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Answering Your Coronavirus Questions: Face Masks, Pregnancy And The 2020 Census

Apr 1, 2020
Originally published on April 1, 2020 10:20 pm

On this broadcast of The National Conversation, we answer your questions about the economy, face masks, pregnancy during the pandemic and the U.S. Census.

Copyright 2020 NPR. To see more, visit https://www.npr.org.

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ANDREW CUOMO: We have to succeed. We have to find a way. We have to make it happen because too much is at stake.

MICHEL MARTIN, HOST:

Governors around the country issued more stay-at-home orders today. It's Wednesday, April 1. And this is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED from NPR News.

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MARTIN: I'm Michel Martin. Coming up, we're answering your questions, like is now a safe time to get pregnant?

EVE: We keep hearing about a baby boom nine months from now. I'm wondering what's actually known about the impact of COVID-19 on the early stages of pregnancy.

MARTIN: Also, the split over masks. Should you be wearing a mask every day? And if you can make one at home, will it keep you safe? Plus, COVID-19 and the census. Remember; if you have questions about the coronavirus, we want to help. Go to npr.org or go to Twitter using the hashtag #nprconversation. That's all coming up. But first, this news.

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MARTIN: This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED. I'm Michel Martin. Each night, we're here to answer your questions.

ROB SANTOS: Good evening.

JOE MCPHERSON: This is Joe McPherson (ph).

LISA: My name is Lisa (ph).

SANTOS: Rob Santos (ph).

KATHY LANGFORD: Kathy Langford (ph) from Idaho.

LISA: I'm 35 weeks pregnant.

MCPHERSON: I am 65 years old.

SANTOS: I have a question for Hansi.

WENDY: My question concerns the lack of masks.

LISA: Would I be quarantined from my newborn?

CASEY: How will the Census Bureau reach all people experiencing homelessness who do not have an address?

MCPHERSON: Will I receive this special one-time assistance check?

LISA: Thank you.

SANTOS: Thank you.

LANGFORD: Thank you. Bye-bye.

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MARTIN: We have NPR journalists and outside experts here - and by here, I mean a variety of man and woman caves, home offices and other such places - to offer solid facts and correct some of the misinformation that's floating around. Tonight, we've got answers to your questions about the government relief package, masks, what to do about pregnancy during this time and the census. So please keep your questions coming and tell us how you're getting through it all at npr.org/nationalconversation. Or go to Twitter and use the hashtag #nprconversation. But every night, we begin with this question. What happened today?

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PRESIDENT DONALD TRUMP: If you don't get it, it solves a lot of problems. If you don't get it - and you can't get it if you keep the distance.

MARTIN: That was President Trump urging Americans to hunker down, but he said governors should make the call to require people to stay at home. Confirmed COVID-19 cases in the U.S. climbed above 200,000, with 4,600 deaths. Florida, Georgia, Pennsylvania and Mississippi all issued stay-at-home orders. Florida's Republican governor, Ron DeSantis, faced criticism for waiting.

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RON DESANTIS: You know, at this point, I think even though there's a lot of places in Florida that have very low infection rates, it makes sense to make this move now.

MARTIN: In California, a stay-at-home order seems to be working. Governor Gavin Newsom told CNN other governors need to follow suit.

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GAVIN NEWSOM: What are you waiting for? What more evidence do you need? And there's no greater intervention - period, full stop, none - than physical distancing.

MARTIN: New York saw another nearly 400 deaths yesterday. Governor Cuomo ordered New York City playgrounds close to step up social distancing.

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CUOMO: We have to succeed. We have to find a way. We have to make it happen because too much is at stake.

MARTIN: University of Washington epidemiologist Dr. Ali Mokdad, whose models show the possibility of more than 100,000 U.S. deaths, said every state should impose stay-at-home orders even if they are not seeing the virus.

ALI MOKDAD: There is no guarantee that the virus is not already circulating there. And then we should be careful, and we should be ahead of it and prevent its spread in these communities.

MARTIN: Vermont Senator Bernie Sanders joined calls to delay Wisconsin's primary election still scheduled for Tuesday. Democratic Governor Tony Evers told NPR it's not just about the presidential primary.

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TONY EVERS: We have thousands of elected officials whose positions will be going vacant. And we need them to help us in this virus.

MARTIN: In Austria, the Czech Republic and Slovakia, authorities are telling people to wear masks or face coverings in public. But the head of the World Health Organization, Dr. Tedros Adhanom Ghebreyesus, says they only recommend that people who are sick and those caring for them wear a mask - for now.

