'We may have not seen the worst of this': Idaho doctors share COVID-19 projections
Hospitals in Idaho are bursting at the seams amid our state’s COVID-19 surge — and state officials are predicting the situation could get much worse. According to a model compiled by the Idaho Department of Health and Welfare, the state could see a worst case scenario of as many 1900 hospitalizations in a single by the end of November, which is a major increase over current levels.
Idaho Matters is joined by Dr. David Pate, former CEO of St. Luke's Health System and a current member of the Idaho Coronavirus Task Force, and Dr. Louis "Chip" Roser, a Primary Care Medical Director at Saint Alphonsus.
“If we don't act as a community and don't come together and work together to stop this [...] I think we are going to be in a situation that's quite dire.”
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Gemma Gaudette: You're listening to Idaho Matters, I'm Gemma Gaudette. Hospitals in Idaho are bursting at the seams amid our state's COVID-19 surge, and state officials are predicting the situation could get much worse. According to a model compiled by the Idaho Department of Health and Welfare, the state could see a worst case scenario of as many as 1900 hospitalizations in a single week by the end of November. That is a major increase over current levels. Joining us today to talk about this are Dr. David Pate, former CEO of St. Luke's Health System, as well as the current member of the Idaho Coronavirus Task Force and Dr. Louis "Chip" Roser, a primary care medical director at St. Alphonsus. I want to thank both of you for joining us today.
Dr. David Pate: Thank you, Gemma.
Dr. Louis "Chip" Roser: Thank you for having me on.
Gemma Gaudette: And I just want to say a note to our listeners: this is taped today. Normally we're live at noon, but we had some scheduling issues, so we're going to get to the questions that we have in. But if you do have a question, still send it in email@example.com. We will just get to those questions next week. So with that, said Dr. Roser, I want to start with you. How are things at St. Alphonsus right now?
Dr. Louis "Chip" Roser: Well, I think that,obviously, things are are very stressful and the resources are being pushed to their limits. My expertise certainly isn't in the hospital. I'm an outpatient physician and so I can speak to that much, much better. And I think that what we are trying to do as outpatient doctors is relieve our colleagues in the hospital as much as possible. And so we're creating room in our schedules so that we can see people that are acutely ill with COVID. I think initially when the outbreak occurred last year, we were working quite hard to kind of keep people centralized and out of our clinics. And now that the numbers are so much higher, that's just not possible any longer. Those clinics have been overwhelmed. And so we've kind of, dispersed all the patients back out to their primary clinics, and we've made the clinic so that there are places where people that are well can safely be seen and then people that are sick can be evaluated and tested for COVID and other acute illnesses. So we're all kind of stretched to the limit, of course, with the increased numbers and then obviously the problems with staffing that I think everyone's well aware of-- that we just don't have the staff that we need both in the hospital and in the outpatient clinic.
Gemma Gaudette: So, Dr. Pate, I want to talk a little bit more about the weekly briefing that Health and Welfare held yesterday. I did mention the worst case scenario--in the end of November 1900, hospitalizations per week according to a to a model that the department put together. We should note that as of just Friday, there were 777 patients hospitalized with confirmed or suspected COVID, which includes patients who were hospitalized in prior weeks. Now with that said, that number...I mean, we're talking 1900 in a single week. We're talking potentially 300 deaths a week. I mean, Dr. Pate, this seems frankly unimaginable.
