Update on the New Coronavirus Outbreak First Identified in Wuhan, China | January 28, 2020

good morning everyone and thank you for joining us here today at HHS today’s press conference aims to do two things provide an overview of what we know about the current novel coronavirus outbreak and highlight some of what HHS and the entire Trump administration are doing to prepare for and respond to that threat today I’m joined by dr. Robert Redfield director of the Centers for Disease Control and Prevention dr. Nancy Matheny a director of CDC’s National Center for immunization and respiratory diseases and dr. Tony Fauci director of NIH s National Institute of Allergy and Infectious Diseases today’s briefing replaces CDC’s daily tel abri thing as we thought it important to provide the media with a face-to-face opportunity to ask questions of our top public health experts first let me provide a brief update on the situation as of today the CDC has reported five cases of the novel coronavirus infection here in the United States China has now reported more than 4,500 cases Americans should know that this is a potentially very serious public health threat but at this point Americans should not worry for their own safety this is a very fast-moving constantly changing situation dr. Redfield and dr. Fauci will walk through some more details of the current situation and response part of the risk we face right now is that we don’t yet know everything we need to know about this virus but I want to emphasize that does not prevent us from preparing and responding we have the experience of responding to two earlier coronaviruses that emerge to cause serious illness in people SARS and MERS and we have experienced responding to bird flu outbreaks in Asia one challenge is that with an emerging virus like this our current assessments are based on an uncertain denominator our denominator is the 4,500 plus cases that have been identified in China as well as more than 60 cases in other countries but these early cases are naturally the most severe cases because patients presented themselves to healthcare providers how does this skew our understanding of the virus first we’re still determining the real speed of spread of this disease which is represented by a number known as R naught which is the average number of additional people infected by a given person with the disease one paper found are not estimates for this virus ranging from 1.5 to 3.5 as compared with say a number of 12 to 18 for measles we’re also still learning about the severity of the virus currently China is reporting more than 100 deaths from the more than 4,500 cases that is a high rate but again the cases that have been identified skew to the severe including patients who are older or have other illnesses the mortality rate may drop over time as we identify a broader set of cases we’re also working to understand the incubation period this number varies for coronaviruses with extremes being anywhere from 2 to 14 days that number could be higher or lower for this virus finally we’re working to determine whether there is a symptomatic transmission normally with a corona virus we see more viral shedding and more transmission when a person is more symptomatic China has reported there may be evidence of a symptomatic transmission all of these questions must and will be answered in order to provide a proper risk assessment but they are not stopping us from focusing on applying tried and trued Public Health methods in the meantime the PlayBook for responding to an infectious disease outbreak is relatively simple and multi tiered you identify cases isolate people diagnosed them treat them then you tracked out all the contacts of the infected person and you do the same with those people and the same with contacts of contacts if necessary that approach is how public health departments and health care providers working with the CDC are handling the cases here in the United States and I am very grateful the hard work that they are all doing together this kind of work coupled with studies at analysis is also how we answer the questions I described earlier on January the 6th we offered to

send a CDC team to China that could assist with these public health efforts I reiterated that offer when I spoke to China’s Minister of Health on Monday and it was reiterated again via the World Health Organization’s leadership today in Beijing we are urging China more cooperation and transparency are the most important steps you can take toward a more effective response beyond that all options for dealing with infectious disease spread have to be on the table including travel restrictions but diseases are not terribly good at respecting borders so we would have to assess carefully whether the evidence recommends any steps beyond the thoroughly tested methods I just described I know this PlayBook well because I was in the same building here in the 2000s serving as general counsel and then as deputy secretary alongside some of these very same fine scientists and public health officials when we responded to the SARS outbreak monkey pox anthrax attacks pandemic flu preparedness and a number of other infectious threats that has given me a deep appreciation for the institutions that oversee our response the United States has the world’s finest public health system we’ve been monitoring this virus and preparing a response since back in December but it’s more than that preparing for these kinds of outbreaks is part of the daily life at HHS and for America’s public health professionals preparedness is a day job around here we are constantly making investments training personnel at all levels carrying out simulations and exercises and sharing information this commitment goes straight to the top the President and I have been speaking regularly about this outbreak and I have been speaking with the senior officials at HHS and the White House multiple times each day since the outbreak began to represent an international threat the president is highly engaged in this response and closely monitoring the