neither the el paso medical society its members nor pbs el paso shall be responsible for the views opinions or facts expressed by the panelists on this television program please consult your doctor in order to prevent the spread of the virus we all need to do our part one of the easiest ways to prevent that is by wearing a mask in order for a mask to do its job it needs to cover your nose your mouth and your chin first you should wash your hands with either sanitizer or soap and water before putting on a mask then pick up your mask by one of the ear loops to make sure that there's no tears or stains on the mask if it is dirty throw it away immediately if it's intact take both loops and put it over your ears like this and then press down on the bridge of the nose to make sure that it fits and there are no uh gaps once you are done with the mask please take it off the same way both ear loops pull it away and put it either in a ziploc bag or throw it away if it's a surgical mask if it's a cloth mask make sure to wash it with soap and water and keep it dry for the next use do not put your mask down at your chin or above on your forehead when you're starting to remove it as that just contaminates the mask thank you so much for doing your part to prevent the spread throughout this that was dr days the mask tutorial rockstar our first kobit 19 program was back march 12 2020. that was exactly eight months ago to the date and at that time there was not one coveted case that was confirmed here in el paso yet what a difference eight monks make so march 12th we open up the program at that time with these words the fear of the unknown it's a powerful thing and it still is but at this point we know a lot more but there's still a lot that we don't know so some of the questions that we're going to be asking are why do some people show symptoms why do some people don't why is it that some people who are showing symptoms they're doing okay and they bounce back easily but other people simply don't it lasts for weeks for months and others obviously are passing away this evening is uh something that we're going to be talking about how the hospitals are responding to covet 19 and also community partners people that are coming into town that are helping out so it's an update on how el paso is responding to the rise of cases here in town this program is live like it always is call us we've got two questions or two medical students here from texas tech paula foster school of medicine the telephone number eight eight one zero zero one three this program is underwritten by the hospitals of providence and we also want to thank once again texas tech paula foster school of medicine for providing the medical students with us today we have aiza ralph and we also have mural garam see and they're going to be answering the phones and then they're going to be texting me the questions so if you see me on my phone every now and again i'm not being rude i'm just trying to figure out what questions they are that you are bringing my way good evening i am katherine berg and you are watching a special edition of the el paso physician [Music] again we um have been eight months since we've had a real update on what's going on with covid here in el paso and again i open the program if you just are joining us back on march 12th we didn't have any cases and that was the first time we talked about covid on this program so there's a lot that we've learned with us this evening we have nico and don't you dare call me nicholas tahara i stole that from a very good friend of ours um he is the group ceo for the hospitals of providence and we also have dr kenneth beruman and he is the network director of emergency medicine so we have someone who's talking about logistics administration everything that's happening all over town there's been beautiful partnerships and people helping each other with all the hospitals involved and nico thank you so much for for being that guy and uh dr bruman man you're gonna get all kinds of questions tonight so it's going to happen fast and we're going to try to get through most of what we can i do want to throw out really quick uh a website that is updated almost daily if not daily and that is e p strong so just think of el paso strong epstrom.org that's where you will get numbers what to do how to get testing what the numbers are right now it's a great website to get all kinds of information and also if you are not a person who likes to get on the computer there's also a hotline a covet hotline for the telephone two one two six eight four three for those of you out of the 915 area code the area code is four 915-212-6844 so on that note uh it's a lot to cover but nico i would love for you because you're that guy i feel like i've known you for a million years and you've just come through the ranks at hospitals of providence and not all that time but talk about what you're doing all day every day kind of since covid came into play and and you can take just a couple of seconds couple of minutes we're going to go into a lot of questions later but just so that the people at home kind of know what questions to throw your way sure i appreciate that first of all thank you for allowing me and dr beruman to be here um what i do all day is covet all day long i mean put it quite simple i have the easiest job in the hospital by far people like dr baduman and the staff are the ones in front of the patients taking care of the patients every day my job is quite simple make sure the team has the resources they need to do what they're trained to do it's easier said than done but we spend all day long working on that me and my fellow ceos working with other ceos in town to make sure we get those resources working with federal agencies state agencies working with our parent companies working with community partners that is what i spend my time on um it's a journey of a lifetime something i'm very proud of and and i do have to say for the people at home because everybody at home has a home life nico is a dad he's got a 10 year old and an eight-year-old yes i do and mamacita and papasita are over here and there's homeschooling going on so please understand that everyone on this table feels that pain as well as the professional stuff that we're going through all day every day so i think that's so very important because we want the audience to see you all as people and this is something that you're that you're dealing with dr beruman all right um i want to say so give us a little bit of your background prior to covid and then going into pro covid of what you're doing all day every day so i'm a native alpaca i went to nursing school here at utep and then worked at sierra and then went to medical school some nine years later went to parkland and trained at southwestern came back i was recruited back and i've been here for now going on 21 years back going on 21 years so you're you were an expat and now you're back that's right anyone who's anyone comes back that's right it's a thing i have to tell you it's totally a thing i agree um i'm going to fix something here on my computer so what i want to do is go into the surge i mean we're not telling you anything that you don't already know at home there's a surge going on uh it's happening yes in el paso where nationals everywhere but there's a surge all over the country and there are surges in many pockets of the world as well what i want to focus on today is not what abc news is going