>> SENSE THE FIRST APPEARANCE OF A NEW CORONAVIRUS FROM CHINA ABOUT TWO MONTHS AGO, GLOBAL
SPREAD OF THE DISEASE AND NOW
LOCAL CASES HAVE SENT A JITTERY
PUBLIC LOOKING FOR ANSWERSMENT
WE TURN NOW TO THE SCIENTISTS
FOR THOSE ANSWERS.
>> AND WE HAVE SOME GOOD ONES
WITH US THIS MORNING.
DOCTOR EILEEN MARTY IS A
PROFESSOR OF INFECTIOUS DISEASES
AT FLORIDA INTERNATIONAL
UNIVERSITY.
SHE’S A U.S. NAVY VET, WORKS FOR
THE WORLD HEALTH ORGANIZATION.
MOST RECENTLY IN THE FIGHT
AGAINST EBOLA.
DOCTOR JOSE CASTRO IS A
PHYSICIAN AND INFECTIOUS DISEASE
SPECIALIST AT THE UNIVERSITY OF
MIAMI MEDICAL SCHOOL.
HIS TEACHING AND RESEARCH FOCUS
ON AMONG OTHER THINGS INFECTION
CONTROL AM GOOD MORNING, GREAT
TO HAVE YOU COME IN.
>> SO GREAT TO HAVE YOU IN.
>> GOOD MORNING.
>> WE SHOULD DO THE ELBOW BUMP.
>> TRUTH BE TOLD, WE’VE ALREADY
HUGGED AND KISSED OTHER PEOPLE
TODAY.
SO YOU KNOW,S THAT IS AN
ACTUALLY GREAT PLACE TO START.
HOW CONCERNED GENERALLY SPEAKING
IN THIS PLACE AND TIME SHOULD
PEOPLE BE ABOUT LEVELING AND
DO-- LIVING AND DOING THINGS
LIKE THAT?
>> THAT IS A COMPLEX QUESTION.
BECAUSE IT DOES HAVE TO DO WITH
WHO YOU ARE HUGGING AND KISSING,
RIGHT.
AND HOW OLD THEY ARE, AND THE
SAME THINGS.
WHAT ARE THEIR RISK FACTORS AND
WHAT ARE YOUR RISK FACTORS FOR
HAVING COME IN CONTACT WITH THIS
PARTICULAR HAVE A-- VIRUS BEFORE
DO YOU YOUR HUGGING AND CUZZING.
THE BETTER YOU KNOW THE PERSON,
YOU LIVE WITH THEM, GO AHEAD AND
HUG AND KISS.
>> UH-HUH.
>> AND THEN TAKE IT FROM THERE.
>> DR. CASTRO, LET ME ASK YOU, I
FEEL IN EVERY DAY LIFE OVER THE
LAST WEEK OR SO AN INCREASING
LEVEL OF ANXIETY IN OUR
COMMUNITY, AMONG PEOPLE I DEAL
WITH, PEOPLE I WORK WITH.
I THINK WE ARE ALL TAKING, DOING
FIST BUMPS AND WASHING OUR HANDS
A LOT.
HOW CONCERNED, HOW MUCH ANXIETY,
HOW MUCH WORRY SHOULD WE HAVE
THESE DAYS.
>> I THINK THIS IS A NEW
DISEASE.
YOU KNOW, THE ANXIETY SUNDAY
STANDABLE IT IS TRANSMISSIBLE
BETWEEN HUMANS AND IT IS
SPREADING AS WE KNOW IN
DIFFERENT PARTS OF THE WORLD.
HOWEVER THE MORTALITY, HOW MANY
PEOPLE DIE WHEN THEY CATCH
INFECTION IS PROBABLY AROUND,
YOU KNOW, AROUND 1 PERCENT OR
LESS.
>> CAN I JUST INTERRUPT YOU FOR
A MOMENT, WHAT WE ARE HEARING IS
3 PERCENT, WHICH IS.
>> YEAH, THERE IS A LOT OF
CONTROVERSY BECAUSE THE ACTUAL
NUMBER OF PEOPLE INFECTED IS
UNKNOWN.
SO AT THE END WE SEE MOST PEOPLE
WHO IS SICK AND GETS INTO THE
HOSPITAL.
MAYBE ONE EXAMPLE WE CAN TAKE
WHERE IT WAS KIND OF A NATURAL
EXPERIMENT WAS ONE OF THESE
CRUISES WHERE EVERYONE WAS
TESTED.
