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Good morning. I am like friedman, the 113th president of the National Press club. I am journalist in residence at university of maryland global conference campus and the executive producer of the public broadcasting series the dekalb report. 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, respirators 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 include community outreach, disease surveillance, environmental health, immunization, tuberculosis control, and Public Health Emergency 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 University Medical Center in dallas, mother Francis Hospital in tyler, texas, and Henderson Memorial Hospital in henderson, 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. Thank you, sir. Appreciate it. Thank you, mike. Good morning, everybody. Its a pleasure to be here. I thank you for the invitation to be here today. I want to start off by saying the importance of you, the media. We in local Public Health, in Public Health in general, are counting on you to communicate with the American Public about the daytoday steps that they can take to prepare for the coronavirus. A few words about mike mentioned it briefly. Cho or theiterate, nac 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 shared with naccho this year is my year is transformational leadership. My partner with the state territorial officials is dr. Smith out of arkansas, Arkansas Health commissioner. Mine is transformational leadership. And his is community resiliency. I think both of those just pair together so well as we deal with this particular situation that we have on our hands that we are facing. Again my organization our , mission is to prevent illness in the northeast Public Health district, protect our community. A little bit more about my organization. We have programs and services in east texas, in 21 counties. We serve as the w. I. C. Provider in 20 counties in east texas. We also do Emergency Preparedness in seven counties in east texas along with community outreach, immunizations, t. B. Control, environmental health, and we are fortunate to have many 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 that are here to interact with the community. Our work is often referred to as invisible. I look at you and the audience right now how many of you think , daily about your local Health Departments . The answer is you probably really 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, have vaccinations provided. Those things that help you to lead an active, productive life. As a matter of fact, the back of my business card, i gave out a couple of business cards 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 or other reportable diseases are indeed local, via surveillance, contract taking and information to the public for one of three things, either selfmonitoring their symptoms isolating , themselves, meaning to separate themselves from the public, these people separate ill people from those that have communicable to those that are healthy and then 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 just sometimes repeating the message is repetition is something that we must do at this particular point in time. Let me just kind of 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 animals 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, hubei province, 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 no vaccine 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. I 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. How 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 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. We did a local story, where my cpio is a male, the tv interns went to 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 kind 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. 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 seasonal flu rates, but we dont know what the denominator is. It may be worse but it may be a lot 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. That is one issue they are dealing with. What is thei, smoking rate in china . I checked it yesterday. 14 of americans smoke. 31. 8 of people in 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 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, answer 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 went 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 county government, the city of 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 Health Emergency 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 no vaccines and no antivirals. 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 know. 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. 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 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 reporting 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. To 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 announced there are test kits now. My concern is, i heard something today that they are looking at possibly having some local commercial labs be able to do the testing so they can get the results quicker. Do you know anything about that . I can speak to texas. 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. It has to get there, number one, and then 72 hours after that. Confirm testing will be sent out to the cdc but you can have a preliminary diagnosis and a whole lot faster time. A message when out from apac, 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 . 