Sat, 15 Aug 2020

Interview: CDC HeadSays Masks Are Essential in Coronavirus Fight

Voice of America
15 Jul 2020, 10:05 GMT+10

WASHINGTON - VOA contributor Greta Van Susteren interviewed Dr. Robert Redfield, director of the U.S. Centers for Disease Control and Prevention regarding the current coronavirus pandemic.

Among the topics of discussion, Redfield said wearing a mask is essential to fighting the infection rate of the coronavirus, adding that if everyone in the country agreed to wear a mask, the infection rate would be significantly lower within weeks. He agreed with reopening schools this fall, saying he is "absolutely" comfortable with the idea, and said the pandemic is going to cost the U.S. between $5 trillion and $7 trillion.

Here is a transcript of their discussion:

Greta Van Susteren: Doctor, thank you very much for joining me. 

Dr. Robert Redfield: Thanks for having me. 

Van Susteren: And we are at least 6 feet apart, right? a safe social distance. We're not wearing masks 

Redfield: ...got a mask here in case... 

Van Susteren: and I got mine in my pocket. But thank you for joining me. Tell me, what is the CDC? 

Redfield: You know, CDC is one of the agencies within the Department of Health and Human Services that really focuses on public health. Its dominant mission is to be able to detect, prevent, and respond to outbreaks around, around the world. We constantly are looking at public health threats, whether they're infectious disease, or whether there can be chronic diseases like tobacco use, diabetes, obesity. So it's a wonderful organization of more than, if you count all the contractors, more than 20,000 individuals, dedicated epidemiologists, physicians, nurses, health care professionals, pharmacists that spend their energy to try to understand disease in this nation, and then look for strategies to intervene to try to improve the human condition. 

Van Susteren: Headquarters is in Atlanta, but do we, does the CDC have any offices overseas? 

Redfield: Yes, so headquarters is in Atlanta. CDC also has multiple offices in the United States. Outside of Cincinnati, (Ohio) outside of Pittsburgh, Morgantown, (West Virginia) up in Fort Collins (Colorado) in Spokane, Washington. And then we have offices in over 45 countries around the world. Really its prime mission again is that idea of being able to have the ability to detect, respond, and prevent pathogens. We always say it's better for our nation if we can deal with the outbreak over there -- recognize it, respond and prevent that outbreak. And I think is a critical mission of CDC, to provide the overall, what I call, health security for this country, to be able to have that full capacity. The coronavirus outbreak is a great example, you know, of a pathogen that occurred somewhere else and ...

Van Susteren: ... it doesn't respect borders ...

Redfield: ...doesn't respect borders. 

Van Susteren: It doesn't care. 

Redfield:...doesn't care. 

Van Susteren: Does the CDC have a branch in China? You mentioned the coronavirus. Do we have one there? 

Redfield: We do have, we've had an office for a number of years. The American CDC in Beijing, China, CDC. The big important thing is to secure the appropriate long- term funding to let these offices have sustainable ability to build. And this is something that's a priority for me. I'm working very hard to try to secure long-term funding for what I call our global health security strategy. Much of what the overseas operations that CDC has been able to build were built around the PEPFAR (President's Emergency Plan For AIDS Relief) program with ... 

Van Susteren: ...President (George W.) Bush.

Redfield: President Bush's PEPFAR program and that expanded CDC role, we're a very strong component of the overall PEPFAR program. So China, we've had an office there for more than 30 years, working side by side with the China CDC. I'm trying to expand that office now. It actually had gotten shrunken down to a handful of individuals based on funding constraints that occurred after the global health security agenda funding, which was all a supplemental funding from the Ebola outbreak of 2014. You know my big goal is to try to get people to realize that these important core capability missions like the global health security's got to get into base funding, so that we can build them. 

Redfield: I guess it's sort of akin to, I think of this as if you had come to me last summer  and said, "We want the taxpayers to pay $400 million for masks. I would have said, 'Have you lost your mind? We need $400 million for this.' Now, fast forward to now, when all of a sudden we have this pandemic, I'm saying where are those masks? You know, and you say well we didn't have the funding. You know, so it's, you've got a tough road there because it's almost, as soon as the crisis, we're ready to fund you. It's before the crisis. 

