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[Monkeypox Update Press Conference]

[00:00:19]

GOOD AFTERNOON.

I'M WILLIAM MAM PUBLIC INFORMATION OFFICER FOR AUSTIN PUBLIC HEALTH AND THE MODERATOR FOR TODAY'S NEWS CONFERENCE.

SPANISH INTERPRETATION IS AVAILABLE ON ATX AND THREE TO START, WE WILL HAVE OPENING REMARKS BY AUSTIN.

DR.

DOES WALKS AUSTIN, TRAVIS COUNTY HEALTH AUTHORITY FOLLOWED BY DR.

KRISTIN MONDI OF DELL MEDICAL AT THE UNIVERSITY OF TEXAS AT AUSTIN.

THEN DR.

MIKE STEFAN LOVITCH OF COMMUNITY CARE, AND WE WILL CLOSE WITH ADRIAN STIRRUP DIRECTOR OF AUSTIN PUBLIC HEALTH.

WE WILL THEN OPEN IT UP TO OUR POOL REPORTER WHO WILL ASK QUESTIONS ON BEHALF OF MEDIA, DR.

WALKS OVER TO YOU.

GOOD AFTERNOON, EVERYONE.

UM, WE'RE HERE TODAY TO TALK TO OUR COMMUNITY ABOUT MONKEYPOX MONKEYPOX IS A VIRUS THAT, UH, IS CAUSING ILLNESS IN OUR COMMUNITY.

AND AS A GROWING CONCERN, AS WE HAVE, UH, IDENTIFIED MORE CASES OVER THE LAST FEW WEEKS, AND WE WANTED TO HAVE A DISCUSSION AND MAKE THE COMMUNITY AWARE OF THE SITUATION, THIS VIRUS IS NO LONGER SOMETHING THAT WE CAN SAY IS JUST ASSOCIATED WITH TRAVEL.

WE NOW HAVE SPREAD IN OUR COMMUNITY.

AND SO IT'S IMPORTANT THAT WE UNDERSTAND THAT THIS HOW THIS VIRUS IS SPREAD AND HOW WE CAN PROTECT OURSELVES.

THE VIRUS IS SPREAD WHEN SOMEONE, UM, IS IN CONTACT WITH A PERSON WHO HAS MONKEYPOX AND THEY TOUCH THE SKIN OF THAT PERSON, WHERE THE RASH IS LOCATED, UM, HAVE SEX WITH A PERSON WHO HAS MONKEYPOX, UM, SHERIFF'S UTENSILS, UH, OR BEVERAGES WITH SOMEONE WHO HAS MONKEYPOX, UM, OR HAS SPLASHING OF, UH, BODY FLUIDS IN THE EYES NOW THROUGH GENITALIA, UM, BECAUSE THE VIRUS IS, UH, IN THE FLUIDS THAT I'VE DESCRIBED.

AND IT'S ALSO PRESENT IN THE SCABS THAT FORM AFTER THE, UH, BLISTERS FROM THE RASH START TO DRY UP.

SO IT'S IMPORTANT TO CLEAN SURFACES AFTER SOMEONE HAS, UM, TOUCHED THOSE SURFACES OR, UH, SAT ON, UM, UH, CLOTHING OR USED LINENS, UM, TO MAKE SURE THAT YOU'RE NOT PUTTING YOURSELF AT RISK AND TO CLEAN THOSE SURFACES, IT WILL BE IMPORTANT TO, UH, WEAR A MASK AND GLOVES AND EYE PROTECTION SO THAT YOU CAN KEEP YOURSELF PROTECTED.

UM, THIS DISEASE THAT IS CAUSED BY THE VIRUS THAT IS CAUSING THEM MONKEY POX IS SELF-LIMITED.

UM, SO MOST PEOPLE WILL HAVE, UM, ILLNESS AND RASH AND HAVE RESOLUTION OF THE ILLNESS WITHIN 21 DAYS.

UM, HOWEVER, IN SOME PEOPLE IT CAN BE SEVERE CAUSED SEVERE ILLNESS.

AND MY COLLEAGUES WHO ARE HERE WITH ME TODAY, WE'LL TALK TO YOU MORE ABOUT THOSE DAY-TO-DAY ARE CURRENTLY WORKING WITH THE DEPARTMENT OF STATE HEALTH SERVICES AND THE CDC TO PROVIDE TESTING TO PEOPLE WHO WE SUSPECT HAVE MONKEYPOX.

UM, AND WE ARE ALSO WORKING WITH THE DEPARTMENT OF STATE HEALTH SERVICES AND THE CDC TO OBTAIN VACCINES THAT ARE LIMITED AT THIS POINT IN TIME FOR YOU, SOME PEOPLE WHO HAVE HAD CLOSE CONTACT WITH PEOPLE WHO HAVE HAD MONKEYPOX CONFIRMED, WE'RE ALSO WORKING WITH THE CDC TO SAVE MEDICATIONS, TO TREAT MONKEYPOX, UM, AND THAT MEDICATION IS LOCATED IN THE STRATEGIC NATIONAL STOCKPILE.

SO WE DO HAVE WAYS OF COMBATING THIS DISEASE FOR THOSE PEOPLE WHO ARE AT RISK FOR SEVERE DISEASE.

UM, AND THOSE SUPPLIES ARE BEING, UM, SET ASIDE FOR THOSE PEOPLE WHO ARE AT RISK FOR SEVERE DISEASE.

UM, WE CURRENTLY HAVE NINE CONFIRMED CASES OF MONKEYPOX IN THE TRAVIS COUNTY AREA AND EIGHT, UH, PRESENTIVE CASES, WHICH MEANS THOSE PEOPLE HAVE HAD THAT PRELIMINARY TEST THAT SHOWS THAT THEY HAVE NON-VARIABLE OR ORTHOPEDICS.

AND THAT IS THEN SENT FOR CONFIRMATION TO THE CDC TO CONFIRM MONKEYPOX WITH THAT.

I WILL TURN THIS OVER TO MY COLLEAGUE, DR.

CHRISTINE MONDAY FROM UT DELL MEDICAL.

SHE'S THE CHIEF OF INFECTIOUS DISEASES.

THANK YOU, CHRISTIE.

OKAY.

THANK

[00:05:01]

YOU SO MUCH, DR.

WACHS.

UH, AGAIN, I JUST WANTED TO REITERATE WHAT SHE SAID THAT FOR THE VAST MAJORITY OF PATIENTS, IT'S REALLY A MILD SELF-LIMITING DISEASE.

UM, JUST A LITTLE MORE INFORMATION, CLASSICALLY MONKEY POX.

