* 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.
          [00:00:15]
          GOOD MORNING AND WELCOME TO COVID-19, TALK WITH LOCAL HEALTH AUTHORITIES. 
          JOINING US FROM HARRIS COUNTY IS DR. 
          ERICA BROWN, THE CITY OF HOUSTON, DR. DAVID PURSE. 
          A SPECIAL THANKS TO KATHY INGER, PAST PRESIDENT ROTARY CLUB OF HOUSTON TO OUR PRODUCERS, DAVID CASTILLO, PRISCILLA KEY. 
          I'M STEPHEN WILLIAMS, DIRECTOR OF THE HOUSTON HEALTH DEPARTMENT. 
          LET'S START OFF WITH STATUS. 
          HARRIS COUNTY THREAT LEVEL IS NOW AGREEING WITH COVID CASES AND HOSPITALIZATION IS DOWN. 
          WHAT ABOUT COVID DAILY DEATH NUMBERS? YEAH, SO WHEN WE TRANSITION TO, UH, THE REPORTING SYSTEM SIMILAR TO THE CDC, UH, WE REPORT OUR NUMBERS ON A WEEKLY BASIS NOW. 
          SO I DON'T HAVE DAILY NUMBERS. 
          UNFORTUNATELY, THERE ARE STILL, UM, PEOPLE ACROSS THE COUNTRY AND AROUND THE WORLD WHO ARE DYING FROM COVID, BUT CERTAINLY NOT AS MANY AS WE PREVIOUSLY HAD. 
          SO, UH, OUR NUMBERS ARE NOT GOING UP AS RAPIDLY AS THEY PREVIOUSLY WERE. 
          WHAT'S THE INCIDENTS RIGHT NOW? YOU KNOW, SO THAT'S, UH, HARD TO SAY BECAUSE WE HAVE SO MANY PEOPLE WHO ARE TESTING AT HOME, AND WE HAVE A REALLY TINY NUMBER BY COMPARISON OF FOLKS WHO ARE TESTING AT OUR SITES. 
          SO WE GET OUR NUMBERS FROM, SO IT'S ALMOST IMPOSSIBLE TO SAY WHAT THE INCIDENCE RATE IS. 
          NOW. 
          WE ARE LOOKING AT THE HOSPITALIZATIONS. 
          IT'S A BETTER INDICATOR, AND THOSE ARE WAY, WAY DOWN, UM, UH, FORTUNATELY, BUT, UM, AND, AND SO WE'VE GOT A METRIC UP THERE ABOUT, UH, POSITIVITY RATE AND OUR, OUR WASTEWATER. 
          SO THE NUMBERS ARE ALL MOVING IN THE RIGHT DIRECTION. 
          AND JUST TELL US A LITTLE BIT ABOUT WASTEWATER WHILE YOU'RE TALKING. 
          YEAH, SO THE WASTEWATER ISS DOWN, AS YOU CAN SEE THERE, TO, TO 48%. 
          AND THAT IS A COMPARISON TO THE JULY 6TH, 2020 VALUE, WHICH IS THE PEAK OF THE FIRST WAVE. 
          BUT WE HAVE BEEN A LITTLE BIT LOWER THAN THIS. 
          I, I, MY MEMORY, I'D HAVE TO GO LOOK AT IT, BUT I THINK WE WERE DOWN TO AS LOW AS, UH, 31% AT ONE POINT, UH, SINCE WE STARTED MEASURING THE WASTEWATER. 
          BUT THIS IS AN EXTREMELY LOW NUMBER. 
          AND OVER THE LAST COUPLE WEEKS, THE WEEK OVER WEEK CHANGE HAS BEEN PRETTY DRAMATIC, LIKE DROPPING BY ALMOST HALF PER WEEK. 
          SO, UM, YEAH, THE WASTEWATER IS DROPPING DOWN. 
          NOW WE, WE SAY THAT, BUT THIS IS NOT THE TIME FOR US TO DROP OUR GUARD. 
          WE'RE SEEING, UH, YOU KNOW, INCREASING RATES OF COVID IN, UH, NORTHERN EUROPE OR IN ACROSS EUROPE. 
          AND I'VE HEARD AT LEAST ONE REPORT THAT PERHAPS IN BOSTON THEY'VE SEEN THEIR WASTEWATER GO UP. 
          SO, UH, YEAH, THINGS ARE GOOD RIGHT HERE IN HOUSTON FOR NOW. 
          BUT DON'T COUNT YOUR CHICKENS BEFORE THEY'RE HATCHED, AS THEY SAY, I'M SUPPOSED TO BE GOING TO BOSTON NEXT MONTH FOR A PHA DAVID, SO MAYBE I  SHOULD BE MINDFUL OF THAT. 
          BMJ MEDICAL MEDICINE PUBLISHED A STORY THAT VACCINE COULD SLIGHTLY ALTER A MENSTRUAL CYCLE. 
          IS THAT TRUE? THE DATA SHOWS THAT IT, IT IS POTENTIALLY TRUE. 
          UM, THAT, UH, IMMEDIATELY FOLLOWING THERE MAY BE A, A, A LONGER OR A HEAVIER, UH, MENSTRUAL CYCLE, BUT THAT IT QUICKLY RETURNS TO NORMAL. 
          OKAY. 
          IS CHRONIC COVID AND LONG HAUL OR SOMETHING, THE SAME THING. 
          UM, SO, YOU KNOW, THERE'S, THERE'S NO REAL TEST FOR, FOR LONG COVID. 
          AND SO RIGHT NOW, EVEN THE TERMINOLOGY IS A LITTLE, IS A LITTLE, UM, UH, FUDGY, IF YOU WILL. 
          SO I WOULD, IT DEPENDS ON, YOU KNOW, UM, WHO'S, WHO'S TALKING, BUT THEY'RE, YOU CAN PROBABLY CONSIDER 'EM TO BE THE SAME THING. 
          SO, YOU KNOW, ONE THING IS THAT WHEN YOU SAY CHRONIC, ANY CHRONIC ILLNESS, IT GENERALLY IMPLIES IT'S A LIFELONG. 
