 Good afternoon and welcome to COVID-19 and the black community, a year of loss and lessons today will be having a conversation about the extraordinary impact of the COVID-19 virus and pandemic on the black community in Indiana and beyond. I'm Molly Martin and I'm the director of New America Indianapolis, we're so pleased to partner with the Indianapolis recorded day to bring you one more in a series of conversations about COVID-19 and black and brown communities. We're honored to be joined today by Paul Babcock, CEO of Health and Hospital Corporation of Marion County, Dr Virginia Cain will join us shortly. She's the director of the Marion County Public Health Department, Carl Ellison, the CEO and president of the Indiana Minority Health Coalition, Dr Curtis Wright, the president and CEO of Eskenazi Medical Group, and Dr Eric Yancey, a pediatrician at Riley Children's Health. Before we get started, as we do anytime we're talking with and about the black community we have some principles that we like to lay down at New America Indianapolis. We like to start out by simply saying, obviously, black lives matter. Black voices are central to our economic and social lives. They should be elevated and amplified like everyone else's voices we hope these programs give equal time and consideration. We know that race and ethnicity are not the same. And similarly, we know that the black community is not a monolith and that we'll be talking about a variety of experiences with the virus and in the city. We hope that you'll join us with your questions in the chat today if you're joining us on zoom. If you're joining us on Facebook live. If you see me disappear it's because I'll be looking at some questions over there as well. But before we jump into the panel conversation, I want to introduce my partner, Oshia Boyd who will be moderating with me today she's the editor of the Indianapolis recorder, and we'll say more about this important series, our partners, and today's event. Oshia. Thank you so much Molly. It's been a year since COVID came on the scene. And what a long year it's been. I think we have learned a lot. We still want more answers we're still trying to figure out where do we go from here. And we want to talk about that today. We also want to kind of revisit where we've been and lessons we've learned and how we can use those lessons we've learned for the future. The recorder we're coming up on our anniversary of our very first town hall on about COVID-19 when the first came on the scene and I can just think about it think back and I'm just like wow. Wow, what a time that was what a time. So we want to make sure that we answer questions that we give give our community good information, make sure they know how to proceed best and we want to also of course vaccines are top of mind for everyone. So we want to make sure we get you good information about the vaccines and about this this illness that has come up come on the scene a year ago. So thank you. And I will kick off the first question. I kind of want to talk to everyone about where we stand today. We have infection rates where we have with infection rates vaccine rates. And also, is there a difference. This is a lot. I know there's a lot coming at you all at once. So I can come back to it, but also we want to know, is there a difference between how the black community experiencing the recent improvements with COVID-19 compared to the white community. So Dr. Yancey, I'll start with you. I'm really going to just mention a few things from the pediatric standpoint. And of course we've been actually working straight through it so we've kind of been in there the whole while. And early on it was pretty well known that children seem to not to be as physically damaged or physically affected as as adults and even older people. That's kind of held true, and that we do have some some children who were pretty severely affected. Thankfully, the numbers are going down now. But the one of the bigger things in the pediatric standpoint was the emotional impact, the psychological impact, and the educational impact. Those were huge. We have seen some studies coming in that show about a 30% to 35% increase in acute psychologically related events into emergency departments, acute anxiety episodes, significant depression occurring. And it's going to be I think years before we figure out what the educational impact was concerning the lost school time, the lost in-person learning. Distance learning is a stopgap, but I think most educators would tell you that we're not looking at the same as in-person learning. So what we've seen from the pediatric standpoint is that whatever we didn't pick up in the physical aspects, it certainly hit us from the emotional standpoint. Dr. Yance, I just want to stay there for just a quick minute. When you talk about the psychological impact for youth, that is a pretty big deal. And we often don't think about psychological impacts of children. How much this has affected them? What can parents do to make sure their children are okay? Because it's been a long year for kids especially. Well, let me just hit one thing, and that is to say that one thing that's reassuring for children is when you can tell them there's an end to something. I'm from Baton Rouge, Louisiana. I went through a bunch of hurricanes. And I remember those hurricanes would come, we didn't evacuate or anything, but we'd be under the bed and whatever. But we knew that my mother would say, or my dad would say, tomorrow this will be over, no matter what happened, no matter how the wires were flapping around and electricity was off and off. But they would say, tomorrow this will be over. And that was reassuring and that was comforting. Well, the problem with the pandemic is that no one has been able to tell the children tomorrow this will be over. So what it is, is a situation where it's a long term stress related to the loss of their friendship, their playmates and whatever, and nobody can tell them when. So what we can do is try to, as parents, as grandparents, whatever, just try to keep the kids in the moment. Now we can start to see a little light at the end of the tunnel, but early on we're hoping to keep the kids in the moment and saying, no, we're not sure, but this is what we're going to do today. This is the activity we're going to do today. Our day is going to consist of this and this and this, and tomorrow we'll take care of tomorrow when it comes. Because if you give a lot of people a lot of false hope for this week, next week or whatever, and it doesn't happen, that just becomes more depressing. So what we can do now is tell the children, it looks like there's a light at the end of the tunnel. Grandma's going to go out and get her shot. Grandpa's going to go out and get his shot. Okay, and this is going to make it better for everybody. And I think that's the best thing we can do for the children now. Thank you so much. Carl, let's come to you. So where do we stand today from your perspective at Indiana Minority Health Coalition? Well, I think as Dr. Yancey said, there is light at the end of the tunnel, but there's still a long road to go. Because if Virginia came on here, Virginia came would say that black and brown populations still suffer disproportionately from COVID-19. So even though the overall positivity rates are declining, even though hospitalizations, ICU utilization, et cetera, are experiencing downward trends, it's still true that black folks make four times the rate of hospitalizations compared to white and three times the deaths. We also know on the flip side with respect to vaccine and vaccine reluctance that a majority or 35% or so of black people still are vaccine resistant. And we also know that higher income groups, the higher the income group, the more likely are to get to what the vaccine and the more likely you are to take it. So while it's great to have vaccines and the landscape is changing rapidly with more product coming online, the challenge for the population of color still can we get our share of the shots? Can there really be vaccine equity? And right now the dashboard indicates that there's underperformance both in Indiana and the United States for the population of color to get the shot. So there's hope, but there's still a lot of work to do. And that's what we're here to talk about today. Very very deep conversation. Paul, what are things, how are things on your end? Where are you seeing as far as the trends go? Well, I mean, I can't disagree with anything that my colleagues have said thus far. I think the interesting thing that we need to think through and understand is at the beginning of the pandemic, you know, there was the essential employees and those are generally our, you know, black and brown neighbors helping keeping, you know, quote unquote, the city and the country moving while, you know, a lot of folks stayed home to, you know, be safe. And so the challenge we're facing now is how do we acknowledge and remember that when we're trying to give out vaccines and get people protected and cared for every day, you know, we get phone calls over here about people demanding to get a shot. And the hard part is you got to say no, because if you say yes, the next thing, you know, big brother comes in and takes away all your vaccine and then you're, you know, you're in an even worse spot than when you started. So it's just really this catch 22 where we have to acknowledge the what are essential neighbors put into beginning and figure out a way to get them access to the vaccine to continue to do what they're doing now, if that makes sense. Thank you. Dr. Wright. Well, I think I can add a couple of things so I am a internal medicine doctor so I'm a doctor for adults and I specialize in hospital medicine. So I'll agree with my colleagues and certainly throughout the time frame we've seen a disproportionate number of black and brown folks admitted into the hospital, end up on a respirator and, you know, can die. We've also seen this disproportionate utilization of vaccinations. The other thing that I want to add to it, however, is, you know, very early in this pandemic, we saw the ER, for instance, had a really decreased number of visits. We continue to see that. And it's not because people stopped having a heart attack. It's not because people stopped having strokes. It's because they weren't coming to present for health care. And I think that, you know, when we talk