Former head of the cdc about why the cdc botched the testing. Larry summers will tell me how low he thinks the markets will go. Ill talk to tony blair about how todays World Leaders should navigate this historic crisis. We are all in this together. All that and more. But first heres my take. The outbreak of an epidemic is something of a natural disaster, a spontaneous natural eruption that is no ones fault. That doesnt mean we do nothing about it and let it run its deadly course. The evidence is now clear, the spread of the virus can be greatly slowed if governments act early, aggressively and intelligently. Unfortunately that does not describe the response of the United States government to the coronavirus pandemic. We can track the speed of the outbreak since january by which time the virus had spread from china to other countries. In south korea, after an initial spike, the number of new cases has slowed. Hong kong, singapore and taiwan, despite lots of travelers from china, have kept numbers low from the beginning. In the United States, however, we are seeing accelerating increases. What did the successful countries do that seems to have worked . They began testing early and often. They coupled these tests with careful quarantines of those infected and tracking wither they had been to better predict where the next outbreaks might occur. The Public Health systems had Surge Capacity because funding had been adequate and authorities largely communicated simple, clear and consistent messages to the public. One new study which has not yet been Peer Reviewed argues without enhanced detection and restrictions on movement the number of cases in china could have been 67 times higher by the end of february. And had china just started acting one week earlier, there could have been 66 fewer cases. Who would have thought look how long ago, six, seven, eight weeks ago. Who would have thought we would have this update. The New York Times reported that a speech was given in atlanta in 2018 saying the threat of pandemic flu is our Number One Health security concern. We know that it cannot be stopped at the border. The day after she made the speech, the white house eliminated her unit. Trump did make one good decision, banning most travelers from china into the United States. That bought the United States sign. Alas that time was wasted. Testing turned into a fiasco. If this were a war, the generals in charge of that operation would have been relieved of their command. Just one comparison, as of friday, south korea has tested about 250,000 potential cases. It has a population of about 50 million. In the United States, this would be the equivalent of testing about 1. 5 million. As of friday, according to the cdc, the United States had conducted about 15,000 tests and Public Health labs, more in private labs but we dont know how many. Per capita the United States tested far fewer people than most other advanced countries. Trumps most recent dramatic move, the travel ban on most of europe is symbolic of the administrations actions. The thousands of americans currently in europe are apparently exempt as are a small number of others, more importantly the disease is already in the United States and spreading. The policy was so poorly thought through that amendments, corrections and reversals were made to the president s speech within minutes of his having delivered it. This crisis seems to have been designed to bring out the worst of trump. The president doesnt like or trust experts, often explaining he knows more than they do. He has bluffed and fibbed his way through much of his life, and thinks nothing of doing so again, except this time we are not charmed or amused by the bluster, but rather frightened. In most global crises, the United States takes the lead and provides comfort and assurances to the world in this one, trump has been mostly awol. When he does appear, it is to blame the disease on foreigners and announce policies that remember force that view. The broad collapse in Global Markets is surely in part a reaction to the vast vacuum of leadership in the white house. Donald trump views everything from the narcissistic prism of his ego. He dismisses opposing views and insists even the senior most members of his administration repeatedly praise him and his leadership at all times. Watching the heads of americas leading science agencies prefacing their statements with ritual praise for the dear leader has been deeply depressing. Come to think of it, the Trump Administration has been copying the wrong korea. Instead of the intelligence and expertise of south korea, it is emulating the siycophancy and propaganda of north korea. For more, go to cnn. Com fareed and read my Washington Post column this week. Lets get started. Why did the American Government botch the testing of americans for covid19 . Joining me now is tom frieden, the former director of the cdc, and the former Commission Earl of the new York City Health department. Hes now the president and ceo of resolve to save lives. So, everybody is trying to figure this out. South korea has tested, as weve all learned now, hundreds of thousands of people in a country of over 50 million. The u. S. Still seems to be in the 10,000 to 15,000 range. Why . First thing to understand is that cdc has done this before very effectively in influenza, in other responses rapidly provided tests for Public Health, not just to the u. S. , every state, but more than 100 countries around the world quickly and high quality. Something went wrong this time that should be looked at by an independent group so it doesnt go wrong in the future. The second thing to understand is that testing is not just done at Public Health labs. For something of this scale you need the public laboratories to be there and faster. They are just coming online now. Also hospitals can do some testing as well. You saw the reports that there were, for example, in seattle, hospital labs that wanted to do it and they were essentially told no, stop testing. It appears as though it was because the federal government did not want the numbers to go up. I dont know what was done by whom or why. But Laboratory Developed tests, such as those done in hospitals are regulated by the fda. In late february they loosened their criteria on having that done differently. Its also important to understand the role of testing. If you dont have symptoms or your mildly ill and not at risk for severe illness, theres no reason to be tested once we know that coronavirus is spreading. The focus now has to be whats most important, redaucing the number of infections, reducing the likelihood that someone who gets infected will die from it and limiting the amount of societal damage from this pandemic. President trump says that the reason things went badly is president obama made some changes to the testing that complicated matters. That obamas response to h1n1 was a disaster. The you were the head of cdc then. What do you say . Facts matter. The fact is this has been a bipartisan focus with continuous progress, going back to george w. Bush who did a lot of excellent things on pandemic influenza preparedness. We in the Obama Administration advanced those. We were able to get test kits