Of allergy and infectious diseases. This is 40 minutes. Good afternoon, everyone. Thank you for joining us here today. This is the h. H. S. Briefing on the china c secretary azar good afternoon, everyone. Thank you for joining us here today. This is the h. H. S. Briefing on the china coronavirus and we aim to do two things today. Provide the American Public with an update on the risk presented by the virus, and provide the latest update on the actions that president Trumps Administration is taking to respond to the outbreak and keep americans safe. Im joined today by the Principal Deputy director for the centers of Disease Control and prevention in atlanta. Dr. Anthony fauci of the National Institute of allergy and infectious disease. Dr. Kadlec, h. H. S. s assistant secretary for preparedness and response, and the commissioner of food and drugs. Contacts with those travelers. We have three cases as of this morning, we still have only 14 cases of the china coronavirus detected here in the United States. Involving travel to china, or close contacts with those travelers. We have three cases among americans repatriated from wuhan. And we have 40 cases among american passengers repatriated from the diamond princess in japan. I want to thank the responders and communities that have worked with h. H. S. And the administration to provide these americans with the treatment they need. Im also grateful to the governors and other state and local leaders who have worked with us in Close Partnership so far. The immediate risk to the general American Public remains low. But as we have warned, that has the potential to change quickly. There is now Community Transmission in a number of countries, including outside of asia. Thats deeply concerning and communities spread in other countries will make successful containment at our borders harder and harder. Thats why weve already been working closely with state, local and private sector partners, to prepare for mitigating the virus potential spread in the United States. Because we will likely see more cases here, as we have said, throughout this episode. The doctor will provide some more details on what that will look like, including how we would treat potential cases that arise from Community Transmission here in the United States. This preparation has been possible in part because of how aggressively President Trump has responded to this outbreak. As soon as we knew of the threat presented by this novel virus, Public Health leaders were monitoring it and beginning to prepare. The travel restrictions that the president put in place at the beginning of this month have given our country valuable time to continue to prepare and that is precisely what those measures were designed to do. That includes working with congress. Yesterday the White House Center request to congress to make at least 2. 5 billion in funding available for preparedness and response. Theyre five major priorities within the supplemental request which i underscored this morning before the Senate Appropriations committee. First, we need to expand our surveillance work, building on an existing system we have within c. D. C. s influenza surveillance network. Second, we will need funds to support Public Health preparedness and response for state and local governments for what could be a very large scale response. We dont know, but we must prepare for that just in case. This support complements the significant funds that these partners have received from c. D. C. For preparedness. About 2 3 of the billion dollars a year in recent years. Third and fourth, we need to support the development of therapeutics and the development of vaccines. Given the scale of this outbreak, the private sector sees a real market for both kinds of countermeasures, as well as for diagnostics. But federal funding and guidance can accelerate this work. Dr. Fauci will discuss that more in depth. Fifth and finally, we need funds for the purchase of personal protective equipment for the Strategic National stockpile, the topic that dr. Kadlec can address. Ill conclude by noting that though scheduling conflicts prevented this briefing from including other members of the president s Coronavirus Task force, well be providing a new update from interagency leaders soon and we expect to continue doing so regularly. Earlier this afternoon, on cnbc, the National EconomicCouncil Director offered an update on how we see this outbreak affecting the economy. This morning a doctor from c. D. C. Provided the usual telebriefing. As dr. Schuchat will emphasize in a moment, the Trump Administration will continue to be aggressively transparent as the outbreak and our response evolve. Well continue keeping the American People and the media apprised of the situation, as well as what everyone can do to prepare. In the meantime, ill continue to work closely with President Trump and the president s task force on our preparations to keep americans safe. With that, ill hand things over to dr. Schuchat from an update from the c. D. C. Dr. Schuchat thanks so much. Id like to start out by saying its a difficult and uncertain time. We, along with our partners around the country and around the world, have been confronting a dynamic, rapidly evolving situation. Id like to let americans know that c. D. C. And our nations Public Health agencies are preparing every day for this type of situation. Preparedness started long before this outbreak. The u. S. Governments response to the spread of a Novel Coronavirus into our country began as soon as reports of an unidentified flulike illness emerged from wuhan, china. 