An audio file of this briefing is available here

Moderator:  Thank you very much.  Good morning, everyone, from the U.S. Department of State’s Asia Pacific Media Hub in Manila.  I am Zia Syed, the Hub Director, and I would like to welcome our participants dialing in for this briefing.

Today we are pleased to be joined from Atlanta, in the United States, by Dr. Barbara Marston, the COVID-19 International Task Force Lead at the U.S. Centers for Disease Control and Prevention, or CDC; and from Bangkok, Thailand, Dr. John MacArthur, the CDC Thailand Country Director.

The scope of today’s call is the U.S. CDC response to the COVID-19 pandemic in Southeast Asia and coordination efforts with national governments in the region.

We’ll begin today’s call with opening remarks from Dr. Marston and Dr. MacArthur.  We’ll try to get to as many questions as we can during the time that we have, which is approximately 30 minutes.  Please note that due to the high number of journalists on this call, we ask that you please limit your questions to just the one question so others can participate.

Finally, as a reminder, today’s call is on the record.  And with that, I’ll turn it over to Dr. Marston.  Please go ahead.

Dr. Marston:  Thank you, Zia.  Good morning, good afternoon, and good evening to everyone.  Thank you for joining us today.

The COVID pandemic is a difficult situation and it’s going to require resilience around the world.  As of 3pm Bangkok time on April 14th, the World Health Organization had reported over 1.8 million cases globally from COVID-19 and over 117,000 deaths.  That included 122,000 cases and 4,000 deaths in the Western Pacific region, and over 18,000 cases and over 800 deaths in Southeast Asia.

We know that behind every one of those deaths is a real person who has left behind grieving family and friends.  As a public health agency, efforts to prevent illness and loss of life are the top priority for CDC, both in the U.S. and around the world.  To help achieve this, CDC has been working globally for 70 years.  We have more than 50 offices around the world where we’re working hand in hand with host-country governments on specific health problems such as HIV and malaria, and on broad issues such as laboratory capacity and workforce development.

CDC is proud of its longstanding relationship with the people of Southeast Asia and the Pacific.  We have a long history of supporting public health work in the area.  In fact, in 1950, we sent a team to Southeast Asia to assist in developing programs in malaria control and public health.

I’d now like to turn the call over to Dr. John MacArthur, the CDC Thailand Country Director.  Dr. MacArthur can provide some additional detail about the work in the region.

Dr. MacArthur:  Thank you, Dr. Marston, and good morning to all of you, and I really appreciate you joining us today.

The Association of Southeast Asian Nations, or ASEAN, region has a long history of battling emerging infectious diseases going back more than 20 years.  The region has experienced Nipah, SARS, avian influenza or bird flu, pandemic influenza, Zika, and of course now COVID-19.  Because of their earlier experiences, ASEAN Member States were quick to agree to the international health regulations and work towards achieving the core capacity requirements under this new framework.  Mechanisms such as the Asia Pacific Strategy for Emerging Diseases and the Global Health Security Agenda have served as useful vehicles to assist the region in preventing, detecting, and responding to emerging infectious diseases.

The U.S. Centers for Disease Control and Prevention, or CDC, has a longstanding commitment to the Asia Pacific region, with many bilateral relationships dating back decades.  We currently have offices in six of the 10 ASEAN member states, China, and Papua New Guinea, down in the Pacific Island nations, focusing on key capacities for vital health security:  workforce development, public health emergency management, national lab systems, and surveillance.  Surveillance, of course, is monitoring and tracking the pattern of disease occurrence in those countries.

In Thailand, where I am currently posted, CDC has its largest overseas operations, which began 40 years ago with the establishment of the first Field Epidemiology Training Program, or FETP, outside of North America.  Over the years, we have worked with many host governments to build FETPs as well as to support the ASEAN+3 Field Epidemiology Training Network.  Currently, graduates of these disease detective programs are providing the leadership and the on-the-ground epidemiology expertise needed to combat COVID-19 in Asia.

