Inner-city populations remain at high-risk for poor health outcomes, and premature death due to preventable diseases and en- vironmental factors associated with known socioeconomic and primary health care inequities. In many of these communities COVID-19 spreads at faster rates than other communities. We will take a look at inner city communities in and around Baltimore and ask the questions: Where are we in the midst of COVID 19 and what is the outlook for tomorrow? How do we positively impact health outcomes at the individual, family and community level looking at population health management, standards of care, and selfcare. Profound Conversations is a moderated discussion with a question and answer segment for listeners to contribute thoughts and seek guidance.

Show Topics and Highlights

What about the coronavirus is having the greatest impact on communities?

Are certain people truly essential workers, or are they sacrificial?

“Some cities are doing a good job of getting data and tracking who’s been impacted by the coronavirus, how are poor neighborhoods in Baltimore reacting?”

You’ve got to go to those places that are ugly.

It doesn’t matter how wealthy you are if your lungs are collapsing.

“We have systems set up to advantage one group over another.”

We need to keep allowing community leader to share their struggles and their successes. There needs to be an outlet for community voices.

“I care because I was raised in an environment  where I was always taking care of somebody and I learned to enjoy it early on. So essentially, what I'm doing is an outgrowth of environment I was lucky enough to grow up in and I want other people to have an environment that has something of beauty in it, even though the circumstances may be quite dire.” 

Profound Conversations Executive Producers are the Muslim Life Planning Institute, a national community building organization whose mission is to establish pathways to lifelong learning and healthy communities at the local, national and global level.   MLPN.life

The Profound Conversations podcast is produced by Erika Christie www.ErikaChristie.com

Full Transcript

Erika Christie

Hello, everyone, thank you for attending today's webinar. We've just got a quick technical technical thing for everyone to know. For those of you who are watching, if you would like to be chatting amongst yourselves. There is a chat feature inside the webinar so you guys could be having conversations about what we're having, what's going on. Also, if you have any questions That you would like to ask the panelist or the host, there is a Q&A feature for most of you is probably at the top of your screen. So if you'd like to ask the panelists, while the webinars going on or for the Q&A session at the end, please go ahead and put your questions in the Q&A session. Right. And I would like to hand it over now to our hosts, the Howard Linda.

Linda Howard

Welcome to profound conversations. So, first, I'm going to ask our attendees to listen to a quote from Margaret Whitley. Very great change starts from very small conversations held among people who care. Very great change starts from very small conversations. Held among people who care. Today we have with us two individuals who care and that are doing work in the community and their own way. And rather than me introduce them, I will ask that they tell their story. And for them to share a personal story that comes to mind from their most recent experience that punctuate who they are, what they do, and why they do it.

Andre?

Andre L Robinson Jr

Well, first is like being poor. It's no great honor, but I will take it. Thank you. So I think that the thing that reflects back to me most immediately as I live in work in a neighbor hood that is one of the most historic black neighborhoods in America, actually the West, Baltimore's Westside, and specifically on Druid Hill Avenue. And I am also a gardener. So one of the first things I ever do if I'm ever moving into a place to start working on the yard so I have, you know, I get to see some beauty, even in the midst of segregated neighborhoods. And one of the things that is constantly sort of underscore to me and taking care of the back alleys, the backyards that face another row of houses opposite me on another street is how many how easy it is to understand how the vectors for disease for for these kinds of environmental damages and so on and so on could be fomented in an area that's practically a swamp land back there all kinds of weeds and overturned buckets and people if we clean a lot people sweep through the alley. In a couple of weeks, in the middle of the night and push out all kinds of trash and garbage, and even though dumping illegally is a federal offense, by the way, because it could be toxic waste in that dump. They do it all the time. So can we clean it up? They do it, they do it again.

And

sometimes it feels very frustrating to have to do that over and over again. But I'm also remembering I think a grandparent asking me well, whose pickle is that? Whatever it is that I was worried about, that if you care about that thing the most, then you just clean it up. It's like just like I didn't take a shower one time and go on spectacularly clean, I never have to do this again. places that are this traveled on will get used very poorly because they don't recognize the value of it. So you have to see inherently the value in the environment and the people in that environment as being valuable and valuable enough to do it again and again. Like I will not quit Until I catch them till they catch the dumpers until I catch the other folks doing that, I have to see and understand the intrinsic value of where I stand. And I'm lucky enough to have lived in the world where that has been affirmed for me. But that's basically who I am. I care because I was raised in an environment of carry on the oldest of 10 kids, so I was always taking care of somebody and I learned to enjoy a bit early on. So essentially, what I'm doing is an outgrowth of environment I was lucky enough to grow up in and I want other people to have an environment that has something of beauty in it, even though the circumstances may be quite dire. So long story, long winded answer, but that's, that's why I do what I do.

Linda Howard

Thank you. And Dr. G.

Dr Panagis Galiatsatos

Perfect. Thank you, Miss Linda Howard. And so going second, it's great because I get to see how Mr. Andre I'm uncertain how much time he took and so forth. But Miss Linda Howard you are spot on. I mean, our, our narrative of our own experience is going to shape how we as adults act and so forth. And now I'm a physician and a scientist at Johns Hopkins and assistant professor, I'm a lung doctor in critical care. I'm, I'm a son of immigrants. So my Baltimore story is different. But it's my story. And it's it's it. I say this because it's one big story of Baltimore. I mean, that's what makes this city so magical. Traveling two miles, you're always with a diverse population. So the first thing is long. I've had the pleasure of seeing it every day. So I know how to do it, but I know he's Italian Santos or Dr. G is a lot of my patients affectionately call me. And so I have my story real quick, is I always like to start off by saying, I know we all have very specific thoughts towards Johns Hopkins. For me, Johns Hopkins has rejected me Three times. The first time was when my mom went to go give birth. They said no, they were full. So she ended up going to Franklin square, which took quite some time during the heavy winters of February. Now circling back the way life should have it is I now have a physician there. And I walked in as a young doctor, you know, specifically out of a US campus. I wanted to be stationed there because that's, that's the community I grew up in Greektown Highland town area. And I just became so frustrated in the field of medicine. And it's not medicines fault, right medicine should never have been perceived to be synonymous with health. You know, it's it plays a role in its health is so much more than just seeing a doctor and so forth. But nonetheless, you know, I would see my own community members, my next door neighbors to my soccer coach, fall victim in a variety of health care gaps that regardless of all the money spent on my medical education, I couldn't help It was frustrating for me, I knew the science, I knew the patient, then I realized it was there's something else behind this, you know, and and realizing that contextual level variable that where you're geographically located will dictate so much of your outcomes from health economics. Trust me, I know as adults, we always get that kind of realization that the fairy tales that we've been seen as a child to some extent that lenses lost. To me, that's what health equity means. We're seeing it and we're realizing that it the American Dream is just it's not achievable for a lot of people. So I've devoted my entire career to Yes, learning the science as best as possible. But can we try to close those gaps and my story, my narrative, as I just said, is mine. But one of the great ways of doing it is exactly what this what we're doing right now. Bringing in diverse people in a collaborative way to hear everyone's story and work together. So I I like to always say that I work at Hopkins because here's the thing intuition that a lot of people don't perceive in a great eye, you know, and I was guilty of that at one point, but now I get to try to rewrite their story and try to resources to the communities that need it. So I can't thank you all enough for allowing me to be on this zoom stage, especially with Mr. Andre Robinson.

