Of harvard the dean medical school. Of the reportr from last september, giving a grim warning of the impact of the pandemic. The phone lines are open. 202 7488000 if you live in the eastern or central time zones. 202 7488001 for those of you in the mountain and pacific time zones. A line set aside for medical professionals, doctors, nurses, emts, 202 7488002. Thank you for joining us. We begin with the numbers, courtesy of Johns Hopkins university. Around the world, 3. 6 million confirmed cases and the global death toll approaching 257,000. Is joining us. Y he is the dean of Harvard Medical School. I want to start with a story you were quoted in in the wall street journal. You were working with chinese doctors privately for best practices and treatment. Dr. Daley we are. The current pandemic respects no international boundaries. Medicine and science are forces for International Diplomacy that transcend politics. In late january, when it was clear that the virus was ravaging china, colleagues from china reached out to us asking for help. It was a time when there was tremendous tension between our countries. Our government was struggling. Channelse not formal for communication. The centers for Disease Control was not involved in china. The National Institute of health was rebuffed. Because of personal connections, we linked to our chinese colleagues and began working together. In those early times, they were reaching out to us for help. Very quickly, the tables were turned and we started asking them for help. The communication continues. It is a model for cooperation. In those clinical trials, those long conversations, what has surprised you the most . Are unique, there features to this virus. We were interacting directly the doctor who had been the hero of the first sars outbreak. He was the chinese physician who discovered sars and brought it to prominence. This secondin sarslike virus, he was elevated to national prominence. Valuable hisne how expertise has been to us and our community . Theas sharing his insights, distinctive nature of this very inflammatory infection, how it howdifferent, healthy they were treating patients in the icu on the ventilator. That provided our physicians with advanced warning for how to deal with this virus. Think of the importance of international cooperation. It is essential. Host in early february, on the first day of the new month, we had seven cases here in the u. S. Later, 189,000 cases. Today, almost 1. 2 million cases. When you look at that and hear those numbers, what do you think . Guest that is the nature of an epidemic. It is exponential in its growth. In early january, when there were simple whispers of a growing ammonia of unknown cause in china, that stuff the ears of those in the medical community that this could grow out of control. When an infection spreads from one person to three or four others, then to another three or four others, it grows by leaps and bounds. It was a problem in early to mid january not to recognize that the explosive numbers of infections happening in china were soon to be on our shores as well. We were behind in responding to this and we have learned difficult lessons. Host you are the dean of one of the most prestigious medical schools in the world. Andou talk to professors medical students, what are they saying about this virus . Guest this is a defining episode, a cataclysmic Public Health crisis that defines a generation, just in the same way our world war ii defined fathers generation, this pandemic will define a generation of our medical students. I have been inspired by their response. I was on the phone today with the president of our first year class and she described with great pride now our students responded. They stepped forward, started taking calls from anxious patients, who wanted thoughtful and wise advice on covid they developed a covid curriculum, which has now been translated into 37 languages and is informing people around the globe. They created coloring books so they could describe the covid experience to threeyearolds and sevenyearolds. And they volunteered to give care. I have been inspired by the way that this Younger Generation has responded to this, and it gives me hope for the future. Host we are talking to dr. George daley, the dean of the Harvard Medical School. You mentioned children. There are some reports out with complicating factors that we are learning about of those under the age of 16 that contract coronavirus. What do you know about that . Guest it is widely believed that this is a virus that disproportionately strikes the elderly, and that is true. But i believe that it is a misconception to believe that the very young can go off scott free. Atm placed scientifically boston childrens hospital. Childrene center for affected by covid. There is a condition, an inflammatory condition, that is othern the context of viral diseases, called kawasakis disease. Inflammation of the blood vessels. When it attacks the blood vessels of the heart, it can be dangerous for kids. This is a lesson we are learning about this virus, and we cannot take the exposure to any class of people, especially kids, for granted. No one will be spared in the longterm to the ravages of this virus. Thank you for taking my call. I had a question about coronavirus. They tested all of the passengers on the diamond princess cruise ship. Of did not have any symptoms covid19 but they still tested positive. My first question, how does the order of symptoms progress . And what advice would you give for people wendy economy fully opens up, that have asthma, diabetes, and hypertension . Guest what you have pointed out is something we have learned about this virus, which, even though it is related to the first sars virus in 2003, it has a very significant degree of spread and contagion in individuals that are they symptomatic. The original sars virus was not transmitted until someone had symptoms. That made it easier to control. Is transmitting the virus, as we have seen and learned from the a symptom attic transmission on the cruise ships, it makes it much more difficult to control, which is part of the reason why this virus