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TEDROS ADHANOM GHEBREYESUS: This is still a very new virus, and we're learning all the time. As the pandemic evolves, so does the evidence, and so does our advice.

MARTIN: Globally, there are more than 900,000 confirmed cases and 42,000 deaths. NPR reporter Danielle Kurtzleben is here to explain what happened today and to answer more of your questions about the economic effects of COVID-19. Danielle, it's good to hear your voice, even if I can't see you.

DANIELLE KURTZLEBEN, BYLINE: Yes, good to talk to you.

MARTIN: So we saw a number of states issuing stay-at-home orders. The president today at the Coronavirus Task Force briefing was asked why they haven't issued a nationwide stay-at-home order. And what was the response? Why not?

KURTZLEBEN: Right. So today in the briefing, Trump responded to that by saying states are different. Every state has a different circumstance. And this echoes something that President Trump and Vice President Pence have said over, you know, the last week or two. And, really, what Trump was also saying was that, you know, some states just have lower levels of the virus, which seemed to imply that maybe they don't need as strict of orders as other states do. Now, of course, you could, as one of the public health experts in that intro did, you could argue the opposite - that a stay-at-home order would help keep low numbers from getting high.

Now, but there's one other question that really looms over all of this - is the legal question. Legal experts have told my colleague at NPR, Brian Naylor, that it's not clear that a president can - could legally issue a nationwide quarantine or sort of stay-at-home order. So when you hear questions about this, that's a big thing to keep in mind.

MARTIN: And there's been a lot of talk about banning domestic air travel. Is there any indication that that could happen?

KURTZLEBEN: So once again, he was asked about that today. And they're - and he said they're looking at that sort of a ban, so really not a lot of clarity. Now, there was some discussion of keeping the ban between so-called hot spots, cities with a lot of coronavirus patients, like, for example, New York City. But Trump also said that he is hesitant to do this sort of thing because it would be, quote, "clamping down on an industry that's desperately needed." And it's kind of an extension of the back-and-forth he's been doing on balancing the economy with public health. And there is no question that this is hurting particular industries and that it's hurting millions of Americans.

But, you know, there's a good reason. On a broad scale - it's important to think about this - that it's not necessarily an either-or between economics and public health. There was a survey of top economists this week from the University of Chicago. It found overwhelmingly, they think that abandoning lockdowns, broadly, too early is worse for the economy in the long run than having tight lockdowns right now. So it's not necessarily a choice.

MARTIN: So let's turn to what I think we could call people's personal economy questions.

KURTZLEBEN: Yes.

MARTIN: It's the first of the month, and there are a lot of bills coming due today. We heard from a listener in San Jose, Calif., who wanted to know what can be done to reduce auto insurance rates. And I assume this question arises from the fact that a lot of people aren't driving because they're not going anywhere.

KURTZLEBEN: Right.

MARTIN: Danielle, any thoughts about that?

KURTZLEBEN: Yeah. I mean, it's a totally reasonable question to ask right now. And, you know, I looked around a bit, and a good place to start is see what your insurance company is doing already and saying already about the coronavirus. Some are already at least taking some preliminary steps like letting you defer your payments at least for a month. Now, beyond that, many companies seem to be, you know, putting these sorts of - seem to be saying that they're flexible. Now, I mean, one thing you might also want to do is, you know, look into your options. Will your company allow you to suspend your coverage? Maybe. But also, what are your state's requirements if you should decide to suspend, if you should decide to cut back your coverage?

MARTIN: As you would imagine, still a lot of questions coming in about the big relief package that was passed by the federal government last week. Here's one from Nanette (ph) in Portland, Ore.

NANETTE: I have never, I don't think, gotten a direct deposit refund from the federal government on my taxes, but they do have direct deposit for my Social Security money every month. And I'm wondering will they be able to use that direct deposit information for my $1,200 money?

MARTIN: Danielle?

KURTZLEBEN: I am so pleased that we got this question tonight. I'm pleased to help people because literally minutes before we came on the air, we got new guidance on this, and the answer is yes. They'll be able to - for usual Social Security recipients, they will be able to use your direct deposit information to get the money to you. Now, this had been a big back-and-forth this last week with the IRS initially saying you'd have to file some sort of a return. Well, there was big bipartisan pushback from Capitol Hill, saying to the IRS, no, seriously, just give people their money. Just put it in their accounts. Just do it. So tonight, we finally got this clarity on it.

MARTIN: All right. Good to hear. And here's a question from Joe in California about that relief check.

MCPHERSON: I am 65 years old. I was originally placed on permanent disability as a result of my former career with aircraft. Now my status is retired with disabilities. Will I receive this special one-time assistance check?

