Doctor, what do you know about treatment . And what are we hopeful for . Greta, thank you for having on. There are potential treatments that are being talked about. Medications like chloroquine, to malaria. Prevent hydrochloroquine. Its thought that these antivirals do have and antiinflammatory properties. There have been some very, very of france andout china demonstrating potentially reducing theions duration of symptoms as well as illness. Need nowat we really are Clinical Trials that make sure these medications are safe and effective to treat covid19. We also need basic answers to questions, such as who should get them, at what dose, center how long. Clinical trials of these types of medications are critical. And what do you make of these trials, these treatments being york and theyre going to start tomorrow . Well, these are already fda medications. So theyll be used in an offlabel capacity and im sometal by hospital, patients will be receiving these, but its really important informationect again and the Clinical Trial is the best way to go. Doing this with other antiviral treatments. So theres promise here, but we moving be cautious forward. How would it work if these treatments are successful . Successful,theyre then the fda would provide an approval and more americans would be able to get these medications. Depending on what the trial shows. Questions are who would be helped . Is this for postexposure prophylaxis . Is this for treatment . Is this for individuals who are ill . Ill or before they get so all these questions need to answered. But it could be very important, particularly given that we dont ave a vaccine, we wont have vaccine for 12 or 18 months. If any of these medications, either these are other medications, other antiviral medications, if they do pan out, have access to that hopefully over the course inthe next several months advance of a vaccine. Status of as the vaccine and how would that work . Phase 1 vaccines in Clinical Trials have begun in the city of seattle with the nihs leadership. Individuals have already started to receive vaccines. To assessstep is safety of the vaccine as well as the effectiveness. Can an individual ramp up their response . So does the vaccine work . To followally have individuals for many, many months up to a year because its there arent side effects that we dont know about. Willis is the process that take many months, up to a year, and then you talk about the production of the the vaccine and then the dissemination. So we really are talking about to 18 months. That is the solution here, but untile a ways to go and then, its all about mitigation distancing and protecting our healthcare system, testing, all of these were talking about buy timeally how we essentially until we have a vaccine. Doctor, how do you respond to people who compare this to the flu . Go ahead. Great question. Make this comparison in the sense that we know that this virus that is more severe than the flu by any stretch of the imagination. The question is how many fold . Veryow that this is transmissible on average. For every 1 individual with this virus, they will transmit it to are 3 individuals if there no precautions that are taken. We have no vaccine like we did flu. We have no treatment like we do with flu. We have no immunity. The world doesnt have immunity. And so its best not to compare to flu. This is a serious situation and apples to of an oranges comparison. I want to encourage our join in. O if you live in the eastern part country. Mountain pacific. And medical professionals, we hear from you this morning, as well. What are you seeing on the front lines . I want to share this headline from theand others newspaper this morning, this is the new york times. Taste may be and peculiar clue. On friday, reports from around the world called on adults who lose their sense of smell to for sevenemselves days, even if they have no other symptoms to slow the diseases spread. What do you make of this . Gretta its a good question. Every day almost every hour learning more from case reports so i think it will be interesting to follow this still, the most common symptoms or covid19 are shortness ofugh, breath. Many individuals will have these symptoms. Own. Ll get better on their a minority will after several days get worse and thats really for hospitalization. Someindividuals might have gastrointestinal symptoms and other symptoms, but were going to continue to hear reports like because everyone is going to respond differently when they experience when and if they experience the virus. Out to you,ds doctor, over the past few days . The over the weekend, about spread of this virus . Well, i think its best to at three factors. The first is testing. The second is the medical surge and the third is social distancing. Just over the last couple of days were hearing progress on testing front, more americans are able to get tested. Near the numbers that we need to and therefore, unfortunately, theres some on. Oning of testing going theres some important developments related to point of care testing. Testing, theres progress there. We did lose quite a bit of time ball. Are behind the eight when it comes to the healthcare surge, were hearing from the colleagues, my healthcare workers that they dont have the personal protective equipment that they need. Were worried about critical theres aterials so lot of material as well as equipment being deployed to areas, such as new york city a concern overis the next several days. We dont want any situation in states just like wuhan, china, experienced or northern italy experienced, but the most important i allk development is americans really focusing on social distancing, and its these Community Mitigation measures that are extremely. I mentioned that on average if done, every 1 person will transmit the virus to 2 to 3. What were trying to do is reduce that ratio all the way down to less than 1 because then can slow the epidemic and we know this works. Data from seattle just a couple showed that social distancing interventions, canceling mass gatherings, closures, teleworking, all of this reduces contact and a study from seattle showed that if you do this over the course of four weeks and you by 25 ,ontact rates that can reduce new infections over four weeks by 