 My name is Juliana Chan, I'm the Chief Executive Officer of Wild Type Media Group and a science communicator based in Singapore. We are here today to discuss an unfolding situation that of a novel coronavirus, the Wuhan virus. It is named because it first appeared in December in a seafood market in Wuhan, the largest city in Hebei province in central China, with a population of 11 million. So it has been compared to SARS, which caused the deaths of nearly 650 people across mainland China. And today, we have already had more than 570 cases and 17 reported deaths. Just today, a few hours ago, Singapore where I'm from announced its first confirmed case. So we have three experts with us today to help us put in context the unfolding situation. On my left, we have Dr Jeremy Farah, Director of the Wellcome Trust in the UK. Next, we have Dr Richard Hatchett, Chief Executive Officer of SAPI, which stands for Coalition for Epidemic Preparedness and Innovations. And finally, we have Mr Stefan Bancel, Chief Executive Officer of Moderna, a US-based biotech company. So I'll start with trying to understand what we are dealing with right now. And for that, Jeremy and Richard, could you kindly tell us what we know now of the virus and what do we expect to happen next? Yeah, thanks very much and thanks to everybody for joining. Just back to a little bit so you can appreciate what I'm going to say. I am a infectious disease person by background, worked very, very closely with China during the SARS outbreak and spent 20 years living in Vietnam but working very closely with many countries in the region. That's my background of where I come from. This infection which has come about from the beginning of December started, as you say, in an animal market in Wuhan and probably was a virus that was infecting animals. Most likely, I think, bats in that market and it crossed the species barrier and it came into infecting humans after working or visiting that market. Subsequently, through the month of December and then the early days of January, that infection spread from animal to human but then most importantly from human to human and now we are sort of the end of January so we are about six weeks into this outbreak. This virus can now clearly spread between humans. It's spread by the respiratory tract. That means that somebody with symptoms would have a cough, a sore throat and would pass it to somebody else by coughing or sneezing in the same way that influenza is spread around people. It is not SARS. The virus is in a similar family to SARS but this looks different to SARS and the difference is probably it's easier to pass between human beings. SARS was quite difficult to pass between humans and people were most infectious when they had symptoms and therefore it was relatively easy to bring the epidemic under control. When the infection spreads between humans easily, it's actually very difficult to bring the epidemic under control and so there's a very big difference between SARS and what we believe we know about this virus so far. The infection is now spreading, of course, across China and many cities in China have reported cases. Indeed, Singapore reported a case and other countries have and I think we can expect that there will be many more cases in China and that there will be many more cases in other parts of the world. I would stress also in comparison with SARS that the infectious rate will probably mean in the long term that it will cause fewer people will die, 10% of people died in SARS. I suspect the mortality rate with this infection will be lower than that as it spreads to a much wider population. So what we have is a broader infection with probably a less marked percentage of people dying but that is in some ways from a public health perspective is harder to deal with. We can't predict the future and we're living in a period of great uncertainty at the moment because we don't have all the information we need. China recognised this, it shared the information very quickly, that was different to SARS and therefore it alerted the world to this outbreak happening. That would not have happened maybe 10 or 20 years ago and we should congratulate China in the way they've been open and sharing the information. The future, the world has got to think about how we can prepare now by developing vaccines. Richard will talk about that, drugs that may counter this infection but also what we can do at a public health and societal level to try and prevent the epidemic spreading further than it might otherwise do. Thank you, Jeremy. Do you have any points to add? I think Jeremy has given a terrific summary of what we know. I would like to underscore what we don't currently know and what makes it very difficult, as Jeremy is saying, to prognosticate the future. We do not have a detailed understanding of infectiousness. We are inferring a lot from the numbers of cases and I think Jeremy's inferences are strong but we have to recognise that we don't know anything with certainty yet. We don't understand the transmission dynamics of the disease. We don't understand yet the severity of the disease. It is very difficult during a period when the number of cases is increasing exponentially to make inferences about the severity to understand what the mortality rate actually is. We don't know the number of cases. We don't know the extent of spread. This is all critical information that will inform the needs required to bring the outbreak under control and I am sure that Chinese authorities are digging as quickly and deeply as they can to understand all of these factors and so over the next several weeks and even months we will have a greater understanding of all of these issues and it will help us tailor and target our response appropriately. By point of comparison, in 2009 I was working in the White House helping orchestrate the pandemic response to H1N1. We knew by the end of April that the virus that was spreading H1N1 was going to cause a global pandemic. We did not have an accurate estimate of severity until August and that was with a virus that was reasonably well understood from the beginning and very