>>BOB ZALTSBERG: Welcome to Noon Edition on WFIU. I'm your host Bob Zaltsberg from the WFIU WTIU newsroom. I'm co hosting with Sara Wittmeyer the WFIU WTIU news bureau chief today. We are continuing to do this show remotely based because of of course the coronavirus and covid 19. Today we're going to talk about that disease. We're gonna do an update on October 19 and the spread in the Monroe County community. We have four guests with us today, three of them with us before and some on a number of occasions. We have Penny Caudill who is the Monroe County Health Department administrator, Dr. Tom Hrisomalos an M.D. with IU Health Southern Indiana Physicians who specializes in infectious disease, Dr. Aaron Carroll is the director of surveillance and mitigation for the covid 19 at IU. And we're being joined today also by Maggie Mulligan who's an Indiana University student, a sophomore studying recreational therapy. And she's a member of the Gamma Phi Beta sorority. You can follow us today by checking us out on Twitter at noon edition. You can also send us questions there. And you can send us questions to the show at News at Indiana Public Media dot org. And I have to say we've had a lot of questions in the last week or so. We've had over a thousand questions since we started taking them about the corona virus. But in the last couple of weeks we've gotten quite a few questions. And I want to start out with trying to get an understanding of one. And that has to do with the positivity rates. I guess I will start with Penny and then Dr. Hrisomalos or Dr. Carroll can join in. It seems as if you know the new positivity rates for specified unique cases versus all cases that seems to have sort of come into the spotlight recently. So can you define unique cases? And which is a number that we should really be paying attention to? Penny? 

>>PENNY CAUDILL: Certainly. Thanks for having me today. It is confusing. And you know we want to look at data from all different perspectives. When we look at individuals what they can tell us is you know whether or not maybe multiple people are testing versus you know everybody getting one test, the thing about covid 19 is that this isn't a sort of a one and done you test for it and you're finished. You could be exposed later and test positive. So there is a place for all of the information. One of the things that, looking at individuals only does, is if someone tested, say, in the spring and they were positive and then they tested positive again, maybe they had a re infection, now we - that new test would not be captured. So we don't want to rely just on those individual tests as well. The percent positivity - when we look at that especially on a seven day rolling average, that gives us all of the tests that are done, all the negative tests, all the positive tests together and then how many of all the tests that were done were positive to really give us that snapshot of what's going on in the past week. So that gives a little more weight to that that piece of data. And the other physicians may be able to give us some additional information and clarity around that. 

>>BOB ZALTSBERG: Yeah. Let me follow up just to make sure that that I'm clear. I'm not actually - I'm not sure that I am totally clear on it. So the number - when we're talking about positivity rate, we've been using that as a benchmark in several different ways. Are we talking about that you know all tests number? If you want your positivity rate to dip below 5 percent is that all tests or is that the unique tests? 

>>PENNY CAUDILL: All tests. You know I mean certainly you know unique individual has its place. I'd like to see them all low. But certainly it's all the tests that were done for that particular week because I might - maybe I'm testing every week. But my negative tests two weeks ago were negative and they were part of that picture at that time. My - if I test today and I'm positive then that's a different picture and I'm still part of that kind of whole group. So the intent is to give us a snapshot of where we are and what's circulating currently in the community. 

>>BOB ZALTSBERG: OK. And so in the - you know in the opening, I think Sara mentioned in the in the opening to the show that the positivity rate had gone to 15 percent compared to three and a half percent just a couple of weeks ago or maybe even a week ago. But that 15 percent is for the unique cases, correct? 

>>PENNY CAUDILL: Yes. 

>>BOB ZALTSBERG: OK. So maybe Dr. Hrisomolas and Dr. Carroll can join us here. But so far an apples to apples comparison, what's been happening in in Monroe County in terms of the rate? 

>>TOM HRISOMALOS: This is Tom Hrisomolas. I would for a moment I'll just emphasize what Penny just discussed. We need multiple measures to try and get a handle on what happens to be going on in the community. And to expand on that just a little bit, imagine this, that for example individuals who work at nursing homes are getting tested once a week. Or some of them are getting tested twice a week. That can influence the number of other people who may be tested positive maybe unnecessarily but are going back and testing again and again and again and seeing when they - when their tests might be negative. You can see all this - all these tests then can confound the statistics. And so we need multiple measures to try and get a handle on what's really happening. And so that's why you see you know different things followed and different things tracked. From Monroe County - and I would certainly you know ask Penny and Dr. Carroll at IU their impressions. But certainly we've seen an increase in cases. We've seen an increase in cases back around July 4th. We've seen an increasing cases here more recently. You know it seems to correlate with some of the students coming back in town. And, indeed, if you look at the county's numbers - what is it about 60 percent of our cases are in individuals under age 29 in contrast to some of the surrounding counties. So I think that certainly plays a role. But you know there's a lot of other factors that go into it as well. I think everyone's had a little bit of isolation fatigue. And they've been a little bit more active and out there. And I think that increases risks as well. 

