Good morning, i am the 113th president of the National Press club. The executive producer of the public broadcasting series. The spread of coronavirus is now affecting everything from travel and major events to the stock market, in addition to the human toll. Government, community, faithbased and corporate organizations across the country and around the world are meeting, monitoring and urging people to take precautionary measures, including washing your hands frequently, using hand sanitizer, social distancing on site and staying home if you are not feeling well. We are here this morning to learn more about how our local cities and counties are preparing for possible outbreaks. Do local Health Officials have enough protective equipment, including masks and gloves on hand . Are Hospital Personnel and First Responders trained up to deal with coronavirus patients . Are tests for the virus readily available . What is being done to educate the public in our local communities . To help answer these and other questions, we welcome to the National Press club George Roberts jr. , president of the National Association of county and city Health Officials. Considered the voice of the nations nearly 3,000 local Health Departments. Mr. Roberts has served as the chief executive officer of the northeast Texas Public Health district since november, 2006. Services provided by his home Health District including community outreach, disease surveillance, environmental health, immunization, tuberculosis control, and Public HealthEmergency Preparedness. Mr. Roberts has more than 35 years of health care experience, the majority of which was spent in hospital administration. He previously served at the Baylor UniversityMedical Center in dallas, mother Francis Hospital in tyler, texas, and Henderson Memorial Hospital in hen derson, texas. He received his bachelor of Business Administration from Southern Methodist university in dallas and a masters degree in Health Administration from the Washington University school of medicine in st. Louis. Mr. Roberts, the National Press club podium is yours. Mr. Roberts thank you. I appreciate it. Good morning, everybody. Its a pleasure to be here. I thank you for the inslitation to be here today invitation to be here today. We in local Public Health, in Public Health in general, are counting on you to communicate with the American Public about the daytoday steps they can take to prepare for the coronavirus. A few words about mike mentioned it briefly. The National Association of county and city Health Officials is the voice of local Health Departments through 3,000 departments across the country. We have the theme that i have is ed with naccho this year leadership. My partner, dr. Smith out of arkansas, Arkansas Health commissioner. Mine is transformational leadership. His is community resiliency. Both of those pair together so well as we deal with this particular situation that we have on our hands that we are facing. Our mission is to prevent illness in the district, protect our community. A little more about my organization. We have services in east texas, in 21 counties. We serve as the w. I. C. Provider in 20 counties. We do Emergency Preparedness along with community outreach, immunizations, t. B. Control, environmental health, and we are fortunate to have many great partnerships and working relationships which include the c. D. C. And in texas, the Texas Department of state health services. Local Health Departments are, to use a phrase, your boots on the ground. We are the ones here to interact with the community. Our work is often referred to as invisible. I look at you in the audience. How many of you think daily about your local Health Departments . The answer is you probably dont. A lot of times our work is invisible while we are out there every day doing such things as making sure you have clean water, have safe food to eat, vax nations provided vaccinations provided. As a matter of fact, the back of my business card, it says Public Health, your invisible guardian. A lot of times the work we do is invisible. But, you know, until when things are going well, our communities and citizens are working, living their lives and being productive members of society. However, in situations like today, our work is much more visible. All responses to the coronavirus are local, via surveillance, contract taking and information to the public, selfmonitoring their systems, isolating themselves, separate themselves from the public, these people separate ill people from those that have communicable to those that are healthy, to quarantine, more of a restrictive type thing, to restrict their movement in the community. Now, i want to spend just a minute i know all of you have heard about coronavirus, but what i found in situations like that is sometimes repeating the message, repetition is something that we must do at this particular point in time. Let me go back to the genesis of this whole thing for just a moment. So coronaviruses are a large family of viruses that are common in people and many species of an mass, including camels, cattle, cats and bats. Rarely, rarely, animal coronaviruses can infect people and spread between people such as we have such things as the normal coronaviruses that probably all of us have had called the common cold. Thats a coronavirus. Then we have more serious situations like mers. We remember that several years ago as well as sars. This one is now named the virus here is called sarscovid2. Many patients at the epicenter were in wuhan, china, had some linkage to a large seafood and live animal market, suggesting animal to