WHAT WE KNOW FROM THAT CRUISE IS
THE MORTALITY WAS
RELATIVELY-- IT WAS LESS THAN
THAT NUMBER.
SO PROBABLY LESS THAN 1 PERCENT.
THAT, YOU KNOW, IS VERY LOW.
SO WHEN YOU TALK ABOUT
POPULATION, IT IS STILL HIGH.
>> YOU KNOW, THAT IS A REALLY
INTERESTING CHARACTERIZATION.
BECAUSE RIGHT NOW OFF THE COAST
OF SOUTH FLORIDA, PORT
EVERGLADES IS A CRUISE SHIP, TWO
OF THE CREW MEMBERS NEED TO BE
TESTED BECAUSE THEY CAME OFF THE
SHIP OFF SAN DIEGO.
I DON’T WANT MINUTE TO THINK
THERE IS A CRUISE SHIP OF PEOPLE
THAT MIGHT BE INFECTED OR MAY
BE, BECAUSE TO YOUR POINT, WE
JUST DON’T KNOW.
DR. MARTY, THERE ARE NOW IN
SOUTH FLORIDA TWO CASES,
PRESHUMP TIFF CASES IN BROWARD
COUNTY.
IS IT FAIR TO THINK THAT THERE
ARE VERY MANY MORE CASES OF
PEOPLE WHO JUST DON’T KNOW IT
YET.
>> THAT’S WHY WE NEED TO DO
SURVEILLANCEMENT YOU NEED TO GET
A REAL HANDLE ON THE DATA.
WE NEED TO GET THAT NEUM RATER
AND DE NOMINATOR SO WE ACTUALLY
UNDERSTAND WHAT THE RISK FACTORS
ARE.
IF WAS DONE IN CHINA AND BECAUSE
THEY WERE-- IT IS THE TYPE OF
GOVERNMENT THAT WILL TEST YOU
WHETHER YOU WANT TO OR NOT.
AND SO FOR EVERY SINGLE CASE
THAT THEY FOUND, THEY TESTED EF
RESINGLE FAMILY MEMBER AND THEY
TESTED NOT JUST EVERY SINGLE
FAMILY MEMBER, BUT EVERY SINGLE
CLOSE CONTACT OF THAT CASE.
>> CAN YOU GO AND YOU WERE
EXPLAINING TO US EARLIER AND I
WOULD LOVE FOR OUR AUDIENCE TO
HEAR WHAT SURVEILLANCE ACTUALLY
MEANS, TAKING SORT OF POLL IN
SORTS IN A SCIENTIFIC WAY OF
TESTING.
CAN YOU GO INTO A LITTLE BIT OF
THAT DETAIL SO PEOPLE UNDERSTAND
THAT.
>> YOU HAVE ALREADY-- YOU’VE
ALREADY DONE IT PERFECTLY.
IT IS BASICALLY POLLING
DIFFERENT POPULATIONS TO GET A
REAL SENSE OF WHAT IS GOING ON.
SO GET-- TO GET AN UNDERSTANDING
OF THIS ENTIRE OUTBREAK.
NOW UNFORTUNATELY THE DATA FROM
CHINA DOES INDICATE A HIGHER
THAN 1 PERCENT FATAL ITERATE.
AND THEY IDENTIFIED ASYMPTOMATIC
CASES DOING THIS INTENSE TESTING
OF SO MANY PEOPLE.
BUT MOST OF THOSE ASYMPTOMATIC
PATIENTS THAT WERE TESTED AND
WERE ASYMPTOMATIC AT THE TIME
THEY WERE POSITIVE, EVENTUALLY
SHOWED SYMPTOMS.
>> I WANT TO TALK ABOUT MORE
SURVEY SLANS.
-- SURVEILLANCE.
DR. CASTRO, IF SOMEBODY IS
WATCHING THIS WHO HAS A FEVER OF
100 OR SO, HAS A DRY COUGH, HAS
AN UNDERLYING HEALTH CONDITION,
MAYBE HAS DIABETES OR LUPUS OR
SOMETHING AND THEY ARE WONDERING
WHETHER THEY SHOULD BE TESTED,
WHAT SHOULD THEY DO?
>> SO WE HAVE TO UNDERSTAND,
PROBABLY THE PUBLIC HAS TO LEARN
AS WE’RE LEARNING.