>>BOB ZALTSBERG: OK so if I can just focus in on these numbers again. So Dr. Hrisomolas with - what number - I mean if just an individual is out there trying to gauge how well Monroe County is doing? Is it this seven day negativity rate percentage for all tests that people that just the layperson can be paying the most attention to or should be paying the most attention to? 

>>TOM HRISOMALOS: Well I would say yes. I think that's a good one to follow. Personally you know we all follow what is most valuable and important to us. I'm - since I'm not strictly speaking involved in public health but I involve - I'm more involved in taking care of patients. I follow what the hospital census is and how many people we have in the intensive care unit. So everyone is following a little bit different number but I think 80 percent positivity number is a good one to follow. 

>>BOB ZALTSBERG: OK. And Penny could you just tell us what that is right now? 

>>PENNY CAUDILL: Today's positivity rate? 

>>BOB ZALTSBERG: Yes. 

>>PENNY CAUDILL: Was that the question? 

>>BOB ZALTSBERG: Yeah. 

>>PENNY CAUDILL: That just popped up it at noon. So today's all tests was eight point two percent. I think that people have been watching and part of that going up. And we know that Indiana University is doing a wonderful job at a really robust testing on campus and people affiliated with the university. And as numbers come in and different systems are put in place to merge that information certainly the universities across the state. I think that there was some challenges between labs reporting and the state system getting those put in. That is being corrected. And we saw some of that correction today. I don't know what all of those labs were that they were in countering that with. But we did have conversations with the state for a while but certainly this week to really address that. And so I think that we'll continue to see some changes there. But it was eight point two percent today. 

>>BOB ZALTSBERG: All right. Thank you. So Dr. Carroll can you give us your perspective? Give us an overview of what you're seeing in the numbers as it pertains to the university. 

>>AARON CARROLL: Yeah. I mean positivity rate is a metric. But to say that it's like the most important or the one that we should follow it's important to understand that what's really important there is not just the numerator. But also the denominator because of course it's the number of cases and the number of tests and what can really influence that is not just the number of cases which is of course the number of infections but also how many tests are you running. And the positivity rate is going to be very different in different populations for most of Indiana, the positivity rate that we're looking at is of symptomatic or people we believe to be at high risk because the vast majority of people who are getting tests are being referred to a test by a physician or who are concerned they have been exposed and therefore at higher risk and are running out to get a test on their own. That's most of the tests. So seeing a positivity rate of 8 percent there is as you're saying OK. That's an a high risk population but what we're doing at IU, the vast majority of tests that I'm running are on asymptomatic people. We're doing somewhere between 10 and 15 thousand tests a week on people who are not symptomatic. And you know depending upon our populations we're seeing very low. On most of our regional campuses our positivity rate is zero. At UIPY the positivity rate is significantly below 1 percent. In the Greek population, you know in week two, I think it was a 25 percent which is horrifyingly high. But they are very high risk population. Amongst the dorm population of Bloomington on the other hand it was low around 3 percent which of course concerns us because that's a whole prevalence. And 3 percent is still higher than we'd like to see. But there's a difference between being concerned about a prevalence of 3 percent or a positivity of 3 percent in a dorm population and saying, OK, 5 percent in Indiana would be great. That's because we're thinking it's mostly symptomatic for Indiana. And I'm knowing it's almost entirely asymptomatic in the Bloomington dorm. So it's just important to know what we're testing. And Penny is right. There have been some difficulties in how our tests are being reported to the state. And that's partially because how the lab that we've been contracting with has been reporting it. It appears that they reported the positives much earlier than the negatives. But it's important to understand that globally we're going to be dropping the rate in Monroe County - positivity rate down. Because again we're doing so many tests in asymptomatic people that even when we're concerned it's lower than 8 percent. Our testing rates overall have been significantly lower than 8 percent in mitigation tests. And so as the number of cases may still be rising the positivity rate could still be lowering because we're testing a different group of people which makes just using the positivity rate problematic if you're only carrying about one metric. 