THERE'S TWO STRAINS.

THERE'S A WEST AFRICAN STRING, WHICH IS ONE THAT'S BEEN CIRCULATING IN THIS OUTBREAK AND A CENTRAL AFRICAN STRAIN.

THIS WEST AFRICAN STRAIN IS, IS THE ONE THAT'S BEEN ASSOCIATED WITH MORE MILD OR SYMPTOMS AND, UH, PER THE CDC AND WHO GENERALLY EXPECTED MORTALITY OF LESS THAN 1%.

HOWEVER, THERE ARE POPULATIONS THAT CAN BE AT HIGHER RISK.

SO THERE'S HOST FACTORS AND THEN EXTENT OF VIRUS EXPOSURE AND THE NATURE OF COMPLICATIONS.

AND TO GO INTO THAT IN A LITTLE BIT MORE DETAIL, UH, FOR EXAMPLE, WE, WE DO SEE FROM PRIOR PRIOR STUDIES AND CDC GUIDANCE THAT PEOPLE, FOR INSTANCE, WHO ARE IMMUNOCOMPROMISED, THEY MIGHT, THOSE THAT MIGHT BE ON CHEMOTHERAPY OR VERY POTENT STEROIDS OR IMMUNE MODULATORS, OR HAVE VERY ADVANCED HIV INFECTION CAN, FOR EXAMPLE, BE AT HIGHER RISK, UH, PREGNANT WOMEN, THEY CAN BE AT HIGHER RISK.

AND WE KNOW THAT THE DISEASE CAN PASS FROM THE PLACENTA TO THE FETUS.

AND THEN ALSO FROM DATA YOUNGER CHILDREN, THE CDC TYPICALLY SITES CHILDREN UNDER EIGHT CAN BE AT HIGHER RISKS.

SO THOSE ARE HIGHER RISK POPULATIONS.

AND THEN WITH REGARD TO THE EXTENT OF VIRUS EXPOSURE AND NATURE OF COMPLICATIONS.

SO PEOPLE DO NEED TO BE CAREFUL WHEN MANAGING THEIR OWN LESIONS.

YOU COULD TOUCH A LESION.

AND THEN FOR EXAMPLE, ONE, SOME CASES HAVE CITED WHERE YOU COULD ACCIDENTALLY INOCULATE YOUR EYE, FOR INSTANCE, RUBBING IT OR PUTTING IN A CONTACT LENS.

AND THAT COULD LEAD TO A PRETTY SEVERE INFECTION IN YOUR EYE.

OR IF PEOPLE HAD MULTIPLE SKIN TOUCHING, YOU KNOW, PERHAPS IN INTIMATE RELATIONS AND THEY ENDED UP GETTING EXTENSIVE MONKEYPOX ON MANY PARTS OF THEIR BODY, INCLUDING VERY SENSITIVE AREAS, NOT ONLY THE EYES, BUT PERHAPS MUCOSAL AREAS LIKE IT COULD CAUSE IF YOU'VE GOT IT IN THE ANAL AREA, RECTAL BLEEDING COLITIS, UM, IT'S, IT CAN PASS THROUGH RESPIRATORY SECRETIONS.

SO IF YOU'VE GOT A LOT IN THAT WAY, THERE'S, YOU KNOW, POTENTIAL FOR, UH, CASE REPORTS OF A PNEUMONIA.

UH, AND THEN FOR SOME PEOPLE THAT HAVE A LOT OF IRRITATION SCRATCH THEIR LESIONS, PICK AT THEM, WHATEVER THERE'S BEEN, PEOPLE COULD GET REALLY SEVERE SECONDARY INFECTIONS REQUIRING HOSPITALIZATIONS.

AND SO I THINK IT'S THOSE KINDS OF MORE SEVERE WIDESPREAD, OR PEOPLE ACCIDENTALLY AUTO INOCULATE THEMSELVES IN A, IN A, IN AN AVERAGE AREA LIKE YOUR EYE, UH, EXTENSIVE ORAL LESIONS WHERE YOU COULDN'T REALLY EAT OR SWALLOW.

THOSE KINDS OF THINGS IS WHERE I, WHERE I THINK DEFINITELY OUR HEALTH AUTHORITY APH OR THE STATE WOULD ASSIST IN OF COURSE GETTING, UH, THERAPIES FOR THAT.

UM, BUT OVERALL FOR THE PERSON THAT JUST GETS THESE CLASSIC SMALL NUMBERS OF LESIONS ON YOUR SKIN, LIKE DR.

WACHS SAID, IT'S GENERALLY MILD DISEASE THINGS CLEAR UP IN A FEW WEEKS AND THE MORTALITY IS LESS THAN 1%.

AND WITH THAT, I WILL PASS IT OVER TO DR.

STEPHAN ALPHABET.

WHO'S OUR, UH, ASSOCIATE DIRECTOR OF SEXUAL HEALTH PROGRAMS AT COMMUNITY CARE FOR SOME ADDITIONAL GUIDANCE.

THANK YOU SO MUCH A MONDAY.

UH, IT'S A PLEASURE TO BE WITH YOU ALL TODAY.

UH, THANK YOU, DR.

WACHS FOR INTRODUCTION AS WELL.

UH, MY NAME IS DR.

MIKE, STEPHANIE AND I'M A PHYSICIAN AS DR.

MANI SAID, UH, REPRESENTING COMMUNITY CARE, UH, LOCAL NONPROFIT COMMUNITY HEALTH SYSTEM.

MM.

BUT GETTING TO MEET THE HEALTH NEEDS OF OUR LOCAL RESIDENTS HERE IN AUSTIN, TRAVIS COUNTY, UH, ONE OF THE FOUR CS, THE PROVISIONAL SERVICES AT THE DAVID POWELL CLINIC, WHICH IS A MEDICAL HOME, BUT YOU DO NOT KNOW THAT DELIVERS HIV PRIMARY CARE TO NEARLY HALF OF ALL BULLETS WITH HIV IN TRAVIS COUNTY WITH AN ADDITIONAL FOCUS ON THE PREVENTION OF HIV AND SEXUALLY PRETENSE.

TODAY, I HAVE BEEN INVITED TO SPEAK FROM THE PERSPECTIVE OF ONE OF A MULTITUDE OF DIFFERENT LEADERS HERE FOR A HEALTHCARE TEAM THAT IS ON THE VERY FRONT LINES OF THIS OUTBREAK AT MY CLINIC AT THE DAVID CALTECH, WE HAVE DIAGNOSED AND CARED FOR APPROXIMATELY HALF OF THE EXISTING CASES OF MONKEYPOX IN

[00:10:01]

AUSTIN LET'S COUNT DAYS WHILE WE DO NOT CURRENTLY AT COMMUNITY CARE OFFER ANY TYPE OF MASS TESTING FOR MONKEYPOX.

