1 00:00:11,440 --> 00:00:13,640 Welcome to the Clinical Center Grand Rounds, 2 00:00:13,640 --> 00:00:17,440 a weekly series of educational lectures for physicians and 3 00:00:17,440 --> 00:00:20,080 health care professionals broadcast from the Clinical 4 00:00:20,080 --> 00:00:23,040 Center at the National Institutes of Health in 5 00:00:23,040 --> 00:00:24,840 Bethesda, MD. 6 00:00:24,840 --> 00:00:28,400 The NIH Clinical Center is the world's largest hospital totally 7 00:00:28,400 --> 00:00:32,080 dedicated to investigational research and leads the global 8 00:00:32,080 --> 00:00:35,040 effort in training today's investigators and discovering 9 00:00:35,040 --> 00:00:37,200 tomorrow's cures. 10 00:00:37,200 --> 00:04:27,920 Learn more by visiting us online at http://clinicalcenter.nih.gov 11 00:04:27,920 --> 00:04:31,760 IN 2019 FOR HIS CAREER 12 00:04:31,760 --> 00:04:34,280 CONTRIBUTION TO HHS IN 2019 HE 13 00:04:34,280 --> 00:04:36,920 RECEIVE THE AMERICAN COLLEGE OF 14 00:04:36,920 --> 00:04:38,720 PHYSICIANS AWARD FOR CAREER 15 00:04:38,720 --> 00:04:40,080 TRAFFIC TO CLINICAL 16 00:04:40,080 --> 00:04:43,800 EPIDEMIOLOGY. 17 00:04:43,800 --> 00:04:46,040 DR. HENDERSON IS A FELLOW OF THE 18 00:04:46,040 --> 00:04:48,320 AMERICAN COLLEGE OF PHYSICIANS, 19 00:04:48,320 --> 00:04:50,320 THE INFECTIOUS DISEASE SOCIETY 20 00:04:50,320 --> 00:04:52,280 OF AMERICA AND PUBLISHED MORE 21 00:04:52,280 --> 00:04:54,640 THAN 180 PEER-REVIEWED JOURNAL 22 00:04:54,640 --> 00:04:56,600 ARTICLES AND MORE THAN 80 BOOK 23 00:04:56,600 --> 00:04:59,520 CHAPTERS. 24 00:04:59,520 --> 00:05:02,800 HE ALSO SERVED AS A COMMITTED 25 00:05:02,800 --> 00:05:06,640 CAREER MENTOR IN THE FIELD OF 26 00:05:06,640 --> 00:05:10,280 EPIDEMIOLOGY AND INFECTION 27 00:05:10,280 --> 00:05:12,680 CONTROL INCLUDING ME AND JOIN ME 28 00:05:12,680 --> 00:05:20,600 IN WELCOMING DR. HENDERSON FOR 29 00:05:20,600 --> 00:05:24,560 HIS TALK, COVID-19 PANDEMIC 30 00:05:24,560 --> 00:05:33,280 LOOKING BACK AND FORWARD. 31 00:05:33,280 --> 00:05:35,320 >>HER PRESENCE WAS A SURPRISE I 32 00:05:35,320 --> 00:05:36,200 HAD TO TAKE ALL THE TERRIBLE 33 00:05:36,200 --> 00:05:39,280 THINGS I WAS GOING TO SAY ABOUT 34 00:05:39,280 --> 00:05:43,120 TARA OUT OF MY TALK. 35 00:05:43,120 --> 00:05:44,240 THANK YOU FOR THE KIND 36 00:05:44,240 --> 00:05:44,600 INTRODUCTION. 37 00:05:44,600 --> 00:05:46,840 I'D LIKE TO BEGIN BY THANKING 38 00:05:46,840 --> 00:05:48,920 DR. MERKO AND HIS TEAM FOR 39 00:05:48,920 --> 00:05:50,520 INVITE MEG TO PARTICIPATE IN 40 00:05:50,520 --> 00:05:52,360 THIS LECTURE SERIES. 41 00:05:52,360 --> 00:05:53,120 I'M CERTAINLY PLEASED AND 42 00:05:53,120 --> 00:05:55,480 HONORED TO DO SO. 43 00:05:55,480 --> 00:05:58,240 AND I'M AWARE PEOPLE WHO STOOD 44 00:05:58,240 --> 00:06:01,880 AT THIS PODIUM IN THIS SERIES 45 00:06:01,880 --> 00:06:10,440 AND QUITE HUMBLED BY IT. 46 00:06:10,440 --> 00:06:11,520 WE'RE GOING TO TALK ABOUT 47 00:06:11,520 --> 00:06:15,040 SOMETHING WE LIVED THROUGH, THE 48 00:06:15,040 --> 00:06:15,760 COVID-19. 49 00:06:15,760 --> 00:06:17,080 HAVE NO DISCLOSURES ONE OF THE 50 00:06:17,080 --> 00:06:19,840 SAD THINGS IN MOST OF MY CAREER. 51 00:06:19,840 --> 00:06:21,120 THIS PRESENTATION WILL NOT 52 00:06:21,120 --> 00:06:22,760 ADVOCATE FOR THE USE OF ANY 53 00:06:22,760 --> 00:06:26,120 UNAPPROVED OR OFF LABEL DRUGS 54 00:06:26,120 --> 00:06:27,280 THOUGH I MAY MENTION OTHER 55 00:06:27,280 --> 00:06:30,480 PEOPLE ADVOCATE FORG THEM. 56 00:06:30,480 --> 00:06:32,360 I HOPE AT THE END OF THE TALK 57 00:06:32,360 --> 00:06:36,800 YOU'LL BE ABLE TO RELATE THE 58 00:06:36,800 --> 00:06:39,280 COVID PANDEMIC IN CONTEXT FROM 59 00:06:39,280 --> 00:06:43,840 ONE PANDEMIC FROM THE PAST TO 60 00:06:43,840 --> 00:06:45,280 DISCUSS SUCCESSES AND 61 00:06:45,280 --> 00:06:46,240 IMPROVEMENT FOR OUR RESPONSE TO 62 00:06:46,240 --> 00:06:48,520 THE PANDEMIC AND HOPE WE'LL BE 63 00:06:48,520 --> 00:06:51,280 ABLE TO DESCRIBE THE PRINCIPLES 64 00:06:51,280 --> 00:06:52,600 ON WHICH A SUCCESSFUL RESPONSE 65 00:06:52,600 --> 00:06:56,600 MAY BE FORMULATED AS THE GOSPEL 66 00:06:56,600 --> 00:06:57,720 ACCORDING TO HENDERSON. 67 00:06:57,720 --> 00:06:59,960 I'D LIKE TO START WITH A MAJOR 68 00:06:59,960 --> 00:07:00,320 DISCLAIMER. 69 00:07:00,320 --> 00:07:02,880 THAT IS THE OPINIONS I EXPRESS 70 00:07:02,880 --> 00:07:04,600 IN THIS DISCUSSION ARE MINE AND 71 00:07:04,600 --> 00:07:06,120 MINE ALONE. 72 00:07:06,120 --> 00:07:07,760 THEY DON'T REPRESENT THE 73 00:07:07,760 --> 00:07:09,480 LEADERSHIP OF THE CLINICAL 74 00:07:09,480 --> 00:07:12,680 CENTER FOR NIH, HHS OR THE 75 00:07:12,680 --> 00:07:14,920 U.S. FEDERAL GOVERNMENT. 76 00:07:14,920 --> 00:07:17,840 I ALSO WANTS TO APOLOGIZE IN 77 00:07:17,840 --> 00:07:18,480 ADVANCE AND PRESENTERS SHOULD 78 00:07:18,480 --> 00:07:20,160 TAKE NOTE OF THE FACT YOU SHOULD 79 00:07:20,160 --> 00:07:23,560 NEVER DO THIS, BUT I APOLOGIZE 80 00:07:23,560 --> 00:07:26,280 FOR THE TEXT HEAVY NATURE OF MY 81 00:07:26,280 --> 00:07:26,880 SLIDES. 82 00:07:26,880 --> 00:07:27,680 THE TALK CONTAINS A LOT OF 83 00:07:27,680 --> 00:07:28,680 INFORMATION AND WANT THE TO BE 84 00:07:28,680 --> 00:07:32,360 CERTAIN TO USE LANGUAGE THAT 85 00:07:32,360 --> 00:07:34,640 PRECISELY CHARACTERIZES MY 86 00:07:34,640 --> 00:07:39,080 MESSAGE RATHER THAN RELYING 87 00:07:39,080 --> 00:07:44,600 WHOLLY ON MY ENFEEBLE BRAIN TO 88 00:07:44,600 --> 00:07:50,680 CALL UP TERMS ON THE FLY. 89 00:07:50,680 --> 00:07:51,920 I'D LIKE TO ABOUT OUR INITIAL 90 00:07:51,920 --> 00:07:53,080 RESPONSE WHEN WE LEARNED ABOUT 91 00:07:53,080 --> 00:07:54,160 IT IN 2020. 92 00:07:54,160 --> 00:07:55,760 SOME SUCCESSES AND OPPORTUNITIES 93 00:07:55,760 --> 00:07:57,040 FOR IMPROVEMENT AND PRINCIPLES I 94 00:07:57,040 --> 00:08:00,200 THINK ARE AN IMPORTANT PART OF 95 00:08:00,200 --> 00:08:05,840 ANY PANDEMIC RESPONSE, A FEW KEY 96 00:08:05,840 --> 00:08:10,600 LESSONS LEARNED AND PREPAREDNESS 97 00:08:10,600 --> 00:08:12,680 AT THE INSTITUTIONAL LEVEL AND 98 00:08:12,680 --> 00:08:18,720 FINDING A NEW NORMAL. 99 00:08:18,720 --> 00:08:22,600 IT'S THE KIND OF EPICURVE WE'VE 100 00:08:22,600 --> 00:08:25,400 SEEN THE PAST THREE YEARS 101 00:08:25,400 --> 00:08:27,040 LOOKING AT THE EARLY SLOPE AND 102 00:08:27,040 --> 00:08:28,040 HOPING IT WOULD NEVER GET HIGHER 103 00:08:28,040 --> 00:08:35,920 THAN THE FIRST PEAK AND THEN 104 00:08:35,920 --> 00:08:37,400 WAITING FOR THE DOWNWARD SLOPE 105 00:08:37,400 --> 00:08:38,480 AFTER THE PEAK OF A SURGE. 106 00:08:38,480 --> 00:08:40,600 SOME MAY HAVE GUESSED IT'S NOT 107 00:08:40,600 --> 00:08:41,360 SARS. 108 00:08:41,360 --> 00:08:44,360 THIS IS THE EARLY PANDEMIC CURVE 109 00:08:44,360 --> 00:08:48,120 FROM INFLUENZA PANDEMIC OF 1918. 110 00:08:48,120 --> 00:08:50,000 THE 1918 INFLUENZA PANDEMIC 111 00:08:50,000 --> 00:08:52,920 AFFLICTED OVER 25% OF THE 112 00:08:52,920 --> 00:08:54,280 U.S. POPULATION. 113 00:08:54,280 --> 00:08:55,280 MORE THAN 25 MILLION PEOPLE. 114 00:08:55,280 --> 00:09:00,440 IN THE U.S. MORE THAN 675,000 115 00:09:00,440 --> 00:09:03,160 PEOPLE DIED ROUGHLY 0.5% OF THE 116 00:09:03,160 --> 00:09:05,440 U.S. POPULATION AT THE TIME. 117 00:09:05,440 --> 00:09:07,480 THE INFLUENZA PANDEMIC OF 1918 118 00:09:07,480 --> 00:09:10,680 KILLED AN ESTIMATED 50 MILLION 119 00:09:10,680 --> 00:09:13,560 PEOPLE WORLDWIDE, ONE-FIFTH OF 120 00:09:13,560 --> 00:09:14,720 THE WORLD'S POPULATION WAS 121 00:09:14,720 --> 00:09:16,560 ATTACKED BY THE DEADLY VIRUS AND 122 00:09:16,560 --> 00:09:18,080 WITHIN MONTHS OF THE FIRST 123 00:09:18,080 --> 00:09:18,800 APPEARANCE KILLED MORE THAN 124 00:09:18,800 --> 00:09:20,640 PEOPLE THAN ANY OTHER ILLNESS IN 125 00:09:20,640 --> 00:09:23,800 RECORDED HISTORY. 126 00:09:23,800 --> 00:09:26,640 IN ONE YEAR THE AVERAGE LIFE 127 00:09:26,640 --> 00:09:28,040 EXPECTANCY IN THE UNITED STATES 128 00:09:28,040 --> 00:09:30,120 DROPPED BY 12 YEARS. 129 00:09:30,120 --> 00:09:31,640 THINK OF THAT. 130 00:09:31,640 --> 00:09:33,760 LIFE EXPECTANCY FELL SO FAR, SO 131 00:09:33,760 --> 00:09:35,400 FAST IN PART BECAUSE IN THE 132 00:09:35,400 --> 00:09:38,000 MIDST OF THE PANDEMIC IT WASN'T 133 00:09:38,000 --> 00:09:39,280 THE TYPICALLY YOUNG AND VERY OLD 134 00:09:39,280 --> 00:09:42,200 PEOPLE THAT YOU CAN SEE DYING 135 00:09:42,200 --> 00:09:44,000 BUT IN 1918 IT WAS ALSO I GUESS 136 00:09:44,000 --> 00:09:46,720 I DON'T HAVE THIS POINTER, MAYBE 137 00:09:46,720 --> 00:09:48,560 I'M POINTING IT THE WRONG WAY, 138 00:09:48,560 --> 00:09:53,840 JUST GO BACK. 139 00:09:53,840 --> 00:10:01,520 IN 1918 YOU SEE THE PEAK IN 25 140 00:10:01,520 --> 00:10:08,040 TO 34-YEAR-OLD AGE GROUP LOTS OF 141 00:10:08,040 --> 00:10:10,400 DEATH AND OUT SOCIALLY AND 142 00:10:10,400 --> 00:10:13,000 WORKING AND TO THE VIRUS. 143 00:10:13,000 --> 00:10:16,080 THE SO-CALLED W-SHAPE CURVE AND 144 00:10:16,080 --> 00:10:17,000 THINGS REALLY AREN'T SO 145 00:10:17,000 --> 00:10:17,280 DIFFERENT. 146 00:10:17,280 --> 00:10:19,720 HERE'S AN ARTICLE FROM THE 147 00:10:19,720 --> 00:10:24,360 WASHINGTON TIMES BACK IN 148 00:10:24,360 --> 00:10:27,320 SEPTEMBER 27 OF 1918 WITH THIS 149 00:10:27,320 --> 00:10:30,400 WOMAN DEMONSTRATING THE USE OF A 150 00:10:30,400 --> 00:10:33,920 NEWLY DESIGN MASK TO DESIGN TO 151 00:10:33,920 --> 00:10:36,840 HALT THE SPREAD OF THE PLAGUE. 152 00:10:36,840 --> 00:10:39,160 YOU SEE THE SEATTLE WASHINGTON 153 00:10:39,160 --> 00:10:40,240 POLICE OFFICER GOING OUT ON 154 00:10:40,240 --> 00:10:42,640 THEIR BEATS WEARING THEIR MASKS. 155 00:10:42,640 --> 00:10:43,800 I FOUND THIS INTERESTING GIVEN 156 00:10:43,800 --> 00:10:45,480 THE CONTRIBUTION TO THE STATE OF 157 00:10:45,480 --> 00:10:47,880 WASHINGTON TO THE EARLY PART OF 158 00:10:47,880 --> 00:10:49,240 THE PANDEMIC FOR COVID-19 AND 159 00:10:49,240 --> 00:10:52,560 LAST BUT NOT LEAST IN THE 160 00:10:52,560 --> 00:10:55,720 PICTURE IN THE LOWER RIGHT 161 00:10:55,720 --> 00:10:57,880 BECAUSE THIS ALSO HAS A LITTLE 162 00:10:57,880 --> 00:10:59,480 BIT OF A BASEBALL THEME THREE 163 00:10:59,480 --> 00:11:01,000 PEOPLE ALL WEARING MASKS, ALL 164 00:11:01,000 --> 00:11:02,960 DIFFERENT BUT ONLY ONE OF THOSE 165 00:11:02,960 --> 00:11:07,080 MASKS LIKELY HAS ANY IMPACT ON 166 00:11:07,080 --> 00:11:08,400 THE TRANSMISSION OF RESPIRATORY 167 00:11:08,400 --> 00:11:08,640 VIRUSES. 168 00:11:08,640 --> 00:11:10,240 THE PICTURE ON THE LEFT HERE IS 169 00:11:10,240 --> 00:11:16,040 FROM A U.S. ARMY CAMP IN FRANCE. 170 00:11:16,040 --> 00:11:17,720 I'M NOT CONFIDENCE THE CURTAINS 171 00:11:17,720 --> 00:11:23,920 YOU SEE HAD MUCH IMPACT ON 172 00:11:23,920 --> 00:11:27,080 MANAGING COT-TO-COT SPREAD. 173 00:11:27,080 --> 00:11:31,520 THE FIRST TRANSMISSION LIKELY 174 00:11:31,520 --> 00:11:39,000 WAS AT FORT KANSAS WHERE 500 175 00:11:39,000 --> 00:11:43,720 TROOPS AT FORT RILEY WERE 176 00:11:43,720 --> 00:11:44,320 QUICKLY INFECTED. 177 00:11:44,320 --> 00:11:45,880 IT'S A SMALL BUT SOPHISTICATED 178 00:11:45,880 --> 00:11:46,280 AUDIENCE. 