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 introductions of disease, notably at ports of entry. We restricted travel into the u. S. And have issued multiple travel advisories for countries currently experiencing Community Spread. Our travel notices are changing almost daily as we get new information. And we believe these precautions are working. So far, as secretary azar described, our Public Health system has detected 14 cases in travelers or very close contacts of travelers here in the United States. Among passengers repatriated from by the state department from wuhan, china, and from the diamond princess, there are an additional three and 40 cases. The fact that we have been able to keep cases to this low level is an accomplishment. Especially given that we are, unfortunately, beginning to see Community Spread in a growing number of other countries. Based on what we know right now, we believe the immediate risk here in the United States remains low. And were working hard to keep that risk low. But we must use this time to continue to prepare for the event of Community Transmission in the United States. Part of that preparation is educating the public and our state, local and private sector partners about what transition from aggressive containment measures to Community Measures or Community Mitigation would look like should we end up there. Under our current aggressive containment posture, patients infected with the coronavirus who have mild or no symptoms are being placed in Health Care Facilities for very close observation and isolation. That intensive level of medical care is not typically needed, as weve watched these cases and learned over the past several weeks, we realized that other approaches to management are likely fine. Outside this period of aggressive containment, the usual and appropriate care for most patients who develop the Novel Coronavirus or covid19 would be management at home through home isolation. With use of Health Care Facilities only as needed for those who have is severe presentations, the elderly, those with medical conditions requiring closer observation. We will maintain for as long as practical a dual approach where we continue these measures of aggressive containment to this disease, but also employ strategies to minimize the impact on our communities. However, current global circumstances suggest its likely that this virus will cause a pandemic. In that case, Risk Assessment would be different and new strategies tailored to local circumstances would need to be implemented to blunt the impact of the disease and further slow the spread of the virus. What these interventions would look like at the Community Level will vary depending on local conditions and on the emerging information about how severe the virus may be. Now, its 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 become infected and how many of those will develop severe or more complicated disease. We have been preparing to address this type of threat and limit the impact on our communities for many years. As some of you heard from the doctor of the c. D. C. Today, weve begun laying out for the public what it will look like to mitigate the spread of the virus. They are obvious, commonsense tools like good hygiene, social distancing, things like staying home when youre sick, things we talk about during a difficult flu season, or things that we talked about during the 2009 h1n1 pandemic. We will be transparent with the public about these measures and the potential that these tools will be necessary. There is literally a playbook for the use of these tools. And one that the states and local Public Health have exercised. We are committed at the c. D. C. And across h. H. S. And the u. S. Government to radical transparency, to making sure were sharing what we know when we know, and were giving you a sense of what the future may hold. Id like to now turn things over to dr. Fauci for his update. Dr. Fauci thank you very much, anne. Im going to give a very brief update on the Countermeasure Development that i introduced to this audience on a number of occasions over the past couple of weeks. And the first regarding the issue of vaccine. You might recall that i had mentioned when we first introduced the topic of vaccine that very shortly after the sequence was put on a public database, we began a Vaccine Development program which was one of several supported both by the n. I. H. , as well as and even independent individuals that we have been involved in collaborating with for peard of time. One of these vaccines i think serves as the prototype of the timing of what we were talking about. You might recall i had mentioned that from the time we had available sequence, we would hope to be in Clinical Trials within two to three months. And i said, barring any glitches, that would be the fastest ever in any vaccine that weve gone from the identification of a pathogen to putting it into a human in a phaseone trial. Im happy to report to you this afternoon that we are on time at least and maybe even a little better. The gene has been expressed in the platform, in this case, a messager r. N. A. The material has been produced. Its been put into mice. Its now getting ready to go through the regulatory