Worst Case Scenario is over 2 Million Deaths, which is horrifying. Doubling down on Public Health measures, social distancing, handwashing, those numbers could be lower. These are appropriate estimates by dr. Fauci. We do not know what the future holds. So much depends on how much we follow the guidelines. You have been speaking a lot about the pandemic of 1918. I want to put two numbers on the table. 50 Million Deaths in 1918. Deaths as a 675,000 result of spanish flu. You have pointed out we have not learned the lesson from a century ago. This comes as part of our regular Public Health history and we need to be prepared as much as possible and learn from the past experience. In 1918, 6 175,000 deaths in the thatry but we learned social distancing works. Entists have studied social distancing was implemented immediately and they had much lower death rates than in philadelphia. We need to understand what social distancing can do and apply measures today to save lives. Hear the term bending the curve, what data do you look at . Dr. Koh we are in a situation where cases and deaths are still rising. We have the highest number of cases in the world in the United States and deaths that double every three days in the u. S. Alone. Gic deaths today curve and getting on the other side of the break epidemic will require seeing webers go down and then might be able to roll back guidelines but now is the decision to extend the guideline for another 30 days was the right decision and scientifically the only decision that could be made. The president says he hopes the economy will be back up and running by june 1 and someday we will get past this pandemic, even though it might come back later in the fall. What lessons can we take away . What mistakes can we apply for the future in terms of federal response on public response . Future, we need to invest more in Public Health prevention and preparedness. State Health Commissioner through 9 11 and anthrax and after that we saw tremendous attention to prevention, treating, education. Then,unately, since attention has waned. Right now we have so many challenges with testing and getting the government to work to protect people and i think we are finally seeing some progress. We need to wrap up testing and continue testing special populations. By extending regulations for another month and doubling down on Public Health, we could get to the other side. Many have pointed out there were a lot of bureaucratic delays in terms of Public Health response. Someone who served as the assistant secretary for hhs, how do you correct that . Dr. Koh better planning and coordination and training in the future. Us have been involved in government and academia in the community and seen exercises and time wherebut in a there are so many Public Health threats with respect to opioids, tobacco, Mental Health and other issues that make up in average Public Health day, often we do not spend a moment to prepare for the future, which is desperately needed. So i hope as an outcome we see dedicated attention to prevention and preparedness Going Forward. Passedkage Congress Just should be a great help to hospitals and the community. Attentiond sustained to all the things Going Forward. Koh is on therd line and served in the Obama White House as the former u. S. Assistant secretary for health and human services. We will get to your phone calls and a moment. For you personally, how is it impacting your life . Dr. Koh i am fortunate because i am a professor now so i get to teach classes online. I get to keep running my research and grant opportunities virtually so i am fortunate but there are many others who are not as lucky as i am. I am very respectful and appreciative of the Frontline Health care workers and the hospitals right now. They are in a battle and need our help and support. I am also grateful to all the people running essential businesses in our communities. Stations,ore, gas people making the economy go forward one day at a time. We need to support one another while staying apart. Anything your students are asking that gives you pause . Is that a Silver Lining everyone now understands the importance of Public Health. It is a hard concept to understand but it protects Peoples Health 24 7 and it works. Just have a normal, healthy day when it works and you dont appreciate it. But in times like this, you get to see what Public Health can give to each person. The gift of health. How important it is to protect the health of a person. This pandemic reminds us of that and i hope we can learn the lessons Going Forward. Host what is it about this virus that makes it so insidious . Dr. Koh it is a new novel it camerus and when into our country we had a late start in terms of getting testing and surveillance and coordination. It quickly grew. It is rising at exponential rates. Data with respect to cases and deaths. This is always a threat in the background. These pandemics are happening now and will happen in the future so we have to be better prepared Going Forward. Questionss get some for the doctor. He teaches at harvard. Sarasota, florida joins us. Good evening. Thank you for your time. Healthy but may have had exposure, we followed quarantine guidelines and are quite ill at the end of january. Test showrent exposure or current virus, and , shouldows exposure blood or plasma donations be offered . Exposed, youou are can quarantine yourself. That means you are exposed but not necessarily infected. After 14 days you can lead quarantine. What we need to track is if you get sick, you have more than 100. 