Gauging the response, what is working and what has done well. We made toefforts implement travel restrictions and limit travel from china clearly bought us some time. It slowed the rate of new cases coming into the country, i think the question becomes what we do with that time and we did some things well and some things not so well. I think we prepared the nation, we got the Health Care System prepared. We will educate providers. Learn more about the virus and how it spread and how you can combat it. One thing we didnt do that we should have was had in place broader screening. We should event omitted screening weeks ago and really a month ago or even more. To try detect small outbreaks early. We had problems rolling out a diagnostic test, we took a very linear approach in my view and depended upon one test promulgated by the centers for disease prevention rather than not it also working with academic labs together diagnostics. Then we had to scramble and so we are now just getting in place the kind of screening capacity this country that we probably shouldve had weeks ago. What that means is there cases in the United States probably they came in some point in midjanuary or maybe earlier than that from china probably that have been spreading. We probably have at this point certainly hundreds of cases that may be in the low thousands in certain regions. There will be certain hotspots in the country, this a pervasive spread. A country through had 30 million people, several thousand cases a soll of small number braided the risk is still low. But the challenge is now it spread in the country it will make it harder, not impossible, but harder to contain those outbreaks and also mitigate the continued spread. Host does that factor to the two deaths in Washington State, what does that suggest as far as concentration, possible concentration in the United States . Caller parts of guest parts of Washington State look like they could be a hotspot now. York,is a case in new given how much travel comes through new york city. I think you have cases where people are hospitalized, that suggests there a lot of people underneath those cases, but those are the ones that we will identify first, the patient they get tested first are the patients who have presented our right now in hospitals that are very sick with an undiagnosed form of pneumonia and now the doctors have the capacity of the coronavirus they will test those. The initial cases that we identified in this country will be skewed heavily towards more severe patients. Those anded back from Start Testing other people who might be mildly symptomatic, we will start to find more cases of more benign illness from coronavirus because we do know most people dont get very sick from coronavirus and a large percent, any meaningful symptoms at all is just a small percentage the development moan you in a small percentage that go on to have really severe illness and find themselves in intensive care. Ourt our guest host guest here to answer your questions on coronavirus. If you have a question, 2027488000 for democrats,epublicans 2027488001 independents 2027488002. At can also text us 2027488003. I want to play the Healthy Human secretaries secretary. I want you to listen to what he has to say and then respond to it. [video clip] we promulgated it out in the country. There was a third element to the initial because we do believe in quality testing here in the United States, there was a third element of the test that was specific to all coronavirus is. Some labs were unable to validate their own reporting on that. Cdc never had trouble with that. Had full throughput, no delays on testing there. Authorizedsday we over 40 laps to use the test results in the first two elements of that model of coronavirus. Yesterday morning we authorized homebrew test by certified Clinical Labs around the country. That, what isg to your response to that . Guest i will look forward before a look back. Looking forward by the end of this week we will have the capacity to test about 10,000 patients a day. Test,unning about 100 some have more capacity than that. By the end of next week if we can get online the academic labs because theyre not given regulatory flexibility. Medical centers to promulgate their own tests. If we get most of those labs online we should have potentially another 10,000 patients a day testing capacity. In two weeks time we could have capacity of test upwards of 20,000 patients a day. Thats a Pretty Healthy capacity. Thats assuming we can get the academic labs. Others will be quick and be able to get on to what we call their Automated System where they might be able to run hundreds of samples a day. It is the case that cdc has problems manufacturing a kit that could be used by other labs and Public Health labs. With the emergency use authorization and the laws put , saying as part of that cdc would go first. The first lap up and running would be cdc and they would thosep kits to advance two Public Health labs, state and local labs run by Public Health authorities and Start Testing for the pathogen as well. The reason we do that, one the reasons why we do that is because of access to samples. If you have a pathogen of significance like this virus or a pandemic flu strain, you want to handle that carefully. Cdc will be the first to have access to it and give samples to the lab. You want cdc in charge. Thats what happened here. The challenge was the kit they manufactured, cdc is in the manufacturer. They run a highcapacity lab that they dont routinely make kits, thus the work of manufacturers. They are in the business of manufacturing kits. So when cdc went to manufacture that they didnt have a problem with will be caller reagent. One of the components of that kit, hindsight being 2020 we could have done and what we should probably think about doing in the circumstance is cdc should go first, but simultaneous to that we should also be working the manufactures to a developed approved kits and we should be working with a high complex a labs, let