(air whooshing) (upbeat newsy music) - Welcome to "At Issue," I'm H Wayne Wilson.

Thank you, as always, for joining us for the conversation.

And I wish I didn't have to say this, but, once again, it's time for an update on the coronavirus.

It keeps changing, we keep following it, and we have a panel of three experts to talk about it.

But let me first, just real briefly some numbers.

Since the start of the pandemic, more than 800,000 deaths in the United States, 51 million cases of coronavirus.

And of the 800,000 deaths, 1/5th of them are in the 45 to 64 year old range.

In Illinois, more than 30,000 deaths from coronavirus.

So, once again, we are going to be talking about what we need to do and what to expect in the future with Dr. Stephen Hippler.

Dr. Hippler is the chief clinical officer at OSF Healthcare.

And, once again, thank you for joining us.

- Thank you.

- And with us is Dave Mingus.

Dave Mingus, he's a licensed behavioral health professional, and he is with UnityPlace, actually it's three units that have joined together under the banner of UnityPoint Health.

- That's correct.

- [H] And it used to be?

- Tazwood Center for Wellness.

- Tazwood Center for Wellness.

- Yeah.

- And for those of you looking at Dave and saying, "He's with the UnityPlace?

I thought he was mayor of East Peoria."

Well, you're right, he was the mayor for 12 years.

And also with us, Katy Endress.

Katy is the director of epidemiology at the Peoria City County Health Department.

Katy, thank you for joining us.

- Thanks for having me.

- And, Dr. Hippler, we have to talk about Omicron.

Let me start with South Africa was one of the earlier ones, maybe not the first, but one of the early ones, and there was a dramatic rise in cases.

And now it looks like there might be a significant drop-off in South Africa.

Is there anything we should take in terms of a positive vibe from that information?

- Well, H, you know, the numbers you presented at the opening are very sobering.

And as we come into now our third winter of COVID and we're dealing with Omicron, that as you said, started in South Africa, spread to Europe, and is now really starting to be impactful in the United States.

We have a lot of anecdotal information that it spreads very quickly, doubling every day or two, and is much more contagious than Delta.

But the thought is is that it may not be quite as severe.

Although, in the United Kingdom this week, they reported eight deaths, so it's certainly more than the Omnicold that we hear about.

It's not something that we should take lightly.

And how long it lasts here, we'd have to wait and see.

Every country and population, because of their genetic makeup, it appears is fighting the COVID virus a little bit differently.

So I don't think we can extrapolate what is happening in South Africa and think that it's going to be mild and short-lived here.

- So with Omicron now the dominant strain here in America, 73% of new cases I believe is the percentage, and because it's less virulent, or at least that's what we anticipate, are we going to take COVID a little too lightly, at least a portion of our population?

- We really shouldn't, because we really don't know the effects of the Omicron variant in the United States population.

We have different genetic makeup than those in South Africa, we have different comorbidities of obesity, diabetes, and hypertension, and different vaccination rates than they have in South Africa.

So how it affects the United States' population is still yet to be seen.

And I would encourage everybody to take it as seriously as all the other coronavirus variants in the past.

- And I assume, as a physician, you're going to tell us, "Get vaccinated, and then boosted."

- Absolutely, it's unequivocally clear the best protection against COVID in general, and Omicron in particular, is to complete your first series and then get a booster.

- What is, Katy, the percentage of the population here in Peoria County that has been fully vaccinated?

- We're sitting right now right around 55%.

And to sort of reiterate what Dr. Hippler was saying, I think it's important to note that the experience of Omicron will be different among those that are vaccinated compared to those that are unvaccinated.

Unvaccinated individuals are three times more likely to end up in the ICU having severe illness and possibly death with any of the variants, and I think that will likely be the case with Omicron as well.

So getting vaccinated, yes, is very important.

- And the definition of fully vaccinated is what?

