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From YouTube: Committee on Public Health and Human Services 11-19-2020
Description
The Committee on Public Health and Human Services of the Council of the City of Philadelphia held a Public Hearing on Thursday, November 19, 2020, at 1:00 PM to hear testimony on the following items:
200403 Resolution authorizing the Committee on Public Health and Human Services to continue to hold hearings to assess the City of Philadelphia’s efforts, as coordinated by the Managing Director’s Office and human services departments, to prevent and treat abuse, addiction, and disease related to the use of opioids; and to assess the City’s response to the 2020 Restorative Investment Plan for Kensington Residents.
200520 Resolution authorizing the Committee on Health and Human Services to hold hearings to evaluate the City of Philadelphia’s plan for distributing, tracking, and otherwise managing the roll out of the COVID 19 vaccine.
A
B
Good
afternoon,
I
understand
that
state
law
currently
requires
that
the
following
announcement
be
made
at
the
beginning
of
every
remote
public
hearing
as
follows.
Due
to
the
current
public
health
emergency
city,
council
committees
are
currently
meeting
remotely,
we
are
using
microsoft
teams
to
make
these
remote
hearings
possible
instructions
for
how
the
public
may
view
and
offer
public
testimony
at
public
hearings
of
council
committees
are
included
in
the
public
hearing,
notices
that
are
published
in
the
daily
news,
inquirer
and
legal
intelligence
here
prior
to
the
hearings
and
can
also
be
found
on
phl
council
dot
com.
B
D
B
And
a
quorum
of
the
committee
is
present
and
this
hearing
is
now
called
to
order.
This
is
the
public
hearing
of
the
committee
on
public
health
and
human
services
regarding
resolution
number
two:
zero:
zero.
Five:
two
zero
resolution
number
two:
zero
zero.
Four
zero
three
is
being
held
at
the
request
of
the
sponsor
and
will
not
be
heard
today.
B
And
can
I
ask
that
that
if
you
are
not
speaking,
please
mute
your
phone?
Thank
you
before
we
begin
to
hear
testimony
from
the
witnesses
we
have
for
today.
Everyone
who
has
been
invited
to
the
meeting
to
testify
should
be
aware
that
this
public
hearing
is
being
recorded,
because
the
hearing
is
public.
Participants
and
viewers
have
no
reasonable
expectation
of
privacy.
By
continuing
to
be
in
the
meeting,
you
are
consistent
into
being
recorded
additionally
prior
to
recognizing
members
for
the
questions
of
congress
they
have
for
the
witnesses.
B
B
C
C
Thank
you,
madam
chair,
and
I
appreciate
this
opportunity
and
thank
you
for
being
a
co-introducer
of
this
resolution
for
this
extremely
important
conversation
that
we're
about
to
have
here
today.
So
I
want
to
thank
everybody
for
joining
us
here
today
to
discuss
the
covet
19
pandemic
and
the
covet
19
vaccine.
C
We
are
joined
by
doctors,
policy
makers,
infectious
disease
specialists
and
other
leaders
in
the
fight
against
covet
19
in
philadelphia.
We
are
here
today
with
the
hope
of
understanding
at
minimum
the
following
one:
what
is
the
process
timeline
and
associated
with
the
development
of
distribution
of
covet
19
of
the
covet
19
vaccine?
C
So
what
is
the
process
by
which
the
vaccine
should
be
distributed
and
administered
in
philadelphia,
including
timelines
cost
barriers
to
effective
distribution
and
the
infrastructure?
Three?
How
to
effectively
educate
the
philadelphia
public
about
the
safety
and
efficiency
of
the
vaccine
administered,
especially
in
communities
that
have
a
historically
based
mistrust
of
the
health
system,
for
the
role
that
city
government
plays
in
ensuring
that
philadelphia
gets
vaccinated
and
how
we
should
measure
the
success
of
programs
aimed
at
vaccinating
the
philadelphia
public
in
the
interest
of
time?
C
I'm
going
to
limit
my
comments
at
this
particular
moment,
except
to
say
that
covet
19
pandemic
has
not
only
resulted
in
a
dramatic
loss
of
life
and
well-being.
It
has
seriously
damaged
the
philadelphia
economy.
It
is
going
to
take
time,
effort
and
commitment
to
rebuild,
but
the
process
can't
begin
until
philadelphians
are
vaccinated.
B
B
So
we
want
to
change
that
dynamic.
This
is
a
great
opportunity
to
do
so,
and
so,
if
we're
able
to
flush
out
the
ways
in
which
we
operate
and
the
ways
in
which
we
communicate,
I
think
that
we
can
all
be
very,
very
successful
and
have
successful
outcomes
for
all
of
our
communities.
So
I
want
to
thank
the
councilman
for
his
poor
thought
and
vision
on
this,
and
that
being
said,
why
don't
we
hear
from
our
first
testifier
doctor
if
you
could
again
state
your
name
for
the
record
and
then
proceed
with
your
testimony?.
H
H
However,
social
distancing
measures
that
require
business
closures
and
restrictions
on
gatherings
have
also
resulted
in
social
and
economic
strains
and
hardships
for
the
city
and
for
individuals
immunization,
with
a
safe
and
effective
covet.
19
vaccine
is
a
critical
component
to
the
national
strategy
to
control
this
pandemic
and
may
be
the
single
most
important
component
of
the
strategy.
H
In
addition,
phase
3
clinical
trials
to
determine
safety
and
efficacy
of
several
of
the
most
promising
vaccines
are
very
near
to
completion
and
their
results
should
be
available
soon
and
by
soon
I
mean
within
the
next
few
weeks.
Large-Scale
manufacturing
of
the
covet.
19
vaccines
is
being
done
simultaneously
with
these
clinical
trials,
which
will
allow
for
rapid
release
of
the
vaccine
once
it
receives
the
authorization
from
the
u.s
food
and
drug
administration.
H
This
is
expected
to
include
restrictions
on
the
persons
who
are
eligible
to
receive
the
earliest
doses
of
vaccine
arriving
in
this
city.
Since
1994,
the
health
department's
immunization
program
has
served
as
one
of
64
programs
funded
by
the
cdc
to
control
vaccine
preventable
diseases
and
increase
immunization
coverage
across
our
city.
