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COVID 19: Testing In Universities & Non-Healthcare Settings, 12/17 · The SHEA Podcast

• 0:09
  SPEAKER_02: Welcome to the Rapid Response Podcast brought to you by the Society for Healthcare Epidemiology of America, Shay, promoting the prevention of healthcare associated infections and antibiotic resistance and seeking to advance the field of healthcare epidemiology and antibiotic stewardship.
• 0:24
  SPEAKER_02: I'm Dr.
• 0:25
  SPEAKER_02: Cindy Prince, Clinical Associate Professor of Epidemiology at the University of Florida, and I will serve as your moderator.
• 0:32
  SPEAKER_02: Discussion on the podcast does not reflect today's perspective, but facilitates communication of multiple perspectives and experiences as we go through this challenging time together.
• 0:41
  SPEAKER_02: Today is excited to launch this episode of the podcast COVID-19 updates of what we know now.
• 0:46
  SPEAKER_02: Today's discussion will focus on testing in universities and non-healthcare settings.
• 0:51
  SPEAKER_02: Our speaker today is Dr.
• 0:52
  SPEAKER_02: Christina Woods, a hospital epidemiologist at Mount Sinai West Hospital.
• 0:57
  SPEAKER_02: Thank you for joining us today.
• 0:58
  SPEAKER_02: Before we start our discussion, I would like to turn it over to Dr.
• 1:01
  SPEAKER_02: Jennifer Hallahan to get us started with a news brief and guidance update for the week.
• 1:06
  SPEAKER_00: Thank you, Dr.
• 1:07
  SPEAKER_00: Prince.
• 1:08
  SPEAKER_00: As of December 16, 2020, there have been 71,919,725 cases of COVID-19, including 1,623,064 deaths reported to the World Health Organization.
• 1:22
  SPEAKER_00: On December 15th, the United States reached the grim milestone of having over 300,000 deaths from COVID-19.
• 1:28
  SPEAKER_00: On December 11th, the Food and Drug Administration issued an emergency use authorization for the Pfizer BioNTech COVID-19 vaccine.
• 1:36
  SPEAKER_00: The Advisory Committee on Immunization Practices issued an interim recommendation for use of the Pfizer BioNTech COVID-19 vaccine in persons aged 16 years of age or greater for the prevention of COVID-19 on December 12th.
• 1:49
  SPEAKER_00: A report published in the Morbidity and Mortality Weekly report evaluated factors associated with positive SARS-CoV-2 test results in outpatient health facilities and emergency departments among children and adolescents aged less than 18 years in Mississippi from September to November 2020.
• 2:04
  SPEAKER_00: Among children and adolescents aged less than 18 years in Mississippi, close contact with persons with COVID-19 and gatherings with persons outside the household and lack of consistent mask use in school were associated with SARS-CoV-2 infection, whereas attending school or childcare was not associated with receiving positive SARS-CoV-2 test results.
• 2:23
  SPEAKER_00: A paper published in JAMA on December 10th titled Risk Factors Associated with In-Hospital Mortality and a U.S.
• 2:30
  SPEAKER_00: national sample of patients with COVID-19 evaluated epidemiologic characteristics of patients with COVID-19 treated in U.S.
• 2:37
  SPEAKER_00: hospitals.
• 2:37
  SPEAKER_00: This cohort study was conducted using Premier Healthcare Database, a large geographically diverse all-payer hospital administrative database, including 592 acute care hospitals in the United States.
• 2:48
  SPEAKER_00: Inpatient and hospital-based outpatient visits with the principal or secondary discharge diagnosis of COVID-19 between April 1 and May 31st, 2020 were included.
• 2:58
  SPEAKER_00: Overall, 64,781 patients with COVID-19 were analyzed.
• 3:02
  SPEAKER_00: The median age was 46 years for outpatients and 65 years for inpatients.
• 3:06
  SPEAKER_00: In hospital mortality was 20.3% among inpatients.
