Discussion on the corona virus, the former Ebola Response coordinator under president obama. Live coverage from the center for American Progress on cspan2. Im pleased to welcome you to the center for American Progress. Im glad you could join us for this critically important conversation. The default for the coronavirus exceeds 3200 people, with 200 cases confirmed inside the United States. As Health Officials warn the coronavirus will ultimately become widespread in the United States, serious questions have emerged how the federal government is responding. Around the world countries are beginning to take significant measures including restricting travel, closing schools, postponing religious pilgrimages and imposing quarantines. Critics say the Trump Administration has been slow to address this crisis. The president and his team are set to downplay the risks saying last night but everything was going to work out fine because the virus, quote, will go away by april contradicting the cdc guidance itself and most importantly a crisis like this we need to be able to trust the information we get from the government and trust that the Trump Administration has exhausted years ago. Theres no question the president and his administration are mismanaging this response unfortunately. Donald trumps personal frustration has paralyzed this administration with inaction in early days and poor planning, polarized politics and lack of communication has undermined public confidence. The public continues to receive mixed messages with few daily briefings and public Health Officials often prohibited from making public announcements. Where do we go from here . The Trump Administrations missteps should not stop us from coming up with solutions was that is why we find this so important. We are joined by a distinguished panel of experts who will discuss how to prepare the country and the world to fight this potentially devastating outbreak. It gives me great pleasure to turn the conversation over to new executive Vice President for policy, mara redman. [applause] thank you. I am very glad to be here and glad to be having this conversation with all of you because of the terrific experts we have the i will ask them to take their seats and we will go right into the questions we have. Doctor seek emmanuel, a senior fellow at the center for American Progress but also vice provost for the promise of medical ethics and Health Policy at the university of pennsylvania and Senior Health advisor in president obamas administration. Ron blaine, the response coordinator and earlier chief of staff to two Vice President s and numerous other experiences at senior levels of government as well. Lisa monaco, senior white house coordination advisor, senior fellow at Nyu Law School and years of experience at the Justice Department in various senior roles, doctor jennifer, epidemiologist whose work focuses on Global Health, bio surveillance, Infectious Disease diagnostics, outbreak preparedness, cant think of a group that is better suited to help us understand and get the basic facts and science and explanations about what to do with the situation we are facing today. I should note doctor Rachel Levine wanted to be with us today but because of the current challenges she is facing in pennsylvania, immediate issues there today, she was unable to join us. With that, lets start. [inaudible conversations] okay. Start with you, jennifer, if we could. I am going to ask you, given your in depth science background if you could lay out the basics for us. A lot and a lot some science. I am being generous. What is covid19, how does it transmit between humans, help us understand the words pandemic, isolation, quarantine and a little bit more about how to interpret mortality rates and things like that. Covid19 is a disease caused by a newly recognized human coronavirus. Coronaviruss are viruses that circulate the planet but this is a new one, all best federal logic analysis and genic analysis suggested started in bats, possibly through some other animal, likely a mammal but we dont know what that animal is. It is a respiratory virus and possibly some exceptions it is largely driven through droplet transmission meaning when someone is sick they expel virus from their body in large droplets that fall to the ground and 2 surfaces a distance of three feet. Just to stress because i have questions, can i get the virus when i go running, it doesnt just hang in the air like other viruses, diseases like tuberculosis are known to do. Where we are now is a situation where we have approaching 100,000 cases being reported worldwide, these are largely confirmed, i looked up how many countries, 85 countries as of now reporting cases. Just because the country hasnt yet reported cases, meaning it doesnt have them. We have to hundred cases that have been reported. More than half of them are occurring in people who have not traveled. Likely as a result of local transmission. We have cases in so many countries where we have local transmission in multiple countries, not possible for me to not call that a pandemic. There has been some debate over the use of the word but the World Health Organization is particularly reticent to use it. It comes with a lot of baggage particularly if it is misinterpreted to be a signifier of how severe the virus is. From an epidemiological standpoint im merely referring to geographic spread when i use the word pandemic. We are very much in a pandemic. This virus has shown itself capable of spreading very quickly