* 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. [00:00:14] WELL, GOOD MORNING. WELCOME TO COVID TO 19 TALK. I'M YOUR HOST, DR. JANINA WHITE WITH THE HOUSTON HEALTH DEPARTMENT, FILLING IN FOR DIRECTOR STEVEN WILLIAMS. WITH US TODAY IS OUR LOCAL HEALTH AUTHORITIES, DR. DAVID PURSE, WITH THE HOUSTON HEALTH DEPARTMENT, AS WELL AS DR. ERICA BROWN WITH HARRIS COUNTY PUBLIC HEALTH. SPECIAL THANKS TO THE ROTARY CLUB OF HOUSTON, PAST PRESIDENT KATHY FINNER AND OUR PRODUCERS, DAVID CASTILLO AND PRISCILLA KEY. SO LET'S GET STARTED, AND I'M SO GLAD TO BE BACK WITH BOTH OF YOU ALL THIS MORNING. UH, JUST AS A STARTING FOR STATUS IN THE LANDSCAPE OF THE CITY AND COUNTY, UH, STATUS FOR COVID, UH, DR. BROWN, CAN YOU MAYBE GIVE US SOME CURRENT UPDATES ON THE STATUS FOR CO AS WELL AS MONKEYPOX? SURE. SO, UM, UM, FOR COVID, I APOLOGIZE, I DON'T HAVE THE STATS OTHER THAN WE ARE YELLOW, UH, ACCORDING TO OUR GRADING SYSTEM, WHICH IS A GREAT THING. THAT'S ONE STEP AWAY FROM GREEN. LET'S, LET'S STAY THERE AND KEEP TRENDING IN THE RIGHT DIRECTION. UM, SPECIFIC TO MONKEYPOX THOUGH, UM, THERE ARE A TOTAL OF 599 CASES, UH, IN THE COUNTY AS OF YESTERDAY. UH, OF THOSE 471 WERE ATTRIBUTED TO CITY OF HOUSTON AND 128 WERE WERE ATTRIBUTED TO UNINCORPORATED HARRIS COUNTY. DR. PER, DO YOU WANNA GO AHEAD? I WAS GONNA SAY THANK YOU, DR. BROWN, AND I'LL KICK IT TO YOU, DR. PER FOR SOME STATS. BUT ONE OF THE OTHER QUESTIONS THEY ASKED FOR STATS, SO I WAS LEAVING THIS FOR YOU ESPECIALLY, IS POLIO AND WASTEWATER, AND THEN THEY ASK ABOUT FENTANYL. YEAH. SO NEW QUESTION ABOUT A FENTANYL. OKAY, SO WITH THE POLIO, IT, IT'S INTERESTING. SO, UH, WE ARE PREPARING TO START TESTING FOR POLIO IN THE WASTEWATER. BUT A COUPLE OF THINGS PEOPLE NEED TO UNDERSTAND IS THAT WE ARE ALMOST CERTAINLY GOING TO FIND POLIO IN THE WASTEWATER. AND THE REASON IS THERE ARE MANY PEOPLE WHO TRAVEL TO HOUSTON WHO WERE RECENTLY VACCINATED WITH THE ORAL POLIO VACCINE IN CENTRAL AND SOUTH AMERICA. AND SO THEY WILL EXCRETE THAT VACCINE INTO THE, UH, SEWER SYSTEM. AND SO WE WILL, WE'LL PICK IT UP THERE. THAT DOES NOT MEAN THAT WE HAVE VIRUS SPREADING THROUGHOUT THE COMMUNITY. SO WE EXPECT THAT WE WILL FIND SOME, WE'RE GONNA HAVE TO THEN TRACK TO SEE IF IT'S GOING UP, GOING DOWN. AND THE REALITY IS THERE, THERE, THERE WE WILL ALSO BE ABLE TO WORK WITH THE CDC BECAUSE THE, THE SPREAD THAT'S OCCURRING IN NEW YORK IS ACTUALLY FROM SOMEBODY WHO GOT INFECTED BY SOMEBODY ELSE WHO HAD RECEIVED THE ORAL POLIO VACCINE. AND IN VERY RARE CASES, THAT VACCINE WILL REVERT BACK TO AN INFECTIOUS FORM. UH, THE REASON THAT THAT FORM OF VACCINE IS USED IN OTHER PARTS OF THE WORLD, NOT IN THE UNITED STATES, IS BECAUSE IT'S EXTREMELY INEXPENSIVE. IT'S PENNIES PER DOSE AND IT BE GIVEN ORALLY. AND SO IN A LOT OF PLACES, UM, IT'S JUST EASIER TO, TO VACCINATE LARGE NUMBERS OF PEOPLE THAT WAY. BUT THERE IS IS THIS SMALL RISK THAT IT WILL REVERT BACK TO AN INFECTIOUS TYPE. THAT'S WHY HERE IN THE UNITED STATES, WE DON'T USE THE ORAL FORM. WE HAVEN'T IN A COUPLE OF DECADES NOW. UM, AND SO THE CASE IN NEW YORK WAS SOMEBODY WHO HAD GOT EXPOSED TO SOMEONE AND IT REVERTED BACK. THEY'VE DETESTED THE WASTEWATER IN THE NEW YORK CITY AREA AND THEY FOUND THAT THERE IS A FAIR AMOUNT OF IT, AND THEY CAN DETECT WHETHER IT IS THE INFECTIOUS FORM VERSUS JUST THE, THE VACCINE FORM. UH, AND WE WILL WORK WITH THE CDC. SO ONCE WE GET OUR SAMPLES BACK, OUR INITIAL SAMPLES WILL ALMOST CERTAINLY BE POSITIVE, BUT WE WILL THEN HAVE TO GO TO THAT NEXT LEVEL TO SEE IF WE HAVE ANY INFECTIOUS FORM. UM, SO, UH, KEEP, YOU KNOW, STAY TUNED FOR THAT. SO