.

Good evening and welcome to Prime Time.

I'm Bruce Haines.

According to the Centers for Disease Control and Prevention, respiratory illnesses are appearing earlier and in more people than in recent years.

Public health experts are concerned that an expected winter rise in covid cases could collide with a resurgent influenza season and emerging cases of respiratory syncytial virus or RSV and that's all leading local efforts to encourage the promotion and the protection of public health .

At the forefront of that is Allen County Health Commissioner Dr. Thomas Cutline who was appointed to the position in July and this year that was when the activity took place during his second job he continues his service as a practicing emergency physician at Parkview Health .

Dr. Goodwin has almost 30 years of essential health care and leadership experience in northeast Indiana and he is with us tonight to talk with us and to take your calls on this very special edition of PrimeTime.

>> And Dr. Gupta, I thank you very much for being with us here, sir.

Thank you, Bruce .

Thanks for inviting me tonight.

It's been about four months but maybe feels more like the four hours from July through the of October.

>> How has the experience been in this world so far?

Yeah, time is has gone pretty quickly with it.

So actually starting this role as public health commissioner it's been it's been a great time.

It's been very exciting and most of all it's been very educational for me.

I'm not I wasn't 100 percent certain what I was going to get into when I started this but I knew that I thought this was something I had been interested in for quite some time.

And so I've been able to step into this role and work with the staff at the health department.

And what I found is that the staff are doing an excellent job.

They have a really well oiled machine and it's been fun to work with them.

>> It's a lot of fun.

Well and will schooled for the position I would think the Segway has been made easier by your career focus in emergency medicine and I'm wondering if there are any carryovers between emergency medicine at Parkview Health and such and what you're you're finding in your role as the health commissioner recognizing we've had our share of health emergencies just in the last couple of years.

>> Yes, absolutely.

That was one reason as an emergency physician in Fort Wayne for the past almost 30 years now I felt like I had a lot of insight into what was already going on.

I was heavily involved with covid and how that was managed and how things were rolling with that and what the statistics were with those and so we've always been on the front line in emergency medicine for infectious diseases.

We've always been the people that are exposed first that are going to see the first patient that has Ebola or some other new disease, something like that.

So I've learned a lot about those infectious diseases and I've had to be prepared for those.

And now as moving into my role really just take that role that I already have is as far as learning about those infectious diseases and I educate other people about them and try to prepare the whole community for that so that it's not just me worrying about my patients that I'm seeing in the emergency department but now I'm worried about the patients that are seen across the county and that education seems as if it is one made easier when pictures can help speak and go alongside words something that many of us have discovered is through the L.A. County Health Department's website our regular postings of activity in a variety of areas and of course of recent note has been that of covid 19 and as we had done a couple of years ago through Deb McMahon when she was in that capacity and Dr. Sutter as well.

>> Let's take a look.

If we can at some of the current reporting on covid-19 to kind of answer the lead question perhaps where are we now?

>> Yeah, so right now with covid we're in a good spot in a bad spot.

I think the good spot is if you look at this graph the this is a seven day average of deaths in Allen County and if you look at the end of that graph it's almost zero and in fact our number is is zero that we've had if I'm looking at the right graph.

So I think the number that we've had for the last seven days has been zero.

So that's really good.

You can see the big spike that we had in January, December, January of the end of last year and the beginning of this year.

So that's a that's really a that's the good part about it is what we're seeing today hasn't caused a lot of death but it has caused a lot of what I call disability or patients that had to take off work or patients that are feeling terrible.

So if you look at the next slide, those are the number of cases I believe.

>> Yeah, those are the cases that are occurring in that one county on a regular basis and that's a harder number to measure today.

>> Yes.

One more slide please.

And that's a little harder.

No, no, that's a little bit harder to measure.

So these are only data we can only get data points from laboratories in the area or in Allen County that are reporting to the state on a daily basis.

So all those people that test for covid at home, we don't really get any data on those but we know there's a lot of people that are testing at home for covid some negative, some positive and then the next graph also shows the deaths and then that that again is easier to see that the deaths over the last seven days has been zero, which is a great number.

I mean we've had twelve hundred and two deaths in Allen County from covid.

That's a huge number.

That's a lot of people and that's something that's like 27 forty sevens crashing.

All those people lost their lives and from that we're from Allen County so it's a it's a good thing to see that seven day average is zero.

>> That's the good part about it.

It seems to us is we pause here but we will continue with the slides in moments but that you have folks who are able to test at home as well as test in medical clinics, PCR versus antigen it how does that impact the data that we're we're seeing?

Yeah, so the tests that are done in the clinics whether they're PCR or antigen test test those are reported to the state so that data is all there.