about lessons learned, you know, in particular for black and brown folks, they're less likely to see doctors. They're less likely to seek preventive health care. And that's something that we really need to consider, you know, moving forward that no matter what comes, you have to be at your best day of health, so that, you know, that you're not taken down another rung by whatever that happens. So we have to make sure that people are seeing their doctors. And I also want to just finally echo what Dr. Nancy said in adults as well. I think mental health. One of my colleagues always says that's our next public health crisis. And you know, we see the same thing in adults. And I think that there's still a stigma attached to that. We know that COVID, the loss, loss of jobs, loss of family members, the loss of businesses, the loss of, you know, freedom has taken its toll on a number of people. And we have to encourage people to seek out general health care, but also mental health care. Thank you. Molly, I'll turn it back over to you. Thank you, everyone. All of you spoke to the disproportionate impact, obviously that's what we're talking about today and that disproportionate impact happens in an ecosystem where black and brown communities are already disadvantaged in terms of wages, being able to work from home or not having affordable childcare, etc. But another way that black communities have reported poor outcomes, even prior to COVID-19 is their interaction with health care systems. And Carl Ellison I'm coming to you first I know that you have talked about the need to advocate for different treatment by engagement of black communities by health care providers. What do you think we've learned in the last year about how to make sure that black patients are able to get the care they deserve and able to self advocate. Well, I think the health delivery system is still on a learning curb. We at least have had more recognition that racism, structural racism is a public health concern that's been articulated by hospitals here in Indianapolis, and elsewhere around the United States. So, although we have more recognition that racism is a factor in what happens in our society. We still don't have the discipline to break that down and say, okay, well, how does that impact us. So, you know, when we have to argue over, can we get minimum wage to $15 after no raise for seven years. It suggests that we're not really yet able to address racial disparities that relate to income, for example, along that relate to health care. You don't have a health care sector yet it's really looking at its collection policies, you know, often, you know, if the building get paid and someone got sent to collection there was often poor people white people who were adversely affected from a credit point of view. So, so there are any number of reforms that I need over time. But I think for the most part we've heard an articulation of race, we've not seen enough yet with respect to bias training. We've not seen enough with respect to really just an analogy to racism, among all elements of the healthcare delivery system. And it's not that health care providers are not trying. I think they are but the reality is that just like the society we have a ways to go to really be comfortable that we reconcile racial discrimination as a way of life. Coming to you next doctor right on a similar point, you know as someone who is both a practitioner and a CEO of a hospital corporation. How do you manage that question about making sure that your practitioners have anti racism training, but also recognizing that there are times a black patient would like to see a black doctor someone who may understand their experience in navigating their health and navigating what it is to be black in America. And there's lots of components to that and I agree with Carl 100%. I think we're continuing to be on a learning curve. I think in general, we're behind the curve and certainly where we want to be my medical group in particular the fortune of, you know, being as to Nazi, and we do have a, you know, a proportion of black doctors that is two to two and a half times. On average, we have a big proportion of doctors that are two times the portion of Latinx doctors and I think that that is because of, you know, for thinking I think that there is a emphasis that, you know, race. As you already mentioned, Molly really isn't a thing, you know, there's ethnicity and race is a marker for the social determinants of health that is not in particular has been really, you know, out on the forefront of, you know, the determining at the end of the day, education is key. You know, we need to have a degree of cultural competency amongst all of our physicians. You know, we know that, you know, for instance, you know, 2% of our black are 2% of our doctors are black males. So, you know, for that patient that wants a black male doctor. At the end of the day that doctor may not be available in all specialties or primary care. So it's incumbent on us as the health system to make sure that all of our doctors are culturally competent all of our doctors are trained as Mr. And that is an ongoing learning experience for everyone and that requires the input in the voices of the community. Thank you so much. Dr. Right. I want to welcome Dr. Virginia Cain. Hi, Dr. Cain. So we mentioned she is the director of the Marion County Public Health Department. We're so glad to have you. Well, thank you. I'm sorry, I was just on a national CDC's first conference, Biden Harris CDC conference on COVID-19 national across the country and so just honored to be able to talk about some of the initiatives that we're doing here on the local level. Well, we're glad to have you to talk about them here so you're excused. No problem at all. But you know, Dr. Cain before you came on, we were talking with Oshia about where we are today and your colleagues on screen talked a little bit about where the black and brown communities of Marion County are now in relation to COVID-19 infection rates, whether or not folks are feeling positive about vaccinations, their ability to kind of recover quickly. Do you have any reflections on kind of where we are now and as is of Marion County? In terms of race or in terms of overall for the COVID-19 cases, which one do you want me to talk about first? I would love to hear about both and disaggregated by race. Okay, so initially, let me just say we're doing fantastic in terms of curtailing there and controlling our epidemic. I'll just remind people one of the measures we look at to measure how well a community spread is doing is we look at what they call positivity rates. These are the number of positive cases in a community that are positive for an entire population and our red standard is a 5% positivity rate. So if you're less than 5% of your population being positive over a two week period, but we have a second criteria to which is the number of daily cases that occur. We hit for the first time today, we're at 3.6% positivity rate. Now we've only had one week so far of being at the 5% or less, so we need two weeks. But in terms of the number of cases a day, we're only at 128 cases and we need to get down to 50. Now this is remarkable because in December, we were experiencing over 1000 cases a day. What did I say? We were having new reported 1000 cases per day that happened in December, 900s, 800s a day, and our positivity rate was as high as 16.4%. So the community is responding to our measures that we put in place and they must actually be doing a lot of social distancing and wearing their mask for that we are very appreciative of. So we're just right now at 128 days, we need to, we want to see that reach down of at least technically 35 days, 35 cases a day for at least two weeks and then we are really golden. But for the concern of these mutant strains that are out there that are 70% almost more contagious than the current strains that we're experiencing now. So otherwise, I have to give my kudos to my colleague up there at the top our president and CEO, Mr. Babcock, a lot of consultants from the Fairbanks School of Public Health, the mayor of course, with his leadership has helped us make a big difference. Now let's talk about the racial breakdown. So when this epidemic first started, we saw that African Americans were making about 35 to 40% of the newly formed cases back there in April, May and June. Since that time, we have about twice the death rates of their white counterparts. So twice the deaths, having twice the amount of hospitalizations compared to our white counterparts. Now that it's happened now, we've had new cases occurring where almost the number one group of people getting the number of cases now are occurring in our Asian American population, our Burmese population, followed by Latino X population, with now African cases, the lowest of all the through racial and ethnic groups for experiencing COVID-19 cases. And I think we can relate that to the fact that we've done an extensive amount of testing in our people of color, communities hard to reach doing that contact tracing that we needed to do in order to prevent the spread of the infections in our community. So we're doing a remarkable job in the African American communities. We have a lot more work to do with our Latino X population and our Burmese population, but doing very well so far in the number of cases category. Can I jump in Molly with the question for Dr. Kane? Dr. Kane, how do you balance the good news that you just shared with the fact that we still need to take precautions that as you mentioned, there are new strains that are highly transmissible. So how do you keep that message at the forefront, top of mind, but also celebrate the, I don't know, celebrate the right word, but also just recognize that we are making positive strides. So it's going to be tough and you have just hit the nail on the most critical question. And the problem is there's a lot of fatigue out in their community. They're tired. They want to get rid of the mask. They want to go back to our original normal lifestyle that we had before this epidemic started. So it's really hard pushing that message, guys. I need to get us down so low that if we do see these mutant strains coming in our community, it'll be a much lower spread so that we have time enough to get more people vaccinated. But we also have more time to do significant contact tracing so we're having a