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  • NATURE PODCAST

Coronapod: Massive coronavirus outbreak strikes iconic Californian prison after it rejected expert aid

This is the last episode of Coronapod in its current form. Please fill out our short survey to let us know your thoughts on the show.

Benjamin Thompson, Noah Baker, and Amy Maxmen discuss the latest COVID-19 news.

In this episode:

01:47 Disaster in San Quentin

San Quentin prison is facing a massive outbreak, we dig into how they got there. The crisis has arisen despite warnings from experts, and offers of free tests, which were declined. We ask why? And what can be done now?

News: California's San Quentin prison declined free coronavirus tests and urgent advice — now it has a massive outbreak

29:51 One good thing

For the last episode of Coronapod, our hosts pick out ways that the pandemic has changed them for the better, including professional flexibility, a renewed focus on the power of reporting and time with family.

36:07 Lockdown and children's health

Reporter Lorna Stewart asks if lockdowns could have any lasting impact on her young children - what evidence is there on the effect of isolation on young minds?

Survey: Co-Space Study: Supporting Parents, Adolescents and Children during Epidemics

Never miss an episode: Subscribe to the Nature Podcast on Apple Podcasts, Google Podcasts, Spotify or your favourite podcast app. Head here for the Nature Podcast RSS feed.

doi: https://doi.org/10.1038/d41586-020-02093-y

Transcript

Benjamin Thompson, Noah Baker, and Amy Maxmen discuss the latest COVID-19 news.

Benjamin Thompson

Welcome to Coronapod.

Noah Baker

In this show we're going to bring you Nature's take on the latest COVID-19 developments.

Benjamin Thompson

And we'll be speaking to experts around the world about research during the pandemic.

Amy Maxmen

I really don't know how this plays out we also don't know a ton about this you know virus so there's so many open questions I just have a really hard time making predictions because I don't know how the outbreak is going to change.

Benjamin Thompson

Welcome to Episode 17 of Coronapod. I'm Benjamin Thompson once more in the South London basement and as ever, I'm joined by Noah Baker and Amy Maxmen. Hi both.

Amy Maxmen

Hi.

Noah Baker

Hi, Ben.

Benjamin Thompson

Here we are then Episode 17 we're a few months in and it's the last in the, kind of, this iteration of Coronapod. It's been quite the journey but you know how things with you at the moment where are you what's going on?

Amy Maxmen

I'm in the same room in Cambridge, Massachusetts, accompanied by Dolores the Chihuahua.

Noah Baker

I'm in a slightly different room in the same county with a different family member now that I'm inside, the same makeshift studio that I've always been in. So from Ben and Amy's perspective on this video call we're on right now, I might as well be in exactly the same place because all they can see is comforters and like a wire cage, like I've got some kind of weird fetish.

Benjamin Thompson

Right. How's that for a start to the podcast then? Okay, well, we are going to cover some ground, I'm sure. Before we start that it's worth reiterating that things are going to be changing up in the next episode of the show. And it's going to be in the regular Nature Podcast, which goes out on Wednesdays, maybe we can talk a little bit about that later on. But for the time being Amy, this week, you've been working on a story about San Quentin Prison in California and how the outbreak has been manifesting itself there.

Amy Maxmen

Yeah, so right now, it's still the third largest outbreak linked to a single facility in the US might soon be the second largest. There's more than 1,600 people infected. Those are inmates and staff at San Quentin State Prison. And, so far, seven have died and that, of course is going up. So it's a really tragic, massive, ongoing outbreak. But kind of the background of the story is, is as upsetting as the outbreak itself.

Noah Baker

So we knew you've mentioned to us many weeks back that prisons were a potential hubs for big outbreaks. Now, this is something that's been known for a long time. Lots of people in close quarters.

Amy Maxmen

Yeah, I mean, so like you said, we've known congregate settings, places where people live together are at high risk. And if you look at a list of, you know, the New York Times has a running list of the biggest outbreaks in the US and the majority are in prisons, which makes sense. So like way back in March, this was when there's a big prison in New York City that was having a massive outbreak at Rikers Island. When that happened. You remember I've talked about this COVID testing lab that was set up at UC Berkeley part of their mission was to try and offer free tests to places like prisons. So seeing Rikers and knowing that San Quentin, so it was just about a 20 minute drive, if that from UC Berkeley, they said, Listen, we can process tests for you. Even if it's just 200 tests a day, that's still something and they got an email back then, you know, that was like, ‘Hey, thank you so much. But we're all set. No thanks’. It turned out I think a month later, there's another COVID testing lab at UCSF/Chan Zuckerberg Biohub. They too, reached out to San Quentin and said we've got free tests because again, they're philanthropically supported. And part of their mission is getting tests to people who aren't paying for them. So they said, great, we can we can also test for you for free. And they had sort of a similar non-response. So all of this is kind of mounting in the month before this outbreak March, April, May June.

