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New, more contagious coronavirus strain discovered by researchers

WE EXPECT THEM TO BE THE BEST PEOPLE WE CAN REALLY HAVE AND ALL MEMBER STATES WILL BE INVOLVED IN CONTRIBUTING TO THE PANEL MEMBERS OF CANDIDATES. OF COURSE, IT WILL BE UP TO THE COCHAIRS COINCIDED WITH ME TO SELECT THE MEMBERS. I THINK THAT WILL ALSO HOPEFULLY HELP US IN BALANCING THE CAPACITY OF THE PANEL ITSELF AND THERE WOULD BE AN INDEPENDENCE GREATER IT. WE'RE NOT GOING TO USE W.H.O. SECRETARY I CAN'T THINK ATE MEAN WE WILL HAVE ADDITIONAL MANPOWER BUT NOT ONLY THE INDEPENDENT SECRETARIATE. AS THE IT'S ALSO OUR CONCERN THAT THE MEET THE EVALUATION IN THE MIDDLE OF THE RESPONSE COULD HAVE SOME EFFECT. BUT WE WILL DO EVERYTHING TO BALANCE IT IN ORDER TO LEARN AS WE GO. THANK YOU. . >> THANK YOU DR. TEDROS AND DR. RYAN. OUR NEXT QUESTION COMES FROM ANTONIO BERTE OF THE SPANISH NEWS WIRE. AND PLEASE, YOU'RE WELCOME TO ASK IN SPANISH IF YOU PREFER. PLEASE UNMUTE YOURSELF AND GO AHEAD. >> GOOD AFTERNOON. CAN YOU HEAR ME? >> VERY WELL. PLEASE GO AHEAD. >> OKAY. YES, I WILL MAKE MY QUESTION IN ENGLISH SPANISH IF I MAY. [ SPEAKING FOREIGN LANGUAGE ] >> OUR ADVICE HAS BEEN QUITE CONSISTENT IN ADVISING COUNTRIES TO NUMBER ONE OPEN UP SLOWLY IN A STEPWISE FASHION. AND TO WAIT BETWEEN DIFFERENT PHASES OF REOPENING AND TO ENSURE THE DATA ON THE VIRUS IS CLEAN AND CLEAR AND TELLS US WHERE YOU ARE AND TO BE READY TO MOVE BACKWARDS OR FORWARDS DEPENDING ON WHAT THE DATA IS TELLING YOU AND TO ACCEPT THE FACT THAT IN OUR CURRENT SITUATION IT IS VERY UNLIKELY THAT WE CAN ERADICATE OR ELIMINATE THIS VIRUS THAT ARE VERY PARTICULAR ENVIRONMENTS WHICH THAT CAN OCCUR BUT EVEN THEY RISK REIMPORTATION. WE HAVE SEEN COUNTRIES MANAGE TO GET TO ZERO OR ALMOST 0 MANAGED TO REIMPORT AND SAID THERE IS EITHER RISK FROM WITHIN OR WITHOUT AND THERE IS A GIVEN THERE IS ALWAYS A RISK OF FURTHER CASES THE TRANSMISSION THAT OCCURS IN THAT SITUATION CAN BE SINGLE, SPORADIC CASES WHICH CAN BE RELATIVELY EASILY ISOLATED AND QUARANTINED. AND MORE WORRYING PATTERN IS LARGE CLUSTERS OF CASES THAT COULD OCCUR IN ASSOCIATION WITH SUPER SPREADING EVENTS WITH LARGE CROWDS GATHERED AND THE VIRUS IS PRESENT AND YOU GET A SMALL EXPLOSION OF CASES WHICH CAN VERY QUICKLY MUSHROOM INTO MUCH LARGER CASES. VERY ANALOGOUS TO A FOREST FIRE. A SMALL FIRE IS HARD TO SEE BUT EASY TO PUT OUT GOOD A LARGE FIRE IS EASY TO SEE THAT VERY DIFFICULT TO PUT OUT. YOU REALLY NEED A SYSTEM WHERE YOU CAN DETECT THE SMALL FLAMES IN THE SMALL EMBERS THAT MAY BE THEY ARE AND YOU CAN DETECT THAT SMALL FIRE AND PUT IT OUT BY GOOD SURVEILLANCE, GOOD DETECTION AND AGGRESSIVE TESTING AND BY ISOLATING CASES, QUARANTINING CASES THROUGH ALL OF THIS, AND I THINK THIS IS A VERY CENTRAL MESSAGE, THAT WHEN THE VIRUS IS PRESENT THERE IS RISK OF SPREAD AND AUTHORITIES CAN HAVE SURVEILLANCE IN PLACE AND ALL OF THOSE MEASURES WITH TESTING BUT IT COMES DOWN TO COMMUNITIES AND INDIVIDUALS AND HOW WE PROTECT OURSELVES AND OTHERS. WHEN THE VIRUS IS IN YOUR COMMUNITY IT IS QUITE CLEAR THERE ARE THINGS YOU AND YOUR COMMUNITY COULD DO TO REDUCE THE RISK OF THOSE INFECTIONS AND IT IS IMPORTANT THAT PEOPLE FEEL EMPWERED AND THEY HAVE THE KNOWLEDGE TO BE ABLE TO DO THAT. IT REQUIRES A VERY STRONG PARTNERSHIP, A TRUSTING PARTNERSHIP BETWEEN COMMUNITIES AND AUTHORITIES, A TRUSTING PARTNERSHIP BASED ON HONESTY AND TRANSPARENCY AND REGULAR INFORMATION EVERYONE CAN TRUST AND BASED ON A SUSTAINED EFFORT BY EVERYBODY. IT IS A VERY TOUGH RIGHT NOW FOR EVERYONE TO MAINTAIN THE KIND OF VIGILANCE PEOPLE ARE BEING ASKED TO MAINTAIN. IT