As protesters ignore mask and social distancing guidelines during the special session of the legislature in Boise this week, Idaho doctors are continuing to fight COVID-19 in hot spots like Canyon and Ada Counties. On Idaho Matters this week, we talk about mitigating risks of the virus in schools, why politicizing mask wearing is problematic for public health, and how the virus is spreading among members of the Latinx community.
Like every Wednesday, Idaho medical experts join Idaho Matters to answer your coronavirus questions.
Our panel today:
- Dr. David Pate, former CEO of St. Luke's Health System and a current member of the Idaho Coronavirus Taskforce.
- Dr. Darin Lee, Emergency Department doctor and Vice President of Medical Affairs at Saint Alphonsus Medical Center, Nampa.
- Dr. Sky Blue, infectious disease doctor from Sawtooth Epidemiology.
Read the full transcript here:
GEMMA GAUDETTE: You are listening to Idaho Matters, I'm Gemma Gaudette. As we continue to cover the coronavirus pandemic, we know that so many people have questions, you have concerns, and here in Idaho Matters, we do want to answer your questions with facts. The best way to do that is to bring in Idaho medical experts, which we have been doing every Wednesday for quite a few months now. So if you have a question for our doctors, send us an email at email@example.com. Joining us today, Dr. David Pate, former CEO of St. Luke's Health System, as well as a current member of the Idaho Coronavirus Task Force, Dr. Darin Lee, emergency department doctor and vice president of medical affairs at St. Alphonsus Medical Center in Nampa. And Dr. Sky Blue, infectious disease doctor from Sawtooth Epidemiology. Thanks, everyone, for joining us today.
ALL: Yeah, happy to be here. Thank you.
GAUDETTE: Dr. Pate, I want to start with you. And what I would like to talk about from the get go is schools. We know that with schools reopening -- I mean, some are opening virtual as some have a hybrid, some have opened fully -- there is no longer a conversation about if schools should reopen. So now the question is, how can the health care community respond if or when we see an uptick in cases?
DR. DAVID PATE: Yeah, well, it's a great question and it's a great concern to me because we're entering into an experiment and yes, there have been school reopenings in other countries during the time that ours have largely been closed. But there's no country that opened their schools with as much community spread as we have in some of the areas where school boards are talking about opening their schools in person.
Second, we're already seeing significant concerns. We've seen lots of outbreaks at colleges and universities, which I doubt is much of a surprise to any of us doctors on this phone call. And then another fear that I've had is that we may have been falsely reassured about how favorable this infection is in children, because if you look at what happened when we had our first big outbreak of this, schools closed down around the country, around the world really, and really the exposures children have had during these six, seven months has been relatively few. And therefore, for us to conclude, which we're already proving is wrong, that kids don't get sick or kids don't spread this virus. I think we may have greatly misjudged the impact on kids. And we'll see. But we just saw out of Florida who's ahead of us. They now have nine thousand infections in kids since they opened their schools. So I think we're in for a surprise. Frankly, I don't think is surprising to the medical community. And so what the medical community is doing is telling schools, look, you really ought to think about two things.
One, should you open? That horse is out of the barn? And our point is look at what's happening in the community spread, because that's going to tell you what you're likely going to be facing in your schools.
And then the second question is, can you open? And there it's really about how thoughtful are your plans? And I still as I look at some of the school plans, I still see things that are not well addressed and some things that are addressed in ways that concern me. For example, there is often a misconception that face shields are a substitute for face masks, which they are not in most situations. And there's a lot of times a great thought about what will happen in the classroom, but little thought about what happens in all the other activities and things outside of the classroom. So, you know, we stand at the ready. We're going to be there to to help. I just wish schools would have asked physicians and public health experts for more help, particularly on their operational plans up front.
GAUDETTE: And then Dr. Blue, on top of all of the school reopenings we saw at the Idaho state capitol this week filled with protesters, many of them did not wear masks. They did not keep a safe, physical distance in crowded rooms. So I'm curious about how you personally feel when you see that. But then also, I mean, you see the patients that you care for who are so very sick from COVID-19. So, you know that, I would assume, could have been potentially a super spreader event.