          NOW WE'VE NOT NECESSARILY SEEN THAT WITH COVID YET, SO, UM, I I'VE NOT USED THAT TERM CHRONIC COVID. 
          'CAUSE IN MY MIND, THAT USUALLY MEANS IT'S A LIFELONG THING. 
          LIKE ASTHMA IS GENERALLY FOR, YOU KNOW, FOR ADULTS, IT'S GENERALLY A LIFELONG I ILLNESS. 
          IT'D BE CHRONIC ASTHMA AS AN EXAMPLE. 
          SO WE HAVEN'T HAD COVID LONG ENOUGH YET TO REALLY CALL IT CHRONIC, BUT LONG HAUL YET. 
          ABSOLUTELY. 
          OKAY. 
          YEAH. 
          MENTIONED THIS EARLIER, CASES IN EUROPEAN COUNTRIES ARE RISING. 
          BASED ON THAT, DO YOU PREDICT THE DECREASE IN CASES HERE MAY REVERSE, YOU KNOW, AS, AS DAVID JUST SAID, DON'T COUNT THE CHICKENS YET? WE'LL, WE WILL SEE, HOPEFULLY, IF WE CAN CONTINUE TO, UM, GET PEOPLE VACCINATED WITH THE BIVALENT BOOSTER, WE WON'T SEE, UH, SO MUCH OF A RISE. 
          UM, BUT IT IS VERY, VERY POSSIBLE VACCINE MYOCARDITIS VERSUS POST COVID MYOCARDITIS AND PERICARDITIS, WHICH IS WORSE. 
          DO VACCINES CHANGE THE SEVERITY OF NUMBERS? YEAH. 
          SO, UM, FIRST LET'S TALK A LITTLE BIT ABOUT THOSE TERMS. MYOCARDITIS AND PERICARDITIS. 
          THEY'RE, THEY ARE, UH, SIMILAR BUT DIFFERENT. 
          MYOCARDITIS IS AN INFLAMMATION OF THE HEART MUSCLE ITSELF, AND PERICARDITIS IS AN INFLAMMATION OF THE PERICARDIUM, THE SAC THAT THE HEART, UH, SITS IN. 
          THEY'RE BOTH INFLAMMATORY. 
          AND YOU, WE'VE SEEN THEM BOTH, UM, YOU KNOW, WITH PEOPLE WITH COVID. 
          AND THE, THE BASIC TO ANSWER THE QUESTION IS, IN THE CASE OF WHERE WE'VE SEEN IT AS A RESULT OF VACCINE, IT HAS BEEN GENERALLY IN ADOLESCENT MALES, IT'S BEEN SHORT-LIVED. 
          [00:05:01]
AND, UM, WITH BASIC, SIMPLE SUPPORTIVE CARE, THEY, UH, LARGELY DO JUST FINE AND, AND RETURN TO NORMAL. 
          PEOPLE WHO GET THE MYOCARDITIS IN PARTICULAR FROM COVID INFECTION, OFTEN HAVE MORE PROBLEMS. UH, MANY OF THEM RE RE RESOLVE JUST FINE, BUT THERE'S A GREATER INCIDENCE OF IT WITH THE ILLNESS AS OPPOSED TO THE VACCINE. 
          AND IT CAN TEND TO BE, IT TENDS TO BE A LITTLE BIT MORE COMPLICATED NOW THAT WE'RE AT THE BEGINNING OF A NEW SCHOOL YEAR, MASSLESS. 
          BUT IT'S THE PREVALENCE IN SCHOOLS, UNFORTUNATELY, PREVALENCE SEEMS TO BE LOW. 
          HOWEVER, UM, WE CAN'T FORGET THAT HOME TESTING, RIGHT? WE DON'T NECESSARILY HAVE REPORTS FROM HOME TESTING. 
          WHAT WE THINK IS HAPPENING IS BECAUSE THERE'S BEEN SUCH A WIDESPREAD THROUGHOUT THE COMMUNITY OVER THE SUMMER AND THINGS WITH OMICRON IN PARTICULAR, PERHAPS WE'RE, WE'RE GETTING SOME IMMUNITY THAT WAY AS WELL. 
          BUT FORTUNATELY WE'RE NOT SEEING, UH, TOO MUCH PREVALENCE IN THE SCHOOLS. 
          BUT THERE AGAIN, WE CAN'T ACCOUNT FOR THE HOME TESTING PORTION AS WELL. 
          CAN YOU PROVIDE ANY UPDATE ON COVAX? DR. 
          HOT HOTEL SEEMED TO BE GETTING BEATEN UP ON SOCIAL MEDIA. 
          WHAT ARE THEY SAYING ABOUT YEAH, I DON'T, I DON'T KNOW. 
          I DON'T DO SOCIAL MEDIA VERY MUCH 'CAUSE IT'S , BUT, UH, SO COVAX IS, YOU KNOW, IT'S, IT'S BEING USED LARGELY, UH, IN INDIA. 
          AND, UH, THE, THE LAST TIME I LOOKED, WHICH IS JUST A FEW DAYS AGO, IT WAS OVER SE UH, I THINK OVER 7 MILLION DOSES HAD BEEN GIVEN. 
          AND THEY'RE FINDING VERY FEW PROBLEMS WITH IT, AND IT SEEMS TO BE PRETTY HIGHLY EFFECTIVE. 
          SO I, I THINK THE NEWS IS GOOD ABOUT CORPORATE BACKS. 
          UH, IT'S, UH, NOT QUITE, UH, I THINK THEY'VE GOT THEIR APPLICATION IN, IN SEVERAL OTHER COUNTRIES. 
          UM, I DON'T KNOW WHERE WE STAND WITH THE FDA. 
          I SUSPECT THEY'VE GOT IT IN, IT HASN'T BEEN APPROVED HERE YET, BUT THE EARLY NEWS OUT OF INDIO, WHICH SEEMS TO BE WORKING JUST FINE. 
          SO, UM, I FEEL BAD FOR DREZ. 
          ERICA, YOU GOT ANY COMMENTS ON THAT? DO YOU KNOW WHAT THEY'RE SAYING? I, I, I DON'T KNOW EITHER. 
