World Health Organization Coronavirus Update Transcript – January 23, 2020
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For bearing with us for the last hour and a half, almost two hours. Thanks also to all journalists while online. I understand we have more than 150 journalists who are watching us and listening to us right now. I do. By dialing in or by what she does on your Twitter and your Facebook account. We are late, so I will just keep it short for those online who would like to ask questions. Please dial 0 1 on your keyboard and you will be put in the queue as we have announced earlier.

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And you have a nameplates here with us. We have Dr. Dangerous WTO director general purpose. So did you sound? Who is the chair of the emergency committee? We have Dr. Michael Mike Ryan and we have Dr. Mulya, a bunker call from Department of Diseases and Zoonosis Unit. Mike Brown is the head of emergencies at w.s Shaw. You know, today was the first meeting of the Emergency Committee on International Relations on a novel coronavirus. And I will give a floor immediately to Dr.

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tetras.

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Thank you. Thank you, Tarek. And good evening to everyone in the room and everyone online. We're really sorry that we're late, but thank you all for your patience. As you know, this is an evolving and complex situation. And I would like to thank Dr. Hassan for his leadership of the emergency committee and all members of the committee, the advisors and those who made presentations earlier today during the deliberation. I was very impressed by the detail and detail and depths of China's presentation.

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I also appreciate the cooperation of China's minister of health, who I have spoken with directly during the last few days and weeks. His leadership and the intervention of President Xi and Premier Li have been invaluable. And I know you're following the actions they are taking, all the measures they have taken to respond to the outbreak. Today, there was an excellent discussion during committee meeting, but it was also clear that to proceed, we need more information. For that reason, I have decided to ask the emergency committee to meet again tomorrow to continue their discussion.

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And the chair, Dr. Sun, has agreed with that request. The decision about whether or not to declare a public health emergency of international concern is one I take extremely seriously and one am only prepared to make with appropriate consideration of all the evidence. Our team is on the ground in China as we speak, working with local experts and ofissues to investigate the outbreak and get more information. We will have much more to say tomorrow. And thank you very much.

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And we'll be glad to answer any questions you have. But before that, I will give a chance to their chair. Dr. Drew, sad to say a few words. And after that, my two have to say on the actions we have recommended. Thank you. Thank you very much. Dr. Tedros. And thank you all for you all to be to be presented this evening. It's true that the committee met during several hours today. We heard very interesting report from the Republic of China about the situation in China.

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We also heard reports about the situation in Japan, in Thailand and in Korea following this. We had also the analyses of the situation made by W.H.O. Secretariat. And then we entered into a discussion about important advice to provide to the DG of W.H.O.. That is, is it is the situation corresponding to a public health emergency of international concern? And what advice is should be given to the the DG, the views of the members of the committee, considering the information provided was split about the opportunity to advise the.

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Shouldn't. The decision of a fake boat, we formulated a series of recommendation concerning the improvement of containment and mitigation measures which are already important in China and also about the measures that should be taken by member states. One of these measure is the improvement of sharing of information and cooperation between member states in such in such a situation. One of our advices wide was to suggest to the DG that the emergency committee should be reconvened very early evening sensory and in fact the situation is evolving rapidly, as said Dr.

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Tedros. And for this reason, we of course agree completely with his decision to reconvene the committee tomorrow. Considering the evolution of the situation and the measures taken not noticeably in China. Thank you.

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Good evening, everyone. And again, thank our member states for their excellent presentations today at the emergency committee and also for their actions already taken in the face of this evolving epidemic. Just briefly summarize to you, the W.H.O. has been on full activation over incident management system since the last day of 2000 and 19 across the three levels of our organization. We've been coordinating a series of global expert networks and partnerships that have dealt with laboratory diagnostic assay development, infection prevention and control, clinical management, standardize data collection, medical modelling, research and development, and many other pillars of the response.

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We've been providing technical support to member states, both member states affected and unaffected states. We've been sharing critical updates with member states through our E.S. platform, with member states, with disease outbreak news and through the W.H.O. website. We have released a comprehensive technical package of interim guidance for 2019 and COVA. These materials are online, reviewed, daily and update of regularly. We've updated travel advice for international travel and health in relation to the outbreak. In addition, we have been working very, very closely with global partners and the Global Coordination Mechanism for Research and Development for epidemic diseases.