Noah Baker

I feel like you're painting a picture of a whole load of like delicately balanced blocks that are ready to collapse at any moment in time, so you know, there is all this potential risk in congregate settings in all these various prisons, there's offering of testing, but that's being turned down, you know, you'd assume that maybe that's because there was already testing that was commensurate in place. But perhaps given that we know where this story ends, that isn't true. I'm kind of interested to know, at what point did anyone raise the alarm? Was there like a flag raised? Was there a kind of a beacon that went hang on something bad might be likely to happen here any moment now, if we don't sort of make sure that we're prepared?

Amy Maxmen

That's a great question. And so the answer is yes. So separate from these testing labs, there's this group at University of California, San Francisco, and they're called Amend and they were asked to actually consult on the California State Prison systems and they were asked to do that by the federal court. The reason the federal courts involved is that actually there's lawsuits that date back to 2001 against the California correctional system, and mainly these have to do with providing inadequate health care, and they have extreme overcrowding. So they were brought to the Supreme Court eventually and even the Supreme Court decided that they're overcrowded and in other lawsuits that there was a decision that healthcare was so inadequate that they should be overseen by the federal court. So an appointee of the federal court helped work with this group at UCSF to ask them to consult on the prison system. So this was all pre COVID. So when COVID happened, this group started putting out they have a whole website you can look at they have like recommendations for what the prisons should be doing. They have, you know, instructional videos to show wardens they've got a whole slew of things that the jail should be doing and kind of a controversial and yet you know, headlining measure is yes you should be testing regularly to make sure that, you know, staff aren't, for example, infecting people, but also, the prisons really need to depopulate they're more than 120% of capacity even today. And what they're saying is, there's really nothing you can do to get around that fact with COVID if you've got people that are sleeping close together that that is a huge risk. So it's great to have tests. But the tests are not going to be able to keep up with people compressed in such a small space. And there's even two law firms that have also been involved with the various court cases against California correctional systems. And those two law firms brought these kind of recommendations from UCSF and from others forward in like a series of motions to the court. Those were denied. And they were asking the governor of California Governor Gavin Newsom, saying you really need to step in here. So all of this was going on these alarms were all happening up until this outbreak.

Noah Baker

Okay, so this really is quite a complex sort of tinderbox you're describing here just like waiting for something to give and spark off an outbreak. What happened with this outbreak that's now ongoing? Was there a key moment?

Amy Maxmen

So what happened with this particular outbreak is there's a prison you know, near LA in an area called Chino, another part of California. It's about seven hours south of San Francisco. And that prison had an ongoing outbreak, they decided to transfer 120 inmates from the prison in Chino, up to San Quentin. And there is a rule saying you're supposed to test people before you transfer them. But it didn't say when they needed to be tested. And it turns out, some weren't tested for two, three, even up to four weeks before that transfer, which means between the time they got a negative test, three weeks passed when they were in a prison with an outbreak, and these were all medically vulnerable inmates that were put in vans and moved for seven hours up to San Quentin. So one can only imagine that if not all of them were infected, or if some of them weren't infected, at that point a lot worse by the time they arrived to San Quentin.

Noah Baker

That really does sound like a sort of a recipe for a super spreader event, you know, taking a load of vulnerable people that have been in a place where there was an outbreak and then putting them all in a close quarters van for seven hours. I mean, that's just like you've engineered super spreading there.

Amy Maxmen

Yeah, exactly. And then you put that him into another prison. At that point, some of them started showing symptoms, tests were done, and 25 of them tested positive. But this wasn't immediate. This was after they had already been in the same close quarters as other inmates at San Quentin. As cases rapidly mounted the person who was appointed – they're, it's called a receiver – the person who was appointed by the court to oversee health care in California prisons he taps UCSF, the group that had been consulting on health care and says, will you go to San Quentin, and take a look, visit, and give some recommendations. So a group of epidemiologists and public health specialists and health policy people from University of California, San Francisco and UC Berkeley, they went to San Quentin, and that was on June 13. I think there was roughly 100 cases around them.

Noah Baker

No, there's a lot that they came back with and they learn while they're there. But I think before we talk about that, you actually have a recording from one of those researchers from when you interviewed her. And I think it's really worth playing that out. It's not the greatest quality recording in the world. But what she says it took my breath away he went, I heard it.

Amy Maxmen

Yeah, that sounds good. If she's a graduate student at UC Berkeley School of Public Health, Ada Kwan.

Ada Kwan

I had never been to San Quentin before. One of the units is called Badger, you walk into the atrium and you are immediately in front of five tiers of jail cells. And some of the windows were open, but there we were told that some of the other windows had been welded shut and the fan systems, we were told hadn't worked for years or so. And so the air that was in there was just circulating, you can feel that the air had been sitting in there for a while. And the ability of the incarcerated to scream and talk through their doors gave us some foreshadowing of how COVID it could spread. One of the most striking memories that I have was as we were walking out of Badger Unit individuals across the tiers were just screaming for our help. And they were just asking us, please help us please let people know what we're experiencing in here. And I can't imagine the physical toll and the mental toll that all of them are experiencing with every hour being there.

