Hello and thank you for joining us for our series "Perspectives on the Pandemic."
This is the time of experts and expertise. Every moment of the day we
crave information about the pandemic. How many cases, how many deaths, what do the
numbers mean, how do we prevent it, why did this happen to us, and when will
things return to normal? And it is the experts we look to to shed light on answers to these questions. We thirst for expertise,
hard-earned expertise--years in the lab working on a single problem, careers devoted to
better understanding of public health policy and public health practice,
countless calculations extracting meaning from numbers, a lifetime of
research on the causes and ultimate impacts of pandemics on the history of
humankind. "Perspectives on the Pandemic" pulls the experts to center stage. A
medicinal chemist, a panel of public health experts, a theoretical
statistician, an historian, all shining their specialist's light at a time of
darkness and confusion. Dr. Melissa Walker is an Associate Professor of
Public Administration and the Interim Director of the Hugo Wall School of
Public Affairs. She joined Wichita State in 2006 after a
postdoc fellowship at the Center for Healthcare Studies at Northwestern
University's Feinberg School of Medicine. The focus of Dr. Walker's policy
research is on access and the cost of health care. She has studied treatment of
diabetes when patients do not have health insurance, as well as Medicaid
reimbursement of services provided to individuals who experience intellectual
and development disabilities.
Melissa Walker will be moderating our panel and I invite her to introduce them. Thank
you, Andrew. I'm looking forward to this discussion. We have an all-star panel of
experts with us today. Phillip Brownlee is the Executive Director
of the Medical Society of Sedgwick County. Adrienne Byrne is the Director of
the Sedgwick County Health Department. Venus Lee is with us today. She is the
CEO of the GraceNet Health Clinic. Shelley Duncan is the Executive Director
of Project Access. What we're going to do is spend about 20 to 30 minutes hearing
from each of these experts. Each will have a different take on COVID-19, and
then what we want to do is open this up for questions and answers using the chat
or by raising your hand. To kick things off I'd like to say a little bit about
what's going on with COVID-19. Cities, counties, states and nations are making
difficult choices to protect citizens and standup health care systems. From
staying at home, to physical distancing, we are changing our daily routines. What
happens if these steps are taken too late or rolled back too soon? What's
happening to those among us who are most vulnerable: people who have weakened
immune systems, seniors, individuals who experience disabilities, people who don't
have health insurance? These are things we'll be talking with our panelists
about today. I'd like to start with Adrienne Byrne for more on what's going
on in Sedgwick County and with the Sedgwick County Health Department.
Welcome, Adrienne. Hi, good afternoon. So we currently have 354 cases of COVID-19 that
we are aware of in Sedgwick County. We've just really begun to ramp up our testing
in the last week and a half. Prior to that we were testing about 20 to 25
people a day, mainly because of the restrictions
that KDHE had with who could be tested and since then they have loosened
up those restrictions, and we also have a contract with a local lab, Quest, which
allows us to establish our own criteria for testing. So, in the last week and a
half, we've taken samples from like, today we had a hundred and fifteen people
scheduled to be tested. We can test as many as three plus hundred. We just need
people to call in to 211 to be able to be tested. I think part of the
lack of numbers is that, for the first handful of weeks, people couldn't get in,
because the criteria was established and it was set the way it was. And now, like
people often do with the flu, they're just staying home and dealing with it.
But in regards to what we do at the health department and what our disease
investigators and NPs do all the time, we really need to know who was
positive so we can then do the contact tracing and find out who all they had
contact with two days prior to becoming ill. And then up to when they
were positive and the close contact is anyone that is six feet, within six feet, for
longer than ten minutes without personal protective equipment. So, you know that is
our goal to be able to take samples from as many people as possible and there is
no out-of-pocket charge to that because that allows us to mitigate that
spread in our community. Thank you, Adrienne. There's been a lot of discussion about testing and it looks like
there's more testing going on now. Could you talk a little bit more about the Health Department and how its
engaging in testing? Yes, and we started, at the Health Department, we activated
our incident command system at the very
beginning of March, March 1st, March 2nd, and have been monitoring it since then.
