Latest / The SHEA Podcast / COVID-19: Healthcare Professional Involvement In Vaccination Campaigns, 1/28/21

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COVID-19: Healthcare Professional Involvement In Vaccination Campaigns, 1/28/21 · The SHEA Podcast

• 0:07
  SPEAKER_01: Welcome to the Rapid Response Podcast brought to you by Society of Healthcare Ephreneology promoting the prevention of healthcare associated infections and antibiotic resistance and seeking to advance the field of healthcare ephreneology and antibiotic stewardship.
• 0:24
  SPEAKER_01: I'm Dr.
• 0:24
  SPEAKER_01: Walid Javid, hospital ephremiologist at Mount Sinai Downtown, and I'll serve as your moderator.
• 0:31
  SPEAKER_01: Discussions on the podcast does not reflect Shay's perspective, but facilitate communication of multiple perspectives and experiences as we go through this challenging time together.
• 0:44
  SPEAKER_01: She is excited to launch this episode of Podcast COVID-19 updates, What We Know Now.
• 0:51
  SPEAKER_01: Today's discussion will focus on healthcare professionals' involvement in vaccination campaigns.
• 0:58
  SPEAKER_01: Our speaker today is Dr.
• 1:00
  SPEAKER_01: Tyson Bell, Assistant Professor of Medicine and Convenience of Infectious Disease and Pulmonary Clinical Care at the University of Virginia, as well as the Director of Medical Intensive Care Unit at UVA Health.
• 1:14
  SPEAKER_01: Thank you for joining us today.
• 1:16
  SPEAKER_01: Before we start our discussion, I would like to turn it over to Dr.
• 1:20
  SPEAKER_01: Hannah Hand to get us started with a brief news and guidance update for this week.
• 1:25
  SPEAKER_00: As of January 27, 2021, there have been 99,638,507 confirmed cases of COVID-19, including 2,141,468 deaths reported to the World Health Organization.
• 1:39
  SPEAKER_00: As of January 26, 19,902,237 people have received at least one dose of vaccine against COVID-19 in the United States.
• 1:49
  SPEAKER_00: The Minnesota Department of Health released a statement confirming the nation's first known COVID-19 case associated with Brazil P1 variant on January 25, 2021, and a patient recently returned to Minnesota after having traveled to Brazil.
• 2:02
  SPEAKER_00: The Minnesota Department of Health stated that while this variant is thought to be more transmissible than the initial strain of the virus that causes COVID-19 disease, it is not yet known whether the variant causes more severe illness.
• 2:12
  SPEAKER_00: This case marks the first documented instance of the Brazil P1 variant in the United States.
• 2:16
  SPEAKER_00: The variant was found through the Minnesota Department of Health's variant surveillance program.
• 2:21
  SPEAKER_00: This variant was found from random samples collected from a number of laboratories.
• 2:25
  SPEAKER_00: According to news on the British Medical Journal website, the new UK variant of SARS-CoV-2 may be associated with an increased risk of death, emerging data are suggesting.
• 2:34
  SPEAKER_00: In a briefing paper published on January 22nd, the government's new and emerging restroid virus threats advisory group highlighted several preliminary analyses showing a possible increase in the severity of disease associated with the new variant of concern, B-117, which first emerged in Kent in September.
• 2:50
  SPEAKER_00: Two unpublished papers, one from London School of Hygiene and Tropical Medicine and one from the Imperial College London, reported an increased case fatality rate.
• 2:58
  SPEAKER_00: Both studies analyzed cases of the new and old variant by linking community testing data with death data.
• 3:03
  SPEAKER_00: Based on these analyses, there is a realistic possibility that the infection with variant of concern B 117 is associated with an increased risk of death compared to infection with non-variant of concern viruses, the briefing paper said.
