hello everyone thank you for joining us
this afternoon
um we have dr jeanne marrazzo she is the
director of the division of infectious
diseases here at uab
with us she's going to be able to cover
a lot of topics related to covid today i
know there's a lot in the news
but specifically she's here to address
some concerns surrounding the labor day
holiday weekend
heading into that and how we can have a
safe weekend without hopefully seeing
cases spike
we will open it up for a q a here after
her opening remarks and with that i will
let dr marrazzo come up
thank you savannah hi everybody happy to
be here to talk to you
on this thursday before yet another long
holiday weekend
part of the reason we wanted to talk
today is that we have
i think a sense of anxiety and deja vu
going into these long three-day weekends
because
the last several including memorial day
the fourth of july in particular have
been associated with
post-holiday surges first in the number
of cases that we start to see in that
seven day period
and then of course with the number of
hospitalizations and ultimately deaths
typically
in that 14-day period on so
we are really concerned
that despite the fact that we are all
really tired of this to say the least
um in fact we are entering what
some people might call the most boring
part of this
day two the middle passage whatever
metaphor you want to use
it's the part where we're just sort of
slogging through we don't really have
any new tools yet to control this
pandemic
we're still using the same blunt tools
of social distancing
wearing a mask and washing your hands or
the hygiene part
to actually do what we know works to
prevent transmission and we do know that
those three things
particularly mask wearing based on now
some really nice assessments
that have been accumulating since the
last time we talked here
that masks really do work as does social
distancing so really
important considerations um
so i think the the main message really
that we want to leave you with today is
that there's no time to let
up or this is not a time to let up we
are seeing
some positive trends and those include
a stabilization to a decline in the
number of hospitalizations
even here at uab i think the last time
that we had a press conference
or recently we were in the triple digits
for confirmed covid hospitalizations
we're now
down in the range of 50. so that's a
very very big advance
there are also some counties that had
managed
and appear to maybe be continuing to be
down that prevalence
down below that level of positivity or
prevalence that we like to see
which is less than five percent and
that's really encouraging
that said we're still seeing a lot of
cases so in alabama
we saw almost ten thousand cases this
week if you look at the daily case
counts across the country
they still remain between 30 and
45 000 people and the deaths are not
really going away and they're not
declining in all states there are a
handful of states
about six to eight that still have
increasing case counts
and increasing deaths so i really want
to impress upon people
that while we have made some strides
with a lot of sacrifice
we are still in a place where we have a
lot to do
not only to keep driving things down but
equally importantly and
almost more critically to prevent that
post-holiday surge
that we can almost predict will happen
if people
do do what they tend to do on a
three-day weekend which
is as i mentioned coming up
the other thing i would say is the other
part of this is that of course labor day
for many of us
is almost like at the new year right you
know you get back to work seriously you
get back to new hours the kids are back
at school
the days start to get cooler you start
to do more
indoor stuff all of those things could
really
impair our ability to rigorously social
distance also really make us sick of
wearing masks particularly if we're
indoors
and equally important it starts to usher
us in
to the fall and winter respiratory virus
i.e influenza season
so big concern is that we are going to
start to see the introduction
of influenza in particular we don't know
when that happens typically the uptick
starts to occur in october and into
november sometimes it's later
but really really critical that we be
in the best position possible with covid
before we start to get into the
influenza
season and really critical to get your
flu vaccine as soon as
you can a couple of other things i want
to mention
with regard to the post-labor day time
frame
mentioned going back to school we've
already seen
some impressive outbreaks particularly
in universities across the country and
indeed in alabama
a lot of people have been discussing
vigorously
what the best way to handle these
outbreaks
is or are should we just shut the
schools down
should we send children children or kids
students back to their home communities
and just call it a day and
maybe come back in january when things
are settled
that's a really interesting and
important question and i think it
has a lot of dependent variables but in
general
if you have an outbreak on a campus
university campus and you have the
capacity to
maintain some semblance of comfort
and order safety and security and
education virtually for the students on
that campus
it actually makes sense probably to keep
those students
on campus and part of the reason for
that is not only that
it gives you more control
more ability to chart what's happening
to those students
not just from their own personal health
perspective but from the propagation
of the epidemic or the outbreak
in that context it also really really
critically
keeps them from returning to vulnerable
