THANK YOU FOR JOINING TODAY'S
LISTENING SESSION HOSTED BY THE
NIH RESEARCHING COVID TO ENHANCE
RECOVERY INITIATIVE ALSO KNOWN
AS RECOVER.
THIS EVENT IS BEING RECORDED AND
ALL PARTICIPANTS HAVE BEEN
MUTED.
BEFORE WE BEGIN WE'LL SHARE A
FEW HOUSEKEEPING NOTES.
AS A PARTICIPANT YOU'LL HAVE THE
ABILITY TO UNMUTE YOURSELF AND
TURN ON YOUR CAMERA AND VIEW
PARTICIPANTS AND PARTICIPATE IN
THE CHAT.
WHEN WE GET TO THE DISCUSSION
PORTION OF TODAY'S AGENDA WE'LL
ENCOURAGE YOU TO TURN YOUR
CAMERA ON TO ENGAGE IN THE
DISCUSSION AND YOU'RE WELCOME TO
TYPE IN THE CHAT PANEL.
DURING THE Q&A AND DISCUSSION,
WE WILL ASK YOU VIRTUALLY RAISE
YOUR HAND TO SPEAK.
YOU CAN DO SO BY CLICKING ON THE
REACTION BUTTON AND THEN RAISE
HAND.
ONE OF THE HOSTS WILL THEN
INVITE TO YOU UNMUTE YOURSELF.
FINALLY, WE ENCOURAGE EVERYONE
TO CHANGE YOUR NAME AS IT
APPEARS IN ZOOM IN ORDER TO ADD
YOUR ORGANIZATION AND LOCATION.
TO CHANGE YOUR NAME, YOU CAN
CLICK ON PARTICIPANTS, THEN
MORE, RENAME AND THEN FROM THERE
YOU CAN CHANGE YOUR NAME.
THANK YOU ALL AND NOW I WILL
TURN IT OVER TO DR. WILLIAMS TO
INTRODUCE TODAY'S SPEAKERS.
>> GOOD AFTERNOON.
THANK YOU FOR JOINING US FOR
TODAY'S LISTENING SESSION FOR
THE NIH RESEARCHING COVID TO
ENHANCE RECOVERY INITIATIVE ALSO
CALLED NIN -- NIH RECOVER.
I'M NASA TASHA WILLIAMS FOR THE
INSTITUTE FOR EXCELLENCE AND
HEALTH EQUITY AND THE LEAD FOR
THE CLINICAL SCIENCE CORPS.
I'M REALLY HAP TO BE HERE WITH
YOU ALL TODAY AND I AM ONE OF
THE CO-HOSTS FOR THE SESSION.
TODAY'S SESSION IS THE SECOND IN
A SERIES OF DISCUSSIONS TO HEAR
FROM PATIENT, COMMUNITY AND
OTHERS AFFECTED BY POST-ACUTE
SEQUELAE OF SARS COV2 OR PASC
INCLUDING LONG COVID.
IN THIS CASE WE ARE SPECIFICALLY
INTERESTED IN HOW LONG COVID IS
AFFECTING BLACK AND INDIGENOUS
COMMUNITIES OF COLOR.
RECOGNIZING COMMUNITIES OF COLOR
ARE DISPROPORTIONATELY AFFECTED
BY COVID-19 AND MAY SIMILARLY
EXPERIENCE A BURDEN OF LONG
COVID.
HISTORICALLY, WHAT WE KNOW IS
MISINFORMATION AND STRUCTURAL
FACTORS SUCH AS ACCESS TO HEALTH
CARE MAY POSE AS BARRIERS FOR
RACIAL AND ETHNIC COMMUNITIES.
IT'S ALSO LIKELY THAT THESE
BARRIERS EXIST WHEN ADDRESSING
LONG COVID.
AS WE SEEK TO BETTER UNDERSTAND
THE NEEDS AND PRIORITIES OF
APPRECIATES WHO ARE MOST
AFFECTED BY LONG COVID, YOUR
ORGANIZATION'S VOICE IS A
VALUABLE PART OF THIS
CONVERSATION.
I WILL NOW TURN IT OVER TO MY
CO-HOST DR. ANDREA LERNER TO
INTRODUCE HER SELF.
OVER TO YOU.
>> THANK YOU, DR. WILLIAMS.
GOOD AFTERNOON, EVERYONE AND
THANK YOU FOR JOINING.
MY NAME IS ANDREA LERNER AT THE
NATIONAL INSTITUTE OF ALLERGY
AND INFECTIOUS DISEASES PARTS OF
THE NATIONAL INSTITUTES OF
HEALTH.
BACK TO YOU, DR. WILLIAMS.
>> THANK YOU, DR. LERNER.
NOW I WANT TO INTRODUCE THE
DISCUSSION MODERATOR.
WE'RE DELIGHTED TO HAVE
DR. JAMES HILLDRETH THE
PRESIDENT AND CHIEF EXECUTIVE
OFFICER OF THE NATION'S LARGEST
PRIVATE INDEPENDENT HISTORICALLY
BLACK ACADEMIC HEALTH SCIENCES
CENTER.
HE IS ALSO A TEMPORARY VOTING
MEMBER OF THE VACCINES AND
RELATED BIOLOGICAL PRODUCTS
ADVISORY COMMITTEE, A MEMBER OF
THE ADVISORY COMMITTEE TO THE
NIH DIRECTOR AND SERVED ON THE
PRESIDENT'S COVID-19 TASK FORCE.
WE ARE HONORED TO HAVE HIM JOIN
US TODAY.
NOW THAT WE FINISHED OUR
INTRODUCTIONS, WE WILL BEGIN
WITH A BRIEF OVERVIEW OF THE
RECOVER INITIATIVE AND THEN THE
REMAINING SESSION WILL FOCUS ON
OUR DISCUSSION.
I'LL HAND IT OVER TO YOU,
DR. LERNER.
>> THANK YOU VERY MUCH.
SO I'LL JUST TAKE A FEW MOMENTS
TO TALK ABOUT THE PURPOSE OF
ZA'S LISTENING SESSION.
AS DR. WILLIAMS MENTIONED, TODAY
WE ENGAGE WITH PATIENTS AND
ORGANIZATIONS REPRESENTING
COMMUNITIES OF COLOR INCLUDING
THOSE HARDEST HIT BY COVID TO
BETTER UNDERSTAND THE LEVELS OF
AWARENESS OF LONG COVID AND
DISCUSS OPPORTUNITIES TO PROMOTE
DIVERSE AND INCLUSIVE
PARTICIPATION IN THE RECOVER
INITIATIVE STUDIES.
NOW I'LL JUST GIVE A BRIEF
OVERVIEW OF THE RECOVERY
INITIATIVE AND WHAT IT'S
STUDYING.
SO I'D LIKE TO JUST CLARIFY SOME
TERMINOLOGY.
SO THE RECOVER INITIATIVE IS
STUDYING THE POST-ACUTE SEQUELAE
OF SARS COV2 INFECTION.
THIS ABBREVIATED P-A-S-C, PASC.
THIS TERM REFERS TO THE EFFECTS
OF COVID-19 THAT -- THE EFFECTS
COVID-19 HAS ON THE BODY AFTER
THE INITIAL PARTS OF THE
ILLNESS.
SO THE LATER TERM AFFECTS OF
COVID-19 AND SARS COV2 INFECTION
THE VIRUS THAT CAUSES COVID-19.
UNDER THIS UMBRELLA, IS ALSO
WHAT IS REFERRED TO AS LONG
COVID.
PASC IS MEANT TO REFER TO A
BROAD VARIETY OF AFFECTS.
WHAT IS OFTEN REFERRED TO AS
LONG COVID YOU MAY HAVE HEARD
PEOPLE DESCRIBING ONGOING
SYSTEMS, WAXING AND WANING
SYSTEMS THAT IMPACT QUALITY OF
LIFE AFTER THE INITIAL PERIODS
OF COVID-19.
SO PATIENTS VARY IN THE TIMING
AND EXTENT OF RECOVERY.
PEOPLE REPORT SYMPTOMS RANGE
FROM MILD TO TRULY
INCAPACITATING AND THESE
SYMPTOMS CAN INVOLVE MULTIPLE
PARTS MUCH THE BODY AND AFFECT
OVERALL QUALITY OF LIFE.
SYMPTOMS REPORTED DUE TO LONG
COVID CAN RANGE FROM THINGS LIKE
FATIGUE, SHORTNESS OF BREATH,
BRAIN FOG OR DIFFICULTY THINKING
OR CONS -- CONCENTRATING,
GASTROINTESTINAL PROBLEMS AND
ANXIETY AND DEPRESSION AND
SOMETIMES CAN LAST A LONG TIME.
PEOPLE MAY HAVE ONGOING SYMPTOMS
SIMILAR TO THE SYMPTOMS THEY HAD
EARLIER WITH COVID-19 THAT
PERSIST OR PEOPLE CAN DEVELOP
NEW SYMPTOMS THAT CAN WAX AND
WANE.
WHILE WE DON'T FULLY UNDERSTAND
THE IMPACT OF POST-ACUTE
SEQUELAE AND SARS COV2 AND LONG
COVID, WE KNOW GIVEN THE SCOPE
OF COVID-19, THIS IS LIKELY A
LARGE PUBLIC HEALTH IMPACT AND
IMPORTANT TO ACKNOWLEDGE THAT.
SO NOW I'LL JUST PAUSE TO SEE IF
THERE ARE ANY QUESTIONS ABOUT
PASC OR LONG COVID THAT I'VE
JUST DISCUSSED.
OKAY.
I'M NOT SEEING HANDS RAISED OR
ANYTHING IN THE CHAT.
SO NEXT I TOLD YOU A LITTLE BIT
ABOUT WHAT RECOVER IS STUDYING.
NEXT I'LL TALK ABOUT THE GOALS
AND STRUCTURE OF THE RECOVER
INITIATIVE STUDIES.
SO THE GOAL OF RECOVER IS TO
IMPROVE RAPIDLY OUR
UNDERSTANDING OF AND ALSO THE
ABILITY TO PREDICT, TREAT AND
PREVENT PASC AND UNDER THAT
UMBRELLA INCLUDING LONG COVID.
SO THE KEY SCIENTIFIC AIMS WE
WOULD LIKE TO UNDERSTAND THE
FULL CLINICAL SPECTRUM.
SO ALL THE DIFFERENT
MANIFESTATIONS OF PASC AND THE
BIOLOGY THAT UNDER LIES THE
RECOVERY FROM COVID-19.
WE'D LIKE TO DEFINE THE RISK
FACTORS, THE INCIDENTS AND
PREVALENCE AND DIFFERENT
SUBTYPES OF PASC BECAUSE WE'RE
CALLING EVERYTHING BY ONE NAME
NOW BUT AS WE LEARN MORE ABOUT
IT, THIS IS LIKELY MULTIPLE
DIFFERENT CONDITIONS.
WE AIM TO STUDY THE PATHOGENESIS
OF PASC AND LONG COVID OVER
TIME.
AND THIS MAY BE ABLE TO BE
RELATED TO OTHER NONE DISORDERS
AND INFORM OUR KNOWLEDGE ABOUT
OTHER DISORDER.
AND ULTIMATELY WE'D LIKE TO
IDENTIFY INTERVENTION TO TREAT
AND PREVENT PASC.
SO WHAT IS THE RECOVER RESEARCH
APPROA
APPROACH.
THE GOALS OF THE INITIATIVE ARE
TO UNDERSTAND PASC INCLUDING
LONG COVID, ADVANCE CLINICAL
TRIALS AND INFORM TREATMENT AND
PREVENTIVE STRATEGIES FOR PASC.
SO THIS WILL BE ACCOMPLISHED BY
MULTIPLE DIFFERENT TYPES OF
STUDIES.
SO AT THE HEART OF THE RECOVER
INITIATIVE IS WHAT WE'RE CALLING
THE RECOVERY COHORT.
TO GET INTO THIS MORE IN THE
NEXT SLIDE, BUT THIS IS A COHORT
OF INDIVIDUALS WITH COVID-19 AND
PASC AND THEY'LL BE FOLLOWED
OVER TIME TO UNDERSTAND THE
PROGRESSION OF THEIR RECOVERY.
COMPLIMENTS AND IN ADDITION TO
THE RECOVERY COHORT AND PART OF
THE RECOVER INITIATIVE WILL BE
STUDIES OF ELECTRONIC HEALTH
RECORDS, STUDIES OF REAL WORLD
DATA AND INCLUDED IN THAT ARE
THINGS LIKE MOBILE HEALTH AND
WEARABLE TECHNOLOGIES THAT CAN
RECORD DATA AS PEOPLE RECOVER.
