paid sick leave for those impacted. the package also includes enhanced unemployment insurance and increased federal funds for medicaid. when the bill is ready for debate on the house floor, we will bring you live coverage here on c-span. host: she is a research professor at georgetown university. here to help us better understand the coronavirus and the federal response to it. when it comes to the virus itself, what do we know and how much remains unknown? guest: we have a lot of data from what unfolded in china. kly. we are trying to understand some of the basic biology of the virus but we have a grasp of who is at moderate risk and who is at severe risk. understanding who needs to be most protected of transmission

and understanding enough about the virus to start putting together diagnostics and begin the process of developing vaccines and other countermeasures. it is a long process but we have enough knowledge to get on that pathway. host: what is the most important thing to learn about the virus? what termsnderstand mean. we are throwing words around. because they are technical terms, they have a different meaning to people working in epidemiology and public health than when they might be echoed in different settings. the most important thing to moststand is we think young, otherwise healthy people, are at risk of infection, but not necessarily at risk of severe disease. people who are older, who have underlying conditions, cardiovascular disease, heart

appear, diabetes, they to be at higher risk of more severe disease. those are the people who seem to be at highest risk of severe pneumonia. that is what we clearly understand right now. when we throw around terms of case fatality rate of 2%, 3%, it gives the impression we have a strong grasp on a ratio that is still an estimate and we are trying to understand it. host: another term thrown around. coronavirus has been genetically sequenced. what does that mean? guest: that is an interesting and exciting development that happened quite early. the chinese researchers published a full genetic sequence of an isolated coronavirus from a patient relatively early in the outbreak. they sequenced it from a patient -- they published the full

sequence in january. it means we have a map of the full genetic complement of the virus. it helps us understand, first, medially, which viral family belong to, it helps you understand what the characteristics of that virus are likely to be. the second thing is that genomic sequence, the letters that make up the full genome of the virus, ae blueprint of the virus, or template we used to make diagnostic testing kits using molecular diagnostic testing, which is a rapid way of testing viruses that does not require you to need a lot. when we say we have the full genome of the virus, it lets us do several things. we can understand characteristics about the virus isolateets us compare from different times to understand if the virus is changing. host: are there different

strains? isolates that are being sequenced and being published in databases suggest the virus is not changing rapidly. there are enough viral clues that tell us when a virus has been introduced into a population and use it as a clock but that -- there does not look like a huge amount of variation. -- it suggests it is the underlying health of the population being affected or something about the way the outbreak is being managed. host: julie fischer is sarcastic, and associate research professor at georgetown university's center for global health science and security. she is with us to take your questions as we try to understand coronavirus. phone lines are split up regionally. if you are in the eastern or central time zones, it is (202)

748-8000. if you're in the mountain or pacific time zones, it is (202) 748-8001. the line for medical professionals is (202) 748-8002. the phone lines are open, so you can start calling in. julie fischer is here. south korea being lauded for its testing capacity. what had they been able to do right and why can't we replicate that, or are we replicating that? guest: just to begin with what south korea is doing and why we are looking to them, south korea was very aggressive right out of robuste in developing a diagnostic testing capacity -- the ability to test a lot of people accurately and quickly. about trying to learn their diagnostic tests out the door. what they have done is they have

really pushed a positive risk communications message and done a good job figuring out how to manage cases and test them outside of hospitals and other health facilities. they are getting out the message, if you think you have been exposed, if you have symptoms, if you're even work, here are testing stations. pictures,e have seen they are drive-through testing stations. come here and get tested. we will collect your contact information. we will let you know in a few hours what the results are. and then they are following up aggressively with people tested. you can get a message via text or other electronic -- good news, or you have tested positive. if you have these symptoms, here is what you should do. you can self-quarantine, try to keep yourself from infecting

others. if you are not comfortable with that, and you need to be with people, they have set up care facilities that are not necessarily medical facilities, they are converted government facilities, community center like approaches, like we do in a disaster like a hurricane, or you give people shelter. people can have meals and they can be sheltered with others so they don't feel isolated, but are still quarantined, but not putting a big burden on the health care system. hospitals toing provide care for the most severely ill. what is fascinating about what south korea has done, they have pushed testing, have been transparent, they are letting people know on a micro geographical level on where cases have occurred near them and urge them to take precaution and be aware. they are giving people options

