Hey everyone it's Josh. I hope you're well hope everyone is safe and healthy. uh thank you so much for taking a few minutes out of your day to spend time with us at our cup of Joe with Josh Virtual Town Hall and I'm uh it's on Facebook live so hopefully everyone's getting a chance to uh to watch and if you have any questions just as a reminder, please post them uh in the comment section. um you can also email us if that's uh better for you at Josh Gottheimer. At mail.house.gov, Josh aim at Mail.house.gov and I'll get your email as we're going here and look at my phone and I'll try to get to as many questions as possible. We tend to get more than we can get you in a lot of time, but we'll try to get back to you. regardless, we're we are uh very lucky uh as those of you who've done this with us before to be joined by a special guest and unfortunately a repeat guest uh chief medical officer of Holy Name Medical Center Doctor Adam Jarrett um who. I have found to just be a really wise and sage adviser, not just to me but really to our entire district throughout the pandemic and uh has been there for so many people and so many families and um does a wonderful job. We're very grateful for him and for his leadership and really his straight forward uh answers and you know explain things to people like me who are not doctors uh but in a way that I think we can all really understand so we can. Really uh to have a good grasp of what we continue to face in this health crisis and this economic crisis um obviously we've had waves of ups and downs um and um looks like we're going into a tougher period right now and I'll turn to doctor Jared in a minute to uh talk a little bit more about what we're facing and what he sees and um the you know what we need to be doing to be safe and stay healthy during uh during this wave um let me just uh go. A couple quick items that I've written down um uh and again if you have a question, please just post it. we'll try to get to it and or you can email me as I said at Josh Dot heimer. at mail.house.gov. um right now, we're continuing the fight as you know uh against the pandemic we still have work to do um it's one of the reasons why I've been working incredibly hard uh as coach the problem Solvers Caucus to get another uh coveted package passed uh relief package passed that with stim. To help our families to help uh make sure our front line health care workers and first responders have what they need that our hospitals have what they need and of course um uh ensure that our small businesses can make it through a very tough time. That's why I went on another round of p and support for child care and health care and for the food insecure and of course for our state and local governments uh which are key in having very tough times right now we've had 48956 positive. In the counties that make up the fifth district and our counties, we've had 24890 in Bergen uh 20775 at the seventeen. 1700 in little over 701 and more than 1500 in Sussex um unfortunately is that the uh number that I've uh had to discuss publicly far too many times and it's painful every time of we've lost nearly 3700 people in the counties that make up my district. uh the key now is to make sure. That we don't lose more and that we do everything possible and take all the precautions, including, of course wearing masks social distancing um uh and making sure that we wash our hands and don't touch our face and all the things that all of our doctors and public health officials have recommended which we know have helped tremendously in getting our numbers down after the spike and um and keeping them at levels uh that are hopefully manageable for all our care providers. um a couple other uh. Items and I wanna make sure that I cover um uh as part of the relief package, one thing that I learned pretty quickly was that you have to stay at the table to get things done right now as you know, um the parties uh have uh left the table are not negotiating right now uh looks like through the election on Tuesday, they've decided not to negotiate. I think that you know frankly is unacceptable. then we will keep pushing them back to the table uh and after immediately after the election they get back to the table. Um we put out a framework which I think makes sense for negotiating in terms of what's in putting us. The dollars, but more importantly, the values and the items that we are fighting for, I think are critically important. so we've we've gotta get it back to the table and I'm I'm really urging all negotiators, but especially after the election to get back because as we face flu season and as we face winter and we face higher numbers uh and continue and our businesses and local governments continue to struggle. We need to help them and a lot of our non profits that provide food for others. We've seen a huge bike and not just people inability to pay. Rent but also an ability to feed their families and so the soup kitchens and food kitchens and food pantries are getting maxed out. I just talk to somebody last night who just said the numbers keep going up. um that's why we have provided resources in our first packages, which were all bipartisan and signed into law um to make sure that our uh our our school lunch program and school breakfast program um how do what it needed, but also our local non profits and food pantries and everything that provide resources to other people and you think now