Good afternoon.

I'm doctor Mandy Cohen, I'm the secretary of the North Carolina Department of Health and Human Services and today, I'm joined by doctor Charlene Wong assistant secretary for children and families and practicing pediatrician at Duke.

Monica mcghee and lee williamson are Americans Island let sign language interpreters and jasmine and jakeem it heavier our Spanish interpreters.

As far as today's covid numbers as of this morning, there were 2156 new cases reported just today.

1095 people are currently hospitalized right now with covid across North Carolina.

And sadly there have been a total of 18,371 deaths from covid.

While we as a state remain in the red zone with the highest level of covid transmission.

Our trends have improved significantly which is exactly what we want to see.

We also have made great progress in vaccinations more than 72% of adults in the state have received at least one dose of a COVID-19 vaccine.

And this month we're East re reached another significant milestone in our fight against covid children ages 5 to 11 can now receive a safe and effective COVID-19 vaccine.

Last week the FDA authorized and the CDC recommended all children ages 5 through 11 should get a lower dose of the Pfizer COVID-19 vaccine to protect against serious illness.

Just like other routine vaccinations for kids the Pfizer COVID-19 vaccine underwent a thorough testing and review process by the FDA and an independent scientific committee to ensure it is safe and effective for children.

They reviewed data from clinical trials, some of those which are conducted right here in North Carolina with more than 3,000 children.

The data shows that the lower dose of the Pfizer COVID-19 vaccine protects kids from serious illness.

And that there were no safety concerns or serious side effects.

Having a safe and tested vaccine for our younger kids is fantastic news.

Children as you know are vulnerable to COVID-19 just like everyone else.

Well kids tend to get less sick than adults.

Unfortunately kids do get covid and can experience some of those longer term symptoms like headaches for memory loss and muscle fatigue.

We also saw more kids hospitalized this summer with the more contagious version of covid the Delta variant.

Additionally kids are at risk of a rare condition called multisystem inflammatory syndrome in children or mis-c after getting covid.

During the most recent surge pediatric cases of the virus rose by more than 200% across the United States.

As a parent.

Having a safe vaccine to protect my young daughters from COVID-19 is a huge relief.

My daughters were vaccinated this past weekend because I want to do everything possible to keep them healthy and to get them safely back to the things they love.

Like most kids might my daughters don't like shots.

But we talked as a family about the reasons it was important to protect them from covid just like we protect them from flu.

And other childhood illnesses like chicken pox.

We are sharing our families covid vaccine experience in our new PSA videos.

We'll take a look at it right now.

Hi this is doctor Mandy Cohen secretary of the North Carolina Department of Health and Human Services.

>> And I'm here today at our pediatricians office getting our COVID-19 vaccines these are my daughters who are at 79 is Evelyn and Sophie I could not be more relieved to get them their vaccine today we know that this vaccine has been through a rigorous clinical trial.

I've gotten a chance to look at that data myself you know we love our kids so much and we want to make good decisions for them and their health and I was really happy that we have a safe and effective covid vaccine and I was really proud of them today that they got their vaccine was a huge sigh of relief for mom.

So I hope everyone goes out and gets their covid vaccine for their kids as soon as possible.

>> Everyone 5 and older can get a COVID-19 vaccine.

Visit my spot dot NC .gov.

>> Proud Mama.

So already more than 24,000 children in North Carolina have received their first dose like adults children are given 2 doses of the vaccine, however each dose is about one 3rd the amount given to people ages, 12 and older children under but children between 5.11 should not receive that that larger 12 and older dose.

Children like adults can experience temporary side effects from the vaccine like older kids including temporary arm soreness headache being tired or a key for a few days, I'll share that my daughters didn't have any side effects from this first dose not even a sore arm, but we know every kid is different.

We have plenty of vaccine supply across the state kids can get vaccinated at any location that has this smaller dose of the Pfizer vaccine available.

This includes their pediatrician or doctor's office or hospital.

Unlike other vaccines, younger children can also get vaccinated at local pharmacies and grocery stores making it even easier for parents to find a convenient location for them.

We've also worked with community partners to set up 9 family COVID-19 vaccination centers in historically underserved communities to make sure vaccine is easily accessible.

The centers will be operating for the next 6 weeks and they have vaccines for all ages as well as boosters.

