of 2023 part 1 Tuesday night at 7:30 on PBS Hawaii for updates on your favorite programs follow PBS Hawaii on Facebook you're watching PBS Hawaii supported by viewers like you it's not just TV it's life PBS Havi home is [Music] Here Local broadcasts of insights on P b bs Hawaii   are made possible by the support of viewers like you Mahalo and by first Insurance Company of Hawaii protecting Hawaii's families and businesses since 1911 ulupono initiative building a more sustainable Hawaii by investing in local food renewable energy clean transportation and waste and freshwater management Hawaiian Electric to learn about our commitment to sustainability and reducing carbon emissions visit hawaiianelectric.com sustainability Carl Smith ball providing Legal Services throughout Hawaii and the Pacific since 1857 making a positive difference in the communities where we live and work Federal officials approved a new coid 19 booster shot for most people as the country heads into another holiday season the booster is build as providing enhanced protection against coid 19 variants currently circulating around the country how many people will actually get the shot what should you do what is the status of the Corona virus join the conversation about coid 19 it's still here tonight at 7:30 p.m. on insights on PBS [Music] Hawaii Aloha and welcome to to insights on PBS Hawaii I'm Lauren day the severity of Co 19 pandemic has faded but there are still thousands of hospitalizations and hundreds of deaths each week in the United States hospitalizations have been increasing since late summer and some experts worry that immunity from previous vaccinations and infections are fading an updated Co 19 shot that targets a more recent Varian of the virus should now be available through Healthcare Providers Statewide so what can we do to protect against Co 19 and avoid another surge in numbers this upcoming winter season we look forward to your participation in tonight's show as a reminder you can email or call in your questions we also have a live stream of this program at pbshawaii.org and on the PBS Hawaii Facebook page now to our guests in studio we have Dr Sarah kemell the state of Hawaii's epidemiologist and chief of the Disease alate Control division she received her MD from UCSF and completed her residency at UCLA she is also an alumna of the epidemic intelligence service fellow fellowship program at the Centers for Disease Control and prevention Hilton Ral is the president and CEO at the healthc care Association of Hawaii he has worked in the health industry for 32 years including the last 20 here in the state prior to his current role he worked for 10 years at Hawaii Pacific Health as vice president for Contracting Dr guihan dendra is a pulmonary and critical care physician at the Queens Medical Center and the director of medical education critical care for the University of Hawaii Internal Medicine Residency program he sees patients who have pulmonary complications due to Long Co we also have in studio Angela Kean she is a former Hawaii media personality and worked as a reporter in TV anchor for more than 15 years after recovering from Co 19 she has battled long Co we will get to her story in just a bit um but Dr Kimo I want to go to you first can you give us sort of the landscape of where we are today here in the state of Hawaii as far as Co 19 goes sure so while we are seeing now a downtrend overall in Co 19 cases test positivity and hospitalizations I would say in the overall landscape it is still very possible that we could continue to see a surge later this year we've seen that with Co before where we'll have some Peaks and valleys um as you mentioned during the summer we actually had a fairly steep increase in Co 19 cases hospitalizations uh and um that came at a very difficult time U but we are now seeing that start to level out right now Hilton how are our hospitals across the state doing as far as coid 19 goes our hospitals overall are doing very well right now we're averaging on any given day between 70 to 80 positive Co coid positive cases each day those are patients who are impatients in our hospitals who have tested positive for coid now many of those are incidental coid they are in hospital for some other reason and they were tested and found to be positive with coid so the number of patients being treated for coid in our hospitals is actually quite low the number of patients we only have less than all today we had seven coid patients in our ICU but again some of those are incidental we did have a small surge of coid hospitalizations in mid August where we got up over 100 coid patients a day for a number of days but that has actually gone down just a little can you talk a little bit about maybe the severity of the cases that we're seeing when it comes to coid right now well the good news is that the the severity of illness for coid is not severe at this point in time so there's quite a bit of activity the positivity rate as Dr Campbell said has come down a little bit but it did get up in for some days it was up around 20% of the cases that were being tested so we at a positivity rate of around 20% it has dropped down it now it's back down into s single digits again so there's a fair amount of coid around a lot of people are testing positive but in terms of severity of illness fortunately we are not seeing a lot of people really sick with coid now it's still a problem because some people can get very sick people can still die from coid but overall the level of severity is what we' been seeing in the last few months is nowhere near as severe as it has been in earlier stages with some of the early variants definitely good news to hear that it's not as severe but I know you know we have folks like Angela here in studio when you or someone who has experienced long Co I'm sure um to hear that it's not as severe you probably want to share your story as well so that folks know that the risks out there um Angela I know your story is one that we want to get to but first of all how are you doing today I'm doing great I'm about 90% back to normal it it did affect neurologically my brain um that part has been resolved and I still have a few physical issues left um you know with my body surgeries and things that need to be fixed um due to long coid but my brain is great I'm thinking great I'm back to work and I'm a very happy person that's awesome to hear so glad to see you smile as well I want to hear a little bit more about um your your symptoms and what you experience but first Dr dendra can you talk a