just wait a couple minutes here for some
folks to join us for a few seconds i
guess
all right i'll go ahead and get started
good evening i'm ben casler mayor of the
city of bexley and i welcome you and
thank you for joining our september 1st
2021 covet 19 ask an expert panel
when we last hosted an ask an expert
panel the month was november 2020.
we were at the front end of a surge of
cases that would continue into early
2021 and slowly taper off as vaccines
became widely available
and from what we can tell bexley
residents have done a great job of
becoming vaccinated in the interim and
our community outperformed the county as
cases tapered off in the late spring
june of 2021 was our lightest month
since the beginning of the pandemic with
a mere nine cases throughout the whole
month
but with the rise of the delta variant
we began to see an increase in our
statistics in july and we began to hear
reports of breakthrough coveted
infections and more stories of
symptomatic infections among children
this past week bexley broke the 1 000
mark of total infections in the
community since the beginning of the
pandemic
the vaccine remains the strongest tool
to protect and against severe symptoms
and masks and other protective measures
remain a critical tool to helping curb
spread and protecting our most
vulnerable populations including our
children who do not yet have access to
the vaccine and are more medically
vulnerable populations among whom even
breakthrough cases can pose a risk
tragically one such bexley resident
passed away earlier this summer
the pandemic remains a serious threat to
the health of our community and the
delta variant poses new challenges
as this disease and our public health
tools continue to evolve it made sense
to reconvene and ask an expert panel to
help dive into the latest guidelines and
the need for continued vigilance and to
answer questions about vaccine timing
and efficacy booster shots and a myriad
of other questions
our guests today
are more than a panel
they have self selflessly helped our
community navigate this pandemic and
their expertise and guidance has saved
lives in bexley there's no doubt in my
mind
here to introduce them is our moderator
for the evening and co-host of this
event bexley library director ben
heckman
thanks ben thank you mr mayor um it's my
honor to be here tonight i will do my
due diligence and uh
bringing your questions to the q a
section of the zoom to our
esteem panel
and we will try to get all your
questions answered i'm sure many of you
have
a lot of questions uh so helping us
answer those tonight we have uh dr roger
friedman he's an allergist and
immunologist at the ohio ent and allergy
group
he works with petri
he works with kids and adults
also with us this evening
dr nicholas thunderberg is associate
professor at the division of medical
laboratory science at the ohio state
university
his primary professional areas of
interest are immunology molecular
biology clinical trial design and
infectious diseases
and
last but certainly not least
abigail norris turner dr turner is an
associate professor at the department of
internal medicine at the ohio state
university
and she
for 20 years has been an infectious
disease
epidemiologist and so with that we're
going to take our first question
to
dr abigail norris turner if you can give
us an uh kind of an update a picture of
what bexley looks like what outside
community looks like kind of where we're
at right now with everything
yes thanks ben thank you for the
introduction um i'm happy to start
things off
with sort of setting the stage about
where we are with covid um in bexley and
then broadly in ohio and in the us
um so as the mayor mentioned as of today
or this week we've crested a thousand
cases in bexley actually as of 5 pm
today um 1021 cases had been reported um
in bexley residents since march of 2020
so to provide some context for those
numbers
on september 1st of 2020 so a year ago
and six months after the start of the
pandemic there had been a total of 113
cases in bexley
on january 1st so four months later
cases had increased more than five-fold
to almost 600 cases so that was the same
search that we saw around the country um
starting with the thanksgiving holidays
and going through about the end of
january we saw cases increase
exponentially all over the country
and then as the benefit of vaccines
began to set in and it's more and more
people were vaccinated um cases began to
drop slowly at first and then much more
quickly um and again as the mayor
mentioned um the numbers uh for may and
and june and july were very low in
bexley and we really we really felt as
did the country that we had turned the
corner on this
um so again just just thinking back
or comparing where we are now to where
we have been so um with the increase in
cases that we've seen in the last couple
of weeks and for just over a month um
the two week incidents per hundred
thousand in bexley so that's the kind of
metric that the state tends to use and
cdc tends to use since the two-week rate
um is just over 200 per hundred thousand
um so for people who may have been
following along in past times um the
ohio department of health for example
uses
a threshold of one hundred per hundred
thousand sort of indicates high risk and
we're about double that now we're about
two hundred per hundred thousand but in
january things really were much much
worse and um
we briefly crested over 800 per hundred
thousand during that time so so although
where we are right now um feels scary
for a lot of people and the trend
associated with where we are right now
is a bit scary the actual numbers are
still quite a bit lower than they were
um about eight months ago
um thinking a little bit more broadly
about the state of ohio um so again for
folks who are who are watching those
daily numbers i'm i know not everyone
looks as closely as i do but um
you you could have stopped paying
attention and really missed the big
changes so um just about two months ago
we were averaging around 200 cases per
day in ohio
and yesterday we had nearly 6 000 cases
in one day
so it's really a 30-fold increase um in
that period of time that's just
extraordinary but it's the pattern that
the delta variant has exhibited in lots
of places around the world and
unfortunately we're seeing it in ohio um
just a little asterisk there today's
number was over seven thousand cases so
you might have
had even another jolt between yesterday
and today but um today includes about a
thousand cases that actually belong with
earlier days so really today looks about
the same as yesterday
um and and you know um
in the country we're seeing similarly
rising rates um it's very variable by
state and it's tracked very closely with
vaccination coverage
and so i'll just end this introduction
by talking a little bit about vaccines
in our local space and in franklin
county so um the franklin county public
health website lists vaccination
coverage by zip code so anybody can go
at any time and and click on the 43209
um and
what it shows is actually of all the
residents in our zip code we have 61
percent who are fully vaccinated
according to franklin county public
health that's 43209 so that includes
bexley but also includes parts of
whitehall that are also for 329. um in
franklin county the numbers are are not
quite as good so 43
of all residents are fully vaccinated
63 of those 12 and older 65
of those 18 and older and 86 percent of
the high-risk group of 65 years and
older
so i'll stop there i'm happy to answer
questions about any of those if we get
into them later in the session
excellent thank you doctor um i have a
follow-up question for uh dr thunderberg
so
i think there's a lot of people out
there who are like well i'm vaccinated
and so i should be good to go
can you explain to us how the delta
variant is different than
the earlier variant
sure yeah so the the delta variant uh
has a number of different mutations that
make it more transmissible and
potentially cause more severe disease in
folks
um so
previously it seemed like the the
vaccine you know with the alpha variant
and you know uh kind of normal soros
kobe 2. um it seemed like the vaccine
was relatively well protective against
some of those earlier strains but
the delta variant
and some of its mutations in the spike
protein
make these viral particles more
infectious so
whereas people were spreading uh soros
kobe 2 to one or two other people
earlier in in the pandemic uh folks that
are infected with delta are more likely
to spread it to you know five to seven
people
um so if you're vaccinated there's still
a chance that you could you know become
infected with soros kobe 2 and pass on
to someone else
thank you um
so dr friedman how is it
different clinically out in the world
now than it was
this time last year
yeah that's a great question ben um
so
the way i like to to talk about it right
now is that um our original
coronavirus uh
covet 19
um
it depends when in the world we're
talking about when when last year
obviously as as dr turner told us and as
we knew last year um winter time we had
huge huge numbers and things were very
dire for a long time especially before
we got the vaccine once we got the
vaccine things again seemed to be doing
very well the vaccine did well for the
people who got vaccinated and a lot of
our mitigation steps seem to be working
fairly well and then suddenly literally
july happened and the the difference is
again as dr frederberg said very
astutely is that this
the way i like to think about
our delta variant is think of what we
had before as covet 19
and now we have coveted 21.