So it's really all the data on the people who have covered tests at home that we don't really have any access to those people cover a broad swath.

We have graphics to share on the age comparison of those that are confirmed with positive cases and I'll let you carry the tour.

>> Yeah, just the numbers here show that there's a lot of people of a younger population that have covered and that the older population this is the number of people and of course some of this has to do with the age distribution of the population.

So just because you have younger or fewer older people you're going to have fewer positive covid tests in older people and then if you go to the next slide interesting there's fifty four percent of the covid positive test that we have in Allen County are female and forty five percent are slight minority are male and then I can yeah let's go on just to kind of recap on the other slide I think this slide is easier to to read and easier to see but the average age of the people that die from covered in Allen County has been seventy five point four and the median is seventy seven.

So with our youngest person that passed away was age for and the oldest one hundred and seven certainly certainly that number just shows that this affects everybody.

It affects different people differently.

There's no doubt about that.

You see a lot of people like as husband and wife may have covered the husband may get seriously ill.

The wife may just lose her sense of smell.

It's really is something that we haven't figured out why that's happening yet.

>> But that's that's certainly something that you see if you look at the next slide, the age distribution there that really this this slide is weighted with deaths.

So the other slide that we saw age distribution was number of cases.

So this is the number of people that die.

So sixteen percent of the people that have passed away from covid have been 90 plus years old and you know that somewhere in like the twenty twenty percent range of those people that had it so a high proportion of people 90 plus that get covid don't survive covid.

And then if you look at the next slide just one more point on that.

I think as I pointed out earlier, the females had a higher proportion of covid but the males have a higher death rate from covid so more males have passed away from covid than than females even though more females actually had covid and there's to my knowledge no scientific explanation for this yet as we're going through time and recognizing there have been a number of seasons in which booster's and immunizations have have vaccines have been administered, is there a way to necessarily know before we understand currently what's taking place, what the trend has been like?

>> Did it start high with with those who who wished to be vaccinated Válková and then come down?

>> Do you do you get a sense of where those trends are and behind the question is that the sense of to what extent are people falling off, you know, because they're exhausted or they don't see the the gain for getting a shot or what have you.

>> There's lots of different rabbit holes to get with this stuff.

Yeah, there's yes, there's a lot of reasons I think why people are not getting vaccinated today like they were two years ago when covid vaccine first came out.

First off when covered in when the vaccine first came out, we were reaching and grabbing for everything that we could and the variant of covid that was there caused a lot of mortality or caused a lot of death and the variance so today though the covid we're seeing the Omma Convery and there's multiple Omicron variants that are out there but that McCahon variant that we're seeing today does not cause the death rate that it does before so people have less fear of it today than they did two years ago.

So that's a that's a big difference and then and then some people have had maybe minor reactions to the vaccine and don't want to risk getting another vaccine and getting another bad reaction from that.

And certainly you can understand that I think there's still a very significant population though that needs to covid vaccine and I think that those especially the older people and when I say older that includes myself and I've had my second or third or fourth covid vaccine I can't remember now my fourth.

So I think the older people when I say fifty and above those people need to definitely continue to get their covid vaccine.

I think the other interesting things are that are softer signs that we're seeing in populations are that people that are vaccinated or have been vaccinated have less tendency to have long covid and long covid is a disease nobody wants to have and a lot of people that have covered end up with what we call a brain fog not really a technical term but it's brain fog and I think everybody could understand that.

So but those people that have had vaccination have less tendency to have brain fog or symptoms from covid that prolonged on that vaccine front your appearance today is fortuitous.

There's a story in The New York Times today, a study by Pfizer and biotech saying that their updated booster released in September is nearly four times better as its predecessor in boosting antibodies against the currently dominant version of the virus for people 55 and older, yes means although only about eight percent of Americans age five and up have even received the new booster's.

And even though it is four times better, it seems like there are plenty of seats no waiting and maybe fewer reasons why not to get the booster right?

Absolutely.

I think there are definitely fewer and fewer reasons and I think that that's a great article just from a standpoint that it takes a little bit of time for us to know exactly how effective the vaccine is going to be and how well it's going to protect people.

And and what I see are people that I guess let me back up I think that your options are this fall you're probably going to get a virus.

You're probably you may get covid again because a lot of people have already had it.

You may get RSV, you may get a rhinovirus or something or influenza and you can you can play the lottery and and say well I'm going to get one of those and I'm going to have to take a week off work because I'm going to be ill or you can get a vaccine and decrease the chance if you happen to take off work and how often do you have a prolonged illness and even something that's worse in hospitalization or things like that?

