Louisiana and thats pretty darn close, that is a great first try at that. Great, admiral you the white house and lead developer of the hhs wire Public Health policy recommendation so i was hoping you could give us an overview of the Current Situation on the ground today. The situation on the ground with the pandemic, i think everyone understands that similar to where we were post memorial day, we had a significant increase in the number of cases, the hospitalizations are starting to go up as well and we do however, know how to defeat the pandemic to control it until we can get vaccines and youve heard this so many times before but physical distancing is important, wearing the mask when you cannot physically distant is really essential, the American People have done a good job, we do rank among the top in the world and mask wearing that weve got to get better as well as doing the good hand hygiene and with all of this we have to have a program of smart testing and im sure we will talk a lot about that, we do have the power to control we saw how we did in arizona, florida, texas across the sun belt but we ask really important point in this pandemic where cases are going up with his Community Spread, weve done a great job in certain aspects by protecting the elderly but if theres hi Community Spread to go be hard to do that, number one method today, those 3ws are incredibly important, where the masks when you cannot physically distant and avoid indoor crowds, wash the hands and please be tested when asked to be tested because about 75 of people, at least 50 and up to 75 of the people could be completely asymptomatic and the only way to know you have it is to get tested and prevent spreading by wearing a mask when you cannot physically distant. That is good to know as you noted were seen changes in terms of infections in fatalities, on friday the u. S. Recorded a record single day high of more than 83000 new cases and saturday was 39 cases short of the previous, is this a reflection of expanded testing or a false surge. Let me answer that in two different ways, i think were very comparable to what was going on in july and august so testing may be identifying some of the cases, i think thats clearly true but what were seen in is an increase in the numbers, back in march and april, we were only detecting one of every 15 cases you cant really compare to march and april and the surge and not only because the case numbers are up and we can calculate that but we know the hospitalizations, but to put into perspective there are many areas, several areas of the country where hospitals are becoming full and strapped but were still at 41000 people in the hospital compared to a high of 76000 in july, we really have a mixed picture but we really have to reengage the Public Health measures that we know that the hospitalizations can go up substantially, the good things that we know, a lot more younger people and its one reason the hospitalizations are shorter and we have effective therapy that we can apply against it, there is nothing that were going to do that is better than preventing infections in the first place and those of the Public Health measures that we talked about until we get a vaccine, vaccines are coming, we are very encouraged that there are open trials and preliminary data look good, this is awkward to be here tomorrow, make it the first vaccines out this year, we are hopeful and were hopeful they will be useful with screening in elderly protecting the elderly and most honorable, we can only have a few million in most of the benefit, the American People even if everything goes well, at least until mid 2021, we are to be very disciplined about our mask wearing, avoiding crowds particular around the holidays it doesnt have to be hundreds of people but Family Gathering of 20 or 25 or 30 still means we have to be careful about our interactions and hygiene in particular if theres people within our family. Admiral we have heard that the pandemic is putting a new strain, and a plan to get resources to these areas, there has been rationing care or they put in no need to ration care, were in a tremendous supply situation compared to march or april, im not going to say one hospital on one day does not have a certain type of ppe but we know almost every state has a 60 90 day storage of ppe within the state in addition to all that we have in the National Stockpile, we have 150,000 ventilators and the National Stockpile and we monitor drugs on a daily basis. The idea of ration is really not one that is close to reality, we have the resources to have care to all who need it and let me say in certain areas. He froze. We are working with Public Health service which i represe represent. I have you now, you can continue, well see if it keeps going. We had a little connection failure but hopefully your viewers heard that there is no idea of rationing care, we have the ppe in most states had a 60 to 90 day stockpile in 150,000 ventilators in the stockpile and only about 60 of hospitalization where we were in july, we have a lot of in the system but in certain areas we know the hospitals are getting high in wisconsin and physical resources but manpower resourc resources, we have plenty of resources and to absorb the care, as a pediatrician, i am always going to emphasize prevention although we have the resources, our best weapon is to wear a mask, physically distant and wash your hands to prevent those infections from going up, we dont want to get in a situation where were tax in the hospital system, it is to minimize and not see how many we can take care, again everybody has the power to prevent infections by doing the 3ws, where a mask and wash your han hands. Speaking of the 3ws or two of them wear a mask and was watr distance, there was another outbreak in the white house, five aids to Vice President pence have tested positive and white house chief of