AT THIS TIME, WE DO OFFER TESTING FOR OUR ESTABLISHED PATIENTS AT COMMUNITY CARE.

IN ADDITION TO A PARTNERSHIP THROUGH AUSTIN, PUBLIC HEALTH FOR TESTING ON A CASE BY CASE BASIS FOR PATIENTS WHO ARE NOT YET ESTABLISHED WITH COMMUNITY PROVIDERS WHO MAY NEED TESTING.

AND I AM HERE WITH YOU TODAY, AS I HAVE BEEN ASKED TO SPEAK TO THE CURRENT 2022 MONKEYPOX OUTBREAK WITH RESPECT TO, UH, SELECT COMMUNITIES FROM BOTH MYSELF AND OUR TEAM SERVE ON A DAILY BASIS, NAMELY, THE DISPROPORTIONATE IMPACT THAT MONKEYPOX OUTBREAK HAS HAD ON GAY AND BISEXUAL MEN, BOTH LOCALLY, NATIONALLY, AND ON A GLOBAL SCALE.

SO WE ALSO KNOW BASED ON EXISTING DATA, THAT MANY OF THE MONKEYPOX CASES ARE ACTUALLY OCCURRING AMONGST PEOPLE WITH ESTABLISHED HIV INFECTION GLOBALLY.

AND I THINK NOW IS THE TIME TO BE BOTH VOCAL AND VIGILANT ABOUT A VIRUS THAT IS CIRCULATING IN OUR COMMUNITY LOCALLY.

SO AS DR.

WACHS HAS ALREADY ALLUDED TO TRAVEL TO, UH, TO ENDEMIC AREAS, UH, WERE HIGH NUMBERS OF MONKEYPOX CASES IS OCCURRING IS NOT THE ONLY RISK FACTOR FOR ACQUISITION OF MONKEYPOX LOCALLY.

AND WHILE I JUST WANT TO ECHO THE SENTIMENTS THAT WE ARE CERTAINLY VERY FORTUNATE THAT THE VIRUS IS NOT DEADLY AND THE VAST MAJORITY MOSTLY BECOME INFECTED AND IS TIME LIMITED IN MOST CASES AND RESOLVES WITHOUT TREATMENT.

BUT NONETHELESS, A MONKEYPOX VIRUS CAN STILL MAKE PEOPLE ILL.

AND THERE IS A RISK FOR COMPLICATIONS AMONGST THOSE PEOPLE WHO HAVE COMPROMISED OR WEAKENED IMMUNE SYSTEMS. UH, SOMETHING THAT I, I, I THINK IS IMPORTANT TO SPEAK TO TODAY.

THE MONKEY POX VIRUS ITSELF CAN CAUSE A PAINFUL RASH, THE PERSIST FOR MULTIPLE WEEKS FOR HUNTING ISOLATION AT HOME.

AND WE'VE SEEN MULTIPLE INSTANCES WHERE PATIENTS COME SEE US IN CLINIC COMPLAINING OF FEVER, SWELLING OF LYMPH NODES, MUSCLE ACHES, COUGH, SORE THROAT, AND A MYRIAD OF OTHER SYMPTOMS. AND OF COURSE THERE IS ALWAYS THE RISK OF TRANSMITTING THE VIRUS TO OTHERS AND FEELING THIS OUTBREAK EVEN FURTHER NOW, IN SOME OF THE INITIAL PEOPLE DIAGNOSED WITH MONKEYPOX IN PARTS OF EUROPE, INCLUDING ITALY AND SPAIN, THE VAST MAJORITY OF REPORTED INTIMATE SCALE SKIN CONTACT AMONGST SAME SEX PARTNERS.

NOW, WHILE A SIGNIFICANT NUMBER OF THOSE DIAGNOSED WITH MONKEYPOX WERE ALSO LIVING WITH HIV.

THE WORLD HEALTH ORGANIZATION HAS REALLY SIMILAR ESTIMATIONS AS WELL, PRELIMINARY DATA AMONGST MONKEYPOX INFECTIONS OVER THE RECENT MONTHS.

AND PEOPLE LIVING WITH HIV DO SUGGEST THAT THOSE WITH ADVANCED HIV ARE AT HIGH RISK OF DEVELOPING COMPLICATIONS RELATED TO MONKEYPOX.

WHEREAS THOSE INDIVIDUALS WHOSE IMMUNE SYSTEMS ARE BETTER OFF AND MORE INTACT AND WHO ARE MAINTAINED ON A MEDICATION REGIMEN THAT SUPPRESSES THEIR HIV A FAIR MUCH BETTER WITH A MONKEYPOX INFECTION AND DO NOT EXPERIENCE OTHER COMPLICATIONS.

THEY MAY WARRANT A TREATMENT FOR HOSPITALIZATIONS, BUT JUST SO IT'S WITH MANY THINGS RELATED TO THIS CURRENT OUTBREAK, NEW DATA CONTINUES TO ARISE WEEK TO WEEK.

NOW I WANT TO SPEAK TO SOMETHING THAT I THINK IS VERY IMPORTANT HERE.

THERE'S BEEN A LOT OF TALK GLOBALLY AND NATIONALLY, AND THE SPHERES OF INFLUENCE OF PUBLIC HEALTH AND MEDICINE TO AVOID STIGMATIZING SELECT GROUPS OF PEOPLE WHO HAVE BEEN IMPACTED BY THIS OUTBREAK.

IN THIS CASE, I'M SPEAKING ABOUT GAY AND BISEXUAL MEN OR ANYBODY REPORTING INTIMATE SKIN TO SKIN CONTACT AMONGST SAME SEX PARTNERS.

AND I DO AS A PHYSICIAN, AS A PHYSICIAN, STRONGLY AGREE WITH THE SENTIMENT AS WELL.

I THINK IT IS INCREDIBLY IMPORTANT TO CLARIFY IS THAT MONKEYPOX IS ABSOLUTELY NOT A DISEASE OF THE GAY COMMUNITY.

RATHER IT'S CIRCULATING RIGHT NOW AMONGST A SMALL SUBSET OF THIS POPULATION, BUT THAT WE KNOW HISTORICALLY THAT THIS VIRUS HAS SIMILARLY IMPACTED OTHER VERY DIFFERENT GROUPS OF PEOPLE IN THE PAST.

