WEBVTT Kind: captions Language: en 00:00:00.340 --> 00:00:02.070 - Good morning, everyone. 00:00:02.070 --> 00:00:05.940 So we're currently experiencing a large resurgence 00:00:05.940 --> 00:00:08.450 in COVID-19 cases in our community 00:00:08.450 --> 00:00:11.210 and in many communities across the United States. 00:00:11.210 --> 00:00:15.970 And this resurgence is due to the new version 00:00:15.970 --> 00:00:20.090 of the SARS-CoV-2 virus called the delta variant. 00:00:20.090 --> 00:00:22.110 And I know that many people have questions 00:00:22.110 --> 00:00:23.620 about delta variant, 00:00:23.620 --> 00:00:24.980 why it's different, 00:00:24.980 --> 00:00:27.880 why we're seeing this surge in cases now, 00:00:27.880 --> 00:00:30.070 particularly across areas of the South, 00:00:30.070 --> 00:00:32.830 in the Midwest where vaccination rates are lower 00:00:32.830 --> 00:00:34.820 than they are in other parts of the country. 00:00:34.820 --> 00:00:38.620 So we have some graphics that our team here at IXL 00:00:40.380 --> 00:00:43.850 in partnership with Dr. Peter Angeletti's team 00:00:43.850 --> 00:00:45.380 at UNL have developed 00:00:45.380 --> 00:00:48.820 to help us demonstrate the delta variant, 00:00:48.820 --> 00:00:50.890 how it invades 00:00:50.890 --> 00:00:54.960 and impacts human respiratory epithelial cells, 00:00:54.960 --> 00:00:59.000 and why delta variant is more severe 00:00:59.000 --> 00:01:02.370 and is causing more serious outbreaks than we've seen 00:01:02.370 --> 00:01:04.700 in previous waves of the pandemic. 00:01:04.700 --> 00:01:05.680 So we're gonna go ahead 00:01:05.680 --> 00:01:09.950 and take a quick look at delta variant 00:01:09.950 --> 00:01:12.230 and what's different about this virus. 00:01:12.230 --> 00:01:15.840 So this is a representation of the SARS‑CoV‑2 virus. 00:01:15.840 --> 00:01:19.250 It's the virus that causes COVID-19. 00:01:19.250 --> 00:01:20.620 One of the most important features 00:01:20.620 --> 00:01:22.580 of the virus are these proteins here 00:01:22.580 --> 00:01:25.010 that stick out from the cell surface. 00:01:25.010 --> 00:01:26.530 Those are spike proteins. 00:01:26.530 --> 00:01:29.370 They're actually what give the virus its appearance 00:01:29.370 --> 00:01:31.160 that make it look like a crown 00:01:31.160 --> 00:01:32.960 under electron microscopy. 00:01:32.960 --> 00:01:34.720 It's why it's called coronavirus. 00:01:34.720 --> 00:01:37.210 But the other important thing about these spike proteins is 00:01:37.210 --> 00:01:40.230 it's how the virus attaches itself to our cells 00:01:40.230 --> 00:01:42.330 and allows it to gain entry. 00:01:42.330 --> 00:01:43.280 And what we've seen 00:01:43.280 --> 00:01:45.530 with delta variant is there's some changes 00:01:45.530 --> 00:01:48.210 in the spike protein that allow the virus 00:01:48.210 --> 00:01:52.080 to bind more tightly to its cell receptor 00:01:52.080 --> 00:01:55.170 and to gain entry into cells more readily. 00:01:55.170 --> 00:01:57.610 And we're gonna look at a video now 00:01:57.610 --> 00:01:59.143 that demonstrates that. 00:02:01.730 --> 00:02:05.900 So this video shows us a human respiratory epithelial cell. 00:02:05.900 --> 00:02:08.390 These are the cells that line your airways 00:02:08.390 --> 00:02:10.020 and inside your lungs. 00:02:10.020 --> 00:02:14.300 And this is one of the primary targets for coronaviruses 00:02:14.300 --> 00:02:15.280 and the delta variant. 00:02:15.280 --> 00:02:18.340 And here, we see the delta variant virus binding 00:02:18.340 --> 00:02:20.470 to its cell receptor, 00:02:20.470 --> 00:02:21.930 which is the ACE2 receptor 00:02:21.930 --> 00:02:23.210 on the outside of the cells. 00:02:23.210 --> 00:02:26.020 And that's how it gains entry inside the cell. 00:02:26.020 --> 00:02:27.700 Once it's in the cell, 00:02:27.700 --> 00:02:30.970 it releases its RNA genetic code. 00:02:30.970 --> 00:02:33.260 And that genetic code is then turned 00:02:33.260 --> 00:02:35.530 into proteins by the cell. 00:02:35.530 --> 00:02:38.390 Those viral proteins are then able 00:02:38.390 --> 00:02:43.390 to go inside kind of the the manufacturing area of the cell. 00:02:44.020 --> 00:02:46.340 This is called the endoplasmic reticulum. 00:02:46.340 --> 00:02:49.490 And what the virus does is it now hijacks the cell, 00:02:49.490 --> 00:02:51.430 and turns it into a virus factory. 00:02:51.430 --> 00:02:55.970 So now, the cell is just making virus, proteins, and RNA. 00:02:55.970 --> 00:02:58.210 Those get packaged into a new virus 00:02:58.210 --> 00:03:01.120 that then moves through what's called the Golgi apparatus 00:03:01.120 --> 00:03:02.370 to get enveloped. 00:03:02.370 --> 00:03:05.600 And then it comes out of the cell surface, 00:03:05.600 --> 00:03:08.750 and goes on to infect other cells in the body, 00:03:08.750 --> 00:03:10.460 and also to infect other people. 00:03:10.460 --> 00:03:13.640 Those are the viruses that we shed out of our nose 00:03:13.640 --> 00:03:16.120 and our respiratory epithelium 00:03:16.120 --> 00:03:17.380 that make it infectious. 00:03:17.380 --> 00:03:20.130 And what we know about the delta variant is, again, 00:03:20.130 --> 00:03:22.040 it does a much better job of binding 00:03:22.040 --> 00:03:24.800 to the cell surface receptor and gaining entry. 00:03:24.800 --> 00:03:27.580 It also does a better job of turning your cells 00:03:27.580 --> 00:03:29.150 into that virus factory, 00:03:29.150 --> 00:03:31.870 so it produces many more progeny, 00:03:31.870 --> 00:03:35.120 many more daughter virus particles 00:03:35.120 --> 00:03:37.310 than previous versions of the coronavirus. 00:03:37.310 --> 00:03:38.500 And we know that people 00:03:38.500 --> 00:03:42.250 with delta variant can shed up to a thousand times 00:03:42.250 --> 00:03:43.840 or more the amount of virus 00:03:43.840 --> 00:03:46.630 from their nose and respiratory epithelium 00:03:46.630 --> 00:03:48.430 than with the previous virus. 00:03:48.430 --> 00:03:51.480 Again, this is taking us through the process one more time. 00:03:51.480 --> 00:03:55.050 Remember, the RNA gets turned into proteins, 00:03:55.050 --> 00:03:56.740 which then hijack the cell. 00:03:56.740 --> 00:03:59.010 And now the cell is just making new viruses. 00:03:59.010 --> 00:04:01.870 Those new virus particles get packaged together. 