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Next Steps In Responding To COVID-19 In Monroe Co.

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>>UNIDENTIFIED PERSON: Production support for Noon Edition comes from Smithville; fiber internet streaming TV, home security and automation in southern Indiana. More information at Smithville.com. And from the Bloomington Health Foundation partnering with local organizations and citizens to invest in programs that address our community's health needs. Bloomington Health Foundation, improving health and well-being takes a community. More at BloomHF.org. 

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>>BOB ZALTSBERG: This is Noon Edition on WFIU. I'm Bob Zaltsberg from the WFIU WTIU newsroom. We're recording the show remotely today to avoid the risk of spreading of COVID-19. I'm co-hosting with Sara Wittmeyer with WFIU WTIU news director. We have a packed program today talking with city, county, IU and health officials about the next steps in responding to COVID-19 and the next phase of the opening up prospects that we have here in Monroe County. Our guests are Julie Thomas, the Monroe County Board of Commissioners president, Mayor John Hamilton - Bloomington Mayor John Hamilton, Kathy Hewett the Monroe County Health Department lead health educator, Dr. Tom Hrisomalos with IU Health southern Indiana physicians. And he specializes in infectious disease. And Kirk White assistant vice president for strategic partnerships at Indiana University. You can follow us on Twitter today @NoonEdition. Can also send us questions to the show at News at Indianapublicmedia.org. As I said, we have a lot to talk about today, and I want to start with Kathy Hewett because the Monroe County Health Department has issued a new health order. And I know you've had a lot of input on it. But Kathy, if you could sort of explain what the new order says when it's going to go into effect I'd appreciate that. 

>>KATHY HEWETT: Hey, good afternoon, everybody. I am happy to do that. The new order that was created and signed by Dr. Sharp will actually go into effect on the 30. And it will last until June 15. And what it does is it moves Monroe County into the stage three of the governor's back on track plan with the exception of the size for social gatherings in size three for the state as a whole. The gathering sides can be up to 100 people. In Monroe County, that'll be limited to 50 people. 

>>BOB ZALTSBERG: What are some of the key changes going from two to three? 

>>KATHY HEWETT: Some of the key changes will it be that retail stores and malls can increase their capacity to 75% and the mall common area will be 50%. Adult daycare services can open. Race ways can open without spectators. And gyms and fitness areas can open with the following guidance and restrictions. 

>>BOB ZALTSBERG: OK, those are just a few, I'm sure. We'll talk about more of them as we go along. I wanted to ask Julie Thomas County commissioners president and John Hamilton the Bloomington mayor and Dr. Tom Hrisomalos who's an infectious infectious disease specialist to talk about. And I'll go with Julie and John. And John, first, to talk about why it's OK to move on to Phase 3. The state, the city and county, Monroe County has been a little slower to move forward. What are the indicators that you're looking at to say it's OK to move forward at this point? Julie, want to go first? Thank you so much for having us here today. 

>>JULIE THOMAS: We are guided by the data and science that we get from IU health Bloomington Hospital and also from, of course, our health department and Dr. Sharp. So they're the ones who are looking at how all of these numbers work together. But we - some of those data points include the bed usage at the hospital but also the infectious rate among those tested. And we're fairly low on that number. But there are so many computations that go into it. And we rely on your great guidance with data and science. And it's - but staying in these less restricted times is going to require that people wear face coverings when they're in public and keep social distancing, stay home if they're ill, get tested if they're ill and to wash their hands regularly. And that's a pledge that we've all signed. It's going to be very important to do that in order to allow us to continue to loosen restrictions. But if things change, we will immediately follow the guidance of our health department and we will make things a little bit more restrictive because we want to protect the health of our community. 

>>BOB ZALTSBERG: All right, Mayor Hamilton. We can't hear you, mayor. We seem to have lost the mayor. Let me go on Dr. Hrisomalos. So what kind of things have you seen that indicate that this is a good move? 

>>TOM HRISOMALOS: From the standpoint of, you know, are IU Health Bloomington Hospital, we have seen significant decline in our inpatient census for Cuban patients. At present, we tend to have - whereas back in middle of April, my gosh, we probably had up towards 30 patients in the hospital at a time where our census is running low. Maybe, you know, three or four cases at any one time. So we clearly have seen a decline and it's certainly much more manageable. The other insight that I think we could share from the hospital experience is that these measures that sometimes are unpopular. The social distancing, the wearing masks and things like that do indeed work. You know, we were on the - the hospital was on the frontline of this and initially we started isolating COVID patients and health care workers wearing personal protective equipment. And we found that that worked. It stopped transmission to the workers in the hospital, but we found that there were asymptomatic patients in the hospital who did indeed spread infection to other individuals and health care workers not only our experience but experience all across the country. What we've identified is that as soon as patients, for example, coming into the emergency room were put on masks and health care workers 100% of the time in all areas everywhere wore a mask all day long, all the time all that transmission stopped. And so these mechanisms that can be used to help reopen the economy and can be used in the public are indeed effective. And we have good evidence that they work. 