The
program
is
federally
funded
to
oversee
the
government,
purchase
and
local
distribution
to
vaccines,
to
70
percent
of
children
in
the
city
and
to
many
vulnerable
adults.
I
point
this
out
because
it
indicates
that
we
already
have
experience
in
managing
large-scale
immunization
programs.
H
H
The
local
plan
was
developed
by
the
health
department,
guided
by
recommendations
from
the
kovic
19
vaccine
advisory
committee.
The
vaccine
advisory
committee
is
comprised
of
local
stakeholders
representing
health
care,
vulnerable
populations,
faith-based
organizations,
the
business
sector,
insurers
and
others
in
the
city
affected
by
the
pandemic.
H
The
covet
19
vaccine
distribution
plan
in
philadelphia
covers
a
variety
of
topics,
including
defining
critical
populations,
recruiting
and
training
providers
on
vaccine
use,
storage
and
handling
models
of
vaccine
distribution,
data
collection
and
reporting,
public
information
and
monitoring
covet
19
vaccinations
for
safety
and
uptake.
Given
that
vaccine
availability
is
likely
to
be
limited,
initially,
philadelphia
is
planning
for
a
phased
approach
to
covet
19
vaccinations
in
phase
1
vaccine
administration
will
concentrate
on
populations
at
high
risk
of
acquiring
infection,
transmitting
infection
to
vulnerable
populations
or
suffering
severe
consequences
of
infection.
H
This
phase
will
likely
include
health
care
workers
with
direct
patient
contact,
critical
workforce
and
persons
with
defined
underlying
medical
conditions,
as
the
supply
of
vaccine
increases.
In
phase
two,
the
health
department
will
prioritize
vaccinating
those
persons
who
were
not
reached
in
the
first
phase
and
were
still
needed
to
be
vaccinated,
as
well
as
it
will
expand
to
include
moderate
risk,
essential
workers
and
additional
persons
who
might
experience
complications
of
infection
in
phase
3
covet.
19
vaccine
supply
will
be
sufficient
for
the
entire
population.
H
H
There
is
much
we
don't
know
about
coven
19
vaccine.
We
don't
know
if
the
fda
will
find
the
vaccine
or
several
of
the
vaccines
to
be
safe
and
effective,
and
therefore
issue
an
emergency
use
authorization.
We
don't
know
which
populations
the
fda
will
authorize
as
eligible
to
receive
the
earliest
doses
of
vaccine.
H
H
H
B
C
C
I
B
I
I
We
have
been
working
on
our
covid19
vaccine,
beginning
in
january
of
this
year,
when
the
genetic
sequence
of
coronavirus
was
released
out
of
china.
We
are
leveraging
an
adenovirus
based
platform
that
we
have
used
to
develop
other
vaccines,
the
first
of
which
was
approved
in
europe
this
summer.
That
platform
has
been
used
to
develop
an
hiv
vaccine,
an
ebola
vaccine
and
an
rsv
vaccine,
and
has
been
used
in
now
over
110
000
individuals,
but
specifically
for
the
covid
vaccine.
I
I
Based
on
this
data,
we
move
forward
into
a
phase
one
two,
a
clinical
trial
that
has
enrolled
over
a
thousand
individuals,
the
safety
and
immunogenicity
of
which
convinced
us
and
the
fda
that
we
could
move
forward
into
a
phase
three
clinical
trial.
We're
now
in
phase
three
clinical
trials,
they're
called
ensemble
one
and
ensemble
2..
The
ensemble
1
trial
is
important
because
it's
a
single
dose
vaccination
series,
which
is
different
from
some
of
the
vaccines
that
will
become
available.
I
I
During
this
period
of
uncertainty,
we've
made
our
full
phase
three
clinical
trial
protocol
available
online,
and
we
are
committed
to
publish
the
results
of
our
trials
in
peer-reviewed
journals
and
in
the
case
of
the
phase
1
2a
trial
that
I
referred
to.
We've
made
that
available
on
med
archive
online
before
it's
available
in
print.
I
We
also
understand
the
importance
of
including
a
diverse
population
in
our
clinical
trials
and
are
committed
to
enrolling
a
us,
a
population
in
our
trial.
That's
consistent
with
the
us
demographics,
specifically
focusing
on
enrolling
african-american,
hispanic
and
native
american
individuals
in
our
clinical
trial
and,
finally,
we're
committed
to
safety.
I
We
understand
that
if
the
general
population
does
not
believe
in
the
safety
of
the
vaccines,
they
will
not
agree
to
take
it,
and
so
we
have
signed
a
vaccine
manufacturer's
pledge
stating
that
we
will
not
put
forward
the
vaccine
for
approval
by
the
fda
until
we
feel
confident
that
we
have
achieved
safety
and
efficacy
signal.
In
our
phase
three
trials,
the
ensemble
one
clinical
trial
will
enroll
up
to
60
000
individuals
and
the
ensemble
ii
clinical
trial
will
enroll
up
to
30
000
individuals.
I
So
these
are
very
large
phase,
three
clinical
trials
and
then
finally,
I
would
I
would
end
where
carolyn
johnson
mentioned
as
well.
We
have
scaled
up
our
manufacturing
capability.
In
parallel
with
conducting
the
clinical
trials,
we've
signed
a
manufacturing
agreement
with
the
u.s
government
to
supply
100
million
doses
of
the
vaccine
in
2021,
we're
partnering
with
operation
warp
speed.
So
the
distribution
of
the
vaccine
would
flow
through
the
federal
government
during
the
pandemic
period
and
we've
agreed
to
the
a
not-for-profit
price
for
our
vaccine
as
well
during
the
pandemic
period.
B
Well,
thank
you
very
much
for
your
testimony.
I
just
have
one
quick
question
and
that
is
when
you
stated
that
there
were
you're
planning
to
have
over
or
approximately
100
million
doses
here
in
the
united
states.
Can
you
talk
about
your
worldwide
vision
because,
as
we
know
this
the
this
pandemic,
it
travels,
it
spreads
it's,
you
know
it's
moving
around,
and
so
what
does
it
look
like
in
terms
of
distribution
beyond
our
borders?.