00:04:01.870 --> 00:04:04.240 They come through the Golgi apparatus, 00:04:04.240 --> 00:04:05.520 and they get enveloped, 00:04:05.520 --> 00:04:07.620 and then they are extruded outside 00:04:07.620 --> 00:04:11.510 of the cell going on to infect other cells. 00:04:11.510 --> 00:04:13.780 Now I think if we move forward, 00:04:13.780 --> 00:04:17.230 we can look at how vaccines protect us. 00:04:17.230 --> 00:04:18.650 So if we stop here... 00:04:18.650 --> 00:04:21.060 And let's go back a little bit if we can, 00:04:21.060 --> 00:04:22.083 or start again. 00:04:23.170 --> 00:04:24.003 No worries. 00:04:27.060 --> 00:04:27.950 All right, keep going. 00:04:27.950 --> 00:04:29.130 Just a second. 00:04:29.130 --> 00:04:30.400 Stop right there. 00:04:30.400 --> 00:04:31.233 Perfect. 00:04:31.233 --> 00:04:33.210 So this is the receptor on the cell 00:04:33.210 --> 00:04:34.350 that the virus binds to. 00:04:34.350 --> 00:04:35.900 That's the ACE2 receptor. 00:04:35.900 --> 00:04:37.800 And again, this is the spike protein. 00:04:37.800 --> 00:04:39.240 And that spike protein 00:04:39.240 --> 00:04:42.700 and the ACE2 receptor work like a key and a lock. 00:04:42.700 --> 00:04:44.730 They fit very tightly together. 00:04:44.730 --> 00:04:46.120 And the better the fit, 00:04:46.120 --> 00:04:49.570 the more the virus is able to gain entry, 00:04:49.570 --> 00:04:50.610 the tighter that bond. 00:04:50.610 --> 00:04:51.780 And we know, again, 00:04:51.780 --> 00:04:53.920 delta variant gives you a very tight fit, 00:04:53.920 --> 00:04:57.400 a much tighter fit with that ACE2 receptor. 00:04:57.400 --> 00:04:59.080 Now, a way to prevent the virus 00:04:59.080 --> 00:05:01.090 from gaining entry are these things 00:05:01.090 --> 00:05:02.480 which are antibodies. 00:05:02.480 --> 00:05:05.590 So those antibodies also target that spike protein, 00:05:05.590 --> 00:05:07.660 and they bind to the spike protein, 00:05:07.660 --> 00:05:10.860 and block its ability to be able to bind 00:05:10.860 --> 00:05:11.720 to the cell receptor. 00:05:11.720 --> 00:05:14.240 So when that lock and key can't fit together, 00:05:14.240 --> 00:05:16.270 the virus can invade yourself, 00:05:16.270 --> 00:05:18.250 and it's taken away, and killed, 00:05:18.250 --> 00:05:20.340 and disposed of by the immune system. 00:05:20.340 --> 00:05:22.380 And these antibodies are what are produced 00:05:22.380 --> 00:05:23.900 when you get vaccinated, right? 00:05:23.900 --> 00:05:26.780 The vaccines produce very high levels 00:05:26.780 --> 00:05:28.840 of neutralizing antibodies. 00:05:28.840 --> 00:05:31.800 Much higher than the levels of antibodies you get 00:05:31.800 --> 00:05:32.840 with natural infection. 00:05:32.840 --> 00:05:34.420 And that's the reason, 00:05:34.420 --> 00:05:36.400 at least one of the main reasons we think 00:05:36.400 --> 00:05:40.580 why vaccines for COVID-19 work so much better 00:05:40.580 --> 00:05:43.580 than protection from previous infection. 00:05:43.580 --> 00:05:45.920 You get much higher titer of antibodies 00:05:45.920 --> 00:05:48.830 with two doses of the vaccines. 00:05:48.830 --> 00:05:51.890 And when you have these high titers of antibodies, again, 00:05:51.890 --> 00:05:55.230 you block the spike proteins' ability 00:05:55.230 --> 00:05:57.110 to bind to its cell receptor. 00:05:57.110 --> 00:05:58.520 It can't get into your cells. 00:05:58.520 --> 00:06:01.100 It can't hijack them to make more viruses. 00:06:01.100 --> 00:06:04.260 And again, it's taken away and killed by the immune system. 00:06:04.260 --> 00:06:05.640 And that's why it's so important 00:06:05.640 --> 00:06:09.020 that we get as many of our community vaccinated as possible, 00:06:09.020 --> 00:06:11.090 so we can avoid that scenario 00:06:11.090 --> 00:06:13.210 of the virus infecting a cell, 00:06:13.210 --> 00:06:15.030 and we can get to this scenario 00:06:15.030 --> 00:06:16.580 where everybody has antibodies 00:06:16.580 --> 00:06:18.970 that prevents that cell invasion 00:06:18.970 --> 00:06:21.060 and replication of the virus. 00:06:21.060 --> 00:06:23.510 So I think that's what we have for the graphics. 00:06:23.510 --> 00:06:24.860 And again, I think it's really helpful 00:06:24.860 --> 00:06:27.580 to kind of be able to visualize what's going on 00:06:27.580 --> 00:06:28.870 at a cellular level. 00:06:28.870 --> 00:06:32.100 I think we have an even a more close up version 00:06:32.100 --> 00:06:33.970 of the virus invasion 00:06:33.970 --> 00:06:36.410 and what happens when it gets inside the cell 00:06:36.410 --> 00:06:37.930 that we can play here. 00:06:37.930 --> 00:06:40.153 But I'm happy to take any questions now. 00:06:41.280 --> 00:06:42.113 Yes? 00:06:42.113 --> 00:06:43.180 - [Audience 1] So they always are saying 00:06:43.180 --> 00:06:45.560 that the delta variant is more transmissible 00:06:45.560 --> 00:06:46.830 and obviously more contagious. 00:06:46.830 --> 00:06:48.770 Is there anything else that it does particularly 00:06:48.770 --> 00:06:52.520 to the human body that like the other versions 00:06:52.520 --> 00:06:56.080 of COVID haven't done that you've noticed 00:06:56.080 --> 00:06:57.710 that's like strikingly different? 00:06:57.710 --> 00:06:58.630 - Right, great question. 00:06:58.630 --> 00:07:01.130 So again, you're correct. 00:07:01.130 --> 00:07:03.850 It does appear that the virus is much more transmissible. 00:07:03.850 --> 00:07:07.170 Probably twice as transmissible from person to person 00:07:07.170 --> 00:07:08.860 as the original virus was. 00:07:08.860 --> 00:07:10.990 And people shed much more virus 00:07:10.990 --> 00:07:13.030 from their respiratory epithelium. 00:07:13.030 --> 00:07:15.590 One of the reasons why it is much more transmissible. 00:07:15.590 --> 00:07:17.040 The other thing that seems 00:07:17.040 --> 00:07:19.250 to be more and more clear is it's able 00:07:19.250 --> 00:07:22.360 to cause more severe disease in an individual 00:07:22.360 --> 00:07:25.330 compared to previous versions of the virus. 00:07:25.330 --> 00:07:26.440 So if you look at some of the studies 00:07:26.440 --> 00:07:29.350 that have come out of Canada and Europe, 00:07:29.350 --> 00:07:33.590 the delta variant seems to cause around two times 00:07:33.590 --> 00:07:37.000 or even two to three times the rate of hospitalization, 00:07:37.000 --> 00:07:39.760 the rate of ICU admission for a given person 00:07:39.760 --> 00:07:42.090 compared to older versions of the virus. 