- Right now it's still having received two doses of either the Pfizer or Moderna vaccines, or a single dose of the Johnson & Johnson vaccine.

- So it does not mean the people who have been boosted that's a lower percentage?

- Yes, mhmm.

- Dave, let me turn to the mental health aspect of coronavirus.

Just the 30,000 foot view first, what have you seen over this last almost two year period now during coronavirus, in terms of mental health conditions in Central Illinois?

- As far as mental health, we've seen a spike in anxiety and depression, but that's not just in Illinois, that's globally.

It's a global disease with those symptoms worldwide.

But specifically in this area, we're seeing particularly among young people, but universally, I mean, there's about 50% of the people who are walking around with symptoms of anxiety and depression.

And many of those may not have the severity to be diagnosed, but they're sad, they're confused, not knowing as far as what information to believe or not believe.

There's a lot of divisiveness among families, as far as vaccinations versus non-vaccinations and how they're gonna handle the the holiday season as far as arguments or non-arguments.

So a lot of those inner dynamics as far as communication, but it's definitely had a tremendous effect on our healthcare workers and essential workers.

I mean, a year ago, year and a half ago, they saw devastating situations where they had to be the last people to tell somebody goodbye.

They had to work with the family that wasn't there.

I've done a number of debriefings, and I don't think anybody can really appreciate where those healthcare workers have been, as far as the bodies they've seen and the magnitude of what they had to endure as far as helping people out.

And that's caused a real stress among healthcare workers and essential workers as well, where they're tired right now, they really are, and they need a break.

And bringing people in from outside is helpful at times, but it's different than their schedule.

And they talked about how they can be heroes one moment, and the next moment, you know, they're being shunned because they're walking through Hy-Vee with their ID badge on, and people are just kind of spreading the aisles for them.

- And let me ask Dr. Hippler to expand on that, in terms of the, I'll just say the general condition of the staff, RNs, physicians, everybody at OSF Healthcare.

- Yeah, Dave is right, it's not just OSF Healthcare.

I think, in general, in United States healthcare, everybody's tired.

This has gone on for a long period of time.

We've seen so much death, so many issues all along the way.

Everybody's just tired and praying for all this to end.

This third wave or this next wave this winter is going to be particularly hard if we start seeing more and more, especially unvaccinated people, coming into our emergency rooms, hospitals, ICUs being intubated and dying.

It just wears on people over the long course of this pandemic.

- And, Dave, that's true of mental health providers?

- Absolutely, absolutely.

It's a tough job right now.

But as Dr. said, particularly with the healthcare, it's particularly severe.

There's a little pause and I would do debriefings with medical staff in the area.

And I remember at many of them, it's like this pause, "But we're not getting our hopes up because we think something's gonna happen," and they anticipated this.

So they really haven't totally relaxed.

They'd been in that fight or flight, even when the pause was there, and now we're seeing where it probably what they said has come actually true.

- So there's a shortage of clinicians for mental health services?

- Absolutely.

- [H] Which means what in terms of the client?

How delayed is a client in getting services?

- Oh, we want people to get services and we really do everything we can to get them in.

But the fact is that many people aren't gonna get a service, and most people don't come in for a service anyway.

I mean, most people who have anxiety and depression go on and struggle with it for perhaps their whole lives.

So we encourage people to get in.

But when they do come in, there could be long waits, there could be long periods of time between sessions.

We're doing the best we can, but quite honestly, it's not good enough.

- And, Katy, at the Peoria City County Health Department, stressful no doubt, a delay in offering certain services at the Health Department?

- Absolutely, and I think COVID fatigue is real.

And it's something that's worn on all of us over these last, nearly two years.

You know, our case investigators and contact tracers that are calling people on the phone that are, you know, experiencing possibly one of the worst times of their lives in isolation, in quarantine, maybe a family member in the hospital that they can't be with while they're sick, these phone calls have been really, really stressful and challenging on our staff over the last nearly two years.

