- [Announcer] Tune in to Basin PBS, or stream live from the Basin PBS Facebook page Wednesday, August 18th at 7:00 p.m. for a Basin PBS town hall special, The COVID Surge in West Texas: How to Stay Safe.

You'll hear from healthcare workers and administrators from Midland and Odessa Hospitals as we discuss how to keep our community safe, amidst the surge of the Delta variant.

In partnership with NewsWest9, made possible with generous support from the Abell-Hanger Foundation.

(birds chirping) You're watching the Basin PBS Live Town Hall, The COVID Surge in West Texas: How to Stay Safe, hosted by Becky Ferguson and Victor Lopez, in partnership with NewsWest9, made possible with generous support from the Abell-Hanger Foundation.

- Good evening, and welcome to a Basin PBS Town Hall Special, The COVID Surge in West Texas: How to Stay Safe.

Our topic tonight is the emergency situation facing our medical community.

Tonight, we will focus on how the new spike is affecting our hospitals, staff, patients and community at large.

To that end, our guests tonight are exclusively from the medical community.

The COVID virus, which seemed, momentarily, to be losing its grip is rearing its ugly and dangerous head once again.

I'm Becky Ferguson here with Victor Lopez of NewsWest9 along with doctors and medical executives from the Basin's major hospitals.

For the next hour, we will ask our experts wide-ranging questions about the COVID variant called Delta that is the cause for great concern for our medical community, and by extension, our entire region.

We are coming to you live from the Basin PBS Anwar Family Studio.

If you, our viewers, have questions throughout the evening, please visit our Facebook page and we will do everything we can to get them answered for you.

Tonight's event is made possible with the generous support of the Abell-Hanger Foundation and in partnership with NewsWest9.

Welcome Victor.

And, if you will, please introduce our panel.

- Thank you, Becky.

And first of all, let me say that it is my pleasure and my honor to be here with you and this panel tonight.

And we at NewsWest9, we have combined our forces and we have what we are calling our vaccine team.

And our main focus is to get facts not fear out there about COVID-19, the new Delta variant and, of course, the vaccines and just everything that has to do with COVID.

We want our viewers and everybody out there to make sure that they are as best informed as possible.

So now let's go ahead and introduce our panel who is here with us from Odessa Regional Center and Big Spring's Scenic Mountain Medical Center, we have medical doctor Rohith Saravanan and President Stacey Brown.

Representing Odessa Medical Center Health System, Chief Nursing Officer, Christin Timmons, critical care physician, Dr. Alejandra Garcia and President and CEO, Russell Tippin.

And from Midland Health, we have President and CEO, Russell Myers and Vice President and Chief Medical Officer, Dr. Larry Wilson.

Thank you all for coming.

Now, the breakdown of tonight's program will consist of approximately four categories of questions.

- Thank you so much, Victor.

And for you all at home, I want to let you know that all of us up here are vaccinated and that we are socially distance and that the folks here in our studio are also all masked and socially-distance.

So I wanna begin tonight if each of you all will tell us what the current situation is at your hospital?

And Dr. Saravanan, may we start with you please?

- Sure, Becky.

So the current situation in the hospitals across our entire region is that we are full.

We are full with patients who have COVID and with non-COVID related cases.

In this current surge, we're seeing the highest level of admissions related to COVID compared to the previous surges much sooner than the previous surges.

And that's what's worrying us so much is because it is not quite done rising yet.

So we are gonna see even more numbers come in and our hospitals are full at this time.

And it's hard to predict how we'll be able to keep up with rising numbers.

- Ms. Brown, is the same true at your Big Spring Hospital?

- Yes, it is.

And the only thing that I would add to that, that we're seeing this time around that's different from our previous surges is it's hitting our younger population much harder.

The majority of the patients in our hospital are 60 and below.

And so that's very concerning.

That is not what we saw before.

And we're also seeing, currently, at both ORMC and Scenic Mountain that over 90% of our inpatient COVID patients are not vaccinated.

So we believe this is avoidable and preventable if we all take personal responsibility.

Ms. Timmons?

- So I think I'd echo the exact same at Medical center.

And I know Russell will be giving you some numbers.

We are full as well between COVID and non-COVID.

We've overflowed into many other units.

We've prepped many overflow units.

We have staff that are out sick.

We have staff that have volunteered to work extra.

So I think everyone is just pulling together because they are continuing to see the spike.

We're seeing the flood into our urgent cares as well as our emergency room.

And we're holding patients where we don't normally hold patients.

So we're really trying to work through just where to put all the patients and give them the care that they need.

- Good evening.

I have the number person.

- Good, tell us.

- I can tell you tonight at Medical Center, we have 84 COVID in-house, and that's a breakdown: out of those 84, 61 of those are unvaccinated.

15 are vaccinated and the rest are unknown.

So our number has continued to hold there.

Just our overall load is higher.

And I think I echo what everybody said is that it's amazing the difference that the vaccine will make in your ability to survive this and have a better chance to get through this COVID issue.

But right now, our number tonight is 85.

- [Becky] Dr. Garcia.

- Well, I'm not a number person, but I'm currently working in the ICU.

Our ICU has been full for the last three weeks.

We've been struggling on how to make new beds to accommodate oncoming patients.

Like they mentioned before, we're boarding patients in places that, in different situations, we wouldn't.

And currently in our ICU, we have 37 patients COVID.

95% of our patients are unvaccinated in the ICU.

- [Becky] Dr. Wilson, are you having a similar experience at Midland Memorial?