00:07:42.090 --> 00:07:44.870 And so it not only spreads more easily, 00:07:44.870 --> 00:07:46.550 it causes more severe disease. 00:07:46.550 --> 00:07:47.990 And that's I think one of the reasons 00:07:47.990 --> 00:07:51.620 why we're seeing so many more ICU admissions 00:07:51.620 --> 00:07:53.660 from this current wave of delta variant 00:07:53.660 --> 00:07:55.790 than we would necessarily suspect. 00:07:55.790 --> 00:07:57.990 Infections are primarily occurring 00:07:57.990 --> 00:07:59.480 in unvaccinated individuals, 00:07:59.480 --> 00:08:00.840 particularly serious infections 00:08:00.840 --> 00:08:02.840 that are requiring hospitalizations. 00:08:02.840 --> 00:08:06.630 And previously, we didn't see as many hospitalizations 00:08:06.630 --> 00:08:09.389 in people in their 30s, and 40s, and 50s. 00:08:09.389 --> 00:08:11.970 But now, we're seeing that quite commonly. 00:08:11.970 --> 00:08:14.560 And so, that I think is very good evidence 00:08:14.560 --> 00:08:15.870 that the delta variant is able 00:08:15.870 --> 00:08:18.300 to actually cause more severe disease in people 00:08:18.300 --> 00:08:19.933 than previous variants. 00:08:23.097 --> 00:08:25.010 - [Audience 2] First, any question? 00:08:25.010 --> 00:08:27.460 - [Audience 3] What do we know about the transmission 00:08:27.460 --> 00:08:29.690 of the delta variant to a fetus 00:08:30.540 --> 00:08:34.763 in either a woman who is vaccinated or unvaccinated? 00:08:35.910 --> 00:08:37.190 - That's a great question. 00:08:37.190 --> 00:08:39.580 We don't have a lot of data 00:08:39.580 --> 00:08:42.700 on infections of the fetus in pregnancy. 00:08:42.700 --> 00:08:44.830 We do have more and more data now, 00:08:44.830 --> 00:08:49.160 however that show pregnant women are especially vulnerable 00:08:49.160 --> 00:08:50.980 to delta variant infection. 00:08:50.980 --> 00:08:53.110 And we're seeing many more hospitalizations 00:08:53.110 --> 00:08:57.260 among pregnant women compared to previous versions 00:08:57.260 --> 00:08:58.120 of the virus. 00:08:58.120 --> 00:09:00.920 We also know from studies that have been done now 00:09:00.920 --> 00:09:04.580 on tens of thousands of pregnant women in clinical trials. 00:09:04.580 --> 00:09:05.620 And in addition, 00:09:05.620 --> 00:09:07.430 millions of vaccinations, obviously, 00:09:07.430 --> 00:09:09.690 that had been given across the US 00:09:09.690 --> 00:09:12.223 that these vaccines are safe in pregnancy. 00:09:14.150 --> 00:09:15.620 They don't affect fetal development. 00:09:15.620 --> 00:09:17.940 They don't affect childbirth. 00:09:17.940 --> 00:09:20.060 They don't affect fertility. 00:09:20.060 --> 00:09:22.440 So the vaccines have a very good safety profile. 00:09:22.440 --> 00:09:25.670 And it's very important for pregnant women to get vaccinated 00:09:25.670 --> 00:09:28.370 because their rate of complications from infection 00:09:28.370 --> 00:09:32.623 with COVID-19 are much greater than non-pregnant women. 00:09:34.350 --> 00:09:35.183 Yes? 00:09:35.183 --> 00:09:36.830 - [Audience 4] Have you encountered any misconceptions 00:09:36.830 --> 00:09:39.410 about the vaccine and the delta variant specifically 00:09:39.410 --> 00:09:41.210 that you wanna dispel? 00:09:41.210 --> 00:09:44.520 - Well, I'm not sure that there are specific misconceptions 00:09:44.520 --> 00:09:46.140 about the delta variant. 00:09:46.140 --> 00:09:49.500 But obviously, a lot of misinformation and misconceptions 00:09:49.500 --> 00:09:51.120 out there around the vaccine. 00:09:51.120 --> 00:09:52.750 One of which I just pointed out 00:09:52.750 --> 00:09:56.380 that people have really attached to the rumor 00:09:56.380 --> 00:09:59.320 that there are fertility issues associated 00:09:59.320 --> 00:10:00.230 with the vaccine. 00:10:00.230 --> 00:10:02.400 And that's simply not been demonstrated 00:10:02.400 --> 00:10:04.550 in any of the data we have. 00:10:04.550 --> 00:10:05.820 There's also no evidence 00:10:05.820 --> 00:10:08.610 that there are long-term effects from the vaccine. 00:10:08.610 --> 00:10:13.600 Again, we don't routinely see long-term effects 00:10:13.600 --> 00:10:15.430 from vaccines that would manifest themselves 00:10:15.430 --> 00:10:18.700 after several weeks after vaccination, 00:10:18.700 --> 00:10:20.550 and so have no reason to believe 00:10:20.550 --> 00:10:23.500 that we would have long-term effects from these vaccines. 00:10:23.500 --> 00:10:26.680 The safety profile of these vaccines is very much in line 00:10:26.680 --> 00:10:29.440 with all of the other routine vaccinations 00:10:29.440 --> 00:10:31.030 that we typically use. 00:10:31.030 --> 00:10:34.180 And again, we've had now hundreds of millions of doses, 00:10:34.180 --> 00:10:37.430 over 300 million doses of these vaccines given to Americans 00:10:37.430 --> 00:10:40.730 and billions of doses given to people worldwide. 00:10:40.730 --> 00:10:44.720 And there has been no vaccine ever I think 00:10:44.720 --> 00:10:48.870 that has had the safety profiling and monitoring 00:10:48.870 --> 00:10:51.570 that these vaccines have had prior to full licensure. 00:10:51.570 --> 00:10:53.420 And so I have extreme confidence 00:10:53.420 --> 00:10:54.750 in the safety of these vaccines 00:10:54.750 --> 00:10:56.320 and certainly the efficacy data 00:10:56.320 --> 00:10:58.540 of these vaccines is quite clear. 00:10:58.540 --> 00:11:01.940 We are seeing primarily unvaccinated people 00:11:01.940 --> 00:11:04.260 being hospitalized now with delta variant. 00:11:04.260 --> 00:11:07.630 And the rate of hospitalization for people 00:11:07.630 --> 00:11:10.720 who are fully vaccinated is still low. 00:11:10.720 --> 00:11:12.480 Certainly, breakthrough infections are more common 00:11:12.480 --> 00:11:13.313 with delta. 00:11:13.313 --> 00:11:15.190 And we know that the vaccines aren't perfect. 00:11:15.190 --> 00:11:16.290 None are, 00:11:16.290 --> 00:11:19.130 but we're seeing a dramatic reduction 00:11:19.130 --> 00:11:21.510 in severe infections and hospitalizations in people 00:11:21.510 --> 00:11:22.803 who are fully vaccinated. 00:11:24.210 --> 00:11:25.043 Yes? 00:11:25.043 --> 00:11:26.190 - [Audience 5] I know that there are a lot of unknowns 00:11:26.190 --> 00:11:27.600 when it comes to the vaccines. 