To talk about the ongoing efforts to develop a vaccine. Join the conversation tonight 8 00 eastern on cspan. Next remarks from former fda commissioner Mark Mcclellan on the Coronavirus Response. He spoke at a Duke UniversityVirtual Event for half an hour. The room is open, thank you for joining us. Welcome to the latest Duke University media briefing. Bem Greg Phillips and i will monitoring this. Today we are discussing what the federal government, states and cities must do to reopen safely. Thanks to those reporters who submitted questions. People can ask questions by the q and a window. With me as dr. Mark mcclellan, physician and economist from the center for health policy. He was previously commissioner of the u. S. Food and drug administration. Welcome. Dr. Mcclellan thank you for setting this up. Thanks for being with us. We will get started. You coauthored a fourphase Coronavirus Response plan. What elements of states have got to have in place to begin . We are moving from phase one to two, and one is not just one big step. In some sense but is the wrong term. We are not opening up to the way things were before. We are seeing maybe phase two a, stepsd, and e, with some forward and backward along the way as we gradually turn on the fossett. It will enable some businesses to reopen under modified conditions, get in place some of the additional steps that are needed for work successfully. That includes key dimensions. One of them is a Health Care System not under duress. Adequate capacity for potential further searches in the virus and the capacity for Critical Services americans need. Many have been putting off unfortunately during this staying in place. The second his responses by business it is responses by businesses. We are in this together. It will not be under the same circumstances businesses reopen. You will see a lot of steps like we see in Grocery Stores and other essential businesses. ,leaning and disinfection practicing on employees to see if they are sick, that they are not coming into work. They are practicing the same kinds of isolation we have had universally for people who have at risk for transmission. ,ace masks will be common continuing to follow the longstanding advice about frequent handwashing and not touching faces and being careful not to go out if you have any covid19 symptoms. Follow cdc guidance and get into testing. We need to Pay Attention to protecting those who are elevated risk of serious complications from covid19. For Older Americans and those , thisomorbidities reopening needs to be especially careful on your part in terms of continuing to practice distancing and taking steps to minimize your risk. If you are living with people going out more and taking they need to take extra precautions. Andnt to emphasize testing the containment part of this phase, the test capacity is ramping up. It is Getting Better at talk about initiatives underway to improve that and trace contacts and contain any outbreaks that occurred. Steps in multiple dimensions with expectation we may need to take a pause in some areas and the back if there are signs of epidemic picking up again because through all of this the virus will be with us. Greg that leads us into one of the questions we got from a reporter. Importantbout how Contact Tracing is. Do we have the capacity to do enough, and if not, how soon could we . Dr. Mcclellan scaling up different places at areas around the country and the need for the volume of Contact Tracing that ry of it. Will va areas that are facing increases in cases or a heavy burden, even if they are on the way down, that is more contacts to trace. They will need more aggressive attention to testing and tracing as they start to reopen. In areas where there is more control, lower level of case activity, it is easier to get to the stage of testing and tracing which should be the goal. You will see in the states that are reopening, some close attention to increasing the testing and tracing capacity. Country, thed the region, northeast region, hundreds of contact tracers as a. Art of their efforts to expand in california there are digitally innovative efforts in texas. Austin, increase capacity. In many of these areas people who have backgrounds in health, medical students who have or who have different backgrounds, public employees, as well as people going through Training Programs to support the tracing capabilities. You will see in the coming days and weeks new jobs as a part of these efforts for containment. Followup. Is one have we ever done Contact Tracing successfully with a prior outbreak . Dr. Mcclellan we have done that on an ongoing basis. It is not just for a new some yearsu, h1n1 ago, or in the case of sars where we had very effective identification cases and Contact Tracing and isolation quarantine around them. They were different. There is tracing that goes on on an ongoing basis. That theydifferent in have not been as widespread and there is not as asymptomatic transmission. Whenwe have to be vigilant we see a case to make sure we are getting that case surrounded by rapid Contact Tracing. In that way this is going to be at an unprecedented level. It is already at an unprecedented level for the pandemic. A differentwill see scale, different steps. Ask people who they have been in digital apps with, can help people identify, what privacy protections can be used to augment them. Also talk about how this will be an effort to span across other healthbesides public authorities. Health care providers potentially helping to identify contacts and people get the care they need in isolation, not at home or somewhere out of the community. Keep those people as close to the community as possible but out of the system. I also mentioned the top of my areents how businesses going to need to participate in these efforts, having programs in place to remind employees about getting tested and helping support the Community Efforts around further outbreak. Greg i will remind everybody if you would like to ask questions, type them in the window. I will move on to other questions we got in advance. This person said we are expecting an announcement regarding schools