And, oh gosh, I guess we're at the end of April. These last two months are about a
year and a half long, but we began doing walk-in testing at the time and in
the very beginning we had maybe 15, what they were calling test kits on
hand that enabled us to go ahead and sample and put it in the tube and ship
it off and so we would do walk-ins, and
since then, as the testing supplies became more available, then we have
ramped up more. And so currently, we have over 3,000 swabs and the solution, saline
solution, and tubes, so we have everything we need to sample over 3,000
people. And you know my hope is that we continue to get those supplies in.
They've been trickling in and this is not unique to Sedgwick County. It's been
all over the country and, particularly health departments that don't
usually test for the flu, we weren't preferred vendors. And so the preferred vendors, being medical hospitals and doctors,
they were preferred, and so naturally they were going to get those supplies before others. So, you know, as we've gotten more
then we're able to test more. Even though we were, prior to the last
week, about testing 18 to 20 percent of all the tests. That seems low, but I heard
that we were the second highest of all testers, of all the sites testing.
So that means that there's a lot of testing going on
on more of a minimal basis around Sedgwick County, so a lot of providers
are testing, but probably more their patients versus opening it up to the
general population. So that has been the struggle from the beginning. It's just
the lack of supplies has been so frustrating. I think we have about 15,000,
an order of 15,000 swabs outstanding and
they slowly trickle in. So we had, I think, about 2000 that came in
yesterday. We're hopeful that this is going to continue more because then that
allows us to get a much better feel for what's going on in the community, not
just with how many people that we have that are ill, but we can test more
asymptomatic people to find out, have a better feel for how many people that are asymptomatic actually
have COVID-19 that could be transmitting. In a perfect world, what would the testing rate be for a thousand residences
in Sedgwick County? I'm not sure if it was John Hopkins or where we got the information that if we were really
wanting to have a good feel, the calculation was over 700 people a day
that we would be able to test and we could test at least half of that, if not
more, if we had the residents. So I'm hoping that we're going to be able to
reach more because as we've gotten more samples in, supplies, we've been able to
expand who all we are able to offer testing to, because it had been just
symptomatic people. As of last week, if a nursing home even has one case
we're going to either go in there and do it, or coordinate with the nursing home
so that they're able to do it. Test every resident and test every employee.
We are open to testing any employee that is like a first responder, medical staff,
corrections, even if they're asymptomatic, because we know in our residential
facilities the highest risk are the staff because of the ones coming and
going. So we'll test those, that staff, every week to help monitor that. If
someone just wants to call and go through 2-1-1 --and the same thing
with staff in residential correction facilities, any first
responder--and then we're going to test. Now we can't make anyone do this but, we
want to be able to test any contact person
of a case. They're still going to need to be in quarantine. Let's say we
test them on day five in quarantine and day seven we find out they're negative,
they still need to remain in quarantine because the viral load just may not be
high enough to detect and so we know that people can be exposed and it's
showing thirteen days later, then develops symptoms. But we're just trying
to get more of a grasp on what's going on in our community, and the more people
we test, the more of their contacts we can get out of circulation to minimize that
spread. Thank you. Philip, I'm going to turn to you next and ask you to
provide some perspective on COVID-19 here in Sedgwick County. Philip
Brownlee is the Executive Director of the Medical Society of
Sedgwick County. Thank you for being here today with us. Thank you. Let me brief you,
briefly, just kind of explain what the Medical Society is. It's an association
of physicians in the county. We're involved in a lot of different things:
advocacy, support for physicians and practices in a variety of ways. We
help oversee the EMS system in the county and are involved in a lot of
different initiatives. On the COVID issue, from an association standpoint, it's been
more of a support role for our physicians, so we send regular updates,
informational updates to them. We have done PPE
drives to help support particularly the smaller practices that really are pushed
out of the PPE lanes. We've also arranged for counseling programs for
nurses and physicians that need kind of a confidential outlet and support, so
we've done that support role. The Health Department and Dr. Minns, the Chief
Public Health Officer for the county, also approached us about forming a
committee of experts that could help advise them on COVID issues. So, I
contacted ten different frontline physicians,
these are the people that are in the room with the COVID patients, and
every single one of them, even though they're under great stress and working
long hours, all agreed to help. And for the past month they've been meeting and
discussing these issues. It's been a variety of issues, things from you know,
hydroxy-chloroquine, you know, trying to encourage people not to use that, those
sorts of issues, but then in the past week and a half or so they also shifted
focus, as the county has, on looking at reopening. This particular group, you
probably saw on the paper perhaps yesterday, did make some
recommendations and offer some advice. This was misconstrued in some way. The county asked this group to be formed and the county
manager asked that this group focus only on health and not be
concerned about economic impacts and other considerations because they're
getting, of course, a lot of input on that issue. That was kind of the charge, and
this panel then offered these recommendations knowing that some of
them wouldn't be appreciated and certainly wouldn't be followed. There was
some misunderstanding in that was this officially from the Medical Society
or not and, if it was and we helped convene this group and formed it to help, but an
issue like this is really more complicated for a large society to try
to come up with, in a quick way, policies. So these were recommendations of the
panel and that was kind of discussed at the commission meeting today and it was
misrepresented that the Medical Society was somehow backing away.
