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>>> WELCOME BACK TO "MORNING
JOE."
IT IS JUST ABOUT THE TOP OF THE
HOUR ON THIS THURSDAY, MAY 14TH.
LET’S DIVE RIGHT IN.
>>> JOINING US NOW, FORMER FALD
COMMISSIONER DR. SCOTT GOTTLIEB.
>> HEY, DOCTOR.
THANK YOU SO MUCH FOR BEING WITH
US IT LET’S START BY TALKING
ABOUT THE TESTS THAT ARE BEING
USED AT THE WHITE HOUSE RIGHT
NOW.
THOSE ARE THE ABBOTT TESTS.
OBVIOUSLY A LOT OF PEOPLE
EXCITED ABOUT THE FACT THAT THEY
ROLLED OUT ONE OF THE FIRST
TESTS THAT COULD PROVIDE QUICK
RESULTS.
NOW WE’RE FINDING OUT THAT NOT
AS ACCURATE.
YOU TWEETED ABOUT THIS
YESTERDAY.
NOT AS ACCURATE AS IT ONCE WAS
HOPED, BUT CAN YOU JUST TALK
ABOUT THIS PROCESS?
AND IT IS A MESSY PROCESS WHERE
FDA GUIDELINES, BECAUSE IT IS A
PANDEMIC, MAYBE THEY’VE BEEN
LOWERED AND THINGS HAVE BEEN
SPED UP AS FAR AS REGULATION
GOES MUCH MORE THAN USUAL AND
THE SORT OF TRADE-OFFS WE WILL
BE MAKING LIKE THIS?
>> I DON’T THINK IT IS SO MUCH A
REGULATORY TRADE-OFF AS IT IS A
TRADE-OFF BETWEEN DIFFERENT
KINDS OF TESTING TECHNOLOGY.
THE MACHINE BEING USED AT THE
WHITE HOUSE OR THE IMAGING
MACHINE CLEARED OVER THE WEEKEND
OR A SIMILAR MACHINE INSTALLED
IN DOCTOR’S OFFICES, THESE ARE
TESTS TYPICALLY USED TO TEST FOR
STREP THROAT OR FLU.
THE VIRTUE IS THEY’RE CHEAP AND
EASY TO USE IN THE DOCTOR’S
OFFICE.
THEY’RE HIGHLY SPECIFIC MEANING
IF THEY SAY YOU HAVE STREP
THROAT, FLU OR CORONAVIRUS IN
THIS CASE, THEN YOU DO BUT
THEY’RE NOT THAT SENSITIVE.
MEANING A CERTAIN NUMBER OF
PEOPLE WHO HAVE THE TESTS DONE
WHO HAVE THE INFECTION, THE TEST
WILL SAY THEY DON’T HAVE THE
INFECTION.
USED IN THE HANDS OF A DOCTOR,
IN A DOCTOR’S OFFICE BY A
PROVIDER WHERE A PHYSICIAN MAY
HAVE THE SUSPICION THAT THE
PATIENT MAY HAVE A CONDITION,
THE DOCTOR KNOWS IF THEY GET A
NEGATIVE THEY MIGHT SEND OFF A
CON FIR TORREY
CONFIRMATION TEST TO BE SURE.
IF YOU GET BACK A NEGATIVE
RESULTS, YOU ARE GOING TO COUNT
ON THAT AND SAY THAT PERSON IS
ALL CLEAR.
FOR THAT KIND OF A SITUATION YOU
WANT A MUCH MORE SENSITIVE TEST
THAT’S UNLIKELY TO MISS ANYONE.
>> SO WE HAVE AN NBC COLLEAGUE
WHO TESTED NEGATIVE FOUR TIMES,
ENDED UP WITH THE CORONAVIRUS
ANYWAY.
OBVIOUSLY AN OUTBREAK IN THE
WHITE HOUSE, A FEW PEOPLE HAVE
GOTTEN IT IN THE WHITE HOUSE
DESPITE BEING TESTED EVERY DAY.
IS THERE A SPECIFIC TEST THAT
YOU THINK SHOULD BE USED IN THE
WHITE HOUSE?
>> WELL, IT IS A TOUGH CALL
BECAUSE THE WHITE HOUSE WANTS A
TEST WITH A HIGH THROUGH PUT.