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As part of the research and development blueprint, working with institutions such as SAPI and others on advancing medical interventions, diagnostics, therapeutics and vaccines. And at the moment the landscape's analysis for those have been completed. We're working on a sample of virus sharing. We're working on developing and disseminating clinical trial protocols and many other issues related to the carrying out of structured evidence based research in the field as needed. The priorities right now, notwithstanding the deliberations of the committee member states affected, have implemented a number of control measures.

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These have focused on W.H.O. agrees the primary issue is to limit human to human transmission, to reduce secondary infections, especially amongst close contact and particularly in health care environments. We need to prevent transmission through amplification events and super spreading events and obviously prevent further international spread. Reducing zoonotic transmission or transmission from animals to humans is important, and identifying the animal source or sources and limiting exposure to those sources is exceptionally important. We need all member states to focus on early identification and isolation of of suspected cases and probable and confirmed cases.

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And we are working closely to equip countries to be able to detect and isolate and provide up to my standards of care. There are many unknowns to address in this event, including clinical severity and the true extent and nature of disease transmission. Communicating critical risk and event information to all communities is the responsibility of everybody. Our member states, the media and W.H.O. and we at this time was particularly countering misinformation that that may affect people's behavior. And and lastly, minimizing social and economic impact is important at this time.

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So the organization is fully activated at all levels with our partners. In response to this event and. We await further deliberations tomorrow of the committee with as I say, we await those deliberations. Thank you very much. Before we go to questions for as I have to apologize to Dr. Sylvie Beyong, who is sitting next to Dr. Μei. I know Dr. Brian is our director of Global Infectious Hazard and Preparedness. And she, together with the marea, may answer some of your questions.

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So we will start with the questions from the room for those on line. I will just repeat that. If you have a question, please, type 0 1, your part and you will be put in line. We will take questions if I was because agree one by one and I will ask you to introduce yourself first and the that you are working with. So we will start with. I think her colleague from China. Generally stuff from that I'm a journalist or from CCTV.

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And my question is to your excellency, Mr. Director General, Dr. Tuttle's about the relig- also evaluation of the measurements by the Chinese government in response to the academic after the other brief offer to sign a knighting novel, Corona Virus Academic. How would you comment on the liaison and reporting between the Chinese government and the relevant departments with the WTO or with your expert group already in China? What evaluation does coverage or have on Chinese medical institutions regarding outbreak or control and patients and treatments?

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Thank you. Yes. Thank you. Of course, this is a novel coronavirus and it's a new discovery. So identifying the pathogen was done swiftly. And it shows the capacity that China has now and the sequencing was done quickly. But more importantly, it was shared immediately. And that's why Korea, Japan, Thailand were able to diagnose the new coronavirus quickly. In addition to that, action was taken immediately, especially on the market to market seafood market and followed by action by other actions was very commendable.

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And the involvement of the leadership starting from the president himself, who gave really clear guidance. The premier and the minister was also very impressive and different actually from previously, you know, from previous actions. You see their capacity. And you see the political commitment. And that's continuing. And we appreciate that. But at the same time, although there is good capacity in China, they have also invited our experts. So our experts are now on the ground as we speak with China, Chinese experts assessing the situation.

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And that's why we're saying we will have more information and we will reconvene tomorrow. So that's what we see from WJR side. And we really encourage China to continue that way, because not only that, we'll help China to clean the outbreak as soon as possible, but also to help in preventing it from spreading internationally. Thank you very much. Please introduce yourself, Michael. My name is Michael, claiming to write an interview. This is my question, which is the level beyond which a local emergency becomes an international emergency, according to W.H.O.

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. That was my no. Would you like to take a. Pointed to the to the criteria in the age of the Internet regulations as a very specific formulation related to the international aspects of the risk. But there are three essential criteria about the nature of an unusual expect of whether the the disease has demonstrated transmission beyond borders, and in that it's not just necessarily the movement of the case somewhere else. It may involve a determination of whether local transmission has occurred when that case arrives, arrives.

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And that's not a that's a nuanced and very important distinction to make. And also whether there has been an interference or likely interference with travel and trade. So the jars as an instrument is specifically designed to ensure that the appropriate public health actions are taken to contain the disease without unnecessary interference with travel and trade. There is a balance here to be struck, and that balance is something that the emergency committee tried to address and then their advice to the director general.