and cova-21 is way more infectious
it's way
more contagious it's way more deadly and
before covert 19 was very unlikely to
get past our immunizations there were a
few breakthroughs but not many whereas
this one there's a fair amount a lot of
people who are who are getting this
disease are much sicker and and for a
lot of reasons they're much younger
we're seeing lots and lots of very sick
people who are in their 30s and 50s and
actually in their their teens also you
know at children's hospital right now
we've got
basically 20 kids in the hospital with
uh with covet and that's a huge number
for us and five kids in the icu
with uh most of them have this misc
disease so
we're seeing just a a huge out
a huge increase in this overall and the
other thing we're seeing
is that the original again covert 19
did not seem to spread very easily
outdoors if you were outdoors it was
really pretty safe but where we first
got concerned in bexley and uh was last
month with july 4th when we recognized
that there had been spreading events it
at fireworks displaced all over the city
it wasn't bexley but it was new albany
and dublin and stuff people were outside
having a good time doing what we thought
we were safe to do and it turns out that
that this variant uh again i'm just
going to call it covet 21 is is
much spreadable outdoors more likely to
cause problems in in vaccinated people
and more likely to put people in the
hospital that that's that's what's been
really going on right now and and we've
you know the the other factor of it then
is that that
because we're tired of this i mean we're
all tired of this nobody you know we
thought we were kind of done and and the
cdc in june said basically if you're
vaccinated throw away your mask you
don't have to wear a mask anymore and
nobody and and we've been a little slow
to get the message back that we're
really sorry we need to use that mask
again especially indoors
especially indoors and and also with
large outdoor groups and i think we're
in bachelor we've been very attuned to
that and i think we've responded to that
very well but but frankly a lot of
places haven't and i think that's what
the the problem we're seeing right now
uh dr norris turner i think
dr friedman just mentioned the la you
know
with our mass we didn't need them and
you know i personally went about eight
weeks thinking that we were in the clear
what what guidance is there now what is
different than before
and what should people really be doing
in adhering to
um
as this on as we head into the fall and
and the colder months
yeah i think this is something that
people are really struggling to figure
out how to adjust their own practice
right we were all
in good habits um
you know over the last year and really
so freed to be able to let go of so many
of those things um and and the changes
were endorsed by cdc as dr friedman said
um
with vaccinations so
so the changes are now um
that
that people should wear masks inside uh
even vaccinated people should wear masks
inside if you just want to follow one
rule um that's the best rule is it's
people should wear masks inside
regardless of vaccination
status and that you know if you want to
get into the qualifications they should
wear masks inside when they're close to
people and they can't be socially
distanced they should wear masks inside
when there's not good ventilation they
should wear you know etc etc but the one
rule is just to wear masks inside even
if you're vaccinated um of course within
family units you know people are not
wearing masks inside their own homes
with their own families of course that
makes sense and there will be other
exceptions similar to that but the
safest thing at this point um is to go
back to that practice of assuming that
you might have covid and assuming that
people you interact with might have
copied um and to minimize the chance of
transmission you should wear a mask
i want to highlight i know some folks
who are listening are really interested
in hearing about data that support um
some of this some of these
recommendations and so i just want to
highlight a couple things that have come
out in the literature in the last couple
of weeks related particularly to the
transmissibility of delta so what so why
does this guidance come back you know
regardless of vaccination um
and so so and and also um about the the
severity of delta iso so that somebody
may have posted a question in the q a
about how do we know that this
infection is both more transmissible um
and more dangerous so
um there was a story that was in the in
the new york times as well as in the
scientific literature about a teacher
who took off her mask
to read her classes i'm sure so many of
you saw it um the teacher was
unvaccinated and she was infectious at
that time but the children were all
vaccinated right um and 80 percent
50 of the class became infected and 80
of those kids were in the front two rows
of the classroom so that one-way mask
when people are unvaccinated doesn't
work you have to have two-way masking to
really prevent transmission of delta
it's just that much more infectious it's
that much stickier um
similarly someone asked a question about
the severity of the delta variant
compared to other
um to earlier variants um of sars kobe 2
and i thought someone might ask this so
i
pulled up some of this data which i'm
going to read to make sure i don't get
it wrong so there was a big study from
the united kingdom that was published in
the lancet uh that looked at severity of
disease among about 9000 people with the
delta variant um compared to about 35
000 people who'd had the alpha variant
so that was what we used to call the uk
variant or b117 for people who remember
those names so they looked at
hospitalizations among people who were
infected with those variants over time
and they found that the delta patients
were younger the mean age was actually
29 years then the alpha patients
they had more than double the risk of
hospital admission compared to the alpha
patients um and they used the emergency
room more than the alpha patients so
signaling that they had more severe
disease
we don't have this this adds to evidence
um from like there was an early study in
scotland
also the early public health of england
technical report with a similar trend um
we don't yet have the same information
about kids to say that they're having
more severe disease but the suggestion
is that we will soon see that kind of
information based on the case numbers
that we're seeing
and
i'll open this up to the three of you
talk the breakthrough cases
do we have any data on breakthrough
cases and and what
what's you know what's the severity of
illness with the breakthrough case that
that you know that we've seen and and
do we think that'll go up go down
so let me answer that first and i'm sure
nick and abby may add some more to it
but on the ground
uh in real life and seeing patients
we're seeing lots of breakthrough cases
and the good news is that the chances of
any of our breakthrough cases again
meaning someone who's been fully
vaccinated getting covered uh the
chances of them ending up in the
hospital in the icu
on a ventilator or dying is incredibly
small compared to the non-vaccinated
people the the numbers that people have
used are are you know 30 to 1 29 to 1
ratio and and that's that's that's
pretty impressive
but
what we're seeing in real life also is
that people who are getting covetor and
vaccine are sick
it's not like they have just necessarily
just a cold or a sore throat or a little
bit of a sniffles they're they're
getting fevers for three days five days
seven days they're off work for ten days
they're getting headaches they're the
fatigue has been very significant
there's been a little change it seems as
if there's been a little less loss of
taste and smell that seems to have been
a little less with the the delta variant
but again they've still been very sick
and and um you don't want to get this
that that's that's the real key and so
you want to do anything you can and and
as as abby said i mean that's why
getting vaccinated is important and
