COVID-19 & Flu 2020 ~ Ask an Expert
Hi everyone my name is alison goddermeyer, and i'm the multimedia, public relations, specialist here at sarasota, memorial healthcare, system. We're getting ready, to face, the intersection. Of the covid19. Pandemic. And the annual, flu season. Joining me to talk about this and answer some questions from the community. Are dr manuel gordillo, the medical director of smh, infection, prevention, and control. And lisa collins-brown. The director of emergency, services, here at smh, thank you both so much for joining us, thanks for having us, hi ellison. So dr gordillo. People have a lot of questions, about the intersection, of these two respiratory, viruses. So how concerned. Are you. What, about what might happen, if we wind up facing kind of a twindemoc. If you will. Yes so that would be the main concern that what some people have called it twindemic. Double. Trouble. Some other and. Some other, designations. Of that, type, you know but uh i think we. What there. Could be several scenarios. Here. Uh there could be the best case scenario. Which will be. Something, like what happened. In, march. Where. The. Covet, virus, came. And, this result, is a near disappearance. Of. Influenza. Virus, at that time. In united, states. And probably one of the reasons, that it disappeared, is because people start, doing the social distance physical, distancing. Washing their hands a lot. So even, even when there was no mask use. All that was enough, to. Hold, the transmission. Of influenza, viruses. There are other. Winter viruses, to circulate. Some of them we continue, to see them through april. If we look at what happened in the southern, hemisphere. In. South america, and south africa, and new zealand, in, australia. During this last. Uh, season. The same thing happened, they did not, historically. Low. Transmission, of influenza. And very little other viruses, other than sars, kovi, ii. So, and this is attributed, to the same thing, social distance in physical, distance, in hand hygiene, and mask use and. On top of that, all those countries did a lot of. Promotion. Of influenza. Immunization. So we're doing our part we're we're promoting, influence, immunization.
And We continue to give the message, that people should do all the other hygienic. Measures, so that would be the best case scenario. That we will have a very attenuated. Influenza. Season. The, the. Worst case scenario. Is. Influenza. Is, unpredictable. Yes that's what happened in the southern hemisphere, but we don't know what's going to happen to us. So now we have the, both, viruses, circulating. And on top of that. We don't know what the effect of both viruses, will be. So that would be, um. One. One way of looking at it you know, but uh as we always say. We need to prepare, for the. Worst, and, hope for the best. So, you know, this is, what we've been doing preparing, for the worst. Yeah lisa to that end how does your team. In the emergency, room and emergency services how does your team prepare, for the possibility. Of, a, bad twindemic. Well i mean we're already prepared, because covet, has made sure that we've. Gone through all those processes. And. You know we're doing all those things that. Will translate, over to the flu if we had an influenza, breakout. So, um even in our waiting room, we have, chairs separated. We have, a, screener, at the front door checking these temperatures. We hand every single patient a mask that walks through our door and the visitor. That's with the patient. We're using a lot of sanitary. You know protocols, in terms of wiping down surfaces. Um, so we're already doing all those things and though you know we're going to continue, to do those and, for the foreseeable. Future. Um and i think to dr gradello's, point is that it's already, kind of, helping. Um. To decrease. What we're seeing the community with flu we're not really seeing any flu yet. Um, especially, here. In our emergency, department, so, hopefully all those things are going to go into are going to continue, in place and help prevent. Any additional. Spread of the virus, and also flu. Dr gordillo, is it possible, to get both viruses, at the same time. It is possible. Again, going back to the end of. The last, influenza, season, it was a rare event. And since then. In in the southern hemisphere. In the northern hemisphere, there's been case reports. There's been small, series, that's published, in some countries. There's one, one small series in louisiana. So we're hoping, that. If it occurs, that they tend not to occur together. But, there's, more data that needs to come in to make a more definitive. Assessment, of that. And this may be kind of the same answer but what happens if you say had coveted. And then get the flu, would those antibodies. Help you at all or make the, symptoms less severe. Yeah there's no, no, cross protection. From one virus to another, they're very different, antigenically. And and the antibodies, for one virus the nuts does not protect you against, the other. Uh in in with regards, to the the covet, itself, we don't even know that you know if you have covada, where those antibodies, going to protect, you. We think it does a little bit but we don't know, how, how well and for how long. And there are other respiratory, viruses, that go around at this time of year as you, mentioned, before. Some of them bronchitis. Even the common cold. How can people tell them apart. So that's going to be the challenge. You know how can you tell, those apart, and that's, one of the reasons, that uh, we are hopeful, that, all these non. Pharmacologic. Interventions. To prevent these viruses, will help. End, the vaccine, for influenza. Because it's very difficult, to tell tell them apart unless you test for them. And testing, is uh it's not always available, you know yes uh if, in in certain settings like hospitals, you can do testing. In certain, settings like you. Urgent care centers, we will have. Uh testing, for this, you know but it will not be available.