little bit about what exactly is long Co I know you treat patients um who you know have had long Co coid like Angela so long coid is anyone if you use the CDC definition those individuals who have had coid and are 30 days or more after their infection and still have persistent symptoms U it could be brain fog cognitive dysfunction it could could be shortness of breath it could be cough it could be hair loss it could be uh numerous other things even sleep disturbances can be caused uh could be the result of long coid and so these these are some of the symptoms that we do see um I primarily treat lung related complications of lung long coid and these really we need to think about how of all the people who do get coid up to as many as 20% of people can develop long coid on those people who have had coid so it's still something that we need to to be vigilant about and that we need to make sure that people find the help that they need when they have these symptoms what is your recommendation as far as the best way to protect yourselves yourself against Co 19 well first if you do develop coid and you do get coid one of the most important things is make sure that if you're in the right age group to get treated with paid we know that with paid treatment that you can actually reduce the amount the chance of getting long coid so that's one thing the other thing is make sure that you're immunized you have your immunization because immunization will reduce the severity and the likelihood of getting long coid so those are two reasons to to look forward to to protect yourself also use common sense if you're in if you have underlying health illnesses and uh you need to avoid places where there are a lot of people there or if you do just mask up and so some of some of those things will help reduce that incidence of not only acquiring coid but also development of long Co Dr Kima I want to talk about the latest Co 19 shot how is is it different from the previous round of shots and who would you recommend get it so the new Co 19 shot is created to more closely Target current circulating strains of Co 19 that's the biggest difference it's really uh it's still an mRNA vaccine it's still based on the same principles and science as the older vaccines but the targeting of the strains towards current strains this is becoming more like how we think about flu vaccines you target the circulating strains for the current season so you get the best protection Hilton you and I were chatting about this before we went on the air but um can you tell us a little bit about the difference in wording between a booster and a vaccine or a shot well the CDC is recommending that the current shots that have just come out uh actually not be called a booster because technically it's not a booster it actually is a different formulation same based on the same technology as Dr kampbell said but it is is a different formulation and just like we have flu shots every year we don't call the flu shots a booster because those flu shots do change or the vaccine actually changes from year to year so we're in this stage now with this disease that it's going to be with us just like the flu is and the general that it's expected that the recommendation is going to be that maybe once a year hopefully not more than once a year that people do get their annual vac uh their annual coid shot so again we you know we're trying to discourage CDC health professionals are trying to discourage was word of the use booster because it really doesn't apply to what is to the way the vaccines are being used now and the way they're being formulated and with the co 19 shot can you also get the flu shot at the same time or do you need to spread out uh between those two vaccines I would defer to the Physicians on that it's safe to get and effective to get flu and Co vaccines at the same time even additional vaccines like RSV since that's another of the big three that we're thinking about this respiratory season um Dr Kimo I have a question for you from Mike from Miki he said took the new coid shot today and I'm going to Vegas in a week how effective will it be against the new variants the formulation of the shot is designed to be maximally effective against the current circulating coid strains so that is the idea about getting the new vaccine is um get that new shot before you travel because what you may be exposed to in new places you're more likely to have maximum protection through the new vaccine MH Angela I want to go back to your story you first got coid very early on in the pandemic it was March of 2020 you know we didn't have a CO vaccine booster we didn't have any anything at the time no one um really knew what was going on even at the time can you share a little bit about your story um I know that you said that you were sick for quite a while that first time around I was performing a wedding as a wedding Minister um had a a couple come from Australia and someone was carrying the virus and we just didn't know it um I was sick for eight weeks uh at the very beginning I was pushing for testing and was even calling the media uh to ask for testing and it finally came it was too late for me but I was able to confirm that I that I had it there was no treatment at that time so I was sick for eight weeks wow um I would leave my mother videos I would send her videos in the middle of the night because I was afraid that I wasn't going to wake up the next day I was constantly in contact with my PCP my primary care physician and she felt that I had enough medical knowledge and experience and medical equipment and treatments um that I could ambulate at home and so I did I ambulated at home for eight weeks um following that was this Cascade of medical issues and it started with my brain I had memory issues I was forgetful I failed um six different medications for ADHD for memory um anti-depressants I developed severe major depressive disorder was suicidal um I'm not someone who believes in suicide so there was a point that I had to reach out far beyond what most people do and um I found a physician named Dr Jason kefir and um he's a brain specialst uh specialist and psychiatrist and through his treatments I've been able to recover by about 90% wow and now I work for him so that's amazing um any advice that may maybe you have two other people out there still struggling and still dealing with their long coid symptoms absolutely I get um inquiries and messages from all over the world I think that patients have to be their own Advocate um they have to go beyond um you know what