[16:11] i think that individuals probably decided to stay in the comfort of their homes [16:17] but we are going to go ahead and get started i'm committed to starting on time and ending on time my name is stacy [16:23] stanley and i'm the superintendent in united public schools i'm just really grateful for those who are here for [16:30] those who are watching virtually for you spending time with us this evening i think that it is very [16:36] important for me as a leader to make certain that the community [16:41] is provided with information from credible leaders in the medical field [16:47] and so that is why i always like to have medical providers with me when we're [16:53] talking about conditions of kovic the way that the evening will work [16:59] is we will have an opportunity to have the [17:04] physicians and the public health providers to respond to some questions at the same [17:10] time you are shortly if you haven't already going to see a qr code on this screen [17:17] and when you see that qr code i'm going to invite you to take out your phone if you have one a [17:23] smartphone and if you have a qr reader you will be able to scan that qr reader [17:28] we are running also at the same time something called a thought exchange and what thought exchange does is it allows [17:34] us to capture information related to a question and our question [17:39] this evening i don't have it completely memorized but our question this evening is we want everyone who's here everyone [17:46] who is online to be able to share with us information that they believe that we [17:52] need to know as leaders that i need to know that my administrative team needs to know and of course our school board [17:58] members need to know related to our layered mitigation [18:04] protocols that we have in the system to protect our students as best we can around [18:10] coving and so remember those later mitigations they certainly include masking but they're very much more than [18:16] that we have hepa filters in each one of our classrooms we [18:21] actually seek to provide physical distancing as much as we possibly can you know it's a [18:28] little bit trickier um in some of our classrooms and in our cafeterias but we seek to do that [18:34] we also have our air exchangers turned on so that they have the [18:39] greatest air exchange in our schools we also are [18:45] looking for symptoms and we screen for those we have began [18:51] testing so there's a couple of things that we do at testing first of all if a student is a close contact [18:58] we are going to send that child home with a test kit and their families can administer that [19:04] test kit right at home to learn whether or not they are actually infected with coveted as well [19:11] if they aren't it lessens the time that they would need to be implementing we are also [19:17] beginning to use a rapid antigen test in some of our schools [19:24] so that right away if we to limit the amount of whole class [19:29] quarantines that we need to do we have some schools that are prepared and they're [19:36] set up as where they are able to administer that rapid antigen test that's not happening [19:41] everywhere it's not happening all the time but my ultimate goal is to make certain that we can keep our [19:48] students in school so you'll remember we started out the school year [19:53] with a plan with an ultimate goal of having our students in school [19:59] five days a week in person and with the least disruptions [20:06] related to quarantine related to students being ill as it relates to coping and so that has [20:12] been the foundation of the work that we have done throughout the school year whether it was offering our vaccination [20:19] clinics to make certain that we could get as many students vaccinated whether it was our testing [20:26] protocols that i just spoke about or whether it was any of those other [20:31] layered mitigation efforts that we have in place so as our [20:37] guest speakers our panelists speak with you today as you have the opportunity to fill out [20:44] questions i ask that you keep that in mind our our goal remains to have our students in [20:51] school in person five days a week and with the least amount of disruptions [20:58] so we're going to go ahead and get started by introducing our panelists immediately to my left here is dr nick [21:05] kelly nick is the public health administrator for the city of bloomington's public [21:10] health division in that role he is also the incident commander for covid19 operations [21:17] prior to coving19 he directed the division work on public health preparedness [21:23] planning and data analysis national accreditation strategic planning performance [21:30] management and other administrative duties i bet it is hard to think that you had [21:35] something that you did prior to to go with he is passionate about evidenced based [21:42] public health and health equity he lectures on public health impacts for [21:47] critical infrastructure in the technology leadership institute at the university of minnesota [21:54] in 2012 he was a fellow in the emerging leaders in biosecurity [22:02] from the center for health security at john hopkins he earned a phd in environmental health [22:09] in 2011 and a master's in environmental health in 2008 [22:15] both from the university of minnesota welcome dr kelly [22:21] [Applause] thank you for all your hard work [22:28] all right uh to the left of dr kelly is dr louis p zeidner he is the system [22:34] director for clinical triage and transition services at mhealth fairview [22:40] in his role he is responsible for reducing barriers and accessing care for patients with mental health and [22:46] substance use needs in the last year he has supported the launch of minnesota's first [22:53] path program to meet the needs of those experiencing a mental health crisis [22:59] and opened a virtual transition clinic for patients waiting for an appointment [23:05] to start care through his career dr zeidner has focused his work on addressing the [23:11] challenges people face in complying with recommended care plans at both the [23:17] population and individual level much of his work has focused on [23:22] obstacles to medication compliance dr zeidner has a phd in developmental [23:28] psychobiology from the university of connecticut and resides in minnesota [23:34] welcome dr cycle [Applause] [23:41] and next is dr susan spygart dr sweibert is a child and adolescent [23:48] psychiatrist she's a graduate of the university of minnesota medical school and has completed her residency and [23:55] fellowship training at the university of minnesota dr sweiger is a member of the american [24:01] academy of child in adolescent psychiatry and the academy of eating disorders [24:08] she provides psychiatric evaluation and treatment for adults adolescents and [24:14] children and has a particular interest in the treatment of eating disorders and associated illnesses [24:21] she has been employed with the emily program since 2005. she is the mother of an edina public [24:28] schools graduate and two current edena high school students welcome dr smith [24:36] [Applause] and last but not least is dr christine [24:42] tompkins dr tompkins is a board-certified pediatrician [24:49] she has worked downtown at hcmc in their outpatient clinic for nine years [24:55] she also has a master's of public health degree and considers public health to be integral [25:01] to her practice of pediatrics she has three children any diamond [25:06] public schools welcome dr tompkins [Applause] [25:16] i saw a few people pull up their phones uh and they scanned the qr code if you are not here [25:23] when i talked about that this is part of our thought exchange and with thought exchange that allows you to go in you're [25:30] going to give us some feedback as administration on what it is you want us to think about what do we need to know [25:36] about as it relates to our layered mitigation strategies and so we haven't haven't had [25:41] the opportunity to scan that qr code i invite you to do so now you can go in and give feedback um and then you can [25:49] also interact with the other individuals who are engaging within the thought [25:54] exchange as well but we are going to go ahead and get started [25:59] and so um i'm just going to ask an initial question and you can respond [26:05] not necessarily in the order from left to right just whoever wants to go first so as you consider the local context of [26:12] covet through the lens of your particular role in the health [26:18] what would you like to share with our stakeholders and uh you may take up to five minutes [26:24] to respond hi everybody [26:30] as dr stanley mentioned i'm christine tompkins and i'm a pediatrician at hcmc downtown [26:36] um i just wanted to say before we start dr stanley did ask all of us to come here [26:41] today but there was no agenda given right she just basically said if you could tell people what you want [26:46] them to know about kovid what would you tell them so she doesn't actually know what i'm going to say [26:52] um so it's true i'm gonna share with you five things that i think you need to know about [26:57] covid from my current point of view i don't actually think any of this information will be too shocking [27:02] um but i'm happy to clarify or answer questions if you guys have any number one [27:08] our hospitals are full full full full this was you know a headline on the star trip today that we're at you know our [27:14] max census icu right now and in addition to that we have no staff so our staff shortages range from icu [27:22] nurses to outpatient clinic outpatient clinical staff and it's trickled down to many uh community pediatric offices as [27:28] well you may have noticed when you try to call your pediatrician's office that it's taking longer for somebody to get back to you and this is why [27:35] at my institution hcmc right now there are federal healthcare workers deployed [27:41] to help