COVID-19 Brief: Thursday, June 4, 2020 with guests Dr. Anne Zink and Dr. Michelle Rothoff
The Homer COVID-19 Incident Command Team welcomes epidemiologist, Dr. Michelle Rothoff and Chief Medical Officer for the State of Alaska, Dr. Anne Zink to the panel to take questions from the listeners.
Also, Jenny Carroll, Comminucations Officer for the City of Homer goes over the updated State quarantine and testing mandates for travelers.
And, DHSS Public Health Nurse Lorne Carroll and Derotha Ferraro from South Peninsula Hospital respond to the listeners and provide local updates and perspectives.
Kathleen Gustafson, KBBI:
This is KBBI Homer AM 890 I'm Kathleen Gustafson. Welcome to the Thursday COVID 19 brief with the Homer incident command team on the line. Jenny Carroll from the City of Homer. Let's check in. Are you there?
Jenny Carroll, Communications Officer, City of Homer:
I am Kathleen. Good morning everyone
KBBI: Good morning. Also, Derotha Ferraro from South Peninsula Hospital. Do you read?
Derotha Ferraro, Spokesperson, South Peninsula Hospital:
I read loud and clear. Good morning
KBBI: And Nurse Lorne Carroll from the Alaska Department of Health and Social Services, Public Health Nurse.
Public Health Nurse Lorne Carroll, Alaska Dept. of Health and Social Services:
Good morning team. You're loud and clear, Kathleen.
KBBI: Good Morning. Also a special guest this morning, Dr. Michelle Rothoff from the Alaska State section of epidemiology. Are you there?
Alaska State Epidemiologist, Dr. Michelle Rothoff: Good morning.
KBBI: Good morning, and thank you so much for joining the brief. If any listeners have questions they can call, Chloe is standing by, 235-7721 is the number if you have questions for the panel, but I have been collecting questions since I called for them on Tuesday morning, and so I've got a few. One is perfect for Dr. Rothoff, epidemiologist for the State of Alaska, so I want to start with immunity, because a lot of people are asking questions about immunity. Is there immunity from COVID 19 after a person is designated as recovered?
Dr. Rothoff: Yeah. So that's a great question. And you know, a lot of people are wondering about that. Unfortunately because this virus is new, there's just still a lot we don't know. What we do know is that most people who get infected with SARS Cov2 virus that causes COVID 19, most of those people will develop detectable antibodies against the virus within days to weeks of the onset of their symptoms. What we don't know is how well these antibodies work to protect people from getting reinfected. We also don't know how long this immunity lasts. So there are still a lot of unknowns.
KBBI: Thank you, because that was my next question, if there is immunity, how long does it last? I also was wondering about, the other question I got on Tuesday is: Is this virus still understood primarily to manifest in the respiratory system? But while I've got you, I would like to bring on Dr. Anne Zink to the COVID19 brief and, may I direct that question to you about the nature of this virus and whether or not it is mutated. The question being: Is the virus still understood to primarily manifest in the respiratory system?
State of Alaska Chief Medical Officer Dr. Anne Zink:
Yeah. No, I appreciate that question. So we continue to follow the molecular genetics of this disease and try to understand it. They're kind of different variants we call cLADS and slight changes that we see. It's an RNA virus and RNA viruses do tend to change. However, currently we don't see any significant changes for us to think that it would have significant changes of the way that impacts humans. But we continue to watch it closely. It does hit a receptor that is both in the lungs as well as the gut, the kidneys, and throughout the rest of the body. So it can affect numerous organs within the system, not just the lungs.
KBBI: And, this question, I would love to direct to Dr. Zink, but also to Dr. Rothoff, are there any medicinal preventative measures, drugs, vitamins, herbs that a person can take to boost their immunity from COVID 19 specifically or just to boost their immune system?
