WEBVTT - Bonus: When -- and HOW -- can we return to 'normal'? 0:00:00.240 --> 0:00:06.600 Hi everyone, I'm Katie Kurig, and welcome to Next Question. Today, 0:00:06.600 --> 0:00:09.520 on a special bonus episode, we begin to consider what 0:00:09.760 --> 0:00:13.920 life after coronavirus might look like. The pandemic will no 0:00:14.040 --> 0:00:18.239 doubt have an enormous impact on the way we work, learn, travel, 0:00:18.680 --> 0:00:22.200 or even just interact with each other. But before we 0:00:22.239 --> 0:00:24.479 can even get to that, we have to answer my 0:00:24.680 --> 0:00:28.800 next question, when and how can we return to normal? 0:00:29.360 --> 0:00:32.519 And what will normal even look like. This is going 0:00:32.600 --> 0:00:35.760 to be a long struggle until we have a vaccine. 0:00:36.120 --> 0:00:39.040 The virus is likely to be with us and is 0:00:39.080 --> 0:00:41.640 likely to change the way we have to go about 0:00:41.640 --> 0:00:44.479 our lives, even when we begin to come back out again. 0:00:45.080 --> 0:00:47.839 Dr Tom Frieden is the former director of the U 0:00:47.880 --> 0:00:51.159 S Centers for Disease Control and Prevention a k a. 0:00:51.440 --> 0:00:54.400 The c d C, and before that was New York 0:00:54.480 --> 0:00:58.400 City's Public Health Commissioner. He's now the president and CEO 0:00:58.840 --> 0:01:02.840 of Resolved to Say Lives. He's called this pandemic world 0:01:02.840 --> 0:01:08.080 War C with the humans against the coronavirus, and while 0:01:08.080 --> 0:01:10.560 it's daunting to think we're still at the start of 0:01:10.600 --> 0:01:13.640 this war, Dr fried is thinking about the future we 0:01:13.720 --> 0:01:16.880 all long for, and he's just released a four point 0:01:16.920 --> 0:01:19.480 plan that will help the country get up and running 0:01:19.840 --> 0:01:28.320 as soon and safely as possible. You have stressed that 0:01:28.480 --> 0:01:32.200 reopening is not about the date, it's about the data. 0:01:32.560 --> 0:01:34.760 With that in mind, explain for us what you think 0:01:34.800 --> 0:01:37.679 the data needs to reveal in order to ensure a 0:01:37.720 --> 0:01:41.080 safer returned to life as we once knew it, or 0:01:41.920 --> 0:01:45.520 somewhat as we once knew it. To get out to 0:01:45.560 --> 0:01:47.840 the new normal, we need to look at three things. 0:01:47.880 --> 0:01:51.360 The first is how widely the virus is spreading and 0:01:51.480 --> 0:01:54.680 whether it's decreasing. You don't want to go out when 0:01:54.680 --> 0:01:57.080 it's about to explode again, and you don't want to 0:01:57.120 --> 0:01:59.120 go out when there's so many cases that they might 0:01:59.200 --> 0:02:03.560 overwhelm health or public health systems. The second is how 0:02:03.640 --> 0:02:06.560 prepared our health care systems are so we can prevent 0:02:06.600 --> 0:02:11.119 healthcare workers from becoming affected and also provide good care 0:02:11.200 --> 0:02:15.520 to people with coronavirus and continuing continuing to provide care 0:02:15.720 --> 0:02:20.079 to people who need chronic care, whether it's cancer screening 0:02:20.160 --> 0:02:23.919 or diabetes care. What we're seeing is people foregoing very 0:02:23.960 --> 0:02:26.840 important services, So that has to be ready, and our 0:02:26.880 --> 0:02:28.840 public health system has to be ready to do what 0:02:29.360 --> 0:02:34.040 I call box it in testing isolation, contact casing, and 0:02:34.120 --> 0:02:37.760 quarantine four corners of a box. If we get that right, 0:02:38.240 --> 0:02:42.280 we can limit the spread of coronavirus from cases and 0:02:42.360 --> 0:02:45.480 clusters so it doesn't explode again and force us to 0:02:45.480 --> 0:02:50.679 come back in. You're such a well respected public health official. 