communities and reintroducing
the chain of transmission into those
other places
and that's going to be especially
difficult if those communities have
already made
great strides in controlling covid and
as you know there are a lot of places
now particularly in the northeast
that have done a great job getting down
to
what are very low levels of community
positivity and infections
so you really don't want to sort of send
these students back
into those communities where they may
also not be
rigorously practicing the kinds of
methods that i mentioned
and then making their contacts
vulnerable
it's a very number of really disturbing
stories in the press the last couple of
weeks of places that really didn't have
much
maine is a great example there was a big
wedding there
and those wedding guests ended up
infecting a whole series of people
including an elderly woman who had never
left her home and died
because she was exposed to people who
had come from that wedding so
we want to avoid those tragic events we
want to avoid
the public health challenge of
introducing the infections back and
getting those
economies back off track and then we
also want to try to take care of
students
from an educational and a health
standpoint
in the places that they're staying so i
think
those are my main messages
one more thing i would say is if you
look at the
modeling that people are doing based on
what we have seen from previous
three-day weekends
so let's say what happens after memorial
day or what happens even more
concerningly after july 4th weekend
happens after labor day then we are in
for
a not good scenario in september and
early october it basically means that
our hospitalization rates are probably
our death rates are going to climb way
back up to the levels that we saw in
july so it's really important because we
narrowly escaped
a serious crisis with hospital capacity
and icu capacity as you all know
in july and early august just narrowly
it's really important that we do not
revisit that situation and the only way
we can do that is to keep hanging on
with our agreed boring painful
old measures of social distancing
wearing your mask and washing your hands
so i wish that
i wish that i had better news i will
share one
piece of good news that i know people
were interested in talking about and
that's the
recent data that came out i think the
day before yesterday it may have been
yesterday
in the jama which concerned several
studies
looking at steroids and their treatment
for covid
really good news in that the stereo use
of steroids in several studies and then
in a big analysis of a bunch of smaller
studies
showed that people who were severely ill
and hospitalized
very important caveat had a reduced
mortality by about a third
when steroids were used that's great
news
it's similar to what the recovery trial
from the united kingdom
showed us a few months ago and that's
what made everybody
get on board with steroids and it also
changed many of our guidelines
where we actually are using steroids
the caveats i think are that the people
in those studies were critically ill for
example in one study they had to have
adult respiratory distress syndrome or
ards meaning they were intubated and
really having trouble
oxygenating their lungs so
we don't know yet how it's going to
perform again
in people with mild illness and the
other huge group we are still struggling
with are people who are in the clinic
either with newly diagnosed covid or
covid that just
has taken them out for several weeks and
i want to emphasize
that just because you're young you may
not get a pass
on this you know you may not die because
you're a 20 year old healthy person
although it's not out of the question
but we are absolutely seeing and we are
hearing reports of young people who are
really
physically limited weeks even months
after their covid infection so be aware
this is no picnic for anybody and really
nobody
gets a pass except those people who are
lucky lucky enough to have asymptomatic
infection but even they remember
are capable of transmitting the
infection to other
vulnerable people the last thing i'll
just mention before i take questions is
remember we've heard a little bit in the
last couple of weeks now
about the possibility of re-infection so
a very persuasive case
last week published from i think las
vegas
where they had a young man who quite
convincingly
had two different strains of the virus
several months apart
and they know that because they looked
at the genetic sequence of that
virus so should we be concerned about
that it's definitely something to keep
in the back of our minds what we tell
people
who have had covid when they ask us if
they can get reinfected
is that yes it's a theoretical
possibility it probably doesn't happen
in most people
but we just don't know yet and we
recommend that you continue to use the
same precautions that everybody else is
using in other words
just because you've had covid doesn't
mean you can assume you're immune
and that's a really um hard
not welcome piece of news and hopefully
we'll understand more about it
as we understand more about the
immunology of this infection
um i think i will stop there and
go ahead and start taking people's
questions
fantastic thank you so much um dr
marrazzo and just a few housekeeping
items before i go into q
a um we haven't done a news briefing
like this in quite some time
this is live on facebook you cannot see
anything right now on the computer
or you would see me um so we will send
out a recording of this after the fact
as well
if you've got a question please raise
your hand or drop it into the chat but
