Louisiana and thats pretty darn close, that is a great first try at that. Great, admiral you the white house and lead developer of the hhs wire Public Health policy recommendation so i was hoping you could give us an overview of the Current Situation on the ground today. The situation on the ground with the pandemic, i think everyone understands that similar to where we were post memorial day, we had a significant increase in the number of cases, the hospitalizations are starting to go up as well and we do however, know how to defeat the pandemic to control it until we can get vaccines and youve heard this so many times before but physical distancing is important, wearing the mask when you cannot physically distant is really essential, the American People have done a good job, we do rank among the top in the world and mask wearing that weve got to get better as well as doing the good hand hygiene and with all of this we have to have a program of smart testing and im sure we will talk a lot about that, we do have the power to control we saw how we did in arizona, florida, texas across the sun belt but we ask really important point in this pandemic where cases are going up with his Community Spread, weve done a great job in certain aspects by protecting the elderly but if theres hi Community Spread to go be hard to do that, number one method today, those 3ws are incredibly important, where the masks when you cannot physically distant and avoid indoor crowds, wash the hands and please be tested when asked to be tested because about 75 of people, at least 50 and up to 75 of the people could be completely asymptomatic and the only way to know you have it is to get tested and prevent spreading by wearing a mask when you cannot physically distant. That is good to know as you noted were seen changes in terms of infections in fatalities, on friday the u. S. Recorded a record single day high of more than 83000 new cases and saturday was 39 cases short of the previous, is this a reflection of expanded testing or a false surge. Let me answer that in two different ways, i think were very comparable to what was going on in july and august so testing may be identifying some of the cases, i think thats clearly true but what were seen in is an increase in the numbers, back in march and april, we were only detecting one of every 15 cases you cant really compare to march and april and the surge and not only because the case numbers are up and we can calculate that but we know the hospitalizations, but to put into perspective there are many areas, several areas of the country where hospitals are becoming full and strapped but were still at 41000 people in the hospital compared to a high of 76000 in july, we really have a mixed picture but we really have to reengage the Public Health measures that we know that the hospitalizations can go up substantially, the good things that we know, a lot more younger people and its one reason the hospitalizations are shorter and we have effective therapy that we can apply against it, there is nothing that were going to do that is better than preventing infections in the first place and those of the Public Health measures that we talked about until we get a vaccine, vaccines are coming, we are very encouraged that there are open trials and preliminary data look good, this is awkward to be here tomorrow, make it the first vaccines out this year, we are hopeful and were hopeful they will be useful with screening in elderly protecting the elderly and most honorable, we can only have a few million in most of the benefit, the American People even if everything goes well, at least until mid 2021, we are to be very disciplined about our mask wearing, avoiding crowds particular around the holidays it doesnt have to be hundreds of people but Family Gathering of 20 or 25 or 30 still means we have to be careful about our interactions and hygiene in particular if theres people within our family. Admiral we have heard that the pandemic is putting a new strain, and a plan to get resources to these areas, there has been rationing care or they put in no need to ration care, were in a tremendous supply situation compared to march or april, im not going to say one hospital on one day does not have a certain type of ppe but we know almost every state has a 60 90 day storage of ppe within the state in addition to all that we have in the National Stockpile, we have 150,000 ventilators and the National Stockpile and we monitor drugs on a daily basis. The idea of ration is really not one that is close to reality, we have the resources to have care to all who need it and let me say in certain areas. He froze. We are working with Public Health service which i represe represent. I have you now, you can continue, well see if it keeps going. We had a little connection failure but hopefully your viewers heard that there is no idea of rationing care, we have the ppe in most states had a 60 to 90 day stockpile in 150,000 ventilators in the stockpile and only about 60 of hospitalization where we were in july, we have a lot of in the system but in certain areas we know the hospitals are getting high in wisconsin and physical resources but manpower resourc resources, we have plenty of resources and to absorb the care, as a pediatrician, i am always going to emphasize prevention although we have the resources, our best weapon is to wear a mask, physically distant and wash your hands to prevent those infections from going up, we dont want to get in a situation where were tax in