Dr. Zink: This is a great question. The more that people are able to take care of their health, to all exercise on a regular basis, eat a wide range of fruits and vegetables, taking care of their overall health and immunity, it makes a difference. Healthier people definitely do better with this disease. Some interesting data coming out about vitamin D and trying to understand more of that, how protective that is or isn't, particularly in the inflammatory and response system. At this time, however, we don't really have any good trials or data to say that there's a specific vitamin or a specific medicine that can be used, but it's a good reminder. Taking care of our overall health, making sure that we are our heart and our lungs and our bodies are well taken care of in case we do get COVID. Dr. Rothoff and if you had any additional comments?
Dr. Rothoff: Yeah, I would just say I would align with some general ways that people can boost their immune system. Making sure that you're getting enough sleep, trying to keep your stress levels down, which is easier said than done. Exercise, it's social interaction, I'm sure that it is important. Also making sure that any chronic conditions that we have, diabetes or other things are under the best possible control can help.
KBBI: Oh, thank you. Dr. Rothoff. On the line is Cathy calling in live. Cathy, are you there?
Cathy: I'm here.
KBBI: Go ahead with your question.
Cathy: I had a friend, about a month and a half ago, came into the State and was in quarantine and she was checked on every couple of days. Since then, I've had two friends come into this State. They filled out the forms, they're on quarantine, but nobody's checking on them. Is that no longer happening?
KBBI: So Nurse Carroll, would you like to address that or is there someone else from the panel who's interested in addressing that?
Nurse Lorne: Yeah, that's a good question. As COVID continues to unfold, one thing that we're certainly seeing is that the public health workforce, especially the EpiNurses and the local Public Health Nurses are very busy with index case investigations and contact tracing for those folks that have a positive COVID result. And so at this point, it's really important that those essential services are reserved for the positive cases and those that are close to them. So kind of thinking about statewide, in terms of public health nursing, there's only 16 public health centers and 158 employees in the section but you're bringing up a good point that there is a greater need than we can actually meet with the public health force so the section of public health nursing has been hiring some short term non-firms and these are oftentimes local nurses that have time and they're motivated and really want to help out the local public health nurses.
KBBI: Thank you. Go ahead.
Dr. Zink: I might expand on that or I really appreciate that we're also expanding our workforce in general. So UAA is hiring additional people to be able to do better contact investigation and tracing and to support the tremendous job that our public health nurses are doing. You guys are very fortunate down there to have an amazing public health nurse and the connection to the community with the new travel mandate. There is some changes to travelers coming in and so we are also looking at an app based support system to check on people on a regular basis. And people will see changes at the airport starting late Friday night, early Saturday morning that includes education as well as trying to connect with passengers who are coming in to really minimize that risk of COVID in their entrance.
KBBI: Well, thank you, Dr. Zink. I know that Jenny Carroll, the Communications Officer for the City of Homer, is going to go into the mandates, the travel mandates in depth a little later in the program. But your answer, Dr. Zink, Chief Medical Officer for the State of Alaska, leads me to another question, which is what are the qualifications for a contact tracer, if the university is going to be hiring them?
Dr. Zink: So it's a great question. There's actually numerous different positions within this. We're working with our Epi team that oversees the HENO and works with public health nursing and then contact investigators and there are different levels of that so I don't have the exact qualifications on hand right now. I don't know if Lorne has any other specific details on it, but it's all being run via the UAA, but we'd be happy to connect you all with Terry who is helping to oversee that contract and the different specific qualifications.
Nurse Lorne: Yep. Maybe just a couple of things to add is that if you go into Workplace Alaska, there might be some information there, but feel free to call local public health nurse, anytime at 235-8857 and we'll make sure you're connected to them. So that's 235-8857.
KBBI: Thank you, Nurse Lorne. And any listeners who would have a question for Chief Medical Officer for the State of Alaska, Dr. Anne Zink or epidemiologist, Dr. Michelle Rothoff, their time is limited today, they probably won't be here for the whole half hour. So if you have a question, 235-7721 is the number to call and someone is standing by to take your call. Also, the next question that I have that I got off my voicemail is about healthcare workers having the PPE that they need, the equipment to protect themselves. Are they still having to reuse PPE multiple days in the State? Does the State buy PPE for distribution to hospitals across Alaska? And is there anyone that can take that question?
