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  • >>> Hello, everyone.

  • Welcome to CDC's private partner call.

  • We're so grateful that you've joined us today.

  • With me is Dr. Nancy Messonnier, director for national center for

  • immunization and respiratory diseases as well as the senior official for

  • CDC's COVID-19 response.

  • >> NANCY MESSONNIER: Good afternoon and thank you for joining us today.

  • I'm happy to take a few minutes to go through an update, and then I

  • think we have some time for questions.

  • CDC is responding aggressively to the global outbreak of COVID-19.

  • This is historic, unprecedented outbreak.

  • We really haven't seen anything like this since perhaps the pandemic of

  • influenza in 1918.

  • Globally, there are somewhere up to 80,000 cases across 169 WHO member

  • countries, and unfortunately more than 3,000 deaths.

  • In the United States, there are about 10,000 cases with more cases

  • really every day, 3,000 new cases since yesterday.

  • Every state in the United States has been impacted as well as the

  • District of Columbia, Puerto Rico, Guam and the U.S. Virgin Islands and

  • there have been 150 COVID deaths reported so far.

  • We should expect these numbers to go up over the next few days as we are

  • really in an acceleration phase, says but different parts of the country

  • have been impacted differently. Some states are well into their

  • outbreaks where other states are really just beginning.

  • CDC is adapting some of our existing surveillance systems to better

  • track COVID-19, and you'll be seeing more information on our website.

  • We do know that the virus is capable of spreading easily and sustainably

  • from person to person.

  • And we also know that older people and people with severe chronic

  • conditions are at higher risk for serious COVID-19 illness, and so we're

  • asking them to take special precautions, and we're asking everyone to

  • take special precautions to protect them.

  • I know that everybody wants to know how long this outbreak will last.

  • But the truth is, we don't really know.

  • What we do know is that if we act together and act now, we can bend the

  • curve of the epidemic so that less people are impacted, and so that our

  • health system, health sector has more time to catch up.

  • The duration of the outbreak depends on many factors.

  • It depends on how well we do at social distancing and travel

  • restrictions.

  • It does depend a little bit on what is happening with sustained

  • transmission in other countries. It is a new virus.

  • We know some things about it from research here and some things about it

  • from other countries, and we know about similar viruses, but we have

  • some details that we don't specifically know yet. For example, the

  • duration of immunity after infection and all the details about

  • transmission and clinical severity.

  • There are upwards of 50 modelers across the United States working on

  • these kind of questions, and we have a lot of data that we're looking at

  • to try to make these predictions which I know we all want.

  • The next point is what you can do.

  • And we are at a phase where we really need everyone to come together to

  • respond to this public health threat.

  • On March 16th, the White House Coronavirus Task Force and the President

  • issued new guidelines to help protect Americans.

  • This is called the 15 days to slow the spread.

  • It lays out guidelines for a nationwide effort to slow the spread, and

  • it calls for implementation of measures to increase social distancing

  • between people at all levels of society.

  • This is a massive proactive preventive response to COVID-19 to slow the

  • spread and blunt the impact of the disease on the United States.

  • But in order to do this, we need everyone's help to pitch in, everyone

  • across all of our communities has a role to play.

  • We're asking people all across the country to stay home as much as

  • possible and practice social distancing, which means that we're

  • decreasing the opportunity to transmit between people.

  • This includes canceling of postponing gatherings of more than ten people

  • and closing schools in some areas as determined by local and state

  • governments.

  • We've asked about -- we've been asked about guidelines for working

  • outside, and the guidance remains the same.

  • Stay 6 feet apart.

  • That's about two arms' lengths, and cause and sneeze into your arm

  • because you don't want to expose other people to your coughs and

  • sneezes.

  • You need to know that there is no vaccine currently to protect against

  • COVID-19, and scientists are working as fast as they can.

  • Even with that, it likely will be a year before we have a vaccine that

  • we can give to everyday Americans.

  • And there aren't any approved medications to treat it yet.

  • There are a whole bunch of treatments being investigated, and the

  • President announced earlier today with FDA, the rapid speed-up of all of

  • those treatments, and we hope that we'll have specific treatments soon.

  • But those things are not yet widely available, and so we need to make

  • sure that our clinicians have all the information they need to treat

  • their patients.

  • We do know, though, that right now the best, most effective thing that

  • we can do is social distancing.

  • It actually sounds to some people mundane, that is stay home, but in

  • fact, there's a bunch of scientific research on this with more than 20

  • different published articles that talk about what -- how effective

  • social distancing can be in combination with other measures, and we know

  • that social distancing works better when it's implemented in concert

  • with other measures.