Apart from training disease detectives, CDC offices throughout Asia have been working to strengthen surveillance and laboratory systems as well as public health emergency management programs, all necessary for a successful fight against this virus.  Like much of the world, the Asia Pacific region has put in place a variety of measures in an attempt to flatten the curve of the pandemic.  While the ASEAN Member States make up 9 percent of the world’s population, they have only experienced 1 percent of the cases, and less than 1 percent of the deaths.  The CDC remains committed to working closely with our partner governments throughout the region to support them as they work diligently to reduce the risks of this virus on their people.

Dr. Marston and I are now happy to take any questions that you may have.

Moderator:  Thank you very much.  We’ll now begin the question and answer portion of today’s call.

Let’s go ahead and take a question from – the questions are just coming in now — let’s actually take a question we received in advance first.  Let’s take a question that we got from Gerry Flynn from ThmeyThmey in Phnom Penh, Cambodia.  His question to you was, “How can regional actors in Southeast Asia work multilaterally to address the current COVID-19 pandemic and prepare for the next viral event?”

Dr. Marston:  John, I think I’ll let you have that one.

Dr. MacArthur:  Sure.  As I mentioned in my introductory remarks, the region has seen a number of these emerging infectious diseases, and because of that, I think that really the countries have come together in a variety of different sorts of multilateral forums to try to address this.  I’ll mention three main ones.

ASEAN has, increasingly over the last few decades, played an important role in health.  So they have a health cluster, which within that health cluster has certain areas such as the ASEAN+3 Field Epidemiology Training Network I mentioned in my opening remarks.  They also have teams addressing issues about zoonotic diseases, or those diseases that can be transmitted from animals to humans.  They have teams that are looking at strengthening laboratories across the region, and they also have teams that are focused on emergency operation centers.

I think one of the benefits of these relationships is that they address issues both at the senior policy levels, but they also bring together technical experts to discuss the problems that the nations are facing, and also relationships are developed where they can pick up the phone and have conversations.  And I’m seeing this in real time in Bangkok where some of the neighboring countries know of a patient who tested positive for COVID, but got on an airplane before they were able to be hospitalized in one country, and they traveled to a second country — and with those networks that have come up through these ASEAN meetings allows people to pick up the phone and call somebody in the other country to discuss the fact that this patient has come through.

United Nations organizations obviously play an important role in the multilateral context in this region as well, both the World Health Organization’s Southeast Asia Regional Office and the Western Pacific Regional Office, but also those organizations that are involved with zoonotic diseases – again, diseases that go from animal to humans.  So, the Food and Agriculture Organization or the World Organization for Animal Health.

And then the last thing I’ll say is the academic space has also been quite active and there’s something called the Southeast Asia One Health University Network, which brings together academicians and human health and animal health and environmental health to try and address emerging threats to the ASEAN region.

Moderator:  Thank you very much.  Next we will go to Thar Oo from Voice of America.  Thar, can you please go ahead?

Question:  Yes.  My name is Thar Oo from the Voice of America Burmese service.  I just came from the Myanmar.  I have a specific question about the Myanmar, because you know that Myanmar has found so far 63 positive cases — few comparing with the other neighboring countries, but tens of thousands of Myanmar migrants just came from Thailand recently.  So, my question is:  Do you have any concern about the Myanmar situation and do you, U.S. CDC, have any cooperation with the Myanmar officials right now?

Dr. Marston:  We do actually have an office in Myanmar, and I think Dr. MacArthur works closely with that office from Thailand so I’m going to let him answer.

Dr. MacArthur:  Sure, and thanks, Thar Oo, for that question.  I will say this:  CDC has been working with the Myanmar Ministry of Health and Sports really since the time of the bird flu outbreaks in the mid-2000s.  In fact, that was myself during my previous time out in the Asia region.  And we began at that point in time to build surveillance systems and laboratory networks within the country, really at that point in time, looking at influenza because that was the fear of the potential for pandemic influenza.  But it’s those structures, the laboratory structures, and the epidemiology structures and surveillance structures that are in place now that are working to detect and respond to the virus in the country.

