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Online Press Briefing with Dr. Daniel Singer (CDC) and Joshua Karnes (USAID)
April 5, 2020

April 3, 2020

Online Press Briefing

Dr. Daniel Singer
Regional Director for Central Asia, Centers for Disease Control and Prevention (CDC)

Joshua Karnes
Director of Central Asia Health and Education Office, U.S. Agency for International Development (USAID)


Moderator:  Hello.  I would like to welcome journalists to today’s virtual press briefing with Dr. Daniel Singer, Regional Director for Central Asia for the Centers for Disease Control and Prevention, and Joshua Karnes, the Director of the Central Asia Health and Education Office from the U.S. Agency for International Development.

Before I turn it over to – I’m sorry?  Oh, go ahead.

We will try to get to as many questions as possible in the approximately 30 minutes, looks like maybe a little bit more, that we have today.

With that, let’s get started.  Dr. Singer, Mr. Karnes, thank you so much for joining us today, and I’ll turn it over to you for opening remarks.

Dr. Singer:  Thank you so much, Vanessa.  It’s a wonderful opportunity to be able to talk to people from all around the region and to describe the work that we’re doing.  I am Daniel Singer; I’m the Director for the Centers for Disease Control and Prevention’s offices across Central Asia.  We established our first office in Almaty in 1995, so we are celebrating a quarter-century of supporting Central Asia.  Currently, we have offices in Kazakhstan, Tajikistan, Uzbekistan, and Kyrgyzstan, and we have staff in all of those areas, in all of those countries, providing technical support, training, and expertise in areas around laboratory testing, disease surveillance, disease monitoring, and advanced epidemiology.  We’ve been training people since the beginning – sorry, go ahead, go ahead.

Thank you.  We have, I believe, more technical experts in public health and epidemiology than any other foreign organization in the region.  Our goal in being in Central Asia is to help these countries develop their capability to prevent, detect, and respond to infectious diseases.

With regards to the current pandemic of coronavirus, we’ve been working with these countries since the virus was first detected in China, in December.  We have an emergency operations center that we supported in Kazakhstan, and are in the process of developing similar centers in the other countries.

The emergency operations center in Kazakhstan is now the hub for all coronavirus response in that country.  The director of that center as well as one of their staff were trained at CDC’s Public Health Emergency Management Fellowship Program.

We’ve, over the last couple of decades, trained dozens of epidemiologists in the countries within Central Asia, and all of them are now being used in responding to coronavirus.  For example, we were recently asked by the Ministry of Health in Kazakhstan to evaluate their health care facilities and assess their infection prevention in preparation for coronavirus.  We’ve completed that report and sent it on to the ministry of health and the appropriate authorities.

Our own epidemiologists continue to work daily with the Ministry of Health, and we are providing them not just technical consultation but financial resources and supplies and other laboratory reagents to help them in responding for coronavirus.

That’s an overview of my agency.  I’d hand it over to my colleague to describe USAID, and then we’ll take your questions.

Mr. Karnes:  Thanks, Dan, and thank you, Vanessa, for giving me this opportunity to talk about how the U.S. Government is supporting COVID-19 response in Central Asia.

So my name is Joshua Karnes and I am the Health and Education Office Director here at USAID, and since – so, go on.

As Dan mentioned, since December, when China first acknowledged these first troubling infections, we have been engaging our host government counterparts on a day-to-day basis, providing technical assistance and brainstorming alongside them, trying to develop solutions that work for the Central Asian context.

I want to say that I have been deeply impressed by the dedication of the ministries of health.  I see emails and WhatsApp messages literally at all hours of the day and night, and it is an honor to work beside these impressive and talented public servants.

I’ve been working here in Central Asia for the last three years, mainly fighting HIV and drug-resistant TB, and this assistance is just a simple continuation of our more than 25 years of deep partnership in the region.

So to fight COVID-19, the U.S. Government, USAID, together with CDC, we’re focusing on six main areas.  First, we want to improve the laboratory capacity of the countries to detect COVID-19.  We’re also working on improving surveillance, so when you find a case, finding all of the other people around that person that could have been infected and tracking those people.

And of course, our first responders, they are the most important people; they are on the front lines fighting this virus, and we want to make sure that they are protected and that they do not get the virus themselves.  So we are trying to reduce – we’re trying to prevent new infections and making sure that people who are in the hospital do not get additional infections, so infection control and prevention.

We also know that about 80 percent of COVID cases are light cases, but 20 percent of the cases are rather severe, some of them requiring hospitalization and 5 percent requiring actual ventilation, so being on a ventilator.  And we want to make sure that the case management in Central Asia, the caring for COVID patients, is of the highest quality.

We also know that in a pandemic, people are scared and they start to gossip and rumors start to go wild.  So we want to make sure that people are getting the correct information about the coronavirus, and we are fighting the false information that often is shared in WhatsApp groups, on Facebook – the fake news.