>>BOB ZALTSBERG: I think I understand all that. 

>>AARON CARROLL: Good. 

>>BOB ZALTSBERG: So Dr. Carroll, are there other? Is the university measuring other large apartment complexes? I mean are you able to pinpoint any other hotspots among students because there is communal living in places off campus? 

>>AARON CARROLL: Yes. We divide - the buckets we put people in for the most part are are in each campus, employees faculty and staff. We put buckets of off campus students, buckets of on campus students. In Bloomington we're also looking at Greek because that's been a significant predictor. We are not yet looking at off campus apartment buildings. Our data on where off campus students live is not precise enough or accurate enough to get that yet although we're certainly working towards that. So I can tell you for instance that in Bloomington campus, our dorm population is sitting at a slightly lower positivity rate than our off campus non Greek housed population. But our Greek off campus students are significantly higher than our non Greek off campus students. And our Greek town students in general have been much higher than any other group. Employees, faculty and staff have been almost non-existent cases in what we've measured. And so it's it's different. Can I tell you which you know which apartment building off campus might have a higher population? No not yet. Again we're working towards that level of precision. But we're monitoring all of these groups so that we can figure out where we need to focus in the future and determine what measures we might need to take to make things safer. 

>>BOB ZALTSBERG: All right. Maggie Mulligan is with us. Maggie is an Indiana University student, a sophomore studying recreational therapy. And she's a member of the Gamma Phi Beta sorority. So Maggie is your sorority one of that's been quarantined? 

>>MAGGIE MULLIGAN: Yeah. My sorority just recently got on quarantine. 

>>BOB ZALTSBERG: OK. So I guess I want to ask you just sort of a general question. I mean I think we've heard from a lot of people Dr. Carroll just mentioned. I - it would be really difficult it seems to me for a fraternity or a sorority to be able to have the ability to social distance and do the kinds of things necessary to keep everybody safe. So I guess my question is how possible is it for that kind of communal living which is based on you know being social and being together as sisters or a fraternity as brothers you know? How realistic is it that can stay - you can keep a number down in an organization like that? 

>>MAGGIE MULLIGAN: I mean it's extremely unrealistic. But the issue is not that we're just a social group. The issue is that we're living in a house together where we share kitchens and bathrooms and living rooms together. And we don't really have a choice but to share these facilities together. I mean we have a risk of catching kill them when we go to the bathroom because we don't who's been in there previously or where they've been. It's pretty much the same as when you're living in your house back home. I mean you share all the same utilities. You share the same room. It's just even though we're living separately, sleeping separately. We have to leave our rooms eventually. I mean we can't just stay in our rooms. So it is very unrealistic. And it's quite frankly really challenging to social distance and to wear these masks and to keep up with studies on top of all of that. 

>>BOB ZALTSBERG: So what's - if you don't mind me asking, what's your life like they're under quarantine? 

>>MAGGIE MULLIGAN: Well it's very unique. It's very - it's been very stressful. I mean my sisters and I - I mean if you can imagine living in a small room, a room almost the size of a closet and then being told that, when we leave these rooms, we have to wear masks to go to the restrooms, to the living room to even go outside for a little bit for some fresh air. It's extremely draining mentally and extremely draining just physically. I mean we've been told to live in these rooms and to - for a mental break to work out in our rooms. But that's not possible with the space that we've been provided. And of course each house is different. I can't speak for every house. But my house specifically doesn't have that ample amount of room for us to move about and to feel any sense of freedom. So it's just been this constant like weigh on our shoulders this whole quarantine and covid and everything going on. 

>>BOB ZALTSBERG: So do you know - are you aware of what happens next? I mean I assume the quarantine will be two weeks. How often are you being tested during that time? Or will you be tested at the end of the two weeks? What could happen next? 

>>MAGGIE MULLIGAN: The testing has been kind of random on our part. We were originally told we'd be tested every week. That has changed. It's been every after quarantine. Next for us would be to see the positivity rates, how they are affected within these next few weeks because you know if we have another positive case that's in the house we go back onto quarantine. That's been the whole deal is that we could be in a constant cycle of being quarantined. And right now my sorority is dealing with girls who are now moving out and trying to find off campus housing because they just simply don't feel safe anymore within the house which is - you know has nothing to do with the house itself it's just covid and how it's infested all of these houses as a whole. So right now when these girls do choose to leave and to move off campus, they're gonna start using separate rooms for isolation and start moving girls around just to rise up the more safety and some more isolation because right now isolation is a really big problem within every sorority. It's getting people out of their rooms and getting them away from everyone else. There's a huge issue. So that's the next step - is figuring out how to more properly isolate people within the houses without making them leave or go home. 

