Speakers and Reactors:

Dr. Charles Denham – Moderator
Dr. Greg Botz
Dr. Chris Fox
Dr. Brittany Owens
Dr. Christopher Peabody
Asst. Chief, Vicki King
Chief Bill Adcox
David Beshk
Jennifer Dingman
Charlie Denham

 

Dr. Charles Denham:  Good day. I’m Dr. Charles Denham. I’m chairman of TMIT Global and one of the co-founders of the Med Tac Bystander Rescue Care Program. I’ll be both a speaker and your moderator today.

We’re so very blessed you’re joining us to learn how to keep your family safe. Jennifer, would you set our sights today?

Jennifer Dingman:  Thank you so much for your kind introduction, Dr. Denham.

I’m really excited to be here today and learning more and more about COVID. You guys have been such a lifesaver. I’ve had friends ask me questions and I’ve referred them to the modules and to the website.

And it’s really been great because people just don’t know what they need to know about this. Today’s program is going to be very, very interesting. We’re talking about the future and surviving this pandemic that is going to become just something that we’re going to have to learn how to live with.

And I’m very excited about all of the knowledge and the wisdom that’s going to come today from our wonderful speakers. I’ll give it back to you; Dr. Denham and I’ll see you all later.

Dr. Charles Denham:  Thank you so much and thank you all for being here. Thank you, Jennifer. Thank you for your steadfast support of patients and families. It’s really a terrific opportunity to now be able to kind of summarize where we are in this process of the COVID pandemic.

All of us are suffering from COVID fatigue but we’ve got some very insightful information that we want to share with you today. And also refer you to, we don’t have all live speakers today.

We’re going to refer to some really great work that others have done on our webinar series. We have Dr. Gregory Botz who’s in the ICU today, recorded our program last night as we did with Dr. Chris Fox. You see on the second line, the chairman of emergency medicine at the University of California, Irvine.

Dr. Botz is a full professor of anesthesia and critical care at MD Anderson Cancer Center and also a full professor and adjunct professor at Stanford Medical School.

Live, we have one of the real pathfinders in emerging threats and threat safety science and that’s Chief Bill Adcox. Chief Adcox is not only the chief of police at Houston for the Medical Center for the University of Texas healthcare programs but also the chief security officer at MD Anderson, our number one medical center treating cancer in the world. Dr. Christopher Peabody will refer you to who is a wonderful young man in his 30s who is also an emergency medicine doctor and an innovator.

He’s the director of the Innovation Center at the University of California, San Francisco and we’ve been working with him since he was a third-year medical student, and I met him when I was on faculty at Harvard Medical School.

We’ll also refer you to some of the great work that has been contributed to you by Vicki King who’s the Assistant Police Chief with Chief Adcox.  Brittany Bartow who is a community physician and pediatrician and Mr. David Beshk who saved the life with our Med Tac program who is a world-class educator and worked together with Charlie Denham who is my son on a checklist to focus on how families can be safer during the COVID crisis.

Our purpose, mission and values are important to us. Our purpose is to measure our success via how we protect and enrich the lives of families, patients and caregivers.

This community of practice was founded to tackle the issues of critical essential workers. Our mission is to save lives, save money and create value in the communities we serve and the ventures we undertake.

And our core values, we try to live every day, we fall short, I’m sure all of them but we really focus on our eye care core values, integrity, compassion, accountability, reliability and entrepreneurship. We have nothing to disclose by any of our speakers or the recorded sessions. No funding has been received for this program through the last 24 months from pharmaceutical companies or device companies in healthcare.

It has been purely philanthropy. You could go to our website to come back to be able to download information and we’ll put information we’re referring to and keep updating the website and for this webinar and be able to watch the sessions that we’ve addressed.

Our April 22, 2022 progress report video will be out shortly and it’ll address a kind of a recap of where we are in over the last 24 months.

Suffice to say that we are in COVID fatigue. However, we’re really seeing a surge again in Europe and we hope maybe it’ll be a blip here, maybe it’ll be a surge, maybe it’ll be a non-event or maybe it’ll be another crisis with the B2 virus.  We’re not going to cover this variant that is part of the Omicron lineage today, but we need to really remember that this is a critical issue. And what I thought I would do is play a video that is what’s called “Data in Motion” by Johns Hopkins.

We downloaded it this morning so you can see the latest numbers and we don’t have to quote them. So here we go and we’ll play that for you now.

Video – Data in Motion by Johns Hopkins

Dr. Charles Denham:  I highly recommend going to not only the Johns Hopkins site which is really well maintained, see the data in motion, look at the heat maps of concern to me as I live in Southern California and you can see that we’ve really got some intensity there and that just isn’t referable to our or reflected of our population.

We’ve really got an issue here. And so, my family and I are staying very, very vigilant and we’re being very careful. And let’s hope that maybe that this isn’t one event.

We just don’t know whether it will be or not with the virus. We recommend that you go to our website and we’ll continue to update these programs. We record everyone, we produce them as a mini documentary and right now we’re contemplating producing a book along with Chief Adcox and Dr. Botz.  We started an emerging threats community of practice. We’re going to be gearing that up with a lot more intensity as we hope that the COVID crisis will dissipate.

And there are about 30 different things that really should keep if they’re not already keeping our leaders of medical centers up at night, should be keeping them up at night. And pandemics was one of the issues that was critically important.

We have wonderful leaders from multiple organizations and you see it just a handful of them reflected on the slide before you today. Well, I would just let you know that some of these threats are invisible until they become visible.

Some are invisible threats that we know are going on and only when something bad happens that we are recognizing them. And it’s important that we recognize that.

Epidemics and preparation were actually one of the issues that we had identified a year before the COVID crisis. But there are other issues, employee fraud, patient fraud that also are critical issues that we’re addressing.

Just for those that have not watched our programs before, TMIT is a nonprofit 501C3. We were working in the area of innovation, quality improvement and product services and technologies. We were asked to help put together the survey for the LeapFrog group.

And we worked with the group purchasing organizations which developed our 3100-hospital network and 3,000 communities. And over 38 years, we’ve been able to have a wonderful set of subject matter experts now numbering well over 500 that are in clinical, operational and financial areas.

This particular coronavirus community of practice was served originally by about 40 to 50 subject matter experts. It’s grown to know well over 100. And we tap a lot of the resources we have, not only the live contributions, but also recorded and enduring content from our two Discovery Channel films that were global.

And you see a number of the noteworthy names of individuals that were contributors to the programs. And we have three more Discovery Channel or possibly Amazon media documentaries that will be coming out, one, three minutes and counting.

However, we’re addressing a number of other ones. So, what happened was we focused originally when this crisis happened on creating family safety plans for critical essential workers.

And you see, I won’t rattle off the names of the logos that are on the screen before you, but we had wonderful contributors to focus on readiness, response, rescue, recovery and resilience.

We undertook a 1,000-family household study and we have well over that amount now in terms of the data that we’ve been studying, critical essential workers.  How can we stop the virus in the homes of critical essential workers?  We found out that the general public was really interested in this and our focus was on head, heart, hands, voice.

What do the families need to know? What needs to motivate their heart or their emotions? What must they do, hands and voice? What could they say to others?

