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As restrictions are lifted, how to apply lessons from health care workers to daily life

In all but two U.S. states, stay-at-home orders are being lifted, and businesses are reopening. But can the lifting of restrictions be safe, when COVID-19 is still increasing in many parts of the country? Atul Gawande, a surgeon at Brigham and Women’s Hospital and chair of the joint health care venture Haven, joins Judy Woodruff to discuss how to control virus spread as daily activities resume.

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  • Judy Woodruff:

    In all but two states, stay-at-home orders are being lifted. Many states are still restricting how widely they will reopen, and only will do so gradually.

    But there's no doubt questions are increasingly focused on how that can be done, while minimizing risk to the public health.

    Dr. Atul Gawande is focused on that. And it's the subject of a piece he wrote for the "New Yorker" Web site. He's a surgeon at the Brigham and Women's Hospital in Boston and the chairman of Haven. It's a joint health care venture created by Amazon, Berkshire Hathaway, and J.P. Morgan. And he joins us from Boston.

    Dr. Gawande, it is so good too have you with us again.

    You are reminding people that, even as we move ahead, it is important to keep the basics in mind. So, tell us again, what are the basics?

  • Atul Gawande:

    Well, I think the basics come from the fact that there have been a group of workers who have been going to work right through this epidemic. And those are health care workers.

    And we have managed in the United States to manage so we can go to work and not spread the virus. And there are four components to what I have called a combination therapy.

    The components are ones you all know. But each of them are flawed. But when you put them together, it stops the virus. And we are demonstrating that in health care.

    So, what are they? Number one is hygiene. Number two is distancing. Number three is screening, screening people for even very mild symptoms, so they stay home, rather than go into work. And fourth are masks.

    And the main value of the masks is that we can spread the disease, we now know, before we have developed symptoms. And the best way to keep from infecting other people is a mask, because it is our respiratory droplets, when we talk, when we breathe, when we cough, that we have the ability to spread the virus.

  • Judy Woodruff:

    Assuming they can get the test and have access to the test.

    But as you look around the country, Dr. Gawande, and you see how these states are opening up — and, as we said, most of them are now trying to open up to one degree or another — what do you see that gives you hope, that makes you feel reassured, and what do you see that is worrying you?

  • Atul Gawande:

    So, the things that give me hope, number one, we are finding that we have managed to lock down successfully enough that we did not exceed the hospital capacity.

    And in most parts of the country, there is enough hospital capacity for the capability to open up. Number two is that we have — testing capacity actually has increased significantly. In a lot of parts of the country, reports are now coming out in many states that we're — we haven't used up the capacity enough.

    People aren't coming in for the tests. And we need to call up your doctor or go to your — one of these drive-through spots. CVS has them, Rite Aid, Walgreens, and get tested, if you have even the slightest symptoms. Those are what gives me news, is we are climbing that, and that it is getting better.

    Now, what am I worried about? What I am worried about is that we're having this debate about our culture of what we're going to do to secure safety for one another. It's a debate that's about safety and freedom, right? Keep me safe, leave me alone.

    And we're putting too much emphasis on the minority who are refusing to participate. The reality is, if the vast majority of us, we — if we get even just 60 percent wearing masks that are 60 percent effective — that is to say, there is double-layer cotton, at least, and fit well — then we can avoid spreading infection to other people.

    The value is, I protect you, you protect me. And we don't have to all be perfect. We don't have to be vigilantes about it, but we do have to build a culture where we feel my job is that I never want to be the one to put you in the hospital. I never want to be that person.

    That is the culture of health care that we have built that keeps us safe, when we go into work at a place that has risk, and we have managed to avoid turning hospital into places of spread.

  • Judy Woodruff:

    And even as we are keeping ourselves safe, we need to constantly remember how important it is to keep others safe as well.

    Dr. Gawande, I also want to ask you about the news today that has given investors hope. We see the markets going up today because there are reports that progress seems to be made in the very early stages of a vaccine.

    Put that in context for us. What are you seeing? How much hope should we have at this point about a vaccine and when?

  • Atul Gawande:

    Well, first, I have got to say it is extraordinary to see the progress that has happened to this point.

    You are absolutely right. This is just the first step on a multistage journey. But the fact that you have three companies now — you have Chinese — a Chinese vaccine, an Oxford vaccine, and this one from Moderna here in Boston. And all three have not only been produced. They have gone into trial and already have some early results in the first few weeks that — that is an indication not that they work yet.

    But that would have taken, in previous times, three to five years. This happened in weeks. I mean, that's stunning.

    Now, the entire vaccine process from concept to finish, my vaccine colleagues tell me, it's never been done in less than 20 years before. So the fact that we have got this front end already at this stage, and that we will have others coming out into the summer, 100 vaccines that are coming out into tests, it does give a lot of hope that, within a couple years, we could be into production.

    Is this a matter of just months away? No. I think we have to be ready for that. And being ready for it means being ready to understand, we all have to take seriously really learning how to take what works. And if we are going to come out and work together and be with one another, we have got to be able to do those basic steps and work together on that.

  • Judy Woodruff:

    One other thing I want to ask you.

    And that is, we have just learned today, President Trump says that, for the last week-and-a-half to two weeks, he has been taking the drug hydroxychloroquine, I guess typically prescribed for malaria, but he's taking it prophylactically.

    What do you make of that?

  • Atul Gawande:

    Well, there are have been multiple trials, studies now.

    They have so far shown no benefit from hydroxychloroquine. And one has shown that there is serious heart risks from the drug.

    So, as a physician, I am not advising to patients that this is a good idea. There will be better trials to come. And — but right now, there is no evidence it works, and, in fact, it could be harmful.

  • Judy Woodruff:

    Dr. Atul Gawande, thank you very much. It is always goods to have you with us. Thank you.

  • Atul Gawande:

    Glad to be here. Thank you.

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