Boston City TV, MA Office of Early Childhood, 30 Nov 2022

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From YouTube: BPHC / Early Childhood RSV Townhall - Nov, 30th 2022

Description

The Office of Early Childhood and Boston Public Health Commission (BPHC) hosted a Town Hall on RSV, COVID-19 and the Flu for Parents and Early Childcare Providers. Dr. Sarimer Sanchez, Medical Director of the Infectious Diseases Bureau at BPHC presented information and answered questions to support efforts to care for the city’s youngest residents.

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Perfect well welcome this evening. My name is Kristen McSwain and I. Am the director of the office of Early Childhood for the city of Boston, we're so glad to have all of you join us tonight for our joint town hall with the Boston Public Health commission um and we're doing this this evening, because many of you have expressed to us that you have concerns moving into the fall and winter um about all the different respiratory illnesses that are um prevalent in our community.

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And so we've asked Dr Sanchez from the Boston Public Health commission to come and walk us through um everything that we should know and also to share the resources of the Boston Public Health commission with us and to answer our questions so without further Ado I'm gonna transition us to Dr, Sanchez um and she's got some slides and we will go through this evening and make sure we answer all of your questions. But thank you for being here.

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Thank you so much to everyone for for being here today, I'm Dr, sari Sanchez I'm, an infectious disease uh doctor um and I work for the Boston Public Health commission, and it is truly um I'm very happy to be here with you all. um If there's anything, there's going to be a lot of information tonight and I'll try to sort of keep it as high level as possible, but I think the real takeaway is that we at the Boston Public Health commission are here to support you.

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um We are here and available we're going to provide our phone numbers for the Infectious Disease Bureau, which is our office that oversees a lot of the guidance on covid-19 on respiratory viruses. But we really are here to support you and our Boston families. And again it really is a delight to be here um we're going to talk I'm, going to really focus on respiratory illnesses that are very common in this season and that you all have already started to call um with questions as Kristen was just highlighting and I.

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Think part of what I'm going to highlight tonight is. There are a lot of common features of the respiratory viruses, including RSV, including flu and including covid-19, and those commonalities inform how we can prevent infection, how we can keep our families safe and how we can keep our daycare facilities uh safe as well. So I'm going to talk a little bit about why in some ways, hi, which I think Kristen was just highlighting, which is that respiratory viruses are a very common. Yes,.

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I think we're still landing on some of the channels.

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I I stopped, as did you hear anything now.

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They're not are they in the channel they're on phones, so you you need to select. Could we three.

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Good, okay, all righty. So the reason why we're all here is that respiratory viruses, like the ones we're going to talk about tonight, are a very common cause of colds and illnesses affecting the upper and lower respiratory tracts, such as the nose, the throat the ears and the lungs.

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And there are many common respiratory viruses currently in our communities, including covet influenza and respiratory, substantial virus or RSV, and we're going to start to see more of them, because viruses can be seasonal and often spread more in certain times of the year, such as now, which is the winter.

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But again what I'm going to highlight is that there are some commonalities here in terms of how they spread, including through the air and respiratory routes and through close contact, and that this can really inform how we protect our families and that there are vaccines and antiviral treatments available, especially for code with 19 and 4 blue, and that these are really important tools to prevent disease spread.

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In the past two years, we've really just been seeing mostly a lot of covid I. Think that's been one of the really different things is that in recent weeks, we've started to see more and more of RSV um and not you know, reported by the CDC and here in Boston we are starting to.

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See around rapidly.

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Rise in the number of flu cases here in the city and we're going to expect to see more of this as families gather over the holidays and as it gets colder, and so today is really important for us to highlight what are the key steps in everyday actions that families I know that there are parents here that eec facil, that daycare and easy facilities can take to keep us all healthy and safe, especially those who are at higher risk of severe disease from these viruses. And so tonight we'll provide an overview of RSV fluent covid.

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Those are the three viruses we're going to focus. What are their symptoms, how they spread, who is at higher risk for severe disease and when to call your pediatrician and then how to prevent diseases and transmission both in the home, as well as in our daycares, and then some information on the Boston Public Health commissions flew in covid-19 vaccines and treatment, clinics that were offering free around the city and some pamphlets and resources that we at the Infectious Disease Bureau have for you.