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But that does not mean the public health action starts with the declaration of a failing. Public health action is already underway. Comprehensive international public health action in support of the affected states is already underway. But what of what deliberation of a fake Canaletto is the issuance of temporary rate, temporary recommendations that are more binding in terms of international law on those member states? So one would ask the question, are our member states implementing all those measures at the moment?

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We would consider necessary to contain this disease and then beyond that are the further temporary recommendations that will be needed. So in that sense, it's a real it should be a reinforcement of existing action. And that's why it took the time to explain the actions that are being taken. And in that sense, we need to separate the the fake is a very particular concept in this regard. Thank you very much. Stephanie, please. There we go. Sorry.

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Reuters. Never. Hey, could you tell us whether the panel don't know would be appropriate for the chairman or Mike? Tell us about the discussion of evidence that you were seeing about human to human transmission and what evidence you might have been presented with about any mutation in the virus, which, you know, possibly made it more transmissible or any super spreading events that you may have seen.

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Can you give us an idea of what your understanding is at the moment?

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I think we are in agreement with the with the Chinese authorities, who have been very clear and transparent, that there is evidence of human to human transmission. And the the evidence points to human to human transmission in the context of close contact with the suspect case or within a within a healthcare environment. So the virus clearly and this is not unusual. Previous Saras stars epidemics and Murs epidemics have demonstrated human to human transmission. The current Ebola epidemic in Congo has gone through multiple generations of human to human transmission.

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It is not the existence of human to human transmission that purely determines the impact of the event. What matters is the route of that transmission and whether we've identified those routes adequately and then give the proper advice to break the chains of transmission and whether we can track those chains of transmission in in an appropriate way. And we're back to the simple actions of public health. Early identification of cases, identification of high risk contacts following those contacts and ensuring that if they develop illness, that they're isolated quickly.

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So those are the principles. So we may go through generations of human to human transmission. If the route of transmission is still due to close personal contact and droplet infection, then the device or the disease is essentially containable. The the issues that arise are the unknowns as to whether or not there are other routes of transmission occurring. And at this time, it is not possible to determine that. Absolutely. It would appear that the main routes of transmission are along the expected routes of transmission for coronaviruses, and that is part of the extension of the deliberation of the committee is to further consider these matters.

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Thank you very much. If it is because you don't want to. One wants to add something to this. If not, we will give her a chance to see some of the journalists who are listening to us online and who dialed in. We will start with Helen branswell if Helen can hear us. Helen, do you hear us?

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Well, yes. So much for taking my question. I was hoping that perhaps my could expand a bit further on the transmission issue. Have you had a clear indication that this is sort of stuttering transmission from among people or are you seeing any sort of third, fourth generation cases among people? And I would also be interested in w Rachel's reaction to the news that is effectively being quarantined. This is a very severe action. And and I would like your thoughts, please.

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Thank you very much.

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And we didn't hear you very well. But I understand there was a question about a transmission and possible generations of transmission. The second part of your question, please, partners.

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I would like the Bureau Joe's comment on the decision by authorities in China to effectively seal off all her. It's a very severe measure. And I'm wondering what W.H.O. thinks about that.

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Thank you. Helen, we understand first questions about transmission. A second question is about the measures put in place by one city. Who would like to think I can start and hand over to Sylvie or Maria? My understanding is that we have not at this point confirmed third, fourth generation transmission that our colleagues can. Can. Can. Can speak. Can speak to that. And in reference to a previous question, Stephanie's previous question on the genetic diversity, the virus is showing stability and they're not showing a divergence or any unusual activity of viruses change every time someone is infected.

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It's a tiny differences in the virus, but we're not seeing huge changes in the viral genomic sequence in that regard. So maybe a capacitor two to three years or so of it just maybe address the issue of generational transmission. Thanks for that question. So we had some thank you for that question. With regards to human to human transmission, what we're very thankful to the colleagues to sharing information about the situations in their country. What our colleagues have shared with us is, as Mike has described, some human to human transmission amongst close contacts and what investigations are underway to fully determine the extent of this.

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So at the present time, we don't know the full extent of human to human transmission, but what we've seen are human to human transmission events amongst those contacts and families and in health care settings. And as Mike said previously, this is not unexpected for a respiratory pathogen. We have not been presented any evidence or have seen any evidence of ongoing transmission where we've had third or fourth or fifth generation. But as we said, our colleagues are working very hard to better understand the extent of infection and where this infection is occurring.

