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hello everyone my name is michael berry

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i am the director of the UCLA Center for

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chinese studies and a professor of asian

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languages and cultures and it's my great

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pleasure to be hosting this event and be

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able to be introducing our speakers

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tonight we actually way back in February

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on February 10th the Center for Chinese

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Studies co-hosted an event with the

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School of Public Health at UCLA which

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was probably one of the earliest events

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on the corona virus in the United States

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an academic forum and one of my guests

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for that event and a participant and

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actually kind of our co-conspirator well

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put the whole thing together

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was Professor Roger D Dalls who is a

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distinguished research professor of

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Epidemiology and infectious diseases at

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UCLA he is also the director of the

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multi Center aids cohort study and he is

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dean emeritus of the UCLA School of

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Public Health and Rogers been a great

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supporter of the Center for Chinese

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studies for many years and I'm so happy

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that he's agreed to join us tonight as a

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kind of moderator and discussant but his

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first duty is going to be to introduce

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our wonderful speaker and so I'm going

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to turn it over to Professor details' to

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introduce professor Wu who will be the

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main speaker tonight professor Wu has

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worked in the field of hiv/aids for over

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30 years and it's published over 450

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academic papers he was the architect and

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the longtime director of the very

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successful China AIDS Control program he

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has received many honors including the

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2005 International Rolston Award for

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implementing harm reduction in China he

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was elected to the Hall of Fame by the

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fielding School of Public Health at UCLA

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and he's received the prestigious UN

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AIDS gold medal in 2008 and has received

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innumerable awards from the government

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of China relevant to today's talk

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dr. wu has also actively involved in

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china's successful response to the SARS

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code one epidemic which occurred in 2003

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and he is now playing a leading role in

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China's response to the SARS op2

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epidemic in China and so he can give you

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firsthand knowledge of how to go about

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confronting a disease that was totally

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unknown five months ago so I I should

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also say that the professor Wu is a

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graduate of UCLA and we're more than a

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little proud of him so yeah thank you

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for your introduction and also sank that

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barrier for organized this online

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lecture so it's great pressure to join

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you I'm going to talk use my PowerPoint

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slides

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let me

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you

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you

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so what I'm going to talk

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it's a prevention of kuba 19 from a

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public-house spective in China

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so let's go back to reveal early events

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so in last December cities the first

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epidemiological alert was the rest the

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bar local Wuhan Health Authority

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second day National Health Commission in

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China CDC immediately sent invest

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investigation team to look who helped

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make the investigation the early cases

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had common exposure there were policy

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for the market the market was closed

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immediately the following day on January

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1st even we do not know what causes a

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pneumonia

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we immediately reported the Chi perpetuo

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and other countries including United

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States we informed in there it's unusual

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epidemic we do not know what is a

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passenger yet the common symptom it's a

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pneumonia On January 7th prana virus was

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isolated and identified as a pathogen

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for this epidemic on journey returns we

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had live as a sequence shared with de

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Blasio and other countries letter

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sequences sharing is very important to

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for other countries to make a bagging of

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speaker feeds on January 11th the first

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the PCR test the Keats was sent it to

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Wuhan or clinical diagnosis on January

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20th kuba 19 was a to the to notify

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about disease is required by law for all

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the doctors need to report cases

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diagnosed at wieszczyk over the 19 three

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days later who has city was shut down in

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the following days another 15 cities in

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Hawaii was shut down

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so review these early events will

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disband it very quickly it only took

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seven days to identify pathogen it only

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took four days to develop test the keys

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the earliest scientific funding is

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critically important that you response

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to the epidemic the key finally include

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identify virus as a pathogen for the

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epidemic we developed test the keys for

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diagnosis we identify incubation period

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for cover 19 we also identified a

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transmission mode all of this together

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are very important scientific base for

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develop control strategy for China as

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well for the rest of the world so this

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rice user epidemic curve occurred in the

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China in the early epidemic click early

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around behind shut down large number of

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coordinating cases could not be admitted

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to the hospital - bottle acts in the

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early epidemic one is hospital bed many

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patient cannot be admitted to the

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hospital

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the either stay in the clinic crowded in

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the clinic or stay at a home that Acosta

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rep the transmission among patients and

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in the community

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the second better lag it's as a

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capability to provide PCR test for aging

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the wedding for diagnosis the calm

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symptoms of curve 19 in the China its

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include fever dry cough fatigue there

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are most common three symptoms and we

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also observed clinical diagnosis of

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cases Lee's murder of moderate case

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severe or critical case four critical

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case commonly observed among patient

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have medical conditions such as

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hypertension diabetes cardiovascular

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disease lung disease or kidney disease

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this dynamic a change of the clinical

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diagnosis or symptoms on the onset of

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illness patient may be mitre or moderate

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or severe or critical so most of them

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recover some become severe so without

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reasonable care some moderate or minor

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cases become severe or critical Sammy

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died best on the early assessment we

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have three a key in size fester on

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epidemic in the China and the first to

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look eight transmission dynamic so the

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close contactor was the major epidemic

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transmission mode in the China so we

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observed a majority across contact earth

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diagnosis cases so firmly crossed

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accounted for majority a secondary

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attack the rates it was about ten

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percent in the early outbreak and

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reduced to three percent with a faster

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isolation of cases from a community

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transmission in the close setting is a

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happy Nimba is not a major driver in the

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China and

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in the school has not been observed that

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it's simply because during the epidemic

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season

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so most of schools are closed so far

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even today we only have a small

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proportion of a school opened most are

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take online class

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so Moses ago were opening in the early g

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m-e june the second alleged history at a

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diagnosis approximate 80% are martyr or

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moderate fifteen war severe five percent

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were critical approximate ten to fifteen

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percent of my to moderate case become

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severe approximated 15 to 20 percent of

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severe become critical in terms of

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average time from exposure to onset of

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symptom was five to six days every time

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from symptom onset to recovery for minor

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cases it's about two weeks for severe

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cases is a three to six weeks every time

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from onset of symptoms to - it's two to

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eight weeks truly a simple medicate

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infection is unknown without a

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theological study so in the initial

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early with our estimation about less

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than one percent in terms of prevalence

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we are now doing nationwide serological

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survey the study is ongoing we have

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connected a specimen laboratory testing

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just a finished we're not doing on an

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isis the final result will be issued to

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the public very soon children tend to be

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minor disease then a doubt so wicked and

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an isis the mitre or moderator case a

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kind of for over ninety percent among

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children aged at a less than a GS 18

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years number three wire ology

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Myra's sharing is a heist earlier in the

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course of disease

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so what are we are identify for mars

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sharing it is started cheap about one to

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two days prior to simply unset that is

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very important for the public health

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prevention message so i still remember

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in the CROI meeting i made a

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presentation i remind because this virus

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shedding is a different from massage the

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public wear mask is very important to

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stop transmission

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the virus can isolated from us - but

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there's no epidemiological evidence for

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fecal or a transmission yet while I was

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a sharing usually continues for seven to

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twelve days in the minor motor of the

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case could it be more than two weeks in

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the severe cases patients who recover

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and be PCR positive after symptom

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reserve resolve we still observe some

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who patient she say are positive even

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the diagnosis could be 19 in a February

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so it we do not understand is the

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continuing sharing virus or they have

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Rick Rick infected

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we are still carry out a study to

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understand so China uses a fundamental

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public health measures to to contain the

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epidemic that including universal

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population measures everybody wear masks

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and hand-washing and keep distancing the

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second case on assassination and

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management that's very important to

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quickly identify cases and isolate them

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from a community in order to reduce

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transmission in the community number

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three close contact to quarantine so for

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all the diagnosis cases we make

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immediately epidemiological

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investigation identified crews

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contactors all the close contact s

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needed to be quarantined for 14 days

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either at a home in the early stage

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finally ordered closed contactor hood in

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the designated hotel for quarantine the

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number for suspension of paprika

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gathering the number of five move and

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the restriction

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let's look it is a magnitude of this

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public health message in numbers

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nationwide we have one point of opening

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people on the wind at least ten days at

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a home isolation or quarantine so that

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are very important that you separate the

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suspected people with infecting people

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that it's very powerful to stop

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transmission look at a Hebei province we

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have a turtle fifty nine point two

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million people subject to condom

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sanitaire for two months for who has

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city we have over 10 million people shut

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down for 76 days the hospital bad in the

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early epidemic they were only about two

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sovereigns hospital bed for infectious

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disease the hospital bed increased

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sharply quickly to over 50 sovereigns

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that including building new hospitals

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and 16 temporal module hospital or share

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hospital health workers were overloaded

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and we have over 40 servants health

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providers deployed to Hebei to provide

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assistance that is critically important

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that you reduce workload four loko has

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workers that also have for to reduce the