0:02:50.960 --> 0:02:53.359 I do think that a lot of people listening may 0:02:53.400 --> 0:02:58.800 think the numbers, the estimates were we're too high, that 0:02:58.880 --> 0:03:03.400 the number of cases didn't match what people and scientists 0:03:03.440 --> 0:03:08.480 were predicting. Why can you help people understand why that 0:03:08.600 --> 0:03:11.840 was the case, and is it because of the measures 0:03:11.880 --> 0:03:16.919 that were taken. We're learning more about coronavirus literally every day, 0:03:16.960 --> 0:03:19.920 but it would be a big and potentially fatal mistake 0:03:20.040 --> 0:03:22.880 not to take this virus very seriously. Just look at 0:03:22.919 --> 0:03:25.120 what has happened in New York City, where there have 0:03:25.200 --> 0:03:30.600 been seventeen thousand confirmed or probable cases and twenty one 0:03:31.240 --> 0:03:36.640 excess deaths in less than six weeks. That compares with 0:03:36.800 --> 0:03:39.880 thirty thousand deaths in New York City in two years 0:03:39.920 --> 0:03:45.200 of the influenza pandemic. This is the worst health threat 0:03:45.280 --> 0:03:50.760 of our lifetime, and it is very, very dangerous, particularly 0:03:50.800 --> 0:03:53.440 for people over the age of sixty and for anyone 0:03:53.520 --> 0:03:57.880 with underlying health conditions, but also just a variety of 0:03:57.880 --> 0:04:01.480 people in their thirties and forties and get very very ill. 0:04:01.920 --> 0:04:08.520 So this is an enormously deadly pandemic and unfortunately bad 0:04:09.120 --> 0:04:12.200 as it has been, this is just the beginning. The 0:04:12.320 --> 0:04:15.600 virus will be here until we have a vaccine. What 0:04:15.720 --> 0:04:20.520 about until there's a better treatment. The treatment would make 0:04:20.520 --> 0:04:22.760 a really big difference. If we had good treatment for 0:04:22.760 --> 0:04:26.240 this vaccine, and including good preventive treatment, and that could 0:04:26.279 --> 0:04:29.719 come well before a vaccine, that would make a big difference. 0:04:29.760 --> 0:04:33.400 That could decrease death rates, decrease overcrowd against care units, 0:04:33.960 --> 0:04:37.360 help people be safer. So yes, the treatment would be terrific, 0:04:37.720 --> 0:04:40.040 but we don't have one yet. And and do you 0:04:40.080 --> 0:04:43.080 see I know there's been a lot of global cooperation 0:04:43.200 --> 0:04:47.960 among scientists and researchers. Do you see anything that gives 0:04:47.960 --> 0:04:52.880 you optimism about a potential treatment that may pre come 0:04:52.960 --> 0:04:57.680 before a vaccine? So far, nothing is working out and 0:04:57.839 --> 0:04:59.400 a few of the things that have looked at have 0:05:00.000 --> 0:05:02.960 not proven to be effective. I am encouraged that there's 0:05:03.000 --> 0:05:06.800 really good global collaboration that the World Health Organization is 0:05:06.839 --> 0:05:10.760 helping to link together scientists from all over the world. Interestingly, 0:05:11.000 --> 0:05:15.520 paywalls have come down on scientific publications, and preprints have 0:05:15.600 --> 0:05:18.480 gone up. These are two big changes in how medical 0:05:18.520 --> 0:05:22.000 science works. So we're learning more really fast, and I'm 0:05:22.120 --> 0:05:25.080 encouraged that if we do identify a good treatment, will 0:05:25.080 --> 0:05:27.919 find out about that quickly and I hope then be 0:05:28.000 --> 0:05:30.440 able to apply it widely. But we don't have it now, 0:05:30.640 --> 0:05:33.679 and what we need to do now is to stay 0:05:33.720 --> 0:05:37.320 home so that the virus doesn't explode again. That's our 0:05:37.720 --> 0:05:41.280 most blunt weapon against it, and box it in. That's 0:05:41.279 --> 0:05:44.240 our most precise weapon against it. That's how we can 0:05:44.320 --> 0:05:48.160 prevent an outbreak. From becoming an academic, I want to 0:05:48.160 --> 0:05:52.240 talk more about how to restart the economy and some 0:05:52.360 --> 0:05:54.599 of the things that you have in mind, But first 0:05:54.640 --> 0:05:58.159 I'm curious Dr. Freedom. Have you been able to or 0:05:58.480 --> 0:06:02.600 have scientists been able to get a better understanding of 0:06:02.760 --> 0:06:06.839 some of the mystery surrounding COVID nineteen. The fact that 0:06:07.080 --> 0:06:13.039 some people are affected so intensely and are incapacitated and 0:06:13.160 --> 0:06:18.520 often killed by this virus, and others can be completely asymptomatic. 