Idaho Doctor Describes "Dangerous" COVID-19 Hospitalizations As State Prepares For Possible Care Rationing
Idaho hospitals are over capacity and admissions are approaching the highs of last winter. If trends continue, hospitals will have to implement crisis standards of care — where life-saving resources are given to patients who have the best chance of recovery over patients with less favorable chances.
Idaho Matters unpacks the state of Idaho's health system capacity and answers your questions with the help of two local doctors:
- Dr. David Pate is the former CEO of St. Luke's Health System and a current member of the governor's coronavirus task force
- Dr. Laura McGeorge is St. Luke's Health System Director, primary and specialty care
"It is really, really grim right now. We're actually over or above capacity in our St. Luke's Health System across critical care."
Read the full transcript here:
Gemma Gaudette: You're listening to Idaho Matters, I'm Gemma Gaudette. The rate of hospital admissions per capita among Americans 29 years and younger is at the highest point of the pandemic, this according to federal data. The data also shows that compared to July 4th, six times as many children are being admitted to hospitals and daily deaths are up 281% over the last six weeks. And eight states have issues that are more than 90% full. Here in Idaho, we are getting closer and closer to having to enact critical standards of care. Joining us today to discuss all of this and also answer your questions are Dr. David Pate, the former CEO of St. Luke's Health System, as well as a current member of Idaho's coronavirus task force. And Dr. Laura McGeorge, St. Luke's Health System Medical Director,Primary and specialty care. I want to welcome both of you to the program.
Dr. Laura McGeorge: Thanks Gemma.
Dr. David Pate: Thank you Gemma.
Gemma Gaudette: And remember, if you have questions, you can email us firstname.lastname@example.org.
Gemma Gaudette: Dr. McGeorge, I'd like to start the conversation with you today. Can you update us on where your hospital system is at when it comes to COVID 19?
Dr. Laura McGeorge: Yeah, thanks, Gemma. It is really, really grim right now. We're actually over or above capacity in our St. Luke's Health System across critical care. And I think my guess is when we're hearing that we're at a certain percent capacity of critical care, as reported to the state or in other areas, I think that may include potentially like a snapshot of time that maybe has changed and also does not include the fact that multiple additional intensive care unit beds have been opened up at St. Luke's and opened up across the state. So we're actually solidly over capacity in a very dangerous situation with our critical care and I'll go into those details in a little bit for you in a second here. So above capacity for critical care, we are at capacity or a little above for kind of the intermediately sick people, the people on telemetry in the hospital. We have opened our cardiac observation unit and turn that into an intensive care unit. That unit now is full. We also have repurposed one of our normal telemetry units that previously, like if you were recovering from a heart attack, you may be on that unit. We have repurposed that unit where it can now take intensive care patients there. We have patients on the floors in the hospital that are on something called BiPaP and that is basically an external mask that provides inhalation and exhalation support to patients short of the ventilator going down into their lungs. Historically, those patients would be in the intensive care when they're on that. Because we have no beds, we are now having to treat those patients on the floor in some of these units.
And we are also keeping patients on the floors because we don't have beds where normally they would have been escalated and moved up to the intensive care unit. The other thing is, I've mentioned a couple of places where we've opened up additional intensive care beds. We're looking at other options possibly to open up intensive care beds. But I would say two things about that is the best care you get in an intensive care bed is with a doctor that is trained and experienced in taking care of intensive care patients, having critical care nurses and having respiratory therapist who are critical care specialists or trained in that area. We are at a point now where our staff I mean, frankly, we have some staff out sick with COVID. But all of the staff that are working are absolutely physically and mentally exhausted. And we are working to look for options, to have other people kind of step in so that they can actually just take a rest. I can tell you, you know, critical care nurses don't come out of the woodwork. They don't come out of the air. And so we will need to have people that that is not necessarily their area of expertise who are going to have to start stepping in and working in these areas. So, again, it's whether you have COVID or not, that is obviously very concerning. I will say in some of our intensive care units, the only patients in the unit are COVID--100% are COVID.
