THIS IS THE TRANSCRIPT OF THE CDC CALL FROM YESTERDAY.
I FORMATTED IT TO MAKE PARAGRAPHS.
IN TWO PARTS
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Transcript for the CDC Telebriefing Update on COVID-19
Press Briefing Transcript
Wednesday, February 26, 2020
Please Note: This transcript is not edited and may contain errors.
Welcome and thank you for standing by. At this time, all participants are on listen-only mode until our question and answer session. At that time, if you would like to ask a question, please press star then one. Please be advised today’s conference is being recorded. If you have any objections, you may disconnect at this time. Now I would like to turn the meeting over to Mr. Benjamin Haynes. Thank you. You may begin.
Thank you. And thank you all for joining us for today’s update on CDC’s COVID-19 response. We are joined by the director of CDC’s national center for immunization and respiratory diseases who will give opening remarks. I will now turn the call over.
Thank you for joining us. The global novel coronavirus situation is rapidly evolving and expanding. There are still a lot of news coverage about community spread in a few countries since the last time we talked. This means that cases of COVID-19 are appearing without a known source of exposure.
Communities include Hong Kong, Italy, Iran, Singapore, South Korea, Taiwan, and Thailand. Community spread is often a trigger to begin implementing new strategies tailored to local circumstances that blunt the impact of disease and can slow the spread of virus. The fact this virus has caused illness – including illness resulting in death, and sustained person-to-person spread is concerning. These factors meet two of the criteria of the pandemic. The world moves closer towards meeting the third criteria. Worldwide spread of the new virus.
The U.S. has been implementing an aggressive containment strategy that requires detecting, tracking, and isolating all cases as much as possible and preventing more introduction of disease notably at points of entry. We’ve restricted travel into the United States while also issuing extensive travel advisories for countries currently experiencing community spread. Our travel notices are changing almost daily. We’ve also enacted the first quarantine of this scale in the U.S. And are supporting the state department and HHS in repatriating citizens from high-risk areas.
We are doing this with the goal of slowing the introduction of this new virus into the U.S. and buying us more time to prepare. To date, our containment strategies have been largely successful. As a result, we have very few cases in the United States and no spread in the community. But as more and more countries experience community spread, successful containment at our borders becomes harder and harder. Ultimately, we expect we will see community spread in this country.
It’s not so much a question of if this will happen anymore but rather more a question of exactly when this will happen and how many people in this country will have severe illness.
We will maintain for as long as practical a dual approach where we continue measures to contain this disease but also employ strategies to minimize the impact on our communities. At this time, there’s no vaccine to protect against this new virus and no medications approved to treat it. Non-pharmaceutical interventions or NPIs will be the most important tools in our response to this virus.
What these interventions look like at the community level will vary depending on local conditions. What is appropriate for one community seeing local transmission won’t necessarily be appropriate for a community where no local transmission has occurred. This parallel, proactive approach of containment and mitigation will delay the emergence of community spread in the United States while simultaneously reducing its ultimate impact.
To illustrate how this works, I’d like to share with you some of the specific recommendations made in the document I mentioned last Friday including some of the steps we would take here if needed. This document is called Community Mitigation Guidelines to Prevent Pandemic Influenza United States 2017. It draws from the findings of nearly 200 journal articles written between 1990 and 2016. This document looked at what can be done at the individual and community level during a pandemic when we don’t have a vaccine or proven medical treatment for the disease. We’re looking at data since 2016 and adjusting our recommendations to the specific circumstances of COVID-19. But this posted document provides a frame work for our response strategy. Based on what is known now, we would implement these NPI measures in a very aggressive, proactive way as he have been doing with our containment efforts.
There are three categories of NPIs.
Personal NPIs which include personal protective measures you can take every day and personal protective measures reserved for pandemics.
Community NPIs which include social distancing measures designed to keep people who are sick away from others and school closures and dismissals.
And environmental NPIs which includes surface cleaning measures.
NPIs routinely recommended for prevention of respiratory virus transmission include everyday personal protective measures. These are preventive measures we recommend during influenza season. These NPIs are recommended during a pandemic regardless of the severity level of the respiratory illness. Personal protective measures reserved for pandemics include voluntary home quarantine of household members who have been exposed to someone they live with who is sick.
Now I’d like to talk through some examples of what community NPIs look like. These are practical measures that can help limit exposure by reducing exposure in community settings. Students in smaller groups or in a severe pandemic, closing schools and using internet-based teleschooling to continue education. For adults, businesses can replace in-person meetings with video or telephone conferences and increase teleworking options. On a larger scale, communities may need to modify, postpone, or cancel mass gatherings. Looking at how to increase telehealth services and delaying elective surgery.
