(upbeat music) (graphic pops) (upbeat music continues) - Hello and welcome to "Journal."

I'm Steve Kendall.

There's always something new on the public health front, so we thought it would be a good idea to get an update on what's going on with the Wood County Health Department from the Commissioner, Ben Robison.

Thank you so much for being here today.

As I said, there's always something new on the horizon.

Of course, you're dealing with all the usual things, all of the environmental things, restaurant inspections, all the day-to-day stuff.

But there's always something new and you're always trying to stay kind of ahead of the curve on what's happening and trying to anticipate things.

I know one of the projects you're talking about right off the bat is something called Project DAWN.

So kind of give us an idea of what that is and why that's so important.

- Yeah, so Project DAWN has been around for a while.

It's an initiative of the Ohio Department of Health.

And Project DAWN both was named for an individual named Dawn who died tragically of overdose, but it also is an acronym that stands for Deaths Avoided with Naloxone.

The purpose of this project is to make naloxone available to be able to respond to overdose events in the community, both for individuals who may be using drugs themselves, or people who may encounter drugs unexpectedly, like first responders.

- Hmm, okay, and kind of explain to people what naloxone does when you administer, what its purpose is and why it's so important that first responders, and now this other program, is important.

- Yeah, so what naloxone can do is it basically interrupts the overdose process by binding to the receptors that drugs are binding to themselves.

What's great about naloxone is that if you administer it to someone who isn't having an overdose, it's completely benign, it doesn't hurt them at all, so people have the ability to be trained.

And then, if they encounter something that looks like it could be an overdose, they can administer that substance, and that allows them the opportunity to potentially save a life.

- [Steve] Yeah, and first responders, of course, firefighters, EMS people, law enforcement people, they've been doing this for quite some time.

This kind of expands it to another group of people who usually are at the scene of, unfortunate, like a crash, or a fire, or something like that, they're there to provide another service.

So what's the new group that's kind of now involved with this that are now considered first responders?

- Yeah, so there are three groups that you can participate in for Project DAWN.

Groups A and B are looking to administer naloxone into the community overall.

- [Steve] Okay.

- And can serve anyone based on their interest in trying to provide the substance.

But Group C is unique to health departments and is intended to serve only first responders.

And so we were approached at the Health Department by Representative Haraz Ghanbari, and he proposed an initiative to make a naloxone, through Group C participants, available beyond the traditional first responders to include tow truck drivers who are often the only people that are on the side of the road when first responders are addressing a stalled vehicle, for instance.

- Yeah, so now you bring them in and take them through this.

Is it the same training you would give to other first responders?

Is it different in any way or not?

- The training for administering naloxone is actually pretty straightforward.

It takes only about 15 or 20 minutes, helps you to identify the signs and symptoms of an overdose, and then how to administer the substance itself.

And so we have gone through some trainings with local tow truck companies that have an established relationship with Wood County first responders.

And in order to do that, we reached out to the Ohio Department of Health because it is their program, and they recognized, like we did, the value of this project, and so they gave us the authority to go ahead and do this and to make this available on an ongoing basis using a broader definition of first responders to include the supportive staff that may be involved with them in their execution of their duties.

- [Steve] Yeah, now how many people roughly, so far, have you trained on the tow truck driver side now?

Because obviously there are lots of tow truck operators out there, companies, that sort of thing.

So you have to sort of start small and keep expanding, right?

- [Ben] That's correct.

So we've trained about a dozen as of right now.

And, in addition, to those dozen operators that we've trained, we've also trained a core of volunteers, as well as staff, and that will ensure that we can help to continue to provide these trainings on an ongoing basis.

We're gonna keep reaching out to the tow truck companies to figure out the best way to make it available.

And our volunteers are available to support other jurisdictions should there be other health departments that wanna get this off the ground and aren't quite sure how to do that.

- Yeah, now across the state, I don't know whether you have this answer or not, how many counties or how many other areas are doing Project DAWN the way you've just described it?

- There are hundreds of Project DAWN participants.

- [Steve] Ah, okay.

- But the number of providers per county varies.

And, like I said, the group C participants that serve first responders exclusively is unique to health departments.