I
Yes,
absolutely
if
there's
a
coronavirus
anywhere
in
the
world,
it
can
get
it
can
get
everywhere
in
the
world
very
quickly.
I
completely
agree
so
we've
scaled
up
our
manufacturing,
not
just
in
the
u.s
but
in
europe
and
in
and
in
asia
as
well-
and
we
are
in
discussions
with
similar
advanced
purchase
agreements
that
we
have
for
the
u.s
government
to
in
2021
supply
hundreds
of
millions
of
doses
around
the
world.
C
Thank
you,
madam
chair
and
and
doctor.
I
I
want
to
thank
you
for
taking
your
time
out
today.
J
was
the
only
pharmaceutical
company
that
was
able
to
join
us.
So
we
appreciate
your
presence
and
your
your
expert
expertise,
and
I
think
you
know
my
two
questions
you
may
have
answered
in
your
in
your
opening
statement.
You
know
reiter
reiterating
the
reasons
why
people
should
not
be
afraid
to
take
the
vaccine
when
it
is
available.
C
C
You
know
taken
that
public
opinion
and
you
know
you're
talking
about
that
and
making
sure
and
to
ensure
you
know
that
the
public
can
be
confident
all
right
of
all
the
hard
work
that
has
been
done.
So
I
I
want
to
thank
you
for
your
time
and
I
want
to
thank
you
for
answering
those
questions.
Thank
you,
madam
chair.
B
B
I
do
believe
that
this
is
so
important
that
there
are
other
pharmaceutical
giants
who
could
have
certainly
made
themselves
available,
so
I
certainly
want
to
spend
a
special
thank
you
to
johnson
and
johnson
for
making
sure
that
that
you
had
someone
here
at
the
table
here
in
philadelphia
where
covet
has
just
been
exploding,
as
we
know
as
it
is
around
the
nation,
but
really
it's
been
exploding,
particularly
in
the
african-american
community.
So
I
really
wanted
to
say
a
great
big.
B
Thank
you,
because
I
do
believe
that,
as
your
time
is
valuable,
you
prioritize
it
made
time
to
come
and
talk
to
us,
and
I
think
that
that
just
goes
a
long
way
in
terms
of
making
people
feel
comfortable
and
making
people
feel
that
you
know
this
is
someone
that
we
can
connect
to
that.
Will
that
understands
our
concerns
that
here's?
What
some
of
the
things
are
that
we
are
worried
about
and
is
a
voice
that
that
we
can
connect
with.
B
B
B
Okay,
one
moment:
okay
and
we're
gonna
rearrange
some
things
here
as
well.
Dr
nettles,
you
can
be
dismiss
at
this
point.
We
have
three
testifiers
from
jefferson
university
that
have
to
leave
by
2
p.m.
So
we're
going
to
include
them
to
sort
of
rearrange
the
schedule
and
add
them
to
this
panel
as
well.
So
sabrina,
can
you
call
their
names
and
have
them
start
their
testimony
for
the
record.
D
Dr
bon
ku,
the
marta
and
robert
edelson
professor
of
medicine
and
design
director
health
design,
lab
professor
of
emergency
medicine,
thomas
jefferson
university,
dr
rose
ritz,
executive,
vp
and
chief
innovation
officer
at
jefferson,
health
and
thomas
jefferson,
university
and
dr
john
zurlo,
the
w
paul
and
ida
haven's
professorship
of
infectious
diseases.
Director
division
of
infectious
diseases,
chair
jefferson,
enterprise,
clovid,
19
task
force
at
thomas
and
jefferson
university.
J
All
right
good
afternoon,
I'm
bonk
from
jefferson
health,
I'm
an
emergency
medicine,
physician
I've
been
working
throughout
this
pandemic
in
the
emergency
room
and
I'm
on
the
operation
team
for
jefferson
working
with
the
city
on
covid
mobile
testing
sites.
I
worked
last
night
in
the
emergency
room,
so
apologies.
If
I
sound
a
little
bit
sleepy,
you
know
working
last
night,
I'm
concerned
about
where
we're
heading
this
winter.
J
There
is
a
a
high
risk
for
transmission
of
the
source
cov2
virus.
And
what
also
concerns
me
is
that
I
see
a
lot
of
patients,
not
taking
the
flu
vaccine
seriously,
that
a
lot
of
them
are
not
getting
the
vaccine.
So
I
think
we
need
to
be
very
concerned
about
the
messaging
for
this
new
vaccine
that
is
being
rolled
out
and
just
a
few
lessons
learned
from
implementing
and
launching
two
covid
community
testing
sites,
one
in
the
southwest
and
one
in
the
northwest
is
that
it
is
critical
to
work
with
community
partners.
J
J
B
There
thank
you
very
much
doctor
if
we
could
have
the
next
panelist
to
state
your
name
for
the
record
and
begin
your
testimony,
and
I
did
notice
that
a
number
of
you,
dr
stanford
and
some
other,
have
to
be
out
and
have
some
time
constraints
so
we'll
make
sure
we
get
to
you
as
quickly
as
possible
and
before
you
have
to
depart
so
we'll
get
you
as
quickly
as
possible.
Thank
you.
K
Hi,
my
name
is
rose
ritz.
I
am
the
head
of
innovation,
chief
innovation
officer
here
at
jefferson.
My
comments
really
are
based
on
two
things:
one
my
time
in
the
defense
department
and
can
buy
a
warfare
defense,
it's
funny,
it's
the
opposite
side
of
this
problem,
but
there's
still
a
lot
of
moving
around
of
materials
that
you
need
in
order
to
either
to
do
diagnostics
or
to
do
therapeutics
with
very
similar
cold
chain
management
challenges.
K
That
is
soon
to
enter
human
trials,
and
one
of
its
key
points
is
it's:
it's
low
cost
and
easy
logistics,
but
for
today
what
I
I
just
want
to
emphasize
a
few
points
that
ms
johnson
did
already
allude
to
at
a
high
level.
Of
course,
we've
all
heard
about
the
the
importance
of
maintaining
the
vaccine
quality
through
the
supply
chain
and
ensuring
that
there
are
no
breaks
in
the
cold
chain.