- You've heard it from every place in Midlands, no different than what we were experiencing in Odessa.

We had, this morning, 98 patients in our hospital with the critical care unit, has been full for over a week.

We are holding critical care patients outside of the critical care unit, had an OB/GYN doctor, a conversation with her today.

And she'd never experienced this in her career where she was taking care of a patient that was gonna go in for a C-section in the preoperative area and the patient that had come back from a C-section, COVID-positive had complications, was intubated and was kept in the preoperative area of OB/GYN rather than going to the critical care unit, because there was no bed there for them.

This is unprecedented.

We've never experienced anything like this before this virus.

The Delta variant, specifically, is hitting so hard and so fast with this transmissibility that the trajectory is straight up.

And where we're at today and has been mentioned already, it's gonna get worse before it gets better.

And what we're seeing today with case counts in our community are 145, 150 cases a day.

And when you have those kinds of cases now, seven days from now, 10 days from now, a percentage of those patients, 20% of those patients are gonna require medical care.

And it's unprecedented.

Our ED has been holding admissions all week long in the teens that should be upstairs being cared for in a different environment.

It's been rough.

- Don't wanna say the same thing everyone else has, although I could, because our experiences are all very similar but two points that haven't been made, one is staffing.

We have serious concerns about the adequacy of our nursing and respiratory therapy staff especially.

We were fortunate today to begin to see some of the state's resources arrive in Midland.

Some more are coming by Monday.

And we're hopeful of adding a few more open beds.

We don't have a space problem.

We have a staff problem.

We do have beds we could open if we had people to work in them.

And so as the state's resources come in, in smaller numbers than we need, but certainly very welcome, we'll open a few more beds either the end of this week or Monday or Tuesday.

The other point that I'd like to make that I think is really important is that to one extent or another, all of us are tertiary destination facilities for the many small hospitals around our region that I know were in your viewing area, those small hospitals throughout the year depend upon us to do specialty care that they can't do.

They don't have the resources in their small communities and all of us are turning them away today as are hospitals all over the state to which they try to send the patients they can't care for in their EDs or in their hospital inpatient environments.

So it's not just a Midland and Odessa problem.

It's a regional problem.

And there's really not much progress being made to solve that right now.

- Let me ask a follow up really quickly.

You said that we can't take patients from smaller hospitals.

So what happens to those patients?

- They stay where they are.

They search for hospitals at greater and greater distances that can take them, sometimes out of state.

We've been hearing anecdotes of people going as far away as Colorado and I heard one the other day, they were talking to a hospital in South Dakota.

This is really extraordinary and unprecedented to have to say no to the people that depend on us every day.

And it's just where we are.

We can't offer services we don't have to offer and nobody can.

And that's a tough situation, not just for us, but for everybody around us.

- Absolutely.

- Now you mentioned just now that you don't have the space, you don't have the staff.

And if one of you from each hospital can address this question, how are you dealing with the PPE and equipment respirators, things of that nature?

What are you doing?

What are your levels right now?

And what are you doing to compensate?

And Russell, we'll go to you.

- Yeah, let me start.

We didn't say we don't have the space.

We actually do have space.

We don't have staff to staff that space.

So we're fortunate that as staff come in, we actually have beds we can open.

We have plenty of PPE.

One of the early lessons of the pandemic was to overstock your PPE supplies.

Once the supply chain recovered from its initial shock, especially with China being shut down where a lot of this stuff is manufactured, I think most of us have seen the ability to stock up PPE and that's not much of a concern.

Respiratory disease is the heart of this problem.

So ventilators are really crucial.

We have ventilators left.

We just signed off on a purchase of some upgrade tools to take some old ventilators out of mothballs and put them back in service.

I think we're all facing something like that.

So ventilators are okay, we're in pretty good shape there for now and as is the case with most equipment.

This really is a staffing concern more than anything else for us right now.

- We're exactly the same, Mr Meyers.

It is a space issue as far as when you start filling up your ICU and your beds.

And then when you have the space, you don't have the staff to put with that.

So we echo that comment.

Our situation on our PPE is great, exactly the same, to get ahead of the game.

Last time we learned a very valuable lesson.

One good news is we are very short on ventilators and we ordered 40 ventilators last week.

They shipped today and they're in our facility today.

So it'll take a few days to get those tuned up and ready to go.

But that's 40 additional on top of what we have.

And I get asked all the time, "Well, why didn't you get ventilators sooner?"

The ones we're replacing are not that old.

We've just worn them out 'cause they're constantly in use, 24 hours a day, seven days a week.

And so that issue is there, but at the same time, it's something that we've all learned to adapt and we've all gotten very creative on how we use our machinery and provide our staff with PPE and protective gear.

- I would say it's definitely the same with Odessa Regional and at Scenic Mountain.

We have always been well-stocked on the PPE.

That's not been an issue for our facilities.

Remember, we too are part of a healthcare system.

So we're part of the Steward Health Care Family.

And so we have over 45 hospitals across the country.

So we can oftentimes pull resources from hospitals who may not be affected as strongly as what we are.

It gets challenging when you start to see surges everywhere.

But yet that is a resource for us as well as renting or acquiring more equipment when we need it and asking help from the state.

So that's where we stand.

- Dr Saravanan?

Oh, you were gonna add something?

- Just one quick comment on the equipment: in-patient equipment, we prepared for because we saw this coming and we knew that the supply chain could keep up because so many new companies now started making masks all of a sudden after last time.

So like everybody said, inpatient, we're good.

