OU Medicine COVID 19- Public Update

OU Medicine COVID 19- Public Update


– I just wanna welcome everybody. We have a lot of people
that are live streaming right now from the media,
as well as on Facebook Live, for our media briefing on
COVID-19 at OU Medicine. My name is Jennifer Schultz. I am the Senior Vice
President of Marketing and Communications
(chime) for OU Medicine
(chime) and we are gonna go
through kind of a slightly different format for the
media briefing today. Some of our media friends that are here today, all of them that are here today experienced some of the
restrictions that we have in place to avoid unnecessary
exposure to our patients. You will notice that we have
hand sanitizer on the tables. You’re encouraged to use it before and after our presentation. You will also note that
we have implemented social distancing in
place for our speakers and your cameras are very far apart. We’re in a very large room. We typically don’t do media
briefings in this room, but this allows for our
speakers as well to have space. These are some things that
you’re gonna hear about today that will help us stop
the spread of COVID-19. We’ve gathered many of
our experts here today to offer you facts about this pandemic. Many of these individuals need
to get back to their clinics to care for their patients, and also are part of
our public health group for OU Medicine that is working
on practice and protocol. So we’re gonna get right to it. Our first speakers are here
to talk about OU Medicine’s enterprise-wide preparedness for COVID-19. Chuck Spicer is the President
and CEO of OU Medicine, Inc. and Doctor Jason Sanders
is Senior Vice President and Provost of OU Health Sciences Center. I will ask them to come to
the podium one at a time. First off, Chuck Spicer. – Good morning and thank
you for being here. I’m Chuck Spicer, President CEO of OU Medicine. Our healthcare system is focusing on a critical challenge to our city, our state,
our country, and the world, and we are confident in our ability to take up that challenge. Our health system includes
OU Medical Center, the Children’s Hospital,
OU Medical Center Edmond, OU Physicians in Tulsa and Oklahoma City, the Stephenson Cancer Center, Harold Hamm Diabetes Center, and OU’s seven health
professions colleges. Our teams have been working and
are working around the clock to prepare employees and patients to meet the needs that
do arise and will arise. More importantly we have been working proactively with state
and local officials, the State Department of Health, the City County Health Department, our community hospital partners, and the Oklahoma Hospital Association to help prevent and reduce
the spread of COVID-19. We have been preparing for
this since we first heard about the virus several months ago. Our most important responsibility is the health and safety of our patients, staff, visitors, and students. Precautions and protocols across
our healthcare system have been established to help
achieve that level of protection and hospital university readiness teams made up of physicians, epidemiologist, public health experts and
clinical and hospital leaders have been meeting regularly, deploying for ongoing preparedness and assure we are there for the challenge. Some of the specific
steps we’ve taken include institutionalizing a stringent visitation policy for our patients, restricting vendor access, adopting strict travel
guidelines for our staff, ensuring we have appropriate inventories of critical supplies and equipment to meet the needs of our patients, reviewing all non-emergent surgical cases and procedural cases and rescheduling appropriately
to protect our resources, as well as to protect the exposure and risk to our patients and staff. We’re already practicing
social distancing. We’re including virtual
meetings for any meeting comprised of ten or more people, implementing virtual
work-from-home policies, altering our food service
and cafeteria policies, and limiting the number of
people that ride our shuttle and shuttles at one time
and cleaning them regularly. Additionally we have
developed a variety of tools to provide direction and
assistance to our teams, share those with the hospital association on how we can handle COVID-19 together because we believe our responsibility is to help stop this
disease from spreading not just in our hospitals, but outside the walls of our buildings. We’re offering these materials
to anyone that needs them and we’ll make them
available on our website, oumedicine.com/coronavirus. I’m confident in these times. We have great partners
to address challenges and one of my great partners
is Doctor Jason Sanders who I’ll hand off to to talk
about the specific things that OU Health Sciences Center
is doing regarding COVID-19. Thank you. – Good morning. Thank you, Chuck. As we focus on eliminating
the spread of COVID-19, it’s been humbling and
inspiring to witness the entire OU Medicine combined team rally with ideas and actions. No organization in the state of Oklahoma is more equipped to fight this virus than the combined efforts
of OU Medicine, Inc. and the OU Health Sciences Center. Our healthcare and academic leadership is made up of highly
talented and skilled experts, including researchers,
infectious disease specialist, epidemiologist, public health officials
and medical providers in nearly every specialty, many of whom you will hear from today. We have been proactively and aggressively studying COVID-19, the coronavirus virus, and are here to bring you the latest information about the virus. Regarding our educational programs, the Health Sciences Center
in Oklahoma City and Tulsa are adopting course formats and making temporary modifications in order to respond to the
changing COVID-19 situation. Our students are receiving
information from their colleges about using online resources, as well as making modifications to instruction in clinical
and community formats. We are dedicated to mitigating
the risk related to COVID-19 to our students in our campus community while at the same time fulfilling
our mission to the state to train health
professionals and scientists. By limiting exposure and
educating the public, we are committed not only to slowing, but to ending this deadly disease. Today you will hear from some of our top experts in their fields regarding the latest COVID-19 information, including Doctor Linda Salinas, an infectious disease specialist who serves as the epidemiologist
at OU Medical Center, Doctor Aaron Wendelboe, an epidemiologist with the OU Hudson
