Business as Usual: COVID-19 Expert Provides Vaccine Insights

 

Transcription: 

So good afternoon, everyone. This is Audrey Russo, President and CEO, the Pittsburgh Technology Council, we are in for a treat. Today on business. As usual, I will introduce our guest in one moment. But in the interim, I want to give a couple of shout outs and acknowledgement, first of all Huntington bank for being our partners all through the journey, really appreciate their partnership, as well as the Jewish health care Foundation, the Jewish health care Foundation, and its three operating arms. If you don't know anything about them, we'll put some info about them in the link. But they offer a unique in excuse me, a unique brand of activists philanthropy to advance healthcare, innovation, advocacy, collaboration, education in the interests of better population health. And then I also want to give a shout out to 40 by 80, which is the wholly owned organization by the tech Council, and it's a nonprofit, it's the latitude and longitude of Pittsburgh. And we work hard to make sure that people aren't left behind, and they actually have access to technology. So today, we are very excited to be hosting someone who has been non stop on the circuit, in terms of talking about lots and lots of things and has an amazing pedigree in terms of his work. And his name is Dr. Amesh Adalja, excuse me, I'm having a hard time talking today. And he is the senior scholar at the Johns Hopkins Center for Health Security, but he's involved in lots and lots of things. And I don't want to do anything to underestimate his esteemed background. So I'm going to welcome him to the forefront. He has joined joining us here from Pittsburgh, but he is being recognized all around the world. In terms of a lot of subject matter expertise, we're going to talk about the impact of the current phase of the pandemic on a region's healthcare system. And also talk about lots of things because he actually has a background in technology and engineering that comes out of Carnegie Mellon. So some of you may be tracking him and he can speak on a lot of topics. So I want to welcome him to the forefront. Thank you so much for being here. And if you can just set the stage for a moment and just talk about, you know your background, just a little bit, because there's so many topics that we want to jump into today. And thanks for taking the time with us. Sure, thank

you for this invitation. And thank you to speak to such an important group. And like Audrey said, I have I'm talking to you from Pittsburgh, and although I have a Johns Hopkins title, I'm a senior scholar at a think tank at Johns Hopkins. It's focused on emerging infectious disease, pandemic preparedness, the intersections of infectious disease and national security. I am also a practicing physician in infectious disease, critical care and emergency medicine in Pittsburgh. I am a Carnegie Mellon graduate, I did all my training, after medical school in Pittsburgh at Allegheny general and at UPMC. I'm still on staff at many of these hospitals. And in my home base is Pittsburgh. What I what I do during the during these types of major pandemic or infectious disease emergencies, try to serve as a subject matter expert resource to the general public to the media, as well as work on a lot of projects to try and, and make this never happened again. And as part of that I like to talk to all kinds of groups about how important pandemics are and how to predict and prevent it and to deal with them. So I'm happy to to join this group and to hear your questions.

No, absolutely. I mean, I think one of the things that's really interesting and will and I'd like to weave this into our questions are some of the predictions on the societal impacts that this will have in terms of that as we move forward, particularly as we get a vaccine. And we'll jump into that. But I think I'd like you to sort of share with everyone what your what your thinking is, in terms of as we turn the corner, because our hope is that there will be a vaccine, people will take it, and we will turn the corner. But we think life might be a little different. I think based on your observations, you probably have some really interesting perspectives.