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. Andrew with cq rollcall. Secretary azar 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 . My organization, we have 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. As a local Health Department, 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. So often in life, when things are going i mentioned Public Health is your invisible guardian. We are working 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. You dont just bring people in, 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 . 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. Hi, im with axios. I have two questions. One of them hopefully quick. Some local counties or some counties are asking for local emergency funding, even though they dont have any confirmed cases yet but there are some cities nearby that might have confirmed cases. Is that the proper response . Mr. Roberts again, what i found in my organization you may not have a confirmed case but weve had several suspect cases and several cases of monitor. Basically you have other diseases out there that need to be monitor sod youre having to take staff away from a lot of their other jobs so you do need extra funding just for the situation. Fortunately in east texas we never had an ebola case but we spent a lot of time preparing for that type of situation. Thank you. You mentioned in china and some other countries theyve essentially shut down the cities that are experiencing a lot of spread. Do you see the freshman government having a role in that if we ever get to that point . Just because you said there was a casebycase basis in terms of cities and that could cause a lot of economic instruction for some local cities. Mr. Roberts yes, obviously our system of government here is totally different. I would see that first starting at a local level and moving up to the state and national but i would see more those types of situations starting locally versus nationally. Thats my opinion at this point and again, i think the response the United States would not be able to do anything remotely similar to what china did because of the way our system of government is and thank goodness or for our freedoms here. Your organization, the National Association of county and city Health Officials represents nearly 3,000 local Health Departments nationwide. What are some of the questions that youre getting from them now . Are you being inundated with questions and how are you handing these . Mr. Roberts a lot of the questions that youre asking, a p. P. E. Question. How do you meet with your city and counties . What are the relationship with doctors, whats the role of local Health Authority . I can speak to texas on that but others whats the medical direction . How much authority does the local Health Authority have versus the individual physician . There are many, many questions that have come up and i think thats what naccho is here for, that resource. In texas we have a state association of county and city Health Officials and we have mail streams, we can just throw out a question to your peers and let them answer it. Saccho is very important by naccho is as well. Lloyd freeman and i had a state Association Meeting this week in houston and houston was dealing with a situation where the Harris County judge came and they were dealing with a situation of we have no confirmed case of volunteer volunteer coronavirus at that point in their community but do we cancel the houston rodeo and stock show, which is a major, major event in that Community Community and they were saying no because theres not a reason to do that. So every community i think probably issues about closing of things will be probably something that naccho will have to deal with as well. A lot of employees are represented by yoinls. Talk about the relationship between your organization and the unions and whether there are collaborations already underway to deal with in since the unions first responsibilities are to protect their own members. Mr. Roberts in my state, we do not have a union in our organization so i cant totally address the union thing but i will tell you as the leader of my organization, my job is to make sure my employees are protected. My employees are my number one resource. I cant do any my job without my employees. Whether or not i have a union or not, i want to make sure my employees are protected. Ok, we have three questions. Well take all three in a row. Mr. Roberts glad you have the answers. Im with science news and i have two related questions. First, what percentage of local Health Departments actually have kilts to do the testing and then also, lab corps and Quest Diagnostics will be offering tests so should people go for their Health Department or call their doctor for testing at one of the commercial labs . Mr. Roberts i dont have we basically have to get that from the c. D. C. Im not exactly where im getting that prosecute but were accessing im not sure when the commercially available tests will be available but my always answer would be if you have a concern about your health, contact your physician or your medical provider and i would also ask they be contacted. Call them first to let them know your symptoms so the providers can great you with the proper protected equipment on so they dont get sick. We want our providers out there healthy every day taking care of people. Ivey touched on this some but i was wondering whether you could walk us through the fact would officials consider when holding a kind of oneoff event like the rodeo. What do you look at . Mr. Roberts sure, whats the case on the ground . How many cases of, in this case, coronavirus, do you have in your community . At what level do you sit one case, 10 cases . It would be in concert with