Dr. David Pate: Well, it does Gemma--especially when you consider that it's avoidable. But when you look at these models--and models are only that, they're models. But if you look at kind of the consensus model where you kind of average them all together and you look at some of the worst case scenarios we've been tracking right along this model that heads to where you're saying we could end up and I do not have any idea how we'll handle that if we get to those levels. Because, as Dr. Roser and others have said, I mean, we're already feeling pushed to our capacity and, you know, Gemma, you and I have talked before that there seems to be this mismatch between the public's perception of, 'well, you know, everything's OK', but then what we're seeing inside the walls of our hospitals--and you know, we've had reporters come in the hospitals. Obviously, we're not going to parade the public through our hospitals, but we've had reporters go in and come out in tears after what they've seen. You've heard many medical people describing what is going on in there and becoming tearful as they they talk about just how bad this is.And as you said, we may not have seen the worst of this. Now what I have always said is if you want me to predict what things are going to be like, you have to tell me two things: how's the virus going to behave? In other words, is it going to be acting the same way or are we getting the variant, whatever? And how are people going to behave? Because we know that if everybody did what we said, even for just two or three weeks, we would tremendously change the trajectory of this disease in Idaho. And I know there's a lot of people out there in Idaho that don't want restrictions, don't want mandates. And I'll tell you, one of the best things then...is could we just come together? Could we just agree to do this for one month? If we could do that, we could get past this. And I don't know what's in the future, but we could get past this, bring it down, relieve our hospitals and save a lot of suffering and a lot of death.
Gemma Gaudette: I want to also talk about the Pfizer vaccine in particular with 5 to 11 year olds, because I'm hoping maybe this is a bright spot in all of this. Pfizer and Biotech, they submitted data that they say show the shots are safe in children ages 5 to 11. So Dr. Pate we talked about this last week, but what does that actually mean? I mean, can we start kind of projecting when this might be available to 5 to 11 year olds?
Dr. David Pate: Yeah. You know, we can't know for sure, but we certainly, as you asked, we can project. In other words, we know that under normal circumstances, it would take the FDA four to six weeks to review a request like this. So, you know, with that in mind, there is certainly reason to be hopeful that that authorization for the use of that vaccine, it could be here at the end of October, beginning of November, and that would be very welcome. First of all, you know, kids, although they don't typically get real sick, some do, but they play a huge role in the transmission of this virus. And secondly is, right now we have a lot of RSV, the respiratory syncytial virus going around. And Dr. Roser and I are both getting prepared for influenza that could be coming. Oftentimes is here in November, but we don't know what's going to happen this year exactly. But certainly if we can get people--everybody vaccinated that can be against COVID--and as many people as possible get vaccinated against influenza, then we're going to have a shot at getting through this. If we don't, I certainly fear based on what we've seen elsewhere and even early in Idaho, that the combination of COVID and RSV or the combination of COVID and influenza is going to make people even more sick at a time again when our hospitals are overwhelmed.
Gemma Gaudette: Dr. Roser, how concerned are you in regards to something like the flu hitting right when we are still in this surge and things could get could get worse? I mean, when we look at last year, we barely had any flu, but everybody was masking. That is not the case this year.
Dr. Louis "Chip" Roser: You know, I think Dr. Pate really kind of laid out the concerns that we in the medical community have, I think that certainly now we are seeing some RSV in children at higher numbers than we would expect at this time of year. And as Dr. Pate said, we are going into influenza season and the combination of all of those things is frankly terrifying. I mean, I think that really, when you look at the clinic capacity, the hospital capacity, it's already there. I mean, people are doing more than they have ever done before with fewer health care workers. And to add in, you know, influenza and RSV on top of the Delta variant and its effectiveness is really scary. And I would echo Dr. Pate comments about coming together as a community. I mean, this is a public health crisis, and I think that a large portion of the public is focusing on their individual concerns and rights, when this is a public health and we need to act together as a community to help mitigate the overwhelming rates of infection that we're seeing. Because if we don't act as a community and don't come together and work together to stop this, as he suggested, I think we are going to be in a situation that's quite dire.
Gemma Gaudette: And I want to take it back to children, because when Health and Welfare did their weekly update yesterday, they said that 20% of the cases currently reported of COVID 19 cases are among children, which is much higher than what we saw during last December. That's according to Dr. Catherine Turner, she's the deputy state epidemiologist. In fact, the week of September 20th, nearly 1700 pediatric cases were reported by the state. The peak last winter was just a little bit more than 1100 and Dr. Pate I bring this up because this is such a big increase in pediatric cases. It's doubled just since mid-August. And yes, children are not physically as impacted as adults, but they are getting it, they are getting it at rapid numbers and there is a domino effect to that.