fill in as we are so incredibly short-staffed this obviously is a problem for people that are very seriously sick with cobia [27:48] but it's also a problem for the rest of us is we never know when we or our families will need emergency or hospital [27:53] care a year ago with our winter covered peak our first winter colder peak [27:59] we had bethesda and then saint joe hospital to care for coca patients those institutions closed down and as it was [28:06] and as a result we've lost about 400 beds further we couldn't re open those institutions if we wanted as we're so [28:12] short staffed when kovitz started there were also many more volunteer nurses respiratory therapists and physicians [28:18] that were flying over the all over the country to cover gaps and staffing but that's no longer happening due to [28:24] healthcare provider burnout number two kids get sick with cobit i know at the [28:29] beginning of this pandemic like way back in the tiger king era uh we heard that kids don't really get [28:35] sick or transmit clover to others well anybody that has kids in school nowadays [28:40] knows that that's not no longer the case why did we think it was one way and now it's another [28:46] because the whole thing was so new and it hadn't really seated itself in the pediatric population yet [28:51] covet and viruses go where it's easy and at first that meant older vulnerable nursing home populations as more older [28:59] people have gotten vaccinated it's eventually drifted towards the unvaccinated children kids now and i think dr kelly will touch [29:06] on this represent the highest percentage of unvaccinated people and thus serve as a giant reservoir for viral replication [29:13] even though most children though not all which i'll talk about in a second don't get deathly ill from covet by them [29:19] getting infected the virus lives on more viral activity in kids means more [29:24] viral activity in general which means higher numbers of deaths and hospitalizations from corporate [29:31] number three some kids are getting very very very sick with covet and this has been more pronounced since [29:37] the summer time when i mentioned before that our hospitals are full that is likewise true of our children's hospitals [29:44] in addition to the normal and rsv and bronchiolitis we see this time of year there are an increasing number of [29:49] covered pneumonia misc and ards cases from copic patients and it affects every [29:56] child at any stage of life from newborns to school-age kids to teenagers as in adults most of the pediatric [30:02] patients ending up in the icu are unvaccinated either because they were ineligible or because they were eligible [30:08] and did not yet receive the vaccine while i know pediatric death rates of covet are low they are not zero [30:15] and that's unacceptable if you've ever had to be with a family while their child is dying you know that there is truly nothing more awful [30:23] number four school for our children needs to be a priority learning loss and decreased socialization has been significant for [30:29] many kids and has disproportionately affected children of color in children with special health care needs in [30:36] addition as clinicians we're seeing higher numbers of patients with certain conditions due to lockdowns and [30:41] e-learning notably more patients with obesity more patients with eating disorders like anorexia or bulimia which [30:48] i'm sure my colleagues would talk about increased numbers of mental health diagnoses like depression and anxiety [30:53] behavior problems sleep disorders eye problems like nearsightedness because so many children have been on screens [31:00] i don't call the schools for this like the hospital they were trying to do the best they could under once in a century [31:05] set of circumstances i think we truly owe our school staff and administrators and certainly our school nurses [31:11] a debt of gratitude for the degrees to which they've had to adapt under impossible circumstances but to keep our [31:16] kids in school the whole community has to play along even though all of us myself included [31:22] are very very very very tired of coved it's still here and we don't know when things will get back to normal whatever [31:28] that will mean as such we need to make sure we as families are doing right to keep our [31:34] kids in school we need to do the mental calculus and deciding what things our kids and families are going to do do [31:39] your kids play sports fine be smart about it test them regularly get them vaccinated consider having them wear a [31:46] mask especially if they're unvaccinated and prepare yourself for when you get a notification that they've been exposed [31:52] and need to quarantine are you planning on getting together with family or traveling for christmas great make sure everyone eligible is [31:58] vaccinated consider everyone having to take a test to make sure no one ends up positive i can't tell you the number of [32:03] people that called me the weekend after thanksgiving that somebody ended up positive at thanksgiving and everybody was exposed and now what are we all [32:10] going to do very very many people sadly this is the world we're living in at present i don't think we need to live [32:16] in fear but i do think we need to live in reality and be responsible and the last one number five [32:23] covet is going to be with us forever eventually turning endemic when will this happen when will this be over when [32:29] can we take our mask off the short answer in my opinion is when our hospitals are no longer overrun when we [32:35] have room in our ers and icus for anyone who needs it and it's not a constant crisis to find beds or staffing we are [32:42] nowhere near this point at present i am hopeful because of expanding vaccine eligibility and new therapeutics [32:49] entering the market that we will make heavy with this and eventually be able to better control transmission but we're [32:55] just not there yet thank you thank you [33:01] who would look to go next [33:06] hi i'm susan swagger i'm a child and adolescent psychiatrist and my day-to-day job right now is that [33:15] i see kids adolescents adults in our partial hospital program [33:20] and they come to us you know anywhere from [33:25] three to three weeks to three months and they spend the day with us and then they go [33:31] home and sleep at night and i would say [33:36] in my experience since the start of the pandemic the number of people struggling [33:42] suffering with mental health has just astronomically seemed to increase [33:48] you may have more data but in my day-to-day um our waiting lists are incredibly long [33:55] you know on my way here i was just talking to a colleague at prairie care who's waiting for a spot [34:02] for one of her patients you know asking how much longer it would be [34:07] and as these kids are waiting you know they're trying to do the best they can [34:13] out in the community but they're getting sicker and sicker and that makes when they get to us more [34:18] difficult to treat i also have been receiving a lot of just phone [34:26] calls from friends family neighbors about you know this is going on my kid [34:32] is depressed my kid is anxious where do we go what do we do [34:37] and i think most people know there's a big shortage of mental health care out [34:43] there but i would really encourage you not to not seek out that [34:48] care because of the shortages out there there's there's help to be found [34:54] um i think it's critically important for our kids [35:01] to remain in school and i was thinking about you know what what are the big things that [35:06] school provides for kids i think the structure of school is [35:12] hugely important for mental health i remember in the days of online school you know some of my kids [35:19] would grab their computer and do their school work in bed and not [35:25] brush their teeth until the middle of the morning and be in their pajamas all day [35:31] and you know that's fun to do from time to time but that lack of structure is i [35:37] think pretty damaging um obviously the connection with teachers [35:43] and peers is hugely important you know my kids and a lot of kids have [35:50] been involved in extracurriculars which i think is probably one of our most favorite parts of school [35:56] and having that not be available has been um really really tough i think [36:04] um you know you were talking about just obesity and the movement that you get just from [36:10] getting up getting out of the house walking through the halls i think that's really important as well [36:16] um you know obviously teachers and staff are doing the best [36:21] they can on online learning but obviously you're not [36:27] getting the whole experience i remember my daughter was taking anatomy last year [36:34] and she was so bummed out that she wasn't going to be able to dissect an eyeball you know you just can't do that online [36:42] [Music] and then i also think you know when kids are home all day [36:49] i don't think you know social media is the enemy necessarily but i think the [36:55] opportunity to be on your phones and on social media much of the day is there and hard to resist [37:04] i i think you know a couple of the other contributors to people's struggling right now is [37:11] just the unpredictability of where covet is going you know i think at first we we [37:17] thought oh this is going to be maybe a few month thing and then things will get back to normal [37:24] clearly that is not the case and we have to figure out how to be resilient and be able to [37:32] you know kids adults teachers workers not get burnt out and be able to sustain [37:39] ourselves over time with this happening i think also you know not as much now [37:45] but in the beginning i think one of the things that a lot of us and a [37:50] lot of people who struggle with depression and anxiety look forward to are you know those [37:56] highlights in life going to be able to