>>> Hello, everyone.
Welcome to CDC's private partner call.
We're so grateful that you've joined us today.
With me is Dr. Nancy Messonnier, director for national center for
immunization and respiratory diseases as well as the senior official for
CDC's COVID-19 response.
>> NANCY MESSONNIER: Good afternoon and thank you for joining us today.
I'm happy to take a few minutes to go through an update, and then I
think we have some time for questions.
CDC is responding aggressively to the global outbreak of COVID-19.
This is historic, unprecedented outbreak.
We really haven't seen anything like this since perhaps the pandemic of
influenza in 1918.
Globally, there are somewhere up to 80,000 cases across 169 WHO member
countries, and unfortunately more than 3,000 deaths.
In the United States, there are about 10,000 cases with more cases
really every day, 3,000 new cases since yesterday.
Every state in the United States has been impacted as well as the
District of Columbia, Puerto Rico, Guam and the U.S. Virgin Islands and
there have been 150 COVID deaths reported so far.
We should expect these numbers to go up over the next few days as we are
really in an acceleration phase, says but different parts of the country
have been impacted differently. Some states are well into their
outbreaks where other states are really just beginning.
CDC is adapting some of our existing surveillance systems to better
track COVID-19, and you'll be seeing more information on our website.
We do know that the virus is capable of spreading easily and sustainably
from person to person.
And we also know that older people and people with severe chronic
conditions are at higher risk for serious COVID-19 illness, and so we're
asking them to take special precautions, and we're asking everyone to
take special precautions to protect them.
I know that everybody wants to know how long this outbreak will last.
But the truth is, we don't really know.
What we do know is that if we act together and act now, we can bend the
curve of the epidemic so that less people are impacted, and so that our
health system, health sector has more time to catch up.
The duration of the outbreak depends on many factors.
It depends on how well we do at social distancing and travel
restrictions.
It does depend a little bit on what is happening with sustained
transmission in other countries. It is a new virus.
We know some things about it from research here and some things about it
from other countries, and we know about similar viruses, but we have
some details that we don't specifically know yet. For example, the
duration of immunity after infection and all the details about
transmission and clinical severity.
There are upwards of 50 modelers across the United States working on
these kind of questions, and we have a lot of data that we're looking at
to try to make these predictions which I know we all want.
The next point is what you can do.
And we are at a phase where we really need everyone to come together to
respond to this public health threat.
On March 16th, the White House Coronavirus Task Force and the President
issued new guidelines to help protect Americans.
This is called the 15 days to slow the spread.
It lays out guidelines for a nationwide effort to slow the spread, and
it calls for implementation of measures to increase social distancing
between people at all levels of society.
This is a massive proactive preventive response to COVID-19 to slow the
spread and blunt the impact of the disease on the United States.
But in order to do this, we need everyone's help to pitch in, everyone
across all of our communities has a role to play.
We're asking people all across the country to stay home as much as
possible and practice social distancing, which means that we're
decreasing the opportunity to transmit between people.
This includes canceling of postponing gatherings of more than ten people
and closing schools in some areas as determined by local and state
governments.
We've asked about -- we've been asked about guidelines for working
outside, and the guidance remains the same.
Stay 6 feet apart.
That's about two arms' lengths, and cause and sneeze into your arm
because you don't want to expose other people to your coughs and
sneezes.
You need to know that there is no vaccine currently to protect against
COVID-19, and scientists are working as fast as they can.
Even with that, it likely will be a year before we have a vaccine that
we can give to everyday Americans.
And there aren't any approved medications to treat it yet.
There are a whole bunch of treatments being investigated, and the
President announced earlier today with FDA, the rapid speed-up of all of
those treatments, and we hope that we'll have specific treatments soon.
But those things are not yet widely available, and so we need to make
sure that our clinicians have all the information they need to treat
their patients.
We do know, though, that right now the best, most effective thing that
we can do is social distancing.
It actually sounds to some people mundane, that is stay home, but in
fact, there's a bunch of scientific research on this with more than 20
different published articles that talk about what -- how effective
social distancing can be in combination with other measures, and we know
that social distancing works better when it's implemented in concert
with other measures.