significantly lower spread. So I'm going to be really worried about spring break because we've seen with the Thanksgiving holiday, our case just shot up. Then when that holiday went over, came down, we had the Christmas New Year's holiday shot up. And then it's come down real nicely. So I'm very, very concerned about people loosening their, their standards of precaution, infection control. It's a constant message we have to give out. And we have to give it out related to the fact of these mutant strains of which we have 14 now. In the state of Indiana, there are three screens. One, the most common is United Kingdom. That's the one we want to see because it's the less contagious and most susceptible to our current vaccines we have now than the South African screen, which is way more violent and maybe the most common one of all is the Brazilian screen. Both our current vaccines have about two thirds protection against the virulent screens. But we may, if we get it in very, very large numbers, and we haven't vaccinated enough of our people, and it's very, very contagious. So that's a huge concern for us. We don't want to erode all this good will and good progress that we have had. On that same note, thank you, Dr. Kane. That's, that's so important to remember to keep, stay vigilant. There are other problems that people are reporting, side effects, other conditions. A question related to that is for you, Dr. Yancey. It came into the chat from Ms. Johnson. Can you speak to the spike in a syndrome linked to COVID with children and teens called multi-system inflammatory syndrome? What's this about? How much do we need to be worried about these kind of coexistent, correlative illnesses? Well, if you have a situation where you have something that's previously not known, a couple of things are going to happen. Number one, as you see an increase in the primary cases, an increase in COVID cases, then you're going to see an increase in the potential complications to those. However, the other thing that happens, which is a little bit different, is that the more we know about something, the more efficient we become at diagnosing it. And so that makes the numbers go up because it's more easily recognized, it's recognized sooner. And so we really don't have a handle on preventive strategies except to prevent primary cases in the first place. But I think you see the numbers climb to some degree because it's more easily recognized now. The knowledge of this has grown exponentially over the past year. And so we now, the things that we called other things before, we now know to be, as you mentioned, the MISC. And so the numbers on paper will say, okay, now we have this many more cases. But the way to handle that is that if you continue to beat down the primary cases, you're going to see far less in the way of MISC because you won't be getting the infection in the first place. But what I usually say to parents who are worried about it, do everything you can to keep you and your family safe from catching it in the first place, you won't have to worry about the complication from it. But I think that a better recognition of the syndrome and the fact that the complication rate lags a little bit behind the fall in primary cases. So now you, so we're looking at situations where people may have gotten infected two or three weeks ago, okay, and now we're seeing those. So hopefully as the numbers come down, we'll see much less of that. It varies in its intensity. There are certain, you know, stable treatments for that as well. But once again, trying hard not to get it is the paramount thing. Thank you so much, Dr. Yancy. Paul, I haven't forgotten about you before I swing back to Oshia. Dr. Cain mentioned you specifically as someone who's played a real leadership role in getting correct information out to folks across Marion County about COVID-19 and how we can stay safe. So Dr. Yancy's point of what we can prevent by preventing that primary infection in the first place. Tell us a little bit about the opportunities and challenges in educating folks around Marion County around COVID-19. Yeah, sure. Thanks. Dr. Cain was just being nice because she's always nice to me. That's why she gave me that shout out. But, you know, the challenge that we faced from the beginning, and I think we still face it now. My colleagues can probably attest this as well as, one, there's just a suspicion amongst, I think, people of the government. And then two, the biggest challenge that we've always faced is this is a novel virus. You know, every day we learn something new about it and, you know, that changes the message. You know, when we made the mask mandate, we didn't know, you know, had we had known that masks were going to be successful on day one, we probably would have, you know, started out our communications with masks on March 23, 2020. You know, but instead we said, stay home and, you know, but go to the grocery store very, as little as possible, you still have to go and nobody had a mask on and then a month and a half later we realize, oh, wow, masks help protect. And so it's the challenge of, you know, getting people to agree with the one, the message and who's doing the message, but to, you know, stay information and every day it changes. And, you know, it's hard to stand up one day and say one thing on the next day. Oh, actually, I was wrong. Don't listen. Do this instead and get people to actually buy in, right? There's a certain level of credibility gap that begins to be created and figuring out how to get over that every day is really the biggest challenge we've had in communication. Thank you so much, Oshia. I'll come back to you and yet thank you to everyone who's putting questions in the chat. We know that you're eager to talk about vaccines. Oshia, take it away. Thank you, Molly. So there's been a few things that and it kind of goes into the question I'm going to ask now. So we've talked about this return to normal. Dr. can everyone wants to go back to normal. Dr. Nancy, you mentioned the fact that, you know, there's no end in sight. We can just tell people over to be over tomorrow. Paul, you mentioned the inconsistent information we have at the very beginning and the fact that it is novel. And so that meant it's new and people had a hard time seeing things change and trusting when you're changing day to day meant to me. And we know in the very beginning, we were just kind of all over the place trying to figure out what was what was going on. Do we do you think that maybe the message should have been more open with, hey, we have no clue what's what is going on here, but we're trying our best. And how do we help people understand now that normal. Is it ever going to be normal what it used to be. When we think about, when we go back to December 2019, you know, is, are we going to get to that point and how do we help people to understand and also the the cold fatigue how we help people understand that maybe one day we'll get there but it's going to take all of us working together to get to that point. And Carl, I'll go ahead and start with you. Just to pull you into the conversation, because I know that I don't have a lot to say. Well, that's actually a hard question. I think, as this pandemic evolves, we do learn more. We know more people who are who are affected by it. And most of us now know somebody we work with or somebody that's in our sphere friends that had somebody who's been impacted by this. And so there's more incentive now than ever to try to say to our peers and others to join us and to do those things and talking about that we need to try to protect everyone. And just recognize that we cannot predict an end, but we can certainly predict the fact that if we do more to protect ourselves protect our neighbors, get that shot. We can perhaps all get through this. And it's a conversation that almost has to occur at the individual level. I mean, it has to occur among various groups, because I think in the long run, you trust somebody, you know, who took the shot and did not and it did not cause the impact. And so I think it's going to take kind of a people to people, touch one another, talk to one another time to move along. Now along the way, we'll also maybe learn more about some of the side effects. I mean, my wife got the shot yesterday. I'm finally get the shot on Thursday, my first shot. And I've been waiting and hoping I can get the shot. A lot of Americans like me, you know, we really want it. And so a lot of what our organization is focused on is kind of make sure we get those who are willing to take the shot to make sure they get that shot as early as possible. And so for people who are black and brown, again, it's not just vaccinating resistance, we also have less capacity to be able to get to the shot as they become more widely available. So we're going to be focused on that over the next couple of months in hopes that you'll then see the share of the percent of shot to go into black and brown populations increased to be closer to our share of the population. It's sort of, this is our greatest problem but it's our greatest, but it's our greatest hope. We just have to work with one another to try to move the needle in the right direction. And our graph to do, it just requires us all to take it on to really be a story for our neighbor and for ourselves to do what Goodbook said we should do on a routine basis as relates to this particular vaccine, this particular pandemic. And I think we'll see progress. Thank you. Thank you. Dr. Wright, do you have any idea, do you foresee normal in our future? Do we have a new normal? Is it okay for us to create a new normal? I'm thinking I might wear a mask forever now. Well, I guess I'll start with the last part. I do think it's okay to create a new normal. You know, I do see an insight though, however, you know, whether or not that includes mask, I don't know. I think as we learn more about the virus, it might be that, you know, once with the vaccines, you might be more at risk during the winter, for instance, and we might have to, you know, mask up during the winter. I think, you know, I just can't emphasize enough what Carl said, you know, given the mistrust we have amongst healthcare providers of how critical it is for, you know, for us to get vaccinated and then to help someone along. You know, we have, we each have our issue or our fears and, you know, you may not trust me, you may not trust Dr. Kane, I trust