STEVE INSKEEP, HOST:
The United States is approaching 100,000 deaths from COVID-19, the most by far of any nation on earth. This milestone is an occasion to ask what might have been done differently.
NOEL KING, HOST:
Some new analysis offers an answer. Researchers at Columbia University did some modeling, one estimate of what might have been. In their scenario, they asked, what if social distancing had been enforced across the country a week sooner? They found that 36,000 fewer people would have died.
INSKEEP: NPR global health correspondent Nurith Aizenman has been covering this story. And she's on the line. Good morning.
NURITH AIZENMAN, BYLINE: Good morning, Steve.
INSKEEP: How did researchers reach that quite dramatic number?
AIZENMAN: So the lead researcher, Jeffrey Shaman, has been putting together one of the more prominent disease models in this pandemic. And for this analysis, he and his collaborators used a similar approach. They basically looked at the data that we have to date for each county in the United States - how many confirmed cases, how many deaths, as well as factors like, how dense is the county? How do people commute to work, driving cars or taking the bus?
INSKEEP: Sure.
AIZENMAN: And for all that, they estimated how fast the coronavirus was spreading at various points in time. And they found that from March 15 on, the rate really slowed due to people beginning to social distance in a big way, voluntarily or due to stay-at-home rules. So then they calculated, what if that behavior had kicked in a week earlier on March 8? They found a week makes a huge difference. We would've had 55% fewer deaths through May 3. And with a two-week head start, we would've had 83% or nearly 54,000 fewer deaths.
INSKEEP: Yeah, because it's just math. It's, like, compound interest. A couple fewer cases a couple months ago might be many fewer cases now. But I guess we should note that things look very different back in, say, early March. It might've been hard to make that decision back then.
AIZENMAN: Right. And even if officials had taken action sooner, would people have complied to the same degree? Here's what Shaman, the researcher, had to say about it.
JEFFREY SHAMAN: The reality is that, you know, the United States has had a very cushy existence since World War II. We've not had a lot of things that have required a lot of sacrifice. We've not been primed for dealing with or thinking about infectious diseases.
AIZENMAN: So he says, whether there would have been the political will or the public will to take action earlier is up for debate. Of course, it's worth pointing out that leaders in some countries - South Korea, Germany, New Zealand - the leaders there did make the case to their citizens earlier on. And they've benefited. They have far fewer cases and deaths per capita than the U.S.
INSKEEP: And you just named three countries that have democratic systems. They weren't authoritarian governments. They were able to persuade people to do this. But now, of course, we have done weeks of social distancing. What's the analysis show about the future?
AIZENMAN: Yeah. This study also runs simulations to see - now that we're opening up again - if we do have a rebound of cases, how big of a difference will it make if we act immediately or if we wait? And again, because this virus spreads exponentially, as little as a week or two can result in significantly more deaths. Here's Shaman again.
SHAMAN: We have to be so responsive and so attentive to what's going on and able to quickly identify when there's a resurgence of the infection in a community, and to respond to it quickly and to have the will to do so and not repeat our mistakes.
AIZENMAN: And he says, for that, we still need a much more robust system than we currently have for testing to identify people, contact tracing, helping people quarantine and isolate.
INSKEEP: Nurith, thanks very much.
AIZENMAN: You're welcome.
INSKEEP: That's NPR's Nurith Aizenman.
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INSKEEP: OK. The numbers are getting better in the United States. But why are some metro areas improving more rapidly than others?
KING: It's an important question. Dr. Deborah Birx of the White House coronavirus Task Force said this week that three numbers are declining nationwide. There are fewer new cases. Fewer people are going into the hospital. And fewer people are dying. That's good news. But she said there are three areas where cases have plateaued. They're holding steady and not declining - those are Washington, D.C., Chicago and LA.
INSKEEP: NPR's Melissa Block is in one of those three areas, Washington, D.C. Hi there, Melissa.
MELISSA BLOCK, BYLINE: Good morning, Steve.
INSKEEP: OK. What does it mean that coronavirus is - it's not going up, but it's plateauing, they say, in Chicago, LA and D.C.
BLOCK: Yeah. I think that comment from Dr. Birx is a bit of a head-scratcher. I think of plateau and I think of something totally flat. And in all these places, really, the trend lines are going down, maybe just not as sharply as in other cities. Take Washington, D.C. Mayor Muriel Bowser has said the city is on track to meet its targets for reopening.
And she points to barometers like sustained decrease in community spread of the virus for 10 days. The goal is to get to 14 days. She says in terms of testing capacity, hospital capacity, they're on track there. So they are on the right track, she says. Haven't seen as steep of a decline as they would like. So she has extended the stay-at-home order in D.C. until June 8.
INSKEEP: And the surrounding areas - Washington, D.C., of course, is surrounded by Virginia and Maryland. They've also...
BLOCK: Yeah.
INSKEEP: ...Kept stay-at-home orders in place, right?
