This video is part of a Siri's were creating using video conference technology during the Corona virus crisis.

I'm joined today by Dr Lena Wen.

Dr.

Wen is an emergency physician and public health professor at George Washington University.

Previously, she served as Baltimore's health commissioner.

She's a former text mid Atlantic speaker.

Also welcome Lena.

Ah, happy to be with you, Dave, during these challenging times.

Absolutely.

So this Corona virus, it's here among us.

And you know, I think we all are sort of yearning for things to return to some form of normal.

But that's maybe not so easy.

What?

What kind of process are we looking at to learn to live with this virus over the next year or so?

E.

You're right that it is a very difficult time and actually one that I don't know that we could have imagined even weeks ago, much less months ago.

I mean, when we first saw the images of what was happening out of China and then when it became closer and closer to us, I think we began to see that this could impact us, but in tone it hit the U.

S.

And so quickly and in such a visceral way, I don't think we processed what this really means.

And I think for a lot of us were experiencing this in deeply personal ways.

Certainly the individuals who have loved ones who have become build or who have developed symptoms and our concern about be ill or who have but exposed to Kovar 19 the new virus themselves.

They're going through pain and suffering that would be unimaginable not so long ago.

But I actually think for all of us were home called upon to make sacrifices in a way that again we might not have imagined and could not have imagined, I mean, the idea of schools being cancelled off, businesses being shuttered and us not having gatherings, even something as basic as not being able to shake hands or not being able to see relatives.

Um, it's just a very different time, and I think it's a time that calls upon all of us to have a type of collective selflessness because for the first time, I think for a lot of us, we're seeing just how interconnected all of our fates are.

I mean, we are in an interconnected world, but in this case my health is also instrumental to your health.

My being healthy and keeping my family healthy is also what's going to prevent this disease from being transmitted in the community.

And we know that Corona virus is not something that only effects those who are medically vulnerable and the elderly.

We know that it's something that could affect each of us, and so wow, it affect each of us.

It's also our collective responsibility to stop the transmission off the buyers from person to person.

And I think it just calls upon us to make peace with those sacrifices and to understand shoe that if other people are making much greater sacrifices than we are, then we have an obligation to do our part.

And if we don't the selfishness off one person or 10 people could have a profound impact on the rest of society.

So I think you know, we always talk about social distancing in these times, but in a way, the social closeness and the interconnectedness of all us is even more clear than it normally is.

Absolutely, And you know I think, in terms of timelines.

You know, Dr Fauci has said that, you know, we don't get to make the timeline the virus next, the timeline.

And, you know, I think that we've been looking at this is kind of an event right now where, you know, this is we're having toe very suddenly adapt to all of these kinds of changes.

But I think that one of the things that you know we probably need to get used to is that this is something that will be with us in various ways for a very long time.

You know, we may need to go through multiple waves of lockdowns and other kinds of behavior modifications that, um, you know, we'll change our society.

Can you give some sense?

Is like, sort of what the process is for how we might, you know, for example, start to open restaurants and go back to work places.

Well, at the time that we're speaking right now, we're pretty far from being able to loosen the restrictions that are being placed.

And that's in part because of the work that we're doing in the work that we have not done too.

So you were talking about this being a process, and I think that's a very good way of framing it, that there is a process and also them, as you were saying, Funny, Dr Fauci, that the virus is what dictates the timeline.

But it's not just the virus.

Yes, the virus does stick to the timeline because it's a disease that we it's a new disease.

We don't know exactly how this disease exactly operates.

We don't know whether we're going to see you a temporal variation with that seasonal variation, depending on temperature.

But we also are not powerless against this virus either.

There are very specific interventions that we can do that will change the trajectory of the disease spread.

And so when we look at what happened in other countries, we know that if social distancing measures were applied aggressively and early and consistently, that that would flatten the peak and reduce the peak rate of transmission in the total number of cases, too.

But if those social distancing measures were spread out over time, then especially if they're implemented too late, then you see a much higher peak.

You see higher numbers of people who are infected, you see a longer term of infection, and unfortunately, you see more people dying because our hospitals will become out of capacity.