work we’re doing to keep Americans safe I’ll give you a brief sense of the work being done across HHS beyond the CDC activities that I’ve mentioned our emergency response arm the assistant secretary for preparedness and response or asper is assessing the level of preparedness we have with the strategic national stockpile which includes pharmaceuticals and other necessary medical supplies HHS is administration for children and families is working with the State Department to assist any Americans who will need assistance being repatriated to the United States NIH asper and FDA are pursuing research into and assessing the possibilities for vaccines diagnostics and therapeutics which is necessarily a longer-term project in addition to the work being done in government there are basic precautions all Americans can take healthcare providers should be on the lookout for patients with travel history to China especially who Bay province and for relevant symptoms late on Monday the CDC in the State Department issued a level-3 travel advisory for all of China this higher level of alert means that Americans should reconsider or postpone travel to any part of China the State Department has also maintained what they call a level four warning for who Bay meaning Americans should not travel there in closing I’ll remind the American people one more time we are working hard to keep you safe we are constantly preparing for the possibility that the situation could worsen and your health and safety has been and will be our top priority to discuss more about the current state of the epidemiology and CDC’s work I will now hand things over to CDC’s director dr. Robert Redfield thank you Thank You mr. secretary and thank all of you for joining us here today as we discuss the latest development that are involved in this situation it is a rapidly changing situation in the United States and throughout the global community right now we know of 18 international locations that have identified cases of this new virus including the United States to better protect the health of the American public during the emergence of this novel coronavirus and based on the evolving information from China CDC has reassessed its entry strategy and decided to expand to screening travelers from the five airports originally 220 airports in the United States my thoughts and prayers are with all the health care providers and frontline responders that are handling this public health threat as well as the people of China I know that many Americans may be worried about the virus and I wanted to let them know a few things that they can do everyone has a role to play in helping contain the

spread of this virus CDC in conjunction with the State Department has updated our travel guidance and now recommends that travelers avoid unnecessary travel to China it’s currently the flu season in respiratory disease season and there’s a lot of respiratory disease out in our nation we recommend washing of the hands covering your mouth mouth when you cough staying at home if you’re sick for health care providers we ask them to be on the lookout for people with the travel history from China especially who Bay province if they develop fever and respiratory symptoms and if you’re a health care provider that’s caring for a confirmed patient we ask you to follow the recommended infection control procedures for all people that may have this infection we ask you to follow the CDC guidance and how to reduce the risk of spreading your illness to others and for people who have may had close contact with someone who was a confirmed patient we asked them also to follow that guidance and if you have symptoms to contact your health care provider right now there is no spread of this virus in our communities here at home this is why our current assessment is that the immediate health risk of this new virus to the general public is low in our nation the coming days and weeks are likely to bring more confirmed cases here and around the world including the possibility of some person to person spread but our goal of the ongoing US public health response is to contain this outbreak and prevent sustained spread of the virus in our country now I’d like to turn over this briefing to dr. Nancy messenger who is the director of CDC’s National Center for immunization and respiratory diseases thank you dr. Redfield I want to take a few minutes and let you know what the CDC teams on the ground in Arizona California Illinois and Washington State have been doing to assist the state and local public health department contact investigations contact investigation means tracing everyone who comes in direct contact with the confirmed case of this new virus it’s essential that we detect illness among contacts in order to make sure that if these contacts are infected that gets the best and most appropriate care and they understand what steps they must take to prevent spreading of the illness to others contacts are watched for signs of illness for multiple days after the last day that they were in contact with a patient if the contact develops a fever or respiratory symptoms they will be tested to see if they are also infected right now we have only a handful of patients with this new virus in the United States we’re conducting contact tracing for every one of those patients because we still think this strategy will allow us to contain the outbreak I want to take thanks the patients here in the u.s. that have missed new virus as well as their close contacts for their cooperation during these investigations I also want to take a minute to thank our public health colleagues at the state and local level as well as all the health care staff who have been caring for these patients our ability to coordinate and react this quickly is entirely dependent on those collaborations but we here is not CDC in isolation but our state local and territorial partners as well as other federal agencies as dr. Redfield said right now we think the risk to the general public in the United States is low but risk is dependent on exposure