• 3:10
  SPEAKER_00: 15.9% received invasive mechanical ventilation, and 19.4% were admitted to the ICU.
• 3:16
  SPEAKER_00: Median inpatient length of stay was six days.
• 3:19
  SPEAKER_00: Median ICU length of stay was five days.
• 3:21
  SPEAKER_00: Common acute complications among inpatients included acute respiratory failure, acute kidney failure, and sepsis.
• 3:27
  SPEAKER_00: Older age was the risk factor most strongly associated with death.
• 3:30
  SPEAKER_00: Receipt of statins, angiotensin converting enzyme inhibitors, and calcium channel blockers was associated with decreased odds of death.
• 3:37
  SPEAKER_00: Compared with patients with no hydroxychloroquine or azithromycin, patients with both azithromycin and hydroxychloroquine had increased odds of death.
• 3:45
  SPEAKER_00: A guidance document was published in the Lincent Infectious Diseases on December 14th on defining and managing COVID-19 associated pulmonary aspergillosis.
• 3:53
  SPEAKER_00: The key points of this guidance document are that the increasing number of reports on COVID-19 associated invasive pulmonary aspergillosis raise concerns about the superinfection as an additional contributing factor to mortality.
• 4:04
  SPEAKER_00: The European Confederation for Medical Mycology and the International Society for Human and Animal Mycology instituted a group of experts to propose consensus criteria for a case definition of KAPA and to provide up-to-date management recommendations for the diagnosis and treatment of patients with KAPA.
• 4:21
  SPEAKER_00: Three different grades are proposed: possible, probable, and proven, and voriconazole and or isovuconazole are recommended as first-line treatments for possible, probable, and proved COVID-19 associated pulmonary aspergillosis.
• 4:34
  SPEAKER_00: On December 15th, the Food and Drug Administration authorized the first rapid over-the-counter coronavirus test that can be done at home.
• 4:40
  SPEAKER_00: This test, called a loom, is a lateral flow assay.
• 4:44
  SPEAKER_00: A report published in British Medical Journal December 15th demonstrates that lateral flow tests miss over half of cases.
• 4:50
  SPEAKER_00: The rapid test is most widely used in UK university schools and care homes detected just 48.9% of COVID-19 infections in asymptomatic people when compared with the polymerase chain reaction test.
• 5:01
  SPEAKER_00: Real-world data from the Liverpool pilot have shown.
• 5:04
  SPEAKER_00: The Innova lateral flow SARS-CoV-2 antigen test failed to detect three in 10 cases with the highest viral loads in preliminary data released from the field evaluation of testing in asymptomatic people.
• 5:16
  SPEAKER_00: And that's the news for this week.
• 5:17
  SPEAKER_02: Thank you, Dr.
• 5:18
  SPEAKER_02: Hanrahan.
• 5:18
  SPEAKER_02: I now want to move into the discussion with Dr.
• 5:21
  SPEAKER_02: Woods.
• 5:21
  SPEAKER_02: Thank you so much for joining us today.
• 5:23
  SPEAKER_02: You know, we've talked a lot, I think, about testing in healthcare settings, whether that be inpatient or outpatient.
• 5:29
  SPEAKER_02: But can you talk a little bit about some of the non-healthcare settings where you've been working to test for COVID-19?
• 5:35
  SPEAKER_01: Absolutely.
• 5:35
  SPEAKER_01: Thank you, Dr.
• 5:36
  SPEAKER_01: Prinz.
• 5:37
  SPEAKER_01: I'm very happy to be part of this conversation.
• 5:39
  SPEAKER_01: Yes, I do think there's been so much focus on healthcare settings, but of course there are so many people who are dealing with this in their businesses, in schools, and in other places.
• 5:48
  SPEAKER_01: Because I'm in New York City, I've been able to provide some guidance to some of these individuals.
• 5:52
  SPEAKER_01: So some of the places that I've worked with include early childhood centers, elementary and middle schools, theaters, performing arts groups, and some businesses, including some of the banks in Manhattan, and we also have some museums that have reached out to myself and those within my group.