intensively studied so many of these answers may not become available in the time fashion that we would all like and we're going to have to make decisions under ambiguity and uncertainty and we're going to have to make decisions that have potentially very significant cost. We are seeing that currently in China with some of the decisions about travel restrictions and we as an organization, CEPI, we were set up to fund vaccine development. Vaccine development is a very expensive undertaking but if we don't take steps now, we won't have the vaccines in a time fashion. Thank you, Richard. So Jeremy, this is for you. So I'm Singaporean Chinese and you may be aware that on Saturday is the first day of Chinese New Year is warrensing in Tui. So hundreds of millions of Chinese people around the world will be traveling to either go home or visit loved ones. We know that they have already locked down the city of Wuhan and others as well. Are countries taking enough precautionary measures? What else must we be doing? No, I do know it's China. I was born in Singapore so I am ingrained in that. In many ways, this outbreak so often happens, couldn't be happening at a worse time. I mean, in Chinese New Year, I believe I'm right in saying about 450 million people will be traveling in China alone than many people in the region and then globally. During the pandemic of 2009, which Richard refers to when we started working together in some ways, we did some work in Vietnam when I was living at the time, travel restrictions are in very important sense that the authorities are doing something. It's a very important statement to communities that this is serious. The actual impact of travel restrictions, at least in my opinion, are not going to be the answer. Firstly, you can't stop everybody traveling. If you stop people traveling, they often find other ways to travel that may be not so obvious. And in the end, if I were infectious now with no symptoms, I could pass it on even though you may not know I was sick. So travel restrictions can buy you a bit of time and that's very important to do. It might buy you a day, it might buy you a week, it might buy you two or three weeks. But in the end, you have to use that time to put in place the critical public health interventions that you need because travel restrictions on their own will not stop this epidemic moving. Thank you. So on that note, I think Richard, it's a good time to talk about CEPI because it was launched three years ago right here in Davos in the shadow of the Ebola outbreak in West Africa. So what is CEPI's response to Wuhan virus and what is on the research agenda? CEPI, the Coalition for Epidemic Preparedness Innovations was established by global public health authorities. Jeremy played an important role with others in setting CEPI up and was funded by a number of philanthropic organizations in sovereign countries for exactly this kind of event. It was set up to develop vaccines against diseases like Ebola that we know about and to be prepared for the next unknown disease, the next epidemic, so that we could respond rapidly. So CEPI is focused exclusively on vaccines and we have been working very aggressively over the last couple of weeks to assess the situation first, to try to make determinations about what steps are appropriate and as the epidemiologic situation has unfolded our sense of what we need to do has become more clear and our sense that we need to move faster and move farther perhaps has also become more clear. Today we can announce, in fact this is the first time that we've announced this, three partnerships to develop vaccines against the novel coronavirus. Two, with partners that CEPI already works with. One, a company called Inovio that will manufacture a DNA vaccine. A second with the University of Queensland that will manufacture a recombinant subunit vaccine. And the third, a new partnership in fact, but one we've contemplated for quite a long time with Moderna and with the U.S. National Institute for Allergy and Infectious Diseases to develop an mRNA vaccine against the novel coronavirus. Our hope is to have these vaccines developed very rapidly and to move them rapidly into human clinical trials perhaps as early as the summer. And I would like to give Stefan a chance to talk about his program. Thank you, Richard. Stefan, maybe you could share with us about this vaccine and when we can expect it. Good, so thank you again for having me and having the company. So let me maybe say a few words about Moderna so you understand what we're trying to do here. So Moderna is a biotechnology company based in the U.S. And what we're trying to do with the U.S. government through NIH and with CEPI is to use our technology to help. So Moderna, what we do is we make mRNA medicines which is of course a new technology where we inject basically instruction into humans for humans to make their own medicine using your own machinery of yourselves to make your own protein as medicine. The company currently has 16 clinical trials around the world including with global companies like Merck or MSD on the side of the world, AstraZeneca and others. We are in oncology, in cardiology, in rare genetic disease, in autoimmune disease. And of course the topic of today infectious disease vaccine. So far we have started nine clinical studies around the world for infectious disease vaccines. We have those more than a thousand people and we've done a few viruses like pandemic flu viruses, H10S7, RSV and also HMPVP IV. So if you think about mRNA, the very interesting thing for fast response is that mRNA is a platform. And that provides the potential for two benefits. One is efficacy because if you think about it by using the human cells to make the protein of a virus which is how a vaccine mechanism works, we are trying to mimic a natural infection but without giving the virus. The second piece of course is manufacturing. If you look at traditional vaccine technologies, they take a lot of time to develop because every product is unique. In our case because we have an information-based molecule, messenger RNA. It's the same technology that we use for