Dr. Kane. But, you know, you're going to trust your friend and family and, you know, they might have the same concerns and I think that's, you know, super important. I saw the question about, you know, have any of us been vaccinated, you know, I'm vaccinated. My wife is also a physician's been vaccinated. We made sure that my father-in-law, my mother-in-law, they've all been vaccinated. And to date, I've been unlucky in getting my parents vaccinated, but, you know, I'm trying my best there in Florida and that's a little bit more difficult than it is in India. Do they want to get vaccinated, Curtis, or are you just being able to challenge it to being registered? They are begging to be vaccinated and they've registered three different ways. I mean, another thing I'll just say out loud, I mean, there's a reason why people are, you know, dressed it up like a grandmother or, you know, pain their way to get this vaccine. You know, it's because, you know, it is like gold, you know, people want it and people are willing to do bad things to get it. Thank you. And I think we should also mention that today, just brought out today that age 60 is allowed to get the vaccine. Dr. Canyla means you still can't get vaccinated. Thank you, Paul. I am 29 and holding. So thank you. I have a long way to go, right? That you do. Molly, I'll turn it off. Sure. Thank you, Ashiya. So while Dr. Cain continues her long wait for her 30th birthday, we've had several questions about the vaccine on Facebook and in the chat. And one of them is pretty specific and I'll ask the panel because I don't know who has a remark on this. Have you heard of and have you heard anything about the vaccine and pregnancy or the vaccine and fertility? Should mothers or mothers to be be concerned? I see some some acknowledgments. Dr. Cain, did you have something? Yes, I can answer that. So one of the things that we have realized with these clinical trials that a lot of times normally we like a significant number of pregnant women to participate in the clinical trials. Unfortunately, with Pfizer and Moderna vaccines, we didn't have a significant number of women in the clinical trials. But we have noted that if you're pregnant and you get the COVID-19 infection, you have severe complications, which could result in the loss of your baby. So we also know that those two vaccines are related of what's called messenger RNA vaccines. It's usually, it's a man-made product of a component that's normally in all of our body cells. So most scientists feel that it doesn't cause any major harm to pregnant mothers. And so they say you need to have a private discussion with your OBGYN or family practice or your nurse practitioner, whoever your healthcare provider is and have a discussion. If it looks like, for example, you out in the public a lot, you may be exposed to a lot of people, then it probably behooves you to get that vaccination. But if you are maybe not out there a lot in the public, you have less risk to get infected from the COVID-19, you may want to hold a little bit, but it is an individual decision with their individual providers. And the study has started though with pregnant women. So Pfizer is doing a study now with pregnant women. So hopefully in a month or so, we will get some answers related to that. So I'm just going to add that that study is ongoing, but we do have data from at least 20,000 pregnant women that have received the vaccine without any negative outcomes. So I think that's very promising. And all of the major or all of the obstetric societies have recommended that they have this conversation and they're, you know, are saying that the benefits outweigh the risk. It's wonderful. Thanks, Curtis. Good. Dr. Yancey, have you had any questions from parents about the safety of vaccines for their children? Are there children that you would recommend be vaccinated? I've kind of heard just as a parent of a 10-year-old that these kiddos might be the last in line and that that might be wise. So where do you come down? It's going to be a while before I think there's enough clinical trials to say get across the board because they're just now coming down on the ages of trying to enlist a son of children for some of the clinical trials. So it's going to be a while before I say there is going to be widespread vaccinations of the children. I have had a number of parents ask me what do I think, you know, when we get it and when it gets down to there and I say absolutely. When it gets down to that level where there's the clinical trials that are present, absolutely, that I would strongly recommend it. And just to back up a little bit, I've had both of mine and I basically got a little bit of a sore arm and that was it. So I'm out promoting it right and left on all my social media pages and whatever. And hopefully, some folks are saying, hey, if he can do it, then I can do it. But I think there's going to be a while on the children and, you know, I'll tell you a while I got them, I just want to throw this in as regards to the children. The most malleable minds right now are the minds of the children. And so therefore I think that what we have to do now is we have to plan for the next pandemic with education to the children at this point. We have to plan for the next one. And so, in a very transparent fashion, we have to talk to our children and say, let me tell you what we did wrong. Let me tell you how we got this wrong, because otherwise, you know, we got it wrong in a lot of different ways by not listening by being divided by being divisive in our things we did by fighting back and forth about things that kind of really were kind of benign in their tolerance to them. We need to actually start working on the children now for the next pandemic because you know if history is correct. At some point there's going to be another one I think we can handle it much better. If our five, six, seven, eight, 10 year olds now know, okay, this is what they got wrong. This is what we're going to get right. And children are our future right like the song says, before I swing to Oshia, Paul, I wanted to ask you about access to vaccines it's come up a couple times from you and from Carl, we've had a number of Facebook questions and questions in the chat about barriers like travel, access age, folks who are perhaps homebound and elderly. What would you say to someone out there who could wave a magic wand and make some of those barriers go away what's a policy lever that they should press in terms of vaccine equity. Well, I mean that's a great question. And so I'll address it in one way I'm going to, you know, borrow an idea from my mentor, the great Dr. Cain and say that we need to get a van and, you know, make sure that that van can get into the neighborhoods and just give shots right we're struggling right now from, I think, not only do we not have enough vaccine but it requires two shots, right and so that's the big challenge for people because it just requires coordination and let's be honest, the most vulnerable neighbors have, you know, they have difficult lives right sometimes people got to work right and you know you may be able to get a vaccine on a Tuesday but you can't on Wednesday because you're working the night shift or something and so the struggle I think we're facing is just the one the way the businesses are set up and hopefully once the Johnson and Johnson comes online, you know, we can do, we can go into our communities across the city of Indianapolis and get people vaccinated with one shot and not have to worry about how they can get back to the facility to you know, and then from a policy lever standpoint I really think, you know, there's one thing that I think, you know, people your audience as well as just folks across, you know, the country need to understand is that from a global perspective, local governments don't have that much control over, you know, getting vaccines, getting access to, to, you know, PPE, a lot of it comes from the state which then comes from the feds and, you know, I think there's a big policy blame that needs to be highlighted for, you know, that happened a year ago. And unfortunately we're still seeing the downstream impacts of a poor federal response here at the local level on a day to day basis and, you know, that's unfortunately one of those things that you can't change with the magic wand or even probably with a time machine and so we're just trying to, you know, live with what we have and make the best of the situation. Ben too, sorry. Please. I think one of those things that one of the things that we've been doing here at the health department under direction of our epidemiologist Joe Gibson, and work so well with our testing finally getting into the heart to reach communities is looking at our GIS mapping where we can look at zip codes and see based on population density, where there's no color but also where our cases are where we need to be putting our vaccination sites, just like we did for testing when people weren't getting testing, but where were the cases occurring so that we needed to put sites in those areas. We're right at same model, where we in discussions now with hospital systems that have vaccine partnering with fuss and local churches. So bringing that team mobile strike team or how do you want to call it, bringing that team to a church, where we can set up a vaccination site at that particular church, or maybe another large venue that's well recognized by someone else. So, hey, you partner with like a sickle cell center to reach sickle cell patients. Are you partner, I think it's well, well much partner with Urban League, in order to vaccinations at the Urban League site. So, or you look at a social service agency that's, that's given resources out to Latino ex populations. So really trying to bring those venues to those sites and curse we're forgetting you to it as Genazi for, for doing our partnerships. And so I think that's how we need to outreach to our people of color. Why do you know the vaccinations we give in Marion County, 63% are Marion County residents, but 37% are coming from Fort Wayne, South Bend, Evansville, who are not people of color, of course, coming to Marion County and getting vaccinated because it's easier for them to get vaccinated here than in their county but what's the result of that and in our surrounding counties. The result of that means I have about 37% of the vaccinations that I've given out