1 00:00:00,120 --> 00:00:03,480 Speaker 1: Hi, This is new because of the coronavirus. I am 2 00:00:03,480 --> 00:00:06,960 Speaker 1: currently staying at home in Rome, where my wife serves 3 00:00:06,960 --> 00:00:09,800 Speaker 1: as the United States Ambassador of the Holy See. She's 4 00:00:09,920 --> 00:00:12,880 Speaker 1: leading the embassy in dealing with all the different changes 5 00:00:12,880 --> 00:00:16,440 Speaker 1: being brought about by the pandemic. To bring you this 6 00:00:16,520 --> 00:00:19,919 Speaker 1: episode this week, I'm recording from my home, so you 7 00:00:20,040 --> 00:00:26,200 Speaker 1: may notice a difference in audio quality on this episode 8 00:00:26,200 --> 00:00:28,920 Speaker 1: of News World. This episode is the fourth in a 9 00:00:29,000 --> 00:00:33,199 Speaker 1: series of episodes. We're presenting a COVID nineteen healthcare breakers. 10 00:00:33,680 --> 00:00:36,760 Speaker 1: We're looking at treatments for COVID nineteen that will help 11 00:00:36,880 --> 00:00:41,680 Speaker 1: improve the patient outcomes. Hydroxychloroquine as a drug which was 12 00:00:41,680 --> 00:00:45,600 Speaker 1: originally developed to treat malaria, and President Trump has talked 13 00:00:45,600 --> 00:00:50,559 Speaker 1: about for treating COVID nineteen infective patients. While some warnings 14 00:00:50,560 --> 00:00:54,320 Speaker 1: have been an issue about the efficacy of hydroxy chloroquine 15 00:00:54,520 --> 00:00:58,160 Speaker 1: and COVID nineteen, the warnings have been on early observations 16 00:00:58,160 --> 00:01:03,680 Speaker 1: of patient use and not unlitically supervised clinical trials. Sanford Health, 17 00:01:04,040 --> 00:01:07,240 Speaker 1: based in Sue Fall, South Dakota, just be him the 18 00:01:07,319 --> 00:01:11,720 Speaker 1: first to lead a comprehensive clinical trial investigating the anti 19 00:01:11,760 --> 00:01:16,039 Speaker 1: malarial drug A droxychloricum to understand its role in treating 20 00:01:16,280 --> 00:01:20,920 Speaker 1: and potentially preventing COVID nineteen. I'm pleased to welcome my guest, 21 00:01:21,600 --> 00:01:35,440 Speaker 1: doctor David Pierce, President of Research Innovation for Sanford Health. Hello, 22 00:01:35,520 --> 00:01:38,640 Speaker 1: doctor Pierce, you are the President of Research Innovation for 23 00:01:38,720 --> 00:01:41,360 Speaker 1: Sanford Health. Tell me how you get your start in 24 00:01:41,400 --> 00:01:44,440 Speaker 1: this field. I am very fortunate to be the president 25 00:01:44,520 --> 00:01:48,320 Speaker 1: of Research here at Sandford Health. Eleven years ago, Sanford 26 00:01:48,400 --> 00:01:50,800 Speaker 1: Health did not have a research arm, and they took 27 00:01:50,800 --> 00:01:53,480 Speaker 1: the bold move as a health system to establish a 28 00:01:53,560 --> 00:01:56,680 Speaker 1: research arm. What we've done over that period of time 29 00:01:56,960 --> 00:02:00,720 Speaker 1: is built a strong portfolio of research, a lot of 30 00:02:00,720 --> 00:02:04,160 Speaker 1: preclinical research with respect to certain areas that we have 31 00:02:04,320 --> 00:02:08,240 Speaker 1: specific interests in and heediatrics for example type one diabetes, 32 00:02:08,600 --> 00:02:13,000 Speaker 1: regenitive medicine, RD diseases, and of course oncology with COVID. 33 00:02:13,080 --> 00:02:16,639 Speaker 1: We have a strong background in launching vaccine clinical trials, 34 00:02:16,720 --> 00:02:19,600 Speaker 1: so we have a very strong infectious disease group. So 35 00:02:19,760 --> 00:02:21,920 Speaker 1: my role in that period of time has really been 36 00:02:21,960 --> 00:02:25,720 Speaker 1: to build research that is patient orientated. As a health system, 37 00:02:25,760 --> 00:02:28,880 Speaker 1: we want to have good, rigorous research, but certainly something 38 00:02:28,919 --> 00:02:31,200 Speaker 1: that truly does go from the bench to the bedside 39 00:02:31,639 --> 00:02:34,800 Speaker 1: despite what we're going through right now in terms of 40 00:02:34,840 --> 00:02:37,720 Speaker 1: the huge impact that COVID nineteen is having on a 41 00:02:37,760 --> 00:02:40,399 Speaker 1: lot of individuals. I mean that really fits what our 42 00:02:40,400 --> 00:02:43,160 Speaker 1: mantle is about in terms of taking a real rigorous 43 00:02:43,160 --> 00:02:45,400 Speaker 1: approach in terms of how can we produe the best 44 00:02:45,440 --> 00:02:47,880 Speaker 1: for our patients that they're going to be diagnosed with this. 45 00:02:49,000 --> 00:02:53,679 Speaker 1: Sanford Health is the largest provider of Royal healthcare in 46 00:02:53,720 --> 00:02:57,119 Speaker 1: the entire country. How do you think that changes how 47 00:02:57,200 --> 00:03:01,000 Speaker 1: you all think about dealing with something like pandemic? It 48 00:03:01,120 --> 00:03:03,720 Speaker 1: sort of has changed our thinking, but it hasn't changed 49 00:03:03,760 --> 00:03:06,640 Speaker 1: our thinking. Our footprint is over the square of miles 50 00:03:06,639 --> 00:03:10,600 Speaker 1: of Texas, so video visits and tell ahealth is something 51 00:03:10,600 --> 00:03:12,919 Speaker 1: that's so embedded in the way we view and treat 52 00:03:12,960 --> 00:03:16,760 Speaker 1: our patients. As of today, people are seeking that more 53 00:03:16,840 --> 00:03:19,600 Speaker 1: because of this shelter. I'm that individuals are having so 54 00:03:19,720 --> 00:03:22,720 Speaker 1: if they're getting a fever or symptoms potentially thinking they 55 00:03:22,720 --> 00:03:25,920 Speaker 1: have COVID nineteen disease. Right now, the video visits that 56 00:03:26,000 --> 00:03:28,920 Speaker 1: we've embedded really ramped up and are able for us 57 00:03:29,000 --> 00:03:32,200 Speaker 1: to truly effectively start looking at whether people should come 58 00:03:32,240 --> 00:03:35,400 Speaker 1: in to be seen, maybe give them a