Excerpts from Telebriefing

WHAT WOULD MITIGATION LOOK LIKE IN THE U.S. AND THE HEALTH CARE  CONDITIONS ARE IN PLACE IF YOU NEED TO HAVE THAT KIND OF CHANGE IN YOUR RESPONSE STRATEGY?

  I UNDERSTAND WHAT YOU’RE ASKING ABOUT IS THE CHANGE BETWEEN CONTAINMENT AND MITIGATION AND WHAT IT WOULD LOOK LIKE AND THANKS FOR THAT QUESTION BECAUSE IT ALLOWS ME TO SAY THAT IT’S NOT BLACK AND WHITE.  THERE ARE TIMES WHEN THOSE COMPONENTS MERGED TOGETHER ACROSS THE UNITED STATES, POTENTIALLY AT DIFFERENT LOCATIONS IN THE UNITED STATES DEPENDING ON WHAT HAPPENS.  WE’RE CONTINUING TO HOPE THAT WE WON’T SEE COMMUNITIES SPREAD AND CERTAINLY HOPING THAT OUR MEASURES GIVE US EXTRA TIME TO PREPARE BY GAINING OURSELVES THIS TIME, THE HOPE IS THAT WE’LL HAVE MORE TIME TO PREPARE.  BUT FRANKLY OUR MODEL SUGGESTS THAT WE MAY BLUNT THE HEIGHT OF ANY CURVE AND THAT WOULD BE THE VALUED OUTCOME.  WHAT DOES THIS LOOK LIKE, MITIGATION, IS WHEN YOU STOP TRYING TO TRACE CLOSE CONTACTS AROUND EVERY CASE TO CONTAIN THE CASE, AND INSTEAD TO FOCUS ON — FOCUS ON THE DISRUPTION AND THE COMMUNITY TRYING TO DECREASE THE BURDEN, TRYING TO DECREASE THE MORBIDITY AND MORTALITY.  DOING EVERYTHING TO HELP AT A SOCIETAL LEVEL.  THE KIND OF THINGS THAT WE’RE TALKING ABOUT ARE COMMUNITY LED LEVEL DECISIONS.  FOR EXAMPLE, IN GENERAL, SOCIAL DISTANCING, SCHOOL CLOSURES, CANCELING MASS GATHERINGS, SORT OF NONPHARMACEUTICAL INTERVENTIONS WE’RE TALKING ABOUT THINGS LIKE TELEMEDICINE, TELESCHOOLING, TELEWORKING SO THAT AT A SOCIETAL LEVEL WE TRY TO DISRUPT THE SPREAD.  IN A SITUATION LIKE THIS WHERE WE DON’T HAVE A VACCINE AND WE DON’T YET HAVE A SPECIFIC COUNTERMEASURE, THOSE KIND OF NONPHARMACEUTICAL INTERVENTIONS AT A COMMUNITY LEVEL ARE REALLY IMPORTANT.  THAT’S WHY IN THIS TIME THAT WE HAVE GAINED OURSELF IS WORKING CLOSELY ACROSS ALL OF GOVERNMENT AND WITH OUR LOCAL AND STATE PARTNERS ON PLANNING FOR THOSE OPERATIONS.  FORTUNATELY IN THE UNITED STATES BECAUSE WE HAVE DONE A LOT OF PLANNING AROUND PANDEMIC INFLUENZA WE HAVE A GOOD HEAD START, BUT WE NEED TO LOOK AT THE PLANS, SEE HOW THE CURRENT SITUATION MIGHT ALTER THEM AND YOU’LL SEE A LOT OF THE GUIDANCE COMING UP ON THE WEBSITE IN THE COMING WEEKS.  NEXT QUESTION.

ALSO, YOU MAY BE ABLE TO BLUNT THE HEIGHT OF ANY CURVE.  I MEAN, WHAT DO YOU MEAN ABOUT THAT?  CAN YOU SAY MORE ABOUT WHAT YOUR MODELS ARE PREDICTING?  

