Good morning. I am my friedman, the 113th president of the National Press club. I am a journalist in residence at the university of maryland global campus and 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 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 Frances 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. Mr. Roberts thank you. I appreciate it. Good morning, everybody. Its a pleasure to be here. I thank you for the invitation to be here today. I want to start by saying the importance of you as 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 they can take to prepare for the coronavirus. A few words about mike mentioned it briefly. Naccho, National Association of county city Health Officials , is the voice of local Health Departments through 3,000 departments across the country. The theme that i have shared with naccho this year is 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, and promote Public Health. 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, Vital Statistics 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 . [laughter] 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, have 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 Tracing 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 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. Early on, many patients at the epicenter were in wuhan, Hubei Province in 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. There may be more uptodate information but 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 this 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. And we have antivirals such as tamiflu when we get the flu. How do we handle this . So well, first thing we do is , avoid contact when people are sick. I am not sick today. So thats good news. ,but 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. And we do it. But 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. I may it my man card pulled if i dont stay home when im sick 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 was flying yesterday and i saw people in masks. At our naccho 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 fit test for an n95 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. Clean hands because 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 . Still we do not know the denominator. 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. Four measles roughly 12 to 18 people are infected. The for tally rate 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. 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 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. We were worrying about things other than coronavirus until about two months ago. 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 are 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 two making sure they have the c. D. C. Test kits to be able 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. To determine they could be considered for testing. 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. Emphasis 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. We 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 our n95 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 kadlaj 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 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, particularly the state of texas 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 . What do they cancel an event, etc. 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 those 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 compared 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. That is what we are potentially facing here. 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 . We started with h1 and one and we do not have a 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. Some questions have been submitted. How much will getting tested for coronavirus cost you if you are uninsured . Mr. Roberts that is a good question. I understand they are trying to 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. Since it is it, 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 . Mr. Roberts 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 ppe, like the n95 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 reporting increased discrimination stemming from coronavirus fears. How can local governments protect these citizens and their 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. Thereeral Public Health is a Public Health lab in 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. Right now you have to ship the test directory to the cdc. It has to get there, number one, and then 72 hours after that. Hopefully that will reduce the time. Confirmatory testing will still have to go to the cdc but you can have a preliminary diagnosis and a whole lot faster time. The next question a message , when out from apac, saying that there was 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. My concern with that is they have not given us any more information as to who these people were or were they were, where 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 quietthey were not the first people to have it. When you look at a situation like that, they say dont raise the alarm. And everyone is 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. So, 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 think that its kind of like i , almost compare it to the flu. Exposed to things like that all probably you areexposed to things like that all the time. In those situations, they would probably 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 . Sure. My organization, we have roughly 70 plus percent of my budget comes from grants wic is my largest program. 60 of my funding comes from the wic program. But preparedness funding is then i have pretty stout. ,i also get funding for chronic disease management, immunizations. For immunizations. And again, im not as a local , health department, there are a few large cities around the state that gets funding from the cdc. But i get my funding from texas. I get a substantial amount of my funding from cdc. 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. So a lot of times our work goes, we people are not seeing what we are working below the are doing, day in, day out. Obviously now we are a lot more visible. We need types of things what has , been essential in my organization is my epidemiologist, preparedness staff, pio. My entire team. 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. Last week. If we get this funding, lets dont sit around and wait around. My sense is they heard the message. It was a week ago when President Trump asked for the extra , funding, and senator schumer made his counter offer, and he signed this morning. So, we are hopeful on a for that money, but 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 dont just bring people in, like a newsis, reporter, you do not just bring a new person in and they know what to do. You have to have people skilled and ready to go. For situations like this. Robert with Fierce Health care, 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 . Am anecdotally, i have 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. So you have a tendency when you , are dealing with people in isolation, you are taking those masks off you are wearing that , material, taking it on and off pretty frequently. So 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. Some local counties, some 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 . Well it is all about you may , not have a confirmed case but we have had several suspect cases, we have had cases of monitoring. What it does, is basically, you have other diseases out there that need to be monitored. So, you are having to take staff away from their other jobs. It is, you do need extra funding it does just for the situation. Fortunately in east texas, we never had ebola 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 in 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 of those types of situations locally than nationally. My opinion at this point. I think the response United 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. Your 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 are asking, that ppe question, how do you meet with your cities and counties, what is the role of the local Health Authorities . The relationship with doctors . I can speak to texas on that. What is the medical direction . How much authority does the local Health Authority have versus a physician . There are many questions that have come up. I think that is what naccho is here for, to be that resource for our other locals. I know in texas, we have a state association of county and city Health Officials. And we have email streams were that we can throw out a question and let our peers answer it. State cho is important but naccho is all important. What are the best practices out there . We had a state Association Meeting this week in houston. Houston was dealing the harris with the situation. The Harris County judge came and they were dealing with the situation, we have no confirmed cases of coronavirus in the community, but do we cancel their houston rodeo and stock show . What is a major, major event in that community. They were saying no. ,because there is not a reason to do that. Every community will, issues about closing things