60 . You reduce contact rates by 50 , that can reduce infection rates by 7580 . If you can reduce contact rates by 75 , you can actually reduce cases. Ber of new so we know this works and that is i think the central message American Public right now many of whom are at home, stay at home. Y by doing that, you will be healthcaree future surge, protecting fellow americans. What are you looking for, and from policy holders in washington . Do you think, for example, that should invoke the president ial the defense act in order to respond to the needs for healthcare workers . Defenseill take the production act first, and then ill take congress second. You know, in terms of the defense production act, what the president is saying that he will thethe authorities of defense production act when he get worse. Hen things and im of the posture that you the to use the authority of defense production act before things get worse because you res parrots respirators ventilators overnight. I think the voluntary commitments from the private great, but without knowing whats required or meeting its difficult to know whether were meeting the so i would advise the u. S. Government to be transparent and say all right, we are preparing for a potential severe pandemic. What is the gap . Amount of supplies needed . What are the specifications of those plays . The private ask sector voluntarily can you meet this . I suspect the supply and the not there and thats why invoking the full authorities of the defense production act right now are absolutely critical. In terms of congress its congress comet together in a bipartisan manner to pass this next stimulus just did with the second emergency appropriation a couple ago. Eks all of these, in fact, are Public Health interventions, even though we dont talk about the socialll distancing, whether its whetherment assistance, its protecting workers, whether its supporting Small Businesses, whether its paid leave, all of these things make possible and sustainable the distancing measures that are absolutely critical to curve so itandemic betmperative that congress together on a bipartisan basis and quickly get this release to the healthy choice becomes the easy choice. Thats the principle. Doctor, if they dont act or it takes them all week to act, that . S the fallout of versusg does this go on quick action and what is your best prediction for how long this goes on . Thatthink the longer congress takes, thats less support to the American Public to Small Businesses to do the right thing from a Health Perspective so i think that is critical. We dont know how long this particular pandemic wave will last. We are certainly still on the pandemicof the initial curve in the United States. Monthst know how many this will last. This could last up to 18 months if you compare it to past pandemic. There have been multiple waves over many seasons, up to 18 months. Take this oned to step at a time and do the right time. One day at a lets get to calls. Hillsboro, new jersey. Go ahead joe. Yes doctor. I wanted to get your opinion on feel the government handled this as far as having aidlies for our Health Workers and could they have been more prepared number one . Number two, its good to see hasbody on there who thesearity with some of diseases instead of a politician talking on the phone. What can we take away to learn this next time something occur . Is does in the case of a severe pandemic, we need much more than we have stockpiles for. Stockpiles, 10s of millions of miscs and respirators. We will likely need hundreds of millions, maybe over 1 billion. Stockpiled thousands of ventilators. If its a severe pandemic, we need hundreds of thousands additional ventilators. I think right now what youre deploying the critical medical material and personal protective equipment that we have, and i think that is ongoing, but i think we need to think moving forward that there is a significant gap, how are we going to meet that gap . American public want to hear from the scientists and early on, you know, there was this sort of image in the press the president h and all the scientific leaders in the backdrop, and i think many people said that it really flipped, and i think wthe American People want to knw want tonce, they understand the facts and hearing directly from scientific experts fauci is really important for the american more ofo i hope we hear that directly from the scientists. Clear water, florida. Hi, albert. Good morning and thank you for taking my call. We be cleaning our money and the mail . Its the most touched and circulated thing in our country, you dont know whether its coming from. Should we be cleaning and sanitizing our money . You know, thats a great question. Probably the best thing to do, be todvice would continuously wash your hands. There have been some studies, on on money, not necessarily mail, but a recent study that the out looking at how long virus could potentially live on cardboard. Its about 24 hours. And plastic about 72 hours. There are going to be more and , but i thinkthere the best advice is if youre not wash your hands particularly after youre touching something that you dont know where its been or from. It has come susan in new york. Hello, doctor. Interested to hear what you have to say and i appreciate your comments, but i just heard overay that we would need wonder howasks and i as someone whos an expert in expertology, but not an in supply chains and deliveries, you would seek to manage a shipments like that. But my initial question i came felt thiswas how you bipartisan fight in Congress Might impact the financial and its relevance to the supply chain of the 3,000 shippinghat they are to new york hopefully for the trial to begin tomorrow. Think in terms of the supply chain, yes, we need a lot personal protective equipment. And whether thats supporting orrent manufacturers manufacturers who havent been mobilizing, quickly its probably an all of the above strategy because clearly, what is there right now, if you up all of our current assets in the Strategic National stockpile, what the military has, currently in the supply chain, that would not last us soough a severe pandemic and i think we need to look at all of these items. The connectivity to theeconomic picture, and stock market i