Out There in the community. To test everybody. You know when you come to, uh, healthcare, centers. Hospitals. Emergency. Emergency, rooms and urgent care centers we can test you for this but it will if you are out there at home, it's going to be very difficult to tell the difference, so you will have to be evaluated. By, your healthcare, provider. In order to determine. One or the other, or, one of the, multiple, viruses, that are out there. And how many different, tests are are available, to diagnose, or rule out those viruses. And are there still limitations. On that testing. Further. Who should get tested, and when. Yes so, those are very difficult, questions, and they're, excellent, questions. You know and we have technologies. Nowadays, to test. But, um. The test. The, the testing technology, is very sophisticated. And it's uh. The. The supply, chain is still limited, even now 10, months into the. Into this pandemic. We still have limitations. On where can we use our best test. So. There are, molecular. Tests, that test for all these viruses. That we're going to use, but we need to reserve, those for people are going to be admitted to the hospital. Those are the best tests, you know the pcr. Test. The mp swaps and nasal, swaps. And some oral swaps. So, then. We didn't, we need other tests that have been more widely, available. And we do have that, there, some of them are new some of them are not. Uh influenza. Antigen, tests for example they've been around for years. We have that our disposal. This is kind of like a point of care test so it can be done quickly, can be done, and, you do the swap and you get the results, in 15-20. Minutes. And similar, technologies. Will be used, also, for covet. In outpatient, settings. Like urgent, care centers. We can, with trying to implement, this, in. Doctor's, offices. Fpga, offices. Those are, simpler, tests, that are point of care. So it can be done, faster. The disadvantages. That are is not as sensitive. You know may miss a few cases. So. Um. We have to be, very. Mindful. On when to use it how to use it and there's, there's a lot of discussion, going among the physicians, staff. And the urgent care centers, and the emergency, rooms and and the clinics. On deciding. When to test when it comes down to influenza. And like. Lisa said earlier we are not seeing any influence in the community. So there is really no good reason to test for influenza, yet. But. We have. A lot of surveillance. Systems, that are looking, to see when influence, is here. When influence is here sometimes, we have to test. And then we have to make a decision. When do we test you ask we need to test when it's going to make a, difference. So if you are very young. Like they're less than two, to five years old or younger, you, test them they're very old. You also test them the immunocompromise. You test them, or is, if it's going to make a difference. On making infection control decisions, or public health decisions. Let's say that you live with somebody, that, is cancer has cancer and has immunotherapy. At home. Or you're living with somebody that's pregnant at home then, all these complex, decisions, need to be made at the point of care. And, we're, in, constant, discussions, with all the dogs the pas, that the apr, ins. Uh the. The nursing, staff, to educate, and make. This a smooth, process. So lisa, if someone, has symptoms. When and where, should they seek, medical care, and will screening, or, triage, for care be different, this year because, of the intersection, of flu and covid.
