1 00:05:09,900 --> 00:05:11,934 Probably on a wide shot, so 2 00:05:11,934 --> 00:05:15,967 Probably on a wide shot, so don’t look too disappointed. 3 00:05:20,633 --> 00:05:21,466 My sister’s telling us there’s 4 00:05:21,466 --> 00:05:25,399 My sister’s telling us there’s no sense. Okay. Hi welcome 5 00:05:25,399 --> 00:05:26,434 no sense. Okay. Hi welcome back. Sorry we had some 6 00:05:26,434 --> 00:05:27,600 back. Sorry we had some technical difficulties. I’ll 7 00:05:27,600 --> 00:05:28,734 technical difficulties. I’ll just say what we set off the 8 00:05:28,734 --> 00:05:30,599 just say what we set off the top already. my name is Nika 9 00:05:30,599 --> 00:05:31,900 top already. my name is Nika Alexander. I’m with the 10 00:05:31,900 --> 00:05:32,434 Alexander. I’m with the communications team here at the 11 00:05:32,434 --> 00:05:34,000 communications team here at the World Health Organization 12 00:05:34,000 --> 00:05:34,966 World Health Organization today, we’re going to be 13 00:05:34,966 --> 00:05:37,666 today, we’re going to be talking about clinical care for 14 00:05:37,666 --> 00:05:39,067 talking about clinical care for Kobe to care for patients who 15 00:05:39,067 --> 00:05:40,399 Kobe to care for patients who are sick with Cot. two people 16 00:05:40,399 --> 00:05:41,900 are sick with Cot. two people here to talk about that one is 17 00:05:41,900 --> 00:05:44,000 here to talk about that one is doctor Janet Diaz. She’s our 18 00:05:44,000 --> 00:05:45,534 doctor Janet Diaz. She’s our clinical lead in the emergency 19 00:05:45,534 --> 00:05:47,300 clinical lead in the emergency program at WHO clinical care 20 00:05:47,300 --> 00:05:49,601 program at WHO clinical care and also doctor Maria Kirk, who 21 00:05:49,601 --> 00:05:50,999 and also doctor Maria Kirk, who you’ve met before she’s the 22 00:05:50,999 --> 00:05:53,033 you’ve met before she’s the technical lead for Covina right 23 00:05:53,033 --> 00:05:54,533 technical lead for Covina right off the top of the. Understand 24 00:05:54,533 --> 00:05:55,967 off the top of the. Understand this better Janet I just wanted 25 00:05:55,967 --> 00:05:58,233 this better Janet I just wanted to ask you to explain a little 26 00:05:58,233 --> 00:06:00,567 to ask you to explain a little bit how you work how you learn 27 00:06:00,567 --> 00:06:01,667 bit how you work how you learn about treating patients when 28 00:06:01,667 --> 00:06:03,700 about treating patients when it’s a new disease. uh thank 29 00:06:03,700 --> 00:06:06,000 it’s a new disease. uh thank you um I’m happy to be here 30 00:06:06,000 --> 00:06:09,366 you um I’m happy to be here with you all uh so as the 31 00:06:09,366 --> 00:06:10,267 with you all uh so as the clinical lead for 32 00:06:10,267 --> 00:06:11,300 clinical lead for covid-nineteen and actually 33 00:06:11,300 --> 00:06:12,133 covid-nineteen and actually work not just for 34 00:06:12,133 --> 00:06:13,599 work not just for covid-nineteen also work in 35 00:06:13,599 --> 00:06:15,233 covid-nineteen also work in other outbreaks of infectious 36 00:06:15,233 --> 00:06:16,600 other outbreaks of infectious emerging infectious diseases um 37 00:06:16,600 --> 00:06:17,900 emerging infectious diseases um one of the early things that we 38 00:06:17,900 --> 00:06:18,500 one of the early things that we have to do starting at the 39 00:06:18,500 --> 00:06:20,599 have to do starting at the beginning of the pandemic was 40 00:06:20,599 --> 00:06:23,233 beginning of the pandemic was uh you know really have a good 41 00:06:23,233 --> 00:06:23,867 uh you know really have a good excellent communication with 42 00:06:23,867 --> 00:06:25,467 excellent communication with the clinicians that were on the 43 00:06:25,467 --> 00:06:27,233 the clinicians that were on the front line and so as part of 44 00:06:27,233 --> 00:06:29,067 front line and so as part of that. And in order to do that 45 00:06:29,067 --> 00:06:31,034 that. And in order to do that we developed the Covid-nineteen 46 00:06:31,034 --> 00:06:33,233 we developed the Covid-nineteen clinical network and that 47 00:06:33,233 --> 00:06:35,166 clinical network and that gradually increased in 48 00:06:35,166 --> 00:06:35,700 gradually increased in participation and 49 00:06:35,700 --> 00:06:36,700 participation and representation with clinicians 50 00:06:36,700 --> 00:06:38,000 representation with clinicians from many different countries 51 00:06:38,000 --> 00:06:39,966 from many different countries around the world as the 52 00:06:39,966 --> 00:06:42,000 around the world as the pandemic spread um and that 53 00:06:42,000 --> 00:06:43,500 pandemic spread um and that provided us a form and 54 00:06:43,500 --> 00:06:45,333 provided us a form and continues to provide a forum We 55 00:06:45,333 --> 00:06:47,200 continues to provide a forum We met twice a week for the most 56 00:06:47,200 --> 00:06:48,700 met twice a week for the most of the pandemic and now meet 57 00:06:48,700 --> 00:06:50,933 of the pandemic and now meet once a week where clinicians 58 00:06:50,933 --> 00:06:51,867 once a week where clinicians really share their experiences 59 00:06:51,867 --> 00:06:53,000 really share their experiences caring for patients and at the 60 00:06:53,000 --> 00:06:55,233 caring for patients and at the beginning, this was so 61 00:06:55,233 --> 00:06:56,667 beginning, this was so essential to understand the 62 00:06:56,667 --> 00:06:59,199 essential to understand the disease. What were the? What 63 00:06:59,199 --> 00:07:00,467 disease. What were the? What kind of treatments or 64 00:07:00,467 --> 00:07:02,433 kind of treatments or clinicians and from that and 65 00:07:02,433 --> 00:07:03,700 clinicians and from that and what challenges they were 66 00:07:03,700 --> 00:07:04,700 what challenges they were facing, you know what were 67 00:07:04,700 --> 00:07:06,267 facing, you know what were their observations and from 68 00:07:06,267 --> 00:07:07,800 their observations and from that we were able to start to 69 00:07:07,800 --> 00:07:09,401 that we were able to start to inform how the clinical 70 00:07:09,401 --> 00:07:10,966 inform how the clinical guidance for patients with 71 00:07:10,966 --> 00:07:13,566 guidance for patients with covid-nineteen should develop 72 00:07:13,566 --> 00:07:15,867 covid-nineteen should develop um initially there was not much 73 00:07:15,867 --> 00:07:16,833 um initially there was not much evidence, meaning that you know 74 00:07:16,833 --> 00:07:19,033 evidence, meaning that you know the the research was ongoing. 75 00:07:19,033 --> 00:07:20,700 the the research was ongoing. uh starting you know at the 76 00:07:20,700 --> 00:07:22,433 uh starting you know at the beginning ongoing just so we 77 00:07:22,433 --> 00:07:23,733 beginning ongoing just so we can put this in time you’re 78 00:07:23,733 --> 00:07:25,734 can put this in time you’re talking January starting in 79 00:07:25,734 --> 00:07:26,833 talking January starting in January and the doctors who are 80 00:07:26,833 --> 00:07:28,700 January and the doctors who are looking after. With this new 81 00:07:28,700 --> 00:07:30,933 looking after. With this new disease, yeah and we you know 82 00:07:30,933 --> 00:07:31,967 disease, yeah and we you know published our initial guidance 83 00:07:31,967 --> 00:07:34,100 published our initial guidance at the end of January um and 84 00:07:34,100 --> 00:07:36,733 at the end of January um and that was based on indirect 85 00:07:36,733 --> 00:07:37,666 that was based on indirect evidence, which meant it was 86 00:07:37,666 --> 00:07:38,867 evidence, which meant it was kind of evidence. We didn’t 87 00:07:38,867 --> 00:07:40,366 kind of evidence. We didn’t have it for a cot, but we knew 88 00:07:40,366 --> 00:07:41,700 have it for a cot, but we knew had experiences with clinicians 89 00:07:41,700 --> 00:07:43,467 had experiences with clinicians that took care of me that took 90 00:07:43,467 --> 00:07:44,900 that took care of me that took care of stars that took care of 91 00:07:44,900 --> 00:07:47,567 care of stars that took care of you know other viral pneumonia 92 00:07:47,567 --> 00:07:49,600 you know other viral pneumonia and so we use that as best as 93 00:07:49,600 --> 00:07:51,667 and so we use that as best as we could to inform the guidance 94 00:07:51,667 --> 00:07:53,534 we could to inform the guidance um as much as possible, 95 00:07:53,534 --> 00:07:54,500 um as much as possible, understanding that it wasn’t, 96 00:07:54,500 --> 00:07:55,766 understanding that it wasn’t, you know it was indirect 97 00:07:55,766 --> 00:07:57,267 you know it was indirect evidence um but it was the best 98 00:07:57,267 --> 00:07:58,000 evidence um but it was the best we could and then over time we 99 00:07:58,000 --> 00:07:59,767 we could and then over time we learned more about the disease 100 00:07:59,767 --> 00:08:01,267 learned more about the disease and updated our guidance and 101 00:08:01,267 --> 00:08:03,267 and updated our guidance and expanded the guidance uh 102 00:08:03,267 --> 00:08:05,399 expanded the guidance uh accordingly. So not to play 103 00:08:05,399 --> 00:08:07,067 accordingly. So not to play innocent here, there’s a reason 104 00:08:07,067 --> 00:08:07,767 innocent here, there’s a reason we’re speaking with you today 105 00:08:07,767 --> 00:08:10,033 we’re speaking with you today of all days and that’s because 106 00:08:10,033 --> 00:08:12,533 of all days and that’s because WHO just released some updates 107 00:08:12,533 --> 00:08:13,500 WHO just released some updates some new guidance on how to 108 00:08:13,500 --> 00:08:15,900 some new guidance on how to care for patients. There’s one 109 00:08:15,900 --> 00:08:17,467 care for patients. There’s one particular drug that is has 110 00:08:17,467 --> 00:08:18,999 particular drug that is has shown itself through these 111 00:08:18,999 --> 00:08:21,033 shown itself through these studies to be quite effective, 112 00:08:21,033 --> 00:08:23,701 studies to be quite effective, explain that one for us, please 113 00:08:23,701 --> 00:08:25,100 explain that one for us, please great. So um so I do think 114 00:08:25,100 --> 00:08:26,066 great. So um so I do think that’s why we are here today 115 00:08:26,066 --> 00:08:27,667 that’s why we are here today and I think we have to 116 00:08:27,667 --> 00:08:29,599 and I think we have to acknowledge actually and uh 117 00:08:29,599 --> 00:08:30,467 acknowledge actually and uh acknowledge many different 118 00:08:30,467 --> 00:08:32,166 acknowledge many different people out there uh and I would 119 00:08:32,166 --> 00:08:34,734 people out there uh and I would like to do that. The trials um 120 00:08:34,734 --> 00:08:36,734 like to do that. The trials um in order for us to develop the 121 00:08:36,734 --> 00:08:38,100 in order for us to develop the evidence based to write 122 00:08:38,100 --> 00:08:38,533 evidence based to write guidance to write a 123 00:08:38,533 --> 00:08:39,599 guidance to write a recommendation that’s 124 00:08:39,599 --> 00:08:41,300 recommendation that’s trustworthy that we can stand 125 00:08:41,300 --> 00:08:43,700 trustworthy that we can stand by uh we need uh trials which 126 00:08:43,700 --> 00:08:46,233 by uh we need uh trials which are uh you know researchers 127 00:08:46,233 --> 00:08:47,534 are uh you know researchers that conduct clinical trials 128 00:08:47,534 --> 00:08:49,300 that conduct clinical trials which recruit patients which 129 00:08:49,300 --> 00:08:51,133 which recruit patients which randomize them and then do you 130 00:08:51,133 --> 00:08:52,999 randomize them and then do you know a pre specified 131 00:08:52,999 --> 00:08:54,867 know a pre specified statistical analysis of uh you 132 00:08:54,867 --> 00:08:56,900 statistical analysis of uh you know the the intervention that 133 00:08:56,900 --> 00:08:57,966 know the the intervention that they’re testing and they go 134 00:08:57,966 --> 00:08:58,866 they’re testing and they go through a process the 135 00:08:58,866 --> 00:08:59,666 through a process the scientific process when they 136 00:08:59,666 --> 00:09:00,900 scientific process when they make the evidence available for 137 00:09:00,900 --> 00:09:03,033 make the evidence available for us to put into a guide. So I 138 00:09:03,033 --> 00:09:05,300 us to put into a guide. So I think we need to thank uh all 139 00:09:05,300 --> 00:09:07,367 think we need to thank uh all the trials both in 140 00:09:07,367 --> 00:09:08,233 the trials both in corticosteroids, which is the 141 00:09:08,233 --> 00:09:09,233 corticosteroids, which is the topic of today’s 142 00:09:09,233 --> 00:09:10,000 topic of today’s recommendation, but all the 143 00:09:10,000 --> 00:09:12,099 recommendation, but all the trials that are doing all good 144 00:09:12,099 --> 00:09:13,267 trials that are doing all good studies and interventions 145 00:09:13,267 --> 00:09:14,100 studies and interventions around the world because that 146 00:09:14,100 --> 00:09:16,933 around the world because that is how we are going to inform 147 00:09:16,933 --> 00:09:18,633 is how we are going to inform improving hopefully and giving 148 00:09:18,633 --> 00:09:19,700 improving hopefully and giving uh finding life-saving 149 00:09:19,700 --> 00:09:21,934 uh finding life-saving treatments for covid-nineteen 150 00:09:21,934 --> 00:09:23,700 treatments for covid-nineteen in regards to corticosteroids 151 00:09:23,700 --> 00:09:26,000 in regards to corticosteroids um the story began the story of 152 00:09:26,000 --> 00:09:27,700 um the story began the story of corticosteroids severe illness 153 00:09:27,700 --> 00:09:29,667 corticosteroids severe illness and viral pneumonia has had a 154 00:09:29,667 --> 00:09:31,433 and viral pneumonia has had a long history and one that you 155 00:09:31,433 --> 00:09:33,833 long history and one that you know has. And mostly 156 00:09:33,833 --> 00:09:35,533 know has. And mostly environment pneumonia and not a 157 00:09:35,533 --> 00:09:36,300 environment pneumonia and not a good history. You know that we 158 00:09:36,300 --> 00:09:39,199 good history. You know that we were concerned about harm with 159 00:09:39,199 --> 00:09:41,033 were concerned about harm with corticosteroids and other uh 160 00:09:41,033 --> 00:09:42,533 corticosteroids and other uh viral ammonia, including 161 00:09:42,533 --> 00:09:45,300 viral ammonia, including influenza sass and uh so at the 162 00:09:45,300 --> 00:09:46,567 influenza sass and uh so at the beginning of this pandemic we 163 00:09:46,567 --> 00:09:48,999 beginning of this pandemic we were hesitant uh uh uh we and 164 00:09:48,999 --> 00:09:52,100 were hesitant uh uh uh we and we advised against it um but at 165 00:09:52,100 --> 00:09:54,867 we advised against it um but at the same time critical steroids 