Linda Howard

Dr. G. Can you tell us a little bit about the calls that you've been doing with john hopkins? Around the Coronavirus?

Dr Panagis Galiatsatos

Yep.

So how did it start? So I um, when the pandemic exploded, the and the Governor Hogan mandated this lockdown. At this moment, my division starts sending out a schedule and you know, one of my anxieties began of realizing we all have to go in and out, you know, work with the patients and anxiety as a critical care doctor wasn't just I want to go I want to go and help these patients. But at the same time, it's you know, making sure I can stay protected and my staff so there's an anxiety there. Right. But then that Saturday morning, when I got the schedule was heightened in a different direction. And I received a call from a community member. This was Mark Carter, he's a leader over at sandtown. Winchester specifically had a new song Academy. And he called me, and I'm already kind of anxious about going into the COVID-19 units. And then he's taken into a very different direction that I at that moment didn't even think about he goes, this is going to ravage minority populations, like you wouldn't believe. You know, from the conversations about mass testing and screening. People aren't historical, they're still thinking about, you know, from Tuskegee to Henrietta Lacks, this is not going to go over well. And then other things, you know, if you're going to ask you what a quarantine, they need a source of income, they need food, but you can't the populations, the most vulnerable ones are going to be hit hard. My heart sank because everything he's saying, of course, it's true. And right now it's been reaffirmed and what we couldn't do As small as it may seem, but Miss Howard, I mean, gosh, the conversation you opened it now makes these calls seem more extraordinary than I ever thought it could be. But was let's get the community leaders, those who have already the trust of a variety of populations. That's a streamlined source of up to date, facts, objective facts, met with an interactive conversation, to hear their successes and their struggles of managing COVID-19. We can't sit as an authority dictating this without hearing about what people are struggling to do in order to achieve it. Right same quarantining sounds very easy if you live in a mansion with tons of resources, but to do if you're on panca Street in Highland town, and you live day to day by a check so we did these calls specifically for that like I we need to hear not to say that a hospital has a solutions but Gosh, darn it, we can definitely network we can definitely connect people anon Hassan from Masjid Allison Must be over in northwest Baltimore. One of his first conversations with me was how do we get the Syrian refugees food? Not that they can't work be connected him with meals on wheels. And it's been one of the most promising outcomes that we've had. So yes, these phone calls were designed to get to community leaders twice a week to hear some updated facts, answering their questions about COVID-19, but also hearing from them what we can be doing. And when Friday specifically, we always allow these community leaders to share their struggles and their successes, more struggles and successes, but we're getting there. But for me, we needed to make sure there was an outlet for voices to be heard in the community, to be met in real time with healthcare professionals who are pulling the strings to some extent of what all of this means and what what do we do going forward. And we can't have that disconnect. We can have the authority you know, the authority of top stay disconnected from the community who's over here doing what the best they can have. merge them together. So that was the genesis of those calls. And, you know, it's been one of the most promising things. I mean, listen to everyone talk about what they're doing. And I emphasize that if you've ever listened to the call, you know, the way I open it is as a critical care doctor, I'm not your frontline. I'm your last line. You all in the community. With every single person, get the resources they need to quarantine and isolate. They will save more lives than any doctor or nurse. Right. We are your last line of community. My opinion, is your frontline.

Linda Howard

And I will tell you, MLPI we've listened in on the calls and they are incredible and a great service to the community. So thank you for for doing that. Because some of the questions that I've heard and the information that has been shared on that on those calls, with communities, leaders being able to share things that they're they're doing, as well as being able to get some question answered. So thank you very much for the work that you're doing on those calls twice a week. And Andre, have you? Have you had an opportunity? Or did you know about the calls?

Andre L Robinson Jr

I do not know about those, just until I, you know, got alerted to being on the show. And it's a great pleasure to be on the show with Dr. G. So I wasn't aware of those but we generally have been sharing very broadly. It's an interesting kind of sort of transfer a bit of a drum that's been happening because in the places where most of the information of course is being disseminated as this is in a digital environment. And of course, I live in work in a neighborhood that has very little broadband, right. So stuff that's that's coming down is passing enormous chunks of the community and depending on which block you live on my block is 50% empty, and many of the blocks around here about 50 or 60%. An empty so there's various levels of information that is being passed from absolute bullshit to rumor to, you know conspiracy theories and then facts are lost in this somewhere in as we live in an environment where disinformation and misinformation has been weaponized, then there are a lot of people trading in that depending on how much discernment they have. So it's right now a bit of a mess and it's always kind of chaos in the beginning of a crisis. So that's to be expected but I was already in a pandemic, right I was already in a neighborhood that has been experiencing the the troubling standard that you know, demography is destiny, right is very, very true in black and poor communities, really throughout the world in Baltimore is a very specific place to stay The specific impact specifically on black people, because so much was encoded in the law. It says that thou shalt not help those people particularly. And then so this would be what? My friend Dr. Melba Taylor does emergency medicine in New York would say the expected surprise, right is a petri dish that allows various viral and bacterial infections to to smack down on the the most marginalized populations. And so they stay at the ready to be victimized by it, because they were already in a victimization. So that pandemic was already here. And it's only going to get worse before it gets better. But I still at the some at the at the standing that I have feel that it will get better because now we have folks like Dr. g working inside of that particular institution. and many others like him, I'm sure but only if we gave him $10 million He could hire, you know, 100 of his friends in an hour to come in actually write that ship. And all of us right now have this technology, at least at our disposal. It's not accessible. It's not accessible in my neighborhood. Because the information is not able to disseminate. I loaned my Wi Fi to my neighbors as we had that discussion before. And it only goes so far, there's a there's a limit to how far I can distribute that information. And I and the normal thing that we would do would be to gather and share information. So it's only on this platform that we're able to debate and discuss and define and discern what's going on. So those old inequities are going to continue to be a place where this pandemic will spread and we'll come back again and again and again, because they were already damaged by all this historical, you know, weight and nonsense that's been parked in these communities. Since these committees We're even allowed to be over here in this neighborhood right? There was severely racially restricted neighborhoods in Baltimore until quite recently in the and in many ways they still are. So that's the biggest challenge is that yes, the information is out there. But wading through to find the facts is much more difficult in an area that's already been victimized by the successive wave after wave after wave of disenfranchisement, you know, at all, you know, you can, you know, can fill in as many of the things around that they've been dissed over and over again, for decades and decades. intergenerationally So, you know, that that damage was already baked in.

