With the pandemic. Governor larry hogan is joining us from annapolis. And we will talk with the mayor of seattle, washington. First we will talk with an Infectious Disease specialist from Boston University school of medicine and Public Health, and we want to hear from you. Open. One lines are if you are a medical professional, we would love to hear from you. Send us a tweet and we will read it. Or on facebook. Good tuesday evening. We will walk through the numbers from Johns Hopkins university, indicating there were 785 deaths in the single day in the u. S. The total confirmed cases around the world, 855,000, more than 42,000 deaths in the u. S. , leading the world with well over 180 6000 cases of coronavirus. Is dr. Us in boston benjamin linus, an Infectious Disease physician and a professor of medicine in epidemiology at the Boston School of Public Health. Thank you for being with us. Let me begin with the numbers that again, between 100,000, 240,000 potential deaths in the u. S. Alone. How did they reach those numbers . Guest they are staggering numbers. I am on as a doctor but i think i have to react just as a person. It is very upsetting, these numbers rival deaths in the vietnam and kia and korean war. Scientifically, what we are experiencing is this is what it means to have a pandemic with 1 mortality. There was a time several weeks ago or month ago where people were debating if it is not so bad, 99 of the people recover, is not so much. This is what it means to have 1 mortality. It isa lot of people when a novel virus and theres no immunity in the community. It is difficult to stop transmission, and 1 is a large number of deaths. Host as somebody who studies Public Health and this virus, what are your questions . What do you want to know about covid19 that you dont know tonight . Guest one thing i think we really need to find out is more about longterm immunity to the virus. With thery preoccupied crisis and the surge, and trying to stabilize our hospitals for what is coming. I think we are making progress, but if we think one step ahead, the big question lingering on everyones mind, how does this in . What does it look like when we come out of our houses . Until we have a vaccine, how can we come out of isolation and physical distancing and feel comfortable we are not going to have a rebound . It is theoretically possible. I think we need to learn a lot about the immune response of this virus. How neutralizing are the antibodies people make after theyve been infected, how long do they last, what is the possibility of a vaccine . These are the things we need to know to have an effective strategy to end the epidemic. Host part of that strategy is communication and Public Health. If you could turn the clock back to early or mid january, what do you think should have happened that did not . Guest what happened in january is not an immediate recognition of the fact that this is a novel, potentially pandemic respiratory virus. This is a scenario that Public Health experts and emerging pathogen experts have been thinking about forever. We know this can happen. Things like sars and mers in recent memory. To recognize and has real potential for danger, and jump into action. That doesnt necessarily mean we should have been social distancing from day zero, it we should have been rolling out testing more effectively so we had a shot at isolation and containment. On to mitigation where we are trying to minimize the damage being done now, but early on we mightve had an opportunity to contain it and end it. And weve done that in the past. Sars was very scary. It was a little like the coronavirus, but 10 times more fatal. We avoided that epidemic. I wish we had been more active with their containment six weeks ago. Ist dr. Benjamin linus joining us via zoom, he is associated with the Boston University school of public medicine and health. Ron is on the line from new york. Good evening. Caller i am just curious if when the warm weather comes, if the virus can be passed along by just getting a mosquito bite . Host thank you, we will get a response. Guest there is no evidence the virus can be passed by a mosquito bite. It is an upper respiratory virus and we know the transmission is from what we call aerosol droplets, from coughing and sneezing. D spit droplet that comes out. It does not hang in the air and its not really something that is circulating such that you could pick it up from a mosquito bite. I want to reassure him, that is not in our future. Host how is the Boston UniversityMedical Center preparing . They are already in the throes of this, but preparing for the worst in the weeks ahead . Guest we are doing everything we can. We put a lot of systems into place for officially testing people, thinking about the way patients move through the hospital so we can isolate those infected, take good care of them, but also keep people not infected separate, and work thinking about how to keep our staff safe. Were we are we are working hard and treatment protocols. All of the hospitals around boston are working together to think about protocols. As much as this is an anxiety isvoking time, it scientifically and professionally thrilling to see the level of science and the level of collaboration going on around the world. There is really so much activity right now going on with trying to figure out the best treatments and how we can help people infected. Host is what we are seeing right now in new york going to be repeated in boston, cleveland, philadelphia, and other large melt metropolitan areas . Guest i wish i could answer that definitively. No one really knows the answer now, but i am hopeful, and not just naively so, that new york is facing a specific set of difficult challenges that are somewhat unique to new york. How densely populated new york is, its heavy alliance on public, mass transportation, and not as much space for so many people. I think other cities can hopefully avoid that outcome. We are going to see, but i want to be hopeful the answer is no. Host the president with a tweet a short while ago, 30 days to slow the spread. He advises allamericans