166 00:09:54,867 --> 00:09:56,999 the same time critical steroids are cheap widely available and 167 00:09:56,999 --> 00:09:59,634 are cheap widely available and commonly used and has been used 168 00:09:59,634 --> 00:10:02,066 commonly used and has been used in different types of uh 169 00:10:02,066 --> 00:10:04,467 in different types of uh critical illness um in the ICU 170 00:10:04,467 --> 00:10:08,399 critical illness um in the ICU in the past so uh. New at the 171 00:10:08,399 --> 00:10:09,566 in the past so uh. New at the You know the early days of the 172 00:10:09,566 --> 00:10:10,933 You know the early days of the pandemic, the steroids we’re 173 00:10:10,933 --> 00:10:12,567 pandemic, the steroids we’re starting to be used you know 174 00:10:12,567 --> 00:10:14,667 starting to be used you know with um because they were there 175 00:10:14,667 --> 00:10:15,933 with um because they were there and people were hoping maybe 176 00:10:15,933 --> 00:10:17,367 and people were hoping maybe there’s a benefit in this viral 177 00:10:17,367 --> 00:10:20,466 there’s a benefit in this viral pneumonia. so quickly though we 178 00:10:20,466 --> 00:10:21,733 pneumonia. so quickly though we encourage the trials again to 179 00:10:21,733 --> 00:10:23,367 encourage the trials again to not just don’t just give the 180 00:10:23,367 --> 00:10:24,667 not just don’t just give the steroid put in patients and 181 00:10:24,667 --> 00:10:26,533 steroid put in patients and trials. so we can get you know 182 00:10:26,533 --> 00:10:28,066 trials. so we can get you know good evidence of efficacy and 183 00:10:28,066 --> 00:10:29,533 good evidence of efficacy and safety, and so that really 184 00:10:29,533 --> 00:10:32,833 safety, and so that really started um by mid June. if 185 00:10:32,833 --> 00:10:33,700 started um by mid June. if everyone remembers, I guess mid 186 00:10:33,700 --> 00:10:36,033 everyone remembers, I guess mid June or the third week of June 187 00:10:36,033 --> 00:10:36,934 June or the third week of June uh the recovery colleagues in 188 00:10:36,934 --> 00:10:40,900 uh the recovery colleagues in the UK published uh their uh 189 00:10:40,900 --> 00:10:42,534 the UK published uh their uh hallmarks study and the prelim. 190 00:10:42,534 --> 00:10:43,633 hallmarks study and the prelim. We’re also published in the New 191 00:10:43,633 --> 00:10:44,667 We’re also published in the New England Journal on the 192 00:10:44,667 --> 00:10:46,033 England Journal on the seventeenth of July, which 193 00:10:46,033 --> 00:10:47,767 seventeenth of July, which showed a benefit for critical 194 00:10:47,767 --> 00:10:49,599 showed a benefit for critical steroids dexamethasone in 195 00:10:49,599 --> 00:10:52,467 steroids dexamethasone in particular in patients with um 196 00:10:52,467 --> 00:10:54,267 particular in patients with um uh patients on oxygen therapy 197 00:10:54,267 --> 00:10:56,700 uh patients on oxygen therapy and patients on uh ventilation. 198 00:10:56,700 --> 00:10:58,066 and patients on uh ventilation. so the patients who are very 199 00:10:58,066 --> 00:11:00,733 so the patients who are very sick um and no benefit or 200 00:11:00,733 --> 00:11:02,534 sick um and no benefit or potential for harm actually in 201 00:11:02,534 --> 00:11:03,900 potential for harm actually in patients who were mild. so you 202 00:11:03,900 --> 00:11:07,166 patients who were mild. so you know not in not on oxygen, not 203 00:11:07,166 --> 00:11:10,133 know not in not on oxygen, not on ventilation so when that 204 00:11:10,133 --> 00:11:14,700 on ventilation so when that study came out um it was. You 205 00:11:14,700 --> 00:11:16,133 study came out um it was. You know the the studies the 206 00:11:16,133 --> 00:11:17,633 know the the studies the results were you know were 207 00:11:17,633 --> 00:11:19,500 results were you know were very, you know positive um and 208 00:11:19,500 --> 00:11:21,033 very, you know positive um and there were other trials ongoing 209 00:11:21,033 --> 00:11:22,700 there were other trials ongoing at the same time and because 210 00:11:22,700 --> 00:11:23,700 at the same time and because those results of those studies 211 00:11:23,700 --> 00:11:25,966 those results of those studies are so the recovery study was 212 00:11:25,966 --> 00:11:28,000 are so the recovery study was positive, The other trials you 213 00:11:28,000 --> 00:11:29,534 positive, The other trials you know, stopped rolling because 214 00:11:29,534 --> 00:11:30,867 know, stopped rolling because now patients were like no we 215 00:11:30,867 --> 00:11:32,166 now patients were like no we wanna get the steroids and so 216 00:11:32,166 --> 00:11:34,399 wanna get the steroids and so there was about seven other 217 00:11:34,399 --> 00:11:37,033 there was about seven other trials that are ongoing um that 218 00:11:37,033 --> 00:11:38,533 trials that are ongoing um that we reached out to and we were 219 00:11:38,533 --> 00:11:40,833 we reached out to and we were already in discussions with um 220 00:11:40,833 --> 00:11:42,867 already in discussions with um with the trials because what 221 00:11:42,867 --> 00:11:44,399 with the trials because what happened. If you have too many 222 00:11:44,399 --> 00:11:45,833 happened. If you have too many one, we say enroll in trials, 223 00:11:45,833 --> 00:11:46,999 one, we say enroll in trials, but we also want trials to be 224 00:11:46,999 --> 00:11:48,266 but we also want trials to be big enough to find the answer. 225 00:11:48,266 --> 00:11:49,033 big enough to find the answer. If you have too many small 226 00:11:49,033 --> 00:11:50,767 If you have too many small trials, you won’t have enough 227 00:11:50,767 --> 00:11:51,500 trials, you won’t have enough patients and then you might not 228 00:11:51,500 --> 00:11:53,700 patients and then you might not find a real answer. So we 229 00:11:53,700 --> 00:11:54,999 find a real answer. So we started a weekly meeting with 230 00:11:54,999 --> 00:11:56,300 started a weekly meeting with the trials of these other 231 00:11:56,300 --> 00:11:57,667 the trials of these other trials and I don’t have the 232 00:11:57,667 --> 00:11:58,700 trials and I don’t have the time to go through all the 233 00:11:58,700 --> 00:12:00,033 time to go through all the papers and their names, but I 234 00:12:00,033 --> 00:12:01,934 papers and their names, but I have to acknowledge really the 235 00:12:01,934 --> 00:12:03,033 have to acknowledge really the great collaboration. so this 236 00:12:03,033 --> 00:12:05,033 great collaboration. so this was part of the WO clinical 237 00:12:05,033 --> 00:12:06,933 was part of the WO clinical research working group. so um 238 00:12:06,933 --> 00:12:08,734 research working group. so um we invited them to join us, We 239 00:12:08,734 --> 00:12:10,599 we invited them to join us, We said. We wanted to see if we 240 00:12:10,599 --> 00:12:12,233 said. We wanted to see if we can pull the data pull the 241 00:12:12,233 --> 00:12:13,966 can pull the data pull the trial data uh together in order 242 00:12:13,966 --> 00:12:16,233 trial data uh together in order to make the evidence-based 243 00:12:16,233 --> 00:12:18,767 to make the evidence-based stronger so we had the recovery 244 00:12:18,767 --> 00:12:21,033 stronger so we had the recovery cohort. We knew there was seven 245 00:12:21,033 --> 00:12:23,300 cohort. We knew there was seven other trials that had enroll 246 00:12:23,300 --> 00:12:24,900 other trials that had enroll patients um and that those were 247 00:12:24,900 --> 00:12:26,700 patients um and that those were gonna stop enrolling because of 248 00:12:26,700 --> 00:12:27,300 gonna stop enrolling because of recovery. so it’s an 249 00:12:27,300 --> 00:12:28,800 recovery. so it’s an opportunity to pull all the 250 00:12:28,800 --> 00:12:30,599 opportunity to pull all the data and do a much more robust 251 00:12:30,599 --> 00:12:32,767 data and do a much more robust analysis about the estimates of 252 00:12:32,767 --> 00:12:35,367 analysis about the estimates of effect for corticosteroids um 253 00:12:35,367 --> 00:12:36,734 effect for corticosteroids um and so that was a lot of work 254 00:12:36,734 --> 00:12:38,599 and so that was a lot of work in rapid work because what we 255 00:12:38,599 --> 00:12:41,700 in rapid work because what we wanted to do with the WHO is to 256 00:12:41,700 --> 00:12:44,734 wanted to do with the WHO is to provide trustworthy transparent 257 00:12:44,734 --> 00:12:45,934 provide trustworthy transparent guidance and by trustworthy, it 258 00:12:45,934 --> 00:12:47,300 guidance and by trustworthy, it means you believe the process 259 00:12:47,300 --> 00:12:47,934 means you believe the process that we went through to write 260 00:12:47,934 --> 00:12:49,667 that we went through to write the guidance and so no longer 261 00:12:49,667 --> 00:12:51,433 the guidance and so no longer will we. Face of the pandemic 262 00:12:51,433 --> 00:12:52,500 will we. Face of the pandemic where we didn’t have the 263 00:12:52,500 --> 00:12:53,700 where we didn’t have the evidence now we actually had 264 00:12:53,700 --> 00:12:55,300 evidence now we actually had evidence but now specific 265 00:12:55,300 --> 00:12:56,867 evidence but now specific disease, not based on previous 266 00:12:56,867 --> 00:12:59,200 disease, not based on previous diseases that estimations 267 00:12:59,200 --> 00:13:00,700 diseases that estimations previous uh practice, but 268 00:13:00,700 --> 00:13:02,300 previous uh practice, but actually something specific to 269 00:13:02,300 --> 00:13:04,933 actually something specific to this disease. so exactly so. so 270 00:13:04,933 --> 00:13:06,267 this disease. so exactly so. so then you know. so then the 271 00:13:06,267 --> 00:13:07,700 then you know. so then the methods changed. So then we 272 00:13:07,700 --> 00:13:09,533 methods changed. So then we went through a very strict 273 00:13:09,533 --> 00:13:12,166 went through a very strict process at WO you know WHO as 274 00:13:12,166 --> 00:13:13,700 process at WO you know WHO as every as I think most people 275 00:13:13,700 --> 00:13:14,666 every as I think most people know you know, develops a lot 276 00:13:14,666 --> 00:13:16,333 know you know, develops a lot of norms and standards and 277 00:13:16,333 --> 00:13:17,700 of norms and standards and develops guidelines, according 278 00:13:17,700 --> 00:13:19,233 develops guidelines, according to a very strict protocol 279 00:13:19,233 --> 00:13:20,966 to a very strict protocol normally. Here take about one 280 00:13:20,966 --> 00:13:23,400 normally. Here take about one or 2 years to develop because 281 00:13:23,400 --> 00:13:24,866 or 2 years to develop because they wait we wait for the 282 00:13:24,866 --> 00:13:27,266 they wait we wait for the trials to finish to get peer 283 00:13:27,266 --> 00:13:28,667 trials to finish to get peer reviewed to publish and then we 284 00:13:28,667 --> 00:13:31,133 reviewed to publish and then we go on a process developing a 285 00:13:31,133 --> 00:13:32,599 go on a process developing a guideline development panel 286 00:13:32,599 --> 00:13:35,267 guideline development panel that looks at the evidence and 287 00:13:35,267 --> 00:13:36,533 that looks at the evidence and then formulates the 288 00:13:36,533 --> 00:13:37,500 then formulates the recommendation and this 289 00:13:37,500 --> 00:13:38,934 recommendation and this process. I think if we would 290 00:13:38,934 --> 00:13:40,467 process. I think if we would ask our colleagues from quality 291 00:13:40,467 --> 00:13:41,267 ask our colleagues from quality norms and standards can say it 292 00:13:41,267 --> 00:13:43,267 norms and standards can say it takes up to 2 years so we don’t 293 00:13:43,267 --> 00:13:44,599 takes up to 2 years so we don’t have 2 years and of course we 294 00:13:44,599 --> 00:13:45,500 have 2 years and of course we weren’t going to do that. So we 295 00:13:45,500 --> 00:13:46,999 weren’t going to do that. So we may we decided to go on a path 296 00:13:46,999 --> 00:13:48,667 may we decided to go on a path of the living guidance, which 297 00:13:48,667 --> 00:13:50,000 of the living guidance, which means we’re gonna go in this 298 00:13:50,000 --> 00:13:51,667 means we’re gonna go in this robust manner. So do the same 299 00:13:51,667 --> 00:13:52,633 robust manner. So do the same thing get the evidence, which 300 00:13:52,633 --> 00:13:55,833 thing get the evidence, which is why? Coordinated the WHO 301 00:13:55,833 --> 00:13:58,733 is why? Coordinated the WHO react um is the rapid evidence 302 00:13:58,733 --> 00:14:01,567 react um is the rapid evidence appraisal of therapeutics and 303 00:14:01,567 --> 00:14:03,601 appraisal of therapeutics and uh, and that was what we 304 00:14:03,601 --> 00:14:05,000 uh, and that was what we coordinated for the prospective 305 00:14:05,000 --> 00:14:06,233 coordinated for the prospective analysis that has been 306 00:14:06,233 --> 00:14:08,499 analysis that has been published today in Jama that 307 00:14:08,499 --> 00:14:09,267 published today in Jama that takes the data from the seven 308 00:14:09,267 --> 00:14:10,934 takes the data from the seven other trials we brought 309 00:14:10,934 --> 00:14:13,267 other trials we brought together the evidence um in the 310 00:14:13,267 --> 00:14:14,533 together the evidence um in the meta analysis that we presented 311 00:14:14,533 --> 00:14:15,700 meta analysis that we presented this to the guideline 312 00:14:15,700 --> 00:14:17,534 this to the guideline development panel, which is an 313 00:14:17,534 --> 00:14:19,100 development panel, which is an independent panel, The names of 314 00:14:19,100 --> 00:14:20,734 independent panel, The names of the panel members are in the 315 00:14:20,734 --> 00:14:21,567 the panel members are in the guidance that you’re that you 316 00:14:21,567 --> 00:14:23,667 guidance that you’re that you can see online also on the 317 00:14:23,667 --> 00:14:25,967 can see online also on the website. And this panel look at 318 00:14:25,967 --> 00:14:27,967 website. And this panel look at the evidence deliberated on the 319 00:14:27,967 --> 00:14:29,267 the evidence deliberated on the evidence and then came up with 320 00:14:29,267 --> 00:14:31,601 evidence and then came up with recommendations and I have to 321 00:14:31,601 --> 00:14:32,900 recommendations and I have to also acknowledge this isn’t you 322 00:14:32,900 --> 00:14:34,867 also acknowledge this isn’t you know this is uh a large team’s 323 00:14:34,867 --> 00:14:36,000 know this is uh a large team’s work and so I need to 324 00:14:36,000 --> 00:14:37,300 work and so I need to acknowledge our collaborators 325 00:14:37,300 --> 00:14:42,166 acknowledge our collaborators from um from uh from magic. uh 326 00:14:42,166 --> 00:14:43,500 