• 6:07
  SPEAKER_01: So a pretty diverse group of individuals who are looking for some guidance as to what to do to keep their students safe, to keep their employees safe, and to keep those who come in to enjoy some of these settings safe as well.
• 6:20
  SPEAKER_02: Yeah, it's very diverse and it's actually interesting.
• 6:22
  SPEAKER_02: I didn't think about some things like certain businesses that might be wanting testing for their employees.
• 6:27
  SPEAKER_02: But what are some of the challenges that you're seeing then in these different settings?
• 6:31
  SPEAKER_01: Well, each of the settings brings a completely different set of challenges just based on what they are.
• 6:36
  SPEAKER_01: For example, we know that there are some basic tenants that do keep us all safer and healthier, and they're not necessarily always possible.
• 6:43
  SPEAKER_01: For example, in early childhood centers, it's really difficult to get the really little kids to math.
• 6:47
  SPEAKER_01: It's really difficult to keep them separate from their peers.
• 6:50
  SPEAKER_01: When they're having a tough time, when mom or dad leaves them and they're crying or having a bad day, it's impossible to tell that educator to not go and comfort the child and to physically be there to give them a hug or to make them feel better.
• 7:01
  SPEAKER_01: So in some settings, the basic tenants that we would put into place are just not possible.
• 7:05
  SPEAKER_01: And then navigating around those is a challenge in and of itself.
• 7:08
  SPEAKER_01: Access to testing, I think, is another challenge.
• 7:11
  SPEAKER_01: In New York, you can go online and you can find all these great testing centers, but even then it still feels like it's not as easy as it could be.
• 7:17
  SPEAKER_01: And some of these centers don't have ways of standing up their own testing.
• 7:21
  SPEAKER_01: They don't have partnership with anywhere specific to send their employees or to send their students.
• 7:27
  SPEAKER_01: So that is also another challenge that they have.
• 7:29
  SPEAKER_01: Sometimes the willingness of the employees to follow guidance is also variable.
• 7:33
  SPEAKER_01: We've seen in New York in particular, some businesses, in particular some of the larger banks, have a culture where they have death, where everyone works closely together.
• 7:42
  SPEAKER_01: And because they feel like such a family, it's a difficult thing to try to convince them that masking is important in that setting and that they do need to build a little bit of a different culture, at least temporarily, of having some more space.
• 7:53
  SPEAKER_01: And getting them on board with that has been a challenge as well.
• 7:56
  SPEAKER_01: And then the risk tolerance varies by institution, and that means that the policy decisions that they're gonna put in place are gonna vary.
• 8:03
  SPEAKER_01: You know, most of the schools that I've worked with and the theaters and the performing arts spaces have been incredibly receptive and have wanted to sort of do the best that they can in terms of putting some strong guidelines in place for their students and their faculty about the behaviors that they expect both in and out of work.
• 8:18
  SPEAKER_01: And that's not necessarily something you can do in a business setting, for example.
• 8:22
  SPEAKER_01: There's a little bit more leverage, I feel, with schools, and everybody feels it's much more important to make sure that you're protecting those children and also those educators, where in a business setting, when you have adults who are used to making their own autonomous decisions, it's a little bit more difficult to bring in some policies into those spaces.
• 8:38
  SPEAKER_02: Yeah, it's really interesting, I think, this idea that we think about this all the time and we think about what are the best precautions to put in place to prevent COVID-19 infection.
• 8:47
  SPEAKER_02: And yet I think when you go to some of these settings, you realize that maybe people don't always have that awareness of how to do that.
• 8:53
  SPEAKER_02: And I love that idea that, you know, well, they feel like a family, so they're just going to be interacting with each other and not the best idea at the moment.
• 9:00
  SPEAKER_02: So when you're doing testing in some of these different settings, how's that comparing to doing it in the healthcare setting where you also are?