Redfield: This is the probably the most important point I'd like to make to you and your audience, is that when it comes to global health security and public health, we need to take a posture of being over-prepared, not underprepared. For over 50 years, this nation has underfunded public health. And I think it's so important. I'll argue now's the time, I think everyone's been alerted.

Van Susteren: We're like, we got it we got a message. 

Redfield: This is gonna cost us $5, $7 trillion, this pandemic. And we had, you know, underfunded capacity. We don't have any comprehensive data system across the nation. We need to have a comprehensive public health data system that's not only in real time, so the data is actionable, it's got to be predictive. We need laboratory resilience. A lot of the questions about when we developed the early lab test, it was developed for a platform that all the public health labs have, but that platform can only do 30 to 50 tests a day. We need resilience in the public health platforms. They should have had high throughput machines, but there wasn't an investment. We need a public health workforce. 

Van Susteren: Was the CDC involved in, I assume it was, in the Ebola outbreak in Africa, when it started in West Africa and Liberia and some of those nations. But CDC was actively involved in that? 

Redfield: Absolutely, it played a major role actually, and a lot of the funding that we had to begin to expand our global health efforts in our global health security space came from the supplemental of the 2014 Ebola outbreak that when it wasn't used, we could invest it. But one of the problems of supplemental funding is when it's over, it's over. It's hard to build something that's not built on a base-level funding. 

Redfield: So I'm arguing now that it's a critical time, I say now's the time for Congress to invest in public health core capabilities -- data, lab, workforce, global health. Now's the time to do it and do it in a way that's in the base funding so it can continue to build. So that it doesn't go out of date every three to five years. And I say that this is our opportunity to give this nation a public health core capability not only that it deserves, it needs, but that it deserves. 

Redfield: And many people don't realize CDC, about some states, 70% of the funding that we provide the states is the public health funding for that state. So when you fund CDC, our funding then goes out to all the states, the tribes, the territories and local health departments and forms the public health infrastructure of this entire nation. And that needs to be now invested in in a very serious way, in base funding. 

Van Susteren: And I assume there's also an exchange of information of technology, information, learning so that even if the funds may be spent domestically here in the United States, what the CDC learns here since viruses for instance, have no borders, is that is that the African continent Asian and South American continent, it goes all over the world an exchange of information. 

Redfield: Both ways. It's a bidirectional learning curve. You know when I looked at what I've learned over the years from my work in Africa and AIDS, I've been able to bring back to Baltimore. OK. Same thing with CDC, what we learn overseas, we can bring back to the United States. What we learned domestically, we can bring overseas. When it comes to infectious disease, you see that there is no barrier. 

Some people think CDC is just a domestic organization. You know some people think CDC is just a global or international organization. The fact is we're, we're a global organization, both domestic and overseas. And we really need to be that because as you said, these pathogens don't know any borders.

Van Susteren: Now, I want to talk about vaccines, where we are. But before that, since we have so many hotspots in the world, is that people obviously are worried about vaccines, but they're also worried in the short time about treatments. And it seems to me that the one that's, that seems to have the most faith, at least in the public domain right now might be, is remdesivir, which was developed for Ebola. Am I right, that that sort of is the leading contender, but we're always looking for more and better? 

Redfield: Well it's the important first step. I mean, remdesivir is an important step, what has been shown and proven now to actually have improvement. It can lower the length of stay in individuals in intensive care, and a very special subgroup, if it started at the right time, it does appear to actually decrease mortality. Important advancement that's out now. 

Van Susteren: And is that because it's sort of like Tamiflu to the flu? It reduces the viral load, so if you have less viruses in your system, you're less likely get so sick? 

Redfield: It clearly is antiviral. that's how it works. Its challenge is, once you've already, when this virus causes infection in your body, it gets to a stage that actually what's really causing disease for you is not the virus, but your body's response to it, the inflammation. So when you're in that inflammation phase, remdesivir isn't going to work so much. That's when you heard the recent data about steroids. Steroids work helping save lives when you're in the inflammation phase. Remdesivir helps when you're in the viral replication phase. 