College of Public Health, Doctor Dale Bratzler, OU Medicine, Enterprise
Chief Quality Officer, Doctor Doug Drevets, Chief of Infectious
Diseases at OU Medicine, Doctor Rodney Edwards, Chief of Maternal-Fetal Medicine
at the Children’s Hospital, Doctor Moe Gessouroun, Chair of Pediatrics at
the Children’s Hospital, and finally I want to leave two notes about our combined efforts
at an academic health center. First I want you and
our listeners to know, the first to know, that we are in the final
negotiations of an agreement between Doctor William Hildebrand, an OU Health Sciences researcher, and Pure MHC to identify novel targets for a therapeutic
vaccine against COVID-19. We will give you more information
as it becomes available. Secondly we are also
finalizing an agreement with another researcher to begin preclinical testing of
another COVID-19 vaccine to help bring a vaccine to
patients as quickly as possible. Thank you. – Thank you, Chuck and Doctor Sanders. Up next is Doctor Linda Salinas, OU Medical Center epidemiologist and infectious disease specialist. Doctor Salinas will be
talking about the importance of preparedness in
hospitals to ensure we can care for patients, as well as
our temporary visitor policy. Doctor Salinas. – Good morning and thank
you for the opportunity. As Jennifer just said, I’ve been asked to discuss the importance of hospital preparedness, and specifically the OU
Medicine hospital preparedness. I’m going to combine these two because they are very much linked. Clearly preparedness plays a vital role in controlling this pandemic. As OU Medicine, we have dedicated areas to
specific patient care needs, ICU patients versus non-ICU patients, set up for all three of our hospitals. As Chuck alluded to, we have provided a tool
kit which is updated, sometimes twice daily, with new recommendations as new information becomes available. This is an online resource
for all of our providers. It discusses things such as
testing, how do we order a test, what do we do for healthcare
worker screening, et cetera. We have daily briefings, often multiple daily briefings, with regards to the
availability of supplies, especially important, the
personal protective equipment. We have staffing plans and
staffing contingency plans. We have worked with all services because this touches everybody who touches a patient in the hospital. We work with our laboratory personnel in assuring they know how to
handle and collect specimens. We worked with our environmental services, transportation services, and just to assure everybody understands our processes. The hospital and campus leaderships have multiple briefings daily as new developments come to light and we adjust our
recommendation based on this. Importantly we have a collaborative effort going across all the
hospitals in the city. It is not uncommon for me to
speak at least daily with other hospital epidemiologist to assure we are messaging things and
keeping ourselves aligned. Our new visitor policy was put into place about a day ago and includes one visitor for our adult facility, so OU Edmund and OU Medical Center, and this visitor is to
be 18 years or older. There are two visitors for
our Children’s Hospital and our Women’s Hospital. This is certainly all in an
effort to protect our patients, their families, our hospital caregivers, and an effort to mitigate the possible transmission of the virus. Thank you all. – Thank you, Doctor Salinas. Next up is Aaron Wendelboe, PhD, OU Hudson College of Public
Health epidemiologist. He is going to talk about
what actually is a pandemic and the trends we are now
seeing regarding COVID-19. – Good morning. A pandemic is an outbreak of disease with sustained transmission
in multiple countries. The decision of the
World Health Organization of when it decided to
declare it a pandemic was probably more dictated by public reaction
rather than the pandemic reaching any size or scope. Since the turn of the century, we have experienced at
least five pandemics: the SARS pandemic of 2003, the H1N1 influenza pandemic of 2009, the MERS pandemic of 2012, the Ebola virus pandemic of 2014 and the Zika pandemic of 2016. What makes this coronavirus
pandemic different? It is the unique
combination of being severe, but not too severe, along with
being highly transmissible. This has made responding
to COVID-19 a challenge. For example, in 2003, SARS, which was caused by a
virus related to the COVID-19, actually was more severe. It had a higher case fatality rate, but because of this, more cases were detected and therefore we were able to track and prevent additional transmission. In contrast, the 2009 pandemic of H1N1 influenza, it turned out not to be as severe as we had previously feared
and so it didn’t end up stressing the public
health or healthcare system to the extent that COVID-19 has. COVID-19, just to reiterate, it is severe, but not
necessarily severe in everyone, and I’ll get to some of
those statistics in a minute. I realize that the primary
question on everyone’s mind is: how is this pandemic going
to unfold in the future? Unfortunately it’s difficult to predict because it all depends
on what we do today. There are two primary factors that will effect how the pandemic unfolds and those have to do with transmission. There’s known transmission and unknown sources of transmission. From the first time the
U.S. saw a case of COVID-19, we were able to identify
the source of transmission for every case for approximately a month. During that time we had a slight increase in the number of cases. About three weeks ago, the U.S. had the first case of COVID-19 with unknown transmission, meaning that there was evidence of ongoing transmission in the community. When this happens it makes it difficult to identify every single
case in the community and therefore prevent transmission. Because this we are now in the situation of ongoing transmission
in the United States. We’re trying to predict what
will happen in the future and to do that we can look at countries that started their pandemic before us. One thing that we have learned is that social distancing works. We’ve learned that because
if you look at the response of countries like China and South Korea, they have instituted
aggressive social distancing and other public health measures and have been able to bend the curve, which we’ll talk about later. There are other countries that continue to have increasing doubling rates that are stressing the healthcare system. Italy and Iran are two of those countries that continue to see