that's why wearing masks is so important
and and i'm going to give one extra plug
when we talk about masking um
again especially right now well why
because
not as many people are wearing masks in
situations i think it's time for many of
us many of you can to get a better mask
i think that's that's one of things i
would suggest to lots of people that are
certainly the bandanna is probably not a
good really really effective uh mask
anymore but if you can get and you can
now if they're available the can 95s and
the n95 you can get on amazon you get
somewhere you get from the city of
bexley we've got lots of mass that are
more effective not only in protecting
the the other people but in protecting
yourself too because it does have some
filtering capabilities and so
again i well i know we're going to all
emphasize this again and again but we're
in masks getting vaccinated and just
going back to to being very careful with
each other i think that's what's so
important
so just to follow up on that just a
little bit um thinking about the immune
system and how your immune
response is developed following
vaccination you know if you end up being
infected with a breakthrough infection
uh following vaccination
again the vaccine is probably going to
keep you out of the hospital it's going
to probably keep you from having severe
disease and keep you alive
um but your immune system you know the
great thing about this vaccine is it
your immune system remembers the vaccine
and it can mount this response and fight
off the infection so it limits the
severity of the disease it hopefully
limits the symptoms and potentially it
limits the window that you're infectious
to other people so i think that's kind
of what's being
coming up in some of the data it seems
like the infectious window for people
that are vaccinated seems to be shorter
than potentially folks who haven't been
vaccinated so that's another another
real benefit and again it's it's that
immune response that comes
following a subsequent challenge to
copen19 after you've been vaccinated
that release offers that kind of
protection it doesn't always protect
against infections but it does seem to
limit the severity and then the duration
of of these breakthrough infections
so let me add one real quick thing that
that made me remember that lots of
patients lots of my patients and lots of
people have said well i had coveted so
why do i need to get the vaccine and and
the answer is exactly what nick said
because the vaccine amplifies your
response and the natural immune response
is not bad but not as good as we want it
to be and it clearly wanes and delta if
you have very little protection against
delta from having had the the old alpha
uh variant and and so the the most
protected people are those who you know
had covet then get vaccinated but even
those even those people we're seeing
breakthroughs in so this this this again
this delta is a beast and and it's uh
it's just a nasty um virus and it keeps
changing on us
and
um dr thunderberg i think a question for
you about how this keeps changing
and the need for additional shots
booster shots um
can you talk a little bit about what
what the point of those are what that's
the the hope of those
are going to be
and maybe how long that is hopefully
going to last
sure sure so you know the the
coronavirus is out there in the
population you know infecting people and
replicating inside of of people and as
it replicates it develops new mutations
some of those mutations are probably
going to make the virus better at
infecting people better at replicating
you know give it some sort of of change
right
some of those mutations are going to be
detrimental to the virus so maybe maybe
some of the viruses won't be as
infectious
what we're seeing again with delta is
that it has this combination of
mutations that makes it potentially more
infectious and cause more severe disease
um so what the new vaccines and the
boosters sorry the the booster shots for
the vaccines are really trying to do is
one boost the amount of antibodies that
you have floating around in your system
so the antibodies are floating around to
bind up the virus to prevent the virus
from actually infecting your cells
and two you can actually tweak these
vaccinations a little bit to potentially
be more effective against new strains so
let's say we have
another variant next year or six months
from now or something like that
these newer vaccines could potentially
be
changed up a little bit to have a better
response to some of these new strains uh
potentially providing your immune system
with um with more protection um against
infections or against severe disease
excellent um and so opening it up to
everybody
you mentioned
new variants coming
um
what do we think about that is that
something that we just need to get into
our mindset
we're going to be with some version of
this as we move into the future
and we have to kind of prepare for that
both mentally and with our day-to-day
practices
i mean i can i can give a
generic response to this and i'd
welcome nick to jump in with a specific
comment on which variants maybe are you
know kind of directly coming down the
pike so so
i mean to reassure the world there are
many people who are very very closely
tracking genomic analyses of circulating
variants right now to see what's
changing over time and where who's being
impacted by it um ohio state just as one
of many many examples has a extensive
sequencing program where they look at
every every positive case in a student
um or staff member who's tested figure
out what variance it is and track it
over time right so
that's just in ohio there are programs
like that all over the world um so we
won't be surprised when a new variant
emerges um and we won't be surprised
that a new variant emerges a new variant
will emerge there will be more to tell
about this story um but then i think
your question is also without using
these words you were getting at this
idea of like we've we've been in this
pandemic state you know an epidemic that
is becomes crosses into many geographic
areas and populations becomes a pandemic
but it's just a really big epidemic
right um and eventually there will be a
pivot where these this disease becomes
endemic it becomes something that has a
seasonal pattern it's always in the
background we associate um this that
that when we enter winter there is going
to be a bit of a increase in cases it's
the way
you know malaria is endemic in certain
parts of the world actually hiv is
endemic in the united states it's just
out there we know people encounter it we
might encounter it in our in our life
and we manage that risk over time and if
we have a compromised immune system or
we're medically fragile or we have young
kids like we maybe manage it differently
but it's kind of there in the background
and at some point covered 19 or stars
kobe 2 is going to switch from being
epidemic to being endemic um and there's
a lot of predictions about when that'll
happen the most recent ones that i've
seen i've said somewhere you know kind
of spring summer of 2022 like we'll get
through this cycle and then you know a
year from now when we're back to school
in that fall it will it will be more in
this endemic state and i anyway i don't
know what my colleagues here think about
that that sort of timeline coming
i think we hope you're right
i i i think that's our best uh yes or
that it doesn't become endemic there's
still a possibility that that you know
this will go a bit more away than that
and but i think there's a reasonable
probability that we'll be getting
vaccines for for coronavirus for the
next few you know years it would be
surprising if we didn't need it in in
2022 and maybe 2023 and then hopefully
we'll we'll have just background noise
on it and and not be
as bothersome to our site we hope we
hope if we if we get more people
vaccinated and and i think that's a good
possibility
let me can i let me
you didn't ask directly but you you did
before but i just want to make sure i
add the the child part about this the
pediatric part because
that that's become a much
