Emergencies and crises that take place across the community. Number of people who serve in the same capacity . I think there is a great example of who is on the ground in this community, and it is replicated across the country. Even those places without confirmed cases are doing the same work, so from the basic answering questions, there is a ton of concern in the community, working with schools, deciding what others who are doing large gatherings, what are the what should they be doing and what shouldnt they be doing, working with health care, how to get people in line for testing. They are also monitoring folks who may have symptoms while they are waiting for their tests to get back, and they are tracking down who they are in contact with, making sure they are ok. Seeing if they need to be tested. Host what is the Public Health infrastructure looking like at this point . Publicpeople who are Health Professionals are dedicated to this work and they do spend time not just making sure they have the plans in place, the systems in place, that they do those exercises so that when something does happen and they need to activate, they can do that pretty quickly. At the same time, Health Departments are not wellfunded. They really have been hit hard in the 2008 recession and have not necessarily recovered from where they were, so there are fewer people in the Health Department that are able to work on a broad range of issues. They can be shifted to this response, and they have smaller budgets. The executive was saying, there is not just a bunch of money that they are waiting for these types of crises. With less, song we are trying to support them. Billion passed by congress, expected to be doned by the president , what you think about how that is doled out . Guest we were appreciate that we appreciate how congress is invested in this response. We know there were a lot of different numbers thrown out there, so we appreciate not just that they did it so quickly, but that it was so robust. At the samem, time, we appreciate there was different language for the states and localities for the response, and that is important. The money has to get out the door. That can take a lot of time, so we are hoping that those theific dollars targeted to localities can grease the wheels and get the money out the door quicker, rather than saying this has to go out in 30 days. Which is a really amazing thing for folks who are waiting for these dollars. But then the way funds trickle, they get to the state level and they also need to get to the local Health Departments. We are hoping that people can move to get to these to get these dollars out to the front lines. Host are the dollars automatically spent, or does the state have to be reimbursed by the government . Guest not clear about that. There is provision in the law that says for a response that has taken place from january 20 to today can be reimbursed. So it really looks like those dollars are for current and future activities, a large part of money, but that there is also a provision that says if you have been spending money until this point, we can reimburse you for that. Host our guest here is to talk response public at the state and local level. For the eastern and central time , 2027488000. When it comes to the medical what doesals, staffing look like . Is more staff brought in at this time . Guest it depends on the location. About a quarter of workforce has been lost since the 2008 recession, so that is fewer bodies in the building that you can pull from. Even if they are not working on Infectious Diseases. In certain areas, we know that they have started trying to hire new people to work on this. Some areas are calling in medical temps, for lack of a better term, to come in and work on the response. Some places are activating these their medical reserve corps, which is a group of people who have clinical background, some do not, but who can volunteer with operations in a Public Health response. Even things like making sure your phone list is uptodate so you can make sure you are reaching out to all the right people and helping to liaise with the education department. Host what does day to day look like . What is going on in these localities . Guest every day, the story changes and the story on the ground changes. Early in the response, a lot of it was getting lists from the state or federal government saying these are the people who came in from abroad that might need to be monitored, tracking those people down, making sure thermometers, places to stay, food, sending results into a nurse that is checking on them. In some areas where they have cases, they are doing contact tracing, so who have you been in touch with, reaching out to those people. A lot of links to testing as well as tons of Public Information and working with the other local Health Departments, local Department Like education, transportation, housing. Host the health and human spoke withretary local officials at this time. I want to play you what he said. The state and local Public Health departments are the leaders in this country on any type of response like this. We get our information from them, they are experts. We provide background support, we are surging to help them. We provide a lot of infrastructure. Are a trusted local source of authority in this space. We count on them. Members of the house, the senate, the public should count on local, state, and Public Health leaders also. He is right. K these are the folks on the front lines. These are also the trusted members of your community. You might see your local Health Official at the Grocery Store or the school play. They know not only health and Public Health but what is unique to your to where you live and what it means to be part of your community. They have this important lens to work. He