And not every county does this, but many do, and it's because we recognize the value that first responders provide and we wanna support them in the execution of their duties.

- Yeah, has there been any pushback about, well, now we're, I mean, initially there was some controversy about even administering this drug.

People were saying, "Well, all you're doing is you're basically creating a situation where people are gonna be repeat offenders, because now they know there's an, 'quote, unquote' 'easy way out.'"

So kind of explain when a first responder approaches, what are some of the things they look for to say, "Oh, this person might be experiencing an overdose?"

- Yeah, so for the first responder, they're gonna be identifying those signs of symptoms.

Oftentimes, they will be unresponsive, they could be having eyes rolled back in their head, they could be having challenges with breathing or, basically, it looks like they're just not behaving as you would expect.

Sometimes the symptoms of an overdose can appear, in some situations, like a heart attack, and that's why people are encouraged to administer if they think it could be an overdose, even if it isn't, 'cause it doesn't do any harm.

But the other thing that can happen, too, is when first responders are responding to a scene, maybe clearing a vehicle, they have to go through an inventory of that vehicle to understand what's there.

And in the process of doing that search, they, themselves, could be exposed.

- [Steve] They may get exposed.

- That's correct.

- [Steve] Yeah.

And purely accidentally.

What exactly, I mean, the administration, how does that actually work?

Is this an injection?

How straightforward is this for people?

- [Ben] Yeah, it's actually an inhalant.

- [Steve] Ah, okay.

- [Ben] You put it right into the nose and it gets inhaled.

It's like a strong, if you've ever seen a- - [Steve] Oh, like the old, break the thing under your nose and suddenly you're back awake kind of thing.

- Well, it's sort of like if you've seen a rescue inhaler, it has sort of that sort of idea.

It sprays a mist, and then it can be inhaled.

Because it's being taken up by the lungs, it acts very quickly.

- [Steve] That's what I was gonna ask, yeah.

- [Ben] And can help to counteract what is going on really fast.

The scary thing about some of these substances is that they have a life in the body that's longer than naloxone.

- [Steve] Ah.

- [Ben] So, in some cases, it can take more than one dose.

- [Steve] That's what I was just gonna ask.

If you do it and then, oh, you see maybe a response, but maybe not the full recovery you expect, how many times could you, you can continually administer this?

Or is there a limit on how many times I can use the inhaler, in this case?

- [Ben] Yeah, you can continue to administer it.

But every time there's an overdose, the individual is gonna be transferred to the hospital because they wanna get them something that's more ongoing support and make sure that they understand the level of dosage they've received, and provide ongoing treatment until that dosage has gone out of their body.

- Yeah, but when they're at the scene, they're gonna keep trying to do, to make sure the person is then transportable to get them to the next stage of treatment.

- [Ben] That's right.

- How has the response been as you've talked to companies?

They're on board, most of them?

Because it's one more thing now they have to keep account of, and, you know, and there's a certain amount of responsibility here.

I mean, it's a training thing, it's a medical thing, that sort of thing.

So yeah, how has the response been?

- It's been really positive, it's still new.

So as we're reaching out, people are understanding the purpose of what we're trying to get off the ground.

We expect that we'll continue to get uptake as people get the word out, and thank you for helping us to do that.

But I think that these are individuals that are already connected to first responder agencies and so they have the opportunity to provide the support on an ongoing basis.

And they understand the risk that it is to them, so I think that's the connection point is that they wanna provide a resource and support that would be really valuable if they encountered an unexpected situation.

- Yeah, when we come back, I have one more question about treatment for this and just where we are with regard to the opioid situation, because we've been talking now for more than it's, well 12, 13 years, get a feel for how we're doing better, same, how are we progressing if we are.

Back in just a moment with the commissioner of the Wood County Health Department, Ben Robison, here on "The Journal."

Thank you for staying with us on "The Journal."

Our guest is Ben Robison, Commissioner of the Wood County Health Department.

Just to kind of follow up on our discussion about the opioid situation, kind of gives us an idea of where we are now, because there was a time when this was the major health issue we were dealing with, and then it sort of has fallen a little bit below the radar because of other things that have happened.