DR. SKY BLUE: Yeah, sure. And right before I get to that, just to add a little bit to what Dr. Pate was saying, you'd ask about what health care professionals should look for. And that's exactly right. We're just at the ready for the suspicion that cases will arise. I think what really needs to be there, if you're going to open, is the idea that it is -- we try to say, is it safe to reopen? There's never going to be a safe point to reopen. It's just one level of safety are we OK with and then how can we respond? And 'we' really needs to be the school and the health districts where that school is, because as we know, at the current rate of community spread, there will be for every five hundred kids in a school, there's going to be probably five to 10 who come in the first day who are positive for the coronavirus. So there is going to be spread. How do we respond to that spread? Depends on how they can be detected and then how quickly you can stop the spread in those high density environments. That isn't something we can do as physicians that has to be in contact tracing and school plans. So we're just going to be on the lookout for new cases, both in those kids, in teachers, in staff and in the community. And I think that's what we can do for the health care.
And that's kind of what comes to mind when I see the images of what went on in the state capitol. You know, we're Idaho and we want to preserve autonomy and personal freedoms, but we're also a state that would almost do anything to help their neighbor. We'll drop everything to go help dig their car out of a ditch, help them pull in hay off their field. That's what we do. And I just don't understand the fact that masks are actually helping our neighbors. We're helping the fellow Idahoans to stay safe. So mass, sure, that's an issue. We say that it's an affront to our personal freedom to decide whether or not we wear a mask or not. But I see it the other way. It's an opportunity for us to help our fellow Idahoans, our neighbors, help them stay safe. So when I see crowded people coming in to a location where our legislators are attempting to do their business, they have to be there. We're actually putting them at risk by crowding in there and not wearing masks. And it's not the Idaho way to not help out those individuals. So there is a very good chance that one person in there could have been positive for coronavirus. And in that setting, there is a high likelihood that transmission will occur. Still, the majority of those will stay fairly mild or even asymptomatic. But in there, there will be somebody who could have a severe outcome. And I was the person crowding in there and at any way could have been responsible for somebody being really sick, having to be hospitalized, I'd feel terrible about that. And I just don't quite understand where the disconnect is when the individuals who are protesting their rights, but not the consideration of the rights and the people next to them or around them.
GAUDETTE: And then Dr. Lee at St. Alphonsus, you're starting to see a lot of COVID infections in multigenerational and immigrant households. Can you talk a little bit, you know, about that, but also, how do you mitigate something like that or can you?
DR. DARIN LEE: So thanks for the question, you know, we in the emergency room, we cover from Boise, through Nampa all the way to Ontario, our group does. And so we are able to see a large portion of the Treasure Valley. And what we've noticed is that within certain households, it seems to be more prevalent. We see in immigrant households here in Boise, we definitely see, and that is partially due to multiple generations living in the same household. As you go further out west towards Napma and Ontario, you'll see the same thing. And probably one of the reasons why Canyon County has such a high rate of transmission right now. And it's difficult because you have family members in the household who are you know, they're working adults and they are and they have to go to work. And they may not get that sick from COVID, but their father or the grandfather in the house will come in to the emergency department, extremely sick. And those are the patients a lot of those we're seeing disproportionately admitted to the ICU.
And so I think that's also just in looping back with what Dr. Pate and Dr. Blue said, but also a consideration when it comes to schools, because we're not talking about just the schoolchildren who we know sometimes have a mild illness, although some of them do get sick. But in certain communities, there are more of those multigenerational households where the grandfather or the grandmother is in the same house. And that is a real concern for them getting sick and not only getting sick, but getting sick to where they have to be hospitalized in the ICU or potentially have a fatal infection. So it's just a little bit different as you move across the Treasure Valley. It's a little different at each place, but it's always a concern.
GAUDETTE: Before we get to our listener questions. I have a couple of more questions I want to get to. And Dr. Blue, this one's for you. Hong Kong researchers are reporting what appears to be the first confirmed case of coronavirus reinfection. Apparently, a 33 year old man who had COVID in late March seemed to contract the virus again four and a half months later when he was traveling in Europe. So what does that mean for potential vaccine effectiveness? But also, could this be a different strain of the virus?
