STEVE INSKEEP, HOST:
A tally by Johns Hopkins University says 210,000 Americans have died of coronavirus. But yesterday, one very high-profile patient returned home.
NOEL KING, HOST:
That's right. The infected president rode a helicopter from the hospital back to the White House. And afterward, he stood on the White House balcony, took off his mask and turned toward his aides to help him make a video.
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PRESIDENT DONALD TRUMP: I learned so much about coronavirus. And one thing that's for certain - don't let it dominate you. Don't be afraid of it. You're going to beat it.
KING: It's not clear if the president has beaten the illness. His doctor says it'll take a week to know. But he's now back in a building where hundreds of people work and where others have tested positive.
INSKEEP: What is the president's strategy as the nationwide death toll keeps climbing? We'll talk this through with NPR White House correspondent Franco Ordoñez and NPR science correspondent Joe Palca. Gentlemen, good morning.
FRANCO ORDOÑEZ, BYLINE: Good morning.
JOE PALCA, BYLINE: Good morning.
INSKEEP: Well, the president says he feels better than he has in 20 years, Joe. Can we trust that that feeling is going to last?
PALCA: It's hard to say. It's not certain that it will because this is a very strange disease. You can feel great for a little while and then, poof, you start plummeting downhill. So it's just hard to know.
INSKEEP: And what was the advice specifically from his doctor about that?
PALCA: Well, I mean, the doctor keeps saying, look, we've got to monitor you carefully for the next few days because this is the time period where if that crash is going to occur, it's going to occur around now.
INSKEEP: OK. So that is his condition as best we know. Franco, what did you make of the style of the president's return?
ORDOÑEZ: Yeah, it was, you know, a really highly staged event. It was clear that he knew this would be a moment that would be captured by cameras - you know, how they set up the flags on the South Portico for his arrival, the pulling off of his mask, the standing there to salute Marine One, his helicopter, as it left and even how he turned to walk back into the White House as cameras clicked away when, by the way, he was not wearing a mask as others were standing by. It was really, really all a very dramatic made-for-TV moment to send a message to the American people that, you know, like him, they could beat this. Here's more from that video.
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TRUMP: We have the best medical equipment. We have the best medicines all developed recently.
ORDOÑEZ: But, you know, when it comes to public health advice, the president has been a lot less clear. He's even mocked people for wearing masks. And, you know, last night, he didn't even mention the 200,000 people in this country alone who have died from the virus or the more than 7 million people who have contracted it. But the staged, you know, return kind of works with his overall strategy to be optimistic, to focus on beating this and reopening the country and not on the people who have gotten sick or who have died.
INSKEEP: And he can point, I guess, to his own case. He posed as someone who's beating the virus. Joe Palca just gave us the asterisk on that. We do have to wait a little while, and that's according to his own doctor. But, Joe, what kind of care has he received?
PALCA: Well, I mean, he's getting the best that American medicine has to offer without having to fill out any forms or do the insurance. I'd worry about that. He's getting round-the-clock attention when he gets back to his house. He's had access to experimental drugs, for example. He's gotten a cocktail of something called the monoclonal antibodies. And that is the new drug that he was talking about when he said all these drugs are new, but the other drugs he has been given, Remdesivir, which is another antiviral drug, that's been around for a while. It was actually tested on Ebola. The other is dexamethasone, which is a steroid that's been around since the '50s. And it seems also like an odd choice because people who get that drug are usually suffering from severe disease. And we haven't had any indication from the president that his case is all that serious.
INSKEEP: OK, so could this aggressive treatment potentially backfire?
PALCA: Yes, there are a lot of doctors that seem to be worried that that's the case. These drugs, some of the drugs anyway, that the president getting, Remdesivir and this Regeneron cocktail, they're experimental, so they may not work as hoped. And they may, in fact, turn out to be harmful for some people. We don't know. And it could be that they're overmedicating, which is a phenomenon sometimes called VIP syndrome. Here's Dr. Mitchell Levy, chief of critical care medicine at Brown University.
MITCHELL LEVY: The VIP syndrome is not just that VIPs demand therapies. It's simply that they're treated differently. And this is really the case for doctors' spouses and their family. And so their loved ones are often treated in a way that's outside the usual standard of care, which is never good.
PALCA: So, for example, in deciding to give him steroids as a preventive measure against some inflammation that might come up and cause him trouble breathing, they might be suppressing his immune system, which is important - which steroid drugs do and which is important to have a healthy immune system to fight off a viral infection. So, you know, it may be the best thing to do or it may not be. It's certainly not standard of care for a patient who isn't terribly sick.
INSKEEP: He is able to return home. He was able to shoot this video yesterday, so doing better he says for the moment. Important patient - but one of millions of coronavirus patients over the past many months. And one part of the president's job that he says he's returning to is directing a strategy against the pandemic. So, Franco Ordoñez, has that strategy been changing much lately?