to stay at home for the month of april. Many states having stayathome orders intimate and some into early june. Eugene is joining us from new jersey. Good evening. Caller yes, i am really alarmed at what is going on in new jersey. I have been a lifelong democrat said, life, so i they are only testing four hours a day even though new jersey is supposed to be the second worst hit by the disease. I tried to, governors office, because i contributed to his campaign. I could not get a person anywhere. I tried to, Representatives Office in washington. I could not get a person. I tried to call my state senator and could not get a person. What is going on . I am not a conspiracy theorist but this is dreadful. I am thinking, if i had the disease and was trying to contact someone and i could not get anyone, and then why is camden working on bankers hours . Stations inesting new jersey and camden is testing p. M. 12 00 until 4 00 host we will get a response. Guest thats an outstanding question. I cannot comment on camden specifically or your elected officials but i can comment on testing. You have your finger on a big problem. We are still behind in testing. There was a time a couple of weeks ago we were having a hard time getting test even in hospitals, there were patients who did not have test results for eight days. , where ial settings work now, we are able to get tests. We would like to have a onehour rapid diagnostic and i think that is coming, we now have a 24 hour diagnostic. If you are sick and you come into a health care center, you will get tested. However, what we dont have now, and as you point out, is Widespread Community testing. I dont see how we get out of this epidemic until we are at the point where we have Widespread Community testing for anybody who had any system or risk of exposure. If we dont see that, we are behind. We see that in the numbers now, because what we call a positivity rate, the percentage of tests we take that is positive is still far too high to suggest we are doing enough testing. As we start to roll out more and more testing, you would think we would be testing more and more negative people because we are expanding the pool of people being tested and we havent seen that yet. We need to see that if we are going to end this. Thats the only way we get containment. Host william, you are on the air. Caller thank you. With, my question deals older individuals such as myself trying to get medications from my Health Care Provider that under law are restricted. , and imultiple sclerosis deal with a lot of pain. I used to be a republican a long time ago and now i am a democrat. Beingnestly, i am a human and i am trying to selfisolate. Provider isre making that almost impossible in to gethave to go my meds once a month. I am asking for a two month supply and i cant get it. I dont understand why health care is putting me at risk. Host thank you for the call and good luck to you, william. Guest i am very sympathetic to that situation, and i am assuming from the question that the medication is some sort of painkiller. This is a topic very near and dear to my heart because still, but prior to the covid epidemic, the main focus of my research was this. Other people experiencing this our folks in recovery but potentially taking medication for opioid use disorder, and they are having similar problems. If you are on methadone, in normal tones times, you go to your methadone enacted what you do your methadone clinic every day. What do you do . Healthful issued some helpful guidance on methadone. You can bring home a one or two week supply and not have to come in every day. I think youre provider in thinking about a pain medication is trying to balance a desire to help you to stayathome and at the same time wanting prescription safety. Before we had an epidemic of cobit and we still have an epidemic of before we had an epidemic of covid19, we had an epidemic of overdoses. Frankly, i dont know the exact right answer for how many opioid medications we should be giving to people to balance out that not difficult situation of wanting you to come out of the house but not wanting to flub the prescription opioid situation. I cant speak for your provider, but i would imagine those are the things in his or her mind, and i think you have to have an honest conversation with your doctor about that. Host we welcome our listeners on cspan radio. Our guest is dr. Benjamin linus, from boston Universities School of health. The task forceg is considering the possibility of asking all americans to wear a face mask. Is that beneficial . Guest you know, i dont think anyone knows that answer. Whetherthink we can say facemasks and public is helpful. I will start with the easy part. To the extent that that guidance causes a rush on facemasks in the community and causes competition in community settings, then absolutely not in my mind. Ofre is a very real risk inhospital transmission now that is occurring even with masks. When healthcare workers become infected, they can affect infect other patients come and the virus spreads in the community. We know that is real. And to the extent that guidance for public masks is going to limit our masks and hospitals, i think we cannot possibly go in that direction. The harder question is ok, fine, but if we are able to wear masks in public and also in the hospital, is a beneficial . Going in that is directions and other countries have done that. I cant tell you the exact answer. I think with all things, not just masks, a lot of questions come my way about the safety of delivered groceries, things like that. It is important to make a difference between what is theoretically possible and what is happening in the real world. The virus is driven by respiratory droplets. It is driven by people sneezing or coughing in close proximity and enclosed rooms. It is spreading in workplaces and in homes. Potentially in the subway and places like that. Its not really being spread by the specter of a secret vice floating in the air while you go youra walk or is on grocery delivery on a piece of plastic. But these are the things the