The university of Birmingham University of alabama at birmingham. About looking at the reopening that is happening in many states across the country. What are you looking for as possible early indications of spikes as States Reopen and the summer ensues, and fall begins . What we are all concerned about is the expansion of cases that happens over time. If we open up too soon, then it casese an increase in that we will see, and they will engage with us in a way that is in cases. Spikes what i am expecting to see over the next couple of weeks and months is that we are going to have a slow climb. I do not think we will see a spike. In alabama we have seen since we reopened at the beginning, we had about 180 cases a day, on average. 520 newne 1, we had cases a day. You can see that reopening probably was associated with an increase in cases, but we were also testing a lot more, so you can ask the question was it more testing or new cases . I think it was both. Host was there an inevitability about the rise in cases no matter when the reopening happened . Guest in my opinion, yes. It makes sense to me. What do we have . Hasave a virus that nobody seen before, and that means the majority of the population is susceptible. If they get exposed, they will get infected and they will not have natural immunity. Mitigation, the like we had with the stayathome orders and the shutdown at home, sheltering at home, then people are not intermingling and there is not much transmission. You relax that and people start coming back together and you will see cases. The question that still remains, one, does the summer time lead to a reduction of cases on its own, which has been seen with other corona viruses. It has been seen with seasonal flow. Why would that happen . Perhaps because people are spread out and are outside more and not in indoor locations much. I do not think the virus has changed, but maybe the way we interact with each other. Because we were sheltering at home, we release and go back to interacting, i think we will not see a decrease necessarily, but we might see a leveling off for a slow rise that will happen over the next several months. Then, the question is what happens in the fall . What we are all concerned about is that is when we might see a spike in cases. Host just a point of reference to our viewers and listeners for where things stand. Number ofs, total cases, nearly 1. 9 million. The deaths, 108,211. The worldwide cases are over 6 million. You are the director of Infectious Disease division at uab medical, what is your division focusing on in particular with covid19 . Guest just a small correction, i am a member of the division, a former director. What we are focused on is addressing the epidemic, not only here in birmingham, but engaging with our state Health Department and working statewide. What we would like to do is have widespread testing throughout our state. There are hotspots, like in most states where there seem to be more cases than in other areas. Weidentifying those hotspots can go in and do Contact Tracing, which means you find the person who is infected and put them under quarantine, and then you test the people they have been in close contact with over the last several days. What they do know, and this is important, the peak time of transmission from one person to another is in the 24 hour period before symptoms develop, that is very important, so the person feels fine, they are in a restaurant or at a sporting event, or out on the beach or somewhere, and they are around other people and they could be spreading the virus to other people even though they are not sick. They might get sick the next day. Having Contact Tracing at the point where these hotspots are, we are hoping that we will start to mitigate the epidemic in our local environment. Is there a way that case Contact Tracing can be done, not in a state like alabama, but broadly, as people travel, granted they will travel less. The people still will be traveling. Guest that is a good question. Gumshoe, workned, it out a case Contact Tracing as you interview the person and how you find those folks, there are technologies that can help us. There is some debate, that we can get into, where you use a cell phone, and with permission, the cell phone could have a program or app that identifies anyone within a six foot radius of that individual over the last two to three days and can identify those individuals, even if they have traveled. And then they could be tested. It is a little bit new and people are concerned about the privacy issues, in my opinion, if it is an opt in so you can say, i am concerned about this and i am ok with people monitoring my phone if others around me are likewise agreeing to that, then that could be eight an important tool. That could be an important tool. Sagg, we michael welcome you to the conversation. Forlines are 2027488000 the eastern and central time zones. Mountain and pacific, 2027488001. And, if you are a medical professional, 2027488002. We will get to calls momentarily. The cdc chief testified before a House Committee yesterday. Chief years, cdc message about the virus not resonating with the public. I want to play you some of the comments and get your thoughts. Here he is. [video clip] i think the first thing i would like to see is those individuals that partake in these peaceful protests, or have been out protesting, particularly if they are in metropolitan areas that have not controlled the outbreak to the extent we want, minneapolis happens to be one with significant transmission and d. C. Is another one. We want those individuals to consider being evaluated and getting tested, and obviously, going from there. Because i think there is a potential, unfortunately, for this to be a seeding event. The way to minimize that is to have