Dr. Zink: Yeah, I can take that question. It's a fantastic question and it has been one of the major limiting factors. We have been purchasing personal protective gear, including N 95 masks, and these things called barrier surgical masks. When people, when hospitals or clinics submit a request, we do try to fulfill those requests and send them in. We are still asking people to be conscientious of their PPE usage, and can be reusing them and so we do see a lot of facilities still reusing them. We are starting to see some movement within the supply chain itself and so we're encouraging people to look down their normal supply chain avenues to try to secure PPE but the State is needing to still supplement that. And Dr. Rothoff, I know that you have also been working with the PPE aspect. I don't know if you've other additions to share?
Dr. Rothoff: No, I think, I think that covers it.
KBBI: Okay. Thank you Dr. Rothoff and Dr. Zink, the last question that I have on my list right now is can the State get enough tests to engage in widespread testing? We are going to discuss a little later in the show with Derotha Ferraro from South Peninsula Hospital about their collaboration with Seldovia Village Tribe Health Center doing pop-up testing all over the place and the testing that's going on at the hospital. But this question is more for State officials. Can the State get enough tests to do widespread testing?
Dr. Zink: That's a great question. There's many things that go into the test. So the swabs, the UVM, the personnel to run the machines, the people to collect it, people to stand up those drive-through and popup stations and it's been great to see your community standing up and setting those up. And all of those things need to exist to make sure that there's widespread testing. Currently we, if you look at test per population, we are the eighth most tested State in the country. So compared to a lot of other States, we are doing much more aggressive, widespread testing than many other places. The big thing is that we're really want to encourage anyone at the beginning of any new symptoms, fever, chills, shortness of breath, cough, runny nose, sore throat that you get tested and we want to make sure that's accessible kind of throughout the State. And then we are testing asymptomatic people in all sorts of different situations, so congregate living facilities, longterm care facilities, some of it associated with travel, seafood process workers, other areas where people are at high risk for introduction of a disease, living in, kind of close quarters to make sure that we're testing. And it always feels like there's never quite enough testing, always trying to move in front of that on a regular basis but I have had significant increasing in machines. I was just looking at our State supply this morning and, you know, we do have a lot of swabs and a lot of UVM to be able to support popup stations and testing. Sometimes it can take a bit of time to get it to the right place and it's not every machine and every type of test available in every location. And so really appreciate communities having a broad range of testing options and using the different testing options for the different needs and so using the really quick ones when you really need to know right then, versus sending into the high processing machines, ANMC or at the State lab or out-of-state, some of the commercial labs for, kind of, big bulk testing. So we do have a lot of testing compared to other places, but it's always a work in progress, but please get tested at the beginning of any symptoms.
KBBI: Thank you. And also I just got a text from KBBI News Director Jay Barrett who was asking can Dr. Zink expound on the connection between cases in the lower Peninsula and Anchorage and Eagle River. The gathering she mentioned over the weekend sounded large. Does she have more info and does she expect any more cases to come from that gathering, or from any gathering such as Memorial day?
