WEBVTT 00:02.840 --> 00:06.470 I will go ahead and get started . Uh , 00:06.480 --> 00:08.630 first of all , good morning . My name 00:08.640 --> 00:11.050 is Olga . Bash Bush . I'm a program 00:11.050 --> 00:13.272 officer at the Washington Foreign Press 00:13.272 --> 00:15.328 Center . I want to welcome you today 00:15.328 --> 00:18.050 for this . On the record zoom briefing . 00:18.380 --> 00:20.730 The topic is lessons learned from Ebola 00:20.740 --> 00:23.640 for Corona virus preparedness . This 00:23.640 --> 00:26.010 briefing is being life stream on the 00:26.020 --> 00:28.360 Foreign Press Centre's website , which 00:28.360 --> 00:32.260 is f p c dot state dot gov . We will 00:32.260 --> 00:34.440 produce a transcript and video after 00:34.440 --> 00:36.329 the briefing and post them on our 00:36.329 --> 00:39.080 website . If you publish a story as a 00:39.080 --> 00:41.400 result of this briefing , please share 00:41.400 --> 00:44.010 your story with us by sending an email 00:44.020 --> 00:47.550 to D . C F P C at ST dot gov 00:48.380 --> 00:50.713 Just a couple of things to keep in mind . 00:50.713 --> 00:53.040 While using Zoom , we have muted all of 00:53.040 --> 00:55.096 the participants and turned off your 00:55.096 --> 00:57.096 video . Please ensure that you have 00:57.096 --> 00:59.318 clicked on the participant list covered 00:59.318 --> 01:01.207 over your account and change your 01:01.207 --> 01:03.318 account to reflect your name and news 01:03.318 --> 01:05.970 outlet . Our briefers will get give 01:05.970 --> 01:08.330 short opening remarks and then we will 01:08.340 --> 01:10.720 open it up for questions . If you have 01:10.720 --> 01:13.340 a question , please go to the chat box . 01:13.510 --> 01:15.566 There is a feature their that allows 01:15.566 --> 01:18.030 you to virtually raise your hands . At 01:18.040 --> 01:20.330 that time , we will amuse you and turn 01:20.330 --> 01:22.497 on your video so that you can ask your 01:22.497 --> 01:25.360 question . I am honored to introduce 01:25.370 --> 01:28.030 our to briefers who were not only on 01:28.030 --> 01:30.720 the front lines during the Ebola crisis 01:30.730 --> 01:32.952 but are currently working to help those 01:32.952 --> 01:35.570 that are affected by Cove in 19 . Dr . 01:35.570 --> 01:37.626 Colleen Kraft is the associate chief 01:37.626 --> 01:39.626 medical officer at Emory University 01:39.626 --> 01:41.850 Hospital , associate professor of 01:41.850 --> 01:43.739 infectious diseases and associate 01:43.739 --> 01:45.461 professor in the department of 01:45.461 --> 01:47.683 Pathology at Emory University School of 01:47.683 --> 01:49.830 Medicine . She is also a medical 01:49.830 --> 01:52.220 director of microbiology laboratories 01:52.220 --> 01:54.276 at every and director of the Medical 01:54.276 --> 01:56.164 Microbiology Fellowship program . 01:56.740 --> 01:58.796 Additionally , Doctor Crest research 01:58.796 --> 02:01.090 interests include antibiotic resistance 02:01.100 --> 02:04.710 and fecal microbiota transplants . Dr . 02:04.710 --> 02:06.543 Kraft was one of the finish that 02:06.550 --> 02:08.580 physician leaders in the effort at 02:08.590 --> 02:10.990 Emory University Hospital to receive 02:11.070 --> 02:13.090 and care for patients who had 02:13.090 --> 02:15.257 contracted Ebola virus disease in West 02:15.257 --> 02:19.220 Africa in 2000 and 14 . Her colleague 02:19.230 --> 02:21.397 and our second briefer is doctor Anish 02:21.397 --> 02:23.690 Meta . He is an associate professor of 02:23.690 --> 02:25.912 infectious diseases at Emory University 02:25.912 --> 02:28.280 School of Medicine . He is also the 02:28.280 --> 02:31.010 chief infectious diseases services for 02:31.240 --> 02:34.290 uh Emory University hospital . Dr 02:34.290 --> 02:36.512 Muchas research and clinical paths have 02:36.512 --> 02:38.679 focused on treatment of and protection 02:38.780 --> 02:41.130 against infections in immuno 02:41.130 --> 02:43.510 compromised hosts , including patients 02:43.520 --> 02:45.740 with organ transplants and stem cell 02:45.740 --> 02:48.540 transplants . Dr . Metta has served as 02:48.540 --> 02:50.360 a member of the Emory Serious 02:50.360 --> 02:52.790 Communicable Diseases unit since 2000 02:52.790 --> 02:55.410 and nine and was one of the physicians 02:55.410 --> 02:57.510 at Emory University Hospital who 02:57.510 --> 02:59.590 successfully treated the first Ebola 02:59.590 --> 03:02.650 patients in the United States in 2014 . 03:03.440 --> 03:05.384 And with that I will pass it on to 03:05.384 --> 03:07.440 doctors , craft and meta . Thank you 03:07.440 --> 03:09.662 both for joining us today and thank you 03:09.662 --> 03:11.773 for your service to our communities . 03:12.340 --> 03:14.173 Thank you very much for the kind 03:14.173 --> 03:16.396 introductions . Both finish , and I are 03:16.396 --> 03:18.396 very happy to be here . As speaking 03:18.396 --> 03:20.451 with you . We've spent a lot of time 03:20.451 --> 03:22.340 together working on these serious 03:22.340 --> 03:24.562 pathogens , and we feel like we want to 03:24.562 --> 03:26.729 share our experience with you . We are 03:26.729 --> 03:28.562 going to do very limited opening 03:28.562 --> 03:30.673 remarks because our preference always 03:30.673 --> 03:32.673 and what has worked the best during 03:32.673 --> 03:35.330 this time is to have questions . We can 03:35.330 --> 03:37.441 give you some high level Overbey view 03:37.441 --> 03:39.386 on our perspectives and what we're 03:39.386 --> 03:41.497 doing . It's always better to sort of 03:41.497 --> 03:44.120 answer exactly what you want us , Teoh , 03:44.130 --> 03:46.463 What you want to hear about Essentially , 03:46.463 --> 03:50.280 Um And so my role right now and , uh 03:50.360 --> 03:52.416 Ah , any sure Dr Meta can talk about 03:52.416 --> 03:56.000 his role , uh , during his time is to 03:56.000 --> 03:58.500 really is is numerous in our hospital 03:58.830 --> 04:01.480 on . And so , uh , I'm working in our 04:01.480 --> 04:03.647 health care system leadership group to 04:03.647 --> 04:05.869 try to work on general preparedness for 04:05.869 --> 04:08.340 our hospital . Specifically , I've also 04:08.340 --> 04:10.130 been very intertwined with our 04:10.130 --> 04:12.810 laboratory testing since I'm a clinical 04:13.030 --> 04:15.630 diagnostician as well as a clinician 04:15.630 --> 04:17.810 who sees patients . That's that's my 04:17.810 --> 04:20.500 happy place . And so I've worked a lot 04:20.500 --> 04:23.100 with how we develop our our testing for 04:23.100 --> 04:26.650 Kobe 19 . Um , And also how , 04:26.660 --> 04:29.990 um uh , how we've done syrah logic 04:29.990 --> 04:32.046 testing of assisted with that across 04:32.046 --> 04:35.560 our system entity . Um And then I've 04:35.560 --> 04:37.782 helped Dr Meta on his research study by 04:37.782 --> 04:40.580 approaching patients and then obviously 04:40.580 --> 04:42.747 will be taking care of patients in the 04:42.747 --> 04:45.110 hospital is Well , what I wanted to 04:45.110 --> 04:47.340 just briefly mention were two topics 04:47.350 --> 04:49.540 about what we did during the time of 04:49.540 --> 04:51.750 Ebola five years ago and what we're 04:51.750 --> 04:54.790 doing today . So my first topic is 04:54.790 --> 04:56.901 really on health care worker safety . 04:57.240 --> 04:59.296 This is something that I became very 04:59.296 --> 05:01.462 passionate about that . We became very 05:01.462 --> 05:03.830 passionate about in 2014 that we 05:03.830 --> 05:06.770 believed that doing provider centred 05:06.770 --> 05:09.810 care was it was important to having 05:09.820 --> 05:12.880 excellent patient Karen Outcomes . We 05:12.880 --> 05:15.047 always focus in the health care system 05:15.047 --> 05:17.102 right now on patient centered care , 05:17.102 --> 05:19.269 which I think is obviously crucial and 05:19.269 --> 05:21.790 important . But we believe that 05:21.840 --> 05:24.340 protecting our health care workers is 05:24.350 --> 05:26.670 of utmost importance to be able to then 05:26.670 --> 05:28.614 deliver that excellent care to our 05:28.614 --> 05:31.890 patients . So during Ebola , we had a 05:31.890 --> 05:34.010 very small group of about 30 people 05:34.010 --> 05:36.121 total that ever went in those rooms , 05:36.121 --> 05:39.350 and we pretty easily could it service 05:39.350 --> 05:41.517 each other's support group and support 05:41.517 --> 05:44.110 network . We had a lot of support over 05:44.110 --> 05:46.166 time from the health care system and 05:46.166 --> 05:48.610 from our community to be able to 05:48.610 --> 05:51.050 navigate that time . And really , if 05:51.050 --> 05:53.161 you think about it , that small group 05:53.161 --> 05:55.383 of people were the main people affected 05:55.383 --> 05:57.383 during that time . We were the ones 05:57.383 --> 05:59.439 that were working long hours dealing 05:59.439 --> 06:01.606 with this pathogen . But remember , we 06:01.606 --> 06:03.939 were practicing containment at the time , 06:03.939 --> 06:06.210 and that was effective , so we knew we 06:06.210 --> 06:09.190 could not get any , Um , 06:09.840 --> 06:12.140 we is a song as we kept Ebola in that 06:12.140 --> 06:14.196 room . It was not going to spread in 06:14.196 --> 06:16.362 the community . And so that was really 06:16.362 --> 06:19.270 a a focus of our team . And we were 06:19.270 --> 06:21.430 highly successful in that we were 06:21.430 --> 06:23.770 extremely proud of the fact that our 06:23.780 --> 06:26.040 all of our patients recovered . We were 06:26.040 --> 06:28.151 also extremely proud that none of our 06:28.151 --> 06:30.320 health care workers contracted the 06:30.320 --> 06:32.430 disease . That is something we felt 06:32.430 --> 06:34.580 very strongly about and worked to the 06:34.580 --> 06:37.250 utmost of our abilities to do that . 