AND ALSO STUDIES OF HUMAN
TISSUE.
AND SOME FEATURES UNDER PINNING
ALL THESE TYPES OF STUDIES ARE
THEY INVOLVE HUNDREDS OF
RESEARCHERS AND SITES ACROSS THE
WHOLE COUNTRY.
WE AIM FOR INCLUSIVE AND DIVERSE
PARTICIPATION IN THESE STUDIES.
THEY'LL ENROLL CHILDREN, ADULTS
AND PREGNANT INDIVIDUALS.
COMMUNITY ENGAGEMENT IS A
CENTRAL TENET AND MULTIPLE
RESEARCHERS WITH MULTIPLE TYPES
OF EXPERTISE ARE INVOLVED.
NOW I'LL TURN IT BACK OVER TO
DR. WILLIAMS TO TALK ABOUT THE
NATIONAL SCOPE OF THE RECOVER
INITIATIVE.
>> THANK YOU SO MUCH,
DR. LERNER.
AS YOU CAN IMAGINE, A STUDY OF
THIS MAGNITUDE REALLY WILL TAKE
PLACE ACROSS THE COUNTRY.
THE RECOVER COHORT ANTICIPATE
ENROLLING, ADULTS, CHILDREN AND
THEIR CAREGIVERS AND PREGNANT
PARTICIPANTS AND THEIR NEWBORN
INFANTS.
IT WILL HAVE HUNDREDS OF
CLINICAL SITES ACROSS THE NATION
TO REFLECT THE ETHNIC AND RACIAL
DIVERSITY AND REACHING ALL
REGIONS AND AIMED TO ADDRESS THE
FUNDAMENTAL QUESTIONS IN THE
FIRST 12 MONTHS, PROVIDE
LONGITUDINAL FOLLOW-UP AND LAY
THE FOUNDATION FOR STUDIES OF
PATHOBIOLOGY AND CLINICAL
INTERVENTIONS.
AND ANALYSIS OF ELECTRONIC
HEALTH RECORDS OF MORE THAN 36
MILLION ADULTS AND PEDIATRIC
PATIENTS.
THE RECOVER CONSORTIUM INCLUDES
A MAIN PROTOCOL DEVELOPMENT.
DEVELOPING THE MAIN PROTOCOL
INCLUDED COLLABORATION WITH OVER
200 INVESTIGATORS, 33 PATIENTS
WITH INPUT FROM NIH SUBJECT
MATTER EXPERTS, PROVIDED PHASE 1
AWARDS TO 30 CLINICAL COHORTS
AND THREE LARGE SCALE ELECTRONIC
HEALTH RECORD STUDIES.
IT IS ESSENTIAL FOR HARMONIZING
THESE STUDIES AND THAT INVOLVES
STANDARDIZING SCIENTIFIC AIMS,
TESTS AND PROCEDURES.
A UNIFIED ENTRY CRITERIA BASED
ON THE WORLD HEALTH ORGANIZATION
FOR ALL COHORTS MAKING
CONSISTENT DATA STRUCTURE ACROSS
ALL COHORTS AND A HARMONIZED
DATA MANAGEMENT AND ANALYSIS
PLAN.
WE'LL CREATE TIERED PHENOTYPING
APPROACH FOR ADULTS AND
PEDIATRIC COHORTS AND PLANNED
ADAPTIVE DESIGNS REALLY BASED ON
CONTINUING ANALYSIS AND THE
EVOLVING SCIENCE AS WE CONTINUE
TO LEARN ABOUT COVID.
IN SUM, ALL COHORT AND SITE
STUDIES ARE HARMONIZED UNDER A
MAIN PROTOCOL.
AS WE MENTIONED THE RECOVER
INITIATIVE IS PATIENT FOCUSSED.
SOME FEATURES INVOLVE INCLUDING
OVER 400 ATTENDEES AND THE
DISCUSSION AND REPRESENTATION
ACROSS THE GOVERNANCE STRUCTURE
AND COMMUNITIES AND
REPRESENTATIVES WILL BE INCLUDED
AND COMMUNITY ENGAGEMENT ADDS
VALUE TO EVERY ELEMENT OF THE
INITIATIVE.
WE'LL TAKE A BRIEF PAUSE TO SEE
IF THERE'S ANY QUESTIONS AT THIS
POINT.
>> I HAVE ONE QUESTION, IF I MAY
ASK.
IT SEEMS LIKE YOU'LL BE USING
ELECTRONIC HEALTH RECORDS.
I KNOW CERNA AND EPIC ARE THE
TWO UTILIZED.
FLORIDA PROVIDERS THAT AREN'T ON
THOSE SYSTEMS, WILL THAT BE
ALTERNATIVE WAYS TO PARTICIPATE
IF THEY DON'T HAVE ACCESS TO
THOSE SYSTEMS?
>> WE WOULD BE HAPPY TO WORK
WITH ANY OF TO THE SITES DOING
RECRUITMENT TO BETTER UNDERSTAND
THEIR NEEDS BUT MANY OF THESE
SITES ARE PART OF THE ELECTRONIC
HEALTH RECORDS AND WE WELCOME
DISCUSSIONS TO BETTER UNDERSTAND
THOSE NEEDS.
THANK YOU FOR YOUR QUESTION.
SO NOW I WILL JUST LIKE TO
REMIND US AGAIN ABOUT OUR
MODERATOR FOR TODAY'S LISTENING
SESSION.
DR. JAMES HILLDRETH AND SHARE IN
ADDITION TO HIS POSITION, HE
GRADUATED FROM OXFORD UNIVERSITY
WITH A Ph.D. IN IMMUNOLOGY AND
OBTAINED HIS M.D. FROM JOHNS
HOPKINS UNIVERSITY AND LATER
BECAME THE FIRST AFRICAN
AMERICAN IN THE 125-YEAR HISTORY
OF JOHNS HOPKINS SCHOOL OF
MEDICINE TO EARN FULL
PROFESSORSHIP AND TENURE IN THE
BASIC SCIENCES AND ALSO SERVED
AS THE FIRST AFRICAN AMERICAN
DEAN OF THE COLLEGE OF
BIOLOGICAL SCIENCES AT
UNIVERSITY OF CALIFORNIA DAVIS.
AND OCTOBER, 2008 HE WAS HONORED
FOR HIS CONTRIBUTIONS TO MEDICAL
SCIENCE BY ELECTION TO THE
INSTITUTE OF MEDICINE.
PART OF THE NATIONAL ACADEMY OF
SCIENCES.
AND HE ALSO EARNED AN HONORED
DOCK RAT FROM THE UNIVERSITY OF
ARKANSAS AND INDUCTION IN THE
ARKANSAS BLACK HALL OF FAME.
WE ARE HONORED TO HAVE DR. JAMES
HILLDRETH JOIN US TODAY.
>> AS YOU HEARD I WAS PART OF
THE PRESIDENT BIDEN EQUITY TASK
FORCE AND SPENT A LONG TIME
DISCUSSING LONG COVID AND THE
MINE MINE ORTIZED COMMUNITIES.
WE THING LONG COVID-19 WILL
DISPROPORTIONATELY AFFECT
COMMUNITIES OF COLOR AND FROM MY
PERSPECTIVE AS A PHYSICIAN
SCIENTIST WE KNOW THERE'S A LONG
HISTORY FOR WOMEN AND MINORITIES
WHEN THEY PRESENT WITH
CONDITIONS NOT READY DIAGNOSED
BY OBJECTIVE MEASURES SUCH AS
TESTS OR PROCEDURES.
OFTEN TIMES THEY'RE NOT TAKEN
VERY SERIOUSLY BY THE PROVIDERS
AND CHRONIC FATIGUE SYNDROME IS
AN EXAMPLE OF THAT.
AS YOU HEARD FROM MY COLLEAGUE,
LONG COVID ENCOMPASSES
CONDITIONS THAT IMPACT MULTIPLE
SYSTEMS IN OUR BODIES WHICH
MEANS TEAMS OF INVESTIGATORS AND
PHYSICIANS ACROSS MULTIPLE
SPECIALTIES AND VIROLOGISTS AND
PULMONOLOGISTS WILL BE INVOLVED
IN FINDING ANSWERS AND TAKING
CARE OF PATIENTS.
MINOR TIED COMMUNITIES WON'T
HAVE ACCESS TO SPECIALISTS.
IT'S VERY IMPORTANT AND THIS IS
ONE OF THE RECOMMENDATIONS THAT
CAME FROM THE TASK FORCE THAT WE
MAKE SURE UNINSURED PERSONS IN
COUNTRY HAVE ACCESS TO THE
TREATMENT THEY'LL NEED AND THE
APPROPRIATE DISABILITY
CONSIDERATIONS BE GIVEN TO THOSE
INDIVIDUALS TO MAKE SURE THE
IMPACT ON LONG COVID IS NOT A
DISPROPORTIONATE BURDEN ON THEM.
THOSE ARE JUST A FEW OF THE
THINGS WE TALKED ABOUT AND
RECOMMENDED IN OUR REPORT TO THE
PRESIDENT.
WE INVITE YOU TO GO TO THE
WEBSITE THERE AND LOOK AT THE
REPORT AND RECOMMENDATIONS WE
MADE.
TURN ON YOUR VIDEO BEFORE YOU
ASK YOUR QUESTION IF YOU'D LIKE
TO BE SEEN BY THE COMMUNITY AND
PLEASE INTRODUCE YOURSELF BY
NAME AND TELL US WHAT
ORGANIZATION YOU ARE FROM.
IN OTHER WORDS TO MAKE SURE AS
MANY VOICES CAN BE HEARD AS
POSSIBLE, WE ASK YOU MAKE ONLY
ONE COMMENT OR ASK ONLY ONE
QUESTION AND LIMIT YOUR TIME TO
TWO MINUTES AND THAT WAY ALL OF
US CAN TAKE PART OF THIS VERY
IMPORTANT CONVERSATION AND WAIT
TO UNMUTE.
WE CAME UP WITH QUESTIONS TO
ORGANIZATION OUR CONVERSATION
TODAY.
THE FIRST ONE IS REALLY
IMPORTANT.
IT RELATES TO OUR PERCEPTIONS OF
THIS.
THE QUESTION IS WHAT IS YOUR
PERCEPTION OF THE LEVEL OF
AWARENESS AROUND LONG COVID AND
ITS SYMPTOMS IN YOUR COMMUNITY?
WE ALL KNOW THAT AS WE TALKED
ABOUT BEFORE, MANY PEOPLE DON'T
RECOGNIZE LONG COVID FOR WHAT IT
IS.
THERE'S A GREAT NEED TO MAKE
SURE WE HAVE AN UNDERSTANDING OF
THE LEVEL OF UNDERSTANDING FOR
OUR COMMUNITIES ABOUT THIS.
AND SOME OF THE THINGS WE MIGHT
ASK AS PART OF THAT QUESTION IS
ARE THERE SPECIFIC GROUPS OR
INDIVIDUALS THAT WE MIGHT FOCUS
ON AND MIGHT WANT TO REACH AS WE
DO THIS WORK?
AND WHAT HAVE PEOPLE HEARD ABOUT
RECOVER AND LONG COVID?
AND RECOGNIZING ALL OF US MAY
NOT RECOGNIZE THE LEVELS AND
SYMPTOMS OF LONG COVID, WHAT
HAVE YOU HEARD IN YOUR COMMUNITY
PEOPLE TALK ABOUT UP GETTING
OVER COVID.
A LOT OF TIMES THERE'S LONG
COVID HAPPENING BUT PEOPLE
AREN'T AWARE THERE'S A NAME FOR
THIS PHENOMENA.
BASED ON ALL THAT AND YOUR
KNOWLEDGE OF WHAT IS AH
HAPPENING, WHAT DO YOU THINK ARE
THE BEST MODALITIES FOR GETTING
THE WORD OUT DELIVERING
INFORMATION ABOUT LONG COVID FOR
THE COMMUNITIES YOU'RE HEAR
REPRESENTING.
WITH THAT I'LL OPEN IT UP FOR
COMMENTS AND QUESTIONS.
YOU CAN ENTER YOUR QUESTION IN
THE CHAT OR -- OH, I SEE.
DR. MUNOZ, I BELIEVE, FROM NIH.
>> YES.
I'M ONE OF THE FOUR CO-CHAIRS OF
THE STEERING COMMITTEE OF NIH
SEAL.
DO WE HAVE AN ESTIMATES OF THE
PEOPLE WHO SUFFER FROM COVID WHO
GO ON TO SUFFER FROM LONG COVID?
>> MY UNDERSTANDING IS THAT
SOMEWHERE BETWEEN 20% AND 30% OF
INDIVIDUALS WHO GET COVID-19
WILL GO ON TO SUFFER FROM LONG
COVID.