could have been used more in our people of color hard to reach populations. So we have a lot of challenges here that people are not aware of, because we may have a higher group of people who are not techie techie. They don't have a computer. They don't have access to internet. And so once you open that appointment site up. Hey, it fills up so fast your head swims the appointment slot so you can't get an appointment. Now we have call centers. And they're important too. But, but when you have limited vaccine, everybody is calling it's even sometimes hard to get into the call centers. So I want to remind people, we do have a call center Marion County Health Department, eight to five incident questions related to vaccines, testing sites, places to go for vaccination, there to answer your question. We have it in Spanish. Okay. And we can address and do translations for our Burmese population as well. Thank you. I'd like to stay on vaccine accessibility for a little bit. Dr. King brought up several issues. And one of them is how do we then avoid people getting the vaccine if they should not if they're taking away people coming in from out of Indianapolis coming Marion County coming in taking the vaccine. And also how do we make sure that those who are supposed to get it actually have access if they can if they're not techie techie as you said they can't get on get online and sign up if they call and the numbers busy how do we make sure that we ensure they get the vaccine. You're here on mute Dr. King. First, first let me address about people coming in from the outside to get vaccinated here in Marion County but they don't reside in Marion County. We are on a state registration site for you to sign up for vaccine. And so that the system is not set up to say you can only get an appointment in your county. Okay. So we've addressed this concern to the state. And so I think they're they're investigating in and looking at that to see if there's that's anything that they want to address. I think for the call centers. They have engaged the AARP Association for to help assist people make their appointment for them by phone. But we've also reached out to a lot of our faith based organizations over 40 of them to say hey, that is one thing you can do at your church. You can pick a time for members of your congregation to help assist people who don't have the ability to make appointments themselves. You if they have a phone, you can get the information from them on the phone and do their appointment for them and tell them when their appointment is. There are all kind of different ways how to do this, we are partnering we're going to be parting with the state Department of Health to do our mobile units and have a separate now this is, I got to keep this quiet okay. But we may have a separate manual appointment system that only we know for setting up those mobile units. Okay. So there's a lot of questions in the chat regarding the vaccine. A lot of questions. So I'm going to start with this one and I'm not sure who is the correct person to answer so I just throw it out here and we'll see what happens. Are there any agreements in the works for small businesses with professional credentials to visit elderly patients homes to deliver the vaccine. If not, is there a task force to address this issue. So let me say we have a task force that looks at retired health care professionals, people who are active as health care professionals willing to help volunteer for us on the weekends. Okay, are there any any agreements in the works for small businesses with professional credentials to visit elderly patients homes to deliver the vaccine. If not, is there a task force to address this issue. That looks at retired health care professionals, people who are active as health care professionals willing to help volunteer for us on the weekends, looking to work to how to be able to go into a person's home who's homebound and not able to do vaccinations themselves. So we are we have a task force and we were pulling up our volunteers we've got black nurses Association of who are participating. We have a number of volunteers of people of color helping to assist us, and we have a number we have retired professors so we're trying to work out the logistics of how do you identify a legitimate person whose own bound, as opposed to someone who just hey I don't feel like going to the testing site. I'm just going to call Sam homebound and let them come in and come and vaccinate me. So we're trying to define those criteria and Medicaid has a significant criteria that can help us with that. We have space organizations know who some of their home bounds are but you know, everybody's not affiliated with the church so we have to have other mechanisms to figure out how to reach these folks, but we have not specifically looked at small businesses to contract to do those services per se, but it's something definitely for us to look at and be interested in. Oh, I'm sorry I was muted. Thank you Dr can I thought I clicked the microphone molly hand it over to you. Sure, I'm actually coming to Carl on this one. So Carl there have been some questions in the chat about what happens when you have leftover doses of the vaccine at the end of the day, especially in a retail environment. And we hear stories about folks being able to maybe get on the call list or maybe things being thrown away. So Carl two questions one just out out about in your life have you heard about vaccines being thrown away your colleagues can probably also speak to this. Certainly, if there are things like call lists or if getting a leftover shot becomes a factor of who you know, how do you guard against that becoming another frontier of racial or socio and economic inequity. Well, I'll leave the vaccine leftover questions and Jenny and the doctors on the panel because that's really more of a clinical question I understand it does happen because those things not precise and then maybe just a ramification of how we're handling the vaccine distribution and utilization process. So far as the other question with respect to how do you, if you will preclude people from taking advantage of the system. I don't know that you can because our the criteria for the state is we start with those who are old, oldest, and we bring it down to those different levels. And it assumes that we will have some vaccine equity by virtue of 211 and all the various organizations are there to help. And I think but as Jenny said, and I think it's really really important to note that this is really going to require unconventional outreach. I mean, it's really going to require the whole village really taking us on as a way to get shots on those who want them but those who I think increasingly will see as they have friends and family who get the shot that they would take it to, you know, we need like a community right here, we get the shots out there because it's ultimately the only way we can protect everybody. So, I guess, Molly in a way that the world is never perfect. And, and whether it's leftover vaccine or whatever, just bear in mind that this has been both in the state and a nation are herculean effort. I mean, this has really been a tremendous effort toward public health, where we are seeing progress and we've really been able to invent our way to current future this more hopeful. But for products of color who are still discourse impacted, the work is never done, certainly not done in this regard. And so my advice is rather than focus on how we can preclude folks from gaming the system. We need to focus more on how do we get those indeed the shots to get the shots into, and to frankly just leave it to the clinician and the other professionals to figure out how we get the most out of every dose and how we avoid any waste along the way. Thank you so much. We belong to each other that's such an important point. Dr right we've had some very specific questions in the chat about folks with other conditions who should be wary we already talked a little bit about women seeking fertility treatments or expectant mothers. We have some women in the chat who have been treated for cancer, or maybe have recently been treated and they're wondering if the vaccine is safe for them. Dr right. Do you have any perspective. Yeah, let me just maybe answer the talent of the other question to about extra vaccine. I think, you know, particularly at Eskenazi we recognize that that is an issue. I mean you make appointments. Some people don't shop for their appointment. And then you have extra vaccine. And what we've done in our facility is, you know, we know who is eligible for the vaccine. And if you're coming for an appointment for another reason. And we know that there's vaccine available and you have a doctor telling you that we have this vaccine ready for you to go so we could get you down to the vaccine site and get you vaccinated and that's how we've solved that in our system. I think, you know, the general of thumb is that everyone we want everyone to be vaccinated. And, you know, when you had the question about no levers and you know things that are going to be, you know, hold, I think that the game is going to change when we have a unlimited or a a vaccine supply to vaccinate the entire population. You know, whether or not you are a supporter of block of ground people, whether you are a supporter of Democrat or Republican. If we don't get 85% of people vaccinated, we're not going back to normal. So I think, you know, once we have a supply, the game is going to change and you're going to see all sorts of things coming out of the woodworks. But now back to your question. I think that really the only contra indication to getting vaccinated is having a or being at risk for anaphylaxis. And we know that originally from the trials that with the Pfizer, according to their study about, you know, 2.5 out of 1 million people would have anaphylaxis. And then 2.5 out of 1 million for the Moderna. And then now with our safety monitoring that's down to 4.5 in general. And there's basically, you know, those that have known anaphylaxis to a ingredient called polysorbate or polyethylene glycol, which are both lipids that are used to deliver the mRNA vaccine into the cell. So, and that's really why we watch people for 15 minutes, up to 30 minutes after they get the vaccination. But at the end of the day, everyone else should be vaccinated. And, you know, that is a very short list