issues of getting it to go. So i would project that we would be in a human trial, i would say, within a month and a half. And i thought that may cut a week or so off. Hopefully further no glitches. The thing we want to understand, we want to make sure people dont get confused, getting a vaccine into a phase one trial within a threemonth period, you need at least three to four months to determine if its safe and whether it induces the kind of response that you would predict would be protective. Once do you that, you graduate to a much larger trial. The end of the number of people in the phase one trial is 45. When you go to a phase two trial, youre talking about hundreds, if not thousands of individuals to determine efficacy. That is a trial they would have to conduct in those countries in those areas, where theres active transmission. That itself, even at rocket speed, would take at least an additional six to eight months. So when youre talking about the availability of a vaccine, even to scale it up, youre talking about a year to a year and a half. Now, you shouldnt be discouraged by that because it is certainly conceivable that this issue, with this coronavirus, will go well beyond this season into next season. So a vaccine may not solve the problems of the next couple of months. But it certainly would be an important tool that we would have. And well keep you posted on that. Secondly, and final liquor the issue of therapeutic interventions. There are a number of candidates that we are now looking at that have shown some suggestion, either in vitro, in an animal model or in some trials that were done during the outbreak. One of these, and there are several were considering, is a nucleotide analogue. Today as i speak, there are two major Clinical Trials going on in china which are randomized, controlled trials, which means that we will get an answer whether or not it works or doesnt work. I think within a reasonable period of time. An identical copy of that trial is now being implemented in nebraska with our colleagues who are taking care of the individuals who were take frnt diamond princess and brought back here. In addition to our colleagues in japan. So im optimistic that we will at least get an answer if we do have a therapy that really is a game changer. Because then we could do something from the standpoint of intervention for those two are sick. So hopefully ill get the opportunity in the future to continue to update on these interventions. Thank you. Id like to introduce dr. Kadlec. Dr. Kadlec thank you. Were repatriating p. M. Approximately 1,100 americans from the diamond princess cruiseship in japan. We are pleased that the Passengers Evacuated have completed their 14day quarantine and have returned to hair homes and families safely. Passengers evacuated from the diamond princess are in the process of completing their 14day quarantine at two d. O. D. Installations. One in california and one in texas. Medical professionals from our National Disaster medical system and c. D. C. Are continually monitoring the health of these passengers. Any passengers that show signs of illness are moved off the d. O. D. Facility and tested for this virus. Passengers who tested positive for this coronavirus cannot stay on the military installations and these patients are being transported safely to a network of special Pathogen Treatment Centers such as the university of Nebraska Medical Center as part of our aggressive containment posture. These individuals are being placed in these facilities for quarantine and isolation purposes only. An intensive level of medical care is not typically needed by most of these individuals. At these centers, the patients who develop this infection can participate in the Clinical Trial that dr. Fauci described. We are honored to have helped n. I. H. To raise a Clinical Trial within the special network of treatment centers. In addition, our Biomedical Advanced ResearchDevelopment Authority is working with to develop two possible treatments and with others to screen existing and investigational treatments and compounds to identify any that have potential use in treating coronavirus. And to develop vaccines using Vaccine Technology that h. H. S. Supported for pandemic influenza vaccines. Were reviewing hundreds of proposals for additional therapeutics and vaccines and a particular diagnostic that can be used in hospital and Clinical Labs or doctors offices. Were also prepared to support c. D. C. And department of Homeland Security at designated military installations where americans returning to the u. S. On commercial flights can be quarantined based on their travel history. Most recent location to receive such a traveler is a naval base in ventura county, where one american is currently completing quarantine. Any quarantine of any of these military installations would not have any symptoms or positive test results. Quarantine is based solely on their travel history that places them in highrisk for possible exposure. Their health is continually monitored and theyre transferred safely to medical facilities for testing and treatment if any symptoms develop. Its now my pleasure to introduce the doctor from the f. D. A. Thank you for the opportunity to update you today on f. D. A. s coronavirus activities. The f. D. A. Plays an essential role in overseeing our nations medical products as part of our Vital Mission to protect and promote Public