March 15, 2020 • 23 mins
Newt interviews Dr. Jay Butler, M.D., Deputy Director of Infectious Diseases at the Centers for Disease Control and Prevention and answers COVID-19 questions on every American's mind.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
I am officially declaring a national emergency in furtherance of
the order emerging every state to set up emergency operations centers,
effective immediately. We want this thing to end. We don't
want a lot of people getting infected. We want it
to end and end as quickly as possible. If you
are sick, you're not going to miss a paycheck. Your employer,
including small businesses, have the ability to provide paid leave
(00:23):
to you. On this episode of News World, the coronavirus
or COVID nineteen is now in the United States. This week,
the lives of all Americans changed at the urging of
President Trump, Vice President Pence, the National Institutes of Health,
and the Centers for Disease Control and Prevention. Americans were
(00:46):
told to begin social distancing and if you show any
signs of symptoms of COVID nineteen, you should self isolate
or self quarantine for fourteen days. This is the first
time many of us have faced a global pandemic in
our lifetime, and we have many questions about how to
face this new challenge. I'm pleased to welcome my guest,
(01:07):
doctor j Butler, Deputy Director for Infectious Diseases at the
Centers for disease control and prevention. You've seen a number
of various epidemics come up and new strains come out
(01:30):
over the years. This one seems to have aroused a
great deal more anxiety and a great deal more intense response.
What do you attribute that to? Well, I think as
we compare it to other epidemics, there's a number of differences.
Comparing this to the last public health event of similar magnitude,
(01:52):
which would be the H one in one influenza pandemic.
We are dealing with something that we've watched from a
fall where we focused on containment measures for a couple
of months, and in some ways, I think there may
actually be a little bit of coronavirus fatigue in the public.
But now that it's here and everyone realizes that this
(02:14):
is real, there's been kind of an awakening and some
of the response right now may not be as timed
as well as it should be, because we do think
that this is going to get worse before it gets better.
The H one in one pandemic, of course, emerged right
here in North America, so we started right out with
it in our back yard. We've had more lead in
(02:36):
to this particular virus The other thing that's different is
we're accustomed to influenza. In fact, I would say the
greatest misnomer in all of healthcare is it's just the flu,
because influenza is actually a terrifying infection. Coronavirus is something
that has not been in the public discussion very often,
(02:57):
and while public health officials and infectious disease clinicians are
familiar with coronaviruses, it sounds very new and very different,
and when things are new and different, they can sound
very scary. The impact of any kind of major health
event goes beyond just the number of people who get
sick or the number of people who may die, but
(03:18):
there's also a societal impact that translates into an economic impact.
An economic impact can then have secondary effects on health outcomes.
So there's a big picture of the interactions of how
these emerging infectious diseases can really change life for a
period of time. In comparing what the response has been
(03:43):
in Italy to the response in parts of Asia, it's
a bit like comparing oranges and elephants. The epidemic emerged
in very different ways, and of course society is very
different in Italy as opposed to China, the governmental structure
is very different, and of course as we look at
the response, then in the United States, we have yet
(04:05):
another type of society altogether, where we highly value our
freedom and our mobility, and the customary approaches have been
to use least restrictive means to control infectious diseases. So
the response now in the United States is in many
ways unprecedented in response to an unprecedented situation, which also
(04:29):
requires a partnership among agencies and the non government sector,
as well as flexibility on the part of the public.
I know everyone becomes frustrated when it's not easy to
just contain the spread of the virus. So our goal
is really to look at how we slow the spread.
And the initial response was how do we slow the
(04:50):
global spread? But now that it is in the United States,
how do we sload the spread within our community so
that the healthcare system doesn't become overwhelmed. And I think
what we're hearing from Italy is that the healthcare system
has become overwhelmed in many ways. One of the questions
I've been asked I don't have a good answer for
is if you look at South Korea, where they apparently
(05:13):
developed a drive through model. They have massive testing. Then
they've seemed to have had a model of maximizing tests
without regard to whether you had any indications because they
want to detract people at the earliest possible date. I
get the sense that we had a very different model
of testing. Could you explain what the American model of
(05:34):
testing has been and why it's operated the way it has. Yeah,
I think the biggest difference in the approach to testing,
particularly now that the availability of tests is more widespread
in the United States, has been based on clinical indication.
