20 Episode results for "Hospital Of Philadelphia"
Why More Working Families Are Turning to Public Health Insurance
"This podcast is brought to you by knowledge awarded. ooh. An increasing number of working families are turning either Medicaid or to the Children's health insurance program for coverage for their kids new research which by the Children's Hospital Philadelphia shows that even when these parents get insurance coverage through their place of employment large or small businesses with benefits they are still priced Christ out of adequate coverage. The study looked at the period from two thousand eight to two thousand sixteen and found that insurance rates increase by double digits many private and public sector businesses found even middle income families making almost seventy three thousand dollars annually had to rely on public insurance to make ends meet meet with more we are joined in studio by Doug Strain whose research project manager at policy lab at the Children's Hospital of Philadelphia and he's Co author of the report titled Growth Growth of Public Coverage among working families in the private sector the road by the way appears in the July edition of Health Affairs Doug Nice meeting you thanks for having me. Thank you thank you I guess let's start with with the research that you did an kind of the the story behind why this was so important sure so we actually kind of like to think of this as a kitchen table issue when you're talking about programs like Medicaid and chip you're thinking at the federal level you know millions of children but we approach this from in that kind of a kitchen table. We're thinking about families in these lower income brackets middle income families so it's families making up to fifty sixty thousand dollars a year for a family of four and over the last decade or so we've seen pretty steady increases in both the cost of health insurance premiums as well as how common deductibles are so it adds up to quite a bit of money that's coming directly out of people's pockets to pay for health insurance and what's really changed about this in the last decade it is that we kind of think of employer sponsored insurance. If you're working family you get coverage through your employer. We think of that as being high quality coverage also affordable but with these is big changes. We're actually starting to see the families are being priced out of that coverage and so what we wanted to ask was with these increasing prices are families families seeking health insurance for their children elsewhere and so in terms of the numbers of people that you looked at in the percentages. How many people are can we get a gauge are relying on these programs right now sure so we looked at a data set that allows us to capture everyone in the United States nationally representative Kay what we found is that it was about twenty percent of kids in working families were covered with Medicaid or the Children's health insurance program worked out to about eight point six million kids in working families so obviously when you look at families that are unemployed or below the federal poverty level that are using Medicare our study focused on those working families that are in that are using Medicare and from a historical perspective. Those are numbers that are that are on the rise is at this point at this point yeah part of that is a trend over the last two decades where we've seen a continually decreasing insurance among children which is great. That's a big win. We're at historically historically low on insurance rates in the US and Medicaid and the Children's health insurance program which was started here in Pennsylvania is a big reason for that. We're joined here in studio studio by Doug Strain of the Children's Hospital Philadelphia. We're talking there about their report. involving working families using more Medicaid and the program Graham your comments are welcome at eight four four wharton eight four four nine four two seven eight six six or if he likes send us a comment on twitter APP is Radio One thirty two or my twitter account which is that that Dan looney twenty one now as you mentioned this to degree this is the people at the dining room table and the impact that has but this also has to be the thought process assists of where we're going from the policy side where we're going with these programs and the necessity of having these types of programs moving forward we assume because we expect expect the cost either to at worse stay where they are now but most likely continue to increase yeah you're absolutely right about that and I think the numbers that we found in our paper really served served to drive home that the role of Medicaid and chip is changing and it's changing really quickly for working families and I think that's something that we need to be much more intentional about incorporating into policy discussions about the future trip children's health insurance. So what we found is that I should explain we. We looked at where parents worked so they work at a small business. Did they work at a large corporation Russian or did they work in the public sector and we weren't very surprised when we found that the children most likely to be covered by a public insurance were those who had mom or dad working for for small business. Small businesses tend to have more expensive health benefits if they offer them at all for smaller businesses. They're not required to offer benefits under the affordable care act so we weren't very surprised that's actually kind of what the chip program in particular was kind of designed to fill that gap so we found that over time those kids were mom and dad worked for a small business the highest odds of having public insurance and increased over time quite a bit so that in the lowest income bracket we actually found that in two thousand sixteen four to five kids were mom or dad was working for a small business covered by either. Medicaid or chip but like I said not the most surprising finding but it's always good to have your your suspicions confirmed by but when you're talking about then moving up a level in terms of more I guess what we call Middle link-up families who are working in these areas and they are the ones that also still have to rely on these types of programs that does give you really an a a an eye opening look at where health costs have really gone in the last decade to do and the impact that it's having on on citizens here in the United States where we've had somewhat stagnant wage growth over the last couple of decades yeah. You're exactly right about that so we found that among these slightly higher income families we'll call them moderate income families yeah so let's say it's a family family for earning anywhere from forty to sixty thousand dollars a year. We actually found when mom or dad worked at a small business there was a forty three percentage point increase in the proportion of kids and those families that were covered with public insurance and then was between two thousand eight and twenty sixteen so forty percent more kids in those families were covered by public insurance but we actually also found that in middle income bracket it was even among kids where mom or dad worked for a large company a corporation that we saw a big growth in the proportion that were covered with public insurance it was lower than the the families where mom and dad worked for small business but it was definitely growing too and I think it's really important to keep in mind. There's many many more the families that worked for large corporations the employees lots more people kind of by nature and and so if we're thinking about the future of where families are getting their healthcare coverage coverage you know the story in our mind. We kinda tend to go to those families where mom and dad works for a small business but we actually found in our data. Is that many more families that are working and have a doc ID public insurance. They work for large corporations so I think that's a real change in how we have to think about the role of the public insurance is playing working family and it's also a change in how all companies themselves are viewing the health piece for their employees as well because many of those companies are probably the ones that traditionally have had health coverage as a piece to their employees working for the company for for decades yeah exactly and you're absolutely right about that and a big part of the change is the rising cost of healthcare coverage in the US which is driven by rising cost of healthcare and so that comes in the form of increasing premiums so if you look look between two thousand eight and two thousand sixteen the the cost of premiums for family coverage at the average. US Company increased by fifty seven percent so that as of two thousand sixteen families were paying on average about fifty two hundred dollars a year for coverage you know and that's a big increase. If you're a family making forty thousand dollars a year you know an extra two three thousand dollars going towards your family premium when you're wage has increased. That's something that families absolutely feel and what we think we're picking up on in the state is that families are doing them at and they kind of recognize king nuys if we can cover kids medicaid or chip. We're GONNA save money. Yeah we're joined here in studio by Doug. Strain and part of this doug is obviously also the fact that period you start. We're talking about the economic downturn in this country as well where it became harder and harder for people to be able to focus on having health coverage just in general for or their family. You're you're one hundred percent right about that. I think you know we intentionally chose this period of two thousand eight thousand sixteen since we're starting right at the very worst of the recession in there and then up through the recovery in two thousand sixteen and what we think we may have picked up on is that there were there could have been families who lost employment or lost their benefits during the recession and enroll kids in Medicaid or chip when they didn't have employer sponsored insurance to turn to any longer and what we think could be happening this is this is somewhat of about hypothesis but I I think it's reasonable to think that working families when they got a job again when they gained employment again they may have kept their kids on public insurance because the kids were already enrolled and they saw how much money could be saving and I think it's important to mention also these are really good insurance programs. This is Medicaid and chip. They provide really really high quality coverage for kids and in some cases just as good as you get or even better than you would get in probably in some of the private health programs as well correct absolutely. There's there's some really great studies out there that show you know. I think there's someone of a dated perception but I think it's still definitely out there that if you have medicaid can be really hard to find a provider and that can be true in some cases but in general I think for children in particular Medicaid and chip have really high provider access and quality and really strong benefit packages but should there have been an assumption and I'm taking this as a lay person that the farther you got away from the recession that the numbers of people using Medicaid and chip should have gone down to a degree even factoring in going back into the workforce you would think so but I think I think if everything state exactly the same if all costs of healthcare coverage stayed the same you might see that but what we've actually seen is that wages I just haven't haven't kept up with the increases in the cost of healthcare coverage and we seem really dramatic increases in the rise of healthcare costs so both premiums premiums and deductibles so it's about you know we saw like I said about a fifty seven percent increase in the cost of premiums for family coverage and during that same period we just grew by about twenty nine percent so we're seeing that healthcare cost sir taking up a larger proportion of families bottom line and what we think is happening is is is families are kind of doing the math. Even if mom or dad has job after the recession so is the expectation becau- because of again maybe this is a a hypothesis here but because because of where we have gone through this data over a nine year period and the expectation that cost in healthcare are not going to be going down significantly any any point that we are going to see. Even more people decide that make that decision that Medicaid and chip is a cheaper option. You can save money. Eh but you can still get as good coverage as you would with a lot of the private plant yeah. I think that's a pretty reasonable guest. Obviously we don't know the future but all signs all assigned seemed to be pointing to increasing enrollment in Medicaid and chip among kids in working families. I think and I think that's something that we need to take very seriously seriously as we think about the future of children's health care coverage I'm an objective researcher but I also strongly believe that children should have access to high quality coverage and I think that the lowest possible uninsured rate among children is to everyone's benefit and so I think we need to I think these data can kind of inform policy discussions moving forward as we think about kind of how working families are going to be making financial decisions and how that relates to their children's healthcare coverage moving forward. There's many different approaches if you wanted to talk about policy options for families might cover their kids in the future and I definitely won't claim to be an expert in that many many different approach approach isn't it could even vary by state but then that was gonna be my next point is that a part of this is a federal issue that we're talking about here but it makes you wonder how much the states may have to be involved in this in this process moving forward absolutely. I mean a we all know that healthcare policy in Washington has been a gridlock for the last few years. That's very saying yes and so I think a lot of the action is probably going to be at the state level if we want to see if we want to see action. Shen in both maintaining and increasing access to benefits to make sure that children have coverage moving forward and I think it's important to note too you know the the Children's health insurance the program in Medicaid the quad qualification levels by income vary by state so you know the the way the amount that you have to earn in Texas in order to qualify for public the coverage differs from what it looks like in Pennsylvania so you know even though we saw increases in working families that there were using public benefits for their kids in some states families didn't have the option to switch to public coverage because they just earn too much and so there was nothing there so I think the demand is probably even greater than what we're seeing in the actual enrollment numbers for Medicaid and chip it's just that varies by state and so those families are still feeling the squeeze even if they can't enroll their kids in public coverage eight four four nine four two oh seven eight six six is the number if you'd like to join in with a comment or question we're joined here in studio by Doug Strain of the children's Hospital of Philadelphia. He's a research project manager at EH policy. Lab and one of the people involved in the report that we are talking about again. It is titled Growth of Public Coverage Among working families in the private sector the report appearing in the July edition of Health Affairs. We go to Houston Texas Rama's on the line Rahm. Go ahead yeah hi via the pediatric clinic in Houston Houston and lot of Medicaid kids and my question is I heard in the last year there has been a big drop and made a kid in Dortmund nationwide and I'm trying to understand. What does this do to assist because the economy has improved therefore the income qualification? They don't meet the threshold you know they got on the threshold. Are there's another theory is that there's a lot of fear from the big ration- and part of you that wants urine public benefit you might not qualify for you know. Green Garden Sean sometime to understand the drop and why Okay Okay Ron. Thank you so again. Your data looked up to twenty sixteen but looking at that data and maybe laying this out a few years. Can you see something where we're Rahm is is pointing to with the with the drop numbers that he's talked about yeah. No I'm familiar with those numbers. Last year. We did actually see a decrease in Medicaid in Roman for children nationwide and actually I agree I think I think part of it is what we refer public charge so people people perceiving perceiving sometimes correctly that they may not be able to qualify for residency status or citizenship if they're if they're using public benefits and and so that could have caused some people to to worry about their families broader wellbeing if they were to enroll their child child in Medicaid or the Children's health insurance program so I think that's actually very real. I think there's those concerns are legitimate I think also there's been a lot of discussion about Medicaid work requirements around the country there and we know from previous literature that children's Medicaid enrollment is closely tied to their parents so if mom or dad is enrolled in Medicaid than their kids are much more likely to be as well and if we whether parents no longer qualified all five for for Medicaid due to a requirement in their state or I think just kind of these these conversations that are out in the air may have given some of the false perceptions that they no longer qualified for Medicaid door that they maybe didn't have the paperwork place to prove that they were employed maintain their their medicare enrollment and therefore their kids enrollment could have dropped off some as well well I think like I said I do think that in working families we're going to continue to see this increase in enrollment in Medicaid and the Children's health insurance program but I do think that there are policy concerns are very legitimate that are going to keep families from enrolling even when they actually need it Ram. Thanks very much for the call eight four four nine four two seven eight six six if you'd like to join in with a comment or question eight four four nine four two seven eight six six stories like send us a comment on twitter at Biz Radio One thirty two or my twitter account which is at Dan looney twenty one and again. I'm going to go back to something which I think is the perception you alluded to it before is that I think we still have this perception. Even with the increase in costs that the company itself is going willing to take on enough a fair share of the health coverage cost to be able to make it affordable for their employees and we're seeing that it's just not not the case anymore because of of the company's bottom line that they have to worry about with the coverage and the cost that they're incurring no I think in some ways you can think of the employer employers in some ways they're kind of a middleman you know their their purchasing health insurance and when the cost of that goes up yeah. I mean they're trying to they're. You're trying to look out for their bottom line as well so they have to make sure that they're offering something that they can afford and part of that is caused companies to turn to health insurance offerings like high deductible health plan where they have to pay a lot more out of pocket before the health insurance benefits really start to kick in so yeah. I think I think that is actually a pretty legitimate concern. Turn in which is why I think we need to be mindful. That part of the policy conversation here is going to be about controlling healthcare costs future. We've seen really consistent upward tick in in healthcare costs over the last decade and I think if we want to be serious about making sure that families maintain access to healthcare healthcare her and have health care coverage. That's affordable. I think controlling healthcare costs as part of it I can we even start to have an and there's obviously a huge conversation going on right now about healthcare Karen where it needs to go in general and there have been brought up the idea of being able to bring together companies entities to be able to bring ring three or four church groups or three or four companies together to be able to try to lower the cost of healthcare. It's an idea that that I think hasn't been. We haven't haven't gone far enough down the road at this point with yeah. No I think that's I am definitely. I don't WanNA claim to be an expert on that but my general feeling is that that could make health insurance prince affordable for more small employers so these families that we see in our study that are using Medicaid or chip to cover their kids when mom and dad worked for a small business that could be an option to Kinda band together with other small businesses or or groups to kind of increase the risk cool and lower. Some of those healthcare costs but I don't think that that is going to be abandoned. I don't think that that is going to be an ultimate. Solution to keeping healthcare costs down for working families. Particularly as wages are stagnating igniting. How important is it for you and the other people you worked with on this report to continue to look at this data as we move forward because of what you found found in this in this nine year window to understand better where we're going with this in the in the years to come yeah absolutely so we should should give it a little bit backstory. We actually put out a a paper in two thousand sixteen. I believe so that was using data up to twenty thirteen and we saw similar trends. It was slightly different question but so we use this paper that we just put up to kind of check back on those towns. I think absolutely we need to we need to kind of keep an eye on this moving forward and and kind of have our ears to the ground of of working families are using to cover their kids for health insurance. Yeah I think that's I think that's a really important piece. Honestly we can slice the data one hundred different ways show hello and show all the different ways that working families are being impacted by these costs but I really do think this paper kind of gives the important messages about rising costs and how working families families are going to be dealing with it in the future so I think our next move is going to be. We're actually working with the Leonard Davis Institute here at Penn to put together a brief. That's going to be coming out later here. This fall kind of laying out some of the policy options. The states can consider as they're trying to figure out how to deal with us and there's all sorts of different approaches. Approaches won't quite get to get into the weeds here. It gets very weedy but again. Do you think that the way to approach is moving forward. Maybe the best approach is look at this from the state level. I think that's I think that's probably the most feasible option in the short term. I think ultimately this is going to have to be a federal conversation but as we as we talked about before I don't think that's likely to materialize and the next year or two. That's the unfortunate part of it is that we can't get to that point at this point but but uh when you're talking about all all of the different families you mentioned you're talking about nationwide data at this point it does make you wonder you know what the mindset said is of the average consumer right now that they have to be extremely worried that they can't afford the private health insurance that is coming from their employer that they you feel that the best option for them to go with these programs from the from the federal government yeah absolutely and I mean I think it's I think this is this is an issue that it's it can sound own kind of abstract or hard to think about when you're at the national level but when you really bring it back down to like the dollars that a family is thinking about so to give you an idea in the middle income bracket of our study we we were looking families earning about two hundred percent of the federal poverty level so let's say a single parent and their one child. That's they'd be earning about thirty two thousand dollars a year the looking at an increase from three thousand to five thousand dollars to have health insurance through your employer for those two. That's a really tangible amount of money really impacts like day-to-day choices that those families are making and I don't think you can blame them for seeking out an affordable option. It's just the rational economic choice that they're making especially when the benfits on public insurance are comparable in any the filter down effect that that obviously occurs when you have to pay more for that health insurance then you can't buy the same type of food items you you have to think about different transportation. It's that filter down effect that I think a again. It's another piece of the story that that needs to be even talked about even more to to be able to truly understand how much healthcare really does play a role in so many different areas of our lives yeah absolutely and I think there's actually one kind of occurring in policy piece to this that has come up in the last couple of weeks where there's been a proposal by the administration's. Office of Management and Budget to change in the next decade how the federal poverty levels calculated so using different inflation index and what it would actually mean for a lot of working families even though they wouldn't be earning any different the dollar amount wouldn't be changing what they have in their bank account amount fewer families will be considered below the federal poverty level so that means fewer families will qualify for these programs like Medicaid chip and whether worries me is that we've demonstrated demonstrated with our data is that there is a need for this and the healthcare costs. There's no signs that they're going to be trending downward anytime soon. So it concerns me a lot someone in who who cares about children having access to high-quality benefits that there could be families who currently have this need who in the future would no longer qualify even though nothing has changed in their bank account. Doug thanks for for coming in greatly appreciate it appreciate it strain from the Children's Hospital of Philadelphia again the report growth of public coverage among working families in the private sector many thanks the Doug coming into the studio for more insight from knowledge at Wharton Please Visit Knowledge Dot Dot upenn Dot Edu
#43-Supporting Gender Identity and Development With Linda Hawkins, Ph.D., MSEd, LPC
"Do. Do. Welcome back to creative therapy umbrella. This is a place where we talk about all different types of creative arts, therapies, expressive therapies and creative approaches to therapy. Today's episode is quite special, not that the other episodes aren't, but I get to speak with Dr. Linda Hawkins About Gender Development and identity. With the recent rollbacks in healthcare rights, new rules have erased explicit nondiscrimination protections for the LGBT community and healthcare providers are being sent a message that they can deny care to this community. Linda, who is the CO director of the gender and Sexuality Development Clinic and a family services specialist not only gives us an overview of gender development and identity, but she also discusses the important elements of supporting the LGBT community through direct client care as well as through systemic advocacy. There are a ton of resources that Linda has given as well in this episode, and those are listed in the show notes so don't forget to check those out. Thank. You guys so much for listening and enjoy the episode. Okay Linda welcome to the PODCAST. Thanks Kate Yeah. Thanks so much for being here today. It's a pleasure. I wish I was actually in. Person might be Ripley System in the United States. It is an amazingly beautiful place. I do love it here. Lots to do that's for sure. Definitely yeah, well for our listeners. Could you tell us a little bit about what you do in your practice? Sure, sure so! In my role at Children's Hospital of Philadelphia I have kind of two hats My primary role is as the director of the Gender and Sexuality Development, program and that program serves transgendered, Non Binary Gender, expansive children and use their families. the disciplinary clinic that includes mental health, adolescent medicine and Chronology Nutrition and many of the other sub specialties in the hospital, and we. Care for Kiddos and their families through medical, social, legal, spiritual and educational transition upstage about twenty one The program has two clinics one in Philadelphia one in Voorhees New Jersey. And so I get to say I'm the choreographer of fun. In that rule of meeting with families identifying their needs and then Greg graphing their care throughout their transition process My background is as I'm a licensed professional counselor and I have a PhD in Human Sexuality Rally in Human Development. Though my my. SPECIALTY IS L G B Q. Children Youth and families, so it's a nice pairing of my clinical skills, and my research. Background in that role. In my second rule is within the larger hospital system I am I oversee the LGBTQ up patient and staff policies and practices, and I purposefully made my role have both of those had involved because in order for my clinic. You Really Be Successful in my Putian, to feel well protected and for Trans Staff to feel honored and respected. I need to be overseeing the institutional guidelines that make sure that that happens so. I'm not only focusing on the clinic itself in the care within the clinic, but also the larger climate of the as a whole to assure that it is as trans competence and transfer me as possible. So that's. That's me in a nutshell. That is awesome. You've got a lot of different. I would imagine a lot of different hats that you get to wear in your work. Yes absolutely and sometimes as hats are. Easy and sometimes they're hard, but nevertheless they I feel like worked with other hospitals that have gender clinics when they don't have that second hat of the climate in culture. US support it. It doesn't go as well. And that feels like even as therapists, a really important thing of the The work we do in the therapy room is really important, but then also how we're advocates for our clients outside of that and making connections in the community like that dual role of the internal and the systems. Exactly and that actually the where the thought came from is. We create great safe situations in our offenses and then get act mirror that concept. Then, we out of our offense to then make a community or a system that will embrace the safety and adopt the safety that we've created actually the systemic approach that I take yeah. I love that. Can we break down those two things a little bit and talk about Let's dive into the supportive care in the you know the therapy room, the practice room what are some things that are essential to providing that supportive care for our youth? A Win When I when I? I get a chance to meet with the family. And you know assessing where wherever babies ad, and then we're where we need to start our hair I really like to focus on the parents and the family structures the family system and then the school systems those are usually the first two. And then the third is the faith system those virtuality. Starting with the parents or the caregivers? Will we know from the research? Is that when young people went trans? Young people have the support of parent or caregiver their odds, and and attempted apart odds of self-harm attempts to harm. Ethically reduced Our colleagues out in Seattle. Christina often and her research longitudinal research with transition as shown that parental win when transient parental support an affirmation that the rates of anxiety and depression and suicide -ality actually reduced to the same levels as Non transgender kids persist gender kids experience on. In general, so that's a phenomenal thing for me to be able to share back with the parent as in helping them learn to embrace a child that they might not have known was right in front of them. And so it's really that's where I do a lot of Miami support for the actually directly into the parents. So when when kids have parental support their their thoughts of suicide. and. Then having the young person connected to a medical clinic again significantly reduces their so when when parents come me I tend to find the I put them into one of three categories actually four categories one is completely accepting and those are the fun ones that are like a breath of fresh air and nowadays there are many more parents who have knowledge about gender, exploration and transgender identity are open to it, and so I sometimes meet parents with you know six seven eight nine year, olds who? Two three years have been affirmed in their true gender identity, and fabulous is that you know we seek to completely joyous and. May have their own additional things going on, but really sacred really really happy little people. The next category would be. The three that. Beacon, my more fervent work is. Parents who have a big head, a big heart or a big challenge? No, when a parent has a categorize them as big head is that they've come in read everything. They sometimes walk into my office with a stack of articles that are highlighted and they say this is not my kid I read everything there is and. I don't think my kid is trans and I I'm phasing not going to believe this. Once. I understand that that's where a parent is coming from. Is there politically leaning into their hearts? I need activate their heart as it comes to their their care for their child. Revisiting in a time, when when the parent was more connected their heart for their kid, their love for their kid, even going back to some of their dreams hopes when they found out that they were going to be a parent for that child. Once I'm able to connect the parent back their heart. It loosens up some of that head space. Do against some more new information. And, then if somebody is, I realized that, if a family coming in or apparent, coming in is in the big Harte's. They're coming in and they nineteen hundred have seen statistics about so harm is recited ideation. They're terrified and they'll say to me Linda. I don't know what to do. I don't understand this, but I love my kids so much and I'm scared. Those situations might charge is then we'll win and thoughtfully. Add knowledge so that they can learn to understand the child that they have in front of them. And then the last category is the big challenge, so these are these are parents who come in and their their. Their head is closed off in their heart is closed off. Those, premiere the hardest. And Status Families to my work with, but it a it informs me about were any disturbed. I need to open up their hard and their head to the idea of having a transgender child. I love those Framing, the categories framing you know having kind of a structure like that so. So grounding and such a great way to connect with parents of when you know, you know okay, if this is, this is our barrier. How can we break through this kind of having that structure so helpful? Yeah, and and you know it can feel like you're chilling with Jello, and you're trying to figure out where to start any type of therapeutic work, and so I I really feel like going back to some of our clinical underpinnings frameworks foundations. When I'm struggling, I don't know what to do next. It helps me prepare. Enter frame myself in in a thoughtful manner, and also to be like. Am I just winging rest and being able to take now? There's a plan here. Helpful, the have that grounding. Absolutely. and then the second stage, the stomach areas that I mentioned after working with families, parents and caregivers is Ben's rule. When I started the clinic at some Hustle of Philadelphia and two thousand fourteen about two-thirds of the young people that I met were not in school because of bullying. There's some kids to are integrated industry much better. Through home, school or online school, but the majority of the kids that I was talking to were were home, not by choice, but because of. Innings Eddie and depression caused by bullying so the. The next advocacy step that I found for supporting our translator I'm sitting on binary minis was getting out into the schools and helping schools established policies and practices in have trainings so that the bullying can stop. What's been really fun to see? Is that more and more kids are back in school and I was now. We're down to about prior it. Only. Fits the kids now out of school because of feeling so anxious in the face. So that's another place where the advocacy of getting out there in teaching and training. loons in working with local. Educational organizations to pick up some of the training. Needs has also been really helpful. And the third spaces faith there's I think that a misunderstanding or a hypothesis and urban myth if you will that. People in Algebra community. We will step away from faith or church or their belief. In order to balance their sexual orientation, their gender identity, and that's that's really A. A shortcoming and minimization of the importance of phases. For. Ran US and their parents and families in so that other systemic area where we work really hard to create the equally safe environment. Is We create in our office is is we go into? The churches end to similar education oftentimes with families. I buy side, do help. Churches and synagogues to. CREATE NOT NOT ONLY IN A. non-discriminatory type of faith practice, but also an inviting and welcoming type of practice. That is purple in their inclusion of transgender people. And that seems like the those within the family, the school and the spiritual long process, as it seems like it would be long processes to to make some of those changes happen. It is and it's. It's one of those one of those Coulter changes that doesn't happen overnight and it's a A clunker teams have requires continual feeding and nurturing though Also. When I work with a therapist in the community, I tried to let them know they don't have to do this. All themselves and becoming arts of coalition, where you're partnering your expertise in your clinical skills in in your patient and families skills with other people who can also per her It further climate changes in families in schools organizations in. You don't have to do it all yourself. Yes we can definitely feel that way. Sometimes of how how do we tackle the? But knowing that there's a much larger community out there to do it with is so helpful. Absolutely absolutely. So. Can you tell us a little bit about a little bit about how? Some of this policy also affects. Hospitals and healthcare what those things kind of look like, and if there's anything as therapists, we can do to support our clients with their the process that they go through and health care and the barriers they go through. Yeah, so it's interesting is a you're in Denver man I'm in Philadelphia, so. Unfortunately the. Timeliness of this conversation is pretty powerful, considering the information that came out of. DC on Friday with. The the efforts to roll back the nondiscrimination protection of by five him in so I feel like said. With with therapists finding out how to be the best advocates for their clients, as well as keep in mind, what a client or a patient or might be coming into your office with as far as distress or worry aren't really encouraged therapists to find find some sort of. US, outlet, or a governing organization vaction. Jet You the topics in a way that feels digestible and also Prioritizes some of your patient populations with what's happening ever so quickly within policy changes? So when it comes to following the late breaking news both positive and challenging were transgender folks of any age. Not Pediatric patients is the National Center for transgender equality though ends. He Dot word that is an organization also out of Washington DC that manages. transgender policies and reviews transgender politics for for the entire nation, so if you have listeners who are. In Colorado or in other states, they can go to this site and They have state by state breakdowns. What's going to be important for you to know when it comes to healthcare policy? Is Houston Policy in your state? So. That's really I financially. A really helpful resource to than I am not crew mainland news to see who I'm supposed to be listening soon. How to interpret what's coming out? Yes? And then you know the way I put that into practice in my sessions tonight been doing all this week is. At the warmer. Checking in to see how folks are doing if the if. If family doesn't say I'm really worried about what was coming out of DC during their again at the beginning of this fashion on specifically asked. You did you hear about the news that came out on Friday on? Do you have any questions or concerns about it? Because I feel like important to put it in the room? Especially, since the information on Friday about about act one, five, five, seven has to do with health care. That also gives me a chance to put it in the room and say I'm not afraid to talk about this. And if they say that they aren't aware of initially, are aware of it. Be Able to say explicitly. I want to know that. A, hospital system in all of our care providers, an affiliates will never change their stance on non-discrimination. We will forever take care of you and your families and we will do that in opposition of anybody who tells US otherwise. Being able to that confidence out there Whether it's stated as a way or not. Those are some ways that were bringing that into practice. one of the Nice things that we've been able to do with the recent switched. Our health is actually reach reach. Families further further away from the hospitals in being families trips into the hospital and and even the Clinton career telehealth, so that's. Nice policy that got shifted very quickly for us to be able to do I know. In in in Colorado, you all have had provision offer telehealth for quite some time, but in Pennsylvania region have that vision. That's exciting. Do you think that will? That will continue past covert or extend itself past that? We are hooping A. Couple of folks in hospitals started a really rapid Quality Improvement in quality assurance study on hill to document the benefits so that. When the insurance companies and the licensing bureaus say that they want to be done with our emergency licensing to do this work in their emergency fund to this work that will be able to can new in some. Form. I love that it's so exciting to see that With this change that we're kind of talking a little bit off air about it that there's been so many benefits as well of the changes in Telehealth, and how we can reach more people and reach people differently and how supportive that can be. Yeah it's it's it's. It's important for at least my soul to hand to try to find some silver linings every day. And I'm highlighting that is reminding. Yeah something that POPs in my mind. is a rural access to even therapy in general and a larger hospital organizations is really difficult, and I think something like this. The change in telehealth is really exciting in that realm in that Your location won't be a barrier doesn't have to be a barrier. Yeah and I know for for your area. You're being able to have clinicians to. Can you tell a health? You. You're my friends over at temperatures hospital. Talk about how they reach out almost five state. In your vicinity so that? That's that's really phenomenal. We were able to. Meet with families that would have spent easily for hours in the car each way to get our hospital so. Just the the amount of emotional energy, financial energy that we're saving for family is is a definite overlying vollers. Yes, and if we can take one barrier away, that's that's a good day. Absolutely yeah? So can you tell us a little bit about? CAN WE DIVE INTO GENDER DEVELOPMENT IN? In itself a little bit about when gender identity might solidify or when you know, some of those things might happen along the development of children, tweens, teens and. Young adults. Cure. so for many of the folks listening you definitely had an exam on this at some point and then be exam. We got our licenses. Move on seven refresh. This'll be a refresher course, yes. That knowledge so what we know from literature and research is. The development is very much happening in childhood, and between the ages of of one and two, and then moving into three years old children are absorbing and processing thousands of shoes every day about under from the color clothes that they're put in from the the messages that they're given from cartoons and books and. Multiple places and. So you know I always like to. I like to. have. Little ones are walking around with who the new it's in their head when it comes anger on one posted its. Boy and on the other posted its girl and as little ones or taking in all of this information about what girl on. Then putting these facts for these little factoid 's onto. Those individual posted ducks. Could look like is Joey is. Being instructed about boy rule so boys like blue boys like kicking balls, his like Ruffin, humble boys are like has a beard, and so that posted a way. Has Lou has all has checked? Has Beard has? All those words going to that posted and then for Jamie. taking in all of this cues about what girl as She putting those items onto her group posted and vice versa so in genie as you know. I wanted to play the fire truck depending on the family, it may say Oh, that's fine, or they might say. Oh, fire trench! Two boys play with here Jamie. Here's doll. Addressing a little bit, but in families, the the gender expectation and the gender rules are over and. Over. But again, those those little ones are populating those posted notes Pretty Pretty. Adamantly and we know that, because by age three given the opportunity for healthy development. Otherwise we start to hear what's been percolating in those little heads. And we hear any say I'm a girl, mommies, girl, and maybe if there's a pet. Pink. Caller. You know kitties girl. And equally, there's this name in comments going on from. Little! We and in our language re society. That's where. Three little ones start toge-. Affirmations confirmation that their rights as well as correction so. When he says I'm a girl. I'm a girl. Adults around say yes. Jamie her grow. Lenny came. You have beautiful long hair and you're going to be princess. Sunday so there's that tone of affirmation. What the? Routine is really. By what's on her post, it note. And then there's the corrective comments when let's ECOWAS SAYS I'm I'M A girl? I like dogs. I like princesses depending on the family or the school over the turn for the daycare shall, we might hear. Sure. That's fine Joey. You can be whoever you want to be or you can like whoever whatever you wanna like or in our family. Colors don't have genders in toys belong to boys or girls. They belong to everyone that would be a confirmation in some families, so we might hear boys don't like dolls. Stop that. Or don't be Assissi. Then Joe is GonNa look at that posted, noted his head and say. Wait is again. Okay. Or not on the boy posted on the growth So what we then no, after aged three in starting age four through six is really where young people start to confirm and understand whether or not they fit with what's on that hosted or they don't. So the youngest is who I met with in my clinic our times as young as four and five years old, and those families tend to come via their pediatrician, where apparent will take their Kiddo in the office say. Joey keeps saying girl, and he's fighting us when we take him for a haircut. And he says his name is is Julia, and he only wants to be called Julia, and now he's not sleeping while he's crying all the time. Those are examples of wow. This is a kid who really has a strong understanding of who they are. and I always liked to frame this into in the larger under development process, which is. Completely natural and fairly typical for kids in the in that five year old range to explore gender and to try on different things. When I talked preschool when I lifted. My favorite off ever it was really fun to watch the FI the foreign five year old, trying on gender in in creative play having Jamie be ad and put on a suit and tie during the dress up area and then having Joey. What on address and forget I'm going to be mommy today, and so while that is a very very typical PART OF UNDERDEVELOPMENT GENDER, play gender exploration for the majority of children, the majority of children to not continue on with a level of persistence and insistence. And equally have ongoing stress when they keep butting up against a gender rules or expectations that don't them. so. Many folks will say okay, so for somebody to be transgender. They have to have known themselves within this time frame context so only kids who come out as as transit for environmental related transgender, and that's actually not the case, probably about fifty percents of my my patients clients. Did have some realizations as young as four five six years old at that they're transgender. However, if all other category of folks who come to this understanding later in life, and those later times in life can be during puberty where body changes start to happen, and the level of distress and duress really stretched to Spike and there might then be a new clarification around. The feelings that might have happened earlier in life that they were quite aware of or maybe didn't know how to. Categorize as actually identifying feeling transgender And then there are the kings who. Back at four and five learn the messages on the posted and know exactly who they are in the also know that it's not going to be okay in their family. Those are often young people who come out and share with us about their gender identity later on in life, and I always think of geography as a big variable in knowledge and understanding so I. was talking with a family yesterday and with the young person who is assigned male at birth way identifies female, and even living in Philadelphia where we think they're Iris, other snow, much information all over the place in Philadelphia in support of transgender people. This young person. Living in Philadelphia. was with somewhat sheltered. When it came to media and information, and didn't realize that the thoughts feelings she was having We're really linking her to being transgender prisoners. While she was in ninth grade and had the pleasure of working with a counselor who helped her really Ivan Shoe, Heidi in depression about her body and help to really understand that that that anxiety and depression was because She really isn't a boy that her distress with her body is because she's a transgender earl. How amazing that she was able to finally get that, and how frustrating that she couldn't. have access to that care earlier. it does make me wonder about how development and identity how that looks across age development with anxiety and depression in this ninth grader. Does that look different for? Let's say someone in preschool or it can, and that's actually great. I'm glad glad trim that question of its ways. We can add this to our time together, which is that often primes will I was afraid of us at clinicians didn't have a class on under identity development. We might have passed the test on Aaronson, but we didn't really. Get a full lesson on proactive therapeutic techniques for supporting lgbtq clients unless you. Signed into do that as elective. You probably didn't have a