from um from uh from magic. uh that’s the magic ecosystem that 327 00:14:43,500 --> 00:14:45,166 that’s the magic ecosystem that is helping us with the 328 00:14:45,166 --> 00:14:46,500 is helping us with the methodology support in order to 329 00:14:46,500 --> 00:14:47,833 methodology support in order to develop the guidelines faster 330 00:14:47,833 --> 00:14:49,601 develop the guidelines faster and also Jonathan Stern, who is 331 00:14:49,601 --> 00:14:52,233 and also Jonathan Stern, who is the methodology from the um. 332 00:14:52,233 --> 00:14:53,466 the methodology from the um. prospective analysis so again 333 00:14:53,466 --> 00:14:54,700 prospective analysis so again just to acknowledge your so 334 00:14:54,700 --> 00:14:56,233 just to acknowledge your so many players here that um 335 00:14:56,233 --> 00:14:58,467 many players here that um contributed to this to this big 336 00:14:58,467 --> 00:15:00,599 contributed to this to this big effort so fast forward. Is 337 00:15:00,599 --> 00:15:02,334 effort so fast forward. Is developed and what we found and 338 00:15:02,334 --> 00:15:03,833 developed and what we found and what the final recommendations 339 00:15:03,833 --> 00:15:07,033 what the final recommendations uh say are relatively to 340 00:15:07,033 --> 00:15:07,833 uh say are relatively to recommendations so all this 341 00:15:07,833 --> 00:15:08,633 recommendations so all this work for two recommendations 342 00:15:08,633 --> 00:15:10,233 work for two recommendations and I’ll just read them because 343 00:15:10,233 --> 00:15:13,300 and I’ll just read them because it’s better to read a strong 344 00:15:13,300 --> 00:15:14,867 it’s better to read a strong recommendation for steroids 345 00:15:14,867 --> 00:15:15,667 recommendation for steroids systemic steroids. That means 346 00:15:15,667 --> 00:15:17,433 systemic steroids. That means uh steroids either oral 347 00:15:17,433 --> 00:15:22,999 uh steroids either oral steroids or through the IV um 348 00:15:22,999 --> 00:15:24,767 steroids or through the IV um uh impatience with severe and 349 00:15:24,767 --> 00:15:26,367 uh impatience with severe and critical cot. So that’s the 350 00:15:26,367 --> 00:15:28,333 critical cot. So that’s the first recommendation and the 351 00:15:28,333 --> 00:15:30,467 first recommendation and the reason we made. Recommendation 352 00:15:30,467 --> 00:15:32,800 reason we made. Recommendation was because the evidence shows 353 00:15:32,800 --> 00:15:35,700 was because the evidence shows that if you give uh 354 00:15:35,700 --> 00:15:36,934 that if you give uh corticosteroids you will have 355 00:15:36,934 --> 00:15:39,667 corticosteroids you will have and I’m going to different 356 00:15:39,667 --> 00:15:43,100 and I’m going to different numbers so. 87 fewer deaths per 357 00:15:43,100 --> 00:15:45,267 numbers so. 87 fewer deaths per 1000 patients if that would 358 00:15:45,267 --> 00:15:46,700 1000 patients if that would that make sense to you so those 359 00:15:46,700 --> 00:15:48,500 that make sense to you so those are the lives kind of save so 360 00:15:48,500 --> 00:15:50,000 are the lives kind of save so you have fewer deaths simpler. 361 00:15:50,000 --> 00:15:51,633 you have fewer deaths simpler. That’s around nine and 100 yes 362 00:15:51,633 --> 00:15:53,366 That’s around nine and 100 yes and of the sickest patients of 363 00:15:53,366 --> 00:15:56,633 and of the sickest patients of the sickest patients. Yeah. So 364 00:15:56,633 --> 00:15:58,099 the sickest patients. Yeah. So that’s the absolute reduction 365 00:15:58,099 --> 00:15:59,399 that’s the absolute reduction the second recommend um and so 366 00:15:59,399 --> 00:16:01,534 the second recommend um and so that’s in the sickest patients. 367 00:16:01,534 --> 00:16:03,566 that’s in the sickest patients. So that’s something that 368 00:16:03,566 --> 00:16:04,900 So that’s something that clinicians who are caring for 369 00:16:04,900 --> 00:16:06,234 clinicians who are caring for patients with Kobe should do 370 00:16:06,234 --> 00:16:07,866 patients with Kobe should do for those who are the sickest 371 00:16:07,866 --> 00:16:10,734 for those who are the sickest who are taking an oxygen um 372 00:16:10,734 --> 00:16:13,599 who are taking an oxygen um either through AV. Or through a 373 00:16:13,599 --> 00:16:15,267 either through AV. Or through a mask, that’s right, yeah and we 374 00:16:15,267 --> 00:16:17,033 mask, that’s right, yeah and we have and should be taking and 375 00:16:17,033 --> 00:16:18,100 have and should be taking and the guidelines. It’s very clear 376 00:16:18,100 --> 00:16:19,900 the guidelines. It’s very clear how we’re defining the severe 377 00:16:19,900 --> 00:16:20,999 how we’re defining the severe disease and the critical 378 00:16:20,999 --> 00:16:22,134 disease and the critical disease and both of those 379 00:16:22,134 --> 00:16:23,700 disease and both of those subgroups, both of those groups 380 00:16:23,700 --> 00:16:24,934 subgroups, both of those groups of patients and these are 381 00:16:24,934 --> 00:16:27,000 of patients and these are generally patients who would be 382 00:16:27,000 --> 00:16:27,667 generally patients who would be hospitalized and these are 383 00:16:27,667 --> 00:16:30,133 hospitalized and these are under the medical care medical 384 00:16:30,133 --> 00:16:31,267 under the medical care medical physician. Yeah, So I wanna be 385 00:16:31,267 --> 00:16:32,000 physician. Yeah, So I wanna be clear cuz the second 386 00:16:32,000 --> 00:16:35,001 clear cuz the second recommendation is it is very 387 00:16:35,001 --> 00:16:37,467 recommendation is it is very important as well. This was a 388 00:16:37,467 --> 00:16:39,466 important as well. This was a conditional recommendation not 389 00:16:39,466 --> 00:16:40,933 conditional recommendation not to use corticosteroid so 390 00:16:40,933 --> 00:16:41,467 to use corticosteroid so against the use of 391 00:16:41,467 --> 00:16:43,333 against the use of corticosteroids in patients 392 00:16:43,333 --> 00:16:45,467 corticosteroids in patients with non severe cot. So that 393 00:16:45,467 --> 00:16:47,599 with non severe cot. So that means the. That are um have 394 00:16:47,599 --> 00:16:49,566 means the. That are um have mild, you know they may have 395 00:16:49,566 --> 00:16:51,633 mild, you know they may have symptoms um and then maybe 396 00:16:51,633 --> 00:16:52,934 symptoms um and then maybe those symptoms are bothersome. 397 00:16:52,934 --> 00:16:53,933 those symptoms are bothersome. You know not to discount 398 00:16:53,933 --> 00:16:55,067 You know not to discount symptoms. you know symptoms of 399 00:16:55,067 --> 00:16:55,967 symptoms. you know symptoms of mild disease because you know 400 00:16:55,967 --> 00:16:57,599 mild disease because you know those can be bother but they 401 00:16:57,599 --> 00:16:59,966 those can be bother but they don’t have physiological signs 402 00:16:59,966 --> 00:17:02,133 don’t have physiological signs and I say that in a scientific 403 00:17:02,133 --> 00:17:04,599 and I say that in a scientific way physiological signs of um 404 00:17:04,599 --> 00:17:06,366 way physiological signs of um of an inflammatory response 405 00:17:06,366 --> 00:17:08,599 of an inflammatory response that’s leading to respiratory 406 00:17:08,599 --> 00:17:11,700 that’s leading to respiratory distress um so and the reason 407 00:17:11,700 --> 00:17:12,700 distress um so and the reason and the reason we said. That 408 00:17:12,700 --> 00:17:15,100 and the reason we said. That was because there was a concern 409 00:17:15,100 --> 00:17:17,267 was because there was a concern for harm. So that so the data 410 00:17:17,267 --> 00:17:19,200 for harm. So that so the data was less clear on this, but 411 00:17:19,200 --> 00:17:22,166 was less clear on this, but there was a concern for harm in 412 00:17:22,166 --> 00:17:23,433 there was a concern for harm in that subgroups. So then, of 413 00:17:23,433 --> 00:17:24,833 that subgroups. So then, of course, uh we would recommend 414 00:17:24,833 --> 00:17:27,100 course, uh we would recommend not to use it in those patients 415 00:17:27,100 --> 00:17:27,833 not to use it in those patients and each time you’ve been 416 00:17:27,833 --> 00:17:29,534 and each time you’ve been careful to say not to use it in 417 00:17:29,534 --> 00:17:31,134 careful to say not to use it in those patients. so you’re 418 00:17:31,134 --> 00:17:31,933 those patients. so you’re talking about what physicians 419 00:17:31,933 --> 00:17:34,333 talking about what physicians should consider using with 420 00:17:34,333 --> 00:17:35,700 should consider using with their patients. This isn’t for 421 00:17:35,700 --> 00:17:37,067 their patients. This isn’t for even though we’re doing this 422 00:17:37,067 --> 00:17:38,333 even though we’re doing this Facebook live for the general 423 00:17:38,333 --> 00:17:40,533 Facebook live for the general public and everyone’s free to 424 00:17:40,533 --> 00:17:42,033 public and everyone’s free to watch and ask questions. This 425 00:17:42,033 --> 00:17:43,700 watch and ask questions. This guide is not for us to take 426 00:17:43,700 --> 00:17:44,900 guide is not for us to take home and do or not do 427 00:17:44,900 --> 00:17:46,800 home and do or not do ourselves. It’s really this is 428 00:17:46,800 --> 00:17:49,500 ourselves. It’s really this is guidance it’s. People who are 429 00:17:49,500 --> 00:17:51,166 guidance it’s. People who are in the hospital setting and 430 00:17:51,166 --> 00:17:52,633 in the hospital setting and caring for sick sick the 431 00:17:52,633 --> 00:17:53,667 caring for sick sick the sickest of patients had a good 432 00:17:53,667 --> 00:17:55,700 sickest of patients had a good summary. Yeah at that, And if 433 00:17:55,700 --> 00:17:56,900 summary. Yeah at that, And if you look clearly, I mean the 434 00:17:56,900 --> 00:17:58,199 you look clearly, I mean the guidance is available online, 435 00:17:58,199 --> 00:18:00,399 guidance is available online, but it is for clinicians and 436 00:18:00,399 --> 00:18:02,267 but it is for clinicians and then as well as health care 437 00:18:02,267 --> 00:18:03,667 then as well as health care decision makers and policy 438 00:18:03,667 --> 00:18:06,100 decision makers and policy makers because when we issue 439 00:18:06,100 --> 00:18:07,667 makers because when we issue guidance, especially strong 440 00:18:07,667 --> 00:18:08,000 guidance, especially strong recommendations, those are 441 00:18:08,000 --> 00:18:10,166 recommendations, those are things that policy makers can 442 00:18:10,166 --> 00:18:11,467 things that policy makers can you know can do in order to 443 00:18:11,467 --> 00:18:15,001 you know can do in order to make this drugs? You know the 444 00:18:15,001 --> 00:18:16,367 make this drugs? You know the intervention available to its 445 00:18:16,367 --> 00:18:18,933 intervention available to its population. Um can we just? We 446 00:18:18,933 --> 00:18:19,967 population. Um can we just? We just one more time because we 447 00:18:19,967 --> 00:18:21,000 just one more time because we put out a lot of guidance and 448 00:18:21,000 --> 00:18:22,799 put out a lot of guidance and we put out a lot of advice and 449 00:18:22,799 --> 00:18:24,133 we put out a lot of advice and so just to emphasize what you 450 00:18:24,133 --> 00:18:25,467 so just to emphasize what you said in the clinical guidance 451 00:18:25,467 --> 00:18:26,867 said in the clinical guidance that came out today is meant 452 00:18:26,867 --> 00:18:28,133 that came out today is meant for clinicians and it’s meant 453 00:18:28,133 --> 00:18:29,933 for clinicians and it’s meant for the decision makers who are 454 00:18:29,933 --> 00:18:30,666 for the decision makers who are making decisions about the 455 00:18:30,666 --> 00:18:32,267 making decisions about the treatment of patients. so it’s 456 00:18:32,267 --> 00:18:34,033 treatment of patients. so it’s not for someone to go over the 457 00:18:34,033 --> 00:18:34,967 not for someone to go over the counter and choose to do it 458 00:18:34,967 --> 00:18:36,166 counter and choose to do it themselves. It’s for those who 459 00:18:36,166 --> 00:18:38,633 themselves. It’s for those who are caring for a sick 460 00:18:38,633 --> 00:18:40,100 are caring for a sick individual and as you’ve just 461 00:18:40,100 --> 00:18:42,000 individual and as you’ve just said the recommendations for 462 00:18:42,000 --> 00:18:44,233 said the recommendations for severe patients to use or to be 463 00:18:44,233 --> 00:18:45,433 severe patients to use or to be recommended to use but not for 464 00:18:45,433 --> 00:18:46,667 recommended to use but not for the mild patients. so I just 465 00:18:46,667 --> 00:18:47,734 the mild patients. so I just wanted to emphasize that again 466 00:18:47,734 --> 00:18:49,266 wanted to emphasize that again cuz. Sometimes it is for 467 00:18:49,266 --> 00:18:50,866 cuz. Sometimes it is for individuals, but this one is 468 00:18:50,866 --> 00:18:52,100 individuals, but this one is specifically for clinicians and 469 00:18:52,100 --> 00:18:53,767 specifically for clinicians and decision makers and another 470 00:18:53,767 --> 00:18:55,467 decision makers and another side of that. It’s something 471 00:18:55,467 --> 00:18:56,233 side of that. It’s something you mentioned off the top as 472 00:18:56,233 --> 00:18:57,833 you mentioned off the top as well that dexamethasone and 473 00:18:57,833 --> 00:18:59,666 well that dexamethasone and other corticosteroids are 474 00:18:59,666 --> 00:19:01,466 other corticosteroids are actually inexpensive and widely 475 00:19:01,466 --> 00:19:02,000 actually inexpensive and widely available so they’re actually 476 00:19:02,000 --> 00:19:04,199 available so they’re actually there is a risk that people 477 00:19:04,199 --> 00:19:05,766 there is a risk that people could think this is something 478 00:19:05,766 --> 00:19:06,900 could think this is something that I can do because you can 479 00:19:06,900 --> 00:19:08,300 that I can do because you can actually go and buy this drug. 480 00:19:08,300 --> 00:19:11,367 actually go and buy this drug. It’s not something that’s new 481 00:19:11,367 --> 00:19:12,867 It’s not something that’s new itself from being developed 482 00:19:12,867 --> 00:19:13,667 itself from being developed somewhere in the lab and then 483 00:19:13,667 --> 00:19:15,933 somewhere in the lab and then scare supply in a good way. 484 00:19:15,933 --> 00:19:17,399 scare supply in a good way. It’s actually widely available 485 00:19:17,399 --> 00:19:19,267 It’s actually widely available to. Physicians around the world 486 00:19:19,267 --> 00:19:21,667 to. Physicians around the world so that those caring for 487 00:19:21,667 --> 00:19:23,333 so that those caring for patients in hospital can have 488 00:19:23,333 --> 00:19:25,500 patients in hospital can have access to it and WHO actually 489 00:19:25,500 --> 00:19:27,134 access to it and WHO actually increased access your 490 00:19:27,134 --> 00:19:28,300 increased access your explaining that little bit to 491 00:19:28,300 --> 00:19:29,700 explaining that little bit to me the other day as well that 492 00:19:29,700 --> 00:19:30,799 me the other day as well that although it’s widely 493 00:19:30,799 --> 00:19:32,266 although it’s widely accessible, there are some 494 00:19:32,266 --> 00:19:33,767 accessible, there are some exceptions. There’s some places 495 00:19:33,767 --> 00:19:35,100 exceptions. There’s some places where it’s not accessible in 496 00:19:35,100 --> 00:19:37,834 where it’s not accessible in WHO has um a mass doses of 497 00:19:37,834 --> 00:19:40,233 WHO has um a mass doses of dexamethasone for that purpose. 