flu vaccines that have already been in the clinic or Zika vaccine that we are testing in the clinic with Bada, U.S. agency, or the project that we are working on for this new virus. So it provides a speed to get very quickly clinical grade material so that you can start quickly clinical trial. So if you think about the company, our number one focus in vaccine of course is to develop commercial vaccine for viruses for which there is no vaccine on the market today. And a good example is CMV, C2 megalovirus, which is now in phase two in the U.S. that's one of our products for a very important virus that affects birth defects. And so what we've always wanted since we started this company is to say because it's a platform and because of what I describe as potential benefits, it would be a very nice tool for emerging pathogen. And so we've always partnered since we started the company with government agency like Bada, which is part of the Secretary of Health in the U.S., or DARPA, which is part of the Department of Defense, so partnership with the Gates Foundation. And we're very, of course, pleased today and honored to be partnering with CEP to join forces. And so the project here is we are providing the technology to help. And so the design of the vaccine has been done over the last few weeks at the NIH in the U.S. because they have access to the sequence of virus. As Jeremy said, the U.S. government got access very quickly to the sequence, which, of course, is very important information to start making a product. Without that, you cannot do that. Stefan, do we have a timeline on this? We don't have a timeline yet because this is an endeavor that has never been done before. Trying to go so fast for a vaccine has never been done before. But we have never done it on a compressed time that we are doing now, which is why we need to work together. The U.S. government is helping us doing the design because we have great expertise there. What we are doing is we're going to make the product quality clinical grade material thanks to the support of CEP. CEP is actually funding this, and I would like to give a lot of kudos to the CEP organization because I reached out on Monday. And by this morning, the agreement was in place, formally signed between both organizations, which is really remarkable. As Richard said, we have been talking for a long time. We know CEP well and they know Moderna very well. And then we will provide this material to the NIH who will be running the clinical study. Thank you. Thank you. That's terrific updates. At this point, I would like to open it up to the floor. Do we have any questions from the audience, please? Okay. The three of you will collect three questions. Please introduce yourself and give us a short, sharp question. Thank you. Thank you. So I'm a journalist from China's ties media. My question is to Dr. Farer and Mr. Hatchet because you mentioned that maybe the imposition of travel restrictions might not work because people might still try to find ways to go out and in of the city. Is it because that Wuhan is so large, it has more than 10 million residents that this measure's effectiveness might decrease? And because such measures on such a city of such large scale has never been imposed, but do you think there's any historical presidents that we can, that Wuhan can use and other cities who has been shut down can use to ensure that public panic won't escalate and we have enough resources and necessities to provide to the Wuhan people? Thank you. Thank you. And the next question from this gentleman. I'll collect a few. Thank you. My name is Zichuan. I'm with China's Xinhua news agency, the state news agency. I was wondering, Mr. Hatchet said you have started three partnerships to develop the vaccines, which is of enormous importance to the Chinese people right now. How confident are you? You are going to start the human trial, in the summer. Could you give us a more explicit timeline on this? How confident are you? You are able to do this. Have you been, I mean, talking or working with any Chinese authorities of government health authorities? Thank you very much. Maybe the third question, and then we'll answer. This is from Xinhua as well. I'd like to know is there any risk of the short transmission due to the block of city? And any suggestions can you offer to the government in terms of making sure that the local treatment capacities and resources are sufficient? I'd like to pull forward the question to Mr. Farah and Mr. Hatchet as well. Thank you. I think we'll start with the travel restrictions and historical experience. Maybe see you. I think Jeremy is deferring to me. This is actually a topic that we looked at intensively. Just as part of my own background, I also helped the U.S. develop its national pandemic preparedness plan in 2005 and 2006. And the stimulus for that was avian influenza, H5N1, a flu that had a very high mortality rate. And we faced a prospect at that time of facing a virus with a high mortality rate when we had no other controlled interventions. And so the only, in such circumstances, truly the only thing that you have are non-pharmaceutical interventions, including travel restrictions, but also including cancelling mess gatherings and closing transit systems and closing schools. At that time, we devised a, we looked at how could you have those interventions implemented in a way that maximized their benefit and minimized the cost. And we developed a approach that we called community mitigation interventions. And CDC published guidance on this several years ago. There is a literature, which I would certainly encourage Chinese authorities to evaluate and review, and certainly would be happy to talk with them about that, although that's not my current job. I do think one thing that's important to understand is that when you don't have treatments and you don't have vaccines, non-pharmaceutical interventions are literally the only thing that you have. And it's a combination of isolation, containment, infection prevention and control, and then these social distancing interventions. There is historical precedent for their use. We