          I DON'T REALLY DO. 
          SO, YOU KNOW, I THINK YOU'VE BEEN A GREAT CONTRIBUTOR THROUGHOUT THIS ENTIRE PANDEMIC. 
          OKAY. 
          IS LONG HAUL UNRELATED TO AGE, RACE, OR SEX? UM, SO, UM, AFTER THE INITIAL DIAGNOSIS, UH, SEVERAL FACTORS, UH, DO AFFECT, UM, SEEM TO BE ASSOCIATED WITH LONG COVID. 
          UM, AND SOME STUDIES ARE SHOWING THAT UNFORTUNATELY THERE, THERE IS POTENTIALLY, UH, UM, RELATION TO ETHNICITY, SOCIAL, SOCIAL VULNERABILITY, UM, AND AS WELL AS INSURANCE STATUS, ODDLY ENOUGH. 
          SO IT SEEMS THAT THESE THINGS MAY BE RELATED TO UNFORTUNATELY, CHRONIC DISEASE. 
          UM, OF COURSE THE DATA IS STILL, IS STILL, UM, UM, BEING RESEARCHED, BUT THERE DOES SEEM TO BE SOME, UH, RELATIONSHIP AND RELATED TO THAT, I THINK, UH, THE NEXT, UH, COMMENT AND QUESTION, POST COVID CENTER SHOWS, UH, TEXAS P-P-P-C-C SHOWS, CITY LOCATIONS AND SPECIFIC FOCUS. 
          IT SHOWS ONLY ONE LOCATION IN THE MEDICAL CENTER THAT FOCUSES ON THE HEART. 
          SOME DAYS I CANNOT GET OUT OF BED AND HAVE DRAGGED MYSELF TO A NEUROLOGIST, CARDIOLOGIST, NEUROPSYCHOLOGIST APPOINTMENTS ALL AROUND TOWN AND A MONTH APART. 
          SINCE IT SEEMS TO HAVE TO DO WITH YOUR VISITS SEQUENTIALLY, THIS IS YOUR TWO AND COUNTING. 
          WHEN IS THE MEDICAL COMMUNITY GOING TO FOCUS MORE ON THIS GROWING COVID IMPACT IMPACTED COMMUNITY, ESPECIALLY WITH THE HEART? YEAH, I THINK THAT'S A LITTLE DIFFICULT TO ANSWER AND I, I'M SORRY TO HEAR THAT, THAT YOU'RE HAVING THOSE SYMPTOMS. UM, THERE ARE CERTAINLY LONG COVID CLINICS. 
          UM, I, I AM AWARE OF AT ALL THE MAJOR MEDICAL CENTERS, UM, CERTAINLY IN THE TMC, ALTHOUGH SOMETIMES IT'S DIFFICULT TO ACCESS, UM, JUST BECAUSE OF LOCATION. 
          HOWEVER, WHAT I WOULD SUGGEST IS, IS IF THERE'S SOMETHING SPECIFICALLY RELATED TO THE HEART TO A CERTAIN, UM, UM, WORK THROUGH, UH, IF YOU, IF YOU ARE INSURED, WORK THROUGH YOUR INSURANCE FOR CARDIOLOGY REFERRAL, WHICH THEY THEN MAY LEAD TO ADDITIONAL REFERRALS INTO OTHER, UM, LONG COVID PERHAPS, UH, PROGRAMS FOR CERTAIN, MAKE SURE THAT YOU ARE, UM, CHECKING OUT ANY SYMPTOMS. YOU MAY BE  THE HEART. 
          HOW COMMON IS BRAIN FOG AND WHAT ARE THE MANIFESTATIONS, HOW IS BRAIN FOG DIAGNOSED AND TREATED? SO, UM, BRAIN FOG IS RELATIVELY COMMON. 
          SO IT'S A, IT'S, IT'S A, A, UH, DESCRIBED AS BEING SLUGGISH OR SLOW THINKING, UM, DIFFICULTY CONCENTRATING. 
          UM, AND AS IT RELATES TO COVID, UM, WE ARE SEEING SOME PREVALENCE OF IT, ABOUT 20 TO 30% IN, UH, PATIENTS WHO HAVE BEEN DIAGNOSED WITH, UM, WITH LONG COVID. 
          UM, IT DOES OFTEN RESOLVE WITH LONG COVID AFTER SEVERAL MONTHS OR SO. 
          UM, BUT TREATMENT, UM, IS REALLY DEPENDENT ON, UM, THE DIAGNOSIS. 
          THERE ARE OTHER THINGS THAT ALSO, 
          [00:10:01]
UNFORTUNATELY CAUSE BRAIN FOG. 
          A LOT OF, UH, CHRONIC DISEASES CAN CAUSE IT AS WELL. 
          UM, AND SO TREATMENT OF THAT CHRONIC DISEASE, UM, SOMETIMES WILL RESOLVE THE ISSUES AS WELL. 
          MY PCP TELLS ME MY CT SCAN SHOWS PULMONARY PLEURA FIBROSIS. 
          IS THAT PLEURISY MESOTHELIOMA? HOW IS FIBROSIS TREATED? YOU'RE ONLY GONNA TEST THIS TODAY, AREN'T YOU? IT'S LIKE A BOARD EXAM FOR CRYING OUT LOUD , THEY SEE WHETHER THEY'RE REAL DOCTORS. 
          THAT'S WHAT IT IS. 
          I THINK , SO EARLIER I, I TALKED ABOUT MYOCARDITIS VERSUS PERICARDITIS. 
          I MENTIONED THE HEART SITS IN A SAC CALLED THE PERICARDIUM, WHERE THE LUNGS SIT IN A SAC. 
          UH, SIMILARLY IT'S CALLED THE PLEURA. 
          AND SO PLEURISY IS A INFLAMMATION OF THE, THE PLEURA, THE, THE EXTERIOR, UH, LINING OF THE LUNG AND THE INTERIOR LINING OF THE, THE CHEST WALL. 
          SO THAT'S, THAT'S PL MESOTHELIOMA IS A FORM OF CANCER, AND IT CAN OFTEN BE FOUND IN THE PLEURA, BUT IT CAN ALSO BE FOUND ELSEWHERE. 
