Hello and welcome to PBS39 NW ya's community update on coronavirus that's brought you with help from our community partner Lehigh Valley.

Health Network.

We're coming to you live from the PPE public Media Center in Bethlehem.

I'm Brittany Sweeney Our guests today include Dr Robert Crinkles Cleetus, the Vice President of Transformation and Critical Care Medicine at LVHN, as well as Stephanie McGraugh of the Pennsylvania Pharmacists Care Network to discuss how pharmacies can help get us through this pandemic.

We'll meet them in just a few moments.

In the meantime, if you have a question you can give us, call the phone numbers for a 4 8 2 1 0 0 0 8.

Our guest will answer some of your questions live.

Plus, four daily coronavirus updates.

Be sure to sign up for our newsletter.

You can do that at our website coronavirus.

Lehigh Valley .org.

You can find helpful information there in both English and Spanish.

Let's take a look at today's top headlines.

The state's positve test rate for the coronavirus has dropped again.

The eighth straight week of lower numbers.

The positive test rate reached a high of more than 16% in December.

But that number decline to 8.6 percent by last week.

Down from 9.3 percent the previous week.

Even so, 59 of Pennsylvania's 67 counties continue to show substantial spread of the virus.

Updated data on case counts and deaths was delayed today because server maintenance, according to the Department of Health, evidence is growing that having Covid-19 may not protect you from getting infected again with new variants and new research suggests that people can get second infections if they had a weak defense response the first time.

While scientists say they think re infections are rare and usually less serious, they say there is a solution.

Get vaccinated as soon as possible and take steps to avoid infection.

And finally, throw the yellow flag on the Tampa mayor's order requiring masks at Super Bowl parties.

fans and crowded sports bars.

As the clock ticked down on last night's Super Bowl outside the stadium, social distancing was abandoned as fans celebrated Tampa Bay's win over the Kansas City Chiefs.

Many ignored an executive order signed by the Tampa mayor requiring face coverings at Super Bowl festivities.

Let's meet our guests for the day.

Dr Robert Crew Cleetus is the Vice President of Transformation and Critical Care Medicine at LVHN.

We'll talk about how telling this medicine is being used to treat Covid-19 patients.

Also here today is the executive director of Network operations for the Pennsylvania Pharmacists Care Network Stephanie McGrath.

Thank you both so much for joining us.

Today.

Stephanie, we'll be with you in just a few minutes.

We will begin today with Dr Craig Cleetus.

Again, thank you for joining us.

Dr Vice President, transformation Vice President transformation.

For critical care.

That sounds like a very important job.

Can you tell us a little bit about what that means and what transformation is in the medical industry?

Sure.

Yes, of course.

So listen, we were changing.

We wanted to figure out new ways, better ways to see our patients to get them access to our health care, to to care for them at the right time, at the right place, with the right tools.

Sure.

A big part of your work is to incorporate telemedicine into treating Covid patients.

Telemedicine, of course, taking off in the past year as this pen get pandemic began and really things just switching completely over to telemedicine.

When and if possible.

So talk to us about that process.

How has that gone switching over to telemedicine?

So it's been great.

You know, we have had we've really had a big opportunity to utilize telemedicine.

We were prepared.

We've been doing this for, you know, over 15 years at Lehigh Valley Health Network.

And then that experience really allowed us to switch switch the processes very quickly since March, we've performed over 170,000 telemedicine visits with our patients.

So when it comes to telling medicine and treating Covid-19 patients, how does that all work?

Yeah.

So we know one program really excited that we can now offer the people.

The Lehigh Valley is a program we're calling LVHN it home and LVHN at home was really designed to help care for patients with Covid or patients that we suspect may have Covid care for them at their home using some of these telemedicine services so no one.

Outram go ahead.

Yeah, I was just going to say does that start with them coming into the hospital first or is this completely remote Gamma Will do so.

It really was designed for our patients who are coming into the emergency room largely patients who come to the E-D.