498 00:19:40,233 --> 00:19:43,067 dexamethasone for that purpose. Yeah. So exactly I think this 499 00:19:43,067 --> 00:19:45,433 Yeah. So exactly I think this is for clinicians but as a 500 00:19:45,433 --> 00:19:46,900 is for clinicians but as a patient or as a person in the 501 00:19:46,900 --> 00:19:48,000 patient or as a person in the community, you should be 502 00:19:48,000 --> 00:19:49,399 community, you should be informed you know cuz you will 503 00:19:49,399 --> 00:19:50,967 informed you know cuz you will be talking with your clinician 504 00:19:50,967 --> 00:19:52,500 be talking with your clinician when you go see and if you know 505 00:19:52,500 --> 00:19:55,433 when you go see and if you know you were. One was to have 506 00:19:55,433 --> 00:19:57,400 you were. One was to have severe disease or or have you 507 00:19:57,400 --> 00:19:58,999 severe disease or or have you know critical disease. then 508 00:19:58,999 --> 00:20:01,100 know critical disease. then this is a this is a therapy 509 00:20:01,100 --> 00:20:02,633 this is a this is a therapy that should be strongly 510 00:20:02,633 --> 00:20:03,899 that should be strongly considered the clinician should 511 00:20:03,899 --> 00:20:05,500 considered the clinician should strongly consider it for for 512 00:20:05,500 --> 00:20:07,166 strongly consider it for for that patient um so as an 513 00:20:07,166 --> 00:20:09,100 that patient um so as an informed patient person in the 514 00:20:09,100 --> 00:20:09,967 informed patient person in the community or for your loved 515 00:20:09,967 --> 00:20:11,100 community or for your loved one, this is it’s an important 516 00:20:11,100 --> 00:20:14,734 one, this is it’s an important piece of information um WO we 517 00:20:14,734 --> 00:20:19,466 piece of information um WO we did procure uh um dexamethasone 518 00:20:19,466 --> 00:20:22,600 did procure uh um dexamethasone uh in anticipation of this uh 519 00:20:22,600 --> 00:20:24,367 uh in anticipation of this uh you know that this was gonna be 520 00:20:24,367 --> 00:20:28,166 you know that this was gonna be has is a life-saving drug and. 521 00:20:28,166 --> 00:20:29,134 has is a life-saving drug and. So has the potential even 522 00:20:29,134 --> 00:20:30,567 So has the potential even though it’s widely available 523 00:20:30,567 --> 00:20:32,133 though it’s widely available like anything else during the 524 00:20:32,133 --> 00:20:34,566 like anything else during the pandemic the markets uh has a 525 00:20:34,566 --> 00:20:36,234 pandemic the markets uh has a potential to become scarce, 526 00:20:36,234 --> 00:20:38,900 potential to become scarce, potentially to certain um 527 00:20:38,900 --> 00:20:40,867 potentially to certain um communities or member states uh 528 00:20:40,867 --> 00:20:42,633 communities or member states uh based on the way the markets 529 00:20:42,633 --> 00:20:43,567 based on the way the markets and the procurement patterns 530 00:20:43,567 --> 00:20:44,900 and the procurement patterns around the world. so so just to 531 00:20:44,900 --> 00:20:48,133 around the world. so so just to ensure that there was a stock 532 00:20:48,133 --> 00:20:49,433 ensure that there was a stock ready to give to those um 533 00:20:49,433 --> 00:20:52,467 ready to give to those um vulnerable communities that may 534 00:20:52,467 --> 00:20:55,034 vulnerable communities that may not have access uh we are um we 535 00:20:55,034 --> 00:20:56,533 not have access uh we are um we are currently we have sent the 536 00:20:56,533 --> 00:20:57,833 are currently we have sent the information out to our regional 537 00:20:57,833 --> 00:20:59,100 information out to our regional offices that will disperse this 538 00:20:59,100 --> 00:21:01,667 offices that will disperse this to the. Is to ensure that 539 00:21:01,667 --> 00:21:03,100 to the. Is to ensure that anyone who’s not potentially 540 00:21:03,100 --> 00:21:05,134 anyone who’s not potentially doesn’t have some or has a low 541 00:21:05,134 --> 00:21:08,033 doesn’t have some or has a low stock um can we can assist with 542 00:21:08,033 --> 00:21:10,100 stock um can we can assist with procurement and distribution 543 00:21:10,100 --> 00:21:12,000 procurement and distribution just a few things a few points 544 00:21:12,000 --> 00:21:14,100 just a few things a few points of clarification Uh we’re 545 00:21:14,100 --> 00:21:15,267 of clarification Uh we’re sometimes asked why we’re not 546 00:21:15,267 --> 00:21:16,667 sometimes asked why we’re not wearing masks when we’re 547 00:21:16,667 --> 00:21:17,566 wearing masks when we’re sitting together like this, 548 00:21:17,566 --> 00:21:19,566 sitting together like this, we’re following WHO guidance um 549 00:21:19,566 --> 00:21:21,300 we’re following WHO guidance um and what we know from from the 550 00:21:21,300 --> 00:21:23,200 and what we know from from the evidence so far um if you’re 551 00:21:23,200 --> 00:21:25,034 evidence so far um if you’re able to be at least a meter 552 00:21:25,034 --> 00:21:27,033 able to be at least a meter apart from other people and if 553 00:21:27,033 --> 00:21:28,933 apart from other people and if you’re not in a in a clinical 554 00:21:28,933 --> 00:21:30,833 you’re not in a in a clinical setting um WHO doesn’t 555 00:21:30,833 --> 00:21:33,666 setting um WHO doesn’t recommend wearing a. It’s not 556 00:21:33,666 --> 00:21:35,633 recommend wearing a. It’s not needed um so good ventilation 557 00:21:35,633 --> 00:21:36,133 needed um so good ventilation as well and we have good 558 00:21:36,133 --> 00:21:37,799 as well and we have good ventilation. It’s the door is 559 00:21:37,799 --> 00:21:39,100 ventilation. It’s the door is open and the air is flowing 560 00:21:39,100 --> 00:21:40,133 open and the air is flowing through and that’s another 561 00:21:40,133 --> 00:21:41,566 through and that’s another important part of of 562 00:21:41,566 --> 00:21:42,933 important part of of controlling your space, but we 563 00:21:42,933 --> 00:21:44,133 controlling your space, but we do make sure that we’re far 564 00:21:44,133 --> 00:21:45,133 do make sure that we’re far apart and that’s why we’re not 565 00:21:45,133 --> 00:21:46,600 apart and that’s why we’re not wearing masks the other thing. 566 00:21:46,600 --> 00:21:47,700 wearing masks the other thing. Sometimes people ask about this 567 00:21:47,700 --> 00:21:49,100 Sometimes people ask about this room. This is called the India 568 00:21:49,100 --> 00:21:50,500 room. This is called the India Room and a lot of the 569 00:21:50,500 --> 00:21:51,866 Room and a lot of the decorations here. Most of the 570 00:21:51,866 --> 00:21:53,433 decorations here. Most of the decorations were donated by 571 00:21:53,433 --> 00:21:55,467 decorations were donated by India to WHO when when this 572 00:21:55,467 --> 00:21:59,399 India to WHO when when this building was opened um a few uh 573 00:21:59,399 --> 00:22:00,999 building was opened um a few uh oh and one more thing. uh this 574 00:22:00,999 --> 00:22:02,867 oh and one more thing. uh this is Facebook. And you’re meant 575 00:22:02,867 --> 00:22:04,467 is Facebook. And you’re meant to be able to ask us questions 576 00:22:04,467 --> 00:22:07,433 to be able to ask us questions so if you are on uh Twitter, 577 00:22:07,433 --> 00:22:09,966 so if you are on uh Twitter, you can ask us questions using 578 00:22:09,966 --> 00:22:12,167 you can ask us questions using #ask WHO and on the other 579 00:22:12,167 --> 00:22:13,500 #ask WHO and on the other platforms, Facebook LinkedIn 580 00:22:13,500 --> 00:22:14,933 platforms, Facebook LinkedIn and YouTube You can leave your 581 00:22:14,933 --> 00:22:16,100 and YouTube You can leave your question in a comment and so we 582 00:22:16,100 --> 00:22:17,867 question in a comment and so we have some questions already. um 583 00:22:17,867 --> 00:22:19,100 have some questions already. um I don’t know if you can pull 584 00:22:19,100 --> 00:22:20,666 I don’t know if you can pull this up quickly. Janet Do you 585 00:22:20,666 --> 00:22:21,800 this up quickly. Janet Do you know how many patients in the 586 00:22:21,800 --> 00:22:23,933 know how many patients in the end were involved in this trial 587 00:22:23,933 --> 00:22:25,267 end were involved in this trial if you added the ones from all 588 00:22:25,267 --> 00:22:28,200 if you added the ones from all the different trials a range of 589 00:22:28,200 --> 00:22:29,967 the different trials a range of 9000 is it is that some 590 00:22:29,967 --> 00:22:31,067 9000 is it is that some somewhere around the range of. 591 00:22:31,067 --> 00:22:32,900 somewhere around the range of. Who are involved? Yes, I can 592 00:22:32,900 --> 00:22:36,000 Who are involved? Yes, I can pull that up um in the analysis 593 00:22:36,000 --> 00:22:37,066 pull that up um in the analysis the prospective analysis 594 00:22:37,066 --> 00:22:40,600 the prospective analysis there’s 1007. 1700. 1703 and 595 00:22:40,600 --> 00:22:43,466 there’s 1007. 1700. 1703 and then if we add on the uh 596 00:22:43,466 --> 00:22:45,767 then if we add on the uh recovery trial, I’m sorry that 597 00:22:45,767 --> 00:22:46,900 recovery trial, I’m sorry that I don’t have everything off the 598 00:22:46,900 --> 00:22:49,634 I don’t have everything off the top of my head. There were 599 00:22:49,634 --> 00:22:53,734 top of my head. There were 7000. 7100. 7184 patients so in 600 00:22:53,734 --> 00:22:56,200 7000. 7100. 7184 patients so in total the panel the GDG panel 601 00:22:56,200 --> 00:22:58,700 total the panel the GDG panel from WHO that we convened a saw 602 00:22:58,700 --> 00:23:00,700 from WHO that we convened a saw eight trials um evidence from 603 00:23:00,700 --> 00:23:04,233 eight trials um evidence from eight trials 7184 patients now 604 00:23:04,233 --> 00:23:05,700 eight trials 7184 patients now enroll. So that was one 605 00:23:05,700 --> 00:23:07,267 enroll. So that was one question we got the reason 606 00:23:07,267 --> 00:23:08,666 question we got the reason we’re spending a lot of time 607 00:23:08,666 --> 00:23:10,000 we’re spending a lot of time explaining this is we get a lot 608 00:23:10,000 --> 00:23:12,000 explaining this is we get a lot of questions about how does WHO 609 00:23:12,000 --> 00:23:12,900 of questions about how does WHO come up with this guidance. 610 00:23:12,900 --> 00:23:14,267 come up with this guidance. What is it based on where does 611 00:23:14,267 --> 00:23:15,700 What is it based on where does it come from and that’s why we 612 00:23:15,700 --> 00:23:16,599 it come from and that’s why we wanted to spend a bit of time 613 00:23:16,599 --> 00:23:18,167 wanted to spend a bit of time off the top explaining this 614 00:23:18,167 --> 00:23:19,400 off the top explaining this because this is really 615 00:23:19,400 --> 00:23:20,667 because this is really important. This is this is life 616 00:23:20,667 --> 00:23:23,200 important. This is this is life saving advice that we give and 617 00:23:23,200 --> 00:23:27,100 saving advice that we give and we can’t be wrong basically um 618 00:23:27,100 --> 00:23:28,833 we can’t be wrong basically um Maria can you make the leap 619 00:23:28,833 --> 00:23:29,900 Maria can you make the leap Then to the other guidance? we 620 00:23:29,900 --> 00:23:31,267 Then to the other guidance? we give it’s not clinical 621 00:23:31,267 --> 00:23:32,601 give it’s not clinical guidance. It’s not a done 622 00:23:32,601 --> 00:23:33,633 guidance. It’s not a done exactly the same way, but how 623 00:23:33,633 --> 00:23:35,067 exactly the same way, but how do we develop an 624 00:23:35,067 --> 00:23:36,166 do we develop an evidence-based? How do we 625 00:23:36,166 --> 00:23:37,933 evidence-based? How do we develop the information that 626 00:23:37,933 --> 00:23:39,267 develop the information that informs what advice we give 627 00:23:39,267 --> 00:23:41,367 informs what advice we give people. Yes, so thanks Nico. So 628 00:23:41,367 --> 00:23:43,267 people. Yes, so thanks Nico. So yes, so we are an evidence 629 00:23:43,267 --> 00:23:44,567 yes, so we are an evidence based organization. We are 630 00:23:44,567 --> 00:23:47,000 based organization. We are driven by science um and so we 631 00:23:47,000 --> 00:23:49,167 driven by science um and so we have a very robust process for 632 00:23:49,167 --> 00:23:50,300 have a very robust process for the development of guidance and 633 00:23:50,300 --> 00:23:51,700 the development of guidance and in the beginning as Janet has 634 00:23:51,700 --> 00:23:53,266 in the beginning as Janet has said, um actually our first 635 00:23:53,266 --> 00:23:54,899 said, um actually our first package of guidance for 636 00:23:54,899 --> 00:23:55,833 package of guidance for covid-nineteen before it was 637 00:23:55,833 --> 00:23:57,267 covid-nineteen before it was even named Covid-nineteen was 638 00:23:57,267 --> 00:23:58,267 even named Covid-nineteen was issued on the tenth of the 639 00:23:58,267 --> 00:24:00,667 issued on the tenth of the eleventh and the twelfth of 640 00:24:00,667 --> 00:24:01,500 eleventh and the twelfth of January um and that guidance 641 00:24:01,500 --> 00:24:03,266 January um and that guidance was based on our experience 642 00:24:03,266 --> 00:24:03,833 was based on our experience with other Corona viruses. 643 00:24:03,833 --> 00:24:06,367 with other Corona viruses. Other respiratory pathogens 644 00:24:06,367 --> 00:24:07,966 Other respiratory pathogens mears um, and we issued that 645 00:24:07,966 --> 00:24:09,534 mears um, and we issued that and that is constantly being 646 00:24:09,534 --> 00:24:11,234 and that is constantly being updated and the way that we do 647 00:24:11,234 --> 00:24:12,534 updated and the way that we do that is we look at the evidence 648 00:24:12,534 --> 00:24:13,966 that is we look at the evidence we look at scientific studies 649 00:24:13,966 --> 00:24:15,799 we look at scientific studies that are being published. 