Across St. Luke's, about two thirds or more of all intensive care patients are in the hospital because of COVID-19. I will just also share that I am aware--you know, we work very closely with other health systems and of course, are also working very closely with the state--but we have word that in north Idaho hospital there is at capacity as well as eastern Idaho, too. Again, that "at capacity" or "over capacity" is especially acute in critical care. I think it's really imminent that we likely will see a request probably coming into the state that we are going to have to move to crisis standards of care in the state of Idaho. St. Luke's itself as a hospital or a health system has not yet sent patients out of state. I don't know if we would be able to if we tried, but we have not. We have tried to get word out that we don't have capacity, although we do continue to get requests in from other states to take patients from other states, and we just have had to tell them no, because we do not have capacity. So as far as pediatrics go, we do see a little bit of increase in pediatric hospitalizations here. I know that is being seen nationally. Maybe we'll talk about that a little bit more later, but not not so much a capacity issue here for inpatient critical care, pediatrics. And that that's all I have, Gemma.
Gemma Gaudette: That, well, that's staggering when you say that is all you have Dr. McGeorge Dr. Pate, I want to play a piece of video from Dr. Jim Souza. He is with St. Luke's. He has been one of the doctors advising the West Ada School Board, and he spoke last night during a school board meeting. We're going to play this piece of audio really quick.
Dr. Jim Souza: "If the hospital systems in the state, have run through all their surge capacity, right, done everything we can. So we've closed our ambulatory units, we've closed our operating rooms, we've redeployed our staff all to provide critical care. We've taken, you know, patients who just need a hospital bed and moved them to Mountain Home or Jerome or McCall to critical access hospitals. If we've done all those things and we still can't manage the surge, we'll indicate to the state, and there's a plan, that we need to activate process standards of care. Once a crisis is declared, then we activate our plan. And our plan involves scoring people in the emergency department. So individual humans would receive a score based on their severity of illness that determines whether or not they qualify for, not admission to the intensive care unit, but a trial of admission to the intensive care unit. And that means they're rescored at 72 hours. And if things are going in the wrong direction for them and someone with a better score needs the bed, we would reallocate the resource. That is, as I said, unconscionable, never done in these United States, and would represent a complete and total failure of our ability to work together to prevent that from happening--if it occurs. Thank you for the opportunity to describe the state that none of us ever wants to see."
Gemma Gaudette: Dr. Pate, can we be very blunt on what Dr. Souza was saying--he used the word reallocating a bed. My understanding of what he said is that it's 72 hours, if you are not doing well, if you are not getting better and someone else has been scored higher than you, you could very well be sent home to die and a different patient would get that hospital bed. That will also apply for children.
Dr. David Pate: Yeah, so, Gemma, as you know, I don't have any trouble being blunt and direct. I think if anyone listened and really understood what Dr. Souza just said and they listened and understood what Dr. McGeorge said at the beginning of this program, your jaw should have dropped. I can tell you, as somebody who has both been a practicing physician in hospitals and run hospitals, this is terrifying. So what we're talking about is, first of all, what Dr. McGeorge was explaining about people that ordinarily, if we had an ICU bed, we would transfer them to the ICU. But because we don't, we're treating them on the floor. And you might think, well, what's the big deal there in the hospital? Well, when you're on the floor, the systems, the layout, none of that is designed for treating critically ill patients in an optimal manner.