THAT'S A BIG LONG ANSWER ABOUT POLIO, FENTANYL. FENTANYL IS ALSO ANOTHER, UH, STORY THAT WE NEED TO BE PAYING ATTENTION TO. THE AMOUNT OF FENTANYL THAT IS BEING, UH, CONFISCATED BY, UH, LAW ENFORCEMENT LOCALLY GOES UP YEAR AFTER YEAR AFTER YEAR. AND IT'S, IT'S EXTREMELY HIGH. NOW, UH, IN ADDITION, THE, UH, THE FORMS OF FENTANYL, THERE'S NOT JUST ONE FORM OF FENTANYL. THERE ARE NOW MULTIPLE FORMS OF FENTANYL IN THE, THE, UH, CHEMISTS, IF YOU WILL, THAT MAKE FENTANYL DO THAT ON PURPOSE FOR A COUPLE OF REASONS. ONE IS THEY'RE TRYING TO MAKE IT EVEN MORE POTENT MM-HMM . SO THAT PEOPLE WILL HAVE A MORE IMPACTFUL, UM, HIGH WITH LESS AMOUNT OF DRUG THAT THEY HAVE TO SMUGGLE ACROSS THE BORDER. UH, SO THAT'S ONE REASON THEY DO IT. THE OTHER REASON THEY DO IT IS IT IS EVERY TIME THEY CHANGE IT, IT KICKS AROUND SOME OF THE TESTING THAT WE CAN DO. SO HERE IN THE HOUSTON AREA, WE DON'T USE THE, UH, TEST STRIPS. AT LEAST LAW ENFORCEMENT DOESN'T USE THE TEST STRIPS BECAUSE THE TEST STRIPS WILL SOMETIMES COME UP NEGATIVE BECAUSE IT ISN'T TESTING FOR THE MOST CURRENT FORM OF FENTANYL THAT'S ON THE STREET. SO IT DOESN'T REALLY DO US A WHOLE LOT OF GOOD. THEY HAVE TO ACTUALLY SEND IT TO THE CRIME LAB. THE CRIME LAB CAN TEST FOR ALL THE DIFFERENT FORMS. MORE WORRISOME IS THAT THE FORM THE, UH, UH, THE FENTANYL IS NOW COME TO THE UNITED STATES IS STUFF THAT'S TARGETED TOWARDS CHILDREN. THIS IS REALLY, REALLY SCARY. SO A COUPLE THINGS. ONE IS NOW, YOU KNOW, STREET CHALK. THERE IS A FORM OF FENTANYL THAT IS BEING SOLD IN THE STREET THAT LOOKS LIKE A PIECE OF STREET, UH, OF CHALK FOR KIDS TO DRAW [00:05:01] THINGS ON THE, ON THE SIDEWALK. THE PILLS ARE COMING BRIGHTLY COLORED, PURPLE, PINK, ORANGE, RED, GREEN. UM, SOME OF THEM ARE, UH, IMPRINTED WITH VERY SOPHISTICATED PILL PRICES LOOK LIKE, JUST LIKE THE STUFF THAT YOU GET IN THE PHARMACY EXCEPT FOR THEY'RE BRIGHTLY COLORED, THEY GET MORE ATTRACTIVE FOR CHILDREN. THAT IS NOT BY MISTAKE, THAT IS NOT BY ACCIDENT, THAT IS ON PURPOSE. IN ADDITION, THEY'RE NOW CUTTING IT FOR THE PEOPLE WHO IN WHO SMOKE OR INJECT, UM, THE FENTANYL, UM, PRETTY GOOD. THOSE WHO SMOKE IT OR, OR ORALLY INGEST IT, THEY'RE NOW GIVING IT A HONEY FLAVOR SO THAT, UM, YOU KNOW, IT, I DON'T KNOW, IT TASTES LIKE HONEY NOW. UM, ALL KINDS OF BAD NEWS WHEN IT COMES TO FENTANYL. UM, YEAH, SO THAT'S THE ANSWER ON FENTANYL. NONE OF IT'S GOOD. NO. UH, THANK YOU FOR SHARING THAT. I KNOW WITH THE PUBLIC HEALTH UPDATES, COVID WAS THE LEADING CAUSE OF DEATH IN THE 20 19, 20 DATE, I BELIEVE, 2021 DATA, BUT THEN, UH, ACCIDENTAL, UH, OVERDOSE, WHAT YOU'RE MENTIONING IN ALL THESE DIFFERENT FORMS THAT IT TAKES. AND CERTAINLY SOMEONE'S NOT INTENDING TO REALLY HAVE THEMSELVES HAVE THAT SELF-HARM THAT WAY. SO NOW THAT'S BECOME THE NUMBER, NUMBER TWO. SO THANK YOU FOR SHARING ALL THAT INFORMATION AND A LOT OF GOOD INFORMATION. SO NEXT GROUP OF QUESTIONS ARE ABOUT TESTS FOR COVID. UH, FDA HAS EXTENDED THE EXPIRATION DATE ON TESTS. DO EITHER OF, YOU KNOW, DO EXPIRED KITS NOT WORK AT ALL? YEAH. SO, UM, THIS IS A, A REALLY GOOD QUESTION. UM, IT IS NOT RECOMMENDED TO USE EXPIRED KITS EXCEPT FOR THE ONES THAT THE FDA HAS SENT OUT. UM, INFORMATION ABOUT WHICH ONES THEY HAVE EXTENDED THE EXPIRATION DATE, WHICH TECHNICALLY MEANS THEY ARE NOT EXPIRED. UM, THERE IS A LIST THAT YOU CAN REFER TO, UM, AND VISIT AT DASH HOME OTC COVID-19 DIAGNOSTIC TESTS. AND THIS IS, UH, AT FDA.GOV THAT WILL GIVE YOU A LIST OF THE TESTS THAT THEY'VE EXTENDED THE EXPIRATION DATE FOR. THOSE ARE THE ONLY ONES THAT CAN BE USED. ANYTHING ELSE THAT HAS AN EXPIRATION DATE THAT IS NOT ON THAT