• 3:15
  SPEAKER_00: The Prime Minister Boris Johnson referred to the data at a Downing Street press briefing on January 22nd, where the government's chief scientific advisor, Patrick Valance, said that the preliminary analyses suggested that in every 1,000 men aged 60 years who were infected with a new variant, 13 or 14 might be expected to die, compared with 10 in 1,000 infected with the original variant.
• 3:36
  SPEAKER_00: However, further analysis was needed because the data involved a relatively small number of people, around 8% of the total deaths occurring during the study period, and did not include data on hospital admission.
• 3:47
  SPEAKER_00: A report published in Morbidity and Mortality Weekly Report provides an update on allergic reactions, including anaphylaxis, after receipt of the first dose of Moderna COVID-19 vaccine in the United States from December 21st, 2020 to January 10, 2021.
• 4:03
  SPEAKER_00: During this time period, monitoring by the vaccine adverse event reporting system detected 10 cases of anaphylaxis after administration of a reported 4,041,396 first doses of Moderna COVID-19 vaccine, which translates to 2.5 cases per million doses administered.
• 4:21
  SPEAKER_00: In nine cases, onset occurred within 15 minutes of vaccination.
• 4:25
  SPEAKER_00: No anaphylaxis-related deaths were reported.
• 4:28
  SPEAKER_00: The implications of this are that locations administering COVID-19 vaccines should adhere to CDC guidance, including screening recipients for contraindications and precautions, having necessary supplies, and staff members available to manage anaphylaxis, implementing recommended post-vaccination observation periods, and immediately treating suspected anaphylaxis with intramuscular epinephrine injection.
• 4:50
  SPEAKER_00: A paper published in the British Medical Journal examined gut microbiota composition reflects disease severity and dysfunctional immune responses in patients with COVID-19.
• 5:00
  SPEAKER_00: Authors investigated whether the gut microbiome is linked to disease severity in patients with COVID-19 and whether perturbations in microbiome composition, if any, resolve with clearance of the SARS-CoV-2 virus.
• 5:12
  SPEAKER_00: Researchers obtained blood, stool, and patient records from 100 patients with laboratory-confirmed SARS-CoV-2 infection.
• 5:18
  SPEAKER_00: Serial stool samples were collected from 27 of 100 patients up to 30 days after clearance of SARS-CoV-2.
• 5:24
  SPEAKER_00: Gut microbiome compositions were characterized by shotgun sequencing total DNA extracted from stools.
• 5:30
  SPEAKER_00: Concentrations of inflammatory cytokines and blood markers were measured from plasma.
• 5:34
  SPEAKER_00: Gut microbiome composition was significantly altered in patients with COVID-19 compared with non-COVID-19 individuals, irrespective of whether patients had received medication.
• 5:44
  SPEAKER_00: Several gut commensals with known immunomodulatory potential, such as Fecalobacterium prosnitiae, Ubacterium rectale, and bifidobacteria were underrepresented in patients and remained low in samples collected up to 30 days after disease resolution.
• 6:00
  SPEAKER_00: Authors found that this perturbed composition exhibited stratification with disease severity concordant with elevated concentrations of inflammatory cytokines.
• 6:08
  SPEAKER_00: The authors conclude that associations between gut microbiota composition, levels of cytokines, and inflammatory markers in patients with COVID-19 suggest that the gut microbiome is involved in the magnitude of COVID-19 severity, possibly via modulating host immune responses.
• 6:23
  SPEAKER_00: Furthermore, the gut microbiota dysbiosis after disease resolution could contribute to persistent symptoms, highlighting a need to understand how gut microorganisms are involved in inflammation in COVID-19.
• 6:34
  SPEAKER_01: Thank you, Dr.
• 6:35
  SPEAKER_01: Hannah Rand.
• 6:36
  SPEAKER_01: I now want to move into discussion with Dr.
• 6:38
  SPEAKER_01: Bell.
• 6:39
  SPEAKER_01: So, Dr.
• 6:40
  SPEAKER_01: Bell, as director of medical ICU at University of Virginia Health System, how have you been involved in vaccination rollout?
