20210820covidcarroll

>>BOB ZALTSBERG: Welcome to noon edition at WFIU. I'm your host Bob Zaltsberg hosting with Sara Wittmeyer, the co-host and news bureau chief of WFIU WPIU. We're talking with guests about the spread of COVID 19 vaccinations and mask mandate and we hope to address the myths during the program. Just our seventy seven thousand vaccinated people in Monroe County. It is one of the safest places in Indiana. State Department of Health label the county as a yellow advisory level one step lower than all surrounding counties. You can follow us today by sending us your questions to Twitter at noon edition. You can also send us questions using the email address news at Indiana Public Media dot org and you'll be talking with Sara and myself but also any Penny Caudill who's the health administrator at the Monroe County Health Department, Dr. Tom Hrisomalos, the infectious disease specialist with Indian IU Health and in the second half of the program will be joined by Dr. Aaron Carroll chief health officer for Indiana University and Professor. He's also a professor of pediatrics with the IU School of Medicine. So thank you very much for being here. I know you've you've been with us before Dr. Hrisomalos and Penny and we really appreciate all the time that you've devoted to trying to answer questions about what's going on and keep us updated on the situation with COVID. I want to start with the Penny Caudill today and Penny if you could sort of set the stage for where we are now. And we're starting to get a lot more cases again. I know we do a story every day at WFIU about what the state numbers show and the county numbers show and things aren't looking very good, it seems to me. Could you explain what's going on? 

>>PENNY CAUDILL: Certainly. Thanks for having me. You know I said the other day that I feel a little bit like deja vu that we've been here before. If people are following that the case numbers and the data they can see that you know where our numbers are rising and we're back kind of where we were last winter early spring. So we we were seeing lots of improvement but that has definitely went away. As you noted in your introduction in the state advisory Monroe County is in yellow. We have been there now for several weeks. But our numbers continue to go up. So our cases per 100000 are at a hundred and forty one. And just to keep in mind that every time we talk about a case we are talking about individuals who are set and those individuals some may have mild disease some will end up in the hospital and some may die. And we want to reduce that possibility. We want to reduce as much infection as we can, and that is is our goal is to improve this. If you look at that state map right now Monroe County is still in yellow. But we are surrounded by a sea of orange and some red. 

>>BOB ZALTSBERG: So what do you attribute the fact that we're in yellow in the Monroe County - I say we're - actually we've got counties all those counties around us that are orange are counties that listen to WFIU as well. Why do you think that Monroe has been able to stay in the yellow while the rest of the counties haven't been? 

>>PENNY CAUDILL: Yeah. Well that is a very good question and I'm not sure that I have an exact answer to it but I will say this one of the reasons that Monroe County reinstituted the mask requirement for indoor public places was because we had that surge in and cases and people with infection greater transmissibility we know that we're seeing the Delta variant which is much easier to transmit. Circulating has been in Indiana and nationally it's accounting for over 90 percent of all the cases at last I saw. All of those things and that means people - our vaccination rates were very good. We were making good progress and that started to slow. So the mask requirement was reinstated in early August so that we could try to contain and get a handle on this spread and slow it down. So hopefully that's part of the answer. I think that in general we have a population that does try to follow recommendations whether they're in regulation form or not. And that does help. 

>>BOB ZALTSBERG: So where are we now in Monroe County with the percentage of people who are vaccinated? 

>>PENNY CAUDILL: I looked at that just before I came on. And we just today had 58 percent of our full of our eligible people who are fully vaccinated. So we wanted to be at that 60 percent early this summer. So while I'm happy that our vaccination rate continues to go up I am concerned that it has waned and that we are seeing much slower uptake of vaccine. We've been doing outreach clinics and we often go ready and prepared and hoping to give you know 100 vaccines and we may only give two or three. 

>>BOB ZALTSBERG: All right. Dr. Tom Hrisomalos I wanna ask you just in general about what you're seeing on the ground from your perspective as well and then we'll get into some specific questions. 

>>PENNY CAUDILL: Sure I think we are seeing pretty much what Penny just identified. We have been seeing it and increasing cases the number of individuals hospitalized with COVID has gone up a good three fold or more. We're not as bad as we were about let's say in December and January where our inpatients census that the in the south central region hospitals Bloomington, Bedford, Bailey, Morgan is probably half of what it was at that point but significantly greater than it was back in early July. So we are seeing an increased number of cases. And some of those are fairly seriously ill including ICU patients and ventilated patients. 