We're calling these 15 days a pause, a chance to reset, but it really
won't -- will only be effective if every community across the United
States takes it seriously.
Now, we do have a lot of guidance on our website, and now we're really
working on tools to help with implementing and translating that
guidance.
So we have, for example, guidance for people who have been isolating at
home to help determine when they can discontinue isolation.
That continues to be updated as more information is available.
We're reviewing and updating our travel notices almost daily. There's
currently what's called the level 2 --
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I'll start back with we do have travel notices on our website being
updated almost daily. There's currently what's called the level 2
travel notice for the whole world, which indicates ongoing community
transmission.
And essentially what it means it that we're recommending that older
adults and people of any age with serious chronical medication
conditions should consider postponing travel to most global
destinations.
Domestically, we don't generally issue that kind of guidance, but in
general, we're saying that people at high risk should stay home and that
everyone should be thinking seriously about their travel, especially
globally but even domestically.
Expect more information about this every day.
We also have guidance documents for caring for someone at home.
If you have someone sick in your home with COVID-19, of course, you
should be taking care of them.
But you need to be doing it safely.
We don't want you to get infected, too.
How to disinfect your home if someone's sick and keep workplaces, homes
or commercial establishments safe. We have guidance for child-care
settings, healthcare professional fact sheets, and a new landing page on
our website for those at risk specifically older adults, those with
underlying conditions.
And again, check back every day on our website because you'll see more
information and more tools daily.
Of particular interest to you may be our business guidance and the
expanded guidance covering environmental cleaning and disinfection
recommendations that addresses cleaning recommendations in various
settings, including answering questions we've heard about the bleach
solution proportions for use on surfaces, addressing linens and
clothing, and personal protective equipment.
Another useful tool on our COVID-19 website home page, we now have a map
of the United States.
It shows the number ofs confirmed COVID cases state by state.
You can also click on your state to be taken to the state department
COVID-19 page where you can get more detailed information for your
state.
The intensity of an outbreak may differ according to geographic
location.
The local health departments will have guidance specific to your
communities.
Before we open it up for Q&As, I would like to address some of the
topics in areas many of you have already submitted questions on.
So --
>> Okay.
Let's start by -- let's see, we're getting a whole bunch of questions in
here.
I'm going to try to aggregate them.
Could you speak a little bit about how bad you think the pandemic will
get?
>> NANCY MESSONNIER: So I think this is a really important question. Of
course, we all want to know how bad this is going to get and how long
it's going to last.
Right now we are in an acceleration phase. That is, we've seen 3,000
new cases since yesterday.
We're on the upward part of a curve, and we should expect more
acceleration over the next couple days.
That's why it's so important that we all act now and act together to
bend that curve so that we can moderate the impact.
What that means is lowering the curve so that we have less cases every
day and hopefully less cases total, but also by having less cases every
day, we really can help the health sector catch up.
How long is it going to last? I don't know for sure, but I think we
should expect to see at least some places have impact for this disease
through the summer.
>> Great. Thank you.
Okay.
A question about if someone is -- tests positive, recovers, and then
is -- is it possible to become reinfected again?
>> NANCY MESSONNIER: Yeah.
This is a great question that we've been asked a lot.
This is a new disease. It's only been discovered since beginning of the
year.
And so there's some information that we don't have yet.
In general, for most respiratory infections, getting infected leads to
immunity, and that immunity protects you against either the whole
disease or at least having serious disease, so we're hoping certainly
that that's true for COVID-19, but this is an area where there's lots of
research, and I expect there to be more information coming.
So we don't know for sure yet.
We certainly hope so.
>> Thanks. Okay. Many, many questions from our partners about closures
such as why child-care centers and schools are closing, why some prisons
are implementing restrictions while others are not.
Is there any general advice you can give on closures?
>> NANCY MESSONNIER: So closure decisions are made at a state and local
level.
CDC does provide guidance, but ultimately the decision to close is made
at the state and local health department level, and for your businesses,
the decision should be made in conjunction with state and local health
departments.