imagination can see and of course it is theoretically possible but that doesnt help us. I want you to remember that you can always dream up scenarios, but what we have to do now is stick together and listen to the data. Host melissa, thank you for waiting. Thank youllo, dr. , for speaking to the American People about this plague on our great nation. I just want everybody in america to take time to pray more frequently for each one of us, if a want to ask you, superhuman has the virus, can they give their plasma and help some deals . Guest thats a fantastic question and the nih is asking that question right now. There is some evidence that if you give monkeys plasma of a monkey that has recovered, it can be protective. I dont know all of the details of the protocol but there is a study going on right now with plasma from people who have been infected who produced antibodies, and administering that. Theres also a large effort in the pharmaceutical industry to synthetically manufacture those antibodies. You can imagine, that is a better approach if we can do it, because we can manufacture a lot more than we can harvest and we dont have the issues of putting human product into another human. It is a strategy we are pursuing heavily right now. We will have to see what happens. I think there is reason to be hopeful. Host finally, the timeline in terms of a vaccine what is your guesstimate . Guest 18 months . Its not a given that a vaccine could necessarily be invented. This, i haven do some colleagues who are some of the smartest people i know, incredible scientists working on this. I think we also have the entirety of the american pharmaceutical industry, and a lot of ingenuity behind this. I think we will get there. If we do, i think it will take about a year and a half. We might be able to speeded up a little bit because of the urgency, but it will be one of the single greatest scientific achievements in history, and i will go down now that whoever gets the vaccine should win the nobel prize. Host thank you for your time and expertise. Hopefully we can call you again, dr. Benjamin linus affiliated with the boston Medical Center and a professor of medicine and epidemiology at Boston University school of medicine and Public Health. Thank you. Guest thank you you, good night. Host youre watching the primetime addition of washington journal, we are back every morning at 7 00 eastern time. Governor larry hogan joined us from annapolis earlier. A reminder, in a couple of minutes, we will check in with the mayor of seattle, washington, to continue the primetime programming. Host how is your state doing . Guest we are trying to deal with that the best we can. Host the president said we are in for a very painful two weeks ahead. You are talking to the experts, just how painful . Guest i think it will be pretty painful. Theelieve that here in maryland, dz and virginia area, we are maybe about two weeks maryland, d. C. , and virginia area, we are about two weeks behind. We expect dramatically escalating numbers in our region and we are dealing with the same issues everyone around the country is faced with, looking at hospital surges and the lack of availability of ventilators and personal protective equipment and masks, testing. We are working around the clock with a dedicated team of incredible people that are trying their best to save as may lives as they possibly can and keep people from getting sick. Host there was a story in the Baltimore Sun that at least one pastor is going to continue to hold Services Despite the order you put in place this week in maryland. What do you tell that pastor and others who defy the order, the stayathome order . Guest i havent heard that report, but we will make sure that does not happen, because it is against the law for them to hold any kind of a gathering over 10 people, and we will make sure the state or local Law Enforcement will shut that down. Host we also heard from governor andrew cuomo, indicating the states are competing against each other in terms of getting these ventilators, and now fema is getting involved. Have you had that problem in maryland . Guest it is sort of an issue not just with the ventilators but with all of the things, from the white house and the folks at the federal level, theyve been saying the governors are on their own and they should go out and secure these things on the open market. Which weve all been trying to do. But governors are all out there trying to compete for a very small number of these various have the and so now we federal government and each of the states and other countries trying to compete for what is basically not enough of all of these various things that everybody desperately needs. I think we are having discussions with all of the nations, governors and the federal government about how to set up a better system and improve that. Weve got to figure out how to best allocate some of these limited resources, and this overwhelming demand. The bottom line is there just are not enough to go around for what everybody desperately needs. Weve got to figure out the best way to fix a really bad situation. Host how would you fix that after the pandemic is over . Guest i think in the future, weve got to be better prepared both at the federal and state individualour Hospital Systems and hospital levels. I dont want to monday morning quarterback and take a look at what went wrong 10 years ago or last year or last month or last week, i just want to focus right now on what we can all do ether to do the best while best job we can for today and next week into two weeks from now, so we can make sure we dont lose so many folks in america. After this is over with, weve got to look at what happens when this thing comes back again in the fall, or when we have another pandemic. We cant be caught flatfooted like this again, it cannot happen in america. Host a nursing home in mount airy, maryland had multiple cases, i believe more than 60. What happened . Why so many . Guest it is a tragic situation. One of the most difficult things we have been dealing with, and it is very similar to the situation in the