of people that I mentioned. You know, for instance, that polyethylene glycol, you can get that over the counter. That's what merilax is. You know, that's what you get for a colon prep. You know, very safe stuff. And then particularly if you have a history of cancer or you're immunosuppressed, if you're elderly, you're at high risk for having bad outcomes from COVID. So we definitely want you to get vaccinated. Thank you so much. Oshia, I'd like to come back to you. Yes, thank you, Molly. I think we will be remiss if we didn't talk about the hesitancy in our community to get the vaccine and talk about the why the hesitancy exists and how are you combating that with education. I think a lot of people, and this is part of what we're here for, is to educate on the importance of getting the vaccine. So I'll start with you, Dr. Yancy. Okay, that's kind of like, I love that slow curve ball right now, right in my wheelhouse there. Okay, first of all, one of the things we have to do is, and this is what I always try to do, acknowledge the reasons why people are hesitant to get a vaccine. I think that the acceptance of, if I can start talking to someone and say, I understand that when you look back historically at some of the things that have occurred, then I understand that because when you first dismiss their hesitancy, then you lose them right there. So what I would say is that this number one, some of the things that occurred. Well, let me just back up for a second. First thing I think it probably wasn't the best idea. Okay, to give it a name that appeared that it was going to be rushed through. Okay, so when you say, you know that next time we may rethink that when you say operation warp speed. Okay, then people just imagine that this is going to be rushed. And so if we talk about how long it takes to develop a vaccination. They say, Well, I don't want this thing is not even tested. Okay, so what I've tried to do is tell where the where the shortcuts came. In other words, this time we didn't have a company didn't have to go out and raise the money to say, Okay, now we'll start the clinical trials that was provided by the government. The company didn't have to say, once you got to a certain stage of the company didn't have to say we need to be, we need to make sure that we, you know, get all of this through before we invest any money into production. Because if we if we set up all the equipment for the production, and then it doesn't get approved. Then we have a problem. So they can actually move forward further ahead of time because the government said, go ahead and give it and do what you got to do to set it all up for once and then we can start making it so you won't lose any money. So so there's so so nothing was cut from the standpoint of development nothing was cut from the standpoint of clinical trials or anything like that. It was the the red tape involved after these things come about now here's one other thing. A lot of the scientists actually left their projects to go work on this development. So let's say have an eight scientists, you know, eight hours a day, you know, working on something now you've got 100 sciences, you know, 12 hours a day working on it so you can move these things through faster. So if you remember, they were not ready. And there was a lot of political pressure to get it done by quote by the time of the election. Okay, it wasn't ready then so they said, Nope, we're not doing it. So something I actually throw in, especially for our communities of color is one is one of the lead researchers on on the, the, the, the method of putting this together was Dr, you know, kiss me to a Corbett. Okay, and that the Corbett is an African American scientist who was one of lead one so I say to people, I don't think she develop a vaccine it's going to hurt her own people. I think that when I get the, the information that when I get the kickback that says, you know, so from some of my elder saints and I just put up it says, you know, well if God wanted me to get this I'm going to get it and I say what I say to that is, and I actually was trying to find a picture I took of that that says, you know, hey, in this deadly pandemic, you know, God sent a lifeboat and I chose to get on. And so I think what you what you want to do is, and I speak to a lot of the elderly, the saints who say, you know, if God decides to give you deliverance, okay, through a certain method, and you choose not to that's on you. So I think that from the scientific standpoint, it was not rushed, but it was like red tape that was cut out. From the acceptance standpoint, why would this African American scientist develop a vaccine is aimed at hurting you. And then from the, from the deliverance standpoint, I can't tell God what kind of method he's going to use to deliver his people from a back from a pandemic. Thank you, Dr. incident I think what you're talking about from the scientific perspective, and the reason why it was so much shorter. I don't think that's been widely understood about how we got here today so thank you for enlightening that today because that really helped. And I know Dr. Can I know this is kind of like your life's work here. So, I know you have something to add about why I want to say that actually is something called messenger RNA is a new platform technology, and actually they've been working on that technology for over 10 years. This was just the first opportunity we can use that technology for this new vaccine. And like he said I'm sorry for all the men that are on this panel, but we had a bad sister. She's the last scientist at NIH what am I saying she's the last scientist who developed this vaccine. Anthony Fauci personally hired her. So you know she's bad. Now, I will also say people been in accidents right, and sometimes you bleed and sometimes you've had to have a blood transfusion. And it's like Charles Drew, an African American discovered plasma could have blood transfusions but that's not widely known in this community. So she's a similar person a graduate of University of Maryland, very shop and she's always. So she was an undergraduate and high school had a mission of serving her people. So, hey kudos to her. Thank you Dr. Kane. Everyone should have a Dr. Kane. Everyone should be so lucky to have a Dr. Molly. Sure. Well, yeah, I think I would agree I think so with many you have quite a fan base on Facebook Dr. Kane which you may know. So one thing that you just said really leapt out of me and I hear it a lot I work for a think tank right and so people say to us, you're not a doctor. I'm not going to listen to you about whether or not I should get vaccinated. I would say, I'm pointing at my screen you're a doctor and you're a doctor doctor and seem to support vaccination. If you're equipping me just your average Molly on the street to explain to someone where they could go to find someone they can trust to hear about vaccines from. We could send them certainly to the Marion County Public Health Department website. Are there other spokes people Dr. Kane I'll start with you that you would recommend as trustworthy voices on vaccination. So I honestly feel not everybody doesn't have a connection, but I really think someone that you've gone to for a long time like your healthcare professional, who you've known for years you get your health care from, and maybe you don't have a personal one but maybe some family member has and has had a lot of success. I think you think about those individuals first. I also think we have some fantastic, fairly qualified community health students, and they are a great venue to get some excellent information. And I'm telling you we got some, some outstanding healthcare organizations people of color, probably the number one here is the Indiana Minority Health Coalition, who just does a tremendous job out here in the community not only with COVID-19 but others. So we have a number of community based organizations. We have our great news media social media with the recorder. They have print information. You can go to your radio stations, but we have a number of trusted community leaders, and then a lot of churches have healthcare professionals in their, in their facilities. So look to them and see if they can provide a good education and excellence. Most of our health department sites have a link to the Centers for Disease Control and Prevention. And then if you don't know, hey, call our call center. We got about 12 people on the call center, eight to five. They can help find that information for you if you don't have it available. But talk to your trusted community leaders. I think number one is your healthcare professional because they're going to spend the time to really try to stay up to date. This information is, I mean, it's so rapid coming every day. It's hard to keep up with all of this. So look, look to do that. And your hospital systems have special outreach that they do out into the community. So, hey, just call us. We'll find someone for you to talk to. Carl, do you want to speak to that at all? You are a great spokesperson for minority wealth leaders. Where would you put this information out? Who are you turning to? Well, actually, there is a groundswell of community leaders and African American and Latino organizations, which are stepping forward to provide message information to those communities. For example, tomorrow night in South Bend, there is a webinar like this one on COVID that's been put on by Beacon Health System as well as Black Expert Number Organization in that area. And then on Friday, there is another one where the Urban League and NAACP, IMHC and others are also addressing this for African American. So we're seeing a really around the state and the nation, sort of a groundswell of community leaders who are coming forward to provide useful information, but also to encourage everyone to get the shot. And so I think that there will be more and more messengers who come to the forefront because in the community they just decided they needed to be part of getting the message out of encouraging people to get the vaccine. And it's unfortunate we don't have all these catalogs yet, but if we did, I think we'll find an enormous amount of just indigenous community-based folk who decided to try to make an impact on their neighbors to get the shot. It's actually pretty amazing, pretty remarkable. And so we're really kind of enthused by what we see and recognize that we can