How to pronounce "angiotensin"

hi dr. chu hey Whitney how are you thank

hi dr. chu hey Whitney how are you thank

hi dr. chu hey Whitney how are you thank you for being with us today I'm good

you for being with us today I'm good

you for being with us today I'm good thank you so much for having me on you

thank you so much for having me on you

thank you so much for having me on you know I I'm store that you're working

know I I'm store that you're working

know I I'm store that you're working around the clock these days so it really

around the clock these days so it really

around the clock these days so it really it means a lot that you took some time

it means a lot that you took some time

it means a lot that you took some time to be with us and you know I think I I

to be with us and you know I think I I

to be with us and you know I think I I asked how you are but I would love to

asked how you are but I would love to

asked how you are but I would love to hear you know truly like how are our

hear you know truly like how are our

hear you know truly like how are our things going how are you making out in

things going how are you making out in

things going how are you making out in these times yeah I mean I personally

these times yeah I mean I personally

these times yeah I mean I personally can't complain you know Oregon is not

can't complain you know Oregon is not

can't complain you know Oregon is not New York right now we've actually taken

New York right now we've actually taken

New York right now we've actually taken a lot of early public health measures

a lot of early public health measures

a lot of early public health measures and are being pretty successful at

and are being pretty successful at

and are being pretty successful at flattening the curve so certainly I mean

flattening the curve so certainly I mean

flattening the curve so certainly I mean we're seeing cases it is a time like no

we're seeing cases it is a time like no

we're seeing cases it is a time like no other in healthcare I mean really

other in healthcare I mean really

other in healthcare I mean really experienced nothing like this it is you

experienced nothing like this it is you

experienced nothing like this it is you know I'm part of this kind of big

know I'm part of this kind of big

know I'm part of this kind of big community of frontline health care

community of frontline health care

community of frontline health care workers and talking to my friends around

workers and talking to my friends around

workers and talking to my friends around the country and around the world really

the country and around the world really

the country and around the world really who are in the emergency room or or are

who are in the emergency room or or are

who are in the emergency room or or are working in the intensive care units and

working in the intensive care units and

working in the intensive care units and it it is an incredibly stressful time as

it it is an incredibly stressful time as

it it is an incredibly stressful time as a whole but but here in Oregon we're

a whole but but here in Oregon we're

a whole but but here in Oregon we're lucky to still be waiting for the wave

lucky to still be waiting for the wave

lucky to still be waiting for the wave to hit us and and you you know mention

to hit us and and you you know mention

to hit us and and you you know mention this at Oregon is not has not been hit

this at Oregon is not has not been hit

this at Oregon is not has not been hit as hard as some other states but I guess

as hard as some other states but I guess

as hard as some other states but I guess could you talk a little bit more about

could you talk a little bit more about

could you talk a little bit more about what you were saying there with Oregon

what you were saying there with Oregon

what you were saying there with Oregon flattening the curve and tell us a

flattening the curve and tell us a

flattening the curve and tell us a little bit more about what the situation

little bit more about what the situation

little bit more about what the situation looks like there and then also in your

looks like there and then also in your

looks like there and then also in your hospital specifically yeah I mean the

hospital specifically yeah I mean the

hospital specifically yeah I mean the the first case in the United States of

the first case in the United States of

the first case in the United States of course came to Seattle which is just

course came to Seattle which is just

course came to Seattle which is just three and a half hours up the road as it

three and a half hours up the road as it

three and a half hours up the road as it happened it came the first case that was

happened it came the first case that was

happened it came the first case that was detected was someone who works at the

detected was someone who works at the

detected was someone who works at the school were my that my kids attend which

school were my that my kids attend which

school were my that my kids attend which is one block from my house so when it

is one block from my house so when it

is one block from my house so when it came to Oregon it started feeling real

came to Oregon it started feeling real

came to Oregon it started feeling real very quickly and then early on we saw

very quickly and then early on we saw

very quickly and then early on we saw the pattern that we were seeing across

the pattern that we were seeing across

the pattern that we were seeing across the United States I mean the doubling

the United States I mean the doubling

the United States I mean the doubling times here were every two and a half to

times here were every two and a half to

times here were every two and a half to three days

three days

three days and I think between watching what was

and I think between watching what was

and I think between watching what was happening in Seattle where the case has

happening in Seattle where the case has

happening in Seattle where the case has really exploded we we took our

really exploded we we took our

really exploded we we took our stay-at-home order very seriously you

stay-at-home order very seriously you

stay-at-home order very seriously you know so schools were shut down pretty

know so schools were shut down pretty

know so schools were shut down pretty early on people have really been trying

early on people have really been trying

early on people have really been trying to abide by stay-at-home recommendations

to abide by stay-at-home recommendations

to abide by stay-at-home recommendations and and we we watched that doubling time

and and we we watched that doubling time

and and we we watched that doubling time start to stretch out and the progressed

start to stretch out and the progressed

start to stretch out and the progressed the projections for what our hospitals

the projections for what our hospitals

the projections for what our hospitals would see for our needs for bed space

would see for our needs for bed space

would see for our needs for bed space for intensive care unit base and for

for intensive care unit base and for

for intensive care unit base and for ventilators started going down until

ventilators started going down until

ventilators started going down until until you could see that probably we

until you could see that probably we

until you could see that probably we will be within the resources that we

will be within the resources that we

will be within the resources that we have in our state

have in our state

have in our state which is wonderful and earlier this week

which is wonderful and earlier this week

which is wonderful and earlier this week you know Oregon was able to to clench to

you know Oregon was able to to clench to

you know Oregon was able to to clench to send 140 ventilators to New York City

send 140 ventilators to New York City

send 140 ventilators to New York City there try to help them meet the need in

there try to help them meet the need in

there try to help them meet the need in this time of crisis so it's you know

this time of crisis so it's you know

this time of crisis so it's you know we're still at the stage where it's very

we're still at the stage where it's very

we're still at the stage where it's very very different from state to state I

very different from state to state I

very different from state to state I mean the cat is kind of out of the bag

mean the cat is kind of out of the bag

mean the cat is kind of out of the bag in certain states in Washington and in

in certain states in Washington and in

in certain states in Washington and in New York but many other states still

New York but many other states still

New York but many other states still have the opportunity to change their

have the opportunity to change their

have the opportunity to change their fate so it's really a day-to-day battle

fate so it's really a day-to-day battle

fate so it's really a day-to-day battle to make sure that we stay in the game

to make sure that we stay in the game

to make sure that we stay in the game and that we we continue to be really

and that we we continue to be really

and that we we continue to be really vigilant with all of our public health

vigilant with all of our public health

vigilant with all of our public health measures or even escalate efforts so

measures or even escalate efforts so

measures or even escalate efforts so that we can get over that hump and get

that we can get over that hump and get

that we can get over that hump and get to the other side of this thing I mean

to the other side of this thing I mean

to the other side of this thing I mean and that's it's amazing to hear that

and that's it's amazing to hear that

and that's it's amazing to hear that things seem to be going really well or

things seem to be going really well or

things seem to be going really well or going or doing much better and and you

going or doing much better and and you

going or doing much better and and you know I'm curious I'm talking about those

know I'm curious I'm talking about those

know I'm curious I'm talking about those other states that you mentioned that

other states that you mentioned that

other states that you mentioned that maybe aren't faring as well I know

maybe aren't faring as well I know

maybe aren't faring as well I know you're in touch with a lot of colleagues

you're in touch with a lot of colleagues

you're in touch with a lot of colleagues in other parts of the country you know

in other parts of the country you know

in other parts of the country you know what are you hearing from folks who are

what are you hearing from folks who are

what are you hearing from folks who are maybe in some of those harder hit areas

maybe in some of those harder hit areas

maybe in some of those harder hit areas yeah it's really unlike anything you've

yeah it's really unlike anything you've

yeah it's really unlike anything you've seen I mean the thing to understand

seen I mean the thing to understand

seen I mean the thing to understand about emergency care and disaster

about emergency care and disaster

about emergency care and disaster response systems is this is what we do

response systems is this is what we do

response systems is this is what we do you know it's not like we run on the

you know it's not like we run on the

you know it's not like we run on the assumption of of normality you know we

assumption of of normality you know we

assumption of of normality you know we we are always planning for the

we are always planning for the

we are always planning for the worst-case scenario and so we're we're

worst-case scenario and so we're we're

worst-case scenario and so we're we're prepared for disasters but but normal

prepared for disasters but but normal

prepared for disasters but but normal quote-unquote normal disasters are

quote-unquote normal disasters are

quote-unquote normal disasters are they're so much more contained than this

they're so much more contained than this

they're so much more contained than this so you know we're ready for earthquakes

so you know we're ready for earthquakes

so you know we're ready for earthquakes hurricanes other national natural

hurricanes other national natural

hurricanes other national natural disasters or maybe a single mass

disasters or maybe a single mass

disasters or maybe a single mass casualty all these things that have so

casualty all these things that have so

casualty all these things that have so much more so many more sort of borders

much more so many more sort of borders

much more so many more sort of borders to them you know these discrete events

to them you know these discrete events

to them you know these discrete events maybe they affect a single city or a

maybe they affect a single city or a

maybe they affect a single city or a region or you know you're in a position

region or you know you're in a position

region or you know you're in a position where other states or regions can can

where other states or regions can can

where other states or regions can can chip in I mean you've seen after some of

chip in I mean you've seen after some of

chip in I mean you've seen after some of our largest disasters things like 9/11

our largest disasters things like 9/11

our largest disasters things like 9/11 other countries were so willing to sort

other countries were so willing to sort

other countries were so willing to sort of lend a hand in terms of our our of

of lend a hand in terms of our our of

of lend a hand in terms of our our of addressing our aftermath and and this is

addressing our aftermath and and this is

addressing our aftermath and and this is one of those things where where should

one of those things where where should

one of those things where where should the help be coming because we're all

the help be coming because we're all

the help be coming because we're all dealing with this at the same time and

dealing with this at the same time and

dealing with this at the same time and so everybody is either in full in it you

so everybody is either in full in it you

so everybody is either in full in it you know like they are in New York City

know like they are in New York City

know like they are in New York City either they're they're in there just

either they're they're in there just

either they're they're in there just trying to deal with a huge caseload of

trying to deal with a huge caseload of

trying to deal with a huge caseload of patients and then very sick patients and

patients and then very sick patients and

patients and then very sick patients and just scrambling to be really creative

just scrambling to be really creative

just scrambling to be really creative around these these limited resources

around these these limited resources

around these these limited resources that we have everything from personal

that we have everything from personal

that we have everything from personal protective equipment to the medications

protective equipment to the medications

protective equipment to the medications and space and ventilators and healthcare

and space and ventilators and healthcare

and space and ventilators and healthcare workers to just being in full-on

workers to just being in full-on

workers to just being in full-on preparation mode and that's kind of

preparation mode and that's kind of

preparation mode and that's kind of where we are right now in Oregon because

where we are right now in Oregon because

where we are right now in Oregon because our our peak is expected to hit at the

our our peak is expected to hit at the

our our peak is expected to hit at the end of April or early May and so we're

end of April or early May and so we're

end of April or early May and so we're using that precious time to try to

using that precious time to try to

using that precious time to try to figure out in every eventualities our

figure out in every eventualities our

figure out in every eventualities our are we going to to handle this surge so

are we going to to handle this surge so

are we going to to handle this surge so no matter what whether the wave has hit

no matter what whether the wave has hit

no matter what whether the wave has hit or whether it's about to hit everyone is

or whether it's about to hit everyone is

or whether it's about to hit everyone is really working 24/7 around this pandemic

