Notice about returning to capitol hill if legislation concerning the coronavirus was to be considered. Watch live coverage of the house on cspan. See the senate on cspan two. He is the author of the book the next pandemic. Departmentean of the and a professor at nebraska medical center. Thank you for being with us. Newst to begin with some from the washington post. Contamination at the cdc lab delays the testing rollout. Here are some of the details. Host that was also handling synthetic coronavirus materials. The scientists also said that the proximity deviated from accepted procedures and jeopardized for the virus. Cdc officials took more than a month to remove the unnecessary steps from the kids. Kits. I want you to unpack what that means in terms of testing and some of the Lessons Learned from these missteps. Guest thank you. Cdc is the premier Public Health agency in the world. Actually, many countries have renamed their Public Health agencies cdc, including in china , were cdc does not mean anything, so this is highly uncharacteristic of this agency. It is one slice of the cdc. It does appear that something happened with the testing kits. For 47 days after the sequence was announced by china, that is how long it took them until we had testing up and running in the United States. But that was just this test. What we probably should have had it was widescale, commercial level testing starting almost immediately. I would say that the fact that we did not have widescale commercial testing up very quickly at the end of january like some countries has really defined this outbreak for us to this point, and continues to defined this outbreak for us, because widespread testing is really going to be necessary as we think about reopening america again. To thing we need to do reopen america is make sure we decrease transmission. The first thing we need is widescale testing to quickly isolate cases and define their contacts to find their contacts. Host the failure with the testing, keeping the Public Health labs from performing disease surveillance intended to protect predict and minimize harm before the wider virus became widely established. It seems like it was a 12 punch. O punch. Guest absolutely. If we had enough testing, there would not have been limits on who was tested. The border,we close there had already been thousands of individuals who had returned from china and a likely there was already community transmission. We had had submission sufficient testing, had already been testing, finding cases of community transmission, and doing what we are now going to do, does identify those individuals and isolate them and find their contacts and quarantine them. Host another headline. This is from cnn. There had been people who seemed to have recovered from covid19. In this case, about 140 in south korea, only to see a comeback. Can you see can you explain why . Guest that has gotten a lot of headlines lately. It may well be up to 160 at this point. South korea is doing a whole lot of testing, so there is potentially three or four different reasons. It is a likely is that function of the tests. Either the first or the second test is wrong is what most people think, because it is not clear on the Second Time Around it these people are sick. We have lots of experience, including here in the u. S. , that when people get tested at the end of their illness, they may be negative for two or three days and positive and the negative. It suggests that the test limits. This is a nucleic acid test. Aher thoughts are it truly is reinfection. A third thought is that it is a reactivation. So somehow the virus is dormant and. Then it colleagues our south korea colleagues are investigating these options. Worldwide, people are seeing the same thing. Have been talking about whether or when states should begin to reopen. The headline from omaha owner of the large mall crossing outlets planning to reopen the mall this month amid the pandemic. Is that a smart move . Guest this is them 1 million question. When can your open america . Rolling set every openings across america, but it will have to be in conjunction with what the local conditions are and whether or not there is really low enough transmission locally to reallow opening. The president has outlined his threephase plan that has phases of decreasing transmission. You wait two weeks before you open up a little bit more. Even when we reopen, we all need to be honest with ourselves it is not going to be what it was back in january. We should expect continuing social distancing. We should continue to expect masks. It is going to be different. You could talk about the malls, opening the beach in jacksonville, opening golf courses in minnesota. These are individual situations in individual states based on local conditions. Host the book is titled the next pandemic. In the book, you write the following i wonder if our global preparedness efforts would be better financed if governments always had to reimburse families, communities, and corporations affected by an outbreak. Can you explain . Guest we are seeing that now. One of the things that people do not appreciate about pandemics economic, and political consequences of epidemics. It is very easy to talk about this is what happens in an individuals health, from a Health System, but now for all weus here in america, realize there are significant social, economic, and political applications. That line goes to multiple other conversations in the book about recognizing these implications. If you recognize these implications, you will spend more time and money on preparedness. Nowadays, i am sure every country in the world thought wish i wish i put the money in the preparedness. I wish i had supported the various global efforts so we werent. Where we had been printer if we have been better prepared, we have recognized this earlier. Hopefully, potentially, we would not