NYC ER doctor: I have to 'plead to test people' for coronavirus

let's talk to dr. Scott Gottlieb, former FDA commissioner and CBC contributor, sits on the boards of Pfizer and aluminous and Dr. Matt McCarthy and an infectious disease only for a

doctor

author of superbugs, the race to stop an epidemic, thank you both for joining us. Just to start on a little bit of a different tangent, gentleman, I mean, when did we discover penicillin? like in the 30s or so, I mean by this what we

have

done in the last 90 years in the entire history of human existence it is amazing where we are now discovered in 1927 because especially available in 1944 we

have

had a long successful history of diagnosis and therapeutics and we are getting better and better now that we can search when we sequence this instantly almost with Korea we can do it in an automated way why shouldn't we have hope that we can get to a therapeutic quickly let me tell you the problem right now before we come here This morning I was in the emergency room seeing patients.

I don't have a rapid diagnostic

test

available yet; Well, that's easy to do, right? It's hard to make. it's easy for some countries to do, what happened in the United States is that the CDC created a top EI Senate

test

in 50 states and then said oh wait, don't use it, let us fix it, how fast is it now? , we mark. I heard it's coming very soon but I'm here to tell you right now in one of the busiest hospitals in the country. I don't have it within my reach. I still have to call the Health Department.

I still have to present my case. begging for

people

to be tested, this is not good, we know there are 88 cases in the United States, there will be hundreds by midweek, there will be thousands next week and this is a test, what do you do with

people

in the emergency? If you can't test them well, we call them and try to test them, isolate them. We have a great team of infection control professionals who know how to handle this, but they are paralyzed by the fact that we don't have a diagnosis. testing available people sent home because I read reports about that over the weekend we will not be sending people home we are making sure they get the supportive care we can provide but keep in mind we have this in New York State now , TRUE? whoever tested positive was only the 32nd test we have done in this state, which is a national scandal, they are testing 10,000 a day in some countries and we can't get this off the ground.

I am a practitioner on the front lines and I do not have the tools to adequately care for patients today. You know the challenge is that providers can't take the right precautions if they can't. You like to talk about this for weeks. Yes, this is what we must do with you. I know about therapeutics I think this meeting will focus on vaccines, we need to have a vaccination strategy. I think we are one or two years away from having a vaccine. I think we need to think about what we're going to have in the fall as a backup.

Hopefully this will start to dissipate in July and August, but it will probably return in the fall and then what's next? The only thing that might be available in the short term is a therapy, you know, if we have antibody-based prophylaxis. or a medicine because the vaccine law is not something that exists in the HIV regime that can work honorably. Well, we have an HIV drug, Calitri, that we are studying right now. It is in a clinical trial and the information will not be available. For a while, the message today is that we are hearing from this administration that the risk is low and that things are probably going to be fine, you don't need to change your lifestyle, that is simply not true, there will be thousands of cases here .

We have already moved from containment to mitigation, we are trying to lessen the severity here, you will see widespread disruption to daily life, don't believe the false reassurance, what does that mean in terms of what people need to do on a daily basis? Well, look, I think. that I think we're going to have outbreaks here in the US, there's no doubt about it. I think in some parts of the country we're past a point where we can contain this, we're going to have to look at mitigation. Washington state, California, does not. It doesn't need to become an epidemic.

What I'm saying is that we have a much more advanced healthcare system. We have better infection control procedures in hospitals. I think we have the capacity to do it. I agree that we need to start taking more aggressive steps right now to make sure. that this does not become a meal, the best head tests from China on how to do it, possibly beyond the disadvantages of the epidemic, how they do it well and there is also something called the boomerang effect that we may be seeing in who at this point . which is that in the places that we think are clear are starting to have rates of increase, we may see things recover, but the key here is not to believe in the false security that I am telling you, the cases are about to increase and only then will we be able to inform ourselves. decisions on that minimum and denominator about mortality absolutely, so if we're talking about the mortality rate, I see numbers like 1 to 2 percent.

I don't think the model we're using, we're using data from Korea. We think that's the best and what is that point two point four percent? Oh, that's twice as bad as a seasonal phrase. A very bad flu season. Keep in mind that the flu kills between twenty-five and sixty-nine thousand Americans, so that has already occurred in the economic effects. They are already much more than double the mortality rate of the flu, we are in ten times longer, what do you think of the diamond princess? because I know it's not a typical population but the case fatality right there is going to be probably above one percent when I said absolutely and you know if you're Asian because it's an older population so if you're eighty on a cruise ship you're in trouble, I mean the fatality rates above ten percent that we are seeing between the ages of one and nine is extremely low, there is a lot on a kinematics, almost absolutely, so widespread surveillance will begin to give us information so that so we can make these informed decisions about whether March Madness should be canceled, are there different tiers? of panic across the country and the reason I ask is because I was in Detroit last week and this is a small example, but I asked a room full of clients and investors if they were worried about the

coronavirus

and they unanimously said no. and I said: You're not worried because you think you're going to catch it and you'll still be fine, or you're not worried because you don't think you're going to catch it.

Yes, I think this has been the case for a while. This will be at the regional level. There will be regional outbreaks where more focus will have to be placed on certain parts of the country. Washington State. We're probably a couple of weeks away from taking some important steps in Washington state to try to mitigate the spread in Northern California. It's a couple of weeks away, it has an incubation period of potentially a couple of weeks, so we're always going to be behind the eight ball on this. We are reacting to the news two weeks later, well, we have many undiagnosed cases to resolve.

His point right now is that there are probably thousands of cases in this country that we now need to hand over the card, so we are going to have a spike in cases before we start to catch up with the real number. The level of spread, you know, it's a big country, 330 million people, so even if you have several thousand cases, you're at risk of getting it, it's still low, but that could change very quickly. Japan has taken some pretty extreme measures, such as closing schools. They are not diagnosing their cases, there is an aggressive South Korea or Italy, that is what we are going to look for to close the schools here.

Definitely, you know, we're hearing that life is going to be normal, that's not true and to address the previous question, I will tell you that I live in Westchester when I walk around Westchester, I'm not really worried about the

coronavirus

, but when I get on the train 6:00, when I walk through Times Square, when I'm in the emergency room every day. A single day seeing patients I am very worried, very interested in Santoli, yes, yes, because I, because I travel by subway, how many, how many cases do you suspect that you have seen? If you had enough cases, if you did the test, how many cases would you do?

We have tested well, we have seen a case in New York. I bet there are hundreds. I bet there are thousands in the United States. The longer we wait to start testing, the worse it will be, but I'm sure. telling you as a practicing

doctor

that we are not there, why do I see? I thought tests were being shipped to California in bulk. I thought the testing capacity by the end of this week would be around a hundred public health labs. a capacity to do a hundred tests a day, so that's 10,000 tests a day by the end of this week, which still requires doctors like you to call the State Department of Public Health to order testing which is cumbersome by the end of the following week. that we should have maybe up to another 10,000 tests capacity per day, so we will be able to do 20,000 tests per day as we bring in academic labs, which will make it much easier for physicians like our guests to order tests. inside your house that's not available, yeah, but you want it right, that's right, so a week or two from now is when we're going to start getting real information right now, we're still largely flying blind, so that if you are worried about fear and uncertainty we are still in the thick of things you you