really working 24/7 around this pandemic

really working 24/7 around this pandemic and you know when I think about

and you know when I think about

and you know when I think about emergency workers even before this time

emergency workers even before this time

emergency workers even before this time you know I always think about them in

you know I always think about them in

you know I always think about them in general just like a you know sort of

general just like a you know sort of

general just like a you know sort of chaotic frantic space and you know I

chaotic frantic space and you know I

chaotic frantic space and you know I have mentioned that that may change have

have mentioned that that may change have

have mentioned that that may change have changed a little bit in the recent weeks

changed a little bit in the recent weeks

changed a little bit in the recent weeks and so could you talk a little bit about

and so could you talk a little bit about

and so could you talk a little bit about what your day-to-day experiences are

what your day-to-day experiences are

what your day-to-day experiences are like now as compared to what they would

like now as compared to what they would

like now as compared to what they would have been like what they were like

have been like what they were like

have been like what they were like pre-pandemic yeah totally and again I'll

pre-pandemic yeah totally and again I'll

pre-pandemic yeah totally and again I'll speak to the experiences of health care

speak to the experiences of health care

speak to the experiences of health care workers that I'm hearing from everywhere

workers that I'm hearing from everywhere

workers that I'm hearing from everywhere you know rather than just mine

you know rather than just mine

you know rather than just mine individual er but there there's kind of

individual er but there there's kind of

individual er but there there's kind of two parts to this one is in normal times

two parts to this one is in normal times

two parts to this one is in normal times we run hospitals pretty lean you know so

we run hospitals pretty lean you know so

we run hospitals pretty lean you know so we don't we don't run it so that you

we don't we don't run it so that you

we don't we don't run it so that you walk into a shift and you're relaxing

walk into a shift and you're relaxing

walk into a shift and you're relaxing for half of it you know or or so that we

for half of it you know or or so that we

for half of it you know or or so that we have a bunch of empty beds just in case

have a bunch of empty beds just in case

have a bunch of empty beds just in case I mean you run it to be pretty close to

I mean you run it to be pretty close to

I mean you run it to be pretty close to maxed out all the time because we really

maxed out all the time because we really

maxed out all the time because we really run it for financial efficiency you know

run it for financial efficiency you know

run it for financial efficiency you know so hospitals more and more are very full

so hospitals more and more are very full

so hospitals more and more are very full we're not expanding hospital wards we're

we're not expanding hospital wards we're

we're not expanding hospital wards we're really running them as pretty close to

really running them as pretty close to

really running them as pretty close to peak and in the emergency department I'm

peak and in the emergency department I'm

peak and in the emergency department I'm on a regular day let's say a weekend

on a regular day let's say a weekend

on a regular day let's say a weekend evening shift when when an ER doctor

evening shift when when an ER doctor

evening shift when when an ER doctor walks in or an ER nurse walks in you

walks in or an ER nurse walks in you

walks in or an ER nurse walks in you kind of stop and take this deep breath

kind of stop and take this deep breath

kind of stop and take this deep breath because you know you're going to be

because you know you're going to be

because you know you're going to be running non-stop basically all-out for

running non-stop basically all-out for

running non-stop basically all-out for your entire shift eight to twelve hours

your entire shift eight to twelve hours

your entire shift eight to twelve hours or whatever it is and so in normal

or whatever it is and so in normal

or whatever it is and so in normal circumstances we are I mean you feel

circumstances we are I mean you feel

circumstances we are I mean you feel pretty close to max capacity and then

pretty close to max capacity and then

pretty close to max capacity and then add on to that a pandemic and you kind

add on to that a pandemic and you kind

add on to that a pandemic and you kind of think of your worst regular day and

of think of your worst regular day and

of think of your worst regular day and and in places where they've already hit

and in places where they've already hit

and in places where they've already hit search it's twice regular or three times

search it's twice regular or three times

search it's twice regular or three times or five times or ten times that and so

or five times or ten times that and so

or five times or ten times that and so you went from it never was a relaxing

you went from it never was a relaxing

you went from it never was a relaxing job I mean it was always a stressful job

job I mean it was always a stressful job

job I mean it was always a stressful job where there's only so much one person

where there's only so much one person

where there's only so much one person can do and yet you're doing more than

can do and yet you're doing more than

can do and yet you're doing more than that all the time and just trying to

that all the time and just trying to

that all the time and just trying to keep people safe - really - really you

keep people safe - really - really you

keep people safe - really - really you know some order of magnitude higher than

know some order of magnitude higher than

know some order of magnitude higher than that so places that are hit hard really

that so places that are hit hard really

that so places that are hit hard really impossibly busy and then and then on the

impossibly busy and then and then on the

impossibly busy and then and then on the flip side we are we have really done a

flip side we are we have really done a

flip side we are we have really done a lot of work in terms of public messaging

lot of work in terms of public messaging

lot of work in terms of public messaging and messaging through a health system

and messaging through a health system

and messaging through a health system that if you are not very sick you should

that if you are not very sick you should

that if you are not very sick you should stay away because first of all we need

stay away because first of all we need

stay away because first of all we need to care for these kovat 19 patients and

to care for these kovat 19 patients and

to care for these kovat 19 patients and also you don't want to get sick by

also you don't want to get sick by

also you don't want to get sick by coming here because this is where the

coming here because this is where the

coming here because this is where the Cova 19 patients are coming so for your

Cova 19 patients are coming so for your

Cova 19 patients are coming so for your own safety and your family's safety

own safety and your family's safety

own safety and your family's safety please stay away and so people even

please stay away and so people even

please stay away and so people even people with very serious health

people with very serious health

people with very serious health conditions are are staying away

conditions are are staying away

conditions are are staying away and our caseload in the emergency room

and our caseload in the emergency room

and our caseload in the emergency room is actually very different and so we're

is actually very different and so we're

is actually very different and so we're disproportionately seeing patients who

disproportionately seeing patients who

disproportionately seeing patients who have fever

have fever

have fever you know respiratory illnesses symptoms

you know respiratory illnesses symptoms

you know respiratory illnesses symptoms that are likely cope at 19 but almost

that are likely cope at 19 but almost

that are likely cope at 19 but almost everything else has gone away or gone

everything else has gone away or gone

everything else has gone away or gone down I think what else has contributed

down I think what else has contributed

down I think what else has contributed to that is that with all of this social

to that is that with all of this social

to that is that with all of this social distancing so people are staying at home

distancing so people are staying at home

distancing so people are staying at home they're not going to parties or bars or

they're not going to parties or bars or

they're not going to parties or bars or restaurants or places where you might

restaurants or places where you might

restaurants or places where you might drink a lot and get into trouble

drink a lot and get into trouble

drink a lot and get into trouble afterwards so a lot of that Friday night

afterwards so a lot of that Friday night

afterwards so a lot of that Friday night Saturday night trauma that we would

Saturday night trauma that we would

Saturday night trauma that we would normally normally see car accidents from

normally normally see car accidents from

normally normally see car accidents from drunk driving or just from high traffic

drunk driving or just from high traffic

drunk driving or just from high traffic conditions I mean all the things that

conditions I mean all the things that

conditions I mean all the things that happen when you throw a whole bunch of

happen when you throw a whole bunch of

happen when you throw a whole bunch of humans together in close quarters though

humans together in close quarters though

humans together in close quarters though that is kind of our bread and butter in

that is kind of our bread and butter in

that is kind of our bread and butter in the emergency room and we're not seeing

the emergency room and we're not seeing

the emergency room and we're not seeing that whole chunk as much the puzzling

that whole chunk as much the puzzling

that whole chunk as much the puzzling thing is actually why we're not seeing

thing is actually why we're not seeing

thing is actually why we're not seeing things that have no relationship to Cove

things that have no relationship to Cove

things that have no relationship to Cove in nineteen imeem heart attacks strokes

in nineteen imeem heart attacks strokes

in nineteen imeem heart attacks strokes those diseases have not gotten any

those diseases have not gotten any

those diseases have not gotten any notice that they should wait until kovat

notice that they should wait until kovat

notice that they should wait until kovat is over you know and so where are those

is over you know and so where are those

is over you know and so where are those diseases I mean there was an op-ed in

diseases I mean there was an op-ed in

diseases I mean there was an op-ed in The New York Times the other day

The New York Times the other day

The New York Times the other day wondering if people who have very

wondering if people who have very

wondering if people who have very legitimate reasons to come into the

legitimate reasons to come into the

legitimate reasons to come into the hospitals are also avoiding avoiding the

hospitals are also avoiding avoiding the

hospitals are also avoiding avoiding the house but not that other things aren't

house but not that other things aren't

house but not that other things aren't legitimate but you know things that that

legitimate but you know things that that

legitimate but you know things that that are true emergencies that we should be

are true emergencies that we should be

are true emergencies that we should be seen immediately otherwise can lead the

seen immediately otherwise can lead the

seen immediately otherwise can lead the very poor outcomes or even death in a

very poor outcomes or even death in a

very poor outcomes or even death in a short period of time what you know what

short period of time what you know what

short period of time what you know what kind of collateral damage are we seeing

kind of collateral damage are we seeing

kind of collateral damage are we seeing because people are afraid to come in so

because people are afraid to come in so

because people are afraid to come in so but all of that adds up to a very

but all of that adds up to a very

but all of that adds up to a very strange environment in the hospital

strange environment in the hospital

strange environment in the hospital right now yeah I mean and that's and

right now yeah I mean and that's and

right now yeah I mean and that's and that's so interesting to hear it sounds

that's so interesting to hear it sounds

that's so interesting to hear it sounds like in some ways people are being

like in some ways people are being

like in some ways people are being really more thoughtful about how when

really more thoughtful about how when

really more thoughtful about how when they actually do need to seek out care

they actually do need to seek out care

they actually do need to seek out care and when they can handle something

and when they can handle something

and when they can handle something themselves and I and I imagine it

themselves and I and I imagine it

themselves and I and I imagine it probably remains to be seen whether

probably remains to be seen whether

probably remains to be seen whether that's better that people are dealing

that's better that people are dealing

that's better that people are dealing with some things on their own at home or

with some things on their own at home or

with some things on their own at home or or whether that's worse what is your

or whether that's worse what is your

or whether that's worse what is your take on that probably a mix of both I

take on that probably a mix of both I

take on that probably a mix of both I mean I think the truth is right in the

mean I think the truth is right in the

mean I think the truth is right in the middle I think when we go back to normal

middle I think when we go back to normal

middle I think when we go back to normal it's hard to imagine a time they'll come