person spread. Getting back to the coronavirus issue, there are seven known coronaviruses that can infect people. Four of those seven are what we consider it has specific numbers here but basically thats the common cold. The other ones are mers, which we found in 2012, the middle eastern respiratory syndrome. In 2012, there were 2,500 cases of that and 858 people died as a result of mers. Then we had the sars back in 2002. There were 8,000plus cases of that, 775 deaths. Now we have the coronavirus. Uptodate reporting right now, i checked the c. D. C. Website this morning. The c. D. C. Said there are 99 cases of coronavirus in our country right now. There have been 10 deaths and 13 states reporting cases. That was the most recent information i had about two hours ago when i checked the c. D. C. Website which is what i am referring to at all times. As of march 4, the c. D. C. Said they had tested 1,526 cases patients for coronavirus. So how does it spread . One thing is mainly its person to person, so if i were to cough right now, i think you are roughly six feet away from me so we are probably in good shape. For a person within i may cough and i may get respiratory droplets or air droplets on you. Thats how it spreads when i either cough or i sneeze or Something Like that. Thats how we spread this. To a lesser extent, we talked about surfaces. So lesser extent you can get it from touching a surface. It lives on a surface from a few hours to nine days. I dont have the exact science on that, but just know that cleaning a surface is probably a good thing to do. So what can we do in situations like this . How do we address this when we have a new, novel virus out there . There is novak seen yet and wont be a vaccine for a while. There are no antivirals to deal with. We have a flu vaccine. How do we handle this . Well, first thing we do is avoid contact when people are sick. I am not sick today. Thats good news. Avoid contact with people who are sick. Avoid touching your eyes, your nose and your mouth. How many of us routinely touch our nose . We dont even think about it. Try to avoid doing that. Stay home when you are sick. Thats one of the big things here. Tell people, sometimes i may get we need to stop that. If you are sick, please stay home. You dont want to its not you are not helping your fellow peers or coworkers if you dont stay home when you are sick. Cover your cough or sneeze with a tissue. Throw the tissue into the trash or the toilet. Clean and disinfect frequently touched items and surfaces using a regular household cleaning spray or wipe. The next one i have seen i saw people in masks. At our Leadership Meeting last week we had a gentleman from the c. D. C. And i asked him several times to try to get something. I said, so is the regular mask that you wear does that provide you any protection . He said the c. D. C. Does not regular that the general public wear a mask. I said, what if i wear the c. D. C. Does not recommend the general public wear a mask. The c. D. C. Does not recommend that people who are well wear a face mask to protect themselves from respiratory diseases. Remember that. If you wear a mask, its not doing you any good unless you are sick. Leave the mask, ladies and gentlemen, for the Health Care Providers. When you go to the hospital, thats the time to probably put on a mask. Think about it yourself. I will look at the audience, raise your hand. Ow many had a test have a mask . If you put it on, it may not do any good. You have to have a fit test. Health care workers are tested. This is one right here. The biggest thing that i can recommend to you and probably the most instructive to me over the last week or so as we have dealt with that, wash your hands often with soap and water for at least 20 seconds. I have had to challenge myself to do that. You can sing the happy birthday song. I have resorted to the simple count to 20. If you do that, you are washing your hands longer than you are probably used to. That will make a huge difference. If you cant use that, use some type of alcohol based substance to clean your hands. We as americans, we like to shake hands with each other. We like to hug each other. Those are the types of things we like to do. Here is an interesting we did an interesting story in our organization a while back and it was around National Hand washing day. There was data that came out from i checked this morning. Data that said get this one. When people go to the restroom, how many people wash their hands . Well, the data shows that only 31 of men and only 65 of women wash their hands after they use the ress room. Ladies and gentlemen restroom. Ladies and gentlemen, if we can take a step in that, we may help protect ourselves from coronavirus or other diseases that are out there in our population. Did a local story, where my cpio is a male, the tv interns twonet a local restaurant and tested it to see if these were unscientific studies. It really was pretty darn true. Please wash your hands, men and women, after you use the restroom. So what is the incubation period for this thing . I am sharing this with you for your information, for those of you in the audience and at home, but number two, when we go to local gatherings in our community, these are the types of things we are repeating. A lot of things for you, the media, can do to help us is repetition of the messaging is so, so important. So how deadly is this thing . Right now dr. Fauci, i saw a story, said the death rate from coronavirus is 3. 