to talk to us the national news i want to focus on what we are doing in el paso and nico i'd like for you to start that because you kind of went into it a little bit about you say you have the easiest job in some ways it's the most important job because it's all about communication and access to what your people need and on that note going back to march in april it's like okay we we know more is coming it was different then we knew there was going to be like maybe a little slow and then come back in the summer and we're hot and heavy now so talk us through what you and members of your team and how you've kind of talked with other people in el paso and then after that we'll talk about the outside world yeah no i appreciate that it's been a journey so you talk about my wife um you know believe it or not she was the first person to let me know about this thing called coronavirus oh goodness uh we were at home in early january she woke me up one night and told me about this thing going on and and like everyone else you never quite take it as seriously as it was going to be oh i'm not on a cruise ship exactly um and then one thing becomes another and she's proven right it's this major issue we have to deal with i still remember like it was yesterday the first meeting i had with my team in the hospitals of providence to talk about n95 masks and people right because that was the first thing on the radar um and since then it's been just such an interesting journey because at first and like you mentioned it in march there weren't any cases but yet we were on state of high alert and then we went through some surges but small compared to where we are now but over time cases have gone higher but that state of awareness dropped until last month when all of a sudden we saw the cases rise dramatically and since then um i've been very happy to say that the preparatory work that went in between between now and has proven very effective um and we can get into it i'm sure we will with questions but it's not just the hospitals of providence it's at umc it's los palmas till seoul it's it's the city it's physicians we have done remarkably well of handling the surge um it's kind of hard to outrun the virus right but all being told i'm very proud of where we've gone okay i do want to uh for those of you who haven't seen numbers as of today i am going to go through some numbers so you can kind of see what on the administrative level nico and dr beruman are dealing with so currently in the hospitals throughout this county i don't know if it's through the county or just el paso city you might be able to tell me but we have 1 148 people in hospital we have 287 people in icu and of those 287 people 204 of them are on ventilators i'm saying that going back to dr days it is so important yes to wear your mask but seriously i i'm just driving over here i'm looking at parking lots of stores like burlington and i shouldn't say we're oh i should have said that i'm getting in trouble but just in general if you don't have to go out don't go out really and it matters to all of the people that you're working with it matters to people who are on the front lines and it's i say that dr beruman i would love for you to right now to give the plea to people who are just in earshot of this show of how important it is if you have to go out wear a mask fine but if you don't have to go out don't and i'll let you take it that's exactly right there's so many opportunities for us to avoid going out now there's the the people that are doing stuff online the deliveries for food the deliveries for products all those things are very much available and yes we miss going out and seeing our friends or checkers that we always see but you know right now is the time where we really need to clamp down we're talking about limiting the spread that's already been out there and the the the smaller amount of people that we expose or we get exposed to either way is slowly going to drop these numbers back down where we can be much more under control exactly and and that on that said i want to say that uh the last couple of days uh we were going up on up and i was at the last couple days we come down just a smidge so there was that spike we have thanksgiving coming up and thanksgiving is that time to meet with people um on on that note when you're looking at let's talk about the civic center maybe maybe that's where my mind's gonna go and it's gonna come back and circle here so we have so many people in the hospitals that we are in all hassles setting up extra spaces for patients to be how did that decision come to be and who and how was that being done no so uh you're absolutely right for on a couple things one is i can connect with you under looking by the big box stores and seeing who is there just last night my family and i this is the our version of a joy right now we went out before curfew and we drove around all the stores just to see who's open and who's not and who's behaving themselves yeah fortunately well past ones are great at masking but uh so we saw that anyways back to your question about the alternative care site um along the way especially over the last five weeks with the state and federal agencies we've received tremendous support on multiple levels they've seen the data as quickly as we see the data um they saw that our hospitals had reached capacity exceeded capacity and now something else needed to be done so um and when you say they who is they i think that's always that's a great question so in this case they would be the state of texas governor abbott's team okay um saw what was happening here before the alternative care site was ever established there were other resources granted to us so like for example today there are over 1300 medical personnel that the state has helped organize and the federal agencies for el paso and most of those are nurses but also it includes physicians physicians who are intensivists er physicians hospitalists are here in el paso because those agencies have coordinated that for us so they have always been doing that then they saw the numbers they projected where the growth was going to be in the cases and determined an alternative care site also known as the field hospital was needed they came in very efficiently and established that field hospital and i'll be honest with you when i did that first tour of the site and dr beruman you were there i was talking to another physician there and we looked at each other with two general impressions one is this is actually an impressive facility the second one is we can't quite believe we're living through this yeah because you see this in movies where field hospitals are set up but here we are but it was comforting to see the quality of it and it was going to be 50 beds we've already reached the threshold of 37 patients in that 50. now they're going to be adding another 50 that should be available this sunday that's what i heard last night so that's going to be available by sunday yes so if you could describe what these beds look like because i i've seen some photographs and i know some people who are working on the projects and we say beds but each one of them is its own room there you go so they're essentially a cubicle that's set up with with the equipment that you need in the hospital room essentially and and what it is is self-sustained air area where you would see a patient normally we don't want to have very ill patients there we want to have those that