* This transcript was created by voice-to-text technology. The transcript has not been edited for errors or omissions, it is for reference only and is not the official minutes of the meeting.
          [COVID-19 Talk with Local Health Authorities (#86)]
          [00:00:15]
          GOOD MORNING AND WELCOME TO COVID-19, TALK WITH LOCAL HEALTH AUTHORITIES. 
          JOINING US IS DR. 
          ERICA BROWN, REPRESENTING HARRIS COUNTY, DR. DAVID PERSCH, REPRESENTING THE CITY OF HOUSTON. 
          A SPECIAL THANKS TO OUR PRODUCERS, DAVID CASTILLO AND PRIS, PRISCILLA KEY AND A VERY SPECIAL THANKS TO, UH, KATHY FINNER, PAST PRESIDENT ROTARY CLUB OF HOUSTON, WHO PROVIDES WITH THESE QUESTIONS. 
          AS A MATTER OF FACT, WE WERE TALKING EARLIER, IT SEEMS LIKE, UH, UH, QUESTIONS ARE NOT ONLY COMING IN, UH, REGARDING COVID, BUT ALSO MONKEYPOX, AND THESE ARE OUR LOCAL HEALTH AUTHORITIES, AND SO THEY'RE CERTAINLY PREPARED TO ANSWER ANY QUESTIONS RELATED TO PUBLIC HEALTH ISSUES, CURRENT STATUS, ANY CHANGE TO SYMPTOMS LIST. 
          SO I'LL TAKE THAT ONE. 
          UM, SO REALLY NOT SO MUCH. 
          SO WHAT WE'RE FINDING WITH WHAT'S GOING ON NOW IN THE COMMUNITY IS WE'RE SEEING MORE BA FOUR, BA FIVE, WHICH IS ANOTHER, UH, VARIANT OF A SUB VARIANT OF OMICRON. 
          AND WHAT WE'RE SEEING IS NOT A, NOT A LOT OF CHANGE. 
          THE, UM, ONE THING IS PROBABLY NOTABLE IS THAT THERE SEEMS TO BE LESS OF A PROBLEM WITH THE LOSS OF SENSE OF TASTE AND SMELL THAN WE SAW WITH EARLIER. 
          BUT FOR THE MOST PART, THE SYMPTOMS ARE THE SAME. 
          NOW, THE, THE BIG CHANGE, IF ANYTHING, HAS BEEN THAT THE SEVERITY OF ILLNESS SEEMS TO BE LESS. 
          UM, BUT THAT'S WHAT I HAD TO RE, THAT'S HOW I WOULD RESPOND TO THAT. 
          ARE HOME TESTS ACCURATE FOR EACH NEW VARIANT? UM, SO IN, IN GENERAL, THEY ARE THERE, THERE'S SOME CAVEATS TO THAT IN TERMS OF SOME TESTS BEING, UM, UM, MORE EFFICACIOUS THAN OTHERS. 
          UM, BUT IN GENERAL, HOME TESTS, UM, JUST UNDERSTANDING THE SCIENCE OF AT HOME TESTS ARE LOOKING FOR, UM, THE PEAK OF INFECTION. 
          SO IN GENERAL, REGARDLESS OF THE, THE VARIANT, UM, THEY, THEY WORK PRETTY WELL, BUT THERE ARE ALWAYS POSSIBILITIES THAT YOU'RE EITHER TESTING TOO EARLY OR MAYBE A LITTLE BIT TOO LATE. 
          UM, UM, SO THERE COULD BE SOME FALSE NEGATIVES IN THAT AS WELL. 
          YOU KNOW, THAT'S A POINT THAT I THINK WE NEED TO EMPHASIZE BECAUSE I'VE GOTTEN SEVERAL CALLS AND SAID, YOU KNOW, I, I NEED TO GO AND GET TESTED. 
          I WAS EXPOSED YESTERDAY, LIKE, WAIT A MINUTE, , RIGHT? NOT YET. 
          THAT'S TOO SOON. 
          YES, WASTEWATER. 
          SO, UH, THE WASTEWATER CONTINUES TO RISE. 
          I THINK THIS IS IMPORTANT. 
          SO WE'RE UP TO 709% TO REMIND PEOPLE THAT, UH, WE PICKED THE PEAK OF THE FIRST WAVE BACK ON JULY 6TH, 2020 IS AN ARBITRARY 100% VALUE. 
          AND THE REASON IS THAT YOU NEED SOME MEASURE USE OF THIS BIG, LONG, HUGE NUMBER OF, THE BUNCH OF DECIMAL POINTS, WOULDN'T MAKE ANY SENSE TO ANYONE. 
          SO WE'RE NOW UP TO 709%. 
          THAT'S SEVEN TIMES WHAT IT WAS BACK IN, UH, THE PEAK OF THE FIRST WAVE. 
          BUT WHAT'S IMPORTANT IS IT'S, IT CONTINUES TO GO UP ABOUT 10% EVERY WEEK. 
          AND THAT'S THE TAKEAWAY, IS THAT THE, THE, THE VALUE IS HIGH AND IT'S CONTINUING TO RISE. 
          SO, YOU KNOW, THIS IS, WE'RE FAR FROM OVER YET CURRENT PERCENT OF PEOPLE BEING HOSPITALIZED FAR VERSUS WITH COVID. 
          YEAH. 
          SO UNFORTUNATELY WE STILL DON'T HAVE A, A, A SPECIFIC ANSWER FOR THAT. 
          UM, OBVIOUSLY WE KNOW THAT PEOPLE ARE HOSPITALIZED AND THEY HAVE COVID INFECTION. 
          UM, THOSE THAT ARE COMING IN WITH COVID ANECDOTALLY, UM, JUST IN TALKING TO OUR HOSPITAL PARTNERS IS INCREASING A LITTLE BIT. 
          BUT IN GENERAL, IT'S VERY HARD TO PARSE OUT WHO HAS OTHER CHRONIC DISEASE STATES THAT ARE, UM, UM, BRINGING 'EM INTO THE HOSPITAL VERSUS, UM, THOSE WHO ARE COMING IN WITH COVID. 