• 9:08
  SPEAKER_01: So I think a lot of things when you sort of look at it in the non-healthcare settings versus the healthcare settings, there are a lot of differences there.
• 9:14
  SPEAKER_01: Acceptance of and familiarity with infection prevention protocols are different.
• 9:18
  SPEAKER_01: Again, the ability to test.
• 9:19
  SPEAKER_01: So in the healthcare setting, we have a way, we have our lab, we have a way of getting our employees tested, we have a way of getting our patients tested.
• 9:27
  SPEAKER_01: In these other settings, we've had to resort to either partnering them with their local urgent care center, their local testing center, making them aware of where those testing centers are.
• 9:37
  SPEAKER_01: In some other groups that I've worked with, we have resorted to some of these test kits that they can obtain and they can swab their own snares and then send it off to the reputable labs.
• 9:48
  SPEAKER_01: For example, Lab Core is doing one of these kits through Pixel Labs.
• 9:51
  SPEAKER_01: You know, the plan is you have the individuals, say within that performing arts theater, they all will send out and they'll get their test kit, and then at certain intervals you're telling them to test and they're sending them out because they may be in a more remote setting for some time and they're not able to actually access a testing center.
• 10:08
  SPEAKER_01: So that's been a very interesting uh sort of difference.
• 10:11
  SPEAKER_01: Also, the ability to contact trace is different in these places.
• 10:14
  SPEAKER_01: So, you know, in a hospital we have a framework to deal with our employees who are sick and exposed.
• 10:19
  SPEAKER_01: Most of these businesses and most of these institutions don't have that.
• 10:22
  SPEAKER_01: They just tell them to go to their own doctor.
• 10:23
  SPEAKER_01: So even being able to get information about who else might have been exposed, it feels very different to these institutions and to these schools because they don't normally do that.
• 10:32
  SPEAKER_01: So that's been another challenge.
• 10:33
  SPEAKER_02: Yeah, that is so interesting.
• 10:35
  SPEAKER_02: So we've got these sort of non-traditional settings and then healthcare settings, but I feel like there's also these settings that fall in between that they're healthcare adjacent.
• 10:43
  SPEAKER_02: So you've got psychiatric facilities and detox centers.
• 10:47
  SPEAKER_02: So what about testing in those spaces?
• 10:49
  SPEAKER_01: Yeah, so in our hospital, we actually have an inpatient psychiatric setting.
• 10:54
  SPEAKER_01: We also have some inpatient detox and those present their own challenges.
• 10:58
  SPEAKER_01: So in those situations, I almost feel like it's more of a college or university type setting in the sense that they're living in these congregate living situations, but they're also interacting in ways that are different to the traditional inpatient hospital settings.
• 11:12
  SPEAKER_01: They're going to group therapy or art therapy.
• 11:14
  SPEAKER_01: We can be very clear about where we expect them to sit and that we want them to do hand hygiene before they come into there and wear their masks.
• 11:20
  SPEAKER_01: But sometimes because of their active psychiatric issues or their active substance abuse, they're not really able to comply with some of these things.
• 11:26
  SPEAKER_01: So that's difficult.
• 11:27
  SPEAKER_01: So they're not always masking as well as you would hope that they would be.
• 11:31
  SPEAKER_01: For example, alcohol hand sanitizer is not something we can leave in our detox unit because we worry about the potential of ingestion.
• 11:38
  SPEAKER_01: So that makes it a challenge in its own way.
• 11:40
  SPEAKER_01: And I do feel that in those spaces, I almost think of them more as a college or university type setting, both in the way that we deal with potentially an outbreak in one of these settings, but also in the way that we do testing in them.
• 11:51
  SPEAKER_02: So what are the testing protocols for some of these non-healthcare settings then?
• 11:55
  SPEAKER_01: I think again it depends on the setting that it is.
• 11:58
  SPEAKER_01: For the psychiatric inpatient facility or for the detox center, we do more regular testing because we're looking to screen the individuals that are coming in.