are stepping down a little bit more control limited oxygen amounts but we have oxygen we have places for restrooms we have places for for help you know cleanliness everything else it's pretty much a self-sustained hospital and that's we're already getting so many questions in here from the audience um and when you say self-sustained hospital it's impressive because really you're walking into a whole different room and you're completely separated from everyone else they're already asking about some vaccines so i don't know i don't want to jump ahead of ourselves i would like to first talk about testing because i think that will be a better flow i know that in the beginning let's go back to march because again that's when the show was going on we're like hey there's testing sites here and then and then all of a sudden it was just overwhelming and now you know you have different stories from different people i mean we all have friends i waited five hours in line and i waited 12 days to get my results etc so for people who are listening what is what is the process now that's being again you go to el paso strong i respect that but since we're here on the air what is the best way to get a test and the most realistic expectations that people will have on receiving the results in the old days all of my guests were over here so i feel like whoever's on this side gets ignored dr barum and i'm so sorry i'm so used to looking this not a problem um but since it's testing either one of you can can throw that out there dr bruman do you want to take that on now i think the advantage we have is we have multiple testing centers around around the city and every day it seems like almost every day it seems to change and it has to add an added added potential for extra so the key is you're going to find out where can i go to that's closest to me and that's going to be the shortest wait for me now the times on these tests really can vary depends on how many get submitted at one time you know where these get to get processed they try to turn it around as quickly as possible okay but i mean that can vary dramatically just depending on the flow of the patient yeah we try to get that back to the patients as quickly as possible so here's my follow-up question to that um and i don't know and again every patient's so different which we're finding out incubation times right so there are people like utep's got its own testing center if there are contractors there or people who are working at the civic center there are contractors there however that works a test is administered when someone knows oh someone in the crew of 20 had covid so all the other 19 got tested do they do it right then do they take another test five days later this is where it gets complicated because yes i've been exposed you know you've been exposed you don't know how close you don't know if somebody breathed on you you don't know but you get a test that day but the question is the incubation period would the test be able to pick up that you were exposed that day or do you have to have exposures for a couple of days and then the test picks it up i think that to me that's a question people will ask me that question because they think oh well you do the medical show you know these things i don't i really don't so however you can best explain when you can become positive after being exposed to someone with covid am i making sense with the question i'm asking okay okay generally we think it's 7 to 14 days okay you think the incubation period is the whole idea of getting tested right then when you get it known you got exposed is were you already positive and have you exposed other people right okay so it's a part of contract tracing now seven to 14 days is going to allow us to kind of see what the incubation period is that's generally what we think the other thing is these tests are not 100 right exactly so you may test negative and then three days later test positive you know there's an error rate with tests they're not 100 perfect my follow-up on that then is since there is that seven to ten days if that person knows that they were exposed should they automatically schedule a test for say eight or nine days later i say they quarantine is what they should absolutely do is quarantine themselves okay and then you can talk to your your your caregiver whoever that is and they'll help you arrange a test for yourself okay absolutely add on to that dr program is right on um one of the most dangerous aspects of this virus is that it sheds itself before you're even symptomatic right that's exactly the so to his point about if you think you've been exposed materially [Music] want to admit that you available have not worn your mask you don't want to be that person who has well i knew i was supposed to stay six feet away but i didn't no one wants to be that person so rather than admit it you hope that you're not really infected but that's how problems occur right um the other thing i'll add we talked about testing i just was listening to the latest report over 530 000 tests have now been done in el paso county yes yes and so talk about so and many of those i mean some of those are retesting sure so let's talk about that because we've got a population of i always think you know seven hundred thousand to me i like saying that number yeah so saying that we've got two four or you know three-fourths of the population tested that's not the case there are people that get multiple tests that's correct but that's a good thing that people are actually getting comfortable with the fact that they need to go out and test dr beruman i feel like this is so important when you say the word quarantine i would love for you to define that because some people think oh i'll just be in this tv room and everybody else can be in that tv room define that for people i think that's so important cause i think oh well i was only in there for 15 minutes or 20 minutes or whatever think about all those people that you love in that house and who you would never want to expose you're going to limit yourself to one room and stay in that one room hopefully with a restroom in it or somewhere you can get to the restroom quickly you're going to have one person bringing food and water and that kind of stuff so that you're not exposing the entire family okay so that's the whole key is you really quarantine means isolating yourself okay and the other thing is when we talk about exposure you should think like we think in the hospital everybody is positive right if you treat everybody as positive you're going to be a lot more cautious about how you interact with people i agree and in my head too again i've got an 18 year old and a 23 year old i say to them because in the early days it was like all the young kids they're fine in the early days i said pretend like you have covid and you're making sure nobody else gets it and now you know we obviously see it and we've gotten we'll go through the age for a minute too but go out there thinking that you could spread it to anybody because again you were talking about being asymptomatic you could have it you can have it shed you know like you said it's shedding before you even become having symptoms niko you talk about people being trained for this my my sons nicholas and alex when i go home uh they they're trained now they give me air hugs like run up in the stomach like go wash up dad go wash up but that's just the way things work now and it makes me proud of