The Korean approach has been more oriented towards, if you will,
any nose that walks in off the street can get
(05:56):
a swab, and whether or not that's really of benefit
or not, I think is a challenge. It also's created,
i think concern in the United States because we've initially
had challenges with the test reagents, with a problem with
one of the controls that are involved in assuring that
it's a quality test. That was addressed, and then the
(06:19):
very next week we started running into problems with some
of the equipment and the reagents that are used to
extract the RNA from the clinical specimen, which is actually
not an issue of newly developed reagents, but rather a
global supply chain issue. And I think when anything appears
to be in short supply, that makes it more attractive.
(06:41):
And I'll use the example of toilet paper. Suddenly toilet
paper is sold off the shelves. The concern is out
there that it's in short supply, so everyone wants it.
Is not the solution, but testing is an important part
of being able to monitor the progression of the epidemic,
and with the visibility on where infection is occurring, that
(07:04):
allows the opportunity to implement appropriate prevention measures at the
right time. And since we don't have a vaccine at
this time, we don't have FDA approved drugs for treatment.
Some of our best measures are some of the old
fashioned public health tools, such as hand hygiene we've talked about.
(07:26):
Social distancing can include things like reducing or canceling mass
gatherings and in some instances, considering school closures. The important
thing to remember, though, is to do these things at
the right time and other ways. We want to do
the right intervention at the right time based on the
right evidence. We go back to test rec What is
(07:48):
the test. It is a swab into the nose is
Based on the data that CDC is collected, have now
made the determination that swab both of the nose and
the throat is not necessary, that the swab into the
nose alone is sufficient, and that actually will help maintain
the supply of reagents as well as equipment to be
(08:10):
able to collect the specimens. Again, it's important to recognize
that this testing has been going on globally and as
we progress into the pandemic that is beginning to strain
the global supply of many of these supplies that are
required for the testing. Because we live in a day
of just in time inventory and the ability to ramp
(08:33):
up and suddenly produce ten to one hundredfold times what
the baseline product was can be a challenge. Even though
we're calling it a nose swab, really it's a NASA
fare and jail swab. And the swab is passed into
the opening of the nose and then passed as far
back as possible, and then it's withdrawn and the specimen
(08:56):
is submitted to the lab where the viral RNA is
extracted during the first step of the processing, and then
that extracted material it goes into a plimerase chain reaction assay,
and this is a process using a variety of enzymes
where there's multiple cycles that try to amplify that genetic
(09:19):
material to determine whether or not it's present or not.
And a positive reaction suggests that indeed, that viral RNA
is present. It doesn't prove that someone is infectious, but
it is evidence that they are infected and if they
have symptoms, that's important to know that test is positive
(09:41):
and is the most likely cause of the illness that
the provider is seeing and that the patient is experiencing.
Should we be doing something to ramp up the supply
or is it take too long. There's been a number
of steps taken to increase the availability of testing Here
at CDC. There is a very intense of effort to
identify what were the quality control issues that were slowing
(10:05):
the availability of the reagents. We are now working with
FDA as well as private sector partners to look at
ways to be able to use other platforms to perform
the PCR assay. There's also work going on in the
government and private sector to identify alternative ways to make
the diagnosis. It would be wonderful to have a point
(10:27):
of use essay where it could be like influenza, where
there would be basically a test kit that would be
in your provider's office, a swap could be done and
we would have a result within a few minutes. We
don't currently have that, so one of the challenges is
using the PCR technology. The number of laboratories that can
run the assay has been relatively limited, but as we've
(10:50):
been able to identify and approve alternative platforms for running
this particular PCR, the availability has increased, but it's important
to recognize that still it's not a limitless supply, so
the approach in the US has been more clinically based
and also risk based. We know that older individuals are
at higher risk of serious infection, so we are working
(11:13):
on some guidelines for clinicians to be able to identify
who is most important to test, and also it's important
to be able to use these tests in situations where
there's a high risk of transmission, particularly in long term
care facilities. I mentioned mass gatherings earlier. Anywhere where we
have people living in close proximity to one another, there's
(11:35):
a risk of transmission, and long term care facilities are
of particular concern. Given that they are situations where people
who are advanced in age oftentimes live in close contact
with one another. So are there specific additional things we
should be doing in nursing home settings. Basically, don't go
(11:56):
visit unless there's some overwhelming reason, because you don't want
to come in and affect everybody who's in the nursing home,
which apparently happened in Washington State. Yeah, that's absolutely right.