travel to be able to do track whatever it is and not being able [38:05] to have some of those things has been really hard for kids i think [38:10] um you know i think a lot of us have lost [38:16] loved ones from pulpit and i think obviously [38:23] that is a grieving period i think overall though [38:29] dealing with covet has been kind of a trauma for for the world so to speak [38:35] and figuring out how to manage with that going on [38:41] the last thing that a lot of my patients bring to me is [38:47] frustration and anger that they can't control what other people are doing [38:52] as far as like masking and vaccinating um you know i think developmentally they're [39:00] doing exactly what they should you know trying to figure out what they believe why people believe what they believe [39:07] um so as as we probably struggle with that as adults i think kids are doing that as [39:13] well that's all i got thanks thank you [39:20] thank you thank you [39:34] well just in general we are seeing about a 17 increase [39:39] in mental health patients in crisis showing up to the emergency department [39:44] a seven percent increase in child adolescent crisis this morning when we did huddle we had [39:52] 26 patients meeting our ed's waiting for a day at just on a mental health site we had [39:59] 87 waiting across the system for medical beds well we had no icu this morning i [40:05] believe we have one this afternoon we have 307 patients [40:11] in the hospital perfect crisis so copenhagen is definitely as i just [40:17] said a major problem across our health system but i'd like to talk about it [40:23] in more of a generic sense cova is more than a virus [40:28] it has been a major impact on virtually everything we do in society [40:34] it's closed our schools it's changed how we interact with each other it's changed how we look at each other it's changing [40:40] everything about it and so although we may manage the virus let's say [40:46] the vaccines and other things we also have to manage all the other companies [40:54] the first thing i would say about what i've seen in emerging departments [41:00] particularly is before you can take care of others you have to take care of yourself so as [41:06] parents as teachers as administrators and school nurses take your own pulse first look at how [41:13] this has impacted you look at ways in which you need to take care of yourself and how [41:24] the second thing is that we will never be the same as we were in [41:31] march of 2019 well we have been impacted by this that [41:36] has a long-standing impact whether that's as a result of the virus per se [41:42] or some of the impacts of fear about virus here about going out your event directors and others [41:49] all those different things have impacted us and we will see that for generations [41:55] i remember when my grandmother used to talk about the depression [42:00] depression was long gone by the time we talked about it but she still had that was some 30 years after the depression [42:07] was locked up these things have an impact on us and haven't impacted us [42:16] the impact for people uh returning to normalcy taking our mass [42:23] off or whatever will be in part each dependent okay [42:29] not everybody has the same reaction some of it is developmental and different age groups will have a [42:36] different impact [42:44] the third element that i wanted to talk about was really resilience as humans were pretty resilient and you [42:50] will get through this it will look different we will be different [42:55] but we will get through it we are all on a mental health continuum [43:02] some of us before closing were struggling [43:07] those folks are struggling more today than they were before some are doing okay but had some periods [43:12] of struggle they are struggling more than they were and some were doing just fine [43:19] um we're high achieving and they are struggling today we're all a little bit shifted on that continuum [43:29] you need to have some understanding of where we are and sort of what we're managing in that context [43:36] but we also need to find the balance between what is normal [43:43] where are we along that continuum i think there's a new medical diagnostic that's being used [43:51] called the google search and every symptom gets [43:58] searched on google and we look at the most pathological aspect [44:03] of whatever it says anxiety is normal [44:09] anxiety gets us up in the morning anxiety gets us performed at school anxiety has many good features [44:16] having anxiety is not a paraben problem when anxiety gets to a place where it [44:22] gets in the way of performing and it gives them a way of being able to function in your day-to-day life that [44:27] becomes a problem we all have a range of emotions sometimes we're sad [44:34] that's normal having sadness is not abnormality [44:39] when sadness gets in the way and you're able to really do function that's a problem that means care [44:45] but i think right now we are pathologizing we are looking at each other we're looking at our kids and [44:51] waiting for the pathology and i think we need to manage that we need to be vigilant about things that [44:58] are concerned but we also have to understand that we are all a little bit struggling [45:05] and we're going to have a little bit more anxiety a little bit more sadness a little bit more struggle for the day [45:13] so i would just finish with saying we need to be vigilant [45:20] without worrying we need to have grace versus frustration [45:26] we need to have loving as opposed to anger and i think as we look at each other as [45:31] we work with each other as we interact with each other if we can have a little bit more grace [45:38] a little less worry a little bit more we can manage through this crisis [45:49] so a lot of really fantastic points to kind of build on i'm i'm nick kelly i'm the [45:56] public health administrator for the city of wilmington which which has the privilege of serving [46:01] city of edina too which means i get to work really closely with our school partners [46:07] and and other partners to try and make the diana healthy and well the best we can [46:13] something that i think is important to think about is we we're often very focused on [46:19] individual actions i i don't think a whole lot about [46:24] individual actions my my job is to help think about how do we take care of the [46:31] thousands of people that follow dyna home that work here that go to school here [46:36] and so uh on an individual level uh as you've heard you know many kids [46:43] manage pulpit just fine if they happen to get it some have some pretty serious [46:48] reactions the thing that i think though is how many people that kid interacts with [46:54] how many people are in that family what we look at from a population [47:00] standpoint is it's one thing to manage an individual case but if you have [47:06] a rare thing at a large population it becomes relatively common [47:11] and so we look at that from that standpoint of you're managing individual decisions at [47:17] a population level because what i worry about is not just covid impacting our health system [47:23] and in the challenges for education but i worry when we're helping process challenges [47:28] with contact tracing for the school i worry at one point i'm going to get a phone call of what do we do we have no [47:35] place to send a kid to broken arm because our health care system is on the verge of collapse [47:42] that's managing things at a population level and there's there's strategies we employ to do that and it's layers of [47:49] risk reduction so all of our mitigations are really structured at the population level [47:55] they they work many times at an individual level but their utility and value is additive [48:02] they're so much more powerful with a higher percentage of people using it [48:07] so for example we talked about vaccination being just critical that's the number one tool in mitigation that [48:12] we're trying to get everybody to go for to use incredibly safe very effective [48:18] we're continuing to learn and evaluate that but as of the end of last week [48:25] eighty percent of individuals that reside in the dinosaur codes above the age of five [48:31] are fully vaccinated and 88 have one dose and so [48:37] we're doing really well that's something to be really excited [48:43] about but we also have to continue to be humble and diligent [48:49] we see places all around the world with really high vaccine coverage that let [48:54] down mitigations before they know what's going on or things stabilized and all of a sudden they're back into a [49:00] crisis those layers you really need that stability to really start backing things down and [49:06] then be able to bring things back up and i think we're going to see this reality as as mitigations come down [49:13] we'll pull them back up we'll pull them back down this is going to be a little bit of a process as we learn to [49:20] overcome the different things hopefully problems i think one of the things we have to [49:27] think about is my individual risk reduction so there are things that i'm not doing as a [49:33] parent that happens to be a public health professional i have three kids a second grader a kindergartner and a [49:38] christian my preschooler is not eligible to reject me so there are things that we won't do at [49:44] this point until that kid is vaccinated once that kid is vaccinated our risk tolerance changes because he's fully [49:51] protected we think about things that way you think about that then and the way it [49:57] impacts thousands of students in the school district we're in the community [50:03] that gets you to that population health level i think we need to be very comfortable [50:08] patience and flexibility i get asked all the time what's going to happen with this variant and i tell [50:13] people i don't know um science takes time it's a process you [50:19] have to do it really well very rigorously