They're open during the evening and weekend hours they have live Spanish interpretation and have people on site to answer questions.

And remember COVID-19 vaccines are free to everyone even if you don't have health insurance and regardless of immigration status.

You can find vaccine locations at my spot dot NC .gov.

We also have information on our website about how to talk to your children about the COVID-19 vaccine.

If you still have questions talk to your child's doctor.

You can also visit my spot dot NC .gov to get accurate information.

Don't wait to vaccinate your kids vaccination helps keep children healthy and helps them be safe in the classroom, playing sports and attending events and other activities they enjoy.

Doctor Wong and I will now take your questions.

We'll start here in the room if you have any.

Yeah tuna.

>> I see doctor Cohen haven't been here in a while so forgive me if I have a couple of questions here.

So you know you have a new group eligible for vaccination it gives us an opportunity kind of to reset the message.

We know the vaccine is extremely effective at keeping you alive and out of the hospital.

Can we set the record straight though does the vaccine lessen your chance of getting infected in the first place and if so by how much.

>> Well first, thanks for that question.

I want to make sure parents know that this vaccine is effective at keeping their kids from getting covid in the first place, but we saw in clinical trials was I 90% effectiveness from those clinical trials meaning effective at preventing the child from first getting covid and we know that's the first step in preventing them from getting really sick from covid if we can prevent them from getting covid in the first place that means that they're not going to be at risk of getting a severe reaction to covid if they get it to get hospitalized or to get that rare inflammatory disease that I that I mentioned.

>> So you mention that Miss see the eye camping out and say you know we know that there's measles mumps rubella smallpox chicken pox these are dangerous diseases for children covid yes, you mentioned there have been some extreme cases but in the Wall Street Journal this week.

2 physicians one from Sloan Kettering one from Cornell Medical School reported of the 28 million children between 5.11 in America, 94 have died 562 have been hospitalized out of 28 Million.

I'm not good at math, but that's a very very tiny tiny tiny percentage.

So with that is the pretense why is this an emergency that children should get vaccinated now and not wait a few years for more research.

>> I think is a great question because we want to remind folks that even though the risk of hospitalization and death are rare in children as well as the this inflammatory condition, it is possible.

And now we have a safe tool to protect our children idoc waited and I I want to have doctor one way into right that we all for example use car seats or seat belts with our kids even though the risk of dying in a car accident is pretty rare for a kid which is great.

But we want to do everything we can as parents to protect our kids and so I see the vaccine because it is safe.

As one of those really effective tools to per to protect our kids let me turn it over to doctor want to add more.

>> Yeah, thanks for the question.

I think you know importantly any preventable hospitalization are preventable death in a child.

It's very worth it.

You know to also put into context.

It is a small number fortunately, we don't have that many children who die each year, but in one year with COVID-19 and has become a top it's been in the top 10 lists now the things that are killing our younger children and again every death of a child that we could have prevented is a true tragedy.

I will also just say you know as doctor Cohn is mentioning, we have lots of kids who are getting really ill over 50,000 in the country who have not needed to go into the hospital fortunately, many of those children, you know we're able to give them treatment support them and haven't come out.

But certainly we don't want any child to go into the hospital and family who was you know having to deal with that stress going to the hospital if they don't need to because we have the safe and effective COVID-19 vaccine.

For young.

>> I think in the tweens we knew about some cases Meyer could itis in young males in particular.

What do we know about that as a side effect in these trials and here in North Carolina.

Do we have any cases of that and so far those immunization or let me turn it over to doctor won again.

>> So in the clinical trials we didn't see any of those myocarditis cases in the children ages 5 to 11.

There are a couple of reasons we think that's the case so number one the dose of the vaccine for our 5 to 11 year-old it is smaller and its smaller meaning that they're going to have you know less in part because we want didn't want them to have so many of those temporary action but still wanted to make sure that it's affective fortunately for us our younger children have very robust are strong immune system so when we give them a vaccine even better than adults they are able to really Mount that robust protection or immune response that we're looking for and so because we knew that they had that more robust immune response.

We were able to bring that dose down which also meant that we would see less of these other temporary actions or more serious side effects like myocarditis.