LIST, THE REAGENTS, UM, MAY HAVE DETERIORATED SOME, AND SO YOU MAY NOT GET, UM, UM, UM, ACCURATE RESULTS. SO IT'S NOT RECOMMENDED TO USE THEM. SO IF YOU HAVE AN EXPIRED TEST AND YOU'RE NOT SURE WHETHER THE IT'S BEEN APPROVED TO BE EXPANDED, GO TO FDA.GOV. UM, I THINK THEY HAVE IT UP, IT'S UP ON OUR SCREEN NOW. UM, AND THEN, AND TAKE A LOOK AT THE TEST THAT YOU HAVE AND SEE IF THE EXPIRATION DATE, UM, IS, UH, UM, STILL GOOD. I WILL SAY TOO, UM, IF YOU HAVE EXPIRED TESTS, UM, PLEASE GO AHEAD BY TOMORROW AND REORDER. UM, UM, THE, THE GOVERNMENT, THE FEDERAL GOVERNMENT HAS ANNOUNCED THAT TOMORROW THEY WILL STOP, UM, EXTENDING THE FREE TESTING, UM, TESTING, UM, UM, PLAN THAT WE HAVE. SO IF YOU WOULD LIKE ADDITIONAL TESTS, PLEASE GO AHEAD AND ORDER THEM BY TOMORROW. TOMORROW WILL BE THE LAST DAY THAT THEY'LL BE FREE. THANK YOU FOR SAYING THAT. SOMEONE DID ASK US THAT QUESTION. SO GOOD INFORMATION WITH REGARDS TO TRANSMISSION AND A SET, A SET OF QUESTIONS ON TRANSMISSION. UH, JAPANESE AND TAIWANESE ARE AMONG THE WORLD'S MOST FASTIDIOUS IN MASK WEARING AND QUARANTINING AS OPPOSED TO TEXAS, WHEREAS SPORT EVENTS, MASKS AND DISTANCING ARE NON-EXISTENT, YET THE INFECTIONS, HOSPITALIZATIONS AND DEATH RATES ARE HIGHER IN THE ORIENT WHERE THE HOAX, I DON'T KNOW IF EITHER ONE OF YOU WANNA, THAT MAY BE MORE OF JUST A STATEMENT, YOU KNOW, SO I'LL, I'LL TAKE THAT AND I WOULD, UM, TO EVERYONE WHO'S LISTENING, YOU KNOW, THERE'S A GREAT RESOURCE. IT'S CALLED, UH, WORLD O METERS. AND IF YOU GO TO WORLD O METERS, UH, THERE IS A CORONAVIRUS TAB AND IT HAS THE, UH, CORONAVIRUS ACTIVITY SINCE THE BEGINNING OF THE PANDEMIC FOR EACH INDIVIDUAL COUNTRY. AND THEN WITHIN THE UNITED STATES, YOU CAN ACTUALLY BREAK IT DOWN, UH, TO A STATE. AND IF YOU LOOK AT JAPAN AND TAIWAN, YOU'LL FIND THAT THEY HAD EXTREMELY LOW NUMBERS OF CORONAVIRUS UP UNTIL REALLY JUST THIS YEAR. UH, AND WHEN YOU DIG INTO THAT AND FIND OUT, YOU KNOW, WHAT CHANGED, BECAUSE THEY HAVE HAD A, A SIGNIFICANT INCREASE IN CORONAVIRUS CASES, HOSPITALIZATIONS AND DEATHS, WHICH THEY DID NOT SEE IN THE FIRST TWO YEARS OF THE PANDEMIC, WHICH YOU'LL SEE IS TWO THINGS HAVE HAPPENED. ONE IS IN THOSE COUNTRIES THEY'VE LOOSENED UP ALL THE RESTRICTIONS THAT THEY HAD IN PLACE. THEY KEPT THEM SO CORONAVIRUS, UM, I DON'T WANNA SAY CORONAVIRUS FREE, BUT MINIMAL IMPACT, THEY'VE LOOSENED UP A LOT OF THOSE RESTRICTIONS. AND THAT OCCURRED AT THE SAME TIME THAT WE WENT INTO THE OMICRON VARIANT, WHICH IS EXTREMELY CONTAGIOUS. AND SO THEY'RE DEALING WITH SOME SERIOUS PROBLEMS NOW BECAUSE THEY BASICALLY HAVE GOT A, UH, COMMUNITY THAT HAS NO HERD IMMUNITY FROM PREVIOUS INFECTION. UM, IN TAIWAN, FOR EXAMPLE, THEY ALSO HAD A PROBLEM WITH WHEN VACCINE BECAME AVAILABLE, THERE WAS A LOT OF, UH, ANTI-VAX RHETORIC THAT WENT AROUND. AND SO THEY HAD A HARD TIME GETTING PEOPLE TO BE VACCINATED. SO COMPARED TO THE UNITED STATES WHERE WE'VE GOT A FAIR AMOUNT OF HERD IMMUNITY, EITHER THROUGH VACCINATION OR PREVIOUS INFECTION IN JAPAN AND IN TAIWAN IN PARTICULAR, UH, VERY LITTLE HERD IMMUNITY FROM PREVIOUS INFECTION. AND [00:10:01] THEY'RE ALSO DEALING WITH THE SAME PROBLEMS WE ARE WITH THE, UM, THE STIGMA THAT'S BEEN BROUGHT AROUND VACCINE AND, AND SO ON AND SO FORTH. SO, UH, THAT'S, THAT'S THE CHANGE. AND I SEE THAT WE'VE GOT THE WORLD OF METERS, UM, UP THERE NOW, AND I, I MISSED WHICH COUNTRY THIS MIGHT BE, BUT YOU CAN CLICK ON ANY COUNTRY IN, IN THE WORLD AND GET, UH, SO THERE'S A GRAPHIC THERE TO GET THE NEW CASES ACROSS THE ENTIRETY OF THE PANDEMIC. GREAT, THANK YOU. THE, THE COUNTY SPENT A LOT OF MONEY EARLY BUILDING AND