0:06:18.839 --> 0:06:22.400 It's got to be more than just underlying conditions or 0:06:23.680 --> 0:06:26.520 or someone's age. What are some of the things that 0:06:26.600 --> 0:06:31.080 we're learning about how this virus operates. We're literally more 0:06:31.440 --> 0:06:34.000 every day, but there's still a lot we don't know. 0:06:34.960 --> 0:06:38.200 We do know that age is the strongest predictor of 0:06:38.240 --> 0:06:41.400 how bad this infection will be, and kids under the 0:06:41.440 --> 0:06:44.400 age of twenty rarely get seriously ill from it. On 0:06:44.440 --> 0:06:48.119 the other hand, people over sixty often do. It's often 0:06:48.240 --> 0:06:52.839 fatal for them. We don't know which underlying health conditions 0:06:52.880 --> 0:06:58.760 are riskiest. Diabetes, kidney disease, lung disease, heart disease seeming 0:06:58.839 --> 0:07:01.880 the most concerning, but that's something will learn more about. 0:07:02.279 --> 0:07:05.280 We don't know whether some people have more severe disease 0:07:05.320 --> 0:07:09.200 because they were exposed to a bigger amount of virus 0:07:09.400 --> 0:07:12.760 what's called the innoculum. And one thing that I'm very 0:07:12.840 --> 0:07:16.400 intrigued by, although there's no proof of this, is that 0:07:16.440 --> 0:07:20.520 there may be very subtle genetic differences in different strains 0:07:20.520 --> 0:07:24.040 of this virus that may be associated with higher or 0:07:24.160 --> 0:07:27.840 lower severity of illness. That's just a theory at this point, 0:07:27.960 --> 0:07:31.080 there's no evidence to support it, but it's something that 0:07:31.360 --> 0:07:34.200 would be a clue as to how we might make 0:07:34.240 --> 0:07:38.000 a vaccine that might immunize people without making them sick. 0:07:38.560 --> 0:07:41.080 Can you help me understand that better. When you say 0:07:41.080 --> 0:07:45.400 a different, a more powerful strain, explain what you made 0:07:45.400 --> 0:07:49.040 by by that. For people who aren't scientists or doctors 0:07:49.120 --> 0:07:52.000 listening to this, well, the first thing to say is, 0:07:52.120 --> 0:07:54.880 we have no idea. We don't know why some people 0:07:54.920 --> 0:07:58.040 get sicker than others. It could be they're exposed to 0:07:58.120 --> 0:08:01.360 a higher dose or a noculum of the virus, but 0:08:01.560 --> 0:08:04.360 we know that if they have underlying conditions that could 0:08:04.400 --> 0:08:08.480 make it worse. And there is a possibility that there 0:08:08.520 --> 0:08:13.600 are certain types of this virus. It's all Sarah's cove too, 0:08:13.800 --> 0:08:18.160 it's all one particular species of coronavirus, but there are 0:08:18.200 --> 0:08:22.920 already a lot of genetic differences within that species. And 0:08:23.080 --> 0:08:25.440 one theory that some of us are beginning to wonder 0:08:25.560 --> 0:08:29.200 about now with no evidence, just something that should be investigated, 0:08:29.560 --> 0:08:32.600 is whether some of the strains that are circulating are 0:08:33.160 --> 0:08:36.559 less deadly than others, and might account for the fact 0:08:36.600 --> 0:08:39.440 that you're seeing a very high proportion of people with 0:08:39.480 --> 0:08:43.600 no symptoms at all in some outbreaks and a very 0:08:43.640 --> 0:08:46.960 low proportion with no symptoms at all in others. The 0:08:47.040 --> 0:08:49.640 New York Times, in fact, had a front page piece 0:08:49.760 --> 0:08:53.719 about a seemingly healthy guy who was on a ventilator, 0:08:53.800 --> 0:08:56.600 I believe, for thirty two days and came out the 0:08:56.640 --> 0:09:01.320 other side pretty miraculously. But he seemed to be very 0:09:01.440 --> 0:09:06.760 atypical for someone who would be made so seriously from 0:09:06.760 --> 0:09:12.760 this virus. No one should be overconfident about this virus. 0:09:12.960 --> 0:09:17.040 Thirty year old doctors, nurses, and others with no underlying 0:09:17.040 --> 0:09:23.439 conditions have become desperately ill, and some have died from it. Unfortunately, 0:09:24.360 --> 0:09:27.839 no one is immune from this virus. Maybe people who 0:09:27.840 --> 0:09:30.960 have been recovered from it, maybe, but barring that, there 0:09:31.040 --> 0:09:34.800 is no natural immunity. And that's why we're so concerned. 