>>BOB ZALTSBERG: We're going to give our numbers again before I let Sara - I know Sara has a question but news at Indiana Public Media dot org is how you can send us questions. And at noon edition is our Twitter handle. You can send us questions there too. Sara. 

>>SARA WITTMEYER: We keep getting a lot of questions. But before we move to those, Maggie, I just want to ask, I mean how do how did you feel when IU first invited students back. And now looking at it, what do you wish you would known? 

>>MAGGIE MULLIGAN: Yeah. So I'm out of state. So I was just dying to get back to Bloomington to be back here again. Bloomington's my home. I mean I love being here. I love studying here. I'm on the dance floor here. So I have that as an extra curricular that I absolutely adore. So when we were invited back of course I jumped at the opportunity to come back. And I felt safe knowing that the university would keep me in the know, text me regularly. And they told me that I would be safe within my authority health as well as long as we follow these guidelines. And two weeks in, I hate to say it, it's kind of blown up in my face a little bit. I just I was kind of - I wasn't blindsided because I was very very in the know about how how horrible this virus and how vastly it progressed. And I just - I wish coming back to IU there had been more protocols in place by the university itself. It felt very like it was kind of on the sororities shoulders to figure it out. And although the university doesn't have any claim over the house. Like it's all based on individual stories nationals and you know they're their rules. But you know these are you students within the houses that are getting sick. And I just feel like the university would take a little bit more responsibility in helping us with isolation. And you know they gave us the hotel was an option. But now the hotel is filled out. And we can't use the dorm that's made for isolation. So it's just felt like we've come to the point of no return. And now it feels like we have no choice but to either stay in this house and get infected or to go home and risk infecting family members or to spend more money and get off campus housing. It's just - I feel like when I came back to IU would have liked to know what the plan would have been at this point. I feel like I just did not know what would happen if I come to this point that I am right now and I wouldn't know what to do. I wish the university had had a plan for this rapid increase of numbers of covid within each house. 

>>BOB ZALTSBERG: Can I ask Dr. Carroll about that. But first I do want to ask you Maggie. So how many of your sorority sisters are actually sick? 

>>MAGGIE MULLIGAN: Well according to a statement released yesterday actually each house has identified how many members are exactly sick. And according to that, there is 43 members currently infected with covid at Gamma Phi Beta. But they have all isolated, quarantined. They're out of the house now. 

>>BOB ZALTSBERG: OK. Dr. Carroll I just want to get your reaction to what Maggie said about the university's responsibilities and also how well that they've prepared the students for this kind of eventuality. 

>>AARON CARROLL: So I think we've been very consistent. I mean I've been involved in the planning from the restart committee since we were in March. I think the restart committee determined pretty early that we could not see a way that fraternities and sororities could be safe for the reasons that we've just articulated. No blame, no anger. It's just impossible to imagine how to do communal living the way that they do and keep it safe. But fraternities and sororities or off campus housing and they wanted to open. And they're independent. And so we we at that point said look, if you're gonna do this, we would give you the same recommendations that we give know when we think about the dorms de-densify massively, singles or doubles only, significant numbers of bathrooms or how many people would be there. You know real complex levels of cleanliness, you know, real - you know explaining to people that outside of your room you, need to be masked so only your roommate is the person you are not amsked with. And everybody else hundred percent masking. And not eating in the building because eating is a significant source, especially communally eating - huge danger. And so not to do that. To them even talk about making sure that you have significant quarantine and isolation space set aside where people will be completely removed from everybody else, that the risk of infection would not would not go up. Now I've just laid out a list of recommendations that are pretty much impossible to do and have a fraternity or sorority house, which is why we said we don't think this can be safe. But fraternities and sororities moved ahead and came up with plans that they thought would be adequate. We, when asked, I said I don't - asked personally, I said I don't actually think that is what we said or that is enough. But again fraternities and sororities exist as off campus housing and manage themselves. We can work with them, with respect academics but they've taken significant pride in being very independent organizations. And so we can make recommendations for those who live off campus. And we're monitoring them. And we can certainly control and make sure that our dorm populations meet the standards that I just said. But I cannot fix what is in the fraternities and sororities to make it what I just said. Now we tested them along with everybody else because we wanted to monitor what was going on. And we did on arrival testing for all of them so that they would start at the same low levels of prevalence that the dorm populations would. And we even tested everybody off campus in Bloomington as well to start off on the best foot. But it raged almost instantly. I'm not - I'm not again, this is not about blame. This is not about pointing a finger. It is just I think the way that the houses are set up. It's hard to imagine that they can meet the criteria for which it was safe. But again fraternities and sororities made plans and decisions and moved forward with how they thought they could manage this safely. You know the numbers of students who were infected in the fraternities and sororities right now would overwhelm Ashton. It is not as if we have space set aside that where we even if we wanted to use it and we need to save that for the dorm population because we have housing contracts with them and we are you know making sure. And they're already filling up but there's literally not enough room to house everyone who is needs to be in isolation or quarantine from the houses at this point. They would multiple times over overwhelm our capacity. That's how quickly the infections went. And that's why you know we're only in the third week of school right now. But we've had multiple conversations and multiple discussions where we've advanced our recommendations quickly from this appears to be raging to this does not appear to be safe to this - you know we need to quarantine whole houses because at this point everyone is a close contact of everyone else to we don't think that this is still - we still are consistent in saying this does not appear to be safe. And it appears that the plans that have been put in place are not adequate. Now we're left with a series of unfortunately bad choices. It is not as if there's a magic button to push that can fix this. We have tried to find other facilities where we could potentially house that many people in isolation. But it's incredibly difficult. And we're still finding that infections are spreading in the houses even when we know all of this because it's incredibly hard. But you know we have to move forward as best we can. We're still trying to do everything we can to advise and help and do this as safely as possible recognizing that there just aren't a lot of great options available. 