as we head to. And the holiday just how tough this is gonna be on so many families um and uh with that, let me say that there's a lot of other items that I do wanna cover including nursing homes and um and what's going on in the nursing home facility, especially after those word and premise that there was a case of the state run veterans home and we can talk about that in a minute and other issues, but let me get right now to uh our guest who um is really has his pulse on what's going on on the uh along with our other. Me chief medical officer and our other hospitals. We just did a call. I think it was uh 2 days ago with all of our uh with a senior uh medical officials and all of our hospitals in the in the district and all the counties are represent and um and I'm really grateful that they keep up their communication talking to each other, not just about p that we need to make sure we have enough of them and having to help each other but what they're seeing uh in their hospitals. so with that, I will turn it over to uh the chief Medical Officer of Holy Name uh Doctor Adam. Thank you congressman and also thank you for your support throughout this uh entire pandemic you are really key to making sure that uh the hospitals uh all got together and spoke on a regular basis, which was really crucial to helping us get through this and better serve our patients and thanks for being there uh as the second wave begins to hit so I can talk to the group a little bit about what we're seeing now on the ground and and there absolutely is a change from a month or so ago we uh about a month or so we're averaging. Two to four patient at any one time with Corona virus um our positive testing rate was in the one to two, maybe 3% of the most um and that was the rate we were staying at uh since we came off that first wave and in the past several weeks, I would say about two and a half weeks now we've seen a significant increase so we're now averaging about twenty to twenty-two uh in patients with coronavirus and our positive rate for all the outpatient test we're doing is now closer to 5% a significant change from before. But not thank goodness, not the kind of exponential growth that we saw in March and we can talk a little bit about why that might be back in March. Um we really went from five patients 1 day to attend the next twenty to thirty within a week um and we saw that tremendous exponential growth now, we're seeing some growth um, but it's really more we we have We see more patients we plateau. We see a little more patience we plateau. so it's a much slower growth rate and we're also seeing more patients who are here in the hospital for a couple of days and then well enough to go home. Uh we don't fully understand that we can talk a little bit about that um, but that's obviously very optimistic that the patients were seeing and it's not just here at Holy name, but it's it's at the all the other hospitals in northern New Jersey because we're speaking to them on a regular basis. The patients are not presenting as sick and are able to come into the hospital for a couple of days and then leave that doesn't mean that this is still not a serious disease. Unfortunately, we've still had a couple deaths in the last month from Corona virus. This is still a very serious disease. But the vast majority of people that we're seeing now who are sick enough to come to the hospital are really not as sick as they were back in March. Thank goodness, we don't really understand why that is um there are some people who think that the virus maybe has changed in a way that um it's not as uh deadly. I'm not sure that's the case, but that's a possibility. There's also no doubt that we're seeing a younger group of people again who are being uh infected this time uh at least right now and that group of patients are less vulnerable to the virus. They can still get very sick, but they're not likely to get as sick. The other thing and I think the. A thing that's impacting this, the most is the mask wearing in social distancing so mass wearing it social distancing as everyone should now know is more about protecting other people than it is about protecting you if you're infected and don't know it by wearing a mask and by social distancing you are uh minimizing not eliminating but minimizing the risk to the people around you. uh you certainly do that better when you're outside then when you're inside because being inside does create additional risks. But I think what we're learning. Is that mass is also to protect us and at some level they may protect us completely from getting infected, but there's more and more thought that wearing a mask if you are exposed to someone with the virus, it decreases the amount of viral load that your body has to uh fight against and decreasing that viral load allows either your body to fight it off and where you don't develop any symptoms or if you do develop symptoms, they're much less severe and that is why uh we think we're seeing patients who are not presenting as sick and who are recovering uh better. Do you are you know? there's lots of questions Doctor about the um the spike and whether or not we are prepared or not prepared what we have to go back to the way it was before where we go and have to go inside. I'm just reading. I've got a bunch of emails since we started this and the common thing people are asking is like is it gonna have to go back to where we were