0:09:35.200 --> 0:09:38.480 Not only have there been more than seventeen thousand COVID 0:09:38.520 --> 0:09:40.840 deaths in New York City so far, it could get 0:09:40.840 --> 0:09:44.080 two or three times worse, and other parts of the US, 0:09:44.160 --> 0:09:46.800 other parts of the world haven't gone through that yet, 0:09:47.320 --> 0:09:53.720 so they're at risk of explosive outbreaks. When we come back, 0:09:54.040 --> 0:10:09.480 Dr Tom Threeden on our COVID testing fiasco, We're back 0:10:09.520 --> 0:10:15.240 with Dr Tom Frieden, former director of the CDC. Testing 0:10:15.360 --> 0:10:19.240 is such an important factor, Dr Frieden, But gosh, that 0:10:19.280 --> 0:10:23.480 seems to have been a massive ship show. Excuse my French. 0:10:23.559 --> 0:10:27.120 In terms of getting the testing up and running. What 0:10:27.320 --> 0:10:31.800 the heck happened here? We still have far too few 0:10:31.920 --> 0:10:36.120 tests compared to what we need. The CDC stumbled early 0:10:36.200 --> 0:10:38.560 on there was a problem with their test kit. Their 0:10:38.600 --> 0:10:41.280 test kit has worked fine for two months and we 0:10:41.360 --> 0:10:44.480 still have a major shortage. That's because it's really a 0:10:44.559 --> 0:10:48.120 three leggedge to it. You need the CDC providing tests, 0:10:48.320 --> 0:10:53.360 to public health laboratories, hospitals developing their own tests, and 0:10:53.440 --> 0:10:57.680 the commercial laboratories figuring out how they provide very large 0:10:57.800 --> 0:11:02.840 volumes of tests. And this has been increasing, but too slowly. 0:11:02.880 --> 0:11:07.800 And that's why we've just released guidance on who should 0:11:07.800 --> 0:11:11.360 be tested, because right now we don't have enough tests 0:11:11.400 --> 0:11:15.000 for everyone, and therefore we really need to scale up 0:11:15.040 --> 0:11:18.480 testing for those who need it most, including people whose 0:11:19.480 --> 0:11:22.640 lives may be saved by being tested, or people who 0:11:22.720 --> 0:11:25.360 when we know they're infected, we can isolate them and 0:11:25.440 --> 0:11:28.920 prevent a large and deadly outbreak of the disease. So 0:11:28.960 --> 0:11:31.839 when you say are you talking about elderly people and 0:11:31.920 --> 0:11:34.880 those with the underlying conditions, I mean who is in 0:11:34.960 --> 0:11:38.080 this subset of people who should be tested right now? 0:11:39.120 --> 0:11:42.719 Most important are people with symptoms who are being hospitalized 0:11:43.160 --> 0:11:47.800 for our overage sixty or who have underlying health conditions. 0:11:48.400 --> 0:11:52.000 Next most important is anyone in a congregte facility who 0:11:52.080 --> 0:11:55.959 has symptoms. That's a nursing home or a homeless shelter, 0:11:56.240 --> 0:11:59.440 or a prison or a jail. Next is health care 0:11:59.440 --> 0:12:02.720 workers who of symptoms so we can make health facility 0:12:02.840 --> 0:12:05.839 is safer. And anyone who's a contact of a case 0:12:06.160 --> 0:12:10.160 who is symptomatic, plus all people hospitalized where COVID is 0:12:10.200 --> 0:12:16.240 spreading to prevent hospital outbreaks of COVID, it's really important 0:12:16.240 --> 0:12:20.400 that these individuals get tested because that can greatly reduce 0:12:20.480 --> 0:12:23.000 the spread of the infection. And when there is an 0:12:23.000 --> 0:12:27.520 outbreak in a conic facility, then it's important, uh then 0:12:27.559 --> 0:12:30.320 that all they are get tested, whether or not they 0:12:30.320 --> 0:12:33.600 have symptoms. But just to test those groups is over 0:12:33.640 --> 0:12:36.200 a million tests a day and we're doing at most 0:12:36.280 --> 0:12:39.480 a quarter of that now I know about a hundred 0:12:39.559 --> 0:12:42.240 and fifty thousand tests a day, so less than a 0:12:42.320 --> 0:12:46.080 quarter of that certainly. And when are we going to 0:12:46.120 --> 0:12:50.000 be able to have enough tests available? What about that much? 0:12:50.040 --> 0:12:53.520 Bally hood Abbott laboratories fast tests that you could get 0:12:53.559 --> 0:12:56.640 the results in you know, five to eighteen