We know that the vast majority of people who become
infected with this coronavirus have very mild symptoms. There is
some evidence that people can be infectious or at least
(12:18):
have the virus detectable in their nose and throat before
the onset of symptoms. So even though you may be
at low risk yourself of severe illness, we want to
be able to limit the amount of exposure to people
who are at higher risk. I was actually in South
Korea at the very beginning of the virus becoming an
(12:39):
international problem. And if you walk into a building, they
check your temperature. We walked into hotels and they would
check our temperature, And apparently in Singapore you get a
strip every time your temperature is checked, and at the
end of a day. You can have three or four
or five strips that you're kind of wearing something that
proves that your temperature was all right. Should we be
(12:59):
doing something like that level of intense measurement. It's one
of the options to be able to screen for early
symptoms of the illness and be able to separate people
who are potentially infected from others. One of the challenges though,
is we've learned more about this COVID nineteen coronavirus, is
that not everyone has fever early in the course of
(13:22):
the illness. Most people do develop a fever at some
point in the course of the illness, but it's not
universally present. So temperature screening can be part of the
overall response, but it's important to recognize that there are
other prevention measures, such as being able to have hand
hygiene products available or making sure that soap and water
(13:44):
is available as well as towels to dry hands, and
then frequently touch surfaces may play a role in transmission.
For instance, if I sneeze into my hands and I'm infected,
I could put my hand then on the counter, and
then thirty seconds later someone else comes along touches the counter,
the virus is capable of surviving on surfaces at least
(14:05):
for a period of minutes to even a few hours
under the right conditions. In fact, in laboratory we can
create conditions where it might survive for days, but we
don't know that that happens in real life. To focus
on hand hygiene is important, and then cleaning those frequently
touched surfaces. Thinking about ways that we can minimize our
(14:25):
exposure to one another and to frequently touch surfaces is
something that we can all do to help reduce spread
of the coronavirus. If you start to have symptoms, is
there a way for you to distinguish without a test,
between the flu or having a common cold, or this
is actually coronavirus? What's the difference. Unfortunately, there's no way
(14:48):
to distinguish this coronavirus infection from some of the other
common coronavirus infections, or for influenza, or from rhinovirus, or
from respiratory since issue virus, the whole slew of respiratory
viruses out there that can cause respiratory symptoms as well
as fever and muscle ake. So it really does require
(15:10):
that when you develop symptoms that you self isolate and
it's more important than ever that we don't try to
tough it out and just go into work when we
have a respiratory illness, because it's just putting other people
at risk. Next, what Americans can do to protect themselves
from the spread of COVID nineteen. Even if you're healthy,
(15:50):
Is there a virtue to maximizing the number of people
in your shop who work from home or who telecommute
rather than coming in. Yeah, that's an important part of
social distancing, particularly at this point in the epidemic, so
that we can reduce the rapid spread of the infection
and distribute the impact of the epidemic over as long
(16:13):
a period as possible. So, even though you may be
at low risk of severe infection yourself, keep in mind
that people you work with, particularly those who are older,
those with chronic heart, lung, kidney disease or diabetes, or
who are on immuno suppressive medications, may be at higher risk.
(16:34):
If I wash my hands regularly and I try to
avoid large groups. Are there other specific things the average
Americans should be doing. I think the final thing that's
important for everybody to do is to monitor the situation closely.
Some of the best Sources of information include the website
(16:55):
at the CDC, CDC dot gov slash COVID nineteen, as
well as information through your local or state health department.
