He served in the Obama White House and is the former new York City Health commissioner and currently president and c. E. O. Of an Organization Called resolve to save lives. Well talk about that in a moment. To begin, dr. Frieden, with the debate going on in states around the country. Your advice as they look to reopen their economies, many casebycase, gradual basis . Were all eager to get out as soon as possible. Go out too if we soon, we could have a resurgence cases,s, an explosion of which could overwhelm our Healthcare Facilities with the lives of Healthcare Workers and to having to go back in for a longer period of time so the challenge here really is to at six different factors. First is, is the virus coming down . Are we seeing fewer cases and least twohs for at weeks . Second, is our Healthcare System so that if there is another surge in cases, we can manage those cases, helping to survive and preventing Healthcare Workers from becoming infected. Third, is there a Public Health system ready to box in the virus. Boxitin the approach with testing, isolation, Contact Tracing and quarantine. The four corners of the box, if theyre right, you can control cases and clusters so they dont explode. Those are the three andacteristics of the virus our response to it but there are another three in society. Be ready tohave to shelter those who are medically vulnerable for longer. With people, people diabetes or serious lung disease or Heart Disease are going to longer stay in for because theyre very vulnerable to this. This component is a safer society. Its not going to be normal when back. Its going to be a new normal that may include, for example, no more handshakes indefinitely. Hand sanitizer at the entrance of every building before you go in. Ways to open doors and push Elevator Buttons without touching. Not going out if youre the least bit ill and if coronavirus is spreading in your community, wearing a mask to protect others and yourself. And six, recognizing we may have to go back to physical we may have to tighten the response again if cases begin to rise. Thats what we want to avoid and why its so important to have isolation, testing, Contact Tracing and quarantine. If we do those things, well be able to come out as soon and as safely as possible. Steve when you see plans in georgia and tennessee with plans earlypen the economy as as this friday, whats your reaction . Dr. Frieden it depends on the details. Have to look at whats happening with the virus in the community. If youre not seeing consistent its very risky. Its a risky experiment, its trial and error and thats the kind of error in loss ofresult life. But there are nuances. There are some approaches to that make a lot of sense. Package pickups at the stores rather than people going into a store where they might congregate. Bedoor spaces which will much safer than indoor spaces as long as you prevent crowding. Tough issues here. How do you get buses and subways going again, what do you do about Nursing Homes . March, groundarly zero for coronavirus in this country are Nursing Homes. There are 1. 5 Million People who live in Nursing Homes in the u. S. And you could see 100,000 or more of those individuals die in the coming months or Year Coronavirus infection if we dont get better at detecting. Steve and the c. D. C. Is based in atlanta. I mention that because your successor, dr. Robert redfield, today, in a story this morning in the washington post, that there is a possibility that the on our of the virus nation, his words, next winter, will be more difficult than what through right now. We know is, what that in most of the United States, its really been a small public who have haveinfected and we dont any Natural Immunity to this virus so if the virus doesnt the better and not harm us as much and if we dont develop a vaccine which is the next year, then were going to have to live with this virus and figure out how to control it as well as we can. We dont know what the future will hold. We learn more about this virus all the time but i want to the bad you a sense of just how things are here in new york city. I was born in this city. Training hereal at the height of the aids epidemic. Health degreec here, my medical residency here. I was at the Health DepartmentEpidemic Intelligence Service officer for the c. D. C. Programthe tuberculosis here and was Health Minister here for 18 years. I spent a lot of time in this city and ive never seen anything like this. No one alive has seen anything like this. Disaster this big was the 19181919 flu pandemic. Pandemic, 6. 7 million new yorkers, there were a over two30,000 deaths flu seasons and in less than two months there have been more than 15,000 deaths from covid19. All day and all night we hear going, ambulance sirens. Thats how were all going to remember this. The c. D. C. U. S. , identified more than 10,000 infected Healthcare Workers in two months and many probablyo were infected and not diagnosed so this is a really, really serious pandemic and anyone who underestimates it runs the risk fatal error. Steve your website, resolve to save lives, you mentioned this but i want to ask you about the practicality of the four steps to box it in. The website that you want to first make sure there able to test who has virus and then you want to isolate those individuals. And howou isolate them do you quarantine them . Meansieden isolation either in the home or in a cant beor if someone safely cared for in their home, are places around the u. S. Getting hotels or other facilities where people who are dont need hospitalization can be cared for. Usedher countries theyve some mass forms of care. It has to be appealing. Think it absolutely has to be voluntary. But if youre living with your a smallold mother in apartment, theres a very high risk that she could get the it so youand die from want to be