179 00:11:46,280 --> 00:11:48,600 I KNOW FOR SURE. 180 00:11:48,600 --> 00:11:58,880 WHO IS THIS MAN? 181 00:12:05,880 --> 00:12:09,280 YOGI IS A PLAYER WON 10 WORLD 182 00:12:09,280 --> 00:12:10,400 SERIES CHAMPIONSHIPS. 183 00:12:10,400 --> 00:12:11,400 THE MOST IN MAJOR LEAGUE 184 00:12:11,400 --> 00:12:11,640 HISTORY. 185 00:12:11,640 --> 00:12:13,400 HERE YOU SEE HIM IN A VARIETY OF 186 00:12:13,400 --> 00:12:14,400 OTHER POSES. 187 00:12:14,400 --> 00:12:17,000 MY FAVORITE WHICH IS THE SECOND 188 00:12:17,000 --> 00:12:21,680 FRAME WHERE YOU SEE YOGI IN THE 189 00:12:21,680 --> 00:12:23,880 ARMS OF DON LARSON WHEN HE 190 00:12:23,880 --> 00:12:25,600 PITCHED THE ONLY PERFECT GAME IN 191 00:12:25,600 --> 00:12:28,000 THE WORLD SERIES HISTORY IN GAME 192 00:12:28,000 --> 00:12:29,600 FIVE OF THE 1956 WORLD SERIES 193 00:12:29,600 --> 00:12:31,320 AGAINST THE THEN BROOKLYN 194 00:12:31,320 --> 00:12:36,160 DODGERS OCTOBER 8 OF 1956. 195 00:12:36,160 --> 00:12:39,160 WHILE YOGI'S BASEBALL PROWESS IS 196 00:12:39,160 --> 00:12:41,680 UNDENIABLE AND PUT HIM IN THE 197 00:12:41,680 --> 00:12:42,840 BASEBALL HALL OF FAME HE'S BEST 198 00:12:42,840 --> 00:12:46,400 KNOWN FOR HIS APHORISMS OR MORE 199 00:12:46,400 --> 00:12:49,400 PRECISELY YOGIISMS. 200 00:12:49,400 --> 00:12:52,360 THE BEST KNOWN QUOTE IS 201 00:12:52,360 --> 00:12:57,280 APPLICABLE BETWEEN THE 1918 202 00:12:57,280 --> 00:12:58,760 INFLUENZA PANDEMIC AND COVID-19 203 00:12:58,760 --> 00:13:00,200 PANDEMIC I THINK IF HE WERE 204 00:13:00,200 --> 00:13:02,120 ASKED ABOUT THE SIMILARITIES AS 205 00:13:02,120 --> 00:13:07,480 HE SAID ABOUT ROGER MARIS AND 206 00:13:07,480 --> 00:13:10,600 MICKY MANTLE IT SEEMS LIKE DEJA 207 00:13:10,600 --> 00:13:11,560 YOU ALL OVER AGAIN. 208 00:13:11,560 --> 00:13:14,280 LET'S TALK ABOUT EARLY DETECTION 209 00:13:14,280 --> 00:13:14,960 AND EARLY RESPONSE. 210 00:13:14,960 --> 00:13:17,800 YOU SEE THE TIME LINE IN CHINA 211 00:13:17,800 --> 00:13:22,280 ON DECEMBER 30 OF 2019 A CLUSTER 212 00:13:22,280 --> 00:13:24,080 OF CASES OF PNEUMONIA WAS 213 00:13:24,080 --> 00:13:26,040 REPORTED TO THE CHINA NATIONAL 214 00:13:26,040 --> 00:13:27,280 HEALTH COMMISSION. 215 00:13:27,280 --> 00:13:31,720 THERE'S BEEN SOME INTERNET 216 00:13:31,720 --> 00:13:33,000 CHATTER PRIOR TO THE REPORT 217 00:13:33,000 --> 00:13:35,120 MOSTLY FROM PHYSICIANS WHO HAD 218 00:13:35,120 --> 00:13:35,760 DONE TRAINING IN THE UNITED 219 00:13:35,760 --> 00:13:38,120 STATES AND HAVE COLLEAGUES OR 220 00:13:38,120 --> 00:13:38,720 MENTORS IN THE UNITED STATES 221 00:13:38,720 --> 00:13:44,480 ASKING ABOUT CARE OF PATIENTS 222 00:13:44,480 --> 00:13:45,080 WHO HAVE UNKNOWN RESPIRATORY 223 00:13:45,080 --> 00:13:52,200 INFECTIONS. 224 00:13:52,200 --> 00:13:54,880 AND THERE WAS A WHOLESALE MARKET 225 00:13:54,880 --> 00:13:56,200 THEY THOUGHT MIGHT BE THE 226 00:13:56,200 --> 00:13:58,160 EPICENTER FOR THE PANDEMIC AND 227 00:13:58,160 --> 00:14:01,600 SOME PEOPLE STILL BELIEVE IT 228 00:14:01,600 --> 00:14:03,720 WAS. 229 00:14:03,720 --> 00:14:06,480 SIX DAYS LATER A NOVEL CORONA 230 00:14:06,480 --> 00:14:08,280 VIRUS WAS ON JANUARY. 231 00:14:08,280 --> 00:14:13,840 IN JANUARY 11 THE FIRST FATAL 232 00:14:13,840 --> 00:14:16,320 CASE WAS REPORT AND THE CHINA 233 00:14:16,320 --> 00:14:19,120 SHARED THE WHOLE GENOME SEQUENCE 234 00:14:19,120 --> 00:14:21,320 OF THE VIRUS WITH SCIENTISTS AT 235 00:14:21,320 --> 00:14:22,160 THE WORLD HEALTH ORGANIZATION. 236 00:14:22,160 --> 00:14:24,600 ON THE 13th THE FIRST CASE WAS 237 00:14:24,600 --> 00:14:26,000 REPORTED IN THAILAND. 238 00:14:26,000 --> 00:14:30,440 ON THE 19th THE FIRST CASE 239 00:14:30,440 --> 00:14:34,800 REPORTED IN KOREA AND TWO IN 240 00:14:34,800 --> 00:14:36,000 BEIJING AND ONE IN THE PROVINCE 241 00:14:36,000 --> 00:14:37,480 AT THE 16th THE FIRST CASE WAS 242 00:14:37,480 --> 00:14:41,280 REPORTED IN JAPAN AND THE 20th, 243 00:14:41,280 --> 00:14:45,880 THE CHINESE REPORTED THE HEALTH 244 00:14:45,880 --> 00:14:46,760 CARE WORKERS WERE COMING DOWN 245 00:14:46,760 --> 00:14:49,440 WITH THE INFWEKS AND BY THE 24th 246 00:14:49,440 --> 00:14:51,960 THE CHINESE REPORTED 835 CASES 247 00:14:51,960 --> 00:14:57,000 IN CHINA, 549 FROM WUHAN AND 286 248 00:14:57,000 --> 00:15:00,480 FROM THE OTHER 31 PROVINCES, 249 00:15:00,480 --> 00:15:01,000 MUNICIPALITIES OR SPECIAL 250 00:15:01,000 --> 00:15:04,840 ADMINISTRATIVE REGIONS. 251 00:15:04,840 --> 00:15:06,520 HERE'S THE EPICURVE MOST ARE 252 00:15:06,520 --> 00:15:07,800 FAMILIAR WITH. 253 00:15:07,800 --> 00:15:11,360 PUBLISHED DAILY FROM FEBRUARY OF 254 00:15:11,360 --> 00:15:14,080 2020 UNTIL MARCH 23 OF 2023 BY 255 00:15:14,080 --> 00:15:18,800 THE NEW YORK TIMES AND SHOWS THE 256 00:15:18,800 --> 00:15:20,560 INITIAL EPIDEMIC AND DELTA WAVE 257 00:15:20,560 --> 00:15:25,680 AND THE OMICRON WAVE AND TWO 258 00:15:25,680 --> 00:15:26,400 SUBSEQUENT SMALLER WAVES. 259 00:15:26,400 --> 00:15:29,520 IT'S BEEN A REALLY ROCKY ROAD. 260 00:15:29,520 --> 00:15:32,600 MORE THAN 108 CASES OF COVID 261 00:15:32,600 --> 00:15:34,000 OCCURRED IN THE UNITED STATES 262 00:15:34,000 --> 00:15:36,440 AND THAT IS ASSUREDLY AN ARE 263 00:15:36,440 --> 00:15:38,520 ESTIMATE. 264 00:15:38,520 --> 00:15:40,560 ASYMPTOMATIC AND MILDER CASE 265 00:15:40,560 --> 00:15:43,480 NEVER REPORTED AND BEGINNING IN 266 00:15:43,480 --> 00:15:48,600 EARLY 2022, HOME TESTING BECAME 267 00:15:48,600 --> 00:15:51,320 PREVALENT AND FEWER CASES WERE 268 00:15:51,320 --> 00:15:51,560 REPORTED. 269 00:15:51,560 --> 00:16:02,120 TO DATE, 1,174,109 PEOPLE DIED 270 00:16:02,360 --> 00:16:05,720 IN AMERICA AND THE MORE THAN 1.1 271 00:16:05,720 --> 00:16:07,080 MILLION WHO DIED REPRESENT 272 00:16:07,080 --> 00:16:10,160 ROUGHLY 0.35% OF OUR ENTIRE 273 00:16:10,160 --> 00:16:10,440 POPULATION. 274 00:16:10,440 --> 00:16:12,480 SO CONSIDER THIS, IN A TIME WHEN 275 00:16:12,480 --> 00:16:16,600 SCIENCE AND MEDICINE HAVE MADE 276 00:16:16,600 --> 00:16:17,240 ASTOUNDING DIAGNOSTIC, 277 00:16:17,240 --> 00:16:19,680 THERAPEUTIC AND PREVENTIVE 278 00:16:19,680 --> 00:16:24,440 INTERVENTIONAL STRIDES, WE DID 279 00:16:24,440 --> 00:16:26,520 NOT FARE MUCH BETTER WITH THE 280 00:16:26,520 --> 00:16:28,520 COVID THAN 1918 WHEN WE DIDN'T 281 00:16:28,520 --> 00:16:31,600 HAVE ANY DIAGNOSTIC TESTS OR ANY 282 00:16:31,600 --> 00:16:32,600 THERAPEUTIC INTERVENTIONS OTHER 283 00:16:32,600 --> 00:16:43,000 THAN SUPPORTIVE CARE. 284 00:16:44,040 --> 00:16:45,800 AND DESPITE THE PROVISION OF 285 00:16:45,800 --> 00:16:48,240 CRITICAL AND CLINICAL CARE MORE 286 00:16:48,240 --> 00:16:50,760 THAN 1.1 MILLION AMERICANS ON. 287 00:16:50,760 --> 00:16:53,600 EARLY ON EXPERTS HOPED NO MORE 288 00:16:53,600 --> 00:16:56,240 THAN THE TYPICAL FIVE TO 50,000 289 00:16:56,240 --> 00:16:59,240 PEOPLE WHO DIE ANNUALLY FROM 290 00:16:59,240 --> 00:17:00,040 INFLUENZA WOULD DIE FROM COVID. 291 00:17:00,040 --> 00:17:03,320 IT'S FAIR TO SAY ALL OF US WERE 292 00:17:03,320 --> 00:17:04,360 SORELY DISAPPOINTED. 293 00:17:04,360 --> 00:17:09,280 HERE'S THE TIME LINE IN THE U.S. 294 00:17:09,280 --> 00:17:11,520 JANUARY 3, THE CDC DIRECTOR 295 00:17:11,520 --> 00:17:14,960 DR. ROBERT REDFIELD WAS NOTIFIED 296 00:17:14,960 --> 00:17:18,040 OF A MYSTERIOUS ILLNESS 297 00:17:18,040 --> 00:17:19,240 SPREADING IN WUHAN. 298 00:17:19,240 --> 00:17:20,600 THREE DAYS LATER HE MADE CONTACT 299 00:17:20,600 --> 00:17:21,440 WITH THE CHINESE GOVERNMENT AND 300 00:17:21,440 --> 00:17:23,480 OFFERED TO SEND A GROUP OF 301 00:17:23,480 --> 00:17:25,520 SCIENTISTS FROM CDC TO HELP THEM 302 00:17:25,520 --> 00:17:28,160 INVESTIGATE THE PROBLEM TO MY 303 00:17:28,160 --> 00:17:28,800 KNOWLEDGE THAT OFFER WAS NEVER 304 00:17:28,800 --> 00:17:30,800 ACKNOWLEDGED. 305 00:17:30,800 --> 00:17:33,520 ON THE 8th OF JANUARY, CDC 306 00:17:33,520 --> 00:17:36,760 ISSUED ITS FIRST PUBLIC ALERT ON 307 00:17:36,760 --> 00:17:40,480 THE 17th THEY BEGAN AIRPORT 308 00:17:40,480 --> 00:17:42,160 SCREENING IN NEW YORK, LOS 309 00:17:42,160 --> 00:17:43,520 ANGELES AND SAN FRANCISCO BEHIND 310 00:17:43,520 --> 00:17:44,880 THE JANUARY OF 20 THE FIRST 311 00:17:44,880 --> 00:17:46,800 U.S. CASE WAS REPORTED AN 312 00:17:46,800 --> 00:17:48,600 AMERICAN CITIZEN TRAVEL FROM 313 00:17:48,600 --> 00:17:51,480 WUHAN TO WASHINGTON STATE. 314 00:17:51,480 --> 00:17:56,600 THE 23rd, CDC SOUGHT AND FDA 315 00:17:56,600 --> 00:17:58,440 EMERGENCY USE AUTHORIZATION FOR 316 00:17:58,440 --> 00:18:01,480 THEIR PCR TEST ON THE 31st THE 317 00:18:01,480 --> 00:18:06,520 DEPARTMENT OF HEALTH AND HUMAN 318 00:18:06,520 --> 00:18:07,960 SERVICES DECLARED PUBLIC HEALTH 319 00:18:07,960 --> 00:18:10,160 EMERGENCY LASTING TO MARCH 23, 320 00:18:10,160 --> 00:18:10,360 2023. 321 00:18:10,360 --> 00:18:14,880 ON FEBRUARY 4th, THE FDA ISSUED 322 00:18:14,880 --> 00:18:19,400 THE PCR TEST BUT TWO DAYS LATER 323 00:18:19,400 --> 00:18:24,600 THE CDC TEST KITS WERE FOUND TO 324 00:18:24,600 --> 00:18:27,520 BE DEFECTIVE. 325 00:18:27,520 --> 00:18:31,120 ON THE 15th, YOU PROBABLY ALL 326 00:18:31,120 --> 00:18:35,560 RECALL THE 338 U.S. NATIONALS 327 00:18:35,560 --> 00:18:37,360 STRANDED ON THE DIAMOND PRINCESS 328 00:18:37,360 --> 00:18:38,320 CRUISE SHIP. 329 00:18:38,320 --> 00:18:40,200 ON THE 20th THE FIRST INSTANCE 330 00:18:40,200 --> 00:18:42,080 OF COMMUNITY TRANSMISSION WAS 331 00:18:42,080 --> 00:18:42,960 CONFIRMED IN CALIFORNIA AND AT 332 00:18:42,960 --> 00:18:45,560 THAT TIME MOST OF US WHO HAD 333 00:18:45,560 --> 00:18:48,680 BEEN WATCHING FROM AN 334 00:18:48,680 --> 00:18:49,480 EPIDEMIOLOGIC PERSPECTIVE FELT 335 00:18:49,480 --> 00:18:51,160 THE HORSE HAD ALREADY RUN. 336 00:18:51,160 --> 00:18:55,120 BY THE 28th, THE CDC TEST KIT 337 00:18:55,120 --> 00:18:56,600 WAS REVISED AND IT WASN'T UNTIL 338 00:18:56,600 --> 00:18:58,880 MARCH 3 THEY LIFTED RESTRICTION 339 00:18:58,880 --> 00:19:00,960 ON TESTING FROM THE CDC AND THAT 340 00:19:00,960 --> 00:19:04,800 PUT US A MONTH AND A HALF OR TWO 341 00:19:04,800 --> 00:19:06,200 MONTHS BEHIND THE CURVE. 342 00:19:06,200 --> 00:19:08,440 ON THE 11th OF MARCH, THE WORLD 343 00:19:08,440 --> 00:19:09,240 HEALTH ORGANIZATION DECLARED A 344 00:19:09,240 --> 00:19:09,680 PANDEMIC. 345 00:19:09,680 --> 00:19:11,840 ON THE 12th, COLLEGES AND PUBLIC 346 00:19:11,840 --> 00:19:13,920 SCHOOLS BEGAN TO CLOSE. 347 00:19:13,920 --> 00:19:18,160 ON THE 16th, BOTH DHHS AND CDC 348 00:19:18,160 --> 00:19:20,480 ISSUED GUIDELINES ABOUT THE NEW 349 00:19:20,480 --> 00:19:23,360 DISEASE AND BY THE MARCH 31, 350 00:19:23,360 --> 00:19:25,440 2020 THE U.S. EXPERIENCED 370 351 00:19:25,440 --> 00:19:30,160 DEATHS, 164,000 CASES AND USED 352 00:19:30,160 --> 00:19:32,000 MORE THAT BE 1.07 MILLION TESTS. 353 00:19:32,000 --> 00:19:37,120 THAT WAS NOT NEARLY ENOUGH. 354 00:19:37,120 --> 00:19:39,040 SO WHERE DID IT COME FROM? 355 00:19:39,040 --> 00:19:42,400 THERE'S A VARIETY OF THEORIES. 