06:38.640 --> 06:40.751 How that's changed during the time of 06:40.751 --> 06:42.751 Kobe 19 is different . We've had to 06:42.751 --> 06:45.470 scale up this incredible machinery of a 06:45.470 --> 06:48.100 health care system from just this small 06:48.100 --> 06:50.710 cadre of highly experienced individuals . 06:50.730 --> 06:52.619 We've now had to scale that up to 06:52.619 --> 06:54.619 everyone . Everyone is on the front 06:54.619 --> 06:56.950 line . Everyone must be supported . And 06:56.950 --> 06:59.172 so that Is that a new challenge for our 06:59.172 --> 07:01.061 health care system ? I think it's 07:01.061 --> 07:03.006 brought us closer together . We're 07:03.006 --> 07:05.250 gonna be a different place after this 07:05.380 --> 07:08.050 pandemic . We have done things 07:08.050 --> 07:10.217 differently . We've deconstructed some 07:10.217 --> 07:12.520 old ways of doing things and I think I 07:12.520 --> 07:14.870 round a daily in our health care system 07:14.880 --> 07:17.810 just as a leader and we have happy 07:17.810 --> 07:19.980 people at the front lines . We have 07:19.980 --> 07:22.036 people that are going into rooms all 07:22.036 --> 07:24.091 day long wearing personal protective 07:24.091 --> 07:26.313 equipment that feel supported and proud 07:26.313 --> 07:29.160 of what they're doing . We also do not 07:29.160 --> 07:31.500 have an increased exposure per se in 07:31.500 --> 07:33.500 our health care workers , and we're 07:33.500 --> 07:35.620 very , very proud of that . There is 07:35.620 --> 07:38.450 community transmission in the United 07:38.450 --> 07:40.900 States . So are our approach is no 07:40.900 --> 07:43.070 longer containment . There are 07:43.070 --> 07:45.181 approaches , risk mitigation . And so 07:45.181 --> 07:47.348 we continue to really work to keep our 07:47.348 --> 07:49.126 health care workers safe in the 07:49.126 --> 07:51.370 processes that we have . And we have a 07:51.370 --> 07:53.426 whole leadership group for our whole 07:53.426 --> 07:56.020 system that's been tirelessly working 07:56.020 --> 07:58.390 on supply chain . So we have not had a 07:58.390 --> 08:00.612 lot of supply chain disruptions because 08:00.612 --> 08:02.940 we're very proactive in serving what we 08:02.940 --> 08:06.720 had in using very novel ways to wash 08:06.730 --> 08:08.619 and reuse our personal protective 08:08.619 --> 08:10.563 equipment and then being extremely 08:10.563 --> 08:12.563 resourceful about where we find our 08:12.563 --> 08:14.841 supply chains . I'm very proud of that . 08:16.190 --> 08:18.420 In terms of diagnostic testing , there 08:18.420 --> 08:20.476 was a lot of interesting things that 08:20.476 --> 08:22.531 happened during Ebola virus time . I 08:22.531 --> 08:24.698 love to spend a long time sharing that 08:24.698 --> 08:26.920 with you , but there was rapidly became 08:26.920 --> 08:29.070 some diagnostics , but it took us a 08:29.070 --> 08:31.600 little bit to get those approved and 08:31.610 --> 08:33.943 and it was only needed for a few people . 08:34.490 --> 08:36.601 I think one of the things that's been 08:36.601 --> 08:38.823 really underappreciated in this current 08:38.823 --> 08:41.190 time is that we have never , ever had a 08:41.190 --> 08:43.990 diagnostic as rapidly as we have for a 08:43.990 --> 08:46.760 new pandemic virus . There's a lot of 08:46.760 --> 08:48.927 focus on the last lack of test kits in 08:48.927 --> 08:50.982 the last black of testing , which of 08:50.982 --> 08:53.149 course should be a goal of ours in the 08:53.149 --> 08:55.316 United States . But But there is under 08:55.316 --> 08:57.427 appreciation , as I've said , for the 08:57.427 --> 08:59.593 fact that we created a diagnostic test 08:59.593 --> 09:01.538 that the FDA has allowed us to use 09:01.538 --> 09:03.371 these tests on patients and give 09:03.371 --> 09:05.538 clinical results in an extremely short 09:05.538 --> 09:07.870 period of time . Again , I'm biased 09:07.870 --> 09:10.160 because I work at Emory as opposed and 09:10.160 --> 09:12.327 and I'm intimately involved in this in 09:12.327 --> 09:14.160 these diagnoses . But we have an 09:14.160 --> 09:16.710 extremely useful test that we're using 09:16.710 --> 09:19.870 in our patients and in the community to 09:19.870 --> 09:23.160 diagnosis this disease , and we're 09:23.160 --> 09:25.290 really proud that we have not had any 09:25.290 --> 09:27.440 interruptions in the supplies to be 09:27.440 --> 09:29.900 able to do this , testing both rapidly 09:29.940 --> 09:32.107 and in sort of batch testing . We have 09:32.180 --> 09:34.180 high confidence in the results that 09:34.180 --> 09:36.236 we're getting , and so that has been 09:36.236 --> 09:38.250 its own journey during this time to 09:38.250 --> 09:39.694 sort of figure out how to 09:39.694 --> 09:41.917 operationalize that how to grow that we 09:41.917 --> 09:44.760 now contest about 800 people 800 tests 09:44.760 --> 09:48.550 today in the virus testing aspect . 09:49.240 --> 09:51.400 Ah , sirrah logic testing is its own 09:52.040 --> 09:55.470 topic . We are able Teoh test to see if 09:55.470 --> 09:57.303 people retrospectively have been 09:57.303 --> 10:01.110 exposed to the cove in 19 disease . So 10:01.110 --> 10:02.832 I really wanted to hit the two 10:02.832 --> 10:04.610 highlights , which are personal 10:04.610 --> 10:06.777 protective equipment and protection of 10:06.777 --> 10:08.943 health care workers and how passionate 10:08.943 --> 10:10.999 we are about that here and then also 10:10.999 --> 10:13.054 diagnostic testing for Coben and how 10:13.054 --> 10:15.240 that's being ramped up . So I will 10:15.310 --> 10:17.830 pause . Now Let Dr Meta speak and then 10:17.830 --> 10:19.997 take any questions regarding my topics 10:19.997 --> 10:23.530 or any other topics . Hello , 10:23.530 --> 10:26.050 everyone . Thank you , uh , Dr Kraft 10:26.050 --> 10:28.530 for those comments and has been an 10:28.530 --> 10:32.320 amazing leader in our preparedness and 10:32.320 --> 10:36.060 our implementation for not only Ebola 10:36.310 --> 10:39.100 but also now for the novel Corona virus . 10:39.330 --> 10:42.310 19 infections that wears a so going 10:42.310 --> 10:45.080 back Teoh are times taking care of 10:45.080 --> 10:47.300 patients with Ebola . As Dr Kraft 10:47.300 --> 10:49.750 mentioned , we learned a lot in that 10:49.760 --> 10:51.593 care of those patients on how to 10:51.593 --> 10:53.760 protect ourselves and how to take care 10:53.760 --> 10:57.110 of patients at the same time , UM is 10:57.110 --> 11:00.040 part of that . We needed to communicate 11:00.040 --> 11:02.870 that information more broadly , and 11:02.880 --> 11:04.824 during our time hit taking care of 11:04.824 --> 11:07.047 patients were connected with colleagues 11:07.047 --> 11:09.102 all over the world in discussing our 11:09.102 --> 11:11.410 care . But some of these really hard 11:11.410 --> 11:13.910 lessons , important lessons on how to 11:13.910 --> 11:16.620 protect the , uh , our personnel and 11:16.620 --> 11:19.040 how to train and be prepared for these 11:19.300 --> 11:21.578 needed to be communicated more broadly . 11:21.640 --> 11:23.980 So under the leadership of Dr Bruce 11:23.980 --> 11:27.690 Ribner and Dr Craft , we formed an 11:27.690 --> 11:29.857 organization at that time known as the 11:29.857 --> 11:31.968 National Ebola Training and Education 11:31.968 --> 11:34.134 Center , with colleagues in University 11:34.134 --> 11:36.400 of Nebraska and Bellevue Hospital in 11:36.400 --> 11:38.690 New York City , it is now known as the 11:38.690 --> 11:41.000 National Emerging Special Pathogens 11:41.000 --> 11:43.111 Training Invention Occassion Center . 