their PCP can do for them the challenge here in Havi is that it can take months to see a specialist it can take five to six months to see a lung specialist it can take two to three months to see a gastro neurologist or an immunologist or a rheumatologist um so there there needs to be patience and persistence and for people who do think that the virus is just manini or not a big deal anymore I want to always think about have people think about long coid because even if you have a minor case of coid long coid is very very real and those symptoms can last uh persistently for months and years for some people Dr dendr hearing Angela's story is that something that you see quite often or still regularly even though we are now almost four years later into the pandemic absolutely because even though I see mostly lung related long coid my lung patients will say you know what I'm not thinking the way I used to think I I forget I can't do the things from higher level functioning that I used to do and so this is a very common thing that we do see and the reason for it is really unclear and I think more more of the science needs to be looked at to try to figure out why do people with uh long coid and cognitive dysfunction what why is that happening and so I think my plug if you will for more research on this is is absolutely important doctor how do you determine if someone has long coid is there a test for it or how do you know you know their symptoms or what they're experiencing is from the Corona virus so it's it's mostly from the history because my patients will say you know what I felt fine I've been doing well and very similar to what Angela was saying I feel fine and then I got Corona virus and then after that 30 days later I kept on getting kept the shortness of breath I still had my shortness of breath I couldn't get better so so that history part is really important to know because and we've seen this in some of our studies that some of our immune markers are even elevated even long term so I don't we don't have a single test at this point but the history is very key and right now we're doing investigations to see if we can find a a better test the reason why since we're on the topic of long coid um ingred on Facebook is asking can't people get ser ious long coid after mild cases happened to my Bay Area friend who ended up hospitalized and is still in pain it's not resolved absolutely you don't have to be hospitalized to get long coid so although the incidence of long coid is higher in those who have been Hospital hospitalized even with mild cases of coid you can develop long coid symptoms MH um I know um Hilton Dr Dr Kimbell all of you have been advocating for getting the new coid vaccine um what would you say to those who are reluctant to get vaccinated against coid maybe you know second third time well first I just want to say how powerful the story that Angela shared is and um folks who work the very dedicated folks who work at Department of Health continue to hear a lot of those stories as we follow up cases as well um and I think that's that part of the human story is part of the reason why these shots are um really a great advantage that we have now and so important to take advantage of um we're very fortunate in a way to have such an effective and safe vaccine uh and so I think the key now is how do we use that to our best advantage and it's really U making sure people understand that the shots are safe and effective and that there's value in getting them that you can prevent serious illness that might occur because of Co 19 um we have a caller from puno asking I'm 85 years old and have seven vaccinations already should I get the RSV vaccine is that something Dr Kimbell maybe you could comment on and I did I did mention we're now sort of looking at the tripid demic of coid flu and RSV RSV stands for respiratory sensial virus it's another um essentially a common cold virus but it can be quite serious especially for infants and for older folks for kapuna uh so there is an RSV vaccine available now for people 60 and above um and it is uh effective at preventing RSV in those groups and so that's another vaccine that you can get now for protection is there any sort of um maybe concern people should have about getting you know multip maybe it be the RSV if you have to take RSV vaccine the flu vaccine and then coid vaccine or can you get all of them at the same time or close to each other so according to the CDC it is safe and effective to get all three at the same time um often it's hard to get in multiple times for different visits so uh if you have the opportunity to go in and get all at once I do recommend it um if you're not able to get all at once you can still get them spread apart we have a couple viewer questions still on the topic of long coid Angela are you still experiencing any long coid symptoms or I know you had mentioned about 90% recovered I'm about 90% uh recovered interestingly enough last May uh that was kind of my ending long coid I had gotten better I was Triple vac vaccinated but unfortunately that was May in July I got Co again I was only sick for five days and my long coid reignited unfortunately so since last July about a year a a little over a year ago um I've been working on you know working on everything with treatments and I would say I'm about at 90 90% back to normal the most important is that my brain is um back online and doing better and I have no depression but I think the other things that I structure that I struggle with are structural issues you know ENT issues and autoimmune issues that might be physical in nature but for the most part I would say 90% I'm back to normal um Dr dendra we have a a Norma Norma from Manoa asking my husband also had long coid but he also has pulmonary fibrosis what is the best treatment for this for the most important thing is make sure that that you are having a good relationship with your primary care physician and your pulmonologist if you have pulmonary fibrosis you most likely have a pulmonologist so the the the issue is there are some of my patients who have had who have underlying lung disease like like uh like this like this individual has who do then get coid they're at high risk so it underscores the importance of vaccination early treatment with paxo it if you get it if you do get coid those are the most important things and then from the other standpoint of what can you do about it and how can you get better from it so a lot of times there's a ensure of time that is necessary but unfortunately we don't have any pill