1 Episode results for "Dr Steve Goodman"
Democracy Now! 2020-03-13 Friday
"From New York. This is democracy now anybody that needs a desk. It's a test. They have to tell anybody that needs cast gets a test says the president of the United States. That's simply untrue. There have been just eleven thousand tests in the United States so far since the corona virus outbreak began. Compare this to nearly twenty thousand tests for Corona virus every day in South Korea alone the head of the National Institute of Allergy and Infectious Disease says the. Us is failing when it comes to testing for the virus. The idea of anybody getting it easily the way people in other country doing we're not set up for that. I think you should be yes. But we're not today. We look at how the trump administration has failed to account for what it'd be thousands of corona virus infections because of ongoing problems with access to testing. We'll speak with professor. Justin Leslie of the Johns Hopkins Bloomberg School of Public Health Senior author of a new study that suggests the median incubation period for the new corona virus is about five days and epidemiologist. Dr Steve Goodman at Stanford Medical School Associate Dean of the School. Both are holding classes online for the rest of the porter over concerns about the outbreak. And yes Dr. Goodman is my brother all that and more coming up. Welcome to democracy now democracy now dot. Org the Warren Peace Report. I'm Amy Goodman. The Corona virus pandemic is continuing to spread across the globe. According to the World Health Organization Corona virus has now infected over one hundred thirty five thousand people and killed nearly five thousand. Kenya and Ghana have confirmed their first corona virus cases. India's reported its first corona virus death. The death toll in Italy has surpassed one thousand while the country's medical system struggles to treat the sick. Meanwhile satellite photographs have been published online showing what appeared to be mass graves in Iran. Where Corona virus victims have been buried? The official death toll in Iran is around four hundred twenty nine but many fear. The actual number is far higher France Ireland Austria Belgium. Turkey and Norway have all begun taking steps to close schools to stop the spread of the virus here in the United States. The number of reported corona virus in factions jumped by nearly four hundred Thursday to about one thousand six hundred fifty but the actual number is believed to be higher congresses. In House. Doctor has privately told Capitol Hill staffers that he expects seventy to one hundred fifty million people in the United States will contract the virus. Six states have announced plans to close all public schools. Oregon Ohio Michigan Maryland Kentucky and New Mexico schools in Houston Texas near Seattle are also closing. Almost five million. Children are being impacted by the closings own major sporting events in the United States have been halted the NCWA has cancelled for the first time. Ever the men and Women's College Basketball tournaments known this March madness Utah Jazz player Rudy. Gobert has apologized after testing apologised after testing positive for corona virus. Just days after. He jokingly touched reporters microphones and phones while leaving a news conference Monday go bare wrote quote. At the time I had no idea I was even infected. I was careless and make no excuse. I hope my story serves as a warning and causes everyone to take this seriously unquote Disney has shuttered all of its theme parks around the world including Disneyworld and Florida. New York state has banned public gatherings of more than five hundred people including all Broadway shows on Thursday New York City mayor. Bill de Blasio declared a state of emergency as the number of confirmed cases in New York jumped from forty two to ninety five in a single day but the last twenty four hours have been very very sober literally yesterday morning. Feels like a long time ago We got a lot information. The course of the day yesterday a lot changed and then last night it does seem like the world turned upside down in the course of just a few hours on Wall Street. The Dow Jones Industrial Average plummeted ten percent Thursday in its biggest drop since one thousand nine hundred eighty seven airlines and cruise companies have been particularly hard. Hit major international cruise lines including Princess cruises and Viking suspended operations. President Trump's ban Europeans flying into the United States from twenty six European countries goes into effect midnight tonight. The stock market losses came despite the Federal Reserve injecting about one point five trillion dollars into the financial system in an effort to prop up. The market's former Labor secretary. Robert Reich tweeted total student. Loan debt one point seven trillion total cost of the Fed's short-term bank funding one point five trillion America has socialism for the rich harsh capitalism for everyone else Reverend William Barber of the poor people's campaign tweeted overnight. They found one point five trillion dollars for Wall Street but they can't find money to provide healthcare and living wages for one hundred forty million poor and low wealth people in America the trump administration's facing widespread criticism for its handling of the corona virus outbreak on Thursday. Dr Anthony Fauci. The Director of the National Institute of Allergy and Infectious Diseases said the. Us is failing when it comes to testing for the virus. The system does not is not really geared to what we need right now. What you are asking for that is a failing and it is a failing very. Let's admit the idea of anybody getting it easily. The way people in other countries are doing it. We're not set up for that. Do I think we should be yes? But we're not the BBC reports nearly twenty thousand. People are being tested for Corona virus every day in South Korea. Far More than the eleven thousand tests done in the United States since