Hello everyone. Thank you for joining us today. We'll start in just a second. Good morning everyone welcome to today's covid- 19 media availability with the Southern Nevada Health District. I'm Corey from the Office of Communications and I will be moderating today to admit a few more people to the room and there we go to answer any questions you may have today. Our panel includes Doctor White Crash hour our medical investigator Misty Robinson, Senior Public Health Preparedness Planner and Jeff Quinn, manager of the Office of Public Health Preparedness, If you're joining us by computer today, please click the raise hand button. Bottom of the participants list to let us know that you wish to ask a question or you can always type that question in the chat box if you are joining us by phone press star nine to raise your hand, Thank you all for your participation today and you have our permission to record today's session. We are now ready to begin. Do we have any questions? We're gonna be helping at a not too distant point. We're gonna be helping a few of the countries that if you got your camera on today and you're not one of our panelists, please to say that if you don't mind around the globe also alright questions anyone. this is Michelle from the Nevada Independent, I was wondering if you can give any sort of an update on the temporary structure that SN HD is building as well as the Isogo Q isolation Center for the homeless. Do you guys have dates when either of those will be open? So this is Jeff Quinn with Southern Nevada Health District, so the the we're in progress of identifying the the vendor to set up the isolation quarantine facility here at Southern Nevada Health District. That process is still in process now Cashman of the Cashman Field location was set to open up several times and I think the target date for that facility. opening up will be on Monday of next week. So I've muted everyone. if you need to ask your question, please use the raise your hand feature. so if you're on the computer that will be under your participants list if you're on the phone hit start nine have a question from Mary Hines here, she says any indication of the curve of disease any signs that it is like leveling off. I guess I can take that take that question, so we do know that we are still the number of cases per day is increasing and we it seems like it's still increasing exponentially. There may be signs that the rate of like the curve the rate of curve of the curve is is decreasing slightly, so we're still in exponential growth, but it's possible that the slope of that exponential curve. has decreased slightly, I know that's a little bit. it's a little bit of a mouthful, but basically we're seeing some early signs that that potentially the school and business closures have had some impact. It's a little bit early to tell I think we're gonna have to do a more rigorous analysis and we've got several people here who are working on that. Okay, I have a question from someone phone number ending in 744 zero. Thanks. that's Kevin Rader at The Associated Press I was asking on Wednesday about the materials being received, processed and distributed at the Convention Center. Are you able at this time to tell us what's coming in what's being distributed? Yes, so it's a Las Vegas Convention and Visitors Authority we received manage inventory from the federal strategic National stockpile. so as that PPE comes in it gets broken down and then coordinated through the multi agency Coordination Center, our County ALC for Reese resource request that have come in so we fill those based on priority groups and the priority groups or acute care hospital so the 18 large acute care hospitals that we have throughout the Valley our EMS. Both private and the fire Department EMS law enforcement and then other health care system partners so as that PPE comes in it gets broken down and distributed to out generally it's we have 22 S and H D facility or two S H D preparedness People down there working with the National Guard and with Clark County to to actually break that down. I know that we received more inventory our last bit of inventory that we received through managed inventory yesterday and today and that right now is being distributed out to the recipients. Our next question comes in the chat box for Miranda Wilson. How are you telling deaths at this point and determining if a patient is a Corona virus victim? what's the involvement of the coroner's office in that process? So we we find out about deaths in two ways. One of them is if if we're actively investigating a case and we know that a certain person has a positive laboratory test and then we find out from the hospital that that person is deceased. That's one way we find out about it. We also find out through the Corner's office so often you know often they will know about deaths prior to us knowing about it. And so we received communication from them as well. we also an additional way we find out about desk is through death certificates and there's often a time like through that most of the time we've already picked up those those deaths, but we do find an additional cases that way there's some concern about people who die who haven't been tested and the Council for state and territorial epidemiologist has released a like a case definition. Basically people who you suspect may have had copied symptoms and then died and so we're trying to figure out how to incorporate that data as well, You know what we don't wanna do is is really systematically under count them the number of deaths so that's that is a challenge so also this is Missy Robinson with the Office of Public Health Preparedness the corner when they arrived at a death scene. if if that person was at home, then they will be. Swabbing the decedent to process for covered positive