them though because they know that we have to keep distance until um things are safe okay i respect it completely um questions here from the audience and i don't know this question i will make this disclaimer so again there's so much it's not known um there's a lot of political stuff going on we're not going to talk about politics we're not going to talk about any of the political stuff one of the questions here from the audience is for employees that are working in hospitals if they feel that they're getting sick they are immediately asked to go find a test and before they report back to work and i guess the question is what is that real protocol so this is kind of a question from the audience saying well what is that exactly so so if somebody's feeling ill they're getting tested right away exactly but what is the the directive right now sure so um when this all started we put in strict protocols when you first come into the hospital we do temperature checks and we do a screening if you feel any symptoms if you have a temperature you don't come into the building to begin with right do you remember okay to call the occupational health nurse employee health nurse and then that individual walks you through the steps and what they'll do is look through your symptoms look through your temperature look through your wrist stratification of who you've been exposed to and that's very important because per cdc guidelines if you have been exposed to someone for over 15 minutes 24 hour period okay within six feet without adequate ppe then you probably do need to go test sooner rather than later however if not they'll give you different guidance so that's generally how we approach it i will tell you that the cdc has always been changing its guidelines as it's been learning more and as that happens so do we exactly and i think sometimes too when people are like hey that's not what they said yesterday it's because we are learning as we go as we go um another question here from the audience again we've got two wonderful medical students let me go to the other question here boy part three in that question i love it uh i'm gonna go up a little bit um no that's not the biopsy that was the last show that we did so can you demonstrate the correct way to wear a mask i like that question of the three type of masks um which one is the best one to wear how easily does a virus spread through the eyes so that's a three-part question so first let's let's talk about the first two questions so we see people wearing the scarves we people seeing you know seeing bandanas and dr broom and i'm sending this your way what is the best mask to wear that everybody has accessible to i mean i see them everywhere i mean if grocery stores et cetera the best mask if you can still get it are surgical masks there's plenty of those now being available the other one would be a multiple layer mask a single layer of material is not going to work i mean yes it covers the face but it doesn't catch the material something like i'm wearing is an n95 it has very tight seal it has an electrostatic charge it's what we use in the hospital but the general surgical masks are generally well available that's probably the best option or if you say that we can take a picture of nico's face here we go um and what i see above nico is he's got that nice wire on top because some of us have really beautiful petite noses and other of us have big honking noses so that can cover up really nicely this is three layers right here um and so the bandanas and the scarves i heard and please correct me if i'm wrong if i can blow out a candle my mask is not good right is i don't know this is one of those i mean that might be the case but the whole idea is it's really you're blowing out virus and you may be sucking in virus so that's the whole idea yeah and so that the gaps up here and these gaps down here right and and people are notorious for bringing down their mask when they're wanting to talk that's the worst thing to do right absolutely i will credit el paso i think new york times did a a study i took a picture of it today yeah that indicated we did better at masking than most communities um but that isn't really our challenge our challenge is uh we get around family and friends and we let our guard down yeah and we take the masks off we do great in public it's when we're around our family our mothers our fathers or siblings that we take it off and that's what we need to watch out for because we just think everything that's exactly right when you're thinking about your families that's when you should be most worried and take the opportunity to to call them to do i mean there's so many different ways now with zoom yeah face time right and thinking about how you're going to protect those members of the family that you love and it's really limiting their exposure and yes i know it's tough but we will get through this as we have every single other thing we will get through should i tell my story now about my elbow please so yes we shall get through so today and this is something to hospital staff it matters if you have other issues going on that aren't covered related you still need to go check it out i thought i was going to come in with a big band-aid on me if you check out this elbow i've got this nice little golf ball hanging out right here um i have a sign in my yard that says this too shall pass and about a month and a half ago i went out there and i added the word eventually and then i tripped on my garden light and fell in but the bottom line is i went today to get it checked out because it's freaky looking and i thought should i wake it's covered we're really spiking right now at the end of the day this is a medical program you all are medical professionals you are in facilities that specialize in taking care of what's happening right now so if you have a medical issue dr bruman i'm going to throw it your way if you have a medical issue talk to the folks at home that if you actually no i'm going to switch this to niko because now nico has a story okay without revealing a name first of all i love the fact that you showed that on tv people know all kinds of stuff about that that's great i love that comfort level that's why i'm wearing these sleeves today because i thought i'd have to hide it but you're talking about a friend of yours you told me your story yeah and a friend of mine who's very well educated very informed individual in the community he contacted me yesterday via email and said he felt like he was having a heart attack and it's been going on for several days but he was concerned that the hospitals were full and he wanted help finally getting to without best hospital that had the most space that scenario didn't exist before covet that person just came in right fortunately in his case it was okay yeah he ended up okay but there are many instances and dr buruman can tell you story after story right or it doesn't end up so well when people delay their care right and let's talk about strokes heart attacks let's talk about the symptoms that yeah right now you call 9-1-1 all the time sensitive stuff is extremely important to activate immediately don't worry about what you're going to be in the er we know how to take care of you once you're there the key is if it's something with your brain a stroke weakness problems either speech from with your vision anything like that it's on new onset you need to come in right away for every minute you don't have