          UH, THE, UH, MESO HELIUM IS A TYPE OF TISSUE THAT'S FOUND THROUGHOUT THE BODY, BUT IS OFTEN WHEN YOU HEAR ABOUT MESOTHELIOMA. 
          IT'S A, IT'S A CANCER FOUND IN THE CHEST, UH, CAVITY. 
          AND THEN FIBROSIS IS BASICALLY SCARRING OF THE LUNG TISSUE, GENERALLY DUE TO SOME EITHER A CHRONIC ILLNESS OR A PREVIOUS, UH, INFECTION. 
          AND UNFORTUNATELY, BECAUSE IT IS A SCARRING, THERE'S, THERE'S NO, YOU KNOW, GREAT WAY TO, TO REVERSE IT. 
          UM, DOCTOR, YOU KNOW, PATIENTS ARE OFTEN TREATED WITH WAYS TO IMPROVE YOUR LUNG FUNCTION IN SPITE OF THE FIBROSIS, BUT THERE'S NO GREAT WAY TO TO REVERSE THAT SCARRING ONCE IT OCCURS. 
          UNFORTUNATELY, THE MORE I HEAR, UH, Y'ALL DISCUSS THIS, AND WITH THESE QUESTIONS, IT, IT INSPIRES ME TO ENSURE THAT I'M UP TO DATE ON MY VACCINATIONS. 
          . 
          MM-HMM . 
          LY. 
          HUH? LY YEAH, IT'S A LITTLE SCARY. 
          . 
          ON THE LAST PROGRAM, YOU HAD A GREAT DISCUSSION, A GREAT SESSION ON COMPLICATIONS OF COVID, INCLUDING LONG HAULERS. 
          COULD YOU ENTER GREATER DEPTH AS GREAT DEAL OF CONFUSION? ANY NEWS YOU CAN SHARE? Y'ALL HAVE HAD I THINK, A CONTINUED DISCUSSION ON THIS, BUT ANYTHING ELSE YOU WANT TO MAYBE SUMMARIZE? UH, YOU KNOW, SO I WASN'T ON THE LAST, UH, MEETING BECAUSE I WAS ON VACATION, SO, UM,  CONGRATULATIONS TO DR. 
          DR UH, UH, BROWN AND DR. WHITE WERE HAVING HAD SUCH A GREAT, UH, UH, CONVERSATION. 
          ALL I'LL SAY ABOUT POST COVID IS A LITTLE BIT OF WHAT I'VE ALREADY SAID. 
          IT'S VERY DIFFICULT TO DIAGNOSE. 
          IT'S, YOU KNOW, GENERALLY PEOPLE ARE INFECTED. 
          W WILL HAVE COVID-19 DISEASE, THEY'LL GET BETTER WITHIN ABOUT A, A, A FEW WEEKS, RIGHT? UH, GENERALLY TWO WEEKS OR THREE WEEKS MAYBE. 
          SO THE LONG HAUL SYMPTOMS ARE GENERALLY NOT CONSIDERED TO BE LONG HAUL UNTIL, UNLESS THEY ARE PERSISTENT OR THEY START UP AFTER FOUR WEEKS FROM YOUR, YOUR INITIAL ILLNESS. 
          UH, THERE IS GROWING EXPERTISE IN THIS, UH, BECAUSE WE DO HAVE SOME CLINICS WHERE THERE ARE, YOU KNOW, UH, OR PATIENTS WITH LONG HAUL ARE BEING EVALUATED AND, AND CARED FOR BY DOCTORS. 
          BUT IT IS A COM POSTVIRAL ILLNESS IS NOT A NEW PHENOMENON. 
          BUT WITH COID, BECAUSE MOST VIRUSES WILL INFECT, LIKE YOU GET A COLD VIRUS, IT PRETTY MUCH INFECTS YOUR NOSE, RIGHT? AND YOUR UPPER AIRWAY ES UH, LUNG TENDS TO BE MORE PULMONARY, UM, ALTHOUGH NOT VIRAL, BUT YOU KNOW, A STREP THROAT OR SO THERE'S A BACTERIA, IT'S YOUR LUNGS, RIGHT? SO MOST PATHOGENS TEND TO INFECT ONE ORGAN SYSTEM. 
          GENERALLY MENINGITIS GOES TO THE MENINGES IN THE BRAIN. 
          COVID, THERE'S, YOU KNOW, IT, IT CAN IMPACT ANY ORGAN SYSTEM WE'VE SEEN, SKIN, EYE, HEART, INTESTINES, LUNGS, BLOOD VESSELS, BLOOD ITSELF IN ITS CLOTTING FACTORS. 
          SO THE THING ABOUT COVID THAT MAKES IT SO DIFFERENT IS THAT IT SEEMS TO BE ABLE TO IMPACT EACH AND EVERY ORGAN SYSTEM, WHICH MOST VIRUSES AND BACTERIA, UH, DON'T DO. 
          SO IT IS A GROWING, UH, AREA OF NEW EXPERTISE. 
          AND, UM, I WAS PART OF THE PREVIOUS CONVERSATION, SO I DON'T KNOW, MAYBE DR. BROWN, YOU SHOULD GO MORE. 
          YOU DON'T KNOW HOW IN DEPTH YOU WENT LAST TIME. 
          MAYBE THERE'S SOMETHING THAT YOU COULD ADD. 
          I DON'T KNOW. 
           THE SAD PART ABOUT IT'S, I DON'T REMEMBER. 
          SHE HAS BRAIN FOG, RIGHT, EXACTLY. 
          I HAVE A VIRUS RIGHT NOW, AND I'M TRULY IN FOG. 
          , . 
          UH, THE NEXT QUESTION, ACTUALLY, I THINK Y'ALL HAVE COVERED THIS, AND THAT WAS EXACTLY WHAT HAS ENCOMPASSED BY THE TERM CHRONIC COVID. 
          AND YOU EXPLAINED THAT EARLIER, I THINK. 
          UH, OKAY, WE GOTTA MOVE ON A LITTLE BIT. 