it's hard to imagine a time they'll come

it's hard to imagine a time they'll come back to normal but probably when we go

back to normal but probably when we go

back to normal but probably when we go back to nor

back to nor

back to nor we'll see some things we've learned can

we'll see some things we've learned can

we'll see some things we've learned can stay out of the emergency room or you

stay out of the emergency room or you

stay out of the emergency room or you know I think we're being very creative

know I think we're being very creative

know I think we're being very creative about telehealth right now and I'm

about telehealth right now and I'm

about telehealth right now and I'm getting people to get health care

getting people to get health care

getting people to get health care through their computers or their phones

through their computers or their phones

through their computers or their phones and I think we'll probably find that

and I think we'll probably find that

and I think we'll probably find that that that we continue to have expanded

that that we continue to have expanded

that that we continue to have expanded use of telemedicine after this because

use of telemedicine after this because

use of telemedicine after this because it worked so well I bet people actually

it worked so well I bet people actually

it worked so well I bet people actually be very happy and surprised by the

be very happy and surprised by the

be very happy and surprised by the number of things that you can do at home

number of things that you can do at home

number of things that you can do at home for some common health conditions but I

for some common health conditions but I

for some common health conditions but I also think that when the surge is over

also think that when the surge is over

also think that when the surge is over for every state we will get an influx of

for every state we will get an influx of

for every state we will get an influx of those delayed care cases that will kind

those delayed care cases that will kind

those delayed care cases that will kind of be the second surge of stress on the

of be the second surge of stress on the

of be the second surge of stress on the healthcare system not directly rated

healthcare system not directly rated

healthcare system not directly rated related to code 19 but what we're kind

related to code 19 but what we're kind

related to code 19 but what we're kind of calling the collateral damage I'm

of calling the collateral damage I'm

of calling the collateral damage I'm deferred health problems that really

deferred health problems that really

deferred health problems that really could have benefited from an earlier

could have benefited from an earlier

could have benefited from an earlier visit to the hospital emergency room or

visit to the hospital emergency room or

visit to the hospital emergency room or and in-person visit to your doc to your

and in-person visit to your doc to your

and in-person visit to your doc to your doctor or nurse practitioner or whoever

doctor or nurse practitioner or whoever

doctor or nurse practitioner or whoever and you know as the months have gone on

and you know as the months have gone on

and you know as the months have gone on and you know we've been dealing with

and you know we've been dealing with

and you know we've been dealing with this as a country as a world you know

this as a country as a world you know

this as a country as a world you know for these past few months in emergency

for these past few months in emergency

for these past few months in emergency rooms in your emergency room how have

rooms in your emergency room how have

rooms in your emergency room how have you seen the situation change or worsen

you seen the situation change or worsen

you seen the situation change or worsen you know how are things different now

you know how are things different now

you know how are things different now than they were say back in early

than they were say back in early

than they were say back in early February I mean now we are in it I mean

February I mean now we are in it I mean

February I mean now we are in it I mean all of us to some extent I mean it's hit

all of us to some extent I mean it's hit

all of us to some extent I mean it's hit all 50 states and so it went from this

all 50 states and so it went from this

all 50 states and so it went from this anticipation to really needing to make

anticipation to really needing to make

anticipation to really needing to make those hard decisions and I mean this is

those hard decisions and I mean this is

those hard decisions and I mean this is so challenging always but in this

so challenging always but in this

so challenging always but in this disease we're not familiar with it and

disease we're not familiar with it and

disease we're not familiar with it and so we are learning on the fly so we're

so we are learning on the fly so we're

so we are learning on the fly so we're learning from China from Italy from

learning from China from Italy from

learning from China from Italy from South Korea and then from our own early

South Korea and then from our own early

South Korea and then from our own early States but that decision making changes

States but that decision making changes

States but that decision making changes so fast that that really there are some

so fast that that really there are some

so fast that that really there are some days where I feel like the hospital I

days where I feel like the hospital I

days where I feel like the hospital I walk out of at the end of my shift is

walk out of at the end of my shift is

walk out of at the end of my shift is different than the hospital I walk into

different than the hospital I walk into

different than the hospital I walk into at the beginning of my shift and I'm

at the beginning of my shift and I'm

at the beginning of my shift and I'm hearing this from colleagues all over

hearing this from colleagues all over

hearing this from colleagues all over the place it's not just at my

the place it's not just at my

the place it's not just at my institution where people are sitting you

institution where people are sitting you

institution where people are sitting you know we've created these these COBIT

know we've created these these COBIT

know we've created these these COBIT emergency task force or committees that

emergency task force or committees that

emergency task force or committees that make decisions for for every health

make decisions for for every health

make decisions for for every health system

system

system and people are sitting and receiving

and people are sitting and receiving

and people are sitting and receiving data as it rolls in and then using that

data as it rolls in and then using that

data as it rolls in and then using that data to enrich the response in their own

data to enrich the response in their own

data to enrich the response in their own institution so whether it's I'm trying

institution so whether it's I'm trying

institution so whether it's I'm trying to think of a good example like even

to think of a good example like even

to think of a good example like even just what we decide to do around brown

just what we decide to do around brown

just what we decide to do around brown face masks or around how we manage

face masks or around how we manage

face masks or around how we manage certain types of patients what

certain types of patients what

certain types of patients what medications were looking at as potential

medications were looking at as potential

medications were looking at as potential therapies I mean this is how wild and

therapies I mean this is how wild and

therapies I mean this is how wild and and quick it is a few weeks ago earlier

and quick it is a few weeks ago earlier

and quick it is a few weeks ago earlier in this pandemic we were concerned about

in this pandemic we were concerned about

in this pandemic we were concerned about a certain class of blood pressure

a certain class of blood pressure

a certain class of blood pressure medication called AR B's angiotensin

medication called AR B's angiotensin

medication called AR B's angiotensin receptor blockers and the rumor was that

receptor blockers and the rumor was that

receptor blockers and the rumor was that these were harmful that these would

these were harmful that these would

these were harmful that these would actually lead to more severe disease and

actually lead to more severe disease and

actually lead to more severe disease and there was a question about whether we

there was a question about whether we

there was a question about whether we should be taking patients off of those

should be taking patients off of those

should be taking patients off of those medications who are using them for blood

medications who are using them for blood

medications who are using them for blood pressure control 3 weeks later that

pressure control 3 weeks later that

pressure control 3 weeks later that medication is being used in the hospital

medication is being used in the hospital

medication is being used in the hospital as a potential therapy I mean that is

as a potential therapy I mean that is

as a potential therapy I mean that is how fast a science is changing it was it

how fast a science is changing it was it

how fast a science is changing it was it was bad

was bad

was bad now it's potentially really good I mean

now it's potentially really good I mean

now it's potentially really good I mean I it's a constant process of keeping up

I it's a constant process of keeping up

I it's a constant process of keeping up with what the best evidence is telling

with what the best evidence is telling

with what the best evidence is telling us is right to do and I mean I'll just

us is right to do and I mean I'll just

us is right to do and I mean I'll just tell you you're always wondering am I

tell you you're always wondering am I

tell you you're always wondering am I getting it wrong right now as I feel

getting it wrong right now as I feel

getting it wrong right now as I feel like it's gonna be different in about 24

like it's gonna be different in about 24

like it's gonna be different in about 24 hours and you just do the best that you

hours and you just do the best that you

hours and you just do the best that you can with with current information well I

can with with current information well I

can with with current information well I mean - you've been documenting your

mean - you've been documenting your

mean - you've been documenting your experiences and uh sort of talking about

experiences and uh sort of talking about

experiences and uh sort of talking about what how you've been going through this

what how you've been going through this

what how you've been going through this pandemic and your new podcast doctor's

pandemic and your new podcast doctor's

pandemic and your new podcast doctor's log and you know you've talked about

log and you know you've talked about

log and you know you've talked about some of the unique challenges that

some of the unique challenges that

some of the unique challenges that health workers are facing one of those

health workers are facing one of those

health workers are facing one of those being heightened exposure to the virus

being heightened exposure to the virus

being heightened exposure to the virus and so I'd love to talk about that a

and so I'd love to talk about that a

and so I'd love to talk about that a little bit just you know what are some

little bit just you know what are some

little bit just you know what are some of the physical ways what does the

of the physical ways what does the

of the physical ways what does the physical toll that this pandemic is

physical toll that this pandemic is

physical toll that this pandemic is having on health workers yeah this is

having on health workers yeah this is

having on health workers yeah this is this is so stressful I mean we are used

this is so stressful I mean we are used

this is so stressful I mean we are used to working under conditions where your

to working under conditions where your

to working under conditions where your risk is some nonzero number above that

risk is some nonzero number above that

risk is some nonzero number above that of the general population you know we

of the general population you know we

of the general population you know we see dangerous infections all the time

see dangerous infections all the time

see dangerous infections all the time there is violence in the health care

there is violence in the health care

there is violence in the health care works the workplace because of the

works the workplace because of the

works the workplace because of the volatility of what we see all the time

volatility of what we see all the time

volatility of what we see all the time and so there's a little bit of you know

and so there's a little bit of you know

and so there's a little bit of you know adrenaline there that's that's always

adrenaline there that's that's always

adrenaline there that's that's always present and that we we're used to over

present and that we we're used to over

present and that we we're used to over time you actually become completely a

time you actually become completely a

time you actually become completely a nerd to some of these things that aren't

nerd to some of these things that aren't

nerd to some of these things that aren't a part of other people's day-to-day

a part of other people's day-to-day

a part of other people's day-to-day existence but with this we have a you

existence but with this we have a you

existence but with this we have a you know a disease that's highly

know a disease that's highly

know a disease that's highly transmissible and also is is leads to

transmissible and also is is leads to

transmissible and also is is leads to very severe disease and so you know and

very severe disease and so you know and

very severe disease and so you know and then you throw in there the shortage of

then you throw in there the shortage of

then you throw in there the shortage of this one simple resource which is this

this one simple resource which is this

this one simple resource which is this personal protective equipment and when

personal protective equipment and when

personal protective equipment and when you put those three things together and

you put those three things together and

you put those three things together and we're seeing a high volume of patients

we're seeing a high volume of patients

we're seeing a high volume of patients it's you know it's it really becomes

it's you know it's it really becomes

it's you know it's it really becomes stressful on a different level because

stressful on a different level because

stressful on a different level because it's rare that we see something in the

it's rare that we see something in the

it's rare that we see something in the hospital where we have to worry what am

hospital where we have to worry what am

hospital where we have to worry what am i bringing home to my family member

i bringing home to my family member

i bringing home to my family member because I wasn't perfectly protected

because I wasn't perfectly protected

because I wasn't perfectly protected against this very dangerous disease and

against this very dangerous disease and

against this very dangerous disease and I think when you add on that layer of

I think when you add on that layer of

I think when you add on that layer of personal stress all the time am i right

personal stress all the time am i right

personal stress all the time am i right by doing this thing that I love to do

by doing this thing that I love to do

by doing this thing that I love to do care for patients am I putting my family

care for patients am I putting my family

care for patients am I putting my family at risk

at risk

at risk am i putting other patients at risk my

am i putting other patients at risk my

am i putting other patients at risk my colleagues at risk I think that has been

colleagues at risk I think that has been

colleagues at risk I think that has been one of the most emotionally draining

one of the most emotionally draining

one of the most emotionally draining things of this of this whole pandemic is

things of this of this whole pandemic is

things of this of this whole pandemic is just not just not being free to kind of

just not just not being free to kind of

just not just not being free to kind of go in and just do your clinical duty to

go in and just do your clinical duty to

go in and just do your clinical duty to the top of your potential but having

the top of your potential but having

the top of your potential but having this added layer of of constant stress

this added layer of of constant stress

this added layer of of constant stress about how much you're able to do it

about how much you're able to do it

about how much you're able to do it safely yeah I mean it's seeing these

safely yeah I mean it's seeing these

safely yeah I mean it's seeing these headlines really across the world about

headlines really across the world about

headlines really across the world about the number of health workers who

the number of health workers who

the number of health workers who contract the virus and you know that

contract the virus and you know that

contract the virus and you know that sort of thing is is is really upsetting

sort of thing is is is really upsetting

sort of thing is is is really upsetting and you know thank you doctor true for

and you know thank you doctor true for

and you know thank you doctor true for all you do and I think another thing

all you do and I think another thing

all you do and I think another thing that you talk about you know and also

that you talk about you know and also

that you talk about you know and also thinking about you mentioned not having

thinking about you mentioned not having

thinking about you mentioned not having PPE but also other equipment that we've

PPE but also other equipment that we've

PPE but also other equipment that we've seen a lot in the headlines that are

seen a lot in the headlines that are

seen a lot in the headlines that are we're lacking in the hospitals are

we're lacking in the hospitals are

we're lacking in the hospitals are shortage of our ventilators

shortage of our ventilators

shortage of our ventilators you've talked about this and how it's

you've talked about this and how it's

you've talked about this and how it's not just enough to think about the

not just enough to think about the

not just enough to think about the ventilators themselves but you know what

ventilators themselves but you know what

ventilators themselves but you know what are some other factors that we need to

are some other factors that we need to

are some other factors that we need to consider when we're thinking about the

consider when we're thinking about the

consider when we're thinking about the need for ventilators in in medical

need for ventilators in in medical

need for ventilators in in medical centers and hospitals yeah the the needs

centers and hospitals yeah the the needs

centers and hospitals yeah the the needs are so great and it's really everything

are so great and it's really everything

are so great and it's really everything that you know it's everything that

that you know it's everything that

that you know it's everything that surrounds the ventilator you know it's

surrounds the ventilator you know it's

surrounds the ventilator you know it's it none of these things live in

it none of these things live in

it none of these things live in isolation you know and so when I think

isolation you know and so when I think

isolation you know and so when I think of just the issue of the ventilator um

of just the issue of the ventilator um

of just the issue of the ventilator um that we're running out of it's like well

that we're running out of it's like well

that we're running out of it's like well you you actually need highly trained

you you actually need highly trained

you you actually need highly trained staff to use a ventilator it's not like

staff to use a ventilator it's not like

staff to use a ventilator it's not like you can just take anybody and just put

you can just take anybody and just put

you can just take anybody and just put them next to a ventilator and they can

them next to a ventilator and they can

them next to a ventilator and they can start programming it in this super fancy

start programming it in this super fancy

start programming it in this super fancy you know with with all skill and

you know with with all skill and

you know with with all skill and confidence you know we we rely on the

confidence you know we we rely on the

confidence you know we we rely on the fact that there's a highly trained

fact that there's a highly trained

fact that there's a highly trained workforce including respiratory

workforce including respiratory

workforce including respiratory therapists intensive care unit trained

therapists intensive care unit trained

therapists intensive care unit trained specifically trained physicians nurses

specifically trained physicians nurses

specifically trained physicians nurses who are really experienced in ICU care

who are really experienced in ICU care

who are really experienced in ICU care even to put somebody on a ventilator you

even to put somebody on a ventilator you

even to put somebody on a ventilator you need a number of common medications just

