Transcript for CDC Media Telebriefing: Update on COVID-19 | CDC Online Newsroom

>>> GOOD AFTERNOON, THANK YOU FOR STANDING BY.  AND WELCOME TO THE COVID 2019 UPDATE.  YOUR LINES ARE IN A LISTEN ONLY MODE UNTIL QUESTION AND ANSWER SESSION OF THE CONFERENCE.  YOU PLAY PRESS STAR AND NUMBER ONE TO ANSWER THE QUESTION.  PLEASE STATE YOUR NAME WHEN PROMPTED.  PLEASE LIMIT IT TO ONE QUESTION AND ONE FOLLOW-UP.  IT IS NOW MY PLEASURE TO TURN THE CONFERENCE OVER TO PAUL FULTON, CDC PUBLIC AFFAIRS.

>> THANK YOU, MICHELLE.  THANK YOU FOR JOINING US FOR THIS BRIEFING.  TO UPDATE YOU ON CDC’S COVID-19 RESPONSE.  WE ARE JOINED BY THE DIRECTOR OF THE CDC CENTER FOR IMMUNIZATION AND RESPIRATORY DISEASES WHO WILL GIVE OWNING REMARKS BEFORE TAKING YOUR QUESTIONS.  I WILL TURN THE QUESTION OVER TO DR. MESSONNIER.