I know Johns Hopkins University also has a very well
monitored and edited website, The who has daily updates on
the global situation as well. And the final thing that's
(17:17):
important is while everybody's concerned anytime we have a new
pandemic of an infectious disease, it's important to be prepared
rather than scared. That we're ready to be flexible when
our plans may be frustrated by cancelations or we may
be tied up forced to stay at home because of
(17:37):
quarantine or isolation recommendations. But the more that we can do,
the things that have been recommended all along, such as
being prepared for hurricane, earthquake, or other natural disasters apply
in an infectious disease outbreak as well. So having some
of those non perishable foods on hand is an important
(17:57):
part of being able to stay home as much as
possible if that becomes need it next how soon will
the United States have a coronavirus vaccine? What does your
(18:25):
gut tell you as the earliest we're likely to have
a vaccine, So a vaccine that's ready to enter into
trials and humans maybe a few months away. But there's
still a number of steps that have to be taken
before we have a vaccine that's available to the general public.
So that's at least a year to a year and
a half away. And it's important to recognize this is
(18:47):
not bureaucratic steps and checkboxes that have to be ticked off.
It's critically important that we know a vaccine is safe
and that it's effective before we recommend it to the
general public. What's your sense of somebody who studied his
HU area, is in fact this routine pattern of flu
(19:07):
sort of diminishing in the spring and summer and then
tending to come back in the fall and winter. Is
that in fact a pattern, and if so, is it
also likely to apply to the coronavirus. It's certainly true
as a pattern for the influenza virus that we have
a flu season in the northern hemisphere that aligns with
cold weather months and we see a big decline in
(19:29):
respiratory illnesses during the summer months. The reverse is true
in the southern hemisphere. For this coronavirus. Of course, the
evidence is that it only first affected humans about three
to four months ago, early in the winter of late
November early December of twenty nineteen, so we don't yet
know what it's going to do in the summertime. So
(19:52):
at this point I would not want to take comfort
that it's just going to go away in the summer.
I think it's going to be better that while we
might hope for the best, we also prepare for the
worst and recognize that epidemic may very well continue into
the warmer weather months. Is it also true even if
it did diminish dramatically the summer that, given the pattern
(20:14):
that we've now seen for I think the first recorded
epidemic was like eighteen ninety, that we just better spend
the summer and fall really working to be ready because
it probably will come back. Because these things now, once
they cross over from animals to people, they seem to
like staying with people. Yeah, that's a great question and
(20:35):
a really good point as well. It gets back to
what I was saying, we want to hope for the best,
but prepare for the worst. So it would be very
favorable if we got to break through the summer months
with less transmission, we would still not have a vaccine
available by the fall, so we'd still have a large
proportion of the population that may be susceptible. So we
(20:57):
would want to use that time wisely to be prepared
aired for the potential for a second wave of an
increased number of cases as the cold weather months return. Listen,
I really appreciate this, and I wish you well. I
know how hard you're working and how much of responsibility
you feel for helping the country and for that matter,
of the world get through this, and I just want
(21:18):
to tell you we're very grateful to have a chance
to share these ideas well. I really appreciate the opportunity
to speak with you and really have a longer conversation
about what's going on. And unfortunately it's hard to put
it all into a sound bite, so I love the
opportunity to sort of dig into some of the details.
I'm currently living in Italy, where the coronavirus has spread
(21:38):
from two hundred people to twelve thousand people in the
span of just two weeks. I discussed the situation in
Italy at newts Inner Circle dot com. It's a subscription
service where I offer insights and commentary on the issues
that matter to me. Most joined today at newts Inner
Circle dot com. You can read more about COVID nineteen
(22:02):
on our show page at newtsworld dot com. Newtsworld is
produced by Gingwist three sixty and iHeartMedia. Our executive producer
is Debbie Myers and our producer is Garnsey Slump. The
artwork for the show was created by Steve Penley. Thank
you to the team at Gingwrist three sixty. Please email
me with your comments at newt at newtsworld dot com.