Some of those patients are really sick and we know they need to be hospitalized and they are hospital.

Other patients don't need clearly don't needs to be in the hospital and they're sent home with the appropriate care.

But this new program is really designed for the patients that are kind of borderline like patients who are sick.

We don't want to send them home without any resources.

We want to be able to care for them, but they probably don't need to be in the hospital.

Sure.

So how does that work?

Do they come in?

Do they call?

Do they sign on to the.

My LVHN an app.

How does that all work?

Right.

Right.

So you really we're relying on our E-D colleagues to determine who are the appropriate patients for this program.

The way it works is patients who are in the emergency department who are felts to be good candidate for the program.

What we do is we enroll them in the program and we send them home with a variety of devices, devices like a pulse oximeter, a thermometer and a blood pressure cuff, which just say what I understand is that there's these kids that you're sending home with people.

Is it just that and is it just for Covid patients?

Are there certain kits designed for certain treatments Gamma Well, what we're really talking about now is remote patient monitoring and we're monitoring patients today.

We're monitoring over 1,200 patients with a whole variety of conditions.

But over the last several months, we really have built out programs specifically designed for helping our Covid patients recover at.

Wonderful.

So talk to me a little bit about telemedicine benefits and then some of the downfalls to telemedicine even though this seems to be how it's going to be moving forward even past this pandemic.

What are some of the benefits and the downfalls Gamma Right.

So the benefits of a program like LVHN home that I'm describing, it really allows some patients to be cared for and treated in their home versus having to be hospitalized.

So I think that that's one of the main benefits obvious from a patient perspective.

Many patients do wants to be home certainly again, Stuckey's some patients must be in the hospital.

And this is not not replacing that, but it also a benefit from our network standpoint is it is allowing us to preserve some of these very valuable inpatient beds for the patients who really need them.

Do you have any resistance from patients?

Are you feeling any of that resistance that they want come in, they want to interact with their doctors or has it gone smoothly Gamma Are people really open to telemedicine?

Yeah.

You know, so there's definitely patients who wants to come in.

And that's great.

We're happy to see them.

We really have really taken every effort.

We have very safe facilities.

It's fine to come into the office.

We also have really worked hard on this telemedicine platform making it increasingly convenient for patients and physicians Sure, there's often cases where people just need to come in and be monitored for a certain amount of hours.

Does this kind of help alleviate that and open up beds Gamma Absolutely.

In addition to this LVHN It home program, we have another program.

We started this program in in March.

We call this Covid Home Monitoring.

And in that program we're able to send again patients home with devices which allows them to kind of communicate with our nurses.

We're asking them to send us in information about themself, you know, what is their temperature, what is their pulse oximeter Gamma Pulse oximeter is a device that allows us to monitor the oxygen concentration in someone's blood.

And so that information very often does allow us to keep a patients at home.

But we can provide a very close eye on those patients to make certain that they're recovering at home as we would as we would hope.

Sure.

And I imagine I know this program is still young, but I imagine that because your monitoring people are at a greater rate.

Are you catching things faster because of this?

Yeah, absolutely.

That's the goal, right.

So again, most patients who get Covid will recover uneventfully at home.

Certainly there are many patients unfortunately still today that do require hospitalization.

The monitoring is really been largely designed to try to care for the patients who are being cared for at home and such that we can identify any issues early and get them the care that they need.

Sure.

Dr completist from a financial standpoint, both to the hospital and to the patient.

Can you talk to me about the benefits there Gamma Yeah.

So we're really doing this for a financial benefit.

We're doing this because many patients do prefer to be cared for in their home and as I mentioned, we really need to preserve some of our very valuable hospital beds for those for the Covid patients who need them.

I think that is I think that is that the benefit?

One of the financial benefits of the program in terms of patients, you know, I think it's a lot about convenience.

Telemedicine can be an incredibly convenient tool in order to connect with your health care providers short and post pandemic.

I know right now during the pandemic, a lot of networks are heavily relying on telemedicine, but post pandemic, do you foresee this continuing the same way?