lot on that and. We ended up. Having is situations where we kind of wait for clients bring up shrouded in gender. And I really am encouraging clinicians to Up I open forest, asking the questions about endurance sexuality, so that our clients know that were opened talking about it in hearing about it as well as. Creating a space of discussion and exploration. For little ones I, really encourage clinicians to start to add different questions prompting language into their work either during intakes or early on in their work, especially if there's anxiety or depression. With their clients and that language can sound like just so Jamie I mean how it feels for you to be girl If your parents were told that they had a baby girl in their born. You learn about what it means to be a girl. Present field for you. Are there things that feel right about that? And there are things feel not right about that. Not Everybody feels really great about their gender. Let's talk about what feels good for you. So using that language as a kind of a clinical prom can be really helpful and when I use that in with colleagues and and. Gotten feedback on how gone! It can be really helpful not only to open the door for Jamie to say. Wow I didn't know could feel wrong. For other people actually feels wrong for me and I'm always. For. Bam Wow, that is. Our information to have gotten. As well as spurs this gender kids who were experiencing maybe their own. Friends from the other girls in their families who Jamie might respond with. I, don't you know I'm? A girl, but I feel like the girls greater different than be or. Being able to say I feel like my dad doesn't like kind of boy. I am because I. Don't want to play sports like my older brothers. Don't really opens up an important discussion, no matter what no matter how somebody might identify over a good discussion for US clinically. Explorer. That makes sense absolutely yes, and I love the the phrase. Let's talk about what feels good for you because it's so coming, but it so open to just so there's so much to explore in that statement in itself. Absolutely and it and it. It's unreal enough that it can. It can create some really exciting conversations about you know gender-based hopes and dreams, and an often his questioning curiosities I find with my tweens or my creep preteens. Having those conversations, and and that can lead into a lot of questions like. Is it normal that I fill? Fill in the blank, and they getting some of those really big conversations, growing and also opening the door around sexuality as well I'm. Waiting for client to bring up their having. Discomfort Wednesday. Nudity or sexual thoughts feelings. Putting that overtly into the conversation, when when feeling really rained in your heart in your head when you think about people on Are there people that you're having crushes on her feeling romantic about and tell me about this this lots in those people. Again opening up the conversations. Nights know that they're safe to have enough. Yes, I love. How just putting it out there I? Is that affirming process of? It's okay to talk about it and. I'm not afraid to talk about it, so it's here if you need to. Absolutely I love that. Are there for for any of our listeners who are looking for more resources whether it specifically about gender and health care, and how what that might look like I know you mentioned the National Center, the T. E. but any type of other resources whether it's training books websites that are that would be helpful for our listeners. Yes so locally. You have a wonderful resource right there at Children's hospital You have a gender clinic. Run by really wonderful colleagues of mine I'm I'm biased because of. Paint until Adelphia with me so. So you have a wonderful local resource in that. And then I would say that. As, far as an online resource, the. Ucla Medical Center. If you go to the UCLA Medical Center website and will transgender. They have a really robust. Online presence that includes lots of the medical policies and they keep very up to date, which is wonderful also, if you go to my Website Hospital of Philadelphia under sexual eight development clinic, we have a page just resources, and those could be for clinicians we. Was and we also have reading lists for books for. Professionals for parents eighteen in addition. That are specific to gender, but also around the factuality as well. That is awesome. I will make sure to put links to all of those especially. I'll link separately to that resource list because that. I'm excited to look through. That sounds amazing. Yeah, and it's rate is. Preserving the energy of all the clinicians who are out there especially in private practice where you're doing everything yourself. Finding those those websites that. Have other peoples other people's job. Keep them updated so that you're not having finished. Things updated you just. Go there as well as soon. Families there to do some Missouri destroyed mark and I just thought of another wonderful resource. Center spectrum, gender, spectrum, dot, Org that is wonderful site that has everything under one in one spot. They have resources around education fade. Health Care family were all sorts of stock rate. Now I know the are they have? Transferred some of their many of their. Support groups. Online groups which is agreed to take advantage of from afar, so taking a look at back, stayed in, and even putting yourself on their email list to get a another way of staying. Really, really presidents, and and up to date on all the resources that are out there. And as and another plug, they have a host probably one of the best enter conferences every year. That I go to, and it's it's out in California, but this year because of covid it's going to be an online conference on June. June already on the Lice Sixteen. Gender Spectrum Dot Org. You'll see information about that conference. And it's it's the lineup is pretty spectacular, and I'm not just saying that 'cause I'm one. But what I think is really cool. Is that a are so few register? You will have access do not only be present live during the the conference a, but you also will have access to all of the the film Presentations for three months. For many of us who are spending way too much time on the computer? The idea of attending a full day conference can be very visually and logically daunting, but the fact that they are making it with your registration. You have access to all of the information for three months means you can really watched affection week or take it in really slowly in edible portions though it's, it's a really wonderful conference at is awesome. That is another one of those silver linings I think of coated is how accessible conferences have been. You don't have to go They seem a lot more cheap now to. There's with online. It's so much more accessible, so it's not as expensive. That is awesome. Yeah, those are some great resources and I'll make sure you have all the right things. Wonderful yes, and I love the three months having access to a conference for that long I always like to go back. Even if I've SAT, there have been present, but then you have additional questions, and you can go back and listen to it again for. Particular sessions, and it's always nice to have that extra time to take everything in. Yeah Yeah As soon as I saw that this week on, their website was like that is really interesting yes. Yes, I love that. I'll some well Linda thank you so much for taking the time today to share your passions and your knowledge with us. This has been amazing. Thank you and thanks to all of the therapists were listening for old data every day. Yes, Awesome! All right I hope you guys enjoyed this episode and founded informative. It was so lovely talking with Wyndha- and her training program that she actually mention in the podcast, but she talked to me a little bit off air about sounds amazing, and there's a link to that in the show notes for anyone who's looking to. Get more information on this topic I think it's something every therapist could use if they haven't been able to access this information and get additional training on it. and this feels like a very important conversation that as therapist we need to be having with. our clients and our clients parents especially with the recent changes, so I hope this was helpful and informative for everyone. Also, just reminder there is the anonymous survey in our show notes, and that is for you to voice any concerns. The back requests that you might have for us at creative therapy umbrella. Please let us know if we're missing something. To cover a topic that we have not covered We really want to hear your voice. And also there is a link to our newsletter. You get additional content such as the stuff that's in this episode and in the podcast sent directly to your email. Thank you again so much for listening and be creative.
Is School Safe Amid COVID-19? Polio Raised That Question Too
"Parents are facing tough choices about school in the Covid nineteen era. Here's how people made the same decisions when it came to polio. By francine Numa. Six Year Old Janice, Flood Nichols, and her twin brother Frankie. We're looking forward to Halloween festivities in the Syracuse suburb of dewitt New York in Nineteen fifty three when he came down with what seemed like a cold. But soon, he had difficulty breathing and by Halloween Morning Frankie had been diagnosed with polio. He died the next night eight children in their first grade class would also fall ill with the dreaded disease. And two more died the night her brother was buried. Nichols was hospitalized with the same disease. She was placed in an isolation room and could only see her parents who brought the family's dog through a window. That's the only memory I have because they weren't allowed to visit. Me Recalls Nichols who made a full recovery from paralysis and wrote about her experience in twin voices, a memoir of polio, the forgotten killer. Polio struck communities like dewitt seemingly at random. The United States had previously experienced outbreaks, but from the mid nineteen, forty s to mid nineteen, fifty s they came with relentless regularity while the two diseases diverged significantly the sense of powerlessness and unpredictability polio brought resonates in today's Kovic. Pandemic, not least in the way outbreaks can affect the classroom. The question of schools reopening is the subject of intense national political debate states vary in their mandates and timelines for in person instruction parents and educators grappling with tough decisions about when how, or even if children should return to the classroom this fall weighing social and educational needs against health concerns. Amid this confusion, the dilemmas parents faced in the mid twentieth century can help put the long and uncertain road ahead in perspective. Polio sometimes cropped up in the spring or lingered into fall infringing upon the academic year and catching communities off guard since it's seasonal surges came predominantly during the summer months in San Antonio Texas in outbreak in the spring of Nineteen, forty six closed schools at first for a couple of weeks, and then for the remainder of the term disrupting graduation festivities and prompting quarantines. Despite misunderstandings about how the virus was transmitted mosquitoes and flies were incorrectly considered culprits parents knew it was highly contagious and spread when their children were in close contact with others social distancing in the parlance of this pandemic was the foremost countermeasure. Even if it meant keeping kids cooped up when an outbreak abruptly halted summer fun. There was tremendous fear and they would close swimming pools and bowling alleys and beaches and try to keep kids out of crowds says, David Ozinsky, the author of polio and American Story and director of the division of medical. Humanities at Nyu langone health. My mother would give me a polio test. Every couple of days could I touch my toes could I put my chin to my chest? It was a sickness harbored by silent carriers. The majority were as symptomatic. There was a vast area below the tip of the iceberg of people who were shedding the virus unknowingly, which scared parents says Dr Paul off it. The director of the Vaccine Education Santa Ana professor of Pediatrics in the Division of Infectious Diseases at Children's Hospital of Philadelphia therefore, he said everything became a threat. Though newspapers ran tallies of death and paralysis. The odds of suffering the most devastating effects were relatively low at its peak of almost fifty eight thousand reported cases in nineteen, fifty, two, polio caused approximately twenty thousand paralytic cases nationwide yet the specter of their children in an iron lung was enough to terrify parents into strictly adhering to precautions useful or not exertion they were admonished could worsen symptoms for studiously clean homes were a must summer camp or the fair or even school became suddenly terrifying. During the nineteen sixteen outbreak New York. City. Which bore the brunt of the nation's cases and deaths that year shuttered schools based on rudimentary knowledge of how polio spread and parents took. Note when officials announced a policy of leniency, two, hundred thousand children were absent even when classes resumed the New York Times reported in Minneapolis up parents group lobbied successfully in favor of quote playing safe with additional delays citing and enduring dilemma. No one is absolutely sure of being right one way or the other. Later, closures also elicited mixed reactions as the start of school near in nineteen, forty nine some experts felt schools should not be closed during a polio outbreak nor should their opening be delayed claiming neither altered the outcome according to the Associated Press conversely in nineteen fifty, five during the last major outbreak. In Massachusetts, school communities faced with mounting parental anxiety over the polio situation have postponed school opening dates despite state health officials advised to the contrary. The AP noted both arguments were inherently provable because cases naturally fell when summer ended and responses varied between localities ranging from precautionary closures. After, one case to reopening while polio lingered the optimal level of acceptable risk was as it is now difficult to measure whenever the outbreak it's affects could not be delinked from their contemporary social context when polio shut Chicago schools in nineteen, thirty seven during the Great Depression it parallel. Today's concern that interruptions in learning could be devastating to students and particularly those who were already the most disadvantaged says Michael Hines a historian of education and Assistant Professor at Stanford University. When educators experimented with radio lessons, the shift to add home education magnified socio-economic gaps including disparities in access to technology. Today despite echoes of shorter closures, Kovic is wreaking havoc on education at a magnitude that defies comparison. UN. Secretary General Antonio Gutierrez recently warned of a generational catastrophe globally that could exacerbate entrench inequalities. The longer this goes on the further it will compound the damage especially for those who were on the margins says hines nonetheless, a recent Gallup poll shows a majority of parents don't want. Their children back in classrooms full-time yet springtime hopes of incremental disruptions have vanished pandemic closures appear to be here for the long haul holy. A was eventually defeated in the United States thanks to vaccines administered to millions of school children in Nineteen, fifty five. But the long journey to that point is a cautionary counterbalanced to our impatience for a silver bullet to diminish the threat from. Cova. For now, factors like vaccine development and efficacy remain wildcard says ocean ski will we be talking about in the fall of twenty twenty one? Yes, we will. He says. Perhaps. The starkest truth a history of polio shows us is how little control we have in the face of a virus year after year, parents bore the anxiety of coping with an invisible threat to their children's health mitigating it as best they could within the constraints of their knowledge and foresight though her mother took every precaution possible in the end says Nichols parents knew there was no way they could completely protect their children.
Dr. Lori Billinghurst 5-31-20
"Already a college student but not sure if your school's the right fit just finishing at a community college considered transferring to Montclair State University. There's still time to join us. This ball Montclair. St stands apart from and above other New Jersey universities where a place that pulse students in lift them up join US support community that welcomes your voice. Montclair state is home to students of all backgrounds beliefs and identities to find out how you can transfer to Montclair State. This fall text graduate two four seven four seven four seven. That's graduate two four seven four seven four seven boarding. America is the catch people big controversy. Do kids get the virus so kids don't get the virus. We know that seventy year olds in above get it. What does this morning? It's one of the leading physicians for children in the country Her name is Lori. Billinghurst has worked as a physician at the children's Hospital of Philadelphia and also clinical professor of neurology at the University of Pennsylvania. Dr Billinghurst how are you this morning? I'm great John for having me on again. There's a big controversy around about people saying the schools have to open and kids will be safe because the kits are not getting the virus or the percentages are very low What say you well? I think a difficult subject John because we just don't have a handle right now on the numbers of children that are actually infected by the virus. And I think it's challenging because many children either or a cinematic when they contract covid nineteen or have very mild symptoms And you combine that with Very low rates of testing across the board. No matter where you are in the country. We're just aren't testing enough. It's very difficult to know the numbers of children that have been affected by the virus but in general the overall feeling I think within the pediatric community is that children aren't as significantly affected by it. Meaning they don't have as serious symptoms as obviously older people over the age of sixty those with pre existing health conditions now speaking as a mother Speaking as a common sense her sin if you governor of a state and had to make the decision to opening the schools in September. What do you pick you decide? I think that's a very difficult decision to make. And I'm glad I am not in the position of having to make that decision and to assume the responsibility for the potential consequences of outbreaks in Not only schools but also when daycares you know currently many daycares are closed for the foreseeable future? I think on one hand. You have the challenge of these stresses that families are currently facing with schools and daycares. Being closed children are at home. families are now challenged With the responsibility of educating their children. Many families are ill equipped to do so They don't have the technology or the resources in order to facilitate education. Many school systems haven't been able to develop the online platforms that are needed for that parents. for those that are fortunate enough to still have jobs as you know. Many people across the country have found themselves out of work in the last few months. But for those who have jobs they just don't have child care anymore and it's difficult for them to return to those positions You know they can't rely on on older family members to help them because they're afraid of exposing relatives to the disease. So families are in a really difficult situation right now. They are experiencing mental health. Challenges You know if families are are reporting that You know they have an inordinate stresses right now at home and so for many families having the schools open would enable them to return to their jobs It would enable children to return to in-person teaching and continue their educations but on the other hand You know putting large groups of children back together into institutions places. Those kids at risk for not just exposure to the virus but actually contracting and bringing it home and spreading it. You know when I look around as a mother. I look around at the neighborhood. I'm currently Sheltering and right now and What I've observed over the last few weeks is that I've seen increasing numbers of children out in the neighborhood playing with one another so I think some parents have taken it upon themselves to just stop social distancing and they're making that decision probably for a wide variety of reasons and my sense is looking at this happening in the community. Just the community that I'm I'm and I probably happening in other places as well and I think children are probably going to wind up getting exposed to the virus over the next few months over the summer months but as to what happens in September is anybody's best guess and I think there's going to be a lot of nervous government officials educators who perhaps going aside on the You know one of being conservative and not reopening schools in the way they weren't before last question we've got a minute left big controversy in our country and in Canada about legalizing drugs and invective drugs having on children and he had somebody on on one of our shows hit a day where he says children taking it could experience eight percent drop of intelligence Quotient How do you feel about it? Yeah so you know. Drug and alcohol use in use particularly and teenagers between the ages of thirteen and is is very much a problem. the substance that you are most commonly exposed to alcohol and that then followed by things like marijuana you know tobacco use the opioid crisis Which is obviously a public health. Emergency here in here. In the United States is is less of an issue. Appeal uses is actually quite low in teens but if you look at for instance You know marijuana use Up to forty percent of high school students have tried marijuana by the time they finish their high school years. And that's a very large number and a very concerning number. We have seen declining rates of the perception of marijuana being bad substance and teams meaning. They view it as a favorable thing and and and I'm concerned that a lot of that's related to the mixed messaging that is seen in some where there are medical marijuana laws and Subsequent to that the legalization of marijuana I think You know. Unfortunately it's sends a message to teens when we realize substances like marijuana that it's okay that it's okay for their health but we know that Young people because their brains are still growing and developing until their mid twenties. They are at increased risk for addiction. More so than adults expose themselves and things like tobacco and marijuana and because of this there are more likely to become dependent on substances and continue that addiction in life. And we know that this can have long lasting health consequences Dr Lori her stacking meeting physician for children. Thank you for coming on and giving us your thoughts on both covert nineteen and on Possible Marijuana and Have a great weekend you to always happy to speak with you. John this is the catch roundtable. We right back.
From Nurse to CEO: One Entrepreneurs Journey
"This podcast is brought to you by Knowledge Award Against Shelly Boys founder of Med risk. She found the company in one thousand nine hundred ninety four and was it C._E._o.. Until two thousand seventeen she's now the company's Executive Chairman Rea- speaking with totally about her entrepreneurial journey and it's lessons should he thank you so much for speaking with knowledge orden today my pleasure so I understand you have a bachelor's degree in nursing from viewed West Virginia. What made you want to become an entrepreneur? What's the story there well? I wasn't planning of being becoming an entrepreneur per se. It was just a journey that that led me there. I went to school in Virginia became nurse practiced here. The children's Hospital of Philadelphia then decided to leave to go into medical sales from there went to <hes> work for company that owned and operated medical clinics and it was during that time that I came back to school came to Wharton <hes> formalize my education and <hes> it was that time actually wrote about this business as a marketing plan was intended to be a business it was intended to be or marketing plan for the company that I worked for in and ended up turning into business and <hes> I left the company and when out of my own started men risk so could you explain a little bit about what the marketing plan was and what was the the problem you were trying to solve or the opportunity you're trying to uncover sure so I worked for a company that owned and operated physical medicine clinics and <hes> the concept was to help to manage in control the utilization in the cost of physical medicine particularly in the workers compensation space and so I took it to my employer is a marketing marketing plan to help us attract more pair clients and was not received so well because it was a cost containment strategy <hes> I then took it out to some clients and talk to them about the idea and again was not sort of well received because it was the chicken you know in the Hen House and then finally wrote about it as <hes> as a paradigm shift for for Wharton and so the problem that can just interrupt US air. Ah Is it true that you didn't get very good graded working either vote. Is that true. Oh yes that is that is what happened that is more than true. They were actually my third strike for strikers employer second strike whose clients Third Strike Said Well Certainly Paradigm Shift Business Plan for Warton. You know this'll this'll be my ticket to to to make to make it a go and I'll never forget getting that paperback and and it said P minus not know what the grading system is today but a p minus in one thousand nine hundred ninety four was a half an inch above failure <hes> and I was devastated although I'll give the professor credit because he wrote at the top of the page good idea you'll never get it off the ground though you have a chicken and egg problem I think I think I have that verbatim in my head still today take and he's right and in in in that that really was one of the early objections that I need to overcome to launch to launch the business who took I'd love to understand what executive is going on here. Because when your employer the customers in the professor all felt that this is not good at work what was their objection and what is it about the idea that still kept you going well. I think that their objection stemmed from which one of the three I was I was talking to and so I think all three of them were different and before I sort of go through each one you know I think that the way that I looked at that is that it's not in my mind. A failure of an idea it was they were objecting waiting to something and there was a problem that I needed to solve for each one of them and by solving if I were able to solve those three problems I then felt like you know I I could make this could make this ago and so if you think about back in the you know the early nineties most of our healthcare system was delivered through bricks and mortar people going directly to a facility and getting treatment and basically finding owning allow those facilities on their own and so part of the concept was to not own these clinics <hes> but this concept was to create a network of clinics which is very widespread today but back in the nineties less though <hes> and so it was is to basically contract with clinics and act as a network act as a go-between hence the chicken and the egg a go-between between pairs and providers and we were then sort of the intermediary between clean those two creating value for payers by getting them to the right providers helping to save money getting injured workers care faster and then from the provider's perspective they received of patients and we did all their back end administrative work for for them so we were sort of a go-between between those two <hes> and like I said the employer didn't like the idea because they owned clinics and they just wanted to feed either own clinics. The clients did like the idea because they saw us as a company that own clinics and therefore you're not going to be unbiased. You're just gonNA feed your own. Clinics and Wharton didn't like the idea because I didn't have payers payers and I didn't have providers therefore I'm stuck in the middle and I didn't have either one to get me off the ground. So how'd you to modify your plan in order to make it fly so I think it so if you go back to each of those three groups it taught me a couple of lessons one. It should not have been housed inside a company that owned a dome clinics it needed to be its own business so that gave me validation that it should be its own business <hes> and that would take care of basically objection number one in objection number two objection number three which was probably the toughest which is the you don't have payers and you don't have providers so how you GonNa Leverage one to get to the other and so we created this <hes> will you bought if I build will you buy and so basically we went out to payers <hes> because they have the leverage and we said to a group of payers. We've found an early adopter we said head. Do you like the concept. Do you believe that will help. Injured workers get back to work faster and sooner and they will get good care and that ultimately will save money for you as well and they said yes so. If we build old this network will you buy and they said yes so they basically wrote us a letter in his own typewritten one paragraph we took that paragraph found every provider in the in the tri-state area and I think we started with the Delaware Valley region I and sure enough they said well. This is a really big payer so I'm going to get patients from this pair. I'll sign up and that's really sort of what leveraged want to get to get to the other that that grew from there that's remarkable story because normally people say that entrepreneurs need to win supporters in order to make the business fly but in York is it almost seems like does who objected to your idea actually helped to make your idea stronger and better well. They certainly helped <hes> these hurley helped me feel stronger in terms of the conviction of the idea no doubt but I think that having to solves problems and overcome those objections <hes> ultimately helped really leveraged getting the bit the business off the ground one of the challenges that have heard many entrepreneurs talk about is the difficulty of raising the initial capital. And hiring the first team who can help to execute on the idea. How did you deal with those issues as you were getting metric off the ground <hes> so I guess if you back up for second can you think about you need to have a good programmer product? You need to have great people and then you need some resources and I think what oftentimes happens is people view that not necessarily in the right order if you've got a good idea and you've got great people that are completely compassionate and passionate about the idea and totally convicted to it <hes> you will find money. I mean I say money it's cheap but but you will find you will find money if you really focus on on number one and number two and so <hes> I think wine was sort of making sure that we had the right idea and then secondly whenever you're hiring people whether you're starting starting up or whether you're you know one hundred million dollar company or whether you're market cap of of a billion dollars. It's really about finding the right people for where you are in your life cycle and that will change so who you are and what you need as a startup is often times very different than who you are and what you need is the company grows but finding the right people and putting him in the right place I mean I know everyone says that it probably sounds cliche but it is it is so true and I think our philosophy admission risk is when you look to hire people don't go look for people who are looking for job. Go find go interview and talked everybody you know to find out who's the best and the brightest find a way to hunt them down and then stay on him until the agreed victory to come on board with you stock up what kind of people apple to go hunting for what I think some of the <hes> well obviously a great team has needs to have a lot of diversity and so that's in that also changes over over time and in growing and growing business <hes> I think you can always teach someone skillset <hes> but you can't teach them a demeanor culture a personality and whether that fits within the culture of your organization and I think that AH is so true to what we believe in finding the right people and <hes> many of those tend to be people that have in some of the tougher ones but some of the ones that you really WanNa get right are there's people that have external facing responsibilities so what defines the mattress culture. Oh I think I think we've been pretty true over the years to no matter how big we are always have an open door treat everybody equally with respect and everyone has a role to play and we really are and I know it sounds cliche shaved looking reading emails early this morning and the motivation of people in Hell we treat each other you know they were saying you know you've rock and I think that type of spirit and that type of of <hes> inclusion an open communication is really sort of defined sort of who we are as a as a culture and has you know create a great strides for the leadership position that we've taken in the industry trey asks you went from being a startup to basically national network in I think forty nine states <hes> what was somewhat the key issues that you faced in terms of scaling up your operations. Are there any stories you can tell about the challenges faced and how you dealt with them at different stages. Oh well <hes> cut me off when I when I show share too many I would say the first one is sort of a lack of scale in that <hes> our first client <hes> we actually lost it was actually second class. Take that back but the second client we actually lost so we're getting his great momentum really starting in the business and the client came to us. We're scaling up albeit small and they said you don't know what you don't know. You haven't figured everything out. Call me when you get it right and we were devastated <hes> but didn't look back and I think you know one of the lessons I will remember that day very clearly we sit her name was Mary Beth the client and we said there were seven of US worked at the at the company at the time we were scaling up to about twenty for this and I and and so we went around we said we're GONNA have seven business cards and she gave me seven business cards and sure enough we put one on everybody's phone and we said every time you answer the phone you're GonNa look at this business card and you're GonNa think of her and you're GonNa think of having lost his client and we're going to get her back in that sort of propelled us to that determination of doing what we needed to do due to figure out all the not all but many of the lessons that we had figured out on the first round and they did come back then they were client and they've been acquired multiple times over but they're still wind today and that's twenty twenty five twenty five years is later <hes> but I think one of the lessons that we learned from that is appliance have different attitudes around their ability to take risk even insurance companies during the rest business but many of them aren't risk-takers and so really finding the right clients for where you are in your product. Life Cycle is extremely important so theoretically you've probably should've never brought her on his client because she wasn't risk-taker those that are helped wanting to be on the front end really being innovative and really grow is the kind of clients you want when you're just starting out although you're so hungry you'll take anybody I'll fast forward to another story probably about <hes> we were about two hundred million maybe in revenue and trying to scale and we'd hired some new folks <hes> and operational folks and they came from a background where outsourcing was very predominant and so so we decided that scale and create the efficiencies we sorta were convinced that okay it's okay to outsource so we spent the better half of six months close those two year outsourcing many job functions it was so hard leading team members go as a result of that and during that process we also let some of our her customer service inside but inside customer service facing folks be outsource disaster absolute disaster and these were people that were scripted scripted and and we're really even though when the healthcare business were really relationship business too and if your job is to work with payers and injured workers you don't want to hand that off to someone with the script and they just didn't have they were all about the numbers and not about <hes> the face on the other side of the phone and not a whole rule the room for empathy zero you know because their job was was was was very was very very scripted. I can tell you that it almost took us down. I mean it it was that devastating almost tanked the company. There were times that you know we were like. Are we going to be able to pull this this ship back together and once again it's rallying to get the right people. We also hired made some some <hes> some employment. Employment changes hired the the right people focused on insourcing everything that we outsourced and you know it took us about <hes> how would save three to five years to really really fully get that back and to have clients and really see that ramp up in the five hundred seven hundred million dollar range you know t to to really take the company to the to the next level island and it's so paid off but boy. What a painful lesson no? I think that's that's an amazing story especially because outsourcing is often seen as a coup sort of cost panacea for so many <hes> group situations but your your experience was quite different. It can be but but certainly not in in our situation and no one knows your business better than you do and you know I think that that <hes> bringing all that back in house we've sort of haven't looked back from that sense. When a company is on a growth track I mean one of the ways in which <hes> many companies try to grow is through acquisitions and I understand that <hes> you had <hes> your own experience with an acquisition of medical diagnostic because those management what was that like in? What lessons did you learn to that experience? We're telling all are learning lessons today. That was a big another big learning lesson for us. We were at a time and we were probably Oh three hundred million in revenue I would say and we were trying to decide to we grow deep or do we grow and breath so it was a breath or strategy and in in our space there's lots of Ansari's and so what several other people in the business we're doing is that they were acquiring businesses and going across the answer areas and being more of a conglomerate or an aggregate or and so <hes> we to thought gee this is a great time to to do that as well. We Think WE'LL Buy Radiology Company Radiology and physical medicine <hes> or very synergistic so we'll put those together other will get clients synergies revenue synergies and and and great breadth in and diversity to grow the business sounds great strategy doesn't it right <hes> but in actuality what happened is unbeknownst to us and this was primarily a California based company they were national but they really didn't have much of a national footprint and they were primarily like I said California based <hes> couple things happen. Probably the most shocking talking was about three and a half months after the acquisition California <hes> implemented a new fee schedule and turned a profitable business non-profitable unprofitable overnight so we went for making small acquisition so we be financed internally. We didn't have to raise capital for but small business making a small profit losing money literally overnight so oh that was number one <hes> we still thought okay. There's you know several other states in the country so we started the footprint of expanding into other states and I think the other big lesson that we learn from that. was you know it didn't it was coming into the market is a startup up when the market was really in that segment of the business was really maturing more than others and so to be successful in that business you needed scale and you needed scale fast and that was difficult to achieve given situation California given the fact that we didn't have providers and clients in a national footprint in third and probably what what's most important in the one that that really sort of unsafe forehand but how does understand why why it's time to let go is we then pull back and realized how much opportunity we had to really do what we did and physical medicine in do it better and do it so well that we can narrowly focused on that business and really really did not want the diversion of a small startup business that was struggling line so we we chose to peel back in narrowly focused on going deep and you know double the revenue in a couple of years again very very interesting and important story <hes> I believe even two thousand Seventeen Carlisle group acquired a majority stake in mid risk. How how did that come about in? How did you teen handle that transition so I guess there last question is how the handle it it was seamless? I and I'll talk a little bit more about that in a minute but how that came about <hes> it was actually our second <hes> belt around with private equity we <hes> when I started we raise money with angels so it was it was friends. Not Many family members not that we had a lot of family to tap into <hes> but also I didn't WanNa go Thanksgiving dinner and talk about you. Know is the business profitable so you have to have some downtime somewhere right so so the angel investors that money was really carried us <hes> for about twenty one years and then we decided we were going to go into the providence would he space and can raise some some capital do minority recap to get our our angels for their their investment back and so we did a minority recap with a group called Ta Associates Their High Growth Fund out of Boston <hes> Great Group <hes> and and we were with them for about not quite two years about eighteen nineteen months and we did about two point eight two point eight almost three times return for them in less than two years so everybody was happy on that first round and <hes> and then when we then <hes> decided to go from T._A.. To then do a majority recap we'd already sort of learned many of the lessons of had to deal with with that type of investor and so now I think we felt more comfortable about taking the next step <hes> and interviewed <hes> several folks <hes> and and chose the Carlisle group in that's was again moving from a minority to to a majority <hes> they <hes> we judge folks basically on <hes> two main two main reasons or two main ones that culture fit if you don't have right culture fit with your financial partners and you know you're gonNA hit some bumps in the road. Everybody Body Does No. That's could be a death sentence <hes> or certainly an unpleasant time right <hes> and we haven't had any of those yet but we're prepared if when we do but the one you have to have right culture fit and then second you want to find investors that can help you grow and Carlisle met both of those and they've been a great partner so far <hes> you know they're much more in terms of <hes> growth much more in the transformative type of growth were T._A.. was much more about small Tuck in acquisitions. Carlisle group is is you know very large and and really likes to do large transformative type type of type of things in terms of the team. You asked how that went and <hes> I would. I mean perfect it. You know Mike Ryan was <hes> the president at the at the at the time we had <hes> <hes> transition tim before we four. We started the Carlisle minority majority. We you know I I moved Mike from President C._E._O.. And in fact I mean in many respects he was already acting as the C._E._o.. And and he we now have a great relationship and so it wasn't sort of a difficult if any hand off at all it really was was was very <hes> very seamless in years so many stories where that's not the case where C._e._o.'s are moving are. Handing off to other C._E._O.'s why did you pick him as a C._E._o.. What qualities did did you see from among other possible possibilities that made into right fit? Oh that lists could go on and on on <hes>. He is just truly dynamic leader the there is not sort of. I don't know if I can name one person that doesn't either in the company or outside of the company doesn't respect <hes> <hes> most part like Mike Mike Ryan he <hes> he was working for an insurance company at the time <hes> when I hired him about seven or eight years ago and I said I said to a friend of mine who is the best leader Europe sales in the industry. WHO's the best one he's Oh I know a person but you'll never get him? I said just introduced me to them so they introduced me to to Mike and it took about six months before he accepted the job and quick funny story before he accepted the job. I was actually waiting to get a callback hoping that he would accept the job and I was on vacation but near my phone not so close to near my phone that it went to voicemail and he was actually Ashley calling me to tell me he was going to reject the job. It wasn't GonNa take the good news. My voicemail was full so he never got to deliver the message. I then got back to to the states three days later and and over the course of those three days later then accepted the job when I got back <hes> but but but <hes> more on sort of Mike as leaders so he came in he came in during that very transformative transition period where we were really at a time where the business had outsourced and we needed in source in rallying folks getting clients rallied I because his job was started in sales and then moved on to <hes> to be the president really rallying the team members around bound you know getting that hunger in that passion and bringing all that back in house <hes> is really sort of second to none. It's just it's remarkable to to to disorder see him an action. He's probably one of a few people that I know that <hes> can fire somebody and they'll thank him for and so he's very open I mean if if if he sees something that's not right right he's he's. He's very open his style and any dozen in a way that's very direct <hes> but but people appreciate that and he's got an incredible <hes> team of supporters so thank you when you think back about your entrepreneurial journey. What do you think is the biggest leadership challenge of fist? How did you deal with it? And what are you learn from it. Biggest leadership challenge I would say I would say to not and they're somewhat related and they both relate back to people want about other people in the other about yourself. I think that one of the biggest leadership challenges in was as the mentioned this earlier is the company grows sort of the needs of the organization in therefore so do to the talents and the needs of the people and that can go both toward other people in towards yourself and so for other people there were certain points of time where people that had started in the business business at a certain point needed to change roles or someone needs to be higher than them in the hierarchy of the organization or maybe they need to go do something else and those were personally painful full decisions and very difficult decisions as a leader to make and <hes> but I think that for the health of the organization that's what a leader has to do right so so they were painful but really had to be done the the second one and again somewhat related is around me in that who I was and what I did when we started the business was not going to be what the company needed at certain milestones throughout throughout its its growth and so you know to be the C._E._o.. When zero revenue and continue to be the C._E._O.? When you know exceeds five hundred million revenue I had to be in really enjoy being a professional learner so not only did I have to learn? I also had to adapt and change and I think that you know it's been a wonderful journey for me in learning and growing and always sort of seeking to do better but that's not easy you know and it's not easy to let go thing sometimes and so that's just <hes> it's it's been life-changing for me but <hes> but but very worth Indian. How would you say your experience in Madrid has shaped you as an entrepreneur? I would say shaped me. There's probably defined me so it's it's you know you meet a lot of entrepreneurs out there that are for serial entrepreneurs that that like to take a company to a certain point and and and start over and go to the next one and for me it was really about taking this you know as in really growing with the business and watching the business grow and really feeling like you're a part of it and the fact that you can impact so many so many lives <hes> and so that that journey has really sort of define me and as an entrepreneur and when I when I go and I join meeting with these a young budding entrepreneurs in and you hear their their stories and you sorta think back oh my gosh I remember when <hes> it's it's really it's it's satisfying and is rewarding to think that there's some small part of knowledge you can impart aired on them. We thought it would what you will be doing next. Oh I don't really know I mean I. I'M STILL INVOLVED IN MED risk <hes> and enjoy that I'm dabbling in a few other things and <hes> I don't have <hes> I'm not ready to retire my brain yet so I'm not ready to exit into the sunset or sit on the beach <hes> so I'm I'm enjoying dabbling in some few things enjoy still hanging around Metra's can sort of thinking about and looking at <hes> what my options are for for what's next so not sure but more to come one last question <hes>. What advice would you give aspiring entrepreneurs? Oh I think that <hes> I think that lists could <hes> could go on. If I were to boil that down. <hes> I think the most entrepreneurs we haven't talked about this today but I think most entrepreneurs have some defining moment where they don't doubt themselves as to whether they're gonNa do this or not. Do It isn't GonNa win. Is it GONNA fail my making the right decision. There is some tipping pointer turning point and you'll know when you get it and then when you get that you've got to be truly convicted not to look back and you only look forward and if you ever sorted out you Luger numbers set your number two client you know <hes> then you remember that tipping point and you remember the remember. The points is I'm not I'm not looking. I'm not looking back and and you don't and it's a wild ride. It's a life changing experience. It's and you just have to keep going and looking forward surround yourself with really smart people people. They're smarter than you know a lot of people out there that they're smarter than me and so constantly looking for the best of the best <hes> and however however you need capital along the way whether you do it with angels or minority or majority. Just make sure that that that it's fits right. I'm sure you thank you so much speaking with knowledge at warden such a pleasure speaking with you well you're quite welcomes pleasure.