and while the vast majority of Americans will not have any exposure some people will and therefore will be a greater risk of infection for example healthcare workers caring for patients with confirmed infection and other close contacts they need to be vigilant and the people around them need to be vigilant as the secretary said there is much we need to learn every day we learn more and every day we assess to see if our guidance or our response can be improved as this response evolves CDC will continue its aggressive Public Health response strategy working to protect the health and safety of the American public I’ll now turn it over to dr. Valjean Thank You mr. secretary Nancy I’m gonna give you a brief snapshot of the countermeasures in the form of Diagnostics therapeutics and vaccines that are being investigated and pursued by the NIH by our grantees contractors and why our collaborators in industry first with regard to Diagnostics the CDC has rapidly developed a diagnostic based on the published sequence of the virus the NIH

together with the CDC will be working on next-generation Diagnostics that are more point-of-care so that we can get them more distributed to people throughout the country in the world next is therapeutics there is no proven therapy for coronavirus infection yet there are now ongoing studies that have been initiated with the previous experience we had with SARS and with mares for example back then and between those outbreaks and the current one a number of antiviral drugs have been tested in vitro in some animal models and even in the field anecdotally with historic controls one of them is the antiviral room desapear which some of you may remember was used as one of the elements in the clinical trial against ebola and the other one that is now being used on a compassionate basis by some in China is kaliesha which is a combination of two antiretroviral drugs again I must emphasize there’s no proven efficacy of these but they are being pursued together with the screening of a number of other agents I might point out that is why it is so important that we get isolates of the virus which we will soon have both particularly from the individuals in this country who have now been infected the five individuals that you’ve heard of the other is monoclonal antibodies when we were dealing with SARS we developed monoclonal antibodies as potential therapeutics again no proven therapy because they were not used they were only used in in vitro and animal models given the somewhat close homology between SARS and this and the new novel coronavirus there could be some cross reactivity there that could be utilized however what we’re really trying to do and we will have it soon as we get specimens from individuals who are infected that we will then be able to clone their b-cells and make specific monoclonal antibodies against the novel coronavirus and then finally and most importantly vaccines we have already started at the NIH and with many of our collaborators on the developing of a vaccine the one at the NIH that I’ll just mentioned very briefly is in collaboration with a company called Madonna and the platform is a messenger RNA platform when the Chinese isolated the virus they put on a public database the sequence given the technology of the 21st century we were able to use that sequence pull out the gene for the glycoprotein spike of the petition coronavirus and make that the Imogen to be used in a vaccine right now that’s being prepared I anticipate with some cautious optimism that we will be in at phase one trial within the next three months I want to emphasize because it’s sometimes confused going into a phase one trial does not mean that you have a vaccine that’s ready for deployment it will take three months to get into the trial three months to get safety and immunogenicity data and then you move into Phase two what we do from that point on will be determined by what has happened with the outbreak over those months remember we made a phase one trial with SARS and we never had to use a vaccine but nonetheless we are proceeding as if we will have to deploy a vaccine in other words we’re looking at the worst scenario that this becomes a bigger outbreak so in summary there are three types of interventions that we’re working on Diagnostics therapeutics and vaccines and we will keep you posted as we make progress in each of these thank you thank you very much dr. Fauci dr. Redfield dr. Mattson yay at this point we have time for for questions from the media on the topic of the novel coronavirus so Ricardo don’t get us started if you’ll wait a second just because of the live-streaming to get a microphone before you ask your question thank you okay Ricardo Alonso Zaldivar with AP and my question could you please update us on what is known about the asymptomatic transmission in other words people catching it from somebody who doesn’t show symptoms and could you also tell us how long after a person is exposed does it take for the testing to pick up the virus let me ask dr. Matheny ada take that sure thank you and those are really important questions there have been isolated reports of asymptomatic in