Linda Howard

Now, I know some other cities have done a pretty good job on on getting the data and tracking who's been impacted most by the Coronavirus. Howard Dr. G, do you know whether or not that's being done in Baltimore? Like, can we definitively say the percent how it's impacting African American communities or more of the poor neighborhoods?

Dr Panagis Galiatsatos

Yeah, no. So as of last Thursday, so a week ago today, the state of Maryland released the demographics based on this. And then I think today, if not yesterday, they release it also based on ethnicity. And I say this because those numbers are needed there. And, you know, they begin to paint a very specific conversation that we need to have which we're having today. And unsurprisingly, right where we saw last week, African Americans, unfortunately, are making up almost the majority of the deaths that we're seeing from COVID-19 in the state of the locations that are being ravaged by mortality, predominantly minorities. And the same thing in our Hispanic Latino populations last week I was the critical care doctor in the COVID-19 ICU at Bayview. half the population was nursing home residents from very disadvantaged neighborhoods, or young Hispanic Latino men who need to work who live with eight others in their household. So the household density is high. And he all of them said to me, You know what everyone else is my home is sick, should I be telling them to be worried, I'm sitting here had to put a breathing tube in him like you got to make this you will make this call, someone's got to make this call. And that story that person I'm assuming, can easily be copy and paste it to every other individual living in a socioeconomic status. That is one of disadvantage meant that we need to recognize the need more resources, we need to allocate as much as we can. I mean, the I apologize for how I sound but to live in a country like this. And we all known the disparities exist and now the pandemic is going to cause so many lives to be lost and could have been prevented if we took so much appropriate notice around COVID-19 and getting more testing done early, but we mean we're letting a pandemic showcases everything that you and I've known everything that Mr. Robinson discussed. I mean, it's a lot of lives will be lost because it a strong enough commitment wasn't there to begin with.

Linda Howard

Now, we we've always talked about some of the health disparities and those social determinants of health that has impacted our community for decades. Now that we have the Coronavirus issue. What are some of those disparities that that neither one of you can answer this question? What are some of those disparities that you're seeing? It's having the greatest impact on the Coronavirus affecting these communities more

Andre L Robinson Jr

Well, I don't mind diving in on that, because again, I think that part of the issue is that we have the perfect condition for all the viruses, any of them that you name this one in particular, is impacted by something that's also the known known. It is synonymous that when you say the black community, you mean the poor community, one of the poorest communities, immigrant communities are also expected to be poor, but not always as poor as we remain. And there's, I think, still confusion about why that is, why is it synonymous? Why is the community synonymous with a poor black community? So that's one question we need to ask. Because when you start to pull it that thread, you'll see that those communities were were ensconced in a kind of lose sight, right of poverty. They were would they were to remain poor because The lack of services the lack of this the preponderance of, of the trade in cigarettes and liquor and drugs and all the rest of that for generations, this is not a new thing, right. So as you actually pack all of that into an environment, and it produces a very poor crop, you wouldn't be surprised by that. Right? You wouldn't be surprised the ground that you've never fertilized or watered or broken up or did anything to would produce a poor product. So if in fact, we are in these neighborhoods, not always by choice, and buffeted by all the social determinants of health, they are also the same ones of wealth. If it doesn't matter how wealthy you are, I can see that right now. You can be as rich as you want to be. And if your lungs are collapsing all of your resources, so for the most part, are going to go towards saving your life. But we have systems that are set up to advantage one group over another so knowing all that doesn't make any difference. If in fact you don't deal with the basic environmental degradation, that most people of color black people, particularly poor people will eat poorly, not get to the doctors often won't take care of their teeth, they won't be adequately house, they won't be adequately fed. And so the house itself is providing this enormous vector for all these things to buffet these folks. The challenge to all that is that, as I said, half my neighborhood is empty. When we were finding the money to start to renovate and develop the houses, I can move all the poor people out of the squalor that they live in with enough subsidy and move them into the new stuff and opened up half the neighborhood for a market to live by because these people are no longer suffering in that squalor, if they can get their health and their training and education and their economic viability. See I'm seeing this every time you touch one thing, it opens up this other thing with a bin very purposefully buffeted by a thing. And we can do anything about that until we have a moment that says, an injury to them is an injury to the whole city. If 40% of the city falls off the cliff into squalor and degradation and death and disease and destruction, it doesn't matter how much of your barbecue you're planning to have in Canton, that's going to affect you. bathe us not far behind. So that's really the challenge is the end of this moment for all of us to realize, oh, wow, we really are, quote, unquote, all in this together because the death toll is going to be an optic that we're not going to be able to tiptoe around.

Linda Howard

So now you're talking a lot about the social economic determinants

Andre L Robinson Jr

and the environmental. . .

Linda Howard

And I'll ask Dr. G, is there any of the on the physical health side Some of the things that you're seeing that is impacting the higher rates of contracting COVID-19 and the deaths resulting from it?

