Heliobas Disciple
TB Fanatic
CONTINUED:
Thank you. And as a reminder, if you would like to ask a question, please press star one. Limit to one question and one follow-up. Our next question comes from Eben from Fox news. Your line is now open.
Q: Thank you very much for doing the call today. There has been some political back and forth now that democrats are accusing the president which essentially means the administration and everything that falls under that as being ill prepared for coronavirus, requesting too little of amount in terms of their request for $2.5 billion. Do you feel that we are ill prepared from a financial standpoint? I know you are a clinician and I don’t want you to get too much into politics, but do you have what you need to do your job?
A: I guess I’ll answer that two ways. The first is HHS can provide information or answer questions about the funds that are available. What I can say from my perspective is I’ve been at CDC for 25 years and that if you asked public health officials over the course of that time what they feared as an expectation, it was something exactly like this. And so the idea that we might have a pandemic of influenza or a pandemic of a respiratory viral infection is something that we’ve known about and have been planning and preparing for. That’s why we at CDC have been exercising with the state and local health departments. That’s why the whole of government exercise last year, that’s why we’ve invested so much on the foundation we are now responding.
But that being said, we are never going to ever be able to be so completely prepared that we’re prepared for any inevitability. We always are going to find that diseases surprise us and that there was some consideration that is slightly different from what we planned for. So have we made a lot of progress in the 25 years I’ve been here? Yes. Are we better prepared today than we were 20 years ago? Yes. But are we completely prepared? You know, diseases surprise us and therefore we need to be reacting to the current situation even if it differs from what we planned for.
You know, in general we are asking the American public to work with us to prepare in the expectation that this could be bad. I continue to hope that in the end we’ll look back and feel like we are over-prepared, but that is a better place to be in than being under-prepared. And just like the preparedness for a pandemic influenza provides such a strong foundation for this response, any preparedness we do as a country, at schools, businesses, within our families will always be helpful for whatever the next event is. And so I don’t think in general that preparedness will ever go to waste. Next question, please.
Thank you. Our next question comes from Mike from A.P. Your line is now open.
Q: Hi. Thank you for taking my call. If I could ask a couple. One is just the latest case count, it’s been a little confusing for some of us just to sort out exactly how many U.S. cases there are and how they’re being sorted out. Second, if you could speak to your best and latest understanding of the severity of the disease. Of course there’s some news today about the WHO mission coming back and statements about not finding a lot of undetected cases. I was wondering if that’s related to CDC gearing up for these NPIs. And lastly, talking about the exercising you’ve been doing, what was the weakness or weaknesses that kept coming up in the exercises that you’re most concerned about and you’re really trying to stay on top of now that we have a real time experience happening? Thank you.
A: Okay. So let me — so let me start by saying that I know the case counts can be confusing. I will try to sort out what the numbers are as of today and try to explain why it perhaps is a little confusing. There remain 14 confirmed U.S. cases. We are separating out the cases among repatriated individuals. So those are 14 U.S. Cases. 12 of those are travelers who returned from an area where disease is circulating. Two of those are close contacts of another case. That’s 14. There are three novel coronavirus patients among people who are repatriated from Hubei that is in the repatriated flights. And our website says 36 because we updated this yesterday, but in fact as of this morning, there are 40 positives among individuals repatriated from the “Diamond Princess.” so these are Americans who were on board the “Diamond Princess” repatriated back to the United States. And that’s 40. So that means just to go back that there are 14 confirmed cases picked up through the U.S. public health systems. And 40 plus 3 makes 43 among individuals repatriated into the United States. I do hope that helps.
In terms of the severity, I think that there are a variety of reports that give information about severity. We’ve looked at severity among people, among reported people from Hubei. We’ve looked at reported people from elsewhere in china. And certainly the data coming out from Korea and Iran and Italy suggests also deaths which are concerning.
In terms of our messaging today, I really would say that it is more driven by the community spread in other countries than it is specifically from data from china. And so I think it really is the spreading of COVID-19 through other countries that makes all of us feel that the risk of spread in the united states has — is increasing.
In terms of exercising, you know, there are always small and big things that we learn from exercising. Maybe two specific things I’ll point out is that our exercising did show us that if we had a pandemic, there were going to be supply issues. And I think that we are now across the whole of government thinking through and working on those supply issues. One of them is enough protection for health care workers. This is clearly a priority. The health care workers put themselves on the front line caring for ill patients and has to be a priority to make sure they are protected.
