solution throughout this whole epidemic and not be part of the problem. And so anything that we've done so far, we've tried to follow the lead of whether it's the CDC, our state, the governor and/or the local county officials to, you know, fall in line with what is being required. And so right now, we personally do not have a mask requirement in our municipality. But like I say, it is something that we have discussed in recent weeks.

GREENE: I mean, do you see the evidence for it? Do you yourself believe in it as the mayor? Do you at least, in any way you can, tell your residents that that they should be doing this? Or do you have doubts about some of the evidence that you're hearing?

COLLIER: We have actually - in fact, I've started requiring our staff to wear masks including myself a couple of months ago, to be honest. And so we've also passed along which our local health department and Mobile County has strongly recommended. They've been doing that for a couple of months now. That's when we started our masks within our own staff. And we have shared that information and supported that information to our community. And we do a monthly town crier. That has been in there. We have had signage in place both for the beach - for the beaches and other things that we've had to do. So we have tried to pass that information along and supported those efforts from day one.

GREENE: Do you think it would help you as a local leader to get a clear mandate from the federal government that masks should be worn? Would that make it easier for you to enforce it in your community?

COLLIER: Well, I think it would be easier if it came from - whether the federal government or even the state government for that matter, for our sake. You know, the one challenge I do think we have is being a small community and having a small police department. I do always have concern with the fact of us trying to enforce it. I think that will be a challenging situation. We've also seen in other states and cities where masks are required that you have people kind of taking that into their own hands and confronting people in stores and things because they're not wearing them. And so that part is concerning, as well. But whatever comes down, we will fall in line and do the best we can to support whatever direction that we feel needs to be taken when it comes from the higher ups.

GREENE: I know your county is grappling with a pretty sharp rise in COVID-19 cases. And I know you are a beach community, and I know people were probably trying to get some sun in any way they could. I mean, can you describe what it looked like? I mean, were people being careful on the beach, wearing masks, keeping a distance? How were people handling it?

COLLIER: What we've seen so far - you know, the beaches were closed back a month or so ago. And then when they reopened, we had concerns. But we - as I said, we posted signage on our beaches. We have patrols that work the beaches pretty regularly. And, really, what we've seen since the beaches reopened is most cases, people have done what we've asked them to do. Fortunately, we have space for people to spread out, which makes it very helpful. And so we have we have been very pleased with what we've seen taking place on the beaches. And so what we - you know, we want to continue that as we go forward.

GREENE: That is Mayor Jeff Collier of Dauphin Island, Ala. Mayor, thank you so much for your time this morning. We really appreciate it.

COLLIER: Thank you for having me.

GREENE: And I want to bring in NPR's Allison Aubrey, who is still on the line with us. And, Allison, I mean, as we hear the mayor there thinking about how, going forward, he can protect his community and some of the conversations, I'm amazed that we are now turning to a point where there's still a debate among scientists about how this virus can spread. We're learning more...

AUBREY: Yes.

GREENE: ...Which is a little frightening.

AUBREY: Yes. Yeah, well, I mean the main way the virus is thought to spread is from person to person via respiratory droplets. So say I'm infected, and I sneeze or sing or talk loudly, and particles containing the virus fly out of my mouth. You're standing close, David, within three feet or so. You can become infected. But some scientists say that there's evidence there's another way. They say that lingering, smaller bits of virus can aerosolize and kind of float in the air and perhaps infect people that way. Scientists call this aerosolized spread. Here's how physician Carlos del Rio of Emory explains it.

DEL RIO: An aerosol is something that will remain in the air for long periods of time, as opposed to either dropping quickly or being only from person to person.

AUBREY: Which opens the possibility, David, that someone could get infected even if they're socially distanced.

GREENE: Which would really change a lot of the guidance that we've been given. And, you know, I read that over the weekend, you had these scientists - I mean, a few hundred of them, right? - who signed their names to this letter asking the World Health Organization to go back and review the evidence of what you're describing - this aerosolized spread.

AUBREY: That's right. And, I mean, it's hard to nail down. I mean, for now, the World Health Organization says the primary way the virus spreads is by this close person-to-person contact by these respiratory droplets I just explained. And the CDC thinking on this is really similar. But months into the pandemic, some scientists say it's time to take a look at some new evidence, really try to understand it better. Carlos del Rio says it's complicated. He says it seems to him the virus does mainly spread this way from person to person with these respiratory droplets. That's what he sees when he looks at the evidence so far.

DEL RIO: I think it's been hard to nail it down because, you know, we have a new virus. We're still trying to understand the infectivity and the mechanism of - mechanisms of transmission.

AUBREY: You know, and another question is, if there are these bits of virus floating in the air aerosolized, what is the infectious dose, meaning how much of the virus is needed to infect someone? So believe it or not, David, you know, months into this, there's still a lot of unanswered questions.

GREENE: But this question specifically - I mean, you kind of got at this by saying that, you know, social distancing - we have to think of that differently because even when we're socially distanced, if it's aerosolized, you know, we could pick up on this if we're in the same room with someone.

AUBREY: Right.

GREENE: I mean, talk through the implications of why it's so important to figure this out.

AUBREY: Sure. Well, I mean, if aerosolized spread is happening in a significant way, then we may need to be even more cautious in indoor environments. Everything we're told about masking becomes even more important even when you are socially distanced. In addition, in work spaces or, say, group living environments where people spend a lot of time congregated indoors, there may need to be even more thought given to, you know, air filters, better circulation systems, basically, you know, more protections and safeguards.

GREENE: That's NPR's Allison Aubrey as we begin this week with the number 2.9 million - 2.9 million confirmed coronavirus cases in the United States. Allison, thanks as always.

AUBREY: Thank you, David.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.

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