need a number of common medications just

need a number of common medications just a date and paralyze them so that they

a date and paralyze them so that they

a date and paralyze them so that they can tolerate the insertion of a pretty

can tolerate the insertion of a pretty

can tolerate the insertion of a pretty rigid plastic tube down their throat and

rigid plastic tube down their throat and

rigid plastic tube down their throat and then to keep them in a state that's

then to keep them in a state that's

then to keep them in a state that's comfortable so that they can stay on

comfortable so that they can stay on

comfortable so that they can stay on that tube for many many days which is a

that tube for many many days which is a

that tube for many many days which is a very uncomfortable thing actually and so

very uncomfortable thing actually and so

very uncomfortable thing actually and so you know and so we need all of those

you know and so we need all of those

you know and so we need all of those medications and we need them in pretty

medications and we need them in pretty

medications and we need them in pretty large quantities and then of course you

large quantities and then of course you

large quantities and then of course you know ventilators need to go into

know ventilators need to go into

know ventilators need to go into intensive care units those intensive

intensive care units those intensive

intensive care units those intensive care units require a lot of maintenance

care units require a lot of maintenance

care units require a lot of maintenance I mean the cleaning staff to to clean a

I mean the cleaning staff to to clean a

I mean the cleaning staff to to clean a intensive care unit where there's been a

intensive care unit where there's been a

intensive care unit where there's been a kovat positive patient in these our

kovat positive patient in these our

kovat positive patient in these our larger rooms they have a lot of

larger rooms they have a lot of

larger rooms they have a lot of equipment in it often the cleaning after

equipment in it often the cleaning after

equipment in it often the cleaning after a Koba 19 patient to do it right and

a Koba 19 patient to do it right and

a Koba 19 patient to do it right and disinfect that space so it's safe for

disinfect that space so it's safe for

disinfect that space so it's safe for the next patient that's an hour and

the next patient that's an hour and

the next patient that's an hour and twenty to thirty minute process or more

twenty to thirty minute process or more

twenty to thirty minute process or more depending on the facility so or that

depending on the facility so or that

depending on the facility so or that that room is just out of use and so I

that room is just out of use and so I

that room is just out of use and so I mean there really is a complex team that

mean there really is a complex team that

mean there really is a complex team that it takes in order to maintain an

it takes in order to maintain an

it takes in order to maintain an intensive care unit around a single

intensive care unit around a single

intensive care unit around a single machine it's really hard to to convey

machine it's really hard to to convey

machine it's really hard to to convey that all the time you know it's a lot

that all the time you know it's a lot

that all the time you know it's a lot easier to say we need the single

easier to say we need the single

easier to say we need the single resource let's manufacture it and get it

resource let's manufacture it and get it

resource let's manufacture it and get it there and I will say to just this this

there and I will say to just this this

there and I will say to just this this whole thing is really such an education

whole thing is really such an education

whole thing is really such an education on public health messaging and how we

on public health messaging and how we

on public health messaging and how we get ordinary people and policymakers to

get ordinary people and policymakers to

get ordinary people and policymakers to kind of get galvanized around some of

kind of get galvanized around some of

kind of get galvanized around some of these issues that are buried deep within

these issues that are buried deep within

these issues that are buried deep within a hospital it's like the deeper you get

a hospital it's like the deeper you get

a hospital it's like the deeper you get into a hospital and the further you get

into a hospital and the further you get

into a hospital and the further you get from outside of it the harder it is to

from outside of it the harder it is to

from outside of it the harder it is to communicate these needs and so you know

communicate these needs and so you know

communicate these needs and so you know testing was something that was very

testing was something that was very

testing was something that was very relatable to people and that we were

relatable to people and that we were

relatable to people and that we were really able to raise public outrage

really able to raise public outrage

really able to raise public outrage about because everybody suddenly wanted

about because everybody suddenly wanted

about because everybody suddenly wanted to get tested right I mean you had a

to get tested right I mean you had a

to get tested right I mean you had a virus the the the the Cova 19 disease

virus the the the the Cova 19 disease

virus the the the the Cova 19 disease was in the country you wanted to know

was in the country you wanted to know

was in the country you wanted to know whether you had it and so if you didn't

whether you had it and so if you didn't

whether you had it and so if you didn't then something you knew really wanted

then something you knew really wanted

then something you knew really wanted that test PPE the personal protective

that test PPE the personal protective

that test PPE the personal protective equipment that was a little harder

equipment that was a little harder

equipment that was a little harder that's the first step into the hospital

that's the first step into the hospital

that's the first step into the hospital what do you need if you're working on

what do you need if you're working on

what do you need if you're working on copa90 and you need some PPE and so and

copa90 and you need some PPE and so and

copa90 and you need some PPE and so and there was something so visual about it

there was something so visual about it

there was something so visual about it right we saw pictures of healthcare

right we saw pictures of healthcare

right we saw pictures of healthcare workers with their masks and their

workers with their masks and their

workers with their masks and their goggles and their gowns and and we saw

goggles and their gowns and and we saw

goggles and their gowns and and we saw those images from other countries where

those images from other countries where

those images from other countries where they were wearing them or not wearing

they were wearing them or not wearing

they were wearing them or not wearing them you see the pictures on one of the

them you see the pictures on one of the

them you see the pictures on one of the most vivid pictures I think that will

most vivid pictures I think that will

most vivid pictures I think that will remain in people's memories after this

remain in people's memories after this

remain in people's memories after this is the pictures of the health care

is the pictures of the health care

is the pictures of the health care workers with the bruises around their

workers with the bruises around their

workers with the bruises around their faces for wearing these masks non-stop

faces for wearing these masks non-stop

faces for wearing these masks non-stop because normally we don't always wear

because normally we don't always wear

because normally we don't always wear personal protective equipment for every

personal protective equipment for every

personal protective equipment for every single patient but having to wear it for

single patient but having to wear it for

single patient but having to wear it for patient after patient for hundreds of

patient after patient for hundreds of

patient after patient for hundreds of patients over a shift people started to

patients over a shift people started to

patients over a shift people started to get bruising on their faces and there

get bruising on their faces and there

get bruising on their faces and there was something so visual and visceral and

was something so visual and visceral and

was something so visual and visceral and relatable about that and so we got

relatable about that and so we got

relatable about that and so we got people really excited about PPE and I'm

people really excited about PPE and I'm

people really excited about PPE and I'm so glad because I think we won't get

so glad because I think we won't get

so glad because I think we won't get relief in those in that resource soon

relief in those in that resource soon

relief in those in that resource soon after that our ability to kind of

after that our ability to kind of

after that our ability to kind of communicate our needs are as critical as

communicate our needs are as critical as

communicate our needs are as critical as they are they may be as critical as PPE

they are they may be as critical as PPE

they are they may be as critical as PPE and as testing once you get downstream

and as testing once you get downstream

and as testing once you get downstream to a stage of disease where you need to

to a stage of disease where you need to

to a stage of disease where you need to be treated in the hospital it's very

be treated in the hospital it's very

be treated in the hospital it's very hard to communicate how badly we need

hard to communicate how badly we need

hard to communicate how badly we need these things and get the kind of you

these things and get the kind of you

these things and get the kind of you know the public interest and an outrage

know the public interest and an outrage

know the public interest and an outrage and energy around it but really every

and energy around it but really every

and energy around it but really every single thing that we need in the

single thing that we need in the

single thing that we need in the hospital is is we're starting to strain

hospital is is we're starting to strain

hospital is is we're starting to strain the supply I'd love to

the supply I'd love to

the supply I'd love to I fell in here yeah yeah please Helen so

I fell in here yeah yeah please Helen so

I fell in here yeah yeah please Helen so many questions pouring into Facebook so

many questions pouring into Facebook so

many questions pouring into Facebook so I'll just share a couple and then I'll

I'll just share a couple and then I'll

I'll just share a couple and then I'll jump back off but I think overwhelming

jump back off but I think overwhelming

jump back off but I think overwhelming made the number one question that people

made the number one question that people

made the number one question that people have is how can they help alright I'm

have is how can they help alright I'm

have is how can they help alright I'm sorry that question just kind of kills

sorry that question just kind of kills

sorry that question just kind of kills me it kills me every time and you think

me it kills me every time and you think

me it kills me every time and you think I'd be ready for it because how many

I'd be ready for it because how many

I'd be ready for it because how many people are asking me so Oh give me a

people are asking me so Oh give me a

people are asking me so Oh give me a second first of all everyone who asked

second first of all everyone who asked

second first of all everyone who asked that question thank you I mean we feel

that question thank you I mean we feel

that question thank you I mean we feel feel the outpouring of goodwill and and

feel the outpouring of goodwill and and

feel the outpouring of goodwill and and I mean that is honestly what keeps us

I mean that is honestly what keeps us

I mean that is honestly what keeps us going to work every single day and gives

going to work every single day and gives

going to work every single day and gives us energy to do this and it actually it

us energy to do this and it actually it

us energy to do this and it actually it makes me feel like how can I do more so

makes me feel like how can I do more so

makes me feel like how can I do more so thank you and I will say there there are

thank you and I will say there there are

thank you and I will say there there are a million ways to help I'll throw it a

a million ways to help I'll throw it a

a million ways to help I'll throw it a couple of simple things the first of all

couple of simple things the first of all

couple of simple things the first of all whatever you do to help your own

whatever you do to help your own

whatever you do to help your own community helps us so even if you're not

community helps us so even if you're not

community helps us so even if you're not out there I mean a lot of people are

out there I mean a lot of people are

out there I mean a lot of people are selling face masks and things are

selling face masks and things are

selling face masks and things are contributing to you know to the to

contributing to you know to the to

contributing to you know to the to increasing the supply of PPE and that's

increasing the supply of PPE and that's

increasing the supply of PPE and that's wonderful but but it doesn't have to be

wonderful but but it doesn't have to be

wonderful but but it doesn't have to be that literal so when you contribute to

that literal so when you contribute to

that literal so when you contribute to your local food bank your local homeless

your local food bank your local homeless

your local food bank your local homeless or domestic violence shelter your local

or domestic violence shelter your local

or domestic violence shelter your local diaper bank in any way contributing to

diaper bank in any way contributing to

diaper bank in any way contributing to the needs of the community around here

the needs of the community around here

the needs of the community around here you are helping us and I will tell you

you are helping us and I will tell you

you are helping us and I will tell you even in times of pandemic we are seeing

even in times of pandemic we are seeing

even in times of pandemic we are seeing people come to the hospital because they

people come to the hospital because they

people come to the hospital because they are lacking food and they are lacking

are lacking food and they are lacking

are lacking food and they are lacking shelter because those needs are still

shelter because those needs are still

