Answering Your Coronavirus Questions: Symptoms, Small Businesses And Child Care

Apr 8, 2020
Originally published on April 8, 2020 10:16 pm

On this broadcast of The National Conversation, a doctor takes questions about symptoms of COVID-19 and how they differ from other diseases like the flu. We'll also answer your questions about relief for small businesses, child care and how to navigate relationships.

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

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ANDREW CUOMO: Individual hospitals and larger systems are reporting that some of them are actually releasing more people than are coming in.

MICHEL MARTIN, HOST:

A glimmer of hope from New York. Hospitalizations are slowing down. It's Wednesday, April 8. And this is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED from NPR News.

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MARTIN: I'm Michel Martin. We know that many people are at home. You're worried, and then you get a cough.

LAURA: Is this allergies, bronchitis or could this be a case of COVID-19 that has taken awhile to manifest?

MARTIN: This hour, we're taking your questions on how to take care of yourself at home.

PAT: What should you do to prepare a room for self-quarantine?

MARTIN: Plus, we're answering questions from small-business owners desperate for relief. Send us your questions by going to npr.org/nationalconversation or ask us on Twitter using the hashtag #nprconversation. But first, this news.

This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED. I'm Michel Martin, at home, like you. But our goal here each night, wherever we happen to be, remains to answer your questions.

ROBERT: Hello. This is Robert (ph) in San Francisco.

SOUL TRAM: Hello. This is Soul Tram (ph).

ANNA SCHEMPER: This is Anna Schemper (ph) from Fairbanks, Alaska.

LAURA: This is Laura (ph).

CATHERINE: I'm an independent contractor in Silicon Valley.

KARINA: A lot of small businesses are struggling.

ROBERT: My revenue is disappearing.

LAURA: Here's my question.

CATHERINE: My question is...

NATALIE: I have three questions for you tonight.

LAURA: Could this be a case of COVID-19?

SCHEMPER: Are there preventive measures that can be taken at home?

NATALIE: What does that mean for co-parenting families?

ROBERT: Thanks.

CATHERINE: Thank you.

NATALIE: Thanks.

LAURA: Thanks for your response.

MARTIN: Each night, we'll have NPR journalists and outside experts here to offer solid facts, whatever we know and to correct some of the misinformation that's floating around. And when we don't know something, we'll tell you that, too. Send us your questions about all these topics and more at npr.org/nationalconversation. On Twitter, you can use the hashtag #nprconversation.

But each night, we begin THE NATIONAL CONVERSATION by asking the question, what happened today? Dr. Deborah Birx of the Coronavirus Task Force says the death toll projections are dropping because Americans are following the social distancing guidelines.

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DEBORAH BIRX: That's what's changing the rate of new cases, and that's what will change the mortality going forward.

MARTIN: Initial data from the CDC showed African Americans were disproportionately affected by the virus. Thirty-three percent of patients who needed to be hospitalized were African American, but African Americans make up 13% of the U.S. population.

The World Health Organization is defending their response to the virus after criticism from President Trump. WHO Director Dr. Tedros Adhanom Ghebreyesus warned against politicizing the virus.

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TEDROS ADHANOM GHEBREYESUS: If you don't want many more body bags, then you refrain from politicizing it.

MARTIN: In the U.S., there have been more than 14,000 deaths. New York and New Jersey hit new peaks in their death tolls. New York's governor, Andrew Cuomo, says hospitalizations, though, are going down.

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CUOMO: Individual hospitals and larger systems are reporting that some of them are actually releasing more people than are coming in.

MARTIN: The Coronavirus Task Force warned Philadelphia and Washington, D.C., could be the next hot spots.

Speaker Nancy Pelosi tells NPR a new bill is in the works to help small businesses and states.

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NANCY PELOSI: The states and the localities are bearing a tremendous, tremendous burden in all of this.

MARTIN: Around the world, there are 1.5 million confirmed infections and more than 88,000 deaths. NPR's White House reporter Ayesha Rascoe is here to explain what we heard tonight during the White House briefing. Hello, Ayesha, from wherever you are.

AYESHA RASCOE, BYLINE: Hello. I'm at home.

MARTIN: Well, a hearty wave to you at home from my home. At the briefing today, the vice president and health officials said they were encouraged that the virus may be leveling off. What's giving them that confidence?