increasing number of countries or number of cases. Pandemics have a way of
exposing countries’ values: who do we protect and who do we let be the casualties of disease. As public health professionals, we observe the number of days it takes for the number of cases to double. What we’re trying to do
is make that doubling time be closer to eight to 10 days rather than two to three days. There have been over
7,500 deaths worldwide and just under 100 in the U.S. There have been over
4,700 cases in the U.S. We expect about 10% of detected
cases to be hospitalized. Of all cases we expect
about 80% to be mild, 15% to be moderate, and 5% to be severe. The death rates we can expect will again depend on what we do today. Overall 3% of detected cases may die. This will range from
less than 0.1% to 15%, where increasing age
increases your risk of death. For this and other reasons we are working with everyone to prevent
as many cases and deaths and slow the growth of this pandemic. – Thank you. Up next is OU Medicine’s
Chief Quality Officer, Doctor Dale Bratzler, who will now talk to us about the curve: what it is, why it is
important to flatten the curve, and how the public plays a
role in flattening the curve. – All right, thank you. Good morning everyone. So as I was driving to work this morning, I heard this term that probably all of you have heard frequently: we need to bend the curve. What does that actually mean? So this is the epidemic curve
that we’ve actually seen, both for China and for all of the other countries in the world. Now I will tell you that
this slide now is out of date because as of last night
when I looked at it this orange line now exceeds
the number of cases in China. The rest of the world
has now seen more cases of COVID-19 than we’re seeing in China at the outbreak
of this particular disease, but China has finally bent the curve. They’ve gone from what we
call exponential growth where the number of cases
is doubling very rapidly and they’ve slowed the
growth of the disease. So what did they do? Well they focused on a
lot of what we will call non-pharmaceutical interventions. There is no treatment for this disease, so they weren’t curing people. So what did they do? They went to early detection. I’m told that the peak of the event, they were doing 15,000
tests on patients per day. They went to isolation then of those patients who tested positive. They did social distancing. They put into place travel restrictions. Plane, trains, buses were all shut down. Subways were shut down. They went to quarantine. They closed businesses,
restaurants, factories. They canceled all large public events and closed their schools. There’s data that shows that
had they done those things one week earlier than
they actually implemented some of that social distancing, they would’ve reduced the
number of cases by 66%, but without it, had they not done those things, they would’ve seen 67 times more cases. So they certainly have really ramped up their public health
efforts to bend the curve. So this is what that means visually. I wanna highlight the concept
of health system capacity because, let’s face, in the United States, there are about 45,000 ICU beds. This is data from 2017. In Oklahoma there were
only about 1,250 ICU beds and that number is probably lower now because as you know since 2017 hospitals in the state have closed, but that’s the capacity, the number of nurses, doctors, ICU beds, hospital beds that we have
to care for the population. If we don’t do things like social isolation and social distancing and other things, without those protective measures we’ll see a big spike
in the number of cases, and that’s what happened in China. That’s certainly what happened in Italy where they’ve overwhelmed
the healthcare services that they have in northern Italy. As Doctor Wendelboe said, what we’re trying to do is
stretch the length of time that the number of cases in
our country in our state double because if we can do that,
we can flatten the curve, or bend the curve so that we don’t have
as many cases at once. We may not prevent complete
transmission of this disease, but what we’re trying to slow is the fact that we may overwhelm the healthcare system
capacity to actually do that. So here’s the epidemic
curve for the United States. As compared to Iran, Italy, South Korea, you can see that right now we’re on a path that’s
not particularly good as compared to Japan,
Singapore, and Hong Kong, which did very aggressive
testing and social distancing, which included strict
quarantine, school closures, all of the other things that
we’ve talked about before. I’d like to end my
comments by just talking about what history can teach us here and this is a slide about the Spanish flu, the flu epidemic or pandemic of 1918, which was devastating to the world. I would simply highlight
a couple of things. Think about the flu of 1918
in a similar way to COVID-19. There’s no treatment
and there’s no immunity, which was the case in 1917 and 1918 when this flu actually spread very much. But this is the tale
of two different cities because when Philadelphia identified their first case on September 17th, it was almost two weeks before they implemented social distancing policies versus Saint Louis that
implemented their policies within two days of
identifying the first case. You can see, they flattened the curve. They bent the curve, and that’s what we’re talking
about when we’re talking about slowing the distribution
of this particular illness. – Thank you, Doctor Bratzler. Up next we have Doctor Douglas Drevets, OU Medicine’s Chief of
Infectious Diseases. He will expand upon the curve
discussion a bit to talk about how we can all help
stop the spread of COVID-19. He will also discuss what to do if you are exposed in screening versus testing. – Hello and thank you
for asking me to be here and thank you for being here yourselves. I’ve been asked to discuss or at least touch on three different questions. One is: how can you help stop
the spread or bend the curve? What can each of us do? Second question is: what
to do if you are exposed? And the last question is: what is the difference
between screening and testing? In terms of stopping the
spread and bending the curve, as you saw from the previous
talk by Doctor Bratzler, I think my biggest recommendations is to take social distancing seriously. This really is not a game, although you’re welcome
to turn it into a game if you’re trying to teach