before if there's a spike spike again like last time, so I hope not um and we're not. Seeing that exponential growth, but we also have to be honest with ourselves. There is no doubt that the measures that we took back in March and April and may save lives. There's no doubt in my mind that if we didn't make the changes that we made instead of um losing the number of people we lost, we would have lost more. I don't think we're at the point now where we need to make significant changes from where we are. I am not by any means suggesting that we go back to a more normal life. In fact, I don't think we're gonna go back to a more normal life probably till sometime in 2022 when doctor Anthony Fie said that the other day II felt comfortable cuz I agree with him and I think doctor fie is right a lot more often than he's wrong. We have to realize this virus is gonna be with us, but we also have to get back to some level of normalcy and it's not unexpected that in the winter when we're inside, we're going to see more cases, but if we do it cautiously if we wear mask and socially and limit our activities. To the more essential things, then we can keep the virus under much better control. We're not gonna wipe the virus out the measures that we're talking about are absolutely important to affect you as an individual, but as importantly they're to prevent the kind of pandemic levels of disease that we were seeing that would overwhelm the health care system. That's the biggest fear. it's certainly appropriate to have concerns about this virus in terms of how it affects you as an individual. but we can't let the. Virus runs so rampant that we overrun the health care system because then people that we could have helped we won't be able to help we barely got by that in March and April, we did we did not overrun the system, but it was really close and so we can't let that even become close this time and so I think what our leaders are doing is smart. We're watching. we're seeing the kind of numbers that are being reported and right now in northern New Jersey, the numbers weren't careful monitoring they weren't mask and social distancing and limiting inside activities and. And maybe doing school partially lied and partially uh remote, but I don't think they limit they weren't us doing anymore than that. but the strong caveat is if we start beginning to see that exponential growth, we may have to go back to more restrictive ways. I hope not and I think we need to be really careful about doing that because this is not going away so quick and we can't shut down our society for the next year or two. So it's it's a matter of literally watching day watching the numbers being really. Good about the restrictions that we have, I was on the news the other day and someone asked me about trick or treating and I said, look. I'm not an expert in every single one of these public health decisions, but I would not let my kids trick or treat this year and that's a tough thing to say I think trick or treating is potentially a high-risk behavior. You're exposing awful lot of people to kids who we know are uh asymptomatic carriers and yes wearing masks will help but I. Think that it's worth the risk to trick or treat now what I do recommend is that you have small in your bubble Halloween parties right, so we all now have sort of bubbles of people that were communicating with and we're seeing on a regular basis and I would recommend replacing trick or treating with that type of activity and someone ask me about Thanksgiving and I said, I am making a decision to have a very small family gathering. I am I know that my individual family members are living in their own bubble. Therefore, I'm gonna bring those bubbles together with my kids this Thanksgiving and try to have a small Thanksgiving and and and I'm making individual decisions for me and my family and everyone needs to do. that doesn't mean those decisions are that could be a risk right. I mean, you've got people who if you bring the public together you'll be inside. You can't really wear a mask. the whole time you gotta eat it and it is there is some risk to that, but um we're living in a world now that we that unless you completely isolate yourself, there's gonna be different levels of risk and I know that my children have. Living in their very tight bubbles, they're being very careful and so we've made the decision that at least some of us are gonna get together. We're not gonna bring significant others. It's gonna be a small gathering. um we're we're gonna try to do it outside if the weather warrants it. but if not we'll move inside and I think people have to make their own decisions, There are no high risk people in my family, everyone is low risk and so we made that decision. I am not saying that's the right decision for everyone. I'm not saying that someone who decided. To send their kids out, Trick-or-treating is making a terrible decision look the only way that we are gonna be 100%. full proof is to completely isolate and I'm not recommending that and a dangerous thing is to have a wedding with 250 people without math. I'm not recommending that to me those are the two extremes and everything in between is a risk benefit decision and because this is not going away and I think there's a significant chance. we're gonna be having this conversation next winter next fall. I think we all have to be careful decisions and understand those risks um