Van Susteren: ...which is why then the popularity of Dexamethasone, which is the steroid that's been around forever. So that it tells your body, your immune system, quit inflaming. 

Redfield: Yeah, quit inflaming. It tells you a lot about the pathogenesis, when Tony (Dr. Anthony Fauci, head of National Institute of Allergy and Infectious Diseases) and I saw that data come out about Dexamethasone, we immediately said, you know, OK, confirms our suspicions in the pathogenesis that when we see patients starting getting better. And then all of a sudden they crash, very rapidly on say, day nine, 10, 11 -- that's really their body causing a pro-inflammatory response in their lungs, causing pulmonary insufficiency. Steroids work there. 

Now there's other therapies that are coming on the line right now, they're under evaluation. Taking the serum plasma from people that have convalesced infection. And right now there's a large trial, over 30,000 people, that have been receiving the plasma of individuals that have recovered, to see if that can provide antibodies that will provide benefit to those individuals. 

Van Susteren: And as I understand the convalescent plasma you're talking about, is if you if you blood plasma from somebody who already had the disease, is that the only one who might likely get that is someone who's in the hospital with an IV. It's not like you can use it as a short term, almost an injection into the muscle is sort of a front-line defense for health care workers or nursing homes, which would be good.

Redfield: It's interesting. If you see that it works, and this is the studies that are going on now and hopefully we'll have more data out in the next days or weeks ahead, and you then understand what antibodies are making it work. Then you do have the capability if we get some of the 3 million Americans that have been recovered, if we get them to donate their plasma, you can actually purify that to get antibodies in what we call hyperimmune globulin. So just like you used to get a shot for hepatitis A before you traveled overseas many, many years ago, there is the potential that this could be developed into a gamma globulin, can be prophylactic for nursing home individuals. 

So that's on the, that's on the docket, too, but it really depends. And the last thing I'll say about therapy that's just the ... HHS just awarded a little over $400 million to Regeneron (biotechnology company) the other day, is we now know you can actually make antibodies. You know, monoclonal antibodies that are able then to neutralize the virus and. ...  

Van Susteren: So would that be, in just in very layman's terms, you're making, sort of, I mean, if you have, if you have coronavirus COVID-19, you create antibodies. And what Regeneron would do is make it sort of fake or phony ones for your body to think it has the real ones? 

Redfield: Yeah, outside of the test tube, they're actually cloning those antibodies. So they're making those antibodies, specifically those 123 antibodies outside the test tube that you can then give back to the patient. This is what we did for Ebola, with the recent Ebola outbreak, I think some of your crew was with us in the Congo, I think last, last year. The same company, Regeneron , figured out several antibodies that neutralize the Ebola virus. They made them in the test tube. And we took a disease, it was killing 60, 70, 80% of people. And now giving them those antibodies, we were having mortality rates under 10%. 

Van Susteren: Which is sort of unusual because remdesivir was originally developed for Ebola but unsuccessfully so, but seems to show promise for the coronavirus. 

Redfield: That's right and I think part of that, too, is that the monoclonal antibodies were so successful. In other words, when the remdesivir was compared to monoclonal antibodies, the one developed by NIH (National Institute of Health), as well as the one developed by Regeneron, these antibodies turned the tide. We went from, I was many times in the Congo. And as I say you're looking at 60 to 80% of people dying. And all of a sudden these antibodies came along, and we were saving, if we could get you in the hospital within the first days of infection, we were saving 90% of people. 

Van Susteren: Hydroxychloroquine is another drug we've heard a lot about. In the beginning, it was given a lot of attention, then people backed off, then you hear a little bit more about it. What is sort of the current state of affairs with hydroxychloroquine? And is it prophylactic, or is it a treatment once you have it? 

Redfield: Yeah, I think the key here is looking at the controlled clinical trials. And as you know, you have some that clearly have not shown benefit yet. A recent one announced in Detroit where there was some benefit earlier on. This sort of falls into the range right now, until the data is definitive, of what I call clinical judgment. You know, I'm a physician an internist in infectious disease. And I think each individual clinician makes a decision with their patient about their own circumstance, whether they try to use some of these drugs that are approved for another indication. But, you know, Tony Fauci and I would say, we think that this drug really needs to be evaluated by rigorous clinical trials to see what its role is ultimately, therapeutically. 