That wasn't the case. We've never had a policy on this. We were just
helping convene this. And again I want express my great
gratitude to this group who, you know, offered their best advice and they knew
that there are other considerations but they felt it important to just say what
they think would be a good policy moving forward. Thank you, Phillip.
There's a lot of lingo that we're slinging around here so maybe we should explain a
few things. The Sedgwick County Health
Department is the department that Adrienne Byrne heads. The Medical Society is a
nonprofit organization that advises and provides support in a number of
different ways. 211 is a call center that's being handled by the
United Way currently. It's the number that you can call to find out whether
you can be tested and they administer a protocol to
determine if you meet certain criteria to be referred to the Health Department
for testing. I understand, Adrienne, that the Health Department is doing the
bulk of the testing, or a lot of the testing in Sedgwick County right now.
The recommendations of the ten physicians to the Board of County
Commissioners, to the elected officials last week, emphasized the importance of
testing, particularly as the BOCC begins to think about relaxing the stay at home
order or other restrictions on movement. Just a couple of factoids here, there are
a number of websites that are monitoring mobility in the county, using cell phone
and other data, Unicast and Cubic. It turns out that it's somewhere between
thirty and forty percent of people who are living in Sedgwick County currently
are staying home. They're not traveling to engage in either essential activities
or non-essential activities. But one of the concerns from a policy perspective
is, as the BOCC considers what next steps to take, once the state rolls back its
stay at home order, how that might affect the number of new cases and that will put
more stress on limited testing supplies and so on and so forth.
So during the discussion portion of this, I hope that we get questions about that and
we can engage in more conversation about that.
So, thank you, Phillip. So now I'd like to turn to Venus Lee, who's the CEO of Grace
Med. Grace Med is a health clinic that's on the front lines. It's a
federally qualified health center providing services to people who have,
who often are using public insurance to access health care. I know, Venus,
that the Grace Med has been doing some testing and also continuing to provide
primary care. Can you talk a little bit about that? Okay. One of the things
that we started doing early off, early March, is doing some drive through testing.
When we first started doing the drive through testing, we were only doing it for our
patients and we quickly realized, after doing that for about a week or so, that
we needed to open up that process to the community. And so at that point, we began
testing for anybody, whether they were our patients or not. So we were doing
drive-thru, walk-up testing. We're testing right on Broadway, ans so what we found
is a lot of the homeless, or people who don't have vehicles, had decided to
just walk up. So things changed very quickly and day by day and we have
to pretty much just roll with it. Later through that month, more people I believe
started testing. We began to do some collaboration with Hunter
Health and HealthCore as well. I know that there was a press release put out,
on all of our behalf, where we were able to work together to
decide who was doing what so that 211 would have
a big picture of what everybody's been doing. And we are doing primary care, but
I will say that, one of the things that we instituted was Telehealth. We did
that by making sure that the most vulnerable people we could call them and
say, can we offer you instead of you coming in, a Telehealth visit. So some
things, we've had to make some dramatic changes due to COVID. One of the
things that we had to do early on, which was a hard thing, it was hard for
us, is we had to furlough our hygiene department. And so we just made the
decision to do that. We also had to furlough some of our dental staff
and we furloughed about ten of our medical providers. And one of the reasons
why we did that, early off, is we found that we did not have supplies. When I
say supplies, I mean PPE, and we wanted to make sure that all our providers and
our frontline staff, who were engaging and taking care of our patients, were
able to do so safely. And in order to do that we needed to pull PPE from our
hygienists, our dental, and just pass that on to a lot of our medical staff.