The implementation of environmental NPIs would require everyone to consistently clean frequently touched surfaces and objects at home, at school, at work, and at large gatherings.
Local communities will need to look at which NPIs to implement and when based on how transmission and disease is and what can be done locally. This will require flexibility and adaptations as disease progresses and new information becomes available. Some of these measures are better than none. But the maximum benefit occurs when the elements are layered upon each other.
Some community level interventions that may be most effective in reducing the spread of a new virus like school closures are also the most likely to be associated with unwanted consequences and further disruptions. Secondary consequences of some of these measures might include missed work and loss of income.
I understand this whole situation may seem overwhelming and that disruption to everyday life may be severe. But these are things that people need to start thinking about now. I had a conversation with my family over breakfast this morning and I told my children that while I didn’t think that they were at risk right now, we as a family need to be preparing for significant disruption of our lives. You should ask your children’s school about their plans for school dismissals or school closures. If ask if there are plans for teleschool. I contacted my local school superintendent this morning with exactly those questions. You should think about what you would do for childcare if schools or day cares close. If teleworking is an option for you. All of these questions can help you be better prepared for what might happen.
CDC and other federal agencies have been practicing for this since the 2019 influenza pandemic. In the last two years, CDC has engaged in two pandemic influenza exercises that have required us to prepare for a severe pandemic and just this past year we had a whole of government exercise practicing similarly around a pandemic of influenza. Right now CDC is operationalizing all of its pandemic response plans working on multiple fronts including specific measures to prepare communities to respond to local transmission of the virus that causes COVID-19.
Before I take questions, I want to address the issue of the test kits CDC is developing. I am frustrated like I know many of you are that we have had issues with our test. I want to assure you that we are working to modify the kit and hope to send out a new version to state and local jurisdictions soon.
There are currently 12 states or localities around the U.S. that can test samples as well as we are testing at CDC. 400 samples were tested overnight. There is no current backlog or delay for testing at CDC. Commercial labs will also be coming online soon with their own tests. This will allow the greatest number of tests to happen closer to where potential cases are.
Last, I want to recognize that people are concerned about this situation. I would say rightfully so. I’m concerned about the situation. CDC is concerned about the situation. But we are putting our concerns to work preparing. And now is the time for businesses, hospitals, community schools, and everyday people to begin preparing as well.
Over the last few weeks, CDC has been on dozens of calls with different partners in the health, retail, education, and business sectors in the hopes that employers begin to respond in a flexible way to differing levels of severity, to refine their business response plans as needed. I also want to acknowledge the importance of uncertainty. During an outbreak with a new virus, there is a lot of uncertainty. Our guidance and advice are likely to be fluid subject to change as we learn more. We will continue to keep you updated. I’d be happy to take a few questions now.
Brittany, we’re ready to take questions.
Thank you. We’ll now begin our question and answer session. If you would like to ask a question over the phone, press star, then one and record your name clearly when prompted. If you need to withdraw your question, press star then two. One moment as we wait for the first question. Our first question comes from Lisa from PBS. Your line is now open.
Q: Good morning. Thank you for doing this. I have some more questions about the test kits. Thank you for what you gave us the update on, but can you go into more detail about how they work? Can any hospital now just kind of use a swab to get a sample and then send that to the CDC? And then how long do you estimate it will take to have the kits replaced so that more localities can actually do the analysis and do you have enough money for this kind of field work and test analysis right now?
A: Okay. I’m going to start from maybe the part of a patient perspective which is, you know, right now our focus is still on individuals with a travel history that would put them at risk for COVID-19. Or people who are close contacts of someone who has COVID-19. Those individuals when they are identified by a health care provider, the health care provider calls the health department. The health department helps them triage those patients to make — and then the samples are worked with the health department.
Now, as we move forward, though, if we are looking at the trajectory of expecting that there likely will be community spread of this virus in the united states, the case definition may change away from narrowly around people with travel. Again, that’s what we would anticipate doing as there is community spread. If that happens, it will be more and more important that the clinicians have a full tool kit. That’s why the availability of commercial kits would be so helpful. So in the short-term, it’s the clinician calls the health department. And either the health department already has the test kit themselves or if they don’t yet have it stood up, they send it to CDC. Our turnaround at CDC is within a day. There is a little bit of shipping time. But that’s the process.
In terms of timing, I think at this point what I would say is we are working as fast as we can. We understand the frustration of our partners in the health care sector, in health departments. You certainly can imagine we want to resolve this as quickly as possible. But we have to make sure that while resolving it, we keep to the highest level of quality assurance. Because as important as speed is, it is more important that we make sure that our results are correct.
In terms of funding, there’s already been funds available that are helping us with the activities that we have now that is the diagnostic testing at CDC. And we’ll continue to proceed focused on our priorities which as I’ve said are getting this test kit out to state health departments so they can be doing that themselves as an interim step to getting it commercially available would be a great advancement. Next question.
