2027488001. And if youre a medical professional, call 2027488002. Good friday evening. Well begin, as we always do, was with the numbers. Curment of johns hob kinls university. 2. 2 million cases across the globe and more than 153,000 depths as a result of covid19. In the United States, 692,000 confirmed cases and nearly 7,000 deaths in the u. S. Joining us from baltimore is dr. Leana wen, the former president of planned parenthood the city commissioner from baltimore. Shes the author of a book and the visiting professor of Health Policy and management at George Washington university. Dr. Wen, thank you for being with us on cspan. Guest of course. Happen happy to join you and thank you for the invitation. Host there are reporters that in the city youre in, in philadelphia, in chicago and washington, d. C. , we have not reached the peak yet. What does that tell snull guest two things. One, when we hear we have yet to reach the peak, it definitely brings a level of fear because we dont know where that peak is going to be and weve been talking a lot about testing and i should caution that all the numbers that were talking about have a big asterisk next to them because we really dont know that the number of confirmed cases reflects anything close to the number of cases that they there actually are in our communities. It could very well be given the number of asymptomatic carriers there are that there are far more cases that we currently have. In fact, do i believe there could be smoldering dayses of infections in communities all around the country. We jewels havent picked up on that. The second thing we hear about not reaching the peak. We have to remember that it may not be a bad thing because weve been talking about this concept of flat engine the curve. The flattening the curve, the idea that social distancing. The goal is to reduce the rate of transmission and avoid the surge in the number of infections because if you have that surge you could potentially overwhelm the Health Care System with so many sick patients coming in at the same time so if youre able to flatten the curve and reduce the rate of infection, youre able to move that curve over time so that the peak actually is delayed and ideally that the number of cases is spread out over a longer. Stever having this big surge all at the same time. So the fact thats more my area, d. C. , philadelphia, and many parts of the country have yet to see their peak, in a way it means that social distancing and these measures that were implementing actually is working because its delaying the onset and potentially preventing that huge surge from occurring and therefore saving lives. Host let me follow up on that point of testing. Youre a former Public Health commissioner in the city of baltimore. How are the mechanics of testing supposed to work and in a country of more than 350 million americans, how do you do it successfully . Guest ideally, testing should be made available to everyone who wants or needs a test. Also random people should be selected for testing to understand what is the true rate of Community Spread in places around the country. We are nowhere near that type of capacity right now. Right now in many places youre only able to get tested if youre a hospitalized patients with very severe illness. If you have mild symptoms. If you dont qualify for a hospital stay, you might not be able to even get a test, even if you have all the classic symptoms of virus virus. Youll likely be told to stay at home and selfisles late and assume that you have cone cron coronavirus. Thats a problem colin can i. Clinically. You can imagine has a patient, thats very frustrating to hear you cannot get a test. And for the colin in addition, they want to know, first of all, what type of protective equipment to be wearing. How to treelt the patient. Its frustrating for the clinician but it also really hinders Public Health progress because what that means is were really flying blind. We dont know. There are parts of the country that current have currently have zero cases or are reporting if you very few cases. We dont nome whether thats that true reflection or whether we just dont have the surveillance testing and the next time we find out about that community its because many patients have ended up in the hospital and now our hospital suspects with all yoimpled and we have not had a chance to prepare. So were at a loss until we get to the type of capacity we need and that means potentially looking at millions of tests a day, which is not even close as a country to where we are now. To date weve only performed 3. 5 million tests in total over the last six, eight weeks and thats nowhere near sufficient for what it needs to be in order for us to combat covid19 with the science and data driving decisions. Host weve been trucking with dr. Owen wedge and another part of her story can be found in the Washington Post with the headline its a scary time to be pregnant but im still to grateful. You wrote the following clt i am calm on the outside, on the inside im filled with worry. Even in the best of times, childbirth is a worry. Add to that a world thrown dangerously off kilter by a Public Health crisis. Two weeks ago you delivered your second child. We have some photographs to show our audience. Congratulations but walk us through you were thinking and feeling as you went through this process. Guest thank you for the well wishes. Exactly two weeks ago i gave birth to my daughter isabel, who is healthy and home and were really grateful that so far theres been a good endsing, at least to all of this. I mean, this is my second child, as you mentioned. My first was born two natural years ago and i jewels remember that the types of concerns that i had the first time were completely different from the types of concerns they happened this time. Last time i was worried about what car seat i should be getting and how to breastfeed and care for a newborn. And this time towards the end of my pregnancy was when the pandemic and covid19 really start and would i found in my own hospital experience, for example, last time, everybody was welcome in the delivery room and the hallways were filled with visitors and the postpartum period, you