minutes what 0:12:56.720 --> 0:13:01.679 happened with that. There are tests that are um point 0:13:01.720 --> 0:13:04.960 of care and they're available right where the patient is, 0:13:05.000 --> 0:13:08.800 like the Abbot test, but they're low volume. They take 0:13:08.960 --> 0:13:11.120 less than fifteen minutes, but you only do one at 0:13:11.160 --> 0:13:13.920 a time, so you can only do four patients per 0:13:13.960 --> 0:13:18.320 hour on one instrument. In contrast, some of the large 0:13:18.400 --> 0:13:20.800 tests may take a day to come back, but you 0:13:20.840 --> 0:13:23.960 can do thousands of hours. When we have the tests 0:13:23.960 --> 0:13:27.080 that we need at what you say, a million a day. 0:13:28.840 --> 0:13:31.560 We'll really have to rely on the federal government for 0:13:31.640 --> 0:13:33.880 getting this right. They have to coordinate it. They have 0:13:33.960 --> 0:13:37.119 to make sure the entire supply chain is there, from 0:13:37.520 --> 0:13:42.680 swabs to transport media, to re agents to test kits, 0:13:42.920 --> 0:13:46.840 to machines for testing, to providing the test results. Remember, 0:13:47.120 --> 0:13:50.280 testing is just the first step. Testing is really important, 0:13:50.440 --> 0:13:53.880 but it's not the answer. It's a part of the answer. 0:13:54.240 --> 0:13:58.920 It's about testing, isolating people who are positive, tracing contacts, 0:13:59.000 --> 0:14:02.000 and quarantining the contacts. I can do those four things. 0:14:02.360 --> 0:14:04.560 You can keep the virus in the box so we 0:14:04.600 --> 0:14:09.000 can go out. Let's talk about contact tracing. Tell us 0:14:09.080 --> 0:14:11.920 about that. What do you mean by contact tracing? Because 0:14:11.960 --> 0:14:15.640 I understand you call it an old fashioned shoe leather 0:14:16.160 --> 0:14:19.360 effort of sending human beings out to ask people who 0:14:19.400 --> 0:14:22.600 they've been in contact with. But that could require an 0:14:22.680 --> 0:14:26.440 army of something like three thousand people. So how do 0:14:26.480 --> 0:14:31.560 you organize an effort like that? Contact tracing is hard work, 0:14:31.840 --> 0:14:35.520 but it works. It's traditional public health work. In fact, 0:14:35.840 --> 0:14:39.160 every day, all year round, health departments all over this 0:14:39.240 --> 0:14:42.480 country and all over the world are doing it for tuberculosis, 0:14:42.600 --> 0:14:48.240 for measles, or sexually transmitted diseases HIV and other conditions. 0:14:48.280 --> 0:14:51.040 But we have to do it on a much wider 0:14:51.080 --> 0:14:55.720 scale now it's specialized work. Contact tracers need to be 0:14:55.760 --> 0:14:58.440 able to develop a human bond with patients. They need 0:14:58.480 --> 0:15:02.840 to be able to answer their question is medical, social, emotional. 0:15:03.120 --> 0:15:07.000 They need to be able to link them to services, 0:15:07.000 --> 0:15:10.160 whether it's medical services if they're sick, or social services 0:15:10.200 --> 0:15:14.160 if they have needs, or community supports. That contact tracing 0:15:14.320 --> 0:15:19.200 process supports patients and those they may have exposed so 0:15:19.240 --> 0:15:22.120 that the virus can stop with them, so that they 0:15:22.120 --> 0:15:26.200 can isolate themselves in the case of patients, or quarantine 0:15:26.240 --> 0:15:29.640 themselves in the pace of case of contact, and if 0:15:29.640 --> 0:15:33.320 they do develop the illness, they don't spread it to others. 0:15:33.360 --> 0:15:36.400 That does take time, It takes effort. If we look 0:15:36.400 --> 0:15:40.320 around the world, Singapore, with the population of five point 0:15:40.360 --> 0:15:43.600 six million people, has more than a thousand people doing 0:15:43.640 --> 0:15:46.840 contact tracing. That gives you a sense of the scale 0:15:46.880 --> 0:15:49.600 of the effort that will be needed. Tens or maybe 0:15:49.680 --> 0:15:52.840 hundreds of thousands of people will be needed, and that 0:15:52.920 --> 0:15:56.920 sounds impossible, but it's essential if we're to come out 0:15:57.240 --> 0:16:00.200 as soon and safely as possible. And that gets sent 0:16:00.360 --> 