we are planning to bring live coverage of governor andrew cuomo's latest update set for 11:30, 15 minutes or so from now, we have it live on c-span2. >> joining us from nashville is a professor of preventative medicine and infectious diseases at vanderbilt university medical center. thank you for your time this morning. >> good to be with you. >> the united states surpassed china, 82,000. what do you make of that? what are your concerns? >> my concern is it is going to grow.

we haven't completely defined how widespread this virus is in the united states and how intensely it is distributed in different parts of the country. we need to do more testing. the next several weeks are going to see a surge of cases coming into hospitals. it may not get as bad as new york everywhere but we are already seeing patients coming in a rather steady way in nashville and we expect more over the next several weeks. >> describe what it is like an hospitals when you see these patients. how are they suffering? >> obviously people are very very ill. in a respiratory infection, that involves the lungs. you have difficulty breathing. that is an extraordinarily uncomfortable illness because it makes you extremely anxious and makes everyone around you, your family members, anxious. if it gets bad enough you have to be sedated, you get intubated and put on a ventilator to help you breathe

and recover hopefully while your body fight off this virus. >> why are we seeing people die of cardiac arrest? >> when the lung gets bad, particularly older people with underlying illnesses who may already have underlying heart disease the two of them can work together and be virus can affect any number of organs in the body and so cardiopulmonary arrest is often the final exodus. >> why are ventilators being shared in new york and what concerns do you have with that? >> ventilators are be shared, i anticipate, not having been there, because some people use them for part of the time, can be taken off and other patients can be put on them. obviously that is usually being done when you have a shortage of ventilators. it is not the usual procedure. it can be done safely because

obviously ventilators are used for one patient after another but you have to be meticulous in your infection precautions. if you switch from one patient to another. >> there's a headline in the paper that some doctors are writing their wills. >> that is very serious, isn't it? that is ominous. we are concerned about healthcare workers and their safety. everyone has been trained in the infection precautions. we need the personal protective equipment and we all have to be absolutely meticulous in their use and all of that together, nonetheless there is the risk that healthcare workers can acquire these infections and once the virus is in our bodies, our bodies are just like everyone else's, susceptible to the vagaries of the virus. you may get a less severe

infection. those of us who are a little older and may have underlying illnesses, we may be at hazard it getting more severe infections also. >> the new york times, doctors are writing their wills, what are nurses and doctors needing in their personal protective equipment that they are not getting? described the shortage. >> it varies in different parts of the country. the thing we heard the most about are the masks, both the simple surgical type masks and the so-called more rigorous respirators. people are reusing them, restart allies in them, being meticulous about who uses them. we don't need to have them used casually because they are short supply across the country. we are doing all right here but

we have monitored their use carefully, so it is not useful -- wasteful but we are anxious about the supply chain. things heat up and we get more patients we are concerned about whether the supply will be steady over time. all the more reason among many others to dampen, to flatten the so-called epidemic curve, stretch out the patients over time, that will make it better and easier for us to take care of patients appropriately and safely over a longer period of time. we want to flatten out that epidemic curve and stretch things out. >> host: where at your facility are folks getting tested if they are showing symptoms and how quickly are they getting

their results? >> guest: we have a multifaceted testing program in nashville. the state health the permit has its own testing facility and is running tests at double shift so they are working the maximum. my own institution has a series of assessment centers out here. we don't have them in the emergency room. we don't people who are ill to come to the emergency room and spread their infection elsewhere. they will be assessed carefully. their temperatures taken and if they have a fever and some symptoms related to the lower respiratory act that attract like a car for difficulty breathing then they will be eligible for test. a specimen will be taken and sent to our laboratories. our own institutional laboratory is also up to hear working full time and then our metropolitan government has

assessment centers scattered throughout the city so patients can go there also but i must tell you we are having some difficulty in our health department assessment centers. i learned this morning they have a good relationship with a laboratory that will do the test but they don't have sufficient supply of swabs in order to take the specimen. i know my colleagues in the healthy permit are scrambling, trying to get sufficient supplies to actually take the specimen. once the specimens get to the laboratory the turnaround is pretty good. we get within in a matter of hours or 24 hours, back to the patient and the provider. we are okay at the moment. we would like to test much more widely. >> host: if someone tests positive what do health officials due to trace and

contain the infection from that person? >> we are at a transition between containment where case investigation is important and kind of mediation or moderating the disease, trying to lower the impact, where you have so many cases you can't possibly trace each and every one. a little bit on the county in which you are operating in the resources of the health department we are still trying to do case investigation. get contacts as much as possible, at least informed, and many of them depending on their symptoms tested. we are doing a bit of both in our state. >> host: if you live in the eastern central part of the country, 202-748-8000. mountain pacific 202-748-8001. we want to hear from medical

professionals, 202-748-8002. start filing in so we can get your comments for doctor schaffner. i want to show you interviewers, doctor fauci talking about vaccination, development and trials and have you respond to it. >> one of the most important things is one that i mentioned several times from this podium, to clarify the timeline of the vaccines and will that have any impact on the rebound of what we call cycling of the season. certainly, a vaccine will not help us now, next month, the month after but we went into phase 1 trial. i keep referring to one vaccine. there is more than one. there are a couple of handfuls it vaccines at different stages of development but they are all following the same course and