>>BOB ZALTSBERG: Now Dr. Aaron Carroll is going to be on with us in the second half the program. And I believe that he's quoted as saying that this is a pandemic of the unvaccinated at this point. Would you agree with that? 

>>TOM HRISOMALOS: What we're seeing locally, yes. So if we look at our numbers of inpatients in the south central region we're well over 90 percent are unvaccinated. And only probably between 5 percent and 7 percent, some low number are vaccinated individuals. We look statewide at the IU Health System, half of the vaccinated people who are hospitalized have significant underlying medical illnesses that may have made the vaccine not very effective for them. So to answer your question directly, yes. Most of what we're seeing is serious disease in unvaccinated individuals. 

>>BOB ZALTSBERG: So I wanna - through the program today I want to ask you a lot of questions and I think you've probably been asked before probably even by me about some of the myths. I'm calling them myths but some of the reasons that people won't get vaccinated to try to get to the bottom of it trying to get the science behind it. Like, for instance, do breakthrough cases with people who are fully vaccinated against COVID 19 mean mean that the vaccine is ineffective specifically with the Delta variant. I guess that's just a general question. 

>>TOM HRISOMALOS: Yeah. I would like to address the myth question and say two things first. Once we see both myths about the disease itself and then certainly myths about the vaccine to prevent it. Myths about the disease itself include things like that most young adults you know are fine and don't have significant illness. I mean that's just not true. We see a lot of people, even though they may not be hospitalized, young adults who have protracted persistent symptoms that are quite bothersome to them. Myths about the vaccine are many many. To address your question about how effective the vaccines are, what has been of concern is there - they have been noticing some decrease the effectiveness of the vaccines in preventing illness. Still good protection against preventing severe illness hospitalizations and so forth. But some perhaps decrease in effectiveness against asymptomatic or mild infection Six to eight months after people have been vaccinated. And to be proactive to prevent problems - that's why they're discussing additional booster doses these vaccines are very good. And it's not expected that you know a vaccine like this would necessarily provide lifelong immunity. 

>>SARA WITTMEYER: I'm going to ask Penny about the county's mask mandate and just how that's being enforced because it does seem kind of hit or miss. Certainly it's not universal that people are wearing masks indoors at least in my experience. 

>>PENNY CAUDILL: Yeah. And that's a good question and the answer is we have dealt with this since the beginning when mask mandate first started and was even put in place by the governor. Any kind of regulation, again whether it's a health regulation or police you know traffic regulations, not everybody is going to follow it. And there are processes for handling those things. What we always try to do is to educate and empower people to understand why the regulation is in place, what's required of them and get voluntary compliance. So we are using the compliance officers again. They were helpful to us last spring. And so we are using them again. We started - we wanted to make sure that businesses understood that the mandate went back into effect what it meant. And so we've really been focusing on trying to educate provide signs and information to businesses and then deal with them individually, right? So if we go into a business and they don't have signs, why don't you have signs? Do you realize that this mandate is in place? We can help you get the signs you need those kinds of things. We have renewed our complaint line. And so people can file a complaint and then we will follow up on those. So that's kind of the process really that right now we're focused initially on education making sure that people understand and we get calls every day does this apply to me or not. But it is indoors in public places. So if you are a public business then people can walk into your business then yes it applies to you. And that's been the question. We've not put back a lot of the other things that were in the previous orders. We would like to not have to do any of that. And so we're just asking people to follow the CDC recommendations. That's what our mandate is built around that - because of potential for those cases with for instance breakthrough cases we have dealt a variant that people are more contagious or as contagious if they do have a breakthrough case. And we want to protect everybody. So the new recommendations for even fully vaccinated people were that anybody indoors in public places should be masking at this time. And so that's what the current health order is built around. 

>>SARA WITTMEYER: I gotta say here locally I do feel sorry for people who - you know servers and things who are having to turn people away since we don't have a uniform state mask mandate or anything. I think that's probably a really difficult job right now. 