0:16:04.800 running back home again because we see an explosion of cases. Well, 0:16:04.840 --> 0:16:06.920 I was going to ask you about that. When you 0:16:06.960 --> 0:16:10.000 see the governor of Georgia starting to open up things 0:16:10.080 --> 0:16:14.960 like bowling alleys and barber shops and nail salmons, what 0:16:14.960 --> 0:16:19.440 what do you think? I think, first off, if you 0:16:19.520 --> 0:16:22.400 look at the stay at home orders around the country 0:16:22.480 --> 0:16:25.360 and the data that's come out since from groups like 0:16:25.480 --> 0:16:29.600 Facebook and Google that have analyzed what population movements were 0:16:30.320 --> 0:16:33.360 people stay at home before the rectory statement they heard 0:16:33.400 --> 0:16:37.120 what was happening, I think you'll see some some people 0:16:37.200 --> 0:16:40.560 certainly coming right out and other people waiting. We do 0:16:40.720 --> 0:16:44.640 have to get ready for the COVID world, for the 0:16:44.720 --> 0:16:48.360 new normal where we're going to use hand sanitizers before 0:16:48.400 --> 0:16:50.880 we go into a building, we're going to say six 0:16:50.880 --> 0:16:54.040 ft away from people to the greatest extent possible, where 0:16:54.040 --> 0:16:57.360 we're going to have masks on to protect others as 0:16:57.360 --> 0:17:01.000 well as ourselves. Whenever COVID has spread in an environment, 0:17:01.400 --> 0:17:05.199 certain things are certainly beyond reasonable. You would not want 0:17:05.240 --> 0:17:07.399 to open movie theaters at this time. That does not 0:17:07.520 --> 0:17:09.720 make sense. While you've still got a lot of cases. 0:17:10.560 --> 0:17:15.280 You really try to avoid gatherings of ten people or more. 0:17:15.920 --> 0:17:18.520 You try to keep people together in one group so 0:17:18.560 --> 0:17:21.719 that there is so that if there is spread of COVID, 0:17:21.880 --> 0:17:26.360 it stops there and doesn't explode in society. Remember, if 0:17:26.359 --> 0:17:31.200 the virus spreads widely, it's not just the people who 0:17:32.080 --> 0:17:38.320 volunteered or hum of their own accord we're in public 0:17:38.520 --> 0:17:41.400 that are affected. It's the health workers who they could 0:17:41.400 --> 0:17:46.359 infect and could die. It's the grandmothers and grandfathers, and 0:17:46.440 --> 0:17:49.480 brothers and sisters and children of those they in fact 0:17:49.480 --> 0:17:51.600 who could get very sick. So we have to be 0:17:51.720 --> 0:17:55.800 careful and do this in phasis understanding that when we 0:17:55.880 --> 0:17:59.000 loosen the faucet and come out again, it maybe three 0:17:59.080 --> 0:18:02.000 to six weeks before we see a surge in cases, 0:18:02.400 --> 0:18:05.640 because it takes about a week from exposure to infection, 0:18:05.720 --> 0:18:08.640 about another week to get very severely ill. So it'll 0:18:08.680 --> 0:18:11.439 be weeks before we see the impact of these and 0:18:11.480 --> 0:18:13.560 we don't know whether whether we'll be on our side 0:18:13.720 --> 0:18:16.200 or not, and whether warm or weather will be helpful. 0:18:16.359 --> 0:18:19.439 We hope it will be, but the plain truth is 0:18:20.080 --> 0:18:24.080 COVID is here to stay unless something surprising happens or 0:18:24.160 --> 0:18:26.439 we get a vaccine, and that means we have to 0:18:26.480 --> 0:18:29.480 get used to a new normal where we're going to 0:18:29.520 --> 0:18:32.479 have to be more careful for our own sake and 0:18:32.600 --> 0:18:36.119 especially for the sake of those most vulnerable in our communities. 0:18:36.760 --> 0:18:40.000 Once you get the virus, does that make you immune? 