280

00:16:36,020 --> 00:16:47,089

inception among has providers so we made

281

00:16:44,170 --> 00:16:50,810

differentiation of a level for cases and

282

00:16:47,089 --> 00:16:53,810

probe are given the care in isolation in

283

00:16:50,810 --> 00:16:58,570

terms of category we have turtle or

284

00:16:53,810 --> 00:17:02,240

flies close contact us suspected cases

285

00:16:58,570 --> 00:17:04,320

minor or moderate case severe case and

286

00:17:02,240 --> 00:17:07,580

the critical case

287

00:17:04,320 --> 00:17:08,850

for close contact us our spreading it

288

00:17:07,580 --> 00:17:12,840

quarantine

289

00:17:08,850 --> 00:17:17,880

either at home or in the hotel the early

290

00:17:12,840 --> 00:17:20,220

experience terrors home quarantine is

291

00:17:17,880 --> 00:17:22,830

not the best because at a home you

292

00:17:20,220 --> 00:17:24,450

cannot really perform quarantine they

293

00:17:22,830 --> 00:17:28,470

still have contacted with a feminine

294

00:17:24,450 --> 00:17:31,320

members still have family transmission

295

00:17:28,470 --> 00:17:34,830

then we changed our policy all the close

296

00:17:31,320 --> 00:17:37,290

contact us must be put in the hotel for

297

00:17:34,830 --> 00:17:39,630

quarantine in order to reduce the

298

00:17:37,290 --> 00:17:42,920

transmission because it was contact that

299

00:17:39,630 --> 00:17:47,490

maybe or a very inception it just had be

300

00:17:42,920 --> 00:17:52,200

pre-symptomatic stage for suspected

301

00:17:47,490 --> 00:17:55,010

cases usually put a JIT general hospital

302

00:17:52,200 --> 00:17:57,990

we also met a mistake in the earlier

303

00:17:55,010 --> 00:18:00,150

perspective cases some may inception

304

00:17:57,990 --> 00:18:02,430

some may not infected it does not have

305

00:18:00,150 --> 00:18:05,790

the left her to confirm yet they are

306

00:18:02,430 --> 00:18:09,060

working for laboratory information so is

307

00:18:05,790 --> 00:18:13,740

good suspected cases in the same world

308

00:18:09,060 --> 00:18:18,420

that may also create transmission among

309

00:18:13,740 --> 00:18:20,730

suspected cases so suspect suspected

310

00:18:18,420 --> 00:18:23,280

cases and must be put individual world

311

00:18:20,730 --> 00:18:28,290

in the hospital cannot be put in the

312

00:18:23,280 --> 00:18:32,370

same world reminder moderator case this

313

00:18:28,290 --> 00:18:35,970

majority accounted for 80% of diagnosis

314

00:18:32,370 --> 00:18:38,250

cases we have neither symptom they do

315

00:18:35,970 --> 00:18:41,910

not need to spit sophisticated to care

316

00:18:38,250 --> 00:18:47,130

so the approach in the fonts on shadow

317

00:18:41,910 --> 00:18:48,630

hospital severe and a critical case they

318

00:18:47,130 --> 00:18:52,040

must be prudent in the general hospital

319

00:18:48,630 --> 00:18:58,590

or designated as sophisticated or

320

00:18:52,040 --> 00:19:01,380

advanced the care hospital now I want to

321

00:18:58,590 --> 00:19:03,180

use a few slides to hi not shut Hospital

322

00:19:01,380 --> 00:19:06,750

yes creeper important the public health

323

00:19:03,180 --> 00:19:09,870

measures to contain the epidemic the

324

00:19:06,750 --> 00:19:13,350

Sham hospital has five physical

325

00:19:09,870 --> 00:19:15,780

functions first isolation that's a

326

00:19:13,350 --> 00:19:16,800

critical important put a patient in the

327

00:19:15,780 --> 00:19:17,880

shadow hospital

328

00:19:16,800 --> 00:19:20,250

isolate them

329

00:19:17,880 --> 00:19:22,260

the community and a reduced transmission

330

00:19:20,250 --> 00:19:26,730

in the community there's a critical

331

00:19:22,260 --> 00:19:30,270

important that you stopped epidemic ii

332

00:19:26,730 --> 00:19:33,660

triage so patient in the shelter

333

00:19:30,270 --> 00:19:36,420

hospital are mitre or moderate let me

334

00:19:33,660 --> 00:19:39,810

become severe severe that need to be

335

00:19:36,420 --> 00:19:43,490

referred to that designated hospital so

336

00:19:39,810 --> 00:19:48,630

that's a critical important for triage

337

00:19:43,490 --> 00:19:52,640

number three basic supportive medical

338

00:19:48,630 --> 00:19:57,420

care the number for the any monitoring

339

00:19:52,640 --> 00:20:00,410

rep the referrer number five essential

340

00:19:57,420 --> 00:20:06,780

living a commendation and the social

341

00:20:00,410 --> 00:20:08,190

engagement so services provided EDA

342

00:20:06,780 --> 00:20:12,270

funds on shadow hospital including

343

00:20:08,190 --> 00:20:14,670

following monitoring body temperature

344

00:20:12,270 --> 00:20:17,730

blood oxygen situation and blood

345

00:20:14,670 --> 00:20:18,590

pressure are monitored times three times

346

00:20:17,730 --> 00:20:23,340

a day

347

00:20:18,590 --> 00:20:26,970

number two medications and the

348

00:20:23,340 --> 00:20:31,190

virotherapy eros or inhalation are

349

00:20:26,970 --> 00:20:33,660

provided to patients number three

350

00:20:31,190 --> 00:20:38,510

consonant consonant were provided to

351

00:20:33,660 --> 00:20:43,650

patient experience fear anxiety panic

352

00:20:38,510 --> 00:20:47,630

never for exercise square dancing and

353

00:20:43,650 --> 00:20:51,000

Taiji are two common exercises is

354

00:20:47,630 --> 00:20:54,120

implemented time two times per day

355

00:20:51,000 --> 00:20:56,930

that's very important to for a patient

356

00:20:54,120 --> 00:21:03,690

to be engaged in the shadow' hospital

357

00:20:56,930 --> 00:21:06,000

the number five transfer ease minor or

358

00:21:03,690 --> 00:21:09,120

moderate a patient's condition become

359

00:21:06,000 --> 00:21:12,320

was they will be immediately transferred

360

00:21:09,120 --> 00:21:16,320

to the decks designates the hospital's

361

00:21:12,320 --> 00:21:19,970

the number six discharged when clinical

362

00:21:16,320 --> 00:21:25,530

symptoms or city emerge become a problem

363

00:21:19,970 --> 00:21:28,320

ology as resolved MO and also to

364

00:21:25,530 --> 00:21:30,750

negative PCR test the results then

365

00:21:28,320 --> 00:21:31,780

patient will be discharged from a

366

00:21:30,750 --> 00:21:34,330

hospital

367

00:21:31,780 --> 00:21:39,060

they are continued to be observed for

368

00:21:34,330 --> 00:21:39,060

two weeks in the community or at home

369

00:21:39,780 --> 00:21:45,160

here an example of activity in the

370

00:21:42,910 --> 00:21:49,270

shadow hospital in the left side a

371

00:21:45,160 --> 00:21:52,390

patient had taken oxygen in the middle

372

00:21:49,270 --> 00:21:56,230

it's a health workers to monitor

373

00:21:52,390 --> 00:22:00,400

patients symptom the number the right

374

00:21:56,230 --> 00:22:07,300

side it has provider training the

375

00:22:00,400 --> 00:22:11,170

patient how to do hand-washing this uses

376

00:22:07,300 --> 00:22:16,660

a change of function shadow hospital so

377

00:22:11,170 --> 00:22:19,210

in I think in the ops in half that that

378

00:22:16,660 --> 00:22:22,600

blue it's a number of patients

379

00:22:19,210 --> 00:22:26,260

discharged it is charged in the light

380

00:22:22,600 --> 00:22:29,170

blue in the light blue it's the number

381

00:22:26,260 --> 00:22:32,200

of hospital bad shadow hospital bed

382

00:22:29,170 --> 00:22:34,960

being used for the patient though in the

383

00:22:32,200 --> 00:22:37,690

night read in the light of red is a

384

00:22:34,960 --> 00:22:41,410

number applications in the shadow

385

00:22:37,690 --> 00:22:46,780

hospital were transferred referred she

386

00:22:41,410 --> 00:22:50,230

hospitals for advanced the care the red

387

00:22:46,780 --> 00:22:52,960

bar she was the number of patients

388

00:22:50,230 --> 00:22:59,140

discharged cumulatively from shadow

389

00:22:52,960 --> 00:23:01,600

hospital so they are three advantages

390

00:22:59,140 --> 00:23:05,010

and a two disadvantages

391

00:23:01,600 --> 00:23:10,360

shann hospital can be rapidly

392

00:23:05,010 --> 00:23:11,850

constructed just a Buda a hospital

393

00:23:10,360 --> 00:23:16,390

shadow hospital

394

00:23:11,850 --> 00:23:18,930

it'll be massive scare the hospital bad

395

00:23:16,390 --> 00:23:21,580

capacity could be in the sour ins

396

00:23:18,930 --> 00:23:25,030

provided to the patient at just two to

397

00:23:21,580 --> 00:23:29,410

three days the low-cost it will only

398