>> THANK YOU FOR JOINING US.  SINCE WE BRIEFED YOU LAST THERE’S ONE MORE CONFIRMED CASE OF COVID-19 IN A PERSON WHO HAD BEEN UNDER QUARANTINE FACILITATED BY THE STATE DEPARTMENT AT JOINT BASE LACKLAND.  THERE ARE MORE THAN 600 PEOPLE STILL UNDER QUARANTINE IN THE UNITED STATES BECAUSE OF THEIR RECENT RETURN FROM THE EPICENTER OF THIS OUTBREAK IN CHINA.  IN GENERAL, OUR GUIDANCE IS BASED ON RISK ASSESSMENTS AND OTHER PEOPLE OR GROUPS MAY HAVE DIFFERENT RISKS.  AND THESE PEOPLE ARE GOING THROUGH DIFFICULT CIRCUMSTANCES RIGHT NOW.  BEING QUARANTINED CAN BE DISRUPTIVE, FRUSTRATING AND FEEL SCARY.  ESPECIALLY WHEN THE REASON FOR THE QUARANTINE IS EXPOSURE TO A NEW DISEASE FOR WHICH THERE MAY BE LIMITED INFORMATION.  QUARANTINE IS AN UNUSUAL SITUATION FOR PUBLIC HEALTH RESPONDERS TOO.  THE LAST TIME WE HAD TO QUARANTINE LARGE GROUPS OF PEOPLE WAS MORE THAN 50 YEARS AGO.  SO WHILE WE ARE DOING THE BEST WE CAN, THERE ARE GOING TO BE BUMPS ALONG THE WAY.  I UNDERSTAND THAT ONE OF THE BIGGEST QUESTIONS THAT HAS COME UP INVOLVES QUESTIONS ABOUT TESTING AND WHEN PEOPLE SHOULD BE TESTED.  I WANT TO SAY RIGHT NOW CDC’S RECOMMENDATIONS AND THE POLICIES WE ARE FOLLOWING ACROSS THE BOARD IS TO TEST PEOPLE WITH THE HISTORY OF EXPOSURE WHO ARE SHOWING SYMPTOMS.  THIS IS BECAUSE WE KNOW THAT TESTING PEOPLE TOO EARLY CAN POTENTIALLY MISS INFECTIONS.  PEOPLE WITH STILL LATER BECOME SICK.  LET ME EXPLAIN.  THE OUTER BOUND OF THE INCUBATION PERIOD WE’RE USING FOR THIS NOVEL CORONAVIRUS IS 14 DAYS.  THAT MEANS WE EXPECT SOMEONE WHO IS INFECTED TO HAVE SYMPTOMS SOME TIME DURING THOSE 14 DAYS.  KNOW, AS SOMEONE IS EXPOSED TO THE VIRUS THAT MIGHT NOT SHOW SYMPTOMS RIGHT AWAY AND TESTING ON DAY ONE OR TWO OR THREE MIGHT PRODUCE A NEGATIVE RESULT.  HOWEVER, IT COULD MEAN THE VIRUS HASN’T ESTABLISHED ITSELF SUFFICIENTLY IN THE SYSTEM TO BE DETECTED BY TEST.  IT’S NOT A QUESTION OF THE ACCURACY OF THE TEST.  THE TEST WE’RE USING AT CDC IS VERY SENSITIVE.  IT’S A QUESTION OF WHEN THE VIRUS BECOMES DETECTABLE IN THAT PERSON.  SO IF A PERSON TESTS NEGATIVE ONCE, IT’S NOT CLEAR THAT IT’S A TRUE NEGATIVE.  THE TEST DOESN’T INFORM PUBLIC HEALTH ACTIONS OR CLINICAL CARE.  IN FACT, IN NEGATIVE TEST RESULTS COULD PROVIDE A FALSE SENSE OF SECURITY.  WITH THE INCUBATION PERIOD BEING UP TO 14 DAYS, ONE TEST AT A GIVEN POINT IN TIME ONLY TELLS YOU IF SOMEONE IS INFECTED AT THAT ONE MOMENT.  CDC DID TEST ALL OF THE INITIAL 195 PEOPLE WHO RETURNED FROM WUHAN ON JANUARY 29th.  BUT SINCE THAT TIME, WE HAVE LEARNED MORE ABOUT HOW THE VIRUS BEHAVES IN PEOPLE AND WHEN IS THE OPTIMAL TIME TO TEST THEM TO BEST INFORM OUR PUBLIC HEALTH RESPONSE.  CDC MAY DO TESTING OF ALL PEOPLE AGAIN IF THE RISK WARRANTS IT.  BUT RIGHT NOW, CDC STAFF AT EACH BASE ARE CHECKING TEMPERATURES TWICE DAILY AND MONITORING PEOPLE FOR ANY NEW SYMPTOMS.  