be sitting here in our living rooms today. Host to that note, you write the following in the United States, we are fortunate to have the cdc as our national Public Health agency, and globally to have the who. At the end of the day, and even with the guidance of science, Public Health does not happen in atlanta or geneva, it happens in our communities. It is in our communities that we need to build better Public Health systems and find ways to engage people in that effort. do you think we will see more of that in the coming years . Guest we have to see more of that. I dont think it is a choice anymore. , again, Brilliant Agency in atlanta, but we need to make sure that here in nebraska, then emmett minnesota, wherever you are, you need to make sure your state Health Department is to identifyced cases, quarantine them, make sure your Health System is ready, make sure that as businesses open up you have the right corrective measures in place. That is not happening out in atlanta or in washington. Within your counties and your cities, they need to do that work. Absolutely, this is a time to rethink what Public Health looks like in america and make sure they have the resources for the always work that has been necessary even before this pandemic. We would have local foodborne outbreaks within our communities. Spending a lot of time talking about superbugs. All that stuff was still going on without the adequate Public Health infrastructure to address them. Host we are talking with dr. Ali khan. He is the dean at the university of nebraska medical center. A graduate of the university of michigan and emory university. Spending nearly 20 years at the cdc, including as the director of the office of Public Health preparedness and response. His new book. Lets get to your phone calls. Karen is joining us from michigan. Good morning. Caller good morning. I have a question. If trump and his family and the Vice President can get tested whenever in the hell they want, why cant our nurses and doctors and police and everyone like that get tested . Nancy pelosi said we need testing. Pelosi of getting mad at and our governors, which trump said he is not taking responsibility, why is it rallying around trump when our governors are doing the best that they can without, supposedly, the leader of the United States . He is not doing anything except playing around, sitting on his ass. Mama, you are spot on in your question. On. am, you are spot there is no question we need testing to reopen activities. We need to get transmission down in our communities. If we do not get transmission down, what we will see is this flareup again within the community. We cannot have that happen. Originally, we thought this would not be so bad, but here in the u. S. We are noticing almost 5. 5 of people get this disease die. That is a lot of people dying. We know now from our experience in new york what this can do. It can overwhelm the Health Care System. We cannot have that happen again. To keep that from happening again, we need to get cases down, and that requires testing. The good news is we are now up to about one million tests a week. That is amazing because back in march, on march 3, we had a hundred two cases. That seems like a million years ago. I thought about thousand people have been tested or Something Like that. We are testing about a Million People a week. We need to test about three to 5 Million People a week. Your spot on. We need to massively increase testing. Kits, machines, reagents, swabs. Who needans the people to do that and follow up on those results. It is a whole system that needs to be put in place to make this happen. Ast the president has put halt on funds for the who, putting part of the blame on that organization based in geneva. Your reaction . Guest yeah. There is no doubt there has been some missteps by who in terms of how long it took them to call what is called a Public Health emergency of international concern, how long it took for them to call this a pandemic. However, in hindsight there is been missteps and lots of agencies, institutions, and individuals parts. Halting funding for who in the midst of a pandemic. Who has a leadership role worldwide to help us. Especially and low and middle income countries. They have been amazing. The guidance that comes out from zoe show from who. Their guidelines, guidance has been excellent. I rely on it every day. I look at their situation reports every day to see what they are thinking. Their science has been spot on. I really hope this is a temporary pause in who funding. What we really need is to be supporting who. Host we go to alan from burlington, new jersey. Good morning. Caller it is a pleasure to speak with you, dr. I would like to suggest food for thought for all of us in this country, especially people in government and medicine and epidemiology. A pandemichave had in this world for centuries that has not been addressed sufficiently to eliminate it. That pandemic is a simple one word pandemic called cancer. Cancer. We need to have a war on cancer similar to the war we have declared on virus. It has to be done. Have83 years old and i lived through many deaths in my family and community caused by cancer. We have the biggest industry in the world dealing with cancer, but no success in eliminating it. Food for thought. Lets have concentration on that pandemic and eliminate cancer. Thank you very much for listening to me. Host thank you for the call. Did you want to respond . Guest it is an excellent comment. There are numerous efforts. One of the leading causes of death in america and worldwide to address cancer and the multitude of reasons that people get cancer, including lots of wonderful advances in individual cancers. Spot on. For elimination of cancer, it is a dean of a college of Public Health, i would take people to the point of prevention of cancer and what we can do to prevent cancer, not just