Dr. Zink: Yeah. So maybe I'll start in and I don't know if you've got additional details that you can share. We do know that the more time that people spend in close contact with each other and the more people that mix, the higher rate of transmission, and the more concern that there is. And I think that COVID has been with us for a while, but we have a long way to go. There's been a lot of family gatherings, social celebrations in association with graduation, Memorial day, things like that and we do see clusters of outbreaks associated with these social gatherings and that can really accelerate this disease process. Really, in the Chicago area, that's essentially how the outbreaks got started. There was birthday parties, weddings, funerals, and we were seeing a similar experience in the Eagle River, Anchorage, as well as the Southern Peninsula region. Whenever we see a cluster outbreak like that, we always do expect more cases because then those people go home and then they have close contacts. There's a high rate of attack in a household. So if you're living with other people who have COVID, the chances that you get it are definitely much higher because, again, you've got high exposure in that close setting and prolonged exposure in that close setting with people that you live with. And then, you know, people go to work or they may be hanging out with other friends or other socializations and so it can spread and pass. I think what's hard about this disease is how high the viral load can be before people have symptoms. And so people may feel well and not mean to get anyone sick or infected but can accidentally do that and then the outbreak can take off. So that's what we're seeing in some clusters. It definitely doesn't explain everyone, but our under those are, we're currently in process. Lorne or Dr. Rothoff I don’t know if you have a few other details that you'd like to share.
Nurse Lorne: Yeah. I would just kind of add that down here in Homer, apparently the State has written, reporting on cases, in terms of census designated places that are 1000 in population or greater and kind of culturally the interesting thing down here is, a lot of folks that live outside of Homer proper consider themselves as living in Homer. So like myself, for an example, I live in Fritz Creek, but I say that I live in Homer. And so there's a difference between culturally, how we talk about where we live and how that relates to the raw data that's on the State site, and I kind of point that out because, you know, we are a very small and connected community and transmission is very possible in line with those risk factors of being such a tight community, but also at the same time, we're a global community. You can be from lower 48 to Alaska and then driving down to Homer within just a few hours.
KBBI: Thank you Nurse Lorne. Dr. Zink and Dr. Rothoff, we discussed you guys staying on from 9 to 9:15 and we're past that time now, so if you have things you need to get on with, then just take our thanks and go. But I do have some other questions if you're able to take some, well, I'm just going to ask the question then. So Dave is on line 2. Dave, are you there?
Dave: Hi. Good morning. I'm here. And my apologies if you've answered this question. I just tuned in. Then, what's the overlap between the test, the COVID test and the antibody test? In other words, how long into the case of COVID would you score a positive on an analysis versus when would the antibody test work? Do you have anybody who can speak to that?
Nurse Lorne: Oh, sorry. Go ahead.
Dr. Rothoff: Thank you, this is Dr. Rothoff, I can take a stab at that. So the main test that we're using for diagnosis is called a PCR test and that's the test that tests directly for genetic material of the virus. And that test, in most people, if it's going to be positive, will be positive pretty early on like, you know, pretty soon after they're infected and around the time that they start developing symptoms. And it can actually hit the positivity on that test and actually last for awhile. And then the antibody test or the serology test, which is a blood test, and that test checks for antibodies that the body produces against the virus, the body's immune system. Those antibodies in most people start to appear about day five, six, seven, after the onset of symptoms, so they appear later in the course of the illness and they also persist, we're not quite sure how long. The important thing to remember or realize is that as far as the serology test goes for antibodies, there are still a lot of unknowns about it and so that's why serology testing is not really in widespread use. It's not recommended for diagnosis. We don't really know how accurate the test is, and we don't know what to do with the information. As I said before, somebody might have antibodies against SARS Cov2, but we don't know how protective those antibodies are, and we don't know how long they last. So even if we have the results of a serology test at this point, we don't know enough to be able to really use those results to kind of guide behavior or, you know, give guidance on whether a person can feel like they're protected or not.
KBBI: Thank you Dr. Rothoff from the State of Alaska section of epidemiology. I have one final question for Dr. Zink before I send you all off with our thanks. Someone has just texted in, a community member is wondering if you can speak to the perspectives of those who oppose face coverings, reasons that they may claim that they are ineffective or harmful to people. So Dr. Zink, are you on the call? Okay, well, Dr. Zink is off with our thanks. Thank you Dr. Zink, Chief Medical Officer for the State of Alaska. Dr. Rothoff, are you able to take that or Nurse Lorne.
