As the United States continues to see record-breaking new coronavirus cases, the country’s reopening has become one of today’s most critical topics. We discuss the issue with Forbes’ reporter Alexandra Sternlicht and examine the unsettling resurgence, complications with testing, and the disproportionate impact of the virus on communities of color.


Jeffrey Freedman: Hello and welcome to the RP Healthcast by RooneyPartners. I am your host Jeffrey Freedman. New York up until a few weeks ago was the epicenter of the coronavirus activity in the United States, but with increased testing and social distancing and a slow and methodical reopening, we seemed to have turned the corner and our infection rates have dropped dramatically. But, unfortunately we cannot say the same for other parts of the country where States like, Florida, Arizona and Texas are hitting all-time highs in terms of infections, hospitalizations and even deaths from COVID-19.  

To talk about this and other issues related to these rising figures is Alexandra Sternlicht. Alex is a breaking news reporter for Forbes. Prior to this role she was the under 30 editorial community lead at Forbes and she’s worked for the New York Times as well as the New York Observer. Alex, thank you so much for joining us today. 

Alexandra Sternlicht: Thank you so much for having me, I am thrilled to be here.  

Jeffrey: Great! Now Alex you have been a prolific writer about the coronavirus for Forbes. For the purposes of today’s interview, I want to focus on three important topics that you cover. That is the apparent resurgence in the number of coronavirus cases in the U.S., issues surrounding testing and virus detection and the disproportionate impact to the virus on communities of color. But, before we jump into all that, I would like to start with a question about you and your role as a breaking news reporter for Forbes.

Alex: Oh, thank you. 

Jeffrey: Yes. Now you have been on staff with Forbes for almost two and a half years and during that time you have written on a variety of topics besides coronavirus and as a breaking news reporter, how do you decide what to write about?  

Alex: Oh well thank you so much for having me. I am really excited to get into those topics with you today. So there are three main things I focus on for sourcing breaking news. The first is, I look at notable leaders’ addresses, people like Bill Gates or Governor Andrew Cuomo. The second is subject matter experts such as Dr. Aaron Bernstein who is the Director of the Harvard School of Public Health who can comment on studies and complex topics like you know coronavirus, and the third is social media as this is where movements form from conversation. So I will talk a little bit about that. I look at Twitter, Instagram or Tik Tok and I will see what people are talking about, and then I will figure out how I can best insert facts into these popular conversations. As I believe this is really the role of journalists in this day and age. So, an example of this, a couple days ago I found Jimmy Kimmel trending on Twitter as people called for him to be cancelled due to his black face impersonation from the 90s. Upon further examination and discussion with my editor, I found that conservatives were at least in part leading that movement, including Donald Trump Jr.. Kimmel has been an outspoken anti-Trumper and so this seems like an important thing to add to the conversation. 

Jeffrey: That is really interesting. You also mention something while Tik Tok, all of a sudden that has been a leading form of news so it is not just my teenage daughter trying to make a video? 

Alex: Right totally, one really interesting story I found on Tik Tok is you know primarily teens were talking about saving Baron Trump for the White House and they had all these theories that he actually does not like his father and he is actually a really cool guy. So, there is a whole Tik Tok campaign with I think it was like twenty six point two million views on it to rescue Baron Trump for the White House, which was hilarious and amazing.  

Jeffrey: That is a lot of eyeballs. Wow! All right, but back to the coronavirus and your coverage there. Now, across the world the outlook for containing the spread of the coronavirus has worsened, right? Recorded cases had spiked and here in the United States many states that reopened are experiencing either surges or record-breaking new cases. Can you provide some color and details on which states are having the most issues right now?  

Alex: Absolutely! It changes on a daily basis, but I felt half the states in the US are seeing a surge in cases. We are seeing really troubling statistics in Florida, California and Texas. Florida and Texas did not have shutdowns that were as severe as places like New York and those dates were some of the first to reopen. That’s not so much been the case with California which is interesting to note. One area that’s been particularly fascinating to me is Florida’s Miami-Dade County, where a lot of officials are saying that the lack of social distance practices and eating and drinking is leading to a spike in cases. You know, now experts are saying that Florida may be the new global epicenter of the virus which is quite concerning, and today we heard from both the governors of Texas and Florida who said that all bars will have mandatory shutdowns.  