>>BOB ZALTSBERG: All right, so we have Mayor Jon Hamilton back. Mayor Hamilton, we were asking about what were the measures that you were looking at and how comfortable are you that it's a good time to move forward. 

>>JOHN HAMILTON: Thanks. I'm sorry about getting dropped off, but can you hear me now? 

>>BOB ZALTSBERG: Oh, yes, sir. 

>>JOHN HAMILTON: OK, good. And it's nice to be with you. I'll apologize about that. And I didn't hear everything. But look it's kind of a strange combination of very good health data that we have right now as has been mentioned the hospitalizations are low and the incidents overall appears to be low though, of course, we don't really have good prevalence testing, which is a key thing. On the one hand, that data is good. On the other hand, you know, national information and kind of the experts talking about where we're headed over the next months is very concerning. So I appreciate Dr. Tom. I'll call him that. He's my doctor. Nice to see you, Tom. So - hear you. We have this strange combination of where on the one hand the data look good here now, on the other hand we hear really significant concerns about resurgence and problems. And I think what I would say most is let's really think about the cost benefit of the incidences doing things like wearing masks and continuing to limit social gatherings and large gatherings. Those - we can do those things without a high cost in a lot of ways. Sometimes it's a pain and it's, you know, we don't like it but if those things can really help us avoid a resurgence or potential resurgence they do seem quite important to me. So I think we have to be very careful. I don't - I actually do not like going to 50 people for gatherings. I think that's, from my perspective, that's a little - we need to let the data catch up and see where we go. 

>>BOB ZALTSBERG: So let me clarify, Mayor, the 50 people is still- the 50 people are still supposed to practice social distancing. So they shouldn't be closer than 6 feet from each other, correct? 

>>JOHN HAMILTON: Well, we recommend that, but there is not a legal order that is enforceable so far as I know in, for example, on somebody's lawn or somebody's home. There's no legal requirement that people do that. We don't have a requirement that people wear masks. We encourage it. We don't have requirements that customers at a restaurant wear masks. We require workers to wear masks in restaurants, but not in retail places. So there's a lot of really good practices that we can and should encourage but it's a question of, you know, what is the requirement that we are going to live under. 

>>BOB ZALTSBERG: All right. Let me welcome Kirk White back. Welcome back, Kirk and thank you for your service. I want to ask about the university's plans. There are a lot of plans that were released this week. So, you know, I don't want to go through the entire plan but if you could just give a highlighter to them. What went into the idea that you you do want to bring students back in the fall? 

>>KIRK WHITE: Thanks, Bob. And it is good to be back and appreciate joining the group of leaders today on the call. Yes, the university did announce this week that we want to get their operations back up and running. We've had over 180 different faculty staff and students working on planning. This continues, of course, well through the summer, but I think the most important thing that we see in Bloomington is that it's essential as a residential campus to drive on with our research, with our teaching, with our service because it's essential to the state and to the nation, the things that we're doing. And so that's why we're going to work even harder over the next couple of months to make sure that we can come back safely in the fall, in really three of the three pieces of the academic calendar with fall semester starting on the 24 of August running through the 20th of December and a special new winter session, which would be an intensive session all online or distance 30 November through the 7 of February. And then spring semester would be 19 January through the 8 of February with all online until the 8 of February. And then we would start some in person on the 9 of February. 

>>BOB ZALTSBERG: So essentially students would be here until Thanksgiving and then not come back until February 7. 

>>KIRK WHITE: That's right. They could come back sooner, but the instruction would be online until the 9th of February. And we've cut out the Thanksgiving and spring holidays because we want to limit the amount of travel and additional exposure. 

>>BOB ZALTSBERG: Sara. 

>>SARA WITTMEYER: We've gotten a number of questions. This one for you, Kirk. It's actually a two-parter. How will university work with and educate the community about staying safe this fall after students return? And then the second part, how will it work with businesses that are favorites of students? 

>>KIRK WHITE: Well, those are good questions, and I - you know, as I've talked to Provost Robel and looked at the planning that the campus is doing she sees this as an extraordinary opportunity for us to educate this generation of students about their responsibilities in society and to each other. And that's what we're going to focus on. It will be intensive education for our students. They will be required to sign a commitment, a responsibility, will have some online courses that explain the kinds of safety and responsibility things they should do with the normal protocols that we've all discussed. And we are hoping that, of course, they will follow this not just on campus but off campus as well. It's much more difficult for us to enforce that off campus, but we will work with the community as we always have, whether it be an off-campus housing or other safety initiatives. We're committed to doing that because we're interdependent. The city, the campus, the county, we all have to work together. 

