Public broadcasting series the report with legendary journalist marvin kalb. Im joining you from the Operations Center here in washington, d. C. Harris,t is dr. Patrice. He joins us virtually she is the first africanamerican woman to hold the position and brings to the role several decades as a physician in private practice. Took office in june of 2019, dr. Harris planned to pledge her work to the front line of the opioid crisis. Toay, dr. Harris is here talk with us about an entirely different Public Health crisis, why in this era of conspiracy theories and fake news she believes we must return to a reliance on scientific facts, data, and trusted sources. Dr. Patrice harris, welcome to the National Press club. Our virtual podium is yours. Thank you, greetings, i am dr. Patrice harris, president of the American Medical Association. The coronavirus pandemic presents a challenge the world has not faced on this scale for generations. Said thatn extraordinary times call for extraordinary measures. We are witnessing every day the physicians,ts of nurses, medical workers, Public Health professionals, and the public to manage the enormity of covid19 in our community. Callordinary times often for the most basic of responses. This means as, routine collection of facts and evidence. An examination of research that in been foundational medicine since its origin. We live in a time when misinformation, falsehood, and outright lies spread like viruses online. Through social media and even at times in the media at large. We have witnessed a concerning shift over the last several decades where policies decisions seem to be driven by ideology and politics instead of facts and evidence. Is a growing mistrust in american institutions, science, and in the counsel of leading experts who lives are dedicated to the pursuit of evidence and reason. These challenging times i am addressing the nation to make an appeal for science in defeating this disease. To explain what scientists rely on fact and evidence in carrying out our duties. You can help turn the tide against covid19. I know people are frightened. You are afraid for yourselves and for your family. You are concerned about catching the virus, and youre worried about spreading the virus to others. Any of you have lost jobs or are trying to keep a Small Business afloat. Home andworking from taking care of children whose schools have closed. You have missed graduations and. Ilestone birthdays as a psychiatrist, i understand the fears and sense of loss we are all experiencing and that they are weighing heavily on our affecting our Mental Health. Fear and anxiety are natural emotions in a time of crisis, but as we have seen in the last few weeks, panic can lead to troubling consequence hoarding of food and supplies, spreading of misinformation, and mistrusting the motives of others. It is absolutely ok to be afraid, but please, do not let panic guide your actions. And so, on behalf of our nations physicians, i ask you to respond instead with reason and resolve. Physicians, nurses, researchers, and Public Health experts throughout the world are working tirelessly to contain this pandemic, to develop new tech, to develop treatments, and to create a vaccine, but this will take some time. In the meantime, we must believe good judgment, what the science and evidence is telling us, and be flexible in changing our behavior as our knowledge improves. We do not yet know everything we would like to know about covid19, but there is plenty we do know. Transmission occurs primarily from persontoperson in close contact. Anyone can become infected. This virus does not discriminate. Seniors and those living with chronic disease are much more vulnerable to serious illness from this virus than others. Many more people are carriers for covid19 that have been tested, and they may be asymptomatic or experience only pose amptoms, so they risk to others. The most effective tool we have in this fight is physical distancing, which means every city and state that has not implemented shelterinplace or stayathome orders needs to do so immediately. Based on what we know and what has already worked in other countries and indeed in our country, this is our best chance to slow the spread of the virus. As a physician, i am honored to be a member of one of our countrys most trusted professions. Trust their physicians because they know we do not act or hunches or personal opinions. We take an oath to treat people ethically, and we go where the evidence leads. Not always the case. The origins of modern epidemiology date to 19th century london when a physician ended a severe cholera outbreak long thought to be the result of breathing bad air. He discovered the real cause was Drinking Water from a public pump that had become contaminated by sewage. Association medical itself was founded in 1847 as a andonse to rampant quackery medicine. At the time, syrups or serums were sold as cures for various diseases that not only did not help, they often caused harm. The ama fought to center the practice of medicine around a standard of principles and to develop a code of ethics. Our mission since then has been scienceop the art and of medicine and the betterment of Public Health. Physicians americas in this pandemic is, of course, to care for patients with covid19, using the best, most available,evidence but as skilled as medical professionals and physicians are and as hard as they are working in offices and intensive care units, they cannot carry this burden alone. Play andhas a role to containing this pandemic. The strategy we are asking the public to universally adopt may seem simplistic but are in fact based in science and evidence. And Public Health experts are asking everyone to wash their hands, for example. Children learn even before preschool learn that washing their hands reduces the spread of germs, but how do we know this . The evidence it may be hard to believe, but in the mid1800s, Many Health Care workers did not wash their hands between patients. Still, a link was made between handwashing and