Facebook Live 7/22- Answers

Hi everybody, we’re going to do some updates today on COVID in general. Let’s talk about where we are today. We have to talk about schools. I want to start talking about Virginia and where we are now. As you know, this data situation frustrates me a lot because we have decisions like whether or not to open schools, using data that is not the right data to make those decisions. It makes it really frustrating and it’s where we are today. The public reviews everything, whether or not they have the data and tools to process that information. As we start off talking, I just want to review Virginia because we got a couple of questions.


Let’s start with where we are. Looking at the population of people who are 50 and under, that’s everyone 50 and under, whether they have preexisting conditions or not. Looking at that, looking at all the positive tests done in Virginia, which are over 80,000, we’ve had over a million overall tests done, 64% of those tests that came back are those 50 and younger. The number of people who have been hospitalized are 7,351 total, 29% of those hospitalized are 50 and under. Already, your risk of getting the virus and being hospitalized if you’re 50 and under is significantly reduced because 64% of the tests are in that age group, but only 29% of the hospitalizations. Of all the deaths in Virginia, only 3.7% are anyone under the age of 50. You have 64% of all the positive tests, and only 3.7% of the deaths. What does that mean? That means that getting the virus does not have the same prognosis or risk depending on your age group, that is the biggest variable. So when we start sorting out how anxious you need to be about whether or not you get the virus, what you’re really asking is how anxious you need to be because if you get the virus if you’re going to be sick. Odds are, if you’re under 50 and you get sick, your risks are very small. I think we could identify even more specifically those in that category if the data that was available that was able to process had more specificity, like if there are comorbidities or other risk factors for those 50 and under who get sick and die. Statistically, most of the time that is true. All the rules have an exception.


In medicine when we look at data, we differentiate between data that is collected that can be applied, and data that has a high level of validity because it’s been blinded and highly randomized, versus anecdotal experience. Anecdotal experience is a personal experience you have that frames your point of reference, but when you hold it up to a statistical analysis, it is an exception to the rule, and not necessarily the rule itself. In medicine, we’re very disciplined in deciding the data because your bias and your emotion can reframe your perspective and your ability to make a good and sound decision. That is what is happening right now, and I think some of it is intentional from the media, and some of it is from different reporting agencies with different aspects of agencies of the state.


I think that it is human nature to look for data that supports your narrative. That is one of the things that I have found is so important. One of the disciplines you have to have with data is that you have to have data that conflicts with what you think is accurate. It’s just like the old scientific method: you have a hypothesis, you state what your biases are when you’re looking at evaluating whether or not your hypothesis is true, but you look at everything, and if you’re wrong, you admit it. I don’t think that’s happening. When you have data that curtails the narrative in the media, it’s not being reported because it’s not comfortable for them to look at.


We’ve gone over all of that, and a few other things to look at. I went and looked up typical ICU occupancy and what we’re looking at. The latest data I could find was from the NIH from 2013, and when we looked at that, ICU occupancy, depending on whether you were public or private, a university or not, profit or nonprofit, organization varied between 57% and 82% occupancy. What I look at right now, what we’re looking at is hospital occupancy across the country right now, none of them are over 80% occupancy. The ICU capacity is fully available. In Virginia, we are currently using 21% of our ventilators. We are at 76% ICU occupancy rate, that is absolutely normal. I think we need to point that out as we drill down on some of this data. What I have asked the Virginia Hospital Association, and VDH to report is we need to differentiate between the number of people who are in the hospital with a COVID positive test, and the number of people who are in the hospital being treated for COVID. Those are two different groups. There are people being hospitalized now for other things, like minor surgeries that were put off when hospitals were closed. They are COVID positive, when you look at the VHHA website, all they are reporting are the people who are in the hospital with a positive COVID test, but that’s not really evidence that we have someone in the hospital who is sick with COVID, and I think that is an important differentiating factor.


We have Virginia ICU occupancy right now at 76%, that is average and normal, with an ICU ventilator utilization rate of 21%. That is all the information to give you perspective on the data, and where the data falls short. We are asking the Department of Health to report new positives with relevant demographic information. If we find that almost all of the new positives are in an age group that have an incredibly low risk, I think any epidemiological model I’ve seen, even looking at Washington State information, hypothesizes that there will be an increasing number of positive tests, but the question is whether people are getting sick. We can’t really analyze the data because we don’t have the answers, because they’re not asking the right questions.


That is just a little review of the data on that. We have the graph that we’ll put on the website that goes over where these states are that seem to have upticks in hospitalizations, deaths and positive tests, so we can track that the best we can. You’ll see that none of them exceed what we’re talking about in that study from NIH in 2013.


We also need to talk about schools, because there have been some changes. Many of the localities are coming up with a virtual only option. I spoke with the Superintendent for Henrico on Tuesday when I saw that was the recommendation. I’ll be frank with you, she is extraordinarily frustrated. She is trying to figure out a solution because she is committed to getting kids back to school 5 days a week. The problem is, we’ve talked about this before, the guidelines the state sent down are so complicated that school boards can’t find a way forward. She pointed out to me a number of issues that have created that vice for her. One is that the information from the state came very late. They are preparing for school and making decisions, they need time when they decide to change how they do everything.


The second thing is information from the state is so completely unclear, instead of saying that we want you to find safe guidelines and ways for students and teachers to safely return to school, and we want you to build that system that ensures that so we can make sure that happens, the state gave an enormous number of guidelines that are in conflict with the guidelines published by the American Academy of Pediatrics and the CDC, and the school boards have been completely befuddled trying to sort through that information, and information that is quite frankly misinformation. The bottom line is that they didn’t have enough time to develop the policies and procedures, and the focus has been on compliance. They were focused on complying with the recommendations instead of focusing on figuring out a way to open 5 days a week. The wrong question was answered, the wrong issue was identified to be solved, and the result is that we have a solution that doesn’t really fix the problem, which is we have a lot of kids who need to be in school this fall. I just wanted to put that shout out because I want you to know what your school boards are trying to deal with, this is most profoundly a failure at the state level.