the hospital system, it is to minimize and not see how many we can take care, again everybody has the power to prevent infections by doing the 3ws, where a mask and wash your han hands. Speaking of the 3ws or two of them wear a mask and was watr distance, there was another outbreak in the white house, five aids to Vice President pence have tested positive and white house chief of staff mark meadows said the administration had stopped trying to control the pandemic, we are not going to control the pandemic, we will control the fact that we get vaccines, therapeutics and other mitigation, despite emphasis on vaccine, there is little indication that we will have one until the middle of next year end you talk about that a bit, how do you reconcile the message that we are getting from the white house with what you and the task force or telling americans to do. Im not inside cheap meadows head, i think is being misconstrued, he did talk about controlling through mitigation through wearing a mask through all of the issues, i do believe thats what he meant but instead of trying to figure out what he met i want to be straight with the listeners we are not going to defeat the virus until we get a vaccine in the vaccine is distributed to the American People and we build up heard immunity inappropriate way by getting a vaccine to have immunity but there are things that we can do right now to control the spread, we done in arizona, florida, texas all across the deep south, those were the Public Health measures that are spoken repeatedly already in use all the white house last night that there was physical distancing and everyone had to wear a mask, that is very good we want everybody to channel that, in terms of vaccines, i think we need to clarify i think all of us understand that most americans will not get there vaccines until 2021 it could be hundreds of aliens of people to vaccinate and depending on the vaccine most likely two doses, we are very helpful that we will have millions of doses within the year 2020, it wont be before it has to be proven safe and we are hopeful we will get a read on that but even though those doses that can be available, we can get 50 70 of the benefits in terms of mortality if for example and the vaccine being highly effective in all the result in having an immune response, even if we can immunize our healthcare workers, are vulnerable individuals we might be able to save 80 of the lives just by millions of doses. A lot of this is nuance, yes 300 million americans probably wont get immunize till next year but we could immunize the most critical ones this year assuming the trial continues positively, no we cannot absolutely defeat the virus until we have a vaccine but we can control the spread and flattened the curb and stabilize, everybody can do th that, you dont need to be a scientist or vaccine expert, you need to wear a mask, remind people around you to wear a mask, physically distant, avoiding indoor crowded spaces and even up into the holidays and not a party pooper, having 20 or 30 or 40 people at your house for thanksgiving without appropriate precaution is being careful, that could be a recipe for spread im not saying throw grandma in the cold and not bring urine but be very careful about your hygiene handwashing, physically distant if you can particular those who are very vulnerable, that will save lives and save your family. Speaking of the need to be very careful as you recall we closed bars and restaurants and other businesses earlier this year when we saw numbers that are pretty comparable to what were beginning to see again do you believe we need to go back to that and ramp up coronavirus restrictions. We saw in arizona and texas and florida in the sunbelt in the deep south, if people are very discipline and what i mean by discipline, we have mask swearing, that is 85 90 when you cant physically distant and if he cant limit bars or Indoor Dining to a certain extent, then you have search testing, particularly those that can be spreading, that is the theme of shutting on the economy, however, if we dont do those things lawmakers are going to get pressed against the wall with those measures that none of us want because when you do shut things down people dont get cancer screenings, children or go to school, they dont learn, people have emotional issues and Mental Health issues in the misuse goes up, there is a whole chain of effects that occur with the shutdown in these have to be weighed because the real, the bottom line that we have high neckwear, if we do limit the indoor crowded spaces like bars and indoor crowded restaurant and we have appropriate testing, we will have to do those measures and if we dont changes around lawmakers will feel compelled that her last result there will be a great physical and emotional harm done by that but if its a last resort, its a last resort, were not there yet and if we continue to spread the message about what you can do to stop this what we done in many localities before, thats where we want to be, we dont want to be anywhere else, we can flatten the curb, slow the spread, save lives by doing a simple Public Health measure until we can defeat the virus by widespread vaccination, that is the plan that we need to stick to and avoid the measures as possible, thats going to be on a city by city basis, statebystate basis because its very different in new york and massachusetts than it is from wisconsin or el paso, every community is different and every community has different risk factors, different