blood to that part of the brain you're losing a million neuron neurologic cells right so it's very important for them chest pain chest pain can be any number of things the worst being a heart attack right that's also a time-sensitive action so anything that's time-sensitive you need to come in from that also means belly pain i the last time we had a spike the numbers in our ear dropped dramatically we weren't seeing anything but curvature but what we saw weeks later was the appendicitis that had ruptured yeah the heart attack and now the guys come in with heart failure because you haven't come in at the same time right so the key is we still know how to take care of patients we know how to separate those patients that are ill and we still need you to take care of yourselves and come in for these time sensitive issues right chest pain belly pain diarrhea that hasn't stopped in four days something like that you know when you're ill and there's no reason to stay home we can treat you correctly at the end of the day the safest place to go is a hospital healthcare facility because again you've you guys have got it going on uh we were talking nico i'm to throw us this way because it's just your turn question here from the audience is that all of everybody in my family has been tested positive for covid but nobody is demonstrating a fever is this normal great question because again we were talking about beginning the show some people really get hit hard and some don't i know you're not a medical uh doctor but throw that out there because that's where you said people start letting the guard down oh yeah i test the positive but i'm fine yeah let's go have the barbecue yeah well first i'm happy for that family i mean they're very fortunate my first question is what's the age range of that family right is it a young family or is it someone's my family and i unfortunately don't have any more information than that yeah but what we've seen is if you look at the statistics and you look on the website you told the beginning you look at it the vast majority of positive cases are people between 20 years old and 40 years old however the vast majority of mortalities of death are over 70. right so it's entirely possible that a young family my family for example if we got we wouldn't have any symptoms or if they were they'd be so slight yeah but that's not the danger the danger is that family then going around grandma and grandpa uh going to a store and maybe there's someone helping them at the store who's older that's the danger that exists exactly uh you talked a little bit about numbers we have the numbers here um of patients recently all 29 patients that we have here they did not all occur in one day it occurred in a a combination of days i'm not going to give you the exact dates but out of 29 patients in about a four day five day period one male was in his 30s one male was in his 40s one male in his 50s then we start going up in numbers we have five males in their 60s two females in their 60s um six males in their 70s four females in their seventies three males in their 80s five females in their 80s and one in their 90s so i know that was a lot of wording but dr beruman question here and this is something that came up a couple of months ago with somebody else females and males unfairing better than the other is that is that a thing is it seeing that females i don't know where i watch it was it was a peer-reviewed medical article that i was reading however um because i really try to only read those because be careful on the internet really be careful on the internet but in general males females is that a thing i don't think there's enough data out there to help us decide this stuff there there are so many different variables uh even with specific populations and the issue is that this is an evolving disease for us too as as healthcare professionals we're learning about it and while i'd like to say okay this is a high-risk group and everything else we know the elderly people and people with chronic disease are harassed but the rest i cannot tell you who's going to be more affected than not you know somebody in the same family one person may have severe symptoms and the other person may have no symptoms and there's just not enough data that we've collected on these amount of patients and we probably won't have it for a couple of years that's the way science and medicine works sadly is we're collecting data after the fact right um i was just thinking about a follow-up question ask you dr beruman is uh the majority of the time you will hear with underlying conditions so you hear that wording but what does it mean to the general audience when you say underlying you know conditions was diabetes involved in other so if you can just describe that i know for everybody it's different but in general people with underlying conditions are ones that succumb to covet 19. what how can you define i don't know just maybe throw some examples of her delight i think there's two major components okay one is are you immunosuppressed for some reason are you diabetic are you a lupus patient are you on steroids i mean there's a number of reasons why you can be immunosuppressed do you have hiv number of diseases where you can be immunosuppressed the next thing is are you having problems with either circulation to your lungs or a problem with the lungs itself so it says heart failure where you have problems with that or is this such intrinsic lung problem so those patients i see having the highest risk those patients with lung and heart problems followed by those that are immunosuppressed okay underlying conditions can be any number of things yeah i know you have a huge amount i know i agree you have a huge infection from something else yes that's going to make you more successful right and your body's already immunized and if i could kind of tie in the last few things we've talked about which populations are impacted and also underlying health conditions i think it's important to note that nationally and here locally populations that are most impacted tend to be hispanics and african americans if you look at the statistics they are most likely to have the underlying health conditions diabetes hypertension etc and that's a very real issue if you look at that same website i looked at it today we all know that el paso is 84 hispanic population 90 of the mortalities are hispanic and even in our community there's disproportionate so disproportionate impact so we have to track that very closely in in the days and years and months to come and again the website that niko is talking about is epstrom.org so ep for el paso strong dot org and again there's a wealth of information there uh not only educating yourself but if you have questions there's there's a lot of q a questions on there as well um i didn't answer the third part of one of the questions that we had and it's a great question because we talk about wearing masks um the eyes how easily because we always think of an orifice right whatever the receptors are the eyes the tear ducts how easily does the virus spread through the eyes is a question from the audience and again i know there's a lot we don't know yet but yeah i think really most of it seems to be respiratory related i mean other mucous membranes can be affected but really honestly the coronavirus gets in and attacks what's called the ace receptor so these little spike proteins it's a beautiful little virus with these