treat cancer. In terms of smoking, the leading preventable cause of cancer, diet, exercise, and other things we can do to decrease the incidence of cancer. Host back to the book. Everyite need to gather bit of information you can. You are depending on the journalistic abilities of medical staff or patients as well as good recordkeeping and sharing. That is what allows the aha moment to happen. You say that guys daughter caught it. I dont think thats a coincidence. Otherwise, there is only so much the cdc and other agencies can do, which is why we have developed a nearreligious obsession with data. This current outbreak is an example of that again. I would take the audience back to december, when this outbreak was unfolding in wuhan. That is exactly what happened. These are brilliant clinicians in their communities who were seeing unexplained pneumonia. And something in their mind at trigger for them that these cases do not make sense to us. Clinicians, we are used as used to seeing people come in with fever and ammonia. Say,omething triggers to one too many cases. You take that and combine that with healthcare workers getting sick, suggesting persontoperson transmission. Some of these people saying we work in the same market suggesting a cluster of illness. And all of a sudden they are sending the samples out for sequencing and they were correct. The sequencing came back in december that this is a novel Severe Acute Respiratory Syndrome virus. This was all done by these clinicians working in hospitals in wuhan. That is what the trigger was for the Public Health agencies. Ok, we have a disease here that is a new sars. , which we are now calling covid19. That is the obsession with data. That is trigger by astute clinicians within their community identifying those first few cases and it these links between them. Host could this virus have been developed in a lab . I tweet a lot about the various conspiracy us theories and how having cognitive deficit dissonance about which conspiracy i believe because they do not always agree. This virus was not created in a lab. There is great homology between this virus and a pangolin virus. Pandemicsty of our are caused by zoo are not a viruses caused by animal born viruses. They can spill over into humans. They do not just because one or two infections in humans. They sort of take up residence in humans and cause a pandemic from persontoperson spread. Viruses,uses, corunna live in bats, and occasionally they infect other animals. We believe they infected a cat and a wet market, which is where people by food and animals where people buy food and animals. Had in 2019 was no, there is no evidence that his virus was made in a lab. Host dr. Ali kahn is at the university of nebraska medicine center. Here is the president yesterday talking about china in the Daily Briefing. The question was asked would you be angry at china . The answer might very well be a resounding yes, but it depends was it a mistake that got out of control or was it done deliberately . Its a big difference between those two. In either event they should have let us go in. We asked to go in very early and they didnt want us in. I think they were embarrassed. I think they knew it was something bad and they were embarrassed. Host lets get back to your phone calls. Eff in new york, good morning. Caller i have been reading disease in global outbreak, the lessons from ebola and zika and what is the basic take a way from the article was there is a large difference in the delay from the detection of the disease to the response, beginning of the response. Differences in detection. So my question to you is how can we better act on the advice that the Public Health officials give us once the novel virus like this thats respiratory in nature is apparent which in this case was back in early january, the w. H. O. Said that we should assume that Community Spread is is actually occurring. Even though they reported that china denies that. We didnt act on it. We should have been prepared to act on it. I think the public should have been brought along in this process not only this pandemic but as a matter of Public Health messaging told at the time that we should be prepared to act on these very you are urgent situations when they develop. I wanted to get your opinion on that. Also what that informs us about coming on the other side of the curve and acting on that advice regarding testing and actually knowing precisely the logistics, how many tests do we need . How many tests have to be in the community . What percentage of the population has to be tested and let us know the progress on the logistics of that so we can all see transparently when its safe to begin to lift the mitigation procedures. Host thank you. A lot there. We will get a response. Dr. Kahn. Guest both excellent questions. Let me do the second one first because i addressed it earlier. We probably need to test approximately three million to five Million People a week, would be my guess. We will continue to refine those estimates. The testing and the numbers are o high because theyre not homodeneous across the United States. Decreasing transmission twn the communities. Between the communities. Its not so much the testing but the data. You can show we are having fewer and fewer cases because its linked to people finding the cases, isolating them and quarantining contact. Thats what its about. You are looking so the testing is easy to point to how many testing you are doing. But its really about the cases in your community. Lets not forget that. Testing is a way to get to decreasing cases. That answers the testing question. Please remember, its not about the numbers of tests. Its about the number of cases. You want to drop those and continue to drop those in your community. The testing is the way you find them to continue to drop the cases in your community. Now going back to your first question, there