The other thing that you heard from Dr. Souza and Dr. Bramwell last night was we are what they refer to as "boarding". That meant we're holding them in the emergency rooms because we can't move them out of the emergency room to a critical care unit. What does that mean? Well, what that means is the emergency rooms get backed up. And when you're keeping a person who's critically ill in the emergency room, that ties up emergency room nurses, because they have to be attending to those patients. So things get backed up in the emergency room, which means people have longer waits. Some people may not be able to be seen as timely. And they made the point last night that it's not just COVID we're seeing-- people still have heart attacks, people have strokes and these are conditions that require very prompt attention in order to save their lives and get the best possible outcomes. So what we're talking about is this is going to compromise care to some degree for everyone, whether you have COVID or not. Secondly, as you pointed out, these crisis standards of care, if, God forbid, they have to be implemented--that's exactly right. That if you and I show up to the emergency room with respiratory failure from COVID and there aren't ICU beds, there aren't ventilators, there aren't enough nurses, et cetera, and we have to implement crisis standards of care. They're going to look at you and they're going to look at me and they're going to score us and decide who has the better chance of surviving, you or me. and chances are it's going to be you, Gemma. But when they make that decision, then you're going to get all the resources. And I'm not. I might survive. And they're certainly going to treat me in a caring and compassionate way. They're not just going to send me out the door to die, but it means I won't get all the care that I would have under ordinary circumstances. And my chance for survival is going to be less. This is huge. And people should be very concerned. And I will say it was one of many of the most shocking things about the West Ada school board last night that apparently did not move them, in fact, one of the board members even indicated that he didn't think it was the school's responsibility to try to have to address this problem, which is just absolutely shocking.
Gemma Gaudette: There is, I think, a rage of the responsible right now because Dr. Pate, when we talk about these crisis standards of care and being rated, you know, there are people who have been responsible. There are people that have been vaccinated. And yet there may be someone unvaccinated who might have a stronger ability to survive. And it just seems so unfair at this point that we are in.
Dr. David Pate: Yeah, I think there's mounting frustration, aggravation and in some cases anger about this. For just the reason that you said, because there are people that have done all the right things, have tried to be a good citizen and protect others. And then there are many who, frankly, I don't think they're intentionally doing it. I actually-- you know, a lot of people get mad at the people who aren't vaccinated. I really feel some compassion for them because they have not known who to trust and they've been lied to. And so I feel very badly about that. But nevertheless, they are putting all the rest of us in danger and in many different respects. And just as you said, Gemma, when Dr. Souza talks about that scoring, part of that score is not going to be the fact that, well, I got vaccinated, but you didn't. And so I should get the bed. That's not how we do it. It's going to be even if you're unvaccinated, but I'm vaccinated, but if you've got the better chance at survival, you're getting the bed. So even though I did everything right, I may end up not getting all the care that I ordinarily would.
Gemma Gaudette: Doctor McGeorge, we have a question coming in from Canyon County today, wanting to know what risk fully vaccinated adults have interacting with unvaccinated teens and children under 12 who are not vaccinated--indoors or outdoors. What they want to know is, should we be wearing masks in both settings as well as social distancing and other precautions? They go on to say with kids going back to school, this is of concern to us and how much risk is there for fully vaccinated adults to interact with vaccinated adults who have been interacting with unvaccinated children? I know there's a lot to unpack there.
Dr. Laura McGeorge: It would be a lot easier if everyone were vaccinated. So that's number one. But let's get down to the question. So I would say it matters a little bit. Well, so let me say, first of all, I'm glad that person is vaccinated. We do know that your vaccination can be less effective if you are immunocompromised and there are some types of immunocompromised conditions that are more significant than others as far as that vaccine being less effective. And so, as you know, just released recently that some people should, in fact, be getting a third MRNA vaccine dose just for that reason to help protect them. So let's assume now that the listener is of normal immune status and got vaccinated. What my advice would be is, first of all, interacting with anyone who is unvaccinated--and when I say interacting, I mean, you know, having close contact, so that is typically indoors, it is closer than six feet together for more than 15 minutes, and particularly if it's mask-less-- I mean, that is where there's the highest risk for spread of COVID 19. Now, if you have unvaccinated people living in your house, of course, you're going to have exposure to them and you could potentially bring in the virus to your household. So, again, I think even when you're vaccinated, it is really important to not get exposed to COVID 19.
