Second, support for Arkansas Week provided by the Arkansas Democrat Gazette.

The Arkansas Times and KAR FM 89.

And hello again, everyone and thank you very much for joining us, even should there be a more aggressive government approach and a more accepting public, the near term impact of COVID-19 on public health in Arkansas would be frightful.

And As for the fear factor, it went up a few notches this week, but we'll get to that in just a moment.

First, the agony of American withdrawal from Afghanistan and the Arkansans in uniform who served there may still be serving there.

There and in Iraq some sacrificed their lives in those operations.

Others returned with scars.

Not all of them visible.

The chaos in Kabul seems an especially appropriate time to examine what services are available to Arkansans in uniform those whose worst wounds may be psychic.

Joining us Arkansas Secretary of Veterans Affairs Colonel Nate Todd and doctor Mandy Mccorkindale, clinical psychologist and the lead behavioral health officer of the Arkansas Army National Guard Sir Madam, Thank you very much for being with us.

Colonel will be our Mr Secretary will begin with you.

You retired I think is as a full Colonel in the Mr Barnes and 2013 glad to come back to our great state of Arkansas and serve the veterans of Arkansas.

You know what it is like to be in uniform?

You know what it is like to be with among.

Men and women who have served.

In combat zones, yes, Sir, by last assignment was at Walter Reed Medical Center, where we received many of the casualties.

As you pointed out, both seen and unseen.

The great thing about our military is our mission, and each of us who man or woman that swears allegiance to this Constitution, go into that mission to know that you go and serve where you are required to serve.

In this case, Afghanistan and Iraq, and they have all served proudly.

In two decades of conflict in those two theaters.

There is the sense among some, that are particularly now with the chaos in Afghanistan.

Why did we serve that?

That is a lot of pressure that, uh, an individual and service.

Could feel on 9/11.

This country was attacked and those who have worn the cloth of this nation.

They serve so that Terra would not come to the shores of the United States of America, and they have been successful in that.

That is why we observed and we have fault in this war.

Do you fit?

What would you say to those who who men or women, who would argue?

Did we do this in vain?

I mean now we're leaving, we have the analogy of helicopters off EU S Embassy in Saigon a half century ago.

Almost now helicopters in Kabul or or transport planes.

Well, there was a generation of Afghanistan's.

They have tasted freedom.

I don't think that that country will be the same.

I don't think that part of the world would be the same.

We have to live through the next 20 years to see our impact.

the United States military and the second excuse me, the State Department's impact and the American people's impact on that part of the world.

Dr Mccorkindale, the stress factor on returning vets has to be incredible.

It is, it is and.

And you know, a lot of veterans.

A lot of service members.

I have experiences traumatic experiences that can create some of that internal conflict about why are we here and and and you know, with with an appreciation for the overall mission, right?

But but sometimes they have actual experiences that that creates some internal conflict and and and, and we're seeing more veterans and and service members who are presenting with.

With that question with that exact question.

We have PTSD post traumatic Stress disorder was an unknown term less than a generation ago and now it's sort of entered the lexicon.

You're seeing it.

Right, I like to think of it as, UM, difficulty in recovering from a traumatic event, and so you know, as a lot of the veterans and the and the service members I've worked with, they don't like that term.

PTSD and they don't like to be referred to as disordered.

So you know when when any human goes through a traumatic event, there is a natural recovery process that has to occur.

And but when we are in theater, when we are in the middle of the battle.

When we were when we are deployed, that is not a place where we can actually go through the normal emotions that a person feels after going after experiencing something that's abnormal and and so.

Depending on the way in which a person responds to that, that can create sort of disordered.

Responses or behaviors, but we have excellent treatments that can help a person to go through that natural recovery process.

If you can doctor tell us what without obviously with honoring of a confidentiality, what are some of these vets telling you?

What are they experiencing inside?

What are they sharing with you?

Well, you know currently relative to what's happening in Afghanistan right now.

You know with particular reference to that, sure, sure.

You know, I was.

I was working with a unlicensed psychologist who saw that are in this week and she told me a story.

Her experience with someone who had never sought care at the VA before and had presented to primary care.

