NEW YORK FOREIGN PRESS CENTER, 799 UNITED NATIONS PLAZA, 10TH FLOOR
MODERATOR: Good afternoon, everyone. My name is Liz Detmeister and I’m the moderator for today’s event. Welcome to the Foreign Press Center’s videoconference briefing with Dr. Nancy Knight. First some process items before we begin the briefing. We will now mute all participants’ microphones. Please keep your microphones muted until you’re called on to ask a question. If you have technical problems during the briefing, you can use the chat feature, and we will try to assist you. If the Zoom session fails or disconnects, please click on the link again to rejoin. As a reminding, today’s briefing is on the record.
Now I am honored to introduce our briefer today. Rear Admiral Nancy Knight is the Director of the Division of Global Health Protection at the U.S. Centers for Disease Control and Prevention. Rear Admiral Knight’s career at the CDC started in 2006, where she served in Nigeria as CDC’s Assistant Director for Clinical Programs for PEPFAR, and then in 2008 as the CDC Country Director. From 2010 to 2012, Rear Admiral Knight served in Kenya as the Program Director for the CDC’s Division of Global HIV and Tuberculosis. In 2012, she became CDC’s Country Director in South Africa, leading CDC’s HIV response in the country, which had the largest epidemic globally. She is a former Peace Corps volunteer and a board-certified physician in Family Medicine.
Today, she’ll speak about the CDC’s cooperation with other countries to help contribute to ending the COVID-19 pandemic. Dr. Knight will begin by providing opening remarks, and I will moderate the question-and-answer session.
So let’s begin our briefing. Ma’am, you may open with your remarks.
RADM KNIGHT: Thank you very much. Thank you to everyone for joining us today. COVID-19 is an unprecedented global health challenge. As of earlier today, the World Health Organization’s reported more than 2.6 million cases of COVID-19 in 213 countries and territories. Over 181,000 people have died from coronavirus. We can’t forget that there is a person behind every single one of these numbers.
CDC’s top priority in our work here in the United States as well as around the world is to prevent illness and loss of life. We’ve been working with global partners for 70 years and have staff that are stationed in more than 50 countries around the world. We work side by side with host countries to address pressing public health issues like measles, polio, HIV, and now COVID-19.
As soon as we learned of the threat this pandemic posed, our CDC staff in Atlanta as well as overseas began working in partnership with ministries of health to prepare for and respond to COVID-19. This included technical assistance for things such as points of entry screening and contact tracing, disease surveillance and response, laboratory diagnostics and quality assurance programs, and emergency management as well as workforce development such as disease detectives.
Our long history of public health work in many countries has created partnerships and a foundation that is critical to how countries respond to COVID-19. I look forward to discussing the COVID-19 questions that you have with you all today. Thank you.
MODERATOR: Thank you, Dr. Knight. Now we’ll open for questions. We’ll first hear from those of you participating via the Zoom app, and then I will turn to those who called in. For those of you joining via Zoom, please click on the raise-hand button at the bottom of the participant list or use your chat feature to ask a question, and I’ll call on you. When I call on you, please state your full name and organization.
Okay, our first question is from Pearl.
QUESTION: Hello, Admiral Knight. Thank you so much for making yourself available today. This is News Day and I know that you in 2012 were CDC’s Country Director in South Africa, so I hope you’ll appreciate the angle of my question to you today. I’d like to find out exactly how much in dollar terms or volume is the need gap.
For instance, in Zimbabwe, CDC has listed lower respiratory infections as the second cause of death in Zimbabwe with eight U.S. assignees in the country. How many are IMT/DP – I’m referring to incident manager training here – trained, and what work are these eight assignees doing in the country, especially since CDC, PEPFAR you – under CDC PEPFAR you have been supporting seven central laboratories across the country, including technical assistance through I guess maybe 15 experts at some point. My question is: Are you still helping on COVID-19 through the same labs at all? If so, can you share details on which labs, why, who, and who is actually helping? If you don’t have the information, are you able to provide it to me after this virtual forum?
Thank you so much, Admiral Knight.
RADM KNIGHT: Thank you, Pearl, and it’s nice to hear from you there in Southern Africa. So I think there are some of the specifics, which, as you alluded to at the end, I don’t necessarily have all of those specific details around the individual facilities and things in Zimbabwe, but what I can say is I think your question is really kind of getting to the expertise that we have on the ground at CDC through our CDC office and how those experts are working through the programs that we’ve historically been there with, like PEPFAR, to also address COVID. So I’ll kind of touch on that, and this is applicable not just to Zimbabwe but to several – how we’re working in several countries.