for care with clear instructions about what requires follow-up. host: on testing, how do you read the story from bloomberg? the emergency approval -- approval from the u.s. government potentially speeding up the ability to test patients. the food and drug demonstration granted in emergency use authorization for the test. .he tool is available in europe there is a lot of jargon in there. what does it mean? guest: emergency youth authorization is a key term. early 2000ven in the after anthrax with the recognition that we need a better way to get diagnostic test kits out quickly for diseases or conditions that might not have been a priority before. we have not had to use them. procedure is a

regulatory procedure that takes some time to go through all of the testing. that emergency youth authorization allows the fda to say in a public health emergency, we can use diagnostic tests that are demonstrated to work without the full licensing process because we don't have anything else to offer right now. it is basically an acceleration ,hat lets government agencies state public health laboratories and the private sector bypass some of those slow approval processes to meet an immediate need. that is one of the many has been that identified by the private sector did issue because fda that emergency use authorization, it allows the private sector to offer up testing kits with the hope they can be rapidly effective.

during the seek outbreak, there were more than -- during the zika outbreak, they were more than a dozen kits approved. host: we are giving our viewers a platform. if they have questions about coronavirus, julie fischer is our guest, a professor at georgetown university. if you have questions, now is a good time to call in. she will be with us for about 45 minutes. woodbridge, illinois. good morning. caller: good morning. i called in earlier but i was disconnected. would you think that the government has a certain role to states have a bigger player in dealing with the people in those states and

they are failing to do that? agoinstance, three weeks with the president was talking, telling us about this, i am 55 and i have copd. i had to go to the doctor every three months and she checked me out. i called, she called me back and she thanked before. she does not want me to come in. she has all my medicine and wants me to stay out of public. i listened to the president and the medical field that was around him at that time. on south korea, she was talking about how fast they have gone. i don't know if they have a parliament or congress like we have. do you think when they have these hearings, if they have them, and the witnesses come in, all they do is beat these people up, point the finger at the administration.

i feel they should have more closed hearings and let's talk about the subject and see what we can do. let's get the funding to them and go forward with it. host: thank you for bringing those up. your point that you used the information to identify you are in a high risk group and work with your medical partners to cigarette how to diminish our risk is a good listen -- lesson. two states have a role to play? absolutely. the federal government has resources, technical assets and the decision-makers who can help move money and people around to where they are needed most. ultimately, it is to states and your local government who are dealing on the ground with the reality of people at risk, people who need to be tested and people who need both medical care and follow-up care that

might not necessarily be medical, like making sure if someone is self-quarantined they have food, access to prescriptions and someone there to check on them. none of those things can happen from the federal level. they require cooperation from local government and state health departments. point, letting the state and public health officials and scientists who can do the laboratory work proceed with resources they need and the knowledge they need is the most critical thing we can do. and everyone playing together on the federal level helps make that possible. in ondo you want to weigh how helpful these hearing set been? right what is important now is transparency. we know in public health that the most important thing that we can do as leaders and spokespeople is to be absolutely, 100% honest and

frank. that is the role of public say, what do we know, what do we not know and what can we do to close that gap? we have a lot of health authorities in our country that are knowledgeable and capable of speaking on these issues and letting them speak and answer and address those questions is important. politics creeps in because politics will creep in. as long as we focus on what are the questions, what do we know, what do we not know and what do we have to do to close that gap? host: louisville, kentucky. this is richard. good morning. fischer, you have a calming effect and i appreciate you speaking. people are running around with their hair on fire. how many people will die this

year from the flu? you are think what talking about is the risk comparison, why people are panicking in the face of coronavirus. we do have in any given year tens of thousands of deaths from the flu. it has been a bad flu year and it does not make people afraid in the same way. i think you are absolutely right that we are looking for parallels and ways to manage concern. the real difference is in the year were tens of thousands of people die from the flu and no one brings it up, it is because we are familiar with the flu. we have tools to deal with it. the public does not take the risk as seriously as a child, particularly those at high risk. but they feel it is familiar and they understand it. coronavirus is. the biology is new and 100% of people on earth are susceptible

to infection. i get your point and you are 100% right. this year, there will be tens of thousands of people who die from the flu and no one will get alarmed because they feel they have the knowledge and tools to manage their concerns. with coronavirus, there has been conflicting information. there are a lot of risks we don't understand and people are alarmed but, sir, i completely get your point. we can have 36,000 deaths from the flu in a season and nobody gets particularly alarmed while this is provoking a lot. host: if and when we get a vaccine for coronavirus, will that be shots people have to get when they go and get vaccines before flu season starts? is that something we should expect, a double shot? guest: the biology of the virus will drive how many vaccinations