the outbreak began months ago on Capitol Hill House Speaker. Nancy Pelosi said she's close to reaching a deal with the White House on a corona virus aid package that includes funding for temporary paid sick leave and free virus testing on Thursday democratic congresswoman. Katie Porter of California grilled Centers for Disease Control Director Robert Redfield on the affordability of Corona virus. Testing Dr Redfield. Do you want to know who has the colonel virus? In who doesn't yes not just rich people but everybody might have the virus. All of America will you commit to the CDC right now using that existing authority to pay for diagnostic testing free to every American regardless of insurance. Well I can say that we're going to do everything to make sure everybody can get the time Dr Redfield. You have the existing authority. Will you commit right now to using the authority that you have vested in you under law that provides a public health emergency for testing treatment exam isolation out cost? Yes or no what? I'm going to say I'm going to review in detail with no in more news. On the corona virus. The press secretary of Brazilian President Sharable Sonata has tested positive for cove in nineteen. The official was photographed last week standing shoulder to shoulder with president trump and just a few feet from vice president. Mike Pence during both Sinatra's recent trip tomorrow Lago and Florida the official is also seen standing just behind trump and video taken at the meeting at trump's mar a lago resort South Carolina. Senator Lindsey Graham. Who was at the Mar? A LAGO meeting says he will self quarantine while awaiting the results of corona virus test. So we'll Florida senator. Rick Scott who met separately with Bolsonaro and the eight on Monday the White House however said President. Trump does not plan to get tested and he has repeatedly said this. Meanwhile Australia's Home Minister. Peter Dutton has tested positive for corona virus. Last week he met with President Trump's daughter Ivanka trump and attorney general William bar in Canada. Sophie Gregoire Trudeau the wife of Prime Minister Justin Trudeau tested positive for Kovic nineteen Thursday. She reported mild flu like symptoms after a trip to the UK. Prime Minister Trudeau. Says he does not have symptoms but will work for my solution for fourteen days in the Philippines president. Rodrigo duterte ordered a lockdown of Metropolitan Manila home to thirteen million people to charities. Order cuts off land domestic air and sea travel to and from Metro. Manila and imposes bans. On mass. Gatherings schools have been ordered shut for month and community. Quarantining is in effect local officials WHO DEFIED GOVERNMENT ORDERS FACE. Jail time was tested for corona virus after possible exposure. Meanwhile six of his Cabinet Ministers Sixteen lawmakers and the Philippines Central Bank governor have all gone into self quarantine as the corona virus continues to spread in the United States. Immigration advocates are afraid of a deadly outbreak inside immigration jails Silky Shah Executive Director of detention. Watch network said in a statement. Quote lives are already at risk and detention and with the spread of Corona virus? People are sitting ducks in a system. Notorious for its fatally flawed medical care unquote. They're also mounting concerns that the deportation of asylum seekers from the US and Mexico could accelerate the spread of corona virus across Central America. Honduras cancelled the arrival of flights with people who were deported as the country already declared its first. Two cases of the virus. El Salvador has declared a national quarantine banned all foreign travellers. Even though it hasn't had any confirmed corona virus cases yet this comes as the Guatemalan government announced Wednesday. It would ban the entry of European citizens as well as people from Iran China South Korea. North Korea has an attempt to control the spread of cove in nineteen. Meanwhile doctors working at a refugee camp. Aiding thousands of people in border city of Matamoros are preparing for the inevitable arrival of the corona virus to shelters and camps across the US. Mexico border one doctor at the MONTEMURRO shelter said Cova Nineteen infections along the border will be quote catastrophic and other news from the US Mexico border a nineteen year old pregnant woman from what Allah has died from injuries. She sustained after she fell while attempting to scale the US Border. Wall attempts to deliver her unborn. Baby were unsuccessful after she fell more than nineteen thousand feet. The Democratic National Committee has announced Sunday's Democratic presidential debate between Joe Biden and Bernie Sanders will take place in CNN studios in Washington DC instead of an Arizona because of the cove in nineteen outbreak. There will be no live audience on Thursday Senator Sanders called on President Trump to declare a national emergency and for everyone in the country to be able to get the health care. They need without cost time in the modern history of our country when we are all in this together. This is that moment now is the time for solidarity. Now is the time to come together with love and compassion for all including the most vulnerable people in our society who will face this and DEMOC. From a health perspective or pace of from an economic perspective Sanders also called for an immediate moratorium evictions for Closures and Utility Shut offs during the crisis on Thursday. The Miami Dade Police Department announced its officers would not assist with addictions during the pandemic outbreak. Joe Biden has called for scientists to be in charge of dealing with the corona virus pandemic in the United States in Iraq. The United States launched a series of air raids targeting Iran backed militia groups the US described the attacks as retaliation for a rocket attack that killed two US soldiers and a British army medic Wednesday Aljazeera reports Iraq's military confirmed the US air raids