think right now again, the focus needs to be on health response. Everything else is reactionary can do again to response,e particularly focused on Community Mitigation and social distancing, that is absolutely critical. And if that goes well, then all of the reactionary elements will into place. And we showed our viewers cnbc reported breaking announcinghe fed is new measures, the fed announces new measures to support economy purchases in the amounts needed, main Street Lending facility, 300 billion program backed by the treasury will purchase certain corporate, municipal and debt, as well. So cnn is reporting that the futures market is responding fed announcedhe this morning. Shortly soopening up that, astay on top of well. Dow jones future markets reacting just in the last three hours and they had a negative response to what the senate did movenight failing to forward on the coronavirus aid package. Can watch on cspan 2 as they attempt to take more votes forward on this aid package. Doctor, i want to get your timeson to the new york front page headline. Officials race to stem outbreak as new york becomes the epicenter. A rapid increase in testing has revealed the extent of the outbreak. Spread of the highly contagious virus now appears commonplace. All told, more than 15,000 in new york state have tested positive with the vast majority in new york city region. Is about half of the cases in the United States. Worldwide, the pandemic has than 314,700 people. What are your concerns with new york . Well, i think in new york city, there are two reasons why seeing the spike in cases. One is just increased testing. Thing. S a good and the second is simply its a pandemic inn of the Community Transmission there. Absolutely there are a number of hospitals right now in new york city that have hundreds of patients and beds are filling unit,the intensive care taking care of patients who are seriously ill from covid19. Governor cuomo very smartly has instituted his pause program, thats essentially a stay home, some would call it shelter in place. Is absolutely critical. I wish all states would do this, a stay eight states have home order at this point and the is to limit nonessential movement, nonessential travel. Absolutelyts critical to reduce the surge that is coming. I worry about the front line workers in new york city what already are seeing shortages of personal protective equipment. I worry about the critical medical material like ventilators. Theres supplies being deployed there by the military. The question is will it be enough . Will our social distancing have been enough . Was it early enough . Those are i think the questions sot were going to be seeing right now, i think all eyes if theres anywhere in the country city,now is new york whatever we can do to help our fellow citizen dollars we should and all of us, its really our nonessential movement and travel, staying home, staying safe, but those i think are the things that i am looking at in terms of new york city right now. Okay. Ronda, sacramento. Go ahead. Morning. Ood thank you, doctor for taking our calls. Morning, here in the Sacramento Valley of california, are on a staywe at home order, but as of this morning our local broadcast news saying that those who are inarcerated, such as folks prisons, they have been coronavirus, to employees at our local prisons, also now affected. And the local hospitals up and of california are screaming for the federal in. Rnment to step gavin newsom has asked the white house please send help, we need sooner or later, the nurses and the doctors are patientsend up denying coming in. We have 5 Million People here in only 45,000 beds available. Repor contractingre symptoms and our streets are dead. Mcdonalds stated they are closing all restaurants. A high rate of homelessness here. They have yet to be housed. Gavin newsom stated were going to open up hotels and do what we the homeless, but nothing is being done here in california. So now, were looking towards our president , who yesterday seemed like a fumbling idiot, like a me, he seemed fumbling idiot talking about how its hard for rich people to become president . Not interested in that. Were interested in how we are pandemic. Urvive this lets get a response to what california. Ay about i think officials, they were the first in the country to move forward with the shelter in order. I think its absolutely critical. The stay at for home order that Governor Newsom has enacted. Is allin, i think this to try to reduce close contact rate. Ists why social distancing so important. Thats the best thing we can do from a Public Policy perspective the healthcare surge that is already being seen in so many places. In terms of the healthcare sector, there are many issues discuss from beds, and i think all Health Systems are looking to see how they can increase capacity in terms of beds or looking at other beds. Obviously, the Strategic National stockpile, the military, we do need beds. Need more healthcare personnel as well and we need to think about scope of practice. About bringingk retirees back into the fold. Students,ssional giving them more responsibilities. But then it also comes down to protectiveal equipment and critical medical material. Frontd to get that to the lines. So i hear you and sometimes, it seems that, though, people are thing, itdo the right may steam that nothing is happening at the state level or the federal level, but this is deck, we need every single sector, public, government, private sector, to and do their share and the rest of us we have to do our share as well and thats why staying home and staying safe is absolutely critical. Viewers one for our the economic aid package. Thatreporter tweets out inspector mnuchin says theyre very close to an agreement on a agreement. Buy unlimited amounts of government bonds. Dr. , the Surgeon General this morning told nbc i want americans to understand this its going to get bad. What do you think he meant . Us areink many of looking at the trajectory of like italy that are about 10 to 14 days ahead of us. What were trying to do is trajectory. On that and so absolutely the next week, 10 days from a social distancing perspective, from ensuring that front line healthcare personnel that theyterials need, continuing to expand