IS NOT EASY. BUT WE HAVE TO BE ABLE TO SUSTAIN THAT. IF WE WANT TO AVOID AFTER A LOCKDOWN HAVING MAJOR EPIDEMIC WE NEED TO WATCH OUT FOR THE SMALL CLUSTERS AND WE NEED TO EXTINGUISH THOSE CLUSTERS QUICKLY. WE ALL NEED TO REMAIN VIGILANT. REMAIN VIGILANT WITH OUR PHYSICAL DISTANCING, OUR HYGIENE AND MASKS AND APPROPRIATE SETTINGS AND IN THAT SITUATION WE CAN POTENTIALLY AVOID THE WORST OF HAVING SECOND PEAKS AND HAVING TO MOVE BACKWARDS IN TERMS OF LOCKDOWN. AND YOU HAVE SEEN THIS IN A NUMBER OF COUNTRIES, MANAGING TO DEAL WITH CLUSTERS AND FLAREUPS BY HAVING LIMITED GEOGRAPHIC LOCKDOWNS, LOCKING DOWN SMALL AREAS IN ORDER TO CONTAIN THE DISEASE. IT IS A MATTER OF SCALE I THINK. COUNTRIES CAN AND SHOULD BE ABLE TO CONTAIN THE DISEASE WITH THIS MEASURES. WE WANT TO AVOID WHOLE COUNTRIES GOING BACK INTO TOTAL LOCKDOWN AND IT IS NOT A DESIRE ANYBODY HAS BUT THERE MAY BE SITUATIONS IN WHICH IT IS THE ONLY OPTION. THIS IS A FUNDAMENTAL QUESTION FOR EVERYONE, EVERY COMMUNITY AND EVERY SOCIETY. IT IS GOING TO REQUIRE SUSTAINED EFFORT AND IT WILL REQUIRE A LOT OF TRUST AND IT WILL REQUIRE CLEAR MESSAGING AND A HUGE INVESTMENT OF SUSTAINED PUBLIC HEALTH EFFORT AND A MASSIVE INVESTMENT IN COMMUNITY EMPOWERMENT AND THE CAPACITY OF US AS INDIVIDUALS WITHIN OUR COMMUNITIES TO ACT AND STAY SAFE.>> THANK YOU. AS MIKE SAID I THINK THIS IS SOMETHING WE ALL NEED TO ANTICIPATE THAT THERE IS A POSSIBILITY OF A RESURGENCE AND SMALL OUTBREAKS. BUT I THINK WHAT WE HAVE BEEN ADVISING IS IN THESE SITUATIONS IS TO ACT FAST AND ACT COMPREHENSIVELY USE THE PUBLIC HEALTH INFRASTRUCTURE YOU HAVE IN PLACE AND MANY COUNTRIES HAVE WORKED INCREDIBLY HARD TO IMPROVE THE INFRASTRUCTURE IN PLACE AND TO BE ABLE TO FIND TEST CASES AND ISOLATE CASES VERY QUICKLY. IF THEY HAVE SYMPTOMS AND IF THEY DEVELOP DISEASE TO ENSURE THEY ARE CARE FOR APPROPRIATELY AND IN THE APPROPRIATE FACILITIES. TO PUT CONTACT TRACING TO THE TEST AND CARRY OUT CONTACT TRACING AS COMPREHENSIVELY AS POSSIBLE, QUARANTINING THE CONTACTS THE BREAK THE CHAINS OF TRANSMISSION. AND INFORM THE COMMUNITIES OFTEN AND REGULARLY AND HONESTLY AND THOROUGHLY BECAUSE THE SITUATION IS EVOLVING AND WE KNOW HOW QUICKLY THESE EMBERS CAN TURN INTO FOREST FIRES. AND WITH THAT HOPE THAT IF RESTRICTIONS ARE PUT IN PLACE THEY ARE PUT IN PLACE TEMPORARILY AND THEY PUT IN PLACE IN A LIMITED GEOGRAPHIC REGION ONLY TO HELP AND THEY ARE NOT PUT IN PLACE FOR LONG TIME FRAMES. BUT IT IS POSSIBLE THESE SMALL OUTBREAKS AND SMALL CLUSTERS CAN BE PREVENTED FROM TURNING INTO LARGE OUTBREAKS AND WE HAVE SEEN IT TIME AND TIME AGAIN SO IT IS POSSIBLE. AS MIKE HAS SAID AND AS WE HAVE SAID BE A PART OF THE RESPONSE. EVERYBODY HAS A ROLE TO PLAY AND IF YOU'RE ASKED TO STAY HOME AND YOU CAN'T SAY HOME PLEASE DO AND IF YOU'RE FEELING UNWELL TO STAY HOME AND CALL THE HOTLINE TO FIND OUT THE NEXT STEPS YOU NEED TO TAKE BECAUSE EVERYBODY NEEDS TO PLAY A PART. IT WILL TAKE TIME AS WE TAKE TIME TO FIGURE OUT HOW TO GET THROUGH IT TOGETHER BUT IT IS TO BE EXPECTED. YET WE HAVE TOOLS IN PLACE AND GOVERNMENTS HAVE WORKED INCREDIBLY HARD AND COMMUNITIES HAVE WORKED VERY HARD AND INDIVIDUALS HAVE WORKED VERY HARD SO WE NEED TO PUT THOSE TOOLS IN USE AGAIN.>> THANK YOU DOCTORS. THE NEXT QUESTION COMES FROM THE SHANGHAI MEDIA GROUP, IF YOU WISH TO ASK YOUR QUESTION IN CHINESE WE HAVE THE TRANSLATION SERVICE SO PLEASE DO.