So that was pretty hard. We did, over about three weeks ago start rapid
testing. One of our concerns was--and we go through Quest, too and they have been
wonderful. I just want to say that--in making sure that we have some swab
supplies, as they came in. But as more people began testing it started to slow
down how quickly we were getting the results. So we went from getting results
from about 24, 48, 72 hours to then it taking five to six days. We're
back down to about 24-48 hours, so that's wonderful. But in the meantime we had to
come up with another solution because another thing we instituted, because we
found out that people who were waiting at home, five-six days, they were in panic
mode. We have a provider who actually calls them daily to just check
on them, make sure their spirits are still up, make sure they're continuing to
social distance, to check and see if they've had additional symptoms. So that's
some of the things we're doing, but we found it necessary to get the rapid
tests. So we've been doing that about three weeks, I believe it's been about
three weeks. You can't quote me on that because all
my time is running together. There are days with this, we don't know what
day of the week it is, just to be quite honest. But those are some of the things
that we've been dealing with. Thank you, Venus. I'd like to turn to
Shelley Duncan who is the Executive Director of Project Access, another
frontline organization that's working with patients who do not have health
insurance and do not always have access to regular medical care. So, Shelley
welcome. Thank you. We're affiliated with the Medical Society and we do serve
adults who are living in poverty who have no health insurance, and we
primarily help them find a physician in the community who will donate care to
them. So we have about six hundred and thirty physicians in the community that
donate care and treatment to those that we serve. Most of the people that come to
us have a very serious health condition, so most of the physicians we work with
are specialists. Since the kind of shelter at home, our staff have actually
been working at home, but we're still enrolling patients and I actually talked
with my staff yesterday to ask them about any kind of COVID related issues
and they said, interestingly enough, that most of the people that they are
currently enrolling have not asked about COVID. They have not indicated that
they're having any concerns or symptoms,
but what's interesting is that a number of them are really wanting to hold off
going to see the physician that we would be referring them to. So that was
kind of interesting. I think also the physicians that we work with donate care,
as I said, and they will then identify how many patients they want to see per
year. Some of them, I think, have put things on hold as well, for a number of
different reasons. But the good news is that we're still able to help
people and certainly we're also offering them other resources because, as
I said, the individuals that we serve are low-income, and so they are
expressing more concerns, just I think, about, you know, being able to meet their
basic needs. So we're making a lot of referrals to other organizations that
can provide them the support and help they need, but we still are enrolling
people. Thank you. So I don't think in the short time that we have we'll be able to
solve all of the health, political, and economic implications of COVID-19, but
what I would like to do is to engage you in the conversation and
invite you to ask questions of our experts and see where this leads.
Cheryl, I think you're gonna help us out with this part. Right, here's a question
from Julie Sanders. What has been the average turnaround time for test results
from the date of the swab?
Hi, this is Adrienne Byrne from the Health Department. I can say that from KDHE,
our state health department, it has varied, just a little bit, from the very
next day to a couple days, and Quest, within usually 48-72 hours. So the
turnaround time we've been very pleased with how quickly we're able to get those
test results as compared to some of the stories we've heard around the country
with other labs that were so backlogged that it took longer than a week. Okay,
thank you. Other questions? There's a lot of
conversation now about what happens next and this is a good group of people to
pose that question to. I know the county is thinking very carefully about next
steps. Adrienne, you have been thinking in terms of a phased, different
phases, of rolling back on the stay at home order. Can you talk a little bit
about that? Yes, Dr. Minns, our health officer, was actually going to
talk about his recommendations and then we heard yesterday that Governor Kelly
would be coming out with her recommendations for Kansas during her
press conference tomorrow that I believe it's scheduled for 6:30. So we are
waiting because counties can be more restrictive but they cannot be less
restrictive. And so we're waiting to hear what her recommendations are for
gathering size, her guidance for how retail and restaurants, about capacity, so
that will really help guide us with where we go from here. But it will be a
phased approach because COVID-19 is not going away. It's part of our new norm
for right now and it will be until a vaccination, a vaccine, is developed
it's going to be a phased approach. The goal is to get businesses back
to operating but doing so as safely as possible for the employees and the
consumers. So from the prospective of the Medical Society, what are some considerations with respect to relaxing
or easing the stay at home policy? Well, the Medical Society is a diverse
group so you have a lot of different viewpoints on this and obviously
surgeons and others are eager to be able to do procedures that they've postponed.