Dr. Rothoff: Yeah, I can address that and Lorne can certainly chime in. So yeah, mask wearing, you know, has been a complicated issue and a confusing issue for a lot of people. And again, part of the issue is this is a brand new virus that we've never seen before. We're learning as we go. And so as a result of that, the guidance and recommendations that go out to the public are gonna change over time as we learn more. At this point in time, the CDC recommends that everyone who is out in public, especially in situations where keeping a six foot distance from others outside of your household is not possible, or it's not easy, are recommended to wear a face covering. And the reason for that is, so the face covering does not give complete protection for the person wearing it against becoming infected. It may give some protection, probably less than, you know, the mask that medical workers use, but probably a little bit better than nothing. It seems to get more protection for those around the person wearing the mask. So one thing that we do know about COVID is that there seems to be a lot of people who are asymptomatic, meaning they have no symptoms, or they could have very mild symptoms. So a lot of people can be infected and not know that they're infected. And so if those people are going out in public and they may be infected, not know it, anyone they come into contact with, it could potentially transmit the virus to without even knowing it. We feel that wearing masks helps contain some of those respiratory droplets that we all breathe out when we talk or breathe or sing or shout thereby kind of helping to prevent it transmitting from person to person, especially when we might not even know that we're sick or infected. So there have been some really good studies that show and some modeling studies that show that if the majority of people out in public did wear masks, that transmission rates would really, really decline. So, you know, of course, wearing a mask or not is a personal choice but I think of it as, you know, something that we can all do to help protect each other, to help protect our communities, and to try to decrease the spread of COVID.
KBBI: Well, thank you Dr. Michelle Rothoff from the State of Alaska section of epidemiology. Really appreciate your time and expertise. Is there anything else that you'd like to say before we move on to talking to the incident command team about travel mandates, about local testing?
Dr. Rothoff: I guess the last point I'd like to make is just that, you know, COVID 19 unfortunately is probably going to be with us for a while and at this point in time until we get a vaccine or a treatment that's effective, the absolute best tools we have right now are all of these basic measures that we keep talking about, especially the social distancing. So, making sure that we don't let our guards down and that we continue to maintain, kind of, keeping distance from those outside your household, frequent handwashing, using the face coverings, staying home when you're sick, all of those things are still really important and will continue to be for the foreseeable future.
KBBI: Okay. Thank you, Dr. Michelle Rothoff from the State of Alaska section of epidemiology. You're welcome to stay on the call and jump in at any time if you like, but I'm going to move on now to Derotha Ferraro from South Peninsula Hospital. I know that you had popup testing in the village of Nikolaevsk yesterday and that you are cooperating with Seldovia Village Tribe Health Center to do another one next Wednesday. Can you talk a little bit about testing and how that went yesterday?
Derotha: Happy to, thank you so much, Kathleen. Yes, testing is the theme right now. And we, with the support and help and enthusiasm from partners, we've really been able to up the game on it and just reminder that the more we test, certainly the more we know and the faster the knowledge and awareness happens. So in addition to testing at the hospital, 24/7, at the main entrance parking lot, that is still offered, it's available and you can call 235-0235 when you're en route, there's other options as well. I apologize in advance, but with the various locations, along go different requirements and guidelines. So out on the Spit, every day except Wednesday, daily, except Wednesdays on the Spit until June 13th the hospital is providing a testing location from 9 to 5 daily, except Wednesdays. And that is very much the same requirements as the hospital and that is that you have to be symptomatic, be part of the critical infrastructure or seasonal infrastructure, fisheries, known exposure, recent travel out-of-state. So that site is like visiting the hospital only you’re out at the Spit and you have to have a kind of reason to test. It's not for the “worried well”, it's not for the “I'm curious”, it's for, there's valid reasons to test. Additionally, we are partnering to do pop-up sites. Yesterday was in Nikolaevsk and that was with SVT health and wellness team and they were able, they were there all day and they tested over 50 they were able to do more than 50 swabs there. On Friday, we are partnering with the Ninilchik Traditional Council’s health clinic team, and we are doing a site out at the McNeil Canyon School, so we'll be out there on Friday from 9 to 5. And then next Wednesday, again, with SVT, we will be at the Anchor Point Senior Center. And these are all outdoor, drive through swabbing.