THIS DISEASE HAS A SPECTRUM OF
PRESENTATIONS.
WE’RE LEARNING THAT OVER
WHILE-- OVERWHELMING MAJORITY,
ABOUT PROBABLY 80% WILL HAVE
MILD DISEASEMENT MILD DISEASE
THAT WILL NOT REQUIRE TO BE
ADMITTED TO THE HOSPITAL.
SO PROBABLY YOU KNOW, JUST
TALKING TO YOUR DOCTOR OVER THE
PHONE, JUST REGULAR.
>> STAYING HOME, TREATING
YOURSELF, OVER-THE-COUNTER MEDS
KIND OF THING.
>> YES.
>> WELL, LET’S BE VERY, VERY
CLEAR, RIGHT.
HE’S CORRECT, TECHNICALLY, 80%
OF PEOPLE DO NOT REQUIRE
HOSPITALIZATION.
BUT IN THAT 80% IS, JUST AS YOU
SAID, A RANGE.
AND A LITTLE OVER HALF OF THAT
RANGE IS A WALKING PNEUMONIA.
AND PEOPLE WILL FEEL LOUSY.
AND THEY WILL NEED TO BE, AS ONE
OF THE THINGS THAT DR. CASTRO
AND I HAD THE PLEASURE OF
TALKING ABOUT AHEAD OF TIME, IS
THE VALUE OF WHAT WE CALL TEL
MEDICINE.
SO IT IS NOT-- WE DON’T HAVE TO
JUST DO A PHONE CALL.
WE CAN ACTUALLY SEE THE PATIENT,
INTERACT WITH THE PATIENT,
ALMOST AS APPROXIMATE THEY WERE
IN OUR OFFICE WITHOUT A RISK OF
CON TABLINGON.
AND ALSO BE CLEAR THAT IF THE
PERSON PROGRESSES FROM THAT MILD
OR MODERATE STATE, TO A MORE
SERIOUS STATE, WE HAVE TO HAVE
PROTOCOLS IN PLACE SO THAT WE
CAN THEN BRING THEM INTO A
FACILITY AND GET THEM THE
ADDITIONAL CARE THEY MIGHT NEED.
>> WELL, EVERYBODY WHO HAS, IT’S
FLU SEASON.
PEOPLE ARE SICK.
AND NOT NECESSARILY HAVING
ANYTHING TO DO WITH CORONAVIRUS.
IS WHAT YOU ARE SAYING TO BE
HEARD, I’M NOT FEELING SO WELL.
I’M STAYING HOME, I’M NOT GOING
TO FREQUENT OUT,-- FREAK OUT IF
YOU ARE A NORMAL HEALTHY PERSON.
AND I MAY CALL MY DOCTOR TO SEE
WHERE THIS GOES.
NOT JUMPING IN SAYING OH MY
GOSH, I BETTER GET A TEST.
IS THAT FAIR TO SAY?
>> ABSOLUTELY, YEAH.
SO AS I SAID, MOST OF THE PEOPLE
HAVE A MILD DISEASE.
LESS PERCENTAGE WILL HAVE A MORE
SEVERE DISEASE WITH HIGHER
FEVER, THOSE ARE THE ONES WHO
PROBABLY HAVE A PNEUMONIA.
AND SOME OF THEM WILL EVENTUALLY
V A DEADLY DISEASE.
CERTAINLY THAT GROUP, THE ONES
WHO REQUIRE TO BE IN THE
HOSPITAL WITH ADDITIONAL
MEASURES.
SOME OTHER THERAPY.
>> AND IT IS NOT A RANDOM, YOU
KNOW, WHO’S GOING TO BE SO
CIRCUMSTANCE.
AS WE’RE LEARNING, THERE ARE
CERTAIN FACTORS THAT WILL MAKE
PEOPLE WHO CARRY THOSE FACTORS
TO BE IN THIS GROUP THAT CAN BE
VERY SICK.
>> AND THAT IS AGE.
AS YOU AGE YOUR CHANCES TO
BECOME.
>> SO 70 AND ABOVE, YOU BEGIN TO
GET MUCH HIGHER RISK AND
LIKELIHOOD OF MORTALITY.
I SAY 07 TO 80 I THINK I SAW THE
FIGURE WAS LIKE A 15% MORTALITY
RATE FOR A FATAL CASE OF
CORONAVIRUS.