are needed to make people immune. virusese other corunna that cause common colds -- there are other coronaviruses that don't cause dramatic illness. host: is that what we don't develop vaccines? guest: there are also a lot of viruses that cause upper respiratory tract infections and it would be difficult to vaccinate against all of those. we aim for those that are most likely to cause disease. once a vaccine is developed, there will be testing to show if the vaccine is stable. immune response that is protective. works, that could be enough. if this virus becomes part of the background disease burden that is always with us, the vaccines will be

developed and optimized and deep -- and become part of regular. host: the death rate of coronavirus is higher than the flu, it is more dangerous. but why? what does it attack in the body that makes it more dangerous? guest: part of the problem is everybody on earth is susceptible, every single one of us. not everyone will be infected. of the people who are infected, not all will develop severe disease. those who develop severe disease will be at risk for life-threatening pneumonia. the virus binds to a receptor and gets a foothold in the lining of the lungs, where it attaches and infects. what happens in terms of the disease process is people who have a severewho disease outcome tend to have

inflammation at the surface where the lungs meet air. what that means is the immune response creates a vigorous interaction, trying to destroy the infected cells to keep the virus from spreading further in the body. the damage that can cause at the surface of the long, where we acrosschange of air very, very thin layer's of cells in our lungs, it depends on the cells being permeable. for people who have severe pneumonia, the inflammation of the surface can lead to fluid ofumulating in the air sacks the lungs. people are struggling to get enough air in their body. with enough of those air sacks being filled with fluid, you see pneumonia. people with fluid in her lungs have difficulty breathing. -- people with difficulty.

different about this virus, pneumonia. it is the number of people being infected at once. percentage of them become severely ill, it is large numbers of people being infected, even if only a small percentage become severely ill, that is a lot of people. host: coming up at 8:30. the house will be in at 9:00 a.m. matt in california, you are on with julie fischer. caller: hello, professor. thank you for your calmness. i work at a post office. i wonder if you have any guidelines for people in the public sector. they have been telling us to wash our hands. what about wearing masks or gloves? i woke up with an itchy throat this morning.

is it irresponsible for me to go to work? host: thanks. guest: those are some important questions. i think that right now, the recommendation -- going to your last question first -- if you are symptomatic, and itchy throat is a symptom of respiratory infection, it is also a symptom of allergies. the recommendation is to avoid exposing others. if you are actively coughing and sneezing, one way to avoid infecting others is to wear a surgical mask. it does not sound like you are personally in that boat right now, but it is one thing being recommended. in terms of should you go to work, i think this is a place where, again, guidance from your employer -- from all employers is important. if you are symptomatic, what

should you do? contact someone in your office? let them make the decision? self-quarantine until you are clear? these are conversations that should be happening among employees and management in every setting. particularly in places where we are depending on people to show up and do their work. what are the plans to help people know when they should come into work, to help make clear how they will be paid and supported if they don't come into work? these are important questions. i can't tell you, individually, to go to work or not go to work. i recommend talking to your supervisor and working out a plan for when what happens when people are symptomatic to try to prevent the spread to others. in terms of should you be wearing masks in the workplace, the general recommendation is

wearing a mask if you are healthy does not do a lot to prevent infection by others. wearing a mask for people who are coughing and sneezing is really helpful at not spreading the droplets that carry the virus to other people. even though we feel like ,andwashing is comforting because it seems simple, it is helpful and effective in protecting you in the case someone else sneezes into their , and touches a surface then you have to come along and use the same services. if you touch those and then touch your eyes or nose, you can infect yourself if there is virus sitting there. we touch our faces so often without noticing. the handwashing is an important intervention. the most important intervention is trained to encourage people

who are sick to not expose others. i commend you for thinking forward about your role in protecting other people at your workplace. we are all depending on each other right now. , socials that we have distancing tools, the hand hygiene tools, the self-quarantining tools, those are old-fashioned, non-technological interventions. they are what we have right now and they can help slow the spread of this disease, so that everyone in the workplace, in the community does not become sick at the same time and overwhelm the ability of our health system to provide care to those who are the highest risk of most severe disease. host: when people talk about flattening the curve, can you explain that? guest: the epidemiological curve. the full way of presenting what an illness looks like. when people in public health

talk about the epidemiological curve, they are talking but the number of cases over time. right now, when there is a sharp increase in the number of cases, the curve looks like this. host: we can show viewers the chart that is on the editorial curvef usa today of the without protective measures over time. guest: what that curve is showing us is we predict many of cases would occur in a very short time. the concern about that is our health care system only has so many intensive care unit beds, we only have so many respirators and we only have so many health care workers. if all of those cases occur in findsharp peak, we might ourselves in a position or we don't have enough resources to provide care to those most severely ill. flattening the curve means