staff mark meadows said the administration had stopped trying to control the pandemic, we are not going to control the pandemic, we will control the fact that we get vaccines, therapeutics and other mitigation, despite emphasis on vaccine, there is little indication that we will have one until the middle of next year end you talk about that a bit, how do you reconcile the message that we are getting from the white house with what you and the task force or telling americans to do. Im not inside cheap meadows head, i think is being misconstrued, he did talk about controlling through mitigation through wearing a mask through all of the issues, i do believe thats what he meant but instead of trying to figure out what he met i want to be straight with the listeners we are not going to defeat the virus until we get a vaccine in the vaccine is distributed to the American People and we build up heard immunity inappropriate way by getting a vaccine to have immunity but there are things that we can do right now to control the spread, we done in arizona, florida, texas all across the deep south, those were the Public Health measures that are spoken repeatedly already in use all the white house last night that there was physical distancing and everyone had to wear a mask, that is very good we want everybody to channel that, in terms of vaccines, i think we need to clarify i think all of us understand that most americans will not get there vaccines until 2021 it could be hundreds of aliens of people to vaccinate and depending on the vaccine most likely two doses, we are very helpful that we will have millions of doses within the year 2020, it wont be before it has to be proven safe and we are hopeful we will get a read on that but even though those doses that can be available, we can get 50 70 of the benefits in terms of mortality if for example and the vaccine being highly effective in all the result in having an immune response, even if we can immunize our healthcare workers, are vulnerable individuals we might be able to save 80 of the lives just by millions of doses. A lot of this is nuance, yes 300 million americans probably wont get immunize till next year but we could immunize the most critical ones this year assuming the trial continues positively, no we cannot absolutely defeat the virus until we have a vaccine but we can control the spread and flattened the curb and stabilize, everybody can do th that, you dont need to be a scientist or vaccine expert, you need to wear a mask, remind people around you to wear a mask, physically distant, avoiding indoor crowded spaces and even up into the holidays and not a party pooper, having 20 or 30 or 40 people at your house for thanksgiving without appropriate precaution is being careful, that could be a recipe for spread im not saying throw grandma in the cold and not bring urine but be very careful about your hygiene handwashing, physically distant if you can particular those who are very vulnerable, that will save lives and save your family. Speaking of the need to be very careful as you recall we closed bars and restaurants and other businesses earlier this year when we saw numbers that are pretty comparable to what were beginning to see again do you believe we need to go back to that and ramp up coronavirus restrictions. We saw in arizona and texas and florida in the sunbelt in the deep south, if people are very discipline and what i mean by discipline, we have mask swearing, that is 85 90 when you cant physically distant and if he cant limit bars or Indoor Dining to a certain extent, then you have search testing, particularly those that can be spreading, that is the theme of shutting on the economy, however, if we dont do those things lawmakers are going to get pressed against the wall with those measures that none of us want because when you do shut things down people dont get cancer screenings, children or go to school, they dont learn, people have emotional issues and Mental Health issues in the misuse goes up, there is a whole chain of effects that occur with the shutdown in these have to be weighed because the real, the bottom line that we have high neckwear, if we do limit the indoor crowded spaces like bars and indoor crowded restaurant and we have appropriate testing, we will have to do those measures and if we dont changes around lawmakers will feel compelled that her last result there will be a great physical and emotional harm done by that but if its a last resort, its a last resort, were not there yet and if we continue to spread the message about what you can do to stop this what we done in many localities before, thats where we want to be, we dont want to be anywhere else, we can flatten the curb, slow the spread, save lives by doing a simple Public Health measure until we can defeat the virus by widespread vaccination, that is the plan that we need to stick to and avoid the measures as possible, thats going to be on a city by city basis, statebystate basis because its very different in new york and massachusetts than it is from wisconsin or el paso, every community is different and every community has different risk factors, different social vulnerability, its very compl complex. The last part takes into question from one of our audience members charles from minnesota wanted to know what we require National Social distance on the indoor mask mandate. I i have not been elected in the office is not my decision about which way to go, i can say it is been the policy of the administration this far to respect the local authorities in this regard, i think theres a good argument to say that the federal government mandated something, number one it could never be enforceable and number two it might create adverse behavior in different behaviors that we want to do, its been the policy of the administration to respect with the state and local want to do, i can tell you from a Public Health point