00:23:25,030 --> 00:23:32,070

require small number of as workers to

399

00:23:29,410 --> 00:23:37,690

provide a care to naughty number earth

400

00:23:32,070 --> 00:23:41,860

patients to disadvantage the privacy

401

00:23:37,690 --> 00:23:45,070

cannot be guaranteed and not easy to

402

00:23:41,860 --> 00:23:51,549

meet individual demand in such

403

00:23:45,070 --> 00:23:55,840

at a hospital so now update epidemic

404

00:23:51,549 --> 00:23:58,330

over 19 in the China by May 15 just a

405

00:23:55,840 --> 00:24:02,049

week ago we have to talk cumulative

406

00:23:58,330 --> 00:24:06,130

eighty two thousand nine hundred thirty

407

00:24:02,049 --> 00:24:13,539

three total reported cases and we have

408

00:24:06,130 --> 00:24:16,870

two accumulative days for sovereigns 633

409

00:24:13,539 --> 00:24:21,370

there already included over sovereigns

410

00:24:16,870 --> 00:24:21,990

under reported cases I met a few weeks

411

00:24:21,370 --> 00:24:26,259

ago

412

00:24:21,990 --> 00:24:30,460

ha the turtle could crest fatality ratio

413

00:24:26,259 --> 00:24:33,759

was five point five nine percent now the

414

00:24:30,460 --> 00:24:38,080

epidemic in the China majority are

415

00:24:33,759 --> 00:24:41,409

imported to cases so you can see the

416

00:24:38,080 --> 00:24:45,360

right bar so the rare cada is imported

417

00:24:41,409 --> 00:24:48,730

cases the overall number is very small

418

00:24:45,360 --> 00:24:53,490

so we interpreted the epidemic

419

00:24:48,730 --> 00:24:56,830

it's a almost ended now so our emphasis

420

00:24:53,490 --> 00:25:02,750

to prevent importation in a possible

421

00:24:56,830 --> 00:25:06,020

second away the review

422

00:25:02,750 --> 00:25:10,340

epidemic and the response we have eight

423

00:25:06,020 --> 00:25:13,580

lessons summarized the first size

424

00:25:10,340 --> 00:25:15,890

treatment response as I presented in the

425

00:25:13,580 --> 00:25:20,750

first slides in the earlier response

426

00:25:15,890 --> 00:25:23,530

with quickly for scientific funding that

427

00:25:20,750 --> 00:25:27,550

is critically important for developing

428

00:25:23,530 --> 00:25:29,450

control strategy the number to call

429

00:25:27,550 --> 00:25:31,250

traditional public health measures

430

00:25:29,450 --> 00:25:34,850

create a significant role in the

431

00:25:31,250 --> 00:25:37,820

controller epidemic that including wear

432

00:25:34,850 --> 00:25:41,750

a mask hand-washing social distancing

433

00:25:37,820 --> 00:25:44,900

and ventilation for the fresh air all of

434

00:25:41,750 --> 00:25:49,490

these are critical important the number

435

00:25:44,900 --> 00:25:52,370

sir be critical better not been solved

436

00:25:49,490 --> 00:25:57,040

in the early stage that it was hospital

437

00:25:52,370 --> 00:25:59,990

bed and she's our test the number for

438

00:25:57,040 --> 00:26:02,240

community mobilization and the community

439

00:25:59,990 --> 00:26:04,160

response that a critical important we

440

00:26:02,240 --> 00:26:06,590

call the people's war it's a for the

441

00:26:04,160 --> 00:26:11,180

people by the people or the population

442

00:26:06,590 --> 00:26:14,660

mobilized the number five transparent

443

00:26:11,180 --> 00:26:16,940

public communication so we are

444

00:26:14,660 --> 00:26:19,310

transparent in the early stage even we

445

00:26:16,940 --> 00:26:22,520

do not know the passenger for epidemic

446

00:26:19,310 --> 00:26:24,560

we informed aperture and other countries

447

00:26:22,520 --> 00:26:27,350

we communicate with the world the

448

00:26:24,560 --> 00:26:32,390

potential emerging epidemic occurred in

449

00:26:27,350 --> 00:26:35,750

the war ha then we will report with our

450

00:26:32,390 --> 00:26:38,510

new development the number six

451

00:26:35,750 --> 00:26:41,060

international cooperation the number

452

00:26:38,510 --> 00:26:43,570

four seven leadership coordination in

453

00:26:41,060 --> 00:26:50,870

the cooperation the number eight

454

00:26:43,570 --> 00:26:55,190

logistical support in terms of

455

00:26:50,870 --> 00:26:59,000

King experience we developed for defense

456

00:26:55,190 --> 00:27:02,450

nines as a strategy the first defense of

457

00:26:59,000 --> 00:27:04,940

nine was Wuhan and the who Bay the

458

00:27:02,450 --> 00:27:07,610

second a defense of nine was a Beijing

459

00:27:04,940 --> 00:27:10,910

the stirred defense of nine who base

460

00:27:07,610 --> 00:27:14,690

around in regions the forced defense

461

00:27:10,910 --> 00:27:19,490

nine was nationwide so that prioritize

462

00:27:14,690 --> 00:27:21,880

our resources location and our focus for

463

00:27:19,490 --> 00:27:25,220

earlier that important to four

464

00:27:21,880 --> 00:27:30,380

identified cases and isolated cases from

465

00:27:25,220 --> 00:27:36,650

a community early detection reporting

466

00:27:30,380 --> 00:27:39,050

early isolation and early treatment for

467

00:27:36,650 --> 00:27:41,630

the people by the people we have

468

00:27:39,050 --> 00:27:44,090

community engagement community has

469

00:27:41,630 --> 00:27:48,920

education and the community hygiene

470

00:27:44,090 --> 00:27:53,350

entity disinfection three C's another

471

00:27:48,920 --> 00:27:56,420

three C's coordination cooperation and a

472

00:27:53,350 --> 00:27:58,940

communication resource allocation is

473

00:27:56,420 --> 00:28:02,080

critical important that including health

474

00:27:58,940 --> 00:28:04,640

care workers and the PPE equipment

475

00:28:02,080 --> 00:28:10,660

logistical support and a public

476

00:28:04,640 --> 00:28:10,660

understanding and info damage response

477

00:28:12,940 --> 00:28:20,059

we're continuing develop and revise our

478

00:28:16,850 --> 00:28:22,520

technical our garden ins in terms of

479

00:28:20,059 --> 00:28:25,970

diagnostic and the treatment of protocol

480

00:28:22,520 --> 00:28:30,100

we have a total reversion of seven

481

00:28:25,970 --> 00:28:33,230

editions for the prevention we have six

482

00:28:30,100 --> 00:28:37,190

editions already issued we are now in

483

00:28:33,230 --> 00:28:39,200

the stage develop or revise evans

484

00:28:37,190 --> 00:28:43,670

edition for prevention and control

485

00:28:39,200 --> 00:28:51,760

protocol all of this protocol up a beste

486

00:28:43,670 --> 00:28:56,290

are the new knowledge we acquired now in

487

00:28:51,760 --> 00:28:59,890

to control the epidemic and also to

488

00:28:56,290 --> 00:29:04,180

prevent possible second away epidemic we

489

00:28:59,890 --> 00:29:11,050

Tammany make a risk assessment for the

490

00:29:04,180 --> 00:29:14,350

community for low risk area priority is

491

00:29:11,050 --> 00:29:18,220

filmed importation for media risk area

492

00:29:14,350 --> 00:29:21,700

to prevent importation and stop local

493

00:29:18,220 --> 00:29:25,120

transmission for high-risk area stop a

494

00:29:21,700 --> 00:29:27,880

local transmission treatment exportation

495

00:29:25,120 --> 00:29:30,580

and implement stricter prevention and

496

00:29:27,880 --> 00:29:34,690

control measures all of these risk

497

00:29:30,580 --> 00:29:37,810

assessment and strategy is adjust here

498

00:29:34,690 --> 00:29:45,640

best are change over time of the

499

00:29:37,810 --> 00:29:48,820

epidemic for case management so we have

500

00:29:45,640 --> 00:29:51,760

a different category of cases and we

501

00:29:48,820 --> 00:29:54,910

have a different strategy for suspected

502

00:29:51,760 --> 00:29:58,120

the cases should it be isolated in the

503

00:29:54,910 --> 00:30:03,160

single room cannot appear for the two

504

00:29:58,120 --> 00:30:06,460

suspected cases in the same room conform

505

00:30:03,160 --> 00:30:09,940

the cases and a simple Matic infection

506

00:30:06,460 --> 00:30:14,560

could be isolated in the same room such

507

00:30:09,940 --> 00:30:17,830

as in the shadow hospital for discharge

508

00:30:14,560 --> 00:30:21,670

the cases will be given isolation and

509

00:30:17,830 --> 00:30:25,510

has monitor for another 14 days in the

510

00:30:21,670 --> 00:30:28,560

community or at home we encourage ER

511

00:30:25,510 --> 00:30:35,080

full of observation and respiratory

512

00:30:28,560 --> 00:30:38,710

specimen testing for a sim

513

00:30:35,080 --> 00:30:42,549

chromatic infections cases are

514

00:30:38,710 --> 00:30:45,490