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So I'm going to start by talking about RSD or respiratory synthesisiovirus, which there's been a lot of information over the past few weeks. Rsv is a virus that can cause cold like symptoms. It causes very much not only just cold sneezing cough but can also cause as one of the most common causes of pneumonia in young children, especially those that are younger than one year of age.

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Symptoms include a runny nose, decreased appetite, coughing, sneezing fever um and wheezing, and most people recover in one or two weeks, but RSV can be serious, especially in young infants and older adults. And again, we've heard a lot about this in the media. I want to highlight for those of you that are parents or who work with families, who are the people who are at higher risk for severe symptoms from RSV, meaning the people who can land in the hospital or need more treatment, and those include young infants.

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So typically people the young infants less than six months old, are the infants that we see get more sick.

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Mature infants.

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Children with birth defects, including chronic heart or lung disease, young children, with compromised immune systems, children with muscular disorders and also older adults, older than age, 65 and adults, with compromised immune systems, there's no antivirals or vaccines yet, but there is a treatment that can help prevent severe RSV infection called palavizumab, and this is for high risk infants and young children, and it's given in monthly injections during the RSV season, so, for example, now um typically starting in the fall and through the season, and so for many of you that work with families.

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um You know that might have children that fit within the categories that I mentioned, they're very young. They have heart or lung disease, including potentially asthma, are oftentimes more congenital, birth defects, neuromuscular disorders or who work with families with you know, um you know, with children who fit these categories, they are would be eligible for these treatments that can prevent serious infection, but there's otherwise no antivirals or vaccines for RSV.

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What about the flu we see flu every year as well? Flu is a contagious respiratory illness caused by influenza, and our flu season typically starts in the fall and winter peaking this between December and February.

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But here in Boston we started to see very high rates of flu in the past few weeks, so flu is definitely circulating in the community, and flu is more dangerous for children than the common cold, especially for children younger than five years of old years old or those younger than two, though children who are young again, children younger than five years are at higher risk for severe outcomes for flu, as well as children, with certain medical conditions, including asthma and diabetes, and so part of why I say this is because it's really important for these children to be up to date with their flu shots.

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The best way to prevent flu is by getting a flu vaccine each year, and it's also really important for families with children who are at high risk or even adults at high risk in the home. We know that viruses spread right in the home for them to know that there's flu treatments as well flu treatments can save lives.

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There's antiviral treatments that people can take, including for pills for adults and children that can help prevent severe disease and death, and so it's really important to know that, there's both vaccines and treatment for flu, in fact, the CDC and the American Academy of Pediatrics do really recommend antiviral drugs and treatments to treat children with who might have severe more complicated or Progressive flu illness.

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This is again a recommendation by our American Association of Pediatrics and in fact, that starting antiviral treatment or flu treatment is really recommended for children who are at high risk, which I mentioned are often children that are younger than five years of age or who have medical conditions like asthma, diabetes or chronic heart or lung disease. So really important information for these families to have I also want to highlight, because again, the home children live with their parents with their grandparents with other individuals in the family.

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It's really important to know who is at a higher risk for flu and, if there's anything that you're gonna hear a lot from me is that some of these viral diseases, a lot of the people who are at high risk, are fairly similar, and that often includes older adults, specifically older adults above age 65 and very young children, children less than five years old or even oftentimes children less than two years older, especially at higher risk, those with asthma, those with lung conditions, heart conditions and those with weakened immune systems. That would be I.

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Think the very big takeaway of individuals at high risk for many viral diseases, including flu covet or RSV I, do want to highlight for you all that we're updating our flu nut case numbers in the boston.gov website. We have a flu information center and, as I mentioned, we're rapidly starting to note a very high number of cases of of flu each week in Boston. Just in the past few weeks, we've seen our case cases per week. Double we had 238 cases in the week.

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Just before Thanksgiving and last week we had over four nearly 400 cases across the city, so we are seeing a very early and and um rapid rise in flu here in Boston and again, there's vaccines and there's treatment for flu, so very important for all of our families to get vaccinated, and what about coven I'm going to provide a covert refresher I think we've all learned a lot about cold weather the past few years, but it also is a respiratory virus that causes respiratory symptoms, including cold flus or pneumonias, and most people have mild symptoms.