And finally, where appropriate, we are working with the governments on points of entry, so where people cross the borders, and helping them improve their border screening and security.

I’m excited to announce that partnering with USAID, we have three excellent organizations.  First is the World Health Organization, second is an American organization called Abt Associates, and then we are also partnering with the Red Crescent Societies of Central Asia through the International Federation of the Red Cross.

I want to stress that the United States Government has stood beside Central Asian republics since their independence, and in those over 25 years, we have provided over $6.7 billion in support and partnership, and our commitment to Central Asia remains firm.

A virus like COVID-19 knows no borders, and when we protect America, we protect Central Asia, and when we protect Central Asia, we protect America.  Thank you.

Moderator:  Thank you.  We will now turn to the question and answer portion of today’s briefing.  As a reminder, you may type your questions in at any time into the Q&A tab.  [Speaking in Russian.]

Our first question comes to us from Daniyar Yenikeyev with Infopolis in Kazakhstan.  He asks, “Could you describe the situation related to the spread of coronavirus infection in Kazakhstan?”

Dr. Singer:  Sure.  At this point it’s clear that the virus is spreading in Kazakhstan, although it’s spreading quite slowly.  One of the factors we look at is what’s called the doubling time, the time it takes for the number of cases to double, and over the last week that doubling time has increased from two days to four days, which is a very positive sign.  It suggests that the social distancing and the restrictions on large gatherings that were put in place by the government seem to be working.  There’s a number of other factors that we will look for and we would definitely need additional testing to make sure that we understand the full extent of the disease spread.  So we’ll continue to monitor it, but at the moment it looks like the disease is spreading at a fairly slow pace through Kazakhstan.

Moderator:  Thank you for that answer.  Our next question comes from Abay Otar.  Just a reminder, when you’re asking a question, please include your media outlet and name so that we can identify your – identify you properly.  Abay’s question is, “I would like to know more about the report that Dr. Singer mentioned.”

Dr. Singer:  So the report that I mentioned had to do with infection-control practices within the health system in Kazakhstan.  We were asked by the ministry to work with the trainees that we have trained over the last several years in epidemiology to conduct a survey of polyclinics and infectious-disease hospitals around Kazakhstan.  We gathered data by visiting those facilities over the course of a couple of weeks, and produced a report that talks about the equipment that is available for infection control, the practices, and all of the procedures that are currently followed within each of those facilities.  So that data was then analyzed, put into a report, and given back to the ministry for them to use in prioritizing their own actions and preparing for the arrival of coronavirus.  That work was done before the virus actually occurred in Kazakhstan, and we’ve continued to follow up with them and work with them to identify places where the U.S. Government could provide additional assistance in making sure that the health facilities in the country are ready for additional cases of COVID-19.

Moderator:  Thanks so much.

Our next question goes to Darya Podolskaya with 24.kg in Kyrgyzstan.  She asks, “Does the CDC and the U.S. Government plan to help Kyrgyzstan fight the spread of coronavirus?  If so, to what extent and in what time frame?”

Dr. Singer:  Josh, do you want to start this one?

Mr. Karnes:  So, first of all, my video cut out for about 30 seconds.  So the question about Kyrgyzstan is what we’re doing specifically to support the country?

Moderator:  To fight the spread of coronavirus and what is the aid that we’re providing in Kyrgyzstan.

Mr. Karnes:  Okay.  So with – so one of the excellent partners that we have in the Kyrgyz Republic, is the Kyrgyz Red Crescent.  They have already, if you’ve been flying into Bishkek recently or if you’re at one of the borders, you’ve seen the Red Crescent.  They are providing support at the border entries, helping with testing.  They are also working to fight the spread of false information.  All of the Red Crescent Societies are going to be working on that in Central Asia.

We are working with the WHO to train health providers in those areas that I mentioned before – infection control, surveillance, and case management – and so we’re – we are getting all of those groups ready.  Of course, we can’t do the in-person trainings like we did before, so there’s a lot of virtual trainings that are going on right now.

And then, finally, we are procuring various reagents and supplies that the country needs to diagnose coronavirus and also to treat it.

USAID is focused on the most vulnerable populations.  So, for example, in the Kyrgyz Republic we work very closely with HIV-infected patients and people with TB.  And TB, as you can imagine as a lung disease, they are particularly susceptible to coronavirus, and we’re also making sure that those populations are protected against the virus.