changed uh situation
um
you can see on by the train tracks if
you hear my train in the in the
background
living in north bexley
um
but
children were felt to be pretty immune
when this when this virus first started
when we started back a year and a half
ago it looked like uh children were
going to be lucky and we had a lot of
theories behind it and of course
children are exposed to coronaviruses
all the time as one of the common
cold type viruses that we saw on so we
thought they had a bunch of natural
immunity and and that may have been
actually the answer but kids really
didn't seem to be
as affected by this and there was very
few deaths fortunately very few severe
infections uh nothing like we saw in the
elderly and and other groups
we saw this very interesting condition
this multi-inflammatory system disease
this misc which was kind of a for those
of us in pediatrics was like a
kawasaki's disease and it was very scary
and very very impressive but we we got a
handle on it pretty quickly that
treatment with steroids and iv
hemoglobin could could control it
although there were some consequences
with cardiac effects and so
uh that's what we thought was going to
keep happening unfortunately it's very
clear that delta is different delta is
very different and it's affected
children
much much more so and we're seeing way
more consequences of children
having this disease and being much more
severely affected by it and furthermore
last year we kind of had the belief that
young children especially would not
spread it to adults young children was
very difficult they didn't have enough
viral load and didn't seem to spread it
so that that if the child had it in a
classroom he or she was unlikely to give
it to his teacher as parents that's not
true at all now with delta that they can
spread this thing is just about as
easily as anybody and we're seeing these
truly um
epidemic in in schools especially those
schools that are not having their kids
be masked if your kids are going to
school and not being masked then you're
you're likely to get lots of phone calls
about quarantine and covet and that's
what's happening in our city we're we're
doing a great experiment in our city
because you know a bunch of schools are
making sure all kids are mass and a
bunch of them aren't and as many of you
may know about three of the school
systems that didn't have the kids mask
are now going to mask because they again
they they've had such a big outbreak and
so again this thing is very infectious
very contagious the good news is again
the death rate is still very low but but
you know this is not
it's not a binary thing it's not whether
you die or live it's it's the
consequences of having this disease it's
a very inflammatory disease it's a
vasculitic disease it leads to
myocarditis it leads to pericarditis it
leads to brain issues it clearly you
know when we've seen these i take care
of hundreds now of long haulers who who
and these are again these are mainly
adults but some teenagers and some older
kids who who are still you know six
months a year later they're still
confused their brains don't work the way
they did their body doesn't work the way
they did i've got guys who are you know
great cross-country runners and you know
ran
15-minute you know cross-country and now
they're doing 19 minutes and they
haven't been able to change and everyone
in the field has seen that and we
frankly don't have much to give them we
don't have much to offer in treatment
and stuff it's taught us a lot and
someday i think we'll have some
treatments and we we've learned there's
these special chemicals called cytokines
and and and in our bodies and it's
probably this cytokine release that's
that's causing this and causing the
fatigue and the inflammation and and
we've had diseases like this before
we've had things we call chronic fatigue
syndrome and stuff like that and this is
probably showing us that coronavirus
can do that
i've got a
related question here from the chat so
in terms of kids would you consider this
worse than the flu if they were to get
coveted is this worse than the flu
yes it is this is not the flu this is
way worse than the flu that that that um
sophomorism of that this is oh it's just
the flu what just let them all get it
this is very different we don't get now
children can die from the flu and but
children don't almost ever have
long-term consequences from the flu and
this thing is something that's going to
have some long-term consequences just as
an aside right now then we're we're
seeing an epidemic of of covid in
children of dramatic increase and we're
seeing something again called
respiratory syncytial virus rsv which we
never ever see in the summertime this is
a fall winter virus that now is popping
up in here and and again our our
hospital at children's we've got the the
pulmonary ward is filled with rsv people
who are critically ill and we've got a
bunch again a significant number of
covet people so no there's this is this
is not the flu this is this is way worse
than the flu
so i think that
begs the question and again i'll open
this up to the panel
about uh
vaccinations for children
any idea on what that time frame is and
then
you know do we have any studies or
information about uh
consequences or side effects
let me
let me take a crack at it first
um
for first of all
um
we're very hopeful the reason why we
don't have a vaccine for children five
to twelve right now is that it's being
studied and that's what you want you
want to study children differently and
they're studying it with a different
dose
where where it's instead of 30 units
it's 10 units and so we're seeing if we
can get the same effectiveness
at a lower dose because children are of
course smaller
as we can with adults and hopefully even
by minimizing side effects and so
these studies need to be gone to their
you know no one wants to rush the
pediatric studies we want to have a
vaccine for kids but we want to make
sure that it's darn safe
and so that's what we're hoping and and
you know we've heard that pfizer is is
getting near preparation to submit their
data and sometime in september our hope
is and i think an optimistic view is
thanksgiving that we may have a vaccine
it may be sooner maybe a little later
again i think it will depend on the data
that's what you know anybody out there
who says why don't we have a vaccine for
children well you want to make sure it's
safe you want to make sure you have the
right dose and so that's that's
critically important that that we get
that done right in the i'll give you the
the best statistics and that's the 12 to
17 year olds
you know we have found the pfizer
vaccine which is approved for that age
has a low incidence
somewhere between one and thirty
thousand and one and eighty thousand
of causing myocarditis
after the second dose in young in
particular boys it tends to be much more
common in young boys and and again
we'll just we'll just pick a medium dose
we'll say it's one in fifty thousand now
that's not very common but myocarditis
is is an annoying thing to have it's
inflammation of your heart and and it
can lead to some consequences most
everyone who's had it has resolved on
their own without a problem
but here's the the here's the the
important point if you get covet
and you're a 12 to 17 year old your
incidence of myocarditis is is upwards
of eight to ten percent
and so it's somewhere between 20 to 50
times as likely that if you get coveted
it's way more likely to get myocarditis
because you got covet than the vaccine
and
many of us believe that if you don't get
vaccinated eventually everyone's going
to get coveted that's kind of the the
this is such a contagious
uh
virus i know as dr uh thunderberg said
you know
the way to think about this is that
you know used to be you know two or
three people are now six or seven we
talk about this as as infectious as
chickenpox and
any of you couple or old enough not not
many of you but
no one's older than me but that our
parents used to bring us to chickenpox
parties because they wanted all their
kids to get at the same time chickenpox