IF SOMEONE HAS SYMPTOMS COMPATIBLE WITH THIS NEW VIRUS THEY’RE MEDICALLY EVALUATED AND THEY’RE TESTED.  ANOTHER QUESTION I WANT TO ADDRESS IS HOW THIS VIRUS SPREADS.  BASED ON WHAT WE KNOW NOW, WE BELIEVE THIS VIRUS SPREADS MAINLY FROM PERSON TO PERSON AMONG CLOSE CONTACTS.  WHICH IS DEFINED ABOUT SIX FEET.  THROUGH RESPIRATORY DROPLETS PRODUCED WHEN AN INFECTED PERSON COUGHS OR SNEEZES.  PEOPLE ARE THOUGHT TO BE THE MOST CONTAGEOUS WHEN THEY’RE MOST SYSTEMATIC.  THAT’S WHEN THEY’RE THE SICKEST.  SOME SPREAD MAY HAPPEN BY TOUCHING THE CONTAMINATED SURFACE AND TOUCHING THE EYES, NOSE AND MOUTH.  BUT REMEMBER THIS DOES NOT LAST LONG ON SURFACES. SOME SPREAD MAY HAPPEN BEFORE PEOPLE SHOW SYMPTOMS. THERE HAVE BEEN A FEW REPORTS OF THIS WITH THE NEW CORONAVIRUS AND IT IS COMPATIBLE WITH WHAT WE KNOW ABOUT OTHER RESPIRATORY VIRUSES INCLUDING SEASONAL FLU.  BUT RIGHT NOW, WE DO NOT BELIEVE THESE LAST TWO FORMS OF TRANSMISSION ARE THE MAIN DRIVER OF SPREAD.  WE AT CDC RECOGNIZE THIS IS A DIFFICULT TIME FOR THE PEOPLE WHO HAVE RETURNED FROM WUHAN AS WELL AS THE COMMUNITY SUPPORTING THEM.  AND ASK FOR THEIR CONTINUED PATIENCE AS WE WORK TOGETHER.  THIS IS A DIFFICULT AND CHALLENGING TIME ON MANY FRONTS.  THE FOOTAGE OUT OF CHINA IS UPSETTING.  OTHERS ARE BEING QUARANTINED IN OTHER COUNTRIES INCLUDING ON THE DIAMOND PRINCESS CRUISE SHIP.  ON THE RESPONDERS’ SIDE THERE ARE THOUSANDS OF PEOPLE WORKING AROUND THE CLOCK AROUND THE WORLD TO TRY TO CONTAIN THE DAMAGE.  I LOOK AROUND AND I SEE PEOPLE WHO ARE TIRED BUT WHO ARE DETERMINED AND GOVERNED BY A SENSE OF URGENCY THAT THE HEALTH OF THE ENTIRE COUNTRY IS DEPENDENT AT LEAST IN PART ON THEIR WORK.  THIS NEW VIRUS REPRESENTS THE UNPRECEDENTED PUBLIC HEALTH THREAT AND WE ARE TAKING AGGRESSIVE ACTION TO KEEP THESE PEOPLE, OUR FAMILIES AND OUR NATION SAFE.  WE APPRECIATE EVERYONE’S CONTINUED COOPERATION THROUGHOUT THIS PROCESS.  CDC’S CURRENT ACTIONS INCLUDING QUARANTINES AND THE TRAVEL RESTRICTIONS ARE INTENDED TO SLOW THE INTRODUCTION AND IMPACT OF THE NOVEL CORONAVIRUS IN THE U.S.  HOWEVER, WE MUST PREPARE FOR THE POSSIBILITY THAT AT SOME  POINT WE MAY SEE SUSTAINED COMMUNITY SPREAD IN OTHER COUNTRIES OR IN THE U.S. AND THIS WILL TRIGGER A CHANGE IN OUR RESPONSE STRATEGY.  THIS WILL REQUIRE THE EFFORTS OF ALL LEVELS OF GOVERNMENT, THE PUBLIC HEALTH SYSTEM AND OUR COMMUNITIES AS WE FACE THIS CHALLENGE TOGETHER.  LAST NIGHT, THE VICE MINISTER OF CHINA’S NATIONAL HEALTH COMMISSION ANNOUNCED THERE ARE MORE THAN 1,700 HEALTH CARE WORKERS WHO ARE ILL WITH THIS NEW VIRUS IN CHINA.  MAINLY IN HUBEI PROVINCE. THIS IS CONCERNING AND WE SAW THAT TRANSMISSION CAN BE AMPLIFIED IN HEALTH CARE SETTINGS IF INFECTION CONTROL PRACTICES ARE NOT CAREFULLY FOLLOWED.  