has had such explosive growth across the world. The virus, in many communities, was circulating unknown to all of us, in part because we were not doing a lot of testing. You also pointed out that a particular community that is at ofk are those especially older age are those who have conditions of asthma, heart disease, diabetes. These individuals seem to be particularly susceptible to the virus. Any kind of containment or Mitigation Strategy has to give special attention and protection to those individuals. Is a story today in the los angeles times, that scientists have identified a new strain of the coronavirus that has become dominant worldwide and appears to be more contagious than the version spread in the early days of the pandemic. It occurred in february in europe, migrated to the u. S. , and has been the dominant strain across the world since midmarch according to scientists at los alamos. Guest this is very instructive. I think many in the general public paris that viruses general public worry that viruses evolve to become more deadly. In fact, viruses only evolve to become more transmissible. Thatt is not surprising this virus has evolved, to some extent, to be more easily contagious. Is atunately, coronavirus class of violent class of virus that tends not to be as mutagenic as the flu. The flu changes every year and it is very difficult. The hope is that we will be able to develop a vaccine against this coronavirus which will be durable and allow us to get it under control. That is going to be 12, 18 months in the future. In the meantime, we need to maintain the kind of Public Health strategy social distancing, handwashing, hygiene, to be able to control its spread. Good evening. Just touchedfolks on the just of what i was talking about, the study out of los alamos about the mutating of this virus. A lot of work and dollars are being thrown in right now on making a vaccine. If this mutates further and we end up with different strains, similar to what we have with the flu every year, is that kind of if we for not effort cannot point what we will be giving a vaccine for . The Coronavirus Task bece, is it premature to cutting the effort on that . Seems like we are kind of jumping the gun. Host thank you for the points. Thet let me say more about vaccine strategies. That we canrus raise a potent vaccine against. There are roughly 100 different shots on goal going on across the globe. That is one of the remarkable responses by the medical community. The virus, the relatively low variation among the virus, we actually think we will be able to develop effective vaccines. Important element of the response to the virus. There has been an extraordinary commitment on the part of our faculty. The Harvard Medical School factory faculty has responded with great gusto. We put together something called a Massachusetts Consortium. We reached out beyond harvard to include m. I. T. , the university of massachusetts, tufts, boston university, hundreds of scientists have come together to come together and fight this virus. I think it speaks to the extraordinary commitment of the scientific community. I dont think we are ready to disband any attempts to control this virus. This virus is going to be here for a while. I Needs National leadership am concerned that a Coronavirus Task force would be disbanded at this time. We are not beyond this crisis. This virus will percolate in our community until we develop what is called herd immunity, where a significant amount have been exposed, or a vaccine. We are going to be dealing with outbreaks of this virus for the next year or more. So, no, i dont think we should be disbanding the task force. We need national leadership, spokespersons like dr. Birx, dr. Base, to give the evidence policies that will protect us from this virus. Host carol from california, you are next. Caller good evening. I have two questions. One is a smaller question. The first one is i had heard on newnews that there was a cancer doctor discussing when patients come in where they can breathe with the pneumonia symptoms, where oxygen is getting very low. The success rate, once they get put on the ventilator, having issues because of different things, not being able to move, needg to be turned, they blood thinners at that point. They said the success rate or the survival rate i cant remember if they said 20 , people who get on to ventilators. That not getting people on the ventilators, getting them in sooner would the and getting them more oxygen in other ways. I had heard in japan there was a machine that helped some people with oxygenation. Host what are the risk factors that carol brought forth . Guest the point she is making is that this is a condition that, in some patients, progresses very rapidly to respiratory failure. Relatively, it is a small percentage of patients. But, when they arrive late in the course of the disease and they are already very short of breath, if they end up on a ventilator, it is very difficult to treat them. What i am optimistic about is the fact that we are learning a tremendous amount about this disease. I can tell you that in the first conversation that we had with our chinese colleagues in early february, they already told us about the benefits of proning for the individuals who ended up on ventilators. They already told us about the effectiveness of ecmo to save some of these patients. So, we had a head start. Are anfortunately, there percentage of individuals who ultimately succumbed to this virus. Virus inery aggressive some individuals. We are learning how to treat these patients better. Three months from now, we will know even more. Ares telling us that we responding aggressively and we will do all we can to save as many lives as possible. Host you have just completed the application and acceptance process for students looking to attend Harvard Medical School. What with the acceptance rate . How many did you get and how many did you accept . Tost we are very fortunate be the school of choice for a large number of students. We received over 700 applications, some of the best and brightest students. We can only unfortunately offer positions to about 200 of those students. 