>>SARA WITTMEYER: We got a question. And this is for Penny. We've been talking about sororities and fraternities being quarantined. And the question is what is the difference between quarantine and isolation? 

>>PENNY CAUDILL: Sure. Isolation is when you are ill. So if you have tested positive you know whether you're symptomatic or with isolation you are ill. And the isolation period is at least ten days away from other people not mingling, you're by yourself so that you are not posing a risk to transmit that infection to someone else. So it's 10 days. Plus you have to be 24 hours fever free at least without medication to reduce your fever. And any symptoms that you have had have to be improving. So it's a minimum of 10 days for isolation. Quarantine is - the best way to say it is when you have been exposed, you may have been exposed and you are waiting to see if you will become ill. And that period of time is 14 days. So, again, if you quarantine, you want to not be interacting with others because the more you're interacting if I'm in quarantine and I am interacting with my family, it doesn't matter where you live. If I'm interacting with my family and I become ill, now they are all close contacts and they have to - their quarantine time is now extended. So it can be very very difficult. And certainly isolation and quarantine are both difficult things. Doing it in any household can be difficult. And, certainly, the more people that you have living together, the more difficult it becomes. And you know Maggie talked about sort of that emotional toll that you had your mental health. And it is difficult. Absolutely. And it's part of why we want to intervene as early as we can. And so as you know tests - people are tested and they're positive and you get a certain number. And you have to say we need to intervene in this quickly so that we can stop that spread from just continually going on. 

>>BOB ZALTSBERG: All right. If you have a question or a comment, you can send it to us, news at Indiana Public Media dot org. You can follow us on Twitter at noon edition. We're talking with - that was Penny Caudill who is the Monroe County Health Department administrator. Dr. Tom Hirsomolas from IU Health, Southern Indiana physicians and an infectious disease specialist is with us. Dr. Aaron Carroll director of surveillance and mitigation COVID 19 pandemic at IU is with us. And so is Maggie Mulligan an Indiana University student a sophomore studying recreational therapy who is right now quarantined with the rest of her sorority Gamma Phi Beta. We did have another question that came in about - that I think that Penny you and Dr. Hrisomolas might be able to address just about the county's - you know the spike and in the percentages a spike in numbers in the county. And you know what short term plan might there be to deal with that? Is there anything else other than what's been done so far. And I know you have another meeting and a press availability in about a half an hour. But is there anything else that the county can do or will be doing to try to slow the spread? 

>>PENNY CAUDILL: Well I think that very much of it from a county perspective is that we need everyone in our community to take their responsibility very seriously for protecting themselves and their family and their friends. And so I always feel like a broken record. We are coming into flu season. And we talk about washing hands and cleaning and doing all those kinds of things. And it's true with covid 19 as well. So my message is really the same. It's why we have a face covering requirement, distancing. It's why we have a measure is put in some of the retail establishments and those food establishments to wear face coverings, to seat people, those kinds of things what we really need I feel is individuals to each do their part. And I've said before kind of a we not me mentality. I did not come up with that but I have latched on to it, that we really have to think about what our actions are and how they impact others because we're only going to really reduce the spread of this infection if we all work together to to take all the precautions that we need to. 

