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Transcript of JoCo on the Go podcast 11/17/2020

Theresa Freed 0:00

This episode hear from Johnson County public health officials on COVID-19 in our community. Find out why it's more important than ever to follow safety precautions. Learn how some holiday gatherings could put you and your loved ones at risk. Get ideas on safer ways to celebrate. And if you have to travel, learn steps you can take to reduce the spread of the virus. Finally get the latest on hospital capacity and what it means for you.

Announcer 0:24

Whether you live in or just love Johnson County, Kansas JoCo on the Go has everything Johnson County. Here's what's happening and what's coming up in the community you call home.

Theresa Freed 0:38

Thanks for joining us for JoCo on the Go, I'm your host, Theresa Freed, a Johnson County resident and employee of Johnson County government. We're rapidly approaching Thanksgiving and many people are on the fence. Do I go to a gathering with extended family or friends or do I stay home this year with my immediate family? COVID-19 transmission is high right now. So today we're going to talk about the risks of gathering and holiday travel. We have with us Johnson County Department of Health and Environment Director Dr. Sanmi Areola and Director of Epidemiology. Elizabeth Holzschuh, thank you both for being here today. Just to start off with, what is the current situation with COVID-19 transmission in Johnson County?

Dr. Sanmi Areola 1:18

The level of spread, and the rate of increase, whether we look at it daily, or weekly, or biweekly, is very high. It is the highest that it's ever been. And so the risk, of course, then is as high as it's ever been. Of all the different measures that we use, absolute counts, weekly counts, biweekly counts, daily counts, positivity rate and several other metrics, are not only trending up, they are increasing exponentially. And so the message to the public to our residents is that the risk is pretty high, you should assume that everybody that you come in contact with is, is infected. And the chances are that they are. Elizabeth will very soon provide some numbers in terms of what the risk is, if you are in a group of 10. versus if you are in a group of 15. Of course, the larger the group that you are in, the higher your risk. And that's why it's, it's important now more than at any time prior to now for you to be very careful. You keep your cycle very small, you're still within quote unquote, your bubble. That doesn't change even with Thanksgiving, as a matter of fact, it becomes even more important with Thanksgiving. And I know that these are traditions, things that we have been used to doing times that we spend with our families. But we do love our families, and we want them to be here next year and beyond. And so this the decisions that we make the sacrifice that we make this one time might just be why they're here next year. And it's so very, very important. I'll let Elizabeth throw some numbers out there so you can get a perspective of the level of risk that we have.

Elizabeth Holzschuh 3:32

And so, you know, as Dr. Areola said, the spread in Johnson County is just incredibly high right now, the way I sort of approach any interactions I have is just to assume that whoever I'm interacting with likely has COVID and that's not really all that far fetched right now based on how many people in our community have coronavirus infections currently, and Georgia Tech has this really great tool on their website. If you just want to Google Georgia Tech COVID map, you can pull it up. And what they do is they tell you based on your current level of transmission in your community by county, what's the likelihood that an individual in a group would have COVID-19. And so currently, according to the map, a group of 10 individuals gathering in Johnson County there's more than a one in four chance that somebody in that group has coronavirus infection currently, if that as you go up in group size, so up to 25 individuals that goes up to 37%. So more than one in three chance. And if you get together with say 50 individuals in Johnson County right now, you're really looking at a four and five chance almost 80% likelihood that somebody in that group of 50 has COVID-19

Theresa Freed 4:42

That really does give some some great perspective. You know, when you enter a restaurant or a business or you know, you're just going to an athletic event or something like that to look around and see just what the possibility is there that you could get sick. So of course some people show no symptoms at all, but there are others that face really serious. complications including death? Of course, we haven't talked for a while about who's in those high risk groups? Can you talk about that?