11:43.240 --> 11:46.310 As we've moved forward since 2014 we 11:46.310 --> 11:49.240 have used the's lessons learned from 11:49.240 --> 11:52.430 our three institutions to go and train 11:52.430 --> 11:54.597 hospitals all around the United States 11:54.597 --> 11:56.710 on how to do the things that we did , 11:57.090 --> 11:59.270 knowing that we couldn't always take 11:59.280 --> 12:01.470 care of these outbreaks in small 12:01.470 --> 12:03.470 biocontainment units . But we would 12:03.470 --> 12:05.550 really need be prepared for larger 12:05.550 --> 12:08.340 outbreaks that would affect many 12:08.340 --> 12:10.980 hospitals and affect many wards in the 12:10.980 --> 12:14.160 hospitals , and that unfortunately came 12:14.160 --> 12:16.920 to fruition with the Covered 19 12:16.920 --> 12:20.610 outbreak . We feel fortunate that we 12:20.610 --> 12:22.920 were able to do this training with our 12:22.920 --> 12:25.087 colleagues around the country over the 12:25.087 --> 12:27.309 past five years , and I feel that we're 12:27.309 --> 12:29.476 all in our own institutions . But as a 12:29.476 --> 12:31.698 network of hospitals around the country 12:31.698 --> 12:33.753 better prepared to protect ourselves 12:33.753 --> 12:35.900 while taking care of patients because 12:35.910 --> 12:37.966 of this community that we've created 12:37.966 --> 12:41.460 three p tech . One of the other really 12:41.460 --> 12:43.460 interesting lessons that we learned 12:43.490 --> 12:45.434 during our days and taking care of 12:45.434 --> 12:47.880 patients with Ebola is how to think 12:47.880 --> 12:50.510 about therapeutics and managing 12:50.510 --> 12:53.870 patients of a novel infection . So when 12:53.870 --> 12:56.190 we received our first patient with 12:56.190 --> 12:58.680 Ebola , all of us had read a lot about 12:58.680 --> 13:00.847 a bullet . But we had never taken care 13:00.847 --> 13:03.200 of a issue with Mullah , and there was 13:03.210 --> 13:05.780 a lack of knowledge on how to do this 13:05.990 --> 13:08.650 well and what medicines may or may not 13:08.660 --> 13:12.270 be helpful in that time , we as I 13:12.270 --> 13:14.900 mentioned , we leaned on colleagues and 13:14.910 --> 13:16.910 we passed our knowledge on to other 13:16.910 --> 13:19.077 colleagues which I think really helped 13:19.077 --> 13:21.188 in our care of patients . But when we 13:21.188 --> 13:23.410 looked at the therapeutics that we were 13:23.410 --> 13:25.770 using , we were using data from animal 13:25.770 --> 13:28.370 studies at best , but usually data for 13:28.370 --> 13:31.510 a laboratory studies to make decisions 13:31.510 --> 13:33.410 about how to treat our patients . 13:33.470 --> 13:35.530 There's very limited availability of 13:35.540 --> 13:38.360 any of these medications until while we 13:38.360 --> 13:40.660 had one off or a couple of patients 13:40.660 --> 13:42.771 were treated with . This experimental 13:42.771 --> 13:44.827 medication , unfortunately , did not 13:44.827 --> 13:46.670 learn too much about how these 13:46.670 --> 13:49.110 medications were and who best to use 13:49.110 --> 13:52.210 them it . So in the interceding years 13:52.350 --> 13:54.350 through knee tech , we created this 13:54.350 --> 13:56.910 special pathogens research now , and 13:56.910 --> 13:59.730 the goal of this network was to again 13:59.770 --> 14:02.400 be prepared in an outbreak setting to 14:02.400 --> 14:04.511 not only care for patients but really 14:04.511 --> 14:06.710 understand what was going on with 14:06.710 --> 14:10.100 patients and what was best to treat 14:10.110 --> 14:14.010 those patients with so again , during 14:14.010 --> 14:16.010 our times taking care of Ebola , we 14:16.010 --> 14:18.177 collected many samples from patients , 14:18.177 --> 14:21.140 and we learned so much about the virus 14:21.400 --> 14:23.622 in our four patients , and how the mean 14:23.622 --> 14:25.789 system and the other body systems were 14:25.789 --> 14:27.622 reacting to the vice I can do is 14:27.622 --> 14:30.830 limited to those four 23 the SPR end 14:30.840 --> 14:33.150 that needs a special pathogens research 14:33.150 --> 14:35.450 network . We created an infrastructure 14:35.450 --> 14:38.840 to be able to one collect data on the 14:38.840 --> 14:41.790 clinical , the events of our patients 14:41.790 --> 14:43.957 and their data , their outcomes data . 14:44.420 --> 14:46.420 You also collect samples from these 14:46.420 --> 14:48.476 patients that we could distribute to 14:48.476 --> 14:50.642 scientists around the world and , most 14:50.642 --> 14:53.360 importantly , haven't network in a way 14:53.360 --> 14:57.080 to evaluate potential medications that 14:57.090 --> 15:00.390 may impact the care of these Asian . We 15:00.400 --> 15:02.320 did not want to do these one off 15:02.320 --> 15:04.440 experiments on patients anymore . We 15:04.440 --> 15:06.710 wanted to really contribute the science 15:06.710 --> 15:09.020 of acknowledge . And so having this 15:09.020 --> 15:12.110 network available when Corbett , 19 15:12.290 --> 15:15.870 started to hit our shores really made 15:15.870 --> 15:18.690 it easy for the N I H to come to us and 15:18.700 --> 15:21.090 other networks such as us , to say we 15:21.090 --> 15:23.500 have this medication that we think may 15:23.500 --> 15:25.850 be helpful . We would like to conduct 15:25.850 --> 15:28.090 this clinical trial with you and make 15:28.090 --> 15:29.923 sure that we can collect data on 15:29.923 --> 15:32.090 hundreds of patients instead of just a 15:32.090 --> 15:34.360 few patients . And two . In late 15:34.370 --> 15:36.420 February , the N I H launched the 15:36.420 --> 15:39.350 adaptive of it 19 Trial therapeutics , 15:39.350 --> 15:42.330 otherwise known as the Actress and me 15:42.330 --> 15:44.650 Tech and Emory or some of the leading 15:44.650 --> 15:47.570 sites . We enrolled through every 15:47.580 --> 15:50.360 university hospital and Grady Memorial 15:50.360 --> 15:52.082 Hospital . Whatever affiliated 15:52.082 --> 15:54.600 hospitals , we rolled 100 and three 15:54.600 --> 15:57.320 patients in this clinical trial and 15:57.420 --> 16:00.730 globally re enrolled 1000 and 63 16:00.730 --> 16:03.510 patients in less than or sorry just 16:03.520 --> 16:06.060 over two months . This is an incredible 16:06.060 --> 16:08.680 feat to do in an outbreak setting and 16:08.680 --> 16:10.902 has something is something that had not 16:10.902 --> 16:12.902 been done before . And without this 16:12.902 --> 16:14.847 preparation that we learned out of 16:14.847 --> 16:16.791 Ebola , we learned out of previous 16:16.791 --> 16:18.902 outbreaks did not only be prepared to 16:18.902 --> 16:21.124 take care of a patient and take care of 16:21.124 --> 16:23.236 our providers , but to really be able 16:23.236 --> 16:25.450 to do scientific investigation that 16:25.450 --> 16:27.617 contributes to the patient that we see 16:27.617 --> 16:29.506 the following weeks is critically 16:29.506 --> 16:31.820 important to all of us . And now we're 16:31.820 --> 16:33.870 seeing that data start to emerge 16:33.880 --> 16:36.102 because of having this prepared just to 16:36.102 --> 16:38.213 do research . And hopefully that will 16:38.213 --> 16:40.190 make an impact for not only future 16:40.190 --> 16:42.520 patients with profit 19 but as we 16:42.520 --> 16:45.260 prepare to take care of patients and 16:45.260 --> 16:47.630 future outbreaks as well . So it's been 16:47.630 --> 16:50.900 a real honor to be a part of that Ebola 16:50.900 --> 16:52.844 experience , but it's been an even 16:52.844 --> 16:55.450 greater honor to be part of this global 16:55.450 --> 16:57.550 preparation , not only for care of 16:57.550 --> 17:01.130 patients , care of our providers , care 17:01.130 --> 17:02.800 of our communities and really 17:02.800 --> 17:05.490 contributing to the scientific 17:05.500 --> 17:08.000 knowledge base very rapidly , and with 17:08.000 --> 17:10.590 that I would be happy toe , turn it 17:10.590 --> 17:12.812 back over to our moderators and see how 17:12.812 --> 17:14.979 we can answer questions for everyone . 17:16.280 --> 17:19.780 Great . Thank you . Both . Before we 17:19.780 --> 17:23.020 get started with the questions from our 17:23.020 --> 17:25.580 journalists , I didn't want Teoh , um , 17:25.900 --> 17:28.011 ask you , Dr Meta , would you be able 17:28.011 --> 17:30.122 to go in a little bit more in depth , 17:30.122 --> 17:33.440 how you , your team and your hospital 17:33.440 --> 17:36.050 has the bandwidth to conduct research , 17:36.640 --> 17:39.170 treat patients and also take care of 17:39.170 --> 17:41.114 your health care workers ? Because 17:41.114 --> 17:42.948 obviously you just mentioned how 17:42.948 --> 17:45.114 important that was and that was one of 17:45.114 --> 17:47.226 the lessons learned , and you're very 17:47.226 --> 17:49.226 proud of that work . But how do you 17:49.226 --> 17:51.170 balance all of that with your time 17:51.170 --> 17:52.837 constraints and your resource 17:52.837 --> 17:54.670 constraints ? That's a fantastic 17:54.670 --> 17:56.892 question . And I'm gonna start with the 17:56.892 --> 17:59.003 last part first . So how do we , uh , 17:59.020 --> 18:01.540 organized so that we can take care of 18:02.390 --> 18:04.510 everyone in the hospital ? And it is 18:04.510 --> 18:06.950 through wonderful leadership of our 18:06.960 --> 18:09.690 administration . People like Dr Kraft 18:09.960 --> 18:11.970 and many other people across the 18:11.970 --> 18:14.830 organization that really believe that 18:14.920 --> 18:17.031 over the years we need to prepare for 18:17.031 --> 18:20.190 these outbreaks and important part of 18:20.190 --> 18:22.120 preparation is taking care of our 18:22.120 --> 18:24.287 health care workers . And so they have 18:24.287 --> 18:27.460 put in all the right teams in place and 18:27.460 --> 18:29.682 the right measures in place . And as Dr 18:29.682 --> 18:31.410 Kraft mentioned , we see our 18:31.420 --> 18:33.587 administration coming in , checking on 18:33.587 --> 18:35.587 all of our care teams , seeing what 18:35.587 --> 18:37.800 they need and providing that care and 18:37.800 --> 18:39.760 finding out how we obtain those 18:39.760 --> 18:41.927 resource is that