>>BOB ZALTSBERG: Dr. Hrisomolas. 

>>TOM HRISOMALOS: I would like to say a couple of things. First yes. You know we've seen these increasing cases. And it's worrying worrisome to all of us. The good news in this is, although, we have seen an increase in hospitalizations, it has not been to the degree that we saw you know back in April or would necessarily correlate with the number of cases that we see statistically. And this may well simply be because a lot of these cases are in younger healthier people who will unfortunately recover uneventfully. What I would say is you know we all have lapses. We just all need to focus a little bit better. Maybe we forget to wear a mask when we're around family or friends who we think they might be safe or maybe we go to a restaurant and we sit six feet apart. But that restaurant may have inadequate ventilation or ventilation patterns that move droplets around. Or maybe we don't get tested for mild symptoms. Or maybe some people are not absolutely 100 percent with their quarantine. We can all do better in all of those type of activities. You know it's not a surprise I guess from a medical standpoint. It's not a surprise that we are not 100 percent successful in altering disease with behavioral changes. I mean we struggle with this all the time. How do we get people to be vaccinated against influenza? How do we control obesity and substance abuse and sexually transmitted diseases and smoking? We're just not 100 percent. But if we can all be a little bit better, we can all wear that mask consistently and everywhere, you know we can make a difference. I mean, it's been shown in other places around the world that the more vigorous we are in following the recommendations, the more control we can get on it. So I just would be a voice to encourage people to just take it up a notch one little bit more effort to try and get this under better control 

>>BOB ZALTSBERG: Dr. Carroll, you did say I think on a call earlier this week that you're not seeing any spread caused by what's going on in the classroom. Is that correct? 

>>AARON CARROLL: That is correct. I think you know we do rigorous case - I'm sorry - contact tracing in all of our cases. And pretty much all of them are from activities outside of being in school. Our classes are designed so that not only is everyone universally masked, not only is ventilation great, and we're keeping things very clean and we're encouraging you know hand sanitizing, but they're de-densified to a point where no one should be within six feet of another person even while they're seated. Lots of classes even have assigned seating so there's not bunching up. And professors of course are significantly further out at the front so that even if a case were to enter a classroom, no one should be a close contact. And if no one of course is in close contact, then no one needs to quarantine even if they were in class with somebody who might have been infected. But we've had no infections that we can trace that have occurred person to person in a classroom. 

>>BOB ZALTSBERG: All right. So on that issue of contact tracing, Penny or Dr. Hrisomalos, have you seen from the contact tracing that you know of that's gone on in Monroe County, have there been any other events that you can point to that have created issues? 

>>PENNY CAUDILL: There haven't been any - there haven't really been any specific events that we've been able to identify. But I will say this that even across the state, we - it is those social gatherings. It is mostly where people are gathering with their family and friends that they consider, you know, it's just my family. I'm safe. And it's what Dr. Hrisomalos was talking about. We have to be careful around everyone and you know think about who we might in fact if it's us that's asymptomatic and has been infected. So certainly as we find places that may have multiple people, those are addressed. I mean, we know that you know some businesses have had multiple people maybe who have been infected but not necessarily all at the same time or directly linked to one another. I'm not saying that there aren't any of those cases. There are. But in terms of being what we might call a true hotspot, we've really had very little of those. I am concerned you know with Labor Day weekend. I don't know how people did. And so I'm concerned that we might see another spike. And we've seen that after other holidays that have occurred. So I'm hoping that people were very careful and that we won't see that spike. Contact tracing for COVID-19 is being handled, because we're in a pandemic, a little differently than we handle our other communicable diseases in the sense that the state brought on people to do contact tracing throughout the state to take some of the burden off local health departments. So we are still involved directly with them when there are multiple cases, especially at certain locations. Or if the state process is missing someone, they can't get a hold of someone, then our nurses step in and work on that. And certainly IU has stepped up and brought in contact tracers to work on the people that they're testing in the student population, and that is a huge asset. Certainly when you have lots of positives, it can be very overwhelming. And it can overwhelm a system very quickly. And that will bounce from day to day on how difficult that may be. The state has started a marketing campaign called answer the call just to make sure that people are aware if they get the call from the state health department - and that may come to them as a text or an email or a phone call - that it is very important to call that person back so that they can walk you through what you need to do. And they can assess who those close contacts were. Have you been somewhere that may be a location or a place that we need to identify and do some closer work in. So it's very important to follow up with those contact tracers whether they are IU, whether they're state or whether they're the local nurses. 

