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SOLEDA DR. AMESH ADALJA IS A SENIOR SCHOLAR AT THE JOHNS HOPKINS UNIVERSITY CENTER FOR HEALTH SECURITY, FOCUSING ON INFECTIOUS DISEASE AND PANDEMIC PREPAREDNESS. HE PRACTICES INFECTIOUS DISEASE, CRITICAL CARE, AND EMERGENCY MEDICINE IN THE PITTSBUR METROPOLITAN AREA. DR. ADALGISA, THANK YOU SO MUCH FOR JOINING ME. I’M ALMOST AFRAID TO START WITH THIS QUESTION, BUT I WILL. WHAT ARE YOU MOST WORRIED ABOUT RIGHT NOW? >> I’M MOST WORRIED ABOUT THAT. WE HAVE REACHED A NEW NORMAL WHERE WE’RE CONTINUING TO CONTINUE TO BE PLAGUED BY CASES IN HOTSPOTS ALL OVER THE COUNTRY THAT ARE VERY HARD TO GET UNDER CONTROL AND WHICH PUT HOSPITAL INTO CRISIS. SOLEDAD: SOME PEOPLE TALK ABOUT A BIG LAG IN TESTING AND WE’VE JUST HEARD FROM OUR CONTACT TRACER,, SO -- CONTACT TRACER, SO I WOULD THINK WITHOUT RESULTS, IT KIND OF MAKES THE CONTACT TRACING PART EXTREMELY DIFFICULT WITH A LAG AND TEST RESULTS TAKING SEVEN DAYS IN SOME PARTS OF THE COUNTRY MAKES CONTACT TRACING FUTILE. AND IT REALLY JUST ALLOWS THE OUTBREAK TO CONTINUE TO SPREAD. THE VARIATIONS BETWEEN STATES HAVE TO DO WITH WHAT RESOURCES ARE AVAILABLE IN EACH STATE. AND IT’S WORSE IN SOME OF THE HOTSPOTS WHERE THERE IS A BIG DEMAND AND YOU CANNOT HAVE ANY KIND OF CONTROL OF THIS OUTBREAK UNLESS PEOPLE ARE GETTING TEST RESULTS BACK VERY QUICKL SOLEDAD: SO THEN SUPPLIES ACROSS THE COUNTRY. IS IT JUST. WELL, IT DEPENDS. >> BASICALLY, IT IS, AND IT HAS TO DO WITH WHAT’S CALLED A REAGENT. ONE OF THE INGREDIENTS YOU USED TO TO RUN THE TEST IN TH REGION SUPPLIES. THEY ARE TIGHTLY CONTROLLED AND THERE PRIORITIZE TO HOSPITALS FOR INPATIENT TESTING. FOR THE OUTPATIENTS IS A LITTLE BIT MUCH MORE MUCH DIFFERENT. IT’S KIND OF RATIONED AND IT’S SOMETHING YOU’RE GOING TO DEFINITELY NEED TO DEAL WITH WHEN WE GET INTO FLU SEASON, WHEN WE’RE GONNA HAVE TO BE ABLE TO DIAGNOSE FLU AND CORONAVIRUS VERY RAPIDLY BECAUSE THEY’VE TWO DIFFERENT TREATMENT PATHS. SOLEDAD: CAN YOU WALK ME THROUGH SOME OF THE MOST PROMISING TREATMENTS? >> THE BIGGEST ADVANTAGE WE HAVE NOW IS THE USE OF STEROIDS. SO THESE ARE JUST THE SAME STEROIDS THAT YOU MIGHT HAVE GOTTEN FOR INFLAMMATION IN YOUR KNEE OR FOR ASTHMA. THESE STEROIDS, WHEN GIVEN TO PEOPLE WITH THE NEED FOR OXYGEN IN THE HOSPITALS, SEEM TO DECREASE MORTALITY WE ALSO HAVE AN EXPERIMENT ANTIVIRAL DRUG CALLED REMDESIVIR. THIS TRUCK HASN’T BEEN SHOWN TO DECREASE MORTALITY, BUT IT DOES GET PEOPLE OUT OF THE HOSPITAL ABOUT 30% QUICKER, WHICH IS REALLY IMPORTANT WHEN WE’RE REALLY LOOKING AT HOSPITAL CAPACITY AS A MAJOR METRIC TO FOLLOW. ANOTHER THING THAT WE’RE DOING IS USING CONVALESCENT PLASMA. THIS IS TAKING THE BLOOD OF PEOPLE WHO HAVE RECOVERED AND TAKING OUT BLOOD AND TRANSFUSING THAT THE PLASMA PORTION INTO PEOPLE BECAUSE THERE’S ANTIBODIES IN THERE THAT MIGHT BE BENEFICIAL. AND THE LAST THING WE’RE DOING IS TRYING TO FIND ANTIBODIES THAT PEOPLE HAVE AND BASICALLY SYNTHESIZE THEM, MAKE THEM INTO DRUGS AND THEN ADMINISTER THOSE TO PEOPLE. AND THIS IS ALSO SOMETHING THAT WE THINK WILL BE VERY PROMISING BECAUSE IT WAS WHAT REALLY CHANGED THE GAME WITH EBOLA. SOLEDA TALK TO ME ABOUT ASYMPTOMATIC PEOPLE, BECAUSE IT SEEMS TO ME THAT THEY’RE HUGELY PROBLEMATIC, ESPECIALLY CONSIDERING THAT WE’RE NOT REALLY TRACING AND TRACKING AND ISOLATING PARTICULARLY WEL WHAT IT SEEMS TO BE IS THAT THERE ARE PEOPLE OUT THERE THAT DON’T HAVE SYMPTOMS BUT THEY DON’T KNOW THEY’RE SICK YET AND THEY ARE ABLE TO SPREAD IT. AND THIS IS WHERE THE WHOLE MASK CHANGE CAME FROM. THE MASK POLICY CHANGE THAT IF PEOPLE ARE OUT THERE THAT ARE ASYMPTOMATIC OR PRE SYMPTOMATIC AND CAN SPREAD IT, THEY NEED SOME KIND OF SOURCE CONTROL SO THEY DON’T GIVE IT TO OTHER PEOPLE. SOLEDAD: WHAT’S THE ADVICE YOU GIVE PEOPLE ON MASKS? >> I TELL PEOPLE IF YOU CAN’T SOCIAL DISTANCE, YOU SHOULD WEAR A FACE COVERING. WHEN YOU’RE INDOORS, WHEN YOU’RE IN A CONGREGATE SETTING, WHEN YOU’RE IN SOME KIND OF P