• 6:48
  SPEAKER_02: Well, thanks for having me on the podcast.
• 6:50
  SPEAKER_02: It's a pleasure to speak with Shay, and your organization has been really on the forefront of informing the community, the medical community, the lay community, and combating the pandemic.
• 7:00
  SPEAKER_02: So I couldn't be more pleased to be with you today.
• 7:03
  SPEAKER_02: As far as my involvement in our vaccination rollout campaign, I'm involved in a few efforts.
• 7:08
  SPEAKER_02: The first of which is the effort to vaccinate our local workforce at UVA Health.
• 7:13
  SPEAKER_02: We are initially expanded the phase 1A, which were healthcare employees, initially frontline employees who provided patient care, but then later expanded to all health system employees.
• 7:24
  SPEAKER_02: And then it became clear as this was going on that our local health district, like many other districts across our Commonwealth and across the country, really, were really straying for resources.
• 7:35
  SPEAKER_02: And the lessons that we had learned from the distribution challenges would be applicable to helping our local health district expand to vaccinating community members.
• 7:44
  SPEAKER_02: And so we've actually expanded from 1A, which included just our workforce, to starting to vaccinate some community members that are in our 1B phase.
• 7:52
  SPEAKER_02: And in Virginia, 1B includes frontline essential workers, those over 65 and up, and people with medical condition and living in correctional facilities and other confined care sites.
• 8:04
  SPEAKER_02: So we've started to vaccinate a limited number of people from the community to come to our site and receive vaccinations.
• 8:11
  SPEAKER_02: I'm also involved in a messaging effort.
• 8:13
  SPEAKER_02: As you know, these vaccines require a lot of education because they were developed in a relatively quick amount of time relative to most vaccines.
• 8:20
  SPEAKER_02: And a lot of people have been focused on the actual pandemic itself.
• 8:24
  SPEAKER_02: And once the vaccines were available, there were a large gap in education that most people had, you know, regardless of how closely they may have been following or what their sort of background was.
• 8:34
  SPEAKER_02: And so our president of the University of Virginia got together a messaging advisory group that consists of community members, community leaders, healthcare and professionals in the community as well, and marketing and communication specialists at the university to try to find a good strategy for messaging the community in easily digestible format.
• 8:53
  SPEAKER_02: I've also done some more informal educating.
• 8:56
  SPEAKER_02: I'm very active on my Twitter profile.
• 8:58
  SPEAKER_02: I've documented my experience getting the vaccine, shared how it works.
• 9:02
  SPEAKER_02: I've done a Facebook live stream with my good friend and colleague, Dr.
• 9:06
  SPEAKER_02: Cameron Webb, every Monday at seven o'clock.
• 9:08
  SPEAKER_02: And, you know, in rounds and in the hospital, in the cafeteria, I talk to people about the COVID-19 vaccine to see what their thoughts are, what education they need, and making sure that they have the information they need to make a good decision.
• 9:20
  SPEAKER_02: And lastly, I personally vaccinated people.
• 9:22
  SPEAKER_02: We've had a need for vaccinators like many other places have.
• 9:25
  SPEAKER_02: And so there have been a couple of days where I've volunteered and vaccinated people.
• 9:29
  SPEAKER_02: And then I must say that was one of the most fun experiences I've ever had because most of my job as an intensive care provider is to provide the end-of-life care in kind of the aggressive interventions when you know things have gotten really bad from COVID-19.
• 9:43
  SPEAKER_02: But this was a chance to really prevent someone from getting sick and potentially save someone's life.
• 9:48
  SPEAKER_02: So really gratifying feeling.
• 9:50
  SPEAKER_01: Wow, those are really amazing, amazing things you're doing.
• 9:53
  SPEAKER_01: And I totally agree that actually being participant in vaccination effort in yourself is extremely gratifying.
• 10:01
  SPEAKER_01: So what successes have you seen?
• 10:03
  SPEAKER_01: And likewise, what have been some of the biggest challenges?