0:18:40.040 --> 0:18:43.439 That's still a big question Mark two, isn't it Tom? 0:18:43.560 --> 0:18:47.879 We don't know. There's more information coming out every day, 0:18:48.119 --> 0:18:49.920 and it may be a few weeks or a few 0:18:49.960 --> 0:18:53.440 months before we know. First off, there are antibody tests, 0:18:53.560 --> 0:18:55.800 A lot of questions about those. A lot of the 0:18:55.840 --> 0:18:58.119 tests that are on the market don't work well, so 0:18:58.160 --> 0:19:00.800 the results are not reliable. Even if you have a 0:19:00.800 --> 0:19:04.240 good antibody test, knowing what it means is not clear, 0:19:04.560 --> 0:19:07.760 doesn't mean you're immune. Even if it does, how long 0:19:07.800 --> 0:19:10.800 will that immunity last there's so much we don't yet 0:19:10.880 --> 0:19:13.840 know about this virus. But the more we learn, the 0:19:13.880 --> 0:19:17.040 more we can do to protect people. What I keep 0:19:17.080 --> 0:19:20.080 thinking about, which I know I shouldn't, because this is 0:19:20.119 --> 0:19:23.720 seeing the glass is half empty, is even if there's 0:19:23.720 --> 0:19:27.159 a vaccine for COVID nineteen, how concerned are you that 0:19:27.240 --> 0:19:31.480 another virus, even after a vaccine is developed maybe around 0:19:31.520 --> 0:19:36.000 the corner. Dr Freeden Katie, It is absolutely inevitable that 0:19:36.040 --> 0:19:38.480 there will be another health threat. Whether it will be 0:19:38.800 --> 0:19:41.560 as bad as COVID nineteen or worse, we don't know. 0:19:42.040 --> 0:19:46.000 What's not inevitable is that we will be so woefully 0:19:46.119 --> 0:19:50.160 underprepared next time. And we can avoid being underprepared by 0:19:50.200 --> 0:19:54.159 investing in public health in this country and around the world. 0:19:54.560 --> 0:19:59.359 That means establishing systems to find, stop and prevent health 0:19:59.400 --> 0:20:02.760 threat where they emerge so they don't spread around the world. 0:20:03.000 --> 0:20:06.960 That means ending the practice of selling exotic animals for 0:20:07.080 --> 0:20:11.399 food and markets. That means ending the practice of bush 0:20:11.400 --> 0:20:15.200 meat consumption in Africa where viruses can emerge. That means 0:20:15.200 --> 0:20:19.919 strengthening our early warning system so we know where diseases 0:20:19.960 --> 0:20:24.160 are spreading and can rapidly investigate them and stop them. 0:20:24.240 --> 0:20:27.800 If at all possible. All of this is within reach, 0:20:28.200 --> 0:20:31.959 and with the trillions of dollars that we're losing because 0:20:31.960 --> 0:20:35.240 of COVID, it's clear that it would be the height 0:20:35.280 --> 0:20:40.000 of irresponsibility not to invest in our public house protection 0:20:40.080 --> 0:20:44.879 system in this country and around the world. Well, we 0:20:44.960 --> 0:20:48.520 come back, how to emerge into the new COVID world. 0:20:59.400 --> 0:21:03.320 Let's return to my interview with Dr Tom Frieden. It 0:21:03.359 --> 0:21:06.040 seems to me that we're going to need a nine 0:21:06.080 --> 0:21:11.639 eleven Commission type evaluation about not only this country's response, 0:21:11.680 --> 0:21:14.480 but the global response. Knowing that you don't want to 0:21:14.520 --> 0:21:18.399 get too far into politics, you're the former director of 0:21:18.480 --> 0:21:22.680 the CDC, So how would you assess the government's handling 0:21:22.680 --> 0:21:26.760 of this crisis, both the administration and other agencies, including 0:21:26.800 --> 0:21:32.439 the CDC. Let's start with CDC. CC clearly had a 0:21:32.520 --> 0:21:36.680 problem with the laboratory tests and with responding to that problem. 0:21:36.720 --> 0:21:39.639 I would like to see an independent investigation of that. 0:21:39.760 --> 0:21:43.000 I have no confidence in investigations that are done by 0:21:43.040 --> 0:21:46.560 others who might benefit from selling there was one problem 0:21:46.680 --> 0:21:50.119 or another. There's an excellent laboratory science unit at CC. 0:21:50.320 --> 0:21:52.400 I would want to see them do an internal report 0:21:52.680 --> 0:21:55.560 and then have an external highly expert group through the 0:21:55.640 --> 0:21:59.879 National Academy of Sciences look at that and provide transparently 0:22:00.200 --> 0:22:02.440 what went wrong and how to prevent that from going 0:22:02.480 --> 0:22:05.280 around in the future. That doesn't change the fact that 0:22:05.400 --> 0:22:09.960 the CDC is a fantastic institution with twenty public health 0:22:09.960 --> 0:22:13.640 professionals who devote their lives to protecting people from health 0:22:13.680 --> 0:22:17.560 threats and who are our elite troops in this