Health. Including during Public Health emergencies. Dr. Hahn the f. D. A. Is an active partner in the Novel Coronavirus response, working closely with our government and Public Health partners across the u. S. Department of health and human services, as well as our international counterparts. Our work is multifaceted, focusing on actively facilitating efforts to diagnose, treat and prevent the disease. Surveilling the medical products supply chain for potential shortages or disruptions. And helping to mitigate such impacts as necessary. And leveraging the full breadth of our Public Health tools as we oversee the safety and quality of f. D. A. Regulated products for american patients and consumers. Im happy to answer questions about f. D. A. s activities but ill provide a few updates. First of all, the supply chain. F. D. A. Is keenly aware that the outbreak will likely affect the medical product supply chain. Including potential disruptions to supplier shortages of critical medical products in the u. S. We are proactively reaching out to hundreds of medical product manufacturers to gather information about the supply chain. First, its important to note that f. D. A. s not aware, not aware of any medical product shortages at this time. We are, however, monitoring several products that might be at risk, particularly personal protective equipment. But we do not have any manufacturer shortages to report. Shortage or disruption of medical products is identified by the f. D. A. , we will use all of our available tools to react swiftly and mitigate the impact to u. S. Patients and health care professionals. And we will take steps to quickly share that information with the public. With respect to inspections, for february and march, f. D. A. s identified approximately 100 scheduled inspections in china. The vast majority of which are routine surveillance inspections. Those inspections are just postponed at this time and will be conducted the a later date. Its important to remember that these delay of routine surveillance inspections can happen at any time during the year. And while inspections in china are delayed secondary to the state Department Travel advisory, we will send investigators to other parts of the world to insure we are on schedule for our planned inspections for the year. Of the world to insure we are on schedule for our planned inspections for the year. I would also like to remind everyone that the inspections are just one tool that f. D. A. Can use to monitor compliance and to help prevent products that do not meet f. D. A. s standards f layers in place and is not solely reliant on boots on the ground inspections. Overall, this remains an evolving and very dynamic issue that we will vigilantly monitor. We are committed to continuing to communicate with the public as we have further updates. Thank you. Secretary azar thank you. Lets open it up to questions. If you can wait for the microphone so the tv cameras can hear your question. Reporter thank you. My first question is, as chinas coronavirus seems to be contained, while there are other countries like italy, japan or south korea, [indiscernible] are you considering loosening the travel restrictions regarding foreigners with travel history from china, while considering imposing travel restrictions with, you know, travel histories regarding the above three countries . And also, i notice that you ere still referring to covid19 as the chinese coronavirus. People changed this to covid19 because they think the china crones virus might lead to xenophobia or racism. Do you think its proper to still refer to it as china coronavirus . Thanks. Secretary azar we intend to travel restrictions in place. Were still seeing dozens more fatalities reported per day. We certainly hope china is able to engage in effective containment measures to slow the spread of this virus down but theres nothing at this point that would indicate a change in our posstchur toward aggressive containment measures. Its important to remember that eve been very moderated and titrated in those travel measures. They are based on 14 day the maximum predicted incubation period, so an individual who has been in china for the previous 14 days, who is a foreign national, would not be permitted to enter the United States. An american or permanent resident would be permitted to return to the United States, of course, but asked to home isolate in the completion of a 14day period outside of china. That is not a ban. That is a temporary restriction in line with the Public Health measures were taking. We tried to be very respectful toward travel and of course those restrictions are not based on, other than american and permanent resident vs. Nonamericans really is a matter of focusing our resources. Theyre not base thopped eethnicity of an individual or anything else because as you mentioned it is important that we not engage in that people not believe that because of somebodys ethnicity theyre more likely to have this disease or not. Our criteria are based on travel in effective areas and warn people about travel in aaffected areas based on epidemiology and the evidence. Yes . Reporter thank you, secretary azar. The c. D. C. Said this morning that americans should prepare for their everyday lives to potentially be disrupted by the nevitt spread of the coronavirus in the u. S. Your comments havent gone quite as far and the president tweeted that everything is under