And sometimes, you know, people are frustrated.

They're frustrated that they're gonna miss out on events.

They're frustrated their kids are missing out on their sports activities, or Christmas and holiday activities.

So, yeah, there's been a strain on our workforce as well, and it's something that I think, like Dr. Hippler said, like we're all praying for this to come to an end.

- I wanna comment too, when I say that more needs to be done, I wanna emphasize that all these different agencies are working really hard at the hospital staffs.

I mean, it's not because anybody's not doing their job, they're doing their job plus, but the need is so great, we just can't meet it.

- Dr. Hippler, we know that there are occasions when some of the smaller outlying hospitals want to send a patient to OSF or to UnityPoint, but are you capable of handling that right now?

- Yeah, we are taking some transfers.

But, again, this is a problem not here at our institution or in our community, but hospitals across the country are full right now.

That we get calls for transfers from out of state, because there's no beds in Indianapolis or one in Kentucky.

So the beds are full everywhere and things are starting to back up.

So we do take transfers, as I'm sure UnityPoint does, but it is taking longer to get people in to our hospital and our facilities.

- Literally, from Kentucky?

- Yeah.

- [H] That's a system that's in overload.

- Mhmm.

- Dave, Katy mentioned something about, you know, athletic events and things of that nature.

What kind of stress do you see in families because the routine is altered?

- Absolutely.

Particularly, during a remote learning, COVID took educators by surprise.

And this is not in judgment, this is just a fact, because COVID took us all by surprise.

And with particularly students, I had a number of them who referred in, who were very anxious, very depressed, and part of the reason was because they couldn't get their assignments.

They lived in a remote area of the country where their computer didn't work.

I had a straight A student who was 32 assignments behind, and I kept seeing more students coming in who were really frustrated and upset and weren't sleeping, appetite bad, sense of hopelessness about them because they just couldn't do it with the remote learning.

And as I said, it's not because the educators weren't trying, it's just that this is a whole new area.

With athletics, athletics are really important for not only the athletic part of it, but the social part of it, and the physical.

When people aren't able to fulfill those activities, they begin to get soft physically, where they're not as a good as shape as they were in.

And mentally, I mean, they wanna compete.

They wanna get out there and work and it does affect them.

- We should point out that Illinois State University and the University of Illinois just announced this week that they are going to have the first two weeks of the second semester of the school year remotely.

It'll be virtual learning the first two weeks.

Bradley University has not made a decision with regard to that.

They're still anticipating having students return on January the 19th, I believe it is.

- I think we're better off now than we were before though.

But take a kid, for instance, or a student, no prom, no graduation, when the freshmen come in and they're little checking each other out as far as like who looks good and who doesn't look good, that's gone.

At the college I've watched as students walk they don't walk hand in hand, they walk single file like prisoners almost, you know.

So that had a great effect on our social aspects.

With the mask, I think it's very important.

I believe in masks, but expression is so important that we can read each other's expression and we can communicate directly.

I mean, we're people who are meant to be social.

And when we're not, that has an ill effect on society and individuals.

- Being that Dave mentioned masks, we were masked prior to the taping of this program.

All four of us are double vaccinated and boosted, but we wore masks until the very start of the program.

And let me turn to Dr. Hippler, because yesterday the FDA approved, and I'm not sure I pronounce this properly, but Paxlovid.

It's the first oral medicine for COVID.

Can you explain what it does?

- Yes, it's a medicine that helps prevent the virus from replicating and growing.

So in some of the early studies, it showed a 90% reduction in the risk of hospitalization in those who had mild to moderate COVID.

So really promising drug.

I would caution people that FDA approval does not mean available, right?

We saw this during the vaccines.

Just 'cause it takes months for this to be made, shipped, distributed, and then be widely available.

So it's great news.

It's absolutely great news.

But, again, I would caution people to get vaccinated, get boosted, wear masks if they're at risk.

And the hope is that we'll have an oral drug in the months ahead to treat.