social vulnerability, its very compl complex. The last part takes into question from one of our audience members charles from minnesota wanted to know what we require National Social distance on the indoor mask mandate. I i have not been elected in the office is not my decision about which way to go, i can say it is been the policy of the administration this far to respect the local authorities in this regard, i think theres a good argument to say that the federal government mandated something, number one it could never be enforceable and number two it might create adverse behavior in different behaviors that we want to do, its been the policy of the administration to respect with the state and local want to do, i can tell you from a Public Health point of view that we need to increase neckwear, theres no question we need to do that that is essential to flatten the curve and we need to avoid indoor crowded spaces, how that needs to get done is on a community by community basis, some communities may choose to mandate that, we support that, other communities may say we need educational campaigns because mandating it would give us the opposite behavior that we want because some people are like that and we see the all over europe where theres protest against the mandate and were getting opposite behavior, this is been stressful for everyone, weve been under incredible strain in this pandemic and weve been at this hold the whole time since january and the American People are under strain and i do believe from a Public Health standpoint, Public Health has always been a local measure where people in the Community Work with the community, i tell you what needs to happen, we have 85 people wearing mass, we will find out how that gets done we support the local community and the education and working with children and doing something with the elderly but were telling you what the in results have to be, the best way to get there we believe is the local mayor, county judges and governors. I would like to go to another question from the audience member, victoria from michigan wants to know, with the administration and endless others disregarding basic pandemic safe behavior and incidents resurgence, virus death containment is utterly impossible, the compliance of the cdc guidelines for the rest of us actually make a difference and how. Thank you so much for asking the question, i really appreciate that that gets at the heart of the matter none of us are 100 admission that the data is very clear and they are symptomatic and can virus and something simple like wearing a mask greatly reduces transmission from one person to the next person, we have seen this whether you want to look at the microlevel, like the hairdressers who took care of 129 clients, two of them while they were sick with coronavirus in both of the clients were a mask and what you saw was no transmission, we saw in arizona where the simple measures do make a difference, we see time and time again even summer camps where masks are required, the transmission was minimal, we see a Day Care Centers across rhode island and many other places the transmission is absolutely minimal when we do the Public Health measures, i want to assure the American People that we have to keep her guard up, this is a great weapon against the pandemic, you can save a life in multiple lives if you infect one person, that can affect two people, they really do work and avoid crowds when you can come if youre an area where there spreading, dont have the crowded indoor spaces, there is nothing magical about a bar except that its crowded, indoor are drinking and dont have masks on and if the other house party with hundred people itll be the same different, it does not matter whether crowded or indoor space, make good choices, outdoors versus indoors, smaller gathering versus larger gathering, good ventilation when you can, always wear a mask when he cant physically distant, these things matter, i forget your name but im happy that you asked that question but we gotta keep this up we only have a few more months to go, that few more months could be a difference between 100,000 more people dying and not having that until we get a vaccine, we have the power to do it and keep her guard up. I want to talk about a project you are working on that is really interesting youre helping to coordinate a new Pilot Testing program and for select cities and rhode island with guidance from john hopkins and the center, we are going to get into the finer details of the protocol in the next segment but i was hoping you would explain how the federal government is involved with providing pointofcare of rapid test for americans. Sure, we announced a few weeks ago we would provide 150 million pointofcare on the simple test, its very easy and result in 15 minutes, no need for an instrument we shipped 36 million to the vulnerable in Nursing Homes, assisted living historically black colleges and universities and two thirds of those over 25,000,002 states that they can used to reopen their schools and keep them open and support other critical infrastructure, this is actually happening now, integrate Technology Emphasis dictated technology and only five with the result in five minutes, what were doing on the Pilot Program were very excited the federal government does not work in a vacuum and hopefully everyone understands it, the way it works is by working with the private sector of the academic sector the Nonprofit Sector and the Rockefeller Foundation has been