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From YouTube: World Health Organization: Q&A with Dr. Mike Ryan and Dr. Maria Van Kerkhove (9/23/20)
Description
This World Health Organization program features a conversation with WHO's Dr. Mark Ryan and Dr. Maria Van Kerkhove regarding the latest updates on the COVID-19 pandemic. Recorded on September 23, 2020.
The City of Cupertino would like to express thanks to the World Health Organization for permission to use their video materials during COVID-19 pandemic. More information can be found at https://who.int/covid-19
For more information regarding the impact of the COVID-19 outbreak in Cupertino, please visit https://cupertino.org/coronavirus
A
C
Meeting
with
dr
mike
ryan
and
dr
maria
van
kerkova,
thank
you
for
watching
us
and
thank
you
for
asking
your
questions.
I
will
just
remind
everyone
that
you
can
leave
your
questions
on
twitter
by
using
swco
in
your
tweets
or,
if
you're,
watching
us
on
linkedin
facebook
or
youtube.
Please
leave
your
questions
in
the
comment
section
good
afternoon,
maria
mike.
How
are
you
today
I'm
glad
to
hear?
C
I
know
how
busy
you
are
every
day,
the
whole
this
year,
working
tirelessly
with
scientists
and
countries
around
the
world
and
informing
the
public
about
our
work.
One
one
piece
of
word
that
we
stress
since
beginning
as
part
of
the
public
health
measures
to
identify
covet
cases
and
to
treat
patients
is
testing.
C
D
Sure
so
I'll
I
can
start
thanks
for
having
us
again
alex.
So
testing
is
just
one
of
the
most
important
things
that
needs
to
be
done
as
part
of
any
type
of
preparedness
for
an
event,
getting
yourself
ready
for
an
eventual
event,
and
then
once
it
happens
as
part
of
the
response
and
for
the
for
covid19.
D
You
know
our
global
strategy
is
to
suppress
transmission
and
save
lives
and
livelihoods,
and
that
continues
to
be
our
our
main
focus
and
one
of
the
aspects
of
being
able
to
do.
That
is
to
know
where
the
virus
is
circulating,
know
who
is
infected
with
the
virus,
because
that
helps
us
know
exactly
what
actions
need
to
be
taken
and
so
testing
which
will
identify
if
somebody
is
infected
with
this
virus,
it
was
critical
from
the
beginning.
D
D
You
know
within
the
first
nine
days,
seven
to
nine
days,
china
announced
that
it
was
a
novel
coronavirus
on
the
ninth
a
few
days
later,
the
full
genome
sequence
and
that's
basically
the
the
blueprint
of
it.
You
know
what
is
this
virus
was
made
publicly
available
available
on
websites
so
that
the
world
could
start
the
development
of
diagnostic
tests
and
on
the
13th
of
january,
with
one
of
our
partner
collaborating
centers
in
germany,
charity
and
I
apologize
if
I've
said
it
incorrectly.
D
With
christian
josten
and
his
team
who've
been
collaborators
with
us.
For
years
we
were
able
to
publish
the
first
pcr
essay,
which
is
essentially
the
instructions
of
how
you
make
a
pcr
test
that
allowed
the
entire
world
to
start
developing
tests
to
find
cases,
and
it's
really
unprecedented.
How
quickly
that
happened?
I
know
people
say
to
us,
you
know
was
that
indeed
fast
and
in
fact
it
was
if
you
could
actually
look
back
at
other
outbreaks
and
other
pathogens.
D
It
took
months
if
not
longer,
and
so
this
was
really
fast
and
so
wh
o
very
quickly.
Since
after
publishing
that
essay
that
pcr
essay
those
instructions
we
became,
we
started
working
with
companies
to
say
how
can
we
start
the
production?
How
can
we
start
the
development
of
a
test,
evaluate
that
test
to
make
sure
that
it
was
performing
appropriately,
making
sure
that
production
started
and
meaning
how
much
can
can
be
made
and
then
started
purchasing
and
buying
and
shipping?
D
And
by
the
end
of
january,
in
early
february
we
were
already
shipping
hundreds
of
thousands
of
tests
to
countries
all
over
the
world.
I
don't
have
the
exact
numbers
in
front
of
me,
but
since
then,
we've
been
working
with
companies
all
over
the
world.
We've
been
working
with
partners
and
mike
it'd
be
great.
D
If
you
could
talk
about
our
supply
consortium
because
we
work
with
so
many
partners
to
be
able
to
do
this,
we
we're
shipping
millions
of
diagnostic
products
all
over
the
world
to
help
countries
find
cases
and,
what's
really
critical
is
if
you
know
who
is
the
case,
then
we
know
what
public
health
actions
are
necessary
to
take
so
somebody's
infected
with
this.
If
they
need
clinical
care,
you
know
they
go
into
this
clinical
pathway,
as
we
call
it
to
make
sure
that
they
get
the
appropriate
type
of
care.
D
We
can
carry
out
what
is
known
as
contact
tracing,
so
you
know
you
heard
you
hear
us
say
this:
a
lot
find
and
care
for
and
isolate
cases
and
then
carry
out
contact
tracing.
So
if
you
know
who
is
infected
with
this
virus,
you
can
talk
to
that
individual
and
find
out
who
do
they
come
in
contact
with,
and
then
those
individuals
are
putting
quarantine.
This
essentially
breaks
these
chains
of
transmission,
and
this
helps
us
with
that
first
aspect
of
our
global
strategy
of
suppressing
transmission.
D
So
it's
really
really
critical
and
and
we're
just
so
grateful
for
so
many
labs
that
are
working
with
us.
There's
we're
grateful
that
countries
continue
to
share
these
full
genome
sequences
because
that's
important
for
us
to
to
determine
if
the
virus
is
changing
and
there
are
changes
to
the
virus,
but
it's
still,
it
hasn't
changed
enough.
These
are
normal
changes
with
like
mutations,
the
the
diagnostics
work
and
there
are
more
and
more
diagnostics
being
developed
every
day.
C
Thank
you
very
much.
Maria
mike
maria
mentioned
that
there
is
a
consortium
of
partners.
We
are
working
on
working
with
on
the
on
development
and
production
of
tasks
for
covid19.
Can
you
explain
to
our
viewers,
who
are
we
working
with
and
and
what's
the
way
of
who
collaborating
with
private
and
public
sector
in
this
domain?.
E
Yeah,
I
think
well
as
we're
speaking
about
diagnostics.
I
think
in
the
area
of
diagnostics,
is
a
it's
a
really
good
example.
It's
not
the
certainly,
not
by
any
way
the
only
area
of
collaboration,
but
if
we
look
at
something
like
a
diagnostics
in
general,
we've
got
to
do
the
research
to
find
out
what
the
as
maria
said,
a
new
pathogen.
What
are
the
best
diagnostics,
the
different
types
of
diagnostics
that
have
had
to
be
delivered?
Then
we've
got
to
get
manufacturers
to
work
upstream
with
academics,
to
do
the
research
and
then
produce
them.
E
Then
they
need
to
be
validated
for
use.
Then
they
need
to
be
pre-qualified
to
be
used
by
countries.