IN FACT, DURING A RELATIVELY SMALLER MONKEYPOX OUTBREAK OF THE U S IN 2000 GAY AND BISEXUAL MEN DID NOT SOME HEALTHCARE WORKERS AS WELL, WHO PERHAPS LACKED THE APPROPRIATE PROTECTIVE EQUIPMENT AND AWARE AND WERE IN CLOSE CONTACT WITH THE VIRUS.

SO I DO WANT TO DISPEL.

YEAH, THIS IS OKAY.

PERHAPS AT ALL THE MASTER I WOULD LIKE TO CONVEY TODAY IS ACTUALLY VERY CLEAR.

ANYONE CAN BECOME POTENTIAL CLEAN.

IN FACT, DID WITH THE MONKEYPOX VIRUS TRADED IN COMMUNITIES OF MEN WHO REPORT INTIMATE SKIN TO SKIN CONTACT WITH MALE PARTNERS, NEW PARTNERS, ESPECIALLY HOWEVER, WE DO NOT HAVE TO RUN THE RISK OF MINIMIZING THE CURRENT OUTBREAK AND LETTING IT GO UNABATED BECAUSE THE REAL RISK HERE IS NOT IN THIS SERVICE TO THE COMMUNITY MEMBERS WHO HAVE SUSTAINED A BENEFIT.

[00:15:01]

I SEE THAT NOT ONLY AS ONE OF MANY HEALTHCARE PROVIDERS LEADING THE CHARGE FOR EQUITABLE ACCESS TO SEXUAL HEALTH CARE AND PRIMARY CARE, BUT AS A GAY PHYSICIAN MYSELF, WE'D HAVE THE TOOLS TO HAVE A SENSIBLE AND HONEST DIALOGUE ABOUT THIS OUTBREAK AS IT CURRENTLY STANDS.

AND I THINK THAT THE LGBTQ PLUS COMMUNITY AS A WHOLE HAS PROVEN ITSELF REMARKABLY ADEPT AT CRAFTING AND AMPLIFYING PUBLIC HEALTH MESSAGING TO OUR COMMUNITY MEMBERS IN PART BECAUSE THE COMMUNITY ITSELF HAS BEEN AS SMALL AS A VOCAL ADVOCATE OVER THE YEAR, IT'S OFTEN NOT A SHEER NECESSITY.

THIS IS ABOUT HIV ITSELF.

I WOULD ASK THAT WE REMAINED VERY INTENTIONAL WITH OUR MESSAGING.

SO AS TO CONVEY THAT, WHICH IS FACTUAL AND MINIMIZE STIGMA AND MISUNDERSTANDING, WHILE ALSO ENSURING THAT WE INFORMED COMMUNITIES DISPROPORTIONATELY EFFECTED BY THIS OUTBREAK SO THAT EVERYBODY HAS ACCESS TO ACCURATE FACT-BASED INFORMATION.

BECAUSE I THINK AT THE HEART OF THE MATTER HEALTH LITERACY IS HEALTH EMPOWERMENT.

AND SO WHILE MANY QUESTIONS MAY REMAIN AND THEY ABSOLUTELY DO, I DO WANT ALL OF US TO RECOGNIZE OUR SHARED RESPONSIBILITY TO EDUCATE OURSELVES AND OUR COMMUNITIES.

AND THIS IS SOMETHING THAT WE CAN TANGIBLY DO RIGHT NOW.

THANK YOU VERY MUCH.

AND WITH THAT, I WILL PASS IT BACK TO DR.

WALKS.

THANK YOU.

AND NOW WE WILL HEAR FROM DIRECTORS STIRRUP.

THANK YOU, DR.

WALKS, AND THANK YOU TO, UH, THE MEDICAL PROFESSIONALS ON THIS CALL.

UM, SO NOW IT'S ABOUT A CALL TO ACTION.

YOU HEARD IT.

EDUCATION IS KEY TO MAKING INFORMED DECISIONS THAT WILL HELP KEEP YOU AND YOUR FAMILY SAFE.

UM, AND THAT'S GOING TO BE PARTICULARLY IMPORTANT WHILE WE WAIT FOR VACCINES TO BECOME MORE WIDELY AVAILABLE, WIDELY AVAILABLE.

SO ONE OF THEM MAY, IT MEANS DON'T HAVE INTIMATE CLOSE CONTACT WITH THE PERSON THAT YOU'RE YOU, YOU DON'T KNOW, OR YOU'RE NOT FAMILIAR WITH THEIR HEALTH HISTORY AND THE SAME WAY THAT YOU CUT OPEN THAT STAKE TO MAKE SURE THAT IT'S THE TEMPERATURE THAT YOU REQUESTED.

ASK QUESTIONS OF YOUR PARTNER, KNOW THE FACTS BEFORE MAKING A DECISION TO BE CLOSE OR INTIMATE.

THE VIRUS CAN BE SPREAD.

AS YOU HEARD TODAY IN A VARIETY OF WAYS, SHARING ITEMS COMING IN CONTACT WITH SORES, UM, THAT, UH, THAT COULD HAVE, UH, CONTAMINATED CLOTHES, BED, LINENS CUPS, UM, CIGARETTES, EATING UTENSILS.

I THINK ONE OF THE MOST IMPORTANT THINGS THAT WE LEARNED FROM THE COVID-19 PANDEMIC IS THAT WE NEED TO INFORM OURSELVES WITH INFORMATION.

AND IF WE ARE EXPERIENCING ANY SYMPTOMS AT ALL, WE NEED TO REACH OUT TO OUR MEDICAL CARE PROVIDER TO ASK QUESTIONS AND GET TESTED.

AND WITH THAT, I TURN IT BACK OVER TO WILLIAM.

THANK YOU.

THANK YOU, DIRECTOR STIRRUP.

NOW WE WILL OPEN IT UP TO OUR POLL REPORTER, GRACE READER FROM KX, N WHO ASK QUESTIONS ON BEHALF OF THE MEDIA.

HI, EVERYONE AS ALWAYS, THANK YOU SO MUCH FOR YOUR TIME AND FOR TAKING OUR QUESTIONS.

THE FIRST QUESTION IS FROM US AT KSAN.

WHY IS AUSTIN PUBLIC HEALTH PUTTING THE EMPHASIS ON MONKEYPOX EDUCATION THAT IT IS EVEN THOUGH THIS IS A SMALL NUMBER OF PEOPLE INFECTED AND IS OVERWHELMINGLY NOT FATAL.