is no doubt that there was a lack of imagination in the United States about what , 2002 ct of the sars classic sars, i call it covid19 ew sars. We were fortunate during the classic sars outbreak that we were spared. Canada was not spared and they took this disease very seriously and had a different perspective. South korea had had an outbreak due to a disease called mers, which is also a coronavirus, that really caused big problems for them in their Health Care System. So they also took this disease very seriously and the moment they heard that this new covid19 coronavirus had shown up in china, they like right away started ramping up testing so they could start testing. South korea is pretty much opening up these days because they were so aggressive. But the United States and many other countries did not take it as seriously and should have. But i want to remind people what the flip side is. So many of you i believe even the caller will go back to swine flu where there was a concern that oh, there may be a swine flu outbreak. This was a National Effort to make a vaccine against swine flu. In the end we did not have a swine flu pandemic and instead unfortunately we had a lot of people get serious complication from the swine flu vaccine. So theres always this tradeoff. Are you scaring people about a disease that may not happen versus are you preparing them for a disease that may happen . In this case, unfortunately, there was this thought that the chinese had adequately managed the disease in country and i will admit it. I was one of the individuals who thought yes, china has an excellent Public Health system. Maybe they truly did this was a cluster in a wet market that really had captured that cluster and we were good to go. Unfortunately, because they were not sharing the data very well, they had not captured that cluster and we should have been a lot more concerned and they were not as good with the information that yes, this was causing health care infections outside the facility and community transmission. So i think if we had known all that information earlier, we would have been a lot more concerned here in the United States a lot earlier. Host when the president said in february, this would disappear, it would wash away, was he ccurate . Dr. Kahn . Not sure if you can hear me. Guest i missed that. Host when the president said in february this would disappear, this would wash away, those are is words, was he accurate . Guest so this is the two sides of the coin, where you need to encourage people that there is a solution, and the chinese were doing the same thing, right . They were busy locking down wuhan, encouraging people that by locking down wuhan, they were going to get to zero, while at the same time locking down wuhan and telling people they couldnt go anywhere. So i cant speak for the president on how you are balancing those messages to the community that you need to take severe action but give them hope at the same time, that the end of severe action, you will be able to see the new spring again. Host we will go to betty in louisiana. Good morning. Caller good morning. Thank you for taking my call. Doctor, i was listening when you were talking about how the virus was not genetically manufactured but i think everybody realized they said it naturally occurred, but the thing that has most of us worried and upset is is the fact that china did not let people know it was happening. Neither did the World Health Organization. They covered it up. And the fact that it might have occurred in a lab, thats a plausible theory because they were doing research on bats in the lab. The thing is that we are worried we didnt get notification from the people that should have been notified. For instance, the early doctors you were talking about that noticed it in china, those early doctors are gone. We dont know where they are. You know, and why would you take out the doctors who might have the most information, that could give the rest of the world information about it . Host thank you, betty. Guest so, maam, you are absolutely spot on. I dont think anybody would disagree that the Chinese Government the Chinese People are amazing, right, and theyve gone through an horrific event in their history as all of us are going through in our histories worldwide. But the Chinese Government clearly could have been more forth coming in the information that they provided us. Nobody will disagree with you that they could have been more forthcoming with that information, and for example, some of the early whistleblowers if you want to call them were called in and told not to disseminate the information of what was going on in their hospitals. Thats absolutely true. But that doesnt necessarily mean that they disseminated this virus within their community. Also you are there are numerous labs worldwide that work on coronaviruses and they should be working on coronaviruses. They are one of the leading threats based on what we saw in 2002, that these viruses can cause pandemics and based on what we see now, we know they can cause pandemics. Theres numerous labs working on these viruses and yes, we can never prove the negative. So yes, could somebody in the lab have gotten naturally infected from these coronaviruses and then gone out and infebted other people . Infected other people . Absolutely. Or in any other lab in the world infected from an animal, but its always hard to prove the negative. Its a lot easier to understand what we see with ebola and plague and all of these diseases, people naturally get infected out in the wild or in wet markets and we have lots of examples of that happening naturally. Host we will go to steven in daytona beach, florida. Steven, the beaches are now open in your area . Caller no. My question is, what temperature will the coronavirus be killed if you steam it . Host thank you. Uest thats a great question. By the time you