late. Thursday night hit four locations including an airport under construction in the holy city of Karbala. There have been injuries but no fatalities reported so far. No one has claimed responsibility for Wednesday's rocket attack against British. Us troops but the US blamed the iranian-backed Hezbollah militia back in the United States. Us Army Whistle Blower Chelsea. Manning will soon be released from jail after one year behind bars on contempt charges for refusing to in a federal grand jury investigation into wikileaks. The order for her immediate release comes one day after. Manning was hospitalized Virginia after she reportedly attempted suicide at a federal prison in Alexandria on Thursday judge and the triangle wrote quote. The court finds Ms Manning's appearance before the grand jury is no longer needed in light of which her detention no longer serves any coercive purpose judge triangle however rejected a request to cancel the fines imposed against manning for refusing to testify. Manning will now have to pay two hundred fifty six thousand dollars in two thousand thirteen Chelsea. Manning was sentenced to thirty five years in prison for leaking documents and videos to wikileaks showing evidence of us. War Crimes in Iraq and Afghanistan. President Obama granted clemency in two thousand seventeen a vocal supporter of Donald. Trump was sentenced Wednesday to a one year prison term for threatening to assault and murder Minnesota Congress member Ilhan Omar Fifty five year. Old Patrick Carly Neo Junior. Who told investigators he loves the president and hates radical Muslims in our government unquote cold. Congress member Ilhan Omar's office in two thousand eighteen and delivered the threaten an expletive Laden rant. Congress member Omar is one of the first two Muslim women elected to Congress in is the only lawmaker to wear a hijab at sentencing. Hearing in federal court in Western New York Wednesday Carlino received a short prison term after Congress member. Omar pleaded for leniency. She wrote in a statement to the judge quote. The answer to hate is not more hate. It's compassion. He should understand the consequences of his actions. Be Given the opportunity to make amends and seek redemption the congresswoman said in climate news top United Nations researchers are warning that polarize capture melting six times. Faster than they were in the nineteen nineties. Threatening Sea level rise that will displace hundreds of millions of people. By the end of the century the intergovernmental panel on climate change ice loss data from Greenland. Tactica is in line with some of the most pessimistic predictions of climate change and then even if global carbon emissions were somehow halted today. Arctic ice will continue to melt for another three decades in South Carolina in one thousand nine hundred eighty eight anti lgbtq Q. Law that prohibited public schools from mentioning same sex relationships and sex and health. Education has been declared unconstitutional by a US district judge. The banning of the outdated law comes two weeks after a federal lawsuit was filed by the National Center for Lesbian Rights. Lambda legal on behalf of a high school. Lgbtq student organization and other LGBTQ rights groups. The lawsuit said the one thousand nine hundred law violated the fourteenth amendment by discriminating against. Lgbtq students has prevented them from having access to vital health education. Colorado State lawmakers have approved a bill to replace Columbus Day with a holiday honoring Francis Savior Breen the patron saint of immigrants. The Leadership Council the American Indian Movement of Colorado celebrated passage of the bill writing quote for decades the holiday officially justified the substitution fallacy for history and repeating a false narrative about the heroism of Columbus while ignoring his Taliban crimes against the Indigenous Peoples of the Americas unquote. If the bill is signed by Governor Jared Polis Colorado will join twelve other states and dozens of local governments that will no longer celebrate Columbus Day. Most of the now celebrate indigenous Peoples Day in. Its place and those are some of the headlines. This is democracy now democracy now dot or the Warren Peace Report. I'm Amy Goodman. It's been seven weeks since the first case of Corona virus was reported in the United States. Today we look at how the trump administration has failed to account for what may be thousands of infections because of ongoing problems with access to testing here in the United States. The number of reported corona virus infections jumped by four hundred Thursday alone to about sixteen fifty but the actual number is believed to be far far higher congresses. In House doctor has privately told Capitol Hill. Staffers that he expects seventy to one hundred fifty million people in the United States will contract the corona virus. Six states have announced plans to close all public schools. Oregon Ohio Michigan Maryland Kentucky and New Mexico schools in Houston Texas near Seattle are also closing. Almost five million. Children are being impacted by the school. Closings only major sporting events in the United States have been halted the NCW has cancelled the upcoming men and women's College Basketball tournaments known as March Madness Disney has shuttered all its theme parks around the world including Disney world in Florida. New York State's ban public gatherings of more than five hundred people Broadway has shut down on Thursday New York City mayor. Bill de Blasio declared a state of emergency as the number of confirmed cases in the city jumped from forty two to ninety five in a single day again. These numbers are striking and troubling. We now and even compared to this morning. We've seen a big jump. We now have ninety five confirmed cases as forty two new since yesterday. So you can see the progression now. Mayor de Blasios estimated New York could have a thousand cases of corona virus by next week and said quote. We're getting into a situation