UM, WE'VE LEARNED FROM OUR EXPERIENCE WITH THE COVID-19 PANDEMIC THAT ARMING THE COMMUNITY WITH EDUCATION, UM, ABOUT WHAT'S GOING ON, UM, IN THE PUBLIC HEALTH ARENA IS BENEFICIAL TO ADDRESSING THOSE PROBLEMS BECAUSE THEN PEOPLE CAN MAKE INFORMED DECISIONS ABOUT HOW TO PROTECT THEMSELVES AND THEREBY PROTECT OUR COMMUNITY.

I'LL JUST ADD BRIEFLY AS A PUBLIC HEALTH DEPARTMENT, WE WOULDN'T BE DOING OUR COMMUNITY A DISSERVICE IF WE DID NOT TAKE STEPS TO, UM, BE TRUE TO OUR MISSION, WHICH IS TO PREVENT DISEASE, PROMOTE HEALTH, AND TO PROTECT.

AND SO ANY INFORMATION THAT WE CAN HAVE BEFORE WE GET TO A CRISIS STAGE SO THAT OUR COMMUNITY IS PREPARED, THAT'S OUR JOB.

THE NEXT QUESTION IS FROM CBS AUSTIN, WHEN THE COVID PANDEMIC BEGAN, THERE WAS A LOT OF TALK ABOUT GROUPS BEING HIGHER RISK THAN OTHERS DOES.

MONKEYPOX HAVE ANY HIGHER RISK AGE GROUPS.

THE CDC REPORTS THAT CHILDREN WHO WERE UNDER THE AGE OF EIGHT ARE MORE SUSCEPTIBLE TO SEVERE DISEASE.

AND I PASSED THIS QUESTION ON TO DR.

MONDAY AS WELL.

YEAH.

SO

[00:20:01]

I THINK I TOUCHED ON THAT PRETTY WELL IN MY OPENING STATEMENTS, BUT GUESS WE THINK THAT CHILDREN UNDER EIGHT AND, UM, I KNOW THAT THERE'S SOME DATA OUT OF AFRICA, BUT THAT INCLUDED THE MORE, VILLAR VERY VIOLENT STRAIN THAT IN ONE STUDY THERE WAS EVEN UP TO WHEN YOU COMBINED ALL THE STRAINS, YOU KNOW, HIGHER THAN A 10% MORTALITY.

SO I THINK WE WORRY ABOUT OUR YOUNG CHILDREN, PREGNANT WOMEN.

AGAIN, IT CAN SPREAD TO THE FETUS AND CAUSE MISCARRIAGE, UM, AND THEN IMMUNOCOMPROMISED PEOPLE.

I THINK WE'VE LEARNED FROM COVID THAT THERE ARE A LOT OF PEOPLE TAKING MEDICATIONS THAT CAUSE IMMUNOCOMPROMISE PEOPLE THAT TAKE IMMUNE MODULATORS, HIGH DOSE STEROIDS CHEMOTHERAPY, AND LIKE, UH, DR.

STEFANO, WHICH SAID PEOPLE THAT HAVE PERHAPS, YOU KNOW, VERY ADVANCED HIV.

SO THAT COULD BE A LARGE NUMBER.

AND THEN FINALLY PEOPLE THAT GET EXTENSIVE INFECTION, IF YOU ACCIDENTALLY AUTO INOCULATE YOURSELF OR GET IT IN MULTIPLE SITES THAT COULD LEAD TO POTENTIALLY SECONDARY INFECTION, IT COULD LEAD TO MORE INTRA, UH, ORGAN INFECTION.

IT RARELY, IT CAN CAUSE A SEPSIS LIKE PICTURE OF, UH, PNEUMONIA AND CEPHALITIS THINGS THAT SEVERE EYE INFECTION THAT COULD CAUSE HOSPITALIZATION.

SO, UM, THOSE ARE, THOSE ARE THE MAIN AREAS.

THE NEXT QUESTION IS FROM KUT.

WHAT IS THE VACCINE SITUATION IN AUSTIN FOLKS IN CITIES LIKE NEW YORK HAVE SAID IN NEW YORK CITY HAVE SAID THAT THEY'VE HAD DIFFICULTY SIGNING UP FOR VACCINES.

THEY'RE WONDERING IF APH HAS A PLAN TO SCALE UP VACCINATION APPOINTMENTS, SIMILAR TO COVID.

AND IF SO, WOULD THERE BE A SIMILAR UP SYSTEM? WE CURRENTLY ARE VACCINATING PEOPLE WHO ARE IDENTIFIED AS CONTEXTS CLOSE CONTEXTS OF PEOPLE THAT HAVE BEEN CONFIRMED TO HAVE MONKEYPOX.

UM, AS WE RECEIVED MORE VACCINE SUPPLY, WE HAVE PLANS IN PLACE TO SCALE UP OUR OPERATIONS.

THE NEXT QUESTION IS FROM THE AUSTIN, AMERICAN STATESMAN IS AUSTIN PUBLIC HEALTH, STARTING TO VACCINATE PEOPLE.

AND HOW ARE YOU DECIDING WHO TO VACCINATE? WE ARE FOLLOWING THE GUIDANCE OF THE DEPARTMENT OF STATE HEALTH SERVICES AND THE CDC AND USING THE ELIGIBILITY CRITERIA BASED ON RISK EXPOSURE.

SO THOSE INDIVIDUALS WHO'VE HAD A HIGH-RISK EXPOSURE TO SOMEONE WHO IS POSITIVE FOR MONKEYPOX ARE BEING PRIORITIZED FOR VACCINE.

AND THEN WE FOLLOW THAT GUIDANCE THROUGHOUT THE NEXT QUESTION FROM FOX SEVEN, DO YOU ANTICIPATE MONKEYPOX BEING AS WIDESPREAD AS COVID CAN SOMEONE BE ASYMPTOMATIC AND ARE THE CONFIRMED CASES HOSPITALIZED HOSPITALIZATION OF OUR MONKEYPOX CASES BASED UPON THE SEVERITY OF DISEASE.

AND AT THIS POINT WE ARE FORTUNATE TO REPORT THAT WE DO NOT HAVE, UH, ANY CONFIRMED CASES IN HOSPITAL.

UM, THE ACTUAL SPREAD OF THIS DISEASE WILL REALLY, UM, DEPEND LARGELY ON THE RESPONSE OF THE COMMUNITY, TO THE GUIDANCE THAT WE'RE GIVING TODAY AND HAVE GIVEN, WHICH IS TO PROTECT OURSELVES, UH, AND TO LIMIT THE SPREAD OF THIS DISEASE BY FOLLOWING, UH, THE INFECTION CONTROL MEASURES LIKE AVOIDING CONTACT SKIN, TO SKIN, CONTACT, SEXUAL CONTACT WITH PEOPLE WHO ARE POSITIVE FOR MONKEYPOX HAND-WASHING AND THEN JUST THE SANITIZATION OF HARD SURFACES, UM, AND CLEANING, UH, LINENS AND, AND, UM, UPHOLSTERY APPROPRIATELY.

