(upbeat music) Welcome to At Issue.

I'm H Wayne Wilson, thank you so much for joining us for a discussion about COVID-19.

It doesn't seem to be going away as fast as we would want it to with sub variance and variance and now we've done, we've thrown monkeypox into the mix.

We'll have a discussion about what we should be doing to help protect ourselves, continue to protect ourselves against COVID-19 and some information about monkeypox and to have that conversation, Sarah Overton is here.

Sarah is the chief nursing officer at OSF Medical Group and Home Care, thank you for being with us.

- Thank you.

- And in a multi return appearance, Monica Hendrickson is with us.

Monica is the Peoria City/County health department administrator, thank you for joining us again.

- Thank you for having me.

- So we here talk of BA.4, BA.5.

There seems to be a continuing string of variance, sub variance, how concerns should we be in the general public?

I have a sense that we've got this feeling that we're almost past COVID.

Should we still be concerned?

- I think the basic comes with a virus in general.

There's always some concern about mutations as we've seen throughout the pandemic, different variants that come up and have different quote, unquote skills, right?

Some evade certain treatments, some evade certain vaccinations.

So there should be a level of concern in the fact that it's has ability to mutate.

Overall, though, we have vaccinations, we understand the virus as healthcare providers we have treatment courses and understand a treatment plan for individuals.

And so while we should be vigilant, it should not necessarily take over the majority of our life and kind of how we make our decisions moving forward.

- So when we talk about BA.4, BA.5 and Delta and all the rest of them, and now I think there's something called Centaurus which is 2.75, is it safe to say that as these so far as the variance and sub variance occur, that they are less virulent, they might still spread, but they're less virulent.

Is that a fair assessment?

- I think it depends honestly on the individual, certain risk factors are always going to, I would say exacerbate a patient's symptoms.

So I would say less deadly perhaps, but that may be mainly due to vaccination.

Some of what we're seeing within the communities as far as spread we've also as Monica alluded to, we've got different courses and treatments that have been proven beneficial for our patients.

So we believe, we're hopefully on the other side of this virus and know a little bit more about it, two years into it.

- I don't wanna dwell on numbers, but to give an idea that that COVID is still with us.

Illinois is reported cases of COVID.

In the state of Illinois averaging about 5,000 new cases a day.

Now only 10 deaths, new deaths a day, which is low, but we're still 5,000 reported cases.

How are we doing locally?

- So Peoria County is averaging 50 cases a day.

And I think that's, I made a really good point that we know of.

Because those are from laboratories that are reporting their test results to our system, but many individuals are being able to take at home tests and those test results do not get reported.

So it's safe to assume that it's almost double to triple that number.

So while I say 50 cases are new each day in Peoria County, we're really looking at somewhere closer to a hundred to 150.

- Sarah if I take a home test and it shows positive, should I report it somewhere?

- We definitely encourage you to report it to your healthcare provider.

So either your family physician, a nurse practitioner, if you aren't established, definitely seeking treatment, we've got a lot of telehealth options, but we do want you to report it early because there may be some treatments that are recommended for you.

So while we don't ask you necessarily to call the public health department and report it, we wanna know about it, it'll also change the course of treatment.

Should you need a surgical procedure in the near term, and it's vital information for us to be aware of.

- What about the number of hospitalizations in the OSF system?

- So within the 15 hospitals that we have throughout the entire state of Illinois and Michigan, we're seeing roughly about 95 confirmed with another 40 or so suspected, quite a few are still being treated through our ICUs or on ventilators.

So there is some critical patients that we are experiencing.

We're continuing to see asymptomatic positive patients coming through just to get a routine test before their surgical procedure.

So it's very much out there, I would say we are seeing a summer spike as we go through the seasons, but quite a few convalescing at home luckily.

So they've either been vaccinated or had a previous exposure.

- I'd like to spend a few minutes just talking about what we should be doing.

I have a sense that many of us have set back and said, "The pandemic, I made it through the pandemic."

Are there recommendations?

And I know this might change the pain and what your job is et cetera, but are there some general recommendations Sarah, for us to follow?

- Yeah, I think first and foremost, Monica and I can both agree if you've not gotten vaccinated we really, really strongly encourage you to seek out information from your trusted healthcare professionals and talk to them.

Certainly on the outset of when vaccinations were still new, there was concern, but now several years into this, we've really demonstrated high safety efficacy.

We've vaccinated at least over 200,000 doses just in OSF healthcare alone and doing so every day and have had minimal if any repercussions and we're reporting any of those concerns to our state and federal officials.