each individual recognize the advantage to protect their loved ones and to say i need to go get tested. And, in 3, 5, or seven days get tested. [end video clip] raising concerns about the recent protests and the proximity of the protesters. What do you think we might see after these protests . Concern isink the very real that some of the protesters who are in close proximity with one another, marching, especially if they were not wearing a mask, could well have picked up the virus in that activity, but it is not restricted simply to the protesters. It is about the relaxation of all of the stayathome, and a lot of those locations. Going to a restaurant, and by definition you cannot eat with a mask on. Youre going to be in a closed area, oftentimes indoors, and talking, laughing, that type of thing. That is what is going to lead to transmission. Dr. Redfield is correct, there is a concern about the protesters coming together, i think we share that concern not for protesters, but for everyone. I think that is the message getting modeled. ,e are not hearing unfortunately, a consistent message about what people should do. Everyone sees the impact on the economy, it is profound. We may not be but seeing in our neighborhood someone who has covid. Wait a little while, and that will change because we are relaxing and getting back. Let me pause for a minute, you hear about masks a lot. And that, i think, is a key point. What we have learned about masks over the last couple of months is the following, i mentioned earlier that people are transmitting the virus 24 hours before they develop symptoms. What the mask does is it protects the people around you. If you have the infection, and you are wearing a mask, it will thek to a large degree amount of virus that is coming out into the environment around you, so that there is less likelihood of your friends, neighbors, and family picking it up if you happen to be infected. The image i like to use is going back to the peanuts cartoon, pigpen, the character with the cloud around him. If that is what it is like when someone has the infection and they are spreading it, the mask helps protect that. The punchline is, if you are wearing a mask, what you are communicating is i care about you, the people around me, because i will wear a mask and protect you from getting infected in case i have this. Host we have calls waiting. Let us go first to massachusetts and say good morning to barbara. Caller hello, good morning. A couple of weeks ago, a caller to this program raise the possibility of adding a prophylactic to knock down the virus in the back of the throat by doing deep throat gargling, and he did not suggest any particular thing to use, but i went onto the internet and i found a fascinating study, and if your team could write this down, it is the june 8, 2018 issue of Infectious Diseases throughapy pages 249 259. It was a group of german scientists who study the use of zpi, a 7 h called p gargle mouthwash, and it was an in in vitro, but it killed the virus at the level of 99. 99 . It i really would appreciate if you would look into this, because what was really fascinating was that these german scientists presented this conferenceapanese where this kind of mouthwash, iodine containing mouthwash, is apparently used as on a regular basis. Host im in a let you go, and have you heard about this . This i have not heard of specifically, but let us deconstruct this. What this is is an antiseptic. It could be iodine, but it could be any number of things including mouthwash is that have 70 alcohol. I could go into the lab and show roughly the same impact in vitro, so what does it mean . It means in the test tomb, not inside of a human or animal. And you can show that you can disable the virus and kill the virus in that setting. Thingsere are lots of that we come into contact with every day, just plain old every day mouthwash will work. Let us take a pause, does that mean it will not it will work , in my opinion, no. What that would be doing is perhaps sterilizing the back of the throat, or wherever this mouthwash can go. Heres the problem. The receptors that pick up this virus are throughout the entire respiratory tract, not just the back of the throat including the nose, the back of the nose, and trust me, i am not advising anyone to take any kind of solvent or put it in your nose. That would be dangerous. There is also down in the deep airways. They are called ace 2. They are where the virus bins. Binds. You might sterilize the back of the throat, but then the air that you are breathing in, and going back to pigpen, if you breathe in the air, some of it might get disinfected on the way down, but it will make it into the lungs and that is where a person will be infected. I encourage all of us to do this type of research in the labs and whatnot, that i caution against using any kind of solvent or material as a gargle with the hopes and vision that you will prevent the infection. I am sorry to give you the bad news, but i do not think it will work. Host donna in hampton, virginia. Good morning. Caller a couple of questions for you. You just talked about the masks, and it was all over the internet that the who said that masks do not help, so why are people still promoting it and governor still pushing it . It is ridiculous to me. I am 80 years old. I lived through the h1n1, and i after remember any issues the woodstock 600,000 young people were there. Shoulder to shoulder for days and days, did we ever hear of anything after that . No. Absolutely not. There were no illnesses, no mass outbreaks. On longhis has gone enough, and i think a lot of it is bogus. That the governors are telling you, you have to do this and that. It is more of a controlled virus than anything, and my aspect. For yourank you question, and i think the feelings