One of the things we’re very, very proud of is the launching of the Myanmar Field Epidemiology Training Program.  I think you guys are going to hear me talk about this over and over during our time together because it’s vitally important that we really have those disease detectives in place at a variety of levels to really do the ground work of public health in order to control this virus.

I had the pleasure – time is slipping away from me, but I think it was last month – to lead a team into Myanmar with epidemiologists and points-of-entry migration experts, to work with the Ministry of Health and Sports.  We also visited the airport in Yangon and Naypyidaw and Mandalay and worked with the quarantine experts in those airports in order to improve the way that they are screening returning Myanmar citizens or tourists in those areas.

And then as Dr. Marston pointed out, we actually have a CDC office in Yangon who works closely with the Ministry of Health and Sports to coordinate the technical assistance that’s been coming from the CDC Atlanta office as well as my office in Thailand.

Moderator:  Thank you.  Next if we can go to Siobhan Robbins from Sky News in Bangkok, Thailand.  Siobhan, please go ahead.

Question:  Hello.  I was just wondering — there’s a lot of talk about testing levels and the variety in testing levels across various countries, and we build these [inaudible] tables about the world, and countries’ positions in the world.  But [inaudible] that they’ve done testing.  So, I’m just wondering how accurate our picture in the region really is given the huge variety in the level of testing, and how accurately we can really track the disease at the moment, given that some countries are testing very few, and other countries are testing far more people.

Dr. Marston:  That’s an incredibly important question and an important observation.  So, you’re absolutely right, the testing levels vary in different countries, and interpreting the results of the reports of cases — you really need to take into account how much testing has been done.  Almost always, if testing is limited, it tends to focus on more severe cases, and in that situation, you might see higher reported mortality, more likely hospitalization.  Whereas if the country is able to test more people, then you might see milder forms of the disease or overall lower mortality.  And so that’s really an important aspect of interpreting what’s going on.

I think different countries are able to conduct a certain amount of testing or more or less, and as we see testing capacity scale up, we’re probably going to learn a little bit more about asymptomatic infection or broader infection, and we may end up with maybe lower case fatality rates overall if the number of people that are tested and recognized to have infection is greater.

Moderator:  Thank you very much.  Next, we’ll go to Tommy Rony from Liputan6 in Jakarta, Indonesia.  Tommy, please go ahead.

Question:  I’d like to ask both doctors.  First, to Dr. MacArthur, when do you think is the peak  for COVID-19 in Indonesia?  And then for Dr. Marston, officially, Indonesia has over 4,000 cases of COVID-19.  So, some people don’t believe that, because the number seems too low.  But does CDC have alternative data or a model or prediction about the actual number of cases in Indonesia?

Dr. Marston:  So I didn’t quite —

Dr. MacArthur:  Thank you for that question.

Dr. Marston:  Go ahead, John.

Dr. MacArthur:  Oh, go ahead, Barbara.

Dr. Marston:  No, no, I didn’t understand the first one, but if you did, it was to you so go ahead.

Dr. MacArthur:  It was to me and I believe that the reporter asked if – when we would see cases peaking in Indonesia, and I think that’s a great question, and unfortunately, I don’t have an answer for that.  I think one of the things that all of us are learning with this virus, is that just a little over four or five months ago we didn’t even know this virus existed.  And so one of the things that we are working diligently with our partners around the world is to try to identify how this virus behaves, how it behaves in the northern countries, how it behaves in the more southern countries, and simply I don’t have an answer for you.

Over to you, Dr. Marston.

Dr. Marston:  I think for the second part of the question, we don’t – CDC doesn’t really weigh in on whether official reports are correct or not, but we do think about that.  And so, for example, similar to the last question, if a country presented data that said, well, we had a small number of cases but a relatively large number of deaths, we might wonder if there were unreported cases.