Coronavirus news, updates, hotspots and information for 06-18-2020 COVID-19 AM Alert
"This is corona virus for one one the latest covid Nineteen Info ants new hotspots, just the. For Thursday June eighteen twenty twenty new modeling from Policy Lab at the Children's Hospital of Philadelphia shows Florida has the potential to become the next epicenter for Covid nineteen in the US, according to The Washington Post researchers say the risk of widespread community transmission is the worst. It has ever been the director of the Division of Infectious Diseases at the University of Alabama said the spike in Florida is concerning due to the states aging population and number of nursing homes and retirement. Retirement communities there are eighty two thousand seven hundred eleven, confirmed cases, and there have been three thousand seventeen debts. Three of the highest daily case counts have been reported in the last five days. Transparency in data released by the state health department has been questioned in late April the state. Medical Examiner's report noted a higher death rate than what the health department was releasing the Health Department's stop the release of the medical examiner's report in May. The doctor who created and updated. Updated Florida's official coronavirus dashboard was fired for what she says was refusal to manipulate the data. The governor of Arizona authorized local governments to require masks. Prior to this local governments were not allowed to mandate anything more stringent than what the state dictated. New York City and Washington DC will interface to of reopening on Monday over one point. Five million Americans filed for first time. Unemployment benefits last week Treasury Secretary Mnuchin, said the trump administration is very seriously considering another round of. Of, stimulus, checks. Chile will reinstate some covid nineteen restrictions as cases spike there. After a backlog of thirty one thousand cases were discovered. The President of Honduras was hospitalized for pneumonia Wednesday night earlier. In the day he reported he had tested positive with mild symptoms. The Eiffel Tower in Paris will reopen next week, but the elevator won't visitors who want to enjoy the view. We'll need to use the stairs. The locations of hot spots and US and country diagnosis in a moment. Hotspots displaying faster rates of growth as of June seventeenth, according to The New York Times Hawaii Lee, Nevada and she co county. Arkansas, Anderson. Bailey and Hays County Texas, Union and Lincoln, County Oregon Dickinson, and Clay County Iowa Lanier County Georgia Trusdale County. Tennessee Konica Green and Monroe County Alabama Hidalgo County. New Mexico Canada. Hula County Louisiana you, Windsor, County Wyoming McDonald County Missouri Crawford, County Kansas Clay County South Dakota Lowndes, county Georgia Globally Bulgaria sell. Sudan Kosovo Zambia the Neen s Joaquin there have been two million, one, hundred, sixty, three, thousand, two, hundred, ninety confirmed cases of. Of covid nineteen in the United States and one hundred, seventeen, thousand, seven hundred seventeen deaths, there were twenty, five, thousand, six, hundred ten new cases reported yesterday. The ten states with the highest case counts New York, three, hundred, eighty, nine, thousand, nine, hundred, ten, new, Jersey, one, hundred, sixty, seven, thousand, seven, hundred, three, California, one, hundred, sixty, three, thousand, three, hundred, thirty, five, Illinois, one, hundred, thirty, five, thousand, four, hundred, Sixteen Massachusetts, one, hundred, six, thousand, one, hundred, fifty, one, Texas Ninety, nine, thousand, four, hundred, sixty, six, Pennsylvania, eighty, four, thousand, three, hundred, Eighty, seven Florida eighty. Eighty, two, thousand, seven hundred eleven, Michigan, sixty, six, thousand, six, hundred, ninety, four, Maryland, sixty, three, thousand, five, hundred, sixty, five, the five countries with the largest daily increases for June seventeenth, according to the WHO Brazil. Twenty, thousand, six, hundred, forty, seven India, ten, thousand, nine, hundred, seventy, four Russia seven, thousand, eight, hundred, forty, three, Pakistan, five, thousand, eight, hundred, thirty, nine chalet, five, thousand, thirteen, the ten countries with the highest overall case, counts Brazil nine, hundred, fifty, five, thousand, three, hundred, seventy, seven, Russia, five, hundred, sixty, thousand, two, hundred, seventy, nine, India, three, hundred, sixty six. Six, thousand, nine, hundred, forty, six, united, kingdom, three, hundred, thousand, seven, hundred, seventeen Spain, two, hundred, forty, four, thousand, six, hundred, eighty, three, Peru, two, hundred, forty, thousand, nine, hundred, eight, Italy, two, hundred, thirty, seven, thousand, eight, hundred, twenty, eight, Chile, two, hundred, twenty, thousand, six, hundred, twenty, eight, Iran, one, hundred, Ninety, seven, thousand, six, hundred, forty, seven France, one, hundred, ninety, four, thousand, eight, hundred, five, for the latest updates subscribe for free to corona virus, four one one on your podcast APP or ask Your Smart Speaker to play the corona virus, four one one podcast sound. That brands.
Show 1225: What Is the Evidence on Vaccines and Masks?
"I'm Joe Graydon Terry Graydon. Welcome to this podcast of the People's pharmacy. You can find previous podcasts and more information on a range of health topics at people's pharmacy dot com. Over five million people in the US been diagnosed with covid nineteen, hundred, seventy, three, thousand have died will vaccine save us this is the people's pharmacy with Terry and Joe Graydon. Dr Paul, it is an expert in vaccine -nology he'll tell us what's involved in vaccine testing and when we might expect a vaccine face masks are helpful in preventing the spread of covid nineteen. But only if they work, is there any technology to evaluate the relative effectiveness of various masks? How can we tell of treatment is effective or a waste of time? Dr Off. It will share insights from his new book overkill coming up on the People's pharmacy when modern medicine goes too far. In the People's Pharmacy Health Headlines Cove nineteen now has the unenviable position as the number three cause of mortality in the United States just after heart disease and cancer. The coronavirus has now killed more than one hundred, seventy, thousand Americans in twenty twenty. That means it exceeds deaths from stroke, timer disease, diabetes, accidents, influenza, and pneumonia. Scientists are trying to figure out the best way to assess past covert exposure and immunity. Some tests look at reactions to the nuclear capsule antibody or n protein while others focus on an antibody to the coronavirus spike protein or s protein although fewer people have antibodies that react to the spike protein, those blood samples were more likely to neutralize the virus. In, a test tube, the authors caution their colleagues not to rely on commercially available tests that focus on antibodies to the end protein. This could be especially important in evaluating vaccine effectiveness. How long will it take to reach her immunity public health authorities don't know exactly what proportion of the population needs to be vaccinated or recovered to slow or stopped viral spread. Some have suggested it'll take about seventy percent of the population but other S-, think it might be lower maybe as few as forty percent in some places that have been hit hard by Covid nineteen herd immunity may be close some neighborhoods in Mumbai London or even Brooklyn new. York appear to have a significant proportion of people with antibodies to the corona virus in certain Brooklyn neighborhoods. Eighty, percent of those tested showed antibodies though the proportion in the borough overall is nowhere near that. Likewise in some crowded areas of Mumbai Fifty, seven percent have antibodies in the rest of the city. The rate of positive antibodies is between ten and twenty percent. We don't yet know if these regions will be spared in the event of a second wave of infection, but they might be. There's growing suspicion that standard antibody testing may not tell the whole story about covid nineteen immunity. New Research suggests that people who have had mild infections could develop something called virus specific t cell immunity. Even after antibodies disappear, T. cells can retain their memory of the corona virus for months. If not years exposed to it again, they would alert the immune system to fight it off. The malaria drug hydroxy chloroquine remains a controversial treatment against cove nineteen, a new study from case. Western reserve asked the question whether this drug protect people who take it because they have lupus or rheumatoid arthritis. The researchers analyzed data from the medical records of thirty six health systems according to the authors. Hydroxy chloroquine was not associated with Covid nineteen prevention. Oleander is a flowering shrub that thrives in warm climates around the world and extract of Oleander Leandra. N- has been tested for antiviral activity against SARS. Kobe to this cell culture study indicated that the compound can prevent entry viral infection in a test tube. What's lacking however is animal research or clinical trials. Anyone who considers using the plant therapeutically should be warned that leaves flowers, stems and roots are poisonous. The American Botanical Council put out a notification to consumers quote not to ingest any parts of the plant or capsules tablets, tease or extract preparations made from leaves or other parts of the Oleander plant because it contains chemicals that can cause serious effects to the human heart including death. For years neurologists have been encouraging people who might suspect they're having a stroke to seek emergency care espoused as possible time is brain they say that message has been reinforced this week in Jama investigators studied more than sixty thousand Medicare patients who had strokes caused by blood clots. Those who were treated with clot busting medicine for strokes within forty five minutes of arrival of an Er had better outcomes. They were less likely to die or be readmitted to the hospital. In the following year. The authors encouraged their colleagues to continue striving to shorten door to needle time. And that's the health news from the People Spar Masih this week. Welcome to the People's pharmacy I'm Joe Graydon and Terry Grade in the whole world is waiting expectantly as pharmaceutical companies began clinical trials of Corona virus vaccines. What should we expect and how soon might we see results to find out about vaccine development were talking with one of the country's leading experts Dr Paul off it is director of the Vaccine Education Center at the Children's Hospital of Philadelphia. Welcome to the People's pharmacy. Dr Paul offit. Thank you. Dr Offit you and your colleagues at the University of Pennsylvania. Have written a viewpoint for the Journal of the American Medical Association on developing a SARS covy to vaccine at warp speed, we are all interested in having a vaccine. To stop this pandemic, what should we be considering? Will. So I I think the language that has surrounded this vaccine has been a little frightening. We use terms like were speed or race for a vaccine or who were the finalists and I think people can reasonably be concerned. The corners are being cut or safety measures are being overlooked. On that's not true. The most important thing with the way that we've developed this vaccine is to make sure that we face three trials meaning large prospective placebo controlled trials that involve tens of thousands of people and that we allow those trials to go to completion. We have every assurance from the FDA that that's going to be allowed to happen. So I think as long as that's true than the American public at least be assured of the fact that the vaccine will not have vaccines will not have an uncommon side effect problem serious side effect problem put tens of thousands of people and lease will be effective at a certain level for certain period of time. Can you tell us what a phase three trial consist of and you were talking as though it was one vaccine there's actually several under development Arthur. Yes a handful and I think just in the US I think through the world at fourteen or fifteen currently development. I think there will be more than one vaccine that will be put into the arms of the American people by the middle no later in the middle of next year. So he right Here's the way typically that it works. Typically what happens is you have pre clinical trials and experimental animals. You have an animal, a mouse a ferret a hamster, a monkey that that when you inoculated with SARS Kobe to develop signs incentives similar. What happens to people? You have your idea for how to make a vaccine you try it on the expert model animal and then you can see. Whether works and more importantly literally dissect that were part of the immune responses associated with protection in the animal I'm that's coke so-called proof of concept studies. Then go to the phase one study phase, one studies or usually twenty, two hundred people. So called Ghost ranging frogs, you try a variety of different doses you see which one seems to to work of the best in terms of inducing an. Immune response safely, and then you move forward to the face to trial where you. Now you have your dose, you give them the hundreds of people to make sure that the vaccine is still safe that doesn't cause any common serious side effect problems and it consistently induced an immune response. You still haven't shown whether or not the vaccine works the only way to do that is in a phase. Three trial when you give the vaccine to tens of thousands of people, you get the placebo vaccine to tens of thousands of other people, and then you just let them get get sick or not get sick in just in the natural world and and then you then and only then can you tell whether or not all these immune responses that you've been measuring really do correlate with protection against disease. When we talk about effectiveness when it comes to vaccines I, think a lot of people assume one, one, hundred percent. But for example, the flu vaccine is never a hundred percent. We're very happy when it seventy or eighty percent effective. Any idea how effective the covid nineteen vaccines might be. Given how wrong all of us of generally been every step of the way about predicting this virus I'm still going to go forward and Ryan answer your question I'm going to get this vaccine will be about seventy to seventy five percent effective at protecting against moderate to severe disease, which is the common disease because you go to the hospital and the kind of disease that would cause you to go to the morgue on I think it would be unlikely if it protected against just reinfection ason thematic. reinfection even possibly mild disease associated with reinfection and I think that we're will be would last at least a year and possibly a little longer. So so I think what we can expect from this vaccine is that it'll be short-lived incomplete meaning I don't think it's going to protect you for decades and incomplete in that I think it's not going to protect against all forms of disease just the most the time that's going to get you in the hospital, the kind that's going to cause you to die. Now there seemed to be two general categories of vaccines. There's a lot of excitement about something called 'em aren a messenger aren vaccines, and then the traditional vaccines can you tell us very briefly the difference between these? There are several ways to make a vaccine. Virus inactivated like we make the hepatitis, a vaccine, the rabies vaccines with inactivated polio vaccine you can take a vaccine in weaken. So a live weakened form of the virus that's the way we make the measles vaccine, the mumps vaccine, the German measles vaccine, one of the rotavirus vaccines on you can take just one part of the virus, the so-called purified protein vaccines. We know what protein were interested in with this virus. It's at spike protein that that emanates from the surfaces virus that gives it its crown like appearance if you make antibodies directed against. That spike protein, you'll prevent the virus from binding to cells. So if you use a purified protein approach, me inject somebody with just the protein on. That's the way we make the Hepatitis B vaccine and human papillomavirus next, and so those there's a lot of experience with those axes. Now, her we're looking at a variety of different approaches which have never been used to make vaccines before at least not any that routinely given in the United States. So you can to, as you mentioned the Messenger or a vaccine. So a messenger are is that little bit Of A gene that tells your body to make at coronavirus spike protein. So you nakadate late somebody with about one hundred micrograms of this gene that gene and enters your muscle cells. The gene then is translated into a protein. So you make the, you make the coronavirus protein. Then you make antibodies to that protein on the same thing is really to with the DNA vaccines and then you have the so-called replication defective human or Siemian Adna virus vaccines. ADENOVIRUSES are just common cold virus on by making them replication defective these viruses cannot reproduce themselves therefore. They can't 'cause Z's on injected into your body. The virus enters enters yourself, and then it has been genetically engineered to make that spike protein. So again, you make the spike protein and you make antibodies protein I think those those are strategies that are gonna be I rightly because of the easiest to construct a new, the easiest mass-produce I think they're going to be the first because they were the fastest that doesn't mean they're going to be the last best vaccines which historically has often drew in vaccine development but I think that's what people can expect. Now we've heard an awful lot about how fast these vaccines can be tested in phase three trials. Traditionally how long would it take and in this case? So called WARP speed? Wendy you anticipate we might get FDA approval of the first vaccine. You can't really speed up phase three trial I. Mean if you look at the the current trouser being done by Pfizer and Astra Zeneca Johnson Johnson, and Madonna the the the goal is to inaugurate fifteen to twenty thousand people vaccine to knock late about ten thousand people with a placebo and then, and that's two doses. So let's say that you're starting right now best case scenario. You would be able to get the first os into people in. August. Then you have another dose which would be given, which would be in September. Then you have to wait really two weeks after that second dose to get sort of the maximum unisphere already mid October, and then you wait until you have an adequate number of people in your placebo group who are sick not just. Infected but SIC meeting moderate to severe disease because that's what you're trying to prevent I'm you have to have at least one, hundred, fifteen possibly as many as two hundred people in that group so we have to get a little lucky. You have to be in areas obviously where there's outbreaks and eighty percent of the diseases is symptomatic molly symptomatic, which is not what you're trying. To prove that and remember you're also telling these people at the same time where masks social distance wash your hands. So in many ways, you're you're trying to encourage them not to get sick but again, you're never gonNA actually no other your vaccines effective unless they do get sick. So I really frankly can't imagine that we would have a vaccine any earlier than not early next year. Dr Off it. You mentioned that part of the reason why we need to have these large numbers for phase three trial obviously is to make sure that it actually does protect people against that. Severe moderate to severe disease. Another reason is to make sure that there aren't any really nasty surprises that you know one out of a thousand people has a terrible. Side, effect what kinds of dangers will the vaccine developers be looking for and how confident can we be that they will find anything that is going to be truly worrisome. Right. I when when you when you make a vaccine you and you go from phase one to phase to face three, what you're trying to each step is reduce uncertainty reduced what you don't know, but you never eliminate unserved. So so for example, if you test the vaccine twenty thousand people and you don't find any serious adverse US events, you can say that the vaccine doesn't. Seem to have any uncommon a relatively uncommon serious side effects but twenty thousand people isn't twenty million people. So you only know about rare adverse events after the vaccine is already out, resell them and who I considered to be the father of modern vaccine. said it best quote I never decide relief until the first three million doses are out and that's not gonna be a pre licensure preapproval. Phenomenon I think the things that people are looking for would worry about or so called antibody dependent enhancement that actually by giving the vaccine, you may make people more likely to have severe disease are more likely to be admitted to the ICU than if they never got the vaccine that's actually happened before it happened in the nineteen sixties with a vaccine to prevent it a disease called. Respiratory System Virus which was also respiratory virus, it also happened with measles of our AMIS accion. In both cases, the RCN measles vaccine were inactivated with the chemical formaldehyde. So there is going to be a concern about that, and then I think that's why they're systems in place like the Vaccine Safety Data Lang Ray of program run by the Drug Administration called the prism program which were. Linked computerized medical record systems for tens of millions of people, and you'll be able to see who got the vaccine who didn't, and whether there seems to be a greater likelihood that someone would suffer more severe disease from having the vaccine. Not that also recently happened with a down vaccine. You're actually as a young child who never been exposed to Danke before if you got the Dang, you were worse off than if you never got that exit. You're listening to Dr Paul off it director of the Vaccine Education Center at the Children's Hospital of Philadelphia. He's also the Marines are Hilaman professor of vaccine -nology and a professor of pediatrics at the Perelman School of Medicine at the University of Pennsylvania. Dr Off it has written several books. His most recent is overkill when modern medicine goes too far after the break, we'll talk about how long the backseat will take to get the corona virus under control until we have scenes and probably even after masks are crucial, which ones really were we'll talk with Dr Eric Westman Co author of an ingenious study on mask effectiveness. You're listening to the People's pharmacy with Joe and Terry Graydon. The People's pharmacy podcast is supported in part by Coco via cocoa via coca flaw banal support but cardiovascular health and cognitive function by promoting healthy blood flow that transports oxygen and nutrients to vital organs muscles including your heart and brain cocoa via now comes in even more concentrated formula with four hundred, fifty milligrams of coq AU flavonoids five times more than the leading dark chocolate bar and fifteen times. More than the leading cocoa powder cuckoo via has a proprietary process that preserves cocoa flannels at the highest levels. The product undergoes rigorous testing at every stage to guarantee the highest level of coca flop and also per serving and to provide the purest highest quality product. Possible People's pharmacy listeners can now try cocoa via for twenty five percent off by using the code people's twenty-five, at Koko, via dot com. Welcome. Back to the People's pharmacy. I'm Joe Graydon. I'm Terry Graydon People's pharmacy is brought to you in part by COCO via maker of high potency Coca flat-panel supplements that support cognitive and cardiovascular health more information at Koko via dot com. Also, by Verizon A- An analytical laboratory providing home health tests for hormones, gut health and the microbiome online at V. E. R. I S. A.. N. A. Dot com today, we are talking to one of the world's foremost authorities on vaccine development and safety will also find out about face masks. Our guest is Dr. Paul Audit Director of the vaccine, education center at the Children's Hospital of Philadelphia. He's also the Maurice Are Hilaman professor of vaccine -nology and professor of pediatrics at the Perlman School of Medicine at the University of Pennsylvania. Dr Off it has written several books. His most recent is overkill when modern medicine goes too far. Dr. Off. There are a lot of people who believe that once the vaccine is approved by the Food and Drug Administration were home free that it's like the switch has been turned on and it's just a matter of getting the vaccine to as many people as possible as fast as possible. They probably think that's going to happen in a few days or a few weeks. How long will it take? Once we do have an effective vaccine before this virus basically dies out. As a great question, you know the the CDC has recently stated in the last few weeks that they think that the front line responders meaning healthcare personnel, nursing were workers, people were convinced transit. If you take all the people who were her priority to get this vaccine I, that would be about one hundred, twenty, million people for what is likely to dose vaccine. That's two hundred, forty, million dollars that you have to get into the population that's going to be a tour to force, and you're going to have to have points of care in addition to the doctor's offices, pharmacies that that enable to want to get these vaccines first and second dose out there. I think that in terms of of what percentage of the population you would need to vaccinate in order to stop spread. It depends on the effectiveness of the vaccine if the vaccine is seventy, five percent effective at preventing shedding. Not just modern to severe disease but any shedding associated with a symptomatic infection or mildly thematic infection you would need to vaccinate about two-thirds of the American population. So more than two hundred, million people. And how long do you think it would take before that happens I think it would take a couple years before that happens and I think This is something that really scares me is that I think people need to realize that doesn't mean that you can throw away your masks. I think because in all likelihood, this vaccine will likely protect against modern to severe disease but not mild disease which may still be associated with shedding even if you've gotten the vaccine and even if you're one of those three out of four people for whom the Vaccine Works and works well you. Still should wear a mask I mean you're not it's not like the measles vaccine I mean the measles vaccine provide sterilizing immunity. You're protected against all forms of that illness for the rest of your life. This is not going to be that vaccine and I think people a need to realize it's hard enough to get people to wear masks now and I think wants the vaccine is introduced I suspect it's going to be even harder. Speaking of things that are hard to get people to do European. Attrition you're an expert in vaccines in. It can be hard for some families to accept the idea of. Getting their kids vaccinated. Moore that it's likely to be difficult to convince some people that they should be vaccinated against covid nineteen? What advice do you have for the vaccine hesitant? I would I would count myself as vaccine hasn't right now I don't know what this vaccine looks like. I think everybody that sits around the table at the FDA vaccine devisory committee I would consider to be vaccine skeptic. We all want to see the data before we would ever licenses vaccine for the American Public I. Think it's going to be much easier to convince people when we see what this vaccine looks like. Let's assume that what I said earlier is true that that vaccine is seventy five. Percents effective being that you have a three out of four chance of of not getting this disease. If you get the vaccine and let's say it's been given to twenty thousand people or more safely. Then that's the question knowing that the vaccines we given to twenty thousand people safely knowing that it is highly effective meeting seventy, five percent effective. Would you be willing to take actually knowing that there are about a thousand people a day dying in the United States I think most people under that setting would get. The vaccine but again, we don't really know with those numbers yet. So it's hard to convince people you're listening to Dr Paul offit professor of Pediatrics and the Maurice. Are. Hillman professor of vaccine -nology at the Perlman School of Medicine at the University of Pennsylvania. He's director of the vaccine education. Center. At the Children's Hospital of Philadelphia. We're going to switch gears now for a little while as Dr off, it has just pointed out will still need masks even after we have a vaccine for covid nineteen how? Do, we know which masks really work an interdisciplinary team at Duke University recently published intriguing study. They demonstrated a simple and inexpensive technique for testing the efficacy of face masks were talking next with one of the CO authors of that study. Dr. Eric Westman is an associate professor of medicine and director of the Duke Kito Medicine. Clinic. In the Duke University. Health System. Welcome. Back to the People's Pharmacy Dr Eric. Westman will thank you so much. It's always a pleasure to be on people's pharmacy. How're you doing terry? We're doing very well we hope you are. Doing Great. Thank you. So when I think of Dr Eric Westman at Duke I, think of metabolism I think of loss I think of lifestyle changes. How did you get interested in face masks and cope with nineteen? Well didn't you know there's a pandemic going on. Yeah. So. There were so many different questions than thanks to do Early on in our area there were there were no mass to be found. You could get volunteers to make them Hanso them, and we had no idea. I was involved with a project giving out masks in. If they really worked. So we were faced with hand out mass that are no good or that are untested or do we find a way to test them? And so that we did the ladder. While you know be at a place like Duke, I just called over to our physics department. It turns out you know if you remember back, the April most places were shut down and those kind of a universal response to close the labs and all that. So we had special missions open research lab to do you know urgent covid nineteen research, which was do these masks were handing out and and maybe purchasing or organizations do they actually really work? and. What kind of experiment did the physics folks? Conduct how did they put this together in? Was It really challenging? But we saw a very short communication at to the New England Journal of Medicine that was done by a group at nih boom Mike, collaborators. No, and it was just a very brief video of. Particles being admitted when someone said stay healthy people and then using a laser beam, you can visualize these articles. And then in that brief communications up, they just put a cloth over the. Articles were gone. So we were really extending and doing more research based on that model of letting a laser light light up the particle so that you could see them with a video camera and then we added on analytic component so that the computer analysis would count all the little particles. So we didn't have to do that So basically, something we borrowed on using laser technology is simple optical measurement that. By. Collaborator. Martin. Fisher was able to put together in a day or two. It was with materials lying around the lab remembers at the time in April. You know you couldn't get things. We were all sort of a state of paralysis. You managed actually to test quite a few different types of masks. What did you learn? Well, you know the detail there is we had two test. Ones that we were making are having manufactured in handing out, but then we wanted to calibrate. The instruments that we use really a laser in a box blackhawks and so he used the most effective ones that have been tested. Before the end nineties is in the hospital surgical grade masks knows perform perfectly. Well, I should say I I was surprised and Martin was as well that we were all viewing out these particles when we were just saying stay healthy people five times to if you can imagine sitting