>> THANK YOU. I WILL CONTINUE ASKING MY QUESTION IN ENGLISH AND I THANK YOU FOR TAKING IT. IT IS IN FOLLOW-UP IN REGARDING THE INDEPENDENT PANEL AND WE CURRENTLY KNOW THAT THE PANEL IS SELECTED AND THEY CAN CHOOSE OTHER PANEL MEMBERS SO HOW MANY MORE PANEL MEMBERS WILL BE SELECTED AND ITS AREAS OF EXPERTISE LIKE POLICYMAKERS OR MEDICAL PROFESSIONALS OR SPECIALISTS IN PUBLIC HEALTH? THANK YOU. >> YEAH THANK YOU. SO THE SIZE OF THE PANEL, THERE WAS DISCUSSION OF COURSE BUT NOT YET DECIDED BUT THE COCHAIRS WILL DECIDE AS THEY SEE FIT. IN THE PANEL MEMBERS OF COURSE WILL BE A MIX OF PROFESSIONALS. AGAIN THIS WILL BE UP TO THE COCHAIRS BASED ON TERMS OF DIFFERENCE TO SELECT PEOPLE WHO REALLY FIT INTO TERMS OF REFERENCE. THESE ARE THINGS THAT WILL BE DONE ONCE THE COCHAIRS START ACTUALLY WORKING ON THIS ASSIGNMENT. THANK YOU.>> THE NEXT QUESTION COMES FROM JACQUELINE HOWARD OF CNN, PLEASE UNMUTE YOURSELF AND GO AHEAD.>> THANK YOU FOR TAKING MY QUESTION. WE HAVE NOTICED REPORTS CIRCULATING ABOUT A PNEUMONIA AND KAZAKHSTAN THAT MAY BE QUOTE DEADLIER THAN COVID WHICH IS WHAT SOME OF THESE REPORTS ARE SAYING. I WANTED TO ASK IF THIS IS SOMETHIG THAT W.H.O. IS INVESTIGATING OR CAN THERE BE ANY MORE INFORMATION SHARED ABOUT WHETHER THESE REPORTS ARE ACCURATE OR WHETHER THIS IS SOMETHING ON YOUR RADAR. THANK YOU.>> YES IT IS CERTAINLY ON OUR RADAR AND WE HAVE BEEN TRACKING COVID 19 ACROSS ALL OF EUROPE AND IN PARTICULAR CENTRAL ASIAN REPUBLICS INCLUDING KAZAKHSTAN. ON JULY 5, PATRICK STAN WENT BACK INTO A LOCKDOWN AS COVID 19 CASES SPIKED IN THE FIRST LOCKDOWN WAS FROM MARCH 16 UNTIL MAY 11. THE SECOND LOCKDOWN IS TO LAST TWO WEEKS. AS OF JULY 7 WE HAVE JUST UNDER 50,000 CASES OF WHAT HAS BEEN REPORTED AND THERE ARE A NUMBER OF EXPLANATIONS THAT CAN EXPLAIN THE REPORT OF THE RISE IN THE NUMBER OF PNEUMONIAS AND KAZAKHSTAN AND WE ARE WORKING WITH AUTHORITIES THERE TO INVESTIGATE. MORE THAN 10,000 LIBERATORY FROM CASES OF COVID 19 CASES OF BEEN REPORTED BY NATIONAL AUTHORITIES OVER THE LAST SEVEN DAYS SO THERE'S BEEN A SURGE IN ACTUAL COVID CASES ITSELF. WE ARE LOOKING AT THE ACTUAL QUALITY OF THE TESTING TO MAKE SURE THEY'RE NOT BEEN FALSE NEGATIVE TEST FOR SOME OF THE OTHER PNEUMONIAS THAT WERE PROVISIONALLY TESTED NEGATIVE AND THAT IS LIKELY TO BE A MAJOR CAUSE AND THAT IN MANY WAYS MANY OF THESE PNEUMONIA CASES WILL ALSO BE COVID 19 AND NOT DIAGNOSED CORRECTLY. BUT IT REMAINS TO BE SEEN. WE ARE WORKING WITH AUTHORITIES TO LOOK AT X-RAYS AND REVIEW THEM AND LOOK AT THE PATTERNS OF THE PNEUMONIAS TO MAKE SURE THEY ARE CONSISTENT WITH COVID 19. WHY WOULD BELIEVE THAT MANY OF THESE CASES WILL BE DIAGNOSED AS COVID 19 WE KEEP AN OPEN MIND AND WERE WORKING CLOSELY WITH THE AUTHORITIES TO TRACK THIS AND ENSURE THAT IS THE CASE. IT CAN BE CAUSED BY DISEASES AS WIDE-RANGING AS LEGIONELLA, CHLAMYDIA, INFLUENZA AND OTHER THINGS TO THEIR POTENTIAL OTHER CAUSES FOR CLUSTERS OF ATYPICAL MIND AND TO HAVE DEFINITIVE DIAGNOSIS. BUT THE UPWARD TRAJECTORY OF COVID 19 CASES IN THE COUNTRY WOULD SUGGEST THAT MANY OF THESE CASES ARE IN FACT UNDIAGNOSED CASES OF COVID 19. AS I SAID WE KEEP AN OPEN MIND UNTIL THERE IS ABSOLUTE CONFIRMATION OF DIAGNOSIS OF THESE CLUSTERS.>> THANK YOU AND NOW I HAVE A QUESTION FROM HELEN BRANDT WHILE. PLEASE GO AHEAD. >> THANK YOU FOR TAKING MY QUESTION. MIKE COULD YOU GIVE AN UPDATE ON THE OUTBREAK IN THE ECUADOR PROVINCE? THANK YOU.>> YES WHAT I WILL DO IS PERHAPS PASS TO ANOTHER QUESTION AND I WILL COME BACK ON THAT BECAUSE I WANT TO GIVE NUMBERS, IT IS A NUMBERS PERSON AND I CAN GIVE A GENERAL ANSWER AND GIVE YOU MORE SPECIFIC NUMBERS IN A FEW MINUTES. HELEN YOU'RE AT THE END OF THE CUBE THAT WE WILL COME BACK TO YOU. THIS NEXT IS FROM NHK JAPAN. PLEASE UNMUTE YOURSELF AND GO AHEAD.>> CAN YOU HEAR ME? >> VERY WELL.