that you just expressed is what a lot of people in the country are feeling right now. People are tired of this, they have been bombarded with information, and it is exhaustion at some point. And, heres the problem. As we just heard the numbers from Johns Hopkins at the top of the show, there is about 1000 people dying a day every day of this virus. We are now up to 108 or 109,000 people in our country who have died of this, and that is more than sleaze and seasonal flu and much more than h1n1, and it is not stopping. We have to do something to mitigate this, in my opinion. Let us go back to masks. What the who was saying that i have to look at the exact reference is that wearing a mask by itself does not exactly protect you. It might help some, but the real purpose of wearing a mask is to prevent transmission from a person who has the virus to somebody else. So, as i said earlier, when you wear a mask, what you are saying to your friends, neighbors, and family, i care about you, because if i have this virus, i am much less likely to spread it to you than if i was not wearing the mask. Thanks about it this way, when a surgeon goes into the operating room, they wear a mask. Do they do it to prevent the patient from transmitting something to them . No. They are wearing a mask to prevent themselves from infecting the patient with bacteria or whatever might be in their mouth or coming out of their breathing. It works. The same concept is true here. My opinion is that if we wore masks when we were out in public, we will protect our friends and neighbors from getting this and that will bring down the number of new cases, along with keeping social distance, six to eight feet apart and washing her hands frequently. Host i want to ask you about the retraction of two major reports on studies on covid19, and just to reset for our viewers, the reporting in the new york times, two major studies are retracted for faulty data. They produced astounding results and altered the course of research into the pandemic were retracted by renowned scientific journals because the authors could not verify the data on with on which the results depended. One study under clot undercut the claim that certain malarial drugs care covid19 including concluding that the medications were dangerous to patients. The other found that some blood trip pleasure drugs pressure drugs did not increase the risk. The studies were led by a professor of harvard and depended on Huge International databases of patient medical records birds experts that few had heard of. Life into thehe antimalarial drugs despite a lack of evidence. On wednesday, after the two aboutls noted concerns the studies, the World Health Organization announced that it would resume trials of the medications. Why do you think all of this happened with the studies and the retraction . Yout i am really glad asked that question, because one of the Silver Linings of this horrible cloud of coronavirus is that the public is getting to learn and look under the skirts a little bit of how science happens, because it is happening so fast and we are in this giant time of discovery, which is on one level exciting and another level confusing. This is what those two studies were about. We have Electronic Health records and are valuable for me, because i can get information quickly. Another potential benefit is that you can pull data and information on individual patients, strip the identity away, and just use the outcome. Heres the problem, those data are often times in error, and you say how could a patients medical record be an error. Maybe sometimes a data is entered wrong. Sometimes i diagnosis is put down but it is a rule out, meaning that the doctor thinks that they may have that, but it is ultimately proven incorrect and they failed to take diagnosis off of the problem list. So as the data gets transferred to these large centers, as in the case of these two studies, and people analyze them, and we are talking about tens of thousands of patient experiences, up to 96,000 in one of the studies. You think how could that be wrong, and wouldnt the numbers overwhelm any errors that might be there . And the problem is no. Larger numbers of data that are not pristine or well validated just give you a bigger answer that happens to be wrong. So, in the case of the hydroxychloroquine study is complete wearing comparing one peers one group of people who got it versus those who did not, and the people who did not get it did better. So, i think the problems are two fold. Data may having the not be accurate, i think that is why they retracted. The second thing is something called selection bias. What does that mean . The doctor saw the patient and thought this one is a little sicker than the other so i will give them the intervention. But the person who did not get it did not look as sick. , these why sometimes observational studies show that one intervention does not work as well as no intervention at all because of selection bias. The final point, that is why we need randomized studies that take everybody and randomly hydroxy or a to random placebo. Host we will go back to our collars. Rs. Georgia colle good morning. Regarding question is vitamin d. There have been some studies that show that vitamin d may help the immune system from getting coronavirus in extreme cases, severe cases. Of, i have seen low levels vitamin d among africanamericans tend to lead to severe cases. I am wondering, is vitamin d significant in terms of suppressing severe cases or not . Guest well, thank you. I think vitamin d is an important vitamin. It is what we all need, and there are a lot of people who have vitamin d deficiencies. However, there have been a lot of studies of trying to do replacement of vitamin d again to get the levels back up, it is hard to get the