lasted for 10 days they didn't want to
have you had three kids you didn't want
to be 30 days of itching so you brought
everyone to someone's house to a chicken
box and everybody got it
you all got it right away and that's
that's how that's what coronavirus
especially the delta variant is
i just wanted to jump in and amplify one
thing that dr friedman said just to make
sure it's not lost um because it's true
for many of the comparisons
that people make about the risks they
perceive of the vaccine um and what the
documented risks are of cobit so this
question about myocarditis after the
second mrna vaccine dose in adolescent
boys um
it it was a safety signal in the early
adverse event data
that people needed to take seriously
they went back and looked they double
checked they looked at the trial data
that had come before it people really
wanted to know because if there was a
serious risk side effect associated with
the vaccine
no one who is in this space wants to
wants to pursue a vaccine that has a
serious safety risk associated with it
um and so the numbers that i saw were a
little bit different from the ones that
roger just that roger just cited but
it's still
on the order of an exceedingly
exceedingly small risk of myocarditis um
out of 1 million vaccination doses there
were 10 there will be 10 to 60 cases of
myocarditis um and that but there but it
will prevent 200 covert hospitalizations
and two deaths among adolescents so yes
10 to 60 cases of myocarditis is not
nothing but it is
a treatable condition
um and in fact if those people went on
to get covered they would have much much
much higher risk of that very outcome
myocarditis by getting actual covid um
and and this is true if you look at
hospitalizations it's true if you look
at deaths it's true if you look at lots
of things people fear the vaccine but
they don't have that same fear
associated with covid even though the
risk of that same outcome with covetous
is always many fold higher
i feel like i have very little to add my
colleagues are just so good
well that's actually one thing i'm gonna
one thing i'm gonna add is that anytime
there's statistics believe dr abby's
statistics over mine
mine are so last week and hers are
probably three minutes ago so i i
whatever stats i give up i'll defer that
hers are probably even better
well uh dr nick we're not gonna let you
escape i have a question for you right
now
uh it's from the chat it's a great
question and i and i think it'll lead to
a to a second question is
is there any data that talks about the
breakthrough levels for the different
vaccines
and are there some uh are some vaccines
protecting better than others and when
it comes to boosters
can we mix and match
uh
what is some of the guidance and and the
data behind that
great question yeah and and i will
definitely open this up to to my fellow
colleagues um i can't say for sure that
i've seen data specifically comparing uh
the moderna vaccine versus the pfizer
vaccine on breakthrough infections um
and and maybe my colleagues have that
data i have seen some data recently that
that seems to suggest that potentially
the moderna vaccine uh elicits a higher
antibody tighter than the than the
pfizer vaccine um
whether or not that's
you know really that much better i it's
hard to say because again both of these
vaccines do an incredible job of keeping
people
from having severe disease and keeping
them out of the hospital
so i think there's probably more more
studies that need to be done to to find
out if one vaccine versus another
vaccine has a real
functional advantage uh when compared to
one another um
and i i wonder about the mixing of the
of the different uh vaccines for for the
boosters it seems like if folks get you
know their their usual two
two shots of pfizer or two shots on
moderna um and then the booster shot it
seems like the the immune response
that's elicited from from these boosters
uh is really great i don't know why you
would want to necessarily mess around
with with giving somebody a different uh
a different brand of the vaccine uh just
to try it out um
dr dr norris turner dr friedman uh
anything else
i just
agree that i have heard a lot of
anecdotal reports that people think
there are more breakthrough infections
with people who are vaccinated with
fizer than vaccinated with moderna um
they're only anecdotes right now and
it's a little bit hard to disambiguate
because many more people got the pfizer
vaccine so you would even if they had
equal proportion with breakthrough you'd
have you'd see more numbers or
breakthrough cases with pfizer just just
based on that denominator being bigger
um
there's some idea though that this data
that you just cited nick about um
potentially enhanced immune response to
the to the vaccine
also the symptom profile for people
after moderner was a little bit more
severe
people got a little sicker so maybe
there's a benefit to that to that extra
bit of symptoms like maybe that does
lead to longer term protection but not
there's not data um that i'm aware of on
the on the question of heterologous
vaccination so get a different
get a different vaccine for your third
dose i i from my understanding the fda
is not recommending that if you get a
third dose
right now only only um pfizer has sort
of that third dose is only in the pfizer
space but we assume the modern one will
be coming soon as well um if you get a
third dose you should get the same
vaccine that you got the first time um
although in the uk they did some
interesting trials where they it was a
real mix and match right like you you do
your mrna for your first and you then
you have a viral vector vaccine for your
booster and so very good responses there
so probably you could mix and match on
the biology um on the policy it doesn't
seem like it's what's going to be
recommended at least at first
and i want to make sure i
add one thing and that's
we
at this moment the cdc and fda have not
recommended a booster dose for normal
people
so that is that
that's still i mean it makes sense it
may make great sense and again the exact
time to give it whether you should wait
eight months or six months again there's
lots of internal discussion among very
smart people like abby and nick who
figure out statistics about when you
should do it and whether you should do
it or not so again right now it's
recommended for people with immune
deficiency who have underlying immune
problems who have gone out more than
eight months so we anticipate that it's
going to be approved and recommended but
there's still there's still lots of
people think that the two shots are
doing are all you need and so again i um
i can tell you that my immune deficiency
patients and that's what i treat also um
who have gotten their third dose
it's a little bit of a dicey third dose
they they all eight out of ten of those
people had um worse reactions than they
did from the the first or second and
many of them had some pretty good
reactions and and i i think again what
what dr turner said about moderna i
think many of us felt that modern was a
bit more juice to begin with it seemed
like a bit more potent uh thing and
that's why those of us who got it got no
we didn't choose it we we it was chosen
upon us and and we had uh worse
reactions and for a long time i was
telling people get the fight get get get
the pfizer
i wanted you to be less sick
um
dr fundenberg i had a question about
how do the m
rna and viral vector vaccines actually
work
you know is this a new
technology
um
there's rumors out there that it's
changing genetic code
people are becoming magnetized can you
give us a lay person's understanding of
how this works
and and what to expect
sure sure i i hear this uh hear this all
the time um so so let me just break it
down you know in in the simplest terms
that i possibly can
um and this is this is a an
oversimplification for sure but the the
real ingredients for these vaccines are
basically like your salt water
lipids you know so fat and this mrna and
this mrna is basically a message that
tells your cell
how to make a protein the spike protein
or stars kobe 2.