I BELIEVE ONE OF MY COLLEAGUES
MAY HAVE ADDITIONAL INFORMATION
TO SHARE SO I WELCOME THEM TO
RESPOND AS WELL.
>> THANK YOU.
>> ESTIMATES FOR THE INCIDENTS
AND PREVALENCE OF LONG COVID,
MANY STUDIES FALL AROUND THE
RANGE DR. HILLDRETH MENTIONED.
IT'S IMPORTANT TO ALSO RECOGNIZE
WIDELY RANGING IN THE LITERATURE
AND IT DEPENDS ON SPECIFICALLY
WHAT THE STUDIES ARE LOOKING AT.
WHICH SYMPTOMS, WHICH AFFECTS
AND IN WHICH POPULATION.
SOME STUDIES HAVE SHOWN PEOPLE
WITH MORE SEVERE DISEASE SUCH AS
HOSPITALIZED PATIENTS HAVE A
GREATER BURDEN OF LINGERING
AFFECTS SO IT'S VERY VARIABLE.
>> I SEE WANDA ALTMAN.
PLEASE.
>> I HAD A COMMENT NOT A
QUESTION SO MUCH.
I WAS STRUCK WITH COVID IN JULY
2020 AND ANYTHING LONG COVID AND
LONG HAULERS UNTIL ONE NIGHT I
WAS HAVING INSOMNIA AND TURNED
THE TV TO FULL-COURT PRESS AND
THERE WAS A YOUNG WOMAN ON THERE
SPEAKING TO LONG HAULERS AND THE
WORK SHE HAD DONE AROUND LONG
COVID AND TALKED ABOUT THE
SYMPTOMS THAT I EXPERIENCE NOW.
I WOULD SAY IN THE COMMUNITY
THERE'S NOT A HIGH LEVEL OF
AWARENESS AROUND LONG COVID AND
ITS SYMPTOMS.
I'VE SPOKEN WITH PERSONS WHO SAY
I STILL HAVE THIS COUGH.
I CAN'T GET RID OF THIS COUGH.
I'M STILL NOT ABLE TO TASTE OR
SMELL BUT DONT HAVE AN IDEA AND
I COULDN'T TELL THEM WHAT IT WAS
OTHER THAN SOMETHING THAT
LINGERS AROUND AFTER COVID
BECAUSE I WAS NOT AWARE LONG
COVID UNTIL I WAS INVITED.
I WAS AWARE OF LONG COVID WHEN I
TURNED TO THE TV PROGRAM BUT
RECOVER I WAS ONLY AWARE OF IT
WHEN I WAS INVITED TO
PARTICIPATE IN THE LISTENING
SESSION.
>> THANK YOU.
YOU RAISE AN IMPORTANT POINT
WHICH IS HOW TO GET THE WORD OUT
TO COMMUNITIES NOT AWARE OF THIS
PHENOMENON THAT'S A REAL THING
WE NEED TO FOCUS ON SO YOUR
POINT IS DEFINITELY WELL TAKEN.
I SEE DR. HECKMAN AND DR. ECHO
-HAWK.
>> DID WE LOSE DR. HECKMAN?
ABIGAIL, WOULD YOU LIKE TO GO
WHILE WE GET HIM BACK?
>> SURE, THANK YOU SO MUCH.
ABIGAIL ECHO-HAWK THE ONLY
CENTER FOCUSSING ON URBAN
DWELLING NATIVE AMERICANS AND
ALASKAN NATIVES IN SEATTLE
WASHINGTON SERVING AMERICAN
INDIAN AND ALASKAN NATIVES.
I WANT TO ADDRESS MY CONCERNS
AROUND THE METHODS OF THE STUDY
THAT RAISED SOME AWARENESS FOR
ME OF THINKING ABOUT HOW THE
STUDY MAY HAVE SOME LIMITATIONS
PARTICULARLY WHEN IT LOOK AT THE
INFORMATION RELATED TO AMERICAN
INDIAN AND ALASKAN NATIVES AND
WE FOUND THERE WAS A LACK OF
DATA AS A DIRECT RESULT WE FOUND
NON-COLLECTION OF RACE AND
ETHNICITY OF AMERICAN INDIANS
AND OTHER BIPOC COMMUNITIES AND
WHEN YOU LOOK AT THE EHR RECORDS
AND TRYING TO TRACK WHETHER OR
NOT THEY HAD A COVID INFECTION
AND THEN LONG COVID AFTER THAT
SAY DIRECT RESULT OF THAT, THOSE
LIMITATIONS IN THE DATA ARE
GOING TO SKEW AND NOT PROPERLY
REPRESENT THE AMERICAN INDIAN
AND ALASKAN NATIVE EXPERIENCE
AND THERE'S WORK TO BE DONE ON
THE MISCLASSIFICATION AND
POSSIBLE LINKAGES IN ORDER TO
MAKE THE STUDIES RELEVANT TO A
POPULATION THAT'S BEEN ONE OF
THE MOST IMPACTED BY COVID-19.
IN ADDITION THE RECRUITMENT
STRATEGY MAY BE USING HOSPITAL
RECORDS IN WHICH TO SEND LETTERS
OUT TO FOLKS TO ENGAGE OR
HOWEVER YOU'RE LOOKING TO ENGAGE
PARTICIPANTS WE FIND WHEN PEOPLE
USE HOSPITAL RECORDS ALASKAN
NATIVES OFTEN GO OFF RESERVATION
LANDS AND WHEN YOU CONTACT
THERE'S THE ABILITY TO LIMIT TO
ENGAGE IN AND TO REGULATE ANY
RESEARCH HAPPENING ON TRIBAL
LAND SO I WOULD SUGGEST YOU LOOK
AT YOUR METHODS TO ENSURE YOU'RE
NOT IMPINGING ON TRIBAL
SOVEREIGN TI AND ETHICAL
RESEARCH.
WE'RE STILL IN THE MIDST OF A
CRISIS AND PEOPLE ARE TRYING TO
OVERCOME THE CRISES AND HAVEN'T
BEEN ABLE TO ENGAGE IN WHAT LONG
COVID IMPACTS CAN LOOK LIKE BUT
YET WITHIN MY OWN CLINIC
POPULATION AND THE WORK WE DO
AROUND THE NATION WE'RE SEEING
LONG COVID AND WHEN OUR FOLKS GO
INTO NON-INDIGENOUS HOSPITALS
AND CLINICS, NOBODY'S BELIEVING
THEM.
WE'RE THE IMPACT OF IMPLICIT
BIAS, RACISM AND PREJUDICE AND
THE NON-BELIEF OF THOSE
EXPERIENCING SYMPTOMS.
ONE OF THE THINGS WE HAVE FOUND
IS THAT THE MAINSTREAM
STRATEGIES PARTICULARLY AROUND
COVID VACCINATION AND
INFORMATION AROUND COVID-19
SINCE THE BEGINNING OF THE
PANDEMIC FROM THE MAINSTREAM
PERSPECTIVE DID NOT REACH OUR
COMMUNITY.
MY ORGANIZATION DID THE ONLY
SURVEY ON VACCINE HESITANCIES
AND PERCEPTIONS AND FOUND THE
OPPOSITE OF THE STRATEGY THAT
WAS BEING USED BY MAINSTREAM
STRATEGIES AROUND ENGAGING
PEOPLE AND COVID-19 VACCINES
WHEN YOU THINK OF THE BEST
MODALITIES FOR COMMUNITY
INFORMATION HAS TO BE COMMUNITY
DRIVEN.
THERE'S COMMUNITIES WHERE YOU
NEED TO HAVE ONE UNIFIED MESSAGE
AND HAS TO BE NOT ONLY ADAPTABLE
BUT SOMETIMES JUST COMPLETELY
DIFFERENT IN THE WAY THE
INFORMATION HAS GATHERED.
IT HAD TO BE DONE THROUGH TRUE
COMMUNITY ENGAGEMENT FOR TRIBAL
COMMUNITIES THAT MEANS IN
ADDITION TO NATIONAL INDIGENOUS
ORGANIZATIONS LIKE NATIONAL
CONGRESS AND INDIAN HEALTH BOARD
AND THE INDIAN HEALTH INSTITUTE
AND MY OWN ORGANIZATION.
WE'RE THE TRUSTED MESSENGERS
WITHIN OUR COMMUNITY.
SO THANK YOU.
>> SORRY, ABIGAIL.
I WANT TO POINT OUT ALL THOSE
THINGS YOU RAISED AS CONCERNS
WERE ADDRESSED IN THE HEALTH
EQUITY TASK FORCE.
DISAGGREGATED DATA IS IMPORTANT
AND HOW TO GET THE BEST DATA TO
FIND THE SOLUTIONS YOU NEED TO
ALL THE POINTS YOU RAISED ARE
VALID AND I WOULD INVITE YOU TO
GET A COPY OF THE FULL REPORT
BECAUSE I ASSURE YOU THOSE
CONSIDERATIONS YOU RAISED WERE
ALL WORK WE DID TO FIND
RECOMMENDATIONS ON SOLUTIONS BUT
THANK YOU AND THE TRUSTED
MESSENGER PIECE IS CRITICAL AND
I THINK THE FOLKS AT NIH AND HHS
UNDERSTAND THAT SO THANK YOU
VERY MUCH, ABIGAIL.
DR. HECKMAN, YOU'RE BACK.
GO AHEAD, PLEASE.
>> CAN YOU HEAR IS THE
>> YES.
>> -- HEAR ME?
>> YES.
>> WONDERFUL.
THANK YOU FOR ORGANIZING THIS
AND TAKING INTO ACCOUNT
EVERYBODY'S PERSPECTIVE AND
TACKING THIS LARGE ISSUE.
NOT TO FURTHER COMPLICATE IT BUT
I'M KIND OF WORRIED ABOUT THE
DIRECT AND INDIRECT CYCLES IF
SOMEONE'S BIOLOGICAL SYSTEM IS
INTERRUPTED IMPACTING ACCESS TO
HEALTH SERVICES OR
DISPROPORTIONATELY IMPACT OF
DEATH IN HIGHER COMMUNITIES
COULD LEAD TO TRAUMA AND CYCLE
INTO DEPRESSION AND ANXIETY AND
LESS BEING ABLE TO WORK OR BEING
PHYSICALLY HEALTHY FURTHERING
THE EQUITY GAP IN TERMS OF THE
SOCIAL DETERMINATES OF HEALTH
AND COME FROM THIS AS THE STUDY
OF SOCIAL DETERMINATES OF HEALTH
AND THE CLINICAL PSYCHOLOGIST.
I GUESS I'M CURIOUS, IS THAT
OUTSIDE THE SCOPE OF RECOVER
BECAUSE IT'S NOT DIRECTLY THE
BIOLOGICAL ASPECT OR THINKING
ABOUT THE MULTI-LEVEL COMPLEX
SYSTEMS WHICH PROVIDE THE
FEEDBACK LOOPS THAT KEEP PART OF
THE PROBLEM GOING OR NOT AND
FURTHER THINKING THROUGH
POTENTIAL BUFFERS THAT MIGHT BE
DIFFER IN ADDITION TO THE
DIFFERENTIAL PATHWAYS FOR THE
DISEASE ITSELF.
SIMILAR TO WHAT OTHERS HAVE
MENTIONED HERE SO I WON'T GO IN
GREATER DEPTH AND I'D BE REMISS
TO NOT ALSO THINK THIS AS AN
OPPORTUNITY TO ENHANCE CAPACITY
BUILDING AND WORKFORCE
DEVELOPMENT THROUGH UNIQUE
PARTNERSHIPS AMONG HISTORICALLY
MINORITY INSTITUTES AND THE
PAIRING UP WILL ALLOW FOR THE
STRONG ARE CONNECTION WITH THE
COMMUNITY AND ALLOW FOR A MUCH
MORE COMMUNITY-ENGAGED, HOLISTIC
APPROACH MORE BROADLY.
I'LL LEAVE IT THERE.
THANK YOU.
>> THANK YOU, DR. HECKMAN.
CERTAINLY I KNOW FOR SURE
BEHAVIORAL HEALTH AND BEHAVIORAL
HEALTH CONSEQUENCES OF THIS IS
WHAT THEY'RE LOOKING TO ADDRESS.
I BELIEVE IT'S PART OF THE
STRATEGY TO ADDRESS THE ASPECT.
>> THANK YOU FOR THAT QUESTION,
DR. HECKMAN.
I'LL ASK WE CERTAINLY INCLUDED
THE SOCIAL DETERMINATES OF
HEALTH BECAUSE WE RECOGNIZE THIS
IS BEYOND THE BIOLOGICAL
MECHANISMS OF RECOVERY AND
DEALING WITH LONG COVID.