So, in Indonesia there’s a relatively high number of severe cases and deaths, and that does make one wonder whether if there was more testing, there would be additional cases.  That’s not the same thing as questioning the official reports — we’re not doing that.  But we do wonder if more testing would identify additional people.

Moderator:  Thank you very much.  Next, we’ll go to Sofia Tomacruz from Rappler News, calling from Manila.  Sofia, please go ahead.

Question:  Hi, good morning.  Sofia here from Rappler.  So, my question is a little bit more specific to the Philippines.  As you know, we have the highest number of cases in Southeast Asia, at least as of last night, with around 5,000 cases – a little over that.  My question is:  What should we be prioritizing at this point in time?  Also, because at least in the Philippines, testing capacity is still quite low, although of course they’re trying to ramp that up and everything.  Testing capacity remains low, so there really is that fear that we’re not really seeing a true picture of the spread of the disease, as well as the fear that it’s spreading undetected in communities, especially low-income communities where social distancing measures aren’t really in place.  And of course, there are issues, of course, about, like, the lack of guidelines for rapid testing, which our president wants to pursue.  So, is that a good – I mean, is that something that you would recommend?  And what should we really be prioritizing at this point in time?

Dr. Marston:  I think that’s a difficult question and something we’re all trying to struggle with and figure out.  Even in places that have a hard time doing social distancing, we still recommend at this time, you know, kind of a package of interventions, so doing as much testing and isolation of people that are sick, as is possible.  Doing as much social distancing as possible, as much hand-washing as possible.  What you want to do is slow things down, and then use the time that you gain by slowing anything down, to do everything possible to prepare – so, to prepare the health system, to train health care workers, to help communities understand what the disease is, and what’s going on.

I think if we’re – if we’re lucky, we can slow things down long enough to maybe get a vaccine or some treatments, but we don’t have those right now.  But what we do have to do, if we slow down, is really use any time that we gain to do as much preparing as possible, so increasing testing capacity, or improving the plans at hospitals, or the training of health care workers.  There’s no easy answer.

Moderator:  Thank you.  Next if we could go to Thuan Nguyen from Zing News in Vietnam.  Thuan, can you go ahead?

Question:  Hi, my name is Thuan from Zing in Vietnam.  I was wondering if you could elaborate and give an update on the latest CDC collaboration with Vietnam.  And I want to ask about the – because there was a shipment.  There were shipments of N95 masks from Vietnam to the U.S., produced in Vietnam.  So, I was – and there hasn’t been much details about the second shipment on April 10th.  So, I was wondering if you could give us more updates on the second shipment.  And more broadly, could you give us updates on – because the U.S. has been – has had an interest in finding partners in Vietnam so that they can transfer technology and have medical supplies, including ventilators, produced in Vietnam for the U.S.  So, I was wondering if you could elaborate more on that, or if the U.S. has an interest in other countries in Southeast Asia that produce medical supplies and ventilators there.  Thank you.

Dr. Marston:  Maybe I’ll take a part, and then turn it over to John.  So, definitely the U.S. is facing some shortages of key supplies, and if there are countries that have extra, there’s an interest in partnering with those countries.  I don’t know the details about the masks shipment.  And I think for the collaboration with Vietnam, John can probably describe that well.

Dr. MacArthur:  Sure, thanks for that question.  I think this is actually an important year for Vietnam.  The Government of Vietnam and the United States government are celebrating their 25th anniversary of the resumption of bilateral ties, and health is an extremely important part of the bilateral work that’s going on.  We have a relatively large office working on health-related issues, including HIV/AIDS and global health security.  And so – I think the work on global health security really began, like much of our engagement on health security in the region, around the time of avian influenza in the early to mid-2000s.  Vietnam was a country that was being hit hard by the bird flu, and so we strengthened our relationship with the ministry to work on such key areas as surveillance, laboratory strengthening, and the development of, again, the Field Epidemiology Training Program.