or anything like that that can help solve that for so for this individual I would say it's important to have that connection with your your primary care do doctor or your pulmonologist to help you sort through some of those issues of shortness of breath and then one of the most important things that is really exercise trying to stay a little bit active if your oxygenation is adequate is to try to stay active those are things that can help and also things that'll help your your mood Etc I think that's really important the psychological issue really helps you combat the other symptoms of lung coid so making sure that you're mentally well making sure that you have a support system faith if that is important to you all of those things are going to be important to you I think I think he's raising some very very good points about health in general how we should all be taken care of ourselves and that's something that gets lost with you know we talk about the vaccines we talk about Pax loid we talk about other types of treatment but there is very clear evidence that people who are healthier doesn't mean you're not going to get coid it doesn't and some very healthy people can also die from coid but very clearly people who are healthier who take care of themselves generally do better and so you know there are exceptions unfortunately but it's we all need to take care of ourselves we should be drinking lots of water we should be getting exercise we should be getting good sleep that's good for any disease including you know fighting against flu RSV Co or anything so I I you know having a good relationship with the PCP going for annual checkups taking care of yourself you know eating well those are all good things that we should that we should be doing and it was demonstrated during the pandemic and who knows what's going to come up next you know there's probably going to be another disease at some point that comes up so the more we can do to take care of ourselves be healthy gives us a much better chance of fighting off these diseases Hilter what do you think are are maybe some of the lessons that we have learned throughout the pandemic you and I were chatting earlier about the flu um and how how those numbers kind of dropped off once uh coid came around and a lot of that had to do with people being healthier and and maybe sanitizing more that sort of thing well was pretty amazing um and if you look at the numbers that the Department of Health was producing and they track you know the flu um incidents across the country and they they track the number of deaths and the number number of people who test positive for the flu that dropped off dramatically in 2020 and 2021 so basically we didn't have a flu season in many parts of the country people were so social distancing people were washing their hands frequently people were wearing masks they were taking care of themselves and so it was remarkable just how dramatic the change between 2018 and 19 and then 2020 and 2021 and then as people started to get you know fatigued with wearing masks and the handwashing they just got you know sick of dealing with Co they thought it was going to be inevitable anyway so they stopped those precautions or the incidents or the a lot lot less people were taking care of themselves and the flu vaccine or the incidence of flu came back up again so very very clear correlation between especially for respiratory diseases between taking care of yourself wearing the mask social distancing and the incidence of the flu how are our hospitals doing as far as Staffing goes I know there was a point during the pandemic where you know every Healthcare facility was stretch then I'm sure doing a lot of the things that you mentioned masking up all of us washing our hands also helps out our healthcare workers as well well it did but we were very severely stressed during at least the two most um during the we had two major surges during the pandemic and the the Delta and the Omicron surges we ended up having to bring in over 800 staff from the mainland to take care of patients in our Hospitals now fortunately we got through that we're able to get some very significant amounts of FEMA funding to help us do that really appreciate the partnership with the Department of Health to make that happen we're we're doing much better now right now we're looking at about 23 to 2400 patients a day across the state now that's still higher than what pre pandemic we used to run around 2,000 patients a day Statewide so it's still materially higher than what we were but it has come down a little bit now Staffing is still a challenge on any given day we probably have about 350 to 400 staff from the mainland in our hospitals which is still a lot we're working very hard to recruit staff we're working very hard to grow more staff you know to expand our nursing programs but there's a shortage of workers in many Industries not just Healthcare so Staffing is still one of the single biggest challenges that our hospitals are facing even though for nurses we pay the second highest salaries in the Country California pays the most for nurses and we pay the second highest but even with that we still have challenges getting enough nurses here in the state of Hawaii and I I did want to add that the staffing issues in Hawaii are part of what make our Public Health situation unique as well so while getting preventive care like vaccines is important for your individual health it's also heal important for the health of the overall community and it's in part because we have a fairly thin margin um to overwhelm our Health Care Systems here we run at fairly full capacity and so when you look at something like coid alone perhaps that won't push us over the edge but if you look at coid coinciding with flu coinciding with RSV you end up with a real uh near crisis situation and so that's something that we always have to keep in mind as we think about um how do we protect the the health of our community here in Hawaii um Dr kampbell we actually have quite a few questions about the new vaccine um Cheryl from koua is asking how long after you have coid are you able to to take or get vaccinations and not just the coid vaccine but also flu RSV as well so after getting Co 19 there's no reason you can't get vaccines um getting the coid vaccine right after you've had Co may not be be very useful because your body has already mounted an immune response and so you have some immunity built up and it's likely from a current circulating strain that you just got so the recommendation from CDC is