and then proceed. Because we can't lock ourselves in our houses for the next year or two, and this virus is not going away. There's a question about restaurants and should we open them. Can we think safely open them beyond 25%? Are we gonna have to stick with outside and I saw this people are putting in some restaurants are putting bubbles out. you know you can dine in a bubble um are there so you can stay warm is that what do you think we should be doing there so I'm sensitive to the restaurant industry um but I think going past. 25% is it is concerning um uh I think that being inside is concerning um I think that we need to be very careful and I say that with all sorts of understanding in terms of the impact, this can have on the restaurant community. That's why we've gotta help the restaurants because you got 23% of restaurants, independent restaurants in New Jersey have gone out of business and we want them to be there for themselves and for us when this is all over cuz we're gonna get through this. There is no doubt that we're gonna get through this, but we're gonna be in it for a while. And so I would recommend if you're going to a restaurant spread out be outside if it all possible and I know that's tough for the restaurant industry, but I also know what things were like back in March and April, and I don't wanna even get close to that again. Why are why are other countries taking you know? we're seeing more aggressive measures now in Germany and England and others do you think that's what we're facing again and why that they're going back to shutdowns? Uh I think that there is a possibility that we will get back to that position again. I don't think we're there yet and back in March. I was one of the first to say it's time to shut down, but what we're seeing now is different than what we saw at so in March um if I come if I over the next couple days in the hospital, we begin to see those kind of exponential levels of growth that we saw back in March and April, we may have to shut down further and they're seeing that in Europe now and that's why they're making those decisions II. It's hard to predict the future. It's hard to know if things have changed with this virus, it's hard to know if the. Masks and um distancing is going to allow us to not have to shut down, but we need to be honest with ourselves and say there is a real possibility that we may have to shut down and then we're gonna have to rely on our government to help us get through that. if that's what's gonna have to happen and it could it could there's uh a related questions that's come in um about therapeutics and the drugs you know that we have now and is that really a big reason why people are we're you know. Thankfully, we have fewer people. We've more people coming out of the hospital and fewer deaths. Thank God and do you think that will or you know. Do get sicker uh adding to that question the people you know when our numbers go up is the the good news out of this that we're in a much better place to treat it than we were before and people will far more people living through it. So here's the hard truth. We're in a better place. I wouldn't say we're in a much better place. We have two medicines that now have proven uh benefit for coronavirus and that's rims and Dex, Reeves and antiviral medicine and dexamethasone is. Steroid we know those medicines work, they decrease the amount of time you need to be in the hospital, the des of eone actually showed a decrease mortality rate. our mortality rate I apologize, but neither of those medicines are are are um magic bullets. Neither of those medicines are anywhere near they wouldn't where they would need to be to give up on the importance of social distancing and uh mass wearing I have to tell you if you said to me what is more powerful every single person in this country following social distancing rules and wearing masks. Everyone having access to these medications, which I think we do now the masks and the social distancing are more valuable. They really are these medicines are not good enough to be able to hang our hat on them and say, okay if I get coronavirus, I'm gonna be okay because these medicines are that good. There are handful of other drugs um that are being studied now that I think maybe even closer to being magic bullets, particularly the medicine that the president uh was able to. Um and we are using that medicine here at Holy name in a study format so patients who come in can get that medicine if they enroll in the study, but the science is still not complete. It is very suggested that medicine is gonna be uh beneficial, but we just don't know yet and so I don't want anyone to say well, it's like strep throat. I'll just go to my doctor and get penicillin and that will get me better. We are no we are near that we are better at managing patients on ventilators and understanding a lot of the things that we need to do when patients do get sick, but no one should walk away. From this zoom meeting today, thinking that the medicine is going to be the answer cuz it's not yet it'll help God forbid we get to the point where we were like in March and April. Yes, less people will die, but still people will die and that's tragic and so we need to wear mask and socially distance and you feel now that um and there's uh I've gotten of three emails about pp. you feel that we've got what we need and I'll we've got some Facebook questions here