I do think we have a ways to go before we turn that corner, and we will have a vaccine that will be very, very important to controlling the pandemic. But you have to remember that after any type of pandemic of this scale, where everyone's life has been touched, there are going to be repercussions and cascading impacts that affect all elements of society, not just the healthcare sector, not just my field. But everybody got you because this really shows that this kind of you know, I think it's interesting, because there's many things that we're on the cusp of happening technologically in the way societies function that kind of get pushed over the edge and and now are much more common. So the fact that we're talking together on zoom, I think that's something that's going to be very, very common that you're going to see much more video conferencing, it's going to be less of those flights to Chicago for a one hour meeting and then flying back that's probably not going to be something businesses want to do. There's going to be people who are less likely to To go shopping in shopping malls, those were already on the cusp, they were dying people were getting used to online shopping. And now that last holdouts basically were put in a position where that's all they could do. No, I was somebody that never had downloaded Uber Eats until the pandemic, that's something also that's here to stay, people are going to change the way they think about traveling, vacationing, and where they're going to go. And businesses are going to think about commercial real estate, do they really need this big office space can because people work so efficiently at home, all of that's going to really be very different. And if you go back to, for example, the Black Death and the 1300s, after the Black Death, that led to the peasant revolt, and basically the whole downfall of the feudal system, because so many people died, and that in that pandemic, this European wide pandemic affected people's lives. So you have to remember that pandemics are not just about us, the doctors and the hospitals, it really ripples through the whole society. And there's many things you can't even, you can't even imagine what will what will what will happen, because so many trends that that might have been on the cusp canal go will go forward, other ones will not, it's going to be a different where it's going to be some of you, he says, he asked me when we're gonna get back to normal. And I always say it, we're going to get back to normal after the vaccine, but it's not going to be the same normal because so many things have changed in this time. And I think that's what we have to really prepare for and think about and look at all the technologies, technological solutions, we haven't seen how that will transform our world,

you think we'll ever shake hands again?

Yeah, I do think we'll shake hands. Somebody shook my hand a couple days ago. So I think we will shake hands, I think, I think we will be much more attuned to washing your hands. So so it's okay, if people shake your hands, just wash your hands afterwards. And don't touch your face in between. That's the that's the problem. There's nothing wrong with shaking hands. It's just what you do with your hand afterwards, where the other person's hand has been.

Right. And you never know where the other person's hand has been. So you're right. So thank you for that. So many people are very anxious to see a vaccine, you know, reach the market, but they're also concerned about the speed at which the current vaccine have been developed. You know, in fact, we've heard that this is the fastest vaccine has ever been developed prior to COVID was seven years, I believe. And can you talk about these factors that allowed these vaccines to be developed so quickly. So this is anything about the process that changed or shifted, or whatever.

So this is vaccine development has been one of the bright spots in a very bleak pandemic response. And I was four years for the fastest vaccine in the past that was the mumps vaccine. So with this vaccine, it's less than a year before we about to get approval on the vaccine is already approved in the United Kingdom, it's already approved in Canada. And I think what it really reflects is not kind of any shortcuts, but the harnessing of new technologies. So in the past, historically, the time when Jonas Salk was making the polio vaccine in Pittsburgh, you basically had to take the virus or the pathogen and change it in some way, in order to create immunity when that when you gave it to people, you had to weaken it, you had to give only pieces of it. And that was a very cumbersome process, it took a long time. But in the last 20 or so years, we've gotten so much better at understanding genetic sequencing and understanding the idea of genes that all of this technology was brought to bear on this problem with COVID-19. And this isn't something that was a lot of us in the field. And I actually wrote a major report on this type of technology, just prior to the pandemic, that this type of technology would change the way we faced infectious diseases, because we could rapidly go from discovering a pathogen, even a new one, to developing a vaccine, because all you really need to do and this is what the Pfizer vaccine does. This is what the maternal vaccine does is they find it, they take the pathogen, they find which part of that pathogen is important for your immune system to recognize for immunity. And they basically sequence it, clone it and you get the gene directly, that gene just goes into your cells and your cells start pumping out that protein, just the protein of that that's important, and your immune system reacts to it. So that's something that's very, very fast, very elegant, you basically can make it enough to minimize it. But it's easy compared to what you had to do before. All you need to know is the sequence of the of the pathogen and what what part of the pathogen is important for immunity. So this can really move things into clinical trials very quickly. And that's what happened is that these candidates went into clinical trials so quickly, then the clinical trials went about their usual way, with phase one, phase two, phase three and safety studies. So when you think about the rapidity, the rapidity was getting this vaccine into clinical trials, not the clinical trials themselves. So I have no qualms about the speed, I'm really excited because this is a place where mRNA technology basically showed that it can actually that it can actually meet the demands of an of a highly complicated infectious disease emergency and I do think you're going to see mRNA vaccines now be used for other infectious diseases, the next threats, even outbreaks, and in lots of vaccines that have never had a commercial market are too expensive or too difficult. You may see mRNA vaccines be part of the solution to it. So, you know, I'm actually very pleased with the rapidity. And I think that, you know, I would be in line today if I could have the vaccine right now.