of view that we need to increase neckwear, theres no question we need to do that that is essential to flatten the curve and we need to avoid indoor crowded spaces, how that needs to get done is on a community by community basis, some communities may choose to mandate that, we support that, other communities may say we need educational campaigns because mandating it would give us the opposite behavior that we want because some people are like that and we see the all over europe where theres protest against the mandate and were getting opposite behavior, this is been stressful for everyone, weve been under incredible strain in this pandemic and weve been at this hold the whole time since january and the American People are under strain and i do believe from a Public Health standpoint, Public Health has always been a local measure where people in the Community Work with the community, i tell you what needs to happen, we have 85 people wearing mass, we will find out how that gets done we support the local community and the education and working with children and doing something with the elderly but were telling you what the in results have to be, the best way to get there we believe is the local mayor, county judges and governors. I would like to go to another question from the audience member, victoria from michigan wants to know, with the administration and endless others disregarding basic pandemic safe behavior and incidents resurgence, virus death containment is utterly impossible, the compliance of the cdc guidelines for the rest of us actually make a difference and how. Thank you so much for asking the question, i really appreciate that that gets at the heart of the matter none of us are 100 admission that the data is very clear and they are symptomatic and can virus and something simple like wearing a mask greatly reduces transmission from one person to the next person, we have seen this whether you want to look at the microlevel, like the hairdressers who took care of 129 clients, two of them while they were sick with coronavirus in both of the clients were a mask and what you saw was no transmission, we saw in arizona where the simple measures do make a difference, we see time and time again even summer camps where masks are required, the transmission was minimal, we see a Day Care Centers across rhode island and many other places the transmission is absolutely minimal when we do the Public Health measures, i want to assure the American People that we have to keep her guard up, this is a great weapon against the pandemic, you can save a life in multiple lives if you infect one person, that can affect two people, they really do work and avoid crowds when you can come if youre an area where there spreading, dont have the crowded indoor spaces, there is nothing magical about a bar except that its crowded, indoor are drinking and dont have masks on and if the other house party with hundred people itll be the same different, it does not matter whether crowded or indoor space, make good choices, outdoors versus indoors, smaller gathering versus larger gathering, good ventilation when you can, always wear a mask when he cant physically distant, these things matter, i forget your name but im happy that you asked that question but we gotta keep this up we only have a few more months to go, that few more months could be a difference between 100,000 more people dying and not having that until we get a vaccine, we have the power to do it and keep her guard up. I want to talk about a project you are working on that is really interesting youre helping to coordinate a new Pilot Testing program and for select cities and rhode island with guidance from john hopkins and the center, we are going to get into the finer details of the protocol in the next segment but i was hoping you would explain how the federal government is involved with providing pointofcare of rapid test for americans. Sure, we announced a few weeks ago we would provide 150 million pointofcare on the simple test, its very easy and result in 15 minutes, no need for an instrument we shipped 36 million to the vulnerable in Nursing Homes, assisted living historically black colleges and universities and two thirds of those over 25,000,002 states that they can used to reopen their schools and keep them open and support other critical infrastructure, this is actually happening now, integrate Technology Emphasis dictated technology and only five with the result in five minutes, what were doing on the Pilot Program were very excited the federal government does not work in a vacuum and hopefully everyone understands it, the way it works is by working with the private sector of the academic sector the Nonprofit Sector and the Rockefeller Foundation has been a great partner as well as duke and other universities, we Work Together and talk to each other we have forms together in the rockefeller and duke have been very involved in helping School Districts try to develop plans to reopen schools as we talked about before when children are not in school they have severe and irreversible deficits in their emotional intellectual home at the very critical time, child abuse does not get reported, and hearing screenings, getting kids in school is very important, rockefeller and duke have been supporting that, so we partnered with them to provide them i believe the number to start with is about 120,000 of the by next test, they will be using in multiple School Districts, we know theyre going to be in los angeles, louisville, new orlea orleans, tulsa and rhode island and there is another major School District that we get analysis week that we can talk about but were supplying the actual test to rockefeller and to duke to distribute the School System into test different practices, weve never been in a pandemic like this in modern times were bringing children back to school, a number of possible ways to u