K
And
although
we
did
hear
from
from
johnson
johnson
that
they
have
one
vaccine
candidate,
that
might
be
a
single
dose.
Their
second
ensemble
is
a
is
requires
two
doses
and
most
of
the
vaccines
out.
There
require
that
two
doses
be
given
in
a
very
specific
timing,
sequence,
and
so
an
important
question
that
to
ask
which
differs
from
the
different
vaccine
candidates
is,
if
somebody
only
gets
one
dose,
is
it
that
they
are
only
minimally
protected,
not
fully
protected
or
that
they're
not
protected
at
all
and
for
the
different
candidates
for
some
of
them.
K
K
I
will
say
like
dr
ku,
who
are
doing
shifts
in
the
er
and
putting
themselves
on
the
line
we
have
to
be
able
to
give
it
to
them.
But
when
we
get
into
the
community,
we
have
to
know
that
the
person
is
going
to
come
back
for
the
second
dose.
That's
really
important
and
leasing
vehicles
in
cold
storage
and
making
sure
that
all
of
that
stuff
is
ready
for
the
vaccine
to
be
get
gotten
to
where
it
needs
to
be
in
a
viable
way.
K
Is
such
a
huge
part
of
what
we
need
to
do
and
for
all
of
these
things,
our
health
systems
need
staff,
and
we
need
to
be
able
to
keep
pace
with
all
the
evolving
best
practices
and
make
sure
that
that
the
vaccine
doses
we're
giving
are
viable,
that
we
understand
the
priorities
that
we
need
to
give
them
and
that
we're
managing
all
the
information
at
the
back
end
to
know
how
well
this
works
so
glad
to
take
questions.
But
those
are
the
comments
I
wanted
to
offer.
B
Thank
you
so
much
for
your
commentary,
and
I
think
that
that
we
should
really
underscore
your
point
that
the
the
two
doses
is
a
requirement.
It's
not
an
option,
it's
a
requirement
and
that
that's
something
that
we
really
need
to
pay
a
lot
of
attention
to
to
make
sure
that
you
know
that
this
happens
as
quickly
as
possible
and
that
people
understand
that
two
doses
are
absolutely
required
for
the
maximum
protection
from
covet.
So
thank
you
very
much
for
your
testimony.
A
Can
you
hear
me
good?
This
is
dr
john.
I'm,
the
the
director
of
infectious
diseases
here
at
thomas
jefferson
and
I've
been
the
chair
of
the
covid
enterprise
task
force
here
at
jefferson.
So
a
couple
of
my
comments.
Let
me
start
off
briefly
by
mentioning
a
little
bit
about
where
we
are
in
our
own
institution
with
the
pandemic.
A
We
were
down
to
62
patients
across
our
enterprise,
with
only
12
in
the
intensive
care
unit,
and
now,
since
sometime
in
october,
late
no
september
and
october
we've
increased
and
now
just
for
for
idea
we're
up
to
332
patients
in
census
in
our
across
our
enterprise,
with
51
in
the
intensive
care
unit,
so
not
surprisingly,
we're
seeing
an
increase
in
our
census.
On
the
positive
side,
however,
we've
watched
if
we
compare
march
through
octo
from
october,
our
mortality
overall
for
hospitalized
patients
in
march
was
21
in
october,
though
it's
early
still,
we
still
have
mate.
A
A
All
of
those
are
good
trends.
The
challenge
we
face
is
that
once
patients
are
on
ventilators,
they
tend
to
stay
on
ventilators.
That
number
hasn't
changed
for
a
long
time,
so,
on
the
positive
side,
we're
seeing
positive
trends
in
terms
of
the
hospitalized
patients,
but
on
the
negative
side,
of
course,
we're
seeing
a
continued
rise
and
we
have
not
peaked
yet
in
terms
of
our
census.
A
I
don't
know
if
that's
working,
I
wanted
to
compare
the
the
the
various
vaccines
that
are
available,
the
two
vaccines
that
are
available
in
terms
of
efficacy
in
terms
of
adverse
reactions
and
so
forth.
I
don't
know
if
this
can.
Can
you
see
my
screen?
It
should
say
the
comparison
of
moderna
and
pfizer
vaccines.
A
Okay,
I
don't
know
okay,
yes,
we
can
okay,
very
good,
so
you
see
that
they're,
both
mrna
vaccines,
as
we've
heard.
If
you
look
at
the
endpoints
reached,
there
were
95
cases
in
the
moderna
vaccine,
90
in
the
placebo
5
in
the
vaccine,
170
cases
in
pfizer
162
in
the
placebo,
eight
in
the
vaccine,
and
they
both
have
equivalent
95
or
so
efficacy.
A
If
we
look
at
efficacy
in
older
patients,
we
see
that
there
were
15
cases
in
adults
above
the
age
of
65,
though
they
they
did
not
report
fxc
data
for
this
group.
The
pfizer
reported
a
94
efficacy
in
patients
over
65,
which
was
virtually
the
same
of
course
other
efficacy.
If
you
look
at
the
numbers
of
severe
cases
all
in
the
in
the
modern
they
all
occurred
in
the
placebo
group,
there
were
20
cases
in
diverse
communities,
but
they
didn't
describe
whether
they
were
in
vaccine
or
placebo.
A
As
for
severe
cases
in
pfizer,
there
were
ten
nine
in
the
placebo
and
one
in
the
vaccine
for
adverse
reactions
exceeding
two
percent
of
grade
three.
There
were
only
small
numbers
in
both
and
all
of
them,
things
like
fatigue
and
arthralgias
and
headaches
and
injection
site
pain
that
were
all
very
acceptable.
Quite
frankly,
and
in
the
pfizer
group,
they
noted
that
older
adults
tended
to
report
fewer
and
less
serious
adverse
reactions.
A
So
the
last
comments
that
I'll
make
would
will
be
just
what
we
are
doing
at
jefferson
to
prepare
for
vaccination.
I
I
had
a
group
that
includes
individuals,
a
a
diverse
group
of
individuals
from
around
our
entire
enterprise,
that's
preparing
for
the
receipt
of
vaccination
just
because
we
can
handle
the
ultra
cold.