BRAGGING ABOUT RELIANT PARKING LOT, COVID 10 CITY AND EVEN STAFF THAT WAS SET TRACKED NURSES, NO PATIENTS EVER WENT THERE. WHY? SO I'M NOT REALLY SURE HOW TO ADDRESS THAT QUESTION. I WILL SAY THOUGH, THAT, UM, THOUSANDS OF PEOPLE SERVED, UM, AT INNER PARK, UM, DURING THE HEIGHT OF THE PANDEMIC, UH, WHEN THE DEMAND FOR VACCINE WAS HIGH. UM, UM, I THINK WE ALL SAW THAT THE LINES, UM, TO BE VACCINATED WERE OUT OF THE PARKING LOT. SO, UH, I WILL LEAVE IT THERE THAT I'M, I, I DISAGREE THAT, THAT THERE WAS, UH, MONEY WASTED. UM, AS ANY VACCINES THAT WE CAN MAKE AVAILABLE TO THE PUBLIC IS CERTAINLY WORTH IT. YOU KNOW, WHAT, DO YOU WANT ME TO AGAIN, ADD A LITTLE BIT? 'CAUSE THAT TENT CITY FOR THE HOSPITAL THAT WAS SET UP. SO, UM, THIS IS A GOOD NEWS STORY. SO, UH, YOU KNOW, A LOT OF MONEY WAS SPENT AND WE WOUND UP NOT HAVING TO, TO NEED THAT, THAT THAT'S REALLY BECAUSE THE LOCAL HOSPITALS WERE ABLE TO REALLY AMAZINGLY FIGURE OUT A WAY TO MANAGE THE LOAD SO THAT PATIENTS DIDN'T NEED TO SPILL OVER INTO THAT. REMEMBER, THAT IS NOT A GREAT PLACE IN A PARKING LOT OF A, OF A STADIUM. IT'S NOT A GREAT PLACE TO BE TAKING CARE OF PATIENTS, EVEN THOUGH YOU'VE GOT TENTS AND SO ON AND FORTH. WE'VE HAD TO DO THINGS LIKE THAT DURING HURRICANE SUCTION IN THE PAST, BUT I'LL TELL YOU, AS A PHYSICIAN, THAT IS NOT AN IDEAL PLACE TO BE TAKING CARE OF PATIENTS. SO THE, THE FACT THAT WE WERE ABLE TO AVOID THAT, THAT'S A GOOD NEWS STORY. THE FACT THAT WE HAD THE FORESIGHT AND THE RESOURCES TO PUT IT UP, SHOULD WE HAVE NEEDED IT, THAT'S A GOOD NEWS STORY. SO THE FACT THAT WE DIDN'T USE IT IS, IS NOT NEGATIVE AT ALL. IT'S, IT'S ACTUALLY, YOU KNOW, IT'S THE WAY IT WAS AND WE SHOULD BE ACTUALLY BE THANKFUL THAT WE DIDN'T NEED TO USE IT. THANK YOU, DR. PER, SO HERE'S ANOTHER, I KNOW, UH, NEAR TO BOTH OF YOUR HEARTS, SO I'LL GO QUICK WITH THIS ONE. WHY IS THE COVID RATE IN THE COUNTY JAIL SO LOW? I'M GONNA LET DR. BROWN TAKE THAT ONE. . THANK YOU, SIR. . UM, SO THE, THE JAIL PUT IN, UM, UM, ABSOLUTELY WORKING IN BOTH PARTNERSHIP WITH HOUSTON HEALTH DEPARTMENT, THE JAIL PUT IN SOME PRETTY STRICT, UM, UM, QUARANTINE REQUIREMENTS FOR ANY NEW COMING, UM, DETAINEES. UM, AND SO EVEN THOUGH IT WAS A CONGREGATE SETTING, UM, THERE WAS, THERE WAS RECOGNITION BY THE HEALTH DEPARTMENT AND CERTAINLY BY, UM, THE SHERIFF'S OFFICE AND THE JAIL STAFF THAT THERE WAS A, A HIGH POTENTIAL FOR A REAL PROBLEM WITH COVID IN, IN SUCH A LARGE CONGREGATE SETTING. AND SO, UM, UM, I, I THINK THAT, AGAIN, TO USE DR. PERCY'S, UH, WORDS, THIS IS REALLY A GOOD NEWS STORY BECAUSE THEY HAD THE OPPORTUNITY TO REALLY CONTROL THE POPULATION, UM, AS OPPOSED TO IN THE GENERAL PUBLIC WHERE, YOU KNOW, PERHAPS NOT SO MUCH, UM, WITH REGARD TO QUARANTINE AND, AND REQUIRING ALL NEW DETAINEES TO, UM, UM, BE QUARANTINED FOR A CERTAIN TIME PERIOD, UH, WHILE THEY WERE BEING TESTED, AND IF THEIR TEST WAS POSITIVE, TO THEN MAKE SURE THAT THEY WERE ISOLATED APPROPRIATELY, UM, SO THAT IT DID NOT SPREAD, UM, IN SUCH A, A LARGE CONGREGATE SETTING. SO IT WAS, IT WAS REALLY A NEW STORY. YEAH. MM-HMM . GREAT NEWS STORY, DR. BROWN, GREAT WORK THAT YOU DID, UM, HAS COVID CROSSED OVER TO PETS AND DOGS. SO IT HAS, UH, IT'S VERY RARE, BUT WE'VE SEEN IT WITH, UH, CATS AS WELL MM-HMM . AND, UH, WHAT WE'VE NOT SEEN, AT LEAST THAT I'M NOT AWARE OF, IS IT COMING BACK FROM A PET TO, UH, A HUMAN. BUT THERE ARE A HANDFUL OF CASES WHERE, UH, A HOUSEHOLD PET, NORMALLY A CAT OR A DOG, UH, HAVE BECOME INFECTED BY SOMEBODY, UH, WHO IS INFECTED IN THE HOUSEHOLD. SO YES, IT CAN HAPPEN, AND, UM, BUT YOU KNOW, WHEN YOU CONSIDER THE MILLIONS OF