So with the laboratory capacity, for example, that you mentioned, yes, you’re absolutely right. We have been working with laboratories like the – through the HIV program, the PEPFAR program, to strengthen their ability to do the diagnostics, to have the equipment to be able to do their HIV testing, to be able to have the appropriate supply chain systems, and to be able to have good quality management systems and well-trained laboratory staff.
So one of the things that we are doing is using those existing capacities that have been built and through those partnerships and helping to pivot those to COVID-19. So again, I’m not certain about the specifics for Zimbabwe itself, but I know that this is happening amongst a number of countries. One example that I know of where this is already happening is in DRC, that they were able to pivot that capacity that’s been developed in their National Institute for Biomedical Research at INRB and immediately start testing for COVID.
You also touched upon, I think, just the overall partnership that exists between the U.S. Government, CDC, and the host country governments, and those are definitely being utilized to be able to support countries and identify what the COVID needs are.
I’ll go ahead and stop there. Thanks, Pearl.
MODERATOR: And next we’ll take a question from Delin and then I have several questions that have written in.
QUESTION: Hi, can you hear me?
QUESTION: So my question is about —
MODERATOR: Sorry, Delin, you cut out.
QUESTION: Can you hear me now?
QUESTION: Is it okay? Okay. So first, thanks for your time, Dr. Knight, and my question is about the cover image of the Emerging Infectious Diseases magazine. So some people criticized that the image may cause some potential stigma or discrimination problems, so do you think this kind of gaps of knowledge or understanding or culture would affect the CDC’s effort to coordinate the global cooperation to contain the virus?
RADM KNIGHT: Thanks, Delin. I just want to make sure I understand your question. I think you were asking about stigma that could be – that could exist around the virus, and are you speaking about – with regard to China specifically?
QUESTION: Yeah, yeah, because the latest cover image of the magazine Emerging Infectious Diseases has been criticized by some people for that potential issues. So I just want ask you these questions.
RADM KNIGHT: Okay, all right. Thanks, Delin. My apologies, but I haven’t seen the cover that you’re referring to. I think in regard to your question, however, in terms of stigma and potential discrimination, we at CDC are certainly very attuned to ensuring that our messages are not ones that would lend to stigma and to discrimination. We recognize that the coronavirus is not targeting just one sub-population around the world. There is – every population is at risk of coronavirus, whether that’s someone from China or someone from the United States or someone from Europe or someone from South America or from Africa. The virus does not discriminate in who or how it would attack, so thank you for that question.
QUESTION: Thank you.
MODERATOR: Okay. We had a question from Demna Devdariani – I’m so sorry – from Georgia. Demna, go ahead.
QUESTION: Good afternoon, everyone. My name is Demna. I’m a DC-based reporter from the Republic of Georgia. I work for a national TV broadcaster called TV Imedi. I will ask two quick questions: Has CDC of the United States has – have been communicated by Georgian CDC or the Government of Georgia, and if so, to what extent have you coordinated – did you coordinate with them?
RADM KNIGHT: Thanks for that question. Yes, we have very strong relationships with the government in the Republic of Georgia, and in fact, we have a CDC country office in the Republic of Georgia. And so we have staff there. At this time we have several Georgian staff who are there and who have been with our office for a number of years, and then we work – those Georgian staff work very closely with some of the staff that we have back here in Atlanta across a variety of types of expertise.
One of the big programs that we have worked with the Georgian Government on which I think is quite important for the outbreak of coronavirus is what we call the field epidemiology laboratory training program. That’s quite a mouthful. I like to call them disease detectives. So these are people who are trained – in this case, people from the country of Georgia, but also from countries in the region are trained within that program – and they are trained in epidemiology. They are given the skills to be able to identify when something abnormal is happening, so when there’s an abnormal cluster of illness or an abnormal cluster of deaths, and then to be able to go into the communities and appropriately investigate that kind of an abnormal cluster.
So this is utilized for outbreaks that can occur at any point in time and can – those skills can very effectively then be applied to coronavirus and looking for outbreaks of the coronavirus, for doing the contact tracing that’s required to help to contain the outbreaks of coronavirus, and for providing the critical linkages by collection of samples to the laboratory for testing. Thank you.