BLOCK: Right. And as you know, this is one intensely interconnected community, people going back and forth and a lot of mobility. Prince George's County, Md., for example, surrounds about half of Washington, D.C. It's overwhelmingly communities of color, mostly African American and Hispanic, that have been disproportionately hit by the virus.
I spoke with Dr. Joseph Wright at the University of Maryland Capital Region Health System in PG County. He's the chief medical officer there. He calls PG County the epicenter of the epicenter, and said that they've had what he calls a tsunami of COVID patients coming through their doors. So I asked him if they are past their peak. Here's what he said.
JOSEPH WRIGHT: Sometimes you can only appreciate the peak in the rearview mirror. We have just now, just, literally, this week, seen a flattening of our local health system curve.
BLOCK: And like a lot of people that I talked to, Steve, he is very worried about this holiday weekend, Memorial Day. With a lot of people out and about, he's worried that that flattened curve could spike upward again.
INSKEEP: OK. So there's concern. But D.C. is actually on a trend slightly downward, not entirely flat. What about Los Angeles and Chicago, the other cities that Birx mentioned?
BLOCK: Well, our colleague Adrian Florido reports that in LA County, the number of hospitalizations of COVID patients is decreasing every day. The rate of transmission has dropped quite a bit. That's the number of people that each person who's infected with the coronavirus then passes the virus on to. Back in March, before California put stay-at-home orders in place, each infected person in LA was infecting about 3 1/2 people. Now officials say that number has fallen to less than one. So that's a good indicator.
INSKEEP: Yeah.
BLOCK: And it'll be important to keep that rate low if LA plans to stick to its plan to have most of its economy back up and running by July 4. Then there's Chicago. And NPR's David Schaper has been looking into that. Same thing there, statewide numbers for Illinois - and that's essentially a proxy for Chicago since almost all the cases that have tested positive are in Chicago - according to the public health director there, the numbers are trending down. So a little bit of a problem of trying to figure out what Deborah Birx means by plateauing.
INSKEEP: Well, thanks for the fact check there, Melissa, really appreciate it.
BLOCK: You bet.
INSKEEP: That's NPR's Melissa Block.
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INSKEEP: All right. There is other news in the world, including a trial that resumed in Germany.
KING: That's right. Two defendants are on trial for war crimes. They're both former members of Syria's military. These men fled to Germany along with refugees. And they claimed asylum there. But then authorities learned about their past and accused them of crimes against humanity. Prosecutors have linked them to systematic torture conducted by Syria's government.
INSKEEP: NPR's Deborah Amos has covered Syria's war for years and is on the line. Deb, good morning.
DEBORAH AMOS, BYLINE: Good morning.
INSKEEP: What's happened so far in this trial?
AMOS: So as you said, it began last month, resumed this week. And it's remarkable because, for the first time, these former Syrian officials are confronted by Syrian torture victims in person in court. One of them accused as a former colonel. The other is a checkpoint guard. When the indictment was read out in court, the victims heard a summary of their testimony. One horrible crime after the other, says German attorney Patrick Crocker, who represents them.
PATRICK CROCKER: There were very emotional reactions. I was sitting in front of our clients. I checked every once in a while. I saw that they were, yeah, finding it difficult. But in the end, they were really happy that they were there. It made us all aware, again, of what is actually at stake here.
AMOS: The main defendant, Anwar Raslan - he's in his late '50s - was in charge of interrogation in a prison known as Branch 251 when the uprising began in Syria. He gave his first statement in court this week. It was read by his lawyer. He denied all charges. He said there were criminals that took over his prison. They ignored his complaints about brutal treatment. It wasn't me, is his defense. And this is a trial that could take more than a year.
INSKEEP: Well, how much evidence is there that it was him?
AMOS: There's a lot. There's testimony from a German immigration official who said he started hearing about Anwar Raslan from arriving refugees. There are official documents that were smuggled out of Syria that shows that Raslan signed his name to reports that went all the way up the chain of command. Those documents do not explicitly mention torture, according to sources who've seen that. The Assad regime has long denied that there were any - there's any torture in the country.
INSKEEP: So these two defendants, as we mentioned, were plucked out of the flow of Syrian refugees to Germany, hundreds of thousands of people. What do the other refugees have to say about it?
AMOS: So activists in Germany are trying to get the details to their community from German to Arabic as the court is done. One is Wafa Mustafa. She's an activist. She was speaking on a Zoom conference call from Berlin this week. She knows that there is a painful process of managing expectations. Her father is still detained. And somehow, she hoped that the trial would speed his release.
WAFA MUSTAFA: For a second, I definitely thought so. But then I also told myself that, definitely, it's needed to have hope. But it's also needed to have patience. I, myself, might not see the day that justice will be achieved in Syria. It's satisfying enough that I know that someone will.
AMOS: Also satisfying, she said, as others said in this conference, it's the first time that the victims have a voice in seeking justice.
INSKEEP: Well, Deborah, thanks for listening to them, always appreciate your reporting.
AMOS: Thank you.
INSKEEP: NPR's Deborah Amos. Transcript provided by NPR, Copyright NPR.
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