Unknown Speaker

So far, so I think Miss Robinson laid out incredibly well, how we arrived to a lot of these health care gaps. It has to do with those contextual level variables of neighborhood status and the access you have in your neighborhoods. From a medical standpoint, you know, this conversation and I call it almost the physiology of poverty because living in disadvantaged neighborhoods where that contextual level, all of them, no, it's the access to certain foods that are processed that relate to your diabetes and hypertension, right. And so we realized those two pre existing conditions, patients who have them and they get COVID-19 they have worse outcomes. Tobacco, right, so we smoking, injures your lungs, guess what you could get an infection. Your lungs are To do worse, we've seen already already signs of that coming out of China, but also kind of preliminary results out of Italy. But I see this because guess where the majority of tobacco stores that sell tobacco. So the variables called tobacco store density, goes hand in hand with more disadvantaged neighborhoods have higher access to tobacco. So a lot of the medical conversations that we have, you know, the surface as a condition, right, diabetes, high blood pressure tobacco, and when they're rooted in the these non biological factors, right, the way the neighborhood is set up, the way the food access is set up, living in a constant stress, and you can overlay those communities with the highest homicide rates and the amount of stress they have. Yes, guess what that is going to lead to hard to control blood pressure. If you're living every day with this, you know, how am I going to live today and so forth. And I say this because that's what's escalating. A lot of these patients once they get COVID-19. So the factor of will they do worse if they get it? Yes, it was pre pre existing conditions will lead to worse outcomes. But then why are some many hotspots so vulnerable? It actually goes back to what Mr. Robinson was saying, you know, the neighborhoods of socio economic disadvantage, have higher what's called household density, meaning just more people live in their compact place, asking them to quarantine and self isolate. That's hard. Right in regardless of how the housing unit was set up, I think it's one of the examples that I always love to give is, you know, Miss Beth, the over the leader of a house of Ruth, which is a housing unit met from women of violence and trauma, and their whole model of the housing unit is built on collegiality and sharing a common space and so forth. And, you know, selling out this practice, social distancing, how do they do that when that's going to unravel the mental health of them. So, over there is non biological factors at play. better, much more prevalent in disadvantaged neighborhoods, and in minorities that culminate in biological diseases that we call these morbidities and pre existing conditions. And then you add a virus like COVID-19. It's, you know, the need.

Linda Howard

I'm gonna do a little shift, because we've been talking about some of the environmental factors that have led to it some of those, the social economics and some of the pre existing health conditions. And if on our, on our flyer that went out, the subtitle was, are we truly essential.

And we've now been designated as essential workers. Meaning going to work in the fast food restaurants, going to work in the supermarkets, going to work in places where there may be a moment Much higher exposure. It may be driving, it may be driving an Uber. But you have situations where we have a population that is going to work being designated as a social workers. And I won't say that this is my quote, I heard this or this question, but I heard this on one of the new shows. And I don't remember who said it. But his comment was, are we truly essential workers? Or are we sacrificial workers? And when you look at some of the conditions, that those who are going to work because they have to some of the conditions that they have to go into where there's all the conversations about medical staff, not having, you know, protective gear, but what is the responsibility of the businesses like The supermarkets in the fast food restaurants to protect, quote these essential workers so that they are they don't become the sacrificial workers and and Dr. G, I heard you say that your patient said something about him going to work because he had to, and then everyone in this household is sick.

Dr Panagis Galiatsatos

I mean, at that that point, the clinical experience that I have, I mean, reaffirms what you just said. I mean, it's To me, it's it's so ironic that the essential personnel are also those who look at the look at the economic gap between those who are paid as non essential employees. Right. Much of an infant daycare versus the essential. Yeah, by all means. I mean, I think that point is well taken.

Andre L Robinson Jr

Yeah, I think that again, you know, these things should be considered expected to a certain extent, it you know, unless you want to have a 17 hour, you know, podcast here. The bottom line is that this is this is always kind of been this way, right? The elites exploit those that are at the other end of the food chain because they're expendable. And that's so much essential, but they're expendable employees because I can always replace you. Because there's so many people that absolutely app have to have a minimum wage entry level job at all times. So we are using these euphemisms like essential worker where in fact once the this particular crisis will end at some point or another will go back to some semblance of the normal pandemics that we will expect in places where every the generations that preceded us had to fight for dignity on the job of education. Right, because if you worked in steel plant, you could be ground up by the machine. If you worked in a chicken processing plant, you could be grounded by the machine, you can get black lung diseases at any workplace, if they don't really give a shit about the workers because they're replaceable, they're expendable. So I think this is, once again, you know, the old adage is to not let a crisis go to waste. Well, this is one that we also should really, really consider that this will keep happening over and over again, that, in fact, Baltimore may never get well.

Baltimore will never really truly be okay, if it starts if it doesn't actually take this moment to look at how do we build a world so that that young voice that just came in the room with Dr. G, that they are okay, because we're really doing things right now for them. And if we don't do that for them and abroad, sense of them that I, you know, there are many communities in the Black Butterfly that weren't able to quarantine at home or go to school at home because there's no Wi Fi there. There's no computers there. There's no technology platform to enable them to continue to work. The economy is not online economy is making it moving stuff, right. That's the that's the real thing that we quote, unquote, quote, have discovered suddenly, that we will forget about paying them $15 an hour, three years from now, when it will only still be worth $9 or less then, when in fact, we always knew that the lion's share of the economy was in small business and people making and doing stuff and moving it along. So where do we get that level of enlightenment from this bottom up approach that COVID is going to provide us with to say, hey, this can wipe us all out. There is no wall that you can't shut down. You can't be on this section of the plane. You can only touch because everybody that brings you stuff touches everything, including your food. So is this not the moment where we go? Well,

if I have 8000

square foot house, I can quarantine. If there are nine people living in my 2000 square foot house or 1500 square foot house, that's going to be a little bit more difficult. So how do we get that population to have more resilience in their own systems, they can't be ensconced permanently in poverty, they just cannot. And if we look at the real reasons why that is, it's gonna make a lot of people who are still with us, very uncomfortable, and we have to be okay with that because it's not okay for them to be comfortable with that level of oppression and

suppression as well.

Linda Howard

Do we know if anybody is is having the conversations with these businesses about?

Andre L Robinson Jr

I think they are I see a lot of it online. I'm involved in some of those. There's an organization here called known because I'm trying to think of it of course fly out of my head for a second. But yeah, you know, there are organizations here that are starting to kind of take that on because they had a similar kind of culture going on in their own environment. And so when you start to address those things in your own environment, you don't have to look long to see the disparity in Baltimore, as Dr. g was saying, it's less than a mile from any one of us up or down. So when we can see it's so starkly in front of us, and know that really, we can't be okay with it being that way anymore. Then I think that it's at least a moment. It's an opportunity in that moment to say, listen, we've got to build stronger connections. We've got to make sure that most of our kids who can get through that we, we look at learning as it separates from education, because learning is supposed to happen very early on and that's not happening and communities that are Where our children are huddling in classes in their overcoats. They're not even thinking about. Everybody in the class doesn't have a laptop. They don't even have heat or water in the school. Right. So shift ventures is name of the company that was thinking about, you know, Todd marks, you know, there's a bunch of folks in this town, at institutions to city lab, Dr. Thompson at City lab, there are a lot of people who are tackling this stuff, and a lot of the wisdom in that room. And also in rooms like at the, you know, coffee house, Coppin heights, Community Development Corporation, there's a bunch of folks that are tackling this stuff. We're not privy to all of it because we can't gather 200 people in the room. But there's, maybe this is going to be the big blessing of having 120% conversations happening right now this dynamic stuff going on in Baltimore, because we have such a robust intellectual knowledge and practice comments in the sea. Yeah.