control. Can you address the difference. And given what you know now are you expecting Community Spread in the u. S. In the near future and how confident are you that the sust prepared to respond . Ask you azar let me to reply. I think to help americans prame what to expect its help to feel think about a bad flu year or even the 2009 pandemic where in different locations at different time the circumstances required different measures. The idea of exactly what that will look like in the United States is hard to say and of course the images weve been eeing from china, from hubei provines are different than what we expect in the u. S. Context. I think whats important for people to be to stay informed, stay aware and to learn about the circumstances. We really think everyday measures like covering your coughs or your cough or sneeze, staying home when youre sick are very important and of course the evergreen, wash your hands. We do know at the beginning of e h1n1 pandemic schools were closed, thats a mitigating measure. They were closed briefly until we learned what to expect and we realized the tradeoff of the disruption of School Closures and the benefit of School Closures for that particular virus, the equation suggest wed didnt need to do that and instead moved to a message of children staying home when theyre sick. I think the comments were to frame what might happen in the future. Very important to say that our efforts at containment so far have worked. And the virus is actually contained here in the United States. We dont want to delay possibilities and it was an educational moment that she alked about. Reporter just on the the respiratory is there any more information about other groups and to the f. D. A. The question, what sort of personal protective equipment are we talking about . Facemasks . That sort of thing . Anecdotely its clear that there are people who were judged on asymptomatic when questioned who likely transmitted infection in the time they were in the asymptomatic stage. The question is, is that a predominant mo dal i have to transmission, what we call the driver of an outbreak or sit one thats minor . From talking to people who are other there, we get more and more information, it looks like a, it does occur but b, it is not something that is predominant way its transmitted. We need to be aware of that in issues of testing and things like that but i think were getting closer to a better understanding of that in terms of personal protective equipment, were talking masks,s reprator, gowns. Theres no question that theres pressure on the demand side here. So were keeping a very close eye on this and a forwardleaning approach. We may in fact see some effect on the supply chain there. Reporter earlier today members of congress had a lot of questions about whether or not the emergency supplemental request would be enough and i guess can you kind of offer some insight into how you guys came to that number and why you think its enough. Secretary azar the supplemental request would authorize 2. 5 billion in funding, thats to be spent between now and september 30 of this year. We would have a provision to have carryover spending until fiscal year 2021 if needed but its this years spending. We told appropriators were in the middle of looking at next years appropriation, lets Work Together on that, on top of, in addition to, any additional needs. Well have a lot more learning. Were learning every day and every week more about this virus and the disease progression and that will help inform those longer term discussions about 2021. The 2. 5 billion, five key areas. We have to expand our Surveillance System to be comparable to what our flu surveillance is like. We want to test people with flulike symptoms that resonate with the coronavirus so we can make sure we have rapid detection, thats part of the scaleup there. Our state and local partners are the frontlines of any Public Health response. We fund about half of state and Public Health already and 670 million a year of emergency response, but we know therell be additional needs. Third, vaccine r d. Bets onto have multiple the table. We want to see that along as quickly as possible we feel can assess whether theres a need for us to make the market in terms of purchasing. This has such global attention right now in the private and the private market players, major pharmaceutical players as you heard are engaged in. This we think this is not like our normal bioterrorism procurement processes where the government may be the unique purchaser, say, of smallpox therapy. The market here we believe will actually sort that out in terms of demand, purchase, stocking, etc. , but well work on that to make sure were able to accelerate vaccine as well as Therapeutic Research and development. And then the doctor will lead our efforts in addition on personal protective equipment procurement, for instance, scaling up acquisitions of facemask which is would be primarily used for Health Care Providers to protect them in multiple interactions in the community. Our advice remains as it has been that the average american does not need an n95 mask. These are really more for Health Care Providers and also gowns for use in hospital set, gloves etc. That type of equipment that we would add to our existing tockpile there is. Reporter when you guys are saying c. D. C. Are and what the c. D. C. Are saying is different. You have the president saying i think its going to be under control. You have someone else saying its contained. Senator graham saying its been getting worse not better. And the c. D. C. Saying americans need to prepare because this might get bad. Which is it . And what exactly do you think we need to do to prepare . Schuchating to ask dr. To talk about some advice but were trying to engage in radical transparency with the American Public. Each of those messages is accurate but addressing a particular aspect of what were talking about. So for instance, abroad, this is spreading quite rapidly. In the United States, thanks to the president and this teams aggressive containment efforts this disease as dr. Schuchat said is contained. We are two weeks with no additional u. S. Based cases. 