(22:24):
If you've been enjoying Newtsworld, I hope you'll go to
Apple Podcast and both rate us with five stars and
give us a review so others can learn what it's
all about. On the next episode of Newtsworld, coronavirus panic
sent world stock markets crashing last week, with an index
of global stocks setting its largest weekly fall since the
(22:48):
nineteen eighty seven global financial crisis and over five trillion
dollars wiped from the global market value last week. We'll
discuss the coronavirus and its impact on the star market
and the global economy on the next episode. I'm newt
gangwish this is news world,
I am officially declaring a national emergency in furtherance of
the order emerging every state to set up emergency operations centers,
effective immediately. We want this thing to end. We don't
want a lot of people getting infected. We want it
to end and end as quickly as possible. If you
are sick, you're not going to miss a paycheck. Your employer,
including small businesses, have the ability to provide paid leave
(00:23):
to you. On this episode of News World, the coronavirus
or COVID nineteen is now in the United States. This week,
the lives of all Americans changed at the urging of
President Trump, Vice President Pence, the National Institutes of Health,
and the Centers for Disease Control and Prevention. Americans were
(00:46):
told to begin social distancing and if you show any
signs of symptoms of COVID nineteen, you should self isolate
or self quarantine for fourteen days. This is the first
time many of us have faced a global pandemic in
our lifetime, and we have many questions about how to
face this new challenge. I'm pleased to welcome my guest,
(01:07):
doctor j Butler, Deputy Director for Infectious Diseases at the
Centers for disease control and prevention. You've seen a number
of various epidemics come up and new strains come out
(01:30):
over the years. This one seems to have aroused a
great deal more anxiety and a great deal more intense response.
What do you attribute that to? Well, I think as
we compare it to other epidemics, there's a number of differences.
Comparing this to the last public health event of similar magnitude,
(01:52):
which would be the H one in one influenza pandemic.
We are dealing with something that we've watched from a
fall where we focused on containment measures for a couple
of months, and in some ways, I think there may
actually be a little bit of coronavirus fatigue in the public.
But now that it's here and everyone realizes that this
(02:14):
is real, there's been kind of an awakening and some
of the response right now may not be as timed
as well as it should be, because we do think
that this is going to get worse before it gets better.
The H one in one pandemic, of course, emerged right
here in North America, so we started right out with
it in our back yard. We've had more lead in
(02:36):
to this particular virus The other thing that's different is
we're accustomed to influenza. In fact, I would say the
greatest misnomer in all of healthcare is it's just the flu,
because influenza is actually a terrifying infection. Coronavirus is something
that has not been in the public discussion very often,
(02:57):
and while public health officials and infectious disease clinicians are
familiar with coronaviruses, it sounds very new and very different,
and when things are new and different, they can sound
very scary. The impact of any kind of major health
event goes beyond just the number of people who get
sick or the number of people who may die, but
(03:18):
there's also a societal impact that translates into an economic impact.
An economic impact can then have secondary effects on health outcomes.
So there's a big picture of the interactions of how
these emerging infectious diseases can really change life for a
period of time. In comparing what the response has been
(03:43):
in Italy to the response in parts of Asia, it's
a bit like comparing oranges and elephants. The epidemic emerged
in very different ways, and of course society is very
different in Italy as opposed to China, the governmental structure
is very different, and of course as we look at
the response, then in the United States, we have yet
(04:05):
another type of society altogether, where we highly value our
freedom and our mobility, and the customary approaches have been
to use least restrictive means to control infectious diseases. So
the response now in the United States is in many
ways unprecedented in response to an unprecedented situation, which also
(04:29):
requires a partnership among agencies and the non government sector,
as well as flexibility on the part of the public.
I know everyone becomes frustrated when it's not easy to
just contain the spread of the virus. So our goal
is really to look at how we slow the spread.
And the initial response was how do we slow the
(04:50):
global spread? But now that it is in the United States,
how do we sload the spread within our community so
that the healthcare system doesn't become overwhelmed. And I think
what we're hearing from Italy is that the healthcare system
has become overwhelmed in many ways. One of the questions
I've been asked I don't have a good answer for
is if you look at South Korea, where they apparently
(05:13):
developed a drive through model. They have massive testing. Then
they've seemed to have had a model of maximizing tests
without regard to whether you had any indications because they
want to detract people at the earliest possible date. I
get the sense that we had a very different model
of testing. Could you explain what the American model of
(05:34):
testing has been and why it's operated the way it has. Yeah,
I think the biggest difference in the approach to testing,
particularly now that the availability of tests is more widespread
in the United States, has been based on clinical indication.