So what I saw today, and I'm glad to hear that and there is there is that that dialogue that we're hearing about But that was something cut out of the process to create this kind of rapidity that you're talking about. And you're, you're essentially saying no, there wasn't,

none of the things that people are talking about what got cut out was all of the stuff that could be cut out, because we were using technology that basically had been the same for, you know, 100 years in general for the way we make vaccines. And now we're kind of using 21st solutions to it to a 21st century problem.

And that's, that's exciting for the future, the what's the replicability of that?

It's very replicable, these are. So mRNA vaccines are part of what we call a general class called vaccine platform technology. So since I'm talking to tech people think about your Nintendo machine or your Atari, your Atari, and that's your platform and the different game cartridges that you put in, those are the new things that you that that's what you use the platform for. So you can basically adapt this to any type of target. And it's not just mRNA platforms. The AstraZeneca vaccine uses a carrier virus to deliver the spike protein from the Coronavirus. So this is a whole new way of doing vaccines. And I think that you're really it's not surprising to me that those companies like Madonna, Pfizer, AstraZeneca are at the front of the pack, because they were using vaccine platform technologies. And we knew that that would rapidly speed the development of a vaccine because you can't afford to wait and an infectious disease emergency, it's been one of the biggest problems that we faced, that we were it's kind of an inside had been an insoluble problem when it comes to pandemic response.

And we've had a lot of pot, I mean, the results are pretty positive. So let's let's jump jump to some of the questions aimix. And Jonathan, I'll pluck some of them out.

Yeah, let's start with Isabella love. This is a little bit of a long one here, so bear with us. So she asks, people get COVID-19 tests and feel and behave as if they are safe. Yet they could have passed to someone in the health clinic or hospital long enough to have contracted COVID-19. On the way out. I understand that getting a positive case, I'm sorry, I understand that getting positive case persons of the population certainly helps save us. But how do we better express the negative test only speaks to up to that moment, not afterward.

So what I always tell people is a negative test is one moment in time it is a slice in your life where you were negative, that doesn't mean that you're not going to be negative, you can't be positive A day later. So you have you have to take it with a grain of salt, realizing Yes, I'm negative at this moment. But it doesn't mean that I can let my guard down, it can definitely decrease the risk. So a person I would rather be around somebody that told me that they got a negative test five minutes ago than someone who got a negative test five days ago, or never had a negative test. That's important, but you can't use it as the be all and end all you still need to use common sense, common sense. And we saw what happened at the White House, Amy Coney Barrett rose garden ceremony where many people got infected, because there was over reliance on negative tests without any other common sense measures, serial testing is a little bit different. So if you can test yourself twice a week or every day when you brush your teeth, that's a different story. And I think we will maybe get to that point there is a lot of people pushing for this right now. It's in the Biden transition documents. And I think that this is a that will work. And we saw how well it worked with, for example, the NBA, the NHL, on those the sports teams where they use daily testing couple to couple to a lot of other precautions because they were kind of cocooned away. But serial testing is something I think people are going to use. But one test is one moment in time decreases the risk somewhat but not ironclad and don't get a false sense of security or you will get burned like the White House did.