Noah Baker

It was heavy to hear that, really quite heavy.

Benjamin Thompson

Goodness me I mean harrowing stuff. I mean, it's an environment, a tinderbox environment for disease transmission.

Amy Maxmen

Yeah. And when I talked with these researchers, they really see this through the eyes, you know, of humans who care but also have epidemiologists, so when they see that this is an old structure, where the fans aren't working, where there's no ventilation, they see stagnant air. And, you know, I think in some cases that we're fans on but they point out has to be air exchange, like fresh air exchange. It's not just moving the same air that's contaminated. And when they talk about how they can hear people yelling everybody, I guess it was loud because people were trying to yell out to them through these doors in the cells. These are open, they're grates. And so when they hear people yelling out through the grates, they're not just talking about what they're saying. What they're thinking is, they're sending out these aerosolized water droplets that we send out when we yell. And that's how the virus travels. We know that. So they're seeing all of this through the lens of like, this is how an outbreak spreads.

Benjamin Thompson

And I guess the environment as well is really incompatible to the things that we outside have taken for granted, distancing, sheltering, mask use, it is not a situation where, where those are possible, I suppose.

Amy Maxmen

Yeah, exactly. So it's simply not possible. So that's why the day after their visit, they put out a report on June 15. And it's called an urgent memo. You can read it even online. They make a number of recommendations, you know, such as we need to have a team of, you know, epidemiologists that are there to advise on the prison system, but also you know, somebody who's appointed person on tests, but their top line recommendation is in San Quentin in particular, you need to reduce that population by half immediately. And they say, if you don't, and this is a quote, ‘it will have dire implications for the health of the people incarcerated at San Quentin, custody, staff and the healthcare capacity of Bay Area hospitals’. So this has massive repercussions. And of course, saying reduce the prison population by half sounds completely absurd to some people. But what they're saying is, that is the option here.

Noah Baker

And that has been done to some extent already, right? Prisons across the States have been trying to release certain inmates early or inmates have nonviolent crimes, speeding up their release date in order to try to do that. Has that happened to San Quentin at all?

Amy Maxmen

You know, I don't know how many people San Quentin has released. Across California, it's been about 3,500 since March. So although that has happened to have hasn't happened nearly enough, the prisons are still overcrowded. And this certainly didn't happen after this urgent memo came out. It certainly didn't go down by half. That's in no way the case. And, you know, sure enough, so it was 198 when they said you have to reduce it by half, they definitely didn't come close to half. And just two weeks later, cases were close to 1,400.

Benjamin Thompson

I mean, if we can say that that's what they recommend they think should happen. I mean, there's a strong possibility that that won't happen. I mean, here in the UK, as well, there was talking about releasing, temporarily releasing, you know, a few thousand prisoners. And I think only a fraction of a fraction of a fraction have been to date. So if we assume that doesn't happen, what other options are there to try and curtail the outbreak and protect all the people involved.

Amy Maxmen

San Quentin is very hard. Right now, it's more than a third of people are infected there. So that's going to be really devastating. For prisons that don't have outbreaks or a very small number of people infected. The idea is there you want to do frequent testing. So one option that a researcher at Berkeley put forward and they put this in the memo is for a prison such as, say Folsom, which is also old structures and overcrowded, just like San Quentin, that's another prison in California, they could do pool testing. So that means take samples from 10 people put them into one tube and run a test on that tube. And that will at least give you a sense of is there COVID in this hospital. So that's like one way that you could do regular surveillance but not have to, you know, test everyone all the time. So that's kind of an option for just being able to do regular testings. It's not perfect, but you get a much better sense of who's infected. You certainly want to do that for staff. The other thing I was talking about is cohorting. So can you put people in different sections so you have staff of prisons only working with say, I'm going to throw out a completely random number. I don't know what the number is. But let's say you have 20 inmates in one area, have the same staff working with those 20 or something like that. So at least if there's an outbreak it's just that cohort instead of the whole entire group, because right now, the problem is a lot of the staff will move between different groups. So they're also going to be moving it around the prison.

Noah Baker

Yeah, I think it's probably worth mentioning as well that, you know, the depopulation sort of requirement or recommendation is really important. And part of that is because, you know, if you've got a really overcrowded present that everyone's in close quarters, but another big part of that is that if every single one of your cells is occupied at capacity, then where do you put someone who needs to quarantine? Right? You, if you find someone that tests positive, you need to have some free space somewhere in the prison to shuffle people around in order to be able to cohort infections and quarantine them in some way that's sensible, and you need some slack to be able to do that kind of logistics.