RASCOE: In cities and states with the biggest outbreaks, there are early signs that the number of new cases is stabilizing and not dramatically rising the way they were. This means that the number of total deaths is looking like it will be lower than some of those early, really horrific projections from models. But the situation is still very serious, and the experts on the task force emphasize that people still need to follow the guidelines - avoid gatherings, stay home when possible, wash hands - and that it's especially serious for people with underlying medical conditions, and that includes many people in the African American community as a result of historic long-term discrimination. So black Americans have been hit really hard by the virus. And there are still trouble spots. The task force said tonight that Philadelphia is emerging as a new hot spot.

MARTIN: And, you know, of course, we got a lot of questions from listeners about when things will return to normal. Here is Patrick (ph) in Fort Collins, Colo.

PATRICK: I want to know what factors are public health officials considering when looking at how to mitigate this virus in the future. And I also want to know how long is this going to be a legitimate health threat.

MARTIN: I'm sure that everybody wants to know that. Ayesha, what are you hearing?

RASCOE: What the experts are saying is that this will be a concern until there is a vaccine, and that won't happen for a year, year and a half at the earliest. So they want to be able to contain this outbreak and then be ready for next season in the fall and winter. Right now, experts are meeting to figure out what steps need to happen in terms of a national testing program and guidance so that people can eventually go back to work and schools can reopen. And if and when it comes back in the fall, Dr. Fauci has said the health system will be in a better place and better equipped to test, isolate and contain flare-ups before they turn into these massive outbreaks.

But there are a lot of things that still need to be figured out before things can go back to normal. And even when we kind of go back to work and things like that, things will be different because it's not going to just disappear.

MARTIN: That is NPR White House reporter Ayesha Rascoe. Ayesha, thank you.

RASCOE: Thank you.

MARTIN: We're going to turn now to NPR science correspondent Jon Hamilton. Welcome to you, Jon.

JON HAMILTON, BYLINE: Hi.

MARTIN: And at that White House briefing, we got a sampling of new guidelines for critical workers who may have been exposed to the virus so they can go back to work. What did we learn?

HAMILTON: So these guidelines come from the Centers for Disease Control and Prevention, and they're really for workers who are considered to be part of what the CDC calls the nation's critical infrastructure. So what that means is, you know, law enforcement, people who answer 911 calls, workers in the food supply chain. Until now, if one of these workers came within 6 feet of someone that had - was thought to be infected, they had to stay home for 14 days. The new guidelines say they can keep going to work if they take some precautions. So they need to have their temperature taken before work. They need to wear a face mask. And they need to keep some distance from other workers. And, of course, if they get sick, they can't come in.

MARTIN: So, of course, everybody wants to - we've heard so much about social distancing. Some people prefer physical distancing. And we've gotten so many questions about that, as you might imagine. So let's hear some of them. I mean, this one is from Dan (ph) in Seattle, who has a question about the technical distinctions here.

DAN: We're seeing a lot of advice to quarantine, to shelter in place, to stay at home. But there are so many exceptions to the requirements, like you can travel, but how far? There's just so many loose ends to these concepts, and I was wondering if somebody could lay things out as specifically as possible and explain the rationale behind these things.

MARTIN: OK, so shelter in place, quarantine, stay at home - Jon, help us out.

HAMILTON: Yeah. I'm feeling Dan's pain here because, you know, shelter in place is kind of an unfortunate term. You know, I grew up in California, where people used it to talk about what you do when an earthquake hits. It's also been used for, you know, active shooters, tornadoes. The problem is those events have some kind of endpoint. You know, you shelter in place, and then you're told it's safe to come out, and it's over. Coronavirus - it could go on a long time, and most people can't just lock themselves in their homes until this thing is over. You might need to go out and get food or medicine. Also, you know, going out is not necessarily dangerous with coronavirus. Exercising outside can be safe if you're not going near other people and things like that. So you have all these exceptions, which is what Dan is talking about.

And I think we all need to figure out what we can do to minimize our own risk and the risk to other people while still living our lives rather than trying to come up with very, you know, set definitions of things like shelter in place. You know, for me, what this means is keep trips outside the home to a minimum. Keep your distance from other people. But it doesn't mean you never leave your home.

MARTIN: OK, another question about social distancing from Brett (ph) in San Francisco.

BRETT: I'm an avid gardener, and I've noticed that a lot of people, when they're outside, they stop and they talk in the parks and the sidewalks and they maintain a prudent 6 feet. And it occurred to me that people could do the same sort of thing while gardening. You might spend an hour or two with your friends in conversation but still maintain a safe distance. And I'm wondering if that sounds safe to medical professionals.

MARTIN: What about it, Jon? Can the man garden with his friends?