>>SARA WITTMEYER: We've gotten several questions about IU's responsibility to students and to the community. And I guess I'd like Maggie to respond first. Though the one question I'm going to ask is someone just said IU opened, implying safety for all students. What happens to help students not spread the virus? And if students do have the virus, is the university taking responsibility for their care and offering them support? 

>>MAGGIE MULLIGAN: Yeah. Absolutely. I can't speak for obviously the whole student population. But speaking as someone in Greek life, you know, going back to what Dr. Carroll said earlier, you know, we did follow those guidelines - these guidelines of if you get it, isolate. And you need to get out of the house for 48 hours right after. We followed all of these guidelines. And even with following those guidelines obviously the virus is spreading. Now the support that the Greek life has gotten from IU has been pretty minimal. As Dr. Carroll said, the Greek life houses work as independent institutions. So the problem we're seeing now is that we have girls that are testing positive in our sorority, and they're going to Home2 Suites which is what IU told us to do. But now you know that hotel is full. So really the support - there is some support missing from IU for students who are testing positive on campus. And we're kind of being seen as one big statistic instead of being seen as individuals who need help and who need resources once they get sick and how to prevent that from spreading. 

>>BOB ZALTSBERG: I'd like to follow up with you Maggie. I think you know when things happen like you know over Labor Day weekend very early you know that afternoon 2:00, there were social media posts of students identified as probably without any proof identified as fraternities and sororities. So I'm not going to blame fraternities and sororities but just students who were lashing together pontoon boats at the lake. I mean, they clearly weren't social distancing. And you know there's this sort of drumbeat that says well the students just aren't taking this seriously. They aren't paying attention to this. And I'd just like to get your response to that. I mean what do you see among the people that you come in contact with and other students at IU about you know how seriously they're taking this and how - what kind of responsibility they feel for the greater community they live in. 

>>MAGGIE MULLIGAN: Of course. I cannot speak for the population of students who have decided to turn their back on the virus and have decided to forego social distancing and wearing the masks. But what I can tell you is about the population of students that are hiding, terrified in their rooms of this virus. And they are not leaving their houses. And they are not even thinking about going within six feet of anyone. I mean, there are girls that have escaped just to go away from their roommates even though the roommates haven't even been exposed. They just want to avoid it altogether. I mean, really. Like these people that are gathered on pontoon boats and these people that are going out in public, yes, they can be identified as students. And yeah, maybe a lot of them are part of Greek life. But if you were going to talk about these gatherings, you also need to take into consideration all the people that aren't even affiliated with IU at these gatherings. I mean, have you really taken into consideration picking apart those groups of people and identifying them for who they are? I mean, I can say that when I drive through Kirkwood or like I see Lazhars gathering, I see a lot of people who aren't even in college. So I do not agree with these students who are gathering and who are foregoing all of these protocols that are in place. But what I do think we should be focusing on instead is a population that is completely against it and are scared of it right now. 

>>BOB ZALTSBERG: Sara? 

>>SARA WITTMEYER: I just wanted to give Dr. Carroll a chance to respond to is IU taking responsibility for students and how this is affecting the community of outside of the campus. 

>>AARON CARROLL: Well, yes. I'd first of all I'd argue that our goal all along has been to be - to make it safer to be part of the IU community than not to be in the sense that students are - I mean I think like Maggie said, Bloomington is our home. We have like eighty seven thousand students I think who are part of IU right now and about ten thousand, twelve thousand of them live in dorms. Another twenty four hundred, three thousand live in fraternity houses. And everyone else is not. They are part of off campus. They are in our communities. They live in Indiana. They are part of all of this. And online only or not online only, 70 80 thousand students live in Indiana or are part of Indiana or would have come any way because being part of college is living in Bloomington. And so knowing that, our goal was to create schemes to do a better job of symptomatic testing and caring for students you know medically when they get sick to, as Penny has said, invest significantly in contact tracing and isolation, to create large schemes for asymptomatic testing which do not exist in the rest of Indiana or in the real - the rest of the world, building up labs on campus. So eventually we hope to by October be able to do something on the order of 15000 tests a day, which will be more tests than the rest of Indiana combined because we want to make it as safe as possible. And that is our goal. We are monitoring groups all over. As like I said before, we are testing students, faculty and staff on and off campus at all of our campuses. And we're seeing a huge amount of success. Many of our regionals, as I said before, are you know flirting with zero percent positivity. And as we know, that is not the rest of Indiana. Even our dorm population, as I said, has been about 3 percent. And we would like that to be better. And as dorms have risen above 2 percent or so, we've done significant universal testing of them as we've done with the Greek houses. We move them rapidly into Ashton for quarantine or isolation where they are rigorously, you know, not permitted to leave because that - and some people may think that's unfair - but that is part of what we need to do in order to make sure that we keep that safe. And we're even monitoring our off campus populations to see where that is in case we needed to sort of nimbly move in and say these are not. For the most part it's being maintained pretty low. We do have some populations where it is much higher. We are working as much as we can to limit that. But we cannot control them and tell them exactly what to do. And so giving advice and then working with the county is sort of our best effort. 