THEY WANT A TEST THEY CAN GET A
QUICK RESULT BECAUSE OF BRINGING
PEOPLE IN AND OUT OF THE WHITE
HOUSE AND THAT’S WHY THEY LIKE
THE ABBOTT MACHINE.
THE OTHER MACHINE WITH HIGHER
SENSITIVITY BUT IS A PRETTY
QUICK MACHINE IS A GENE EXPERT.
THAT TAKES ABOUT 45 MINUTES AS
OPPOSED TO THE ABBOTT MACHINE
WHICH TAKES BETWEEN A 5 AND
15 MINUTES.
THE SEFI GENE EXPERT TAKES
LONGER TO GIVE A RESULT BUT THE
SENSITIVITY IS MUCH HIGHER.
THAT’S A BETTER MACHINE IF YOU
WANT TO USE A POINT-OF-CARE
MACHINE AND YOU DON’T HAVE A
MARGIN IN TERMS OF MAKING A
MISTAKE IN TERMS OF HAVING A
RESULT THAT SAYS YOU DON’T HAVE
CORONAVIRUS WHEN IN FACT YOU DO.
IT MIGHT BE A BETTER MACHINE FOR
THAT KIND OF A PURPOSE, BUT THE
POINT IS WE NEED TO MAKE SURE
THAT THE TECHNOLOGY WE ARE USING
IS FIT FOR PURPOSE.
THERE’S DIFFERENT TOOLS THAT
COULD BE USED FOR DIFFERENT
PURPOSES.
FOR EXAMPLE, IF YOU ARE A
BUSINESS OWNER AND YOU WANT TO
DO WIDESPREAD SCREENING IN THE
WORKPLACE, IT IS A SITUATION
WHERE YOU MIGHT USE HIGH THROUGH
PUT PCR OR DO NEXT GENERATION
SEQUENCING WHERE YOU CAN HAVE
POOL SAMPLES.
YOU CAN HAVE 50 PEOPLE SPIT IN A
TUBE AND THEN IF YOU GET A HIT
AND YOU FIND SOMEONE HAS A
VIRUS, YOU TEST PEOPLE
INDIVIDUALLY.
THERE’S DIFFERENT TECHNOLOGIES
SUITED TO DIFFERENT PURPOSES AND
YOU NEED TO MAKE SURE YOU ARE
USING THE RIGHT TOOL FOR THE
RIGHT PURPOSE.
>> YOU TESTIFIED YESTERDAY IN
FRONT OF JIM CLYBURN’S COMMITTEE
ON THE CORONAVIRUS CRISIS.
THE HEARING WAS FOCUSED ON
REOPENING THE ECONOMY WHILE WE
STILL HAVE THE CORONAVIRUS.
SO HOW ARE WE DOING RIGHT NOW?
WHAT ARE THE RECOMMENDATIONS
THAT YOU GAVE JIM AND THE REST
OF THE COMMITTEE, AND WHAT DO
YOU SUGGEST WE DO MOVING INTO
THE SUMMER, MAKING SUMMER PLANS
AND EVEN AS MY FAMILY DID
YESTERDAY, NOT ONLY MAKE SUMMER
PLANS BUT STARTING TO MAKE PLANS
FOR THE FALL AND SCHOOL?
WHAT ARE WE LOOKING AT?
>> YES, IT IS REALLY HARD TO
TELL WHAT THE FALL IS GOING TO
LOOK LIKE.
YOU KNOW, IT IS HARD ENOUGH TO
KNOW WHAT THE NEXT MONTH IS
GOING TO LOOK LIKE.
RIGHT NOW IF YOU LOOK AT WHAT IS
HAPPENING NATIONALLY, EVEN WHEN
YOU BACK OUT THE STATISTICS FROM
NEW YORK YOU SEE A DECLINING
EPIDEMIC NATIONALLY.
OVER THE LAST TWO WEEKS WE HAVE
ACTUALLY STARTED TO SEE A
DECLINE IN NEW CASES AND IN
HOSPITALIZATIONS, EVEN AGAINST
THE BACKDROP OF MORE TESTING.
THAT’S THE GOOD NEWS.
WHAT WE’RE ALSO SEEING AN
EPIDEMIC THAT IN CERTAIN STATES
IS EXPANDING.