Amy Maxmen

Yeah, exactly. And that also kind of gets to another big problem at San Quentin. And I'm sure at other prisons, you already don't have a lot of space. So you need to quarantine anybody you think is potentially infected, say the bunkmate of somebody who has COVID there's a good chance they're infected, so you want to quarantine them. So you want to be able to also get really fast turnaround on test results. So it's one thing for me, I got a test actually, when I came to Boston, and it took five days for me to get the results, I can live with that. But in a prison, you need to have that result in 24, 42 hours, you know, certainly no more than 72 hours because you're using up space, you're quarantining them, and there's not a lot of space. And so that's why it was also really inexcusable, that test results are taking five to six days to return.

Noah Baker

And that's I guess, what brings us back to one of the things you mentioned right at the beginning, which is that there was offers of more testing capacity that were turned down what happened there? Do you have any sense of why or what the justification for that was? Or if those offers were accepted? Could it potentially have changed the outcome here?

Amy Maxmen

I think there's no question that it would change some outcomes. I mean, Fyodor Urnov, one of the directors of the testing lab at UC Berkeley. He even said we could have turned around you know, those 120 inmates that were transferred to San Quentin, they could have been tested within 24 hours. So it certainly would have made a difference. And I, you know, really tried to get at that question, well, why weren't they taken up? And it's a tricky question to answer, but I'll tell you kind of what I learned through different avenues. So first of all, now, lawmakers in California, some lawmakers, are upset about what's going on in San Quentin. So there was a hearing last week that I listened to and at that hearing, Senators held two people kind of accountable for this. It was the secretary of California Department of Corrections and Rehabilitation. And the court receiver, the person who was picked to oversee healthcare in the prisons. And so they were asked what happened with the testing here and they said things like, testing has been limited. Test turnaround time has been really slow. And Secretary of CDCR that's the California Department of Corrections. He said it's really hard to obtain contracts to sufficiently test all of the inmates and all of the staff. The researchers, I spoke with who offered tests will disagree with with some of these things. So let me break that all down a little bit. So first of all we can say these two people at the top, I suspect those are not the people that were able to make all the decisions. I think it goes above them. And as far as test being limited, that could be tests from the provider that the California state prisons were using, which is Quest. That's what San Quentin was using. Quest Diagnostics is a big corporation in the US that's handling a large chunk of our COVID tests. Well, they've been backlogged a lot during this outbreak, and they're open about that it's on their website when they're backlogged because as we have surge in cases, which we have right now in the US, they've got a warning saying we're backlogs in the south. We're backlogs in the southwest. We're backlogs in the west of the US right now, which means they've got a pile up of tests, they can't get to them quickly. So the question is, well, why didn't San Quentin go to other people knowing that Quest can't handle it all?

Noah Baker

Okay, so that is the question that I have been sort of silently screaming the whole time that you've been talking. Did you find out any answer to that question from any of your sources who are offering testing? You know, there are scientists that were offering testing? Do they know why?

Amy Maxmen

A researcher at UC Berkeley Public Health kind of talked with San Quentin officials about this. And what he found out is there was a couple of reasons. The main one they pointed out is that Quest Diagnostics uses software that interfaces directly with San Quentin's. So when they see that there's a positive result, they can pretty seamlessly send that result to San Quentin. And it goes right into their record keeping system. So that's already been there. Because I don't know this for sure but I'd be willing to bet that San Quentin was already using Quest for other diagnostic services previously, so they kind of had this existing infrastructure. And now to go to a different provider, especially these ones at UCSF and UC Berkeley. Those testing labs, you know, are not classical clinical labs, so they don't already have the same Electronic Health Record system, that a lot of hospitals want and that this prison wanted.

Noah Baker

I was waiting, Amy for you to say the words, electronic health records. And I just was like, again, I would never have thought before this pandemic happened that I would ever think that something like this would be such a big deal. But it has been such a huge stumbling block, which has had really big repercussions across the States, this electronic health record and compatibility problem. It's mad.

Amy Maxmen

It is mad. It is and I think you know, something I hear a lot from researchers is this is not business as usual, like, fine if that's the case, and other times maybe we should work on it. But like, you know, it's obviously come up many other times in healthcare, but right now is an emergency. And just in case it's not clear to anybody listening. San Quentin is in the fifth richest county in the US. San Francisco is extremely wealthy. And it's known as a tech hub. Like you can't go out in San Francisco and not be surrounded by software engineers. This is sort of like what San Francisco does. So it's a huge irony that despite this wealth of resources, that that would be the stumbling block.

Benjamin Thompson

Which begs the question, then how can it be fixed then if that's in an area with that has all the aces to potentially do it and it can't be done? Can it not be done?