KBBI: And those tests are open without restrictions, is that correct?
Derotha: That's correct. The McNeil location on Friday, and the Anchor Point Senior Center location next Wednesday, do not have restrictions, so those are opportunities to just go get tested. And the question about supplies, however I will, you know, for example, we have 3000 swabs at the hospital right now available. That sounds like a lot but we do want to give respect to the fact that the supplies are not unlimited and so just making sure that there's kind of valid reasons to be tested is always a good use of the supplies. As of yesterday, in total we had tested 1,749 since the start of this, starting March 12th, 1485 are negative, 29 are positive results and 225 are pending. I want to give a qualification on the word positive results. So those results might not be on 29 unique individuals. Some folks who test positive come back as part of the overall COVID 19, you know, life of that disease to test to make sure that they're negative, so that then they can kind of resume their normal living.
KBBI: We're at the point now where people are testing multiple times until they’ve tested negative. I can have surgery scheduled or go to work and that sort of thing.
Derotha: That’s exactly right. So 29 positives does not necessarily mean 29. It does not mean 29 people. And the other thing is with the addition of all these testing, kind of slows up the system a little bit because a lot of these are being processed right in South Peninsula Hospital. Some are getting sent directly to the State lab, some local. It all depends on the situation. And so the turnaround time, we are definitely looking at 48 hours, sometimes even longer, depending on the time of day that you're swabbed, just because of transport time and everything. So we just asked everybody to be patient, especially from these pop-up ones, be patient because, there's just a transfer and turnaround times and sometimes lags within the lab.
KBBI: Thank you Derotha Ferraro from South Peninsula Hospital. Jenny Carroll, Communications Officer for the City of Homer, I apologize for keeping you waiting all the whole half hour, but you were on the call, you were paying attention to Governor Dunleavy's press conference yesterday, or his statements yesterday regarding quarantining and travel. Can you talk a little bit about what was the information that was put out?
Jenny: Sure, thank you. Yeah. Chloe Pleznac’s story covered it very well, but we can take a little time this morning to dive into the details a little bit more. The main thing to know is that starting on June 6th, that would be at midnight, so in the middle of the night, Friday night. Most people going to Anchorage catching red eyes, are like, it's not Friday or Saturday, but know that it's Saturday morning at midnight, the Health Mandate 10 has been amended by the Governor to ask everyone who's entering the State of Alaska to still self quarantine for 14 days, unless some of the categories are met by the traveler. And this includes Alaskans who are traveling outside and returning home in a five day or less period of time, it includes people who are coming up to Alaska to visit or be a tourist. So it covers everyone, that you are asked to self quarantine for 14 days unless you have, before you travel here, gotten one of these SARS Cov2 PCR tests that Michelle Rothoff talked about. If you get one of those 72 hours, that's three days before you depart to Alaska, and it comes back negative, you will come into the State on the airline and you'll show that negative result to an employee at the airport and we'll be checking people coming into the State and then you're free to go, no quarantine required. That's kind of the one and done. If you want to come to Alaska and not be doing any testing or quarantining. What I've heard from people on our COVID call line is the City of Homer is that it's difficult for people to access testing like that in their home states and get the results back. So if that's the case, if you are unable to get testing, the two step testing process that you can do without quarantine requirements, when you get to the airport, you can pretest after, you can test at the airport actually, as long as there are testing supplies, and at that time you will be asked to quarantine for the period that you're waiting the results of the test. So that would reduce the 14 day quarantine period down while you're waiting for the test. If the test is negative, you're free to go and visit and do what you want in Alaska. If the test is positive, then the steps will be taken for isolation and managing your health care situation. Then, all travelers who are pre-tested or tested at the airport will receive a voucher for a second test that they're asking you to do within 7 to 14 days after you arrive. If you remember back to Anne Zink earlier in the