BLUE: So we're looking forward to reviewing the details of that case when it's finally published. And so a lot of what we're seeing is just the reports and in news media and the preliminary reports out there. But a lot of experts in this disease and viral diseases are not necessarily surprised by that. And a couple of things to point out. One is we talk about immunity but what do we really mean by immunity? And most of the time, we think that immunity means that you will never be infected with that virus again or that infection again. And that's what we think of by immunity. And it isn't really the case in most infections. There are some that once you recover from it, you will not be infected in any way again. But most respiratory viral infections do not provide an immunity that keeps you from having any sort of infection again. We think that immunity might offer some protection for recurrent severe illness. And that's kind of what we saw in this gentleman, from what I understand from the preliminary reports. He had a symptomatic illness in March with the typical symptoms and then was tested even though he was asymptomatic after some recent travel. So he did not have a fever or a cough or the symptoms that we think of. But his test, and I believe it was saliva, came back positive for the virus. They were able to look at the fingerprint of that virus compared to the virus that he had before. And that fingerprint was different. It was different enough that we can say it wasn't just persistence of pieces of the RNA from his previous infection, that it was a new infection. It is not different enough that we say it's a new strain. It's just some mild variations in the same strain of the coronavirus. So it isn't the fact that we're seeing a new strain circulating that our immunity doesn't play a role. But I suspect that his prior infection actually left him with some protection from recurrent severe disease. And that's what we hope to see in individuals who have recovered. But we can't say that they won't get an infection like this and we can't say that they they won't be able to spread it again. And I think it's been on this show or others that we've said that if you've recovered for this, our recommendations are still the same. You know, wear a mask, maintain your distance. We don't know what recovering from it means. Certainly, we're going to be waiting to see how our vaccine protects us. Most of the vaccines are looking at what we call a prime and boost. So you'll get an initial vaccination and then you'll get a booster. We hope that stimulates further immunity, may offer further protection, but whether it will prevent an infection like this where you can test positive in saliva or a nasal swab and potentially even transmit but remain asymptomatic, that would be a positive outcome for our vaccine. It will inform us that it may not cut down on necessarily transmission, however, and we'll just have to wait and see the results of our vaccine trials. And as more and more people have recovered and been exposed to the virus, again, we'll understand more and more what that protection will really look like.
GAUDETTE: I want to get to some listener questions now. And Dr. Pate, Paula has a question. She would like to know if it's safe for two people who do not live in the same household to ride in a car together, if one person is in the back seat, one person is in the front and both people are wearing masks.
PATE: You know, I think Dr. Blue actually said this very well at the beginning of the show, and I won't get his words exactly right, but he said it's not a matter of safe or not safe. It's a matter of degree or what risk we're willing to accept. So if Paula is asking, does this make it impossible for either of them to get infected? No. Now, obviously, the safest thing is to be with people you live with. So the fact that these are people that don't live together increases the risk. The safest thing is not to be around anybody else, but obviously the fewer people you're around, the less chance somebody is going to be infected and doesn't know it. So to people is not highly risky. And of course, wearing masks is very good.
But I do want to straighten out a common misperception, and that is that people tend to think that that distancing without a mask is the same thing or same equivalency of risk as not distancing with a mask. And let me just say that distancing is always your primary goal, keeping away from people. Masks are just intended to decrease the risk when you can't be distanced from people. So the other thing that occurred to me as you read this, it struck me as peculiar when you first said about one of them riding in the back seat, what I then began to wonder is what Paula is really asking. What about doing rideshares, being in a taxi or an Uber or something like that? Again, I think when you're assessing the risk of being around somebody else, you are taking on the risks of all of that other person's behaviors. And so, you know, Gemma, I know how seriously you take this. So if I were to decide to be with someone, I probably wouldn't worry about being real close with you. But on the other hand, somebody who's going around to to backyard barbecues and parties and so forth, I don't want to be anywhere around that person. And so if it is a reference to an Uber driver or taxi driver, just understand those people are coming into contact with an awful lot of people. And I don't know what the compliance is in cars about masks. So, no, this is not completely safe, but it would depend on the exact circumstances to decide how safe.
GAUDETTE: Yeah, I always say I don't if I don't know you I don't know where you've been in a situation like this.
So, Dr. Lee, an interesting question from from Zoe through our Instagram page @BoiseStatePublicRadio. She says are lower numbers lately due to proportionately low testing or are positivity rates decreasing?
LEE: Well, that's a really good question. We do know that we actually are doing quite a bit more testing now, but we're just some testing. We're not doing that we were doing before. So we are not testing asymptomatic patients where we were testing before, but we're still testing quite a few patients. And so by definition, if you're testing less people than you will probably be catching less cases, especially the asymptomatic patients. And I think it's probably less important to follow the number of total cases, although that does have some importance and really more important to follow the number of patients like they do in the staging for the state of people who are hospitalized, people who are coming to the emergency department, people who are in the ICU. This is basically testing the capacity of the hospital system. And so those are the numbers, I think, that are important to keep track of. And if you look at the the state staging guidelines, those are some of the most important numbers in there. There is a portion of about the total number, but I find the total number to be less helpful than really looking at those other points that are testing the capacity of the hospital.