particularly as Surveillance System struggle to catch up. That is where we are now. In my believe we are in a situation where the idea of fully stopping the spread is not a realistic goal. We are more at the point we are trying to mitigate the impact of the virus on our community. Thank you. I have been told i need to hold the mic closer to my mouth. Not sure what that meant for others. Talk about your isolation, quarantine. I saw it in your notes. I will give you the opportunity on that. What kind of surveillance we are currently using in the United States and some of those 85 other countries and i guess there are differences between and among but what kind of surveillance are we using to track and learn more and what impact does that have an you use the word mitigate as opposed to contain and does that follow from the type of surveillance . Globally surveillance isnt perfect but part of the reason it has not been perfect, lets pause this is very hard. The fact we had 85 countries reporting cases, the fact that 85 countries have been able to implement testing for a never before seen virus is something we should celebrate, there are few opportunities of something good happening but there is. I want to give credit to that. That said, many countries for a long time, surveillance and testing was contingent on travel from china and until last week that was the case in the United States, where you could only be tested unless you were a contacted but known case, you can only be tested if you had a lower respiratory infection and traveled to wuhan and were sick enough to be hospitalized and travel to broader china. A number of countries showing local transmission. We didnt update the case of efficient reflect the fact that more countries coming from other countries. Our approach, thinking about surveillance, in my view, has been strained, without a view to looking to what is likely to come. If you are only testing people who have traveled to china and in fact you reduce people traveling from china of course you are not going to find many cases because you dont have people in that category to test as much as you could before. This comes up a lot, we bought ourselves time with these measures. It is possible we reduced the number of people coming in with the virus but have no way of assessing that from our testing. Many countries were like that. It will probably come up, to define isolation and quarantine. Isolation is something we do all the time. It means if somebody is sick, you put them somewhere so they can spread the disease to others. And stay home unless they require hospitalization, for the sickest people. That above all, in responding to this virus in reducing its impact on the community. This is where we are putting the most attention. Theres a lot of attention on quarantine and this means separating from society, restricting movement of people who are well, they dont have any systems but you think maybe they have been exposed to. This is not something we do in Public Health but to the degree it is happening now is unprecedented. I dont think we have fully examined the consequences and in particular when we do things like quarantine Healthcare Workers who may have been exposed we will find ourselves without sufficient resources to respond if we continue to indiscriminately apply quarantine. To ron klain, you mitigated the spread of ebola. Youve been less than positive about the white houses attempt to control communications on a variety of issues but particularly public Health Officials and you have noted probably effective Pandemic Response requires trust in government. Can you describe a little bit why trust in government is so important on these issues specifically and address the issue of whether this the issue is with credibility in this administration on this issue with the American People and our foreign partners and how that affects, how that impacts an Effective Response . What we are seeing is both a failure of confidence and failure of confidence. Second on the confidence part of this, as you alluded to we are far behind other countries in testing people for this virus. When we hear the viruses in x state but not x state we havent tested in that state. The same for the global map, no cases of coronavirus in Subsaharan Africa it is not because there are no cases of coronavirus in Subsaharan Africa but because we havent tested. Here at home that lack of confidence is causing us to be blind as to where the viruses and how extensive it is and so on and so forth. If i were back in mild job at the white house i would be pushing to have us do 30 million tests to test people in nursing homes, test people with adequate respiratory illness, people who regularly visit nursing homes. There would be long lines of people we should test, the administration think they would 75,000 tests by the end of today, maybe, maybe, maybe 1 million next week. That is a huge gap. The second confidence gap is on hospital preparedness as we talk about what needs to be done to get the system ready to deal with the kind of challenges you were referring to. On the confidence side, communication side the Trump Administration is doing everything wrong. By that i mean the obvious thing which is having the president go out and say things that are not true, that fall into the categories of both misleading and deliberately unhelpful. He told everyone to go to work with coronavirus, that is not only a bad communication, but a very bad communication. What we are seeing is even if you