>>BOB ZALTSBERG: It is. And you know - and I try every chance I can to just say you know we all need to - everybody is stressed and certainly would like this pandemic to be over, right? That it has taken a toll on everybody. And I think that we just all need to kind of take a breath and remember to be kind somebody you know in that business whether it's a greater at a store or a server in a restaurant. They're doing their job. And they're trying to do the best that they can. And that's really what we look for as well when we go into these businesses. And we follow up on complaints is how - you know, are they really trying? Are they doing everything they can to comply and to get compliance. The compliance officers that we have can sometimes assist them in modeling or teaching how you might be able to to approach someone which I think the easiest initial thing is to say it looks like you forgot your mask or didn't realize we have a requirement locally in the county. But we have one for you and you know hopefully people will accept that. And - but this is a community. You know you've got choices and if you are in a business that requires them that falls under this mandate then you either need to go and follow the the law or I would say not go that there are some some exemptions and that can complicate kind of being able able to observe compliance as well. 

>>SARA WITTMEYER: We got a question Penny about schools that are not enforcing the requirements. So what about those? I mean I know we've done some reporting about Seven Oaks classical schools saying they were not going to require masks to be in there at the county. 

>>PENNY CAUDILL: Sure. So we we have a process for schools as well that the current order does say that they shall follow the CDC guidelines and the Indiana Department of Health guidelines. And so those guidelines are that schools should be everybody again indoors and in schools should be masked at this time. And so that is the expectation with this order. Again, we take every possible avenue we can to get voluntary compliance and if we don't reach that then we can issue fines or citations. There is a process for those to be appealed or paid or were dealt with. And you know we never want to end up in court but sometimes that can happen. 

>>BOB ZALTSBERG: If you have questions today about COVID 19 where we are right now with the the regulations are as Penny just talked about or who should get a boost or any kind of questions, just send them to us at News at Indiana Public Media dot org or you can follow us on Twitter and send us questions there at noon edition. Dr. Hrisomalos I have a couple of specific questions I want to ask you these are reasons why people have given for not getting the vaccine. And I wanted to have give you a chance to address that based on the data or the science. Do MRNA vaccines like Pfizer alter a human's genetic code or potentially lead to cancer? 

>>TOM HRISOMALOS: So the answer to that is no. Messenger RNA vaccines, the messenger that is in the vaccine goes into the is absorbed into the cytoplasm of the cell. It does not go into the nucleus. It does not interact with the DNA. It does not alter the DNA and there is no genetic alteration or risk of cancer. 

>>BOB ZALTSBERG: All right. I've heard some questions asked about whether the vaccine could harm the fertility of young people who might take it. 

>>TOM HRISOMALOS: Sure. They've looked firstly at issues in women who baby desiring to be pregnant or women who are pregnant and they've obviously looked at many women who have been vaccinated and have not identified any issues that would impair fertility that would complicate pregnancy and in fact the major health organizations such as the American College of Obstetrics and Gynecology and so forth now recommend that women get vaccinated and even that pregnant women especially get vaccinated because they are at increased risk for serious complications of viral infections including COVID. So it's important to protect them. And the vaccines have been found to be safe in that population. They have been continuing to look at all kinds of issues regarding fertility and sperm counts and men and so forth. And as of present, no. There does not appear to be any significant complications or problems in that setting. 

>>TOM HRISOMALOS: One that's a little bit about about history and perspective. A lot of people just say you know what I don't want the government telling me what to do. It's my body. And if I don't want to get a vaccine vaccination, I don't have to. Aren't there - I guess I'm asking this way - aren't there certain vaccinations that that people are required to get for going to school or for certain reasons or am I wrong about that? 

>>TOM HRISOMALOS: No. There are. And there have been for you know many many many years. That's always a difficult issue to address because certainly people have the rights to make decisions about themselves and so forth. I would just emphasize to those individuals that it's not all about you as an individual. It's about your actions helping to protect those around you who may not be as fortunate as you are. That may not be as healthy as you are, that may not be able to defend themselves. And they need the help of all of us. And the consideration of all of us in terms of a public health effort. So my response is it's just not all about you. 

>>BOB ZALTSBERG: OK. One last question along these kinds of questions. Can you take the vaccine if you have an egg allergy? 

>>TOM HRISOMALOS: Yes. So when the vaccines were the messenger RNA vaccines, the Pfizer and the Moderna vaccines were initially rolled out, there were some allergic reactions. And of course that has been looked at very carefully and individuals who had egg allergies, penicillin allergies, medicine allergies bee sting allergies are not at any increased risk for allergic reactions to these vaccines. It appears that the rare allergy to the vaccine is related to a chemical in its manufacture. And that is not present in a lot of these other products that we're talking it's it's a polyethylene glycol which is actually a very common chemical. It's in cosmetics and it's in laxatives and it's and things of that sort. An allergy to that is actually very rare. But no, if you're allergic to other things it's OK to get this vaccine. 