Um, Well obviously. If you have a, physician, that you can contact, if you're having symptoms, or those kinds of things, you want to reach out to your own personal. Physician. We have the urgent cares, also available, in our system. That. Patients, can present to. But for, life-threatening. Like anything life-threatening. Shortness of breath dizziness. Chest pain chest pressure. Ongoing, fever, cough etc, that you know you feel like you need to come to the emergency, department. Um. You know we're. Obviously, open 24, 7.. And we do a lot here to be able to. It is very safe to come to the er, um, and one of the things that we did see during. Um, coved. Was people were delaying coming to the emergency department, so, we definitely don't want to see that so we're still looking for patients to come in that have, stroke, and, heart. Chest pain and those kind of things but. Um. We do do testing, here, in, the emergency, department. We can, also do. Flu testing, but, once again if patients have symptoms a lot of times we just treat them. Instead of needing to test them. And we do the same thing at the urgent cares as well. And, for. Triaging. Is it the same now where. People who have symptoms are being separated, to prevent spread. Yes because we're not going to know, what they have until we get them tested to see what they have so, anybody, with those same type of symptoms, because flu symptoms and covet symptoms are. A lot alike. So patients. You know when they first walk in we're definitely not going to know what they have, um so we are separating, patients. Um like i said we're giving a mess we're giving them, some foam and hand sanitizer. And then we're separating, people in the waiting room. And then lisa, you kind of mentioned this but. For people who have been tested, and say do have covid, or, do have the flu many of them are, staying, home and able to treat at home. At what point should they seek emergency, care symptom-wise. I really think if they have that consistent. Or persistent. Symptoms. And, they develop, either. Difficulty, breathing, shortness, of breath. They begin to have any kind of chest pain, ongoing, nausea, vomiting, diarrhea.
Anything Like that that could cause dehydration. Dizziness. Other symptoms. You know once again they can always contact, their. Doctor. Their doctor may ask them to come into the emergency, department. But really. Once it's ongoing, and they're unable to care for themselves, they really need to come on into the emergency, care center. Yeah that's that's a very good advice, lisa. Just want to, add. With. What we've seen especially, with covet but it can also happen with influenza, is confusion. Especially, in the, elderly. And sometimes, that's a sign of uh, of, hypoxia. Or is just a part of the disease. So, we've seen quite a bit of those. Elderly, patients, presenting, with confusion, and having severe. Colleague, or severe, influenza. So all the other symptoms, that you mentioned, of course. And one thing that we're uh where. The dogs are recommending. Uh people, is to. Try to get if you have if you've been diagnosed, with this try to get a pulse oximeter. Now you can get it for not a whole lot of money even from amazon. Or from any pharmacy. And check your, pulse oximeter. At home. You know if you get low oxygen, readings. It's a sign that you probably belong, in the emergency, room or in the urgent care center. For those who. Do, have, symptoms. Maybe they're not getting tested, they're just staying home with, potentially, covet, or potentially, the flu. Dr guardio can antiviral, medications, like tamiflu, help them and if so, how soon, soon should they start them. Well it won't help with kobe. It will obviously, help with, influenza. So but the the key with influenza, and tummy flu, is to start it early. So. Less than 48, hours is optimal. Now in certain, situations. Uh. Tummy flu can help even, after the, 48, hours, if you're, immunocompromised. Or you're sick enough to come in the hospital, you're going to get something to even pass the. First 48, hours, but. It's recommended. That, this is given, early. So. Lisa was. Talking about, uh, you know coming into the hospital, and in the hospital. All the, all the the staff is well trained in in providing, you with. This medication. In the proper setting under at the right time early on, but the same thing goes, if you are not sick enough to go to. The hospital, emergency, room or urgent care centers, you can still call your doctor. And they will do, a phone triatch. Usually. And then, they can, i can. Do. This can lead to a telehealth. Um. Consultation. With one of the dots or appearance. Or, pas. And make a decision. Right there whether you need, that, medication. Or other, testing. Or some other intervention. Lisa you spoke before about, the symptoms, that. We should, immediately. Get patients to the hospital, for but. Sometimes, kids aren't as good as expressing. Their symptoms so what symptoms should, parents, worry about in children. That is the time to get their children to the emergency, care or, urgent care center. Um i think it's still kind of the same symptoms, i mean children are still experiencing, those i think with, most kids especially, with coved, you're seeing more like cough, and. Fever shortness, of breath. Um. So it would be the same for children if they're experiencing, ongoing. Shortness of breath difficulty. Breathing. Any kind of pain. Pressure in their chest. And then. Confusion. Would be the other thing lethargic. You know unable to drink or eat. Children, can. Compensate.