I wanna get to but um uh on the pp front that we sort of have. There, I know I know you're sure that you've talked to me about the real challenges. staffing shortages you know versus now, gloves and masks. Yeah. we're in a much better place with PAs are the other hospitals in northern New Jersey as compared to uh back in March, but you almost can never have enough because you don't know right. so I don't wanna say that it's we we are we are perfect because we are we are as good as we possibly can be we are prepared if the if the number of patients is even more than we're back in March and April, so we are better prepared. um we are prepared if we get. The same type of impact we had in March and April, and even more, but you never you never feel comfortable enough because you know what the potential impact of not having appropriate. I'm a little bit concerned about testing. We're in a much better place with testing, but testing could very easily become a problem again. Um we at least now have task we now have agents, but we don't have unlimited amounts of agents and that's just because we can't get them from the vendors right and then you mention staff staff to me is the largest concern because you know this isn't a baseball. Where I got extra pictures in the bullpen, you know, I have only so many critical care nurses and critical care doctors and only so many technicians and respiratory therapist and we are getting in a better position and thank goodness the vast majority of our staff got through the first round of this without significant issues. although we did have some deaths amongst our staff and that was tragic um but um. I'm worried about the impact on the staff in terms of the emotional impact and then having to go through this again because it was really a uh emotionally draining and terrible experience and I'm worried about having enough bodies that can do the job if we get anywhere uh like we were back in March or April, but we are in a much better position. We're we're better trained. We're better prepared. we built out five different IC awards and prep and during March and April, we've kept them up so if we if we have the kind of volume that we need, we can concentrate more on. For the patients and not building out space, all our covenant nineteen patients are staying in those dedicated areas. Now they're cared for by a dedicated staff. The staff has the adequate p. We have the medications we need, but there's always the fear that we could get back to where we were and it's hard to know if you're ever prepared for that situation. um two quick questions I wanna get you here um one uh been reading about new cases of veterans home is that true and we've seen it um the BS. There is a uh there was um we got indication that there was one potential case. they've tested that resident um the first was positive. The second was negative, the retesting that resident they've separated that person out from the cohort and that person out from um from the rest of the residents um and informed families and tested uh other residents who are exposed. I think sixty plus other residents um as well as I think seventeen or eighteen staff, I had a briefing yesterday from. Head of the state, the state the state, it's a state run facility the veterans home in pre and I had uh a briefing yesterday from the interim head there at that home, as well as the interim director of the state Veterans Affairs, um uh department so from that commissioner uh about steps they're taking not just for this but to be prepared for the flu season and winter here. one thing I've trusted to them is to make sure they have a very clear plan. They're communicating with the family members. the family members can be in. Touch if they have to do shutdowns like they're doing right now, I think for 2 weeks and not allowing visitors um so we need to make sure that they follow clear plan have P have regular testing and have what they need. um that's very important. There's a question about P um and for the small businesses that you know I've been pushing for months now for a second round of loans for our small businesses um or grants depending on how you take it as a as a recipient, you know these are forgivable loans um in most cases um assuming. The guidelines are followed and I believe that for businesses that have had revenue loss significant revenue loss they there should be another round of P. We have the resources left in the first round about 130000000000 left. We've encourage and what I propose our bipartisan proposal that there's another um uh Swat and resources put against those uh against the P program to help our small businesses, which are in there many of them very tough shape to help get through this. I've spoken to far too many um. Business owners in the last months, including I just I think yesterday my last conversation with a small business owner who's just struggling they've. they've put everything into it. uh everything they've had all their savings um to build these businesses and it's just heartbreaking and as this one entrepreneur said to me yesterday, somebody owns a diner in the district that it's not just about his family, he said. It's it's about the seven or eight families that he also takes care of who work there and then he. Responsibility for who've worked there for many years and uh so it is it's just you know we just have to help people. That's why we're pushing so hard