>>BOB ZALTSBERG: You have questions or comments for our panelists today. You can email us at new@indianapublicmedia.org, and you can also follow us on Twitter @NoonEdition. So we - think to follow up on that question was with Kirk white and with the mayor and Julie Thomas, the idea of the students coming back, I think, does make a lot of people nervous because, you know, as one business owner I was talking to this morning who actually sent us that question, you know, her business is still open. She sees a lot of students now who, you know, never, didn't leave. And that, you know, they come in groups. They don't social distance. They don't wear masks. You know, how are you going to bring the - How are you going to bring the community people together with the university to talk about these off-campus behaviors and try to work on that? And I guess I'll start with the mayor first. I mean, how involved have you been in these conversations with the university? 

>>JOHN HAMILTON: Well, we work very closely with university or a large employer or large institution, an integral part of the city, and we work regularly Lauren (unintelligible) Provost is meeting two or three times a week with us. And we will continue to do that. And it is a challenge. I think the education is critically important on this. But we're going to have a - and I think the word Provost Robel, there may be some cognitive dissonance. That's a IU fancy word, I guess, for - there may be very strict regimens on campus for mask wearing and for behaviors. But stepping off campus under the rules that may come both from the state and from local authorities as we are, they may be very different rules. Now how you get a population to accommodate both of those? And it's complicated because the health indicators are very good right now. But we also - it's kind of like you see a radar forecast of what may be coming at you and you're like, well, why should I put up boards on my windows now it seems good. But I do think we're going to - we'll be talking, and I know we will about how to manage this because public health is the first priority. And there may be a number of things that we can do that really protect health and support the economic restoration that we all want to see happen by doing some things that that may make all of that smoother. So it's it's tricky in each state. You know, you see states doing different things and different communities. And I look forward to working with the university on this. And I know they will be very intensive as they have been very intentional about how to keep everybody in their communities safe, which is also our community. 

>>BOB ZALTSBERG: Anything to add, Commissioner Thomas? 

>>JULIE THOMAS: Sure. I'll just add that we do get questions from business owners and others in the community who say why don't you require the use of face coverings in public. And the issue is enforcement. We certainly don't have that kind of capability to roam through the community and ticket people. And it's a very difficult thing. So we focus on the positive aspect of it. We wear our face coverings as a sign of respect and caring for the community, and we ask our residents to do the same. Those who choose not to they're sending a signal. And it's - so it's important to thank those who do wear their face coverings, who do practice social distancing. We're doing the right things because that allows our economy to rebound locally. It allows us to live in a less restricted environment. And so we do continue to ask people to follow those guidelines. 

>>SARA WITTMEYER: Kathy, we got a question for you wondering if the new stage that's going to take effect, whether the gathering size includes churches. 

>>KATHY HEWETT: OK. That's a really good question. So thank you. No, it does not include churches. Churches do not have a gathering limit. We are asking, though, because of the situation that they still do virtual services if possible, that there is no limit on the actual service. There's a caveat, though. Gathering size limits do include things that can go along with the actual church service like wedding receptions or funeral services after the gathering size. That applies to the limit, but not the actual church service part. 

>>SARA WITTMEYER: And I assume you're giving guidance about things like communion and those sorts of things. 

>>KATHY HEWETT: I know that we have talked with them many church leaders, and there are ways that they can do it. People can bring their own and participate. They should not share any resources or pass things hand to hand. 

>>SARA WITTMEYER: OK. And just another quick question here for you, Kathy. This is from Melinda, and she wants to know what is the difference between positive tests and COVID cases. Does a positive test constitute the case? Does a positive... 

>>KATHY HEWETT: I'm just - I'm thinking through it. It depends on how they're actually using it. Positive tests can mean all the tests that were positive. And a positive case would be all the people who are positive. So some people may have gotten more than one positive test. 

>>BOB ZALTSBERG: OK. I think that - yeah, that makes some sense. Good. We haven't - we've had a lot of questions about contact tracing, and I'm not sure who the best person to answer this. Maybe you, Kathy. But you're one of them had to do with the churches - or a large social gathering. Do we have enough to do the contact tracing necessary if there is a large social gathering? 

>>KATHY HEWETT: Yes... 

>>BOB ZALTSBERG: Beyond that - OK. Good. Let me ask you - well, go ahead and answer that, and then I've got another question. 

>>KATHY HEWETT: OK, the state has hired over 500 people to do contact tracing for the state of Indiana. So they have enough resources. Plus, there's other people, other state workers and even local workers that can be called in to help as needed. So there should be enough people to handle that. 

>>BOB ZALTSBERG: OK. We've had about three different questions come to us asking can they apply to be a contact tracer. They want out. 

>>KATHY HEWETT: They should contact the Indiana State Department of Health. They are the ones that are hiring for that. 