  • We're calling these 15 days a pause, a chance to reset, but it really

  • won't -- will only be effective if every community across the United

  • States takes it seriously.

  • Now, we do have a lot of guidance on our website, and now we're really

  • working on tools to help with implementing and translating that

  • guidance.

  • So we have, for example, guidance for people who have been isolating at

  • home to help determine when they can discontinue isolation.

  • That continues to be updated as more information is available.

  • We're reviewing and updating our travel notices almost daily. There's

  • currently what's called the level 2 --

  • [ No audio ]

  • Sorry, I understand that we lost audio.

  • Had to regroup over here.

  • I hate technical difficulties, says but let's see.

  • I'll start back with we do have travel notices on our website being

  • updated almost daily. There's currently what's called the level 2

  • travel notice for the whole world, which indicates ongoing community

  • transmission.

  • And essentially what it means it that we're recommending that older

  • adults and people of any age with serious chronical medication

  • conditions should consider postponing travel to most global

  • destinations.

  • Domestically, we don't generally issue that kind of guidance, but in

  • general, we're saying that people at high risk should stay home and that

  • everyone should be thinking seriously about their travel, especially

  • globally but even domestically.

  • Expect more information about this every day.

  • We also have guidance documents for caring for someone at home.

  • If you have someone sick in your home with COVID-19, of course, you

  • should be taking care of them.

  • But you need to be doing it safely.

  • We don't want you to get infected, too.

  • How to disinfect your home if someone's sick and keep workplaces, homes

  • or commercial establishments safe. We have guidance for child-care

  • settings, healthcare professional fact sheets, and a new landing page on

  • our website for those at risk specifically older adults, those with

  • underlying conditions.

  • And again, check back every day on our website because you'll see more

  • information and more tools daily.

  • Of particular interest to you may be our business guidance and the

  • expanded guidance covering environmental cleaning and disinfection

  • recommendations that addresses cleaning recommendations in various

  • settings, including answering questions we've heard about the bleach

  • solution proportions for use on surfaces, addressing linens and

  • clothing, and personal protective equipment.

  • Another useful tool on our COVID-19 website home page, we now have a map

  • of the United States.

  • It shows the number ofs confirmed COVID cases state by state.

  • You can also click on your state to be taken to the state department

  • COVID-19 page where you can get more detailed information for your

  • state.

  • The intensity of an outbreak may differ according to geographic

  • location.

  • The local health departments will have guidance specific to your

  • communities.

  • Before we open it up for Q&As, I would like to address some of the

  • topics in areas many of you have already submitted questions on.

  • So --

  • >> Okay.

  • Let's start by -- let's see, we're getting a whole bunch of questions in

  • here.

  • I'm going to try to aggregate them.

  • Could you speak a little bit about how bad you think the pandemic will

  • get?

  • >> NANCY MESSONNIER: So I think this is a really important question. Of

  • course, we all want to know how bad this is going to get and how long

  • it's going to last.

  • Right now we are in an acceleration phase. That is, we've seen 3,000

  • new cases since yesterday.

  • We're on the upward part of a curve, and we should expect more

  • acceleration over the next couple days.

  • That's why it's so important that we all act now and act together to

  • bend that curve so that we can moderate the impact.

  • What that means is lowering the curve so that we have less cases every

  • day and hopefully less cases total, but also by having less cases every

  • day, we really can help the health sector catch up.

  • How long is it going to last? I don't know for sure, but I think we

  • should expect to see at least some places have impact for this disease

  • through the summer.

  • >> Great. Thank you.

  • Okay.

  • A question about if someone is -- tests positive, recovers, and then

  • is -- is it possible to become reinfected again?

  • >> NANCY MESSONNIER: Yeah.

  • This is a great question that we've been asked a lot.

  • This is a new disease. It's only been discovered since beginning of the

  • year.

  • And so there's some information that we don't have yet.

  • In general, for most respiratory infections, getting infected leads to

  • immunity, and that immunity protects you against either the whole

  • disease or at least having serious disease, so we're hoping certainly

  • that that's true for COVID-19, but this is an area where there's lots of

  • research, and I expect there to be more information coming.

  • So we don't know for sure yet.

  • We certainly hope so.

  • >> Thanks. Okay. Many, many questions from our partners about closures

  • such as why child-care centers and schools are closing, why some prisons

  • are implementing restrictions while others are not.

  • Is there any general advice you can give on closures?

  • >> NANCY MESSONNIER: So closure decisions are made at a state and local

  • level.

  • CDC does provide guidance, but ultimately the decision to close is made

  • at the state and local health department level, and for your businesses,

  • the decision should be made in conjunction with state and local health

  • departments.