asymptomatic need to be isolated and put

515

00:30:42,549 --> 00:30:49,600

it in the medical observation for 14

516

00:30:45,490 --> 00:30:51,820

days if they become symptomatic they are

517

00:30:49,600 --> 00:30:55,570

transferred to the hospital if they

518

00:30:51,820 --> 00:30:59,490

continue to be asymptomatic they will be

519

00:30:55,570 --> 00:31:02,860

discharged when they have a cheapie cr-

520

00:30:59,490 --> 00:31:06,130

for clothes a contactor of asymptomatic

521

00:31:02,860 --> 00:31:08,940

cases they will be treated as Chris

522

00:31:06,130 --> 00:31:11,799

contactor of simple medical infection

523

00:31:08,940 --> 00:31:14,769

any person will have gross contacted

524

00:31:11,799 --> 00:31:19,120

with a simple medical cases need to be

525

00:31:14,769 --> 00:31:21,789

take a specimen for two days and medical

526

00:31:19,120 --> 00:31:24,039

observation will be routed for the crews

527

00:31:21,789 --> 00:31:32,260

contractor at the designated oppressor

528

00:31:24,039 --> 00:31:35,590

such as a hotel contact tracing so for

529

00:31:32,260 --> 00:31:39,039

all a simple medical cases or simple

530

00:31:35,590 --> 00:31:41,919

medical cases we were do investigation

531

00:31:39,039 --> 00:31:45,340

epidemiological investigation try to

532

00:31:41,919 --> 00:31:48,510

identify their close contactor that's

533

00:31:45,340 --> 00:31:53,380

critically important so we use multiple

534

00:31:48,510 --> 00:31:55,960

strategy help to identify eye contact us

535

00:31:53,380 --> 00:31:58,750

so we have multiple departmental

536

00:31:55,960 --> 00:32:02,830

cooperation assist to making sure we can

537

00:31:58,750 --> 00:32:06,830

identify as many as quickly as a 40 as

538

00:32:02,830 --> 00:32:10,160

our contacts of hospital

539

00:32:06,830 --> 00:32:12,800

we tried to identify all the clothes

540

00:32:10,160 --> 00:32:16,780

contactors and making sure oculus

541

00:32:12,800 --> 00:32:16,780

contactor I put it in the quarantine

542

00:32:18,370 --> 00:32:23,300

close contact to put it in the

543

00:32:20,750 --> 00:32:26,030

quarantine either at a home or desert

544

00:32:23,300 --> 00:32:29,750

designated places in the earlier stage

545

00:32:26,030 --> 00:32:32,660

we encourage home quarantine that are we

546

00:32:29,750 --> 00:32:35,660

changing policy order those contacts

547

00:32:32,660 --> 00:32:39,410

must be in the hotel for quarantine for

548

00:32:35,660 --> 00:32:44,110

14 days the temperature and the symptoms

549

00:32:39,410 --> 00:32:47,540

are monitors twice a day no outdoor

550

00:32:44,110 --> 00:32:50,420

activities are nowadays then deliver

551

00:32:47,540 --> 00:32:52,340

analysis are supplied by local community

552

00:32:50,420 --> 00:32:55,160

that's it very important for the

553

00:32:52,340 --> 00:32:58,870

community support you provide logistical

554

00:32:55,160 --> 00:32:58,870

support or four people in the quarantine

555

00:33:01,570 --> 00:33:11,210

so ed earlier we are two optimist air we

556

00:33:07,310 --> 00:33:15,620

interpret the epidemic may be like SARS

557

00:33:11,210 --> 00:33:19,370

will go away however it is seems that we

558

00:33:15,620 --> 00:33:21,620

were living with virus for long time so

559

00:33:19,370 --> 00:33:27,440

now we have to develop the non term

560

00:33:21,620 --> 00:33:30,230

strategy whew dancing with virus for the

561

00:33:27,440 --> 00:33:33,740

long-term strategy we need to prevent

562

00:33:30,230 --> 00:33:38,450

importation of cases and to prevent

563

00:33:33,740 --> 00:33:40,640

community resurgence of epidemic so we

564

00:33:38,450 --> 00:33:43,520

have control strategy for import the

565

00:33:40,640 --> 00:33:46,990

cases we have tailored control measures

566

00:33:43,520 --> 00:33:50,900

for the community risk assessment and

567

00:33:46,990 --> 00:33:54,980

strategy the earlier for early strategy

568

00:33:50,900 --> 00:33:55,970

will modify and stress and in the change

569

00:33:54,980 --> 00:33:59,350

of the situation

570

00:33:55,970 --> 00:34:03,080

so with strengthened case reporting and

571

00:33:59,350 --> 00:34:06,490

surveillance enhance never to rate

572

00:34:03,080 --> 00:34:10,429

testing capacity in the country level

573

00:34:06,490 --> 00:34:14,149

women ten we did community prevention in

574

00:34:10,429 --> 00:34:17,510

the control methods resume production

575

00:34:14,149 --> 00:34:20,300

and work prevention control protocol at

576

00:34:17,510 --> 00:34:27,320

various risk levels

577

00:34:20,300 --> 00:34:30,110

we'll explain one by one first control

578

00:34:27,320 --> 00:34:34,550

strategy for importing the case we have

579

00:34:30,110 --> 00:34:38,060

created local chain from a border to

580

00:34:34,550 --> 00:34:42,050

community to home for traveler coming

581

00:34:38,060 --> 00:34:47,419

back to China so in the entry point we

582

00:34:42,050 --> 00:34:51,080

have screaming screening will request

583

00:34:47,419 --> 00:34:54,440

traveler reporting the past of 14 days

584

00:34:51,080 --> 00:34:57,040

history health status we have a

585

00:34:54,440 --> 00:35:00,850

temperature screening at the entry point

586

00:34:57,040 --> 00:35:04,700

page in the world be categorized as

587

00:35:00,850 --> 00:35:08,630

conformed the cases or suspected case or

588

00:35:04,700 --> 00:35:11,270

close contactor we have medical

589

00:35:08,630 --> 00:35:15,980

examination provided a for suspected the

590

00:35:11,270 --> 00:35:18,980

symptoms confirm the case or suspected

591

00:35:15,980 --> 00:35:21,850

case a to the entry point will be

592

00:35:18,980 --> 00:35:25,700

transferred to designate the hospital

593

00:35:21,850 --> 00:35:28,900

close contractors will be put in the

594

00:35:25,700 --> 00:35:33,770

designated hotel for quarantine

595

00:35:28,900 --> 00:35:37,880

quarantine is required for two weeks for

596

00:35:33,770 --> 00:35:44,660

a travelers regardless it's a domestic

597

00:35:37,880 --> 00:35:49,970

or foreigners so earlier or active

598

00:35:44,660 --> 00:35:54,710

detecting cases is implemented we use

599

00:35:49,970 --> 00:35:58,970

five strategy to promote early detector

600

00:35:54,710 --> 00:36:03,440

earth cases so house facility and all

601

00:35:58,970 --> 00:36:07,430

levels will alert for implementing early

602

00:36:03,440 --> 00:36:10,670

case identification we use existing

603

00:36:07,430 --> 00:36:14,360

surveillance network to identify early

604

00:36:10,670 --> 00:36:17,990

cases we have health status monitoring

605

00:36:14,360 --> 00:36:21,050

of close contact us we have port health

606

00:36:17,990 --> 00:36:24,650

quarantine for imported a case detection

607

00:36:21,050 --> 00:36:27,920

at a primary level organization and

608

00:36:24,650 --> 00:36:32,270

employment and employer they will have

609

00:36:27,920 --> 00:36:34,040

the else check for all the employee all

610

00:36:32,270 --> 00:36:38,000

of these five

611

00:36:34,040 --> 00:36:43,850

combined together will help us to

612

00:36:38,000 --> 00:36:47,300

identify chasers in the early stage we

613

00:36:43,850 --> 00:36:52,310

also have specific prevention measures

614

00:36:47,300 --> 00:36:55,430

for the zoom of economic we create the

615

00:36:52,310 --> 00:36:58,510

health code and the travel card for

616

00:36:55,430 --> 00:37:03,620

people traveling without a restriction

617

00:36:58,510 --> 00:37:07,100

we also created point-to-point never

618

00:37:03,620 --> 00:37:10,100

cooperation that means organized mind

619

00:37:07,100 --> 00:37:13,460

workers return to home point by point of

620

00:37:10,100 --> 00:37:15,980

the director transfer microwork from

621

00:37:13,460 --> 00:37:21,740

from their home to the manufacturer

622

00:37:15,980 --> 00:37:25,400

designated cities we also create the

623

00:37:21,740 --> 00:37:34,850

prevention car to car lines for work

624

00:37:25,400 --> 00:37:37,520

resume in the enterprises now gender

625

00:37:34,850 --> 00:37:38,750

control called normalize of prevention

626

00:37:37,520 --> 00:37:41,300

not an emergency

627

00:37:38,750 --> 00:37:45,050

so normalize our melissa bonds in order

628

00:37:41,300 --> 00:37:47,830

to prevent a second away for the day me

629

00:37:45,050 --> 00:37:51,880

for most people for the daily practice

630

00:37:47,830 --> 00:37:57,160