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Okay. Thank you. Thank you, Larry. On one hand, the measures that have been taken, we are we we're following the situation. And we are in contact with the Chinese authorities 24/7 and almost daily contact with directly with the minister himself. And what they're doing is a very, very strong measure and with full commitment. So based on the situation taking the action that they think is appropriate, it's very important. We stress to them that by having a strong action, not only they will control their out the outbreak in their country, but they will they will also minimise the chances of this outbreak spreading internationally.

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So they recognize that and they are doing because that's for their own country. But at the same time, China should play a bigger role in global health. So they are taking more significant measures to limit or minimize the international spread. So as long as it's tailored to the problem. And with the commitment that we see now, I think we commend their actions, but since we have the team on the ground, we will get more information on the situation and the actions being taken.

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I mean, an assessment and assessment of that on the mutation. I agree with what Mike said. There is stability. We don't see any significant variation. But at the same time, we also believe that we have to be cautious and assess, continue our assessments critically, because significant mutations can can happen anytime. So we should keep that within the of attention. Thank you. Thank you very much. We will stay with with journalist on line. We will go to John Kline from Science.

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John, can you hear us?

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I can. Thank you. Can hear me.

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We can hear you. But please speak aloud and go ahead. Yes.

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Well, thanks for taking my call. I just want to clarify what it is that the committee is deliberating. It seems like the three things that Mike Ryan picked up have been met in terms of declaring a fake. So what is it specifically that gives the committee pause to determine a fake? What needs to occur? Is it third generation transmission? What is it exactly? All those things you mentioned, the terms have been met.

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Thank you. Thank you, John, for that question. Thank you for this question. It's precisely the questions which were raised during the meeting of the emergency committee. It was the question of the assessment of severity and transmissibility. Of course, we we had information provided by the Chinese authorities that this information, of course, they are limited by the recent outbreak which has occurred. And the committee felt that it was a little too unpriced size to very clearly state that it was time to declare.

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To suggest to the DG to declare a fake. This is why the opinion of the committee was it was a split. And this is why it was suggested that according to the evolution of the situation, we, of course, would be extremely ready to reconvene as soon as necessary in order to discuss about additional information. And clearly the information provided the Basel one is one information. Thank you very much. We will go back here to the room. There was a gentleman who really wants to ask questions here.

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Please introduce yourself.

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You from Tyson? I have two questions. First, do you have any rough ideas about the victim? Victim of this May was the people who died today share new characteristics in terms of gender, age or existing pre-existing health problems. And second, has the animal bacteria been identified or which animal did the disease come from? Do you have any idea on that, too? Thank you. Thank you so much for these questions. It's about Slawson and A of populations, maybe.

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Yes. So. Yes. So there have been some deaths associated with this outbreak. And from the information so far, there are some characteristics of those individuals. Many of them have had underlying conditions, underlying medical conditions and have been of older age. So based on our past experience with other respiratory pathogens, advanced age and underlying conditions are our known risk factors for developing severe disease and death with regards to the animal source. There are many investigations that are currently underway in China, in Milan and in the live animal markets, for example.

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We understand that they are investigating and taking samples from animals that were in that market and they're also doing some environmental samples of those markets to determine if the virus is in those markets. Possibly just a supplement. Dr. Fring from the National Health Commission to their present to the very deep presentation and give a lot of very useful information. So Dr. Pheng from the National Health Commission. The from the data presented from from. From China. The age distribution of the of the cases is, as you said, very much skewed to older age groups with 72 percent of cases being over 40 years of age.

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The male to female ratio as males represents 64 percent of those cases. Interesting that they report also the 40 percent of cases had underlying diseases like diabetes, high blood pressure, cardiovascular disease. So we have to be very careful. I'm looking at age distributions because if the disease more severely affects older people because of underlying conditions, that doesn't mean that there aren't infections and other age groups. It just means that the visible infections of stray sick people maybe in those older age groups.

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So that's I think. But the present was was pointing to it's it's it's the data we have. And we again, we thank China for that data and for the excellent presentations today. But there are still unknowns and we don't have the full extent of that data to do that. But from what we know now, two thirds males, mainly people over 40 years of age with this more severe spectrum of disease and and the the cases, as we as many have said, who died, many of them had underlying significant underlying conditions, which is, again, a feature that we've seen in previous outbreaks of corona viruses, if I'm not mistaken.

