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Brian Lehrer: Brian Lehrer on WNYC. According to The Atlantic magazine's COVID tracker, there are currently 34,000 Americans hospitalized for COVID. That number doesn't get enough media coverage. In my opinion, there's too much focus on cases, which can be mild or not, but 34,000 people are in the hospital for COVID right now, and only one left the hospital after a few days claiming he was cured by being given antibodies.

President Trump: They're going to say that they're therapeutic and I guess they are therapeutic. Some people don't know how to define therapy. I view it different. It's a cure. For me, I walked in, I didn't feel good. A short 24 hours later, I was feeling great. I went to get out of the hospital.

Brian: The other number that I always watch closely is deaths and the week ending on Saturday, October 10th, according to The New York Times COVID tracker, an average of 702 Americans per day have died from the virus. Now that's exactly the same as for the week ending September 10th, 702 deaths every day, that week on average. In the last month, we have made exactly zero progress as a nation. 702 deaths a day, nearly 5,000 American human beings dying from COVID every week when you multiply that by seven, and it's happening week after week after week but most of what we hear from the resident is this.

President Trump: Seems like I'm immune. I can go a way out of a basement, which I would have done anyway, and which I did. Because you have to run a country, you have to get out of the basement. It looks like I'm immune for I don't know, maybe a long time or maybe a short time. It could be a lifetime. Nobody really knows, but I'm immune.

Brian: Immune, what does that word really mean? We'll get to that. Today the President will hold another in-person rally in Florida that will bring probably thousands of people together with little or no social distancing, even after the Amy Coney Barrett event at the white house two weeks ago, with all the hugging and very few masks that even the reserved Dr. Anthony Fauci, who tries to stay away from politics, acknowledged, qualifies as a super spreader event.

One other thing before we bring in our guest on this, the Trump administration last year suspended federal funding for medical research involving fetal tissue. the Regeneron antibody treatment, that Trump is now trying to take personal credit for and calls a cure, was developed with the use of fetal tissue. Joining me now is New York Times science writer, Apoorva Mandavilli. Her recent articles include one on the fetal tissue issue. Thanks for doing Apoorva, welcome back to WNYC.

Apoorva Mandavilli: Thank you, Brian, it's nice to be back.

Brian: Let me start with some basic things about the President and the other 34,000 hospitalized people. Then we'll get to fetal tissue. Your latest article is headlined Offering few details, the White House doctor says Trump is no longer contagious, what information is missing and how much doubt does that cast on that conclusion?

Apoorva: Well, that letter was worded in a very strange way that Dr. Conley issued. It didn't say that the President tested negative for the virus. It didn't say exactly what his viral load is. It used a lot of scientific jargon, which among the experts that I spoke to caused some surprise and some consternation about the kinds of things that they had looked for. There was a lot of reading between the lines because it was so unclear.

Basically, I think people think that he probably has continued to test positive and so they are looking for other ways of describing it so that it sounds like a negative. We really cannot be sure that he's not infectious. We really cannot be sure how much virus he has left in his body without more information.

Brian: Would it matter to the status of how contagious he is if he tests positive at this time because in fairness as I understand the CDC guidelines, and maybe I don't understand them, the President would probably be clear to interact with people again because it's been more than 10 days since his first positive COVID test and he is not showing symptoms of getting worse, based on his public appearances. Is that a fair conclusion?

Apoorva: It's partly fair. As the CDC does say that most people stop being infectious around day 10, but in the President's case, there are a few other factors that we need to look at. One is that he did have some dips in oxygen. He did receive some oxygen at some point. We don't know the details of that, but we don't know exactly how severely affected he was. We haven't seen a CT scan of his lungs. What the CDC says is for most people, 10 days may be okay, but if you are moderately or severely affected and have needed oxygen, that could be longer, it could be up to 20 days.

The other thing is that the President has been getting the steroid called dexamethasone and when people take that drug, they do actually shed virus for a bit longer than 10 days. That may also be the case. There are a few unknowns here. In fact, there are a lot of unknowns here and it makes it very hard figure out exactly what the President's health status is.

Brian: On the word immune, the way the president used it. He makes it sound like he's Superman. I'm so strong, I'm immune, but technically having the virus does produce antibodies, which are presumed to give you immunity at least for a while. Technically, when he says he's immune or probably immune, is he correct?