One of the things that we're struggling with now is that because there isn't enough staffing in the hospital to admit everybody that would normally meet admission criteria, there are certain patients we're trying to treat as an outpatient.

So maybe you need a little bit of oxygen, but you're not quite at a stage where you need very invasive ventilation or pressure.

So then we try to send them home with some oxygen.

So we need something called an oxygen concentrator.

And those machines are becoming slightly harder to find.

So it's harder to send patients home who have a high need for oxygen from our ERs, rather than admitting them.

- While I've got you, I know that some, I shouldn't say optional, but some elective surgeries have been postponed.

And can you address that?

What kinds of operations are being postponed?

What sort of problems is that creating.

- Sure.

Actually, a very simple answer to that, as you heard, it's the staffed beds that's the problem.

So an elective surgery that would need a staffed bed is the one that we would try to postpone.

Elective is a very difficult word to talk about in healthcare because, you've heard me say this before, but people, that person that's been suffering with knee pain for years and years, if you ask him, "Is your surgery elective?"

Well, no, to him, it's not but to the healthcare system, it looks elective at this time because he'll need a bed after that knee surgery and we don't have a bed to put him in.

- Dr. Garcia, can you address that question as well?

- Yeah, so a couple of things: I love that it has been mentioned that the problem in staffing in the hospitals, and I wanna elaborate on that because when you say staff and it sounds pretty general, so I wanna paint the real picture.

The picture is in an ICU, in an ideal scenario, you would have a ratio of one-to-one nursing to patient.

You would have a nurse that is attending to that patient throughout the entire shift, because these are highly complicated, critically ill patients.

That has gone out of the windows.

All of my nurses, currently, are triple because we're stretched thin.

We do not have the people to care for the patients we are admitting to the hospital.

We usually should have two or three respiratory therapists in one critical care unit with 20 beds.

I have one respiratory therapy taking care of 20 critically ill patients out of which all of them are ventilated.

So when we say we don't have staff, we truly are stretched extremely thin.

We are caring for the patients in the best way we can with the resources we have, but not in the safest way, not in the ideal scenario.

The other important thing when we say about shortage of staff is the staff that it's working, has been working extra.

Everyone are pulling extra shifts.

I'm on my third week in a row doing the ICU currently because we don't have enough people to take care of this patients.

My nurses are double shifting the normal shift they do.

And it still amazes me that people, against all odds, are getting up out of bed and going back to work every day to do this for 12 hours, knowing that they're walking into an environment that is not ideal, but everyone is pulling to do the best we can because we don't have another option.

- Dr. Wilson, can you tag team on that and talk about the effect on morale of the current situation?

- Sure, there's a couple of elements to that.

One of the pieces is that I think our healthcare society or group is really resilient.

We've been through several surges and everybody's just pulling together and making it work.

And you get used to working with triple coverage in an environment where it should have single coverage.

You have nurses on the floor carrying seven or eight patients when they normally carry four or five patients in the best of circumstances.

But they develop a really strong, cohesive strength together.

The difficulty becomes, and this is different with this surge than we've experienced with previous surges.

But now that we have the opportunity to do something to really stop the spread of this virus and everybody could be vaccinated, and that would really reduce the load, there are breakthrough cases, but they're small and they don't tend to get really, really sick.

It has been mentioned here already.

And so when you're working this hard and you've been through this so many different surges already, and you're looking at a population coming in, that's un-vaccinated by choice, it hurts.

And it sucks the energy out of people.

And we've had nursing staff and other staff basically say, "I'm done," and just walk away from the hospital and you cannot blame them, but it's not many and most everybody sticks together and works hard because it's the right thing to do.

You work in healthcare and you recognize that a lot of the things that we take care of all throughout our careers is related to the choices that people make in their lives.

And this is just a really significant example of that where people are making a poor choice and we in healthcare are paying the consequences as are those people that are in the critical care unit and other environments that are dying.

- Now, we have already established the fact that the majority of these new patients that you're seeing are majorly unvaccinated.

And the first big wave we saw a certain age range of patients.

I would like to address this current wave that we're seeing.

And Christin, I wanna go ahead and start with you.

What is the average age of the patients you're seeing now and how do these numbers now compare to the first time?

- The first time we had our surge, we were averaging more of those people that were in the 70 to 85 year old population, your nursing home patients.

And now we're seeing, at our facility, we're seeing anywhere from, I would say 40 to 55, would be the bulk of what our patients are.

We do have some that are younger.

We have some that are older, but the main range is in between there.

And they're seeing those that are super sick.

And I think that's another reason why the staff are having such a hard time, is not just because they're working extra and double time and with less resources, but because they see the fear and the uncertainty in the eyes of people that are their age.

They're having to take care of people and put people that are 20, 25 on ventilators that they've never had to do before, unless they were in a serious car accident.

These are just basic things that they don't have to deal with on a regular basis.

And so I think that's contributing to some of that concern with our staff and just their lack of: I don't know if I can pull through and keep pushing on.

- We've talked a lot about the numbers and the virus has affected so many people in a lot of different ways.

It's, of course, taxed the hospital staff, but it's hit some harder than others.

And we're gonna look at a patient right now.

- My name is Rosalinda.

And I was hit with COVID twice this year.

And I was in ICU for a whole month.

In the month of March, we came up positive with COVID on a Sunday and it was including all my family, my three children, my husband and I. I was the only one admitted to the ER.

After that, about five days after, I coded on the doctors and was placed in ICU, CCU.

From there, I passed about two weeks and a half to three weeks in coma.

I was fully intubated, 100% on oxygen.