steam it, the teem is boiling and the coronavirus will die at that temperature. There is also research being done whether or not you can look protectivematerials, equipment and steeming it using heat to try steaming it using heat to try to kill it. That information is readily available if you are thinking about using it for decontamination purposes. Host m. I. T. In coordination with the World Health Organization studied a sneeze because we have been told to stand six feet apart. As you can see from this research that covid19 is spread through respiratory droplets, and as this video shows you, a sneeze can travel up to 26 feet. Guest i always like to couple e experimental data with the epedemioligi data. Sneezes can travel quite far. There is lots of information conducted here at the university of nebraska by one of our faculty members in the college dr. Lowe health where has looked in contaminated rooms of people with covid19 and he can find it out in the whole room, out in the air, etc. , but you need to couple that data where you can find virus in the environment with where do people get infected based on their proximity from the patient and from that information, what it looks like is most people get infected because they have direct contact with another person. Thats usually close contact, 10 to 15 minutes, sort of talking to somebody. So thats droplet transmission. What we dont see a lot of us is somebody who had no association with anybody and so they walked into a room and they just sort of got infected. You see that very, very rarely. So you know that most of it is droplet transmission. Host if you have a standard sneeze in which you are not using your arm but you spray in an area, how many droplets otentially could be exposed . Guest what happens is you go out to the third power of the radius, that concentration gets lower and lower as you get farther and farther out. So the closer you are, the more likely you are to get infected. This is why we tell one of the reasons although the main reason is to protect you from infecting others, before you get sick. 40 of infection is before you get sick. One of the reasons you wear a mask when you are outside is when people are sneezing or coughing, you dont want that to get into your face and nose. Host we go to roger in middletown ohio. Good morning. Caller good morning. First of all, i appreciate the job theyre doing. I want to thank the president for saving my life. I am 86 years old. I am a korean veteran and i understand that so many people are calling and condemning the president , condemning the doctor. Theyre talking of a primary book and the government has the greatest lawyers, greatest doctors. You see five or six people, thousands behind the president , the doctor, and all these people that are working hard, and i went to the store last night, had to wear a mask. I also saw people running all over the place with their kids with no masks. Eople die from this thing. Theres no go back to work. If you go back to work and you can separate yourself from people, fine. But you take it to somebody else and they take it home to their families, the poor people in these Nursing Homes who didnt have a chance. Think of the sadness their family has gone through. Do we want to go through that again . I dont think so. I think, you know, if they would have spent the money on these Infectious Diseases that they spent trying to get mr. Trump out of office, we are talking billions of dollars they wasted that could have been put on cancer or other things like that. The Elections Come up, theyre spending hundreds of thousands of dollars a day to try and get mr. Trump out of office. Its not going to work. He has too many brilliant people behind him. Look what theyre running against him this year. I mean, this guy is spacey. Host ok, we will leave it there. Thank you for the call. Guest thank you for that question, sir. Let me make two points. One is prevention is always the best buy. Prevention is the best buy when we talk about health. If i want to prevent you were getting cancer or Heart Disease or if i want to prevent the next pandemic, its always the best buy, preparedness prevention, always less costly. The second thing is to remember and honor the heroes of this outbreak, whether theyre the health care providers, the Public Health people in your own communities, worldwide and all the essential people who dont have the opportunity to stay at home, the person stocking the shelves, the one driving the buses around. Theres a lot of people out there who are heroes right now and thank you for recognizing them and we should all recognize them, that they dont have a choice to be at home and theyre out there right now today making sure that society is continuing. Host after Hurricane Katrina in louisiana during the george w. Bush administration, he wrote the noling your book. The u. S. Government including fema would never make these mistakes again. A rare instance where lessons did not need to be relearned and a stark reminder that citizens see their governments primary responsibility as being to keep them safe. , s go to gale in jamestown good morning. Caller good morning. Dr. Hawn, i am glad that i could speak with you. I wanted to ask a scientific question, a hypothesis i have from some reading i have been doing. There are millions of people on ace inhibitors and when we look , they inhibitors conversely stimulate the receptor, this virus has a predilection for the wo receptor. I wanted to ask you and your colleagues, would you consider doing an analysis study of the millions of patients who go into ards so precipitously after being in the hospital for a week and their lungs just collapse. This is a question that i think needs to be looked at and needs be studied by you as an eminent epidemiologist. Just wanted to ask your thoughts on that. Host thank you for the question. Dr. Kahn . Guest thats an