Dr. David Pate: Well, there is, and this is what I have tried to explain to school leaders and school boards--largely unsuccessfully--that yes, it is true that if you look at the numbers, children are far less likely to die than adults. Children are far less likely to be hospitalized than adults. But let's tell the rest of the story. Number one: a lot of these children are getting infected, are taking this virus to home, and they're infecting their unvaccinated parents and they're unvaccinated parents are a lot of times the ones that are ending up in the hospitals in these ICUs. I'll tell you something I haven't heard talked about, but which just scares the dickens out of me. And that is, for example, someone who reached out to me about a single mother with four children not vaccinated and one of her children is significantly ill with COVID. That scares the fire out of me, because if that mother gets infected and she's unvaccinated, even if she just gets in the hospital, who's going to take care of those four kids? And then, of course, the more worrisome question what if she dies? Now we've just made for children, orphans...so..we have to understand there's a lot more impacts. The other thing is that last year... we might have one child in the hospital with COVID at a time. We've now had at times 10,13 children in the hospital with COVID... just at at St. Luke's Children's Hospital. And so we're certainly seeing more now. That doesn't necessarily mean Delta is more serious or severe. It may be the fact that just a whole lot more kids are getting infected today, but nevertheless there are kids ending up sick. And then I do think we need to keep in mind for everybody out there that thinks they understand everything about COVID. You're wrong. I don't understand everything about COVID, and what we don't know is some of the long term effects that this infection may have on these children. So we do not want children to get infected. And whether it's the fact that they're going to help spread it and infect somebody who will end up getting very sick or this potential that they could get very sick or maybe have some long lasting complications.
Gemma Gaudette: I have two questions from Koda--and Dr. Roser I'm going to give the first one to you. So Koda writes in saying 'I would like to thank our health care providers for being there during these very difficult times. If I send flowers to any of the facilities in Boise, such as St. Luke's or St. Alphonsus, would they get there?' And Dr. Roser, I just want to ask this question, frankly, because I think there are people who want to let health care workers know that they do appreciate what they're doing because there has been so much backlash.
Dr. Louis "Chip" Roser: And I really appreciate that sentiment, I think that when I talked to my colleagues, they are getting very tired and and burned out and frustrated. So I think that it's wonderful to hear from the community that they want to show their support. And I think any type of support that you can send...flowers, thank you cards or we've seen some signs in the community, all of those things are so appreciated. Just to let people know that their hard work and the fact that they're, you know, reaching their limits, but continuing to show up every day to provide the care that the community needs to keep everyone safe and on the road to recovery, I just think it's amazing, and I'm so impressed with the dedication of my colleagues and the care that they're giving and so any appreciation that you might reach out and give to anyone that, you know, in the health care community would would be very timely and so appreciated.
Gemma Gaudette: Dr. Pate, Beth writes in saying 'an acquaintance has an adult daughter with leukemia. She is being treated at a cancer care center in a neighboring state. My acquaintance told me that her daughter's cancer doctor told her daughter to refrain from getting a COVID vaccine. Are there medical conditions where a doctor would advise against the vaccine?'
Dr. David Pate: Well, there's very few circumstances where we would not advise someone to get vaccinated because of a medical condition. One thing that with vaccinations, sometimes we do have to be careful with is that we've had vaccines that have live virus--but what we call attenuated where it's not so strong, but it's still alive--and we have to be careful giving those to people with immune compromised conditions. But that's not what we're dealing with with COVID. COVID is not a live virus. Covid does not have the ability...these vaccines do not have the ability to actually cause infection, so there's very few circumstances under which someone cannot be vaccinated. Obviously, I don't know all the details about this particular patient. What my guess is is that this patient, having leukemia, probably has gotten chemotherapy that would wipe out most or all of her immune cells at the moment. And so that wouldn't be a useful time to vaccinate her because she's not going to respond. I doubt this physician is telling her that she should never get vaccinated. I think he's probably just telling her now is not the right time because you're not going to respond. Let's wait till you get past this part of the chemotherapy. And then, yes, you definitely should get vaccinated.