In addition, the myocarditis syndrome we know happens more often not just with covid but myocarditis happens from other viruses to this is something that we see as a practicing pediatrician, sometimes we see kids get myocarditis or its its cousin para card, itis when kids get other viruses too.

We know that we see this more often in general in our older teens because some of that has to do with the hormones and puberty and sort of how that affects the way that their bodies react when they get infected with these different viruses and so for all of those reasons number one we were glad to not see any cases of myocarditis in the clinical trials and there are some pretty good reasons we think that's the case in to be lower risk in these children of course we'll continue to monitor with the CDC.

The FDA are continuing to monitor for any of these rare side effects in the younger age groups as well.

>> Doctor Cohen in your fireside chat that you had last night.

One thing you mention was that it's still much better to not have covid at all and have covid can you talk about the risk of a long-haul covid so if hospitalizations are low and death is also very very low that risk what is the risk of a long-haul covid case and how prevalent is that in children yet so I'll start now one doctor want to win as well but what we are seeing I think we're only at the beginning of understanding.

>> What the long-term impacts of having covid are even for those who have a mild covid illness we're seeing that children can have longer term side effects fatigue headache.

Muscle aches.

Lethargy again different kinds of tiredness so we are seeing that in children and adults.

And so I think what we want to do is say well look we have a tool here that is safe and effective at preventing your child from getting covid in the first place, let's use that safe and effective tool to make sure they don't get covid I think we're still learning to understand again over time how long how long is long covid and how long will it last let me turn over to act one.

>> Yeah, you know when my patients and my parents asked me this question what the way I respond is.

It's unknown unknown because we like doctor called was saying we're still really learning a lot about it.

I will say the patients who I know who have gotten long COVID-19 I'm really debilitating really scary for the family have some patients to say like you know they just there that they have a brain fog.

The way that they think just as a normal and it can last for so long the other thing that's quite scary with it is that we don't yet know what the best ways to treat it are and again these are the types of symptoms that really impact what our children can do on a daily basis can they go to school or not can they play with their friends are they performing at school the way that they used to because they have this long covid the same way that we're seeing in adults as well again these these can be really debilitating symptoms that can last for a really long time and it's scary because it's unknown unknown whereas we had a known safe and effective vaccine which we know can prevent covid mild illness long-term effects acute really severe illness.

We have that safe and effective vaccine.

>> Last question I promise you identified 70% as the threshold, the target for adults vaccinations what threshold are you hoping for children North Carolina, what percentage and is there a marker that you want to set for we get let's say this X amount of of kids vaccinated schools can start maybe even preschools start relaxing.

>> Mask requirement.

Well we certainly want to get as many of our kids vaccinated as possible.

It's why we're talking about it today we're doing a lot to make sure we can answer questions for parents.

I want parents to no the asking questions is absolutely okay and to get those questions answered by practicing physicians in and get good information about making this decision for their their family.

I think when we we put out the 70% number is back in the spring and actually now that covid is even more contagious.

I don't think we know exactly what the right number is in terms of everyone being vaccinated we need we see we need to have a very high level of immunity amongst everyone in order to really see this covid become something that we can live with so we want to see a lot of folks get vaccinated so they can protect themselves their children and others.

So that's our focus for for today, thanks.

>> Yeah Brian Anderson here at the AP had a few questions first on the boosters for adults aged 18 to 64.

Let's say you're otherwise healthy adult you don't have any of those CDC qualifications but Thanksgiving is coming up.

Christmas is coming up maybe have unvaccinated relatives or you're planning a flight or something what would be your recommendation for these otherwise healthy adults should they get a booster now sure so first I would say anyone who has gotten the Johnson and Johnson vaccine and it's been more than 2 months no matter your age you should be getting a booster so if you've got Johnson and Johnson and his folks know I did.

>> Get Johnson and Johnson.

A number of months ago, so I did get a booster.

So so Johnson and everyone should get a booster on Pfizer and Moderna we are saying that it is really recommended for those over 65 with underlying medical conditions and for those who may be at higher risk of covid exposure.

So I think that could be near be in your work setting Warren something that you're doing in your your your personal life so I think that there is some opportunity for folks to assess their own risk and to know whether or not they are at higher risk for for exposure to covid and whether or not boosters right for them and again has we 6 months since you are fully vaccinated for Pfizer and Moderna.