356 00:19:42,400 --> 00:19:45,120 THE MOST PREVALENT IS IT EVOLVED 357 00:19:45,120 --> 00:19:48,440 AND ADAPTED ITSELF FROM NATURE. 358 00:19:48,440 --> 00:19:50,680 THERE'S A FAIR AMOUNT OF 359 00:19:50,680 --> 00:19:54,880 EVIDENCE FOR THAT AND A LOT'S 360 00:19:54,880 --> 00:19:56,560 WRITTEN ABOUT IT AND SOME 361 00:19:56,560 --> 00:20:00,600 BELIEVE IT'S A LABORATORY 362 00:20:00,600 --> 00:20:03,560 INSTITUTE OF VIROLOGY IN WUHAN 363 00:20:03,560 --> 00:20:05,280 AND SOME BELIEVE IT WAS 364 00:20:05,280 --> 00:20:06,160 INTENTIONALLY RELEASED BY THE 365 00:20:06,160 --> 00:20:06,840 CHINESE GOVERNMENT. 366 00:20:06,840 --> 00:20:10,040 WE DON'T HAVE DEFINITIVE 367 00:20:10,040 --> 00:20:11,000 EVIDENCE OR PROVING EVIDENCE FOR 368 00:20:11,000 --> 00:20:13,360 ANY OF THOSE THEORIES AND WE MAY 369 00:20:13,360 --> 00:20:15,680 LIKELY NEVER KNOW PRECISELY 370 00:20:15,680 --> 00:20:16,920 WHERE IT CAME FROM. 371 00:20:16,920 --> 00:20:20,320 BASED ON ALL I READ I'M 372 00:20:20,320 --> 00:20:23,160 REASONABLY CONFIDENT THE PRIMARY 373 00:20:23,160 --> 00:20:25,000 HYPOTHESIS THAT IS EVOLVED AND 374 00:20:25,000 --> 00:20:27,240 ADAPTED FROM NATURE IS PROBABLY 375 00:20:27,240 --> 00:20:28,400 MOST LIKELY. 376 00:20:28,400 --> 00:20:38,240 THAT'S THE CASE WE KNOW FOR SARS 377 00:20:38,240 --> 00:20:40,600 COV1 AND MERS TWO CLOSELY 378 00:20:40,600 --> 00:20:42,840 RELATED CORONAVIRUS. 379 00:20:42,840 --> 00:20:46,680 I HAVE NO EVIDENCE THAT IT WAS 380 00:20:46,680 --> 00:20:47,680 INTENTIONALLY RELEASED AND THERE 381 00:20:47,680 --> 00:20:50,920 IS SOME THAT SAYS A LABORATORY 382 00:20:50,920 --> 00:20:52,320 INCIDENT IS POSSIBLE. 383 00:20:52,320 --> 00:20:54,800 THE EARLY SPREAD CHINA WAS 384 00:20:54,800 --> 00:20:56,280 DRAMATICALLY UNDER REPORTED. 385 00:20:56,280 --> 00:20:59,320 SO WHAT WENT WELL FOR US. 386 00:20:59,320 --> 00:21:01,560 THE RAPID IDENTIFICATION AND 387 00:21:01,560 --> 00:21:02,640 SEQUENCING OF THE VIRUS GAVE US 388 00:21:02,640 --> 00:21:05,440 A LEG UP AND GAVE US GREAT 389 00:21:05,440 --> 00:21:05,800 OPPORTUNITIES. 390 00:21:05,800 --> 00:21:07,240 I THINK ONE OF THE BIGGEST 391 00:21:07,240 --> 00:21:07,800 SUCCESSES CAME FROM THE 392 00:21:07,800 --> 00:21:11,760 DEPARTMENT OF HEALTH AND HUMAN 393 00:21:11,760 --> 00:21:16,000 SERVICES GENERATING OPERATION OF 394 00:21:16,000 --> 00:21:17,480 WARP SPEED WHICH CALLING ON THE 395 00:21:17,480 --> 00:21:19,960 LEADERSHIP OF THE AGENCIES WITH 396 00:21:19,960 --> 00:21:23,880 FRANCIS COLLINS HIMSELF TAKING A 397 00:21:23,880 --> 00:21:24,600 SIGNIFICANT ROLE IN OPERATION 398 00:21:24,600 --> 00:21:27,160 WARP SPEED AND QUICKLY MADE A 399 00:21:27,160 --> 00:21:32,560 PARTNERSHIP WITH BIG PHARMA AND 400 00:21:32,560 --> 00:21:36,520 ENCOURAGED REPURPOSING OF 401 00:21:36,520 --> 00:21:37,960 ANTIRETROVIRALS AND THEY 402 00:21:37,960 --> 00:21:41,440 ENCOURAGED AND HELPED TEST AND 403 00:21:41,440 --> 00:21:45,280 MOVE TOWARDS EMERGENCY USE 404 00:21:45,280 --> 00:21:50,040 AUTHORIZATION FOR NEW ANTIVIRAL 405 00:21:50,040 --> 00:21:54,760 AGENTS, THE FORMER IS PAXLOVID 406 00:21:54,760 --> 00:21:56,040 AND ENCOURAGES MONOCLONAL 407 00:21:56,040 --> 00:21:58,520 ANTIBODIES THAT WERE OF GREAT 408 00:21:58,520 --> 00:22:00,360 BENEFIT LESS SO OF THE VARIANTS 409 00:22:00,360 --> 00:22:02,320 WHERE THE MONOCLONAL VARIANTS 410 00:22:02,320 --> 00:22:06,800 DID NOT ATTACH AND HELPED PROVE 411 00:22:06,800 --> 00:22:09,840 THE BENEFIT OF CONVALESCENT 412 00:22:09,840 --> 00:22:10,640 PLASMA OF PEOPLE ILL WITH THE 413 00:22:10,640 --> 00:22:10,880 DISEASE. 414 00:22:10,880 --> 00:22:14,560 THEY ENCOURAGED THE DESIGN AND 415 00:22:14,560 --> 00:22:16,600 DEVELOPMENT OF DRUGS TO TREAT 416 00:22:16,600 --> 00:22:19,840 THE CYTOKINE STORM A SIGNIFICANT 417 00:22:19,840 --> 00:22:22,840 PART WHEN PATIENTS GET SICK AND 418 00:22:22,840 --> 00:22:27,320 IL6 RECEPTOR BLOCKERS AND 419 00:22:27,320 --> 00:22:28,000 INTERMERS WERE USEFUL. 420 00:22:28,000 --> 00:22:32,560 VACCINE DEVELOPMENT WAS ALSO AN 421 00:22:32,560 --> 00:22:36,640 ASTOUNDING SECOND HAUCCESS IN M. 422 00:22:36,640 --> 00:22:40,040 YOU'RE ALL FAMILIAR WITH THE 423 00:22:40,040 --> 00:22:41,080 mRNA PLATFORM WHERE SCIENTISTS 424 00:22:41,080 --> 00:22:49,800 HAD A SIGNIFICANT PART OF 425 00:22:49,800 --> 00:22:52,280 DEVELOPMENT FROM THAT PLATFORM. 426 00:22:52,280 --> 00:22:54,160 THE ADENOVIRUS VACCINES WERE 427 00:22:54,160 --> 00:22:56,880 HIGHLY EFFECTIVE AND ENDED UP 428 00:22:56,880 --> 00:22:58,280 HAVING UNANTICIPATED 429 00:22:58,280 --> 00:23:00,480 CONSEQUENCES BUT WE NOW HAVE 430 00:23:00,480 --> 00:23:02,240 PROTEINS SUBUNIT VACCINES ON A 431 00:23:02,240 --> 00:23:04,200 VARIETY OF OTHER PLATFORMS ALL 432 00:23:04,200 --> 00:23:07,040 OF WHICH HAVE EFFICACY BUT THE 433 00:23:07,040 --> 00:23:07,880 REMARKABLE THING IS THE VIRUS 434 00:23:07,880 --> 00:23:11,360 WAS ISOLATED ON THE 7th OF 435 00:23:11,360 --> 00:23:13,640 JANUARY, SEQUENCED ON THE 12th 436 00:23:13,640 --> 00:23:18,080 AND THE FIRST EUA WAS GRANTED ON 437 00:23:18,080 --> 00:23:20,200 DECEMBER 2 LESS THAN A YEAR OF 438 00:23:20,200 --> 00:23:24,600 THE SEQUENCING OF THE VIRUS. 439 00:23:24,600 --> 00:23:26,160 THE EFFICACY OF THE VACCINES AT 440 00:23:26,160 --> 00:23:28,720 FIRST WAS ALMOST UNBELIEVABLE. 441 00:23:28,720 --> 00:23:32,520 THE EFFICACY DATA GREATER THAN 442 00:23:32,520 --> 00:23:32,680 95%. 443 00:23:32,680 --> 00:23:34,120 AND THE VARIANT SPUN OFF WAS 444 00:23:34,120 --> 00:23:35,160 LESS AND LEGS EFFECTIVE IN TERMS 445 00:23:35,160 --> 00:23:39,320 OF PREVENTING INFECTIONS BUT 446 00:23:39,320 --> 00:23:40,840 REMAINED EFFECTIVE AT PREVENTING 447 00:23:40,840 --> 00:23:41,280 BIRTH MORTALITY AND 448 00:23:41,280 --> 00:23:49,280 HOSPITALIZATION. 449 00:23:49,280 --> 00:23:52,240 THIS IS THE GOSPEL ACCORDING TO 450 00:23:52,240 --> 00:23:53,120 HENDERSON AND MY TAKE AND 451 00:23:53,120 --> 00:23:54,120 EXPRESSES MY OPINION. 452 00:23:54,120 --> 00:23:59,040 THERE WAS NO CENTRALIZED 453 00:23:59,040 --> 00:24:00,200 COORDINATED FEDERAL RESPONSE. 454 00:24:00,200 --> 00:24:01,840 RESPONSE WAS DECENTRALIZED TO 455 00:24:01,840 --> 00:24:04,320 THE STATES AND MUNICIPALITIES 456 00:24:04,320 --> 00:24:08,120 AND AS MANY APPROACHES AS HEINZ 457 00:24:08,120 --> 00:24:09,840 HAS VARIETIES. 458 00:24:09,840 --> 00:24:12,840 WE HAD THE ABILITY TO IMPLEMENT 459 00:24:12,840 --> 00:24:13,080 TESTING. 460 00:24:13,080 --> 00:24:15,800 WE LACKED UNIFORM STANDARDS FOR 461 00:24:15,800 --> 00:24:17,720 REPORTING DATA AND THAT PREVENT 462 00:24:17,720 --> 00:24:20,000 THE TIMELY AND ACCURATE TRACKING 463 00:24:20,000 --> 00:24:21,480 OF SPREADING. 464 00:24:21,480 --> 00:24:24,280 REPORTING SYSTEMS AT THE START 465 00:24:24,280 --> 00:24:27,040 OF THE PANDEMIC WERE 466 00:24:27,040 --> 00:24:29,720 INCONSISTENT AND ANTIQUATED. 467 00:24:29,720 --> 00:24:30,640 A SUBSTANTIAL FRACTION OF PEOPLE 468 00:24:30,640 --> 00:24:32,640 WERE REPORTING TO CDC AT THE 469 00:24:32,640 --> 00:24:40,680 START WERE REPORTING BY FAX AND 470 00:24:40,680 --> 00:24:42,360 AND THERE WERE A FEW CASES, WE 471 00:24:42,360 --> 00:24:44,120 HAVE THEM AT HAND. 472 00:24:44,120 --> 00:24:48,320 THE POPULATION DOESN'T NEED TO 473 00:24:48,320 --> 00:24:51,920 BE CONCERNED AS REPORTS WERE 474 00:24:51,920 --> 00:24:53,040 TRIVIALIZED AND AS THE PANDEMIC 475 00:24:53,040 --> 00:24:56,560 BEGAN TO UNFOLD WE HAD ALSO 476 00:24:56,560 --> 00:25:03,200 ACCESS TO PPE AND COUNTED ON THE 477 00:25:03,200 --> 00:25:04,400 STOCKPILE FOLLOWING NOVEL H1N1 478 00:25:04,400 --> 00:25:06,560 BY THE TIME WE GOT TO THOSE MOST 479 00:25:06,560 --> 00:25:11,280 ERROR OUT OF DATE AND REALLY NOT 480 00:25:11,280 --> 00:25:11,560 USABLE. 481 00:25:11,560 --> 00:25:13,760 WE HAD PROBLEMS WITH MASKS AND 482 00:25:13,760 --> 00:25:15,480 GOWNS AND CRITICAL SHORTAGES OF 483 00:25:15,480 --> 00:25:17,080 REAGENTS FOR TESTING. 484 00:25:17,080 --> 00:25:20,560 WE HAD PROBLEMS WITH THE INITIAL 485 00:25:20,560 --> 00:25:21,960 INTERPRETATION AND DELINEATION 486 00:25:21,960 --> 00:25:23,520 OF COVID-19 EPIDEMIOLOGY. 487 00:25:23,520 --> 00:25:24,760 THINK THE TRUE PANDEMIC 488 00:25:24,760 --> 00:25:26,160 POTENTIAL MAY HAVE BEEN 489 00:25:26,160 --> 00:25:28,320 INITIALLY DISCOUNTED IN PART 490 00:25:28,320 --> 00:25:31,000 BECAUSE OF THE EXPERIENCE WE HAD 491 00:25:31,000 --> 00:25:35,600 WITH BOTH SARS 1 AND MERS. 492 00:25:35,600 --> 00:25:36,920 THOSE DISEASES BALM MORE DISEASE 493 00:25:36,920 --> 00:25:38,680 AS THE PATIENT BECOMES MORE 494 00:25:38,680 --> 00:25:42,840 INFECTIOUS. 495 00:25:42,840 --> 00:25:44,680 AND THERE'S PEOPLE IN HOSPITALS 496 00:25:44,680 --> 00:25:46,000 PROVIDING CARE AND THAT'S WHAT 497 00:25:46,000 --> 00:25:52,320 WE SAW ESPECIALLY WITH SARS COV1 498 00:25:52,320 --> 00:25:54,880 IT WASN'T AS TRANSMISSIBLE IN 499 00:25:54,880 --> 00:25:55,520 THE COMMUNITY BECAUSE PEOPLE 500 00:25:55,520 --> 00:25:57,240 WEREN'T THAT SICK WITH IT AND BY 501 00:25:57,240 --> 00:25:58,240 THE TIME THEY WERE THEY WENT TO 502 00:25:58,240 --> 00:25:58,720 THE HOSPITAL. 503 00:25:58,720 --> 00:26:05,440 IT'S NOT THE CASE FOR SARS COV2. 504 00:26:05,440 --> 00:26:09,400 TRANSMISSION WAS INITIALLY AS A 505 00:26:09,400 --> 00:26:12,640 DROP LET SPREAD, NO WORD OF 506 00:26:12,640 --> 00:26:15,000 AEROSOL TRANSMISSION BUT IN THE 507 00:26:15,000 --> 00:26:15,720 RIGHT CIRCUMSTANCES AND WITH THE 508 00:26:15,720 --> 00:26:17,600 RIGHT PATIENT IT'S PROBABLY THE 509 00:26:17,600 --> 00:26:20,600 CASE AEROSOL AND IF THE AIR 510 00:26:20,600 --> 00:26:23,680 HANDLING IS POOR MAYBE AIRBORNE 511 00:26:23,680 --> 00:26:25,320 TRANSMISSION MAY OCCUR. 512 00:26:25,320 --> 00:26:34,640 A BIG PROB WAS ASYSTEMATIC -- 513 00:26:34,640 --> 00:26:39,280 ASYMPTOMATIC TRANSMISSION WAS 514 00:26:39,280 --> 00:26:44,000 DISCOURAGED THAT AND MASKS AND 515 00:26:44,000 --> 00:26:54,520 WE NEEDED ENOUGH MASKS WITH THE 516 00:26:54,840 --> 00:26:55,240 HEALTH CARE PROVIDERS. 517 00:26:55,240 --> 00:27:01,320 MANY PROBLEMS COULD HAVE BEEN 518 00:27:01,320 --> 00:27:04,760 OBVIATED WITH TESTING AND 519 00:27:04,760 --> 00:27:05,040 QUARANTINE. 520 00:27:05,040 --> 00:27:07,960 THOUGH THE VACCINE WAS PRODUCED 521 00:27:07,960 --> 00:27:08,960 WITH BREAK NECK SPEED THE 522 00:27:08,960 --> 00:27:14,720 LOGISTICS AT THE START WERE LESS 523 00:27:14,720 --> 00:27:16,800 THAN STELLAR RESULTING IN 524 00:27:16,800 --> 00:27:17,120 INEQUITIES. 525 00:27:17,120 --> 00:27:19,400 WE HAD PROBLEMS FROM THE 526 00:27:19,400 --> 00:27:20,600 NATION'S MULTIPLE RESPONSE FALSE 527 00:27:20,600 --> 00:27:22,640 STARTS. 528 00:27:22,640 --> 00:27:25,080 POLITICAL OPINIONS ENTIRELY VOID 529 00:27:25,080 --> 00:27:28,560 OF FACTUAL EVIDENCE WERE 530 00:27:28,560 --> 00:27:32,120 REPRESENTED AS FACTUAL NEARLY 531 00:27:32,120 --> 00:27:33,880 EVERY DAY AND RECOMMENDATIONS 532 00:27:33,880 --> 00:27:35,240 WERE HIGHLY POLITICIZED. 