QUESTION: And if I may very quickly, just to follow up, if you – the CDC of the United States follows up on the work and efficiency of the local CDCs, such as, for instance, the Georgian CDC and your staffing there, and if so, what would be your evaluation and your assessment to the work and effectiveness of the CDC in Georgia? Thank you.
RADM KNIGHT: Mm-hmm, yes, we’ve been a partner with the CDC, the Georgian CDC itself, and while we haven’t done – I think what you’re asking is whether we’ve done any kind of a formal evaluation of the Georgian CDC. I’m not aware if we have ever done that, but we do work hand in hand with them on many of their public health programs. I’ve mentioned the field epidemiology training program, but we work with them on a number of other disease-specific programs like rabies, for example, and then other public health issues within the country such as infection prevention and control practices within the health care facilities. So our collaborations do span across a wide spectrum of subject matter expertise between CDC experts and the Georgian experts.
MODERATOR: Carla Bleiker from Deutsche Welle submitted the following question: “When do you see international travel between Europe and the U.S. becoming possible again?”
RADM KNIGHT: Thanks for that question, Carla. Unfortunately I don’t have a specific answer as to when, but I think what we could talk about is what are some of those factors that we have to look at as it relates to travel, whether it’s travel between the European countries and the United States or just travel in general.
So certainly one thing that we – that’s very important that we look at are those epidemiology curves, so looking at the cases that are occurring and the number of cases that are occurring on a day-to-day basis in every country, in the United States as well as the European countries and other places, and assess the risks of travel.
And when I say the risks of travel I don’t just mean the risk to a country in which a traveler might arrive, but we also have to think about the risks to travelers themselves as they are – as those are places then in which they would congregate, right. In order to be able to travel, like air travel, people have to go into the airports. It’s going to be difficult to maintain some of the social distancing that’s necessary in that kind of an environment as well as on the airplanes, and I know that many airlines are looking and working to address that from kind of that initial phase through every step through the airport entry and travel.
But it’s important that we look at all of those things and that we look at the risks to the individual travelers as well as the risks to countries where those travelers might be going to and use that as some of that data behind making decisions for how and when travel movement might become less restricted.
MODERATOR: Thank you. We also had a question from Beatriz Bulla from the Brazilian newspaper O Estado de Sao Paulo. She’d like to ask: “Is there a cooperation plan with Brazil and how would that work?”
RADM KNIGHT: Yes, thank you very much for that question. We do have collaborations with Brazil. We have had an HIV collaboration and TB collaboration through the President’s Emergency Plan for AIDS Relief, or PEPFAR. We’ve had that collaboration with Brazil for many years now.
In addition to that, CDC is standing up regional offices in several locations around the world, and Brazil is one of those locations that has been identified within this first wave – maybe I’ll call it that – or first phase of regional offices. So we will have someone who will be working not only with Brazil but with other countries in the South America region to help draw these lines of connectivity between the public health expertise and public health needs on the ground within South America and the public health expertise that exists back in CDC.
As I mentioned earlier, we have staff in more than 50 countries around the world, one of which is Brazil currently, but obviously that’s not everywhere. So that’s why we’re looking to having this regional approach that can allow us to extend our reach from where we are currently – currently have staff placed to be able to address public health challenges on a broader scale.
MODERATOR: Thank you. Now I’ll go to someone who’s raised his hand. From China Business Network, Weier Ge.
QUESTION: Yes. (Inaudible.)
QUESTION: Okay. So I got a question from swabs made in northern Italy to ventilators made in China, we’re seeing countries and states are rushing to the market crazily bidding for products needed to combat COVID-19. So what lesson should we learn from this, and what kind of global cooperation is needed in the face of a global pandemic? And as suggested by Dr. Fauci, the virus for sure will come in fall again. So what the global community shall prepare together?
RADM KNIGHT: Yes, thank you. As you’ve said, it’s important that we all think across the global community about what are these commodities that are currently most needed and will continue to be most needed for coronavirus and for all of us to be able to effectively protect and respond to coronavirus.
Here in the United States we do know that our leadership is really looking to expand the domestic production of health and medical resources. This has been done through several of the things that have been approved by the White House and Congress to be able to take some of these authorities that we have domestically to expand production, and this would apply to personal protective equipment, ventilators, a wide variety of products that might be needed, and that can certainly help for alleviating some of the gaps that we currently see.