preliminary diagnosis 59 00:03:35,400 --> 00:03:39,200 Speaker 1: through that methodology. I one did Sanford first begin to 60 00:03:39,240 --> 00:03:43,320 Speaker 1: notice COVID nineteen. They think our first COVID nineteen patients 61 00:03:43,360 --> 00:03:45,760 Speaker 1: at the beginning of April. We were watching the world 62 00:03:46,040 --> 00:03:48,960 Speaker 1: as everybody was, and then watching the nation as they 63 00:03:48,960 --> 00:03:51,440 Speaker 1: were developing, knowing full well that we would be getting 64 00:03:51,760 --> 00:03:54,839 Speaker 1: our first patients. So we've been able to prepare very 65 00:03:54,960 --> 00:03:56,960 Speaker 1: much in terms of the fact that we've had a 66 00:03:56,960 --> 00:03:58,960 Speaker 1: lot of preparations in place before we even had our 67 00:03:59,000 --> 00:04:02,720 Speaker 1: first diagnosed PA, what were your primary sources of information 68 00:04:03,400 --> 00:04:07,600 Speaker 1: in order to get ready since you did have about 69 00:04:07,680 --> 00:04:11,560 Speaker 1: six weeks of advanced warner. I think following the CDC 70 00:04:11,720 --> 00:04:16,400 Speaker 1: guidelines was very important in preparation our physicians and our administration. 71 00:04:16,640 --> 00:04:20,239 Speaker 1: We're communicating with other health systems across the nation, particularly 72 00:04:20,279 --> 00:04:22,840 Speaker 1: when it came to Ppe, we knew exactly what we 73 00:04:22,880 --> 00:04:25,360 Speaker 1: needed to prepare for the types of numbers that we 74 00:04:25,400 --> 00:04:28,480 Speaker 1: were going to have. We started quitting the modeling in place. 75 00:04:28,920 --> 00:04:32,080 Speaker 1: Physicians obviously trained across the nation and have been able 76 00:04:32,120 --> 00:04:35,240 Speaker 1: to communicate with physicians around the nation in terms of 77 00:04:35,360 --> 00:04:38,600 Speaker 1: how the care and the preparedness of patients should be 78 00:04:39,000 --> 00:04:42,400 Speaker 1: readied well. As you began to get patients, and you've 79 00:04:42,400 --> 00:04:48,400 Speaker 1: had one significant industrial outbreak. The meat processing plant in 80 00:04:48,560 --> 00:04:52,600 Speaker 1: Sioux Falls was concentrated in one plant and the families 81 00:04:52,640 --> 00:04:55,599 Speaker 1: associated with that plant. Did you take any lessons out 82 00:04:55,600 --> 00:04:58,640 Speaker 1: of that experience. What we have to remember is COVID 83 00:04:58,760 --> 00:05:01,960 Speaker 1: nineteen is a disease, and despite the fact that we 84 00:05:01,960 --> 00:05:05,640 Speaker 1: were prepared, so little is known about the natural history 85 00:05:05,640 --> 00:05:09,840 Speaker 1: of the disease. And we are knowing that some individuals 86 00:05:10,080 --> 00:05:12,440 Speaker 1: who are COVID nineteen positive take a couple of tail 87 00:05:12,480 --> 00:05:14,120 Speaker 1: and all and they maybe sleep for a couple of 88 00:05:14,200 --> 00:05:16,760 Speaker 1: days and with a fever and they would cover very 89 00:05:16,839 --> 00:05:20,160 Speaker 1: quickly all the way through to some individuals, whether they 90 00:05:20,200 --> 00:05:23,280 Speaker 1: have other co morbidities or not, end up on a ventilator. 91 00:05:23,360 --> 00:05:26,479 Speaker 1: And obviously many people are dying from this. So what 92 00:05:26,640 --> 00:05:29,560 Speaker 1: we did is we basically put together a registry so 93 00:05:29,600 --> 00:05:32,560 Speaker 1: we were ready. So every patient that touches Sandford now 94 00:05:32,680 --> 00:05:34,640 Speaker 1: is the option to be in a research registry, so 95 00:05:34,640 --> 00:05:38,000 Speaker 1: we can track the disease across the plathora of all 96 00:05:38,040 --> 00:05:41,000 Speaker 1: of the different individuals and how it's actually affecting them. 97 00:05:41,360 --> 00:05:43,520 Speaker 1: And that's really going to help us with the natural history, 98 00:05:43,560 --> 00:05:45,520 Speaker 1: so we can have a greater understanding and a lot 99 00:05:45,560 --> 00:05:48,720 Speaker 1: of this, of course, comes from learning from what's happening 100 00:05:48,720 --> 00:05:52,360 Speaker 1: in other systems. For example, at some point someone said, well, 101 00:05:52,400 --> 00:05:54,680 Speaker 1: let's just flip the patients onto their stomach, and that 102 00:05:54,960 --> 00:05:57,919 Speaker 1: was having a much better outcome with respect to the 103 00:05:58,600 --> 00:06:02,599 Speaker 1: cub respiratory distress syndrome. And we stadly home by following 104 00:06:02,600 --> 00:06:04,920 Speaker 1: all of our patients through this registry that that can 105 00:06:04,960 --> 00:06:07,960 Speaker 1: make a greater contribution to understanding not just the basis 106 00:06:07,960 --> 00:06:10,280 Speaker 1: of the disease, for the treatment of the disease, and 107 00:06:10,279 --> 00:06:13,360 Speaker 1: then hopefully make a bigger impact on our patients. So 108 00:06:13,640 --> 00:06:16,640 Speaker 1: in that sense, I mean you've gradually build up a 109 00:06:16,760 --> 00:06:20,320 Speaker 1: unique set of knowledge because as I understand that, you 110 00:06:20,400 --> 00:06:23,560 Speaker 1: also have the advantage that your patients tend to be 111 00:06:23,640 --> 00:06:29,000 Speaker 1: geographically stable as compared to a big city where they 112 00:06:29,080 --> 00:06:32,440 Speaker 1: might be moving constantly. As I understand it, you are 113 00:06:32,560 --> 00:06:36,680 Speaker 1: launching a pretty large study. You're doing it within the 114 00:06:36,800 --> 00:06:41,280 Speaker 1: right scientific model with a randomized placebo control group, so 115 00:06:41,320 --> 00:06:43,600 Speaker 1: you'll be able to tell whether there's a significant difference 116 00:06:44,120 --> 00:06:46,839 Speaker 1: in the outcomes for the two population. What led you 117 00:06:46,880 --> 00:06:49,680 