looked intensively, did an intense analysis of the use of non-pharmaceutical interventions in U.S. cities during 1918. And what we found was that cities that introduced multiple interventions early in an epidemic had much better outcomes. And the challenge, of course, is it's very difficult to sustain these interventions because they impose enormous costs. And they also can produce enormous anxiety among the affected populations. It is actually the reason why it's so important to move quickly to develop things like vaccines. Thank you, Richard. I think the question from Tsinghua is what are some of the efforts with China on this? How are you collaborating with China? Sure. So members of my staff do have, through their personal professional networks, many of them come out of a biotech or pharmaceutical background. We do have connections with Chinese companies and with public sector officials. Dr. George Gao, who's known to all of you who knows the Chinese environment and the current director of China's CDC, in fact served on CEPI's Scientific Advisory Committee. So we have reached out. We are in discussions, but those discussions are not as mature as the partnerships that I announced today. Okay, we can take a couple more questions. Oh, very quickly on the timeline. So the timelines that I mentioned of potentially getting the vaccines into clinical trials in the summer. Dr. Fauci from NIAID also mentioned that timeline with respect to the Moderna program. Those certainly depend on the development programs going well. I think they are our best estimate of how quickly we could feasibly get there if we don't encounter roadblocks. It will also be very important for our regulatory partners to work with us to help us understand what exactly is required before we can move vaccines into clinical trials. The advantage of the platform technologies is that they have been with the same platform, different vaccines, but the same platform have already been in humans, both for Moderna and for Inovio, one of our other partners. So we think that will expedite the ability to move these into clinical trials. More questions? This lady on the right. Maybe we'll take both. Just first of all, how concerned are you with the Chinese New Year on the way? What other, what else, if you were advising China, what other precautions could they take? Obviously we've got two more cases in Hong Kong as well. Hong Kong has learned from SARS, but what else could China do? And lastly, why is this particular infection causing so much panic? Maybe the next question. And speaking to... So yesterday there were 448 cases of which 102 were defined as severe or critical, which is actually about a quarter. So coming back to the how, you know, how... We cannot know what the case fatality rate is, which, if you know, was 10% for SARS and up to 37% for MERS, but MERS was less widespread. But this looks, this could be actually what we're looking at, up to 25%. If we assume that, we know that people take a long time, days, if not weeks, to actually die from a disease. And we're looking at the comorbidities that are existing, diabetes, hypertension, coronary artery, these usual suspects. In addition, the confluence of... This is a pathogen which targets the lungs in a fairly polluted environment in the middle of winter with considerable other pathogens. And we wouldn't... I'm just trying to understand the dimension of the spectrum that we're looking at and not wanting to downplay or over. Yeah, so as Richard said, when you're in these circumstances and you do not have drugs specific and you do not have vaccines, you're reliant on classic public health measures. And what that means is hand-washing and social distancing and, yes, hand-washing travel, where it's at all appropriate, masks. And the earlier you do that within a city, the more chance you have for reducing. But what it does effectively is buy you some time to do the other things that are going on, including the vaccine development. Why panic? Well, the world has sort of been prepared. Really, sort of, if you like, sort of getting ready for something like this, really, since SARS, 18 years ago. And SARS left really deep scars on particularly the Asian and Toronto systems. And of course, we had the pandemic. So whenever you see an animal virus coming across humans, passing between humans and causing both mild and severe disease, of course, the world is now really primed to know about that. And inevitably, that causes a degree of panic. I don't think you can over... We don't want to overstate the panic here because there is so much uncertainty. And we want to keep a sort of calm, moderated approach to it. But we do have to take this incredibly seriously because you don't often get an animal virus coming to humans, passing between humans and being spread by the respiratory route. It's what Richard and I and many others would have been frightened of for the last decade. The only thing I'd say on severity and case fatality rates, and this is just a general statement across all of these epidemics, going back to all of them, including NIPA that I've been involved in since 1999, in the main, at the beginning of the epidemic, you see the more severe end of the spectrum. There are the people that seek hospital care. There are the people that seek intensive care. And that usually dominates your early. You can't tell for some weeks, actually, until you see the full spectrum of illness quite how severe the spectrum is. And at the moment, we're in that period of uncertainty. Yes, 25% of the moment of the people may have had severe disease or be dying. We don't know what that really means in terms of the denominator in the population that has the infection, how many severe, and how many are dying. And we could all guess, but it would be a guess, as Richard said earlier. We sort of have to live at the moment with that degree of uncertainty and not be intimidated by it. With one-off time, uncertainty is the last word we heard. I would like to thank our three speakers and our experts for joining us today at the issue briefing room. Thank you very much for joining us today. Thank you.