GAUDETTE: And Dr. Blue, before we take a break, we have gotten quite a few questions on this topic regarding vitamin D protections. And so Esther says, I received an email from a college friend who lives in Owyhee County which said that zinc and vitamin D will protect people from COVID-19. I'm worried about nonmedical professionals sending out information like this. I am a firm believer we must look at the science and hear what our medical professionals have to say. I would greatly appreciate it if one of your doctors could speak to this issue.
BLUE: Sure. And I just love it that individuals are saying, how can we protect ourselves? And I think that's definitely the right question out there. However, I also commend her for getting another opinion about this, because I think there's a kernel of truth in that. But the short answer is it will not protect you. Zinc is a great trace mineral. It's probably the most abundant trace mineral in our body next to iron. It really is an important cofactor for many parts of both our innate and adaptive immune system, the things that help fight off infection. Same with vitamin D. And so those two supplements are very important for health and good functioning of our immune system. But it will not protect you from the infection. It might help your immune system respond a little bit better. It's certainly important for a lot of other components of our health. And so by all means a supplement or correcting deficiencies -- some people are truly deficient and should have that corrected, but it will not protect you. And I love analogies. And I was thinking about an analogy for this, and I think it matters from what Dr. Pate was mentioning is how safe are you being in the first place? So if you are trying to keep yourself from getting bitten by a mosquito, you're worried about a small tear in a screen window. By all means, fix that small tear. But if you're not spending time in your house and you're outdoors, that small tear is not going to be making much of a difference. If you're in your house but your front door is wide open -- meaning the people around you are wearing masks -- then that small tear in your screen is not going to make a difference. If you're doing everything else you can, then by all means, you know, a zinc supplement, a vitamin D supplement, correcting your deficiencies will make your immune system even stronger and might make a difference. But in that same vein, a good night's sleep, eating well, exercising is also going to improve your immune function, just just knowing that these alone are not going to prevent you from getting infected with the coronavirus.
GAUDETTE: Right. Dr. Pate, Sue wants to know during cold and flu season, if we still don't have enough tests to go around, how do we know if we have COVID or just a cold or the flu? Schools and businesses say they will send anyone home with symptoms until they have a negative test. But if you can't get a test, could we potentially be sending thousands of people home who might not need to be home?
PATE: Well, I think Sue's hitting on some very important points, the first thing is that she's quite right. If Dr. Lee and Dr. Blue and I, if we were to hear somebody's symptoms, once we get into cold and flu season full bore, the three of us would probably have a difficult time sorting out who likely has COVID and who doesn't because the symptoms can overlap so much. Certainly there would be some things that we could look at for clues, but it's going to be very hard to sort these these out. And so I think this is going to create a number of problems for us. Number one, a year ago, most moms, if their kid had the sniffles and the cough, maybe a low grade fever, they'd keep their kid home for a couple of days. Then the kid was better than we sent them back to school. This year, I expect every mom will think their kid has COVID --
PATE: So that's going to be a big demand on health care providers. And I've certainly been getting the word out. Get prepared for this. How are you going to handle this? And certainly that may have implications for further stressing our testing capabilities. But the other problem that we're going to have here is that some of these people are going to be sent home or stay home because they have symptoms.
But the question is going to be, when is it safe for them to come back? If we're talking about a cold or flu, then certainly once their symptoms subside, once they haven't had fever for 24 hours, then it's probably safe for those kids to come back. But if they do have COVID and most won't, but if they do have COVID, that may not be safe to send them back. And so are we going to make sure that every kid that has symptoms gets tested, even though we know most won't, have COVID? Who's going to pay for that? I don't know that the insurance companies are. And then there's going to be people that aren't insured or can't afford it. So how are they going to get tested? So I just think there's a myriad of issues here. And so I'll just close by making a plea to everybody listening. Please get yourself and everyone in your family the flu vaccine next month or even in October, get the flu vaccine. Because if we as doctors have one last thing to have to worry about, that would be very, very helpful.
GAUDETTE: Be like me and bother your pediatrician every week about when they're getting it so that you can get your kids vaccinated as quick as possible.