Dr Panagis Galiatsatos

Mr. Andre, I want to piggyback on that because you're right. I do really think COVID-19 could be the trigger to fully address healthcare disparities. But caution I want and because you can eat everyone here can probably emphasize this. The caution I want to present is that in moments like this even back to the riots four years ago, right, we had a lot of action, but in my opinion, not a lot of commitment committed for the long haul, right? You do your wedding vows for its forever actually mean say in this moment, but things look bad let's do something that's what hopefully this call can be used for, to put people to commit not just act on and now and let's get some food now. No, we need a commitment. That's to me the biggest gap of all of this every time whenever the next pandemic comes and we have the healthcare disparities are faced with again, because if we haven't committed right back where we were, I mean, we were just with with riots four years ago, how much be one Baltimore damaged me things that we see this was in my opinion, like, it is If you want to conquer healthcare disparities, you need one asset that many of us all have, whether you're a son of an immigrant or minorities live in Baltimore, that's great international, we have it, right. That's allows us to be persistent enough to translate to others to make a commitment. That's what we need love to know. Good, makes a lot of feel good stories. That's fantastic. But when the pandemic is over, and it'll end COVID-19 will leave it healthcare disparities don't stay.

Linda Howard

Right. Let me ask you, Dr. G, because we talked a little bit about your calls on twice a week but you work with medicine for greater good, and an innovative medicine for greater good you've done have worked on a lot of great initiatives in the community reaching out to religious communities doing education in order to impact some of the chronic conditions and screenings has coverton Team changed, anything that you're doing? Or is there something different new initiatives that we can expect to see as a result of COVID-19? Or some of the lessons learned with COVID-19?

Dr Panagis Galiatsatos

So so it goes back to this conversation about action and commitment when this when COVID-19 occurred. What was interesting, so medicine for the greater good gives me honor and hope every day because we get to make an impact, not only in the communities, but on the 21st century physicians, that's the other bolt like I want to put out as many disciples of this as possible. So they go out knowing the science knowing the patient, but knowing the community, right, that's the transformative thing we're trying to do. And then the pin democrates, we begin these calls, and from the highest authorities of Hopkins, when people were like, how do we get to the community, everyone's kind of work in their silos. We're sitting here we're like, you know, myself, Dr. Dean Hale is blood another colleague, and so when Ray and other colleague, really, we're doing these calls twice a week, we get these amazing immunity. leaders that are going to be saving more lives than ever could. And I'm sitting here because all we did was pull on the strings of trust. And we built over time and time again, strings of trust were built the fabric there. Because as as one Reverend Reverend King out of Provence said to me once he's like, someone asked me so why do you trust them? He's like, they show up. That's half the battle just be present in their shoes, walk in their blocks, with human beings. That's it. And so what I'm hoping changes out of this is that hospitals who have a community relations group or you know, feel good group that doesn't help her once a year changes or to know because if you ever we ever face a new pandemic again and you need people to quarantine again, if you build an outstanding community group, a real one not want to put on a health fair once a year, health fairs are fine, don't get me wrong, I can always use new free pens, but a real commitment or real commitment one not just about temporary action, one that every week, we're touching with you every month, we bring you to our home where every month we go out to your home. That's what I'm hoping changes to hospital needs to be not on the sidelines anymore. These communities need to be in there, not just geographically dropped in there no clue in there, know that know these human beings that are, you know, give us identities. I mean, I'm a doctor because of patience. But at the end of the day, I'd rather be seen as a community member that just happens to be a doctor. And it changes.

Linda Howard

I know some of our attendees are not from Baltimore. Can you just give people a sense in terms of where john hopkins is situated in terms of in Baltimore and what communities it is?

Dr Panagis Galiatsatos

So there's two Hopkins hospitals because if I don't talk to the other one, then I'm letting the one that I think is also equally important. So Hopkins Hospital, the behemoth the kind of mothership of the entire Hopkins healthcare system is located somewhat on the east side of Baltimore City and in a predominantly African American neighborhood, and One of a median income, I think, no more than $15,000 in speed you located in Far East of Baltimore City, but still within the city boundaries located in really socioeconomically disadvantaged neighborhoods, one really right with a lot of immigrants, so used to be Germans and Greeks, now a high influx of Hispanic Latino, as well as northern Africans, and a lot of just blue collar workers who were ravaged when the factories left. So both hospitals sit with high populations of minorities, high populations of societally socioeconomically disadvantaged individuals. That's where these two behemoths of the hospital are situated.

Linda Howard

And Andre, I know you live and work in Baltimore, can you give those on the call just a sense in terms of where you are because I want people to get a sense of where you are in the community?

Andre L Robinson Jr

Yeah, I'm sort of its constant, sort of The beginning of the west side which really starts at sort of Charles Street, I'm in on Druid Hill Avenue in the heart of marble Hill. And it's really sort of the the, you know, the the middle of the beginning of the west side if you will, but it's one of Baltimore's most historic black neighborhoods. So my I operate in between dolphin Street and Druid Hill Park, which is also it's a actually a neighborhood that was built for the wealthiest Baltimore Aryans, we really must know it became a black neighborhood over time after successive waves of of white flight because they were covenants, covenants against blacks or Jews living in this neighborhood when they were created. But they became eventually Jewish immigrant and they allowed us and and so intimate in the civil rights era when the housing fair housing legislation kind of opened up and people could move to other places because they were very racially restricted neighborhoods all over Baltimore. So they're very well built and designed very beautifully elegant architectural gems like all over the place that were abandoned and then became, you know, black and then of course, once they became black, you couldn't borrow any money from the bank to repair your house. So they sort of slid over a 70 years into a very slow decry decline. So once other epidemics, crack epidemics, you know, the corrupt fleecing epidemics, crime epidemics happen, you continue to just devastate the neighborhoods. So, but it is still, the bone structure of one of the most elegant neighborhoods really on the East Coast is really still here. So I'm here because I'm a real estate developer in a community developer, creative place maker. I build galleries and theaters and restaurants and give people a place to play. Once these neighborhoods return, and I say once they return because they're quite beautiful and every place around Just remember is already completely gentrify. Right I grew up in Washington DC houses we sold there for 100 grand are selling for $900,000 now, so those folks will come to Baltimore because you can still find a house for 50 or 60,000. You may have to put $200,000 in to fix it, but it is well worth it because it is they are gems. So that's

part of the

the upside, if you will, to a hammer of course everything looks like a nail. So I'm a builder and so this is an opportunity to build and get things cleaned up. Once you do that, and adequately house people. We don't have to make a killing on every house. You know, we can take a face, you take a haircut on houses them, you can do them at this level of scale. And those people are adequately housed. I think you'll see all the other outcomes both in education and health and social mobility. More than anything else, which is the real answer to unbridled racism is upward mobility. I think you'll see Baltimore become the center of the least the multicultural, multicultural world because a lot of people here from other places.

