Yesterday as well as the new york governor andrew cuomo. The headline in forbes, new york to begin Clinical Trials for coronavirus treatment. Doctor, what do you know about this treatment . And what are we hopeful for . Greta, thank you for having me on. There are potential treatments that are being talked about. Medications like chloroquine, to treat and prevent malaria. Hydroxychloroquine used to a medication treat diseases like lupus. Its thought that these medications do have antiviral and antiinflammatory properties. There have been some very, very small studies out of france and china demonstrating potentially these medications reducing the duration of symptoms as well as illness. And so what we really need now are Clinical Trials that make sure these medications are safe and effective to treat covid19. We also need basic answers to questions, such as who should get them, at what dose, for how long. So the Clinical Trials of these types of medications are absolutely critical. And what do you make of these trials, these treatments being sent to new york and theyre going to start tomorrow . Well, these are already fda approved medications. So theyll be used in an offlabel capacity and im sure hospital by hospital, some patients will be receiving these, but its really important that we collect information again and the Clinical Trial is the best way to go. Nih is doing this with other antiviral treatments. So theres promise here, but we have to be cautious moving forward. How would it work if these treatments are successful . Well, if theyre successful, then the fda would provide an approval and more americans would be able to get these medications. Depending on what the trial shows. So again, the questions are who would be helped . Is this for postexposure prophylaxis . Is this for treatment . Is this for individuals who are very ill or before they get ill . So all these questions need to be answered. But it could be very important, particularly given that we dont have a vaccine, we wont have a vaccine for 12 or 18 months. If any of these medications, either these are other medications, other antiviral medications, if they do pan out, then we would have access to that hopefully over the course of the next several months in advance of a vaccine. So what is the status of a vaccine and how would that work . Well, vaccines in phase 1 Clinical Trials have begun in the city of seattle with the nihs leadership. Individuals have already started to receive vaccines. The first step is to assess safety of the vaccine as well as the effectiveness. Can an individual ramp up their immune response . So does the vaccine work . And you really have to follow individuals for many, many months up to a year because its important that there arent side effects that we dont know about. So this is the process that will take many months, up to a year, and then you talk about the scaling up and the production of the vaccine and then the dissemination. So we really are talking about 12 to 18 months. That is the solution here, but we have a ways to go and until then, its all about mitigation and social distancing and protecting our healthcare system, testing, all of these things that were talking about now is really how we buy time essentially until we have a vaccine. Doctor, how do you respond to people who compare this to the flu . Go ahead. Its a great question. Its best not to make this comparison in the sense that we know that this is a virus that is more severe than the flu by any stretch of the imagination. The question is how many fold . We know that this is very transmissible on average. For every 1 individual with this virus, they will transmit it to 2 or 3 individuals if there are no precautions that are taken. We have no vaccine like we did with flu. We have no treatment like we do with flu. We have no immunity. The world doesnt have immunity. And so its best not to compare it to flu. This is a serious situation and its a bit of an apples to oranges comparison. I want to encourage our viewers to join in. If you live in the eastern part of the country. Mountain pacific. And medical professionals, we want to hear from you this morning, as well. What are you seeing on the front lines . I want to share this headline with you and others from the newspaper this morning, this is the New York Times. Loss of smell and taste may be a peculiar clue. On friday, reports from around the world called on adults who lose their sense of smell to isolate themselves for seven days, even if they have no other symptoms to slow the diseases spread. What do you make of this . Gretta its a good question. Every day almost every hour were learning more from case reports so i think it will be interesting to follow this still, the most common symptoms of coronavirus or covid19 are fever, dry cough, shortness of breath. Many individuals will have these symptoms. Theyll get better on their own. A minority will after several days get worse and thats really the time for hospitalization. Some individuals might have some gastrointestinal symptoms and other symptoms, but were going to continue to hear reports like this because everyone is going to respond differently when they experience when and if they experience the virus. What stands out to you, doctor, over the past few days . Even over the weekend, about the spread of this virus . Well, i think its best to look at three factors. The first is testing. The second is the medical surge and the third is social distancing. Just over the last couple of days were hearing progress on the testing front, more americans are able to get tested. Nowhere near the numbers that we need to and therefore, unfortunately, theres some rationing of testing going on. Theres some important developments related to point of care testing. So testing, theres progress there. We did lose quite a bit of time so we are behind the eight ball. When it comes to the healthcare surge, were hearing from the front lines, my