HEALTH CARE WORKERS ARE ON THE FRONT LINE, SUPPORTING THE PHYSICAL AND MENTAL HEALTH OF THOSE WHO ARE INFECTED.  AS WE LEARN MORE ABOUT HOW THIS VIRUS IS SPREAD, KEEPING HEALTH CARE WORKERS SAFE IS A HIGH PRIORITY.  CDC HAS PUBLISHED GUIDANCE FOR HEALTH CARE WORKERS ON HOW TO PROTECT THEMSELVES AS THEY CARE FOR PATIENTS AND I’M HAPPY TO REPORT THAT SO FAR NO HEALTH CARE WORKERS IN THE U.S. HAVE BECOME INFECTED IN THE LINE OF DUTY.  BEFORE TAKING QUESTIONS, I WANT TO GIVE YOU AN UPDATE ON TWO MORE THINGS.  FIRST, YESTERDAY, SECRETARY AZAR MENTIONED THAT THE CDC HAS BEGUN WORKING WITH FIVE PUBLIC HEALTH LABS TO CONDUCT COMMUNITY BASED INFLUENZA BASED SURVEILLANCE SO WE CAN TEST THOSE WITH FLU LIKE SYMPTOMS FOR NOVEL CORONAVIRUS.  THOSE PUBLIC HEALTH LABS ARE IN LOS ANGELES, SAN FRANCISCO, SEATTLE, CHICAGO AND NEW YORK CITY AND I WANT TO THANK THEM FOR THEIR PARTICIPATION, COLLABORATION AND SUPPORT.  THIS IS JUST THE STARTING POINT AND WE PLAN TO EXPAND TO MORE SITES IN THE COMING WEEKS UNTIL WE HAVE NATIONAL SURVEILLANCE.  THIS IS LEVERAGING OUR EXISTING INFLUENZA AND VIRAL RESPIRATORY SURVEILLANCE SYSTEMS.  THIS IS AN EXTRA LAYER OF OUR RESPONSE THAT WILL HELP US DETECT IF AND WHEN THIS VIRUS IS SPEADING IN THE COMMUNITY.  ALL OF OUR EFFORTS NOW ARE TO PREVENT THE SUSTAINED SPREAD OF THE VIRUS IS IN OUR COMMUNITY BUT WE NEED TO BE PREPARED FOR THE POSSIBILITY THAT IT WILL SPREAD.  RESULTS FROM THIS SURVEILLANCE WOULD BE AN EARLY WARNING SIGNAL TO TRIGGER A CHANGE IN OUR RESPONSE STRATEGY.  SECOND, AS WE TALK ABOUT THE POTENTIAL THREAT OF THIS NEW VIRUS, I WANT TO REMIND EVERYONE OF THE VERY REAL THREAT OF SEASONAL INFLUENZA.  REPORTS OF INFLUENZA LIKE ILLNESS AND TESTING FOR INFLUENZA HAVE INCREASED IN THE PAST FEW WEEKS.  WHILE INFLUENZA “B” WAS PREDOMINANT IN DECEMBER, WE HAVE SEEN A SHARP RISE IN INFLUENZA “A” H1N1 RECENTLY.  HOSPITAL RATES IN CHILDREN ARE HIGH, ABOUT AS HIGH AS WE SAW DURING THE 2017-18 SEASON WHICH WAS A SEVERE SEASON.  SO FAR THIS SEASON, WE ESTIMATE THAT THERE HAVE BEEN AT LEAST 26 MILLION FLU ILLNESSES, 250,000 HOSPITALIZATIONS, AND 14,000 DEATHS FROM FLU, SOME OF THOSE AMONG CHILDREN.  WE HAVE THE VACCINES AND THE DRUGS TO FIGHT FLU ILLNESS.  WE DON’T HAVE THE TOOLS YET FOR THIS NOVEL VIRUS BUT THERE ARE THINGS EVERYONE CAN DO TO CONTAIN THE SPREAD OF THE VIRUS.  STAY INFORMED.  CDC’S UPDATING THE WEBSITE DAILY WITH THE LATEST INFORMATION AND ADVICE FOR THE PUBLIC.  AND REMEMBER TO TAKE EVERYDAY PREVENTIVE ACTIONS TO PREVENT THE SPREAD OF RESPIRATORY VIRUS.  WE RECOGNIZE THE UNCERTAINTY OF THE CURRENT SITUATION AS ALWAYS CDC PUBLIC HEALTH EXPERTS STRIVE TO MAKE THE BEST RECOMMENDATIONS ON THE MOST UP TO DATE DATA.  OUR GUIDANCE WILL CHANGE AS WE LEARN MORE ABOUT THIS VIRUS. I’D BE HAPPY TO TAKE QUESTIONS.