>>BOB ZALTSBERG: OK one last one. I said that was going to last one for now. But one last one. We just got one sent to me by our producer that says you know my immune system will fight the virus off vaccines weaken your ability to naturally fight on sickness. Is that correct? 

>>TOM HRISOMALOS: No. Absolutely untrue. Firstly in many individuals who have relatively mild infection with this COVID virus do not generate a very strong immune response. And we indeed have seen individuals with COVID more than once their first infection last spring and now another infection again this year or back in December or so and so the natural immunity against this virus may not always be as good as we hope. The vaccine boosts your immunity and in fact individuals who have had COVID and then get the vaccine afterwards have the best immunity of anybody. So it enhances, it augments, it improves the immunity in everybody including the people who have had COVID. 

>>SARA WITTMEYER: One quick follow up to one of Bob's myth buster questions. But another question I know we got was about antibiotics. If you're allergic to a lot of antibiotics, will that - yeah. 

>>TOM HRISOMALOS: Yeah. That does not appear to be a risk either so medication allergies do not cross react with these vaccines. So no dog if you are allergic to penicillin or something of that sort it's A OK to get the vaccine. 

>>SARA WITTMEYER: OK. And another question, doctor, as well is can you talk a little bit about kids in schools right now and being unvaccinated. Do you have any sense of where we are in terms of getting a vaccine and why the vaccine we have now isn't suitable for children? 

>>TOM HRISOMALOS: Well it's not that it's not suitable. It's just that the FDA would will not give emergency use approval or approval for those vaccines until they have the data in that age group. And so the data that's been submitted to the age group has been for 12 and above for Pfizer and 18 and above for Madonna and Johnson and Johnson. The data for younger kids under age 12 has been submitted to the FDA and everyone is anticipating that the FDA will give approval for the vaccine for younger children sometime hopefully early this fall. 

>>BOB ZALTSBERG: All right. We are about halfway through the program now. And I want to give you our numbers again. You can find us or you can send us your questions, news at Indiana Public Media dot org and you can also follow us on Twitter at noon edition. We have Penny Caudill from the - the health administrator for the Monroe County Health Department with us. That was Dr. Thomas Hrisomalos infectious disease specialist with IU Health. And we are also being joined now by Dr. Aaron Carroll, chief health officer at Indiana University also professor of pediatrics. And this is a really good time to ask you Dr. Carroll about that children. You recently published you had an article published in The Atlantic that made a case for vaccinating children under 12 years old as soon as possible. And I wanted you to talk about that then. 

>>BOB ZALTSBERG: Well thanks for having me. You know I think that article was was you know a preemptive measure because of course vaccines have not yet been approved for kids at that age group. 

>>AARON CARROLL: But to try to at least get out in front of the many questions and concerns of parents who might be questioning whether they should vaccinate their kids. So you know of course when we shut down schools about a year ago or even more than a year ago last spring, you know the concern was not so much that you know kids were at major risk but the kids could actually be a vector of transmission to parents or certainly grandparents who were at major risk. Of course now that we vaccinated most grandparents and vaccinated a lot of parents, the question now turns to well what is the risk to actual kids. A lot of people minimize that and say it's not that great. It's not that big a deal. But the risk is still there. You know three at least 350 kids have died of COVID and last year probably more. Many many many thousands have been hospitalized thousands have had MISC multi inflammatory syndrome COVID which we really don't understand that well but appears to exist. And that's real. Those are numbers that are worse than almost any flu season that we've had. And that shouldn't be minimized and we would absolutely advocate to immunize kids against flu. But of course you know kids are part of our community. And in addition to the danger that they pose to the danger that's posed to themselves there's there's danger to everyone else. And the more people that are unvaccinated in the community the more people that get covered the more chance there is for variance to rise and spread, the more danger than everyone else is still in the areas where kids are in hospitals and in ICUs, significantly increased numbers are mostly in areas and states where many people are unvaccinated which is of course a reason to get more adults vaccinated. But those numbers are increasing because Delta is more contagious. And kids can absolutely get Delta. And the only way that we can truly start to prevent the spread is to get as many people as possible vaccinated that includes kids the risks from vaccines are incredibly small the risks from COVID are real and much much larger. Even for children, the risks from the current vaccines are incredibly small but the risks while they can be smaller for children are still real for comfort and they're still real in the sense that they can spread out even further. People can get breakthrough cases and certainly we're seeing cases amongst the unvaccinated. So you know this is at the moment a theoretical discussion but hopefully in the next few months it will become a much more real one. And I think we absolutely can make an easy argument that the kids should be vaccinated as soon as we can. 