533 00:27:35,240 --> 00:27:37,320 THE EARLY TESTING PROBLEMS AT 534 00:27:37,320 --> 00:27:40,560 CDC LIKELY CAUSED THE PUBLIC TO 535 00:27:40,560 --> 00:27:41,560 LOSE SOME CONFIDENCE AT THE 536 00:27:41,560 --> 00:27:45,000 INCREDIBLE AT THE TIME WE NEEDED 537 00:27:45,000 --> 00:27:47,120 THEM MOST. 538 00:27:47,120 --> 00:27:48,760 GOVERNMENTAL COMMUNICATION AND 539 00:27:48,760 --> 00:27:54,440 TRANSPARENCY WAS OBLITERATED. 540 00:27:54,440 --> 00:27:56,600 SPEAKING TRUTH TO POWER I'LL 541 00:27:56,600 --> 00:28:04,440 CALL A COLLEAGUE, TONY FAUCI LED 542 00:28:04,440 --> 00:28:06,760 TO GAGGING OF EXPERTISE AND YOU 543 00:28:06,760 --> 00:28:09,320 LOOK AT THE TASK FORCE TO SEE 544 00:28:09,320 --> 00:28:10,520 WHAT HAPPENED WHEN THEY SPOKE 545 00:28:10,520 --> 00:28:11,440 UP. 546 00:28:11,440 --> 00:28:12,720 THE INTERFACE BETWEEN SCIENCE 547 00:28:12,720 --> 00:28:16,560 AND POLICY WAS SEVERELY DAMAGED 548 00:28:16,560 --> 00:28:19,680 AND I HOPE NOT INEXTRICABLY. 549 00:28:19,680 --> 00:28:22,640 HERE'S EXAMPLES OF 550 00:28:22,640 --> 00:28:23,400 MISINFORMATION SPREAD ABOUT 551 00:28:23,400 --> 00:28:25,800 COVID AND SARS COV2. 552 00:28:25,800 --> 00:28:27,280 THE EXTENT OF EARLY SPREAD WAS 553 00:28:27,280 --> 00:28:27,560 MINIMIZED. 554 00:28:27,560 --> 00:28:29,360 WE ONLY HAVE 18 CASES AND WE 555 00:28:29,360 --> 00:28:30,760 KNOW WHERE ALL ARE. 556 00:28:30,760 --> 00:28:34,040 YOU DON'T HAVE TO BE WORRIED. 557 00:28:34,040 --> 00:28:35,400 THE SERIOUSNESS OF THE DISEASE 558 00:28:35,400 --> 00:28:37,880 WAS VASTLY UNDERESTIMATED. 559 00:28:37,880 --> 00:28:39,040 IT'S JUST LIKE THE FLU. 560 00:28:39,040 --> 00:28:42,960 YOU'LL GET IT AND GET OVER IT. 561 00:28:42,960 --> 00:28:45,360 IT'S NOT A PROBLEM. 562 00:28:45,360 --> 00:28:50,840 PEOPLE ARGUED MASKS WERE 563 00:28:50,840 --> 00:28:52,840 INEFFECTIVE BUT THEY'RE NOT 100% 564 00:28:52,840 --> 00:28:55,480 EFFECTIVE SO IF YOU FIND ONE 565 00:28:55,480 --> 00:28:57,960 INSTANCE THEN YOU CAN REDUCE THE 566 00:28:57,960 --> 00:29:03,360 ARGUMENT TO SAY NAR -- THEY'RE 567 00:29:03,360 --> 00:29:05,040 NOT EFFECTIVE AT ALL. 568 00:29:05,040 --> 00:29:07,840 PEOPLE ADVOCATE FROM THE USE OF 569 00:29:07,840 --> 00:29:08,920 UNPROVEN THERAPIES. 570 00:29:08,920 --> 00:29:11,840 FOR EXAMPLE, HYDROXYCHLOROQUINE 571 00:29:11,840 --> 00:29:14,000 AND ON ONE OCCASION ON NATIONAL 572 00:29:14,000 --> 00:29:21,360 TELEVISION EVEN THE USE OF 573 00:29:21,360 --> 00:29:25,720 INTRAVENOUS CHLORIDE OR LIGHT TO 574 00:29:25,720 --> 00:29:28,320 HELP RID THE BODY OF THE VIRUS 575 00:29:28,320 --> 00:29:32,600 AND SOME LEADERS EXPRESSED 576 00:29:32,600 --> 00:29:34,880 SUPPORT FOR THE CONSPIRACY 577 00:29:34,880 --> 00:29:35,160 THEORIES. 578 00:29:35,160 --> 00:29:43,000 THERE WAS AN EQUAL AMOUNT OF 579 00:29:43,000 --> 00:29:43,680 VACCINE EFFECTIVENESS. 580 00:29:43,680 --> 00:29:45,600 THERE'S ALWAYS RISK. 581 00:29:45,600 --> 00:29:47,680 THEY WERE UNBELIEVABLY SAFE IN 582 00:29:47,680 --> 00:29:48,720 COMPARISON TO OTHER NEW 583 00:29:48,720 --> 00:29:49,120 VACCINES. 584 00:29:49,120 --> 00:29:51,360 THERE WAS THE ASSERTION ALL OVER 585 00:29:51,360 --> 00:29:54,560 THE INTERNET THAT VACCINES CAUSE 586 00:29:54,560 --> 00:29:55,160 INFERTILITY. 587 00:29:55,160 --> 00:29:59,800 THERE WERE ALLEGATIONS mRNA 588 00:29:59,800 --> 00:30:04,120 VACCINES CAUSE IRREVERSIBLE 589 00:30:04,120 --> 00:30:04,600 HARM. 590 00:30:04,600 --> 00:30:05,440 THERE WERE SUGGESTION THE 591 00:30:05,440 --> 00:30:09,480 VACCINE RECIPIENTS WERE AT 592 00:30:09,480 --> 00:30:10,840 INCREASED RISK FOR SUDDEN DEATH, 593 00:30:10,840 --> 00:30:11,560 ALSO UNTRUE. 594 00:30:11,560 --> 00:30:13,840 THERE WERE FINANCIAL 595 00:30:13,840 --> 00:30:14,120 MOTIVATIONS. 596 00:30:14,120 --> 00:30:15,160 A GROUP CALLED AMERICA'S FRONT 597 00:30:15,160 --> 00:30:17,280 LINE DOCTORS GARNERED $15 598 00:30:17,280 --> 00:30:20,560 MILLION BY IMPLEMENTING A PLAY 599 00:30:20,560 --> 00:30:22,760 TO PAY CONSULT SERVICE THAT 600 00:30:22,760 --> 00:30:29,000 CHARGED $90 TO PRESCRIBE 601 00:30:29,000 --> 00:30:30,240 HYDROXYCHLOROQUINE. 602 00:30:30,240 --> 00:30:32,600 WINSTON CHURCHILL SAID IT BEST, 603 00:30:32,600 --> 00:30:34,600 A LIE HAS HALFWAY AROUND THE 604 00:30:34,600 --> 00:30:36,440 WORLD BEFORE THE TRUTH HAS A 605 00:30:36,440 --> 00:30:40,560 CHANCE TO PUT ITS PANTS ON AND 606 00:30:40,560 --> 00:30:43,560 HAS SAID, SOMETIMES WE FIND 607 00:30:43,560 --> 00:30:45,320 WE'VE MET THE ENEMY AND IT'S US. 608 00:30:45,320 --> 00:30:47,040 HERE A PAPER FROM THE JAMA 609 00:30:47,040 --> 00:30:51,320 NETWORK OPEN THAT DID A DETAILED 610 00:30:51,320 --> 00:30:53,240 ANALYSIS OF HOW A FAIRLY LARGE 611 00:30:53,240 --> 00:30:55,920 NUMBER OF PHYSICIANS COMMUNITIES 612 00:30:55,920 --> 00:31:03,360 TO COVID-19 MISINFORMATION ON 613 00:31:03,360 --> 00:31:07,360 SOCIAL DETERMINATE. 614 00:31:07,360 --> 00:31:08,600 LET'S TURN TO THE FIVE 615 00:31:08,600 --> 00:31:09,960 PRINCIPLES I'LL TALK ABOUT 616 00:31:09,960 --> 00:31:10,360 PRIMARILY. 617 00:31:10,360 --> 00:31:11,720 THEY'RE NOT THE ONLY PRINCIPLES 618 00:31:11,720 --> 00:31:14,440 BUT THESE ARE ONES I THOUGHT 619 00:31:14,440 --> 00:31:16,120 WERE WORTHY OF EMPHASIS. 620 00:31:16,120 --> 00:31:19,320 FIRST, THE UNIFIED EFFECTIVE 621 00:31:19,320 --> 00:31:22,720 CENTRALIZED NATIONAL RESPONSE IS 622 00:31:22,720 --> 00:31:24,560 ESSENTIAL AND EFFECTIVE 623 00:31:24,560 --> 00:31:26,120 COMMUNICATION IS REQUIRED. 624 00:31:26,120 --> 00:31:26,720 PUBLIC HEALTH SYSTEMS AND 625 00:31:26,720 --> 00:31:28,800 LABORATORY SUPPORT SYSTEMS ARE 626 00:31:28,800 --> 00:31:31,520 CRITICAL TO IDENTIFY TRACK AND 627 00:31:31,520 --> 00:31:32,960 CONTAIN NOVEL PATHOGENS AND 628 00:31:32,960 --> 00:31:33,960 SCIENCE MUST BE THE DRIVING 629 00:31:33,960 --> 00:31:35,600 FORCE FOR INTERVENTIONS. 630 00:31:35,600 --> 00:31:37,800 THE CONNECTION BETWEEN SCIENCE, 631 00:31:37,800 --> 00:31:39,280 SOCIETY AND POLITICS HAS NEVER 632 00:31:39,280 --> 00:31:40,480 BECOME MORE CLEARER THAN IT IS 633 00:31:40,480 --> 00:31:43,240 TO ME RIGHT NOW. 634 00:31:43,240 --> 00:31:47,120 FOR THE COVID PANDEMIC FOR AN 635 00:31:47,120 --> 00:31:49,360 APOLITICAL VIRUS, POLITICS 636 00:31:49,360 --> 00:31:51,240 PLAYED A FAR TOO PROMINENT ROLE. 637 00:31:51,240 --> 00:31:53,680 WE HAVE TO CAPITALIZE ON 638 00:31:53,680 --> 00:31:54,280 SCIENTIFIC DISCOVERIES AS 639 00:31:54,280 --> 00:31:54,960 RAPIDLY AS POSSIBLE. 640 00:31:54,960 --> 00:31:57,000 FIRST ABOUT THE RESPONSE. 641 00:31:57,000 --> 00:31:59,440 IN MY VIEW, AGAIN THIS IS MY 642 00:31:59,440 --> 00:32:00,320 VIEW, THE FEDERAL GOVERNMENT 643 00:32:00,320 --> 00:32:02,720 MUST LEAD THE RESPONSE WORKING 644 00:32:02,720 --> 00:32:04,240 CLOSELY WITH STATE AND MUNICIPAL 645 00:32:04,240 --> 00:32:05,160 HEALTH DEPARTMENTS. 646 00:32:05,160 --> 00:32:06,640 LEADERSHIP SHOULD BE THE 647 00:32:06,640 --> 00:32:10,720 LEADERSHIP OF DHHS, HOMELAND 648 00:32:10,720 --> 00:32:12,640 SECURITY, CDC, NIH, FDA AND 649 00:32:12,640 --> 00:32:16,240 OTHERS DIRECTLY CONNECTED TO THE 650 00:32:16,240 --> 00:32:16,920 WHITE HOUSE WITH EVERYBODY FOR 651 00:32:16,920 --> 00:32:22,440 THE SAME PAGE. 652 00:32:22,440 --> 00:32:24,560 AND FOR EMERGENCY PREPAREDNESS 653 00:32:24,560 --> 00:32:27,080 DISCIPLINES AND THE TEAM SHOULD 654 00:32:27,080 --> 00:32:29,680 BE SCIENCE AND EXPERTISE BASED 655 00:32:29,680 --> 00:32:30,200 INCLUDING EXPERTS IN 656 00:32:30,200 --> 00:32:30,920 COMMUNICATION FOR ONCE THEY HAVE 657 00:32:30,920 --> 00:32:32,800 A MESSAGE KNOW HOW TO 658 00:32:32,800 --> 00:32:35,520 COMMUNICATE TO THE PUBLIC AT 659 00:32:35,520 --> 00:32:38,560 LARGE AND SHOULD INCLUDE POLICY 660 00:32:38,560 --> 00:32:41,160 ADVISORS FROM BOTH SIDES AND 661 00:32:41,160 --> 00:32:42,360 WORK FROM THE START OF THE 662 00:32:42,360 --> 00:32:44,360 PANDEMIC TO GET EVERYBODY TO THE 663 00:32:44,360 --> 00:32:44,880 SAME PAGE. 664 00:32:44,880 --> 00:32:50,000 WE'RE ALL FACING THE SAME FOE. 665 00:32:50,000 --> 00:32:52,560 I THINK IT HAS TO BE CENTRALIZED 666 00:32:52,560 --> 00:32:54,240 OTHERWISE WE WOULD HAVE WHAT WE 667 00:32:54,240 --> 00:32:56,560 HAD IN THIS PANDEMIC WHICH IS 668 00:32:56,560 --> 00:32:58,320 REALLY A NUMBER DID, 50 OR 60 669 00:32:58,320 --> 00:32:59,720 APPROACH AT THE STATE LEVEL 670 00:32:59,720 --> 00:33:02,480 RANGING FROM THE RIDICULOUS TO 671 00:33:02,480 --> 00:33:03,160 THE SUBLIME. 672 00:33:03,160 --> 00:33:06,400 I THINK YOU HAVE TO INTERPRET 673 00:33:06,400 --> 00:33:09,360 NEW DATA WITH CAUTIOUS AS NEW 674 00:33:09,360 --> 00:33:11,440 DISEASES ARE RUNNING WITH 675 00:33:11,440 --> 00:33:13,120 SURPRISES AND ASYMPTOMATIC 676 00:33:13,120 --> 00:33:15,640 TRANSMISSION WAS A SURPRISE OF 677 00:33:15,640 --> 00:33:16,960 THE DISEASE. 678 00:33:16,960 --> 00:33:20,400 YOU HAVE TO REACH CONCLUSIONS 679 00:33:20,400 --> 00:33:25,360 DELIBERATELY AND NOT ALL 680 00:33:25,360 --> 00:33:27,400 PRONOUNCEMENTS WERE CORRECT. 681 00:33:27,400 --> 00:33:29,680 TRANSPARENCY IS CRUCIAL AND MUST 682 00:33:29,680 --> 00:33:32,200 BE COGNITIVE OF AND ADJUST TO 683 00:33:32,200 --> 00:33:33,080 CUSTOMER INPUT. 684 00:33:33,080 --> 00:33:36,200 WE HAVE LOTS OF CUSTOMERS. 685 00:33:36,200 --> 00:33:39,800 SUCH SITUATIONS REQUIRE 686 00:33:39,800 --> 00:33:41,600 DIRECTION BY STATE DEPARTMENT 687 00:33:41,600 --> 00:33:43,320 LEADERSHIP AT LEFT DAILY OR AT 688 00:33:43,320 --> 00:33:45,080 THE START OF THE PANDEMIC TWO OR 689 00:33:45,080 --> 00:33:46,680 THREE TIMES DAILY 690 00:33:46,680 --> 00:33:46,800 . 691 00:33:46,800 --> 00:33:47,680 IN ADDITION, FREQUENT 692 00:33:47,680 --> 00:33:48,360 COMMUNICATION WITH THE PUBLIC 693 00:33:48,360 --> 00:33:50,960 AND PRESS IS CRITICAL. 694 00:33:50,960 --> 00:33:51,600 CLEARLY DIFFERENTIATING BETWEEN 695 00:33:51,600 --> 00:33:54,200 WHAT WE KNOW AND WHAT WE THINK. 696 00:33:54,200 --> 00:33:57,200 I THINK ON SEVERAL OCCASIONS 697 00:33:57,200 --> 00:33:58,600 DURING THIS PANDEMIC OUR 698 00:33:58,600 --> 00:33:59,440 COMMUNICATIONS AROUND THE TWO 699 00:33:59,440 --> 00:34:01,360 DIFFERENT THINGS WHAT WE KNOW 700 00:34:01,360 --> 00:34:03,600 AND WHAT WE THINK WAS BLURRED. 701 00:34:03,600 --> 00:34:04,760 I THINK POPULATION-LEVEL 702 00:34:04,760 --> 00:34:06,200 GUIDANCE SHOULD BE ACCOMPANIED 703 00:34:06,200 --> 00:34:10,600 BY IDENTIFYING FACTORS THAT 704 00:34:10,600 --> 00:34:12,480 INFLUENCE INDIVIDUALS' RISKS SO 705 00:34:12,480 --> 00:34:14,000 INDIVIDUALS CAN CREATE THEIR OWN 706 00:34:14,000 --> 00:34:14,920 INDIVIDUALIZED RISK ASSESSMENT. 707 00:34:14,920 --> 00:34:18,040 FOR THIS PANDEMIC WE LEARNED 708 00:34:18,040 --> 00:34:20,600 QUICKLY THAT PEOPLE OLDER THAN 709 00:34:20,600 --> 00:34:23,960 65 AND PEOPLE WITH CHRONIC 710 00:34:23,960 --> 00:34:25,400 OBSTRUCTIVE LUNG DISEASE OR 711 00:34:25,400 --> 00:34:27,000 KIDNEY DISEASE WERE AT 712 00:34:27,000 --> 00:34:28,600 EXTRAORDINARY RISK FOR SERIOUS 713 00:34:28,600 --> 00:34:30,480 CONSEQUENCES OF THE DISEASE. 714 00:34:30,480 --> 00:34:31,560 GETTING THAT INFORMATION OUT AS 715 00:34:31,560 --> 00:34:35,720 QUICKLY AS POSSIBLE IS CRITICAL. 