          BECAUSE AGAIN, AT THIS POINT, FOR SAFETY REASONS, EVERYONE IS BEING TESTED FOR COVID. 
          WHO COMES? CDC SAYS, BA FIVE NOW ACCOUNTS FOR OVER 50% OF YOUR CASES. 
          HAS IT BEEN PROVEN THAT BA FIVE HAS GREATER SEVERITY? IS THERE ANY PROJECTION OF HOW BA A FIVE WILL GROW? SO BA FIVE IS, UH, GROWING IN OUR COMMUNITY NOW THAT 50%, UH, VALUE ACROSS THE UNITED STATES, REMEMBER, THERE ARE PLACES LIKE NEW YORK THAT ARE AHEAD OF US. 
          SO WE'RE, WHAT I'M HEARING FROM OUR HOSPITAL PARTNERS IS THAT WE'RE JUST A LITTLE BIT BELOW 50%, OR MAYBE A THIRD. 
          A THIRD OR MORE IS B FIVE, BUT IT'S GONNA GROW. 
          UM, IT'S, AND THE REASON IS NOT THAT IT MAKES PEOPLE SICKER, BUT IT SPREADS MORE EASILY. 
          SO THE SEVERITY OF B FIVE DOESN'T SEEM TO BE ANY DIFFERENT, BUT IT SPREADS SO MUCH MORE EASILY THAT THAT'S WHY IT'S, IT'S GROWING, AND WE CAN EXPECT TO SEE, UH, MORE AND MORE CASES OF BA FIVE AS TIME GOES ON. 
          DO PEOPLE WHO HAVE COVID EARLY HAVE MORE OR LESS RESISTANCE TO OMICRON? UH, SO THAT DEPENDS ON, ON A COUPLE THINGS, MORE OR LESS COMPARED TO, TO THOSE WHO DIDN'T HAVE INFECTION OR COMPARED TO THOSE WHO WERE VACCINATED OR BOTH. 
          SO THE BOTTOM LINE IS WHETHER YOU WERE INFECTED BEFORE OR YOU GOT VACCINATED, THAT IS PROVIDING YOU SOME LEVEL OF RESISTANCE TO THE NEXT, UH, INFECTION, 
          [00:05:01]
INCLUDING OMICRON. 
          NOW, OMICRON AND IN PARTICULAR, BA FOUR AND BA FIVE ARE SUFFICIENTLY DIFFERENT FROM THE PREVIOUS, UH, VERSIONS AND FROM THE VACCINE. 
          THE PEOPLE ARE GETTING INFECTED AND THEY'RE GETTING SICK. 
          MANY PEOPLE ARE GETTING SICK ENOUGH THAT THEY WON'T GO TO WORK, BUT WE'RE NOT SEEING THE INCREASE IN HOSPITALIZATIONS AT THE RATE WE SAW BEFORE. 
          SO YEAH, IF YOU WERE INFECTED BEFORE, IT DOES PROVIDE YOU SOME PROTECTION. 
          UM, BUT OMICRON IS CRAFT OR BA FOUR AND FIVE, I SHOULD SAY, ARE PRETTY CRAFTY. 
          SO PEOPLE ARE STILL GETTING SYMPTOMATIC. 
          THEY'RE JUST NOT GETTING AS SICK. 
          NOW, IF YOU'RE UNVACCINATED AND YOU WERE NEVER SICK AND YOU GET BA FOUR OR BA FIVE, YOU CAN EXPECT TO GET JUST AS SICK AS ANYBODY ELSE WOULD'VE. 
          A LONG TIME AGO, I HAD COVID WHILE PREGNANT, MY BABY IS NOW SIX MONTHS OLD, SHOULD SHE BE VACCINATED? DO ANTIBODIES LAST LONGER, AND INFANTS? SO THIS IS THE OPPORTUNITY FOR US TO PUT IN A SHAMELESS PLUG AS LOCAL HEALTH AUTHORITIES, UM, FOR ALL CHILDREN WHO ARE ELIGIBLE TO BECOME VACCINATED. 
          UH, UNFORTUNATELY, UM, COVID-19 HAS BECOME A LEADING CAUSE OF DEATH IN CHILDREN. 
          UM, AND I THINK WE NEED TO BE VERY AWARE OF THAT. 
          UM, ALTHOUGH FOR MOST, UM, IT, IT'S A LESS SEVERE ILLNESS AT THIS POINT, IF YOU'VE BEEN VACCINATED, UM, IT, IT HAS RISEN ON THE SCALE OF CAUSES OF DEATH. 
          UM, SO TO ANSWER THIS SPECIFIC QUESTION, ABSOLUTELY YOUR SIX MONTH OLD SHOULD BE VACCINATED TO PROTECT THEM. 
          UM, I, IMMUNITY IS IMMUNITY, UH, REGARDLESS OF THE, OF THE AGE. 
          SO I CAN'T SAY THAT THE IMMUNITY LASTS LONGER, BUT IT WILL PROVIDE PROTECTION. 
          UM, WE KNOW FOR A TYPICAL AVERAGE OF ABOUT SIX MONTHS, AND IT'S IMPORTANT TO KNOW THAT, THAT THE, THE BABY WILL NOT HAVE FULL IMMUNITY JUST LIKE WITH ADULTS UNTIL THEY HAVE HAD A FULL, UH, PRIMARY SERIES AND ARE TWO WEEKS OUT FROM THAT. 
          OKAY? SO I'M NOT GONNA GET INTO THE, THE SPECIFICS, UH, ABOUT EACH VACCINE AND HOW MANY DOSES, BUT IT, I, I WOULD HIGHLY RECOMMEND THAT ALL CHILDREN SIX MONTHS OF AGE AND OLDER BE VACCINATED AGAINST COVID-19, BECAUSE AGAIN, IT IS A LEADING CAUSE OF DEATH FOR CHILDREN. 
          NOW, THANK YOU FOR THOSE NOT ELIGIBLE TO RECEIVE INITIAL VACCINES. 
          WHICH ONE SEEMS TO WORK THE BEST IN CURRENT CONDITIONS? SAID WE WEREN'T GONNA GET INTO THAT. 