colleagues, healthcare workers that they dont have the personal protective equipment that they need. Were worried about critical medical materials so theres a lot of material as well as equipment being deployed to areas, such as new york city right now that is a concern over the next several days. We dont want any situation in the United States just like wuhan, china, experienced or northern italy experienced, but i think the most important i think development is all americans really focusing on social distancing, and its really these Community Mitigation measures that are extremely. I mentioned that on average if nothing is done, every 1 person will transmit the virus to 2 to 3. What were trying to do is reduce that ratio all the way down to less than 1 because then we can slow the epidemic and we know this works. Data from seattle just a couple of weeks ago showed that social distancing interventions, canceling mass gatherings, school closures, teleworking, all of this reduces contact rates and a study from seattle showed that if you do this over the course of four weeks and you reduce contact rates by 25 , that can reduce new infections over four weeks by 60 . If you reduce contact rates by 50 , that can reduce infection rates by 7580 . If you can reduce contact rates by 75 , you can actually reduce the number of new cases. So we know this works and that is i think the central message of the American Public right now many of whom are at home, stay safe, stay at home. By doing that, you will be reducing the future healthcare surge, protecting fellow americans. What are you looking for, from congress and from policy holders in washington . Do you think, for example, that the president should invoke the president ial the defense production act in order to respond to the needs for healthcare workers . Sure ill take the defense production act first, and then ill take congress second. You know, in terms of the defense production act, what the president is saying that he will use the authorities of the defense production act when he needs to, when things get worse. And im of the posture that you have to use the authority of the defense production act before things get worse because you cant make masks and respirators and ventilators overnight. I think the voluntary commitments from the private sector are great, but without knowing whats required or needed, its difficult to know whether were meeting the challenge so i would advise the u. S. Government to be transparent and say all right, we are preparing for a potential severe pandemic. What is the gap . What are the amount of supplies needed . What are the specifications of those plays . Then you can ask the private sector voluntarily can you meet this . I suspect the supply and the capacity is not there and thats why invoking the full authorities of the defense production act right now are absolutely critical. In terms of congress, its imperative that Congress Come together in a bipartisan manner to pass this next stimulus just like they did with the second emergency appropriation a couple of weeks ago. All of these, in fact, are Public Health interventions, even though we dont talk about them, but all the social distancing, whether its unemployment assistance, whether its protecting workers, whether its supporting Small Businesses, whether its paid leave, all of these things make possible and sustainable the social distancing measures that are absolutely critical to modify the pandemic curve so it is imperative that congress bet together on a bipartisan basis and quickly get this release to americans so the healthy choice becomes the easy choice. Thats the principle. Doctor, if they dont act or it takes them all week to act, what is the fallout of that . How long does this go on versus quick action and what is your best prediction for how long this goes on . I think the longer that congress takes, thats less support to the American Public to Small Businesses to do the right thing from a Health Perspective so i think that is critical. We dont know how long this particular pandemic wave will last. We are certainly still on the upslope of the initial pandemic curve in the United States. We dont know how many months this will last. This could last up to 18 months if you compare it to past pandemic. There have been multiple waves over many seasons, up to 18 months. So we just need to take this one step at a time and do the right thing one day at a time. Lets get to calls. Joe, hillsboro, new jersey. Go ahead joe. Yes, doctor. I wanted to get your opinion on how you feel the government handled this as far as having supplies for our health aid workers and could they have been more prepared number one . And number two, its good to see somebody on there who has familiarity with some of these diseases instead of a politician talking on the phone. What can we take away to learn from this next time Something Like this does occur . Sure, a lot of questions there. You hope for the best and prepare for the worst. In the case of a severe pandemic, we need much more than we have stockpiles for. We have stockpiles, 10s of millions of masks and respirators. We will likely need hundreds of millions, maybe over 1 billion. We have stockpiled thousands of ventilators. If its a severe pandemic, we would need hundreds of thousands of additional ventilators. I think right now what youre seeing is deploying the critical medical material and personal protective equipment that we have, and i think that is ongoing, but i think we need to think moving forward that there is a significant gap, how are we going to meet that gap . The American Public want to hear from the scientists and early on, you know, there was this sort of image in the press conference with the president and all the scientific leaders in the backdrop, and i think many people said that it really should be flipped, and i think the American People want to know the science, they want to understand the facts and hearing directly from