Speaker 1: decide to undertake a trial on the scale that's a 118 00:06:49,760 --> 00:06:52,360 Speaker 1: great question. To the first part that registry that I've 119 00:06:52,400 --> 00:06:55,520 Speaker 1: talked about is that we intend to follow the patients 120 00:06:55,640 --> 00:06:59,320 Speaker 1: who basically been diagnosed in whatever treatment regimen they've had 121 00:07:00,040 --> 00:07:02,120 Speaker 1: respect to COVID nineteen, We're going to follow them for 122 00:07:02,160 --> 00:07:04,840 Speaker 1: five years. This virus is clearly going to have an 123 00:07:04,880 --> 00:07:08,560 Speaker 1: impact on people's health, posts treatment and recovery, and we 124 00:07:08,600 --> 00:07:10,680 Speaker 1: need to understand that and then of course with the 125 00:07:10,720 --> 00:07:14,280 Speaker 1: different treatments, obviously following the health of those individuals is 126 00:07:14,360 --> 00:07:17,520 Speaker 1: very important. Switching to the second part of hydroxy chloroquine, 127 00:07:17,720 --> 00:07:20,600 Speaker 1: very early on in this pandemic was really thrown out 128 00:07:20,640 --> 00:07:24,120 Speaker 1: there as a potential treatment for COVID nineteen because it 129 00:07:24,160 --> 00:07:27,160 Speaker 1: was already known. What it does is it actually elevates 130 00:07:27,160 --> 00:07:31,560 Speaker 1: the pH al canalizes certain compartments in our cells, and 131 00:07:31,640 --> 00:07:35,560 Speaker 1: that actually prevents viruses from actually entering the cells. So 132 00:07:35,600 --> 00:07:38,720 Speaker 1: that was already known potentially as a mechanism. We don't 133 00:07:38,760 --> 00:07:41,360 Speaker 1: know the natural history of this disease. The science has 134 00:07:41,400 --> 00:07:43,800 Speaker 1: really been rushed right now. I don't believe in the 135 00:07:43,880 --> 00:07:46,080 Speaker 1: history of mankind, in the space of four to six 136 00:07:46,120 --> 00:07:48,680 Speaker 1: months we've ever figured out the whole basis and natural 137 00:07:48,760 --> 00:07:51,800 Speaker 1: history of a disease. Then that's important because when there's 138 00:07:51,840 --> 00:07:55,320 Speaker 1: the right time to use hydroxy choroquine as a potential treatment. 139 00:07:55,800 --> 00:07:58,320 Speaker 1: If we believed potentially could be blocked from entering the 140 00:07:58,320 --> 00:08:01,120 Speaker 1: cells of this drug, then it has the potential to 141 00:08:01,200 --> 00:08:03,520 Speaker 1: stop the spread of the virus if you are infected. 142 00:08:03,560 --> 00:08:05,920 Speaker 1: But I think the study that we felt that was 143 00:08:05,960 --> 00:08:08,680 Speaker 1: important based on what we were hearing, was is could 144 00:08:08,680 --> 00:08:12,800 Speaker 1: you be prophylactic with this particular drug. Christi Nomar government 145 00:08:12,880 --> 00:08:15,640 Speaker 1: helped procure us a supply of the hydroxy chloroquine, and 146 00:08:15,760 --> 00:08:18,880 Speaker 1: what we're doing is enrolling two thousand individuals across the 147 00:08:18,920 --> 00:08:21,720 Speaker 1: state of South Dakota, working with not just our own 148 00:08:21,760 --> 00:08:25,480 Speaker 1: health system, but other health systems and individuals that at 149 00:08:25,520 --> 00:08:28,440 Speaker 1: a high risk. So people are high risk with respect 150 00:08:28,440 --> 00:08:31,120 Speaker 1: to the more severe form of the disease in terms 151 00:08:31,160 --> 00:08:34,880 Speaker 1: of their health and their age, but also healthcare workers. 152 00:08:35,160 --> 00:08:38,200 Speaker 1: So if there is a potential exposure to COVID nineteen, 153 00:08:38,280 --> 00:08:42,480 Speaker 1: we are then consenting individuals and explaining exactly what this 154 00:08:42,640 --> 00:08:46,640 Speaker 1: research study is and making sure that they're totally appropriate 155 00:08:46,720 --> 00:08:50,079 Speaker 1: to receive hydroxy chloroquin They're going to be randomized and 156 00:08:50,200 --> 00:08:55,840 Speaker 1: taking hydroxychloroquine for the five days period after that exposure, 157 00:08:56,120 --> 00:08:59,000 Speaker 1: and then we will see whether that helps prevent the 158 00:08:59,160 --> 00:09:03,680 Speaker 1: disease develop on the basis that COVID nineteen virus, if 159 00:09:03,720 --> 00:09:06,600 Speaker 1: you've been taking this drug, has a decreased ability to 160 00:09:06,760 --> 00:09:09,520 Speaker 1: enter the cells and then crouls the infection and then 161 00:09:09,559 --> 00:09:12,320 Speaker 1: the rest of the disease. Let me make sure I 162 00:09:12,400 --> 00:09:17,839 Speaker 1: understand you are actually testing out the theory that once 163 00:09:17,880 --> 00:09:21,440 Speaker 1: we know that you have been infected, but before you 164 00:09:21,559 --> 00:09:26,480 Speaker 1: have any particular symptoms, if we could intervene with this drug, 165 00:09:27,000 --> 00:09:31,760 Speaker 1: it might actually block the rise of the symptoms. And 166 00:09:31,800 --> 00:09:34,680 Speaker 1: so that's why it's a prophylactic. So it's not a 167 00:09:34,800 --> 00:09:38,439 Speaker 1: therapy once you're sick, but it's actually a therapy to 168 00:09:38,559 --> 00:09:43,640 Speaker 1: block the sickness in advance by blocking the ability of 169 00:09:43,720 --> 00:09:47,160 Speaker 1: the virus to penetrate into your cell system by the 170 00:09:47,480 --> 00:09:51,920 Speaker 1: piping level of acidity. Is that close. That's absolutely right, 171 00:09:51,960 --> 00:09:54,400 Speaker 1: And if you think about it, that's exactly why if 172 00:09:54,400 --> 00:09:57,640 Speaker 1: you take hydroxy chloroquin as a prophylactic if you're going 173 00:09:57,640 --> 00:10:00,800 Speaker 1: into countries where malaria is prevalent, So if you know 174 00:10:00,840 --> 00:10:03,280 Speaker 1: you're going to be exposed to malaria, then you take 175 00:10:03,280 --> 00:10:06,439 Speaker 1: a course of this drug and it prevents the parasite 176 00:10:06,440 --> 00:10:09,160 Speaker 1: plasmodium in that particular case to being able to give 177 00:10:09,200 --> 00:10:12,400 Speaker 1: you that disease. So you're absolutely right if you're exposed 178 00:10:12,400 --> 00:10:15,679 Speaker 1: to COVID nineteen. This trial will randomize you, so some 179 00:10:15,720 --> 00:10:18,360 Speaker 1: people will be getting hydroxy chloroquine and some people will 180 00:10:18,360 --> 00:10:21,439 Speaker 1: not be getting hydroxy chloroquin so we can compare if 181 00:10:21,480 --> 00:10:23,880 Speaker 1: you were taking it and we're exposed, whether you're less 182 00:10:23,920 --> 00:10:42,839 Speaker 1: likely to develop the disease. How soon do you hope 183 00:10:42,880 --> 00:10:46,520 Speaker 1: to have the two thousand people lined up? When it 184 00:10:46,520 --> 00:10:50,320 Speaker 1: comes to clinical research, you're obviously recruiting individuals. We will 185 00:10:50,360 --> 00:10:53,400 Speaker 1: be launching this trial. What's taken a little bit of time, 186 00:10:53,440 --> 00:10:56,240 Speaker 1: it's just lining up the recruitment strategy, and that's in 187 00:10:56,360 --> 00:10:59,000 Speaker 1: terms of getting the information to the right people, and 188 00:10:59,040 --> 00:11:01,959 Speaker 1: then really you're getting the faques out there because obviously 189 00:11:01,960 --> 00:11:04,840 Speaker 1: there's been a lot of press about hydroxy chloroquine in 190 00:11:04,960 --> 00:11:06,960 Speaker 1: terms of what it can and can't do, so we've 191 00:11:07,000 --> 00:11:09,959 Speaker 1: made sure we wanted to get our educational items together. 192 00:11:10,040 --> 00:11:12,640 Speaker 1: They're working with the fact that there's the three largest 193 00:11:12,640 --> 00:11:15,080 Speaker 1: health systems in South Dakota doing this. I would hope 194 00:11:15,120 --> 00:11:17,839 Speaker 1: we would recruit those two thousand people in the month 195 00:11:17,920 --> 00:11:21,959 Speaker 1: of May. Partly, I think because the President mentioned it 196 00:11:22,520 --> 00:11:27,440 Speaker 1: hydroxychloroquin you have to be pretty controversial all the way 197 00:11:27,480 --> 00:11:29,360 Speaker 1: from yes, you should use it to know you should 198 00:11:29,360 --> 00:11:33,360 Speaker 1: never use it. I gather that there's a general agreement 199 00:11:33,800 --> 00:11:38,600 Speaker 1: that we need some kind of large scale study to 200 00:11:38,720 --> 00:11:41,320 Speaker 1: begin to get a sense of accurately what its effect is. 201 00:11:41,840 --> 00:11:44,680 Speaker 1: And some people are confused and think that the FDA 202 00:11:44,760 --> 00:11:48,000 Speaker 1: has said you shouldn't use it without a doctoral So 203 00:11:48,320 --> 00:11:51,160 Speaker 1: the FDA and as you also the National Institute of 204 00:11:51,200 --> 00:11:53,920 Speaker 1: Health and put out guidelines which is basically, don't take 205 00:11:54,000 --> 00:11:57,240 Speaker 1: hydroxy chloroquine unless you really are under a clinical trial 206 00:11:57,320 --> 00:12:00,720 Speaker 1: setting or whether a physician is right commending that you 207 00:12:00,800 --> 00:12:03,960 Speaker 1: take this. So in terms of prophial access, obviously that 208 00:12:04,000 --> 00:12:06,360 Speaker 1: would be a clinical trial, and then obviously if the 209 00:12:06,520 --> 00:12:09,600 Speaker 1: subscribing physician will be able to speak to the individuals 210 00:12:09,600 --> 00:12:12,280 Speaker 1: about what are the effects that the drug could have. 211 00:12:12,600 --> 00:12:14,839 Speaker 1: But I think that guests at the larger point in 212 00:12:14,960 --> 00:12:17,320 Speaker 1: terms of the information out there, some people are saying, 213 00:12:17,360 --> 00:12:19,319 Speaker 1: why are we doing this trial. Obviously it's the right 214 00:12:19,320 --> 00:12:21,960 Speaker 1: thing to do for our patients. That's what we do 215 00:12:22,320 --> 00:12:25,280 Speaker 1: here at Sandford. The larger question is that I think 216 00:12:26,080 --> 00:12:28,200 Speaker 1: a lot of people want an answer to this question, 217 00:12:28,240 --> 00:12:30,760 Speaker 1: and I think we can answer this question very rapidly 218 00:12:30,800 --> 00:12:33,240 Speaker 1: with the design of what we've put together. I think 219 00:12:33,280 --> 00:12:37,000 Speaker 1: America deserves an answer on this drug. Our physicians require 220 00:12:37,040 --> 00:12:40,199 Speaker 1: an answer on this drug. They are the frontline right now, 221 00:12:40,200 --> 00:12:43,160 Speaker 1: our physicians, and obviously that we're providing this information for 222 00:12:43,240 --> 00:12:45,559 Speaker 1: them so they truly know what to do for that patients, 223 00:12:46,440 --> 00:12:49,320 Speaker 1: Would that be overly optimistic? When do you think you'll 224 00:12:49,360 --> 00:12:54,040 Speaker 1: probably have your first substantial insights and to the applica 225 00:12:54,120 --> 00:12:56,600 Speaker 1: CEO of the drug. One of the things that we're 226 00:12:56,640 --> 00:12:59,360 Speaker 1: tunting about this study is is the scientific rigor that 227 00:12:59,400 --> 00:13:02,560 Speaker 1: we're bringing this It is a controlled clinical trial, and 228 00:13:02,720 --> 00:13:06,840 Speaker 1: like any clinical trial, when you meet certain milestones in recruitment, 229 00:13:06,880 --> 00:13:09,880 Speaker 1: you can start doing an interim analysis. For example, patients 230 00:13:09,920 --> 00:13:12,559 Speaker 1: will be getting a prescription a five day course of 231 00:13:12,640 --> 00:13:15,920 Speaker 1: hydroxy chloroquin and we will be following them through that 232 00:13:16,000 --> 00:13:19,080 Speaker 1: period of time. After two to four weeks, we will 233 00:13:19,080 --> 00:13:22,000 Speaker 1: start getting