accept, and i dont, that Donald Trumps single a goal is to keep the stock market up during the coronavirus thing, him saying things that are erratic and irresponsible is not reassuring people but making people more anxious. s efforts to just treat the virus away is making public anxiety about the virus worse, not better. What should he do . What he should do is let the Public Health experts be the voice of the response. The idea they told doctor tony fauci is sold 6 president s, the worlds leading Infectious Disease exit, that he shouldnt go on television, let some staff flunky in mike pences office say it is okay, is ridiculous. The idea they sidelined senior official that the centers for Disease Control is ridiculous. That is who the public should hear from both to get Accurate Information and to lower the level of anxiety about the disease and at least get it right. That is the biggest problem we have on the communication side but if they dont fix the confidence problems, all the confidence problems will get worse and worse. Could you follow up on your point, you mentioned the president and the stock market. How do you think right now we should be thinking about the economic challenges we are facing, supply chain issues and issues beyond the stock market on this . We are already seeing ripple effects from the anxiety of coronavirus in the economy, im not just talking the stock market the cancellations of travel, cancellations of conferences are going to start to ripple through the economy. We will see other sectors hit by this. It is important for us to focus on who is going to be hurt by this economically. That is the least among us, right . It will be the hourly wage workers in the Hospitality Industry and other industries who lose their jobs. We are talking School Closures all over the country already, some School Closures, the president that affect to work in schools. It affects the children, many, their source of nutrition for breakfast and lunch is the schools. If we close the schools how we feed those children . People who are laid off from work for weeks or months at a time, what is going to happen to their income . What this is going to expose is a lot of weaknesses in our economy already on the lower rungs in particular. A pandemic suggests something that is global and worldwide and this is. Like a lot of things that are global and worldwide, it affects all of us differently. We need to be aware of the fact that some people, the Economic Impacts are going to most severe. Thanks very much. Let me turn to you. For number of reasons including the fact that in 2018 you presciently sounded the alarm about failures to prepare adequately for emerging Infectious Diseases. In an article im curious whether you came up with the title or someone else did but for all who are interested the title was the next pandemic will be arriving shortly. You argued that the United States needs to treat pandemic diseases with the same urgency as a transnational threats. What should the United States be doing to improve how we treat pandemic diseases like the one that according to jennifer we are facing now at the National Security priority that it should be . First on your question i did not come up with the oped title. I should say i was not alone by any stretch of the imagination. Every person on this panel and legions of experts behind us used 2018, the one hundredth anniversary of the spanish blue pandemic to sound the alarm about the dangers posed by pandemic disease but i didnt come up with the title, normally oped writers decry those who put alarmist and inaccurate titles on their pieces. Unfortunately, couldnt make that criticism here. What do i think we should do first . We should recognize pandemic disease as a National Security threat, as a transnational threat like we do other things like terrorism, cyberthreats, and let me anticipate some concern with that framing. I imagine folks may say here we go again, everything is a security issue, we are going to secure pandemic disease and that is the last thing we should be doing. Let me all a those fears which when i say we should approach this as a National Security threat what i mean is we should apply a whole of government approach of the kind ron just talked about just that threat, just like we do other transnational threats and by that i mean diplomacy, Intelligence Driven approaches, Public Health and domestic preparedness issues and i would lean on the diplomacy piece of this. Ron knows very well the significant piece the diplomacy played across the administration up to the president ial level to really help us get our arms around the ibo epidemic. When i say National Security i need to apply whole government approach to this. We have to name it. We have to organize around it. What does that mean . It means identifying it as a National Security threat and approaching it and organizing our government from that perspective. We did that post ebola on rons excellent recommendation. Ron was dubbed the us ebola coordinator. I remember his last recommendation to president obama. Im not revealing any state secrets. Is last recommendation on his way out the door in that role was we should never ever have to appoint, no future president did have to appoint a disease specifics are. President obama took that recommendation, the National Security team as a whole took on that recommendation and what did we do . We created a Global Health security and pandemic preparedness directorate within the National Security council to work a