also mentioned the import of federal support for local and state Health Departments, and that really is critical. Local budgets are tight. And Health Departments are just a part of that. So in order to really we have so many tools in Public Health, but in order to deploy them into communities across the country, on coronavirus or any Public Health issue, we need the resources and support to do that. Host do you get a sense of the communication between the federal government and the localities . What is the quality of the information being exchanged . Guest it is important that all information is maintained so that people are speaking with the same voice. There are numerous calls a day with different sectors of Public Health, and obviously there is a thegoing on coordinating at federal level, the federal response, and the state and local level. Always times is when people want more communication, when people say they have so many emails, let me just do my job. It is hard to strike the right balance, but for the whole sector of local, state, and federal Public Health. Host we start with south carolina. His is john for our guest you are up first. Hello. Caller good morning. Can you hear me all right . Hello . Host go ahead, we can hear you. I appreciate you letting me talk. Caller i appreciate you letting me talk. She doesnt know what shes saying. She says your local people are going to help you, whatever, but they dont even have testing kits. The federal government is saying if you think you are sick, call your doctor. What is your doctor going to do . Are telling you stay home. This is ridiculous. From what i understand, china is the only one that got any kind of antidote. And they are not giving it up. Host we will leave it there. The idea of testing kits lets start on that track. Guest that is a good point. You dont know what you dont know, and that is the key for testing. The federal government has sent out testing kits, to my knowledge, and this could have changed since yesterday, not every state i think six states are in progress, but every other state is able to test, and there are Public Health department, Public Health labs that can test. It is about volume. Getting the kids out there, getting the labs up and running, at the same time private Lab Companies are pulling together developing their own tests, which hopefully will be online soon. But testing is crippled. The more we test, the more cases we will find that is how we get the broad picture of where there are outbreaks and what we can do to protect ourselves. Host the caller made a point about not having a doctor. Where do you go if you are sick and suspicious . Is, it hasquestion been used for many decades, for hundreds of years around things like tuberculosis, and if you keep yourself away from folks who are sick, you have less of a chance of getting sick. If you are sick, try not to make other people sick. If you call and you say i have a bad stomach ache, they probably will say, that is not one of the symptoms of coronavirus. There are other places you can go. If you have a provider, this is where you can go. We can screen for what you may need to know to do depending on your symptoms. Localdoes the state or level have something to offer . Iesco the local health the park guest the local Health Department folks, whether they have the money in the bank at this point you go and respond. For testing, state, local, and Public Health harmon labs are covered, that is free. Country, there are different orders to Insurance Companies just yesterday, the Insurance Company lobby said they are going to make testing free as well if you have private insurance. Those are all in progress. If there is a recognition there is a recognition that we need to ensure we are not putting up any barriers to people getting tested. Host lets hear from charles in illinois. I get amy question is, flu shot every year as recommended. I am over 65. When the coronavirus is finally finally has a vaccine, will i be required to take two shots every year . And one, a comment for cspan. There is an official name for coronavirus and i keep hearing it verbally, and it is published by the world health organization. Would cspan please put that on the screen so we know how it is spelled . Thank you. Host i will let you take that part. Guest i will take the second part first. I think it is covid19, what you might be referring to peer there are lots of different ways area the reason they have special names for it is that coronavirus is are a type of virus. But therenovel one are others. Going back to vaccines. , thisu and coronavirus one and all are different. Flu shots are so important, it is really critical. That is one of the troubles right now, it is hitting during flu season. Do i have if any, and at the same time, just because everyone has symptoms, does not mean they have similar vaccines. I dont know what the vaccine protocol is going to look like. If dr. Felty from nih he is really leaving that work. He said it could take a year to 18 months before Something Like that is publicly available. And what they will figure out between now and then, looking at the vaccines but also as we look may be the virus is who recommended to get that vaccine. In order to keep themselves safe. Host from dallas, texas, hello. Caller good morning. Thank you very much, cspan. The question that i have for the canl Health Departments is they perhaps do a better job of communicating the local bigurces in the event of a covid19 breakout. That left what left an indelible mark on me was the fact that in china they built a hospital in a day because of all of the patients when i say local resources, im talking about, how many beds are available in a metropolitan area . How many ventilators do they have . How many isolation rooms do they have . And what