MARTIN: Danielle?

KURTZLEBEN: So assuming you are not a dependent of anyone - adult dependents would not benefit from this. Assuming that's not true and assuming you have a Social Security number - it sounds like you would - then, yes, you are entitled to this money. Once again, as with that last question on Social Security, there's some question of whether it would direct deposit or be sent to you. Now, Social Security Disability Insurance recipients, SSDI, they do receive - this is getting a little technical, but go with me here. They receive these forms called SSA-1099s. That is the information that the IRS will be using here. So there's good reason to think that if you're getting a direct deposit for your SSDI that you would get it here, too.

MARTIN: Let me see if we can squeeze another one in here. Jennifer (ph)...

KURTZLEBEN: Sure.

MARTIN: Jennifer in Colorado had a question about the $1,200 check that people have been referring to here. She says, my income from my 2018 and 2019 tax return would make me ineligible for the $1,200 aid. However, I am now unemployed with no income. Am I eligible? And how would the federal government know that I should be eligible?

KURTZLEBEN: All right. This is a doozy. I will try to keep this simple because, listen; she's right. The IRS is looking at your 2019 or your 2018 income here. Now, the problem for this woman is that she has low income in 2020. So here's the technical thing here. This payment you are getting this year - the $1,200 - is technically an advance payment on your 2020 taxes, so the ones you'll pay next year. In other words, this woman is technically eligible, but she has no way of getting the money this year. So the bad news is no money this year, but potentially, if not great, good news is she may get it next year when she files her taxes.

MARTIN: Well, thanks for the reporting on that. Even if it isn't necessarily the answer that people want, at least it's an answer.

KURTZLEBEN: Absolutely.

MARTIN: That's NPR reporter Danielle Kurtzleben, who covers the economy and politics. Danielle, thank you.

KURTZLEBEN: Yes. Thank you.

MARTIN: You can hear much more of our extensive coverage when you download the NPR One app. Go to the Explore tab and click on The Coronavirus Outbreak for a curated stream of stories. And if you have questions, we want to help. Go to npr.org/nationalconversation. Or on Twitter, use the hashtag #nprconversation. Up next, NPR science editor Maria Godoy answers questions about masks. This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED from NPR News. Please stay with us.

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MARTIN: This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED. I'm Michel Martin. Since we launched this program almost two weeks ago, we've been getting many questions about masks - in fact, so many that today, we want to dedicate this next part of the program solely to the topic. How should we use masks? Why is there a shortage? What types are there? And can we make them ourselves? NPR senior science editor Maria Godoy has been reporting on all things masks for a while now, and she is with us now. Maria, thank you.

MARIA GODOY, BYLINE: Thank you.

MARTIN: So there's a lot of ground to cover. Let's jump in with our first question from Justin (ph) in Denver, Colo.

JUSTIN: I recently heard that the CDC is reconsidering its stance on masks, and it seems that masks may now be recommended for the general public. So I'm curious to know why the change and what the truth this. Should I be wearing a mask when just going out for groceries? And if so, what kind of mask should I be wearing?

MARTIN: All right, so let's take those one by one. So start with why did the CDC reconsider, if, indeed, they have?

GODOY: Well, they actually haven't changed their official guidance yet. They're still saying the general public doesn't need to be wearing masks. But they also say that, you know, they are actively reconsidering it, and that's because there's growing evidence that people who don't show any symptoms yet can still spread the virus.

And, in fact, the CDC today - just today published data looking at Singapore at locally transmitted cases there. And it found that 6% of those cases could be traced back to people who weren't showing any symptoms at all when they infected others. So, you know, given that the idea is not so much that people should be wearing masks to protect themselves from getting sick but more to prevent them from infecting other people because they're not showing symptoms, so they don't know that they're sick.

And, you know, there's actually evidence that you can emit infectious droplets not just from coughing, which is what people think of, but also just from talking. So if - you know, wear a mask. It might offer you some protection as well. Really, the primary benefit is seen as possibly keeping you from infecting others.

MARTIN: And what about the second part of Justin's question? What kind of mask should he wear?

GODOY: So N95 respirators are considered the gold standard because they block out 95% of, you know, airborne pathogens. That's what the 95 refers to. Surgical masks are good at blocking out. They're like a physical barrier. They can block out large respiratory droplets. But both of those are in critically short supply. And I think absolutely everybody agrees that they need to be reserved for health care workers. They're the ones who are in close contact with people who are infected, so they're the ones who really need them.