>> THANK YOU.  IF YOU’D LIKE TO ASK A QUESTION, YOU MAY PRESS STAR ONE.  PLEASE LIMIT TO ONE QUESTION AND ONE FOLLOW-UP.  THANK YOU.  LENA SUN FROM “WASHINGTON POST,”  YOU MAY GO AHEAD.

>> HI, THANK YOU VERY MUCH FOR TAKING MY QUESTIONS.  FIRST, COULD YOU PROVIDE A LITTLE BIT MORE DETAIL ABOUT HOW THIS SURVEILLANCE IS GOING TO WORK IN THOSE FIVE LOCALITIES?  AND THEN SECOND, I WONDERED WHETHER YOU COULD TALK A LITTLE BIT MORE ABOUT THE INFORMATION YOU HAVE GOTTEN OR WHAT YOU KNOW ABOUT THE HEALTH CARE WORKERS.  DO WE KNOW WHETHER THEY WERE INFECTED RECENTLY?  IS IT, YOU KNOW, JUST SORT OF A LATE DATA COMING THROUGH FROM EARLIER ON?  ANY MORE LIGHT YOU COULD SHED ON THAT WOULD BE VERY HELPFUL.  THANK YOU.

>> SURE.  THANK YOU.  SO IN RESPONSE TO THE FIRST QUESTION, WHAT I WOULD GENERALLY SAY IS THAT WE ARE LOOKING AT EXISTING SURVEILLANCE SYSTEMS FOR BOTH INFLUENZA AND FOR VIRAL RESPIRATORY DISEASES AND MODIFYING THEM TO BE ABLE TO DETECT THIS NEW CORONAVIRUS BECAUSE THAT’S A REALLY EFFICIENT WAY FOR US TO STAND UP WITHOUT BUILDING INDEPENDENT SYSTEMS.  IF YOU GO TO THE FLU VIEW, YOU WILL SEE ALL OF THE SYSTEMS THAT WE’RE USING AND THAT SHOULD BE ABLE TO DESCRIBE IN MORE DETAIL BASICALLY WHAT WE’RE DOING AT THOSE SITES.  EVERY ONE OF THOSE SITES IS A LITTLE BIT DIFFERENT SO IT’S NOT EXACTLY THE SAME OPERATIONS IN EACH OF THE SITES, BUT BASICALLY WE’RE TAKING THOSE FIVE SITES’ FLU SURVEILLANCE SYSTEMS AND ADDING ON LABORATORY TESTING AT THE PUBLIC HEALTH LABS FOR NOVEL CORONAVIRUS.  ABOUT THE SECOND ISSUE, ALL WE HAVE SEEN SO FAR IS THE REPORTS THAT CAME OUT OVERNIGHT.  IT’S OBVIOUSLY A CONCERNING NUMBER SO I WANTED TO MENTION IT.  WE DON’T HAVE MORE DETAILS YET AS TO WHEN THOSE CASES OCCURRED.  THAT IS, YOU KNOW, WHEN OVER THE COURSE OF THE OUTBREAK THE CASES OCCURRED AND WE’LL BE HOPING FOR MORE INFORMATION AND OBVIOUSLY THE TEAMS IN THE FIELD HOPEFULLY WILL BE ABLE TO PROVIDE THAT AS THEY GET — AS W.H.O. TEAMS GET THEIR MISSIONS MOVING.  NEXT QUESTION.

>> ADRIAN JOSEPH, YOU MAY GO AHEAD.

>> THANKS.  SO THE W.H.O. SAID IN THEIR PRESS BRIEFING THIS MORNING THAT I THINK A 12 MEMBER TEAM HAS — IS GOING INTO CHINA INTO THREE PROVINCES, THEY DIDN’T SPECIFY WHICH AND I GUESS I’M WONDERING IF THE CDC OR ANY AMERICAN MEMBERS ARE PART OF THE TEAM OR THERE STILL NEGOTIATING POSITIONS ABOUT GETTING THE U.S.  TEAMS IN?

>> I HADN’T SEEN THAT NOTICE YET, BUT I’M HAPPY THAT WAS ANNOUNCED.  I DO UNDERSTAND THAT THERE’S A LARGER TEAM GOING IN.  WE’RE QUITE HAPPY THAT THE CHINESE GOVERNMENT WILL HAVE THE ADVANTAGE OF SOME OUTSIDE EXPERIMENTS.  WE HOPE THAT THE CDC STAFF WILL BE INCLUDED IN THE MISSION BUT I DON’T HAVE THE DETAILS AT HAND AS TO EXACTLY THOSE 12 MEMBERS ARE.  AGAIN WHEN WE HAVE THAT INFORMATION WE’LL DEFINITELY PROVIDE IT.  NEXT QUESTION.

>> MIKE STOBBE FROM THE ASSOCIATED PRESS, YOU MAY GO AHEAD.

>> HI, THANK YOU FOR TAKING MY CALL.  FIRST, FOLLOWING LENA SUN’S QUESTION — I’LL GO TO YOUR WEBSITE BUT ARE THESE PUBLIC STATE — STATE PUBLIC HEALTH LABS OR CITY LABS OR — JUST A LITTLE BIT MORE ABOUT THE FACILITIES AND WHAT TESTING SYSTEM HAS ALREADY BEEN PART OF.  ALSO, COULD YOU GIVE US AN UPDATE ON THE TEST KITS THAT WENT OUT TO THE STATES?  HOW IS THAT GOING?  HAVE THEY WORKED OUT THE REAGENT PROBLEM THAT THEY REMANUFACTURED IT OR WHEN ARE NEW KITS GOING OUT?  THANK YOU.