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But again we know that especially older adults and people with medical conditions, and this can include children with medical conditions or really young children, or at increased risk for severe illness, meaning needing to be hospitalized needing a breathing tube needing oxygen or death. Now there are vaccines and treatments to um to prevent covid-19, severe diseases and to prevent deaths, and these are really important.

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Part of what I'm going to highlight here is that the the people who are at higher risk for covet again a very similar list from what I just said about RSV and flu, and that includes older adults, adults above the age of 65 and individuals with with cancer with lung disease, asthma, diabetes, heart disease and compromised immune systems.

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These people are at a higher risk of being hospitalized of needing intensive care requiring a ventilator or dying, and so it is really important for not not only that all families be vaccinated, but that especially those families who have children or adults with these medical conditions or an older age that they really be vaccinated. So for covid-19, there's vaccines available for everyone age, six months and older, and we recommend that everyone ages, six months and older, both children and adults, be vaccinated against covet 19.. Everyone five years and older is eligible for a booster.

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Our new bivalent boosters came out in the past few months and everyone who's five years or older and who already received their their first series of covid-19. Shots should go get their booster, especially if it's been two months since any last dose of vaccine. You are eligible for the new boosters and these are really important for us to be able to keep our families healthy and safe for the winter.

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There are also covid-19 treatments and again it's really important for families to know that covid-19 treatments as well as influenza treatments can save lives. These are pills that are available for adults and children, especially those at high risk that I mentioned, and so these are safe, effective and free. You do not need insurance and there is a state hotline. There is a phone number that you can call it's listed there 508-213-1380. This is a self-referral line.

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There's also another number I think that we're gonna we can put in the chat, and there are multiple languages and they're actually clinicians doctors. If you don't have a doctor, you can speak to a doctor in multiple languages and they will help you figure out. If you are eligible for treatment and again, this is safe, effective and free.

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So for all of these viruses, I'm now going to start start talking a little bit about what you can do when you're sick and what you can do to help keep yourself from getting sick, including in daycares and at home. So when, should you call your doctor? That's often a question I get as a doctor. When should I call you when should I call my pediatrician first of all, I would say that doctors are always especially pediatricians for kids.

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We always want to help families ensure that their children are up to date on their routine vaccines and care. That is really important and again, especially as we enter the winter. So really just if you ever need. If you are a parent and you you're not sure whether your child might be eligible for a vaccine to call your pediatrician's office and they can help you figure out and get vaccines and get your child up to date.

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If your child is sick, um you know there are a few most children recover from respiratory virus and illnesses at home and by themselves. But there are a few symptoms that you, as a parent, can watch out for or if you're at a daycare, and you have a child who's sick who hasn't yet been picked up. There are a few symptoms that you really need to be looking out, for that would warrant calling a pediatrician right away or seeking emergency care, and that's often three big buckets dehydration change in Behavior or sleepiness.

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If you notice, a child has changed in that way or difficulty breathing. So, for example, if if a child has fewer than one, what diaper every eight hours, you notice that they're not feeding very well, you notice, difficulty, breathing gray or blue color in the tongue, lips or skin, unusual sleepiness or decreased activity, or just that they're not as alert.

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You know, as you typically notice them or if you notice a fever, and they are younger than three months of age or a fever above 104 degrees, repeatedly for any child, poor sleep and symptoms that worsen or do not start to improve after seven days. You really should be calling your doctor. So that's one big piece, so I just gave a lot of information, but I'm going to summarize some very key points about each of these viruses for you for flu.

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Vaccines are available for everyone in the family older than six months, and everyone should get their flu shot every year. So if you haven't gotten your flu shot, your children haven't gotten your flu shot. Now is the time and food treatments are available for adults and children, particularly those at high risk for covid-19. We also have vaccines and in fact most people are likely due for a booster, especially adults and children older than five years, but anyone ages, six months and older, is eligible for vaccines.

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So we have vaccines and we have treatments as well, especially for adults and children, older than 12 years old, and so it's really important, particularly for fluent covid, that families know um when to you know, to reach out to make sure that they get vaccinated and that they have a treatment plan.