A
Prioritization
really
involves
a
very
diverse
group
of
people
trying
to
identify
the
individuals
in
phase
1a,
who
are
at
greatest
greatest
risk
for
exposure
to
covid.
Hence
it'll
be
individuals
all
individuals,
not
just
doctors
and
nurses,
but
everyone
who,
who
works
in
intensive
care
units
in
emergency
departments
and
so
forth,
and
so
on
and
and
so
we're
working
through
trying
to
create
tears
of
individuals
who
will
receive
vaccine
in
various
orders
and
then
ultimately
trying
to
put
names
and
numbers
to
those
tiers.
A
We
obviously
need
to
overstate
or
over
invite,
ultimately,
the
number
of
people
who
will
be
in
that
early
phase,
because
we
really
don't
know
what
the
uptake
will
be.
Will
60
of
people
agree
to
be
vaccinated?
Will
90
of
people
agree
to
be
vaccinated
among
our
employees?
The
answer
is,
we
don't
know
on
the
positive
side,
we
have
two
excellent
vaccines
in
terms
of
both
efficacy
and
adverse
reactions.
A
Program
of
information
so
that
we
can
really
get
all
the
information
out
as
best
we
can.
I
think
the
last
piece
that
I
think
is
going
to
be
very
challenging,
as
has
been
mentioned,
is
the
logistics
of
vaccinations.
How
will
we
do
this?
How
can
we
maintain
the
cold
storage
and
and
guarantee
that
that's
the
case?
Obviously
we
don't
want
to
waste
a
single
dose
of
vaccine,
so
we're
going
to
have
to
knowing
the
the
amounts
of
vaccine
in
the
units
that
are
given
to
us.
A
We
need
to
over
subscribe,
so
we
can
make
sure
that
we
don't
waste
any
of
it.
We
don't
want
to
reach
the
five
day
point,
which
is
the
time
which
the
vaccine
can
be
refrigerated
at
least
pfizer
and
have
vaccine
left
over,
because
people
haven't
shown
up.
So
I
don't
want
to
understate
the
the
challenges
of
of
doing
this
kind
of
thing,
so
that
is
that's
kind
of
my
update
and
and
testimony,
and
I'm
I'm
happy
to
take
questions.
Please.
B
G
Yes,
thank
you
so
much
madam
chair,
and
thank
you
to
you
and
the
council
sponsor
for
this
really
important
hearing
and
we're
lucky
to
have
so
many
illustrious
guests
on
here.
A
couple
of
questions
that
I
had
related
back
to
dr
ku.
I
think
dr
banku
from
jefferson,
if
he's
still
with
us
and
dr
stanford,
you
know
one
of
the
issues
that
I
think
we're
dealing
with
is
that
there
and
I
think
councilman,
heenan
and
others
have
spoken
to
it
before
that.
G
There's
a
lot
of
misinformation,
so
getting
advanced
notice
ahead
of
time
about
the
kinds
of
misinformation.
How
it
spreads
would
be
helpful
so
that
we
can
counter
it.
My
second
question
is,
I
think-
and
I
think
dr
bong,
who
said
it
earlier
and
we've
talked
about
it
before
and
dr
zerlo.
I
think
you've
made
it
very
clear.
We
don't
need
to
wait
until
the
vaccine
is
you
know
underway
or
whatever
a
marshaling
of
this
effort
in
a
city
of
our
size.
G
Where
I
think
is
I
I
read
somewhere
that
the
covid
positivity
rate
was
in
the
double
digits
in
our
city.
I'm
not
entirely
sure
if
that's
accurate,
but
you
know,
new
york
city
is
at
what
three
percent,
so
you
know
we
we
will
need
to
do
a
majority
of
the
city,
an
all-out
marshalling
effort,
on
a
scale
of
you
know,
a
massive
deployment
is
going
to
go
beyond
the
doctors,
it's
going
to
go
beyond
hospitals
and
those
who
have
medical
care
or
those
who
believe
in
medical
care
and
treatment.
G
So
you
know,
I
think,
now
kind
of
staking
out
and
as
you're
doing
very
clearly,
I
think
with
all
of
us
making
clear
that
we
would
be
foolish
to
be
waiting
right
now.
We
know
a
massive
deployment
is
going
to
happen.
It
literally
probably
needs
to
go
block
by
block
and
in
certain
neighborhoods,
as
I
think
dr
sanford
and
dr
q.
You've
you've
made
such
a
compelling
case
for
in
our
black
and
brown
neighborhoods
and
immigrant
neighborhoods
in
particular.
We
will
have
to
go
block
by
them,
and
so
there
will
be.
G
You
know
we
are
going
to
have
to
figure
out
how
to
plan
that
out,
because
that
will
take
a
long
time
and
it
is
absolutely
not
reliant
on
the
timing
of
of
the
vaccine
because
the
vaccine
is
coming.
So
I
think
you
know
the
the
main
questions
that
I
have
are
those
areas
you
know.
Do
we
feel
like
from
your
perspective,
you
have
identified
the
key
areas
that
you
would
start
on
a
map
in
terms
of
vaccine
vaccinations
that
would
go.
You
would
do
you
know
your
ex
areas.
G
First,
are
they
based
on
anything
in
particular
and
are
have
they
been
clearly
shared
with
the
rest
of
the
city
and
are?
Is
the
city
in
agreement
with
you
so
that'd
be
one
and
then
two,
like
you
hear
a
lot
about
like
why
people
don't
trust
medical
treatment,
why
the
current
virus
isn't
real?
Why
I'm
not
gonna
get
my
flu
shot,
and
so
you
know
as
you're
listening
to
these,
it
actually
doesn't
hurt
for
you
to
kind
of
unpack.
You
know
like
share
them
with
us
where
people
hear
them
from.
G
Is
it
just
rumors?
Is
it
internet,
like
you
know?
How
are
we
dealing
with
it?
And
I
think,
as
you
said,
a
counter
strategy
that
is
purposeful
and
widespread
on
behalf
of
the
city
is
going
to
be
key
for
us
to
make
it
through.
Nothing
would
be
worse
than
having
a
vaccine
available
and
having
one
of
america's
largest
cities
either
not
wanted
or
not
be
able
to
access
it,
but
we
have
plenty
of
history.