650 00:24:15,799 --> 00:24:17,666 that are being published. They’re not published on the 651 00:24:17,666 --> 00:24:19,601 They’re not published on the specific pathogen we look for 652 00:24:19,601 --> 00:24:20,066 specific pathogen we look for similar pathogens. so, for 653 00:24:20,066 --> 00:24:22,000 similar pathogens. so, for example, we didn’t have much 654 00:24:22,000 --> 00:24:23,134 example, we didn’t have much evidence specifically on the 655 00:24:23,134 --> 00:24:25,033 evidence specifically on the stars COtwo virus, but we look 656 00:24:25,033 --> 00:24:26,534 stars COtwo virus, but we look at Cyrus Colby one studies we 657 00:24:26,534 --> 00:24:27,966 at Cyrus Colby one studies we look at influenza studies. We 658 00:24:27,966 --> 00:24:30,000 look at influenza studies. We look at me, Kobe studies and we 659 00:24:30,000 --> 00:24:31,599 look at me, Kobe studies and we pull that together and then we 660 00:24:31,599 --> 00:24:33,267 pull that together and then we work with huge numbers of 661 00:24:33,267 --> 00:24:34,500 work with huge numbers of scientists all over the world. 662 00:24:34,500 --> 00:24:35,867 scientists all over the world. so we put together this 663 00:24:35,867 --> 00:24:36,867 so we put together this international networks, Janet 664 00:24:36,867 --> 00:24:38,267 international networks, Janet is leading on the clinical 665 00:24:38,267 --> 00:24:39,566 is leading on the clinical side. We have laboratory 666 00:24:39,566 --> 00:24:41,267 side. We have laboratory networks, EY networks um 667 00:24:41,267 --> 00:24:42,300 networks, EY networks um infection prevention and 668 00:24:42,300 --> 00:24:44,633 infection prevention and control networks, and we bring 669 00:24:44,633 --> 00:24:45,967 control networks, and we bring together specialist. All over 670 00:24:45,967 --> 00:24:47,566 together specialist. All over the world, we hold these 671 00:24:47,566 --> 00:24:49,066 the world, we hold these teleconference where we have a 672 00:24:49,066 --> 00:24:50,700 teleconference where we have a direct exchange of information 673 00:24:50,700 --> 00:24:51,867 direct exchange of information and what Janet highlighted on 674 00:24:51,867 --> 00:24:53,300 and what Janet highlighted on the clinical side is that in 675 00:24:53,300 --> 00:24:54,234 the clinical side is that in the beginning of the pandemic 676 00:24:54,234 --> 00:24:55,867 the beginning of the pandemic in January, we had clinicians 677 00:24:55,867 --> 00:24:56,900 in January, we had clinicians that we’re dealing with you 678 00:24:56,900 --> 00:24:57,466 that we’re dealing with you know there are very few 679 00:24:57,466 --> 00:24:58,866 know there are very few patients in the beginning, so 680 00:24:58,866 --> 00:25:00,533 patients in the beginning, so we had clinicians who are 681 00:25:00,533 --> 00:25:02,100 we had clinicians who are dealing directly with the stars 682 00:25:02,100 --> 00:25:03,700 dealing directly with the stars Kobe two patients talking to 683 00:25:03,700 --> 00:25:05,033 Kobe two patients talking to clinicians all across the 684 00:25:05,033 --> 00:25:06,066 clinicians all across the world, you know and that’s 685 00:25:06,066 --> 00:25:07,199 world, you know and that’s faster than any paper that can 686 00:25:07,199 --> 00:25:08,833 faster than any paper that can be published so that exchange 687 00:25:08,833 --> 00:25:10,900 be published so that exchange of information helps us 688 00:25:10,900 --> 00:25:12,500 of information helps us understand what is being used 689 00:25:12,500 --> 00:25:14,433 understand what is being used how it is being used and what 690 00:25:14,433 --> 00:25:16,399 how it is being used and what works um we gather all the. 691 00:25:16,399 --> 00:25:17,500 works um we gather all the. Published and published, We 692 00:25:17,500 --> 00:25:19,100 Published and published, We discussed it We debate it. This 693 00:25:19,100 --> 00:25:20,966 discussed it We debate it. This is a positive exchange this 694 00:25:20,966 --> 00:25:22,599 is a positive exchange this this constructive discussion 695 00:25:22,599 --> 00:25:24,900 this constructive discussion and we see how we judge the 696 00:25:24,900 --> 00:25:27,233 and we see how we judge the guidance or the evidence itself 697 00:25:27,233 --> 00:25:28,166 guidance or the evidence itself because not all studies are 698 00:25:28,166 --> 00:25:30,000 because not all studies are good. studies are high quality 699 00:25:30,000 --> 00:25:31,467 good. studies are high quality studies, so we rate them we 700 00:25:31,467 --> 00:25:33,366 studies, so we rate them we grade them um and then we see 701 00:25:33,366 --> 00:25:35,134 grade them um and then we see how that evidence is turned 702 00:25:35,134 --> 00:25:37,433 how that evidence is turned into advice um and then we 703 00:25:37,433 --> 00:25:39,067 into advice um and then we issue this in the form of these 704 00:25:39,067 --> 00:25:40,533 issue this in the form of these documents that we published on 705 00:25:40,533 --> 00:25:42,099 documents that we published on our website, but even when we 706 00:25:42,099 --> 00:25:43,534 our website, but even when we issue them, we’re constantly 707 00:25:43,534 --> 00:25:46,000 issue them, we’re constantly reviewing them all the time. 708 00:25:46,000 --> 00:25:47,500 reviewing them all the time. Not that that’s the idea that 709 00:25:47,500 --> 00:25:48,700 Not that that’s the idea that it’s living and then what you 710 00:25:48,700 --> 00:25:50,066 it’s living and then what you see is published, It’ll say 711 00:25:50,066 --> 00:25:51,567 see is published, It’ll say interim guidance at the top 712 00:25:51,567 --> 00:25:52,434 interim guidance at the top because this is something that 713 00:25:52,434 --> 00:25:54,667 because this is something that is evolving that is changing um 714 00:25:54,667 --> 00:25:55,900 is evolving that is changing um and you know someone asked me 715 00:25:55,900 --> 00:25:57,134 and you know someone asked me recently uh you know when is 716 00:25:57,134 --> 00:25:58,300 recently uh you know when is the science is going to be done 717 00:25:58,300 --> 00:25:59,434 the science is going to be done like when are you gonna be done 718 00:25:59,434 --> 00:26:00,733 like when are you gonna be done with the science. One of the 719 00:26:00,733 --> 00:26:01,534 with the science. One of the studies is gonna be done and 720 00:26:01,534 --> 00:26:02,700 studies is gonna be done and that’s not how science works 721 00:26:02,700 --> 00:26:04,567 that’s not how science works science is a process This 722 00:26:04,567 --> 00:26:06,300 science is a process This evidence gathering is a process 723 00:26:06,300 --> 00:26:07,533 evidence gathering is a process and we will always continue to 724 00:26:07,533 --> 00:26:09,067 and we will always continue to do that. and as Janet has said, 725 00:26:09,067 --> 00:26:10,734 do that. and as Janet has said, we’re so grateful to so many 726 00:26:10,734 --> 00:26:12,467 we’re so grateful to so many researchers all over the world 727 00:26:12,467 --> 00:26:14,000 researchers all over the world Clinicians front line workers 728 00:26:14,000 --> 00:26:15,567 Clinicians front line workers Public health professionals 729 00:26:15,567 --> 00:26:16,900 Public health professionals Civil society patient groups 730 00:26:16,900 --> 00:26:18,833 Civil society patient groups who are actually communicating 731 00:26:18,833 --> 00:26:19,599 who are actually communicating with us talking with us and 732 00:26:19,599 --> 00:26:20,900 with us talking with us and helping us together this to 733 00:26:20,900 --> 00:26:22,566 helping us together this to turn. Evidence that that can 734 00:26:22,566 --> 00:26:24,900 turn. Evidence that that can save lives so I’m not being 735 00:26:24,900 --> 00:26:26,566 save lives so I’m not being rude. I’m checking I have to 736 00:26:26,566 --> 00:26:27,467 rude. I’m checking I have to check my phone. that’s fine, 737 00:26:27,467 --> 00:26:28,700 check my phone. that’s fine, even while you’re talking to 738 00:26:28,700 --> 00:26:29,633 even while you’re talking to see what some of the questions 739 00:26:29,633 --> 00:26:30,667 see what some of the questions are that are coming in first 740 00:26:30,667 --> 00:26:31,900 are that are coming in first from our social media team, 741 00:26:31,900 --> 00:26:33,034 from our social media team, that’s that’s monitoring for 742 00:26:33,034 --> 00:26:35,867 that’s that’s monitoring for your questions. Um we have one 743 00:26:35,867 --> 00:26:38,866 your questions. Um we have one uh we have one on a profit left 744 00:26:38,866 --> 00:26:41,233 uh we have one on a profit left prophylactic treatment. This is 745 00:26:41,233 --> 00:26:42,934 prophylactic treatment. This is utwo via Facebook is wondering 746 00:26:42,934 --> 00:26:45,067 utwo via Facebook is wondering if there are any prophylactic 747 00:26:45,067 --> 00:26:46,567 if there are any prophylactic or basically treatments that 748 00:26:46,567 --> 00:26:47,667 or basically treatments that would prevent you from getting 749 00:26:47,667 --> 00:26:49,399 would prevent you from getting sick in the first place. Is 750 00:26:49,399 --> 00:26:51,500 sick in the first place. Is there any any evidence? Towards 751 00:26:51,500 --> 00:26:54,133 there any any evidence? Towards that at the moment we don’t 752 00:26:54,133 --> 00:26:56,099 that at the moment we don’t have any published evidence of 753 00:26:56,099 --> 00:26:58,866 have any published evidence of an effective uh uh preventive 754 00:26:58,866 --> 00:27:01,966 an effective uh uh preventive prophylactic um intervention uh 755 00:27:01,966 --> 00:27:03,867 prophylactic um intervention uh but there are many ongoing 756 00:27:03,867 --> 00:27:06,700 but there are many ongoing trials uh so we look forward to 757 00:27:06,700 --> 00:27:09,133 trials uh so we look forward to seeing the outputs um of those 758 00:27:09,133 --> 00:27:10,700 seeing the outputs um of those trials, but uh to date we don’t 759 00:27:10,700 --> 00:27:11,934 trials, but uh to date we don’t have and then that leads to 760 00:27:11,934 --> 00:27:13,300 have and then that leads to another question. We received a 761 00:27:13,300 --> 00:27:15,533 another question. We received a few times. What about Hydroxy 762 00:27:15,533 --> 00:27:17,100 few times. What about Hydroxy chlorine has it had any 763 00:27:17,100 --> 00:27:19,367 chlorine has it had any benefits that we know of either 764 00:27:19,367 --> 00:27:21,633 benefits that we know of either clinically or profit relaxing 765 00:27:21,633 --> 00:27:23,633 clinically or profit relaxing prevent. preventive. Thank you. 766 00:27:23,633 --> 00:27:26,133 prevent. preventive. Thank you. Sorry, I was coughing before 767 00:27:26,133 --> 00:27:31,367 Sorry, I was coughing before it’s full service um so we 768 00:27:31,367 --> 00:27:33,100 it’s full service um so we currently are conducting. also 769 00:27:33,100 --> 00:27:34,699 currently are conducting. also a meta analysis, which means we 770 00:27:34,699 --> 00:27:37,100 a meta analysis, which means we are synthesized the evidence of 771 00:27:37,100 --> 00:27:39,734 are synthesized the evidence of the trials that have looked at 772 00:27:39,734 --> 00:27:43,533 the trials that have looked at uh hydroxy chlorine um as an 773 00:27:43,533 --> 00:27:44,267 uh hydroxy chlorine um as an intervention and I think you 774 00:27:44,267 --> 00:27:46,066 intervention and I think you know it’s uh I don’t we don’t 775 00:27:46,066 --> 00:27:48,633 know it’s uh I don’t we don’t have those results yet. so I um 776 00:27:48,633 --> 00:27:50,833 have those results yet. so I um at this point we have been 777 00:27:50,833 --> 00:27:53,233 at this point we have been recommending um hydroxy cleric. 778 00:27:53,233 --> 00:27:55,067 recommending um hydroxy cleric. To be used under the context of 779 00:27:55,067 --> 00:27:57,334 To be used under the context of clinical trials um uh because 780 00:27:57,334 --> 00:27:58,634 clinical trials um uh because we didn’t have a strong sense 781 00:27:58,634 --> 00:28:01,067 we didn’t have a strong sense of efficacy and safety um but 782 00:28:01,067 --> 00:28:02,667 of efficacy and safety um but we are getting close to looking 783 00:28:02,667 --> 00:28:03,834 we are getting close to looking at a med analysis, which is 784 00:28:03,834 --> 00:28:05,233 at a med analysis, which is again and I think this is an 785 00:28:05,233 --> 00:28:05,966 again and I think this is an important part because we don’t 786 00:28:05,966 --> 00:28:08,467 important part because we don’t make it uh when you start to 787 00:28:08,467 --> 00:28:09,300 make it uh when you start to write guidance when they’re 788 00:28:09,300 --> 00:28:10,700 write guidance when they’re evidence is coming, We may not 789 00:28:10,700 --> 00:28:12,534 evidence is coming, We may not just write it based on one 790 00:28:12,534 --> 00:28:13,467 just write it based on one clinical trial. as you saw, we 791 00:28:13,467 --> 00:28:14,633 clinical trial. as you saw, we didn’t write the evidence just 792 00:28:14,633 --> 00:28:16,833 didn’t write the evidence just based on recovery, we actually 793 00:28:16,833 --> 00:28:18,333 based on recovery, we actually pull evidence from a you know a 794 00:28:18,333 --> 00:28:20,601 pull evidence from a you know a total of eight trials and for 795 00:28:20,601 --> 00:28:21,467 total of eight trials and for hydroxy when we’re gonna have 796 00:28:21,467 --> 00:28:22,267 hydroxy when we’re gonna have to we have to do the same thing 797 00:28:22,267 --> 00:28:24,634 to we have to do the same thing we actually um have to pull and 798 00:28:24,634 --> 00:28:26,099 we actually um have to pull and do a robust analysis and 799 00:28:26,099 --> 00:28:27,066 do a robust analysis and present this to the development 800 00:28:27,066 --> 00:28:28,166 present this to the development of the guidelines Development 801 00:28:28,166 --> 00:28:29,966 of the guidelines Development panel and that’s a. That will 802 00:28:29,966 --> 00:28:31,867 panel and that’s a. That will likely happen um you know in 803 00:28:31,867 --> 00:28:34,700 likely happen um you know in the very near future to look at 804 00:28:34,700 --> 00:28:36,999 the very near future to look at that. uh you know what is um 805 00:28:36,999 --> 00:28:38,934 that. uh you know what is um what will be the you know the 806 00:28:38,934 --> 00:28:39,966 what will be the you know the updated recommendation on 807 00:28:39,966 --> 00:28:42,033 updated recommendation on Hydroxy Can I can I add 808 00:28:42,033 --> 00:28:42,500 Hydroxy Can I can I add something to that because I 809 00:28:42,500 --> 00:28:43,066 