Website and look at how states were prepared or not prepared for this pandemic. As you look across all 50 states and u. S. Territories, where were the missteps . John well i would start by , saying that federal funds have decreased. The funds that provide states resources they need. To prepare for an emergency like coronavirus. After 9 11, we saw a dramatic increase in Emergency Preparedness funds made available to states and local centers for the rest of the country. Over the years, those funds have been significantly decreased. The Public HealthEmergency Preparedness fund from the cdc that went to the states and big cities actually decreased by a third. The hospital preparedness money that helped Hospital Systems prepare for an emergency like the one we are facing have actually been cut over the years by 50 . A starting point in terms of assessing how well states are doing is recognizing that they have lost some valuable resources over the years that they need to be prepared. Host im going to refer to a piece this morning in the washington post. What comes after the illness. He makes a very simple but important point. That is the pandemic is making us realize health is not just an individual issue. John well, absolutely. I think what we have learned very dramatically is we have a responsibility to each other as a society. And that people need to not just be thinking about what is in my best interest but recognize that , particularly with highly infectious illness like coronavirus we need to take a communitywide approach and think about protecting each other. We are seeing that playing itself out i think around the country as people go into social isolation and social distancing and begin to think about how they can protect their own health but also protect others. Host another story that has been getting a lot of attention com,is available at nytimes. Front page of the newspaper. Blunders costing a vital month in the fight against this pandemic, blaming not only flawed kits but also lack of leadership at many levels and bureaucracy and red tape. Why did this happen . Why so many missteps leading to where we are today . John well, i think it is a complicated story. Part of what we were facing was a brandnew virus, one that has not been seen on the globe. And so there was a lot of complications just in starting up and becoming familiar with the virus itself. Clearly, there were problems at cdc with the test that it has developed. It was not able to be used in the normal Public Health laboratory system. And so, and then when it needed to be adjusted and fixed, it took weeks before that happened. And when you are fighting an epidemic like this, losing weeks is very serious. Because you lose the ability to control the epidemic by initially identifying early cases, containing them, keeping the virus from spreading. So those lost weeks that were associated with the faulty tests and too narrow a definition of who should be testing. Initially, there was a recommendation that only people that had returned from china or had been exposed to someone who was already sick should be tested. And that too narrow of a recommendation meant we were not able to get a clear enough picture of how the virus was spreading through the country. Host what are the lessons as you see what is happening in new york, california and Washington State, and how can they be applied to other states . John it is clear that you need to get ahead of the virus as much as possible. In those parts of the country where they have not seen many cases, it is important to do what in the Public Health service is known as containment. That is find out as quickly as possible where the people are who are infected. And then do contact tracing. Contact tracing involves figuring out who they might have exposed. Contact those people. Get those people in isolation. In the places where there are relatively few cases, you want to aggressively address that containment approach. However, in places where we are already seeing large numbers of cases like detroit, louisiana chicago, containment is not , enough. You have to focus on mitigation. Spreads widelyit through much of the population, you have got to have in place advisories or shutdown orders that keep businesses closed and encourage all people to stand people to stay in their homes for a few weeks. You really need to have different approaches depending on where you are with the infection rates and where you are in the number of cases. Host and to that point, this is a headline from the ap. The virus hotspots growing in middle america. Here are some of the details. The coronavirus continues its unrelenting spread across the u. S. With fatalities doubling in two days. And authorities saying on saturday that infant who tested positive had died. It pummeled big cities like new york, new orleans, and chicago and made its way too into rural america. As hotspots erupted in small midwestern towns and Rocky Mountain ski havens, a cluster of three counties in rural indiana have had a surging rate of confirmed cases. One of them, decatur county, indiana, population 26,000, had 30 cases with one confirms ed death. In idaho, a scenic ski haven now has around 100 confirmed cases of covid19, the highest rate per capita outside the new york city area. Two people have died. My question, does this surprise you, what we are seeing not only in the hotspots but in every state of the country . John it is not surprising. We knew this was a highly infectious virus. We have seen it spread rapidly in china, in europe. And so it is not surprising that it is spreading quickly around the United States. But we are a big country. Where communities are is different, and it is important to do an analysis of where each unity is and get ahead of the infection if at all possible. In places where they have not seen many cases yet, it is important they take aggressive action in terms of testing, isolation, contact