00:11:27.600 --> 00:11:29.880 But obviously, as we learn more about the delta variant, 00:11:29.880 --> 00:11:31.410 possibly other variants, 00:11:31.410 --> 00:11:33.070 how much do you expect that we will have 00:11:33.070 --> 00:11:35.950 to tweak vaccines or feature other Medicare 00:11:35.950 --> 00:11:37.950 or anything else that we have to do 00:11:37.950 --> 00:11:40.640 to prevent our bodies to fight it? 00:11:40.640 --> 00:11:41.940 - That's a great question. 00:11:43.832 --> 00:11:45.200 There's a lot of questions 00:11:45.200 --> 00:11:47.630 that experts and scientists have about: 00:11:47.630 --> 00:11:49.220 How long will immunity last? 00:11:49.220 --> 00:11:51.860 When will we really need people to get boosters? 00:11:51.860 --> 00:11:53.620 Will those boosters need be to different? 00:11:53.620 --> 00:11:55.350 Well, we need to modify the vaccine 00:11:55.350 --> 00:11:57.260 to reflect some of the newer variants. 00:11:57.260 --> 00:11:59.090 Right now, I don't think we have the answers 00:11:59.090 --> 00:12:01.070 to those questions yet. 00:12:01.070 --> 00:12:04.430 What is clear is that the longer we allow the pandemic 00:12:04.430 --> 00:12:05.410 to go on. 00:12:05.410 --> 00:12:09.060 And this is not just a problem here in the US. 00:12:09.060 --> 00:12:10.100 This is globally, right? 00:12:10.100 --> 00:12:13.590 The more people that are infected with new variants 00:12:13.590 --> 00:12:14.600 of the virus, 00:12:14.600 --> 00:12:16.710 the more we have partially immune 00:12:16.710 --> 00:12:19.010 partially vaccinated populations out there 00:12:19.010 --> 00:12:20.600 with the virus circulating, 00:12:20.600 --> 00:12:23.530 the more opportunities we give for new variants to arise 00:12:23.530 --> 00:12:25.650 that may eventually be able to do a better job 00:12:25.650 --> 00:12:28.880 at escaping the protection from the vaccines. 00:12:28.880 --> 00:12:30.680 We hope that we can vaccinate enough 00:12:30.680 --> 00:12:31.720 of the world's population, 00:12:31.720 --> 00:12:33.445 so we prevent that from happening. 00:12:33.445 --> 00:12:34.720 And then we just have 00:12:34.720 --> 00:12:37.410 to worry about periodic booster vaccines 00:12:37.410 --> 00:12:39.220 for people going forward. 00:12:39.220 --> 00:12:41.260 I think it's true that eventually 00:12:41.260 --> 00:12:43.228 most of us will need a booster shot. 00:12:43.228 --> 00:12:45.330 Right now, we're not seeing evidence 00:12:45.330 --> 00:12:47.700 that indicates that there's an emergency 00:12:47.700 --> 00:12:49.950 that we need boosters right now. 00:12:49.950 --> 00:12:52.980 And from a global perspective, 00:12:52.980 --> 00:12:53.940 we're all better off, 00:12:53.940 --> 00:12:55.090 and we're all better protected 00:12:55.090 --> 00:12:57.700 if we vaccinate a larger proportion 00:12:57.700 --> 00:12:59.120 of the world's population, 00:12:59.120 --> 00:13:02.160 so we can suppress global transmission of the virus 00:13:02.160 --> 00:13:03.390 rather than focusing on 00:13:03.390 --> 00:13:06.070 what might be incremental improvements 00:13:06.070 --> 00:13:08.670 in individual protection with the booster right now. 00:13:10.950 --> 00:13:11.783 Yes? 00:13:11.783 --> 00:13:12.949 - [Audience 4] Is there any indication 00:13:12.949 --> 00:13:14.424 that this hits harder on children? 00:13:14.424 --> 00:13:17.320 There's been a lot of discussion about that. 00:13:17.320 --> 00:13:18.790 - Well, I think it's- 00:13:18.790 --> 00:13:20.310 - [Audience 4] Do we know yet? 00:13:20.310 --> 00:13:23.230 - I don't know that we have definitive answers on that. 00:13:23.230 --> 00:13:24.860 But certainly, anecdotally, 00:13:24.860 --> 00:13:29.860 we're seeing many more pediatric admissions for COVID-19 00:13:30.140 --> 00:13:31.830 than we have in previous waves. 00:13:31.830 --> 00:13:34.010 I think it's also important to remember 00:13:34.010 --> 00:13:39.010 that we are seeing at the same time rising rates of RSV 00:13:39.350 --> 00:13:41.450 or respiratory syncytial virus, 00:13:41.450 --> 00:13:43.460 parainfluenza virus infections, 00:13:43.460 --> 00:13:46.970 and even early influenza infections in children, 00:13:46.970 --> 00:13:50.020 which this is an unusual time in the middle of summer 00:13:50.020 --> 00:13:52.340 to see many of those respiratory viruses. 00:13:52.340 --> 00:13:57.190 And this is probably an effect of the face masks 00:13:57.190 --> 00:13:58.430 kind of being removed, 00:13:58.430 --> 00:14:00.750 and a lot of the non-pharmaceutical interventions 00:14:00.750 --> 00:14:02.690 that we were taking that were suppressing all 00:14:02.690 --> 00:14:03.980 of these respiratory viruses, 00:14:03.980 --> 00:14:05.730 not just COVID-19. 00:14:05.730 --> 00:14:08.930 I think now that those protections have been lifted, 00:14:08.930 --> 00:14:10.620 we're seeing a resurgence in all 00:14:10.620 --> 00:14:12.240 of these different respiratory viruses. 00:14:12.240 --> 00:14:15.960 So we're seeing not only a surge in COVID 19 cases in kids, 00:14:15.960 --> 00:14:19.630 but I think a combination of all of these other viruses. 00:14:19.630 --> 00:14:22.360 Which for the very young infants 00:14:22.360 --> 00:14:26.100 and children who have underlying comorbidities, 00:14:26.100 --> 00:14:28.120 these infections can be very serious, 00:14:28.120 --> 00:14:29.840 RSV and parainfluenza. 00:14:29.840 --> 00:14:33.300 And so all of these I think are going to be eating 00:14:33.300 --> 00:14:36.320 into our pediatric critical care resources, 00:14:36.320 --> 00:14:38.740 which are obviously pretty limited to begin with. 00:14:38.740 --> 00:14:40.540 And so I'm very worried about what's gonna happen 00:14:40.540 --> 00:14:43.923 with the pediatric hospital capacity over the coming weeks. 00:14:45.310 --> 00:14:46.720 - [Audience 6] Do you think that members 00:14:46.720 --> 00:14:50.520 of the community should at this point be kind of scared 00:14:50.520 --> 00:14:51.520 of what's happening? 00:14:52.700 --> 00:14:54.450 - I think people should be very concerned 00:14:54.450 --> 00:14:56.470 about the trends we're seeing. 