As of today, actually we’ve done 44, 90-minute broadcasts, including those we do in patient safety, 24 specifically in survive and thrive training programs.

And you see the other list of the deliverables that we’ve undertaken. We just want to remind you that all of our 90-minute programs have been produced, but we also are producing very short videos you can watch on your phone and we’ll be continually updating them in the next, in the weeks ahead regarding the next normal, addressing masks, ventilation and a number of the issues that we still need to really be focused on. This survive and guide program covered a number of topics.

We started with coming home safely and you’ll see a number of the titles that we have on this page, the new normal and the four piece we’re going to cover today a little bit with Chief Adcox.

We covered Delta, Omicron. I think the most recent videos and the most recent productions have really helpful as we go forward, testing to navigate care, our stress, emergency safety net fraud and then also addressing the safe practices that are critical. So, as we go forward, we also want to thank our college and young adult team who’ve worked with us on vaccines and a number of areas in vaccine hesitancy.

They come from a number of great organizations, a lot of overlap with our top medical centers as you’ll see and they were great contributors not only to vaccine hesitancy, but also what families can do. And we think of a family being two roommates at college. That’s a living unit and they’re the family away from home.

And so, we had these great contributors. Now there’s been a real challenge with misinformation, disinformation and mal-information. And I found that this graphic was very helpful.  I found it on the web, it was absolutely trippy. Misinformation is unintentional mistakes and inaccurate information, spreading false information but it lacks the intent.

The intent to harm is really disinformation. We see that coming from the Soviet, the former Russia and from those that are trying to defeat science and solid science.

And that’s fabricated deliberately with the intent to manipulate. And mal-information is the deliberate abuse of private information, releasing people’s emails in their locations and putting people at risk that is an intent to harm, but may not be falsification of information. We produced a videotape called the vaccination conversation which we’re updating now. However, we’re collaborating with one of my favorite friends who is Jeremy Kagan, a full professor at the University of Southern California Film School, who has been producing great videos. We mentioned it during our last program. However, we’re going to play a video that we think for those of you that are tackling vaccine hesitancy, we’re going to play this 10-minute video tape because we do have time today to do it.

10-minute video tape:  Guess who’s back, baby?

Hey, welcome back, my man. I miss you at the robotics competition. I heard you won. Congrats. Yeah. Hey, Charlie. Hey. So, you finally got your co-vaccine shots?

Yep. Now I’m all vexed up and ready to kick some balls.

Hey. I know you’re happy to be back, Charlie. Watch your language.

But, Dad, we are kicking balls today, aren’t we?

You know what I mean. I know what you’re doing. So, get out there. Do your warm-up. It’s Coach on the field.

Yes, Coach. You heard him, guys. Let’s go kick some balls.

I am so glad Charlie can finally go back to classes and soccer and anything that gets him out of the house. I was going insane with him and his sister and my mom home all day, every day.

It’s too bad you can’t have a celebratory margarita.

I know, and I want one so bad.

Why did you wait so long to let him out of the house if the kids don’t have to be vaccinated to go back to school?

I know, but my mom, you know, with her cancer.

But what does cancer have to do with COVID? They can’t get vaccinated?

Oh, yeah. People with cancer can get the vaccine. Yeah, my mom is vaccinated.

It’s just that people with immune disorders like cancer are still vulnerable.

That’s why Charlie, Coach, and I got vaccinated. Not only to protect ourselves, but also my mom and my little one, Anna. She’s still too young to get a vaccine.

Hey, Coach, I hope that vaccine gives them super strength and super speed, or else we’re looking at another zero on the scoreboard.

Don’t worry. We’ll do just fine.

Want to make it interesting? $20 says we lose. Again.

Why would you bet against your own team?  We’re on the same side.

So that’s a, no? You scared? The vaccine makes your pee-pee soft?

I’ll take that bet, Robert.

Huh?

You heard me. I’ll take the bet.

Just so we’re clear, you’re saying that you want to bet that if we lose, I would win…

$20, that is correct. But if they win, you get yourself and Ricky vaccinated.

And you’ll shut up for the rest of the season.

No way – keep your money. I’m not going to risk my manhood for a couple bucks.

You know the vaccine doesn’t cause impotence.

Oh, yeah? What about that guy? What’s his name? From accounting?

Oh. Oh, he wasn’t vaccinated. Erectile-disfunction was a side effect from actually getting COVID.

What? Nah.

I’m telling you, man, it’s true. Side effects from COVID are way worse than the possible side effects from the vaccine. A New England Journal of Medicine study found that the vaccine has no effect on a erectile-disfunction. However, a mild COVID infection could, you know…

How do you know all this?

I did my research, man. I’m all…backst…up.

You know what? It’s on.

Hey, it’s so awesome that you’re back.

Thanks.

Hey, Dweeb. I heard you got the vaccine. I bet that’s why it’s still so scrawny. It looks like you got a reverse Captain America Super Soldier serum. A super Dweeb serum.

Hey, I also got the vaccine. Anything you want to say to me?

Yeah. The vaccine is an international ploy orchestrated by the powerful elite to keep control over the masses to further their murderous agenda. So shut up and get in line.

Where do you hear all that?

On social media.

My mom says social media spresds a bunch of lies and misinformation, and I shouldn’t believe anything that’s not from a reliable source.

And do you just do everything your mom says? What even if she, a fascist?

What? No, she’s a doctor.

Do you even know what a fascist is?

All I know is the elite are actually lizard people, and the vaccines have microchips in them, activated by 5G networks.

He’s crazy. Just shoot.

Well, my parents are only worried the vaccine was developed too quickly, so that’s why I’m not vaccinated.

You’re not vaccinated?

No, he’s not.

You know, soon they might not allow him to play if he’s not vaccinated.

No, really? He’d be devastated. I mean, I’m vaccinated, and his dad had COVID, so he has immunity. But with the kids, I just feel like the vaccine happened really quickly, and… I’m still scared.

As you should be. We all care about our children’s health and what they put in their body. We hear these concerns all the time from parents at the hospital. And I explain to them, the vaccine was not created overnight. The first vaccine ever was created in 1796. That’s over 200 years ago.

Thinking that the vaccine was created from scratch in the past year, it’s like thinking that PlayStation 5 was developed from scratch too. But we all know that it started with the Atari in the 70s, then the Nintendo, then the Super Nintendo, then the Sega Genesis, then the Nintendo 64, then the PlayStation…

Wait, you’re mixing consoles?

That’s my point. They were all built on previous technology, even if they were “different”.

Just like the different vaccines?

Exactly! Moderna, Pfizer, Xbox Series X, PlayStation 5. All brand new, but built on previous technology.

And as far as your husband, even if he had COVID, he still needs the vaccine and boosters to help protect him against new variants. Okay, but what about infertility and all those things’ people talk about?

Not only did the vaccine not affect my fertility, but my doctor says that my baby will also be born with some immunity. Right, Doc?

That’s right. We’ve had pregnant women who were not vaccinated die from COVID at the hospital, and it’s heartbreaking to see families shattered like that over something that could have been so easily prevented. I mean, what people need to understand is that, yes, even with a vaccine, they could get COVID, but what’s most important is that it helps prevent it from becoming something more serious. Or even death.