If all these old patients come in and all at the same time, then we just don't have the resources to treat people.

And unfortunately, people will tie because we have to ration pair.

And so what needs to happen is that we have two very urgently stabilize our health care system because that is going to be the reason for mortality and actually a reasonable mortality that we just cannot forgive ourselves for if we have to ration care not only to those patients with chronic buyers, but also to other patients.

Because health care continues to happen.

People are still going to be coming in with heart attacks and strokes and diabetes complications and other things that need hospital care and, if they cannot get care than they will also suffer as a result.

So we have to stabilize the health care system 1st 2nd is we have to get mass testing because otherwise we don't know the truth spread of crow, the buyers in our communities, and that's really important.

We need data and science to guide our decision making and on Lee after we're seeing number three, which is the effects of our social distancing measures on Lee.

After we're seeing the peak off, the number of cases begin to decline consistently.

Then we can start potentially rolling back these social restrictions.

And ideally, we have the data at that point to roll them back one community, one region at a time or several regions at a time, but not all at the same time.

Um, and I get concerned, though, that because we've been late because we have not consistently applied social distancing across the board because we don't have widespread testing because we haven't had the focus on strengthening our health care system that we need as a result of being lanes.

I'm afraid that that's actually going to cost us more time, and I think it just reminds me of something that my mentor and um and I know someone that you love and admire dearly.

Also a text.

Mid Atlantic Speaker Congressman Elijah Cummings used to say that the cost of doing nothing isn't nothing that there is a cost off in action, and unfortunately, we're seeing that cost now, when we don't pay attention to public health to prevention, when we don't act quickly enough, we see that actually, there will be a lot more pain and suffering and lives lost.

But we need to look forward.

We can't just navigate from where we wish we were.

We need to navigate from where we are and we need to do everything we can and that May is continuing to make the sacrifices that will seem very difficult.

But at the end of the day, they are what our life saving?

Absolutely, and in terms of testing, I mean, I think that's been cited repeatedly.

Uncertainty.

You just mentioned it as a prerequisite for, you know, trying to get things back on track.

I understand that there's a couple of different kinds of testing that air potentially available.

Can you talk about, you know, kind of what are the constraints on testing and what are the different kinds that we may need in order to get back to work?

So there has been some excellent reporting done about the missteps in testing and why it is that the U.

S.

Is so far behind other countries when it comes to having widespread testing capacity.

I think in general it has to do with lack of anticipation because even after tests were actually being produced and distributed, then we found out that the swab that was used, that's used to actually get the test, that that was in short supply.

And then we found out that the re agent used to process these tests were in short supply.

And so it's one thing after the other and then Ben there was a problem with personal protective equipment that if nurses and doctors and health care workers don't have equipment toe actually collect test the same matter, then you can't do the test either.

And so I think that's been one trend along the way that so much of the of the process of combating Club in 19 has been looking at what's already happened instead of anticipating what we need going forward, which is something that I hope that will be changed, but looking forward to testing the things that we do need and are on the horizon, one is point of care testing.

You can't have people wait 56 days for a test results that's not practical in a clinical setting and it doesn't make sense for public health.

Measurements were looking at something that happened a week ago.

You need point of care testing, meeting testing that's done at the bedside available within the hour.

And there are no tests that are being developed.

Thio Thio To this extent that are really important.

The second thing is you need to look at not only the tests or whether somebody has an acute infection round.

Ideally, we also get to the serology test looking at antibodies because there are people who may have Half Corona virus and may have had no symptoms or mild symptoms or because of lack of testing, never got tested.

It would be good to find out if there are people out there in the community who have immunity are ready to grow the virus because that would certainly change how they interact with society.

And they might be the first ones to be able to return to work.

Or you could imagine if they were frontline health care workers.

It gives them a level of protection as well, and that is no ordinary about testing is you needed to be widespread.

Everyone who has symptoms should get tested.

Everyone who has exposure should be tested.

And beyond that, we need surveillance testing.

So that we understand is it that 50% of the people who are walking around actually half Corona virus and are spreading it and just don't know it or are we talking about 1% or 10.1%?