  • I talk about the acceleration of bend the curve, and that is true

  • nationally, but this really does look differently in some communities

  • compared to others. Some communities are already seeing a whole lot of

  • disease, and some communities are seeing very little.

  • And that may explain why guidance differs in different places.

  • But in general, we are asking everybody across the country, even in

  • places that haven't yet seen a lot of disease, to take this seriously

  • and act now.

  • I know it's disruptive. It's certainly disruptive for my family. It's

  • certainly disruptive for my colleagues here at CDC as we all figure out

  • how to cope.

  • But working together is the best way for us to impact this disease right

  • now.

  • >> Thank you. Okay.

  • We're receiving a lot of questions from individuals unsure about

  • continuing their regular doctor and dental appointments.

  • What advice do you have for them?

  • >> NANCY MESSONNIER: Yeah. It's really important right now that we take

  • into account how much work our healthcare sector needs to do to take

  • care of patients with COVID-19, to be able to make sure that those

  • patients are taken care of, a lot of doctors' offices and a lot of

  • communities are recommending that individuals postpone their regular

  • doctor and dentist appointments.

  • And that's things like routine visits, cleaning, checkups, elective

  • procedures.

  • I would also say, though, that there are some things that we don't want

  • to delay.

  • And if you have questions, you need to call your healthcare provider.

  • For example, childhood infant vaccines, it's important that we still get

  • those vaccines in.

  • But it's important that we do it safely.

  • And so if you have questions about your routine care, you should contact

  • your own healthcare provider who's best equipped to come up with

  • recommendations for your particular situations.

  • >> Great.

  • And in the inverse, there's some questions from dentists or doctors

  • wondering if they should continue to see patients.

  • >> NANCY MESSONNIER: Yeah.

  • I know that many dentists have elected to postpone routine visits,

  • cleanings, checkups and elective procedures.

  • And I think that is partly also to make sure that the healthcare sector

  • can focus on COVID-19 and also to make sure that the personal protective

  • equipment that our healthcare doctors need is reserved for those at high

  • risk, that is those that are taking care of COVID-19 patients.

  • >> Thank you.

  • So a lot of people are asking questions related to when things will open

  • again, like restaurants, when they'll be able to hold a conference or

  • when they'll be able to go back to work?

  • >> NANCY MESSONNIER: Yeah.

  • I mean, I want to know when things will go back to normal as well.

  • And I think the answer is for now, we all need to be in this together,

  • and we all need to be pausing.

  • How long it will take, I don't know.

  • I think we need to expect there to be disruption through the spring.

  • But it will look differently in different communities. It is going to

  • be something that we all need to be working on together, both pausing

  • together and then making decisions together about when to reopen.

  • And that's difficult to see, but I do want to reassure everybody that,

  • you know, as disruptive as this is going to be, we need to know that

  • this is going to end.

  • Pandemics will end.

  • And how disruptive it is, partly depends on us working together to bend

  • that curve to make sure that our healthcare sector can catch up.

  • But I can't tell you that it's going to end by next week until we start

  • really impacting this disease, we have to expect that we're going to

  • have to ask a lot of each other and our communities and things that we

  • consider to be routine may look a little differently for a while.

  • >> So a question from people in an area where community spread has

  • occurred.

  • Should staff be wearing masks, and also what is CDC's stance on gloves?

  • >> NANCY MESSONNIER: Well, yeah.

  • I think the really important thing right now is to make sure that those

  • who need masks have masks.

  • And that really is folks who are in the healthcare sector taking care of

  • patients with COVID-19.

  • So part of the reason that I would ask you and your employees to not try

  • and go out and purchase masks is that we need to make sure that those

  • who really need them have them.

  • Healthcare workers are at highest risk, and we need them to continue to

  • be able to do their jobs.

  • So I'm asking you to please not go out and purchase masks and make sure

  • that those who have them need them.

  • In terms of gloves, most people in most jobs don't need gloves, but that

  • is something that if there's questions, you should be asking -- looking

  • at your -- what the specific job is and what the specific situation is

  • in your community.

  • But in general, this is something where what we're asking people to do

  • is to do good hand hygiene.

  • Just like your mom told you growing up.

  • You need to be washing your hands, not touching your face.

  • And for most people, those are the right guidelines.

  • Wash your hands.

  • Don't touch your face.

  • Stay away from other people.

  • That should protect you and also protect our communities.

  • >> Thank you.

  • What do we do if we have a sick employee or if an employee has a sick

  • family member?

  • >> NANCY MESSONNIER: So I'll start with this.