Now we have to pivot, and we need to figure out what we need to do to make this work for families going forward. I have had so many families and advocates and groups reach out to me over the last 2 days. There is a public hearing, not everybody will be able to speak, but there is a lot of chatter about this on Facebook. This is on Thursday for the school boards, so if you want to express your opinion, that is the way to go and let them know what you think. Keep in the mind the unsolvable riddle they’ve been given.


Now we have to figure out what we have to do for everybody going forward to make sure that families who need brick and mortar schools can get that. We will have to come up with a lot of solutions that are creative, and I think this is what schools could have done to create opportunities for kids who need to be in school. You know that, you’ve seen the American Academy of Pediatrics, it’s more risky for kids in Virginia, maybe all, to be home than to be in school looking at their medical analysis of getting COVID versus their medical analysis of the risk of not being in school. They are subject matter experts.


How do we modify? We’ve got a lot of community groups who are talking about pods. They’re talking about hiring teachers so they have direct interactions with their kids and teachers in their neighborhoods for small groups. That’s going to come with all the risks of being in school without necessarily the appropriate checks and balances. Families are going to have to adapt and modify however they can. I think there are ways the state can help make a difference, we’ve already talked about what we can do on funding for schools to take on the additional expense of opening and cleaning and setting up appropriate policies. Now that that is not going to happen, I do think we have to keep that in the wings for when schools do open, but I do think there are things we can do. Parents are going to need a tax credit because instead of having public schools where kids have a safe place to go, they’re going to have someone else watch their children or watch them themselves. I’m going to be proposing a tax credit, I think we also need to be looking at supporting people who are at the lower end of the financial opportunity scale in Virginia. We need to have earned income tax credits for those individuals because they may not get tax credits that offset the tax credits for daycare. We have to look for places that have daycare that are subsidized by the state. Oftentimes those places require copays, I think we’re going to have to waive those copays. We’re going to have to offer grants.


We have to remember when we’re talking about early childhood education alone, which is something I’ve advocated for and copatroned the legislation for to make sure kids have the valuable education they need to start school and to go into kindergarten and succeed. We know that is a strained workforce. Those individuals don’t get paid a lot of money to do a really important job of educating our kids. They’ve been essential workers, 60% of those daycares have been open the entire time and those individuals have been going to work every day. We’ve had one outbreak that we’ve talked about before which is not to say we haven’t had positives, we’ve only had one outbreak. The burden on that system is now going to become even more intense and immense, and we need to support that system. We need to find a way to get grants to those childcare centers, especially the preschool centers, but also centers that are going to be taking care of children during the day, so that they can actually provide the services we’re going to need.


What’s really happening here? We’re not going to have kids in school learning. We’re not going to have all the resources that we’ve invested in building our school programs, so we’re going to have kids learning somewhere else. They may be able to learn at home with their families if they have amazing home resources. But then the other option is that there is a surrogate who is going to be there instead. These children are going to have a surrogate there to support their learning while they learn virtually with their teachers. Instead of our teachers, somebody is going to be there with our kids. We now have to pivot and find a way to support that, but I don’t know how that is going to work.


Constitutionally, Virginia has an obligation to offer a free, quality education in Virginia, that says school, not virtual. You know I support virtual education. I want anybody who needs it to have it, I’ve advocated for it and supported legislation for it the past 4 years in the Senate. We’ve passed it in the Senate all of those 4 years. The problem is you can’t have virtual alone. Virtual is a great asset and adjunct but schools support numerous other assets for our kids besides the curriculum. How are we going to support families and support other industries in our community working to fill this void? We’re going to have to do this with money in the legislature. I’m going to be proposing that legislation when we go back to special session because this is a COVID related crisis that is happening now because schools cannot open because of the mandates that were handed down by the state with the wrong sense of direction. Those are pieces of legislation I’m going to be carrying. We’ve talked about limited immunity for COVID, people will get sick. Schools and childcare services can’t control that. The bottom line is there needs to be some immunity because we can’t let the additional burden of litigation be placed on these individuals who are trying to get care for our kids.


We have to talk about vouchers. We have to have a real conversation. If a free education is going to be required by our constitution, the money allocated to education may have to be reallocated to parents so they can get a brick and mortar education because that is not being offered in a lot of places. These are all things that are going to have to be discussed at special session. You’re going to see a lot of conversations about budget because we have new revenues. We’re very fortunate that the outcome and revenues were not as severe as we thought. We still need some information back on that. We’ll have to see where we stand. Any way we look at this there are going to have to be cuts, but they won't have to be as severe as we thought. The issue is we’re going to have to redirect a lot of other money to cover ongoing costs that we’ve talked about. We’re going to have to have a robust conversation about policing, and what needs to be done. You’re going to hear a conversation there. We’re going to talk about COVID and about the budget. That’s what we’re expecting at the special session, that’s coming up in August. Reach out to your legislators, this is the time for your voice to be heard.


I will not be doing a Facebook Live next week. My oldest son is getting married August 1st, and we are going to be with family that whole week, so I am taking that week off. But my office will be there to answer your questions.




PAID FOR AND AUTHORIZED BY FRIENDS OF SIOBHAN DUNNAVANT

Dr. Siobhan Dunnavant
Office:

804-698-7512
Email Me 
Mailing Address:
PO Box 70849
Henrico, VA 23255

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