action from several countries those are countries that only have a few cases as opposed to for example in China where the majority of cases are we’re looking at that data closely it’s important to know that right now in the United States we have only five cases and we have no evidence of human team and transmission from those cases those cases themselves traveled to China and so that’s an example of direct transmission from China but that’s something we’re watching closely and obviously as more information becomes available we would have to change our operations if indeed that was a significant issue in terms of how long it will take from the time that you’re infected to develop a positive test what I can tell you so far is that the patients that we’ve seen in the US have tested positive and we’re following them but the way that we’re looking at close contacts is by doing more than one test so that we can understand if for example we picked them up initially and they’re not infected and then later on they go on to develop disease as many of you know that is something we do see in other infections where there is a period of time early where you have mild symptoms before you go on to more significant disease the PCR tests that we have you know we’ve really rapidly turned around from having sequences available online to being able to get a PCR it’s a testament to CDC laboratory ins ability to do something really rapidly and I’m proud of them but as dr Feld she said we’re gonna continue to work on other Diagnostics that can also help us to understand better the spectrum of illness thank you very much how about with the leather jacket here thank you Robert Delaney with the South China Morning Post I just wanted to follow up on media reports that the White House is considering travel restrictions from China to the US and the other question I had was about the offer to for the CDC team to to support a solution by working with the health authorities in China can you give us some more information about what the response from China has been to that and who has been involved in that interaction thinking so in terms of in terms of travel restrictions as I mentioned in my opening remarks it’s important to not take anything off the table with a rapidly emerging novel infectious disease we will be constantly assessing the appropriate public health measures to be taken based on the science evidence and epidemiology that we learn including some important information is dr. Missoni a spoke about and as I spoke about in my opening that we hope to learn from by working on the ground in China as quickly as possible so we can see raw data raw evidence and help design the types of studies and analytics that really are needed that leads to the your second question which is the offer that we have made which we do hope that the Chinese government will take us up on that CDC experts are standing by ready willing able to go immediately to China either on a bilateral basis or under the auspices of the World Health Organization so I have been directly engaged in those discussions with Minister MA the Chinese Minister of Health as well as with the director-general Tedros of the World Health Organization and he had director-general Tetris just had meetings this morning in China so it would be Tuesday morning in China with senior most officials I found my interactions with the Chinese government to be very productive and cooperative and I’m hopeful that we’ll have a positive resolution and be able to deploy especially under the auspices of the World Health Organization one thing that we can do is let me ask dr. Messina to talk a bit about what we do when or dr. Redfield what we do when our teams go how we provide assistance with the CDC currently we do have a CDC office in China that’s embedded in the China CDC we would add our personnel there to help them really define the epidemiology and answer some of the critical questions that were asked about asymptomatic transmission for example in particular and what is the incubation period since there’s been such a wide range we also can assist them to begin to understand really the spectrum of infection we developed a diagnostic test that we can use to actually tell after the fact when somebody has actually recovered were they actually infected or not so this is the critical thing we do we we augment laboratory support but most importantly we augment the epidemiology capacity to answer these critical questions that are so necessary to understand for future public health action in the green there is there talk of appointing someone to a coronavirus czar role so at this point this is a public health issue our department is leading this effort it’s a public health matter it is what we do is our day job is preparedness and response for public health matters we are tightly coordinated across the

interagency throughout the National to federal government so as other departments whether homeland security state department transportation commerce we’re all working together in a very transparent way under the leadership of the National Security Advisor so there’s a full interagency process but the lead right now is very much a public health preparedness and response activity led by HHS thank you how about the there that she entering with United dnews group Taiwan secretary Taiwan has to confirm eight cases already but Taiwan is excluded by WH o would you be concerned that Taiwan may not be able to receive the latest updates from WH oh and how would you as enhanced cooperation with Taiwan on this matter thank you thank you so we always work to ensure close collaboration with Taiwan public this is a public health matter not a political matter in any way and certainly work to ensure the technical technical expertise and exchange of information happens and as the United States can help to support that effort we certainly continue that and then hey mr. secretary left stat you said more transparency and more cooperation from the Chinese government was the best response so beyond allowing the CDC team that to join them there what measures would you like to see that government take that it hasn’t yet so first having lived through the SARS episode I can say that the the posture of the Chinese government levels of cooperation and interaction with us is completely different from what we experienced in 2003 and I want to commend to them for that they are still obviously learning just as we are about a rapidly emerging infectious disease situation but getting WH o CDC experts on the ground to be able to assist the Chinese experts this is a major interracial aquel thish uu and we basically just need the best public health people we have in the world working on this right now and so getting them there to do the types of work that dr. Redfield and dr. mess and I have spoken about in addition as dr. foul Chi mentioned the more actual isolates that we can get actual live isolates we can get the more robust