or to figure out if they're covered positive before they will do any type of autopsy or anything like that, so they they have adjusted their protocols to account for that. Our next question comes from Michelle Price. hi, I'm wondering you know with test and such short supply. you generally have to have most if not all of the symptoms to get a test right now, but the statewide rate of positives is still about 11 percent and I'm wondering if we think that's low when if we have any sense of how many false negatives there might be so I think our suspicion is that a greater percentage aren't so sorry I. Is that if you just tested everyone in the population, the percent of people who would test positive is is likely lower than the estimate We're getting and the reason being is the people who are being tested now are systematically people who are more likely to have symptoms, so they're more likely to symptoms more likely to have severe symptoms cuz a lot of the testing is happening at hospitals and also at clinics. So we know that people who are symptomatic are more likely to even. So someone who's symptomatic versus asymptomatic so who has the disease? The symptomatic person is more likely to have a positive test. it's difficult to know what the like false negative rate is because the main source of testing is is that are the test we're doing the PCR test usually when you're trying to gauge like false negatives or false positives, you're comparing the current tests are using with the gold standard. So, for some example, some tests have like a culture. Do and you know the culture is like the gold standard for this everyone's pretty much using the PCR test PCR sort of the the Gold standard right now, so it makes it very difficult to assess you know like the rate of false positives and false negatives. We we do know anecdotally that people during the course of their illness, they may be infected, but they made initially taste test negative and then later test positive. So we think that the sensitivity of the test depends on sort of the disease. Like how much virus they have in their body at a certain time and so below what they're certain threshold, you know they made any test negative. even if they have infection all these things are really difficult to parse this time. Our next question comes from Cynthia from Telemundo. Can we talk about the recovery cases? What's the expectation on that an increase? Sorry can you say that one more time? Can we talk about the recovery cases? What's the expectation on that and increase? Oh, you mean, like do we expect the number of recovered to increase overtime? Yeah, I mean, so we are putting out that or will I think we have given estimates of the percent or the numbers recovered. That's really based on a lot of different assumptions. I mean at the end of the day, the recovered people who recovered are basically the people who. The total number of people who had the illness when you subtract the number of deaths I mean in the long run that's kind of what it is. so we we know that the estimates of the mortality for this are probably something along the lines of one percent or less than one percent, so we would expect that everyone else would eventually be recovered or would fall into that recovered category. So we're trying to give sort of real time estimates of that number. But at the end of the day, you know that is what you expect, you expect you know 90 -. Greater than 99 percent of people to have recovered now, that is a little bit difficult because we're not testing every single person. we don't know 100 percent of the people who have the disease but based on estimates from from different countries, you know we we suspect that the the death rate is probably one percent or less than one percent in the population. So we'd expect that you know some somewhere around the order of 90 -, nine percent of cases are Hey, we're taking a question now from the phone number ending in 2962. Hi, it's Dana Jentry from the Nevada current I was wondering have you done anything to determine death by ethnicity. Yeah we so as you know that as the number of cases increase, it becomes difficult to systematically collect all this information for every single case. we are prioritizing people who are hospitalized and people who die so we do have that information. I'm pretty sure we're gonna put out that information at. Time I don't have the information at the tip of my fingers, but I think you know, I think it's reasonable that we're gonna have those conversations about releasing that information. Mary Hines asks What are the science that the curve is flattening? What does this mean? please elaborate? I don't wanna speak too far ahead of myself here cuz I think I wanna make sure that I wanna make sure that we have like the rigorous analysis to back up what we're saying so I I do know that people in our office, our Office of Epidemiology and Disease Surveillance are are working on On sort of determining the effects of some of the interventions that happened so far, but I don't wanna speak too much about it now cuz I I don't wanna give sort of false information or preliminary information if that's okay with everybody. Michelle Rendell asks the latest report still indicates we do not know the race or ethnicity of 40 - one percent of the cases in Clark County. Why what steps might the health district be taking together that data and better identify any race or So during the course of a usual disease investigation under ordinary circumstances with the disease, that's we basically other diseases that we investigate if we hear about a case or we are reported a positive lab or something like that we reach out to that individual. We do a very detailed interview. We gather information at that time. We also review medical records and parts that information