And we have a mental health team embedded within primary care at our VA here in Little Rock.

And that's where she was working and and he was really expressing a lot of anger.

Frustration in underneath that oftentimes is sadness and fear, and so you know when you don't know what's going to happen when we don't know the 20 year, how are we going to be able to look back on this?

Our brains can create lots of different scenarios, and oftentimes that goes to worst case scenario, and so you know, it is natural and normal to feel a wide range of emotions in response to viewing the media coverage and.

And you know seeing what's happening over there.

Especially because so many of our service members are veterans developed.

Really strong relationships with their Afghani partners with their translators.

Those people were embedded in their teams and so they become part of the service that they're doing there and and so that's really hard to think about someone who has been on your team that could be in jeopardy.

Offers the secretary first, or what is the state and then the federal government?

What are we prepared to do?

What services are available through the state beginning with you?

So I share with you, our Department of Human Services has a broad range of recovery systems, mental health facilities throughout the state that veteran.

If in fact we would hope that they were enrolled in VA healthcare.

However, if they choose not to, we ask that they seek those services throughout our states.

UAMS has a great system.

We ask that veterans seek help through those.

Areas and we have 200,000 veterans in Arkansas, many of them.

The majority of them are doing quite well.

We need them to share with their colleagues at veteran none veteran, their service, and their experience and how they have contributed after their service to the military.

We think that that will help all veterans as we talk about our service.

How do they go about doing that?

They contact your office, they please.

What's the contact point?

Well, the Arkansas Department of Veterans Affairs is a good place.

However, we think the Central Arkansas Veterans Healthcare system is the place of point of contact the Fayetteville, Ozark VA Medical Center for Arkansans and on the east part of the state, the VA Medical Center for those in Southwest Scuse Me, Arkansas Shreveport Services five counties Miller County, Lafayette, Shreveport Little River and.

For those in the Ford NE Poplar Bluff that the health care system has a wealth of resources for veterans both in their mental health and their physical health and their emotional health, and we have a think there's a crisis hotline to Mr Secretary.

If you want to make mention of Oh yes, if a veterans in crisis we ask that they reach out through the crisis.

Hotline that number 1-800-273-8255 one 800.

2738255, however, we ask that better not to wait to their crisis and we asked the family member to help.

That family member can observe some things that are veterans going through that that veteran in their own mind think that, oh, I'm handling this.

So we asked the family to assist us also and getting their veteran to one of our medical health care systems.

From the from the clinical side Dr and from the federal side.

Sure so.

Of course, Central Arkansas VA here in Little Rock, but like like the secretary mentioned, Fayetteville has services.

There are also outpatient clinics, community based outpatient clinics across the state where they can seek services.

The the phone number to the VA here in Little Rock is 501-257-1000.

That's a great entry point.

Another resource that I think would be helpful to point out is military.

One source, particularly for guardsmen or reservists.

That is a wonderful resource to get connected to counseling services.

Also with the Arkansas Army National Guard, we do have a behavioral health officer.

Who is a full time?

Are there and can help our reservists and guardsmen to get connected to services across the state.

The Secretary mentioned that that there is the impulse I think in a lot of men and women is it don't leave me alone.

I'm handling this.

I'm OK, I know what I'm doing.

Just back off.

You encounter this.

As a clinician, I guess some reluctance, some embarrassment, maybe even shame to reach out right?

And so you know, that's one of the advantages of having.

Mental health providers that are Co located within primary care.

Sometimes it can be a little bit easier to seek services through your primary care team, but you know also reach out to your fellow veterans.

Reach out to the team that you served with.

I mean, this is a time to connect and to share and to talk about your experiences, your thoughts, and your feelings related to everything that's going on and and what better you know group of people than the people that you served alongside.

Mr Secretary, I'll give you the last word we got about 90 seconds remaining.

Arkansas PBS has been a great friend to the Veterans of Arkansas.

We thank you Mr Barnes and Arkansas PBS for this opportunity to chat with veterans and give them information, but that leaves us 45 seconds Doctor.

I'll give it to you and I would make mention also that you are a major as well in the Army National Guard.

Yes Sir.

Yes you know, no.