Linda Howard

I want I want to give Dr. G, a moment to talk about the building healthy communities through medical religious partnerships. The and I know, this is what the third

edition of the book?

Dr Panagis Galiatsatos

Yes, it's our third edition. Yes. And right. So, I think

a book about you know, kind of what I felt like was an obvious idea, right, you know, going out talking to people and hearing how they can make their communities healthier. I mean, working with faith based organizations in your I'm a member of a church, I love my community. We adults gather Once a week, everyone is invested in one another. I mean, that is a great sense of community. And knowing that knowing there's a cultural identity there's everyone is looking out for each other. Well, why not have them hold some of the responsibility to help their loved ones stay healthy. And I see that not to shift responsibility off of a doctor or nurse. But I see this because every individual realizes the more they're part of the network, a cohesiveness and identity. They're gonna have better outcomes. And working with faith, faith based organizations just make sense. And I remember the first time I worked with a congregation, where the Reverend when when he realized this is Reverend Dred Scott out of St. Matthews and Turner station when he realized like, you know, I think it was an idea who always knew, but he's like, I can be saving lives. And again, oh my gosh, if doctors, nurses, we see patients for 30 minutes every three months. I mean, I'm not managing their care. They're managing their care if they can have you all in the community helped reaffirm these strategies. That's powerful, but more than anything, Can we do it in a way that's culturally sensitive? is in alignment with what your faith and your beliefs are? Can we just be human beings to try to take a public health concern and meet it with the community health interests? favorite examples goes, this was with Reverend Dante Hickman or I believe, nice Fisher Pittman out of Southern Baptists when we sat down with them, and you know, our mind, we know the data how low flu vaccinations are in African American communities. And so his discussion with us really was centered on economics, like we need jobs, we need jobs. My staff and I were from mgg medicine for the greater good. We come back about a week later, they take me back on short notice. And we said, Hey, you know, flu vaccinations have been proven to keep kids from missing school. That's huge, because if a kid doesn't miss a day of school for being able to meet the parents can go to work. Guess what, Vax flu vaccine has been shown to help adults also not miss days of work. So if you don't miss a day working and there's a paycheck so we We took a community health interest because working as a health interest, I mean, that gets you so much access. And we aligned it with a population health strategy of vaccination. And we've got a bigger impact or we made a public health impact. And that, because we learned the communities and they learned us build the trust, there it is. So the book is that it is having the the communities out there faith based organized organizations, churches, mosques, synagogues, work with their hospitals to teach the hospital, you want us to worry about diabetes, great. How do we do that? Where it's in, it's in alignment with how we preach with how we work and so forth, and gives them the resources, the communities, the resources to work with hospitals, and then how to get it in an impactful way out into their community members. That's it. That's though, and I say this because it sounds like the world's simplest idea, does it get a new third edition? Maybe not but you will miss Linda Howard. Still I'm still in all of that opening speech you had in comment, you know, conversations, and have the biggest impact. And that's what this book is. It's just identifies hate being able to be a human interact with another human group to be able to provide their resources out in the community. Yeah, that's life changing. That's monumental. I will say the bias I have with the book is that the majority of examples come out of Baltimore. And I know Miss Linda Howard, you just said a lot of people on this call may not be from Baltimore, right. But I think I can speak as well as Andre Robinson, that the best thing that this city has to offer art is its people. And I don't mean not being a son of Baltimore. I know I'm throwing myself in that. But it is, I mean, the grit and tenacity faced by enough is but that the communities have and their diverse communities. I applaud them and how many people continue to keep their heads up when, you know, they may be perceived, especially to sound like this, that they're sacrificial. So I I agree with Mr. Robinson and the book, thank you for letting me speak on it. But it goes back to the line with everything we've been talking about if we can restructure the social engineering, I know that's tough, but with a really good commitment, with economics and transportation and mobility. I'm hoping the hope never exists. Again, because we've solved it. We fixed it all. I would love to be forgotten, as opposed to a kind of a novelty right now, that's not fair. You know, there's lies felt lost because of this, this series.

Linda Howard

I'm going to challenge both of you to answer this question and to be to answer it in a very short timeframe, because I want to be able to ask people if they have any questions. Yeah, but because we have people who are on the call that are from different places, and right now we're, you know, around the country, really around the globe. We are struggling with this epidemic, and not just the epidemic, but the reality He said the epidemic of brought forward. And so if you were to give other communities because we've been we've been doing a deeper dive in terms of Baltimore in the next couple of weeks, we're going to be taking this same type of issues and looking at it across the country. But if you were to get to give some other communities or institution, one piece of advice as to how they can be proactive and what can we do, kind of moving forward looking forward to, to change to get a better outcome than what we've had so far? With Corona with the Coronavirus? I know I said a lot and I miss the answer in a short period of time.

Dr Panagis Galiatsatos

Mr. Robinson do me go first since you went first.

Andre L Robinson Jr

Yeah.

Dr Panagis Galiatsatos

So in brief, actually, I mean, you gave my examples. Maybe this is an easy cop out for me, but it's those calls and what they represent is Two groups working together and talking in a mutual moment. You know, so it's, I know again, it sounds simple, but just create a connectivity with doctors, scientists, working with the community, even if it's two hours a week, that's two huge hours. That's math and make it interactive, not just let's talk and people will no, make it interactive. Let them email your questions and talk about it. That's my simple request. You know what, if you want to hear what's happening with the community and why they're struggling to quarantine nicely? Well, then listen to them.

Linda Howard

Thank you. Andre?

Andre L Robinson Jr

I agree if I could, if I had would offer any advice to to any other community that's wrestling with this, I would actually encourage them to sort of dial it back to I mean, Gregory Porter has this wonderful song called Take me to the alley I don't know if you've ever heard it. But if you don't go to the alleys if you don't go to the place where people are the most suppressed and think that the glossiness of Over here at some high level Think Tank conversations going to actually trickle down to those people where the the the disease has a has a diseases of society right original corruption of racism has has seeded this thing into the ground. And if you don't go to those places and try to deal with that I know it's a tough thing to address makes people very uncomfortable living it is exponentially more uncomfortable. So if you don't go to those places where those where the damage has most been done, well any surgeon can tell you you can just go Oh, that looks pretty ugly. There's a stitch it up and make a nice clean dressing on top of it. That thing will continue to corrupt internally and degrade until that organism is dead. So you've got to go to those places and get those other things sort of cleaned up face the facts as balding says you can't solve anything that you cannot face you face it and then get some friends To deal with some stuff, so we just under neighborhood builders Incorporated, got a group of other developers who are already working in this community, many of which were friends and colleagues anyway, and said, Hey, we got to worry about food, and housing, education, we'll handle that because everybody's gonna have to repeat this year. I don't care what anybody thinks, right? This year is done. You're gonna have to repeat this year academically. But if you can do with housing and food, there's a lot of stuff you can invest in still make manifest inside of healthy neighborhoods you're rebuilding that are clean, you clean the wound, and then you stitch it up. You don't do the reverse of that. So that's what I would advise his people to get into the place where the ugliness is face that and bring some friends with you many hands make light work.