an indication, but the investigators will have to 234 00:13:22,040 --> 00:13:24,280 Speaker 1: be blinded, as it were, to who has drug and 235 00:13:24,400 --> 00:13:27,200 Speaker 1: who does not have drug, because otherwise you create that 236 00:13:27,280 --> 00:13:31,280 Speaker 1: analytical bias with respect to that. So whilst I would 237 00:13:31,320 --> 00:13:34,320 Speaker 1: say optimistically if we have the two thousand recruited by 238 00:13:34,360 --> 00:13:36,880 Speaker 1: the end of May. If you think through the timeline, 239 00:13:36,920 --> 00:13:39,480 Speaker 1: there is how many people by the end of May 240 00:13:39,520 --> 00:13:42,760 Speaker 1: would have actually been through that course of drugs. When 241 00:13:42,800 --> 00:13:45,280 Speaker 1: you've had fifty percent recruitment, you can do what's called 242 00:13:45,280 --> 00:13:48,400 Speaker 1: an interim analysis and start taking a look at the 243 00:13:48,480 --> 00:13:50,600 Speaker 1: data with respect to that. So I hope that the 244 00:13:50,679 --> 00:13:53,880 Speaker 1: results from our internoonal analysis would be something we could 245 00:13:53,920 --> 00:13:56,160 Speaker 1: look at probably by the end of May if all 246 00:13:56,200 --> 00:13:59,560 Speaker 1: go as well. What are the ethical rules? So I'm 247 00:13:59,600 --> 00:14:02,079 Speaker 1: out here and I don't know whether I'm getting the 248 00:14:02,120 --> 00:14:05,280 Speaker 1: placebo or I'm getting the drug to what extent is 249 00:14:05,280 --> 00:14:08,560 Speaker 1: at a challenge because if it does work, I'm in 250 00:14:08,559 --> 00:14:10,760 Speaker 1: a group that didn't get the thing that worked. A 251 00:14:10,840 --> 00:14:13,480 Speaker 1: clinical trial is an increased treatment option. So this is 252 00:14:13,600 --> 00:14:16,440 Speaker 1: the opportunity if you've been exposed to COVID nineteen to 253 00:14:16,559 --> 00:14:20,240 Speaker 1: receive a treatment. If you receive placebo, and if you 254 00:14:20,320 --> 00:14:24,920 Speaker 1: develop the disease, obviously you will seek treatment from your position, 255 00:14:25,320 --> 00:14:28,160 Speaker 1: and then you will be given typical standard of care 256 00:14:28,480 --> 00:14:30,600 Speaker 1: and treated for the disease. It does not mean that 257 00:14:30,640 --> 00:14:33,080 Speaker 1: you're not going to be treated like any other individual 258 00:14:33,160 --> 00:14:36,480 Speaker 1: or any other patient that has COVID nineteen. What you're 259 00:14:36,480 --> 00:14:39,880 Speaker 1: doing is potentially helping the pass When everybody answer the question, 260 00:14:40,160 --> 00:14:43,680 Speaker 1: is the prophylactic use of hydroxy chloroquin a benefit with 261 00:14:43,800 --> 00:14:48,680 Speaker 1: respect to this disease? People talk now about the potential 262 00:14:48,800 --> 00:14:53,280 Speaker 1: second wave coming in the fall, which I guess often 263 00:14:53,320 --> 00:14:56,800 Speaker 1: happens with viruses. From your perspective, looking at all the 264 00:14:56,840 --> 00:14:59,360 Speaker 1: researchers being done, do you have a sense we're going 265 00:14:59,400 --> 00:15:02,160 Speaker 1: to be a lot bet are prepared by September than 266 00:15:02,200 --> 00:15:05,520 Speaker 1: we are now? Absolutely. I think the other part of 267 00:15:05,520 --> 00:15:08,880 Speaker 1: what we've been actively participating in is in this gets 268 00:15:08,880 --> 00:15:11,560 Speaker 1: to how I was describing this is a disease in 269 00:15:11,680 --> 00:15:15,480 Speaker 1: terms of some people end up with acute respiratory to 270 00:15:15,520 --> 00:15:19,520 Speaker 1: stress syndrome. We've been exploring a number of trials that 271 00:15:19,600 --> 00:15:22,800 Speaker 1: can actually treat that if you are connected to a ventilator. 272 00:15:22,920 --> 00:15:26,200 Speaker 1: Right now, the potential treatment options are better than they 273 00:15:26,240 --> 00:15:28,960 Speaker 1: were a few months ago, so we will certainly be 274 00:15:28,960 --> 00:15:32,320 Speaker 1: better prepared for that. And then if hydroxy chloroquin does 275 00:15:32,400 --> 00:15:35,520 Speaker 1: turn out to have some sort of profile axis, then 276 00:15:35,600 --> 00:15:37,880 Speaker 1: obviously if a second wave is coming and we know 277 00:15:37,960 --> 00:15:41,640 Speaker 1: that there's a large population that are being exposed, then 278 00:15:41,760 --> 00:15:44,840 Speaker 1: they could be prescribed. This as a way of avoiding 279 00:15:44,880 --> 00:15:48,640 Speaker 1: developing the full blown disease. Of course, obviously testing is 280 00:15:48,720 --> 00:15:51,200 Speaker 1: ramping up, but the most important testing for that will 281 00:15:51,240 --> 00:15:54,600 Speaker 1: be the antibody tested to individuals that have actually been 282 00:15:54,640 --> 00:15:57,560 Speaker 1: infected and may not have known that they've had the disease. 283 00:15:57,600 --> 00:16:00,520 Speaker 1: We're hearing more and more about not just individuels who 284 00:16:00,720 --> 00:16:03,720 Speaker 1: have mild disease but are asymptomatic, and that's really led 285 00:16:03,760 --> 00:16:06,600 Speaker 1: to the spread of this. So obviously if we can 286 00:16:06,600 --> 00:16:10,000 Speaker 1: track individuals that are positive and have been positive, that 287 00:16:10,080 --> 00:16:12,440 Speaker 1: will just help us in terms of really making sure 288 00:16:12,480 --> 00:16:31,320 Speaker 1: the right people get some sort of prophylactic treatment. Isn't 289 00:16:31,320 --> 00:16:36,360 Speaker 1: there also some concern that in fact, getting the disease 290 00:16:36,400 --> 00:16:39,600 Speaker 1: and surviving it may not mean that you're immune for 291 00:16:39,640 --> 00:16:42,200 Speaker 1: the future, that you may be able to reacquire it. 292 00:16:42,800 --> 00:16:46,480 Speaker 1: That's literally just