>> THANK YOU. AIRBORNE TRANSMISSION. G ACCORDING TO THE SCIENCE RELEASED YESTERDAY AIRBORNE TRANSMISSION OF THE VIRUS CAN OCCUR IN HEALTHCARE SETTINGS AND SOME OF AND/OR IN CROWDED SPACES HAVE SUGGESTED THE POSSIBILITY OF AEROSOL TRANSMISSION AND BASED ON THE EVIDENCE YOU HAVE SO FAR DO YOU RECOGNIZE AIRBORNE TRANSMISSION IS A REALISTIC DANGER IN OUR DAILY LIVES AND WHAT IS YOUR RECOMMENDATION TO THE GENERAL PUBLIC?>> THANK YOU FOR THE QUESTION AND YES YOU HAVE HIGHLIGHTED A SCIENTIFIC BRIEFLY PUBLISHED YESTERDAY ON TRANSMISSION OF COVID 19 AND THE SARS VIRUS THAT CAUSES OVID 19 AND IN THE SCIENTIFIC BRIEF IT IS NOT A GUIDANCE DOCUMENT BUT A BRIEF WHICH SUMMARIZES ALL AVAILABLE LITERATURE AND EVIDENCE WE HAVE ON HOW THE VIRUS IS TRANSMITTED WHEN IT TRANSMITS BETWEEN PEOPLE AS IT RELATES TO THEIR INFECTION AND WHAT IT MEANS IN TERMS OF BREAKING CHAINS OF TRANSMISSION. WE LOOK AT DROPLET AND AEROSOL WE LOOK AT FECAL AND ORAL AND LOTS OF DIFFERENT MODES. OUR ATTEMPTS TO DO THIS IS CONSOLIDATING WHAT WE KNOW ABOUT THE VIRUS AND THERE IS NEW LITERATURE BEING PUBLISHED AT LEAST EVERY SINGLE DAY SO THIS IS A LIVING REVIEW WHAT WE CALL IT A LIVING REVIEW WHICH MEANS IT WILL BE UPDATED REGULARLY AND WITHIN THE BRIEFLY TALK ABOUT DROPLET AND AEROSOL IN YOUR SPECIFIC QUESTION IS ABOUT AEROSOL TRANSMISSION. IT IS ONE OF THE MODES OF TRANSMISSION WE HAVE BEEN CONCERNED ABOUT SINCE THE BEGINNING PARTICULARLY IN HEALTHCARE SETTINGS AND THERE ARE MEDICAL PROCEDURES CALLED AEROSOL GENERATING PROCEDURES WHERE WE KNOW THE DROPLETS CAN BE AEROSOLIZED WHICH MEANS THE PARTICLES COULD STAY SUSPENDED AN AREA FOR LONGER TIME. IN THOSE SITUATIONS WHERE THE HEALTH WORKER IS CARRYING OUT THOSE PROCEDURES AND FOR THOSE WORKING IN THOSE AREAS WE RECOMMEND AIRBORNE PRECAUTIONS WHICH IS A CERTAIN TYPE OF PERSONAL PROTECTIVE EQUIPMENT FOR HEALTH WORKERS AND OUTSIDE OF HEALTH SETTINGS THERE IS A POSSIBILITY THERE COULD BE AEROSOLIZED PARTICLES IN SPECIFIC SETTINGS LIKE INDOOR SETTINGS WHERE THERE ARE CROWDED CONDITIONS AND WHERE THERE IS POOR VENTILATION AND WHERE PEOPLE ARE SPENDING PROLONGED TIME FRAMES. WHAT WE HAVE SEEN IS THERE ARE SOME OUTBREAKS THAT HAVE BEEN REPORTED IN THESE CLOSED INDOOR SETTINGS WITH POOR VENTILATION WHICH INCLUDE WHAT YOU HAD MENTIONED, THE NIGHTCLUBS AND CHOIRS, FITNESS CENTERS, WHERE AIRBORNE TRANSMISSION COULD NOT BE RULED OUT. IN THOSE OUTBREAKS THAT COULD BE DROPLET TRANSMISSION AND CONTAMINATED SURFACE TRANSMISSIONS. WHAT WE ARE CALLING FOR IS MORE SYSTEMATIC RESEARCH TO BE DONE IN THESE TYPES OF SETTINGS SO IT IS NOT JUST HOW AND WHEN TRANSMISSION HAPPENS BUT THE SETTINGS IN WHICH THEY HAPPEN SO WE NEED A BETTER UNDERSTANDING OF THESE PARTICULAR SETTINGS AND THE OUTBREAKS HAPPENING SO WE CAN BETTER UNDERSTAND HOW TRANSMISSION IS HAPPENING. IN TERMS OF EVERYDAY LIFE WE RECOMMEND A COMPREHENSIVE SET OF PACKAGES WHICH INCLUDE PHYSICAL DISTANCING WHICH DOES INCLUDE HAND HYGIENE AND RESPIRATORY ETIQUETTE AND IT INCLUDES THE USE OF FABRIC MASKS WHEN YOU CANNOT DO PHYSICAL DISTANCING. AND TO ENSURE THAT WHEN YOU HAVE THESE CLOSE SETTINGS YOU HAVE GOOD VENTILATION SO IT IS A COMBINATION OF PACKAGES THE DOMINANT ROUTES OF TRANSMISSION FROM ALL OF THE AVAILABLE EVIDENCE AND OUR UNDERSTANDING WORKING WITH LARGE GROUPS OF DIFFERENT DISCIPLINES, IS DROPLET AND CONTACT ALTHOUGH THERE MAY BE OTHER MODES OF TRANSMISSION WHICH WE DO NOT RULE OUT. SO WE HAVE REQUESTED AND THROUGH OUR BLUEPRINTS WHICH WE BEGAN WORKING ON SINCE FEBRUARY, IS TO ACCELERATE RESEARCH IN THE AREA AND TO MAKE SURE THAT WE HAVE WELL CONDUCTED STUDIES SO WE COULD BETTER DETERMINE THE DIFFERENT ROLES OF TRANSMISSION AND SO THAT ALL OF THE ADVICE WE GIVE IS AS UP-TO-DATE AS POSSIBLE.