And so at this point in time, really – our team that’s up in Hanoi working very, very closely with ministry of health counterparts on many, many aspects of this outbreak response, providing technical assistance in the areas of surveillance, data analysis, laboratory testing, the actual going into the field and doing investigations, contact tracing with the Vietnamese counterparts, and really, sort of trying to support them and their approach.

I think that my opinion is that in the conversations I’ve had with our team in Hanoi, is that the public health system in Vietnam is very strong.  The government at the highest level took this seriously, and have really taken a whole-of-government approach to the response, and I think that’s why we’re seeing some successes in Vietnam.

Moderator:  Thank you.  Next if we can go to Narin Sun from the Voice of America in Phnom Penh, Cambodia.  Narin, please go ahead.

Question:  So I have a question to Dr. —

Moderator:  If you’re on the line, Narin Sun, can you please go ahead?  Oh, please, go ahead.

Question:  I have a question for Dr. Marston that’s related to Cambodia.  I just want to know what the Cambodian government so far has asked CDC to help, in terms of treatment, training or any personal protective equipment, things like that.

Dr. Marston:  So, actually I think the question might be better for Dr. MacArthur.  Again, he’s working in the region and familiar with the activities that are in the region.  I know we were asked to assist.  We’ve been very active in helping with contact tracing in Cambodia, so when people are identified as having COVID, just tracking down the people that they’ve been in contact with, and that’s been something the CDC office has been helping with a lot, and also there was a cruise ship scare in Cambodia and I know the CDC office was asked to assist with that.  But I think John will know better exactly what support is being provided.

Dr. MacArthur:  Sure.  I don’t have visibility on actual requests for commodities, but I can tell you that we have a team in Phnom Penh in our CDC Cambodia office that are working, again, closely with the Ministry of Health.  It’s really sort of these same key areas of health security, because we put them in place, like in Vietnam, like in Myanmar, like in so many countries around the region, during the time of the bird flu in the mid-2000s.  So really, again, a focus on surveillance, laboratory strengthening, workforce development.  There’s an FETP program that’s in Cambodia as well.  And I know in my conversations with our main health security epidemiologist there, that he’s really working hand-in-hand with the government to ensure that the surveillance systems are in place to detect possible cases and then to try to ensure that the health care workers who identify those possible cases can take the specimens in a safe way that’s not going to infect them, get those specimens into the laboratories and get an accurate read of whether or not that’s actually COVID or not, and so he continues to work rather closely with the Cambodians on that.

Moderator:  Thank you very much.  Next we’ll go to – next, if we could go to Michael Sullivan who’s with NPR in Chiang Rai, in Thailand.  Michael, please go ahead.

Question:  Hi, thanks for having me.  This may sound a little repetitive after the previous caller’s question, but I would like to ask what you make of the remarkably low numbers that are coming out of Vietnam.  I mean, how do you explain them?  Is it testing?  Is it surveillance?  Is it contact tracing?  Is it Vietnam getting a jump on this early, back in January?  Is it their previous experience with SARS and H1N1?  Or should we be wary of the numbers, the same way we’re wary of China’s numbers now?

Dr. Marston:  I think we can probably both contribute to that one.  I mean, one of the most important things is that I don’t think anybody really has a full understanding of why certain things are happening in certain places.  There are so many different factors that go into it.  It could be partly ecological, but they’re certainly related to the quality of responses, and I think Vietnam has had a very strong response.

And John, I don’t know if you want to comment on specifics.  I think the short answer is we don’t know, but we do know some of the things that are probably contributing to the low numbers there.

Dr. MacArthur:  I will say that my team in Bangkok, we have a regional sort of approach, but the team, the CDC team in Hanoi is quite strong and so they haven’t asked for a lot of assistance out of my office.  But, the same thing that has caught your attention has caught my attention, and so I actually reached out and asked the health security team that very question.  And the response that they told me was, one, is that, again, they had a political commitment early on at the highest level and that political commitment went from the central level all the way down to the hamlet level, really adopting a whole-of-government approach.  It wasn’t just about the Ministry [of Health].