• 12:06
  SPEAKER_01: So for example, in our setting, we do testing upon admission and then we have brought in more routine testing on a weekly basis to make sure that those residents that we have are not actually COVID positive because we do understand that somebody can come in and test negative initially and could be incubating from outside.
• 12:23
  SPEAKER_01: And so in that setting, we felt that there was a higher risk of the potential that they could maybe transmit amongst themselves, especially since they're participating in some group activities, albeit at a distance.
• 12:33
  SPEAKER_01: And so that's what we've decided to do.
• 12:35
  SPEAKER_01: In some of the other institutions, some of the schools that I've dealt with, they've really felt strongly that they can put into place a lot of the social distancing, the hand washing, putting up plexiglass, you know, making sure their children are masked, distancing the desks.
• 12:48
  SPEAKER_01: And in those settings, testing doesn't necessarily have to happen on a regular routine basis.
• 12:52
  SPEAKER_01: You can absolutely make an argument for doing some routine screening to look for asymptomatic individuals.
• 12:58
  SPEAKER_01: But if all those other control measures are in place, an institution can certainly decide to have a testing policy for those who become symptomatic and then exclude them from being in the school or being in the institution.
• 13:09
  SPEAKER_01: And that has definitely worked well in some of the groups that I have advised.
• 13:13
  SPEAKER_01: So I think it really depends on first of all what the access is to testing itself, and then what the institutional philosophy is and to what extent they're able to implement some of the distancing.
• 13:25
  SPEAKER_01: And if that's not possible, then I think testing does have a much more prominent role.
• 13:29
  SPEAKER_01: And then testing on a scheduled basis definitely makes a lot more sense.
• 13:33
  SPEAKER_02: That's so interesting.
• 13:34
  SPEAKER_02: Yeah, just not something that I've been thinking a lot about.
• 13:36
  SPEAKER_02: So thank you for that.
• 13:38
  SPEAKER_02: In my world, I'm in a university setting, and of course, we're doing some testing here.
• 13:42
  SPEAKER_02: So what's the aim of testing in this university setting versus other settings?
• 13:46
  SPEAKER_02: And what are you doing with the information that comes from testing in the places where you are doing the testing in these non-traditional settings?
• 13:53
  SPEAKER_01: So for our psychiatric inpatient facility and also for the detox center, obviously, if we were to have multiple individuals test positive, you would then worry about the potential of an outbreak.
• 14:02
  SPEAKER_01: And I think having that information is important because it could mean closing the unit, making sure we're adequately quarantining people.
• 14:08
  SPEAKER_01: And so in that setting, I think it's useful to know that ahead of time so that we can potentially limit the spread of COVID through a facility like that.
• 14:16
  SPEAKER_01: Most of the schools that I'm dealing with are schools in New York City.
• 14:19
  SPEAKER_01: And I think if you have a few sporadic cases, it's not as clear what to do in that situation.
• 14:23
  SPEAKER_01: If it's not clearly an outbreak in the school, you know, there's no way you can quarantine New York City.
• 14:27
  SPEAKER_01: There's no way you can quarantine the neighborhood.
• 14:29
  SPEAKER_01: You can certainly go back to the school and make sure that some of the other protocols are actually happening in the correct way.
• 14:34
  SPEAKER_01: But sporadic cases here and there in the school aren't necessarily going to be something that's going to necessitate a closure the way that it would for an inpatient facility for detox or for psyches.
• 14:44
  SPEAKER_01: Having said that, again, if you do detect an outbreak in the school, that certainly makes sense then to close that or if you have something similar in performing arts group where they're physically close, they're speaking, they're singing, you're going to need to make a decision about how long you're going to need to close for and ensure that you can reopen healthy.
• 14:59
  SPEAKER_01: But I think that'd be another great question actually for you is what you're doing with these test results in the university setting.
• 15:05
  SPEAKER_02: Yeah, so it's been an interesting ride in how this has gotten set up at the university setting.
• 15:10
  SPEAKER_02: But at this point, we're doing testing for anyone who wants a test and that they can get tested anytime.