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They might want to know you might want to know if your child is eligible for covid-19 or flu treatments or of anyone else in your home, like your grandparents, your your other older adults or people with medical conditions such as diabetes, chronic lung disease, heart disease or immunocompromise for RSV. We don't have vaccines or treatment yet, but there is something called that prophylaxis that that medication that I mentioned for high risk infants and children that can help them prevent severe disease.

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So now we're going to talk a little bit about some general principles for eecs, about respiratory viruses and a big part again of how we think about disease prevention is knowing how viruses spread. So these viruses flu, RSV and covid-19 they spread through droplets in the air and through close contact the virus. You know, really, you know, spreads through droplets in the air that then land on someone's, ear, nose and mouth, such as when an infected person, coughs or sneezes.

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When you have direct contact, you know close contact with someone who's infected like when you kiss your child kiss the face of someone, that's that has RSV or flu or less likely, but still we see when you touch a surface that has virus in it, but really the most common way is the respiratory droplets, that's really the most common way, but for some viruses like RSV, we know that they can live for many hours on surfaces and so, in addition to sort of covering our nose and mouths and taking measures to prevent respiratory transmission, it's also important to wash our hands and clean surfaces regularly, because these viruses can live.

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If on surfaces, when are you most contagious? You know, when is anyone in the family most contagious people with flu and other respiratory viruses are most contagious in the first three to four days after symptoms begin, and this is going to help explain some of our guidance to aecs, as well as to families. But people who are sick can infect others one to two days before symptoms and up to five to seven days after becoming sick or longer, depending if the person has a weakened immune system.

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But again most people really are contagious in those first three to four days after symptoms and so a big part right.

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Knowing that the virus is spread in the you know, through those respiratory droplets in the air um and through close contact, there are very key everyday actions that we can take families in the home in in our daycares to prevent disease spread, particularly this winter, and that includes covering our nose and mouths, especially while we're indoors, and especially, if you feel sick, a mask have been a key tool for that in the past two years and they're still important tools to prevent spread, because you know the respiratory droplets Mass can keep them from Landing in your nose and mouth, and so that's really big.

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Similarly, there's something called respiratory etiquette. It's been a principle of infectious disease um prevention that we've had for quite some time, which is just cover your nose and mouth. If you cough or sneeze and don't do it with your hands, but do it with your upper shirt sleeve or with a tissue, um because, obviously, if you do it with your hands- and you don't forget to wash them, you can spread the disease to other ones, but really important, covering your nose and mouth and especially your cause and sneezes.

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So you don't get others sick, washing our hands, often during the day with soap and water or with with a hand sanitizer and having you know, access to that in our day cares making sure that we make time for children to wash their hands that we model that behavior that we teach. It is really important.

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Cleaning frequently touched surfaces such as doorknobs phones and toys, and I'll talk a little bit about safe cleaning of toys that are frequently shared, something that I say is an infectious disease doctor. All of the time is avoid touching your face with unwashed hands, keep your hands below your shoulders or, if you have to touch your face, make sure to wash your hands just before doing that, especially if you touch your eyes, nose or mouth and importantly, stay home and away from others.

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If you feel sick and avoid close contact such as kissing shaking hands, sharing or eating utensils with others who are sick. These are Big everyday actions that can really help us keep safe and healthy this winter. Now, what are some more specific guidance for our daycares so for covet? You know I, think not much has changed in the past few months. We know we at the Boston Public Health commission have continued to recommend that children and staff will have tested positive for covid-19 should stay home for at least five days. They should notify.

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You know we ask parents to notify daycare so that they are aware, and if, after five or days more of staying home, and especially if the child or staff member has tested negative, they can come back, but we still really do recommend masking.

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um You know at least until day, 11 or day, 10 or 11 if people are able to mask, especially if a staff member now there is no quarantine uh for covid-19, but we still recommend that children and staff who are exposed to covid-19 should test in the three to five days after that exposure and that's really because if they test they can catch infection and prevent spreading disease to others and day cares um by staying home.

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We also continue to recommend that children and staff were exposed should mass for 10 days if they are able again to keep um to contain spread in our day cares. um Otherwise. For some of the other respiratory viruses, there aren't exactly isolation or any quarantine requirements.

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What we often tell people is that individuals, children staff who are diagnosed or experiencing any cold like a respiratory illness except for covid-19, can return to eec or to the daycare when they have been AFE bra without the use of fever-reducing medicines for 24 hours, and they are feeling well and fully able to participate in daycare activities.