  • Information about who among your employees is sick, actually may have

  • issues around confidentiality in terms of you disclosing that to other

  • employees in the workplace. You have to balance that, of course,

  • against wanting to make sure that individuals that are exposed to that

  • patient with COVID-19 are safe.

  • And we do have guidelines on our website about how to conduct a risk

  • assessment. Employees who are exposed to a coworker with COVID-19 can

  • use those guidelines in order to look at their potential exposure.

  • Now, it's different if it's an employee who has a sick family member at

  • home with COVID-19.

  • In general, employees who are well themselves that have a sick family

  • member should notify their supervisor and refer to CDC guidance, but at

  • this point, if you have somebody that you live with in your family home

  • who has COVID-19, you really should be staying home with them.

  • We don't want to risk you passing the disease along to your coworkers.

  • >> Thank you. Okay.

  • This question -- let's see.

  • Is from an employer who's not working in the medical field.

  • Should or can employers check workers' temperatures?

  • Is it legal to do so?

  • >> NANCY MESSONNIER: That's a private company decision.

  • I would definitely check with your counsel on the legalities of doing

  • that because it really will differ.

  • But we are at a place when we're asking all of you to really consider

  • your policies on teleworking, social distancing. You have clearly a lot

  • of folks on the phone are in different businesses.

  • And maybe you need to have your employees physically at work.

  • But if at all possible, we're asking you to have your employees

  • teleworking to the greatest extent possible. That is part of social

  • distancing, not coming in contact with other people.

  • >> Okay.

  • If an individual is sent home because they have a fever, when should

  • they be allowed to return to work?

  • The question -- oh.

  • So normally we ask if they have a doctor's note. However, given that

  • the healthcare system is so overloaded, is that necessary?

  • How should this be handled?

  • >> NANCY MESSONNIER: Yeah.

  • So it brings me to something that I want to talk about, which is that we

  • are having a pandemic of COVID-19, but it's also respiratory viral

  • season.

  • We're at the end of influenza season, so there is still influenza

  • circulating.

  • And at this time of the year, there are a variety of other viral

  • respiratory diseases that are circulating.

  • And I say that because if you have a runny nose and a sore throat and a

  • cough, it's possible that you have COVID-19, but it's also possible that

  • you have any of the myriad of other viral respiratory diseases that are

  • circulating.

  • We don't want people going into healthcare unless they need to.

  • For most individuals who are at low risk, that is who are young, who

  • don't have chronic medical conditions, if you have a fever, a mild

  • fever, a cough, a sore throat, we want you to stay home.

  • We don't think you generally need to go in for diagnostic.

  • We think you can ride this out at home.

  • For people who have chronic underlying conditions or who are older, you

  • need to contact your healthcare provider because you may well need to go

  • in for a diagnostic.

  • And, of course, if you have, you know, serious illness and you're

  • getting progressively worse, you need to call 911.

  • But in general, we really do want people who are otherwise healthy to

  • ride this out at home.

  • And we do have guidance on our website about when you can discontinue

  • home isolation. It's a little complicated.

  • So I would say go through it on our website.

  • But if it's been at least three days since you've recovered, that is

  • resolved your symptoms, or at least seven days since the symptoms first

  • appeared, we think it's safe for you to go back to work.

  • But, again, as I said before, what we're really asking is for everyone

  • to telework as much as possible.

  • So if you don't need to come back to work, you can do your work from

  • home, we would definitely prefer that you do that.

  • >> Thank you. Okay.

  • This question is from someone in a retail office with about 10 to 13

  • people there.

  • If someone is confirmed positive for COVID-19, what are the guidelines

  • for self-quarantine?

  • Is it automatic that everyone in the office would just self-quarantine,

  • or if we are practicing social distancing, would the others be able to

  • continue working?

  • >> NANCY MESSONNIER: So social distancing does mean that we want people

  • to be home as much as possible. Of course, it depends whether the bank

  • branch has closed, what the operations are.

  • You know, again, our gathering guidance says we want people to be as far

  • apart as possible so we stop this thing and we slow it down.

  • In specific answer to your question, they should self-quarantine, those

  • with close and frequent contact.

  • We do have guidance that allows you to assess risk, and it looks a

  • little different depending on how much contact you had with somebody

  • with COVID-19.

  • You need to clean and disinfect high-touch areas, and we need to stay

  • apart as much as possible.

  • You know, there are some other questions that we're getting asked a lot,

  • and it reminds me to go back to that, which is how is COVID-19 spread?

  • People are wondering if it's spread through the air, if it's spread

  • through surfaces.