Then
we
need
to
have
an
access
framework
and
we
need
to
be
able
to
get
them
to
countries
at
a
price
that
people
can
afford,
and
then
we
have
to
train
the
health
workers
and
the
people
on
the
front
line
to
be
able
to
use
those
tests
properly.
E
So
it's
a
whole
chain
of
activities
and
it
has
to
be
connected,
and
no
one
institution
has
all
of
the
capacities
along
that
chain
to
make
that
happen.
So
what
we
did
at
the
beginning
was
really
come
together
across
three
really
important
parts
of
the
supply
chain
globally,
because
the
supply
chain
was
broken.
When
we
cast
our
minds
back
to
february
march,
the
whole
world
shut
down
airlines
shut
down,
nothing
could
be
moved,
factories
were
empty.
Universities
were
empty,
a
lot
of
what
we
consider
normal
life
had
had
stopped.
We
couldn't
stop.
E
We
needed
diagnostics,
we
needed
to
produce
them
at
scale.
We
needed
to
get
them
to
countries
so,
and
that
was
the
same
for
medical
oxygen.
That
was
the
same
for
medical
equipment
and
ventilators.
That
was
the
same
for
for
personal
protective
equipment.
So
there
were
many
many
areas,
but
if
we
take
the
diagnostics
as
that
area
who
do
we,
we
reached
out
through
the
un
supply
chain
platform
that
we
created
with
the
world
food
program
at
unicef,
and
so
many
others
reached
out
to
other
partners
each
partner
playing
its
part?
E
We
worked
with
the
foundation
for
innovative
new
diagnostics,
find
who
did
a
lot
of
work
in
exploring
and
validating
which
producers
could
produce
new
diagnostics
at
a
certain
quality.
We
worked
with
chai
the
clinton
health
access
initiative
that
worked
with
us
in
the
global
fund
and
developing
a
a
diagnostics
consortium
where
we
had
a
group
working
on
procuring
this
stuff,
finding
it
a
group
working
on
how
to
pay
for
it,
the
gates,
foundation
and
others
provided
purchase,
guarantees
that
allowed
us
to
do
advanced
purchasing.
E
E
And
then
we
had
a
group
working
on
allocation
models
to
see
to
estimate
what
did
countries
actually
need
and
also
to
see
if
they
had
the
lab
technicians
and
the
trained
people
to
use
the
tests.
If
they
said
were
sent
there,
did
they
have
the
reagents?
Did
they
have
the
transport
media?
So
it
wasn't
just
sending
the
test,
there's
a
whole
amount
of
infrastructure
and
again
working
downstream
with
lots
of
different
agencies.
E
So
this
required
a
huge
collaboration
between
many
different
types
of
entities-
public
private
academic
ngos,
un
to
come
together
to
fix
a
problem,
and
I
think
a
huge
amount
has
been
done.
That's
now
evolved.
The
diagnostics
consortium
of
the
of
the
supply
chain
platform
is
now
evolving
into
becoming
the
diagnostics
consortium
of
the
act
accelerator.
In
other
words,
a
further
acceleration.
We
were
getting
up
to
millions
and
millions
of
tests.
E
The
act
accelerator
is
now
going
to
try
and
get
like
20
30
40
million
tests
a
month
going
out
to
countries
that
will
be
dependent
not
only
on
the
existing
pcr
test,
but
on
other
tests
like
antigen
tests
and
others.
So
we're
working
very
closely
within
that
consortium
of
the
act
accelerator
to
further
scale
up
access
to
testing,
and
that
takes
it
to
another
level
and
in
that
we
thank
our
colleagues
at
united
at
the
global
fund
at
the
gates
foundation
and
again
those
same
partners
working
to
further
accelerate
the
activity.
E
So
you
know
who
sits
in
a
sense
in
a
privileged
position
to
be
able
to
bring
together
and
leverage
and
to
to
bring
those
combinations
together.
But
it's
the
agencies
and
those
institutions
all
the
way
from
that
academic
unit
that
develops
that
interesting
new
test
down
to
that
frontline
trainer
who's
training
lab
techs,
how
to
use
it
each
and
every
one
of
those
individuals
is
vital.
E
C
Thank
you
very
much
mike.
You
also
mentioned
in
this
long
process
that
there
is
validation
and
pre-qualification
so
that
the
quality
fulfills
certain
level
of
criteria,
quality
criteria
to
be
used
does
who
play
any
role
in
validating
or
pre-qualifying
diagnostics.
And
if
yes,
what's
the
role
that
who
plays
that,
we
can
now
explain.
E
Yeah
we,
we
won't
go
into
terrible
detail
on
this,
there's
a
huge
function
on
who
for
pre-qualification
in
general
and
mari
angela,
samara
and
emir
cook
and
others
do
a
fantastic
job
with
their
teams,
and
this
is
a
service.
That's
provided
to
the
world,
not
just
during
epidemics,
but
for
in
between
for
all
kinds
of
drugs
and
diagnostics,
and
what
pre-qualification
does,
and
there
are
differences
here
between
licensing
and
pre-co,
and
I
know
I'll
explain
it,
because
people
get
confused
right
countries
licensed
products.
E
E
Many
countries,
though,
don't
necessarily
have
that
same
firepower
and
what
they
will
tend
to
do
is
they'll,
look
at
a
new
licensed
product
and
then
they'll
ask
that
who
pre-qualifies
that
product?
In
other
words,
the
who
ensures
that
the
licensing
process,
the
research,
the
data,
the
production
capacity,
is
safe
and
efficacious,
and
in
some
senses
then,
who
puts
a
stamp
to
say
this.
Producer
of
this
product
is
pre-qualified
to
sell
through
on
the
international
market,
and
that
gives
assurance
to
countries
that
they're
not
only
buying
a
safe
and
efficacious
product.
B
E
Their
regulatory
authorities
to
accept
these
products
more
easily
and
it's
a
huge
service
and
it's
hugely
important
in
this
pandemic,
but
you
can't
understate
the
value
of
that
to
our
member
states
over
the
last
40
or
50
years.
It's
hugely
important
and
in
the
same
vein,
for
diagnostics
and
for
other
products.
This
time
around
vaccines
will
have
the
same
issues.
There
are
other
mechanisms
short
of
pre-qualification
where
who
and
other
national
authorities
can
issue
emergency
listings
and
others
to
bring
products
to
the
market
more
quickly.
But
there
are
stringent
criteria
for
that.
E
We
won't
get
into
that
today,
but
there
are
emergency
mechanisms
to
do
that,
but
again,
they're
they're,
subject
to
very
strict
criteria
and
very
strict
data
requirements,
but
again
hats
off
to
those
teams,
because
these
are
the
unsung
heroes
of
wh,
because
the
work
they
do
to
ensure
that
medical
products
are
not
only
safe
and
efficacious,
but
the
countries
can
rely
on
them
in
terms
of
their
production.
Processes
is
a
huge
service
and
one
we're
grateful
for
two
because
we're
in
the
front
line
and
we
need
those
products.
So
these
are
the
real
heroes.
D
This
is
all
countries
needing
something
and
needing
access
to
it
really
really
quickly,
and
one
of
the
positives
of
this
is
because
the
sequence
was
shared
so
quickly
and
because
so
many
companies-
and
so
many
groups
are
developing
these
products.