Another issue is the NPIs. The non-pharmaceutical interventions. We have worked across governmental sectors to get input into our planning guidance. But it’s one thing to plan for those NPIs. It’s certainly another thing to be able to implement them at a large scale. And I think one of the reasons that we’re talking about this so proactively today is that we recognize that implementing NPIs at this level that we want to prepare the american people that their lives could be interrupted. Next.
Thank you. Our next question comes from Eric of ABC news. Your line is open.
Q: Thanks, Benjamin. Thanks, Nancy for taking our questions. I’m wondering like the chicken and the egg with the case definition and the testing. If you’re telling us today it’s not a question of if but when there’ll be community spread and it’s very difficult to — for clinicians to know the difference between flu and COVID-19, how come you’re not widening the case definition to test more people?
A: So let me answer that two ways. One is that we have more than one layer of surveillance. I think I talked about this in a previous call, but maybe just to talk about it a little more. There is a specific patient-under-investigation case definition that really does focus on travel because that is where the cases that are picked up through our public health systems are.
But we are also aware and concerned about the possibility for broader spread in the U.S. That’s why the Secretary and we announced last week that we were going to be doing more community-based surveillance relying on the infrastructure of our influenza. So we have already started that surveillance system. We’re rapidly working within the next couple weeks to expand that more broadly. As well, we have a variety of other more community-oriented surveillance systems that we’re working to stand up to be able to look for those cases in the community. So this is proceeding in stages with the one surveillance but community surveillance also rapidly starting. Brittany, we have time for two more questions, please.
Thank you. And our next question comes from Lauren from San Antonio Express News. Your line is now open.
Q: Thank you for taking my call. I wanted to ask about the 14-day incubation period that has been reiterated by many public health officials including the quarantine of the evacuees. We’ve seen some isolated reports coming from other countries suggesting that it is possible that the incubation period has been longer in some individuals in other countries who have been quarantined for more than 14 days. And I was wondering if you guys have any reason to suspect whether the incubation period may be longer than 14 days for those of Wuhan that have been released from their quarantine.
A: Thank you. That’s actually a really important question. And something we’re looking at closely. Some of the reports that you’ve seen are reports in the media, not reports in peer reviewed literature. And it impacts our ability to fully scientifically evaluate them. As I’ve said in previous meetings, there are a team of — there are more than 50 modeling mathematical modeling groups in the United States all working with us to look at a variety of issues around this response to novel coronavirus. One of the things they’re certainly analyzing is all of the available data on the incubation period. And the data so far still supports using 14 days as the top window.
In terms of isolated reports elsewhere, there are a variety of possibilities. One possibility is — there’s a variety of possibilities – what we’ll do is continue to synthesize and evaluate the available data trying to make a data-driven decision. And if more data becomes available that suggests a longer incubation period, we will certainly be visible and public about that. I think at this point, we’re still comfortable that 14 days is the appropriate top line for that. Last question, please.
Thank you. And our final question comes from Ben from CNN. Your line is now open.
Q: Hi, thanks so much for taking my question. This morning while he was traveling in India, President Trump said that he thinks that the coronavirus is a problem that is going to go away. He seems very optimistic about this and we’re trying to figure out exactly why he believes so strongly that to be the case. And so my question for you is what information is your agency specifically giving the president and the White House about the current state of the coronavirus outbreak?
A: As you imagine, we brief the Secretary daily and the Secretary is the lead of the White House task force. And Dr. Redfield the CDC director is briefing them daily. In terms of the course of this illness, we have a — again, a team of mathematical modelers working with us to try to predict the trajectory. One hypothesis is that we could be hopeful that this could potentially be seasonal. Other viral respiratory diseases are seasonal including influenza and therefore in many viral respiratory diseases, we do see a decrease in disease in spring and summer. And so we could certainly be optimistic that this disease will follow suit. But we’re not going to know that until time keeps ticking forward. We’re going to be, again, preparing as if this is going to continue, preparing as if we’re going to see community spread in the near term. But I’m always going to be hopeful that that disease will decline either for the summer or that, you know, we’ll be over-prepared and we won’t see the high levels of transmission here in the U.S.
Thank you, doctor. And thank you, all, for joining us for today’s briefing. Please visit CDC’s 2019 novel coronavirus website for continued updates. And if you have further questions, please call the main media line at 404-639-3286 or email media@CDC.gov. Thank you. Thank you for your participation in today’s conference. All participants may disconnect at this time.