But if you want a mask, you know, to wear to a grocery store, some people suggest maybe you can make your own. There's really not a lot of rigorous science on homemade masks. There was one small study done that looked at masks made from cotton T-shirts, and it found, yeah, they could help block the wearer from emitting some microorganisms - not a lot, but, you know, some people are arguing that in these times, something is better than nothing.

MARTIN: Our next question is from Lydia (ph) in Chattanooga, Tenn. She writes, how are we to effectively use the masks, as in, can they be reused? If so, how? Do they need cleaning? And how should they be cleaned? Maria, do you have any advice for Lydia?

GODOY: Yeah. I mean, so ideally, if you're talking - it depends on what kind of mask you're talking about. Like, if you're - really, N95s and surgical masks are supposed to be single-use items. Given shortages, health care workers are having to reuse them. And basically, they say when you can't breathe through it, that's when you know that you are done with that N95 mask. So you have to, you know, you have to discard it.

There are also N95 masks that you can buy - that the general public can buy - that are reusable. And they come with filters that you change out. And they have exhalation valves But the problem with those masks is that they do protect you, but those exhalation valves - they don't filter out the air that you're breathing out, so they don't really protect other people from whatever you're breathing out.

If you're going to make your own mask, I talked to one doctor who told me to think of it like underwear. You wouldn't re-wear a dirty pair, you know? So he says maybe you keep a stack of homemade masks by the door. And every time you go out, you take a new one. When you come home, you throw it in the laundry and you, you know, wash it in warm water and detergent.

MARTIN: That was very vivid, Maria, so thank you for that analogy.

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MARTIN: That's going to stick with me. And let me see. If you're just joining us, if you have a question for Maria, please submit it by going to npr.org/nationalconversation. Or you can go to Twitter using the hashtag #nprconversation. And Kathy from Idaho has a question about homemade masks. Let's hear it.

LANGFORD: I've seen patterns online for home stitchers to make face masks. They're not N95, but they'd be better than nothing. They say that hospitals want these. Do they really? And if they do, how can people at home make them and deliver them without breaking social distance rules?

MARTIN: What about that, Maria? And thank you, Kathy, for being - for thinking of this. I mean, if you have that skill set, for thinking of the health care workers who need these, people who work in these settings. So what about it? What about it, Maria?

GODOY: So I think if you are thinking of donating to a hospital, and I, you know, definitely commend that urge, I would call the hospital first and make sure that they want the masks. And then also ask them if they have any, like, guidelines or specifications they want you to follow for how to make them.

But again, I spoke to a doctor in New York City today. He's on the front lines, and he's been wearing homemade masks that his friends and family have made for him. And his staff are wearing them, too. And he basically wears them over the N95 respirator because they're having to reuse those respirators for several shifts. And so the masks - homemade masks are like a second layer of protection from them. And, you know, he says they've made them with fun patterns, and it's actually - you know, what he told me, like, these are really dark days in the trenches. And, you know, sometimes masks add a little bit of levity, especially if you use a fun pattern.

MARTIN: And can you just remind us again why is there a shortage of masks?

GODOY: Well, I mean, it's a complicated answer. I think the short version is that a lot of mask production and, like, the production of the materials used to make them was based in China. And when this outbreak began, the factories were shut down as part of the response in China. And those factories are getting back up and running, but the masks are staying in China because, I mean, they're still dealing with this pandemic, right? In the U.S., we do have some manufacturing capacity, but it's not something you can just ramp up overnight.

MARTIN: And then Wendy (ph) is wondering about masks being worn in public. And here's her question.

WENDY: My question concerns the lack of masks I see in public. I know people in Asia, specifically in China and South Korea, have prevented or slowed down the infection of COVID-19 with masks. So I'm just wondering why it is when I take a walk in the park with my mask I see nobody else with masks?

MARTIN: Maria?

GODOY: Well, so part of that question is that maskwearing is already culturally common in lots of parts of Asia, and some of it stems from, like, previous outbreaks, including the SARS outbreak of 2002, 2003 and even earlier ones. And I think it's too early to say there's definitive proof that maskwearing is what's helping some of these countries slow the spread of this disease. But, you know, some public health officials are looking at them and saying, well, maybe masks are playing a role.

There's one infectious disease expert based in Hong Kong. His name is Ben Cowling. In Hong Kong, just about everybody wears masks in public. And he says the evidence basically is that masks are likely helping somewhat in reducing transmission. But if you had to choose between wearing a mask or staying home, just stay home. That's if they're - yeah - during this outbreak in 2003, there actually was some research showing that masks provided some protective benefit.

MARTIN: All right. Thank you. That's NPR senior science editor Maria Godoy. Maria, thanks again.

GODOY: Thank you.