Absolutely. So what do we know about you know how long this new vaccine will provide protection, some herds two to three months, but the trials have not been long enough to actually know yet.

So the trials have not been long enough to know that's the main answer. Usually though, with a vaccine like this, we expect at least a year plus for protection, we will do what are called natural history studies and follow people who've been vaccinated, look at their antibody levels, look at their T cell level, see if they get infected. I suspect it's going to be over a year. I don't know how long it may be. It could be two years, it could be five years before a booster might be needed. And the next vaccine might be a second generation that you might be getting a second generation vaccine it might not be that the Pfizer maternal vaccines are the ones that we use as part of our routine vaccinations. After this public health emergency is over.

It's Dino, um, how we'll be able to track and prove that people have had the vaccine would be like a certificate or some method to know that, yes, I've had this,

you're going to be cards issued. You probably have had cards, even when you got your other childhood immunizations, but your parents might have thrown them away or not paid much attention to them. But there are, there are certificates of vaccination that you often can get. The only one that's really ironclad is the yellow fever one which you have to get because you need that for entry into certain countries which I I have a yellow fever card, but we will get have something like this. And remember there is a state immunization registry. Most people don't know that that exists, but it does exist where your name is put into into a registry that that keeps track of who's been vaccinated. So we will have a way to keep track of who gets vaccine especially because these are two dose vaccines. We've got to make sure people are coming back for their second dose.

So Amish let me just jump in real quick and riff off of some of these because there's a lot of questions in here. So do you what about the UK is concerned about not giving the vaccine What about the allergy phenomenon some of the stories that have occurred though.

So what happened just to recap was, the UK approved this vaccine on an emergency userbase basis and started vaccinating a couple of days ago. And in their first days of data vaccination two individuals, both health care workers, both with the history of severe allergies who were prescribed epi pens have had severe allergic reactions. They're okay right now. But that's led the UK regulatory agency to say if you have severe allergies, meaning allergies to a food to a medicine to another vaccine, or if your doctor has prescribed you an epi pen that you should hold back on this vaccine for now until they figure out what happened. Likely, there was some cross reactivity between something in the vaccine and something that these two individuals happen to be allergic to we don't know enough information, I suspect, the FDA and the Canadian government will also put out some guidance on this shortly. But so right now, that's what we're hearing from the UK, it's important remember that we do get severe allergy allergic reactions at about a rate of one and 1.4 million for for vaccine. So this isn't something that's completely unexpected. It didn't occur in the clinical trials. But again, when you move from a smaller population of 10s of 1000s of people in a clinical trial to start to actually the general public, you're going to see see more side effects in reaction. So I don't think this changes anything about the vaccine, we may get some specific guidance for the Pfizer vaccine regarding this allergy. But we need to know more about these two individuals in what they actually allergic to. And it doesn't it doesn't erode my confidence in the vaccine. And like I said, I still would be getting this vaccine if I could right now.

And what do we know enough yet? right now. So like, if the vaccine was available to people like you that are in front lines, do we know the length of time that the vaccine is actually working and effective?

I think this is a question I just answered. I think it's likely going to be over a year. We don't know we have natural studies and follow people to know that answer.

Okay. Okay, Jonathan, jump to a couple of questions. Because I also want to tell you that one of the individuals on our team, Brian, who's is in the majority of trial, so he is participated in that. Absolutely exciting. So we're all we're all pretty excited about all this. So Jonathan, good to go to a couple of questions.

Yeah, we got some great ones here further up in the chat earlier on. So is this the same sort of vaccine development that's being applied to like a bola

similar Ebola did use a vaccine platform technology. So Merck has a licensed Ebola vaccine, and that vaccine used the carrier virus, a virus called vsv, or vesicular stomatitis virus, it's an animal virus and they basically took they basically put inside the Ebola glycoprotein gene, which is the important gene for the immunity to Ebola. And that was something that changed the way we dealt with Ebola because it really was instrumental in stopping the the DRC outbreak that spiraled out of control a couple of years ago. This is also the technology that Merck is using and one of their vaccine development projects for Coronavirus as well using that same platform just reusing it just like a Nintendo game, switching the cartridge out.