a great partner as well as duke and other universities, we Work Together and talk to each other we have forms together in the rockefeller and duke have been very involved in helping School Districts try to develop plans to reopen schools as we talked about before when children are not in school they have severe and irreversible deficits in their emotional intellectual home at the very critical time, child abuse does not get reported, and hearing screenings, getting kids in school is very important, rockefeller and duke have been supporting that, so we partnered with them to provide them i believe the number to start with is about 120,000 of the by next test, they will be using in multiple School Districts, we know theyre going to be in los angeles, louisville, new orlea orleans, tulsa and rhode island and there is another major School District that we get analysis week that we can talk about but were supplying the actual test to rockefeller and to duke to distribute the School System into test different practices, weve never been in a pandemic like this in modern times were bringing children back to school, a number of possible ways to use the test they could certainly be used for symptomatic children and contact on the spot, they can be used to test teachers every week or twice a week and they can be used for screening and we really want to support the academic and the Nonprofit Sector who are working directly with the School Districts to understand how to utilize, we dont have time to wait six months thats why were distributing and testing them at the same time we know the test performance work very well and how does that utilize, thats what were doing with the rockefeller and with the School Districts around the country who have very interesting pioneering thoughts and we want to make sure that we can share best practices around the country, that is what this is about, the federal government working together with the Nonprofit Sector like rockefeller in the academic like duke in her School Districts working together the way its meant to be were on the same team to get the same results. Thank you so much for sharing we will keep her eyes open for that but im afraid thats all the time that we have left for this segment, thank you so much for joining us. I really appreciate the opportunity, we want to reach the American People and remember the messages, we can do a lot to control the pandemic and im happy to be on anytime you want me, thanks for the Great Questions and the viewers for the Great Questions. Thank you again, well be right back with senior scholar from John Hopkins Center for Health Security and founding director of the center for Health Policy at Duke University doctor mark, stick with us. Hello i am from the american university, we are talking today why safely reopening schools is a National Priority to prevent further spread of covid19 and how we get there, i am thrilled to be joined by the president of the Rockefeller Foundation which is leading these Pilot Testing protocols for k 12 schools in four cities and one state across the country that has the potential to inform decisions right now on widespread testing, it is great to have you. Thank you its great to be with you. To send her kids back to school is one of the most controversial debate of reopening the country, right now most of the schoolchildren havent returned to classrooms is fall, we see the strain its putting on families and employers and most important leave the kids and all parents want to know if its safe to send their kids back to school especially with the new surges. Im a parent of three kids in elementary, middle and high school and i can tell you that weve looked carefully as an institution rockefeller has around the world and as theyve done in much of europe and much of asia as they continue to do an parts of africa, school should be opened in america through k12 education, you said is it safe for everybody today, the answer unfortunately is probably not, the reality schools that are better resourced, private schools and some Public Schools that just have the Financial Resources in the Community Support to put in place a practices that work to keep kids, faculty and staff safe are able to be open thats why we see across the Nation Private schools largely open in some form and in some states using very large numbers of Public Schools open in some fo form, the reality, we know what to do to keep schools open and its a matter of making the investment putting the policy in place and making sure education in this country is not just a privilege for those who can spend 30 40000 a year for private education but frankly every single american as its supposed to be. You and rockefeller has been clear that its a domino effect when you open up a school then youre helping with the employers in the childcare because school is the heart of the community. That is right schools are the heart of the community and critical for the education of our kids in the next generation and frankly schools are important to get the economy going because you need those parents to be freed up to participate in the work whether its virtual and online and if they are essential workers out and about in the broader economy and the reality is covid19 is going to be with us for many, many months still, maybe longer and we have to figure out how to manage through it, when i say schools can be open, thats a judgment based on real data we know from looking at 1100 schools in the Brown UniversitySchool Database