something to that because I don’t it’s important that 810 00:28:43,066 --> 00:28:44,933 don’t it’s important that people understand that there’s 811 00:28:44,933 --> 00:28:46,367 people understand that there’s a lot of studies that are 812 00:28:46,367 --> 00:28:47,700 a lot of studies that are ongoing. There are a lot of 813 00:28:47,700 --> 00:28:48,734 ongoing. There are a lot of clinical trials that are 814 00:28:48,734 --> 00:28:50,267 clinical trials that are ongoing, which are like our 815 00:28:50,267 --> 00:28:51,866 ongoing, which are like our gold standard type of study, 816 00:28:51,866 --> 00:28:52,400 gold standard type of study, especially for treatments 817 00:28:52,400 --> 00:28:54,000 especially for treatments because it’s there’s a certain 818 00:28:54,000 --> 00:28:54,934 because it’s there’s a certain methodology that you use for a 819 00:28:54,934 --> 00:28:56,700 methodology that you use for a clinical trial um because 820 00:28:56,700 --> 00:28:58,099 clinical trial um because there’s so many that are being 821 00:28:58,099 --> 00:28:59,100 there’s so many that are being done. many of them are really 822 00:28:59,100 --> 00:29:01,199 done. many of them are really small in size and they have a 823 00:29:01,199 --> 00:29:03,433 small in size and they have a few. Have enough patients 824 00:29:03,433 --> 00:29:05,700 few. Have enough patients enrolled in them to get a high 825 00:29:05,700 --> 00:29:06,734 enrolled in them to get a high quality answer. It doesn’t 826 00:29:06,734 --> 00:29:08,066 quality answer. It doesn’t actually get us to that full 827 00:29:08,066 --> 00:29:09,233 actually get us to that full answer, which is why it’s 828 00:29:09,233 --> 00:29:10,433 answer, which is why it’s important that we’re able to 829 00:29:10,433 --> 00:29:13,166 important that we’re able to work with all of the clinical 830 00:29:13,166 --> 00:29:13,866 work with all of the clinical trial uh trials the people who 831 00:29:13,866 --> 00:29:15,266 trial uh trials the people who are running those clinical 832 00:29:15,266 --> 00:29:16,800 are running those clinical trials who are willing to work 833 00:29:16,800 --> 00:29:18,399 trials who are willing to work with us to pull the data, which 834 00:29:18,399 --> 00:29:21,033 with us to pull the data, which is Janet explain means bring 835 00:29:21,033 --> 00:29:21,667 is Janet explain means bring together the different data 836 00:29:21,667 --> 00:29:23,100 together the different data from all of the different 837 00:29:23,100 --> 00:29:24,133 from all of the different studies pull it together. Bring 838 00:29:24,133 --> 00:29:25,500 studies pull it together. Bring it all together and then do an 839 00:29:25,500 --> 00:29:27,100 it all together and then do an analysis on that because with 840 00:29:27,100 --> 00:29:28,300 analysis on that because with so many clinical trials, those 841 00:29:28,300 --> 00:29:29,300 so many clinical trials, those numbers are really small and 842 00:29:29,300 --> 00:29:30,667 numbers are really small and it’s not enough to get us the 843 00:29:30,667 --> 00:29:32,300 it’s not enough to get us the concrete. That that everyone 844 00:29:32,300 --> 00:29:33,900 concrete. That that everyone wants that we want so that’s 845 00:29:33,900 --> 00:29:35,199 wants that we want so that’s what takes some time but again, 846 00:29:35,199 --> 00:29:36,699 what takes some time but again, I’m gonna say it again. We are 847 00:29:36,699 --> 00:29:39,067 I’m gonna say it again. We are evidence based we’re a science 848 00:29:39,067 --> 00:29:40,499 evidence based we’re a science organization and we need the 849 00:29:40,499 --> 00:29:43,233 organization and we need the studies to be done and we’re 8 850 00:29:43,233 --> 00:29:45,000 studies to be done and we’re 8 months into a pandemic I again 851 00:29:45,000 --> 00:29:46,534 months into a pandemic I again 8 months into a pandemic to 852 00:29:46,534 --> 00:29:48,133 8 months into a pandemic to have clinical trials being done 853 00:29:48,133 --> 00:29:49,733 have clinical trials being done all over the world to have this 854 00:29:49,733 --> 00:29:51,067 all over the world to have this meta analysis being done and 855 00:29:51,067 --> 00:29:52,267 meta analysis being done and have these results being given 856 00:29:52,267 --> 00:29:54,667 have these results being given in real time is really 857 00:29:54,667 --> 00:29:55,966 in real time is really incredible and it’s due to the 858 00:29:55,966 --> 00:29:57,067 incredible and it’s due to the collaboration and the expertise 859 00:29:57,067 --> 00:29:58,434 collaboration and the expertise and the critical review and the 860 00:29:58,434 --> 00:29:59,633 and the critical review and the processes that we have in place 861 00:29:59,633 --> 00:30:03,233 processes that we have in place that we’re set up. To rapidly 862 00:30:03,233 --> 00:30:06,333 that we’re set up. To rapidly um be used um not skimping on 863 00:30:06,333 --> 00:30:08,700 um be used um not skimping on any of the quality control to 864 00:30:08,700 --> 00:30:09,900 any of the quality control to actually get it out really 865 00:30:09,900 --> 00:30:11,233 actually get it out really really quickly and still be 866 00:30:11,233 --> 00:30:12,599 really quickly and still be robust. It’s something it’s 867 00:30:12,599 --> 00:30:14,300 robust. It’s something it’s what WO can do. We have that 868 00:30:14,300 --> 00:30:16,367 what WO can do. We have that convening power and who else in 869 00:30:16,367 --> 00:30:17,633 convening power and who else in the world would bring together 870 00:30:17,633 --> 00:30:19,467 the world would bring together all of these um clinicians if 871 00:30:19,467 --> 00:30:21,633 all of these um clinicians if it wasn’t the UN agency who’s 872 00:30:21,633 --> 00:30:23,433 it wasn’t the UN agency who’s job was to do that basically to 873 00:30:23,433 --> 00:30:24,734 job was to do that basically to pull the best knowledge in the 874 00:30:24,734 --> 00:30:26,467 pull the best knowledge in the world on the subject, um a few 875 00:30:26,467 --> 00:30:28,266 world on the subject, um a few questions on this as well and 876 00:30:28,266 --> 00:30:28,867 questions on this as well and this one in particular comes 877 00:30:28,867 --> 00:30:32,133 this one in particular comes from is Moana on on Twitter 878 00:30:32,133 --> 00:30:33,033 from is Moana on on Twitter asking about long-term effects. 879 00:30:33,033 --> 00:30:34,467 asking about long-term effects. So we’ve been talking about 880 00:30:34,467 --> 00:30:36,066 So we’ve been talking about studying medicine. medicines 881 00:30:36,066 --> 00:30:38,133 studying medicine. medicines and treatment. But at the same 882 00:30:38,133 --> 00:30:39,433 and treatment. But at the same time, you’re also looking at 883 00:30:39,433 --> 00:30:41,500 time, you’re also looking at how patients experience and 884 00:30:41,500 --> 00:30:43,567 how patients experience and recover from Cot. Can you tell 885 00:30:43,567 --> 00:30:44,533 recover from Cot. Can you tell us a little bit about what 886 00:30:44,533 --> 00:30:45,700 us a little bit about what we’re learning and how we’re 887 00:30:45,700 --> 00:30:47,966 we’re learning and how we’re learning more on long-term 888 00:30:47,966 --> 00:30:51,333 learning more on long-term effects. So it’s uh it’s a very 889 00:30:51,333 --> 00:30:52,367 effects. So it’s uh it’s a very important question and it’s 890 00:30:52,367 --> 00:30:53,567 important question and it’s something that’s a high 891 00:30:53,567 --> 00:30:56,766 something that’s a high priority for us at this time. 892 00:30:56,766 --> 00:30:58,300 priority for us at this time. Um the way we are gathering 893 00:30:58,300 --> 00:31:00,033 Um the way we are gathering information about long-term 894 00:31:00,033 --> 00:31:02,433 information about long-term effects is a multi prong I 895 00:31:02,433 --> 00:31:05,900 effects is a multi prong I guess one is that uh we in the 896 00:31:05,900 --> 00:31:06,900 guess one is that uh we in the clinical network that we have 897 00:31:06,900 --> 00:31:09,899 clinical network that we have you know. You know the 898 00:31:09,899 --> 00:31:11,367 you know. You know the clinician started to report 899 00:31:11,367 --> 00:31:13,000 clinician started to report that they were seeing reporting 900 00:31:13,000 --> 00:31:13,867 that they were seeing reporting so we heard you know when we 901 00:31:13,867 --> 00:31:15,734 so we heard you know when we start, they were reporting that 902 00:31:15,734 --> 00:31:17,466 start, they were reporting that patients were having some uh 903 00:31:17,466 --> 00:31:19,733 patients were having some uh deficits or limitations after 904 00:31:19,733 --> 00:31:22,433 deficits or limitations after acute illness, you know during 905 00:31:22,433 --> 00:31:23,599 acute illness, you know during this period after discharge 906 00:31:23,599 --> 00:31:27,599 this period after discharge from hospital and that was not 907 00:31:27,599 --> 00:31:28,000 from hospital and that was not necessarily unexpected, I’d 908 00:31:28,000 --> 00:31:29,399 necessarily unexpected, I’d have to say for the patients 909 00:31:29,399 --> 00:31:30,934 have to say for the patients who are critically ill or 910 00:31:30,934 --> 00:31:33,001 who are critically ill or severely ill in hospital. We do 911 00:31:33,001 --> 00:31:35,233 severely ill in hospital. We do see sometimes uh limitations 912 00:31:35,233 --> 00:31:37,734 see sometimes uh limitations due to that just being that 913 00:31:37,734 --> 00:31:40,667 due to that just being that sick um. Of those limitations 914 00:31:40,667 --> 00:31:42,567 sick um. Of those limitations range and have been reported 915 00:31:42,567 --> 00:31:43,399 range and have been reported between physical limitations, 916 00:31:43,399 --> 00:31:46,599 between physical limitations, you know like uh being stiff or 917 00:31:46,599 --> 00:31:50,333 you know like uh being stiff or being weak uh to uh 918 00:31:50,333 --> 00:31:51,899 being weak uh to uh psychological um complications 919 00:31:51,899 --> 00:31:54,500 psychological um complications such as depression or poor 920 00:31:54,500 --> 00:31:55,467 such as depression or poor concentration or cognitive, you 921 00:31:55,467 --> 00:31:58,399 concentration or cognitive, you know not not being as clear 922 00:31:58,399 --> 00:32:00,833 know not not being as clear minded as once was before uh to 923 00:32:00,833 --> 00:32:01,900 minded as once was before uh to respiratory complications, 924 00:32:01,900 --> 00:32:03,467 respiratory complications, which are the most obvious 925 00:32:03,467 --> 00:32:04,300 which are the most obvious because of the severe pneumonia 926 00:32:04,300 --> 00:32:06,433 because of the severe pneumonia or the need of the ventilation 927 00:32:06,433 --> 00:32:08,934 or the need of the ventilation to respiratory deficits. Then 928 00:32:08,934 --> 00:32:10,966 to respiratory deficits. Then to neurological deficits as 929 00:32:10,966 --> 00:32:12,667 to neurological deficits as well, so I think what we’re 930 00:32:12,667 --> 00:32:14,267 well, so I think what we’re seeing is that it’s not uh it’s 931 00:32:14,267 --> 00:32:16,099 seeing is that it’s not uh it’s a multi system and that’s a 932 00:32:16,099 --> 00:32:19,100 a multi system and that’s a medical term. but it’s uh we 933 00:32:19,100 --> 00:32:21,567 medical term. but it’s uh we have that we need to follow 934 00:32:21,567 --> 00:32:22,900 have that we need to follow patients um especially those 935 00:32:22,900 --> 00:32:24,934 patients um especially those that have persistent symptoms 936 00:32:24,934 --> 00:32:26,534 that have persistent symptoms or were severely or critically 937 00:32:26,534 --> 00:32:28,900 or were severely or critically ill in the hospital uh and do 938 00:32:28,900 --> 00:32:30,133 ill in the hospital uh and do it, You know a careful 939 00:32:30,133 --> 00:32:32,267 it, You know a careful assessment of their symptoms 940 00:32:32,267 --> 00:32:33,399 assessment of their symptoms after discharge see what it 941 00:32:33,399 --> 00:32:34,967 after discharge see what it what goes away and what kind of 942 00:32:34,967 --> 00:32:36,667 what goes away and what kind of persist longer than one would 943 00:32:36,667 --> 00:32:38,433 persist longer than one would expect and then in certain 944 00:32:38,433 --> 00:32:40,601 expect and then in certain patients also. Physiological 945 00:32:40,601 --> 00:32:41,867 patients also. Physiological limitations such as problems 946 00:32:41,867 --> 00:32:43,899 limitations such as problems with the heart, the lungs the 947 00:32:43,899 --> 00:32:44,467 with the heart, the lungs the brain, psychological 948 00:32:44,467 --> 00:32:48,099 brain, psychological psychiatric and physical just 949 00:32:48,099 --> 00:32:48,633 psychiatric and physical just to understand. but at the same 950 00:32:48,633 --> 00:32:50,466 to understand. but at the same time, it’s not just that it’s 951 00:32:50,466 --> 00:32:51,134 time, it’s not just that it’s interventions right and one of 952 00:32:51,134 --> 00:32:52,666 interventions right and one of the early interventions, which 953 00:32:52,666 --> 00:32:53,700 the early interventions, which is actually in our guidance is 954 00:32:53,700 --> 00:32:56,199 is actually in our guidance is actually rehabilitation. so 955 00:32:56,199 --> 00:32:58,533 actually rehabilitation. so doing the um care of patients 956 00:32:58,533 --> 00:33:00,334 doing the um care of patients not just with the ICU doctor or 957 00:33:00,334 --> 00:33:01,799 not just with the ICU doctor or the ID doctor or the 958 00:33:01,799 --> 00:33:03,300 the ID doctor or the respiratory you know, but we 959 00:33:03,300 --> 00:33:04,867 respiratory you know, but we actually with the team, which 960 00:33:04,867 --> 00:33:06,467 actually with the team, which includes an occupational 961 00:33:06,467 --> 00:33:08,333 includes an occupational therapist and rehabilitation 962 00:33:08,333 --> 00:33:11,033 therapist and rehabilitation expert. Uh et cetera, 963 00:33:11,033 --> 00:33:12,267 expert. Uh et cetera, potentially a neurologist so 964 00:33:12,267 --> 00:33:15,233 potentially a neurologist so that the team finds any 965 00:33:15,233 --> 00:33:16,399 that the team finds any potential early signs of a 966 00:33:16,399 --> 00:33:18,167 potential early signs of a limitation and is able to start 967 00:33:18,167 --> 00:33:20,000 limitation and is able to start doing um interventions to 968 00:33:20,000 --> 00:33:21,567 doing um interventions to improve function. So I think 969 00:33:21,567 --> 00:33:22,967 improve function. So I think that’s uh that’s quite 970 00:33:22,967 --> 00:33:24,601 that’s uh that’s quite important. So what we’re so 