and then basically your cells start
presenting this protein your immune
system recognizes it responds to it says
hey this isn't something that my body
should be producing this is something
foreign let's make a bunch of antibodies
let's have a t cell immune response to
it let's get the immune system going
let's release a bunch of cytokines let's
let's generate an immune response that
hopefully will provide lasting memory so
if you're challenged to source kobe 2
again in the future you know you can
fight it off again this limiting the the
severe disease limiting the time of
infection limiting the
rate of hospitalization in these folks
that have been vaccinated
so the real contents of of these
vaccines are are relatively simple
um they are a newer technology and i
believe these are the first vaccines
that that have been
um tried and now fda approved for the
pfizer vaccine that's an mrna vaccine i
know people are interested in developing
other vaccines using this mrna
technology
but it's not brand new we've known about
these kinds of things for a while we've
known about mrna and how mrna is
translated into proteins for a long time
that's that's kind of
molecular biology 101
there's no way that the mrna that you're
going to get from this vaccine is going
to get into the nucleus of your cell and
integrate into your your genome it's not
going to integrate into your genes it's
not going to change your genes
and in fact you know the vaccine that
you're going to get again is basically
lipid covered
mrna so it's kind of a recipe that's
covered in in lipids
that's going to to go away really
quickly i mean it's i i don't honestly
know how long it stays in your body i'm
sure somebody's probably studied but i
would imagine it's on the on the order
of days to weeks that that that um any
products from that vaccine are going to
be there and then go on um so it's not
going to have any kind of long-term
effects that way
and as far as magnetism i really don't
think there's any any metal in the
vaccine so i don't think that's that's
going to be much of a concern
excellent okay we had we have a couple
questions here from the audience i want
to say audience you're doing great
please send more questions um
is it safe uh dr norris turner i'm gonna
direct this to you is it safe for older
people to be outside without a mask if
they social distance
yes
okay
to be outside without a mask if you
social distance the time to wear a mask
outdoors
is when you're right up close to people
so a concert a festival a football game
some place where you can't get away from
people's
breath
um
if you can smell the breath of the
person near you
you could get code from them so
put some space there right you could i
mean one way to think about it is like
if you're in a small room with somebody
and they have not brushed their teeth
like you kind of know but if you're the
same distance away from them outside you
might not know right you're not actually
smelling them
um think about that when you imagine
what you can inhale from what is inside
somebody else's body
great and i have a little bit of a
follow-up again i'll open this up to
anyone here so with the current state of
covid
um what would you recommend is the most
ideal time to receive your yearly flu
shot
yeah the the um
there's some recent recommendations and
thoughts that that um with what's going
on right now
that it may be advantageous
to wait a little longer than usual to
get uh your your flu shot and part of
that reason is that flu's not out here
right now at all so with rsv and covet
going on it it's tough to have a third
interloper come in and to to get
influenza right now and we know that
that influenza vaccines do tend to wear
off and so you so
as a recommendation i would make right
now and that may change but right now i
would say sometime in october would be a
a good time if you've already gotten it
that's great but i would for for my
personal patience and for me personally
i'm gonna probably wait to sometime in
early to mid october
excellent and uh i don't want to neglect
the mayor he's been on this uh koi
hasn't said much i'd like to address me
you're good
we got uh
we got here that i think is a little
more you know public policy how do you
approach some of these things
the the questioner here says my child's
alternative school is not requiring mass
they're strongly recommending those
uh for those not vaccinating
his school is only 11th to 12th grade
and there are a few others
only and they're the only ones wearing
the mask
um they're also not really updating
what's going on as far as cases in the
school
uh they finally got some of those
numbers
and
what would you say
what can i do to get them a mask and
publish a dashboard so i think they're
saying mayor that uh the bexley has a
great dashboard uh and so how can they
share that with their school
yeah um so
you know obviously educational arena is
a little bit out of out of my normal
zone but i think what that question is
really getting to is public policy and
how are we crafting a policy that is
uh rational
and consistent
and that is doing what we need it to do
in terms of ensuring health of our kids
and our our populations
um and first off
that is an appropriate kudos to the
bexley school district it has been
really amazing seeing the organizational
expertise around handling um
the pandemic in general and uh the the
data that they've gotten out in the way
that the the systems that they've set up
thanks
in part to some of the folks on this on
this panel so
kudos to them i would say you know
first off there's a reckoning happening
right now i think with some of the
schools that are not requiring masking
and this uh this comment i think gets
right to that saying the number of
positive cases that school has and the
number in quarantine so even outside of
the recommendations that are
are given from our franklin county
public health department and from the
cdc which do recommend masking in the
classroom
i think that there's a practical
hardship that's happening right now
because the delta variant does have such
a greater capacity to spread
and therefore
is very disruptive to these classrooms
where masking is not currently happening
none of us want to send our kids
to mask we wish that we didn't have to
do that but nonetheless
it is the most effective tool right now
and it's going to become i think more
critical as
there is additional community spread
as there is more indoor activity um and
so i think that and you know what these
are 11th and 12th graders mentioned in
this in this question
they probably have siblings you know
many of them who are not maybe of age to
be vaccinated so i think that's one
thing we talk a lot about in the city is
you know i've had a vaccine i think many
probably all of you have had the vaccine
i i know that i'm at lower risk of
serious side effects but i have kids who
haven't had a chance for a child who
hasn't had a chance to get vaccinated
and i know that my friends do and i know
that community members do and i know
that when i go to the grocery store i
don't know the story of the person i'm
next to and so i think there's
um a compassion that goes with this
and it's a rational compassion and that
is how can we protect those in our
community and what is the cost and the
cost in this instance
if it's the grocery store
is putting that mask on before you go in
and taking it off as you leave it's such
a low cost to provide a greater level of
protection to those in our society who
are most vulnerable that's what we're
about
and so i think um i'm sorry i kind of
swerved from the pressure point but
they're asking how do we how do we
impact administration and i think you do
it with data and with
if i were running i shouldn't say what i
would do if i went to school if i were
hypothetically
helping to talk about what we might do
in that school i would say what does
franklin county public health recommend
and that is a bare
basic platform from which to go and