          GO AHEAD, . 
          YEAH, SO, UH, REALLY THERE'S, THERE'S NOT A WHOLE LOT OF OF DIFFERENCE. 
          THEY'RE ALL WORKING PRETTY WELL. 
          REMEMBER, YOU KNOW WHAT, A GOOD VACCINE WILL HAVE ABOUT A 60, 70% EFFICACY RATE. 
          SO WE ALL GOT SPOILED WITH THESE 90% RATES. 
          UM, SO KEEPING IT REAL, THEY'RE ALL PRETTY GOOD. 
          BUT AS TIME GOES ON, ONE THING TO KEEP IN MIND IS THAT IF YOU MIX AND MATCH, THAT DOES SEEM TO GIVE AN ADVANTAGE, UH, AS OPPOSED TO STICKING WITH ONE BRAND, UM, AS YOU GET MORE AND MORE VACCINES. 
          WHAT ABOUT MULTIVALENT, NANOPARTICLE BASED VACCINES? IT'S BEEN REPORTED THAT A SINGLE IMMUNIZATION ABOLISH ALL INFECTIOUS VIRUS WITHIN THE LUNGS AFTER A SINGLE DOSE AND HAMSTERS . 
          SO, SO THIS IS A LITTLE BIT COMPLICATED. 
          SO, NANOPARTICLE, UH, BASED VACCINES ARE, UM, BASED ON LITERALLY THE SHAPE OF THE PARTICLE. 
          THAT'S HOW THEY WORK, UM, TO GET INTO THE CELLS AND TO PRODUCE AN IMMUNE RESPONSE. 
          UM, SO, UM, FIRST OF ALL, IT'S NOT GONNA COME FOR A LITTLE BIT OF TIME BECAUSE IT'S STILL IN THE DEVELOPMENT PHASE, BUT IT DOES APPEAR TO HAVE, UM, A LITTLE BIT MORE EFFICACY IN, UM, UM, ERADICATING THE DISEASE, UH, IN THE EARLY STAGES AND PROVIDING SOME IMMUNE RESPONSE. 
          UM, THE STUDIES THAT WERE DONE, UM, UM, WERE NOT NECESSARILY, UH, TO CREATE A NANOPARTICLE VACCINE TO COMPETE WITH OTHER COVID VACCINES, BUT RATHER JUST A DIFFERENT MECHANISM, UM, UH, FOR A DIFFERENT TYPE OF COVID VACCINE. 
          AND AGAIN, REALLY BASED ON THE SHAPE OF, OF THE PARTICLE AS OPPOSED TO, UM, AN MRNA OR AN RNA REPLICATION. 
          WHAT ABOUT THE IMPORTANCE OF NASAL VACCINES TO PROMOTE MUCUS CELL IMMUNITY AND HELP BLOCK THE TRANSMISSION CHANGE? YEAH, SO THE CONCEPT OF, UH, NASAL VACCINES IS NOT ENTIRELY NEW. 
          UH, AND WE'LL SEE HOW THEY WORK, BUT THE, THE CONCEPT REALLY IS THAT WHERE THE, UH, WHERE PEOPLE WOULD GET THE VACCINE ADMINISTERED THROUGH THEIR NOSE, AND SINCE WE KNOW THAT A LOT OF SPREAD OF COVID IS BECAUSE YOU BREATHE IT IN, THAT IF THERE'S, IF WE WIND UP WITH HAVING GREATER PROTECTION IN THOSE NASAL, UH, PASSAGE NASAL PASSAGES, THAT YOU MAY AS THE, YOU KNOW, THE, THE PERSON RIGHT QUESTION BREAK THE TRANSMISSION. 
          IN FACT, HOPEFULLY YOU WOULDN'T GET INFECTED AT ALL. 
          SO THIS HAS, UH, YET TO BE PROVEN, BUT IT'S A, AN INTERESTING CONCEPT AND IT'S NOT ENTIRELY NEW. 
          SO WE'LL SEE WHERE IT GOES. 
          NEW YORK CITY'S OFF OFFERING PACKS OF LID AT MOBILE TESTING SITES, SO PEOPLE WHO GET POSITIVE RESULTS CAN GET THE MEDICINE IMMEDIATELY. 
          IS THAT BEING CONSIDERED HERE? UM, SO HARRIS COUNTY IS NOT CURRENTLY CONSIDERING THAT. 
          UM, 
          [00:10:01]
JUST TODAY, AS A MATTER OF FACT, OVERNIGHT, UM, THE INFORMATION WAS RELEASED, UM, THAT, UH, PHARMACISTS, UH, ARE NOW ABLE TO, UM, ON PRESCRIP PAXLOVID. 
          UM, HOWEVER, IN HARRIS COUNTY, UH, IN PARTICULAR, WE HAVE NOT STARTED THAT PROGRAM AND WE HAVEN'T EITHER. 
          ON THE CITY SIDE. 
          SEEMS LIKE SOME PEOPLE ARE GETTING COVID MULTIPLE TIMES AFTER TAKING PAXLOVID. 
          SHOULD IT BE TAKING LONGER A HIGHER DOSE? YEAH, SO THIS IS A GREAT QUESTION. 
          SO WHAT THE PHENOMENON IS THAT PEOPLE, UM, ARE DIAGNOSED, THEY'RE PRESCRIBED, UH, PLO WHERE THEY MAY HAVE SOME MILD SYMPTOMS OR PRESCRIBED PLO WHERE THEY GET BETTER AND THEN AFTER THEY START TAKING THE MEDICATION THAT THE SYMPTOMS COME BACK. 
          SO A COUPLE OF INTERESTING THINGS ABOUT THAT. 
          ONE IS THAT PHENOMENON OF HAVING MILD SYMPTOMS GETTING BETTER AND THEN GETTING SICKER AGAIN, THAT IS SEEN IN PEOPLE WHO AREN'T GIVEN PAXLOVID AS WELL. 