4 . That was an article i saw in the last couple days. Now, do we think its more deadly than that . Do we think its less deadly . The vast majority well in excess of 90 of the cases around the world are in china. We dont know how many cases there really are out there. Why . Because this coronavirus, kinds of like the common cold, a lot of times we think maybe we have a headache that morning, we go about our business. A lot of people may have coronavirus or the covid19 and not really realize theyre sick. There is probably a lot of testing that went on in china that they didnt really understand. So how deadly is this thing . They basically and what is the spread rate . For coronavirus, the covid19, so if i have it, if i am diagnosed with it, i can infect two to four people. The seasonal flu is typically a one to one type of thing. You have more Infectious Diseases like measles. Roughly 10 to 1 people are infect 12 people are infected. Going back to sars and ebola, the fatality rate was close to 60 . Sars, it was 10 . So the message there is that it appears that 3. 4 is higher than sm flu rates, but seasonal flu rates, but we dont know what the denominator is. It may be worse but it may be a ot better than we think. Symptoms, again, pounding the message here. Fever, cough, shortness of breath. How many of you in this audience and at home, how many have ever had fever, coughness, shortness of breath . I will raise my hand. Do we think we had coronavirus . So from the research of covid19 we know 80 of cases are mild with most people not needing hospitalization. However, older adults and people with Underlying Health conditions like heart disease, lung disease, diabetes, greater risk of complications. So for lets talk about china for a second. I have never been to china. Maybe some of you in the room have been to china. Its my understanding air quality there is not as good as ours. I pulled up my phone this morning with the c. E. O. Of naccho. We asked siri what is the smoking rate in china . I checked it yesterday. 14 of americans smoke. 31. 8 of neem china smoke. So therefore a respiratory illness, theyre already higher risk of having these issues. So how is this different from the flu . Well, we have similar symptoms and lung complications. Its spread through droplets. Its caused by different viruses. Just for perspective here, we have worldwide right now i didnt see the exact count this morning, the Johns Hopkins website which i found to be very instructive. Its just under 100,000. Worldwide deaths as of yesterday, 3,053. I will say though, look at the recovery rate. Most people are recovering from this. Now, lets talk about the flu this year in the United States. Go back to the c. D. C. Data. The c. D. C. Estimates just in the u. S. I said around 100,000 worldwide of coronavirus. Just in the United States this year, 32 Million People have had the flu in the United States. With 18,000 to 46,000 estimated deaths. So far this year from the seasonal flu. I wont ask for a raise of hands, how many of yall had a flu shot this year . Very good. Thank you for doing that. So we talked about our background and symptoms. We talked about steps you can do to prevent the spread of coronavirus. Now how do we address this in our community . The primary reason for me coming here today. One thing we have been doing how many of yall heard about the coronavirus back before christmas . There is a young lady in the back that heard about it. I think i had heard briefly about it but it started to ramp up in january. We celebrated the new year, didnt know a lot about coronavirus. So what have we been doing been doing locally since that time . We have been assessing people who have risk of contracting the disease. We have been testing persons of interest who have been traveled to impacted country, china, italy, iran, south korea, japan, or on cruise ships that had traveled to ports of entry and exhibiting symptoms we talked about already. We have been working with our local Health Care Providers i am using this more a local basis but i will say this on a national basis, naccho members are working with Health Care Providers to make sure they know what to look for, answers questions and in some cases making sure they have the c. D. C. Test kits to test for the virus. The guidance for testing has really shifted this week. Like in our market, if we had a suspect case, we have had to talk with our department of Health State Services in texas as well as the c. D. C. And now its my understanding that that testing has gone more into providers hands. A provider can if they believe that this person needs to be tested for coronavirus, if there is a travel history or other types of way they may have contracted the disease, the provider has the ability to start doing that. Local media i am going to harp on this a lot. We are really counting on you to really get the message about this out to the public. The public is looking to you for information on this. So we have worked with our local media. We have worked with our radio stations, our television stations, our social media. We try to put out the information from the c. D. C. , what we have learned. We are trying to come up with new ways to communicate the message to people. Hope theyll listen and hopefully wash their hands more. We inventoried preparedness supplies. In our market, we have a warehouse that has a cache of preparedness supplies. We have inventoried masks and encouraged our local Health Care Providers to do the same type of work, make sure they have personal equipment they need. Our Preparedness Team has been meeting with our hospitals, area schools, government officials to update them and discuss preparations for this. I had a chance to see a doctor the