sometimes it's important based upon your
community to be more restrictive there
might be contexts
very special contexts where maybe you're
less restricted but probably in general
use that guideline
go with that and then see if you need to
make additional provisions in order to
protect your population so i i would
suggest that administration
follow your public health guidelines
and if they change follow those change
guidelines and you can't go wrong with
that as a metric
yes and i would say just as the
library director we've been requiring
mass to come into the building and use
our facility because
uh the majority of our patrons who come
in are young children can't be
vaccinated and so we're asking everybody
to do their part for the typical 20 or
30 minutes that they're in the building
and
there's my little plug for the library
um
uh dr norris turner we're talking about
school is there some school transmission
data
um i know that now that everybody's back
in school
um you know i've heard some some
anecdotal evidence of parents who have
children that had a runny nose they
tested positive and then they were fine
they were running around the whole time
they never had anything but then it got
the parents sick
so can you talk a little bit about data
that we might have surrounding some of
those interactions
yes so there's a couple things pardon me
about what you just said that i i'll
just highlight so
um so the first thing is bexley city
schools um has
universal masking for staff and students
k-12 um during the school day so all
adults that come um into the building
wear masks and um and all the kids wear
masks and it's going
really well compared to our neighbors um
compared to other central ohio districts
it has many fewer cases and many fewer
kids in quarantine and not zero in
either case there are cases of course in
our city um but many many fewer than
many of the districts around us um
and you know nobody has asked on this on
this webinar um and maybe no one will
but the question i'm the most tired
about answering is whether masks work um
so i'll just answer it now before
anybody before anybody asks is to say
look at our school system like look at
what's happening right now in the
building everybody's wearing masks and
we have one of the lowest case loads in
in all of central ohio it's because
masks work um and so
um it's a really great testament to the
staff and the kids in the building the
superintendent and the school board for
for embracing that policy um on the
question of transmission from children
to adults um and dr friedman mentioned
this earlier in the early stages of the
pandemic with earlier variants there
wasn't very much transmission from kids
to adults the transmission in fact even
in in districts nationwide the
transmission was generally going from
staff um to students adults down to kids
um and that has changed with delta
the viral load is so high um and parents
caring for children especially small
children you have to have close care
with people you get right up close to
their face you share air um and that is
leading to to these transmissions um and
and you know
dr friedman mentioned it earlier about
these this fourth of july outbreak um
was sort of one of these stories where
um the kids were doing great um and a
bunch of vaccinated adults got sick by
having that close contact with highly
infectious
kids high viral load kids not
particularly sick kids although they
were somewhat symptomatic um and then
and then we've now seen that story told
over and over and over again
uh i've got a question here from the
chat that'll open up to all of you again
they wanted to know about
over-the-counter tests
so i think i i personally again
anecdotal this is how people deal with
information uh we have i think i've
heard of some people who are sick and
then they take the test they have
symptoms and they're and they're getting
negative results so people are assuming
maybe that's a cold or some other thing
that's going around
what is the best test to get if you
can't get into an urgent care is the
over-the-counter abbott test a good test
and can you walk us through some of
those uh practices
and i'll jump if
if others don't have an opinion okay um
so the best test to get is a piece of
our test um we we know that that's the
nasopharyngeal swab um that's sort of
one that pricks your brain um
um and it takes often 48 hours to get a
result back and i think that's probably
the kind that the questioner is saying
they they can't get as on the timeline
that they want um and so the rapid tests
are called antigen tests um and they're
usually ready in about 15 minutes there
there is a whole like a hierarchy of
tests but those are like the two general
categories that people will see
um so the primary one that you see in
central ohio is the abbot binex now
antigen home test um and the city has
them and will distribute when people
need them columbus public library has
them i mean the state had two million
and has distributed them around the
state so that's the kind that you can
get for free in most places and the test
is fine
it is not perfect in both directions it
can give false positives and false
negatives um it's a better test when
people have symptoms and it's
less accurate when people are
asymptomatic um but if the scenario is
don't get feel bad and don't get tested
or feel bad and use an imperfect test
then i would say to use the imperfect
test any bit more information that we
can put into the surveillance system
about testing and about the results of
testing is an advantage for our whole
community right it's very hard to make
predictions about what's happening if
people don't get tested particularly in
this area of breakthrough cases a lot of
people who have been vaccinated choose
not to get tested and then and then we
just don't know about those infections
um
there are two kinds of those antigen
tests though they're both made by abbott
they're both called binax now um the
kind that you can get through the
library and through the city and through
the school
comes with an app
and it connects you with a proctor who
observes you take the test and then the
results of that test get entered into
the state surveillance system the odrs
system and they get included in the
tallies
you can buy an over-the-counter kind
just at target or walmart for 25 for a
2-pack actually i don't know if that's
what they still cost that's what they
used to cost um and those are truly home
tests and they don't end up in the
surveillance system um and so those are
less informative at the population level
those are harder as an epidemiologist i
understand why people use them um i wish
people would use the other crime with
the proctor because we get we get to see
those numbers change over time we get to
see what's happening um but that but
that's the difference between those
tests
yeah and
two things one is that um
they have been selling out and they've
been very difficult to get because so
many people have been getting them so
it's been a very big chat they were
readily available and they were they
were down to two for 20 bucks even
when
but now they're hard to get because so
many people have used them and i think
part of the the thing that and abby is
alluding to
we are under counting people not over
counting people because lots of people
are getting positive tests and they're
not reporting it they're not calling the
health department oftentimes they're and
and that's why we i believe we've seen
way more breakthroughs than the
percentage that people have been giving
us so far
okay we've got another question here
uh
about some other things what about the
pneumonia shot when is it
that's an easy one that again you can
get the pneumonia shot at any time
any time just you know
some people get my pneumonia shot and
flu shot the same day and that's
perfectly fine i probably wouldn't get
my covet shot in my with another shot
that same day just because of the more