Van Susteren: And I should add that, that's been used for malaria so at least it is safe from that perspective for...

Redfield: ...and used for lupus, yes, for lupus, it's a drug we know the safety profile very well. 

Van Susteren: Scientists always look, as you say, you know you're very careful and you want studies and you want trials and I got that. But if you are sick, and you have coronavirus and you have placed in front of you remdesivir, convalescent plasma, or hydroxychloroquine. Which one are you going to grab right now realizing that, you know, six months from now your answer, maybe in a month now, would be different -which one are you going to grab? 

Redfield: It depends on where I am. if I'm in the hospital and all of a sudden I'm starting to, we call it desaturate, meaning my ability to oxygenate my blood is starting to not work the way it's supposed to. I hope that the physicians in there will be able to put me on remdesivir at this point in time. 

Van Susteren: So, OK, but it may change even an hour or two. 

Redfield: I hope that we're going to hear about convalescent serum and monoclonal antibodies in the next eight weeks. and we're going to have a bigger portfolio. 

Van Susteren: Here's what I see is the problem with remdesivir, the one that you would grab, is that it's not delivered by IV and you're going to get it when you're in a hospital and you're pretty sick. Tamiflu, which reduces the viral load like remdesivirr, is if I start to get like for the flu, I start to get sniffling, I can call my doctor my doctor will call it into the drugstore, and I can get it very early on before I get this giant flu viral load. There is no, as I know, delivery system to get remdesivir early on, before I get that giant viral load and I'm in the hospital sick and I need an IV. 

Redfield: The other important thing, Greta, is that we don't have data that remdesivir is a benefit at that point...

Van Susteren: ...at the early point. 

Redfield: We don't know that, so. ...

Van Susteren: Are you studying that? 

Redfield: There's some that have moved it earlier, that have shown the efficacy of those individuals that are just starting to, as I say, their lungs not to work. We now know that there's a benefit in that subgroup. Just like we know remdesivir doesn't work if you're too far along either. So it's really knowing exactly where the patient is at the time. But your biggest question is do we have a good therapy to use early for coronavirus, prior to basically needing to go to the hospital? And right now, we don't have, you know, compelling evidence that we have a drug in that space at this moment in time. 

Van Susteren: When you talk about the breathing, though, aren't you talking not about the viral load so much but the inflammatory is starting to get the best of you so maybe you don't want the remdesivir -- when you start to get the breathing issue. Isn't that sort of an early warning? Or not? 

Redfield: If you do it at the very beginning, it's that virus now replicating well in your lungs and your body's starting to react to it. If you can shut that replication down, then you can get a benefit. If you keep replicating and your lungs start not working so well and you need to go on a ventilator, by that time you need the steroids because the inflammation now has really sort of taken over as the dominant pathology that we're trying to reverse. 

Van Susteren: Now the vaccine, I read there's something like 160, 170 places around the world right now, looking at a vaccine for the big race, it's like the race to the moon almost. Is that right, a number of places around the world looking at it? 

Redfield: But yeah this is the big one. This is clearly, I want to remind people, I mean this is, this is the key. Biomedical innovation. When I started in my practice of medicine with HIV, my patients had a 10-month survival. Now they can live a natural lifetime. Science is going to solve this problem, OK? 

 But we're in a race right now because clearly this virus has the potential to particularly cost the life of those of us that are vulnerable, that have multiple precondition medical conditions. We've seen obviously in our nursing homes, we've seen individuals over the age of 75. And this virus is clearly not --- it's here with us right now. We had hoped that it would dissipate over the summer, we didn't see that.  

So we're getting ready for the virus in the fall to be complicated with the flu virus at the same time, which is going to be a difficult time for us where we have both, and so racing to try to make sure we can get an effective vaccine to begin to protect the vulnerable, protect those individuals that are first responders and then ultimately protect the American public, and then the rest of the world is really a goal and when they use the term Operation Warp Speed, this is really a highly accelerated program, not to undermine scientific integrity, not to cut short to safety. 

