Coronavirus p they write that today larry kudlow has confirmed that the administration is considering timely and targeted federal interventions to help workers, firms, and industries heard by coronavirus as fears mount over the growing Economic Impact of the spreading out. Read more at washington post. Com. Thentil 1 30, when briefings get underway, we will show you more from todays washington journal. This is dr. Christopher morris of George Washington university, the Global Health professor here to talk about the global and u. S. Coronavirus response and everything related to that. Good morning, sir. Guest thanks for having me, pedro. Host what is the perception of what is going on with the kiwanis virus the coronavirus and what is the reality . Guest there is so much around this about what is true and what is just rumor. Without getting really clear messaging from our top leaders, it is tough to understand the right calibration for preparedness versus fear, versus confidence. This is something that it is a it willw virus, and take time to get our hands and our heads around it. Host in terms of what . What is the administration not providing as far as leadership . Guest the entirety of the Public Health response needs to be more robust and direct, in terms of talking to people about what is their role in this, what is the officials role, and what can we expect going forward. There is a lot of room for some leadership messaging in terms of what we are doing about diagnostics, travel bans and restrictions, what is the future portending for the outbreak, and what can people do in their everyday lives . Rogue messaging about isolating yourself and taking care of handwashing and not touching your face. That is true, but people need more than that. Host when it comes to the virus itself, is part of that information provided as far as what it is exactly and how much it spreads and the rate it spreads and the things we dont know on those fronts . Guest it is not being delivered at this point because we do not know how to package that up yet and how far ahead of the data we can go confidently to develop it. We look at experiences in other countries, certainly china was a main experience we had to work with, but now we can look at data coming out of south korea, italy, europe, and the u. S. As well p that tells us more about what we can expect in terms of the ultimate more billet morbidity and every day we get new numbers, new ideas about which way this thing is pointing, and i think we need to make sure we are moving along and advancing that so that people can have confidence that we are developing a plan. Host what do you take from the numbers come as far as we are heading particularly in the u. S. . Guest the numbers are certainly troubling. We look at the china experience and their numbers are coming down. A lot of folks i talked to, especially in the marketplace, they are seeing that as a positive. It looks like the china response has broken from the transmission chaining over there. We look at the rest of the world and it is growing quite rapidly. It is spreading geographically and the numbers are going up and up. So this is this is a balance. Can we make our response robust enough to do something perhaps or is that not something that will be in our toolkit because they have a much different approach available to them then we have in most of the rest of the world. So i think at this point, really what we need to do is get our own numbers as best we can. Has involves everyone been saying a lot more diagnostic testing going on so that we can really calibrate what is going on in our communities, whether or not we have an opportunity to contain, or if we drop back and look at this thing in a broader way. I guess well be with us until 9 00. If you want to ask questions about coronavirus exposure in the United States and the 202al response, it is 748, 8000. When it comes to the kits, can you describe them . Also the amount of kits that guest i have not seen the kit handson myself, but i have used these in the past and it is a direct detection of virus genome in the sample they take from people. Some of the problems were clearly that it was complicated to some degree in terms of how individual labs would validate the results. They have tried to make repairs to those from the cdcs point of view and now we are waiting to receive those in a much broader scale to state and hospital labs so we can get the testing rolling. The delays there i am not sure what is causing that. There is a lot of consternation in the Public Health community about what is taking so long, and there is concern about, is it all the way correct at this point . Are we going to receive something that will be available and let us get through the testing slog that we have on backlog we have at this point . There have been emergency authorized products by fda that will allow program let some producers provide alternative kits. Those have not been validated either necessarily to the point that we prefer, but at this point we need more or less everything we get our hands on it we will have to do the validations, kind of, in flight, to see if some are better than others. Kits have been developed all around the world for this response, every country either counting on what the who has provided or relying on their own. There will be a number of experiences we can pull from. Hopefully we will find the best solution. One of the most critical things is trying to get the test time down to as short as possible and out to as close to patients as possible. The quicker we can do those two things, the better we will understand the outbreak, the trajectory and the scope. Host what is the turnaround time for getting the test administered and the results . Guest the results we are hearing about coming out of state laboratories and cdc, that still seems like we are looking at 24, 48, even 72 hours. I am sure that could be cut down as things