for the medical records if we don't talk to the person individually. This becomes very difficult when we start to see you know hundreds of cases being reported in a single day. we have about 50 people currently who are working on doing these investigations and each investigation. each of these individual calls can can take a couple of hours two or three hours to do into identify contacts and stuff. So just based on the math, you know, we don't really have enough staff at this time to to do these detailed phone interviews. What we're trying to do is we're trying to. US to shift our strategy to rely on more electronic means of communication so people who are not in this like really high priority group. so people who for example, haven't died or aren't hospitalized or don't fall into several other priority groups, but we're trying to work on electronic notifications so so notifying them via text or via Email and then collecting some of these other information now, just because of the sheer number of cases we're at the end of this, we probably aren't gonna I mean we we aren't gonna have. data and we see this across the country, you know with the CDC, they reported, for example on hospitalizations and the risk factors Associated with those hospitalizations. We see that they were only reporting on five percent of the total number of of cases. so so this is an issue really across the entire country. some some areas have chosen to stop contact investigations altogether and they're just basically surveilling this passively through laboratory reports so throughout. We have to we have to really prioritize our our limited resources so as much as we want perfect data I think right now the most actionable information that we want is information about close contacts of people so the more people we identify who have a positive test and the more we identify close contacts The more we can recommend those close contacts a quarantine at home if that's if they fall into the the appropriate risk category is then those are people who aren't spreading the disease potential. Others if they do develop the disease. Let's go back to another phone question call or ending in 6314. Hi, this is Kendall Kim from Channel Three. I have a couple of questions the first one being I know we've discussed the potential flattening of that curve in the need for more rigorous analysis, as you said yesterday, though we sided with UNC the I guess peak dates seventeenth through nineteenth. they'll go so going into a week from today is that still what we're looking towards in the future. I guess that is that a peak day. The estimated peak date, I think that you're referring to is based on the models put out by the Institute for Health metrics and evaluation in Seattle and I know this has been a very influential model. It's something that as I understand it's influencing decisions at the National level. you know the this is a very niche area of epidemiology and there are lot of people working on this and they have a lot of different models and it's it's These models are good for planning purposes as far as determining estimates of the peak and allocating resources and things like that, but we really have no way of knowing wish model is gonna be the most accurate Some some other types of models that have been put out projected peaks being much later at a much later date. And so at this time, I think we just have to sort of wait and see which model ends up being correct so it would be nice to hear that. our peak comes sooner rather than later. Yeah. I have a second question as well. I know that there's been the study of antibodies of recovered cases in other cities throughout the. Is there anything like that going on here? I can't speak on that topic. I don't I don't know what research is being done outside the health district on that topic. You know that this is an area that I know a lot of people are interested in looking at the antibodies after recovery, I think we still don't really know even if people who develop antibodies if they have if that provides long-term immunity against repeat infection so I think it's a little early to speculate. we have a few reporters with follow up questions but first we are gonna go with those who have not yet handle chance to ask ah from Jacky ah can you talk about hospital capacity right now and expectations for where the classes will be when we had our peak also any update on when you expect to hit our peak Jeff Do you want to speak on hospital capacity? So with with the hospitals interesting enough right now, a lot of our emergency departments are not seeing the huge surge that we're seeing in other parts of the country now last week and weeks before prior to this, they were extremely busy with a number of cases that they were seeing of potential covered patients. we are still an influenza season so a lot of our cases may. Still be what's currently circulating in the community however, right now we're kind of in a in a working management of those patients. A lot of the health care facilities have implemented triaging and set up in their parking lots triage areas where they can screen the large number of individuals that were coming in and that is still a weight wait and see with this this particular virus. it's it's very unknown. You know could be seeing future dates where we have surge surges of of patients flocking to our health care facilities, and we need to be prepared to manage that surge as it comes in. I think I can comment again about the you know the peak, and when will that happen, one of the things that makes these sort of estimations complicated is that you're relying on past data to project something in the future and a lot of times when we receive this information on these sort of models, we change our behaviors so we some of these models can estimate