14 cases on february 11. 14 cases today. That is remarkable level of containment here in the United States. The only additional case we have are ones we imported as part of our humanitarian repatriation efforts. Then we try to be very transparent with the American Public. We have from day one said we cant hermetically seal off the United States. I stood here at this podium, stood at the White House Press briefing when we announced our initial travel restrictions and we always said we expect to see more cases. That should we dont want people surprised if they see more cases here in the United States. Thats an important part of transparency. People shouldnt panic when they see new cases. They should know the government predicted we would have them and we have things in place. That gets to what we were talking about this morning. Previewing for the American People, as we see additional cases, we may not have a vaccine or therapeutic but we have Public Health tools we can and will use. Its important for people to know we arent helpless. We have tools. We have actually defined playbook for taking steps to help if we do see Community Spread, how broad any type of Community Spread we do not know. Make prekixes to with a virus, but we have options. All of this is a part of the same message which is a serious thing worldwide. Weaver taking it incredibly seriously here in the United States. Were doing the most aggressive containment efforts in history to prevent further spread in the United States. Were going to continue taking those measures. But we are realist that well see more cases. As we see more cases we might have to take Community Mitigation efforts. What will those look like . Were being transparent about those also. Its all to make sure that the American Public go on this educating with us so that people can predict what wed do and say in advance because weve been transparent bout what our playbook is. Reporter do you understand why saying prepare to have School Closings and have plans for your kids for day care, be prepared, you have members on the hill asking, or telling you they dont think the u. S. Is ready, do you understand why thats setting off alarm bills . Secretary azar i cant account for people on the hill and what they say. Reporter but its set off alarm bills. Secretary azar id like dr. Schuchat to address what the what they were talking about. Part of preparedness is an educated population thinking about the future. We hope those steps arent necessary. We hope we dont face these eventualities. Transparency is being candid with people about what the continuum of potential steps are so they can start processing in their own heads, thinking about in their own lives, what that might involve, might involve, not will, we cannot make predictions with any degree of certainty about how a virus will spread or what can happen. What we can say now is that thanks to our aggressive containment efforts, we have contained the spread of this into the United States, 14 cases now for two weeks solid. Were going to keep working to contain the spread of this. But if we need to, well take appropriate Public Health measures to help mitigate that dr. Schuchat to elab rit on the steps. When we think about Community Measures, not just the aggressive containment around each individual case but other context, we think about the individual or personal steps mitigating spread, things like staying home when youre sick. We think about the community steps, things like a different approach to gatherings. Perhaps if youre elderly with underlying conditions you may not go to the big concert and others could. We also think about environmental measures. Things like cleaning commonly touched surfaces a little more than you might otherwise. A big focus is the Health Care System. And really using it appropriately and not overusing it or underusing it in helping people, having the Health Care System be prepared and also helping consumers, patients know what to expect when they want to seek care, when to call a nurse line instead of going to the doctor yourself. So i think this playbook that they laid out was really foreshadowing the kinds of things we may need to do. Of course weve been watching the situation in china closely and then of course recent emergence of Community Spread in italy, in iran, in south korea, have raised questions with people of what might happen here. We want people to be ready in terms of if we do see Community Spread, what would that mean to you . Maybe Something Different in your community than another community, depending on local circumstances. But we wanted people to look at what that road map might be. We