levels up, and i do not think vitamin d alone is going to be sufficient to improve an immune system response to either this virus or any other situation. One of the things we have to be careful of, and i want to put this caution out there, if you think your vitamin d levels are low, just to go to the store and buy a bunch of vitamin d intake it, there could be a downside in terms of calcium, and your calcium levels can go high if you overdo the vitamin d. So what do you do . Go to the provider and have them check your level. If it is low they can do replacement and monitor you. Holland, ohio. Good morning. The problem i have with all of this, and i just think we had the disease as last time, the swine, ebola, and i think there was another one when mr. Obama was in, no one shut crazy. D went out and i think people accept things when you and the people give it to them what can happen and what you should do to take care of yourself. And then it went with everybody should wear a mask. It is not true. Wearing a mask can be harmful to some people, and i feel it is a nasty thing to put on and breathed in, and touch it and do everything. A lot of people do not know how to carefully work with match. With masks. Most of them have it down trying to breathe anyway. That is not the real way, and another thing, as a constitutional people have choices. If you want to wear a mask, you wear one, it will protect you. If another person tries chooses not to do it, when god is set a number, we will leave, but we should be careful. That does not mean you play with your life. I do not like the idea of what you did and everything, i am not blaming the president , i am blaming everybody. This was said to be a panic. I believe and i do not want to put you down and say anything about anybody, but i believe this is man doing things. Use you want to lead us and us by using certain things and saying this is horrible, this is just a virus, and we will have them from here on out. Host you have studied Infectious Diseases for a number of years, she says this is just a virus. Is this like anything else that you have seen or studied . Guest no. It is a virus for sure, but nothing like i have ever seen before. A lot of us in school studied the hypothetical of a major pandemic, and we have never seen Something Like this. You mentioned ebola, for example. Minorwere pockets and epidemics. Major for the people it affected that it did not spread worldwide and it was not transmitted readily through the air from one person to another like this virus. We talked about influenza, someone mentioned the earlier epidemics of that. Andlso burned itself out, in terms of being able to be stopped. Within the community, and the reason for that is that enough had enough people had exposure to other influenza a viruses that allowed the immune system to knock it down. The problem here is that this is a virus never seen by humans before, meaning that everybody is acceptable. The first problem. The second problem is a bigger one, it is transmitted through the air. Infected, they start breathing and the virus goes into the environment. If they are talking, it goes further. If they are yelling, it goes further, or singing. There is a case and a study out of Washington State where there was a choir practice, and there were 50 to 60 people in a room for 2. 5 hours singing together. One of the people was infected. 52 people got infected. Two people died. So, the point is that this is a very contagious virus, that spread easily through the air, and can be fatal. Rightsar you about our to make our own choices, you are right, and you have a choice about whether you want to wear a mask and everything you pointed out is correct, it is not easy to wear a mask, it is hard. But that mask is not going to protect you as much at his will protect people around you as much as it will protect people around you. As i said, you can wear a mask, and if you do to me what you are communicating to the people around you is that i care about you, and i am wearing this mask because i do not know if i have the virus or not and i could be spreading it to other people including you so i will wear that out of respect. It does not mean you will have to do it. To me, that is what wearing a mask is about. Host you mentioned ebola and other viruses burning themselves out. Any indication that the Novel Coronavirus is burning itself out . Guest not yet, i hope it does. Let us explore that. How might it burn itself out . We have seen the other coronavirus, sars or mers did burn themselves out. We are not 100 sure how it happened. It tended to be in the hotter months like the summer, although the middle eastern violent virus uttered occurred in the middle east. I am not sure what mitigated that. We are hoping that happens with this. No evidence that it will happen yet. Your question at the top of the hour was what do we expect to see over the next several months . And, i expect it to stay flat, not as far as numbers, we will continue to see spread. I am worried about the fall when people start congregating inside. If we see a surge of cases, it will be a mess because it will not only be coronavirus, seasonal influenza will come in, and we will have a problem distinguishing between the two. Host question from minnesota. How you ask the doctor on many people over age 60 are asymptomatic . Guest i do not know the answer. The reason we do not know the answer just yet is number one we have not done nearly enough widespread surveillance testing because the tests are available, but they are being dedicated to the people who have symptoms because of the relative short supply. We are getting better, but we are not there yet. Hopefully, we will get Something Like that in the next couple of months. Host newport news, and welcome, myra. Hello there. Guest