          UH, VACCINE SIDE EFFECTS. 
          AFTER FOUR PFIZER SHOTS WITH NO REACTION, THE BIVALENT EFFECT OF SUBSTANTIAL SWELLING, SWELLING AT THE SHOT LOCATION THAT LASTED FOR A NUMBER OF DAYS, WHAT MIGHT THAT BE? SO, INJECTION SITE SWELLING IS A, IS A, UM, VERY COMMON SIDE EFFECT OF ANY VACCINE. 
          [00:15:01]
AND SO IT COULD HAVE HAPPENED WITH ANY OF THE, UH, UH, COVID-19 VACCINES THAT YOU RECEIVE. 
          IT'S NOT SPECIFIC TO THE BOOSTER. 
          UM, SO THE BEST I CAN SAY IS THAT IT, IT'S A KNOWN, UM, UM, REACTION TO ANY VACCINE INCLUDING THE COVID VACCINES. 
          WHAT IS QUANDRO? VALENT? TEXAS ALREADY IS IN FLU SEASON. 
          IS THIS EARLY? YEAH. 
          SO QUADRIVALENT MEANS THAT THE VACCINE, THE FLU VACCINE ACTUALLY IS PROVIDING, UH, PROTECTION AGAINST FOUR DIFFERENT TYPES OF INFLUENZA VIRUS. 
          SO WHEN WE TALK ABOUT WITH COVID, THE BIVALENT, THAT MEANS THAT THERE'S, YOU KNOW, TWO FORMS OF VIRUS ARE, UM, YOU'RE, YOU'RE GETTING PROTECTION FROM TWO FORMS OF THE VIRUS, TWO MUTANT. 
          SO QUADRIVALENT MEANS THAT THERE'S FOUR, AND TO HAVE, I'LL SAY MULTIVALENT, UM, IN, UH, VACCINES IS NOT NECESSARILY NEW. 
          IN FACT, THE FLU VIRUS, SORRY, THE FLU VACCINE FOR YEARS HAS BEEN MULTIVALENT WITH TWO, THREE AND OR OR FOUR, UH, VERSIONS OF THE FLU VIRUS. 
          UM, GIVING YOU PROTECTION FROM FOUR OF THOSE IN THE SHOT IS, IS, UH, FOUR IS A FAIRLY HIGH NUMBER, BUT TWO OR THREE IS VERY, VERY COMMON. 
          OKAY. 
          AND THAT'S, I, I, THAT'S I SAW FOR PRISCILLA ACTUALLY PUT SOME STUFF UP TO SUPPORT THAT FLU MISS FOR THOSE UNDER 50. 
          GOOD, BAD. 
          WHY ONLY BELOW 50? YEAH. 
          SO ANYTIME, UM, UM, MEDICATIONS AND VACCINES ARE CONSIDERED UNDER MEDICATIONS, RIGHT? FOR FDA APPROVAL, UM, THERE'S, THERE'S RESEARCH DONE TO SHOW WHAT'S THE MOST EFFECTIVE, UH, ROUTE OF TRANSMISSION. 
          SO FLU MIST IS, UH, A NASAL, UH, VERSION OF THE FLU VACCINE. 
          IT HAS BEEN SHOWN TO BE EFFECTIVE FOR THOSE, UM, BETWEEN THE AGES OF TWO AND 49. 
          SO THE, THE DATA SHOWED THAT THOSE ABOVE 50, IT MAY NOT HAVE AS MUCH EFFICACY. 
          AND SO THAT'S WHY IT'S RECOMMENDED FOR THOSE AGES TWO, UH, TO 49. 
          UM, IT'S EFFECTIVE THOUGH. 
          AND SO, UM, AGAIN, FOR THOSE WHO MEET THE ELIGIBILITY CRITERIA, CERTAINLY IS A, IS A GOOD, UH, OPTION. 
          AUSTRALIA HAS HIGH FLU. 
          SHOULD WE TAKE THAT AS A PREDICTOR? YEAH, WE, WE, WE SHOULD. 
          SO THE, THE FLU VIRUS CIRCUMNAVIGATES THE GLOBE EVERY YEAR, UH, NORTHERN HEMISPHERE, THEN SOUTHERN HEMISPHERE, AND THEN BACK TO THE NORTHERN HEMISPHERE. 
          AND IN FACT, IT IS THE VIRUS THAT IS CIRCULATING IN THE SOUTHERN HEMISPHERE THAT THE PHARMACEUTICAL COMPANIES, UH, USE TO CREATE THE VIRUS, I'M SORRY, THE VACCINE THAT WE WILL GET BECAUSE IT USUALLY IS SIMILAR, ALTHOUGH, YOU KNOW, EVERY YEAR IT CHANGES A LITTLE BIT AS IT GOES AROUND. 
          SO THE FLU VIRUS MUTATES JUST LIKE COVID DOES. 
          AND SO THEY, UH, YOU KNOW, THEY, THEY TAKE WHAT'S CIRCULATING IN THE SOUTHERN HEMISPHERE. 
          BUT WE'VE ALSO SEEN THAT WHEN THE SOUTHERN HEMISPHERE HAS A BAD FLU YEAR OR A, A SOFT FLU YEAR, UH, WE TEND TO BE SIMILAR. 
          NOW THIS YEAR, YOU KNOW, IT'S GOING TO, WE, WE HAVE LOTS OF REASONS TO ANTICIPATE A, A DIFFICULT FLU. 
          NOT ONLY DID AUSTRALIA HAVE, UH, A MORE DIFFICULT FLU SEASON THAN, THAN USUAL, BUT YOU KNOW, THE LAST TWO YEARS WE'VE BEEN WEARING MASKS, WE'VE BEEN SOCIAL DISTANCING, WE'VE BEEN WASHING OUR HANDS. 
          UM, UH, YOU KNOW, THE FLU VACCINE UPTAKE HASN'T BEEN WHAT WE WOULD LIKE IT TO BE, BUT BECAUSE PEOPLE ARE DOING ALL THOSE OTHER THINGS, WE HAVE REALLY, REALLY MILD FLU YEARS. 