What really has been cut out of the process that usually takes multiple years is the decisions to invest in the product at the time it goes into a phase three trials, as if it works, to produce it , 100 million doses. At the end of the day, we may have a lot of souvenirs, from the different vaccines that we bought ahead of time. But the reality is, if one or more of these vaccines work, the moment we know it works, the FDA knows it works. There'll be 100 million doses of that particular vaccine available to the American people. We won't have that delay.

Van Susteren: What is the, every year I get a flu shot, which is a vaccine. And the flu vaccine is sort of, it's a moving target like sometimes it's been 50% good vaccines, sometimes it's 29%. Is there something unique about this coronavirus vaccine so when we get when we get a vaccine, we can say, bingo, we have it or is this going to be a moving target? 

Redfield: Very important. So like you mentioned, flu changes. And the vaccine that you need to induce the response you need to protect to the seasonal flu changes, so that's why we have to create a new one every year. These coronaviruses are much more stable in their, what we call their antigenicity towards what is the important protective immune response. As we begin to work, if you look at other coronavirus, just like SARS and MERS, again, we're still learning about this particular virus. But we anticipate that this is going to be a much more stable situation. 

We don't know the duration of how long immunity lasts in the setting of natural infection. We don't really know what the correlate is. Yes, we're trying to learn that, but I think we're pretty comfortable that with this class of virus, if we can get a vaccine the question will be not changing the vaccine, but how often do you have to give the vaccine? What immune response do you have to maintain to stay protected? 

Van Susteren: How about production though? If we find a vaccine here in the United States, can we produce it fast enough so that we can get it to Africa, or we can get it to Asia, we can get it to Europe? Is that the warp speed is that like...

Redfield: Right now there's a huge investment being made in what we call manufacturing production capability, which normally wouldn't happen until after the FDA told the company that they know this vaccine worked and they're going to approve it. And then the companies would begin to try to develop manufacturing over time. Clearly here, as I mentioned, each of these products is being looked at to bring 100 million doses at risk. And then, and then obviously ramp up their production capability. 

Van Susteren: Alright, let me turn to schools, which is a huge issue here in this country. Is that what's, how do you figure out whether to open schools, not to open schools? We have got public health, we've got the economy, we've got school we got this this tough balance, and I guess for a starter question, do kids transmit to kids? 

Redfield: You know, right now we don't have a lot of evidence that kids are a critical component of what we call the transmission cycle of this virus. 

Van Susteren: And that would include to adults, too? 

Redfield: Yeah, unlike flu, where we know that, you know, childhood school transmission of flu can really see outbreaks in the community. We really don't have that evidence or we don't have it in our household studies that we've done where we've looked at who's bringing the virus into the household, it's usually the adult that's bringing the virus into the household. 

The other thing that we know is that children, really, one of the things that's unique about this virus is it can go anything from nothing, no symptoms, all the way to make you critically ill and need to be intubated. The spectrum of illness, as Tony says, as I say, is really the largest we've ever seen. ... 

Van Susteren: ...does damage on different organs and might be your heart and my lungs ...

Redfield: ...very large and as you said, it's got some interesting complications with causing coagulopathies and problem with different organs. When we look at kids in general, and individuals under the age of 45, pretty much in the absence of significant medical conditions, this is really an asymptomatic illness. We've looked at the individuals under 18, we've had 52, I think, individuals under 18 that have died, many of which have other comorbidities, out of the first say, 118,000 that we've looked at. So if you look at that, the risk of mortality for individuals under 18 right now is about 0.1 per 100,000, or about 1 in a million with the data that we have right now. As opposed to those people that are over 75, where the risk is really much, much greater, about 3,000 per 100,000. 

Van Susteren: So do you feel comfortable opening schools and even if  --you feel absolutely? 

Redfield: Absolutely.

Van Susteren: You feel absolutely, comfortable? 

Redfield: What I feel is this, it has to be done safely. My biggest concern about opening schools is making sure we protect the vulnerable, that we're protecting the teachers, and we're protecting the children that are vulnerable. I would argue that the public health risk, because I don't think it's public health versus opening schools. I think it's public health versus public health. I think the public health risks to K-12, if continuing to have these schools closed is real. Whether it's the absence of mental health services for the 7.1 million kids who get their mental health service in school, whether it's in nutritional services that some of the kids get, whether it's the fact that this is where most of our mandatory reporting for sexual abuse and child abuse is, whether it's the impact of socialization, whether it's really a lot of kids just learn better face to face. 