hello. Caller hello. The question of the mask, wearing a mask in public has almost seem to become a cultural issue. , i kind of understand what people feel like their liberties or rights are it goes back to maybe being in the home of the brave and the land of the free. It is it seems to go against of whatltural beliefs rights they have and do not have. I have been trying to figure out how do you breach that cultural belief. Beliefs arethat our to look out for the others, as i , and to ber myself concerned about the other people. For some, that does not seem to override the greed they feel against the degree they feel against wearing the mask. I think it would be, at this point in the summer, if we can. Help, fall, it will also wearing a mask with the flu, and with other contagious viruses out there, or even the common cold. I hope people will come to realize that we are all in this together, and if we can help one another, nothing is permanent, we just want to get through this maybe ail we can have vaccine, or some kind of antiviral medication that will help us, and i just pray that, as people think about this and make these decisions that we will all come together and Work Together in this. Host we appreciate that. Dr. Sagg . Guest i underscore all of your sentiments. I think we should celebrate our diversity, we are a diverse nation, and i think that makes us great. A lot of people have different opinions. In this setting because we are dealing with a very aggressive virus easily transmitted, i think we need to try and pull together. Unfortunately, and this is the part that has been frustrating for me personally, a lot of the science has become embroiled in politics, and people taking a side about one particular intervention and another, there isfor that. That is what i think is pulling as a part a little bit, some of our political thoughts are interfering to a degree, with how we are interpreting science and the facts. What i am trying to do is lay the facts out there as i see them from my perspective, as a scientist and clinician. That is what i think we need to do, focus on the facts and let the truth come through, and then people will decide if they want to wear a mask or not. What i am hoping, just like we came together for world war ii, we have to come together as you said to fight the virus because it is also a threat. It is an enemy, it is just a silent enemy in terms of it spread from persontoperson, and that is what the big threat is. The the caller mentioned mask and the return of flu season. I want to go back to the testimony yesterday and the reporting in the washington times. And experts say the dual threat of a coronavirus wave and a flu season could be bad to manage. Only 40 of americans avail themselves of the flu shot under ordinary circumstances so Everyone Needs to do their part before a covid19 antidote is available. He said this single act will save lives and we are hoping that the American Public will see that the flu vaccine is one major way they can help the nation get through this fall. Guest i could not agree more. More people that get the flu vaccine, the more chance we have for something called herd immunity. That people have immunity against the flu virus for this coming season, and if enough people have immunity against it, even if some to gets the flu, there is less people around them that they can affect and get sick to transmit the virus to others. More than 47 much of people getting the flu vaccine, then i think he is right. We have a much better chance of mitigating the flu this coming fall and into the winter. The other thing is, i sound like a broken record, but i think wearing a mask in that setting will decrease flu transmission to a degree, because it is spread to the respiratory route. Host let us hear from catherine from kansas. Thank you for waiting. Go ahead. Caller yes. Thank you for taking my question. And, your time. About five minutes ago you were talking about doing another study on the hydroxychloroquine and i heard you on three different occasions you said hydroxy urea, are they the same thing . Guest no, my mistake, thank you for calling that out. Is used in hiv, and that is where my background is. Hydroxychloroquine is what i meant to say, thank you for bringing that up. Hydroxychloroquine has been around for a long time, and it has been used in malaria. It was also used for a lot of lupus. With a number of people are on hydroxychloroquine. You have a lot of experience with it, do not know 100 yet if it does or does not work for sure against of the coronavirus. Thank you for pointing that out. It was a mistake on my part. Host do you think it is appropriate that people take it in a prophylactic manner in a preventative manner . Guest well, up until this past week, we did not know the answer to that. As of yesterday or the day before, a paper was published in new england journal of medicine in a randomized trial comparing hydroxychloroquine versus a placebo in terms of preventing acquisition of coronavirus and they saw that there was no statistical difference between the two. For this particular population, people at risk for acquiring coronavirus taking hydroxychloroquine did not prevent them from getting infected. Host steve in albuquerque. , i agree withgg your statement a while ago that this disease and the drugs are being politicized. In particular, i think the media came down on hydroxychloroquine because the president suggested itt he said that he used and suggested that it would be useful. My question is this. The media stated that people were dying everywhere from Heart Disease because of the drug, it is my understanding that it is a prescription drug, so consequently, some doctor somewhere had to think it was good in order to have patients using it. Secondly, for a patient sick ,nough just