DAVID GREENE, HOST:
We are getting closer to another stunning number. The globe is nearing 1 million deaths from the coronavirus. Here in the United States, the number of new cases is actually on the rise again with about 43,000 cases per day. NPR's Allison Aubrey joins us to talk about these numbers and also maybe the latest on when we could expect a vaccine. Allison, thanks for being here, as always.
ALLISON AUBREY, BYLINE: Good morning, David.
GREENE: So where are we headed, as we sort of step back and think about this grim million milestone of deaths around the world?
AUBREY: Yeah. You know, I mean, the virus is surging in some places that seemed to be successful earlier in the pandemic in limiting the spread - so a rise in Spain, in France, areas within the U.K. back to stricter restrictions because of the rise. India has about 6 million cases. Brazil, Argentina are hot spots. Iraq and Iran, lots of cases there. And here in the U.S., as you say, after a recent period of decline, over the last week or so, there's been about a 20% increase in new cases with multiple states, including North and South Dakota, Wisconsin, Iowa all trending upwards. And some experts I've spoken to say this death count around the globe could double from 1 million to 2 million by the time we get a vaccine and get most people vaccinated.
GREENE: Which could still be awhile, right? I mean, the timeline is so important in terms of...
GREENE: ...Trying to get a handle on this. There are all these questions about how effective a vaccine might be once one is approved, and meanwhile, it all seems politicized.
AUBREY: Yeah, absolutely. I mean, last week, on the same day that President Trump's top scientific advisers tried to assure lawmakers on Capitol Hill that there would be transparency in the vaccine approval process, that science would rule the day, President Trump weighed in, just kind of throwing cold water on the FDA's new rules aimed at ensuring safety and effectiveness in the approval process.
I spoke to Josh Sharfstein about this. He's a former principal deputy commissioner of the FDA. He's now at Johns Hopkins Bloomberg School of Public Health. And he told me that this is not the way it's supposed to work, David. President Trump should leave the agency alone to do its job, he says.
JOSH SHARFSTEIN: What is coming from the White House is bizarre. And I believe President Trump is undermining the process in two ways. One, he is making judgments about what may or may not work for a vaccine, and he has no basis to do that. But he's also attacking the integrity of the FDA. He's saying that what they're doing sounds political. And, you know, he's basically hitting at the kneecaps of the process we all depend on.
AUBREY: And he says, ultimately, this could really get in the way of people getting vaccinated, once we do have a vaccine, if they don't trust the process.
GREENE: Well, Allison, just remind me. I mean, the best advice we're getting is from top officials, like the director of the CDC, Robert Redfield, and he was talking about a vaccine being ready for all Americans by the middle of next year. I mean, is that still the general thinking among experts?
AUBREY: You know, yes. I mean, that's the best guess. But before then, David, there needs to be solid evidence of both safety and effectiveness. You know, there's so much anticipation, so much hope being put into this, yet Josh Sharfstein says we're still very much in the evaluation process. He says, you know, officials - including Stephen Hahn, the FDA commissioner appointed by Trump - should be transparent, offer up more information. Right now one of the vaccine trials is on hold, but it's not entirely clear why.
SHARFSTEIN: If there's a vaccine trial that's on hold for a safety reason, the FDA should explain why it's on hold and what it's doing to evaluate the concern so that if they wind up announcing that the trial's restarting, people can have confidence in the fact that the FDA has really looked into the situation.
AUBREY: You know, he says right now there's just too little information being shared.
GREENE: Allison, I've talked to some people who I know who have gone through COVID and feel like they have stuff that lingers, I mean, for weeks, for months.
GREENE: And this is what's being called long-haulers.
GREENE: I mean, how common is that? And then tell us about what that means exactly.
AUBREY: Yeah. I mean, it's not clear yet how common it is. I mean, there are lots of reports, as you say, many people who say they've had COVID, supposedly recovered but now experiencing lingering symptoms, everything from fatigue to lung, heart or nerve damage. Anthony Fauci was actually asked about this in a Senate hearing last week, and he talked about one recent study, David, where doctors did MRIs on people who had recovered and found that many of them had some level of inflammation in their hearts.
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ANTHONY FAUCI: I think we need to be careful and just watch what happens because one of the possibilities is that, A, it could clear up and they have no problem for the rest of their lives; the other thing's that they could wind up - when you have inflammation, you could have scarring. That could lead to arrhythmias later on, or that could lead to cardiomyopathies. I do not know what it would be, but it's something we really need to keep our eye out on.
AUBREY: So what you hear Dr. Fauci saying there is time will tell, but this is certainly something to take seriously.
GREENE: Something else, I mean, to take seriously - I mean, just looking beyond people who get sick, the close to a million deaths around the world, there's also the economic hardship from all of this around the world. There's new data now showing that the number of Americans who are food insecure, meaning they might not have enough to eat, is really on the rise. I mean, what can you tell us about that?
AUBREY: Sure. Survey data, federal survey data, from this month shows about 23 million Americans reported that their household sometimes or oftentimes didn't have enough to eat. And this appears to be significantly higher compared to the pre-pandemic rate. So, you know, hunger, David, is not always easy to spot. It does not mean that people aren't eating anything, right? Typically, when people don't have enough money for groceries, they load up on cheap foods that are calorie-dense - full of, you know, sugar, refined starch, kind of junk foods, foods that don't provide the nutrients the body needs to be healthy. So this might explain why food insecurity and obesity track together.
I spoke to Tom Sherman about this. He teaches a course to first-year medical students on food insecurity at Georgetown University Medical Center. He says there are really a lot of factors at play here. I mean, the stress of being poor may also drive physiological changes, such as increasing appetite hormones.
TOM SHERMAN: You just end up consuming more calories. I mean, there is a pretty significant data suggesting that consumption of ultraprocessed foods lead to increased weight gain.
AUBREY: And what we've learned during the pandemic, David, is that people with obesity have been hit hard by COVID and tend to have more serious illness. So the fact that food insecurity could play into this, it just shines a spotlight on the need to address these issues.
GREENE: NPR's Allison Aubrey, always here for us on Mondays to help us understand what's happening. Allison, Thanks so much.
AUBREY: Thank you, David.
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