716 00:34:35,720 --> 00:34:36,600 PUBLIC COMMUNICATION SHOULD 717 00:34:36,600 --> 00:34:40,400 ALWAYS BE QUALIFIED. 718 00:34:40,400 --> 00:34:42,120 CANDIDLY ACKNOWLEDGING THE 719 00:34:42,120 --> 00:34:44,600 LIMITATIONS OF OUR CURRENT 720 00:34:44,600 --> 00:34:47,040 KNOWLEDGE AND MAINTAIN PUBLIC 721 00:34:47,040 --> 00:34:47,360 HUMILITY. 722 00:34:47,360 --> 00:34:51,000 IT'S EASY FOR THE AGENTS TO MAKE 723 00:34:51,000 --> 00:34:52,280 US ALL HUMBLE. 724 00:34:52,280 --> 00:34:52,840 IT'S EASY. 725 00:34:52,840 --> 00:34:59,200 WE HAVE TO MAINTAIN THAT 726 00:34:59,200 --> 00:35:00,560 HUMILITY AND WE SHOULD 727 00:35:00,560 --> 00:35:02,000 ACKNOWLEDGE WHEN WE MADE 728 00:35:02,000 --> 00:35:03,680 MISSTEPS OR ERRORS IN JUDGMENT 729 00:35:03,680 --> 00:35:04,480 EMPHASIZING THE NEW KNOWLEDGE 730 00:35:04,480 --> 00:35:06,840 THAT RESULTED IN THIS SET OF 731 00:35:06,840 --> 00:35:11,280 RECOMMENDATIONS OR NEWER 732 00:35:11,280 --> 00:35:11,640 RECOMMENDATIONS. 733 00:35:11,640 --> 00:35:13,960 I CAN'T EMPHASIZE THIS ENOUGH, 734 00:35:13,960 --> 00:35:14,960 EFFECTIVE PUBLIC HEALTH SYSTEMS 735 00:35:14,960 --> 00:35:16,000 ARE CRITICAL. 736 00:35:16,000 --> 00:35:22,040 DECADES OF NEGLECT HAVE LEFT OUR 737 00:35:22,040 --> 00:35:22,640 PUBLIC HEALTH SYSTEMS LIGHT 738 00:35:22,640 --> 00:35:25,840 YEARS BEHIND WHERE THEY NEED TO 739 00:35:25,840 --> 00:35:27,240 BE. 740 00:35:27,240 --> 00:35:29,000 EXISTING PUBLIC HEALTH SYSTEMS 741 00:35:29,000 --> 00:35:31,000 ARE UNDER STAFFED, UNDER 742 00:35:31,000 --> 00:35:35,920 RESOURCED AND UNDER INCENTIVIZED 743 00:35:35,920 --> 00:35:38,800 AND THE UNITED STATES NEEDS A 744 00:35:38,800 --> 00:35:40,040 CONSISTENT, SUSTAINABLE 745 00:35:40,040 --> 00:35:42,440 LONG-TERM COMMITMENT TO PUBLIC 746 00:35:42,440 --> 00:35:42,840 HEALTH. 747 00:35:42,840 --> 00:35:45,360 THE CURRENT STRATEGY OF DUMPING 748 00:35:45,360 --> 00:35:48,600 MONEY IN FOR A CRISIS AND 749 00:35:48,600 --> 00:35:53,040 WITHDRAWING IMMEDIATELY WHEN THE 750 00:35:53,040 --> 00:35:54,280 CRISIS 751 00:35:54,280 --> 00:35:57,960 CRISIS EASES IS NOT SUSTAINABLE. 752 00:35:57,960 --> 00:36:00,600 COUNTRY NEEDS AN ADDITIONAL 753 00:36:00,600 --> 00:36:01,960 80,000 PUBLIC HEALTH 754 00:36:01,960 --> 00:36:02,280 PROFESSIONALS. 755 00:36:02,280 --> 00:36:03,560 ALMOST HALF OF ALL EMPLOYEES 756 00:36:03,560 --> 00:36:06,840 WORKING AT STATE AND LOCAL 757 00:36:06,840 --> 00:36:07,960 PUBLIC HEALTH AGENCIES LEFT 758 00:36:07,960 --> 00:36:08,600 THEIR JOBS BETWEEN 2017 AND 759 00:36:08,600 --> 00:36:12,840 2021. 760 00:36:12,840 --> 00:36:15,680 A 2021 SURVEY OF STATE AND LOCAL 761 00:36:15,680 --> 00:36:18,480 GOVERNMENTAL HEALTH WORKERS 762 00:36:18,480 --> 00:36:20,200 FOUND 27% INTENDED TO LEAVE 763 00:36:20,200 --> 00:36:22,200 THEIR POSITIONS WITHIN A YEAR 764 00:36:22,200 --> 00:36:24,480 AND NEARLY 40% OF THOSE SAID 765 00:36:24,480 --> 00:36:25,120 THEY'RE DECISION TO LEAVE WAS 766 00:36:25,120 --> 00:36:30,680 INFLUENCED BY THE PANDEMIC. 767 00:36:30,680 --> 00:36:34,240 ACCORDING TO THE OUTGOING CDC 768 00:36:34,240 --> 00:36:36,480 DIRECTOR AT THE PANDEMIC START 769 00:36:36,480 --> 00:36:40,000 THERE WERE 187 HEALTH CARES 770 00:36:40,000 --> 00:36:41,000 REPORTING ELECTRONICALLY TO THE 771 00:36:41,000 --> 00:36:41,600 CDC. 772 00:36:41,600 --> 00:36:43,880 THAT NUMBER NOW EXCEEDS 25,000. 773 00:36:43,880 --> 00:36:46,960 A HUGE INCREASE THAT STILL 774 00:36:46,960 --> 00:36:49,120 INCLUDES ONLY 25% OF U.S. HEALTH 775 00:36:49,120 --> 00:36:49,880 CARE FACILITIES. 776 00:36:49,880 --> 00:36:51,480 SIMILARLY, AT THE START OF THE 777 00:36:51,480 --> 00:36:54,080 PANDEMIC, ONLY A HANDFUL OF 778 00:36:54,080 --> 00:36:55,960 U.S. EMERGENCY ROOM DEPARTMENTS 779 00:36:55,960 --> 00:37:03,360 WERE SUBMITTING REPORTS OF 780 00:37:03,360 --> 00:37:03,960 SYNDRO 781 00:37:03,960 --> 00:37:08,960 SYNDROMIC SURVEILLANCE AND 782 00:37:08,960 --> 00:37:11,560 NEITHER IS ENOUGH TO ADDRESS A 783 00:37:11,560 --> 00:37:12,680 RAPIDLY SPREADING PANDEMIC. 784 00:37:12,680 --> 00:37:13,640 THE INFRASTRUCTURE FOR UNITED 785 00:37:13,640 --> 00:37:15,800 STATES IN THE UNITED STATES IS 786 00:37:15,800 --> 00:37:18,000 WOEFULLY INADEQUATE AND NEEDS 787 00:37:18,000 --> 00:37:20,560 INFUSION OF HUMAN CAPITAL AND 788 00:37:20,560 --> 00:37:21,040 RESOURCE FUNDING. 789 00:37:21,040 --> 00:37:24,600 THE COUNTRY NEEDS A NATIONAL 790 00:37:24,600 --> 00:37:28,680 BROADBAND REAL TIME ELECTRONIC 791 00:37:28,680 --> 00:37:32,240 SYSTEM SYNDROMIC SYSTEM 792 00:37:32,240 --> 00:37:33,400 EVALUATED DAILY BY QUALIFIED 793 00:37:33,400 --> 00:37:35,800 SCIENTISTS AND NEW STRATEGIES 794 00:37:35,800 --> 00:37:37,720 SUCH AS WASTE WATER SHOULD BE 795 00:37:37,720 --> 00:37:38,960 EXPANDED TO INCLUDE THE WHOLE 796 00:37:38,960 --> 00:37:41,000 COUNTRY NOT JUST A FEW PLACES. 797 00:37:41,000 --> 00:37:42,960 THE AMERICAN COLLEGE OF 798 00:37:42,960 --> 00:37:44,040 PHYSICIANS CALLED FOR A NATIONAL 799 00:37:44,040 --> 00:37:46,480 DATA HEALTH INFRASTRUCTURE THAT 800 00:37:46,480 --> 00:37:49,000 PERMITS REAL-TIME BI-DIRECTIONAL 801 00:37:49,000 --> 00:37:50,360 DATA SHARING AMONG HEALTH 802 00:37:50,360 --> 00:37:52,440 DEPARTMENTS, PHYSICIANS AND 803 00:37:52,440 --> 00:37:52,800 LABORATORIES. 804 00:37:52,800 --> 00:37:53,840 IT WILL BE TRICKY BECAUSE PEOPLE 805 00:37:53,840 --> 00:37:55,440 WILL WORRY ABOUT THE SECURITY OF 806 00:37:55,440 --> 00:37:57,360 THEIR DATA BUT WE HAVE TO MEET 807 00:37:57,360 --> 00:38:01,360 THAT PROBLEM AND SOLVE IT. 808 00:38:01,360 --> 00:38:04,600 CDC'S LABORATORY RESPONSE 809 00:38:04,600 --> 00:38:07,280 NETWORK COMPRISED OF NATIONAL 810 00:38:07,280 --> 00:38:09,200 REFERENCE AND SENTINEL 811 00:38:09,200 --> 00:38:11,440 LABORATORY OFFERS A REASONABLE 812 00:38:11,440 --> 00:38:12,680 TESTING INFRASTRUCTURE TO 813 00:38:12,680 --> 00:38:16,240 ADDRESS PANDEMIC THREATS. 814 00:38:16,240 --> 00:38:19,680 THERE'S ACCESS TO TESTS WITH A 815 00:38:19,680 --> 00:38:22,760 STOCKPILE OF SUPPLIES AND 816 00:38:22,760 --> 00:38:24,560 REAGENTS TO IDENTIFY THREATS. 817 00:38:24,560 --> 00:38:26,240 THE NATIONAL LAB WAS RESPONSIBLE 818 00:38:26,240 --> 00:38:27,240 FOR A MAJOR MISSTEP. 819 00:38:27,240 --> 00:38:29,440 WE NEED TO KEEP THAT IN 820 00:38:29,440 --> 00:38:29,760 CONSIDERATION. 821 00:38:29,760 --> 00:38:32,080 THEY ADVOCATED FOR A TEST THEY 822 00:38:32,080 --> 00:38:33,360 DEVELOPED THAT WAS FLAWED 823 00:38:33,360 --> 00:38:36,600 DESPITE THE AVAILABILITY OF AN 824 00:38:36,600 --> 00:38:38,600 EFFECTIVE W.H.O. DEVELOPED TEST. 825 00:38:38,600 --> 00:38:40,440 THE NATIONAL LABORATORY AND 826 00:38:40,440 --> 00:38:43,120 LABORATORY RESPONSE NETWORK HAD 827 00:38:43,120 --> 00:38:45,240 AN URGENT MANDATE CREATE A TEST 828 00:38:45,240 --> 00:38:46,840 AND REDISTRIBUTE TO ALL AGENTS 829 00:38:46,840 --> 00:38:52,600 AND LABORATORIES IN THE COUNTRY. 830 00:38:52,600 --> 00:38:54,400 RAPIDLY AVAILABLE ACCURATE TEST 831 00:38:54,400 --> 00:38:55,960 CRUCIAL TO A RESPONSE. 832 00:38:55,960 --> 00:38:58,720 IF THIS IS IMPRACTICAL FOR THE 833 00:38:58,720 --> 00:39:01,360 LABORATORIES WE HAVE I WOULD 834 00:39:01,360 --> 00:39:02,640 ADVOCATE FOR BUILDING A WARP 835 00:39:02,640 --> 00:39:06,400 SPEED LIKE PARTNERSHIP WITH THE 836 00:39:06,400 --> 00:39:07,160 LARGE LABORATORY CONCERNS IN THE 837 00:39:07,160 --> 00:39:10,640 COUNTRY TO USE THEIR RESOURCES 838 00:39:10,640 --> 00:39:13,480 AND THEIR EQUIPMENT AND REAGENTS 839 00:39:13,480 --> 00:39:16,120 AS A PARTNERSHIP VERY MUCH LIKE 840 00:39:16,120 --> 00:39:17,720 WARP SPEED AND IF THAT'S 841 00:39:17,720 --> 00:39:20,200 POSSIBLE I THINK WE SHOULD 842 00:39:20,200 --> 00:39:21,520 ESTABLISH THOSE RELATIONSHIPS 843 00:39:21,520 --> 00:39:23,600 NOW AND GET THEM ON THE BOOK TO 844 00:39:23,600 --> 00:39:26,480 GET READY FOR THE NEXT PANDEMIC 845 00:39:26,480 --> 00:39:32,360 AGAIN ACCORDING TO DR. WAL EN 846 00:39:32,360 --> 00:39:33,400 SKI LABORATORIES LACKED 847 00:39:33,400 --> 00:39:35,040 EQUIPMENT AND SKILLED PERSONNEL 848 00:39:35,040 --> 00:39:38,320 AND STRATEGIES MUST FLOW FROM 849 00:39:38,320 --> 00:39:40,280 SCIENTIFIC UNDERSTANDING. 850 00:39:40,280 --> 00:39:43,400 YOU PROTECT THE HEALTH OF ALL 851 00:39:43,400 --> 00:39:44,520 LIVING IN THE UNITED STATES 852 00:39:44,520 --> 00:39:45,880 WHILE MINIMIZING DISRUPTION TO 853 00:39:45,880 --> 00:39:46,600 NORMAL SOCIETY FUNCTIONING. 854 00:39:46,600 --> 00:39:57,040 THERE HAS TO BE A BALANCE. 855 00:39:58,040 --> 00:40:08,520 I ALWAYS ADVOCATE WE BEGINNING 856 00:40:09,440 --> 00:40:13,120 -- BEGIN WITH CONSERVATIVE 857 00:40:13,120 --> 00:40:14,800 ADVICE AND THEN IT'S NECESSARY 858 00:40:14,800 --> 00:40:18,680 YOU'RE IN A BETTER PLACE. 859 00:40:18,680 --> 00:40:19,880 DISCOURSE MUST BE BIDIRECTIONAL 860 00:40:19,880 --> 00:40:26,600 AND FILLED WITH PATIENTS AND MUE 861 00:40:26,600 --> 00:40:35,440 -- HUMILITY AND SHOULD 862 00:40:35,440 --> 00:40:36,880 FORTUNATE WE SHOULD PROVIDE DATA 863 00:40:36,880 --> 00:40:38,840 FOR COVID AND WE HAD AGGRESSIVE 864 00:40:38,840 --> 00:40:40,600 TESTING WE WERE LIKELY TO LEARN 865 00:40:40,600 --> 00:40:43,600 QUICKLY THE VIRUS COULD BE 866 00:40:43,600 --> 00:40:49,560 SPREAD PRE OR ASYMPTOMATICALLY 867 00:40:49,560 --> 00:40:51,400 AND COULD HAVE PROVIDED ROUTES 868 00:40:51,400 --> 00:40:53,520 OF TRANS MISSION. 869 00:40:53,520 --> 00:40:56,200 DETAILS OF THE HOST PATHOGEN 870 00:40:56,200 --> 00:40:57,320 INTERACTION AND RELATIONSHIPS 871 00:40:57,320 --> 00:40:58,560 SHOULD PROVIDE AVENUES FOR 872 00:40:58,560 --> 00:41:00,600 THERAPEUTIC AND PREVENTIVE 873 00:41:00,600 --> 00:41:02,320 INTERVENTIONS. 874 00:41:02,320 --> 00:41:07,760 WHAT HAVE WE LEARNED? 875 00:41:07,760 --> 00:41:11,560 AGAIN, THE GOSPEL ACCORDING TO 876 00:41:11,560 --> 00:41:11,840 HENDERSON. 877 00:41:11,840 --> 00:41:15,120 BEWARE OF PRESYMPTOMATIC SPREAD. 878 00:41:15,120 --> 00:41:17,640 ALWAYS BE AWARE IT COULD BE OUT 879 00:41:17,640 --> 00:41:18,040 THERE. 880 00:41:18,040 --> 00:41:19,480 IN THIS PANDEMIC WE GOT BEHIND 881 00:41:19,480 --> 00:41:20,600 THE CURVE IN PART BECAUSE OF 882 00:41:20,600 --> 00:41:22,080 THAT. 883 00:41:22,080 --> 00:41:25,320 SECONDLY, GENOMIC SACRIFICE IS 884 00:41:25,320 --> 00:41:27,400 IMPERATIVE TO TRACK RNA VIRUSES 885 00:41:27,400 --> 00:41:28,480 THAT MUTATE OFTEN. 