And my family, during that time that I was awake, that week before I fell in coma was actually questioning me, what was my favorite color, what was my favorite song because the doctors had told them to prepare for a funeral.

After I got out, there was a celebration of the doctors and nurses out in the hallway.

I was watching them through the glass and I thought they were maybe having a party for somebody.

I did not realize that they were actually celebrating because I had recognized that I was in the hospital.

And I did not realize that a whole month had already passed.

Once I insisted to be let go from the hospital and I came home, I was still not walking.

I came home in a wheelchair and now I'm out of the wheelchair, but I'm in the walker now.

It was just sad.

It hits you to come to reality of everything that you go through with COVID.

But the care with my daughter has been really hard.

She is a special needs.

She has multiple, multiple disabilities that is constantly needing somebody at her bedside.

I'm not able and that has been really hard.

And I know, in certain way, maybe she's thinking where's my mom, what happened because I was always there.

And now I see that I'm way off, apart from her because of my condition now.

It's not the same and the message that I wanna get through to the ones that are not vaccinated is go get vaccinated.

I think your family needs you still.

It's very important for us to have safety for us and for others.

- Now, putting a face to the pandemic is always hard.

It hits home.

And a lot of people have a lot of questions and probably first and foremost is what do we expect going forward?

And maybe even one of the most asked questions, how long is this surge going to last?

Dr Saravanan, can you address this for us?

- Sure, I think a lot of this is in the community's hand at this point.

We will only know how long it'll last if enough people are able to control the spread of this virus, not just through what we knew before, but also what we know now.

In the last two surges, we did not have a vaccine available.

The only thing that we had is masks, social distancing, not congregating in places, washing hands, et cetera.

With this surge, we have a vaccine available and the vaccine has been around for more than eight, nine months.

So it is in the community's hand to really figure out how long this is gonna last.

We talked about the younger age group being admitted to the hospital.

We have to understand why.

If you look at the DSHS dashboard for vaccination, you'll see today that in Ector County and Midland County, over the age of 12, so 12 and over, all eligible patients to receive the vaccine, the vaccination rate's about 45% fully vaccinated.

If you look at age over 65, it's 75% fully vaccinated.

So you can see why the older population is now not in the hospital as much.

The younger population is.

So we have to take that into consideration and use every resource we have to control it.

And that'll answer the question of how long it'll last.

- Dr Wilson, I noticed that the Delta virus, the Delta surge started earlier in Britain and in India.

And I think I'm reading now that those numbers are starting to wane.

Do you anticipate something similar here?

- I do.

There's only so many people that are gonna get the virus.

I mean we have what, 140,000 or so people?

And if 40% of them are vaccinated, that takes out those folks out of the loop.

But the real challenge continues to be that it's burning so fast that we can't keep up with it.

We talked about, before we had the vaccines, slowing the burn so that we can manage the care, get back to doing things, socially distance.

Don't congregate, be smart about what you're doing.

And that way, you can get about doing things.

And we're gonna have some people get sick, but it'll be a manageable number.

With this, we can't manage this and it's not slowing down at this point because so many unvaccinated people are getting sick and it's really over, wiping out our resources, wiping out everything that we have and how we can manage things going forward.

- Now, speaking of the vaccine, we've already established that people are getting single dose, double dose and even a third dose.

What about the booster?

Recommended?

Yes, no?

The FDA is currently-- - Currently the recommendation is the booster is for those people that are on immunosuppressive therapy, organ transplant patients, significant immunosuppressive drugs.

It's really up to the providers of those patients to suggest whether or not they're the right candidates for those medications at this time.

There's a lot of conversation now.

And we anticipate in the next few, within weeks as sometime recognizing that there seems to be a reduction in the amount of antibodies in persons at about eight months or so.

So anybody who's been vaccinated eight months ago or so, so the earliest vaccinated people should be eligible, perhaps in September to be vaccinated.

- We did hear from the White House today or from HHS, that the recommendation for people at the eight-month mark past their second dose should get a booster.

There's been, which has been typical of this virus, communication has been challenging, the FDA and the CDC and the White House and HHS are not necessarily all on the same page at the moment, but we seem to be moving toward boosters for everyone who's vaccinated at the eight-month mark.

And we're gearing up and planning for that ourselves in Midland.

I think you all know, we did a successful mass vaccination effort early on in the process, as did our friends in Odessa.

We'll do that again.

It'll be interesting to see what the demand looks like.

But I would expect that the early adopters, the same people who enthusiastically embraced the vaccine from the beginning will be back to get their booster when that opens up to them.

And, hopefully, they'll bring along with them some people who didn't get their first dose.

That's what we're hoping.

- Dr. Garcia, I've heard folks say COVID is gonna be with us so we just need to go about our lives as normal.

How would you respond to that?

- Well, in an ideal situation, you wouldn't overwhelm the health system and people that should not die is gonna die because the systems are overwhelmed.

I think it's about personal responsibility and accountability for your decisions.

We have to start thinking about our communities and stop thinking about ourselves.

Vaccination, it's not about you.

It's about the people around you.

It's about your community.

It's about your family.

And sadly, we're seeing more and more frequent the story of having multiple family members in the ICU at the same time.

I have three family members from the same family currently in our ICU.

And so you're affecting your own family members, your loved ones, your neighbors, your parishers.

It's your people.

So I think it's a personal responsibility towards everyone that you get in contact with.

- Do either of y'all see in the future, the habit of doing a COVID vaccine on a yearly basis, like you do the flu shot now.