Maybe I can come by the clinic this week, just talk to you about it?

Of course. Bring your husband and son and I’ll answer all the questions you have. And at the end, we can get them their first shot. We have both the adult and kids’ doses at the clinic. And maybe a booster for you while we’re at it.

Okay. I still can’t believe you’re betting against your own son.

I’m just being realistic, okay?  Admit it – they suck.

Oh, come on, Ref! What are you doing?

Hey, what happened? What’d I miss?

Foul, a penalty kick.

Wait, wait, wait, wait. Hey, Ricky, you’ve got this.

Hey, Charlie. I’m sorry about everything I said about the Super Dweeb serum, you know?

It’s okay. We’re on the same team, right? Ricky, Ricky, Ricky, Ricky, Ricky, Ricky, Ricky, Ricky, Ricky, Ricky, Ricky.

Are you going to be a team player and root for your team? Or are you going to root against your own son just so you can win?

Let’s go, boys!

Dr. Charles Denham:  So, this video, we think did a great job. There are others that we have on our website that are multilingual and suffice to say we’re not going to cover vaccines today, but we really believe that everybody needs to be up to date and rely on the advice of your personal physicians. Last month we covered what is the state of our safety net, our public safety net, and this really is comprised of law enforcement, our firefighters, our EMS, our emergency departments, but also good Samaritan care and bystander rescue care because truly you will be the first responder to your family. It’s a real pleasure to introduce Chief Bill Adcox, who is the Chief Security Officer and Vice President at MD Anderson Cancer Center. He’s the Chief of Police at the University of Texas at Houston Police Department. He has just been a longstanding champion of performance improvement in the emerging threats that we’re addressing much broader than COVID. And our hope is again, Chief, that we can get back to and you’ll hear from Dr. Botz that we will be really excited about getting back to some of these emerging threats.

We covered the issue of the state of our safety net and the fact that we’ve got major gaps in the safety net last month, and we have video actually showing metaphorically how some of the safety net isn’t even beneath us. And because things have evolved so quickly, and that there are major gaps. Chief, would you go through the concept of how you taught us our whole team about left of boom that you derive from the military.

Chief Bill Adcox:  Sure, Dr. Thank you everybody for being here today. And left of boom this is a term that was coined by the United States military, while we were battling terrorism on the front lines in Iraq. The terrorists had become very well, very, very good at developing IDDs which are improvised explosive devices and planning them and our vehicles would drive over them and large explosion with damage vehicles and unfortunately it was killing a lot of our soldiers and the injuring them seriously injured. And so, the military was able to obtain a tremendous amount of funding billions of dollars in order to harden the vehicles, so that they could survive an ID attack. And that was that was okay but they were still occurring and what they learned pretty fast is they needed to do something to prevent IDDs from being planted to begin with. And they went back to Congress for more money and understanding was as they felt like they’re giving them money to deal with the problem so they explained as they needed to get left of boom left of the explosion.

Meaning they needed to go upstream and try to identify how could they work with the Iraqi community how could they work with the different organizations to identify more technically skilled individuals that were building these IDDs. And in order to disrupt that. And so, you wouldn’t have so again, it was as you look at that graph in front of you, it was how do you get upstream to the left there and stop it. How do you stop it from happening to begin with. So left to boom obviously is before something happens and then right at boom is what you would do after the event, terrible event. And so really it came from the United States military. And it’s so helpful to us to really be able to communicate the 4-P model that we use in all of our projects, which are prevention and if, and if you could just help us kind of understand a little bit more deeply the two different factors of Sure, this is very critical and this is a model that we recommend everyone use.

So, with prevention you have two types of prevention primary prevention and secondary prevention. And then the second type of prevention occurs when an incident or an event does not happen. You’ve actually prevented it. Secondary prevention is if an incident or an event harmful event does occur. Our efforts are focused on reducing overall harm. So, we’re able to, you know, make sure that through partnerships working with the communities, working with the different parties that we can we can reduce the residual outcome.

So, you see your secondary prevention is you have, if you have an event is it’s going to be less harmful less damaging preparedness is as you said Dr. Denham is our state of readiness. And that’s how we ensure that we can effectively respond to harmful or damaging events. So, for example, this is what you do to prepare such as having an advance of an event you established early warning systems. You’ve trained your, your, your people, you do exercises you have really solid special operational plans. All your planning is done, etc. So that you’re very well prepared in the case that you did you did an event might take place. So that you can respond to it – protection.

The third, the third prong is protection for us. It’s an agile and adaptive model where we leverage people processes and technology to best protect the institutions the patients ourselves and others. And so really protection is pulling all that together and having that model. And last is that loop that we’re doing that constant performance improvement looking at it all the time.

So, if you have a focus on quality assurance and improvement across all service lines across all events and use a data driven process, you’re able to review these events you’re able to take the necessary action to make improvements. And the last thing I will say about the model – the model is not independent each of these things do not take place in a vacuum. They’re all interrelated and interdependent, and they feed upon one another. And so, you really need to have a full model in place and have a very solid understanding of how it works. And that is the best way that you’re going to be able to protect yourself. And that’s the best way that you’re going to be able to prevent events for your organization. There’s no doubt about it.

Dr. Charles Denham:  Well thank you chief and, and we’ve applied this to the multiple projects that we undertake and for those of you that are just getting to know us or working with your families you can hear, we’re using a lot of the leading-edge innovative ways of dealing with threats and so this emerging in our Med Tac program which was actually focused originally on the leading causes of death for what we’re good Samaritans with no clinical training could take the best medical practices and the best tactical practices from law enforcement from with great leaders like Bill, and be able to tackle the first crisis in eight to 12 minutes before EMS arrives. Our emerging threats community was started before the COVID crisis and for more than 30 years we’ve been delivering patient safety know how and knowledge with our community of practice and our cure The severity of the disease is just directly related to the viral volume or the viral load that people get preparedness is like what we’ll hear from Dr. Bouts here shortly is this being ready that state of readiness and then the protection is what’s really important about protection. These days is if somebody gets sick in your home, how do you keep someone else from getting sick stories, stories sell data tells and I have family members that I’m helping manage and advising.

I’ve had family members die of COVID. I have family members and good friends that are suffering from long COVID. I have friends right now that are getting have been infected multiple times with COVID. And so how do you protect the rest of the family at the time when boom occurs or when somebody gets infected. Again, these are some highlights of some of the content that we’ve covered. We talked about inside threats and outside threats and the inside threats to your family or those intrinsic to your family are, if you’ve got somebody in the elderly age group, if you’ve got somebody who’s immune compromised for any sort of disease like this trans post-transplant post cancer, currently receiving cancer treatment, having a hyper reaction to viruses. I’ve got these things in my own nuclear family.  I’m over 65, my son has had an adverse reactions to viruses, and I have other family members who are at risk, and so that’s where the inside threats we need to recognize them. And so outside threats are how much community immunity is there, meaning how many people are protected out where you live, and are up to date on vaccinations, and are there well-ventilated areas where you can circulate, and the idea of resilience building is really hardening the target.