So so I would say just not just the current vaccine but I think this year the flu vaccine is absolutely going to be important if you want to try to if you want to try to stay healthy and do the things that you want to do and go out to restaurants and eat at the restaurants and go to church and different activities with your families then getting vaccinated will almost undoubtedly allow you to do those things without a lot of fear of becoming critically ill from those viruses.

>> It's a good way to Segway to what seems to be a second thread of impact in our national community and that is the influenza season.

So covid is potentially on the rebound.

Flu has always been with us.

A person can apparently get a coveted booster shot and a flu shot at the same time.

>> Yes.

Or you can get one now and one later.

What's your sense that you've seen in maybe it's all anecdotal but does it matter?

I've seen people that have gotten both the flu and the covid vaccine same time and didn't have any problems at all and then there are some people that are if you're worried about it then just wait a couple of weeks between those vaccines because if you do the covid vaccine in two weeks you'll have your full immunity from that and then you can get your flu vaccine.

>> But I think that if it's really a comfort level and what you what you want to do on a personal level if you want to do them both at the same time because you're a super busy person and you want to do it on Friday because you may not feel good on Saturday and you're going to be off work and that's great.

>> I mean the state has already reported its first deaths due to influenza.

I'm wondering if the attention to vaccines in general of which covid continues to be an inspiration has how has the response been to flu vaccinations?

Is there a little more of a seasonal average or something a little better or worse than that?

>> Yeah, I don't have any numbers on the number of people that have been vaccinated for the flu.

I know there's a lot of people that are still getting and I would just tell you that if you're if you've got the flu vaccine in the past I mean we it's been pushed to really get more and more people especially in health care vaccinated for flu or for influenza because we're so exposed to that and and it's not necessarily just passing it on to other people but it's keeping yourself healthy.

So I don't know the number of people that have gotten the flu vaccine but I would tell you whatever it is, I think we should try to double it.

>> The numbers are bearing out that apparently eight hundred eighty thousand cases of influenza illness and sixty 900 hospitalizations.

Three hundred and sixty flu related deaths nationally including one child.

>> Why are the numbers so high so early on?

Yeah, I think that a lot of it is some of it is catch up.

So we were you know a lot of people were wearing mask last year and we were wearing masks up until really a few months ago and we didn't have exposure to those viruses so we didn't have any immunity developing over the years because the flu virus changes a little bit each year and we get exposed to a little bit different flu virus.

But your immunity from one year to the next, you know, helps give you a little bit of protection.

And so if you don't have any exposure to the flu for a year because you are wearing a mask, then your immunity level is going to wane and you're going to need to get that that vaccination.

>> But there's no doubt I worry this year influenza could be could really be tough for everybody.

But I also worry as we talked about covid being there and then and then other things like RSV you mentioned at the beginning and let's go there now because mentioning either a tri pandemic or a triple pandemic triple DIMMICK we covered the flu and respiratory syncytial virus which deserves an explanation.

>> Yes, respiratory syncytial virus or most people talk about it as RSV is a virus that's spread among the population.

There are older people that have RSV and younger people.

We talk about it in kids most of the time because children when they're exposed to RSV or have an active case of RSV have much more difficulty than adults do for the most part.

Having said that, there's still about seven or eight thousand people adults in the United States that die every year from RSV.

So it's not because you're an adult you don't have to worry at all about it if you've had other medical issues and preexisting conditions like significant heart problems, lung disease, those types of things are going to make it bad.

We worry about it in the kids though because kids get what I found at an emergency physician is it kids get sick really quickly.

They get better really quickly but they get sick really quickly so they may get the RSV infection.

They may be OK but you have to keep a close eye on them.

Not all of them have to go to the hospital and not all of them have to be hospitalized fortunately.

But the younger they are the more we worry about them and the more difficulty it just causes significant breathing difficulties for these kids and it lowers their oxygen level to dangerous levels.

And so we have to put them on oxygen and try to support them as much as we can.

>> Yeah, and regarding children, a community Montessori school in New Albany this week right on the border of Indiana and Kentucky.

Thirteen students out with the flu half of all classes that had up to 40 percent of students were home sick with either the flu or RSV of the school closed canceling classes Thursday and Friday of this week.

It made me wonder from a larger concept standpoint about the importance of coordination.

We've learned a lot about that between all aspects of community life and the medical community and the role that health commissioners play in that across the state in the nation.

>> What can you share about the kind of introduction to that dynamic that you've had so far ?

>> Yeah, so that's that's been a really interesting facet of the health commissioner job that I've learned as far how much data is generated on a regular basis and on an hourly basis or every couple of hours .