They also were open to inputs from outside technical advisors such as CDC and WHO and academic partners, and so they worked, sort of close to – listening to the advice from experts from different organizations and there was a feeling that that was beneficial.  They developed evidence-based guidelines, and so they looked at what was being recommended by CDC, they looked at what was being recommended by WHO, they looked what was happening within their own country, and adopted sort of those more global guidelines to be more specific to Vietnam based on the data.

I will say that – and I think I mentioned this in one of my other responses – that our teams have gone out to the field and worked closely with the contact investigation teams, and we’ve done the same thing in Thailand.  And I think when we have these strong relationships with host governments that allow us to essentially embed ourselves within the ministry.  In Thailand, for example, my office, which has 160 or 170 staff, two laboratories , is actually on the Ministry of Public Health campus.  And so those relationships are strong, and it kind of allows us to get a sense of whether the numbers are real, the numbers are not real, only because of deficiencies in testing and some such, or whether there’s some reason to hide those numbers.  And from the communications I’ve had with my Vietnam team, is they, at this point in time, don’t have any indication that those numbers are false.

Moderator:  Thank you very much.  We’re going to be wrapping up soon but we’ll take just a few more questions, if that’s okay.  Next we’ll go to Donabel Norei Magsino from GMA News Online in Manila.  Donabel, please go ahead.

Question:  Hello, thank you.  In the Philippines, we have more than 5,000 confirmed cases of COVID-19.  We have over 300 deaths and 300 recoveries.  You mentioned earlier that we need to buy more time, and the government has implemented an enhanced community quarantine over Luzon which covers many provinces, to limit the mobility of the population.  It’s in effect until April 30.  Does CDC suggest extending this lockdown?  What parameters should be followed?  And what would you recommend?  What parameters would you recommend to lift the strict confinement measures in the Philippines?  And what should the health sector do to maximize this lockdown?

And finally, my other question is, how does the CDC picture the health system in Southeast Asia after this pandemic?  Thank you.

Dr. Marston:  I missed the last part, but I think we can kind of pick up the question of when to lift guidelines for restricting movement or community lockdowns, or whatever you want to call them.  Nobody knows completely how to do that yet.  And again, the U.S. is trying to figure that out, lots of countries are trying to figure that out.  The factors you have to consider are – have cases declined?  What would happen if there were more cases?  Is the health system ready to take on some more cases? And to balance all of those things.  I think it’s a difficult question that everybody is grappling with now, and we wouldn’t have a specific recommendation for precisely what to do in the Philippines.  Whatever is done, it’s going to have to be done carefully and kind of watched, and I think people have to be ready to possibly change their mind.  So, make a decision, watch what happens, and be ready to change that decision.

Moderator:  Thank you, Doctor.  Next we’ll go to Sharon Margriet from Narasi TV in Jakarta, Indonesia.  Please go ahead, Sharon.  Looks like, actually, Sharon just dropped off the line.  In that case, can we go ahead and go to Phan Vietanh, Phan Vietanh from VnExpress in Hanoi.

It may just take a second to open the line.

Question:  My question is how – yes, can you hear me?

Moderator:  I can.  Can you just introduce yourself, please?

Question:  Yes, my question is:  How do you see the efforts of Vietnam in containing COVID-19, and what does the U.S. want to see in the cooperation with Vietnam in this campaign?  Thank you.

Dr. Marston:  John, I know you’ve said some of that already (inaudible).

Moderator:  Dr. MacArthur, you’re there?

Dr. MacArthur:  Yes, sorry, I didn’t hear Dr. Marston if she was handing it over to me.  Yes, I think again that the communication I’ve had from my team in Vietnam is that they’re working quite closely with the Government of Vietnam and that they believe that the Vietnamese government is doing a good job.  They specifically highlighted, again, the strong public health systems, the whole-of-government approach, the fact that they’re utilizing evidence to drive some policy decisions that now for 15 years or so, they’ve been – the government has been building the disease detectives that are necessary to do the on-the-ground contact tracing, really, the public health heavy lifting that’s necessary to get this epidemic, pandemic under control, and that they’ve got some strong laboratories.