out fast. Something went wrong here. We have to find out why to prevent that in the future. You fundamentally disbeau th dispute that h1n1 kits went out, about a million kits went out within a month of the disease. Does that strike you as right . For years as i traveled around the world, dozens of country thanked me and thanked the u. S. Because of the cdc Lab Test Kits that went out, first to the u. S. And then everywhere in the world and performed very well. At cdc in my time there we created a new unit of Laboratory Science and safety, we upgraded our laboratories. We got money from congress to improve molecular detection. The same 20,000 Public Health professionals who dedicate their lives to promoting health around the world when i was there are still there. The leadership under me is still there as well. Cdc is still the greatest Public Health institution in the world. Its taken a hit here, but if you want good advice on what to do about coronavirus, the best place in the world to get it is the cdc website. Do you think the travel ban makes sense . A lot of people are saying it kind of hits at the wrong problem because the disease is already here. There are a couple things to be clear about. Reducing travel from china without a doubt bought us time it reduced the number of cases, but it would never prevent this from coming to our shores, thats why any travel restrictions or bans are only useful if we use that time to prepare better if we wash hands, cover coughs, not going out if were sick that vulnerable get ready to shelter if need be and reduce contact with others. That Health Care Facilities really get ready to surge safely, so they reduce the risk of infections, have the ability to treat large numbers of people quickly if thats needed and have the ability to surge up the number of people who can be safely cared for in intensive care units. All right. Stay with me. When we come back, ill ask tom frieden to explain something. He says the worst Case Scenario has as many as 1 million americans dying. Ill ask him to explain that number when we come back. A sommelier searches for the perfect wine. But i hear a different calling. The call of a schmear of cream cheese. 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Because i think americans find it very hard to understand exponential growth, which is what is happening here, and this is why things are going up. If you look at the cases, the number of cases seems to be doubling in america about every three days, Something Like that. There were 1,500 roughly, three days becomes 3,000, 6 days, 6,000, 9 days, 12,000s. 15 days, 48,000. 21 days, 192,000. 24 days, 384,000. 27 days, 768,000. And in 30 days, one month, 1. 5 million. So thats exponential growth, and then after that, from 1. 5 million to 3 million. Thats numbers infected. Is that what youre worried about . Fundamentally to see how bad this will be is we look at two numbers. First, how many people are severely affected and what proportion of the population does it affect. With influenza we have a vaccine and immunity that protects some of us from it. With this new virus, we dont know fully how its spreading, how readily it spreads. In what season is will spread. In what season it will spread. Its new. Thats why you have this two by two matrix you say assume it has a 1 fatality rate, and one of those plausible scenarios you have a million americans dying. One of the striking things about the analysis that we did for think Global Health is it could be small and caused hundreds of deaths or large with a million deaths. We dont say thats going to happen. We say these are the possibilities. What we can do about it is substantial. And theres been a lot of understanding recently about flattening the curve. What we can do to prevent a huge peak in cases, which might outstrip health care capacity. Thats what we saw in wuhan what were seeing in parts of italy now and what we want to avoid here. Explain what you mean by flattening the curve, lets say a Million People do get infected. It makes a big difference if it doesnt happen over 30 days but rather over 09 day over 90 daysn you have a Hospital System that can take care of them. Even if the same number get ill but it stretches out over months, you wont overwhelm your Health Care Facilities as much. Thats important because overwhelmed Health Care Facilities result in not being able to give the best possible care to people severely ill. Will it go away in april when the weather gets hot . Theres no way to know what this will do in a different climate. It has never circulated in the world before. Its new. There are some other strains of coronavirus that have both a winter peak and a summer peak. We can hope it goes away. Bottom line, we need to work for the best and plan for the worst is it possible the fatality rates we have are too high because in fact there are many more people who are infected and we dont know about . In other words, the denominator is much larger than we think. So were looking at and saying 3 out of 100 are dying, but actually its 3 out of 1,000 because theres 900 people infected that we dont know about. As a former cdc director, theres two things im so frustrated about. First, i would like to be hearing from the top world experts at cdc every single day. What are they doing . Whats their guidance . Guidance from the top Public Health officials to the american people. Second, there are crucially important questions that we dont know the answers to. Do children spread this . If they dont, theres much less reason to close schools. Does this spread from asymptomatic people . Sometimes yes. How important is that . Does it spread from contaminated surfaces . If so, cleaning makes sense. And what proportion of people die from this . For that we have to get a better sense of who gets infected, how many people get infected and what are the people most likely to have severe illness or death so we can prioritize them for services. The more we know, the better we can protect people. How does this go away . In china theyre now resuming Economic Activity, resuming the gatherings. I look at it and i think its amazing what theyve been able to do, but wont it just start up again if you start letting people go back to, you know, to all the commingling that caused it in the first place . China has done something extraordinary. They basically had hundreds of millions of people stay home for a month. They scaled up their ability to deal with infection during this time. Its continuing to spread but at a low rate in wouuhan, but we dont know if it will come roaring back once the economy restarts. They have such a tight program now, theyve been able to identify imported cases and prevent those from 13reding, but every country in the world will have to deal with that. This means all of us need to change our behavior, we need to protect the most vulnerable, protect our Health Care Front Line Workers and ready to scale up and cut back on Mass Gatherings that can spread this to lots of people from lots of people. The president keeps saying, he said it many, many times, this is going to go away. Are you as sanguine i shouldnt say sanguine, are you as confident this will go away . We will get through