So how can we shrink the inside risk and threats, how can we shrink the outside risk and threats that’s the game of the next normal. And so, as we look at those things and go forward, that’s really what’s critical for us is, and we see in our hospital system staffing shortages with COVID, have really increased the risk to those from the outside, but also your inside threats because they’re not able to get to see their doctors. So, it’s really important that we recognize that.  So, we’ve asked Dr. Botz now 24 months after the beginning of this community of practice to really address for us, the family safety plan and what we call the five hours and so we’re going to have Dr. Dr. Botz, who is both a professor of anesthesiology and critical care at the UT University of Texas MD Anderson Cancer Center, but he’s also an adjunct full professor clinical professor in the Department of Anesthesiology at Stanford Medical School. He also has done a fellowship an extra year of training on simulation. He’s been a God send to us as our clinical leader, but also to emphasize deliberate practice of the things that we need to do, and the things that we can do.

And so, when we talk about this family safety plan, I recorded late last night and then edited this morning, his latest take on what we what we need to do so I’m going to play that video for you now.

So, Dr. Botz, we’ve entitled this program The Next Normal.  I’m not sure that we’ll have a normal, but as we head forward, what’s your general advice to families regarding as we head into this next phase.

Dr. Greg Botz:  Well, I think all of us have two years’ worth of fatigue in dealing with Covid and its implications both on our, our work, our home life, and every other aspect that we have had to manage over the last two years. My advice is to keep up the cause. Stay vigilant. We see a bright future ahead but we aren’t sure that we’re out of the rough water yet. It looks like the latest variant may be more transmissible, but maybe less likely to cause a hospitalization or even death that may be tremendously affected by the fact that people have been vaccinated and boosted. But I think stay the course, stay vigilant, stay safe. Great, you know, as we look at masking, you know, we’ve been great proponents of it. We know that care, many caregivers have done great and have not contracted the illness by, by using high quality masks. It’s my belief that we really need to be careful as we go forward and those of us that are immunocompromised or could potentially spread it to somewhere at one else or just risk averse should use masks at will what you take and and what have we learned about masks. You’re absolutely right. I know there’s a lot of controversy about wearing masks now that some of the restrictions have been eased. My opinion is that masks are part of that public health strategy that’s been in place for two years now to try to protect our populations, especially the vulnerable populations. So I think masking plays a big part in how we move forward. Obviously, if you’re outside, if there’s lots of air moving, the masks play less of a role. But inside, you can’t tell where the aerosol might be. And so variants may be moving through our communities, not causing significant illness in most people. But if it gets passed to someone who’s immune, immunocompromised or has a lot of chronic health problems, it could be pretty significant in them. Obviously, being vaccinated is one of the strongest measures that we can do to try to reduce the impact of the coronavirus. But masking still plays a role. I still wear a mask when I go into public areas where people that I don’t know are congregated or if I’m inside. When I’m outside, I don’t wear one. I enjoy the outside with the fresh air, but I still wear one when I’m in a situation where I think that the risk is increased. So, you know, we both have talked about this many times about social distance. And now that we know so much more about the aerosol spread and transmissibility of the virus,

Dr. Charles Denham:  I tend to look at social distance and ventilation together. So, when I’m with my son, we go to a restaurant or we have to go in to order something. We always wear a high quality mask. We try to sit outside. We never sit inside at all if we can possibly do it. And we kind of strike the balance of distance and ventilation and closed spaces and public spaces. Is that a reasonable way to kind of think about distance and ventilation?

Dr. Greg Botz:  Well, absolutely. I think it comes back to the fact that this is a virus that is transmitted by respiratory droplets that can hang as an aerosol for some time. Anything you can do to reduce the risk of coming in contact with an aerosol is to your benefit. So, you’re absolutely right. Wearing a mask, staying outside, keeping a distance that may reduce the risk of moving viral particles between people in an aerosol are all good things to do. I think we should still maintain those practices.

Dr. Charles Denham:  Fantastic. Testing. We now know a lot more about testing, the value of how we might use an at home test, an antigen test, versus a PCR and a laboratory test, and the timing which we cover again, we’ll cover again in this webinar. This is one of the really valuable things that we can have as we look at the dynamic balance between the background immunity or community immunity in an area and the infection rate. And when we’re gathering together, do you think that it would be valuable for us to all have masks, all have tests on hand, so that we can kind of manage that dynamic?

Dr. Greg Botz:  Well, I think so. I think that having the ability to do testing at home, when you are going to have a family gathering or have a particular activity for which you feel there is risk, then doing an antigen test at home to know what your antigen status is at that time gives you some confidence moving forward. And it also helps you to maybe trace where you may have come in contact with the virus if you do become infected to try to make sure that those that were there with you get the information that they’re at risk as well.

Dr. Charles Denham:  Well, Dr. Botz, we started out with our survey and now have more, many more than 1000 family responses. To our survey addressing the five hours. We’re now 24 months into this pandemic. And as you look at advising families of critical essential workers and the general public, let’s cover the five hours and so the first star is readiness. After 24 months. How should a family look at readiness?

Dr. Greg Botz:  Well, I would hope that a family would look at readiness the way we did from the very beginning, which is have a plan. Think about what your risks are, especially if you have family members who are in a high risk population with immunocompromised or chronic medical problems. And use that information to formulate your plan and stay ready. You should constantly think about what are the risks in not only my community, but in the activities that I’m going to do now, especially since things are opening up and we’re much more likely to be in contact with a larger groups of people. We need to think about that in trying to maintain the safety of ourselves and our families. The second is response. We know a lot more about what to do if we have a family member who has a positive test. And many of us are getting notified frequently that our family members are kids in school are in contact with someone that has been confirmed to have the disease. Anything new that we should think about as we think about how to respond if a family member A: gets sick or B: is in contact with someone who has had the virus.

Dr. Charles Denham:  Well, I think that not only did we think about readiness but now we’re thinking about how to actually deploy our family safety plan if in fact someone becomes infected. It’s the same strategies that we’ve talked about all along to try to reduce not only the risk to the person who has the coronavirus for their safety but also the safety of those around them. I think that the strategy is still the same. I think having vaccination as part of the readiness plan has perhaps mitigated some of the concern for a very severe illness that we might see in someone who comes down with the COVID viral infection. But nonetheless, the rest of those strategies in our family plan still remain true and we should practice them. Our third R is rescue and we certainly know a lot more about what to do if we have a family member who is sick and needs to go to the emergency department. You and Dr. Peabody from UCSF, our wonderful teammate and Dr. Chris Fox from UCI and his colleagues have really helped us understand the factors that are important as we try to rescue someone who might be getting sick. Now we’ve been around quite a few that have gotten sick and actually needed help getting to the hospital or even have long COVID and might need to go to the hospital. Any tips regarding 24 months after we have started to learn about this virus?

