Dr. Kevin pham, contributor to daily signal, former graduate fellow of policy at the heritage foundation. What is your medical background . Graduated medical school in 2017 at university of toledo. I went to Business School and got an mba in health care administration. Thoughts onre your andcontagion of covid19 states reopening . Is it time to reopen . Guest that depends on the state. Each state is in a slightly different place. Some states have decided they are ready, and that is a statebystate decision. Is going to be longer in reopening. Places like colorado and georgia have decided they can reopen. Frankly, it has not been a disaster. I think they were right to make that choice. About three or four weeks since georgia and colorado opened. That being the case, we have not seen a complete devolution. Some states already. U. S. U look at a map of the , there are some states that are almost untouched the virus. It would be simple to do Contact Tracing to track the doubledigit cases there is opposed to trying to track down tens of thousands. Host the Washington Post has a headline, as hotspots are wrapped, researchers warn of second wave in the south. Time you relax Mitigation Strategy you see a possibility for resurgence. Thats why we are going to have to be careful. Are so many measures we can take but we cant maintain lockdown for a long time. We cant go on forever. It is not because people are impatient it is because people need to get out and continue with activities. This is not a selfish thing. Include daily lives essential activities. Maintainout and certain social distancing practices, that will be the best way moving forward without seeing resurgence. Host you also have a background in business. Balance economics and Health Concerns . Inmost policymakers mines, Health Policy is good economic policy. It reflects the mentality of the heritage foundation, the response to the pandemic is going to be a delicate balance between life and livelihood. Those two are not different things. They are the same thing on a continuum. Save lives by crushing livelihood, you end up losing both. We are trying to thread needles here. There is no perfect answer, no right answer, just a series of wrong answers and we are trying to pick the least wrong. We may be not see a spike in cases, but the decline we have seen is going to taper off into a longer tail. We maintainf economic lockdown we are going to start losing people not just to the virus but to economic w oes. Host i want to invite our viewers to call in and share your thoughts. What is it like where you live . Host Eastern Central parts, your number is 202 7488000. Mountain pacific, 202 7488001. We want to hear from medical professionals, 202 7488002. I am going to play governor cuomos part of his briefing where he talked about the state gradually opening. [video clip] people ask all the time, what is going to happen . What is going to happen is what we make happen. There is no predestined course. There is nothing preordained. Is ais going to happen consequence of our choices and actions. It is that simple. If people are smart and responsible, and if the employers who are opening , ifnesses do it responsibly employees are responsible. If individuals are responsible, then you will see the infection rate stay low. If people get arrogant, cocky, casual, become undisciplined, you would you will see the rate go up. Been about what we do. It has never been about what government mandated. Government cannot mandate behavior. Mandate the cannot behavior of 19 million people. It can give you facts that lead conclusion, and new yorkers have been great about following facts. We are at another pivot point. Numbersare reopening, are down, we can increase activity. What is the consequence . It depends on what we do. Do your part, wear a mask. Host dr. Kevin pham, your thoughts . Guest most of that was right on. You shouldhe said have to be responsible it is simple none of this is simple. It is not quite so simple as just being responsible. A bunch of people have to be in close quarters just by nature of their work. If you work in the kitchen, it is difficult to isolate yourself. Wearing masks is going to make a big difference, just being in close proximity to other people, it is difficult to decide how you are being safe. Is you areing stratifying risk among different parameters. Byber one, doing your part not congregating too much unnecessarily. But people who have to be in close proximity to others, what they are effecting as far as risk is how it pertains to their outcomes there most of the mortalities have unfortunately been in people 55 or older. Have been over 65 years of age. 45 as you get younger, below 45 the mortality rates toomes small until you get 20 where it is almost statistically zero. There is nobody who is invincible, but your risk between the ages of one and 20 is very low. If youre a 20yearold working in a kitchen, i do not think it is going to be that unsafe. This is about balancing risks. Americans are used to assessing risk. I think we can trust them to balance risk and go about their lives. With percussion and a mind ,owards hygienic methods washing hands, Wearing Masks. I think we can trust the American People to do this. Host paterson, new jersey. About you mentioned congregating too soon. Memorial day weekend is arising. Curiousm jersey, i am as how we keep a spike from happening in jersey that can overflow anywhere else . It is the way we would do that each individual needs to take responsibility for his or her own life and family. I is not going to be believe new jersey still has certain lockdown measures. Aside from that, if youre going to be out on a picnic, picnic away from another family. Youre probably not going to play pickup basketball. Sun with thehe weather hopefully warming, it is more difficult for the virus to transmit. Updated guidelines that most transmission has not been by contaminated surfaces. Most has been from person to person. If you are outdoors it is more difficult. Unless you are spending a lot of time in close proximity, youre probably not going to spread to another stranger. There