I will speak for myself personally and my family, we are all vaccinated, however, have really changed dramatically how we are behaving now that the delta variant is around in Idaho. We do know that people that are vaccinated can actually get the COVID virus. They also, you know, more likely are going to just have what feels like a common cold or might not even have any symptoms at all, but certainly could potentially have the virus and then spread it to their family members. So, again, back to being super cautious, you know, not eating in public areas indoors. If you want to go out to a restaurant, the best way to support these restaurants now is take out. But certainly eating outdoors is far, far safer than eating indoors in a public area. Again, you know, gymnasiums and, you know, movie theaters where people are in for a prolonged period of time, those kinds of areas are just higher risk right now and certainly should never--or you know, going to the store and those kinds of things--I would not do that today without being masked. It's just too important right now. There's too much COVID in the community. And we know that the delta variant is just very, very contagious.
Gemma Gaudette: I do want to get to some questions we have about the boosters, but before we do that, we did talk briefly in the first segment about the West Ada school board meeting last night. And Dr. Pate, we have had several questions come in this morning in regards to West Ada school districts masking policy. So the first question is this, from Carol. She says, since West Ada school district is now allowing the opt-out decision for students to wear masks, what degree of protection does that give my child who wears a mask? Given what we know about the transmissibility and severity of illness of the delta variant? Can you answer that question first and then we have another one?
Dr. David Pate: Sure. Well, you know, I was very disappointed in West Ada board, especially when they certainly had my recommendation for universal masking--they didn't like my answer. They asked Dr. Peterman earlier in the week. He recommended universal masking. And then last night they got new opinions from Dr. Souza and Dr. Branwell, who both recommended it, and yet they decided not to follow any of the public health or medical expert advice. So if, you know, if your child wears a mask, wears a mask properly and wears it all the time while indoors, then they're going to have a fair degree of protection. It's hard to know exactly, because I need to know what kind of mask and what are the ventilation properties of the school, but something about maybe an 80% reduction in the chance of the child being infected. The problem is, is that, first of all, your child is very likely to eat lunch in the cafeteria. And all of those students who--there are going to be students are infected--are going to be there. And we're not going to know who they are. And your child is going to be at risk. The other thing is, you know, I've used the analogy that if somebody is going to be shooting at me, I would sure like to have a bullet proof vest. But the bullet proof vest is not going to give me a 100% protection. And so I think you definitely want to have a mask on, but it's not going to give you a 100% protection. And there seemed to be a lack of fundamental understanding that it is far better to prevent those respiratory droplets from leaving the person who's infected rather than just masking others in a hope that it will help block the virus once it's already transmitted in the air.
Gemma Gaudette: And we have another question about West Ada. We are keeping this person anonymous because they work for the West Ada School District. This person is vaccinated. They wear a mask. They try to social distance. They are a support person. So they do not have direct contact with the students. However, they walk in the same halls as the student. They touch the same doors. This individual has elderly parents. The parents have both been vaccinated. This person visits their parents several times a week. So the question is, is it safe to go visit them directly from school or should I go home and shower and change clothes first, or should I not be visiting them at all right now?
Dr. David Pate: So,no, I don't know that it's necessary for the person to have to go home and shower and change clothes before they make a visit. Of course, if they want to,I certainly wouldn't discourage that. But I don't think that's necessary. You know, and I think that the biggest good factors in this scenario is that this person that works at the school district is vaccinated and wears a mask and the parents are vaccinated. I think that without knowing the specifics of what this person does at the school that might still put that person at risk, the risk is low. And I would sure hate for this person not to be able to see their elderly parents. So I think be very good about wearing your mask. You might want to consider even moving to a higher quality mask, depending on what kind of mask you are wearing. And just to have that extra precaution. But if the person vaccinated wears a mask all the time while in indoors and then gets their booster--I mean, all three of them, the person that works at the school district and the parents, when it's time, which is eight months after their second dose gets their boosters-- I think you'll be doing everything reasonable to protect against the potential infection of the parent. So I think they're going to be in good shape.
Gemma Gaudette: Dr. McGeorge, Cara from Twin Falls wrote in and asks, has the COVID booster vaccine been designed especially for the delta variant, or is it the same vaccine then that we were given initially? And if it is the latter, is that a concern?