IF YOU LOOK AT STATES LIKE
MINNESOTA, NEBRASKA, MISSOURI,
ALABAMA, ARIZONA, WISCONSIN TO
SOME DEGREE, KANSAS, KENTUCKY,
TENNESSEE, TEXAS, YOU ARE SEEING
CASES GO UP IN THOSE STATES.
SO NATIONALLY THE TREND IS IN A
POSITIVE DIRECTION BUT THERE ARE
STILL STATES THAT ARE PRETTY HOT
AND WE’RE STILL SEEING LOCALIZED
OUTBREAKS.
THAT IS LIKELY TO BE THE CASE.
THIS WILL NOT BE A UNIFORM
EPIDEMIC.
EVEN AS THE NATIONAL TRENDS
IMPROVE WE WILL STILL SEE HOT
SPOTS AND THERE’S STILL A RISK
THAT A STATE CAN HAVE AN
OUTBREAK WHICH CAN LEAD TO A
MORE REGIONAL SPREAD.
I THINK AS WE GO INTO THE SUMMER
I’M HOPEFUL THERE WILL BE A
SEASONAL EFFECT HERE.
SO AS WE GET INTO THE SUMMER
MONTHS OF JULY AND AUGUST THE
VIRUS WILL START TO DISSIPATE IT
IT PROBABLY WON’T GO AWAY,
ESPECIALLY SINCE WE ARE OPENING
AGAINST THE BACKDROP OF A LOT OF
SPREAD, BUT I AM HOPEFUL THERE
IS A SEASONAL EFFECT THERE.
ONCE WE COME BACK IN SEPTEMBER
THAT WILL BE A NEW RISK,
ESPECIALLY AS IT STARTS TO
COLLIDE WITH FLU SEASON.
IT IS TOO EARLY TO TELL WHAT IT
IS GOING TO LOOK LIKE.
I THINK THERE WILL BE AN ATTEMPT
TO OPEN SCHOOLS IN THE FALL.
THIS WILL BE SOMETHING PROBABLY
MADE ON A LOCAL BASIS, STATE BY
STATE AND LOCALITY BY LOCALITY,
DEPENDING ON THE BACKGROUND
SPREAD IN THE COMMUNITY AND
THAT’S PROBABLY THE RIGHT WAY TO
MAKE THE DECISIONS.
>> WE ARE HEARING REPORTS, I
THINK IT IS OUT OF SOUTH KOREA,
WHERE THERE WAS SPREAD IN
WORKERS’ DORMS.
IS THERE A POSSIBILITY THAT
MAYBE OFFICIALS SPLIT THE BABIES
AND THEY ALLOW PEOPLE TO GO BACK
TO SCHOOL, BUT MAYBE YOU ARE FAR
MORE SUSPECT OF SENDING A BUNCH
OF COLLEGE STUDENTS OR HIGH
SCHOOL STUDENTS INTO DORMS.
>> YOU KNOW, THE COLLEGES RIGHT
NOW ARE STARTING TO CONTEMPLATE
WHAT THEY’RE GOING TO DO ABOUT
RESIDENTIAL COLLEGE CAMPUSES AND
I HAVE HAD SOME DISCUSSIONS.
THEY’RE LOOKING AT THINGS LIKE
TESTING EVERYONE BEFORE THEY
COME BACK ON COLLEGE CAMPUSES.
THAT’S ONLY GOING TO PROVIDE SO
MUCH PROTECTION BECAUSE THE
VIRUS SPREADS AND TESTING
EVERYONE AS THEY ENTER DOESN’T
MEAN YOU WON’T HAVE AN OUTBREAK
AFTER THE FACT.
I THINK SOUTH KOREA REINFORCES
IT IS AT RISK COMMUNITIES THAT
FACE THE HIGHEST RISK OF THE
VIRUS.
SO PEOPLE WORKING ON PRODUCTION
LINES, PEOPLE WHO WORK IN
GROCERY STORES, THEY’RE AT
HIGHER RISK OF CONTRACTING THE
INFECTION AND WE NEED TO MAKE
SURE WE HAVE TESTING AT THOSE
WORK SITES.
THAT’S BEEN A CHALLENGE, TO MAKE
SURE WE ARE GETTING THE
RESOURCES WHERE THEY’RE NEEDED
THE MOST.
>> DR. GOTTLIEB, I WANT TO ASK
YOU MORE ABOUT REOPENING
COLLEGES.
MY FIRST QUESTION THOUGH IS
SOMEWHAT RELATED.