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However, if the daycare or any site is experiencing a cluster, if they're starting to see multiple people with cold like a respiratory illnesses, and that typically is more than three cases in the past week, we tell them that they should consider excluding sick adults and children for up to five days after illness to help contain spread, and this is guidance that we at the commission often give our daycare facilities.

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You know that people, if they are experiencing a cluster or a high number of cases in their in their day, daycares that people should stay home for longer than the 24 hours to help the facility contain spread, um and we have our phone number here at the infection disease Bureau, it is 617-534-5611. We ask daycares to notify us if they have clusters or if they need support around this and other guidance. We really are here for you. We also provide guidance on cleaning and it's a you know: High touch surfaces and shared items and toys.

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You know should be cleaned daily to reduce the risk of spreading germs by touching surfaces, again less likely for the viruses to spread via surfaces, but still a potential, and you know that this cleaning frequency you might want to increase it to twice daily or before and after use, when you have a lot of people with colds in your daycares I, do want to note that toys and other products that children place in their mouths should be cleaned with soap and water only or in a dishwasher.

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You know we should really avoid using any other chemicals on these products, because that can be dangerous, so using soap and water can help us to clean these products um and- and you know um and keep um you know, keep germs from spreading. There are other resources um in in um you know. In in websites, there are national standards called caring for our child, children that go through the differences between cleaning, sanitizing and disinfecting, but really sort of thinking about making sure that surfaces that are in contact with food or with someone's mouths.

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Really you want to sort of think about soap and water and that you really only disinfect. um You know what other surfaces that aren't sort of present that risk of toxicity I want to briefly talk about some free resources that we at the commission are offering specifically around covid-19 and flu.

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um You know we're offering free walk-in, covid-19 flu, vac and and flu vaccines at two sites, currently at the Bruce bowling building, Tuesdays Wednesdays, Thursdays, Fridays and Saturdays from 12 to 8 P.M, no idea insurance is needed and we're offering it to children and adults of all ages and also at the Lena Park Community Center. In Dorchester we have hours of Mondays and Fridays from 9 30 to 5, 30 and Wednesdays ones to seven and Sundays ten to two. So this season we're offering free, walk-in, covid-19 and full vaccine.

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So we really want to get our families vaccinated again to help our daycare stay open and stay safe. We also are happy to partner with you, your daycare to offer free covid-19 and full vaccines at events or even at your sites. Do call us and we're happy to sort of think about how to bring vaccines to you.

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We have many vaccines for this purpose again for covid-19 and flu and for our families, and we also have many rapid covid-19 testing kits that we are happy to make available to you if you start to experience more cases or if you want to distribute them to your families and so again, I think the bottom line is that we really are here to provide you with information and resources.

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It does not stop with tonight's call and I'm going to transition it over to Lucas Manley, one of our senior program managers um at our infectious disease Bureau to talk about some other resources, posters and signage that we do have that we can provide to you as well. Luke are you there.

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I am thanks: Dr Sanchez, um so, as Dr Sanchez mentioned, my name is Luke Manley I'm, the senior program manager for education and Community engagement um in the Infectious Disease Bureau at the Boston Public Health commission. um So, as you can see up on the screen here, this is the first of our resources. We have some posters that communicate a bunch of different things. We have masking 101, which in six different languages, these posters actually all come in six different languages. We may be short on some these.

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These we've had in stock for quite some time, as I said masking 101, which you have six different languages all on the same poster. That's the one to the far right. The far left is kind of like a kid-friendly flu vaccine, poster which we also have in six separate different languages and then in the middle is stop the flu, which we also have in six separate different languages. I believe those are these ones. We have in English Spanish, Haitian, Creole, chinese, vietnamese and Portuguese and the next one.

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So this is part of our um our newly developed healthy at home for the holidays um brochure Extravaganza. We also had some magnets, which you'll see briefly, but these are the brochures um we have these in 12 different languages.

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um The one to the far left is our our Pinnacle healthy at home for the holidays, which gives you a of an overview of kind of everything that Dr Sanchez just talked about of. You know the basics of washing your hands and covering your mouth and nose when you cough or sneeze, but also vaccination and boosters, and so on and so forth.