offered the opportunity to relocate until no longer infectious. You also need to go through the process of Contact Tracing. A tried and true Public Health process. It happens every day all year the country. Und but its going to have to happen at much higher rates now to help control covid19. Its a process from getting to know a patient, talking with and walking them through hour by hour what happened, and who theyre went, had exposed, so those be warned they may be getting the infection and they need to quarantine stay separate from others so that if they do become infected, they dont spread it to others. How you stop the chain of transmission. I make an analogy to a hurricane warning. You expect the government and society to warn you if a hurricane is coming so you can yourct yourself and family. In the same way, if youve been yoused to covid19 and might develop the infection yourself and spread it, you need to be warned so that you can take steps to protect yourself and your family. Tove the website is resolve save lives. The president and c. E. O. Of that dr. Tom frieden joining us from brooklyn, new york. Lets get to your phone calls. California. Heim, good evening. Caller dr. Frieden, we have a of test kits in this country and the problem i see is that basically the world has had a test kit out there thats available. If were going to reopen up the why cant we get some of these test kits to some these governors and mayors in their state and use those on the testelying kits still under development . Thank you very much for your time. Steve thank you for the question. Dr. Frieden thats a great question. All the focus of attention is on testing. Be clear, theres testing for the virus and theres testing for antibodies its importantd to take those separately. The Antibody Testing is still under development. Kits one a lot of test the market. Some dont work well. We still dont know what it antibodies,e whether that will give you fornity or not and if so, how long. So focus on the testing for the p. C. R. ,hats called chain reaction, tiny fragments virus that are present and that test production is very problematic. Time and itsg not just a kit. Its the swabs to collect the and the liquid to transport the test in and chemical reagent that is you run the as the test well kits themselves and the equipment to run it with. In testen an increase kit availability around the u. S. Itsthe past few weeks but still very far from where it needs to be and let me make one clear. The c. D. C. Stumbled early on. There was a problem with their with themnd a problem addressing that problem and letting it be used when it was much needed in february. But the c. D. C. Test kit has been working fine for a couple of months now. Is that hospital laboratories and commercial laboratories need to ramp up the of tests and the federal government must coordinate that. Just take a bigpicture 30,000feet look, were doing between 120,000 and 150,000 tests a day in the u. S. Sounds like a lot but if you work out the highest priority anyps, anyone hospitalized, Healthcare Worker symptoms, anyone in a nursing home or congregate facility such as a jail or homeless shelter or project who has symptoms, and anyone in a disease that might be covid, youre talking about than what weore have. Three times more. So until we get to four or day, were going to have a shortage and if were people who arent in those priority groups, well have an even larger shortage so to get past the debate and say we dont have enough tests. While before be a we get them. Lets do everything we can to get as many tests as rapidly as possible. Hand, lets make the best use of the tests that we have today and make sure that the highestg priority people, were isolating people effectively in their theyre not ill and can be safely in their home. Home, iff their communities can come up with the resources to support patients to do that. Hospitals, with go the Infection Control so they dont nursingt there, in homes if theyre there. Out who trace to find has symptoms and quarantine the contacts. Harvard study said we may need between five and 20 million tests a day. You concur with that conclusion . Ourfrieden weve looked at estimates. It depends on the traces you make. Are you going to test people who at Nursing Homes at all, once a week, twice a week . Calculations indicated that if you tested everyone you want to test, it could be as 20 million tests a day. So yes, weve made that same calculation, but the more the bareone is minimum, to test the highest priority people, will be on the 400,000, 500,000 tests a day in the u. S. And were only a third of that now. That doesnt mean that its hopeless. Lot we can do even though we dont have enough tests. We can make sure we apply those tests to the highest priority patients who will benefit the most from it and to the situations that will reduce the spread the most. We can make sure were isolating people effectively. Findingake sure were contacts and warning them so they can isolate and quarantine themselves. Example,rk city, as an there arent nearly enough tests and for weeks we have been telling people, if youve got symptoms, cough and fever, dont come in for a test, stay home. If youre having trouble breathing, medical complications, call your provider and see about coming in but for most people with a cough and fever, well assume you have fewd and if you went in a things would happen. You might infect others on the way. In you might infect others getting care. You will use scarce resources, kits, the doctors and time, swabs, personal Protection Equipment and if youre positive youll be told been toldould have otherwise, stay home. If youre negative, going through that process might get you infected so the situation is different in different parts of the country, even in different states. You need to look at what the local situation