Dr. Laura McGeorge: Gemma, thank you. So the current vaccines that are available, again, the Johnson and Johnson or Jansen vaccine--there was just some information that hit the press today regarding a potential booster for that, so more to come--we'll have to look at the data and look and see what the FDA does. And that would be the same vaccine. It would just be another one. If they're looking at the messenger RNA, the Pfizer and the Moderna vaccines, that third vaccination is the same vaccine. So it's kind of like if anyone's had the hepatitis B vaccine where you get a three dose course to get vaccinated. It's the same vaccine. It just each time incrementally builds up the immune system. And we do know that the antibodies, you know, over time, they can wane a little bit. So it's not surprising that getting that extra boost is important, particularly with this huge pandemic, particularly knowing that the delta variant has a higher viral load and so more likely to spread and get sick. The manufacturers are working on potentially new vaccines over time that would work against different variants, kind of like how their flu vaccine each year we have to have a different flu vaccine. The holy grail, of course, would be as if we could have one coronavirus vaccine. But I don't know, you know, for life. I doubt that's ever going to be possible. But that would be nice.
Gemma Gaudette: Dr. McGeorge, this listener sent this email in after hearing the beginning of our program today, after she heard both you and Dr. Pate talk about where we are capacity wise. This individual writes, I work in the ICU and Boise. I have lost compassion and sympathy. At what point do the unvaccinated, which is what we are seeing 100% of the time in the ICU, not get preferential treatment over the rest of the population? My coworkers and I are overwhelmed. We are exhausted, angry and frustrated. And once a COVID patient is ventilated in the ICU, their stay is weeks long.
Dr. Laura McGeorge: Wow, all I can say is wow, and I thank that nurse or respiratory therapist for sending that in. I think that that sentiment is--I know he or she is not alone in that sentiment--and we are hearing that. I mean, there is just emotional and physical exhaustion. There is some moral exhaustion along the lines of exactly what this listener's referring to, that what is so demoralizing is that this is, in fact, you know, if you look at all of those intensive care stays that are unvaccinated, which is essentially all of them for COVID, not quite, but essentially, you know, pretty close to all of them. Absolutely preventable, absolutely preventable. And so it is not only, again, physically exhausting, probably some cynicism starts to step in and just very, very difficult for our health care workers to continue to maintain the level of compassion. People went into health care because they care so much about people, want to help them and have an inordinate amount of compassion, but that is running out given the physical and mental exhaustion. And we are trying so hard to support our staff along those lines, as I mentioned earlier. You know, as Dr. Pate mentioned, the way things work is if we go into crisis standard of care with rationing, it is really who has the likelihood of surviving, you know, really reading that and then making decisions on who's going to be able to be on the ventilator or have that bed in the intensive care unit.We do not look at vaccine status on that. And I think that really bothers a lot of people. But that is how our legal and ethical and moral decisions are in health care in the United States. And, you know, we don't turn people away with other...So I'll give a different example. If somebody is speeding in their car at 100 miles an hour and they're hit head on because they made a bad decision and even perhaps did something illegal, we're not going to turn them away. They are also going to get as good a treatment as as we can possibly give. So even though I'm very sympathetic, we all wish that many, many more people were vaccinated. We will take care of whoever comes into the door to the best of our ability. I will add one other thing, though Gemma. You know, not only our health care workers all exhausted, I think what is really, really tough is I recall earlier in the pandemic, people were supportive. Remember those " I heart health care workers"?
Gemma Gaudette: Oh, absolutely. Yes.