Do you think it'll drop off?

Do you think it'll ramp up or what do you think post pandemic?

Well, yeah, no, I think I see a very bright future for telemedicine in part.

There's legislation in terms of reimbursement that's going to be very important in determining how things go in the future.

I'm very hopeful that Congress will do the right thing and continue with the reimbursement regulations as they are right now in the pandemic.

But we'll have to we'll have to wait and see how that evolves.

But you know, I aside from reimbursement, which is obviously a very important topic, I do see that both patients and physicians alike are really starting to understand and see real benefits in how telemedicine can be used to increase access to make to increase convenience and really what we're really trying to do again is to deliver the right care at the right time.

And I think telemedicine can go a long way towards that accomplishing that goal.

Sure.

Of course, critical care is one of your specialties.

We do call our question for you.

This is Sandy.

She's saying her mother is 85 getting her first dose of the vaccine tomorrow.

She wants to know supposed if she's supposed to have a kidney ultrasound on Wednesday.

Is there any problem with that?

Should she be worried about getting her dose and then having kidney ultrasounds?

Fauci 4:52 Yeah.

No.

2, there'd be no reason why she couldn't go ahead with that test.

You know, there are some patients who do have some mild side effects after the vaccine, but usually that's limited to just kind of a sore arm in most people.

So there'd be no reason why she couldn't get that test.

Sure.

And when it comes to rolling out that vaccine, when it comes to the critical care unit, are you giving it to people who are in critical care at this point?

Or do they wait until they're in a better standing and a better health?

Right.

So we're not we are not administrating to people people who are in the intensive care unit right now with Covid.

That's not an appropriate time to be trying to vaccinate.

Vaccinate.

The vaccine is really designed to try to prevent patients getting Covid in the first place.

It's not a treatment for Covid.

Sure.

I want to go back to telemedicine a little bit more.

Just wondering what are some of using telemedicine?

What are the top treatments right now?

Where does it work best for telemedicine?

Outside Covid or outside of Covid?

Sure.

So, you know, we're we're all learning together where is the best time and place in situations to use telemedicine?

You know, for example, many patients needs to come and see me for follow up on, for example, a CAT scan of their chest.

If you have an abnormal growth, sometimes we're concerned that may represent a tumor.

So we will occasionally we'll have a follow up cat scan scheduled.

It really is very convenient.

Instead of coming into my office to just do that over a telemedicine encounter, that's one example where we're trying and working hard to to really understand when is the best time.

Certainly there are times when patients do needs to be in my office, for example, when I need to perform physical examination, if I need to listen patient's heart or lungs that today is best done face to face in the office.

Sure.

Dr Craig Cleetus, folks are watching.

I know you said this before, but for those watching, listening, can you give them the information they need to et in touch with an LVHN doctor if they want to take advantage of telehealth Gamma So all of our practice is are equipped to utilize telemedicine.

You reach out to your physician and indicate to them that you'd be interested possible to have the visit perform using elements.

Great.

Dr Robert completist critical care medicine at LVHN.

Thank you so much for joining us today.

And we continue this community update on coronavirus on PBS39.

You can hear the rebroadcast on the radio tonight at 9:30 on WLVT News.

91 three FM.

Let's bring in our next guest.

Stephanie McGrath is a pharmacist who serves as executive director of network operations of the Pennsylvania Pharmacists Care Network.

It's a group focussed on enhancing patient care within communities right through your neighborhood drugstore.

Stephanie, thank you so much for joining us today.

Thank you for being here.

The first question I have for you what is the Pharmacists Care Network in whose involved in Pennsylvania?

That's a great question.

It's a network of community pharmacies, mostly locally owned across the state.

There are about 160 community pharmacy locations that are enrolled in our network in Pennsylvania.

It's part of a larger network called the Community Pharmacy Enhanced Service Network, which makes up about 3300 pharmacies nationwide.

If you think about from a chain perspective, it's slightly larger than Rite Aid just under the size of Walmart.