other day before he would meet with the Vice President. He wept through several things, he told us get prepared. That was his message. Get prepared for this. Just this week in my locality, we have met with we had a large meeting on wednesday with our probably 75 people, our of y government, the city tyler, several smaller municipalities, police chiefs, fire chiefs came to meeting. We talked about this situation with the coronavirus. We gave them talking points. What are you doing to be prepared . How will you handle the situation . We also met with Emergency Management officials as well. Public Health Departments this is very important. Public Health Departments spend a lot of time preparing for situations like this. Thats why i have a Public HealthEmergency Preparedness department and the c. D. C. In our state has funded us preparedness. What does it cause us to do on a daily basis . We are building relationships. As they say in life, the first time you meet somebody is in the middle of an emergency. You want to know your partners so you establish that ongoing relationship to where when you have a situation that comes up like coronavirus or maybe in our market like a tornado or south of us hurricanes, so thats we want to be that trusted partner and i think we are that trusted partner in our community. Now, we also talked about the other day, what do you do if this thing gets large and you have to maybe close your schools or Community Events . How will you make those decisions . Well, the answer in tyler, texas, may be different than washington, d. C. Or the state of washington. Each community is going to have to make those decisions about when do they close the schools . One of my School Superintendents in our area made the comment, you dont close schools if you have the flu, do you . No. We close it if we have an attendance rate of 84 . Thats when we make a decision to shut down schools for a couple days, do major cleaning. That will be up to communities to have those conversations inside their communities and talk about that and make decisions. We have to balance between there has to be a fine balance between protecting the community, understanding the risk and mitigating fear. Protecting the community, understanding the risk of the situation and mitigating fear. So what can we do today . Well, ive heard this Infectious Disease doctor who i have a great deal of respect for. I asked him the other day what is this all about . He said george, this may be bad flu season with novak seens and no antivirals. No vaccines and no eanl virals. How do we handle that . Good Public Health measures. I have been in this town for over 13 years. I lived through h1n1. I lived through the ebola scare. H1n1, the first case might have been in texas. The first confirmed case of ebola in the United States was in dallas. There was a lot of fear about that. We lived through that. How did we do that . We didnt have an ebola vaccine. How did we do it . With Public Health measures that i talked about. Washing your hands, covering your coughs, staying home when you are sick. Cleaning surfaces, just being taking Common Sense Solutions to this whole thing. So i want to stop there, ladies and gentlemen. I know you have a lot of questions that i potentially can answer for you. Again, thank you for what you are doing to get this message out. Please share the messages about the symptoms. Please share the messages about what we can do about this whole thing and together we will get through this thing. Thank you. We invite questions from the journalists that are in our audience. If you want to hold your hand up, we will bring the microphone to you. Let me begin. With some questions that have been submitted. How much will getting tested for coronavirus cost you if you are uninsured . Mr. Roberts that is a good question. I know the c. D. C. Test does not cost anything. When they become commercially available i dont i am not sure what that will cost. What i would hope for in the future is many of us have gone to our physician or practitioner and been tested for the flu. I would hope in the not too distant future we have some type of test that will give us instantaneous results. I dont know when that will come about. The f. D. A. Is working on it. As of right now, i understand the c. D. C. Test kits, there is no cost to that. Thank you. We hear that we may see a dip in the infection rate as the weather warms up and then a spike in the fall. Can you address that . Mr. Roberts i wish i could. Thats what happened my memory of h1n1, thats what happened with h1n1. But again it is a novel, new virus. We dont know the answer to that now. Ask me that question in a year and i probably can answer that for you. I hope its true but i cant say it. We dont know the answer to that. Can people be infected a second time . I heard dr. Fauci, listened to him the other day talking about that. He doesnt think so at this point. That was when there was reinfection. At this particular point in time, the answer is no but it could happen. I heard this morning that the cases in china are starting to level out. I dont know if you heard that this morning. I see some head shaking. Thats good news right there. What percentage of local hospitals medical supplies are manufactured overseas, some in the very countries most affected by the coronavirus outbreak . Mr. Roberts thats been one of the real lessons is how much is actually manufactured in china. So much of our the masks as well as medicines are manufactured in china. There will probably be real changes as we go about that. I dont know. I think its a fairly large amount that is