- Are we concerned that people might take a relaxed attitude and say, "Well, there's a medicine for that, so who cares?"

- Yeah, I hope not.

And, again, it may be a while before this is widely available.

With winter coming, and the Omicron variant, influenza this winter, I think the next six to eight weeks, we're gonna see a lot of respiratory illness in our community.

- Well, mentioning respiratory illness, what about flu?

I mean, it's flu season, and, yes, I have my flu vaccine.

Is this gonna be a bad one?

- Well, right now the prevalent strain is H3N2.

And the last time H3N2 went through our community was 2017 and it was a bad year, and the outbreak started right around Christmas time.

So, again, we don't know what this year holds, but really important for people to also get their flu shot.

Interesting only about 50% of seniors get a flu shot, 30% of people overall get flu shots.

We take it for granted that flu will come every year, but I wonder what it would be like if we all committed to getting a flu shot, and practicing those good hygienic techniques, to prevent the spread of flu in the winter time, the same way we do with COVID.

- Katy, at the start of the show, I introduced you as the director of epidemiology at the Health Department.

I know that epidemiologists deal with distribution of numbers, et cetera.

But would you please explain to us why this is important with regard to disease?

- Sure, so the numbers that you mentioned at the very beginning of the program, those are the kinds of things that we're tracking at the Health Department.

The number of cases in our community, the distribution of illness in our community, who's being more severely affected than others.

So we know, based on the data that we collect, that this past week was the highest case count that we've seen this year, and the second highest we've seen since the beginning of the pandemic.

And so we're not only looking at those case counts, but we're looking at vaccine breakthrough cases.

And we know, from looking at that data, that individuals that are vaccinated are less likely to be admitted to the ICU than those that are unvaccinated.

And so we're looking at the severity of the illness, we're also looking at how it disproportionately impacts some people more so than others.

We know that in our community, people of color, our communities of color have been disproportionately affected.

Case counts there are about 1 1/2 times what they are for their white counterparts, and also hospitalizations are higher.

We know that, you know, hospitalizations among black and brown people are about twice what they are for their white counterparts.

And our 03 and 05 zip codes here in Peoria have also been disproportionately impacted.

So we've long seen health disparities in these communities, and the COVID pandemic has somewhat exacerbated that.

- And I'm expecting Dr. Hippler to say, "Yes, we're seeing evidence of that."

- Absolutely, absolutely.

You know, there's a lot being talked about, about breakthrough infections, and we do see some breakthrough infections.

But, again, they typically, if they end up in the hospital, they're a day or two and leave.

Those who are unvaccinated are the ones that end up in the intensive care unit and have the much higher risk of dying.

- Katy, there is a tracking system, the Vaccine Adverse Event Reporting System.

I mean, it collects valuable information, but one of the problems is people, especially people who are anti-vaxxers, are using the numbers and not interpreting them properly.

What's the value of that reporting system?

- I think it's valuable to have a system set up that we can gather that information.

But when looking at that data, you have to remember that correlation does not equal causation.

So someone may have had, you know, an event after a vaccine, but it doesn't necessarily mean that the vaccine caused that event.

Also, that anyone is able to report in that system.

So as you said, there are some people that may have not have the best of intentions in entering information in that system.

So, yeah, you just have to take it at face value and keep in mind that the correlations that are indicated there do not necessarily equal causation.

- I wanna talk a little bit about some positive things, Dave.

Even though families are at home a lot more, there may be some disagreements more often than in the past.

But are there steps that they can take to try to minimize that?

- Absolutely, absolutely, and I think it's important.

COVID's here, it's going to stay.

It's going to be here long-term.

Therefore, I think that what we need to do within our families is take control of what we can control.

We can't control the political system, or we can't control the world, but we can control ourselves, how we respond to things, and the environment that we live in.

And it's real important that we make the home the safest place we can be, particularly for our children, that they feel safe.