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The one in the middle is reminding people of people about flu season and also the convergence of flu season with uh covid-19 and that you can get both at the same time, but that we also have vaccines for both that you can get at the same time and just cut some common q and A's around flu and covet 19. and the far right.

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One is on kind of a a slightly denser one, but uh giving all the facts about long, covid um and describing post-coveted symptoms and how to treat it, how to prevent it and how to look for it.

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Luke we have a question in the chat about whether you can print those directly from the website or if you have to order them.

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um The answer is both right now you can order them, but we will very shortly have all of these available um um on the website, so that folks can download the brochures themselves and print them out and fold them themselves, or they can order directly from us and save some carpal tunnel and have us do the folding for them.

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um So these are the magnets, as I mentioned before, so the one on the left is the kind of a distilled version of the healthy at home for the holidays brochure, which just gives you a um a little overview of the basics for how to protect yourself, keeping Gathering, small, getting tested wearing a mask and so on and so forth, and then on the far right is kind of one which snags both covid and flu season, but also just all around information for people and handy to have on the fridge which just um it outlines all of the basics for cooking safely, so making sure to chill your food and clean surfaces separating Meats from vegetables and that sort of thing and cooking to the correct temperature and you'll see there in the very center.

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It gives a a little thermometer, which shows you all the different temperatures that all your food should be cooked too, and this is also um which actually, in the next slide, will see the 12 different languages that we have that one available in as well.

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Phil mentioned the six po, the posters we have in six languages: Chinese English, Haitian, Trail, Portuguese, Spanish and Vietnamese, and the 12 languages for the brochures and magnets. We have Arabic cake, birdie and creole Chinese English French, Haitian, Creole, pastu, Portuguese, Russian, Somali, Spanish and Vietnamese.

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Thank you Luke and.

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That's it for me, thanks Dr Snapchat.

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um So that was a lot of information and I um I'm we're. We want to provide more space for questions. I I do see some in the chat as well, but Kristen. How do you suggest we walk through some of these.

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Well, I see why don't we go ahead and start with some raised hands? Claudette, did you have a question? Do you want to come live.

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Yes, sorry I couldn't get myself unmuted okay, so my question is: uh who do we contact uh to get the brochures and the posters and stuff like that.

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Luke I'm going to turn that one over to you.

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Sure um folks can contact me and Tegan Evans. Our associate Bureau director for infectious disease has kindly put my email in the chat, so it is L as in Louie um M as in Mary and then a and as in Nancy L, E Y at b, p, h, c dot org.

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If you can't see the chat and if you didn't get any of that and need me to give all my letters again, I'm happy to do it. Just let me know.

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Yeah and I also just want to say you know if, if you, you know for any guidance for any additional questions, we at the Infectious Disease Bureau are also available at our phone number, which is 617-534-5611 as well. Okay,.

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Do we have other questions that folks want to have answered.

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Didn't know it's me clauded again, I have one question. It was for the doctor that spoke first. What's the difference between the A and the B virus through virus? That's.

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Good I did see that question in the chat. I was hoping, we'd get to it. So there are different strains of flu. It's the same virus, but just different strains in some ways. It's almost it's a you know similar to sort of the different variants that we see from covid-19 oftentimes we're seeing more of the flu a at this time of the year, and then we typically see some more flu B later, but importantly, there's they're, just different strains of the same virus and our vaccines protect us against both which I think is.

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You know a really important piece more. You know um to keep in mind, but there are just different strains.

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So Beatrice Zapata has her hand up and I think Beatrice. You need translation, yes on Espanol.

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See ah gracias.

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The night forward, that's embarrassing, is.

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The recommendations.

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Okay, so it's recommendation.

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I understand Spanish, but the middle of the trans interpreter um translate just for others sake of the call, so that, because those are very good questions.

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Translate the question, but so that others or I'm happy to um oh I, see wait. Are we good? Okay? Can I keep going.

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So you should be able to. We should be able to hear you now. Oh.

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Okay, okay, so there's no need for I, wasn't sure if we needed to re-translate her question back to English.

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um Yeah so I'm having Tracy.

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You can hear you, but only because I'm in the English Channel hold on in in order to have to be in the English Channel.