Gemma Gaudette: Julie in Boise, wanted to share this story because she's hoping that it might help. She attended a cardiology appointment with her mom earlier this week, and Julie says 'we touched on emergency room access related to my mom's health issues. The cardiologist brought the conversation to a full stop and shared the following. A gentleman in the Treasure Valley experiencing chest pains did not seek emergency care last weekend due to believing he could not go to an emergency room and receive care. The gentleman died. The cardiologist was very concerned that this situation could repeat itself. He said please go to an emergency room if you need emergency care, you will receive care. We do not want people to think that they cannot go to the hospital.' Dr. Roser, there seems to be a recurring theme where people equate crisis standards of care with...'I can't go to the emergency room if I have an actual emergency.'
Dr. Louis "Chip" Roser: Yeah, unfortunately, this is just a tragic story and unfortunately a misunderstanding, like you pointed out, Gemma. That it doesn't mean that the hospitals are closed, that the emergency rooms can't see you, it just means that they're at capacity. They're...people still need to go to the emergency room for emergencies. And when you have chest pain or symptoms of a stroke or car accidents, you know the emergency rooms are open and can care for everyone. I also think that... I've heard many patients express concerns about going to the hospital because of their risk of getting COVID. And I think that this is misrepresented as well. The hospitals are actually quite safe places to go because everyone there is masked. Both hospitals have implemented vaccine mandates, so virtually everyone at the hospital is vaccinated with a very few exceptions, and everyone is required to wear a mask. So these are...not only do they have capacity to care for people, but they're actually quite safe. And so I would encourage anyone with symptoms that they perceive to be an emergency to go ahead and go to the emergency room because they will be cared for and it will be a safe environment.
Gemma Gaudette: Dr. Pate, Jason writes in he says, 'I work on a floor dedicated to only COVID patients. I received the Pfizer vaccine, but I've seen several patients with the Pfizer vaccine become infected more than the other vaccines. They are usually are older or they have risk factors such as diabetes. I am concerned that my resistance against the Delta variant is waning. If there are vaccines about to expire, will they be available to health care workers? Furthermore, is it recommended that I get a Pfizer booster or could I get the Moderna?'
Dr. David Pate: Yeah. Good question. So let's take the first part of the question first--and that is because Jason actually works with COVID patients on a COVID floor--and if I understood this question correctly-- he initially did get the Pfizer vaccine. The FDA and CDC have just come out with advice on boosters, and what they have said is as long as it's been six months since Jason's second shot, he actually is eligible for a booster. And it's very likely that whatever hospital he works for is going to offer those to their employees so he might just check with his hospital. But those are approved now for him to get boosters--not everybody--but because of his circumstances, he is eligible for a booster. Now the question about can he mix it? Could he now get a different vaccine other than Pfizer? That is not authorized currently. However, I'm told that Moderna has just completed their study of 'mixing and matching' is what we call it, where somebody's got either J&J or Pfizer and now gets Moderna, and they are getting ready to submit that data to the FDA for review. I understand J&J has done the same kind of trials where they've taken people that have gotten Pfizer or Moderna and then giving them J&J, and that is going to the FDA, maybe in the next week or two. And then similarly, Pfizer will be submitting their data when they're used as the change up from somebody that got Moderna or J&J. So I would say right now for Jason, he needs to get a Pfizer vaccine as the booster. However, I suspect in the next month--maybe...might be two. But in the next month, we will have the answer to this question about whether it's safe to mix, whether you should mix or whether you should avoid mixing.