>>BOB ZALTSBERG: OK. Dr. Tom, I want to ask you - I want to bring you in. I would imagine that, you know, now that we're continuing to open up a little more, again, what are - I doubt that the key things have changed much, but have you seen certain things that are helping more than others. You mentioned the wearing of the face mask. Are there other key things that are going to help us as we start to open up? 

>>TOM HRISOMALOS: Yes, this is, of course, a very moving target, and we've been learning a lot over time. I emphasize to people that this is a dangerous virus. This is - it causes a lot of - can cause a lot of serious illness. I think about 10 days ago the south central region of IU Health we discharged our 100th patient. And I know in the south central region, which includes in-patient facilities, you know, Wilmington, Bedford, (unintelligible). We've had about 29 deaths. And so this is not a minor illness. The two other comments I would make is as we've learned more we've learned how to treat it in the hospital setting much better than we did before. We have access here in Bloomington to both the convalescent plasma that people have been - heard about and the emergency use drug remdesivir. You know, we're using both of those in patients that need it. And so we've gotten better about how to manage cases. In terms of opening up and prevention, I would just emphasize what other individuals here have already said. And that is there are just times when there are vulnerable individuals in our community and businesses that are taking - that are at risk. And in those times, you know, it's going to require some special effort on the part of all the rest of us in terms of following these rules, following the pledges, following the personal protective equipment the masks and so forth. And this is just one of those times. And I think we all got to step up and do it. I think if we can do that, if we can convince everybody that's the right way to do it, if we can get the Indiana University students to cooperate, we can be OK. And everyone's concern and worry is how successful will we be? 

>>SARA WITTMEYER: So another question that we've got, this one is from Laura. And I think Dr. Tom you might be able to answer this. But she says if cases and deaths both continue to increase but hospital beds and ventilators are at acceptable levels, does everything then remain open? So maybe Dr. Tom you can chime in and then Kathy. 

>>TOM HRISOMALOS: Well I would say that these things will go hand in hand. If we start seeing an increase in cases in our community and an increase in community spread, we will see an increase in hospitalizations and deaths. I mean, so it's not one or the other unfortunately. 

>>KATHY HEWETT: Yes. I can agree with that. One thing we also did to pull into this though is we've had an increase in testing. We have a new facility that is doing a lot more testing now. So our numbers may go up. Hopefully our deaths will stay the same. But as when you test more for a disease you often find more cases. So it might just be related to that as well. But we're watching the numbers every day. We're watching it from multiple sources, and, if we see a surge, we're definitely going to be talking with the hospital and trying to ensure that we're doing everything we can to keep the numbers as low as we can. 

>>BOB ZALTSBERG: Kirk White, I know you are going to have to leave us a little early. You've still got 15 minutes or so to be with us. But I wanted to follow up with you about something you said earlier. You talked about you know the provost Lauren Robel who wrote quite an eloquent piece for the faculty, staff and students who might have read it. What kinds of education efforts are going to be done? I mean, are these going to be, you know, outside of the regular academic classroom? Or you know - you said they have to sign a pledge. How are you going to make sure people read the pledge? How diligent can you be? 

>>KIRK WHITE: Well, that's a good question. And we've had some experience with this because we asked students to agree to other pledges as they become students. For example, at the freshmen induction ceremony we ask them to agree to a code of conduct for the campus and for their activities while they're a student. And what is being looked at now is perhaps a special online class that would be required for students to go and complete that would be on our online delivery platform on Canvas so that they could - like any other class - they need to take this to understand exactly what the expectations are and the importance of them following it all. And you have to remember of course that, you know, our students come from all kinds of backgrounds. Some countries that they come from, for example, are very comfortable with all this and are used to it. Others aren't. If you're in a rural Indiana community, in many cases, this is not a priority and it's not a problem. And so we've got to get them up to speed with what our expectations here are at the Bloomington campus. 

>>BOB ZALTSBERG: All right. I know with - you know you've got some faculty that are going to be more comfortable going into the classroom than others because of age, preexisting conditions. I would assume that is the same - I know it's the same with students. You know, I've known students who have had autoimmune disease of some sort that caused them to miss class already. I mean, how are you going to deal with those kind of issues when you've got some people that just aren't ready to go back into the classroom? 

>>KIRK WHITE: That's right. And we're working on ways to accommodate both faculty and students and staff as well. If you're in a vulnerable category, you may still be able to take the class online and then interact where things are comfortable for you. And you can interact in a safe environment. Well, we're gonna make those things happen through distancing. For example, we'll be shrinking the capacity of all the classrooms significantly - perhaps by two thirds in some cases so that we can maintain that six foot distancing in large classrooms or whatever size the classroom might be. 

>>BOB ZALTSBERG: Yeah. I heard a number I think that the university is saying for 6 foot distancing every student would need fifty five square feet. 