including the following for strategy

631

00:37:51,880 --> 00:38:00,710

Moscow wearing social is tensing

632

00:37:57,160 --> 00:38:05,030

ventilation and a disinfection and has

633

00:38:00,710 --> 00:38:08,690

habit all of these for strategy are

634

00:38:05,030 --> 00:38:11,140

implement implemented nationwide and the

635

00:38:08,690 --> 00:38:18,770

further all the Chinese people is

636

00:38:11,140 --> 00:38:21,020

massive it's universal then we have the

637

00:38:18,770 --> 00:38:22,810

strategy for Disease Control and

638

00:38:21,020 --> 00:38:27,080

Prevention

639

00:38:22,810 --> 00:38:30,380

we have also for strategy early

640

00:38:27,080 --> 00:38:33,440

detection temperature screening in the

641

00:38:30,380 --> 00:38:36,500

public places and the triage aid our

642

00:38:33,440 --> 00:38:41,870

patients and a fever clinic early

643

00:38:36,500 --> 00:38:43,520

investigation and precisely control that

644

00:38:41,870 --> 00:38:49,460

means now we

645

00:38:43,520 --> 00:38:54,200

more precisely identify community or

646

00:38:49,460 --> 00:38:57,410

unit for implementing strict control

647

00:38:54,200 --> 00:39:02,450

measures once we have the new cases not

648

00:38:57,410 --> 00:39:08,210

who community we may only have a board

649

00:39:02,450 --> 00:39:15,050

or a building limited as infectious the

650

00:39:08,210 --> 00:39:19,840

number for early treatment we identified

651

00:39:15,050 --> 00:39:25,780

the key places key incident shield as a

652

00:39:19,840 --> 00:39:29,570

priority for prevention so with the 40

653

00:39:25,780 --> 00:39:32,450

reopening Lehman pressors so in the

654

00:39:29,570 --> 00:39:36,370

following places is a 40 reopening

655

00:39:32,450 --> 00:39:39,800

shopping malls Superman

656

00:39:36,370 --> 00:39:43,100

okay who tells restaurant all of these

657

00:39:39,800 --> 00:39:45,110

without any restriction as not as the

658

00:39:43,100 --> 00:39:49,940

implementing for strategy for the

659

00:39:45,110 --> 00:39:52,750

general public like a masker warren the

660

00:39:49,940 --> 00:39:57,830

second category is an additional

661

00:39:52,750 --> 00:40:01,310

reopening into africa places there

662

00:39:57,830 --> 00:40:05,900

including the public parks significant

663

00:40:01,310 --> 00:40:10,220

support sports venues libraries new

664

00:40:05,900 --> 00:40:15,080

themed galleries movie theaters all of

665

00:40:10,220 --> 00:40:20,900

this are reopening conditional and also

666

00:40:15,080 --> 00:40:24,010

have limited personal flea prevention

667

00:40:20,900 --> 00:40:29,570

measures for key institute that include

668

00:40:24,010 --> 00:40:33,410

hospital granting institutions but where

669

00:40:29,570 --> 00:40:37,450

homes so personal aren't there a

670

00:40:33,410 --> 00:40:40,730

category so we have different opening

671

00:40:37,450 --> 00:40:47,120

strategy ways prevention control

672

00:40:40,730 --> 00:40:49,790

strategy to assist then we identify key

673

00:40:47,120 --> 00:40:53,960

populations and american institutions

674

00:40:49,790 --> 00:40:57,130

for prevention to control with new

675

00:40:53,960 --> 00:40:59,580

normal life for the

676

00:40:57,130 --> 00:41:03,520

vulnerable population we identified

677

00:40:59,580 --> 00:41:08,920

Anthony people children pregnant

678

00:41:03,520 --> 00:41:14,520

pregnant women is a poor people patient

679

00:41:08,920 --> 00:41:19,090

away is severe chronic or disease and

680

00:41:14,520 --> 00:41:21,640

also have a personal protection mental

681

00:41:19,090 --> 00:41:25,060

health support and an even support for

682

00:41:21,640 --> 00:41:28,450

this vulnerable population for the

683

00:41:25,060 --> 00:41:31,990

medical incident shield the strategy

684

00:41:28,450 --> 00:41:33,180

included strengthen nosocomial exacting

685

00:41:31,990 --> 00:41:36,660

control

686

00:41:33,180 --> 00:41:41,320

strictly implement requirements earth

687

00:41:36,660 --> 00:41:46,240

district the management stricter visit

688

00:41:41,320 --> 00:41:49,000

and the management accompany care for to

689

00:41:46,240 --> 00:41:54,400

avoid across infection all of the

690

00:41:49,000 --> 00:41:57,040

strategies are implemented in maple

691

00:41:54,400 --> 00:41:59,320

settings because we observe another of

692

00:41:57,040 --> 00:42:02,230

cluster transmission occurred in the

693

00:41:59,320 --> 00:42:06,570

medical settings in the child I know a

694

00:42:02,230 --> 00:42:11,050

cluster long stood the hospital settings

695

00:42:06,570 --> 00:42:14,050

family setting so this class setting is

696

00:42:11,050 --> 00:42:19,780

critically important in the medical

697

00:42:14,050 --> 00:42:24,810

settings school setting and the

698

00:42:19,780 --> 00:42:24,810

communities those schools it's a

699

00:42:25,920 --> 00:42:33,160

wonderful high-risk group in the

700

00:42:30,520 --> 00:42:35,530

community so for the school we have

701

00:42:33,160 --> 00:42:40,900

health monitoring that we have any

702

00:42:35,530 --> 00:42:44,470

report of seeing no symptoms they need

703

00:42:40,900 --> 00:42:47,890

to report zero reporting in the morning

704

00:42:44,470 --> 00:42:50,950

afternoon example enrollment and we have

705

00:42:47,890 --> 00:42:54,940

registration and management of absence

706

00:42:50,950 --> 00:42:59,140

due to illness if a patient if a student

707

00:42:54,940 --> 00:43:02,980

or teachers reporters they have absence

708

00:42:59,140 --> 00:43:06,190

they need to report or illness in the

709

00:43:02,980 --> 00:43:09,970

community we have a grass road community

710

00:43:06,190 --> 00:43:11,009

management fire to identify cases in the

711

00:43:09,970 --> 00:43:13,769

earliest

712

00:43:11,009 --> 00:43:21,960

so community-supported in the china is a

713

00:43:13,769 --> 00:43:28,109

very very strong in order to support the

714

00:43:21,960 --> 00:43:30,569

previous the strategy we I report it we

715

00:43:28,109 --> 00:43:33,930

have technical support that include the

716

00:43:30,569 --> 00:43:37,200

following your testing reagent and si

717

00:43:33,930 --> 00:43:40,319

equipment and research and development

718

00:43:37,200 --> 00:43:44,609

why to provide the technical support for

719

00:43:40,319 --> 00:43:47,400

him prevention prevention one of ret

720

00:43:44,609 --> 00:43:50,670

important is testing testing now in the

721

00:43:47,400 --> 00:43:54,960

China we called testing should have

722

00:43:50,670 --> 00:43:58,259

provided she as much as a passport for

723

00:43:54,960 --> 00:44:04,589

key populations the key populations that

724

00:43:58,259 --> 00:44:07,109

includes those contact us or we sit with

725

00:44:04,589 --> 00:44:10,920

me and a patient at a civic earning

726

00:44:07,109 --> 00:44:13,470

newly admitted patient and in the portal

727

00:44:10,920 --> 00:44:17,640

quarantine all of this identified as

728

00:44:13,470 --> 00:44:23,160

keep in now in the China in the Wuhan

729

00:44:17,640 --> 00:44:27,900

City is myself myself PC are screaming

730

00:44:23,160 --> 00:44:30,539

for the general public in Wuhan almost

731

00:44:27,900 --> 00:44:36,349

everybody in the Wuhan will be tested in

732

00:44:30,539 --> 00:44:39,119

the next ten days also testing are

733

00:44:36,349 --> 00:44:41,430

provided to people who we need to be

734

00:44:39,119 --> 00:44:43,289

tested for other population if you

735

00:44:41,430 --> 00:44:46,950

people wanted Tier one I wanted to be

736

00:44:43,289 --> 00:44:50,489

tested they can be offered for is our

737

00:44:46,950 --> 00:44:53,910

test fit our test is very cheap now in

738

00:44:50,489 --> 00:44:58,739

the Chinese cause the only about less

739

00:44:53,910 --> 00:45:04,769

than $10 a test all the tests now is a

740

00:44:58,739 --> 00:45:08,069

free key population are three is only

741

00:45:04,769 --> 00:45:11,670

people wanted here to be tested there

742

00:45:08,069 --> 00:45:14,970

will be paid by either Institute by

743

00:45:11,670 --> 00:45:21,230

individual themselves the cost it's

744

00:45:14,970 --> 00:45:21,230

affordable and accessible as well

745

00:45:21,910 --> 00:45:28,670

let's end us my slide presentation thank

746

00:45:26,569 --> 00:45:33,799

you for your attention if you have any

747

00:45:28,670 --> 00:45:35,089

questions or interest we can discuss you