to take this drug the doctors would be overseeing it closely, and they would know of his cardiac problem, his or her cardiac problems and would not use it in that situation. What is your thinking on that . Guest i love your question, because it gets to the heart of two things. One, what is the natural side effect of hydroxychloroquine. One of the things that can do is interfere with the heart rhythm, and i can get into the technical reasons, a very small fraction of people will gets will be put at risk for arrhythmia, and abnormal heart rhythm that can be fatal. That was a heart problem that people were talking about. Complication, and perhaps was overblown. He was the problem. In the case of coronavirus, it does not matter if you are taking hydroxychloroquine or not, this virus is pretty evil. Once somebody gets the infection , this virus distributes throughout the entire body through the blood system and into organs like the heart, and kidney, or the brain get damaged. So, there are a lot of heart complications just from coronavirus itself, and there can be heart attacks or other types of heart problems, the heart not pumping efficiently, so, if someone is taking hydroxychloroquine on top of whatever the virus is doing, you will hear reports that this person was on hydroxychloroquine and had a heart problem. Where the two related, not necessarily. I think that is what has been blown up in the course of days. This is what is nice about this program that you are watching. We can go into the details a lot more than in a 32nd sound bite. That has that is what has happened. We need a comparative study, to look at hydroxychloroquine against a placebo blinded, where the patient and provider does not know what they are getting and see what happens. Did it work, and where there cardiac complications more in the hydroxychloroquine group than the parsley or stand a placebo. My opinion . We will not see a huge difference in the heart abnormalities. I think we will see it in both groups whether or not hydroxychloroquine works remains to be seen and that is an open question. Host question from paul in indianapolis who asks what is the effect of ace inhibitors on covid19 infections . Guest great question. If you remember to one of my earlier answers about the gargling, i said that they were something called ace 2 inhibitors, and there are different types. Ace1is an there is an and two. Has hypertensive drugs that work against it. There is unlikely to be protection solely from a high Blood Pressure drug. What is not known that by blocking the ace 1, doesnt have any impact on the expression of ace 2. Does taking a high blusher lead pressure drug increase the number of ace 2 receptors, or decrease the number making them potentially more or less susceptible to the virus. It is unknown. Right now, we do not have the answer, let us pull back to pull back real quick. This virus was not described until december 2019. We are four months into an epidemic. These questions are spot on, that there are no ways that we can have answers in that short amount of time. Host we americans expect packages overnight and food to be ready when we order it online these days, does it frustrate you a little bit as a doctor that we want results from medical studies as quickly as we want a package from amazon . Guest absolutely. And not only that, we have gotten used to the fact that if we have something wrong with us we can go to our provider and get some sort of remedy. It might just be physical therapy, but we are looking for something. I can tell you, i had covid back in march, and i tell you the hardest thing was sitting up at night not knowing if my symptoms were going to get worse and i would go to the hospital, and the most frightening thing was i knew that there was no treatment yet. And that is a scary thought, so yes, i wanted a treatment as much as anyone, and we have not had the time to develop it yet. We have been very much conditioned on immediate stuff, hit the remote control, change the channel, get amazon packages to us, get treatment, because of years of research that have been going on for most of our medical ailments. So, there just has not been enough time, and there is no substitution for time. Host what is your view on how soon a vaccine may be available . The trillions dollar question, almost literally. That will be a way out for us. Vaccine,e an effective let us go back to the influenza question in that vaccine. If we give enough people that vaccine, we change the game dramatically, because as i said, the reason this virus is so dangerous to us is that all of us have never seen this virus before, so we are all susceptible. If we get a vaccine networks, it will create the situation if we get a vaccine that works, it will create a situation where all of us will be protected. Our immune systems will be primed to fight, so even if we or immune system will knock it out. So, how soon and how quick . I do not know. We are seeing Vaccine Development at a speed that we have never seen before. Fauci was talking to dr. Not too long ago, and he told the story about how when the virus was first described out of china and they published on june 10 the actual sequence host january 10. Guest what did i say . When they published the sequence on january 10, the scientists at nih pulled out the key parts of the virus from its genetic candidateand created vaccines within two days after the sequence was published. That is amazing. Those have gone on, several of them, to create candidate vaccines and trials. The earliest in my opinion that we will see results from the studies, in my opinion, at the earliest would be the end of this year. Some people say earlier, we will see. Hopefully it is earlier. But, we do not know if it will work, and we do not know if it will be safe. And that is