          SO IT'S NOT JUST IN THIS GROUP, IT DOES APPEAR TO BE OCCURRING MORE COMMONLY IN PEOPLE WHO ARE GIVEN PAXLOVID, BUT IN THAT, IN THAT TEXT, WHAT IT MAY VERY WELL BE IS THAT IT IS WORKING JUST EXACTLY AS IT'S SUPPOSED TO, KEEPING THE INFECTION AT BAY. 
          AND THEN, UM, YOU KNOW, WHEN YOU REACH THE LIMIT OF THE MEDICATION THAT IT, YOU KNOW, THE VIRUS THEN HAS A CHANCE TO COME BACK. 
          SO IT'S NOT THAT THE PS OF IT DIDN'T WORK, IT'S JUST THAT THE VIRUS WORKED LONGER AND HARDER. 
          AND SO, SO THAT'S WHAT WE'RE SEEING NOW IN TERMS OF SHOULD BE TAKEN LONGER AND AT A HIGHER DOSE. 
          THOSE ARE GREAT QUESTIONS THE MANUFACTURER'S LOOKING AT, YOU HAVE TO WORRY ABOUT THE COMPLICATIONS OF THE MEDICATION AND, UH, I DON'T HAVE THE ANSWER TO THAT YET, BUT I'M SURE THE MANUFACTURERS ARE LOOKING AT IT BECAUSE, UM, YOU KNOW, THERE WOULD BE A MORE EFFECTIVE TREATMENT IF THEY, AND QUITE HONESTLY, IT'S A GREAT BUSINESS MODEL IF THEY GIVE YOU MORE OF IT FOR LONGER. 
          SO I DON'T HAVE THE ANSWER TO THAT. 
          HARRIS COUNTY PUBLIC HEALTH SHOWS SOME RACIAL AND ETHNIC MINORITIES COMMUNITIES HAVE BEEN DISPROPORTIONATELY AFFECTED BY COVID-19. 
          IS THAT DUE TO VACCINE ACCESS OR OTHER RISK FACTORS? UM, THIS AGAIN IS A REALLY GREAT QUESTION. 
          IT IT IS MULTIFACTORIAL. 
          SOME OF IT HAS TO DO WITH ACCESS, WHICH IS WHY, UM, PUBLIC HEALTH AND, UM, THE CITY HAVE, HAVE TAKEN GREAT EFFORTS TO, UM, UM, TAKE MOBILE UNITS OUT AND, UM, KIND OF DO POP-UP SHOPS FOR VACCINATION IN ALL, UM, UH, AREAS OF HARRIS COUNTY. 
          UM, SO YES, ACCESS IS, IS ONE ISSUE. 
          UM, UM, EDUCATION ABOUT THE VACCINES AND UNDERSTANDING ABOUT THE VACCINES IS ANOTHER, IS ANOTHER ISSUE. 
          UM, UM, THERE DEFINITELY ARE SOME GAPS IN, IN HEALTH LITERACY, UM, AMONG, UM, THOSE WHO ARE UNDERSERVED. 
          AND SO WE'RE, WE'RE REALLY TRYING TO, TO PUSH EFFORTS TO MAKE SURE EVERYBODY UNDERSTANDS THE NEED AND THE IMPORTANCE OF GETTING VACCINATED. 
          UM, AND THEN AGAIN, UM, THERE'S, THERE'S SOME ECONOMIC FACTORS THAT PLAY INTO THAT AS WELL. 
          AND SOME, UM, UM, UM, AGAIN, UNDER HEALTH EDUCATION, PERHAPS NOT, UM, KNOWING THAT THE VACCINE IS FREE. 
          UM, AND SO AS MUCH AS, AS WE'VE BEEN, UM, PROMOTING FREE VACCINES, UM, AND BEEN TRYING OUR BEST TO GET OUT TO, UH, ALL AREAS, UM, THERE ARE STILL SOME WHO, UM, ARE, ARE BEING TOLD, UM, FROM VARIOUS ENTITIES OR, UM, ARE, ARE NOT USED TO RIGHT. 
          FREE MEDICAL CARE. 
          UM, THIS IS, THIS IS SOMETHING THAT'S NEW FOR ALL OF US WITH THIS PANDEMIC. 
          UM, AND SO AGAIN, IT'S MULTIFACTORIAL, BUT, BUT WE WERE REALLY TRYING TO DO OUR BEST TO GET OUT TO THOSE WHO, UM, ARE DISPROPORTIONATELY AFFECTED AND WELCOME. 
          ANY SUGGESTIONS AND, AND FRANKLY, ANY, ANY FREE ADVERTISING THAT YOU CAN PROVIDE TO ASSIST US. 
          ABSOLUTELY. 
          SINCE COVID SEEMS TO BE IMPACTING THE VACCINATED, WHAT ABOUT UNVACCINATED? YEAH, GREAT QUESTION. 
          SO REMEMBER WE SAID EARLIER THAT BA FOUR AND B FIVE ARE STILL, ARE NOW SUFFICIENTLY DIFFERENT THAT THEY'RE ABLE TO INFECT PEOPLE WHO WERE PREVIOUSLY VACCINATED OR PREVIOUSLY INFECTED. 
          UH, THOSE WHO ARE UNVACCINATED REMAIN CLEARLY AT INCREASED RISK FOR HAVING MORE SEVERE ILLNESS. 
          THE, UM, I'M, I'M TALKING ABOUT UNVACCINATED AND PREVIOUSLY UNINFECTED, THEY'RE, THEY'RE AT THE GREATEST RISK FOR GETTING THE MOST SEVERE ILLNESS. 
          NOW YOU'RE GONNA HEAR FROM THE HOSPITALS THAT THE MO THAT A MAJORITY OF FOLKS WHO ARE BEING ADMITTED WITH COVID ARE VACCINATED. 
          THAT IS A MISLEADING, OF COURSE, THAT'S THE CASE WE'VE GOT, WE'RE PUSHING 70, 80% OF THE ADULT POPULATION IS NOW VACCINATED. 
          SO, YOU KNOW, A LOT OF THE FOLKS WHO MENTIONED EARLIER, UH, BY DR. 