748

00:45:33,799 --> 00:45:38,660

know thank you then you know there was

749

00:45:35,089 --> 00:45:41,230

certainly an exhaustive presentation and

750

00:45:38,660 --> 00:45:45,290

it's very impressive how thorough it is

751

00:45:41,230 --> 00:45:48,799

it's really hard to ask questions when a

752

00:45:45,290 --> 00:45:51,260

couple of questions come to mind I think

753

00:45:48,799 --> 00:45:55,040

one of the issues that is not settled as

754

00:45:51,260 --> 00:45:57,290

yet is what proportion of cases are

755

00:45:55,040 --> 00:46:00,920

actually asymptomatic and whether

756

00:45:57,290 --> 00:46:05,660

asymptomatic cases can in fact transmit

757

00:46:00,920 --> 00:46:10,790

disease so I wondered how you plan to

758

00:46:05,660 --> 00:46:12,410

identify asymptomatic cases it would

759

00:46:10,790 --> 00:46:15,859

appear that in new Han where you're

760

00:46:12,410 --> 00:46:17,990

testing everybody you'll find them or at

761

00:46:15,859 --> 00:46:22,880

least you'll find them for that moment

762

00:46:17,990 --> 00:46:27,319

in time but over the long run what sort

763

00:46:22,880 --> 00:46:31,150

of strategies would you recommend for

764

00:46:27,319 --> 00:46:34,160

identifying those who are asymptomatic

765

00:46:31,150 --> 00:46:37,480

through a surveillance program or or

766

00:46:34,160 --> 00:46:39,470

other strategy

767

00:46:37,480 --> 00:46:41,380

thank you for that question very

768

00:46:39,470 --> 00:46:44,119

important the critically important the

769

00:46:41,380 --> 00:46:46,880

intensity pre-banned a possible across

770

00:46:44,119 --> 00:46:49,640

the transmission or epidemic actually we

771

00:46:46,880 --> 00:46:51,890

do have data even in the early stage in

772

00:46:49,640 --> 00:46:55,430

the china we implemented the cruise

773

00:46:51,890 --> 00:46:57,470

contactor isolation or quarantine so in

774

00:46:55,430 --> 00:47:02,240

the cruise contractors particularly in

775

00:46:57,470 --> 00:47:04,040

the quondam province they tested over 10

776

00:47:02,240 --> 00:47:08,300

meaning close contact

777

00:47:04,040 --> 00:47:13,070

so by tests across contactor the

778

00:47:08,300 --> 00:47:14,690

identify cases they are PCR positive

779

00:47:13,070 --> 00:47:18,470

without a symptom

780

00:47:14,690 --> 00:47:21,800

so that has actually two categories some

781

00:47:18,470 --> 00:47:24,200

of in the pre sympton stage when you

782

00:47:21,800 --> 00:47:27,410

continue observe they may become

783

00:47:24,200 --> 00:47:30,349

sympathetic and Masson we remain

784

00:47:27,410 --> 00:47:34,820

asymptomatic so we look at a desert

785

00:47:30,349 --> 00:47:37,119

proportion so a ma or are identified PCR

786

00:47:34,820 --> 00:47:37,119

positive

787

00:47:37,170 --> 00:47:44,869

this age in depth for another two weeks

788

00:47:40,589 --> 00:47:49,829

about once one set less than one sir

789

00:47:44,869 --> 00:47:53,460

remain asymptomatic majority about

790

00:47:49,829 --> 00:47:57,990

chooser will become symptomatic so

791

00:47:53,460 --> 00:48:00,680

that's one of their that we have also we

792

00:47:57,990 --> 00:48:04,369

have serological study that I'm going

793

00:48:00,680 --> 00:48:10,230

that study may have some potential issue

794

00:48:04,369 --> 00:48:12,690

for false positive given the two

795

00:48:10,230 --> 00:48:14,519

preference is very low in the China we

796

00:48:12,690 --> 00:48:18,779

do not have the community transmission

797

00:48:14,519 --> 00:48:20,970

so it's only in Omaha we have community

798

00:48:18,779 --> 00:48:22,589

transmission in the son community in the

799

00:48:20,970 --> 00:48:25,920

majority of China we'll only have a

800

00:48:22,589 --> 00:48:31,440

cluster transformation in the hospital

801

00:48:25,920 --> 00:48:34,349

setting and in family settings so in

802

00:48:31,440 --> 00:48:39,000

terms of transmission we do observe so

803

00:48:34,349 --> 00:48:43,589

ways a close contactor of cases they are

804

00:48:39,000 --> 00:48:47,990

even in the pre asymptomatic so then we

805

00:48:43,589 --> 00:48:52,019

can categorize close contactor Earth

806

00:48:47,990 --> 00:48:55,680

confirmed cases close contactor Earth a

807

00:48:52,019 --> 00:48:59,309

symptomatic cases then we observe which

808

00:48:55,680 --> 00:49:02,609

proportion become infected us

809

00:48:59,309 --> 00:49:07,079

informatica cases have a lower secondary

810

00:49:02,609 --> 00:49:10,109

a correct and also the rip-rip who's

811

00:49:07,079 --> 00:49:11,819

ever called reproductive a number where

812

00:49:10,109 --> 00:49:15,259

they can reprove that member is a

813

00:49:11,819 --> 00:49:20,279

smaller compared with confirmed cases

814

00:49:15,259 --> 00:49:24,240

however because asymptomatic cases they

815

00:49:20,279 --> 00:49:28,890

are not easy to be identified we become

816

00:49:24,240 --> 00:49:34,799

potential risk for possible second

817

00:49:28,890 --> 00:49:38,009

arrays or for the epidemic the only

818

00:49:34,799 --> 00:49:40,890

point I make in terms of your response I

819

00:49:38,009 --> 00:49:44,759

think if I heard you correctly you said

820

00:49:40,890 --> 00:49:47,670

one third would be asymptomatic I would

821

00:49:44,759 --> 00:49:48,450

say the one third of 1.4 billion people

822

00:49:47,670 --> 00:49:52,920

is not just

823

00:49:48,450 --> 00:49:55,290

all that one-third strikes me is a

824

00:49:52,920 --> 00:49:56,730

fairly high proportion of asymptomatic I

825

00:49:55,290 --> 00:50:01,020

don't know of other diseases

826

00:49:56,730 --> 00:50:05,760

well polio would be that high no no I

827

00:50:01,020 --> 00:50:08,490

think our our may be a missile I expect

828

00:50:05,760 --> 00:50:13,730

not clearly I'm talking about a 1/3 it

829

00:50:08,490 --> 00:50:13,730

means among people get virus

830

00:50:14,330 --> 00:50:24,760

population it's far the denominator were

831

00:50:20,810 --> 00:50:29,660

case us identify the pizza positive a

832

00:50:24,760 --> 00:50:31,860

mob piece our poverty while surd are

833

00:50:29,660 --> 00:50:34,020

symptomatic

834

00:50:31,860 --> 00:50:35,790

okay I have to think about that one for

835

00:50:34,020 --> 00:50:38,940

a while but I'll come I'll come back at

836

00:50:35,790 --> 00:50:42,060

you next couple of weeks and then the

837

00:50:38,940 --> 00:50:45,020

other question I have is that you know

838

00:50:42,060 --> 00:50:50,670

in the United States now what's going on

839

00:50:45,020 --> 00:50:55,950

is that we are opening up stores are

840

00:50:50,670 --> 00:50:59,580

opening up restaurants etc and I think

841

00:50:55,950 --> 00:51:01,710

it's pretty impressive that you've gone

842

00:50:59,580 --> 00:51:04,590

through an opening up situation you've

843

00:51:01,710 --> 00:51:15,060

been opened up in Wuhan for what about

844

00:51:04,590 --> 00:51:19,110

two to three weeks now we opened our

845

00:51:15,060 --> 00:51:20,550

April force at 8:00 okay well I think

846

00:51:19,110 --> 00:51:22,620

what's impressive that's even more

847

00:51:20,550 --> 00:51:25,080

impressive because that's that's enough

848

00:51:22,620 --> 00:51:29,970

time for several incubation periods -

849

00:51:25,080 --> 00:51:33,300

but transpired it's my impression that

850

00:51:29,970 --> 00:51:34,100

you have not had a resurgence that's

851

00:51:33,300 --> 00:51:38,820

correct

852

00:51:34,100 --> 00:51:44,460

so you've you've taken very dramatic

853

00:51:38,820 --> 00:51:48,180

steps to keep the population under

854

00:51:44,460 --> 00:51:50,070

monitoring you you've been in the United

855

00:51:48,180 --> 00:51:51,660

States you were a student here you sort

856

00:51:50,070 --> 00:51:55,980

of know how we operate in the United

857

00:51:51,660 --> 00:52:01,290

States are there lessons from China that

858

00:51:55,980 --> 00:52:05,240

would be feasible for the United States

859

00:52:01,290 --> 00:52:05,240

as we attempt to open up

860

00:52:05,260 --> 00:52:13,900

tough question I think it's a different

861

00:52:09,910 --> 00:52:17,380

situation in the China after strict

862

00:52:13,900 --> 00:52:20,200

implementation of strategy we almost no

863

00:52:17,380 --> 00:52:23,360

community cases almost no community

864

00:52:20,200 --> 00:52:26,579

cases except a few in

865

00:52:23,360 --> 00:52:30,749

[Music]