let's go with raising our hands
first and so if someone has a question
they'd like to start with
we can kick it off
all right jeff eliasoph feel free to ask
your question
all right i think you're muted okay how
about am i unmuted now
yes good i appear to be showing up in
channel six's view box so that's my
first question how do i get over there
okay there
there we go um my question of course
would be about a vaccine
and uh november first all of a sudden
when we were hearing that
nothing was going to be remotely
possible from dr fauci until
sometime next year
what should alabama be doing to prepare
for such an event if
uh if such a thing is possible and is it
possible now
all of a sudden leaving the politics
over the site is it possible to have
a vaccine ready for wide use on november
1st
jeff that's a great question and i was
sure
someone was going to ask it um so this
and it's a really complex answer which i
will try to break down
quickly so that we don't spend a half an
hour talking about this because we
really could
so back when we were talking about
the projected timeline for a vaccine dr
fauci
i most experts emphasized
that the way clinical trials were
conducted
were that you would enroll a whole bunch
of people first in those phase one
safety vaccines which we now
sorry phase one safety trials which we
now know there have been a number
that look good so we are actually
through a number of those phase one
trials
moving quickly into phase three trials
and phase three
are called efficacy trials that's where
you figure out
does the vaccine work okay
at that point the best case scenario
that we were talking about was
maybe available next spring or next june
and the reason for that was
we know that for example the modern
vaccine study is now
i think almost almost two-thirds
enrolled if not more of its 30 000
participants right
so you're going to follow those people
who either got the vaccine
or a placebo product over the course of
the next several months
to see what happens that study
has been powered to look at the
incidence of coronavirus disease
in people who got that vaccine and if
you use that as a marker
the best case scenario i think
especially in areas that still have a
lot of coronavirus
which is not the whole country anymore
probably you might get a signal sometime
in early 2021
and i think that that's what people were
thinking about and maybe a signal of
efficacy would be so
great that the monitoring boards for the
study would say in february stop the
presses
because this looks so good we can't even
continue to study it anymore
and you can imagine then ramping up and
getting it out
now what we're hearing is that
the availability of a vaccine sooner
might hinge on two things one
is that there are european data
particularly for a couple of vaccines
uk data and that the fda
should potentially consider whether
those data are
enough to assume that they're our
efficacy and i need to refer back to the
previous question because i forgot to
mention the second measure of efficacy
so the first is the number of cases
the second are markers of immune
reaction to the virus so that means you
get the vaccine
four weeks later they take some of your
blood and they say are you making the
antibodies that we think will protect
you from the virus and
really for the oxford vaccine in
particular the uk vaccine astrazeneca
vaccine
that's the evidence we have and that's
the evidence that we have for all the
vaccines we have no evidence
that it's going to reduce the number of
cases so let's go back
to to what we're hearing now we're
hearing now the two things first as i
said
that the uk data in particular for this
single vaccine and maybe even other
european data is enough
the second is piece of this is that oh
maybe we don't need to prove that a
an effective vaccine reduces the number
of actual
infections in people maybe we can just
say
that it induces protective antibodies
in people and if that's the case let's
just approve it on the basis of
protective antibodies and get it out
there because we need to
so what are my concerns with this and
there's a great perspective article
again in jama
um that i would love to share with you
all um
if you tweet me i'll i'll send i'll put
it on my twitter feed but
and it's it's very accessible but it
talks about
the concerns with getting a vaccine
out too fast and i would say there are
several first of all
we don't know enough yet about what
real immunity long-lasting robust
immunity to
the coronavirus is i mentioned before
the person who got reinfected
how do we know that that's not going to
be a risk with whatever vaccine we use
okay so
so i think some people would probably
disagree with me and say would say oh we
can measure really sophisticated kinds
of antibodies and if i
saw that response i'd be comfortable
getting that vaccine that may be
but it is a definite data-free zone
or data arguable zone and it's a risk
the second is
we have never used an a messenger rna
vaccine
in a human population before before
these trials
this is a totally new technology we
think it's safe
but we don't know it's not a tried and
true method and so
that for me really increases the bar for
safety
a lot okay the third thing is
that problems that come with vaccines
can be rare events but they can be
devastating
and that's why we have vaccine
registries and it's why we are
super super careful in the phase three
studies to follow people carefully
at least for a year if not longer
what's a good example of when that was
not done
many of you are probably too young to
remember i barely remember it myself but
swine
flu swine flu was a perfect example 1976