your children how to do this, but this is something real and it
is something that works. Some of the things that
you have already heard throughout many media outlets are practicing good personal hygiene. If you have a cough, make sure to cough into your sleeve instead of out to the open, use a tissue, and then wash your hands. Frequent hand washing is important. This is important because
the virus can live for a particular period of
time upon those surfaces. If you’re spreading disease
when you’re talking and coughing to a variety of places and
then you’re touching things and then you touch your face or your nose, you are contaminating yourself
and infecting yourself. On average we touch our
face about 90 times a day. So if you can also slow that
down, that would be helpful. The social distancing norms are somewhat difficult to
explain and they may mean different things to different people. In general it will be six feet and 30 minutes from folks. That’s generally what is
required to spread the disease, meaning that if you’re within six feet with somebody for longer than 30 minutes. Now that’s not always the case, but that is generally the case, and realize there are nuances to that. Something else you can do
is develop creative ways to communicate with friends, children, and loved ones without
being in their presence. So this will help with
the psychological aspects of social distancing and isolation and through this you can
encourage them and yourselves, and by doing that then we will all sort of protect one another. The next question is: what
to do if you are exposed? First thing to do is to remember that not all exposures are the same. There are high-risk exposures,
there are low-risk exposures. Typically a high-risk
exposure will be something, if you’re in close proximity, meaning within six feet
for a long period of time with someone with a known
case of the disease. That will be harder and harder to establish until we
can get testing going, but in general that will
be a high-risk exposure. If I’m in this room and there’s somebody up in the 25th row of this room who ends
up having the disease, we see each other from 50 feet, wave, that is not a high-risk exposure. So you have to think about this. Not all exposures are the same. Remember also that not all exposures will necessarily result in infection, and not all infections result
in symptoms of disease. There is a large cadra of
folks who are infected, but who do not show symptoms of disease. So just because you’re exposed, you will not necessarily get infected. If you are infected, you will not necessarily
develop symptoms of disease. If you do develop symptoms, remember right now in Oklahoma
it could be something else. We still have quite a bit of influenza circulating in the community. So if you do develop symptoms, my advice would be to
get tested for influenza. It is a treatable disease. The sooner you get that treated, the sooner you’ll be better. If you have minimal or no symptoms, please do not rush out to get tested. This will overwhelm the
limited testing capabilities and it will just not be helpful to you or to the medical community. The advice would be to stay at home and protect those around you. Stay away from others. That said if you are
high risk for progression or having severe disease, for example, if you’re over the age of 65
and have a variety of medical, what are called comorbidities
or medical conditions such as high blood
pressure, heart disease, lung disease or diabetes, then you do need to call your provider and seek some guidance. If you are exposed and if you get sick and then if your symptoms progress, particularly to the point
of shortness of breath, that would be the trigger to seek medical attention and get seen. The last question is: what is the different between
screening and testing? Think of screening as a process by which the medical
community assesses risk. We’re trying to figure out: do you have a high risk of infection or a high-risk exposure,
or is it low risk? So screening may likely include a detailed history of where you’ve been and if you’ve been in direct contact with somebody who’s been
diagnosed with the COVID disease, or for example if you have
just returned from an area where there’s a very
high burden of disease, meaning higher than Oklahoma. In terms of testing, testing is when we actually
look for the virus itself. Right now the test in Oklahoma
and in most of the country or what’s called a polymerase
chain reaction test where we’re looking for
viral genetic material. It’s a swab. It’s inserted back into
the back of the nose. It’s just a little bit uncomfortable, but that’s the best way to get a specimen. It’s then run on a machine and we can look and see if the virus is actually there. Caveat to that, remember that just if
you test negative today doesn’t mean that next week you won’t become infected and then test positive. So just because you test negative once does not give you a pass
for the next several months while we’re going through this. This is a fundamentally different counsel than for other infectious
diseases such as Hepatitis C, in which case we’re measuring
often the body’s response to the infection by measuring antibodies and when it is critically important for you to get tested
so you can get treated. This is a different disease. We have different test and we have to deal with them and
the answers differently. So realize that not all testing for infectious diseases is aligned. So lastly I would like to stress that we are all in this together. We can all do our part
for social distancing. We can take the guidance from the national health
authorities seriously and by helping each
other with perseverance and calm determination,
we will get through. Thank you. – Thank you, Doctor Drevets. Next up we welcome Doctor Rodney Edwards, Chief of Maternal-Fetal Medicine at the Children’s Hospital at OU Medicine. – Good morning. I’m to talk to you about the special case of pregnant women and this virus. Unlike some other viruses,
as best we know yet, there is no vertical
transmission of COVID-19 from, that is from mother to
fetus during the pregnancy or from mother to infant
at the time of birth. Thus far it doesn’t
seem like the infection is worse in pregnant women
compared to other individuals. There are some viruses that are worse during pregnancy than in
the non-pregnant state. Influenza is an excellent example. The reasons for that have more to do with pregnancy physiology than with the