It
means
there
are
literally
hundreds
of
products
on
the
market
and
it's
really
confusing
to
know
which
one
should
I
use.
Where
do
they
work
best
and
do
they
actually
perform
as
well
as
they
claim
on
the
box?
D
You
know,
and
so
the
service
that
that
mike
has
described
through
our
pre-qualification
and
through
that
whole
process
is
incredibly
important
to
know
which
ones
you
can
rely
on,
which
ones
are
more
reliable
and
I
think
that's
really
really
important,
because
just
having
a
test
done,
if
it's
not
a
quality
test,
then
you
don't
know
if
you
are
actually
infected
and
you
don't
know
for
certain
and
that's
really
what's
important
and
somebody
walking
around
in
their
country
wanting
to
know
if
they
are
infected
they're
going
to
want
to
know.
If
I
got
that
test.
C
Thank
you
very
much.
I
think
it
was
really
important
to
explain
this
process
and
that
we
do
play
a
role
in
ensuring
that
safe
and
quality
products
in
this
case
tests
are
on
the
ground
and
that
countries
are
using
because
several
viewers-
not
only
during
this
slide
but
before
we're
asking
how
do
we
know
the
tests
are
safe?
Who
is
who
is
ensuring
the
quality
et.
D
Cetera
because
they're
not
perfect,
like
we
should
say,
I
mean,
even
if
you
have
high
quality
products,
they're,
not
always
perfect,
and
it,
and
it
does
depend
not
just
on
the
test
itself.
It
depends
on
how
the
sample
is
collected,
make
sure
that
you
know
for
a
respiratory
pathogen
you
normally
and
if
anybody's
had
a
test
for
this
you
know,
there's
a
there's.
A
little
tiny
almost
looks
like
a
q-tip,
it's
not
a
q-tip,
but
it
goes
up
your
nose
and
it
goes
pretty
far
back.
It
doesn't
hurt.
D
I've
had
the
test
a
couple
of
times
it
doesn't
hurt,
but
it's
a
little
awkward,
and
so
just
so
people
people
are
aware
of
that.
But
all
of
those
products
also
are
important
and
just
as
important
as
the
test
itself,
you
know
to
make
sure
you
have
all
of
the
right
supplies
in
addition
to
the
actual
test
itself,
making
sure
the
right
sample
is
collected,
making
sure
that
it's
stored
appropriately,
that
the
test
is
run
properly
and
really
really
critically
that
the
result
gets
back
quickly.
D
And
so
one
of
the
critical
things
that
we're
focused
on
is
making
sure
that
not
only
tests
are
being
used
appropriately,
but
that
results
are
coming
back
quickly.
So
some
tests
can
come
back
within
hours,
some
take
24
hours.
But
again,
if
you
get
a
test-
and
you
don't
hear
back
for
a
week
or
so-
that's
that
that
it's
late
yes.
E
I
think
so
I
think
well.
I
think
it
might
be
a
good
idea
at
some
point
in
the
next
few
weeks
to
invite
in
our
colleagues
from
double
fund
and
find
on
our
lab
team
and
maybe
have
a
bit
more
of
a
deep
dive
on
this,
because
it's
it's
it's
a
hugely
important
area
and
really
and
truly
it's
it's
not
just
the
way
jewel.
There
are
so
many
others.
Who've
made
this
actually
work,
but
just
following
on
maria's
point:
maybe
we
will
talk
about
this
later
in
the
interview?
E
It's
it's
not
just
about
the
number
of
tests.
Sometimes
we
get
caught
up
on
the
number
of
tests.
It's
like
anything
you
have
in
life,
it's
not
the
quantity,
it's
the
quality
and
it's
how
you
use
those
tests.
These
are
assets.
You
have
these
are
cards
you
play
in
the
game
and
it's
like
poker.
It
depends
how
you
play
your
hand
and
in
that
sense,
when
you
have
tests,
you
can
play
your
hand
one
way
and
lose.
E
You
can
play
your
hand
slightly
differently
and
win,
and
countries
that
have
been
successful
have
used
their
testing
regimes
very
effectively
because
they
think
their
way
through
the
process
they've
thought
their
way
through.
Why
are
we
using
testing?
When
are
we
using
testing?
Who
are
we
going
to
test
how
we're
going
to
make
the
testing
process
really
efficient,
so
the
results
get
back
quickly,
so
we
can
use
testing
as
part
of
our
control
strategy
rather
than
testing
as
part
of
a
defense
strategy
to
say
we're
testing
loads
of
people.
E
It
doesn't
matter
if
it's
not
impacting
on
disease
control.
If
it's
not
getting
people
into
clinical
care
quickly,
it's
just
a
number
and
it
just
becomes
a
dot
on
a
graph.
It's
meaningless.
It's
not
the
number
of
tests,
it's
how
and
where
and
when
they're
used.
How
effectively
is
testing
used
as
part
of
a
comprehensive
strategy?
The
countries
that
have
got
that
right
have
got
the
pandemic
response
right.
I
think
yes,.
E
C
D
No,
I
think
I
mean
our
our
recommendations
for
testing
are
to
really
focus
on
your
suspect
cases
and
those
definitions
for
this,
because
when
you
have
to
prioritize
and
in
situations
where
you
really
need
to
prioritize,
that's
who
you
prioritize
and
there's
a
reason
for
that
is
because
these
we
believe
that
these
individuals
are
more
likely
to
be
infected.
Some
of
it
has
to
do
with
symptoms.
Some
of
it
has
to
do
with
your
contact
with
a
known
case
and
use
those
tests
really
appropriately.
D
You've
heard
us
say
many
times
this
outbreak,
this
virus
operates
in
clusters,
and
so
what
that
means
is
that
there
are
outbreaks
that
happen
and
when
countries
identify
where
transmission
is
occurring,
what
they
normally
do
is
they
do?
What
we
call
an
outbreak
investigation
using
your
tests
wisely
in
an
outbreak
investigation
for
your
known
cases,
testing
your
contacts,
the
higher
risk
contacts
can
really
be
helpful
to
bring
those
outbreaks
under
control,
but
it
needs
to
be
strategic
in
situations
where
so
not
all
countries
are
in
the
same
transmission
intensity.
D
So
we've
we've
outlined
some
guidance
around
when
and
where
testing
can
be
used.
When
you
have
a
few
cases
or
clusters
of
cases,
you
can
really
target
your
suspect
cases
in
your
outbreak
investigation
when
you're
in
a
situation
of
community
transmission-
and
it's
incredibly
intense,
you
may
need
to
prioritize
so
we
make
some
recommendations
on
who
to
prioritize.
This
is
focusing
on
your
suspect
cases.
It's
focusing
on
your
frontline
workers.
It's
focusing
on
those
who
are
most
vulnerable
to
really.
You
know,
use
them
the
most
appropriately.
D
D
If
you
have
symptoms,
you
should
be
any
symptoms.
You
should
be
at
home
and
call
your
medical
provider.
Please.
If
you
are
a
contact
of
a
known
case,
you
should
be
in
quarantine,
and
all
of
that
is
important
and
testing
is
a
part
of
it's
one
part
of
the
strategy.