So you've got that, but specifically related to COVID, the panel that I
helped put together, they obviously are concerned that, well, they believe
that the policies that have been in place have helped limit the
spread of the virus, which has helped the hospitals be able to manage that. And there obviously is a concern that as you loosen that up you have the potential of
causing a spike to occur. Now, there's a lot of factors
involved in that, but that's obviously the concern so any loosening they would
also favor a very phased in approach with clear guidance, particularly on
these places like restaurants where, by their nature, the people eating there
can't wear masks while they eat. There's things like
that. There's still a lot of concern about large gathering places, like
churches. That is just a recipe for spreading viruses. Still, obviously, a lot
of concern and I think there would still need to be a lot of restrictions
on nursing homes because of the vulnerable population there and those
other factors and I know Adrienne and Dr. Minns are working on that. The County
Commission did express concern, desire today of just kind of letting the
businesses figure this out on their own, of letting, trusting, them to do what's
right for their employees and for their customers in that the last thing they want
is to have a cluster in their business. All that is true but the
county also had a meeting with business leaders on Friday and the message was
loud and clear from there on they want guidance. They don't want to open in an
unsafe manner. They need help knowing what to do. All these things factored
in a lot of trepidation by the folks on the front line that we're kind of
jumping off a cliff a bit and we don't know what's going to happen.
They're obviously the ones there on the front lines are nervous about that.
Thank you, Phillip. I have two questions in chat. One from
Coleen Pugh: Today's newspaper published information on testing that is now
available to detect COVID-19 antibodies without a doctor's permission. Do you
have any apprehension for getting this test?
I can say from our health officer
standpoint that we need more time with those antibody tests, that we know
that they are able to detect coronaviruses, but the ability to
specifically detect COVID-19 is still a little bit in question. And as that
article said, these tests are being rushed out without really review by the
FDA. And so we've seen that a lot of them are not effective. There's a
lot of concern by physicians of how trustworthy these are. False positives,
false negatives, all those sorts of things and the delay of when the
antibodies actually kick in. So it depends on when you're tested and
when the antibodies actually start to appear. There's things like that.
Clearly I think in terms of being able to do mass testing, these blood tests
will be key to doing that, to be able to do large groups quickly and I think that
will be important for the future. There's just a lot of concern now that we don't
know how accurate these tests are. Okay, Venus, did you want to comment on that?
I agree with what they both said because even with our rapid test, we're still
doing the swab so that we can get enough data to find out how effective those
tests are. So far, with the ones that we've used for a rapid test they have been spot on,
but we've only been using them for two-three weeks. I just think you need
more testing to determine whether or not this is the appropriate testing going
forward, and to just put them in a situation where they're out
there for anybody to get, I question whether or not they'd be able to read them,
whether or not they would know that, okay, I've had these symptoms for this many
days so now it's kicked in, now it's going to test. I just think it's
scary, a little scary right now and I just think that we need to
make sure we take a pause long enough to just get, I just think we need to be
a lot more safer. I'm just concerned about how fast everything is jumping.
When you listen to the news they're talking about how quickly this is
unprecedented, how fast things are going out and that's just a little bit of a
concern for us and we're on the front line. Cheryl, last week George
Dehner made a presentation on the Spanish flu pandemic and he showed a
slide where he showed the number of cases in different cities. Denver
really jumped out at me because it looked like a camel back and that's one
of the concerns here. We have our own Anthony Fauci right here in Kansas, Dr. Lee
Norman, the Secretary of the Kansas Department of Health and Environment.
He has specifically set some targets for the number of tests that are done in
each community per thousand residents in each county and also would like to
see population testing so we have a better idea of the prevalence of COVID-19 in
Sedgwick County and to do testing, as Sedgwick County is doing, in hot spots,
nursing homes and other places to keep staff safe and to keep the virus
contained. Are you a fan of Dr. Norman's briefings, Venus? Yes, you
want to talk more about this? Well, I listen to and I'm trying to be there
every time the man speaks because he's given enough information that I
trust him and I trust that he's getting it from a good source and I believe
that he's taking a look at not just the economic impact, but he's really trying
to protect us, and that's important so whenever he's on I'm making
sure that a group of us is listening and just drinking
all the Kool-Aid, I'll just say that, at this point. Great, thank you.