Very cool. And that's about there being an annual type of COVID vaccine that will be needed just like having the annual flu shot.

We don't know that yet. It's important to remember though that Coronavirus is an influenza virus is a totally different families. And the reason we get a yearly influenza shot is not because the immunity wears off. It's because the influenza virus is kind of a Master mutator and the strains change. So we have to update the vaccine to make sure that it's active against the strains that are circulating. That's not the case with this Coronavirus. Why we might need another Coronavirus vaccine a year or two years or three years down the road is the same reason we need tetanus shots every five years or 10 years that our immunity might wane. That's what so it's a difference between a booster shot than a total update. It's a new vaccine you get every year for flu, not a booster.

Well, so how what what is your advice for for people who are actually reluctant to think about even taking this vaccine? And many, many people are high risk. Right. So what is your advice? How are you know, they're reticent? They're already conversations around their reticence? What might you advise them?

I think you have to look at this as a risk benefit calculation that there is a risk of this of this virus that's out there that we know that this virus killed 3000 people yesterday, one of the deadliest days in human history, more people died yesterday, yesterday, I think from from COVID, then from 911 are in Pearl Harbor. So this is a real public health threat. And people are getting infected hospitals are getting into crisis. You have this vaccine and every drug everything you do has every drug you take every medicine you take every vaccine has them also has some level of risk and there's some level of benefit. And for the people that are in the high risk categories, people that are above the age of 65 have comorbid conditions, or people like me who are around COVID patients on a day to day basis, that that risk of the vaccine of the side effects of the vaccine are greatly greatly outweighed by the benefit of the of the vaccine. So I think you have to look at it that way. So this vaccine is likely to be approved for 16 years and above. It's not like everybody is going to be asked to get this vaccine, but there are people that are at such risk for severe disease that the benefit is so big That what that there's a there's a considerable level of risk is tolerable included in when you look at the phase 123 and animal data and preclinical data, these vaccines do look very, very safe to me in terms of in terms of their overall risk profile. Yes, you're going to get a sore arm? Yes, you're going to get fevers and chills you might have, you might have a headache, you might be a little tired when you get your vaccine, especially after the second dose. But I think that's much better than getting COVID or spreading COVID.

So there's been a couple of this has come up a couple of times in the questions, will the vaccine be less effective in a surging spread population, that whole thing about surge? And why is that is that true?

We have to remember that the vaccine isn't immediately going to stop, it's not stopped the spread of the virus. And remember, this vaccine is more designed not necessarily to stop the spread of the virus, but to decrease the damage the virus is causing. And that means that it's much more it's effective at preventing symptomatic disease, preventing people from needing to be hospitalized and preventing people from dying. So all of a sudden, if you were obviously vaccinate everybody, you're not going to all of a sudden have cases go down to zero. It's not that type of a vaccine that doesn't have that sterilizing immunity effect. At least that's not what we've seen so far. So it's not like the measles vaccine. So so we will. So there is some strategy that you can think about. So if you're a state, you get allocated x million doses of this vaccine, you have to figure out how do you want to allocate it? Do you want to give it to places that are having a lot of cases like Allegheny County, where we are today? Or do you want to find some rural county where there isn't that many cases or a place where there isn't that many cases and just prevent that from actually ever hitting there? So that's a that's a that's a question that we have to think that each state is probably going to answer differently. I don't think that there's a right or wrong answer. I think each of them have their benefits and drawbacks

to the graph. Yeah, that's great. We're gonna go to the chat in one second. But if you were to assess the state, the current state of Western Pennsylvania right now in the hospitals, would you say we're close to a breaking point right now, I know the numbers just came out today about 1100. Today, and yesterday, we had about 34 deaths.