• 10:08
  SPEAKER_02: Well, we have managed to vaccinate 70% of our workforce in about five to six weeks.
• 10:14
  SPEAKER_02: And, you know, I think that's something to celebrate.
• 10:16
  SPEAKER_02: We were certainly want that much higher, much closer to 100%, but 70% is a good start out of the gate.
• 10:21
  SPEAKER_02: And as I said, we're helping our local health district with the vaccination effort, and that actually introduces new challenges, but it's important because it's something that we should be doing, especially as a state institution.
• 10:32
  SPEAKER_02: I think by far one of the biggest challenges that we've had is that there's a wide variety of levels of excitement for receiving the vaccine combined with different levels of access and entitlement in our workforce.
• 10:43
  SPEAKER_02: And what I mean by that is we have people that are really eager to receive the vaccine, some people who are kind of middle of the road or on the fence, and some who are either opposed or really need more information before they make a decision.
• 10:56
  SPEAKER_02: Combined with that, we have people who have a lot of access to the system, meaning they have connections and they have the ability to try to advocate for themselves and feel entitled to do so.
• 11:07
  SPEAKER_02: And this can create some issues with equitable distribution, especially when demand for vaccine far out needs supply, which is a situation that we have right now.
• 11:16
  SPEAKER_02: And what I try to think of when we think about, you know, who we should be trying to vaccinate first, I think about a ratio in my head where priority, you know, how far up in the line you should be to receive the vaccine according to recommendations in the numerator and your level of access to receiving a vaccine is in the denominator.
• 11:34
  SPEAKER_02: And the biggest wins we can have are when we vaccinate people who are in the highest priority group, but also have the lowest access to resources needed to actually receive that vaccine.
• 11:44
  SPEAKER_02: So between biology professor who may not work in the hospital and our staff who clean and sanitize the patient care rooms, we could probably all agree on who has that higher priority.
• 11:54
  SPEAKER_02: But between the two of them, which one is more likely to have a cell phone, be able to read the email with the complicated sign-up directions, stalk the signup website, and then if that website crashes, wait several minutes on the phone line and then email the hospital leadership if they get frustrated.
• 12:09
  SPEAKER_02: We need to find ways of maximizing this ratio so that we can make sure that people have the high access or high priority but low access can still get vaccinated in an equitable fashion.
• 12:20
  SPEAKER_01: That is quite true.
• 12:21
  SPEAKER_01: And I think the access issue, I think it's nationwide.
• 12:24
  SPEAKER_01: I think as you've alluded to, simplifying the process itself might help us kind of achieve the goals that we all hope that we would be able to.
• 12:33
  SPEAKER_01: So would you say the campaign has been a success at UVA Hell?
• 12:38
  SPEAKER_01: And if so, why?
• 12:40
  SPEAKER_02: Well, success for me is when the job is done.
• 12:43
  SPEAKER_02: And we have between 85 to 100% of our workforce vaccinated with no major disparities that are seen by race, ethnicity, or job level.
• 12:51
  SPEAKER_02: So we haven't gotten there yet.
• 12:52
  SPEAKER_02: So getting close, but still not quite there.
• 12:55
  SPEAKER_02: I did share earlier that 70% of our workforce is vaccinated, but that number is only 56% for our environmental services department.
• 13:02
  SPEAKER_02: And this is one of the departments that were more likely to have lower access issues despite high priority.
• 13:07
  SPEAKER_02: So we definitely need to move the needle there, but we are making some progress towards that.
• 13:12
  SPEAKER_01: That seems to be one of the bigger challenges, as you have alluded to earlier as well, about finding the right mix of communicating to them and also answering all their questions or concerns, and then ultimately vaccinating some groups in the hospital that might be more reluctant or might have less information than the others.
• 13:30
  SPEAKER_01: So you're also about to start working with your local health department.
• 13:37
  SPEAKER_01: What will you be doing in this role?
• 13:40
  SPEAKER_02: Well, we're doing a few things.