It's
not
the
only
part
of
the
strategy,
so
our
recommendations
is
really
to
be
strategic
focus
on
your
suspect
cases
suspected
cases
so
that
you
know
where
the
virus
is,
and
you
know
where
the
virus
isn't.
E
D
That's
a
good
quest,
I
need
tables
in
front
of
me.
It
depends.
It
depends
on
the
test
that
is
used.
So
if
we're
talking
about
molecular
tests
or
or
antigen
based
tests,
it
depends
when
they
are
used.
The
ones
that
are
highly
qualified
have
a
very
high
sensitivity
in
specificity,
and
that
means
when
we
test
someone
we
in
and
they
test
positive.
We
know
that
it's
a
true
positive
and
vice
versa.
If
we
test
them
negative,
we
know
that
they're
a
true
negative.
So
it
varies.
D
E
Again,
it's
not.
The
test
has
some
inherent
parameters
of
sensitivity
and
specificity,
and
then
there
won't
go
into
explanations
like
I
tried
before,
but
I
I
think
it's
important
to
understand
that,
even
with
those
performance
parameters
for
the
test,
the
test
performs
differently
in
different
situations
of
transmission,
so
a
test
will
be
more
or
less
predictive,
depending
on
whether
the
transmission
in
the
community
is
high
in
intensity
or
not-
and
I
know
that
sounds
counterintuitive,
but
it's
important
to
remember
that,
because
we
also
have
to
check
when
the
companies
submit
their
data.
E
We
have
to
understand
what
was
the
context.
What
was
the,
what
do
we
assume
was
the
background
prevalence
of
disease,
because
that
ultimately
affects
the
performance
of
the
test
in
reality,
so
there's
a
difference
between
the
performance
of
the
test
in
the
lab
and
the
actual
performance
in
the
test
as
a
public
health
predictor.
In
other
words,
predicting
do
you
have
stars
or
not
the
likelihood
that
it's
successful
in
doing
that
can
often
depend
on
tests,
do
better
when
there's
lots
of
virus
around
essentially
yeah
and
when
there's
not
lots
of
virus.
D
D
D
That's
when
we
believe
people
are
most
infectious,
so
two
days
before
symptom
onset
up
to
five
seven
days
after
they
develop
their
illness,
and
so,
if
you
use
an
antigen-based
test
during
that
time
period,
you
have
a
higher
likelihood
of
capturing
them
being
positive.
The
pcr
tests
are
more
sensitive
and
specific.
They
operate
better
and
and
and
and
that's
why
people
focus
on
those.
But
these
new
rdts
coming
online
are
going
to
be
incredibly
helpful
as
well
in
specific
situation
where
there's
lots
of
virus
around
they
can
help.
D
E
So
there
are
and
again
this
is
the
issue
of
of
the
difference
between
the
science
and
the
policy
and
the
practicalities
of
actually
implementing
public
health
science
there's
a
translational
process
and,
as
you
translate
results
out
of
the
laboratory
and
into
the
reality
of
the
world,
you
have
to
then
look
at
other
things
like
how
much
training
am
I
going
to
need.
So
if
I
have
a
rapid
diagnostic
test
available
that
requires
very
little
training
to
apply
that
test.
Then
I'm
going
to
be
very
positive
about
that.
E
But
I'll
still
be
aware
that
that
test
is
not
as
good,
maybe
as
a
pcr
test,
but
that
may
be
acceptable
if
I'm
living
in
a
low
income
country-
and
I
have
very
little
lab
infrastructure-
and
I
have
very
few
latrey
and
lab
technicians
once
I
understand
the
performance
of
the
test,
I'm
able
to
use
it's
a
bit
like
having
that
insight.
Once
once.
I
recognize
that
the
test
I
have
isn't
perfect
and
I
know
how
imperfect
it
is.
E
I
can
still
use
that
test
as
long
as
I
recognize
the
imperfections
because
I'm
gaining
the
advantage
of
being
able
to
do
more
tests
and
it's
holding
those
two
things
in
balance
and
finding
a
way
to
make
the
best
public
health
application
of
a
new
tool.
And
we
don't
do
enough
implementation
research.
We
tend
to
focus
our
investments
upstream,
which
is
great,
get
the
new
products,
but
we
need
to
make
sure
that
those
products
can
be
used
effectively
and
a
lot
of
that
comes
down
to
simple
stuff,
like
logistics
and
cold
chain
and
train
tech.
E
E
The
value
of
the
health
system
as
a
system
that
can
deliver
this
kind
of
thing
and
that
we
can
rebuild
our
health
systems
to
make
them
more
agile,
make
them
more
responsive
to
events
like
this
make
them
more
capable
of
dealing
with
an
expansion
of
workload.
And
it's
one
of
the
things
we've
done
over
the
years.
We've
chopped
our
health
systems
down
to
the
bare
minimum.
E
They
have
very
little
capacity
to
expand
and
react
to
an
emergency
they've
become
quite
static
and
rigid,
not
elastic
and
expandable,
and
we
need
a
health
system
that
can
adapt
and
react
and
then
use
new
technologies
quickly.
And
it's
all
of
those
things
need
to
come
together,
so
it's
not
just
about
the
tests
and
sometimes
we
get
caught
up
on
the
test.
D
D
So
in
in
december
we
didn't
know
you
know
in
in
january,
in
february
and
march
and
april,
what
the
whole
world
did
is
they
harnessed
and
leveraged
the
global
influenza
network
and
the
national
influenza
centers
that
exist
in
so
many
countries
across
the
world.
This
is
this:
is
the
global
influenza
network
response,
surveillance
and
response
network?
Excuse
me,
gistris
has
been
in
operation
for
70
years,
and
that
is
a
system
that
has
trained
technicians.
It
has
equipment.
D
You
know
so
most
of
the
flu
labs
were
quickly
adapted
for
covid
and
and
stopped
testing
for
for
flu
and
now
we're
finding
the
right
balance
between
the
two,
because
these
are
viruses
that
circulate
flu
circulates
the
globe
and
as
we
enter
the
winter
we've
just
hit
autumn
in
the
northern
hemisphere
and
as
influenza
starts
to
circulate.
We
need
all
of
the
labs
to
be
able
to
test
for
influenza
and
for
covid
so
that
we
make
sure
we
know
what's
circulating.
D
We
know
what
people
have,
because
there
are
different
clinical
pathways,
and
so
we
need
to
you
know
again:
it's
all
about
the
action.
A
test
is
one
thing,
but
then
what
does
it
mean?
What
do
we
do
and
they're
very
good
systems
in
place?
So
we're
really
grateful
for
the
entire
global
influenza
network
that
is
working
so
hard
and
has
so
many
incredibly
trained
individuals
all
over
the
world.
C
D
B
D
D
There
are
different
types
of
tests,
so
the
pcr
tests
are
are
looking
for
the
rna.
These
part,
these
pieces
of
the
virus
that
you
are
infected
with
and
there's
lots
of,
pcr
assays
that
are
available
and
as
mike
was
describing
part
of
the
goal
of
the
consortium
of
who
was
to
make
sure
that
the
right
tests
went
to
the
right
countries
to
utilize
the
machines
that
were
in
the
country.
I
don't
I
don't.
I
was
amazed
by
this
because
it
isn't
just
about.