>>SARA WITTMEYER: I'd love to get your opinion just on what parents can do to protect their kids anymore. You are going to school in person where they're indoors all day. And is there anything they can do when they are all unvaccinated? 

>>AARON CARROLL: Well the same things I would argue that we need to do for all the time to prevent the spread of infectious diseases. The first and best thing we can do is get everybody around them vaccinated. If teachers and staff get vaccinated if all parents would get vaccinated, if everyone around kids who get vaccinated they would be much more protected than they are right now. So we don't have enough people in Indiana vaccinated. So that would be the first thing we can do. But after that, it's the measures that keep kids safe. It's you know masking as much as possible still works distancing as much as we can more outside time than inside time you know make sure we properly hand wash try not to eat in large groups. All of those things will help. Those things are harder at school but in most cases of coercion are not transmitted in schools. Now we can argue about the fact that cases pop up but most cases of COVID still come in social situations, birthday parties, sleepovers, get togethers you know riding in cars and going places those are the real danger points. Those where the real danger points all of last year we didn't have a ton of classroom transmission of COVID last year. And of course we had much less vaccination last year. I think schools if they do a good job are going to be pretty safe. The danger is everything that really happens outside of that. You know it's the same kind of argument we make at an IU level like we can. You know the classrooms are probably very safe. The danger points are bars their restaurants their parties. Those are the danger points last year. Those will be the danger point of this year. And so we need to do everything we can to be safe outside of those situations just as we are inside you know getting our soapbox for second we've never been good in America at protecting those who are you know and most need of protection during flu season year. I write columns begging people to go get vaccinated. Not enough did. Begged people to stay home from work when they're sick. But we don't have good sick leave policies. I beg people to do a better job of handwashing and you know staying away from others when they're ill or potentially symptomatic and no not exposing others we don't do a good job of that in general. Last year we did because of COVID and hopefully we learn something and we just need to continue that kind of behavior as we move forward. 

>>SARA WITTMEYER: So just a quick follow up. You mentioned vehicles and transportation. Is it safe for kids to be riding school buses? 

>>AARON CARROLL: Well I would - you know I think you know TSA - I think it is - ironically enough it's TSA guidelines I believe. But there are guidelines that all sort of public transportation should require masking which definitely would help inform what I'm talking about car rides. Those kids aren't being - you know when you - I've seen it. When you don't think we put a bunch of kids in the minivan they're not wearing masks. That's where the real danger occurs. Masking will help. Certainly the better ventilation we can. Hopefully they're on the bus not that long. So it's is the danger here is the risk greater than zero? Sure. Is it huge? Probably not. You know we usually see I think more transmission when people are unmasked an altogether for significant periods of time. And hopefully on the bus rides up and back to school, they're not as long. We can keep them well ventilated. And hopefully we'll mask them up and that'll protect things much much more than they otherwise would. 

>>BOB ZALTSBERG: So Dr. Carroll just said - prompted a question from me I'm going to ask Doctor Hrisomalos to talk about it first. The both of you can. All three of you can. And that is do we have an opening here to try to get more people vaccinated by saying you know what? Again some holidays coming up. I mean last year at this time or not not this time a little bit later we talked about the fears about Thanksgiving, the fears about Christmas where people are going to be coming together. They were unvaccinated. They could be super spreader events. I mean can we - is this an entree into trying to persuade people to become vaccinated just maybe it's not too early to start thinking about these holidays that are becoming Doctor Hrisomalos. 

>>TOM HRISOMALOS: Well I think certainly so. I mean I think we know that transmission occurs in those type of close group settings. And we know that if the individuals are vaccinated. They have a decreased risk of acquiring infection let alone serious infection. So you know I think there is a big desire among the among everybody to get our lives back to normal. And, gee, you know how many people do you talk to and said who say, gee, I'm tired of wearing masks? I'm tired of worrying about this? Well we do have a solution. If we could get large percentage of the population vaccinated and maintain that immunity we would get past this a whole lot faster. So yes, for sure. 

>>BOB ZALTSBERG: All right, Dr. Carroll, do you want to address that as well? 