>> THANK YOU. NOW A QUESTION FROM SIMON FROM TODAY NEWS AFRICA WHICH I UNDERSTAND HAS A BURNING QUESTION ABOUT SMOKING IN COVID. PLEASE GO AHEAD.>> THANK YOU FOR TAKING MY QUESTION. MY FIRST QUESTION, I AM WONDERING IF W.H.O. KNOWS HOW THE VIRUS AFFECTS PREGNANT WOMEN AND IF AND HOW IT AFFECTS BABIES, AND IF THERE IS A CORRELATION BETWEEN COVID 19 AND SMOKING AND IF SMOKING MAKES IT WORSE.>> PERHAPS I COULD START WITH SMOKING. GOOD AFTERNOON. WE KNOW THAT IF YOU ARE A SMOKER THE LIKELIHOOD OF DEVELOPING MORE SEVERE SYMPTOMS FOR COVID ARE HIGHER. WE KNOW THAT THE WAY THAT YOU CAN ATTRACT COVID IS NOT YET ESTABLISHED WHAT YOU CAN SAY IS IF YOU ARE A SMOKER THAT YOU SHOULD STOP SMOKING STRAIGHT AWAY BECAUSE OF LIKELIHOOD OF HAVING MORE SEVERE SYMPTOMS>> DO WE TAKE THE SECOND QUESTION? YOU SNUCK WHEN IN. SO THANK YOU FOR THE QUESTION ABOUT COVID 19 AND PREGNANT WOMEN. AND OF COURSE WE ARE ALWAYS CONCERNED ABOUT COVID 19 IN ANY POPULATION AND IN PARTICULAR PREGNANT WOMEN. WHAT WE UNDERSTAND FROM THIS IS THE CLINICAL MANAGEMENT TEAM LOOKS CLOSELY AT THIS AND WITHIN CLINICAL GUIDANCE SPECIFIC RECOMMENDATIONS FOR PREGNANT WOMEN. WE UNDERSTAND THAT AMONG WOMEN WHO ARE PREGNANT THEY DO NOT SEEM TO DEVELOP A DIFFERENT TYPE OF DISEASE FROM WOMEN OF THE SAME AGE THAT ARE NOT PREGNANT BUT THERE ARE STUDIES THAT COME OUT RECENTLY THAT HAVE LOOKED AT REGNANT WOMEN WITH UNDERLYING CONDITIONS. AND IF THERE ARE WOMEN WITH UNDERLYING CONDITIONS THEY ARE AT HIGHER RISK OF DEVELOPING MORE SEVERE DISEASE. THIS IS SOMETHING THAT WE NEED TO ENSURE WE KEEP A CLOSE EYE ON AND ENSURE THAT PREGNANT WOMEN HAVE THE RIGHT CLEAR THROUGH THEIR PREGNANCIES.>> THANK YOU. NOW HAVE ANOTHER QUESTION CAN YOU HEAR ME MARGARET?>> YES. >> THANK YOU. WE HAVE SEEN THE PAST FEW DAYS THE PRESIDENT AND MY QUESTION TO YOU DID ANYTHING CHANGE IN THESE STUDIES OR ARE YOU STILL STICKING TO THE POINT THAT THIS DRUG AT LEAST SO FAR HASN'T SHOWN ANY KIND OF EVIDENCE IN TERMS OF SCIENCE. WHAT IS YOUR POSITION IN TERMS OF TAKING QUARANTINE, NOT TO REDUCE MEDICAL HOSPITALIZED DAYS BUT AS THE PRESIDENT IS TAKING AT THIS MOMENT, THANK YOU. >> IT IS DIFFICULT TO COMMENT ON THE SPECIFIC USE OF HYDRO CLOCKS HE OR HYDROXY CHLOROQUINE AND IT SHOULD BE USED IN THE CONTEXT OF COVID ONLY UNDER STRICT MEDICAL SUPERVISION AND WE WOULD ASSUME THAT IS THE CASE IN THIS CASE. THE FINDINGS REGARDING HYDROXYCHLOROQUINE FOR HOSPITALIZED PATIENTS DO NOT DEMONSTRATE DIFFERENCES IN MORTALITY ALTHOUGH THERE ARE LOTS OF DIFFERENT STUDIES THAT ARE OUT THERE AND AT PRESENT, W.H.O. DOES NOT HAVE USE OF THIS IN HOSPITALIZED PATIENTS ON THE BASIS THE DRUG HAS NOT CLEARLY DEMONSTRATED THE BENEFITS TO THOSE WHO TAKE IT. AND THAT IS FOR INDIVIDUAL CLINICIANS TO MAKE DETERMINATIONS REGARDING THE USE OF THE DRUG ON AND OFF LABEL BASIS. WE CAN ONLY REPORT WHAT WE SEE FROM RANDOMIZED CONTROLLED TRIALS AND OTHER OBSERVATIONAL THAT IS. IN THE END IT IS FOR NATIONAL AUTHORITIES TO DETERMINE ABOUT THE USE OF THE DRUG IN THE CONTEXT IT IS OBVIOUSLY FOR THE USE FOR INDIVIDUAL CLINICIANS TO DECIDE ON HOW TO USE THAT KNOWLEDGE. >> I HAVE A QUESTION FROM GABRIELLA SODA MAYOR PLEASE UNMUTE YOURSELF AND GO AHEAD.