I will say that the relationship between the U.S. government and the Vietnamese government is strong.  The relationship in health is strong.  As I mentioned, that this part year, Dr. Redfield, who’s the CDC Director, actually identified Hanoi, Vietnam, to serve as a future regional hub for CDC activities in the Asia region.  So that sort of, I think, speaks on the strength of the relationship in the health arena between the U.S. government and the Government of Vietnam.

Moderator:  Thank you.  We’ll just take a couple more probably and then we’ll wrap up.  If we could next go to Kim Dong Hyun from Voice of America, Voice of America Korean Service.  Please go ahead, Kim.

Question:  This is Dong Hyun Kim from Voice of America Korean Service.  I express my deep gratitude toward all the efforts that CDC is devoting.  I have a question to Dr. Marston.  Ma’am, the U.S. Government has repeatedly underlined that they are willing to extend humanitarian assistance to North Korea in regards to COVID-19, even though DPRK denies having any infection cases.  I was wondering if CDC is working on creating a [inaudible] manual or guidance toward DPRK potential humanitarian assistance.  If this later becomes a feasible option, are there any specific guidelines to ensure safety of U.S. personnel who would be – potentially be, directly involved in this practice?  And also, since DPRK is denying any infection or hesitant to reveal any internal information, are there any ways to ensure monitoring a transparent and effective process that the U.S. is looking into?  Thank you.

Dr. Marston:  I think for any of our assistance we’d want to see information about what’s going on, and what the needs are.  We’re focused primarily right now in the countries that really have been hard-hit and already have serious implications, higher numbers of cases, in Asia and Africa.  And I don’t know any specific plans for North Korea.

Moderator:  Thank you.  If we could next go to Rachel Thompson.  Rachel Thompson is with Sky News in Bangkok.  Rachel, please go ahead.

Question:  Yes, hello.  A question for Dr. MacArthur.  You mentioned in your opening remarks that you had teams specifically focusing on animal transmission, looking at zoonotic diseases.  Can you tell me a little bit more about the work that you’re doing across the Southeast Asia region to try and establish that animal transmission for COVID-19?

Dr. MacArthur:  Sure, that’s a great question.  Within our health security team in the CDC office, we have a One Health team.  And for those of you who are not familiar with One Health, it’s really bringing together human health, animal health, and environmental health in a more, sort of cohesive, fashion because of the interactions that are close proximity with animals, which can pose disease or disease threats, and I think that may be the overall, overarching hypothesis with these viruses that originated in an animal and jumped the species barrier into humans.

And so, our One Health team is working with a variety of different partners both in Thailand and in the region, at the academic level, at the government level, at the UN level to try to bring together approaches.

I would say that one of the main activities that they’ve been doing up until this point was really looking at surveillance for avian influenza, and so influenzas that exist in poultry for the most part, but that potentially can jump the species barrier and infect humans.  Because this region has a long history of new influenza viruses really affecting humans that have originated in poultry.

Up until early January, there was not any work going on with regards to COVID-19 because we hadn’t looked at it.  Now, the One Health team clearly was paying attention to other coronaviruses such as MERS, but mostly in this region, those cases were imported.

At this point in time, they are exploring future work.  The U.S. government has made funds available through the emergency supplemental for global [inaudible], and some of the work that the One Health team will be putting in place in the future is doing – establishing surveillance right now in that population.  Because you may know that while we don’t really understand where this virus came from, if we look at the genetic sequence of the virus, we understand it’s closely related to coronaviruses that exist in bats.  And so we’re trying to set up a surveillance system not only in Thailand, but possibly throughout the region, where we’ve been trying to understand more of what’s happening with bat viruses, and get an earlier indication of the presence of these types of viruses before they jump from animals into humans.

Moderator:  Thank you.  We have time for just one last question, if we could go to – and we appreciate all of you that were on hold here for quite a while.  Audjarint Wasamon, Wasamon Audjarint, from Voice of America Thai Service.  Wasamon, please go ahead.