So a large number of community pharmacies again mostly locally owned across the country, all joining together to provide better quality care for patients in their communities shore and throughout the last year and when the pandemic first hit, what did that mean for pharmacies, both local pharmacies and those bigger chain pharmacies as well?

Sue, as you know, everyone else, community pharmacies initially struggled in the start of the pandemic but had to maintain pharmacy operations.

They had to continue taking care of their patients in their communities, continue filling prescriptions to make sure that people get life sustaining medications.

But do so safely and to make sure that they're protecting their community pharmacy staff and their communities as well.

So, you know, pivoting to increase the technology that pharmacies support.

Also, we work to ensure the safety of their own staff in spacing out social distancing as well, of course, installing additional barriers in the from getting sick.

Pharmacies started offering Covid-19 testing as those tests became available.

They continue to do so and now pharmacies are involved.

Thankfully, with Covid-19 vaccine administers in our pharmacies alone in Pennsylvania, just the first six weeks of the vaccine rollout have administered nearly 70,000 doses.

Covid-19 vaccine large number to go still.

But we're really, really proud of how these all independent organizations, all independent businesses have really stepped up in this public health initiative.

Sure.

Stephanie, I wanted to ask some pharmacies have the right to administer vaccines.

Others don't have the vaccines to give quite yet.

How do they get involved?

How do they get those vaccins to put those shots into arms Gamma Not as easy as we'd all hope.

So we started it through our partnership with the Pennsylvania Pharmacists Association and the Pittsburgh School Pharmacy.

We've been preparing our pharmacist for vaccine for Covid-19 vaccine since May of 2020.

They have to enroll with the State Department of Health and complete additional training pharmacists in their education and pharmacy students receive vast and very detailed education about vaccines, about public health, immunology.

But in addition to that, during a pandemic there is additional training that's required from the CDC and the Pennsylvania Department of Health.

So this was initiated as well.

And again, some of those safety precautions that I mentioned all come into play with vaccine administration during a pandemic.

This is not a typical flu shot season.

Vaccines can't be administered as if they were administering the flu shot because people have to screen and distanced so carefully.

It's quite quite a bit different process.

But as you can see, they figured it out and have been very successful in just that in and in providing mass immunization efforts.

Sure.

When it comes to administering and preparing to administer that Covid-19 vaccine compared to the flu shot, how does that differ?

Well, you have to do to prepare.

That's different.

Sure.

So the vaccine itself, you know, the two products that are available currently do come frozen and they have different different transportation requirements from each other.

But you see the Moderna vaccine there that this is the vaccine that the majority of our pharmacies have in stock.

It does come frozen and does need to be drawn up from the violence.

As you're seeing there as well.

So this the very carefully measured out and only has a six hour lifespan from the time puncture the vial.

So all of those doses have to be used within six hours.

And we don't want any doses to go to waste.

So our pharmacies have to have a very standardized way of addressing patients.

We have a waiting less so and large numbers of people on standby as well.

So if you know, if someone if there's a no show or you occasionally could could get an additional dose out of a vaccine vial, no dose goes to waste.

We our pharmacies are making sure that they find an arm for every single dose of vaccine for those vaccines.

So in demand right now, how have pharmacies handled that demand?

Just an incredible demand at this point.

It really is.

You know, we talk a lot about vaccine hesitancy, but I don't know that we're experiencing that yet because the supply just does not even come close to the demand.

A number of our pharmacies have tens of thousands of people on waitlists across the state.

So they are very diligently working through these lists to make sure that they're vaccinating the highest risk.

Phase one, a individuals, people that are elderly, people with multiple chronic health conditions first.

So weeding through all of these requests is incredibly time consuming and really an act of love and public health.

I think in all of this so you know, one by one, you know, they're addressing needs in their community and really very quickly turning over the vaccine as well.

So almost soon as they receive the vaccine through the pencil Department of Health, they're instructed to give it.

So they do need to have a number of community relationships already in place.