886 00:41:28,480 --> 00:41:30,080 WE HAVE TO KNOW WHAT'S 887 00:41:30,080 --> 00:41:31,640 CIRCULATING IN THE COUNTRY AND 888 00:41:31,640 --> 00:41:35,560 THEN WE NEED TO WORK WITH BIG 889 00:41:35,560 --> 00:41:37,080 PHARMA TO DEVELOP MONOCLONAL 890 00:41:37,080 --> 00:41:38,800 ANTIBODIES THAT ADDRESS NOT JUST 891 00:41:38,800 --> 00:41:40,200 THE ORIGINAL STRAIN BUT NEW 892 00:41:40,200 --> 00:41:46,240 STRAINS AS THEY'RE SPUN OFF. 893 00:41:46,240 --> 00:41:48,640 THE SPIKE PROTEINS WERE 894 00:41:48,640 --> 00:41:50,640 ASTOUNDING AND EXHIBITED 895 00:41:50,640 --> 00:41:51,680 REMARKABLE OVER ALL EFFICACY 896 00:41:51,680 --> 00:41:54,480 WITH SOME ASPECTS AS I MENTIONED 897 00:41:54,480 --> 00:41:57,440 EARLIER WANING AS IMMUNOEVASIVE 898 00:41:57,440 --> 00:41:59,520 VARIANTS SPUN OFF. 899 00:41:59,520 --> 00:42:01,640 AND FINALLY A HUMAN CHALLENGE 900 00:42:01,640 --> 00:42:03,240 STUDY I THINK I PROBABLY WOULD 901 00:42:03,240 --> 00:42:07,000 NOT HAVE VOLUNTEERED FOR 902 00:42:07,000 --> 00:42:10,040 DEMONSTRATING ONLY A MINORITY OF 903 00:42:10,040 --> 00:42:20,360 PEOPLE RECEIVING A STANDARD 904 00:42:20,360 --> 00:42:24,200 INNOCULUM SPREADING THE SUPER 905 00:42:24,200 --> 00:42:27,400 SPREADER THIGH BOTH SIS AFTER 906 00:42:27,400 --> 00:42:32,560 THE -- HYPOTHESIS AND THOSE WHO 907 00:42:32,560 --> 00:42:34,440 NEVER SAW COVID HAD HAD NEVER 908 00:42:34,440 --> 00:42:37,120 BEEN INFECTED, THE TIMING EXTENT 909 00:42:37,120 --> 00:42:40,640 AND ROUTES OF VIRAL EMISSIONS 910 00:42:40,640 --> 00:42:46,120 WERE ENTIRELY HETEROGENOUS. 911 00:42:46,120 --> 00:42:50,320 DESPITE ALL RECEIVING IDENTICAL 912 00:42:50,320 --> 00:42:52,360 INNOCULA THEY PROVIDED SUPPORT 913 00:42:52,360 --> 00:42:54,960 FOR SUPER SPREADING. 914 00:42:54,960 --> 00:42:56,760 INTERESTINGLY, TWO INDIVIDUALS 915 00:42:56,760 --> 00:43:01,040 OF THE 36 INFECTED EMITTED 86 OF 916 00:43:01,040 --> 00:43:03,400 THE AIRBORNE VIRUS THE 917 00:43:03,400 --> 00:43:04,640 INVESTIGATORS DETECTED AND 918 00:43:04,640 --> 00:43:07,480 CURIOUSLY THOSE WHO REPORTED THE 919 00:43:07,480 --> 00:43:08,640 HIGHEST TOTAL SYMPTOM SCORES 920 00:43:08,640 --> 00:43:11,440 WERE NOT WHO EMIT THE MOST 921 00:43:11,440 --> 00:43:12,520 VIRUS. 922 00:43:12,520 --> 00:43:14,320 INVESTIGATORS FOUND FEW VIRAL 923 00:43:14,320 --> 00:43:15,360 REMISSIONS OCCURRED BEFORE THE 924 00:43:15,360 --> 00:43:16,160 FIRST REPORTED SYMPTOMS THOUGH 925 00:43:16,160 --> 00:43:17,760 THEY WERE CHECKING FOR SYMPTOMS 926 00:43:17,760 --> 00:43:20,200 DAILY AND THAT MAY NOT BE 927 00:43:20,200 --> 00:43:21,400 ENTIRELY RELIABLE BECAUSE WE 928 00:43:21,400 --> 00:43:24,120 DON'T DO THAT AT HOME. 929 00:43:24,120 --> 00:43:26,400 IF YOU WAKE UP WITH A SLIGHTLY 930 00:43:26,400 --> 00:43:28,160 RUNNY NOSE YOU MAY NOT 931 00:43:28,160 --> 00:43:30,320 ACKNOWLEDGE THAT BUT THEY WERE 932 00:43:30,320 --> 00:43:32,000 ASKING ABOUT THAT IT. 933 00:43:32,000 --> 00:43:38,160 70% HAD VIRAL EMISSIONS BEFORE 934 00:43:38,160 --> 00:43:39,400 SYMPTOMS AND THERE WERE HOME 935 00:43:39,400 --> 00:43:42,520 TESTS IN THE STUDY ONLY 2% 936 00:43:42,520 --> 00:43:44,600 PROVIDED A MAJOR ARGUMENT FOR 937 00:43:44,600 --> 00:43:50,520 HOME TESTING. 938 00:43:50,520 --> 00:43:54,800 A BIT ABOUT PREPAREDNESS. 939 00:43:54,800 --> 00:44:00,640 MOST ANTICIPATED NOVEL H1N1 AND 940 00:44:00,640 --> 00:44:01,760 RESURRECTED IT FOR SARS, IF YOU 941 00:44:01,760 --> 00:44:03,800 HAVEN'T DUSTED IT OFF NOW, DUST 942 00:44:03,800 --> 00:44:05,880 IT OFF NOW AND IMPROVE THEM 943 00:44:05,880 --> 00:44:06,880 BASED ON COVID. 944 00:44:06,880 --> 00:44:08,880 ONCE HAVE YOU A PLAN, TEST IT. 945 00:44:08,880 --> 00:44:12,680 AND DON'T JUST TALK ABOUT IT. 946 00:44:12,680 --> 00:44:20,680 YOU HAVE TO PRACTICE AND DRILL. 947 00:44:20,680 --> 00:44:23,040 AND WHEN WE WERE GOING TO 948 00:44:23,040 --> 00:44:25,440 PROVIDE CARE FOR ONLY PATIENTS 949 00:44:25,440 --> 00:44:26,680 FOR WEST AFRICA. 950 00:44:26,680 --> 00:44:30,680 WE HAD FOR A LONG TIME 951 00:44:30,680 --> 00:44:32,480 INTERACTING WITH SCIENTIST AS 952 00:44:32,480 --> 00:44:33,760 THE FORT DETRICK AND THE PLAN 953 00:44:33,760 --> 00:44:36,040 WAS IF ONE OF THEIR EMPLOYEES 954 00:44:36,040 --> 00:44:40,080 HAD AN OCCUPATIONAL EXPOSURE 955 00:44:40,080 --> 00:44:42,840 THEY WOULD BE BROUGHT TO THE 956 00:44:42,840 --> 00:44:43,760 CLINICAL CENTER AND WE'D PROVIDE 957 00:44:43,760 --> 00:44:46,520 CARE AND WE USED TO DO THAT 958 00:44:46,520 --> 00:44:47,040 REGULARLY. 959 00:44:47,040 --> 00:44:48,400 THE DRILLS WENT SOMETHING LIKE 960 00:44:48,400 --> 00:44:49,360 THIS MOST OFTEN. 961 00:44:49,360 --> 00:44:52,600 THEY'LL CALL AND SAY WE HAVE A 962 00:44:52,600 --> 00:44:56,000 PATIENT WITH PLAGUE OR ANTHRAX 963 00:44:56,000 --> 00:44:57,360 EXPOSURE AND WE'D MEET THEM AT 964 00:44:57,360 --> 00:45:02,040 THE DOOR AND GET THEM TO SDSU 965 00:45:02,040 --> 00:45:04,280 AND SAY IF A PERSON HAD AN 966 00:45:04,280 --> 00:45:06,840 EXPOSURE I'D DO THIS OR IF THEY 967 00:45:06,840 --> 00:45:08,360 HAD THE PLAGUE WE'D DO THIS. 968 00:45:08,360 --> 00:45:11,240 WHAT WE DISCOVERED WITH PATIENTS 969 00:45:11,240 --> 00:45:12,360 WITH EBOLA THAT STRATEGY MIGHT 970 00:45:12,360 --> 00:45:13,880 NOT WORK. 971 00:45:13,880 --> 00:45:18,480 WE WERE FORTUNATE WHEN OUR FIRST 972 00:45:18,480 --> 00:45:20,520 EBOLA PATIENT HAD AN 973 00:45:20,520 --> 00:45:22,600 OCCUPATIONAL EXPOSURE BUT NEVER 974 00:45:22,600 --> 00:45:23,160 BECAME INFECTED. 975 00:45:23,160 --> 00:45:24,520 DURING THE COURSE OF PROVIDING 976 00:45:24,520 --> 00:45:27,120 CARE WE FOUND THINGS WE THOUGHT 977 00:45:27,120 --> 00:45:28,240 WOULD WORK AND KEEP PEOPLE SAFE 978 00:45:28,240 --> 00:45:28,760 DIDN'T WORK. 979 00:45:28,760 --> 00:45:32,840 SO WE HAD TO CHANGE THAT ON THE 980 00:45:32,840 --> 00:45:33,000 FLY. 981 00:45:33,000 --> 00:45:36,280 YOU HAVE TO DRILL IN PERSON 982 00:45:36,280 --> 00:45:39,040 HANDS ON TO LEARN WHETHER THE 983 00:45:39,040 --> 00:45:40,200 THINGS YOU'RE ARGUING FOR AREN'T 984 00:45:40,200 --> 00:45:41,080 GOING TO BE EFFECTIVE. 985 00:45:41,080 --> 00:45:43,520 BY THE TIME WE GOT AN EBOLA 986 00:45:43,520 --> 00:45:45,080 PATIENT BECAUSE WE MET EVERY 987 00:45:45,080 --> 00:45:48,400 AFTERNOON AT 3:00 FOR A MONTH OR 988 00:45:48,400 --> 00:45:52,040 TWO DESCRIBING WHAT WENT RIGHT 989 00:45:52,040 --> 00:45:56,200 AND WRONG BY THE TIME WE GOT A 990 00:45:56,200 --> 00:45:58,520 SICK PATIENT THE STAFF WITH YOU 991 00:45:58,520 --> 00:46:00,600 UNBELIEVABLE IN PROVIDING 992 00:46:00,600 --> 00:46:01,720 SPECTACULAR AND SAFE CARE. 993 00:46:01,720 --> 00:46:04,560 WHEN YOU THINK SOMETHING IS 994 00:46:04,560 --> 00:46:06,080 BREWING LOCALLY, CALL YOUR 995 00:46:06,080 --> 00:46:07,200 COLLEAGUES, FIND OUT WHAT 996 00:46:07,200 --> 00:46:08,120 THEY'RE SEEING. 997 00:46:08,120 --> 00:46:10,200 ALSO FOLLOW THE CDC WEBSITE 998 00:46:10,200 --> 00:46:12,920 CLOSELY AND FOCUS ON THE 999 00:46:12,920 --> 00:46:14,640 EMERGING EPIDEMIOLOGY OF ANY NEW 1000 00:46:14,640 --> 00:46:15,920 PATHOGEN IDENTIFIED. 1001 00:46:15,920 --> 00:46:19,120 ONCE YOU HAVE SUCH A PATHOGEN, 1002 00:46:19,120 --> 00:46:20,080 WORK WITH YOUR HOSPITAL 1003 00:46:20,080 --> 00:46:23,320 EPIDEMIOLOGY AND CLINICAL CARE 1004 00:46:23,320 --> 00:46:24,400 PROVIDERS TO DEVELOP PREVENTION 1005 00:46:24,400 --> 00:46:24,680 STRATEGY. 1006 00:46:24,680 --> 00:46:34,480 THE GOSPEL ACCORDING TO HER -- 1007 00:46:34,480 --> 00:46:35,560 HENDERSON CONSERVATIVE 1008 00:46:35,560 --> 00:46:37,880 STRATEGIES BEFORE PROCEEDING AND 1009 00:46:37,880 --> 00:46:39,200 INSTITUTIONAL LEADERSHIP DAILY 1010 00:46:39,200 --> 00:46:41,560 AND TAKE STOCK OF THE 1011 00:46:41,560 --> 00:46:42,120 INSTITUTION'S STATUS. 1012 00:46:42,120 --> 00:46:47,320 DR. GILLMAN AND HIS TEAM DID A 1013 00:46:47,320 --> 00:46:50,440 FANTASTIC JOB DURING THE COVID 1014 00:46:50,440 --> 00:46:50,680 PANDEMIC. 1015 00:46:50,680 --> 00:46:54,280 WE MET FREQUENTLY AT THE START 1016 00:46:54,280 --> 00:46:56,360 AND BY THE END OF THE MEETINGS 1017 00:46:56,360 --> 00:46:58,120 YOU KNEW WHAT WAS GOING ON IN 1018 00:46:58,120 --> 00:47:01,600 THE BUILD. 1019 00:47:01,600 --> 00:47:04,600 YOU HAVE TO COMMUNICATE WITH THE 1020 00:47:04,600 --> 00:47:05,880 STAFF THEY'RE THE CORE OF ANY 1021 00:47:05,880 --> 00:47:07,360 SUCCESS YOU'LL HAVE AND I 1022 00:47:07,360 --> 00:47:08,600 LEARNED THIS FROM MY EXPERIENCE 1023 00:47:08,600 --> 00:47:09,600 YOU MAY HAVE HEARD ME SAY 1024 00:47:09,600 --> 00:47:11,680 EARLIER DURING THE EARLY DAYS OF 1025 00:47:11,680 --> 00:47:12,880 THE AIDS PANDEMIC THERE WAS 1026 00:47:12,880 --> 00:47:14,000 MISINFORMATION ALL OVER THE 1027 00:47:14,000 --> 00:47:16,000 PAPER ABOUT WHAT THE RISKS WERE 1028 00:47:16,000 --> 00:47:19,360 AND HOW MUCH RISK THERE WAS AND 1029 00:47:19,360 --> 00:47:21,400 SO TO DEAL WITH IT I USED IT 1030 00:47:21,400 --> 00:47:24,120 START EVERY DAY ON 13 WEST IN 1031 00:47:24,120 --> 00:47:25,920 THE CANCER UNIT GO THROUGH THE 1032 00:47:25,920 --> 00:47:27,480 NURSING STATION, TALK TO PEOPLE 1033 00:47:27,480 --> 00:47:29,560 AND ANSWER THEIR QUESTIONS AND 1034 00:47:29,560 --> 00:47:30,880 TELL THEM WHAT WAS ON THE FRONT 1035 00:47:30,880 --> 00:47:32,840 OF PAGE OF THE WASHINGTON POST 1036 00:47:32,840 --> 00:47:34,920 WASN'T CORRECT OR WHAT IT REALLY 1037 00:47:34,920 --> 00:47:38,000 MEANT AND THEN GO ON DOWN TO 13 1038 00:47:38,000 --> 00:47:39,520 EAST AND DOWN THROUGHOUT THE 1039 00:47:39,520 --> 00:47:40,560 WHOLE HOSPITAL ANSWERING 1040 00:47:40,560 --> 00:47:41,760 PEOPLE'S QUESTIONS AND TRYING TO 1041 00:47:41,760 --> 00:47:43,920 KEEP US ALL ON THE SAME PAGE. 1042 00:47:43,920 --> 00:47:46,000 IT WAS A TRYING TIME BECAUSE FOR 1043 00:47:46,000 --> 00:47:51,760 THAT PATHOGEN WE DIDN'T KNOW THE 1044 00:47:51,760 --> 00:47:56,680 VIRUS OR ITS SEQUENCE AND WE 1045 00:47:56,680 --> 00:47:58,760 WENT TWO OR THREE YEARS BEFORE 1046 00:47:58,760 --> 00:48:01,680 WE KNEW THE DISEASE AND THERE 1047 00:48:01,680 --> 00:48:02,440 WAS ANGST IN THE STAFF ABOUT 1048 00:48:02,440 --> 00:48:03,400 HAVING PATIENTS IN THE 1049 00:48:03,400 --> 00:48:10,560 HOSPITALS. 1050 00:48:10,560 --> 00:48:13,520 YOU NEED CONTINGENCY PLANS IF A 1051 00:48:13,520 --> 00:48:15,400 PANDEMIC IS DECLARED AND IT WILL 1052 00:48:15,400 --> 00:48:17,320 BE A CRITICAL SUCCESS FACTOR AS 1053 00:48:17,320 --> 00:48:18,440 IT WAS DURING THE PANDEMIC. 1054 00:48:18,440 --> 00:48:20,080 NOT ONLY DO YOU HAVE TO FIGURE 1055 00:48:20,080 --> 00:48:21,400 OUT HOW TO BEST TAKE CARE OF 1056 00:48:21,400 --> 00:48:22,800 YOUR STAFF BUT HOW TO BEST 1057 00:48:22,800 --> 00:48:24,080 SUPPORT THE STAFF. 1058 00:48:24,080 --> 00:48:29,840 AND I THINK A GREAT EXAMPLE OF 1059 00:48:29,840 --> 00:48:30,480 SUPPORTING THE STAFF WAS 1060 00:48:30,480 --> 00:48:33,400 DR. GILLMAN'S DEVELOPMENT OF 1061 00:48:33,400 --> 00:48:35,640 ASYMPTOMATIC TESTING AS AN 1062 00:48:35,640 --> 00:48:35,880 EXAMPLE. 1063 00:48:35,880 --> 00:48:38,800 WE HAD TWO TESTING. 1064 00:48:38,800 --> 00:48:40,600 THE CORE LINE FOR PEOPLE WITH 1065 00:48:40,600 --> 00:48:42,520 SYMPTOMS AND ASYMPTOMATIC 1066 00:48:42,520 --> 00:48:47,920 TESTING FOR STAFF AND MOSTLY FOR 1067 00:48:47,920 --> 00:48:49,480 REASSURANCE AND IT WORKED 1068 00:48:49,480 --> 00:48:49,760 REMARKABLY. 