For Quite a while before. Um they decompensate. And when they decompensate. It's usually quickly, so. Um. Definitely, get in touch with your pediatrician. Um, and like i said we, you know we're open 24, 7 here and we can definitely see children here. And evaluate, them. Great. Dr ordio, are there heightened risks for the same populations. That are typically at risk during the flu season, are there even higher risks, because. Of this intersection. Or twindemic. Potential. Yes absolutely. There, there are. At-risk, populations. Uh based on. On age. Uh. Lisa was just talking about the children among the, children. The the ones that are, most. At risk, are the less than two years old. And for influenza, has been, less than two years old, it's, definitely, but also less than five years old. So, at. The influenza. We clearly, have a. A. An age, cut off where. Influence that tends to be, more severe. For covet. It's not as as, as, clear-cut. Most. Children. Do well with covet. It's uh, perhaps. It is the. More problematic, with covid, are they really really, young, you know the newborns. Um. In terms of, other ages. Poor covet, definitely. Older people, older than 65. Are at higher risk. And pregnant, women. Are another, group that are at risk for both influenza. And covate, especially, for influenza, there seems to be a more steep. Uh risk. The in in, kovis, you're starting to learn, that yes they are at higher wisdom. Than. Than the. Breast. But. Definitely, influence, up, and and. Pregnancy. Is not a good combination. And then we have all the other, immunocompromise. And comorbidities. You know the immunocompromise. Our people are transplant. Their, steroids, and immunosuppressants. They have hiv. Aids, that and and then the ones that have comorbidities. The. The asthmas. People with neurologic. Diseases. Sickle cell anemia. Etc, there's some, diabetes. All those, that sometimes. You know it is. A risk factor for bulk, and they tend to overlap. So dr gaudio we've spoken before about the importance, especially, this season of people getting their flu shot, the question, is is there still time, for people to get the flu shot. Yes. Especially, like lisa said we haven't seen any influenza. Yet. So, definitely. There is time for, for, getting the flu shot the flu shot takes about, two weeks to start. Giving you protection. So we haven't seen any influenza, so definitely. It is a good time to. To, vaccinate. You know you will you may have heard the message, vaccinated, in october, but, november, december. As long as there is. Influence, in the community, you can, vaccinate, even later. If you for whatever reason didn't vaccinate. You have an opportunity, to do it. Speaking of vaccinations. Will a pneumonia, vaccine, help prevent complications, from the flu and covet. Yes. You know like, for example, in. In the 1918. Influenza. Pandemic. Most people died, not because, of, influenza. But because they got a secondary, pneumonia. Back then we didn't have antibiotics. We didn't have influence, not didn't have. Pneumonia, vaccines. Now we do have that and that's why. At least in influenza, we have decreased the mortality. Of novel influenzas. So definitely. We. We recommend, vaccination. For those groups where they are indicated.