>> I mean North Carolinians have gotten any of the 3 available to stirs I don't have those numbers in front of us, but we can we can get that to you.

>> And one more question on the booster, we know there's some interest in and mix and match and you said you've gotten the Moderna having received the J and J would you recommend anyone get a Moderna because it's been proven to have the highest level of antibody resistance, it seems.

>> So what I would say I think that the Pfizer and Moderna vaccines operate very similarly they use a very similar mechanism to teach your body to recognize covid so if you've gotten the Moderna or Pfizer I would probably stick with what you've what you've gotten before for those who got Johnson and Johnson the we do see some preliminary evidence to show that changing over to either the Moderna or Pfizer gives us a slightly stronger immune response.

So that's why I chose to move over to the Moderna but I think it's pretty equivalent.

I don't think we have the precision to say if you got Moderna go to Pfizer Fizer back to Moderna I think they're pretty equivalent.

The once it's an area that I I said is a little different is if you got Johnson and Johnson potentially getting either Pfizer or Moderna.

>> You said 24,000 kids have gotten that from 5 to 11 so far that's right so we've been vaccinating about 5 days now and we've done about 24,000.

We think there's more out there it takes a little bit of a lag time but that 24,000 in and with that number that's 2 to 3% of that age cohort how concerning is it that it's.

>> So small right out of the gate and you know soon there's going to be almost half a million doses available in 24,000 seems to barely scratched the surface, we are at the very beginning of this work that's exactly why we're here today.

It's why I'm sharing the story, I'm about my family's decision to get vaccinated over the weekend it was just authorized you know few days ago and so we are still you know expanding our operations parents have to think about him making making time for it and I think it's a great conversation to have around the dinner table this week and then planned in the next week or so to make an appointment go visit one of these family vaccination sites go to my spot dot NC .gov find a location near you some have appointments have walk ins.

>> Here department had a report that came out recently looking at the effectiveness of incentives and it seemed that there is a signal that the the million-dollar the 4.5 million dollars total lottery package might not have been as effective as these $25 small perks are there any incentives carrots or sticks forthcoming with boosters kids vaccinated any vaccination efforts so well one I'm a turnover doctor Wong who is very involved in writing the paper about the incentives particular this smaller dollar incentives, the 25 $5000 incentives.

>> And why they were effective in so we are looking at ways to replicate that that we saw in our adult population, what would what would we be thinking about for our children population saw turnover doctor want to talk about those.

But yes we are looking at that right now.

>> I think is doctor Cohen is described, you know many times it's it's all about using multiple strategies right we want to get as many North Carolinians kids teens, adults vaccinated the paper that you're referencing I think is the one where we were studying the impact of our summer cards are guaranteed small financial incentives where we were really pleased to see that they did have an impact on reducing the rate this was over the summer when our rates of vaccination were declining and in the sites where we were offering those cards particularly early on which is when we did the study we saw that that really slowed by like half.

The decline in the rate of those vaccination which was which was wonderful, even better in many ways we also were able to do surveys and partner with our with colleagues at the North Carolina Central University.

And what they were able to show in the surveys we were doing is that in particular it seems to promote access and cover the cost of vaccination like transportation or child care lost wages particularly for some of our historically marginalized populations so folks who are low income black latinx and so we're really pleased to see that we are continuing to study the impact of some of the other incentive programs and then I'll just add you know we you know certainly those were incentive programs that we in the department we're sponsoring and running we have seen so many of our vaccine providers partnering up with businesses and foundations and just individual citizens, really creative opportunities to offer lots of different types of incentives.

Some that are going to appeal to different groups right.

We have some incentives for free tickets to an amusement park we had one vaccine provider who had a car donated and they raffled off a car right so I think you know one incentive is not going to work for everyone in one strategy is not going to work for everyone so it's about putting them all together.

>> Follow for you and and and that one was there a single person you're aware of who got the vaccine because of the million dollar lottery.

It seems there's evidence that lots of people got the vaccine because of the $25 cash card or at least went to those locations but is there any evidence that a single person in North Carolina got the vaccine because of the larger lottery.

>> I think certainly anecdotally we've heard from folks that you know that was certainly a big motivating factor it just that extra nudge that they needed extra motivation that they needed.

