My name is Rebecca gold

and I'm working at CDC on the COVID-19 response.

I'd like to introduce you to doctor jay butler, CDCs

department director for infectious diseases.

He'll be giving you an up date about what's happening

currently and also be available to answer some

questions.

Doctor butler.

SPEAKER: All right thank you Rebecca.

Good afternoon or good morning everyone depending on

where you are.

So let's start with a situation up date.

I think everybody's become aware of the spread of the

COVID-19 virus since it's original

emergence in Wuhan China in December of this year.

Over the past two and a half months the epidemic has

progressed.

The first two months really China was the center of the

outbreak and Wuhan province in central China in

particular was impacted.

As of now there have been over 80 confirmed cases in

China and over 3,000 deaths.

However as of about a week ago the number of cases

occurring outside of China began to exceed the number

of cases occurring within China.

Both the cause of

spread of the virus around the world and also because

the number of new cases in China has gun to decline.

Outside of China there's been cases reported now from

some 85 nations.

Of course including the United States.

Overall over 10,000 cases have

been reported from outside of China.

The hot spots currently are in the republic of south

Korea, also a number of cases have been reported with

community transmission in

Japan and then the two other regional hot spots are

Europe, particularly with cases I

aminating out of outbreaks that were occurring in

communities in northern Italy and also the eastern

Mediterranean region with cases I aminating from I ran

particularly the talon of cove.

Here in the United States the number of cases has

increased over the past several days.

With reports of cases from 13 different states.

The cases where there's been community transmission

have primarily been on the west coast but not solely on

the west coastthism is a very fluid situation and as

testing becomes available through an increasing number

of state labs as well as in the near future commercial

laboratories we anticipate that the epidemic will

continue to be

recognized and spread will be better defined.

The issues that I think are of greatest concern to us

right now are spread to people who are more vulnerable

for severe illness.

There has been cases in a long term care facility in

the Seattle area where there have been eight deaths

associated with infection.

The illness

itself is one that's primarily a respiratory illness.

As we know more about the manifestations.

We also know that most people about 80 percent have

relatively mild illness although it may involve

pneumonia.

The majority of people actually do recover but there's

still 20 percent that have more severe illness that may

require medical care or hospitalization.

Mortality is an area of great interest to us because as

we assess the impact of the epidemic and what are the

appropriate interventions and considering both the

risks and benefits we want to know how transmissible it

is and how surear is the illnessment you've probably

heard reports in the illness saying it's 200 times more

fatal than influenza.

I think that's probably a biased statement because we

have less visibility on the milder cases.

Our estimates suggest that it's probably less than one

percent but keep in mind if this is a virus that is

capable of infecting the vast majority of people that's

still a very very significant number.

The people at highest risk are those who are elderly

and also those with underlying illnesses particularly

chronic heart and lung disease as well as diabetes.

The interventions to date have focused on how we could

delay the virus in the country

and limit it's spread.

Those are interventions designed to buy us more time to

be able to be prepared for the entry of the virus and

as we move into a time of progresses of mitigation,

recognizing that community spread is occurring in some

locations again the focus is on how do we spread the

impact of the epidemic over as long a period as

possible so that businesses can remain open as much as

possible and so that the impact on health care is not

going to be overwhelming if it can be at all avoided.

This would also give us more time to develop effective

antiviral

medications and ultimately to have a protected and

preventive vaccine.

Even though it may be possible to have a vaccine that's

ready to enter human trials over the next two to three

months because of what's required to show that's

vaccine would be safe as well as effective I think it's

unlikely that we'll have a vaccine for the general

population in less than 18 months.

There is also a wealth of information that's

available on the CDC website that I wanted to call

attention to.

There are guidelines specifically focused on businesses

how to be prepared.

I think the important take homes from that are issues

related to HR and making sure that em plies

are able to stay home if they are sick.

That will be to your benefit as well as your work

forces benefit as well as your customers.

And then also particularly if you're in the public

service sector being able to provide hand hygiene

products whether that be reminding people to wash their

hands or providing jells to san ties hands as much as

possible those would be things that we would recommend.

Guidelines on large events.