Where are we right now with the opioid situation?

Do you call it a crisis anymore?

Or we're doing better managing, I think, we hope, in that case?

- I mean, certainly the issue is still significant and still is with us.

Part of the reason that we branched out in this new initiative and Project DAWN to expand the people who can support first responders is because they continue to encounter these substances in the field, and the risk of overdose is still very much real for our first responder community.

According to some recent statistics that I saw, Ohio, I believe, is still ranked seventh in the country, with the lower the number being a worse outcome.

So seventh in the country for overdose death.

So we know that we're seeing some improvements and naloxone has helped with that, but we are far from being able to say this issue is fully resolved.

- Yeah, and the situation, too, is, of course, we're dealing with the addiction side of it, which is another whole piece of this.

But, yeah, 'cause I think sometimes people think, "Well, I'm not hearing much about opioids anymore, it must not be as critical as it used to be."

And, yet, as you guys are aware, it still goes on and we're handling it better, we're finding better ways to deal with the outcomes, but it's still a challenge for law enforcement.

It's still a challenge for addiction treatment, all of that sort of thing.

When you look at where you are with a situation like that, with opioids or any other public health issue that comes before you, how do you guys stay ahead of that?

Because you're trying to be proactive on everything you deal with, because reaction serves a purpose, but you always try and maybe try to stay a little ahead of what's about to happen.

Is there anything you're looking at now that, what's the next thing that you're already sort of saying, "Hey, here's where we wanna be five years from now with something versus where we are now on a particular item"?

- Well, that's actually what we're about to undertake.

So we do our community health assessment and our community health improvement plan every three years.

We are just on the front end of that.

We expect to be doing that assessment very soon.

And then, really identifying not only opportunities, but needs that we want to address.

And so that helps us to set those long-term priorities and to really think down the road.

But you're right, our space is to prevent the need before it exists.

If we spend all of our time just dealing with curing and not dealing with preventing, not only is it really expensive, but it's just not as effective, so our space is to think down the road.

In the opioid space, we look at a lot of data.

There are surveillance systems set up in Ohio that help us to understand when we're seeing things that are unusual and that gives us opportunities to intervene.

And we're continuing to see these resources evolve and emerge.

So, here in Wood County, like other places, we have response teams that follow up with individuals who've experienced overdose and help to connect them to recovery.

And that's really what naloxone serves as, as a gateway into recovery.

While there are people that are not always having their overdose experience and going straight to clean living, it's a scary thing.

And so having naloxone available to keep them alive and available helps us to get people into recovery.

- [Steve] It kind of gives a bridge, and then opens a window of opportunity for them to get to recovery, and get to treatment, and that sort of thing.

One of the other things you guys have sort of initiated and then kind of introduced to, and I don't know if it came out of the assessment or not, but you do have now a mobile health center that is available to be available, people used to have to come to the office over on Napoleon Road.

Talk a little bit about that and the purpose it serves, and the services it provides to people.

- [Ben] Yeah, so we were able to get some grant money, and, through that grant, we were able to purchase this mobile health center.

And really the goal of is to take services into places that may not have ready access to infrastructure.

This is a fully self-contained unit.

We can run it in the middle of a field, and the generator that's on it will allow us to run the lights and do all the services that it can support.

So we can do everything from health screenings, vaccinations, behavioral health support, and we envision this being something that helps to expand access in places that have transportation challenges, which we know are real things in Wood County, and really help us understand where we might wanna take services on a more permanent basis by evaluating the extent of the need in the places we visit.

- And, as far as staffing, who typically would be, I'm sure, depending on the reason you're going out, but what typically would be sort of the staff people that would be assigned to this?

- So we have hired some contract staff, primarily nurses that support this.

We will be looking to hire people to help us drive this vehicle and keep it well maintained and interact with the public.

And then, some combination of staff and volunteers are also available when we are doing public events, There's a lot of pieces to it.

We have canopy overhang, so people will approach us.

They'll get their either sign-in sheet or information, they can head into the unit.

There is a wheelchair lift on the back.

So we can serve anybody no matter how they're able to access the vehicle.