characteristics of the virus. So to be conservative, for now we are considering pregnant women potentially at risk, not a greater risk of getting the virus but potentially a greater risk of becoming more severely ill with the virus. We don’t know that for sure. It’s just something that we’re trying to keep in the back of our minds when evaluating if a patient would need to go to the hospital or not and caring for an
incoming pregnant patient, when that occurs. You’ve heard about screening, both at entry into the hospitals. We also are screening
patients and visitors in our three prenatal clinics on campus. As we’re limiting
visitors to the hospital, we’re also limiting
visitors to our clinics. The approach to testing
probably will change, but as Doctor Drevets said, for now, only patients that are
symptomatic are getting tested. That applies also to
the pregnant population. And then obviously this is a situation that I anticipate will evolve both for the overall healthcare population and for pregnancy care specifically and we will continue to
work on the situation and evolve care as necessary. Thank you. – Thank you, Doctor Edwards. Our final speaker this
morning will discuss the latest information
regarding children and COVID-19. Doctor Morris Gessouroun
is the Chair of Pediatrics for the Children’s
Hospital at OU Medicine. Welcome, Doctor Gessouroun. – Well, good morning everyone,
and thank you Jennifer. I do have the opportunity
to give a little bit of good news for the parents
and families in Oklahoma and that is that in general children have very much
milder disease than adults and most present with
minimal or no symptoms. Hospitals in China, Italy, and other states in the United States have reported very few children
requiring hospitalization. So we have every reason to believe that this will also be
true in Oklahoma as well. Moderate or severe disease is rare, but slightly more common in infants, especially those under a year of age, and it also may be the children with significant pre-existing
medical conditions such as congenital heart disease, lung diseases such as
asthma or cystic fibrosis, chronic kidney or liver disease, those with suppressed immune systems such as those on cancer chemotherapy, metabolic disorders or diabetes
may be of increased risk. These children in particular
should be watched closely for the development of the key symptoms of fever, cough, and particularly
difficulty breathing. If this happens, parents should contact the
child’s healthcare provider. The other greatest concern is that although most children
have minimal or no symptoms, they still are infected and can therefore spread the infection to others. There is growing evidence that spread from minimally symptomatic
people including children exceeds that from those
who are visibly ill. Therefore it’s important that
efforts be made by parents to take certain actions
to help reduce the chance that vulnerable people become infected from exposure to children. As you’ve already heard,
practice social distancing. Limit direct contact with
those who are at risk including adults over 60, adults and children
with chronic conditions such as heart disease,
high blood pressure, diabetes, lung disease and
suppressed immune systems. The best bet is to stay home and practice enhanced hygiene measures. Finally by now everyone appreciates that during times of widespread infection one of the most precious
resources that a community must protect is its healthcare providers who must remain available
to treat the most ill. In order to prevent healthcare
workers from becoming ill, many centers, including our own, are developing plans to reduce their exposure to potentially infected but not seriously ill
patients who can delay care. As a consequence, in the long-term best interest
of Oklahoma’s families, we are evaluating how we can limit non-urgent visits to our facilities and we’re working to convert as many necessary visits as
possible to be available by video telemedicine
rather than in person. For patients (mumbles) here at Children’s, our clinics will be in touch to best determine how to provide your children the care they need while minimizing your
family’s exposure to COVID-19. Thank you. – Thank you, Doctor Gessouroun. Thank you to all of our experts this morning that participated. Thank you to the media for joining us. Before we break into the Q&A session, I’d like to announce that today OU Medicine is launching a
public health awareness campaign aimed at educating the general public to help stop the spread of COVID-19. We’re mobilizing many of our
partners around this campaign and are ready and willing to share it, encouraging others to take
the materials, co-brand them, and use them in their own organizations. It’s important to note that
these messages have been vetted by the Public Health Epidemiology Infectious Disease Faculty of
the OU Health Sciences Center which means it’s the most current, latest, evidence-based information about stopping the spread of COVID-19. As this information quickly evolves, we will be updating this campaign. So if you are interested
in using the materials, it’s a marketing toolkit
that includes talking points, prevention flyers, advertising, posters, social media assets, all types of things you can
implement even in your business if you wanna share that
with your employees. There’s also public service announcements for radio and television in it. You can email us, [email protected], and we will share what marketing people call native artwork with you. At this point we are actually going to open the floor for questions. So we’re going to actually
have a Facebook Live audience is gonna be asking questions. So we’ll have some things
coming in from Facebook Live and we do have some of our
experts that have still remained here for questions. So if you maybe wanna
come socially distanced, kind of to the sides, maybe a little more readily
available to answer questions. I’d sure appreciate that. I see we already have one
hand raised around a question. What’s your question? – [Christine] Hi this is
Christine over at Channel 5. You guys mentioned earlier, you guys were possibly trying to develop some things toward a vaccine. I think that was Jason Sanders who mentioned saying about that. Do you mind elaborating
on that a little bit. – So yes I’m gonna
actually ask Doctor Sanders to come over and speak in the mic. The question is around the vaccine that he had mentioned developing. – Some of our roles as an