G
J
I'll
respond
quickly,
100
in
agreement.
This
needs
to
be
a
citizen,
driven
effort
that
we
partner
with
the
leadership
of
the
city
government.
This
is
going.
This
is
the
largest
human
vaccination
effort
in
history
that
that
the
country
is
going
to
undertake,
and
I
get
inspiration
from
the
get
out
the
vote
campaign
that
we
did.
That
was
a
grassroots
movement
that
impacted
every
neighborhood
and
I
think
that's
a
mindset
that
we
need
to
have.
It
can't
be
led
by
the
hospitals
they
can't.
J
It
needs
to
be
this
grassroots
effort
and
working
with
community
partners
already
have
the
trust
of
a
residents
who
may
have
some
vaccine
hesitancy.
So
I
think
I
look
at
this
that
this
is
a
grassroots
effort
led
by
the
city,
but
in
similar
ways
to
how
we
came
together
as
a
city
and
and
voted
in
huge
numbers.
A
My
the
only
comments
I'll
add
are
that
we
appreciate
that
that
is
it's
daunting
enough.
Just
to
get
to
our
employees,
I
mean
on
the
positive
side,
we
do
flu
campaigns
every
year
with
our
employees
and
we
have
a
pretty
good
take
on
the
on
the
downside.
You
know
there
is.
There
are
challenges
with
the
vaccine,
handling
and
cold
storage
that
at
least
make
one
vaccine
a
little
bit
more
challenging
than
perhaps
the
others.
A
So
our
group
and
I'm
sure
other
groups
are
working
for
our
own
patient
population,
but
we
obviously
need
a
coordinated
city
response
to
involve
the
the
the
health
department,
along
with
with
the
into
the
health
care
institutions
throughout
the
state.
If
I
could
just
put
in
a
plug
to
the
health
department,
they've
been
great
to
work
with
the
philadelphia
department
of
public
health
has
been
great
to
work
with.
B
Thank
you,
councilwoman,
believe
it
or
not.
It's
already
in
the
in
the
work
it's
been
announced
just
yet,
but
the
efforts
to
make
sure
that
there
is
education
and
a
plan
of
distribution
and
outreach
into
all
of
our
communities
is
something
that
we
tend
to
do
as
we
did
around
like
get
getting
out
the
boat
and
masking
up
and
all
those
kinds
of
efforts
stuff.
But
thank
you
so
much
for
being.
On
top
of
that,
we
really
appreciate
your
ideas.
B
B
I
think
that
it
wouldn't
be
a
problematic
to
reconvene
this
panel.
You
know
if
we
need
to
come
back
together
again
and
that
we
could
do
so
within
the
next
few
weeks.
Before
the
end
of
this
legislation
legislative
session,
I
would
certainly
be
open
to
reconvening
and
having
additional
conversation
well.
C
I
think
that's
probably
an
appropriate
action
to
you
know,
have
this
resolution,
be
it
to
call
recess
at
the
call
of
the
chair.
So
thank
you
for
for
that
offer.
If,
if
I
can't
so,
I
can
let
the
you
know
the
three
panelists
move
on
with
the
day.
I
get
three
questions,
one
for
each
one
of
them.
Let
me
start
off
with
with
with
dr
banku
one.
C
I
want
to
thank
you
for
working
nights
at
the
er,
and
I
want
to
thank
you
for
being
awake
that
in
itself,
and
I
certainly
appreciate
the
vintage
boombox
that
you
have
in
in
your
background,
but
based
on
your
experience,
treating
patients
with
cova
in
the
er
and
assisting
with
the
operations
for
two
community
covet
testing
sites.
What
should
the
city
government
be
thinking
about
to
make
vaccine
access
and
make
sure
that
the
access
goes
well
in
the
city?
That's
my
first
question,
for
you.
J
And
how
do
we
focus
on
those
sites
and
and
thinking
about
the
humans
that
the
people
from
black
and
brown
communities
have
been
disproportionately
impacted
throughout
this
pandemic
and
and
and
what's
our
moral
imperative
to
focus
on
those
communities?
I
think
these
are
some
maybe
guiding
principles
when
you
think
about
who
gets
the
vaccine
first
in
the
distribution.
C
J
C
K
Yes,
so
the
jefferson
vaccine,
coravax
c-o-r-a-v-a-x,
the
the
key
things
that
that
this
vaccine
focuses
on
are
longevity
safety
and
cost.
So
longevity
being
one
that
we
don't
talk
or
hear,
talked
about
too
much
adenovirus
based
vaccines,
which
you've
heard
from
the
johnson
johnson,
but
others
are
using
too.
K
Those
are
seasonal
vaccines,
so,
whatever
logistics
we
come
up
with
we're
going
to
be
doing
them
again
next
year
and
the
year
after,
just
like
a
flu
vaccine,
the
basis
of
the
the
coravax
vaccine
is
a
rabies
vaccine
that
is
generally
given
once
every
10
years
and
has
long
lived
immunity.
Of
course,
if
we
get
a
vaccine
that
will
help
people
we're
going
to
give
it
to
them,
but
gee
we,
it
would
sure
be
great
to
push
through
one
that
you
didn't
have
to
give
every
year,
because
this
thing
isn't
going
away.
K
So
fast
cost
is
another
key
issue.
The
the
vaccine,
this
corvex
vaccine,
is
the
manufacturing
price
is
so
low
that
even
without
a
subsidy,
the
the
cost
is
in
the
10
range
and
we're
hearing
prices.
Of
course,
we
expect
them
to
be
subsidized
early
on,
but
some
of
these
rna
vaccines
are
upwards
of
300
and
they're
just
expensive
to
make.
So
that's
just
another
thing
to
keep
in
mind
as
we
talk
about
access
and
we
talk
about
all
these
phases
is
bearing
the
burden
of
the
cost.
K
K
It's
true
that
coravax
is
is
not
is
where
we're
entering
humans
is
our
phase
we're
entering
human
trials
very
shortly,
but
the
base
vaccine
is
one-
that's
been
in
literally
billions
of
people,
including
pregnant
women,
children,
older
people
and
has
a
has
a
tremendous
record
of
success
across
a
wide
variety
of
the
community.