Amy Maxmen

I think it needs political will. It needs some leader to say it is absolutely urgent that people in congregate settings, specifically prisons, that these test results are returned within 24 or 72 hours. They need to say this is absolutely essential. So that make it happen. Maybe somebody has to put forward money to say hire that IT guy or hire somebody to manually enter in results. I suspect that you know, maybe even some of these testing services would be able to offer that and if there were also guidelines about how often you have to test people, you know, there would be more pressure on facilities to make sure it happens. And then the other thing that Fyodor Urnov the researcher at Berkeley, something he thought needs to happen is that state or county health department should be able to canvass all of the new testing facilities that have popped up because a lot of popped up between a biotech and university labs and companies that are getting into this, there is a lot of testing labs, they are smaller than Quest. They're smaller than Labcorp. But they're all part of this. So if there was some sort of system that connected all of these labs and said, All right, Quest is backed up, we can send it to this other place. That's ideally what you want to see. That's how it's all going to get moving. Because it's just unrealistic to think that Quest and Labcorp are going to be the only corporations handling all of the testing in the US.

Noah Baker

I might go one step further and say another thing that maybe is needed is a word that Nature likes to talk about a lot, which is interdisciplinarity. So I think it really struck me when you talked about the researchers going into San Quentin and epidemiologists have this like different lens they see the world through, they see the ventilation system and they see a transmission risk that and you need people with that eye to go into those environments to see that and catch those problems in the same way as you need, you know, software engineers to be able to say, hang on, electronic health records are going to be a problem here, or you need prison wardens to say, hang on, this isn't you're not going to be able to move people between cells this easily because, you know, on the one hand, you know, you want to get people that have potential infections and another cell, but I'm sure in prisons, there are also reasons to not put two inmates together in a cell. You know, there's a lot of other things that you have to take into account there. You sort of need all of these different disciplines to be able to come together to be able to solve a problem as complicated in that and joined up thinking doesn't seem like it's been, you know, particularly strong point in this pandemic, especially in the US.

Amy Maxmen

Yeah, I think that's a great point. Certainly, the researchers, epidemiologist need the other sides of it, the side of the people who understand the correctional system, and a glaring gap and that is the fact that somebody thought it was okay that inmates that had been tested four weeks before their move weren't tested. And you know, I should say one thing that California Correctional Department said at this hearing was like, listen, we do care for inmates. And they did put in place measures, for example, they instituted more regular disinfection of the prisons. So they were doing a lot of cleaning. But we've known this as a respiratory disease for quite a while now. So clearly, that was not the main move that was going to be helpful here.

Noah Baker

Amy, do you have a sense of what the prisoners themselves know about what's going on? I mean, I don't know to what extent they're aware of how bad this problem is, I'm assuming they probably are very, very aware, because a lot of the cellmates or other people that they know in the prison are sick.

Amy Maxmen

Yeah, I'm glad you asked. Because I also wanted to know but is this even feel like so a lot of the inmates, it's hard to reach them right now, because they've been under lockdown since March, and they're not allowed to have visitors anymore. And their phone calls are quite limited. So it already was kind of hard to reach people. Now it's extremely hard to talk to people who are inside on the phone. So what I did is I reached out to a mother of an inmate who's in San Quentin. And you know, she wrote me because she's very worried she hasn't been able to see him. She hardly hears from him. And he's sending her kind of increasingly alarming letters for quite a long time now. You know, before the outbreak happened, he was worried that they weren't doing any testing. You know, he was wondering, are they trying to hide something? I have no reason to believe that part's true, but that's what he was wondering because you really don't know. And then he was writing her after he got tested after the outbreak happened. He's actually in the area when you played Ada Kwan's recording. He's in that same part of the prison that she's talking about. And he wrote in a letter that she shared with me, I think it's just a matter of time before everyone catches it. The people he knows around him are getting sick, and they're coughing. If you can imagine just being in this place, you're basically in a cage, where this is all around you. You know that a mask can only do so much you're stuck in it. And you also don't really know what's going to happen if you do get sick, because in some prisons, there's reports of people are sick being put in cells that are meant for a solitary confinement. So it's actually kind of a punishment, which is sort of a fear why people might not want to be tested, there's reports of a lot of inmates not wanting to be tested. And that's one reason. And so it feels terrible to be in it. It's definitely a form of terror I can't even imagine. And for the family members have these inmates, it's terrible. So the mother I spoke with, she just was telling me how she hasn't been sleeping, she's helpless. It's really awful. And a lot of times, they're not told, if their loved one test positive, they're only told if they die, so they really have no idea what's happening. And I heard more of this during that hearing, there were people who stood up and spoke about their fathers or their husbands who are also in prison.

Noah Baker

I mean, that sounds like a terrifying situation for everyone in the prison and for the loved ones of those in that prison. But of course, this problem, which is really severe, is not just a problem for the inmates in San Quentin, because they're still connected to the rest of society that's directed to the rest of California, you know, the outbreak there is not an outbreak that is horrendous but contained within four walls. It's a horrendous outbreak that could spill out into the rest of California more broadly.