Dr. Laura McGeorge: Or "heroes work here"? That seems to have gone away or doesn't seem like the public realizes how much stress is on our team now. and I will tell you, I thought in November and December, we had seen it all. I really did. We were so close to crisis standards of care. I really thought we had seen it all. And the reason why I thought we had seen it all is we made it through winter and we got the vaccine. And this is far worse than that. And the reason why today is far worse is three reasons. One is we literally have more critical care needs today than we did during the worst of the worst time of the pandemic. Two is our health care workers have been at it for 17 months. I have never, you know, even people that go into battle, they're not in battle continuously for 17 months. And then three is, frankly, there are situations where our health care workers are not treated respectfully and they are going out and again, seeing just you know, I just I talked about last week, I went and got takeout at a restaurant and the restaurant was packed and nobody had masks on. It was just the strangest thing, like we weren't even in a pandemic. And yet you go in the hospital and we are in the worst health care situation in the U.S. as far as potentially rationing care that we ever could have... more than we could have ever imagined.
Dr. David Pate:] And Gemma?
Gemma Gaudette:Go ahead, Dr. Pate,
Dr. David Pate: I just want to add one thing--Dr. McGeorge has really well described the current stress and burnout that our health care professionals are facing. But let me tell you, if we get to the crisis standards of care, where we actually have to--like Dr. Souza said, we've never done this before--where we have to decide who we're going to help. We've always helped everybody. But when we have to decide that, I cannot tell you the psychological damage that is going to cause for our health care workers, people who went into this profession to save everyone. And this is going to get really bad. I hope we can begin to develop some empathy for what our health care professionals are going through.
Gemma Gaudette: Yeah, I agree with you 100% on that. Dr. Pate, Katie wrote this today and she starts it with this: this is more of a rant than a question. But she says, please help me understand why people are so hesitant to get a vaccine that they know could save their lives and the health of us who are vaccinated. Are these anti-vaxxers aware that the surge in covered cases and deaths is a result of their selfishness and their ignorance? It is frustrating. It is infuriating that we could be well on our way to normalcy if everyone would do their part and get vaccinated against COVID-19. Why can't the COVID vaccine be required just as all childhood vaccines are? With that being said, Dr. Pate childhood vaccines are not required. They're required to start school in many cases. But there are exemptions. And I would also say to Katie that there are a lot of people who don't believe that they are at risk. They don't believe that this is a big deal. And I think that that is sometimes where the frustration lies is there any possibility of ever even reaching people who do not understand that this is a crisis?
Dr. David Pate: Yeah, Gemma, I haven't given up hope. I am an eternal optimist. I get frustrated, just like Katie. I sometimes have some of those same thoughts, but I talk to a lot of these people. I probably talked personally to about 60 of them, and I've convinced 40 to get vaccinated. But let me tell you, when I talk to them, they have what they think are genuine, legitimate reasons whether we would feel that way or not. They, in most cases, it's not a matter of, well, I just don't care about people. That's not what they say. And I think the problem is, it's what is their news source? What is their source of information? Who is it? Are these qualified people or not? I have a family member who is highly educated. And I have had a number of discussions with him about debunking the kinds of things that he hears. The latest insult was after I gave him a bunch of information, he sent me a video of Dr. Cole to refute my argument. And that's the point where I just put my hands up in the in the air and shook my head. It's, unfortunately, there are people out there that these folks trust for information who are lying to them and they're believing it. And we have to deal with that now. Why do I still have hope? I have hope for two reasons. One, I am hopeful that the FDA approval just announced will move some. Surveys would suggest maybe up to 30% of those that are vaccine hesitant. The other thing is, if this gets as bad as Dr. McGeorge and Dr. Souza and I think it's going to get, it's going to begin to scare some people and I think some more people will get vaccinated. But it's very frustrating.
Gemma Gaudette: It is, and I am so glad you have not run out of hope, because Dr. Pate, I think so many people have. We have questions coming in fast and furious. I want to get to this one from Ambria--Dr. Pate, maybe you can answer it. She says, My eighth grader is back to school tomorrow and I would like to know what type of mask is proven the most effective.
Dr. David Pate: Well, so eighth grader, so I'm guessing that means maybe...what would that be, about 14?
Gemma Gaudette: 13, 14. So I would assume probably a vaccinated kiddo. If mom's going to have him wear a mask, I would assume also probably vaccinated.