our local officials, local leaders. Come together and have a conference about it. Our schools sitting down and talking about it. What is the public saying about it and sometimes i know in austin there was a large petition to try to cancel south by southwest and austin said we have no confirmed cases in our market right now so its on. It would be elected officials, communities leaders making that decision. I would want to weigh in on the conversation as well but it was the it would be the leaders making that call. Fair to say the Tipping Point would vary from location to location . Mr. Roberts absolutely, absolutely. Have there been any conversations about any private Public Partnerships in the past the u. S. Government has funded. Like in fk north carolina, the funded vaccine. Plans in this situation there seems to be a question about whether there are enough diagnostics tests. Would there be an occasion that triggered, gency is neck mass manufacture diagnostics tests . Mr. Roberts i think im looking at our c. E. O. Right now who has intimate knowledge of the bill in the past. Isnt there a bill in the works to try to get testing done . Yeah, i believe theres funding inside the bill that President Trump signed this morning to basically do some of that. This administration has been very proactive on things like privatepublic partnership. I believe the answer is yes, without reading the information myself. But i believe the answer is yes. You had a second question too . Ok. Hi, there. Mr. Roberts hi, there. Im with modern health care. Hospitals and nurses had asked government for preparedness and reimbursement for funding costs but it looks like thats going to be fill filtered through the states and local health agent sills. So what kind of conversations are you having with hospitals and how that money will fitter . Mr. Roberts i havent had that. Weve been talking about response and not the conversation about getting the money out. My guess is there are public Health Officials and states that have had those conversations. I have not yet but thank you for prompting that and im sure that conversation is going to happen sooner versus later, thank you. Hi, i have two questions. The c. D. C. Has sort of relaxed in a sense its recommendations around Health Care Providers and Contract Tracing and Risk Assessment in areas where this is community. Spread. Is that a good idea for Health Care Providers top less mr. Roberts youre referring to the test kilts . Access to testing . No, Health Care Providers themselves and the protections they should have in terms of them not getting sick if theyve been exposed to someone with covid19, what should people be doing to ensure that theyre not then becoming sick and spreading at. Mr. Roberts yeah, that would be part of the answer would be to make sure theyre wearing their proper p. P. E. I havent seen the recommendation youre discussing right now. As far as Contact Tracing. Mr. Roberts contact would be i would home the physicians, if theyre being exposed, theyre doing their own selfmonitoring. Monitoring their symptoms. In terms of testing, i spoke with one physician who had seen so i understand that right now the criteria for testing are that if a physician feels that the person couch covid19 then they can test them mr. Roberts thats knew. Thats my understanding. New. Thats my understanding. With the case in our market, you had to have an assessment by the provider and then a conversation with my team as well as the Texas Department of services but now the provider can make the call so thats why more test kits have been distributed. Particularly in texas. I cant really speak to the other states but texas weve seen more test kits get out there and i think ultimately, you get sick, you go to the physician and go back to his question about the commercially available kilts. My guess is theyll be available sooner versus later. Are we rationing them in the meantime . I spoke to one physician who saw a First Responder who had answered a call with someone who may have covid19, came to her with symptoms and she went to the c. D. C. , asked to test him and could not test that person. Mr. Roberts i think that was up until like the last couple of days. Thats changed. My guess is that well look more to the provider to make that call. A couple of our suspect cases, the first case we had in our market, the provider evaluated the patient and the provider didnt see a need to even go further. The second case was taken on to the c. D. C. And the state made the decision that that did not meet the criteria. I think whats going to happen with this new dry tierra, youre going to see more and more testing done. I think ultimately well see, one of the things we need in Public Health and providers, how many people do we actually have out there and thats where the Contact Tracing can get better and better. Thank you. One of the biggest questions what are the biggest questions that remain in the scientific and medical communities . Mr. Roberts oh, gosh. One of the first questions you asked me, does change of seasons have an impact . How long will it take for this thing to burn out . How quickly can we get a vaccine . Knowing that the vaccine will take probably a year, how quickly can we get ant virus. It would be nice to have at least Something Like a tamiflu we can give to patients like this. Houmple will it spread in the United States once we start seeing more cases in our country. Will it spread can i give it to two to four people or less than that, more like the seasonal flu . Its a new virus so were all kind of learning something new every day. Are you getting questions from some communities, cities, far