And then, we can stay there for an entire business day, head back, empty our tanks, refill the generator, and be ready to go.

- [Steve] Yeah, well, and I guess then the other aspect of that too, while you're there, you're really kind of collecting data too on people that you're treating and that sort of thing that might, otherwise, you may not encounter because they can't travel to a physical facility, a brick-and-mortar facility.

And probably, too, I imagine you use this too at other public events where you wanna make sure people are aware it exists and what the services are, that sort of thing.

So it's kind of a nice advertisement for what you guys do every day.

The more, I guess, the mundane things that people look and say, "Well, that's what you do every day."

This provides an insight to people who may normally be aware of all of the services that are available and just how comprehensive they are.

- [Ben] Yeah, I mean, for us, one of the things that we're doing is cholesterol checks, blood pressure checks.

Both of these things are health indicators that we cannot understand without the testing being done.

So you and I can guess at our own cholesterol numbers and our own blood pressure numbers, but without the evaluation actually happening, we would be just doing that, guessing.

So this gives people the information that they need.

If those numbers are elevated, it gives them the opportunity to make changes and understand how those changes can accomplish a change that they're after.

And really it positions them to be in a place that gives them the information they didn't have about how to make healthy lifestyle decisions.

- Yeah, and I would think too, it'd be more comfortable, maybe for some people too, if you roll into their town for instance, by the town hall or whatever, maybe it's a little less intimidating to approach that particular unit versus going into an office.

Because we know everybody gets, you know, white-coat syndrome, "Well, you know, I just don't know if I wanna go there."

This way it eliminates that aspect of, A, having to travel there, and maybe it's a little less intimidating.

Not that you should be intimidated by any medical professionals, but there is a sense of like, "Oh, I'm in a hospital, or a doctor's office, or whatever."

This is a little more relaxed in that it kind of came to you.

It looks like a typically almost like an RV kind of thing, so it's a little more comfortable.

And it's in your neighborhood, you're not traveling to another location, which, as you mentioned, is difficult, because, increasingly, especially in rural areas, public health services, medical services, in general, are gradually gravitating to larger population centers and there isn't a lot of service in the more rural and exurban areas.

So this is a way to address that.

- [Ben] Yeah, in fact, one of the partnerships we have for the mobile health center is following along with the bookmobiles.

- [Steve] Yeah.

- And since people are coming out and they're used to accessing that service remotely, this is a way for us to be there for those same populations.

And I think as we are, I mean, to be perfectly honest, it's a brand new thing for us, so this year we're gonna learn a lot about how best to make use of it.

- [Steve] Sure.

- We do expect to be at some public events.

We expect to be in places we've never been before.

And as we understand what the level of need is, that helps us to set some long-term goals about how to provide those services, maybe in a continual basis with the mobile health center or maybe in a more permanent basis through an established physical site that serves that community well.

- Yeah, but the good news is this basically, it opens the window, the door, for them to access the healthcare system.

And then, hopefully, if they need more services, they have information about where to go to get those, they get into the system, get in the door.

So, good.

- [Ben] That's right.

- Okay, back in just a moment with more about public health with Wood County Health Commissioner Ben Robison here on "The Journal."

You're with us on "The Journal."

Our guest is Ben Robison, Wood County Health Department Commissioner.

Recently, you've introduced another new program.

It's got a kind of a nice, catchy name too, it's called MoonBeam3.

So kind of give us the skinny on MoonBeam3 and what your hopes are for that particular project.

- Yeah, so the same pool of money that helped us to buy this mobile health center also allowed us to purchase some other disinfecting equipment, and the MoonBeam3 was one of those pieces of equipment that we were able to acquire.

- [Steve] Okay.

- It is a UV disinfection system.

And basically what's neat about this is any place that the light can get to, it can disinfect the germs that are there on those surfaces.

There are some things that are quite contagious.

If you've ever had a stomach bug in your house, and then everybody has it.

- [Steve] Yes, oh, yeah.

- It's because those things can hang in the air, can get people quite sick, and it can be really hard to get to all the nooks and crannies.

- [Steve] To totally eliminate it- - [Ben] That's right.

- [Steve] From every, yeah, crack, crevice, vent, whatever, yeah, kind of thing.