to wait about 90 days after having had confirmed coid before getting the new coid vaccine for other vaccines uh you don't need to delay I would wait until you fully recovered from your Co 19 and then go in to get your other shots but you don't need to have a spefic specific waiting period This one is also for you um from Eric from kuki do the people getting coid now have any idea where they got it are family members also sick is contact tracing even part of this anymore I think a lot of people don't necessarily know where they got coid 19 um you might realize that you were around somebody else who was ill and if they've tested you might know that they have coid 19 but it is a common respiratory virus now and it's out there circulating so um there's always a possibility you picked it up at the store or when you were in a crowded setting somewhere um so it's hard to know uh it testing can still be helpful and as guihan was saying it's very important because you can get appropriate treatment if you know that you have coid 19 especially if you have risk factors for more severe disease and knowing whether it's flu or coid now is quite important as we start to see both viruses circulating because there's a different treatment if you have flu so you want to make sure you're getting the appropriate treatment for the condition that you have doctor can you share what should someone do if they test positive for Co 19 just in case our viewers you know might not be up to date with with the with the new rules I guess well first I can stress the importance of really interacting with your primary care physician first having a primary care physician and interacting with them so that they know your problems most because uh because they know the medications you're under the next thing is if you're in a highrisk group and then it's important that within five days that you start your Pax LD so so so it's really getting on top of that and and depending on your medical other medications you're taking will change the dose of the Pax ofid the so it's really important that you know what's what you're taking your physician your primary care physician knows what you're taking to give you the appropriate dose of the paxel vid is the rule of thumb still quarantine is it five days or 10 days so the rule I'm going to defer that to to Sarah but I've been telling my patients five days and so and or they're free of symptoms so they're not having fevers they're not having cough uh but if they're having fever still even beyond the 5 days I say you need to self isolate yeah that's correct so the CDC guidance is still that if if you know that you have Co 19 you should isolate for at least 5 days and also make sure that your fevers are gone and your symptoms are getting better if you're still having fevers or serious symptoms um you may need to isolate for longer and that's a good thing to discuss with your healthcare provider um there was a question earlier about are we still contact tracing and just to address that um for Co 19 the Department of Health is no longer doing contact tracing in the sense of um calling to find out who were the contacts and trying to identify all those contacts um and tell them to isolate uh but we still do case investigations and so what's the difference between contact tracing and case investigations case investigation is um for certain situations where we may hear about an outbreak for instance or if we have a case in a very sensitive setting like the memory care unit of a nursing home then we may still do a more in-depth investigation to try to make sure that that illness doesn't spread in a setting where it could cause real harm so that's still happening and so we do um find out a lot about certain cases that get reported to us um Hilton this question is for you from ingred on Facebook are hospitals and medical centers and Clinics requiring masks again in general yes um especially now as there has been an uptick as we've talked about and as we're heading into the flu season so the recommendations are that if you're in a um well most of staff especially in clinical areas will be wearing masks they may not be wearing n95s but they at least will be wearing a surgical mask um we meet with the hospital chief medical officers on a regular basis and the chief medical officers you know talk about talk to each other about what they're doing we're trying to be as consistent as possible across the state in terms of what's happening so there is still um you know it's still good practice to wear masks if you're in an environment you know Hospital hosital environment you have people there by definition who are sick right now they may not all be uh coid or only a few small percentage of coid but you know you don't know what people have what they've been exposed to and so taking precautions like wearing a mask is still a very good thing to do when you're in a hospital setting um Angela Sharon is asking what kind of treatments are you getting or have gotten for long coid I know you mentioned or touched on it a little bit but can you share a little bit more sure um most of my issues were centered around my brain um neurological issues depress severe major depressive disorder um I didn't get any kind of assistance um from any of the medications that I took they just didn't work for me and it's that's kind of the case for long coid patients so I turned to a treatment called transcranial magnetic stimulation it's not alternative um it is actually U covered under insurance if you failed several medications for anti-depressants and basically basally what it does is it helps when you get sick with long coid or a neurological condition your brain is in arhythmia so there's parts of your brain that is are working too slow and too fast and um it was actually showing up on my brain maps and my eegs and so um once I started getting treatment that helped get my brain out of arhythmia and back on track and thankfully my insurance paid for it so it was kind of like the lights coming on and seeing things in 3D uh once I got back um to myself um the world just kind of it was it was like opening the doors and the windows and everything uh became so colorful and my my hearing was back on track my paying attention was back on track my executive function was back on track and my depression just melted away so I'm very grateful for how many treatments did it take for that to happen insurance pays for about 36 treatments so I did the full 36 and a few extra um I ended up joining the company so I can go and get treated whenever I need