As far as established locations to administer the vaccine community partners that are assisting in screening patients and getting people in the door just with them, even local police departments directing traffic.

And in many instances we've really seen a number of communities come together on ways that should not really surprising.

But we haven't thankfully had the opportunity see before.

It really, really is a team effort for what are some of the advantages to having pharmacies being able not only test for Covid-19 but now administer that vaccine.

Do you think they've been underutilized throughout this pandemic Gamma I think is pandemic has helped to illuminate how valuable community pharmacies are incredibly accessible.

And one among the most trusted health care providers, patients know how to access.

You can walk into a community pharmacy and ask the pharmaist questions about your medication.

And in this case, walk into a community pharmacy in many locations and obtain a Covid-19 test or a vaccine.

And that's just really I think helped this increase demand for these public health services has really illuminated how valuable community pharmacists are for those that are trained and ready to, you know, to participate and that can put a great strain on even the larger pharmacies.

Are there any resources available to pharmacies and pharmacists throughout this pandemic to get those Covid-19 vaccines out there?

Absolutely.

Sue, you know, a lot of it is planning.

Like I said, we've been working with our State Pharmacy Association for almost a year now to help to prepare our pharmacy teams and getting them ready for all of these additional considerations that needs come into play, engaging with schools of pharmacy in Pennsylvania as well.

Pharmacy interns can can play a role in this process and they have we certainly need many individuals coming together.

Like I said, to pull this off.

These mass vaccinate efforts really, really are incredible.

Sure.

The Biden administration has said 1 million doses will be distributed to 60 500 pharmacies across the country starting as soon as this week.

Do you if any of those pharmacies will be in greater Lehigh Valley area Gamma That's a really great question.

So at this point, when the federal pharmacy partnership, there are over 20 different partners that the CDC and the federal government have partnered with.

I can't see that any of our pharmacy locations are part of that out that allocation.

Our pharmacies are continuing to work with the Pennsylvania Department Health to obtain their vaccine, but they will be involved with this federal pharmacy partnership.

It's it sounds like a lot.

1 million doses over 6500 pharmacies.

It's only about 150 doses per location.

A really significant hundred and 50 doses for each location for sure.

But this is a slow rollout and there is much, much greater.

They're much, much greater numbers to come.

Stephanie, finally, how do you think pharmacies can help assist in combating this pandemic as we move forward Gamma Yeah.

There's so many things that we've seen our pharmacies do from communicating with their patients and their communities, using social media, using their web platforms to be able to communicate.

First of all, it was how to stay safe.

So the masking we had many pharmacies show how to make your own mask at home.

For example, many pharmacies across the state, across the country were compounding hand sanitizer for local law enforcement, for hospital systems, even for their patients in the early stages and still continue to do that through to this Covid-19 pandemic.

And pharmacies are also incredible as we've been talking about access points for education and public health initiatives.

So continuing to share, you know, the right information about the vaccine and about the safety of the vaccine, helping to screen patients appropriately triaged as well.

Patients to know who may be appropriate for the vaccine or maybe need to wait until May.

It is appropriate for them.

You know, I think one of the greatest things that we've seen through the pandemic and as pharmacies are pharmacists are administering Covid-19 vaccine is just this great appreciation from the public for this service.

I've had pharmacists tell me that they've never felt so valued as a health care provider.

Another pharmacist told me that a patient pays her for allowing him more time with his grandchildren.

There's just this real community sense here that keeps us all going.

And, you know, working long hours of every day.

Wonderful Stephanie McGrath from the PA pharmacist Care Network.

Thank you so much for joining us today.

Thanks for having me.

And we want to thank you for watching community update on coronavirus.

We'll be here at 4pm each Monday, Wednesday and Friday PBS39.

And on the radio at 9:30, those same nights on WLVT News.

We'll be back Wednesday, 4:00 with the founder of a Lehigh Valley Facebook group that helps people find available vaccine appointments for PBS39 and WLVT News.

I'm Brittany Sweeney Stacey.