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Oh okay, so I'm good to go. Okay, I just wanted to make sure sorry about the delay, um so I'm gonna, I'm gonna answer in English as I believe I should. Although.

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I'm going to answer in English, so the first question um asked you know, are the covet and from what I feel remember are: are the Colwood 19 vaccine sort of safe and- and you know, thinking about how to talk to parents around the safety of covid-19 vaccines, I continued. We very strongly recommend that all children and adults above age, six months and older, get vaccinated and we you know covid-19 and flu are different viruses, and so they each require their own vaccine to offer protection.

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The flu vaccine does not offer protection against covid-19 uh the covid-19 vaccine does. Similarly, the covid-19 vaccine does not protect against flu. It's really the flu vaccine and so I continue to recommend to parents to keep their children and their families safe. We recommend everyone get vaccinated it and boosted I'm happy to to sort of be available to you know if there are opportunities for us at the commission to help you, with these conversations, I'm happy to do that as well.

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We've often hosted town hall with parents so happy to help you think about how to have those conversations. The second question, a very good one is: can you get covid-19 vaccines and a flu vaccine on the same day and do I recommend it I? Do you know we see?

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We see this a lot in in pediatricians offices, children can get many vaccines in the same day, it's very common with many vaccines for children to get more than one vaccine, mostly because we really want to make sure that they get that protection at the time when they need it. The most and these next months, we're going to see more flu and more covid-19, and so I I would recommend it because it really is important for children to be up to date with their care. You know everyone.

C

We often see symptoms after a vaccine such as a you know, oftentimes a fever, some muscle, aches or arm, but those are very common and again we see them with many other routine vaccines that are given in the same day. So, yes, definitely you can get your covid-19 and flu shot in the same day and then you're done.

C

So, generally speaking, I would say that, especially for a child with asthma, we definitely would recommend that they get their flu and covid-19 vaccines. It's really important because they that child is at higher risk of of very bad disease. From from these um viruses, um you know. Obviously these are very hard questions and you know I think.

C

Obviously you know family should always turn to their pediatricians if they have specific medical questions about their children, but, generally speaking, I would say that asthmatic children are at high risk and should definitely get the vaccine, the the disease that they, you know if they got covert or if they got the flu. That would be. um You know more. You know concerning the symptoms that they can get if they get the than the vaccine. Most children again get the vaccines, but otherwise feel well within a couple of days.

F

C

And thank you so much. You know you bring up a very important point. You are all trusted members and Messengers for your families and that's why it's such an honor and a privilege for me to be talking to you today, because I know that you are very important members of your community and I'm so grateful that our families have um trusted Messengers such as yourselves that are here on this call at 7 30 p.m.

C

On an evening, so I just want to applaud you and thank you all, and that is so I I recognize and that's why I I and the commission want to support you, because it is hard work ahead, sometimes for many of us in our communities wanting to do good. So thank you.

B

uh Teresa bed and I'm. Sorry, if I pronounced your name wrong, did you have a question.

A

C

So for flu, when someone is sick with the flu, um what we um say is part of our guidance is that they should stay home at the very least until 24 hours after um any fever. So, for example, people have to stay home at a minimum until it's been one full day or 24 hours, since they last had a fever and that's without using Tylenol, and we know that with flu oftentimes, a lot of people get fever.

C

So many people end up staying home for three to four days, sometimes because they keep having fever, but at the very least, they need to stay home for a full day after they last had fever and they haven't used Tylenol and that they're feeling well. So, yes, that staff member should stay home until then, foreign.

B

Thank you and Marisol you're next, in line with your hand, raised.

E

C

So I hear a lot of I want to highlight um very important piece. It sounds like some of you are asking not just about staying home, but when you would have to shut down or close, you know your daycare facility I. Definitely would say that you know. If you have questions about when to shut down a facility, you should definitely be calling us and we can help you make those decisions, and so again I want to highlight our phone number.

C

um You know 617-534.

C

um Oh, my goodness, sorry I'm, like literally blanking on our phone number of any of our team members, can quickly help me out, because those are decisions that we can make with you. We generally recommend you know closing a facility really if you're, observing multiple cases and you might need time to disinfect or clean or people just need to, or there are too many people that are sick to actually take care of the children in a safe way like if you don't have enough staff members, you know to take care of children.