there was an outbreak in fort dix new
jersey
among soldiers there they got something
called swine flu
they got really sick and there was a
general worry
that this was going to be a virus that
was very similar to the 1918
flu epidemic virus there was a lot of
discussion about what to do and
president ford at the time
basically gave the green light to go
ahead and
widely administer a vaccine that had not
really been adequately studied
because of the threat of this quote
unquote possible pandemic
45 million people got that vaccine a
couple died
and 450 of them got guillain-barre
syndrome which is
a neurologic disease that can result in
death and respiratory failure
and we know that that is a risk factor
with that vaccine
it's discussed in this jama paper but
it's a real cautionary tale
of how and who knows what the calculus
was at that time i mean
it was a valid concern but there were
many people who thought that was
ill-advised and it was rushed
my big concern about this timeline
that's now out there is that
not only do we not have the kind of
evidence for efficacy yet
yet i'm saying yet maybe they know
something i don't know it's always
possible
but do we really have confidence that we
can go out there and vaccinate
everybody safely without knowing the
longer term
benefits or side effects of this vaccine
that's my
that's my really big concern and then
that's remember happening
on a background where americans are
among some of the most vaccine hesitant
populations in the world
right there are pockets of the united
states where people aren't going to even
get a killed flu vaccine which we know
is absolutely safe or a pneumonia
vaccine or a shingles vaccine or
whatever or measles vaccine right
so you know people have been incredibly
concerned about vaccine safety for
decades and we've spent
countless hours countless press
conferences countless meetings
trying to assure them that we have done
our absolute best
to make sure that every vaccine we give
is safe and that's why it's okay to give
to your children right
this is not that this this is exactly
the opposite of that so it makes me very
concerned again maybe there's an
unbelievable scientific breakthrough
that i'm not aware of that makes
the people who are pushing this
confident of of
saying this and that's always possible
but knowing what i know and i would say
knowing what
most infectious disease your average
kind of academic and practicing
infectious disease physician knows
i think this is a very concerning trend
so long answer but really important for
you
as the excellent media spokespeople you
are
to understand the intricacies of how
these decisions are made and what the
consequences are
thank you for that answer and i think
that everyone on this call would agree
that that is
beyond helpful context and we're going
to go with henry thornton without
yellowhammer news and then we'll go to
miranda with wbhm so henry feel free to
ask your question
hi dr marazzo thank you as always for
being here with us today
my question is about a certain
categorization
issue with the new case numbers we're
seeing come in
so essentially the alabama department of
public health is putting and i'm sure
everyone on this call and you probably
more than us have read about this
already
but they're putting people who've been
tested with the antigen tests
or the rapid tests in a category called
probable cases um i was hoping to
solicit your thoughts
about whether that sort of properly
communicates how
likely someone tested a via a rapid test
is to actually have a case of covid 19
and any advice you can give us in the
media for how to properly
or to communicate those results would be
very helpful
henry this is um something that's been
keeping me up at night for the last
several weeks as i've been thinking
about what the advent of these new tests
is going to do to surveillance and i'm
afraid that all of my
nightmares are basically happening so
it's really complex because first of all
not all of these tests are created equal
going back to the fda
one of the challenges with the fda's
recent behavior has been
that they've granted emergency
authorization use authorization
to so many tests that we really don't
have a clear handle
on what their performance
characteristics are
that's one of the reasons that
responsible reporters like departments
of public health are listing those
infections as positive because
technically right now
if you get a non-pcr test a
non-polymerase chain
reaction test you're supposed to confirm
it with pcr
to actually make sure that it's a
confirmed case now that's
not feasible number one number two it
defeats the purpose right of having
these rapid
easy to do accessible tests so at some
point
you've got to decide is the test being
used for surveillance
so that you can get better assessment of
what the case trends are
in a given place or are they really best
used as diagnostic tools
when you're evaluating the patient who's
sitting in front of you
i would say that the tests are really
designed for the latter purpose right
they're really so you can do
testing somebody who's symptomatic or
maybe test somebody who's been exposed
and is a contact when you get into using
them for surveillance
it's really tricky i'll give you one
other example for for example the
one of the better antigen tests which is
the sofia test
has performance characteristics that
indicate
if you test someone within the first
five days of their symptoms
you're going to get a positive result
like 97
of the time when the patient's actually
infected that's excellent
and if it's a negative test you can
believe that they're really not infected