Jeffrey: Florida and Texas, if they had shut down the same time New York did and really clamp down, don’t you think they would still be having, or let me rephrase that, would they still be having the same issues now? I mean, are they not on such a lag, I mean New York is opening now, was it really expected that they could stay closed for that long?  

Alex: Yes I mean that question is, it is a great one, but unfortunately it is truly impossible to answer. So you know we are just looking at what we have now and with all the differences in states, we are seeing some really troubling things in Florida and Texas.  

Jeffrey: Yes I mean, I think they are doing the right thing now by holding back and certainly if they have to start closing they have to start closing. It is definitely getting scary.

Alex: Absolutely!  

Jeffrey: What is even scarier though you have reported that the number of covid-19 cases and deaths could escalate further in the fall months. So while we are at the epicenter, while we are at the peak right now, the fall is just a few months away, why? What about the fall? 

Alex: Yes so that is another great question. So the IHme model. The Institute for health metrics and evaluation which is used by the White House and other decision making bodies has three predictive models to predict the future of coronavirus. So the first model that they use is the current production which you know, I will give you the definition of, so they say mandates are re-imposed for six weeks when every daily death reaches eight per million. The second is mandate easing, meaning that we continue to lift social distancing mandates and those don’t come back no matter what happens. The third is universal masks, which is really really interesting and that is a scenario in which 95% mask usage in public is mandated in public in every location and same thing as the current projection, mandates reimposed for six weeks if daily does reach 8 per million. So under both the current and mandates easing projections, the models have coronavirus steadily rising until October. Those cases will rise in the fall, but the thing that is fascinating is that the third projection, the universal mask one, though cases will still rise, it will be much much flatter until October 1st. Which suggests the power of PPE with something, so that will be maybe so easy as wearing a mask and you know, nothing is for certain, we have seen that across the board throughout this pandemic, but scientists do point to the virus rising in the fall due to historical precedent where you know, every single fall we see seasonal influenza rise and they believe that coronavirus will be similar in that way. 

Jeffrey: Alright so they think it is going to be cyclical in that regard. That is really interesting, but you mentioned that something as simple as wearing a mask will help flatten the curve. Now compare that to my next topic, you know where you reported on the disproportionate number of covid mortality rates among minorities right? So can you walk us through the facts and figures and explain why the virus is having such a devastating effect in these communities? 

Alex: Absolutely! Yes, very sad the virus disproportionately affects black, hispanic and other minority groups due to the nature of systemic racism which impacts housing, community, health and all the other conditions that lead to increased fatality from the virus. One of the aspects of this that I would like to focus on that I have written about is the exposure of air pollution as it relates to severe covid-19 outcomes. So Harvard School of Public Health on this issue, Dr. Aaron Bernstein said that ‘people who live in cities and next to freeways are disproportionately black population and those people are more likely to have more severe outcomes from covid-19 as they are more exposed to air pollution that creates the pre-existing respiratory conditions known to make covid-19 fatal.’ So this is not nearly all encompassing of why covid-19 disproportionately affects minority communities, but it is something to think about as we think about climate change and systemic racism. Another community that I would like to talk about and that I have written about is Navajo Nation and Indigenous Americans. So, Navajo Nation is home to some a hundred and seventy three thousand Indigenous Americans and it is the location of America’s worst coronavirus outbreak in terms of infections per capita, which is awful. The reason that the disease has hit this the largest Native American Reservation so hard is multifaceted. Many residents live in multi-generational homes, so that makes it nearly impossible to stop the spread within a home because there are just so many people living there. More than 30 percent of residents do not have access to running water so that makes things like hand washing which we know can curve coronavirus really, really hard. Also, the Navajo Nation has very few grocery stores and the grocery stores are used by so many people so that means that grocery stores turn into virus hot beds and that is really, really devastating that community. 

Jeffrey: It really is. There have been a number of different articles. I mean you have done a great job reporting on this. The New York Times Magazine, Linda Villarosa wrote a very powerful narrative of one family’s tragedy in New Orleans during Mardi Gras and the article is entitled ‘who lives, who dies’ and it puts a face on the statistics. She wrote about this gentleman, Dickey Charles, whose only 51 and he was a Zulu Club member in New Orleans and according to the Times article, titled ‘eight weeks after Mardi Gras at least 30 members of the club have been found to have covid-19 and eight would be dead’ and there is just been too many Dickey Charles. I mean, is there anything you have found that could be done differently in the African-American or minority communities that could make a difference? 