Gemma Gaudette: And Dr. Pate, can we talk a little bit more about the boosters because I think there's some confusion around it in regards to, you know, who can get it because at first it seemed like, 'oh, there's going to be a booster, you need to get a booster shot.' And now that's kind of been brought back a little bit to, 'well, if you're over sixty five, if you're 50 with an underlying condition,'... but it's only the Pfizer vaccine. So will at some point everyone need to get a booster? Or do we even know of that answer yet?
Dr. David Pate: We don't know that answer, but we are fully anticipating that the answer is yes. Whether you got Pfizer, Moderna or J&J. It is confusing, just as you said, because the approval process goes through quite a number of steps. But four big ones. One is this vaccine and biologics related committee meets. That was the first meeting they advised the FDA. It's an independent group. Then the FDA takes that advice and the FDA doesn't have to follow that advice exactly. It often does. But the FDA then made one little tweak. Then it goes to the advisory committee for the CDC, which is also independent. That's the ACIP or Advisory Committee on Immunization Practices. And then it made a little tweak and then it send it up to the CDC. And then ultimately, what happened was the CDC director made another tweak to it. So it's understandable people got confused. All of this was only discussed about Pfizer because that's the only data that was submitted and because it is confusing, I did kind of put out a diagram on my blog for anybody that's interested if they want to find out specifically under your circumstances, do you qualify for a booster? My blog is at drpatesblog.com and they can look at that. We do expect that the same discussion is going to occur about Moderna and very soon. So just stay tuned. And also, J&J says they have their data and that they're getting ready to submit it. So again, I think over the next month, two months at the most, we're going to have data and recommendations about mixing and matching. We're going to have data and decisions about boosters--no matter what kind you got. And I think we're going to have authorization for children 5 to 12 for vaccination. So, you know, the FDA and the CDC are doing a lot of work, but October, November, we're going to have a huge amount of new information coming out.
Gemma Gaudette: I want to talk with both of you about once again misinformation, because when we look at vaccine hesitancy and why people are not getting vaccinated, there seems just to be so much misinformation that is circulating out there in regards to that. And what I would like to talk about is a recent article that came out from the Idaho Freedom Foundation. Here is why: there is an article saying that you should not blame the unvaccinated for the activation of the state's crisis standards of care. They say blame the state's big hospitals. They go on to talk about back in the 80s, Idaho had close to four hospital beds for every 1000 residents. Today, the state has slightly more than two beds per 1000 residents. You know, this isn't just an Idaho problem, it is a U.S. problem. And it's basically within this article blaming the hospital system. They have been weighed down by the state's population growth. They've had, you know, bad decisions are being made and this is why we are in this situation. They even cite the issues with Medicaid, that it is a consequence of of grossly underestimating the program's utilization by 53% of Idahoans. With that, said, Dr. Roser, I'd like to start with your thoughts on this because there can be an argument that's made that we don't have enough hospital beds for a growing population. But how does that compare to...yes, but we're also in a public health crisis.
"Do you want us to control health care costs or do you want us to build a system that allows society to be irresponsible? You can't have it both ways."
Dr. Louis "Chip" Roser: Yeah, I think this is a you know, unfortunately, like you said, there is so much misinformation out there and people have beliefs that are almost, you know, religious in nature with their convictions. And they're so strong. And I don't think there's a willingness to kind of be open to the data and what that suggests. And of course, some portion of the Idaho Freedom Foundation's article that you just cited is accurate, right? Some of the beds were closed, and their reason for that was that hospital stays became much shorter and much more of the care in the community was given on an outpatient basis, either through home health or in primary care offices. And so those beds were no longer needed. I mean, for an example, you know, 15, 20 years ago when you had an appendicitis, you know, you spent three days in the hospital. Now it's an outpatient surgery and you go home. Same thing with a total hip replacement. You know, you don't spend several days in the hospital, you get physical therapy and you go home and you see your physical therapist on an outpatient. So those beds have closed, but they've been closed for a long time. And it's because of the fact that the care continues to be given. It's just given in a different location. And clearly, we are in this crisis now. This is a totally preventable crisis, as Dr. Pate mentioned that the vaccines are so effective that they prevent-- initially prevent even infection--which is basically their superpower. They were never designed to do that. They were designed to prevent severe illness, which they continue to be very good at. And I think that if our community had responded in a way that a large percentage of them are vaccinated, then we would not have this overwhelming crisis in the hospital, regardless of the number of beds. It's not about capacity because if people are unwilling to get vaccinated and continue to get infected at high rates, it doesn't matter how many hospital beds there are, they will always be exceeded. We talked about the projections earlier in the program and you can see that they...we are already at capacity. And yet here comes more. And so it's not a capacity issue. It's an inability to recognize the need of the community and to vaccinate so that the numbers start to drop.