Now, You know children, get vaccinated. There's a. Schedule, for vaccination. In children. At a certain, age. And that has resulted. In protection, for the rest of us, because, usually, for pneumococcus. Which is the main cause of bacterial. Pneumonia. It's, usually, the the bacteria, enters, through the children, but now the children, are immune, support, they're giving us some protection. So. We are, partially, protected, because they are not protected, through vaccination. So you will see less pneumococcal. Pneumonia. But still. Especially, when you get to be. Um. Past 65. We still, recommend. Pneumococcal, vaccination. And if you are at. Other ages, with certain, risk factors, like if you're a smoker, you have obesity, diabetes. Copd. Emphysema. Those those type of diseases, we do recommend, that and you should contact, your physician, to. Talk about this and see if this vaccination. Is for you. So dr gordillo. How long should people be staying, home, if they're sick whether it be the flu. Or covet, or any, of these other viruses, we've discussed. How long should people be staying home. Yeah so i'll tell you as i start for what we know well. Uh, we know well for. For. Covet. If you are sick. We give you, 10 days. From the onset of symptoms. You start counting, that'll be day zero you have to come 10 days. If you have an illness, that is not. Severe enough to come into the hospital when you come into the hospital and you get severe disease, it could be a little different. Sometimes, we go up to 20 days but for most people ambulatory. It will be 10 days. As long as that day 10 you're feeling better you're not having fever. You can. Go back to the world. Now. If you have been exposed. It's a little different, you know and this is counterintuitive. A little bit because people say well how come, if i don't have the disease why do i have to wait 14, days, which is what we recommend. When you get exposed. But don't get. The disease. It's 14 days because that's the duration of the incubation. Period. You can become, ill up to 14, days after your exposure. So we recommend. You know if you're not a. As a as a general rule there'll be 14 days, post, exposure. So that's with regards to covet, and, what about other viruses, in influenza. And this is what we've been recommending, through the years, before. The, this. Pandemic, started, which is we tell people to stay home. Until you, have had 24. Hours, with, no fever. And not taking, any. Fever reducing, medications. Such as diet and all or nonsteroidals. Like having profane, and lapras, and those type of things. So that's uh in general what we recommend, for people that have flu-like, illnesses. Or proven, flu. There are some exceptions. Uh and then, you get, the. What the kind of advice you. Give to people, that are not tested, and they don't know what they have. So that what i would say is try to contact your physician, because you need to have a conversation. You know it's not so straightforward, the physician, needs to make an assessment. On. What do they think is going on, but you know, it will frame, within, those two. Those two, um. Opposites. Do you have coffee, or do you have influence, or an influencer, like illness. So. Uh lisa. Can you talk a little bit about you you talked about how we don't have the flu, in our community, yet we haven't been seeing that but we have been seeing a rise in covet 19, cases, locally. And, in the state, so, how does your team, handle that and triage, those patients. While also protecting, the other patients who come into the emergency, room.
Well We have a screening, station. Out front, where patients, arrive when they're coming in by. Private vehicle or their ambulatory, if they come in through there we, are able to screen, every single patient. We check their temperature. We also have a separate waiting room for patients, that have. Covered, related, type symptoms, or flu symptoms. Um and they would be separated. From other patients. We also try to expedite, those patients, back to a private room. Pretty much all of our rooms, are private, in the er. And so we're able to get patients, quickly to a private room and kind of. Get the door shut get the patient in there then all of our staff, wear the necessary. Personal protective. Equipment. Which. Allows, them to take care of that patient safely. And then they come out. They. Wash their hands obviously, and do all the things that they can so they can take care of other patients, but. Um. You know it's just we've learned so much from covet, and it's not that we didn't have those, protocols, in place before. But now, um, you know we've gotten really good at it so. We're able to take care of, large amounts of patients. With and without symptoms. Dr gordillo, we are, entering. The holiday, season, so with thanksgiving, coming up specifically. What are there any ways to minimize. Risks, if you are getting together with family. For the holidays. Yeah this is a tough one. Because. You know people. Have been, separated. A lot of time from their families for about 10 months. You know they were hoping. That the holidays, will come and they get together, with them, and, now we're finding that. Many parts of the country. We're going in record numbers, of cases. So. You know you have to make a real hard assessment. Of this this situation. On what to do and the way that i i would. Suggest. We all should do is there's a couple of things that, to us, first you need to make a risk assessment. Is it worth doing it yes we want to get together with our family, i haven't seen my parents, in 10, over 10 months. I would love to see them, you know they're. In, their 90s. You know who knows how much. Time they would have left in, and uh and this is the time that i usually go to see them but. I, really need to think, uh is it worth, exposing. Them. Uh, and. And, so if you make the assessment. That it's not worth the risk obviously, you need to, not do it, and, find some alternatives. There's still, you know. Zooms, and all these other things that you could do. To substitute. For that. And and that not only goes to the you know to the elderly, parents or grandparents. But there also are a lot of other people that are at risk you know we all have relatives, that are undergoing, chemotherapy. That have had a transplant. That they have diseases, that put them at high risk. Um, so, all this. This needs to be considered, and that's going to be your first, part of your risk assessment. Is, something, that. That it's worth the risk. Um, and because, there's going to be, the worst case scenario. Is that you get together, and someone gets the disease, ends up in the hospital, with the bad outcome. So that's something. First and foremo. Foremost, something that you have to consider. And after that then you in the risk assessment, pre-travel. Or, pre-going. To the holiday. You have to consider. Where. People are coming to you or you're going to somewhere. Somebody, else, where do you where are you going to stay, you know. Hosting, people in your house or visiting, somebody, else's in their homes, it's probably not a good idea these days. Um. The other things that other things that you need to, consider, is where are you going, you're going to a really bad hot spot are you going to castle, texas, or are you going to go to somewhere, in northern wisconsin.