We have three more questions in chat. This is from Mary Liz Jameson. Testing
is essential for recovery, as in the health of people and the health of the
economy. Per million people, Kansas is at the bottom of the US list of states for
COVID-19 testing along with Virginia, Arizona, and the US territories. Why is
this and can we ramp things up? That has been one of the most asked questions
because it is true, and we are finally getting to the place where we can
ramp up, but in the beginning we just couldn't get those supplies. The
county had a team that was devoted to turning over every stone and, you know,
also reaching out to our community and so WSU Tech has actually purchased some
swabs and that we're buying them from them. We've had the community stepping
up to help us as well because some were able to get testing supplies from other
places that it might be educational versus medical, so to speak, so it's
been an issue all over the country but obviously for some of the
states, and Kansas is one, it's been really difficult.
I think the samples, the supplies, have gone to states that had, their prevalence
was much higher, they were having outbreaks all over the place so
the testing supplies were going to naturally go to those. But again, the
important thing is now that, we're slowly, they are trickling in versus us not
having any idea when the next shipment's coming. Thank you. This is a question from
Lynette Murphy. What advice do you havefor people who are immune suppressed as
the county is opening back up. What are the best practices for negotiating with
employers about this for the those of us who may be more conservative
about returning to work than others? Are there special rights we can discuss? From
I can say from a public health perspective, it's important for those
over 60 with compromised or pre-existing conditions, and anyone of any age,
that's immuno-suppressed to stay at home and only go out when they have to,
just for their own protection. In regards to employers, those would be
legal questions on how to respond. I'm afraid I don't have that answer.
I don't know if Philip or Venus have any information on that. I don't have legal
information either, but on the first part Adrienne is also echoing what the advice
of this panel was. They specifically mentioned, you know, if you're
taking immunosuppressive medication you should stay sheltering in
place. If you're elderly, if you've got uncontrolled diabetes, if you've got lung,
kidney, heart conditions, that is their advice. You are still at risk so
regardless of whether things open up, their advice is that you try to stay home.
Now, if you're employed, and my son is in this category, that's unclear what
happens. What their rights are, I don't know. Do you mean if you're employed in an essential
service, or? No, not necessarily, I mean they're going to
open up businesses again and if you work for those businesses, whether it was
essential or non-essential, and you have one of the serious at-risk conditions,
what is your ability to say I'm not comfortable coming back? That legal
question I'm not sure what the answer is. You know,
the interesting thing is we have relied, and I understand the business owners
who said we just want guidance, because we've relied on what
you guys are doing out there to dictate those things because what happens is
then we're covered, we're covered in allowing people to stay home longer, or
then the CARES Act kicks in, or there's some type of legal mechanism that not
only protects the employer but protects the employee, but when you remove those
and you open it up, that is going to be a harder legal question, how much paid time
off you have and those things. One of the things we asked our attorneys when all of
this first came out was, one of the questions was if someone was just scared to come
to work, does this qualify under the furlough program. And the answer from the
attorneys, at that time, was no. So, if we hadn't furloughed because of, for whatever
reason, direction given by the state, or the President on the 15 days, when we
furloughed our hygienists, if the answer wasn't no--so you were in a department that
didn't get furloughed simply because you were scared to be at work--didn't qualify.
So I'm wondering what's going to happen as well when everything opens up. Could I
jump in. Sure, Shelley, go ahead. Well I'm gonna talk with another hat on now.
I also work with the Kansas Business Group on Health and we actually had a
forum yesterday with, this is a membership organization also affiliated
with the Medical Society and we support local employers to help improve quality
and reduce cost of healthcare. And we had a forum yesterday with some of our
members, an HR forum, and it was interesting because there have been
surveys done that really look at what employers are doing relative to their
employees and if they're paying for testing and paying for time, and there's
also the Family First Act, which I wonder if they may expand that.
Interestingly what at least one of the employers said was that they are having
a number of people that are already applying for the EFMLA
and they're having mental health issues because they're really scared of
coming to work, and so that's going to be a really interesting thing, too. When you
think about kind of the mental health side of that, the anxiety, the depression
and all of that, in addition to those people that have a pre-existing
condition. I think at some point there may have to be some
direction on how that very issue is dealt with, but I, too, do not know of anything
at this point that would address that. Okay, thank you. Okay, another question
this is from Kelly Smetak. In general, is the local health care or frontline
feeling overwhelmed by the pandemic issues?