became more efficient, but the fact is that it probably takes about three to four hours. That does not even include getting the sample prepped. Host you talk about taking those test on the fly are you worried about the and result or the information given is valid or accurate or the degree to which it is accurate . Guest we want the best test possible, but at this point, it will not make a real difference in terms of how a patient with severe disease is being treated. This is about understanding the scope of the outbreak. At some level, we can forgive a little bit of test performance if we at least get some results that help us understand just how widespread this thing might be. Host when it comes to the coronavirus itself, we have had several people call into the program over the last several weeks as we have been talking about this and saying, we already have influenza, it kills a number of people every year, why are we so concerned about this virus when we already have influenza . Guest it does a disservice to the situation to compare it to influenza. The comparison stops of the fact that it is a respiratory born, highly transmissible infection. The key differences here the totality of the worlds population is susceptible there is no preexisting immunity. No one has gotten a vaccine. Everyone is able to be infected with this thing. With this thing. That provides a lack of back pressure on transmission. Then when we look at all the different data streams we have to try to calibrate fatality rates, we see a number of different scenarios play out. Just a couple of days ago, the head of who came out with a dramatic statement of something north of 3 . That would be devastating on a global scale. Seasonal flu is on average to on average, estimated to have a fatality rate of. 1 , so that would be many, many times higher. When i look at the south korean data, they are Holding Steady at about. 6 , and they are doing a robust diagnostic push that is not just looking at sick people. It is across the community. That might be a good estimate if we take into consideration the mild cases or asymptomatic cases occurring inside this outbreak. Talking about six times seasonal flu. That is a big number. Seasonal flu on average, it is 37000 andahalf dying every year. Six times that is a big number. Host randy is texting us. The big thing, he says, i have not seen a dress, if you get the virus, can you get it again . Or are you and moon . Or argue immunity . You immune . Guest the expectation is you would be immune, but we do not know about the virus and the immune response. This was one of the many things we have to understand and be on the watch for. The zika outbreak, the ebola the zika outbreak, the ebola outbreak, they taught us to be careful of our dogma and understanding what we think we know. Everything is on the table until we can take it off. Host another text this morning from bakersfield, california, asking, if you would gauge the u. S. Response versus the way south korea responded, if we are as ready as south korea was . Guest south korea also had delays built into their response. They should have been on top of it sooner. But they changed their posture quickly and now i think their response is a bellwether for what the rest of the world should be trying to do. Host lets go to calls. This is tom from iowa. Youre up first for our guest, dr. Christopher mores from George Washington university, a Global Health professor. Tom, go ahead. Caller yes, i have a question and a concern we have prebooked flight tickets from chicago to San Francisco on may 20. I am very concerned. I know we will wear surgical gloves and masks on the flight and try to avoid groups of tourists, but we are really concerned about that and would like your opinion. Guest it is a common question and a common concern. I think Everyone Needs to be thinking about is it the best time to be traveling. Can i push this off . Certainly, i would recommend training yourself before you go on any travel, keep your hands away from your face, keeping good hand hygiene up, washing, using hand sanitizers it is not something you can do right off the bat, im on a plane, i should not be touching my face. It takes a long time to change the behavior. It is something should be trying to do how often do i reach up and rub my nose or my eyes . Those are moments you can possibly contaminate yourself. Host we have the cruise ship off the coast of california not been able to dock. Is that a proper response from the state in your opinion . Guest if you notice there is a lot of transmission going on in a particular community or a ship like that, not letting them just disembark is a good idea, but holding them on a ship without appropriate supplies, quarantines, Infection Prevention control support that is where some of those ships have run into significant trouble. There is a good way to do that and a bad way to do that and i think it is all in how it is executed. Host keith is up next. Keith in fargo, north dakota. Good morning. Caller i was just wondering where did coronavirus get started from . Guest it is a brandnew virus. It has been implicated in a market in wuhan, china, that did sell wildlife products wild animals. The idea is it is an animal disease that has found an ability to be spread in man, so sometime in recent history that virus made the jump into us, and it reminds us that we have to be careful about our intersection with wildlife, how we treat it, and this is one of the consequences of not paying attention to those warnings. Host a viewer off of twitter this morning asking, how do you determine nonsymptom cases and do we test the entire population . Guest to get an ace of the medic fraction, you have to do a broad diagnostic push and youre not just looking for sick people, just doing this in clinics. You are trying to understand what is the totality of this transmission iceberg, as people say. That is important because we need to