war 0:22:17.800 --> 0:22:21.600 against coronavirus. They are working day and night. They are 0:22:21.680 --> 0:22:26.040 doing an enormous amount to strengthen states and cities around 0:22:26.800 --> 0:22:30.800 the country. Their website, CDC dot gov remains the best 0:22:30.880 --> 0:22:34.479 place to go for information, advice, and guidance on how 0:22:34.520 --> 0:22:38.720 to protect ourselves, our workplaces, and our communities. In terms 0:22:38.720 --> 0:22:42.040 of the US response, more generally, can I can I 0:22:42.080 --> 0:22:46.880 interrupt for two seconds? So well? I agree with you. 0:22:46.960 --> 0:22:50.160 I've done work with the CDC. I have so much 0:22:50.200 --> 0:22:54.400 respect for the people there. But something did go terribly 0:22:54.520 --> 0:22:59.080 wrong in this instance. What do you think happened? I 0:22:59.080 --> 0:23:03.440 don't know. I there. The CDC laboratory itself was able 0:23:03.480 --> 0:23:07.240 to do testing throughout this process and never got overwhelmed. 0:23:07.560 --> 0:23:11.000 The problem came in sending out tests that didn't work 0:23:11.080 --> 0:23:14.080 well and then the bigger problem was not responding to 0:23:14.160 --> 0:23:17.080 that problem rapidly. I don't know why that happened, but 0:23:17.160 --> 0:23:18.800 that's one of the things that should be looked at. 0:23:19.440 --> 0:23:23.240 Tom the current the current CDC director, Robert Redfield, he's 0:23:23.240 --> 0:23:26.040 defended the agency and said, quote, it was really the 0:23:26.119 --> 0:23:30.399 responsibility of the private sector and the clinical medicine apparatus 0:23:30.840 --> 0:23:35.800 to develop widespread testing. That's correct, He's absolutely right. It's 0:23:35.840 --> 0:23:38.920 a three legged school. You've got CDC providing tests for 0:23:39.000 --> 0:23:43.280 the public health departments, You've got hospitals developing their own tests, 0:23:43.280 --> 0:23:46.800 and you've got the commercial sector developing the tests for 0:23:46.920 --> 0:23:50.280 large numbers of patients. And you can know for certain 0:23:50.320 --> 0:23:52.600 that it's correct because the CDC test has worked fine 0:23:52.680 --> 0:23:55.520 for two months and we still have a major shorts 0:23:55.560 --> 0:23:59.040 of tests because those other two legs got started very late. 0:23:59.480 --> 0:24:04.200 CDC said on January we have to behave as if 0:24:04.200 --> 0:24:07.320 this is a pandemic. But it wasn't until more than 0:24:07.359 --> 0:24:11.840 a month later that the Food and Drug Administration loosened 0:24:12.119 --> 0:24:15.199 regulations to allow the private sector to begin developing their 0:24:15.200 --> 0:24:17.880 own tests. And it wasn't until early March. And whose 0:24:17.880 --> 0:24:20.639 fault was that? I think you've got to look at 0:24:20.760 --> 0:24:25.440 HHS and FDA for that, and what about the administration 0:24:25.440 --> 0:24:28.920 and the task force that was well in place before that. 0:24:29.760 --> 0:24:33.440 I find the organization of this response by the administration 0:24:33.640 --> 0:24:37.040 very confusing. I don't know what the role of FEMA 0:24:37.359 --> 0:24:40.960 versus the task Force versus the Vice President versus the 0:24:40.960 --> 0:24:44.359 White House Coronavirus Coordinator versus the Chairman of the task 0:24:44.400 --> 0:24:47.280 Force is. In our work at Resolve to Save Lives, 0:24:47.400 --> 0:24:50.240 we advise countries fall around the world how to respond 0:24:50.280 --> 0:24:53.800 to an epidemic, and one of the main ways of 0:24:53.840 --> 0:24:56.359 doing that is to organize so that there is a 0:24:56.400 --> 0:25:01.639 single incident manager and a single trusted, not partisan spokesperson, 0:25:02.040 --> 0:25:04.800 and that those people report to the head of state, 0:25:05.200 --> 0:25:07.720 and that the policy decisions are made by the head 0:25:07.760 --> 0:25:12.000 of state. But the operational response has a clear line 0:25:12.000 --> 0:25:17.320 of accountability and a clear nonpartisan communication. I wish we 0:25:17.320 --> 0:25:20.040 would see that in this country. Well, it's been anything 0:25:20.160 --> 0:25:23.800