excellent question. So there is no doubt that this irus uses whats called an ace two enzyme to connect and get into your cell. So there is no doubt about that. The american cardiology association, american heart association, and others have come out and said please do not change the drugs you are currently taking for high Blood Pressure or Heart Disease because they may work on the same set of receptors and there are lots of studies going on to verify that those drugs are not somehow interacting with people getting this disease. So people are looking at that. But for now we do not recommend that people change the drug theyre on for their heart conditions. Host deborah in ohio, good morning. Caller good morning. I am a retired scientist, and i just wanted to thank you so much for focusing on prevention because as a scientist i understand a little bit well, a lot about the immune system. For instance, the white blood cell in our lungs in terms of fighting disease, one of the things i am not hearing from the medical community i think you would be the perfect person to convey this is how important it is right now for us no one is going to agree with this not to drink alcohol because it suppresses the white blood cell and how we need our vitamins and minerals to be within normal range and how scary we dont have the enzyme to break it down after 5 years old and the last thing we want to do is have something in our diet that produces that type of response where we get a lot of mucus. Eating fruits and vegetables and water, plenty of water, have a balanced diet, not too much animal protein, so important in our immune systems. Being overweight suppresses the immune system. I am not hearing enough about that because those are things we can do internally right now. Host thank you for adding your voice to the conversation. What type of scientist were you . Caller microbiologist. Host thank you very much. Dr. Kahn . Guest nice to hear from a microbiologist and nice to hear another champion for prevention. So i would absolutely agree with you and more so now than ever, when we are homebound, to remind people that its really important. Selfcare is more important probably today than ever. For me, it always starts with stopping smoking if you smoke. We know its a modifiable risk factor for covid19. Please, if you smoke, this is there was always a good reason to stop smoking. This is another really good reason to stop smoking. Fruits and vegetables, seven fruits and vegetables every day to get them in. Sleep is important. Exercise every day. Moderation in your alcohol and animal protein, but selfcare is really important. This is a good time to think about your diet and exercise and sleep regimen. Host from michigan, good morning. Guest good morning. Good morning, doctor. I have been listening and doing a lot of research myself, being a retired teacher. He thing that i am concerned about is when our government is going to hold the chinese accountable for their actions . If in fact they have held back a lot of the transparency that was needed to identify the problem going forward. The second thing is i would like to see personally doctors throughout the world to hold the chinese accountable at the United Nations and to expose them for their inability or unwillingness to allow the world to understand what was going on in their country. As long as we fail to provide transparency to the people that we are going to have people who are going to question everything that is done. The information regarding the health is very obvious, but the transparency is lacking. Lacking not only in our country but also in other countries throughout the world. Host thank you for the call. Your response, dr. Kahn . Guest i always want to be very careful when we use the word chinese, because i want to separate chinese from Chinese Government. Chinese are a whole country of wonderful people who just went through a horrific experience. Theyre our friends, our family, our colleagues, our neighbors, my students, my teachers, my faculty. So lets be very careful when we use the word chinese, please. But yes, there are some members of the Chinese Government that could have been more forthcoming about what was going on during this outbreak and its very appropriate to think about how can we work with the Chinese Government to make sure that theyre a lot more forthcoming in the future. I had hoped and i was wrong in the book, and for those who read my book, i have said that after sars 2002 i would never have that they had gotten so much better, i would never expect to see this again from china. But i was wrong. I will be honest about that. I think its because they believe they had contained the outbreak. But regardless, yes, we need to go to a place and not just for the Chinese Government, not the cheaps, the Chinese Government for every government in the world we need to go to a place where we are a lot more transparent about Health Information because the disease anywhere is a disease everywhere. So information, samples, genetic information, we need to get past this mindset of we are going to public this information. We want royalties for it, etc. , etc. No, share the information because it can save lives and a single day can make a difference. Host before joining the university of nebraska medical center, dr. Kahn was the director of the office of Public Health preparedness and response for the c. D. C. Dwayne is joining us from mississippi. Good morning to you. Welcome to the conversation. Caller good morning. I wanted taiwan was early in the game trying to ask the World Health Organization and trying to tell them about this and they wouldnt listen. Our president did a whole bunch of good things and he didnt say the virus would wash out. Thats another misnomer but he did a lot of good things in the beginning of this. He had no idea how bad this pandemic was going to be. The World Health