 Hi, everyone. This is Donna Prosser, Chief Clinical Officer for the Patient Safety Movement Foundation. I'm here today to bring you an update on what's happening with COVID-19. I'm very excited today to be joined by Dr. Arjan Srinivasan from the Centers for Disease Control in Atlanta, Georgia. Hi, Dr. Srinivasan. Welcome. Hey, Donna. How are you? Thank for giving me this chance to talk to the folks in the Patient Safety Foundation. Bill, thank you so much for joining us. Can you tell us a little bit about your background and what you do there at the CDC? Absolutely. So I'm an infectious disease specialist by background and training in healthcare epidemiology. I am an infectious disease physician by training and I still do practice. I see patients on the infectious diseases console service at the VA hospital a couple of times a year. And I am in a group at CDC called the Division of Healthcare Quality Promotion. And our mandate is to improve healthcare safety and quality and also healthcare, safety for healthcare workers. Wonderful. Thank you. Well, excellent. We're so glad to have you here with us today. I wonder if you could tell me a little bit about what you see happening in the United States right now. Where are the hotspots and where are the hotspots we can anticipate in the future? It's a great question. And I think everybody is probably very aware of what's going on with COVID activity in the United States. There's so many news outlets and stories and websites where that information is being tracked. So I think probably everybody knows right now the major hotspot in the United States is the New York area. It's where they're seeing a lot of activity. But of course the situation has evolved now as I heard someone say today, there's really no corner of the country that has been spared COVID in any way that bears activity now in all 50 states. And I think one thing that is important for people to understand and remember, and I think most people know this, is that this is a fast moving issue and it's changing on a regular basis. And it's important for people to understand that what is a hotspot today may not be a hotspot tomorrow. And perhaps more importantly, areas that are not hotspots today could become hotspots. So really important for all of us to be following our local recommendations from our health departments and from local and state health authorities. If there are recommendations to be staying at home, they're looking at activity in your area and making those recommendations based on that. So please do follow those recommendations. It's very hard to know where the next hotspots are going to be. But one thing I will emphasize is that this is not something that's going to be limited to cities. And I think there was some rumors going around and people saying, oh, well, if I live in a less populated area, then I'm not at risk. And that's not true. This is a problem in both urban and rural areas in the city and in the countryside. So all of us need to be paying attention and doing our part. Great. Thank you very much. You know, one question that a lot of people have is regarding PPE, personal protective equipment. There's a lot of concern out there that there might not be enough PPE and equipment for healthcare workers to adequately care for patients. Can you talk just a little bit about what could we maybe say to healthcare workers to help them to feel safer in this situation? You know, I think part of it is that we do have to acknowledge that there is a challenge. There's not enough PPE in every place in the country for all of our healthcare workers to have what they need. And that is a reality and it's not news to anyone. We see those reports of the healthcare workers who can't get the PPE that they need that's recommended to take care of patients. And this is an issue that is front of mind for everyone who's involved. It's, you know, I'm on calls with the task forces that are working on this and the new FEMA task force that's been stood up in personal protective equipment is absolutely at the top of everyone's list. And I know that there are all sorts of things that are being done to increase the PPE supplies. As I mentioned, CDC does have recommendations on our websites for ways that people can extend the use of personal protective equipment. It's not something we would normally do, but we recognize that when supplies are short, there are steps that you have to take to extend those supplies. And in some situations, there are steps that have to be taken to prioritize certain types of PPE in certain situations when supplies get quite short. And a good example of that is the issue of the N95 respirators versus the surgical masks that are being used in healthcare. You know, our recommendation, our preference is for the use of N95 respirators for healthcare workers who are providing direct patient care to patients who are known or suspected to have COVID because they do provide respiratory protection. We know in some places they don't have enough N95 respirators for that to be the case for all healthcare interactions. And so they are prioritizing those N95 respirators for the higher use interactions or higher risk, I'm sorry, interactions. But we really do hope that supplies will begin to expand so that we can make sure that every healthcare worker has the protection that they need. And I have to tell you, it is truly humbling to see what healthcare workers in this country are doing. So many of them showing up to work every day. Despite these concerns and the issues with PPE and the limited supply, it just I think it humbles all of us as a nation to see what our healthcare workers are doing. And I think, you know, we owe them a debt of gratitude that we can never repay. That is so very, very well put. I absolutely agree. It really, it warms my heart to see what our profession is doing right now. So very well said. I wonder if we could talk just a little bit about the visitor policies and hospitals. Now, obviously, in an effort to prevent spread of disease in their facilities, hospitals are really significantly reducing visitation. Can you help people to understand why that is and what are some things that families can do to mitigate not being present when their families really need them to be an advocate? Yeah, such a good question. You know, something I think we all struggle with. I mean, if my wife was in the hospital, I would want to be at her bedside the entire time that she was there. And we know, though, that some of the challenges are is that people who are very minimally symptomatic or even asymptomatic can transmit COVID. And if we walk into a hospital into a health care facility, the issue is that of course we're not just coming into contact with our loved one who's there. We're coming into contact with all of the health care providers and in potentially coming into contact with other patients, some of whom may have very fragile immune systems. So the recommendations to really try to curtail visitations in hospitals and in nursing homes is an effort to protect the health care workers and the other patients that are in those facilities from getting exposed to people who might be carrying COVID and might be transmitting the infection, even though they themselves may not have symptoms that they would think to say, oh, I don't feel well, I shouldn't go to the hospital. The good news, I guess, is that we live in an age where we do have some other options. And one is like what we're doing here today, right? You can use all of the different types of a social media applications and real time streaming to try to connect with your loved one and FaceTime and all those other things. And I think we all have to acknowledge, again, in the interests of full transparency and disclosure is to say it's not the same. You know, it's simply not the same. But we have to acknowledge that we're doing this out of an abundance of caution to try to protect not just your family member who's there, but all of the other people who were there in the hospital. And so we're asking people to make that sacrifice as a way to try and help with some of this. And, you know, our guidance really is intended to be flexible. We recognize that there are some situations when the family member or a loved one just has to be there. And so, you know, there is an encouragement that people handle this on a case by case basis. And in situations where you it's an end of life or a situation where you really need the family to be there, that you work to find ways to make that possible. Yes, speak with you and you have really given our network a lot of information to think about. I appreciate that. And I hope we'll get an opportunity to speak with you again soon. I hope so. I'd love to be back anytime. Well, thank you so very much. Have a wonderful rest of your day.