we don't have any data on how that test
performs in somebody without symptoms
and yet it's being used widely for
screening
do i think it's good yeah i do think
it's good because i think you can
probably believe the negative test but
we don't know
so the the short answer is that
i think the probable numbers are
reliable
from the standpoint of accuracy for
positivity so
if you have a probable test by one of
these antigen tests by and large
i think you can believe it and again it
may be that there's a new antigen test
that's going to come out tomorrow
that makes me a liar but in general i
think you can believe it
i would personally rather see those
tests on the dashboard
in the probable category than see them
being missed which was my concern my
concern was that
all these tests were going to come out
people were going to be doing them in
the point-of-care situation
or in places that weren't connected to
reporting structures
and we weren't even going to see those
numbers and we were going to have a
false sense of security
as the pcr test reporting came down
so i'm absolutely glad that they're
there
it doesn't tell us again with precision
how many
tests are being done because that part
we don't know with the pcr test we know
what that denominator is because they're
all done in a laboratory
with the other things who knows who's
doing them so i would say believe the
positives
be skeptical about the number of people
that are being tested
and know that the con the probable
designation
is really um kind of just a for
i think it's more of a formality at this
point because
technically you are supposed to confirm
them with pcr
i've been frustrated and though with the
recent reporting
on adph as you know there have been a
lot of
influx of old tests that hadn't been
reported
there's now delays in reagents again so
there's delays in testing so
remember i think charting day-to-day
numbers is
helpful but i wouldn't you know rest i
wouldn't
sort of depend on it you really have to
look at trends
probably ideally over 14 days and over
17. seven days
thank you and thank you henry um we'll
go to miranda with wbhm you can ask your
question
hey okay thank you so much um dr marazza
going back to
the topic of a possible vaccine
um you know i'm just curious since you
mentioned
that we don't know the long-term you
know efficacy
or effects of even a current phase 3
vaccine like moderna
no i i have to wonder like if a vaccine
like that
did come out would you get it yourself i
mean
i know that we don't know the long-term
effects so i'm just curious from your
point of view
knowing having so much knowledge about
this stuff yeah thanks for that
excellent question miranda
um if i was going to get a vaccine
and first of all i'm planning on
volunteering for a trial so
i think that that is a really important
thing for us to do because we're trying
to get people into trials and i feel
like it's important i haven't done it
yet but i
i'm on the list um if i was really going
to get a vaccine
i i would want to be really sure of its
safety i mean
i again that's just the way that we're
all wired right
um what would that take that would take
my assessment of the database that came
up out from these studies so
let's just take the madeira vaccine as
an example in january what if it looks
really good
well the first time a modernity vaccine
was ever put in a person
was last march okay that means
you're potentially thinking about
licensing and distributing a vaccine to
millions of people that has been in this
world
for less than a year it's really a risk
benefit balance at that point right
there are so many people who who remain
vulnerable to this infection because
they can't social distance
maybe they can't mask and maybe there
are other issues
maybe they have immunocompromise that
puts them at a very high risk of
complications if they get infected
you know someone in those situations
could say
this looks okay it looks good it's been
out a year
i think it's very reasonable other
people
like me might say you know i've done
okay so far
doing my boring masking hygiene and
social distancing
i'm going to keep doing that until i see
how this evolves
over the course of the coming months
now is is that's something i have to
think about a lot because what if
something changes in the next month what
if we find another consequence
of covet infection you know what if we
find out that reinfection
is the rule rather than the exception
we don't know but at this very moment i
would say i would probably not get it
that said if there was full-throated
endorsement from something like the
american college of
immunization practices the acip and
there was a great database and people
felt like
it was awesome then i would consider it
but but i'm
inherently cautious about this i guess
the other thing to say is that
you know just when we put new drugs on
the market sometimes they look great in
phase three for safety and then you put
them on the market and when they get
into millions of people you start to see
the rare but consistent side effects
so we have to be very very vigilant
about that
thank you miranda thank you dr marrazzo
morgan with fox 6 feel free to ask your
question
thank you savannah dr Marrazzo i'm just
curious about
how african americans are
disproportionately
impacted by this virus and in terms of a
vaccine there's a lot of conversation
happening
nationwide that there's not enough
diversity
in the enrollment that has already
happened can you tell me first if
at uab y'all are having issues
enrolling a diverse population of people
for these trials
and then secondly can you tell me about
why it is so important to have