So if you look at Western Pennsylvania, as an aggregate, you know, we definitely have a lot of community spread. There are many, many cases out there. And we know that those are an underestimate, because people are not getting tested. And, and hospitals have record numbers of admissions. But I would think it's spread a little bit unevenly. So if you look at the city of Pittsburgh, and our big academic medical centers, like UPMC, and Allegheny Health Network, their capacity looks okay, it doesn't look I'm not worried about their capacity, I actually think that we in the city of Pittsburgh and Allegheny County, in general have been relatively have been really, really fortunate that we have all of these medical resources here because it never got bad even during the height in the fall. And I think that both of these health care systems have enough assets to to get through this. But if you look, just go over go up one county, my hometown, I'm from Butler, I'm a high school graduate, that hospital is in trouble, they have about 200, or a little less than 200 beds, they have maybe 20 to 30% of their whole hospital census is COVID-19 patients and that's not sustainable. They've already suspended surgeries that require people to stay overnight that have that are non emergency. So that's something I'm really worried about looking at the rural hospitals in the suburban hospitals that don't have the ability to rapidly scale up that don't have a lot of staff that they can move around to be able to increase their staffing. So that's Butler if you go even further, if you look at hospitals like like Armstrong and kittanning or you worry about think about even more like Titusville, Clarion, or all of those hospitals, I think that's that's going to be the problem is that there is you know, we have capacity in Erie, we have capacity in the in Pittsburgh area. But this that kind of area in between, those hospitals are very small, they don't have many resources, they don't have big ICU, so many of them don't have full time critical care infectious disease doctor. So I think that's what we have to really think about is how to prevent those hospitals from going into crisis and collapsing.

Okay, Jonathan, there are a couple of more questions out there, if you can grab them

really good ones here. I want to know if someone has tested positive for the antibody, should they still get the vaccine. vaccinated carrier also spread COVID to non vaccinated people.

So if you have an antibody that tells you that you've had some infection in the past, right now, the guidance is if you've been infected, within 90 days or so, maybe let a couple other people in your group go ahead of you, that you that's that's okay. If it's within 90 days, depending if it's been longer than 90 days, I suspect you're still protected more so than you you are definitely protected more so than someone who's never been infected. So it's less of a priority. If you if you kind of have to stand in line I would I would let people go in front of me. Indeed, I just got antibody tested a couple days ago, I'm still negative but but I would have probably let people go in front of me in my in my priority group if that was the case. So so it is an industry when you have the antibodies that the vaccine is going to boost those antibodies, you'll probably have even more protection. But we don't know how long natural immunity lasts. It's likely about a year or so. reinfection is extremely extremely rare. The second question was the vaccine and spread spreading into other people this is the concept I was alluding to earlier called sterilizing immunity is this vaccine like the measles vaccine. It doesn't appear that the Pfizer vaccine is like that, that it is very good at preventing symptomatic infection, but we don't know yet if it's good at preventing asymptomatic infection, and if you have asymptomatic infection, can you you can technically still pass the virus to others, they're going to be doing some follow on studies to look and see if people who are vaccinated are still able to be infected asymptomatically. Interestingly, the AstraZeneca vaccine did provide some data that showed that they do look, it does look like they can prevent asymptomatic infection. So this is probably why you're going to see not much change with guidance on mask wearing and limits on gatherings, because we still at least, there's still gonna be a lot of people that aren't vaccinated. So we're still going to have to take some take some precautions, even when people are vaccinated until we kind of get closer to the herd immunity threshold for this virus.

What's your prediction on things? 21? What do you think in terms of, you know, interactions, etc.

I do think that once we get into the summer of 2021, will be back to us. Basically back to as normal as it's going to get with all the caveats i said earlier that people might have changed, but looking looking like summer 2021 should be back, but it won't be like the summer of 2019. Right. Okay.