00:14:56.470 --> 00:14:59.670 I think many of us were hopeful several weeks ago 00:14:59.670 --> 00:15:03.810 that our course of the delta wave would be more similar 00:15:03.810 --> 00:15:05.610 to the UK. 00:15:05.610 --> 00:15:06.830 So in England in the UK, 00:15:06.830 --> 00:15:09.920 they've seen a pretty dramatic spike in cases, 00:15:09.920 --> 00:15:12.820 but their hospitalization rates did not go up 00:15:12.820 --> 00:15:17.100 at near the same proportion as they had with previous waves. 00:15:17.100 --> 00:15:19.530 What we're seeing currently in places like Florida 00:15:19.530 --> 00:15:23.870 and Louisiana, Arkansas, Missouri, Mississippi, 00:15:23.870 --> 00:15:27.570 everywhere in the US that we're seeing delta wave growth, 00:15:27.570 --> 00:15:28.780 we're seeing hospitalization 00:15:28.780 --> 00:15:31.710 and ICU admission rates that are going up 00:15:31.710 --> 00:15:34.500 at the same rate or even higher than they were 00:15:34.500 --> 00:15:35.770 back in the fall. 00:15:35.770 --> 00:15:38.600 And that's a really dire warning sign 00:15:38.600 --> 00:15:41.000 that we're not going to have the same experience 00:15:41.000 --> 00:15:42.230 that the UK did. 00:15:42.230 --> 00:15:46.290 We're seeing hospitals already overwhelmed in places, 00:15:46.290 --> 00:15:49.390 in parts of Florida, and parts of Texas, and Louisiana. 00:15:49.390 --> 00:15:52.310 And unfortunately, I think that trend's going to continue. 00:15:52.310 --> 00:15:54.870 So I'm concerned this is going to be the worst phase 00:15:54.870 --> 00:15:57.130 of the pandemic for much of the US, 00:15:57.130 --> 00:15:59.020 particularly states like ours 00:15:59.020 --> 00:16:00.873 that have low vaccination rates. 00:16:02.140 --> 00:16:05.130 - [Audience 7] How far behind those states are we? 00:16:05.130 --> 00:16:07.660 Is there weeks, months before? 00:16:07.660 --> 00:16:09.570 - So we're probably a month, 00:16:09.570 --> 00:16:11.960 three to four weeks behind many of the states 00:16:11.960 --> 00:16:15.340 that were the earliest to experience a delta surge. 00:16:15.340 --> 00:16:16.500 And so that means 00:16:16.500 --> 00:16:20.550 that most of those states have not yet peaked by any means. 00:16:20.550 --> 00:16:23.230 And so we're going to see continued growth 00:16:23.230 --> 00:16:25.700 for at least the next three to four weeks, 00:16:25.700 --> 00:16:27.500 if not longer to be honest. 00:16:27.500 --> 00:16:30.750 If we follow a time pattern similar to the UK, 00:16:30.750 --> 00:16:34.020 we may be in for another six weeks of growth. 00:16:34.020 --> 00:16:35.430 That doesn't account for the fact 00:16:35.430 --> 00:16:37.240 that we're about to open schools, right? 00:16:37.240 --> 00:16:39.250 And we know that in the UK, 00:16:39.250 --> 00:16:41.720 kids and schools drove transmission 00:16:41.720 --> 00:16:45.150 of the delta wave quite significantly. 00:16:45.150 --> 00:16:47.470 And so when we open schools, 00:16:47.470 --> 00:16:48.970 particularly if we open schools 00:16:48.970 --> 00:16:51.040 without kids with face masks 00:16:51.040 --> 00:16:52.683 and other non-pharmaceutical interventions, 00:16:52.683 --> 00:16:55.220 there's layers of Swiss cheese that we've talked about 00:16:55.220 --> 00:16:57.540 and how you block propagation of the virus 00:16:57.540 --> 00:16:58.570 through a community, 00:16:58.570 --> 00:17:00.780 we're just gonna be throwing gasoline on a fire 00:17:00.780 --> 00:17:01.613 at that point. 00:17:01.613 --> 00:17:03.880 And we're gonna see much higher rates of transmission. 00:17:03.880 --> 00:17:06.140 And unfortunately, the way things are going, 00:17:06.140 --> 00:17:09.040 that translates into increased hospitalizations, 00:17:09.040 --> 00:17:10.710 increased ICU admissions, 00:17:10.710 --> 00:17:12.060 and we're gonna see increased deaths. 00:17:12.060 --> 00:17:15.150 And those deaths are not gonna be an 85-year-olds anymore. 00:17:15.150 --> 00:17:17.972 Those deaths are now occurring in 45-year-olds. 00:17:17.972 --> 00:17:20.993 And that's gonna be a significant difference. 00:17:20.993 --> 00:17:22.480 - [Audience 8] How frustrating is it for you personally 00:17:22.480 --> 00:17:25.620 to try to go to all these lengths to get through the people? 00:17:25.620 --> 00:17:27.770 I mean, we've got this simple breakdown that you have 00:17:27.770 --> 00:17:29.550 that everybody has seen the photos of the lungs, 00:17:29.550 --> 00:17:31.330 the unvaccinated versus vaccinated. 00:17:31.330 --> 00:17:34.360 I mean, how many more ways can you get through 00:17:34.360 --> 00:17:36.593 to members of the public? 00:17:36.593 --> 00:17:37.810 - Well, we're gonna keep trying. 00:17:37.810 --> 00:17:40.460 We're gonna keep talking about the data we have 00:17:40.460 --> 00:17:41.430 and the facts. 00:17:41.430 --> 00:17:44.870 And hope that people can change their behavior. 00:17:44.870 --> 00:17:45.860 And that collectively, 00:17:45.860 --> 00:17:49.740 we can work on reinstituting many of these protections 00:17:49.740 --> 00:17:53.090 that got us through the fall and winter wave. 00:17:53.090 --> 00:17:55.970 I'm actually encouraged somewhat by some of the data 00:17:55.970 --> 00:17:57.690 that's coming out of states 00:17:57.690 --> 00:18:01.030 that are experiencing large waves of delta variant. 00:18:01.030 --> 00:18:01.970 And even here, 00:18:01.970 --> 00:18:05.670 we are starting to see more vaccinations happening 00:18:05.670 --> 00:18:07.770 compared to where we were a couple of weeks ago. 00:18:07.770 --> 00:18:09.560 If we can build on that momentum 00:18:09.560 --> 00:18:11.810 and get enough of the community vaccinated, 00:18:11.810 --> 00:18:12.890 we'll be free of this. 00:18:12.890 --> 00:18:16.050 If we were able to reach high rates of vaccination 00:18:16.050 --> 00:18:16.883 in the community, 00:18:16.883 --> 00:18:18.412 80% of the community vaccinated, 00:18:18.412 --> 00:18:21.420 we really would have a very mild experience 00:18:21.420 --> 00:18:22.590 with this delta wave. 00:18:22.590 --> 00:18:24.710 And I think the UK is a great example of that, right? 00:18:24.710 --> 00:18:26.290 They have much higher vaccination rates, 00:18:26.290 --> 00:18:29.100 particularly among kind of young and middle-aged adults. 00:18:29.100 --> 00:18:31.470 And that's why they're not seeing this explosive growth 00:18:31.470 --> 00:18:32.750 in hospitalizations. 00:18:32.750 --> 00:18:34.480 So if we can get there... 