So when I look at the relative risk of say death of COVID(-19) among kids and compare that to the relative risk of flu, you're far more likely as a child to die from flu. And that's even in an environment where we have a vaccine that if you took, you wouldn't have been at risk. So, I think it really is time. 

Now each jurisdiction is going to have to work through it. They're going to have to figure out exactly, you know, we've given guidance. And that's just what it is, it's guidance. I've said it's guidance to help facilitate the opening of schools. And I don't want to see it be as a guidance that's a rationale to keep schools closed. And we'll work with the school districts on how to take our guidance and operationalize it in a practical way to get these schools open. But yes, I think it is, from strictly a public health point of view, I'm not going to get into the larger debate but from a public health point of view, I think it is extremely important that we open these schools. The vigilance though, it has to be there, is to make sure we're protecting the vulnerable teachers, making sure we have alternatives for children that are vulnerable because of their medical conditions. But I think we can do this in a very thoughtful safe way. 

Van Susteren: Would you go to a big event, enclosed, like a concert, a rally, or a political convention or a church, without a mask? And would you go to one with one if everyone's wearing a mask? 

Redfield: Yeah, and that's the key here, and I think it's an important point for me to emphasize. The key is the mask. If we all, if this whole nation, really decided to make the personal responsibility and sacrifice like many of our ancestors had to do in World War One and World War Two. If we just all did one thing, we all just decided for the next four, six, eight weeks we're going to wear masks, all of us, this outbreak would really come to a halt. I mean the masks really do work. You can seem them in MMWR (Morbidity and Mortality Weekly Report) today from CDC coming out about hair salonists that were infected, but they wore a mask and they were, they didn't see any transmission. We have household contact studies coming out that the households, or someone was infected in the household, but they all used the social distancing, masks, hand washings, we didn't see transmission. If they didn't do that, we saw over 70% transmission. 

So one of the things I can say for sure, face coverings and masks really work. I tell people, we're not defenseless against this virus. We have one of the most powerful weapons in the world. ...

Van Susteren: Even the mask- 

Redfield: You can see, little mask. I have another one that's a little more, you know, stylish. 

Van Susteren: I have an N 95, I have a bunch of those. 

Redfield: This little ditzy mask. All right, this is a powerful weapon against this virus, alright, and if we all did this, right? And we wash our hands. And we have vigilance about closing operations that promote irresponsible behavior. I'm a big advocate of closing bars right now. Because I think people that spent too much time in bars are not social distancing and not wearing their mask and they're not optimizing. What I'm asking them to do is to be part of the solution. But we could actually bring this down. We could, we could defeat this enemy, if everyone just made a commitment for the next four or five, six, seven, eight weeks to really be vigilant about wearing a mask. We know this now works. I wish I knew it worked six months ago, I didn't know it works. 

Van Susteren: Why didn't we know six months ago?   

Redfield: We didn't have the data. Again, CDC, unfortunately, and fortunately, is not an opinion organization. It's an organization that is science-based, data-driven. We've got to get the science and data. You'll see, we're coming out with an MMWR today, I have an editorial today in JAMA, the American medical journal, American Medical Association again, about the importance of the fact that the masks work. So wear a mask. Wash your hands. All right. Don't decide right now, particularly the millennials and the Generation X, you know, take a take a break from the bars right now. And I don't want people to close the bar just to go in their home and have a big gathering in their home, OK, please? You know I don't want that either. I really want people to take this seriously. I had hoped that the summer was going to be easier for us. It's clearly not. we don't know this virus, I think the thing that I keep trying to repeat when people ask me what do you predict? The fact is I can't predict. I don't know this virus, I know flu. 