The Korean approach has been more oriented towards, if you will,
any nose that walks in off the street can get
(05:56):
a swab, and whether or not that's really of benefit
or not, I think is a challenge. It also's created,
i think concern in the United States because we've initially
had challenges with the test reagents, with a problem with
one of the controls that are involved in assuring that
it's a quality test. That was addressed, and then the
(06:19):
very next week we started running into problems with some
of the equipment and the reagents that are used to
extract the RNA from the clinical specimen, which is actually
not an issue of newly developed reagents, but rather a
global supply chain issue. And I think when anything appears
to be in short supply, that makes it more attractive.
(06:41):
And I'll use the example of toilet paper. Suddenly toilet
paper is sold off the shelves. The concern is out
there that it's in short supply, so everyone wants it.
Is not the solution, but testing is an important part
of being able to monitor the progression of the epidemic,
and with the visibility on where infection is occurring, that
(07:04):
allows the opportunity to implement appropriate prevention measures at the
right time. And since we don't have a vaccine at
this time, we don't have FDA approved drugs for treatment.
Some of our best measures are some of the old
fashioned public health tools, such as hand hygiene we've talked about.
(07:26):
Social distancing can include things like reducing or canceling mass
gatherings and in some instances, considering school closures. The important
thing to remember, though, is to do these things at
the right time and other ways. We want to do
the right intervention at the right time based on the
right evidence. We go back to test rec What is
(07:48):
the test. It is a swab into the nose is
Based on the data that CDC is collected, have now
made the determination that swab both of the nose and
the throat is not necessary, that the swab into the
nose alone is sufficient, and that actually will help maintain
the supply of reagents as well as equipment to be
(08:10):
able to collect the specimens. Again, it's important to recognize
that this testing has been going on globally and as
we progress into the pandemic that is beginning to strain
the global supply of many of these supplies that are
required for the testing. Because we live in a day
of just in time inventory and the ability to ramp
(08:33):
up and suddenly produce ten to one hundredfold times what
the baseline product was can be a challenge. Even though
we're calling it a nose swab, really it's a NASA
fare and jail swab. And the swab is passed into
the opening of the nose and then passed as far
back as possible, and then it's withdrawn and the specimen
(08:56):
is submitted to the lab where the viral RNA is
extracted during the first step of the processing, and then
that extracted material it goes into a plimerase chain reaction assay,
and this is a process using a variety of enzymes
where there's multiple cycles that try to amplify that genetic
(09:19):
material to determine whether or not it's present or not.
And a positive reaction suggests that indeed, that viral RNA
is present. It doesn't prove that someone is infectious, but
it is evidence that they are infected and if they
have symptoms, that's important to know that test is positive
(09:41):
and is the most likely cause of the illness that
the provider is seeing and that the patient is experiencing.
Should we be doing something to ramp up the supply
or is it take too long. There's been a number
of steps taken to increase the availability of testing Here
at CDC. There is a very intense of effort to
identify what were the quality control issues that were slowing
(10:05):
the availability of the reagents. We are now working with
FDA as well as private sector partners to look at
ways to be able to use other platforms to perform
the PCR assay. There's also work going on in the
government and private sector to identify alternative ways to make
the diagnosis. It would be wonderful to have a point
(10:27):
of use essay where it could be like influenza, where
there would be basically a test kit that would be
in your provider's office, a swap could be done and
we would have a result within a few minutes. We
don't currently have that, so one of the challenges is
using the PCR technology. The number of laboratories that can
run the assay has been relatively limited, but as we've
(10:50):
been able to identify and approve alternative platforms for running
this particular PCR, the availability has increased, but it's important
to recognize that still it's not a limitless supply, so
the approach in the US has been more clinically based
and also risk based. We know that older individuals are
at higher risk of serious infection, so we are working
(11:13):
on some guidelines for clinicians to be able to identify
who is most important to test, and also it's important
to be able to use these tests in situations where
there's a high risk of transmission, particularly in long term
care facilities. I mentioned mass gatherings earlier. Anywhere where we
have people living in close proximity to one another, there's
(11:35):
a risk of transmission, and long term care facilities are
of particular concern. Given that they are situations where people
who are advanced in age oftentimes live in close contact
with one another. So are there specific additional things we
should be doing in nursing home settings. Basically, don't go
(11:56):
visit unless there's some overwhelming reason, because you don't want
to come in and affect everybody who's in the nursing home,
which apparently happened in Washington State. Yeah, that's absolutely right.