that the prevalence of coronavirus showing up in schools in america is roughly one case per 1000 kids for every two weeks the school is open, if you put in place a practices that he just mentioned work, mostly wearing mass, staying socially distant and having plexiglas dividers and air filtration, you should be able to run the classroom in a different way obviously, you should be able to run the classroom safely for the students and the teachers when the background transmission rate in schools is not low and that is something rockefeller has committed to doing with Public Schools around the nation in partnership with the department of health and Human Services and i believe if the data from the early examples comes back successful as we hoped when expected in america should commit itself to making sure every american child more or less gets a chance to go to school next semester. Neil i want to talk about the recent report you have on widespread cave 12 opening schools, the upside of this report is testing this key the approach that is priority for rockefeller and when you look at countries like new zealand, south korea, germany, they were able to keep their economy in schools open because of the very strong widespread Rapid Testing plan but when it comes to schools, we know affordable testing is a challenge, how can you make it easier for schools to do the testing so they can reopen . First, you are absolutely right, testing is only way out if we are going to reopen schools next semester beyond the mask wearing and social distancing i just described, youre also right to point out the nations that have done this successfully have made last result testing free and accessible to all of their people, america has not been one of those nations, we applaud the actions that he spoke has taken in terms of acquiring 150 million of the rapid antigen test that can be deployed quickly and get your result in 15 minutes and cost 5 a test, if we had enough volume of that and if we had clean protocols for the center for Disease Control on house rules should use those test to screen their population on a regular basis, we could get about the business of opening school, the center has published such protocols after doing very careful analysis with experts around the nation and the answers of course are very depending on the community or in in the rate of the transmission, adding testing to the basic strategy of social distancing and mask wearing should enable schools in america to open for nearly every kid, as a nation we should make that commitment to our next generation and to ourselves right now and thats going to take some bold leadership right away. Were going to hear from the report after this discussion i want to branch out the idea of data, i know you are a data geek and i am a little bit too, schools are at the heart of the community as we said you are testing students then teachers and School Ministry dues and that data is a really good indicator of what is happened on a globalized level, how did data inform the larger decisions, how do you scale that added National Global level and how do you get that data, i feel if data is a great indicator of government and managing the health and safety of their people you know they dont always want to share it, how do you get the data by convincing government is a public good. I think theres a question of opening data accessible but also the extremely practical reality that the only way you be back a pandemic is by taking people who are contagious out of the chain of contagion, its a simple concept and in america we know 50 60 of the spread is largely coming from people with symptoms and 40 50 is coming from people without symptoms, if you are going to find people without symptoms who could be spreaders and take them out of the chain of transmission to keep schools safe, you need fast Rapid Testing for everybody, symptoms are not so you are able to find those people who are potential spreaders and ask them to stay home and stay quarantine and get a confirmatory diagnostic test, that strategy of broad screening testing or surveillance testing for people who are both symptomatic and to really need it and for those who are not showing symptoms but want to go to school for example is something we should put in place across americas k12 educational system very broadly. To do that it takes more than protocols in the process has been fantastic because there protocols are the only ones out there and as mentioned previously we will test the protocols and six public School Districts around the nation to make sure we have data, demonstrated work and to optimize them, we also need actual federal reimbursement, 5 a test might not sound like a lot but the reality if you testing everyone in the School Community including faculty and staff and kids on a twice a week basis or once a week basis, when you added to all the cost of installing plexiglass and putting in place social distancing on campus, most american schools dont have those resources, the public funding for that effort is necessary and especially paying for testing so that the schools themselves do not have to bear that burden, that is something that weve called for and its absolutely necessary and an urgent matter. Yesterday rockefeller announced 1 billion commitment to deliver an equitable and sustainable recovery, talk to me about the urgency on the equity piece whether on the medical front or economic front and where the focus of the investment is, im sure youve seen even the