Thank you. And our next question comes from Craig from KNX 1070 news radio Los Angeles. Your line is now open.
Q: Thank you, doctor. I appreciate your time. Couple of questions. There’s been a lot of talk about what’s being done to prepare for possible people who would be quarantined. I’d like to know what that is. And also is the Chinese government leveling with you? Are they telling you the truth? Have they given you the straight dope, so to speak, as to what you need to know about the coronavirus?
A: So in answer to your first question, I would say generally we are working on a daily basis with state and local health departments across the country on exactly those issues. What are the local considerations for quarantine or isolation and how can they be resolved? And in each location in the united states, it may end up being a slightly different answer. Our focus is on the best health of the individual whom we are working with in terms of whether they need quarantine or isolation.
In terms of the Chinese government, there has been a WHO team on the ground in China as well in Wuhan. There are data coming out from those efforts. We have a lot of information from china. Frankly, we have a lot of new information from all the other countries around the world now that are reporting community spread and we are as quickly as possible trying to synthesize that information. It is providing us more data in terms of making our own estimations in the U.S. Of what we’re going to see. Communities that are having community spread are certainly very informative in terms of what we might expect in the united states. And I think that whole body of evidence is frankly coming really quickly at us. That’s why we have a team of people here at CDC synthesizing it all.
Next question, please.
Thank you. And our next question comes from Megan from STAT. Your line is now open.
Q: Hi there. Thank you so much for taking my question. I’m wondering if you could expand a little bit on whether you are reconsidering testing people with travel history to other countries now where they might be infected. And I’m also wondering if you could say whether or not the agency has considered getting tests from another country that’s supplying tests to other nations as well.
A: So the answer to the first question is certainly, we’re considering what the spread of illness in other countries looks like and how it impacts the potential risk the Americans traveling abroad in those countries. Those conversations are going on as we speak. We obviously are working closely with the partners on those considerations. And when there is new information in terms of case definitions, we’ll definitely publicize that broadly. You know, as I said, we are still at the stage of containment, but we are already starting to plan for mitigation. And part of the mitigation planning is the participation of community spread in the united states. And as that happens, it would certainly dramatically impact how we’re considering who is on the case. As you can imagine, the symptoms of novel coronavirus look a lot like other viral respiratory diseases that are circulating this time of year. So it’s going to be difficult for clinicians to differentiate fully on the basis of those — solely on the basis of the symptoms.
In terms of diagnostic tests, what I would say is we’re working closely with FDA on this. And obviously with the state and local health department partners. And I think that we are rapidly moving towards getting those kits more available in the U.S. In the systems that we have. Really I think we’re close. I just wouldn’t want to give an estimate of when until we’re there. But I think we’re close. And remember, a dozen states now have the kit and are testing and there’s tests available in the U.S. So I think we’re making forward progress.
Thank you. And our next question comes from Lena Sun from Washington Post. Your line is now open.
Q: Thank you. I had a couple questions. One is if a dozen states have the kit, then do they still need to send those tests to CDC for confirmation? Which are the states that have the tests? And more broadly, your comments today seem to represent a significant escalation in the sort of severity and urgency of the now. At a briefing this morning for Congress, I believe some members were told that we now face a very strong chance of an extremely serious outbreak. Is that the CDC’s feeling right now that we face an extremely strong chance of a serious outbreak?
A: Okay. So let’s see. The first question, it’s 12 state or local health departments. And so it’s not 12 states total. We are still as a point of part of how we roll out these tests, those tests that are positive still do come to CDC for confirmation. I think that’s just part of a normal process to ensure we are keeping to the utmost quality control. I don’t have a list of state or local health departments in front of me, but I think we can provide that.
In terms of a change in tone, I guess what I would say is as I look back on the scripts of the telebriefings that we’ve given over the past month, we have for a long time been saying — we have for many weeks been saying that while we hope this is not going to be severe, we are planning as if it is. The data over the last week and the spread in other countries has certainly raised our level of concern and raised our level of expectation that we are going to have community spread here. So I think that that’s perhaps the change of tone you’ve seen.
I think what we still don’t know is what that will look like as many of you know. We can have community spread in the united states and have it be reasonably mild. We could have community spread in the united states and have it be very severe. And so that is what — that is what we don’t completely know yet. And we certainly also don’t exactly know when it’s going to happen. I think it would be nice for everybody if we could say, you know, on this date is when it’s going to start. We don’t know that yet. And so that’s why we’re asking folks in every sector as well as people within their families to start planning for this because as we’ve seen from the recent countries that have had community spread when it is hit in those countries, it has moved quite rapidly. So we want to make sure that the American public is prepared.