HAMILTON: (Laughter) Well, needless to say, I am not a medical professional, and I try not to play one on the radio. But my understanding, having read all the guidelines, is that people can engage in outdoor activities like this if they maintain a safe distance. So, you know, just the same way you might talk to your neighbor over a fence or go for a run with a friend who stays 6 feet away, it seems like the social distancing would allow for a conversation while, you know, planting vegetables. I guess the advice would be, you know, make sure you keep a few furrows between you and your gardening friends.

MARTIN: And share the produce, of course, right?

HAMILTON: And share the produce, absolutely.

MARTIN: Absolutely, especially to - with your friends at NPR. So we actually got a couple of questions about sharing custody of children. This is not a laughing matter, so let's go to Jessica Maine (ph) of Denver on this question.

JESSICA MAINE: My question is about the incubation period in light of sharing custody of a child. So let's say that parent A is exposed perhaps on Day 1, like at a crowded grocery store. Do you still count 14 days from the Day 1 of likely exposure or from the day symptoms begin? When is it safe for me to get my child back? I have asthma and am at high risk.

MARTIN: And, Jon, before you answer, I want to say that later in the program, we're going to speak to a lawyer about navigating shared custody right now. But first, what about Jessica's question? When is it OK to see your kid after a parent they're sharing custody with has been exposed?

HAMILTON: Well, the mathematics part of this problem is pretty easy. The incubation period for coronavirus is usually about five days, almost never as long as 14 days. So if it's been 14 days since parent A went to the grocery store and if parent A and the child don't have symptoms, the statistics say you're pretty safe. If anyone in the other household does have symptoms, then, of course, they should be tested. And, obviously, if anyone tests positive, that time period is going to be much, much longer.

And I'm glad you're talking to somebody later because it's worth noting that, you know, coronavirus is causing all kinds of disruption to joint custody arrangements. Often, the concern is the child's safety. But for somebody like Jessica who has asthma, which means that getting the coronavirus can be really bad, it means that she needs to avoid the virus.

MARTIN: That is NPR's Jon Hamilton. Jon, thank you.

HAMILTON: You're welcome.

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. If you have questions, we'd like to help. Go to npr.org/nationalconversation. On social media, use the hashtag #nprconversation. Up next, what to do if you think you have coronavirus but don't need to go to the hospital. We'll talk about how to manage at home.

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MARTIN: This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED from NPR News.

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MARTIN: This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED. I'm Michel Martin.

There are more than 400,000 confirmed cases of COVID-19 in the U.S. The severe cases end up in the hospitals, but many sick people with milder symptoms are fighting to get better at home. There are also thousands having symptoms trying to figure out if they are sick with the virus or have a different illness.

You've sent us many questions about these situations, so joining us now to give us some answers is Dr. Lucy McBride. She's a physician practicing internal medicine in Washington, D.C. She did her medical training at Harvard Medical School and Johns Hopkins University Hospital. Dr. McBride, thanks so much for taking the time to talk with us.

LUCY MCBRIDE: I'm delighted to be here. Thanks for having me.

MARTIN: So many different scenarios, so we're going to begin with a question from Jason (ph) in Seattle.

JASON: I know that there's evidence that some people never get symptoms, but it would seem incredibly useful to be able to self-diagnose mild symptoms to know that one should completely self-quarantine in that case. What are some examples of mild symptoms associated with mild cases of COVID-19?

MARTIN: How about that, Dr. McBride? Can you tell us some of the first symptoms of the virus? And do you - can I just ask you, do you even use the term mild yourself medically, or first symptoms?

MCBRIDE: I do, yeah.

MARTIN: What's the most used? Is mild symptoms OK?

MCBRIDE: Mild symptoms is perfectly fine.

MARTIN: OK.

MCBRIDE: And it's actually a lovely word given that some symptoms are not so mild. But most people do have mild symptoms. The symptoms that we're talking about are sore throat, runny nose, fatigue, a light cough. The challenge is, as Jason is alluding to, that these symptoms mimic a lot of other illnesses and even allergies that we're seeing with the pollen season, so it can be very confusing to patients. One thing I might suggest to Jason is to check the CDC website. They have a nice symptom checker, but it's obviously not a substitute for talking with your personal physician to help tease out what you're dealing with at home.

MARTIN: Our next question is from Anna in Fairbanks, Alaska. Let's listen.

SCHEMPER: Are there preventive measures that can be taken at home during the initial days of illness to prevent the virus from moving to the lower airways? For example, after a surgery, you may be encouraged to walk, use a spirometer and sit upright in bed to prevent pneumonia. Would similar actions be helpful during the onset of the virus?