help facilitate the communication, but the leadership to cause to have it happen really is coming from local levels and we're blessed by just a citizen of the state who decided to make this issue one that they want to make a difference about. It's wonderful. It's much nicer to hear from someone who's your neighbor than a stranger. And hopefully as Dr. Yancey points out, we all acknowledge when we shared the news about vaccines, the history of racism and the reasons that people have to be afraid that folks know that we understand and are credible. Oh, Shia, I'd like to come back to you. Thank you, Molly. I have a couple of questions about young people. One is from a panelist and one was just one that I've already had, so I'll kind of mix them together. Do we expect younger black people when they can get vaccinated? Do we expect them to get vaccinated at a higher rate or a lower rate than older black people? And also, are we excluding testing? Are we excluding young people in testing as we focus on older people? So let me see. I think I want to get you in the conversation, Paul. So I'm not sure this is your wheelhouse exactly, but I want to get you in here because we haven't heard from you for a minute. I appreciate that. You know, as the youngest person probably on the panel, I guess I can speak to the youth. And if I did. Not younger than Dr. Kang. You're not younger than Dr. Kang. Oh, you're right. I forgot I am not younger than Dr. Kang. Yeah, I think young people will will come get the vaccine once it's available. But I do think, you know, and I'll defer to my doctor colleagues on this call from a medical standpoint, you know, I think the decisions that were made from who, you know, giving the healthcare workers frontline facing and then going from age just looking at the numbers and what we see it's it was it's the right decision. Hopefully, though, once we get more vaccine, we can just convince young people that this is the right thing to do going forward. Right. And the bigger, I think, larger policy question will we have to face as a society is, are we going to mandate it? And, you know, like similar to the flu, you know, you have to have a flu shot to come work at Eskenazi or Marion County Public Health Department. If you don't get it, you know, you don't get the job. And the question for us is really, I think as a society, you know, are we going to require people to get the COVID vaccine no matter their age once enough of it's available. I think that's going to be the challenge. Let me throw something in and I'm going to throw something that I, I, I don't disagree, but I think it's going to be particularly challenging in that when we look at vaccine vaccine rates among adolescents, they are far lower than vaccine rates among younger and because they're at that independent age and they're not being kind of like brought in many times by the parents to get this. We've seen a very good immunization rates in the vaccines that are required to attend school. The meningitis vaccine at the, you know, entering the sixth grade and then again at the junior year around 16 and certain others, okay, that have been pretty high. The ones that don't, that are not requirements for school, the, the immunization rates are sometimes pretty, pretty low. So I think that exactly as you mentioned, if it becomes something that's required, those rates are going to go up. They're going to have a job to not, it's not so much a matter of convincing them that they should get them, it's a matter of the availability, unless you're playing a, unless you're playing a high school sport or something. Many times we just don't have a lot of contact and touch with the young people. And so therefore it's going to, that's going to require some different strategies to get them in. Maybe school strategies, you know, maybe weekend strategies that wherever, but that's going to be a particularly challenging battle because even now with the current vaccines, those rates are lower. To that, to that, to that factor. So, you know, we just had a really, we had a new director for IU Simon Cancer Center and he's the new director and he comes out of New York City. And so I told him the one thing you can do on the chair of that of the advisory committee group for the cancer community. And the one thing I told him that the one mistake you cannot make here in Indiana is say you do not like basketball. So, and the point for this is, I think you're going to find I think Paul was talking about more like college students but even in high school, what you're going to find out I think for people who are sports minded that you have a lot of sports say hey I'm not going to play with a team that may affect me with a team. So, I want to know that they are vaccinated. I'm already seeing that on the college level, but I think you're going to see that more on the K through, you know, sports elementary to even K to 12, because they're just so sports incentivize, and I see that really pushing the line maybe for the adolescents, especially just the ones who are like cheerleading cheerleading and things of that nature in order to make their school environments safe. Can I just say I just say that the Pfizer vaccine was studied down to age 16 and then the maternity down to age 18 is, and as Dr. Janser you mentioned that they're continuing to study that in other age groups. Thank you. So quick question Molly that came in to me. So we were talking earlier about pregnancy and COVID-19 vaccine, but recently there's been a lot of talk about mammograms and COVID-19 vaccine and so women can can Dr. right can you kind of clear up some maybe confusion on what is going on with should you get your COVID-19 vaccine and your mammogram close together should you space them out or because I know there's a lot of talk about that now. Yeah, so the basic answer is if you're due for a mammogram and the code of action, you should you should get both. You know, so the, the, the bottom line is that, you know, with the vaccination, you can have pain at the site of injection, and then about one in 10 people you can have what we call lymph adenopathy to get a swelling of the lymph node that, you know, drains the, you know, the infection fighting cells in that area, and that could be picked up on a mammogram and potentially confuse the situation and I would emphasize potentially. So the recommendation is to get that mammogram but it's also to let the doctor know that you've had your COVID vaccination so that they'll be able to take that into account when they're looking at it. So definitely, we want people to continue to get their breast cancer screening and we definitely want people to get their vaccination. Thank you so much for clearing that up, Molly. And continuing with the vaccine questions, we have a comment in the chat that if young people are less likely to suffer kind of the harshest version of COVID-19, why would it be necessary to get them vaccinated so Dr. Nancy, I'm going to come straight to you. I have a feeling you have a reply. Okay, well, just because you have less, the two reasons. One, just because you have less of a risk doesn't mean you have no risk. And we do know that there are some, that there are some young people who have become incredibly ill and there are deaths that have occurred in young people. The second thing is, we tend to measure a lot of things by death rates, but there's a lot of disability rates that are tougher to measure. There's evidence now of some of the younger people who had moderate cases of COVID with certain types of heart damage, secondary to it, certain types of even minimal kidney damage that's related. So it's not totally benign just because they don't end up on ventilators in the hospital. And so this may affect them later on in life, so certainly with athletic careers. I can see it coming that at some points, some of the higher level programs are going to say, you know, did you have COVID? Let's run these tests and we'll see. We have a return to play from cardiology sections now. And that return to play is it looks at certain types of things. Looks at EKGs, looks at sometimes echocardiograms and things like that. So just because the young people are not dying from it or ending up in the hospital at the same rate doesn't mean that it's a benign illness. It's not. And therefore, I think it's still very reasonable to go ahead and get the vaccine to prevent those potential complications later on. Thank you, Dr. Yancey. If you if it occurs to you and you could share with me information about statistics where folks could find more information about studies related to young people. Someone in the chat has asked for that background and I can certainly share it since they registered for the webinar. Thank you so much. I wanted to add that I never know what people consider young or old, but I just wanted to add that, you know, for young adults, you know, and I consider that, you know, 35. You know, we've already had, you know, 4,000 to 5,000 deaths. Well, I want people just to, you know, bring it back into perspective that, you know, yes, we've had 500,000, you know, that's nationally. The majority of them being elderly, but you know, we've, we've had plenty of people die that are between the ages of 30 and 50. Thank you so much, Dr. Right. Well, I have a question for you earlier in the event you talked about kind of big brother visiting you if you make the wrong move on administering vaccines. We had someone in Facebook ask if you are under 60, and you roll up at a CBS and you end up with a dose that was going to get tossed because they're at the end of the day. Have you done something wrong? Are you allowed to have the vaccine if you're under 60? Yeah, of course. I mean, yeah, I think speaking for myself, you know, we want to put as many doses in as many arms as possible. And so, you know, if there's an extra dose and somebody shows up at the end of the day, I mean, of course they should get it right. I mean, but I mean, the larger issue is as we have to, you know, follow the rules and administer, you know, within the guidelines, the goal is never to waste a dose. And so trying to manage that has been a challenge. In the beginning, you know, we were learning how to draw and, you know, how many doses to draw. And now we've kind of got that figured out to where we don't waste. There's no possibility of wasting and I actually don't think we've thrown away any doses since this