But vaccination is huge, proper hand hygiene, staying home.

If you don't need to travel, certainly encouraging you to seek other means to maybe communicate and support.

If you are feeling like you're sick, test, there's readily available tests either at home or even through our healthcare facilities.

And then overall social distancing still recommended and maintained.

- Let me follow up on something that Sarah said, Monica, and that is get vaccinated.

For those of us who are double dose or single dose, depending on the vaccine, what about boosters?

- So definitely you wanna make sure that, if you are eligible to get a booster, get your booster, and especially for those that are higher risk, that need to get a second booster follow up with that as well.

I think the importance recognition about vaccinations and you brought up the different variants is that people have heard concerns about whether or not the vaccines match the current variant that is going through our population.

And the key to recognizes is maybe not a perfect match, but the vaccines still give your body some notes, or some playbook a little bit about what you can and your body can respond to.

So while it's not a perfect match, it gives enough so that you have an immune response so that you're not fighting from ground zero your body is starting kind of ahead of the game.

So again, you're decreasing the risk of hospitalization or severe illness.

- So a second booster for at least some people.

- Definitely.

- Are we looking at a third booster or an annual booster once?

I mean, might this turn into, excuse the comparison, but into the annual flu vaccine.

- Definitely, and you made a point about people kind of stepping back and saying, "I've kind of survived the pandemic," and that might be true.

We might be at the point where we're kind of starting to see ourselves out of the pandemic, but we are still now in the endemic phase, where that's what influenza is, where you are looking at possibly changes to an annual vaccine so that it adapts to what the current variant is or what we are forecasting as the next mutation, so to speak.

So I think while we wanna be completely done with COVID and never have to talk about COVID again, it now might be part of our just normal routine vaccination process that we do as we do with influenza.

- What about mask wearing?

Are there guidelines for wearing a mask or is it up to me?

- There's a little bit of a mix.

Some locations are still requiring masking, especially healthcare facilities, the health department as a whole, we treat ourselves as a healthcare provider, and so definitely masking in those situations.

I think where it becomes more up to you is first and foremost, recognizing your risk, not only from your health risk, but what it means for you to be possibly out of pocket for five to 10 days, because you're ill, is that a risk that you're able to take?

But overall masking again has been demonstrated be highly effective in controlling the spread and transmission of COVID.

So it's something that is a useful tool to have.

- So if you're traveling, wear a mask?

- I highly recommend it.

- If you go to the drug store, wear a mask?

- Yes.

Let me turn to Sarah for a conversation about medications.

We were talking about vaccines.

Now we've seen the president took Paxlivid.

There are other medications.

Can we kind of do a little primer on what is Paxlivid and who should take it?

When should they take it?

- Well, it's very important.

I don't wanna say, globally that everyone is eligible, 'cause there's definitely criteria that makes you eligible for that treatment, and it's early.

So again, connecting with your healthcare provider.

Paxlivid is an antiviral medication that helps your body basically boost its immune response and fight off the virus a little bit more effectively.

Evusheld is another medication that's actually been recommended to be given to our extremely high risk, like active cancer patients that are receiving chemotherapy.

So those medications and certain subgroups and populations are crucial to treatment.

So again, always consulting with your family physician who knows you the best.

- And those are prescription drugs?

- Yep.

- Are there any non-prescription drugs?

- Well, Paxlivid also, I will say you do not need a prescription from your physician, but we could certainly educate you as to your risk factors that would make you eligible.

Our retail pharmacy locations have the medication and actually our pharmacist can dispense it without a prescription.

- The symptoms seemed to be changing Monica.

I mean, there were a lot of symptoms when COVID-19 first appeared on the screen, but taste and smell were one of the big deals early on.

That doesn't seem to be the case much anymore.

I assume this is because the variance, sub variance have different ways of attacking your body.

- Definitely this time I think the ones that we see is sore throat and then followed usually within I would say 12 hours, sinus congestion, sinus drainage.

Usually the coughing is much more of like a post nasal drip cough.

So very similar to allergy season where people kind of assume that, oh, I wake up in the morning, I kept the windows open last nigh it's just allergies that are coming to play.

But that's why testing is so important to make that distinction.

- So if I wake up in the morning and I have a raspy voice or something's not quite normal, I should test?

- You should test.

- Because we may write it off as oh, allergies again.

- Yeah, I would definitely test, especially if you know that, oh, after my first cup of coffee or I had a glass of water, after breakfast this usually clears out on its own.

And if it doesn't, that's a really key indicator.