          BROWNS, A LOT OF THE FOLKS COMING INTO THE HOSPITAL ARE COMING IN BECAUSE OF THEIR APPENDICITIS, THEIR INFARCTED BOWEL, THEIR PANCREATITIS, THEIR KIDNEY DISEASE, AND THEY'RE TESTING POSITIVE, AND A LOT OF THOSE FOLKS ARE VACCINATED. 
          SO THE, THE BOTTOM LINE HERE IS THAT IF YOU'RE UNVACCINATED, ESPECIALLY IF YOU'RE UNVACCINATED OR NEVER INFECTED BEFORE, THAT IS YOUR HIGHEST RISK FOLKS FOR HAVING THE WORST OUTCOME IF THEY GET INFECTED. 
          NOW, WHAT ARE YOUR THOUGHTS ABOUT THE INEV OF INFECTION ? UH, THAT'S REALLY COMPLICATED. 
          UM, YOU KNOW, A, AS MANY, I, I, I THINK THERE ARE TWO WAYS TO ANSWER. 
          NUMBER ONE, I THINK WE NEED TO BE VERY CLEAR THAT, UM, 
          [00:15:01]
WE'RE STILL IN A PANDEMIC, UM, ACROSS THE WORLD IN THE COUNTRY IN HARRIS COUNTY. 
          UM, MILLIONS HAVE BEEN AFFECTED. 
          HAVING SAID THAT, WHEN YOU LOOK AT THAT NUMBER AS COMPARED TO THE NUMBER OF THE PEOPLE OF PEOPLE IN THE WORLD, TECHNICALLY, IT'S NOT A HUGE, HUGE NUMBER. 
          SO, UM, UH, IF WE'RE TALKING ABOUT, UH, IN RELATIONSHIP TO THE SUSCEPTIBILITY AND THE ABILITY OF, UM, UM, THE VARIANTS TO SPREAD, RIGHT, WE ARE, WE'RE IN A PHASE WHERE, WHERE WE HAVE VARIANTS THAT SPREAD MORE EASILY, BUT ISN'T INEVITABLE FOR EVERYBODY. 
          I I DON'T THINK THAT THAT IS, IS PERHAPS AN ACCURATE STATEMENT WHEN WE JUST LOOK AT THE RAW DATA. 
          BUT AGAIN, IT DOES NOT DIMINISH THAT IN CONTEXT TO OTHER PREVIOUS ILLNESSES. 
          UM, AND, AND NOT HAVING HAD A PANDEMIC IN OUR LIFETIME. 
          IS THIS A HUGE NUMBER? ABSOLUTELY. 
          IT'S A HUGE NUMBER WHERE WE'VE HAD SOME DEVASTATING CONSEQUENCES. 
          WELL, THERE BE EVER BE SUCH A THING AS HERD IMMUNITY. 
          . 
          YEAH. 
          WELL, DO WE THINK WE'LL EVER ACHIEVE HERD IMMUNITY? THE, THE, THE REASON WE HAVEN'T ACHIEVED HERD IMMUNITY SO FAR IS BECAUSE NEW VARIANTS HAVE COME ALONG AND TO SOME DEGREE PUT US BACK TO SQUARE ONE. 
          SO AS LONG AS WE CONTINUE TO GET MORE VARIANTS, UM, IT'S GONNA BE A CHALLENGE FOR US TO REACH HERD IMMUNITY. 
          BUT, UH, COULD IT HAPPEN? SURE. 
          UH, YOU GOTTA REMEMBER, ALL OF US HAVE GOTTA DO OUR PART TO SLOW THIS THING DOWN IF WE WANNA HERD IMMUNITY SO LONG AS WE CONTINUE TO SPREAD THE VIRUS. 
          AND WHAT WE REALLY THINK NOW IS HAPPENING IS THAT MOST OF THE NEW VARIANTS ARE COMING FROM FOLKS WHO HAVE GOT THESE LONGER ILLNESSES. 
          THOSE TEND TO BE THE FOLKS WHO'VE GOT, YOU KNOW, SOME IMMUNE SYSTEM PROBLEM WHERE THEY DON'T GET RID OF THE VIRUS RIGHT AWAY, THEREFORE, A LONGER TIME FOR A NEW MUTANT TO OCCUR, BUT THAT PERSON GOT INFECTED BY SOMEBODY ELSE. 
          EVERY ONE OF US HAS OUR PART IN THE, IN THE, UH, YOU KNOW, SOLUTION HERE. 
          SO, AND SOME COUNTRIES AND AREAS OF THE US IT APPEARS COVID NUMBERS ARE DECLINING. 
          IS THIS JUST A DECLINE OF ONE VARIANT WITH ANOTHER GETTING GEARED UP ? YEAH, GREAT QUESTION. 
          SO WHEN THEY REPORT THE COVID NUMBERS IN A COUNTRY OR PART OF THE UNITED STATES, YOU KNOW, THAT'S ALL THE COVID INFECTIONS THAT ARE CURRENTLY OCCURRING THERE, UM, TO THE BEST OF THE ABILITY TO MEASURE IT. 
          REMEMBER, A LOT OF FOLKS ARE TESTING AT HOME, THERE'S NOT GETTING RECORDED. 
          SO, UH, WE TALK ABOUT THE NUMBERS, IT'S, IT'S A GUESS AT THIS POINT, BUT YOU CAN TELL WHICH DIRECTION THINGS ARE GOING, AND THERE IS THIS WAVE PHENOMENON. 
          SO WHILE THE NUMBERS ARE DECLINING IN SOME AREAS, I EXPECT THAT THEY WILL DECLINE. 
          NOW DOES THAT MEAN WE'RE NOT GONNA HAVE ANOTHER WAVE? ABSOLUTELY NOT. 
          SO WE'RE PROBABLY WHAT OUR FIFTH WAVE, UM, IF WE GET ANOTHER VARIANT, THERE'LL BE ANOTHER WAVE. 
          MM-HMM . 
          IS THERE SOME REASON THE SECOND BOOSTERS ARE NOT RECOMMENDED FOR HEALTHY PEOPLE UNDER THE AGE OF 50? SHOULDN'T WE JUST USE THEM TO VACCINATE ANYONE WHO WANTS THEM RATHER THAN WATCH THE BATCHES EXPIRE? UM, SO NO. 