bill and melinda gaetz Foundation Point out 25 years of progress in terms of building up lowincome vulnerable population has been less than 25 weeks and thats really startling. It is startling and we looked carefully at most major shocks and recoveries whether the Great Depression or world war ii or the Global Financial price under crisis much more recently and we see a similar trajectory which is when the world recovers slowly, people who are poor and vulnerable are paid the highest price by far. Today on a global basis the World Bank Estimates that 425 Million People will be pushed back under an expanded definition of the poverty line around the world as a result of the covid19 economic crisis, we know in america, 19 is extraordinarily inequitable, black americans are three to 125 times were hospitalized then one in 1000 black americans has died from covid19, we said to ourselves rockefeller that there was 107yearold institution i had nothing to do is before my time but twice been awarded the nobel prize for significant advances in science and innovation to fight inequity and make the world more just and we said this is that moment, this time matters right now and we went to the Capital Market in ways that resources enable to commit yesterday 1 billion supporting a truly equitable recovery, what that means more resources to expand testing and tracing and develop better test and improve the science of how to apply in americas k12 school, itll mean were able to invest in bringing green energy and solar power to the billion people on this planet that wake up every day and live in the dark without electricity and for a way to not pull themselves out of poverty into the modern economy, these are solvable problems in her greatest moments as a nation america has stood up and made Big Investments in the own infrastructure and a Marshall Plan to rebuild western europe after world war ii, we can do this if we do it together in our billion dollar pledge and commitment is an extraordinary effort for us but its small in the big picture if we want to work with others to make sure the recoveries equitable in its broadest sense. I have to encourage people to read the investment, think the piece about electricity and how that translates to available Internet Access for economies, if you are disconnected, i think thats going to be the definition of poverty and what holds people back to gay, i think were looking for silverlining after the pandemic caused so much destruction for the vulnerable and i think you make a good point there were at this point and its important to see at the moment and move forward in a much more equitable, i could go on for hours but now are going to hear from the authors of the report to hear about the new testing protocols, the president of Rockefeller Center foundation. So great to have you. Thank you, i am so glad mark and caitlin are speaking they have a lot to offer this country if we just listen to what they have to say. Absolutely welcome back if youre just joining us im eugene scott the political reporter for the fix of the Washington Post and joining me now are marked the founding director of the Mongolia Center for Health Policy at Duke University and caitlin rivers the senior scholar at John Hopkins Center for Health Security, it is great to have you both, welcome to Washington Post live. Thank you so much for having us. I was hoping you could talk to us through the report that you coauthor, the first of its time a Risk Assessment on testing guidance that can be adapted to reflect the risk of covid19 and the community, what is the basic framework . The basic framework sits in of what youve been talking about this excellent event for a multipronged strategy to get schools open, it is so important for the development of our children and its important for the Overall Economic recovery, testing is not the only component, it needs to go along with the other steps that have already been discussed like masks and face coverings and steps to mitigate the risk of spread in schools like dividers and better ventilation but along with that we think there is considerable evidence that testing can make a big difference, the other thing that is changing is the availability of test, we had significant shortages during the course of the summer especially the laboratory or pcr tests that are used for detecting infections in people who are symptomatic but there has been really important recent progress in making available much more widely the test that can be used at the point of care like the test that was referenced earlier, the federal government has started purchasing, we expect the supply of the test to keep increasing to the point that more americans can get the ongoing testing support as one component of staying safe in the important things that they need to do just like the mba in leagues have done just like the universities are starting to do if they have resources, it is really important now to get support out and the Rockefeller Foundation has advocated International Strategy supported by the federal government to make these supports for safe reopening available to many more public School Districts and other high risk settings and dont have the resources on their own, the report lays out, how were going to get there, how we will develop evidence quickly on which approaches to testing in collaboration with the other steps to enable a lot more progress on School Reopening that we have seen so far. Regarding School Reopening, doctor rivers can you talk