MARTIN: First, Dr. McBride, tell me what a spirometer is because I do not know. And then you can tell us what measures you recommend.

MCBRIDE: A spirometer is a plastic device that people use to help inspire and to get a full breath of air and to basically exercise their lungs. And so it's something that we'll use in pneumonia patients or asthma patients. In the case of coronavirus, when people are dealing with the virus at home, the key is really to let your immune system do its thing, to let your body fight the virus. There is no targeted treatment for coronavirus, as you know, for people with mild symptoms at home, and so time is the tincture (ph), and Tylenol for aches and fever. And the key is also maintaining your general health, so hydrating, eating regular meals, walking around when you can and staying quarantined, of course.

MARTIN: Soul Tram from State College, Pa., is wondering about hospitalization. And here's this question.

TRAM: What kind of treatments or care are being given to COVID-19 patients in a hospital other than the extreme treatment of being on a respirator? In other words, if I were at home sick with the virus and I don't want to be on a respirator, what benefit is there to go into the hospital?

MARTIN: And I'm really glad for this question because how exactly does home care differentiate from hospital care? And at what point is it absolutely necessary to seek medical help?

MCBRIDE: Again, this is where it's crucial to have a relationship with a primary doctor who can help you know when it's time to go to the hospital. What the hospital can do is a couple of things. One, supportive care - first making a diagnosis and understanding what we're dealing with. Are we - is this a diagnosis of coronavirus, or is this something else? Is it a pneumonia or is it a coronavirus pneumonia? Is this the flu? And then the hospital can offer access to treatments like oxygen and other medications that are now being investigated for coronavirus treatment in the most severely ill patients.

MARTIN: Mary (ph) in Ohio has a question about pneumonia. She writes, it sounds like folks who are pretty sick, like with pneumonia, are nevertheless told to stay home and take care of themselves. How should senior citizens prepare for this? And I'm going to amend this question, if you don't mind, Dr. McBride, to say people who live alone. You don't have to be a senior to live alone and be really enfeebled if you're sick. So what do you say?

MCBRIDE: Right. It's one of the more terrifying situations for my older patients, particularly when they live alone, because they feel - some of them feel like they're being told by media and things they're hearing on the Internet that they're supposed to stay home no matter what. That's absolutely not true. The hospital is there for you with open arms if you need to be there. But again, I'll go back to my refrain that it's important to have a doctor to help you understand what is going on and how sick you are, how likely is it that you can treat your symptoms at home or how urgent is it to get you to emergency care.

The beautiful thing about this shift recently in medical care to telemedicine by necessity is that doctors are now able to reach people more than ever in their homes by TV screen, by remote access. So hopefully in the future, we'll be seeing more access to doctors by virtue of telemedicine.

MARTIN: If you have a question for Dr. McBride, send it to us at npr.org/nationalconversation or share it on social media using the hashtag #nprconversation. Up next, we have Pat (ph) from New Mexico.

PAT: What should you do to prepare a room for self-quarantine? I only have construction masks and gloves from home improvement projects. And what about disinfecting the room afterwards?

MARTIN: Dr. McBride, what do you say?

MCBRIDE: So there's nothing you really need to do to prepare to quarantine an ill patient. The key is that they have a comfortable bed, access to water and that they have a mask and gloves to use when they absolutely need to go outside of that sort of safe, sealed-off space. But there's nothing you have to do to really prepare to be sick in a quarantine space.

After someone is sick, that's when you need to make sure that the room is as virus-free as possible. The nice thing that we are seeing in more and more data that's coming out is that the virus doesn't actually live on fabric, like bed sheets, for very long, and it lives more on, like, metal and soft plastics, like doorknobs and like elevator buttons and apartment buildings than it does on sheets. So in reality, you could actually just have the person, you know, convalesce and recirculate in the house when they're well and then let the room - just sort of let the virus die in the room for a day, day and a half and then it might be fine. You might want to Clorox it just for safe measure, but that's all that you need to do.

MARTIN: Our next question is from Laura in Olympia, Wash., and she's wondering about allergies.

LAURA: I often have a spring cold triggered by allergies, but I've had a dry cough for almost a month now. It was pretty infrequent, but it's getting more frequent and more chesty in the last week. I don't have a fever or any other obvious symptom. Is this allergies, bronchitis or could this be a case of COVID-19 that has taken awhile to manifest?

MARTIN: Dr. McBride, I'm betting you're hearing this from - you're in Washington, D.C., which is known for its beautiful, you know, flowers, but also...

MCBRIDE: That's right.