Additionally, we have longstanding technical partnerships in place that I’ve touched upon as well as financial support with a number of countries, and we’ve been able to help countries to be able to prepare to respond to this pandemic. Some of those things that we help them to do is to identify what are some of their commodity gaps and needs and help them to quantify and forecast what some of those needs might be in the future.
So I think if we’re all working collectively on identifying ways in which from every country we can expand production within those different countries, and then also work, again, at every country’s level to identify current needs as well as forecasted needs so that collectively we can work to address some of these gaps that exist.
QUESTION: And how about preparing for the fall?
RADM KNIGHT: Yeah, I think that’s part of that forecasting component is preparing for the fall. While we’re all working right now, especially through our collective mitigation efforts of social distancing and staying at home, as we look to the fall in terms of changes of weather, in terms of the changes of potential movement, of loosening of mitigation efforts in different places, we have to really watch closely what the impact of those things are on the coronavirus and on the outbreak. We have to be prepared to watch the data at a very local level and to address it through real-time changes in mitigation efforts so that as we move forward in these next several months we’re able to better address – all of that really plays into the commodity needs then, and then be better able to address those commodity needs. So working on it not only at the product development and production level but at the core of epidemiology and disease control level as well.
QUESTION: Thank you.
MODERATOR: We have another question that was sent in via text from Bas Blokker from NRC Media in the Netherlands. “Thank you for your time, RADM Knight. How confident are you that the amount of tests in the U.S. is sufficient to determine the epidemic’s trajectory as necessary to successfully implement the ‘opening up America’ policy?”
RADM KNIGHT: Yes, thank you for your question. So in the United States, we have been working to improve our testing capabilities for the Americans in our various communities, and that’s something that I’m sure you’ve heard our leadership from Washington, D.C. talk about a number of times. We have – through the FDA, they have fast-tracked their process, so that as test kits get developed, they go through what’s called an EUA process. And I’m sorry, I’m going to forget what that stands for, but it’s a way to be able to move products onto the market without having to do the very lengthy process that is normally required because of the outbreak.
So it’s a combination of the manufacturers and putting forward and moving forward those new test kits and new commodities quickly, the FDA’s processes to help make that happen faster, and then working with local and state public health officials to ensure that they have the – those commodities that they’re getting moved through the resources that they have to that local level where they need to be used.
MODERATOR: Thank you. Now we’ll take a question from Olivia Zhang.
QUESTION: Yeah, hi. My question is that I think we heard – well, I just wonder exactly what the cooperation with China looks like right now? We heard, like, doctors are still communicating with each other from the two countries where a WeChat group, like, about the treatment or the spread of the virus and stuff. Would you say like on the scientific level the communication between the two countries are still remains the same regardless of the geopolitics that is going on?
RADM KNIGHT: Yeah, thank you for your question. So our collaboration with China, as with many other countries, has been a long one when it comes to the public health collaborations. We do have a CDC office, a U.S. CDC office that is located in China, and we currently have – some of our American staff are still there in that U.S. CDC office. And then we also have Chinese staff, locally employed staff, who are part of our CDC staff there, and they continue to have ongoing collaborations with our counterparts in the China CDC.
One of the programs I mentioned earlier, the Field Epidemiology Training Program, or disease detective program, is one that we’ve helped with China’s CDC to establish a number of years ago, and that continues to be an ongoing partnership that we have there.
We also have an influenza program there with – of course, is also important for the COVID outbreak because of the collaborations that we’ve had historically in relation to respiratory diseases. And then the other components of our collaboration are around tuberculosis and then building capacity in global health more broadly and working collectively between the two of us with other countries. So all of those existing relationships continue and are utilized through those collaborations to share information around the activities that are happening for coronavirus.
QUESTION: Yeah, just to follow up about, like, the U.S. CDC’s office in China, there has been reports of, like, the personnel was cut during this administration. I wonder, like, can you elaborate more on the CDC’s office like in China, like how many staff there and things like that?
RADM KNIGHT: Yeah. Currently we have – I believe it’s three American staff who are there, and then we have around 11 locally employed staff. I think over the years, from year to year and from country to country, out of those more than 50 countries that I mentioned, we do have fluctuations in our staffing where sometimes where we have to reduce staffing for one reason or another, or maybe we have a shift in staffing because there’s a program that we’ve been working on that has been successfully handed over, and so it becomes more of we continue those technical collaborations but maybe we don’t have to be as hands-on as we were before. So whether it’s the China office or another office, we will often see from time to time fluctuations within the staffing maybe going up for a while and then perhaps going down for a while.