manufactured over there. Thank you. Some people are worried about their pets contracting the disease. What are local Health Officials telling people about that . Thats a question i havent had yet. I am sure i will get that at some point in time. I will look to you. I have not heard any issues with pets right now. Have yall heard that . Have you heard about pets i see you shaking your head. There was a case of a dog in hong kong that tested positive for the virus, but there is no indication whether the the dog had no symptoms. There was no indication whether the dog was sick or it can pass the virus on to anybody. I havent heard of anything like that. Thats something that we need to something i need to investigate to know the answer to that. A question that came in from one of our journalists, some Asian Americans are rorming increased discrimination stemming from coronavirus fears. How can local governments protect businesses from this type of situation . Thats a good question. Thats going to be challenging but i think over time initially it came from china but now we are seeing it in italy and some other places. I think over time thats probably going to subside. How are physician offices being prepared and educated as we move forward . Thats one of our tasks in our local communities to talk to doctors, work with i have physicians on my Health District board. There are physicians in the community, talking to them. The county medical societies, the hospitals. Its continually having those Public Health and doctors are getting education on their own as well. Thank you. We have a question. Hi, i have two questions, one of them hopefully is quick. The problem that i have heard from different people and this goes back to the National Governors conference when the governor of hawaii was concerned about the test kits, not so much the kits but the fact to get the test results done he had to send them back to the mainland. Atlanta. So my concern is i heard something today that theyre looking at possibly having some local commercial labs be able to do this testing so they can get the results quicker. Do you know anything about that . Mr. Roberts i can speak to texas. Yesterday the governor announce. Governor abbott announced there are several test gets at Public Health labs in texas. A Public Health live in texas, tyler. We hope by the end of the month we can have these test kits. Test kits already out in several public labs in texas. That is the problem coming having that delay. You have to ship the test directory to the cdc. One,s to get there, number and then 72 hours after that. Testing will be sent out to the cdc but you can have a preliminary diagnosis and a whole lot faster time. Apac,essage when out from saying they have been aware that a group of policy attendees from new york was potentially in contact prior to the conference with an individual who contracted coronavirus. That individual did not attend the conference, but this group has been added to the self quarantine list. They have not given us any more information as to who these people were or were they were, what sessions they attended. Again, we are looking like secondgeneration, they have been in touch with the person that got it from new york prior to coming to apac. They were not the first people to have it. When you look at a situation like that, they say dont raise the alarm. They just want us to be cautious with it, but when youre looking at Something Like that there were 18,000 people at that event. When you have something where it could be secondary people, how concerned should we be about that . That . I think there is cause for your antenna going up. I almost compare it to the flu. Exposed to things like that all the time. I would think that the local Health Departments and state Health Departments might be trying to do some Contact Tracing with the individual to see who they contacted, maybe close contacts. Cq rollcall. H said departments get half of their funding from the federal government. Is that correct . Can you identify some of the main federal funding streams that departments like yours and your members rely on, and what the trends for those have been . Have organization, we roughly 70 plus percent of my budget comes from grants wick is my largest program. 60 of my funding comes from the wic program. Preparedness funding is pretty stout. Chronic disease management, immunizations. Department,ealth there are a few large cities around the state that gets funding from the government, but i get my funding from texas. Wic program is usda grants. Your other question i didnt understand. What have the trends been in recent years . Has the federal funding been enough for you to do your job . In a situation like this, they just passed the emergency spending bill yesterday. How quickly can you utilize those funds, or do you need more reliable sources of funding . I appreciate the question. , when thingsife are going i mentioned Public Health is your invisible guardian. People are not seeing what we are doing, day in, day out. What has been essential in my organization is my epidemiologist, preparedness staff, pio. It is all hands on deck right now. We hope to get extra funding to deal with this. As i understand, the bill, 30 days, something in the bill that said 30 days after . That is something we were talking to elected officials about. If we get this funding, lets dont sit around and wait around. My sense is they heard the message. When President Trump asked for the extra funding, and senator schumer made his counter offer, and he signed this morning. On a daytoday basis, we could always use