They're kind of like the shock absorber of society.

Watch media, when I say watch media, I'm actually saying, don't watch media.

- [H] Wait a minute, Dave.

- Use discretion, how's that, H?

- [H] Okay.

- Use discretion because it's important.

And right now we're being bombarded, and it's really mixed messages for our kids.

I mean, they really don't know what to think.

And you hear certain people talk about how, "I wouldn't get vaccinated, it's a conspiracy," and you got a four-year-old there.

And then you hear somebody else of authority say, "If you don't get vaccinated, you're going to die."

Well, that's a four year old.

And we have to be conscious that with little minds we have to not oversaturate them with information that they can't handle.

And exercise is really important, doing positive things is important, volunteering somewhere is important, and really taking control.

And what I like to do in therapy is call it the here and now.

For here and now, you're healthy, you're safe, the roof's not leaking, that's all you have.

You don't have a past, you don't have a future, for here and now things are okay, and bask in that and not worry about what's gonna happen in the future.

But it's real important that families really use this as a time to get to know one another and take advantage of the situation, and not spend a lot of money perhaps, but just that quality time together it can be very positive.

- Dr. Hippler, Dave mentioned that the coronavirus may be here for a while.

I know you don't have a crystal ball, but might we see coronavirus evolve into a flu-like seasonal event?

- I think some of the leading experts are thinking that it will be endemic, meaning it will be with us for a long time just like flu.

It will continue to evolve and mutate, and some form of it will be with us for a time to come.

- And let me ask both you and Katy, Dave mentioned some things to do to minimize the mental health stress caused by the coronavirus.

Could the two of you share some positive encouragement about what to do to preserve physical health?

Katy, if you wanna start with a couple.

- Sure, absolutely, I mean, we both already stressed the importance of getting vaccinated, getting your booster shot if you haven't already.

Children ages five and up are now eligible for vaccines, so you can get your children vaccinated as well.

And it's very important that people are able to gather with their families this holiday season, but there are lots of things that you can do to ensure that you're doing that safely.

So there's at-home COVID tests, the antigen tests, that you can take prior to gathering so that you make sure that you have a negative test going into that event.

And then you can also, you know, wear a mask if you're indoors.

But, fortunately, this weekend, it looks like it's going to be pretty nice out.

So you can even open windows and turn on fans to increase air circulation and ventilation.

- [H] And Dr. Hippler some other suggestions as to what we can do to minimize the impact of COVID.

- Yeah, I completely agree with Katy.

I would add to that exercise, getting appropriate sleep.

- Absolutely.

- Sleep's really, really important.

So getting appropriate sleep.

And I would say to avoid drinking too much, avoid smoking, and those other habits that may bring us down.

- [Dave] That's a very good point, if I may?

- [H] Go ahead, Dave.

- Because in the debriefings that I did for medical staff, that was one of the first things that they talked about resorting to was alcohol use to deal with the stresses and strains that they had, which really just exasperates the situation even more.

- 'Cause I think what Dave is doing with the mental health is probably as important if not more than the physical health.

So to have a trusted counselor, colleague, friend that you can talk to, I think is going to be critically important in the months ahead.

- And with that, we have finished the first half hour of discussion.

We'll continue the discussion here in the studio.

We hope you'll continue that discussion at home and take this to heart, coronavirus is a serious disease.

And, Dave, five seconds.

- Five seconds, I wanna say you heard us talk about demand for staff.

If you call any of our agencies, I guarantee you we will get you in if you need help.

Please call if you need help.

- And with that, say thank you to Dr. Stephen Hippler of OSF Healthcare, to Katy Endress of the Peoria City County Health Department, and Dave Mingus from UnityPlace.

- Thank you.

- Thank you all.

And thank you for joining us on "At Issue."

Next time, we'll be back with a discussion about young people and how to keep them from going down the wrong path and getting involved in criminal activity.

That's on the next "At Issue."

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