PEOPLE WHO GOT INFECTED AND THE MILLIONS OF PETS WE HAVE AT HOME MM-HMM . REALLY SMALL NUMBERS, WE HAVE SOME RESEARCH QUESTIONS. SO LET ME GO TO A FEW RESEARCH QUESTIONS, UH, A LITTLE BIT OF A RAPID FIRE TO LEAVE TIME. I KNOW WE HAVE SOME MONKEYPOX QUESTIONS AT THE END. A RECENT STUDY, DR PER JAMA, SUGGESTS THAT AS COVID-19 MUTATES, THE INCUBATION TIME DECREASES LOGICAL. SO IT IS A LITTLE BIT LOGICAL IF YOU THINK ABOUT IT. YOU HAVE A VIRUS THAT'S SPREADING AROUND THE GLOBE. IT'S THE, IT IS THE VIRUS BECAUSE IT SPREADS MORE EFFECTIVELY THAN ANYONE ANYTHING ELSE THAT'S AVAILABLE UNTIL THE NEW ONE COMES ALONG THAT SPREADS EVEN MORE EFFECTIVELY. WELL, PART OF THAT IS NOT ONLY WILL IT SPREAD MORE EFFECTIVELY, IT WILL ALSO PROBABLY HAVE A SHORTER INCUBATION PERIOD. AND SO THIS DOES MAKE SENSE, AND, UH, IN FACT, JAMA DID FIND THAT, BUT THIS ALL HAS TO DO WITH WHAT MAKES THE NEXT VIRUS THE MOST [00:15:01] PREDOMINANT ONE IN ITS ABILITY TO INFECT PEOPLE MORE QUICKLY, MORE EFFECTIVELY, AND SO THAT IT THEN TURNS AROUND AND SPREADS TO ANOTHER PERSON. SO, YEAH, THIS DOES MAKE SENSE. THANK YOU. UH, DR. BROWN, A NEW STUDY IN BRITISH JOURNAL OF MEDICINE SUGGESTS THAT 20 MINUTES OF DAILY EXERCISE SEEMS TO BE RELATED TO A LOWER LIKELIHOOD OF ADVERSE COVID OUTCOMES. IS THIS SOUND ADVICE FOR COVID OR JUST BEING HEALTHIER IS GOOD FOR EVERYONE? BOTH. SO IT SOUND ADVICE FOR, TO BE HEALTHIER FOR EVERYONE, THIS IS SOMETHING THAT WE'VE HEARD FOR MANY, MANY YEARS NOW THAT EXERCISE IS CERTAINLY RECOMMENDED. MODERATE EXERCISE DAILY IS CERTAINLY RECOMMENDED. UM, THERE WAS A STUDY DONE, UM, THAT FOUND THAT, UM, UM, MODERATE EXERCISE AND A, AND A LITTLE BIT LESS VIGOROUS EXERCISE, UM, DID AFFECT THE RISK OF, UH, UM, COVID HOSPITALIZATION AND SEVERE DEATH. I THINK WHAT STILL REMAINS TO BE SEEN AND, AND NOT SURE THAT IT REALLY MATTERS, FRANKLY, RIGHT, IS WHETHER IT'S SPECIFICALLY RELATED TO COVID INFECTION OR IS IT RELATED TO JUST BEING HEALTHIER. SO I THINK THAT THE TAKE HOME MESSAGES EXERCISE HELPS YOU BE HEALTHIER, WHICH IN TURN HELPS YOU FIGHT INFECTION. OKAY. DR. PER WILL, WILL WE BE ASKING THE QUESTION, DID THE PATIENT COME TO THE HOSPITAL WITH OR FOR MONKEYPOX? WE WILL TO SOME DEGREE. NOW WITH MONKEYPOX, IT'S, IT, YOU KNOW, IT'S THE PATIENTS WHO NEED HOSPITALIZATION ARE DIFFERENT AND SAY, COVID. AND I THINK WE'RE RELATING THIS QUESTION TO OUR EXPERIENCE WITH COVID. MOST OF THE PATIENTS WHO ARE GONNA WIND UP BEING HOSPITALIZED, AT LEAST SO FAR, ARE BEING ADMITTED FOR PAIN CONTROL BECAUSE THE LESIONS ARE SO EXTREMELY PAINFUL. THOSE WILL BE PEOPLE WHO ARE ABSOLUTELY BEING ADMITTED OR MONKEYPOX OR BECAUSE OF MONKEYPOX BECAUSE THE LESIONS ARE PAINFUL. THERE'S, YOU KNOW, THERE WON'T BE MUCH CONFUSION THERE. NOW, WHEN IT COMES TO PATIENTS WHO DIE, UH, WHICH HOPEFULLY THERE'LL BE VERY FEW, THEN THERE WILL BE THE QUESTION, AND, AND ON AUTOPSY, THEY'LL PROBABLY BE ABLE TO FIGURE IT OUT BECAUSE THE PEOPLE WHO ARE GONNA GO ON TO HAVE THE MOST SERIOUS COMPLICATIONS WILL BE MOST LIKELY THOSE WHO'VE GOT OTHER COMORBIDITIES OCCURRING. AND SO THEN THE QUESTION IS, DID THE MONKEYPOX INFECTION JUST HAPPEN TO BE COINCIDENTAL WITH THAT? WAS THE MONKEY POX TO CONTRIBUTE? DID IT TAKE A PREVIOUS EXISTING ILLNESS, SORT OF PUSH IT OVER THE EDGE, OR DID THE PATIENT DIE SPECIFICALLY BECAUSE OF THEIR MONKEYPOX INFECTION? SO THE DEATH CASES, IT MAY BE A LITTLE BIT MORE CONFUSING, BUT FOR MOST OF THE REST IT'LL BE ADMITTED FOR PAIN CONTROL. THAT'LL BE BECAUSE OF, UH, MONKEY BECAUSE OF GREAT. THANK YOU FOR THAT. DR. BROWN LANCET INFECTIOUS DISEASE HAS PUBLISHED A STUDY USING A 20-YEAR-OLD