academic health center is to bring research from the laboratory to patients. So there are two announcements. One: one of our researchers is working with a company called MHC
to develop a new vaccine, so a researcher here taking
our laboratory research, bring it to clinical environment. The second one was, as many academic health
centers across the country and you’ve seen on the national news bringing a vaccine that was developed elsewhere into our clinical environment. You’ve seen that in other diseases with our Stephenson Cancer Center. It’s exactly the same. People resources that we have here to bring vaccines for COVID-19. The only caveat I would
say for our listeners is we have great hope in vaccines. There will be a vaccine for COVID-19. The question is, when? But I really wanna underscore what all of our experts have said at this point, and particular Doctor Bratzler said. I think the 1918 pandemic slide that hopefully that everyone saw, we really need to act
now in stopping spread. We wanna reassure the audience
that as we’re doing that, we’re looking at the long run and preventing this in the future. We’ll fully participate
in vaccine development. – [Woman] This is (mumbles)
from (mumbles) Fox 25. You also mentioned that there will be free clinics. Where will those be located or are you able to say
where they will be located? And that’s for Jason Sanders. – So the question was about
clinics and clinical patients. – So I can start. We’re working with the state, State Health Department, Oklahoma City County Health Department. As Doctor Drevets discussed, we’re at a phase now of distinguishing screening and testing. So in general the
approach would underscore if you have symptoms, and particularly if they’re mild or if you don’t have
an elevated risk by age or by associated conditions, we are recommending to isolate yourself, and as you heard yesterday
from national experts, not only isolate yourself, but as much as possible
isolate your family. We are nationally and
locally working with partners to try to increase testing
as rapidly as possible. You saw the curve that Doctor
Bratzler showed earlier, that rise of infections, and we want to get more
information to see where we are in that curve and to see
if what we’re implementing to distance people is working. So right now, that’s the
way we’re looking at it. We are also providing
care for other patients, whether flu or other
conditions in our clinics. In particular as we’re trying to stop the spread as we’re delivering care, we’re asking patients who have symptoms suspicious for COVID-19 to
not come into our clinics, to not come into our
emergency rooms or hospitals unless those symptoms are
severe or they have risk. We on a daily basis will be working with the state to announce screening facilities for our own patients here and for the community. That is under development. We don’t have announcement today, but what we can say clearly today is if you have mild disease, the best step is to isolate yourself. Stop that spread. Certainly if you have symptoms, that’s why we are here to provide care. Others may wanna elaborate. – I have a couple other
questions that are coming in. I have a couple questions
coming in from Facebook Live. So one of the questions is,
I’m gonna bundle it together. It’s really: “Can you have the flu “and COVID at the same time?” In addition to that, “If
you had the pneumonia shot, “does this have any impact “in a person’s reaction to the virus “if it compromises the lungs?” – So those are both good questions. The best data I can tell
you is that of China and I’ll answer the first question first about can you have influenza
and COVID at the same time. I could find two studies
on that, both from China. The first study encompassed only 30 patients, and then had 30 controls. In that study over about 20 to 30% of
patients who had COVID also had one form of influenza or another, either influenza A or influenza B. So in that small study,
you could see coinfection. Last week there was just
published a larger study of patients with
pneumonia caused by COVID. In that study only one out
of about 170 individuals who were tested for both influenza and COVID also had influenza A. So my counsel would be, it is possible that you could have both infections at the same time. The big difference is, we have drugs that can treat influenza. So you need to know if it’s influenza and you can get treated for influenza. If your symptoms go away
and they don’t come back, you’re good. I can’t remember what
the second question was. – It’s about the pneumonia shot. – Oh, yes, also a very good question. If you’ve had a pneumonia shot, how does that change your personal curve so to speak for the COVID disease? So if you’ve had the pneumonia shot and you’ve had a good
response to that vaccine, it will not change your ability
to get infected by COVID, and in fact it probably
will not prevent you from getting COVID pneumonia if that’s where things were going for you. That said, it may prevent you from getting a secondary infection
by the bacteria against which the vaccine works
on top of the COVID. So there is some value in making sure that you’re up to date in your vaccines. I’ll just put a plug in here. There’s also value for stopping smoking. Lung disease is a risk factor for COVID. If you stop smoking
now or stop vaping now, you can in fact improve to some degree the host defenses in your
lungs fairly rapidly. So always a good time to stop. – I have another question
from Facebook Live. “Historically it seems that
pandemics seem to die down “when the weather gets
nice and people go outside. “Do we have any idea if that
might occur with COVID-19?” – We can speculate. One of the reasons why we tend to see the increase in infections, whether it’s influenza or other, acute respiratory infections, including coronavirus
infections during the winter, is because of what we’ve been talking about with social distancing. People come together for holidays. They’re inside. The weather’s terrible and the ventilation isn’t great and that provides opportunities for acute respiratory tract infections to spread among people. During the summer when the weather’s nice, people are outside. There’s more social distancing and it is more difficult to spread
those infections outside. One of the things that makes
it a little bit more difficult to know exactly what will happen with this virus is what has been said. There’s essentially no levels
of population immunity. So because so many more people