So and again we're still continuing to study the impact of that particular larger incentive.

>> Last one for doctor Cullen this off of what Jonah said just sort of about the messaging to parents for the 97% of parents plus have not had their kids vaccinated yet.

You said now is an OK time to be asking questions at the start of it.

What's your your message to parents who got the vaccine themselves and say I'm willing to take a chance with me my husband and try a new vaccine but it's too soon to do it for my kids.

>> Well I want to make sure that folks can get their questions answered what I would say is call your pediatrician.

And all I can share is what I would do for my family which is exactly why we shared the PSA.

We did today so as a mom as a physician and the leader of our health and response work in covid I got my kids vaccinated within a couple days of this vaccine being available and I think that's a you know, I'm not just talking the talk and we're walking the walk in our family because it's so important to protect our kids I want the best for them I want them to be healthy and safe and so I hope with other family seeing what we are doing for our family that will give them more comforted say we can take that step forward but I would say of course ask questions call your pediatrician and find an access point soon.

>> Lucette grace desserts for the kids who know that they did they get they did get some chocolate milk after getting vaccinated.

All right I think we're going to get some questions on the fun.

>> Our first question is from Britain Craver with the Winston Salem going on.

>> Yes secretary Cohen this is Richard credible it was a silent journal.

A quitter central question was already been asked but I was just going to kind of follow up on possible evidence.

The have any kind of Bill what time frame we're looking to see.

In terms of fall.

Demand for the vaccinations for the fog 11 year-old to get a gauge what the man is and how would that compare to the time frame that you have a view from the 12 to 17 year-olds.

>> Thanks Richard.

What I would say different from our adult is that we have plenty of supply here.

We also have plenty of access points so early on.

Back in January of 2020 2021.

You know you couldn't really get access to a vaccine because eligibility was limited for kids, it's widely available plenty of supply.

And lots of access points.

I think we're just wanting to get the message out answer good questions and really understand where.

Bottlenecks night be what I would which airs obviously kids are in school Monday to Friday right during the day so we really have to think about evening hours weekends and so I think it will look a little bit different in terms of the flow of when children will get vaccinated and so we just want to answer good questions have access points out there and make it easy for for families to take advantage of this vaccine.

>> Our next question is from road.

So then what is the health news.

>> Thank you for taking my question.

Out by some of Mike what about the benefits but I do want to know you know of in terms of kids getting their food back and we know they can get a co that and alongside another back in Ghana in an office visit.

>> Sure when I turn over to doctor won't answer that.

Thanks so much rose for the question.

The answer is yes, they sure can.

We know that we want to make sure kids are vaccinated against all the different diseases that we can protect against certainly in the season.

We're in now we really hope that everyone is getting their flu vaccine.

And it is totally fine to get the flu vaccine as well as the covid vaccine at the same time and they're also there are other routine childhood vaccines that can be given at the same time making it more convenient for parents.

All right next question.

>> But left the program in the health mean.

>> And it can you post review what we know about and friend fill up and do their older relatives who might be unvaccinated or what a what we know now I mean for the eye and the ban.

What.

>> I'm going to let doctor one do that one as well.

>> So what we know is that kids are very good transmitters of any virus covid is not different than the other viruses that they pass around certainly you know we have we've seen our kids do very well at learned to do things like wash their hands a lot and wearing masks when they're in public when they're in school.

But certainly we know and this has been true from the beginning of the pandemic but we know that kids are certainly a part of that transmission pipeline.

Certainly also particular within households are we're thinking about these younger children and again when I have patients who I've diagnosed with COVID-19 and you're looking at a 5 year-old and her family and you're thinking.

Okay with a 5 year olds diagnose can I really it's very hard for parents and other people in that House bill to truly isolate away from a 5 year-old because obviously they still need a lot of support just because they're only 5 years old and so certainly we know that kids are passing the virus 2 other children 2 adults that they're around and certainly very concerned if they're passing it to others around them who are unvaccinated I just also put in a plug we still have younger children who are still not eligible to be vaccinated and we know that some of these kids in the 5 to 11 year old age group have younger siblings at home.

My daughter, I was really excited about doing her part we also got our kids vaccinated this weekend.