>> THE LANCET STUDY HAD IT AT 14
POW 8 OVER THE AGE OF 80,
THE-- STUDY HAD 350E78 OVER 780
HAVING A 21.9 PERCENT CHANCE OF
MORTALITY.
>> OKAY.
WE’LL PICK UP RATE HERE WHEN WE
COME RIGHT BACK.
WELCOME BACK. ON THIS SUNDAY WE ARE WITH TWO MEDICAL SPECIALISTS, TWO
PHYSICIANS WHO ARE INFECTIOUS
DISEASE SPECIALIST.
DR. EILEEN MARTY FROM FIU,
DR. JOSE CASTRO FROM THE
UNIVERSITY OF MIAMI MEDICAL
SCHOOL.
SO DOCTOR MARTY, EXPLAIN TO US
ABOUT THE ALGORITHM THAT YOU
WANT TO SORT OF ESTABLISH AND
WHAT IS THE POINT HERE, GET
GOOD, HARD EMPIRICAL DATA TO
HELP POLITICAL AND GOVERNMENTAL
LEADERS MAKE DECISIONS ABOUT HOW
TO ADDRESS THIS?
>> RIGHT.
SO THIS IS BEING SPEER HEADED BY
DR. BABARICCI, RIGHT NOW ON HIS
WAY TO MONACOMENT HE WANTS TO
GET A SERIES OF TASK FORCES
THROUGHOUT THE WORLD AND
TOGETHER WE’LL ANSWER TO HIM AND
CREATE A SERIES OF ALL IMOR
RHYTHMS THAT-- ALGORITHMS THAT
ANY BODY WHO IS HOLDING ANY
LEVEL OF MASS GATHERING CAN GO
THROUGH A SERIES OF TOOLS TO
MAKE IT A RATIONAL AND
REASONABLE DECISION AS TO
WHETHER OR NOT A PARTICULAR MASS
GATHERING IS OR IS NOT AT RISK.
>> NOW IT IS ANECDOTAL BUT WE
HEARD, AND I THINK GLENNA
REPORTED THIS WEEK THAT THE CITY
OF MIAMI SAID WELL, WE TALKED TO
THE CDC.
THEY SAID ANY GATHERING IN
25,000 OR MORE YOU OUGHT TO
RECONSIDER WHETHER YOU HAVE IT.
AND THAT OSTENSIBLY WAS ONE
REASON WHY THE ULTRA MUSIC FS
VAL WAS CALLED-- FESTIVAL CASS
CALLED OFF.
>> THAT IS A LITTLE BIT-- THAT
IS ENOUGH DATA.
THE NUMBER OF PEOPLE IS NOT
ENOUGH TO BE A KICKOFF IN ANY
PARTICULAR PLACE.
YOU HAVE TO TAKE THE NUMBERS THE
PLACES WHERE THOSE PEOPLE ARE
COMING FROM, THE SITUATION AM
THOSE PLACES, AND THE AREA AND
VARIOUS DIFFERENT FACTORS OF THE
COMMUNITY INTO CONSIDERATION.
AND THOSE ARE PART OF WHAT WOULD
FIT INTO THE ALGORITHM SO THAT
THEN DECISION MAKERS CAN DO
APPROPRIATE AND REASONABLE
PLANNING.
>> THAT HAS BEEN VERY CONFUSING
TO A LOT OF PEOPLE THIS WEEK.
>> DR. CASTRO, ONE OF THE, ALONG
WITH THE SAME LINES.
INFORMATION COMING OUT OF THE
PEOPLE WHO NOW IN FLORIDA ARE
INFECTED AND EVEN WHO HAVE
PASSED WERE THIS, HAS BEEN VERY
BASIC.
WE KNOW GENDER, WE KNOW COUNTY,
WE KNOW AGE.
BUT PEOPLE ARE CRAVING DETAILS
FOR THEIR OWN BENEFIT, FOR THEIR
OWN DECISIONS.
WHERE IN BROWARD WERE THESE
PEOPLE MIGHT I HAD BEEN WITH
THEM, WHAT SHOULD I DO.
WHAT PREVENTS, UNDER THE GUISE
OF PRIVACY LAW, IS WHAT THE
HEALTH OFFICIALS ARE SAYING,
THAT WE CAN’T RELEASE ANY MORE.