971 00:33:24,601 --> 00:33:26,433 important. So what we’re so what we are doing those we need 972 00:33:26,433 --> 00:33:28,300 what we are doing those we need to understand better so we’ve 973 00:33:28,300 --> 00:33:30,099 to understand better so we’ve developed um uh we are in the 974 00:33:30,099 --> 00:33:32,399 developed um uh we are in the process of developing a case 975 00:33:32,399 --> 00:33:33,734 process of developing a case record form, which is for 976 00:33:33,734 --> 00:33:36,267 record form, which is for doctors to use with their 977 00:33:36,267 --> 00:33:37,067 doctors to use with their patients in order to make sure 978 00:33:37,067 --> 00:33:38,033 patients in order to make sure they collect all the right 979 00:33:38,033 --> 00:33:39,034 they collect all the right symptoms when they see their 980 00:33:39,034 --> 00:33:40,700 symptoms when they see their patients and follow up as well 981 00:33:40,700 --> 00:33:42,667 patients and follow up as well as what kind of test to do with 982 00:33:42,667 --> 00:33:45,367 as what kind of test to do with patients in the follow up and. 983 00:33:45,367 --> 00:33:47,100 patients in the follow up and. And then also supporting 984 00:33:47,100 --> 00:33:48,667 And then also supporting observational research 985 00:33:48,667 --> 00:33:50,267 observational research protocols so that patients get 986 00:33:50,267 --> 00:33:51,467 protocols so that patients get followed up in a cohort so that 987 00:33:51,467 --> 00:33:53,399 followed up in a cohort so that we can actually understand 988 00:33:53,399 --> 00:33:56,300 we can actually understand better how common or uncommon 989 00:33:56,300 --> 00:33:57,766 better how common or uncommon these complications are and 990 00:33:57,766 --> 00:33:59,300 these complications are and who’s getting them um, but 991 00:33:59,300 --> 00:34:00,534 who’s getting them um, but there’s a lot to learn and then 992 00:34:00,534 --> 00:34:01,434 there’s a lot to learn and then I think the fourth thing to 993 00:34:01,434 --> 00:34:02,600 I think the fourth thing to acknowledge um you know that 994 00:34:02,600 --> 00:34:04,000 acknowledge um you know that we’ve heard actually from 995 00:34:04,000 --> 00:34:06,099 we’ve heard actually from patients themselves who’ve had 996 00:34:06,099 --> 00:34:08,201 patients themselves who’ve had persistent symptoms um and know 997 00:34:08,201 --> 00:34:10,667 persistent symptoms um and know that they are um they are out 998 00:34:10,667 --> 00:34:12,667 that they are um they are out there so we’ve had the 999 00:34:12,667 --> 00:34:14,000 there so we’ve had the opportunity to hear directly 1000 00:34:14,000 --> 00:34:15,467 opportunity to hear directly from patients. Uh what. 1001 00:34:15,467 --> 00:34:16,567 from patients. Uh what. Experiencing and what they’re 1002 00:34:16,567 --> 00:34:17,867 Experiencing and what they’re finding challenges and seeking 1003 00:34:17,867 --> 00:34:18,833 finding challenges and seeking care. so we’re trying to 1004 00:34:18,833 --> 00:34:20,000 care. so we’re trying to address that in the next 1005 00:34:20,000 --> 00:34:22,000 address that in the next version of the guidance um and 1006 00:34:22,000 --> 00:34:23,300 version of the guidance um and I think I heard this I’ve been 1007 00:34:23,300 --> 00:34:25,066 I think I heard this I’ve been hearing this from you more most 1008 00:34:25,066 --> 00:34:26,833 hearing this from you more most often is actually working with 1009 00:34:26,833 --> 00:34:28,233 often is actually working with these groups of patients as 1010 00:34:28,233 --> 00:34:30,700 these groups of patients as Janet said, who reached out to 1011 00:34:30,700 --> 00:34:31,500 Janet said, who reached out to us. Yes, so some of the some of 1012 00:34:31,500 --> 00:34:32,967 us. Yes, so some of the some of the groups contacted me through 1013 00:34:32,967 --> 00:34:34,967 the groups contacted me through some social media channels, so 1014 00:34:34,967 --> 00:34:37,067 some social media channels, so I reached out to them and said, 1015 00:34:37,067 --> 00:34:40,100 I reached out to them and said, Can you help us talk to you? uh 1016 00:34:40,100 --> 00:34:41,067 Can you help us talk to you? uh because some of the patient 1017 00:34:41,067 --> 00:34:42,833 because some of the patient groups are starting to form and 1018 00:34:42,833 --> 00:34:43,867 groups are starting to form and I reached out to one of the 1019 00:34:43,867 --> 00:34:46,667 I reached out to one of the groups is the. SOS group um and 1020 00:34:46,667 --> 00:34:48,700 groups is the. SOS group um and they helped me helped us pull 1021 00:34:48,700 --> 00:34:49,734 they helped me helped us pull together different patient 1022 00:34:49,734 --> 00:34:50,500 together different patient groups from around the world, 1023 00:34:50,500 --> 00:34:51,467 groups from around the world, and I think these patient 1024 00:34:51,467 --> 00:34:52,700 and I think these patient groups are forming and you know 1025 00:34:52,700 --> 00:34:54,166 groups are forming and you know what they really ask for us. It 1026 00:34:54,166 --> 00:34:55,233 what they really ask for us. It was a wonderful opportunity for 1027 00:34:55,233 --> 00:34:56,933 was a wonderful opportunity for us to listen and to and to hear 1028 00:34:56,933 --> 00:34:58,400 us to listen and to and to hear from us. Jenna has said to 1029 00:34:58,400 --> 00:35:00,099 from us. Jenna has said to listen to the patients 1030 00:35:00,099 --> 00:35:01,700 listen to the patients themselves um and what they you 1031 00:35:01,700 --> 00:35:02,900 themselves um and what they you know they they asked for for 1032 00:35:02,900 --> 00:35:04,533 know they they asked for for three things they asked for 1033 00:35:04,533 --> 00:35:05,599 three things they asked for recognition. you know that this 1034 00:35:05,599 --> 00:35:07,133 recognition. you know that this is something that that many 1035 00:35:07,133 --> 00:35:08,700 is something that that many people are dealing with um they 1036 00:35:08,700 --> 00:35:10,966 people are dealing with um they ask for rehab. Uh you know as 1037 00:35:10,966 --> 00:35:11,967 ask for rehab. Uh you know as Janet has explained like how 1038 00:35:11,967 --> 00:35:13,500 Janet has explained like how did how do we help them going 1039 00:35:13,500 --> 00:35:15,734 did how do we help them going forward and? For research, so 1040 00:35:15,734 --> 00:35:17,633 forward and? For research, so you know, the director general 1041 00:35:17,633 --> 00:35:18,667 you know, the director general joined our call with them. um 1042 00:35:18,667 --> 00:35:20,133 joined our call with them. um this was a couple of weeks ago. 1043 00:35:20,133 --> 00:35:21,667 this was a couple of weeks ago. We’ve heard we heard them loud 1044 00:35:21,667 --> 00:35:22,900 We’ve heard we heard them loud and clear. uh you know we will 1045 00:35:22,900 --> 00:35:23,599 and clear. uh you know we will continue to work with the 1046 00:35:23,599 --> 00:35:24,934 continue to work with the patient groups, but I think 1047 00:35:24,934 --> 00:35:26,300 patient groups, but I think what is really important for us 1048 00:35:26,300 --> 00:35:27,866 what is really important for us to understand the extent uh you 1049 00:35:27,866 --> 00:35:29,467 to understand the extent uh you know what is what is happening 1050 00:35:29,467 --> 00:35:31,167 know what is what is happening in terms of people as they and 1051 00:35:31,167 --> 00:35:33,533 in terms of people as they and it’s not just people with 1052 00:35:33,533 --> 00:35:35,334 it’s not just people with severe disease. Um I think we 1053 00:35:35,334 --> 00:35:37,600 severe disease. Um I think we do need to recognize that early 1054 00:35:37,600 --> 00:35:39,500 do need to recognize that early on in the pandemic, it was it 1055 00:35:39,500 --> 00:35:40,534 on in the pandemic, it was it was very difficult for 1056 00:35:40,534 --> 00:35:42,300 was very difficult for everybody to get a test and it 1057 00:35:42,300 --> 00:35:43,867 everybody to get a test and it really depended on the testing 1058 00:35:43,867 --> 00:35:45,500 really depended on the testing strategy of the country itself. 1059 00:35:45,500 --> 00:35:47,599 strategy of the country itself. so many people who are. Um you 1060 00:35:47,599 --> 00:35:49,166 so many people who are. Um you know for having this long term 1061 00:35:49,166 --> 00:35:51,567 know for having this long term effects may not have had a 1062 00:35:51,567 --> 00:35:53,233 effects may not have had a confirmed test back when so 1063 00:35:53,233 --> 00:35:54,500 confirmed test back when so they wanna make sure that 1064 00:35:54,500 --> 00:35:55,966 they wanna make sure that they’re recognized and that 1065 00:35:55,966 --> 00:35:56,534 they’re recognized and that they get the care that they 1066 00:35:56,534 --> 00:35:58,500 they get the care that they need and so for us we work with 1067 00:35:58,500 --> 00:35:59,900 need and so for us we work with our member states to ensure 1068 00:35:59,900 --> 00:36:01,233 our member states to ensure that they can get the care that 1069 00:36:01,233 --> 00:36:02,833 that they can get the care that they need to articulate what 1070 00:36:02,833 --> 00:36:04,300 they need to articulate what that care actually needs, But 1071 00:36:04,300 --> 00:36:06,667 that care actually needs, But as Janet explains, it’s many 1072 00:36:06,667 --> 00:36:07,533 as Janet explains, it’s many different systems. It’s not 1073 00:36:07,533 --> 00:36:09,067 different systems. It’s not just respiratory uh long-term 1074 00:36:09,067 --> 00:36:10,567 just respiratory uh long-term effects. There’s many effects 1075 00:36:10,567 --> 00:36:13,067 effects. There’s many effects that need to be researched and 1076 00:36:13,067 --> 00:36:14,267 that need to be researched and studied and so we’re working 1077 00:36:14,267 --> 00:36:15,433 studied and so we’re working very hard to do that so that we 1078 00:36:15,433 --> 00:36:17,667 very hard to do that so that we have a better. Space again to 1079 00:36:17,667 --> 00:36:18,833 have a better. Space again to make sure that people get the 1080 00:36:18,833 --> 00:36:19,966 make sure that people get the care that they need, but we’ve 1081 00:36:19,966 --> 00:36:21,467 care that they need, but we’ve heard you. we hear you, We will 1082 00:36:21,467 --> 00:36:23,433 heard you. we hear you, We will continue to work with you. This 1083 00:36:23,433 --> 00:36:25,034 continue to work with you. This is a two questions that are 1084 00:36:25,034 --> 00:36:26,600 is a two questions that are related. Fidel asks. Can you 1085 00:36:26,600 --> 00:36:28,466 related. Fidel asks. Can you comment on the reelection rate? 1086 00:36:28,466 --> 00:36:29,934 comment on the reelection rate? What are the risk factors 1087 00:36:29,934 --> 00:36:31,667 What are the risk factors associated with re infection 1088 00:36:31,667 --> 00:36:33,267 associated with re infection and then Alberto asks how many 1089 00:36:33,267 --> 00:36:34,434 and then Alberto asks how many months do you know uh the 1090 00:36:34,434 --> 00:36:37,033 months do you know uh the people have immunity after 1091 00:36:37,033 --> 00:36:39,567 people have immunity after having cot So this is been a 1092 00:36:39,567 --> 00:36:41,367 having cot So this is been a recent topic with people 1093 00:36:41,367 --> 00:36:43,700 recent topic with people getting cod seeming to recover 1094 00:36:43,700 --> 00:36:45,067 getting cod seeming to recover and then there are few cases of 1095 00:36:45,067 --> 00:36:46,133 and then there are few cases of people getting seeming to get 1096 00:36:46,133 --> 00:36:48,166 people getting seeming to get the disease a second time so a 1097 00:36:48,166 --> 00:36:52,700 the disease a second time so a second. Yes, so um yes, what we 1098 00:36:52,700 --> 00:36:55,199 second. Yes, so um yes, what we understand from from um all the 1099 00:36:55,199 --> 00:36:57,566 understand from from um all the research across the globe is 1100 00:36:57,566 --> 00:36:58,500 research across the globe is that when people get infected 1101 00:36:58,500 --> 00:37:00,600 that when people get infected with the virus, COtwo virus 1102 00:37:00,600 --> 00:37:02,300 with the virus, COtwo virus that their body develops an 1103 00:37:02,300 --> 00:37:04,333 that their body develops an antibody response and immune 1104 00:37:04,333 --> 00:37:05,500 antibody response and immune response um and we are seeing 1105 00:37:05,500 --> 00:37:06,900 response um and we are seeing this consistently across 1106 00:37:06,900 --> 00:37:08,667 this consistently across studies people with mild 1107 00:37:08,667 --> 00:37:09,600 studies people with mild disease people with moderate 1108 00:37:09,600 --> 00:37:11,267 disease people with moderate disease even people with severe 1109 00:37:11,267 --> 00:37:12,400 disease even people with severe disease even people with 1110 00:37:12,400 --> 00:37:13,733 disease even people with asymptomatic infection. so even 1111 00:37:13,733 --> 00:37:15,233 asymptomatic infection. so even people who don’t have symptoms, 1112 00:37:15,233 --> 00:37:16,700 people who don’t have symptoms, no symptoms at all, we’ll 1113 00:37:16,700 --> 00:37:18,700 no symptoms at all, we’ll develop an antibody response. 