- I think that's possible.

- So the best way to answer that question is to know whether, you have to understand why you would need a booster shot or another shot.

One reason is, like Russell was saying, if your antibody count falls below a threshold that no longer protects you, then you need a booster.

Or if there is a new variant that is no longer susceptible to the old vaccination that we had.

So that remains to be answered, whether we'll need something yearly, or if it'll need something every five years, we don't know.

There are certain viruses like measles and mumps and rubella that they don't mutate much.

So you got shots when you were a kid, you've never had a shot for that again, since childhood, but then there's certain viruses that mutate a whole lot, like the influenza virus that we have to get a shot every year.

And we vaccinate against 23 different new variants, and that doesn't even cover every new variant that we discovered.

That's just the ones that we think are gonna hit each year.

So can we go about our normal lives, even with COVID around for a long time?

That might not be our choice.

It's gonna be around.

It's how well we control the spread of it.

We've learned how to do that with the flu season, by giving flu shots.

We will learn how to do that with COVID as well.

- Another element to what Dr. Garcia, both of the doctors have said is that this virus, the coronavirus, does mutate very rapidly.

And the mutation that we're dealing with right now is the result of a rapid spread of the virus in a community somewhere.

Every time the virus replicates, there's an opportunity for mutation to occur.

So along with the idea that we have a personal responsibility for everybody around us.

If you get this virus and there's a lot of people, that one of the arguments you hear is well, I'm young, I'm healthy, I'm not gonna get really terribly sick, but you're still gonna carry the virus in your body.

And there's an opportunity for one of these variants to be developed in that environment.

So the more we suppress the virus from replicating, the more likely we will avoid the next Delta.

And that's a really important message that I think people seem to miss because this variant is nothing like the variant we had with alpha, the very first virus that we had.

This is a completely different animal.

It's getting younger people, it's getting them really, really hard.

They're in the critical care units, et cetera.

Can you imagine having something like this with the transmissibility but also avoiding our immune system?

I mean there could be a monster virus out there and we're just allowing it to propagate and increase the risk that that's gonna develop in our community.

- Of course, you've talked about the importance of vaccines.

Are there other prophylactic treatments?

I hear folks talk about maybe taking hydroxychloroquine or ivermectin or supplements.

Can you address that?

- Yeah, I remember at the very beginning of this thing, there was a lot of conversation around using a number of different medications like that for any number of different reasons.

And I think it's partly because we didn't have much information.

And when you have a gap in the information, you try to fill that gap.

It's in human nature, I think, you want a solution, you wanna be able to do something.

We all, as providers, you wanna try something.

And as time has passed, we've had an opportunity to do some studies.

And we've got some very smart researchers doing that work, and they pretty much eliminated all of the early beliefs around those things.

So there's observational studies.

Remember, 80% of the people that get this infection are gonna do fine.

They're not gonna need to see anybody in a hospital.

So if you try a medication on a group of people, if you have 10 patients and eight of them do great, you say, I've found a cure, but the reality is that's normal.

That's exactly what you expect.

Maybe all 10 will do fine because that's a small subset.

But when you actually do a study and you look at a larger body of people and you look at what the outcomes are, unfortunately, ivermectin has not panned out.

It's not bad.

I mean, it's a safe medication.

We use it for parasitic disorders, but it doesn't help with COVID.

Hydroxychloroquine, same thing, it hasn't proved to be effective.

I see no harm in taking extra nutritional supplements, but the vitamin D thing, that was a study that should have been done multi-variate because this is a group of people that you're looking at just vitamin D, but maybe they're malnourished.

And if they're malnourished for any number of different reasons, their vitamin D will be low but so will a lot of other things.

They didn't do so well.

So they tried the vitamin D, they did better.

In more controlled studies, it hasn't proven to be that effective.

So you pretty much have eliminated all those opportunities.

And we had a town hall group meeting with our community doctors in Midland last night.

And I had one of the immunologists on the phone with us, involved in the communication.

And he's a board-certified, fellowship-trained immunologist.

And his recommendation is if you get this, 80% of you're gonna do fine, stay well hydrated, get plenty of rest, take care of yourself with all this regular supportive things that you do.

And he had no recommendations for any outpatient therapy, save one, if you are a person that's at high risk and you're overweight, or you've had diabetes, or you have underlying medical conditions, or you're over 60 years of age, we were actually using 50 in our community, Regeneron therapy, or the monoclonal antibody therapy has been shown to reduce hospitalizations and length of hospitalizations for people that are at high risk and then come down with the infection if you get the medication started early.

So in that population, there is something that can be done for everybody else in supportive therapy.

- [Alejandra] I'm gonna add to that, if I'm allowed.

- Absolutely.

- I wanna make it clear for everyone.

We all want a magic solution.

We're all hoping for a magic pill or magic medication that we can give people and fix people.

It doesn't exist.

We haven't found it.

So you're gonna find a lot of documentation, a lot of information out there, bad and good.

The reality is there's one medication that has proven mortality benefit.

It's the steroids on patients that need oxygen.

Aside from steroids on patients that need oxygen, just doesn't exist a medication that has proven actual difference in mortality and helping patients.

And I wanna make sure that's clear because we all want that medication, that miracle to come out, it just doesn't exist.

There's a lot of misconceptions in the community.

Once you get to an ICU, there's no magic solution, there's no magic medication.

- A caveat to Dr. Garcia's comment is that the prednisone therapy does not help people that aren't requiring oxygen.

- Correct.