are susceptible to infection, then there could be
underlying transmission during the summer and fall months that we wouldn’t see with some
of the previous infections. – Yes. – [Woman] Do you guys
know if the (mumbles) is (speaks off mic) current situation is around
testing here in Oklahoma? I mean we’re supposed to be getting (speaks off mic) five or more tests. Do you know, have any idea? – So the question is
around testing in Oklahoma and our work with the
Department of Health. – I don’t have the latest update on the available number of tests. As we know that we’ve been told that those tests will be
made available quickly. The State Health Department
has done some testing. There’s no local testing option, private lab testing in
the state currently. We’ve identified private labs across the region that we can use in addition to the state, but we are in regular contact with both the City, County Health, and with the State Health Department. I got a call where we’re waiting. We’re in the press briefing, so I think it’s a very fluid situation. Everybody’s trying. I know the state’s pushing hard. The providers are working together, so how we can approach this
in some level of consistency. I’ve been regularly in conversation with the other major health system CEOs so we can work together on
some collaborative responses. – [Woman] How important is testing? Is it the head of the CDC that
can answer (speaks off mic)? – The question is: how
important is testing? Doctor Drevets. – It’s hard to give you the right adjective
without sounding trite. It is very important to get testing, that we have the ability to
test large numbers of people. What we’re doing now in
terms of limiting testing is largely because we
don’t have enough tests. Now that’s not a surprise
to anybody in this room and we hope that much of these guidelines or much of our guidance
will evolve and over time. So we’re really trying
to prioritize testing for the people that we really, and by we I mean the medical community, that we really have to
know if they have COVID or if it’s influenza, or bacterial pneumonia, or something else. So what we do in the hospital situation is we try to rule out other diseases, and then select out the individuals who we have to urgently know if it’s COVID for infection prevention reasons or to do other things. So it’s quite important, and I’m not the first one to
have made that observation. – Another question? Do you wanna add something else, okay. – As Doctor Drevets
said, it’s our reality. You see the numbers. You could see how many test are available in other countries. Going back to what we showed earlier, we have to make decisions now
in the absence of that data and with the public awareness campaign. That’s why we really
hope that those listening in your viewer communities, listen to what we’re advocating today. We’re advocating this
in the current situation with the best information that we have and we would urge people
not to wait for testing, but on the individual circumstance that we discussed earlier,
but as Oklahomans, the best thing that we can do now is to stop the spread and
to intervene quickly. – Question. – [Woman] I gathered from
what everybody’s been saying we’re sort of in a tipping point between stopping the spread and making it exponentially worse. What advice would you have for state and local policy makers
who are trying to decide whether to keep businesses
open, or close businesses, or how to limit social distancing? – So the question that
has been asked is around, reference to the flattening the curve and what would we say
around social distancing and advice around decisions. – I think that they are listening and I think that they could look at places that’ve intervened early. What they’ve done is, Dale showed on a slide
how early intervention and what activities that
they’ve put in place to stop, that would bend the curve, flatten the curve rather. I know that we’ve had
regular conversations with the State Health Department with people in state government outside the Health Department. I believe there’s a lot
of activity for solutions. We’re eager to see that
and stand ready to engage with the state on how we could
be a part of that solution. – [Woman] So are you recommending closures of businesses and restaurants to help promote social distancing– – I’m recommending we
look at what’s worked. – Another question? – [Woman] Today, Saint Patrick’s Day, a lot of people were packed into a restaurant, in a bar. That’s happening more frequently and it seems as though people are taking it into their own hands. As medical experts, what can you tell people who
are going into packed places? We just wanna hear from you. What are you telling them? – So the question again
is about people wanting to go out to bars and
restaurants and being in crowds and what would our
recommendations be around that. – So my recommendation for
folks who still want to go into crowded venues would
be that they need to think about what the downstream
consequences of this is. What would they do if four five days after they went into a crowded place, what are they gonna do if they come down with fever, chills, and a dry cough? What are they gonna do if they are in a high-risk group and they get sick? What are they gonna do
if they can’t go to work for the next two weeks
after they get sick? So I think as Americans we value our freedoms and our personal independence and in a sense these things need to be thought through very carefully because we are a free people
and we are a free country. The best advice I could
give them is to think through the consequences
of your decisions. We see that everyday in people for example who decide to start smoking, or who decide, I’m not gonna take my medicines today for my diabetes and my
high blood pressure. That’s a bad decision, but we don’t, my role is to give advice. So I would just urge people to think through the consequences, think them through thoroughly. My advice would be to follow
what folks you trust are doing and I hope that we have gained your trust that we are doing what we
think needs to be done. You heard about the measures
that the OU Enterprise is taking to carry on business, but also to limit
exposures in the workplace. So I think that’s a good place to start. – Thank you, Doctor Drevets. I just wanted to add one other thing is that people are generally very terrible at assessing their own risk. With regard to this epidemic, we can see that there are 10