CAN YOU EXPLAIN WHY IT IS
IMPORTANT TO WEAR A MASK AND,
MORE SPECIFICALLY, HOW IMPORTANT
IS THAT MEASURE COMPARED TO
OTHER MEASURES IN THE LIST OF
GUIDELINES BEING PUT OUT BY THE
GOVERNMENT, THE WHITE HOUSE?
>> WELL, THE MASK IS REALLY TO
PROTECT PEOPLE FROM YOU.
SO THE CLOTH MASK WE TALK ABOUT,
IT MIGHT PROVIDE SOME PARTIAL
PROBATION TO YOU AS AN
INDIVIDUAL, BUT WHAT IT IS
REALLY DOING IS IT IS CUTTING
DOWN ON THE RISK THAT SOMEONE
WHO HAS THE INFECTION MAY BE
ASYMPTOMATIC OR MILDLY
SYMPTOMATIC AND KNOW KNOW THEY
HAVE CORONAVIRUS, SO IT CUTS
DOWN ON THEIR RESPIRATORY
DROPLETS AND ABILITY TO
TRANSMIT.
IF ARE WEARING AN N95 MASK, THAT
WILL AFFORD MORE PROTECTION FOR
YOU AS AN INDIVIDUAL BUT THERE’S
BEEN A SHORTAGE OF THAT
EQUIPMENT SO WE HAVEN’T BEEN
ABLE TO GET THOSE MASKS OUT TO
THE PEOPLE.
THAT HOPEFULLY WILL CHANGE IN
THE FUTURE AND WE CAN MAKE IT
AVAILABLE TO CONSUMERS, BUT THE
MAIN BENEFIT OF THE MASK IS TO
CUT DOWN THE RISK OF
TRANSMISSION FROM THE INDIVIDUAL
THAT MIGHT BE INFECTED TO
OTHERS.
IT IS AN IMPORTANT MEASURE.
IF WE CAN GET PEOPLE TO WEAR
MASK ON A WIDESPREAD BASIS IT
CAN CUT DOWN ON TRANSMISSION.
WE HAD ONE STUDY THAT SHOWED 50%
REDUCTION IN A COMMUNITY THAT
WORE MASKS.
IT IS A SIMPLE INTERVENTION,
WEARING A MASK.
>> ABSOLUTELY.
WHAT DOES IT LOOK LIKE IN U.S.
COLLEGES?
YOU HAD SAID THAT YOU THINK U.S.
COLLEGES MIGHT BE ABLE TO
WELCOME STUDENTS BACK IN THE
FALL.
I HAVE GOT A GIRL GOING TO UVA
IN THE FALL SO I’M PERSONALLY --
I MEAN ARE THESE KIDS GOING TO
BE ASKED TO WEAR MASKS?
HOW IS IT GOING TO BE POSSIBLE
THAT COLLEGE KIDS ARE GOING TO
NOT MIX AND SPREAD THE
CORONAVIRUS?
>> YES, YOU KNOW, THIS IS
ALWAYS -- YOU THINK OF, LIKE,
BARRACKS, PEOPLE COMING BACK IN
THE MILITARY AND COLLEGE DORMS
BECAUSE YOU HAVE A LOT OF PEOPLE
COMING FROM A LOT OF DIFFERENT
COMMUNITIES, MIXING, LIVING IN
CLOSE QUARTERS.
>> YES.
>> COMING FROM COMMUNITIES WHERE
THERE MIGHT BE MORE SPREAD SO
THESE ARE HIGH-RISK SITUATIONS.
I THINK REALLY THE DECISIONS
AROUND THIS WILL BE MADE IN JULY
AND AUGUST AND ARE GOING TO
DEPEND ON WHAT THE SPREAD IS IN
THE COUNTRY AT THAT TIME.
YOU KNOW, AGAIN, I HAPPEN TO
BELIEVE AS WE GET INTO JULY AND
AUGUST THERE WILL BE A SEASONAL
EFFECT HERE SO YOU WILL START TO
SEE SPREAD DISSIPATE A LITTLE
BIT HOPEFULLY.
HOPEFULLY WE DON’T REOPEN AND
REIGNITE ANOTHER LARGE OUTBREAK
OR EPIDEMIC.
WE GET INTO JULY AND AUGUST,
THERE IS A SEASONAL EFFECT AND
THERE MIGHT BE AN ATTEMPT TO
REOPEN COLLEGE CAMPUSES AND
SCHOOLS.