to um but I see a lot of long coid patients coming through the clinic who just like me um have try just about everything and nothing works and once they're able to get their brain treated and get well neurologically things kind of come back um to life Dr dendra maybe you can uh touch on this we've got a couple of long coid questions uh from our viewers are people with long coid contagious no people with long coid aren't contagious for coid now there is some thought of some viral persistence and for the national coid trial called recover there's one uh section that is looking at viral persistence and they are looking at a use of paxit in that in that situation but that's at this point it's all experimental uh whether there is actual communic virus it's probably not uh um I also wanted to ask this question for for you doctor this is from someone or viewer from Pearl City saying most people who have long Co got it from the first variant can you get long Co from the newer variants maybe you can also touch on his first uh part of that comment as well yes so yes you can get long Co from any of the variants I think it's really harder to get some of the data just because right now a lot of people are getting coid and we don't know the denominator because really a lot of these patients are testing at home they're they're doing their own test they're self-isolating and they're we don't have all the data so that that denominator if you wish uh is is probably much larger than and that we know of so I can't really give you an an incidence of how what the incidence of long Co is with each of the variants maybe I'll defer that to Sarah as well no you're exactly right so with the shifts and testing you know initially people were only getting tested in a setting where all those results get reported to the Department of Health the expansion of testing through self testing was a great thing because it made testing much more accessible but it does it's a tradeoff so there's less visibility into what what's the denominator what is the total number of people who are getting coid right 19 right now and I I can even say from personal experience I nearly fully recovered um in May of last year and then in July I got coid again and even though I was vaccinated and got treatment um it my long Co reignited from that new variant that I got last um July and so now I'm in recovery at 90% but still um that was a completely different variant than what I got the first time yeah and I still do see patients who come to me and said you know what I got coid in the beginning of of the year and I still have persistent symptoms and so I still see patients coming to a clinic presenting with long coid even though they're they're in the they got it from an Omron variant versus an alpha or Delta with the current variant that's going around what are some of the symptoms that are most common or does it vary from Patient to Patient well like all the most recent variant I think the one that is most populous is the uh eg5 variant that is out there and that one you still have the same symptoms it's starts as an upper respiratory issue and and so those are the things that you would see with that are we still seeing a lot of patients that lose their sense of taste and smell that sort of thing yes we still Lo have people lose their sense of taste their smell we still see those symptoms as well um Dr Kimbell this one is from a a VI viewer commenting on Facebook I heard that I can test positive on a home test for up to 90 days how on Earth am I supposed to know when I can end my self isolation so getting uh using self- test kits is a little bit more erratic it's it can be harder to interpret um often with antigen based testing which is what's in the self- test kit you don't stay positive for as long but it's true some people can stay positive for a very long time even on antigen testing I'd say um those are difficult situations to interpret you probably want to consult your healthc care provider but generally speaking if your symptoms have fully resolved and you've waited the time period That's recommended those 5 to 10 days depending on how long your symptoms last um it's okay to stop isolation now masking is another precaution that people can take so if you're living in a household with someone who's very vulnerable and you're worried about that persistent positive test in addition to talking to your primary care physician which I would recommend I would also say you can continue masking um to protect others in your household um Dr Kimble since we're on you June is asking I've taken all the coid vaccine shots and yet two months ago I got coid and got very sick what's the point of getting the vaccines vaccines are very effective at preventing the worst outcomes of Co 19 but they're not 100% we don't have any 100% you know prevention absolute um prevention methods so it is still possible to get sick after getting vaccine um what we do know is you look at the overall numbers your chance of getting very sick is far less if you've had the vaccine than if you didn't you never know what your illness might have looked like if you hadn't been vaccinated and would you still be here today so I think those um you just looking at vaccine efficacy those are the studies that are done to say if you look at similar populations what's the outcome for those who were vaccinated and weren't and we we definitely see a very strong benefit to being vaccinated I know the topic of getting vaccinated for some can be controversial we have someone who wrote in saying my friend does not believe in the vaccines says they haven't been tested properly and she won't get them what do you say to a person who feels like that I I think this is a question that maybe everyone um Can chime in on and I think we've all had conversations with people who feel that way and for some people getting vaccinated is a very person decision um I always lead with the data that I know um and what I would recommend to myself my family um I recommend my parents to get vaccinated my kids to get vaccinated because I really do believe that the evidence shows the benefit of the vaccines um I think also keeping in mind that millions of people have been vaccinated with the coid vaccines and so these vaccines have one of the best safety records of any vaccines known to man I if I can just add to for that you know when people say that to me that vaccine hasn't been tested there's been no vaccine in history that has been tested to the extent that the coid vaccines have been tested because we've never in