Amy Maxmen

Yeah, staff who work in San Quentin, they live outside of the prison. So they have families, they have their own interaction, some of them have to have other jobs. There are health workers who might work at San Quentin and then go back out into hospitals and of course, inmates, some of them are also transferred to hospitals when they're sick. I think most recently, I think there's something around 62 inmates right now that are in hospitals around the Bay Area. But yes, it's not going to just be contained there and we're never going to end COVID if we allow this to keep on happening.

Benjamin Thompson

So what does happen then? I mean, we've talked a lot about large outbreaks in different areas and you can close down a cruise ship right? You can say no, no more cruises, for example. You obviously can't close down prisons wholesale. So what is going to be done do you think? What is your sense of what happens next to protect the people who are incarcerated?

Amy Maxmen

You know, I don't know. I know that heat has been building on this. Like I said there was a hearing, there likely be more hearings. There's senators and assembly people in California that are really now starting to yell about this. There's the law firms that are involved that are also raising this. Remember, California Supreme Court, you know, decided that California violated the Constitution, its prison systems violated the Constitution for cruel and unusual punishment. So, you know, maybe this will go I'm not a legal person, but maybe this will go back to a court at some point, because it sounds pretty cruel and unusual to me to be stuck in a room near people who are this sick or to be that sick myself. In addition, San Quentin is now sending samples to UCSF Biohub. So they got their first batch of samples last week. So something has changed there. So at least I think that they will be working with UCSF Biohub to expand their testing beyond just Quest and I'm not sure maybe they're going to add more as well. Also, there's been more statements from the secretary of CDCR saying that the prison is going to expedite the release of more inmates that have fewer than 180 days left on their sentences.

Noah Baker

You know, it's yet another example of this pandemic flushing out systemic problems which exist in society, and now they're being seen, but maybe at least an upside is that after this, perhaps they will come to light lights being shed on them, and maybe they might be changed and there may be some new policies put in place.

Amy Maxmen

Yeah, I mean, even speaking, for me personally, I'm a science writer, I don't write about the correctional system in the US, I had some vague sense that some things were wrong, but this was eye opening for me. It really was.

Benjamin Thompson

Well, I mean, I'll put up a link to your news report in the show notes. But for the time being, let's maybe move on to our regular feature that we do at this time, which is One Good Thing where we maybe have to think about one thing that stood out to us that's, you know, made a smile in the past seven days. But given that we're going to be changing Coronapod up, I thought maybe we'd expand it out a little bit. And we've been doing this for a few months now. And of course, the world seems to have changed hugely in that time. So I thought maybe, maybe it'd be nice for us to think about maybe how we've changed in that time and how it's affected us, I suppose, in a good way, I hope, who would like to go first?

Noah Baker

I'm happy to. Yeah, so full disclosure, I might be a bit like gushy here, and I'm sorry, if I am a bit gushy. It's not in my usual sort of British leanings to be gushy. So as listeners will all know, we have been producing this from inside makeshift recording studios that we've built. So my team in particular the multimedia team me, Ben and also our colleagues, Nick, who you might know from the Nature Podcast and Shamini and Dan they are also facing the same challenges. And when I originally had a conversation with my boss about how we were going to do this, I said, just so you know, producing multimedia content from home without proper Internet connections and so on is not going to be easy. And yet, somehow, my brilliant team has done it. And I'm really impressed with how much they have achieved in this time, I've actually had to do some stats and things for, you know, the kind of time you have to send stats up to your editor every so often to see how everyone's been doing. And we've done really darn well considering the massive hill that people have had to climb in this time. And I think there's something to be said for the versatility of people that really, really want to get good work done, and keep covering this really vital story which is, you know, so central to us and our audience and, and I am just really very proud that people have managed to do it and produce things like Coronapod, which has been an experiment but one that I'm really, really very proud of. So, yeah, here's the working from home for the future. But hopefully a little bit more in the office as well because, you know, I miss a recording studio that has you know, chairs. That was really great that place.

Benjamin Thompson

The South London basement is losing it's charm a bit, Noah, I won't lie to you. How about you Amy? What have you got?