          SO WHAT THAT HAS NOW CREATED IS THAT AS A POPULATION, WE HAVE LESS HERD IMMUNITY TO THE FLU BECAUSE SOME OF THE PEOPLE WHO WOULD'VE GOTTEN INFECTED OVER THE LAST TWO YEARS WOULD'VE SOME RESIDUAL IMMUNITY BECAUSE OF THEIR PREVIOUS INFECTION. 
          THEY DON'T HAVE THAT NOW, RIGHT? SO WE HAVE ABOUT THE SAME AMOUNT OF INFLUENZA VACCINATION RATES THAT WE USUALLY HAVE, IN FACT, A LITTLE BIT LOWER WITH ALL THE ANTI-VAX TALK THAT'S GOING ON. 
          BUT WE HAVE NO RESIDUAL HERD IMMUNITY FROM INFECTIONS OVER THE LAST TWO YEARS. 
          SO, YOU KNOW, WE ARE AT RISK FOR, UH, A POTENTIALLY BAD FLU YEAR. 
          AND THE OTHER THING I WANNA POINT OUT IS THAT THIS WILL BE A REALLY BAD YEAR FOR SOMEBODY TO GET THE FLU AND RECORD HOSPITALIZATIONS. 
          THE HOSPITALS HAVE NOT RECOVERED FROM COVID. 
          WE'RE SEEING RESTAURANTS BACK ONLINE. 
          WE'RE SEEING ENTERTAINMENT, PROFESSIONAL SPORTS, ALL THESE OTHER THINGS AS SOCIETY ARE COMING BACK AND RECOVERING. 
          BUT THE HOSPITALS HAVE NOT, AND THEY, AND THEY HAVE NOT, UH, RECOVERED BECAUSE OF THE NURSING SHORTAGE. 
          SO WE HAVE LOTS OF HOSPITALS IN OUR COMMUNITY THAT HAVE GOT EMPTY WINGS, NOT BE, YOU KNOW, THEY GOT BEDS THERE, BUT THEY DON'T HAVE THE NURSES TO STAFF 'EM. 
          SO, UH, THIS IS, YOU KNOW, AS WE'RE ENTERING INTO THIS FLU SEASON AND WITH THE POTENTIAL FOR ANOTHER WAVE OF COVID COMING, AS WE'RE SEEING IN EUROPE, UH, THIS IS, YOU KNOW, I'M A LITTLE BIT, I'M A LITTLE ANXIOUS ABOUT WHAT WE'RE GONNA HAVE COME, YOU KNOW, NOVEMBER, DECEMBER, JANUARY, UH, HERE IN HOUSTON IN TERMS OF HOSPITAL CAPACITY. 
          SO I, I, YOU KNOW, ANYBODY WHO'S WATCHES, IF YOU HAVEN'T GOT YOUR FLU SHOT, IF YOU HAVEN'T GOT YOUR PY BAIN SHOT, UH, YOU NEED TO GO 
          [00:20:01]
GET 'EM NOW. 
          OKAY? LET'S GO OVER TO A HALLOWEEN ALERT, RAINBOW CANDY, FENTANYL, LACE, CANDY, AND CHALK. 
          IS THAT FOR PACKED OR JUST LOOSE CANDY THAT NO ONE SHOULD BE TAKEN FROM STRANGERS? SO I, I THINK THAT, UM, OBVIOUSLY THIS IS A REALLY UNFORTUNATE TREND. 
          UM, AND SOME OF THEM, THE PRECAUTIONS THAT WE WOULD NORMALLY TAKE, UM, REALLY APPLY HERE TO TALK TO YOUR CHILDREN ABOUT NOT TAKING ANYTHING FROM STRANGERS, UM, NOT TAKING ANYTHING THAT IS, UH, LOOSE OR FOR INSTANCE, UM, THIS REMINDS ME OF SWEET TARTS AND SKITTLES, UM, YOU KNOW, THOSE KINDS OF THINGS. 
          UM, AND REALLY HAVING, HAVING UNFORTUNATELY, A SERIOUS CONVERSATION AND ACTUALLY SHOWING THE PICTURES. 
          JUST A LITTLE ANECDOTE. 
          UM, UM, I, MY YOUNGEST IS A TEENAGER AND I DID LITERALLY SHOW THIS PICTURE TO HIM AND ADVISE HIM, THIS IS WHAT IT LOOKS LIKE. 
          IT'S NOT CANDY, YOU KNOW, AND I WASN'T TRYING TO SCARE HIM, BUT I LET HIM KNOW YOU CAN DIE. 
          MM-HMM . 
          UM, AT THE SAME TIME, AGAIN, IT IS HALLOWEEN SEASON. 
          WE HOPE TO HAVE A SAFE HALLOWEEN SEASON. 
          UM, I AM SURE THAT KIDS WILL BE OUT, I KNOW IN MY NEIGHBORHOOD, I GUESS BECAUSE PEOPLE FEEL LIKE WE'RE MOVING, UM, OUT OF COVID, UH, PEOPLE IN MY NEIGHBORHOOD DECORATIONS HAVE BEEN UP SINCE SEPTEMBER, SO PEOPLE ARE EXCITED THIS YEAR. 
          SO I EXPECT A RECORD, UM, UM, TURNOUT FOR HALLOWEEN, UM, JUST AS WE WOULD NORMALLY DO, TAKE PRECAUTIONS, UM, AND, UM, INSPECT THE CANDY. 
          UM, IF IT'S LOOSE CANDY, UH, I WOULD HIGHLY SUGGEST YOU THROW IT AWAYS, UM, JUST FOR SANITARY REASONS AS WELL. 
          UM, UM, AND THE BEST WE CAN DO IS REALLY HAVE CONVERSATIONS WITH OUR CHILDREN, UM, AND, AND LET THEM KNOW THAT THESE ARE SOME, SOME SERIOUS THREATS. 
          UNFORTUNATELY, THAT IS UNFORTUNATE. 
          WHAT IS A HYPERACTIVE IMMUNE SYSTEM? YEAH, SO HYPERACTIVE IMMUNE SYSTEM IS BASICALLY WHAT IT, IT SOUNDS LIKE. 