D
We
have
100
million
tests
or
26
million
tests
or
whatever
it
is
it's
about
getting
the
right
test
to
the
right
technician
in
the
right
lab
in
that
country,
with
all
the
supplies
that
are
necessary
for
that
and
the
right
reagents
and
the
right.
So
it's
an
incredible
match.
Work.
That's
that's
great!
So
there's
the
pcr
tests.
These
are
being
widely
used.
These
are
highly
accurate
and
we
rely
on
these
globally
and
you
can
get
a
test
back
from
pcr
within
hours.
D
D
There
are
these
antigen
based
rapid
diagnostic
tests
and
these
detect
the
proteins
of
the
cysco
v2
virus
in
an
individual.
These
are
done
as
they
say
rapidly,
where
you
can
get
results
back
within
within
minutes
within
15
minutes,
30
minutes
something
like
that,
and
essentially
you
take
a
sample.
You
put
it
in
in
the
the
the
test
tube
and
then
a
little
drop
of
that
goes
on
to
this
strip.
D
That
looks
almost
like
a
pregnancy
test,
you
know
and
it
moves
up,
and
it
tells
you
if
you're,
if
you're
positive
or
not
those
there
are
a
number
of
those
that
are
online,
some
perform
better
than
others,
but
as
those
get
rolled
out
as
that
performance
improves,
this
will
be
very,
very
helpful,
but
these
antigen-based
rdts,
we
outline
guidance.
We
release
guidance
about
the
use
of
antigen-based
rdts
last
week.
D
The
first
is
to
respond
to
suspect
outbreaks
in
remote
areas
where
you
don't
have
pcr
testing
so
in
a
remote
setting
in
institutions
or
semi-close
communities.
The
second
one
is
to
support
outbreak
investigations,
which
I
described
earlier,
where
you
have
at
least
one
pcr
positive
case.
This
will
help
you
understand
the
extent
of
that
outbreak.
You
could
test
your
contacts,
including
asymptomatic,
closed
contacts,
it'll
help
you
understand
who's
at
risk
and
who
is
infected.
D
The
third
is
to
monitor
trends
and
incidents
in
specific
higher
risk
populations.
Like
frontline
workers,
for
example,
and
again,
they
will
work
better
where
in
in
settings
where
you
have
more
virus
circulating
and
then
the
fourth
area
is
in
areas
of
community
transmission,
and
so
those
types
of
areas
will
really
antigen
based
rdts
will
be
very
helpful
to
use
and
will
take
the
pressure
off
the
pcr
systems
that
are
in
place.
D
So
these
are
the
two
main
tests
that
look
for
active
infection.
Am
I
infected
with
stars?
Go
g2
virus
now,
there's
a
third
type
of
test
which
are
the
serologic
based
tests.
These
will
measure
the
levels
of
antibodies
in
an
individual
and
antibodies,
develop
after
one
two
three
weeks
after
infection
sometimes
longer
and
will
tell
you
if
you
have
been
infected
in
the
past.
We
don't
recommend
those
for
active
case
finding,
but
those
help
us
understand
the
extent
of
infection
that
had
circulated
in
the
population
and
that
helps
us
understand.
C
D
Tests
because
they
measure
different
things
and
they're
all
helping
us
to
really
again
reach
this
goal
of
suppressing
transmission
and
saving
lives.
The
fact
that
we
have
the
market
almost
flooded
with
these
tests
is
a
positive
thing.
It
there's
innovation
that
is
happening.
We
talked
about
two
types
of
tests,
but
there's
all
these
other
types
of
tests
that
are
out
there
that
are
being
explored
and
it's
really
pushing
the
boundaries
of
what
we
can
do
and
I
think
that
that
should
be
celebrated.
D
There
does
need
to
be
this
proper
evaluation,
so
we
know
how
well
they
work
and
there's
processes
in
place
that
that
do
that.
But
I
think
that
it's.
This
is
a
good
thing.
I
think
this
is
a
really
good
thing
and
we're
always
looking
for
new
technologies
and
we're
looking
for
new
advances
to
be
able
to
have
quicker
more
rapid
tests
close
to
the
patient.
We
call
these
point-of-care
tests.
E
There
is
a,
I
think
in
future,
it's
happening
already,
and
I
think
there
is
this
emergence
of.
We
call
multiplex
testing
the
ability
to
use
the
same
platform
for
diagnosing
multiple
different
infectious
diseases,
and
I
think
we
are
reaching
a
point
and
I
think
somehow,
on
the
on
the
lab
side,
if
you
remember
cast
your
mind
back
to
the
50s
and
60s
those
of
you
who
can
remember
that
far
back,
you
know
when
big
companies
were
asked,
you
know
how
many
computers
would
the
world
need.
E
It
was
like
less
than
100
now,
when
we
looked
at
telecommunications
infrastructure
around
the
world,
and
people
wondered
how
developing
countries
were
going
to
develop
all
of
the
telecommunications
infrastructure
and
mobile
phones
came
along,
and
countries
have
leapfrogged
the
need
to
develop
all
of
that
heavy
infrastructure
by
having
a
much
lighter
infrastructure
that
does
the
same
job.
I
think
we're
seeing
the
same.
Ultimately
in
laboratory
science.
E
In
the
old
days
we
saw
the
big
public
health
laboratories,
the
national
public
health
lab,
and
it
was
a
lot
of
investment
in
bricks
and
mortar
and
labs
and
walls
and
things,
and
it
was
very
much
a
was
almost
like
one
of
those
magical
scientists.
We
had
to
be
hugely
qualified
and
it
was
a
you
know,
kind
of
a
mystical
thing.
How
lab
people
made
diagnosis
and,
to
be
quite
frank,
some
of
my
laboratory
colleagues
are
some
of
the
most
clever
innovative
creative
people.
E
I've
ever
met,
but
I
think
we're
seeing
much
more
so
now.
This
with
the
fourth
industrial
revolution,
with
miniaturization
the
same
way
as
we've
seen
with
the
computers
we're
seeing
a
revolution
in
how
we
make
diagnosis
and
we're
seeing
platforms
emerge
that
can
diagnose
at
the
same
time,
90
different
infections
simultaneously,
and
I
think
we're
going
to
see
a
brand
new
era
and
I
think
maybe,
if
the
the
kobit
pandemic
has,
I
think,
generated
its
own
momentum
to
solve
the
culvert
diagnostics
problem.
E
I
can
assure
you
so
I
can
really
understand
where
the
listener
is
coming
from,
but
I
think
maria
is
right.
We
need
the
innovation
now,
but
we
also
need
to
move
to
a
more
multi-diagnostic
diagnostic
platform
where
we
don't
just
have
to
keep
climbing
the
same
hill
of
diagnostics.
Every
time
we
have
an
epidemic.
D
Yet-
and
I
think
that's
why,
in
the
beginning,
when
you
have
an
emerging
pathogen
like
cysco
v2,
when
you
don't
know
in
the
beginning,
what
labs
will
do
is
they'll
take
they'll,
take
a
sample
from
a
patient
who's
sick
and
it's
normally,
they
show
up
in
hospital,
and
this
is
the
situation
that
happened
in
china.