THERE ARE SOMETHING LIKE 50 DIFFERENT GROUPS IN THE UNITED STATES RIGHT NOW THAT ARE DOING MATHEMATICAL MODELING AROUND THIS OUTBREAK.  AND WHAT WE’RE DOING IS LOOKING ACROSS ALL OF THOSE GROUPS AND LOOKING AT ALL OF THE MODELS TO TRY TO GET THE BEST DATA THAT WE CAN TO HELP US INFORM THE U.S.  RESPONSE.  THEY’RE LOOKING AT A WIDE VARIETY OF THINGS AND STARTING WERE THE SAME ASSUMPTIONS WE CAN LOOK AT THOSE THINGS WITH THE DIFFERENT MODELS TOGETHER.  ONE OF THE THINGS THAT OUR INFLUENZA MODELERS HAVE LOOKED AT IS THE IDEA THAT IF YOU COULD PUT IN PLACE SOME OF THESE COMMUNITY MITIGATION EFFORTS, YOU CAN DELAY THE ON SET OF THE PEAK OF THE CURVE BUT ALSO BLUNT THE CURVE.  

SO I GUESS WHAT I WAS TRYING TO EXPLAIN AND THERE’S A PICTURE SITTING IN FRONT OF ME, I WISH I COULD POINT IT OUT, BUT I THINK IT MIGHT BE ON THE WEBSITE.  BUT IT’S A TYPICAL PICTURE THAT WE USE WHEN WE TALK ABOUT THESE KIND OF INTERVENTIONS WITH PANDEMIC INFLUENZA.  YOU KNOW, THE IDEA IS THAT THIS VIRUS IS BEHAVING IN MANY WAYS LIKE WE’D EXPECT INFLUENZA IN TERMS OF ITS SPREAD.  THEREFORE, WE THINK THE SAME MITIGATION EFFORTS MIGHT HAVE THE SAME KIND OF IMPACT AND THAT’S WHAT WE’RE USING THE MATHEMATICAL MODELING TO LOOK AT. 

>> HI, I WAS HOPING YOU COULD PROVIDE SOME MORE CLARITY ABOUT THE MISSION — THE WORLD HEALTH ORGANIZATION MISSION AND WHETHER U.S. OFFICIALS WILL BE PART OF IT ALSO.  HOPING YOU CAN FIND DISTRESSING — YOU CAN TALK ABOUT WHAT YOU FIND DISTRESSING ABOUT THE WUHAN FOOTAGE.

>> YES.  AS I SAY, WE — I HAD NOT SEEN THE ANNOUNCEMENT THIS MORNING FROM THE WORLD HEALTH ORGANIZATION.  I DID UNDERSTAND THAT THERE WAS SOME THE ADVANCE — THE ADVANCED TEAM WAS PLANNING FOR A FURTHER MISSION WITH MORE STAFF SO I’M HAPPY TO HEAR THAT THAT HAS BEEN ANNOUNCED.  THE COMPOSITION OF THE TEAM IN TERMS OF WHO THE ACTUAL MEMBERS ARE ON THIS FIRST TEAM HASN’T BEEN ANNOUNCED YET SO I CAN’T SPEAK TO THAT.  BUT WE CONTINUE TO HOPE THAT CDC STAFF WILL BE — WILL BE INCLUDED IN THAT MISSION.  OBVIOUSLY, I BELIEVE THAT WE HAVE GREAT EXPERTISE HERE AT CDC AND I HOPE WE CAN USE IT TO SUPPORT OUR CHINESE COLLEAGUES.  

TERMS OF WUHAN, WHAT I WOULD SAY IS THAT THE PICTURES CERTAINLY SHOW CASE THAT THE CITIZENS OF WUHAN ARE SUFFERING, BOTH FROM THE DISEASE, BUT ALSO FROM THE FEAR THAT IS CLEARLY PRESENT IN THEIR COMMUNITIES AND I THINK THAT WE SHOULD ALL FEEL FOR THAT SUFFERING AND, YOU KNOW, OUR WORK HERE IN THE UNITED STATES IS TO CONTAIN THE VIRUS.  WE KNOW THAT THERE ARE CASES HERE, WE EXPECT THAT THERE MAY BE ADDITIONAL CASES. 

 BUT WHAT WE’RE FOCUSING ON RIGHT NOW IS CONTAINING THE VIRUS WITH ONLY 15 CASES HERE IN THE UNITED STATES.  WE REMAIN OPTIMISTIC THAT OUR AGGRESSIVE MEASURES HAVE SLOWED THE IMPACT OF IT HERE.  AND WE’RE GOING TO CONTINUE TO MOVE AGGRESSIVELY IN THAT WAY.  PREPARING FOR THE SPREAD BUT HOPING THAT WITH THE MEASURES WE HAVE TAKEN WE’LL BE ABLE TO PREVENT IT