shelter because those needs are still paramount for people and so when you

paramount for people and so when you

paramount for people and so when you help in those ways that is healthcare

help in those ways that is healthcare

help in those ways that is healthcare that you are giving directly and you are

that you are giving directly and you are

that you are giving directly and you are helping us every single day keep people

helping us every single day keep people

helping us every single day keep people healthy so those things are so valuable

healthy so those things are so valuable

healthy so those things are so valuable I think the second thing is to come into

I think the second thing is to come into

I think the second thing is to come into the healthcare mentality which is that

the healthcare mentality which is that

the healthcare mentality which is that this is not going to be short it is

this is not going to be short it is

this is not going to be short it is going to be prolonged and there is no

going to be prolonged and there is no

going to be prolonged and there is no single campaign that will win this thing

single campaign that will win this thing

single campaign that will win this thing they're going to be many campaigns after

they're going to be many campaigns after

they're going to be many campaigns after campaigns and I always feel like I'm

campaigns and I always feel like I'm

campaigns and I always feel like I'm giving bad news but I want people to

giving bad news but I want people to

giving bad news but I want people to kind of spread the word that this needs

kind of spread the word that this needs

kind of spread the word that this needs to be a really sustained effort we don't

to be a really sustained effort we don't

to be a really sustained effort we don't have an end date we may even have a

have an end date we may even have a

have an end date we may even have a second surge of disease on particularly

second surge of disease on particularly

second surge of disease on particularly if you don't get this right we don't

if you don't get this right we don't

if you don't get this right we don't have a timing for things like vaccines

have a timing for things like vaccines

have a timing for things like vaccines and effective treatments those things

and effective treatments those things

and effective treatments those things simply take time so I would say take the

simply take time so I would say take the

simply take time so I would say take the little breaks that you need to from

little breaks that you need to from

little breaks that you need to from you're helping roll help when you have

you're helping roll help when you have

you're helping roll help when you have the energy and you know and the

the energy and you know and the

the energy and you know and the resources to do so but also take time

resources to do so but also take time

resources to do so but also take time for yourself but understand that this is

for yourself but understand that this is

for yourself but understand that this is not going to be short and then the last

not going to be short and then the last

not going to be short and then the last thing I would say is remember that

thing I would say is remember that

thing I would say is remember that sometimes what we don't do is as

sometimes what we don't do is as

sometimes what we don't do is as important as what we do do and so people

important as what we do do and so people

important as what we do do and so people are always worried that they haven't

are always worried that they haven't

are always worried that they haven't done enough but remember that restraint

done enough but remember that restraint

done enough but remember that restraint is so important here and one example

is so important here and one example

is so important here and one example I'll give is every time there's a whiff

I'll give is every time there's a whiff

I'll give is every time there's a whiff of promise around a medication people

of promise around a medication people

of promise around a medication people are going out and they are they are

are going out and they are they are

are going out and they are they are trying to get people to prescribe it to

trying to get people to prescribe it to

trying to get people to prescribe it to them they're they're filling these

them they're they're filling these

them they're they're filling these prescriptions and in quantities that are

prescriptions and in quantities that are

prescriptions and in quantities that are much higher than than anybody needs and

much higher than than anybody needs and

much higher than than anybody needs and really there's some medication hoarding

really there's some medication hoarding

really there's some medication hoarding that's going on so I would ask people

that's going on so I would ask people

that's going on so I would ask people you know wait for the evidence and the

you know wait for the evidence and the

you know wait for the evidence and the recommendations please let health

recommendations please let health

recommendations please let health professionals guide how we use these

professionals guide how we use these

professionals guide how we use these resources and and please don't do the

resources and and please don't do the

resources and and please don't do the toilet-paper thing for any resource in

toilet-paper thing for any resource in

toilet-paper thing for any resource in healthcare we need to we need to have

healthcare we need to we need to have

healthcare we need to we need to have enough restraint that the limited

enough restraint that the limited

enough restraint that the limited resources we have yet to those who

resources we have yet to those who

resources we have yet to those who really need them that goes for a number

really need them that goes for a number

really need them that goes for a number of things also those you know hi Phil

of things also those you know hi Phil

of things also those you know hi Phil tration facemasks some people in the

tration facemasks some people in the

tration facemasks some people in the public do not need to be wearing those

public do not need to be wearing those

public do not need to be wearing those and those should go directly to health

and those should go directly to health

and those should go directly to health care workers one of the question and

care workers one of the question and

care workers one of the question and then I'll jump back into the comments

then I'll jump back into the comments

then I'll jump back into the comments but even there's a question around the

but even there's a question around the

but even there's a question around the risk of using a drug for something it

risk of using a drug for something it

risk of using a drug for something it wasn't intended and I guess this is a

wasn't intended and I guess this is a

wasn't intended and I guess this is a reference to Cora Queen which has become

reference to Cora Queen which has become

reference to Cora Queen which has become a kind of a word that non-medical

a kind of a word that non-medical

a kind of a word that non-medical professionals are now using liberally

professionals are now using liberally

professionals are now using liberally but what do you make of the kind of the

but what do you make of the kind of the

but what do you make of the kind of the sudden resurgence of people's awareness

sudden resurgence of people's awareness

sudden resurgence of people's awareness and knowledge of chloroquine and what

and knowledge of chloroquine and what

and knowledge of chloroquine and what should we actually think about it yeah

should we actually think about it yeah

should we actually think about it yeah there you know every time there is a

there you know every time there is a

there you know every time there is a pandemic there are a number of

pandemic there are a number of

pandemic there are a number of medications that have the

medications that have the

medications that have the radical benefit because they have in

radical benefit because they have in

radical benefit because they have in vitro action against against the virus

vitro action against against the virus

vitro action against against the virus and there have been many disappointments

and there have been many disappointments

and there have been many disappointments I mean all all these medications that

I mean all all these medications that

I mean all all these medications that we're talking about hydrochloric win and

we're talking about hydrochloric win and

we're talking about hydrochloric win and as if through Meissen and antivirals

as if through Meissen and antivirals

as if through Meissen and antivirals that are effective against different

that are effective against different

that are effective against different viruses we wonder can it work against

viruses we wonder can it work against

viruses we wonder can it work against this virus maybe the excitement about

this virus maybe the excitement about

this virus maybe the excitement about these medications hydroxychloroquine i

these medications hydroxychloroquine i

these medications hydroxychloroquine i think is the one that's been mentioned

think is the one that's been mentioned

think is the one that's been mentioned the most I mean really through the roof

the most I mean really through the roof

the most I mean really through the roof I'm excited too it would be nice to know

I'm excited too it would be nice to know

I'm excited too it would be nice to know if it works we have very little data on

if it works we have very little data on

if it works we have very little data on these we have not been able to do these

these we have not been able to do these

these we have not been able to do these randomized control trials that will

randomized control trials that will

randomized control trials that will allow us to know not only are they

allow us to know not only are they

allow us to know not only are they effective but is the is the good that

effective but is the is the good that

effective but is the is the good that they're doing does it exceed the harms

they're doing does it exceed the harms

they're doing does it exceed the harms because all these medications have

because all these medications have

because all these medications have potential toxicity on you know they have

potential toxicity on you know they have

potential toxicity on you know they have psychiatric side effects they have

psychiatric side effects they have

psychiatric side effects they have cardio toxicity particularly in

cardio toxicity particularly in

cardio toxicity particularly in combination with other medications that

combination with other medications that

combination with other medications that affect your heart they can cause very

affect your heart they can cause very

affect your heart they can cause very serious illness seizures and even death

serious illness seizures and even death

serious illness seizures and even death and we've seen we've seen an early death

and we've seen we've seen an early death

and we've seen we've seen an early death from from the use of chloroquine so so a

from from the use of chloroquine so so a

from from the use of chloroquine so so a lot of caution here in every sense there

lot of caution here in every sense there

lot of caution here in every sense there is no indication for people to go out

is no indication for people to go out

is no indication for people to go out and start using these medications as

and start using these medications as

and start using these medications as either prophylaxis or treatment I'm

either prophylaxis or treatment I'm

either prophylaxis or treatment I'm really worried about how people can hurt

really worried about how people can hurt

really worried about how people can hurt themselves and advertently particularly

themselves and advertently particularly

themselves and advertently particularly if they're taking these outside the

if they're taking these outside the

if they're taking these outside the recommendation of a health professional

recommendation of a health professional

recommendation of a health professional I mean that's just a nightmare waiting

I mean that's just a nightmare waiting

I mean that's just a nightmare waiting to happen and I'll also say I mean this

to happen and I'll also say I mean this

to happen and I'll also say I mean this goes in line with with the issue of

goes in line with with the issue of

goes in line with with the issue of medication shortages but I mean the the

medication shortages but I mean the the

medication shortages but I mean the the treatment for hydroxychloroquine or

treatment for hydroxychloroquine or

treatment for hydroxychloroquine or chloroquine overdoses is is generally

chloroquine overdoses is is generally

chloroquine overdoses is is generally benzodiazepines which is another

benzodiazepines which is another

benzodiazepines which is another medication that we're in very short

medication that we're in very short

medication that we're in very short supply of we need critically for

supply of we need critically for

supply of we need critically for intensive care unit patients and so you

intensive care unit patients and so you

intensive care unit patients and so you know everything has consequences that we

know everything has consequences that we

know everything has consequences that we will then have to grapple with so not

will then have to grapple with so not

will then have to grapple with so not you know unsupported you so these

you know unsupported you so these

you know unsupported you so these medications this really has the

medications this really has the

medications this really has the potential to be another disaster buried

potential to be another disaster buried

potential to be another disaster buried within this disaster we do not want that

within this disaster we do not want that

within this disaster we do not want that okay I'm jumping off thank you so much

okay I'm jumping off thank you so much

okay I'm jumping off thank you so much back to you Whitney

Helen you know it's so you talked about

Helen you know it's so you talked about

Helen you know it's so you talked about sort of how you've been advocating for

sort of how you've been advocating for

sort of how you've been advocating for PPE and our need for that and you

PPE and our need for that and you

PPE and our need for that and you advocate for a lot of things in this

advocate for a lot of things in this

advocate for a lot of things in this public health space that I think are

public health space that I think are

public health space that I think are just really critically important at this

just really critically important at this

just really critically important at this time and one of those things is the work