we can ensure any therapeutics or vaccines would be more targeted and on top of the genetic sequences that has been shared I mean it is it is excellent that China put the genetic sequencing online and complied with the international health regulations work that was what enabled our teams at the CDC this is really a historic accomplishment within one week within one week the CDC had invented a rapid diagnostic test within weeks we have a candidate vaccine out of NIAID that we’re working on this is really remarkable and that has that rests on a foundation of transparency and collaboration under the international health regulations sharing genetic sequencing and isolates thank you yeah the other thing is in the in the area of research I mean everyone appropriately is concentrating on the public health aspects of it which are absolutely critical but we’ve been collaborating with Chinese scientists many of them have actually trained in the United States so it would really be very nice if we could get more open interaction not only in a public health arena but also on sharing research data and research endeavors so it’s combination of the two that’s right here in front here yes I’ll wait for the mic please yeah hi this is Shana from Agilent france-presse obviously we’re in a containment mode and firefighting mode right now with regards to the corona virus and learning more and diagnosing but on a more on a broader level or what do what does this new corona virus tell you about corona viruses in general and how we can contain them with regards to keeping wild animal markets and and and and you know consuming those wild animals should we should this be the focus so that we’re not always looking for the next coronavirus which is about to come out thank you for your question I think first I want to say and that it’s really important although we know a lot about SARS and we know a lot about MERS we really don’t know a lot about this new corona virus and I would be reluctant to encourage people to translate knowledge from those two viruses to this virus that’s the first thing that I would say so as we learn for example we don’t actually know how this virus jumped into into man bats are the most common you know source of these viruses in general so that’s the larger assumption but what what was there a second vehicle or not and if so what it was like MERS it’s camels you know so I think we’re still learning and we’re trying to you know we’re going to sort of stay where the data is but I would just caution us from taking lessons from MERS as a pathogen and

lessons from SARS and say okay we know because neither of those for example had significant asymptomatic transmission and as was alluded to we’re trying to figure out is that just a rare event or is it more so again I think we just have to wait and see what we learn over the next couple of weeks the black blouse yep hi Breanna Ely from Politico I was just wondering if you guys are considering declaring a public health emergency for the outbreak yeah so we have we have various authorities that we use one of them as you mentioned is section 319 of the Public Health Service Act which is a public health emergency I will use that authority whenever I’m it’s recommended by our public health officials that they believe any incident is a sufficient stature to invoke it as well as when the authority is implicated by that or necessary I think it’s very important to remember where we are right now we have five cases in the United States each of those individuals with direct contact with Wuhan and no person-to-person transmission in the United States but I won’t hesitate at all to to invoke any authorities I need to ensure that it to ensure that we’re taking all steps to protect the American people don’t hesitate in the lease but I’ll do it when it’s appropriate under the under the standards that we have in the authorities that I need yes in the front here Wendy Jones NBC when will the additional airport screenings start and the current charter plane returning from Wuhan with Americans will those people go into quarantine in California and for hello let me ask dr. Nelson if you could take the let me take the first part which is as you know we have been over the past week doing enhanced screening at five airports specifically around travelers returning from Wuhan what we’re doing is expanding our activities to 20 quarantine stations and really building on our regular day-to-day activities at those quarantine stations so our regular activities at quarantine stations focus on identifying ill patients and that’s what we’re going to be doing here identifying ill travelers returning from China so that we can make sure that they’re appropriately treated so that they don’t pass on this illness to others but also it’s an incredibly important opportunity for us to educate those returning travelers but the signs and symptoms of this novel coronavirus they are an important part of the equation we want travelers to understand that even if they don’t have symptoms when they come back to the United States if they develop symptoms they should contact their health care provider immediately so that’s a really important part of this expansion identification of ill passengers but an opportunity to educate them so that they can be part of helping us contain this disease and then with with regard to the the flight of individuals who are connected to the u.s. embassy consulate in Wuhan returning with family members we will be heavily engaged with that flight in the transport of those individuals they’ll be screened evaluated constantly there will be physicians on the flight and we’ll take whatever the appropriate evidence-based Public Health measures are with as we would in any other situation so well that’ll all be dependent on what we learn as we screen speak to people as we do the type of evaluation we would do in any type of infectious disease contact tracing type activity in the back there with five hi jason Barty from think global health i wanted to ask about the rapid diagnostic test