Amy Maxmen

Yeah, I think you know, the same kind of impulse that you've had to do the podcast, just kind of this impulse to say this is horrible and troubling in so many ways, but we just need to be reporting on it. I feel like I'm in the front seat of a bus that's just like careening down the side of a mountain. And I just want to be in the front seat and just see it every day, even though it's terrible. It just feels like what I'm supposed to be doing seeing it and just somehow documenting it. And I feel like, I don't know how that's going to change my life right now. But I can say that, you know, when I went to Sierra Leone, and I was there for three months during the Ebola outbreak to report there, I wasn't originally going to be there for three months. I was just going to be there for 10 days, but I stayed and I stayed because it was so important and just mind blowing and eye opening and ever since then it's changed the kind of story I want to cover is changed the kind of people I want to speak with the kind of questions I ask people. So, you know, as a result that changes what I end up writing for the news and for Nature specifically. So it changes all of that. So I guess I'm kind of aware that I don't know exactly how this is going to change what I'm writing, but I know that it will. And I feel like also, the good part is I know I'm in the right job, because that's kind of what I can be doing right now. I can't be our researchers that are testing that I talked about. That's just not my role in life. This one probably is. After talking with Ada Kwan, she's the graduate student you played earlier from UC Berkeley, and she's talking about that feeling where she had inmates asking her for help and crying out to her. And that's terrible. And I'm sure it's gonna sit with her for a long time and I don't know her well, so I don't know what happens next. And I'm sure it's an awful feeling. But, you know, I want to believe that either she or some other people that have been through this, that's going to alter, you know, everything they do going forward and maybe she'll be doing even more meaningful work than she might have previously. So I guess that's kind of my hope for this.

Noah Baker

Absolutely. It is also nice. I think you've mentioned this before, when you have your sort of chosen career option validated a little bit by a horrible situation. You know, I remember you saying, when something terrible happens, your first instinct is that you want to find out what it is and everything you can about it. And I have the same kind of reaction. Like if something bad happens, I want to know everything I can about that as quickly as possible. And I think, Hmm, maybe journalism is the right job to be in after that.

Amy Maxmen

Yeah, for sure. Definitely. And I think I might be really bad at some of the other things. Like I don't know if you'd want me as your doctor. Can you imagine me as an activist, I'd be like, sorry, guys, bad news. Like you can't have that.

Benjamin Thompson

Well, let me bring it home then, both and I think my mine is maybe slightly different. We have been, well I have been at home for quite a long time now. And it dawned on me another day that my kid has been locked down for a quarter of her life.

Amy Maxmen

Wow.

Benjamin Thompson

In a strange way, it's actually been a blessing to be able to be here to be part of that. Right? I haven't spent my time on commuting trains and what have you and be able to see her, you know, start to get a personality and you know, figure out what's going on in the world. So I mean, I do obviously speak through the privilege of I'm well, I have a roof over my head and all these things as well. But in a weird way, it actually has been quite a valuable time just to be able to be part of a family in our in our little home.

Amy Maxmen

That's lovely. That's great.

Noah Baker

It really is.

Benjamin Thompson

Alright then both well listen, Noah and Amy, you know, thank you so much for the last 17 episodes of Coronapod but as we've mentioned a few times this, isn't it, right? You are both I hope you're going to be joining me on a Wednesday, when we're going to do sort of a cut down version of this in the regular Nature Podcast because of course the pandemic isn't over and there's a lot going on. So, you know, I hope you both join me then to continue Coronapod 2.0.

Noah Baker

Yeah absolutely, Coronapod 2.0. Yeah, that sounds good.

Benjamin Thompson

Noah and Amy, thank you so much.

Noah Baker

Bye, Ben.

Amy Maxmen

Bye.

Benjamin Thompson

Now we talked just now about some of the positives we've taken from the past few month, but lockdowns have been of course tough on everyone. And trust me, being in lockdown with a baby who has just started developing opinions and wanting to explore the entire world has added some extra challenges. One thing I have been thinking a lot about is what effect this period might have on her. It's only been the three of us here in the South London flat so I'm concerned how she'll react when I, I don't know, drop her off for nursery, and I'm a little bit worried she thinks her grandparents are 2D disembodied heads that live in the iPad. And it turns out that I'm maybe not alone in these worries. Around the world researchers and parents are worried about what lockdowns could mean for young minds. From social behaviours to language development scientists know that the first few years of life are critical for learning, but relatively little is known about the impacts of isolation at such a young age. Psychology reporter Lorna Stewart reports from the front line.

Lorna Stewart

These are my daughters, Scout is three and Willow is one. Scout loves dinosaurs. Willow loves everything Scout loves, preferably everything Scout is holding right now. Lockdown has been hard. Don't get me wrong we're very fortunate and others have certainly faced greater hardships. But I wonder and worry about whether three months locked inside is going to leave an indelible mark on Scout and Willow's interests, their personalities, and most worryingly on their mental health.

Helen Dodd

In those early years children do huge amounts of development you know really crucial and developmental milestones. And we really need to be thinking about what they're missing out on and how that might affect some of those milestones.

Lorna Stewart

For Willow, she's already been locked inside for a quarter of her life. And it's a long time for Scout too. She can barely remember anything from life before lockdown. I'm sure I'm not the only parent wondering about these things. But what evidence is there? Are young children going to be impacted by lockdown in a lasting way.

Helen Dodd

I'm Helen Dodd. I'm a professor of child psychology at the University of Reading and a UKRI Future Research Leader.

Lorna Stewart

Helen Dodd has been asking parents of pre-schoolers to complete a survey during lockdown. So far 1,700 families have taken part.