MARTIN: A hearty elbow-bump to you. Tomorrow on THE NATIONAL CONVERSATION, we'll answer questions about home schooling. What are your challenges - tell us - and questions? Send them to npr.org/nationalconversation. Please stay with us.

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MARTIN: This is THE NATIONAL CONVERSATION FROM ALL THINGS CONSIDERED. I'm Michel Martin. Coming up, we're taking your questions on how the pandemic could affect the census.

UNIDENTIFIED PERSON: Should the Census Bureau be deploying hundreds of thousands of field staff across the U.S. when COVID-19 can be transmitted from asymptomatic carriers?

MARTIN: Now, news.

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MARTIN: This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED. I'm Michel Martin. In the middle of this pandemic, not all major life events can be put on hold. People are still getting pregnant and having babies. And a lot of listeners have questions about how coronavirus changes all aspects of birth. NPR investigations correspondent Sacha Pfeiffer has been reporting on this. And she's with us now. Sacha, good to talk with you.

SACHA PFEIFFER, BYLINE: You too, Michel. Thanks for having me.

MARTIN: And Dr. Leana Wen is also on the line. Dr. Wen is an emergency physician and public health professor at George Washington University. She previously served as Baltimore's health commissioner. And she's also pregnant. And I do want to mention we are not violating other social norms. She told us we could spill the beans on this happy news. And she is going to give birth herself soon. I want to say welcome. And actually, I want to say, yay, congratulations, Doctor.

LEANA WEN: Thank you very much. Glad to be with you tonight.

MARTIN: So what's it been like to be pregnant in the middle of a pandemic like this?

WEN: Well, pregnancy is already a stressful time. And this is certainly a new level. So I had my son 2 1/2 years ago. And there were a lot of different concerns then. I mean, I thought about what car seat to buy and how I would be breastfeeding. And now my concerns are about hospital capacity and whether I can have someone with me in the delivery room. And so it's just a extraordinary time that's quite unimaginable even a month ago.

MARTIN: Well, thank you for taking the time to be with us to answer some of these questions, as well as you, Sacha. So let's turn to some of those questions now. We have two different questions from Mackay (ph). And this is the first one.

MACKAY: I live in Moab, Utah. I am a nurse practitioner in Monticello, Utah. I am also currently 11 weeks pregnant. And I have been concerned about not knowing the effect of coronavirus on pregnancy and on fetuses.

MARTIN: Well, Dr. Wen, what do we know at this point?

WEN: Well, there is a lot that we don't know. But here's what we do know. It does appear or, rather, it does not appear that pregnant women are at elevated risk for having severe effects from COVID-19, which is different from H1N1 and some other respiratory illnesses where pregnant women were very severely affected. So it does not appear that that's the case for COVID-19. However, pregnant people are medically vulnerable and should take additional precautions.

Now, in terms of the effect on the fetus, those studies done so far are extremely limited. We would not know about the effects earlier in pregnancy because this is such a new virus. But in terms of infections in the third trimester, the initial studies do not appear to report maternal-fetal transmission. Also, COVID-19 is not found in amniotic fluid or in breast milk.

However, there was a study published just last week that had a report of three newborns that tested positive for COVID-19 whose mothers had it. And it's unclear so far whether that transmission occurred in utero. So all this is to say that this is very dynamic. And we need a lot more research. But it certainly contributes to a time of uncertainty for pregnant women.

MARTIN: And Mackay's second question has to do with her work in health care. Here it is.

MACKAY: Because I am a pregnant nurse practitioner, I'm wondering if there is better personal protective equipment that I should be using or different personal protective equipment that I should be using just to keep myself safe and my unborn child safe.

MARTIN: Well, Dr. Wen, as a pregnant health care provider yourself, any recommendations?

WEN: Mackay and all of our health care providers needs personal protective equipment that's suitable, that is up to standard. And it is a big problem, as you've reported on. And we know about that. We just lack this equipment - masks and gowns and goggles for everyone. And it's a big problem because our frontline providers really need it. And so I would certainly encourage for Mackay to have the conversation with her supervisors about whether she'll be able to access this equipment that she needs to protect herself and her family and her patients.

MARTIN: Here's a question specifically about early pregnancy.

EVE: This is Eve (ph) in Seattle. We keep hearing about a baby boom nine months from now. I'm wondering what's actually known about the impact of COVID-19 on the early stages of pregnancy.

MARTIN: So let's take that in two parts. And, Sacha, I'll go to you first on this. Are hospitals anticipating a baby boom in nine months?