testing so we can isolate cases tell individuals who may have been exposed to quarantine themselves. All of these things are really important. So i think when public serviced thinkhose remarks, i theyre looking at there are usntries that are ahead of and we want to make sure particularly those countries like italy that have suffered greatly, that we dont follow in that path and because of that, i the next particularly week to 10 days are absolutely nation. For this lets go to anthony, minneapolis. My thing is a statement. I remember when they had the ebola, im not sure the exact number, but they were saying it was like 200 beds available in country because i think nebraska and some other places had it. Should have been something to tell people and our to prepare for a pandemic like this. And also, we should this another call for us to reexamine how much money we spend on defense. Defense also means for pandemics. People can make germs, you see how weak we are, our poorly prepared and everything. And my last part of it is im socialtuck with this distancing. I dont know how long this is going to last, how long are we expected to stay in the house and when will school start back and all of that. The virusrom getting to if you go into the hospital or dont go in the hospital, youre take before cured . Thats what i would like to know. Thank you very much. Question. For the thank you. Ill take the first one and i agree with the caller, we have significantly underinvested in healthnd local public preparedness, in hospital capacity, in what we call our agenda tolth security prevent, detect and respond to outbreaks globally. All of these things have put us in a difficult situation, and responding to a potentially severe pandemic. So i think this idea that we have taken for granted prevention as well as preparedness is really important have to learn from that lesson. In terms of how long will social distancing be required, i think its overwhelming if if we future,o far out in the and i think we need to take sort of small increments right now. We know that this is a critical thats why the stay home orders for the next couple are so important. In by stay home, shelter place, pause, i think the core thatiple there is authorities are trying to limit nonessential movement and so what that means is if you have to go to the pharmacy, if you have to go to your healthcare provider, if you have to go to the grocery store, thats okay, take individual protective measures. If you have to go check on a relative, if you want to go for a walk, by all means, do it. Protectivevidual measures. Please continue your important work. Have projected this will be required for a long time. Maybe perhaps as long as it takes to come up with a vaccine. All know that that would be very difficult for the American Public to do so i think important aspects here over the coming weeks and months is to calibrate our response in a datadriven manner realizing that we cant all just stay home for the next 18 months, realizing and we need to take this one step at adheringd the focus is to the stalemate shelterinplace orders. Country can do that, at least some of the states like florida and the louisiana and washington where the numbers look quite concerning. Jim, your question. Jersey, your question . Caller i understand what you are saying. We have to be really careful when we talk about things like stayathome. People have to go out and buy food supplies. They ought to be able to go out and get what they need for a couple of days and go home. When you say stayathome, things like hoarding go on. You dont want to commit resources to overdo it because then you stuck down the line recovering. In the obamang is administration, someone said never miss a crisis. There are people who will use it to set up their view of the world which ghost goes to a very centralized government limited on individual freedom. We dont want to go that way. Thanks for what youre doing. Guest terrific comment. You are right. We have to do a better job explaining shelterinplace, stay home, exactly what that means. Limiting is on nonessential travel and movement, reducing the contact rate, ensuring the American Public knows what they can do and what they should not do is critical. ,ometimes these terms particularly like locked down and shut down in quarantines, do a disservice. I think stayathome and shelterinplace is better. It needs to be communicated appropriately to the American Public. Host valerie, cedar ridge, california. Good morning. Caller good morning to you too. Im trying to get my tv off. I want to make a couple of comments. I think the way this is being handled is very mature. Our congress is starting to come together. Our president is working with them. I believe we are getting scientists and people working together. , notnk this is wonderful the virus itself. But there was so much infighting and attacks between different groups and parties. We are finally starting to say this is our real enemy and becoming one United States again. I dont believe calling the president names or calling each other names is helping anybody. He is the president we have. We need to look to him for leadership. We are thankful for the scientists and medical professionals. I think we have got to stop the namecalling and attacking. It is time for maturity. It is time for adult decisions. Host ok, valerie. Guest important point. This is a time for the country to come together to overcome any differences they may have. I think you are seeing that increasingly, particularly over the last couple of weeks. I think the federal response over the last month has significantly ramped up. I think the public messaging is correct. I think some of the criticism early on was that this was a tale of two responses. Is good andresponse moving in the right direction. But there is this idea we may have lost several important weeks a month or even six in january and the first half of february, when there was a bet from the white house on containment. Microbes know no borders. Testingit is ramping up , putting forward social increasing the supply of critical medical material as well as personal protective equipment, there is a thought some of this could have been done weeks ago. What we are doing right Speaker Pelosi good afternoon