necessary and to work 18:41.927 --> 18:44.190 in such an environment . It makes it 18:44.200 --> 18:46.930 much easier for us to then take care of 18:46.940 --> 18:49.320 patients . Dr . Kraft and I are both 18:49.320 --> 18:51.598 involved in the care of these patients , 18:51.598 --> 18:53.810 and so we use our administrative asks 18:53.810 --> 18:56.090 me as being the chief of infectious 18:56.090 --> 18:58.290 disease at my hospital , and Dr Kraft 18:58.290 --> 19:01.750 is being this issue medical officer for 19:01.750 --> 19:04.790 our hospital to really organize our 19:04.790 --> 19:06.846 care teams to make sure that we have 19:06.846 --> 19:09.350 the right teams in place to make and 19:09.480 --> 19:11.490 prioritize that we can take care of 19:11.490 --> 19:13.323 those patients safely and we can 19:13.323 --> 19:15.510 deliver excellent level of care every 19:15.510 --> 19:17.510 single day . Every single patient , 19:17.510 --> 19:19.732 whether they have government 19 or they 19:19.732 --> 19:22.010 have other . My and then finally , 19:22.010 --> 19:24.232 coming back to that research piece that 19:24.232 --> 19:26.288 you talked about so again is part of 19:26.288 --> 19:28.810 our preparation . We had a research 19:28.810 --> 19:31.510 team in place . However , this outbreak 19:31.580 --> 19:33.802 and this research project should not be 19:33.802 --> 19:36.024 far greater than we expected , and this 19:36.024 --> 19:38.080 is where it's be . It is a wonderful 19:38.080 --> 19:40.900 place to be in a community that really 19:40.900 --> 19:43.660 understand science and clinical care . 19:44.040 --> 19:46.470 And so we were able to have multiple 19:46.470 --> 19:48.581 research teams come together and then 19:48.581 --> 19:51.930 particularly are Emory Vaccine 19:51.930 --> 19:53.970 Therapeutics Evaluation unit . Team 19:54.230 --> 19:56.370 really came in with their wealth of 19:56.370 --> 19:58.314 experience in doing these clinical 19:58.314 --> 20:02.000 trials and came and really led the 20:02.000 --> 20:05.630 effort toe care to deliver thes trials 20:05.630 --> 20:08.430 to our patients . And so , using all 20:08.430 --> 20:10.652 the resource is of a broad institutions 20:10.652 --> 20:13.370 such as Emery to focus not only on the 20:13.370 --> 20:15.481 care of these patients but also doing 20:15.481 --> 20:17.537 good research and also , at the same 20:17.537 --> 20:19.703 time , taking care of all of our other 20:19.703 --> 20:21.814 patients and all of our providers was 20:21.814 --> 20:23.981 critically important for our success . 20:25.140 --> 20:28.000 Thank you . Our first question is from 20:28.000 --> 20:31.040 Pearl Matiba . She's from News Day of 20:31.040 --> 20:33.120 Zimbabwe . Ah , Pearl , if you could 20:33.120 --> 20:35.231 just wait while we amuse you and turn 20:35.231 --> 20:37.453 on your video and then you can ask your 20:37.453 --> 20:38.453 question . 20:45.490 --> 20:48.890 I'm just saying audio . Thank you so 20:48.890 --> 20:52.710 much . Dr . Meter and Dr Kraft , I 20:52.710 --> 20:55.550 really appreciate all your experience 20:55.550 --> 20:58.020 from Emory University Hospital . This 20:58.020 --> 20:59.853 is fantastic . knowledge , and I 20:59.853 --> 21:02.240 appreciate your availability here today . 21:02.460 --> 21:06.180 So I'd like to ask you , um , in with 21:06.180 --> 21:09.380 all that you have learned , Um , if you 21:09.380 --> 21:11.730 transfer that knowledge in terms off 21:11.740 --> 21:15.060 what you learned on Ebola to covet , we 21:15.060 --> 21:17.570 have countries such as Botswana , 21:17.580 --> 21:19.770 Mozambique , South Africa , Zambia and 21:19.770 --> 21:23.400 Zimbabwe who have a lot off 21:23.550 --> 21:26.440 cross border returnees off their 21:26.440 --> 21:28.920 nationals crossing the border and so on 21:29.390 --> 21:32.420 right now . So we have some 21:32.420 --> 21:36.320 transmission that way . Can you relate 21:36.320 --> 21:39.720 what you learned from Ebola in terms of 21:39.720 --> 21:43.160 how to handle cross border transmission ? 21:43.540 --> 21:45.230 Um , and if you could speak 21:45.230 --> 21:47.300 specifically , I know you might talk 21:47.300 --> 21:50.000 about measures , but access to 21:50.010 --> 21:52.700 information in this region can be 21:52.700 --> 21:55.530 difficult . So can you try to be as 21:55.530 --> 21:57.363 specific as possible in terms of 21:57.363 --> 21:59.370 measures , advice , policy 21:59.370 --> 22:02.320 recommendations ? Possibly , Um , any 22:02.330 --> 22:04.880 data you might be able to kind of maybe 22:04.880 --> 22:08.170 make comparisons and also you , even 22:08.170 --> 22:10.150 though you are in the medical 22:10.150 --> 22:12.560 profession and so on , you cannot do 22:12.560 --> 22:16.060 this task alone without government and 22:16.060 --> 22:19.200 policy leader political will , you will 22:19.200 --> 22:21.367 never accomplish what you're hoping to 22:21.367 --> 22:23.770 accomplish . How do you balance that 22:23.770 --> 22:27.030 civil society , academia and , ah , 22:27.040 --> 22:30.570 policymaker and government . 22:31.240 --> 22:32.962 That's cumbia . Really . tough 22:33.110 --> 22:36.910 balancing act . Thanks . Thank you for 22:36.910 --> 22:38.960 that question . Um , how long do we 22:38.960 --> 22:41.250 have for this answer ? Just kidding . 22:42.280 --> 22:46.230 Ah , a very 22:46.230 --> 22:49.750 comprehensive questions . So I feel I'm 22:49.750 --> 22:51.972 trying to take notes on the question to 22:51.972 --> 22:54.139 make sure that I answer all of it s so 22:54.139 --> 22:56.250 I really appreciate your question And 22:56.250 --> 22:58.361 having spent , um , have a real heart 22:58.361 --> 23:01.260 for Africa and the in the , um uh , 23:01.270 --> 23:04.360 clinical care in in Africa . And so 23:04.370 --> 23:06.730 you're bringing me back , Teoh . Lots 23:06.730 --> 23:08.897 of places have been in the last year . 23:09.130 --> 23:11.820 Ah , and so there is quite a lot of 23:11.820 --> 23:15.360 difficulty between balancing academia , 23:15.370 --> 23:19.300 civil society and policy making . I I 23:19.310 --> 23:21.540 cannot pretend to know at all and being 23:21.550 --> 23:24.330 expert , allow this . I think , um , 23:24.400 --> 23:26.344 the main thing that you hit upon , 23:26.344 --> 23:28.178 which is something I feel really 23:28.178 --> 23:29.956 passionate about and working on 23:29.956 --> 23:32.800 contracts to be able to implement 23:32.810 --> 23:35.950 infection prevention practices globally . 23:36.440 --> 23:39.260 So distilling down what we can do to 23:39.260 --> 23:41.400 protect , protect ourselves in our 23:41.400 --> 23:44.640 health care workers first and foremost , 23:45.490 --> 23:47.268 no matter what . The setting is 23:47.268 --> 23:49.323 something that we've been working on 23:49.323 --> 23:51.546 for five years . And Pearl I'm gonna or 23:51.546 --> 23:53.768 would you prefer Miss Matiba earlier is 23:53.768 --> 23:55.880 fine . Perlis . Fine . Thank you , Dr 23:55.880 --> 23:59.410 Kraft . Um , Pearl , I think that , uh , 23:59.420 --> 24:02.640 you know , I think I'm gonna be real 24:02.640 --> 24:05.410 honest , and I This is a perspective 24:05.660 --> 24:07.827 that infection prevention and training 24:07.827 --> 24:11.450 is not sexy . It's been very difficult 24:11.450 --> 24:14.040 for us to raise money even domestically , 24:14.200 --> 24:16.311 even after carrying for patients with 24:16.311 --> 24:18.367 the bola virus disease for people to 24:18.367 --> 24:21.550 want to make this an innovative and 24:21.940 --> 24:25.480 widely accessible set of skills . Ah , 24:25.490 --> 24:28.120 this sounds kind of , um , hand waving 24:28.120 --> 24:30.440 and maybe excuse generating . But you 24:30.440 --> 24:32.551 would be surprised we can raise funds 24:32.551 --> 24:34.773 for pediatrics . We can raise funds for 24:34.773 --> 24:37.170 cancer . I disease that I was a part of 24:37.170 --> 24:39.930 some of the I work in Sierra Leone that 24:39.930 --> 24:42.910 Emery did after the Ebola outbreak . 24:43.640 --> 24:47.320 But we we have not made this a sexy and 24:47.470 --> 24:51.240 globally important training . So I 24:51.250 --> 24:53.600 is One of my goals is to change that . 