• 13:41
  SPEAKER_02: So our local health district, as a part of the 1B effort to vaccinate community members, they've set up a mass vaccination tent that exists in one of our parking lots in Charlottesville.
• 13:51
  SPEAKER_02: And it's set up, but they actually didn't have enough staff or vaccinators to actually run that site.
• 13:57
  SPEAKER_02: So we've sent some of our employees to help vaccinate their campaign over there.
• 14:02
  SPEAKER_02: And I mentioned that we also have opened our own site to community members to help offload the local health district.
• 14:08
  SPEAKER_02: And then the third is really formulating the message to our diverse stakeholders in the community.
• 14:12
  SPEAKER_02: We've been tasked with coming up with the overall strategy to find ways to reach people, to give them information that they need and to advocate and demonstrate that to people that the vaccines are safe and effective.
• 14:24
  SPEAKER_02: Our strategy that we come up with will be employed by our local health district, and then we can assist with getting the message out more formally.
• 14:31
  SPEAKER_01: So why did you decide to take part in the rollout both uh GVA Health and locally in Virginia?
• 14:38
  SPEAKER_02: You know, as you mentioned before, I do work at a hospital system at an academic medical center.
• 14:42
  SPEAKER_02: And, you know, we're tasked with a few things advancing research, clinical education, and providing good patient care.
• 14:49
  SPEAKER_02: But fundamentally, we're also a community hospital for the community that surrounds us.
• 14:53
  SPEAKER_02: And I believe a hospital's mission is to improve health, and that really extends beyond the walls of the institution.
• 15:00
  SPEAKER_02: It really should reach into communities, especially for the University of Virginia.
• 15:04
  SPEAKER_02: We're a state institution.
• 15:05
  SPEAKER_02: Our charge is to improve and serve the Commonwealth of Virginia.
• 15:09
  SPEAKER_02: And then for me, when working at a hospital that should be penetrating into the community, I have an interesting training background where I've combined infectious disease or critical care.
• 15:18
  SPEAKER_02: And I've received training in business.
• 15:20
  SPEAKER_02: I got MBA recently and I've learned about solving logistical challenges that businesses face.
• 15:26
  SPEAKER_02: And this is a community that actually invested in me when I was an undergraduate student.
• 15:30
  SPEAKER_02: I grew up an hour away from here, went to college here for undergraduate, graduated in 2005, and then became a physician, you know, largely from a lot of the mentorship and the investment that University of Virginia made in me.
• 15:43
  SPEAKER_02: So for me in this moment, with what's happening now and my skill set, I feel like I should do whatever I can to try to help beat back this pandemic.
• 15:51
  SPEAKER_01: How would you advise other healthcare professionals looking to get involved in the organizational local vaccination campaigns, especially knowing everyone's time is so limited?
• 16:02
  SPEAKER_02: Yeah, no one has free time.
• 16:04
  SPEAKER_02: And you know, that's the theme of 2020 and 2021 now that a lot of us are stretched.
• 16:09
  SPEAKER_02: But I will say that there are several opportunities to be able to help out with vaccination effort or the education campaigns.
• 16:15
  SPEAKER_02: I think first is to look in, see what your local institution is doing and if there are any ways that you can help with that.
• 16:22
  SPEAKER_02: I know off the top of my head, the vaccination issue and having vaccinators seems to be a pretty common issue across the health system.
• 16:29
  SPEAKER_02: One main reason is because we're in a surge right now.
• 16:32
  SPEAKER_02: Hopefully, you know, at the top of that surge, but still we have a very high case count and healthcare systems are stretched.
• 16:37
  SPEAKER_02: And so it might be challenging to even have people that can vaccinate and volunteering yourself to vaccinate people.
• 16:43
  SPEAKER_02: I know for me as a physician, you know, despite being in healthcare several years, I don't think I'd actually given someone a vaccination until I started giving vaccinations for COVID-19.
• 16:52
  SPEAKER_02: Even though it was something new, it was relatively easy to do and certainly a lot of fun and very gratifying.