Dr. Lee, this kind of piggybacks to to the question that Dr. Pate just asked. Emily has this question. She says, I know Idaho has failed to meet the criteria to move out of stage four multiple times, but I'm having a hard time understanding why in the midst of the concerning spike in cases, hospitalizations and deaths, that we have failed to move back to earlier stages of reopening instead of simply not moving out of Stage Four, with the exception of Ada County being in stage three, which also seems high since it's one of the state's hot spots.
LEE: Yeah, that's a really good question and kind of what I had mentioned before, I think of this staging as a capacity issue. I'm sure Dr. Pate can talk more about the actual criteria that go into it. But really, it's a capacity issue of the hospitals. And so in the beginning, when this all started, we didn't really know what our full capacity was. We didn't know if we had full PPE. We didn't know if we had enough tests, and we certainly didn't at the beginning really didn't even know who was being who had COVID, who didn't. As we've moved on in these last four months, the hospitals have done a really good job of increasing their surge capacity, securing the PPE. We're doing testing now at a much higher rate, specifically within the hospitals. And so our ability to take care of those patients currently now, even though we have more ICU patients now than we've probably ever had, we still have the capacity to take care of those patients. It's still of concern. And that's why we're still, I think, at this stage. But right now, we are able to meet the need and meet the demand of what is going on in the community. And so I think that's why they have left it at stage four at this point in time and not had to move back except into Ada County. But I think it's important to think about in that not just the number of people who have COVID, but what is the the strain on the hospitals and their capacity. And currently, they've done a really good job, both with combination with what the state has done and then put all the hospital systems have done to try to increase the capacity of our hospitals. But we're still falling short. And things like testing, as Dr. Pate mentioned before, you know, trying to do testing when we start to go into cold and flu season is going to be a little bit of a nightmare just in the sense of who do we test and do we have enough tests. And so I'm just hoping that our capacity can go up even more so than it has in the last four months.
GAUDETTE: Dr. Pate, if you could maybe piggyback a little bit on that, because you are on the coronavirus task force and you have talked about this before. Yes, Ada County in stage three. Canyon County is not and frankly, probably should be. But again, this goes back to we're in two different health districts with two different ideas about this virus.
PATE: Yeah, you know, I've made no secret of it that this is a frustration to me. I understand that historically and going back to the time when the public health districts were enacted back in 1970, Idaho was a different place. But given where we are today and given that we're dealing with a fairly contagious virus, first of all, it makes little sense to divide the Treasure Valley into two portions governed by two different public health districts because this virus circulates. You're right. We've got differences in Ada County, differences in Canyon County. But yet we also have people that live in Canyon County and work in Ada and probably the reverse. And so a lot of this just doesn't make sense from the containment of a virus situation. And then what we've seen play out is two different, very different approaches to handling this pandemic. And as a consequence, we see two very different degrees of severity of community spread of this virus. So it is frustrating for all of us. It doesn't, frankly, make a lot of sense. And of course, that's all been compounded by the fact that we do have some members on some of these public health districts that really are poorly informed or misinformed and not giving the proper regard to medical and scientific information.
GAUDETTE: That's a very generous way to say it.
Yes, Dr. Blue?
BLUE: You know, you've been listening to all these questions from both the listeners and the doctors. And it just seems to me that it keeps coming up, that this is a choice between either you are reducing the number of cases or opening the economy. And it just seems like that is not -- it's a false dichotomy. It's not the true choice. We can do both. What do you think is the understanding of why doing the things like closing bars and in person restaurants and wearing masks to allow us to have a wider opening of the economy and schools? Why do you think it's always held up as a choice as one or the other?
GAUDETTE: That's so interesting, Dr. Blue, because I absolutely agree with you that I think when you think of it, it's like if you wear a mask, if everyone wears masks, we can reopen. Right. And and it just seems to have been very politicized. And I think we need to try to get away from that and look at this as --. And as you said, Dr. Blue, from the very beginning, you know, we're good at helping our neighbors in Idaho. So let's continue to help our neighbors. Right. And you wear the mask.
Dr. Blue, before we take a quick break, we do have a question from Jessica. And she wants to know, what are we learning? What is contact tracing teaching us about COVID transmission in in Idaho at this point?
BLUE: I like how she phrased that question is, what is it teaching us? Most time we think of contact tracing as a tool. It's a tool to help prevent or break the chain of transmission and infection. And so normally when we have somebody who is diagnosed with an infection, when the numbers are such that we can do very rapid contact tracing, what we do is go out and find their contacts, and the contacts of those contacts and tell them to watch who they're around so we can hopefully prevent the spread to another ring of contacts and another ring of infections.