MARTIN: ...Horrendous pollen at this time of year, so I am betting you are getting this question all over the place from your patients.

MCBRIDE: I - you're absolutely right. I'm talking to patients every day about this exact question. It's probably the most common question I'm getting. And the first thing is not to panic because a lot of people are suffering from allergies, and people are often familiar with their seasonal allergy symptoms. That said, I'm telling people that they need to presume this is coronavirus because it's so prevalent in the community and there's such a high risk of community spread...

MARTIN: Wow.

MCBRIDE: ...That I want people to be...

MARTIN: Call a doctor. Call your doctor.

MCBRIDE: Yeah, call your doctor.

MARTIN: That is Dr. Lucy McBride, a physician practicing internal medicine in Washington, D.C. Thank you so much. Go...

MCBRIDE: Thank you for having me.

MARTIN: Keep those questions coming at npr.org/nationalconversation.

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MARTIN: This is THE NATIONAL CONVERSATION FROM ALL THINGS CONSIDERED. I'm Michel Martin. Coming up, we'll be answering all your child care-related questions.

NATALIE: In the age of social distancing, what does that mean for co-parenting families?

MARTIN: And what small-business owners need to know about the federal government's relief bill. But first, this news.

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MARTIN: This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED. I'm Michel Martin.

When Congress passed a $2 trillion relief package last month, it seemed help was on the way for many small businesses. Here's Senate Majority Leader Mitch McConnell on the bill.

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MITCH MCCONNELL: We're talking about new federally guaranteed loans on the order of hundreds of billions of dollars to address immediate cash flow problems.

MARTIN: Now it's been nearly two weeks since the bill was signed. And in many cases, those immediate cash flow problems have not been met with immediate relief. We've heard from so many of you on this, so here to help is Danielle Kurtzleben, who covers the economy for NPR. Welcome back, Danielle. Good to hear your voice.

DANIELLE KURTZLEBEN, BYLINE: Yeah, it's good to talk to you.

MARTIN: So let's start with a basic question. Mary Mitchell (ph) of Portland, Ore., asks, what aid is available? And to talk more about this, I want to bring in a voice that we had on the program a couple of weeks ago. Lyn Stout owns an event company in Virginia called Bond Events, which has taken a hit in a time when big gatherings are mostly banned. And this is what she told us two weeks ago.

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LYN STOUT: The impact has been just devastating. In the course of two weeks, we've had every single contract, pretty much, for Q2 disappear. So far, we've been able to keep everybody. We've got some savings. We're really fortunate and have prepped for that a little bit. But, you know, I don't know whether to furlough employees or whether to try to reduce their salaries to keep them on payroll.

MARTIN: So, of course, we called Lyn back. And she's here on the line to update us. Welcome back, Lyn. How you doing?

STOUT: Hi. Thank you so much for having me back.

MARTIN: How's it going?

STOUT: It's a little stressful, but...

MARTIN: Any news? Anything going on?

STOUT: You know, we've managed to keep our 12 employees on payroll. We got through April 1 OK. We made the hard decision on Monday to cut, across the board, our salaries to try to give us a little bit more leeway. We've applied for everything under the sun, everything from the disaster relief loans to the PPP. We got in on time. We got in early. We've received confirmations for everything, but we haven't heard any - it went radio silence after we got the confirmations.

MARTIN: And you're hearing the same thing from a lot of people in your circle - right? - of small-business owners - same?

STOUT: We actually have a great group of event professionals. We're in the live events industry, so it's a pretty stressful time for all of us. So we have about 250 members in the D.C. area, and not one person has heard anything. So it's very stressful for everybody. And we're not quite sure what to expect next.

MARTIN: OK. So, Danielle, what aid is available, as briefly as you can? And why is this moving so slowly?

KURTZLEBEN: Right. So very briefly, Lyn mentioned a few of the things that are available. There is that PPP program, that Paycheck Protection Program. That is the one that's getting all of the news, all of this attention for good reason. Aside from that, she also mentioned there are disaster loans - economic injury disaster loans - they're called EIDL loans - that the Small Business Administration is administering. Those existed before this crisis. Businesses can apply for them. They make - you can apply for a $10,000 advance, which could come quickly. It would be a grant. That exists.

The other thing is, yes, states and local governments have their own funds, loans, grants that they are doing as well. So while these big federal programs are getting all of this attention, small businesses that are listening, that is also a place to look.

MARTIN: And why so slowly?