They
identified
patients
with
pneumonia
of
unknown
etiology,
and
that
means
they
didn't
know
what
it
was,
because
when
you
run
it
through
the
lab,
you
run
it
for
influenza
and
sars
and
mers,
and
for
all
of
your
known
pathogens.
D
And
then,
once
you
exhaust
that
you
know
you
say:
okay,
what
is
that?
And
so
we're
getting
quicker
at
being
able
to
do
this
in
full
genome
sequencing
is
helping
tremendously
push
that,
but
we're
also
seeing
innovation
wise
of
looking
at
saliva
based
testing.
You
know
how
can
we
take
different
types
of
think
about
kids
and
sampling
children
and
if
you
need
to
take
blood
versus
you
need
to
get
a
nasal
swab
versus
if
they
could
just
spit
into
a
cup.
D
So
there's
lots
of
different
practical
things
that
can
help
diagnostics
move
faster,
and
so
all
of
that
innovation
is
happening
and
so
yeah
we're
just
it's.
It's
pushing
it
and
each
one
of
these
events,
because
this
will
not
be
the
last
pandemic
and
it
will
not
be
the
last
emerging
pathogen
but
we're
in
each
time
we're
in
a
better
situation.
But
let's
see
how
we
use
this
as
a
way
to
drive
this
even
further
and
investor.
C
There
are
some
questions
coming
about
the
isolation
and
discharging
from
after
having
covered
19.
What
are
the
recommendation?
Is
it
repeated
repeating
tests,
but
I
want
to
read
this
one.
In
particular,
some
countries
still
require
two
negative
tests
to
de-isolate
cova-19
patients
if
they
are
baseline,
immunocompromised
or
hiv
or
chem
or
on
chemotherapy
treatment.
Is
there
any
evidence
to
support
this
approach.
D
So
that's
a
really
excellent
question,
a
very
specific
one
so
who
what
we
do
is
we
work
with
our
lab
partners?
We
work
with
clinicians,
we
work
with
epidemiologists
to
really
understand
patients,
and
we
understand
when
someone
is
infectious.
So
what
we
understand
from
the
data
that
is
available
and
to
do
this.
Well,
you
need
to
follow
the
same
patient
over
time
and
collect
repeat
samples
from
those
individuals.
You
need
to
do
that
from
asymptomatic
cases,
mild
moderate,
severe
cases,
so
we
really
understand.
Is
it
the
same
depending
on
your
disease?
D
What
we
understand
for
and
what
our
isolation
discharge
isolation
criteria
is
based
upon
is
that
type
of
data?
What
who
recommends
we
recommends
is
initially.
In
the
beginning
of
the
pandemic,
we
recommended
two
negative
tests
at
least
24
hours
apart
when
you
have
a
pandemic,
that
has
at
least
31
million
known
cases,
and
there
may
be
more
that
are
currently
unrecognized
testing
becomes
challenging.
D
So
we
were
asked
to
look
at
the
data
and
to
try
to
come
up
with
a
non-test-based
discharge
criteria.
When
I
say
discharge,
I
don't
mean
discharged
from
hospital.
I
mean
discharged
from
these
isolation.
Isolation
procedures
because
they're
no
longer
infectious
so
for
an
asymptomatic
individual.
So
this
is
somebody
who
tested
positive
once
for
a
pcr
test.
Our
recommendation
is
10
days
isolation
and
then
they
can
be
discharged
from
isolation
for
a
symptomatic
patient.
D
Now
countries
can
continue
to
use
testing
as
part
of
their
discharge
criteria,
because
some
individuals
may
be
test
positive
for
longer.
But
what
we
know
from
pcr
testing
is
that
the
pcr
test
itself
will
measure
parts
of
the
virus
itself.
It
doesn't
tell
you
if
there's
live
virus,
that's
replicating
and
that
they're
infectious.
What
we
need
for
that
is
to
do
what's
called
virus
isolation
where
you
take
the
sample
and
you
try
to
grow
it
in
a
lab
and
see
if
it
can
grow,
and
that
means
that
it's
replicating
and
that
it's
infectious.
D
So
that's
what
the
isolation
criteria
is
on
and
we
know
for
immunocompromised
individuals.
They
can
test
positive,
pcr
positive
for
for
long
periods
of
time,
and
so
some
countries
will
still
require
that
two
negative
tests.
So
we
give
the
option
we
wanted
to
give
options
to
to
all
of
our
member
states
to
be
able
to
say
if
you
don't
use
testing.
This
is
the
criteria
we
have
this
online.
We
have
an
infographic
which
we
could
provide.
D
That
makes
it
a
little
bit
easier
to
follow,
but
that's
that's
where
we're
coming
from
and
we
constantly
look
at
the
data
and
we
constantly
are
looking
at.
You
know
what
what
is
new.
The
reason
we
have
this
for
symptomatic
patients,
the
10
days
from
symptom,
onset
plus
three
days
of
symptom
resolution
is
because
we
know
that
severe
patients
can
shed
virus
live
virus
longer,
and
so
we
want
to
just
ensure
that
and
those
those
individuals
are
hospitalized,
so
they're
already
in
isolation.
E
E
E
In
terms
of
that
evidence
you
speak
about,
so
we
can
give
better
guidance
to
countries,
because
we
don't
want
to
be
in
a
position
necessarily
where
people
are
being
held
in
hospital
or
being
told
to
self-isolate
for
longer
than
they
need
to
it's
tough
enough
to
live
with
the
disease
associated
with
immunocompromise
than
to
be
further
isolated
more
than
you
need
to
be.
So
I
do
think
it's
worth
us
taking
a
look
at
that
again
and
that
specific
thing.
D
And
we
and
we
hope
our
collaborating
centers
in
our
labs
that
are
able
to
carry
out
this
type
of
research
are
doing
so
because
you
really
need
good
data.
You
don't
need
this
type
of
study
in
you
know
100
countries
or
even
10
countries.
We
needed
well
done
well
characterized
well-conducted
study
following
individuals,
taking
repeat
samples
and
providing
that
data,
so
we
work
with
a
lot
with
with
a
group
of
an
entire
international
network
of
laboratorians
and
clinicians,
and
so
yes,
this
is
something
we
we
will
continue
to
look
at.
I.
C
Thank
you
very
much,
I
think.
With
this
answer,
you
covered
a
lot
other
questions
that
we've
been
receiving,
but
before
we
close,
I
just
want
to
reflect
on
serological
tests,
because
we've
received
a
lot
of
interest
over
days
on
this.
What
have
we
learned
so
far
from
zerological
studies
about
immunity,
recovery
about
antibodies,
about
the
reinfection?
So
these
are
the
frequently
asked
questions
on
our
social
media
and
would
be
good
if
we
can
explain,
maybe
once
again
what
we
know
so
far
sure.
D
It's
my
favorite
question
because
I
am
very
very
passionate
about
these
serologic
studies,
because
we
as
a
global
community,
have
recognized
the
importance
of
these
types
of
studies
in
these
emerging
pathogens,
and
you
know
11
years
ago,
15
years
ago,
when
we
were
talking
about
h5n1,
which
is
an
avian
influenza,
and
it's
rarely
circulated
it
just
spills
over
and
we
had
no
idea
the
extent
of
this
infection
and
there
were
all
these
studies
that
were
being
done
and
they
were
done
differently.
There
was
different
methods
used.