REGARDING THE VO O2 MAXIMUM AFTER CONTRACTING OR RECOVERING FROM COVID. ARE WE SEEING SIMILAR OUTCOMES IN HARRIS COUNTY? AND IT WAS A REFERENCE TO THE A LANCET ARTICLE. YEAH, SO, SO, UM, LUNG VOLUME IS, IS ONE OF THE WAYS THAT WE MEASURE THE HEALTH OF THE LUNGS. UM, AND SO WHEN WE SEE DECREASED, UH, UM, VOLUME, IT'S A HALLMARK OF, OF, OF LUNG DISEASE. THIS STUDY, UH, WAS DONE IS, IS LIMITED THOUGH IT WAS DONE IN YOUNG ADULTS IN THE SWISS ARMED FORCES. UM, AND THE PHYSICAL COMPLICATIONS OF COVID, UH, CAN PERSIST FOR MONTHS AND CAN CAUSE SOME IMPAIRMENT. BUT, UM, NOT SURE THAT THIS STUDY REALLY TELLS US VERY MUCH AT THIS POINT BECAUSE IT WAS SO LIMITED. SO I CAN'T REALLY COMMENT ON WHETHER WE'RE SEEING SIMILAR OUTCOMES IN HARRIS COUNTY, BUT THERE IS A POSSIBLE RELATIONSHIP, AGAIN TO, UM, LUNG DAMAGE AND THE FACT THAT COVID DOES, UH, UM, CERTAINLY AFFECT THE LUNGS AT LEAST FOR, UH, SOME TIME. THANK YOU. SO SOMEONE MUST BE FOLLOWING YOU, DR. PER 'CAUSE I THINK YOU'VE HAD THIS COME UP MULTIPLE TIMES IN, UH, OUR, OUR, UH, SHOWS IS THAT THEY ASKED MORE THAN 60 YEARS AGO, A VIROLOGIST NAMED THOMAS FRANCIS JR. COINED THE TERM, THE DOCTRINE OF ORIGINAL ANTIGENIC SIN. SO I KNOW I'VE HEARD YOU SPEAK ON THIS. SO THEIR QUESTION IS, DO YOU THINK THE SAME THING IS HAPPENING WITH THE CORONAVIRUS? SO IT'S A LITTLE BIT TOO EARLY TO KNOW. SO THE CONCEPT OF ORIGINAL ANTIGENIC SIN IS THAT IF YOU ARE VACCINATED AGAINST A DISEASE AND IN, WE'LL USE CORONAVIRUS AS EXAMPLE. SO THE VACCINE THAT'S OUT THERE NOW IS AGAINST THE ORIGINAL, UH, THE ORIGINAL VERSION OF THE, OF THE VIRUS. THAT'S WHAT YOUR CURRENT VACCINES ARE UP UNTIL PERHAPS NEXT WEEK. UM, THE THEORY OR THE CONCERN IS THAT YOUR IMMUNE SYSTEM THEN BECOMES IMPRINTED, SUCH THAT WHEN YOU GET VACCINATED FOR SOMETHING, WHICH IS LIKE THE COUSIN OF THAT, THAT IT WON'T RESPOND, UM, AND DEVELOP IMMUNITY TO THE COUSIN BECAUSE IT'S, IT'S GOT TUNNEL VISION, IF YOU WILL, ON THE ORIGINAL ANTIGEN THAT IT WAS, UH, CONDITIONED TO RESPOND TO. NOW, THE LABORATORY STUFF THAT THEY'VE DONE WITH THE MICE, UH, SUGGESTS THAT'S NOT NECESSARILY GONNA BE THE CASE HERE. UH, BUT YOU KNOW, HUMANS ARE NOT MICE. AND SO AS WE GO FORWARD WITH THE BA FIVE, UM, AND YOU KNOW, THE NEW BIVALENT THAT'S COMING OUT THAT'S GONNA HAVE PROTECTION AGAINST BA FIVE AND HUMANS WILL WILL FIND OUT, IT'S, IT'S CERTAINLY NOT GONNA MAKE ANYBODY, YOU KNOW, IT'S NOT GONNA CAUSE ANY HARM. THE QUESTION IS, WILL YOU ACTUALLY DEVELOP THE AMOUNT OF PROTECTION AGAINST BA FIVE IN ADDITION TO THE ORIGINAL OR NOT? SO [00:20:01] WE'RE GONNA HAVE TO WAIT AND SEE, BUT THE PRELIMINARY, UH, STUFF AGAIN IN MICE SUGGESTS THAT WON'T BE A PROBLEM, BUT WE'RE GONNA HAVE TO WAIT AND SEE. THANK YOU. SO LET'S USE OUR LAST FEW MINUTES. WE'LL SWITCH TO MONKEYPOX. UH, THE QUESTION IS, IS THERE A REASON IF YOU ARE NOW IN THE RISK GROUP FOR MONKEYPOX, THAT YOU SHOULD CONSIDER GETTING A VACCINE? ABSOLUTELY. UM, SO, SO THE RISK GROUPS AGAIN INCLUDE, UH, UH, HIV POSITIVE, THOSE WHO ARE ON HIV PREP, UM, PROPHYLAXIS, UM, ANYONE WHO HAS HAD, UM, UH, ANONYMOUS SEX OR MULTIPLE SEXUAL PARTNERS WITHIN THE LAST 21 DAYS, THOSE WHO WORK IN, UM, UM, SETTINGS WHERE, UM, UM, THERE MAY BE, UM, UM, CLOSE CONTACT AND ACTIVITY, UM, SUCH AS BATH HOUSES, SAUNAS AND THINGS. ANYBODY WHO HAS HAD GONORRHEA, CHLAMYDIA OR SYPHILIS IN THE LAST YEAR, UM, UM, THE, THE, UM, UM, GAY MAN POPULATION, UM, MEN HAVING SEX WITH MEN. UM, AND THE REASON, AND OF COURSE DIRECT CONTACTS, UM, AND THE REASON THAT, UM, IT IS IMPORTANT TO GET VACCINATED IS, IS BECAUSE, UM, INDIVIDUALLY, ALTHOUGH THE DIS THE, THE, THE VIRUS