Alex: You know it is absolutely horrible and there have been way too many stories of family birthdays, graduations, pool parties and more that ended with such deep sadness. I truly do not have an answer to your question because again, you know hindsight is 20/20, but yes it is so sad.  

Jeffrey: Yes I guess going back to the basics when you can wear a mask, stay socially distant and hand wash but in a lot of these communities they can’t as you say, because they are multi-generational and they are all living together.  

Alex: Exactly. 

Jeffrey: It is very tough. All right switching topics to testing and the related issue of contact tracing. You have reported several times actually that some people believe increased testing is the reason while others refute the notion that testing explains the spike in new cases. Can you explain what the facts are here? 

Alex: That is such a good question and it is so pertinent to what we are seeing right now in the rise cases in the United States. So while increased testing can help explain this rise because you can’t, you obviously cannot be confirmed positive for coronavirus without taking a test, but we no longer have a test shortage in this country. So at the beginning of the pandemic when tests were hard to come by in the United States there were likely under reported cases. The side note, we have seen this to be true from recent studies that actually measure coronavirus levels from sewage of all things. I recently wrote about this, so they did a test on the sewage in Erie County in New York, and that showed that there were almost three times the amount of positive cases as those reported, and that gets back to testing and potentially test storage and asymptomatic cases. But, with increased testing, should come increased contact tracing, those things are hand in hand. So epidemiologists argue that you actually see a decrease in positive cases as testing increases because you should be able to contact those in close proximity to those testing positive for COVID-19 and say ‘hey you have likely been exposed to a COVID-19, please self-quarantine or take a test.’

Jeffrey: You mentioned contact tracing and how that is supposed to help, but I live in New York and while we were the epicenter and there are so many positive corona cases around here, I haven’t seen any contract tracing. I know I have been in contact with people and thank goodness I did not get the virus but why is it that I find in the definitely New York or the United States even, why are we so against contact tracing where it is pretty popular outside of the United States?  

Alex: Yes, Jeff, that is such a good point. I think a lot of issues around contact tracing and why you are seeing what you just described is the fact that contact tracing has become really politicized in the United States where people are saying it’s hardcore surveillance, it violates citizens rights. So that is why it has been such a contentious issue here and why some would argue that our contact tracing efforts are not where they need to be. Where if you look at South Korea, which has been a really interesting place for the virus as they have pretty much avoided doing any sort of major shut down basically due to large-scale testing and contact tracing, they have pretty much successfully curved the virus. But their contact tracing efforts many would say in the United States, they just totally violate privacy because it is surveillance of citizens and the government mandates that they would be monitored in order to trace where they are going and trace the virus. So there is a lot to unpack there.

Jeffrey: So personal privacy versus public health conflicts. 

Alex: Exactly. Exactly. 

Jeffrey: All right so if contact tracing is out, testing is our only way then. So, in April the Rockefeller Foundation published a roadmap for the U.S. to reach 3 million tests per week by late June and to quote from their report, this is their report, ‘testing is our way out of the crisis, instead of ricocheting between an unsustainable shutdown and a dangerous uncertain return to normalcy, the United States must mount a sustainable strategy with better tests and contact tracing and stay the course for as long as it takes to develop a vaccine or a cure’. Now, what is your reaction to this and is this plausible?  

Alex: That sounds right to me. Again, I go back to South Korea, it is not perfect and cases do continue to occur there but they have increased testing and contact tracing to such an extreme where anywhere you go, you take a test. Yes we just talked about their contract tracing methods maybe being too invasive for the United States but you know, it is up for debate and they have been really successful. So it makes me very hopeful to see other countries effectively combating COVID-19 and the fact that we have these precedents around us in our surrounding nations. I hope that our leaders will draw from this and bring America to a comfortable new normal.  

Jeffrey: I agree with you. I hope so. Alexandra this has been great, it has been so informative. Thank you so much for your investigative reporting and for joining us here today.  

Alex: Thank you so much for having me. It’s been a real pleasure. 

Jeffrey: We hope you enjoyed this week’s podcast. If you have any questions, comments or future story suggestions, please reach out to us on social media. Thank you and we hope you enjoyed the RP Healthcast. 

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