>> SO THE FIRST QUESTION IN TERMS OF WHAT PUBLIC HEALTH LABS ARE TALKING ABOUT, THESE ARE THE SAME PUBLIC HEALTH LABS THAT WE HAVE BEEN TALKING ABOUT THE NETWORK OF PUBLIC HEALTH LABS THAT IS THE INFRASTRUCTURE OF A LOT OF PUBLIC HEALTH SURVEILLANCE IN THE UNITED STATES.  SO AMONG THE SITES THAT I MENTIONED ONE OF THOSE AS A CITY — THE OTHER IS A PUBLIC HEALTH LAB AND THEY’RE PART OF THE NATIONAL SURVEILLANCE NETWORK THAT WE DO FOR INFLUENZA WHICH IS WHY I DIRECT YOU TO FLU VIEW.  THEY’RE CURRENTLY TESTING FOR INFLUENZA AND THE IDEA IS THEY’LL TEST THE INFLUENZA NEGATIVE SPECIMENS FOR NOVEL CORONAVIRUS.  SORRY, FOR SARS COVID 2.  SO IT’S BASICALLY TAKING THE ALREADY EXISTING INFLUENZA PUBLIC HEALTH LABORATORY SURVEILLANCE AND LOOKING AT THOSE THAT ARE FLU NEGATIVE FOR THIS NEW VIRUS.  AGAIN, IT’S AN EFFICIENT WAY TO STAND UP SOMETHING VERY QUICKLY.  IN TERMS OF THE LAB KITS AS WE HAVE TALKED ABOUT WE CAN BE PROUD OF HOW RAPIDLY OUR LABORATORY — WE CAN DEVELOP THE LAB DIAGNOSTIC IT IS BEING USED AT CDC UNDER HIGH QUALITY STANDARDS AS WE MOVED QUICKLY TO GET THAT OUT TO THE STATE AND THE STATES DID THEIR OWN VERIFICATION, THERE WERE SOME PROBLEMS WITH ONE OF THE REAGENTS AT THE STATE — THAT THE STATES IDENTIFIED.  THEY WERE GETTING INDETERMINANT ANSWERS WHICH IS A SIGN THAT THERE NEEDED TO BE SOMETHING DONE DIFFERENTLY.  SO WHAT WE’RE DOING AT CDC IS REFORMULATING THOSE REAGENTS AND WE ARE MOVING QUICKLY TO GET THOSE BACK OUT TO OUR LABS AT THE STATE AND LOCAL PUBLIC HEALTH LABS.  BUT OBVIOUSLY WE HOLD OURSELVES TO THE HIGH QUALITY STANDARD AS WE SHOULD AND AS OUR STATE AND LOCAL PARTNERS DO AND WE WANT TO MAKE SURE THAT EVERY DOT IS DOTTED AND EVERY “T” IS CROSSED BEFORE WE PUT THE KITS OUT.  AS SOON AS I HAVE AN ACTUAL TIME LINE I’LL GIVE IT TO YOU BUT I HATE TO PROJECT BECAUSE I WANT TO MAKE SURE THAT EVERYTHING IS DONE AT THE HIGHEST POSSIBLE LEVEL THAT CDC AND FTA AND ALL OF YOU EXPECT OF US.  NEXT QUESTION.

>> — FROM THE SOUTH CHINA MORNING POST, JIMMY, GO AHEAD.

>> HI, I JUST WANTED TO GO BACK TO WHAT YOU WERE TALKING ABOUT IN TERMS OF THE — MOVING ON FROM KIND OF — [ INDISCERNIBLE ].  IS THIS LIKE WHERE THE GOVERNMENT OFFICIALS HAVE BEEN BROACHED — THIS SUBJECT.  WHAT WOULD MITIGATION LOOK LIKE IN THE U.S. AND THE HEALTH CARE CONDITIONS ARE IN PLACE IF YOU NEED TO HAVE THAT KIND OF CHANGE IN YOUR RESPONSE STRATEGY?

>> THANK YOU.  I UNDERSTAND WHAT YOU’RE ASKING ABOUT IS THE CHANGE BETWEEN CONTAINMENT AND MITIGATION AND WHAT IT WOULD LOOK LIKE AND THANKS FOR THAT QUESTION BECAUSE IT ALLOWS ME TO SAY THAT IT’S NOT BLACK AND WHITE.  THERE ARE TIMES WHEN THOSE COMPONENTS MERGED TOGETHER ACROSS THE UNITED STATES, POTENTIALLY AT DIFFERENT LOCATIONS IN THE UNITED STATES DEPENDING ON WHAT HAPPENS.  WE’RE CONTINUING TO HOPE THAT WE WON’T SEE COMMUNITIES SPREAD AND CERTAINLY HOPING THAT OUR MEASURES GIVE US EXTRA TIME TO PREPARE BY GAINING OURSELVES THIS TIME, THE HOPE IS THAT WE’LL HAVE MORE TIME TO PREPARE.  BUT FRANKLY OUR MODEL SUGGESTS THAT WE MAY…

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