However, she asks, what are we learning from it? And it's a good question because I'm not getting much feedback with contact tracing from the health districts here in Idaho as a clinician. I know that they are doing some contact tracing, but I don't know how timely it is and what they're learning from it. However, nationally during this pandemic, we've learned an extraordinary amount from contact tracing. We've realized that from what Dr. Pate was saying is what are the risks of transmission? You know, he like laid out the fact that if you're indoors, that's a lot higher than outdoor. If everybody around is distancing, that's better than if you can't distance. If you can't distance, you're better off if you're wearing a mask. So that's what we've learned from contact tracing. We found those contacts, found out what their exposures are, and then follow them to see if they became infected. We've also learned that the household transmission is a lot higher than the casual contact in non households. So when I have an individual who comes in who's positive from a household contact, I actually see a more severe illness than if somebody says, I don't know how I got it. It must have been the grocery store or the park or some other indoor environment. So we're also learning about disease severity in the types of exposures and transmissions early on. We've got in some of the numbers that have informed us with what we call the transmission rate or the R.T. -- that's what we've learned from contact tracing. So we do learn a lot, but most often is thought of as a tool when we get the cases down low enough that we can really jump on each new case and block that transmission to others. That's what most of us are thinking about when we talk contact tracing.
GAUDETTE: We have a new question in from Ingrid. And I would like all three of you to to weigh in on this. But she wrote us asking, what are some of the most promising vaccines and therapies? So, Dr. Lee, can I start with you? And we'll just kind of do a round robin.
LEE: Sure. I probably can't speak much to the vaccines. I know there's a lot of work being done. Most of what we're seeing has been reported in the news as well. And as far as the therapies go, that changes on on a month to month basis. We've had some success with various things. Nothing has been sort of the one thing makes everything better kind of treatment. Remdesivir has been something we have been using for patients who are hospitalized, who are sicker. And there's been a lot of news about the convalescent plasma therapy that has been in the news lately as well. And again, we're seeing some positive results. But again, it's not like one thing is going to for every patient will help. Steroids also help in some patients. And a lot of this has to do with the severity of illness. I will just say that in regards to that, most patients that I see in the emergency department that I then send home, I don't send them home with any medication. There's no medication that really seems to be effective in those patients who have the more mild symptoms, slowing it down or preventing it from getting worse. So most of it is supportive care. It is taking medication for the fever. It's making sure that they're staying well hydrated and resting and doing the things that you would normally do for any cold or flu.
GAUDETTE: And Dr. Pate, your thoughts on vaccines or therapies?
PATE: You know, it's a fascinating question and it depends on what she means by holding the most promise, whether she means which ones are likely to be the safest and most effective or which ones we're going to have first. There's something like one 163 vaccines in trials. There's only less than a handful that are in what we call the Phase Three trials, the ones that we really need before we can approve a vaccine. And so what's interesting about it is the vaccines that have made it into that last big phase of clinical trials are pretty much all new technologies or platforms that we haven't used before. So it's going to be very interesting. We certainly have seen some encouraging preliminary results from these vaccines. But it looks like if we don't get any surprises in the Phase Three trials, that the most likely vaccines to emerge first and be available are going to be these new technologies. And they're very exciting.
For example, one is a technology using messenger RNA, which probably doesn't mean a lot for your listeners. But what is exciting about this is, first of all, it doesn't contain anything infectious. In other words, there's a common misconception with the flu shot that if you get the flu shot, you can get the flu. Well, that's not true because we use killed virus. This one is not something that could be infectious. So you're not going to get COVID from this vaccine. And the new technology is actually easier to mass produce. So that's a plus. But it is a new technology. So we're going to have to see how that comes out. Some of the more tried and true types of vaccines actually killing the virus or attenuating the virus or using proteins from the virus haven't gotten this far along in the clinical trials. So those are the ones that we're used to, but they're just not as far along. So it's it's going to be interesting. And we're all anxiously looking forward to the more data.
GAUDETTE: And Dr. Blue, I would love to get your opinion, but we are running out of time. So my apologies because I really wanted your thoughts on that as well. But, you know, tick tock, I'm live and we have to make sure we hit our out time. So my apologies, Dr. Blue, to not get that question from you as well.
I want to thank all of you for taking the entire hour with us today. I appreciate not only your expertise, but what all of you are doing for our community to keep us safe, but to also get us the right information.
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