and once that data comes out [50:25] you deal with what the data tells you there are times where the data says something that nobody really wants to [50:31] hear that's what the data tells us and we adapt we [50:36] overcome and we adjust that's something that [50:41] we don't always like to do we like instant answers instant changes [50:47] quick fixes we don't always have that improvement and so i think being patient and flexible and having that humility [50:54] there are so many things that we are going to learn in the next few weeks that we wish we would have probably [51:00] known tonight as we're talking about that's been the entire history [51:06] every time we change a policy or a process something changes a few weeks later [51:11] that we learned now maybe we should reevaluate that or rethink about that so being patient and [51:17] flexible and knowing is really really important and the thing i tell my team [51:23] the folks that i'm talking to about colgate is you got to be patient [51:29] you got to care about each other we are all going through this together [51:35] i mean i remember the gut punch i felt on thanksgiving when my phone started going off about a [51:40] new variant i know most of you dealt that too i'm not immune to those things either [51:47] these things impact us all and you know we need to be honest and talk about it and have those conversations there are [51:55] hard things about everything we're dealing with the code none of this is easy [52:01] and i think the way we handle it with being kind to each other patients grace and humility [52:07] is an amazing way to set examples for our kids [52:13] thank you just a wide span of things there um [52:18] really hearing which it said to hear about the mental health impact [52:24] with with everyone and especially with students to really hear about what is happening [52:31] you in our hospitals and so i started saying that i really wanted to make certain that we had individuals who [52:37] were in the trenches and really know what's happening and care about our community at the same [52:43] time so thank you for that um now i just have a few questions let me start with the [52:48] question for christina nick we hear about conflicting we hear many [52:54] conflicting stories around the impact of covet on youth what is important for us [53:01] to know about the impact of our youngest mothers and i'll explain to you why i asked that question when we [53:08] started out our safe schools plan this year our youngest learners were at the [53:14] forefront of our minds um we knew that we had older students at the high school where we had even in august 73 of our [53:21] high schoolers were fully vaccinated we also knew that we had 62 of our high [53:28] schoolers have siblings younger citizens and so that is uh one of the reasons why [53:33] i asked that question so what is important for us to know about the impact of culinary [53:40] foreign [53:45] i think when we think about the impact on our youngest learners um you have to understand it impacts them i mean [53:52] my son with the kidnappers are when schools shut down three school years [53:58] it impacts the the way we talk about it the way we process it it has a huge impact [54:05] the best place for those kids to be is in classroom i don't think you're going to get any disagreement about that but it is a [54:12] classroom that has layers of medication and ways to keep them as safe as possible because the last thing you want is kids [54:18] in a classroom that missed 10 days 21 days again and again and again you want them [54:24] there and you want them to be healthy the the layers of mitigation are so critical um i i think about it you can [54:32] use whatever food analogy you want think about whether it's lasagna a sandwich all the different layers you [54:39] add on top make that an amazing meal it's the same thing with mitigations you start with a really strong foundation of vaccination [54:46] ventilation filtration high quality masking socially distance [54:52] you can do a huge amount of work any later in testing uh you can do a whole lot to to mitigate [54:59] in a school setting so those kids can be in a classroom and learn in from the amazing educators [55:06] but i think a lot of it impacts the approach you take to those mitigations and conversations [55:12] as a parent i've i deal with copay all day long and all night long and i've learned there are times when i [55:19] can't talk about people either i can't deal with things or i can't talk about this because my kids are listening and and [55:26] you can see the anxiousness or the stress that they get and we've got to talk to it [55:33] and so being intentional about when you're having that conversation of okay whose turn is it to not work if this [55:38] happens that's not always the greatest thing for your kid to be listening to because they [55:44] watch the struggle that you're going through i guess i would just add to that you [55:50] know kids listen i mean one of the i think the biggest blessings for school-age children [55:57] during this pandemic is developmentally they're at what's called a concrete phase right so they don't they don't [56:04] have a sort of more formal operational idea of well why is this happening and why are we doing this you tell kids [56:10] you've got to wear a mask so you keep your schoolmates safe got it okay i'm gonna do it and they [56:16] don't question it so you know at the beginning of the pandemic we were like kids are never gonna wear masks guess [56:22] what they all did right my son started kindergarten last year and i mean it was [56:27] like every parent was bleeping because they all watched you know 100 kids line up with mass on their face just standing [56:33] there thrilled they didn't know anything different right and they were just thrilled to go to school and it was like oh my god we are idiots [56:39] because these guys nailed it i think the other thing i'd like to say is you know this as they mentioned this [56:45] will affect them for the rest of their lives but not necessarily in a bad way they'll learn [56:51] really good lessons like what did we do when things got tough you know we stayed home [56:56] with our family we played outside with our neighbors you know it's not all bad [57:04] thank you this next question is for susan and lou [57:10] this is a little daily i receive email from parents who are really concerned [57:15] about their children concerned about their mental health um [57:21] and scared quite frankly for what this means means for them longitudinally [57:27] and so that's why i wrote this question so i put this question out because i know that we have so many [57:33] parents right now so many family members that are wondering this what indicators might parents watch for [57:40] as they monitor their child's mental health okay this is one of those three-part questions right sorry about [57:46] that [Music] families really want to know how do they support [57:52] what do they do to take care of their students and for older students they often ask me [57:59] you know dr stanley what are the things that i need to tell them to look for can they really self-monitor [58:07] and then who's their first line of support knowing [58:12] that our mental health care system is inadequate at this point [58:18] i can start you know i think we all have days where we're sad or it's [58:26] a crappy day and you know that's not depression but [58:31] watching for things like persistent sadness apathy just lack of being able to look [58:38] forward to things to experience joy you know [58:43] maybe you're noticing your child that used to love to [58:49] go sledding and they're just being kind of not excited about it anymore [58:56] um i think other things to watch for low energy low motivation [59:04] i was seeing a little girl this week and you know i was thinking about [59:12] this meeting and she said you know things are just so hard you know the [59:18] things that i didn't even think twice about before they're just so hard they take so much [59:24] effort so much energy that would be one of one of the key things to look for um and [59:32] then of course we don't want to forget about anxiety like someone said i think you know a [59:38] certain level of anxiety is not necessarily a bad thing [59:43] i think when kids and adults get to the point where the worry the anxiety is causing them to [59:50] ruminate to not sleep causing them just a high level of distress that can become a problem [59:58] and then i think obviously um the more scary things you know kids [1:00:05] talking about not wanting to be here anymore hopelessness um [1:00:10] you know frankly talking about wanting to hurt themselves whether that's more self-injury or to not be here anymore [1:00:18] i guess one one piece of advice i would have is to not shy away from those discussions [1:00:25] if you have concerns you know talk to your kids about them you know if if they aren't having [1:00:31] suicidal thoughts you know talking about it is not going to make it any worse [1:00:38] um i think that's that's one thing that sometimes we get afraid of and then obviously getting them the help that [1:00:45] they need at sap [1:00:50] you know i think some kids are going to be more introspective than [1:00:56] others just like adults are um and younger kids may not have the [1:01:01] language to be able to let parents know how they're feeling um [1:01:08] you know this is just kind of a simple thing that sometimes we do as a family and i know other families do this [1:01:16] um you know we'll talk about highs and lows for the day and [1:01:21] you know parents are involved in that as well and i think when kids are hearing their [1:01:27] parents talk about struggles or you know this made me feel that way this was a challenge this is what i did about [1:01:34] it they become used to that language and used to [1:01:40] having permission to talk about these things you know i think there's so many [1:01:47] different you know [1:01:52] people that kids can go to i think you know obviously parents teachers [1:01:57] school counselors i think a lot of kids go to their peers [1:02:04] for support and i guess the one thing i would say about that is you know make sure your kids know that [1:02:10] if their friends are struggling that an adult should be told because then they can get the help they need you know [1:02:17] almost never is a friend you know in the long term angry that [1:02:22] another fan friend you know met with the school counselor because they're concerned about them [1:02:34] so i think as parents we often have a plan for our kids or whether that's a written plan or [1:02:41] whether that's a conceptualization and covert has changed those plans [1:02:46] and that's not good or bad that just is um they didn't have a sports team last [1:02:52] year they didn't have all the grades that they were going to have they got a little bit sloppy in some of [1:02:58] their patterns and part of the what do i do part of [1:03:03] that question is is this really a pathology child or is this this a change [1:03:08] in the plan and i think it's okay to have a change in plan uh we're all having a changing plan and [1:03:15] how that feels what that looks like what if the child doesn't have the same [1:03:21] experience that you had thought they would have over time in terms of [1:03:28] you know things to watch for um i think many of them have been mentioned already [1:03:34] but i think isolation is an important one and isolation is a particularly difficult one during this time [1:03:40] because we're all a little bit more isolated we're spending a little less time in social gatherings we don't go out quite [1:03:47] the same way that we did precoc but there's isolation in terms of [1:03:54] pulling away from family pulling away from others pulling away from all activities and those are concerning at [1:04:01] times at the same time adolescents [1:04:06] isolate so finding that right is simple but i think at the extremes of response [1:04:14] of not being overly hyper vigilant but also paying attention of knowing [1:04:20] your child's specifics and being able to attend to those specifics [1:04:25] the greatest challenge i think through the last year has been the school is closing or at [1:04:32] least the school is not being physically open um and i don't know that i fully got it [1:04:38] until watching this last year how important the eyes and ears of the school are [1:04:46] parents have unconditional love for their kids and that's an important feature of being [1:04:52] a parent those schools have a clear tied sense of kids in a different way [1:04:57] and the role of the teacher and the role of the nurse and the role of the counselor and the role of the school [1:05:04] social worker all of those people together play an important role and [1:05:09] that's been missing so as parents i think we've had to attend in a different way to our kids [1:05:16] and we're not always as good at that as the professionals are so like finding that right balance [1:05:22] is important thank you [1:05:28] okay this is christine and you've talked about this a little bit [1:05:35] and you know as as i speak with with family members as i honestly speak with a lot [1:05:41] of different people in the community even grandmas and grandpas you know they're wondering about an [1:05:46] offering for this you know when is this going to end and i [1:05:52] tell them that sadly they don't have that answer for them right they don't know when that's going to happen [1:05:57] and i'm not a medical provider and so i'm wondering if you and you've talked a [1:06:02] little bit about this but um what are the top two to three steps that you would encourage our community [1:06:08] we're talking about edina right now that you would encourage our community to take to lessen the community spread [1:06:15] of the virus because i know we are at high transmission rates right now [1:06:21] and then if you could explain to us why those steps are so important [1:06:28] so it kind of goes back to our foundations the everybody over the age of five [1:06:35] needs to be vaccinated if you're eligible for a booster you need to get your booster [1:06:42] vaccination and then getting the booster is a phenomenal tool [1:06:47] if we had the luxury of time my guess is the the vaccine vm our day vaccines were using would have been a [1:06:53] three dose vaccine just like a lot of our childhood immunizations we moved as fast as humanly possible [1:07:01] with the right science we saved over 100 000 lives [1:07:06] we're dealing with boosters now boosters add an additional layer of immunologic [1:07:12] projection you get more polyclonal antibodies you get better t-cell activation you get a [1:07:18] lot better immune response six months post so if you're eligible for a booster get [1:07:24] the next thing is is wearing so you have your your vaccination and [1:07:30] then what you want to be doing is being very intentional about where you are what you're doing from a risk standpoint [1:07:37] so aside from vaccine being in a place that's well ventilated with really good filtration [1:07:43] so the dinosaur's done a fantastic job on that then thinking about the the additional [1:07:48] layer of case you you change the physical air and the component in that present then you're worrying on your [1:07:54] personal protection so we've moved on from talking about it from a source control standpoint to [1:08:00] what you're wearing your face covering to protect others and protect you [1:08:05] but there's a wide gamut of what you can use on that end to protect you [1:08:11] and protect others and then anytime you have symptoms test [1:08:16] uh you know even fully vaccinated something different get tested [1:08:21] it's the easiest way to stay safe and keep each other safe i guess i would just add you know the [1:08:28] vaccine um what the vaccine has meant has sort of changed over time you know when the initial [1:08:34] physio vaccine studies were done the end point was to reduce morbidity and mortality and you know that was what they were [1:08:40] measuring in the study and uh we got lucky for a few months where we had you [1:08:46] know basically neutralizing antibodies and that we basically wouldn't get infected well then alpha again way back uh like a [1:08:53] year ago came along and that started to change and then certainly last summer with delta that changed even more [1:09:00] so you know at this point vaccination doesn't doesn't provide you a guarantee that you [1:09:06] won't get coveted and that's what i hear from a lot of families in clinic that don't want to get vaccinated well you can get the vaccine you can still get [1:09:13] covet that is absolutely true uh although your risk is i think like four to seven times lower [1:09:20] if you're fully vaccinated and boosted now um but so it's not an excuse for [1:09:26] just okay well we're vaccinated we're just gonna go do whatever the heck we want you still need a mask and you still [1:09:32] need to test right our goal for vaccination now is to keep us out of the hospital as i mentioned before in my [1:09:38] opinion that's when we're going to know that covet is over is when we can absorb patients that need hospital care into [1:09:44] the hospital right because at this point they're just completely clogged with cova patients that tend to stay there [1:09:50] for weeks if not months at a time and it's just too it's just too much in the system so you [1:09:57] know please please get vaccinated please wear your masks and please test if you have symptoms even if you've got your booster [1:10:04] even if your kids are all vaccinated you just never know the vaccine means something different knows it's damage [1:10:09] control it's trying to keep you out of the hospital and try not you know trying to prevent you from dying which is great but it doesn't mean that you don't [1:10:15] transmit the illness anymore i think it's it's important to be realistic [1:10:21] vaccine is an incredible remarkable amazing life-saving tool [1:10:27] we don't compare other vaccines i mean you don't you don't see people arguing in the street of my varicella vaccine is better than [1:10:34] this blue vaccine like we don't compare vaccines like that but the reality is they all work a little different [1:10:41] incredible tools but have different outcomes and processes and so [1:10:47] our vaccines are still very remarkable it is it's amazing how well they're doing keeping people out of the hospital [1:10:53] and how well they're doing keeping people from dying you know you look at the data here in minnesota um the [1:11:00] rate for people being uh dying under 50 [1:11:05] that are fully vaccinated with a breakthrough case you know they rounded it down to zero per hundred gallon [1:11:12] it doesn't really happen it's incredibly rare [1:11:17] and so we we got over excited in our communication [1:11:24] to prevent all illnesses there was caution in a lot of those statements so you know you think it will [1:11:31] you think it's going to do this um but we often lose that nuance and in exuberation for a vaccine works in the [1:11:37] mid 90s because that's just phenomenal it's still working incredibly well for [1:11:43] hospitalization and we've got to be patient to find out how it's going to work [1:11:52] vaccinations that that is a strong key that i've heard there and [1:11:58] then for our systems continuing to offer those layered mitigation strategies [1:12:04] supported well it believe it or not it's already seven o'clock i have a few more [1:12:10] questions but i want to see um what questions might members in our audience have i know that we have [1:12:16] individuals online what questions you might have and um we were passing [1:12:23] our own cards and there was a purpose for the passing around cards so that we could get to as many questions as [1:12:28] possible and so um jeff jeff and val are going around and [1:12:34] they're collecting and so um this gentleman right here had a [1:12:39] question and i'm wondering mary do we have any questions online [1:12:45] while folks are writing down their questions [1:12:53] and make sure [1:13:04] okay we have some questions about asking and some questions about vaccinations [1:13:10] so um [Music] since vaccinated children are not [1:13:16] eligible for a booster do vaccinated kids have a higher risk of [1:13:21] getting covered if it's been greater than six months since their last dose [1:13:30] i mean we don't know but probably right meaning immunity is waning immunities and pfizer especially they're [1:13:37] starting to do um consider booster trials for kids i think the firsts are for 16 to 17 but for sure 12 to 15 will [1:13:44] come shortly after that um but they are trying to get the science out there [1:13:49] again as we've all talked about this whole thing is just moving so fast that it's hard to kind of [1:13:55] anticipate i mean we can see where we need to be but we're just not there yet in terms of having the data to support it [1:14:01] you know as a parent of kids that have been vaccinated um yeah i'm watching the data i'm watching that once once they're [1:14:09] eligible i will work on getting them boosted but it's the same thing i tell the adults that are eligible for being [1:14:15] boosted walking don't run to get your booster run to go get your first dose and your second dose [1:14:21] walk to go get your booster it is not like six months hits and your body all of a sudden stops everything [1:14:28] immunologically right it is a slow decline it's still there still provides protection but it's not as high as we [1:14:35] want it and then we can boost it much higher than what it was after your second post with a booster at the [1:14:40] appropriate [Music] [1:14:48] thank you and one of you spoke to this but i think it's it's [1:14:54] worth repeating uh the answer how can you say kids are protected after the shot when [1:15:00] individuals can still get infected and still transmit the virus [1:15:07] yeah so so this this goes back to some of the ways we've [1:15:13] communicated about vaccines what this does what that does um the science continues to change yet [1:15:20] sometimes the way we talk about process and understanding and so you'll you'll watch the cdc change [1:15:27] protocols and processes throughout the pandemic and really drive it with evidence [1:15:33] for me when i say somebody's protected by vaccination the first goal we always have is [1:15:39] prevention from dying the second goal is to prevent you from being hospitalized and the third goal is to grant you beginning [1:15:45] so our vaccines are doing an amazing job protecting you from diving getting hospitalized and [1:15:53] depending on the time frame what variance it is does a remarkable to [1:15:58] not as well as we want job because we're going to get sick and the evidence continues to emerge on [1:16:03] breakthroughs that the duration and the intensity of shedding is much shorter [1:16:09] and so we see some emerging and compelling data suggesting that even if you did get the [1:16:15] breakthrough the infectious time you have is a much smaller window [1:16:21] but we're we're continuing to get more and more data i guess i would just say you know you can get injured in a car crash whether [1:16:27] you have an airbag or not right but we still use an air hatch because we know that it's likely to provide [1:16:34] better protection and less harm to the individual and that's the exact same thing with vaccine [1:16:40] so and truthfully i mean vaccines provide personal protection but as a pediatrician i mean the true magic of [1:16:46] vaccines is when everybody does it right and then we are trying to shut the door or slowly close the door so it's harder [1:16:52] for koben to come here and that's so you know that's why we're doing this [1:16:59] thanks now i'm going to preface some of these to say that um i know as superintendent [1:17:06] that masking can be a very contentious topic [1:17:11] and so some of these questions may seem they may be questions you answer [1:17:17] there may be questions that i respond to um and they may seem a little contentious and [1:17:23] um in my experience and talking with individuals they literally just want to get some type of answers [1:17:32] okay so i think this one's for me when can our children stop wearing masks [1:17:39] when can masking be an option [1:17:45] i always think it's really important to be able to look at the science to look at a variety [1:17:52] of numbers that are out there every week i am able to get a set of numbers [1:17:58] that help us know about in transmission rates within the city of [1:18:03] edina vaccination rates within the city of edina [1:18:09] we are monitoring our coveted incidents within our schools all the time [1:18:15] every friday we report our coveted incidents with our students with our teachers or with our staff actually [1:18:22] and then also um we report [1:18:27] um our quarantine rates and so um i wish honestly that i could sit here [1:18:33] and i could say um to the community you know what it will occur on x-date [1:18:40] um i can honestly say to you that i think that as a leader as a superintendent [1:18:46] that would be negligent of me to do that because i don't have that specific [1:18:52] answer for you what i will say is know that it is on my mind at all times [1:19:00] because i do receive from the community frequently i do receive calls from the community [1:19:05] frequently now that's through a superintendent's lens [1:19:12] how would you if any of you want to respond to that when do you think that our children [1:19:19] might be able to stop wearing faster i would i would say we [1:19:26] we have layers of mitigation to keep things under control and those layers are important [1:19:32] and when we have case rates in the hundred per hundred thousand and our hospitals are [1:19:38] overwhelming that is not the time to change [1:19:44] so i like to see stability and soundness and data [1:19:50] so you know last year was always going to wait wait a couple of weeks if we're on a continuous trend for several weeks [1:19:57] things are stable things aren't changing then start having conversations but you [1:20:02] if you if you take things down you've got to have a process to take it back out [1:20:08] because if we've learned things with coping once we think we haven't figured out a new [1:20:13] area and something else changes we are going to keep adapting and so [1:20:19] absolutes with bogus are are i think really challenging [1:20:24] i also feel like you know for people that have been proponents of masking it doesn't mean that we like [1:20:30] masking right i mean i we can all have a party at my house when this is done i i [1:20:35] mean all of us hate masks and can't wait for our kids to and us to stop wearing them but they do [1:20:42] work you know and we found it out very early that albert lee school district started several weeks before edina and chose you [1:20:49] know mass stops optional and they had i don't remember the numbers now but [1:20:54] they had many many children that tested positive and were quarantining within the first week of school so and i think if you look at the edina [1:21:02] district and the numbers that they have on a weekly basis that are testing positive or quarantined and you compare [1:21:08] them even to other districts in the metro that have looser rules or less mitigation edina has done [1:21:14] a really good job it's not perfect but it has kept most kids in school most of [1:21:19] the time and you know i think as the science has evolved with you know quarantines and everything what [1:21:26] was an automatic 14 day quarantine last year has been modified this year because we've had better testing and better [1:21:31] access to testing and vaccination and so you know they could move the needle as [1:21:36] the science has changed so i understand holy how how much we all want to get rid [1:21:42] of masks but it's just i mean it's just not not now [1:21:50] um i think this may be for you have you studied data from neighbors neighbor schools [1:21:56] surrounding districts i would imagine more masked are optional and have they had [1:22:04] so i've not looked at data directly or analyzed it [1:22:10] my colleagues with the state health department students and there's been national data comparing [1:22:16] school districts with or without or counting with or without mass requirements [1:22:22] the data is consistent uh without it you see a higher case rate you see more health rates you see more [1:22:29] challenges that was already alluded there are districts in the metro that don't have [1:22:35] much in the way of requirements very loose enforcement those schools are routinely facing [1:22:42] challenges with case rates with challenges with mitigation [1:22:47] and frankly a whole lot of extra work for their their school nurses the [1:22:53] administrators trying to manage things if they're if they're actually following the quarantine and prospects [1:22:59] so yeah we definitely see that in there [1:23:04] okay um susan i think this one's for you [1:23:10] we know that wearing masks can add to mental health issues how does edina think covet is worse for [1:23:17] kids than mental health impact when we have high fast rates [1:23:22] and kids don't get aside [1:23:28] as sick i'm sorry i'm sorry let me read that one more time we know that wearing masks can add to mental health issues [1:23:35] how does edina think covet is worse for kids than mental health impact when we have high vax rates and kids don't get [1:23:43] as sick [1:23:48] i think the first premise is untested and i would contest it [1:23:54] well i don't know that there's any data to say that marrying mass creates mental health challenges [1:24:01] um it seems to bring angst to people but angst in the mental health crisis is not [1:24:06] the same i do think as others have