I have a 5 and a 7 year-old and they were really excited not only about protecting themselves, but we have neighbors who live next or who have younger children and they were really excited about doing their part to protect some of those younger children.

Great thanks next question.

>> Our next question is from where we left near the wcnc.

>> I think so much for taking my question I to question about booster shots now with Pfizer asking for authorization for everyone, 18 and older to get a booster.

You have any concerns that that might be.

Even more of a turnoff for people who haven't even gotten their first doses now knowing.

Okay, it's not just to shop to 3 and then possibly you know boosters after that thank you.

>> Chloe I think the important thing for unvaccinated folks to know is that you are 4 times more likely to get covid if you are unvaccinated and 20 times more likely to die of covid if you are unvaccinated that means 2000% more likely to die.

I don't want any more unnecessary lost lives to covid here in North Carolina or anywhere across the country or the Globe.

Now we have a safe and effective vaccine.

Yes, our immunity can can wane over time this virus can change over time and it might mean we we need boosters over time.

But you really need to protect yourself with that primary vaccine.

It is safe and effective and we want to do everything we can to make sure we're answering questions that folks feel comfortable getting vaccinated it really does protect their and could save their life.

Next question.

>> Our next question is from Derrick Bell and there but that 46.

>> Thank you for taking my question this is Derek with a FOX 26 news now.

County is one of among several counties and municipalities in the area.

Still have a mask mandate they decided to change the guidance earlier this week to reflect if it's under 5% for 7 days.

They will end their mask and they just want to get your reaction to that and also we had a chance to talk to some businesses and they are still interested in keeping up their mandates and the kind of want to see what kind of support they can get from the state released from local authorities on that and what they can expect to see what some of these local mandates it.

>> We're well first we haven't had a statewide mandate in quite some time but we have had local mask mandate.

And what we know from our trends is that we still have a lot of virus here in North Carolina as I mentioned right at the beginning of this press conference.

We are still in that's what the CDC designates for us as the red zone meaning the highest level of viral spread now, we're we're we're going down we might be an orange soon which is a good good news, but we still have a high level of viral spread and we want to be protecting each other and ourselves so I would still encourage folks to be wearing masks in any public indoor setting.

I think that our local entities can continue to look at their local trends look at the state trends and as we continue to come down.

I do think that it is right to revisit whether or not mandates are are necessary but we're not quite there yet.

I think we're focused on making sure folks can take advantage of vaccines.

Vaccines are what is going to put this pandemic in a rearview mirror.

Officially.

So that's why we're focused on getting everyone vaccinated and I think it will help us continue our trends in the right direction and allow us to move away from a meeting to wear masks as much, but we got to do that do the do the work on vaccines.

>> Thanks Sir, I work very well under 5.46.

>> It within that same thing how the big saying that that happening over the last few weeks or so or at least some of the some of the news that's been going on has been this treatment bill for COVID-19 that has been known to reduce deaths and for that matter some hospital patients.

The is it helped closely watching this right now though it's going to be a couple process and do you think this is something that they likely and whatever remaining local restrictions that are out there wants to prove.

>> It's as we've tried to fight COVID-19 over now nearly 2 years different phase of this have presented us with different tools we're at so much of a better place right now than we were a year ago we have vaccines we have some treatment we know how to prevent the transmission of this virus with the fact that there is more treatment coming down the pike is great news.

It's another tool up until now treatment has really been either an infusion or injection which does limit the availability of those treatments with a pill that could be more widely available again I think another great tool to help us put this pandemic in our rearview mirror.

It's not available yet.

And still vaccine is the best mechanism to protect yourself again love having more tools think having a pill to treat covid does again get us closer to really putting the entire pandemic in our rearview mirror but we're not quite there yet.

All right we have anyone else on the on the line.

>> Our next question is from Jason the Bruin with W UNC.

>> They can to grow and wnt thanks for that the question I to travel again my question to 2 questions there around.

>> The I think program in K 12 schools and the first is around nurses, I know dhhs some funds to districts around the state to hire nurses.

But district we talk to and as I'm sure you likely know it's difficult right now to hire nurses as another line to work obviously their their workforce shortages and you probably I've seen the ships entered us recently projecting short of a really as many as 10,000 or even 20,000 nurses.

So the question is how can you ensure.