Gemma Gaudette: Dr. Pate, I would like your thoughts on this because you ran Idaho's largest health care system for a decade. And I think, as Dr. Roser said, I mean, some of the numbers in that article... they are accurate. And that could then also, I think it plays into misinformation.
Dr. David Pate: Well, Gemma, you're exactly right, in fact, it's the worst kind of misinformation because what people do is they take this underlying...a little bit of facts, a little bit of true information and then they just sprinkle it with misinformation. And so when people read that or hear that it sounds 'Oh, well, that kind of rings true. So it must be right.' When actually this is people writing this that have no idea what they're talking about. And it's just to to think that at a time when we have never seen more heroism from our hospitals and health care professionals that we're going to say 'you know, it's not really the fault of the unvaccinated, it's the fault of the hospitals.' I mean, you asked me to share my thoughts. I'm going to do you the favor and keep some of my thoughts to myself. But let's go back to a few things that Dr. Roser said that are just exactly right. First of all, we have this saying-- you don't build the church for Easter Sunday. Meaning that you do not build facilities for the most highest capacity that you could ever imagine. And of course, I will tell you as --because you're quite right, I've led hospitals and health systems for the last 20 years--I never thought that if we had a public health emergency, that people wouldn't follow advice. And so, yeah, we didn't have any scenario planning to say, 'well, let's let's assume that there's a pandemic. It's highly infectious, but nobody wants to take precautions to protect themselves. How many hospital beds should we build?' We would be building hospitals on every corner. This is crazy. And of course, Idaho Freedom Foundation would be the first organization during normal times to be telling us, well, our health care costs are too high. So I spent the last decade trying to bring health care costs down, trying to--as Dr. Roser was talking about--you know, there's a lot of conditions we used to hospitalize people that we've come up with safe ways to just do the procedure and send them home. Used to be when you got a knee replacement, you were in for a couple of days to the hospital. Now we're sending people home from knee surgery. He mentioned appendicitis-- a gallbladder surgery used to be in the hospital for three to five days. We send them home now. We've come so far and what St. Luke's was trying to do was to streamline our our business so that we were able to do more in less expensive ways for people. But we never imagined that people wouldn't cooperate with public health recommendations. So this article is absurd. You don't get to have it both ways. Do you want us to control health care costs or do you want us to build a system that allows society to be irresponsible? You can't have it both ways.
Gemma Gaudette: I appreciate both of your thoughts on that. Let's get to some more listener questions. Dr. Roser Karen wrote in saying, 'I was told that no one has ever contracted COVID when with other people outdoors. Are we really safe, unmasked outdoors?'
Dr. Louis "Chip" Roser: I think this is a really good question-- everyone wants to know what they can do and what they can do safely, right? And I think that obviously this is a respiratory virus, and so it has to spread person to person. It's and that's all this is, it's just a biological process and the virus is going to do what it does and it will spread from person to person. So the closer you are and the less ventilation there is, the higher your risk. And obviously, being outside helps significantly mitigate that risk. And I can't say that no one has ever gotten infected outside. I don't think that's possible. But I do think that substantially reduces your risk of infection. And I think if you're vaccinated and you're with other vaccinated people and you're outside--then your risk is very, very low. And I don't think a mask is necessary. If you're, you know, going to be close to other people that you don't know, even outside and you're going to be talking loudly or being in close proximity, then yeah, I would recommend that you wear a mask even outside, because if you're close enough to get those respiratory droplets, then you're at risk for becoming infected.