understand how much is going on in the community, because that will then let us know where there are maybe risk groups we need to protect before it gets there. It will also tell us more about calibrating expectations for how many people get sick and how many people will die of this thing. Host another viewer asks a question off of twitter saying, is or any evidence the coronavirus leaves permanent damage to internal systems, which results in permanent physical impairments such as blindness . Guest i have not seen any data in terms of longterm followup of survivors. That is certainly something that needs to be watched for carefully, but there is nothing to suggest that is going on at this point. Host bee in texas. Good morning. Caller i have a twopart question. We are not hearing anything about mexico, and i live near the border, and i am really old. I have this question about why are we not hearing what is happening in mexico with all the people waiting to come into the United States, and the other question i have dont you think it is strange that all of a sudden china immediately jumped on starting building hospitals, putting people in quarantine, we are sitting here watching, and all of a sudden it is all over the world . I mean, come on. Is it airborne . Thank you. Every country has its own response. There have been a lot of the same problems as we have in this country. Do they have the capacity, technology to pull it out . Do they believe it is a threat, do they need to take it as seriously as countries that are nearer to the outbreak zone . It is a patchwork of responses. We cannot force anyone to have a necessary response that i believe we need to be having. In terms of the chinese response to the outbreak, they really did an amazing job mobilizing National Resources to respond to the outbreak in wuhan, and certainly a lot of the world responded with travel restrictions and limitations in an effort to isolate china and that area of china from being able to contaminate the rest of the world, but since that time has long passed, it is important that the rest of us get on with our preparations. Host this is bob, bethlehem, pennsylvania. Caller good morning, doctor. Host you are on. Go ahead, bob. Caller good morning, doctor. I have a question pertaining to ebola. When they took patients that recuperated, they had their antibodies in their serum, and used that as a way of fighting previous people that could come down with ebola. Is there anybody looking into the effectiveness of the serum inside of the people that have recuperated . Looking forward to your answer. Guest i am not aware of any passive antibody from people that have survived the infection being used to protect people going through it now. We have used that in other passengers and other pathogens over the years. It was not terribly effective for ebola virus, and there are reasons to believe it might not be the most effective therapy here for respiratory virus where a lot of the infection is happening in lung space, which is difficult to get the antibody to that you would otherwise delivered intravenously. Host jim in texas asked the question, there are reported to be two strains. Which are we see a . Can you compare the two . Guest this is brandnew, and i must say i have not looked at the data on the definition of these two types. It is something we need to be aware of in terms of this is a brandnew virus. It is going through its initial rounds of infection in the human population and it will be mutating as it goes. We need to be aware of the possibility of different types to arrive. Host jen from seattle asked, is it more likely that people recover than die . Guest absolutely. Since this is mainly a mild disease, most people will recover if they have symptoms at all. We are worried about the top fraction of people that have preexisting conditions or advancing in years. Those are the ones we are more concerned about the recovery status from the virus. Host again, our guest is from George Washington university, a Global Health professor here to answer your questions about coronavirus. This is deborah, west chester, ohio. You are on. Go ahead. Caller thank you for taking my call. Im a retired microbiologist and i am pleased to have the opportunity to speak to you because my question is focused more on the future. You know, in china, they have a different culture in the United States regarding food safety. You can have a pigpen in the back of a restaurant. In the United States, you cannot store raw meat above fruits and vegetables. In china, they have been affinity for taking live animals and they have live animal markets. When you combine that in a city of 11 Million People like in wuhan, and you look at their culture, and you look at the pig, one of their favorite Animal Protein sources, which is a mixing vessel, as you know, you really have to ask yourself, is that a practical their culture and population is not a good fit. It is an ideal fit for an emerging virus, especially from animals to people. I am wondering, since this is your field, im wondering if the World Health Organization in combination with the wto should not be establishing standards for our supply chains. Is it really smart . Host thank you, deborah. Guest it is certainly something we dont really do or allow here in the states or number of other western countries. But really here, i think the issue is the demand exists, so will this outbreak change that demand within the cultures that use wild animals, bushmeat, or slaughter to table practices. That is something i have seen a lot of Media Coverage on, and it might be changing because of this outbreak alone. Host you might have seen Media Coverage of a picture going around, cans of lysol, the coronavirus is listed on that. What do you gauge when you see that kind of thing and what should you be telling people about lysol . Guest these products all have some ability to serve as a disinfectant, and