little spikes in it that cuts down to the ace receptor and it's usually coming through the respiratory system so are there other modes of transmission most likely positive positive possibly but right now for sure we know the primary is respiratory okay and in the old days i remember you bring home groceries you spray them or leave them outside for a couple of days and let them kind of sit there for a bit um question here from the audience uh medications if i am staying at home if if i was diagnosed with covid and i'm staying at home and i'm taking care of myself as directed you know they're they're um quarantining is there any kind of medications that i should eat are there some kind of foods i should eat this is actually a great question because we really are trying to educate the population on even if you're not feeling any symptoms and you're sitting at home you're quarantining what can they do to make themselves feel better i mean i think about the normal flu stuff right have broth this and that and the other but the key is nutrition and hydration hydration hydration and nutrition i mean really whatever you're going to want to eat a lot of these patients not a majority but a lot of them have loss of taste yeah lots of smells so suddenly stuff doesn't become appealing so it's harder for them to eat so the key is find something that's pleasant to you get the nutrition in keep your fluids going and then monitor yourself am i feeling short of breath when i walk across the room boy that was different than yesterday i wasn't feeling that you know something's different right you've got to monitor yourself you know your body better than anybody else and you can tell when stuff is going wrong and i would strongly suggest uh because we have this issue a lot with just different shows let a couple of people know several people know that you're at home you're quarantined you're tested so that people call in on you people check on you you were talking earlier about chest pains this and that and the other if you're starting to have any kind of breathing respiratory issues going immediately because things can happen really really quickly i can tell you i had a lady come in it's an elderly woman with a pulse oximetry of 26. what does that mean that means normally it's between 90 and 100. that's why we measure how much of your hemoglobin has oxygen attached to higher fitness okay so how many normally people are completely out and or dead or just not responsive she was awake and talking to a mind like mine that says i've never seen this before it's baffling we don't know enough about why this person with a sad of 26 is doing okay right and the person over here with 77 is dying there's just so much more to learn about this disease yeah no kidding but the key is communication and checking on each other and making sure that we're eating we're drinking and we have communication to know when we're getting worse on that note too and i'm sorry i know we're going to rush through this show it's an hour but it's like five minutes you talked about contact tracing earlier just just quickly and i know we're still learning a lot too um but super important that if you do get a phone call that asks about that take it seriously and if you can tell the audience that's extremely important the city has established a lot of contact tracing resources what that means is if you test positive or someone you know test positive what they're going to do is call that person or call you and say please tell me where you've been please tell me who you've been in contact with and don't lie like you said you could be embarrassed that you did do this but tell them it's so important please tell them you are potentially saving a life right and that's not a cliche it's not a trite statement it is quite literally the truth um contact tracing is only as good as people who answer the phone and are honest um the city is trying people are trying uh hopefully we can make that better i don't know if this is an important question or not are all those going to be 915 numbers the reason i'm asking is that if i have a number that's not 915. that's a great question often i don't answer it i don't know either i don't know we'll find out we'll find that out and we'll we'll pop it on to the website um only because i know myself as well uh dr beruman because we we are going up think of some stuff that you all really want to get across tonight because time is flying vaccines anything you feel comfortable talking about with what your idea of i think what we've learned over over time is vaccines work okay uh we've seen it with polio we've seen with smallpox and yes there are side effects to almost every single vaccine i got a shingrix vaccine for shingles i got fevers and chills it's one of those things but listen this is the way we have saved lives in the past if the vaccines will come out eventually i promise you the availability will be limited initially and will cover those people at highest risk but i tell you over and over again we've seen the saves lives we've seen it change smallpox we've seen it change polio we see a change influenza okay so the key is vaccines are safe and effective right and they have not been caught there's nothing to think about autism or any of that stuff right it's not been proven right the key is it's safe and effective and if it comes about that's the best way of us getting control of it and i will throw out right now a plug for the good old-fashioned flu vaccine and reason why maybe talk to the audience why because that's just one more thing you have a little bit of defense for and it also kind of rears up your defense systems right so the the vaccines do rear up your immune system the issue with influenza is also a respiratory disease so the last thing you want to do is have an influenza when you know you already feel lousy and you have trouble breathing and then you get covered on top of it right if you get a double whammy like that your risk of getting very very old goes up dramatically so the key is if we can protect ourselves from a known process like the influenza let's cover it it's already out there let's cover us for that at least that cuts down one component of what we're going to be dealing with if we could if we should get covey okay and the good thing too is i i see and hear all over the city flu vaccines for free you know so if you're not insured or whatever you there's i don't wanna again i already in any place that gives them call and find out if there's a way to get them for free there there are all kinds of ways of getting them for free actually el paso strong too has that information on there as well i will tell you that much like a lot of the other things we are actively proactively preparing for the vaccine when it's available so hospitals in town plus physicians have already the chance to apply to be considered as someone to dispense the vaccination i just signed the form yesterday and i'll know in the next 10 days and then i'll get approval as the hospitals of providence to dispense that so we're working through with the government already on this working through which the phases are going to be of who first responders like dr blumen would be first in line um and so we'll make sure we stay ahead of that for the community's sake so when the vaccine's available we'll be first in line so i'm going to ask if you don't mind to just explain how preparing is i mean different dissemination points uh what