IF SOMEBODY'S BEEN USING THOSE THINGS WHO IS POSITIVE FOR MONKEYPOX.

AND I'LL JUST ADD TO THAT, THAT IT'S IMPORTANT THAT PEOPLE WITH MONKEYPOX TALK TO THEIR PROVIDER, THE CDC HAS HANDOUTS, BUT THERE IS A LOT OF PERSONAL RESPONSIBILITY.

YOU CAN BE CONTAGIOUS UNTIL YOUR LESIONS ARE COMPLETELY SCABBED, CRESTED.

THEY FLAKE OFF AND YOU HAVE NEW SKIN GROWTH.

SO THAT COULD BE THREE TO FOUR WEEKS.

AND IN LOOKING AT OTHER DATA LIKE THE WHO, BECAUSE IT'S NOT FULLY DETERMINED ABOUT THE SEXUAL TRANSMISSION PIECE, THEY RECOMMEND THAT PEOPLE USE CONDOMS FOR ADDITIONAL 12 WEEKS AFTER THAT.

SO THAT REQUIRES SIGNIFICANT, YOU KNOW, PERSONAL RESPONSIBILITY.

BUT I THINK OUR COMMUNITY CAN DO THAT.

[00:25:01]

I DO WANT TO ECHO WHAT, UH, DOCTORS, MONTE AND WALKS HAD JUST MENTIONED WITH RESPECT TO TANGIBLY, WHAT PEOPLE IN THE COMMUNITY CAN DO RIGHT NOW, BECAUSE, UH, WE DO KNOW THAT THE, AS DR.

WACHS HAD MENTIONED JUST NOW THAT, UH, THE VACCINE AVAILABILITY IS, IS, UH, LIMITED IN QUANTITY AT THIS TIME, THERE ARE FUTURE PLANS AND I'LL DEFER TO AUSTIN PUBLIC HEALTH, UH, ON THAT FOR FURTHER DISCUSSION.

BUT, UM, PEOPLE IN THE COMMUNITY WANTS TO KNOW BOTH ON THE SERVICE PROVIDER SIDE AND FOR COMMUNITY MEMBERS, WHAT THEY CAN DO RIGHT NOW TO HELP MITIGATE OR REDUCE THEIR RISK.

AND AS I HAD SAID, IN MY OPENING REMARKS, HEALTH LITERACY IS HEALTH EMPOWERMENT, UH, SEEKING VERIFIABLE, TRUSTED RESOURCES FOR EDUCATION, VISITING THE CDC AND THE WHO IS WEBSITES, I THINK ARE GREAT RESOURCES, REAL TIME.

UH, SOCIAL MEDIA PLATFORMS HAPPENED TO BE VERY BIG PLATFORMS BY WHICH WE SHARE AND AMPLIFY INFORMATION TOGETHER AS A SOCIETY NOW.

AND I THINK IT'S INCUMBENT UPON ALL OF US.

PRODUCTOR MONTE WAS, HE HAD JUST SAID PART OF OUR POSSIBILITY AS CITIZENS IS TO DE YEAH.

AND IF WE ARE SPREADING INFORMATION ON SOCIAL MEDIA AND MIMIC COOPER VIA THE, UM, TUB DIFFICULTY WITH YOUR AUDIO AND YOUR VIDEO, I'LL MOVE ON TO THE NEXT QUESTION.

AND IF HE GETS THAT FIGURED OUT, WE CAN COME BACK TO IT.

UM, AND DR.

WACHS, YOU WERE JUST ANSWERING SOME OF THOSE QUESTIONS FROM COOPERATIVE PO, BUT THE, THEY ARE ASKING ABOUT THE VIRUS ON SURFACES AND THEY ADDITIONALLY ASK HOW LONG THE VIRUS HAS.

CONTRACTABLE FROM AN OBJECT.

THE CDC HAS PUT OUT, UM, A DOCUMENT THAT STATES THAT FOR 15 DAYS AFTER SOMEONE WHO'S HAD MONKEYPOX HAS, UM, NOT OCCUPIED, UH, UH, PREMISES THAT WE CAN STILL FIND LIVE VIRUS.

UM, SO IT'S IMPORTANT THAT WE UTILIZE EPA APPROVED CLEANING PRODUCTS AND FOLLOW THE INSTRUCTIONS FOR HOW TO USE THOSE AND, AND ALLOW THOSE CHEMICALS TO DRY.

UM, AND THEN, YOU KNOW, CONSIDER STEAM CLEANING UPHOLSTERY WHEN NECESSARY AND MAKING SURE THAT WHEN WE'RE WASHING CLOTHING AND BED LINENS AND WHATNOT, THAT WE'RE HANDLING THOSE WEARING GLOVES AND MASK AND EYE PROTECTION.

UM, BECAUSE AS I SAID, THE FLUIDS, BODY FLUIDS AND SCABS HAVE LIVE VIRUS AND CAN POTENTIALLY IMPACT THOSE THAT ARE HANDLING THOSE, THOSE OBJECTS.

THE NEXT QUESTION IS FROM UNIVISION, DOES APH HAVE ENOUGH TOOLKITS NEEDED TO TEST FOR MONKEYPOX IN CASE DEMAND FOR TESTING DOES GO UP.

WE DO HAVE ENOUGH SUPPLIES FOR TESTING.

UM, WE ARE COLLECTING THE SAMPLES THAT ARE SUBMITTED BY PROVIDERS OF PATIENTS THAT THEY'RE SEEING.

AND THEN THOSE SAMPLES ARE ACTUALLY BEING RUN BY THE DEPARTMENT OF STATE HEALTH SERVICES, UM, LABORATORY.

UM, WE DO HAVE ONE LAB THAT AS A COMMERCIAL, THAT'S DOING TESTING AS OF YESTERDAY, AND WE'RE ANTICIPATING THAT MORE COMMERCIAL LABS WILL BE COMING ONLINE IN THE COMING WEEKS, WHICH WILL HELP, UH, WITH THE, THE TIME FACTOR AND, UM, UH, THE INCREASED NUMBERS OF SAMPLES THAT WILL BE RECEIVING.