more money. We need that to be ready to go in a situation like this. In,dont just bring people you have to have people skilled and ready to go. I had a question going back to the issue with where you get ppe and drugs. Have local Health Departments and hospitals experienced any shortages of ppe, any other drugs because of the coronavirus . If so, how do you handle that . [indiscernible] i understand from the state of washington, where they have had a lot of the cases, they have burned through a lot of the ppe dealing with people. When you are dealing with people in isolation, you are wearing that material, taking it on and off pretty frequently. It is a pretty high burn rate. Im concerned we will have shortages of that. I understand part of the funding is to help people resupply for that. I am with axios. Two questions. , someocal counties counties are asking for local emergency funding, even though they dont have any confirmed cases yet, but cities nearby may have confirmed cases. Is that the proper response . You may not have a confirmed case but we have had several suspect cases, monitoring. There are other diseases out there that need to be monitored. You have to take staff away from their other jobs. You do need extra funding just for the situation. Fortunately in texas, we never had anabolic case but we spent time preparing for that. Thank you. You mentioned in china and other countries, they have essentially shutdown a lot of the cities experiencing a lot of the spread. Do you see the federal government having a role and that if we ever get to that point . You said there was a casebycase basis in terms of cities. That could cause a lot of economic destruction for local cities. Our system of government here is totally different. I would see that first starting at a local level, and then moving on to state, national. I would see more those types of situations locally than nationally. My opinion at this point. United the response states would not be able to do anything remotely similar to what the china did because the way our system of government is. Thank goodness for our freedoms here. Organization represents nearly 3000 local Health Departments nationwide. What are some of the questions you are getting from them now . Are you being inundated with questions, and how are you handling these . A lot of the questions you question, that ppe how do you meet with your cities and counties, what is the role of the local Health Authorities . I can speak to texas on that. How much authority does the local Health Authority have versus a physician . There are many questions that have come up. I know in texas, we have a state association of county and city Health Officials. We have email streams were reconfirm my questions. What are the best practices out there . We had a state Association Meeting this week in houston. County judge came and they were dealing with the confirmed we have no cases of coronavirus in the community, but do we cancel their houston rodeo and stock show . They said, no. There is no reason to do that. The issue of closing things will be something that they will have to deal with as well. A lot of employees, municipalities are represented by unions. Talk about the relationship between your organization, unions, whether there are collaborations already underway to deal with this, since the first responsibility is to protect their members. In our state, we dont have a union in our organization, so i cannot totally address that. The leader of my organization, my job is to make sure my employees are protected. My employees are my number one resource. I cannot do my job without my employees. Whether or not i have a union or not, i want to make sure my employees are protected. Three questions. Aaron garcia. Related questions. What percentage of local Health Departments actually have kits to do the testing . Lab core and Quest Diagnostics will be offering test. Where should people go for testing, their doctor office, or a commercial lab . We have to get that from the cdc. Im not sure where we are getting that from. We are accessing those. I am not sure when the commercially available test will be available. My always answer to the question will be, if you have a concern about your health, contact your physician or medical provider. I would also ask that they be contacted, call them first to know about your systems symptoms, so they can greet you with the proper agreement on. We dont want our providers to get sick. We want the providers healthy out there, taking care of people. Does that answer your question . You have touched on this but i wonder if you could walk us through the fact, if local officials consider whether to cancel a large event. What exactly do you look at . What is the case on the ofund, how many cases coronavirus do you have in your community . Is in one case, 10, a lot . They would be in concert with our local leaders. Government officials, Community Leaders come together and have a conference about our schools. Happen . Going to there was a large petition in and they cancel sxsw, said we have no confirmed cases , so it will go on. Officials up to local to make the conversation. I would want to weigh in on the conversation but the leaders are making that call. [inaudible] absolutely. I was wondering if there have been any conversations about any publicprivate partnerships . In the past, the u. S. Funded the novartis plant in North Carolina that funded vaccines. In this situation, there seems to be a question about whether there is enough diagnostics tests. Is there a potential for the u. S. To work with diagnostic manufacturers, so that