>>AARON CARROLL: Well I mean I want to say I hope so. But I think science communication and changing people's minds is incredibly hard. And it is detailed like individual level work. We'd like to - all - we all want to believe there's a tweet or a simple like you know soundbite or a tick tock. It'll suddenly convince everyone who's not vaccinated to go get vaccinated. The people who can be convinced easily have been convinced the rest are kind of require more effort and resources and local input. Sometimes it has to come from trusted voices within a community and finding the right voice in the community can be difficult especially for people outside the community. I also think that you know finding out what exactly the reason people are resistant to vaccination is super important. It could be misinformation or disinformation. It could be mistrust of the health care system. It could be you know the fact that no one everyone's peers are not vaccinated it could be fear. It can be financial. Lots of people believe that these vaccines are expensive they can't afford them. It could be logistical. They just can't get time off. Well I mean whatever it is, figuring out what it is and then trying to work to overcome that barrier requires resources and effort and time and a lot of individual level commitment that we don't really often have enough of. And so I hope that you know appealing to people's sense of the holidays are coming up will work. I hope that people seeing more and more cases in the hospitals are filling up will work. I hope that positive messaging we keep putting out will work. But I think it's going to take still a lot of work and a lot of effort to get this job done. 

>>BOB ZALTSBERG: Just to make sure that everybody understands the vaccines are free to anybody. 

>>AARON CARROLL: Free. absolutely. 

>>BOB ZALTSBERG: Okay, Sara. 

>>SARA WITTMEYER: This is a question we got in for Dr. Hrisomalos. It sort of follows along with what we were talking about earlier but this is from Larry. He says several people I know with auto immune diseases such as rheumatoid arthritis are wondering if we developed an effective immune response to the vaccine. Is there anything we should be doing differently? And also does having an auto immune disease make you by definition immune compromised and eligible for a booster shot? 

>>TOM HRISOMALOS: Several parts to that question. Individuals with auto immune diseases per se are not necessarily more susceptible to this infection but individuals who are on immunosuppressive therapy certainly are and those individuals particularly who are on for example steroid therapy or we're on to minute closest factory inhibitors who have rheumatoid arthritis who are being treated cancer patients HIV patients organ transplant patients all those individuals are at increased risk. We don't have great routine testing that can tell us whether or not they've responded well to the vaccine before most of the antibody testing that's available is qualitative positive negative. And we - and although there are some tests that are being developed that could tell us better whether someone might be protected or not. Those are not the routine ones that you might go get available anyway so the FDA did approve booster vaccines for those individuals who meet certain criteria of immune suppressive diseases or therapies and those can be obtained now if you fall into one of those categories those booster doses can be given and even individuals who did not respond to the first two doses a good percentage of them may well respond to a third dose. And so that's certainly worth doing. 

>>BOB ZALTSBERG: Want to follow up on that and maybe Penny - Penny you sent out a press release yesterday that was about the the booster shots and you know I've been reading a lot about it because I feel like I fall into one of the categories that might be able to use a booster. And a lot of places I've read have said things like eight months after your second dose you should get it. I think what your press release said yesterday from the CDC was 28 days after your second dose would be fine to go get a booster. Can you talk about what the regulations are now? 

>>PENNY CAUDILL: Yeah. So I guess to clarify because I think so many times people get confused. There's lots of conversations going on right now about this third does for people who are immunocompromised and there's kind of a short list if you will of those individuals who does third shot is being recommended for. 

>>BOB ZALTSBERG: And then there's talk about the general population - more of the general population and a booster dose which may come this fall, right? So that the third dose that doctors smallest was talking about if you fall into one of those categories you can get it. Now there wasn't a specific - it was just that it should come at least another month after that second dose that your original got. So yes. When we talk about those boosters that may come and may get approved later in the coming weeks or months, that's where they're really talking about after that eight months. Does that answer your question? 

>>BOB ZALTSBERG: Yeah absolutely. Absolutely. That clarifies it. I appreciate it very much. Dr. Carroll we've got students are coming back in great big groups this weekend and they've been coming in all week. We've heard - I think I've heard the term 90 percent are vaccinated of IU faculty and staff and students. Is that correct. 

>>AARON CARROLL: So we'll actually be I believe updating our dashboards with public information. It's kind of - I mean it will be differentiated by campus a bit. I think the numbers we've released so far broadly are for all of our campuses. You know approaching 85 percent impact at this point it might even be at 85 percent or more and it'll be different on each campus. But until those numbers I think get posted later today I think that's what I can say. 