a peek at a certain time, then if we all take measures such as you know, government governors just like order the school closures and the business closures on essential business closures. And that has the effect of not only decreasing the height of that peak, but it pushes that peak out to a farther date. so it becomes difficult to know when we, for example, just say we get to that date estimated by the Institute for health metrics and evaluation if if we reach that peak and it seems like the cases are still going up. but not as much we don't really know if that model is an inaccurate or we don't know if our behaviors have changed conditions such that. Peak is gonna be at a later date. That's what makes it so complicated and another thing about the hospitals. The hospitals are reporting that there's a flattening number of of patients coming in with covered so right now, they're staying at level capacity, but we do expect that to go up. Vanessa Murphy is asking, Are you noticing clusters of positive cases? or are you keeping track of that meaning the locations of those cases with that information be released, and can you identify one or two specific posters for us? So for every case when we identify if we have an index patient so the person who originally tested positive and we investigate that we identify their contacts and we're we monitor those contacts either through the phone or through through electronic means. and when we find out those people have symptoms, then we will promote testing and we identify people who who now have the infection and so we are seeing you know throughout the Valley. we we've seen a lot of cases where. their their family members for example of the index case who then becomes positive and this is to be expected. We know that the family members are at the highest risk of of developing the infection. I think the state also put out information recently, I saw it in the news about about cases Associated with a nursing homes and long term skilled nursing facilities, and this is another situation that we're monitoring you know there. There's so many individual cases and there's so many. That's not really feasible to put out this information all time in in real time. I think you know a lot of this stuff. A lot of information we're putting out has to be the analysis has to be done sort of ahead of time and once you build that analysis, then it becomes easier to maintain it. So I think as time goes on, we'll be putting out more and more information, but it's sort of an incremental process. Reno Gazette Journal asks in observing code nineteenth behavior are you seeing similarities to past pandemics that included a second wave of cases? is that something that we can expect in Southern Nevada? I think we I think that's a question that we can't answer just based on our case numbers. I think that question has to do with more of what we think about this this disease. This is a Corona virus it belongs to a large family, chronic viruses that are mostly seasonal so it wouldn't be unexpected. I guess if this becomes if this follows more of like a seasonal pattern but at this. Just don't know that you know the two chronic viruses that are most similar to this and you know they they well in the case of Sara as far as was basically a controlled and and eliminated and so we never got to see the answer that question of whether it demonstrated seasonality. But I think based on the other chronic viruses, I wouldn't be surprised. And we're gonna go back to some of our follow ups. This is for color ending and 2962. how do you have any numbers on infections in nursing homes still nursing facilities? So nursing homes and skilled nursing facilities, those those type of facilities are regulated by the state and not by selling Nevada Health district. So those information that information would have to come from from the state. I did see an article just recently where that information was requested of the state and it was published in a news article. so I think the state is putting out that information. This question is for Jeff from Ken Rider at AP following up what has come in test kids PPE masks gowns ventilator sanitizers, and can you quantify received items? Yeah. so the the manage them the federal managed inventory is is somewhat limited and and what items we receive and 90 - five math surgical math gowns and and other face shields The clear plastic face Shields other items that are not included as part of the The manage inventory will be goggles. we have received some some limited hand sanitizer Primary PPE that the gowns and the 90 - five mask and surgical masks is generally what's in the inventory shipments that we've received now. We have also through the generosity of a lot of our southern Nevada business partners they have donated an an amount of of PPE and and other items. we did receive a on loans through the state of California 50 ventilators but A request from our Q care hospitals for over 600 ventilators so really working through our multi agency Coordination Center will take resources like that and be able to to give up those those limited resources as we get them. we also had a hundred gallons of a hand sanitizer donated, which was one of the unusual items that we received but working with with one of our local bottling companies were able to to you know put in. Unity youth quantities so that we could distribute that out with with that with you know the the generosity of the Sands Corporation, the wind Corporation a lot of the items that they have donated will be are currently in the process of being broken down and distributed out. so where is some of our our health care facilities rehab hospitals and individuals that have not received any of the management. From previous shipments are are likely to get some quantity at this point now