>> [ FOREIGN LANGUAGE BEING SPOKEN ] >> IT IS DIFFICULT TO PREDICT THE TRAJECTORY OF ANY EPIDEMIC IN COUNTRIES AT THE MOMENT BUT MEXICO NOW HAS THE FIFTH HIGHEST COVID 19 DEATH TOLL AND HAS HAD RECORD-BREAKING DAYS IN THE LAST WEEK OF RECORDING NEARLY 70,000 CASES IN A SINGLE DAY BUT IT'S TOTAL CASE IS NOW SURPASSING A QUARTER OF 1 MILLION. MEXICO AT THE SAME TIME IS IN THE PROCESS OF REOPENING AND IN THIS THE NUMBER OF CASES HAS INCREASED SIGNIFICANTLY AND IT IS A PATTERN WE HAVE SEEN IN MANY OTHER COUNTRIES OPENING ECONOMIES IN THE MIDST OF INTENSE COMMUNITY TRANSMISSION CAN LEAD TO AN ACCELERATION OF CASES WHICH IS NOT UNIQUE AT ALL TO THE MEXICAN SITUATION. IN MEXICO LIKE OTHER COUNTRIES IS BALANCING THE DEMANDS OF COMMUNITIES TO GET BACK TO WORK AND TO BE ABLE TO EARN LIVINGS WITH A SIGNIFICANT RISK OF INCREASED AND INTENSIFIED AND ACCELERATED COVID TRANSMISSION. AND SO I THINK FROM THE PERSPECTIVE OF MEXICO AND OTHER COUNTRIES IN THIS SITUATION, THEY MAY FACE A CONTINUED INCREASE IN CASES OVER TIME BECAUSE AS I SAID IN PREVIOUS INTERVENTION TODAY THAT IF THE VIRUS IS PRESENT AND TRANSMITTING EFFICIENTLY A COMMUNITY LEVEL AND COMMUNITIES CONTINUE TO MIX AND ENGAGE IN NORMAL ACTIVITY AND PUBLIC HEALTH SURVEILLANCE IS WEAK IN THAT SITUATION AND THERE'S NOT THE ABILITY TO IDENTIFY CASES QUICKLY, IF THESE DO NOT WORK IN CONCERT TOGETHER AND IF YOU REACH THE POINT WHERE THE NUMBER OF CASES EXCEEDS THE CAPACITY OF THE PUBLIC HEALTH SYSTEM TO CHASE DOWN CONTEXT AND CASES AND IT EXCEEDS CAPACITY OF THE HEALTH SYSTEM TO COPE WITH SEVERE CASES WE'RE RIGHT BACK WHERE WE STARTED IN FEBRUARY AND MARCH WITH SYSTEMS EFFECTIVELY FAILING THE FACE OF THE PRESSURE OF THE NUMBER OF INFECTED. WE NEED TO TRY TO AVOID THAT. AND AGAIN THE QUESTION IN THE COUNTRY THAT IS THE SIZE OF MEXICO AND MANY OTHER COUNTRIES LIKE IT IS LOCATED ON A NATIONAL LEVEL AT THE WHERE THE VIRUS IS UNDER CONTROL AND WHERE WE CONTINUE TO UNDERSTAND WHAT HOTSPOTS ARE AND WE MAY HAVE TO SLOW DOWN OR REVERSE PARTS OF THAT REOPENING AND INTENSIFY COMMUNICATIONS WITH COMMUNITIES. AND AGAIN IT COMES DOWN TO A CERTAIN EXTENT TO TRUST, THERE MUST BE CONSISTENT AND CLEAR MESSAGING ON RISK FROM AUTHORITIES AND LEADERS WE MUST BE HONEST WITH OUR COMMUNITIES ABOUT THE SPREAD OF THE DISEASE IN OUR COMMUNITIES AND WE MUST COMMUNICATE THE RISK APPROPRIATELY. WE MUST GIVE PEOPLE THE INFORMATION THEY NEED TO MAINTAIN PROPER SOCIAL DISTANCE AND TO ENGAGE IN PROPER PERSONAL HYGIENE AND WEAR MASKS WHERE APPROPRIATE WE MUST SUPPORT OUR COMMUNITIES AND DOING THAT AND CONSISTENTLY MESSAGE THAT IN AN APPROPRIATE WAY. AGAIN IT IS DIFFICULT FOR COUNTRIES, ESPECIALLY WHEN THE INDIVIDUAL ECONOMIC CONSEQUENCES TO INDIVIDUAL FAMILIES ARE NEGATIVE AND YOU CANNOT GO TO WORK AND YOU CANNOT EARN MONEY AND YOU CANNOT FEED YOUR FAMILY THERE IS A HUGE CONSEQUENCE AND WE FULLY UNDERSTAND THE PRESSURES THAT THE PEOPLE THEMSELVES ARE UNDER AND WE FULLY UNDERSTAND FROM THAT THE PRESSURES THAT GOVERNMENTS ARE UNDER BUT WE HAVE TO FIND A WAY TO BALANCE THESE TWO IMPORTANT ISSUES AND HAVE TO FIND A WAY TO BALANCE THE COVID 19 ACCELERATION AGAINST THE ECONOMIC REOPENING BECAUSE IT IS VERY CLEAR FROM A NUMBER OF COUNTRIES THAT OPENING IN THIS SITUATION WHERE YOU HAVE INTENSE COMMUNITY TRANSMISSION AND A WEAK PUBLIC HEALTH RESPONSE LEADS TO A DIFFICULT SITUATION THAT MAY PUSH A WHOLE COUNTRY BACK IN TERMS OF THE PROGRESS IT MAKES. AND THAT IS NOT INCONSEQUENTIAL. AND BLIND REOPENING, NOT ASSOCIATE WITH A CAREFUL STEPWISE PROCESS BASED ON DATA AND OPEN COMMUNICATION, IT MAY NOT LEAD TO WHERE ANYBODY WISHES TO GO IN ANY COUNTRY, MEXICO INCLUDED.