Dr. Greg Botz:  Well, I think the concept of rescue is important because we have to have a plan for how to go from home care where we are providing the level of care necessary for someone who’s infected with coronavirus to now seeking health care in a hospital or a clinic. And I will tell you perhaps the difference over the last two years is that it’s not the chaotic pandemonium that it was before in an emergency room. And the health care system is learning how to work in a PPE driven environment much better than we did initially. First, the supplies are better. People are used to using those strategies and so it’s more part of the fabric of how we practice. But it still can be challenging because of the safety measures in place. Access to emergency departments can be limited simply because of those strategies they still have in place. Remember that people are going there also for other routine care, injuries, illnesses, all the reasons that people might go to an emergency room prior to COVID are still in play.

Dr. Charles Denham:  But now we have people who may need rescue because they aren’t able to manage their illness at home and they seek additional care or higher level of care. I think it’s still the same challenge. It may not be to the same magnitude, but we have to take that into account when we’re making our plan. Our fourth R is recovery. And I don’t know about you, but many of us have friends, family members, colleagues that are now suffering from long COVID. And I use the term time bomb. This is really a, this is a time bomb in that it goes off after someone may have been sick. Your advice to folks regarding what we know about long COVID.

Dr. Greg Botz:  I use it as a cautionary tale to say people may be tired of COVID.  But listen, you do not want to get long COVID. This is a terrible, terrible thing that happens to you. Right. When we think about recovery, we’re not only considering those people that have perhaps a normal recovery from a viral illness, which is how we hope COVID moves going forward in that it’s just one of the other viral syndromes that we have to deal with. And we aren’t seeing the very critically ill response that people have and certainly at risk for ending up in a nice you with life support and, you know, very significant and organ system dysfunction. But you’re absolutely right. We need to think about long COVID, which is the circumstance where people who have been infected with COVID have long standing, prolonged symptoms that can affect many of our organs. Notably, there’s a lot of cognitive problems that can go along. We’ve heard about the brain fog and people who have had long COVID are very limited in their ability to go back to work because they can’t multitask. They can’t remember things. They’re afraid of making mistakes, especially if they’re working in a high stakes environment like many of our essential workers are. They can have respiratory problems like a prolonged cough or difficulty with breathing or with sputum production and things like that that limit their ability to carry on their activities of daily living. There can be cardiac abnormalities that people see most notably would be just having a very high heart rate attack of cardiac for no real reason. You know, they’re not exerting themselves very much and suddenly their heart rates going in the 120 to 140 range. There can be neuromuscular problems that can go on with problems with how well you can maintain your balance or how well you can walk and ambulate without putting yourself at risk for falling. All of these things we’ve seen before in a number of different illnesses, but not so concentrated, I think, in a post viral syndrome like we’re seeing in many, many people. The real challenge is that the health care system is learning how to understand and manage log COVID while it’s happening. And we’re really playing catch up. There are a lot of people that are suffering and we don’t have a lot of answers yet because we don’t have numbers that tell us whether the interventions that we’re considering really make sense. We haven’t, we don’t have the power to decide whether it’s an effective intervention or not. And so we’re learning as we go.

Dr. Charles Denham:  Thank you. And the fifth R is resilience. And I like to characterize resilience as a way of living going forward to reduce the potential risk of the threat and use even the military term of target hardening or the law enforcement term of target hardening. And for my family, I look forward and I say, what are the activities that we have over the next month? What’s the ventilation of those buildings where there might be something held? Can we pick an outdoor venue?  Can we pick an outdoor restaurant? Can we socialize, or go to church services that are outside and really reduce our vulnerability from the outside threat?  Yet everybody in the family vaccine is up to date, fully vaccinated, I think is determined it’s going to go away. I think up to date is perhaps another way we can look at it. And so, this idea of resilience or hardening the target of your family to these outside threats as well as the inside threats of vulnerabilities.

Dr. Greg Botz:  Well, I think you’re right. I think resiliency is really an important dimension of our ongoing response to the COVID pandemic and any other illness or any other chronic medical problem that we face. I think that the idea of critically evaluating your activities moving forward to understand both the risks that it might pose to you and your family and the vulnerability that you might have at that particular time in you or your family is an important consideration. And you also have to think about the dimension of resiliency, which is if something happens, how well do we respond and manage it so that we don’t fall apart so that we don’t have a catastrophic event?

Dr. Charles Denham:  Well, Dr. Botz, you’ve been such a terrific leader of our clinical work in Med Tac. And we had no idea that we’d be focused on COVID over the last 24 months. I just want to take a moment to thank you and get you to comment on our Med Tac program, which we actually started in 2015. I can’t believe the pictures of my son when he was a little Cub Scout and now he’s just earned his Eagle Scout project with a rescue station. Dr. Botz, I just want your thoughts regarding the fact that we just found out that one of our team, this is the fourth time that one of our team just out in their daily lives, saved a life. You save lives every day as an acute care doctor. It’s your business. But for those of us that don’t get to do this and have the honor of serving God by saving other people’s lives, it’s pretty exciting to see just our core team out in their daily lives and have four lives saved.  Your thoughts.

Dr. Greg Botz:  Absolutely. That is such great news. When we started this project, our intention was to raise the collective knowledge and skills of bystanders, because we knew there was a gap between an event and the arrival of professional first responders to manage that event. And we know there are lots of simple, effective techniques that can be used that saves lives. Our mission has been to educate people on those particular interventions and give them the opportunity to practice them so that when they need to use them, they will. And I think we are seeing that it’s very effective. We’ve had a number of people who have stepped up and have helped people in need. That’s great. That’s a win for all of us. I’m excited to get back to the basic technics of Med Tac, which is looking at those things that remain a threat to our young people, both K to 12 students, students in college and those who are early in the workforce. I’d like to get back to those things that remain preventable causes of death in that population. And although COVID has been an important focus for us over time, we need to get back to the business of educating the public so that they can save lives as bystanders in these events.

Dr. Charles Denham:  Well, Dr. Botz, it is so exciting here on the West Coast to be seeing our high school students leading the charge at putting rescue stations at beaches, at schools, at parks. Your comments to them, these high school students who have stepped up with it, these are pretty difficult and more complex projects than anybody could imagine to put something in for the general public that would include an automatic defibrillator and stop the bleed kits and PPE for COVID.

Dr. Greg Botz:  Yeah, I think it’s really important that these kids keep pushing forward with what they know is the right thing to do. I think one of my favorite sayings is I was growing up was those that say it can’t be done are frequently interrupted by those who are actually doing it. I think if you don’t allow someone to say no, and that be the end of the discussion, but really work to show them why this is so beneficial with relatively cheap equipment that can be deployed by nearly anyone with some training that really do have the possibility of saving lives. It’s the good cause. We should continue to do that. We know that it is. It’s a matter of making others know that this is the right thing to do for that situation in that location at that time. And that’s what our high school students are doing. They’re taking that charge and moving forward and they’re making it happen. And that’s really, really exciting.

Dr. Charles Denham:  Well, thank you for all you’ve done.

Dr. Greg Botz:  Thank you.