thinking of literally shutting down at this point and do you see some time in the near future somebody taking that stem . Mr. Roberts actually shutting off a city, per se, actual quarantine . Ive not heard of any city thats considering that. Ive heard a lot of should i cancel my event, my conference, an event that im planning to have. What should i do about Church Services . What would cons tumet shutting down the school for a period of time if one or two cases come up. Thank you, we have amount question. One of the things you mentioned was people staying at home if theyre sick. Mr. Roberts yes, maam. Would you like to repeat that . One of the things you mentioned was people staying at home if they are sick. One of the questions thats been asked, particularly in the senate, is about workers who have, you know, service jobs and dont have paid sick leave and so they want to stay home but its a difference of putting food on the table. Are public Health Officials talking with local employeers about dealing with that situation and trying to encourage that . Mr. Roberts yeah, thats a good question. I would hope that local employers would do that and see the need because, again, if the employee it may hurt them if theyre not there to work that day but if they come to work and get other people sick then that employer has something more to deal with the day after or the day after that. Its better off for the employer to be able to offer that paid time off than it should in this situation the alternative. Another question. Yes, maam. Im with media. And i think you talk about the smoking rate. Is there scientific proof that if you smoke, you have more chance to get the virus . Mr. Roberts yes. Well, let me qualify that. We know smoking is harmful to you for your lungs. You can see the data here in the United States really going back to the 19 sixth where we started looking, that smoke was hazardous to your health. Why . We found it may cause lung cancer and over the years weve seen xrays of people, their lungs and basically the damage that cigarette smoke does to your lungs. Im making the correlation with the higher smoking rate in china programs that perhaps the lungs or the people in china arent as strong with the higher smoking rate. Smoking is not good for your lungs and this is a respiratory illness so thats the correlation im making. Right, but not this specific virus . Mr. Roberts no, respiratory since this is a press aratorrey illness, its respiratory illness, its affecting your lungs, shortness of breath so the smoking doesnt tend to help you when you get a respiratory disease. I understand there are like patients and ic like if in person has no symptoms but he or she doesnt have symptoms that wouldnt if shes wearing a mask, does that mine mies the chance of me getting infected . Mr. Roberts im going to go back to the general c. D. C. I was asking the same type of questions as you to the c. D. C. Guy the other day. He was basically saying the c. D. C. Did you u. D. Does not recommend the use of masks at this time. We want to keep them for Health Care Providers and those who actually need it for personal protection. Does that answer your question . Not really. [laughter] mr. Roberts not really . We assume were both Healthy People but what if im in facted but i dont know and im not wearing a mask. So how do people like you wearing a mask probably help you from getting a virus from me. Because im not wearing a mask. Mr. Roberts so if youre infected, should you wear a mask . But i dont know im infected. Mr. Roberts again, so if youre healthy, again, go back to the whole c. D. C. Guidelines. If youre healthy, the c. D. C. Does not recommend that you wear a mask. Im kind of that talking point. Let me follow up on that then. Mr. Roberts thank you. Do you envision a time when the c. D. C. May change it protocol on that . Mr. Roberts well have to see how this whole thing goes would be the answer. It would probably be whats happening at the particular time. Do we have any other questions from we do. Hi, im from german television. In germany we have a lot of coronavirus cases so we have the problem that the supermarkets are empty. There are a lot of preppers buying it to paper and water. Do you see the same problem in the u. S. , that there are a lot of people who wants to buy everything for their homes . And the second question are there any planned events to inform the public what they have to do and what they have to what they have to buy, for example . Mr. Roberts preparedness, we talk about what sthouled should you do just for normal routine. Be prepared for, say, for example, bad weather comes or maybe a snow day here in d. C. Or theres a power outage or Something Like that you could always have several days worth of food and maybe water on hand. Whats going to happen here in the United States if theres an outbreak with people, you know would the shelves be emptied of the items you talked about . Bottled water and things like, that that remains to be seen. I guess thats a possibility. Our overarching theme at the National Press club this year is why journalism matters and here we are engaged in this scenario and here you are at a News Conference at the National Press club in fronts of in many a number of journalists. Can you speak as a last comment about the role of journalists in this and what you might ask of them . Mr. Roberts sure. Thank you, mike. Again, its a pleasure to be with yall today and i opened up saying the value of you in journalism. Youre here to get the facts out to people, to try to give them solid information. Its my job to give you the best information i have but im counting