QUESTION: Just the one final point, what is – like, how many people – what’s a maximum people like the U.S. CDC’s ever had in China?
RADM KNIGHT: Oh, I’m not sure.
QUESTION: Okay. Is it like 20 or maybe like even more or something like that, or like – probably always, like, one-digit people?
RADM KNIGHT: Yeah, I’m definitely not sure how many. And if you’re asking 20 in terms of Americans there or in total?
QUESTION: Americans, yeah.
RADM KNIGHT: My guess is we’ve probably not had that many. We typically in our offices will have a smaller number of Americans, and then more locally hired staff that work directly with our American staff but all part of our CDC offices.
QUESTION: Okay. Thank you very much.
RADM KNIGHT: Mm-hmm. You’re welcome.
MODERATOR: Thank you. The next question is from Kasume Abe from Cross FM, Japan. He says: “Hello, Nancy. I’d like to ask you about facial masks. The mask is good for protection for the virus that I might be emitting, but is it also good for protection from someone else?”
RADM KNIGHT: Mm-hmm, okay. Thanks for your question. Yeah, so the face masks – and by face masks, we’re talking about the cloth face masks or cloth face protection, and I’m not talking about the medical face masks. So you’re absolutely right. The face mask – the cloth face mask, because we know now – we’ve learned over the last couple of months something that we didn’t know at the beginning of this outbreak, and that’s around two very important things.
One is that when someone has gotten the coronavirus that they can have what’s called – they can be pre-symptomatic. So that means they may have the infection, but they do not yet have symptoms. And in that pre-symptomatic phase, we have learned that they can also be infectious.
We’ve also learned a second important thing, which is that people may get the virus and have the infection and never develop symptoms. So they go through their entire infection being asymptomatic, and that they can also be infectious.
So whether you’re pre-symptomatic or asymptomatic, we’ve learned that there are people like that who can be infectious, which we didn’t know at the beginning of the outbreak. So in a community, then, it’s important for us to wear the face cloth – that’s why it’s a recommendation here in the United States – because as you go out, you don’t know if you might be in a pre-symptomatic phase or in an asymptomatic phase, and that cloth face mask can help you to protect others. Whether it’s going out to run an essential errand to get food or something like that, it’s important for us collectively within the community to protect one another.
You’re also right on that second point. So the face – the cloth face mask is not a replacement for a medical face mask or like a respirator. So it’s not going to protect the wearer from someone else that might be infectious. That’s why our health care providers – we need to make sure that they have those medical face masks.
MODERATOR: Thank you. We also have a question from Bukola Shonuga from Global Media Production in Nigeria. She asks – or he asks: “Is there any collaboration with Nigeria considering its population size and position in Sub-Saharan Africa?”
RADM KNIGHT: Mm-hmm, thank you very much, and I’m happy to hear from one of our – my Nigerian colleagues there since my overseas career with CDC started in Nigeria when I worked in Abuja for three and a half years. And yes, we continue to have strong collaborations with the Nigerian Government, with the ministry of health and the Nigeria CDC.
We have – our current portfolio of work from CDC in Nigeria includes a variety of different disease-specific collaborations like HIV, tuberculosis, certain outbreaks that occur like Lassa fever, and also includes influenza and Global Health Security. So through Global Health Security work, we have been partnering to really take a close look at the public health capacities that exist within the country that are necessary for being able to prevent, detect, and respond to outbreaks and public health threats.
So those same collaborations are being built upon and pivoted to address the outbreak of coronavirus that’s happening there.
MODERATOR: Thank you. Our next question is from Alex.
QUESTION: Thank you, Liz. This is Alex Raufoglu from Turan News Agency of Azerbaijan. I appreciate you, Nancy, for making yourself available for us today and also, of course, for your earlier comments on the South Caucuses countries, Iran’s immediate neighbors.
I wanted in particular to ask about Azerbaijan. How do you assess the situation in the country in terms of the number of cases, the number of deaths, and perhaps the rate of recovery? Is there more to be done? And what do the people of Azerbaijan, Georgia, and Armenia need to know about some of the data that are being provided by their next-door neighbors like Iran and Russian governments, assuming that they are not necessarily accurate? Thank you.