will be something naccho 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 unions first responsibility is to protect their members. Well, i can just say in our , state, we dont have a union in our organization, so i cannot 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. That is my employees are my , number one resource. I cannot do my job without my employees. So, whether or not i have a if my job is to protect union or , not, i want to make sure my employees are protected. Three questions. Erin garcia with science news. I have two related questions. What percentage of local Health Departments actually have kits to do the testing . Labcorp and Quest Diagnostics will be offering test. Where should people go for testing, their doctor office, or a commercial lab . So, cdc. I do not have anything, we basically have to get that from the cdc. Im not sure where we are getting that from. We are accessing those. Quest and 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 let them know about your symptoms, so they can greet you with the proper agreement on. So they do not get infected. We dont want our providers to at the end of the day 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 factors that local officials consider when deciding whether to cancel a large event. What exactly do you look at . Sure. I think you have to look at what , is the case on the ground, how many cases of coronavirus do you have in your community . What with the level have to be before you . Is it 10 cases . A lot . They would be in concert with our local leaders. Government officials, Community Leaders come together and have a conference about our schools. Sitting down and talking about it, what is the public saying about it . Austin they tried, there was a petition to cancel sxsw, and they said we have no confirmed now. In our market right so it is on. The answer would be it would be a conversation among elected officials and Community Leaders to help make that decision. And then i would want to weigh , in on the conversation but the leaders are making that call. Is it fair to say the Tipping Point would vary from location to location . Absolutely. Med tech insight 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 emergency is triggered, they can mass manufacture diagnostic tests . I think our ceo has intimate knowledge of the bill isnt 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. This administration has been very proactive on things like publicprivate partnerships. Without reading the information myself, i believe the answer is yes. Im with modern health care. Hello. Hospitals and nurses had asked congress for funding for preparedness, reimbursement for their response cost. It looks like that funding will but 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 . Yes and i frankly have not had that. We have been talking about response, getting information out. We have not had a conversation about the money, at least in my market. My guess is there are hospitals Public Health 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 first, around Health Care Providers and Contact Tracing, and Risk Assessment in areas where there is community spread. Is that a good idea for Health Providers to have less . You are referring to access to testing . No. Im talking about 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 . Yes, well that would be part , of the answer would be to make sure they are wearing the respiratory, there proper protective equipment. As far as Contact Tracing . Well, contact would be for a physician, i would hope physicians if they have been exposed that they are doing their own selfmonitoring, checking for fever and cough and monitoring their symptoms. In terms of testing, i spoke with one physician i 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. That is the new, because it was 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. To determine if they were going to do the testing. Now it is more providers who make the call. Debtor can make the call. That is why more test kits have been distributed. I cannot speak to those states, but in texas we have seen more test kits get out there. Ultimately, i think it will be that you get sick, you go to the if physician, and then coming back to your question about commercially available. When the commercial test kits will be out there but my guess is sooner versus them later. Are we rationing in the meantime . I spoke to one physician who said they 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. I know a couple of our suspect , cases, 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 dutch taken on to the cdc. The cdc and 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 . What is our denominator . That is where the Contact Tracing can get better and better. What are the biggest 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 have an 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. What are the how much will this actually spread once it gets to the United States once we start seeing more spreading in our country . I quickly will it spread can i give it to two or four people . Or is it less than that, more like the seasonal flu. There are many questions. Again, it is a 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 and future somebody taking that step . Shutting off of a city . As a quarantine . Ive not heard of any city considering that. I have heard, should i cancel my event, should i cancel my conference, an event im planning to have. Those are the types of things like that. What should i do about Church Services . What would constitute shutting down the schools for a period of time, if one or two cases, . Joyce friedan, medpage today. One of the things you mentioned was people staying at home if they are sick. Would you like to repeat that . [laughter] 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. [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] 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. Because again, if they are, the employee may, it may hurt them if they are not there to work that day. But if they come to work that day and they get other people sick, then that employer has more to do what the next day or the day after. So it is more of it is better off for the employer to offer that paid time off in the situation, than the alternative. China media, 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. You can see the data here in the u. S. , going back to the 1960s, we started looking that smoking was hazardous to your health. 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. So 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. So therefore, and that is the correlation i am making. Right, but not the specific virus . No. Since this is a respiratory illness, it is impacting your lungs. With fever, cough, shortness of wrath. Smoking does not help you when you potentially get a respiratory disease. Shortness of breath. You said the cdc does not recommend people to wear masks. Does not wreck meant Healthy People to wear masks. I understand there are some asymptomatic patients. If this person has no symptoms, but they are infected, if they are wearing a mask, does that minimize the chance of me getting infected, if they dont know that they are infected . Is probably better for the person. But we want to begin and 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. At this time. We want to keep them for the hospital providers, those that need them when they go to the hospital and need that as personal protective equipment. Did that answer your question . Not really . We assume we are both healthy. But what if im affected and i what if im infected and i do not know and im not wearing a mask . ,Healthy People, like you are wearing a mask, and that would prevent you giving the virus to me. Or getting the virus from me. If you are infected, should you wear a mask . And i would go back to the cdc. If you are healthy, going back to the cdc guidelines, the cdc does not recommend that you were a mask. I am kind of pounding that talking point. Healthy, the c. D 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 they have to pull their to follow the federal response of the coronavirus out rake, go to cspan. Org coronavirus. Hearings, briefings, and review the latest events any time at cspan. Org coronavirus. Tonight, on q a, daughter of former four term alabama governor and president ial candidate George Wallace, talks about her fathers career and what inspired her to write her book. In 1996, we took our youngest son, who was nine at the time, to the Martin Luther king Museum Historical site in atlanta. Church, to his grave, and over to the museum. Newly constructed at the time. Were going to the exhibits and we came to the exhibit, the alabama exhibit, and it showed the baptist church, fire hoses and dogs in birmingham, and george watt George Wallace standing. Me and said up at he was so sad. Why does popeye it broke my heart. Popper told why he did those things to others, but i know he was wrong. Maybe it would be up to you and me to help make things right. Locked watch on cspans q a. On wednesday,ally Chuck Schumer made comments about Supreme Court justices near gorsuch and brett kavanaugh, saying they would pay the price for voting against abortion rights. Several senators came to the floor to react
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