through the the resource request that have been submitted to the multi agency Coordination Center pretty much, it's it's still a fraction of what is what we've actually received and what we're able to distribute out so nobody has gotten the full amount that they have requested. they get a fraction of that and it's it it really is Important to recognize that so still purchasing PPE through a commercial means if we can get it there have been other jurisdictions as well that have purchased PPE that may also be purchased by health care providers that that as they need them, those are some of the smaller mom and mom and pop type provider groups where they're maybe not affiliated with the larger acute care hospitals, but an individual. A private practice provider could go that that option and go that route but I do know that that from the inventory that was donated for me, they're the governor's supply the sands the win those those items will be offered up to some of the smaller health care providers in the community as as soon as as Monday and Tuesday of next week, in addition to that the multi Agency Coordination Center is receiving a number of vendors that I would like to sell items. US the multi agency Coordination Center, is vetting those vendors to ensure that they are providing quality PPE and items that we need so that process is ongoing as well. Miranda Wilson asks the health district just received $503000 in Grant money through the Care Act. Do you know what that money will be used for. I can't say what what that specific money will be used for, but generally when we receive either federal funds or Grant funds, there's a very specific use on how that that money can be spent generally it might be to cover costs that that that the southern Nevada Health District and other community partners have already incurred in the response to Covered 19 and those dollars generally you know, go very very. Fast, it's only a fraction of of the amount of money that's being spent to protect the public health and in the community so we could always use more money and that is really what we are working through not only the governor's office in the state and local government but with our congressman and senators to get more allocation of funding and resources for the state of Nevada. Michelle Rendell ask Congressman Congressman Mark Ammo Day announced a week ago that Nevada was expected to receive 15 Abbott ID. Now rapid testing platforms have any of those arrived in Southern Nevada and where would those be deployed first would health care workers or any other group you prioritize for having access to rapid results testing. So with with resources like the Abbott testing machines generally that that type of instrumentation is a point of care type of instrument, it's to assist health care providers with providing immediate benefits or treatment possibilities for the the patients under their care. I know that some of those those pieces of equipment have been received here in Southern Nevada and they've been distributed out and and primarily where these these locations are. Would be at an acute care facility. Alexander is a part of from Univision is asking. Can you please talk about the criteria you use to determine that someone is cured? Sure, so the CDC has They have basically for determining the end of how my solution or an isolation in a hospital setting they have testing criteria. They have non-tesco thing criteria so testing criteria basically States that after a certain period of time without you know, fever or symptoms, they didn't test that individual and they perform repeat testing certain interval and after two negative tests and they're considered cleared because ask access to. Is difficult and we don't have as many tests as we would like. There's also a non-tesco thing criteria based basis just on clinical symptoms now. Be when Southern Nevada Health District makes calculations regarding recovered word, we're using different information. so if we have information on on people's symptoms that we factor that in if we have information on hospital visits, for example, like when when someone was discharged from a hospital we make assumptions for example, if someone's currently hospitalized for for the disease than we assume that they're they're not recovered when they're released, We assume that there's a certain period. Time, for example, about a week where they may still have the illness and but our are sort of on the road to recovery. So there are a lot of those different assumptions that are going to that number now they're as far as I know there hasn't been one energized way to calculate this number across the country. So I think estimates you get from different States and different counties are gonna have different methods and they're not necessarily gonna be completely compared to comparable. I think this is I think this new. you have to take the green little bit ah we can we can cut it using a consistent methodology so overtime ah you can compare our current numbers with our previous numbers but if you start campaign you know one country to another one state to another I think um those results could be misleading Andrews Leno is asking when do you think schools will be reopened? I don't know I don't know the answer to that question. I think that's gonna be a decision that's made of a higher level and I think that's gonna be made based on what we're seeing in Clark County. in terms of the number of cases we're having and whether those cases seem to be going up or down. Yeah, that's that question is really for the Clark County School District Superintendent. Mary Hines has to follow up from earlier she's asking what about geographic clusters like downtown or Sun City, and she's also asking. Do you envision a shortage of ventilators? So as far as geographic