          SO, UM, A LITTLE BIT OF BACKGROUND ON, ON HOW UM, RECOMMENDATIONS ARE MADE FOR ANY MEDICATION. 
          UH, IT REALLY HAS TO DO WITH THE RISK VERSUS THE BENEFIT OF TAKING THE MEDICATION. 
          SO AT THE POINT WHERE THERE IS SHOWN TO BE NO ADDITIONAL BENEFIT TO THE MEDICATION AND OR THE VACCINES, MEANING, UM, WE'RE NOT GONNA GET ANY MORE INCREASED, UH, PROTECTION FROM IT, UM, THERE MAY BE NOT IN THIS CASE PERHAPS, BUT THERE MAY BE INCREASED RISKS WHEN YOU START ADDING ON DOSES OF THINGS. 
          AND THIS IS FOR ANY, AGAIN, ANY MEDICATION, ANY VACCINE, UM, UM, THE MEDICAL SOCIETY WEIGHS THE RISKS VERSUS THE BENEFITS. 
          AND SO IN THIS CASE, THERE'S NO ADDED BENEFIT TO ADDING VACCINE TO THOSE WHO ARE HEALTHY AND UNDER THE AGE OF 50. 
          SO THE, THE, THE HIGHEST LEVEL OF, UM, UM, VACCINE IS WHAT IS CURRENTLY RECOMMENDED. 
          SO, AND YOU KNOW, IT, AGAIN, IT'S A RISK VERSUS BENEFIT, AND WE NEVER WANT TO ENCOURAGE TAKING MORE THAN WE NEED TO, UM, FOR THE HEALTH BENEFIT OF THOSE IN THE COMMUNITY. 
          SO IT'S ABOUT WHO'S AT RISK, CORRECT? HOW LONG DO YOU HAVE TO WAIT AFTER OUR SECOND BOOSTER TO GET A BIVALENT WHEN AVAILABLE AND WHEN THE NEW BIVALENT COMES OUT, WILL THIS NEGATE THE NEED FOR BOOSTERS THREE OR FOUR? GREAT QUESTION. 
          SO, UM, THEY'RE NOT OUT YET, SO WE DON'T KNOW WHAT THE RECOMMENDATIONS ARE GONNA BE. 
          SO I'M GONNA MAKE A, A PREDICTION THAT IT'LL PROBABLY BE A FOUR TO SIX MONTH RECOMMENDATION AFTER YOUR SECOND BOOSTER BEFORE YOU GET THE BI VALENT. 
          I'M, THAT'S A PREDICTION ON MY PART. 
          AND WHAT I'VE SAID IS, YOU WANNA MAKE A MISTAKE IN PUBLIC HEALTH RIGHT NOW, MAKE A PREDICTION. 
          SO LET ME GO AHEAD AND MAKE A PREDICTION. 
          UH, SO I THINK IT'LL BE A FOUR TO SIX WIN MONTH WINDOW. 
          UM, AND WILL IT NEGATE THE NEED FOR BOOSTERS THREE AND FOUR? IT, IT, IT PROBABLY WILL BECAUSE IT'S GOING TO BE, IT'S BI VALENT, WHICH MEANS WHAT IS IN THE, THE BOOSTERS RIGHT NOW, WHICH IS AGAINST THE ORIGINAL STRAIN WILL BE IN THE, UH, THE NEW ONE THAT COMES OUT. 
          NOW, THERE MAY BE A RECOMMENDATION THAT YOU GET THE BIVALENT A SERIES OF TWO. 
          WE'LL HAVE TO WAIT AND SEE, BUT, UH, YOU WON'T NEED TO GET, IF YOU HAVEN'T GOTTEN THREE AND FOUR YET, AND YOU'RE GONNA WAIT FOR THE BIVALENT TO COME OUT, IT'S, UM, PROBABLY GONNA START YOUR SERIES OVER AGAIN. 
          [00:20:01]
OKAY? PLEASE WEIGH IN NATURAL IMMUNITY VERSUS VACCINATION. 
          WELL, I THINK THAT WITH, WELL, THIS, THE, WHAT THE DATA HAS SHOWN IS THAT NATURAL IMMUNITY, UH, IF YOU GOT INFECTED, YOU GOT NATURAL IMMUNITY THAT ACTUALLY DID PROVIDE YOU A LITTLE BIT BETTER PROTECTION THAN VACCINATION IN THE BEGINNING. 
          THE FIRST SERIES, UM, I'M GONNA JUMP AHEAD HERE. 
          NATIONAL IMMUNITY PLUS VACCINATION, THAT IS CLEARLY THE BEST WAY. 
          IF YOU WERE INFECTED BEFORE, YOU SHOULD GO AHEAD AND GET VACCINATED. 
          UH, NOW THAT IS CLEARLY SUPERIOR TO EITHER IMMUNITY OR JUST VACCINATION ALONE. 
          NOW, THAT IS NOT TO SAY THAT IF YOU WERE VACCINATED, GO OUT AND TRY AND GET NATURAL IMMUNITY. 
          IT ONLY WORKED. 
          I SHOULDN'T SAY IT ONLY WORKED, BUT THE OBSERVATION WHERE IF YOU GOT SICK FIRST AND THEN YOU GOT VACCINATED, THAT GAVE YOU BETTER PROTECTION THAN JUST BEING SICK ALONE. 
          NATURAL IMMUNITY PLUS VACCINATION PLUS BOOSTER, EVEN BETTER. 
          EVEN, YEAH, EVEN BETTER. 
          UM, YOU GOTTA REMEMBER THAT, YEAH, THE, THE, THE, UM, IT WINDS UP BEING A COMBINATION. 
          SO THERE'S, THIS GETS REALLY COMPLICATED. 
          SO WE TALK ABOUT THE ANTIBODIES, IT GETS A LOT OF, UH, TRACTION IN THE MEDIA ABOUT THE NUMBER OF ANTIBODIES AND THE LEVELS OF YOUR ANTIBODIES AND HOW LONG THOSE ANTIBODIES LAST. 