Thank you. And as a reminder, if you would like to ask a question, please press star one. Limit to one question and one follow-up. Our next question comes from Eben from Fox news. Your line is now open.
Q: Thank you very much for doing the call today. There has been some political back and forth now that democrats are accusing the president which essentially means the administration and everything that falls under that as being ill prepared for coronavirus, requesting too little of amount in terms of their request for $2.5 billion. Do you feel that we are ill prepared from a financial standpoint? I know you are a clinician and I don’t want you to get too much into politics, but do you have what you need to do your job?
A: I guess I’ll answer that two ways. The first is HHS can provide information or answer questions about the funds that are available. What I can say from my perspective is I’ve been at CDC for 25 years and that if you asked public health officials over the course of that time what they feared as an expectation, it was something exactly like this. And so the idea that we might have a pandemic of influenza or a pandemic of a respiratory viral infection is something that we’ve known about and have been planning and preparing for. That’s why we at CDC have been exercising with the state and local health departments. That’s why the whole of government exercise last year, that’s why we’ve invested so much on the foundation we are now responding.
But that being said, we are never going to ever be able to be so completely prepared that we’re prepared for any inevitability. We always are going to find that diseases surprise us and that there was some consideration that is slightly different from what we planned for. So have we made a lot of progress in the 25 years I’ve been here? Yes. Are we better prepared today than we were 20 years ago? Yes. But are we completely prepared? You know, diseases surprise us and therefore we need to be reacting to the current situation even if it differs from what we planned for.
You know, in general we are asking the American public to work with us to prepare in the expectation that this could be bad. I continue to hope that in the end we’ll look back and feel like we are over-prepared, but that is a better place to be in than being under-prepared. And just like the preparedness for a pandemic influenza provides such a strong foundation for this response, any preparedness we do as a country, at schools, businesses, within our families will always be helpful for whatever the next event is. And so I don’t think in general that preparedness will ever go to waste. Next question, please.
Thank you. Our next question comes from Mike from A.P. Your line is now open.
Q: Hi. Thank you for taking my call. If I could ask a couple. One is just the latest case count, it’s been a little confusing for some of us just to sort out exactly how many U.S. cases there are and how they’re being sorted out. Second, if you could speak to your best and latest understanding of the severity of the disease. Of course there’s some news today about the WHO mission coming back and statements about not finding a lot of undetected cases. I was wondering if that’s related to CDC gearing up for these NPIs. And lastly, talking about the exercising you’ve been doing, what was the weakness or weaknesses that kept coming up in the exercises that you’re most concerned about and you’re really trying to stay on top of now that we have a real time experience happening? Thank you.
A: Okay. So let me — so let me start by saying that I know the case counts can be confusing. I will try to sort out what the numbers are as of today and try to explain why it perhaps is a little confusing. There remain 14 confirmed U.S. cases. We are separating out the cases among repatriated individuals. So those are 14 U.S. Cases. 12 of those are travelers who returned from an area where disease is circulating. Two of those are close contacts of another case. That’s 14. There are three novel coronavirus patients among people who are repatriated from Hubei that is in the repatriated flights. And our website says 36 because we updated this yesterday, but in fact as of this morning, there are 40 positives among individuals repatriated from the “Diamond Princess.” so these are Americans who were on board the “Diamond Princess” repatriated back to the United States. And that’s 40. So that means just to go back that there are 14 confirmed cases picked up through the U.S. public health systems. And 40 plus 3 makes 43 among individuals repatriated into the United States. I do hope that helps.
In terms of the severity, I think that there are a variety of reports that give information about severity. We’ve looked at severity among people, among reported people from Hubei. We’ve looked at reported people from elsewhere in china. And certainly the data coming out from Korea and Iran and Italy suggests also deaths which are concerning.
In terms of our messaging today, I really would say that it is more driven by the community spread in other countries than it is specifically from data from china. And so I think it really is the spreading of COVID-19 through other countries that makes all of us feel that the risk of spread in the united states has — is increasing.
In terms of exercising, you know, there are always small and big things that we learn from exercising. Maybe two specific things I’ll point out is that our exercising did show us that if we had a pandemic, there were going to be supply issues. And I think that we are now across the whole of government thinking through and working on those supply issues. One of them is enough protection for health care workers. This is clearly a priority. The health care workers put themselves on the front line caring for ill patients and has to be a priority to make sure they are protected.