So
we're
excited
about
this
vaccine.
We
in
trying
to
hit
those
three
key
things
which
our
team
felt
were
so
critical.
K
We
do
have
some
money
from
the
the
state
from
dcd
that
we
appreciate
very
greatly
and
we
have
industrial
partners,
but
we're
excited
about
this
and
we'd
sure
like
to
bring
this
thing
home
for
philly
in
a
way
that
that
helps
both
us
and
and
is
a
vegan
for
the
world.
So
thank
you
for
asking
the
question.
B
D
B
M
Thank
you
so
much
so
my
name
is
dr
charles
karens,
and
thank
you
chair
cindy
bass.
Vice
chair
bob
henan
and
your
distinguished
councilmen
are
colleagues.
It
is
truly
an
honor
to
be
providing
this
testimony.
I
currently
serve
as
the
walter
h
and
leonard
annenberg
dean
of
the
college
of
medicine,
professor
of
medicine,
emergency
medicine
senior
vice
president
of
medical
affairs
at
trexel.
M
Thus,
I
am
studying
the
copen-19
virus
testing
people
for
the
virus
from
learning
how
to
best
care
for
people
with
a
virus
learning
how
to
promote
vaccination
against
the
virus,
all
the
while
assessing
situational
awareness
in
order
to
be
prepared
to
pivot,
with
any
new
information
pertinent
to
the
testimony
of
others.
Today,
the
recent
national
academy
of
medicine
report
for
equitable
allocation
of
coveted
vaccines
states
that
vaccine
hesitancy
is
on
the
rise.
M
Thus,
we
need
a
proactive
approach
to
providing
information
on
the
value
of
vaccination
and
to
address
any
barriers
in
receiving
the
vaccine,
including
issues
of
language
access
and
the
importance
of
providing,
culturally
and
linguistically
appropriate
access
to
enhance
trust
among
our
african-american
and
communities
who
are
suffering
the
most
at
drexel.
Colleagues
in
the
colleges
of
medicine,
public
health,
nursing
and
health
professions
are
working
to
better
understand
these
issues
and
address
them
in
communities
in
western
north
philadelphia.
M
We
propose
that
the
philly
facts
system
be
augmented
by
incorporating
further
proactive
community
programs
to
directly
support
copenhagen.
Vaccination
in
these
communities,
which
have
been
traditionally
underserved
by
healthcare
and
frankly,
have
been
underrepresented
in
covet-19
testing,
currently
we're
working
with
saint
christopher's
hospital
for
children
to
provide
copin
19
testing
to
these
underserved
communities
in
philadelphia,
we're
also
using
community
health
workers
to
assess
to
assist
in
the
education
awareness
warm
hand-offs
of
vaccination
to
better
engage
the
community
and
gain
trust
as
a
proactive
approach
to
addressing
this
already
stated.
M
M
We
also
propose
to
utilize
cobit
19
information
platforms,
including
mobile,
and
web-based
applications
to
facilitate
vaccination
access,
confirm
dosing
regimens
and
provide
longitudinal
information
on
efficacy
and
safety.
There
are
outstanding
questions
on
whether
the
vaccine
protects
those
who
have
already
had
prior
exposure
to
the
sars
code,
v2
virus
and,
frankly,
how
long
any
protection
confirmed
by
the
vaccine
last.
M
M
The
system
could
also
link
to
the
phillyvac
system
and
any
applicable
programs
across
the
city
state
in
the
country.
Thus,
I
strongly
encourage
the
city
to
follow
a
smart,
creative
and
inclusive
approach
to
covet
19
vaccination,
building
upon
the
phillyvac
system
and
incorporate
universities,
proactive
community
programs
and
augmented
digital
platforms.
M
B
N
I'm
dr
p.j
brennan,
I'm
an
infectious
disease
physician
and
chief
medical
officer
of
penn
medicine
good
afternoon,
chairman
bass,
councilmember
hennen
and
members
of
the
committee.
Thank
you
for
inviting
me
to
testify
on
this
important
issue.
On
behalf
of
penn
medicine,
I
would
like
to
thank
you
for
your
leadership
in
addressing
the
covet
19
pandemic.
As
you
know,
the
covenant
19
pandemic
has
had
a
disproportionate
impact
on
economically
disadvantaged
and
minority
communities
in
philadelphia
in
an
effort
to
just
to
address
this
disproportionate
impact
on
our
vulnerable
communities.
N
Penn
medicine
has
worked
to
expand
testing
in
the
west
philadelphia
community.
This
spring
penn
medicine
worked
with
the
philadelphia
department
of
public
health
to
stand
up
a
community
testing
site
at
sayer
health
center.
In
his
first
week,
the
sayers
site
staffed
by
penn
medicine,
nurses,
doctors,
physician
assistants
and
operational
support,
saw
a
volume
of
906
patients,
more
than
88
of
whom
were
identified
as
african-american
testing
at
sayer
is
available
to
members
of
the
public
at
no
cost,
regardless
of
whether
they
are
penn,
medicine,
patients
or
medical
insurance.
N
Walk-Up
tests
without
referrals
are
available
and
the
site
is
open
monday.
Through
friday.
The
sayers
site
has
performed
19
652
tests,
since
it
opened
on
may
4th,
as
cases
of
cases
have
surged
in
the
city.
Over
the
past
week,
sayer
is
averaging
350
tests
a
day
and
as
a
beacon
of
access
for
west
philadelphia.
N
The
sayer
testing
site
also
provides
screening
and
navigational
support
for
mental
health
and
social
needs.
Penn
medicine
site
at
4040
market
street
also
provides
testing,
regardless
of
insurance
to
date.
31
of
18
513,
test
recipients
at
40
40
market
street
were
not
penn
medicine
patients
between
our
testing
sites
at
sayer,
40
market
and
radnor.
We
have
performed
51
138
tests
since
the
beginning
of
the
pandemic.
N
N
N
Our
six
hospitals
have
treated
four
thousand
five
hundred
seventy-five
inpatient,
coven-19
patients
and
our
emergency
departments
have
treated
six
thousand
forty
four
coveted
nineteen
patients,
three
thousand
three
hundred
twenty
one
of
whom
were
admitted
this
spring.