Dr. Sanmi Areola 5:09

So first of all the data in terms of the more serious consequences tend to occur in the older population, people that are older than 80, for the most part, but I will say that a majority of our cases are occurring in people that are younger than 70, which is about 90% of our cases, in people that are younger than 60, about 81% of our cases. It is occurring, and hospitalization, greater than 50% of that is occurring in people that are younger than 70. And so, so age, obviously, is a risk factor, but also other predisposing factors. Obesity is a big piece, and it is very good. We'll come in and give you some numbers about when you look at the percentage of our population that are older than 70. And you look at the percentage of our population that will be used or have other chronic conditions. And the percentage of our minority population who seems to be the biggest brunt of this, you will know that as a county, really, a large percentage of our population have either predisposed or at higher risk, because of age, at higher risk because of obesity and other chronic conditions at higher risk, because they are just persons of color. All of those makes it very important for us, not just to think about ourselves, but really underscores the responsibility that we have, as part of the society to take all the steps that are needed to ensure we contain the spread of this virus.

Elizabeth Holzschuh 6:54

Absolutely. So when we talk about really severe outcomes, particularly death in individuals who are under the age of 60. And really the predisposing factor that we see at the greatest rate are people who are obese are severely obese based on their BMI. And what we know from other data is that one in four Johnson County adults is classified as being obese. So this is not a minor, you know, issue here. And what we also can see too, is that we have really healthy people who end up being hospitalized sometimes for weeks or months. And there's something really unique about coronavirus that can cause the immune system to over respond. So even people who are exceptionally healthy who have great immune systems, sometimes we see really severe outcomes in them. And so I think from my perspective, what I constantly keep in my mind when I think about my own health and safety and that of my family, is that we really don't understand who when they contract coronavirus are going to have those really severe outcomes. It doesn't seem to discriminate. You know, some people get away with having really mild or even asymptomatic infections, and some people have this really severe illness. And it's not just what you experienced at the time you get infected, but we're hearing more and more about individuals that are so called long haulers, meaning that they have long lasting effects from coronavirus, whether that's neurological or GI or heart-related conditions, even months after they recover from COVID-19. And so while some people do get away with having a very mild illness, that's not the likelihood for everybody. And we just don't know who those people are, who are not going to be able to get it through an illness from this disease.

Theresa Freed 8:29

So just Next, we have high levels of transmission in the community. And I think the concern all along has been hospital capacity and being able to keep what keep up with the level of sickness in the community, not just from those who have COVID, but also others. And as we get further into the flu season, this concern grows. So where are we at with hospital capacity right now?

Dr. Sanmi Areola 9:05

I think in the past couple of weeks, we have heard quite a bit from a hospital CMOs and other executives. And they have been as clear as they possibly could be that they are at capacity. Some of them really have exceeded their capacity. And that's got to worry us as a community. Some of them are considering stopping elective procedures. Again, the messages have to be clear we want people to go to their doctors and seek and continue the care that they need. We want people to take their flu shots by, here's the thing, with flu for example some of the basic steps that we are taking to control and protect ourselves against COVID, also will work to protect us against flu. So there's an advantage to that. But your question was around our hospital capacity. And that is worrisome if hospitals get to a place where there are no beds to keep people who are sick, and we run out of space in our ICUs.. And the number of available ventilators are threatened even though we are managing these conditions better, that's got to be worrisome. Now, you will see data that really at this time of the year, it is not unusual for the hospitals to be at or near capacity. The difference though, is the contribution of COVID to this, and the number of their resources that COVID is, is taking. And you also have to consider that a lot of their their staff are affected too. So their staff test positive has to be in isolation. And staffing has been a big challenge, not just in hospitals, it is true for skilled nursing facilities or long term care facilities. Again, you have this level of spread in the community, it impacts everything. It is impacting our schools, and all of those things, if we don't take the steps that we need to control them, immediately, we are going to get overwhelmed, our students will be overwhelmed. And what that means is no, we're not just doing what's out there, what that means is if there are no space, in hospitals, means that I get sick and you get sick, then the hospital is making a decision of who is going to get treated, or who's not. To put it even more bluntly, you could get to a place where they're making a decision of who is going to die and who is going to live. And that's not a place we want to keep our hospitals at.