>> THANK YOU DOCTOR RYAN, THE NEXT QUESTION IS ON COVID AND SUCKING AND THIS COMES FROM JIM GROUP. PLEASE GO AHEAD. >> HELLO AND THANK YOU AS I LOOK TO THIS QUESTION AS I TYPE TO YOU I WOULD BE HAPPY IF YOU JUST PASS IT ALONG YOURSELF AND I APPRECIATE IT BUT IT IS ONE OF THOSE STUPID QUESTIONS BECAUSE THE ANSWER IS OBVIOUS BUT I'LL ASK ANYWAY. THE QUESTION WAS WITH COVID 19 AND SMOKING, HER ROYAL HIGHNESS SAID PEOPLE WHO SMOKE ARE MORE LIKELY TO CONTRACT THE VIRUS AND ALSO MORE LIKELY TO SPREAD. SO I QUESTION IS WHAT IS THE SPREADING ASPECT OF IT AND IS IT BECAUSE THE VIRUS CAN LINGER IN SMOKE OR IS IT BECAUSE OF THE EXHALE FACTOR OR BECAUSE THE SMOKER IS NOT WEARING A MASK? I REALIZE IT IS PROBABLY ALL OF THE ABOVE AND IF I'M WRONG, AND THE ANSWER ISN'T THEN MIKE YOU COULD ANSWER. >> I CAN TAKE THAT. AS I SAID IT LEADS TO MORE SEVERE DISEASE AND THAT IS THE MAIN CAUSE. THAT IS WHY AT THE MOMENT WE KNOW THAT 618 MILLION PEOPLE WANT TO QUIT SMOKING AND WE KNOW THAT 400 MILLION IS THE LATEST ESTIMATE THAT WILL TRY TO STOP SMOKING. THAT IS THE GOOD NEWS. WITH TODAY'S INITIATIVE WE HOPE THAT WE WILL BE SUCCESSFUL IN HELPING 20 MILLION TO SUCCEED IN THIS. THAT THEY ARE THE FINAL ESTIMATES WE HAVE. >> THANK YOU. PLEASE GO AHEAD WITH THE NEXT QUESTION.>> THANK YOU MY QUESTION HAS BEEN ASKED TO LET ME USE THE CHANCE TO ASK ABOUT HOW THE WAY FORWARD IS LOOKING IN TERMS OF TREATMENTS. OBVIOUSLY HAVE SOME NEGATIVE RESULTS ON SOME EXPERIMENTAL TREATMENTS. IS IT BECOMING CLEARER THE NEXT ONES ARE THAT NEED TO BE TESTED? BECAUSE I THINK WE'RE GETTING TO THAT SECOND PHASE.>> I CAN START AND PERHAPS MIKE WOULD LIKE TO SUPPLEMENT ON THIS BECAUSE IT IS A BIG QUESTION HAT YOU ASKED AND A GOO WHAT I CAN SAY IS WITHIN OUR CLINICAL MANAGEMENT NETWORK AND WITHIN THE R&D GROUP THERE ARE A NUMBER OF THERAPEUTICS AND DRUGS CURRENTLY UNDER EVALUATION AND THOSE CLINICAL TRIALS ARE UNDERWAY THEIR SMALL TRIALS AND OF COURSE THE SOLIDARITY TRIAL IS UNDERWAY. WHAT THE CLINICAL NETWORK IS DOING AND WITH R&D PARTNERS IS WORKING WITH THOSE THAT ARE CARRYING OUT THOSE CLINICAL TRIALS AND TO FOLLOW THEM IN REAL TIME BECAUSE MANY OF THEM ARE SMALL AND THERE ARE POSSIBILITIES THAT WE COULD TRY TO DEFINE THE DATA COMING IN FROM THE STUDIES SO WE CAN GET A QUICKER ANSWER TO THESE QUESTIONS. I DO NOT HAVE ANY SPECIFICS ON WHICH ONE IS THE NEXT ONE, THAT IS THE TRILLION DOLLAR QUESTION HERE, BUT I THINK THERE ARE A NUMBER OF THERAPEUTICS THAT ARE INTERESTING THAT WILL COVER DIFFERENT ASPECTS OF THE DISEASE, WHETHER THEY ARE THE PREVENTION OF DEVELOPING MORE SEVERE DISEASE OR PREVENTING PEOPLE FROM DYING. A LOT ARE CURRENTLY UNDERWAY AND THERE ARE HUGE NUMBER CLINICAL TRIALS. MIKE YOU WANT TO ADD ANYTHING?>> NO. I THINK YOU HAVE SAID IT ALL. I THINK THE CLINICIANS THAT CAME TOGETHER LAST WEEK HAD ESSENTIALLY THE SAME VIEW AND THERE ARE LOTS OF EXISTIN THERAPIES WE HAVE SEEN AND SOME DATA THAT THERE ARE EXISTING THERAPIES FOR OTHER DISEASES MAY HAVE IMPACT. WE WILL CONTINUE TO FIND POTENTIAL TREATMENTS AND THE DRUGS WE ALREADY HAVE AND JUST BEING ABLE TO PICK THE BEST OF THOSE CANDIDATES AND BRING THEM INTO THE SOLIDARITY IS IMPORTANT AND THAT IS WHY THE SOLIDARITY AND RECOVERY AND DISCOVERY TRIALS WERE DESIGNED AS MULTI-ARMS. THEY ALLOW US WITH OTHER PARTNERS ACROSS MANY COUNTRIES TO BRING THIS INTO THAT ARMORY OF POTENTIAL DRUG. THE BIGGER QUESTION IS NEW MOLECULES AND NEW DRUGS BEING DISCOVERED BECAUSE THEY OBVIOUSLY HAVE A MUCH LONGER PATHWAY TO BE USED IN HUMANS AND THE ADVANTAGE YOU HAVE WITH EXISTING DRUGS AS MANY OF THEM HAVE STRONG SAFETY PROFILES AND ARE APPROVED FOR OTHER DISEASES AND THEY COULD BE RELATIVELY EASILY INTRODUCED IN RANDOMIZED CONTROL TRIALS. WE HAVE A SAFETY PROFILE FOR THOSE DRUGS. OTHER DRUGS OR NEW MOLECULES THAT HAVE TO BE DEVELOPED HAVE TO GO THROUGH THE WHOLE RIGOR OF SCIENTIFIC SAFETY, SCOPE AND PROCESS THAT TAKES LONGER TO BRING THOSE DRUGS INTO RANDOMIZED CONTROLLED TRIALS BECAUSE THEY HAVE TO GO THROUGH PRIMARY SAFETY STUDIES FIRST. THAT