HOW FAR DOES HIPA, THE FEDERAL
PRIVACY LAW DEALING WITH MEDICAL
ISSUES, HOW FAR DOES THAT GO AND
WHAT CAN WE KNOW TO ALLOW US TO
MAKE BETTER DECISIONS ABOUT
THESE CASES.
>> WILL WELL, THE INFORMATION
THAT WE HAVE FROM FLORIDA, FOR
THE FEW CASES THAT WE KNOW, IS
PROBABLY ANECDOTAL.
AND JUST IS REALLY IMPORTANT TO
KNOW THAT LOCALLY, WITH
TECHNOLOGY-- BUT STILL WE DON’T
HAVE THE TOOLS, AND BY THE TOOLS
ABOUT DOING SCREENING IN THE
POPULATION.
>> MY QUESTION WAS WHY CAN’T WE
KNOW MORE ABOUT THESE BROWARD
KAITIONS, ABOUT THESE PEOPLE,
WHERE HAVE THEY BEEN.
WHERE DO THEY LIVE GENERALLY.
WHAT STORES HAD THEY VISITED AND
MIGHT I HAVE BEEN THERE.
WHY CAN’T WE KNOW THAT.
>> TYPICALLY THE HEALTH
DEPARTMENT WILL DO AN
INVESTIGATION.
TYPICALLY THEY DO CASE TRACING.
THEY GET INTO WHAT THEY CALL
INDEX CASE.
THEY COLLECT INFORMATION.
AND THEY SHOULD BE DOING
TESTING.
>> BUT THEY HAVEN’T BEEN VERY
FORTH COMING.
BEFORE WE RUN OUT OF TIME, HERE
ARE TWO GREAT PHYSICIANS.
>> YOU WANT TO ASK YOU TO GIVE
OUR AUDIENCE, GIVE US SOME
REALLY GOOD SOLID INFORMATION.
YOU HAD SAID DURING A BREAK THAT
YOU ARE KIND OF SICK OF HAD
ADVICE, WASH YOUR HANDS FOR 20
SECONDS, SING THE BIRTHDAY SONG
AND THAT’S IT I MEAN ARE YOU
SAYING WASH YOUR HANDS LONGER
THAN 20 SECONDS.
>> WE’VE ALWAYS SAID IT IS A 40
TO 60 SECOND HAND WASH.
WE’VE ALWAYS INSISTED THAT
YOU’VE GOT TO CLEAN UNDER YOUR
FINGER NAILS BY RUBBING YOUR
FINGERS LIKE THIS AND PAYING
ATTENTION TO EACH AND EVERY
DIGIT, THAT TAKES TIME, EACH AND
EVERY DIGIT AND THN THE WRIST
AND THEN OF COURSE LATH
ARERRING, ONCE YOU DO THAT, YOU
DON’T HAVE TO BOTHER COUNTING,
BECAUSE IT WILL BE 40 TO 60
SECONDS BECAUSE YOU WILL DO A
BETTER JOSH.
>> I LACK FORWARD TO THE
TUTORIAL YOU DO ON YOUTUBE ON
HOW EXACTLY TO WASH HANDS.
>> A LOT OF THAT HAND WASHING
COMES WITH DRYING WITH THE
HANDS, SO LET’S REMEMBER TO
MOISTURIZE, WHEN WE ARE DOING
ALL OF THAT HAND WASHING.
>> NO TOUCHING YOUR FACE, EYES,
NOSE, MOUTH AND HAND SANITIZER.
>> NOT TOUCHING IS VERY
IMPORTANT BUT IT IS NOT EASILY
DONE.
AND SOMETIMES WE JUST DO IT WITH
BEING CONSCIENCE.
SO REALLY EMPHASIZING HAND
WASHING VERY OFTEN, AND IF
ANYTHING, IT WILL BE THAT
MESSAGE, WE HAVE TO KEEP WASHING
OUR HANDS.
>> AND SURFACES.
WE HAVE TO KEEP OUR SURFACES AS
CLEAN AS POSSIBLE SO THAT WHAT
WE TOUCH.
>> AND COMMON SENSE AND DON’T
PANIC.
>> THAT’S RIGHT.
>> ALL RIGHT, DR. MARTY, GREAT
TO HAVE YOU COME IN.
>> THANKS FOR HAVING US.
>> ALL RIGHT, UP NEXT WE’RE
GOING TO TAKE CORONAVIRUS AND
SEVERAL OTHER BIG STORIES LIKE