this is an envelope virus that is readily disinfectable by a lot of these products. It is not incorrect. I think what we have to be aware of how important is the surface versus the respiratory protection versus social distancing all of these things come together to create a complex scenario of how people get infected. Until we know what is the most likely or most important ways we are transmitting to each other, we need to cover all the bases. Certainly, washing your hands and disinfecting surfaces, we have to do that until we know for certain that is something we need to continue doing. Host what kind of information have you seen on social media . Guest i try to stay off of that stuff as much as possible. Host from new jersey. Jerry is next up. You are on with our guest. Caller one of the comments i have is i am really getting upset about all the media, including cspan, 24 7, discussing this virus with different opinions instead of just giving facts. Letting the press conferences give the facts that they know today, tell the people the best way to protect themselves. But these opinions by the way, you have not given answers it is just a matter of , conversation. My thing is this is set to panic people and i am really upset about that because to do this 24 7 the sky is falling, it is horrible for people. There are elderly people that have real Health Issues that can get affected by this. I believe stress will be more harmful to more people. Can we cut it back a bit, not make it 24 7, abc, nbc, cnn, fox this is getting ridiculous. Get the facts, tell people how to protect themselves, which we know dont touch your face, wash , her hands, and the disinfectants they are charging 50 a bottle could you let people know is not necessary to do those things. Tell people to wash their hands with soap and water. Host thanks. Any response to that . Guest i think the fear is palpable there. I appreciate the fact that we have not yet helped people take the next step. What is it they need to do beyond being aware of this . Right now, we are putting out a pretty hackneyed message about Something Else is coming we dont know what that is, you need to keep yourself as clean and distant as possible. This is like the first thing i was saying to you we need to look forward now as a nation, as a response, to try and find ways to protect people, specifically like the caller is talking about, people that are at higher risk. How will we protect the elderly, the immunecompromised . In your last hour, an elderly man with preexisting conditions working in the transportation industry, that guy is spot on in terms of being concerned about his health. How are we going to protect him . The answers are difficult because we are not china we do not have complete control over our population like they do. We have to find ways to try and create spaces for people to isolate themselves without taking themselves out of their ability to take care of themselves in an economic way. People cannot necessarily stay home and not work because it is good for the outbreak, but it does not help them put food on the table, pay their rent. We have to really be looking at policy ways and implementation ways to try to enable protect , vulnerable populations will we get through this outbreak. Host i will address your concern ours is not a means of fear mongering. Ours is a means of information. We invite guests, have press conferences without comments from us or anyone else, and weve had members of Congress Talking about this particularly as 8 billion was approved by congress and to be signed by the president. All of that is available on cspan. Org for you to consume for yourself and you can make decisions for yourself about coronavirus. 8 billion figure passed this week by congress, as a dollar figure, how does that work, and particularly the sectors it will work . Guest that is not entirely clear to me how it will be deployed to greatest effect. It does not seem like a longterm, like the right number, given the challenges if this is truly communitydriven transmission at this point, and it is going to go quite broadly through the u. S. , that will be just a first stop. Much to the point i was just talking about, how are we going to enable people to be part of this response because it is going to be all hands every american will have a role in this. The role can be to stay home. How are we going to make that happen . I think some of the future funds for this fight will have to come to terms with helping those people protect themselves and take themselves out of transmission chains. If that is our strategy. Host we will go to st. Petersburg. This is michael calling. Good morning. Caller hey, dr. Mores. I have a point i would like to bring up that i dont believe anyone has covered yet in the media and then ask you a question about that. The point is, thus far, officials, in response to the coronavirus, continue to tell us the risk is low. Additionally, they are instructing us that simple preventative cold and flu measures such as washing your hands and specific types of hygiene will prevent the transmission, yet we are seeing governments worldwide shut down portions of society at large when infections occur. In contrast, every year, thousands die every year in the u. S. And abroad from the flu, yet we dont see no same closures of portions of society at large. My question to you is are you concerned there is underlying seriousness and underlying points with this that the local and foreign governments are not leading us to believe yet . Guest i think without getting too conspiracy theorist about it, there probably are overreactions happening out of ignorance because we just dont know what we are facing. When we are told numbers like 3 fatality rate that is so dramatically different than any influenza outbreak save for the 1918 flu that it would require significant measures to isolate individuals and populations. When we start to talk about