KURTZLEBEN: That's a great question (laughter). Lyn is in broad company here. I've spoken to a lot of businesses who are waiting. Now, I can't speak to anybody's particular place, but here's what I have been hearing from banks. One is that banks had been - at least banks I've spoken to - banks had been waiting on some paperwork from the SBA, the Small Business Administration, to close the loans and get money out. So in some places, banks have been able to say, yes, Lyn, your loan is approved. We just are waiting on some forms. Now, as I understand it, I heard from a bank today saying they got the go-ahead. So in some places, some people, some businesses might be in luck.

There are a few other things, though. One is that banks still have to go through a series of steps to avoid - to stave off money laundering, fraud, that sort of thing. And that is causing things to be a little slower, and it's causing some banks to restrict it to only their existing customers. That has created some hurdles as well.

Aside from that, there have been technical glitches. Banks have reported problems with the SBA website. Some banks at first said they didn't get guidance, they got late guidance, that forms changed overnight. So there have been some hurdles. There are strong hopes that things are going to get, you know, back on track and on the rails as this goes on now.

MARTIN: Lyn, any more questions we can try to answer for you?

STOUT: I do. Do you expect Congress will extend another PPP to industries like mine that can't just turn on a stove and some lights and get back up and running quickly? I think it's going to take awhile for the live events industry specifically to get back up and running because it's going to take people awhile to gather again. So we could really benefit from another extension on this thing. Do you see that happening for special industries?

KURTZLEBEN: So as a rule, I don't predict 'cause no one can predict what Congress is going to do. But I can tell you that, you know, look; Secretary Steven Mnuchin has said he wants to add $250 billion to this program. And Republicans and Democrats on Capitol Hill have both expressed interest in, yes, putting a lot more money into this. So there is - there are some good signs for that. It's just a question of horse trading of what else different parties want in the bill, don't want in the bill. So that's the thing that we are watching this week here in Washington.

MARTIN: Well, Lyn Stout, owner of Bond Events, I hope you know that we are wishing you and your employees the best of luck going forward, as well as all the folks who are struggling through this situation. Thanks so much for talking to us once again. Keep in touch.

STOUT: Thank you. We appreciate your reporting. Take care.

MARTIN: And, Danielle, we heard from a number of independent contractors who are trying to understand what help they might have available to them if they don't have any employees. This is Robert in San Francisco, who is self-employed as an international tour operator.

ROBERT: I've heard that part of the PPP stimulus package entails loans to small businesses that will be forgiven if the funds are used for payroll. Would that apply to paying myself my usual draw out of the business because I don't have payroll expense per se? There are no employees here. It's just me. Thanks.

MARTIN: Danielle, what about - I'm betting a lot of people are in that same situation. What do you say, Danielle? Do companies without employees have access to some of this government money?

KURTZLEBEN: Yes, there is a provision in the CARES Act saying that payroll can - it doesn't just apply to what you think of as strictly payroll. It can apply to the sum of money that is income of a sole proprietor or an independent contractor, so wage, commission, income, all sorts of those things.

Now, I will say, though, beyond that, that this is where it may get complicated for some people because, for example, if you're a plumber, for example, and no one is calling you into their house right now, for obvious reasons, it might be hard to get income and claim a lot of payroll. So I asked some experts today, and here's what they said. First things first, if you have an accountant or lawyer, ask them for help on this. But aside from that, this law was written quite broadly, as one expert told me, with regard to sole proprietors. So what we might expect in the coming days, what we should expect in the coming days and weeks is more guidance from the government on how those people should handle this. It's very broad, yeah.

MARTIN: Danielle, need to jump in here. If you have a question for Danielle Kurtzleben, send it to us at npr.org/nationalconversation. Danielle, you can't go anywhere. You have to stay and talk to us some more. We need to take a short break, but Danielle's going to stay with us. And hopefully you will, too. This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED from NPR News. More in just a couple seconds.

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MARTIN: I'm here with NPR's Danielle Kurtzleben, and we're talking about your questions about financial help for small businesses. Let's hear from somebody else who's having trouble accessing the relief funds. And this is Catherine (ph), who is an independent contractor in Silicon Valley.

CATHERINE: I wanted to apply for the Paycheck Protection Program. And when I called my financial institution, Bank of America, where I have held accounts for over 20 years, they refused to help me because my accounts are not classified as business accounts. How are we supposed to access these funds if our own financial institutions refuse to process them?

MARTIN: Danielle, what about that?