RADM KNIGHT: Thanks for your question. And I’m afraid I don’t have all of the – of every country’s numbers in front of me. But what I can say is that through our – back here at headquarters, maybe I’ll touch a little bit on how we’re working from here in Atlanta to kind of look at and collaborate with countries and regions around the world, because I think that’s part of the response to your question.
We have a large team. Since the CDC activated our Emergency Operations Center back in January, of course, a significant part of our activation and our response here is very much focused, as the United States public health agency, focused domestically. And we have a large – large teams that are working directly with our own states and territories and tribal communities to address the outbreaks here domestically.
We also have a large team, however, that is focused on working with countries – not just our staff that sit in CDC offices around the world, but collectively reaching out and working with countries around the world. That team helps us to be able to look at the data from WHO and to look at trends that are occurring within countries, and to help to identify best practices that countries might be using and share those best practices to serve as platforms to share those best practices with other countries, and to help with collaboration between countries within the region, like I mentioned with regard to our Georgia office.
So it’s really – it’s a collection of the work that we have that’s being done to help address coronavirus through staff that are sitting in those countries directly with counterparts, but then also back here at headquarters that are collaborating with countries where we may or may not have staff sitting. And we’ve held different – we’ve held calls with several different countries where we don’t have staff, just so that we can talk and share information between technical experts here in Atlanta and technical experts in those countries to learn from one another.
QUESTION: Right. And in terms of Iran and Russia, do you have any comment on the data that we are receiving from them, how accurate are they? Can we rely on their information?
RADM KNIGHT: I think that with every country, it’s every country’s responsibility to have public health systems in place to be able to look – collect their data and provide that data so that as a global community we are able to have that full vision of what the outbreak looks like globally, what the pandemic looks like globally, and what is happening – where we see places that are getting worse so that we can help to address that collectively, as well as where we see places that are getting better so that we can look at lessons learned and best practices.
QUESTION: Thanks so much.
RADM KNIGHT: Thank you.
MODERATOR: Thanks. Next I’m going to call on Sandra Muller.
QUESTION: Can you hear me?
RADM KNIGHT: Yes.
MODERATOR: Yes. Go ahead, Sandra.
QUESTION: Thank you for hosting us. My first question – I have three really short question. The first one is that the CDC was founded in 1946 as a successor of the World War II Malaria Control in War Areas program, right? So you are historically really, really good against malaria. And there is this drug which is called chloroquine, and I’m French – I’m French, and this drug separates France in two parts. There is the pro-chloroquine and the against chloroquine, so I wanted to know if you are able and you have the ability to speak about the result of this drug.
I remember, I think, Governor Cuomo spoke about this, and he told that there was studies in the FDA, but you know there is so many studies. We are completely – it’s completely confusing – was my first question.
As a foreigner, as a Parisian, I wanted to know if you heard about Dr. Raoult. He was the expert of chloroquine in France, so I wanted to know how is your collaboration in France. And I saw – I watch on TV like everybody, because you know we have a lot of time to watch TV now, you have a lot of campaign and a lot of advertising, and I just wanted to know more about the “dispositive” of your campaign. How much does it cost? What is your invest? And it’s a lot – you did a lot to communicate and to warn people abroad what we have to do, so thank you so much.
RADM KNIGHT: All right, thank you, Sandra. I hope that I’ll be able to remember all of your questions, but let me just start from the beginning, as I think your first question was around chloroquine and kind of the use of medications to try to treat COVID-19.
So currently there are no drugs or other therapeutics that have been approved by – in the United States. We have the FDA as our authority. So there are no drugs or therapeutics that have been approved by our U.S. FDA, our Food and Drug Administration, to prevent or treat COVID-19. As far as the evidence to recommend for chloroquine or hydroxychloroquine, there’s currently not enough evidence to recommend for that for the prevention or treatment of COVID-19.
And – but the evidence I think that you may have cited is that there are some studies that are taking place, not just around chloroquine or hydroxychloroquine but around a number of different medications. At CDC, we are not the lead for those studies by and large, and so what I typically recommend if there are communities or individuals who are interested in finding out more about the clinical trials that might be taking place – because these are very important for us to be able to have clinical trials to look at the impact of potential – a number of different medications for potentially preventing or treating COVID-19, so I generally will recommend that they look to the NIH’s website. There’s a clinical trials website that lists off all of the clinical trials that are currently in place and enrolling patients into them. And then WHO also has, from their website, a place where you can go to look at clinical trials that are not just NIH-funded clinical trials. So those would be two places to look for more information about that.