>>KIRK WHITE: Yes. 

>>BOB ZALTSBERG: That's quite a few more than they usually have. 

>>KIRK WHITE: Absolutely. It's - you know, what we're talking about here is a major change. Things will not be the same as we've expected. And this will not be business as usual when we come back. And we will - we're going to - we're working now to explain that to students as they start to look at the fall. Orientation starts in mid-June. We'll start with that and with our new students, and then of course with the continuing students as they get ready to come back as well. This will be different times. 

>>BOB ZALTSBERG: OK. Sara? 

>>SARA WITTMEYER: Kirk, with that we've gotten a couple questions about students wearing masks. Sherry says I haven't seen a student wearing a mask yet. And then we've got another question. I guess Sherry is maybe more of a comment - but another question saying why can't we just make it a requirement rather than recommending it? 

>>KIRK WHITE: Well, on campus we're going to issue masks to everyone. So that's going to be part of coming back to campus is that you're gonna get masks. We've ordered - through our procurement services ordered masks so that we can issue them to everybody. They're reusable. And that will be an expectation at that point. 

>>BOB ZALTSBERG: All right. I wanted to ask Mayor Hamilton and Julie Thomas just sort of - well, sorry. I think Sara's got some more questions. Sara, go ahead. I don't mean to step on you. 

>>SARA WITTMEYER: A lot of the questions we are getting are about contact tracing. So Kathy, maybe you can just help explain this a little bit more for folks who are confused about it. So this one is who do contact tracers contact - everyone the positive person had close contact with in the recent past or everyone the person has passed? 

>>KATHY HEWETT: OK. The contact tracers contact everybody they've had close contact with during the time or when that person was infectious which would have been two days before they started symptoms up to 14 days. But it's close contact. So it's not just everybody that they've walked by or everybody that they've been in a room. It's close contact. 

>>SARA WITTMEYER: And then I think you addressed this earlier but if someone has an interest in being contact traced, all of that goes through the State Department of Health? 

>>KATHY HEWETT: Correct. 

>>SARA WITTMEYER: OK. So it does not matter on their location anywhere in the state. 

>>KATHY HEWETT: I'm sorry? 

>>SARA WITTMEYER: Like we've gotten questions about whether they can just come to the health department and fill out a form. 

>>KATHY HEWETT: No, they would go through the Indiana State Department of Health for that. 

>>SARA WITTMEYER: OK. 

>>BOB ZALTSBERG: It's probably a good point to say we've had over 700 people ask us questions - 700 different questions have come in. And some have been from various parts of the state. So we're trying to get to as many of them as we can. And we really appreciate you all being here with us today. And a few have questions for us here at home - if have questions, you can send them to news@indianapublicmedia.org or you can follow us on Twitter @noonedition. I wanted to ask Mayor Hamilton and Julie Thomas just about more of an economics thing. What's this mean to the city's budget and the county's budget? How has this affected budgeting? How will this affect budgeting this summer? Mayor, you want to go first? 

>>JOHN HAMILTON: OK. Well, it's going to hit the budgets. 

>>JOHN HAMILTON: We know we're going to have - we've already seen significant reduced revenue in certain categories of food and beverage tax and innkeepers tax and gas tax and a number of places. The two main ongoing sources for city government are property taxes and income tax. And we expect particularly on the income tax we'll see some reductions. The good news is the city and I think the county too are in good fiscal shape. We've been very prudent and have built reserves up in rainy day funds and this is a rainy day. So we're going to be focused on maintaining the essential services which we have been doing. But frankly, I also believe government's role is a countercyclical role. When the economy is bad and when people are hurting, that's when government often needs to do the most to step in and try to reduce the suffering and damage and accelerate the recovery. So we'll be doing both of those things, and there's a lot of pencils sharpened and work going onto the 2021 budget and maybe even some supplemental work this year to try to do what we can. But it's going to be complicated. 

>>BOB ZALTSBERG: Julie Thomas, same question. 

>>JULIE THOMAS: Sure. Thank you. It's a great question. The commissioner's role is legislative and executive and the county council's role is fiduciary. And I know the county councilors are taking this event very seriously. They're working through a number of different models for what may happen and how we can respond effectively. As the mayor pointed out, we do have a healthy rainy day fund, and we are able to be flexible yet still provide the efficient and effective government services that we're known for. We've been - we've utilized some of the food and beverage funding, as the city has, to assist the small businesses in our community to ensure that once we do open up to a less restrictive environment that those - you know, it's the heartbeat of our community's economy that those small businesses are able to come back. We've given grants of over $197,000 to 25 local businesses outside the city of Bloomington that are connected with tourism. And we're really proud of that. And we're really glad to see that we're keeping these businesses afloat so that we can have a vital community once this pandemic is over, whenever that may be. 