00:18:34.480 --> 00:18:35.560 And we don't have much time, 00:18:35.560 --> 00:18:36.720 but if we can get there, 00:18:36.720 --> 00:18:38.760 we can really avert the worst part of this. 00:18:38.760 --> 00:18:40.900 And again, that's been encouraging to see 00:18:40.900 --> 00:18:43.330 that we are starting to make an impact in vaccination. 00:18:43.330 --> 00:18:46.000 So hopefully, we can continue. 00:18:46.000 --> 00:18:47.000 - [Audience 9] Should people including those 00:18:47.000 --> 00:18:50.033 who are vaccinated be changing their habits right now? 00:18:51.240 --> 00:18:52.260 - Yes, absolutely. 00:18:52.260 --> 00:18:55.260 I think that the CDC was right on 00:18:55.260 --> 00:18:59.160 in adjusting their masking guidance. 00:18:59.160 --> 00:18:59.993 Yeah. 00:18:59.993 --> 00:19:01.530 It could take issue whether they should have changed it 00:19:01.530 --> 00:19:03.390 to begin with several couple of months ago. 00:19:03.390 --> 00:19:04.360 But at any rate, 00:19:04.360 --> 00:19:08.020 I think it's clear that not only should unvaccinated people 00:19:08.020 --> 00:19:10.370 be wearing face masks in public, indoor spaces, 00:19:10.370 --> 00:19:12.000 but vaccinated folks as well. 00:19:12.000 --> 00:19:14.510 And we know that we're seeing higher rates 00:19:14.510 --> 00:19:15.560 of breakthrough infections. 00:19:15.560 --> 00:19:17.390 We know that vaccinated people are able 00:19:17.390 --> 00:19:18.810 to transmit to others. 00:19:18.810 --> 00:19:20.100 That happens at a lower rate 00:19:20.100 --> 00:19:21.410 than it does with unvaccinated, 00:19:21.410 --> 00:19:22.500 but it still happens. 00:19:22.500 --> 00:19:26.090 And so if we want to maximize protection of the community 00:19:26.090 --> 00:19:27.420 and minimize the number of cases, 00:19:27.420 --> 00:19:29.810 minimize hospitalizations and deaths, 00:19:29.810 --> 00:19:32.152 everybody should be wearing face masks indoors, 00:19:32.152 --> 00:19:33.910 in public settings. 00:19:33.910 --> 00:19:36.050 Then we should be doing a lot of the things 00:19:36.050 --> 00:19:38.060 that we did back in the fall and winter 00:19:38.060 --> 00:19:42.321 that allowed us to navigate that surge that we experienced. 00:19:42.321 --> 00:19:43.154 Yes? 00:19:43.154 --> 00:19:43.987 - [Audience 5] I know ideally, 00:19:43.987 --> 00:19:45.430 we want the vaccination rate of a 100%. 00:19:45.430 --> 00:19:47.170 That's probably living in a perfect world, though. 00:19:47.170 --> 00:19:49.080 So but what rate would you say? 00:19:49.080 --> 00:19:51.250 Is it ideal that you would be able 00:19:51.250 --> 00:19:54.707 to achieve that probably 75%, 80? 00:19:54.707 --> 00:19:57.440 - So it's a bit of a guesswork, right? 00:19:57.440 --> 00:20:00.070 But if you look at the epidemiology 00:20:00.070 --> 00:20:04.510 and modeling based on what we think the reproductive number 00:20:04.510 --> 00:20:05.700 of this viruses, 00:20:05.700 --> 00:20:08.410 it gets you to a herd immunity threshold 00:20:08.410 --> 00:20:10.477 of around 85% or so. 00:20:10.477 --> 00:20:13.840 And so ideally, you'd like to have 85% 00:20:13.840 --> 00:20:16.310 of the entire population vaccinated. 00:20:16.310 --> 00:20:19.710 And obviously, we don't have vaccines eligible 00:20:19.710 --> 00:20:23.130 for children under the age of 12 right now. 00:20:23.130 --> 00:20:27.380 And so that takes a bit of the population off the table. 00:20:27.380 --> 00:20:28.270 The reality is, 00:20:28.270 --> 00:20:30.930 in the real world is a lot messier than that, right? 00:20:30.930 --> 00:20:33.140 And so transmission generally occurs 00:20:33.140 --> 00:20:35.120 in smaller pockets of the population. 00:20:35.120 --> 00:20:37.620 And it's particularly school-aged children, 00:20:37.620 --> 00:20:39.500 young adults and middle-aged adults. 00:20:39.500 --> 00:20:41.640 They're the most connected in our society, right? 00:20:41.640 --> 00:20:43.360 They bump into the most people every day. 00:20:43.360 --> 00:20:45.990 They're most responsible for virus transmission. 00:20:45.990 --> 00:20:48.740 So if you can just get vaccination levels up high 00:20:48.740 --> 00:20:50.703 in that particular population, 00:20:51.670 --> 00:20:53.520 the rest can kind of take care of itself. 00:20:53.520 --> 00:20:58.270 So I do think that a legitimate target seems to be 00:20:58.270 --> 00:21:01.350 at least 70% of the entire population vaccinated. 00:21:01.350 --> 00:21:02.320 Again, if you look at the UK, 00:21:02.320 --> 00:21:03.480 that's about where they are. 00:21:03.480 --> 00:21:04.313 And again, 00:21:04.313 --> 00:21:07.020 their experience with delta wave has been much, much better. 00:21:07.020 --> 00:21:08.940 Hospitalization rates much lower. 00:21:08.940 --> 00:21:11.130 I think once you get to 75% or 80%, 00:21:11.130 --> 00:21:13.280 you really start to see dramatic suppression 00:21:13.280 --> 00:21:14.480 of transmission. 00:21:14.480 --> 00:21:16.500 The reality is we have a long way to go, right? 00:21:16.500 --> 00:21:19.140 So the more vaccinations we can get in the community, 00:21:19.140 --> 00:21:20.950 the better off we'll be. 00:21:20.950 --> 00:21:22.560 Again, I think once we get to rates. 00:21:22.560 --> 00:21:24.680 There are states in the US 00:21:24.680 --> 00:21:26.010 that have achieved those rates. 00:21:26.010 --> 00:21:26.960 States in the Northeast, 00:21:26.960 --> 00:21:28.710 particularly Vermont, and Maine, 00:21:28.710 --> 00:21:32.200 and New Hampshire have pretty high vaccination rates. 00:21:32.200 --> 00:21:35.300 And they're seeing a relatively mild waves 00:21:35.300 --> 00:21:36.590 of the delta so far. 00:21:36.590 --> 00:21:38.140 So we have a long way to go, 00:21:38.140 --> 00:21:39.420 but I think we can get there. 00:21:39.420 --> 00:21:42.070 And again, if we can get to those rates, 00:21:42.070 --> 00:21:45.533 we'll really navigate this relatively smoothly. 00:21:46.650 --> 00:21:48.070 - [Audience 6] Is there (sound breaks up) 00:21:48.070 --> 00:21:51.260 you might have four local school districts 00:21:51.260 --> 00:21:55.510 who right now are just recommending masks 00:21:55.510 --> 00:21:58.140 and not requiring them of their students, 00:21:58.140 --> 00:22:00.210 especially the younger ones? 00:22:00.210 --> 00:22:01.043 - Right. 00:22:01.043 --> 00:22:02.610 Well, I know there have been some school districts 00:22:02.610 --> 00:22:06.500 that have now moved towards at least mandating vaccines 00:22:06.500 --> 00:22:09.430 in elementary school students who don't have the option 00:22:09.430 --> 00:22:10.490 to be vaccinated. 