- I think that's a really important thing to say, because we have a lot of doctors in the community that because they've heard that prednisone helps, they're using it and this is in a population that you may end up creating, if they're diabetic, for instance, you can end up creating worsening of their diabetes.

And we're having a fair number of patients show up to our hospital and our emergency department in diabetic ketoacidosis and other complicated conditions.

And some of those patients have been treated as an outpatient on steroids when it wasn't appropriate.

So in that subset of the population that we talked about earlier, that might be able to go home on supplemental oxygen, they are candidates for steroid therapy, but no one else should be getting it.

Nobody should be started on antibiotics.

Nobody should be started on all of these other things.

It doesn't help.

- All right, I wanna go ahead and move on to something else that I'm sure you all, all are very familiar with.

There is that group that instead of population out there that still believe that the numbers are not accurate, that none of this is as serious as the hospitals and the media are portraying it.

But I would like to know what is the responsibility of the individual out there as we go forward through this pandemic?

What does the public have to do?

- I'll say simply get vaccinated.

I mean, that's a single thing that can stop.

We would not be dealing with the Delta variant critical crisis that we're dealing with right now if 70, 80% of our population had been vaccinated before it began.

Now it's burning so brightly that I think we need 80 or 90% vaccinated before we could really stymie it.

And it's sort of self-inflicted.

- One point we've been making here in the last few days and we were trying to reinforce it last night with this town hall meeting with our local medical community is talk to your doctor.

There are very few of us that don't have a trusted medical authority in our lives, so primary care doctor, a physician in the family, someone who is a trained medical professional, get your information from that trusted source.

And remember that that's the person you trust with all the rest of your health.

Don't rely on someone you don't know who posted something on social media that sounds good to you.

Ask your doctor, talk to the people that actually have a knowledge base that can be applicable to this situation and can give you good advice, in addition to being vaccinated.

But if you have a question about being vaccinated, ask your doctor, then I think you'll get a consistent answer from them.

- I think that's what I would agree with.

- If you have to do your own homework.

You can't just have the, well, I read this on Facebook and then we hear a lot of that.

You trust us to take care of you when you're sick, we're asking you to trust us now.

And I think that's the message that we have to get out to everyone.

To Russell's point, you come to us when you're sick and you have providers.

Go to them, talk to them because unless you guys do your homework, we're not gonna stand up here and convince a mass crowd of people that it's the right thing.

Go and have those individual conversations, because it only takes one time to see what we all see to say, oh, wow, this is not just a hoax.

This is not just something they're trying to push at me because we've all seen reality.

And until it hits home for you and somebody close to you, it's not gonna sink in, but it's real.

And you just heard a story like that.

Dr. Garcia has her own story of having COVID.

It's real and it's there.

And you just have to ask the right questions and to the right people in order to make the right decisions.

Dr Saravanan, can you talk a little bit about breakthrough cases because I've also heard folks say, well, if you can get COVID, even if you're vaccinated, why bother?

- So yeah, two things on that: first, the overall published data on breakthrough cases is less than 1%.

So the most recent number was 0.02% of cases are breakthrough cases.

So out of 100,000, 10,000 people, there's two that would get COVID.

So that's very important because if you look at our entire US population, we have over 300 million people who've gotten the vaccine.

And so if you look at how many of those vaccinated people actually get COVID, it's very small.

And the second important thing is if you're gonna make a gamble on if you would get COVID or not, whether or not to get vaccinated, the gamble is not worth it because you're seeing the people that are unvaccinated in the hospital, who are more likely to be in the ICU, more likely to be on a ventilator.

Why take that gamble versus the other gamble is, oh, should I get a shot that is so new and I don't know what the long-term effects of the shock could be?

Do you know what the long-term effects of COVID could be?

Post-COVID syndrome is a very real thing we're starting to see right now.

We don't even know how to fully characterize it yet.

We've given it a name.

We don't even know how to fully characterize it, but that is not a gamble worth taking.

So the shot is much safer than the alternative.

- Now you mentioned the breakthrough cases, a lot has been said about the so-called long haulers.

What can either of you, I mean do long haulers have more or less to worry about than somebody else that is possibly getting COVID for the first time or even the second time?

I think the post COVID syndrome is that comment.

It's about those people that we don't know how long it lasts and the effects of having COVID, how long it lasts in their system.

I mean we're starting to see some observational studies come out in cardiac conditions in post-COVID patients, but those are not big enough like we said, to actually talk about publicly and say this is a fact that.

That is coming, as more data is collected, as there are more people that have gone through COVID and that are now being hospitalized again, for something unrelated to COVID.

We don't know if it's related yet or not.

We will be drawing correlations as a nation, as a world, we'll be drawing those correlations.

Then we'll be able to educate on that, but it's not worth the risk.

- An add on to that is I had a conversation with one of our vascular surgeons in the hospital this past week and in the last 18 months, he and another one of our vascular surgeons have managed about 10 patients that had thrombosis in their aorta, which, big words, big vessels, but the idea's that they're clotting in blood vessels that normally don't clot.

Similarly, our cardiovascular surgeons have mentioned that or I've seen that we've had a bypass surgery case come through our CVOR almost every day of the week in the last couple of weeks.

And normally it's one or two a week.

And the similarity in all of these patients is that they all were post-COVID.

So there's a thrombotic syndrome that is related to COVID that we don't fully understand yet.

And it's in everybody's literature.

We talk about it, but we don't really understand what it means, how long it lasts, what the factors are, but I'm sure you're seeing a lot of these same patients with pulmonary embolus and women that are pregnant and they're having clots in their placentas.