in front of a box with a laser, a green light she and there's nothing and then you start speaking the these articles starts floating around and you. Think it reflected in you can see them. So the best ones were the ones that have been tested or longtime, the ninety five and the surgical masks. Then we started testing the cotton mass that people were making the volunteers and we were handing out and those actually performed really well, at zones are two layers. It was about eighty percent as good as the head ninety five in surgical grades than we also threw in some BANDANAS IN A. Another company donated some next lease items and the thinner and more porous material is the worst performance. So the band performed at about fifty percent. Effectiveness. And then this one layer neck ater only it didn't work at all. All articles just came right through. So it would be better not to rely on a single layer neck ater. But if you have several layers of a homemade mask, for example, that might be pretty good. Well you know that's the thinking based on the results that we have. Now there's a lot of other research on fabrics and number of layers that test the air coming in. So if you imagine all the tests in the past have had to do with is the wearer of the NASC protected. So find him into a room where I know someone has the virus. Virus can be in the Air I'm you want that end ninety five? In fact you get what's called fit tested to make sure that it's almost perfect seal because you don't want any the face mask and gown gloves and you change it every time. So that was the traditional testing. and. So what's interesting is one masks that was tested the old way meaning low pressure in just one direction in performed really well. But when we tested with people wearing it and trying to prevent spread from outside. The transmission of particles it didn't perform well. So it contest well under one circumstance when you're trying to see if the wearer is protected, but it may not perform well when you tested for the other circumstance, which is if you're, you're know you're sick are you going to spread it to somebody else? which mouse was that I'm imagining it might be in ninety five with a event. Well. So we at first the end ninety five, that's. The best one that hospitals use, but some of them have vowel that allows the air to go out. Without. Being filter. To, actually, these didn't perform very well in in our first round just sharing the information to my friends and colleagues. One of them pointed out will urine ninety five is about as well as cotton was going on. While it was because of the valve. So if you're going into room with someone who you know has disease hostile. It's okay. If you have a valve on it is you're not trying to protect the person who's already sick from us not sick, right so but if you're out in about and I think some. Airlines and even the CDC has a advisory. That community spread is not stopped with these ninety five with excavation. Boban, and we we found that to be true articles came right through that acceleration bow Dr Westland. There are so many different masks on the market in fact you you looked at fourteen with your colleagues and I'm just wondering how can we make sense of the different kinds of masks and we're trying to make an informed decision which ones should we be wearing in the community? It's really important to know. The masks that are needed in the hospital are different than the masks that are needed in the community. The ideas different. You're protecting the wearer the mask in the hospital because you know someone has the disease in the community you don't know is someone else has the disease and you don't know if you'd have disease. So you WANNA protect other people from US putting them. That's called community spread, and so the mass don't have to be as good. But they do have to block some things. That's where we want you to use the best masks that you can get. That doesn't impede the flow of really good mass to the medical community that I think early on everything was up in the air you didn't work out the mass don't work, which is not true. They have always worked, but there was sort of a a supply issue now that there are plenty of nasty. I would ask you to choose the best one that you can get and comfortably used to protect yourself and other people. And homemade masks the do it yourself variety actually can be helpful if they have what is it two or three layers of fabric. Yes, you wanted to find. Fabrics cotton is a great one that has a lot of thread count per inch. You can find all the details on online quickly that it one or two layers more layers the better but then trade office is harder to wear breathe through. So you have to find that balance on if you pull the fabric to light and you can see right through it, see daylight or breathe right through it that's not going to be such a good one. And, if people want to see the video of the actual experiment, I believe, Duke University has made that available on its website. Is that right? Yes. So that all of the data that we collected in videos so that you can see yourself these particles when people speak are available for you to watch in fact, trying to work through some sort of demonstration because it is hard to believe. I can envision a demonstration where someone you could walk up have yourself in front of a boxers will similar system so that you can test it out for yourself. So Dr Eric Westman wants the take home message on your experiment. Well I think we were all surprised to find that just speaking. We're emitting these particles that you can't see with the I that you can see with laser. And the possibility that you're spreading disease including a virus. That's. Deadly, that's a little concern so that it was a sobering finding, all of us who were the subjects in this study that it was reassuring to know that articles come out when you're speaking are blocked by the cotton level in grade two or three layers that were being made by the volunteers we weren't handing out bad masks they weren't perfect, but they don't have to be perfect in the community and then we're calling. The. Question to these one layer air next lease is you WANNA call it that it's not native lease at it's polyester not to be careful that you're not actually making things not wearing not stopping or maybe making things worse because the particles looked smaller on that initial analysis we did. So I think, the bottom line is where something that works and the Bandanna in next idea is not such a great idea. Dr. Eric. Westman. Thank you so much for talking with us about your mask research. My pleasure it's always great to catch up with you. Dr Eric Westman isn't associate professor of medicine in the Duke, University Health System, he's CO author of the masks study published in science. Advances. After the break will return to doctor often to discuss his new book over CAL scientific trials of treatments have been around longer than you might guess the first one figured out how the British Navy could avoid scurvy. Does it always make sense to treat fever. Doctor Office will tell us why you don't really have to finish all your antibiotics. You're listening to the People's pharmacy with Joe and Terry. Graydon. This people's pharmacy podcast is brought to you in part by Verizon Dot com there is on a lab offers home health tests that allow you to monitor your hormones and health conditions. You can take control of the quantitative assessment of your health and learn about male and female hormone balance the stress Hormone Cortisol Leaky Gut Gluten intolerance, or your gut microbiome. Take a more active role in tracking your health and take twenty percent off your first order of a male intesting opportunity with the discount code people. That's Upper Case Peo P.. L. E. TO LEARN more, go to verizon dot. com. That's V.. E.. R. I S. A. N. A. DOT COM. Come back to the People's pharmacy on to create and I'm Terry Grady the Eagles pharmacy is brought to in part by COCO via maker of high potency Toko flavonoids, supplements that support cognitive and cardiovascular health more information at Koko via dot com also by verizon an analytical laboratory providing home health test for hormones, gut health, and the microbiome online at V. E. R. I S. A. N. DOT COM. So far we've discussed how vaccines are tested and learned about a relatively simple technique to evaluate the efficacy of face masks now we. Return to our conversation with Dr. often he's looked at a number of instances where modern medical practice strays beyond the supporting Science Darker Paul Audit is professor of pediatrics and the Maurice Are Hilaman Professor Evac Sinology at the Perelman School of Medicine at the University of Pennsylvania. He's director of the Vaccine Education Center at the Children's Hospital of Philadelphia Dr Offit. You're an expert on evidence based medicine and we spoke with you earlier in the show about the race to develop a vaccine against covid nineteen that will be both effective and safe. We'd like to talk now about your excellent new book overkill. Modern medicine goes too far. Thank you very much. Dr Offit you start your book with a story, a a Scottish surgeon. Dr James Lynn. Why. Is His story so important to your book? He what Dr Linda was he brought us into the world of of of the scientific method. Would he did was people on British ships who WANNA long trips would austin suffer disease called scurvy, which is a severe disease that we now known to be not be vitamin C deficiency. But that wasn't known that this is the seventeen hundreds. We didn't know what vitamin C was till the early nineteen hundreds. So what he did was to try and figure out a way to prevent scurvy he gave people a variety of things gummer on vinegar or. Citrus fruits like lemons, oranges or lime we found out was that those who eight sisters fruits and not the other things didn't get scurvy. So he proved it. It proved that an thoughtful controlled manner that was the scientific method I mean you you can ask the question, what is it? The causes scurvy and people can have all different ideas about what it is but that's the beauty of science doesn't have to be a belief system. It's an evidence based system provided the evidence to prove that that. In fact, if you gave the sellers the routers. That, they could then be protected. It's actually where the British and ended up getting their name. was because they would often bring large source of limes when the ships after they, they realize the importance of the signings. How long did it take for his colleagues to accept his discovery way too long it took really decades for them to accept the discovery and It's he wasn't well known. He had a very long treatise about four hundred pages was buried in the middle of the treatise and and so took a long time. But you know the data went out I mean if you're this is what's so good about this I mean you can look at, for example, hydroxy chloroquine today which has been offered for the treatment or prevention of Covid nineteen. It's scientific question it can be answered by the scientific method and it has. been answered and you know. So you have now study after study after study showing if you take two groups of people, give one hydroxy work when don't don't give it to the other make sure those two groups were alike in terms of their the degree of illness, and then you can see whether hydroxy corker works. It doesn't matter what people say is so often that that's what will happen people say look this doctor says this not doctor says that it doesn't matter will the only matters is what the data show in this book overkill. That's what I've tried to do try and bring it back to the signs. Now Dr how can ordinary people get access to that kind of scientific evidence so that instead of relying on the the guy they saw on the internet or the doctor on television, they actually can find out what the study shows. I think I think it's hard. Is The answer I mean there are roughly four thousand medical and scientific papers published a day in the literature day and you know they follow a bell shaped curve summer excellent summer awful most more or less. And I try and go through basically about fifteen or so a situation book where there's abundant scientific evidence that we shouldn't be doing something in modern medicine treating fever finishing off the antibiotic course where there is abundant evidence says, we shouldn't be doing that, but we do it anyway I think it would people can do by reading this book is at least arm themselves with that information that they when they go to their doctor, they can at least be better informed as better advocates for their own health. I really want to ask you about treating fever because that's something out almost every. Parent is tempted to do when the baby or the toddlers bikes fever you wanNA. Do something to make them feel more comfortable. So why shouldn't we treat fever? It's not just to help the child feel better. I think that parents actually think that lowering a fever is going to speed recovery and you undermine that in your book you I think first all it does make the child feel better I or us. Feel better I mean when you either symptoms associated with fever like headache muscle pain or chill. So you do feel better I. Think you wrongly equate the notion that feeling better means that you are better your underlying diseases better but that's not true. We now our study after study after study showing that that when you treat fever, which is an important part of your response and adapted part of your immune response, the you actually prolong or. Worse, this this has been shown again and again, and again me, why do we make fever? Why is it that everything that walks crawls swims or flies when the surface of the planet makes fever and the answer is your immune response works better in a high temperature. You know the B. Cells to make antibodies do that more efficiently the neutrophils which comprise plus traveled areas infection until bacteria better, and so you know I go through the data showing that's true but we just can't help ourselves. You know we we don't like to have fever. We'd like to suffer eager and and so we wanted to make it better it really in the end doesn't make us better at all. Well, and it's not just us. I mean, it's not unusual for health professionals to recommend maybe acetaminophen maybe ibuprofen. When either the child or the adult has a fever? Why do you think your colleagues continue to do that? Like people to feel better and I think that's part of it in it's been ingrained in this frankly since the invention of aspirin in the late eighteen hundreds I think now is you're starting seeing the last say twenty or thirty years the emergence of data clearly shelling the the treating fever prolonged worsens illnesses you're starting to see advisory committees. Now saying you know don't be so fast to treat fever. Why don't we wait maybe only treated a certain level although frankly others no level above which you you you really need to treat fever. Had the person doesn't have chronic heart disease or chronic lung disease were that kind of metabolic kit of fever because you have an increase, your basal metabolic rate about twelve percent for every degree centigrade that they you feel that they can't take that kind of hit that make sense. Otherwise you're fevers don't hurt people think that you know that fries your brain that's not true. I mean that's heat stroke, which is an environmental fever not a physiological fever. So I just think it's ingrained us. We do like to feel better ourselves who played packers. anti medicines for their. You even describe in your book model. Not just malaria therapy, but he therapy as a treatment can you very briefly give us that historical perspective right? We used to put people in fever cabs before there were antibiotics to treat their syphilis to treat their gonorrhea and it worked and then were arguably outlandishly because again in your in the pre antibiotic era we would inject people with malaria parasites in the in the early nineteen hundreds really up until the mid nineteen hundred, they were injected with the malaria parasites because malaria would induce fever and the know we had anti malarial drugs like quinine that had been available since the mid eighteen hundreds. So could you know they? Even her couple of days, and then you treat compact. There was a Nobel Prize awarded in thousand, nine, hundred seven for malaria therapy for the treatment of syphilis. Well, nowadays, of course, we treat syphilis gonorrhea with antibiotics and that's completely appropriate, but I do want to ask you about more common treatments of an diseases with antibiotics. You've suggested that the rule that has been a lay down that you must finish every last fill in your antibiotics course. Is My true. So what's the evidence for that? Right and the important thing is it really doesn't matter what I say. The only thing that matters again is with those studies show an and the think about it from an in medicine. If you have pain, you're given pain medicine still the pain's gone in medicine if you have asthma on your give bronco violators, which opens up all. Breathing tubes until your asthma's gone why is it that we set a predetermined length of illness for antibiotics if for example, you have a kidney infection and you have you have back pain and your white blood cells in your urine and you have bacteria your urine, and then you treat somebody with antibiotics and in two or three days the back pain is gone the fever's gone the bacteria. Were gone from the urine the white cells your why do we continue to treat I mean and the answer is wrong. One is that we need to continue treat to finish off the quote unquote antibiotic course so that we don't create resistant bacteria, which is a bacteria that are resistant to antibiotics. That's not true. The opposite is true. Not surprisingly the longer you treat the more likely. Water create resistance we know that now and so now people are using shorter and shorter courses antibiotics or kidney infections aren't being treated for ten to fourteen days. Now he's find you can treat them for seven days five days, three days, and advisory committees are now catching up to those studies were they are recommending much shorter courses for appendicitis for Sinusitis for bladder, infections kidney infections skin infections. But it's been slow food for the medical community get up to that. Well I want to specifically go to your field of pediatrics and ask you about antibiotics for. Ear Infections. That used to be something that a kid who had an ear infection would automatically get an antibiotic and yes, you had to finish the entire course finish that bottle of pink that you kept in your refrigerator. That's no longer the case. Tell us why was right for children who can tell you whether or not their ear hurts like for example, children over two years of age you just need to treat till they're better and often that's only a few days and then you can stop that antibiotic. So you know there's no reason to set a predetermined length I mean, why do we pick seven days? Why do we? Pick fourteen days we do do we think bacteria reproduce themselves on the basis of the lunar month or what are we pick ten days when we think back to themselves on the base of the metric sits now treat the patient I mean this really is a perfect example of personalized medicine. There was a study done in Spain which was great. They took people who admitted to the intensive care unit with serious back through. And what they did with one group as treated him for two days in which they didn't have favorites treat patient no longer has Steve for today's they stop which ended up being about five days of therapy and or they they treated for ten to fourteen days. There was no difference in outcome. So again, treat all the patients better now you have symptoms because of your. Immune response you have symptoms in the case of bacterial pneumonia because white blood cells go to your long and try and kill the bacteria when your symptoms abate meaning you know home have fever it's easier to in the case of pneumonia. Your Immune System is saying we've won we've killed the bacteria were good. So why do we keep treating? There was just no good Reza. Dr Off. It Americans take an enormous number of medications. How did we get here? What we believe in magic pill? We think that there's just this magic medicines out there for anything that ails us and I'm certainly the pharmaceutical companies appeal to that through a barrage of advertising and it's really hard I. think for you know for good scientific studies to break through that barrage of advertising the data for example, who takes something like like vitamin E., which which many people take it megadose levels. The data could not be clear vitamin E. increases your risk of prostate cancer. The reason is it's an antioxidant. You can actually shift the balance in your body home to too far. Away from oxidation and and you know you need oxidation to do things like cancer cells or clean out clogged arteries, and so there are five excellent study showing that that's true. We're this regulated industry I think vitamin E. megadose vitamin E would have a black box warning on it. It says this product increases your risk for prostate cancer. When those ladies came out, it was a big headline in the Wall Street Journal saying it was this end of popping vitamins. But again, you have an industry which is a multi multibillion dollar industry that that is just you know the scientific studies that show that the industry is many ways flawed has no chance against that that. Roger Advertising. Gutter off at you talk in your book about heart stints and how they don't prolong live. She talked about surgery for knee arthritis being unnecessary. You talk about a number of things that it's very hard. To, move this ocean liner that is modern medicine, and you also talk about choosing wisely you talk about ignorance you talk about fee for service and and how we got in this pickle how do you see changing? And adopting some of the latest and most. Solid. Scientific evidence when it comes to medications or procedures. I just imagined that that everybody in the world will read this book and say boy thanks. I never thought it that way in the entire face of medicine will change. Your if it doesn't work out that way there's a price to pay for these things I mean I I do think that there is is a feeling among the population that the magic medicines may be don't do everything that they hope they do and that it's you can have a good exercise program, for example, Diet Program and that that you know that you don't really need that knee replacement which has side effects. I mean not some of which your severe. Not The least of which is undergoing general anesthesia that if you can avoid those things in a more natural way Z. logical way that if people are drawn to that so I think. You're starting to see some transfer deathly starting to see some change with art van Botox. You're definitely starting to see some transfer. The Gordon Harshness Cleveland Clinic now doesn't essentially the head of the cardiology route there doesn't do heart stance because you know as long as you do other things like control retention, high blood, pressure control, Bay, cholesterol, do it put people on good exercise programs? There's no difference in someone who gets art sentence someone who doesn't, but it's hard. You know again you're leaning up into an industry they're you're asking you know or And that whole profession, it makes a living this not to make a living off this anymore and it's it's hard to convince people to do that I I would say all as my book it really vote the most anger from physicians. It was the Hart Senate, Chapter? And from people who said, look at art sent a much better. But that's why you do controlled studies in remarkably controlled studies have been done for heart sense where people either got a heart center didn't get heart center. They didn't know whether they got an opposite went through the procedure right up to the point of actually leaving the stent there which was remarkable that actually got got. Institutional Review Board approval for that kind of study. But again, the data are the data. You know it's little again, it doesn't matter what cardiologists say. The only matters is what those studies show in the studies now are very clear on this. offit what would you like our listeners take away? From your exceptional book overkill. So, they can protect themselves from either ineffective or unnecessary treatments. I. Think that that medicine evolves slowly and even when there are clear data showing that something is or isn't a value on, it takes a while for people to change their behaviors physicians also on they they WANNA, believe they're helping people they believe they've done something the same way for ten or fifteen or twenty or thirty years, and they're they're less quick to change. So I think what the purpose of this book is to empower you not to be your own doctor but to just be a better advocate for your own house, you can have more information when you see the physician so that you could be the best advocates for your home. Dr Paul Off. Thank you so much for talking with us on the People's pharmacy today. You've been listening to Dr Paul off it director of the Vaccine Education Center at the Children's Hospital of Philadelphia. He's also the Maurice Hillman professor of vaccine -nology and professor of pediatrics at the Perlman School of Medicine at the University of Pennsylvania. Doctor. has written several books. We've been discussing his most recent one overkill when modern medicine goes too far Lynch Seagal produced today's show our Dr Ski engineered Dave Grade At. It's our interviews B. J. Liederman composed our theme music to People's Pharmacy is produced at the studios of North Carolina Public Radio W. UNC. The People's pharmacy is brought to you in part by Verizon, an analytical laboratory providing home health tests for hormones, gut health, and the microbiome online at V.. E. R. I. Essay N., Dot Com, and by cocoa via offering plant-based nutrients in the form of coq AU flavonoids for brain and heart health. Line at via dot com to buy a CD of today's show or any other people's pharmacy episode, you can call eight, hundred, seven, three, two, two, three, three, four, today show one, thousand, two, hundred, twenty, five, that number eight, hundred, seventy, three to twenty, three, thirty, four on the web a- People's pharmacy dot com. When you visit the website, you can share your thoughts about today's show. You'll also find a link to the. Publication Science advances with Dr Westmin- study, you can subscribe to the podcast through apple podcasts, stitcher Google or your favorite podcast provider. It's posted on our website every Monday morning at our website, you can sign up for our free online newsletter to get the latest news about Kobe nineteen and other important health stories in Durham North Carolina I'm Joe Graydon and I'm Terry Graydon. Thank you for listening. Please join us again next week. Thank you for listening to the People's pharmacy podcast. It's an honor and a pleasure to bring you our award winning program weekend and week out. But producing and distributing. This show is a free podcast takes time and costs money. If you like what we do and you'd like to help us continue to produce high quality independent healthcare journalism please consider chipping in all you have to do is go to people's pharmacy dot com slash donate whether it's just one time or a monthly donation. You can be part of the team that makes this show possible. Thank you for your continued loyalty and support we couldn't make our show without you.
Coronavirus news, updates, hotspots and information for 06-16-2020 COVID-19 AM Alert
"Google this is corona virus for one one, the latest COVID, Nineteen Info and new hotspots, just the fax for Tuesday June sixteen twenty two t for the fourth day in a row Texas reported a record number of hospitalizations corona virus with two, thousand, two, hundred, Eighty, seven, there are ninety, one, thousand, seven, hundred, twenty seven confirmed cases in the state with two thousand eighteen jets. Texas has reported over one thousand cases a day for the last eight days. The highest was twenty five hundred on June, tenth the. The majority of cases are in and around Houston and Dallas Houston officials have cautioned that if numbers continue to rise, the city may have to shut down once again on May Twentieth The Washington Post ran an article noting that Dallas Houston Alabama and parts of Florida could see a second wave over the next month due to rapid reopening, the model cited was by policy lab at Children's Hospital of Philadelphia nearly one month later, Texas Florida and Alabama have some of the steepest increases in the US the. The FDA pulled its emergency authorization for chloroquine and hydroxy chloroquine as a treatment for covid nineteen, a CDC report notes that cove nineteen patients with underlying health conditions like heart, disease and diabetes were twelve times more likely to die due to the virus, airlines in the US will strictly enforce a mask on board. Those who refuse could be banned the US Open tennis tournament related. They hope to stay on schedule. Opening August thirty first in New, York there will be no spectators. The World Health Organization noted. Noted that. There have been more than one hundred thousand confirmed cases of Covid nineteen reported each day for the last two weeks when the pandemic began, it took nearly two months to reach the one hundred thousand mark after three weeks with no new cases New Zealand has reported to the cases were from two women who recently entered the country from the UK to visit a dying relative. Greece will reopen to international tourists on Monday the locations of hot spots and US and country diagnoses in a moment. Hotspots displaying faster rates of growth as of June fifteenth, according to The New York. Times Hawaii Lee, county, Arkansas Greensville County, Virginia Nevada County Arkansas Dickinson County, Iowa Trusdale County Tennessee Troup County, Georgia Lagrange County Indiana Green and Monroe County. Alabama Lincoln County Oregon Clay County. South, Dakota Clay County Iowa, sugarcoat County Arkansas Warren County North Carolina globally Iraq Israel North Macedonia. Bulgaria Kosovo Jordan as what teeny Liberia, the Neen and Suriname. There have been two million, one, hundred, fourteen, thousand twenty six confirmed. Cases of covid nineteen in the United States and one hundred sixteen. Sixteen, thousand, one hundred twenty seven deaths, there were nineteen, thousand sixty seven new cases reported yesterday, the ten states with the highest case council New York, three, hundred, eight, thousand, seven, hundred, nineteen, new, Jersey one, hundred, sixty, seven, thousand, one, hundred, three, California one, hundred, fifty, five, thousand, six, hundred, thirty six, Ellen Annoy one, hundred, thirty, four, thousand, two, hundred, forty, seven, Massachusetts, one, hundred, five, thousand, six, hundred, Ninety, Texas, Ninety, one, thousand, seven, hundred, twenty, seven, Pennsylvania, eighty, three, thousand, six, hundred, Eighty, seven, Florida, Seventy, seven, thousand, three, hundred, eighteen, Michigan Sixty six. Six thousand, three, hundred to Maryland Sixty, two, thousand, six, hundred, fifty, three, the five countries with the largest daily increases for June fifteenth, according to the WHO Brazil twenty, one, thousand, seven, hundred, four India, eleven, thousand, five, hundred to Russia eight, thousand, two, hundred, forty, six, Chile, six, thousand, nine, hundred, thirty, eight, Pakistan, five, thousand, two, hundred, Forty, eight, the ten countries with the highest overall case, counts Brazil, eight, hundred, Eighty, eight, thousand, two, hundred, seventy, one Russia. Five, hundred, forty, four, thousand, seven, hundred, twenty, five, India, three, hundred, forty, three, thousand, ninety one. One united, Kingdom, two, hundred, Ninety, eight, thousand, three, hundred, fifteen, Spain, two, hundred, forty, four, thousand, one, hundred, nine, Italy, two, hundred, thirty, seven, thousand, two, hundred, ninety, Peru, two, hundred, thirty, two, thousand, nine, hundred, ninety to France, one, hundred, ninety, four, thousand, three, hundred, five, Iran, one, hundred, ninety, two, thousand, four, hundred, thirty, nine, Germany, one, hundred, Eighty, eight, thousand, two, hundred, thirteen, for the latest updates subscribe for free to corona virus, four one one on your podcast APP, or ask Your Smart Speaker to play the corona virus four one one podcast found. That brands.