>>SARA WITTMEYER: We've gotten a couple of questions about masks. We have one for you, Julie, and then one for the mayor. But Julie first, could the county require or strongly encourage grocery stores to hand out masks at the entrance? That's from David. 

>>JULIE THOMAS: Right. We do encourage it. We encourage any business to provide masks if they can for customers or to require customers to be wearing a mask if they cannot provide them. It's really up to each business just as a business will make a decision that they won't have a customer without shoes on in their business, right? That's something that each business can control. And again, the issue of requirement is tricky because it's very difficult for us to police and enforce the whole community in that way. And so we really just want to appeal to people's better nature to focus on having that respect for others by wearing a face covering. 

>>SARA WITTMEYER: Yeah, I imagine. Mayor, you're probably going to answer this question kind of the same. This question is from Denise, and she says many people in my precinct are wondering how mandating mask wearing can move forward. They have asked the question and had local governing agency give them a different reply or just not respond. 

>>JOHN HAMILTON: Well, that's never encouraging. But I actually - actually I think we could require masks. The governor could require mask wearing, and we have in certain settings but we could do it. We could require every customer in a restaurant to - or a retail store to wear a mask. Certain numbers of states have done it - Ohio and Kentucky, our neighbors have much more extensive mask requirements. We could do that locally. That would tend to come from the Health Department, would need to put that in place unless the city did a separate declaration, which we've worked really hard to make it a consistent approach. But we absolutely, in my view, could require masks more extensively than the state does if we feel the health of our community demands it. And I do think it's worth exploring that. Enforcement is difficult to be sure, but, you know, enforcement is often difficult. But if the health - if the health data and demands tell us that the cost of that is worth the benefit as we see it, then that's really important. Again, we have very good data right now. We don't have a lot of insurance. I'll just make one very quick point that the prevalence testing that was done at the state level a few weeks ago showed that 2.8% of Hoosiers have had this disease either currently or in the past, recent past. That's 10 times more than we know about, and 45% of those people who were tested were pretty much asymptomatic. Meaning, they really didn't know it. So it's really important to be sensitive to this protecting each other even if you may feel great. But you may still be a carrier. So the mask and the distancing are orders that we have put in place in very limited ways at the state and local level. But we could do more. 

>>SARA WITTMEYER: Before we lose, Kirk, I want to ask a question that we just got. The question is about dorms and just saying with single occupancy dorm rooms, is it going to be the responsibility of RAs to check on student health and help with contact tracing? Will RAs always be getting training? 

>>KIRK WHITE: Yes. You know, our residential programs and services staff, the RAs on each of the floors have a responsibility to support the students no matter the situation, and this one's no exception. We as a university will do contact tracing so in cooperation with state local authorities. But we will be able to assess, you know, who's in what areas so we can assist the local authorities in doing that tracing. That's not going to be all a responsibility of residential programs and services. There will be as part of - it's part of the comprehensive effort that includes the IU Health arrangement that we have to telehealth and testing. This all comes together so that we can take care of the university population as a whole. 

>>BOB ZALTSBERG: All right. Kirk White, thank you very much for being here with us today. We really appreciate it. 

>>KIRK WHITE: Bob, I can stay a little bit longer. I - my other reading was canceled, so up to 1 o'clock. 

>>BOB ZALTSBERG: We're happy to have you. Yeah, we're happy to have you. I have a question for Dr. Hrisomalos. We still continue to see mainly on social media claims that, you know, this isn't that much - we aren't saying it's not as serious as a flu, but people will say that's not that much more serious than the flu or people suggesting that, you know, this is a hoax of some sort. And you as a health care professional, can you just talk about, you know, the facts when it comes to COVID-19 and why all these measures are really necessary? 

>>TOM HRISOMALOS: Oh, it's interesting both to look at data that comes in, you know, nationally and internationally and what we're experiencing here locally. I mean, I can say very clearly that we have never seen in the 30 years that I've been in practice the degree, the severity of illness from influenza. We've never had 10 people on ventilators at the same time in the hospital from the flu. And part of that is not because influenza is a benign disease. It certainly can be serious, but influenza has circulated for in the population forever. And so some - a good percentage of the population has some degree of immunity. We have a vaccine for it that can protect a lot of people. So it doesn't rise to the level of severity. I constantly see in the news media people quoting, well, the mortality for influenza is 0.1% and this is really not a whole lot higher. But people need to remember that those numbers are estimates and calculations. And the estimate for influenza is based on projected cases and so forth as well. And it's probably not accurate. The mortality for influenza is probably significantly lower than 0.1%. And I think there's good data to suggest that the mortality of COVID is probably at least 10 perhaps 15 times greater than seasonal flu. Mixed with the fact that there's no immunity to this virus in the population as Mayor Hamilton mentioned 2.8% of the citizens of Indiana have evidence of having had this that leaves 97% less susceptible. And so it is more serious. And it's pretty obvious if you've taking care of patients or if you've been in the hospital and you've watched these cases. It's certainly more serious than the flu. 