4ymptoms, over temperature and shortness of breath. At that point, connect with a Health Care Provider and get tested to see if you have it or not. News is testing sites are popping up everywhere in every state and we are trying to keep the testing sites away from Embattled Health care systems with drivethrough facilities. I am hoping all those options are available. Host lets go to maps in naples, florida. Us how manyell hundreds of cases and of deaths [indiscernible] dangersinimizing the that were created by this epidemic . Agrees theeryone response has not been timely or optimal. We are making progress and making up for it but the testing , for example, we have close to one million tests but we need many more. We need the best coordination between the State Government and federal government right now. Governorsant to see bidding against one another for bidding governors against each other for supplies. Coordination is critically important. Planning is important Going Forward for every hospital, state, and federal government. Host this is a related tweet. Mike says, up until two weeks ago, there were professional sports and celebrity events going on and no one mentioned people dying and now all of a sudden it is a catastrophic situation. Can you touch on those points . Dr. Koh this is the danger of this virus. When it grows, it is exponential growth. Right now we are having some discussion about highrisk and lowrisk parts of the country but lowrisk today could be highrisk tomorrow. So we are moving quickly. If you are living in a part of the country that is considered low risk, stay ahead of this and get as much prevention and proactive Public Health in your Community Working with leaders and mayors, this is the time to do it. The representative woke up sunday morning and was feeling ill and lost her temper her sense of taste and smell and those are some of the early signs, with cramping and fevers. She is one of the members of the house and rand paul battling illness. What will Congress Need to do in the future in terms of how they operate for the next five or six weeks . They wont be back until end of april at the earliest. Dr. Koh congress has passed three release packages so far. Its important. It is important to consider the package is a start because we do not know what the future holds. Hospitals have been under tremendous stress anyway before this started. Public health has been under resourced for far too long and 24 7 so iem working Hope Congress takes the opportunity to track this every day and try to keep generating resources we need. Host lets go to shelby and ohio. Good evening. Hello. About symptoms, how do you know what the symptoms are . Do you have vomiting or diarrhea like with the flu, or what . Steve just summarized key symptoms. Fever, cough, shortness of breath. There are some gastrointestinal symptoms. Diarrhea and other g. I. Symptoms. Could feelnning, he like a common cold or the flu. It could feel like the common cold or flu. Stay in touch with your health care professional. As it gets more uncomfortable for you, your doctor could recommend you get tested. You iscation between important. Also go toan coronavirus. Com for a list of symptoms and questions that can be answered. Do to says, what can you help yourself if you have the virus and you are at home . Is there a way to treat symptoms with overthecounter drugs . Dr. Koh if you are infected, go into isolation. You need to be in a separate room from everyone else in the house and hopefully have your own bathroom and make sure utensils you use are separate from everyone else. Practice as much distancing from others in the house as much as possible. , we are hoping you could then be a source of support for others. Isolate yourself if you have the virus. Host Johnson Johnson announced testing for a vaccine could come as early as september. What does that timetable tell you is a Public Health official . Dr. Koh tremendous efforts to try to accelerate vaccine production now. Dr. Fauci has talked about this. His best projections are a year or more might be needed to get vaccines for the general public. So the projection you are citing sounds early to me, but you never know. We have tremendous expertise in the country. Is the time where the u. S. Is leveraging their tremendous scientific power. We have research for a vaccine and new therapeutic innovations so we are hoping when we get to the other side of this, we will have effective vaccines and treatments Going Forward. Hosta is joining us in north carolina. Retired Infection Control nurse and prevention nest and i am returned and all the i am surprised all the coverage i have seen on tv i of thet heard mention Infection Control department and the nurses and the role they play and it is a very Important Department and they are unsung heroes. They are always dealing with these things. They do pandemic plans for the hospitals. I am surprised with this 24 7 coverage that i have never seen any discussion of their role. Dr. Koh thank you for your service and commitment to these very important issues. I agree with you. The frontline workers in the hospitals are heroes and Infection Control experts like you are tremendous champions for prevention. Over recent years we have had much more attention to decreasing infections in hospitals. Disinfection of facilities like hospitals is very important in times like this. Hospital administrators are key and we need to keep hospitals as infection free as possible and keep the risk down for doctors, nurses, and patients and make is practicing disinfection measures at home. Host from Winter Springs florida, good evening. I have a question about social distancing. Theyafraid eventually when open up the world to restaurants, businesses