coming out right now. This is all 293 00:16:46,480 --> 00:16:49,640 Speaker 1: part of that natural history. I think it's typically unusual 294 00:16:49,760 --> 00:16:52,960 Speaker 1: for a virus, if you've been infected, for you to 295 00:16:53,120 --> 00:16:56,560 Speaker 1: have a secondary infection of that same virus. That said, 296 00:16:56,560 --> 00:16:59,760 Speaker 1: we're still learning about COVID nineteen in terms of how 297 00:16:59,760 --> 00:17:03,120 Speaker 1: it may be adapting. It doesn't have a huge mutation rate, 298 00:17:03,560 --> 00:17:05,560 Speaker 1: but it does have some novel ways of how it 299 00:17:05,600 --> 00:17:09,560 Speaker 1: behaves in the cells. We're still learning with respect to that. 300 00:17:09,600 --> 00:17:11,960 Speaker 1: I think the other part is the testing. It's still 301 00:17:12,080 --> 00:17:16,359 Speaker 1: very important because individuals that are still positive who recovered 302 00:17:16,800 --> 00:17:21,479 Speaker 1: maybe developing other symptomology through a secondary viral infection. It's 303 00:17:21,520 --> 00:17:23,440 Speaker 1: not unusual for us to get more than one cold, 304 00:17:23,480 --> 00:17:26,080 Speaker 1: for example, during the cold season, and when they have 305 00:17:26,160 --> 00:17:28,960 Speaker 1: the symptoms again a month later after recovering, it's quite 306 00:17:29,000 --> 00:17:32,600 Speaker 1: possible the COVID nineteen is still there in a latent 307 00:17:32,680 --> 00:17:36,440 Speaker 1: way of not actually causing the underlying new symptoms. When 308 00:17:36,440 --> 00:17:41,240 Speaker 1: you're putting together two thousand person study given this particular drug, 309 00:17:41,640 --> 00:17:46,359 Speaker 1: are there parts of the population that you're deliberately excluding? 310 00:17:46,520 --> 00:17:49,240 Speaker 1: I know, for example, a lot of talk about cardiac 311 00:17:49,359 --> 00:17:53,480 Speaker 1: risk when using this particular drug. Yeah, so our physicians 312 00:17:53,480 --> 00:17:56,399 Speaker 1: have put together a score which is basically in terms 313 00:17:56,400 --> 00:17:59,240 Speaker 1: of the susceptibilities that you may have. We know from 314 00:17:59,240 --> 00:18:04,280 Speaker 1: what we're hearing is more with obesity, hyperlipidemia, hypotension, type 315 00:18:04,280 --> 00:18:07,480 Speaker 1: two diabetes, and cardiac issues are definitely going to be 316 00:18:07,520 --> 00:18:10,879 Speaker 1: at risks that the cardiac issue, particularly with hydroxy chloroquine. 317 00:18:11,040 --> 00:18:14,439 Speaker 1: So any individual that is consented into this study sits 318 00:18:14,480 --> 00:18:17,640 Speaker 1: with a physician that is consented into the study, so 319 00:18:17,680 --> 00:18:19,680 Speaker 1: we can make sure that we're not going to put 320 00:18:19,680 --> 00:18:23,679 Speaker 1: a patient at risk. So there are some reasons to 321 00:18:23,680 --> 00:18:27,320 Speaker 1: be certain that you go see your doctor before you 322 00:18:27,400 --> 00:18:30,840 Speaker 1: randomly try to use this because it does have potential 323 00:18:30,920 --> 00:18:35,000 Speaker 1: dangerous side effects for people who have certain medical conditions. 324 00:18:35,000 --> 00:18:37,600 Speaker 1: Would there be a fair way to put it that's 325 00:18:37,640 --> 00:18:40,760 Speaker 1: really per the FDA guidelines And why we've built this 326 00:18:40,800 --> 00:18:44,359 Speaker 1: into the clinical trial is that screening individuals that potentially 327 00:18:44,680 --> 00:18:47,760 Speaker 1: could have side effects it is what we want to avoid. 328 00:18:47,760 --> 00:18:50,240 Speaker 1: So we're only going to recruit individuals that we're confident 329 00:18:50,320 --> 00:18:53,160 Speaker 1: that will not have a side effect from the hydroxy chloroquine. 330 00:18:53,560 --> 00:18:56,320 Speaker 1: One other topics I'm picking up from a lot of 331 00:18:56,440 --> 00:19:01,200 Speaker 1: hospital administrators that since we are not in fair faced 332 00:19:01,200 --> 00:19:05,200 Speaker 1: with a crisis of available ICU units intensive care units, 333 00:19:05,200 --> 00:19:08,680 Speaker 1: so we're not faced with a crisis of available beds, 334 00:19:08,720 --> 00:19:12,520 Speaker 1: that for the economic health of the hospitals and the 335 00:19:12,640 --> 00:19:17,359 Speaker 1: return to normal medical treatments around the country, that most 336 00:19:17,359 --> 00:19:21,000 Speaker 1: of the states should in fact pull back from the 337 00:19:21,200 --> 00:19:25,520 Speaker 1: various executive orders that told hospitals to basically keep all 338 00:19:25,560 --> 00:19:28,560 Speaker 1: their rooms clear in case there was a gigantic surge, 339 00:19:29,000 --> 00:19:30,880 Speaker 1: which even in New York, because we built so many 340 00:19:30,920 --> 00:19:34,000 Speaker 1: extra hospital beds, that turns out we never came close 341 00:19:34,040 --> 00:19:37,760 Speaker 1: to the number of beds that were available. From your perspective, 342 00:19:38,160 --> 00:19:41,040 Speaker 1: do you think it's important that we find a way 343 00:19:41,080 --> 00:19:44,399 Speaker 1: to go back to normal business in that sense and 344 00:19:44,440 --> 00:19:48,440 Speaker 1: allow people in most states, unless there's a huge surge, 345 00:19:48,760 --> 00:19:50,600 Speaker 1: to allow people in most states to go back to 346 00:19:51,080 --> 00:19:57,199 Speaker 1: regular medical procedures and normal relationships in the hospitals. I 347 00:19:57,240 --> 00:19:59,840 Speaker 1: think that's a great question. I think now we've gotten 348 00:19:59,840 --> 00:20:01,639 Speaker 1: to that point, and I think we had to be 349 00:20:01,720 --> 00:20:04,879 Speaker 1: measured with that consideration early on because we just weren't 350 00:20:04,960 --> 00:20:07,919 Speaker 1: sure at what level an impact in terms of the 351 00:20:08,000 --> 00:20:11,000 Speaker 1: needs that the hospitals were going to be required for this. 352 00:20:11,480 --> 00:20:14,760 Speaker 1: I think that COVID nineteen hasn't affected the fact that 353 00:20:14,800 --> 00:20:19,680 Speaker 1: people still need healthcare, People still need medical procedures right now. 354 00:20:20,080 --> 00:20:22,480 Speaker 1: I think a health system like us, we have a 355 00:20:22,520 --> 00:20:26,680 Speaker 1: tremendous organization here, is to be prepared for that. So 356 00:20:27,119 --> 00:20:29,960 Speaker 1: we know there's still going to be COVID nineteen patients there. 