1069 00:48:49,760 --> 00:48:51,720 WE HAD AN UNBELIEVABLE NUMBER OF 1070 00:48:51,720 --> 00:48:54,320 PEOPLE ROTATE AND THE PROGRAM 1071 00:48:54,320 --> 00:48:56,200 WENT ASTOUNDINGLY WELL. 1072 00:48:56,200 --> 00:48:57,840 AT THE START YOU COULD WALK IN. 1073 00:48:57,840 --> 00:48:59,520 BY THE END YOU NEEDED 1074 00:48:59,520 --> 00:49:00,640 APPOINTMENTS TO GET THE TESTS 1075 00:49:00,640 --> 00:49:01,520 DONE BUT TOLD THE STAFF WE WERE 1076 00:49:01,520 --> 00:49:05,520 SUPPORTING THEM. 1077 00:49:05,520 --> 00:49:07,160 IF VACCINES ARE DEVELOPED FOR 1078 00:49:07,160 --> 00:49:08,600 THE NEW DISEASE, IF YOU CAN 1079 00:49:08,600 --> 00:49:10,880 PROVIDE IT, PROVIDE IT IF YOU 1080 00:49:10,880 --> 00:49:14,520 CAN'T FIND A WAY TO FACILITATE 1081 00:49:14,520 --> 00:49:19,080 ACCESS FOR STAFF AND PROVIDE 1082 00:49:19,080 --> 00:49:21,360 ACCURATE INFORMATION AND 1083 00:49:21,360 --> 00:49:23,760 PERSISTENT LEADERSHIP PRESENCE 1084 00:49:23,760 --> 00:49:24,800 ANSWERING QUESTIONS AND 1085 00:49:24,800 --> 00:49:27,400 DISPELLING RUMORS AND CORRECTING 1086 00:49:27,400 --> 00:49:29,000 DISINFORMATION WILL BE KEY. 1087 00:49:29,000 --> 00:49:30,640 ON THE OTHER HAND AT THE 1088 00:49:30,640 --> 00:49:32,240 CLINICAL CENTER TO THE EXTENT 1089 00:49:32,240 --> 00:49:33,760 POSSIBLE DON'T LOSE TRACK OF THE 1090 00:49:33,760 --> 00:49:34,000 MISSION. 1091 00:49:34,000 --> 00:49:36,360 THERE WILL BE SCIENTISTS IN ANY 1092 00:49:36,360 --> 00:49:38,720 PANDEMIC THAT'S GOING TO WANT TO 1093 00:49:38,720 --> 00:49:39,560 STUDY THE PATIENTS. 1094 00:49:39,560 --> 00:49:41,880 THEY'LL WANT TO LEARN MORE ABOUT 1095 00:49:41,880 --> 00:49:44,040 THE DISEASE AND DETECT IT OR 1096 00:49:44,040 --> 00:49:46,000 TREAT IT AND AN EQUAL NUMBER OF 1097 00:49:46,000 --> 00:49:48,160 SCIENTISTS WHO WILL NOT LET THE 1098 00:49:48,160 --> 00:49:50,840 PATIENTS NEAR THE BUILDING. 1099 00:49:50,840 --> 00:49:55,560 I GOT READY TO GET SARS PATIENTS 1100 00:49:55,560 --> 00:49:57,920 IN 2000. 1101 00:49:57,920 --> 00:49:59,280 THE SARS AND MADE IT AS FAR AS 1102 00:49:59,280 --> 00:50:00,560 TORONTO. 1103 00:50:00,560 --> 00:50:04,920 WE HAD INVESTIGATORS IN HEART, 1104 00:50:04,920 --> 00:50:06,840 LUNG AND BLOOD INSTITUTE WRITE 1105 00:50:06,840 --> 00:50:08,360 PROTOCOLS TO BRING PATIENT TO 1106 00:50:08,360 --> 00:50:09,280 STUDY THEM. 1107 00:50:09,280 --> 00:50:10,640 WE HAD INVESTIGATORS AT THE SAME 1108 00:50:10,640 --> 00:50:15,400 TIME IN INSTITUTES THAT SERVE 1109 00:50:15,400 --> 00:50:16,040 SERIOUSLY IMMUNOCOMPROMISED 1110 00:50:16,040 --> 00:50:18,160 PATIENTS AND TRANSPLANT PATIENTS 1111 00:50:18,160 --> 00:50:20,920 WHO ARE NOT THAT KEEN OF HAVING 1112 00:50:20,920 --> 00:50:21,920 THESE PATIENTS IN THE HOSPITAL 1113 00:50:21,920 --> 00:50:23,720 SO YOU HAVE TO WORK WITH ALL OF 1114 00:50:23,720 --> 00:50:25,320 THEM AND ASSURE THEM WE CAN DO 1115 00:50:25,320 --> 00:50:26,160 IT AND DO IT SAFELY. 1116 00:50:26,160 --> 00:50:30,600 THE FIRST THING YOU NEED TO DO 1117 00:50:30,600 --> 00:50:33,400 IS ENSURE THE INFRASTRUCTURE 1118 00:50:33,400 --> 00:50:35,080 SUPPORTS THESE STUDIES AND THIS 1119 00:50:35,080 --> 00:50:36,240 IS WHAT THE CLINICAL CENTER GETS 1120 00:50:36,240 --> 00:50:37,960 PAID FOR AND WHAT THE COUNTRY 1121 00:50:37,960 --> 00:50:39,360 REALIZE ON US FOR AND HAVE TO 1122 00:50:39,360 --> 00:50:41,440 FIGURE OUT A WAY TO GET THE WORK 1123 00:50:41,440 --> 00:50:41,640 DONE. 1124 00:50:41,640 --> 00:50:43,440 YOU HAVE TO PLAN WITH THE 1125 00:50:43,440 --> 00:50:45,240 WORKING STAFF AND PRINCIPLE 1126 00:50:45,240 --> 00:50:45,960 INVESTIGATORS AND ANYONE ELSE 1127 00:50:45,960 --> 00:50:49,280 INVOLVED IN THE STUDIES. 1128 00:50:49,280 --> 00:50:51,480 FOR SARS IT WAS AN EFFECTIVE 1129 00:50:51,480 --> 00:50:52,760 TOOL FOR IDENTIFYING CRITICAL 1130 00:50:52,760 --> 00:50:56,120 RISK POINTS. 1131 00:50:56,120 --> 00:50:58,520 YOU NEED TO ENSURE THE 1132 00:50:58,520 --> 00:51:02,360 OCCUPATIONAL MEDICINE IS ENGAGED 1133 00:51:02,360 --> 00:51:02,720 IN MEDICINES. 1134 00:51:02,720 --> 00:51:10,520 IT'S THE MOST CRITICAL PARTNER. 1135 00:51:10,520 --> 00:51:16,600 SUPPLIES MAY BECOME A CRITICAL 1136 00:51:16,600 --> 00:51:17,480 ISSUE. 1137 00:51:17,480 --> 00:51:19,760 YOU HAVE TO ENSURE THE SUPPLY 1138 00:51:19,760 --> 00:51:21,840 CHAIN FOR PERSONAL PROTECTIVE 1139 00:51:21,840 --> 00:51:22,080 EQUIPMENT. 1140 00:51:22,080 --> 00:51:23,960 IF THE SUPPLY SHORT FALL OCCURS 1141 00:51:23,960 --> 00:51:26,240 YOU SOMETIMES NEED TO BE 1142 00:51:26,240 --> 00:51:27,120 CREATIVE. 1143 00:51:27,120 --> 00:51:28,520 MY FAVORITE EXAMPLE OF 1144 00:51:28,520 --> 00:51:30,120 CREATIVITY IN A PANDEMIC CRISIS 1145 00:51:30,120 --> 00:51:33,400 WAS EM PLIFIDE BY A COLLEAGUE, 1146 00:51:33,400 --> 00:51:34,760 DR. HASLER THEN THE HOSPITAL 1147 00:51:34,760 --> 00:51:36,520 EPIDEMIOLOGY AND NOW THE CHIEF 1148 00:51:36,520 --> 00:51:40,160 OF MEDICINE AT THE UNIVERSITY OF 1149 00:51:40,160 --> 00:51:45,240 MASSACHUSETTS BAY STATE IN 1150 00:51:45,240 --> 00:51:46,800 SPRINGFIELD, MASS. 1151 00:51:46,800 --> 00:51:49,320 HER HOSPITAL QUICKLY RAN OUT OF 1152 00:51:49,320 --> 00:51:49,680 GOWNS. 1153 00:51:49,680 --> 00:51:51,320 WHEN SHE COULDN'T FIND A 1154 00:51:51,320 --> 00:51:54,520 SUPPLIER TO SEND GOWNS SHE 1155 00:51:54,520 --> 00:51:56,600 CALLED THE BOSTON RED SOX AND 1156 00:51:56,600 --> 00:52:00,600 PURCHASED HUNDREDS OF THE 1157 00:52:00,600 --> 00:52:02,920 DISPOSAL PONCHOS IN THE BALLPARK 1158 00:52:02,920 --> 00:52:04,880 AS A STAND-IN FOR GOWNS. 1159 00:52:04,880 --> 00:52:11,280 SHE THEN WENT TO LOCAL PRISON 1160 00:52:11,280 --> 00:52:13,520 AUTHORITIES ANDS CONVINCED THEM 1161 00:52:13,520 --> 00:52:16,520 TO GET THE INMATES TO SEW GOWNS 1162 00:52:16,520 --> 00:52:19,160 TO HAVE A CONTINUOUS SUPPLY OF 1163 00:52:19,160 --> 00:52:20,560 GOWNS. 1164 00:52:20,560 --> 00:52:21,560 SIMILARLY PEOPLE AROUND THE 1165 00:52:21,560 --> 00:52:25,000 COUNTRY LEARNED HOW TO REUSE, 1166 00:52:25,000 --> 00:52:28,800 SAVE AND PRESERVE THE LIFE OF 1167 00:52:28,800 --> 00:52:31,440 N95 MASKS EXTEND THEIR USEFUL 1168 00:52:31,440 --> 00:52:31,840 USE. 1169 00:52:31,840 --> 00:52:34,680 SO YOU SPLAY TO MAKE CONTINGENT 1170 00:52:34,680 --> 00:52:36,600 PLANS TO PROVIDE CARE FOR 1171 00:52:36,600 --> 00:52:38,560 PANDEMIC PATIENTS, A UNIT MAY 1172 00:52:38,560 --> 00:52:39,760 NEED TO BE DEDICATED. 1173 00:52:39,760 --> 00:52:42,520 DR. GILLMAN DID THAT HERE ON THE 1174 00:52:42,520 --> 00:52:44,960 SIDE OF BE AN ICU AND DEPENDING 1175 00:52:44,960 --> 00:52:48,120 ON THE SCENARIO YOU MAY HAVE TO 1176 00:52:48,120 --> 00:52:50,040 PAUSE ELECTIVE SURGERY AS MOST 1177 00:52:50,040 --> 00:52:51,040 HOSPITALS DID THROUGHOUT THE 1178 00:52:51,040 --> 00:52:51,400 PANDEMIC. 1179 00:52:51,400 --> 00:52:56,040 LABORATORY SUPPLIES ARE LIKELY 1180 00:52:56,040 --> 00:52:57,640 TO BE EQUALLY SCARED. 1181 00:52:57,640 --> 00:52:59,480 IN THE COVID INSTANCE, OUR 1182 00:52:59,480 --> 00:53:03,200 DEPARTMENT OF LABORATORY 1183 00:53:03,200 --> 00:53:04,400 MEDICINE DEVELOPED COVID TESTS 1184 00:53:04,400 --> 00:53:06,040 ON SEVERAL PLATFORMS. 1185 00:53:06,040 --> 00:53:08,600 IF WE DIDN'T HAVE REAGENTS FOR 1186 00:53:08,600 --> 00:53:09,640 ONE PLATFORM THEY USED THE OTHER 1187 00:53:09,640 --> 00:53:11,920 PLATFORM TO RUN THE TESTS AND 1188 00:53:11,920 --> 00:53:14,480 GOT ALL THOSE TESTS VALIDATED 1189 00:53:14,480 --> 00:53:17,600 FOR CLINICAL USE AND DEVELOPED 1190 00:53:17,600 --> 00:53:20,040 STRATEGIES SUCH AS BATCH TESTING 1191 00:53:20,040 --> 00:53:22,600 FOR PREVALENT SAMPLE THAT WERE 1192 00:53:22,600 --> 00:53:24,280 AN ASSET. 1193 00:53:24,280 --> 00:53:27,440 THEY VALIDATED TESTS USING 1194 00:53:27,440 --> 00:53:33,880 DIFFERENT SWABBING TECHNIQUES OR 1195 00:53:33,880 --> 00:53:36,600 NASO PHARYNGEAL SWABS THAT 1196 00:53:36,600 --> 00:53:38,760 ENSURES ROBUSTNESS OF TESTING. 1197 00:53:38,760 --> 00:53:42,080 HOW DO WE FIND A NEW NORMAL. 1198 00:53:42,080 --> 00:53:48,560 PEOPLE WHO WORK IN OFFICES CAN 1199 00:53:48,560 --> 00:53:50,760 WORK AS EFFECTIVELY AT HOME AND 1200 00:53:50,760 --> 00:53:52,240 THERE'S PEOPLE WHO PROBABLY 1201 00:53:52,240 --> 00:53:54,880 DON'T NEED TO BE HERE THOUGH IT 1202 00:53:54,880 --> 00:53:55,680 FLIES AGAINST MY OWN THOUGHT. 1203 00:53:55,680 --> 00:53:59,080 I'M NOT TALKING ABOUT CRITICAL 1204 00:53:59,080 --> 00:54:02,440 CARE DOCS BUT WE HAVE PEOPLE WHO 1205 00:54:02,440 --> 00:54:03,760 WORK FOR THE HOSPITAL WHO CAN DO 1206 00:54:03,760 --> 00:54:05,560 AN EFFECTIVE JOB OF WORKING FROM 1207 00:54:05,560 --> 00:54:10,480 HOME AND WE SHOULD TAKE V 1208 00:54:10,480 --> 00:54:10,720 ADVANTAGE. 1209 00:54:10,720 --> 00:54:13,680 IT'S GOOD FOR THE EMPLOYEE AND 1210 00:54:13,680 --> 00:54:14,320 HOSPITAL. 1211 00:54:14,320 --> 00:54:16,360 WE'LL BE USING SOURCE CONTROL 1212 00:54:16,360 --> 00:54:17,320 MASKING MORE FREQUENTLY. 1213 00:54:17,320 --> 00:54:19,040 OF ALL THE SURPRISES FOR ME IN 1214 00:54:19,040 --> 00:54:22,880 THE PANDEMIC THE EFFICACY OF 1215 00:54:22,880 --> 00:54:24,560 SOURCE CONTROL MASKING ACTUALLY 1216 00:54:24,560 --> 00:54:25,560 STUNNED ME. 1217 00:54:25,560 --> 00:54:28,480 AT THE BOTTOM OF THE SLIDE I 1218 00:54:28,480 --> 00:54:33,520 LEFT A REFERENCE TO PAPER 1219 00:54:33,520 --> 00:54:38,600 PUBLISHED BY MICHELLE WOBURT 1220 00:54:38,600 --> 00:54:40,440 LOOKING AT HOW MANY SOMETIMES 1221 00:54:40,440 --> 00:54:41,440 RESPIRATORY VIRUSES WERE SPREAD 1222 00:54:41,440 --> 00:54:42,280 IN THE FIRST YEAR OF THE 1223 00:54:42,280 --> 00:54:44,600 PANDEMIC COMPARED TO LOTS OF 1224 00:54:44,600 --> 00:54:46,360 SPREAD IN YEARS PRIOR. 1225 00:54:46,360 --> 00:54:48,320 SO SOURCE CONTROL MASKING WORKS 1226 00:54:48,320 --> 00:54:49,400 AND THAT'S WHY WE'RE STILL DOING 1227 00:54:49,400 --> 00:54:52,200 IT AT THE BEDSIDE AND AT THE 1228 00:54:52,200 --> 00:54:53,080 CLINICAL CENTER. 1229 00:54:53,080 --> 00:54:58,280 I THINK HAND HIGH GEEJ IS NOT 1230 00:54:58,280 --> 00:55:00,000 JUST FOR HOSPITALS. 1231 00:55:00,000 --> 00:55:01,480 HOPEFULLY IN THEATERS, GROCERY 1232 00:55:01,480 --> 00:55:05,200 STORES, OTHER PLACES AROUND THE 1233 00:55:05,200 --> 00:55:07,920 COUNTRY BECAUSE HAND HYGIENE HAS 1234 00:55:07,920 --> 00:55:10,040 EVERYONE WORKING IN EPIDEMIOLOGY 1235 00:55:10,040 --> 00:55:12,680 KNOWS IS THE SINGLE BEST WAY TO 1236 00:55:12,680 --> 00:55:15,800 PREVENT TRANSMISSION OF 1237 00:55:15,800 --> 00:55:16,400 INFECT 1238 00:55:16,400 --> 00:55:16,880 INFECTION. 1239 00:55:16,880 --> 00:55:18,560 THE RISK ASSESSMENT NEEDS BECOME 1240 00:55:18,560 --> 00:55:19,880 PART OF OUR NEW NORMAL. 1241 00:55:19,880 --> 00:55:22,920 WE NEED TO FOCUS ON VULNERABLE 1242 00:55:22,920 --> 00:55:24,800 POPULATIONS MINDFUL OF HEALTH 1243 00:55:24,800 --> 00:55:25,120 DISPARITIES. 1244 00:55:25,120 --> 00:55:29,760 FROM THE GET GO WE HAVE TO 1245 00:55:29,760 --> 00:55:32,600 EMPHASIZE PREVENTION AND 1246 00:55:32,600 --> 00:55:34,240 BOOKMARK THE CDC WEBSITES AND 1247 00:55:34,240 --> 00:55:36,600 NOT JUST BOOKMARK IT BUT GO 1248 00:55:36,600 --> 00:55:37,520 VISIT IT FREQUENTLY. 1249 00:55:37,520 --> 00:55:39,440 BASED ON THE ACTIVITY AND THE 1250 00:55:39,440 --> 00:55:42,080 COMMUNITY SHOULD MAINTAIN A LOW 1251 00:55:42,080 --> 00:55:43,120 THRESHOLD FOR INTERVENTIONS 1252 00:55:43,120 --> 00:55:44,040 SOCIAL AND MEDICAL. 