I mean listen, imagine if call me Sir.

For a living, as they say.

You had to get that in there, didn't you?

Uhm, you know?

I I would just add that it what what has been experienced.

Again abnormal not a human normal human condition or experience and so it is.

I want to normalize people's reaction to this and encourage the utilization of the resources that we've talked about today, particularly the veterans.

Crisis line is also an Ave to get connected to VSO.

You don't necessarily have to be, you know, suicidal to make a call that that is a resource they have counselors nationwide that are responding to those calls, and then they can also help that veteran get connected to their local VA system there, because we're simply out of time.

Doctor Mr. Secretary, thank you both for your time.

Come back soon and we'll be right back.

We're back emergency rooms in Arkansas are overflowing intensive care.

Beds are increasingly scarce.

Confirmed cases are increasingly common and the state will soon surpass 7000 deaths.

Since the coronavirus outbreak began.

Still, there is significant public opposition to vaccination masking and social distancing.

Now the immunization rate has improved, suggesting that some Arkansans some have at least become more fearful of the virus than the vaccine, strengthening the fear factor perhaps are the latest pandemic projections for Arkansas with us now.

Doctor Mark Williams of the UAMS School of Public Health, which developed the model and doctor Jennifer Dillehay, the Chief Medical officer.

The Arkansas Department of Health Doctors we thank both of you for being with us yet again, and Doctor Williams will begin review the report.

The projections that you released this past week, school of Public Health.

There were, frankly, pretty grim chilling, in fact.

We've seen a dramatic increase in cases over July and we see nothing from the models or from the research we've been doing on how the virus is operating in other nations to say to indicate that we're going to have a downturn anytime in the near future and the one thing I do want to say about the models is that numbers are never up.

Meant to be precise, what they are are indications of what's going to happen in the future.

So for example, we are fairly confident that death will soon increase to over 7000 as you mentioned, but it may not occur exactly on the last day of August as we're suggesting.

However, if you look at the trends, the trends are all on a very stark upward linear direction, and given the number of people that are unvaccinated.

In the state and the opening of schools and colleges, we really do not see anything in the near future that's going to bring those numbers down.

Thinking I'm quoting you correctly, Hersey, you referred to the to the situation in Arkansas as a as a forest fire.

Yes, Sir.

And it.

The virus as from what we can tell throughout the pandemic, has been acting very much like a forest fire in the sense that it will rage up and then once it sort of burns itself out in an area, it will come down and it will smolder.

We've never been in a situation where it has gone away, and so you can, as you might recall from May and early June, what we saw was this smoldering.

Of virus in the Arkansas population and once Delta got a really firm threshold to hold in this state and built up enough, uh, numbers, it then just flash fired it increased or doubled in just 30 days.

One of the things doctor that left out I think.

Add parents and grandparents especially was that your projection that.

This one of the sharpest increase, if not the sharpest increase in caseload, would come for those 17 and younger.

Yes, that's absolutely right, uh, this is because of the low percentage of, uh?

Children 13 to 17 who are vaccinated and fully vaccinated and according to the Mayo Clinic as of August 16, that was only 8% of those children.

And of course there's no child under the age 12 that's vaccinated.

With this particular variant of the COVID-19 virus, it seems to be infecting children as at the same rate that it's infecting adults and so, whereas before it may have seemed like children were somehow not being infected, it's not the same this time.

Doctor Dillehay, if we can go to you now, the this past week the FDA gave full approval to the to the Pfizer vaccine.

Uh, this was regarded, I think, as a threshold by a great many individuals.

Is this likely in your estimation to have some impact?

Some positive impacts?

Anyway, on our vaccination rate, which in fact had been going up in the last several days.

Yes, I think it will have a positive impact.

It's was fully approved for people who are 16 years of age and older, so that will help us with our older adolescents, but also for any person that had concerns about whether the vaccine met the full safety and efficacy requirements for the study stun, they have all been completed and shown to be safe and effective.

Like for a second, the Delta variant is it proving more?

More difficult for kids to hand the youngsters handle in the first wave.

This new variant, the Delta variant.

So what is happening with the delta variant is that we are seeing sicker kids then we saw before in greater numbers.