>>SARA WITTMEYER: And Dr. Carroll, just one more question. We've gotten several listener comments just wondering how students are being reprimanded or punished if they are found to be violating the honor code. And particularly we've gotten questions about that incident at Lake Monroe. So is the university taking action against? 

>>AARON CARROLL: We're not a police state (laughter). And so it's very hard. As much as people think like we can take significant action, they're - you know we try very hard to work with students and not go nuclear. I think the one thing that would cause us incredible pause is if we found students were knowingly violating quarantine or isolation because at that point students are actively putting others at risk. If you're not hearing me get a little tense at that, I take that incredibly seriously because you know having a party when you shouldn't have a party - I wish you didn't but I get it. But knowingly violating quarantine or isolation, actively putting other people at risk when you know you are ill and infectious is a significant - not just infraction - against the rules but you know violation of the social contract. And so I imagine if it is determined that people in those pictures or who are you know hosting and going in and out or going to parties who are knowingly violating isolation or quarantine, then the university might be much more strict about enforcement. 

>>AARON CARROLL: We only have a couple of minutes to go. I want to ask Dr. Hrisomalos a couple of sort of basic questions. I know Penny mentioned flu season is coming up. So we had one question from somebody - and we've answered this before on the show but I just want to do it one more time - who asked if the colder weather was going to tamp down the coronavirus. And I believe the answer is no. Correct? 

>>TOM HRISOMALOS: I mean if anything - well, we found that the virus is not very - is not seasonal like we expected it might be. The fact is it didn't disappear during the summer during the warmer weather. And if anything, the colder weather enhances transmission of a lot of respiratory viruses. So I don't - we're not going to see - we're not going to get any help that way. It is critically important for people to get the influenza vaccine. And the question is why. Because we're all as medical professionals we're thinking OK, the fall is going to start and we're going to have people coming in with cough, cold, influenza and COVID and we're going to be struggling with trying to figure out who's got what and what - how - what actions we need to take. So the fewer influenza cases that confound us, the better off we will all be. And so that's the reason why it's very important to get the vaccine. Though ask - the one - another comment I wanted to make is you know really the energy and the planning on the part of students and IU and the public health folks is extraordinary. I mean, this has never really happened before. We've - resources and what we put together is really amazing to me to see it all come together. The problem is we just have a very tough adversary in this COVID. It's very transmissible and it's very serious particularly for high risk individuals. So we just have to persist. We have to continue working. We have to focus. And we have to do just a little bit better than we've been doing so far. 

>>BOB ZALTSBERG: All right. We're out of time. I want to thank you again, Dr. Tom Hrisomalos, for being with us today as well as Penny Caudill from the Monroe County Health Department, Dr. Aaron Carroll director of surveillance and mitigation for the COVID-19 pandemic at IU. And thanks for joining us, Maggie Mulligan an IU student who is in quarantine right now at Gamma Phi Beta sorority. I want to thank our producers Bente Boutier and John Bailey, engineers Matt Stonecipher and Mike Paskash, Sara Wittmeyer my co-host. And I'm Bob Zaltsberg. Thanks for listening. 

>>UNIDENTIFIED PERSON: Noon Edition is a production of WFIU public radio. A podcast of this program is available at wfiu.org/noonedition. Production support comes from Smithville - fiber internet, streaming TV, home security and automation in southern Indiana. More information at smithville.com. And from Bloomington health foundation. This September hosting the virtual 21st running of Hoosiers Outrun Cancer, a 5k run/walk supporting those in the community facing a cancer diagnosis. Registration and more at hoosiersoutruncancer.org.