a reduction in disease. Many women died before studies found that returning patients disease andrisk of death if their doctors washed their hands. Handwashing became necessary protocol for physicians and now for everyone in society. We are asking for social distancing, or as i prefer to call it, physical distancing because we can and should build strides to have meaningful social interaction while maintaining a safe social distance safe physical distance. We know this is difficult for people, but we know from history it is infected. A century ago, the United States and the world faced a pandemic of influenza known as the 1918 flu. We know from history it is effective. As a result of physical distancing, death rates varied widely. Described recently in national geographic, philadelphia reported its first case of influenza on september 17, 1918. Days later, they held a war 200s parade attended by thousand people. Sadly, two weeks later, at least 20,000 City Residents had contracted the flu. Contrast philadelphias approach with that of st. Louis. St. Louis had the benefit of watching what was happening on the east coast, and Public Officials acted quickly. Two days after the first case was reported, the city of st. Louis shut down. Two different approaches to physical distancing, and two different death rates. By the end of the epidemic, st. Louis had half the death rate of philadelphia. So lets use the experience of a century ago as a guide for today. If the citizens of philadelphia knew then what we know now of the direct link between a large social gathering and a spike in cases, there is little doubt that they would have chosen not to attend that parade. We are also asking that physical distancing measures not be relaxed prematurely. We understand that people are suffering great financial and emotional pain and having much of the economy shut down and not being able to gather with their loved ones. Here, too, the evidence from the 1918 pandemic is instructive for today. Therospective study in journal of the American Medical Association found that nonpharmaceutical decisions such as School Closures and a ban on public gatherings were beneficial and should be sustained throughout the peak of a pandemic. Further, cities acting in a timely and comprehensive manner experienced lower death rates. The ama is encouraged by those federal and state leaders who are willing to keep physical distancing restrictions in place until the evidence suggests it is safe to return to normal. Repeat our call for governors who have not yet implemented physical distancing in their state to do so immediately. In truth, the nation needs more much more from our leaders. The public is already making incredible sacrifices by acting on the evidence. All of us need to trust that our institutions are also keeping science at the four of their decisionmaking. With that in mind, the ama calls toall elected officials affirm science, evidence, and fact in their words and actions. We call on media to be vigilant and communicating factual information from credible sources and to challenge those who choose to trade and misinformation. We call on tech platforms to advance evidencebased information from credible sources and reduce the spread of misinformation. Our governments scientific institutions now and in the future to be led by from politicaled influence. We call from we call for an environment in which physicians, scientists, and other experts are free to communicate evidencebased factual information without fear of retaliation or retribution. We call for determinations about safety and efficacy of drugs to be made by scientists and researchers based on the data and that treatment decisions should be made by a shared decisionmaking process between a patient and his or her physician without intrusion by any third party, government, or otherwise. We call for the robust collection of data, including data segmented by race and ethnicity, to make sure we have a thorough understanding of the pandemics impact on every community. Called the response to this pandemic a war. We must ensure the war is and not us virus ce. Inst scientist despite solid evidence behind the measures in place, misinformation about covid19 is fearding rapidly, due to or various political agendas. You may have heard some of these false claims yourself. Lessanamericans are likely to get covid19 that is false. A new way tos force vaccinations on people who do not want them also false. Children cannot contract covid19 false. These kinds of rumors and conspiracy theories inevitably leads to more illness, more suffering, and more death. Have a why we all responsibility to seek out and share information only from credible sources. Faced and overcome enormous Public Health challenges before. Smoking,educing finding treatments for hiv and polio andicating other vaccinepreventable diseases challenges that required changes in thinking, changes in public policy, and changes in behavior. We must approach covid19 in the same way, by relying on the science and evidence to inform our decisions and our actions. , thereis new pandemic are many unknowns. It is critically important, to the, that we go back core knowledge we have relied on in the past. As evidence evolves, necessarily, our strategies, tactics, and behaviors should change accordingly. It is science, research, and evidence, and not wishful that gives ideology us hope as we face uncertainties around this pandemic. It is science that will bring about proven treatment for covid19. It is science that will bring about a vaccine. Nationerson in this shares accountability in allting this virus, and we have a responsibility to do our part. At times like these, we may feel a sense of helplessness or hopelessness, but we are not powerless in this health crisis. We must all commit to evidencebased actions to fight this disease. My mostng, i offer heartfelt thanks to all of the physicians, nurses, and Health Professionals who are heroically fighting this pandemic. I also want to thank those who are cleaning our facilities