>>BOB ZALTSBERG: All right. So compared to last year at this time when students were coming back. How do you feel about the - about our ability to make sure that we don't get into some sort of a serious spread and that students faculty and staff can stay well? 

>>AARON CARROLL: Well I mean you know the first the first and best thing we can do is get as many people vaccinated as possible which is why we enacted the vaccine mandate back in May because we just knew that you know high levels of vaccination were going to be more protective than almost all the other measures that we can do combined. That said we're still clearly masking up indoors at the moment. We will still be doing asymptomatic testing on those who are unvaccinated once a week. We're still offering significant amounts of you know symptomatic testing for everyone that needs it through our labs and our campuses as well as voluntary testing for anyone who wants to get tested, vaccinated or unvaccinated at any time. We have robust contact tracing quarantine and isolation for those that need it where we're set up with everything we have, you know last semester and more. You know if you'd asked me a year ago at this exact moment, I was panicking. I think I felt like I was having all the panic attacks every day because we had no idea how this was going to go. COVID was somewhat new. We were bringing people back together we didn't have a lot of what I just described we did not have our own testing facilities we could not test at the numbers we would like. We were you know sort of flying blind and open everything was going to go okay. And even though we had built up symptomatic testing the beginning of our asymptomatic testing, contact tracing isolation, it was all new. This year we're entering with all of that and it's significant levels of vaccination across all of our campuses. Eighty five percent you know some campuses higher and that will provide much more protection. I wouldn't say that we're, you know, overconfident or you know even that you know we're just not careful. Like we're still as I said before doing significant levels of asymptomatic testing of people who are not vaccinated will still be doing real contact tracing and isolation will still be following CDC guidelines of testing people who are close contacts, that three to five days just to make sure that you know we're not seeing too much spread even into the vaccinated population. And we'll mask up and be careful. But I believe that that vaccination works and I believe that because of it you know those that are you will be safer that than than those who are not at IU in the sense that the time we spend amongst each other at IU is amongst an incredibly vaccinated population. I wish Indiana was at 85 or 90. I really do. I - that is not the truth. Most of the serious outcomes that we're still seeing in terms of hospitalizations or worse ICU and you know God forbid death are so so so much skewed to unvaccinated people. And we're going to do our best to get the last few people that you vaccinated if we can. But we really do believe that the time people spend you at work and at school will be amongst the safest time they will because because there is such a high level of vaccination. But of course we watched all the data will be super careful. And we'll be monitoring. And if we need to make further adjustments we will. But I definitely feel better going into this semester than I did last or last fall. 

>>BOB ZALTSBERG: So just to clarify will there be a vaccination clinic that is open to students and also Penny in Monroe County? Can people walk in anywhere or somewhere and just get a vaccination on demand? 

>>AARON CARROLL: Well I mean we we still I believe vaccinate our student health clinic. And we're doing so but but I mean we should be clear. I think you know one of the reasons that we stood up a site on IU's campus last year was one to help serve the community because there just wasn't enough vaccine as well as of course to serve his constituents and the broader community in Bloomington. But at this point vaccination is widely available. The problem is not demand - the problem - or the supply. The problem is demand has gone down people can get vaccinated same day walk in most drugstores. In most you know lots of supermarket chains not to mention many many many other sites. And so while we did offer vaccination for everybody checking in for instance to I use dorms there was not a huge amount of uptake other than what we had preschedule because you know people were coming from international at this point again. The problem is not supply. It's that we just need to convince people to go get vaccinated who are still unvaccinated and so we certainly would stand up infrastructure if it was needed because of all of a sudden a massively increased demand. But we're just unfortunately in Indiana not seeing that demand. 

>>BOB ZALTSBERG: Penny anything to add? 

>>PENNY CAUDILL: Certainly. Thanks, Dr. Carroll. Because that did that to everything that he said and you know that that site over time like other sites saw less and less demand. We continued to do vaccination clinics. We have what we referred to as maternal Mondays on Miller Drive. And if you can make an appointment you can still use our shot dot IN dot gov to do that. But we talked about at the beginning of the show we do have outreaches planned. Our big outreach really starts in September with schools. So we usually do flu vaccines in our public schools and out and some of our private or charter schools and we are doing that again this fall. And we'll have COVID vaccine available for students who are 12 and over. So parents can you know provide consent and they can take care of that flu vaccine and the codeine vaccine if they have not already done that. So that will be taking up a lot of our time this fall and then we'll be looking at how we might be able to enhance other provide additional time. But as Dr. Carroll said providers offices now have vaccine in many of those. So it is much easier to get than it was when we started this process in December, January, February. 