on you to get that information out to the public where they know what they should do, they know how they should handle things. I hope that youll take from today while theres nona vaccine or antivirus yet, here are sthicks you can do. Washing your hands, covering your cough. Staying home when youre sick. Cleaning the surfaces of your health. Those measures proved very ffective in announce such as n 1h 1, ebola and other things. Were counting on you. Please, please, ask us questions. In my market, like today youve challenged me on some questions that i need to get better informed on. So please, please keep up the work youre doing and let people know theres a situation out there and find that balance between communicating the risk and also mitigating the fear. Mike im going to put social 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 were all drinking a lot of coffee these day. Mr. Roberts thank you. Based on that, im going to shake your hands too. Mike thank you very much. Thank you for joining us today. Thank you, everybody. Mr. Roberts thank you. [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] next mr. Roberts you didnt have a question yet. I dont need to. Thank you for answering my question about the funding. In a case like this where this there is an emergency funding issue, how does that trickle down to you. Mr. Roberts sure. Is it more for like paying overtime or buying supplies or is it hiring new employees . Mr. Roberts so in our situation, the funding will go to the c. E. C. And then the c. E. C. Will issue the funding to the state. The state of texas in my situation will be responsible for amending my contract, etc. When will that happen . Hopefully sooner versus later. I would use that money for buying supplies, potential travel to places but really, extra boots on the ground is what i need right now. And how hard is it in an emergency to just find new people to come to work for you . Well, that is another question and we fortunately in tyler we have a new school of rule Community Health so ill probably be leaning on them to help us with this. Get some interns in, some students to help with some of he basic contact work we can do. But well do our utmost to do that as fast as we can as soon as we can get some from combra money. You talked about the mr. Roberts in texas, its called the home address grant. We also have a state grant for endeep yolingses. Its alled called all hazards grant. From your paul would it be better to just be able to have this level of staffing that you might be staffing new the emergency. Better to have that level at all times . Mr. Roberts absolutely. We tend to basically ramp up for emergencies and staff back down. Are you ready to go when the emergency happens . Thats what were having to do right now. You think thats the best approach . Mr. Roberts i would like to have more funding to have more people ready to go in situations like this. [indiscernible] mr. Roberts oh, yes, thank you. Our work, the public, the local government lost of its work in the last decade so this is greatly impacted or allow you to prepare and respond to situations like there . Unlike other areas of the government that were built back up after the great recession, ours was not and thats why ere facing [indiscernible] i dont f the money now that [indiscernible] mr. Roberts right. Is that like correlated with the reduction in the size of the federal over time . Its part of that. After 9 11 there was an influx of funding in the Emergency Preparedness fund. Thats been reduced by a third. Out of sight, out of mind when theres not an emergency. The money goes towards other and s so were facing going to al respond, but what happens if stash ve to pull their to other critical washington journal live every day with news and policy issues that impact you. Saturday morning, well discuss the u. S. Response to the coronavirus and potential impact on children, with dr. Roberto dibase of Childrens National hospital. Then the shortage of life saving drugs in u. S. Hospitals with rosemary gibson, author of china rx. Watch cspans wash journal live at 7 00 eastern saturday morning. Join the discussion. This weekend on book tv, merril leadership, reflections from a watergate lawyer and the effect of a twoparty political system on democracy. Saturday night at 11 00 p. M. Eastern. In the nations city, former chicago mayor and Obama Administration chief of staff roam emmanuel on innovation at a local level and in her latest book, jill banks talks about her legal career, including her role as one of the three special assistant prosecutors in the watergate case and in terwards, arguments that the twoparty system is damaging americas democracy. Hes joined by Georgetown University professor and awe thorough a manu dalic. What happened be the advantages . The issues of consensus are not political issues but the challenge is we need to have some system but which we can agree that some set of rules are fair and some set of procedures are fair and we can aentitled abide by those outcomes. All this weekend on book tv and be sure to tune in next weekend for our twoday live coverage of the tucson festival cspan on book tv on 2. A state dinner at the white house. Vice president and mrs. Linden johnson are among those lnydon johnson are among those ho joined president kennedy. The 195 film Firm Alliance on the state visit by the shah and empress of iran with president john kennedy and first lady jacklin kennedy. President kennedy i phoenix on behalf of all of my fellow americans in welcoming you to the United States. The interests of both of us is the same

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