WE HAVE ADDRESSED THOSE ISSUES.
THANK YOU FOR THAT QUESTION.
NEXT QUESTION.
>> THANK YOU FOR THE HELPFUL
BRIEFING AND LIFT UP WHAT
ABIGAIL SAID EARLIER ABOUT
AMERICAN INDIANS AND I WAS
TAKING COPIOUS NOTES.
HAVE YOU LOOKED AT DATA
DISAGGREGATION AND THE
INDIVIDUALS AND CHILDREN WHO
SUFFER FROM LONG COVID.
I ASK THAT BECAUSE PART OF THE
CONVERSATION ABOUT COMMUNITY
REACH AND STRATEGIES AND TRUSTED
NAVIGATORS AND PART OF
UNDERSTANDING OUTREACH AND
ACCESSIBILITY IS ALSO
UNDERSTANDING THE DATA AND WHERE
THERE MAY BE GAPS FALLING SHORT
BOTH BECAUSE WE DON'T HAVE IT OR
SOME OF MENTIONING OF RACES
MISCLASSIFIED.
CURIOUS IF THERE'S MORE
INFORMATION ON THAT.
I APOLOGIZE, I'M WITH THE
CHILDREN'S DEFENSE FUND AND MY
FANTASTIC COLLEAGUE ON THE CALL.
>> SINCE THERE'S NOT A LEVEL OF
AWARENESS OF LONG COVID AS A
PHENOMENON AND CONDITION, I DO
THINK THOSE WHO PRESENTED
THEMSELVES WITH THIS DISORDER
PREDOMINANTLY NON-MINORITY WE
HAVE TO RAISE AWARENESS IN THE
MINORITY COMMUNITY AND FOR
PEOPLE TO COME FORWARD.
I'LL LET MY COLLEAGUES SPEAK TO
THAT, DR. WILLIAMS AND
DR. LERNER.
>> YEAH, I AGREE.
THERE ARE REAL GAPS IN TO THE
DATA WE HAVE ABOUT LONG COVID
FOR MANY REASONS AND ROBUST
DATA'S NEEDED AND RECOVER IS
HOPING TO FILL SOME OF THOSE
GAPS.
>> WE HAVE JOHN KALEEKAL.
TAKE IT AWAY.
>> GOOD AFTERNOON.
I'M PEDRO MARTINEZ AND
REPRESENTING UNIDOS U.S. FOR
SENIOR PREPAREDNESS AND RESPONSE
AND I APPRECIATE THE OPPORTUNITY
TO BRING OUR PERSPECTIVE.
THE LONG AND SHORT OF IT HERE IS
THAT AS WE'VE BEEN DISCUSSING,
THERE IS LOW AWARENESS WITHIN
THE LATINO COMMUNITY IN REGARDS
TO WHAT LONG COVID IS.
I THINK A LOT OF THAT STEMS FROM
THE EARLIER MESSAGING WITHIN THE
PANDEMIC THIS COVID-19 VIRUS WAS
NOT ANYMORE SEVERE THAN THE FLU.
I THINK FOLKS HAD A
MISUNDERSTANDING FROM THE
BEGINNING AND THE SCIENCE OF
COURSE WASN'T THERE AT THAT
TIME.
THAT BEING SAID, THE FOLKS WHO
POTENTIALLY HAVE BEEN IMPACTED
THE MOST WOULD BE ESSENTIAL
WORKERS.
THOSE WHO HAVE BEEN OUT WORKING
IN THE FIELDS, WORKING IN
SERVICE INDUSTRY JOBS.
THOSE WHO ARE IN THE POULTRY
PROCESSING PLANT AND SO FORTH
THAT MAY BE THOSE WHO COULD BE
MOST IMPACTED BY LONG COVID BUT
HOWEVER, THEY MAY NOT EVEN BE
AWARE OF LONG COVID AND WHERE
THE JARGON COMES INTO PLAY, WHAT
IS LONG COVID AND WHAT'S THAT
MEAN AND SEQUELAE, MOST FOLKS
DON'T UNDERSTAND WHERE THAT
MEANS.
I COME FROM A VIOLENCE AND
PREVENTION BACKGROUND SO I'M
AWARE BUT IT DOESN'T MEAN WHAT
THE GENERAL PUBLIC IS.
FINDING THE WAYS TO COMMUNICATE
WHAT LONG COVID IS AND WHAT THE
SYMPTOMS ARE COULD BE HELPFUL.
IN ADDITION TO THOSE WHO
POTENTIALLY MIGHT BE IDENTIFIED
IN HAVING LONG COVID ARE THOSE
WHO HAVE ACCESS TO HEALTH CARE
DISCOVERY AND HAVE HEALTH CARE
INSURANCE AND HAVE PERHAPS DOING
WELLNESS CHECKUPS ON A YEARLY
BASIS.
IF THOSE INDIVIDUALS DO NOT HAVE
ACCESS TO HEALTH CARE OR LOW
ACCESS TO HEALTH CARE THEY MAY
NOT HAVE THE ABILITY TO EVEN
KNOW THIS IS AN EXTENDED COST OR
MENTAL HEALTH ISSUES OR
CHALLENGES OR WHATEVER THE LONG
COVID SYMPTOMS MIGHT BE ARE
RELATED TO LONG COVID BUT MAY
THINK IT'S RELATED TO SOMETHING
ELSE.
I THINK THOSE ARE POINTS I
WANTED TO MAKE AND HOW CAN WE
BEST DELIVERY THIS INFORMATION.
ONCE AGAIN REEMPHASIZE TRUSTED
COMMUNITY MESSENGERS ARE GOING
TO BE THE BEST WAY TO BE ABLE TO
ADDRESS LONG COVID AND TO BRING
THE POINTS FORWARD TO THE
COMMUNITY FOR THEIR AWARENESS
AND TO ADDRESS MISINFORMATION
AND A NUMBER OF OTHER THREATS TO
THAT WILL BE COMING DOWN THE
ROAD.
ONCE AGAIN I APPRECIATE THE
OPPORTUNITY TO CONTRIBUTE AND
LOOKING FORWARD TO PROVIDING
MORE FEEDBACK.
>> THANK YOU.
>> NEXT WE HAVE JOHN.
>> THIS IS JOHN KALEEKAL
REPRESENTING THE ASIAN PACIFIC
ISLANDER POPULATION AND WANTED
TO ADDRESS MODALITIES FOR
DELIVERING INFORMATION.
I'M THINKING ABOUT YESTERDAY WE
JUST HOSTED A WEBINAR WHERE WE
DISCUSSED VACCINE EQUITY AMONGST
THE API COMMUNITY AND FOCUSSED
IN ON TWO ORGANIZATIONS AND ONE
OF THE BIG TAKEAWAYS I'M
THINKING ABOUT IS THERE'S A LOT
OF DISPARITIES WITHIN THE BROAD
COMMUNITY AMONGST OUR SOUTHEAST
ASIAN COMMUNITY AND HAWAIIAN AND
PACIFIC ISLANDER COMMUNITIES AND
WHAT THEY HAD RECOMMENDED WAS --
AND I DON'T THINK THIS IS
ANYTHING GROUNDBREAKING BUT
TAILORING TO THESE COMMUNITIES
DEVELOPING RESOURCES IN MULTIPLE
LANGUAGES, MAKING SURE THEY'RE
SUFFICIENTLY AND ADEQUATELY
TRANSLATE AND COMPREHENSIBLE IN
THOSE LANGUAGES.
AND THEN ONE OF OUR COLLEAGUES
SHARED IF YOU, FOR EXAMPLE, SHE
WORKS WITH THE FILIPINO
COMMUNITY IN HAWAI'I AND SAID IF
YOU WANT TO REACH FILIPINOS YOU
HAVE TO SEND FILIPINOS AND
WORKING WITH THOSE COMMUNITIES
TO FURTHER THE EFFORTS OF THIS
PROGRAM.
I THINK THAT APPLIES WITH
VACCINES AND ALSO WHAT YOU'RE
TRYING TO DO WITH INFORMATION
WITH LONG COVID AND REACHING
THESE COMMUNITIES.
AGAIN, I DON'T THINK IT'S
GROUNDBREAKING BUT WORTH SHARING
WITH THE TEAM.
>> THERE'S A FEW QUESTIONS IN
THE CHAT WE CAN TURN TO.
ONE IS FROM TERESA.
SHE WRITES, ARE THERE
SIGNIFICANT DIFFERENCES IN THE
NUMBER OF INSTANCES OF LONG
COVERED BASED ON WHEN PEOPLE
INITIALLY CAUGHT COVID?
>> I HAVEN'T SEEN EVIDENCE WITH
LONG COVID BUT DEPENDING ON YOUR
EXPERIENCE YOU'RE MORE LIKELY OR
LESS LIKELY TO GET LONG COVID.
>> YOU'RE UNDERSTANDING IS THE
SAME AS MINE.
THAT'S ANOTHER KNOWLEDGE GAP
AND, YES, THAT'S A GAP IN OUR
DATA.
>> I WOULD JUST ADD MANY OF THE
PATIENT REPRESENTATIVES WE WERE
WORKING WITH WERE DIAGNOSED WITH
COVID IN EARLY 2021.
THERE SEEMS TO BE AN ASSOCIATION
WITH THE EARLY VARIANTS BUT IT'S
STILL UNKNOWN.
>> THE NEXT QUESTION OR COMMENT
IS FROM EDWARD.
IT RELATES TO WHETHER OR NOT
PERSONS WHO HAD COVID-19 THAT
WERE NOT DIAGNOSED BY PCR TEST
ENTERED INTO EHR, WHAT IS THE
WAY TO DEAL WITH THAT.
AS YOU PROBABLY KNOW OR HEARD OR
READ, FOR EVERY PCR DIAGNOSED
CASE OF COVID THERE'S OTHERS
THAT OCCURRED THAT WERE NOT
DIAGNOSED.
IN FACT, ONE OF THE ISSUES WE
HAVE WITH THE AT-HOME ANTIGEN
TESTING KIT IS THOSE CASES ARE
NOT BEING REPORTED TO THE CDC
NECESSARILY SO IT'S ANOTHER
MAJOR CHALLENGE WE HAVE KNOWING
THE FULL SCOPE OF THE PROBLEM IS
SOMEWHAT CHALLENGING GIVEN THE
POINT YOU JUST RAISED.
ONE OF THE RECOMMENDATIONS WE
MADE IN OUR REPORT OUR
RECOMMENDATIONS TO THE PRESIDENT
FROM THE HEALTH EQUITY TASK
FORCE IS WHETHER OR NOT THE CASE
WAS DIAGNOSED WITH A PCR TEST OR
NOT AND SHOULD BE ENTITLED TO
TREATMENT AND YOU RAISE A GOOD
POINT THERE'S A LOT OF COVID-19
CASES NOT FORMALLY DIAGNOSED
WITH A PCR TEST.
I DON'T KNOW IF THERE'S A
COMMENT ON THAT.
>> EXCELLENT POINT.
INDIVIDUALS WHO GO THROUGH THESE
PROTOCOLS WILL BE TESTED BUT
THERE'S ALSO A LIST OF SYMPTOMS
THAT ARE ACCESSED AS WELL.
>> OKAY.
AND THE NEXT ONE I'LL READ IT
AND INVITE MY COLLEAGUES TO
COMMENT.
THIS IS FROM DR. HECKMAN.
CONTINUOUS STREAMS WITH STRONG
POTENTIAL FOR CLINICAL VALIDITY
AND EXTERNAL VALIDITY WITH
ACCEPTABLE ADHERENCE WILL BE
HIGHLY IMPORTANT AND MINIMALLY
INVASIVE SUCH AS -- I CAN'T READ
THAT.
STRONGLY PREDICTIVE OF COVID-19.
POSITIVE TEST THREE DAYS IN
ADVANCE, MORBIDITY AND OTHER
MEASURES THAT CAN BE COLLECT.
I THINK WHAT YOU'RE REFERRING TO
IS THE IMPORTANCE OF WEARABLES
AND DR. LERNER MENTIONED THAT IS
GOING TO BE AN IMPORTANT
COMPONENT OF THIS WORK THAT'S
GOING TO BE DONE.
YOUR POINT IS DEFINITELY WELL
TAKEN.
THERE'S ONE MORE IN THE CHAT.
HOW DOES THIS MIRROR OTHER
CHRONIC CONDITIONS MANAGEMENT
VERSUS OR DIVERGENCE AND HOW CAN
IT BE COMPARED ACROSS THE
FRAMEWORK, ATTACHED WORK LOAD
CAPACITY MODEL.