is and how to you havethe resources to do the three things that must be our goals in this response number of people who get infected, reduce the number of people who die and reduce the our society and the economy. Steve dr. Tom frieden is joining us from new york, a of overland college. Earned his medical degree from columbia university. Includes internal medicine, Infectious Diseases and Public Health. Mary is joining us from selma, virginia. Good evening. Evening. Ood i have just a short question. If a person passes away with the virus, does the virus still live body . T steve thank you, mary. You,om frieden thank mary. The virus does live but not for very long but you do want to be it can spreade from one person to another so you have to be careful and undertakerhe profession knows how to do that safely. Americans too many are dying from this and sadly, many more will die in the coming thats but we need to keep number to the absolute minimum. Steve we were talking about the study and testing between five to 20 million per day. One of the authors of that study onl join us this friday cspans primetime edition of the washington journal. Michael is next in hopewell junction, new york. Withe on the area dr. Frieden. Caller my question is, through all the businesses being shut essential businesses that are deemed essential, which and uber grubfood hub, doordash delivering, one tracking any of the people delivering this food and contacting the food. The amount of crosscontamination brought to peoples homes from that is my first question. M. P. A. Ond one is why is and the subway system still open in new york . Michael. Ank you, dr. Frieden two great questions. Yout off, for delivery, really want to encourage everyone to wear a mask. It protects the people around in food, youu take want to wash your hands after you take in anything from the outside. Thats a Good Practice generally. In terms of the food itself, it that things like ware and plates can be contaminated so use silverware thats washed. We havent seen foodborne virus but youis can always heat something. Subway in newe york city, its for essential workers. Is down 90 top 95 in new york. A colleague of mine takes the work. To she described being the only subway car each day. But there was a nice sign the put up, it has an worker, getssential on board. Nonessential worker, why are you reading this sign, go home. So its there for the essential workers. Is joining us from gastonia, North Carolina. Good evening. Caller hi. Is about vaccine. I know its a ways away. But when should they start planning how to distribute the its available . And we were so far behind the thee on the virus, and protection and stayathome, i they planke sure enough ahead that when its available, i mean, for instance, but im in perfect health. My husbands 65 and he has a lot of health issues. Think he should get it before me but i think i should get it before like a 45yearold whos in good health. So, i mean, when and how are going to start planning for the vaccine . Steve thank you, robin. Dr. Frieden . Dr. Frieden what a great question, robin. This is really important. It may be a year, two years, maybe more, before we have a vaccine. One of the things thats so important is to be transparent decisions being made. There wont be enough for everyone and it will goesquestion about who first. In all likelihood healthcare are on the front line and its essential they get vaccinated. So they can protect themselves theyork safely and so dont spread it to other patients and other Healthcare Workers. Thats the kind of discussion to have over the coming months. Vaccine came, we were able to get that out availablece it was due to the vaccine for children americans. All there are public systems like vaccines for children that work with the private sector and are the usual patterns. What you dont want to have happen is that somebody gets it because their insurer or their doctor or their state has more pull with the manufacturer. Think we can all understand waiting, theres a fair way to decide who gets it first and thats an Important National discussion. Thatnt have to have discussion yet but its a great time to think about that. Follow up marys question and ask you about the different strains of the flu. Different there is a strain and vaccine to try to combat that. Would this vaccine combat covid19 and whatever strain of flu we might get in 2020, 2021 . Dr. Frieden no, in all likelihood there would be this wouldaccines so be a vaccine, if it comes, for covid and well also have a flu alsone because there will be a flu year. Interestingly, the physical distancing were doing and hand washing were doing to control covid is probably reducing the impact of influenza, as well. Steve diana is next in san antonio, texas. Caller good evening. Wanted to make a comment that i think that everyone work and going back to should be mandatory to wear a ank no matter if you work at office or restaurant for the remainder of the year at least. And, yeah, and i dont really believe theres going to be a wave of this covid19. Masks, its for the a really good idea. What weve learned about covid were learning more every day, is that people who dont have symptoms can spread it to others. One group that are going to have symptoms in a couple of days are called presymptomatic people and people who are completely asymptomatic and theyre shedding the virus. For those individuals, if theyre wearing the mask, less likely to spread it to others so its socially to wear a mask. In terms of what covid does in the future, no one can predict with certainty. We can predict, is if it spreads the way it has spread get explosiven outbreaks which kill a lot of endanger Healthcare Workers and can overwhelm our Healthcare System so its to havey important tracking systems to see where its spreading, to see where in peopleincre