this representation in the trial to make
sure that the vaccine is working
appropriately for everyone
great questions miranda thank you for
those so first of all we have not
started a vaccine study yet
at uab um we will be we hope starting
the astrazeneca vaccine study in the
coming weeks and when we do that you
will be the first
group to know about it because you've
been loyally following us for so long on
this topic
um that said we are already mobilizing
to be sure
that we reach out and try to
pull in as diverse a population
as we can get and not just diversity
but also i think it's really important
to enroll people who are the most
vulnerable and who are likely not only
to suffer
the most from this infection but who are
likely to benefit from the vaccine the
most and you mentioned african-american
people
there is no question about the
disproportion percentage of deaths
disproportionate percentage of deaths
that these people
as african americans black americans are
experiencing
and absolutely that would be a
principal focus for us to enroll so
one advantage that we have here is that
we have an alabama vaccine research
clinic that's led by dr paul gapford
many of you know paul
he's worked a lot on influenza vaccines
as well as hiv vaccines
and so this group our group has a lot of
experience of reaching out to people who
are more vulnerable
from whatever reason that might be
socioeconomic standards
maybe there are elderly people all kinds
of things that
increase people's risk of getting those
kinds of infections so
so we are teed up and we already have
community outreach
folks who are trying to make sure
we have a lot of people who are ready to
enroll
it's been a big challenge with the
modernist study and i'm sure you've
heard some of that press
you know sometimes the first people who
line up for these studies
are the people who have the best access
to and best information about medical
care of course
and while those people are critically
important
to study as well and to get the benefits
as well
really really have to pay attention to
who really needs to benefit from a
vaccine-type
intervention so thanks for that question
thank you morgan does anybody have a
question that they'd like to ask
we are going to try and wrap around two
o'clock um just in the interest of time
so if you've got a question um okay um
jeff eliasoph feel free to ask your
question
okay dr moreso again many thanks um
i come from a family of doctors i wasn't
smart enough to be one but your
explanations of complicated things
are wonderful for viewers uh and i think
we get a great benefit out of that for
our folks um
on the question of numbers at
uab itself right now um
i know their day-to-day uh differences
here but
they seem to be uh down uh
give some context about why that may be
happening
uh here and i guess restate your fear of
what
may be coming here over labor day yeah
thanks jeff that's a great question
i think there are a couple things
happening when you look at so every day
i get a list
because we're trying to get people into
research studies in particular
um every day i get a list of people who
are admitted
who are discharged and who are
designated as convalescent or recovered
the list of people admitted has
dramatically
come down i mean we were really very
high in july which gets to the second
part of your question this is where
we're going to be if labor day
is not taken seriously so really very
high
and then the list of discharge people
was really very small
we're now seeing a much more equal
distribution and
i think what's happening is that not
only are we seeing fewer cases coming
into the hospital from the community in
terms of admissions
because people have been largely
adhering particularly in birmingham
to the social distancing mask wearing
directives which is fantastic but also
we've been i think reducing the length
of stay of folks we've gotten better
at certain measures to take care of
people
i would say the biggest things being
more availability of Remdesivir
routine use of steroids and much
interestingly
more sort of vigorous approaches to the
way we handle intubated patients which
includes proning turning them over to
make sure that
all of their lungs get good oxygen
penetration so
um and if you look at our mortality
rates unfortunately they're not zero
but they're really good compared to many
other centers
so we've been seeing fewer patients
admitted
the people who are admitted we've been
trying very hard to keep out of the unit
the other thing i should mention is that
we learned quickly not to put people on
the ventilators very soon as did many
other
people we learned that from our
colleagues in new york and seattle
because our initial instinct was
immediately to put people on a
ventilator
and it turns out that with this weird
disease
if you can keep them off a ventilator
and just give them high flow oxygen
through a nasal cannula and get them
through that earlier period
they do much better it's something it's
really interesting so we've been doing
that a lot more
i mentioned the way we're handling
proning and then there's also the
steroids so
i think we have learned an incredible
amount
in the last several months about how to
take care of people
and i think that's kind of gotten our
folks out and discharged
quicker so all of that has taken all of
the work that everybody's done and i
think
your question about labor day just
brings me back to
please don't make all that
for not because if we
if we start to fill up again we start to
see the hospital being
broken down by covid we can't continue
to give people care
for the things that we need to give them