24:53.860 --> 24:55.527 Currently , working with some 24:55.527 --> 24:57.471 foundations to try , Have you been 24:57.471 --> 24:59.638 worked with them ? A tumble foundation 24:59.638 --> 25:01.860 where we're trying to figure out how we 25:01.860 --> 25:04.580 can best put this information in a low 25:04.580 --> 25:06.413 tech or high tech way . I mean , 25:06.413 --> 25:08.636 everybody has smart phones , you know , 25:08.636 --> 25:10.969 no matter where , almost where you live , 25:10.969 --> 25:13.136 how we can get that information widely 25:13.136 --> 25:15.358 disseminated to these porous borders to 25:15.358 --> 25:17.191 the cat , urban capital cities , 25:17.191 --> 25:20.100 Kinshasa and others . And so the way 25:20.100 --> 25:22.322 that I view this is we've got to figure 25:22.322 --> 25:24.322 out how to get information into the 25:24.322 --> 25:27.010 hands of every person and then , um , 25:27.760 --> 25:29.816 fortunately , or unfortunately being 25:29.816 --> 25:31.816 next to the CDC . I've had a lot of 25:31.816 --> 25:33.760 colleagues who have gone in on and 25:33.760 --> 25:35.982 tried to create some of this policy for 25:35.982 --> 25:38.640 these regions in Africa . And so , 25:38.650 --> 25:40.872 unfortunately , it's difficult when the 25:40.872 --> 25:42.706 civil society does not trust the 25:42.706 --> 25:44.872 government , such as in the Democratic 25:44.872 --> 25:47.094 Republic of the Congo . That was really 25:47.094 --> 25:50.600 a , um that was upside down world for 25:50.600 --> 25:52.711 CDC who are very used to working with 25:52.711 --> 25:55.270 the government locally , to be able to 25:55.270 --> 25:57.800 educate and support the individuals in 25:57.800 --> 26:00.780 the population locally . When those two 26:00.780 --> 26:03.250 aren't aligned , there's there's that's 26:03.250 --> 26:06.800 very , very difficult task . So I would 26:06.800 --> 26:09.950 say that , um , 26:10.440 --> 26:12.880 the policies need Teoh first and 26:12.880 --> 26:15.480 foremost educate and focus on the 26:15.480 --> 26:18.500 education of of the nation around 26:18.500 --> 26:21.300 infection prevention practices . Um , I 26:21.300 --> 26:23.560 think it's very hard we've seen that 26:23.560 --> 26:26.410 globally , the containment of this is 26:26.830 --> 26:30.600 impossible right now , at least for non 26:30.600 --> 26:33.390 Wuhan located individuals and countries . 26:33.680 --> 26:36.800 Wuhan was able Teoh create a scenario 26:36.800 --> 26:38.967 where they actually contained in their 26:38.967 --> 26:41.133 population , which is quite dramatic . 26:41.133 --> 26:43.133 And I don't know that that could be 26:43.133 --> 26:45.078 replicated . So when we're talking 26:45.078 --> 26:47.110 about societies that don't have the 26:47.110 --> 26:49.277 ability to do containment , then we're 26:49.277 --> 26:51.332 really focusing on risk mitigation . 26:51.540 --> 26:54.230 And I think it believes with it starts 26:54.230 --> 26:56.230 with the very basic level what I've 26:56.230 --> 26:58.508 just talked about , which is education . 26:58.508 --> 27:00.230 And then we build on that with 27:00.230 --> 27:02.850 diagnostic testing and triaging . So I 27:02.850 --> 27:04.628 have no idea if I even , like , 27:04.628 --> 27:06.906 approached the answer to your question . 27:07.240 --> 27:09.360 But I would love to have continued 27:09.360 --> 27:11.471 discussion about this . And I am very 27:11.471 --> 27:14.880 passionate about how we how we roll 27:14.880 --> 27:16.991 this out . I'm not interested in just 27:16.991 --> 27:19.269 protecting domestic healthcare workers . 27:19.269 --> 27:21.430 I think if we can create a global 27:21.430 --> 27:24.220 culture change where we understand our 27:24.220 --> 27:25.998 personal responsibility and the 27:25.998 --> 27:27.998 prevention of transmission diseases 27:27.998 --> 27:30.650 that we will be in a better place , it 27:30.650 --> 27:32.650 will take care of people everywhere 27:32.650 --> 27:34.594 without having to even do policy . 27:35.540 --> 27:37.651 Thank you very much , Dr Kraft . Um , 27:37.651 --> 27:39.780 I'm sure that I will try to recharge 27:39.780 --> 27:42.600 you after this at some point that thank 27:42.600 --> 27:46.240 you . Right . Thank you . Our next 27:46.240 --> 27:50.020 question is from , um , Miss , 27:50.030 --> 27:52.850 not a Theron from Indo Asian News . 27:55.640 --> 27:59.000 But thank you so much for your time 27:59.000 --> 28:02.160 doctors . My question eyes basically 28:02.160 --> 28:04.382 this Let me just introduce myself . I'm 28:04.382 --> 28:06.271 Nikki with the integration , Your 28:06.271 --> 28:07.938 Service and Observer Research 28:07.938 --> 28:09.993 Foundation , which is a think tank . 28:09.993 --> 28:12.160 Justus Context . I'm from India . I 28:12.160 --> 28:14.880 live and work in the US , though , and 28:14.890 --> 28:16.970 there seems to be a dozen wearing 28:16.970 --> 28:19.081 definitions off a luck lock down just 28:19.081 --> 28:21.570 between these two countries alone . Um , 28:21.580 --> 28:24.210 purely from a medical best practice 28:24.210 --> 28:26.460 point of view , how would you suggest 28:26.460 --> 28:28.300 is the best way to go from here 28:28.310 --> 28:30.360 Wherever we are in the U . S . My 28:30.360 --> 28:33.160 question relates to the U . S . I also 28:33.160 --> 28:35.580 want you to talk a little bit about the 28:35.580 --> 28:38.250 possibilities off digital contact . 28:38.250 --> 28:41.600 Tracing where technology is available 28:41.600 --> 28:44.660 at scale were smartphones . Thank you . 28:49.240 --> 28:52.060 So I'm trying to answer the the contact 28:52.060 --> 28:54.060 tracing issue just a little bit . I 28:54.060 --> 28:56.227 think there have been some really nice 28:56.227 --> 28:59.340 innovations in an ability to use 28:59.340 --> 29:01.820 technology . Such a smart phones help 29:01.830 --> 29:04.820 epidemiologic epidemiologist trace 29:04.820 --> 29:07.290 who's infected and who's not . And also 29:07.290 --> 29:09.860 here at Emory . Our colleagues in a new 29:09.860 --> 29:12.370 emergency medicine created an app that 29:12.370 --> 29:14.537 allows people to really say what their 29:14.537 --> 29:16.648 symptoms are , what they're feeling , 29:16.648 --> 29:18.814 and understand what the risk for of it 29:18.814 --> 29:21.037 is . And all of those can feed into our 29:21.037 --> 29:22.981 epidemiologic data pools to really 29:22.981 --> 29:25.770 understand the impact beyond , you know , 29:25.770 --> 29:27.937 the testing that we're rolling out . A 29:27.937 --> 29:29.937 doctor craft mentioned all of these 29:29.937 --> 29:31.937 data can be used together to really 29:31.937 --> 29:34.710 help us understand the impact that , uh , 29:34.850 --> 29:37.150 coveted has had on our communities and 29:37.150 --> 29:38.983 also how it's moving through our 29:38.983 --> 29:41.150 communities . That's something that we 29:41.150 --> 29:44.180 really need . Toe move . I and Nikki , 29:44.180 --> 29:47.170 can you repeat your first question for 29:47.170 --> 29:51.100 us ? Um , purely from a medical best 29:51.110 --> 29:54.350 practice point of view . Where does the 29:54.350 --> 29:57.010 U . S go from here ? Forget about the 29:57.010 --> 29:59.630 politics . All the people that you have 29:59.630 --> 30:01.900 to deal with as an epidemiologist 30:02.220 --> 30:05.990 Assume you were creating policy purely 30:05.990 --> 30:08.630 from a medical perspective or immuno 30:08.630 --> 30:10.850 compromised populations for healthy 30:10.850 --> 30:13.370 populations . Whoever What would you 30:13.370 --> 30:15.970 say ? Uh , I can answer this one , 30:15.970 --> 30:18.790 Doctor meta if you want . Okay . 30:19.540 --> 30:22.970 Uh , so I I'm going to say two things . 30:22.970 --> 30:25.040 One . I appreciate that You want to 30:25.040 --> 30:28.160 make this a very sliver of of the 30:28.160 --> 30:31.000 context . I think it's impossible to 30:31.000 --> 30:33.250 make the medical recommendations be 30:33.250 --> 30:35.220 completely out of context , toe 30:35.230 --> 30:37.710 everything else that's going on . Um , 30:37.870 --> 30:40.037 you know , I think all of us intersect 30:40.037 --> 30:42.203 with many different groups of people . 30:42.203 --> 30:44.203 This is a very big struggle in many 30:44.203 --> 30:46.259 different ways . I mean , it's we're 30:46.259 --> 30:48.592 intersecting stress at every level . Um , 30:49.040 --> 30:52.530 I'm very involved with refugees near 30:52.540 --> 30:54.373 near where I live in Clarkston , 30:54.373 --> 30:56.840 Georgia , And , um , the intersection 30:56.840 --> 30:58.951 there , with their abilities and what 30:58.951 --> 31:01.360 they can dio is a lot different than 31:01.370 --> 31:03.481 you know , a middle class family that 31:03.481 --> 31:05.203 lives across the street from a 31:05.203 --> 31:07.203 potentially . So , you know , I I'm 31:07.203 --> 31:09.148 gonna just acknowledge that in the 31:09.148 --> 31:11.148 beginning , before I talk about the 31:11.148 --> 31:13.259 policy part , I'm also going to say , 31:13.259 --> 31:15.592 and this is probably gonna be unpopular . 31:15.592 --> 31:17.481 Um , is that while we're gonna we 31:17.481 --> 31:19.537 should have policy that protects our 31:19.537 --> 31:21.759 public . I think that what I've seen in 31:21.759 --> 31:24.410 the last week in the United States and 31:24.410 --> 31:26.632 again , I've been focused on the United 31:26.632 --> 31:28.743 States because I'm trying to get this 31:28.743 --> 31:30.799 hospital ready to serve the needs of 31:30.799 --> 31:33.021 the community . Given that our governor 31:33.021 --> 31:35.330 basically has rescinded , are stay at 31:35.330 --> 31:38.330 home policy starting last Friday . And 31:38.330 --> 31:41.650 so I've been very ultra focused on on 31:41.720 --> 31:43.720 the United States , and I I'm sorry 31:43.720 --> 31:45.942 about that , everybody . But I will get 31:45.942 --> 31:47.998 more global when I have a little bit 31:47.998 --> 31:50.220 more time to focus on that . Um , but I 31:50.220 --> 31:52.553 think that it's really difficult . Teoh , 31:53.740 --> 31:56.710 Uh , I think what we should be doing 31:56.710 --> 31:58.920 for better for worse is is what I kind 31:58.920 --> 32:02.810 of said . Teoh . Matiba , Makybe Tae 32:02.810 --> 32:04.921 Be sorry , Pearl . I want to say your 32:04.921 --> 32:07.310 last name correctly . Um What ? What I 32:07.310 --> 32:09.310 said to her is that there has to be 32:09.310 --> 32:11.370 some level of empowerment , an 32:11.370 --> 32:13.810 instruction to the individual . I'm not 32:13.810 --> 32:15.866 saying that people should be free to 32:15.866 --> 32:18.380 make their own choice everywhere , But 32:18.380 --> 32:20.710 I think with we are confusing people 32:20.710 --> 32:23.370 with the messages that were giving , um , 32:23.450 --> 32:25.450 people don't understand how to make 32:25.450 --> 32:27.172 these decisions . They have no 32:27.172 --> 32:29.506 framework in which to make the decision . 