Dr. David Pate: Yeah, well, that'll be the key thing. First of all, is to have the child vaccinated. Now, as far as a mask for children, you know, the highest quality efficiency mask we have is the N95. But a lot of children can't really tolerate that very well. So I would consider going down a level at that age to something like a KN95, because that will be very, very effective. And it also gives you more room in the mask for your lips and stuff. People talk about how kids are chewing on masks. It's pretty hard to chew on those masks. Of course, this is an older kid. So KN95 or if even that's not tolerated, they make some KF94 masks that are really kid friendly. And especially for younger kids if needed. The most important thing, though, is not exactly which kind of mask, but that they wear the mask, wear it continuously and wear it properly. And that means molding it around the nose, making sure there's not gaps on the side. And the other thing you can do, if you want a enhanced protection, but simple, take the surgical or procedure mask, put that on first and then over it, put a cloth mash that hopefully is at least two or three ply and put that over the procedure or surgical mask that will help make sure it closes those gaps and that will provide very high quality as well.
Gemma Gaudette: And I think that's a good point, what you pointed out about how kids can tolerate certain masks, my 13 year old forgot his mask the other day and so he was given a KN95 mask to wear for the day and he got in the car after school and was like, this is the worst mask ever! He hasn't forgotten his mask since...he did wear it, but...
Dr. David Pate: It's uncomfortable for him.
Gemma Gaudette: Yeah. Dr. McGeorge, I want to get to this question from Sheila. She's been listening to the program today and she says, how can we support health care workers other than get ourselves vaccinated? And she points out, I am vaccinated.
Dr. Laura McGeorge: Thanks. I do want to add one other thing on the prior question, too, about assuming that that teenager is vaccinated and hopefully is because, again, to what Dr. Pate said that is the number one, two and three thing. And then masking. The other thing is, I just want to point out, we are seeing teenagers who are, you know, in the state of Idaho, you need parental consent for vaccinations. And we are seeing teenagers who want to get vaccinated, but mom or dad will not let them. And, you know, that to me is pretty sad when that happens. And please, if your teenager wants to get vaccinated, please do let them go ahead and get vaccinated.
Gemma Gaudette: I'm so glad you pointed that out, because, yeah, if your teenager is coming to you, maybe let's listen to them. So we have about two minutes left Dr. McGeorge, Sheila wants to know how can people help health care workers? How can we support health care workers other than getting ourselves vaccinated? And she did point out that she is vaccinated.
Dr. Laura McGeorge: I think, you know, again, standing up for safety. So, making sure that you and the people you feel safe having conversations with are doing the right things to minimize this huge surge that we're in already. So that's one thing that they can do. Two is, you know it is very disheartening for health care workers to leave the hospital and then go out to the grocery store and see people that are unmasked. So, you know, wearing masks. But on a more personal level, I think, you know, if you know a health care worker thanking them, even as that is, you know, thanking them and acknowledging the work that they're doing and the trauma that they're going through is tremendously helpful. I know we have set up actually through our foundation where people can donate and we use that to support our staff financially in some circumstances as it relates to COVID. And we also can use that then to provide thank you meals to our staff at work on behalf of the community or on behalf of other St. Luke's employees that want to support them. I'm sure that other hospitals and health systems also would welcome those kind of contributions too.
Gemma Gaudette: Well, I want to thank both of you, as always, for the endless and tireless work that you have done, that you continue to do, as we go through this next, frankly, unimaginable surge. So thank you, thank you, Dr. McGeorge, and for what you do on the frontlines. Thank you, Dr. Pate, for being the voice, talking to people, not losing hope. Thank you both so very much.
Dr. David Pate: Thank you, Gemma. Thanks, Laura.
Dr. Laura McGeorge: Thank you.
Gemma Gaudette: And remember, our medical experts, they will be back here Wednesday. We will spend the entire hour once again next week talking about this. If you have questions, get them in, email@example.com. Our panel of medical experts today, Dr. David Pate and Dr. Laura McGeorge. Our producers are Frankie Barnhill and Samantha Wright. I'm Gemma Gaudette. It is Wednesday. We'll see you back here tomorrow.