• 16:58
  SPEAKER_02: So I would encourage you to look and see if there are opportunities there.
• 17:01
  SPEAKER_02: And then contact your local health district.
• 17:03
  SPEAKER_02: I can almost promise you that they could appreciate any help that they can get, whether it's helping with messaging the community or helping with logistical challenges that they have, maybe vaccinating, and then talk to your colleagues about the vaccine.
• 17:15
  SPEAKER_02: You know, we started this pandemic with the public health messaging, the social distancing, and it became clear that maybe social distancing wasn't the right term because we wanted to enhance our social bonds.
• 17:26
  SPEAKER_02: And I've used this as an opportunity to connect with people that I'm gonna work with on a daily basis, but I may not necessarily interact with.
• 18:38
  SPEAKER_02: She looked like she wasn't terribly excited to get the vaccine.
• 18:41
  SPEAKER_02: And so I asked her about that and said, you know, I'm glad you're here, but you look like you're not very excited.
• 18:46
  SPEAKER_02: So tell me a little bit about that.
• 18:48
  SPEAKER_02: And she shared that she had some hesitancy about the vaccine, but that she saw that people like me and other colleagues have received the vaccine and talked about our experiences.
• 18:57
  SPEAKER_02: And she felt like, you know, despite my reservations, I feel like this is what I need to do to protect myself.
• 19:03
  SPEAKER_02: And I told her, you know, contact me later if you want to talk a little bit more, because, you know, you're probably one of many people who feel the same way.
• 19:10
  SPEAKER_02: And she actually emailed me yesterday and asked me if I wanted to participate in a large phone conference she was getting together with some of her other colleagues and friends and family to talk about the vaccine.
• 19:20
  SPEAKER_02: And so that one moment where I engaged with someone and they were going to get the vaccine anyway, but I took that chance to engage them and it's opened up into a much larger opportunity to educate the community.
• 19:31
  SPEAKER_01: That's quite brilliant.
• 19:33
  SPEAKER_01: Thank you.
• 19:33
  SPEAKER_01: So we have had a lot of discussion on vaccine hesitancy on this podcast.
• 19:38
  SPEAKER_01: What do you think is important to know in addressing that not only with other healthcare professionals, but also the general public as we continue these vaccination campaigns?
• 19:50
  SPEAKER_02: Well, I think the first step is to recognize that there's a large information gap that people have when it comes to the vaccines.
• 19:57
  SPEAKER_02: And I think providing that information in an easily digestible format is really essential in many different ways, whether it's webinars or printed material or other sorts of ways to engage.
• 20:09
  SPEAKER_02: You know, America's had to have a biology lesson, epidemiology lesson, and immunology lesson kind of all at the same time in the course of a year.
• 20:17
  SPEAKER_02: And that's a lot to kind of take in, but people want to know what's in the vaccine, how does it work, what are the side effects I can anticipate, and what do we know and what don't we know about the vaccines?
• 20:27
  SPEAKER_02: And so we need to meet that education gap with good material.
• 20:30
  SPEAKER_02: I think one other concern that I've received a lot is just general hesitancy about the process and the fact that these vaccines have been developed.
• 20:39
  SPEAKER_02: I'm talking about the Moderna and the Pfizer vaccines, much earlier than the usual timeline for vaccine development.
• 20:45
  SPEAKER_02: And so explaining that the three major parts of vaccine going from development to an actual arm have all been accelerated, but in safe ways.
• 20:54
  SPEAKER_02: So the technology that's been used, the mRNA, is not a completely new concept that someone made up.
• 20:59
  SPEAKER_02: It actually been studied for decades in that the clinical studies have were able to be stood up or done so in a way that maximized efficiency by either combining phases one and two or phase two and three with a lot of coordination and good funding to make sure that enrollment could accelerate.
• 21:15
  SPEAKER_02: And fortunately and unfortunately, the pandemic was raging in the midst of these clinical studies.