where the only analogy is war unquote the New York Times reports fewer than two thousand people in New York have been tested. There have been just eleven thousand tests throughout the United States. Compared this what. Bbc is reporting. Nearly twenty thousand people are being tested for Corona virus every day in South Korea alone at a Congressional hearing Thursday on the Corona virus outbreak Democratic Congress member Debbie Wasserman Schultz of Florida press. Cdc Director Robert Redfield on the limited availability of Corona virus tests medical workers who think they've been exposed. Redfield was unable to answer and then turn to National Institute of Health official. Dr Anthony Fauci for guidance. This is how Dr Fao Who's the director of the National Institute of Allergy and Infectious Diseases? Top MEMBER OF TRUMP'S CORONA VIRUS. Task Force responded. The system does not is not really geared to what we need right now. What you are asking for that is a failing and it is a failing. Let's admit it. The fact is the way the system was set up. Is that the public health component. That doctor that doctor Redfield was talking about was a system where you put it out there in the public and a physician asks for it and you get the idea of anybody getting it easily. The way people in other countries are doing it. We're not set up for that. Do I think we should be yes? But we're not okay. That's really disturbing. And I appreciate the information. Dr Found she. Statement appeared to directly refute a claim president trump made just last week. Anybody that needs a desk. It's a test we there there they have the. Does anybody WANNA test gets test. That's what president trump said. This comes the trump administration's corona virus task forces gun two days with no press briefings and the World Health Organization has officially classified the Corona virus outbreak as a pandemic for the rest of the hour. We're joined by two guests and Baltimore. Justin Leslie is with us. He's associate professor at the Johns Hopkins Bloomberg School of Public Health Senior author and new study that suggests the median incubation period for the new corona viruses about five days and joining us from Stanford University. Which is now close to students on campus. It's got online learning. Dr Steven Goodman is with US associate dean at Stanford Medical School where he's also a professor of epidemiology and Population Health and medicine. Oh and he's also my brother. He joins us from Stanford University. Yes they are continuing light Johns Hopkins to hold their classes online over concerns about Cova. Nineteen we welcome you both to democracy. Now Steve Let's begin with you. I consider you my lifeline on issues like this and that's why we called you. Why don't we start? By this issue of testing it is absolutely astounding that in countries like north like in countries like South Korea where we hear the test or something like twenty thousand a day in this country. It is believed that there have only been eleven thousand tests over the entire period of this outbreak. How is this possible? What happened? Well I don't know all the details of what happened. But it is clear that they were decisions that were made centrally about what test to use and restrictions on who could do the test that has been changed and finally other laboratories including one at Stanford have finally been authorized to Develop and now deliver their own tests so the original decisions to use a US specific test not the one That was suggested by the. Who which has been used in many many other countries in retrospect obviously was a big mistake and we had trouble manufacturing and distributing a valid test centralized at the CDs. Now this is a critical issue. Right I mean there was a test available. It was the World Health Organization tests the one that countries all over the world are using now but the CDC made a decision not to accept that test. They made their own passed. Sent it out and it was faulty. That's right now. We're having to depend on the many labs around the country and commercial laboratories to develop and offer this test. We are really just gearing up now for that The Stanford test which is the one that's being used regionally also for a variety of medical institutions. I think they This week they were offering between two and three hundred a day. They say that next week they'll be up to about a thousand a day. That obviously is not remotely enough to track the where the epidemic is going But that's what we have right now. Regionally nationally I don't know what the capacity is but as Dr Fao. She said we are way way behind. Well let's bring Professor Justin Wrestler into this conversation from Hopkins from Johns Hopkins. Let's talk about. Why testing is so important. Why is it so important that we know in this country Where the disease is where the outbreak is. Why is it important to know the number I mean this is our ability to have situational awareness about what's going on with the virus where it is how to react. So the most extreme measures that we take to combat the virus essentially potentially closing whole cities down like they did in China Italy. We don't WanNa do those places where there isn't a lot of you know there isn't actually a lot of disease and we don't want to wait till the hospitals are filling up with dead people to do those because then it's too late so we want to react in time and that has to that means we need testing and that means we need to be testing with the right intention. I think there is still some inertia towards trying to test people who've traveled etc with the idea that we're going to go around those people and contain and Tristar contacts and try to find those chains of transmission But I think we maybe need to rethink that with the idea that we really want is situational awareness about what's going on in the community and what's our silent out you know. What silent outbreaks might be happening so that we can respond? Accordingly in our