905 Ben Case: Successful Fundraising Through Mastering Relationships
"Here's what you can look forward to on this episode of the nice guys on business highly successful fundraising, especially major gift fundraising. You know, the high end fundraising that I specialize in really is about relationships. But there's some things that you have to do to get to that successful excellent relationship. And if you're not doing those things, then it's not gonna happen. You look down. They know you're lying and up. They know you don't know the truth. Don't you seven words when four will do don't shift your weight, look, always at your Mark. But don't stare be specific. But not memorable be funny. But don't make him laugh. He's got to like you. Then forget, you the moment you've left his side, and for God's sakes. Whatever you do don't under any circumstances. Listen to the nice guys on business. Need an education on how to grow your business? The nice guys are here to help. Learn about great customer service networking, and how just being nice can help you prosper now here all your host, Doug Sandler and Strickland. Bonner Benjamin our case is a professional fundraising consultant now, listen up nice guy community, if you don't know what that is you're in the right place because I didn't either before I was introduced Benjamin through a friend of mine through bestseller publishing. He served in the nonprofit sector for forty one years in personally been involved in successful solicitation of over one point one billion dollars in gifts. That's pretty cool and worked for and been engaged by organizations that are raised over four point eight billion dollars themselves as fundraising experience includes working with the Metropolitan Opera in New York Duke University children's hospital, Philadelphia and others right now. He's a CEO of focused on fundraising Inc. A company that provides consulting services and online training for fundraising, and nonprofit management. Okay. It sounds like a mouthful, but I'm telling. A year and a good spot. He's going to relate the information and the business that he is built to the businesses that you guys are building. Now today as well case recently launched in and online learning twelve series webinar called the daily dozen habits of highly successful fundraisers. He also shares his professional experiences in Twenty-one tips for highly successful fundraisers as well and international bestseller in nine business categories in six countries ban. Welcome to the nice guys on business podcast wonderful to be here. Thank you talk. I am. I am happy to have you here. And you know, nice guy community. You know, how technology goes with me as you've heard me in Strickland talk many times on the on the Tuesday and Thursday episode technology, normally as my friend today Benjamin was very very kind to me. I was a little bit late. I was at working on improving. My is by getting a second thirty two inch monitor cups from my to my to my current system. So Benjamin thank you for your. Thank you for your patience as I work this through, and and I think you're young guy. Right. You're like what eight you're in your thirties. Forties. Where are you at ninety seven? Years old. Pretty good. We're ninety seven year old. I'm ninety seven ninety seven all my life. My my mom's eighty five and she might be looking for a guy. I don't know if that would be okay. We don't have to go there. I wasn't. I'm happily married for forty plus years. So my gosh. Goodness gracious. Okay. So she's used to you being in the nonprofit sector. So tell me that there is actually business in a four profit person that comes out of the nonprofit sector, many of my community members might be coming out of the nonprofit thinking how do I ever do this on my own? So why don't you share a little bit about how you got started. And how you've turned this into a thriving business really right out of college. Well, my major in business was college. I'm sorry. My major in college was business. And really the first thing that I did was going to a big fortune five hundred company and did sales with them for two years and really found myself in the not for profit world raising money I had the opportunity to either go into admissions for my alma mater or go into fundraising from myemma modern four thousand dollars. A year more I went into fundraising over at missions. And that was the right decision. I made forty plus years ago. So it's a great thing. And and really what you know in fundraising when you're successful in it you deal with a lot of business leaders billionaires. I mean, you name them. I've I've visited with them. And you learn a lot about business Byd just being out there in dealing with these folks. And then of course, you mentioned I worked at Duke University. I worked at the school of business. So for seven years, I was involved very directly in a business and business education at the future school there Duke University. So I took all of that and rolled it into starting my own business twelve thirteen fourteen years ago in fortunately, we've been very very very successful. What's really cool about what you say. And and I I think you hit it right on the head is that when you're a guy, especially new just getting into the into the business world or into your business or or actually working for another company at the time and. And you start meeting with all of these people that are, you know, really so far down the road from you. And I look at this. This idea of getting into the podcasting space when I got involved, it was like all of the people, and I've done we've done almost nine hundred interviews and six hundred plus of those have been arm. Sorry, nine hundred episode six hundred plus have been interviews, and it is amazing free coaching have gotten through the years. And I would assume it was the same way when you started really working with a big organizations in these guys that were, you know, worth billions of dollars or are hundreds of millions of dollars just giving you advice. Oh, it's like you'd hang on their every word. I'm sure exactly right. And in fact, the next book that I'm doing I'm intentionally including lessons from the most successful business people that I've dealt with and that I've worked with because I I really don't wanna start name dropping, but the lessons that I learned from these folks being one on one with them really really really helped me shape. My work my career in the success that I've enjoyed now. I. It it has. I bet it has. So tell me a little bit about I want to answer the question as I would because they don't want to taint the answer for you. Because I think you already have the answers you you probably have been asked these questions a bunch of times. But I'm really curious about it. And I'll let me give you the answer that I would give first. And then I'd love you to chime in mine will be one one word answer. So what does it take to become a highly successful fundraiser? And I would say if there was one word that I would bring it down to I would say relationships now, I don't know if that is anywhere near the right answer. But what would you say, absolutely right highly successful fundraising, especially major gift fundraising. You know, the high end fundraising that I specialize in really is about relationships. But there's some things that you have to do to get to that successful excellent relationship. And if you're not doing those things, then it's not gonna happen. So yeah. To get to relationships you really have to start with some elements in some really important things that that you have to do. And we include these I. Interviewed many many many fundraisers business leaders and did questionnaires and did all kinds of surveys to understand. What are the habits of highly successful fundraisers? What really does it take to become a highly successful fundraiser, and I really focused on habits as opposed to characteristics or qualities or anything like that. Because I've seen in business as well as in fundraising, so many people who succeed that have all kinds of different characteristics. So what are the habits that they really have to have to do we developed the daily dozen out of that? And it starts with integrity. And I know that that's an important word you because I've seen it in you. And I've seen it, you know, in everything about your organization at your program, your podcast that you have your really starts with integrity. And if you and you've seen this the people in our world in politics and business that haven't integrity failure down the tubes that go fast in integrity is not something that we can do some of the time. Has to be all of the time. It has to be a habit that we have twenty four seven three hundred sixty five all the time in really emphasized that with all the folks that I work with with all the nonprofits with all the fundraisers that I work with it all starts with integrity. Then from there. I believe you absolutely have to have high issue. You have to have high emotional intelligence you've seen that in the business world. We see it everywhere. People with high Q are far more likely to succeed there know that they know themselves they're comfortable with themselves out of that they're able to build trust. What's more important business than building trust? If you can't trust the people that you're working with you've definitely got a problem all of that trust comes out of I think communicating accurately being able to paint a good vision really highly successful fundraisers than I think clearly highly successful entrepreneurs highly successful business people are able to communicate accurately, and that's really important. They use the right words for the right situa-. Nation the right people that they're dealing with the communicate accurately and to do that they have to listen. Well, I have a whole presentation due on listening. Well, how many people, you know, would raise their hand. If you were to ask a question about what's important. You know, is is listening as important talking. I think everyone would raise their hand and said, yes. And then you ask them the question. How many of you have taken a course on listening? Nobody raises their hand. It's so that's right. And we've got two years. We've got one mouth we need to make sure we use them proportionately. That's what I teach. And I teach it's really important to listen well to be able to communicate accurately, and then out of that we get to the word that you and I talked about earlier, which is excellent relationships building. Excellent relationships you build that on integrity you build on high e to trust communicating accurately listening. Well, and all of those things helped you to built excellent relationships. Now, the difference between a highly successful fundraiser, and a professional visitor this point, which is they have to be able to ask for the gift your people that are in business. They have to be able to ask for the order if there are not preneurs, and they want to raise the money. They have to be able to ask the person across the table to invest in their business. They have to be able to make the ask. And that's the difference between someone who's a professional visitor and someone who's a professional fund. As they have to be able to ask for the order. And they always I I really teach people that you always have to be ready to ask the number of times as a fundraiser. And as a business person where I wasn't ready to ask. And I've seen this people that I work with. You know, the opportunity comes the person's ready to buy and for whatever reason they're not ready to ask for the gift. And then whom it doesn't happen, right? They waste the opportunity. So not only do you have to be willing to ask the gift. You have to be ready to ask at all times. You gotta be able to discern. When is right to ask. When is not ready to ask you got to be able to do that. But either way you have to be ready to ask those of the things that I really boiled down when I say what's take to be a successful fundraiser. And I think every one of those things applies to be in a successful business person. Entrepreneur salesperson, whatever it is. You're doing I think every single one of those applies. Yeah. Amen to that. I I would say one hundred percent as you are going down the list communication relationships. Integrity, listening skills. I mean, every one of those is can apply to to to the business world nonprofit for profit doesn't matter big business small business and it works with relationships too. It's not just in the in the in the world of of. Selling or if you're selling your ideas? I mean, you are always selling and building relationships with the people in your organization. So I would I would say one hundred percent, I agree with you. Tell me a little bit about how you deal with somebody that that comes or, you know, let's say a customer or a donor that is that is unhappy because although we wanna make sure that we, you know, have integrity, and we and we share with them our feelings of gratitude and build a good relationship can listen and have great relationships with them. The the issue is that sometimes the matter what you do you're going to have somebody that's on happy. Now, when you have somebody giving you money for the, you know, and they're not really expecting anything in return except service. Right. I mean, or or am I am I off as here? I think donors are expecting to see and feel impact for their gift. They're expecting to be paid attention to to feel good about what it is. They're doing. And I think the same thing is true with your customers. They want to know that what they're buying is going to have an impact that it's going to be positive situations going to be positive experience for them. So, you know, turning an unhappy customer or unhappy donor into a happy customer. Happy donor. I believe you have to go through the same kind of process. Either way. I I agree with you. And I think that that is it's relevant. No matter again, prop for profit nonprofit. Can you share maybe an action item something that somebody could do, you know, even today that would help them kind of grow their business to the next level? Whether it's through bettering their relationships, or or listening more effectively is there something that we I mean, those that are in my community they love when they're able to take action on the advice that somebody in our audience is or. In our guest. Jerry's is sharing. So is there something that you could share a best practice? Absolutely. I was on coaching fundraiser the other day, and I was talking with him about what it is that he needs to be doing to continue to improve his work and his business. You know, he's using the nonprofit world and really what it was. And this is what I would be telling everybody is make the list start with the list of what it is. You think needs to happen to successfully improve your business to make it grow. There may be one item two items three items five items. I certainly wouldn't have a list of ten or fifteen. Thanks. I have to do because you really need to be able to focus down on. What it is you want to improve make that list and then get to work on it figure out. What's the next step? What's the first priority in there? What's the thing? That is most important for me to successfully built my business or grow a business. Whatever it is. I'm trying to do what's the most important priority item in there? And then what's the next step to move forward on improving that? So what's the first? Priority. I'm gonna work on in which the next step that I'm going to do to get going on that. And then get going on take action move forward. And I just think that that's really really important make the list prioritize identify. What's I out of what's I figure out what your next step on that? And then get working on it. And those are things that again, I teach people in the not for profit world, it absolutely applauses the for profit world. What's the most important thing you need to do to improve your business strengthens grow? It. Let's identify that. And let's get working on that today right now. So ban wrote a book called Twenty-one tips for highly successful fundraisers. It was a bestseller is the bestseller over on Amazon echo. And encourage you to to pick up a copy is that it focused focused on fundraising dot com is at the best five for them to reach that focused on fundraising dot com. It's FOC US E D focused on fundraising dot com. Our website that can order the book consign up for our weekly tip that we do that can get notices on everything that we have going on the webinars and everything else that we're teaching. And like I said, I really do believe everything that we do applies. Whether you're a business person entrepreneur or in the not for profit world is I am. So Ben take off your your fundraising hat for just a second and put on the hat of a guy that owns and runs a business and talk to me about the motivation behind the book, because I know there's a lot of people in our community, you know, and you probably know this from being a guy that's written a book that has been successful on Amazon and probably other channels as well, you're not getting rich from the book. It's it. What is it that was that motivated you to get behind the idea of writing a book and marketing a book, really, what motivates me is helping people? That's really what my life is about. It's why I'm in the not for profit world as opposed to the for profit world, but helping people I think can apply whether you're in the not for profit or the for profit world. It's what you know, really. Is all about my work. And what I'm doing is. I'm trying to help people. I'm very expensive, which is a good thing. Yeah. Absolutely. It's a great thing unless you got your family. That's exactly right. I'm very expensive. Very expensive. You know, some people came to me, and they're always coming to me and ask it for help. And they can't pay for what it is. You do. So that's why we launched the webinars is so that we could provide information useful information applicable information to people so that they could go to go to work using this good information on fundraising or business or whatever at a much lower price point. And then of course, the book allows you to do that at a much lower price point to. So to me the book everything that I do is about helping people. So whether it's the book, the webinar or the consulting that I do it's all about helping folks. And that's really what motivates everything that. I do. Oh, yeah. I completely agree with that. So if you if you didn't go into the into the fundraising world when you first got out of college. What do you think that you would you know, what would you do? What would you go into? I would I would be in sales. I mean, there's so many crossovers between sales and marketing and what you do in as a fundraiser. I probably would've. Grown to be a VP for marketing, a probably would have gone into opening my own business as I ended up doing any way, you know, with focused on fundraising. And and that's where I probably would have been always thought I was going to own a restaurant. One of my first jobs was as a bus boy for Marriott. Hot shoppes in in Washington DC, where I grew up, and I always thought it was going to own a restaurant, and I had all kinds of different restaurant ideas. But when it came down to it, I decided that you better open a business with something that, you know, something about him. What I knew knew most about was the not for profit world. And that's why opened the business, you know, that that deals would not profits. But that's that's awesome. That's what a great story as a matter of fact, a hot shop juniors. I I grew up in Baltimore. So thank crop to too far away. You're in North Carolina now, right or you somewhere else. Nowhere in North Carolina and really like North Carolina. Great place to be. Yeah. I just moved to Los Angeles about a year ago and lived in the DC area for about six years spent a lot of time down. Town a lot of time. So so you you grew up in the same very similar environment that I grew up in. So how long were you in DC for born and raised in the district till I went away to college North Carolina. And then we lived there for thirteen fourteen years, you know, when I was working up there over the last thirteen fourteen years, we moved to North Carolina about a year ago two. So I've seen DC before there was a beltway, and I've seen DC with beltway and everything else that goes on. It's a it's a vibrant town. I really really like a Washington as a place to live and to do business. I thought it was very good place to do business for me dre manageable. Certainly the traffic's a bit of a problem but liked Washington compared to L A. I'm okay. I mean LA is LA is kinda staff. I think that that Washington DC traffic is kind of how you know. It's very very modest compared to the L A has traffic spread out everywhere. DC at least you know to avoid that four ninety five around our round the rush hour time. That's exactly right when I had appointments in the district. And I think this is important for your listeners to that started at nine AM. I would go in at six AM to avoid rush hour. Just because you wanna use your time will. Yeah, that's really important for business owners to make sure that you're maximizing use your time. I'd go in. I'd find a restaurant Starbucks somewhere to sit through my work right near my wherever my point was Bouma. I'd be there at nine o'clock. I was never late. I was always one time. And I was using my time really wisely which as a business owner absolutely critical to do. Agreed agreed will bend. Thank you sharing for sharing. All your information again nice guy community if you head over to his his his website, which is focused on fundraising dot com. We'll make sure we put a Lincoln the show that you'll have access to his book either throw a site or through Amazon as well. Aband-? Thanks again for being on the show, and Sharon all year, your insider tips on out on highly successful fundraising, but a highly successful a capability for running a business it self a for profit business tubes it so thanks for being here on the show. Great to be home. Thanks, doug. Nice guy community. Never underestimate the power of nice again special. Thanks to Benjamin case for being on the show. All of his information will be right there in the show notes. Steve o'brien. Go ahead and take us out of here. The nice guys want to hear from you. Call forty two forty two DJ. Doug and ask any questions you like well except about the cloud. Nobody understands the cloud. Don't bring up Santa Claus. Either. Doug, still a believer?
Episode 17: Overcoming Immunotherapy Resistance
"This is novel targets brings in life. The science around innovative new trucks, gene itself for pres. Welcome back to season free. I'm Peter put one of the hottest topics around at the moment is why do you mean a for a piece work in some people? But not in others. Why do they stop working at? If we want to obtain long, durable responses, then we have to understand this resistance. If you get immunotherapy, and you have no immune response. You're basically getting no therapy. You just getting an inert antibody doing nothing. If you have no immune response, you have up front resistance that needs to be overcome tumors are devious nation to being smart and can use various different ways to become resistant. Before we start on our journey. Let's go up on a trout and down of immunotherapy landscape. There are more than eight hundred immunotherapy combination trials underway. Will they provide the answers? We're looking for probably not don't go to mills from MD Anderson. Cancer center offers his perspective. I don't want to take away from the incredible sight. This is really neat. But it's time for some rigor. And you know, we're doing trials, and I sit there, and I say there is no reason to do this trial. There's no mechanistic reason the logical reason and no ability to interrogate the results to explain whether it did or didn't work. And that's what worries me I won't tell you where but I sat in an advisory board. And we actually had visors said, look, it's absolutely clear you were doing this trial. It's absolutely clear. We do not support you doing this trial. There is no reason that you have given us it says, you should do this trial. But at least get samples and interrogate them in depth to ask what did and didn't happen. And that was not on the agenda. It just an. Option of let's throw them in. It has to do with the fact that this is an incredible market. And that every patient has been convinced that if we just tweak their immune system there cancer's going to disappear and they want the agents and the logic behind. It is not there are companies who are rigorous Mechlin co trials, but others in a rush to clinic have simply just from two agents together. There are two pieces of advice that I give to all companies the instant that you have declared a drug candidate that you were going to the clinic with the first thing, you do is you Termine the mechanisms of resistance. I don't care about sensitivity resistance because that is going to tell you what combinations to us. What we see? From our cloud is the eight hundred combination trials unlike a patchwork of fields with different crops, but it's too early to say which will make it to market some most seat of. Will fail will be left to rot him a field. Don't to Jason Lucas a melanoma specialist and runs can set Meena for trials of university of Chicago mostly combinations. That I see right now, I think are likely to further help people they're already helping unfortunately, I think a lot of the combos are going after the same population of patients who are mildly tesol inflamed. And then it's really just gonna be a race for indications about which one is a little better than the other one. But broadly speaking, I think we need to think more about the people who don't currently benefit at all. And how we could bring them into the fold of immunotherapy benefits, and we can't lump over eight hundred or more trials together. There's a very different phenomenon between taking a twenty percent tumor shrinkage up to eighty percent tumor shrinkage in an individual patient and taking the twenty percent response rate population in increasing that to an eighty percent response rate population, probably the mechanisms that we're gonna need to go about those two approaches are completely different an anti PD one PD L one checkpoint inhibitor isn't going to work if the warriors of immune SIS. The CD eight positive T-cells are present the simply nothing for the chip point to release the brake on. We need a combination strategy, but Leisa fire of immune system and in the process, tons of cold non inflamed Chuma into a hot one. Don't James Kelly is chief of genital urinary malignancies brench and two retro of medical oncology service at the national concert is shoot. If you have a campfire, and you have the checkpoint being the acceleration. You can then really cause that to go gangbusters. But if you have would just sitting there with no campfire you throw the seller. Not nothing's gonna happen. He has some citing data on a novel combination strategy, but could make immunotherapy people can prostate cancer more from delta Kelly later. A different scenario is what T-cells all present. But that being suppressed immune system over to no longer functional one way to have come this to talk it immunosuppression within the tumor micro environment. Don't Alicia breast cancer specialist of Johns Hopkins University school of medicine, I think of Dennison signaling as being like a wet blanket over the immune system. So really wanna kick that off? So that the immune system can really wake up and become active and kill that tumor through a multiple ways to do this more from delta eminence later, what we're learning is that this trusted she to overcome resistance will depend on what's dynamically happening immune system of each person house will hear from Dench in. And I remember later we all have different immune set point, which means even for a piece set to become the ultimate personalized medicine. Before we start on journey. We need to talk about terminology to make sure we're all on the same page. I've been using term resistance, but it's the best way to describe this lack of response. I don't think tumors generally become resistant to them Yoon system, but they can escape from particular immune based therapies, but that doesn't mean those immunotherapy aren't still important. You just may need to adds something to the treatment that still Daniel Chan from genetic. So is it resistance or immune? Don't look again. I think at this point with the field. We don't have enough of a fundamental understanding to say what we should call it. I mean, we call it. The drugs are working resistance is something that we described when a patient's getting drug and then it stops working. We call that resistance that seems pretty fair to me now on a micro level are the immune cells still there in which case that might be resistance because they're still present. But they're not functional where? As another form of resistance might be that the immune cells are gone from the tumor that might be immune exclusion. But I'm not sure that any of them really inform. Our understanding to a great degree so far because an individual patient who has developed progression on a PD one antibody, we're really knocking to be able to say what the mechanism is, you know, right now, we're not very good at that. We need to be clear when we talk about respond to consider for P. We're talking about an objective clinical response, a partial or a complete response that less for time patients predominantly who respond to PD one are those patients whose immune system has already mounted a response to the tumor at baseline, and adding the PD one really just takes away those last breaks, which is in the tumor, micro environment and allows those t cells to be functional and kill the tumor, which means that a number sponsor is someone whose immune system has not mounted an active anti-cancer response. So how do we turn a number sponsor into a responder? This is the heart of what it's going to take to. The benefits of immunotherapy to more people. Don't you least to novel targets under recent annual meeting? We have very early, but very interesting story emerging another way perhaps to generate immune infiltrates, our immune activity within a T cell poor tumor. What we did was we took a group of patients with prostate cancer. We said, okay, we'll we wanna look at what's going on with these patients, and we want to treat them on the study that we had open of Perkin hitter and development. So this is a lap ribbon development. And the idea here was could we see any type of immune responses turns out that park inhibitors work, really, well and prostate cancer if you have DNA damage response pathway mutation of the initial ten patients we enrolled there were three patients that were bracket too. But none of the rest of the patients had any mutations in DNA damage response. Pathways. We gave them or Lapper and develop and what we found was that a large proportion of patients actually had nice clinical responses substantial declines in PSA, and this were associated with tumors that were shrinking and we had objective responses seeing and this has been long lived. So it looks like a crew immune type phenomenon. So he might say well what's going on? It's not a park affect because the majority of the patients didn't have damages and DNA response pathway, and it doesn't appear to be primarily just a development affect because you wouldn't expect that high proportion of patients having a response. So turns out that the park inhibitor can cause double stranded DNA breaks, and what could happen then as you could have this leakage of DNA into the site of plaza in which is very potent stimulator of the sting pathway, and then you could get gammy interfere in production in all the genes that are associated with gamma interferon that could cause activision of an immune response to bring in dendritic cells macrophages could allow T-cells cells to work better up regulate MAC and one of the things with prostate cancer. Sometimes MAC is down regulated. So this could really all of a sudden shine the spotlight on the tumor and allow those teeth goes to work and the development coming in locking the PD L one expression, which will be up regulated by the interferon. Well, allow this to work better. Hit on something. That has some very interesting signals there. We're in rolling prickly. Another fifteen patients where we're getting biopsies before. And after so we can further study this. So stay tuned on that I'm really excited about that one. And if we can take something that's pretty well tolerated. By the way, these were impatience with pretty advanced disease. Most of them had prior chemotherapy. So this may be a way to bring in immunotherapy into prostate cancer. I hope we'll have more data within the next six to eight months. Wow. Giving pop inhibitor generated double strand DNA break that then triggers the sting dangerous signal. Immune system of the shouldn't be happening. Could this be a major breakthrough in prostate cancer? It's too early to tell but you can hit gullies evidence. I haven't. Moment. The sting pathway is attracting a lot of interest. We hood Thome guy s g took about sting agonists bucking to loop. Don't loot up the story. We think some of the most exciting next generation immune drug targets are in Nate immune activators because this idea that you need to continue to stimulate your active, immunity, the only can do so through a Nate immune activation. People have probably heard of sting agonise and toll like receptors. I think this will really come into play in the near future to prime antigen presentation to drive those t cells and get them out to the tumor who should get the sting Atkinson. No should everybody. Get one to give. Everybody's immune system of boost. Is that the idea? Well, we would argue currently that we could differentiate this better if we did a more in depth biomarker analysis of each patient coming in, and we advocate strongly that gene expression, profiling around game interferon really gives us the most information such that if patients had a high gamma score they oughta probably be able to get monotherapy PD one antibody and do pretty well. If they have sort of intermediate score, I think combination there see till four blockade or something else could be reasonable. But certainly if they have a very low, gene expression. Around gimme interferon. That means there's not cells in the two or micro environment. Those patients absolutely need something like a sting Agnes to prime the pump and get it going. So that would definitely be a population of patients, and we think that's what a third of all human beings who have cancer. They should get something to prime the pump and get it going and people argued it could be sting at its people already about radiation chemotherapy, and so on and so forth. All these different things you can do. But that point being is that population should not get monotherapy when just can't work because there's no immune response. So in that setting. We should do something to get the immune system. Prime to going before we come in with him. You know therapy now that only those extremely non inflamed tumors, or do you do some mediums and so forth. That's very good question. I don't know the answer. And that's really probably where randomized clinical trials would be necessary to know, what level of inflammation, the tumor micro environment. You really need to then add some extra to prime it further before you could come in with PD one a lot of work still to do in that way. In addition to stink. This new scenes don't viruses of two of such. Shing approaches that may have an important role to play in lighting, overcoming initial resistance. Don't to remi- again, certainly there's a great interest in this idea of Neo antigens being highly emitted genyk and sequencing patient's tumor to really understand what the Neo antigens are there in developing, for example, a personalized cancer vaccine where an immune responses induced to mutated protein specific for that patient's tumor, and that's a very high priority area for clinical translation in terms of transforming coal tumors into tumors will different primal boost mechanisms better in certain Kansas compared to of us. We don't yet know we still have a lot to learn about what field tecumseh for P should be for each person. You're listening to noble talk podcast. Even if you have some immune response, there are multiple ways that you can escape for Vate one of the battle cross to become this is too much for environment. Like, a pund it's a complex ecosystem of inflammatory and immune cells that surrounds Fatuma post Mazda miata for P we'll requires to catch vis and identify what needs to be talked on individual basis. Don't Emmons highlights. One approach there's multiple pathways of immune suppression that can be active within the tumor micro environment. They can be so based or they can be immune checkpoint signaling based or they can be metabolic Dennison is a metabolic pathway that can be immune suppressive, it impacts multiple different types of immune cells within the tumor, micro investment in transforms it from something that's pro- immuno-genetic and support. Cinnamon response something that really is immune resistant, and I think of Dennison signaling sort of being. Like, a wet blanket over the immune system. So really wanna kick that off? So that the immune system can really wake up and become active and kill that tumor. So bit luck at London foggy morning of sounded. That's exactly right. There are strategies to do this. That are just now entering the clinic by targeting CD, seventy three or the upstream components of the denting signaling pathway that's a cell surface protein that catalyze the formation of alternately Dennis seen. So you prevent Dennis protection. The other approach is to inhibit Denison, signaling downstream where it didn't seem fines to its receptor. In this case. There are some antagonise of signaling through the dentist to the two receptor, and that has some great promise in preclinical models for helping to promote tumor, immunity, both alone in combination with immune checkpoint blockade in both of those strategies are entering the clinic. Didn't seem signaling is a trucking a lot of interest from companies, but. But we need to talk CD Seventy-three MVP to a receptor we await data to fully understand the optimal combination strategy. But it is important to note that removing the immunosuppressive folk will only have an effect if we're all t cells present Luca gen from our model of tesol inflamed and non inflamed. Most of the tumor, micro environmental approaches really affect the inflamed tumors because the T cells, we think are the, you know, the actual therapeutic element to all of this. So if the T cells aren't president modulate Schumer environment doesn't matter because it's still nothing will happen. It's possible that modulating MDIS's or t rigs will make the T cells more robust to kill more tumor. But again, it's really in that population of people who already have some inflammation happening. So I think that those approaches are interesting, but I think they almost sort of double down on the people who are already gonna benefit a little bit and they're going to push that benefit up a little higher. But it's unlikely that most of the tumor invited environmental director. Coaches that have been proposed to date are really going to drag people from the completely non responder population into the responder population. Because we think that the biology of the really truly non responders is not cells. It's time for a message. From us sponsor, we greatly. Appreciate the support of Genentech and just to be clear. Sponsors have no control of the topics. We cover who interview over questions that we asked instead of reading a cool message doing many interviews vignettes, which scientists and clinical researchers that's your on the podcast. We heard about immunity cycle from dungeon derailment. I caught up with a vicious ACO annual meeting in Washington DC. Hi, I'm vice president of cancer -nology genetic. Hi, I'm Daniel Chan vice president global head of cancer immunotherapy at Genentech and Roche year ago poke test we heard, but you're writing in new paper, we have a pay patrol the immune set point what's the idea behind that? The idea behind the set point is to try come to grips with the fact that people exhibit highly variable resp-. To immunotherapy in particular. And one of the main reasons for it is that people have highly variable immune set points. In other words, some people are more likely to respond to certain stimuli and others, and we try to understand what are the various factors that contribute to the likelihood or lack thereof of response. One of the nice things about the cancer. And set point is that it does build upon the cancer immunity cycle that is still the foundation, but we're the cancer immunity cycle. Tries to simplify all of cancer immune biology, the cancer set point builds upon it and book ends it and takes it to its extreme complexity, and it's important to recognize that complexity because what it does is it creates a framework to now start to fit in all of the developing data in this field and give us a way to start to look at it all together in a way that we can understand it hoick research has joined to use this in practice too. Of his concept. We have all of these different multifactorial factors influence people's immune system and everybody has an individual immune set point. I think it gets used in two ways one is in the first instance to better understand the mechanisms of immune response. So if for example, you can understand the individual genetic variations that either predispose someone to respond or not then you can look at what the affected or what the variable genes are and understand where they fit into an overall mechanistic sense think longer term, what would hope is that you can get a idea in amalgamated set point view that you can kind of use diagnostic in some senses probably years off. But nevertheless, you add up all of the various things that would contribute to somebody's likelihood of responding to a particular therapy and know enough about what they are. So that you could tailor or modify your therapies accordingly. It's interesting it does allow. How this if we think about it from the clinical standpoint to take any individual patient and understand the complete intricacies of their cancer immune interaction, and so in many ways, this is a hyper personalized approach that one can take now in the clinic it may or may not lead to hyper personalized therapy. But it does at the minimum allow us to understand clinical data in a, hyper personalized fashion, any given patient understanding all of the different factors that may influence, whether they develop an active anti-cancer immune response or don't develop when at all environmental factors like but microbiome sunlight how we possibly going to capture a west someone fits on. This dial is to a are what the hiawatha low in. Well, if you're living in the north Finland in the middle of the winter than sunlight, probably isn't going to be too much of a factor, assuming that sunlight effects are acute. As opposed to chronic but more seriously. I mean, the microbiome is I think something is attracting a great deal of potential over the last several months because there is more and more objective evidence to say that the particular 'Bacterial communities that live in your gut actually do play a large role in one's ability to respond to different types of immunotherapy or even exhibit the adverse events associated with some of these therapies once you know, that you can then either avoid or include particular types of therapies, or possibly even take an action to alter the microbial communities that are found in particular patient, so that individual response better or with a lower adverse event incidents. So there are a lot of factors obviously that can influence whether or not you have an affective anti cancer immune response, we don't yet know how important each one of those factors is, but this type of data does give us a sense of the kind of things that we may want to collect. And until we know the impact. Act. We can start to collect that data. Now. Ultimately at the end of the day. We don't know yet whether sunlight exposure particular bacteria in your gut are going to be important drivers if they are in the long run, we'll either use them as their apy or use them to understand whether patients going to respond to therapy, if they're not important we won't collect that data anymore. One things I had mentioned is an idea to crowd source of information additional data. What's the thinking behind that? Well, this has to do specifically with the review that has just come out where we sat down and in our own inimitable fashion with something to drink and try to decide which are the various factors that may play a role. And I think it's clear that neither Dan there. I can think of everything I'm pretty sure fatigue. Played a little part in it. Iran is started to brainstorm on this and even after hours of brainstorming. We're pretty sure that we only captured a small fragment of what is now. Tone in immune biology as it relates to cancer. And then I think dawned on us that you know, what this is the perfect opportunity to think about crowd sourcing, and especially given how fast data is being generated in this field. No one personal organization can collect all of this. But as a crowd, we can do this. And when we went back to nature with this. They were very excited. And so we are now partnering with nature to try to launch a crowd source version of this map, usually you write reviews such as this. And there are some people who like it, some people don't, and then also whole bunch of people who say, how could you not have mentioned, you know, we did mention it. Okay. You mentioned the Mets. No. And and you have your soapbox doesn't that raise issues of signal noise? If anybody can just post to his well, I think it will be curated to the extent that alternative facts will. Be removed. We will ask for references as people enter the statea. But I think it's true much like anything. That's crowd source. Take wikipedia. It's a useful reference. But you can't expect that everything in there will be a hundred percent, correct. But that doesn't make it not a useful tool. If you'd like to more about the constant immune point and potentially contribute to it. We've put a link to a nature paper Minova targets website. It's freely. Available to download just sent to IRA any alternative facts. What I took away from talking done an IRA is the complexity of our immune system of coming resistance will have to be personalized to. ACO we hoped why someone constipation who initially responded to anti PD one point for P thin, quite resistance. Progressed. Don't Judy Bremer's. A lung cancer specialist at Johns Hopkins, Bloomberg Kimmel institute, the majority of patients who've responded do have long durable responses, but there is a group of patients, although they do respond their disease progresses. Again, one particular way that our group has found was actually chromosome loss in patients whose disease initially responded than than progress. Our group has done whole XM sequencing on tumors before treatment as well as well on therapy and found for at least a small group of patients that loss of hetero gossipy did quite an was associated with progression of the disease. So the thought is that tumor may lose the Neal antigen where you're T-cells actually recognizing the peptide that then is lost. And you can't recognize the other potential peptides that the tumors expressing. We've put a link Nova talk dot com to the paper published in cancer discovery that discusses fees findings motel. Oh, willy of come. Visit quad resistance. Don't lose says, it may depend on whether the immune response was tricky. But just won the election. You could have an overwhelming response to one engine or you could just have a little bit towards lots of them, and that may be different in different patients. And if it turns out that it's that complex that'll be hard to know how to generalize phenomenon across all patients. If you can kind of have either sort of version would then when you go to resistance because even more complicated because if resistance is you'll lose that one dominant. How do you readjust that one clone to get it back? Whereas if it's resistance always little ones that may be a completely different mechanism. We just don't know we need better annotation of patients who become resistant to me, no therapy. And those are very hard to get patient doesn't have much incentive to get a tumor biopsy. If you just told them the drug doesn't work anymore. How will we keep track of a patient's immune profile as it changes with treatment? That's the story for another episode. But loss of antigens as a means of immune escape is also seem not so for P. We heard about this back in episode eight from delta group. He's one of the pine is in the field of therapy for pediatric acute lymphoblastic leukemia. Halo. My name is Steven Greg. I'm a pediatric psychologists a children's hospital Philadelphia, we've looked into the mechanism antigen loss. And it's particularly sophisticated an evil the way these leukemia cells do this a lot of the changes are spliced variations. So there are at the Arna level. They're not genetic loss of CIT and most of the cases we can detect spice variations patients who never relapse, and we can detect splice variation patients do relapse. So it's not predictive if we want to increase the percentage of Joe Bill remissions, we've caught T so for how will we have come unto loss? And so I think the the real way to do this is to consider more than one target. And so I think a lot of us are thinking about the potential for adding a second target to get that tiny baseline CD nineteen negative cells out of the way and one of the ones that has propose for that purpose to CD twenty two and two. Footing teasha for is not just restricted to blood Kansas such as well as we'll hear in the moment. Christine Brown is professor of immunotherapy at city of hope national medical center in California. She's a pioneer in a field of cotija for P for brench humus that just Leo blessed? Duma cheapie is commonly known. Her presentation ACO blew me away. It was one of my highlights that meeting plead just recently published a case report of a patient with multi focal GBM in which we were able to deliver Carty cells that recognize specific receptor, I'll thirteen receptor alpha two, and we delivered the cells into his CSF and saw regression of multiple lesions in his brain as well as a large lesion in his spine. It's really a remarkable finding I mean, Cleo bless is one of the most difficult tumor types to treat and so we've been really focused on trying to develop an optimized cartesian therapies to treat this important unmet medical need. And so we're treating patients that are at second third fourth line of recurrence. These are patients that really don't have any other. Other therapeutic options, and so we're testing the safety of cartesian delivered locally into the tumor itself or into the sea Assaf, this Rupel spinal fluid, and you know, this is really a first in human. And so we weren't sure what we were going to see. And so this individual came to city of hope really his unconscious told him he had only two months to live any came in our nurse surgeon. Dr Ben embody who's the clinical PI for this trial respected, three of his five tumors in his brain, and we actually infused cartesian L's into his largest tumor legion. And we were encouraged because we saw no relapse or progression near the site of tesol infusion and really for most patients, usually see disease progressing, right at the edge of the respected cavity. Instead his tumor were cavity which just collapsing on itself. And so no one has ever given. Been cartels into the CSS ever. The my group's preclinical data really provided proof of concept that this might be an attractive way of of allowing these cells to traffic to multi focal disease, which was really his clinical setting. And when we administer them, it was beyond expectation, so the nurse urgent who leads the trial called me in the afternoon was November thirtieth and he's like Christine, you'll never believe it. I thought I was looking at the wrong scans all his tumors are melting away. Unfortunately. These cancers are aggressive, and they find ways of evading therapies as they did our therapy and his tumors came back after several months, and that was really disappointing for us heartbreaking, you know. And he he's continuing to battle his recurrent disease were treating him again. Combining his therapy with checkpoint inhibitors to try to really push the balance in favor of the immune system again for this individual. You mentioned the reason for the relapse was antigen lost. Is that similar to what we've seen with CD nineteen talkative therapy? We've seen that reported by Dr and colleagues of a sentence in pediatric aero, right? So antigen loss seems to be a common escape pathway for these tumors, either B cell malignancies, solid tumors when you have single targeted cars. And so I think the field is a whole. Well, there's a lot of emphasis on developing. These combination approaches either engineering T cell to express to America, antigen receptors or combining t cells expressing American interceptors with different specificities. So I think there's a general idea kind of like the HIV field that we want to box in antigen escape and the question is do you need to targets three targets four targets. What is that magic number and is going to differ, depending on what that tumor is. So you'll slug correctly. You showed the time of relapse. It wasn't immune desert. That was struck me as very surprising. If you've have Delvis immune response was it gone. His relapse tumor would be considered much colder tumor than the the tumor prior to therapy. And that intrigues us as well. And understanding that intrigues us a lot. And is that why he was able to recur even though he continued to get Carty cell fusions every three weeks. Wchs. It's an outstanding question. But it makes you think that this is why the tumor was able to recur post therapy because somehow the immune desert was able to exclude are Carty cells that well, actually, the realize tumor didn't express the antigen to activate our cartesian ELS. And then the recurrent tumor seem to be able to the dodge the moon system as well. So, you know, our work is still ahead of us were actively investigating this to understand this is really citing didn't work, but Dr Brown and colleagues doing offers real hope to bring him so patients who allies might have a dismal prognosis as you'd like to know more personal income level talkies website to the case report published last December in the New England Journal of medicine. We're at the end of Joni together. No, we haven't yet conquered resistance. But we're starting to understand a lot more about the challenges and potential ways to. Come. It is some for such would on him to field. Next month. We're in Chicago Esco, the annual meeting of American society in Cologne quality, it's the Super Bowl. Consummate is hope to see you. This is noble targets bring to life signs around innovative, new, trucks and self earth. He's the production of flu is publishing southern churches. Executive producer music from David Schulman's album plot life, motel I'm Peter afoot. Thanks for listening.