reported cases in Oklahoma. So people may be tempted to think that the situation here is not that bad. People need to realize that those numbers reflect essentially five to seven days out of date because the reported cases are just that: they’re reported and they’re known. They’re not the time
that they were diagnosed. They’re not the time that the
transmission was happening. All of that was happening days before. So people have a tendency
to look at the numbers today and think that that’s their risk today, but it doesn’t reflect
what’s actually happening in the community right now. – Go ahead. – I’d like to add one
more comment to that. I think it’s important to understand that when you have the news indicating that there’s only 10
report cases and people may be a little bit complacent about that, understand that 80% of
people have mild symptoms and children have virtually no symptoms but are carrying the
virus and can spread it. So this is a circumstance that that piece of news is deceptive and we need to be aware, particularly in the face of the fact that we have very limited
testing capability, that we don’t really know how
widespread this is right now and I think we have a social
responsibility to each other. No one wants to be the person who goes out to socialize in a crowded area, and then potentially be in contact with a high-risk person
and transmit that to them and effect their lives. So it’s really really important for us to be socially conscious about this. – I have a couple other questions. I know our experts are
needing to take off very soon. I think one of the questions is: “Is it possible for a person “to get COVID-19 more than once?” That’s a Facebook Live
question that has come in. – So that’s a great question. Is is possible to get
COVID-19 more than once? The shorter answer is we don’t know. It’s a brand-new infection. It was first identified
probably in December, perhaps earlier than that, and we won’t know these answers until folks who have documented infection, we have time to follow
them and see what happens. – So maybe we take one
final question in the room. Who has not asked a question yet? – [Woman] Yeah. What kind of procedures does OU Medicine have in place if the healthcare worker might be exposed to COVID-19, or I guess, some, yeah, or show symptoms themselves? – Okay, so the question is: what type of procedures
do we have in place if a healthcare worker is
exhibiting symptoms of COVID-19? – First we have the ability to
screen, whether there’s risk. As Doctor Drevets has
talked about earlier, we have a protocol, an algorithm we follow to assess that risk and determine if a test is needed. If a test is needed, we have an isolated testing site that we’ve identified away
from our care facilities so the test can be conducted there. In the event there’s an exposure, without a confirmed
test or need for a test, we do have isolation if
someone’s traveled somewhere. Whether there’s an
at-risk nation or state, we have isolation and
quarantine guidelines. – Okay, I have one final question
from a reporter in Tulsa. Doctor Sanders, I think
this might be one for you. It is asking the question around, “What are novel targets
for a coronavirus vaccine? “What does that mean?” – So thank you for the question. The role of vaccine is to provide a vaccine to individuals in the community who haven’t been infected
to prevent an infection. You’ve heard earlier that one of our first lines of defense in the body is your body’s own immune system. Doctor Drevets mentions for example that stopping smoking
now can help boost that. The vaccines that you’re familiar with, childhood vaccines, flu vaccines, are a boost to your body’s defenses when a new virus is exposed to the body. So how do you help boost that immunity? You try to have your own
immune system recognize parts of that virus as it
enters the body and attack it. So that’s what a novel target means. It’s looking at things on this virus, think of it as signs on a virus, however it makes the most sense, you’ve seen pictures
of it, it’s very small, so that your body recognizes
it and attacks it. We’ll share more details going forward about how the vaccines work, but another way to look at the target is not only how you first
identify this new virus, how it’s different than
flu or other viruses that individuals are exposed to, but then how the body responds. That boost of the immune system is not only recognizing the virus, but the immune system’s response. Probably won’t go into
further details on that, but we’ve learned a lot and
leaders like Doctor Drevets, as we’ve learned from other
viruses like HIV and AIDS and in our studies of cancer, we really learn all the
complexities of the immune system. So it’s not just how our immune system recognize it, but how it responds. So hopefully that helps. – [Woman] Sorry, I have one more question. The State Department of
Health just put out numbers. There’s now 17 confirmed
cases in Oklahoma, that number doubling, nearly
doubling just within a day. Can you just talk about what we can expect in the next few days from you guys and is this a surprise to you at all? – So the question is: the State Department
of Health just put out that we have 70 confirmed
cases in Oklahoma. – [Woman] 17. – 17 confirmed cases in Oklahoma and wanting to know what we think we could expect with that information. – I’ll start, then have
our experts comment. We’re not surprised. We’re prepared for this. As you’ve heard, that data already lags several days and the actual number of
cases is higher than that because of what we discussed
in lack of testing. Others may wanna comment. – Sure, I’ll start, then let Doctor Wendelboe
fill in when I finish. So think about it. Our testing, we’re looking
backwards five to seven days. What I mean by that, on average it takes folks around
five days to get symptoms, and then if it takes two more days to get results after they’ve been tested, if they were tested on day
five and it’s positive, then you’re out to day seven. So you’re seven days out from when they actually got infected. So this is again not
particularly surprising. It does give us a look
at what’s happening. Unfortunately you have to
realize that the reported cases, we’re always looking
backwards several days, and in this case perhaps
up to a week or more. Doctor Wendelboe. – One additional thought is just that as testing is made more available, we actually hope to diagnose those cases. If we can do that more quickly, then it’ll be a tool to help us track those contacts
and stop transmission.