them make diagnostic inside their lab. Thats what fda did last week. They announce this on saturday. They a High Complexity Lab at the medical centers can now make their own tests subject to their own specification. Dones what we could have three weeks ago, but that is hindsight. We need to learn from that going forward. The bottom line is we will have capacity but that also means there has been spread and we will start turning over that and start finding we have hundreds and the low thousands of cases in this country right now. To the contact trait and try to contain the spread where it can and mitigate it where it can. State, iWashington State, ia think we are approaching mitigation steps to control the spread. Host the lines for the segment, 2027488000 for those in the eastern and central time zones and if you live in the mountains pacific sign zones, 2027488001. Dr. Scott gottlieb joining us. Harry is in woodbridge, virginia. Youre on with our guest. Caller good morning. Is should we be buying masks in the second question is i was online to buy a mask to protect myself because im the only one because as i the house. Onlinewent to buy one but i saw the prices, a pack of 10 is costing over 100 to 200 on amazon or ebay. Like that costing for five dollars before. Should we be worried and what should we do about these prices are what should the companys be doing about these prices. Isst Hand Sanitizer as well filling out online. Prices have gone up. Its a board Public Officials tell people about what they can do to lower their individual risk. People are concerned, i think its appropriate people are concerned. The risk of contracting coronavirus right now unless youre in one of those really specific regions where it might be spreading like certain counties in Washington State or northern california, the risk is pretty low right now. Thats going to increase. Its going to increase over time. I think its important people understand to lower individual risk. Putting on a mask probably wont help that much. The biggest benefit is that a propensity prevents you from touching your face. We have exchange with coronavirus causing the common cold. Its from shaking hands, touching a dirty surface. Handwashing really becomes important. It sounds a some thing so simple it cant possibly work. Ive been fairly maniacal about using Hand Sanitizer, i impose that on my family as well. That can really reduce your risk. The coronavirus probably lives on surfaces like doorknobs for a couple of hours. On surfaces like cardboard its lasting a bit longer bread touching, shaking someones hand and then touching your face, those of the ways we are most likely to infect with this virus. Its not their droplet transmission prayed that is a risk, someone close to you talking very close, sneezes in your vicinity. It doesnt remain suspended in the air for a long amount of time. The most likely route of transmission is probably going to be picking it up and touching your face. Virginia, hampton, this is donna. Donna from hampton, hello . Caller good morning. Thank you for taking my call. I have a comment into question the doctor. Least five family members spread across the United States that are in the medical field. Saying the same thing you said. Wash your hands, its very important. Is youam concerned with never hear anything in this virus that it is affecting small children, it is affecting adults is rather odd. Thatone of these people believes Mainstream Media has made a bigger deal out of this. If you look back at the records of the regular flu, more people die every year from the regular flu. This is another virus. Basically the cold is a whole another virus. I think the panic has been caused by Mainstream Media. Host dr. Gottlieb. Guest i dont think this is another virus, i respectfully disagree the caller. This isnt the flu. China didnt shut down their entire economy because they were having a particularly bad flu season. They did it because they were confronted with a string of the virus that could be very deadly. We dont fully understand this virus yet but we have a lot of data now and looks at the case fatality rate for the number of people who died and develop the disease and coronavirus might be around 1 . , but bys not sound high proportion of other viruses it is extremely high. The flu by comparison is. 1 or last. When a bad flu season, one person will succumb to the flu for every 1002 attracted. It may be that one person succumbs to the coronavirus per 100 who contracted. The number of new infections you get expect individuals also is very high. , its on the 1. 5 or 1. 3 so for every person get the flu you will get on. 5 or 1. 3 who are infected prayed with coronavirus, we believe that that figure is at least two, most people agree its at least two and it could be as high as six based on some of the analyses but its probably higher than two. So it spreads efficiently and it can be very deadly. Now the thing about this virus is there is not a typical spectrum of disease. What i mean is with the flu, if you give 100 people the flu, they will all get pretty sick, therell be some people with milder symptoms and some of more severe symptoms. But it will be sort of a smooth amount of illness. Therell be some mild, some severe and a bunch in the middle. With this its a little bit more binary, there is people who develop very mild or moderate symptoms or are asymptomatic and there are some people who become really sick. About 80 of people have mild illness or maybe even virtually a symptomatic. Will develop0 some form of pneumonia with this. And so you are seeing these sharp, theres not a lot of whole lot of in between. But the one white buildings are in ammonia from this, there developing it in pretty sick of get forms in ammonia in many cases. The people who are immunocompromised or vulnerable for other reasons, maybe they are elderly or have diseases, that can be quite serious. Host the Vice President will address the coronavirus and the u. S. Response to it in 5 00 this afternoon. Cspan3see