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Thank you very much. We will go back on line with James Gallagher from BBC. James, can you hear us?

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Hello. I wanted to ask a very similar question to the one that Helen did, and that was about the public transport shut down in Wunan. And I suppose, first of all, I was asking wants to know whether that was made in consultation with the W.H.O. on the recommendation of the W.H.O.. Is it something that was initiated by the Chinese authorities themselves? And also, what would you say to the people in and who have who in some respects are in quarantine in the face of this novel coronavirus that, you know, decided whether or not is a global emergency, what you say to the people who are really living this tonight.

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Thank you very much, sir. Someone would like to answer this question. On the public transport and other mass gatherings, as you know, should be avoided. So they are taking measures based based on that and also our recommendations, we are going to go based on the discussion today later on. But these are from our previous discussions and they know the measures they should take in order to prevent transmission, especially mass gathering is one of the risks. And so I don't think on public transport, we cannot say they have done something unusual on the population.

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I think the measures which I've taken, as I said there were just announced today. So we will need some time to understand the specific measures that are being taken since we are working with them. If there are any recommendations that we should give them, we can. We can give them. Thank you very much. Hope this answers your question. We will go up to Denise Denise Grady from from New York Times. Denise, can you hear us?

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Yes, thank you. Can you hear me? Yes, please. Go ahead. OK. Thank you. Dr. Ryan, could you please clarify the numbers? The figures that you just gave, it wasn't clear to me if the percentages you were talking about the overall picture of people who are sick or the people who have the severe cases. So if you could go through that again and make it very clear what the what the what those numbers are. Again, thank you.

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Yeah, the the the data we presented was referring to what we reported were reported to today, which was two hundred and ninety one cases, which included those clinical cases requiring admission to hospital. So probably, as I said, at the more severe end of the spectrum. The figures that I quarter of 64 percent male and 72 percent Over40 referred to that group of 291 individuals. I hope that clarifies. Thank you so much, Denise, we have to please so have a rota on this.

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And any word with a tie vote or something? Is that what you mean when you said there was a split?

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You questioning the divergent views within the committee? 50/50 even. And thank you very much. So we go back here to the room, please.

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Yes. Thank you very much. Let's look on my your process on Mexico. In one practical question, what is going to be the name of this virus? You, however, already. I mean, what is going to hurt? What is going to be then the name and in is a virus is spreading exponentially. What is your observation on this? Thank you. Dr. Brantly, currently we use the name 2019 and Gorvy for novel coronavirus. But we will convene a committee to decide on the official name.

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As you know, the tradition for viruses is to name them after the place they have emerged. But we are just being discovered. But yet we have it's not known yet because investigations are underway. And who we are. For the time being, using this nickname, I would say. And the committee will further discuss what is the appropriate name? prose's new virus.

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Yes.

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Is one of the things that, you know, this relates to earlier questions about what we know about the human-to-human spreading. And it is still very early days, you know, to to characterize the full extent of this human to human transmission. What we're hoping for from our Chinese colleagues and also from any countries that have an export ID case or at least imported into their country is to look for onward transmission. What level of secondary transmission amongst close contacts exists?

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We haven't seen any secondary transmission from any of those export cases. And that is quite important within China. We've asked our colleagues in China to further explain to us what they're doing to better understand the extent of infection in mewhen but also in other parts of China and then importantly amongst those cases that they've identified. How many of those are related to human to human transmission? And then in what context to that human to human transmission take place? Was it in a household?

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Was it in a health care facility? Was it in the community? So those are critical pieces of information that we need to know to be able to characterize the full extent of transmission. Maybe I should supplement here because there's a difference between a daily reporting of cases and when those cases had the runs. And many of the cases reported over the last two days could be cases that have been picked up retrospectively based on enhanced surveillance. And their data wants it to be over many, many days, many weeks, we don't know.

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That is why we did receive some really helpful disaggregated data from China a number of days ago around the original cluster, around the Woolhandler, around the world and cluster around the seafood market. It will be extremely helpful at this point that China and I believe they have every intention to do so, is to share that disaggregated data, because it's really important that we're able to do that secondary analysis, construct those epidemic curves and estimate the doubling times and the rates of of of movement of the virus, both in terms of temporal rate and the geographic region.