>>BOB ZALTSBERG: Sara. 

>>SARA WITTMEYER: Kirk, we got a question about football, which you might not be able to answer yet. But it's just, is Indiana University going to take steps like Ohio State University? And if so, who will get priority for tickets and what will you be doing about the suites? 

>>KIRK WHITE: Yeah, that's a question I can't answer yet. A lot of that depends on what the conferences decide to do - NCAA and Big Ten and their guidance. That's going to be one level other, of course, our university will take a look at those cases, as well. I think in general everyone's looking at where are we in the ability to be able to do the testing and tracing. And that will impact whether there will be athletics as we know it in the fall. But as I said earlier, things are going to be different because we're working because of the environment. 

>>BOB ZALTSBERG: OK, I just thought of something else I want to ask Dr. Tom about the influenza issue, and that is the effects, you know, for people who don't die. I've been reading a lot about how seriously damaged people can be from COVID if they make it through and they get out of the hospital how they may have long-lasting, even lifelong effects. So are the, you know, the side effects - if you survive the disease, are the issues that you may have after are they more serious than influenza? 

>>TOM HRISOMALOS: Oh, we have seen after COVID cases fairly prolonged recovery in some patients where people struggle with symptoms for quite some time. Perhaps most alarming in that category are these individuals who have an increased risk of blood clots forming both in terms of strokes, heart attacks, pulmonary embolism, things of that sort which is not something that we typically see with the flu and probably reflects the degree of inflammatory response to this virus. So yes. And we're learning as time goes on. But there are additional complications, cardiac complications. Even in healthy individuals, we've had COVID. There seem to be heart complications at least for a few weeks afterwards that can develop. And so yeah, a lot of unique longer term manifestations. 

>>BOB ZALTSBERG: All right, thank you for that. I want to ask Kathy Hewett next. We've had a lot of questions. We always have a lot of questions about testing. Can you sort of update us on Monroe County's testing capability now and who tests are available to and who are the people that should be getting them? 

>>KATHY HEWETT: OK, we have a new testing site that's being run by quantum, and it is on South Walnut out in the National Guard Armory. They're encouraging anybody who is over the age of 65 or at high risk from underlying health conditions to go get a test. That information is - you can find the contact information on the Indiana State Department of Health website along with information on how to contact IU Health. They are also doing testing for people who are symptomatic. People can also get tested at Monroe Hospital. And CVS out in (unintelligible) is also doing testing now. 

>>BOB ZALTSBERG: None of these... 

>>KATHY HEWETT: (Unintelligible). 

>>BOB ZALTSBERG: Yeah, none of these are walkup sites. I know we had a question yesterday, I think, that, you know, is there a place that I can go and just, you know, walk up and stand in line and get a test. 

>>KATHY HEWETT: No, there is no walk-in. All of them do require appointments, but the contact information at all available on the Indiana State Department of Health credit virus webpage. 

>>BOB ZALTSBERG: OK. So, you know, I'm going to admit my age. I'm over 65. So if I do go out and get a test, what's the value of me knowing if I, you know, if I have the virus or not? If I'm asymptomatic and I wear a mask, what's the value? 

>>KATHY HEWETT: Well, if you know, you can still take those precautions to make sure that you're not infecting anybody else. But with this test - if you're asymptomatic, there's not a huge benefit. If you're not having symptoms. All it would tell you is that you're infected right now and then to make sure to isolate yourself. But if you do have symptoms, then it is more a benefit so that you would know whether you would be infected. 

>>BOB ZALTSBERG: So it's a good idea anyway. 

>>KATHY HEWETT: It's still a good idea and they also do want to find prevalence - so how many people are asymptomatic who are carrying the disease. 

>>BOB ZALTSBERG: All right. So Mayor Hamilton and Julie Thomas and Kathy Hewett to a degree, so what's next? What are the next steps that Bloomington and Monroe County would have to have to move even further? Of course we haven't gotten to Phase 3 yet, but you'll be looking for certain things during Phase 3 I assume. What are those things? 

>>JOHN HAMILTON: You named me first. I guess I'll go. I know - and I certainly want to hear from the others. I - look, I want to make a point generally which is we have heroes among us in the health care system both in hospitals like Dr. Tom and his many, many, many colleagues as well as Kathy Hewitt and her colleagues in our public health system. I do want to note that Indiana is dramatically under-invested in our public health system. Among the countries, our state is among the lower - very low in terms of the investment in public health. And of course this has helped demonstrate the gaps in our overall health care system where people - we have - the health care system has stepped up. But hospitals are under severe pressure. Some are under severe fiscal pressure. They've been laying off people. Not at IU Health thankfully. But this has demonstrated how important it is to invest in the infrastructure to protect ourselves. We've talked a lot about (unintelligible) and I can talk till the cows come home about the importance of individual actions which are incredibly important. But we need to recognize how important public investment in these fundamental protections are. And we're not where we need to be on those. 