Another issue is the NPIs. The non-pharmaceutical interventions. We have worked across governmental sectors to get input into our planning guidance. But it’s one thing to plan for those NPIs. It’s certainly another thing to be able to implement them at a large scale. And I think one of the reasons that we’re talking about this so proactively today is that we recognize that implementing NPIs at this level that we want to prepare the american people that their lives could be interrupted. Next.
Thank you. Our next question comes from Eric of ABC news. Your line is open.
Q: Thanks, Benjamin. Thanks, Nancy for taking our questions. I’m wondering like the chicken and the egg with the case definition and the testing. If you’re telling us today it’s not a question of if but when there’ll be community spread and it’s very difficult to — for clinicians to know the difference between flu and COVID-19, how come you’re not widening the case definition to test more people?
A: So let me answer that two ways. One is that we have more than one layer of surveillance. I think I talked about this in a previous call, but maybe just to talk about it a little more. There is a specific patient-under-investigation case definition that really does focus on travel because that is where the cases that are picked up through our public health systems are.
But we are also aware and concerned about the possibility for broader spread in the U.S. That’s why the Secretary and we announced last week that we were going to be doing more community-based surveillance relying on the infrastructure of our influenza. So we have already started that surveillance system. We’re rapidly working within the next couple weeks to expand that more broadly. As well, we have a variety of other more community-oriented surveillance systems that we’re working to stand up to be able to look for those cases in the community. So this is proceeding in stages with the one surveillance but community surveillance also rapidly starting. Brittany, we have time for two more questions, please.
Thank you. And our next question comes from Lauren from San Antonio Express News. Your line is now open.
Q: Thank you for taking my call. I wanted to ask about the 14-day incubation period that has been reiterated by many public health officials including the quarantine of the evacuees. We’ve seen some isolated reports coming from other countries suggesting that it is possible that the incubation period has been longer in some individuals in other countries who have been quarantined for more than 14 days. And I was wondering if you guys have any reason to suspect whether the incubation period may be longer than 14 days for those of Wuhan that have been released from their quarantine.
A: Thank you. That’s actually a really important question. And something we’re looking at closely. Some of the reports that you’ve seen are reports in the media, not reports in peer reviewed literature. And it impacts our ability to fully scientifically evaluate them. As I’ve said in previous meetings, there are a team of — there are more than 50 modeling mathematical modeling groups in the United States all working with us to look at a variety of issues around this response to novel coronavirus. One of the things they’re certainly analyzing is all of the available data on the incubation period. And the data so far still supports using 14 days as the top window.
In terms of isolated reports elsewhere, there are a variety of possibilities. One possibility is — there’s a variety of possibilities – what we’ll do is continue to synthesize and evaluate the available data trying to make a data-driven decision. And if more data becomes available that suggests a longer incubation period, we will certainly be visible and public about that. I think at this point, we’re still comfortable that 14 days is the appropriate top line for that. Last question, please.
Thank you. And our final question comes from Ben from CNN. Your line is now open.
Q: Hi, thanks so much for taking my question. This morning while he was traveling in India, President Trump said that he thinks that the coronavirus is a problem that is going to go away. He seems very optimistic about this and we’re trying to figure out exactly why he believes so strongly that to be the case. And so my question for you is what information is your agency specifically giving the president and the White House about the current state of the coronavirus outbreak?
A: As you imagine, we brief the Secretary daily and the Secretary is the lead of the White House task force. And Dr. Redfield the CDC director is briefing them daily. In terms of the course of this illness, we have a — again, a team of mathematical modelers working with us to try to predict the trajectory. One hypothesis is that we could be hopeful that this could potentially be seasonal. Other viral respiratory diseases are seasonal including influenza and therefore in many viral respiratory diseases, we do see a decrease in disease in spring and summer. And so we could certainly be optimistic that this disease will follow suit. But we’re not going to know that until time keeps ticking forward. We’re going to be, again, preparing as if this is going to continue, preparing as if we’re going to see community spread in the near term. But I’m always going to be hopeful that that disease will decline either for the summer or that, you know, we’ll be over-prepared and we won’t see the high levels of transmission here in the U.S.
Thank you, doctor. And thank you, all, for joining us for today’s briefing. Please visit CDC’s 2019 novel coronavirus website for continued updates. And if you have further questions, please call the main media line at 404-639-3286 or email media@CDC.gov. Thank you. Thank you for your participation in today’s conference. All participants may disconnect at this time.
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