KURTZLEBEN: Well, this is, unfortunately, a common complaint that I have heard, is that a lot of banks - you know, big banks especially - pretty much any major bank you could think of is saying, you know, we're prioritizing or we're keeping this to our existing business customers. So there are a few routes you might try. One is try smaller banks, regional banks, you know, not your Bank of Americas or Wells Fargos or Chase or whatever, but the smaller regional ones that might only be in your area. Those might be more likely to accept not existing customers.

Aside from that, there are a few other resources to go to. One is your city or state might have a small-business resource office that could give you some information that could help you. One other thing, though, is that there is a push - Senator Marco Rubio from Florida has been talking about this - to get nonbank institutions into lending. He has mentioned hoping that PayPal could get in on it. There's one that I talked to today. It's a place called Kabbage with a K that has told me they're offering loans to not existing customers. Really, these fintech companies, these tech companies may be getting into the game soon.

MARTIN: And this is Karina (ph) from Dallas, who called with a question about the length of the time that businesses will have to be shuttered.

KARINA: Why is the nation not being put under a 14-, even a 20-day quarantine to stop the spread of the virus? I feel like a lot of small businesses are struggling, especially the ones that have to completely close. Most of them - I'm not an expert, but I feel like most of them would be able to close down for 14 or 20, even a month if they have to, and survive.

MARTIN: Danielle, you think?

KURTZLEBEN: Well, OK, a few things here. I mean, she is right that some would be able to survive that long. Some small businesses only have a couple weeks of padding there. But to get at this national quarantine or lockdown sort of idea, one thing here is that, as my colleague at NPR Brian Naylor has reported, it's likely not legal for the president to order such a thing, at least according to legal experts. And so this administration has said they're leaving it up to states right now. Now, that's just kind of where things stand right now, so we have this patchwork of who's allowed out and who isn't.

But, you know, to get at one other thing here, if you ask economists right now what's keeping the economy from getting on its feet, a big thing is testing, not just lockdowns - that if you had widespread testing, if you could identify who's not infected and who's recovered, that would go a long way. But we're still waiting on that.

MARTIN: That is NPR's Danielle Kurtzleben. Danielle, thank you so much.

KURTZLEBEN: Yes, of course. Thank you.

MARTIN: If you have questions, send them to us at npr.org/nationalconversation. Or on social media, use the hashtag #nprconversation. We'd love to hear from you.

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MARTIN: This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED from NPR News.

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MARTIN: This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED. I'm Michel Martin.

There are big challenges facing divorced and separated parents. What do you do with a stay-at-home order if you share custody of a child? Should children stay in one place, or can they split the time between homes? If a child does stay in one home, what should the other parent do to stay in touch? Here to talk through all this is Susan Myres. She is a family lawyer and the president of the American Academy of Matrimonial Lawyers. Susan, thanks so much for talking to us.

SUSAN MYRES: It's my pleasure, Michel.

MARTIN: And I'm just guessing you're getting a lot of questions about this. Are you?

MYRES: We are getting a lot of questions about this, and not just from married couples who have been divorced, but also from couples who were not married and they are either finished with some sort of court process or in the middle of it. It's a question for everybody around the country.

MARTIN: And you helped issue some guidelines to help parents during this time. As briefly as you can because we do want to get to the listener questions, can you just give us a sense of what some of those guidelines are?

MYRES: Well, we've done two guidelines, actually. One was done yesterday. We issued it out in a press release. And that comes after the experience that we had with the seven guidelines we issued in the middle of March. The 19 tips that we issued yesterday expands on those. And it talks about guidelines, which is all we can do because each family is like a fingerprint. They're similar, but they're very different.

MARTIN: OK, so - well, thanks. So go to your website and look these things up, 'cause you're right. We don't have time for all 19, although I'm sure they're important. So let's go to our listener questions. As part of this whole social distancing thing, it's very tricky for everybody, but particularly parents who aren't together. This is Natalie (ph) from Florida.

NATALIE: In the age of social distancing, what does that mean for co-parenting families in the event that one of the family members is diabetic or asthmatic, which make them in the more vulnerable group for contracting the disease?

MARTIN: What do you think, Susan?

MYRES: I think there's a couple of things that Natalie could do, and it includes reaching out to professionals. What she needs is to have some sort of comfort or trust that when the children visit the other parent, they're going to be as well taken care of as they would be in her home. It's not unusual. And after a divorce, couples don't usually trust each other more. But this is one of those times that we really need to put our best communication skills to the front and make sure that we're going to commit to follow the CDC guidelines, if there are any particular guidelines for the children's health.