There
were
different
tests
used.
D
There
were
different
populations
used
and
to
be
able
to
compare
a
study
in
a
study.
It
was
like
comparing
apples
and
oranges
and
we
just
couldn't
do
it,
and
so
this
group
came
together.
Concise
consortium
is
not
a
concise
acronym.
The
consortium
for
the
standardization
of
influenza,
ciro,
epidemiology.
D
And
it
had
an
epi
working
group
and
a
laboratory
working
group
and
the
epi
group.
We
had
hundreds
of
scientists
all
over
the
world
that
were
developing
protocols,
study
protocols
templates
to
say,
if
you're
going
to
do
this
type
of
study.
Please
follow
this
methodology
in
your
country,
adapt
it
as
necessary,
but
follow
this
methodology
so
that
we
can
compare
results
and
then
there
was
a
lab
group
that
was
quickly
developing
the
essays.
What
are
the
tests
that
can
be
used?
D
We've
used
that
for
influenza,
we've
used
it
for
zika,
we've
used
it
for
mers,
we're
using
it
for
covet
19.
and
right
now
there
are
countries
all
over
the
world
that
are
carrying
out
these
zero
epidemiology
studies.
These
studies
measure
the
antibody
response
that
somebody
has
after
infection
when
someone
is
infected
with
the
sars
cov2
virus
they
develop
antibodies,
and
what
we're
learning
about
this
is
how
strong
this
antibody
response
is
and
for
how
long
it
lasts
I'm
going
to
over
generalize,
because
there
are
literally
hundreds
of
studies.
D
I
was
trying
to
look
at
the
database
before
we
came
in
here,
because
I
knew
this
was
going
to
come
up
and
it's
very
difficult
to
summarize
succinctly
and
I'm
not
being
very
succinct.
I
apologize
what
we're
learning
from
these
literally
hundreds
of
studies
that
are
ongoing
is
that
when
we
look
at
the
general
population
around
five
to
ten
percent
of
those
that
are
sampled
have
example,
have
evidence
of
antibodies
in
some
studies
that
focus
on
health
workers
or
frontline
workers
or
people
who
are
more
exposed,
the
zero
prevalence
we
call
it.
These
are.
D
D
But
when
you
look
at
this
collectively,
the
again
over
generalizing,
less
than
10
of
the
world's
population,
has
evidence
of
infection
over
generalization,
so
that
tells
us
nine
months
into
a
pandemic
that
the
majority
of
the
world
remains
susceptible,
and
so
that's
really
critical.
That
means
we
still
have
to
continue
to
put
all
of
these
actions
in
place
to
prevent
transmission.
D
So
we
don't
know
we
don't
know
how
long
those
antibodies
will.
Last
we
don't
know
how
long
protection
will
last.
So
that's
why
it's
important
that
we
continue
to
do
all
of
these
measures
in
place.
We
have
experience
with
other
coronaviruses,
the
common
cold
coronaviruses,
the
cyrus,
kobe,
1
and
mers
covers
covi,
and
we
know
that
antibodies
don't
last
forever.
D
E
But
also
waning
antibodies
doesn't
necessarily
mean
you're
fully
susceptible
to
the
virus,
because
the
the
immune
immune
system
loses
the
the
amount
of
antibody
in
the
blood,
but
it
doesn't
mean
it
loses
the
immunologic
memory.
It
just
may
take
it
longer
to
react
and
we
have
many
situations
where
even
at
the
long
range
you
may
get
the
disease
again,
but
you
may
have
a
less
severe
infection.
So
we
don't
know
that
either.
E
But
you
know
we
can
say
you're
going
to
get
a
new
infection
and
it's
going
to
be
just
as
bad
as
the
last
time
better
or
worse.
We
would
expect.
I
think
that
that
having
a
natural
infection
results
in
immunity
for
a
period
of
time
that
we
cannot
determine
absolutely
but
will
give
you
protection
over
that
period.
And
what
would
these
longitudinal
studies
will
determine
that?
B
E
For
ourselves,
but
to
add
to
the
body
of
knowledge,
so
we
give
our
blood
to
contribute
to
that.
If
you
are
asked
to
be
part
of
a
longitudinal
study,
please
do
because
that
kind
of
information
over
time
is
is
really
vital.
Getting
repeated
information
from
the
same
individuals
from
within
a
community
is
really
that's
the
highest
value
information.
It's
a
gold
standard,
so
please
participate
if
you're
asked
try
to
help,
because
that
will
help
countries
will
help
us
determine
that
over
the.
E
But
please
people,
I
think
it's
it's
it's
important,
because
everyone
is
getting
a
little
concerned.
Vaccine
seems
a
little
further
away
than
it
was
before
the
diseases
is,
is
on
the
rise
again
in
the
northern
hemisphere.
People
are
worried
about
the
influenza
season
at
the
same
time,
and
now
the
antibodies
may
not
protect
us
and
it
may
seem
like
two
states,
so
we
we
do
need
to
balance
this
with
the
fact
that
it
is
been.
E
And
we
shouldn't
just
accept
that
we're
going
into
another
round
of
transmission
and
terms
are
going
to
get
even
worse.
We've
learned
lessons,
and
not
only
on
the
epidemic
control
side,
but
also
on
the
economic
management
side.
So
governments
now
have
to
work
with
communities
to
find
a
really
fine
balance
between
controlling
transmission
of
this
disease,
preventing
mortality
from
this
disease
and
then
sustaining
our
society
and
economic
and
economy
through
keeping
schools
open
and
prioritizing
the
most
vital
aspects
of
social
and
economic
life,
while
preserving
the
lives
of
potential.
E
Very
often
those
who
are
older
and
are
wisest
and
most
cherished
citizens,
while
trying
to
control
transmission
and
everybody
else.
And
again,
I
would
say
to
younger
people
in
this
you're
not
you're,
not
immune
from
this
disease,
and
while
it
may
not
be
a
severe
a
disease
again,
I
say
I
I
mentioned
previously.
E
Studies
in
germany
that
looked
at
cardiac
changes
in
people
who
have
moderate
disease
see
some
very
recent
information
from
a
swiss
study
that
looked
at
people
who
had
mild
and
moderate
symptoms
not
admitted
to
hospital
younger
people,
and
those
of
you
involved
in
sport
will
know
about
vo2
and
the
athletes
will
know
this,
and
I
know
a
lot
of
kids
involved
in
sport.
Your
ability
or
your
your
maximum
capacity
to
process
oxygen
is
a
big
measure.
That's
used
in
sport,
we've
seen
with
symptomatic
individuals.
E
You
know
that
people
19,
I
think,
in
the
swiss
study
of
those
symptomatic
individuals,
not
not
severe
symptoms,
younger
people
mild
to
moderate
symptoms.
19
of
them
have
more
than
a
10
drop
in
vo2
in
in
the
convalescent
period.
They're,
not
processing
oxygen
as
well
as
they
were
before
they
were
infected.
That's
not
good!
That's
not
a
good
thing
right,
so
I
said
before
about
people
finding
this
difficult
to
recover.
E
That's
probably
one
of
the
reasons
why
people
are
finding
it
difficult
to
recover
is
that
your
lungs
may
not
process
oxygen
into
your
blood
as
efficiently
as
they
did
before.