public health measures in terms of people isolating themselves. Dr Steve Goodman if you can talk about what it means not to have a test so you don't know even if you've been exposed to someone who has tested positive and also. Isn't that true that these tests at this point in most cases take days to get results although there are some that are now being developed that simply take hours but what it means for people protecting the community well as Justin said people don't actually know what the threat is. They don't know how many people around them have the disease and they don't know Obviously whether they themselves have the disease if if they have been exposed so it's very very difficult for either public health authorities to calibrate the response properly is Justin Just described or individuals to calibrate their own actions. And and I also want to point out that when we talk about self-isolation or anything that an individual can do the paradigm really has to be not. Just what can I do to protect myself? But what can we each do to protect each other and the act of self isolation is not just individual protection is protecting everybody. You're in contact with but to know how extreme the behavior should be whether you should not go to a park whether you should not go to. The store is very much driven by. Your awareness is just describe it. Situational awareness of how many cases there are often silent cases in your own community in your own neighborhood going to your own stores so this decision. That's personal decision has social and health consequences but without testing. We're flying blind. I WANNA go to the issue of Corona virus. And if you could talk about the different steve or what? The language is corona virus. Cova nine thousand nine hundred for people to understand. Explain that the lexicon there of this disease and also how it compares to the flu. President trump has repeatedly tried to say that the flu kills tens of thousands of people. He said who knew the flu killed. It actually turns out that his grandfather. Friedrich trump died of the flu in this country at a young age but he tried to use it to show you know. Corona virus doesn't even compare so talk about both the language we use and what it means in comparison with the flow. Well Cova nineteen is the name of the disease not the virus specifically And what we're most concerned about is obviously The spread of the disease. Let me talk about The flu and the flu is a big killer and it doesn't affect many people. I think we have roughly in the range of fifteen to twenty million in this season alone in the United States with roughly one in two thousand death rates so in the in the range of fifteen to twenty thousand deaths from the flu so a flu is very very serious. But that represents roughly five to seven percent of the population and the We have and the reason it doesn't represent more is because both we have flu shots and we have years decades of of of of sort of cross reactive immunity built up over people who've been exposed to different Virus strains the difference in this with this virus is to first of all no one is immune so in theory. A hundred percent of the population is susceptible to this virus or very close to it. the second part is the the fatality rate Either for people who present to the medical care system sick enough to go to a doctor or per infection which is something different because not everybody who is infected necessarily goes to a doctor looks to be a fair bit higher than the flu. Maybe on the order of five times maybe even ten times higher than the flu so we have a maybe a much much larger reservoirs susceptible people on the order of ten to twenty times larger and we have a fatality rate. That is between five and ten times larger. So that's why the potential for this even though we have a tiny fraction of the cases and deaths right now why we're taking the extreme measures that we are taking now. All that said a lot of the Taliban rate can be affected by what we do. And that's why we're doing it now. Because the fatality rate is a function both of the age of the people who are infected but also of the capability of the medical care system to take care of them. So we can protect the medical care system that is keep the number of patients coming in at a rate that they can be cared for with adequate ICU beds and ventilators et Cetera. And also healthy Medicare folks. We can keep the That we can keep the totality rate low or least lower than it would have been without that. We're going to break come back to this discussion. We're going to talk about strategies to keep yourself and your family healthy what to say to children both of you. Dr Goodman and Dr. Leslie have children how you're talking to them about. What could be to say the least extremely frightening for them as it is for the whole population and I want to ask Dr. Less learned about the study. He did in China comparing Wuhan and how it dealt with the corona virus with community. Right next door. We're talking to Dr Steven Goodman. He is associate dean of the Stanford Medical School and just an Leslie. Johns Hopkins Bloomberg School of Public Health. Associate professor this is democracy. Now we'll be back with them in a minute is The where A Long Day is over by Norrie. Jones this is democracy now the warring piece report. I'm Amy Goodman and I also just want to say I can't say enough about the team of people who are making this broadcast possible as everyone in this country right now is dealing with this pandemic as people are around the world it takes a community and we have an amazing one here and I am ever thankful every single day seven weeks since the first case of the corona virus was reported in the United States. We're spending the hour looking at. How the trump administration not only has failed to account for what is clearly thousands of infections in this country because of ongoing problems with access to testing. But we're talking about what needs to happen next. This