program, she said that a test is not a substitute for quarantine, and given that someone might be infected or exposed during their travel to Alaska, it's really in the best interest of keeping COVID transmission down in Alaska and protecting our health to do a second followup test to make sure that we've caught or you've caught that period in which your viral load, may be building. The early tests, you might not have enough viral load to trigger the positive and then once you're here and moving around, that viral load could grow. So that's the idea behind the second test, the two ways, that's kinda the two step testing process. There is a third option for people and it gets very confusing, so bear with me, I'll try to make it easy. There is a two step testing process that does not require that short quarantine period. If you can get your test in your departure State within 5 days, not 3, but 5, so a little longer period and you're coming up to Alaska, then the State, when you get here with that negative report, the State will give you one of those vouchers for a second test and they will ask you to go get that second test within 7 to 14 days after you're here. So that's another way to come up to Alaska and start your travels right away without waiting for test results to come back. I would encourage people with detailed questions to go to the State website https://covid19.alaska.gov/ for full details. We will be posting that on the City website https://www.cityofhomer-ak.gov/ and posting in our posting locations around town the hard copies for those without web access, we will be posting those up as soon as I can get to it today, basically, but know that it's effective June 6, 2020 and again, encourage people to do this. It's one of the ways that we have to open up the State, allow people to come up for their family weddings that they planned, for their dream vacations, to visit family that we haven't seen for a long time and still help to keep the transmission down and educate people about how best to travel around Alaska. So, that's what I have for an update on the Health Mandate for International and Interstate Travel. The last thing that I'll mention here, I know we're getting over time, is that still there are critical infrastructure employees traveling in the seafood industry, construction industry, etc. Those travelers will still be following the guidelines of their essential service work plans that their employers have developed with the State of Alaska. So those people will be following a different set of protocols so this mandate update is just for visitors, seasonal workers, family members who are coming to us and for Alaskan residents who are leaving the State and returning.
KBBI: Thank you, Jenny Carroll Communications Officer for the City of Homer. Nurse Lorne Carroll, is there anything you'd like to say to wrap up? Oh, I believe we lost Nurse Lorne.
Nurse Lorne: Yes. Here I am. Yeah. Just one brief thing to piggyback on the comments and information offered about masks is that, you know, CDC guidance oftentimes comes from evidence based practices and it takes time to establish scientific evidence based practices. And so it really highlights the importance to promising practices and that stuff, masks is a very good example like that. So I just really appreciate, other folks as inputs, like the City of Homer for one example, and the hospital, surrounding promising practices.
KBBI: Thank you Nurse Lorne. Derotha Ferraro, any final words for you?
Derotha: Yeah. Real quick. I wanted to thank all of our partners, the City, public health, SVT, and Ninilchik. I mean, we have, we've just been so blessed to have so many people working together in this community. Just, since the thing today was the antibody and serology, just wanted you to know that we have been offering those tests at the hospital. So far we've done 35 and one has actually come back positive, if you will. And so it, just to know that we do have that service if people are wanting to do that. And also the website, the hospital website https://www.sphosp.org/ keeps kind of updated with testing numbers and test sites and requirements for the sites. So please check the website and call with any questions: 399-6212 or the COVID nurse if you're on your way to test up at the hospital 235-0235.
KBBI: Okay. Thank you so much. Last call for questions and comments from the panel. Well then this has been a Thursday COVID 19 brief. Thank you so much callers and people who emailed their questions in. Guests have been Dr. Anne Zink, Chief Medical Officer for the State of Alaska, Dr. Michelle Rothoff from the State of Alaska section of epidemiology and our regular panelists, Nurse Lorne Carroll from the Alaska Department of Health and Social Services, Jenny Carroll, Communications Officer for the City of Homer and Derotha Ferraro, Spokesperson for South Peninsula Hospital