Or In north dakota. Probably, not the best of ideas. So those type of things you need to. Consider. In, and. Definitely, make a good assessment, and then you need to set ground rules to, you know if you're hosting, or you're going somewhere, else. You have to make a decision, and you have to talk to them, to work to your group. Are we going to be wearing masks. In under what conditions. How are we going to be physically, distancing. Uh, and, and we need to, discourage. Presentation. You know which is you know i. I'm a little bit sick. But i already made a commitment to go visit them. Don't make that mistake. Okay if you feel a little bit sick you stay home you cancel your trips, don't feel that you're obligated, to go because you already. Told your grandparents, that you're coming to visit. If you're a little bit sick you don't feel well. Don't go. Um so, those are the ground rules and then also. There that you have to, try to plan on some mitigation. While you're during the, holiday. You know we've learned quite a bit about this virus. Since, march. You know at the beginning, we didn't know what, how much of this is contact, transmission. How much is this, through the air, either droplets, or airborne. We know that, nowadays. Most of the transmission, occurs, in the air with droplet. Or. Through. Airbornes. So, keep that in mind, you know when you go to places, if you have the opportunity, to do things most of the. Activities. Outdoors. That's, going to be much better you know in florida, for example. That will be the way to go obviously if you go to northern minnesota, it will be more difficult to do anything, outdoors. But keep in mind if you can do it, it's much better to do it. So that, will probably, also. Call for change in the way, you do your traditional. Thanksgiving, dinner, sitting at the table a whole bunch of people, sitting there for four hours sometimes. Talking and reminiscing. You're probably gonna have to cut that down, you know either not do it or separate. It might be better to have one person, serving the food to everybody. Rather than people serving themselves. You know to, avoid, and then the the. The typical. The recommendations. That we've always done, still stand. You know, do the hand hygiene, we're probably going to have to have more purely and other forms of, alcohol, wraps throughout the, home for. People to do that frequently. Uh so those are kind of like uh. And one other thing. Is that. Certain, states have their own rules, also.