If it's not following your own history of how you've kind of dealt with in the past, it's definitely a good step to test.

- I mentioned that the president had a recurrence after taking Paxlivid.

Paxlivid isn't a perfect solution to the initial onset of COVID?

- So I think the first thing to know about Paxlivid is that it's primary role is to prevent severity and hospitalization.

So with the president, it worked, he's not having severe symptom, I think he's actually currently asymptomatic and he's not hospitalized.

So it's doing exactly what it needs to.

But because, as Sarah mentioned, what it does is boosts your immune response and the course of the medication is only about five days.

So individuals that take this, we highly encourage them, the pharmacist as well as the healthcare provider about monitoring your symptoms.

'Cause we see people that after their five days might develop symptoms again around day two to three or around day 10 could also again start testing positive.

So if you take that medication you should continue to monitor yourself up to day 14.

- So it wasn't unusual for the president to have this recurrence?

- No, it's not unusual, we see it with Paxlivid, but again, it did exactly what it was meant to do, which was decrease severity.

- We've heard about studies coming up and I know Monica wants to talk about this, but could we have, Sarah could you just explain what long COVID is?

- Sure, I'd be happy to.

So what we've been experiencing and actually our physician service line councils continue to review the literature and information, but depending on actually several risk factors, hospitalized due to COVID not being vaccinated.

And then several that have immunosuppressive diseases processes already, we're starting to see this continuation of the COVID fog or the brain fog the exacerbation of a cough for longer than the normal cause of what we would see convalescence which is 20 days or so.

And so for months and months and even into years, they're seeing that they're unable to return to work, they have increased dyspnea.

So they're short of breath doing physical activities.

And we believe that a lot of that and I know Monica will tell us a little bit more, but we believe a lot of that is contributing factors to the disease cause and how basically our body has changed due to the virus.

- So with long COVID, is it a case of you get COVID-19, might the symptoms disappear temporarily and come back?

- Correct?

- Or they could last throughout?

- Both, what we're seeing is both.

Both with our employees that are in healthcare settings, because we also have employee health.

We're seeing our mission partners who've been unable to return to work.

And we're also treating several patients who are saying, "I am so physically taxed that I can't return back to my job."

And so when we're studying the symptoms, it's really varied.

So anxious to see what research we'll point to , and how we are able to combat it and treat it.

- So Monica research being done at least in part locally.

- Yes, this is actually really exciting.

So the NIH or National Institute of Health put out funding for research around long COVID and University of Illinois, College of Medicine Peoria through the partnership with University of Illinois and Chicago was a selected site to really study long term COVID, one, to understand what exactly the definition is of a long COVID.

And also to that point, we know kind of qualitatively or anecdotally kind of what people have seen as maybe the risk factors, but really diving into what could be those conditions that push them to be at a higher risk for having long COVID.

So it's UICOMP, OSF is a partner agency, UnityPoint Health, as well as the Peoria City/County Health Department.

And then we have some community based organizations, Central Illinois Friends, Tri-County Urban League and neighborhood house.

And so we are actually currently enrolling adults that had COVID, either tested positive through a laboratory or a home test, had symptoms.

And the goal is to really work with them to understand what symptoms they had, how their disease went through and then kind of look at, how they progress moving forward.

So it's a really exciting study to have here locally.

- So someone could sign up for this if they have lingering symptoms?

- Lingering symptoms or even they just had their COVID diagnosis and wanna be able to monitor themselves moving forward to see what puts 'em at risk.

And they can just sign up by going to a website, which is I-L-L-I-N-E-T.org, so illinet.org.

- One more time, spell it out.

- I-L-L-I-N-E-T.org.

- Okay, and Sarah mentioned brain fog, the fatigue, it becomes that invasive that you can't even return to work.

- There is a spectrum of kind of long COVID conditions and of the severe end there are people that really can't go through their daily functions anymore.

- So at the top of the show, I said, gee whiz, we're just maybe getting to the point where we can tolerate COVID-19 and now we've got monkeypox.

What is monkeypox, Sarah?

- Sure, and I will say that this is right when we are also talking about influenza, which I, more passionate about influenza.

So monkeypox has been a disease that's been present in Africa for quite some time decades.

More recently, there's been transmission through the states.

I think there's about 72 countries that now have documented cases similar to smallpox.

So it is a lesion-based droplet transmission, but really it's much different than the respiratory transmission that we're used to with the common cold and COVID and influenza.

So right now, I believe in the state of Illinois, we have about 500 cases give or take.

So we're already starting to see a couple patients that have come through our healthcare facilities.