  • In general, it's spread through respiratory droplets. From what we know

  • about the virus, it's not airborne.

  • It doesn't spread through vents and airport buildings or in

  • condominiums. It's spread through respiratory droplets.

  • In general, the virus seems to be spread mainly from person to person,

  • but it's also possible that a person can get COVID-19 by touching a

  • surface or object that has a virus on it and then touching your own

  • mouth, nose or eyes.

  • And so what that means is if you're standing next to somebody who has

  • COVID-19 and they cough on the table in front of you and then you touch

  • that surface right away and touch your own face and mouth and nose, you

  • could be exposed to COVID-19.

  • We don't think this is the main way it's exposed.

  • We need to learn more about it.

  • And there are studies ongoing about the survivorability of the virus on

  • surfaces, and that's why, again, it's important to cover your cough, to

  • not touch your face, and to wash your hands a lot and to disinfect

  • surfaces.

  • That should be part of everyone's actually routine practice all the

  • time, but especially now when we're faced with a pandemic like this.

  • >> So we've talked a lot about social distancing, and I'm wondering if

  • you can share really what the purpose is.

  • Does it really reduce the number of total infections, or does it simply

  • slow the pace of infection or spread it out over a longer period of

  • time?

  • >> NANCY MESSONNIER: So this virus is new, but it's not the first

  • respiratory virus that we've dealt with as a country or that we've

  • thought through.

  • And so we do know a lot about how these kind of viruses spread.

  • And therefore, what we're talking about is both of those things.

  • If we can bend that curve, we can decrease the overall number of people

  • that are sick, but we can also decrease the number of people that are

  • sick week by week.

  • And both of those things are important. Obviously, having less people

  • overall get sick would be great.

  • But also, if we can decrease the number of new cases week by week, it

  • can really help our healthcare sector have fewer patients to have to

  • treat and make it easier for them to treat the patients that they have.

  • And so both of those things are true, and both of those things are the

  • goal of this mitigation strategy, staying apart is the most effective

  • thing that we can do right now.

  • >> In terms of vaccine development, can you tell us what the status is

  • and when these vaccines will realistically be available to the general

  • population?

  • >> NANCY MESSONNIER: Phase 1 clinical trials are starting now, and

  • that's the earliest clinical trial where the vaccine is given to a small

  • number of people.

  • But the vaccine development process takes a while, even with so many

  • researchers across the world working on vaccines.

  • We expect it will be 12 months, maybe even 18 months before the vaccine

  • is ready for most Americans to get it.

  • And that's because before a vaccine is given to the population, we need

  • to make sure that it works and we need to make sure it's safe.

  • And what that means for you all is that right now our toolkit doesn't

  • have a vaccine in it.

  • That's why we are so focused on social distancing.

  • >> So if the government requires a mandated lockdown for an extended

  • period of time like two months or more in order to do what you were

  • speaking about, flattening the curve and preventing the spread of the

  • virus, how likely is it for the virus to resurface?

  • Months or years from now?

  • Even though these extreme measures were in place?

  • >> NANCY MESSONNIER: So I think that we're going to learn a lot from

  • other countries that have had to deal with this before we do.

  • But remember that this is a new disease, but we know a lot about

  • diseases like this.

  • And our goal to mitigate is the thing that makes the right sense, the

  • most sense now, if, for example, we mitigated it now and it came back a

  • year from now, it would look a lot different because we'd likely have a

  • vaccine and also people would have been already exposed and we would

  • have better tools, better treatment, better diagnostics.

  • So things could look a lot better even if we have to face this again.

  • >> One more question.

  • How long should employees remain at home if they're no longer showing

  • signs of illness, especially if they were never tested?

  • >> NANCY MESSONNIER: So this depends a little bit on what your community

  • is doing.

  • And so I would say that what you need to look to first is what's going

  • on in your local community in terms of rates of disease and guidance.

  • We do have guidance for how quickly people who are -- who have had

  • COVID-19 should remain at home, basically isolated.

  • And in this context isolation is really what we do when somebody who is

  • sick stays at home.

  • So we do have guidance on our website for how long somebody should stay

  • at home if they have signs of illness, even if they were never tested.

  • And guidance is on our website.

  • Even if you get better, if you can stay home and socially distance,

  • we're still recommending that you do.

  • >> Thank you. Thank you so much for joining us today.

  • Unfortunately Dr. Messonnier has to go.

  • If we didn't get a chance to answer your specific question, please go

  • ahead and check out our website, which is www.cdc.

  • gov/COVID, C-O-V-I-D. Thanks again for joining us, and let's work

  • together to flatten the curve.

>>> Hello, everyone.

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