PFEIFFER: Well, I mean, I think we're all in quarantine. A lot of people are going to be stuck in their homes with one another for weeks and maybe months. So I think in a kind of amusing way, they think, yep, that might result in a lot of babies in about nine months. Although, I will note that there are also people saying that there're probably going to be a lot of divorces as people are pent up in their houses together. So that's a segment for another time. But, you know, as Dr. Wen said, we don't know a lot yet about the early stage. I'll let her answer that one.

MARTIN: And, well, what about that, Dr. Wen? You started answering that earlier in a prior question. But at the beginning of a first trimester, do we know anything about this?

WEN: We just don't know. We've only known about COVID-19 for over three months. And so we have no idea really about earlier in pregnancy. I will say that COVID-19 is part of a group of viruses called coronaviruses, which other coronaviruses do not appear to have a direct effect on the fetus in early pregnancy. Although, if someone is very ill and has a high fever, that in itself could lead to complications like preterm birth.

MARTIN: And a related question, is COVID-19 changing access to birth control and other reproductive health services, Dr. Wen?

WEN: Well, reproductive health care is part of standard medical care. And medical care in general is affected, even by the fact that everyone should be heeding social distancing guidelines and trying to go out as little as possible, being exposed to people as little as possible. So I would encourage everyone to look into telemedicine options and to talk to their provider about which appointments can be put off and which cannot be. Perhaps some can wait a few months, while others may not be able to. But we have to understand that the landscape of health care overall is changing.

MARTIN: And, Sacha, unless you want to answer that as well, I have another question from Lana (ph) in Lake Oswego, Ore., who sent us this big-picture question.

LANA: Is it safe to get pregnant? Or should a couple wait to conceive?

MARTIN: Sacha, are people you've been speaking to suggesting putting off getting pregnant?

PFEIFFER: Well, in terms of fertility treatments, if we go that route, the American Society of Reproductive Medicine actually last month recommended that doctors and fertility clinics suspend and temporarily stop doing fertility treatments. I think there's just so much we don't know about how COVID-19 affects pregnancy, as Dr. Wen said. It's also unclear when the pandemic will end that the advice has been it's better to just wait.

Now, if you're already pregnant, that's obviously one thing. But if you're trying to get pregnant, the suggestion is you might want to wait till we're in the clear because we just don't know enough to make pregnant women feel comfortable about how this could affect their babies.

MARTIN: Dr. Wen, we need to take a break in just a minute or so, but do you want to add to this? I mean, clearly this is a personal decision. But what about your colleagues, your colleagues that you're talking to about this. Is there advice on this that they're sharing?

WEN: I mean, only to say that it's so difficult because reproductive decisions are so personal and depend on the medical context but also financial and whether there's caregiving available and stage in life. And so I hope that people will all take the time to think about the best choice for themselves and their families with all of these factors in mind.

MARTIN: We're going to need to take a short break. But I'm hoping that our guests, Dr. Leana Wen and NPR's Sacha Pfeiffer, will stay with us for THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED from NPR News where we are taking your questions. And you can keep sending them using the hashtag #nprconversation or go to npr.org/nationalconversation. Please stay with us.

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MARTIN: NPR investigations correspondent Sacha Pfeiffer and emergency physician Dr. Leana Wen are with us to answer more of your questions about pregnancy, birth and COVID-19. One listener asked about delivery.

LISA: My name is Lisa. I'm 35 weeks pregnant in Seattle, Wash., due May 4. If I were to contract COVID-19 before going into labor, how would labor and delivery be handled? Would I be quarantined from my newborn?

MARTIN: Sacha, you've been reporting on this. So how are the hospitals that you've been contacting handling this? And does this vary from place to place?

PFEIFFER: So the answer to the caller's question is, unfortunately, if she were to have COVID-19 or even be suspected of COVID-19, she would probably first be put in a separate part of the maternity ward to prevent infection from spreading. And after her child was born, there is a chance she would be separated from that newborn for 14 days. Again, pretty tough for new mothers. They could be breastfeeding during this time because, as Dr. Wen said, at this point it's not believed that the coronavirus can transmit through breast milk. But you would have to be apart from your baby.

But yes, many hospitals are having to put in place new plans. They're doing a lot more prenatal visits by telehealth to avoid in-person visits. A lot of them are limiting the number of people that can be in the delivery room to one person. So if you had a doula, you might have to choose between a doula and a spouse or a partner.

Although, in New York state, recently some hospitals said not even a spouse or a partner in the delivery room. The state health department stepped in and said, no, you have to let at least one person be there. This woman should not be alone. But we're seeing a lot of policies like that go into place in hospitals around the country.