I talk about the acceleration of bend the curve, and that is true
nationally, but this really does look differently in some communities
compared to others. Some communities are already seeing a whole lot of
disease, and some communities are seeing very little.
And that may explain why guidance differs in different places.
But in general, we are asking everybody across the country, even in
places that haven't yet seen a lot of disease, to take this seriously
and act now.
I know it's disruptive. It's certainly disruptive for my family. It's
certainly disruptive for my colleagues here at CDC as we all figure out
how to cope.
But working together is the best way for us to impact this disease right
now.
>> Thank you. Okay.
We're receiving a lot of questions from individuals unsure about
continuing their regular doctor and dental appointments.
What advice do you have for them?
>> NANCY MESSONNIER: Yeah. It's really important right now that we take
into account how much work our healthcare sector needs to do to take
care of patients with COVID-19, to be able to make sure that those
patients are taken care of, a lot of doctors' offices and a lot of
communities are recommending that individuals postpone their regular
doctor and dentist appointments.
And that's things like routine visits, cleaning, checkups, elective
procedures.
I would also say, though, that there are some things that we don't want
to delay.
And if you have questions, you need to call your healthcare provider.
For example, childhood infant vaccines, it's important that we still get
those vaccines in.
But it's important that we do it safely.
And so if you have questions about your routine care, you should contact
your own healthcare provider who's best equipped to come up with
recommendations for your particular situations.
>> Great.
And in the inverse, there's some questions from dentists or doctors
wondering if they should continue to see patients.
>> NANCY MESSONNIER: Yeah.
I know that many dentists have elected to postpone routine visits,
cleanings, checkups and elective procedures.
And I think that is partly also to make sure that the healthcare sector
can focus on COVID-19 and also to make sure that the personal protective
equipment that our healthcare doctors need is reserved for those at high
risk, that is those that are taking care of COVID-19 patients.
>> Thank you.
So a lot of people are asking questions related to when things will open
again, like restaurants, when they'll be able to hold a conference or
when they'll be able to go back to work?
>> NANCY MESSONNIER: Yeah.
I mean, I want to know when things will go back to normal as well.
And I think the answer is for now, we all need to be in this together,
and we all need to be pausing.
How long it will take, I don't know.
I think we need to expect there to be disruption through the spring.
But it will look differently in different communities. It is going to
be something that we all need to be working on together, both pausing
together and then making decisions together about when to reopen.
And that's difficult to see, but I do want to reassure everybody that,
you know, as disruptive as this is going to be, we need to know that
this is going to end.
Pandemics will end.
And how disruptive it is, partly depends on us working together to bend
that curve to make sure that our healthcare sector can catch up.
But I can't tell you that it's going to end by next week until we start
really impacting this disease, we have to expect that we're going to
have to ask a lot of each other and our communities and things that we
consider to be routine may look a little differently for a while.
>> So a question from people in an area where community spread has
occurred.
Should staff be wearing masks, and also what is CDC's stance on gloves?
>> NANCY MESSONNIER: Well, yeah.
I think the really important thing right now is to make sure that those
who need masks have masks.
And that really is folks who are in the healthcare sector taking care of
patients with COVID-19.
So part of the reason that I would ask you and your employees to not try
and go out and purchase masks is that we need to make sure that those
who really need them have them.
Healthcare workers are at highest risk, and we need them to continue to
be able to do their jobs.
So I'm asking you to please not go out and purchase masks and make sure
that those who have them need them.
In terms of gloves, most people in most jobs don't need gloves, but that
is something that if there's questions, you should be asking -- looking
at your -- what the specific job is and what the specific situation is
in your community.
But in general, this is something where what we're asking people to do
is to do good hand hygiene.
Just like your mom told you growing up.
You need to be washing your hands, not touching your face.
And for most people, those are the right guidelines.
Wash your hands.
Don't touch your face.
Stay away from other people.
That should protect you and also protect our communities.
>> Thank you.
What do we do if we have a sick employee or if an employee has a sick
family member?
>> NANCY MESSONNIER: So I'll start with this.