We know that the vast majority of people who become
infected with this coronavirus have very mild symptoms. There is
some evidence that people can be infectious or at least
(12:18):
have the virus detectable in their nose and throat before
the onset of symptoms. So even though you may be
at low risk yourself of severe illness, we want to
be able to limit the amount of exposure to people
who are at higher risk. I was actually in South
Korea at the very beginning of the virus becoming an
(12:39):
international problem. And if you walk into a building, they
check your temperature. We walked into hotels and they would
check our temperature, And apparently in Singapore you get a
strip every time your temperature is checked, and at the
end of a day. You can have three or four
or five strips that you're kind of wearing something that
proves that your temperature was all right. Should we be
(12:59):
doing something like that level of intense measurement. It's one
of the options to be able to screen for early
symptoms of the illness and be able to separate people
who are potentially infected from others. One of the challenges though,
is we've learned more about this COVID nineteen coronavirus, is
that not everyone has fever early in the course of
(13:22):
the illness. Most people do develop a fever at some
point in the course of the illness, but it's not
universally present. So temperature screening can be part of the
overall response, but it's important to recognize that there are
other prevention measures, such as being able to have hand
hygiene products available or making sure that soap and water
(13:44):
is available as well as towels to dry hands, and
then frequently touch surfaces may play a role in transmission.
For instance, if I sneeze into my hands and I'm infected,
I could put my hand then on the counter, and
then thirty seconds later someone else comes along touches the counter,
the virus is capable of surviving on surfaces at least
(14:05):
for a period of minutes to even a few hours
under the right conditions. In fact, in laboratory we can
create conditions where it might survive for days, but we
don't know that that happens in real life. To focus
on hand hygiene is important, and then cleaning those frequently
touched surfaces. Thinking about ways that we can minimize our
(14:25):
exposure to one another and to frequently touch surfaces is
something that we can all do to help reduce spread
of the coronavirus. If you start to have symptoms, is
there a way for you to distinguish without a test,
between the flu or having a common cold, or this
is actually coronavirus? What's the difference. Unfortunately, there's no way
(14:48):
to distinguish this coronavirus infection from some of the other
common coronavirus infections, or for influenza, or from rhinovirus, or
from respiratory since issue virus, the whole slew of respiratory
viruses out there that can cause respiratory symptoms as well
as fever and muscle ake. So it really does require
(15:10):
that when you develop symptoms that you self isolate and
it's more important than ever that we don't try to
tough it out and just go into work when we
have a respiratory illness, because it's just putting other people
at risk. Next, what Americans can do to protect themselves
from the spread of COVID nineteen. Even if you're healthy,
(15:50):
Is there a virtue to maximizing the number of people
in your shop who work from home or who telecommute
rather than coming in. Yeah, that's an important part of
social distancing, particularly at this point in the epidemic, so
that we can reduce the rapid spread of the infection
and distribute the impact of the epidemic over as long
(16:13):
a period as possible. So, even though you may be
at low risk of severe infection yourself, keep in mind
that people you work with, particularly those who are older,
those with chronic heart, lung, kidney disease or diabetes, or
who are on immuno suppressive medications, may be at higher risk.
(16:34):
If I wash my hands regularly and I try to
avoid large groups. Are there other specific things the average
Americans should be doing. I think the final thing that's
important for everybody to do is to monitor the situation closely.
Some of the best Sources of information include the website
(16:55):
at the CDC, CDC dot gov slash COVID nineteen, as
well as information through your local or state health department.