And then I think I don’t quite recall what that last part of that question was. I think it was something around cost, but I’m not sure what it was.
QUESTION: No, no, that’s the one question is do you work with France because it’s like similar and some people they believe in this drug, too, and especially – we spoke in France – I’m living in USA, but we spoke a lot about the Dr. Raoult from the south of France and he is fighting against everybody to say that this medicines works very well, and what your President in United States is saying the same thing. So I wanted to know if you have some contact with him. And my last question, it was about – so my second question is sort of the French, and my last one, it was about all the “dispositive”, the commercial, the advertising. There is message everywhere like wash your hand, do social distance. I wanted to know how much does it cost to you because it’s a lot, like – I watched some ad in – constantly on television, on every channels, like maybe in a newspaper from CDC. So I think it cost a lot, and my newspaper specialize about like communication, advertising, so I wanted to know if you have a number to communicate or maybe later, I don’t know. Thank you.
RADM KNIGHT: Okay, okay, thank you, Sandra. So the first – or the second part of your question, then, around the individual in France, I certainly don’t have contact. I really can’t speak to whether or not others within CDC have contacts, but just kind of more broadly, we do work closely with our counterparts in national public health institutes not only directly from CDC but also through – we’re a member of IANPHE – it’s the International Association of National Public Health Institutes – and I know France is – through the national public health institute there is a member as well. So we do have connections as public health specialist to public health specialists at the national level with France.
And then on your question around the communication and messaging, so a lot of what we do as CDC is we can help to develop some of those communication tools and messages and then share those with our states and local – states and counties, our states and local public health counterparts. So what you may be seeing could be things that we as CDC are putting out directly, or it could also be things that we have developed and we have shared with our partners, with our states, so that they can use them and to help promote the same public health messages, particularly around the really important mitigation efforts to help individuals protect themselves and their communities during the coronavirus outbreak.
So I don’t think that there’s probably any one place where you could go to find a cost for that, because it’s really through this network of public health communicators that those messages are getting out.
MODERATOR: Thank you so much. We have a question from Masako Shimizu from Kyodo News about whether there’s any communication or collaboration between the CDC and Japan.
RADM KNIGHT: Thanks for that question. We don’t have a CDC office in Japan, but I know that we have had collaborations with them, particularly over some of the public health response to the significant outbreak of COVID-19 on the Diamond Princess. We had a team of experts who went to Japan and worked closely with the Japan counterparts there on addressing that COVID outbreak and worked closely with the team of experts based here in the United States, where the Diamond Princess returnees to the United States came.
I’m afraid I can’t speak to whether or not there have been ongoing discussions other than, as I mentioned before, at this kind of broader collective public health level where we reach out and talk with one another about lessons learned, and we have countries that have reached out to us, just as we have also reached out to other countries. Thank you.
MODERATOR: Thank you. We have a question from Tuyen Le.
QUESTION: Hi. Thank you, Liz and Dr. Nancy, for briefing. I’m Tuyen Le from Vietnam TV. As we know that CDC launched a regional office in Vietnam in March for COVID-19 research cooperation, so how is that cooperation now?
RADM KNIGHT: Yes, thank you. We do have an office in Vietnam and we’ve – so you’ve mentioned the regional office which was just recently announced. And going back to the question that we had from Brazil – so as I mentioned, there is kind of this first rollout of regional offices, so Vietnam and Brazil were two of those. And in both of those places even before the regional office we have had existing CDC country offices that have worked in a bilateral fashion with our counterparts.
So in Vietnam we’ve had a focus on Global Health Security. We’ve been a partner with – on the Global Health Security agenda and working on some of those core public health capacities like the laboratory system, the emergency response system, the emergency operations center, and training of expertise on public health emergency management. And in addition, there’s a field epidemiology training program where we’ve partnered on the disease detective capacity for outbreak identification from a community level on up to a national level, and a very large collaboration on HIV and tuberculosis as well. So that regional office will have a role in not just looking at what we’re doing in Vietnam but also across the other countries in the region.