Luckily it is not as deadly of a disease.

It's something that, again, Africa's been dealing with for quite some time, but still something that we need to keep an eye on.

So our role at OSF is really to educate our physicians, our nurses, nurse practitioners, to know the signs and symptoms of COVID, to screen our patients for their risk factors such as travel, any type of exposure to maybe an eroding population.

And so doing an accurate in depth screening for our patients to make sure that we differentiate that diagnosis.

- So Monica, we were able to identify monkeypox in about 1958 or so in animals.

We know that it's been in the human population at least since 1970.

Why all of a sudden are we having, the World Health Organization has actually declared a public emergency with regard to monkeypox?

Why is this happening?

- I think the main reason why is it goes back to the ability for us to travel and be much more global.

So in previous outbreaks or surges of monkeypox that we saw throughout the African continent, it tends to be controlled rather quickly, just because quality of life, ability to move around things of that was very limited, but now we're in a much more globalized situation, people are moving around and so, I can be on the ground in Sub-Saharan Africa and then be back in the state within 10 hours.

And so because of that, we have to, it has spread a lot more so than we have seen previously, but at the same time we understand it.

We understand how it spreads, the transmission process, and we also understand these high risk populations.

So a lot of it's education.

- But we have a vaccine, we've had a vaccine for quite some time for monkeypox.

- Yep, we just receive word of vaccination availability again to those higher risk populations.

We've had the unfortunate event of having to offer a post exposure vaccination to some of our healthcare workers.

So we have had a documented case up in our Chicago market.

So we're definitely educating, we're changing some of our screening tools.

We're providing checklists from IDPH and others to our healthcare organizations, making sure our fit testings up to date for our own healthcare workers to protect them.

But the vaccination I would guess is going to be upon us here soon and have some of that availability, but it's really educating and knowing the risk factors and what to avoid.

- So it will be for a select audience though in terms of vaccination?

Symptoms of monkeypox.

I mean, everyone's familiar with COVID symptoms.

Are there certain symptoms that people should look for?

- I would defer to Sarah, but number one is the lesions I think that's a key indicator that we're seeing here.

- Yeah, definitely, what we're seeing is fever, headache, malaise.

So that's not too undifferent the poxs is definitely a differentiator.

What we see the difference between smallpox and monkepox is swollen lymph nodes.

So if everybody's familiar with those glands in your neck or behind your the bottom of your skull under the armpits, wherever you would see a lesion, if you start to feel that swelling and intense pain, that would definitely be one of the hallmark signs.

And again, we ask you to call us so that we can make sure that we're planning for you to come.

The testing is again, limited similar to COVID, it was a slower rollout.

So we would be able to then partner with our local health department and test if needed.

- So this is similar to smallpox?

- Yes.

- But not to chickenpox.

- Correct.

- Okay, let's go back to COVID for just a moment Monica.

You mentioned the word endemic earlier, meaning it might be just part of our life sometimes.

So is this going to be like flu then?

- I think so.

I think you're gonna see surges a bad flu season, a good flu season, but I think that the challenge still is recognizing, it has that capacity to mutate.

So again, it should not dictate or control everyday aspects of your life, but the awareness that if we are having a bad season or if something changes that we might need to resort to some of those mitigation efforts again.

But again, right now it's really twofold, one recognizing your own risk.

And if you don't know your full risk, definitely get a scheduled appointment with a primary care provider to start understanding your risks.

But also to the risks of those around you, who relies on you in essence?

- So masking be something that in certain situations we might be masking years from now?

- I think so, I think masking is twofold.

I think you're gonna continue to see people, especially during high respiratory seasons start masking.

I feel now that it's part of my, it's definitely my bag everywhere, in my car, but if I'm going into a pharmacy where I know people go there to buy medications, go to my doctor, I'll be masking.

- And Sarah, one quick, last question, get a flu vaccine?

- Absolutely get a flu vaccine, masking is not new, we've been masking during flu season as well.

So get a flu vaccine and back to school time make sure that you get your kiddos vaccinated.

- And with that, our half hour is up, but we can continue the conversation after the cameras are off.

We appreciate your input.

Sarah Overton, OSF, chief nursing officer for the medical group and the city county health administrator for Peoria County, Monica Hendrickson.

Thank you both for being with us on At Issue.

- Thank you.

- Next time, we'll be back with another edition of At Issue.

This time Mayor Rita Ali of Peoria, city manager Patrick Urick, and Eric Echevarria the police chief, will be talking about issues facing the City of Peoria.

Join us for that conversation on the next At Issue.

(upbeat music)