and we can go back to work, i will be scared of a catastrophic plague system where tens of millions of people will die because the virus is not going to go away in august or september. So it is a big fear when we go back to normalcy that this could be a plague situation with tens of millions of people dying. I want to get your thoughts on that. Dr. Koh thank you for your question. That is why it is so important to follow the science and trends. We cannot open businesses right now because the trends are going up. Once they start going down and we see transmission has slowed, its time to open up and it is important to gain the confidence of people like you when we resume our normal lives. That ifeen well studied you are infected, you have a chance of infecting two or three other people. If we cannot down the number two below one, that is what social distancing does, we can make the infection go down and hopefully fade away. That is the goal. Once we do that and we show the best science possible and earn the trust of the public, we will gain the confidence to reopen businesses and schools and get back to normal. Host what do you say to parents of Young Children who want to go outside and play with their friends . Dr. Koh going outside is fine. As long as you stay 6 feet away. This is not the time to have. Arties with other kids teaching your kids that prevention and committing to helping other kids is one of the lessons by staying away because of health reasons. It is a very important thing for parents to teach children right now. Host terry from north dakota, good evening. Thank you for taking my call. I appreciate cspan and your guests. To keeping was back medical workers and First Responders healthy. So much the president has said so much about how did we go from meeting 20,000 needing 20,000 masks to 300. How can we explain to that man so that he realizes if 20 people are sick and we have all of the workers who are changing their masks so frequently, what can we do to help other people understand there is this shortage of masks when we are using so many . Dr. Koh you are absolutely right. This is a time where we need to be careful how we use masks and get respirators. There is a shortage throughout the country. We need to preserve use for Health Care Workers on the front line. This is why we recommend the general public who is healthy to not use masks. They are reserved for those who are sick or caring for the sick. Stockpile and generation of more, hopefully we can get to a butt, we have a shortage, the issue of personal protective equipment is huge right now and we have to be very careful to protect frontline workers who are working day in and day out in hospitals. Host our focus is the Public Health threat from coronavirus. Tomorrow we will talk with the mayor of seattle and governor of maryland to talk about public response. Russell in illinois, good evening. Good evening. My granddaughter is a nurse in the hospital and was exposed to the virus. They did not know the patient had it. Now she is experiencing some of and the hospital told her to stay home. It will not test her they will not test her. She has to go to her personal physician and might schedule a test for her. I think there is a shortage of sucks and the hospital the way they are doing this. All, manyirst of thanks to your granddaughter for her commitment to care for others. The fact she is quarantining herself is appropriate. If she had no symptoms at all it is appropriate she not be tested but any level of symptoms, she needs to talk very closely with her health care professional, her doctor, especially if her fever gets over 100. 4. As the cdc has updated guidelines about who should be tested, Health Care Professionals are in a priority one group. So those factors might come into play when her doctor recommends whether or not she gets tested. ,ost sherry from pennsylvania you are next. Pharmacist, ias a understand we are essential workers and took the oath to protect the people. Have aconcern is i preexisting lung condition and im concerned about losing my job and feel i should be protected with a preexisting condition. Risk with these conditions. As a pharmacist i think it would be nice when zones become hot, that the pharmacy has a drive through that we remain open but only through customers picking up prescriptions through the drivethrough. Dr. Koh thank you for your service. Pharmacists are on the front lines. If you have a medical condition you feel puts you at risk, is something you should confirm with your doctor and talk with your employer as soon as possible. It could be an option that perhaps you do Something Else in dealharmacy that does not with directly interacting with customers. I do not know how many other jobs you could fill but these considerations are very important and if you have concerns about that, please talk intensely with your doctor and employer. It is very important. Host a tweet from david in says, has isolation meaningfully reduced other diseases, especially regular flu . Dr. Koh absolutely. A Key Foundation for Infectious Disease is identifying the infected person and isolating contacts. Racing when the cases were lower in the country, that was the initial on. Tegy that we embarked ,hose key principles identification, isolation, are killers for Public Health prevention. Soht now the country has much disease, we are into the mitigation phase. Hopefully at some point as we get to the other side, we can go back to the contingent phase that involves identification, isolation, and contact tracing. That would give more attention to Public Health staff and communities and that is why Public Health work