that live on. The president is expected and reportedly expected to meet with drugmakers today. As a the coronavirus former head of the fda, what should these conversations entail . Guest i think with respect to trying to get a therapeutic vaccine, we have slowly need to be putting a robust effort behind a therapeutic vaccine. Once ins knew when that a generation strain came along. Maybe thats something we we knew when we came along to be our savior in that setting and we will probably get the vaccine against this virus. That may be a year or two away. That could be focus on a therapeutic or something that can be used as a prophylactic to prevent people who are vulnerable getting the infection. Repeatedly on it a monthly basis and you can use Something Like that for Frontline Health care workers are people are uniquely vulnerable. We have the potential to have a therapeutic by the fall. Its exceedingly unlikely well have it by the fall. Need a shortterm strategy and longterm strategy i think the longterm strategy will be the drug on the shelf or in antibody therapeutic. Work withen some similar kinds of approaches. Thats a thing we can have. What could happen here is march, maybe april will be difficult months, we will see continued spread, the case numbers grow into the thousands in the United States. But then in july and august, section start to slow down. Thats infection slows down. Steps weart of the taking to mitigate spread and in part because coronavirus doesnt transfer as efficiently and summertime. Typically they dont transfer at all. They have no immune system against the might spread it in the summer. But in september as the fall starts it may come back and we need to be ready for it to come back. The best way to be ready is with a therapeutic. If remember, the first edification that was in april 15th of 20 2009 was the first case we identified. That spread an epidemic proportion well into june. It dissipated in the hottest month of the summer and then came back in the fall. But the difference then was we vaccinefirst vaccine from one health care workers. By october we had licensed five vaccines in by december we had mass inoculated the population. Delivering 100 million vaccines by december. And the vaccine effectively vanquished it. It still circulates and still hurts people but not to the proportion we once knew. Host two quick questions off of our social media feed. This one off of twitter saying the coronavirus has an inca bashan period of 14 days and more. Could coronavirus becoming into product and food coming into the United States . Guest it has an incubation period about 14 days. You see that kind of variability in the reporting. That is typically much shorter than that. Probably some the more i can do five to seven days. One of the unusual things here, a lot of people arent starting out very sick so the time to hospitalization some of the studies coming out of china is nine to 12 days. That means people got it, they had symptoms for weeks, they were not very sick and they became very sick and so the hospitalizations are occurring later in the course of the illness. As far as coming in from packaging, its extremely unlikely and it wouldnt be concerned concerned about that. Anything is possible but this shouldnt live on the services for extreme the long amounts of time. Studies theome coronavirus can live on a surface for up to nine days under really optimal conditions so if you put it on an ideal surface at an ideal humidity in ideal temperature, it can live for an extended period of time. That is not typical. These things the other thing is even if it lives on the surface, you have a very rapid decline in the amount of virus on that surface and you need a certain amount of virus to become infected. Even if it is still on trace amounts on the surface, if they are sufficiently low it wont be some of the can actually affect infect you. Host you are next, go ahead. Caller i have a comment into question my comment is i would like to know why the federal government has not stopped our travel from any country to and from who had this virus and i , youreke to know probably not found it out yet, but do we have carriers who have not developed the disease and maybe the people who have already had the disease may be can still spread this disease. I know another disease they found that they were carriers, they get a mild case in the become carriers and they dont really realize about themselves and they spread to other people. Have you considered this . Host we will let our guest respond. Guest we have people who were very sick from a virus and we know we have people who are very sick from the virus now and we had one fatality over the weekend. We have slowly have people who are not very sick with the virus and maybe a symptomatically spreading the virus. Because we know there is a spectrum of disease but we will identify first is people who present to the Health Care System, those people are typically people who have worst worst diseases. There was a study two weeks ago that looked at the amount of virus in peoples mouths and their nose and it looked at people across the spectrum of disease. Mildpeople who had very diseases and some people who were very sick. What they found was the amount in some people had was cases very equivalent whether they were very sick or they had mild disease and that is concerning because with that suggest is people who have very mild disease might have the same capacity as those who are very sick to actually spread the disease. In some other diseases what you will see is the amount of virus we have here and the amount of virus you can transfer comports with how sick you are in some cases. So people very sick would have more virus in their body and they would be able to spread more virus. Youhis case it does appear have a lot of virus youll be able to spread a lot without being very sick. As for the travel restrictions are concerned, they are going to have, they will very rapidly have diminishing utility because once this is spread