care for and
we'll just start the cycle again of
exhaustion demoralization
and probably less of an ability to give
people as much care as they really need
so it's it's definitely linked and i
appreciate you bringing that up
thanks jeff yeah if i could just follow
up real quick on the vaccine
uh i've in this during this last half
hour i've had occasion to speak to the
governor's office
and i've really didn't get anything out
of them other than we're studying this
with the experts this getting ready by
november 1st business
well i know that the governor has
enormous respect for you in particular
and uab so i guess give me a couple of
headlines or sound bites about
what you would tell her about november
1st
in light of the fact that you are not
satisfied that
we're ready to go unless you say uh
somebody out in the world knows
something you don't
we're not really ready on november 1st
to give somebody a 100
safe effective vaccine right now
remember
the governor is also responding however
to the directive of the cdc
so the cdc director dr redfield was the
person who
wrote that letter that came out
yesterday telling states that they
should prepare
now again dr redfield has a lot more
inside information than i do
maybe he knows something that he's
communicating or maybe they're really
trying to get ahead
of the curve and they want people to
gear up
so that anything can be available as
quickly as possible
i mean the headline is hard because you
saw how long it took me to answer the
question
i think the main message is that
we need ironclad proof
and assurance to the extent that anybody
can get it in any vaccine study or any
medical study
that whatever product we make widely
available to our citizens
is as safe and effective as is humanly
possible
we are not at this very moment on
september
4th whatever day it is third fourth we
are not there
right now there is no there's no way
that i have seen
myself and i know that most experts have
seen enough data
to feel like not only today there's
something to roll out
but in seven short weeks i believe that
would be
um that there would be actually yeah
seven short weeks right that there would
be
something to rule out so the the message
to me should be we deserve
the best we we just yes i know there's
urgency
but but we can manage this with
admittedly the tiresome
difficult boring things that we have
talked about and that's not to say we
don't
urgently emergently need a vaccine we do
but we should not
sacrifice our convenience
for the rush to get a product
that we just don't know is
really truly safe to get to people and
we we deserve the best we deserve better
i mean people have been through hell
with this thing
all right um we are at that two o'clock
mark so we're going to just take
miranda's question from wbhm she's had
her hand raised a while and then we will
conclude so miranda you can ask your
question
okay great thanks savannah and i'll make
it super quick and um dr marazza you may
have an answer to this you may not
but i'm sure as the conversation
continues
to progress about vaccines people will
have questions about
pairing a possible cobin 19 vaccine
in addition to getting their flu vaccine
um
as someone that's not overly familiar
with vaccines and how
or whether they could react to one
another um
would you is it possible for vaccines to
react with one
another like would people be safe in
general or we just don't know enough
about it right now that's a fantastic
question of course we don't know enough
about it by now because as i mentioned
these mrna vaccines and protein vaccines
i should mention too
we can talk at another point about the
difference but all of the technologies
that are being used for these
new sars cov-2 vaccines are not in any
circulation right now in terms of
available vaccines we don't know
enough about that in combination with
something like the flu vaccine i will
say though
in general when you're talking about
vaccines that don't involve
a live virus like the pneumonia vaccine
the flu vaccine
you can give them together without a
problem kid get kids get vaccines
they're the classic candidate right the
poor things they're often like little
pin cushions when they come out of the
the pediatrician's office the flu
vaccine in particular is really
interesting
you probably don't need to worry about
that and in fact the studies that are
being done
have explicitly incorporated a protocol
to manage administration of the flu
vaccine
within that study because it would be
unethical right to withhold a flu
vaccine in people who are participating
in covid vaccine trials
going into the influenza season i don't
know what the exact timing is my guess
is that it probably has to be separated
by at least two weeks to 30 days but we
can check on that
but you you probably aren't going to get
them together in a study
but you can definitely get the flu
vaccine this year and
participate in a research study or get a
vaccine if it does come out and we
believe it's safe
thank you fantastic thank you dr moratzo
and i'll come up and give some final
comments
um thanks everybody
that is going to conclude our news
briefing for today
i will send a recording of this out
hopefully the next hour or so
and we'll give us some time just a
little bit patient
if you have any other questions feel
free to email me and we can try and get
those answered
again we cannot stress enough to please
be safe wash your hands
social distance and wear masks wear them
correctly this weekend when you're with
friends and family celebrating labor day
that will conclude our news briefing
today
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