- [Ben] That's correct.

So MoonBeam3 affords us some equipment to make available community-wide sort of on a targeted basis as people have needs.

We're gonna position some with the community, and we're gonna maintain some with us so that we can make them available.

And should we encounter a situation where people are like needing a deep clean, if you will, we can provide this resource to help with that.

And, you know, this is the sanitation step.

So cleaning is getting rid of the stuff that's there, the dirt and the grime, that's right.

- [Steve] It gives a base for things to start to, yeah.

- [Ben] That's right, and then disinfection eliminates the germs.

- [Steve] Yeah, so how large a piece of equipment are we talking?

Is this, obviously, relatively portable?

- Relatively portable and, you know, it's something where it's meant to serve a room, so it has to be able to reach the surfaces with light.

- [Steve] The full- - Right, so we couldn't, you know, just sort of think like your dishwasher.

If you stack your plates in a stack and put them in there, they're not coming out clean.

- [Steve] Yeah.

- In the same sort of way, we have to be sure that the light can reach the surfaces that we're trying to reach.

And if we do, and then we let it run its cycle, we can come out of there being confident that those surfaces are now decontaminated.

- Okay, yeah, and, obviously, this is for public, like, places that entertain the public, restaurants, things like that?

Would they be somewhere you'd come in and use that or not?

Or is it more for home situations?

- We're thinking of places like day cares or schools.

- [Steve] Okay.

- Hospitals would be of value for this.

There could be situations where a restaurant may make use of it, but we're thinking more along the lines of where we tend to encounter people who are sick.

- [Steve] Gotcha.

- Generally speaking, in restaurants, people who are sick don't come to work.

Right?

- [Steve] Don't come to work.

Yeah, hopefully.

- And if you're not feeling well, you don't typically go out and eat.

Right?

- [Steve] Gotcha, gotcha.

- [Ben] So we're thinking more of the places where, you know, with little kids, they don't always know how they're feeling.

- [Steve] Yeah.

- [Ben] My kids can't distinguish between being hungry and being ill. - [Steve] Being ill, so yeah.

- [Ben] So that's probably more of the places we expect that they'd have value.

- [Steve] No, okay, that makes a lot of sense, yeah.

One other thing, and if you look at it, you, obviously, go online and look at your website, all of your social media, things like that, a lot of areas that you cover, and we've talked about them in the past, one of the things though that I noticed too, which is on there, it talks about farmer mental health, because, obviously, just like any group of people, there are stresses, there are times where things go really well and times where there are challenges.

So talk a little about what that program is aimed at doing and helping that particular population, which, you know, is so important to Ohio, so important to the country in general, but dealing with making sure that farmers know what's available to them to help them in those really stressful times.

- Yeah, so this is part of a national campaign and we are just trying to participate in this.

And the campaign is intended to raise awareness, just as you're saying, to the mental health needs of our farming community.

Our Board of Health is a pretty diverse board and represents Wood County effectively, and we have a number of folks on our board who come from the farming community.

- [Steve] Sure.

- And they've spoken openly and honestly a few times about the need for this.

And so as we look at this initiative, our goal is to help people to recognize the warning signs that they can see in friends and family, to help them to be encouraged for when they can seek support.

Also, to help reduce some of the stigma related to seeking mental health support.

And then, finally, to help them to connect to resources.

And know here, in Wood County, we have a health center right under our roof that provides behavioral health services and we wanna be able to make that available, both through the mobile unit and through the brick-and-mortar facility.

But it's really about helping people understand what this is.

And I think, you know, I say often that, "Mental health works just like physical health."

And when we think about it that way, we can think about a bad day being like a scraped knee, right?

- [Steve] Yeah.

- It's something that's gonna heal on its own with a little bit of rest.

And then, we have the mental health equivalent of a car crash, right?

- [Steve] More serious- - Something really traumatic that's gonna require intervention.

- [Steve] Yeah, and, of course, by nature, we try to make sure that people are aware of services that are available, whether it's mental or physical health issues.

But when it comes to mental health, that seems to always be more of a challenge because people are reluctant to ask for help when it comes to those sort of things.