I'll jump in, at least for my group, and I would say no. Thankfully we have not been
overwhelmed by the number of cases. Initially you talk to the folks
running the hospitals and they were utterly panicked that we were on
our own, we're not going to get any supplies, we're going to be overloaded,
your grandmother's gonna fall and break her hip and you can't bring her in,
you're just gonna have to make it on your own. I mean these were the horrors
that they were fearing, but fortunately, I think, in part because of the stay at
home orders and social distancing, that did not happen. So the
volumes have been manageable, and, of course, that now is then feeding
into the discussion--well since they weren't overwhelmed then we ought to be
able to loosen things up. So in some ways we're perhaps being punished
for the success of the stay at home orders, but it's also fair to say if the real
purpose of this was to keep hospitals from being overwhelmed, not necessarily
to stop the virus from spreading, which we can't, but just to
limit that spread, then maybe you can make the case that the hospitals
aren't overwhelmed right now. The PPE supplies have increased there. They're
going to start doing some surgical procedures and elective procedures so they
obviously are confident enough that they're able to start doing that and
still care for, what will be continued, COVID-19 patients. Phillip, this is
Melissa. The first, the very first session in this series involved looking at
estimating when COVID-19 would peak in Sedgwick County. There are lots of
websites now that have sprouted up all over and the estimate is that we're
nearing peak right now, as we speak, as this session happens.
So if that's the case, if the greatest number of cases is right now, then how should we
be thinking about what comes next from a healthcare perspective? Yeah, you're right,
there is a lot of question about exactly when the peak is. Dr. Minns suggested
that we were kind of at more a plateau than a peak, but it's hard to predict and
there's different models and they're based on different scenarios. so it's
hard, but I think, it kind of seems like the general consensus is we're kind of
at that point right now. The concern is that, you know, as you lift the
restrictions that are in place we, maybe we unleash more of the virus and so it
rebounds, maybe in the camel back analogy of Denver. So that is a concern about
how to do this. And you know, I might point out, the White House
issued guidelines on when you should start opening up and we have not met
those guidelines. They include 14 days of reductions, ample testing.
Those guidelines are not met here but, nonetheless, I think largely because the
hospitals have not been swamped and there's just so much pressure,
understandably, completely understandably, to help people get back to work and
businesses open, that we're moving in that direction.
I think Venus has been trying to jump in here so, Venus, I wanted to give you the
opportunity to speak your part. Well, I think they've said everything
so, they've covered it. I just wanted to also say that I knew our
community was generous before, but I have grown to realize just how generous this
community is. I mean even with all the donations and stuff that we have
received, one of our biggest fear as I've said earlier with PPE, and the community
has really come through for us. I mean so much so as salons and stuff dropping
off all their gloves, but it's just been, it's been a hard thing. That's great. Okay,
We have three more questions in chat. This one is from last week's speaker,
George Dehner, who talked about the history of pandemics and the lessons we
could learn from them. George is asking, is there a metric or
threshold that will be decisive in returning to more stringent quarantine
efforts if the number of cases spike after the May 4 recommendations? Hi, this is
Adrienne. When we begin to transition into the next phase, if the
cases begin to spike then we will go back to the phase prior to. If that's
stay at home, there will be those guidelines put in place. We will be
monitoring at the health department. There's going to be a lot of data points
that we are monitoring, seeing what's occurring in the emergency rooms that
would increase in respiratory. We always monitor cases and so there's a
lot of different pieces of information that we're going to be monitoring very
closely during every phase. Adrienne, this is Melissa.
The Maryland Transportation Institute has done some really nice work with
mapping in the US, and one of the things that their work suggests is that fatigue
is beginning to set in. People are tired of staying at home. Are you concerned
that if the stay at home order is lifted or modified in some way, that people
will be more mobile and this will cause the virus to spread? You know, that is
an excellent question. It has seemed like every week since the stay at home order
there's more people on the roads, so I was interested to hear that 40
percent of people that you said, I believe, that 40 percent are being shown
to really stay at home when there's more people out.
There's a lot of people that have really adhered to this because it's been scary
and then others that maybe don't take it that seriously because the goal was the
hospitals and, not just the hospitals though, to reduce the rate of which it
spreads so that we would have adequate resources to then get those contacts out
of circulation. We're going to be looking at hiring ten more
contact investigations just to make sure that we're always ready.