Apoorva: Technically he probably is. We don't know for how long. You've mentioned the word Superman, I'm sure you may have read that one of my colleagues reported that he actually, in fact, wanted to come out and show that he was wearing a Superman t-shirt underneath his shirt. He does really view himself that way. That said, the antibody that he got, the monoclonal antibody, it probably does give him some level of immunity, but that antibody cocktail that he got has really not been tested enough for us to know that, for us to know how long it lasts and whether he really is immune for any period of time.

These are all just really big open questions. Once we have a longer, bigger clinical trial with that cocktail, once we have all of the data in front of us, it'll be a lot easier to tell if he really is immune.

Brian: Of course, if he loses the election, he'll only be immune if he pardons himself, but that's another show. By the way, my producer just told me that Senator Mike Lee, Republican from Utah, who's on the Senate judiciary committee as they hold the Amy Coney Barrett hearings, Senator Mike Lee, who was one of those who apparently became infected at the Amy Coney Barrett introductory event, he was just speaking in the Senate at the hearing maskless. I don't know if there is a comment for you as a science writer on that, whether speaking maskless, this far or this close to when he was diagnosed, constitutes any kind of particular risk.

Apoorva: Well, exactly. I mean, we don't know. If he really was infected at the Rose Garden event, which was September 26th, he may be okay. We don't know enough about any of their health status. We don't know all of the specifics. Honestly, at this point, it is really much safer for everyone to wear a mask because there are no guarantees yet.

Brian: The President had at least three treatments that we know of the Regeneron antibodies, the antiviral drug, Remdesivir, and the steroid, but it's only the antibodies that he's calling a cure. Do you know if medically there is evidence that that's the main reason he seems to be doing pretty well?

Apoorva: We really don't know, Brian, because dexamethasone has been shown to be effective in people who are severely affected.

Brian: That's the steroid.

Apoorva: That's the steroid. We've also been hearing that the President doesn't have a fever, but when you take that steroid, you actually don't have a fever. It can suppress fever. He's also benefiting from Remdesivir, a five-day treatment. We know that that has helped some people. It could be the combination. It could be just the Remdesivir. It could be just a steroid. It could be just the antibody. I think he's basically the only person who has received all of these drugs in this way. It's really impossible for us to know which of these has helped him.

Brian: When the President uses the word "cure", how much of an exaggeration is that from what medical science would label it?

Apoorva: We would call it a treatment. I think the word cure is extremely loaded. I don't know of any scientist who would call this a cure.

Brian: Politically, he's trying to sell a line, I think, that he has found the cure. Don't worry about mass or social distancing, Senator Lee or anyone else or indoor gatherings anymore, but 5,000 people a week, as we said in the introduction, continue to die from the virus in this country and 34,000 Americans are in the hospital for it today. About this cure or treatment, if they were all given Regeneron antibodies this afternoon, how many of them would walkout by the end of the week as a result?

Apoorva: Well, the clinical trial data are not in yet, it's hard to say. I think it's worth noting that Regeneron has 50,000 doses. As you pointed out, there are almost as many people in the hospital right now. If we gave it to every single person who's hospitalized, we'd almost be out, and then what about all the other people who are still going to be infected? This treatment, which is not even a cure, is really pretty limited, it was never intended to be something that's rolled out to everyone.

It's intended for people like the President, it's intended for elderly men, who may not be able to make enough antibody on their own, he also has other conditions, he's overweight, he's a good candidate for this kind of treatment. The idea that somehow this is going to be available to everybody, and that everybody is going to recover and be cured, that's just really, really far from reality.

Brian: From what we've seen this year, I would guess that the majority of the 34,000 hospital lies people right now are elderly men or at least a large proportion of them. The President wants emergency use authorization, I think it's called, so more people can have it more quickly, even as the clinical trials go on. Maybe that's the right move if it's known that the antibody treatment is safe, even if they're still determining if it's effective. Do you know about it, safety testing?

Apoorva: It's so far safe. We know also from just monoclonal antibodies in general. These are used for other conditions. There are a lot of monoclonal antibodies out there for cancer and autoimmune diseases and they are generally safe. I think the bigger concern is, if you rush through an emergency use authorization, as you said, and it seems like oh, this is available now, there is actually a very little incentive for people to even enroll in a clinical trial, it becomes that much harder to show that the treatment is effective. It's not as simple as just assuming that it's okay and let's just try it and roll it out.