when an event is triggered, they can mass manufacture diagnostic tests . Our ceo has intimate knowledge of the bill is in their money in the bill to get testing done . I believe so. I believe there is funding in the bill that President Trump signed this morning to do some of that. Administration has been very proactive on things like publicprivate partnerships. Without reading the information myself, i believe the answer is yes. My name is rachel. Im with modern health care. Hospitals and nurses had asked congress for funding for preparedness, reimbursement for their response cost. It looks like that funding will be filtered through the state, local health agencies. I was wondering if you could elaborate on the conversations you are having with hospitals, how that money will filter . We have been talking about response, getting information out. We have not had a conversation about the money, at least in my market. Im guessing there are hospitals and states that have have those conversations but i have not had them yet. I am sure that conversation will happen sooner versus them later. Thank you. I have two questions. The cdc has sort of relaxed, in a sense, its recommendations around Health Care Providers and Contact Tracing, Risk Assessment where there is community spread. Is that a good idea for Health Providers you are referring to access to testing . Health care providers themselves and protections they should have, in terms of them not getting sick, if they had been exposed to someone with covid19. What should people be doing to ensure they are not then becoming sick and spreading it . The answer would be to make sure they are wearing their proper equipment. Tracing . As contact i would hope, if they are exposed, that they are doing their own selfmonitoring, monitoring their symptoms. In terms of testing, i spoke ith one physician understand right now the criteria for testing is that if a physician feels a person could have covid19, they could test them. That is my understanding. With the case we had in our markets, you had assessment by the provider, and then a conversation with my team, as well as Texas Department of health services, cdc. Now it is more providers who make the call. That is why more test kits have been distributed. I cannot speak to those states, but texas come a we have seen more kits get out there. Ultimately, you get sick, you go to the physician, and then coming back to your question about commercially available. Im not sure, but my guess is sooner versus them later. Are we rationing in the meantime . I spoke to one physician who spoke to a First Responder who answered a call for someone who may have had covid19, came to her with symptoms, and she went to the cdc asking to test that person, and they could not. I think that was up until the last couple of days that that has changed. My guess is we are looking at the provider to make that call. Cases,e of our suspect the first case in our market, the provider evaluated the patient. They did not see a need to go further. The second case was taken on by the cdc. The state made the decision that it did not meet the criteria. What will happen with this new criteria, youll see more testing done. I think that is what we will see ultimately. One of the things that i think we need in Public Health, how many people do actually have out there . That is where the Contact Tracing can get better and better. Biggestare the questions that remain in the scientific and medical communities . Oh gosh. I think one of your first questions that you asked me does the changing season seven impact . How long will it take for this to burnout . How quickly can we get a vaccine . Knowing the vaccine will take probably a year, how quickly can we get antivirals . It would be nice to have Something Like tamiflu to give to patients. How much will this actually spread once it gets to the United States once we start seeing more spreading in our country . Spread l will it can i give it to two or four people . New virus, we are all learning something new every day. Are you getting questions from some communities, cities who are thinking of literally shutting down at this point . Do you see some time in the near future somebody taking that step . Shutting off of a city . City. Not heard any i have heard, should i cancel my event, should i cancel my conference, an event im planning to have. What should i do about Church Services . What would constitute shutting down the schools for a period of time, if one or two cases, . One of the things you mentioned was people staying at home if they are sick. Would you like to repeat that . One of the things you mention his people staying home if they are sick. One thing that was asked particularly in the senate is about workers who have service jobs and do not have paid sick leave. They want to stay home but it is a difference of putting food on the table. Are public Health Officials talking with local employers about dealing with that situation . That is a good question. I would hope the local employers would do that, see the need. Them. Hurt if they come to work that day and they get other people sick, then that employer has more to deal with. Of it is better off for the employer to offer that paid time off in the situation, than the alternative. I think you mentioned about smoking rates. Is there a scientific proof that if you smoke you have more chance to get the virus . Yes. Well, let me qualify that. We know that smoking is harmful to your lungs. Here in the u. S. , going back to the 1960s, show that smoking was hazardous to your health. We found it may cause lung cancer. Over