          BUT THERE'S ANOTHER PART TO YOUR IMMUNE SYSTEM. 
          SO, YOU KNOW, THROUGHOUT YOUR LIFETIME YOU GET INFECTED WITH LOTS OF THINGS TO WHICH YOU PRODUCE ANTIBODIES. 
          AND SHORTLY AFTER INFECTION, YOU HAVE A LOT OF THESE ANTIBODIES. 
          WELL, THEN YOU, THAT'S THE WHAT'S CALLED THE, THE HUMERAL IMMUNITY, UH, A SYSTEM. 
          BUT THEN THERE'S A CELLULAR IMMUNITY. 
          WE TALK ABOUT THESE T-CELL AND B-CELL M THAT'S LIKE THE LONG-TERM MEMORY. 
          AND SO WITH YOUR MULTIPLE VACCINATIONS, THAT'S WHERE YOU DEVELOPED A LONG-TERM MEMORY THAT WILL PROTECT YOU. 
          IF YOU DIDN'T HAVE THAT, AND EVERY TIME YOU GOT INFECTED SOMETHING YOUR LIFETIME, YOU DEVELOPED A WHOLE BUNCH OF ANTIBODIES THAT FLOATED AROUND YOUR BLOOD, BY THE TIME YOU GOT TO BE LIKE 20, 25 YEARS OLD, YOUR BLOOD WOULD BE SO THICK WITH ANTIBODIES, IT WOULD, WE WOULD ALL DIE. 
          SO YOU HAVE TO GET THIS OTHER, THE LONG-TERM, UH, IMMUNITY WITH THE TNB CELLS. 
          AND THAT COMES WITH, YOU KNOW, GETTING VACCINATED AND GETTING BOOSTERS AND, AND IF YOU SHOULD HAPPEN TO GET INFECTED, UM, THAT IN THAT WILL LEND TO YOU DEVELOPING THAT LONG-TERM IMMUNITY THAT YOU NEED. 
          IS ANYONE TRACKING LONG COVID RATES IN THE AREA? UM, SO THERE ARE ABSOLUTELY STUDIES IN, IN TRACKING BEING DONE. 
          UM, UM, NOT NECESSARILY SPECIFIC TO OUR AREA, BUT ACROSS THE COUNTRY IN GENERAL TO REALLY TRY TO BETTER UNDERSTAND LONG COVID. 
          UM, UM, THERE ARE NUMEROUS METHODS THAT THE CDC IS USING. 
          SO THE ANSWER IS YES, THERE IS TRACKING, BECAUSE WE'RE STILL TRYING TO UNDERSTAND, BUT IT'S NOT NECESSARILY SPECIFIC TO A REGION. 
          OKAY, ANOTHER ONE FOR YOU ON HARRIS COUNTY PUBLIC POSTS OF LONG COVID CONDITION, IT SHOWS WOMEN AT RISK. 
          WHY HIGHER THAN MEN? YEAH. 
          UM, SO AGAIN, THIS IS AN AREA THAT STILL BEING STUDIED. 
          WE'RE NOT REALLY CLEAR ON WHY THAT IS. 
          WE KNOW THAT IS BECAUSE THE DATA IS SHOWING IT, BUT WE'RE NOT REALLY CLEAR ON THE WHY. 
          UM, UM, THERE HORMONALLY. 
          AND THEN WITH THAT AFFECTING IMMUNE SYSTEM, SOMETIMES, ESPECIALLY IN PREGNANCY, WOMEN CAN BE IMMUNOCOMPROMISED IN PREGNANCY AND THEN AGAIN AT CERTAIN, UM, HORMONE LEVELS AND THINGS MAY AFFECT THAT. 
          UM, THAT MAY HAVE AN IMPACT FOR WOMEN. 
          BUT AGAIN, THIS IS AN AREA AS WITH SOME OTHER THINGS WHERE, UM, JUST IN GENERAL FOR SOME REASONS, MEN ARE MORE AFFECTED WITH SOME THINGS, WOMEN ARE MORE AFFECTED WITH OTHERS, THIS STILL NEEDS TO BE STUDIED. 
          OKAY, LOOKING AT THE TIME, I'M GONNA BREAK AND DO OTHER NEWS FOR TWO QUESTIONS AND THEN I'LL COME BACK TO COVID. 
          MONKEYPOX OUTBREAK STRENGTHS HAS MORE MUTATIONS THAN EXPECTED IMPLICATIONS. 
          SO, UM, WITH THE MONKEY BOX, THERE'S 2, 2, 2 CLADS. 
          THERE'S THE, THE, UM, THE CONGO AND THE WEST AFRICAN CLAD. 
          AND, AND SO IN TERMS OF MUTATION, IT'S REALLY EARLY TO SEE TO SAY YOU. 
          NOW, HERE'S THE OTHER THING. 
          MONKEYPOX IS A DNA VIRUS AS OPPOSED TO COVID AND EVERYTHING. 
          RIGHT NOW IN THE PUBLIC, WE'RE, WE'RE RELATING TO COVID, WHICH IS AN RNA STRAND. 
          SO DNA, UM, VIRUSES, THEY DON'T MUTATE VERY OFTEN. 
          IT'S VERY DIFFICULT 'CAUSE YOU HAVE TO HAVE THIS, THE, THE A MUTATION ON ONE STRAND HAS TO BE MATCHED WITH A MATCHING MUTATION ON THE OTHER STRAND. 
          SO IT DOESN'T MUTATE NEARLY LIKE, UH, COVID MUTATES. 
          UM, BUT ANYTIME WE DO GET A MUTATION, THE MORE PEOPLE WHO GET MORE WHO GET INFECTED, THE MORE LIKELY THERE IS TO BE A MUTATION. 
          AND WE SAW THAT WITH COVID. 
          WE CAN, UNFORTUNATELY, WE MAY SEE THAT WITH MONKEYPOX AS WELL. 
          AND WITH THE NEW MUTATION, THERE ARE NEW CHARACTERISTICS. 