Brian: I guess that's an ethical question, in any clinical trial, right? To test any treatment for anything, if it shows some effectiveness, and therefore could help more people, especially with a dire condition that could be life-threatening, then how do you ethically withhold it? If you don't withhold it, then you can't get a real firm scientific grasp on how effective it is.

Apoorva: That's right. If you were to say that this is a life-saving therapy, you can't really ethically give people placebo and you need to be able to do that in order to show that this is much more effective than a placebo.

Brian: My guest is New York Times science writer, Apoorva Mandavilli, as we talk about medical issues related to the President's treatment. We can take a few phone calls for her at 646-435-7280, 646-435-7280. All right, fetal tissue research, what's the Trump policy, and what's the relationship between fetal tissue and Regeneron antibody treatment that the President is touting as a cure?

Apoorva: Last year, in June, the Trump administration basically forbade the use of federal funds for any research that uses fetal tissue. That means that scientists wouldn't be able to derive cell lines from fetal tissue, which they do and used to do often, in order to be able to study the immune system, study birth defects, study a lot of different conditions. Fetal tissue has been extremely valuable for biomedical research.

With this ban effectively, last year, he really forbade all of that kind of research. While the Regeneron monoclonal antibody cocktail that the President got was tested using a cell line that was in fact derived from a fetus, it was done a long time ago, it was in the early 70s. The fetal tissue from an aborted fetus in the early '70s was used to derive the cell line called HEK 293T. It doesn't matter what it's called, but the point is that that cell line, which is now used extremely widely in research labs, would not have existed if this ban had been in place in the '70s.

I want to make a distinction here, which is that the antibody itself did not have fetal tissue, did not have fetal cells, but that fetal cell line that was derived from that aborted fetus was used in testing the antibody. It was used at some point in the development of this antibody. That distinction is important because people who are defending the President, certain conservative groups, for example, have pointed out that the cells themselves, were not used in the antibody and so the President is clear ethically and morally.

Brian: Remind us, what's a stem cell? Because we usually hear the term fetal stem cells, you're using fetal tissue. Is it the same debate? Why do scientists need this, no matter what you call it, to come from fetuses, which means I guess those from miscarriages or elective abortions.

Apoorva: That's right. An embryo is very, very early in the development, it's before it's even been implanted into the uterus. When we talk about embryonic stem cells, we're talking about a few days after conception, before the embryo has even been implanted into the uterus. Those embryonic stem cells have also been very useful for research. President Bush actually banned research on them using federal funds, way back in 2001. For many years, researchers here couldn't use them with federal funds. Many researchers actually left, took their research abroad, and set up labs elsewhere in Europe where it was allowed.

In 2009, President Obama lifted the ban. At this moment, research with embryonic stem cells is in fact legal and allowed with federal funds. Fetal tissue is a little bit different. In this case, the cells that we were just talking about came from this aborted fetus, which is, a little bit farther along than an embryo, and they're kidney cells. Embryonic stem cells can become anything. They are what we call pluripotent, you can manipulate them to become any kind of tissue in the body and that's why they're miraculous.

Fetal tissue, on the other hand, it's a little bit farther along, a little bit more mature, it's already become whatever it's going to be kidney, liver, heart, and so on. That's what we've really been talking about, that was used in this Regeneron antibody cocktail.

Brian: Interesting. As you say, this has been an issue since President George W. Bush, who we remember got elected partly based on his conservative evangelical beliefs in politics, restricted new fetal stem cells being developed back in 2001. Here's a clip from the archives.

President Georgi W. Bush: Nancy Reagan has written to me about President Reagan's struggle with Alzheimer's. My own family has confronted the tragedy of childhood leukemia. Like all Americans, I have great hope for cures. I also believe human life is a sacred gift from our Creator. I worry about a culture that devalues life and believe as your President, I have an important obligation to foster and encourage respect for life in America and throughout the world.

Brian: Interestingly, as he referenced, despite Nancy Reagan lobbying him to allow new stem cell lines for a search because they could help find treatments for Alzheimer's disease, which killed her husband, President Reagan, Bush said no, but when President Obama got elected, he changed that policy, as Apoorva told us. Listen to Obama.