Carl Zimmer and Paul Offit on Genetics, Race, and Vaccinations at CSICon 2018
"So people somehow try to find these constellation of characteristics that they can somehow use to define being white in that somehow that is intrinsically biologically special. But it just doesn't work. Hi, everyone. It's me your point of inquiry co-host covens, we're back this week with a couple more interviews that I recorded during last Saipan in Las Vegas, I up checkout. My interview with award winning science writer and New York Times columnist Carl simmer, his talk at sei con was on the powers perversions and potential of heredity, which is also the subtitle to his latest book, she has her mother's laugh after my conversation with Zimmer will hear from Paul off it he'd be attrition inventor of Rotavirus vaccine at tireless advocate for science based medicine, especially when it comes to accedes. Hello everyone. I'm still here. Live from stike con in Las Vegas, and I get to speak to Carl Zimmer today. Thanks for being here. Carl. So Carl gave a talk today about his book and about heredity and misconceptions about this concept, but you raised an interesting point in years past of course, we know that by CS have influenced how scientists carry out research. So when it comes to today's research on Herat be what are the by season mythological issues that you've encountered in covering this in which ones are perhaps the most egregious will. I think that there are. Bias sees in the way that scientists sometimes think about the research in there also just biases that emerge in the data itself. So in terms of heredity and studies on genetics there if you look at the data of who has been studied what populations? Do we understand genetics in connection genetics health? Well is the European population? It's wiping its people in Europe or people the United States of European descent and hardly that is because that has been where a lot of the research began there has been neglected other populations as a result, and you cannot just generalize out from what you learn about the way Jean's work in a your. Opean population to other populations. So just to get one example. By studying European populations. Actually, scientists learned a lot about height height is controlled by many many genes and scientists are denting those jeans, and they can actually like look at the versions of those genes that people have and do pretty good job of predicting their height, you know, within say within a couple inches, which is pretty good in the road genetics. But that's only when they're predicting on people who are European if you look at those same jeans in a group of people from Africa, you do a terrible job. I ended there are tall. People in short people in parts of Africa just tall short people in parts of Europe. But you can become tall by different paths. And I and so by they don't believe they're part of a gene the, gene. There's just a huge amount of genetic diversity in our species. And we right now, we're not we're really been focused on just a fraction of right reminds me of myself actually for my listeners since I'm new to point of inquiry. I am trying to lose about twenty more pounds because I'm pre diabetic, and we have diabetes all through my family in people who are mostly thin, and otherwise very fit, and it turns out that the rate of diabetes and prediabetes in young people in the population is just way higher and the risk factors differ quite a lot on when compared to white people. So I'm interested to seeing to see the research that comes out of India, perhaps reference, genomes, etc. I guess that impacts so many different health issues. Right. Really? Yeah. I mean, and within the United States, you have people from lots of different backgrounds, and so if you're trying to use genetic data that came back from just mostly from one background is going to be a problem when you're trying to do public health across country. But you know, there are people know this this this is not something that people trying to deny the there's a nurse shot. You know, like it takes a lot of effort to start up a whole new research program. As opposed to just building on research program. That's right running. So there are some special initiatives. Now, you know there is a precision medicine initiative from the national institutes of health called all of us and olive festival uh Salma. It's so tired olive fest as otherwise that's all of us. Yeah. Yeah. So so tha majorly the goal is to bring precision medicine to country as a whole public health, I and they fully recognized that they have to reach out to lots of different communities to to get better profile of the genetic -versity of the United States. Even if that means, you know, recognizing that some communities look at this kind of research with a lot of skepticism in hesitance because it hasn't gone well for them interacting with these sorts of scientists in the past. So it's definitely a worker progress for work in progress. But it's good to at least see that initiated. You. You mentioned a lot of misconceptions about heredity any covered a few of them today. What would you think are maybe the top three and most navy stubborn misconception? At least when it comes to just public the American public. I think one big. Misconception is that if your descended from someone special that makes you special, you know, there are there's actually something Charlemagne society actually on which is only open to people who are descended from charming. And you actually have to prove that you're descended concerned people who are known to descend from Johnny to get in. But the fact is pretty much everyone in Europe today is descended from Charlemagne yet is some people can improvement in have the for some reason. Drive to join the society. Yeah. But you know, the implication there is it's part of some, you know, super special group that that's so they really do consider themselves special is what you're saying. I'm not very familiar with them. I wasn't either. I started doing research book. But there they weren't. And I just think that that kind of like. It shows just how much we cherish these these famous people in our past. I mean, I think we all come across someone who claims to have someone famous William the conqueror and so on, but the fact is that genealogy actually doesn't work that way. Like, actually like, you the further you go back, the chant the more more the chances go up that there's gonna be a common ancestor that a lot of people share so mathematicians of actually solve this basically a graph problem. And so in a continent like Europe, if you go back to the time of Charlemagne, if you find someone who has any living descendants, they probably are the ancestor of all the European made his one, and if you go back a few thousand years for further you're gonna find a common ancestor of everyone alive today. So you don't have to go back very far to find a common ancestor. Obviously, we if you go back years, we all have like millions of ancestors. But the fact that you can track yourself back to somebody famous. Really that's not how genealogy works, and you did not inherit that specialness. Yes. You have to have your own special. Exactly, exactly. And so. Yeah. I mean, we specialness is not. Heritage in that way. Yeah. It's better. If you try to do it on your own. So I think you covered this today at I have yet to read what he wrote. But today, the American society of human genetics denounced attempts to use genetics to bolster the idea our notion of white supremacy or racial supremacy, and they write in a statement that they're alarm to see a societal resurgence of groups rejecting the value of genetic diversity and using discredited or distorted genetic concepts to bolster bogus claims with white supremacy. So I've noticed this resurgence is well, what's your observation on this trend, and what do you think is driving it right now? Well, I think that maybe there is a feeling that among some people that they define themselves as being part of this population that that they think is. How better than other populations? And you know, as in the United States says as we have more more people who are Spanish black who people who are not white than that that makes some people feel threatened. And so I think that they then look around for some kind of justification for why they're special in other people are not. And you know, there are just some people who are just. Just you know, are flat out racist and always have been now, they're like a Neo Nazi they now look to these genetic tests hoping to find, you know, quote, unquote, scientific validation that they are superior the stuff that they come up with is is both just as the geneticists say one example is, you know, there is some white supremacists. To like to make a big deal that they can drink milk because you know, northern Europeans have a high levels of lactose tolerance that just means that they descend from cattle hurting societies where natural selection favored a mutation that allowed people to make the enzyme for lactose when results that's it. That is all there's no like, oh, and also that makes you super special and allows you to be there. Reasoning behind this. Then what's where are they getting that their ability to tolerate lactose makes them superior or how do they spin it? It's really hard to find any sort of coherent statement of reasoning about it. Instead, you just see the men, you know, drinking milk in demonstrations. Like as if that's as a gesture I should like that political almost masculine. Yeah. I I don't know. Maybe you could say that. While we shit. I'm curious now, I'm going to look up videos. It must be on YouTube Bryce, today's white supremacist. Yeah milk. I remind premises drinking milk. I learn something new every day. But here's the thing. Here's the thing is that. They might try to claim that we'll lactose. Tolerance is part of like this this great suite of traits that make northern Europeans great or something. I don't know. But it's just like this one result of evolution in humans. But it's the same. It has happened in parallel in other places. 'cause like northern Europe is not the only place where people have raised cows. So if you go to east Africa Vigo, and and look at Masai and other people there Africans dark-skinned avenues, they are also lactose. Tolerant. It's an unusual trait. It is an unusual trait. But it's not some sort of white special trait. So people somehow try to find these constellation of characteristics that they can somehow use to define being white in that somehow that is intrinsically biologically special. But it just doesn't work, you know, even with skin color. I mean, we're very sensitive skin color. I think just because we're a very visual species. But to to try to use skin color as a way of dividing up races. Classifying races is always doomed to failure. And the fact is that like even in Europe. It turns out ancient DNA shows that people in Europe weren't actually light skinned until maybe overall until maybe four thousand years ago. So they've been people, you know, our our own species in Europe about forty forty five thousand years, at least they were quite dark skinned. Yeah. Yeah. I think this is it's not quite it's almost as ridiculous to me. As flat Arthur's, but not recognizable as ridiculous to your typical person. In most people who aren't fatter Thor's are flat Arthur's, those people are nuts, but white supremacy and now these kinds of justification are so mainstream which is what makes it particularly disturbing. Yeah. And it's and it is I mean, it's their hostility extends in many directions. So, you know, my father Jewish and so like, I whenever I'm writing about this sort of stuff on for the New York Times like on Twitter sooner or later. I see somebody referring to me with all those parentheses marks all far there's a Jew talking about this stuff. So we know what that means is just very ugly fact of life right now. And I'm sorry sorry that that made it shouldn't have anyone. But it happens, of course, all of us in its sake can be ugly place. I look I mean, I am. I am not pretend. Ending that I have to deal with a fraction of what other people do this regard. It's just that I think of myself, and very privileged wipers. But I get it while it's if it's good that you recognize that because a lot of people don't so your book, she has her mother's laugh. Tell me about the title, and what the impetus behind this is what you hope readers gather from it. So I think ever since I became a father some teen years ago have two kids I have been really fascinated by Haredi simply because I've been watching these two people grow up, and I know that they're descended from me. And my wife, I look at them in wonder like, well, how did they become becoming? It's fascinating. My kids are seven and five just their behaviors there. So you can pinpoint who they seem to come from him. Sure. Some of this is just invented in our mind, but some of it is uncanny. Any there? I'm sure there's a lot of pattern matching. And and it is funny that like people will say, oh, she got that from you. Oh, she got that from you. Or didn't get that. From me. No way or only member how great grandma Mary had did that. Sometimes she must have guy from great-grandma on there and things like that. So somehow just saying like, oh, she has her mother's laugh to meet kind of captures that that ambiguity of of trying to figure out heredity in wondering, you know. He's this something that's encoded in DNA that you inherited. Or is it something that you inherit through the experience of growing up in household someone? I was just say nobody has done study haired ability of laughter. I can't tell you. If there's, you know laughter flashing your has. Okay. I don't know. But more like a metaphor to get at what I was trying to explore in the book, which is this. How does it heredity has such a power over us in? What is ready action? While check it out. She has her mother's laugh by Carl Zimmer thanks for being here with me today. Thanks so much. There's just so much to consider when it comes to heredity, isn't there? It was just thinking I mentioned before that. I'm a parent of young heads. We spent so much time trying to work with Oren guest heredity, depending on what's going on. But we've been doing that since well before we ever sequenced or even knew about the human genome moving on. Let's dive into my interview with Paul off. It he presented at side this year on communicating back seen science and ventures and miss adventures with the media. Hello everyone. I'm here. Again, live from Las Vegas at side Kahn, which of course, is totally. You know, we come to every year, and we have a great time. And there's no better time than talking to some of these speakers at SICOM. I'm here right now with Dr Paul off it who is a higher less communicator and defender of science and all things back seen. He's called inventor of road of virus vaccine and a hero to the skeptic community. You could say so welcome thanks for being here. So today. Paul talked a little bit about some of his mistakes when it comes to communicating science. And I think that we as a community can learn from that. So can you tell us about a couple of your mistakes? You will have some of the obvious ones that you don't have to answer the question exactly as ask. So once I was asked the question on a local show. So Dr Patel, how many vaccines children get when do they get them in which ones they get. I mean, if you actually answer that question, I think you'll set healthcare communication back about twenty years. I mean, you need a broader answer like children get axes to prevent have Titus and meningitis bloodstream infections among others. Children should make sure they get the vaccines. They need to be safe not to actually answer the records. But it took me a while to figure that out. That's one example. So how would you answer that question today? That's all it answer. The answer by saying children, get vaccines to prevent diseases like, and then just mentioned the disease and not all of that. You get more vaccines. All the Bax this age this age, you got hit back soon decisions Kanter the pretty much conjures that that image of the baby with all of their needle stuck in their leg. That's the other mistake. I made actually all this question. How many how many vaccines coulda child get instead of answering? It the way I should've which has said, the children's responses are broad and deep they can respond to many more vaccines getting I actually answered it the way you knowledge us when answer it was trying to figure out, you know, the sort of nets of antibody diversity, how many how many antibodies can you make you know, give yourselves make antibodies how many b cells having about and I came up with a very conservative figure ten thousand. But when I answered it that way, when I said, it trial could get as many as ten thousand bucks. I became the ten thousand vaccines. I mean here the people challenge me to get down XI's. There was a PR news wire that came up that said I received ten thousand vaccines died. I mean, also like the PR people in my. Ospital call to make sure I was still alive. I mean, it's Molly. That reminds me of the similar mistake. You were just talking to Dr Karl von mobile the plant geneticist. But there was a similar mistake. I think made by a few scientists when it came to drink pesticide and like I would drink that. And then they became the people who would drink toxic pesticides. So just yeah. Let's let's not drink pesticides. Even though maybe they wouldn't hurt. You. What are some mistakes that you see because I know you're pretty active on the internet. So when it comes to, you know, someone being wrong on the internet about vaccines. And of course, there are are many in the pro vaccine and skeptics community that are quick to jump in. And do I mean what I think is the noble work of of correcting misrepresentations about vaccines and other issues. But I do see some mistakes. And I was wondering what you see the most. When it comes to vaccine vaccines in particular biggest mistake to think, we don't need to explain our selves. The thank you know, when my parents were children in the twenties thirties they saw diphtheria killer teenagers. They saw polio. Crippled of young people. They understood the imports. I was a child of the fifties sixties. I have I had mumps I bel- I have I had all those neck convince me vaccinate nitro, but my children are in their twenties. I mean, they don't see these these today they didn't grow up with these over that vaccinations matter faith, faith, and Hoon pharmaceutical industry, medical stabs -ment in the government. There's lack at least in that kind of fade. So I think we need to step back and say, here's why it's still important to get these vaccines because prepared standpoint, you know, we as parents of young children to to give their their their children about fourteen vaccines court different disease. I can be as. As twenty six occupation during that time, you can meet as many as five at one time disease. Most people don't see using biological fluids. Most people don't understand and people look at this. I need a polio vaccine. Why depicts the polio their own black and white? I need theory of accede attendance next what he talking about. So I think it's hard to watch your child get five shots at once. No matter decay, you are in knowledge or science Veraldi. So I think we do need to vigorously explain. So we'd all to them. What's gonna happen is what's happening, which is that you'll see some of these these are coming back. I mean, we eliminated this company in the year two thousand gone, but it came back because we chose not to the accident children. We eliminated rebel which is a dangerous faction. If you get rebellious or measles in the first trimester pregnancy, you have an eighty five percent chance of delivering a child with birth defects, permanent birth defects. Do I think would rebel which we eliminate it from this country could come back? Absolutely for the same reason that measles come back. And then. And maybe that's what it takes. Maybe the only way people are going to really get vaccinated again is they're scared of the diseases that happen really in southern California. Which was a hotbed of antibac- seen activity two thousand fourteen two thousand fifteen there was a measles outbreak. That started in the Disneyland area spread states one hundred eighty nine people, and then suddenly mothers and fathers, southern California. We're getting their vaccinate. Because the vaccination rate call up like noticeably because measles now is knocking at their door or the next door neighbor. And now they were scared. But it's always the children have to suffer ignorance of stuff. Yeah. Yeah. And that's that's unfortunate thing I only had to go through chickenpox. So I consider myself lucky, I'm thirty six, but I guess my kids are luckier than I am because they don't have to get chicken pox before. I had kids I guess up oblivious to a lot of this. I didn't even know there was an anti vaccine movement. And I'm reading all of this information coming at me. And I'm like, wait. I'm supposed to be worried about vaccines. One of my supposed to believe, I don't know. So then I I guess fortunate enough and had some somehow found the skeptics community. I think I was already may be prime to find which was great. And then I learned I learned all about it. And I'm like, oh, yeah vaccines. Great. Good wonderful. Let's do it. But I mean, I think at least in my observation there are a lot of people like that. Not really thinking about these issues until they have kids. So what do you think differentiate someone stay like me, and I should add. I'm I was a huge doctrines fan until I had kids too. So I was the kind of person that was saying, Dr Oz recommended supplements. So I'm still trying to figure out why I went in in the direction of skepticism. So what do you think it is that maybe? Might cause a person than to have a child and not really know about this and fall into the other rabbit hole in decide to either not vaccinate their kids or though some vaccines. It's hard to what your get five shots at once. That's it. That's what you said before. And that's the one little two month old. You're lying. I will be back seen giving us it within twenty four hours birth. And that just doesn't seem fair two months of getting five shots. Once just like, they don't even have enough limbs, it seems to get all that. And so it's that it's motion. And I think for those who has attained its understand why I want to say it. It's not hard to find information on the internet will make you feel better about not vaccinating a group of people who also don't vaccinate you cannot vaccinate to. Here's all the reasons why because backseats calls all these things that they don't actually cause. But at least, you know, it makes you feel like you're not not making a bad trade because right now, it's what you're doing is. You're protecting yourself against infectious disease that could kill you. But if the anti vaccine people argument, essentially is that, you know, I'll risk the infections, which I don't think are that common to prevent these chronic disease. The can be lifelong awful. So so that they think is the trade even though that's not the trick. Right. Yeah. So I guess basically. What you're saying is if you're already feeling like this is very emotional harm than you have confirmation bias than you go to that information on the internet. It's just it's endlessly frustrating. How do you deal with the frustration of of fighting against us? I mean, doesn't it seem like an uphill battle. Sometimes. The I haven't my mind our children who come into our house blew suffering, doc vaccine Venezia's, I mean, they've got it because their parents invariably got bad information, which calls them to make a bad decision which put their child at risk and occasionally death watch that for few times, and you become a vigorous passionate advocate for this. Because that's always your your mind. Would you do is you try to understand mode? Most parents say eighty five percent of the parents who call me really wanna know what's going on. They smell the smoke. They want to know whether it's any fire there reassure bowl. I may really would prefer to trust their doctor because when you go to your documents. I don't want these vaccines, you're saying, I don't trust you. And if I you know, I don't trust for vaccines. There's other things I may not trust you for to you want your doctor to like you because you when you're sick, you want your document care. And when you say yourself apart of your doctor, that's hard thing. So I think most people really do want the facts. And are influenced by the facts may say eighty five percent of the people can be influenced to get back seat. Because once they have the facts they see what the right decisions but fifteen percent or conspiracy theories they think there's a conspiracy to hurt their child. I think you're part of it wonder while they recall to begin with because they know more than I do. And they don't care what I say forget it. And which case I forget it. I bail on those conversations because we live in a country where you can choose not to actually while. Here's the thing. I don't know more than you do and at most of us in this community, the skeptics community don't know more than you. Do we can't all be experts in everything I know that a lot of us want to help. So what is a non expert skeptic to do what are one example say a friend or a neighbor of mine says I, you know, I don't vaccinate my kids. 'cause I've heard that, you know, there's toxins in it XYZ is it should I say some. Thing. So there's there's a neighbor scenario, and then, of course, on the internet. What are what are the two top tips? You can give if someone's questioning not necessarily if they're already in the in the far extreme anti vaccine. I mean because they're not just making the decision for themselves or their children. They're making decision for you and your child if your child is exposed to children on backsied Novak a high percent of fact, you take something like the measles vaccine is ninety five percent effective, which is one of the more effective axes. But one at twenty children there for all right risky had gotten measles vaccine. You don't wanna be in a community to Thailand. Vaccinate. 'cause you're that's what happened. So the California. The second part of your question was all right the internet. So I would say. The wheel answer the question. Get calls like I've done my research on the chicken pox, vaccine decided not to get people mean by doing the research. They read other people's opinions of Maxine the that's really not doing your research. If you want to do research read, the three hundred articles that have been published on chicken box, which would mean you have to have some expertise in Veraldi's Satistics, biology algae, which most people don't have the most doctors don't have. So what do you do you what we turn to experts at least collectively had that advice that advise the centers for disease control and prevention in the American cabinet pediatrics, and those are the experts that have given said, okay, here's the data. I think we can recommend this axiom. Be given this time in this age group x number of those because they they have looked at all the order, but nobody's going to buy that right in the twenty th century trust, this were experts. So I think what what the best you can do is these go to reputable sites. It's not that hard. I mean, I think that sites possible Philadelphia. The mayo clinic the American Academy the address sites that are university affiliated hospital -ffiliated. Raca democ societies affiliated don't go to those sites that sell something as being a conspiracy. Don't go to sites that sell things. I mean, they're selling on chores that should be a hint chanting. Oh, by the way, here's an ion rearranging machine that can make your autism. That should be a clue that this is not a reputable site autism cures part of it is enough to drive me nuts. And then here's here's something. I'll close with something that I've been interested in wondering if you can fill me in on what you know, I've been hearing from more and more parents who are divorced and one is anti vaccine and one is not anti vaccine. So there are the legal issues of compromising on what vaccine their child gets doesn't get have you encountered this in. How has this been playing out in the real world court? Maybe the parents go to court and usually the mother and father each get their own lawyers who then try and argue for the job shooter shouldn't be accidental. It's ugly. Either lawyers that in this is it got into that extent. There early lawyers will vaccine side, especially and can't eat like are they all over the country of I know some names, but we're not to talk. Okay. Okay. I'll try I'll try to pick your brain later. But we don't have to talk about it. Now. Interesting. I mean disturbing but interesting, thanks so much for me. Thank you. This has been your host covets obvi-. Thanks again to my guests Carl's inner and all audit point of inquiry is production of the center. Ring ry CFI is five onc- three charitable nonprofit organization whose vision is a world in which evidence science in compassion rather than superstitions pseudoscience or prejudice guide public policy. You can visit us at point of inquiry dot org. Dairy can listen to all of PEO is archived episodes. Learn about me and my co host Jim Underdown and support the show and CF advocacy work by clicking the blue support. But another site, please remember to subscribe in share with your friends where available on I tunes, Google play Spotify and other podcast apps. Thanks sense. You again in two weeks.
NPR News: 08-11-2020 4PM ET
"Live from NPR news in Washington I'm Laurie London with the Democratic National Convention less than a week away anticipation is intensifying. Joe Biden will choose as a running mate and when he'll reveal has choice NPR's Mara Liasson reports I think the list has remained the same sounds like he's about to make his decision because the vetting committee has pretty much disbanded and it could be as early as today that we find out the campaign has reportedly been preparing even as Biden himself spent some of the past week privately in interviewing contenders in advance of a final decision. Russia's announcement that it has approved. The world's first corona virus vaccine is being met with international skepticism NPR's Richard. Harris tells US Russian scientists have an offered proof on whether the vaccine is safe or effective. The Russian vaccine has so far only been tested on a few dozen people even so Russian President Vladimir Putin announced the nation has approved the product and could start inoculating people in October it's named after Sputnik, the first artificial satellite which the. Soviet Union launched more than sixty years ago Dr Paul often vaccine expert at Children's Hospital of Philadelphia has no vaccine should be approved before it's shown to be safe and effective the notion that they would actually roll this vaccine out into the arms of the Russian public without doing adequate safety and efficacy testing I think a shameful for dozen other vaccines are currently in large scale tests to see if they are safe and effective reported Harris NPR news. The lawyer for a federal judge says, he shouldn't be forced to act as a rubber stamp and automatically dismiss the case against Michael Flynn. NPR's Carrie Johnson reports on an appeals court hearing over prosecution of President Trump's former national security advisor a lawyer for district. Judge Emmet Sullivan says the whole matter could have been over last month. If only the judge had been allowed to have a hearing on the Justice Department's bid to drop the Flynn case. The judge wanted to ask about the government's motives were abandoning the Prosecution Flynn pleaded guilty twice to line to the FBI, but then Flynn got a new lawyer an Attorney General Bill Barr. Arrived at the Justice Department DOJ decided to back away from the case it says it no longer serves the interests of justice if the federal appeals court allows judge. Sullivan to proceed the Justice Department says, it should limit the judges role and require a quick decision Carrie. Johnson NPR News Washington the Big Ten conference won't be playing football this fall because of concerns over the corona virus word comes days after it had released a tentative schedule that it hoped would help navigate a fall season and included potential corona virus disruptions, and at the closing bell stocks gave up early gains the dow down one hundred and three points. This is NPR. A week after opening for in person classes, a surgeon corona virus cases at a high school in Cherokee. County. Georgia has announced. It's closing temporarily. The word comes our hours after a parent rally in support of not wearing masks at the school ellen, Eldridge of public broadcasting reports just over two dozen parents in Cherokee county rallied this morning to support the Cherokee County school board's decision to allow students in school without Masks Michelle Gunter is a parent of a graduate into currently enrolled. Students in the district she says, while many are shouting about masks on social media. She simply wants to show her support we have to come together at some point we have to say you know whatever it looks like I'm here to support the schools I'm here to support the teachers and the administration, and whatever that means however that looks elsewhere. In Georgia, school boards are still deciding the best way to return to classes amid pandemic for NPR, News Ellen Eldridge in canton Georgia. The coronavirus pandemic has led to a revival of sorts for drive in theaters around the country. It's a way for families and couples to be out together while still socially distancing the tradition also seems to be expanding beyond movies. METALLICA is set to be the first act featured in a series of concerts that will be shown in drive ins across the country. The band will film a full concert to be shown as part of the encore driving nights on August twenty ninth. This is NPR.
10-29-20 What's News
"It's time for new, Coal Sandler's what's news from Nicole Sandler, dot com, and the progressive voices network the Supreme Court ruled Wednesday that two battleground states Pennsylvania and north. Carolina can extend their deadlines for accepting absentee ballots after election day the court refused a request from Pennsylvania Republicans for a ruling before the Tuesday election on whether the state can continue counting mail in ballots for another three days but. At least three justices, Alito Thomas and gorsuch are apparently open to taking up the Pennsylvania case again, and potentially throwing out any ballots than arrive within the three days after the voting ends on November third in the North Carolina case, the court upheld a lower court ruling letting the state board of elections extend the counting deadline by nine days as long as those ballots were postmarked by election day. Newly confirmed Justice Amy Coney Barrett who took the oath of office on Tuesday did not participate in these decisions, but she didn't recuse herself either s outlets reporting instead she declined to participate saying she didn't have enough time to get up to speed on those cases. Despite trump's constant claims that we've rounded the curve on Cove Ed. Cases Continue Rising officials in Colorado Idaho Massachusetts and Texas are imposing new restrictions on schools, businesses and social gatherings. Rhode Island Governor Gina Raimondo said at a weekly briefing on Wednesday that she would be announcing new restrictions on Friday saying quote we're in a bad place. It's more than a wakeup call really for every single one of us to ask ourselves what am I going to do differently one forecast published on Wednesday. By the Children's Hospital of Philadelphia warned that the virus is spreading at. Exponential rates across at least half of the states, and that Hawaii is the only state that will not see a rise in hospitalizations during the next four weeks. David Rubin Director of the hospital's policy labs said quote exponential growth is like what we saw in March and April, and we're now seeing that in half of the states in the country, this is like a tidal wave. and. It's not only here are the pandemic also surging again in Europe France and Germany have both announced new four week partial lockdowns to curb the spread in France people will need a certificate to move around and non essential businesses. Restaurants and bars will be closed German restaurants. Bars and clubs will also be closed in order to as Angela. Merkel said, avoid a national health emergency as new daily cases hit a record high. The Czech Republic now has the highest new infection rate and COVID nineteen death rate in the EU. Meanwhile Mexico's death toll has surpassed ninety thousand India's case total has surged past eight million. Only the United States has had more cases with eight point, eight million, and now this justice hospitals are hitting crisis mode where they're overcapacity when our healthcare system is going to be challenged like never before the FBI warned on Wednesday that the US healthcare system is about. To be hit with a series of powerful cyber attacks, the bureau announcing in a press conference that agents had received quote credible information of an increased, an imminent cybercrime threat to US hospitals and healthcare providers. The strain of malware that agents and researchers are currently tracking is known as riot and it is ransomware experts. Say the attacks have already affected five hospitals this week including three in New, York and Oregon, and again they're warning that more attacks are coming. Donald trump continues to mistakenly equate the economy with the stock market, but stocks dropped sharply on Tuesday and even further on. Wednesday as the Dow plummeted nine hundred and forty three points and is down nearly nine percent since September second the sell off which began two weeks ago and intensified on Monday has been triggered by a surge in corona virus cases, and the fact that the White House and Democrats are still at an impasse over relief talks. Lordy. There are more tapes, courtesy, Bob Woodward. This time we hear trump's son-in-law and senior adviser. Jared Kushner bragging back in April that the president was cutting out scientists and getting the country back from the doctor straight in the sense that what he did was you know he's GonNa phone the open up their intrigue phases there was the panic face pain face and then the comeback phase that doesn't mean there's not still a lot. Of Pain and there won't be paid for a while but that basically was we've now put out rules to get back to work trump's now back in charge it's not the doctors they've cut a we we have split negotiate a shuttle really at that time, we were confirming about thirty thousand new corona virus cases each day less than half the rate in the current surge. Owen? Kushner, also had this to say about the Republican Party. Able to do is I say he's basically did a full hostile takeover of the Republican Party. And I don't think it's even as much about the issues I. think it's about the attitude data hit Louisiana as a category two hurricane on Wednesday leaving millions of people on the Gulf coast without power causing at least two deaths. It's since weakened to a tropical storm, but it will likely stay pretty strong as it travels over the southeast. Zeta is the twenty seventh storm of the Atlantic hurricane season one shy of tying the record for the most storms in a season which doesn't officially end until November thirtieth. So anonymous anonymous no longer we now know that it was miles Taylor former department of Homeland Security Chief of staff who on Wednesday revealed that he was the previously unnamed trump administration official who wrote that two thousand, Eighteen New York Times op ED, describing internal resistance to trump. He later anonymously published a book called a warning on Wednesday Taylor. Defended his decision to. Conceal his identity for so long and urged other trump administration officials to speak out. Taylor's now on the payroll of CNN as a contributor and on. Wednesday. Night Chris Cuomo called him out. You lied to us. Miles you asked in August if you were anonymous here on CNN with Anderson Cooper and you said no but you know what the problem is we're having lied is that now you are Aligarh and people will be slow to believe you when you lied about something as important as whether or not you wanted to own this And that's just a bit of what's news for now Nicole. familar. If you appreciate these reports Nicole Sandler show I hope you'll consider making a contribution. My work is one hundred percent listener supported and I can't do it without your help find out more Nicole sampler dot com and please. Donate. Button.