is probably not going to be a high enough load to infect another person. If we are having picnics outside or having grill outs, i think that is going to be safe. The caveat is that so long as you are not in close proximity with an infected person for a long time if someone in your family is infected, you might see a spike. We have to be careful about that and gauge how we have been exposed and who we have been exposed to. That is going to be difficult. This is about balancing risks. If people are immunocompromised, or older, you may want to stay home. Teleconference your memorial day meeting. , but that might be safest way to do it. Host host what you make of the cdcs new statement, coronavirus does not spread easily by touches services or objects . They say it still may be possible. The center for Disease Control prevention has always said it could be possible by touching contaminated services or objects. It just does not spread easily in that manner. The agency now says nor by animals human contact. What do you make of that . Guest thats really good news. Contaminated services could be easy to be left behind. You, ite is in front of will probably be fine. Those will be there droplets land on the table in front of me and someone else comes by and puts their hand on that table, they may inoculate themselves. If that is an unlikely mode of transmission, that is very good news. That second person touches a doorknob, that has been a major concern of mine. That will significantly reduce the possibility of a transmission. It is always important to remember that because it is less likely does not mean it wont happen. Like the transmission outdoors. It is unlikely but it is a function of time. This is all balancing risk. It is a game of percentages and numbers. Whatever makes transmission less likely will be better news. Does that make wearing a mask more important . Yes, in fact it does. On the outset of the pandemic a lot of officials were saying dont wear masks to conserve them for health care workers. That was correct at the time, there was a shortage. The thinking was also that most of the transmission would be by. Ouch now that we know that most transmissions from one person to , it will provide protection as well from receiving the virus. Originally it was thought it was transmission. That fact has not changed since the virus has existed. Know thetand it so we mask will be a bit more important. I do agree that the doctor has properly put his finger on it. The American People want to get back to work, we have the ability to mitigate risk and be smart about what is important. We are missing the opportunity for folks to continue to see doctors, make sure they are taking care of other underlying medical issues that may drive up mortality rates areas we havent anticipated. We will regret the fact that we spent some much time focusing on covid to the detriment of everything else. One of the good host one of the good diagnosis could be done by the clinical interview. It does not have to be done by physical exam. Excuse me. A lot of diagnoses could be made by the clinical interview. A lot of checkups have to have the physical exam. Need toith copd, we listen to your lungs. Anyone with a heart condition, we have to listen to it. We cannot detect a murmur or track its progress. To fact that we are not able get the physical exams right now, means we might be missing deterioration, especially with not having to go to work. We have been in lockdown for a relatively short amount of time. Hopefully no one has deteriorated past the point of no return. If we will maintain this lockdown, we will have much larger chance of losing a lot of possible help we have saved right now. This is about balance. We need to Pay Attention to other pathologies as well. The main focus has been on covid19, rightfully so. I think it is extremely critical. Caller hello. Host go ahead. You fori want to thank r show. You we appreciate it very much. I got most of my question answered in the last 20 minutes done onies have been currency in the disease. Was the question whether it is transmitted by currency . By the exchange of money . Caller yes. If the transmission is happening less by touch and more it will have less of an effect. That is good news. Matter, the low chance of transmitting by touch, there is still some chance. It is less than we had thought before. Seen hasthat i have tracked the transmission by money or credit card, or by the credit card reader. Covid19 is not the only virus out there. Any time should touch one of these things you should probably wash her hands before touching your face. I think that is one of the practices that stores could do to put sanitizer available at the checkout stand so soon as people are using credit cards and money, after that they could go and wash their hands. Host laura is next. I called because i have a question. If covid19 is so very in fact , why havent the homeless. Een really, really wiped out it does not make sense. Guest the who . Host the homeless. That is a continuing question. We see some paradoxes in Public Health. Lower economich there are paradox we can explain all the time. It could be luck or system. Is aomeless population very diverse population. We are not 100 sure. These could be going unnoticed. They dont have access to regular resources so they are probably not going in for testing. We are probably missing a lot of homeless people. They also live outdoors. Transmission when people outside of the building is a lot more difficult. , anyrt of illustrate that , the viral load might not be enough to infect another person. That would greatly help the situation. Those droplets will stay at the center of air for time, possibly long enough for someone to walk through it. The concentration will be much higher. Caller i work in a grocery store. Im upset governors are not making the masks mandatory. To me, it is like wearing a seatbelt. Why is a seatbelt mandatory but masks are not . Half the people that come in the store have masks. Half act like nothing is happening. Im upset it is not mandatory that we wear masks. Especially in grocery