357 00:20:30,280 --> 00:20:32,720 Speaker 1: So let's make sure we can do both. Let's make 358 00:20:32,760 --> 00:20:35,280 Speaker 1: sure we can treat the COVID nineteen patients as and 359 00:20:35,359 --> 00:20:38,679 Speaker 1: when they come into our system, but also provide regular 360 00:20:38,760 --> 00:20:41,720 Speaker 1: day to day healthcare and procedures, and as long as 361 00:20:41,720 --> 00:20:44,520 Speaker 1: we manage that effectively, and let's assume that the health 362 00:20:44,520 --> 00:20:47,800 Speaker 1: system is the best individuals to manage that in terms 363 00:20:47,800 --> 00:20:51,200 Speaker 1: of what's required. If we have enough ppe to take 364 00:20:51,240 --> 00:20:54,240 Speaker 1: care of our COVID patients and any potential spikes or 365 00:20:54,280 --> 00:20:58,200 Speaker 1: surges that are anticipated, as well as we still can 366 00:20:58,240 --> 00:21:01,679 Speaker 1: have the ability to do procedures, then we should go 367 00:21:01,760 --> 00:21:06,080 Speaker 1: forward and do both of those. From your perspective, do 368 00:21:06,119 --> 00:21:10,679 Speaker 1: you know of anywhere that Sanford came anywhere close to 369 00:21:10,800 --> 00:21:14,359 Speaker 1: running out of intensity care units, are running out of 370 00:21:14,359 --> 00:21:17,200 Speaker 1: bed space because of the virus, or was there always 371 00:21:17,200 --> 00:21:21,199 Speaker 1: in effect a surplus available if needed. There was always 372 00:21:21,200 --> 00:21:25,479 Speaker 1: a surplus of needed Because that's what strikes me as 373 00:21:25,560 --> 00:21:31,879 Speaker 1: I understand in retrospect when they had those very early projections, 374 00:21:32,760 --> 00:21:34,760 Speaker 1: why they would have been worried. But with the exception 375 00:21:34,840 --> 00:21:38,560 Speaker 1: maybe of New Orleans and Detroit and New York, I'm 376 00:21:38,600 --> 00:21:43,200 Speaker 1: not sure anywhere ever came close to capacity. We were 377 00:21:43,280 --> 00:21:46,840 Speaker 1: very fortunate because we had time to prepare the models. Obviously, 378 00:21:46,880 --> 00:21:49,480 Speaker 1: had it that we were going to have significantly more 379 00:21:49,520 --> 00:21:52,440 Speaker 1: patients than we've had, but we were able to prepare 380 00:21:52,560 --> 00:21:55,720 Speaker 1: and organize ourselves, and also I think we've learned from 381 00:21:55,760 --> 00:21:58,880 Speaker 1: others as well. And also clearly the social distancing has 382 00:21:58,880 --> 00:22:02,680 Speaker 1: had a huge impact decreasing the number of patients. Given 383 00:22:02,720 --> 00:22:06,080 Speaker 1: the many years you've been studying these things, in what 384 00:22:06,240 --> 00:22:09,119 Speaker 1: ways is this snow virus really different and always is 385 00:22:09,160 --> 00:22:13,000 Speaker 1: it just another variation on the flu. The difference for 386 00:22:13,080 --> 00:22:16,880 Speaker 1: this virus was this extremely infective. I mean, it's very 387 00:22:16,920 --> 00:22:20,320 Speaker 1: contagious and it is very stable as well. So the 388 00:22:20,440 --> 00:22:23,600 Speaker 1: fact that it has the ability to really run rampant 389 00:22:23,640 --> 00:22:27,159 Speaker 1: through what we call communities, spread undetected so quickly, I 390 00:22:27,200 --> 00:22:30,040 Speaker 1: think is the first novelty. And part of it is 391 00:22:30,080 --> 00:22:34,240 Speaker 1: because often viruses are very unstable on the surfaces. For example, 392 00:22:34,280 --> 00:22:36,480 Speaker 1: there was a lot of concern about a Bola a 393 00:22:36,560 --> 00:22:39,119 Speaker 1: number of years ago, but a Bola is very unstable, 394 00:22:39,440 --> 00:22:44,040 Speaker 1: doesn't really survive outside of human tissues, whereas this coronavirus 395 00:22:44,080 --> 00:22:46,840 Speaker 1: clearly can and it can actually stay stable on surfaces, 396 00:22:47,040 --> 00:22:49,440 Speaker 1: whether it's just like the tabletop or a door hand 397 00:22:49,520 --> 00:22:53,000 Speaker 1: or for several hours. So that's what's really made this 398 00:22:53,040 --> 00:22:56,120 Speaker 1: one particularly unique, and that's just added to its ability 399 00:22:56,160 --> 00:22:59,680 Speaker 1: to infect people. When you look at the patient experience, 400 00:22:59,720 --> 00:23:03,320 Speaker 1: all of it are centered. Are there any particular side 401 00:23:03,400 --> 00:23:06,680 Speaker 1: effects of this virus that make it different than other 402 00:23:06,840 --> 00:23:09,760 Speaker 1: viruses rather than just more intensive. I think there's a 403 00:23:09,800 --> 00:23:12,119 Speaker 1: little bit early to say with respect to that, and 404 00:23:12,160 --> 00:23:15,120 Speaker 1: that takes us back to the registry that where we 405 00:23:15,240 --> 00:23:17,280 Speaker 1: feel the right thing for us to do is not 406 00:23:17,359 --> 00:23:20,040 Speaker 1: just monitor our patients in the real time and treat 407 00:23:20,080 --> 00:23:22,359 Speaker 1: them in the real time for this particular infection and 408 00:23:22,400 --> 00:23:25,239 Speaker 1: the symptoms of the disease, but also to follow them 409 00:23:25,280 --> 00:23:27,840 Speaker 1: over a period of time. It's quite obvious. I