time and one of those things is the work

time and one of those things is the work that you're doing with chip health and

that you're doing with chip health and

that you're doing with chip health and I'd love to talk a little bit about that

I'd love to talk a little bit about that

I'd love to talk a little bit about that as far as looking at building emergency

as far as looking at building emergency

as far as looking at building emergency health centers and creating these spaces

health centers and creating these spaces

health centers and creating these spaces at this time and as we're seeing that

at this time and as we're seeing that

at this time and as we're seeing that hospitals are overcrowded throughout the

hospitals are overcrowded throughout the

hospitals are overcrowded throughout the country the world you know I guess how

country the world you know I guess how

country the world you know I guess how how long before we get to a point where

how long before we get to a point where

how long before we get to a point where where we really are beyond capacity and

where we really are beyond capacity and

where we really are beyond capacity and and need to seek out alternative

and need to seek out alternative

and need to seek out alternative measures yeah we're already seeing it in

measures yeah we're already seeing it in

measures yeah we're already seeing it in New York and I think we will actually

New York and I think we will actually

New York and I think we will actually see this space shortage in every major

see this space shortage in every major

see this space shortage in every major city and then a different kind of space

city and then a different kind of space

city and then a different kind of space shortage actually in rural and critical

shortage actually in rural and critical

shortage actually in rural and critical access areas so you know in large cities

access areas so you know in large cities

access areas so you know in large cities we're running out of space in every

we're running out of space in every

we're running out of space in every single cup you know if every single kind

single cup you know if every single kind

single cup you know if every single kind so yes it is the intensive care units

so yes it is the intensive care units

so yes it is the intensive care units and it's the hospital wards and it's a

and it's the hospital wards and it's a

and it's the hospital wards and it's a space in the emergency department and

space in the emergency department and

space in the emergency department and you've seen these I think you've seen

you've seen these I think you've seen

you've seen these I think you've seen these pictures in in emergency medicine

these pictures in in emergency medicine

these pictures in in emergency medicine triage where people packed in there like

triage where people packed in there like

triage where people packed in there like sardines no doubt transmitting disease

sardines no doubt transmitting disease

sardines no doubt transmitting disease while they're waiting you know and so

while they're waiting you know and so

while they're waiting you know and so some hospitals are bumping out to large

some hospitals are bumping out to large

some hospitals are bumping out to large tents places where they can enforce try

tents places where they can enforce try

tents places where they can enforce try to enforce social distancing while

to enforce social distancing while

to enforce social distancing while people are waiting to be seen some of

people are waiting to be seen some of

people are waiting to be seen some of them very sick but there's also housing

them very sick but there's also housing

them very sick but there's also housing needs around health care so increasingly

needs around health care so increasingly

needs around health care so increasingly as we're seeing many many very static

as we're seeing many many very static

as we're seeing many many very static Ovid patients and particularly when you

Ovid patients and particularly when you

Ovid patients and particularly when you add in that layer of inadequate PPE our

add in that layer of inadequate PPE our

add in that layer of inadequate PPE our personal protective equipment um health

personal protective equipment um health

personal protective equipment um health care workers are not wanting to go home

care workers are not wanting to go home

care workers are not wanting to go home and that's a very reasonable thing to

and that's a very reasonable thing to

and that's a very reasonable thing to watch because we we want to we want to

watch because we we want to we want to

watch because we we want to we want to shield our families as we do this I mean

shield our families as we do this I mean

shield our families as we do this I mean a number of many many health care

a number of many many health care

a number of many many health care workers I know are sick and have to go

workers I know are sick and have to go

workers I know are sick and have to go into quarantine away from their families

into quarantine away from their families

into quarantine away from their families and so where do we do that I mean

and so where do we do that I mean

and so where do we do that I mean hospitals are only equipped to handle a

hospitals are only equipped to handle a

hospitals are only equipped to handle a very small handful of health care

very small handful of health care

very small handful of health care workers spending the night you know so

workers spending the night you know so

workers spending the night you know so you go into any hospital in a regular

you go into any hospital in a regular

you go into any hospital in a regular time in the

time in the

time in the they're empty at night and you just have

they're empty at night and you just have

they're empty at night and you just have a tiny handful of physicians who are

a tiny handful of physicians who are

a tiny handful of physicians who are required to stay in house overnight this

required to stay in house overnight this

required to stay in house overnight this is to sleep there you know between

is to sleep there you know between

is to sleep there you know between between daytime hours and so you'll have

between daytime hours and so you'll have

between daytime hours and so you'll have a couple of call rooms and now we have

a couple of call rooms and now we have

a couple of call rooms and now we have this this situation where a large

this this situation where a large

this this situation where a large portion of our healthcare staff does not

portion of our healthcare staff does not

portion of our healthcare staff does not want to go home in between and so we're

want to go home in between and so we're

want to go home in between and so we're getting really generous offers I mean in

getting really generous offers I mean in

getting really generous offers I mean in the in New York City for example the

the in New York City for example the

the in New York City for example the Four Seasons offered its hotel rooms up

Four Seasons offered its hotel rooms up

Four Seasons offered its hotel rooms up to up to health care workers who wanted

to up to health care workers who wanted

to up to health care workers who wanted to stay there to keep their families

to stay there to keep their families

to stay there to keep their families safe or to avoid the commute between

safe or to avoid the commute between

safe or to avoid the commute between shifts and that's great but you know

shifts and that's great but you know

shifts and that's great but you know most hospitals aren't lucky enough to be

most hospitals aren't lucky enough to be

most hospitals aren't lucky enough to be next door to a luxury hotel where they

next door to a luxury hotel where they

next door to a luxury hotel where they can spend a month and so how are we

can spend a month and so how are we

can spend a month and so how are we pumping out housing in addition to all

pumping out housing in addition to all

pumping out housing in addition to all the health care space we need and and so

the health care space we need and and so

the health care space we need and and so that's why I started working with this

that's why I started working with this

that's why I started working with this amazing team it's a project called Joop

amazing team it's a project called Joop

amazing team it's a project called Joop health and we're building three kinds of

health and we're building three kinds of

health and we're building three kinds of units as fast as we can so this this

units as fast as we can so this this

units as fast as we can so this this expanded housing for health care workers

expanded housing for health care workers

expanded housing for health care workers and actually for other people who have

and actually for other people who have

and actually for other people who have covin 19 or likely have codon koba 19

covin 19 or likely have codon koba 19

covin 19 or likely have codon koba 19 and cannot go back to their their living

and cannot go back to their their living

and cannot go back to their their living situation for whatever reasons so you

situation for whatever reasons so you

situation for whatever reasons so you think of people living in homeless

think of people living in homeless

think of people living in homeless shelters domestic violence shelters

shelters domestic violence shelters

shelters domestic violence shelters group homes nursing homes correctional

group homes nursing homes correctional

group homes nursing homes correctional facilities psychiatric units basically

facilities psychiatric units basically

facilities psychiatric units basically all these places that we're calling

all these places that we're calling

all these places that we're calling coronavirus traps because people are

coronavirus traps because people are

coronavirus traps because people are held in there there is no option for

held in there there is no option for

held in there there is no option for social distancing and the infection is

social distancing and the infection is

social distancing and the infection is spreading like wildfire fire unless we

spreading like wildfire fire unless we

spreading like wildfire fire unless we take known cases and actually pull them

take known cases and actually pull them

take known cases and actually pull them out so expanded housing can be used for

out so expanded housing can be used for

out so expanded housing can be used for any of those populations and then basic

any of those populations and then basic

any of those populations and then basic hospital beds and then and then actually

hospital beds and then and then actually

hospital beds and then and then actually these these mobile intensive care units

these these mobile intensive care units

these these mobile intensive care units that are being designed with

that are being designed with

that are being designed with architecture design teams engineering

architecture design teams engineering

architecture design teams engineering teams and a whole bunch of health

teams and a whole bunch of health

teams and a whole bunch of health professionals and also patients and

professionals and also patients and

professionals and also patients and patient advocates and we're trying to

patient advocates and we're trying to

patient advocates and we're trying to make a very functional space that can be

make a very functional space that can be

make a very functional space that can be shipped anywhere in the United States

shipped anywhere in the United States

shipped anywhere in the United States very quickly there are hospitals in

very quickly there are hospitals in

very quickly there are hospitals in remote areas that don't have hundreds of

remote areas that don't have hundreds of

remote areas that don't have hundreds of ICU beds that they can mobilize they

ICU beds that they can mobilize they

ICU beds that they can mobilize they might have two ICU

might have two ICU

might have two ICU but all of a sudden they're not able to

but all of a sudden they're not able to

but all of a sudden they're not able to transfer all the kovat patients that

transfer all the kovat patients that

transfer all the kovat patients that they need to take care of and so we want

they need to take care of and so we want

they need to take care of and so we want to see that their needs as well as we

to see that their needs as well as we

to see that their needs as well as we see that the needs of people and very

see that the needs of people and very

see that the needs of people and very densely populated areas that simply

densely populated areas that simply

densely populated areas that simply don't have room I mean I think the

don't have room I mean I think the

don't have room I mean I think the reality is we can't you know we can't

reality is we can't you know we can't

reality is we can't you know we can't run hospitals that have have endless

run hospitals that have have endless

run hospitals that have have endless capacity for surge I mean that's just

capacity for surge I mean that's just

capacity for surge I mean that's just not something that you can build and

not something that you can build and

not something that you can build and maintain so what are creative ways we

maintain so what are creative ways we

maintain so what are creative ways we can we can do this we can create very

can we can do this we can create very

can we can do this we can create very deployable extra space not just for this

deployable extra space not just for this

deployable extra space not just for this crisis but but for every single other

crisis but but for every single other

crisis but but for every single other one that we face moving forward and you

one that we face moving forward and you

one that we face moving forward and you know when you think about these needs

know when you think about these needs

know when you think about these needs for health workers and and just for the

for health workers and and just for the

for health workers and and just for the broader community you know how much of

broader community you know how much of

broader community you know how much of this is on the government and I you know

this is on the government and I you know

this is on the government and I you know and I'm curious to hear I guess what you