IS SELF-LIMITED FOR MOST INDIVIDUALLY IT CAN BE VERY PAINFUL, UM, CERTAINLY IS IS TAKES A LOT OF TIME OUT OF YOUR DAILY LIFE BECAUSE YOU NEED TO ISOLATE AS LONG AS YOU HAVE THE VIRUS. AND THE, THE AVERAGE TIME, UM, THAT THE VIRUS LASTS IS ABOUT 21 DAYS. SO THERE'S A SIGNIF SIGNIFICANT, UM, UM, EFFECT ON, ON YOUR DAILY LIFE ACTIVITY, UM, AS WELL AS THOSE OF ANYBODY IN YOUR HOUSEHOLD, UM, AND HAVING TO ISOLATE FROM THEM AND MAKE SURE THAT YOU'RE CAREFUL NOT TO, UM, SPREAD THE, THE VIRUS TO THOSE, UH, UH, AT RISK WHO ARE AROUND YOU. UM, THE OTHER PIECE TO THIS AS WELL, UM, ONE OF THE THINGS THAT IS SIMILAR TO COVID IS THAT, UM, SOME OF THE CONCERN IS ALSO FOR THOSE THOUGH OTHER PEOPLE WHO ARE AT HIGH RISK BECAUSE THERE IS A CERTAIN POPULATION, A SMALL POPULATION, BUT IT, BUT THERE IS A POPULATION OF PEOPLE WHO IF THEY WERE TO GET INFECTED WITH MONKEYPOX, COULD REALLY SEE SEVERE DISEASE. AND SO, UM, UM, IT IS IMPORTANT TO GET VACCINATED TO MAKE SURE, UM, THAT WE'RE DOING EVERYTHING THAT WE CAN DO TO PREVENT THE SPREAD. THANK YOU. THEY ASK ONCE A PATIENT HAS FULL BLOWN MONKEYPOX, WHY DO HOSPITAL CLINIC JAIL PUBLIC HEALTH PERSONNEL TRY SO HARD TO GET THE PATIENT A, A MONKEYPOX VACCINE BY THE TIME IMMUNITY MIGHT OCCUR AFTER THE VACCINE, THEY WOULD OTHERWISE BE? WELL, SO I GUESS THERE IS A MIS I GUESS THE QUESTION IS IF YOU'RE INFECTED, YOU HAVE MONKEYPOX, SHOULD THAT INDIVIDUAL BE VACCINATED MAYBE IS WHAT THE, THE QUESTION THEY'RE ASKING? YEAH, SO THE, THE QUESTIONER IS RIGHT IN THEIR, UM, UH, PRESUMPTION IN THE, IN THE QUESTION IS THAT THE VACCINE, ONCE YOU'VE GOT FOOTBALL MONKEYPOX, THE VACCINE IS NOT GONNA OFFER MUCH, MUCH HELP AT ALL. IN FACT, YOUR OWN IMMUNITY WILL PROBABLY FROM THE INFECTION IS PROBABLY GONNA KICK IN BEFORE THE VACCINE MEMBER. IT'S A TWO SHOT SERIES FOUR WEEKS APART, AND YOU DON'T GET FULL IMMUNITY BEGINNING UNTIL TWO WEEKS AFTER THE SECOND SHOT. SO WHEN PEOPLE HAVE FULL BLOWN MONKEYPOX, THAT'S WHEN WE NEVER NEED TO START WORKING WITH OUR CLINICIAN TO SEE WHETHER OR NOT THEY QUALIFY FOR ANY OF THE OTHER ANTIVIRALS OR TPOS, FOR EXAMPLE. NOW ONE, IF YOU ARE A CONTACT OF A KNOWN CASE, YOU MM-HMM YOU KNOW, BUT YOU DON'T HAVE ANY SYMPTOMS. THAT IS SOMEBODY WHO WOULD QUALIFY, UH, FOR VACCINE AND THEY SHOULD GET IT AS QUICKLY AS POSSIBLE. IDEALLY, YOU KNOW, IF POSSIBLE WITHIN, YOU KNOW, FOUR DAYS OF THE EXPOSURE. BUT, UH, NEVERTHELESS, THAT'S GONNA BE HARD TO KNOW. 'CAUSE THE, THE CASES ISN'T GONNA HAVE TO DEVELOP SYMPTOMS. THEY'RE GONNA GO, THEY'RE GONNA GET TESTED, THEY'RE GONNA GET THE RESULTS, AND THEN AT SOME POINT THEY'RE GONNA TELL YOU ABOUT IT. SO, UM, IDEALLY WITHIN FOUR DAYS, BUT AS SOON AS POSSIBLE, IF YOU'RE A CONTACT WITH A CASE BEFORE YOU DEVELOP SYMPTOMS, AND HOPEFULLY YOU WON'T DEVELOP SYMPTOMS, UH, AT THAT POINT. THANK YOU. SO LET ME GO THE LAST QUESTION. THEY, THEY KIND OF GO TOGETHER, BUT I'LL, I'LL BE INTERESTED IN YOUR TAKE ON IT. UM, BOTH OF YOU FORMER CDC DIRECTOR ROBERT REDFIELD SAID HE WOULD NOT HAVE CLOSED SCHOOLS IN RESTAURANTS IN RETROSPECT. AND THEN THE QUESTION ALSO IS, GIVEN FAUCI IS GOING TO BE RETIRING, WAS FAUCI POLITIC, WAS DR. FAUCI POLITICALLY KICKED OFF THE SAFE POLITICAL ISLAND? SO I GUESS THE, YOU KNOW, ONE OF THE QUESTIONS CAN BE SORT OF LOOKING IN, LOOKING BEHIND US TO SEE THE DECISIONS SOME OF OUR, UH, LEADERS MADE WITH REGARDS TO THIS PANDEMIC. DO YOU GUYS HAVE ANY THOUGHTS ABOUT IT? YEAH, LET, LET ME, LET ME JUMP IN ON THIS. AND SO, UM, I DON'T KNOW THE EXACT QUOTE THAT, UH, DIRECTOR REDFIELD MADE ABOUT IT BECAUSE I THINK THAT, THAT, WHEN YOU LOOK AT THE TIMELINE OF THE