Dr. Charles Denham:  So, Dr. Botz has been just a fabulous proponent of saving lives, not only with COVID, but as we’ve said with the, the leading causes of death. Now, let’s just talk briefly about a focus in on emergency care and this issue of transporting a loved one to the emergency department and transporting them home. It’s critical with the with the Omicron that we’re as careful as we were with delta or anything previously. And it’s really a pleasure of mine to introduce Dr. Chris Fox. Dr. Fox is the professor and chairman of the emergency medicine department at the University of California Irvine. He is a sailor. He’s a surfer. He’s a waterman here along the ocean. He’s also done a fellowship. One of the first people to do a fellowship in the use of ultrasound in the emergency department, which is now very commonly used. And I mentioned my son frequently, but it’s kind of interesting to know that my son was on Catalina Island. We were at a scout camp in a remote environment. We had to have Baywatch come and get us because he was very sick. And we thought it was that both myself and an emergency medicine doctor at the, at the scout camp thought that he, he had appendicitis and the small hospital in Catalina on the island, they took care of him because the helicopters couldn’t get him in.  And it was actually Dr. Fox’s innovation in teaching all of the emergency medicine doctors how to use ultrasound to diagnose, diagnose appendicitis that actually kept Charlie from having to have more therapy. So that was a great experience. So, I’m going to ask Dr. Fox from the emergency medicine perspective, but also the general medicine perspective to give his advice to you. Dr. Fox, thank you so much for spending just a few minutes with us regarding this issue of COVID and we can’t believe that it’s been 24 months, 24 – 90 minute programs. We’re so grateful for all the advice that you’ve given us. What do we need to know about this potential, you know, next normal.

Dr. Chris Fox:  Yeah, I think it’s hard to always know what’s going on with COVID but and my predictions have been wrong here and there so, but I think we’re sort of falling, at least in my mind, I’m sort of getting used to it being, you know, maybe we’re in a lull right now it’s not going to ever really go away but we’re in a lull and let’s enjoy this lull as much as we can and kind of get back together with, you know, and, but be safe about it and be smart about it. And certainly, if it starts to surge again, then, you know, take all the precautions now we know what we’re doing we’re good at this. We’re not going to freak out about it, like we used to, we know what to do, Vax and chill. And when you, and then take precautions for yourself if you know that, you know, you need to, and there’s it started to surge up again, or you need to travel to go to a place where it’s surging, then you know exactly what you need to do to protect yourself with the N95s and good hand hygiene and everything else and so, but it’s it’s also good to really enjoy the lulls when we have them and kind of get some, get some normalcy back I think we’re all sort of experiencing that right now and that’s wonderful. I think I’m eligible for it now. And stay and just kind of stay up with whatever the recommendations are, but definitely don’t freak out about it because we know what to do we know how to stay safe.

Dr. Charles Denham:  So, we talk about the five hours – in the first hour is readiness so what I’m hearing you say is that be ready for the, the surge of infections, watch the community immunity, make sure that wherever you’re living because we have people that are national and international, and look at the levels between infections and community immunity to know what to do, but to a family for readiness, you’d still say have N95s on hand have everything to take care of somebody at home, and we have to be as vigilant as we were in terms of readiness, even though we don’t have a surge now.  Fair statement?

Dr. Chris Fox:  I think that’s a very fair statement.  Yeah, don’t throw away the mask certainly not the N95s keep those on hand, because we’ve seen how these searches can just like and tick up like that kind of sneak up on us so when that happens again if that happens again. If that happens again, then we know exactly what you do or somebody travels into your area now that travel is becoming so much more complex I mean, I’ve been traveling a lot in the last three months to two and a half three months just all around and so I feel like I’ve been able to, you know, go into an area like I was in Puerto Rico last week and I’m like, I’m not really sure what’s going on here I’m gonna wear my N95 on the plane the whole way there just in case I’m on a plane somebody could jump on that plane with me who came from some other area. I think any kind of  – anytime you’re on a plane, at least for me, it’s going to be an N95, because you know there’s little pocket surging around the world constantly now and so I think that’s just being safe. And then research the place you’re going to so when you get off the plane like if the local area just doesn’t have it, and they’re lulling like we are here right now then, you know, then you don’t really have stress about it as much. And but everybody has a different risk, you know, tolerance here when it comes that some people always wear an N95 no matter what, and other people kind of look at what’s going on and base their own risk factors on their own medical history and what they need to do to stay safe. And I like that the idea of kind of knowing what you need to do. Vax chill, wear the mask when you’re on a plane and and look at the city you’re going to and seeing what that what the rates are. I think that’s kind of being smart about it.

Dr. Charles Denham:  So Chris, the second R is response and is it reasonable to say that if somebody gets infected that we have to be just as serious just as vigilant to keep the other family members from getting infected and now we have testing so we can do at home testing and it’s reasonable to have testing on hand so that we can know somebody’s infected and use that antigen test for infection and the PCR test to really confirm things.

Dr. Chris Fox:  That’s exactly how I think about it Chuck 100% you know, it’s still, we all know somebody still in our community, you know, pops up here and there still, especially with the travel and people coming home for spring break and just there’s, you know, it’s a global world we live in now so

Dr. Charles Denham:  And then the third R is your area which is the emergency medicine and rescue and we’ve talked in a very detailed way.  We won’t today but we talked about the five rights of emergency care. And making sure that we really know where to go that are over 18 year olds have a medical power of attorney, we know are in case of emergency and, and we know how to get somebody to the hospital if they’re really sick you wearing masks and then leaving the car and having charged phones, any anything else you would add to the emergency visit if somebody’s got COVID and or maybe COVID and an accident.

Dr. Chris Fox:  Yeah, yep, it’s always hard to know when to go to the ER. I know it is for me – it’s hard for everybody. But certainly, I think you covered most of it, Chuck. It’s, you know, you want to use it appropriately and but you also don’t want to delay care should you know, have shortness of breath or a high heart rate or a low blood pressure, you know, or low oxygen, don’t mess around with that stuff – come right to the ER those are all very legitimate reasons to come to the, to the ER – heart rate greater than 100, oxygen less than 90, blood pressure less than 90. You’re definitely coming to the ER for resuscitation at that point so those are kind of some things to keep in mind.

Dr. Charles Denham:  And then Chris the final R. The final two hours are really recovery and you and I had a conversation offline about long COVID.  We don’t want to get long COVID this is pretty serious stuff and this is something to really be careful about. And then, the final hours resilience how do we harden the target of our home and know that if we were to get a wild variant that we’ve that we’re constantly practicing these Rs.  Are those reasonable thoughts and statements.

Dr. Chris Fox:  Yeah, I like how you kind of put that there. At the end – to stay to stay resilient and just, I think, for you know me going into this it’s just knowing that we’re in a really good place with it right now but that could change and if it changes, you know, don’t freak out just stay resilient. We all know what to do. If you think back to your Rs – In the beginning of all this, it was really scary because we didn’t understand this we didn’t know if there’s a vaccine coming, we didn’t know why some people were dying – you know – how do we, how do we keep from getting it. Right. I mean, I, I’ve been around it and it’s just as an example of how good 95s are.

Dr. Charles Denham:  Fantastic.  I still haven’t gotten it. But yeah, so yeah, because I really want to avoid long COVID, you know, like I don’t know what if that is a switch for me and changes, you know, my own body’s, you know, reaction to it like I don’t know what could happen, so for me, vaccination and 95 when I need to, and enjoy the laws. Good. Well, thank you Chris you’ve been just such a great contributor to our program and we just really appreciate it.