I'M NOT FAMILIAR WITH THAT MODEL
BUT DR. WILLIAMS MIGHT BE.
DO YOU WANT TO COMMENT ON THAT?
>> I'M NOT SURE.
DO THEY WANT TO ELABORATE ON
THIS?
>> I WAS JUST THROWING OUT
COMMENTS IF YOU YOU HAVE A
STARTED FRAMEWORK YOU SEE THE
REFERENCE POINT TO A BASELINE.
THERE'S LOTS OF DIFFERENT FRAME
WORKS OUT THERE SO IT'S ONE
EXAMPLE.
>> WE CERTAINLY CAN COME BACK TO
THIS QUESTION BUT TO KEEP OUR
CONVERSATION MOVING ALONG, CAN
WE GET TO THE NEXT SLIDE,
PLEASE.
WHAT YOUR COMMUNITY'S MOST
PRESSING NEEDS WHEN IT COMES TO
COMMUNICATION AND INFORMATION
REGARDING LONG COVID?
WHAT ARE THE AVERAGE APPROACHES
AND INTERVENTIONS YOU FEEL WOULD
BE MOST EFFECTIVE IN YOUR
COMMUNITIES AND HOW MIGHT
RECOVER PARTNER WITH OTHER
ORGANIZATIONS LIKE YOURS TO
BETTER UNDERSTAND THE IMPACT OF
LONG COVID IN YOUR COMMUNITIES?
AND BETTER MEET YOUR PRESSING
RELATED NEEDS.
WE'LL OPEN THAT UP FOR COMMENT
AND DISCUSSION.
WHAT ARE THE MOST PRESSING NEEDS
WHEN IT COMES TO COMMUNICATION
AND GETTING INFORMATION TO THOSE
WHO NEED TO HAVE THAT
INFORMATION?
YOU CAN RAISE YOUR QUESTION IN
THE CHAT AND WE'LL TAKE IT FROM
THERE.
I WANT TO MAKE A POINT IN OUR
TASK FORCE WE FOCUSSED ON
SOMETHING MENTIONED BY A POINT
THAT THE MATERIALS PRODUCED BE
CULTURALLY EFFECTIVE I WANT TO
ACKNOWLEDGE THAT'S SOMETHING WE
SPENT A LOT OF TIME ON.
TER AUTO -- TERESA.
>> I'M FOUNDER OF BLACK COVID-19
SURVIVORS SPORT GROUP.
IN RELATION TO THE BEST WAY TO
GET INFORMATION OUT, ONE THING I
HAVE SEEN IS THAT THERE'S A
DISTRUST IN GENERAL FROM THE
GOVERNMENT AND IF THERE COULD BE
LIKE A CACHE OF INFORMATION OF
GRAPHICS, THINGS THAT ARE
APPROPRIATE FOR A VARIETY OF
AGES FOR COMMUNITY MEMBERS LIKE
MYSELF AND OTHERS ON THE
GRASSROOTS LEVEL TO PULL FROM
THE CACHE FOR DISSEMINATION
WOULD REACH PEOPLE THROUGH
SOCIAL MEDIA AND THAT SEEMS TO
BE THE BIGGEST DRIVER OF
INFORMATION AS WELL AS
MISINFORMATION.
WHEN IT COMES TO LONG COVID, I'M
SEEING SOME THINGS WHERE A LOT
OF PEOPLE MAY HAVE LONG COVID
BUT ATTRIBUTING THEIR PROBLEMS
TO THE VACCINE.
THAT'S A CONTINUATION OF THE
DISTRUST FACTOR AND
MISINFORMATION AND RELUCTANCE
FOR PEOPLE IN THE BLACK
COMMUNITY TO GET THEIR
VACCINATION AND/OR BOOSTERS.
>> SO IF YOU DON'T MIND, TERESA,
COULD YOU ELABORATE ON THE LAST
POINT OF CONFLATING LONG COVID
WITH THE CONSEQUENCES OF GETTING
THE VACCINE?
I THINK THAT'S AN IMPORTANT
THING.
>> SURE.
FOR THOSE WHO HAD BREAKTHROUGH
CASES THEY'RE NOT ALWAYS AWARE
LONG COVID EXISTS.
SO ONCE THEY HAVE GOTTEN THE
VACCINE, SECOND SHOT OR BOOST
ARE BECOME MORE CONSCIOUS AND
AWARE OF WHAT THEY'RE OWN
AILMENTS AND CONDITIONS ARE AND
AUTOMATIC TO ATTRIBUTING TO
HAVING RECEIVE THE SECOND VAX OR
BOOSTER.
AND SO FROM WHAT I'M SEEING,
FROM CONVERSATIONS AND SO FORTH
IN MY GROUP, THERE'S A STRONG
POSSIBILITY A LOT OF THOSE
ATTRIBUTES ARE DUE TO LONG COVID
AND NOT BECAUSE THEY'RE
SUFFERING SIDE EFFECTS BUT THAT
IS A GROWING CONCERN.
PEOPLE WHO HAVE BEEN VACCINATED
ARE OFTEN NOW NOT WANTING TO
HAVE THE BOOSTER.
THAT'S BECAUSE OF THE SIDE
EFFECTS WHICH IN REALITY JUST
MAY BE LONG COVID SO MORE
INFORMATION ABOUT LONG COVID
NEEDS TO BE OUT SO PEOPLE WILL
DIFFERENTIATE SIDE EFFECTS
VERSUS PASC.
>> THANK YOU.
THOSE ARE EXCELLENT POINTS WE
NEED TO CONSIDER SO I APPRECIATE
YOUR THOUGHTS ON THAT.
I THINK I SEE ABIGAIL'S HAND UP.
>> THIS SAY GREAT QUESTION AND
ONE THAT'S IMPORTANT.
WHEN I THINK ABOUT THE AMERICAN
INDIAN AND ALASKAN NATIVE
COMMUNITY AND THERE'S BEEN FOCUS
ON INTERNET ACCESS AND WE HAVE
AN INCREDIBLE DIGITAL DIVIDE.
WE FOUND THE MOST EFFECTIVE WAY
WAS TO SEND LETTERS FROM A
TRUSTED TRIBAL ORGANIZATION
VERSUS EVEN A PAMPHLET AND
SIMPLY DIDN'T HAVE ACCESS TO
INTERNET.
AS A RESULT OF THAT THEY WEREN'T
GETTING THE INFORMATION THEY
NEEDED IN ORDER TO PREVENT,
TREAT AND GET VACCINATED AGAINST
COVID.
DEFINITELY RECOGNIZE THERE'S A
DIGITAL DIVIDE AND MAKING SURE
THAT'S ADDRESSED WHEN LOOKING AT
COMMUNICATION.
WHEN WE THINK OF OUTREACH
APPROACHES AND ANY KINDS OF
INTERVENTIONS, THEY NEED TO BE
COMMUNITY DRIVEN AND INFORMED
AND OPERATED.
WHICH MEANS THE ALLOCATION OF
RESOURCES NEEDS TO GO TO THE
COMMUNITIES.
WHAT WE FOUND IS THAT IT REALLY
TOOK KEY INTERVIEWS AND FOCUS
GROUPS ACROSS THE COUNTRY
ENGAGING WITH THE COMMUNITIES
AND AGAIN RECOGNIZING SIMPLY
BECAUSE WE'RE AMERICAN INDIANS
AND ALASKAN NATIVES THAT WE LIVE
IN URBAN ORGANIZATIONS BUT OUR
HEALTH DISPARITIES REMAIN THOSE
IN LINE OF OUR BROTHERS AND
SISTERS ON THE RESERVATIONS SO
THERE'S ALSO A GAP IN
INFORMATION SO TARGETED
INFORMATION AND RESOURCE AND
FUNDING ARE ESSENTIAL.
THE OTHER THING THAT WE FOUND
THAT WORKS WELL AND CONTINUALLY
SEARCHING FUNDING FOR IS
PEER-TO-PEER.
TRAINING, OUTREACH WORKERS
TRAINING YOUR SISTER AND AUNTIE
TO TALK TO COMMUNITY MEMBERS.
THAT'S WHO THEY BELIEVE.
THERE'S NO TRUSTWORTHINESS IN
THE FEDERAL GOVERNMENT
GOVERNMENT AND WHEN THEY SAY HHS
AT THE BOTTOM OR CDC NOBODY
REALLY CARES.
THAT HAS BEEN A KEY GAP AND WE
NEED TO BE ABLE TO WORK WITH
COMMUNITY TRUSTWORTHY
ORGANIZATIONS AND BEGIN TO BUILD
THE TRUSTWORTHINESS OF OUR
FEDERAL SCIENTIFIC PARTNERS SO
WE BEGIN TO DO THAT WORK TO HEAL
SOME OF THE THINGS AFFECTING
WHETHER OR NOT INFORMATION GETS
TO US.
>> THANK YOU VERY IMPORTANT
POINTS YOU RAISED.
I APPRECIATE THAT.
>> AND THINKING ABOUT THE
MODALITIES IS IMPORTANT SO EVEN
AMONGST SOCIAL MEDIA THERE'S
DISPROPORTIONATE USE OF PLATFORM
DIFFERENT MINORITY POPULATIONS
USE RELATIVE TO OTHERS.
MAYBE YOU WANT TO BE TARGETING
THROUGH INSTAGRAM OR TWITTER
VERSUS OTHER ASPECTS AND MAYBE
WANT TO THINK ABOUT A DRIP
CAMPAIGN THAT CREATES MULTIPLE
AVENUES THROUGH WHICH MESSAGES
ARE COMING TO PEOPLE AND MAYBE
THROUGH DIFFERENT FORMS AND THE
OTHER THING THAT'S IMPORTANT IS
THINKING ABOUT THIS ITERATIVELY
AND THROUGH BEHAVIORAL ECONOMIC
FRAMEWORK.
WHY WOULD SOMEBODY WANT TO COME
BACK FOR MORE INFORMATION IS
BECAUSE THEY'RE GETTING
SOMETHING POSITIVE AND REWARDING
TO INCENTIVIZE WANTING TO
FURTHER ENGAGE AS WELL.
AGAIN, COMING FROM THE
PERSPECTIVE IF WE ASK WHAT
THEY'RE NEEDS AND PRIORITIES
ARE, WE COULD START PROVIDING
SOME OF THOSE WHICH THEN NOW ARE
CREATING A POSITIVE RELATIONSHIP
WHICH CAN FURTHER ENHANCE THAT
TRUST AND BUILD MOMENTUM TOWARDS
LONGER TOMORROW ENGAGEMENT AND
THAT CAN EXTEND TO OTHER HATH
BEHAVIORS.
I'LL LEAVE IT THERE.
THANK YOU.
>> FOR THOSE WHO ARE NOT
BOOMERS, WHAT IS A DRIP
CAMPAIGN.
>> YOU BUILD RESPONSE AND YOU
PROBABLY GET THIS MANY THROUGH
E-MAILS WHERE THEY'LL SAY GET
READY FOR THE UNVEIL BUT YOU
DON'T KNOW WHAT THE UNVEIL IS
YET AND GIVE MORE INFORMATION
AND IT KEEPS YOU HOOKED IN BUT
IT'S ABOUT THE FREQUENCY SO IT'S
ALWAYS IN THE BACK OF YOUR MIND
YOU WANT TO BE ENGAGED WITH THE
RECOVER INITIATIVE BUT DON'T
KNOW WHY BECAUSE IT'S VERY
SUBTLE.
IT'S NUDGING, ESSENTIALLY AND
MARKETING.
>> THANK YOU.
>> I'M WITH THE CHILDREN'S
DEFENSE FUND SOUTHERN REGIONAL
OFFICE AND DO WORK IN RURAL
COMMUNITIES ACROSS ALABAMA,
GEORGIA AND MISSISSIPPI WITH A
NETWORK OF BLACK WOMEN AND
GIRLS.
WE HAVE AND IDENTIFYING WHO
THOSE ARE WITHIN THE COMMUNITY
TO PUT INFORMATION THROUGH.
BLACK WOMEN AND MOTHERS OF ANY
KIND ARE LISTENED TO WHEN IT
COMES TO THINGS ABOUT HEALTH.
BLACK WOMEN AND MOTHERS ARE
GENERALLY IN CHARGE OF HEALTH
CARE ARRANGEMENTS AROUND THEIR
FAMILY.
WE WOULD LIKE TO SEE GREATER AND
REACHING DEEPER INTO COMMUNITIES
AND THINK ABOUT THE
INFRASTRUCTURE THAT'S BEEN PUT
IN COMMUNITIES AROUND HEALTH
CARE.