tracing. In places where it has spread already to the public, they have got to focus on more aggressive efforts to control the spread, to try to bring down the number of cases and flatten the number of cases spreading quickly. Host website is trust for Americas Health. Our guest is the president and ceo of that organization, which is what . How do you define trust for Americas Health . John we are a nonprofit, Nonpartisan Organization that is focused on prevention and Public Health. We are an independent voice that works with policymakers and also educates the public so they have a sense about what they can do to improve the health and wellbeing of the american public. Host lets get to your phone calls. Bob is joining us from texas. Good sunday morning. Go ahead. Caller good morning. Bill thank you so much. , let me explain to you why we are at this point. Khrushchev of russia said years ago, we will destroy the United States without ever firing a shot. Well, they were not smart enough, but the chinese were. All of our chambers of commerce which is all over the country was the 1909s 1990s was shipping out jobs overseas and telling manufacturers it will cost you pennies on the dollar to have slave labor do this. We shipped out. I know about this. I wished i would have saved the paperwork on it. Have,yway, what do we people like beto tear the walls down, let everybody in this country no matter who they are, where they come from, or nothing else. And you know, all you have to do is think about it. We need to know what started it. That is the problem with this country. California burns up every year because they do not prevent forest fires. Host bob thanks for the call. , John Auerbach . John well, i think that what we have learned over the last few decades is we are going to see what we refer to as novel viruses, or illnesses we have not seen before. And what we do have in public is we have the tools to be able to prevent widespread infection if we use those tools aggressively. And so i would say the most important thing we can do in terms of containing new viruses like the coronavirus is strengthen our Public Health system so it is able to detect infection early and contain it. Host next is jennifer from california, maryland. Good morning, jennifer. Caller hi, good morning. Host you are on the air. Please go ahead. Caller i am calling because most of my friends and former colleagues are all talking about a citizens revolts they believe is going to occur in the u. S. Because most people only have one month of actual liquid savings or anything they can turn for draw to. Most people i know have already run out of money who have either been wiped out from their stocks or wiped out from job loss because unemployment is not reacting quick enough. And i was just wondering, a lot of people said the middle class will now be wiped out because the government is not reacting quick enough economically and nobody has buffers. They believe that i wanted to get your thoughts about the fact that the crime rate, everyone knows, is going to go up, and that there will be no more middleclass. There will now be a revolt and there will now be extremely rich people and then everyone else. Everyone i know around here works for the federal government and State Government in maryland. And they are just sitting at home pretending or acting like their internet is not working or like they cannot get secure connections from home. Nobody in government is actually working. So please respond to this. People are saying the government is going to can you respond to the idea that there will be no more middleclass and then there will be a revolt of everyone who has lost everything . Thank you. Host jennifer, thanks for the call. John, that may be a little bit offtopic, but if you do want to respond, feel free to do so. John sure. We have to acknowledge that there has been an Enormous Economic impact of the pandemic. And that is hurting many people. It is also uncovering the fact that we have had, for many people in the country, a limited amount of resources. People do live paychecktopaycheck. And in areas of the country where we have concentrations of poverty, we will see a greater impact of the coronavirus. Because people are already living on the edge, just paycheck by to paycheck. We need to be incredibly sensitive about that. Congress has passed three different coronavirus acts that have had a lot of money that have been included in each one, that have been intended to not only fight the epidemic but also ease some of the economic and social pain that people are experiencing. I think what your caller indicates is that may not be enough or may not be enough to get to people quickly. That is important to Pay Attention to. We know in Public Health that poverty is highly correlated with poor health. And so it is important for us to Pay Attention to the economic and social impact while fighting against the infection. You, i want to share with this is a headline from thehill. Com, quoting the british prime minister, boris johnson, who confirmed he is battling covid19, saying we know things will get worse before they get better. Is that the same situation here in the u. S. . John it certainly appears that way. We are seeing in new york and other hotspots around the country, that the pressure is dramatically increasing on the Health Care System as more people become ill. There are in some cases going to be insufficient number of hospital beds. There are not enough ventilators. And so it is a lot of pressure now for those hotspots to get ahead of the increase in terms of cases. We want to make sure that everyone in the country that gets gets the care they need. That is going to take a tremendous amount of effort. For example, we have seen a survey that just came out this week from the u. S. Conference of mayors that surveyed 200 mayors across the country. And they identified a need for tens of thousands more ventilators than