and cooking our meals and delivering our food. Finally, to all of those who are taking the necessary steps to keep themselves and their loved ones safe, thank you. Thank you, dr. Harris. I now have a series of questions submitted by members of the National Press club. Those of you joining us today are also welcome to submit questions online. I would like to first tap into your expertise as a psychiatrist. You talked about the emotional and psychological impact of the Coronavirus Crisis and how we can all best deal with that. You mentioned changes in behavior, which are generally easier said than done. How does one calm oneself down right now . What are some practical ways people can remain reasonable in the Current Situation . Few practicalst a tips, and i urge everyone to rely on their usual coping skills. I think the first thing is to make sure that you have reliable information. Information often leads to fear. I do tell everyone, myself included, that sometimes you just have to take a moment and breathe. Every morning, i would take a few moments to get centered on the day. Sometimes, you have to, you know, take off cut off the television and take a break from social media. We should all be getting exercise. Ofyou have the privilege being able to walk safely around your neighborhood, get outside again, keeping in mind that you want to make sure you are doing the appropriate physical cannot,ng, but if you you could exercise indoors. I say put on your Favorite Song and just make sure you keep moving. We should all try to get as much sleep as we can and eat as healthily as we can. And really experience those feelings. No one should beat themselves up or be more anxious or worried. Those are normal feelings. I will just say one more thing there is huge disruption in our routine. Tois probably a good idea develop new routines because routines also will help us get through some of the fear and anxiety. Finding new routines not necessarily by design but by necessity, they may be working from home perhaps with a spouse or children around them who are now being distance from school for an indeterminate amount of time. Your training with child and adolescent psychiatry what should, first of all, we be telling our children, our grandchildren to help them best cope with this and talk a little bit about dealing with this and this forced new environment that a lot of people find themselves in . Harris i think the first thing parents and other caregivers should commit to is have ageappropriate conversations. Often children and adolescents guide us in conversation. Answer their questions, but in ageappropriate ways. I also think we should be careful not to ascribe feelings, particularly to our children. Rather than saying i know you are afraid, you may not want to lead with that because in fact, they may be curious. They may not be afraid. Ory of our children adolescents were happy for a school break. Rather than ascribing feelings, you should say, how are you doing today . What would you like to do . What do you think about our new routine . Ask openended questions to get feedback from them. But beults are worried, mindful that our children are watching, and if you are anxious, they will get anxious. Again, not recommending that parents or caregivers hide their feelings, but certainly be youthl that our use are watching. Have you been in touch with the white house . Who from the administration are you listening to with respect to covid19 . Dr. Harris certainly early on, i had the opportunity along with some other leaders of physician organizations to participate in a Conference Call with the president and the members of the task force. At that time, we were able to theg up concerns from Physician Community. And since then, ive had other conversations with members of the task force. As president of the American Medical Association, i have to listen to everyone. I listen to physicians across the country who email me, call me, text me. I review the media posts. I listen to media briefings. Wantinly as a physician, i to be informed. I want to hear from everyone. Certainly we at the ama, and of course, we have a fantastic team at the ama and we have a fantastic team in chicago, we are monitoring every bit of information and making sure we get credible sources of information. We have a covid19 resource page on our website, and we want to make sure we are supporting physicians. Thats why early on in this, we sent letters, and weve sent many letters to congress and the administration. We want to make sure that physician practices, large and small, are supported during this time. Physicians are reducing hours. We are using telemedicine, but it has had a negative impact on physicians on the front line across the country, so i listen to all physicians so i can best learn how to support not only our Physician Community but also the patients that we serve. One of the other things you said in your talk, asking people to stay reasonable and calm and not panic. Reports out of the white house suggest officials disagree over the use of the malaria drug, hydroxychloroquine, as a for covid19. Ment what is the amas position on that drug as a treatment for this virus . Dr. Harris i think our position is our position that you heard me speak about throughout my address. The science and evidence have to rule the day, and when we make treatment decisions about disease,or any other physicians base those course tions of in a shared decisionmaking process with our patients and the fact that we certainly want the process to play out. Absolutely, Clinical Trials are going on right now. Thats how we get the data that , and some of those Clinical Trials are using hydroxychloroquine, and that is appropriate. We know there is compassionate use, but whatever the situation, physicians do not make treatment recommendations as you heard me say earlier on whims. There is a decisionmaking process that physicians go treatment thatry we recommend, and that should continue to hold through for covid19 and anything else we face in the future. Im