scientific experts like dr. Tony fauci is really important for the American Public so i hope we hear more of that directly from the scientists. Albert, clear water, florida. Hi, albert. Good morning and thank you for taking my call. Doctor, should we be cleaning our money and the mail . Its the most touched and circulated thing in our country, you dont know whether its coming from. Should we be cleaning and sanitizing our money . You know, thats a great question. Probably the best thing to do, best advice would be to continuously wash your hands. There have been some studies, not on money, not necessarily on mail, but a recent study that came out looking at how long the virus could potentially live on cardboard. Its about 24 hours. Metal and plastic about 72 hours. There are going to be more and more studies there, but i think the best advice is if youre not sure, wash your hands particularly after youre touching something that you dont know where its been or where it has come from. Susan in new york. Hello, doctor. Im very interested to hear what you have to say and i appreciate your comments, but i just heard you say that we would need over 1 billion masks and i wonder how as someone whos an expert in epidemiology, but not in supply chains and deliveries, you would seek to manage a billion shipments like that. But my initial question i came on to ask was how you felt this bipartisan fight in Congress Might impact the Financial Markets and its relevance to the supply chain of the 3,000 dosages that they are shipping to new york hopefully for the trial to begin tomorrow. Well, i think in terms of the supply chain, yes, we need a lot more personal protective equipment. And whether thats supporting current manufacturers or manufacturers who havent been in the space quickly mobilizing, its probably an all of the above strategy because clearly, what is there right now, if you add up all of our current assets in the Strategic National stockpile, what the military has, currently in the supply chain, that would not last us through a severe pandemic and so i think we need to look at all of these items. In terms of the connectivity to the economic picture, and the stock market i think right now again, the focus needs to be on the Public Health response. Everything else is reactionary so whatever we can do again to support the response, particularly focused on Community Mitigation and social distancing, that is absolutely critical. And if that goes well, then all of the reactionary elements will fall into place. And we showed our viewers earlier, cnbc reported breaking news that the fed is announcing new measures, the fed announces new measures to support economy including asset purchases in the amounts needed, main Street Lending facility, 300 billion Lending Program backed by the treasury will purchase certain corporate, municipal and Mortgage Backed debt, as well. So cnn is reporting that the futures market is responding well to what the fed announced this morning. The market opening up shortly so we will stay on top of that, as well. Dow jones future markets reacting just in the last three hours and they had a negative response to what the senate did last night failing to move forward on the coronavirus aid package. You can watch on cspan 2 as they attempt to take more votes today to move forward on this aid package. Doctor, i want to get your reaction to the New York Times front page headline. Officials race to stem outbreak as new york becomes the epicenter. A rapid increase in testing has revealed the extent of the outbreak. Community spread of the highly contagious virus now appears commonplace. All told, more than 15,000 people in new york state have tested positive with the vast majority in new york city region. That is about half of the cases in the United States. Worldwide, the pandemic has sickened more than 314,700 people. What are your concerns with new york . Well, i think in new york city, there are two reasons why youre seeing the spike in cases. One is just increased testing. Which is a good thing. And the second is simply its a manifestation of the pandemic in Community Transmission there. And absolutely there are a number of hospitals right now in new york city that have hundreds of patients and beds are filling up in the intensive care unit, taking care of patients who are seriously ill from covid19. I think Governor Cuomo very smartly has instituted his pause program, thats essentially a stay home, some would call it shelter in place. That is absolutely critical. I wish all states would do this, i think eight states have a Stay Home Order at this point and the idea there is to limit nonessential movement, nonessential travel. I think thats absolutely critical to reduce the surge that is coming. I worry about the front line healthcare workers in new york city what already are seeing shortages of personal protective equipment. I worry about the critical medical material like ventilators. Theres supplies being deployed there by the military. The question is will it be enough . Will our social distancing have been enough . Was it early enough . Those are i think the questions that were going to be seeing so right now, i think all eyes if theres anywhere in the country right now is new york city, whatever we can do to help our fellow citizens there we should do and all of us, its really again limiting our nonessential movement and travel, staying home, staying safe, but those i think are the things that i am looking at in terms of new york city right now. Okay. Ronda, sacramento. Go ahead. Yes, good morning. Thank you, doctor for taking our calls. This morning, here in the Sacramento Valley of california, as you stated we are on a stay at home order, but as of this morning, our local broadcast news is saying that those who are incarcerated, such as folks in prisons, they have been contracted the coronavirus, to employees at our local prisons, are also now affected. And the local hospitals up and