THOSE ORGANIZATIONS THAT WERE
PUT IN PLACE TO DO OUTREACH AND
NAVIGATION FOR THE ACA ALREADY
HAVE CONTACTS AND HAVE AND ARE
RECOGNIZED FOR BEING CONNECTED
TO HEALTH CARE DELIVERY.
THEN FINALLY AND AS WE THINK OF
LONG COVID AND ALL THE OTHER
THINGS WE'RE TALKING ABOUT WE'RE
LOOKING AT THIS TOWARDS
LONG-TERM STRATEGIES FOR HOW WE
DEVELOP PUBLIC HEALTH SYSTEMS.
OBVIOUSLY OUR PUBLIC HEALTH
SYSTEM NEEDS A LOT AND NEEDS TO
BE CONNECTED MORE INTO
COMMUNITIES.
THOSE ARE COMMENTS I HAVE.
>> THANK YOU.
I WANT TO RAISE A POINT I SEE IN
THE CHAT I THINK IS REALLY GOOD.
WITH THE ORGANIZATION ABC POINTS
OUT AND WANTS TO KNOW WILL THE
INITIATIVE TAKE INTO ACCOUNT A
GLOBAL PERSPECTIVE THAT IS HOW
WILL DATA AND INFORMATION FROM
OTHER COUNTRIES BE INCORPORATED
INTO THIS PROJECT?
I WOULD INVITE DR. LERNER AND
WILLIAMS TO SPEAK ON THIS AND
THANK YOU FOR THAT QUESTION.
>> THANKS VERY MUCH FOR THAT
QUESTION AND IT'S A REALLY
IMPORTANT CONSIDERATION.
WHILE THE RECOVER INITIATIVE
SITES ARE ACROSS ALL 50 STATES
THE INITIATIVE IS DESIGNED TO BE
ADAPTABLE AND NIMBLE AS WE LEARN
MORE ABOUT LONG COVID AND PASC
AND OF COURSE THAT MEANS DATA
FROM AROUND THE WORLD.
AND AS THE SCIENCE EVOLVES SO
WILL THE RECOVER INITIATIVE.
>> THANK YOU ONCE AGAIN.
I'D LIKE TO PROVIDE COMMENTS AND
WHAT COMES TO MIND IS THE
APPROACHES IS A CHALLENGE IN THE
LATINO COMMUNITY AND COMMUNITIES
OF COLOR IS LITERACY ISSUES AND
ASIDE FROM LITERACY IT'S HEALTH
LITERACY, THE LACK OF
UNDERSTANDING OF HOW VIRUSES
SPREAD, SYMPTOMS TO BE LOOKING
OUT FOR AND HOW VACCINES WORK
AND WHAT'S A VACCINE VERSUS THE
COVERED SYMPTOM AND THE HEALTH
LITERACY PIECE IS A WAY TO
ELEVATE OUR COMMUNITY
UNDERSTANDING OF HOW OUR BODIES
WORK AND DON'T WORK TO COMBAT
THE MISINFORMATION THAT IS OUT
THERE THAT SOUNDS RIDICULOUS
BECAUSE WE ALL COME FROM A
BACKGROUND WHERE WE HAVE
BASELINE UNDERSTANDINGS OF HOW
OUR BODIES WORK.
I BELIEVE A WAY TO GET AROUND
THAT IS TO USE SIMPLIFIED TEXT
AND USING PICTURES VERSUS USING
TEXT.
I LOVE THE IDEA OF THE PAM IN
THE AND DOING THE MAILINGS AND
SO FORTH AND THE DIGITAL DIVIDE
IS REAL DEPENDING ON WHAT YOUR
ZIP CODE IS.
I WANTED TO PROVIDE THAT
FEEDBACK.
IN TERMS OF WHICH PARTNER
ORGANIZATIONS TO CONSIDER, WHAT
COMES TO MIND IS OUR COMMUNITY
HEALTH WORKERS, THOSE FOLKS WHO
ARE ON THE GROUND, TRUSTED
MESSENGERS WORKING WITH THE
COMMUNITY FOR YEARS AND DECADES.
THOSE ARE THE INDIVIDUALS THAT
WE COULD PROVIDE THOSE PAMPHLETS
TO OR PUBLIC HEALTH NURSES ALSO
IN THE RURAL COMMUNITIES WHO ARE
THE FRONT LINE PUBLIC HEALTH
WORKERS WHERE THERE IS NO HEALTH
DEPARTMENT BECAUSE THOSE RURAL
COMMUNITY SO SMALL.
AND THE WELLNESS VISITS FOR
PREGNANT WOMEN.
THERE'S ALSO A LOT OF WOMEN WHO
ARE PREGNANT AND THERE'S A LOT
OF MISINFORMATION ABOUT COVID
AND CDC JUST RELEASED A STUDY OF
IMPACT OF COVID OF PREGNANT
WOMEN AND INFANTS AND GOING BACK
TO WHAT PARTNER ORGANIZATIONS I
WOULD SAY THE NATIONAL
ASSOCIATION OF HEALTH WORKERS
AND THE NATIONAL HISPANIC
MEDICAL ASSOCIATION AND NATIONAL
ALLIANCE OF HISPANIC HEALTH.
THESE ARE A COUPLE PARTNERING
ORGANIZATIONS THAT CAN HELP
CARRY THIS MESSAGE FORWARD AND
INCREASE THE COMMUNITY HEALTH
LITERACY AND ADDRESS LITERACY
ISSUES IN GENERAL.
THANK YOU.
>> YOUR HAND WAS UP?
>> I'M A LOCAL PASTOR IN
WASHINGTON, D.C.
ONE OF THE THINGS THAT WE ARE
HAVE FOUND VERY EFFECTIVE IS
BEGINNING TO LOOK AT INTEGRATIVE
SERVICES.
WHAT I MEAN BY THAT IS THE
SEARCH DOING THE ORDINARY FOOD
DISTRIBUTION INCLUDE INFORMATION
SESSIONS IN AND AROUND PROVIDING
INFORMATION WITH COVID.
WE DO NEED IT TALK ABOUT LONG
COVID MORE BECAUSE OUR
COMMUNITIES DON'T REALLY KNOW
MUCH ABOUT THAT.
USING THE INTEGRATIVE SERVICES,
WE ALSO FOUND WHEN WE BRING
ALONG FOOD DISTRIBUTION AND HAVE
KIDNEY DISEASE SCREENING AS WELL
AS HEALTH RELATED MATTERS AS
NOTED FROM OTHER SPEAKERS, WE
FIND IT'S A GREAT WAY TO
COMMUNITY IN A PRACTICAL WAY
ABOUT COMMUNITY HEALTH.
I WOULD RECOMMEND WE DO THAT
BECAUSE THAT IS SOMETHING THAT
IS HELPFUL WHEN WE BEGAN TO
THINK ABOUT WHAT THE HOUSES OF
WORSHIP CAN DO AND
COMMUNITY-BASED ORGANIZATIONS
CAN DO.
I WOULD SAY WE SHOULD JUST NOT
STOP WITH THE INTEGRATIVE
SERVICES BUT LOOK AT AND USE
THINGS LIKE THE ARTS.
FOR EXAMPLE, WITH BLACK
COALITION AGAINST COVID, WE'VE
DONE POETRY SLAMS, WE'VE DONE
OTHER THINGS TO BEGIN TO TALK
ABOUT COVID AND VACCINATIONS AND
TESTING WE CAN USE THE SAME SORT
OF THING AS IT RELATES TO LONG
COVID AS WELL.
THANK YOU.
>> THANK YOU.
THERE WAS A COMMENT ABOUT
SCHOOLS.
>> SCHOOLS ARE A MAJOR
DISSEMINATOR OF INFORMATION.
AND WHETHER IT'S PAMPHLETS OR
FLIERS, POST CARDS I THINK
THEY'RE A GREAT PARTNER TO MAKE
IT HOME THROUGH CHILDREN FROM
SCHOOLS.
WHETHER IT'S PASSING OUT
LITERATURE OR PROVIDING SOME
DEGREE OF CURRICULUM THAT SCHOOL
COUNSELORS OR TEACHERS CAN
UTILIZE TO INFORM THROUGH PARENT
MEETINGS AND PTA ARE ADDITIONAL
AVENUES THAT COULD HAVE
WIDESPREAD EFFECT.
>> THANK YOU FOR THAT.
>> MAY I ASK A FOLLOW-UP
QUESTION FOR TERESA.
SHE PRESENTATIONED PREVIOUS
ONLINE SUPPORT GROUPS AND
WONDERING IF YOU CAN SHARE ANY
SPECIFIC TO BLACK AND INDIGENOUS
PEOPLE OF COLOR YOU ARE AWARE
OF.
>> SUPPORT GROUPS?
SO THERE'S A COUPLE ON FACEBOOK
BUT I'M NOT SURE HOW MUCH
TRACTION THERE IS IN
PARTICIPATION.
I KNOW IN MY GROUP WE HAVE A
GOOD AMOUNT OF ENGAGEMENT.
MY GROUP IS MORE OF A SOCIAL
SUPPORT GROUP AND THAT'S WHAT
I'M LOOKING TO CHANGE AND WHERE
I WAS ADDING THAT FOR ALL OF
THESE SOCIAL SUPPORT GROUPS AND
HAVE THE GRAPHICS AND
INFORMATION WE COULD HAVE WOULD
GO A LONG WAY.
A LOT OF TIME INSIDE THE GROUPS
IS SPENT IN MODERATING IS SPENT
TAKING DOWN MISINFORMATION AND
DELETE I
DELETING INFORMATION FROM
UNRELIABLE SOURCES AND HAVING
SIDE CONVERSATIONS WITH PEOPLE
ABOUT THE BASIC HEALTH EDUCATION
AS SOMEONE MENTIONED EARLIER
THERE NEEDS TO BE MORE KNOWLEDGE
AND EDUCATION ABOUT HEALTH IN
GENERAL AS WELL WHAT RESEARCH
AND SURVEYS ARE.
WHEN WE HEAR ABOUT RESEARCH IT'S
I DON'T WANT TO BE YOUR GUINEA
PIG.
IN GROUPS LIKE MINE THAT WOULD
BE THE PERFECT AVENUE FOR
EDUCATING PEOPLE AND TRYING TO
GET MORE PARTICIPANTS WILLING TO
BE A PART OF THESE COHORTS AND
OTHER TYPES OF RESEARCHING
STUDIES THAT HAVE NOTHING TO DO
WITH FORCING MEDICATIONS AND
EXPERIMENTAL DRUGS ON PEOPLE.
>> I'D LIKE TO INVITE AN
EXPANSION ON THE POINT MADE
ABOUT CONVERSATIONS LIKE THIS
BEING SIMILAR TO EFFORTS AROUND
THE CHILD TAX CREDIT.
WOULD YOU MIND SPEAKING TO THAT
FOR US, PLEASE.
>> WHEN THE ACA WAS FIRST
ENACTED TRYING TO FIGURE OUT HOW
TO GET PEOPLE INTO THE SYSTEM
AND HOW WE USE NAVIGATORS.
THERE'S BEEN A LOT OF
IMPROVEMENTS ON TO WHO ARE
TRUSTED MESSENGERS AND HOW DO
YOU DEFINE NAVIGATORS.
TO ME PART OF THE CONVERSATION
IS HOW IS THIS OUTREACH A WHOLE
OF GOVERNMENT APPROACH AND HOW
ARE WE REACHING PEOPLE WHO MAY
BE IN OTHER PLACES OR OTHER
LOCAL AGENCIES AND REACHING
PEOPLE IN MULTIPLE WAYS SO WE
DON'T REACH THEM IN DIFFERENT
AVENUES THAT MAY NOT BE BEST NOR
COMMUNITIES.
I'M JUST COMMENTING ON THE FACT
THAT A LOT OF THESE STRATEGIES I
THINK ARE SIMILAR STRATEGIES
THAT MANY GRASSROOTS AND
DISTRICT SERVICE ORGANIZATIONS
WERE IMPLEMENTING OVER THE LAST
SIX MONTHS LAST YOU'RE TO GET
FAMILIES TO SIGN UP FOR THEIR
MONTHLY PAYMENT IF THEY HAVEN'T
ALREADY AND MAYBE THERE'S
LESSONED LEARNED AND WAYS TO
STRATEGIZE AND IMPLEMENT THEM
TOGETHER.
MAYBE THERE'S SIMILARITIES AND
OVERLAP AND YOU DISCUSSED
THERE'S NOT COMPREHENSIVE DATA
ON WHO HAS LONG COVID BUT JUST A
THOUGHT.
I HAVE AN ADDITIONAL QUESTION.