32:29.506 --> 32:31.617 So what I would like to do if I could 32:31.617 --> 32:34.300 wave my wand is to say , this is the 32:34.300 --> 32:36.650 framework of behavior you have . You 32:36.650 --> 32:39.370 have your immuno compromised , you have 32:39.380 --> 32:42.130 end stage cancer . Here's here's your 32:42.130 --> 32:44.186 framework that you should be . These 32:44.186 --> 32:46.352 are the things you should be concerned 32:46.352 --> 32:48.574 about . These are the places you should 32:48.574 --> 32:50.463 avoid . Um , because this idea of 32:50.463 --> 32:52.630 saying Stay at home shelter in place . 32:52.630 --> 32:54.741 You know , I've had colleagues say to 32:54.741 --> 32:56.852 me , I have literally gone nowhere in 32:56.852 --> 32:59.120 the last six weeks except the grocery 32:59.120 --> 33:02.040 store and the hardware store . And so I 33:02.040 --> 33:03.873 was like , That's actually going 33:03.873 --> 33:06.460 somewhere and so we it's almost like 33:06.470 --> 33:08.803 putting the public health aspects to it . 33:08.870 --> 33:10.981 While I think it makes sense to those 33:10.981 --> 33:13.940 of us that live and breathe that we we 33:13.940 --> 33:16.850 are missing , educating people on an 33:16.860 --> 33:18.971 individual level how they can protect 33:18.971 --> 33:21.138 themselves . That's what that's what I 33:21.138 --> 33:23.138 think is happening . We've tried to 33:23.138 --> 33:25.193 substitute that by saying shelter in 33:25.193 --> 33:27.193 place , but we cannot do indefinite 33:27.193 --> 33:29.360 shelter in place again for the reasons 33:29.360 --> 33:31.360 that I mentioned earlier . We can't 33:31.360 --> 33:33.527 take medical and health out of context 33:33.527 --> 33:35.638 of economics , and that's really what 33:35.638 --> 33:37.360 we're seeing right . It's It's 33:37.360 --> 33:39.138 literally the competition of of 33:39.138 --> 33:42.530 economic engine and medical medical 33:42.790 --> 33:44.790 health in public health , right ? I 33:44.790 --> 33:46.901 mean , that's what I think , and so I 33:46.901 --> 33:49.310 think we need to be better at trying to 33:49.310 --> 33:51.600 engage and empower the individual to 33:51.600 --> 33:53.822 make good choices , an individual level 33:53.822 --> 33:56.320 as well as having this sort of bigger , 33:56.500 --> 33:58.833 bigger response . I hope that's helpful . 33:59.640 --> 34:01.620 Yeah , actually , yes . I mean , I 34:01.620 --> 34:03.840 think you've answered my question . 34:03.840 --> 34:06.118 Although you started with a disclaimer , 34:06.118 --> 34:09.330 I think you've answered me because this 34:09.330 --> 34:11.550 goes back to what I said . But the 34:11.550 --> 34:14.180 definitions off , locked down can't be 34:14.180 --> 34:18.160 so many . Um , there are so many 34:18.160 --> 34:20.438 across the world and even in these two , 34:20.438 --> 34:22.600 geography is which I closely follow . 34:23.600 --> 34:26.150 Geography with four x The population 34:26.160 --> 34:28.710 off the U . S . Has a far more 34:28.710 --> 34:31.370 stringent block down , but they're the 34:31.370 --> 34:33.740 messaging has been simple and almost 34:33.740 --> 34:37.190 monolithic . Now you can stay . Of 34:37.190 --> 34:39.412 course , you can push back and say No , 34:39.412 --> 34:41.634 That's draconian or too stringent . But 34:41.634 --> 34:43.690 at least there is one single message 34:45.540 --> 34:48.290 and everyone gets it . There's there's 34:48.290 --> 34:50.660 actually policing where they say , Look , 34:50.660 --> 34:52.882 this is the only time you can go to the 34:52.882 --> 34:55.104 grocery store if you want to , and only 34:55.104 --> 34:57.271 one person from each hassle . There is 34:57.271 --> 34:59.450 actually a contact tracing app , which 34:59.450 --> 35:01.950 is actually which is working , and 70 35:01.950 --> 35:04.510 million people have downloaded it . So 35:04.520 --> 35:08.390 with a lot less resource is there Are 35:08.610 --> 35:11.770 there slightly better functioning , 35:11.970 --> 35:15.920 um , methods , even if you 35:15.920 --> 35:19.430 call it to a stringent on and then you 35:19.430 --> 35:23.350 have Allah cart menu , where you choose . 35:24.040 --> 35:26.207 You know , you can go out for a walk . 35:26.207 --> 35:29.620 Glad for . I still don't know . I mask 35:29.620 --> 35:32.270 up and I do everything . But I'm still 35:32.280 --> 35:34.660 free to go out on around every day . 35:36.180 --> 35:39.080 And I'm the question Mark is right 35:39.080 --> 35:41.302 there in front of my eyes when I'm even 35:41.302 --> 35:43.469 when I'm walking . Like , is this OK ? 35:43.469 --> 35:45.860 But I don't know who somebody has to 35:45.860 --> 35:47.971 tell me that at an individual level , 35:47.971 --> 35:50.193 like you said . But yes , sorry for the 35:50.193 --> 35:52.150 long Uh , no , no , I think it's 35:52.160 --> 35:54.327 nothing is beautiful . So I think that 35:54.500 --> 35:56.990 you if you're not gonna give people the 35:56.990 --> 35:59.570 tools to make good choices , then you 35:59.570 --> 36:02.120 need to make the choices for them . But 36:02.120 --> 36:04.520 what we've done is we've said , here's 36:04.580 --> 36:06.691 we're not going to enforce anything . 36:07.230 --> 36:09.650 But we're not gonna tell you what's 36:09.650 --> 36:12.550 good or bad for you either . And so I 36:12.550 --> 36:15.820 mean , I I like the idea of saying 36:15.960 --> 36:18.700 limit this limit this But maybe we 36:18.700 --> 36:20.644 don't enforce it , right . Like we 36:20.644 --> 36:22.700 still have sort of a unified message 36:22.930 --> 36:25.180 where we say if you're this , if you're 36:25.180 --> 36:27.180 this , you know this this is a high 36:27.180 --> 36:29.347 risk . This is low risk , you know ? I 36:29.347 --> 36:31.347 believe walking outside is very low 36:31.347 --> 36:33.569 risk . There's a lot of air exchange in 36:33.569 --> 36:35.736 the atmosphere , right ? But if you're 36:35.736 --> 36:37.847 if you don't know that if no one sort 36:37.847 --> 36:39.736 of just explain some of this like 36:39.736 --> 36:41.847 here's low risk activities , here are 36:41.847 --> 36:44.370 high risk activities if you are someone 36:44.370 --> 36:47.290 that has chronically ill avoid all high 36:47.290 --> 36:49.346 risk activities or medium , I mean , 36:49.346 --> 36:51.457 however you want toe kind of lay that 36:51.457 --> 36:53.623 all out . But you give that Allah cart 36:53.623 --> 36:55.860 menu . But you also educate the person 36:55.890 --> 36:58.112 that's choosing from the menu , right ? 36:58.730 --> 37:01.380 Or you make the menu so accessible that 37:01.380 --> 37:03.602 it makes sense to them so they can kind 37:03.602 --> 37:05.824 of taken stay within the framework that 37:05.824 --> 37:07.547 you maybe you want but haven't 37:07.547 --> 37:09.769 purposely expressed right . Maybe it is 37:09.769 --> 37:11.824 stringent . Could you say you really 37:11.824 --> 37:14.047 shouldn't be doing X y Z if you're this 37:14.470 --> 37:16.440 to let her at a quick personal 37:16.450 --> 37:19.420 perspective to this . So , uh , my 37:19.420 --> 37:21.690 mother spent the last three months in 37:21.700 --> 37:25.340 India and took an evacuation flight one 37:25.340 --> 37:27.810 week ago today , and while she was 37:27.820 --> 37:29.931 there , it was very clear to her what 37:29.931 --> 37:32.250 the rules were and what she could and 37:32.250 --> 37:35.760 could not do . Um , however , given 37:35.760 --> 37:37.927 that she has blended the United States 37:37.927 --> 37:40.038 for over 30 years . That's culturally 37:40.038 --> 37:42.204 different for her now , so it was hard 37:42.204 --> 37:44.204 for her to follow those rules . But 37:44.204 --> 37:46.316 she's not used to having rules put on 37:46.316 --> 37:48.920 her . And so now she's here living with 37:48.920 --> 37:51.750 us . Um and she 37:52.440 --> 37:55.540 is free to do what she wants . And now 37:55.540 --> 37:57.707 she wants to know what the rules are . 37:57.707 --> 37:59.929 And I can't tell you what the rules are 37:59.929 --> 38:02.096 because it's not completely clear . So 38:02.096 --> 38:04.318 I understand that there are . There are 38:04.318 --> 38:06.151 cultural differences , There are 38:06.151 --> 38:08.207 differences of understanding . And I 38:08.207 --> 38:10.262 think as we move forward and prepare 38:10.262 --> 38:12.429 for the next outbreak , we need tohave 38:12.429 --> 38:14.900 this infrastructure of how we implement 38:14.900 --> 38:16.956 these things better in place so that 38:16.956 --> 38:20.510 it's clear for all of our all right . 