are currently available. And millions more facemasks and other personal protective equipment. If we are going to get ahead of the curve, if we are going to make sure that as people get sick, they get the care necessary and that we are protecting Health Care Providers who are on the front lines, we have to pay a lot of attention to making sure ventilators are available, making sure personal protective equipment is available. And so creative approaches in those hot spot locations like new york to increase the number of hospital beds are also going to be necessary. Host from westwood, new jersey matthew, you are next. ,good morning. Caller good morning, gentlemen. Speaking of missteps, the worst was the communist Chinese Government refusing to tell the world about this until it was a bit too late. Also new york is number one with the cases, the worst, has the highest amount of cases, because mr. Cuomo and de blasio delayed shutting down the schools in the subways and and the subways until it was a bit too late. And steve, credit to cspan for showing the daily briefings with experts and president trump, whose Approval Ratings happen to be i believe 60 in this crisis because he has taken charge in effective way by consulting the experts and following their advice. The low rated fake news cnn is now refusing to show the daily briefings because they are like a child who is having a tantrum because the president happens to be doing the best he can under these circumstances. And with the military, with the medical People Consulting and making decisions on those bases. It is sad. I give cspan credit for showing the briefings. Host they are all posted on the website, by the way, if people want to check it out or go back to previous briefings. That is cspan. Org coronavirus. But matt please go ahead. , caller thank you. Thank you. Want to say [laughter] we are fortunate. President trump is not a perfect human being, but he is doing as good a job as could be expected under these circumstances. And we are praying also and doing what we can to help our neighbors, help our neighbors. Host matt, thanks very much for the call. Let me pick up on his point and go back to something the president has said and ask you, mr. Auerbach, what is the role of the federal government compared to states when it comes to an emergency like this . This is the headline from the washington post, trump pushing to open parts of the country as governors in hardhit states warn more needs to be done to combat the pandemic. Where is the line between the response by the federal government, the direction of the federal government, and the resources by the federal government . John the federal government has an essential role in a response like this. In other Emergency Preparedness crises and Infectious Disease outbreaks, it has been the centers for Disease Control that has been the key organization. Because you want an organization that is filled with scientists d experts and those who have been through Infectious Disease outbreaks before. As much as possible, an organization like cdc for expert guidance and for resources, the grants i was mentioning earlier that the centers for Disease Control have given to states have been critical in terms of building capacity at the state and local level. Level. As new funding is available, that is going through the cdc and to the states and locals so they have resources they need to respond. At the local level and state level are on the frontline. They know their communities. The are able to look at capacity of the Public Health system, of the Health Care System, and understand also the cases in their community and who is at greatest risk. You want your frontline people to be sensitive to the particular tease of their communities and take action. States and locals have come as parts of their authority, the ability to put in place a variety of advisories herein they play a critical role. Federal government can look at the information coming from the state and local level, look at it with a global picture, provide guidance, provide resources. It is a partnership. You need people working at all those levels. Guest richard, good morning. John auerbach is joining us via zoom from his home in washington, d. C. Im 82was talking years old. A lot of people are dying. Do we know for sure the virus is killing old folks . Are they computing numbers that everybody is dying . It makes me wonder. Every year, there were days somebody dies. It has since the beginning of time. A respiratory illness and can contract the lungs and cause people with other issues, especially if youre older or have previous existing conditions, make them more susceptible to death. I have a sisterinlaw do to pass away any time but there is no virus around here. We talk a lot about socialism. Socialism will save this country for a little while, but the government might be thinking about how we are going to feed everybody of things do not get better. That may be the next big disaster. We will go to joe next in charleston, south carolina. Caller good morning. I did not know until this morning that your wife is a nurse. I have said a prayer for her. Host thank you. She has been for 30 years. All the nurses and doctors on the front lines. They do a great job. Caller just a Quick Response to the last caller. I think there is been a misinterpretation across this country and maybe john could speak to this. I think if you develop pneumonia, that might be what it says on the death certificate. I think that sows confusion. As far as the response, im happy the cares act passed. I was disappointed in my senators standing up against Unemployment Benefits along with cruise and tim scott. And tim scott. Im concerned about the future. I am 72. I grew up standing in line for the polio vaccine. We finally eradicated polio, like smallpox. My concern is that after we develop a vaccine that some people will not take the thing. If we are going