[00:30:03]

THE NEXT QUESTION IS FROM KATE VIEW, WHAT WAS THE CRITERIA IN ORDER FOR MONKEYPOX TO BE CONSIDERED AS COMMUNITY SPREAD IN AUSTIN? WE STARTED TO SEE, UH, PEOPLE WHO HAD CONFIRMED CASES OF MONKEYPOX IN OUR COMMUNITY THAT WERE RELATED TO THEM HAVING CONTACT WITH SOMEONE WHO HAD NO HISTORY OF TRAVEL, AND THAT SIGNALED THE BEGINNING OF SPREAD IN OUR COMMUNITY, UM, THAT CAN HAPPEN BETWEEN PEOPLE, REGARDLESS OF WHAT SOCIOECONOMIC OR, UH, WHATEVER GROUP THEY COME FROM, DEMOGRAPHIC GROUP THEY'RE THERE FROM.

SO IT'S NOW INCUMBENT UPON US AS A COMMUNITY TO TAKE PRECAUTIONS IN AT ALL, UM, DEMOGRAPHIC LEVELS, BECAUSE IT IS NOW IN OUR COMMUNITY AND IT IS POSSIBLE FOR SPREAD TO OCCUR, OR NOW GOING ONTO THE SECOND ROUND OF QUESTIONS.

SO THIS ONE IS AGAIN FROM US HERE AT KX.

AND CAN YOU GIVE US A GOOD FRAME OF REFERENCE FOR HOW CONTAGIOUS MONKEYPOX HAS BEEN HERE LOCALLY? COULD YOU REPEAT THAT QUESTION PLEASE? SURE.

SO JUST ASKING, CAN YOU GIVE US A FRAME OF REFERENCE FOR HOW CONTAGIOUS MONKEYPOX HAS BEEN, FOR EXAMPLE, COMPARED TO PERHAPS OTHER DISEASES? UM, I THINK PEOPLE ARE HAVING A DIFFICULT TIME UNDERSTANDING REALLY HOW CONTAGIOUS THIS MIGHT BE.

SO, UM, WE WORK AT, UH, UH, REPRODUCTION NUMBER, UM, AND THAT HAS BEEN ESTIMATED TO BE SOMEWHERE IN THE NEIGHBORHOOD OF TWO, WHICH LOOKS AT HOW MANY PEOPLE, ONE PERSON, UH, WILL INFECT AT A TIME.

AND THAT TYPICALLY THE NUMBER HAS BEEN CALCULATED AT TWO, BUT AS THE SCIENCE EVOLVES, AND AS WE LOOK AT WHAT THE SITUATION IS HERE IN OUR COMMUNITIES, AND THEN OUR NATION THAT THAT MAY CHANGE.

SO IT IS, UM, IT IS VERY CONTAGIOUS.

IT'S SPREAD BY CONTACT WITH RESPIRATORY DROPLETS.

IT'S, IT'S ALSO SPREAD BY CONTACT WITH THE FLUIDS, UH, THAT ARE ASSOCIATED WITH THE RASH THAT'S ON THE SKIN.

AND, UH, IT IS ALSO, UM, SOMETHING THAT YOU CAN, UM, SPREAD BY, UH, HAVING THE SCABS THAT STILL HAVE VIRUS THAT'S VIABLE THEM, UM, CONTACTING THOSE WHO ARE NOT INFECTED.

SO, UM, IT IS, IT IS, IT IS CONTAGIOUS AND IT IS IMPORTANT THAT PEOPLE PROTECT THEMSELVES BY WASHING HANDS, WEARING A MASK.

IF THEY'RE GOING TO BE IN CLOSE QUARTERS AND, UH, UH, AVOIDING SKIN TO SKIN CONTACT WITH THOSE THAT HAVE, MONKEYPOX THE NEXT QUESTION FROM CBS AUSTIN WITH AUSTIN ISD RETURNING TO CLASS ONE MONTH FROM TOMORROW, ARE YOU ALL WORKING WITH SCHOOLS ON MONKEYPOX PROTOCOLS AND WHAT SHOULD PARENTS HAVE THEIR CHILDREN DO TO STAY SAFE IN A SCHOOL SETTING? IT'S GOING TO BE IMPORTANT FOR THE ADULTS THAT ARE, UM, CARING FOR CHILDREN TO PROTECT THEMSELVES, AND SO THAT THEIR CHILDREN DON'T BECOME INFECTED.

AND WE WILL BE, AND HAVE BEEN WORKING WITH SCHOOLS ON AN ONGOING BASIS WITHIN INFECTION CONTROL MEASURES IN SCHOOL SETTINGS.

AND WE'LL CONTINUE TO DO THAT.

THE NEXT QUESTION IS FROM KUT, THE CDC ANNOUNCED THIS WEEK THAT IT'S EXPANDING ITS PARTNERSHIPS WITH COMMERCIAL LABS TO TEST FOR MONKEYPOX.

DO YOU EXPECT THAT TO RESULT IN AN INCREASE IN TESTING, TESTING CAPACITY IN AUSTIN? AND IS THERE A POSSIBILITY FOR LARGER SCALE TESTING SITES OR WOULD IT BE ON THE PROVIDER LEVEL? THE INTRODUCTION OF, UM, COMMERCIAL LABS WILL DEFINITELY HELP, UM, IMPROVE, IMPROVE OUR TESTING CAPACITY AND THESE TESTS WILL BE PERFORMED, UH, PROVIDER LEVEL, UM, BECAUSE OF THE NATURE OF THIS DISEASE THAT WILL REQUIRE AN EVALUATION BY A MEDICAL PROVIDER.

THE NEXT QUESTION IS FROM THE AUSTIN AMERICAN STATESMAN, HAVE THERE BEEN POCKETS OF INFECTION? WHAT ARE THE CHARACTERISTICS OF THOSE POCKETS? WHO ARE YOU SEEING HAVE BEEN MOST AT RISK IN TRAVIS COUNTY? WE'RE NOT SEEING, UH, CLUSTERS OF INFECTION.

[00:35:01]

WE ARE SEEING, UM, COMMUNITY, UH, WIDE INFECTION THAT'S HAPPENING IN DIFFERENT PARTS OF OUR COMMUNITY AND THE, UM, WHAT WAS THE SECOND PART OF THAT QUESTION? WHAT WAS THE SECOND PART OF YOUR QUESTION? THE SECOND PART IS WHO ARE YOU SEEING, HAVING BEEN MOST AT RISK HERE IN TRAVIS COUNTY SO FAR? UM, IT'S PREDOMINANTLY BEEN SEEN IN THE 20 TO 49 YEAR OLD AGE GROUP.

UM, AND SO FAR IT'S BEEN THE NEXT QUESTION FROM FOX SEVEN.