That you'll be you'll be able to sort of follow through on his promise to hire all these nurses put them in schools and how would it affect the testing program, the schools can't hire these nurses.

>> Jason great question.

I think you are absolutely right in saying we are certainly seeing a is a shortage of nurses across North Carolina and that is not unique to our state that is happening around the country.

And so it is more challenging to find nurses who are able to be in our schools but we're also the very beginning of that process I think there's more work for us to do before we say it can't be done so we have a lot of work to do with our school systems to make sure that that we are getting more nurses into our schools which is great.

We anticipated that and now made sure to have testing resources available to schools.

Through vendors that we can pair with our school districts and so we are schools are able to sign up with us a program with the state it is free to the schools and we do supply both the test and the the folks to help them do the test so it doesn't have to rely on them hiring a nurse to participate in those testing programs but ideally we want both because this isn't just about testing with our school nurses, we know our school nurses need to be there to help our student body.

For a variety of things including some of the mental health things that we're seeing in our student population, so school nurses to is still a top priority for us, it is going to be a challenge Lake finding nurses everywhere but we're working together with our school districts on that.

>> Follow a case and the Bruins W you and me.

>> Yes, thanks for that.

And the follow-up is maybe just to grab a comment or 2 on the testing program in general.

The big undertaking as you say you know you have the vendors but it still a pretty big job to try to test.

This many students can you talk a little bit about how it's going it, I know that we're hearing it's supposed to be sort of up and running by the end of November.

And it feels like maybe this is something that would have been better to have up and running at the beginning of the school year talk a little bit about.

Maybe why it wasn't ready at at the beginning of the school year and and you know where things stand now.

>> So I would say our schools have done so much to protect our children are really doing so many things across the board and we recognize that testing is yet another thing we're asking them to do in addition to lots of other safety protocols.

So certain school districts, we're certainly ready to work with us right when school started and we did work with them and frankly we're working with them in the last school year but others needed more time to sort of get ready to do this and because as you said this is work that they need to integrated into what what is happening within their school whether they're doing it on site using a vendor so there are logistics that need to be worked out as well as parental consent all of those pieces are are important pieces of the puzzle here.

So as I sat some school districts really out out of the gate doing this and others are are certainly just coming online now I think it's an important part of our being able to keep kids in the classroom, which is our goal.

We want kids to be learning in the classroom.

So if they have any symptoms of covid getting a rapid test right on site so that they could if it's negative they can go right back to class like that's what we want to do so kids are are in the classroom.

As well as surveilling for the virus to make sure we're keeping everyone safe and healthy so those are our goals we share them with the school districts.

But you know it is they have a lot going on and I appreciate that and we'll just continue working with them as fast as we can.

>> Our final question from Patrick Thomas back to you.

>> A doctor cologne that afternoon.

I guess is that for you and dark along I'm curious about the new Delta plus variant and it's going to be more transmissible what the parents like yourself.

Need to keep in mind with the onset of this new Delta variant with the original already being so contagious.

>> Thanks to that question.

So we know this virus is changing we sought change over the summer and become more contagious.

There is a another what's called Delta plus or other types of variance there out there.

So far we haven't seen very much of that here in North Carolina which is good, but we're certainly keeping our eye out for that I'll turn it over to doctor won.

>> You know secretary Cohen was saying we really want to put this pandemic in our rearview mirror the patients I see the parents I see everyone's in the same boat right, especially the kids they really want to put this behind them by getting more of our kids teens and adults vaccinated this is what's going to really help us to prevent more and more of these variants from coming from you know coming to be and then really affecting the way that our kids and were able to live our day-to-day lives.

And so this is why it's so important to not wait to vaccinate because we know that we've got the safe and effective vaccine.

You know parents are asking me you know like doctor Cohen should I do it like right now are is it OK for me to wait, I think you know the thing that I always advise them is I'm a parent too we're all always try to make the best decision for our kids you know if people still have questions that they want to get answered by someone that they know that they trust please reach out to those folks children's health care providers others who are trusted in your community, so that you can get those questions answered so we can get as many kids vaccinated just as soon as possible.

>> Okay I think that was her last question thank you so much for tuning in again.

We hope everyone gets vaccinated and Tate stay safe, thanks so much.