is the critical issue. We're broadcasting from New York. The mayor of New York just cleared a state of emergency in the city. He said while they're about a hundred people who have tested positive just in New York City alone next week. He expects it to be a thousand just down the road in new Rochelle. Westchester is the epicenter of the Corona Virus And that came from one person who tested positive and very soon after his wife and two kids tested positive and now there's well over one hundred fifty people. The National Guard are now in new Rochelle. The schools are closed. They WANNA make sure kids get food because many kids all over this country get free lunch at school. What happens when the schools are closed? So we're going to be talking about a lot of issues still with us. Is Dr Steven Goodman? Associate Dean at Stanford Medical School where he's also professor of academia in population health and medicine Trained as a pediatrician. He is also my brother. My lifeline on issues like these. He's joining us from Stanford University and joining us from Baltimore is Justin Leslie Associate Professor at the Johns Hopkins Bloomberg School of Public Health Senior author on a new study that suggests the median incubation period for the new corona viruses about five days so Justin Leffler I WANNA start there. What does that mean? Why is that significant that the incubation period is perhaps five days? We've been hearing a lot about ten and fourteen and then I want to ask you about your work in China. So the median incubation period is five days so that means a fifty percent of people are going to develop symptoms within five days of being infected. But it's important to remember that's not necessarily the number we're most concerned with if we're thinking about quarantine active monitoring or self-isolation after a potential exposure. Because you know we don't have the people who are infected to be out there on in the community potentially spreading the virus before they know they have it so what we're more concerned with is what we call the long tail of that and that's where we get to the fact that in our study we showed that about ninety. Eight percent of people develop symptoms by twelve days which suggests that the fourteen day period of quarantine or active monitoring suggested by almost every public health agency around the world is pretty good. I mean some people will get through that But you know but it's pretty good and it's going to capture. The vast majority of people who would develop symptoms will do so during that period. So let me ask you about your work in China. Talk about the study that you just completed comparing Luhan to a neighboring city. Tell us about the outbreak in Wuhan. What happened how it was dealt with and how it was dealt with nearby so just to be clear. Our study was looking at the epidemiology in China. We weren't directly comparing with Wuhan but Wuhan just to talk about it. Had you know is the epicenter of the entire outbreak? They clearly had things get out of control in the beginning and had the shut down the entire city and really a lot of the whole province of WHO bay which they've now had to do in Italy as well so it's an example of both how bad things can get if we're not careful about staying on top of things and very proactive. But it's also an example of the fact that you know massive direct action can sort of squash the epidemic and stop the virus so where we did our work in Shenzhen. There hasn't been a big outbreak and part of that. I think is a proactive. Social distancing measures so the types of things. We're starting to see in the United States. Now GET STOPPING MASS EVENTS. Having people work from home and the like but they also had very intensive surveillance and very intensive contact tracing of cases that came in from. Who Bay province and elsewhere in China and that probably played a big role in why they didn't have an epidemic. So can you talk about the fact that it looks like both in China? It's hard to say we're saying there's good news out of China right now because of this terrible pandemic but the actual good news. That's coming out of China and South Korea as opposed to what we're seeing right now in Italy and now the United States were just beginning understand the scope of the outbreak here. Yes China clearly has been able to contain the disease at least temporarily. I think there's a big question of what happens as they start to dial back. All of the extreme measures they've taken in order to contain the disease and whether. We see a resurgence or whether they're excuse me whether they're able to do that. In a way that more gradually a more gradual dial dial back in a way that prevents the virus from resurging and in the country and Italy. Is You know I think? Italy's taking a similar course to China where it remains to be seen. How effective it is you know it is in Italy. It's very different. Culturally population is different and us were in a different part of the outbreak. And I think the hope is since we're early by doing things proactively canceling the NBA cancelling the NCAA tournament. Everybody working from home closing schools that we can get to a point where we're slowing the spread of this virus without having to have measures as extreme as we're taken in China Dr Steve Goodman if you talk about what's happened in Italy The horrific Turn of events there where the entire country is on lockdown where the medical system is clearly overwhelmed and then talk about the United States and this whole issue of flattening the curve a term. I think a lot of people are just beginning to hear right now. But what do you understand? Took place in Italy Well I haven't I don't have special expertise about Exactly what's going on Italy? But what is very very clear. Is that the The gree of spread and And present a has overwhelmed. The medical care system. That is very clear. So part of what's happening. There is an example of winning when an epidemic goes to its peak and is greater