That level of surveillance and understanding is also critical to public health to guide public health measures moving forward?

Sure, that makes a lot of sense.

And I think, you know, at the moment we don't have very good visibility into the spread.

And, you know, I think that puts a lot of future decisions into, you know, uncertainty, Um, in terms of, you know, more final kinds of resolutions to this.

You know, I think that there's a lot of work being done on both treatments and on vaccines.

Um, Mike, understanding is that, uh, most vaccines probably would be, like a least a year, but probably more like 18 to 24 months out on the horizon.

Um, can you give a sense of you know, what we might expect in terms of accedes?

Sure.

So cove in 19 as you know, is a new disease, which means that nobody has immunity to it naturally because it hasn't been around it.

There also is no vaccine and no proven treatment as of yet because of how new it is.

Treatments could be developed a lot sooner because there are existing medications that are anti virals or have other properties that are promising, and there are already clinical trials underway with multiple of these potential treatments.

But ideally, what we need to get to you is what you said Dave, which is getting to a vaccine that will prevent us as much as possible from contracting Kobe 19 in the first place.

And that is the development of that vaccine and being able to roll that out worldwide.

That will be the real game changer.

That's when we can all go back to as much as life as normal as as as we knew it before.

Now, developing a vaccine for a novel disease is very challenging.

It has to go through multiple phases.

They have to demonstrate safety and efficacy, and importantly, it's not just about developing the vaccine.

It's also about making enough because when we think about vaccine.

We think about the moment at which the vaccine gets to people, not just a moment at which it gets approved by the Food and Drug Administration.

And so your rights that the timeline, I think the most ambitious timeline is 12 months.

A more realistic is 18 months, and it may take even longer.

And I think that kind of timeline underscores wine.

These other preventive measures and really drastic measures that we're taking when it comes to social distancing, are so important because if we don't implement these measures, then we're looking at.

Some models show 40 to 60% of the American population contracting Corona buyers.

And if there's a death rate of 1 to 3% that's millions of Americans who could die in the next year.

We have an opportunity to change that and reduce the number of deaths.

But without a vaccine, those types of social distancing measures are our best bet.

And what each of us has to do.

No, absolutely.

I think that's ah, very good advice and in terms of, um, you know what?

What kind of advice?

Would you maybe pass on to people that are watching this at home.

You know, as we enter into this period of living with this virus, this process of starting to manage it, and then ultimately try to bring it under control.

If there was one piece of advice that you could give to, you know, people watching this as a public health professional, what might have been the one piece of advice?

Well, maybe I could give several pieces of advice that I can Sure, Yeah, maybe three pieces of advice.

The first is that there are tangible things that we could do in order to reduce our own risk.

And very specifically, the one thing that I think everyone has come to know in the last several weeks to months is the importance of hand and face hygiene, which I hope is something that will keep up even long after a Corona virus is under control.

I hope will keep on these thieves types of good personal hygiene practices, washing hands for at least 20 seconds with soap and water using hand sanitizer.

Best I'm available.

Stop touching our face or touch our face less.

I think those are good practices regardless and are things that we should continue to keep in mind.

The second is around social distancing.

You know it.

There's a social media campaign that a number of health care workers have launched.

That really breaks my heart every time I see it.

And that's health care.

Workers, doctors, nurses are Mrs Respiratory there.

But everyone who works in this holding up signs that say I stayed at work for you Please stay at home for me.

And sometimes we think about what good am I doing just sitting on the couch watching Netflix?

No, it doesn't feel like we're contributing to the greater societal good, but I want people to know that that is the single most important thing that you can do to reduce the rate of transmission of Kobe.

19.

This new Corona viruses spread person to person, and if we're able to stop that, transmission in its tracks were stopping the virus in its tracks.

And the single most important thing you can do is actually to stay at home and watch Netflix, if you will, and to physically distance yourself understanding how challenging that is.

I mean, I'm about to give birth at the moment that we're speaking, actually, and we caught you with the last possible moment tonight and I mean right after having the baby and I won't be able to have any visitors.