• 15:16
  SPEAKER_02: So we have people who will just test because they're curious or maybe they're concerned.
• 15:21
  SPEAKER_02: We also have some targeted testing that we'll be doing.
• 15:23
  SPEAKER_02: So there are certain groups that are identified as potentially being higher risk, and those will be students in face-to-face classes this spring, students who live in dormitories.
• 15:33
  SPEAKER_02: So of course that concrete housing that we worry about, getting lots of places in those settings.
• 15:37
  SPEAKER_02: And along with that, also students who are in Greek housing or even affiliated with Greek housing because they go there for meals.
• 15:44
  SPEAKER_02: So those are going to be our target groups for spring.
• 15:47
  SPEAKER_02: We've also done some of the wastewater testing.
• 15:50
  SPEAKER_02: So that's been nice to be able to identify potentially at an early time whether you need to go to a certain area of campus and provide sort of on the spot, more convenient testing to really capture a lot of people and make sure that if there is an issue building up, let's say, for example, in a dormitory, that you're able to identify that as early as possible.
• 16:10
  SPEAKER_02: And for us, we're really fortunate because we're partnered with our local health department.
• 16:14
  SPEAKER_02: And so we have folks who are working as disease investigators who, when we have these test results, they're able to do the test investigation and the contact tracing right from the university setting.
• 16:26
  SPEAKER_02: And so when we do that, if we identify positives, number one, we're able to really comprehensively tag everyone who's testing positive who's affiliated with the university.
• 16:35
  SPEAKER_02: And then the other part of that is being able to not clear them for campus.
• 16:40
  SPEAKER_02: So set it up so that they are not attending class, not using the gym, and then being moved out of the dormitory setting if need be to an isolation or quarantine dorm, depending on whether they're positive or they're a contact.
• 16:53
  SPEAKER_02: So, you know, we have all these different settings.
• 16:55
  SPEAKER_02: And I was just talking a little bit about our partnership with the local health departments.
• 16:59
  SPEAKER_02: How is testing getting reported in these different settings where you're doing the testing?
• 17:03
  SPEAKER_02: I think for universities that may not be as challenging, but I think some of these smaller settings where you are in these very specific settings, that could be a lot different.
• 17:12
  SPEAKER_01: Absolutely.
• 17:13
  SPEAKER_01: So within New York, New York actually requires schools to report daily if they have positive tests.
• 17:19
  SPEAKER_01: They actually make them fill out the form even if it's negative.
• 17:21
  SPEAKER_01: So the school every day by a certain time has to go and check off whether or not they've had any positive test reports or not.
• 17:28
  SPEAKER_01: And that doesn't necessarily mean that they are testing their own.
• 17:30
  SPEAKER_01: But if a child is out sick and then the parent is required to call into the school and say, hey, you know, my kid is out, they were tested and we just got the result as positive, it is actually the school's responsibility to report that as well.
• 17:42
  SPEAKER_01: Obviously, the testing centers are reporting, so sometimes there's duplicate reports, but the thought is that they'd rather have the duplicates than not have it reported.
• 17:49
  SPEAKER_01: For us within the hospital, it's also quite easy when we have these inpatient detox centers or inpatient psychiatric facilities.
• 17:56
  SPEAKER_01: We are required to report any positive tests from there as well as part of our usual reporting.
• 18:01
  SPEAKER_01: So there's a structure through our infection prevention department that allows for us to make sure that we're doing that and actually escalating it to our group that does the actual reporting.
• 18:09
  SPEAKER_01: So in that setting, it's easier.
• 18:10
  SPEAKER_01: In businesses, I think it's more difficult because they're not necessarily mandated to do the reporting.
• 18:15
  SPEAKER_01: And in that case, the reporting is done by the facility that actually records the positive test where that employee has been tested.
• 18:22
  SPEAKER_02: Interesting.
• 18:23
  SPEAKER_02: Yeah, I think there's some advantage at least in the fact that everyone's sort of local, right, where you're testing.