Information about who among your employees is sick, actually may have
issues around confidentiality in terms of you disclosing that to other
employees in the workplace. You have to balance that, of course,
against wanting to make sure that individuals that are exposed to that
patient with COVID-19 are safe.
And we do have guidelines on our website about how to conduct a risk
assessment. Employees who are exposed to a coworker with COVID-19 can
use those guidelines in order to look at their potential exposure.
Now, it's different if it's an employee who has a sick family member at
home with COVID-19.
In general, employees who are well themselves that have a sick family
member should notify their supervisor and refer to CDC guidance, but at
this point, if you have somebody that you live with in your family home
who has COVID-19, you really should be staying home with them.
We don't want to risk you passing the disease along to your coworkers.
>> Thank you. Okay.
This question -- let's see.
Is from an employer who's not working in the medical field.
Should or can employers check workers' temperatures?
Is it legal to do so?
>> NANCY MESSONNIER: That's a private company decision.
I would definitely check with your counsel on the legalities of doing
that because it really will differ.
But we are at a place when we're asking all of you to really consider
your policies on teleworking, social distancing. You have clearly a lot
of folks on the phone are in different businesses.
And maybe you need to have your employees physically at work.
But if at all possible, we're asking you to have your employees
teleworking to the greatest extent possible. That is part of social
distancing, not coming in contact with other people.
>> Okay.
If an individual is sent home because they have a fever, when should
they be allowed to return to work?
The question -- oh.
So normally we ask if they have a doctor's note. However, given that
the healthcare system is so overloaded, is that necessary?
How should this be handled?
>> NANCY MESSONNIER: Yeah.
So it brings me to something that I want to talk about, which is that we
are having a pandemic of COVID-19, but it's also respiratory viral
season.
We're at the end of influenza season, so there is still influenza
circulating.
And at this time of the year, there are a variety of other viral
respiratory diseases that are circulating.
And I say that because if you have a runny nose and a sore throat and a
cough, it's possible that you have COVID-19, but it's also possible that
you have any of the myriad of other viral respiratory diseases that are
circulating.
We don't want people going into healthcare unless they need to.
For most individuals who are at low risk, that is who are young, who
don't have chronic medical conditions, if you have a fever, a mild
fever, a cough, a sore throat, we want you to stay home.
We don't think you generally need to go in for diagnostic.
We think you can ride this out at home.
For people who have chronic underlying conditions or who are older, you
need to contact your healthcare provider because you may well need to go
in for a diagnostic.
And, of course, if you have, you know, serious illness and you're
getting progressively worse, you need to call 911.
But in general, we really do want people who are otherwise healthy to
ride this out at home.
And we do have guidance on our website about when you can discontinue
home isolation. It's a little complicated.
So I would say go through it on our website.
But if it's been at least three days since you've recovered, that is
resolved your symptoms, or at least seven days since the symptoms first
appeared, we think it's safe for you to go back to work.
But, again, as I said before, what we're really asking is for everyone
to telework as much as possible.
So if you don't need to come back to work, you can do your work from
home, we would definitely prefer that you do that.
>> Thank you. Okay.
This question is from someone in a retail office with about 10 to 13
people there.
If someone is confirmed positive for COVID-19, what are the guidelines
for self-quarantine?
Is it automatic that everyone in the office would just self-quarantine,
or if we are practicing social distancing, would the others be able to
continue working?
>> NANCY MESSONNIER: So social distancing does mean that we want people
to be home as much as possible. Of course, it depends whether the bank
branch has closed, what the operations are.
You know, again, our gathering guidance says we want people to be as far
apart as possible so we stop this thing and we slow it down.
In specific answer to your question, they should self-quarantine, those
with close and frequent contact.
We do have guidance that allows you to assess risk, and it looks a
little different depending on how much contact you had with somebody
with COVID-19.
You need to clean and disinfect high-touch areas, and we need to stay
apart as much as possible.
You know, there are some other questions that we're getting asked a lot,
and it reminds me to go back to that, which is how is COVID-19 spread?
People are wondering if it's spread through the air, if it's spread
through surfaces.
In general, it's spread through respiratory droplets. From what we know
about the virus, it's not airborne.