38:20.510 --> 38:22.454 I'd now like to pass it on to Miss 38:22.454 --> 38:24.800 Lenka White . And after she asked her 38:24.800 --> 38:27.090 question , will pass it on to China 38:27.090 --> 38:29.420 Business Network . Please go . Ah , 38:29.430 --> 38:31.486 ahead , Miss , Wait . Thank you very 38:31.486 --> 38:33.940 much . I hope you can to share me well . 38:34.320 --> 38:36.470 So thank you for your presentations . 38:36.470 --> 38:39.200 Doctor Craft and Dr Meta , my name , 38:39.200 --> 38:41.040 Miss Link a white and I'm a 38:41.040 --> 38:43.580 correspondent at the United Nations for 38:43.580 --> 38:46.470 the Mainichi newspaper . I hope this 38:46.470 --> 38:48.800 question is not going to be too broad 38:48.800 --> 38:51.070 for you . Feel free to dismiss it in 38:51.070 --> 38:54.030 that case . But I was wondering , from 38:54.030 --> 38:56.197 your point of view , could you comment 38:56.197 --> 38:58.980 on the international community response 38:59.250 --> 39:01.260 such as the U . N international 39:01.260 --> 39:04.330 organizations or the Security Council 39:04.720 --> 39:08.140 toe Ebola and now to commit . Did you 39:08.140 --> 39:10.440 feel the impact bag done differently ? 39:10.440 --> 39:14.030 And do you feel an impact all Thank you . 39:16.120 --> 39:18.680 I'm happy to start with Ebola , The 39:18.690 --> 39:20.690 Doctor Meadow . If you want to take 39:20.690 --> 39:22.968 that last part or you just let me know . 39:23.520 --> 39:25.853 So I think he responds with Ebola again . 39:25.853 --> 39:28.840 Um , and and you all may have better 39:28.840 --> 39:31.173 context for this that you're gonna hear , 39:31.173 --> 39:33.340 you know , American citizen talk about 39:33.340 --> 39:35.507 something that happened in the eastern 39:35.507 --> 39:37.673 region of the DRC , which you may have 39:37.673 --> 39:40.270 more visibility . So their with me . 39:41.400 --> 39:44.910 So I think the response was quite 39:44.910 --> 39:48.120 robust . We learned a lot from 2014 in 39:48.120 --> 39:51.830 West Africa that the longer we sat on 39:51.840 --> 39:53.951 providing assistance to the country , 39:53.951 --> 39:55.951 whether or not , um , you know , we 39:55.951 --> 39:58.007 should be going in and enforcing are 39:58.007 --> 40:00.660 sort of , um , different ideas in that 40:00.660 --> 40:02.860 country about infection prevention or 40:03.000 --> 40:05.111 about quarantine . I think we learned 40:05.111 --> 40:07.770 quickly . We needed to , um , work 40:07.770 --> 40:10.370 quickly and have a global response . I 40:10.370 --> 40:12.720 was very proud of Dr Ted Rose and 40:12.720 --> 40:15.560 others who spoke up quickly and tried 40:15.560 --> 40:18.620 to act aggressively . I think it needs 40:18.620 --> 40:21.340 to be said that that area of the world 40:21.350 --> 40:23.610 is full of strife , and I know all of 40:23.610 --> 40:25.730 you have read the background of that 40:25.740 --> 40:29.000 place . But having been there and , um , 40:29.010 --> 40:31.910 experience some of the overtones , I 40:31.910 --> 40:34.530 think with the global response , it 40:34.530 --> 40:37.480 still took a year to be able Thio 40:38.370 --> 40:40.203 Thio control that because of the 40:40.203 --> 40:44.060 government and local strife , as I've 40:44.060 --> 40:46.282 described earlier in the eastern region 40:46.282 --> 40:49.580 of of the DRC and then also just , 40:50.470 --> 40:52.950 uh , not only that , but obviously the 40:53.120 --> 40:56.290 intense violence that all of the 40:56.290 --> 40:59.070 providers found themselves in . When 40:59.070 --> 41:01.340 you have individuals fleeing into an 41:01.340 --> 41:05.050 Ebola outbreak area for 41:05.050 --> 41:07.520 safety , I think that should alone . 41:07.790 --> 41:10.390 Tell us , um what what we're dealing 41:10.390 --> 41:14.110 with , Um , with over 300 attacks 41:14.120 --> 41:16.480 on these on the individuals and the 41:16.480 --> 41:19.840 units during during even a few months , 41:19.850 --> 41:22.300 I think Ah , you know , the killing of 41:22.310 --> 41:24.254 basically patients and health care 41:24.254 --> 41:26.710 workers by local militias in that area , 41:27.050 --> 41:30.500 including a W H o um official . 41:30.700 --> 41:33.970 I think it should show us that even 41:33.970 --> 41:36.520 with dramatic international response 41:36.520 --> 41:38.690 for containment , it still took us a 41:38.690 --> 41:40.912 year because of all the complexities of 41:40.912 --> 41:44.530 that of that particular outbreak , Uh , 41:44.540 --> 41:47.390 I'll move on to , um , Dr Met . If he 41:47.390 --> 41:49.334 wants to try to answer the cove it 41:49.334 --> 41:53.240 aspect of it to any time there is an 41:53.240 --> 41:56.010 outbreak , it is very difficult for the 41:56.010 --> 41:58.066 international community to gauge how 41:58.066 --> 42:00.177 widespread it's gonna be . It's gonna 42:00.177 --> 42:02.910 be a localized outbreak versus a , uh , 42:03.060 --> 42:06.520 endemic , um , and I think it's always 42:06.520 --> 42:08.870 easy to go back retrospectively and 42:08.870 --> 42:11.550 find problems that , you know , we 42:11.550 --> 42:14.090 could have responded Teoh rapidly . But 42:14.090 --> 42:16.770 I do think that what happened with the 42:16.770 --> 42:20.060 coveted 19 outbreak is is really a 42:20.060 --> 42:23.760 positive overall response . So 42:23.760 --> 42:26.830 very quickly we received information 42:26.830 --> 42:29.970 from our Chinese colleagues about what 42:29.980 --> 42:32.950 they were seen . I remember getting the 42:32.960 --> 42:36.410 email just on New Year's Eve about the 42:36.410 --> 42:38.770 outbreak that the doctors were seeing 42:38.770 --> 42:42.520 there in on , and I think very 42:42.520 --> 42:44.940 quickly we got a answer into what sort 42:44.940 --> 42:47.270 of virus this waas and how familiar it 42:47.270 --> 42:49.800 waas do . Other viruses that we've seen 42:49.800 --> 42:53.110 before and I think overall , the 42:53.900 --> 42:56.880 local medical community response The 42:56.980 --> 42:59.230 public health agencies across the world 42:59.550 --> 43:02.010 have had a overall very good response . 43:02.010 --> 43:05.470 I think we learned , um , how these 43:05.470 --> 43:07.637 things go , as as we're moving through 43:07.637 --> 43:09.359 them and we have to adjust our 43:09.359 --> 43:11.248 particles . But I think overall , 43:11.248 --> 43:13.414 everybody worked very well together to 43:13.414 --> 43:15.692 try to respond the past weekend course , 43:15.692 --> 43:17.859 different countries in different areas 43:17.859 --> 43:20.450 implement different procedures for 43:20.450 --> 43:22.617 public health responses And what we'll 43:22.617 --> 43:24.672 learn now that this is what what has 43:24.672 --> 43:26.810 been successful and what has not been 43:26.810 --> 43:29.032 successful . But we won't know that for 43:29.032 --> 43:31.032 several more months or even years . 43:33.200 --> 43:36.390 Well , thank you . We have one final 43:36.390 --> 43:38.940 question from China Business Network , 43:39.260 --> 43:41.316 as I know are two doctors have to go 43:41.316 --> 43:44.220 and treat a Kobe 19 patients . So , um , 43:44.350 --> 43:46.790 he's go ahead . Uh , China Business 43:46.790 --> 43:50.590 Network . Yes . Thank you . And , 43:50.600 --> 43:53.530 uh , good morning . Uh , can everyone 43:53.530 --> 43:57.260 hear me ? Okay , so , uh , I 43:57.260 --> 44:01.190 gotta , um , to question eso . 1st 1 is 44:01.220 --> 44:04.810 could you help me to understand the the 44:04.810 --> 44:07.080 difference of the different dust rate 44:07.080 --> 44:09.470 ranging from 1000 career and depend at 44:09.470 --> 44:12.500 around 2 to 3 points , US and China 44:12.500 --> 44:15.960 around 5.5% to fuck which 8% to 44:15.960 --> 44:18.940 countries like UK , Italy and Friends , 44:19.010 --> 44:22.410 which stands around 10 13 and 14 . 44:22.890 --> 44:25.130 If we assume that virus treats us 44:25.140 --> 44:27.290 equally , what is the reason behind a 44:27.290 --> 44:29.401 wide range of gas rate , even the one 44:29.650 --> 44:32.150 developed countries and what we can do ? 44:32.150 --> 44:34.206 I mean , us can do more to lower the 44:34.206 --> 44:36.850 death straight . And also , I got one 44:36.850 --> 44:39.600 more question about a usage of the feud 44:39.600 --> 44:42.880 hospital in the US Um , I live in New 44:42.880 --> 44:45.158 York and the Javits Center , and the U . 44:45.158 --> 44:48.530 S s conference is nearly used 44:48.760 --> 44:51.160 during the outbreak , actually , and 44:51.350 --> 44:53.461 actually the comfort is departing the 44:53.461 --> 44:56.530 usto departing New York today with 44:56.540 --> 44:59.960 182 patients treated over 44:59.970 --> 45:03.900 3.5 weeks . This is quite different , 45:03.910 --> 45:07.240 what from what we saw in Wuhan , China . 45:07.240 --> 45:09.700 So if you can give a little bit of your 45:09.700 --> 45:12.310 thoughts of this to thank you , Thank 45:12.310 --> 45:14.532 you . So I think that one of the things 45:14.532 --> 45:16.477 we're learning is that I think the 45:16.477 --> 45:18.588 whole world is understanding better . 