          SO THE, THE IDEA IS WE REALLY JUST NEED TO STOP THIS SPREAD NOW BEFORE, UM, WE CREATE MORE MUTATIONS THAT CREATE MORE PROBLEMS. UM, SO WE'RE REALLY PUTTING YOU HEALTH AUTHORITIES AT TESTS. 
          WE'RE GONNA JUMP TO WEST NOW. 
          NOW,  WEST NOW SEEMS TO BE MAKING APPEARANCE. 
          PLEASE PROVIDE INFORMATION AND CAUTIONS. 
          WE'VE BEEN THERE BEFORE, HAVEN'T WE? ? YEAH, WE HAVE. 
          SO, UM, WEST NILE VIRUS, UM, THE, THE HOST VECTOR IS, IS 
          [00:25:01]
TRADITIONALLY THE MOSQUITO, RIGHT? SIGNS AND SYMPTOMS ARE FLU-LIKE SYMPTOMS, UM, SIMILAR TO, TO A LOT OF OTHER THINGS, RIGHT? SO THE KEY HERE IS IF YOU WERE EXPERIENCING FLU-LIKE SYMPTOMS, UM, YOU'VE HAD RECENT EXPOSURE AS MANY, MANY OF US, ESPECIALLY LIVING IN TEXAS, HAVE HAD, YOU'VE HAD RECENT EXPOSURE, UM, AND A AND A LOVE TAP FROM, UH, MOSQUITOES TO, UM, GO TO YOUR PRIMARY CARE PROVIDER, UM, AND GET TESTED. 
          UM, THAT BEING SAID, FOR MOST, UM, WEST NW VIRUS, JUST LIKE MOST THINGS ARE, IS, IS SELF-LIMITED. 
          NOW, I, I'M NOT GONNA SAY THAT YOU FEEL GREAT WHEN YOU, WHILE YOU HAVE IT, UM, YOU CERTAINLY FEEL LIKE YOU HAVE THE FLU BODY ACHES, FEVER, CHILLS, ET CETERA. 
          UM, BUT FOR MOST IT'S SELF-LIMITED. 
          UM, THERE ARE SOME WHO EXPERIENCE, UH, LONGER SYMPTOMS AND CAN EVEN EVEN EXPERIENCE SOME TRANSIENT PARALYSIS, UM, CALLED GUILLAIN-BARRE SYNDROME. 
          UM, THAT IS A RARE CONDITION. 
          BUT OBVIOUSLY IF YOU ARE BEGINNING TO EXPERIENCE, UM, SOME ABNORMAL SYMPTOMS, THE BEST THING TO DO AGAIN, IS TO SEEK CARE, UH, FROM A PROVIDER. 
          UM, D UH, DR. 
          PER, DID YOU HAVE ANYTHING THAT YOU WANTED TO ADD? NO, NO. 
          I JUST, YOU KNOW, THE, THE, THE USUAL AT-RISK POPULATIONS, THE ELDERLY, THE CHRONIC ILLNESS INFANTS, YOU KNOW, THOSE ARE THE ONES WHO ARE AT GREATER RISK FOR HAVING THE, THE COMPLICATIONS AND THEY CAN BE SEVERE AS YOU'VE DESCRIBED. 
          SO, YOU KNOW, PROTECT YOURSELF FROM MOSQUITO BITES ALL THE TIME. 
          WELL, HOW WOULD AN AVERAGE PROVIDER ACTUALLY KNOW TO TEST FOR WESTBOUND NOW, ESPECIALLY NOW, YOU KNOW, WE HAVE COVID, YOU KNOW, MONKEY PX, YOU KNOW, THAT'S A REALLY GREAT, GREAT QUESTION. 
          UM, AND AND SIMILAR TO, UM, MONKEY. 
          SO NOT SO MUCH COVID RIGHT NOW, BUT MONKEYPOX AND WEST NILE REALLY IS MORE OF A DIAGNOSIS OF EXCLUSION. 
          THERE'S SO MANY MORE COMMON THINGS THAT CAN HAPPEN THAT THOSE SHOULD BE TESTED FIRST. 
          SO, FOR INSTANCE, FLU SHOULD BE TESTED FIRST. 
          WE ARE MOVING INTO FLU SEASON. 
          UM, COVID SHOULD BE TESTED FIRST. 
          UM, OTHER BACTERIAL INFECTIONS THAT CAN CAUSE, UM, SIMILAR SYMPTOMS PERHAPS DEPENDING ON THE PRESENTATION, DEPENDING ON THE AGE OF THE PATIENT, ET CETERA. 
          AGAIN, THERE ARE COMMON THINGS THAT, COMMON IS ALWAYS MORE COMMON, COMMON. 
          BUT ONCE YOU'VE TESTED AND THOSE THINGS ARE NEGATIVE AND YOU STILL HAVE A SYMPTOMATIC PATIENT, THEN YOU BEGIN TO LOOK AT OTHER DIAGNOSES. 
          WELL, THAT'S THE END OF OUR TIME, , AND I REALLY APPRECIATE THE WAY THAT Y'ALL HAVE ANSWERED THE DIVERSITY OF QUESTIONS THAT REALLY WERE, UH, CAME OUT OF, UH, CA KATHY'S LIST. 
          UH, THANK YOU FOR JOINING US FOR COVID-19 TALKS WITH LOCAL HEALTH AUTHORITIES. 
          UH, DR. 
          ERICA BROWN, REPRESENTING HARRIS COUNTY, DR. DAVID PURSE, REPRESENTING THE CITY OF HOUSTON. 
          SPECIAL THANKS TO OUR PRODUCERS, DAVID CASTILLO AND PRISCILLA KEY. 
          UH, SPECIAL THANKS TO PAST PRESIDENT ROTARY CLUB OF HOUSTON, KATHY FINNER, WHO KEEPS REALLY BRINGING THE QUESTIONS IN NOT ONLY ABOUT COVID, BUT OTHER PUBLIC HEALTH ISSUES. 
          I'M STEVEN WILLIAMS, DIRECTOR OF THE HOUSTON HEALTH DEPARTMENT.
* This transcript was created by voice-to-text technology. The transcript has not been edited for errors or omissions, it is for reference only and is not the official minutes of the meeting.