talked about [1:24:12] the more layers of protection better oh you know i think there was a [1:24:18] discussion last year about whether we should go to schools faster and [1:24:24] you know i think the balancing the various pros and cons are important [1:24:30] but i think someone said earlier [1:24:35] kids adapt a lot quicker than sometimes parents do and i have not seen any indication that [1:24:42] american masks creates a specific anxiety [1:24:47] i was going to say the exact same thing i haven't seen that data um [1:24:52] you know i think it goes back to kind of the layered approach the swiss cheese swiss cheese model [1:24:59] you know all these protections need to work together to keep us [1:25:05] safe and more importantly you know keep kids in school [1:25:10] i think um you know not [1:25:15] having kids be able to be in in-person school is i would guess much more damaging than [1:25:23] women okay i'm actually going to put these two [1:25:28] together and i'll start off with the response the first question is is masking part of mdh [1:25:34] guidelines and then the second is more of a statement that question but [1:25:39] it is why are we so anti-science it is documented that kids aren't at risk [1:25:45] masks have no effect and the job isn't working [1:25:51] so the reason why i'm putting those two together is related to mdh guidelines so one of the [1:25:56] reasons why first of all i'll go back to [1:26:02] my foundation what i wanted to see for our students is for our students to be in person [1:26:09] five days a week with the least disruption i heard that time and again from family [1:26:15] members i heard that from students when i was out this summer and talking with them [1:26:22] and the minnesota department of health and their safe schools framework [1:26:28] told school administrators superintendents that if students were massed [1:26:35] they were close contact uh that they would not have to be quarantined now [1:26:42] you know there are situations where kids may have their mask on but kind of pulled all the way down below [1:26:48] their lip or something like that and that's not masked they may have a mask on but they aren't fully masked [1:26:55] so i believe when you look at our quarantine rates [1:27:02] and you compare those to our neighboring districts that masks have had an effect [1:27:09] and that their job is working based on what the minnesota department of health [1:27:15] has told us about what we can do if our students are [1:27:21] wearing a mask correctly and as it relates to being a close contact [1:27:27] or being quarantined that's that's how i'm looking at that as a [1:27:33] superintendent what are your ideas as medical practitioners on um [1:27:41] masks or being science [1:27:47] so something i think we we are [1:27:52] witnessing with the reality with colgan is you are seeing a very public very open [1:27:58] very transparent discussion and disagreement in scientific communities [1:28:04] there are the scientific process is not always [1:28:09] perfectly clean and simple there's experimentation there's the data gathering there's analysis [1:28:16] there are ways to do work that get bias or standards and [1:28:24] in the last two years almost 200 000 papers have been published on kovic [1:28:31] when i did my phd i looked at decades of food work and i looked at about 8 000 [1:28:37] papers the volume of literature out there [1:28:42] almost guarantees you're going to be able to find something that disagrees or agrees with almost any position you have [1:28:49] science as a process has ways to aggregate analyze validate the data when [1:28:56] they do that the the data is crystal clear wherein [1:29:01] masks help so you're gonna if you wanna find some way to disagree [1:29:08] with it you're going to find a paper that disagrees with it you can find papers that support it that at the end of the day it's about the [1:29:14] scientific method of the process and so when you rigorously look at the data [1:29:20] set some standards and evaluation it's not [1:29:26] an anti-science perspective the public normally doesn't care about the scientific process as much as [1:29:32] they've been focused on in the last few years it's normally something that happens at [1:29:37] academic meetings and it's been publicly discussed [1:29:44] thank you okay switch away from mass but i'm trying to get back there as soon as possible [1:29:50] um the incidence of myocardial carditis in young males is rising [1:29:57] can you please warn all parents what can you talk about the incidence of [1:30:03] myocarditis is that accurate this is a great question so um [1:30:10] during the actually it wasn't during the trial of the 12 to 17 year old advisor patients [1:30:15] but it was found after the 12 to 17 year old patients received the vaccine [1:30:22] that there was this incidence where several patients started presenting with myocarditis symptoms [1:30:28] and myocarditis basically is inflammation of the heart muscle and some patients also um [1:30:35] presented with you know pericarditis which is inflammation of the sort of sac that's around the heart [1:30:41] and it can present with chest pain mainly and [1:30:47] i think it was within four or five days of their second adults and as you know the 12 to 17 year old [1:30:52] patients received the full dose of pfizer and there was concern that this you know [1:30:58] was basically going to cause long-term side effects etc i can't speak to every case study [1:31:04] in the study but in general most of the patients did well it was considered a side effect pfizer [1:31:11] was very forward about notifying the public when it happened [1:31:16] um and and warning parents um this is part of the reason that in the younger [1:31:21] children that they did a third of the dose so they're doing 10 micrograms instead of a 30 microgram dose of visor [1:31:28] and you know we're just kind of continuing to watch and see there is a postulation again [1:31:34] this is almost so new that we don't know that those kids may have just been at higher risk and we're not sure had they [1:31:40] gone on to get covered themselves because the actual rate of myocarditis in covid is several hold higher than it [1:31:46] is from the vaccine in this in similar populations and so those kids may have been at risk as well [1:31:52] so i understand parents are scared about their kids and their kids heart and of [1:31:58] course i mean that makes sense but it's again not in isolation you're not comparing myocardialis [1:32:03] to nothing you're comparing you know myoparadise from the vaccine versus a covenant infection which are the two [1:32:09] likely outcomes for every individual in our society right now and that's that's how you kind of have to look at [1:32:15] it so by no means do i want to make light of anybody or their experience or the risk of that but i [1:32:23] also want to make sure that you're comparing it to the appropriate thing i think the warning for parents is if your [1:32:29] kid's not vaccinated and they get by with an artist recovered they're going to have a much harder outcome [1:32:35] in almost all the cases we see with the vaccine-associated myocarditis it's self-eliminating and recovers [1:32:42] quickly kids that get myopic artists from coping are in [1:32:48] the hospital for a much longer period of time have a lot harder outcomes from a cardiac standpoint [1:32:54] it's not it's the same thing but clinically speaking the cardiologists say it's [1:32:59] comparing two different things thank you [1:33:06] how can you tell our children that they have to keep wearing masks and missing out on social and emotional [1:33:12] development because of poorly staffed enclosed hospitals [1:33:23] i get this question often um you know you guys failed you spent millions of [1:33:29] dollars doing this doing that um my healthcare colleagues have to deal [1:33:35] with the ramifications the the reality is about one in five healthcare workers [1:33:41] have left the field the last two years now most of them didn't do it by choice [1:33:47] most of them left because they can't handle the abuse the trauma the challenge [1:33:56] many people have no idea what it's like to try and intubate or sedate somebody that is [1:34:03] without advanced intervention is going to die to have that person fighting you [1:34:08] screaming at you you can only do that so long [1:34:14] there's there's that adage of you know doing the same thing over and over and looking for a different outcome is just [1:34:20] not a good way sometimes an indication of insanity but not from [1:34:25] the mental health standpoint like you can't keep doing the same thing over and [1:34:31] you over expect our health care workers to keep getting deeper and deeper and deeper they have done [1:34:37] so much that's out of the public eye to save thousands and thousands of lives [1:34:43] that huge personal sacrifice at some point you have to say is it working [1:34:49] and the reality is many have had to move on for many reasons [1:34:55] we can't pay somebody the hiring challenges there's people out [1:35:01] there but because of the hostility the challenge the frustration the climate um [1:35:07] people choose to not work and that that impacts the entire society not just [1:35:14] healthcare workers so it is not a binary or you pay healthcare workers more money [1:35:19] that fixes the profit it is a much more complicated issue and [1:35:24] burnout was a thing way before folding [1:35:32] chemical reaction um i guess i would add you know a lot of these questions about [1:35:39] emotional health for their children i think parents are just really scared for their kids because of this whole thing [1:35:44] and so people when they get scared they they wanna grasp for things they wanna you know [1:35:50] they they kind of do funny things and so i can recognize that parents being afraid [1:35:56] of their child and what this whole experience will mean for their child but that's where this is coming