We
don't
know
how
long
that
will
take
to
recover,
so
we
wish
everyone
the
mildest
possible
infection
if
they
are
infected,
but
please
do
don't
assume
that
this
is
an
infection.
E
Without
consequence,
it
may
not
have
a
consequence
of
death
for
you,
but
it
may
have
that
consequence
for
an
older
person,
but
it
will-
and
we
see
more
and
more,
with
long,
haulers
and
and
other
people
who
are
suffering
long-term
effect.
It
does
have
consequences
for
us
all
and
I
just
think
we
need
to
take
that
into
account,
but
speaking
today,
there's
so
much
more,
we
can
do.
We
can
diagnose
this
thing
more
quickly
and
better
than
we
ever
did
before.
We
can
get
people
into
care
more
quickly
and
better
than
we've
ever
done
before.
E
Our
doctors
and
nurses
are
more
skilled
and
better
equipped
than
they
have
been
before.
We've
got
therapeutics
like
dexamethasone
that
help
rescue
very
severe
patients.
We've
got
vaccines
coming
down
the
pipe,
and
we
really
do
then
need
to
focus
to
work
together
to
make
sure
that
we
we
get
through
this
next
couple
of
months,
and
and
so
I
don't
want
people
to
walk
away
from
this
thing,
you
know
sky
is
going
to
fall
in
it's
it's
it's
it's
not
we're
going
to
get
through
this.
D
I
mean
if
I
could
say
something
on
that,
if,
if
our
your
viewers,
our
viewers,
only
hear
one
thing
today,
they
need
to
know
that
there
are
things
that
they
can
do
to
protect
themselves.
Right
now,
and
you
hear
us
say
us
if
you
watch
us
at
all
at
any
of
these
pressers,
we
are
a
broken
record.
We
will
continue
to
say
this
consistently
and
as
clearly
as
hopefully
as
possible
that
you
can
do
so
much
to
protect
yourself
and
to
protect
your
loved
ones.
D
This
means
being
informed
knowing
where
the
virus
is
where
you
live.
You
know,
holding
your
leaders
accountable
to
help
understand
where
this
virus
is
circulating
and
what
you
need
to
do
follow
the
guidance
that
is
put
in
place
in
your
local
area
of
what
to
do,
make
sure
that
you
perform
hand,
hygiene
wash
your
hands.
Carry
your
your
alcohol-based
rub.
Make
sure
that
you
have
this
with
you.
It's
practice,
respiratory
etiquette,
it's
wearing
a
mask,
making
sure
that
you
wear
a
mask
in
the
most
appropriate
settings.
Particularly.
D
Can
you
where
you
cannot
do
physical,
distancing
when
you're
in
enclosed
spaces?
It
means
avoiding
enclosed
spaces?
It
means
improving
ventilation,
opening
your
window,
for
example,
it
means
looking
after
your
mental
health.
You
know
making
sure
that
you
do
something
every
day
that
makes
you
happy.
You
look
at
on
loved
ones,
there's
so
much
that
you
can
do
and
it
means
to
know
your
risk.
Take
a
risk-based
approach
every
day
when
you
leave
your
house
when
you're
on
your
way
to
work.
D
What
are
the
things
that
I
can
do
to
reduce
my
exposure
to
reduce
my
risk
of
infection
and
have
a
plan
talk
to
your
family,
about
this
talk
to
your
kids
about
this
talk
to
your
loved
ones
and
your
extended
family
about
what
do
I
need
to
do
if
I
think
I'm
infected?
What
does
that
mean
in
my
area?
Who
do
I
call?
I
had
an
experience
with
my
own
son
of
saying?
Oh,
he
had
a
sore
throat
when
he
came
home
from
school.
D
C
Thank
you
very
much.
We
just
need
to
explain
as
well.
We
are
not
wearing
masks
here
because
we
are
physically
distant
and
we
are
sitting
in
the
room
which
has
good
ventilation.
We
recommend
wearing
masks
if
you're
in
crowded
clothes
spaces
with
poor
ventilation
and
the
last
question.
I
want
to
ask
because
we're
talking
a
lot
about
what
we've
learned
and
the
question
came
actually
from
our
facebook
viewer,
and
I
think
it's
a
great
one
to
close
with
what
did
you?
What
have
you
two
learned?
C
E
Yeah,
I
think,
humility,
I
think
the
tedros
talks
about
that.
You
all
think
we
know
everything
until
we're
faced
with
the
reality
of
knowing
nothing
and
then
starting
again.
So
I
think
humility
in
the
face
of
a
threat,
this
big
and
the
courage
to
to
get
up
every
morning
and
do
what
you
can
about
it
and
sometimes
that's
the
most
important
thing
you
do,
and
everyone
has
to
do
that
in
their
lives.
Right
now,
so
yeah.
B
E
People
and
people
are
inherently
good
and
people
want
to
do
the
right
thing,
but
sometimes
they're
not
empowered
to
do
that.
They're,
not
given
the
resources
to
make
that
happen,
and
you
know
we're
going
to
have
to
address
some
of
these
systematic
inequities
in
our
society.
We're
going
to
have
to
address
some
of
these
existential
issues
that
we
face,
because
this
pandemic
is
just
really
a
warning
shot
around
how
we're
managing
the
planet,
how
we're
managing
our
societies.
E
C
D
I
think
that
the
answer
of
humility
is
important.
I
mean
we
try
a
lot
to
talk
about
what
we
know
and
what
we
don't
know
and,
and
importantly,
what
we're
doing
to
find
out
and
I
think,
having.
I
feel
grateful
that
we
have
such
a
system
in
place
that
we
are
literally
able
to
harness
the
world's
expertise.
E
Please,
because
I
think
the
time
100
list
came
out
today
and
we're
very
proud
to
see
dr
tedward's
name
there,
but
I
think
more
importantly,
in
many
ways
there
are
two
others
or
a
few
others
named
there.
We
see
tony
fauci
named
there.
We
see
john
jack
myembe,
professor
jean
jack
who's
been
the
father
of
the
fight
against
ebola
for
40
years,
amazing
person,
but
also
a
person
called
amy
o'sullivan,
frontline
worker
in
new
york,
fantastic
great
photo
actually
in
time,
and
I
think
that's
a
real.
E
I
mean
we
can
argue
over
the
list
and
I'm
sure
many
people
are
already
tweeting
their
objections
to
this
hundred,
but
that
one
is
really
important,
because
that
speaks
to
health
workers
and
frontline
workers
all
over
the
world,
and
so
I
think,
it's
great
to
see
those
kinds
of
heroes,
especially
john
jack
and
and
and
amy,
because
they
make
the
difference,
and
it's
just
nice
to
see
a
list
having
people
like
that
on
that.
So
I
just
thought:
I'd
say
that
before
we
break.
C
Also,
we
talked
about
testing
and
diagnostics,
all
those
lab
technicians,
supply
transport
workers,
researchers,
manufacturers,
donors,
everyone
who
helped
us
actually
and
who
keeps
helping
us
to
to
respond
to
this
outbreak
and
to
save
lives
until
next
wednesday,
follow
our
social
media
channel
website
and
join
us
for
for
new
session
next
wednesday.
Thank
you.