1114 00:37:18,700 --> 00:37:21,633 develop an antibody response. What we’re trying to. More 1115 00:37:21,633 --> 00:37:24,033 What we’re trying to. More consistently is how strong that 1116 00:37:24,033 --> 00:37:26,399 consistently is how strong that immune response is in an 1117 00:37:26,399 --> 00:37:27,500 immune response is in an individual and how long that 1118 00:37:27,500 --> 00:37:29,100 individual and how long that immune response last, does it 1119 00:37:29,100 --> 00:37:30,667 immune response last, does it last for months? will it last 1120 00:37:30,667 --> 00:37:33,199 last for months? will it last for years will last for even 1121 00:37:33,199 --> 00:37:33,900 for years will last for even longer than that, So we’re only 1122 00:37:33,900 --> 00:37:35,566 longer than that, So we’re only 8 months into the pandemic, so 1123 00:37:35,566 --> 00:37:36,300 8 months into the pandemic, so there’s only a certain amount 1124 00:37:36,300 --> 00:37:37,599 there’s only a certain amount of follow up that we’ve had in 1125 00:37:37,599 --> 00:37:40,400 of follow up that we’ve had in the studies and in many studies 1126 00:37:40,400 --> 00:37:41,867 the studies and in many studies and in some cities, there’s not 1127 00:37:41,867 --> 00:37:43,700 and in some cities, there’s not a not a huge amount of research 1128 00:37:43,700 --> 00:37:45,867 a not a huge amount of research yet, but uh in in many studies 1129 00:37:45,867 --> 00:37:48,099 yet, but uh in in many studies um we are seeing a consistent 1130 00:37:48,099 --> 00:37:49,467 um we are seeing a consistent antibody response over time, so 1131 00:37:49,467 --> 00:37:51,500 antibody response over time, so somebody who was infect. Immune 1132 00:37:51,500 --> 00:37:53,266 somebody who was infect. Immune response and that that antibody 1133 00:37:53,266 --> 00:37:55,599 response and that that antibody levels stays pretty consistent 1134 00:37:55,599 --> 00:37:56,667 levels stays pretty consistent in some studies, we see a 1135 00:37:56,667 --> 00:37:59,633 in some studies, we see a slight decline um with the 1136 00:37:59,633 --> 00:38:01,966 slight decline um with the example of rein infection um 1137 00:38:01,966 --> 00:38:04,266 example of rein infection um we’ve recently been we’ve seen 1138 00:38:04,266 --> 00:38:06,134 we’ve recently been we’ve seen this case reports of possible 1139 00:38:06,134 --> 00:38:08,267 this case reports of possible re infection from a couple of 1140 00:38:08,267 --> 00:38:09,467 re infection from a couple of countries. uh there’s one in 1141 00:38:09,467 --> 00:38:13,300 countries. uh there’s one in Hong Kong um and that’s uh was 1142 00:38:13,300 --> 00:38:14,900 Hong Kong um and that’s uh was confirmed through sequencing, 1143 00:38:14,900 --> 00:38:16,366 confirmed through sequencing, which means that the first 1144 00:38:16,366 --> 00:38:17,334 which means that the first infection there was a full 1145 00:38:17,334 --> 00:38:18,567 infection there was a full genome sequence that was done 1146 00:38:18,567 --> 00:38:19,966 genome sequence that was done and then the second infection 1147 00:38:19,966 --> 00:38:20,667 and then the second infection there was a sequence that was 1148 00:38:20,667 --> 00:38:22,567 there was a sequence that was done um and it looks like a 1149 00:38:22,567 --> 00:38:23,799 done um and it looks like a different infection. So that’s 1150 00:38:23,799 --> 00:38:24,633 different infection. So that’s where the sequence you can 1151 00:38:24,633 --> 00:38:26,000 where the sequence you can compare the viruses and you can 1152 00:38:26,000 --> 00:38:28,067 compare the viruses and you can say this. This is the second 1153 00:38:28,067 --> 00:38:30,133 say this. This is the second infection um there’s another 1154 00:38:30,133 --> 00:38:32,267 infection um there’s another example in the US um that I’m 1155 00:38:32,267 --> 00:38:34,000 example in the US um that I’m aware of uh it’s in a pre 1156 00:38:34,000 --> 00:38:35,434 aware of uh it’s in a pre print. So this is uh a paper 1157 00:38:35,434 --> 00:38:36,966 print. So this is uh a paper that has not gone through peer 1158 00:38:36,966 --> 00:38:38,267 that has not gone through peer review, but we’re aware that 1159 00:38:38,267 --> 00:38:39,734 review, but we’re aware that there maybe another example of 1160 00:38:39,734 --> 00:38:42,399 there maybe another example of a re infection in the US and I 1161 00:38:42,399 --> 00:38:44,166 a re infection in the US and I think we will start to see 1162 00:38:44,166 --> 00:38:45,966 think we will start to see examples of this as we go 1163 00:38:45,966 --> 00:38:47,233 examples of this as we go forward, but it’s important. we 1164 00:38:47,233 --> 00:38:48,933 forward, but it’s important. we put this into context because 1165 00:38:48,933 --> 00:38:51,734 put this into context because we’ve had 25000000 plus cases 1166 00:38:51,734 --> 00:38:53,500 we’ve had 25000000 plus cases to date um and we’re starting 1167 00:38:53,500 --> 00:38:55,966 to date um and we’re starting to see examples. we may have 1168 00:38:55,966 --> 00:38:57,334 to see examples. we may have 123 examples of re infection, 1169 00:38:57,334 --> 00:38:59,566 123 examples of re infection, but it doesn’t seem to be 1170 00:38:59,566 --> 00:39:01,166 but it doesn’t seem to be common. Um what is really 1171 00:39:01,166 --> 00:39:02,000 common. Um what is really important is that we look at 1172 00:39:02,000 --> 00:39:04,667 important is that we look at the immune. In this particular 1173 00:39:04,667 --> 00:39:06,267 the immune. In this particular individuals did they have an 1174 00:39:06,267 --> 00:39:07,700 individuals did they have an immune response from the first 1175 00:39:07,700 --> 00:39:08,433 immune response from the first infection and at the time of 1176 00:39:08,433 --> 00:39:09,966 infection and at the time of the second infection. What do 1177 00:39:09,966 --> 00:39:10,967 the second infection. What do those antibodies look like did 1178 00:39:10,967 --> 00:39:12,667 those antibodies look like did they decline? And if so why you 1179 00:39:12,667 --> 00:39:14,300 they decline? And if so why you know where these immuno 1180 00:39:14,300 --> 00:39:14,967 know where these immuno compromised patients, you know 1181 00:39:14,967 --> 00:39:16,567 compromised patients, you know what are the characteristics of 1182 00:39:16,567 --> 00:39:18,466 what are the characteristics of that? So it’s too early to make 1183 00:39:18,466 --> 00:39:20,201 that? So it’s too early to make any big broad general 1184 00:39:20,201 --> 00:39:21,400 any big broad general statements other than we do 1185 00:39:21,400 --> 00:39:23,867 statements other than we do have some examples that people 1186 00:39:23,867 --> 00:39:25,233 have some examples that people can be re infected, but it 1187 00:39:25,233 --> 00:39:26,834 can be re infected, but it doesn’t seem to be common um 1188 00:39:26,834 --> 00:39:28,399 doesn’t seem to be common um but we do we’re very grateful 1189 00:39:28,399 --> 00:39:30,234 but we do we’re very grateful for the the countries that are 1190 00:39:30,234 --> 00:39:31,799 for the the countries that are able to do the sequencing um 1191 00:39:31,799 --> 00:39:34,133 able to do the sequencing um over time. Anybody can do do 1192 00:39:34,133 --> 00:39:36,033 over time. Anybody can do do sequences, but that does help 1193 00:39:36,033 --> 00:39:37,533 sequences, but that does help us to determine if it is indeed 1194 00:39:37,533 --> 00:39:39,666 us to determine if it is indeed a second infection or if we 1195 00:39:39,666 --> 00:39:41,466 a second infection or if we just see prolonged PCR 1196 00:39:41,466 --> 00:39:42,267 just see prolonged PCR positivity in some patients, 1197 00:39:42,267 --> 00:39:43,467 positivity in some patients, which is also something that we 1198 00:39:43,467 --> 00:39:45,566 which is also something that we do see. and so then the advice 1199 00:39:45,566 --> 00:39:47,300 do see. and so then the advice for the general public, even if 1200 00:39:47,300 --> 00:39:48,833 for the general public, even if you are someone who’s recovered 1201 00:39:48,833 --> 00:39:51,100 you are someone who’s recovered from the same app, Yes you you 1202 00:39:51,100 --> 00:39:52,867 from the same app, Yes you you need to apply the same 1203 00:39:52,867 --> 00:39:53,900 need to apply the same individual measures you know 1204 00:39:53,900 --> 00:39:55,334 individual measures you know the physical distance the hand 1205 00:39:55,334 --> 00:39:56,700 the physical distance the hand hygiene the respiratory 1206 00:39:56,700 --> 00:39:58,000 hygiene the respiratory etiquette wearing a mask or 1207 00:39:58,000 --> 00:39:59,067 etiquette wearing a mask or appropriate, all of the 1208 00:39:59,067 --> 00:40:00,466 appropriate, all of the measures that we put in place, 1209 00:40:00,466 --> 00:40:02,933 measures that we put in place, please continue to do so. Some 1210 00:40:02,933 --> 00:40:03,700 please continue to do so. Some people might look at this and 1211 00:40:03,700 --> 00:40:05,500 people might look at this and think this is really strange. 1212 00:40:05,500 --> 00:40:07,300 think this is really strange. Why can you catch this disease? 1213 00:40:07,300 --> 00:40:08,667 Why can you catch this disease? but there are other diseases 1214 00:40:08,667 --> 00:40:11,467 but there are other diseases even other Corona virus that 1215 00:40:11,467 --> 00:40:13,601 even other Corona virus that you can catch twice. Yes. so 1216 00:40:13,601 --> 00:40:14,300 you can catch twice. Yes. so there are there are several 1217 00:40:14,300 --> 00:40:15,833 there are there are several Corona viruses that circulate 1218 00:40:15,833 --> 00:40:17,666 Corona viruses that circulate there are four Corona viruses 1219 00:40:17,666 --> 00:40:18,467 there are four Corona viruses that are known for like the 1220 00:40:18,467 --> 00:40:20,100 that are known for like the common cold, you know um and 1221 00:40:20,100 --> 00:40:21,867 common cold, you know um and you can catch the cold and you 1222 00:40:21,867 --> 00:40:23,300 you can catch the cold and you can get more than one we’ll 1223 00:40:23,300 --> 00:40:24,700 can get more than one we’ll have more than once there’s not 1224 00:40:24,700 --> 00:40:26,000 have more than once there’s not great surveillance for the 1225 00:40:26,000 --> 00:40:27,834 great surveillance for the common cold, we don’t regularly 1226 00:40:27,834 --> 00:40:29,867 common cold, we don’t regularly test for that um but people can 1227 00:40:29,867 --> 00:40:31,267 test for that um but people can can can be infected with the 1228 00:40:31,267 --> 00:40:33,933 can can be infected with the common. More than once um with 1229 00:40:33,933 --> 00:40:38,066 common. More than once um with the other one uh which was in 1230 00:40:38,066 --> 00:40:39,633 the other one uh which was in 2003 and then the Corona virus, 1231 00:40:39,633 --> 00:40:42,267 2003 and then the Corona virus, which immersion in 2012, um 1232 00:40:42,267 --> 00:40:43,867 which immersion in 2012, um what we learn from those two 1233 00:40:43,867 --> 00:40:47,001 what we learn from those two Corona viruses um for the first 1234 00:40:47,001 --> 00:40:47,966 Corona viruses um for the first Colby one people can have an 1235 00:40:47,966 --> 00:40:49,200 Colby one people can have an immune response antibody 1236 00:40:49,200 --> 00:40:51,700 immune response antibody response for years for me, 1237 00:40:51,700 --> 00:40:53,300 response for years for me, Corona virus we have examples 1238 00:40:53,300 --> 00:40:55,566 Corona virus we have examples of people even with severe 1239 00:40:55,566 --> 00:40:57,300 of people even with severe infection that their antibodies 1240 00:40:57,300 --> 00:40:59,267 infection that their antibodies decline 10 months after 12 1241 00:40:59,267 --> 00:41:01,266 decline 10 months after 12 months of infection. so again 1242 00:41:01,266 --> 00:41:03,233 months of infection. so again we. Base our understanding of 1243 00:41:03,233 --> 00:41:04,433 we. Base our understanding of what may happen for this 1244 00:41:04,433 --> 00:41:05,867 what may happen for this particular Corona virus based 1245 00:41:05,867 --> 00:41:08,000 particular Corona virus based on past experience, but there’s 1246 00:41:08,000 --> 00:41:08,999 on past experience, but there’s really good research that’s 1247 00:41:08,999 --> 00:41:11,133 really good research that’s being done so again we expect 1248 00:41:11,133 --> 00:41:12,867 being done so again we expect our expectation and our 1249 00:41:12,867 --> 00:41:13,933 our expectation and our experiences that if somebody is 1250 00:41:13,933 --> 00:41:16,133 experiences that if somebody is infected with this virus the 1251 00:41:16,133 --> 00:41:17,233 infected with this virus the COtwo virus, but they do 1252 00:41:17,233 --> 00:41:18,900 COtwo virus, but they do develop an immune response. 1253 00:41:18,900 --> 00:41:19,933 develop an immune response. We’re learning how strong that 1254 00:41:19,933 --> 00:41:21,566 We’re learning how strong that is, and for how long that lasts 1255 00:41:21,566 --> 00:41:23,099 is, and for how long that lasts so that was the question from 1256 00:41:23,099 --> 00:41:24,300 so that was the question from Alberta, who wanted to know how 1257 00:41:24,300 --> 00:41:26,667 Alberta, who wanted to know how long that lasts um we’re going 1258 00:41:26,667 --> 00:41:27,433 long that lasts um we’re going to have to wrap up today. This 1259 00:41:27,433 --> 00:41:29,834 to have to wrap up today. This is a little bit of uh a shorter 1260 00:41:29,834 --> 00:41:30,700 is a little bit of uh a shorter Facebook live. Usually we go a 1261 00:41:30,700 --> 00:41:32,033 Facebook live. Usually we go a bit. But today we have some 1262 00:41:32,033 --> 00:41:34,500 bit. But today we have some constraints, we have to hop off 1263 00:41:34,500 --> 00:41:35,233 constraints, we have to hop off shortly um I’m going to go 1264 00:41:35,233 --> 00:41:36,534 shortly um I’m going to go through some of the countries 1265 00:41:36,534 --> 00:41:37,767 through some of the countries where you’ve joined us from on 1266 00:41:37,767 --> 00:41:39,199 where you’ve joined us from on Facebook from the US from the 1267 00:41:39,199 --> 00:41:40,300 Facebook from the US from the Netherlands, Canada India, 1268 00:41:40,300 --> 00:41:43,467 Netherlands, Canada India, Bangladesh, South Africa, Iraq, 1269 00:41:43,467 --> 00:41:44,833 Bangladesh, South Africa, Iraq, Kenya, Spain, Malaysia, 1270 00:41:44,833 --> 00:41:48,201 Kenya, Spain, Malaysia, Indonesia Kosovo, Rwanda, 1271 00:41:48,201 --> 00:41:49,967 Indonesia Kosovo, Rwanda, Somalia, The Philippines on 1272 00:41:49,967 --> 00:41:51,467 Somalia, The Philippines on LinkedIn, Peru, Honduras, 1273 00:41:51,467 --> 00:41:52,800 LinkedIn, Peru, Honduras, Spain, Germany, India. I’m not 1274 00:41:52,800 --> 00:41:54,533 Spain, Germany, India. I’m not being complete. I’m just 1275 00:41:54,533 --> 00:41:56,667 being complete. I’m just selecting Mexico, Morocco 1276 00:41:56,667 --> 00:42:00,267 selecting Mexico, Morocco Lebanon uh Greece Sudan uh 1277 00:42:00,267 --> 00:42:03,133 Lebanon uh Greece Sudan uh Tanzania. Saudi Arabia as well, 1278 00:42:03,133 --> 00:42:04,567 Tanzania. Saudi Arabia as well, so thank you very much for 1279 00:42:04,567 --> 00:42:06,267 so thank you very much for joining us today. uh 1280 00:42:06,267 --> 00:42:07,066 joining us today. uh congratulations Doctor Diaz. I 1281 00:42:07,066 --> 00:42:08,300 congratulations Doctor Diaz. I think it’s pretty amazing what 1282 00:42:08,300 --> 00:42:09,834 think it’s pretty amazing what uh what the crew was able to do 1283 00:42:09,834 --> 00:42:11,034 uh what the crew was able to do today and we’re really proud of 1284 00:42:11,034 --> 00:42:13,033 today and we’re really proud of you. um thank you for being 1285 00:42:13,033 --> 00:42:14,300 you. um thank you for being with us as well and thank you 1286 00:42:14,300 --> 00:42:16,867 with us as well and thank you as well. Doctor Van Kirk See 1287 00:42:16,867 --> 00:42:19,666 as well. Doctor Van Kirk See you next time. Thank you. Thank 1288 00:42:19,666 --> 00:42:22,734 you next time. Thank you. Thank you.