• 18:28
  SPEAKER_02: I think one concern for us at universities is that we are sending students home or break.
• 18:33
  SPEAKER_02: They're potentially going home to other states and they may be testing there.
• 18:37
  SPEAKER_02: So it can become a challenge for us.
• 18:39
  SPEAKER_02: If they test here and then they go home, you know, we can still get in touch with them.
• 18:43
  SPEAKER_02: They'll be recorded in the state of Florida.
• 18:45
  SPEAKER_02: But if they test in their home state, we may not know about that positive test.
• 18:49
  SPEAKER_02: You know, I don't know whether that's going to be really followed up as well as I perceive we're doing it, but we will have everyone testing when they come back from break.
• 18:57
  SPEAKER_02: So hopefully that will get people covered there.
• 19:00
  SPEAKER_02: So how do you encourage individuals to get tested?
• 19:03
  SPEAKER_02: You know, I think we've had a little bit of this concern at the university level of what a positive test result may bring for them.
• 19:10
  SPEAKER_02: So how do you encourage them to get tested, even if it means that they may be sent home from work or not allowed to attend school?
• 19:17
  SPEAKER_01: Yeah, so I think depending on the different institutions again that I've dealt with, there's been varying degree of acceptance of going to get tested.
• 19:24
  SPEAKER_01: Certainly in schools, anytime an educator has felt unwell, they really haven't had a problem to go and get tested because they really are so focused on making sure that their colleagues and the children that they teach are safe.
• 19:35
  SPEAKER_01: Similarly, in some of the performing art institutions that I've spoken to, again, they very much understand that they are so close to each other that they're doing things that would be considered higher risk, more aerobic type activities, singing and all that indoors.
• 19:48
  SPEAKER_01: And so they also feel a sense of duty to the people that they work with to ensure that they're getting tested.
• 19:55
  SPEAKER_01: I think in some other places it's a little bit more challenging again in some of these other businesses where people have maybe a little bit more of a feeling of you want to come into work, you don't want to let the rest of the team down, you don't want to be seen as the person who's out.
• 20:07
  SPEAKER_01: And in that space, I think the best thing that we can do is really try to appeal to everyone's sense of civic duty, which I think sometimes has surprised us and sometimes it's been appalling to see how little of it there is, but really to try to remind them that you might be young and healthy, you might not really get that sick.
• 20:22
  SPEAKER_01: Of course, we don't know by looking at somebody who will or won't be in that critically ill bucket, but we try to tell them that just because you yourself feel that you may not be at risk, it doesn't mean that you may not come across somebody who is elderly.
• 20:34
  SPEAKER_01: You're going to the supermarket, some people are still going to the gym or whatever it is.
• 20:37
  SPEAKER_01: You may come across somebody who is pregnant, who is elderly, who has a health problem that you're not aware of, maybe even some of the coworkers that they're working with.
• 20:45
  SPEAKER_01: And we try to keep explaining that that is a good reason to get tested and to make sure that you're not coming to work sick.
• 20:50
  SPEAKER_01: But it's a challenge.
• 20:51
  SPEAKER_01: Yeah, absolutely.
• 20:52
  SPEAKER_01: I agree.
• 20:53
  SPEAKER_01: And I can only imagine in the university setting how much more of a challenge it is when you really do have a bunch of young people who really, first of all, don't feel like they're ever at risk for anything and feel like they're on the top of the world.
• 21:03
  SPEAKER_01: They're not home, they're away from their parents.
• 21:05
  SPEAKER_01: And I can imagine that in that setting it's a particular challenge.
• 21:08
  SPEAKER_01: So I hats up to you and your group for getting them tested.
• 21:11
  SPEAKER_02: It can be a challenge.
• 21:12
  SPEAKER_02: I've actually been pretty impressed, I have to say, overall, with how students are doing.
• 21:16
  SPEAKER_02: I think probably the majority of our students are really doing what we need them to do, and I'm appreciative of that.