is it that you are preparing for how to get them out obviously different lab workers first et cetera yeah that's a great question so i'll give you just a couple of examples one is the actual vaccine but depending on whose vaccine it is it's pfizer astrazeneca someone else's they're not all identical some require different kinds of refrigeration um and so let's say it's pfizers it's going to require a certain kind of refrigerator okay and we have to prepare and make sure we have that refrigerator in the hospital then let's take to put that to the side let's take how they define first responders let's say it's physicians and nurses that's obvious but respiratory therapists maybe people in dietary who go into the room to feed people environmental service in advance we're categorizing all of our employees so we know exactly how to phase this and distribute this once we know who so these are the kind of things we do to make sure in advance so when the time comes we don't lose time i love that and it's kind of what you are doing too so that you guys are pretty you know yes we are overwhelmed in some ways but you're a lot more prepared than if you didn't try all this ahead i'm trying to give you kudos and so question here um for doctor yes as we uh from el paso fire we changed a bunch of our paramedics to give x oh perfect giving another way of getting our paramedics to actually give vaccines so great another another way to get that out there in the community so there could be health fairs there could be you know this day at the park that day at the school this day at the that's fantastic uh dr beruman before i give you guys just free rein what you guys want to talk about therapeutics really quick so question here from the audience is those people who are in the hospital what treatments are they being given uh or what seems to be working for people that have covet in the hospital um antibiotics is a question uh but it's a virus so it's a different thing i know it's always a thing but in general what are you seeing works and i know everybody is different again what we're seeing is a lot of this what we're treating is what we call covid pneumonia so it's the lung that actually gets infected we do treat these patients with redemptive air if they're early on and it works quite well we do use antibiotics because we're finding that sometimes they have a combined uh infection and we've seen good outcomes we're not sure about the the whole science of it but we're seeing good outcomes with it so that will continue the other thing is dexamethasone or a steroid right that's the other okay and we also have convalescent plasma which for people who had been infected right we take their antibodies we give them to those that are infected and we have some help there also how is that coming along with people who have had coved and donating is that something we should make a plea fortunately we wouldn't always ask we're always caught on convolution plasma if you have had it please uh go in and get your convalescent plasma done okay get it drawn help the rest of the community okay i think it's very very important excellent i'm very glad that we got to say that and if i could add an emerging therapy just an emergency use authorization a few days ago antibody uh infusion which will be coming up um now this is one that i want our past ones to know um it's an example of how el paso um is helping to lead the way for the country quite literally um this just was approved right now uh in collaboration with border rack we haven't talked about border action is leading the way for the community to make no mistake she's the leader um working with border rac and state and federal agencies um right now as we speak there are people working on establishing a community-based infusion center that will be able to administer this brand new therapy in an outpatient setting now here's the thing nationally there's only 80 000 doses in the state of texas the state of texas is only going to have an initial allocation of 5 000. so that's not very many but get this because of this community infusion center which is a pilot the only pilot in the united states for this we're getting an additional thousand just for el paso this is happening right now hopefully in the next week we'll set this up but i wanted to throw it out there because we are trying to be on the leading edge of the therapies that are available okay and i almost we're at 10 minutes now it goes fast so we've got so much here to talk about what have we not covered yet that you really want to cover um well gosh i mean there's a lot you're right there there really is so much you're going to get the same question i need to make sure that i call out all the support that we've received um from state and federal and city agencies really i mean from the mayor to the county judge all the way up to you know the governor and to federal agencies and just let me give you an example william beaumont right i think as of this morning they've accepted over 100 patients who are military beneficiaries and the va they've accepted over 100. we have an air evacuation system with fixed-wing aircraft that has evacuated over 70 patients out of el paso and taking them to other hospitals um i mentioned the staffing over 1300 um six ambulatory mobile units right uh two disaster medical assistance teams that are coming in coming from the outside u.s air force um in our hospitals with these teams um i wish people knew how much we were being supported nationally on this so i just had to call that out as one thing the other thing i want to call out is how well the healthcare systems in el paso are working together whether it's the hospitals of providence las palmas del sol university medical center me along with our colleagues we speak every day we're not trying to out hospital each other on covet thank god we're trying to work together develop a good solution for the community and that doesn't just administrator this is positions this is staff members everyone's trying to work together doing it very well i love hearing that because this program is a lot about teaming you know whatever teams because no one no no one doctor can cure anybody by themselves and it's it's really nice to have everybody coming together uh dr beruman there are still questions here but anything that you want to stress either something we haven't talked about yet or something that you'd like to restress and i'm coming back to you too because sometimes it's you think about things when the other person's talking i think it's really about maintaining our general health yeah it's mental health i mean it's depressing to be by yourself it's depressing to not have these communications the key is you got to focus on what those things are make you happy and what's positive for you you know it's a matter of keeping those those communications open with your family members making sure that if you're feeling desperate about something you reach out to somebody there's a bunch of stress in this world right now there's people losing jobs there's people losing family members and there's a fear of the disease the effects on people's mental health really affects their immune system also and so the key is realize if you're getting into that state reach out to get some help right you know because the only health care issue is not just coveted right now it's all the other diseases that we deal with and on top of that depression and isolation right i'm