than the medical infrastructure. Can Take care of it and as you may know There have been extremely poignant. pieces Both tweets and and other forms of communication by Italian doctors who literally have with great distress talked about how they had to basically choose life and death for patients for whom they had to choose who to ventilate and who not to because they had a limited number of ventilators. So we don't want to get there in this country so again. It shows that the case fatality rate which ultimately is one of the numbers that that produces the most fear is a is a function not only how many cases or how many serious cases but how much can be absorbed and properly treated by the medical care system. And so that gets right into your second question which is about flattening the curve. The the goal of mitigation efforts now which is to obviously lower the number of cases and spread them out is to keep the number of cases to a level where the medical care system can adequately take care of each one where we have enough personnel where we have an offense leaders. We have enough. Icu beds we have enough beds in the hospital. Take care of everybody. Optimally and the idea of flattening the curve is taking a certain number of cases that would occur in a certain period of time and spreading it out over time for the peak is less and so it occurs over a much longer period of time and hopefully obviously also reducing the number of cases but this match both regionally and nationally between the number of facilities personnel beds and equipment This has to be matched with a number of cases that are in that area. It would be nice to hear from public health officials or national officials how they plan to shift resources. If in fact the medical care capabilities in any particular region is outstripped by the number of cases. But that's what flattening the curve is all about and that's what all of the measures just described by yourself and by Justin are attempting to do and this issue of respirators in the United States of ventilators of the access. Most people they do not want to go to the hospital even to their doctors offices Most people actually will survive this and it's like Flu and for many people it's mild and for children even less so though they can be carriers but this issue of overwhelming. The number of respirators ventilators hospitals around the country. Can you explain that well? Obviously the numbers are limited. I think we have on the order of a million beds and The actual number they're available in any one day about a third of that the number of ICU beds is a fraction of that. And I WANNA make a particular point that this is not just about caring for Cova patients the the number of covert patients entering. The system affects the care of other patients. So the kinds of things that we take for granted in terms of care of any of us for any serious disease is affected by the demand on the medical care system for the care of Kobe patients. So we are not Geared up as a society for the with the surge capacity to handle the number of potential Kovic patients that we would get if we didn't do anything so the kinds of things we're doing now are to keep the numbers below the surge capacity the limited very limited searched Bassetti that we have and again. This is not just a national issue. We can't just count up the number of national beds. We have to look at this regionally. The number of cases in New York City with a number of ICU beds in New York City and have facility to move those cases. If in fact those numbers don't match up Steve Goodman is associate dean at Stanford Medical School. Justin less ler is a professor at Johns Hopkins Bloomberg School of Public Health. Where continuing with them. After this break. Awesome the reckoner by radiohead. This is democracy. Now I mean goodman the British government says up to ten thousand people may now be infected by the corona virus on Thursday British Prime Minister. Boris Johnson called on people who are sick to self quarantine. This is the worst public health crisis for regeneration. Some people compare it to seasonal flu. Alas that he's not right owing to the lack of ood immunity. This disease is more dangerous. And it's going to spread further and I must level with you level with the British public. More families. Many more families are going to lose loved ones before that time. British Prime Minister Johnson. He did not close. Schools are banned gatherings of more than five hundred people. Britain's chief medical officer said in a worst case scenario more than eighty percent of Britain would contract the virus with one percent mortality rate that equates to more than half a billion deaths five hundred thousand half a million deaths half a million here in the United States during his press conference in Vermont Thursday Senator Sanders said the federal government would prioritize the care of communities. Who are that. They should prioritize the care of communities. Most vulnerable during the corona virus pandemic the elderly people with disabilities in house. People low income people. Those who are uninsured an unemployed we need also in this economic crisis to place an immediate moratorium on evictions on Foreclosures and on Utility shut offs. So that no one loses their home during this crisis and that everyone has access to clean water electricity heat and air conditioning. We need to construct emergency homeless shelters to make sure that the homeless survivors of domestic violence and college students quarantined off. Campus are able to receive the shelter the health care and the nutrition they need Bernie Sanders and Joe Biden. We'll debating in Washington D. C. as opposed to Arizona where they were going to debate and there will not be an audience because of the Corona Virus Dr Steve Goodman Dan Dean at Stanford Medical School and Justin Leisler professor at Johns Hopkins Bloomberg School of Public Health or with us from Baltimore and from Stanford California Dr Steve