the more nuanced rates we discussed on this show earlier maybe 1 or less, it is still dramatically more fatal than seasonal flu would be, and again, like i said, since the whole world is susceptible to this, we have many more people that are going to potentially become infected with this virus. Ultimately, that kind of calculus lends itself to, at this point, an overreaction, probably, in what is the best response. It is not necessarily an overreach if we thought we could still contain it. Until nations get a handle on where their pockets of infection are if there are pockets, and it is not totally widespread then the first pass would be , lets see if we can isolate this thing, and crush it out of the population, but if we find that it is really spread too far, that changes how we do this. We cannot rely on isolating whole communities from each other because that is not likely going to be very successful in freedomloving societies. Host we have heard the president take on the World Health Organization of 3. 4 , saying it is a false number. What does that do when he says statements like that and how do you react to that . Guest i reacted with a shocked response because it is not a nuanced response. A look at the numbers china has i do not know anybody that believes that that is the total number of cases china has had, so a lot of what we have done is trying to calculate what is under the hood in terms of total case numbers, and when you open that up, the case fatality rate will drop. That is why we should not be relying on the chinese data to inform that kind of policy decision and that sort of posture. We have much better examples in the global community, such as south korea, to help us calibrate more accurately. Host a viewer off of texas. Do we know how long coronavirus stays transmissible on inanimate objects . Guest that is a great question. Coronavirus in general can persist in hours, even days given certain amounts of humidity, but how frequently that results in a retransmission from that inanimate object to someone else that touches it, it is probably only very efficient in very short periods of time would be my expert opinion. Someone has just touched that thing, not used good hand hygiene, you come in touch the hand railing next and you inadvertently touch your face, that is probably one of the most efficient moments for inanimate transmission like that. Host what is the value of a mask and wearing a mask at this time . Guest so, masks are great for healthcare care workers seeing patients all the time. They have so much contact with potential cases that it makes sense for them to be wearing them. If they are working with people and taking swabs from them, they have to wear face shields as well, because just the act of taking a swab will cause people to cough and sneeze, essentially your face. They need that level of protection. For the general public, it is best for people that are coughing and sneezing to wear masks so they do not spread droplets to the rest of us. If you felt so inclined, i would appreciate for people that are sick that are still wondering out and about instead of staying home if they should be, too put on a mask of the can find one, but it is not indicated and it is difficult to recommend masks when we do not have enough for the healthcare workers that need them right now. At this point, i agree with the guidance that says everyday people to be wearing masks. Save the stocks for health care workers. Host this is deborah from columbia, missouri. Go ahead. Caller you talked about south korea being on top of it. What are they doing that we are not doing, and if you were in charge, how would you do things differently with regard to protocol . Guest one of the more dramatic things that south korea has done is really just a massive diagnostic campaign to understand the scope of the outbreak in their country. They have made the bar to entry for diagnosis very low. They have drivethrough clinics where you dont even get out of your car. You pull up, they swab you, get your information, and text you the results when they are done, maybe a day or two later. That gives them a fantastic view of the community in terms of who is infected, who is concerned about who is infected. Through that lens, they are able to get a much more accurate view of what the status is of transmission in their country. Most other countries are not doing that most other countries are still relying on people not feeling well to present for symptom evaluation and potentially testing, and some of that is driven by the lack of available diagnostics, but really that should not be a longterm impediment to the rest of the world rolling out more communitybased diagnosis. Host daniel. Daniel up next from minnesota. Caller i was wondering if there is a concern with the outbreak on a lot of things at once the census being positive on the communication, the use of cell phones, the phone itself carrying a virus, or the outbreak getting to be more airborne. I see they are spraying stuff in china how would that be in terms of letting whatever it is get excessively worse than creating something as far as having it in our infrastructure or hospitals, how to remodel, redo health care, and even if you dont have health care how would that circumference of having it or not . It is a circumstance of where you are at, what is going on, and how to look at it at all. Guest there is a lot in there. Let me take a couple of them. We have seen a number of countries, teams of people in full spacesuits going around spraying chemicals and disinfectants out in the open and in the community. That is shocking imagery and it does cause a lot of concern, and probably some fear among a lot of people and even policymakers. There is not a great indication that that is the most significant way we can react to this outbreak. I think that is why we have not seen that much of that here in the west. Two. Two concerns about health c