Elizabeth Holzschuh 11:53

And it's not just an impact of COVID to you know, what Dr. Areola is talking about about whether or not there's enough beds is also about car accidents, or some kind of other traumatic injury or a heart attack things that we have no control over. And there is really a limit as to the number of beds and the number of staff. And there's an article yesterday that quoted the Major General, I believe, of the Kansas National Guard who said he's not they're not entertaining the thought of field hospitals right now. Because the reality is, is there just aren't enough staff for those. And so we have a situation of limited resources. And it's not just in the Midwest, it's not just in Kansas City. It's really nationwide, where all of the hospitals throughout our country are really starting to see this burden. And we only have a limited supply of nurses and doctors and respiratory therapists and all of these individuals that are really, you know, cornerstones to be able to treat patients. And the other problem too with COVID is that individuals who are hospitalized with COVID tend to be there for a really long time. You know, with influenza, typically individuals who are hospitalized are only there for a few days. A lot of times we'll see people with COVID, hospitalized for weeks on end, sometimes months even because their health is so poor, and it takes a really long time to be able to get them to the point where they can be discharged to their home, or to a facility if there's even space in a facility for them. And what we know is that out of this number of cases that we're seeing in our community, a proportion of them will be hospitalized. We know that from the data. And we can't stop those individuals from being hospitalized at this point they're already infected and their disease course is already taking place. What we can do as a community is prevent future infections so that our hospitals don't become more overwhelmed. Because we normally see a lag of about 10 days to two weeks from an individual becoming ill with coronavirus and then subsequently having to be hospitalized. So we'll continue to see our case, our increase in the number of hospitalizations as we go forward over the next several weeks. And if people really aren't taking the precautions that we all need know we need to do when it comes to Thanksgiving, we're going to see even more cases, which means even more hospitalizations, and a greater impact on our hospital systems.

Theresa Freed 14:01

So we know of course, given all of those factors that the safest place you can be this Thanksgiving is going to be in your own home with the people you see every morning when you wake up the people you're living with. Are there any ways that people can gather safely to still be able to solve celebrate Thanksgiving this year.

Elizabeth Holzschuh 14:20

So I will say that we know that gathering outside is definitely safer than gathering inside. As of right now, the forecast for Thanksgiving Day is actually 66 degrees. So a really mild temperate Thanksgiving here in Kansas City. So if you are going to gather, I would strongly recommend that you do that outside and keeping distance and I think that a lot of times when we see family we let our guards down and we maybe hug or kiss or you know share food or anything like that. And what's important is that if you are going to gather with people do it outside, but you've really got to refrain from hugging your loved ones and from kissing them on the cheeks. And that's that's really hard to do. And so I think that if you are going together with Family keep that that circle small keep it those individuals that you've been seeing. Talk about what you all are doing to prevent infections ahead of time, are you quarantining? Are you really staying away from really any external exposure? So and haven't really in depth conversations? It's not just, we're going to quarantine. But what does that mean for each individual? Because their definition may vary, you know, are you going to grocery stores, are you going to food, you know, restaurants to pick up food or to eat in and having those conversations to make sure you're really being as safe as possible. Eat outside, and you know, and make sure that your seats are really six feet apart, we know transmission can happen outside, keep your masks on, as until you really start eating. And don't let your guard down. We all you know, we love our family and our friends. But unfortunately, the virus doesn't distinguish who our loved ones are. And because we have the potential to spread this disease before we have symptoms. Or even if we don't ever have symptoms, you can't look at your friend or family and say, nope, you're completely fine. I'm not going to get coronavirus from you. And so again, really having that attitude that everybody you come in contact with likely has COVID-19 right now can help if you keep that in your mind when you're around individuals that may help you keep that distance and keep your mask on and really do those things that we know can prevent infections. But you know, as I said, out of a group of 10 individuals in Johnson County, there's more than a one in four chance that somebody has COVID-19. You know, for me, personally, I'm going to choose not to see my family and loved ones on Thanksgiving. And because it's really just safer. And I know that I'm out in the community, I come to work every day, I have a child who's in daycare, which means that he's exposed or has the potential to be exposed every day. So really thinking about your family situation, your own exposures and the people that you're inviting into your circles, exposures. But truly the safest thing to do is really just gather with those that you live with at this time.