3 that is about a acceptance rate. Ensures that we get the most spectacular students. I can tell you that the students are not only brilliant, they are committed to public service, committed to the calling of medicine. They want to serve, they want to do it selflessly. They are also in they are also interested in the issues of social justice. One of the problems that has been called out in this pandemic has been the tremendous disparities in health care outcomes. This virus has disproportionately struck the elderly, blacks, latinos. It is teaching that we need to do more in the Health Care System to address these problems of social inequality. Our students are on the front lines. I would say, the outstanding class that we would accept and introduced to the medical profession next fall really bodes well for our future. The future is in good hands. Medical you are a student or medical professional, we would love to hear from you. In south carolina. Steve, i hope you and your family are doing well. Especially your wife. I shouldnt say especially your wife, your whole family. Comments about trying to jumpstart the economy too early. I have a source of income so it is easy for me to say we are doing this too early. I am scared that we will jumpstart a second wave if we are not careful. I have noticed people are being a little more complacent, a little more careless in Grocery Stores right now. By the way, i am glad it is a collaborative effort in different countries. A lot of times, there is the impression that other countries might develop a medical procedure. I know it is in the interest of safety. I am not talking about plastic surgery. I am talking about real stuff. With regards to the vaccine , and i know this is a touchy subject once a vaccine is developed, do you think it should be mandatory . I remember getting the polio vaccine, i dont think i had a choice for that. Maybe my parents did. I just lined up every year and took it. I am of the belief that it should be mandatory. Guest thank you for that question. Vaccination has been put forth as a question of individual liberty. Get to control medical decisions for my own body. The problem is, for infectious disease, you cannot control the infection in your own body. It becomes a Public Health risk. Growth ofen, with the a number of individuals and families who are refusing to vaccinate their kids for things like mumps or measles, we actually see outbreaks. We had an outbreak in boston in the College Community of mumps in the past few years. We see outbreaks of diseases long goneought for and controlled. Your individual decision unfortunately impact more. So, yes, a vaccine is a Public Health strategy that is aimed at maximizing the common good. We are all in this world. This pandemic i think should teach us the important lesson that we have to act for the collective good. I have recently been quoted as saying, if a vaccine is developed, it cannot be exclusive to one country or exclusive to the rich. Withve to deploy a vaccine a strategy of containment around the world. The same way we use the polio vaccine and eradicated that scorch from the earth. To thosene then goes pockets. For a new coronavirus vaccine, we have to be strategic about how it is deployed. We will vaccinate around the hotspots in this country. I would argue that the best strategy for containment around the globe. We are one earth. It is a small planet, and the virus will go everywhere and find the vulnerable population. Host just to be clear, you would do the hotspots first . Guest yes, i would. Absolutely. You have heard an up swell of nationalism from different develops saying, if we the vaccine, we will deal with our population first. That is a strategy for disaster. We are a collective community on this planet. Strategy. Global caller thank you for taking my call. Thank you, dr. Daley, for your service, and to the thousands of medical professionals keeping us alive. Drawback, at of young doctor who lost his family to the plague and he disappeared for 10 years, came back, and dedicated himself to saving people. Tradame. Was michel nos he saved many people by opening the windows, giving people sunlight, fixing up the sanitation. Very simple things that can be done. Anding masks and gloves, all of the things we can do. Thank you very much, doctor. Guest thank you for that comment. In history, we have seen individuals come forward and make major breakthroughs that change lives. When we think back to the scorch of polio and we think of the great heroism of jonas salk, the development of that vaccine, i think the world is waiting and hoping. It will happen. I can tell you, the Massachusetts Consortium on pathogen readiness has hundreds of scientists who are working tirelessly to develop new treatments, new antivirals, vaccines, to understand the way this pandemic spreads and recommend thoughtful policy to contain it, to improve the clinical management, and also to share their knowledge openly. This is an example where the biomedical community and the biotechnology and pharmaceutical community, have out have all come together and talked about doing the right thing for the common good. I think it is a tremendous celebration of the excellence of our scientific and biomedical community. I hope that we can continue to support it for after this pandemic passes, and it will, we have to have a durable response because there will be another pandemic. We have had three virus outbreaks in the past 20 years. Lets be ready for the next time we have another one. Host we are talking with dr. George daley, the dean of Harvard Medical School. Next, from oregon, good evening. Regard my question is in to the vaccination is really the key to eliminating the scorch of this disease. But in the same respect that you would not give a measles what scale testing do we need to enact with the whole world . Host thank you. Say, we need more testing. That has been one of the great failures of our national response. Other countries have responded more quickly, like south korea. In order to understand where we need to target the vaccines, we need more community surveillance. We need t