Dr. Chris Fox:  Good to see you Chuck.

Dr. Charles Denham:  So, Dr. Fox has really kind of encapsulated some of the, some of the important issues that we that we really do need to address what we want to do. Before we go to Chief Adcox and Jennifer, and kind of discuss some of the challenges, Chief, that the families of our first responders have.  Just to remind people that in our prior programs, Dr. Toff Peabody, Christopher Peabody, who’s the Associate Director of Emergency Medicine and also the Director of Acute Care Innovation at UCSF, and Dr. Brittany Barto Owens are wonderful contributors.  Their videos that we don’t have time to show today. What’s really important is that we go to the right provider. Please watch the videos that we’ve got.  We’ve got two or three – some are long, some are short. The right providers, the one that might have your medical records, and as Dr, Dr. Fox mentioned, we have a level one trauma center, a major medical center is likely to have a bigger bench strength, faster labs, and a much better way of dealing with somebody with a serious case of Covid. What’s important, your medications, the history of your imaging, your history of your laboratory tests you see the icons there and that on the right side of the page.  The right treatment is making sure that they’re addressing not only the signs but the symptoms that are going on, and Dr. Peabody really wants us to remember that the right discharge is probably the single most important thing that we can do at a visit and why is that?  Because we need to know what our discharge precautions are, what are the precautions necessary to come back so when you’re discharged, you would think it was what they are doing, but these return precautions that you see in the right and the left lower corner of the slide right now are really, really important. Knowing when to come back if you have a fever knowing when to seek care for someone else.  Knowing all these things are absolutely vital and probably the biggest gap in the safety net of emergency care, and then the right follow up. What is the right follow up the continuity of care, just because you went to see an emergency medicine doctor doesn’t mean that trip through our healthcare system is over. So, it’s really important that we recognize that when we are working with anybody who’s sick and we look at this trip to the medical center that it is really, really critical that we understand those things and that we’re focused on them. And we’ll finish up briefly with something that we use routinely in patient safety and quality, and that is the Swiss Cheese Model. One of these barriers of defenses that we have using masks – avoiding poorly ventilated areas, having social distance, washing high contact surfaces – we don’t hear much about it anymore. Why, because it’s probably not as common as we, thought, but there’s still is an environmental risk and what’s really important about masks are after you’re finished with a mask. It is a magnet for the viruses, especially the high-quality ones that are in 95 or the surgical mask have an electrostatic charge that is attracted the virus. So, if you touch the virus to the to the fabric of the mask. So, you don’t breathe it in. But then if you touch that mask, where all the viruses collected touch your eyes, your nose – we touch our faces about 24 times an hour, you can you can then get the virus and so it’s important to realize that the we use this in patient safety to have people help them understand that that the viruses can slip through these the holes in the in the Swiss Cheese Model and actually come through it.

So, what I’d like to do now is just ask Jennifer Dingman to comment as an expert in patient safety and quality, and I’ll go back to Chief Adcox, and then we’ll finish up with a checklist for your families what’s important for your families but go-ahead Jennifer and then we’ll have Chief Adcox –  we’d like for you to respond regarding what our families of first responders who are exposed every day.  Go ahead Jennifer.

Jennifer Dingman:  Thank you, Dr. Denham, what a great webinar this was today all of this really important information and your video was just fantastic. As a soccer mom, raising my children who have long grown up, I can just see how people are going to relate to that and I strongly encourage everyone here to share that with your colleagues, friends and families and anybody who has questions about getting the vaccine with COVID-19. And I think that’s really important to this pandemic. I think it’s really important that we not get too complacent about the coronavirus we really don’t know what’s coming around the corner we don’t know what these variants are going to do. We want to do everything that we possibly can to protect ourselves and those that we love from this virus. These webinars have just been priceless for myself and my colleagues, my family and my friends and I am so grateful to everyone here who has ever participated, all of our past participants and all of our speakers. You’re just wonderful.  I would like very much to continue on and share this and I encourage everyone here to do so and I’ll hand it back to you Dr. Denham. `

Dr. Charles Denham:  Great, well thank you and thank you for all you do in patient safety because you also help us tell the stories that that are important on our other webinar to caregivers and safety and quality.

So Chief Adcox, you are recognized as a leader in threat safety science, and everyone looks up to you in law enforcement. What’s your message to law enforcement families and families of those that are EMS professionals and emergency medicine folks?

Chief Bill Adcox:  Well thank you Dr. Denham and surely thank you for those kind words.

One of the things that – I call it the added pressure pot syndrome, is that first responders EMS, Emergency department physicians and staff etc. And they don’t have the ability to stay home and protect their loved ones to be there during a certain crisis and during certain issues so they, they have to be prepared. They’ve got to make sure that their family members are safe and prepared ahead of time because they, there’s a requirement that you know it’s expected that they’re going to respond to protect the community. So, it’s a little it’s a little added pressure and it certainly is a burden on a lot of people. So, the other thing you really tell them is be prepared. Be vigilant about saying current on your and being updated on your vaccines. If you’re if you’re eligible for booster for you and your family make sure that they get stuck. You know, monitor the current situation in your community in your area and you even if you can’t down to your neighbor and events that you make sure that you keep your family plan up to date.

We’ve talked about that over and over on these webinars. There’s a great template for that, but make sure your family plans are constantly up to date. Don’t, don’t over relax. Make sure that you’re vigilant, be based on circumstances, like Dr. Fox says, particularly when you’re flying make sure you are wearing a quality N95 masks. Make sure that you don’t get that viral load in one place, and it’s your protective. Make sure that you’re masking up whenever you’re going to be in circumstances – perhaps large crowds over a period of time. And then just be really vigilant inside of inside of a structure, whether it’s in good air circulation. Just be really vigilant about everything that you possibly can. And again, just really understanding what’s happening around you and making sure that your fear level and your actions are based on facts,

And lastly, I would just say just like any of you have any questions, contact the experts and rely on the experts and virtually most of your quality hospitals. Your quality hospitals will have lots of experts on the virus. And that’s really, really what needs to be done. I do want to thank you Dr. Denham, and others for 24 months of bringing this information together having it online – this free information for everybody is critical. And well, thank you. Thank you. Thank you.

Dr. Charles Denham:  Well, thank you, Chief. And Chief, you know, the last video we did, we address the state of our safety net and not everybody got to see it because many people are not watching live, they’re so busy these days and trying to get back to work. So, give us just a picture of your take of where we are in our public safety net this kind of the graphic that I have before us of our law enforcement firefighters, our EMS, emergency departments, that our public safety net is as frayed and has got a big a hole in it as our public safety net, doesn’t it?

Chief Bill Adcox:  Oh, absolutely. There’s there are a plethora of reasons and stressors and causes for the problems that we’re having throughout the safety net. And there are tremendous number of weak portions, and even holes in the safety net throughout the entire public safety net. Whether it’s the fact that people are leaving the profession in droves. It’s the stress that’s on the decisions that they’re capable of making at any given time. There’s actually, you know, shortages of certain supplies in certain places. I know that in the law enforcement piece. We’ve had an inordinate number of retirements, the, the employment group, the number of people that are available to become police officers as well as nurses and others that the pool, if you will, the labor pool is just very, very small. And give an example Chicago Police Department used to have, you know, average of 16 to 22,000 applicants each year this past year they’ve had 3800. I mean, if the job and the amount of available people is significant. So, you’re seeing and then of course with all the issues going on with coven and other reasons, there’s a pullback. And so now what you’re seeing is a lot more violence, where I’m going to solve murders and communities.