IS THE PURPOSE OF THE OUTREACH
JUST TO EDUCATE INDIVIDUALS IN
COMMUNITIES ABOUT LONG COVID OR
ALSO TO TAKE A FURTHER STEP TO
GET FOLKS INTO CARE WHO MAY NOT
BE ALREADY UP CARE?
I'M THINKING OF IF I WERE
SOMEBO
SOMEBODY AND THOUGHT IF I THINK
I HAVE THIS WHAT SE IS THE NEXT
STEP AND IF I DON'T HAVE A
DOCTOR OR UNINSURED OR UNDER
INSURED.
>> THE TASK FORCE THE PRESIDENT
APPOINTED WE WERE CONCERNED
ABOUT THOSE WITHOUT INSURANCE
AND DISADVANTAGED COMMUNITIES
WHERE THERE'S NOT INSURANCE OR
ACCESS TO PROVIDERS.
IF YOU YOU MAKE PEOPLE AWARE
THEY HAVE A CONDITION AREN'T YOU
ETHICALLY OBLIGED TO HELP THEM
FIND TREATMENT SO THINK IT'S
IMPERATIVE AS WE RAISE AWARENESS
WE MAKE PLANS TO PROVIDE FOR THE
CARE OF THOSE INDIVIDUALS AND
RELATED TO THAT IS SOME PEOPLE
MAY NOT BE ABLE TO RETURN TO
WORK AND MAKE SURE THE ECONOMIC
IMPACT TO THE FAMILY IS NOT
SOMETHING THEY CANNOT RECOVER
FROM.
YOUR POINT IS WELL TAKEN.
LIKE IN THE EARLY DAYS OF THE
HIV EFFORT WHEN WE WERE TURNING
TO GET PEOPLE TEST BEFORE THERE
WERE TREATMENTS AVAILABLE AND IF
YOU HAVE EVERYONE TESTED AND NO
TREATMENT, WHAT DO YOU DO IN
THAT SITUATION?
YOU YOU RAISE A GREAT POINT
WE'VE LIVED THERE BEFORE.
I THINK THAT'S AN IMPORTANT
CONSIDERATION COMING OUT OF THE
TASK FORCE I WAS A MEMBER OF.
THANK YOU FOR THAT.
>> ONE QUICK FOLLOW-UP.
TO CLARIFY THEN, WILL THE
COMMUNICATION STRATEGIES AND THE
OUTREACH STRATEGIES AND
EDUCATION STRATEGIES AND AGAIN
EVERYONE'S SAID THIS BUT YOU
HAVE TO TAILOR MESSAGES TO THE
COMMUNITY BUT WILL THAT
INCLUDE -- IT IS THE GOAL OF
RECOVER COVID AND THIS
INITIATIVE AND OTHERS TO ENSURE
WE INCLUDE TARGETED MESSAGES
THAT GET PEOPLE INTO CARE JUST
TO MAKE SURE I UNDERSTAND AND
ARE YOU RECOMMENDING THAT.
>> SO I THINK AND NIH'S ROLE IS
HOW TO DEAL WITH LONG COVID.
THERE'S OTHER AGENCIES LIMITED
TO ENSURE PEOPLE WHO NEED THE
CARE WILL GET IT.
BUT ONE OF THE OTHER
CONSEQUENCES OF THIS WILL BE TO
MAKE SURE THAT PEOPLE OF COLOR
ARE PART OF IMPORTANT STUDIES
THAT NEED TO HAPPEN BECAUSE AS
YOU KNOW AND ONE THEIR GOALS OF
RECOVER AND I'LL LET MY
COLLEAGUES WHO ARE RESPONSIBLE
FOR THIS BUT I THINK IT'S A
REALLY IMPORTANT PART OF WHY
IT'S SO IMPORTANT THAT THESE
OUTREACH EFFORTS ARE HAPPENING
TOIANIAN TOIAN ENSURE
-- TO ENSURE THE ANSWERS WE FIND
BENEF
BENEFIT EVERYONE.
>> AND TO ENSURE DIVERSE
POPULATION AND UNDERSTAND THE
CONDITION WITH AN EYE TOWARDS
CLINICAL TRIALS AS WELL.
>> I WANT TO ACKNOWLEDGE IN THE
CHAT AN IMPORTANT POINT MADE
ABOUT WORKING WITH CHURCHES.
THE FAITH COMMUNITY HAS HELPED
GET THE WORD OUT ABOUT COVID AND
MAKING SURE PEOPLE GET
VACCINATIONS.
WE ACKNOWLEDGE THE FAITH
COMMUNITY PLAYS AN IMPORTANT
ROLE IN THIS EFFORT AS WELL.
I WOULD LIKE TO TAKE US TO THE
THIRD QUESTION WHICH MEANS WE'RE
NOT CLOSING THE DISCUSSION ON
THIS BUT TO KEEP THINGS MOVING.
THE THIRD QUESTION THAT WE WERE
TALKING ABOUT WE TOUCHED ON IN A
COUPLE WAYS BUT BASED ON THE
KNOWLEDGE YOU HAVE ON LONG COVID
ARE MEMBERS WILLING TO STUDY IN
PERSON OR DIGITALLY USING THE
DEVICES WITH SPOKE ABOUT EARLIER
AND FURTHER CONSIDERATIONS ARE
WOULD THEY BE WILLING TO SHARE
THEIR PERSPECTIVE WITH DOCTORS
AND SCIENTISTS BY JOINING A
NATIONAL DIALOGUE OR GROUP AND
ARE THERE OTHER WAYS WE MAY NOT
HAVE THOUGHT ABOUT WE'D LIKE TO
ENGAGE WITH THE COMMUNITIES IN
TERMS OF RECOVER.
AND VERY IMPORTANTLY, ARE THERE
OTHER GROUPS YOU FEEL SHOULD BE
DRAWN INTO RECOVER WE HAVE NOT
REACHED OUT TO OR MADE REFERENCE
TO?
PLEASE RAISE YOUR HAND OR PUT
YOUR COMMENTS IN THE CHAT AND
WE'LL KEEP THE CONVERSATION
GOING.
SOME ALREADY MADE REFERENCE TO
THE FACT THAT UNLESS THE
MATERIALS ARE CULTURALLY AND
LINGUISTICALLY APPROPRIATE IT
WILL CREATE A CHALLENGE FOR US
BUT IF WE'RE ABLE TO ACHIEVE
THAT TO MAKE SURE WE DO HAVE
INFORMATION AND MATERIALS THAT
MEET THAT CRITERIA, WHAT DO YOU
THINK WOULD BE THE LIKELIHOOD OF
YOUR COMMUNITY BEING WILLING TO
PARTICIPATE IN THOSE STUDIES?
>> MAKING SURE THE COMMUNITY IS
ENGAGED EARLY ON AND
PARTICIPATING IN THE EARLIER
DIALOGUES AND WITH RESPECT TO
BLACK COMMUNITIES ACKNOWLEDGING
THE PAST AND REPAIR SOME OF THE
TRUST THAT'S OCCURRED AND MAKE
SURE TO LET COMMUNITIES KNOW
THEY CAN HELP SHAPE COMMUNITY
HELP AND AMPLIFYING THEIR VOICE
IS A CRITICAL MESSAGE TO MAKE
SURE IT'S COMMUNITY AND PATIENT
CENTERED TO KEEP THAT ENGAGEMENT
HIGH.
>> GO AHEAD, ABIGAIL.
>> IF WE LOOK AT WHAT'S GOING ON
JUST COVID-19 STUDIES IN
PARTICULAR THE RAD X STUDIES
BEING CONDUCTED BY DIFFERENT
INVESTIGATORS ACROSS FUND BY THE
NIH PARTICULARLY IN AMERICAN
INDIAN AND ALASKAN NATIVE
RESEARCH AND WE TALK ABOUT IT IN
THE PAST AND I'M TALKING ABOUT
YESTERDAY.
AS A RESULT OF THAT THERE
CONTINUES TO BE MISTRUST.
I KNOW THERE'S HESITATION IN
TRIBAL COMMUNITIES ABOUT THE WAY
THE RAD X STUDIES MAY BE USING
SAMPLES COLLECTED FOR BIO
SPECIMEN RESEARCH THEY DIDN'T
UNDERSTAND WOULD BE PART OF.
YOU HAVE TO LOOK AT THE
IMPLICATIONS OF CURRENT COVID-19
STUDIES AND THE IMPACT ON THAT
AS YOU MOVE FORWARD WITH THIS
NEXT ITERATION AROUND LONG COVID
BUT THE ANSWER TO THIS QUESTION
FROM THE NATIVE PERSPECTIVE IS
YES AND NO.
YOU'LL HAVE HESITANCY AND
WILLINGNESS TO ENGAGE.
ONE OF THE MOST IMPORTANT THINGS
TO DO WILL BE ENGAGE TRIBAL
COMMUNITIES, THOSE ON
RESERVATIONS AND VILLAGES FROM A
NATION TO NATION RESPECTING
THEIR TRIBAL SOVEREIGNTY AND
ENGAGING WITH THE NIH OFFICE AND
THE TRIBAL ADVISORY FOLKS ARE
GOING TO BE WILLING BUT THERE IS
GOING TO BE HESITANCY.
AS A RESULT OF THAT THERE WILL
BE LIMITATIONS AND ENGAGING WITH
NATIONAL AND INDIGENOUS
ORGANIZATIONS AND I'LL WILLING
TO SHARE A LIST IF YOU'RE
INTERESTED, WILL BE KEY.
AND WE HAVE TO ACKNOWLEDGE THE
HISTORICAL MISSTEPS FROM
YESTERDAY AND PROBABLY WILL BE
TODAY AND IT'S AN ONGOING TRUST
BUILDING EXERCISE THAT WILL BE
IMPORTANT BECAUSE THE ENGAGEMENT
OF THE COMMUNITY IN THE RESEARCH
STUDIES WILL BE KEY.
>> THANK YOU, ABIGAIL, YOU'RE
POINTS ARE WELL TAKEN.
>> I THINK SOME COMMUNITY
MEMBERS WOULD PARTICIPATE AND
SOME WOULDN'T.
IT DEPENDS ON FUTURE
PARTICIPANTS WILL ALWAYS HAVE
THE RISK VERSUS BENEFIT MOMENTS
WHERE THEY'RE LEARNING WHAT THIS
STUDY IS AND HOW IT'S GOING TO
BENEFIT THEM BUT ALSO THERE'S
ONLY SO MUCH ALTRUISM THAT WILL
GOT PEOPLE TO PARTICIPATE AND
THERE'S TOUCH POINTS WITH THE
PARTICIPANTS.
WILL THERE BE CHILDCARE COVERAGE
AND TRANSPORTATION COVERAGE AND
THAT COULD FACTOR PARTICIPATION
AND RETENTION.
RETENTION IS A MAJOR ISSUE.
ALSO THE ABILITY FOR RAPPORT AND
WHEN PARTICIPANTS CHANGE PHONE
NUMBERS YOU CAN MAINTAIN
COMMUNICATION IS ANOTHER
CHALLENGE FOR RETENTION AND
GOING BACK TO THE RISK-BENEFIT
CALCULATION IF THERE'S A
MONETARY BENEFIT THAT COULD BE
AN INCENTIVE TO PARTICIPATE AND
IN TERMS OF DIFFERENT MODALITIES
OF PARTICIPATION IT DEPENDS ON
THE AGE GROUP AND DIGITAL
DIVIDE.
YOU HAVE FOLKS WILLING TO
PARTICIPATE ON A FACEBOOK CALL
AND ZOOM CALL AND THOSE WHO WANT
SOMETHING IN PERSON FACE TO FACE
AND IN BETWEEN.
TEXT MESSAGING PARTICIPATION AND
WAYS TO CONNECT FOLKS DEPENDING
ON THE AGE GROUPS AND ACCESS IN
ADDITION TO HAVING DATA
COLLECTORS OR THOSE WHO LOOK
LIKE THE COMMUNITY THEY'RE
TRYING TO CONNECT WITH.
IF IT'S SPANISH SPEAKING
PARTICIPANTS AND SPANISH
SPEAKING DATA COLLECTOR THAT'S
ALSO IMPORTANT TO CONSIDER AND
THOSE THE COMMENTS I'D LIKE TO
PROVIDE.
>> EDWARD IVY WITH THE
ORGANIZATION OF CARDIOLOGISTS
AND WE HAVE BEEN WORKING WITH
THE COMMUNITY DURING THIS
PANDEMIC USING ZOOM PLATFORMS
AND OTHERS TO EDUCATE
PARTICIPANTS AND THEY HAVE BEEN
VERY ENGAGED.