It's real and it's all related to COVID and there's similarly, there's neurological disorders that we're seeing with people with anxiety disorder or depression and the lowest common denominator always is that they've had COVID.

- And I'm gonna add to that.

We're seeing patients returning back to the hospital for respiratory failures that recover from COVID, went home, spent a few months, came back, and now they have organizing pneumonias because their lungs really never recover from it.

We're seeing young women that have COVID, mild and severe cases with persistent tachycardia, unexplained symptoms of shortness of breath, inability to tolerate exercise that we still don't know where they're coming from.

So this is people from our own communities, people on all the levels, people that recovered from COVID and I'm an example, that still have racing tachycardia nine months after I got COVID, people with thrombotic events like Dr. Wilson was saying, people that are having respiratory failure, recurrent admissions to the hospital.

So it's real.

Yes.

The data, it's observational.

There's a lot of things that we don't know about it, but it's real and it's out there.

We're seeing it.

- We have a Facebook question.

Somebody is interested in knowing what is being for newborns born to moms that test positive for COVID during their pregnancy?

- I can probably start on that answer.

So the vertical transmission of COVID from mom to baby through the placenta is not always happening because we don't fully understand if the transmission to the infant happened through the placenta or after the baby's born when the mom actually holds the baby close.

So that respiratory transmission is something we know happens for certain.

The placental transmission, we haven't been able to say that it happens for certain.

So for those newborn babies, what we do now is we monitor them.

We test them, we make sure that we protect them.

So if a COVID positive mom gives birth, we make sure that we tell the mom that this is a potential for the baby to get it.

So either the mom masks or the mom pumps, and then feeds the baby with a bottle, and we keep the mom and baby separate, their choice, but we give them those options and educate them on how this moves from mom to baby.

- We've talked a whole lot tonight about how important it is to be vaccinated.

Can we just talk practically for a few minutes about where can folks get vaccinated and where can folks get tested?

And I don't know who's the best person, best people from each community, right?

- I can help some with that.

The easiest way to answer the vaccine question, one of the greatest things that the CDC has done is a master list of vaccine sites.

So you go to vaccines.gov, easy thing to do, type in your zip code and you can find every place locally that offers a vaccine in our community, probably in Odessa too.

Most pharmacies have the vaccine.

The hospital is doing vaccine events in various settings over time.

And we publicize those on our website.

It's not hard to get the vaccine at all.

If you want it, you can find it.

It's pretty easy to find.

Where they're going to testing, testing is a little harder.

We had shut down a lot of the testing over time.

We, at Midland health, are offering drive-through testing through if you call our 68 nurse line, we'll make you an appointment and direct you where to go for drive-through testing.

Our capacity is a little low.

This is another staffing challenge.

We're trying to staff up and increase capacity.

But our website, as of this afternoon, has a list of all the places you can be tested.

Not many of them are free anymore.

So you may have to pay to be tested.

And in some cases, Dr. Wilson may wanna address this, testing may not always be as necessary as you think it is.

But there are plenty of places where you can get it done.

- Just to add to that, we have had come to our emergency room, patients requesting testing, because they wanna confirm they've had an exposure, what have you, and that's really not necessary.

It's not an emergency condition.

And our hospital and our emergency room are so busy right now that coming in there in those circumstances is going to either expose you to COVID or you're going to expose others to COVID.

So it's not the right solution at all.

Also in circumstances where there's a family member that has tested positive for COVID, in my opinion, it's not, I can listen to everybody else, but I don't think it's necessary for everybody else in the family to go get tested.

They should try to quarantine away from the family member that's isolating best that they can.

But if they start coming down with symptoms, they've got COVID, so (chuckles) getting a test to confirm that is unnecessary at this point in time.

This is too transmissible.

It's passing through families so rapidly.

So I don't think it's necessary, perhaps if you're in a family with a mixed group that some are vaccinated, some are not, and you are vaccinated, you might wanna get tested into those circumstances 'cause it's less likely that you're gonna come down with it.

But in other circumstances, I don't think there's any point in everybody getting tested.

- [Becky] Mr. Tippin, will you address testing and vaccinations for Odessa?

- Sure, it's very similar to what Mr. Meyers said.

That's the good thing right now is there's vaccine everywhere, CVS, Walmart, Walgreens, definitely at the hospitals and the clinics, both of our urgent care clinics, our friends at RMC, their clinics, it's everywhere.

And that's why it seems very simple for the answer is go, get it, use your common sense, take care of yourself and your family.

The testing is the same that it's available at our urgent care and walk-in clinics, and also at your physician's office as well.

So the vaccine is not a problem.

And it's out there.

Dr. Saravanan, if someone has had a reaction to a flu shot in the past, is it likely that they would have a reaction to this vaccine?

And will you talk generally about reactions that folks may have to the vaccine?

- Sure, different people define reaction in their mind differently.

So I wanna specify that the only reason you would be scared to get a COVID vaccine is if you've had an anaphylactic reaction to another vaccine.

Anaphylaxis means your throat closed up, you couldn't breathe, they had to stick you with epinephrin, they had to take you to the ER, and you had to sit there for four to six hours to recover.

Very, very few people have had that kind of reaction.

So very, very few people should be scared to receive the COVID vaccine.

Remember the COVID vaccine components are all published on the CDC's website.

The only component that it carries that's active is that mRNA molecule.

Everything else is a lipid layer to protect that delivery system.

You can look up those ingredients, you can look up the ingredients of the vaccine that you may have had a reaction to and decide whether or not they share that ingredient.