ORDOÑEZ: Well, you know, I mean, the daily coronavirus briefings with Dr. Birx and Dr. Fauci ended long ago. And, you know, there really hasn't been much change recently except for now this new firsthand experience. You know, the strategy really appears to be to double down on getting therapeutics and vaccines and to portray things as getting better just around the corner. He's trying to make the case for reelection and it's, frankly, on an issue where Americans judge him very harshly. So the strategy is to convince people otherwise. And we saw a lot of that last night, and I expect we'll hear a lot more in the weeks going forward.
INSKEEP: Joe Palca, as Franco talked about the strategy against the pandemic, he mentioned the president making a case for reelection, which theoretically is a different subject. The New York Times last night reported that White House officials are trying to block guidelines for a vaccine at the FDA for emergency authorization of that vaccine. What's going on?
PALCA: Well, so here's what I think is happening. The FDA has already told companies what kind of evidence they're going to need to show them to convince them that they have a safe and effective vaccine. But the FDA also wants to release the document containing these guidelines so they can say, look, everybody, here's what we're doing, nothing to worry about. This is what we're going to demand. You'll get a safe vaccine. You'll get an effective vaccine. But those instructions seem to rule out having an approval as rapidly as the White House might like. And so they don't want to necessarily have to confront that in a set of published documents.
INSKEEP: So it might conflict with the idea of proclaiming a vaccine before Election Day.
PALCA: It could be that.
INSKEEP: Joe, thank you very much, really appreciate it.
PALCA: You're welcome.
INSKEEP: That's NPR's Joe Palca and also NPR White House correspondent Franco Ordoñez. Franco, thanks to you.
ORDOÑEZ: Thank you.
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INSKEEP: OK. This fall, many colleges and universities have at least some students on campus.
KING: Right. And as you'd expect, the schools do have plans for keeping students safe. But an NPR analysis finds that a lot of them are not taking what seems like a pretty basic step. They're not regularly testing students for the coronavirus.
INSKEEP: What's going on here? NPR's Elissa Nadworny is at the University of Colorado, Boulder, which is the latest stop on her college campus tour. Elissa, good morning.
ELISSA NADWORNY, BYLINE: Good morning.
INSKEEP: What did the data show?
NADWORNY: Well, we know that, in general, widespread testing is key in keeping the spread of COVID-19 low on college campuses. But our analysis shows that is not happening. We used data from more than 1,400 colleges compiled by the College Crisis Initiative at Davidson College. The national data shows that more than 2 out of 3 colleges with some in-person classes aren't doing any regular testing. So some have no clear testing plan and others are only testing symptomatic students. We also found this lack of testing consistent even for colleges in COVID-19 hot spots.
INSKEEP: And when you say only testing symptomatic students, there are so many people who don't necessarily show symptoms or don't show them for a while. But with that said, this doesn't sound that different from the country at large. The country generally isn't testing proactively very much. What's the specific danger for colleges?
NADWORNY: Well, schools are excellent spreading grounds. I mean, they're social places. We've been seeing that all semester. So if they can't get out in front of these outbreaks and they're playing catch-up, then the spread could be happening unknowingly and seeping into surrounding communities. Plus, many colleges are ending the semester early and planning to send students home in November. Here's David Paltiel, a public health expert at Yale University.
DAVID PALTIEL: I am deeply concerned about the fact that Thanksgiving may roll around and we may be sending all sorts of ticking time bombs home.
NADWORNY: So there's two main reasons schools aren't testing a lot. The first is that the CDC didn't recommend it. So just last week, they updated testing guidance to say that regular testing of students might, quote, "prevent or reduce COVID-19 transmission." But even then, they stopped short of making a clear recommendation. Plus, testing is expensive. You know, in some places, tests still cost more than $100 each. Here's Terry Hartle of the American Council on Education, a group of college presidents.
TERRY HARTLE: It's an expensive undertaking. The amount of money college universities will spend on testing is likely to dwarf every projection we would have made a few months ago.
NADWORNY: So that increase he's talking about is due to the fact that it's not just testing once. It's repeated testing. So even if you can get a $25 test, that adds up. In a letter to congressional leaders last week, higher education groups requested at least $120 billion from Congress. That's driven by added coronavirus costs, including testing.
INSKEEP: Does that letter imply then that they do plan to ramp up testing?
NADWORNY: Yeah, we have seen colleges start more regular testing, especially after they've seen outbreaks on campus. I expect we'll continue to see more schools doing frequent mass testing programs as the tests become cheaper. But one thing that's important to remember is that the most effective way to do widespread testing is to make it mandatory, not voluntary. And the more students you test, the better.
INSKEEP: Elissa, thanks so much for that reporting, really appreciate it.
NADWORNY: Yep. You bet.
INSKEEP: NPR's Elissa Nadworny is in Boulder, Colo. Transcript provided by NPR, Copyright NPR.