C

If there's too many people that are sick. Sorry, our phone number is 617-534-5611.

C

My brain is was a little foggy, but always call us because we can give you the guidance on you know when you can possibly remain open. If you feel that it's safe versus when you you know when you feel like you might need to do that. um Obviously you know you should always make decisions around what's Massachusetts, but we're happy to help.

C

Did that answer the question.

C

These are tough decisions, and so often time again, we really do encourage people to call us, um because we can help you take steps if you know to avoid that, unless again, it's what's best for the safety and health of children and staff.

B

Are there any other questions that folks have we have a couple more minutes.

B

Thank you, Marisol other questions.

B

Oh I see a hand, go ahead. I'm I just hit unmute for you, so that you could ask your question.

B

Oh you're, muted, again accidentally.

B

Go ahead, iPhone.

B

F

F

C

Thank you. That's that's all that's! You know again we're very happy to be here again. You can always call us at 617-534-5611 and we're happy to be here um and again. Thank you for sort of everything that you do for our families. I do briefly want to again highlight we have vaccine. We at the Boston Public Health commission have free walk-in clinics for covid-19 and flu vaccines for all ages, no insurance or ideas needed. We have the two sites that I mentioned that the Roxbury and Dorchester, and we also have vaccine vendors.

C

We have providers that work with us and can go to a daycare, can go to an event. So if you have ideas- or if you want um you know to partner with us to give vaccine, um please reach out to us again, you can call us or email um at the email that Luke provided or again call us at 617-534-5611, and we can help figure that out.

C

We really do want to make it easy for our families to get their covid-19 and flu vaccines and we're happy to support you, because we know that that's also important for all of you. As you care for your facilities and Families.

B

Thank you, Dr Sanchez, I, see Tegan has a hand up.

B

You're still on mute, though.

I

Oh there we go it. Wouldn't let me unmute I just wanted to quickly highlight um a phone number for resources and materials. If folks would like to request those, you can call uh Luke directly at 857.

I

-383-8119, you can also email him, but I know that sometimes a phone call is easier so, um and we will be sure and share that with you. So we can send it out to everyone.

B

Perfect, thank you. Paola your hand is up.

J

Thank you, I couldn't admit myself. I will send a follow-up email to everybody. That is here with the phone numbers and the emails and all the information. So you have it on your email. So don't worry about writing down this. If you don't have a piece of paper right now and you can always reach out to me and I can reach out to the the team presenting today.

B

Thank you so much and Beatrice I think that we're going to let you ask the last question this evening.

F

Or favorite is foreign.

C

That's a really good question: I mean a lot of our guidance um that we get um as well. Sort of says that it really is. Fever is the main symptom that um you know. We often say that you know children or adults should stay home for at least 24 hours after the fever.

C

um You know, because we know that many people can often have cough you know can be coughing or sneezing for time after I think what I would say is that, even though fever is the main symptom around staying home, think a big part of it is making sure that the child is able to participate in all activities. And you know whether or not you know if they're sneezing, you know oftentimes if they are sneezing too much or sort of not coughing or you know, I think I think that can be hard, so I do think.

C

But fever is really the the main symptom that we use to kind of gauge formally when people when students um children can come back, but when people when children are sneezing or coughing, that's what's going to be really important to make sure that they have access to tissues that they're covering their costs with either their elbow or with it with it with tissues. And so I do think that that is something.

C

um And if they're able to to wear a mask. I know that some of the children are younger, so not always possible, but at the very least covering their nose, their nose and mouth with tissues um and washing their hands regularly like those should be some of the key features. um If you know when they come back.

C

B

Well, we are right up at 7, 30. I want to thank our partners.

A

B

Boston Health.

G

B

Dr Sanchez, thank you to our interpreters and thank you all for coming I. You know, as Dr Sanchez said, you are spending all day long with our children and our families um and then spending an hour with us and what I know is an incredibly busy um time of year. So we thank you for being here.

B

If you have questions, I hope that Dr Sanchez has made clear just how welcome those questions are please contact them um and if, for some reason you forget, you always know where to find um Paola and me, and we can get you connected so um have a great evening. Thank you again. So very much and we'll talk to you soon. Bye.

C

Have a good night, everyone.

A