had family and friends come and visit and help out and this time our hospital restricted visitors to the point that only one visitor is allowed for patients whoer delivering children and who are at the end of life. That there are no visitors even allowed for any other patients in the hospital. I was worried, too, because there were some hospitals in the u. S. That didnt even allow anyone to be present during delivery and i kept on having night wears nightmares about what that would be like and also, what it would have been like if i got virus virus or were suspected of having covid and wouldnt be able to hold my baby potentially until i tested negative. Its just a very uncertain time. Its not just for me, its for everyone. Its for Health Care Providers who dont know whether im an asymptomatic carrier. Tmpings really a different time of experience. To go into labor and the delivery room, i never saw the face of my nurse because she was wearing a mask the whole time. Understandably but she and all the providers were issued just one mask a week and on the day that i saw her, this was day flee of her mask and it was already fraying. I thought some about these frontline providers. You dont necessarily think about your o. B. Providers as on the front lines of the covid fight but they are and there are so many who puts their lives on the line for others. Im so deeply grateful of the care they got but its also a reminder that health care continues to happen during a pandemic. Yes, we think about the patients with covid but all these other parents are still coming in for emergency surgeries, heart attacks, diabetes and they need to get good care as well and all of that care is put into risk because of the pandemic and the uncertainties were all living in now. Host quick follow up. I was trading emails with a soon to be young mother. Shes nine months pregnant, due in just a couple of days. For her and also those who are considering son conceiving a child at this point, your advice to them is what . Guest there is a lot thats still unknown about this new coronavirus and a lot thats unknown in particular about the effects of covid19 on pregnancy. The studies that have been done so far are on third trimester for obvious reasons, because we dont yet know what may be the effects of covid19 in the first and second trimester because of how knew coronavirus. Is most studies it appears that the virus is not found in am any ic fluid or in breast milk and in fact, there may be antibodies so if the pregnant woman got infected during pregnancy. Potentially she could give antibodies to the new born. We dont know how effective they are but it appears that could be the case. Stirblings because of the unknowns and because pregnant people are considered to be vulnerable. I would advise everyone caution. Shelter in place. Stay at home when possible. Avoid highrisk situations. Dont go to the Grocery Store, even if somebody else can do the shopping for you. If youre pregnant, talk to your o. B. Also about how many visits you really need so as to try to limit your number of visits to a medical setting and come up with a plan. Its always a good idea to have a plan, especially if youre going to be in delivery soon but also recognize that that plan could very well change based only the circumstances were in and be ready for the postpartum period to be really lonely. Thats a period thats vulnerable for a lot of families. Youre dealing with a lot of sleep deprivation and we may be used to that facetofails time with many people but its a good idea to replace that with facetime because thats whats necessary to protect ourselves and our families. Host congratulations. Two weeks after having a baby, we appreciate it. Our guest is dr. Leana wen. Shes the author of the book when doctors dont listen. Lets get to your phone calls. Good in bellville, yism, evening. Coim congratulations, dr. Wen, on your child. I just wonder if were replacing one problem with another. I understand we need to protect the vulnerable but with 2 million out of work, societal problems are going to increase. Alcoholism, abuse. I wonder at what point do we risk, for lack of a better term, to get this economy working again. Hoich thank you for the question. Dr. Wenl . Guest i very much appreciate the sentiment. We all want the same thing. We want to reopen the country and want to go back to work but in a safe way. I want to talk about why covid19, this new coronavirus is so different from anyone else weve seen in our lifetimes. This is a new virus, which means that no one has immunity to it. This is no sack zone and no treatment. It is sack seen and no fremont. About 20 of people who get covid19 end up getting hospitalized. 5 end up in intense active care and the death rate is about 1 . This is a disease that causes Critical Illness and not only among nose that we identify as being the most vulnerable, meaning older individuals and piano people with chronic conditions but were seeing people dying whorp previously healthy 20yearolds. Were seeing children and healthy middleaged people die as well. Its so highly transmittable. Its different from diseases like sav srks sars and mers before which were fatal but not so easily transmitted. But in terms of the asymptomatic issues, its been straight ahead spreading to fast. If we did nothing, we would be looking at millions of people who would die from coronavirus. Already it is one of the leading causes of death here in the u. S. And again, its not just a question of coronavirus. Its all these other medical conditions too. If people are too scared to get medical care because of because theyre afraid to get health care, were going to see more people tying dying and if our Health Care System is overwhelmed, then parents with cancer and all kinalts kinds of memory conditions cannot get their routine care and they will suffer and die as well so at this point we need to have a careful plan for how to reopen the country and were doing that. We need to have good testing, good Public Health infrastructure. We need to stabilize our Health Care System and have things in place in order to reopen. Thats something we should aim for but also recognize that this is a pandemic that none of us have seen in terms of its transmission and severity in your lifetimes and we have to treat it with the seriousness that it deserves. Host dr. Wen born in zheng hype. Came to the United States at the age of. She joins us from baltimore and gordon is next from arlington, massachusetts. Good evening. Caller hi. I just wanted the press conference about testing and if i understand correctly, their strategy is to do surveillance testing and the first thing is, they scaled it based upon 24,000 cases saying that they need 4. 