about why preventing transmission and School Population is so important, we have seen that children are less likely been endorsed to require hospitalization but there certainly has been a rise in infection in some states recently. Thankfully children are at lower risk of severe illness then adults but low risk nonzero, it is possible for them to develop the infection and we dont know a lot about the longterm consequences in children, there is some reason to be concerned even though might not be as high as adult. Schools are not just places where children go, their workplaces for adults and children after they return from school go home as a family who may be vulnerable to infection it is important that we think about schools as ways to prevent transmission in the community at large we need to think about all the Vulnerable People in our communities and schools are connected to all those people, we need to be thoughtful about how we reopen and what tools we used to mitigate the risk of transmission. Going back to the report, for those who are not familiar with Public Health, why is this collaborative Risk Assessment so vital for tackling the Public Health crisis. Its important that the approaches that we take based on the best evidence and the best science that we have and what we did in this report under doctor rivers leadership and collaboration. In to review the evidence, is limited by Getting Better on how to minimize risk in School Settings and how to use testing as a key part of that approach and several times of consideration and one very important one as rod mentioned earlier, how prevalent is covid in the neighborhoods where the school staff and the students are coming from, thats a big determinant on how likely they will be an outbreak and how much testing you might want to do, we also look at the importance of the other mitigation measures like distancing in schools, the other resources that can go in along with testing, reducing the risk of spread and of course we want to Pay Attention to the quality of the test, the tester getting much better so we can think about doing largescale testing in schools and other at risk setting in the United States and challenging to reopen so far especially with as much covid in the community in many parts of the u. S. Now, its important to learn more how exactly the tester going to work and our report describes relying on some of the rapid inexpensive care test which are not perfect but when used regularly can help detect outbreaks early if there is a significant risk and they can be used in conjunction with test and to manage people who do test positive to get them out of the stream of transmission to confirm that there really are infections there, this is all part of an overall Risk Assessment and strategy for using testing effectively to reopen schools. I would like to bring in an audience question and hopefully doctor rivers you can answer this one it is from jb from washington, d. C. And he wants to know why we havent funded fast frequent asymptomatic testing for all at least for all schoolkids to guarantee School Reopening and its worked in the case of the mba. I completely agree with the sentiment that available testing can be an important strategy for making otherwise high risk settings and activities safe, the good news we will start to see more of the products, the market in the coming months, there is already a few tests available but more will be coming with high Production Volume so they will be available and they will be quite cheap to administer and i think were moving in that direction and the sooner we can better understand how best we can use these tests when they perform best, when it might be better to use a different test, those are the gaps in evidence and were hoping to fill in to realize the frequent testing to get people back into the community and back to engaging in school and other highpriority activities. When we look at the pilot cities that were chosen for your research they seem pretty diverse, there is tolleson, los angeles and new orleans, louisville and the state of rhode island more than one city obviously, can you give us ideas how these places were chosen. I will start and we can turn to doctor rivers as well, as you said we did choose to aim for some diversity and setting types of urban these areas are in the approaches the schools are taking in the strategies of support to reopening and there also districts the volunteer and thinking about how to use the rapid test in conjunction with the other strategies to reopen effectively in where the different schools are taking somewhat different approaches to get going for many of the School Districts, this is a step at a time process, not implementing a big city on district wide program everywhere right away, they are starting on a limited basis and expanding it out, some areas are testing how the new tests compare the ones that have been used more widely and they are not do nearly as fast and can be reported as easily, other School Districts are focusing on a couple of schools that want to try regular repeat testing on an ongoing basis to see how it goes and use that experience to help others learn as doctor rivers emphasized with more tests becoming available and the strong commitment from the Rockefeller Foundation to help those tests get schools, the partnership and the help and Human Services to provide the test, we hope that the pilots cannot only report useful results and experiences but can also help with providing good