45:18.588 --> 45:21.150 What epidemiologic tracing is , uh , 45:21.160 --> 45:23.327 through looking at thes death rates as 45:23.327 --> 45:26.560 a surrogate . So I would say that it's 45:26.560 --> 45:30.060 no surprise that South Korea mobilized 45:30.070 --> 45:33.170 their excellent testing strategy very 45:33.180 --> 45:36.240 early . Ah , and in a coordinated way , 45:36.240 --> 45:40.210 we're able to triage patients into 45:40.210 --> 45:42.210 a covert unit or not covered unit . 45:42.440 --> 45:44.720 They also had an incredibly robust 45:44.720 --> 45:46.887 testing program , so they were testing 45:46.887 --> 45:49.540 a lot more of the population . Um , I 45:49.540 --> 45:52.550 don't know as much about the UK data 45:52.560 --> 45:55.620 except for what you told me . But again , 45:55.860 --> 45:58.082 there was a lot less testing their much 45:58.082 --> 46:00.110 like in the US . I think what we're 46:00.110 --> 46:02.277 going to see , um , it's gonna take us 46:02.277 --> 46:04.499 a little bit is that we're gonna have a 46:04.499 --> 46:06.970 lot more asymptomatic positives in the 46:06.970 --> 46:09.490 United States , and that denominator is 46:09.490 --> 46:11.640 going to continue to grow . So I 46:11.640 --> 46:14.510 suspect that our our death rate , at 46:14.510 --> 46:16.677 least for most of the individuals that 46:16.677 --> 46:18.510 most of the states that were not 46:18.510 --> 46:20.980 overwhelmed , um , will probably mirror 46:20.980 --> 46:24.110 South Korea and China in the in the 46:24.120 --> 46:27.350 fact that in that to 2 to 3% range , 46:27.960 --> 46:29.904 that's certainly what we're seeing 46:29.904 --> 46:33.040 locally . Ah , here in Georgia , New 46:33.040 --> 46:36.540 York has its own , um , crisis within 46:36.540 --> 46:39.310 the crisis within the crisis . Probably 46:39.430 --> 46:41.541 You want to think about it that way . 46:41.541 --> 46:44.540 And so , um , the incredible 46:44.540 --> 46:48.090 population Ah , that is close together . 46:48.090 --> 46:51.480 I think um , contributed to ah , and 46:51.480 --> 46:53.424 the other . The other thing is the 46:53.424 --> 46:55.147 probably early introduction of 46:55.147 --> 46:57.258 community transmission that went on , 46:57.258 --> 46:59.560 recognized in New York . Allowed a lot 46:59.560 --> 47:02.720 of these pockets to kind of bloom all 47:02.720 --> 47:05.330 at the same time which crushed the 47:05.330 --> 47:07.830 health care system in New York . Eso 47:07.830 --> 47:10.650 they're doing much better . As as 47:10.800 --> 47:12.800 there's been community mitigation 47:12.820 --> 47:15.042 strategies . I know they've been really 47:15.042 --> 47:17.264 active , at least in Manhattan , in the 47:17.264 --> 47:19.487 urban areas to do that . I know they're 47:19.487 --> 47:21.709 talking about opening up other parts of 47:21.709 --> 47:24.042 New York from the shelter in place , Uh , 47:24.042 --> 47:26.209 and so I think what we're gonna see is 47:26.209 --> 47:28.209 that the probably the case fatality 47:28.209 --> 47:30.320 rate or mortality rate or however you 47:30.320 --> 47:32.376 want to call it will probably be the 47:32.376 --> 47:34.970 same for everyone across the globe . It 47:34.970 --> 47:37.120 may be worse in places that have less 47:38.630 --> 47:42.140 pulmonary or ventilatory ability . So 47:42.140 --> 47:43.973 if you're it's in a country that 47:43.973 --> 47:45.751 doesn't have a lot of breathing 47:45.751 --> 47:47.807 machines for patients , you probably 47:47.807 --> 47:50.029 will see it increased mortality there . 47:50.029 --> 47:52.196 However , I do think that all of these 47:52.196 --> 47:52.110 probably have the same mortality . It's 47:52.110 --> 47:54.510 just that the diagnostic testing to be 47:54.510 --> 47:56.580 able to see all of the cases in that 47:56.590 --> 47:59.920 area is not his robust . So I believe 47:59.920 --> 48:03.060 that it's a product of diagnostic and 48:03.060 --> 48:04.727 white like lack of widespread 48:04.727 --> 48:06.990 diagnostic testing rather than a true 48:06.990 --> 48:09.101 difference in any sort of health care 48:09.101 --> 48:11.280 system . I'll let Dr Meta , um , 48:12.050 --> 48:15.560 confirm or deny my assumption . No , I 48:15.570 --> 48:17.903 very much agree with what Dr CAFTA said . 48:17.903 --> 48:20.070 I think one of the biggest problems we 48:20.070 --> 48:22.292 have is we don't have great denominator 48:22.292 --> 48:24.403 data in many areas of the world . And 48:24.403 --> 48:26.840 as we roll out there busting and we 48:26.850 --> 48:29.850 have zero prevalent studies done and 48:29.850 --> 48:31.961 have our epidemiologists look , we'll 48:31.961 --> 48:33.961 have a much better understanding of 48:33.961 --> 48:36.080 what the attack rate in So the number 48:36.080 --> 48:38.080 of patients number of people in our 48:38.080 --> 48:40.490 community that are infected , our war 48:40.490 --> 48:42.380 infected and also what the true 48:42.380 --> 48:45.470 mortality is . So I would look at any 48:45.470 --> 48:47.610 mortality data right with a grain of 48:47.610 --> 48:49.943 salt , because we just don't have raped . 48:50.970 --> 48:53.570 Secondly , I would say what there is a 48:53.570 --> 48:55.570 lot of interest in understanding if 48:55.570 --> 48:57.514 different populations are affected 48:57.514 --> 49:00.570 differently . Um , and so we do know 49:00.570 --> 49:03.010 that our elderly populations probably 49:03.010 --> 49:06.170 have more risk of severe disease and 49:06.170 --> 49:09.060 worse outcomes in general . On DSO when 49:09.060 --> 49:11.960 you see a country that has big numbers 49:11.960 --> 49:14.016 of deaths very early on . You need a 49:14.016 --> 49:16.071 look to see . Did the outbreak start 49:16.071 --> 49:18.127 occurring in areas where there are a 49:18.127 --> 49:20.349 lot of elderly ? And here in the United 49:20.349 --> 49:22.571 States , some of our biggest additional 49:22.571 --> 49:24.571 outbreaks were in communities where 49:24.571 --> 49:26.682 there were housing . A lot of elderly 49:26.682 --> 49:28.904 in close keep in close contact . And so 49:28.904 --> 49:31.016 I think that has to be considered and 49:31.016 --> 49:32.904 again that will even out once the 49:32.904 --> 49:35.071 outbreak has gone away . And we really 49:35.071 --> 49:37.450 understand . But there may be ethnic 49:37.460 --> 49:39.516 differences as well and not only the 49:39.516 --> 49:41.850 acquisition of the virus , but also in 49:41.850 --> 49:44.090 how severe the disease could be . And I 49:44.090 --> 49:46.201 think that's gonna be another area of 49:46.201 --> 49:48.257 interest for epidemiologists and our 49:48.300 --> 49:50.411 health services researchers to really 49:50.411 --> 49:53.590 look at in the coming months . How 49:53.590 --> 49:56.090 about the usage of the field hospital 49:56.090 --> 50:00.030 in the in the US and you s o . I 50:00.030 --> 50:02.980 view that as a sign of high concern . 50:03.200 --> 50:06.990 Um , and I think all of us would 50:06.990 --> 50:09.080 agree that a field hospital is not 50:09.080 --> 50:12.200 gonna be the same as a acute care 50:12.200 --> 50:15.180 hospital . And so , um , again , not 50:15.180 --> 50:17.124 being intimately involved with how 50:17.124 --> 50:19.347 they're making that decisions , We , of 50:19.347 --> 50:21.458 course , in the state of Georgia have 50:21.458 --> 50:21.340 set up a field hospital . It's not been 50:21.350 --> 50:24.200 opened , but our goal was would have 50:24.210 --> 50:26.266 been to send people that just needed 50:26.266 --> 50:29.050 oxygen and supportive care at , like , 50:29.060 --> 50:31.950 a less acute level to that type of 50:31.950 --> 50:34.300 place and come and convert our entire 50:34.300 --> 50:36.578 hospital to basically being an icy you . 50:36.740 --> 50:38.907 So that would have been our strategy . 50:40.850 --> 50:42.794 That makes sense . So the use of a 50:42.794 --> 50:46.130 field hospital signals crisis . Got it . 50:46.280 --> 50:50.120 Thank you . All right . And with that , 50:50.130 --> 50:52.690 we will wrap up the briefing . I want 50:52.690 --> 50:56.110 to thank both of the doctors for your 50:56.110 --> 50:58.910 time , especially during this pandemic . 50:59.000 --> 51:01.111 Thank you for what you've done , what 51:01.111 --> 51:03.333 you're doing and what you will be doing 51:03.340 --> 51:05.562 in the near toe . Long term future . So 51:05.562 --> 51:07.830 again . Thank you , everybody . Um , 51:07.840 --> 51:11.260 after , um , this briefing , we will be 51:11.260 --> 51:13.371 posting a transcript and the video to 51:13.371 --> 51:17.160 our website at a pc dot state dot Go . 51:17.450 --> 51:19.617 If you have any additional questions , 51:19.617 --> 51:23.030 you can email them to D . C F . P . C 51:23.120 --> 51:25.960 at ST dot gov again . Thank you to the 51:25.960 --> 51:27.793 two doctors . Thank you to every 51:27.793 --> 51:29.404 university and to all of our 51:29.404 --> 51:31.238 participants . Have a good day , 51:31.238 --> 51:33.470 everybody . Thank you . Thank you . 51:35.700 --> 51:37.480 And you're about okay .