clusters. You know as you see from our race, ethnicity data, there's a lot of missing data and so we for every case we have or for most of the cases we have we do Alright, I don't know if it's most. but for a lot of the cases we have we do have certain addresses or zip codes Associated with it now, sometimes it's hard to parse out for certain diseases, whether you're seeing more cases in a specific area because there's increased population density in that area so it's it's not Yeah, it's so it's a little bit complicated. It's also complicated because just say you see a lot more cases in a certain zip code or a certain area does that mean there are more cases in that area or does that mean your your data is more complete there. So that's those are sorts of things that that we are gonna be analyzing, but it's it's sort of premature to release that information at this time and as far as the ventilators go there is an increasing number of patients being innovated and on ventilators, so we do anticipate a need. Additional ventilators in the near future. Vanessa Murphy asks, Are you concerned about Easter services being held even if they're drive-up services? I guess I can answer that question you know I think as I understand it from different faith-based organizations still have to abide by the same restrictions as other organizations and if there are drive by services and things like that, I mean the most important thing is that people are still maintaining that social distance so hopefully any of these services that occur that people are are still taking those precautions and hopefully they're more Services and things like that, so I can't comment on those specifically but you know what we really wanna just avoid is having any situation where they are a bunch of people congregating very closely together. you have any situation like that and they're certainly conditions are right before or the disease to spread and to add on to that metro is They're unforced seeing the governor's regulate or directive to stay-at-home when if you're in the public, you must have a face mask. Yeah. One moment. Okay, Miranda Wilson asking what's your estimate of the test testing capacity in the Valley at this time, such as test conducted per day percent of presumptive cases able to get tests etcetera. I don't have that information and in front of me, so I can't really speak on that right now. right the difficult thing to estimate the testing is is testing is being done not only by the Southern Nevada Public Health Lab, but our commercial labs as well. Quest Lab Core CPL as well as is is medical providers offices if they have the availability to have enough PPE on. To provide those test and people meet the evaluation criteria to be tested, I know that our our hospitals generally will do testing if people are admitted to the to the hospital as well as being those that are medically evaluated. If it's mild they may not receive a test, but they may be still advised to shelter in place at home in isolation. So really I think as as. Testing methodologies become available, I know that through federal resources and and some of our private providers more testing is becoming available and more test methods such as the the antibody testing but as that product becomes available generally, it's being consumed. So really, we still have a very limited capacity and southern. And in Nevada I think for for testing, but we could always use more the extraction kits in the media and the supplies that we used to do testing are in short supply. They're on back order most of the the general suppliers of where we get testing reagents are are they're just the product is not not there and it might be prioritized to other jurisdictions as this is a pandemic that's global. Also have to look at it, the other States and cities being hit more hard than than than we've experienced here in Southern Nevada so with limited resources often times those resources are directed to the cities and States with greatest need and and we're seeing some of that I'm the add on to what Jeff said. I think it's been very heartening to see how commercial labs have really taken off in terms of. I've got amount of testing they're doing and we we see that you know around 60 percent or something like that of of all the positive tests that are coming in are from commercial labs. so that's being being very heartening to see. I think we we can ever have enough tests at this point but I do hope that our capacity continues to expand. And we're gonna go through just about three more questions now. Jackie Costa was following up on something earlier, she said, and the convention Center of serving as a base camp for sorting through donations and shipments of PPE and other supplies. So there's several locations where PPE could be broken down in supplies, but based on on the square footage necessary to to have the space to to be able to do these things Convention Center might be one of the the areas that we utilize, but it's not the the soul area. We have several places identified throughout the Valley or we might stage resources and equipment that we receive in. amount of response to two Covid- 19, so it's it's while it's right now it is it is a favorable location if. If if it was not as widespread as it as it would and if we still had conventions large conventions coming into town, the use of of spaces such as the the Las Vegas visitor and Convention authority may be limited, but the the Las Vegas visitor and Convention Authority has been an excellent community partner in assisting government and the health district with resources necessary to to to maintain our opera. And allow us to continue to distribute distribute PPE that is critically needed by our our health care and and community partners. Cynthia from Telemundo is asking for those who are