and I'm curious to hear I guess what you

and I'm curious to hear I guess what you feel like in thinking about this crisis

feel like in thinking about this crisis

feel like in thinking about this crisis what the government has getting right

what the government has getting right

what the government has getting right both on the federal state level and then

both on the federal state level and then

both on the federal state level and then what are some of the areas that really

what are some of the areas that really

what are some of the areas that really still need more attention yeah I mean I

still need more attention yeah I mean I

still need more attention yeah I mean I I think it's pretty fair to say that the

I think it's pretty fair to say that the

I think it's pretty fair to say that the government response as a whole has been

government response as a whole has been

government response as a whole has been disappointing

disappointing

disappointing the biggest tragedy is that when that's

the biggest tragedy is that when that's

the biggest tragedy is that when that's those first cases came in the United

those first cases came in the United

those first cases came in the United States that we didn't get on top of the

States that we didn't get on top of the

States that we didn't get on top of the testing that day not even that day the

testing that day not even that day the

testing that day not even that day the month before when we knew that this was

month before when we knew that this was

month before when we knew that this was starting to spread and it was clear this

starting to spread and it was clear this

starting to spread and it was clear this was going to be a global pandemic it

was going to be a global pandemic it

was going to be a global pandemic it really I find it hard to even think

really I find it hard to even think

really I find it hard to even think about because I it's so upsetting that

about because I it's so upsetting that

about because I it's so upsetting that we didn't just roll out testing encase

we didn't just roll out testing encase

we didn't just roll out testing encase and contact identification very

and contact identification very

and contact identification very assertively from the beginning I mean

assertively from the beginning I mean

assertively from the beginning I mean that was the difference between what

that was the difference between what

that was the difference between what will ultimately be hundreds of thousands

will ultimately be hundreds of thousands

will ultimately be hundreds of thousands of lives lost and and and having saved

of lives lost and and and having saved

of lives lost and and and having saved all those lives will be that early thing

all those lives will be that early thing

all those lives will be that early thing and you know you're psychologically it's

and you know you're psychologically it's

and you know you're psychologically it's so bad to dwell I'm trying not to dwell

so bad to dwell I'm trying not to dwell

so bad to dwell I'm trying not to dwell on that first mistake but and really

on that first mistake but and really

on that first mistake but and really just kind of move forward and say okay

just kind of move forward and say okay

just kind of move forward and say okay how do we avoid that that that

how do we avoid that that that

how do we avoid that that that and that's kind of been where I'm trying

and that's kind of been where I'm trying

and that's kind of been where I'm trying to push the conversation like okay

to push the conversation like okay

to push the conversation like okay what's the next thing you know it's like

what's the next thing you know it's like

what's the next thing you know it's like okay we're kind of got behind testing we

okay we're kind of got behind testing we

okay we're kind of got behind testing we still aren't where we need to be with

still aren't where we need to be with

still aren't where we need to be with testing but then then what you know what

testing but then then what you know what

testing but then then what you know what are the other containment measures and

are the other containment measures and

are the other containment measures and then when we get to the you know

then when we get to the you know

then when we get to the you know downstream to the treatment everything's

downstream to the treatment everything's

downstream to the treatment everything's really about containment and then

really about containment and then

really about containment and then treatment capacity and I I think

treatment capacity and I I think

treatment capacity and I I think containment is where I really wanted to

containment is where I really wanted to

containment is where I really wanted to focus and then it was like okay well we

focus and then it was like okay well we

focus and then it was like okay well we because we failed in containment we

because we failed in containment we

because we failed in containment we better shift quickly and think about

better shift quickly and think about

better shift quickly and think about here escalation so how do we expand our

here escalation so how do we expand our

here escalation so how do we expand our care capacity and it's sad to me that's

care capacity and it's sad to me that's

care capacity and it's sad to me that's that's where I need to be but since

that's where I need to be but since

that's where I need to be but since we're going to be doing large-scale care

we're going to be doing large-scale care

we're going to be doing large-scale care what are all the little gaps that we

what are all the little gaps that we

what are all the little gaps that we need to fill so and I think the really

need to fill so and I think the really

need to fill so and I think the really hard thing I mean I've been involved in

hard thing I mean I've been involved in

hard thing I mean I've been involved in in these organizations to try to improve

in these organizations to try to improve

in these organizations to try to improve our PPE supply and the and I can you

our PPE supply and the and I can you

our PPE supply and the and I can you know we're all so many hundreds of

know we're all so many hundreds of

know we're all so many hundreds of thousands of people are involved in this

thousands of people are involved in this

thousands of people are involved in this and and I think we're able to boost

and and I think we're able to boost

and and I think we're able to boost supply here and there and and have have

supply here and there and and have have

supply here and there and and have have some successes but what we can't do what

some successes but what we can't do what

some successes but what we can't do what is very hard to do on the grassroots

is very hard to do on the grassroots

is very hard to do on the grassroots level is to centralize our understanding

level is to centralize our understanding

level is to centralize our understanding of the problem I mean there should be in

of the problem I mean there should be in

of the problem I mean there should be in an ideal world a national command center

an ideal world a national command center

an ideal world a national command center that has its fingers on the pulse across

that has its fingers on the pulse across

that has its fingers on the pulse across all 50 states that knows where are all

all 50 states that knows where are all

all 50 states that knows where are all of our hospitals and health systems and

of our hospitals and health systems and

of our hospitals and health systems and clinics what are their patient caseloads

clinics what are their patient caseloads

clinics what are their patient caseloads like and what do they need of every

like and what do they need of every

like and what do they need of every single resource whether it's human

single resource whether it's human

single resource whether it's human resources or or these concrete sees

resources or or these concrete sees

resources or or these concrete sees these recent these supply resources and

these recent these supply resources and

these recent these supply resources and then understands the national supply and

then understands the national supply and

then understands the national supply and can divert resources exactly where they

can divert resources exactly where they

can divert resources exactly where they need to go at the exact right time

need to go at the exact right time

need to go at the exact right time including identifying places that are

including identifying places that are

including identifying places that are getting over the you know the surge and

getting over the you know the surge and

getting over the you know the surge and are able to reallocate to other places

are able to reallocate to other places

are able to reallocate to other places where they're just entering their surge

where they're just entering their surge

where they're just entering their surge so that kind of centralized national

so that kind of centralized national

so that kind of centralized national coordinating role is something that

coordinating role is something that

coordinating role is something that we're really missing here

we're really missing here

we're really missing here and I think not only does it make it

and I think not only does it make it

and I think not only does it make it hard for all of us to get the resources

hard for all of us to get the resources

hard for all of us to get the resources we need but there's real equity issues

we need but there's real equity issues

we need but there's real equity issues here I

here I

here I worried all the time about who is

worried all the time about who is

worried all the time about who is getting the limited resources it's

getting the limited resources it's

getting the limited resources it's probably they're really enriched out

probably they're really enriched out

probably they're really enriched out systems that have a lot of political

systems that have a lot of political

systems that have a lot of political power in their communities and you know

power in their communities and you know

power in their communities and you know have already we're kind of well

have already we're kind of well

have already we're kind of well resourced going in they're likely to get

resourced going in they're likely to get

resourced going in they're likely to get more and smaller and less resource

more and smaller and less resource

more and smaller and less resource places are simply not going to get the

places are simply not going to get the

places are simply not going to get the attention the political will the the

attention the political will the the

attention the political will the the voice do to get what they need and that

voice do to get what they need and that

voice do to get what they need and that affects their their communities and so

affects their their communities and so

affects their their communities and so there's there's huge inequities that are

there's there's huge inequities that are

there's there's huge inequities that are going to be doubled down because we

going to be doubled down because we

going to be doubled down because we don't have a coordinated system that

don't have a coordinated system that

don't have a coordinated system that that has some you know some structure in

that has some you know some structure in

that has some you know some structure in place to make sure these decisions and

place to make sure these decisions and

place to make sure these decisions and resources are equitably made Helen has

resources are equitably made Helen has

resources are equitably made Helen has some got some more questions from online

some got some more questions from online

some got some more questions from online I do I have overweening love for you and

I do I have overweening love for you and

I do I have overweening love for you and gratitude but everything that you're

gratitude but everything that you're

gratitude but everything that you're doing and I have some questions too so

doing and I have some questions too so

doing and I have some questions too so one is someone has five and ninety five

one is someone has five and ninety five

one is someone has five and ninety five masks they want to donate them but

masks they want to donate them but

masks they want to donate them but they're not quite sure how to do that

they're not quite sure how to do that

they're not quite sure how to do that how how can how can they help how can

how how can how can they help how can

how how can how can they help how can they get those masks to you or to your

they get those masks to you or to your

they get those masks to you or to your colleagues thank you

colleagues thank you

colleagues thank you so most hospitals have listed drop-off

so most hospitals have listed drop-off

so most hospitals have listed drop-off locations for n95 and ours and actually

locations for n95 and ours and actually

locations for n95 and ours and actually have built methods for people to be able

have built methods for people to be able

have built methods for people to be able to drive by not get out of your car and

to drive by not get out of your car and

to drive by not get out of your car and risk yourself by coming into a health

risk yourself by coming into a health

risk yourself by coming into a health care center but to be able to do it on

care center but to be able to do it on

care center but to be able to do it on the outside with minimal contact and so

the outside with minimal contact and so

the outside with minimal contact and so I would encourage you to to either call

I would encourage you to to either call

I would encourage you to to either call your local hospital or health system

your local hospital or health system

your local hospital or health system almost everybody has a kovat hotline set

almost everybody has a kovat hotline set

almost everybody has a kovat hotline set up or the hospital operator can divert

up or the hospital operator can divert

up or the hospital operator can divert you to it also if you go on some of

you to it also if you go on some of

you to it also if you go on some of these coordinating websites the one I'm

these coordinating websites the one I'm

these coordinating websites the one I'm involved with is called get us PPE org

involved with is called get us PPE org

involved with is called get us PPE org we have by state a sorted list of

we have by state a sorted list of

we have by state a sorted list of hospitals that are accepting PPE

hospitals that are accepting PPE

hospitals that are accepting PPE donations including the address and

donations including the address and

donations including the address and hours of drop-off so you can go right

hours of drop-off so you can go right

hours of drop-off so you can go right there and hopefully find one that's

there and hopefully find one that's

there and hopefully find one that's close to you and then this is arguably a

close to you and then this is arguably a

close to you and then this is arguably a more personal question so apologies in

more personal question so apologies in

more personal question so apologies in advance but we've seen a really shocking

advance but we've seen a really shocking

advance but we've seen a really shocking rise in anti-asian discrimination

rise in anti-asian discrimination

rise in anti-asian discrimination through this and I just wonder what

through this and I just wonder what

through this and I just wonder what message you have for pew

message you have for pew

message you have for pew or who are turning inwards or who are

or who are turning inwards or who are

or who are turning inwards or who are allowing their fear and anger to turn

allowing their fear and anger to turn

allowing their fear and anger to turn outwards to another to another group if

outwards to another to another group if

outwards to another to another group if you have any words of wisdom on that

you have any words of wisdom on that

you have any words of wisdom on that yeah this is this is another one of

yeah this is this is another one of

yeah this is this is another one of those collateral damage pieces that is

those collateral damage pieces that is

those collateral damage pieces that is so disturbing with this virus I mean the

so disturbing with this virus I mean the

so disturbing with this virus I mean the virus from the minute we were aware of

virus from the minute we were aware of

virus from the minute we were aware of it came along with racism and hatred and

it came along with racism and hatred and

it came along with racism and hatred and I am a part of many Asian American

I am a part of many Asian American

I am a part of many Asian American communities and I mean the stories are

communities and I mean the stories are

communities and I mean the stories are not mine to tell but I will tell you

not mine to tell but I will tell you

not mine to tell but I will tell you that people have had very harrowing

that people have had very harrowing

that people have had very harrowing harrowing experiences directed at them

harrowing experiences directed at them

harrowing experiences directed at them and that their young children that are

and that their young children that are

and that their young children that are clearly linked to fear of kovat 19

clearly linked to fear of kovat 19

clearly linked to fear of kovat 19 because you know people will explicitly

because you know people will explicitly

because you know people will explicitly say things that that relate to the virus

say things that that relate to the virus

say things that that relate to the virus and and why they're people brought it

and and why they're people brought it

and and why they're people brought it into this country and it's a it's a

into this country and it's a it's a

into this country and it's a it's a terrible time and I don't know what

terrible time and I don't know what

terrible time and I don't know what advice I have except that we should all

advice I have except that we should all

advice I have except that we should all be aware that it's happening I have a

be aware that it's happening I have a

be aware that it's happening I have a number of friends who said I didn't see

number of friends who said I didn't see

number of friends who said I didn't see it until you pointed it out and now it's

it until you pointed it out and now it's

it until you pointed it out and now it's it's terribly obvious and so I think we

it's terribly obvious and so I think we

it's terribly obvious and so I think we all I think just acknowledging it when

all I think just acknowledging it when

all I think just acknowledging it when you see it even though you're not the

you see it even though you're not the

you see it even though you're not the target of it being really explicit that

target of it being really explicit that

target of it being really explicit that this is not acceptable right now I think

this is not acceptable right now I think

this is not acceptable right now I think people being the best allies they can be