I know Johns Hopkins University also has a very well
monitored and edited website, The who has daily updates on
the global situation as well. And the final thing that's
(17:17):
important is while everybody's concerned anytime we have a new
pandemic of an infectious disease, it's important to be prepared
rather than scared. That we're ready to be flexible when
our plans may be frustrated by cancelations or we may
be tied up forced to stay at home because of
(17:37):
quarantine or isolation recommendations. But the more that we can do,
the things that have been recommended all along, such as
being prepared for hurricane, earthquake, or other natural disasters apply
in an infectious disease outbreak as well. So having some
of those non perishable foods on hand is an important
(17:57):
part of being able to stay home as much as
possible if that becomes need it next how soon will
the United States have a coronavirus vaccine? What does your
(18:25):
gut tell you as the earliest we're likely to have
a vaccine, So a vaccine that's ready to enter into
trials and humans maybe a few months away. But there's
still a number of steps that have to be taken
before we have a vaccine that's available to the general public.
So that's at least a year to a year and
a half away. And it's important to recognize this is
(18:47):
not bureaucratic steps and checkboxes that have to be ticked off.
It's critically important that we know a vaccine is safe
and that it's effective before we recommend it to the
general public. What's your sense of somebody who studied his
HU area, is in fact this routine pattern of flu
(19:07):
sort of diminishing in the spring and summer and then
tending to come back in the fall and winter. Is
that in fact a pattern, and if so, is it
also likely to apply to the coronavirus. It's certainly true
as a pattern for the influenza virus that we have
a flu season in the northern hemisphere that aligns with
cold weather months and we see a big decline in
(19:29):
respiratory illnesses during the summer months. The reverse is true
in the southern hemisphere. For this coronavirus. Of course, the
evidence is that it only first affected humans about three
to four months ago, early in the winter of late
November early December of twenty nineteen, so we don't yet
know what it's going to do in the summertime. So
(19:52):
at this point I would not want to take comfort
that it's just going to go away in the summer.
I think it's going to be better that while we
might hope for the best, we also prepare for the
worst and recognize that epidemic may very well continue into
the warmer weather months. Is it also true even if
it did diminish dramatically the summer that, given the pattern
(20:14):
that we've now seen for I think the first recorded
epidemic was like eighteen ninety, that we just better spend
the summer and fall really working to be ready because
it probably will come back. Because these things now, once
they cross over from animals to people, they seem to
like staying with people. Yeah, that's a great question and
(20:35):
a really good point as well. It gets back to
what I was saying, we want to hope for the best,
but prepare for the worst. So it would be very
favorable if we got to break through the summer months
with less transmission, we would still not have a vaccine
available by the fall, so we'd still have a large
proportion of the population that may be susceptible. So we
(20:57):
would want to use that time wisely to be prepared
aired for the potential for a second wave of an
increased number of cases as the cold weather months return. Listen,
I really appreciate this, and I wish you well. I
know how hard you're working and how much of responsibility
you feel for helping the country and for that matter,
of the world get through this, and I just want
(21:18):
to tell you we're very grateful to have a chance
to share these ideas well. I really appreciate the opportunity
to speak with you and really have a longer conversation
about what's going on. And unfortunately it's hard to put
it all into a sound bite, so I love the
opportunity to sort of dig into some of the details.
I'm currently living in Italy, where the coronavirus has spread
(21:38):
from two hundred people to twelve thousand people in the
span of just two weeks. I discussed the situation in
Italy at newts Inner Circle dot com. It's a subscription
service where I offer insights and commentary on the issues
that matter to me. Most joined today at newts Inner
Circle dot com. You can read more about COVID nineteen
(22:02):
on our show page at newtsworld dot com. Newtsworld is
produced by Gingwist three sixty and iHeartMedia. Our executive producer
is Debbie Myers and our producer is Garnsey Slump. The
artwork for the show was created by Steve Penley. Thank
you to the team at Gingwrist three sixty. Please email
me with your comments at newt at newtsworld dot com.
(22:24):
If you've been enjoying Newtsworld, I hope you'll go to
Apple Podcast and both rate us with five stars and
give us a review so others can learn what it's
all about. On the next episode of Newtsworld, coronavirus panic
sent world stock markets crashing last week, with an index
of global stocks setting its largest weekly fall since the
(22:48):
nineteen eighty seven global financial crisis and over five trillion
dollars wiped from the global market value last week. We'll
discuss the coronavirus and its impact on the star market
and the global economy on the next episode. I'm newt
gangwish this is news world,
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