is it going to be used for routine screening and can you comment on the efficacy of the of the diagnostic given that the rapid flu test produces false negatives I’ve read yeah thanks for helping me to clarify this isn’t the same thing as a rapid flu test calling it a rapid test but sort of it’s technically an rt-pcr a rapid real-time PCR this is a test that is much more sensitive and specific than some of the rapid flu tests right now it’s only available at CDC and that’s really because before we roll it out to our local partners we want to make sure that it is as good as possible you know developing a rapid test this quickly is hard and if we’re gonna pull it out farther than CDC we want to be sure that it has appropriate sensitivity and specificity in this kind of situation is it exceedingly important that we don’t misdiagnosed somebody and say that they don’t have disease when they do or alternatively scare them when we do so unnecessarily we are moving as quickly as possible to get that test closer to where the patients are and I expect that to be available more locally within a week or two and then hopefully eventually as doctor Falchi was talking about there’ll be more availability of these tests through other means but the CDC tests as quickly as possible we’re

getting it more local in the back third excuse me yep thank you hi Lenny Bernstein like the post over the weekend there began to be concerns about containment within China what’s the latest thinking on that are you feeling any different than say Saturday or Sunday about the possibility of this being contained within China and given how few infections that are outside the country and and no deaths does that tell us anything about the lethality of the virus so it’s obviously spreading rapidly within China I think at this point I believe close to 50% of the Kate the new cases are outside of the the Huan province where we’ve been focused on but let me ask who bands are who’ve a province with Luhan in it let me ask dr. Redfield if he could talk a bit about the evolving nature of the disease over the days it’s clear that the outbreak in China is is continuing I think you those of you who are following the case numbers know that was I think almost 1700 new reported cases like in the last 24 hours I think you’ve also seen from the China response that they’ve mixed and we talked about this word containment and mitigation it’s not like there’s a point where you switch from one to the other we we integrate the two and China’s clearly moved to a number of mitigation strategies you know advising or cancelling public large events and large gatherings obviously a lot of what they’ve done in terms of changing travel areas so I think clearly at this stage we have an ongoing outbreak in China and we need to continue to watch there clearly now is evidence of human to human transmission outside of that one province there’s now over 30 provinces in China that report cases so again this is one of the reasons we’re hopeful that we can get our experts in to work alongside to help try to get a handle on helping them with their broader containment strategy but I do think it’s a emerg thing between what they’re doing from containment and how they’re starting to do certain mitigation strategies on the front here okay we’ll go here first in the front and then the other front I Tom rouse the ABC 7 News a question that drugstores are reporting they’ve had a run on people buying masks to protect themselves is that helpful at all no it’s up it is unnecessary as we said in the United States the risk to any individual American is a Stram lilo we are taking the steps to be prepared for this we are taking aggressive action but the individual American does this should not be an impact on their day-to-day life this and so that would be an unnecessary step thank you and now we’ll go what is the proper a Peter Nicolas from the Atlantic what is the proper role for the US president in the face of a disease like this and what is the message that he should be communicating right now well I think for any of us the proper role is to ensure that we’re being open and transparent we want to the mantra we want to have is that we’re giving you the information we have when we have it so that you the end the American public know what we’re learning know how we’re thinking how we’re addressing the problem and we want to it’s always a balance it’s very difficult to make predictions with an emerging infectious disease viruses are unpredictable and so that’s why the message is is a potentially very serious health issue and but at the moment there’s nothing individual Americans should be worried about but that’s at the moment and just know that you have the most experienced team in the world on this prepared on this this is what we do at the Department of Health and Human Service as well as our other partners in the interagency thank you let me go right there Jeanne Bauman with Bloomberg law I was wondering with the twenty quarantine the expansion to 20 airports what percentage of passengers you’re able to get to screen coming in from China if there are plans still to screen all passengers from China and when you might make a decision on that if you’re doing planning to do so so I’ll ask dr. Besson DEA to clarify on this but the it’s important remember the first thought the first five airports were the airports where most of the flights directly from Wuhan to the United States came into and those individuals received active interview screening etc as well as educating for follow on for any follow-on disease or symptoms that they might have the expansion to the 20 airports now there are no longer flights coming from Wuhan to the United States at this point these 20 quarantine stations are our active quarantine stations we have enhanced staffing there and at those quarantine stations we mana for any signs of illness from any individual coming from China but also