Linda Howard

Wow.

Thank you. I'm gonna so those of you who are attendees, if you could start To just think about the questions that you may have, if you can do a raise to hand if you want to type it in the comment box or the question box, you can do that. But before we get to the questions, and I will, and I and I hope that Dr. G and Andre can hang on with us for a few extra minutes. Is that okay? In case we have some questions great. But I do want to before people drop off the call of any one has to drop off at the top of the hour. I just want to do a couple of acknowledgments in one is that we want to thank Muslim life planning Institute we want to thank medicine for greater good and john Hopkins Bayview Medical Center for all of the work that they do, and for Dr. G being with us, and also Andre for all of the work that he does in Andre has been this is a second time being a guest on our show. So we are very grateful that you have that you can take to support our initiatives, and our and we are greatly appreciative to all of the volunteers, and the MLP team that makes this happen. And that's my business partners, Samuel Sharif, and Kareem Ali, they're both my business partners and my brothers, and two very incredible men that are with us with Muslim life planning Institute. And also Erika Christie, who is our engineer, and she has been, she works very diligently behind the scenes and working with people before they get on the line to make sure we have all of the technical issues hammered out. So I'm going to turn it over to Erika to manage the questions and I already see that there's one hand up so Erika, we're going to turn it over to you.

Unknown Speaker

One thing that I can that I'll say, EriKa, that you're welcome to share or Miss Howard is, if I think you have your emails, I'll email you the quality information for the phone calls Mondays and Fridays. I saw someone talking about doing something similar to Atlanta, join our calls. Listen, I'm not to say we're the gold standard, have no idea what the gold standard of a phone call like this is during a pandemic. But listen in and feel free to steal our formula and run with it in your own respective communities. So if, if, if I email this, the contact information, I know you know, the end of the day, send it out to everyone and listen in and say, Hey, we can easily do this as well in their cities.

Linda Howard

Wonderful. We'll do that to everyone that registered. We have email addresses.

Erika Christie

Okay, and the audio is open for our person who had their hand up.

All right, are you there?

Caller

Yes, I am.

Erika Christie

Yes, please. What Your question.

Caller

This is brother Hakeem in Kansas City. And my question is how do we get a piece of minorities in particular,

to

become less stiff neck with the guidelines that are in place that is actually bringing about the death toll to the communities that are impacted the most?

Andre L Robinson Jr

Um, brother came when you say stiff neck Tell me explain that a little bit more.

Caller

They aren't taking any precautions here in Kansas City.

Andre L Robinson Jr

Okay, got it. Yeah,

I see very much the same thing happening here in Baltimore, in the communities that I live in. Young people are still gathering because they generally have no place else to go. They're still on the corner washing windows because of course they used to be fed at school when they were in school. And so I think that is part of the challenges that and I was talking with some colleagues earlier brother Elijah in his eql Kelly earlier about this and that. I think that the bottom line is that only, there's only a small percentage of the people in the beginning that are ever going to get it in the new model better behavior. People sometimes have to see it in order to believe it. So if in fact, you have a difficulty, there may be more difficulty in following quote unquote, good advice than you may think. If in fact, your house is overcrowded quarantining is not that not an option. If in fact, you're inadequately fed, then you're going to go out to the corner stores. Matter of fact, I have people that go to the corner stores four or five times a day because there's no you know, it's hard to carry four bags of groceries home from a market that's a mile away. So there are conditions that are already visited in a lot of these neighborhoods with the stiff nakedness. To use your term is the most severe in places where people are disconnected to, in to institutions of fat giving, right because we used to gather to do that. Now you have to trust, this bombardment which is filled with a cacophony of some of its disinformation, some of its room or some of its absolute nonsense. So it has the lack of penetration, I think is because of the weakness in our basic structure, that main structure in the black family is to gather, and that is now quote unquote, soon to be against the law. So that's going to be part of the challenge. I think you're going to see a sea change for a little while until people realize, Oh, I came home like in Chicago, I can't I went to the funeral and came home and killed Grandma, and then people will go Oh, I guess I should stop doing that. Stop very smart members of my own family from having a party masks and flasks party. with children very early on in the crisis because they weren't paying attention, these are these people are degree. But they were their object. The rumor was, well, it doesn't really affect black people that much. So we're not getting it or it only affects old people, so we're not getting it. And then the information came out. So I think you have to be patient a little bit and model. What you for anyone who has ears to hear and then let that spread,

that that'd be viral. This

Unknown Speaker

I'm going to reaffirm Mr. Robinson what he said incredibly well. It's it. I mean, if you think about the calls that we that Howard was discussing for us, we get the community leaders on those trust, they're the ones that a variety of religions will listen to, you know, if I go in as a doctor to a community that doesn't really know me, you know, what are they gonna you know, who am I to tell them what to begin to do? I mean, again, it's this is really difficult. You're right to the social reentrant Hearing requests doesn't happen overnight. But if it can come from a trusted voice, you know, and I coming from a government or an academic hospital, you know, those have soured relationships, a lot of times with communities, I recognize that. And so us then coming back, suddenly paying attention to communities that really what are you doing here? Now you want to talk to us, I get it. So working with the community leaders, that's more powerful. That's who helps send that message, identify those individuals and get him or her to kind of be the voice for the community. Yeah, that will move. In my opinion. That's what I've seen to be the catalyst of all of this.

Andre L Robinson Jr

I think some of it also is intergenerational, you also have to make sure that the influences are in the right generation, because young people don't listen to old people. I mean, you know, did read when we were young people

Dr Panagis Galiatsatos

know very true, very young folks as

Andre L Robinson Jr

well are in the generation that actually you're trying to impact and make sure that the influences are also in their demographic because the trust factor is the biggest factor.

Unknown Speaker

ask the question. That was the person the developer out of DC he asked questions, probably still in the queue.