MARTIN: And, Dr. Wen, are there good guidelines out there? Can you amplify this?

WEN: The guidelines are there from the CDC, from the World Health Organization. But they actually keep changing too because the research on this keeps changing. And. Of course, as Sacha mentioned, hospitals have different guidelines as well. And I will just say, as someone who is about to give birth any moment now, I think about this a lot. And it's actually a nightmare that I have of what would it be like if I contracted COVID-19 or had symptoms and just could not touch my newborn. And, you know, it is a very scary thought.

At the end of the day, you know, everything is about risk benefit because we know the benefit of skin to skin and breastfeeding. But the question is, how do you do that safely, given that this is a respiratory virus that spreads through contact? And so there are some things that can be done, including expressing milk instead of breastfeeding directly. And I think at the end of the day we have to follow the best available evidence and also to make a personal decision, understanding how heartbreaking that could be, too.

MARTIN: Let's see if we can squeeze in one more. We have a question from Jennifer (ph). Let's play it.

JENNIFER: I'm Jennifer. And I live in Oregon. And I'm almost 37 weeks pregnant. And I have been planning to do hospital birth. And I think I'm still going to be doing a hospital birth. But I've had some concern about whether or not I should make alternate arrangements or even a backup plan in case the hospital doesn't have beds or nurses available for me and also concerned about the infection risk. How likely am I to be exposed to coronavirus in the hospital environment?

MARTIN: Sacha, you've been reporting on this. So as briefly as you can, what are the providers and the hospitals you've spoken to saying about this?

PFEIFFER: The hospital officials say they still think it's safe for you to give birth in a hospital. Now, that's controversial. Some people think birthing at home can be OK. They say they're doing everything possible not to have shortages of equipment or beds or staff. Some women are asking to be induced early. And at this point, hospitals don't think that's a good idea just because of COVID-19. So mostly they're saying stick with the birth plan you had. Don't make last minute changes.

MARTIN: That's NPR correspondent Sacha Pfeiffer and Dr. Leana Wen, emergency physician. And, Dr. Wen, we want to give you our very best wishes at this time. And this is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED.

(SOUNDBITE OF GABRIEL GARZON-MONTANO'S "FRUITFLIES")

MARTIN: This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED. I'm Michel Martin. In January, a major nationwide effort to count the country's population launched. Tens of millions of U.S. households continue to fill out the forms. But how has the coronavirus pandemic affected the 2020 census? You had questions, so we've invited NPR national correspondent Hansi Lo Wang to answer them. He covers the 2020 census. Hansi, welcome back.

HANSI LO WANG, BYLINE: Thank you, Michel.

MARTIN: So before we get to answering, today, actually, is Census Day. Hansi, what does that actually mean? Do we get a cupcake?

WANG: (Laughter) I haven't gotten a cupcake. Maybe you would get a cupcake later on. But just to be very clear, Census Day is not a deadline like Tax Day. It's not a deadline for submitting your census form. It's just a reference date to figure out where you should be counted. And where you should be counted, the Census Bureau says, is at the address where you usually live and sleep as of today, April 1, Census Day because the census is supposed to be a snapshot of the country's population as of April 1.

And, by the way, we're now less than nine months away from this major legal deadline the Census Bureau's facing. By December 31, it has to present to the president new state population counts. This is required by the Constitution, by federal law because once a decade we reset the political map, we redistribute the seats in Congress, Electoral College votes among the states based on the number of people living in each state.

MARTIN: People had a lot of questions about this, so let's go to the first one. This is from Jillian (ph) in Santa Rosa, Calif.

JILLIAN: People are supposed to be counted where they are or were living on April 1. Are there going to be problems with people getting evicted because they can't pay rent and then not getting counted in the right place or maybe not getting counted at all?

MARTIN: Hansi, evictions are on the minds of many people, especially today. It's the first of the month. How would this affect the census?

WANG: Well, this could really affect the good data that the Census Bureau's trying to get because if people are counted in the wrong place because of the confusion the pandemic is causing, there could be major implications for the next 10 years and how voting districts are redrawn, how federal funding is distributed to local communities for health care, schools and roads.

The general rule to keep in mind is that every U.S. resident should be counted at the address where you usually live and sleep for most of the year as of April 1. If that's an open question for you right now, you do have more time to get settled and fill out a census form later because August 14 is the new deadline for getting forms in. But if you're really not sure where you'll be living because of the pandemic right now, you've been displaced, you can just put the address of where you're staying as of today, April 1.