BUT IF THERE’S OUTBREAKS AND
WIDESPREAD TRANSMISSION OF THE
VIRUS IN THE FALL, YOU COULD
QUICKLY SEE DECISIONS REVERSED
AND SCHOOLS CLOSED AGAIN.
BUT I THINK THERE WILL BE AN
ATTEMPT MADE TO TRY TO DO IT.
COLLEGES MIGHT MAKE DECISIONS TO
TRY TO DO MORE DISTANCE
LEARNING, TRY TO BRING BACK
FEWER STUDENTS.
THEY MIGHT MAKE DECISIONS IN
TERMS OF HOW THEY KEEP STUDENTS
IN THE DORMITORY.
YOU HAVE SEEN SOME PROPOSALS
COME OUT TO TRY TO SEPARATE
STUDENTS MORE.
PUBLIC SCHOOLS MIGHT MAKE
DECISIONS ONLY TO HAVE CLASSES
TWO TO THREE DAYS A WEEK AND
STAGGER IT MORE SO YOU ARE NOT
BRINGING THE WHOLE CLASS BACK AT
THE SAME TIME.
YOU MIGHT SEE COMMUNITIES TRY TO
MAKE DECISIONS TO CREATE SOCIAL
DISTANCING IN THE CONTEXT OF
REOPENING SCHOOLS.
I THINK THERE WILL BE AN ATTEMPT
MADE TO TRY TO REOPEN IN THE
FALL.
>> WILLIE.
>> DR. GOTTLIEB, IT IS WILLIE
GEIST.
YOU AND OTHER DOCTORS HAVE SAID
IT IS ALL BUT CERTAIN
CORONAVIRUS WILL RETURN IN THE
FALL.
WITH THAT IN MIND I KNOW A LOT
OF SCHOOL DISTRICTS WERE
THINKING OF MOVING UP THE SCHOOL
YEAR SO THEY CAN GET SCHOOL YEAR
MOVED UP.
DO YOU BELIEVE THAT THE
CORONAVIRUS WILL BE BACK IN OUR
LIVES IN THE FORM IT IS RIGHT
NOW, IN THE FORM SHUTTING UNDOWN
IN THE FALL?
IF SO, WHAT SHOULD
SUPERINTENDENTS AND SCHOOL
BOARDS BE THINKING ABOUT AS THEY
PLAN TO GO BACK?
>> WELL, THIS ISN’T GOING AWAY.
THIS IS PROBABLY GOING TO BECOME
ENDEMIC.
YOU KNOW, HOPEFULLY WE WILL GET
A VACCINE BUT IT IS SOMETHING WE
WILL HAVE TO CONTEND WITH FOR A
WHILE.
IF WE HAVE GOOD TESTING IN PLACE
GOING INTO THE FALL WHERE WE’RE
ABLE TO DETECT OUTBREAKS WHILE
THEY’RE STILL SMALL, WE HAVE
GOOD TRACK AND TRACE.
WE ARE TRACKING DOWN PEOPLE WHO
ARE SICK WITH THE INFECTION,
TRYING TO LIES LATE THEMISOLATE
ABLE TO PREVENT LARGE OUTBREAKS,
THIS CAN BE A LOCAL ENDEAVOR.
YOU MIGHT HAVE TO SHUT DOWN A
COMMUNITY, TO TAKE MITIGATION
STEPS WITHIN A STATE, BUT YOU
DON’T HAVE THE NATIONAL EPIDEMIC
WE HAD THIS TIME AROUND.
THAT’S THE HOPE.
THAT WILL DEPEND ON GOOD
SCREENING IN A COMMUNITY SO IF
THERE ARE 30, 40 CASES IN THE
COMMUNITY, YOU CAN DETECT AT
THAT LEVEL BEFORE YOU HAVE 1,000
CASES WHERE YOU HAVE AN EPIDEMIC
THAT THE ONLY THING TO DO IS
REALLY SHUT DOWN THE COMMUNITY.
HOPEFULLY WE WILL GO INTO THE
FALL AND BE ABLE TO DETECT WHERE
THIS IS SPREADING.
I THINK YOU WILL SEE LOCAL
SCHOOL DISTRICTS CLOSE.