It doesn't spread through vents and airport buildings or in
condominiums. It's spread through respiratory droplets.
In general, the virus seems to be spread mainly from person to person,
but it's also possible that a person can get COVID-19 by touching a
surface or object that has a virus on it and then touching your own
mouth, nose or eyes.
And so what that means is if you're standing next to somebody who has
COVID-19 and they cough on the table in front of you and then you touch
that surface right away and touch your own face and mouth and nose, you
could be exposed to COVID-19.
We don't think this is the main way it's exposed.
We need to learn more about it.
And there are studies ongoing about the survivorability of the virus on
surfaces, and that's why, again, it's important to cover your cough, to
not touch your face, and to wash your hands a lot and to disinfect
surfaces.
That should be part of everyone's actually routine practice all the
time, but especially now when we're faced with a pandemic like this.
>> So we've talked a lot about social distancing, and I'm wondering if
you can share really what the purpose is.
Does it really reduce the number of total infections, or does it simply
slow the pace of infection or spread it out over a longer period of
time?
>> NANCY MESSONNIER: So this virus is new, but it's not the first
respiratory virus that we've dealt with as a country or that we've
thought through.
And so we do know a lot about how these kind of viruses spread.
And therefore, what we're talking about is both of those things.
If we can bend that curve, we can decrease the overall number of people
that are sick, but we can also decrease the number of people that are
sick week by week.
And both of those things are important. Obviously, having less people
overall get sick would be great.
But also, if we can decrease the number of new cases week by week, it
can really help our healthcare sector have fewer patients to have to
treat and make it easier for them to treat the patients that they have.
And so both of those things are true, and both of those things are the
goal of this mitigation strategy, staying apart is the most effective
thing that we can do right now.
>> In terms of vaccine development, can you tell us what the status is
and when these vaccines will realistically be available to the general
population?
>> NANCY MESSONNIER: Phase 1 clinical trials are starting now, and
that's the earliest clinical trial where the vaccine is given to a small
number of people.
But the vaccine development process takes a while, even with so many
researchers across the world working on vaccines.
We expect it will be 12 months, maybe even 18 months before the vaccine
is ready for most Americans to get it.
And that's because before a vaccine is given to the population, we need
to make sure that it works and we need to make sure it's safe.
And what that means for you all is that right now our toolkit doesn't
have a vaccine in it.
That's why we are so focused on social distancing.
>> So if the government requires a mandated lockdown for an extended
period of time like two months or more in order to do what you were
speaking about, flattening the curve and preventing the spread of the
virus, how likely is it for the virus to resurface?
Months or years from now?
Even though these extreme measures were in place?
>> NANCY MESSONNIER: So I think that we're going to learn a lot from
other countries that have had to deal with this before we do.
But remember that this is a new disease, but we know a lot about
diseases like this.
And our goal to mitigate is the thing that makes the right sense, the
most sense now, if, for example, we mitigated it now and it came back a
year from now, it would look a lot different because we'd likely have a
vaccine and also people would have been already exposed and we would
have better tools, better treatment, better diagnostics.
So things could look a lot better even if we have to face this again.
>> One more question.
How long should employees remain at home if they're no longer showing
signs of illness, especially if they were never tested?
>> NANCY MESSONNIER: So this depends a little bit on what your community
is doing.
And so I would say that what you need to look to first is what's going
on in your local community in terms of rates of disease and guidance.
We do have guidance for how quickly people who are -- who have had
COVID-19 should remain at home, basically isolated.
And in this context isolation is really what we do when somebody who is
sick stays at home.
So we do have guidance on our website for how long somebody should stay
at home if they have signs of illness, even if they were never tested.
And guidance is on our website.
Even if you get better, if you can stay home and socially distance,
we're still recommending that you do.
>> Thank you. Thank you so much for joining us today.
Unfortunately Dr. Messonnier has to go.
If we didn't get a chance to answer your specific question, please go
ahead and check out our website, which is www.cdc.
gov/COVID, C-O-V-I-D. Thanks again for joining us, and let's work
together to flatten the curve.