Goodman this issue of the poor in the United States and people who are working poor who are without insurance people who are unemployed while everyone says that the corona virus hits everyone which is clearly true there are communities that are particularly vulnerable right now how they be protected well this is an issue for public health officials. Obviously they have to be able to take the same measures that anybody would take to to reduce the spread. The ones we've already talked about however the ability for less wealthy or poor individuals to take time off from work to sequester themselves in their homes To Take care of their children May Be quite different than than others. So we we have to think about it. I think Bernie has it about right. We have to think about this as a social responsibility. Not just a an issue for individual action because people's ability to protect themselves are constrained by their own economic circumstances in their own living circumstances if they're living in very very tight quarters with many people in in in in in communities where other people might be sick it is very very difficult for them to take care of themselves and needless to say if they don't have access to medical care or they're afraid to seek it because of Because they're afraid of the bills. That's another huge problem. Easy for people to get tested and to access care and if they're undocumented and afraid to seek and afraid to seek testing as well absolutely justin less slur if you could also address this issue and then. I'd like to ask you how you're talking to your children so I agree. It's absolutely critical to find ways to protect those populations that are not going to be able to take social distancing measures have more trouble with that potentially have food insecurity if they don't go to school or go to places where there might be mass gatherings and I think you know it's one of those things where we do have an individual responsibility not to just you know. Keep ourselves out of the community but do things to help others. Keep themselves out of the community. You know the government is going to be overwhelmed by this and you know we're not as a country set up to provide services in a crisis the way is maybe needed now and now there's a bill being weighed. The Democrat led. House set to vote on a bill that would grant workers fourteen days of paid sick. Leave up to three months of paid family and medical leave. Unemployment Insurance to furloughed workers includes additional five hundred million dollars to help feed low income pregnant women or mothers with young children who lose their jobs or laid off because of the virus outbreak President Trump said. He did not support the bill. But because we're coming to the end of this conversation as people push hard for the entire community to be protected the that sits individuals but it also brings out the importance of people around the world as a community. Can you talk about what you're saying to your kids professor less ler? Yeah I mean my son is six and his school just got cancelled so I'm trying to explain to them that there's the disease out there. It's scary It's wondering why his dad's working so much but the I'm trying to explain to him that it's important to wash his hands that it's important to you know. Think about what he's doing out there in the community and that maybe he won't be able to go to school do the same things that is that he is usually able to do for fun. I can talk more explicitly to my mother who is in their seventies in high risk who I had to sort of say this is real. Stay home self isolate. Don't don't go out and this is why is that. The children don't tend to children. This is not as fatal for as it is for older people especially over seventy and eighty right. I mean and Wuhan at last report I saw from Honda was in detail out of out of thousand deaths over a thousand deaths. Only one was in people somebody under twenty years of age so it's pretty mild and children do not seem to be at risk even more so than the flu where we see children get sick and potentially die occasionally in the youngest age. That doesn't seem to be happening right now for the current virus and but we do not know we know they can get infected and we do not know whether or not they can pass it on so you know keeping children Critical part of our more imperilled presumably. We don't know for sure And Steve What you tell your kids my nieces and nephew who are bit older but also as so many people in this country afraid right now. So what's interesting is that my kids are both in college actually here at Stanford and they're more worried for us. I don't have to tell them everything anything they read. They're smart and they're much more concerned about their threat to us than Than than anything else. So they're taking the steps they need to take to prevent us from getting sick. And it's a very interesting reversal of generational roles. Perhaps a premonition of the future but I think this is a responsibility that many young people feel not just protect themselves because they themselves are not that worried but they are definitely worried about the older generation the same way that Justin is concerned about his mom and of course Gerald Starter just had a baby here in New York in the midst of this pandemic indeed. Yes and she is Naturally self isolating but Is is being extremely careful about her own exposure and needless say their new child. Well I WANNA thank you both for being with us Dr Steven Goodman Associate Dean at Stanford Medical School where he's also professor epidemiology and public health and medicine and also my brother and just in less ler says she professor Johns Hopkins Bloomberg School of Public Health. We also want to welcome to the world. Andre Sorry Marino Camarena congratulations to eagerly and Drian. That does it for our show. Everyone wash your hands be safe. I'm Amy Goodman an enormous. Thank you to the whole team. That may democracy now happened today.