1253 00:55:44,040 --> 00:55:46,560 IF WE'RE HAVING A BIG SURGE OF 1254 00:55:46,560 --> 00:55:48,240 RSV IN A LOCAL COMMUNITY WE 1255 00:55:48,240 --> 00:55:50,640 MIGHT WANT TO CONSIDER GOING 1256 00:55:50,640 --> 00:55:52,880 BACK TO MORE AGGRESSIVE MASKING 1257 00:55:52,880 --> 00:55:55,040 IN BUILDING 10. 1258 00:55:55,040 --> 00:55:56,320 JUST AN IDEA WORTH CONSIDERATION 1259 00:55:56,320 --> 00:56:00,600 AND I THINK WE FINALLY HAVE TO 1260 00:56:00,600 --> 00:56:07,720 FOCUS ON CONGREGATE SETTING FOR 1261 00:56:07,720 --> 00:56:09,320 THOSE WHO BORE THE BURDEN OF THE 1262 00:56:09,320 --> 00:56:11,000 PANDEMIC WITH THOUSANDS OF 1263 00:56:11,000 --> 00:56:13,040 PEOPLE DYING IN FACILITY AND HAS 1264 00:56:13,040 --> 00:56:16,240 TO BE PART OF A NEW NORMAL IS A 1265 00:56:16,240 --> 00:56:18,400 FOCUS ON CONGREGATE SETTINGS. 1266 00:56:18,400 --> 00:56:20,680 WE HAVE TO REVITALIZE PUBLIC 1267 00:56:20,680 --> 00:56:23,920 HEALTH AND MODERNIZE AND 1268 00:56:23,920 --> 00:56:27,080 INTEGRATE DATA SYSTEMS AND 1269 00:56:27,080 --> 00:56:29,160 IMPROVE CAPABILITIES AND ONES 1270 00:56:29,160 --> 00:56:32,120 THERE'S A QUESTION, TEST EARLY 1271 00:56:32,120 --> 00:56:32,520 AND OFTEN. 1272 00:56:32,520 --> 00:56:33,400 WE NEED TO EXPAND OUR 1273 00:56:33,400 --> 00:56:34,840 SURVEILLANCE ACTIVITIES. 1274 00:56:34,840 --> 00:56:38,680 LOOKING AT TESTING TRENDS IN THE 1275 00:56:38,680 --> 00:56:40,600 COUNTRY AND IF THERE'S A 1276 00:56:40,600 --> 00:56:45,160 PATHOGEN CIRCULATING LOOKING AT 1277 00:56:45,160 --> 00:56:46,840 GENOMIC SURVEILLANCE. 1278 00:56:46,840 --> 00:56:49,440 WE HAVE TO INTEGRATE RESPONSES 1279 00:56:49,440 --> 00:56:51,320 FROM EPIDEMIOLOGIC AND CLINIC 1280 00:56:51,320 --> 00:56:56,160 SOURCES IN REAL TIME. 1281 00:56:56,160 --> 00:56:58,400 YOGI BERRA MAY HAVE SAID IT 1282 00:56:58,400 --> 00:57:01,360 BEST, YOU CAN OBSERVE A LOT BY 1283 00:57:01,360 --> 00:57:02,280 JUST WATCHING AND HE ALSO SAID, 1284 00:57:02,280 --> 00:57:02,960 YOU HAVE TO BE CAREFUL IF YOU 1285 00:57:02,960 --> 00:57:04,560 DON'T KNOW WHERE YOU'RE GOING 1286 00:57:04,560 --> 00:57:06,160 BECAUSE YOU MIGHT NOT GET THERE. 1287 00:57:06,160 --> 00:57:08,240 ALSO WISE WORDS FOR THE 1288 00:57:08,240 --> 00:57:08,520 PANDEMIC. 1289 00:57:08,520 --> 00:57:10,320 THERE ARE A SET OF PROBLEMS FOR 1290 00:57:10,320 --> 00:57:13,520 WHICH I HAVE NO PROPOSED 1291 00:57:13,520 --> 00:57:13,800 SOLUTION. 1292 00:57:13,800 --> 00:57:16,600 THE MAJOR TREND TOWARDS SCIENCE 1293 00:57:16,600 --> 00:57:21,440 DENYINGISM -- DENIALISM IS 1294 00:57:21,440 --> 00:57:23,520 CONCERNING TO ME AND THE BAYLOR 1295 00:57:23,520 --> 00:57:26,280 COLLEGE OF MEDICINE AND THE 1296 00:57:26,280 --> 00:57:30,240 CO-DISTRICT OF THE CHILDREN'S 1297 00:57:30,240 --> 00:57:32,280 CENTER WROTE A BOOK A DEAD LIE 1298 00:57:32,280 --> 00:57:34,960 RISE IN ANTISCIENCE IT'S A 1299 00:57:34,960 --> 00:57:36,600 CHILLING READ AND ADVOCATE TO 1300 00:57:36,600 --> 00:57:38,320 ALL OF YOU IT SHOULD BE REQUIRED 1301 00:57:38,320 --> 00:57:40,560 READING FOR ALL OF US IN 1302 00:57:40,560 --> 00:57:40,960 SCIENCE. 1303 00:57:40,960 --> 00:57:44,200 HE BELIEVES IF WE ALL RAISE OUR 1304 00:57:44,200 --> 00:57:47,800 VOICES THAT IT CAN MAKE THIS 1305 00:57:47,800 --> 00:57:49,200 SCIENCE DENIALISM GO AWAY. 1306 00:57:49,200 --> 00:57:50,120 I DON'T HAVE A LOT OF CONFIDENCE 1307 00:57:50,120 --> 00:57:51,400 IN THAT MYSELF. 1308 00:57:51,400 --> 00:57:55,400 HAND IN HAND IS THE UNBELIEVABLE 1309 00:57:55,400 --> 00:57:58,080 ANTI-VACCINE PREVALENT IN THE 1310 00:57:58,080 --> 00:57:58,320 COUNTRY. 1311 00:57:58,320 --> 00:58:01,680 NOT JUST COVID VACCINES BUT NOW 1312 00:58:01,680 --> 00:58:07,040 MEASLES VACCINE AND MY COLLEAGUE 1313 00:58:07,040 --> 00:58:08,560 LET ME KNOW ABOUT THREE WEEKS 1314 00:58:08,560 --> 00:58:14,040 AGO THAT FOR THE FIRST TIME IN 1315 00:58:14,040 --> 00:58:16,520 HER INFECTIOUS DISEASES CAREER 1316 00:58:16,520 --> 00:58:21,680 MADE A DIAGNOSIS OF MEASLES AND 1317 00:58:21,680 --> 00:58:28,480 AS AN EPIDEMIOLOGIST HAS TO WORK 1318 00:58:28,480 --> 00:58:30,440 OUT PLAN FOR A MEASLES OUTBREAK. 1319 00:58:30,440 --> 00:58:34,560 AND THE THIRD IS THE PROBLEM OF 1320 00:58:34,560 --> 00:58:34,880 PRESENTEEISM. 1321 00:58:34,880 --> 00:58:41,640 PEOPLE COME TO WORK WHEN THEY 1322 00:58:41,640 --> 00:58:47,280 SHOULDN'T WE HAVE THE LOVELY 1323 00:58:47,280 --> 00:58:49,000 ASYMPTOMATIC TESTING SERVICE AND 1324 00:58:49,000 --> 00:58:52,120 USUALLY 1% TO 3% AND WE FOUND 1325 00:58:52,120 --> 00:58:53,560 PEOPLE WHO WERE ASYMPTOMATIC AND 1326 00:58:53,560 --> 00:58:58,440 ASKED THEM IF THEY HAD SYMPTOMS. 1327 00:58:58,440 --> 00:59:00,560 ABOUT HALF HAD SYMPTOMS BUT 1328 00:59:00,560 --> 00:59:01,840 THEY'RE ALREADY AT WORK WITH 1329 00:59:01,840 --> 00:59:03,800 SYMPTOMS IN THE MIDST OF A 1330 00:59:03,800 --> 00:59:04,040 PANDEMIC. 1331 00:59:04,040 --> 00:59:05,840 THEIR REASONS FOR COMING ARE 1332 00:59:05,840 --> 00:59:06,760 MYRIAD AND SOME IMPORTANT. 1333 00:59:06,760 --> 00:59:08,320 I DON'T WANT TO LET DOWN MY 1334 00:59:08,320 --> 00:59:08,520 STAFF. 1335 00:59:08,520 --> 00:59:09,960 I HAVE TO TAKE CARE OF MY 1336 00:59:09,960 --> 00:59:10,600 PATIENTS BUT IN A PANDEMIC YOU 1337 00:59:10,600 --> 00:59:16,880 CAN'T HAVE IT. 1338 00:59:16,880 --> 00:59:19,440 THE DISSEMINATION OF 1339 00:59:19,440 --> 00:59:20,560 MISINFORMATION IS BEYOND ME AND 1340 00:59:20,560 --> 00:59:23,720 THE BIGGEST PROBLEM IS A SET OF 1341 00:59:23,720 --> 00:59:26,440 POLITICAL LENSES THROUGH WHICH 1342 00:59:26,440 --> 00:59:29,800 OUR POLARIZED COUNTRY VIEWS 1343 00:59:29,800 --> 00:59:30,720 VIRTUALLY ANY ISSUE. 1344 00:59:30,720 --> 00:59:32,600 I THOUGHT I'D CLOSE WITH 1345 00:59:32,600 --> 00:59:34,400 SCIENTIFIC FOOD FOR THOUGHT. 1346 00:59:34,400 --> 00:59:36,600 THESE ARE SOME QUOTES THAT HAVE 1347 00:59:36,600 --> 00:59:39,200 SOME OF MY FAVORITES RELEVANT TO 1348 00:59:39,200 --> 00:59:42,200 THIS TOPIC AND PRESENTATION 1349 00:59:42,200 --> 00:59:43,640 EINSTEIN SAID ALL OF OUR SCIENCE 1350 00:59:43,640 --> 00:59:45,360 AGAINST REALITY IS PRIMITIVE AND 1351 00:59:45,360 --> 00:59:48,600 CHILD LIKE AND YET THE MOST 1352 00:59:48,600 --> 00:59:51,240 PRECIOUS THINGS WE HAVE. 1353 00:59:51,240 --> 00:59:57,400 AND BROSLIN FRANKLIN SAID 1354 00:59:57,400 --> 01:00:01,600 SCIENCE IN EVERYDAY LIFE CANNOT 1355 01:00:01,600 --> 01:00:04,480 AND SHOULD NOT BE SEPARATED. 1356 01:00:04,480 --> 01:00:07,640 NEIL DE GRASS TYSON SAID THE 1357 01:00:07,640 --> 01:00:09,160 THING ABOUT SCIENCE IS IT'S TRUE 1358 01:00:09,160 --> 01:00:10,320 WHETHER YOU BELIEVE IN IT. 1359 01:00:10,320 --> 01:00:12,160 THE GREAT SCIENCE FICTION WRITER 1360 01:00:12,160 --> 01:00:14,720 WROTE THE SADDEST ASPECT OF LIFE 1361 01:00:14,720 --> 01:00:18,040 RIGHT NOW IS SCIENCE GATHERS 1362 01:00:18,040 --> 01:00:25,760 KNOWLEDGE FASTER THAN SOCIETY 1363 01:00:25,760 --> 01:00:27,920 GATHERS WISDOM. 1364 01:00:27,920 --> 01:00:30,760 AND I HOPE DURING THIS 1365 01:00:30,760 --> 01:00:32,440 CONVERSATION WE'VE BEEN HAVING 1366 01:00:32,440 --> 01:00:33,680 WHERE I EXPRESSED A LOT OF 1367 01:00:33,680 --> 01:00:40,640 OPINION I HOPE I'VE NOT BEGAT 1368 01:00:40,640 --> 01:00:41,160 IGNORANCE. 1369 01:00:41,160 --> 01:00:42,560 SCIENCE KNOWS NO COUNTRY BECAUSE 1370 01:00:42,560 --> 01:00:46,480 SCIENCE BELONGS TO HUMANITY AND 1371 01:00:46,480 --> 01:00:50,280 IS THE TORCH WHEN ILLUMINATE THE 1372 01:00:50,280 --> 01:00:51,480 WORLD AND MY FAVORITE AUTHOR 1373 01:00:51,480 --> 01:00:56,560 SAID SCIENCE IS MAGIC THAT WORKS 1374 01:00:56,560 --> 01:01:02,080 AND EINSTEIN SAID TWO THINGS ARE 1375 01:01:02,080 --> 01:01:06,800 INFINITE, THE UNIVERSE AND HUMAN 1376 01:01:06,800 --> 01:01:08,880 STUPIDITY AND ISAAC NEWTON SAID 1377 01:01:08,880 --> 01:01:12,920 IF I'VE SEEN FURTHER IT'S FROM 1378 01:01:12,920 --> 01:01:15,440 STANDING ON THE SHOULDERS OF 1379 01:01:15,440 --> 01:01:18,440 GIANTS. 1380 01:01:18,440 --> 01:01:20,600 I'VE STOOD ON THE SHOULDERS OF 1381 01:01:20,600 --> 01:01:31,120 GIANTS FOR THE LAST 44 YEARS. 1382 01:01:32,000 --> 01:01:33,760 THIS IS A PARTIAL LIST OF THOSE 1383 01:01:33,760 --> 01:01:37,840 WHO GAVE MY CAREER MEANING AND 1384 01:01:37,840 --> 01:01:40,600 MY MENTOR AND JACK BENNET WHO 1385 01:01:40,600 --> 01:01:44,560 RECRUITED ME HERE AND PROBABLY 1386 01:01:44,560 --> 01:01:50,640 REGRETS IT NOW AND TARA PALMORE 1387 01:01:50,640 --> 01:01:52,640 AND THIS IS THE LIPSETT 1388 01:01:52,640 --> 01:01:53,800 AUDITORIUM AND HE WAS THE 1389 01:01:53,800 --> 01:01:55,160 DIRECTOR OF THE CLINICAL CENTER 1390 01:01:55,160 --> 01:01:56,120 WHEN I CAME HERE. 1391 01:01:56,120 --> 01:01:58,480 LASTLY, THIS IS A LIST OF 1392 01:01:58,480 --> 01:02:00,640 EVERYONE WHO HAS PARTICIPATED IN 1393 01:02:00,640 --> 01:02:02,120 THE HOSPITAL EPIDEMIOLOGY 1394 01:02:02,120 --> 01:02:05,960 PROGRAM AT THE CLINICAL CENTER 1395 01:02:05,960 --> 01:02:07,080 SINCE ITS BEGINNING. 1396 01:02:07,080 --> 01:02:11,640 IT'S NOT A VERY LONG LIFT. 1397 01:02:11,640 --> 01:02:14,600 STARTING WITH JACK BENNET 1398 01:02:14,600 --> 01:02:15,720 TELLING ME HE WAS DOING HOSPITAL 1399 01:02:15,720 --> 01:02:20,600 EPIDEMIOLOGY WITH 5% OF HIS TIME 1400 01:02:20,600 --> 01:02:25,840 AND MY FIRST DEPUTY HOSPITAL 1401 01:02:25,840 --> 01:02:27,400 EPIDEMIOLOGIST AND OUR NEW 1402 01:02:27,400 --> 01:02:30,760 EPIDEMIOLOGIST IS OFF TO A 1403 01:02:30,760 --> 01:02:32,720 TERRIFIC START AND WARE PROUD OF 1404 01:02:32,720 --> 01:02:33,160 HER. 1405 01:02:33,160 --> 01:02:35,840 THERE'S THREE PEOPLE WITH 1406 01:02:35,840 --> 01:02:38,720 ASTERISKS WHO AREN'T PART OF OUR 1407 01:02:38,720 --> 01:02:39,400 PROGRAM BUT I RELIED ON FOR 1408 01:02:39,400 --> 01:02:49,520 YEARS. 1409 01:02:51,800 --> 01:02:55,680 THE PEOPLE'S WHOSE NAMES ARE IN 1410 01:02:55,680 --> 01:02:57,440 YELLOW ARE STILL WANDERING THE 1411 01:02:57,440 --> 01:02:58,400 HALLS AND STILL WORRIED ABOUT 1412 01:02:58,400 --> 01:03:01,040 THE SAFETY OF YOU AND OUR STAFF 1413 01:03:01,040 --> 01:03:03,400 DURING AN ONGOING COVID-19 1414 01:03:03,400 --> 01:03:07,280 PANDEMIC. 1415 01:03:07,280 --> 01:03:08,840 I'D LIKE TO THANK THEM ALL FOR 1416 01:03:08,840 --> 01:03:10,720 THEIR HARD WORK DURING THIS TIME 1417 01:03:10,720 --> 01:03:12,680 AND HOPE IF YOU SEE ANY OF THEM 1418 01:03:12,680 --> 01:03:13,960 IN THE CORRIDOR IN THE NEXT WEEK 1419 01:03:13,960 --> 01:03:17,720 OR TWO, THANK THEM AS WELL FOR 1420 01:03:17,720 --> 01:03:20,600 THE EXTRA HOURS AND EFFORT THEY 1421 01:03:20,600 --> 01:03:23,440 PUT IN AND THEIR INCREDIBLY 1422 01:03:23,440 --> 01:03:27,440 UPBEAT ATTITUDE AS WE DEAL WITH 1423 01:03:27,440 --> 01:03:28,520 THE PANDEMIC FROM THE GRET GO 1424 01:03:28,520 --> 01:03:29,840 THESE ARE THE PEOPLE WHO DID THE 1425 01:03:29,840 --> 01:03:30,040 WORK. 1426 01:03:30,040 --> 01:03:32,600 THANK YOU FOR YOUR TIME AND 1427 01:03:32,600 --> 00:00:00,000 ATTENTION.