why we need large numbers of people to volunteer for the studies and see if the vaccine works. If it does, game changer. Host here is jerry, from fort river, new jersey. Caller hello. A large amount of europe is still using chloroquine. Africa 2ust sent million doses. The cdc stopped trials on the research. Why would they stop it . Has there ever been a research on the people who have been taking the hydroxychloroquine for years for all of their arthritic reasons . Do they still die from it . Do they get a milder case . When you were sick, did you take it . I am curious because i am a retired nurse, and i know for a fact that there are many of us in this field that are taking it prophylactically, so why would now, all of a sudden the cdc or who who stop doing trials. I am shocked that no one seems to think i was told that when the red blood cells and that the virus. Es with if you take hydroxychloroquine will, than the hydroxy attaches to that. Host we will get an answer, thank you for your call. Guest several questions. One, to my knowledge, studies have not been stopped. We are doing a study right now in our institution that is sponsored by the National Institute of health that is comparing hydroxychloroquine with another drug versus placebo, and that study is ongoing, and it is a randomized trial with a couple thousand patients. And we anxiously a rate await the results. There could be some others, but the ones i am familiar with have not been stopped, nor should they be. The second question is about people who are already on it, as you said who are taking it for lupus and etc. The answer is not fully known. There has been one brief report that suggested that they are not being protected against the coronavirus, but whether there is a degree of protection has not been teased out. That question is unknown. Your final question about me. In my particular situation, as i mentioned, this was the first part of march when i was sick. On the sixth day of my own this is when the french study came out, the 23 people, that is all, and showed that it worked. A hold of hydroxychloroquine and i took it for five days. Didnt help me, i do not know. I am here, i did not die. Perhaps it did, but i cannot tell you that i felt any better. Blood, maybe it did something. The final point is that the actual mechanism of how this drug might work is not known, but i do not think it is so much related to red blood cells. I think it has to do with the process of when the virus invades the actual respiratory cells through the inhibitor that i have mentioned five times now, i think. Thet goes into the cell, mechanism is that it disrupts the ability of the virus to infect, but that is not 100 proven. Host what was the first symptoms that you had and did you have to get hospitalized . Symptom there were several, and they were mild. That is the thing that is different between the flu and this illness. I first started feeling a little achy, i got what i called fuzzy thinking where i could not focus on my computer screen. I had head and body aches and a cough, but no fever. That went on for several days, five or six days, and then i thought it was gone and i was done. Day six is when the horror story started, and every night i would have fever chills, headaches, funny fuzzy thinking, worsening cough, my oxygen levels would be dropping not to critical, and that moment to moment wondering of this the moment where i will need to go to the hospital was part of the horror story. And then, it would be gone by the morning, and then come back each night like groundhog day. I never had to go to the hospital. Away, butays, it went it took another two to three weeks for the symptoms to clear. Host john in arcadia, wisconsin. Caller hello. Thest had a question about connection with the laboratory in wuhan. Are they still investigating that . And they have and how they found anything else about if something escape from the laboratory . Because it started there, right . The test that is done to find if you have covid19, i think it is called a pcr test. Has that been used for other viruses or influenza, that is it. Thank you. Guest thank you for the questions. Let us take the first question. Is a huge city. Outside of that city there has been, for a long time, a Research Laboratory that has done work on coronavirus as going back to the original sars epidemic in 2000 and early 2000s. There is a lot of Research Going on there, and the u. S. Had scientists working with them. There was and is a lot of research on coronavirus is going on for a long time. Or there were suspicions thoughts that, perhaps, a virus escape from the laboratory and went into the community, and that is how the epidemic started. Into thet looked records of the wuhan laboratory, but what i do know that looking at the genetic structure that i mentioned earlier that is being used for Vaccine Development, but it is clear looking at that virus and genetic structure that it was a Natural Evolution of another highly related bat coronavirus that just happened to mutate in a way that became infectious for humans where it was not before. Maybe, over time, we will learn something about the lab, but i do not think there is any evidence at this point that there was a plot to release a orus to release a virus that there was any evil doing, rather, i think there is a clear and plausible biologic explanation. This happens all the time in science and biology, where a virus inside of an animal mutates in a way that becomes infectious for humans. Hiv is like that. Let us segue to your second part about pcr. Time, used all of the since the mid1980s. In fact, the viral test for hiv is a pcr test. We can quantify how much virus is there. The test being used for coronavirus right now is a test that amplifies the virus and does not quantify