You know, one thing to keep in mind, though, is if you wait too long to do the census, your address - your home address - does end up on a list of addresses that census workers will likely have to visit in person. And those visits, that doorknocking, could start in most parts of the country in late May. And with the public health crisis right now, the bureau is really urging households to fill out the form now because it's not clear when and if it would be safe for workers ultimately to go out later this year.

MARTIN: Well, we do have a question about that, too, which maybe we'll get to. But before we do that, there's a - related to this topic - a question from Casey (ph) in Oakland, Calif.

CASEY: How will the Census Bureau reach all people experiencing homelessness who do not have an address?

MARTIN: Hansi?

WANG: You know, it's a very complicated situation right now because actually today, Census Day, today was the day where there was supposed to be an in-person count under bridges, in parks of people experiencing homelessness. That's not happening because of the outbreak. There also was supposed to be counting these past few days scheduled, but it's been canceled, in shelters. And that's all been put on hold because of COVID-19.

Field operations for the 2020 census have been postponed. And the bureau's trying to work with shelters to collect records, ultimately. But it's not clear how the bureau when and how it's going to do an in-person count of people experiencing homelessness, especially as we get further and further away from today, Census Day.

MARTIN: Well, we do have another question about this whole question of the field staff. And this is from Robert (ph) in Austin, Texas.

ROBERT: Should the Census Bureau be deploying hundreds of thousands of field staff across the U.S. when COVID-19 can be transmitted from asymptomatic carriers? And what are the implications to a 2020 census endgame and a December submission of the counts?

MARTIN: Well, so two questions there, Hansi, but start with the first one, which is, are there any precautions being implemented to reduce staff exposure?

WANG: Right now the biggest precaution the bureau has taken is postponing field operations until April 15. I'm watching to see if that, ultimately, gets extended, given the changing public health guidance. But this is a really major issue because the U.S. has not done a census without at least some in-person contact. There are some people living in the country that you just cannot reach unless you go to their home, knock on their door.

You know, for example, in Puerto Rico because of Hurricane Maria, workers were supposed to be leaving paper forms outside of every home's door. That's been stopped because of COVID-19. You know, I reported earlier this month there was a recently hired field supervisor for the census in Iowa who tested positive. And this employee attended a training session. And it's really raised questions about, how can the bureau then ultimately train, possibly, as many as a half million workers that it needs to send out to make sure we get a complete count?

MARTIN: Our next question is about rural areas. This is Barrett (ph) in Sitka, Ala.

BARRETT: The census has paused field operations until April 15, but most reporting indicates that the COVID-19 shut down will have to last much longer if it's going to be effective. What's the contingency plan to count remote and rural Alaska communities if the census never gets the opportunity to send workers back into the field due to COVID-19?

MARTIN: Hansi, what about it?

WANG: That's a really good question. I don't know the answer. I'll be looking into this and asking the Census Bureau. And, you know, important to remember rural areas are especially difficult to count. There's a reason why the bureau tries to send people out to visit homes because postal mail may not be reliable. There's maybe not reliable Internet access. And so the question is, could the bureau rely on maybe existing government records to try and fill in the gaps? We're really not sure at this point.

MARTIN: And here's Jason (ph) in Charlottesville, Va., with our next question.

JASON: This event can be described as a displacement in place. We are not refugees. We are just stuck in our homes, seemingly available for even a small census workforce. What about the hospitalized patients, many of whom will be there for three weeks or longer? What about nursing home residents who moved to stay with their family members temporarily?

MARTIN: What about that, Hansi? How will they be counted?

WANG: Well, going back to that general rule, where you live and sleep most of the time, that's where you should be counted. So that could be a nursing home. But the bureau says, you know, if you're at a hospital or temporarily staying in someone's home, they wouldn't necessarily consider that your main residence, unless you don't have a usual home, in which case then if you're at a hospital, you should be counted at a hospital if you're experiencing homelessness.

MARTIN: I think we have time to squeeze in one more. And this one is from Mike in Raleigh, N.C. Should I read it? I'll just read it.

(Reading) The 2020 census is underway in the midst of this pandemic. Getting counts of the population in the best of times is difficult. How important is a complete count for not only the 2020 census counts but for the population estimates that are prepared by the Census Bureau and many states in the 10 years and beyond?

Big question, Hansi. What do you say to that?

WANG: Well, from the state demographers I've talked to, a lot of researchers, it's very important because the census provides us with data that helps us understand the reality of who's living in the country and helps policymakers makes decisions for the next 10 years.

MARTIN: Well, Hansi, as we said, people have a lot of questions about it, so thank you for being able to answer them. That's NPR's national correspondent Hansi Lo Wang. Hansi, thank you. Transcript provided by NPR, Copyright NPR.