people being the best allies they can be

people being the best allies they can be because very hard in the moment when

because very hard in the moment when

because very hard in the moment when you're experiencing that kind of racism

you're experiencing that kind of racism

you're experiencing that kind of racism to stand up for yourself or for your

to stand up for yourself or for your

to stand up for yourself or for your family members so I think this is one of

family members so I think this is one of

family members so I think this is one of those times where we really need people

those times where we really need people

those times where we really need people to call it out and to tamp it down

to call it out and to tamp it down

to call it out and to tamp it down quickly where they see it happening well

quickly where they see it happening well

quickly where they see it happening well sit I mean it's at this point of

sit I mean it's at this point of

sit I mean it's at this point of collateral damage I know that you've

collateral damage I know that you've

collateral damage I know that you've also talked to about some of the other

also talked to about some of the other

also talked to about some of the other downstream medical effects that you've

downstream medical effects that you've

downstream medical effects that you've seen that are not even connected to

seen that are not even connected to

seen that are not even connected to people contracted the virus at all you

people contracted the virus at all you

people contracted the virus at all you know you've talked about domestic

know you've talked about domestic

know you've talked about domestic violence and I'd love to hear you I

violence and I'd love to hear you I

violence and I'd love to hear you I guess address that a little bit more

guess address that a little bit more

guess address that a little bit more just what what are you seeing as it

just what what are you seeing as it

just what what are you seeing as it relates to those sorts of issues yeah

relates to those sorts of issues yeah

relates to those sorts of issues yeah this is one thing that's again been

this is one thing that's again been

this is one thing that's again been traveling around my community my online

traveling around my community my online

traveling around my community my online communities of physicians and nurse

communities of physicians and nurse

communities of physicians and nurse is and this is only anecdotal now I

is and this is only anecdotal now I

is and this is only anecdotal now I don't have the data but I think it will

don't have the data but I think it will

don't have the data but I think it will come as we as we look back but when you

come as we as we look back but when you

come as we as we look back but when you put people into their homes 24/7 and and

put people into their homes 24/7 and and

put people into their homes 24/7 and and when you do that in a very economically

when you do that in a very economically

when you do that in a very economically stressful time where people are losing

stressful time where people are losing

stressful time where people are losing their jobs and feeling a lot of stress

their jobs and feeling a lot of stress

their jobs and feeling a lot of stress about just getting meals on the table I

about just getting meals on the table I

about just getting meals on the table I mean that is a setting in which in which

mean that is a setting in which in which

mean that is a setting in which in which family violence child abuse into their

family violence child abuse into their

family violence child abuse into their partner violence will increase and we're

partner violence will increase and we're

partner violence will increase and we're seeing that in the hospital I mean I've

seeing that in the hospital I mean I've

seeing that in the hospital I mean I've seen a number of cases where people fled

seen a number of cases where people fled

seen a number of cases where people fled to the hospital because their home was

to the hospital because their home was

to the hospital because their home was simply not safe and became abruptly more

simply not safe and became abruptly more

simply not safe and became abruptly more not safe because of stay at home orders

not safe because of stay at home orders

not safe because of stay at home orders I've seen young children harmed because

I've seen young children harmed because

I've seen young children harmed because in their regular lives they could escape

in their regular lives they could escape

in their regular lives they could escape to school for a good chunk of the day or

to school for a good chunk of the day or

to school for a good chunk of the day or they had these extended communities of

they had these extended communities of

they had these extended communities of family members and friends floating

family members and friends floating

family members and friends floating around and then stay at home orders went

around and then stay at home orders went

around and then stay at home orders went to place and everybody retreated into

to place and everybody retreated into

to place and everybody retreated into their homes and there was no that

their homes and there was no that

their homes and there was no that barrier that always was the difference

barrier that always was the difference

barrier that always was the difference between safety and harm was suddenly

between safety and harm was suddenly

between safety and harm was suddenly removed and family violence went up and

removed and family violence went up and

removed and family violence went up and and truly I mean I am a violence

and truly I mean I am a violence

and truly I mean I am a violence researcher I'm always very attuned to

researcher I'm always very attuned to

researcher I'm always very attuned to the patients who come in who are

the patients who come in who are

the patients who come in who are experiencing violence and I have never

experiencing violence and I have never

experiencing violence and I have never seen anything like this before and and I

seen anything like this before and and I

seen anything like this before and and I think you will never attach a cope of 19

think you will never attach a cope of 19

think you will never attach a cope of 19 diagnosis to this know no review of

diagnosis to this know no review of

diagnosis to this know no review of medical records may really may really

medical records may really may really

medical records may really may really attach this to cope in nineteen but I

attach this to cope in nineteen but I

attach this to cope in nineteen but I consider this a very a very sad part of

consider this a very a very sad part of

consider this a very a very sad part of the collateral damage that's happening

the collateral damage that's happening

the collateral damage that's happening directly because of this disease

and you know as we wrap up here I think

and you know as we wrap up here I think

and you know as we wrap up here I think I'm sure that this is something that a

I'm sure that this is something that a

I'm sure that this is something that a lot of folks out there are thinking

lot of folks out there are thinking

lot of folks out there are thinking about too is just you know what is I

about too is just you know what is I

about too is just you know what is I guess the the big takeaway what are the

guess the the big takeaway what are the

guess the the big takeaway what are the the big things that we should know that

the big things that we should know that

the big things that we should know that we should do the ensure that we can get

we should do the ensure that we can get

we should do the ensure that we can get to what is whatever the best case

to what is whatever the best case

to what is whatever the best case scenario is at this point yeah well I

scenario is at this point yeah well I

scenario is at this point yeah well I would say to to give people a measure of

would say to to give people a measure of

would say to to give people a measure of hope and optimism your little actions

hope and optimism your little actions

hope and optimism your little actions are working so I know there's nothing

are working so I know there's nothing

are working so I know there's nothing glamorous about do nothing and

glamorous about do nothing and

glamorous about do nothing and at home and I am so acutely aware of how

at home and I am so acutely aware of how

at home and I am so acutely aware of how much people are sacrificing I mean

much people are sacrificing I mean

much people are sacrificing I mean people are they're sacrificing their

people are they're sacrificing their

people are they're sacrificing their businesses their livelihood people who

businesses their livelihood people who

businesses their livelihood people who are just on the edge of being a feeling

are just on the edge of being a feeling

are just on the edge of being a feeling financially secure are just giving it

financially secure are just giving it

financially secure are just giving it all up to stay at home you couldn't ask

all up to stay at home you couldn't ask

all up to stay at home you couldn't ask for a bigger sacrifice and yet those

for a bigger sacrifice and yet those

for a bigger sacrifice and yet those things are working look at what's

things are working look at what's

things are working look at what's happening in Ohio in Oregon in other

happening in Ohio in Oregon in other

happening in Ohio in Oregon in other states where we're really able to get

states where we're really able to get

states where we're really able to get ahead of this we are protecting

ahead of this we are protecting

ahead of this we are protecting ourselves our family members and also

ourselves our family members and also

ourselves our family members and also importantly our really vulnerable

importantly our really vulnerable

importantly our really vulnerable members of society are our older

members of society are our older

members of society are our older citizens by doing these things and doing

citizens by doing these things and doing

citizens by doing these things and doing that sacrifice so I think while we're

that sacrifice so I think while we're

that sacrifice so I think while we're going through some really really tough

going through some really really tough

going through some really really tough times in these hardest hit cities what

times in these hardest hit cities what

times in these hardest hit cities what we're what everyday people are doing in

we're what everyday people are doing in

we're what everyday people are doing in response is really working so I think it

response is really working so I think it

response is really working so I think it can feel futile I think sometimes to

can feel futile I think sometimes to

can feel futile I think sometimes to just kind of sit quietly and do your

just kind of sit quietly and do your

just kind of sit quietly and do your social distancing thing and nobody you

social distancing thing and nobody you

social distancing thing and nobody you know there's no glory in that and it's

know there's no glory in that and it's

know there's no glory in that and it's also can be incredibly boring I'm

also can be incredibly boring I'm

also can be incredibly boring I'm learning looking online and seeing how

learning looking online and seeing how

learning looking online and seeing how creative people are getting with their

creative people are getting with their

creative people are getting with their dance moves and their bread recipes but

dance moves and their bread recipes but

dance moves and their bread recipes but it really is also heroic work and it is

it really is also heroic work and it is

it really is also heroic work and it is saving lives for sure so thank you to

saving lives for sure so thank you to

saving lives for sure so thank you to everybody for for that simple act it's

everybody for for that simple act it's

everybody for for that simple act it's making everything better well thank you

making everything better well thank you

making everything better well thank you dr. chu I think I speak for everyone and

dr. chu I think I speak for everyone and

dr. chu I think I speak for everyone and how how much we appreciate you coming

how how much we appreciate you coming

how how much we appreciate you coming spending time with us today

spending time with us today

spending time with us today sharing your experiences and your wisdom

sharing your experiences and your wisdom

sharing your experiences and your wisdom and knowledge Helen did you have any

and knowledge Helen did you have any

and knowledge Helen did you have any last things that you wanted to share

last things that you wanted to share

last things that you wanted to share only that it's kind of you to try and

only that it's kind of you to try and

only that it's kind of you to try and deflect but we all know who the heroes

deflect but we all know who the heroes

deflect but we all know who the heroes are around here and it's it's pretty

are around here and it's it's pretty

are around here and it's it's pretty okay to be able to sit on the sofa and

okay to be able to sit on the sofa and

okay to be able to sit on the sofa and watch TV so thank you for everything

watch TV so thank you for everything

watch TV so thank you for everything that you're doing and just the deepest

that you're doing and just the deepest

that you're doing and just the deepest appreciation and gratitude from

appreciation and gratitude from

appreciation and gratitude from everybody who's been watching from

everybody who's been watching from

everybody who's been watching from everyone its head in from hell I'll

everyone its head in from hell I'll

everyone its head in from hell I'll speak for everyone in the world thank

speak for everyone in the world thank

speak for everyone in the world thank you so much thank you dr. chu