just generally we’re always on the lookout that’s what we do on the lookout for anyone coming into the country who’s presenting signs and symptoms of disease working very closely with our partners at Customs and Border Patrol for instance as well as as well as information received from pilots or flight attendants crews of airliners let me ask doctor Messing if there’s any other clarification on that just maybe the clarification that think of screening as part of a layered approach that we use to protect Americans and so screening at the airport is an opportunity to identify ill passengers an opportunity to educate people but we know that several of our patients who are of the five patients that we have in the u.s. now came into the u.s. before we had stood up screening didn’t have symptoms at the airport they themselves understood that they were potentially at risk and when they had respiratory symptoms they told their health care providers that’s how they were identified diagnosed and that’s how we’re able to work to control this outbreak so screening at the airport is important screening passengers returning from China will be something that won’t be starting on a rolling basis to enhance our activity at all 20 of those quarantine stations but it is only one piece of a multi-layered strategy Rita Chen with Radio Free Asia I would like to follow up on the u.s. evacuate its own citizens from ohan and that the wh shows a director-general just addressed he thinks that the action like that is unnecessary so what’s your response to that and do you trust the WTO and China’s ability of managing the crisis this time thank you so we will take all steps that we feel are necessary to protect American citizens I’m not aware of any critique from my good friend dr Ted Rose regarding the United States action with regard to extricate our consulate individuals and their family members and but we will take whatever we believe is necessary to protect Americans we have an excellent relationship with the World Health Organization this is what we do we work constantly together we’ve had we’ve been working on the Ebola crisis in the eastern Congo and Democratic Republic of the Congo this is what we do and so I have great confidence in the World Health Organization and our constant collaboration together to deal with emerging infectious disease threats it’s remember the most important thing that we can do to keep disease coming into the United States is to stop and contain disease away from the United States and so we try to work very actively with our international partners to do that ABC again yeah NBC sorry there seems to be perhaps a conflict between US and Chinese authorities on whether or not this disease is contagious before symptoms of pure what is the CDC saying the Chinese have reported the evidence of transmission in the asymptomatic phase based on data that they have reviewed CDC has not been given the opportunity to review that data so when we say what we say is we haven’t been able to confirm by data the impact of transmission during the asymptomatic phase the Chinese believe they have that data so this is again our hope as we could get more directly involved in China to be able to review and be more definitive we have a limited experience here as dr. missions they already said five cases were evaluating now number of contacts in the context of those evaluations we are trying to address this issue is there any evidence of shedding of the virus in any of these contacts before well we’re going to present the data that we have and we’re not necessarily going to affirm someone else’s interpretation so that’s why you see the differences we haven’t seen that data can confirm that conclusion so just add one thing that seems to get lost in that question is that as Bob said and I agree we would really like to see the data because if there is a symptomatic transmission it impacts certain policies that you do regarding screening etc but the one thing historically people need to realize that even if there is some asymptomatic transmission in all the history of respiratory borne viruses of any type a symptomatic transmission has never been the driver of outbreaks the driver of outbreaks is always a symptomatic person even if there’s a rare asymptomatic person that might transmit an epidemic is not driven by asymptomatic carriers thank you very much Donna one last question thank you thank you well the World Health Organization just announced it that China has agreed to let experts international experts

work with them so wanted to get an update from you on that and on the stage so I didn’t hear that but obviously if that if that is the case delighted with that news and delighted and assuming CDC personnel would be part of that but ask you about funding have you already been in touch with members of Congress about potentially seeking additional funding for the research going on at NIH or you know anything else at CDC that they may require any of any emergency funding that you may request so um by a declaration that I made a determination on Saturday under our infectious disease Rapid Response Fund that Congress funded in 2019 I was able to working with OMB to enable 105 million dollars of funding to be directed towards the response to preparedness and response activities immediately we will keep assessing based on the emerging nature of the preparedness and response activities what’s needed i of course have various secretarial transfer authorities that working with under the direction of OMB and working with Congress can be implicated and of course will we’ll work with the Office of Management and Budget if there ever were a need for additional funding from Congress we’ll take the steps necessary to protect the American people the unfunded won’t be the barrier to that thank you all very much and we’re gonna keep we’re gonna keep doing meetings conferences we want to be as I said completely transparent with the American people about the situation we’re facing and we’ll be learning new information every day as we go through this but thank you for being here with us today thank you produced by the US Department of Health and Human Services at taxpayer expense