          UM, YOU KNOW, YOU CAN THINK OF SOMETIMES AS AN ALLERGIC REACTION BEING A FORM OF A HYPERACTIVE IMMUNE SYSTEM. 
          YOUR BODY GETS EXPOSED TO, UH, UH, A PATHOGEN, WHETHER IT BE A VIRUS OR A BACTERIA, OR PERHAPS JUST DUST OR DANDER OR POLLEN, UM, OR SOMETHING THAT YOU EAT. 
          AND YOUR IMMUNE SYSTEM, WHICH IS DESIGNED TO KNOW WHAT IS YOU AND WHAT IS NOT. 
          YOU, UH, RECOGNIZES THIS IS SOMETHING WHICH IS NOT SUPPOSED TO BE HERE, BUT INSTEAD OF EITHER TOLERATING IT OR MANAGING IT UNDER NORMAL CONDITIONS, IT OVERREACTS. 
          AND YOU CAN, AND IT'S A LITTLE BIT DIFFERENT FROM ONE PERSON TO THE NEXT, BUT YOU CAN GET A VARIETY OF SYMPTOMS. YOU CAN GET BLOOD VESSEL DILATION, YOU CAN GET HYPER SECRETION INTO YOUR AIRWAYS AND INTO YOUR LUNGS. 
          YOU CAN GET, UM, UH, YOU KNOW, INTESTINAL PROBLEMS. BUT THE LIFE-THREATENING ONES ARE REALLY THE RESPIRATORY ONES. 
          UH, WHEN THE BLOOD VESSELS DILATE, THEY BECOME LEAKY. 
          THE FLUID IN THE BLOOD, THE, THE PLASMA PART OF IT, THE WATERY PART OF IT STARTS LEAKING OUT INTO THE TISSUE AROUND IT, CAUSING SWELLING. 
          UM, AND THAT CAN HAPPEN IN A VARIETY OF DIFFERENT ORGAN SYSTEMS. UM, BUT THAT'S BASICALLY YOUR HYPERACTIVE IMMUNE SYSTEM, UH, SYNDROME. 
          OKAY. 
          ALPHABET COVID, WHO COMES UP WITH THESE IS BA 4.6, INCREASING BQ ONE, BQ 1.1 AS OFFSHOOTS OF BA FIVE. 
          DO THEY EVADE VACCINE? IS THAT THE SAME AS X BBB ANTIBODY INVASIVE STRAIN? 2.7 5.2, MY LORD. 
          OKAY. 
          I I'M GONNA TRY TO BE, UH, SUCCINCT AND THOROUGH IN A, IN A SHORT TIME PERIOD. 
          UM, SO THERE, THERE ARE ABSOLUTELY A LOT OF CIRCULATING VARIANTS. 
          UM, UM, SPEAKING TO SOME OF THE QUESTIONS WE HAD PREVIOUSLY ABOUT WHAT THEY'RE SEEING IN EUROPE, UM, UM, THERE'S NO QUESTION ABOUT THAT. 
          HOWEVER, HERE STILL THE MOST PREVALENT VARIANT IS VA FIVE. 
          THE BEST THING THAT WE CAN DO RIGHT NOW WITH THE MOST PREVALENT VARIANTS IS TO GET A COVID BOOSTER, WHICH IS A COMBINATION OF VA FOUR, VA FIVE, AND THE ORIGINAL STRAIN. 
          OKAY. 
          UM, THAT IS TRULY THE BEST THING WE CAN DO TO PROTECT OURSELVES. 
          ARE THERE OTHER VARIANTS CIRCULATING, INCLUDING VA SIX, WHICH IS REPLACING VA FOUR AND BQ ONE ONE AND ALL THESE OTHERS COMING ALONG? ABSOLUTELY, BUT RIGHT NOW, AS WE'VE DISCUSSED BEFORE, THEY ARE NOT, UH, AN IMMINENT THREAT TO US, UM, BECAUSE THE LEVEL AT WHICH THEY'RE SPREADING, UM, AND CERTAINLY, UM, UM, I, ONE OF THE THINGS THAT I CAN'T STRESS ENOUGH IS I REALLY DO BELIEVE IS, AND LET ME SAY THIS ONCE, TO TRY TO PREDICT SOMETHING, AS DAVID SAID, RIGHT? UM, UM, IT, IT, IT ALWAYS IS, IS IS THE OPPOSITE. 
          BUT I REALLY DO BELIEVE THAT THIS IS GOING TO BECOME SOMETHING SIMILAR TO THE FLU, WHERE EVERY YEAR WE HAVE SOME VARIANTS AND WE TAKE A LOOK BACK AT THE PREVIOUS YEARS TO SEE WHAT WAS MOST PREVALENT. 
          UM, AND PERHAPS THAT IS WHAT OUR, OUR VACCINES MAY BE MADE OF. 
          IF WE GET TO THE POINT WHERE COVID VACCINE BECOMES A ROUTINE PART OF OUR 
          [00:25:01]
VACCINE SERIES. 
          UM, SO FOR NOW WE'RE GOING TO SEE VARIANTS, WE'RE GONNA SEE A WHOLE BUNCH MORE ALPHABETS AND MAYBE SOME MORE ROMAN ALS COME INTO PLAY AS WELL. 
          UH, UM, AND IT'S JUST SOMETHING THAT WE'RE GONNA CONTINUE TO MONITOR. 
          BUT FOR NOW, WE ARE STILL, BA FIVE IS THE MOST PREVALENT FOR US. 
          UM, AND THE BEST THING YOU CAN DO TO PROTECT YOURSELF IS TO GET THE BOOSTER. 
          OKAY. 
          MINNESOTA DEPARTMENT OF HEALTH DISCOVERED THE MONKEYPOX VIRUS HAS MUTATED, DOES THAT IMPACT TREATMENT? YEAH. 
          SO WHAT THEY FOUND IN MINNESOTA WAS ACTUALLY PRETTY INTERESTING. 