from but [1:36:01] again as my psychiatric colleagues mentioned earlier there is no data to show that wearing a mask [1:36:08] you know provides any sort of social emotional delay for children again you can find whatever you want on the internet but you know the american [1:36:15] academy of pediatrics which is my sort of parent organization uh is very highly proponent of masking [1:36:21] and because it you know in order to have a child develop social and emotionally they have to make it they have to live [1:36:28] right and even though kids have a low um you know mortality rate from cobit like [1:36:34] i said before it's not zero and the icus at children's right now are full and so i just feel like a lot of [1:36:41] environment sort of a lot of emphasis has been placed on this with not a lot of data so and again the more that we sort of [1:36:49] just buckle down and do all these mitigation measures the sooner this is going to go away i know that sounds silly you know almost [1:36:55] two years into this using the word soon but it's the truth we just we all have to play along and entrust the data [1:37:04] okay time for a couple more questions here um this is what i'm going to say [1:37:12] any questions that we aren't able to have answered here we will make certain [1:37:17] that we have them on our website so the questions will be posted there and will be on our [1:37:23] website some of them are very similar with responses of masking and things [1:37:28] like that um here's a question now what research has been done on learning speech [1:37:35] languages etc over long-term mask use [1:37:43] i just don't think we know yet i mean we're a year and a half into this so that's a fair question [1:37:49] but i don't have an answer for you i know there's folks looking at it yeah but it's it's uh [1:37:55] if we had all the answers to the questions that the scientific community has we wouldn't be having these [1:38:01] conversations but i can't say anecdotally i'm not seeing delays in children in clinic i'm [1:38:07] not seeing children you know not walking more frequently or talking more frequently etc etc than [1:38:12] i've seen in the past and i certainly haven't heard any of my colleagues so that's my end one but [1:38:18] i don't have any other data to share what risk what is the risk for [1:38:25] hospitalization for kids before and after vaccination [1:38:30] please use real numbers [1:38:36] so uh the the best way to get the real number and you know i don't have my laptop in front of me [1:38:42] is you know mdh has on their website rates uh for unvaccinated and vaccinated [1:38:48] individuals for hospitalization uh you can get that you can also pull it up from the cdc's website um they have [1:38:55] rates per hundred thousand uh you can break it down by age groups and you can see [1:39:02] the difference between older adults adults and kids it gets smaller and [1:39:07] smaller but the impact is still there and so while you see the biggest [1:39:14] impact in you know adults over 65 you do see the same magnitude you do see [1:39:21] that impact in young kids under 18. we continue to see that you're much less [1:39:27] likely to be hospitalized much less likely to get sick um i don't have a number for you but [1:39:35] again another anecdotal note is my friend who is a work she's a [1:39:40] physician at children's said within there i see right now zero uh of all the patients that are sick [1:39:47] with coped and are intubated in their icu or in high school hospitalization none of them are vaccinated [1:39:57] all right i think that you spoke to this but is there a spread in schools right now in edina and out of eden what can we [1:40:04] do in addition to current limitation to decrease spread if there is [1:40:11] so so yes we see that in schools all over the country in the state [1:40:17] one of the things we look at is you know is the the case rate in age groups [1:40:23] similar to the background gradient community that's one of the things we monitor and [1:40:28] look at and when people ask well what else can we do and go back to our mitigations our [1:40:34] mitigations are there they're rock solid and sad so you can always look at improving adding [1:40:41] extra filtration and ventilation you can always look at you might have really good mass [1:40:47] compliance well if you're still having a challenge maybe you look at improving the type of masks [1:40:52] or when and how they're used so those tools are there there is a [1:40:57] continuum of how you can improve the quality of those tools which will have an impact on yelp [1:41:08] all right let's say my kid gets cold how many people [1:41:14] have they spread it to how does that impact our entire community [1:41:22] so uh we we use the term are not [1:41:28] that tells us you know the average so to speak number of additional cases from one case [1:41:34] and it's it's a little dependent on the the variance so [1:41:40] we call it also a long tail problem so many cases of kobe may not transmit [1:41:46] to others because of mitigations and other things and then you have some cases that transmit to a whole lot [1:41:53] and so excuse me at the end of the day you get an average [1:41:58] somewhere in that three to eight uh depending on the variance on average uh but we see that routinely in schools [1:42:05] where medications work our quarantines work and some people tell me they get frustrated [1:42:12] that you know nobody got sick in the quarantine and we had to quarantine this many kids and i look at that as an absolute success [1:42:19] that's something to celebrate nobody got sick the last thing you want is a kid to get sick and quarantined and [1:42:25] if they did that's the mitigation to keep others i think you should celebrate it when [1:42:30] nobody gets sick and quarantined because your mitigations have impact [1:42:36] as i mentioned before i mean just by one other person getting it it's just another place for that virus to be and [1:42:43] replicate and so it's just prolonging it's just prolonging the whole thing [1:42:52] okay thank you very much because this last question is for me okay [1:42:57] and i just want to thank you so much for your time i'm going to wrap it up with this question but thank you so much for your time for coming up this evening [1:43:04] um of course you dr kelly this is the first time that i've met the three of you and i am just grateful [1:43:11] that our community has health care providers like you to really [1:43:16] help guide us in our work and more than anything to really take care of us when we're [1:43:21] here thank you so much appreciate that [1:43:29] all right so this question is there merit in extending the edina public school's winter break to two full weeks [1:43:36] like other districts giving student staff and administration cabinet [1:43:41] team and i spent probably close to an hour talking about this today [1:43:47] really looking at what options are and what i will say to everyone is this is incredibly complex [1:43:56] a lot goes into looking at this when we extend a break [1:44:02] that is everyone and we have to figure out ways that we can remain fiscally [1:44:08] responsible um ways that we can make certain that everybody does get paid for those two [1:44:15] days while at the same time they would have those additional two days off [1:44:21] and districts that are doing this they have many more students honestly who qualify for whom you just [1:44:27] first nuts they have many more students who have title one and so they have received [1:44:34] millions more sometimes tens of millions more dollars [1:44:40] [Music] in state and well in federal funding [1:44:46] and i was on a superintendent's call last week and i have a colleague where [1:44:52] he has 60 million dollars and so he's able to take part of that 60 million dollars and figure out how to [1:45:00] pay his entire staff it isn't just teachers it's paraprofessionals it's [1:45:07] it's food service it's bus drivers it's custodians it is everyone [1:45:12] who works in a district to make certain that they were paid what i will tell you is we are definitely looking at that [1:45:19] we are looking at what some options might be [1:45:27] and i cannot sit here tonight and promise you that that that will happen [1:45:32] because um as superintendent it is also my responsibility to make certain [1:45:38] that our district is well taken care of fiscally and i would never want to make a [1:45:45] decision um at this point that would put us in a poor fiscal [1:45:51] position in the years to come and so i just know that my team we were [1:45:57] talking about that this morning and it's not something that we're not aware of [1:46:03] so everyone who joined us virtually everyone who is here with us this evening thank you so much there were [1:46:09] three questions and at 7 31 i said i was going to be on time there are three questions [1:46:15] one is a statement kids are actually getting more viruses [1:46:20] this fall than ever due to over masking their immunity is down [1:46:26] for pneumonia influenza scripture and the common code another cold another one is what does the panel [1:46:33] believe has allowed schools with no masks for vaccination mandates to stay [1:46:38] in school with no outbreaks there are some districts within 10 miles of edina it says and the last one is oh i [1:46:45] answered that is there a minute so there are only two questions i will work with the experts and i will [1:46:51] get those answers and i will make sure that i post those on the website there are a few others over here oh you have [1:46:58] some more over there so mary does have some more over there as well and so we will make sure that we [1:47:03] get those posted on our family call big site but in the meantime thank you everyone who came in today and thank you [1:47:09] everyone who joined us virtually we really appreciate your participation and your steak [1:47:16] holder feedback have a good evening [Applause] [1:47:40] you