Dr. Singer:  I think you summed it up very well.  I would just add that CDC will be providing some direct support to the laboratory system in Kyrgyzstan.  We are waiting on an announcement of additional funding from our own headquarters and plan to use some of that to directly support Kyrgyzstan’s ability to screen at their ports of entry.  We’ve also trained over the last couple of decades over 160 epidemiologists in the region, and some of the best ones have come from Kyrgyzstan.  And I just got information yesterday that we are being allowed to increase our own staff so that we can expand those training programs in the region, and we will be establishing a particular training program called a frontline epidemiology course in Kyrgyzstan in the coming year.

Mr. Karnes:  I just also want to say we – I’m sorry, translate.

I just wanted to quickly praise the Government of Kyrgyzstan for their openness at addressing the epidemic.  They have really been a model of cooperation.  They’ve engaged donors at the very early stage, and it’s a very inclusive process where donors and international organizations and the government are all sitting at the table together on a daily basis, developing strategies to fight the virus.  So I just want to applaud and thank the Kyrgyz ministry of health and their senior government officials for their cooperation and collaboration.

Moderator:  Thank you.  Just to note that we will go a little bit longer – I know we’re just over the 30-minute mark here – just because our – with the interpretation, this is taking a bit longer.

And actually, our top-trending question – Josh, you just touched on this, but our top-trending question right now that multiple participants have – would like for us to ask, from Alexander Shabalin.  He asks about your opinion on how the Kyrgyz Government is working on combatting the spread of the Coronavirus.

Mr. Karnes:  I think I answered it, but I’ll just say again it’s through their openness.  The government has been a model of being open both with the donor community, with the international community, and with their own people about the challenges that they’re facing.  And they have been open to discussion and collaboration.

It’s hard to work in an area where you don’t necessarily have access to the most current information, and having access to that data, having access to the latest reports is really critical.  And it’s really a model of collaboration that we would like to see expanded not just in Central Asia, but throughout the world.

Moderator:  Thanks for that answer.  Our – a number of our questions touch on the topic of disinformation.  Maybe you could just talk about a few of the trending themes that you’ve seen that are – that would fall into the category of disinformation in the region.

And our top question right now is actually from Anastasia Kolivas and she asks, “How does USAID plan to counter disinformation about COVID-19 in Uzbekistan specifically?”

Mr. Karnes:  So – sorry.

So I’ll just talk – I’ll let Dan talk about more of the specific rumors that we’re combatting, but our strategy to combat the rumors is using the International Federation of the Red Crescent Societies.  They are a powerful community-based organization.  There are thousands of on-the-ground volunteers who are – who we’re giving the correct information to.  They are then spreading that information through WhatsApp, through their own personal chats.

We’re also developing specific messages, sound bites that will be shared across the region about correct information.  We’re making sure that people have access to correct information in each country, making sure that hotlines are carrying the correct information, that they’re not spreading the disinformation.  We understand – I mean, there’s fear, people are scared, and they sometimes panic.  But it’s important – all of us have a responsibility of sharing correct information, and when we see something that is incorrect, we need to delete it or tell our friends that they should delete that information.

Going to the Ministry of Health websites and also going to the USAID and especially the CDC’s website is also a way where – a place where you can ensure that you’re seeing correct information.

Dan, what would you add?

Dr. Singer:  I would just make a point that this is a – this is a hard virus.  This is a difficult, difficult pandemic, and the process of fighting it, the process of saving lives is so much harder when you’re not just fighting the virus, but you’re also fighting disinformation.  It’s one of our biggest problems above and beyond the actual virus itself.

The types of information that are out there, they cover all kinds of things about possible treatments, rumors of potentially effective treatments that may not be, rumors about different mechanisms or modes of transmission and how you might be able to avoid getting the virus.  There’s – obviously, a pandemic of this size is not just a health crisis, it also is a economic issue and it’s a security issue for countries.  And in that environment there are always people who will try to capitalize on the crisis for their own benefit.  I’ve seen many different theories speculating that the virus is artificially created by one country or another country.  To the contrary, we have very strong evidence that this a naturally occurring virus.  It’s genetically very similar to a virus that occurs in bats and, in many ways, it behaves like other coronaviruses.  It is a consequence of close interaction between animals and humans, which is exactly how we ended up with SARS and MERS and some of the other related viruses.

So I think that there’s a lot of both accidental and deliberate misinformation out there and I would just reiterate Josh’s comment to go to the WHO website, to go to the CDC website, and to make sure that you’re getting your information from – directly from legitimate sources.

Moderator:  Okay, for our next question we’re actually going to go to the American Space in Dushanbe where there are several journalists dialing in.  A question from Avesta Agency in Tajikistan.  They ask, “Why do you think that there are no COVID-19-positive cases in Tajikistan?  What makes Tajikistan unique in that regard given that almost all neighboring countries have positive cases?”  They also ask, “When do you think the cases in general in Central Asia would start to decrease?”

Mr. Karnes:  I can take the first part if maybe, Dan, you want to take the second part about when infections will eventually go down.