Question:  Hello.  This is Wasamon from Voice of America Thai Service.  I have just a question for Dr. MacArthur.  So, how would CDC evaluate the Thai Government’s ability to handle the COVID situation?  And also, how has the CDC cooperated with the Thai government on combating the virus together?  Thank you.

Moderator:  Were you able to catch that question?

Dr. MacArthur:  Sure, the —

Moderator:  Okay, go ahead.

Dr. MacArthur:  Thanks so much for that question.  And it actually gives me an opportunity to highlight something that we’re very proud of.  That this year in 2020, the new Thai Ministry of Public Health and CDC are celebrating their 40th anniversary of collaborative work, and that began – you guys have heard me in the last hour talk over and over again about — the Field Epidemiology Training Program.  Well, actually the first FETP program outside of North America was established in Thailand in 1980 with the support of CDC, and that program has strengthened, not only Thailand’s ability to do surveillance and public health work through epidemiology, but also they have an international component that has been key in terms of creating the network of epidemiologic workforce throughout the Asia region.

Over the last 20 years, we’ve worked really hand in glove with the ministry to further strengthen, again, their laboratory systems, but also their ability to manage public health emergencies through the development of an emergency operations center.  We also have a specialized team on global migration and quarantine who worked with the Thais in strengthening points of entry, screening for a variety of infectious diseases — not only at airports but also at seaports and land ports.  You know, the Thais recognized the risk early on.  They looked at data, they saw that the number one destination of travelers from Wuhan in the region, in fact in the world, the number one destination was Bangkok.  Thailand had four of the top 20 sites of Wuhan tourists coming to the country, so the Thai ministry saw that early and they initiated point of entry screening at the airports where visitors from Wuhan were coming in and, in fact, detected the first COVID case outside of China on the 8th of January.

Even before they detected that, they had activated their emergency operation center and put their disease detectives in place.  I think that they did a very good job at containing the disease, and then, once it became more sustained in terms of community transmission, then they worked with their policymakers to implement these community mitigation interventions that I think many of you already know, or have heard a lot about — shutting down restaurants and bars, closing schools, closing malls, not allowing large gatherings, et cetera.  But they also put out a lot of very strong public health messages in terms of hand-washing, cough etiquette, sneeze etiquette and those type of things.

So they’re working diligently and as I mentioned, my office is on the ministry campus.  I’ve got epidemiologists and other public health experts embedded with a variety of the Thai teams helping on this outbreak.

Moderator:  Thank you very much.  Dr. Marston, Dr. MacArthur, would you like any final remarks before we close the call?

Dr. Marston:  Thanks, Zia.  I think we just want to say thank you to the press.  We really appreciate the importance of the work that you all do, helping your audiences to understand what needs to be done with this epidemic, and for sharing that information with your viewers and listeners.

Dr. MacArthur:  Yes, from my side I just want to echo Dr. Marston’s words of appreciation.  I think the partnership between the public health community and the press is really vital, especially in times like this, in ensuring that the communities and the population really get accurate information about the pandemic, and you guys play an extremely important part of disseminating that accurate information.  And I just want you, your readers, your listeners to know that they can always turn to us for accurate information, and that can be found at www.cdc.gov.

Moderator:  Thank you very much.  That concludes today’s call.  I want to thank Dr. Barbara Marston, the CDC COVID-19 International Task Force Lead, and Dr. John MacArthur, CDC Thailand Country Director.  And I also thank all of our journalists on the line for participating, and I apologize for those of you if we weren’t able to get to your question.  And also, I understand that some journalists had a hard time joining the call.  I apologize for any of those technical difficulties.

Please stay on the line for information regarding access to an audio recording of the call.  Also, please be aware that a transcript of the call will be posted to our social media platforms and sent out to all of you within a day.

If you have any questions about today’s call, you may contact the Asia Pacific Medio Hub at AsiaPacMedia@state.gov.  Thank you very much.

U.S. Department of State

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