Another important piece in Vietnam, which is – has been useful, I think, in this coronavirus response has also been around infection prevention and control training, kind of building upon those things that I just mentioned and helping to train on sample collection, as well as the COVID testing with laboratory and hospital staff at the national hospitals as well as at provincial hospitals in more than 30 different provinces. So we’ve taken those existing partnerships and applied them to working collaboratively on this training for COVID.
QUESTION: So I know that CDC has had a longtime cooperation with Vietnam, but why Vietnam is chosen for the location for the region?
RADM KNIGHT: I think a number of factors went into that. The overall decisions really kind of combined a lot of factors such as looking at the various countries around the world, looking at the various regions around the world and the work that we already had going on where, of course, to be able to have a regional office in a country we had to have discussions with our counterparts in those countries and ultimately landed upon the first group of countries that was selected.
QUESTION: Yes. And you said that the U.S. CDC help Vietnam a lot in training, so what can Vietnam do to support U.S. or to help U.S. vice versa?
RADM KNIGHT: So your question is what can Vietnam do to help us as well?
QUESTION: Yeah. Yes.
RADM KNIGHT: Yeah, I think with Vietnam, those collaborations are definitely – as with other countries, it’s a two-way partnership. So as we do things like I mentioned – the infection prevention and control training, the implementation of the work at the laboratory level, and looking at the testing practices, the sample collection practices, the emergency operations centers – all of those are things that as we are – in every country we follow generally very similar overall public health practices, public health guidelines, and then you adapt them and you apply them to the specifics, the cultural and the contextual specifics in each country.
So as we do that, we will often learn things from that that can help to improve those practices for other locations as well, particularly as we are addressing perhaps the needs of the most vulnerable populations. That can – what we can learn in one country, whether it’s Vietnam, and then sharing that back to us in CDC or another country, that’s part of the important aspect, I think, of those partnerships is being able to apply – to learn lessons through not just implementing these public health practices but also ensuring that we’re studying them and we are learning from what we’re doing so that we can improve those from country to country.
QUESTION: Thank you very much.
RADM KNIGHT: Thank you.
MODERATOR: Thank you for that. We have one more question that was submitted in writing from Ahmadou Kane from Les Echos Du Jour in Senegal: “You have served in Africa and know the research difficulties there. For you and this global research effort, how can Africa be useful? Should our participation simply be limited to providing volunteers for clinical trials?”
RADM KNIGHT: So I don’t think that Africa’s participation has been limited to volunteers for clinical trials. I think Africa has been a very active partner, the countries within Africa have been very active partners in looking at critical global health security needs that exist and addressing those global health security needs. Research is one part of that. and the clinical trials that you mentioned are one part of that, but there are many other important components to having effective health security – public health security programs within a country.
And Senegal is one country where we have a strong partnership on global health security, and that has really proven quite effective in the response that Senegal has had thus far to COVID. Right now within Senegal, Dakar is the region that is currently most affected within the country, and those disease detectives – the Field Epidemiology Training Program detectives that I mentioned earlier – the graduates from that program have been really important in Senegal’s current response. The resident advisor that is there for the Field Epidemiology Training Program is helping through those graduates of the program to lead the response in the region of Dakar. There have been 212 frontline graduates, so those are ones that go through a shorter three-month training and they work more at the local level, and there have also been nine intermediate graduates that are now supporting that COVID response at the district level for the 212 and at a regional level for the nine.
There are also a number of community-based health workers that have been trained through the community-based surveillance work that we are doing in collaboration. We’ve trained more than 720 community-based health workers, and they are also supporting the COVID response at the village level.
And then at the national level, there are graduates from CDC’s Public Health Emergency Management program. We call it a PHEM, P-H-E-M, PHEM fellow. There are five of those graduates from that program, and they are providing response to the regions and the districts to help them to best coordinate their response, to do their case investigations, their contact tracing, and analyze the data so that that data can be collected and reported out on a national level.
MODERATOR: Thank you, Dr. Knight, for this comprehensive look at the CDC’s efforts and cooperation around the world. I think that we want to be very cognizant of your time and the important work that you’re doing, and so this concludes the hour that we had set aside for this briefing. Thank you to all of our participants, and we will be posting the transcript of this once it’s available and can make the video available to anyone who would like it. Thank you so much.
RADM KNIGHT: Thank you. Thanks, everyone, and I want to make sure that we all continue to do our part – wash our hands, keep our distance, stay home if we’re sick, and stay healthy and safe. Bye-bye, everyone.