I mean, if you've broken a finger, you've scraped yourself, it's like, "Yeah, I might need some help with that."

But when you can't physically see a problem in terms of it being in front of you, probably a lot of the challenge is just making sure that people know this is accessible and how easily they can get into this and to, as you said, remove the stigma of asking for help or recognizing the signs that maybe they do need assistance with their mental situation.

- [Ben] Well, I mean, it's just like anything else.

If we get the right treatment at the right time, recovery not only is faster, but it's more effective.

And helping people to understand the difference between a scrape and a broken bone is important.

I know, like, for us, we have four kids, and so we are often navigating with friends and family in the pediatrician's office, "Do you need to see them for this?

Is this just a standard thing?"

Or, you know, we have a playtime injury and, you know, sister throws a block at brother and hits his head, we need to figure out what to do.

- [Steve] Right, right.

- But timely intervention on the physical front is exactly the same for mental health.

And if we make the right approach at the right time, people have better outcomes, and they prevent those wounds that can be lifelong.

- Yeah, and probably, too, with a group like farmers, because a lot of times they're out there by themselves, you know, so they have a lot of times to think about things because, you know, you've got a lot of things on your mind and you're there by yourself, and you could see where that could create some issues where you're like, "Wow, you know, there's no one there to bounce things off of to reassure you," that kind of thing.

So it is, yeah, it's probably a challenge.

And, again, a group of people that are so self-sufficient and so self-motivated, they push through things that maybe they should maybe consult and say, "Hey, you know, I'm not sure I'm on top of my game here," but they've learned to move through things.

So it's probably more of a challenge to maybe get them to access this particular system.

Is there any other thing that we haven't talked about that people should be aware of that they're available or things that, you know, may be next on the horizon for you guys?

- Well, this is respiratory illness season, and so we continue to provide vaccines.

We're encouraging people to be vaccinated, especially for flu and COVID if are 65 years older or older or have an underlying health condition.

Both of those things, age and health, can contribute to severe outcomes.

So while we're not seeing the population level impacts that we saw, you know, three and four years ago, there's still the risk of individual impacts.

We wanna raise awareness about that.

But also we're seeing two other things, respiratory-wise, this season, we're seeing an increase of walking pneumonia among kids.

- [Steve] Oh.

- And an increase of pertussis cases, or whooping cough, across Ohio as well.

So the interesting thing about those two diseases is that they look like everything else at first.

- [Steve] Yeah, they're sort of like a cold-ish kind of thing.

And then, things get more serious.

- [Ben] Then they develop.

So we're telling parents that if you have kids that have a respiratory illness that just is not resolving, it's time to get them checked out.

And very likely your pediatrician is gonna run some tests for both walking pneumonia and for pertussis.

Pertussis, it can be a little bit scary for infants, children 12 months and younger, up to 1 in 3 of them require hospitalization to recover.

- [Steve] Ah.

- And the risk for older kids and adults is that we can be sick and contagious and have no symptoms.

- [Steve] Oh, wow.

- And so really paying attention to those symptoms early, getting early treatment.

A Z-Pak will knock that out.

They'll often treat the individual and their close family members to prevent that contagiousness.

But that's a complication we're seeing right now, and so, in this respiratory illness season, the advice is still the same.

Stay home when you're sick, and if your sickness is not getting better, seek care and try to figure it out.

- Yeah, seek care and, yeah, get on top of it as quickly as you can and not let it develop into something that, yeah, that may turn out to be really, really serious, and then becomes less and less effective for treatment.

So, good, well, Commissioner Robison, thank you again so much for bringing us up to speed on all this.

And, as you know, anytime you folks wanna come on and talk about public health, more than happy to have you on, because, obviously, the more we know, the better off we can be and the more likely we are to get the right treatment, and get it at the right time, and just be better informed about the things that are out there that we need to keep on top of.

So we appreciate it very much.

- Thanks for letting me be here, and always a pleasure to join you.

- Yep, thank you so much.

You can check us out at wbgu.org.

You can watch us every Thursday night at eight o'clock on WBGU-PBS.

We will see you again next time.

Good night and good luck.

(upbeat music)