00:22:10.490 --> 00:22:13.700 Again, I think the CDC's guidance is pretty straightforward 00:22:13.700 --> 00:22:14.600 and pretty clear. 00:22:14.600 --> 00:22:18.560 And the CDC recommends universal masking for all students 00:22:18.560 --> 00:22:19.923 in a classroom setting. 00:22:20.830 --> 00:22:24.980 Important to remember that respiratory viruses transmit 00:22:24.980 --> 00:22:28.883 through proximity, contact and duration, right? 00:22:30.450 --> 00:22:32.870 Particularly in indoor settings 00:22:32.870 --> 00:22:34.760 where there's less air exchange, 00:22:34.760 --> 00:22:37.520 there's higher concentration of the virus in the air. 00:22:37.520 --> 00:22:39.720 There's nowhere in our communities 00:22:39.720 --> 00:22:42.360 where population density indoors is as high 00:22:42.360 --> 00:22:43.620 as it is in schools. 00:22:43.620 --> 00:22:44.453 Nowhere. 00:22:44.453 --> 00:22:48.650 Office buildings, prisons, anywhere else, 00:22:48.650 --> 00:22:50.820 doesn't approach the population density 00:22:50.820 --> 00:22:53.860 that we put kids in for seven hours a day together 00:22:53.860 --> 00:22:54.870 in a school. 00:22:54.870 --> 00:22:57.690 So it is obvious that schools are one 00:22:57.690 --> 00:23:00.560 of the highest risk environments for transmission 00:23:00.560 --> 00:23:01.393 of this virus, 00:23:01.393 --> 00:23:02.910 particularly of delta variant. 00:23:02.910 --> 00:23:06.400 And again, the UK I think demonstrated that quite clearly 00:23:06.400 --> 00:23:07.460 with their recent wave. 00:23:07.460 --> 00:23:12.460 And so we need to take the maximum protections for students. 00:23:13.000 --> 00:23:15.090 I think it's possible to have students, 00:23:15.090 --> 00:23:17.460 and it's a priority to have students in person in school. 00:23:17.460 --> 00:23:20.340 We all know that that's the best place for kids to be. 00:23:20.340 --> 00:23:22.410 But the way to do that safely is to put all 00:23:22.410 --> 00:23:24.500 of these layered non-pharmaceutical interventions, 00:23:24.500 --> 00:23:26.760 those layers of Swiss cheese together. 00:23:26.760 --> 00:23:29.930 Certainly, vaccine is the most important tool we have. 00:23:29.930 --> 00:23:32.541 But many kids aren't eligible to get vaccinated yet. 00:23:32.541 --> 00:23:37.180 And other things such as face masks, densification, 00:23:37.180 --> 00:23:38.510 increasing air exchange, 00:23:38.510 --> 00:23:39.890 and ventilation in schools, 00:23:39.890 --> 00:23:41.640 all of those are gonna be important factors 00:23:41.640 --> 00:23:43.440 to create a safe school environment. 00:23:45.570 --> 00:23:46.600 Yes, Julie? 00:23:46.600 --> 00:23:48.330 - [Julie] What would you tell to a bunch of high school kids 00:23:48.330 --> 00:23:51.370 who've gone out and gotten the vaccine, 00:23:51.370 --> 00:23:53.130 even though they don't feel they're high risk? 00:23:53.130 --> 00:23:53.963 What would you tell them? 00:23:53.963 --> 00:23:56.710 It's like, "Okay, now, you guys should wear masks too?" 00:23:57.558 --> 00:23:58.391 - Yes. 00:23:58.391 --> 00:24:01.487 - [Julie] What would you say that would persuade them? 00:24:01.487 --> 00:24:04.420 - I would recommend highly 00:24:04.420 --> 00:24:05.970 that even if they're fully vaccinated, 00:24:05.970 --> 00:24:08.450 which I commend those high school students 00:24:08.450 --> 00:24:10.292 that have gone out and gotten vaccinated, 00:24:10.292 --> 00:24:13.100 but would recommend that they continue to wear face masks. 00:24:13.100 --> 00:24:15.080 Again, because they're going to be in one 00:24:15.080 --> 00:24:18.090 of the highest risk environments that we can have 00:24:18.090 --> 00:24:20.780 in a school setting for long periods of time together. 00:24:20.780 --> 00:24:23.860 And we know that all of these interventions work 00:24:23.860 --> 00:24:25.650 on a population scale, right? 00:24:25.650 --> 00:24:28.683 So vaccinations, and face masks, and distancing; 00:24:30.030 --> 00:24:32.280 we like to think of them on an individual basis. 00:24:32.280 --> 00:24:34.210 What's it doing for me? 00:24:34.210 --> 00:24:36.310 But the reality is that they have their effect 00:24:36.310 --> 00:24:37.770 on a population scale. 00:24:37.770 --> 00:24:41.400 And when you apply these in layers across the population, 00:24:41.400 --> 00:24:44.820 they have a synergistic effect in reducing transmission. 00:24:44.820 --> 00:24:48.110 So it's important for us to work together on all of this 00:24:49.149 --> 00:24:51.300 and to recognize that we're not just wearing face masks 00:24:51.300 --> 00:24:52.466 to protect ourselves, 00:24:52.466 --> 00:24:54.300 not even just wearing face masks 00:24:54.300 --> 00:24:55.610 to protect our family members, 00:24:55.610 --> 00:24:57.440 we're protecting our friends, 00:24:57.440 --> 00:24:59.110 our extended family, 00:24:59.110 --> 00:25:00.917 grandma and grandpa. 00:25:00.917 --> 00:25:02.390 We're protecting the neighbor 00:25:03.916 --> 00:25:05.140 who had a kidney transplant, 00:25:05.140 --> 00:25:06.880 who's on immunosuppressive medicines, 00:25:06.880 --> 00:25:10.160 who may not have as good and effectiveness 00:25:10.160 --> 00:25:12.220 of the vaccine as others. 00:25:12.220 --> 00:25:14.670 We wear masks to protect all of those other people 00:25:14.670 --> 00:25:15.600 in the community, 00:25:15.600 --> 00:25:17.626 and they're wearing masks to protect us. 00:25:17.626 --> 00:25:20.743 And that's how we can collectively defeat this virus. 00:25:24.200 --> 00:25:25.033 Yes? 00:25:25.033 --> 00:25:25.866 - [Audience 10] And they've indicated 00:25:25.866 --> 00:25:26.850 that there's a potential 00:25:26.850 --> 00:25:29.220 that maybe the worst is yet to come. 00:25:29.220 --> 00:25:33.540 The first wave was terribly, terribly difficult 00:25:33.540 --> 00:25:36.940 for our first line responders 00:25:36.940 --> 00:25:37.962 - Right. 00:25:37.962 --> 00:25:38.795 - [Audience 10] on the front lines. 00:25:40.070 --> 00:25:42.100 What is their mindset right now? 00:25:42.100 --> 00:25:43.920 How do you prepare them? 00:25:43.920 --> 00:25:46.160 Or what have you learned from the first wave 00:25:46.160 --> 00:25:51.100 that can make potentially a second wave more 00:25:51.993 --> 00:25:53.080 easily navigated? 