866

00:52:26,579 --> 00:52:35,169

uh-huh and poor to the cases Janet so

867

00:52:30,749 --> 00:52:38,619

give it that your voice it's like in the

868

00:52:35,169 --> 00:52:41,679

earlier epidemic a stage so are we

869

00:52:38,619 --> 00:52:44,819

it's a manageable it's a manageable the

870

00:52:41,679 --> 00:52:50,739

different in the United States you have

871

00:52:44,819 --> 00:52:54,849

many many uncontrolled cases so we

872

00:52:50,739 --> 00:52:59,009

become reservoir or transmitter in the

873

00:52:54,849 --> 00:53:02,619

community so that's a very difficult I

874

00:52:59,009 --> 00:53:08,169

think another issue it's a culture

875

00:53:02,619 --> 00:53:12,640

difference so in the China so the

876

00:53:08,169 --> 00:53:15,640

general public follows what we were told

877

00:53:12,640 --> 00:53:18,400

so even I could we have a condo

878

00:53:15,640 --> 00:53:23,410

sanitaire shutdown is a whole country

879

00:53:18,400 --> 00:53:26,559

suddenly stopped that policy is very

880

00:53:23,410 --> 00:53:31,359

hard to be implemented in the European

881

00:53:26,559 --> 00:53:34,559

countries in the American Americans so

882

00:53:31,359 --> 00:53:38,369

because people are more individualized

883

00:53:34,559 --> 00:53:42,189

individualized people are more

884

00:53:38,369 --> 00:53:46,650

prioritize their individual rights so in

885

00:53:42,189 --> 00:53:49,900

the China we do have the community

886

00:53:46,650 --> 00:53:51,880

probably put as a top priority rather

887

00:53:49,900 --> 00:53:56,769

than the individual right so that's

888

00:53:51,880 --> 00:54:00,519

given achacha and in terms of masks

889

00:53:56,769 --> 00:54:04,779

we believe masks are important so

890

00:54:00,519 --> 00:54:07,929

everybody follow the instruction wears a

891

00:54:04,779 --> 00:54:11,289

mask however that take a long long time

892

00:54:07,929 --> 00:54:12,689

for Americans to wear masks to all of

893

00:54:11,289 --> 00:54:15,669

this difference

894

00:54:12,689 --> 00:54:19,679

we still have one person you will wear a

895

00:54:15,669 --> 00:54:21,999

mask yeah even you have like which is a

896

00:54:19,679 --> 00:54:25,869

hospital you do not have a a wear mask

897

00:54:21,999 --> 00:54:28,269

your vice president yeah I I agree with

898

00:54:25,869 --> 00:54:30,039

you I think through the years that I've

899

00:54:28,269 --> 00:54:33,669

worked with you and other people in

900

00:54:30,039 --> 00:54:37,199

China is that the American culture is a

901

00:54:33,669 --> 00:54:39,700

culture of individualism whereas I think

902

00:54:37,199 --> 00:54:42,310

the average Chinese thinks

903

00:54:39,700 --> 00:54:45,310

himself first as a member of the

904

00:54:42,310 --> 00:54:48,339

community and then as a member of a

905

00:54:45,310 --> 00:54:51,550

family and then as an individual whereas

906

00:54:48,339 --> 00:54:54,099

it would be just the reverse I mean the

907

00:54:51,550 --> 00:54:56,800

American culture but I defer to dr.