in north carolina. Are there some unique considerations for reopening schools . Or. Mcclellan there are tw features distinct about schools. They are places where inherently there is close contact between children. That is impossible to avoid especially younger ages. That means there is some potential risk. While the good news about the pandemic is it does not seem to affect otherwise healthy kids seriously at all, compared to people who are older, so the it ishe kids substantially lower say than for someone who is 60 plus. Kids can be potential sources of transmission. The considerations around reopening day care, pregame and and schools is, to minimize for their own sake and preventing spread back to family members in the community. See the same steps with handwashing, not much prek maybe a bit more social distancing. Dont think we will see threeyearolds with masks but may be more games where kids are clapping arms or things that are not quite so close contact. There will be more close contact in these settings. And the other distinctive future is we really need to get our schools and Early Childhood programs reopened. This is important for the development on of children for their wellbeing and helping their parents and the rest of the people in the United States to get back to work and be able to do more of their lives as well. Very high priority area, a lot of effort to get this right. Doesnt mean schools and daycares are reopening but it means extra attention because of these unique features. Greg we have a question from sara krueger. You mentioned the role of businesses. She asked what do you want to see before all businesses can reopen like normal . Dr. Mcclellan i want to emphasize reopening businesses is not going to be the old normal. It will be a new normal. I would like to see progress. Health care systems are good, they can handle not only capacity for potential search in covid19 surge in covid19 but more routine care for people who might have complications from Heart Disease or other issues that need to be addressed in a timely way. Check thee area to boxes. We need to support increased testing and capacity for Contact Tracing so that if there are outbreaks, the virus is still present. We are containing them. For the fight businesses and sells it is a gradual process. People have already seen what this can look like based on experience with essential businesses like Grocery Stores. This is not going back and being in a crowded shop. It will be businesses where the amount, capacity will be limited limitshat the occupancy under normal circumstances would be, whether more protective barriers between customers and staff, more distancing steps in place, markers and other kinds of limits on where people can go. There will be extra handwashing and hand sanitizing capabilities especially to help with minimizing contact with transactions or things like that to help people remember and carry out the frequent handwashing and hand sanitizing ofded to support the risk transmission. Probably know people sitting around in waiting rooms. You have seen pharmacies and waiting for a doctors appointment, that will probably happen in the home with a notification, text message when is about to be your turn. Not back to business as usual at all but some significantly bigger opportunities for people Retail Services and they need and in other areas like going to the movies, watching a show, more distance and a different version of normal. This will and thought unfold gradually. Testing capacity keeps getting stronger and tracing capacity gets stronger and we have more experience, we could do more. People should not be surprised if there is the need for pauses along the way and steps back in certain areas as well. Up, done quick follow you think we will ever go back to the old normal, or is this it . Dr. Mcclellan the old normal when there was not a worry about thatransmission of virus can cause a Significant Health problem, that is a ways off. It will not be the way it is now with limited opening forever either. As you know, there is a tremendous unprecedented amount of work happening at unprecedented speeds for vaccines that can help with immunity and we have widespread immunity and we need a lot for containing contagious viruses. We will get there. People can Pay Attention along the way and let us know how the vaccines are performing. Steps,e is unprecedented to ramp up the capacity for manufacturing, even as critical studies are going on to minimize in going from a vaccine that seems to work and animal testing that works and human testing to widespread distribution of that vaccine. I think there will also be some therapy. Und improving there are a lot of test for drugs that can reduce the of intensive cases that require ventilation now, where it seems like overly strong immune response might be contributing to complications. If we can bring down the severity of those cases and make the virus less like the threat it is and more like a bad flu, that would help. Antiviral treatments that can help, this will make it easier to luke back into the loop back in the direction of the old normal. Greg we have one more question. A question from the Straits Times in washington, dc. We know avoidance measures are only as strong as the weakest spots. What are the weakest spots in the u. S. That authorities should be cognizant of . Themcclellan i think in context of gradually opening, there has been a lot of thought to a dress what are the places to reopen first. Ress what are the places to reopen first. People congregating together, talked about modified versions of going to a restaurant or going to a movie, modified versions of playing golf. It is not so much there are specific areas that are completely offlimits as it is playing paying close attention to principles of distancing even as we reopen and personal hygiene steps and the business cleaning and disinfection steps that are going to be important. With that, we need to be monitoring closely for whether businesses and people are following the guidelines. If they dont, that can create a higher risk of transmitting the virus. That will lead to a higher risk of