You’re seeing traffic accidents and road rage at all time high – more people dying in traffic accidents today than you’ve been many, many years. So, yes, all these things will have an impact on that safety net. And if you can’t, if you can’t make sure that our first responder emergency safety net is intact, then everyone in every community suffers. And it could be catastrophic if it’s you and your family. So, I would say that we all have to pay attention to that.

Dr. Charles Denham:  Fantastic and in the final five or six minutes I just want to draw people’s attention to the fact that you can go and watch the videos that you see here. And, and what I’d like to do is have both you and Jennifer who have both been on every one of them, add anything you think that may have been a value. At first, we, tried to help the essential workers understand how to come home safely, and then everyone was concerned about their families and keeping our kids safe.

And then first one we look at the risk profile of your family, who’s living there, who’s at risk with reference to age, on the low end of children but on the high end of adults and also in you know compromise, the five-hour plan we put together very early. And right now I’m helping manage no less than five people that have somebody sick at home right now, and you do not want to get long COVID. And then we look at the safety plan. We addressed that this issue we did today of emergency medicine, but a deep dive and I highly recommend everybody watch that because it is any emergency, the five rights of emergency care really apply. Well, what did they do – what do you do if your family is in the ICU?  I have a cousin, who’s a newborn cousin, who needs a liver transplant, and because of the rules of the coronavirus but also the risk for the pediatric ICU. There’s a limit, other than parents just being able to see this little girl that’s waiting for a liver. The vaccines variants and victory. A lot of the principles still apply even with an omicron to the BA to long haulers – is really a big deal. And there are more and more people we’ll cover in our next webinar. What do I do if I get long haul disease.

We highly recommend going to a low long-haul clinic. This has helped people that I’ve been helping who are older people that have got long haul, but there are younger people who are getting it to the best practices for reopening we’re going to revisit and then and then chief Adcox addressed the four P’s. As we look at some of the others that might be more important for those of you. And then we spend a tremendous amount of time on that is really a polished, pretty polished documentary is a deep dive on testing that hasn’t changed. So, you can kind of take that to the bank. And then we have Chief Adcox and our other public safety leaders who helped us in the last one. We are going to cover the fraud and the ecosystem, and we are going to cover the safe practices update our 1000 household study and our faith based and what faith-based organizations can do we’re putting rescue stations at faith-based organizations right now.

And then we have Chief Adcox. I’ll go to you first and then I’ll go to Jennifer. Were there any of these webinars that you found particularly important for those you lead in the area of law enforcement, and also as a threat safety science leader anything you want to draw our attention to over the last 24 programs?

Chief Bill Adcox:  There are many but I will say that the ones that were really helpful with my staff and was able to explain, you know, how they could safely go to their homes, go from a hot zone to the warm zone and then back into the cold zone in their homes, how to do that, so that they would protect their family members, as well as the ones that have been out there, the science, the testing, the variants, you know, what was the real risk of having factual information. And I think the last thing was is that many of these talks about how we need to individually and collectively communicate what is the truth, and what really is what we can do so that folks throughout every community and every family can protect themselves. So those are the ones that I would say are the most and then again, you know, even the 1000 household study that to compile what about brought some true value to the largest study I’ve ever heard of in this in this arena to what people should really be looking. So, with that, you know, I think that, you know, there’s bits and pieces of all of these, and I highly recommend that people avail themselves.

Dr. Charles Denham:  Thank you, Chief. Jenny will go to you for the last word to – oh, you know, I have just a couple minutes what I’m going to do is just address the family checklist which I thought if I have time to address which I do have a couple minutes to do and we’ll finish right on time – was a Cub Scout, a fifth grader who’s now in 11th grade – we’ve been working on Med Tac for that long – developed a family lifeguard checklist what to do before a family event during an event and after event take a look at the slides. And what you can do is how to determine how to protect at risk members. We don’t want to be. We don’t want to irritate or offend anybody but if you can find out the vaccination status, are they up to date on vaccines, and whether they’ve had testing and whether they’re traveling.  You heard that from Dr. Fox. This can really help you have a safe event and then make sure ventilation, cleanliness regarding contact surfaces and what to do afterwards can really reduce things if we use the lifeguard. My son had heart disease, he had heart surgery, so he and my wife and I, got certified as BSA lifeguards.  My son and I are both rescue divers with patty rescue divers. We know that lifeguards – 90% is prevention – 10% is rescue.  And so, as we look at these safe practices, it’s really critical that we that we really know that we are that we really want to be a lifeguard, we don’t want to be an emergency caregiver we want to be a lifeguard and prevent anything bad from happening.

So, I just have Jenny, give us the last word and Jenny I’m going to put your lovely image up and share that, and ask that that that to close us.

Jennifer Dingman:  Thank you, Dr. Denham. I just, you know, these webinars have been priceless like I said earlier, going all the way back to March 18th of 2020 for the very first Coronavirus webinar you did. It was about protecting you and your family first responder and family briefing. Through this we learned about, you taught the public and providers about the chief family officer the one person in the family that you taught how to take care of quarantining a family member, taking care of a family member. When it was appropriate to wipe things down – you gave really good advice about that.  All through these webinars, it was always about patients and families. I, and looking at it, I just strongly encourage everyone here to watch each one of the videos of each one of these, share them with people that you love and people that you work with. We have learned so much and there’s yet so much more to learn and I never close doors because we just don’t know what’s happening.  But I can’t urge you enough don’t get complacent don’t get too comfortable because we’re living in the 21st century and things are so different. And the new normal may very well be variants of this virus for the next 50 years or more. And this is just something that we need to learn how to live with get used to and most of all, respect others, respect those that are vulnerable, get a vaccine, encourage others to get a vaccine to protect someone who might not be able to be protected from their own family and someone who is very ill think about that think about what God wants us to do. How God said to love your neighbor as yourself and, and I think these webinars have more than, than shown what true faith true Christianity is about and I just cannot thank enough – Dr. Denham, and Chief Adcox, Dr. Botz, and everyone else who has been here and given their time and energy and expertise to these great webinars. We’ll see you all again. God bless you all. And again, please share this widely. Just let it become viral, get it out there because it’s one of the greatest things that has been given to the American public since this pandemic has begun.  Thank you again.

Dr. Charles Denham:  Well, thank you, Jeni, and you’ve been just been so great. And what we want to do is just let you know that there are all kinds of resources that we have at the end of the program and thank you Je for the kind words. What we like to say is that we fight the good fight. We will finish the race, and we’ll keep the faith and that’s what we’re doing and we’ll see you next month. We’re going to address the key critical stories in performance improvement. What can we learn about long COVID from those that have cared for it and gotten it. What can we do about emergency and all of these things and we’re going to be using story power. Thank you all for coming to our next month. Thank you all, and we’ll see you next month.