slowing down the number of new cases in that epidemiological cases instead of all the occurring in a few days, it is spread out over a number of days. that does it necessarily reduce the number of people infected overall, it might, but most importantly slows down the number of new cases so that the number of people who become severely ill are spread out and we can free up hospitals and health workers to provide them with the standard of care we expect for ourselves and loved ones. host: new jersey is next. you are on with julie fischer of georgetown university. caller: good morning. i am so happy i am able to talk to you. i have two questions for you. i am a 64-year-old grandmother. i adopted by beautiful granddaughter and retired early as 62 to be a full-time

stay-at-home mom. us just got- all of and it was a monster. the baby brought it home first -- she is six years old. and then he got it, and he almost died from it. i got it after both of them ,ecovered, but i had a flu shot and the baby had a flu shot and he did not and he got the worst of it. first,tion to you is, virus, or thethe baby brings the virus some, what do we do? do i have to separate myself from her? do i have to make alternate plans?

is my other question for you , how do they treat this disease if you are positive? host: thank you for the questions. guest: thank you so much. i know that recovering from influenza and facing this again, it is a lot to deal with in a short time. you have some really good questions. going backward from your last question, what did they do to treat this? infected and they have a mild disease, coughing, fever, but they are not severely ill, they are not having problems breathing, no other impact on their other organ systems, then the treatment right now is very noninvasive, supportive care. asking people to stay home and make sure they have plenty of liquids, make them more

comfortable and help them breathe, like they would for any other respiratory infection. it is not specialized care. for people who are severely ill, the hospital treatment is to help them breathe, make sure they get enough oxygen, so there other organs are not damaged, they can continue to breathe until the liars has cleared. and told -- until the virus has cleared. is like caring for other respiratory infections -- we don't have good medical therapy. in terms of what you do if your baby brings it home -- if your granddaughter brings it home, this infection, there are guidelines for care that have been developed and published. the best available technical advice on how to care

for someone who has covid-19 without becoming infected. having the infected person wear a mask -- that might be hard with a six-year-old, but it can be done -- and helping advise the people providing care on how to get rid of the waste that the infected person produces when they sneeze and cough. frequent handwashing, disinfecting surfaces at your home. it is tough. of are in the quandary potentially having to provide care for someone and putting yourself at risk. that is something we are all having to think about and plan for. my advice is to go to the cdc website, read about it, make yourself comfortable and knowledgeable about the guidance. talks about achievable and commonsense measures, getting

someone to wear a surgical mask so they are not coughing and sneezing on you. if they can't wear the mask, there are measures to protect yourself, cleaning all of the services in your house, keep them isolated as much as possible so you are not disinfecting every surface, every minute. just try to contain the spread of infection so you, yourself, are not infected. i wish you the best and i hope you are all able to get through the next couple of weeks without anyone having to deal with the situation. host: our guest is julie fischer , a research professor at georgetown university's center for global health science and security until the house comes with us at 9:00 this morning. we are expecting a vote today as negotiations continued into the night last night on the economic relief package. negotiations between the democrats and president trump over what should be included in

the economic relief package. here is the story from last night about the house being close to striking a deal with president trump on coronavirus response. president trump weighing in about six minutes ago on one of the aspects of the relief package. he said if you want to get money into the hands of people quickly and efficiently, let the people have the money they earn. approve a payroll tax cut until the end of the year. you are doing something meaningful. only that will make a big difference. we are expecting votes today on capitol hill. unclear if that tweet will change anything. the house will come in at 9:00 a.m. julie fischer, this is greg here in washington, d.c. caller: you should be the one that is talking, because what is coming up from the administration is totally, totally unacceptable.

they have political people try to talk about this, it is terrible. from the guideg that is sitting there, it is not helpful. people who know and can inform people and i really want you to get out there and let people know. my mom has cancer. i have talked to her. really, youe is know, could be in that group. it does not matter if you are black or white. you are the people who should be talking. not these other guys who were trying to do this politically. it is not a political issue. it is a health issue. i commend you for doing this. guest: thank you, sir. i really appreciate your kind

words about what i am contributing. part ofng my best to be the public health risk communications effort and i appreciate your kind words. i agree 100% that this should not be political. this is a crisis we should be facing together. one of the most important things is having the technical experts upfront. there are people in the who are technical experts, who understand the challenges being faced at the federal level and it is good to see them outfront communication. i agree that this is a time to not talk about the politics of this and focus on what we can do together and i wish you and your mother the best of luck. what is the center for

global health science and security -- besides coming on this show in this conversation -- are you involved in the official response? like other academic groups, our role is to fill the gaps the government does not have time to fill when it is overwhelmed. we can collect data and analyze data. we can try to identify trends, understand what is happening, identify gaps, but the biggest role for academia with the covid-19 outbreak, we can actually -- as a group, academics can pull together a lot of information really quickly about the actual situation and what is happening in terms of new cases, understanding what interventions are being taken in different places, and trying to identify the best practices.