released from the hospital, Is there a follow-up? So Kobe, it is is really no different than any other disease and that if someone is released from the hospital the discharging doctors usually trying to arrange some sort of outpatient follow-up. now that's something that is easier when they have a primary care provider in which case you would follow up with the primary care provider and if they don't there are other areas or other places they can go a lot of federally qualified health centers. some southern Nevada health district is another one and then. Also people who are released from the hospital, you know those are those are covid- 19 cases that that we continue to monitor from a surveillance Mary Hines is asking where people golfing and playing tennis posing a major health risk. If I understand the question is So you know, I think the the challenge is when you have any situation where people are congregated congregating in close contact so you know if someone is playing tennis, they wilder's actively playing you know they may be farther away from each other, but they're handling same some of the same items like the tennis ball and you know they if they're playing tennis together, then they may also be doing other activities together. you know taking breaks between between games and things like that. golf is the same way you know even though it's outdoor. You know there's a higher chance that people are gonna be close to each other. if they're walking together or they're writing a golf cart together, things like that. so so it's not really just about tennis and golf. It's it's really just about you know any activity. people are doing whether it's indoor or outdoors. We wanna maintain that social distancing. Okay and this is gonna be our last one for today from Vanessa Murphy, the latest stats from state show three percent of cases our children under the age of 10 any other info you can provide on about children with Coven. So the numbers of cases across across Clark County and across the state, you know the the total numbers of cases in kids is quite low. This is probably a factor of of who is being tested, so we know from the literature that kids are much less likely to have severe symptoms. So my expectation is that most kids probably have my inner cold symptoms and most part. You have kids are not taking those kids to be diagnosed at a clinic or hospital, which which is a good thing because we know that there are a lot of of more sick people who need to be evaluated at the hospital so we don't wanna overload them. So yeah. so we this is one silver lining with this disease and that we know that that kids are less likely to have a bad outcomes and we're very grateful for that. My expectation is that if you tested. Every single kid who had cold symptoms, we'd probably see a much higher percentage of of over the cases in in kids. Alright, I do see that someone one of our colors and had their hand raised for a little while. so let's take this as our last question, this is called ending in 2962, go ahead. Hi, it's Dana from the Nevada current I was wondering when you answered Apatow the right time will be to Institute widespread antibody testing. and when that time comes do you think the test will be available. We can step up and help. It's it's it's hard to say when when large large scale antibiotic testing will will become available. it's it's really kind of based on demand. right now, we have great great demand across the country for for antibiotic testing but it's still yet determined what what real benefits that that information provides us? it will let people know whether. I've been exposed to coveted at some point, but it really doesn't put a definitive date on on on Wednesday, somebody may have been infectious or maybe been exposed or or if it even you know materialized in signs and symptoms and in individuals so it's more of a curiosity type thing, but you know I I don't know necessarily and I haven't seen how that that testing is actually employed by either are acute care health, health care providers or or private providers from. Matter but imagine that if if if it if it is available and people are utilizing it that it will will dictate dictate itself as to to its benefits and values. I think if if I would pretty much divert that question to our medical providers to see how the test being used and how how it benefits the the the health of the patients that they're caring for and I can. A little bit on that too, you know, I think this is a time where where there are a lot of different scientists and organizations working to try and do their part including this this pandemic I think they're I think there are you know an anti-body test is not one single test. I think there's a lot of them being developed for some of the concerns I have about about some of the test that I've read is that there could potentially be a large crossroad. With other chronic viruses, so if you see that you know you test positive and you think it's because you had covered, but it turns out that it's because you had another chronic virus that causes common cold symptoms. Then you have this like false sense of security that you know that you don't need to take those precautions and so that worries me a little bit Another issue is you know we see that you have antibodies to cover it and just say you know 100 percent. this is for covered. We still don't really have a good sense of whether this provides long-term immunity. so I think some of those things need to be answered before we start doing Mass testing. Thank you all for attending today's event. If you have further questions, please reach out to our office commute of communications. we here at the Health District hope that you have a safe and healthy weekend and please keep you at a safe distance from others. Thank you.