Gemma Gaudette: Dr. Pate Ingrid wrote in and she's saying, 'is there any monitoring of people with long term symptoms? Does the CDC track for many months or years?' We're not at years yet of this...because she says 'I know someone who had COVID in January and they still cannot taste.'
Dr. David Pate: Yes, so there's no mandatory reporting of what we call 'long COVID.' There are some reports about that. There's some studies being done on these folks, so we're getting some information about what kinds of long term symptoms and problems folks may have. But this is not a situation where you could go to some website and it will chronicle everybody that has these long term symptoms. And you could decide, you know, how many people have them and which symptoms. There will be a lot more information about it as more studies are being completed and lots of places across the country have set up specific clinics to deal with people that are having the challenges of long COVID. One of the areas where we're starting to learn more is about long COVID and kids. For a long time, we didn't know whether that might happen in children. And so there is some evidence that it can happen in children as well--appears to be less common than in adults, thank God. But no, there's no place where you can go for a tally like we have our case counts of infection. You wouldn't be able to go and find a case count of long COVID.
Gemma Gaudette: We only have a couple of minutes left, and I want to take some time to ask each of you really about any silver linings and any hope. And I ask this because there are...I think many of us who are feeling downtrodden, who are feeling that this will never end, that it's hitting your head against a brick wall. And it's difficult to to find any any silver linings in this. So, Dr. Roser, I'll start with you. Even in the midst of this surge and what we are seeing and these these this model projecting how dire it could be come November... is there is there anything that lifts you up in this time?
Dr. Louis "Chip" Roser: You know, I think, Gemma... And I'm really glad that you brought that up because I think that we tend to talk about the negatives of the pandemic, but I do think that there has been some positive aspects of this. You know, as strange as that may seem to discuss, but I think one of the things that immediately came to mind when you mentioned that is the cooperation in the valley, among the hospitals, the health care workers and some of the government agencies. I don't think we've ever seen this level of cooperation between, you know, the large hospitals in the valley, the VA...you know, all the other clinic providers. I just think that the hospitals and the health care providers have done an amazing job coordinating together to do the best they can to provide the care for the Treasure Valley. I would say the other bright spot to me has has confirmed that, you know, just what an amazing group of people that I work with are, you know, their level of dedication and the fact that they're working at capacity and yet they get up every day and go in and continue to provide compassionate, quality care to our community is just...is just amazing. And I think those are those are some of the really bright spots for me.
Gemma Gaudette: Dr. Pate, I've got one minute left for you to take it away.
Dr. David Pate: All right, thanks, Chip. I'll be quick. You know, the bright spot is we have seen the commitment, dedication from our health care professionals. So I'm so proud of them and I want to include the public health professionals. It's been very difficult on them. I think the other thing is we should celebrate the science. It is absolutely astounding. Dr. Roser talked about the cooperation here in the Treasure Valley, among the hospitals and all. We have had worldwide cooperation among our scientists and medical leaders. We've accomplished things that Dr. Rosa and I could not have imagined we would be able to do what we did this past year. Let's just hope we learn from all of this.
Gemma Gaudette: Yes, let's hope we do. Well, as always, I want to thank both of you for joining us today. We've been talking with Dr. David Pate, former CEO of St. Luke's Health System and a member of the Idaho Coronavirus Task Force, along with Dr. Louis "Chip" Roser, a primary care medical director at St. Alphonsus. Now, remember, if you have a COVID-19 question for our medical experts, send us an email firstname.lastname@example.org and we will ask our doctors those questions next week. Again, a heartfelt thank you to both of you for coming on and for continuing to keep us informed with the facts, with the science, helping us move through this. Thank you both.
Dr. David Pate: Thank you, Gemma.
Dr. Louis "Chip" Roser: Thanks, Gemma.