while the federal and state and local public health officials are filling the absolutely critical role of making sure diagnostic tests are available to the people who need them, that there are good communications about what people should do and how they should protect themselves, our role is to look at the big picture, understand what works, identify best practices and share that information with state, local and national public health officials who can act on it. host: tim in wisconsin, thanks for waiting. caller: good morning, c-span, good morning professor. my questions are about paper products. the mail. when you go to your mailbox, say you are wearing gloves, you put your plastic bag,tor -- put it in the freezer, would that kill the virus on the mail?

second question, money. how should we be handling money? the u.s. post, if office was to use ultraviolet light on the mail, would that kill it? my last point, do you think it would help of the federal government would help funding of nurses, because obviously they will be needed. host: that is the question, mail , funding, new funding for doctors and nurses. ms. fischer: tim, there was a study coming out soon that has been shared from federal researchers that did show -- it asked the question, how long can this virus really last. if it is splashed up as an aerosol on surfaces. they did really careful work and it showed the virus just in

a few shortted hours. if it is sitting on a surface like steel or plastic or cardboard, it could last for several hours. in some cases on hard surfaces, maybe a couple days. they did not look at paper, they looked at cardboard. they demonstrated you might be able to find a live virus. let's say someone got the virus on their hands and then touched paper, envelopes, dollar bills. it is theoretically possible there would still be some live virus on those surfaces, but there has been nothing to suggest it could be aerosolized back out on those surfaces. if they sneeze on money or paper and you pick it up, you are

unlikely to put it back into the air in a way you could read that in. the real risk is in touching it and touching your own eyes and nose. hence the handwashing we are focused on. it is possible there might be traces of virus in the community on dollar bills or envelopes, but if you wash your hands carefully after you handle them, it should offer you adequate protection. you should not have to take any other major measures to protect that. in terms of uv light at the post office, the virus is very easily eliminated by applying uv light in a laboratory or controlled clinical setting. in some place you are dealing with large amounts of mail, there are other ways the mail could be treated. overall it would be pretty , intensive and it might give you a false sense of security. even if they could treat the mail at the point it is being handled, it will be taken back out in the community and handled

-- carried to your mailbox. one of our earlier collars from the post office the careful , attention the postal workers are paying attention to their own hand hygiene. the most important thing is not trying to think about ways to treat the mail or dollar bills in bulk, but think about the simple interventions you can take. if you have interacted with mail or dollar bills, wash your hands afterwards and avoid touching your eyes and nose. it is something that is effective. it does not sound comforting that washing your hands is the best, but it really is biologically the best protection. washing your hands carefully so ap for at least 20 seconds. host: can virus spread in swimming pools or the beach? guest: i do not think there is any evidence the virus can spread in swimming pools. swimming pools usually have good

chlorine amounts. this virus is not that durable. it is a respiratory virus it does stick around on surfaces if not disinfected, but if treated with a disinfectant, it is easily destroyed. swimming pools are large and there would be a lot of dilution. i do not think that would be a real can people who are outside in the sun at the beach, that is probably the best place to be with a virus that is degraded by uv light. at the beach precautions would be the same you interacting with would take anywhere. interacting with other people is your big risk, not the virus spreading in the environment. host: steve in asheville, north carolina on the line we set aside for medical professionals. good morning. caller: good morning. thank you, professor, for your wonderful discussion. i have been watching all the different shows. in my humble opinion, you come across very knowledgeable and i think more people can relate. i think we really need this.

my question to you, ma'am, i used to work as an infection control nurse and it really bothers me to see that nursing home up in seattle to have such an outbreak. i used to take care of elderly patients. my question to you, because i am still working in a different area as a nurse -- my question , my friend at a local nursing home in nashville and -- >> we will break away to take you live to capitol hill for a briefing by house democrats ahead of an expected vote on the coronavirus economic aid package on the floor. >> good evening, everyone. thank you for being around at this hour of the night. i am very