do think weve done mitigation before. Weve learned from the past in terms of what was appropriate, what was overkill and we want to educate folks about what we learned and what they can expect. Can you put into one sentence, when she said get prepared, what that means for, if youre caring for someone, like my parents in their 70s or parents of a young child . Dr. Schuchat i would go to cdc. Gov. There are checklists for businesses, consumers, travelers. We have been educating people about travel, heres some places to watch, there are some cases but its contained, here are some places, do not travel unless its essential. Staying informed is the best thing people can do. Hats what i would advice. I see what youre getting about when you ask the question what you should do. They were saying nothing that you should do right now but if it comes to the point where were going to have to respond with mitigation, these are the kind of things you might be thinking about, you might have to do. She wasnt telling you anything that you needed to do now. So you need to do nothing different than you already are doing but she wanted, in the realm of transparency, to let the American Public know, if we need to mitigate, these are the kinds of things you might want to think of. Thats why i think theres no incompatibility with what were saying here and what she said. Reporter hi. I want to ask about the influenza Surveillance System and the use of it, and if youre seeing an increase in flulike or pneumonia symptoms that test negative that may indicate the coronavirus may be spreading . And when do you think the sentinel system for the coronavirus may be up and running . Dr. Schuchat what we are doing is adding a test for coronavirus to individuals presenting with influenzalike illness. Were still in the midst of influenza season and a high proportion of those sess mens are showing influenza of one type or another. As we add the coronavirus, we hope to detect before it gets widespread the occurrence of this if it is out there in the community. Were already beginning this effort in five states, thatll be kind of rolling out over the next couple of weeks and learning from that how to expand it throughout the nation. So essentially its adding the preliminary Chain Reaction test for coronavirus to the other testing for influenza that the Public Health labs are already doing in this influenza Surveillance System. Ecretary azar ok, one more. In the back there. Reporter im with the voice of america. Just for a reality check, i would like to see the a comparison between the lethality and transmissability of this Novel Coronavirus with influenza, the current strain thats going oaround and i would like to also find out if during the ebola jut break, that was between 2014 and 2016, the c. D. C. Helped the liberian government run p. S. A. s about how to protect yourself from getting this. Given the fact that an m. I. T. Study just showed that only 6 to 7 of people wash their hands properly, meaning 15 seconds with soap and water, are there any plans for that . Secretary azar dr. Fauci . Or dr. Schuchat . Dr. Fauci a standard flu season, season of flu, the lethality is 0. . Is 0. 1 . Right now the lethality for the current Coronavirus Infection is around 2 . If you do different studies coming out, 2. 5 , 2. 6 , 1. 9 , about 2 . If you compare it to the sars ut break it was 9 to 10 . If you go through the history of pandemic influenzas, depending upon the year, anywhere from. 5 , to when you get to the 1918 its 1. 5 to 2 . Dr. Schuchat in terms of Consumer Education and hand washing, we are always trying to promote hand washing. Thats a core message for child care kids and for the American Public during influenza season. I would expect to see more of the types of approaches to promoting hand washing. Perhaps try to integrate a little bit more of the innovative approaches and not the old p. S. A. Approach. Secretary azar thank you all very much. Well keep trying to do the briefings, i want to make them as regular as possible so even the media have access to us to get your questions answered. We have our regular c. D. C. Morning briefings, approximately two to three times a week, as well as other events where weve got, i think every single day Senior Leaders out in the media. Were going to keep doing that to make sure were very available and keep giving you information and assessment. Thank you very much. I want to talk about the response to the coronavirus outbreak. Our First Priority is to protect the homeland. We have imposed prudent travel restrictions. American carriers of the coronavirus are in isolation and treatment. Censorship can have deadly consequences. China permitted its own medical personnel and journalist to investigate freely, other nations would have been far better prepared. The United States is deeply concerned by information indicating the Iranian Regime may have suppressed vital details about the outbreak in that country. As of yesterday afternoon, iran was second only to china in coronavirus deaths. All nations, including iran, should tell the truth about the coronavirus and cooperate with International Aid organizations. Senator speak to reporters on a u. S. Response to the coronavirus. What i have to say to you has been publicly reported. I will not say anything that is secure classified. We are heartened by the fact that the number of reported cases that originated in the united