Helen Dodd

We found the top three things that parents were worried about right now were their work, their child's screen time and their child's well-being, and so over 50% of parents are worried about their child's well-being. What we would anticipate and based on what we know theoretically is that some children probably are thriving under lockdown and not having to go to school. And so children who find social situations difficult, children who find school challenging, are probably quite happy at home. And then other children, those perhaps who usually like going to school and like seeing their friends might be having more difficulty right now because they're feeling lonely and isolated and missing out on that social interaction.

Lorna Stewart

Social interaction is certainly on my mind. My girls should be learning all sorts of life skills from interacting with their peers and with other adults. It feels like such an important time in their lives. And I want to know that my daughters are not missing out on vital developmental milestones.

Helen Dodd

So lots of them, they can meet through you know, play with their parents, as long as people are talking to them, sharing books with them, those kind of things, but universally children are being denied opportunity to play with other children. And actually in our data so far, almost half of the children spent no time playing with another child in their house. And so they've been in lockdown and isolated as an only child, or perhaps a child with a much older sibling or with a baby sibling who they can't play with.

Lorna Stewart

A baby sibling they can't really play with. I'm familiar with that setup.

You're working? Oh, What's your job?

Scout

My job is to work very hard.

Lorna Stewart

Your job is to work very hard?

Play is a central part of Helen's research.

Helen Dodd

Because all children play it's quite difficult to see what the effects of play is.

Lorna Stewart

But I think as any parent could tell you, play does seem to be important.

Helen Dodd

There is evidence when play is introduced into restricted environments then it does show benefits for children but that kind of scientifically rigorous research is missing somewhat. And there are some studies for example, and there's a randomised control trial of children and play for hospitalised children, where they were given time to engage in free play, which is very sort of child led. They do what they want to do they start and finish when they want, which shows that first seven to 11-year-old children who are hospitalised their stress levels and their cortisol went down when they were in the play intervention relative to a sort of treatment as usual control. One of the things that's challenging with play research is that when player is restricted the reason for the restriction, often is likely to affect the child's mental health and social, emotional well-being as well. So if a child is hospitalised because they're having long term treatment for a chronic medical condition, that child is already under a lot of stress. Or if a child is in a juvenile detention centre, that child isn't representative of the general population of children. So this is quite a unique situation in terms of thinking about restricting children's play. Because the reason for the restriction for most children doesn't in itself have huge consequences.

Lorna Stewart

It turns out that the pandemic lockdowns could give researchers a chance to find out some new things about play, things which might otherwise be very hard to study.

Scout

I don’t like broccoli.

Lorna Stewart

I'd certainly agree that this period has been 'unique' in many ways. Although for Scout and Willow it's fast becoming the norm and that's really worrying, because there's so much that they, that we all, are missing out on at this moment. In particular, for Scout and Willow, they're missing out on interaction with children their own age.

Helen Dodd

Children learn so much through interaction with their peers. So things like learning about turn-taking about sharing, learning about other people's emotions, how other people react to you, if you do something that's not very nice to them. So those kind of social emotional skills, and also things like theory of mind, so understanding how other children are feeling that other children have feelings that they will express those feelings that you might not like how they feel, and even young children, who have siblings at home, the relationship is different because a sibling, there's always a power differential depending on who's older. And a sibling is kind of stuck with the other one, and a parent will often intervene, you know, whereas when young children and older children to some extent are playing with their friends, the friends will choose whether or not to continue to play with them based on their behaviour. So if you are two years old and you hit your friend around the head with a wooden block, that child may then cry and not want to play with you again and you learn something. If you do that with a sibling often what happens is your parent says no, don't do that and then they carry on playing.

Lorna Stewart

With Helen's words ringing in my ears, I take Scout and Willow to meet up with a friend, Lori.

I'm not going to know for certain weather the isolation of lockdown will have lasting effects on my girls. But I hope that Helen's survey and other ongoing bits of science might give us some answers.

Benjamin Thompson

Lorna Stewart and her family there. Helen's survey that you heard about is still open along with several others investigating the impact of lockdowns on other age groups. If you want to read more or take part we'll put a link to more information in the show notes. So that's it for the last edition of Coronapod in this form, when we started the show back in March, we really didn't know what the next few months would bring. So a huge thanks to all of you who joined us each week, and who told us how useful you found the show. Of course, the pandemic is not over, and the science news will keep coming. So as we mentioned, from next week, we'll be running a shorter version of Coronapod within the regular Nature Podcast, which comes out every Wednesday. If you've not subscribed, just search for 'Nature Podcast' in your favourite pod catcher app, or head over to nature.com/podcast. And for those of you who said how much you've enjoyed hearing Amy's reporting, don't worry, we'll make sure she comes back and you'll hear from me and Noah as well. So until then, I've been Benjamin Thompson. Thanks for listening. And, as always, stay safe.

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