mean, 410 00:23:28,520 --> 00:23:31,159 Speaker 1: looking at the mortality rates that we're seeing across the 411 00:23:31,160 --> 00:23:34,000 Speaker 1: world right now, I think it's clear that this will 412 00:23:34,080 --> 00:23:37,000 Speaker 1: have a long term effect on potentially the health of 413 00:23:37,080 --> 00:23:40,040 Speaker 1: individuals that have recovered. They may have survived the virus, 414 00:23:40,080 --> 00:23:43,520 Speaker 1: but obviously this virus insults some of the organs of 415 00:23:43,520 --> 00:23:46,080 Speaker 1: our body very severely, and I think it makes sense 416 00:23:46,080 --> 00:23:48,080 Speaker 1: for us to be able to track that and then 417 00:23:48,160 --> 00:23:49,840 Speaker 1: hopefully in time I'll be able to give you a 418 00:23:49,920 --> 00:23:53,560 Speaker 1: much better answer to that question. And do you agree 419 00:23:53,560 --> 00:23:58,359 Speaker 1: that it would be wise to presume that we have 420 00:23:58,560 --> 00:24:03,199 Speaker 1: to care for a possible resurgence in the fall, and 421 00:24:03,280 --> 00:24:07,159 Speaker 1: that we shouldn't make whatever investments we need now in 422 00:24:07,240 --> 00:24:09,760 Speaker 1: order to be as prepared as possible to stop the 423 00:24:09,840 --> 00:24:12,840 Speaker 1: virus and its tracks if it starts to re emerge 424 00:24:12,840 --> 00:24:17,560 Speaker 1: in September, October, November. Every virus, whether it's a cold 425 00:24:17,680 --> 00:24:21,159 Speaker 1: or the flu, cycles through different periods of time, and 426 00:24:21,200 --> 00:24:24,200 Speaker 1: there's no reason to believe that coronavirus is going to 427 00:24:24,280 --> 00:24:28,240 Speaker 1: go away anywhere. We can sort of overanalyze the different 428 00:24:28,240 --> 00:24:30,960 Speaker 1: measures that are happening now in terms of whether it's 429 00:24:31,040 --> 00:24:34,720 Speaker 1: the wather, whether it's social distancing or whatever. There still 430 00:24:34,760 --> 00:24:37,000 Speaker 1: will be a retention of this virus even if it 431 00:24:37,040 --> 00:24:39,359 Speaker 1: goes down, and there will be the potential for it 432 00:24:39,400 --> 00:24:41,720 Speaker 1: to come back. But I do think we've learned a 433 00:24:41,720 --> 00:24:45,720 Speaker 1: lot about how maybe there could be some prophylactic treatment 434 00:24:46,160 --> 00:24:50,680 Speaker 1: rapidly returning to social distancing, the antibody testing will help 435 00:24:50,720 --> 00:24:54,120 Speaker 1: us track the virus and those who are infected. The 436 00:24:54,200 --> 00:24:56,520 Speaker 1: utopian name, of course, is that we're hoping there will 437 00:24:56,560 --> 00:24:59,320 Speaker 1: be a vaccine, hopefully as early as the beginning of 438 00:24:59,440 --> 00:25:02,040 Speaker 1: next year. Whether it will be a search like we've 439 00:25:02,080 --> 00:25:04,560 Speaker 1: seen this first time around, I think we've learned too 440 00:25:04,680 --> 00:25:06,879 Speaker 1: much for that to happen, but there probably is a 441 00:25:07,000 --> 00:25:09,080 Speaker 1: risk that this virus will come back to a certain 442 00:25:09,119 --> 00:25:11,679 Speaker 1: degree later this year. I just want to say that 443 00:25:12,119 --> 00:25:14,320 Speaker 1: it's really tremendous that you would take the time to 444 00:25:14,359 --> 00:25:17,359 Speaker 1: help educate people, and that I think that the work 445 00:25:17,400 --> 00:25:20,680 Speaker 1: you're doing at Sanford is going to be both nationally 446 00:25:20,760 --> 00:25:26,000 Speaker 1: and internationally really important, and I appreciate very much that 447 00:25:26,119 --> 00:25:28,359 Speaker 1: you would take some time out of an extraordinarily busy 448 00:25:28,440 --> 00:25:32,000 Speaker 1: day just to share with our audience. Well, thank you. 449 00:25:32,080 --> 00:25:34,480 Speaker 1: It's a privilege to work for an organization that puts 450 00:25:34,480 --> 00:25:37,000 Speaker 1: its patients in front of everything that it really wants 451 00:25:37,000 --> 00:25:43,800 Speaker 1: to do. Thank you to my guest doctor David Pierce. 452 00:25:44,320 --> 00:25:48,200 Speaker 1: You can read more about Sanford House, hydroxytorical and clinical 453 00:25:48,240 --> 00:25:52,720 Speaker 1: trial and healthcare breakthrough it on COVID nineteen on our 454 00:25:52,720 --> 00:25:57,000 Speaker 1: show page newtworld dot com. Neutral is produced by Guinnis 455 00:25:57,000 --> 00:26:02,000 Speaker 1: three sixty and iHeartMedia on Kitty producers DeBie Myers and 456 00:26:02,160 --> 00:26:06,000 Speaker 1: our producers Warn System. The artwork for the show Who's 457 00:26:06,040 --> 00:26:10,840 Speaker 1: created by Steve Enley Special thanks the team at Dingwishta System. 458 00:26:10,960 --> 00:26:15,520 Speaker 1: Please email me with your comments at newsworld dot com. 459 00:26:15,640 --> 00:26:17,879 Speaker 1: If you've been enjoying the tourl I hope you'll go 460 00:26:17,960 --> 00:26:21,120 Speaker 1: to Apple podcast and both rate us with five stars 461 00:26:21,480 --> 00:26:24,240 Speaker 1: and give us a review so others can learn what 462 00:26:24,280 --> 00:26:28,919 Speaker 1: it's all about. On the next episode of News tool Our, China, 463 00:26:28,960 --> 00:26:32,600 Speaker 1: COVID nineteen series continues with Part two, I'll look at 464 00:26:32,640 --> 00:26:35,760 Speaker 1: the role of big data and artificial intelligence from play 465 00:26:35,760 --> 00:26:39,400 Speaker 1: in tracking global pandemics and make the case for why 466 00:26:39,520 --> 00:26:43,359 Speaker 1: United States health authorities should be using this advanced technology 467 00:26:43,520 --> 00:26:46,960 Speaker 1: to create an early warning system to hopefully prevent the 468 00:26:47,000 --> 00:26:51,720 Speaker 1: spread of future pandemics. I'm new Gingwich. This is news World.