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So we look forward to receiving that data from from China as soon as possible. Q Well, first, well, I have my deed and I have a body, body first. Go ahead and then marketed.

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After Coplin, because for Reb., we need more opportunity to change media, put more questions and whatever here or online in China Sea issues.

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So Majin catching problems who also took seeder companion instead hostage Palinkas have the committee to look and say good one food that could easily come. That's considered young Yangon the Ducobu paparazzi girl a velar for Pahad from Seattle to to stick to it. I have another question to Mr. Dedalus. Could you give us the exact time for tomorrow or what time you keep your resorts? Answer whatever. Morning or afternoon. But we need to at least take exact time. The LaRonde.

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Thank you.

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Just to to to say that first question was about whether the committee is giving directions to authorities on their actions or not. And that was directed to professor or somebody. Thank you. I will. I will start it maybe from the second one because human tentacle into so we will start at noon like today, turn on giving advises. We give advises to China. The national government. And also, of course, it will not be limited to that. And most of the guidelines given to the international community to show to countries, neighboring countries and beyond.

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Thank you. These are very similar to what people are planning to travel to China. Should they cancel or postpone plans? And also, what precautions? For those who deem travel necessary. Should people be taken if they are visits in China?

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We will come with Taylor tailored recommendations tomorrow. That's why we reconvening tomorrow. Yes. Yes. Because it's a question on all of the committee was directed at chairman. The response is no. The committee did not provide an advice concerning the measures to be taken the envoy. But it's clear that the information of the men about the measures taken by the UN authorities very recently today are important information and we'll certainly be useful to the reflection of the members of the committee tomorrow.

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Thank you. Thank you very much. I'm just checking if we have more questions online. I'm just saying repeating again, the Doswell line and one draws the question can type 0 1. I would like to see if we have a euro news online.

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Hi, j.r.r. Please go ahead.

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So we were wondering what to do. What can we how can we differentiate between a virus or the flu in Europe without no borders? How can government apply these procedures to the epidemic?

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Jerry, you say that we can distinguish virus from the flu. Yeah, I guess so.

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That's a good question. Thank you for that. So many of these respiratory pathogens that are circulating are it's very difficult to distinguish between different viruses. What we understand from the 2090 novel coronavirus is that it can cause a range of disease in individuals who are infected from mild disease all the way to severe disease and death. That's quite a range. Investigations are still ongoing to to better articulate what proportion of individuals will have mild disease or severe disease and what risk factors they may have to result in more significant disease in the beginning of of an infection.

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You start out perhaps with some mild risk for diseases. What we refer to are the diagnostics that have been rapidly developed thanks to the rapid sharing of sequences by Chinese authorities. So there are labs all over the world now that are able to detect this virus in patients. And so our recommendation is, is to ensure that individuals can be identified quickly and isolated, quickly tested, quickly cared for and managed so that they can prevent any further transmission.

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Thank you very much. Maybe take one or two last questions before we conclude for tonight. Maybe we start first with the Betsy McKay for Wall Street Journal. And then we will give a photo of John here. Betsy, can you hear us? Yes. Can you hear me?

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Yes, please. Okay.

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Great. Thank you very much. I just wanted to add a little bit more about the contact investigation going on in China. How much information do you have on them? And given the rapidly expanding number of cases, do you feel that China has the capacity to do these contact investigations at the time and stop the spread or do they need help from outside?

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So I'll start with that question and maybe others would like to add to that. So what we what we understand in terms of the activities for looking for cases is that Chinese authorities are conducting what we know is active surveillance. As you've heard, the initial cases were picked up through a through their pneumonia surveillance system, which was established after SaaS. Once they identified that cluster, they initiated this active case finding in retrospective case finding of individuals who had pneumonia. Of the people that they identify with infection, they identify their context and then they follow those contacts for for a number of days.

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So they're doing some active contact tracing amongst the identified patients, but they're also looking at health care workers, family contacts and health care workers. And so those investigations are ongoing. We've requested more information to get better details on this. But, yes, it's it's active surveillance and then contact tracing amongst those identified. Thank you very much, Mr. Monk, and call John. Please, if you can just come through, Mike. Yes. Good evening, Johns are Acosta's France24 and The Lancet.

[00:45:49.07]
I was running, sir.