And if it seems impossible to reach an agreement, then at the very least try to create makeup time because what people are afraid of is losing - losing what they have. So if you can make assurances and put it in writing that when we get through this, the children are going to have plenty of makeup time. And in the interim, try to make it as possible and as open to the children as possible so that they see both parents are important through communications with FaceTime, Zoom, all kinds of things that creative parents can create.

MARTIN: A similar question, but I do want to run it by you. This is from Erin (ph) in North Carolina. Here it is.

ERIN: I have a question about child custody and visitation during this time. Not all parents are in agreement about whether to continue visitation as usual in both homes due to concerns about the virus. Yet, restricting a child's visitation could have effects on that child's relationship with the other parent, especially if their visitation is already limited. What do you recommend?

MYRES: Well, what we're seeing through most of the country is that courts are expecting - not just expecting, but they want people to follow court orders. So if there is a lockdown in place where you can still go to grocery stores or go to the pharmacies, there's an expectation that you will be able to manage the visitation as well. Of course, there's going to be lots of exceptions when you're dependent on some sort of communication, transportation is more difficult. But the general rule, the general guideline that our judges across the country are enforcing is follow the orders. Only when you can't follow the orders for exceptional purposes should you be excused. And if there's - if there are going to be enforcements after this is all over, the courts are going to be looking at the parents to figure out, were these parents actually trying to have a good relationship with both parents and their child?

MARTIN: Here's a similar question but from a different vantage point. We've seen a number of comments from parents who have made the decision to keep their kids at one parent's house for the duration of the lockdown. But do you have some advice about explaining this to the kids?

MYRES: A couple of ways that you could explain it to the children, but it depends on the age, Michel, because different ages are going to need different levels of communication. Your older kids, you're going to be able to let them see the news, and they probably know what's going on anyhow. And they'll also be able to communicate in a way that's meaningful with their other parent through the means that we talked about before.

But when you've got the little ones, the ones that are harder to explain to, couple of techniques that we've learned from our friends in the mental health profession is create a routine so that every night, the parent that's not in the home with the child has a phone conversation or FaceTime or something where there's visuals. And maybe there's a shared book in each home and that the parent that's away from the child reads that book to the child every night so that there's an assurance. There's a pattern. There's something that the child can relate to and knows everything's going to be OK. Both of my parents are doing what they need to do to keep me safe.

MARTIN: Before we let you go, Susan, I don't want to gloss past this. There are some disturbing reports that show that domestic violence is increasing at a time like this, and you can understand why. Where can people turn to for help if they're actually sheltering with someone who's hurting them?

MYRES: At the very least, call 911. Secondarily, all the shelters will figure out how to keep you safe. Do not suffer that abuse.

MARTIN: That is Susan Myres. She is a family lawyer and president of the American Academy of Matrimonial Lawyers. Susan, thanks so much for your time. And you stay safe.

MYRES: It's my pleasure. Thank you. You, too. Bye-bye.

MARTIN: And finally, today, we want to end the program by highlighting something that is making us smile right now.

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OLIVIA WILDE: The closest thing I've ever come to being a doctor is putting on a costume. And while it is close, it's not quite the same.

MARTIN: Actress Olivia Wilde played a doctor on the TV show "House." She posted this video to her Instagram in tribute to first responders.

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WILDE: I just want to say thank you to all the real health care heroes out there. And there's some other people who want to say thank you as well.

NEIL PATRICK HARRIS: I'm not a doctor, but I was paid to be one on TV.

MARTIN: "Doogie Howser, M.D.," Dr. Cristina Yang from "Grey's Anatomy," "Nurse Jackie," Dr. Turk from "Scrubs" all joined in the chorus of thank-yous.

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DONALD FAISON: There are real heroes on the front line - real heroes - real heroes out in the street. I'm not one of them. I'm in my house.

SARAH CHALKE: I know that they're recruiting retired doctors and nurses. And if you want to recruit the fake doctors, we are ready. We can help hand you stuff.

MARTIN: Well, I'm sure we all look forward to a time when the biggest medical dramas are playing out on TV and not in real life. But until then...

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KATE WALSH: Thank you so much. You're literally saving our lives.

HARRIS: Please know that when I talk about how to be as a human, who you should grow up to be as an adult, I'm using you all as true examples to my children.

MARTIN: I'm Michel Martin. And I've never played a doctor on TV, but I'd also like to express my gratitude to the doctors in my family and all the medical professionals and hospital workers all over the world who remain on the job. We appreciate you all. We'll be back tomorrow with more of your questions. If you've got a question, go to npr.org/nationalconversation. Tweet us. This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED from NPR News. Transcript provided by NPR, Copyright NPR.

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