So Jonathan, there's still a few more questions out there. I'd like to grab

our own BK here the question, some evidence that the first shot actually gives immunity. Do you know that much?

Yes, we do. We do know the data from the Pfizer vaccine that you do get robust immunity after the first vaccine dose. We don't know yet if how long that first immunity lasts, and how long how robust it is without that second dose Three weeks later, this is an active debate going on right now. Because we have to make a decision about Should we just allocate all of our first doses and not wait for the second dose. So that's something that we have to think about. There are some hospitals and there will be some guidance from the health department about what to do here. And it may be that some hospitals will say, let's vaccinate all healthcare workers with the first dose and we just assuming we're going to get the second dose so we can get as much immunity in place as possible.

Jonathan, any more questions out there that we haven't addressed?

Um, when can we expect to get get to get the vaccine here in western Pennsylvania,

it's poised to go as soon as there's an emergency use authorization from the FDA. We will have it here in western Pennsylvania, many of these big health care centers already have have freezers in place. So I think that this will happen almost immediately, as soon as you hear from the FDA.

So do you think that people just like us that aren't in the front lines of health care will have access to this vaccine by February or March?

I would think maybe closer to March or April, if you're an average risk person, it's not an essential worker, probably probably looking at Spring.

So what do you think before we wrap up? And you've been on the lecture circuit on this and just been an expert since January? I can't thank you enough for your time. today. Is there anything that you think that we've overlooked in terms of the questions that we've asked you that

there's some I think we covered all, maybe this is something that we all predicted, it's important that this didn't come out of nowhere, that the people in my field, including myself, have been writing about this, talking about this and discussing this, about what would happen and how unprepared we were for a pandemic and how there were important plans that needed to be executed. And they were not we gave this virus a major head start in January, February and half of March, taking the wrong actions, and not building up a test trace, isolate ability. So that's why we're in this situation that we're in and we today in the United States in December, still can't do with South Korea and Taiwan could do in March. So what

do you think about the next iteration of an epidemic? Are we prepared this time?

I do. There's a lot of us right now trying to fix all of the holes in our pandemic policy. And I do if you look at, if you look at what's in the Biden transition documents, a lot of what we've been saying since January is now really seeing the light of day. So I think that this is something that often goes through these cycles of panic and neglect. When things recede from the headlines, people stop caring about it. So we had anthrax in 2001, bird flu scare 1005, we had Zika, Ebola, h1, n, one in 2009, all of that comes and goes, and then people forget about it. And it's not a priority. Nobody prioritizes, the health department's of our states in our counties. And I think that's important. We have to think of our health departments as part of our national security against infectious diseases. And I think we can't get that we have to actually adequately resourced them because they're going to be what prevents the next pandemic, from getting as bad as this one did.

Well, listen, I'm thrilled that you're on it, I'm thrilled that you are, you have our best interest because you're here from Southwestern Pennsylvania. And I'm thrilled that you are talking about this each and every day, I am actually raising my hand, I would like to be one of the first that get this to just instill some confidence just to let other people know that this is something that we really need to do to turn the corner. So you're going to be on CNN next. Right? You're going to leave this you're going to go on CNN, yeah. 140.

I'll be on CNN 140

at 140. Okay, well, we actually so appreciate your time. We're going to follow you. He's active on Twitter, on LinkedIn. He shares lots of information. I cannot thank you enough for being with us and for the leadership that you display each and every day.

Thank you. I'm happy to be on and talk to your group and I'm happy to be a resource to anyone in the western Council. in your region,

thank you. Okay, tomorrow we have It's Friday, Jonathan and I think we have the CEO of jazz HR

Lampson is coming on the show, we're talking about hiring trends. I mean, they get all this data about who's hiring and how much they're hiring and what forms he's gonna discuss that also one with their platform and how can help you hire in 2021 should be fun.

Excellent. Thank you so much, everyone. Stay safe.

Transcribed by https://otter.ai