Unknown Speaker

It's that as of today

Unknown Speaker

are their lives have been totally busted

Unknown Speaker

Where is the cost benefit equation here? I don't know, I'm not hearing people talk about it. And I think that's very dangerous. Where is the benefit? Where is the I, I posit, respectfully, that cost far outweigh the benefits that are being imposed on the economic, spiritual and intellectual infrastructure of an already damaged society.

Andre L Robinson Jr

Do you mean the cost of quarantine the cost of social isolation? What which is the cost? what I'm saying? Respectfully, brother?

Linda Howard

We get blasted every day with every death. Only from COVID virus though, although there's 10s of thousands of other deaths happen. Deaths accumulate. That's a statistical bump in the annual death of 3 million Americans that happens every year. And it's far less than the flu season gets to this point in time.

Dr Panagis Galiatsatos

So if I may take a stab at it. And I know I'm going to come at this from a physician standpoint. So it's just the the angle that I can have. The COVID-19 virus is diabolical in a variety of ways, that it's not the quantity that scares us. It's the quality that it has when each patient that comes to the hospital, if you have one COVID-19 patient enter your hospital, that patient needs what's called a negative pressure room. I can tell you a rural hospital has only four of those rooms in a hospital, right? Every 100 beds for them are designated for negative pressure rooms. All right, great. So that means a patient can go in there and be safe that he or she won't transmit that to others, then you need the PP, your average nurse goes into a patient's room once every 45 minutes. That means she has to usually he or she has to change out of those outfits for Dr. may go a minimum once maximum maybe a couple more times in and out. So all of that is requirement and then they need whatever intervention that they will usually need from COVID-19 oxygen, whether it's a nasal cannula or we start increasing it with C pap and bipap and then maybe ultimately, mechanical ventilation to the quality of the care for COVID-19 patient and then using it itself. We know the meaning The median states are not the average that because it gets skewed. But a person if you get this, especially if you develop symptoms enough to get you in a hospital, you're looking at 21 days straight. If you get in an ICU, you're looking up to 40 days of staying in there. Right? And all of those resources I just told you, for one patient sounds like a lot. If you get 100 of those, it's not your right, it's not gonna make a dip on the mortality. But it's going to exert all the resources of a hospital reason why Hopkins gets so many patients sent from elsewhere. It was a hospitals where they're doing in Frederick County in Cecil County is they'll get stabilized, they'll send out so they can make a new bed for the next patient because they can't convert their hospital into an entire Intensive Care Unit. Johns Hopkins Hospital has become one large Intensive Care Unit. Hmm. Before all of this is because if you don't, what's going to happen to your doctors and your nurses is we're going to have to make the we're gonna have to make the decision that no one wants to make. Who do we allocate these resources? To write enough negative pressure rooms, that patients spreading the infection to everyone else, including the staff that are taking care of them. The reason why we have jumped on this and my frustration is we, I know we're all like Donald Trump. We're all about readings and numbers. It's not good enough patients in a pandemic to freak us all out because your average hospital is not built to manage a pandemic. It is not. I just told you a negative pressure room for That's it, you get four for every 100 in a rural community hospital, you get a dozen in one day, that means eight of those patients are going to sit not getting the proper care and doing good to allocate what they need. That's what bothers us. It's not the grandmas numbers. It's that we're about to be making decisions to say some of them aren't going to get the care and some of them will. That's what you're forcing healthcare to do. In a time like this. No one wants to make fat and I don't want the lives of just 10,000 people be walked away. Because we were expecting a million people to die, that's not fair to those 10,000. So, why do you make such a big frustration? What we know what we discuss is that probably close to 40% of the deaths worldwide? were due because we couldn't get them the resources they need. I mean, how does that breaks my heart? You know, I, I saving one life is a blessing, you know, the fact that we let 40% die because we couldn't get them to health care. I mean, you have to live without consciousness in our heads.

Caller

Hello to everyone. And I've gained quite a bit of insight. I really just have a question. Specifically for the doctor. I've heard a lot of responses that I was looking for, but in a solution oriented culture, I understand that we always look to respond and look to, like the doctor said, find resource to avoid a situation to grow Avoid, avoid the growth or the worsening of a situation. My question is this. How did we get here with so much lead time? And and the reason why I'm speaking to this is because I was about 30 days ahead. Living in China. This is I'm just I'm currently displaced because I'm in America now and I live in China. All of my things are in China. I'm here with the carry on back. I was 30 days ahead of this pin, what they're calling this pandemic. This panic-demic, I was 30 days ahead of this maybe more actually, because I think I left January the 12th for holiday travel with the carry on. And I slowly saw this progress. I spent time in Thailand and heard a little bit more I spent time in Japan heard a little bit more. Eventually I decided to make the move to come back. to America versus going back to my temporary home in China.

Linda Howard

How did we get here? Dr. g?

Dr Panagis Galiatsatos

Yeah. So I'm not going to touch on the health disparities component of how we got there, because that's decades and decades and decades. how we got here specifically, I can answer that incredibly briefly, in order to create the models that we need. We take three variables specifically into account, what we're doing is trying to calculate what's called the reproduction rate of a virus. And two of them is this how susceptible people are getting to getting infections. So that means is it airborne is it droplet and so forth. Another one is, how infectious it is meaning once we get symptoms. General 19th was America's first case as well as South Korea's look at South Korea. What they did immediately was do about 20,000 testing a day, right and they've been flat with the curve ever since then. And that's a message from a doctor symbol we love that means patients come in they're sick, but a nice steady pace where we can work and going back to the first person's comment. allocate the As resources in a much more efficient, efficient manner, we did not test at it test thousands a day thousand nuts. If you don't test we can't get that one number that we need to make the most mathematical model guess, estimate hypothesis to govern policy. We didn't have that. And now we're at the mercy that every week you're like, Oh my god, these doctors keep changing what they're saying yes, because if we get new numbers, right, we our numerator is so much smaller than the denominator. Politics with that denominator, we don't want the numbers we want. If you don't guess what the other number that's gonna grow is mortality. What we can do with the numbers is make myself created dedicated quarantine areas. I mean, some areas get to be more loose, others more strict until the virus wears off. Then the release. That's it. I'm not a politician. I'm a public health person to some extent, but that's the mass difference. Just look at those two countries go in two different directions. When they have the same case, the same day, different time zones, I get it. But nonetheless.

Linda Howard

Thank you. Thank you very much. All right, so we are going to in today's session, we do have two more sessions the next next week and the following week to 23rd and the 30th that we'll also be dealing with some of these public health concerns. So if you have registered for this event, you will get a notice of the upcoming profound conversations. Thank you for joining us.

Andre L Robinson Jr

Good to meet you, Dr. G.

Dr Panagis Galiatsatos

Thank you.