Organization was berating him about everything that he did, saying the chinese was correct and then when the truth came out the chinese was doing the biggest lie ever. If we cant hold the World Health Organization responsible for their job, for their job, theyre getting a half a billion dollars and they couldnt warn us of this pandemic. Who do we hold responsible . If not them . Who . Host thank you. Lets get a response. Guest dwayne, thats an excellent question. I think the honest answer is we are all responsible. Each affered every one of us, every country is responsible for this global pandemic. We are responsible for our own preparedness systems and we are responsible, as i said, a disease anywhere is a disease everywhere. We had a global spobt for this preparedness for decades and to be fair to w. H. O. , you know, its not as if they werent reporting every day what was going on in china. We did know what sars did in 2003. We did know it was person to person. We did know it caused health care required infections. We did know it caused community transmission. Some countries like china and like south korea and taiwan, they immediately ramped up their preparedness activities and they had a much better response than many other countries worldwide. So trust me, there is a lot of blame to go around and when the after action reports are done, there will be a lot of blame to go around. But right now w. H. O. Is leading the Global Health fight. This is absolutely would be an unfortunate time to say, you know, lets halt your funding. If we are halting the funding, i hope its very brief, you know, because w. H. O. Still needs to lead this global fight to make sure we can get out of this pandemic and theres plenty of time in the future to sort of lay blame where blame potentially needs to be laid or more importantly as a Public Health professional for me, its not ever about laying blame. Its about thinking about how do you improve your systems for next time so we never find ourselves again in our bedrooms, you know, and have a strategy for the next outbreak, for the one of the headlines from kellyanne conway, in which she referred to covid19 flood being a basic detail my question to you why is it called covid19 . That is a really good question. I thought it would have just been called sars, which is what it was called into 2002 and 2003. I think who was reluctant to call it again what it was called in 2002 and 2003 because it was a little different, but it is called cobit because it is a coronavirus. It is a novel coronavirus. So coronavirus infectious soease, so covid and 2019, 19. Becausee said it was 19 there had been 18 other covid cases. That is not correct, right . Guest the 19 is 42019, when it was first identified. Lets go to gina in apollo, pennsylvania. Caller good morning. Im excited about the people calling in about how cancer and the diseases are formulated like the dairy and all of this stuff. As far ass cancer and , you continue to bandaid over what it did to us, but a lady calls in from putna and says the the money toward that incident the who. To give them passes so they can lie. Taiwan is muffled. Let us have our own money so we can buy our own food to be healthy and go off the bad food that is feeding the cancer. Vitamin d does help, even though that was counted by the professor. Im sorry you are not bringing this stuff in your capacity being brought up by smart people calling into this show. Host thank you for the call and the question. Guest your point is well taken, states, weunited have a responsibility to u. S. Citizens and we have a global responsibility, and i think this pandemic is a good example of how if we do not focus on things going on worldwide, we leave ourselves open for these diseases that can happen anywhere. If we are not engaged in countries like china, how would we know theres another disease going on if we are not engaged with who. How would we know about this pandemic . If any time in our past, this is a great example of why we need to continue the leadership role we play worldwide, to be good partners worldwide, to understand, to help, to be of assistance, to provide that Public Health expertise worldwide and make sure we can provide that expertise and then we have Greater Knowledge of what is going on to protect americans. The book is called the next pandemic on the front lines against humankind gravest dangers. My final question with less than a minute left, how is this all going to end . Guest it is going to end with excellent Public Health systems. It is going to end with support to Public Health, making sure we have a system that allows us to identify cases, quarantine contacts,uarantine make sure we have a Health Care System that can take care of any hotspots, make sure we are protecting our health care workers. Make sure as we open businesses and schools we have good preventive measures in place. Engaged, we have an empowered, informed populace and communities. Make sure we have a strategy as people come back into the u. S. That we make sure they dont bring infection with them. That is how it is going to end. Eventually, we will have drugs and vaccines. If we dont get containment and elimination and eradication with Public Health, we will get it with vaccine or drugs. This will be the power of Public Health in the end. Us. dr. Khan, joining we thank you for being with us. Guest thank you for the opportunity again. Host again, a look at the numbers around the world courtesy of Johns Hopkins universitys the total confirmed cases, 2. 3 million. Deaths around the world now in deaths in 180000 five countries. Yesterday at the Daily Briefing at the white house, the president with this on states trying to reopen and his recommendation. President trump since we released that guidelines to open up america again, and this was two days ago, a number of states led by both democrat and republican governors have un