Dr. Sanmi Areola 16:53

And that's what we want to emphasize is that we our primary recommendation is to not change your cycle, because of, of Thanksgiving, there's opportunities for phone calls, and video conferencing. Look, we want our loved ones to be here, we want them to be healthy. You know, think about it, if you gather together with 10 people, that is 10 different cycles that you're bringing together that easily multiplies your risk by several fold. Because then so this is this is 10 people from 10 different cycles that you don't really know how broad or big their cycles are, you have no idea. And an even for people that are being very careful, we live this life 24 hours a day. But we also recognize that and it's happened, that our risk is higher because we are out here and people do test positive by the nature of what we do. It's very important for us to be to be careful now if you choose to do that. So it's not - outside is better, no question about that - masking when you are not eating or drinking, it's important. And physical distance is important. It's not either, or. It's doing all of these things together that would ultimately reduce your risk. There's a way to drink and still mask, you take a drink, you put put your mask back on. That's that's all you really need to do is get used to that. So the fact that you are drinking doesn't mean that you shouldn't use your mask you can drink and put your mask back on. And, and so keep those things in mind. I think of our own messages. This period we are concerned, our levels are already high. And and we think with people getting together over the Thanksgiving period will dramatically increase the numbers and increase the risk. But we can do something about it. I can play my part, you can play your part. And if we all do that, together, collectively we can reduce the risk to our residents and break this trajectory that we're currently on.

Theresa Freed 19:14

If people are contemplating traveling, is there a way to do that, at least safer to reduce the risk of spread?

Dr. Sanmi Areola 19:23

What so the safest way to travel right now for me would be to be in my private vehicle and absolutely reduce interactions with people. And, and again, there's a preference that we have in public health to not but we also understand that there are physical mental emotional impacts, you can't lock people up all the time. And so if you have for example, need to stop to use the restroom. There you got to be careful and keep your distance wear your mask That's important. But ultimately whatever your destination is, it is, it is very important for you to not enlarge your cycle inappropriately. Again, the broader your cycle is, the higher your risk is, the weather is going to be good like Elizabeth said, use your use the parks go for a walk and, and and talk to people over the phone use Zoom or whatever is available. And I think the, quote unquote inconvenience that we experienced now, with the expectation that in the next few months we'll have vaccines. I think it will just benefit us individually and collectively.

Elizabeth Holzschuh 20:38

Yeah, absolutely. If you're going to travel, certainly private vehicle is by far and away the best option and if you're going to be staying out of town would definitely recommend that you stay in a hotel or some kind of private residence. Because we know that transmission occurs at a much greater rate when you're in a household. And that's because people aren't masking and they're a lot closer contact. And you know, something that I try and remember is that basically when it comes to coronavirus, we breathe all the air that our friends and family are breathing that we're around right that everybody that they come in contact with everybody they share that airspace with and just breathe. That is a potential risk for coronavirus, infection, and then you're essentially breathing their air when they come into your space. And so whatever you can do to limit sharing air, keeping your distance wearing your mask being outside, and all of those things will help but again, the risk for infection right now in Johnson County, but really throughout this country is exceptionally high. And you know of all the times in our pandemic up until now, this is probably the most important time for us to stay home stay within our circles. And because the ramifications are severe, you know, we're talking about hospital capacity, we're talking about the potential of hospitals, having to choose who lives and dies, if there's not enough beds and not enough staff. These are not minor, you know, pieces. And while I know it's been hard for everyone, it's been hard for me, I haven't seen my family in almost a year they haven't seen my son. And this is a single year. And if we can get through this Thanksgiving and this Christmas and get through to when vaccines are available, we can go back to a normal life. And what's really important is that your decisions for this holiday may make it so that one of your loved ones is not there next holiday and so while I know it's hard and we all are tired of this pandemic, we really just need to continue to come together as a community as a society for a little bit longer. And you know, buckle down and we will get through this and by next year I have faith that we will all be able to have Thanksgivings and Christmases and Hanukkahs and holiday celebrations that we all are just really longing for right now.

Theresa Freed 22:48

All right, that's great information. And I think we'll we'll end on that. For more information about COVID and Johnson County go to jocogov.org/coronavirus. Thank you both for being with us.

Announcer 23:04

You just heard JoCo on the Go. Join us next time for more everything Johnson County. Have a topic you want to discuss? We want to hear from you. Follow us on Facebook and Twitter at JoCoGov. For more on this podcast, visit jocogov.org/podcast. Thanks for listening.