5 million tests a month but we have over 600,000 cases. Isnt it underscared by a factor of 34. And even if we had 20 impact tests a month, how does a parent know their child is safe at school or an employer know their employees are safe at work . Host thank you. Whats your background . Im a biomedical researcher and i run a company. Guest i agree with gordon. The numbers currently being presented by the white house Traffic Force are not nearly sufficient for what we need in order to get children back to school and people welcome back to work. It sounded as if there was a jutchings for why there werent enough tests as opposed to starting the other way around. Looking at how many tests we need and then what is it we need to do to ramp up our capacity to get there . In liu of sufficient testing, what i hear from the task force is that since we dont have enough tests, we can do surveillance by looking at the number of people who have this influenzalike illness. Sure, you can monitor that but by the time you see an uptick from hospitalizations for people with flulike simple toments, thats too late. Thats a lifetime of several weeks we could have presented. By the time people end up going to the hospital, theyre also going to get critically ill and die. We need to focus on capturing these individuals before they get so im. In order to do that, we need testing for individuals who have symptoms and are not sick enough to go to the hospital and be able to test anyone who wants a test. That may include employees. Employers and Companies May want to see until you get a negative test, you cannot go back to work. One can imagine when we get point of care testing, where the result is available in minutes. One can imagine a scenario when where an employee is tested right before they go to work and also testing teachers and children in schools on a regular basis. As a parent, i would not be comfortable with leting my child go to school or day care right now where the number of asymptomatic team people could be very high. There was a study this week out of santa clara in california where they measure it would antibodies of individuals who did not necessarily have the illness in but people who did not have symptoms and they were estimating that the case counts were off by a factor of Something Like 50 to 85 times and when were looking at numbers that are wildly, dramatically off like, that we really need to have much better testing in order to reassure anyone that its safe to reassume their normal activities and not inadvertently get infected and end up infecting other people. Host that study you just refered to is available. Well show it to you. Deborah from new york is next. Good evening. Caller good evening. Congratulations on isabel, dr. Wen. I hope little brother or big brother is haim to have her there. Guest very much. So thank you very much, deb be a. Kevin i watched governor cuomos state of the state address that he does every day its now come down to an argument between the governor and the federal government as to who is going to one, open the state and two, . Hos going to fund any testing and this is just this just seems like common sense that it or the the states federal government that should funding the testing. Host deborah, thanks for the question. Well get a response. Guest i mean, its theres a lot of finger pointing and blame thats been going around and at the end of the day, we all just have to say, look, whatever has happened in the past happened already. We cant navigate from where we wish we were. We need to be navigating from where we are right now which is that we should have had a lot more testing up to now and we dont. We can do the post mortem at a later time but we need to move forward and say we need hundredles of millions more tests. We need millions of tests available every day. Knowing that thats the case. Where do we move guard, how do we get there . It doesnt make sense that states are competing against each other for medical supplies. Aa a assume that test kilts are available. It turns out that other things that are needed for the tests are now running out. Once test kilts were available, there werent enough swabs to take the samples then there werent enough reagents to process and get the results of the heses. Tests. Now states are each scrambling to figure out how to deal with this International Supply complain and bidding against each other for supplies. That cannot happen. Its not first quarter, not a good use of taxpayer dollars and it will result in further delays. Thats the roam of the freshman government, to have a Natural National little coordinate napetted strategy. By the way, its also not about states. Its about ventilators, about personal protective equipment. Need a federal strategy for procuring these supplies. When it comes to reopening, it does make sense that there are federal deadlines and that states will figure out how to do this for their own poplations in a way that is science and evidence based but there could also be a federal role in this too because there may be some states that are not going to do the right thing. Weve seen this already with states that much not complied with state at home orders and not been proactive about protecting their own populations. Diseases no boundaries and where he do also need some type of freshman enforcement stage so we end up protecting the health and population not just with people within a single state but for the entire u. S. Host cindy, youre only the airplane with dr. Wen. Good evening. Caller good evening. Thank you for your time, dr. Wen. Bottom line, from all iheard about testing, whether we open our states or not, its always going to be very impo