• 21:22
  SPEAKER_02: Can I ask one more question?
• 21:24
  SPEAKER_02: With the emergency use authorization of the Pfizer vaccine, and now we're kind of on the cusp of Moderna, probably getting the same EUA.
• 21:31
  SPEAKER_02: Do you anticipate that that's going to change your protocol for testing in some of these settings?
• 21:37
  SPEAKER_01: That's a really great question.
• 21:39
  SPEAKER_01: I think unfortunately, some of the places that I'm working in are going to have individuals who are not necessarily going to be some of the first that are going to be up for receiving that vaccine.
• 21:48
  SPEAKER_01: So in those settings, I don't necessarily know that it's going to change much.
• 21:52
  SPEAKER_01: I'm thinking in particular some of the businesses that I've been interfacing with and maybe some of the museums and the performing arts spaces.
• 21:59
  SPEAKER_01: In the schools, again, the children are not necessarily going to be the first in line for those either, but their educators, I would hope, would be higher on the list of priorities.
• 22:07
  SPEAKER_01: So in terms of testing that population, there may be some changes with the educator side of things, not necessarily so much the children, because I'm assuming they're going to be vaccinated at best, maybe summer or fall.
• 22:19
  SPEAKER_02: Right.
• 22:20
  SPEAKER_02: What we're doing at the university setting is as we roll out the vaccine, we will start to pull people out of the mandatory testing.
• 22:28
  SPEAKER_02: So the folks who are in the face-to-face classes and the dormitories.
• 22:33
  SPEAKER_02: I anticipate it'll still be some time before they get vaccinated, of course, but I think we are looking at potentially being able to pull them out of that testing protocol so that we're not consistently testing people who have been vaccinated.
• 22:45
  SPEAKER_01: I think that'll actually give us a lot of really interesting data because it is a setting where we're going to actually be able to know whether or not there's transmission after someone's been vaccinated too.
• 22:54
  SPEAKER_02: Right.
• 22:55
  SPEAKER_01: I could also see some argument for maybe continuing it for some time, even just for understanding whether or not the vaccine is as effective as we're all hoping it will be in the greater population.
• 23:04
  SPEAKER_02: Yeah, that's a really interesting point to be able to kind of continue that since we don't necessarily have all of that information yet from the vaccine companies.
• 23:12
  SPEAKER_02: And that's still a question for a lot of us of what's going to happen.
• 23:16
  SPEAKER_01: You know, you already have a protocol in place in some ways, almost captive groups, that you would be able to get that information.
• 23:21
  SPEAKER_01: And of course, you'll have to go through the appropriate protocols in order to be able to continue testing them.
• 23:25
  SPEAKER_01: But I think it'd be an interesting bit of data to obtain.
• 23:27
  SPEAKER_02: Yeah, I agree.
• 23:28
  SPEAKER_02: I agree.
• 23:29
  SPEAKER_02: Well, Dr.
• 23:30
  SPEAKER_02: Woods, it has just been such a pleasure to get to talk to you about this.
• 23:33
  SPEAKER_02: And thank you so much for joining us today.
• 23:36
  SPEAKER_01: Thank you again for inviting me to have this conversation.
• 23:38
  SPEAKER_01: Really happy to be a part of this, and hopefully this information will help somebody who is struggling with some of these questions.
• 23:44
  SPEAKER_02: Thank you very much to our speaker for sharing your perspectives and experiences.
• 23:48
  SPEAKER_02: This podcast can be accessed on today's online education center, learning CE, under the Rapid Response Program.
• 23:55
  SPEAKER_02: You'll also find resources such as the recorded webinars, healthcare facility outbreak preparedness, and the KOVI town halls.
• 24:03
  SPEAKER_02: You can now receive 50% off your 2021 K membership using the coupon code WELCOME2021 during checkout.
• 24:11
  SPEAKER_02: That concludes this episode of the Rapid Response Podcast.
• 24:14
  SPEAKER_02: Thank you for tuning in.