provisions can be set up quickly in order to s in need . E patient guest i think you make some really great points. Always given occasion around these issues and it is important that they do so, and in a way that gets to communities, that it is not just that you send out one notice. Especially early in the virus, they were spending time and doources not only trying to public communications, but also translate into different languages come a making sure it was getting to different sectors. When it comes to Public Health come indication, there is always more we can be doing. That is an important point. When it comes to things like hospitals and what options are in the community, that will vary between all of them. That is the baseline Public Health preparedness, how it works. That departments are leading in their communities on a daily basis and we are building upon for this response. Is,of the important pieces while china builds a hospital in 10 days, what we want to do is get people out of the hospital unless they absolutely need to be there. It is not particularly the best idea to try to build our way out of this. What we need to do is use our Public Health tools, invest in the Public Health system to be able to say if yet if you have mild to moderate illness, stay home and do not transmit to anyone else. Much of the work right now is calming people in the localities . Guest they are doing a great job. It is easy to pick up the paper and see so many questions, seeing people in masks, ambulances, and be like, whats going to happen . Im a mom. And just for my daughters school, this is what were doing, this is how to keep kids safe. She is coming home and singing happy birthday when she is washing her hands now. She needs to sing it about four times. Those messages are coming in through schools. It is so important to help people understand what are your risks, how you protect yourself in the grand scheme of things, a lot of what you do are the same Public Health messages we are trying to get out there. People are just much more heightened in their attention right now. And then there are different messages being sent out there, so following your local Health Officials and what they are recommending is important. Christopher, in huntington beach, california. Good morning. Caller i have a question because i have a grandmother who has copd, stage iv cancer, and i have had to take her to get a cat scan yesterday. To the building and bought her a mask for i even took her in. But she has to get chemotherapy, and i am concerned that she could get it because she potentially is at high risk. I understand sometimes panic is what is actually going to happen, but i do get waythat this will worse before it gets better. So i am just trying to help her as much as i can. And when i leave the house, even i wear a mask because i believe it will get worse. Takeat the right way to her . Did i do the right thing . Or what is the best way to help her to get treated and not get the illness . Guest first of all, i think she is very lucky to have you. It is important that we take care of our family and neighbors. Clearly this is really scary, especially when youre caring for someone who does have so many underlying conditions in that risk. A couple things in response to what you said, talking to her health care providers, i am not a physician, and so understanding her risks in the general public, in chemo, that changes your immune system and what you are able to fight off, coronavirus or not. So talking about what is helpful and necessary there the cdc does not recommend masks for people who are healthy. First of all, they are not necessarily effective, and they have a lot of information about that for people who are healthy to prevent contracting anything. Really the social distancing, saying state an arm set up a length away from people. Anybody. Ake hands with doing an elbow and a hug is probably not helpful, but they are trying to make changes. Talking about her risks, but for your risks, they are not for theding that general populace. Host the governor declaring a state of emergency did something help did something happen on the Public Health . Isst yes, like a hurricane coming in four days but we are going to call an emergency now. What that does, even when the federal government says they will call a state of emergency, it just means that certain resources can be mobilized, other processes are automatically put in place. Is kind of times it heightening panic, but what that is doing is allowing you to be more nimble in your response. Host north carolina. You are on with our guest. And i i am 88 years old lived through diphtheria. When i was 14 i had diphtheria. Had a Single Person talk about fumigation. Why do they not fumigate homes where someone has this . I understood that when this came around, you had to fumigate. Thanks, mary. Guest thank you for your question and your comment. There is some really good barbecue in goldsboro. I had not heard anything about fumigation. As we learn more about the disease, people are saying keep your distance and that is the best way to keep yourself safe. But if there is anything that comes out of the cdc on that, they will share it. Angeles,m los california. David, hi there. this is really fascinating information and education, and it relates to how ordeal with pandemics National Medical emergencies. If this does not point up the necessity for medicare for all or national healthcare, i dont know what does. So we have this patchwork solution to something , it isally quite tragic only evidence that we need to start doing something on a National Medicare for all basis. That is my comment. Guest i think whatever our solutions are, ill Health System is messy. Healthove more to a oriented response, i think that will that messiness manifest