started. So I mean, but if somebody is under the age of 60 and they show up at Walgreens at the end of the day and there's a dose left and then more power to them. And I think you're getting an endorsement from Dr. Kane, who I'll come to with one last question before I swing to Oshia. We had a question, Dr. Kane, about your advice to folks with diabetes. Do we have any information or tips for folks who have had COVID or perhaps are considering the vaccine or a diabetic because we know that the comorbidity information has been a little daunting. Oh, Dr. Kane, you're on mute. We know that we know that there's a much higher risk of complications if you have an underlying medical condition of diabetes. And so my message to them is make sure that you're under good control. So if you're currently not under good control, work very hard with your provider following the guidelines and getting the medications that you need. You know, at one point, we were doing a lot of telehealth. And so it made it difficult for some people being able to be able to follow telehealth or even having the tools in their homes to even do telehealth. So just want to encourage you, work hard to get your diabetes under control because chronic medical illnesses can put you at a much higher risk for hospitalizations and a much higher risk for requiring intubation as such. And so that's the thing I will say that I think is really critical. And look for us very shortly, I'm sure from the state to talk about adding people under the age of 60 who have certain chronic medical conditions being eligible for getting a vaccine because of higher complications for hospitalizations and even death. Thank you so much, Dr. Kane. I'm looking at the time I want to give Oshia the final word on our program today, but before I hand over the mic, I want to thank our panelists Paul Babcock, Dr. Virginia Kane, Carl Ellison, Dr. Curtis Wright, and Dr. Eric Yancey. I've learned a lot. You have plowed through so many amazing questions from our panelists. Thank you to everyone on Facebook and in Zoom for providing those questions. Thank you on behalf of New America. Thank you to our partners at the AARP who helped make today's event possible. And thanks to folks at Wish TV who are making sure that we reach as many people as possible. But finally, thank you to my partners at the recorder. Oshia, I want to hand to you for final remarks and observations about today. Thank you so much, Molly. And thank you once again for co-moderating and partnering with me. It's always an informative session. My last question to you guys, and I want to, I want to go through everyone. So I'll start with you, Paul. What have we learned? Paul's like, you always put me on the spot. What have we learned in Indianapolis, Marion County from COVID-19 that could help us in future pandemics so that it doesn't take so much of a toll. And I think this is a good place to last, I think it's the good last question. We want to kind of know what can we do to make our lives better so we never have to do this again. Yeah, no, that's a great question. And I think the way I'll start it in framing is that I think we've learned in Marion County and Indianapolis that we're resilient people that, you know, we help each other out and pull each other out by the bootstraps. I think what we need to really now begin to adjust as we think about a future pandemic is, you know, what things can we put in place now and convince people are the right things to do and make them habits. So then the future, you know, because we've had such good habits, like wearing a mask all the time, the odds of more people getting sick and more people dying really decreases. And that's, I think that's what we got to have to figure out how to go forward and do it. Thank you. Dr. Wright, you're muted. I think I started off with saying that people really need to start to see their doctor build a relationship. And again, make sure that they're at the, you know, the height of their health. So that if we do have something, you know, happen in the future that, you know, they're in the best case scenario to be able to handle it, no matter what it is. And then, as we've already mentioned, it's so important to have this trusting relationship with the provider. And I think that the time to visit your doctor is now. Thank you. Carl. In Marion County, we're blessed to have a Jenny came to help us see the light for any pandemic that arises. We are in good hands. But beyond that is my great hope that before the next pandemic comes around, we will have better dashboards that illustrate how when already population particularly compared to white populations in terms of whatever it is, access to medical care shot to where the case may be. And beyond that, that the health systems in the community do a better job of connecting those who are at least advantaged with the health delivery system and the components themselves, you know, that maybe we'll see a world that's more connected from the standpoint of the resources we need to help one another. And as long as we have a Jenny came to get us in terms of what we ought to do. I think in Marion County, we're absolutely blessed for any future that which may come upon us. And since she's only 29 will have her for a nice long time. We don't have even. So I, you know what, I've learned, I learned a lot. And I know that one of the things that we have to have is, we really have to improve our public health infrastructure. That's, that's the first thing, being prepared for something like this. We went into homeless business. I'm in the homeless business. Okay. You know, we've overseen 700 homeless individuals residents, partnering with the city of Indianapolis, but my people on a daily basis are going around seeing homeless people. So we've had to rent six motels starting out. And then we've, we've leased the whole hotel to continue the process, having no idea we'd be in the, in the homeless business. And what I'm trying to say here is, we also owe ourselves a responsibility to address social determinants for our people, because if they be any if they're being evicted, they don't have any food on their table. They don't even know about whether they need to get vaccinated or not, or even have the money or resources to wear a mask. So social determinants is critical that all of us have a responsibility for. And what have I learned? I have learned that our people of color brown and black community based organizations are the best tools measures out there to help us make a difference in our community. We need to be a maternal telling you what to do. But we need to have true partnerships, realized the value of our community based organizations in partnering to knowing how to reach our communities communities. I can't reach as well as they can, because they're on the front lines, they're doing a lot of services, didn't know same social networks. I just think when that happens again, I'll have all that infrastructure in place. You know, I have my feelings hurt by one group of community based organizations and I'm thinking I'm doing fantastic with my language, you know, for like my testing sites and everything they said hey, you got a significant people just can't read. So I don't care what you have Spanish permission or anything, they can't read. So how do you set up the mechanism in order for them to get the education they need to get tested or getting vaccinated. How do you sign them up. And that never would have happened if I didn't listen, have dialogue and value the input that we get. And so I have tapped every one of everyone on this panel, it's up for you, Miss Martin, you're the only ones I haven't had to call them big about something. But now that I got your phone number and everything I just want to say you better watch out. Okay, but I'm also I have to say this, we've been blessed by having a great mayor. I just got to tell you this mayor hot set, because I can make all the recommendations in the world, and if someone doesn't want to follow it. I would be able to make the gains that I've made I've had a fantastic order trustees for health and hospital that has given me the resources in order for me to help work with all of you. And again, let me say, one of my partners in crime, or Mr. Paul back cold CEO and president of health and hospital, it's just been incredible to work with addressing this coven 19 and it's not about me. I've got outstanding staff, and I've got folks who have not even taken a vacation. Since the start of this epidemic marks the eighth, and I've had to force people to take a vacation, because they are committed to public service, and they want to do the right thing. And so I just appreciate that I appreciate my as Genazi colleagues. You wouldn't know this but Eric yes and I long time friends, even before I came in in theapolis and so I just appreciate everything that you do and thanks recorder for getting this message out for the people really need to hear this. I appreciate it. Mr. Bapcock sorry, Mr. Paul Bapcock, thank you. Okay, I just like a couple of things. This is the first is that I think that you mentioned for the next pandemic. We're going to need upfront universal or certainly consistent messaging to the population. If you have diverse and varying messages to the population. That's going to be a major problem that you're going to have all kinds of trouble getting over so that's one thing. The second thing I'd like to say is I'd like to add have added into our grade school curricula. So how do you evaluate good information from bad information, because outside of the pandemic, our children need to know how to everything's on the web now. So our children need to know how do you evaluate something that is evidence based or good information versus conspiracy theories and something somebody just throughout there. That's a major, that's a major platform of what's going to have to you going forward in all sorts of areas. Everybody has a website and everybody's website says something different. You've got we've got to teach at a grade school level. How do you evaluate good information from bad information. And so I'd say those two things universal message and how do you evaluate what's true. Wow, thank you. Couldn't have thought of a better way to end the conversation. Thank you to our panelists thank you to our audience thank you again Molly. This was a very, very informative, informative discussion. Thank you.