I think for Tajikistan, at this stage in the – of the pandemic, there really is no reason for a country to hide their infections.  It’s important that countries are transparent and we do not believe at this time that Tajikistan is hiding any kind of infections.  There is the possibility that there are cases and they have not been tested – they have not been detected through the testing, but there are some countries in the world that still do not have large outbreaks.

What’s important, though – and we’ve been working closely with Tajikistan over the years and we’ve found them quite transparent with regards to data, and so at this time, there’s nothing that would have us directly question that data.  But of course, having enough test kits in country is critical.  You have to – the WHO, I think the motto is: test, test, test.  And that should be our model as well.  And we are working with Tajikistan to ramp up and scale up their testing so they can better detect potential cases.

Dr. Singer:  I would just add on Tajikistan, the ability to report cases is very dependent on the ability to detect them and we’ve been concerned about the – not just the ability of laboratories in the country, but the quality of the test kits that they’ve been receiving.  So we are looking at making some investments in the lab system in Tajikistan and in working with them to make sure that the test kits they have are sensitive enough to detect the virus at all stages of the disease.

On the other question about when the pandemic will peak, it’s a very difficult question because it’s dependent on a number of factors which are all very difficult to model.  We are looking at the spread of the disease globally, we’re looking at eventually a change in season, which may impact this virus, and it very much depends on the actions of each country.

So we know that quarantine and restrictions on movements are effective in suppressing the outbreak, but we’ve also seen that releasing those restrictions too early can cause a second surge in cases so it’s hard to know right now what will be the eventual peak.

Moderator:  Thank you for those answers.  Our next question comes to us from Aygerim Agyltayeva from Almaty TV in Kazakhstan.  They ask, “Did CDC make recommendations for medical workers who are on the front lines of coronavirus?”

Dr. Singer:  Yes, so CDC has a very extensive list of recommendations for medical workers that’s available on our website.  We’ve been translating all of those recommendations into Russian and providing them to the government.  In addition, we’ve been providing comments on Ministry of Health plans to offer ways that they can improve their control of the epidemic and reduce the transmission of the virus within the hospitals and clinics.

Moderator:  [Speaking in Russian.]

Interpreter:  Thank you for that.  We have our last question in Russian and this question is regarding the support that the U.S. Government provides to the countries of Central Asia – Tajikistan, Uzbekistan, Kazakhstan, and Kyrgyzstan – the financial support, the humanitarian support, and the other kinds of support.  What kind of volumes are we talking about?

Mr. Karnes:  Thank you for that question.  I think it’s important – as I said in my opening statement, we have been here since the beginning of independence, and in Kazakhstan in that time – at least this is USAID.  I don’t – I think if you looked at other assistance it would be greater.  We’ve provided $2.5 billion of assistance in Kazakhstan, $1.3 billion in Tajikistan, $1.06 billion in Uzbekistan, and $1.2 billion in the Kyrgyz Republic, and $327 million in Turkmenistan.

So, but that’s dollars.  It’s not just the dollars that count, it’s the technical assistance, it’s working on smart – on electrical grids, on bringing produce from the farm to the market, on developing new water systems, new waterways, working on democracy and governance, improving health and education.  It’s – there’s so much that we’ve been doing and it’s been a wonderful journey, and it’s been an excellent experience having these partnerships with the people of these countries and to see the transformation that has happened in the last 25 years.  It’s an honor.

Dr. Singer:  I would just add that we have – thus far, the U.S. Government has committed approximately $5 million to coronavirus response for the region.  This week I completed another request to our headquarters.  I’m hoping to get that approved soon and we would be bringing in additional resources.

I think it’s important to realize that even though we have this disease in America and it’s severe, and we are focusing on taking care of our own citizens, we are maintaining our commitment to partnership with these countries.  We will retain our staff here, we are growing our staff here, and we expect that we will continue to be able to provide support to all of these countries through this pandemic and afterwards.

Moderator:  Thank you.  Unfortunately, we – there are so many questions and so much interest, there are so many good questions and so many great journalists on the line, we could keep going and going and going.  Unfortunately, we’ve already reached an hour, which is twice the length of our initially planned press briefing, so we will have to go ahead and wrap it up.

But please, get in touch with your press teams, with your embassies, and hopefully we can arrange another briefing like this for you again soon.  Thank you also to our panelists, Dr. Singer and Mr. Karnes, for your time and for your frankness in answering the questions.

So we will send links shortly to all of our participating journalists to the recording of this briefing, and we will provide a transcript as soon as it’s available.  We will also translate the transcript into Russian for those of you who need it.

We’d also love to hear your feedback, so you can contact us any time at TheBrusselsHub@state.gov or provide your feedback to your local embassy contact there at the U.S. embassy.

Thanks again for your participation and we hope that you can join us for another press briefing very soon.


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