The CRUSADE Channel Newscast For August 11th 2020
"Ralph Waldo Emerson once said coup goodful Thailand but Genius Waltz prow. Well, that's funny because when I finish morning prayers, I do want coffee and what little genius I have tells me to choose Crusade Captain Dark Roast. Our coffee is custom roasted from the finest fair trade coffee beans and bag by the heavenly Rose Coffee Company, order your supply a crusade captured dark roast today by browsing to Mike Church Dot com forward slash coffee that's Mike Church Dot com forward slash coffee or call eight, four, four or five crusade. News. News you can trust. because. The truth can be trusted. Trump crusade channel news. Desk. Stacey Cohan Good Morning Crusaders Sater's welcome to Tuesday August, eleven twenty twenty I'm Stacey Cohan reporting from Crusade Channel News desk at the Coen ranch in Winkelmann. Arizona this report is brought to you by McClure tables using Michigan, hardwoods in Michigan to make the best made in the USA Sheffield boards on the market shuffling over to McClure tables dot com. That's M.. C. C. L. U.. R. E. TABLES DOT com here's what to listen for this hour a study on coronavirus transmission in one hundred UK schools described as one of the world's largest Wilkin firm that there is very little evidence. The disease is spreading in those institutions president trump got removed from his press conference and Seattle's moving forward with defunding the police department. President trump was abruptly removed from the briefing room on Monday during a press conference with reporters because of a shooting about a block away from the White House. The president was in the middle of his opening statement when an aide who appeared to be a member of the secret. Service came to aside and escorted him off the podium trump returned to the room after a few minutes and reported that there. had been shooting outside the white. House. It was law enforcement who shot someone it seems to be the suspect and the suspect is now on the way to the hospital trump said secret service shot the suspect outside the fence right near the white. House Washington DC officials said that the first responders took a man with a gunshot wound to an area hospital. The person was in serious if not critical condition. A study on Corona virus transmission in one hundred, UK schools described as one of the world's largest will confirm that there is very little evidence. The disease is spreading in those institutions this according to a leading scientists who proclaimed this recently over the weekend the Sunday Times quoted professor. Russell viner. The President of the Royal College of Pediatrics and Child Health and a member of a government advisory group as saying a new study that's been done in the UK schools confirms there is very little evidence that the virus is transmitted in schools. The some of the largest data you'll find on schools anywhere the. Comments from viner who supports the reopening of schools echoed recent remarks made by a top US public health official who said the united. States must reopen schools for public health reasons public health England. A government agency is conducting the UK steady, which is supposed to be published. Later, this year researchers reportedly tested an estimated twenty thousand students and teachers in one hundred schools across. England. So they could monitor the spread of covid nineteen until the end of the summer school session Dr Susan Coffin from the Children's Hospital of Philadelphia believes that children have deficient concentrations of the virus and they're not capable of transmitting. Liberal Huntington Post acknowledged this in June a few experts including a French epidemiologist have concluded that children are at least likely to spread the virus than adults because they don't have many symptoms and they don't cough several studies have found the rate of spread and the rate of positivity for kids was far lower than for adults according to Dr Sandra cash from the West Med medical group. Coming up are saying that the day they're actually to he confessed his faith which he confirmed by a miracle for protecting himself only by the sign of the cross he walked over red hot coals barefoot without suffering an injury and she was beheaded about the year two, ninety, five at the command of Diocletian in her father's house quota the day loved the poor tenderly regarding them as your masters in yourselves. As their servants Saint John of God, you're listening to cruise sage on news. Hi, I'm Barbara Dooley and I'm excited to share some great news for my friends at bulldog Kia. You can buy a new Kia online and have it delivered straight to your home right now. Twenty Twenty Kia soul LX is our only fifteen thousand, nine, hundred dollars at bulldog in Athens. That's right. You can get a brand new. LX For less than sixteen thousand dollars includes two thousand dollars, customer cash, and a dealer discount of one, thousand, four, hundred and fifteen dollars get your new. Kia. Soul today at bulldog Kia. Wow. What a great deal with their free home delivery service. You can have your new Kia delivered straight to your driveway. So do what all other smart car shoppers do and get your new KIA from bulldog on Atlanta highway inactions or at bulldogs. Dot Com. Thirty two, thousand, twenty, x, number, two, zero, ninety, one. Thousand. Three hundred fifty. Dollars. Incentives taxes tag these items which new details well, say at bulldog Kia, we have two saints. Today's Saint and Susanna Tibur was an only son who was baptized through the persuasion of Saint. Sebastian who was his godfather in baptism during the persecution of Diocletian he lay hidden in his father's house accused by a traitor. He was brought before the perfect and tried he confessed his faith which he confirmed by a miracle for protecting himself only by the sign of the cross he had walked over red hot coals barefoot without suffering any injury, but the miracle was described a magic and he was. Executed this was in the year two, eighty six, the spot of the execution was called at the to Laurel Trees Saint Susanna was a virgin and martyr. She was beheaded about the year two, ninety, five at the command of Diocletian in her father's house this house and the adjoining one belonging to her uncle were near the to laurel trees and were turned into a church. The authenticity of the acts of Saint Sebastian and Zana, has been rightly questioned however, the martyr drums and the day of Death August eleventh are established by the witness of the oldest MARDI algae's and the earliest place of worship. The Seattle City Council voted Monday to move forward with a controversial proposal that would begin the process of defunding the police department. The seven to one vote comes despite objections from the city's police chief mayor and the Seattle police officers guild. The plan would ultimately slash funding the department, but not the fifty percent some had sought Seattle currently has around fourteen hundred police officers. The current plan would see about hundred cut. It will also cut the police departments four, hundred, million dollar budget by about three, million the. Plan also removes officers from a team that dismantles homeless camps. Some city council members have said, the initial cuts are a first step to more sweeping productions and rethinking of law enforcement in Seattle. Delta CEO ED bastion said, it's already added one hundred people to a do not fly list that's for their refusal to don appropriate personal protective equipment even those unable to wear a mask or out of luck according to the new policy bastion also described procedures put in place to keep their flight safer aside from booking sixty percent capacity and blocking off all middle seats Delta regularly sanitizers and uses electrostatic fogging to disinfect the interior. Semir news tips to news at Crusade. Channel. Dot Com stay tuned to the crusade channel would live breaking news updates all day. The best live talk radio anywhere up next the Mike Church show continues I'm Stacey Cohan for the crusade channel seeking news and Finding Truth
Americas hospitals are under attack by Russian-speaking hackers
"Good Morning I'm James Holman from the Washington. Post, and this is the daily to to for Thursday October twenty. In today's news. Hurricane Zeta wars inland after slamming New Orleans. President trump formalizes one of the most sweeping public land rollbacks in American history. And Democrats in Pennsylvania North Carolina claimed key wins, the Supreme Court. But I. The big idea. Russian speaking cybercriminals. In recent days have launched a coordinated attack targeting US hospitals already stressed by the coronavirus pandemic with ransomware that analysts worry could lead to fatalities. In the space of twenty, four hours beginning Monday, six hospitals from California to new. York have been hit by the Riach ransomware which encrypt data on computer systems forcing the hospitals in some cases to disrupt patient care and canceled non-critical Surgeries Ellen Nakashima and Jay Green reported the criminals have demanded a ransom reaching upward of one million dollars to unlock each system and some hospitals have paid the FBI Department of Homeland Security and department. Of Health and Human Services have issued emergency alert to all healthcare providers in America, warning them of the grave threat a woman in Germany died last month when the hospital she went to for emergency care turned her away because it had suffered a similar ransomware attack. She died in route to another facility. These sneak attacks by the Russians have shut down some procedures at sky, Lakes Medical Center in Klamath Falls Oregon the hospital is unable to offer cancer treatments that are computer controlled. The attack is curbed diagnostic imaging as well. Doctors and nurses have turned a paper for patient records because their electric system off line. Noma Valley Hospital in California was also infected likewise Saint Lawrence health system. In Potsdam New, York was taken out Monday hospital had to disconnect its computer systems to prevent the Melwork from spreading. In a more chilling development, the New York Times reporting that these are the same. Russian. Hackers who American intelligence officials researchers fear could so mayhem around next week's elections. These Russians believed to be based in Moscow and Saint Petersburg have been trading a list of more than hundred hospitals in America that they plan to target Alex Holden the founder of hold security shared that information with the FBI. This is obviously scary moment. And last night a hacker released election data from Georgia's hall county. After a ransom they demanded from officials was not paid. Officials are going of their way to emphasize the security of Election Systems in efforts to reassure voters following revelations foreign meddling against that backdrop our country continues to experience record numbers of covid cases and hospitalizations officials in. Colorado. Idaho Massachusetts in Texas yesterday imposed new restrictions on schools businesses in social gatherings. All of this has been a highly politicized pandemic. Some of the restrictions are rising with no regard to local political inclinations. liberal-leaning El Paso has imposed a nightly curfew wall conservative leaning Corday lean in. Past a mask mandate in Massachusetts. A major spike in cases is prompted Boston public schools to suspend in person learning. A fresh forecast published overnight by models at Children's Hospital of Philadelphia warned that the virus is spreading at exponential rates across at least half of our states, and that only Hawaii will not see a rise in hospitalizations during the next four weeks. A secret federal government briefing document circulated top officials and obtained by The Washington, post rates every county in America by levels of concern and it notes that you could drive today from the Canadian border to Mississippi without exiting one of the sustained hotspot counties. Another forecast from the University of Washington Institute for Health Metrics Evaluation Projects that by November eleventh our country's on track to surpass one thousand deaths again, a day from covid. The same projection says the country's on track to exceed two thousand deaths a day by December twenty eighth. These numbers are slightly less grim than the models projection from a few weeks ago but they still envision close to four hundred thousand cumulative deaths from the virus in America by February first. Infectious disease experts emphasize that the future of the pandemic is not fixed. Human behavior is the key variable, but the models also showed that the current rates of infection already a record levels averaging more than seventy thousand new cases a day, and sometimes higher are likely to only increase Tony the government's top infectious disease experts said last night for the first time that the federal government should consider instituting a national mask mandate. Here in DC, the region just hit an eleven week high for new infections and my colleagues are reporting today's newspaper that senior White House officials issued an order to the CDC to stand down when it came to tracing and containing the outbreak that impacted the president several sources including on the record to my colleagues Desmond Butler, Tom, Hamburger Lena Sun and Sarah Kaplan that the White House called off efforts to get to the bottom of the outbreak. After the September twenty, six super spreader event in the Rose Garden and they refused, they refused to allow the sequencing of the genomes virus samples from infected individuals. They also blocked officials from sharing vital information with local public health authorities in Indiana Minnesota in New Jersey that could have helped slow the spread of the outbreak. The genetic analysis in particular would have revealed shared mutations that linked cases in Washington and other affected communities had the administration done such an investigation. It would know whether the infections among five senior aides vice president pence that emerged over the weekend bore the same genetic signature as earlier cases at the White House that could indicate whether the virus was circulating among administration officials for several weeks or had slipped through a second time passed the infection control measures that are in place. White House spokesman Brian Morgenstern claimed in response that it's unknowable how the president became infected with covert but Tom Friedman, the former CDC director countered quote of course it's noble. It's only unknowable if you don't want to know. Let me wrap up the big idea by telling you about a Maryland family. That battled covert at the same time as trump. Remember when the president climb the steps of the White House balcony. After he left the hospital took off his mask saluted no-one in particular and then urged Americans not to fear this disease. Well that exact moment the exact moment. Thirty miles away. Carlton Coach Junior Sat in Annapolis, funeral home staring at the casket. The contained the body of his older sister. Carol Coats Got Covid at the same time as the president. But instead of a sweet at Walter Reed the forty six year old black teacher self isolated in the basement of her family's home. And instead of the experimental cocktail of antibodies that trump got. She received get well cards from her fifth grade students. Carol taught at school just nine miles from the White House. But her illness unfolded in what seemed like a different universe than the one, the the president described. Trump said during that triumphal homecoming quote don't let it take over your lives. If for many people of Color in the United States, the coronavirus has already taken the life of someone they loved. It would take even more from Carlton Coats. Michael Miller reports that Carlton's phone buzzed during his sister's funeral. But the forty, three year old truck driver ignored it. It was only when he returned home and. Salt people gathered in his driveway that he needs something had gone. Wrong. As they stepped out of the car his fiancee pulled him aside she said, I hate to tell you this. But your mom has to way to. The coronavirus crept into that Pretty House with blue shutters and in Toronto, county and it killed the two women that Carlton had known the longest his mom Dale was one of two black receptionists at a predominantly white retirement home in Annapolis called sunrise senior living. She kept working despite her worries about falling ill. Now she's dead. The Reverend Stephen. Tillett. The pastor at Asbury broad neck United Methodist Church were Dale was a member. Told Michael Quote. As the saying goes. When white folks catch a cold. Black folks catch. Pneumonia. And that's the big idea. Here are three other headlines that should be on your radar. Number. One Hurricanes Zeta made landfall in Louisiana last night as a powerful category to intensifying right up until landfall defying earlier forecasts for substantially weaker storm. Shortly after crossing the coast Zeta Slam New Orleans, it's moving directly over the city cutting power to more than eighty percent of residents. The storm unleashed wind gusts over one hundred miles an hour in both coastal Louisiana, and Mississippi, and high winds power to more than eight hundred thousand customers coastal Mississippi has been subject to a storm surge, the raised water levels, nine feet above normal dry-land. The coast resulting in severe inundation and flooding Zeta is now poised to raise through central Alabama northern Georgia and then the mid. Atlantic covering twelve hundred, fifty miles through Thursday evening. Damaging winds. Could stretch into interior parts of Georgia. Were gusts of fifty miles per hour forecast today in Atlanta. That could impact early voting. Number two. Trump yesterday opened up more than half of Alaska's Tonga's national forest to logging and other forms of development. A notice posted in the Federal Register Strips protections that have safeguarded. One of the world's largest intact temperate rainforests for two decades. As of today, it is now legal for logging companies to build roads and cut and removed timber throughout more than nine point three, million pristine acres of forest. The forest features old growth strands of red and yellow Cedar, Sitka Spruce and Western hemlock for years federal unacademic academic scientists have identified Tonga's as an ecological oasis that serves as a massive carbon sink will providing key habitat for wildlife. Like Pacific Salmon and trout black tailed deer and myriad other species. In fact, the forest boasts the highest density of brown bears North America. And it's trees. Some of which are between three hundred, thousand years old absorb at least eight percent of all the carbon stored in the entire lower forty, its forests combined. We'll tropical rainforests are the lungs of the planet. The target is the lungs of North America. This is America's last climate sanctuary. That's how Dominic Della Sala, that chief scientists with the island institute's wild? Heritage. Project put it in an interview with my colleague Juliet Eilperin who won the Pulitzer for us this year for writing about the impact of climate change on Alaska. We'll trump has repeatedly touted his commitment to planting trees through what he calls a one trillion tree initiative invoking on the campaign trail. As recently as last week, his administration has sought to expand logging Alaska and in the Pacific northwest since day one federal judges have blocked several of these plans because they were blatantly illegal but trump has been packing the courts with judges who were hostile to environmental regulations. So that may not continue. And the trump administration tried carefully in this case to dot the i's and cross the TS to stop. Opening the forest from being overturned. Number three. Last night the Supreme Court allowed extended periods for receiving mail in ballots in Pennsylvania and north. Carolina, they declined to disturb lower court decisions that allow Pennsylvania officials to receive ballots cast by election day and received within three days and a ruling by North Carolina's election. Board that said grace period of nine days. In both cases, the Republican Party and state legislators at oppose the extensions and trump has railed on the. Campaign trail against the mail male invoke three conservative justices, Clarence Thomas Sam Alito in Neal gorsuch objected in both cases the newest Justice Amy Conybeare Barrett did not participate in either case but her decision did not signal a blanket refusal and election cases involving trump instead she indicated through a court spokeswoman that the case is needed prompt decisions and having started work on Tuesday. She didn't have time to fully review the briefs. At least seventy three point three million people have now voted nationwide that's fifty three percent of the total number of votes cast in two thousand sixteen in bad news for people trying to vote though more than forty, two, million of the ninety, two, million mail ballots that have been requested by voters nationally have not been returned as the window closes for USPS delivering prompting a flurry of dire warnings from election officials from coast to coast the ballots sent via mail from this point forward may not arrive in time to be counted. An internal USPS reports leaked to my colleague Jacob both. Should distressingly poor delivery rates in swing states with numbers falling below sixty percent And get this. A new report from the Center for Responsive Politics shows that fourteen billion dollars will be spent by candidates and outside groups on the twenty twenty elections. Fourteen billion dollars. That's more than twice as expensive as the two thousand sixteen election. In fact, more money will be spent on the twenty twenty campaigns than the previous two presidential cycles. Combined. and. That's the daily two. Oh Two for Thursday October twenty ninth. Thanks for listening. I'm James Hillman. Stay safe I'll talk to you tomorrow. The Daily two Oh, two is brought to you by Cleveland Clinic and the new podcast caring for tomorrow I'm Joan. London, the host of the series please join us as we explore the challenges and solutions that are defining the future of healthcare look for us wherever you get your podcasts.
Q & A: Vaccine Development And Kids' Questions
"This is corona virus daily from NPR. I'm Kelly mcevers vaccine is not a sure thing and while early results do look promising. They're still a long way to go. What the vaccine development process looks like and later even kids have questions about what's going on right now. Public Health experts answered those questions on the national conversation with all things considered here's NPR's Ari Shapiro. You've sent us a lot of questions about possible vaccines to protect against the coronavirus and here to help. Answer those questions is. Npr's Joe Palca good to have you back. Joe Thanks Ari how you doing. I'm all right. Thanks good let's take listener question. This comes from Logan San Francisco. What goes into making a backseat for this type of Iris? Yeah it's a really. I mean from a scientific standpoint so really interesting question so so what? The scientists are trying to do is to find something that looks to the immune system just as if a virus had come into its body and was about to infect it so they studied the thing on the outside of the virus that the immune system. I sees and they tried to replicate that in one way or another and in the case of the corona virus. It's a protein on the outside. It looks like I've been thinking about it. Like he's like a clove stuck into a tennis ball so it's something that exquisitely recognizes this clove and then figures out a way to just take the clove not the whole virus but the clove by itself or with a few other things attached but not the whole virus or not a healthy virus and put that into a vaccine and the immune system will say oh I think this infection but of course it's not so it will recognize it and then the next time if the real thing comes along it will say oh. I've seen that before that it'll respond our next listener. Sasol is also in San Francisco and he wonders this so far what Congress has been made by the scientists and complete a vaccine and what info do they need to finish So we know that these trials are underway. But what does the finish line look like? At what point can they say like okay? We did it. It's actually the proof is in the pudding. I mean. Say You'RE GONNA have to take all these great ideas there's more than a hundred vaccines under development and there's maybe eight or so that are actually in human trials in their more to come but eventually you have to show that it's safe show that it's provoking an immune response and then show that it actually prevents people from getting sick. But you know with that many trials. I could also mention a scenario where they say okay. We've got a vaccine. It has a sixty five percent effectiveness rate and then later on they say. But here's a different one. That has a seventy percent effectiveness rate and less side effects. I mean it seems like it's not just done you've crossed the finish line right. Yeah I mean it could be interactive like that. I mean sometimes the first one might be a home run they use it and bang. Nobody gets sick again. But you're also right that there may be some that have side effects Another thing to consider as there may be some that work really great but they're hard manufacturer or they're hard to administer so there's a lot of factors that go into deciding whether you have a success or not which is kind of interesting to contemplate all right. We have two questions about. Antibodies and a possible vaccine. I want to listen to them back. I this is Dave in Fort Wayne Indiana over dolgin sailors on the US. Theodore Roosevelt tested positive for coronavirus. Second Time does that mean a vaccine based on antibodies. Such as the one being developed by dirt won't work and related question here from Megan and upstate New York. I've heard that having. Antibodies does not necessarily protect against the second infection of covid nineteen. What does that mean for Vaccine Development? Joe What is the connection between? Antibodies and vaccine there right that this is a problem. If you generate. Antibodies which in theory should protect you. And you can generate them if you actually exposed the virus or you could generate them if you get given a vaccine but if you generate them and they stopped protecting you then you're not any better off than when you started the issue is that it's not clear at this point. People don't understand exactly what's going on with these Sailors on the US Theodore Roosevelt. So it's not clear. How long these? Antibodies are protective or if they're protective while they are clearly a protective for awhile. That seems to be the case. How many people are protected for how long and what circumstances one of the many questions that has to be answered all right? A lot of listeners are telling us they want to get involved including Amanda in Saint Louis. Here's her question. I'm wondering if there's anything else. We who aren't science or health professionals can do to help with the vaccine development. What would you say Joe? Is there anything better? Folks can do exercise patients. I think which he wouldn't be things. Sit quietly stay. Take it's GonNa take a while. And Yeah and people are GONNA have to put up with restrictions their behaviors. They're not going to be crazy about and understandably so patients important. The other thing is you know when they talk about testing this vaccine. They're testing on somebody. You should watch people who are interested and willing and able should watch for advertisements for people want to join the test program to see if the vaccine works. Is that posted on like hospital websites. Where you find out about those things. There's actually a website that I found earlier. That lists all the clinical trials. So if you search around you can find places where they're looking for. Volunteers is not too hard interesting. Okay let's take this next question from K. in Scottsdale Arizona. Who wants to know about how this vaccine might protect? People taking it in those around them wouldn't infected person vaccinated or not still shut the virus exposing others. Joe How does that work? What would you tell Kay? I asked a vaccine this question earlier today. The answer seems to be basically no if you had the vaccine and you're not becoming infected with the virus that's causing in this case covert nineteen. You're not going to be shedding any because you don't have any what you're getting from. The virus is a activated immune system. You're not actually getting a live virus that you can shed and give to somebody else so the I don't think that's going to be one of the big problems right. Npr's Joe Palca thank you. You Bet I'm Michelle Martin. And in this excerpt from the national conversation with all things considered. We'll here's some younger voices. We asked kids to send us their questions. About Corona virus to offer answers and perspective. We called Susannah stuyvesant. She is a pediatric nurse. Practitioner at the Capitol Medical Group which is in the Washington DC. Area and Dr She Jauregui. She is the medical director for the young child clinic at Children's Hospital of Philadelphia and an assistant professor of psychiatry at Perelman School of Medicine at the University of Pennsylvania. Thank you both so much for joining us. China show first up his genesis. Who is eleven high? Well do a back seen. How would it specifically be used on a thank you dr kind of wondering if maybe the question is? Where does the shot go? I'm kind of thinking that might be the question but I don't know tell me you. What the cool thing budget asked. This question is is that because they're all these people working on vaccines right now. They're looking at some really interesting ideas. So one of the ideas is it not to be a shot but for actually to be needle free and the reason why that's important because part of the problems vaccines typically. They need to be refrigerated. And so that can be a little bit tricky. When you're trying to put into trucks and trying to get into all these various places that you can create a formulation that doesn't need to be refrigerated and then if you can also have it. So it's needle free then that could mean that could be like a skin patch which theoretically to go to the through the mail and go to everyone's homes and they get a stick that patch on your arm so one of the things that people working on right now are trying to come up with novel. Ideas and novel ways to create this vaccine. That would work on this really large scale and it could be rapidly deployed doctors Yagi. I think I may have. This may be about the vaccine but it may be a broader question. So I'll just play it in. See what you think. Here it is my name is gus and I live in San Francisco and my question is will it be safe to go back to school without a vaccine? That's really gonNA depend on a lot of factors that really means for Gus. What's happening in San Francisco at the time in terms of transmission rates and the ability to test people and the Department of Health both gives us goes well as California working on all of those issues and monitoring the pandemic and when. They think that it's safe to reopen schools. Then they will go ahead and do that. And have a whole lot of measures in place to ensure that they can limit the spread of Covid nineteen within the school setting. And if we've learned anything over these past several months sheltering in place we know what to do to be safe. We know any to screen. You know any to monitor the to test if at all possible then. We need to do the things that we've been doing every day. Which was handwashing physical distancing. Six feet away. All of those things will be things at the school will do and school districts will do before. They think that kids are ready to go back to school. Suzanne status. I'm GonNa give you this next. One from nine year. Gabby and she called us from Tampa Florida. I know that social distancing is important but how can I make my friends it? When they aren't doing it. This is a really hard one and this is going to Probably require a little bit of help from your parents and what I want you to do. Gabby is to brainstorm with your parents about some things that you would like to do with friends that you can do with a mask on and that you can do at least six feet apart so some of the things that come to mind for my patients that I've talked to is a bike ride where you ride parallel to each other but six feet apart with your mask and helmets on and badminton. I really think this is going to be a badminton summer. More coloring two different posters. You said this is the summer of badminton. I'm not sure that's the answer everybody wants. I've got two questions about a really popular sport in here. They are hi. My name is Quinn and An eight years old and my question is I usually plan the soccer team but were they able to play this summer. My name is Gavin nine nine. I'm Fairbanks Alaska most of them. Are they play soccer and raise be mix of ood soccer outside? My parents say I should probably take the summer off from BMX in soccer. Because of the Corona voters I think Amex and soccer probably okay because they're outside and because they're fun Stem what's his expert. Npr think Suzanne stuyvesant. We're putting you on the spot here. Well actually it's okay because I'm a soccer player and I had my spring season cancelled as well so in addition to that I was super excited to watch the National Women's soccer team play in the Olympics this summer so I am feeling the burn of no soccer but the thing about soccer is that the coaches recommend five thousand touches per day. Okay that's a lot and most of those should be in drills and those are really easy to do with one friend or just in your backyard and you don't necessarily need one of the smart soccer balls for Gavin For his BMX. I believe there is a way that the group could probably figure out a way to do safely. Maybe it would be going on the course one at a time which I think is probably pretty different but I think that that is something that by using guidelines that are on the CDC for camps and Daycares reopening and things like that. I think they could probably follow them guidelines. And get that up and running in some way shape or form. The other things are passing the ball and Lacrosse. Shooting on the goal to there are ways to do these. But we're not going to be in that close contact especially for the Physical Sports Basketball. You can definitely do. Everybody has to bring their own ball and remember to wash your hands before and after and no one on one just playing like knockout horse that Susanna stuyvesant. She's a pediatric nurse. Practitioner at the Capitol Medical Group in the Washington. Dc AND DR WASHY COUP GIROTTI. An assistant professor of psychiatry at Perlman School of Medicine at the University of Pennsylvania. Npr's Michelle Martin to keep up to date with all the corona virus news. Check out your local public radio station. There's a link. Find it in our episode notes. Thanks for listening. I'm Kelly mcevers.
The coronavirus is killing kids. The numbers are low until it's your child.