for a second round of the PB program and you know and I think you know there should be total transparency behind this and accountability so people can see where those resources go cuz our taxpayer dollars. But I think it's it's really important um and one of the things we also push for um in our legislation that we put out um and we voted on in the house was for the reinstatement. State local tax deduction uh full reinstatement and that's that's what the um member of the tax hike bill where they they gutted the same level tax deduction that hurt our state in particular my district in particular majority of people taxes in my district went up as a result of the tax bill and um which was really a red state sticking into the blue states. Uh it's important to put more resources back in people's dollars those dollars back into those pockets right now, so that people have resources to get through this very tough time um and so. Um you know, I think that's a that's a huge issue, but a question that just came in about um and I would say one other thing on on the veterans home um the State-run veterans facility and for all long-term care facilities. The key is to make sure we test as doctor Jared and making sure we have the resources to test and get those results back. Um I've proposed a bipartisan bill called the Nursing Home Pandemic Protection Act with Chris Smith, who's a Republican from South Jersey. We've worked on which says basically all nursing homes and long-term care facilities have to have a crisis plan. Have to have P have to have testing have to communicate with the CC if there is a problem quickly and also have a communications plan for families, so their families aren't left in the dark. like too many families were the first time around. Um there's a question is it possible to get a PC test in county with results in a couple of days? I'll be turning overseas in November and wonder how to get that um doctor Jared. I guess that's a good question for you. Yeah. We're in a much better place Uh II know that here at Holy Name, I typically get a result within 24 hours now um so uh we have a telemedicine program. We don't recommend you go to your if you're feeling sick. Uh we. Don't recommend that you go to your provider or an emergency room without reaching out to your primary care provider and discussing those symptoms first because we still are worried about um people spreading uh the infection, but you should get on the phone with your primary care provider here at Holy Name, We have a telemedicine program that if you contacted us, we could set you up for testing on the same day and you would typically have the results in twenty-four to 48 hours uh closer to 24 at this point and forty-eight if the volume of test that get done uh. Increases it might be uh a slow turnaround time, but it is absolutely uh we're in a much better place as it comes to getting tested uh done now compared to back in March and to that point um what um there's other if you don't can't go to holy name. There's other facilities right. I mean the county has a facilities set up for testing um as we know, also you can go to the go to Cbs and others they have tasks set up PC test right and yes, and as do all the other hospitals. so Hackensack is a program and It has a program has a program to really your best bet is to reach out to your primary care provider, which everyone should have and that person will know uh where the best place is to get a test. What about the antibody tests and where it how's that turned out and what is your thoughts on that? We're we're learning a lot about the antibodies, but we probably still have more to learn than we know uh unfortunately we are seeing that it doesn't look like antibody protection is forever uh recent study came out of Mount Sinai that suggested that people still had antibodies after four to 5 months, which is encouraging, but we are seeing people here. Lost their antibodies in as quickly as 6 weeks, and it's unlikely that the antibodies um are going to give a lifelong immunity to Chrono virus. We need to think about that as it relates to reelection and then we also need to see whether the eventual vaccine is the type of vaccine that you take once in your life or that you need to take every year. So like the flu shot, we don't know the answer to that yet, but we need to be honest with the science and be and be aware that there are things we just don't know and then as we learn them change our policy. And our plans they're also when we get back, you are you sort of bullish on a vaccine in the beginning of next year. Uh I think it's likely that there will be a vaccine available by early next year. I am not sure whether we have the uh ability to get that vaccine uh widely spread early next year. I think it's probably gonna take most of the year to get that vaccine out to people. I wanna make sure that the vaccine goes through all the rigorous signs that it needs to go through and I think that the develop of developers of the vaccine are committed to doing that and are not gonna rust something to the market. That's not safe. So I think we're gonna get there with the vaccine but. And vaccines are not 100% right so the vaccine doesn't necessarily protect every individual what it can do is it can prevent this pandemic from overwhelming our system. so if we can get a large part of the country, vaccinated and the vaccine is at minimal 50% effective