Van Susteren: Let me ask you one last question and it's because we have a large African audience here: Is that a colleague, former colleague of yours, Dr. Robert Gallo, talked to me about bridge vaccines and the live polio vaccine, which we don't use here in the United States and haven't since 1997, but was used in Africa as well as the TB vaccine as a temporary sort of bridge vaccine and as I understand it, it doesn't deal directly with coronavirus, but it tells your immune system to do something special in the short run, so you don't get the coronavirus. Is there any new, do you have any thought on this bridge vaccine because it's cheap, it's 12 cents a dose? 

Redfield: Well, I think it's a great idea, I told Bob this myself. I mean it's actually based on an observation that was made by colleagues of his parents in Russia, the Soviet Union many years ago where they received the polio vaccine during an influenza epidemic. And it was observed that the people that had been the vaccine recipients didn't get severe flu. 

Van Susteren: Are we seeing that in Africa where they're using this particular polio vaccine is there, are they having a less incidents of COVID-19? 

Redfield: It's really important because you point out some of the some of the sideline tragedies of this pandemic. Because one of the things that's happened in Africa is these immunization programs have been curtailed. So right now most African children are not going to die from coronavirus, I told you it's not that pathogenic. But over 120 million haven't gotten their measles vaccine, and measles kills. All right, so I do believe the idea that Bob's talked about, viral interference where you give a live RNA product, and that product replicates. It may teach the cells to develop some defense mechanisms when another RNA virus comes in, that it makes it so that RNA virus can't commit its lifecycle. Very recently something with similar said about BCG too-- that live product, to see if that does it.   

So I'm an advocate. I know our people are looking at those individuals that are getting polio vaccine now, and are getting measles vaccine, what are we seeing difference about the occurrence of coronavirus but I think it's, he's an innovative scientist for more than 60 years. I think it's something that warrants being pursued. 

Van Susteren: And the last thing is that you can't get the virus if you don't come in contact with it.

Redfield: Can't get the virus.

Van Susteren: It's impossible to get it if you don't come in contact with it. That's an important point, I mean people are afraid of it, but if you wear your masks, you stay far away, you don't come near the virus, you're not getting it. 

Redfield: And I even think even, you know, even I think if you wear your mask and you do get close, look at these hairstylists, you know, they're like, pretty close to you. And they were infected, in the MMWR we have out today, and they were just responsible enough to have masks and have their clients wear a mask and they didn't see transmission. So I want to come back to that, that while people worry, and I have 11 grandkids. You know, I have one grandchild with cystic fibrosis. I think people need to have enormous comfort that they've got a lot of power to prevent this virus from entering themselves, the vulnerable people they love, and their children. It's just a change in, you know, a lot of people didn't think the American society was going to adapt to masks. You know, but the fact is, from my travel when I was in North Carolina yesterday, I didn't see a single person in the airport, or on the airplane or in in Mecklenburg area that I was walking, actually, that wasn't wearing a mask. I think it's, the people are getting it. And I just want to make sure that we reinforce that, that this is a powerful weapon. If we do this, we can get this outbreak under control. The other thing I know I want people to do, if I have a second is I need people to get the flu vaccine. 

As you mentioned, you know less than 50% of the American public get the flu vaccine. Next fall is going to be. ... 

Van Susteren: Well they think they're going to get the flu. I mean there's a myth out there that if you get the flu vaccine, you're going to have the flu. I mean, and people say I never got a flu vaccine, I got a flu vaccine once and I got the flu. And that person is now finished in terms of ever getting the flu vaccine. 

Redfield: Yeah, it's ... and a lot of people have that, because you know as you said the flu vaccines efficacy wanes. sometimes it's as low as 25% sometimes as high as 60%. But I will tell you the one thing it does, it keeps children from dying of flu. Right. And it does modify the morbidity and mortality that adults get. So right now, I want to keep flu patients, if they do get the flu, I want to keep them out of the hospital. Because I need those hospital beds for COVID(-19) patients that are coming in the fall. So everyone can do their part by wearing the mask, washing their hands, being smart about social distancing and smart about how they are involved in gatherings when they're obviously, they're always wearing a mask, but they also can prepare their families by getting the flu vaccine. 

Van Susteren: ...and helping them out ...

Redfield: ...and really helping them out. 

Van Susteren: Doctor, thank you very much. Thanks a lot. Thank you. 

Redfield: Thank you, Greta. 

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