the years, we have seen xrays of people, the damage that cigarette smoking does to your lungs. I am making the correlation with a higher smoking rate in china, perhaps the lungs of the people in china are not as strong with a higher smoking rate. Smoking is not good for your lungs. This is a respiratory illness. That is the correlation i am making. But not the specific virus . Since this is a respiratory illness, it is impacting your lungs. Whenng does not help you you potentially get a respiratory disease. You said the cdc does not recommend people to wear masks. Someerstand there are patients. Ic if this person has no symptoms. , if they are infected, are wearing a mask, does that minimize the chance of me getting infected, if they dont know that they are infected . I will go back to the general cdc. I was asked the same types of question the other day. They said the cdc does not recommend the general public use masks at these times. We want to keep them for the hospital providers, those that need them when they go to the hospital, protective equipment. Did that answer your question . Not really . We assume we are both healthy. But what if im affected and i dont know, and im not wearing a mask . You are wearing a mask, and that would prevent you giving the virus to me. If you are infected, should you wear a mask . [inaudible] , goingou are healthy back to the cdc guidelines, the cdc does not recommend that you were a mask. I am kind of pounding that talking point. Let me follow up then. Where youision a time envision the cdc will changes protocol on that . We will have to see how this goes. Be whatprobably is happening at this particular time. Any other questions . German television. In germany, we have a lot of coronavirus cases, so we have the problem that the supermarkets are empty. Are buyingeppers toilet paper, water. Do you see the same problems in the u. S. , a lot of people who want to buy everything for their homes . Second question, are there any planned events to inform the ,ublic, what they have to do what they have to buy, for example . We talked in preparedness, what you should do for normal routine, what you should be prepared for, for example, bad weather comes, or maybe a snow day in d. C. , some type of power outage. You should always have several days worth of food and maybe water on hand. Here,s going to happen United States, if there is an outbreak, would the shelves be empty, items you talk about, bottled water . That remains to be seen. I guess thats a possibility. Theur overarching theme at press club this year is why journalism matters. Here we are engaged in this at ario, and here you are News Conference at the National Press club in front of a number of journalists. Can you speak, as a last comment about the role of journalists in this, and what you may ask of them . Its a pleasure to be with you today. I opened up by saying the value of you in journalism. You are here to get the facts out to people, to give them solid information. It is my job to give you the best information i have. But i am counting on you to get that information out to the public, where they know what they should do, how they handle things. Is not a vaccine or antiviral yet, here are some things that you can do today to prepare for this. Washing your hands, covering your cough, staying home if you are sick, cleaning the services in your house. Those Public Health measures effective during outbreaks such as h1n1, ebola, and other things, and i hope that you will print that. We are counting on you. Ask us questions. Market, like the other day, you challenge me with some questions that i need to do homework on. Your questions help me to better inform my public. Please keep up the work you are doing and let people know. Find that balance between communicating the risk and also mitigating fear. Put socialg to distancing on hold for a moment while i reach under the podium to present you with our appreciation, a National Press club coffee mug. I think we are all drinking a lot of coffee these days. I will shake your hand, too. Thank you for joining us today. Thank you, everybody. [captions Copyright National cable satellite corp. 2020] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. Visit ncicap. Org] you didnt ask a question yet. In a case like this where there is emergency funding issues, how does that trickledown . Is it more for paying overtime, buying supplies, hiring new employees . Works,way that funding the funding goes to the cdc. Issuesthe cdc will issue fundino the state. I will be responsible for amending my contract, etc. Foruld use that money staffing, buying supplies, potential travel. If you missed any of this briefing, its available online, as well as all of our coverage of the federal response to the coronavirus, including hearing, briefings, all the latest at cspan. Org coronavirus. We will have the latest on the coronavirus later disease, and Emergency Preparedness. They are holding capitol Hill Briefing live, 1 30 p. M. Eastern on cspan. Numbers of the Coronavirus Task force hold a press briefing this afternoon on the spread of the virus. We expect to hear from the Vice President and other officials. That is live at 3 00 p. M. Eastern. It will also be on cspan. Org or the president today signing that 8. 3 billion coronavirus emergency funding bill, tweeting after that, spoke to governor gavin newsom of california early this morning about the cruise ship quarantined off the california coast. Coronavirus test kits have been delivered. The testing is taking place now. Here is that briefing from the white house, the bill signing from the white hou