PANDEMIC, UM, CERTAINLY IN THE BEGINNING, YOU KNOW, THE CLOSING SCHOOLS IS ABSOLUTELY THE LOGICAL THING TO DO. BECAUSE REMEMBER, WHAT, WHAT THE PUBLIC NEEDS TO UNDERSTAND IS WHEN WE GET INTO, UH, A, A PANDEMIC OCCURRING LIKE THIS, THE FIRST THING WE WANNA DO IS YOU WANNA SLOW IT DOWN. AND, AND PEOPLE HAVE PROBABLY FORGOT THIS CONCEPT OF FLATTENING THE CURVE, RIGHT? MM-HMM . WE TALKED ABOUT THAT A LOT IN THE FIRST COUPLE YEARS. WE DON'T TALK ABOUT THAT SO MUCH ANYMORE. SO [00:25:01] AT SOME POINT IN THE VERY BEGINNING, YOU WANNA STOP THIS THING, RIGHT? THEN YOU REALIZE, ALRIGHT, WE'RE NOT GONNA BE ABLE TO STOP IT. WE NOW NEED TO TRY TO, TO MANAGE IT AS BEST WE CAN SO THAT WE DON'T GET THIS BIG SURGE OF PEOPLE BECOMING CRITICALLY ILL ALL AT THE SAME TIME, NEEDING HOSPITALS THAT ALL AT THE SAME TIME. THIS IS THE IDEA OF SORT OF FLATTENING THE CURVE. AND SO ANYTHING YOU CAN DO TO SLOW DOWN THE SPREAD IS HELPFUL. AND THEN THE OTHER PART IS YOU'RE GONNA WANNA DO THAT UNTIL YOU HAVE SOMETHING MORE DEFINITIVE TO HELP YOU LIKE VACCINE. AND SO, A COUPLE OF THE THINGS THAT, YOU KNOW, HERE IN THE UNITED STATES, WE, WE TRIED HARD TO FLATTEN THE CURVE. ONCE WE REALIZED THAT WE WEREN'T GONNA BE ABLE TO STOP THIS, WE TRIED REALLY HARD TO FLATTEN THEIR, AND THAT INCLUDED THINGS LIKE CLOSING SCHOOLS AND CLOSING RESTAURANTS AND SO ON AND SO FORTH UNTIL VACCINE BECAME AVAILABLE. THEN AGAIN, IN THIS COUNTRY, WE HAD THIS, ALL THIS, ALL THIS DRAMA ABOUT, ABOUT VACCINE. AND IT'S, YOU KNOW, THERE'S MICROCHIPS IN IT AND IT MAKES YOU MAGNETIC AND ALL THIS OTHER MALARKEY, NONE OF WHICH WAS TRUE. BUT YOU KNOW, THAT, THAT, THAT ALL THAT DID WAS THAT JUST SPREAD OUT THE PROBLEM. AND SO THE NEED FOR, YOU KNOW, TO FLATTEN THE CURVE CONTINUED BECAUSE WE WERE SO SLOW IN TAKING UP ENOUGH VACCINE. SO I, I, UM, I, I DON'T KNOW EXACTLY WHAT, UH, DIRECTOR REDFIELD IS TALKING ABOUT THERE, BUT I, I THINK THAT IT, AT SOME POINT IN THIS, WELL, CERTAINLY EARLY ON, BEING VERY AGGRESSIVE WAS ABSOLUTELY THE RIGHT THING TO DO. UM, AT SOME POINT WE DO NEED TO RETURN TO SOCIETY. HAD WE TAKEN A VACCINE A LOT MORE QUICKLY THAN WE DID, WE'D BE, WE WOULD'VE BEEN A LOT FURTHER DOWN THE ROAD THAN WE WOUND UP BEING. AND AS FAR AS DR. FAUCI, HE'S RETIRING. THE MAN IS IN HIS SEVENTIES. HE IS GIVEN MORE PUBLIC SERVICE THAN ANYONE SHOULD EXPECT OF HIM. I DON'T THINK HE'S BEING KICKED OFF ANY ISLAND. I THINK CONCERNING WHAT HIS LIFE HAS BEEN FOR THE LAST COUPLE YEARS, UH, IT'S, IT WOULD BE CRAZY FOR ANYONE TO THINK THAT HE WOULDN'T RETIRE. HE HAS EARNED IT. AND HE DESERVES A, HE DESERVES A, YOU KNOW, A, A A THANK YOU, A SINCERE THANK YOU. EVEN THOUGH NOT EVERYBODY AGREES WITH HIM. HIS WAS BOTH, BOTH OF THESE GENTLEMEN WHO WERE MAYBE OPPOSED ON SOME ISSUES WENT THROUGH AN EXTREMELY DIFFICULT TIME. AND I THINK THAT THEY DID THE VERY BEST THEY COULD AND WE NEEDED TO LEAVE IT AT THAT. WELL, THANK YOU DR. PER, AND AGAIN, THANK BOTH YOU, DR. BROWN AND YOURSELF. 'CAUSE THESE ARE DIFFICULT TIMES. AND YOU GUYS SHOW UP WEEK AFTER WEEK TO GIVE US THIS OPPORTUNITY TO JUST HAVE THESE FRANK CONVERSATIONS. SO THANK YOU BOTH. SO, I AM DR. JANINA WHITE WITH THE HOUSTON HEALTH DEPARTMENT ON BEHALF OF DR. STEVEN WILLIAMS IN OUR COVID-19 TALK. THANK YOU FOR JOINING US TODAY WITH LOCAL HEALTH AUTHORITIES, DR. DAVID PER WITH THE HOUSTON HEALTH DEPARTMENT, DR. ERICA BROWN, WITH HARRIS COUNTY PUBLIC HEALTH. WE WANNA THANK, UH, KATHY FINNER WITH THE ROTARY CLUB OF HOUSTON, PAT PRESIDENT, AND OUR PRODUCERS DAVID CASTILLO AND PRISCILLA KEITH. HAVE A GREAT DAY. * 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.