it. Quantification is harder to do. We do not need to quantify right now, we are just looking to see if the virus is there. Pcr is used all the time. Host carlsbad, new mexico. This is carl. Multiple symptoms asthma, pneumonia, and bronchitis, and i have been treatment with ultraviolet light, and the doctor who is giving it to me said it could it does kill the virus. , howi want to know is effective is this . Ultravioletvirus with an infusion of bicarbonate and vitamin c. I want to know how effective it is because it is helping my asthma, the rest of it i do not know about. Guest i do not know either, to be honest. I think that, if he were to take a virus like we talked about earlier with iodine, if you take that virus in a laboratory and irradiated, you give it high amounts of ultraviolet light, you can inactivate the virus. Does that translate into terms of taking blood and irradiating it, and my guess would be no. Bloodot see how taking and using an antiviral of ultraviolet light would have any impact on what is going on in the long or respiratory lining. The lining of the lung is where the action is in terms of how this virus is getting into the body and what it is doing once the viruses there. I am not familiar with the approach or treatment, and i am very confident that that is not evaluated with coronavirus, and we are a long way away. I do not think that there is great because does plausibility. Host just a question from cory ,ill, pennsylvania coreville pennsylvania. Is dying with covid19 the same as dying from covid19 . Guest dying with something means that you have an illness, and this other thing is present, and it is not causal. It is present but did not cause the death. Dying from something means that you probably, old almost certainly would not have died but for that agent being present. In my opinion, in most cases, people who are dying with coronavirus present, they are dying from the coronavirus itself, and the damage that it is doing to the body. There are some that they might also happen to have coronavirus on board. Lets say somebody is in a car accident. The car accident led to the fatality, led to the death. Then you test and say, they also had coronavirus. Did coronavirus call the accident . Probably not. Almost all of the cases and i wont say all that i would say the vast majority of people who are dying and they have coronavirus, they are dying from coronavirus. Wards in my hospital, it is Crystal Clear that these people would not be in the hospital but for their illness with coronavirus. I would say the death tolls you are seeing are most definitely a result of somebody dying from the coronavirus or they would not have been in the hospital otherwise. Host a couple more calls. This is emily. Ashburn, virginia. Caller i wanted to thank you for your expertise and the clear and very respectful way in which you are both providing information and dispelling misinformation. Interview there was the issue brought up of possibly having an optin system where people could possibly be tracked. If theyo be tracked were around someone with coronavirus. My first question would be, what would need to happen for that to take place and who would be responsible for putting Something Like that in place . Second question would be, as it happens my husbands sister passed away, not from coronavirus. The state he traveled to is one of the states that has opened up ad is marching forward to greenlight state, even though their cases are rising. I was reading an article stating the people making those decisions, like, he lifted the names of people and what their alltion is and they are economic people and there is not a representation of science on that decisionmaking committee. So, my question is, what can be done about that . And just what your thoughts are. With thet me start second question, because that is something we havent talked about yet. That is how our decisions being made . From a scientific way, we should be waiting for the caseloads to incoming down and then phase the opening up and monitor carefully. I think what has happened in our country is, number one, i think most People Living here are tired of coronavirus. They are tired of thinking about it. They are tired of talking about. They felt the Economic Impact in a major way and it is profound either the number of people who have lost their jobs or been furloughed, the amount of income people are making the stock market is holding steady, i cant quite explain that. But people are tired of it. The elected officials are getting enormous pressure to ,eopen, because they see that yeah, there has been a decrease for the, but the cost economy is too much. So they are opening back up. I think the general public, by my read of peoples attitudes and talking to a lot of people is, it is boiling down to, im willing to take the risk. Im willing to take my chance on getting coronavirus. We are going to reopen. I think that is where we are. I dont think that is going to change. What i do think we can do and taken on, is, ourselves, regardless of what the policy is at the state level. Or in our local unity. We can be responsible. We can do the right thing for ourselves and our neighbors. We can avoid large crowds. We can wear a mask, as we talked about a lot. We can keep social distance. It means with what does that mean . It means at least six feet apart. That is the distance when we are talking, when we are yelling, virus is going to go out to about that distance. The further you are away the less likely, even if that person is not wearing a mask, that you are going to pick it up. Crowding together with no mask. All it takes is one person, especially if it is endorsed and you can get widespread throughout the community. Host dr. Michael saag. Thanks for joining us this hour. Washington journal continues