THEY WANT THE KNOWLEDGE BUT IT'S
GOING IT TAKE USING THE
INDIVIDUALS ON THE GROUND THAT
UNDERSTAND THE GAPS AND
CHALLENGES THAT EXIST IN THAT
COMMUNITY TO BE A PART OF THE
PROCESS.
AND I THINK WITH THAT WE HAVE TO
INCLUDE THEM EARLIER ON.
ENGAGING COMMUNITIES LIKE YOU'RE
DOING RIGHT NOW IS VERY
EFFECTIVE BUT MAKING SURE WE
CONTINUE TO ENGAGE THE
INDIVIDUALS ON THE GROUND
INTERACTING DIRECTLY WITH THE
COMMUNITY.
IT'S COMMUNITY HEALTH TRAINING
PARTICIPANTS WE BEEN ABLE TO
INCREASE KNOWLEDGE ABOUT
CARDIOVASCULAR DISEASE BECAUSE
IT'S STILL THE NUMBER ONE CAUSE
OF DEATH IN THE U.S. AND USING
OUR NETWORK OF CARDIOLOGISTS AND
PROVIDERS FOR OUR COMMUNITY HAS
BEEN A WAY TO ENGAGE THE
COMMUNITY AND GET MORE
PARTICIPATION.
I WANT TO ECHO LIKE EVERYONE HAS
SAID, PEDRO AND OTHERS, IT WILL
TAKE THE ENGAGING THE COMMUNITY
EARLIER ON AND KEEPING THAT
ENGAGEMENT MOVING FORWARD.
>> JENNIFER.
>> I THINK PEDRO TOOK EVERYTHING
I WAS GOING TO SAY AND SAID IT
REALLY WELL SO I WON'T REPEAT
TOO MUCH AND I DON'T SPEAK FOR
ALL ASIAN AMERICAN AND PACIFIC
ISLANDERS AND THERE'S MANY
LANGUAGES AND ETHNICITIES AND WE
LEARNED IS WE NEED TO ENGAGE
COMMUNITIES THROUGH BILINGUAL
CULTURAL NURSES AND THOSE ARE
THE FOLKS PEOPLE WILL TRUST.
TRUSTED COMMUNITY ORGANIZATIONS
LIKE WHAT EVERYONE SAID ARE THE
GROUPS THAT ASIAN AND PACIFIC
ISLANDERS WILL GRAVITATE TOWARDS
AND YES, PEOPLE FROM OUR
COMMUNITIES WILL JOIN IN THIS
DIALOGUE AND PARTICIPATE IN YOUR
ENGAGEMENT EFFORTS AND THERE'S
GOING TO BE VARIATIONS BECAUSE
OF HEALTH LITERACY AND LITERACY
IN GENERAL AND YOU'LL HAVE
YOUNGER FOLKS WHO WILL ENGAGE IN
MORE SOCIAL MEDIA AND WITH THE
OLDER POPULATION I KNOW FROM MY
OWN WORK WITH COMMUNITY HEALTH
WORKERS, YOU REALLY HAVE TO HAVE
SOMEONE WHO SPEAKS THE LANGUAGE
WHO THEY SEE AND TRUST IS GOING
TO BE ABLE TO HELP THEM NAVIGATE
THESE DIALOGUES.
I JUST WANTED TO ADD THAT PIECE.
>> THANK YOU, VERY MUCH AND I
THINK WE ARE COMING CLOSE TO THE
END OF OUR TIME HERE.
I BELIEVE IT'S TIME FOR ME TO --
OH, DR. WILLIAMS, PLEASE, I SEE
YOUR HAND IS RAISED.
>> I'M SORRY, I HAVE THIS
QUESTION OR STATEMENT BECAUSE
IT'S COME UP MULTIPLE TIMES.
I REALLY APPRECIATE WANTING
DOCUMENTS TO BE IN PLAIN
LANGUAGE AND TAKE INTO
CONSIDERATION HEALTH LITERACY
AND REALLY AT THE CSC WE SPEND A
LOT OF TIME ON OUR DOCUMENTS
FROM THE PROTOCOL CONSENT FORMS,
RECRUITMENT MATERIALS WHERE WE
SEND A SIGNIFICANT AMOUNT OF
TIME ADDRESSING HEALTH LITERACY
AND PLAIN LANGUAGE SO THANK YOU
FOR THAT COMMENT.
>> THANK YOU, DR. WILLIAMS.
>> AS FAR AS PEOPLE
PARTICIPATING IN THE STUDIES I
THINK THEY NEED TWO THINGS TO
MOTIVATE THEM.
ONE IS ANONYMITY BECAUSE OF THE
CONCERN OF UNSCRUPULOUS SCIENCE
THAT'S HAPPENED IN THE PAST.
AND ALSO PEOPLE WANTED TO BE
ASSURED THAT THEIR INFORMATION
WON'T BE HELD AGAINST THEM OR
PUT SOME PLACE WHERE IN THE
FUTURE IT CAN COME BACK TO BE A
PROBLEM WITH THEIR EMPLOYMENT OR
ANY OTHER CASE AND INCENTIVES.
THERE'S A FEELING OF RIGHT NOW
THE MEDICAL AND RESEARCH
COMMUNITY IS ASKING, ASKING,
ASKING.
THERE'S A LOT OF GIVE US
INFORMATION, GIVE, GIVE, GIVE
WITHOUT AN OBVIOUS RECIPROCATION
OF WHAT THE PARTICIPANT CAN
EXPECT IN RETURN AND GETTING
MORE TO PARTICIPATE, CONSIDER
THE TIME FRAME IN WHICH THE IN
PERSON MEETINGS OR DIGITAL
MEETINGS WOULD TAKE PLACE
BECAUSE A LOT OF PEOPLE ARE
WORKING CLASS.
MISSING WORK MIDDAY FOR MEETINGS
LIKE THIS, FOR EXAMPLE IS NOT
CONVENIENT FOR A LOT OF PEOPLE.
WE HAVE TO CONSIDER THE TIMING
AND LATER EVENING TO ACCOMMODATE
A LOT OF PEOPLE'S WORK AND HOME
SITUATIONS AND THAT COULD HELP
INCREASE THEIR DESIRE TO
PARTICIPATE.
FINALLY, WHEN YOU THINK OF
HAVING A NATIONAL DIALOGUE, THAT
CAN FEEL AND SOUND WEIGHTY TO
THE AVERAGE PERSON.
DO YOU WANT TO ATTEND A
LISTENING SESSION WITH THE NIH.
THERE'S PRECONCEIVED NOTION
THERE'LL BE CONVERSATION OVER
OUR HEAD AND PONTIFICATING FROM
EXTREMELY EDUCATED PEOPLE AND
THE AVERAGE JOE MAY NOT HAVE A
PLACE AT THAT TABLE.
BEING ABLE TO FRAME THESE
MEETINGS WOULD HELP INCREASE
PARTICIPATION AND ALSO POSSIBLY
HOW CAN THE SAME MEETINGS BE
ORGANIZED IN A MORE LOCAL ASPECT
WHETHER IT'S TRAINED OPERATIVES
AND FACILITATORS WHO COULD DAO
DO COMMUNITY MEETINGS AT THE
CHURCHES OR SCHOOLS SO IT'S A
MORE INTIMATE AND FAMILIAR
SETTING WITH PEOPLE PARTICIPANTS
CAN FEEL RELATABLE TO.
>> THANK YOU.
THOSE ARE EXCELLENT POINTS.
I APPRECIATE IT.
EDWARD, DID YOU HAVE YOUR HAND
UP?
>> I SHOULD HAVE SAID IT HIT AT
THE CONCLUSION OF MY PREVIOUS
COMMENT BUT WE NEED TO BE CLEAR
ON WHAT YOUR ASK IS AND WHAT YOU
WANT COMMUNITY MEMBERS TO DO AND
PARTICULARLY IF YOU'RE GOING TO
ENGAGE GROUPS.
I HEARD LET'S GET COMMUNITY
HEALTH ADVOCATES BUT WHAT IS IT
YOU WANT THOSE ADVOCATES TO DO.
WHAT MESSAGE DO YOU WANT THEM TO
DELIVER TO THE COMMUNITY?
AND IT WOULD BE WONDERFUL IF
THERE IS FOLLOW-UP IN TERMS MUCH
HEY, I THINK I HAD LONG COVID
WHAT SHOULD I DO IN TERMS
GETTING CARE.
THAT NEEDS TO BE FLUSHED OUT
BEFORE YOU START GOING TO
COMMUNITIES WHERE ACCESS MAY BE
LOW ALREADY AND THEY START
FEELING MORE DISENFRANCHISED
BECAUSE YOU'RE NOT GIVING THEM
SOLUTIONS OR STEPS TO TAKE AND I
WANT TO MAKE SURE YOU'RE ASK OF
A COMMUNITY IS VERY CLEAR AND
ANY FOLLOW-UP THAT NEEDS TO
HAPPEN, THAT PROCESS IS VERY
CLEAR AS WELL.
>> EXCELLENT, THANK YOU, EDWARD,
VERY MUCH FOR THAT.
THERE'S A QUESTION WOULD THE
RECOVER WEBSITE BE A ONE STOP
SHOP WITH OUTREACH MATERIALS,
SOCIAL MEDIA, ETCETERA.
WOULD IT BE HELPFUL -- IT WOULD
BE HELPFUL TO HAVE SUCH A
ONE-STOP SHOP.
DR. WILLIAMS, DR. LERNER, DO YOU
WANT TO COMMENT ON THAT?
>> THAT'S THE IDEA TO HAVE THE
CONVENIENCE ONE STOP SHOP TO GO
FOR EVERYTHING RECOVER.
WE'RE ALSO GOING TO BE SHARING
AT THE CLOSE OF MEETING TO SIGN
UP FOR UPDATES ABOUT THE
INITIATIVE SO THAT'S ANOTHER WAY
TO KEEP TABS ON THINGS BUT YEAH,
WE HEAR YOU ABOUT THE EASE OF A
ONE-STOP SHOP.
>> AT THIS POINT IT MAY BE
APPROPRIATE TO ASK IF THERE'S
ANY OTHER COMMENTS OR QUESTIONS
ON ANY ONE OF THE THREE MAIN
QUESTION OR JUST SOMETHING YOU
THINK THE RECOVERY TEAM NEEDS TO
KNOW IN TERMS OF THE WORK
THEY'RE TRYING TO DO RELATED TO
THIS COMMUNITIES YOU REPRESENT?
I'LL OPEN IT UP FOR GENERAL
COMMENTS BEFORE I TURN IT BACK
TO DR. WILLIAMS.
DID ANYONE HAVE CLOSING THOUGHTS
OR QUESTIONS OR CONCERNS?
SO I WANT TO SAY I'M GRATEFUL
FOR THE OPPORTUNITY FOR THIS
CONVERSATION.
I THINK THE WORK THAT RECOVER IS
GOING TO DO AND THE RESEARCH IS
GOING TO DO IS GOING TO BE
REALLY IMPORTANT BUT WILL NOT BE
SUCCESSFUL UNLESS OUR
COMMUNITIES PARTICIPATE.
WE HOPE YOU'LL ENGAGE TO MAKE
THIS HAPPEN AND THIS IS REALLY
IMPORTANT BUT FROM THE SARS
PANDEMIC OF 2003, THERE ARE
INDIVIDUALS WHO COULD NOT GO
BACK TO WORK FOR AS LONG AS TWO
YEARS.
I'M NOT SAYING THAT'S GOING TO
BE THE CASE HERE BUT THIS WILL
BE A REALLY IMPORTANT PROBLEM
FOR SOME TIME TO COME.
THIS WORK IS REALLY IMPORTANT
AND HOPE UP ENGAGE WITH US TO
GET THIS DONE.
I'LL TURN IT BACK TO
DR. WILLIAMS.
THANK YOU VERY MUCH FOR THE
CHANCE TO BE A PART OF THIS
REALLY IMPORTANT CONVERSATION.
>> I'D LIKE TO ECHO
DR. HILLDRETH'S COMMENTS AND SAY
THANK YOU VERY MUCH.
WE APPRECIATE THE SESSION TODAY
AND ALL THE FEEDBACK THAT YOU
ALL HAVE PROVIDED.
WE HAVE THE SITE HERE WHERE YOU
CAN SEE OTHER WAYS TO BE IN
TOUCH AND LEARN MORE ABOUT THE
RECOVER INITIATIVE AND ALSO TO
SHARE THAT WE DO PLAN TO HAVE
ADDITIONAL LISTENING SESSIONS
FOR SPECIFIC COMMUNITIES AND WE
WELCOME PARTNERING WITH YOU AS
WE ROLL OUT THOSE OTHER SESSIONS
AS WELL.
SO THANK YOU ALL SO MUCH.
HAVE A WONDERFUL AFTERNOON.