• 21:20
  SPEAKER_02: So they were able to meet endpoints much sooner than usually anticipated for a vaccine trial.
• 21:26
  SPEAKER_02: And then third, the manufacturing was able to get a boost by being able to happen in concert with the clinical trials.
• 21:31
  SPEAKER_02: And so the fact that timeline was compressed is really a testament to the work that had gone before the pandemic, meeting the right time with the right technology, the funding that allowed to stand up clinical studies and do manufacturing.
• 21:45
  SPEAKER_02: But the important point is that safety was not compromised.
• 21:48
  SPEAKER_02: The independent bodies that review the trials, the advisory committee for the FDA and the advisory committee for the CDC are all involved in every vaccine or therapeutic that gets approved, but we're also involved in this process and we're not influenced by the government in any way and did not have an incentive to put something on the market that wasn't safe.
• 22:08
  SPEAKER_02: And we actually have more data for these vaccines than we usually do for vaccine studies.
• 22:13
  SPEAKER_02: Typical vaccine trial might have four to six thousand people or so, but between the Pfizer and Moderna trials, we have about 75,000 people.
• 22:20
  SPEAKER_02: So a lot more data points and a much more robust data set than we usually have for vaccines, you know, really gives me the confidence that these are safe and effective.
• 22:29
  SPEAKER_01: I think those are really, really great points.
• 22:31
  SPEAKER_01: I think part of what we need to do is to improve the way we communicate these points that you have highlighted, including the data is safe.
• 22:41
  SPEAKER_01: There is a lot of misgivings or miscommunication out there about the safety and efficacy of the vaccine, which despite a lot of good effort, people still get confused about.
• 22:51
  SPEAKER_01: So I think communicating some specific points out would probably be very, very helpful.
• 22:56
  SPEAKER_01: So lastly, I would like to ask you if you have any final words for our listeners about being involved in vaccination campaigns.
• 23:05
  SPEAKER_02: The parting words I would give are to just acknowledge outright that this seems like a very daunting task when you look at where we are compared to where we need to be as far as getting the pandemic under control when it comes to rolling out the vaccine, getting back to normal, whatever normal is going to look like after this.
• 23:22
  SPEAKER_02: You know, our vaccination effort has been slowed by manufacturing delays and distribution problems.
• 23:28
  SPEAKER_02: We still have over 100,000 people in the hospital and a pandemic that's really raging out of control, you know, with the variant situation that has a lot of people concerned as well.
• 23:37
  SPEAKER_02: And it can really seem like, you know, how are we ever going to get here?
• 23:40
  SPEAKER_02: But just like when there's any challenge that we face, when we have to climb a hill, you know, you can focus on you know where you are compared to where you need to go.
• 23:47
  SPEAKER_02: But at the end of the day, what you have to do is keep taking steps.
• 23:51
  SPEAKER_02: And so when I wake up in the morning and think about the task at hand, I think, you know, what's the positive step forward that I can make?
• 23:57
  SPEAKER_02: And as long as we keep taking these steps forward and solving the challenges along the way, we can eventually get there.
• 24:03
  SPEAKER_02: We can keep our eyes on the prize, but just make sure that we keep moving forward.
• 24:07
  SPEAKER_01: That's such an important message.
• 24:09
  SPEAKER_01: Thank you very much to our speaker for sharing your perspective and experiences.
• 24:13
  SPEAKER_01: This podcast can be accessed on Shay's online education center, learning CE, under the Rapid Response Program.
• 24:22
  SPEAKER_01: You will also find resources such as recorded webinars, healthcare facility, outbreak preparedness, and the SHA COVID-19 town halls.
• 24:30
  SPEAKER_01: New members can now receive 50% of 2021 SHA membership by using the coupon code WELCOME2021 until March 31st.
• 24:42
  SPEAKER_01: That concludes this episode of Rapid Response Podcast.
• 24:45
  SPEAKER_01: Thanks so much for tuning in.