And It is keep changes, so if you're going to go to another state please check. With the health department, of the state where you're going on what are the recommendations. Because there are sometimes, restrictions, on the number of people that can get together, and so forth. Um i spoke to lisa, briefly, about, the rise in cases, locally, and nationally, you mentioned, it, what is this rise in cases. Or. This new wave, if you will what does it say to you as an epidemiologist. Well. It's um. Everybody, expected, this to happen, you know. Winter viruses, are winter virus, we're in the winter. Corona, viruses. In general, have that seasonality. They get worse. During, that part of the. Year. And this is a time especially. In the, north and the more temperate, zones where people. Stop going, staying, outside, and they start going, inside. Which is the worst thing for, coronavirus. So. We kind of expected, this to happen, and now it's hitting. It's been 10 months you know everybody's, going through pandemic, fatigue. Or some other, sometimes, unfortunately, we were getting. Mixed messages. Through tvs, and social, media. And things like that, so. I think this is a reflection, of all of that you know there's confusion. There's pandemic, fatigue. There's a, wrong messaging. Coming through, from the top. And then all these other factors that i mentioned, you know the seasonality. The fact that people now are more indoors. And all these are. Something, that the virus loves. We've been hearing a lot about. A potential, vaccine. Do you want to provide an update on, where we stand with a potential cova vaccine, and when that might be available, locally. Yeah, yeah you know. Up until last night we didn't know much about this. But this morning. As you you probably know pfizer, announced, that, their vaccine. Looks. More effective, than anybody. Or any one of us, anticipated. It's early data, it's rather preliminary. But it's uh it's, it's solid, too, you know, um, ex, having a vaccine. That is more than 90. Effective, on preliminary. Data, is, better than. Anybody, expected. You know so i guess will be a, thanksgiving. Holiday, gift for the world. We still have to, wait. Until the, probably until the third or fourth week of november, to see the safety, data. This. This particular, vaccine, was trialled in about, 43. 000, people. And, those numbers, are based on the first 94. Cases, that have acquired the disease. So if you have you, do the math, it means that probably. Around. Nine of them. Uh occurred. In the. On the. Uh vaccine. Side. And the other. The, the balance of that the other. 88. Or, more, occur in the placebo, side. So that's how they tell you that it's more than 90. Effective. So, because there's a lot of transmission, and a lot of infection, going on. You know from here to the end of the month this number could be from 94. Cases. To. The i think they're shooting for about 184. Cases, that reanalysis. Uh so it'll give you all the confidence, intervals, in the statistical. You know. Confidence, on this vaccine, will grow. But the numbers, look great you know i'm elated. I'm very excited. Now. The next step is, you know the difficult, part you know because. There's two two, steps on you coming up with an effective. Vaccine. But an effective vaccine, on anybody's, shelf, doesn't do anybody, any good. That vaccine, needs to be, used, and we need to vaccinate, people and protect them. Now we need to. Overcome. A lot of the other factors. Vaccine, hesitancy. Opposition. To vaccines. You know we need to do a better job. In messaging, people, and explaining. How this vaccine. Is safe how this vaccine, has been developed, with using the best technology, the best science.
Uh, So people. We have a lot of work to do, definitely, you know it's not just the distribution. Of that vaccine, but also, in getting people to accept, it. You guys have given us so much, information. Today, lisa. Last question for you what in your opinion, is the most, important, thing people need to know. Going into. Flu season and coven. Continuing. I think just to remain, diligent. And. You know the reason that those guidelines, are out there in terms of social distancing. Masks. Cleaning, your hands washing your hands, all those good things. Is because they actually work and we've seen that it's been able to. Slow the spread of the. Covet virus, so, if we utilize, those techniques, moving forward, it's also going to help with influenza. And i think that. Hopefully, we'll see. A low. You know influenza. Outbreak, this. Winter, and. You know if we can get the vaccine, then. We've done our job in terms of slowing down the virus, so. Definitely, stay, diligent. Dr gaudio anything else you want to add. Again, you know every time we talk about this we end up saying the same thing you know. Right now. Our best. Tools. To fight this pandemic. And influenza. Are the non-pharmacologic. Interventions. What, lisa just mentioned. Masks. Are also. Very very important. It is a low-tech. Simple intervention. That is available, to everybody. I am back, that way back when at the beginning, there was not as easily, available, but now. We can you can find it everywhere. And. And it's a simple thing, to do, and if we all all do. All of that and on top of that we have the vaccine, and the vaccine, is accepted. Now we're finally. Turning the corner, and now we're seeing. That, a few months from now we may be able to return, to some sense, of normality. Which all of them all of us. Are longing. I'm great all right great thank you both so much for joining us and answering, all these questions. For the community. We we all really appreciate, all the work, you and your teams, have been putting in, during this difficult. Last, 10 months with coveted now entering the flu season we appreciate, it, we want to emphasize, one more time that smh, is working, so hard to keep everyone. In our community, safe. And we should not have people delaying. Urgent, care or emergent, care. Should, they need it, but of course as you guys just mentioned, everyone, should be social distancing. Using proper hand hygiene. Wear a mask. And stay, safe from covid19. And the flu. Have a great day everyone and thank you. Again.