Respiratory pathogen pandemic. It was written in september last year at the request of the world health and the world bank in one a professorthors is of epidemiology and Environmental Health at Johns Hopkins university, also a senior scholar at the Johns Hopkins center for health security. Thanks very much for being with us. Thanks for have me, i appreciate it. What did you find out last september, and would it come through come to fruition in . May of this year . The purpose was to address the possibility of there being a pandemic caused by fastmoving respiratory virus. By a fastmoving respiratory virus. The idea was it could spread quickly and potentially affect multiple countries at once, and what should preparedness look like in that scenario was so many places are affected at the same time . The availability of resources would be limited and it would be every country for itself. What we found is we would probably have not a medical countermeasure like a drug or vaccine to combat the new virus like this, so we would have to rely on nonpharmaceutical intervention, social distancing. We looked into the supply chain issues and anticipated shortages and medical supplies and ppe. We consider the possibility that surveillance would be limited and it would be hard to know who was infected and who was not. Thelso considered possibility are Health Facilities would be overwhelmed because the surge would outpace the availability of resources and impact every Health System across the country. The situation we are in with covid19 resembles much of the findings of our report, which is unfortunate because we did send the warning in the fall. It is unfortunate we are now living up some of the lessons we identified. Differenceis the between an epidemic and a pandemic . Of scale. Is one sometimes people think it is severity. That is not true. We have had pandemics that are mild. In 2009, there was an influenza pandemic. As went as deadly initially feared it could be. Similarly is now affecting countries across the globe, 100 87 countries reporting covid19 cases. Withe 2009, we are dealing much more severe illnesses and greater number of deaths. Host are there lessons from sars or ebola they could be applied to covid19, or is this pandemic, this virus unique . Guest there are overlapping lessons. One is the need for sharing surveillance information between countries. Be utterly dependent on receiving information from other countries to know about this new virus and how to respond to it. That is absolutely something we saw during sars, and we are living through that now, but there are key differences. Some of it is scale relay. Ebola, we solved very deadly and inc in 2014, 2016, the democratic republic of congo that is still not fully over. Both in the west africa epidemic are014 and the drc, there International Resources were countries can pitch in to contain the spread of the disease. And you have a pandemic essentially every country affected at once, those resources are small compared to the need and have to be deluded over the globe. It puts pressure on National Governments to do all they can to take care of their people. Host we had two callers earlier. One question was how long does the virus live on a surface . We know it is an airborne respiratory illness spread among the public, but how long does it stay on a surface . Guest we dont typically think the virus is airborne in the wheenense, meaning facebook. Com\cspa when we talk about airborne, were talking about the particles being in there for some time. Most evidence suggests that viruses spread from droplets, so somebody singing, coughing, sneezing can put viral droplets into the environment and they fall within a sixfoot radius, which is why we talk about social distancing. Dont think that under normal circumstances that the virus hangs out for people to be exposed to or walk into clouds of fibrous or Something Like that. Depends onaces, it the environmental conditions. It is relatively shortlived, but it is important to wash hands after you touch surfaces or others have touched it, so it is always a good idea to wash her hands whether it is a pandemic or not, but it should depend on the surfaces and within temperamental conditions are. Host the second fear question in terms of social distancing, vitamin c, any impact reducing the risk of covid19 based on your research or experience . Guest there are some studies on going, but i have not seen one specifically about covid19 and vitamin c. Put this report out last september, and as you look back at what you produced and see where we are today, are youe big surprises witnessed . Guest a few things. , and forwhat we wrote those of us working in pandemic preparedness, there are certain anticipate one could about the Current Situation we are in from this report. If you ask me what are things the United States would have meuggled with, if you ask what the top struggles were going to be, i would have talked about the fragility of the supply chain, the need to potentially reduce the spread of infection through nonpharmaceutical intervention, i wouldve talked about the fragility of the health and this is true all over the globe the united here in heid states, we dont have a lot of extra capacity. The possibility of becoming overwhelmed is very much there. Those other things i would have guessed. Thatld not have guessed testing for covid19 would be as difficult as it has been, and that would have been one of our bottlenecks in response, particularly from a laboratorybased testing perspective. Of course we knew that having diagnostics that could be used at the bedside in clinical settings is always a challenge, but the early troubles with Laboratory Testing is not something i anticipated. Beenther surprise has just the role of National Government actions haveof the been handed down to the state in the private sector. I know businesses are stepping up to solve problems with the resources. We always knew the private sector would be important, but the degree to which we are relying on them, i would not say it is a full surprise, but exceeded my expectations. So i think just the general decentralized approach to managing this within the country has been somewhat surprising to me. Host one final point, we have seen spikes, especially Nursing Homes and facilities around the country, so how as a society do we better deal with this . Guest this is a really challenging situation. In of the great limitations the u. S. Response to covid19, many states, Nursing Homes have contributed outsized role in the overall deaths occurring, so it is really important that we take a more proactive approach preventing outbreaks in these facilities. It is hard to do this unless they have priority access to ppe for residents, staff, and prior priorityr tory testing, to make sure we catch any infection brought into the facility, maybe a staff member who may be feeling fine and not have any symptoms. When a staff member is infected like that and they dont know it, because of large numbers of People Living under one roof from the vulnerability of patients in the high degree of contacting these facilities, the infections can spread very quickly. It is not simply a case of being able to publish guidelines and hope they can survive. They need help in the active involvement of government to ensure they have the resources they need to protect residents and staff. Host looking at preparedness for a pandemic come of this report was released in september last year, three months before the first covid19 patient. She is a senior scholar at john hopkins and professor of epidemiology and Environmental Health at the hopkins cspans washington journal, live every day with news and policy issues that impact you. Morning, wednesday Reuters Supreme Court reporter on this weeks remote oral arguments. Then, the ceo of the National Association of free and Charitable Clinics on the impact of the covid19 pandemic on Free Health Care clinics in the u. 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I want to begin by expressing my gratitude to the more than 62,000 Service Members on the front lines in the fight against the coronavirus, including over