It's a concern a little bit, because they're already out.
They're congregating at parks and whatnot, but you know as Phillip and
everyone else have echoed, that is the concern with lifting too quickly
and not doing it really strategically and safely, that we're gonna get more
than what we want because our stay at home has been effective, even though not
everyone's doing it, it has helped us be where we are right now. Great, we have two
more questions in chat and we'll probably take a third after these two
questions, but that'll be it for today. The first question is, other than age
group and gender, demographic data such as population group and comorbidities are
sparse for confirmed cases. We need these data to understand treatment. Mississippi is
the only state that I am aware of that is reporting these data. When will states
report or share these data? That's from Mary Liz Jameson. We do have
male and female and, I believe by race also on the website, so that is there.
If the numbers are small, like below five, that is information that we're not going
to release because the smaller, the lower the number is the more
identifiable the information can be, and it is protected health information. We
are releasing more information in the public health system
then we have ever released before. I mean, we've historically had clusters in
in nursing homes because norovirus, which is known as the stomach flu although it
really isn't, if that is in a nursing home it spreads quickly. So this
is something that health departments do as far as monitor and do disease
investigations. It just hasn't been at such a high profile before, so we have
historically told media that we can't share certain information. It's just at
a whole different level at this point than what people are used to. So it may
not seem like we're sharing enough information, but it is so much more than
what we do or have been. So I would recommend that she take a look at our
website because we really are adding more pieces daily as those requests
continue to pour in, but there is information on there about gender and races, or
race. Mary Liz, this is Melissa, and that's a really good question.
One of the problems is when
you're testing people, you may or may not be able to collect demographic
information, especially if you're doing the drive-by swab as opposed to testing
somebody in a nursing home. The Kaiser Family Foundation is a wonderful
resource for health care information and they have some statistics by state. Now,
again, these data are kind of suspect because there's not really good
reporting, but they're showing that about 17 percent of the COVID cases in Kansas
currently involve people who are African-American, and that is much larger
than the African-American population in Kansas as a whole. There are
disproportionate effects likely, based on race and ethnicity and income,
but it will have to wait for more information to be able to dive into that.
I will be at the head of the line doing that and really interested in that
question. Okay, this will probably be the last question, also from Mary Liz
Jameson. Are data on COVID-19 strains being collected? There's at least eight
strains that are known, and where can we find this information
by region? Health does not ordinarily collect information
on coronaviruses. Like the common cold, for example, are one of the corona
viruses, so what public health focuses on are reportable diseases that have a high
transmission rate, and the common cold is just part of what occurs in our
environment. Now when we had SARS and MERS, which are two coronaviruses that
were more deadly, then that's when public health is in there collecting that
information, but it's just like the flu. Flu is not a reportable disease
because it's just very rampant in our community unless it involves the death
of a child. And so the numbers are always a pretty big estimate when you
see flu numbers and flu deaths. We won't be collecting on the common cold,
but we are COVID-19.
Any other commentary from our panelists?
Maybe a good place to end this is by
sharing the county's website, which is a wonderful resource. Sedgwick County.org
and when you go to that page you'll see a link to COVID-19 and data. There
we go, and on the bottom below you'll see that
there's tabs and Each tab has different information on it. And it has dates, so
one of the things I like to do with this is to look at the number of new cases.
Around St. Patrick's Day, Easter, there are spikes. So I think that the concerns
that's been voiced in the questions
are valid concerns. Absolutely.
Well, thank you all, Adrienne, Phillip, Venus, Shelley, thank
you for joining us and being part of this panel, and thanks for those
of you who are listening in. Thank you for having this.
Oops, and next week, I'm on the wrong slide, let me switch over to that quickly. Next week is the last of our
series, Perspectives on Pandemics. Bill Groutas, who is the WSU Foundation
Distinguished Professor of Chemistry, will be joining us next Wednesday, May 6
at 3 p.m. He's going to be talking about his work in
search of a COVID-19 vaccine and therapeutics. He's been working really
hard the last few months to see if he can help develop a vaccine that will
treat this disease. So if you all can join us again next week that would be
great. Hope you all stay well and hope to see
you next Wednesday. Thank you, everyone.