SLOWS DOWN THE PROCESS BY WHICH THE MOLECULES ARE AVAILABLE BUT THERE ARE MANY, MANY OF THOSE MOLECULES THAT ARE CURRENTLY AVAILABLE AND OTHER TREATMENTS ARE CLEARLY ALREADY BEING USED. WE HAVE ANTIBODIES THAT SHOW GREAT HOPE. WE DO USE THEM TO GOOD EFFECT IN EBOLA. I THINK THEY HAVE BEEN GROUNDBREAKING IN REDUCING MORTALITY AND HIGHLY SUCCESSFUL IN REDUCING FATALITY AND TRANSFORM THE WAY WE MANAGE EBOLA AS A DISEASE. I THINK THERE ARE POTENTIAL PLATFORMS AND TYPES OF DRUGS THAT MAY RESULT IN A MUCH FASTER WAY TO GET THOSE TALL PEOPLE WHO NEED THEM. BUT AGAIN IT IS A COMPLEX AREA AND WE ARE VERY VERY PLEASED WITH THE LEVEL OF COLLABORATION BETWEEN INSTITUTES, CLINICIANS, HOSPITALS AND EVERY DIFFERENT KIND OF PHYSICIAN, DOCTOR OR NURSING ORGANIZATION THAT WE HAVE SEEN TODAY. WE HAVE SEEN OTHER FANTASTIC CARDIOVASCULAR IMPACTS AND WHAT WE ARE SEEING IS ONE OF THE FASTEST ACCELERATIONS OF KNOWLEDGE. THAT IN ITSELF IS PROVIDING VERY INTERESTING INSIGHTS FOR WHAT WE ARE TREATING SO WHEN WE LOOK AT OTHER DRUGS AND TRIALS, WE CAN ATTACK THE VIRUS IN TWO WAYS, ONE BY TREATING THE VIRUS AND IN THAT SENSE TRYING TO USE DRUGS THAT WILL IMPEDE THE VIRUS CAPACITY TO HURT US BUT WE CAN ALSO TREAT THE IMPACT ON THE VIRUS BY MODULATING THE IMMUNE RESPONSE TO THE VIRUS IN CERTAIN STAGES WHICH PREVENTS OUR SYSTEMS FROM OVERREACTING AND DAMPENING THE INFORMATION. AND WE CAN LOOK AT VARIOUS OTHER INTERVENTIONS AND WAY LIKE STATINS AND OTHER DRUGS THAT MAY PREVENT BLOOD CLOTTING AND SO WE HAVE TO MANAGE THE VIRUS ITSELF, TREAT THE VIRUS ITSELF, OR THE CONSEQUENCES OF HAVING THE VIRUS. THERE IS A TREMENDOUS AMOUNT OF WORK TO DO THAT AND BEFORE WE UNDERSTAND THE DISEASE IT HAS, I'M HOPEFUL IN TERMS OF THE LEVELS OF COLLABORATION AND LEVELS OF INNOVATION AND WE ARE CONFIDENT THAT WE WILL FIND THERAPIES OVER TIME WHICH BODES WELL FOR THE FUTURE OF EMERGING DISEASES IN GENERAL. AND IN GENERAL FOR OUR ABILITY TO COLLECTIVELY COLLECTED AND ONE OF THE IMPORTANT THINGS IS TO GAIN UNDERSTANDING OF HOW THE VIRUS OR DISEASE OPERATES IN THE HUMAN BODY AND UNDERSTAND HOW IT IMPACTS HUMAN ORGANS AND HOW IT SPREADS AND IT AFFECTS THE IMMUNE SYSTEM. THE MORE WE UNDERSTAND THAT THE MORE RAPID WE UNDERSTAND THAT, IT IS THE SPACE OR PHARMACOLOGICAL SIDE OF THINGS WE CAN DEVELOP THOSE MEASURES. WHILE WE ARE DESPERATELY NEEDING MORE THERAPIES I BELIEVE THE WORLD PROBABLY THIS POINT COULD NOT BE DONE MORE COLLECTIVELY.>> TO GIVE A SPECIFIC EXAMPLE OF THIS SCIENCE SOLUTION AND SOLIDARITY IS ONE OF THE THINGS WERE LOOKING INTO, DOCTOR JANET DIAZ MENTIONED IT THE OTHER DAY, IS TRYING TO OPERATE A NEW MODEL OF WORKING TOGETHER, AND WE'VE REACHED OUT TO A NUMBER OF PIS WORKING ON SPECIFIC THERAPEUTIC FOR EXAMPLE SO THEY CAN WORK WITH US ON A PERSPECTIVE ANALYSIS WHERE THEY AGREE TO SHARE DATA ON THEIR INDIVIDUAL TRIALS AND THEN WE CAN PULL THIS AND WE DO THESE ANALYSES AS THE TRIALS ARE STILL GOING. SO WE'RE LEARNING AND WE'RE ABLE TO UNDERSTAND HOW THESE THERAPIES WORK SO WHEN WE NEED TO ADAPT GUIDANCE, IF WE NEED TO ADAPT GUIDANCE, THAT CAN BE DONE HERE AND THAT IS A NEW MODEL OF WORKING. AND AGAIN AS MIKE HAS SAID THIS IS AN INCREDIBLE SOLIDARITY AND COLLABORATION TO BE ABLE TO AGREE TO SHARE THIS AS THE TRIALS ARE ONGOING BUT IT IS SOMETHING WE'RE TRYING ARE WORKING VERY HARD TO DO WE'RE VERY GRATEFUL FOR THOSE WHO HAVE AGREED TO DO THIS WITH US.>> THANK YOU. >> WE WILL TAKE YOU TO FLORIDA NOW WHERE PRESIDENT TRUMP IS RECEIVING AID BRIEFING ON DRUG TRAFFICKING SO LET'S TAKE A LISTEN.>> LEADERS AND MILITARY GENIUSES AND PEOPLE WHO DO A FANTASTIC JOB. JUST 12 WEEKS THE SURGE OPERATION