YOU WILL SEE OUTBREAKS WITHIN
STATES AND LOCAL COMMUNITIES AND
YOU WILL SEE A ROLLING
MITIGATION EFFORT.
HOPEFULLY IT DOESN’T BECOME AN
NATIONAL EPIDEMIC.
THE RIFB IS WHEN
RISK IS WHEN IT COLLIDES WITH
THE FLU SEASON, THAT BECOMES A
REAL CHALLENGE.
WE SHOULD TRY TO GET MORE FLU
VACCINE INTO THE SYSTEM, WHICH
WE’VE DONE.
MANUFACTURERS HAVE MADE MORE
VACCINE IN ANTICIPATION OF
HIGHER DEMAND BUT GET PEOPLE
VACCINATED EARLY.
>> AS YOU SAY, SO MUCH DEPENDING
ON TESTING.
I WANT TO ASK YOU, DR. GOTTLIEB,
ABOUT THE STATES OF GEORGIA AND
FLORIDA.
THERE’S BEEN A LOT OF FOCUS ON
THOSE TWO PLACES, DID THEY
REOPEN TOO SOON.
THE GOVERNORS THERE SLOWLY
REOPENING THE ECONOMY TO SOME
RETAIL BUSINESS.
IF YOU LOOK AT IT THE LAST
COUPLE OF WEEKS, SPECIFICALLY IN
THE LAST WEEK THEY’VE NOT HAD AN
EXPLOSION OF CASES.
IN FACT, THE CASES HAVE GONE
DOWN OVER THE LAST WEEK.
WHAT SHOULD WE BE READING INTO
THE CASES OF GEORGIA AND FLORIDA
AS OTHER STATES TRY TO DECIDE
WHEN IT IS SAFE TO GO BACK INTO
THE WATER?
>> WELL, ONE THING THAT THOSE
STATES DID WELL WAS THEY GOT
THEIR TESTING UP.
SO WHEN YOU LOOK AT THE DATA
FROM GEORGIA, THE POSITIVITY
RATE, THE NUMBER OF PEOPLE WHO
WERE POSITIVE HAS COME DOWN AS
TESTING HAS GONE UP.
THAT’S A GOOD MEASURE THEY TOO.
FLORIDA DID THE SAME THING.
THEY WERE ABLE TO GROW THEIR
TESTING QUICKLY AND THE DATA
LOOKS GOOD OVER THE PAST WEEK.
I LOOKED AS I CAME ON THE AIR
AND YOU ARE SEEING
HOSPITALIZATIONS NOT TICK UP AND
THE NUMBER OF CASES COME DOWN
AND THE POSITIVITY RATE COME
DOWN EVEN AS TESTING INCREASES.
THAT’S A HOPEFUL SIGN.
THAT SAID, WHAT WE NEED TO WATCH
IS HOSPITALIZATIONS AND DEATHS
BECAUSE THEY’RE MORE OBJECTIVE
MEASURES WHETHER OR NOT YOU ARE
HAVING AN EXPANDING EPIDEMIC.
THERE’S A LAGGING EFFECT ON
THOSE TWO INDICATORS.
SO THE TIME TO HOSPITALIZATION
IS ABOUT EIGHT DAYS.
REALLY WHEN YOU ARE LOOKING AT
HOSPITALIZATIONS TODAY, IT IS
TELLING YOU WHAT HAPPENED EIGHT
DAYS AGO.
TIME TO DEATH IS ABOUT 18 DAYS,
SO PEOPLE WHO SUCCUMB TO THIS
INFECTION TYPICALLY DO TEN DAYS
AFTER THEY’RE ADMITTED TO THE
HOSPITAL ON AVERAGE.
THOSE ARE LAGGING INDICATORS.
I THINK WE NEED A COUPLE OF
WEEKS OF DATA TO KNOW WHAT
DIRECTION THIS IS GOING IN, BUT
SO FAR THE INITIAL DATA OUT OF
GEORGIA AND FLORIDA LOOK
ENCOURAGING THAT THEY’VE BEEN
ABLE TO RESTART ECONOMY WITHOUT
AN UP SURGE IN CASES.
IT COULD BE AN INDICATION THAT
THERE IS A SEASONAL FACTOR.
WE KNOW THAT ACTIVITIES HELD
OUTSIDE ARE LOWER RISK THAN
ACTIVITIES HELD INSIDE, AND SO
LOCALITIES SHOULD BE TRYING TO