examples of how to expand these out, the Rockefeller Foundation is very committed to larger scale testing across multiple states, across multiple districts to make rapid progress as it can. To think any of these findings can be asked bookable like maybe businesses or face communities . I think thats a great question and they absolutely can, i think we are starting to see that like the mba and other sports leagues that have been implementing testing are getting good results in the more that we learned the more we can extend the findings to other settings. There are some tricky considerations that may require, Nursing Homes for example are higher risk settings because the people in the Nursing Homes are particular vulnerable to severe illness and you might want to take that into account in your designing a screening program, you might want to choose a more accurate test but once we start to grow the base of evidence we can explore the different and make sure getting the right test in the right setting and what were really designing a program to meet the objective to reopening and keeping people safe and healthy. What type of timeline are we looking at when we are trying to figure out how these findings can be. The pilot tester going on now and we hope as doctor riverside we will be able to provide early insight from their initial soon, obviously would take more time to do a careful Detailed Analysis but with more schools starting to use testing with experience from other settings like universities and sports leagues, many high schools that have already restarted their sports programs are doing regular testing in those settings now, i think you will see a steady stream of additional evidence, is it all going to be perfect and definitive right away, probably not, are we going to be able to get better based on the growing experience around the country and using testing to support School Reopening, i think so and i point back to the Rockefeller Foundation efforts to share these kinds of learnings, the foundation that is supporting a network of cities and growing network of state that are all coming together, they need to solve these problems to their own populations and since we havent worked out the details, the publicprivate collaboration is a very good way to accelerate progress, and to reports coming out of the foundation about these topics and to reports that many of the cities that are implementing these steps will be making regularly as part of their efforts to reopen and hopefully get ahead of the next semester after the end of the year holidays. I know different cities and states have various challenges when it comes to the pandemic but doctor rivers, do you think it is one particular priority that the federal government should focus on regarding safety reopening schools . I think there is two categories that i would emphasize the first is providing Technical Support its a technical topic to think about how to reopen these its something weve never done before and i think the more Technical Support that we can provide to schools and districts to see through the questions and identify strategies that will work in their context the bett better, the second big pillar is around funding, these interventions that we talk about with masks and testing and distancing require resources and those are coming at a time when they are facing severe budget crises as the economy is faltering in their sometimes not sending their children back to schools rather and so i think the federal government has an important goal to play in making sure schools have the money that they need to implement the mitigation measures and get children back in the classroom safely, those are the two big points that i see. I would love to hear from both of you, do you believe there should be a federal mandate for mask ring given how Much Research that we have showing how effective masks are in preventing the spread of coronavirus. Especially now with so much bread into many parts of the country and this is something that would help with getting more intention and having an impact on spread we have seen and states to implement mandates or local areas, counties, et cetera it does have a Significant Impact on spread and at least cases are surging right now listen be a good way to remind americans that there are steps when theyre interacting with others to help reduce the risk of spread, write a challenging time in the pandem pandemic, cases surging to the highest levels we seen in the u. S. , hospitalization going up in many parts of the country, death rates are increasing, this is a very challenging time if we had into winter, i think it is time for more support for mask use. I agree i think were seeing a serious resurgence throughout the country and we have strong evidence that masks help protect others but i think still substantial evidence, i think with that in mind there is no reason not to do as much as we can to promote mask ring within the community and i think that should include mandates but also include Community Engagement and making sure people really have the resources to implement this which might mean providing masks and making sure people have access to masks and talking to them about why its important and why we need to do it not just for ourselves but also for others. I appreciate you sharing your thoughts and taking time out to educate our viewers on your upcoming project which we will keep her eyes open for, thank you for coming. 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