[00:45:50.09]
Can your deliberations this evening, if you analyze the prospects of the trend in case fatality, the anticipated shooting up? It's quite low at the moment at around 3.8 percent. But in other cases of similar coronaviruses, it's been much higher. And what's the information coming from the field? And secondly, with reference to antivirals, what are the prospects of coming up with one that's effective? Thank you.

[00:46:23.04]
Yes. The question about the fatality rate is clearly one of the question mark which was raised during the meeting of the committee. If we refer to the previous coronavirus, if it mix in 2003 and more recently with the murse coronavirus, the fatality rate was much higher than it appears to be today. But this is one of the aspects which needs to for which we we we would like to have more information, because it's, of course, one very important point to decide whether it is a major public threat, public health threat or not.

[00:47:02.07]
That's the response. Thank you very much. And maybe we can really take the last question for tonight. Firms, antivirals, antivirals. Sorry, but we're going to get there. There there are there have been a number of compounds that have been used in the fight against Corona virus. But it's very important to recognize that there is no recognized effective therapeutic against Corona virus as there are protease inhibitors and interferons that may help as adjuncts to treatment. But they have their own issues with toxicity.

[00:47:40.02]
So the primary objective in an outbreak related to a coronavirus is to give adequate support of care to patients and particularly in terms of respiratory support, multi-organ support, because the disease can cause a multi organ failure and many, many patients can be can be saved in that regard. However, there are potential clinical trials that could be done with agents. And that's what we're really focused on right now, is identifying other therapeutic agents and other opportunities to test new drugs.

[00:48:11.08]
And again, we've been working very closely with authorities in the four countries and again, very much welcome, particularly in this case, the participation of Chinese experts on all of the expert networks that are helping us to move towards one of the opportunities that sometimes can get lost in an epidemic is not collecting the structured data to understand the clinical disease and then using drugs even on a compassionate basis. But collecting the data in a structured way under what we call a muri protocol, which is is a protocol that allows the compassionate use of drugs, but also collects very important data to allow us to advance knowledge.

[00:48:56.01]
And again, we we thank all the countries for working with us. To this end, I don't know. So, you know, I think it's really part of the research effort and research collaboration that you to ease coordinating currently to make sure that discovery also on therapeutics and vaccine is accelerated as much as we can.

[00:49:20.08]
And just to remind everybody, the research to develop a blueprint for epidemics has a broad global partnership called a global coordination mechanism for all of the major research institutions in the world are involved in that collaboration. And again, this is a this is the type of collaboration we need, the sharing of sequences, the sharing of viruses with revision of guarantees around the adequate benefits that go with the sharing, the sharing of clinical knowledge. This is global solidarity and action.

[00:49:52.02]
And we need to see that continue in the coming days. And if I might add to say that, you know, the global community has learned a lot from SaaS and a lot from others. And we're building upon that knowledge. So the advancements that have been made for diagnostics and therapeutics and vaccine, as Mike has said through through a global collaboration and with with the research and development blueprint, the advancements that have been made from mayors over the last seven years could be applicable here.

[00:50:23.07]
And so that we're trying to build upon that knowledge base to see if that work can help in the current situation. Maybe I'll say the final thing, too, I think. OK. I promised this lady one day short, Natalie, have some sort of.

[00:50:44.09]
As mentioned Saras and previous outbreaks before. I was wondering if you could comment on the Chinese transparency and if you could draw a comparison to Uproot now.

[00:50:58.07]
I think on the Chinese transparency, probably I have said a lot earlier. So it will only be a repetition, but the cooperation and transparency is very, very commendable and we really appreciate. And we want that to continue. And today, the committee members have witnessed that during the presentation from China when they were presenting the details of what's what's happening. So I'd like to encourage them to continue that way. Transparency is very important. That really, really helps.

[00:51:33.09]
And if we are going to keep the world safe. Transparency is number one. And that's what we are seeing happening and we encourage them to continue in that direction. You have also heard dating from the Chinese leadership exactly the same thing. We have to be transparent and do everything we can to protect ourselves and also to protect the international community or the world. So with that. Thank you so much again for joining us. And my apologies for keeping you waiting.

[00:52:01.04]
And tomorrow, as we said, we will reconvene at 12:00. And any information that we will have. We will keep in touch with you. Thank you. Thank you very much.

[00:52:14.05]
Yes, sir. Tomorrow, we will inform you about the ways we will communicate the outcome of the American committee. Thanks again. And thanks for patients. More loans are. By next year, we have made.