          THEY FOUND THAT THERE, UH, WHERE THEY'RE SEQUENCING AND THEN ONE OF THEIR LABS, AND WE HAVE MANY LABS ACROSS THE COUNTRY, THEY'RE DOING THIS. 
          THEY'RE, THEY'RE SEQUENCING THE ENTIRE, UH, GENOME, UH, PERIODICALLY RANDOM SAMPLING. 
          AND WHAT THEY FOUND IN MINNESOTA WAS THEY FOUND A, A COUPLE OF OF VARIANTS WHERE A WHOLE SEGMENT OF THE RNA WERE EITHER MISSING OR THEY HAD JUST BEEN SWITCHED AROUND IN THE ORDER. 
          AND IT, YOU KNOW, THESE ARE, YOU KNOW, SO WE TALK ABOUT POINT MUTATIONS WHERE ONE AMINO ACID GETS SWAPPED OUT FOR A DIFFERENT AMINO ACID, YOU CAN, AND THEN YOU GET THESE, YOU KNOW, SEGMENTAL ONES WHERE THEY'RE EITHER MISSING OR THEY'RE, THEY'RE SWAPPED AROUND. 
          AND WE ALSO WORRY ABOUT GETTING SEGMENTS SWAPPED OUT WITH OTHER VIRUSES, RIGHT? AND SO, UM, THERE'S ALL KINDS OF THINGS. 
          NOW, THE ONE THING ABOUT, ABOUT COVID THAT PEOPLE NEED TO UNDERSTAND IS IT IS AN RNA VIRUS. 
          SO IT IS A SINGLE STRAND, SO IT'S CAPACITY TO MUTATE IS MUCH GREATER THAN, FOR EXAMPLE, MONKEYPOX, WHICH IS A DNA VIRUS, AND IT'S DOUBLE STRANDED. 
          AND SO MUTATIONS IN DNA VIRUSES ARE FAR MORE DIFFICULT AND LESS COMMON. 
          AND SO WE CAN THIS 'CAUSE COVID IS AN RNA, THAT'S WHY WE'VE SEEN SO MANY MUTATIONS IN ALL THE ALPHABET SOUP. 
          UM, AND, YOU KNOW, HOPEFULLY, YOU KNOW, THIS WILL SLOW DOWN A LITTLE BIT SO THAT, LIKE DR. BROWN IS PREDICTING, HOPEFULLY WE'LL, WE'LL HAVE ONE HIGHLY EFFECTIVE VACCINE PER YEAR, AND THE NUMBER OF MUTATIONS SLOW DOWN, BUT WE'RE GONNA HAVE TO WAIT AND SEE BECAUSE RNA CAN EASILY MUTATE. 
          HEALTHCARE WORKERS ARE CONTINUING TO LEAVE THEIR PROFESSION AT ALARM AND WAKE. 
          ARE WE READY IN HOUSTON? IF THERE'S ANOTHER SURGE? WE ARE. 
          SO I THINK DAVID ADDRESSED THIS ALREADY. 
          UNFORTUNATELY, HEALTHCARE WORKERS ARE LEAVING AT ALARMING RATES. 
          UM, BUT AS WE'VE SEEN, UM, AND LEARNED FROM WITH COVID AND OTHER, UH, UM, DISASTERS, I WILL SAY, BECAUSE THIS, WE HAVEN'T HAD OTHER PANDEMICS FORTUNATELY, UM, RECENTLY, BUT OTHER DISASTERS IS, UM, THAT, UM, OUR PREPAREDNESS TEAMS ACROSS THE CITY, THE COUNTY, AND THE STATE ARE READY. 
          AND THE PLANS ARE IN PLACE THAT SHOULD WE NEED TO, UH, PARTNER WITH OUR NEIGHBORING COUNTIES AND STATES. 
          UM, WE'RE READY TO DO THAT, TO MAKE SURE THAT WE HAVE ALL HANDS ON DECK, UM, UM, TO SUPPORT THE COMMUNITY. 
          UM, BUT, BUT IT IS TRUE THAT OUR, OUR, UH, LOCAL HEALTHCARE WORKERS, JUST LIKE ACROSS THE, THE CA THE COUNTRY, UM, HAVE LEFT US AT ALARMING RATES. 
          BUT, BUT WE HAVE SEEN AS WELL THAT WE'RE ABLE TO RISE TO THE CHALLENGE. 
          OKAY. 
          A REPORT FROM THE BAKER INSTITUTE MENTIONED THAT ANTI-VACCINE LEGISLATION CAN POSE A THREAT EVEN WHEN NOT PASSED. 
          TEXAS, UH, 2021 LEGISLATION PROPOSED UNSUCCESSFUL ANTI-VACCINATION AND SPECULATION SHOWS THAT IT MIGHT BE SUBMITTED IN 2023. 
          THAT IS TRUE. 
          YEAH. 
          SO, UM, LOOK, WE'RE ABOUT OUT OF TIME, SO I'M NOT GONNA GO TO MY SOAPBOX, BUT, UH, THIS IS JUST FOOLISHNESS, ANTI-VACCINATION, UH, LEGISLATION. 
          YOU KNOW, POLITICIANS SHOULD NOT BE MAKING MEDICAL DECISIONS. 
          THIS IS AN OR, OR QUITE HONESTLY, PUBLIC HEALTH IN MY OPINION. 
          THIS, YOU KNOW, ANYWAYS, I GOT A SOAPBOX, BUT WE HAVEN'T GOT ENOUGH TIME. 
          WE SHOULD TRUST OUR MEDICAL PROFESSIONALS. 
          AND I THINK Y'ALL HAVE CERTAINLY, UH, PASSED THE TEST TODAY. 
          , THANK YOU FOR JOINING US FOR COVID-19 TALK WITH LOCAL HEALTH AUTHORITIES. 
          WITH US WAS DR. 
          ERICA BROWN, REPRESENTING HARRIS COUNTY, DR. DAVID PER REPRESENTING THE CITY OF HOUSTON. 
          SPECIAL THANKS TO PAST PRESIDENT OF ROTARY CLUB OF HOUSTON, KATHY FINNER, OUR PRODUCERS DAVID CASTILLO, PRISCILLA KEY. 
          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.