COULD PEOPLE WITH SKIN CONDITIONS LIKE ECZEMA BE AFFECTED MORE SEVERELY? YES, THAT'S TRUE.

AND I'LL PASS THAT ON TO DR.

MONDAY AS WELL.

YES.

UM, THAT'S A GOOD QUESTION.

PEOPLE THAT DO HAVE SIGNIFICANT ONGOING SKIN CONDITIONS ARE ALSO CONSIDERED AT HIGHER RISK.

I THINK THEY ALREADY HAVE SKIN INFLAMMATION AND THAT MAKES IT, THAT MAKES IT WORSE.

AND, AND ALSO IT COULD PREDISPOSE, UH, WITH MORE SKIN INVOLVEMENT AND, AND A HIGHER RISK OF THEN SECONDARY INFECTION.

YES.

THIS NEXT QUESTION IS FROM THE CO-OP RADIO.

THEY SAY YOU SUGGEST TYPICAL NTIS ARE EFFECTIVE TO REDUCE CONTAGION, AND THAT WE SHOULD FOCUS ON HAND HYGIENE TO SANITARY WIPES, DISINFECT IMPACTED SURFACES AND OBJECTS DOES NORMAL LAUNDRY CLEANING, DISINFECT OBJECTS.

UH, YOU NEED TO CHECK, UH, WHAT YOUR WIPES HAVE AND TOOK THE EPA LIST FOR THOSE, UM, INGREDIENTS THAT ARE EFFECTIVE IN KILLING VIRUS.

UM, AS FAR AS LAUNDRY GOES, THE CDC GUIDANCE FOR CLEANING LAUNDRY IS TO USE REGULAR LAUNDRY DETERGENT IN A WASHING MACHINE.

AND THE FINAL QUESTION IS FROM UNIVISION, THEY ASK, WHAT ABOUT PEOPLE WHO HAVE ALREADY HAD CHICKEN POX BEFORE, AND THEY PROBABLY NEED SMALLPOX.

ARE THEY AT A HIGHER RISK OF GETTING SICK WITH THIS OUTBREAK CHICKEN POX? YEAH.

OR DO THEY MEAN SMALL PEOPLE? HAVEN'T HAD SMALLPOX THAT THAT WAS LIKE ERADICATED AND THE EARLY SEVENTIES, THERE'S A LOT OF CONFUSION, BUT CHICKEN POX IS A MEMBER OF THE HERPES VIRUS, FAMILY, AND S AND, AND THE ORTHOPEDICS IS NOT IN THAT.

THAT'S A COMPLETELY DIFFERENT FAMILY.

IT INCLUDES SMALLPOX, UH, CALLED VERY YOLA VACCINIUM, WHICH IS A TYPE OF, UH, RELATED VIRUS THAT THEY USE TO MAKE THE VACCINE, AND THEN MONKEY POX.

THEY SAID THAT PEOPLE THAT HAVE HAD A PRIOR SMALLPOX VACCINE COULD HAVE IMMUNITY, BUT IF IT WAS GIVEN SO LONG AGO, THEY COULD HAVE WANING IMMUNITY.

BUT IF YOU'RE RELATED TO THE VACCINATION OF SMALLPOX, THAT THAT DOES COME UP.

AND IT'S INTERESTING BECAUSE MY UNDERSTANDING IS A LOT OF PEOPLE IN THE MILITARY HAVE BEEN VACCINATED FOR SMALLPOX.

AND THEN I WOULD SAY THAT IF THAT WAS NOT THAT LONG AGO, THAT WOULD PROBABLY PROTECT THEM.

AND THAT'S THE FINAL QUESTION.

THANK YOU ALL SO MUCH.

THANK YOU AGAIN, GRACE, FROM A READER FROM KX AND FOR BEING OUR PULL ROAD PORTER TODAY.

NOW I'M GOING TO PASS IT ALONG TO DR.

WACHS FOR FINAL THOUGHTS.

I WANT TO THANK MY COLLEAGUES FOR JOINING US TODAY AND THANK DIRECTOR STIRRUP FOR YOUR WISDOM AND CALLED ARMS, UM, AND CALL TO ACTION.

UM, WE'RE HOPING THAT OUR COMMUNITY, UM, HAS, UH, HAD A CHANCE TO DIGEST THE INFORMATION THAT YOU'VE HEARD TODAY, AND THAT YOU WILL TAKE THIS INFORMATION AND HELP US ALL WORK TOGETHER TO, UM, CARE FOR THOSE THAT ARE IN COMMUNITY WHO ARE, UM, DEALING WITH MONKEYPOX AT THIS POINT, UM, AND HELP THEM THROUGH THAT, UNDERSTAND THAT AS SUPPLIED VACCINE BECOMES MORE AVAILABLE, THAT WE WILL CONTINUE OUR EFFORTS AND EXPAND TO OUR CAPACITY TO VACCINATE, AND ALSO KNOW THAT WE ARE HERE.

ALL OF US, ALL OF THE HEALTHCARE PROVIDERS ON THIS CALL AND COLLEAGUES THROUGHOUT THE CITY TO HELP THOSE THAT IDENTIFY THEMSELVES AS HAVING SYMPTOMS OR, UH, AND, AND PRESENT THEMSELVES THAT WE'RE READY AND ABLE TO TREAT THEM.

AND THAT IF WE WORK TOGETHER ON THIS WITH TAKING THOSE INFECTION CONTROL MEASURES

[00:40:01]

THAT WE'VE TALKED ABOUT TODAY, THAT THIS, UH, CAN BE CONTROLLED AND THAT WE CAN, UM, EFFECTIVELY, UH, BRING A STOP TO IT.

SO I THANK YOU FOR YOUR TIME AND ATTENTION.

AND, UH, THANK YOU.

ALL RIGHT.

I WANT TO SAY THANK YOU TO DR.

WACHS DIRECTOR, ADRIAN STIRRUP, UH, DR.

CHRISTINE MONDI WITH DELL MEDICAL AT THE UNIVERSITY OF TEXAS AT AUSTIN AND DR.

UM, MIKE OF STEFANOVICH WITH COMMUNITY CARE.

UM, THANK YOU FOR JOINING US TODAY.

AND OF COURSE, GRACE RATER WITH KX AND FOR BEING OUR POLL REPORTER TODAY, WE HOPE YOU ALL HAVE A WONDERFUL THURSDAY.

THANKS.

ALL RIGHT, GUYS, YOU GUYS ARE ALL CLEAR.

THANK YOU SO MUCH.

THANKS, ROBERT.

THANKS.

CTXO.

THANK YOU EVERYBODY.

THANKS EVERYONE.