history given so many people vaccines over such a large period of time around the world so every demographic every race every subrace you know all the mixtures have received the co vaccine now I'm not saying everyone's gotten it but there are I don't know how many vaccines have been given but there has been no vaccine that has been been tested more in terms of the human population than the co vaccine all the other vaccines we have you know uh are have not had anywhere near the exposure in terms of a worldwide population that the co vaccine has had Dr dendra what about for you what do you tell your patients well I tell my I first ask why what are the reasons why what are the barriers try to try to figure out because as as Dr kemell said it's a very personal decision so I try to ask why what are their barriers to getting the vaccine uh some would say well my my sister got sick after getting the vaccine and I say well that's also a sign of a very healthy immune system that you're you're mounting in a good immune response so I think really is to find the reason why and then from The Reason Why Try to try to say I think this is the best thing for you especially with your underlying disease your underlying illnesses I don't want you to get worse I don't want to see you suffering I don't want that and and really approach it from that that and Angela do you ever have conversations just maybe in your everyday life with people where you know you're talking about should you get vaccinated and you share your story I'm curious what you say all the time um it is there isn't anything that I can say that may not change their mind um but the first time I got sick I was sick for eight weeks and um wasn't even sure I was going to live the to see the next day the second time I was vaccinated I was only sick for five days yes I ended up reigniting my long coid but I was sick for five days and it was I was able to handle it I think it is a very personal um decision and I think that um you have to remember that there are people around you your loved ones um kpuna um people with um all kinds of medical issues and you don't want to uh expose them to that your loved ones to that so even though you might be fine you really have to think of the people that you love around you and do it for them um Dr dendra how many annual vaccines can our our human body handle I know for our Cuna the shingle series of shots is being recommended and then there's also the pneumonia shot we talked about RSV and flu shot can you speak to that I think the shots that you are recommended for your age group you should get and so there's it's there's no like limit to how many shots you can as long as these recommended shots that for your age group for your should be given I don't think there's say you can't have so many shots I don't think that's the way the immune system works one way of thinking about it is where I mean our our immune system exists because we're exposed to infections all the time it's built to see all kinds of different infections and so just the in the natural course of a person's life you're seeing as many antigens presented if not more than what you're seeing through vaccines Hilton do you feel like people have tuned out Co 19 I think a lot of people have we people talk about Co fatigue certainly in terms of masking the handwashing the social distancing um you know it lasted probably in Hawaii we we did very well overall you know Hawaii did remarkably well compared to the rest of the country you know for the the last numbers I saw we had the lowest death rate for the entire duration of the pandemic in the entire nation and one of the lowest infection rates so we did really well as a state that even though we have generally people you know who do take care of themselves and their Community they are concerned about you know their co-workers their families you know people people did get tired of that they said look I'm you know I'm sick of wearing a mask I'm sick of doing all this handwashing I want to go out I want to you know mix with people so there has been you know I was on a plane yesterday I flew back from DC yesterday in the entire plane there was probably maybe 10% of the people on the plane were wearing a mask even though there's a you know there is concerns about flu RSV and and and and Co um so yeah there is there is this you know Natural Evolution that you go through with any type of disease state or stress state where people say look I'm over it I'm just going to take my chances and that's that is unfortunate you know because as I said earlier you know the evidence clearly demonstrates just as we saw with the flu in 2020 and 2021 if you take precautions you can dramatically flu was still out there right it it didn't go away but the there was a dramatically lower incidence of the flu because people were taking good Public Health precautions um Hilton I have a question for you from Malia from Hilo do the hospitals and other health care facilities in the state meet regularly and share data about coid and is that information shared with the government absolutely it is so we work very very closely with the Department of Health we we really appreciate the very close collaboration we have meetings on a regular basis with all the different segments of our the healthc Care community so our long-term care administrators get together at least once a month to talk about what's going on Home Care Hospice Assisted Living hospitals we have our acute care leadership which is executive leadership meets on a regular basis our chief medical officers meet on a regular basis Dr Fink who's the director of the Department of Health he collaborates on those chief medical officer meetings so there's a lot of information sharing that's going on and we listen to what the CDC is you know saying we listen to what department of health is saying we all work together to collaborate and figure out what's best for the people of Hawaii Dr Kimbell do you feel like there is any chance that you know we could go back to where we were in 2020 as far as a shutdown or are we way past that with what we know about Co I think it's really unlikely that we would see a full shutdown happen again um we're really different place with Co 19 than we were before um and a lot of that is as we were talking about earlier the levels of population immunity that we have now early on people were talking about herd immunity well in a way we're as close as we're going to get to herd immunity for coid now which means that even people who didn't choose to be vaccinated have