So we have somebody at our health department that monitors infectious diseases and viruses and some viruses over on a daily or hourly basis and then if those numbers pop up to be really high then we can take action and we have kind of an early warning system throughout the state.

So we're alerted when those tags are popping up and then when you talk about schools, I mean what do schools need to do to be prepared for this or how do we respond to that so we do have good communication with the schools through the school nurse programs and we have a coordinator at the health department that works with them.

They meet on a regular basis and if they need those meetings more frequently they have an urgent meeting then they will make sure that they step up and relay that information.

But that's an important part of the health department and I think if I could say one other thing, I think you know, there was a recently there was a governor's task force on health in the United ER in Indiana and I think that that was a really important study.

It had a lot of people together, a lot of really smart people together to kind of look at the overall health in Indiana.

And one thing that I said when I started this job as health commissioner I want Fort Wayne to be a healthy city.

I want you to be able to go anywhere in the country and if you say you're from Fort Wayne , they might say that's a great economic city.

But I also want them to say that's a healthy city.

That's somewhere that I want to live because if I live there I know that I have a good chance of doing of living longer and having health care that I need and being having people that are paying attention to what's going on.

So having that commission and the issue is that Indiana is only funded about half of what we need.

So there's going to be a lot of legislative work this year to try to get more funding and I think with that funding we can definitely have more robust programs to educate.

I think as a health commissioner I think that we need to make people aware of what services are available.

We need to make services like mental health services as available.

We need to make make people aware of them.

We may need to make them available so they don't have to wait six months to get an appointment.

We need to give them access and we need to and that's getting them to their appointments and we need to make it affordable.

So if we can work on those and if we can have a little more support I think at the health department we can work on projects like that and make a huge impact in our community because that's another project that I just wanted to mention that I think the mental health and opioid problem is is big and affects us all.

We don't even know how bad it affects us but it really does touch us all and that's the biggest thing.

>> I'm sorry when we go oh please.

That's the biggest thing that's decreasing our life expectancy in the state of Indiana.

So the life expectancy has dropped in the past couple of years and that's because the population between twenty five and sixty four is dying quicker than the older people and the older the population sixty five and above is actually living longer but those twenty five to sixty four their life span has gone down so it has to do with mental health and opioid substance abuse but also the infectious diseases we talked about.

>> Yeah and you're trying to return to normal.

I smiled and I saw that quote earlier when you were at your appointment was announcing that the overarching goal was to return the department to normal.

>> We all want that.

Well, I'm not sure what the vaccine is for but on the other hand, it is true that what we're discussing tonight is a an important slice of pie but there's a lot more pie that is to be spread around with obesity opioid addiction, vaccinations, mental health issue as you mentioned.

>> Yeah, it's a great that's why I love this job as far as there's a lot of different animals or different ways you can go about it and and different things to tackle.

But I think you know the end goal we just have to keep our vision and and our vision is to make that community healthier.

The the aspirations for the position are things that you mentioned moments go and also about vaccinations.

Let's share the contact information now and then we can do very briefly in the way out.

This is where the search for information there's a lot out there.

Some of it is more accurate than others.

This is a wonderful place to start and you've got a lot territory to cover with that.

>> Yes.

Yeah.

If you access this website you can sign up to get vaccinations .

>> You can sign up to get different health services that we currently provide.

There's a lot of information on the website and then with this also I'm understanding that there is a pneumonia vaccine that's a one and done shots and there are some good news items on the medical front for those that are wondering do I have to keep making these things an annual experience?

>> Right.

The new vaccine is is a good vaccine that I believe it's over fifty age over fifty.

You should definitely get that pneumococcal vaccine at least once just like the shingles vaccine to and even though this is the kind of thing you see on posters, it is still the three C's of clean cover contained.

There was an admonition for the audience tonight on the way out in addition to just let's be careful out there what would you suggest?

Yes, I think that as you know, we get away we've got away from a lot of masking but that doesn't mean we have to do away with our hygiene and the more we the more frequently we can appropriately wash our hands and cover our cough and if you're sick, stay home, those types of things.

It's just really prudent to do those types of things all the time.

We should have learned some new habits from covid I should have taught us a lot.

I mean it did teach us a lot but even on an individual personal level it should teach us that we always have to keep washing our hands and and keep covering our cough.

And if you have an illness, stay away from people.

Stay home, don't spread it to everybody else.

>> Let's hear the contact information again as we also share our thanks and appreciation to Dr. Thomas Goodwin who is the L.A. County Health Commissioner.

Thank you so much, sir, for being a part of our program .

>> Thank you, Bruce .

Thanks for having me and thank you all for watching as well.

For all of us involved with prime time Bruce Haines again take care.

>> We'll see you again next week.

Good thing