more likely side effects from from covid
vaccine especially if you're getting
your third vaccine and stuff but no you
you can do it any time you want
okay so i guess i will i'll ask one
final question here
we've let me ben can i can i let me just
chime in one last thing because
and that has to do with a little bit
about what i spend my entire day doing
now and that has to do with
hopefully there are very few people on
this webinar about it but but it may be
important for other people and that's
about
the continuing vaccine hesitancy that
that people have because we didn't we
didn't talk about that and and as you
know there's still you know 80 million
americans who haven't been vaccinated
and there's a lot of reasons and and
sometimes there are good reasons and
sometimes there's reasons of
informational access and and there's
cultural reasons and there's a lot of
reasons
but one i want to make sure i mentioned
because this i see every darn day and i
understand this and that is the
disinformation
that the vaccine is going to affect your
ability to have children
that is so common and so in my words
diabolical that it was a clever idea if
you want young
women and parents and mothers to not
have their children vaccinated tell them
that they may not be able to have
children and there is not a scintilla of
evidence and it makes no sense and there
is virtually zero possibility or
probability of that happening but i i
just want to make sure that that that
gets out to other community members and
interested nick or abby have anything
but that's what i deal with just ever
there's so many different things but
that comes down to it tremendously among
adolescents especially girls and
especially mothers of of girls
i agree i have nothing to add
i was i was just going to add that you
know the the thinking behind that which
is not correct right there
between these things is that your immune
system might do something to prevent you
from having kids we won't get into the
details because it's not important but
this has come up in in other other cases
throughout the night
if you got covid
that same mechanism would be in play and
you would potentially end up infertile
too which is again not the case that's
not that's not what's going to happen
but but even that just punches another
hole in in that idea that the vaccine
could be doing something worse to you
than actually getting covet
um so again you know please
get a vaccine
thank you
uh excellent so my last question was
going to be
is there anything that we haven't talked
about tonight that you wanted to mention
so dr friedman you have played your card
already with that advice uh dr norris
turner dr thunderbird
i just was going to answer the the
question in the chat about the efficacy
of the mrna vaccines against the delta
variant so um just to remind people that
the efficacy of the mrna vaccines
against um the original variants of of
sars kobe 2 was about 95 percent 95 was
fizer 94 was modern i think um and so
people of course are looking very
closely at how it's holding up against
delta um and right now the numbers are
pretty like the estimates are pretty
broad um there was a study that came out
of israel that showed only about a 40
protection against the delta variant but
there was a study out of new york city
that showed more than 80 percent
protection against the delta variant and
it's likely that the real answer is
somewhere in the middle between those um
so it is not as effective against
um this is just getting covered this is
just getting being a case of covet it's
not as effective as as the fir as it was
against the first variant but the
the bit of the efficacy that's holding
is protection against serious disease
hospitalizations deaths so the very most
serious disease so
you don't want to get any kind of covet
but you especially don't want to end up
in the hospital on a ventilator um and
the vaccines that we have now are still
continuing to do an excellent job at
preventing those severe outcomes
i was just going to say since it came up
earlier and i actually heard some
friends talking about this you know as
kind of a side note um they they heard a
parent at their school talking about
well we should just have a covent party
like a chickenpox party and everybody
immediately said no that's a terrible
idea and i just want to reiterate that
again
you don't want your kids to get covered
even if they have less severe disease
and if they don't uh end up in the
hospital you know covet you know has
long-term effects we've learned a lot
about you know the immune response to
covet the pathogenesis of coba the
transmission of covet
but you know the the one thing that
really we should all be taking home is
is if you can avoid getting covered by
wearing a mask and getting a vaccine
that that's something that you should
really
consider doing
and last year colleges tried that it
worked very poorly they all got
cancelled
well i would like to before i turn it
over to the mayor to close us out i'd
like to thank all of you for your time
this evening and to thank you all for
your guidance that you've given the
library and the rest of the community
throughout the past year and a half
um i would say i'm looking forward to
more but i hope that
this will all come to an end maybe next
spring so thank you thanks all of you
for your time tonight and uh mr mayor
back over to you uh thank you director
heckman uh for moderating this evening
and uh also extend thanks to our
panelists i know that you all are
are all working in the trenches and
suffering from the fatigue that i think
is plaguing everybody right now
but especially you guys in your position
so thank you so much for sticking with
us and helping our community out and
thanks to the attendees who asked the
questions and and allowed us to uh
help answer those questions this this uh
is live streaming on youtube right now
it will be available there on the city's
youtube channel and we'll make sure that
uh members of the community uh will be
able to view this video uh through our
bexley blast and our web page and i'm
sure the library web page
and to that point
libraries programming
is amazing i just saw the program buy
guide come out in the mail
recently so keep an eye on similar
programs and other programs of interest
and thanks to the library for partnering
with us on this
we have a lot of resources available to
residents relative to covet 19. the city
has recently procured can 95 masks which
you can come and pick up at city hall i
think one of our panelists mentioned the
quality of mask being important so those
masks
are a little bit more rigorous than the
disposable ones or some of the cloth
ones that
you might have so come come on by and
and grab a can 95 mask or two we do have
those rapid tests available at city hall
um if you are symptomatic we would
prefer that we deliver them to you so
there is a link on our website i put it
in the chat it's bexley.org coronavirus
where you can request a one delivered to
your home and we'd be happy to do that
and also put a link in the chat for our
partner in providing covet 19 household
impact assistance darn developmental
assets resource network has been a
fantastic partner in helping the city
with households who have been negatively
impacted financially by covet 19 we are
continuing to provide that assistance
darn cares.org is their website so if
you know somebody or if you have been
impacted uh continuing to be impacted by
covet 19 financial in your household
please reach out to darn and learn more
about that program
so thank you again to all of you for
participating you can follow the city's
information relative to cobia 19 not
just through that website but through
our backslip last weekly email you can
sign up for that at bexley.org and
check out
beckslib.org bexlive.org
for what else is coming up in the
community thank you so much hope you
guys have a great safe
evening and weekend take good take good
care