going to throw out the again there is a covet hotline for those of you that would rather use a telephone area code 915 there is a live person i understand on the line um if it's not covered related if it's mental related ask the question also org epstrom.org and nico i'm sure you can give out the hospitals of providence website really quick too and a telephone number just for people to be able to call the hospitals.com nice and easy use the word the the hospitals of providence.com um telephone number you can do a google search that's the best okay i was gonna say there's so many numbers out there so many numbers out there um and so again we only have a couple more minutes but i would love to uh to expand a little bit more about what's coming in and i know we started talking about the civic center earlier um is that the only place right now i know that outside of hospitals i don't want to go there but i feel like i have to to sh to let people know how heavy this is that we have uh refrigerated trucks coming in too because the people who are passing away need to be respectfully stored as well i say that not to scare people but when we're talking about the masks we're talking about thanksgiving coming up you have family you have family i want to know what you guys are doing for thanksgiving so that the world out there knows okay you know what they're going to social distance you probably have a mom and dad you could go visit maybe you're not etc etc maybe you can talk a little bit about that because that's so important because we are a familia type of a society i spent uh 30 minutes yesterday talking to my mother in kansas not only telling her that of course we weren't coming and i'm the youngest of five kids they're all they're all want to be there i'm not only telling her that but also hearing her cry on the in the line not because i wasn't going to be there but because i was telling her why it was so important not to be around my siblings and her grandkids and i told her and i don't mean to be theatrical but it's important i told her i said you just sacrifice not seeing them right now because if you were to go into the hospital you would not see them right the duration of your stay any of you ever again so it's a choice you're making um so my family and i i mean it's i don't say unfortunately because i love my family but be me my wife my kids at home enjoying the dinner being thankful for what we have and that's our health um so that's what we're going to do excellent thank you for being with us the three of us just having our little turkey and sitting at home and then you know having a little zoom with our other daughter and our other family members i mean we actually had a zoom family member meeting this last sunday it's it's great it's still the same i gotta tell you it's it's become we're in the business world nico and i have a lot of the same meetings together and people with the same meetings it is so efficient you know and the thing is that because you're so concentrated on the person in front of you like if you're talking to your mom i don't know if it was telephone or if you had her on the video screen you can't help it completely focus on her the entire time versus when you're together you're doing this and you're doing that so it really is it's efficient and i say that gosh why would you say that in the world of family but it is because you're having real conversations versus throwaway type conversations uh we have a couple more minutes here i want to give out a little bit more information actually i did want to say that we have i didn't want to throw out another number active cases right now in el paso um active cases are 29 700 recovered cases are 37 000. so when i say that realize we've been in this again for eight months as i said at the beginning of the show the first time we talked about covid on this program the el paso position was on march 12th that was exactly eight months ago we did not have one case diagnosed in el paso at that time so since then we have uh again 37 000 that are recovered 29 that are active and uh icus are filling up so please stay at home if you do not need to go out and wear your masks eyeglasses if you can yeah i have one more thing i have to say and i want to talk to the camera if i could yes which everyone's got the red light on so this one right now i have to say thank you dr beruman thank you to the physicians and the staff they are tired they are fighting through it they're proud of what they do they're proud of each other i want to say thank you because what they're doing is incredible it's heroic i wish people could know exactly how hard they're fighting every day for el paso yeah and this is and this is uh it's funny because that's how i was going to do my closing thanks you just totally stole all that um no but it matters um when we're too we're talking about bringing people in that's one thing but also the people that are coming in are also helping other communities and are coming from other communities who have had hot spots so when you see someone that has scrubs on that you know it said just just throw a nice word and if they look haggard or if you are getting some kind of treatment there is something that oh gosh what are they calling it passion fatigue which is when nurses doctors etc you wanna you wanna rally around whoever is sick and help them out and uh if they get a little short it's because there's so many other things that are going on uh when we were talking i just had another question here and i'm i'm from the audience sorry guys this is going so fast um oh uh the el paso county medical side we were talking about ppe distribution and working with all the partners every day so if somebody needs to get some kind of ppe which is personal protection equipment do you know where they could go i know they're available everywhere but is there a place that they're available for free of their mass for free i know that the el paso county medical society of this helps is distributing ppe um so if you need to you can google el paso county medical society if i had the number memorized right now i'd give that to you also their website is uh el paso county medical society so epcms.com you can go there and find out where you can get some ppe materials and i'm saying this also for healthcare providers out there because it's not you know we're also looking at dentists you're also looking at other healthcare providers that may need this equipment and i'm talking to you if you're sitting at home that the el paso county medical society is as happy to get some of that information to you taking a deep breath i want to say thanks again to our medical students you guys rocked it tonight thank you very much there weren't very many misspellings on here um which is great because it always helps me quite a bit uh where can we go to get free flu shots uh call the el paso county medical society for free flu shots and then also yeah call them and then and we'll get that information too i have 30 whole seconds so you can watch this program back on pbselpaso.org because sometimes it goes so fast and you may miss what we're talking about you can also watch it back on the el paso county medical society's website which is epcms.com this has been a special program on covid response to the community from our great hospitals here in el paso and our healthcare community i'm catherine berg and you've been watching el paso physician good night [Music] [Music] you