00:25:53.080 --> 00:25:54.930 - Well, I'm definitely concerned 00:25:54.930 --> 00:25:56.560 about our first line responders. 00:25:56.560 --> 00:25:58.760 I'm concerned about our healthcare workers. 00:25:58.760 --> 00:26:01.690 I've been in awe of my colleagues in the hospital 00:26:01.690 --> 00:26:03.220 since the beginning of the pandemic, 00:26:03.220 --> 00:26:06.080 particularly nursing staff and respiratory therapists 00:26:06.080 --> 00:26:10.440 and all of the techs who've worked just tirelessly 00:26:10.440 --> 00:26:13.340 in very difficult conditions, 00:26:13.340 --> 00:26:15.770 both physically and psychologically, 00:26:15.770 --> 00:26:17.580 having to watch people isolated 00:26:17.580 --> 00:26:22.580 going through the last phases of their lives alone. 00:26:22.820 --> 00:26:25.360 And that's taken a huge mental toll on people. 00:26:25.360 --> 00:26:28.150 And I think for many of our healthcare workers 00:26:28.150 --> 00:26:31.750 kind of looking now with this looming crisis again, 00:26:31.750 --> 00:26:33.470 it's pretty overwhelming for them. 00:26:33.470 --> 00:26:38.470 And so I'm worried about the state of mental health 00:26:38.610 --> 00:26:40.130 for many of our healthcare workers 00:26:40.130 --> 00:26:42.100 and how we're going to help them navigate 00:26:42.100 --> 00:26:43.660 through this next phase. 00:26:43.660 --> 00:26:44.910 That's gonna be hard. 00:26:44.910 --> 00:26:46.240 And so, 00:26:46.240 --> 00:26:50.900 again, I think trying to protect our healthcare resources 00:26:50.900 --> 00:26:54.370 including our people is a really important part 00:26:54.370 --> 00:26:57.740 of why we need to take aggressive action now. 00:26:57.740 --> 00:26:59.800 We're going to see potentially case rates 00:26:59.800 --> 00:27:01.660 and hospitalization rates 00:27:01.660 --> 00:27:03.250 similar to what we saw in the fall. 00:27:03.250 --> 00:27:05.420 But as opposed to what we had in the fall, 00:27:05.420 --> 00:27:07.260 we have hospitals that are already full 00:27:07.260 --> 00:27:10.270 with some of these other respiratory virus admissions 00:27:10.270 --> 00:27:11.103 that we've been seeing. 00:27:11.103 --> 00:27:12.240 And just in general, 00:27:12.240 --> 00:27:14.150 most of our hospitals have been really busy. 00:27:14.150 --> 00:27:17.540 We don't have the surge capacity that we had previously. 00:27:17.540 --> 00:27:20.870 And we have a bunch of nurses and doctors 00:27:20.870 --> 00:27:23.350 who've been dealing with this for 18 months. 00:27:23.350 --> 00:27:27.090 And a lot of them are just burned out understandably. 00:27:27.090 --> 00:27:30.760 So that's gonna be a lot harder for us 00:27:30.760 --> 00:27:35.340 to deliver good care to all of the people 00:27:35.340 --> 00:27:37.760 that may be flooding our doors. 00:27:37.760 --> 00:27:39.980 And we know that when the hospitals are overwhelmed, 00:27:39.980 --> 00:27:43.200 when healthcare workers are stressed and overworked, 00:27:43.200 --> 00:27:45.350 and taking care of too many patients, 00:27:45.350 --> 00:27:47.460 when critical care nurses are taking care 00:27:47.460 --> 00:27:49.460 of three or four or five patients 00:27:49.460 --> 00:27:50.730 instead of one or two, 00:27:50.730 --> 00:27:53.690 that we know that your outcomes get worse. 00:27:53.690 --> 00:27:55.890 That's been shown not just for COVID, 00:27:55.890 --> 00:27:59.240 for every illness that requires admission. 00:27:59.240 --> 00:28:01.640 And so we're gonna see worse outcomes 00:28:01.640 --> 00:28:04.290 in our hospitals if we continue to stress the system. 00:28:07.730 --> 00:28:09.530 - [Audience 10] Are you able to show us 00:28:09.530 --> 00:28:11.620 what a healthy lung looks like 00:28:11.620 --> 00:28:14.934 and what infected lung looks like? 00:28:14.934 --> 00:28:15.767 - Yeah. 00:28:15.767 --> 00:28:17.600 Let's see if our magicians from IXL can do that. 00:28:17.600 --> 00:28:18.603 There we go. 00:28:19.500 --> 00:28:20.333 All right. 00:28:20.333 --> 00:28:25.333 So this is a 3D rendition of a CT scan or a CAT scan 00:28:25.900 --> 00:28:28.573 of what a healthy lung should look like. 00:28:29.480 --> 00:28:33.150 So this is really a wonder of a technology 00:28:33.150 --> 00:28:35.430 that we can do these 3D reconstructions now 00:28:35.430 --> 00:28:36.480 based on CT scans. 00:28:36.480 --> 00:28:39.880 This is a real CT scan of a real patient's lung, by the way. 00:28:39.880 --> 00:28:41.850 What we have now is a comparison 00:28:41.850 --> 00:28:44.993 of a CT scan of a patient's lung, 00:28:46.247 --> 00:28:50.180 a patient who recovered from COVID-19. 00:28:50.180 --> 00:28:53.930 And you can see the extensive amount of damage. 00:28:53.930 --> 00:28:56.820 There is scarring, and fibrosis, and inflammation 00:28:56.820 --> 00:28:59.090 throughout this lung. 00:28:59.090 --> 00:29:02.730 That is going to be, in most cases, 00:29:02.730 --> 00:29:06.070 in many of these severe cases of damaged lung 00:29:06.070 --> 00:29:07.310 like this permanent. 00:29:07.310 --> 00:29:09.480 This person is never gonna have normal 00:29:09.480 --> 00:29:10.690 pulmonary function again. 00:29:10.690 --> 00:29:11.570 As a matter of fact, 00:29:11.570 --> 00:29:14.560 we've seen patients here at our hospital 00:29:14.560 --> 00:29:17.730 and hospitals across the country have seen patients 00:29:17.730 --> 00:29:22.010 whose fibrosis, scarring, 00:29:22.010 --> 00:29:24.180 and inflammation in their lungs is so bad 00:29:24.180 --> 00:29:26.420 even after they recover from the infection 00:29:26.420 --> 00:29:27.830 that they require a lung transplant 00:29:27.830 --> 00:29:29.680 because their lungs are no longer able 00:29:29.680 --> 00:29:31.900 to oxygenate adequately. 00:29:31.900 --> 00:29:36.420 And so COVID-19 is a severe disease, 00:29:36.420 --> 00:29:39.550 especially of the lungs and respiratory tract 00:29:39.550 --> 00:29:42.380 and in even young people. 00:29:42.380 --> 00:29:44.660 So again, these are often people 00:29:44.660 --> 00:29:47.500 in their 40s, and 50s, and even 30s 00:29:47.500 --> 00:29:49.980 that we're seeing extensive lung damage. 00:29:49.980 --> 00:29:53.410 It can cause longstanding and permanent disability 00:29:53.410 --> 00:29:54.723 even after you recover. 00:29:56.010 --> 00:29:56.843 Thanks, guys. 00:29:56.843 --> 00:29:58.103 This was a great graphic.