>>BOB ZALTSBERG: All right. We have had a couple other quick questions that have come in. And I do want to get to - I know we've talked about this numerous times. But this is just a comment from somebody. And I'd like for somebody to address this comment - the wearing of face masks outside of hospital settings is theater, this listener says, not medicine. Dr. Tom? 

>>TOM HRISOMALOS: Well, in terms of wearing of a face mask there are two situations in which it has been shown not to be theater but to be very effective. One is if you are infected, particularly if you're asymptomatically infected, it is very effective in preventing you from spreading the infection to other individuals who you come in close contact with. Secondly, to protect an individual and it's been shown to be effective in that setting as well, so there may be little value in wearing a face mask if you're outdoors maintaining social distancing and so forth. But if you are coming into close contact with people, the evidence is pretty overwhelming that they are indeed of benefit. And in my mind what a minor inconvenience it is to protect vulnerable people and not only people but to protect the businesses that people are going into and out of. I mean, if you cause infection or bring infection into a business, infect wait staff or anything else, you've hurt - you've harmed that business. And so they are effective. And I think for the benefit of both people and for businesses, they make a lot of sense. 

>>BOB ZALTSBERG: I have another medical question, doctor. Someone asked about ventilators. And you know when does the hospital decide to put a patient on a ventilator - at what stage of the illness? 

>>TOM HRISOMALOS: So the ventilators are utilized when you can't maintain oxygenation with simple supplemental oxygen or masks or nasal canula oxygen. When you can't keep someone oxygenated, then you use a ventilator. We've been very fortunate here in South Central Region. I think our capacity is about 75 ventilators without going into using equipment that's not entirely designed for that purpose - operating room equipment and things like that. And we've always - we've never come close to maxing out our utilization, but - so the most severely ill people where you can't keep them oxygenated. 

>>BOB ZALTSBERG: OK. Thanks for that answer. We've gone through a lot of questions today and we are now out of time. I want to thank all of you for being here. It's been a great program. Thank you to Julie Thomas, Mayor John Hamilton, to Dr. Thomas Hrisomalos, Kirk White and to Kathy Hewett. For my co-host Sara Wittmeyer, for our producers Bente Bouthier and John Bailey and Matt Stonecipher, for engineer Mike Paskash, I'm Bob Zaltsberg. Thanks from listening. 

>>UNIDENTIFIED PERSON: Noon Edition is a production of WFIU Public Radio. A podcast of this program is available at wfiu.org. Production support for Noon Edition comes from Smithville - fiber internet, streaming TV, home security and automation in southern Indiana. More information at smithville.com. And from the Bloomington Health Foundation, partnering with local organizations and citizens to invest in programs that address our community's health needs. More at bloomhf.org.

kirkwood

(Emma Atkinson, WFIU/WTIU News)

Monroe County’s health order, keeping the area in stage two of Governor Holcomb’s five-stage plan to reopen the economy, expires May 31. 

The county is about a week behind most of the state on plans to reopen the economy. Local health officials say the decision to move more cautiously in the next phases was based on a lack of data, testing, and contact tracing ability.

Dining and other approved services have been operating at 50 percent capacity since May 18. If the county elects to move to stage 3 in Gov. Holcomb’s plan next week, restaurants will remain at 50 percent capacity, retail could move up to 75 percent, and gatherings of 100 people will be permitted.

Indiana University has also put out announcements that research activities will recommence in phases starting June 1. They also announced an agreement with their partner IU Health to make COVID-19 screening and testing available to anyone in the IU community that is deemed symptomatic for the virus.

IU put out another announcement this week that classes for the 2020-2021 academic year will include a mix of in-person and online instruction. IU officials that student housing contract with the university will be upheld.

This week, we’re talking with local university, county, hospital, and city officials about the next steps for Monroe County in responding to COVID-19.

You can follow us on Twitter @NoonEdition or join us on the air by calling in at 812-855-0811 or toll-free at 1-877-285-9348. You can also send us questions for the show at news@indianapublicmedia.org.

Note-This week of our guests and hosts will participate remotely to avoid risk of spreading infection. Because of this we will not be able to take callers live on-air. 

Our Guests

Julie Thomas, Monroe County Board of Commissioners president

John Hamilton, Bloomington Mayor

Kathy Hewett, Monroe County Health Department, lead health educator 

Dr. Tom Hrisomalos, MD IU Health Southern Indiana Physicians provider, specializing in infectious disease

Kirk White, assistant vice president for strategic partnerships at Indiana University

For the latest news and resources about COVID-19, bookmark our Coronavirus In Indiana page here.

 

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