"Good morning. I'm James Holman from the Washington Post and this is the daily two for Wednesday April twenty-sixth in today's news. The first corona virus deaths in America occurred weeks earlier than previously thought the CDC Director Warns that the second wave of this contagion will be even more devastating and a new study shows that unproven drug president trump keeps hyping is linked to higher death rates. But first the big idea Schuyler. Herbert loved dressing up in performing. She adored going to kindergarten. She started reading at the age of four. Her Grandma Leona says she could take over a room about a month ago. Schuyler started to complain of headaches within days. She was hospitalized in the Detroit suburbs where she was diagnosed with Cova. Nineteen the disease caused by the corona virus. And then with a rare form of meningitis caused by Kovic nineteen. Her brain started swelling. She was placed on a ventilator and on Sunday. Despite the best efforts of doctors as her family watched the five year old became the first child in Michigan to die of the corona virus and one of a handful of pediatric deaths. In America scholars. Death stands as a heartbreaking exception in a pandemic that has largely spared kids even as it ravages older populations and people with underlying medical conditions. Schuyler was both young and had no pre existing conditions her death serves as a reminder that this virus can present peril to people at any age as of this morning about forty five thousand of our fellow. Americans have been killed by this invisible enemy. We have eight hundred. Thirteen thousand confirmed cases. Nationwide in Michigan about one percent of their thirty. Three thousand cases have been in patients younger than twenty the average age of Corona Virus Patients. Who die in that state is seventy four but losing little ones is obviously especially tragic. I wish you could see scholars picture right now. I've had it open on my computer monitor all morning. She was really an adorable little girl. She lived with her mother. Lavanderia A DETROIT. Police officer for twenty five years and her father at a city firefighter for eighteen years. They lived in a working class neighborhood. With one of the highest rates of the current virus scholars. Story disproves the myth. That children are safe. The family has agreed that the hospital can use Schuyler tissue to research cove in nineteen over the course of this pandemic Boston. Children's Hospital has admitted twenty five kids with Corona virus. Mount Sinai Children's Hospital in New York City is admitted about twenty kids with Cova Children's National Hospital here in DC reported a steady increase in cases of minors as did children's Hospital of Philadelphia at Seattle Children's Hospital. One percent of kids who have been tested have the virus. The good news is that most children who test positive appear to experience severe symptoms at far lower rates than adult. Most of the kids who have gotten sick enough to require inpatient treatment have underlying conditions at the Philly Children's Hospital for example. A doctor we talked with said about twenty five percent of their patients who've tested positive. Have Asthma already. Some have been cancer. Patients couple had diabetes and two were transplant recipients. Well Schuyler did not suffer from underlying conditions. She did fall into other categories that put her at higher risk of contracting the virus. She was African American and CDC data shows that black patients account for a third of reported cases. Even though they comprise only thirteen percent of the total population scholars. Parents have jobs that forced them to continue working outside the home when others were staying in now Eddie and Lavanderia are trying to figure out how to have a funeral for such a vibrant girl during such a dark time and they haven't come up with an answer but they both say they want the world to know. Scholars is life and death. Serve as a message to take cove in nineteen seriously as Eddy. Put it quote. This could have been your kids. And that's the big idea. Here are three other headlines that should be on your radar number one health officials in California disclosed overnight that at least two people who died in early in mid February had contracted the corona virus signaling that it may have spread and claimed lives on American soil weeks earlier than previously known tissue samples taken during autopsies of two individuals who died at their homes in Santa Clara County. California tested positive for the virus. Santa Clara County is where San Jose is in the bay area. The victims died on February sixteenth and February seventeenth. Initially the nation's earliest known coronavirus fatality was believed to have occurred on February. Twenty ninth in Kirkland Washington a suburb of Seattle in March health officials. They're linked to February twenty six deaths to cove at one thousand nine but these new Santa Clara County. Fatalities push the earliest fatality back. Quite a bit altering the whole timeline of our outbreak. It's not yet known exactly how the two people became infected. But Sarah Cody. The county's public health officer told us that the cases are believed to be community transmissions. They don't think that these people had any travel history outside that area but they're still trying to confirm that's the case. The connection between the February deaths and corona virus didn't become apparent until now April due to strict limitations that were placed on testing at the time of their death. Both of the Santa Clara County deaths occurred as the CDC had tightly restricted tests. To only those who had displayed respiratory symptoms and who had recently traveled to China or had close contact with someone who was infected cody says local officials had to call the CDC and discuss the specifics of individual cases before they could even get permission to conduct a test number two even estates move ahead with plans to reopen their economies. The director of the CDC warns in a wide ranging interview with the Washington. Post that the inevitable. Second wave of the corona virus will be far more dire because it is likely to coincide with the start of flu season. Robert Redfield explained that. We're going to have a flu epidemic and the corona virus epidemic. At the same time he said that having two simultaneous respiratory outbreaks will potentially put unimaginable strain on the healthcare system. He says federal and state officials need to use the coming months to urgently prepare for what lies ahead. Stay at home. Orders are lifted. He said officials need to stress. The continued importance of social distancing. They also need to massively scale up their ability to identify the infected through testing and defined. Everyone they interact with through contact. Tracing doing so prevents new cases from becoming larger outbreaks asked about the appropriateness of protests against home orders and calls for states to be liberated from restrictions a term that trump is embraced. Redfield answered quote. It's not helpful. South Carolina Georgia Texas Tennessee and Florida have announced a limited easing of business and recreational closures and social gatherings starting between this week and the end of April which is next week while some of those states have shown a fall and confirmed cases on recent days others have seen increased numbers on other days. None of the states easing restrictions have charted the sustained fourteen day downward trajectory that is outlined in federal guidelines. The ones issued last week trump. Speaking last night's White House briefing said the guidelines work. Mandatory seats can do whatever they want. He said. In addition to a sustained reduction and confirmed cases the federal guidelines also said that hospitals need to be able to all patients without crisis care and have a robust testing system in place before moving to what the guidelines call phase one reopening. It does not appear that any of the states relaxing restrictions have met these thresholds six Republican governors across the southeast have formed their own coalition to discuss reopening the economy the way that governors in the northeast and on the West. Coast did last week. Florida Georgia South Carolina Tennessee Alabama and Mississippi are part of it. These six states have collectively tested one tenth of one percent of their total populations. Meanwhile there continues to be dysfunction at the highest levels of the Federal Government Rick. Bright one of the nation's leading vaccine development experts has been ousted as the head of the Biomedical Advanced Research and Development Authority. A non-political post after clashing with his boss. A trump appointee the assistant secretary of Health and human services bright has been demoted to a narrower role at NIH. And we're learning that there has been a potentially major cybersecurity breach. Nearly twenty five thousand email addresses and passwords allegedly from the NIH the CDC the World Health Organization the Gates Foundation the World Bank and other institutions. That are battling. The pandemic were dumped online by unknown actors site. Intelligence Group says the information was released Sunday and Monday and then almost immediately used to foment attempts at hacking and harassment by far right extremists the lists appear to have been I posted on four Chan a message board notorious for its hateful and extreme political commentary and later Pastebin text storage site and then to twitter and then too far right extremist channels on telegram a messaging APP the largest group of alleged emails and passwords from the NIH with about ten thousand the CDC had the second highest number with sixty nine hundred user names and passwords. The World Bank had five thousand in there were about twenty seven hundred World Bank loggins an Australian cybersecurity expert Robert Potter says he was able to verify that the WHO email addresses and passwords are real. He says the password security is appalling. Forty eight people at the W. H. O. Have Password as their password. He said he also said that others used their own first names or change me as their password. Potter said the alleged addresses and passwords may have been purchased from vendors on the so called dark web number three the anti malarial drug that trump has aggressively promoted to treat cove in one thousand nine hundred head no benefit whatsoever and was linked to higher rates of death for veterans affairs patients hospitalized with the corona virus according to a new government. Study the study by. Va Doctors and academic researchers analyzed outcomes of three hundred sixty eight male patients nationwide with ninety seven receiving hydroxy chloroquine one hundred thirteen receiving it in combination with the antibiotic as he threw. Mason and one hundred fifty eight not receiving any rates of death in the groups treated with the drugs. Were worse than those who did not receive the drugs. Rates of patients on ventilators were roughly equal with no benefit demonstrated by the drugs a panel of experts from the National Institute of Allergy and Infectious Diseases. That's the agency led by Tony. Faucher part of the NIH formally recommended against the use of the drug combination being touted by trump because of its potential toxicities. The president claimed during last night's news conference that he was unfamiliar with the research. It was hard today to find a silver lining to finish with if I'm being honest but I tracked one down in Canada. High School. Kids in Calgary came up with a way to help lonely senior citizens who have been isolated by the contagion. They call it the joy for all project by dialing one eight seven seven joy for the number four. All callers can hear prerecorded continuously updated messages tailored for the elderly. Who were all alone? People Needing Company can dial the number and here messages of encouragement. And that's the daily to two for Wednesday April twenty second. Thanks for listening James Long. Stay safe we'll talk to you tomorrow.
Scientists Fear The Trump Administration Is Putting Politics Before Public Health
"The number was wrong. But on Sunday thank you very much. The trump administration was fixated on it. I just want to emphasize this point because I don't want you to gloss over this this number that's health and Human Services Secretary Alex as are we dream in drug development of something like a thirty five percent mortality reduction then there was the FDA Commissioner Steven Hahn thirty five percents improvement in survival is a pretty substantial clinical benefit, and of course, the president it is proven to reduce mortality by thirty five percent. It's a tremendous number. They were talking about a treatment for Covid nineteen that uses something called convalescent plasma. This plasma is taken from the blood of people who have had the virus and survived and the FDA just approved it for emergency use. But. Turns out the trump administration officials were wildly overstating the benefit of convalescent plasma. That number they used thirty five percent. Came from Israel eating data in one study that has not yet been peer reviewed. The actual number of mortality reduction is between three and five percentage points. Stephen I want to thank you because you have to really stepped up and especially over the last. Few days and getting done coming up from plasma to testing to a seen. More than at any point in this pandemic scientists are afraid that politics are driving public health decisions. Says considered this from NPR. I'm Kelly mcevers. It is Friday August twenty eighth. Support for NPR and the following message come from USA facts, dragging the spread and impact of Covid nineteen within case maps and charts, economic stats and more. See the data at USA facts dot Org. Okay. So just a little more on this convalescent plasma thing. The trump administration appeared to have grossly exaggerated the findings of that study we talked about. As the Washington Post put it the administration mixed up a couple statistical concept's absolute risk reduction and relative risk reduction. In that study, patients did benefit from plasma when the plasma had high levels of antibodies. When people were given the plasma within three days of diagnosis and when they were not on a ventilator. And when they were under the age of eighty. So I I'd like to say is that I personally could have done a better job and should have done a better job at that press conference explaining what the data show regarding convalescent plasma Tuesday two days after that first press conference FDA. Commissioner Steven Hahn was on. CBS News backtracking. Butts. Still insisting the decision to announce the treatment was not political. Even though a day before the announcement president trump had tweeted that when it came to therapeutic treatments for the virus quote, the deep state or whoever over at the FDA is quote making it very difficult. I can assure the American people that this decision was made based upon sound science and data. We shown or here's the thing to remember. Plasma might actually help some people. Experts? Say It isn't dangerous to try it. And they encourage covid nineteen survivors to donate plasma if they can. But it's just the game changer it was made out to be yet. We should also say on Friday the day were recording this. The FDA fired its top spokesperson. The job only eleven days. And ended the contract, the public relations consultant who had worked with Han. Now. You have heard this many times. The president saying this totally unprepared thing that more testing equals more cases of corona virus. And as we have said many times, that's just not how it works. There are states for cases have fallen even as testing rates have gone up. Still. This week something happened at the CDC has a lot of public health officials worried that fewer people will get tested. And that the decision is based on politics not science. Here's what happened before Monday the official guidance from the CDC was this. Testing is recommended for anyone who has been in close contact with someone who has the virus quote because of the potential for a symptomatic and pre-symptomatic. Transmission. This week that language was removed and replaced with new language. Now. Even if you have been in close contact with an infected person, the CDC says, if you don't have symptoms quote, you do not necessarily need a test unless you are a vulnerable individual or your healthcare provider or state or local public health officials. Recommend you take one. NPR's Richard Harris reports on how this change at the CDC happened how the administration is explaining it and what public health officials think about it. There was no press release or announcement, but instead on Monday, the Centers for Disease Control and Prevention quietly updated the website that provides guidance for Kuroda testing. The guideline said people who had been exposed to someone with grow virus should get tested the new guidelines leave that call to people's doctors and state and local public health officials. Led to widespread speculation at the guidance is intended to reduce testing Admiral Brett your Wa from the White House Corona Virus Task Force told reporters that was not the intent. We don't expect that the volume a cast will be reduced, and in fact, we do believe with them upcoming program that the number of tests will go up significantly over the next couple of months. Acknowledged that the guidelines were reviewed and edited in Washington and not simply a CDC product he said the intent is to shift testing. So it's driven more by public health officials around the country unless by individuals who WANNA test, because they're worried but not sick, and in fact, the goal is to make this more strategic and intelligent putting more power and authority in the hands of the public health officials. That's clearly the intended I. think it's explicit within the guy. But springing this as a surprise on public health officials has happened here is a poor way to accomplish that says Dr Georges Benjamin at the American public health. Association nobody knows what they mean and they did that share. This as far as I know with anybody beforehand, and so I think my good friend discussing it a little bit Benjamin agrees that there's a lot of room for improvement in who gets tested and under what circumstances. But he says this new directive doesn't help at the end of the day just undermines the credibility CDC because now you've got everybody pointing fingers at one another and at the truth of the matter is if you want to make sure that the right people get tested with the right test at the right time, then you need national testing strategy that can very thoughtful that science based that is in print and that everybody understands and they've not done that yet. Another big name Dr Anthony Fauci is. Unhappy with the new guidelines, the most prominent member of the coronavirus task force was in surgery when the guidelines were finalized and he told CNN, he was worried that they send the wrong message. NPR's Richard Harris. So. If you look at the number of cases. Right now the US is basically right in between the low numbers of late May early June around twenty thousand cases a day and the high numbers of late July seventy thousand cases a day. And the number of people who are dying is following a similar trend. Not, as bad as it once was, but that's about it. For nearly the entire month of August. Thousand people have died on average. Every day. So. Then the answer to the question of how this ends. Is Pretty much the same it ever was. Without tighter restrictions, this virus will not go away until we have a vaccine. And now some public health experts are afraid. The trump administration might cut corners to develop a vaccine to give him an advantage in the election. NPR science correspondent Joe Palca talked about that with my colleague, Ari Shapiro Hijo Hi Ari the administration says it wants to cut through red tape to speed up the approval process. So much red tape is there well, the job of proving vaccine falls to the Food and Drug Administration, and yes, there is some red tape but but the whole reason the FDA exists is to protect the American people from unsafe and ineffective products. So at a minimum FDA, wants to see any vaccine tested in thousands of people and that any relative side effects will be found and if the vaccine is and they want to know if the vaccine is actually preventing disease that the vaccine. Doesn't have to prevent one hundred percent of disease to get a green light just fifty percent would be sufficient. How soon can those tests be completed? Well, large studies are underway now involving tens of thousands of people, but you can only speed up these trials so much for example, some of the vaccines required to doses a month apart and you can't shorten a month into two weeks he doesn't work. So now there's a separate outside group called the data safety and Monitoring Board keeping an eye on things and they see the data from the study as it comes in Paul offered as a vaccine developer children's Hospital of Philadelphia he's expressed concerns that the trump administration could. Say a vaccine is successful before the data show that but he trusts this outside board will make sure there are no dangerous side effects from the vaccine. If they see strong clear statistically robust evidence that a vaccine is effective in the field trout could even be stopped early for that reason. Great I'm all for it. So let's imagine they do see this. What happens then well, normally that would allow the manufacturer to come to. The FDA. Say Look. We have a working vaccine at that point. The FDA could agree and issue something called an emergency use authorization or anyway. But things get a little murky here because the FDA doesn't have to show the data it's using to make its decision. But in this case, the FDA Commissioner Steven Hahn has promised that the agency would share the data. This is what he wrote in an editorial in the Medical Journal. Jama. Transparent discussion at FDA's vaccines and Related Biological Products Advisory Committee will be needed prior to vaccine authorization or licensor to ensure clear public understanding of the evidence supporting vaccine safety and efficacy. Okay. So if there is that transparency and everybody gets to see the evidence does that mean everyone will be convinced? No. No because there's always differences of opinion, it's rarely clear that something is absolutely working. You're absolutely not working but office says the worst thing would be to authorize the use of an ineffective vaccine to try to stop the pandemic don't screw this up. This vaccine is our best way out of it at this point and to shake the American confidence further with either unsafe or ineffective vaccine would be. Dr Off at who talked to NPR's Joe Palca who was talking to my colleague or Shapiro. Additional. In this episode, from our friends at all things considered for more news, download the NPR ONE APP or listen to your local public radio station supporting that station makes this podcast possible. The show was produced by Brianna. Scotland. Hail Brit Bachman, it was edited by Sami Hannigan and Beth Donovan. Our executive producer is Cara Tallow. And this week, we are saying goodbye to a really important member of our team and Lee who been helping, produce, and fact check the show since we first started back in. March. She's now back at her old job with the NPR one team and we just WANNA. Say Thank you. You made every episode better. We're back with more next week. I'm Kelly mcevers. Good question that's a really good question. Question is free therapy. Thank you for asking me that God that's such. A good question that's an interesting question. But what fresh air interviews are really about are the interesting answers listen and subscribe to fresh air from whyy and NPR.
June 19, 2020: Americans celebrate Juneteenth as the nation continues to grapple with systemic racism
"Hiring is challenging, but there's one place you can go. We're hiring is simple and smart. That place is ziprecruiter where growing businesses connect to qualified candidates. Try It for free at Ziprecruiter Dot. com slash five things ziprecruiter the smartest way to hire. Good Morning I'm Taylor Wilson and this is five things you need to know Friday. The nineteenth of June twenty twenty here or some of the top headlines Oklahoma Governor Kevin stood, insists that a rally in Tulsa on Saturday, for President Donald Trump will be safe and abandoned bus in rural Alaska made famous by the Book and movie into the Wild, was removed by helicopter and a new survey shows that Joe Biden leads president trump by eleven percentage points among registered voters a reminder. We have an upcoming project summer that you could be a part of USA Today is teaming. Teaming up with Corona diaries to hear your stories. We want to know what this summer will be like amid the pandemic. Especially, if you're carrying for loved, wants to tell us your story, go to corona diaries dot co slash, USA Today, there you can follow directions to leave a brief audio message, and to make sure we review your submission. Be sure to also tweet us at USA Today podcast. Your thoughts on navigating this summer may be featured in USA Today stories, and right here on the pod. That's corona diary dot I, O, slash. USA Today now onto the show. Friday marks June eighteenth Americans around. The country will celebrate the day commemorating the end of slavery in the US June nineteenth, specifically references the date when enslaved people in Galveston Texas found out from Union troops that the civil war was over, and they had been freed this year. Celebration of freedom comes as the country grapples with a long history and present of systemic racism. As George Washington University's Jesse Halloween told the Associated Press Black lives matter. And the protests around the death of George has brought racial equality to the forefront of the conversation in the United States. A lot of people are turning to June team as a symbol as a way, they can celebrate and honor the sacrifices that African Americans have made in the United States, and around the world there has been an effort to try to make June t, the federal holiday and or a state holiday for decades, but now major companies like Google major universities like Georgetown. Georgetown? University are making June teeth a holiday. So this is why more and more people are talking about it, because frankly a lot of people didn't know and exists and USA Today Editor Vinci Core. She spoke with Clare Thornton about why covering. June tenth in-depth is so important this June eighteenth. It's about freedom. It's a celebration normally, but this year I just wondered. What does it mean as a black person to celebrate Freedom Day One? We're not really feeling that free. Even freedom isn't necessarily as simple as you think it is all like any, and all sorts of progress in this country have taken so much struggle so much fighting so much black death I mean. You can't really understand this present time without looking at our history and how we got to this moment. If you don't talk about the atrocities committed on black people, then you don't have to deal with it in the President I. think that's part of the reason why we have our sixteen nineteen package and we have our teeth package and we have our Tamir rice package. It's a way of saying no this history it matters, and it's worthy of being revisited and taught and learned. This isn't. Forgotten history. This it's a part of American history. You can listen to part of USA Today's Sixteen Nineteen Project on this Sunday's episode of five things, the project, which was originally published last year. Tell stories about the origins of American slavery. You can also search sixteen thousand nine stories on USA Today Dot Com and hear more of McGinty's conversation with Claire Thornton on Sunday meanwhile protests continue surrounding police, brutality and how it relates. RELATES TO SYSTEMIC RACISM IN ATLANTA FUNERAL arrangements have been set for next week for Ray. Short Brooks who was shot and killed by police last week. Former officer Garrett. Rolf is behind bars, facing felony murder and other charges. A second officer Devon Brosnan was charged with aggravated assaults and other lesser counts, but has been released on bond. It's not clear if he will testify against Rolf Fulton County. District Attorney Paul Howard. Howard said that Brosnan would be a witness something. His lawyers refute it and legal experts say that it's rare for an officer to break the so-called blue, wall of silence and testify some officers in Atlanta did not show up for work on Thursday to protest charges interim police chief Rodney Bryant. The officers are some angry, some fearful. Some confused on what we do in this space. Some may feel a bit abandoned. Abandoned, but we are there to assure them that we will continue to move forward and get through this elsewhere. Activists are putting pressure on a forties to arrest officers in the death of Brianna Taylor in Louisville Taylor was shot and killed on March thirteenth when officers burst into her apartment with a no knock warrant. Her Boyfriend Kenneth Walker shot at them, thinking they were intruders and Taylor was caught in the gunfire. The Supreme Court continued a busy week on Thursday by blocking the trump administration from ending the popular Obama Presidencies daca program the policy allows some six hundred fifty thousand young undocumented immigrants to live and work in the US. Without fear of deportation chief justice. John Roberts wrote the majority opinion going the Department of Homeland Security's action or betrayals and capricious and therefore unlawful. The court was heavily divided five to four on the decision with the four more liberal justices, agreeing and the four more conservatives dissenting for his part. Part President. Donald Trump took to twitter writing quote, these horrible and politically charged decisions coming out of the Supreme Court or Shotgun blasts into the face of people that are proud to call themselves Republicans or conservatives on quote. He also used the opportunity to tell his twitter followers vote trump twenty twenty to force changes to the Supreme Court. Democratic leaders were ecstatic about the move like Senate Minority Leader Chuck Schumer I cried tears of joy a few minutes ago, when I heard the decision of the Supreme Court. On DACA! These wonderful Daca kids and their families have the huge burden lifted off their shoulders. They don't have to worry about being deported. They can do their jobs and I believe I. do believe this someday someday soon they will be American citizens as for the individuals that the decision affects directly, there's a mass feeling of relief as Phoenix's Denise Alvarez said on Thursday. This morning's decision has given me some sort of relief. Eh means that for now I'll still be able to one day. Have my own classroom itself units where I built a home in the community that welcomes my family and is sixteen years ago. The community from which I have learned so much from and hold to give back to through education. For now. Oh, be able to look forward to my graduation in the spring. Go Twenty, twenty one and still be able to my Gaca. In. Before the Decision Pedro via Lobos. DACA recipient in. Texas who's now. A prosecutor told you say today that even with Daca life is lived in two year increments. We live in increments so for me, personally like windows, my next daca permanent. What is my work permit expire? That's Kinda how I see things, and then like a new one I based off of that date so. For Doc recepients at least for me. I view it as two year increments. Thursday's decision follows a landmark decision earlier this week from the Supreme Court. Saying that gay and transgender workers are protected by a civil rights law against discrimination. Florida has shattered its daily record for new corona virus cases with three, thousand, two hundred seven on Thursday alone that number broke another record set just two days earlier, but Governor Rhonda. Santa's said earlier in the week that he had no plans to pull back on reopening efforts, he also attributed a bump in cases to increase testing, but a disease model from scientists at the Children's Hospital of Philadelphia and the University of Pennsylvania found that the sunshine state has. Next big epicenter, meanwhile reopenings continue around the country despite ten states with record numbers of covid nineteen cases this week, cinemark, the third largest movie theater chain in the country, will begin a phase reopening plan on Friday with a handful of theaters in Texas opening up. The company will eventually open all five hundred fifty five locations by July seventeenth, if all goes according to plan, but will not require patrons to wear masks, though it says it will. Will encourage it AMC. The world's largest theater chain also won't require mask use when it begins opening next month. The company's CEO said it didn't want to be drawn into a political controversy, a comment that stirred its own controversy online. There have now been more than eight point. Five million confirmed cases of Corona virus in the US and more than one hundred eighteen thousand debts part of more than four hundred fifty four thousand deaths around the world. The White, house fight with former national security adviser. John Bolton enters the US District Court on Friday, in a case that'll likely to find future cases between the government and former employees looking to write tell all books. The government asked a federal court for a temporary restraining order to prevent the books release saying that it contains classified material. Bolton's lawyer says that He. He received verbal clearance from a national. Security Council expert after working with the White House for months to edit, rewrite or remove sensitive information, but he never received a formal clearance letter and the trump administration says the book still contains sensitive information staffers inside the administration are Furious White House Trade Policy Adviser Peter, Navarro even cold. Bolton's Book Revenge Porn I knew John. John Bruton pretty well after he got in here and my take on him. It's that big lied Bolton. It's book deal. Boatman keeps doing it for the money. That's pretty clear, and and my view is. It's it's The Washington swamps equivalent of revenge porn. He got fired because he did not obey the chain of command because his views were totally out of sync. Sync with President Donald J. Trump with respect to how how to handle international affairs, and he's basically breaking all manner of tradition in terms of issuing a book at this stage and he's at. He's GonNa make a bunch of money. The five hundred seventy seven page book set for release on Tuesday is already sitting in warehouses and media. Outlets have obtained advance copies. Tickets will go on sale Friday for new summer routes on Jetblue, the airline is ramping up service once again. After grounding huge numbers of its fleet during the coronavirus pandemic, the company will add thirty new routes between July and October, and will restore nine routes that were temporarily paused like most airlines jet blue requires passengers to wear masks, and the company will continue to block off seats. Seats through the fourth of July, thanks for listening to five things a reminder you can subscribe for free and rate and review on Apple podcasts. You can also listen to US wherever you find your audio. Thanks as always declare Thornton, for her work on the show and reminder, she's now hosting a special edition. Every Sunday right here on this feed five things is part of the USA. USA Today podcast network. Five things is brought to you by Ziprecruiter I'm sure you're all well aware that it's an election year time again for us to hire a US president. It's a real challenge to determine WHO's most qualified. 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Models suggest a looming second wave of coronavirus in the South
"Good morning. I'm James Hellman from the Washington Post. This is the daily two. Oh Two for Thursday makes me I in today's News Tony Fao. She worries that operation. Warp speed is playing into the hands of the ANTIBAC- sers. President trump considers a travel ban on Brazil as Sao Paulo gets pummel and michiganders reckon with racial disparities flooding and threats of defunding. But first the BIG IDEA. A research team that uses cell phone data to track social mobility and forecast. The trajectory of this contagion is warning that Dallas Houston southeast Florida's Gold Coast the entire state of Alabama and several other places in the south that have been rapidly reopening. Their economies are in danger of a second wave of infections over the next four weeks. This new modeling developed by the Policy Live at Children's Hospital of Philadelphia suggests that most communities in the United States should be able to avoid a second spike in the near term. If residents are careful to maintain social distancing as businesses open up and restrictions or east but. The risk for resurgence is high in certain parts of the country especially in places where cases are already rising fast including the counties of Crawford Iowa Colfax Nebraska and Texas Oklahoma. Yes it's confusing. But there's a county called Texas in the state of Oklahoma. The city of Richmond. Virginia is another cause for concern. At least ninety two thousand one hundred and fifty eight Americans have died. From the corona virus as of this morning an ensemble model that incorporates twenty different leading pandemic models developed by the Bio Status Titian. Nicolas Rush at the University of Massachusetts in Amherst shows a gradual decline in projected covid nineteen deaths over the next four weeks from about nine thousand this week to four thousand in the second week of June but he emphasizes that this is a particularly difficult phase of the pandemic to capture in modeling because of uncertainty about how people will behave restrictions were lifted. Indeed this is an anxious moment. For our nation. As people emerge from shutdowns and communities tried to reinvigorate economic activity scientists and public health experts are monitoring rates of infections hospitalizations. But it's so difficult to forecast during this transitional period because the models can't capture how people adhere to social distancing stinks six feet apart and how often they're washing their hands? And how long are doing it? There are preliminary signs however that hot spots could soon flare up in the south in the Midwest in Texas. There has been an outbreak in El Paso in meat packing plants. In the panhandle specifically Amarillo the rate of positives in Corona virus tests is gone down as the number of tests is increased. Good sign and hospitalization rates are holding steady Republican governor. Greg Abbott has sent surge response teams to places where they're seeing spikes and infections but the number of daily cases is still rising in parts of Lonestar state particularly Dallas and Fort Worth those two cities in north Texas had their highest single day death toll yesterday and researchers at the University of Texas Southwestern Medical Center say that cases in the DFW area could spike this summer with a tripling of daily active cases. If there's a significant easing of mitigation efforts now a presentation prepared by the Department of Health and Human Services and the Federal Emergency Management Agency which was reviewed by my post colleagues suggests that new waves could be steep enough in some places especially in the south to overwhelm ventilator capacity for instance this internal government data indicates that only eight hundred sixty. Six ventilators are in use right now in Georgia which is pursued one of the most aggressive reopening plans but Georgia's supply of two thousand eight hundred and fifty. Three ventilators could be outstripped as soon as the end of. May this is again. According to the Federal Modeling States from Arizona Colorado Tennessee could face similar shortages according to these federal projections which have not been released to the American people. The most alarming reports overnight or coming from Alabama Alabama will probably experience a steep increase in cases in nearly every county over the next month. According to that policy lab model the state began easing it stay at home order and other restrictions earlier this month Republican governor. Kay Ivey has allowed restaurants bars retail businesses. Churches gyms and salons to reopen. Montgomery Mayor Steven Reid said last night that his city is facing a shortage of intensive care beds and now being forced to divert patients to Birmingham by ambulance Birmingham. One hundred mile trip mayor. Reed says he's at a capacity that is just not sustainable. Adding a news conference quote. Our healthcare system is maxed out now. Experts say some communities seem to be abiding much better by social distancing guidelines than others. And I WANNA give them a shout. The data show that Denver Colorado Springs Columbus Ohio and the Research Triangle of North Carolina are looking good in the new forecast. And that's the big idea. Here are three other headlines that should be on your radar number one president. Trump's promise of a warp speed cure to this virus is fueling the Anti Vaccine Movement some of the same online activists who have clamored to resume economic activity echoing. Trump's called the liberate their states from sweeping restrictions are now getting themselves with a cause on the political fringe preemptively forswearing a vaccine to further their baseless claims about the dangers of vaccines and to portray the scientific process as reckless. They've seized on the brisk pace promised for the project which the trump administration branded operation warp speed both movements represent the views of a small minority of Americans but leading medical experts. Fear that the ability of their adherence to spread misinformation especially online and social media could plant seeds of confusion and distrust in the broader public and thereby undermine future efforts to distribute vaccine that would save lives. Tony Vilocci the director of the National Institute of Allergy and Infectious Diseases says that he's grown increasingly. Worried that the name of the White House initiative has led to misconceptions about what exactly is being put at risk by speeding up the effort only financial investments not safety or efficacy FAO. She said that when people hear Operation Warp Speed. They think quote. Oh my God. They're jumping over all these steps and they're going to put us at risk but FAO. She vowed in an interview with my colleague is extremely Becker that no steps will be eliminated rather multiple steps from collecting data to preparing to scale up. The number of potential doses will be pursued simultaneously creating risk the investment. But not for the patient or the integrity of the study number two South Paulo. The largest city in the western hemisphere is emerging as the pandemics latest. Global Hotspot confirmed cases in that city of soared. Thirty four percent and at least five hundred ten people have died in the past week as the public health infrastructure buckles and Brazilian President J Bolsonaro continues to shrug off the crisis across Brazil. More than one thousand people died yesterday. Alone of the coronavirus now ranks third worldwide with two hundred fifty five thousand confirmed cases trailing only the United States and Russia trump who maintains friendly ties with Bolsonaro. A fellow populist said yesterday that he is considering banning all travel from that country in other South American news. Bolivia's health minister was arrested last night. As part of a corruption probe following an investigation of overpriced ventilators Marcelo. Nevada's was detained in connection with an investigation into a four point. Two million dollar contract to buy ventilators that were valued at about a quarter of that price number. Three trump is scheduled to visit eight Ford Plant today. In epsilon t Michigan which is in Washington now county where there have been one thousand two hundred sixty one confirmed cases in ninety deaths from the contagion the situation there highlights the racial disparities that this viruses laid bare black residents make up twelve percent of the county's population but thirty four percent of the confirmed cases. Michigan is dealing with cataclysms on multiple fronts. Yesterday the state passed a grim milestone telling more than five thousand coronavirus deaths though protesters who oppose the state's lockdown rules continue rallying in lansing cutting hair on the Capitol Lawn to protest the restrictions on barbershops yesterday. Few michiganders are eager to reopen until this virus is contained. Instead a lot of local leaders are looking inward examining the cruel realities the faultlines that have led the lopsided death toll epsilon t mayor Beth. Bashar has been frank chocking the disparity up to quote environmental systemic and Economic Racism. Meanwhile president trump threatened to block federal funding from going to Michigan. Yesterday the state has announced plans to increase voting by mail to reduce the public's exposure to the virus in November without evidence trump called the state's plan illegal and he incorrectly claimed that Michigan's quote Rogue Secretary of State is planning to mail ballots. All voters in fact the state is planning to send applications for male unbalanced not ballots themselves. But the president's aggressive and unfounded rhetoric drew immediate rebukes from Democrats in voting rights activists who accused trump of intentionally sowing mistrust in the US election process and his claims. That absentee voting will encourage. Cheating are also at odds with the activities of GOP leaders who are mounting field operations including mass mailings of ballot applications to encourage their voters to cast ballots by mail and yesterday afternoon. Michigan's Governor Gretchen. Whitmer Democrat announced that her state will pursue legal recourse over the dam that broke in the central Michigan City of Midland as ten thousand residents evacuated. Their homes the local river reached a level more than a foot higher than the previous record. The state says the disaster is the result of historic rainfall but also deferred maintenance at the Eden Ville Dam which is owned by an LLC. The news is just so rough flooding the virus locusts murder Hornets can almost feel biblical so yesterday afternoon is I was driving home. Kool and the gang's celebration came on my car radio and I'll tell you the upbeat sound was jarring at first. I assumed it must be some kind of trolling. What on earth is there to celebrate. Then it occurred to me that all of us who are healthy employed free have so many blessings to celebrate in this dark period of death despair and democracy in decline if the past is any guide babies being born in America today will have brighter futures and better standards of living than their parents students graduating albeit virtually limitless possibilities ahead of them. And maybe just maybe a scientist in a lab somewhere just had a lightbulb moment. That will eventually help her. Save lives thinking about the innovators. The dreamers and the youths who haven't yet grown cynical from experiencing the vagaries at this brutish world made me realize that actually are many reasons to celebrate light. She'll shine out of darkness. Tomorrow will be better than yesterday. So I turned up the volume and saying along and that's the daily to for Thursday may twenty first. Thanks for listening. I'm James Attack to you on.