stores. I compare it to seatbelt. Why are they mandatory and masks are not. Host for this worker, he is wearing a mask, is he protecting himself . As far as transmission, the mask will protect reception of the virus. In order to be inoculated, he needs to touch some kind of services. Normally that his nose and mouth. If you get a load of respiratory this. Ts it will service the best way to be protected from other people would be is to wear a mask and goggles. I understand that is unrealistic. People should be Wearing Masks. Goes, themandating problem is if you have a mandate it has to be enforced in some ways. To enforce it it has to require some kind of course of effort with the state. Public Health Requires Cooperation of people because it is made up of two things. The public and health. If they dont see it as important to their health they will not comply as much. Then you get the natural resistance and protest. That is also detrimental. The main thing that needs to happen is proper Public Health messaging. Wearing a mask will not necessarily be mandated but onessary if we will protect another in the community. We are only in this together if we are moving in the same direction. Ed, in melville, new york. Go ahead. Live i live in a metropolitan area in the northeast. We all want to get back to work. How will that be possible when the majority of us take pack commuter trains and subways . Guest that is one of the enduring questions for the pandemic and any future pandemic or epidemic. The Public Transit system is a major spreader. I think more than one study has been a source of infection in new york city. Pretty muchcity, everyone is dependent on the subway system. Are we going to do this in the future . That also could be alleviated by Hand Sanitizer stations at the stations. People need to clean out fans and services as they go on. It will be a difficult question. Some things cities that rely on Public Transit will have to answer. These are questions for specific planning in the future. I dont have the answer to that right now because it is difficult. People rely on Public Transit. This is overdone, it is an overreaction. I think it is on purpose. Im not trying to be a conspiracy theorist but i delivered doordash and i do post mates. Im delivering people mcdonalds and starbucks. Bagels. Is einstein a lot ofis this, people die, there are diseases that kill people. Cancer killed 600,000 people year. There is the food that kills. This covid19 shutdown of the whole economy, government, a cover up. Gabriel says this is not real, what do you say . Guest i think you were saying we are overreacting to the situation. That is going to be a judgment call. I think a lot of these lockdown measures, especially when we have Little Information and the disease is spreading quickly, i pick some of the lockdown measures were appropriate at the time. It is also the start of relaxing some of these mitigation measures. This pandemic is not false, i dont think he was implying that. Point, a verythe bad flu season for us was 2017 2018. I think we lost about 80,000 people. That in lessy over the normal flu season. We are at 94,000 deaths as of yesterday. We will probably crest over 100,000 ford was done. Not just another flu season. Not only did it leave the lights, it spreads very quickly based on those antibiotic studies we have seen. That hadnt been said. The mortality has been high so far. And value has been high concentrated in groups. We could focus on the at risk populations. We should focus on protecting them and our senior citizens. The government has been doing a good job of this. Developed,emic has they be admitted this get into nursing homes. Think that did a lot to mitigate the spread in florida. It prevented the spike we thought we would see in florida. There are certain things we need to be concerned about we know that we could start get a handle on it. Over 90,000 deaths in the United States the speaker of the house and Chuck Schumer have thaten a letter asking what our country reaches 100,000 that he designate all flags flown at half staff to mourn the deaths of all of the victims of coronavirus. Morning. Thank you for discussing this. I live in upstate new york. I was commenting about the mask issue. You im aly tell retired military person. Has made nosk in new yorkr cases state. Cdc has given so many. Essages about Wearing Masks first they werent to be worn. N95, a you had an regular surgical mask does not filter anything. Wearing a mask is really a feelgood thing. It is not scientific, that is my point. Aest it is not entirely feelgood measure. What it is is it will prevent if you have a sneeze or cough, wearing the mask will prevent that cough or sneeze from and wide in front of you. That will be important indoors. Some. L help prevent it will slow down anything that comes at you. There were counties with single digit cases up until this day. A broad measure will not have as much of an impact. Theres not as much of a potential spread. The effect will not show up if you have fewer cases. I dont know what to call it exactly. Such measures will not show any differences when there are fewer cases. Hasace like japan, which very dense cities and there is much more broad acceptance of mask wearing did not get hit very hard with pandemic. Be part of thell masks already. It will be more difficult to see definitively whether they make an impact in your state. Abouton what we do know , we areration works pretty certain. We are fairly certain masks work. Jerry is in rogers, minnesota. Caller there is a cure for covid, it is a Healthy Human immune system. It beats it about 98 99 of the time . These policies that say lock kids in homes to play video games, does that help them with immune systems . Would that improve the system baseball . Ing in minnesota, 85 of the deaths have been in nursing homes. Why are we shutting down atrybody else that are not risk with healthy immune system . Why would we shut them down from going out . Im imagining having a good job helps your immune system. Having money and the job probably helps your immune system. This, this has really been handled