many of them nearly all have had coid uh and so there's some level of immunity there so that really has shifted as we were saying before how much hospitalization and severe illness you see as a result of another surge in coid infections um so as long as the variants continue to be responsive to what our immune system has built up um so that we're able to fight off the worst effects I don't see us going back to a place where we're having that kind of full lockdown that's good to hear I'm sure no one wants to go back to to 20120 um Angela for any of our viewers who maybe they know somebody who had a story similar to you or maybe they themselves had a story similar to you what would you like to say to our viewers and is there maybe any way they can get in contact with you if they want to know more well um there is hope there is definitely hope and I think the biggest thing is to be an advocate for yourself and if you know someone who has long coid to um be an advocate for them it takes lots of resources it takes lots of research it takes lots of trying to find Physicians who you're able to see um I work at brainal Hawaii and they can find me on the website call the clinic and reach out to me I get emails and messages from people from all over the world um asking for help for long coid I think everybody's a little different and it affects them all very differently so there are different modalities and different things that people have to try or need to try in order to get themselves well but there's one thing that I have to say for long Co um patients get yourself outside get yourself in the sunshine let your eyes see the light outside get around um people and if you don't feel that you can be around people in crowds make phone calls get get engaged with people with text messaging with emails with zoom however you can when I was going through treatment what I would do is I would force myself to leave the clinic after treatment and go to the mall and walk around and be around people and I forced myself outside because we tend to isolate ourselves when we have long coid so the sun want camp on that because I think the mental health aspect of this is so crucial yes it is making sure that you're well also what Hilton was saying be good to yourself mental health diet exercise Etc I think that's something that you mentioned earlier the exercise portion of it just being healthier in general uh is really important was speaking to other people that maybe were going through the same thing that you were helpful as well yes and it's amazing how when you start speaking with people how you realize how similar your symptoms are and it's like oh I went through that too and oh I went through that too so speaking to people about it and finding communities where you can be open and share and um you know have that camaraderie of me too that I I also face those kinds of things it can be very empowering because we all give each other hope and lean on each other uh in those times with long coid Hilton do you know do our our medical facilities provide um counseling or therapy for patients with long coid yes they do um we're very very fortunate to have Physicians who are starting to specialize in this um we have a very very robust Health Care System here in Hawaii very very pleased with you know the the type of capabilities we have the resources we have the ability to share information learn from each other so we you know while it is becoming a very you know sort of being not sure if there's a board certification for it yet there may be at at some point in time but you know we are learning from each other we are figuring out you know what it takes and going back to what Dr kemell was saying about the chances of the state shutting down you know we're able we we know so much more about how to treat the disease now and so because we know we we have the vaccinations we have the immunity we have so much better treatment we are much uh much more readily able to detect if people have coid so we're in a much much better place than where we were in 2020 now that being said there is always the potential for other diseases to come so we do need to be vigilant we do need to be careful and we we've leared how to react we can develop vaccines in a very short period of time this is you know the MRNA vaccines you know that had never been done in human history before so we have that ability to do that again if we need to we hope we never have to face it but it may still happen those risks are still out there mhm unfortunately we have just one more minute so Dr Kim I'm going to give sort of the last comment question uh from Cindy from kanoh to you uh she's asking the panel to talk about best practices I know we've touched on that throughout the last hour but you know as we head into the holiday season Halloween Thanksgiving Christmas family gatherings what can our viewers do to stay healthy I think the number one thing as we've all been saying tonight is get the updated Co shot that's going to be a great way to protect you if you're going to be doing things in more crowded situations and for those who are at high risk um you may want to think about wearing a mask during those times when you're interacting with a lot of other people that's still an effective tool in the toolbox vaccine mask up hand sanitizer I'm sure hand s hand sanitizing is very key I mean if there's anything that's one thing in combination with all of the what we've talked about hand sanitizing is key I I think one of the biggest things just to underscore what Sarah has said definitely vaccinate get your flu shot get your coid shot if you're in the correct group get your RSV shot I think those are going to be really important things to to as we go into this next season yeah and if you don't feel well stay home yeah that's a good one stay home well Mahalo for all of you uh for joining us tonight we also want to thank our guests in studio Dr Sarah Kimble the state epidemiologist Dr guihan dendra from Queens Medical Center thank you for being here Hilton Ral from Healthcare Association of Hawaii and Angela Kean long coid Survivor we are so glad that you are feeling much better thank you the devastating fires in lahina have had a massive toll on many of us Statewide next week we will talk to mental health experts about the challenge of coping with the effects of the disaster please join us next week I'm Lauren day for insights on PBS Hawaii have a great [Music] night local broadcasts of insights on PBS Hawaii are   made possible by the support of viewers like you mahalo