908

00:54:54,099 --> 00:54:58,410

Barry because you're doing the expert on

909

00:54:56,800 --> 00:55:01,450

in China

910

00:54:58,410 --> 00:55:04,210

no there certainly are very powerful

911

00:55:01,450 --> 00:55:07,020

cultural differences in terms of how

912

00:55:04,210 --> 00:55:10,089

each of our nations have responded and

913

00:55:07,020 --> 00:55:12,430

in in some cases that has worked the

914

00:55:10,089 --> 00:55:14,500

Chinese benefit and to our detriment in

915

00:55:12,430 --> 00:55:17,290

terms of this notion of individuality

916

00:55:14,500 --> 00:55:18,640

and people you know if you look at

917

00:55:17,290 --> 00:55:21,400

American news and you see people

918

00:55:18,640 --> 00:55:24,040

protesting the quarantine

919

00:55:21,400 --> 00:55:26,440

you know that's directly derived from

920

00:55:24,040 --> 00:55:27,820

this American notion right of individual

921

00:55:26,440 --> 00:55:30,070

freedom and no one's gonna hamper my

922

00:55:27,820 --> 00:55:32,380

individual rights but it's also going

923

00:55:30,070 --> 00:55:34,660

directly against the science and what we

924

00:55:32,380 --> 00:55:36,730

know about how you know nobody's happier

925

00:55:34,660 --> 00:55:45,040

about those protests as a virus itself

926

00:55:36,730 --> 00:55:46,660

I'm sure if I could jump in for a

927

00:55:45,040 --> 00:55:48,490

question and this may be for both

928

00:55:46,660 --> 00:55:50,829

professor Wu and professor details

929

00:55:48,490 --> 00:55:52,780

you're both experts in this field of

930

00:55:50,829 --> 00:55:54,790

infectious disease and epidemiology

931

00:55:52,780 --> 00:55:58,240

you've had many decades of experience

932

00:55:54,790 --> 00:55:59,829

seeing other viruses come and go I know

933

00:55:58,240 --> 00:56:02,530

that neither of you have a crystal ball

934

00:55:59,829 --> 00:56:04,569

but what's your best looking forward

935

00:56:02,530 --> 00:56:06,220

everyone I think is eager to not just

936

00:56:04,569 --> 00:56:07,900

when we can open up but is it going to

937

00:56:06,220 --> 00:56:09,369

recur in the fall is it going to recur

938

00:56:07,900 --> 00:56:11,440

in the winter is it going to be two

939

00:56:09,369 --> 00:56:14,920

years five years what's your best guess

940

00:56:11,440 --> 00:56:17,589

looking forward as to the macro

941

00:56:14,920 --> 00:56:21,760

trajectory of this virus and what we're

942

00:56:17,589 --> 00:56:25,089

in for long term I think the problem is

943

00:56:21,760 --> 00:56:26,349

that the the standard answer is we don't

944

00:56:25,089 --> 00:56:29,770

know

945

00:56:26,349 --> 00:56:33,630

we know how respiratory transmitted

946

00:56:29,770 --> 00:56:38,050

viruses behave the corona virus that

947

00:56:33,630 --> 00:56:43,089

SARS co2 isn't behaving like the typical

948

00:56:38,050 --> 00:56:46,450

respiratory virus and you have a

949

00:56:43,089 --> 00:56:47,800

population that basically has zero and

950

00:56:46,450 --> 00:56:51,930

unity

951

00:56:47,800 --> 00:56:55,540

and so there's a great concentration of

952

00:56:51,930 --> 00:56:58,540

susceptibles I think I agree with

953

00:56:55,540 --> 00:57:01,120

Professor fowey that we're likely to see

954

00:56:58,540 --> 00:57:04,560

ongoing transmission hopefully at a

955

00:57:01,120 --> 00:57:07,570

somewhat lower rate as some of these

956

00:57:04,560 --> 00:57:11,020

interventions hopefully take take effect

957

00:57:07,570 --> 00:57:16,050

I think ultimately hopefully we'll get a

958

00:57:11,020 --> 00:57:18,850

vaccine and while it appears that the

959

00:57:16,050 --> 00:57:22,600

immunity that is associated with the

960

00:57:18,850 --> 00:57:26,230

corona viruses infection is transient

961

00:57:22,600 --> 00:57:28,900

and only lasts for a year or a year and

962

00:57:26,230 --> 00:57:30,700

a half at most this would put us into

963

00:57:28,900 --> 00:57:33,700

the same situation where you have with

964

00:57:30,700 --> 00:57:38,110

the influenza where we just get a new

965

00:57:33,700 --> 00:57:41,200

influenza shot each year with SARS we

966

00:57:38,110 --> 00:57:43,230

would have to get a booster shot every

967

00:57:41,200 --> 00:57:47,080

year so I think that would be the most

968

00:57:43,230 --> 00:57:51,910

optimistic scenario but it does depend

969

00:57:47,080 --> 00:57:55,810

on coming up with a a good vaccine as in

970

00:57:51,910 --> 00:57:59,080

yo what you're reading um I think it's

971

00:57:55,810 --> 00:58:01,690

not a quarter reoccurring so the

972

00:57:59,080 --> 00:58:04,780

epidemic has not gone yet is it

973

00:58:01,690 --> 00:58:07,630

continuing so still global is epidemic

974

00:58:04,780 --> 00:58:14,380

is continued even in the China if we do

975

00:58:07,630 --> 00:58:18,780

not implement in active response so the

976

00:58:14,380 --> 00:58:23,860

epidemic may just take off very quickly

977

00:58:18,780 --> 00:58:27,130

so so the question is how that this

978

00:58:23,860 --> 00:58:29,890

epidemic could continue for how long so

979

00:58:27,130 --> 00:58:33,070

yet let's depend on how quickly we can

980

00:58:29,890 --> 00:58:35,080

even up effective vaccine the good news

981

00:58:33,070 --> 00:58:37,990

it's just a yesterday or before

982

00:58:35,080 --> 00:58:42,820

yesterday a new article published in The

983

00:58:37,990 --> 00:58:46,180

Lancet the vaccine trial the clinical

984

00:58:42,820 --> 00:58:48,550

says - as well as - in China has

985

00:58:46,180 --> 00:58:52,000

demonstrated a very good response so

986

00:58:48,550 --> 00:58:56,020

that's good a sign so hopefully we will

987

00:58:52,000 --> 00:58:59,400

a scientifical movement to quickly have

988

00:58:56,020 --> 00:59:00,650

effective that same be ready for

989

00:58:59,400 --> 00:59:02,840

vaccination

990

00:59:00,650 --> 00:59:06,500

but without vaccine there was a world

991

00:59:02,840 --> 00:59:09,650

will truly change our lifestyle so it's

992

00:59:06,500 --> 00:59:13,340

uncertain very hard to make a prediction

993

00:59:09,650 --> 00:59:17,630

so he's definitely the virus cannot go

994

00:59:13,340 --> 00:59:23,090

away by easily you know basically got to

995

00:59:17,630 --> 00:59:25,010

experts agree on something I would like

996

00:59:23,090 --> 00:59:26,660

to ask one more question this is jumping

997

00:59:25,010 --> 00:59:28,370

off professor details earlier question

998

00:59:26,660 --> 00:59:30,590

about the American and response in the

999

00:59:28,370 --> 00:59:32,000

America again the difference between

1000

00:59:30,590 --> 00:59:35,060

what's happening in China and America

1001

00:59:32,000 --> 00:59:36,950

and I'm wondering doctor rule given you

1002

00:59:35,060 --> 00:59:38,960

have so much more experience and a head

1003

00:59:36,950 --> 00:59:40,640

start on seeing this through in China

1004

00:59:38,960 --> 00:59:43,730

and having at least a couple more months

1005

00:59:40,640 --> 00:59:45,080

than what we've dealt with here I want

1006

00:59:43,730 --> 00:59:47,120

to push that question a little further

1007

00:59:45,080 --> 00:59:49,640

and ask hypothetically if you were

1008

00:59:47,120 --> 00:59:51,830

heading the United States CDC what would

1009

00:59:49,640 --> 00:59:53,210

you do right now that's different than

1010

00:59:51,830 --> 00:59:55,460

how it's being handled what would you

1011

00:59:53,210 --> 00:59:58,790

strongly recommend and be done in terms

1012

00:59:55,460 --> 01:00:02,380

of the current response so I think about

1013

00:59:58,790 --> 01:00:08,750

some important it's a key and an Isis

1014

01:00:02,380 --> 01:00:11,570

the weakness so we need to identify the

1015

01:00:08,750 --> 01:00:13,910

possible weakness so needed to from

1016

01:00:11,570 --> 01:00:20,050

epidemiological our point of view to and

1017

01:00:13,910 --> 01:00:23,590

an Isis data so who are most reach

1018

01:00:20,050 --> 01:00:26,110

and risk of infection are mostly put

1019

01:00:23,590 --> 01:00:29,170

others in whiskers so look at all the

1020

01:00:26,110 --> 01:00:31,900

prevention measures which are not

1021

01:00:29,170 --> 01:00:35,110

implemented appropriately which have not

1022

01:00:31,900 --> 01:00:39,760

been implemented so that are critical

1023

01:00:35,110 --> 01:00:43,150

important in China would our strength

1024

01:00:39,760 --> 01:00:45,790

it's the data so we have files in our

1025

01:00:43,150 --> 01:00:48,690

system we work a day and a night she

1026

01:00:45,790 --> 01:00:51,550

collecting data with ananassa data daily

1027

01:00:48,690 --> 01:00:54,550

identify where is a source of infection

1028

01:00:51,550 --> 01:00:58,120

where it's a top priority need near our

1029

01:00:54,550 --> 01:01:01,120

resources to focus that daily and an

1030

01:00:58,120 --> 01:01:04,750

Isis they are driven response is

1031

01:01:01,120 --> 01:01:09,300

critically important to inform policy to

1032

01:01:04,750 --> 01:01:12,000

inform implementation activity

1033

01:01:09,300 --> 01:01:13,710

so look at a the data are now in the

1034

01:01:12,000 --> 01:01:17,310

united states i sticking at johns

1035

01:01:13,710 --> 01:01:20,130

hopkins clay leading role inform the

1036

01:01:17,310 --> 01:01:22,610

world as a epidemic I'm not a city you

1037

01:01:20,130 --> 01:01:25,320

see now so that's it's a very strange I

1038

01:01:22,610 --> 01:01:29,040

think the other point that I would make

1039

01:01:25,320 --> 01:01:32,130

over the years jr. and I have worked on

1040

01:01:29,040 --> 01:01:34,830

many different projects and the one

1041

01:01:32,130 --> 01:01:38,010

thing that I've discovered through those

1042

01:01:34,830 --> 01:01:43,260

much of the work that jr. and I have

1043

01:01:38,010 --> 01:01:46,980

done as informed policy and as a result

1044

01:01:43,260 --> 01:01:49,380

it's very interesting that we will do a

1045

01:01:46,980 --> 01:01:54,530

research project which has policy

1046

01:01:49,380 --> 01:01:59,640

implications that policy is often

1047

01:01:54,530 --> 01:02:03,420

implemented within months of when we've

1048

01:01:59,640 --> 01:02:08,190

made the observation that is not the

1049

01:02:03,420 --> 01:02:11,160

case in the United States where China

1050

01:02:08,190 --> 01:02:14,280

really does have evidence-based medicine

1051

01:02:11,160 --> 01:02:18,060

as zillion likes to say

1052

01:02:14,280 --> 01:02:20,310

whereas we tend to get it politicized in

1053

01:02:18,060 --> 01:02:21,180

the process so jr. would you like to add

1054

01:02:20,310 --> 01:02:24,590

something to that

1055

01:02:21,180 --> 01:02:26,640

yeah I think that's very important to

1056

01:02:24,590 --> 01:02:29,340

translate as a scientific funding

1057

01:02:26,640 --> 01:02:32,280

emitted into the policy so that's a very

1058

01:02:29,340 --> 01:02:36,380

good advantage in the China as not ad we

1059

01:02:32,280 --> 01:02:38,910

demonstrate it works so could it be just

1060

01:02:36,380 --> 01:02:41,539

one month become a national policy

1061

01:02:38,910 --> 01:02:44,029

quickly implemented

1062

01:02:41,539 --> 01:02:50,329

Oh what makes it exciting about working

1063

01:02:44,029 --> 01:02:52,880

in China Thank You professor Deedle

1064

01:02:50,329 --> 01:02:56,899

steel about maybe a final question for

1065

01:02:52,880 --> 01:02:59,299

our forum now I think we've asked most

1066

01:02:56,899 --> 01:03:04,279

of pretty pretty well explored the issue

1067

01:02:59,299 --> 01:03:06,559

I I would like to thank soon euro as as

1068

01:03:04,279 --> 01:03:09,259

usuals in there was an exhaustive

1069

01:03:06,559 --> 01:03:12,739

presentation you got all the eyes died

1070

01:03:09,259 --> 01:03:16,119

and all the t's crossed and you didn't

1071

01:03:12,739 --> 01:03:18,469

leave much room for questions so I

1072

01:03:16,119 --> 01:03:22,659

commend you on that Bay I think it's

1073

01:03:18,469 --> 01:03:26,419

also reflecting of China and China's

1074

01:03:22,659 --> 01:03:30,469

China's rapid response I'd like to

1075

01:03:26,419 --> 01:03:34,849

emphasize as we close that the interval

1076

01:03:30,469 --> 01:03:37,309

between the time that China first began

1077

01:03:34,849 --> 01:03:39,649

to realize that they were seeing

1078

01:03:37,309 --> 01:03:43,999

something that had not seen before which

1079

01:03:39,649 --> 01:03:47,469

was about the 21st 22nd of December to

1080

01:03:43,999 --> 01:03:50,539

the time that they had identified the

1081

01:03:47,469 --> 01:03:54,829

positive organism and developed the test

1082

01:03:50,539 --> 01:03:57,339

was two to three weeks and within four

1083

01:03:54,829 --> 01:04:00,829

to five weeks they had implemented an

1084

01:03:57,339 --> 01:04:04,399

intervention strategy which appears to

1085

01:04:00,829 --> 01:04:07,519

have worked so I like to underscore I

1086

01:04:04,399 --> 01:04:10,489

don't know of any other disease any

1087

01:04:07,519 --> 01:04:13,459

other emerging disease that had a

1088

01:04:10,489 --> 01:04:15,829

timeline that was that short and yellow

1089

01:04:13,459 --> 01:04:22,299

do you know of any other I don't know no

1090

01:04:15,829 --> 01:04:26,239

I think of that that's create records

1091

01:04:22,299 --> 01:04:29,059

yeah yes well thank you professor

1092

01:04:26,239 --> 01:04:31,009

details for helping arrange this talk

1093

01:04:29,059 --> 01:04:33,139

and for sharing it and moderating it and

1094

01:04:31,009 --> 01:04:36,259

thank you especially dr. Wu for the

1095

01:04:33,139 --> 01:04:37,759

wonderfully informative presentation but

1096

01:04:36,259 --> 01:04:40,130

even more so for all of the hard work

1097

01:04:37,759 --> 01:04:41,559

you're doing at the China CDC and we

1098

01:04:40,130 --> 01:04:44,289

really appreciate you sharing your

1099

01:04:41,559 --> 01:04:47,809

experience with us today

1100

01:04:44,289 --> 01:04:49,699

I might say then yummy me enjoyed your

1101

01:04:47,809 --> 01:04:53,089

presentation she's right over my

1102

01:04:49,699 --> 01:04:55,180

shoulder yeah I saw her yeah just pose

1103

01:04:53,089 --> 01:04:58,990

my regard to her

1104

01:04:55,180 --> 01:05:01,980

nasty yeah thank you okay bye-bye

1105

01:04:58,990 --> 01:05:01,980

you see me