That's another good conversation to have with your physician to ask will I be allergic to the COVID vaccine because I was allergic to something else?

Just having a runny nose, just having some arm pain or weakness and fatigue, that is not considered a reaction to the vaccine, and that should not prevent you from getting the COVID vaccine.

- Now it's being recommended that anyone 12 years old or older get the vaccine.

Is there any legitimate reason, medical or otherwise, that someone should not get the vaccine?

- Only the anaphylaxis.

- Same reason.

- I'll make one other comment, because I think it's an important one.

If you have a little bit of a reaction to the vaccine, you have a low grade fever, arm is sore, you have some respiratory tract symptoms for a day or so, that is a good sign.

It means that your body's actually having an immune response and you're developing antibodies, is exactly what you wanna have happen.

And that's pretty normal after flu vaccines and after the COVID vaccine as well.

So that's to be expected.

And it's not that big of a deal.

Very few people end up having to stay out of work for a day or stay home from school for a day after receiving the vaccine.

By and large, I experienced it myself.

My arm was sore for a day or so.

Took Tylenol, I felt fine.

Felt maybe a little bit more fatigued than usual for a day, but then I'm protected.

I think it's really important to recognize that some degree of reaction is a normal thing.

- We've talked a lot about the importance of getting vaccinated, but can we also talk a little bit about how we should be behaving in the community?

Should we be gathering in large groups?

Should we all be masking when we go to the grocery store?

Give us some guidelines.

Can I start with you Dr. Wilson and we'll hear from the other docs too?

- I would have said if you go back a month from right now, I would have said that, we were all loosening up quite a bit because everything seemed to be kind of settling down.

We were feeling like the vaccine was making a great difference in our community, but then the Delta virus got into our community and it set us back on our heels a little bit.

It's real and it's creating infections so rapidly that even those people that are vaccinated, some circumstances are catching it in the face of vaccination.

Some people that have already had COVID before are getting it again under these circumstances.

And what has ever helped before we had a vaccine, it was the social distancing, the not congregating in large groups.

If you get into a big group setting and you have everybody talking a lot and you're blowing water droplets all over the place, that's the virus.

And that's what we wanna try to eliminate, so I'm making a long answer to yes, I think we should be social distancing, we should be masking again.

I'm not saying don't you have shelter at home.

I don't think that's the right answer, but I mean, be careful and use common sense and we can shut down the viral, mitigate the viral spread in our committee.

- If I can add on to what Dr. Wilson said, generic advice to give is to help risk stratify an activity that you're about to do.

So you're getting invited to a party, you're getting invited to a football game, you're getting invited to a meeting, you're getting invited to some other type of event that's outdoors, maybe a birthday party outdoors.

Risk stratify the event, look at how many people are attending, are most of the people that are attending vaccinated or unvaccinated?

Are most of the people that are attending going to observe masking and social distancing?

How much of this spitting is going to occur while you're there?

And I don't mean literally, but that's what happens when you're talking or singing or shouting.

So in a big football stadium where everybody is packed in and everybody is yelling out loud, that's the worst place for you to be right now.

If you're outdoors going for a jog around our beautiful park, no problem.

You can do that very safely.

You're out playing tennis, no problem.

You're out golfing and you keep good distance, no problem.

So there are several things we can do safely and there are several things we can do safely with the mitigating efforts that we have, like masking and social distancing.

Those stratifying information is on the CDC's website.

You can just google risk stratify activity for COVID.

And it'll give you a list of things that are low risk, medium risk, and high risk.

And then you choose whether to attend and what to do while you attend.

- Now we're getting another question off of our Facebook page, and this goes back to testing.

They want to know is there a cheek swab available for testing and if so, is it accurate?

Anybody who wants to tackle that one?

- Sure.

I can start.

There are several different types of tests available for COVID right now.

The two main ways that you test for COVID is either using an antigen test or a PCR test.

Much of what you find as a rapid tests in certain clinics, in certain urgent cares, also now that you can buy in grocery stores and pharmacies, those are mostly antigen tests, the one you do at home.

A test that you send to a lab is usually a PCR.

It's a little bit more accurate on the negatives.

All the tests have a good positivity rate.

It means if you're a positive on a test, you're positive, 100% positive.

It doesn't matter what the test is.

On the negative results, the antigen tests usually miss one out of five people.

There are about 80% accurate on the negative test.

And the PCR is the best absolute that we have.

There is no absolute in science.

It's the best absolute that we have.

So all those tests are available.

The type of specimen you obtain, the closer you are to the source of the specimen, the better the specimen will be.

So the deeper the swab in your nose, the better you're gonna get a specimen out of it.

If you get just saliva from your mouth, well, not that great, but you'll need a stronger test to amplify it in order to find that virus.

- Dr. Garcia, we have another question.

Somebody wants to know if a parent has COVID, should their children go to school?

- Probably the answer is no.

Those children are exposed to dad or mom that has the virus and even if the child doesn't show signs or symptoms, they can carry enough quantity of the virus in themselves that they can spread to other kids and those other kids are gonna go home and give it to mom and dad, grandma and grandpa home.

So the answer is no, everyone that knows that it's in contact with someone who is infected and possibly exposed, should quarantine at home, as per CDC recommendations.

- And the recommendation is to quarantine for 14 days from the time that that person either recovers or your last exposure to that person.

- I wanna thank you all so much for coming this evening.

I hear thunder.

Maybe we'll get some more rain.

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Thank you, Victor so much.

And NewsWest9.

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