President Obama: The majority of Americans from across the political spectrum and from all backgrounds and beliefs have come to a consensus that we should pursue this research. That the potential it offers is great and with proper guidelines and strict oversight, the perils can be avoided.

Brian: Obama changed the policy from Bush. When President Trump got elected, he changed something back, right?

Apoorva: He changed the ability to research with fetal tissue, which is a little bit different than embryonic stem cells. It is also similarly very valuable for studying certain diseases. For example, one of the research projects that had to be put on hold when this ban came into effect, was looking into a cure for HIV. There are just certain things that you cannot really study using adult tissue and fetal tissue is particularly helpful, ironically enough, for setting the immune system.

Almost everything we know about how the immune system reacts to a virus came from using that kind of tissue in mice in which that kind of tissue was implanted. It's really is a twist in fate that the President is benefiting from a treatment that would actually not have been possible had he put the ban in place earlier.

Brian: Right. I guess we already knew he's not a paragon of ethical consistency. If he is so morally opposed to using fetal tissue to develop medications, we can ask how can he take this Regeneron and touted for widespread use. The science question on that, if they can use the old fetal tissue or stem cell lines from fetuses aborted in the 1970s, as I gather is the case with the Regeneron antibody development, why do scientists say they need additional new ones?

Apoorva: The cell line that they used, was used in a very particular way to test this antibody, but there are so many things we don't know yet. There are still so many scientific questions that need to be answered, like the project I mentioned, where they're looking for a cure for HIV. We don't have all of the resources in terms of the fetal cell lines that we would need to answer those questions. It's absolutely essential that that research still be allowed on an ongoing basis.

Brian: Let's take a phone call. Amy in Manhattan, you're on WNYC. Hi, Amy.

Amy: Hi, Brian and hi, I'm sorry, it's Mandavilli?

Apoorva: Yes.

Brian: Apoorva Mandavilli, New York Times science correspondent. Go ahead.

Amy: Thank you. I have a question and a comment. One is that I've heard some criticism of outcomes for referring to the antibody as Regeneron, which is a company that produces it. Is there a name for that antibody treatment itself or there are drug names?

Brian: That's a good question, because everybody's calling it Regeneron, but that's the name of the company that makes it, so is there a name for the antibody treatment itself?

Apoorva: It's an excellent question. Regeneron is a company that has made many, many antibodies over the years. This is a company with a long experience, so calling it just Regeneron is absolutely not correct as you pointed out. I couldn't tell you the exact compound names because it doesn't have a brand name yet, but it's actually not even one antibodies, two different antibodies, two different monoclonal antibodies that are in a cocktail together. I'm sure they'll come up with a very catchy name, so we can all stop calling it just Regeneron.

Brian: Right, we'll call it "Cure walk out of the hospital" by Regeneron. Last thing, you report that vaccines now being developed, are also being developed with fetal tissue. There's another ethical question for the President, if he's so morally opposed to using fetal stem cells to develop medications, how can he be standing up there touting vaccines that are developed from fetal tissue at the same time?

Apoorva: There are several things I want to point out there, Brian. One is that those vaccines, Remdesivir too by the way, and the monoclonal antibodies, they're all using these cell lines, not exactly fetal tissue directly but cell lines derived from fetal tissue in some cases a very long time ago. That actually is the defense that's being used, not just by the President but, well the President himself hasn't spoken up about it, but in general, that's the defense used by say Congress, for example. Many members of Congress wrote to the President asking him to stop this research and the justification is that these cell lines have already been developed. They're grandfathered in and they are exempt from whatever moral objections there might be.

I should note that the Catholic Church has also said before, that vaccines that are developed in this way, because this is a common way to make them, that there is an exemption for vaccines if there can be no other alternatives that are used. However, in this particular case, there are actually other ways to do some of this research. They're not as good, and it'll be very interesting to see how that plays out. What will Catholics have to decide?

There are some religious groups, I was on a call on Friday with one of these conservative-leaning think tanks and they call these cells tainted. Multiple times they use that word, these cell lines are tainted. If that's the case, what decision will people who are religious and take these things seriously have to make when they think about having to take a vaccine that was developed in this way.

Brian: New York Times science writer, Apoorva Mandavilli, one of her latest articles, Trump's COVID treatments were tested in cells derived from fetal tissue. Thanks so much.

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