>>SARA WITTMEYER: Question for Dr. Carol that we actually got a couple weeks ago when the mask policy was reinstated which is, why it was the mass policy reinstated since the vaccination rate is so high? And was IU compensated in any way to participate in a study about masking? 

>>AARON CARROLL: No well first of all I was like I have no idea if there is a study going on of masking and whether or not some part of IU might have participated in it. But I can tell you I'm not aware of it. And that was not the reason that we did. I do think it's a reasonable question to ask. And it's certainly one that we discussed because as I've said quite publicly in webinars and everywhere else the CDC makes those recommendations and you know in the sense that like they're trying to identify areas of substantial or high risk of transmission and then recommend that people mask up in those areas. And the only way that they have to define that is crude. It's cases per county because that's what's available to the CDC. They're not looking at vaccination rates or is this building safer now building or is this campus safer. They're just saying cases per county and to their credit you know Monroe County is this following CDC guidelines and saying where substantial are high and we're doing what the CDC says. Now we could make an argument - and I think it would not be totally incorrect that perhaps the risk of transmission in IU's buildings would be low because we're so vaccinated. But we don't know and we don't know yet. And maybe we'll have more information on that in a few weeks as everybody comes back to campus. But given the fact that this is the CDC recommendation it's Monroe County you know passes rules. We're good citizens. And we're following along with what's going on. And as other campuses including those other campuses that have required vaccination have also decided to open with masking in order to be extra safe. I think that we're going to you know try to be safe and follow forward. It was not about receiving compensation for doing a study it's about trying to be safe as we reenter the school year. We're certainly going to keep an eye on things and on many of our campuses. If things look incredibly safe as we move forward and it turns out we're just not seeing spread or anything else, you know we may risk revisit that decision and we may do it campus by campus based upon what we're seeing. But you know certainly given that the last year the real surge that we saw was right at the beginning of the semester, it's probably best to enter the semester with a little bit of extra safety and then back off then to not have that safety and then to play catch up. 

>>SARA WITTMEYER: Penny at the beginning of the program. You mentioned something about you know we have the mass in place now and if we have to you know we can look at other restrictions. Is that something that the county is actively talking about now or are you just in a wait and see? 

>>PENNY CAUDILL: I certainly did not mean to imply that we are know awaiting further restrictions. 

>>SARA WITTMEYER: Oh no. And I'm sorry. I don't think you did. But yeah. 

>>PENNY CAUDILL: Yeah we don't - you know, we don't want to have to put any further restrictions. I think the answer is that you know we we are in a different place than we were this time last year certainly and with vaccines. Things are better in that respect. We want to watch and just take those steps that are reasonable and needed and nothing more restrictive than what we really need to do. So with the Board of Health and the health officer and our community partners IU, IU health - got up a whole host of people that we communicate with regularly to make sure that we've got information sharing and and be able to look at what's going on and make decisions for the community as we need to. But I will go back and say, and I think everybody has said it so far. We have the tools to get over this and get over this hump and not need a lot of regulations but we have to use the tools that we have and that vaccination masking our hand hygiene staying home when you're sick you know it is still isolation and quarantine protocols are still needed. All of those things are still things that we need to practice and do. But we have the tools. We just have to use them. 

>>BOB ZALTSBERG: All right. We have less than a minute to go. Dr. Hrisomalos I want to give you the last word. Penny pretty much summed it up. But I was going to ask you also you know what do we need to do now to get back to closer to being normal? 

>>TOM HRISOMALOS: Certainly I guess I would emphasize that we know a whole lot more than we did last year. We're better prepared than we were last year. But we're still learning and there are a lot of questions out there. How long does immunity from the vaccines last? What about breakthrough cases how transmissible are people? So we want to be cautious. We want to be ahead of the curve, want to be preemptive. And that's the way we can get back to a more normal life. 

>>BOB ZALTSBERG: All right. Thank you very much. We've had three great guests today. And I think we've provide a lot of information. Penny Caudill health administrator for Monroe County Health Department Dr. Thomas Hrisomalos infectious disease specialist with IU Health, and Dr. Aaron Carroll chief health officer for Indiana University. For my co-host Sara Wittmeyer, for producers Holden Abshier and Bente Bouthier and for engineers John Bailey and Mark Chilla. I'm Bob Zaltsberg. Thanks for listening to Noon Edition.