the course is you first go into a phase i trial and you have very few people, 45 people in a certain age group, all healthy, none at any great risk of getting infected. you want to make sure it is safe. next thing you do, that takes 3 months, even more, that will bring us to the beginning and middle of the summer. then you go to a phase 2 trial, put a lot of people in there. we hope there aren't a lot of people getting infected but it is likely there will be somewhere in the world that is going on. we will likely get an efficacy signal and we will know whether or not it actually works. if in fact it does we hope to rush it to have some impact on recycling in the next season. that could be a year to a year and a half. i'm not changing any of the dates that i mention but one of the things we are going to do that you need to understand

that is a stumbling block for previous development of vaccines is even before you know something works, at risk, you have to start producing it. once you know it works you can't just a great, it works, now give me another 6 months to produce it. we are working with a variety of companies to take that risk. we didn't take it with the car. we have a the current vaccine but not enough to do it. same with sars. that is one of the things we will push on, to have it ready if in fact it works. >> host: your thoughts after listening to doctor fauci. >> guest: doctor fauci did vaccine developed in 101 there and if i may because i know there's a lot of confusion about this, let me unpack some of that and explain what tony was talking about. first thing in the moment of a vaccine, and make sure we know

what a vaccine is. it is not treatment, it is for prevention. we would like to prevent this disease like we prevent measles, so you don't get the disease at all. the first thing you have to do is work in the laboratory to create a candidate vaccine. then, this is what doctor fauci was talking about. why does it take so long after you have the candidate vaccine in the laboratory to develop it, before it is ready to be licensed for use? two things are very important. you have to make sure the vaccine is safe, that it doesn't make you ill in and of itself was there have been vaccine candidates in the past but have done that. we don't want to do that. we don't want to harm the american people. the other thing is you have to be sure it works, walking through that.

the first stage the doctor fauci talked about is you get a small number of volunteers, people who are recruited themselves, usually young adults who are otherwise healthy. 40 or 50 of them. they get the vaccine, check to make sure nothing adverse other than a sore arm goes on and draw blood periodically to test whether the vaccine has worked in the body. if all of that goes well, by the time you recruit all those people, give them the injections and follow them up that can take three months, surprisingly long. then you open it up and get a larger group of people who volunteer. some of them will get the vaccine. some of them will get a placebo. a salt solution. nobody knows who has gotten what it and in the context of

an ongoing outbreak some people will get sick, others won't, and you will be able to discover whether the vaccine actually prevents the disease. having given it to a larger number of people you have a better assessment of how safe the vaccine is. once you know exactly how well it works, how effective it is and save, then you can go to licensing. the other thing tony said was as you are working through this process, but the government will do is not wait until the whole process is finished, the government will make an initial investment, probably public-private cooperation, working with manufacturers. of doctor fauci and others think the vaccine is going to work they will start making the vaccine in large amounts before the final results are in such

that when the results due to come in, we can start vaccinating the american people right away. >> are they relying on one vaccine? >> guest: now. there are any number of scientists trying to develop a variety of vaccine candidates so we have a number of these trials going on simultaneously. we may wind up with one or maybe four different vaccines. the more the merrier. >> connie, your question or comment for the doctor. >> caller: what is the success rate of people who have been intubated and on respirators? we don't know what the outcome is and how long do they have to stay on the respirator? are we rearranging the chairs on the titanic? that is my first question.

>> guest: those data are not available but we take care of sick people in the hospital and if they get sick or they are admitted to the intensive care unit and push on a respirator. just as with any person with any illness for whom we are giving intensive care we watch the person very carefully, hoping that they respond. some of those patients, the most severely ill patients will die, others will recover and we can gradually wean them off of the respirator. some of those people will leave the intensive care unit and go back to life and recover. our capacity to provide intensive care is so much better than it was 20 years ago. we would expect some of those gravely ill people to turn the

corner and come back, in effect, to life, and go back to the community. >> host: let's go to bill, what do you do? >> caller: i am a retired are in. i volunteer as an ent on my local ems unit. we are taking precautions as far as masks. we do take precautions, drop the patient off at the hospital, sanitize, the vehicle is sanitized. when we get back to our base, we sanitize again and then left out -- we have the option to do that because we are not really a busy outfit. we run 1500 calls a year.

these other units out there which are doing runs after runs after runs, things we thoroughly sanitize and i wonder how they are doing that. >> guest: thanks for your service. i'm glad you are doing that. we need all the help we can get. i think everybody is doing the best i can. simple sanitation with those wipes actually works very very well, kill the virus very rapidly. i think there's usually time to wipe down an ambulance very carefully and thoroughly between patients. we ought to be able to do that. >> host: we go next to priscilla in west virginia. you are a medical professional as well. what do you do? >> caller: i'm a registered nurse in a critical-care hospital.

we use n95 masks because we don't have a shortage yet. we use one mask until it wears out and we put a face shield over it and then clean the face shield and that is what we have been doing. as far as my bigger issue is prevention, people coming into the hospital, encouraging people to stay home. it is frustrated when the president says things like he wants all the businesses to open up by easter or recently said something about trying to figure out which counties are at less risk than others but as we know west virginia has the highest risk population by most people's estimation but we haven't seen a large quantity of cases that we know of.

first of all how do you feel about the method i described of sanitizing the face shield? there is no best way to sanitize masks but minimizing potential contacts. >> guest: good for you, thank you for being out there for us. yes, you can reuse n95 masks, do it with care. between patients you can put them in a paper bag so they can get damaged and we have long known -- >> the west of this conversation on her website, now live to new york governor andrew cuomo's latest coronavirus update.