Also recommended precautions

preventing the spread in election polling locations.

Prevention of spread in

communities, interim guidance on public health

communications for communities.

Additional resources for health care facilities.

Strategies for optimizing the

supply of N95 respirators which I think is of

particular interest to health care providers in the

health care industry.

Strategy taz prevent spread in long term care

facilities which I think is an area of keen interest

given the concentration of high risk individuals in

these facilities.

General guidance for health care facilities.

Also guidance for institutes of higher education

including specific guidelines for

students wanting to study abroad.

There's also some household readiness guidance and

some documents on combating sigma and also frequently

asked questions for children.

I think I will stop at that point and I understand

there is a cue of questions

already so I will turn it back over to Rebecca.

SPEAKER: I am here.

First question we got in advance was we heard there's

on going research on the life span of the virus.

Could that change the cleaning requirements because

right now the website says there there's no need for

deep cleaning or extra cleaning measures.

Is that going to change?

SPEAKER: This is a broad answer to many questions.

We're still learning this virus.

What we know about it so far which suggests that the

routinely touched surfaces can be cleaned with cleaners

that are typically used.

These would be using products according to the

directions on the label.

We do not have recommendations for specific PPE for

prevention of infection of people who are doing the

cleaning but of course the PPE whether that be gloves

or eye protection that are appropriate for the cleaning

solution itself is important to continue.

The survival of the virus on surfaces is one of great

interest to us right now the epidemiology as well as

what we know about other corona virus's suggest that

it's probably spread through respiratory droplets

meaning droplets that are not air born but may be

projected during coughing or sneezing.

But there is some experience particularly with the sars

virus that suggests that surfaces can become

contaminated and that the survival of the virus could

be for a period of minutes or hours and that it could

be potentially

transferred usually through hand contact.

That's one of the reasons why we have such a

concentration on hand hygiene as well as break the very

difficult habit of putting your hands to your face.

There have been a number of projects assessing the

viability of the virus on surfaces and I think that

backs the current recommendation.

However it's important to recognize that some of this

research has really focused on what are the outer

limits under absolutely ideal conditions which may be

unlikely to achieve in real life.

So if you hear of contaminated surface and virus being

recovered for days that may indeed be possible.

What we don't really have evidence for is that that's a

significant mode of transmission.

Questions have been raised about whether or not mail

and packages could become contaminated.

Also question

business money.

You know right now the epidemiology does not point

toward that particularly as we talk about the mail.

We would've seen more I think met static

infections very early in the epidemic given that China

is very interconnected with the rest of the world and

is a major exporter of products in a number of

different goods.

The epidemiology of the spread out from China has also

been exclusively, travel to China, exposure to someone

who issismmatic and then exposing other people after

return.

In terms of specific products it's kind of the routine

things in terms of sodium hypo chloride meaning bleach

type products or alcohol wipes.

SPEAKER: Great thank you.

Do we know if recovered patients are still capable of

spreading the disease?

SPEAKER: It appears the people who are most infectious

are people who are actively ill.

Persons who are coughing and sneezing of course are

having a harder time controlling their secretions and

more likely to transmit it to people around them.

There is some evidence that people are shedding the

virus shortly before the on set of symptoms and there

is also evidence of asymptomatic infection.

At this point in time we have very limited evidence

that those asymptomatically infected people are playing

a significant role in transmission.

But we are very concerned about that possibility and we

continue to monitor it very closely and continue to

collect data.

For people who have had documented COVID-19 infection

our current strategy is to have those people isolate

whether it's in a health care facility or self

isolation at home until there has been two negative

tests consecutive respiratory specimens and this is

usually a swab up the nose and also in the throat

through the mouth and that both of

those tests would be negative on two different

occasions at least 24 hours apart.

There have been some isolated incidences of tests

collected later that were positive showing a very low

viral load and at this point in time we are still

determining what

the significance of those tests are.

The PCR is a very sensitive assay.

Particularly at lower viral loads.

Detecting not so much a proven viable virus as

certain pieces of the genetic material of the virus in

that genetic material certainly could still be present

even after the active infection is cleared.

SPEAKER: What are the other things we should be doing