So in the month of July we had more children admitted to the hospitals as well as to ICU's than we had in any month preceding us in the pandemic.

So I think it's going to be.

Very dumb.

Difficult for the children to come.

Stay well if they are infected, I think we'll have more and more children who will have serious illness and in some cases requiring ventilation I assume.

Yes, there are several children right now in Children's Hospital on the ventilators, so we are seeing that the Delta variant can have very serious consequences for children.

Well to both doctors, the daily demand for ICU beds, and for ventilators of course fluctuates as does the case rate.

But Doctor Williams, the the new case rate, seems to be in the high three figures, if not four figures every day.

Is there a certain demographic of that?

Uh.

That's that's taking the brunt of that right now.

Ah, yes, it seems to be a people under the age of of 40, and the reason for that, at least from what we can tell, is that people under 40 tend to be less vaccinated than people over 40.

And I can give you an example, Arkansans over 65 or 78% vaccinated, so we would expect to see fewer cases and hospitalizations and deaths in that age group proportionately than in.

Those adults who were 40 and under.

Another thing I'd like to mention just because it's oftentimes not talked about, is that even for people that have a mild infection, that is their unvaccinated but.

Infected, but it seems like that you know that they don't have.

You know symptoms bad enough that would put them in the hospital.

One of the real unknowns is what's called long COVID, and the consequences of long COVID the last couple of pieces of research that we've seen here are very disturbing.

One study, for example, found up to 800 symptoms associated with long COVID and long COVID.

It's being estimated can last anywhere from 6 to 12 months, and the people that are most likely to succumb to long COVID are in their 40s.

UN vaccinated and have a mild infection.

Well, we're talking doctor though about you mentioned the six to 12 month period for long COVID, but the long term impact of COVID-19 is we're still studying that right, and it appears to be fairly significant in some cases.

Yes, in some cases it would appear that anywhere almost 80% of people infected with COVID will have some lingering symptoms and up to six months, all right.

Doctor Dillehay is their concern for in those cases involving young people 17 and younger that the impact.

Developmental impact may be even more significant than than first feared.

Yeah, it is worrisome.

There's reports of kids having mental health diagnosis that they didn't have before, such as anxiety or difficulty paying attention, difficulty retaining information that they learn.

We're still have a lot to learn about how it infects children and what the long term implications are, but right now the studies are not very encouraging.

And a a pharmaceutical that's usually are.

Most commonly, I think, used in livestock.

Individuals have been ingesting this in an attempt to treat themselves or to ward off COVID to such an extent, apparently that Mr. Hunt Governor Hutchinson this past week found it necessary to discourage that at a news conference with with Doctor Romero, his health secretary at his side, we do you want to add anything to what they had to say?

Doctor dillehay.

Well, even after Governor Hutchison made his remarks then later on in the week, the CDC issued a health alert as well as the FDA offered warnings against the use of Ivar Mcdean, particularly the veterinarian grade, that medication is not formulated for humans, and it doesn't meet the same requirements for what people take when it's.

Properly prescribed for them, so we are very concerned that people will harm themselves by taking veterinarian grade I ever met in and at the wrong doses.

You know 'cause those tablets for animals are dosed for animals.

That way you know several hundreds of pounds, so it could cause harm to a person.

We recommend that if they want to take I ever met and they talked to their doctor and get.

Prescription, those warn of those admonitions from both the governor of the state health officials from federal officials, is there.

Is there any indication to both doctors?

Doctor Dillehay will stay with you that the message is getting through because the vaccination rates have been increasing, showing some progress.

There.

Doctor dillehay.

Well, we do hope that the message is getting through.

We want people to do well and be safe and we want them to get treatment.

If they do have COVID-19, there's other treatments that are available that are safer and been shown to be very effective and that would be the monoclonal antibodies.

So we encourage people to get their treatment through their physician and not medicate themselves through things that they buy over the counter.

Doctor Williams I wish we could come to you, but we're simply out of time.

Thank you both very much for being with us.

Thank you for watching.

See you next week.

Second, support for Arkansas Week provided by the Arkansas Democrat Gazette.

The Arkansas Times and KUARFM 89.