that probably takes us out of the pandemic phase that we're in that takes us into a place where we're still gonna see Corona virus and we still need to be. Careful with it, but we don't need to worry about overwhelming our system and it's gonna allow us to get back to some level of normalcy. Um just two other things um cuz we talked about testing a minute ago and then I just thought of why if you have questions about where to go for a test, including Holy name and the other hospitals and other local providers, plus the systems we've set up in Bergen County that the county is doing and I wanna thank our county executive Jim Ted for his work there you go to um heimer.house.gov we have uh uh a link set up with all these places where you can go get testing. I'll make sure that you can find that easily on the page. it's there um so that's one. And I'll also say that I've been working with Senator Booker on the nursing home piece of this on the legislation, which is now introduced in the Senate, which I think to doctor Jared's Point is just making sure that we're thinking about all the various and abilities here and that we don't know where this is going so we have to be um very prepared and I'm and why I was, you know I we had a very good briefing with the governor's office yesterday with them uh Department of Veterans Affairs yesterday about uh about Paramus in the sense of having a very clear. And I was glad they you know they was levels of accountability and there were there were certainly um as reports found mistakes were made there um that have now of course been addressed and have a very clear plan and they made changes in leadership there, which I think um we're we're welcomed um and the key is to make sure yes, what do we hold people accountable where mistakes were made when we knew more than when we knew enough, that mistake shouldn't have been made, but the key is going forward and I think if I'm hearing anything from Doctor jar. It's making sure that we don't suddenly um veer off our current plans that we've been implementing right just wearing our masks being social distance being smart sticking to those in your bubble um and not and especially as we go in the winter and flu season and to the point of flu season, I know everyone listening today should get a flu shot. Please make sure you get a flu shot. Um what are you are? you worried you know, flu shot and flu season is just sort of beginning. Yeah. We're in the early part of flu season, and we're really not seeing anything. Fluid at this point is a little unpredictable, you know we could have a relatively mild season uh or very bad season and two things determine that the strain of the flu and our best guess is that this is gonna be a year where the strain may not be too bad based on what's happening other parts of the world and the other pieces the reality of social distancing and wearing mask, so we are all hopeful that the measures that we have in place for Cod may also help us have a much less significant uh flu season, but it's another one of those things that we just. Now, until we know, yeah, I mean it's also uh listen. It's one of those. It's why we need you know one of the reasons why I believe we should strike the Affordable Care Act and have good health care for folks and you know and have continue to stand up to make sure people can we don't know what's gonna be around the bend here and we need to know that we're we have the protections in place and we're very lucky to have some great people like you on the front lines and our all of our front line, health care workers and first responders who have done a phenomenal job and I know this. And I am sure everybody is thinking not again uh right now at the hospital. um so I uh I appreciate everyone and I appreciate you for leading it and everyone there all the staff, the nurses and the text and the doctors for you know you know um being ready for uh a potentially tough few months. Let me make one more pitch for the flu shot uh congressman the flu shot is safe. The flu shot is very safe. um everyone should get a flu shot. the country. Are the reasons to not take the flu shot are very small and you should discuss that with your with your physician if you're concerned about that, but the flu shot is crucial, not just this year, especially this year, not just this year. Everyone should get a flu shot. I'm a big believer that flu shots have saved lives every single year and prevent uh epidemics of flu which we are at risk for uh every single year So please get your flu shot. It's safe it works I. It's a great way to uh to conclude today, I know there's some more emails and others have come in and Facebook post. I know we've uh we've gotta get the doctor back to work um to help save lives and I just wanna thank everyone for taking a few minutes out of your day for this cup of Joe with Josh uh virtual town hall meeting. I'm hoping soon enough. We'll be able to do this in person uh and um uh but for now we'll make sure we keep getting information out there go to heimer.house.gov for any information on testing and other questions you have about these programs that we put in place to help folks. Uh both at the county levels and the state level and the federal level um thanks, I hope everybody is safe. uh stay safe and healthy. God bless. Thank you. Thank you again. Doctor for your time for being a God. Thank you. It's a pleasure. take care. bye everyone.