At
the
height
of
the
pandemic,
our
census
was
about
423
admitted
patients
with
a
10-day
average
length
of
stay
with
many
admitted
patients
in
the
intensive
care
units.
N
In
addition
to
our
efforts
to
directly
treat
covet-19
patients,
penn
medicine
has
implemented
a
number
of
programs
to
ensure
the
safety
of
patients
who
need
medical
care
unrelated
to
covet
19..
This
includes
screening
patients
for
covered
before
appointments.
To
date,
we
have
screened
one
million
four
hundred
fourteen
thousand
seven
hundred
sixty
four
patients
for
covet
nineteen
pandemic.
We've
leveraged
our
penn
care
at
home
service
to
help
decrease
hospital
stays,
reduce
readmissions
and
free
up
hospital
beds.
For
more
serious
cases.
N
N
Over
the
past
few
weeks,
we've
seen
an
alarming
spike
in
covet
19
admissions
at
our
hospitals,
and
we
expect
that
trend
to
continue
as
we
enter
the
winter
months.
We're
confident
that
our
health
system
is
the
capacity
to
handle
another
surge.
We're
concerned
about
the
devastating
toll
this
virus
takes
on
its
victims.
N
We've
established
an
internal
advisory
committee
consisting
of
a
representative
team
of
clinicians
emergency
management
professionals,
ethicists
and
human
resource
officers,
to
plan
for
effective,
efficient
and
ethical
implementation
of
our
vaccine
distribution
plan.
The
team
has
incorporated
the
recommendations
of
the
national
academy
of
medicine,
the
centers
for
disease
control
and
prevention,
the
pennsylvania
department
of
health
and
the
philadelphia
department
of
public
health
into
our
policy
governing
how
vaccines
will
be
distributed
in
accordance
with
ethical
principles
developed
by
the
national
academy
of
medicine
and
cdc
penn.
Medicine's
distribution
policy
aims
to
one
maximize
benefits
and
minimize
harm.
N
Two
mitigate
health
disparities,
three
promote
justice
and
four
promote
transparency.
Understanding
that
supply
will
be
limited
for
several
months.
We
plan
to
prioritize
the
following
groups
for
early
vaccination:
healthcare
personnel
workers
in
essential
and
critical
industries,
people
at
high
risk
due
to
underlying
conditions
and
individuals.
65
years
and
older
penn
medicine
will
assign
the
first
priority
status
to
frontline
healthcare
workers
who
interact
directly
with
patients
who
may
have
covered
19
and
are
therefore
at
the
highest
risk
for
contracting
the
virus.
N
Accordingly,
clinicians
doctors,
nurses
and
advanced
providers
and
staff,
environmental
service,
security,
transport
and
food
service
personnel
who
work
in
areas
such
as
covet,
inpatient
treatment,
emergency
medicine,
labor
and
delivery
trauma,
specimen
collection
and
transplant
donor.
Retrieval
will
receive
the
vaccine
first.
N
N
The
vaccine
will
be
offered
according
to
the
prioritization
policy,
but
not
mandated
at
this
time.
Considering
its
expected
emergency
use
status
when
first
authorized.
If
the
volume
of
vaccine
is
lower
than
the
demand
amongst
eligible
staff,
we
will
implement
a
lottery
system
to
determine
distribution.
A
wait
list
will
be
available
to
all
staff
who
are
not
eligible.
According
to
the
priority
policy.
N
N
The
philadelphia
department
of
health
has
selected
penn
medicine,
along
with
other
city-wide
leaders,
to
provide
subject
matter,
expertise
in
the
clinical
operational
and
emergency
management
aspects
of
the
vaccine
distribution
plan.
Penn
medicine
will
utilize
a
hub
and
spoke
model
for
storage
distribution
and
vaccine
operations.
N
Penn
medicine
is
prepared
to
support
the
philadelphia
department
of
health,
public
health
in
any
community
based
vaccination.
Efforts
for
health
care
workers
and
others
outside
of
the
penn
medicine
system
and
medicine
remains
committed
to
our
partnership
with
the
city
to
address
the
covet
19
pandemic
and
distribute
vaccines
in
a
safe,
effective
and
ethical
manner.
Thank
you
for
the
for
the
opportunity
to
speak
with
the
committee.
L
L
They
need
a
nighttime
session,
they
need
a
weekend
session.
So
when
folks
finish
at
sare-
and
they
finish
at
jefferson-
they
come
over
to
us,
which
is
why
we're
always
slammed
in
there
until
10
o'clock
at
night,
because
we're
there
when
people
get
off
work
and
the
other
place
is
shut
down
and
on
saturday
at
the
lea
chorus
center,
which
is
where
we'll
be
this
saturday
from
11
to
4.,
and
so
I'm
concerned
about
the
distribution.
Why?
L
L
What
I
wanted
to
ask
dr
netter
of
johnson
and
johnson
is
that
again
with
these
different
arms
of
the
vaccine,
which
I'm
excited
about
what
about
the
people
who
have
had
coronavirus
and
who
have
antibodies
when
we
look
at
our
data
now
out
through
six
months,
85
of
the
people
who
we
tested
at
three
months
and
now
at
six
months,
still
have
igg
antibodies
to
coronavirus
and
something
I
would
like
to
know
from
the
phase.
3
data
is
that,
did
you
include
people
who
previously
had
coronavirus
when
you
did
the
study
and
the
antibodies
generated?
L
Were
they
more
efficacious
if
you
got
the
vaccine
or
was
it
equal
to
someone
having
antibodies,
who
had
had
sars
cov2
already?
Why
would
that
be
important?
Because
the
majority
of
the
people
who
have
had
coronavirus
are
black
and
latinx
and,
as
I
mentioned,
85
of
them
still
have
antibodies.
So
if
we're
going
to
go
out
and
encourage
them
to
take
a
vaccine,
it
would
behoove
us
to
be
able
to
say,
and
it's
only
going
to
make
the
antibodies.
L
You
have
that
much
more
potent
or
say
you
don't
need
it
and
we
know
the
antibodies
are
transient,
meaning
they
don't
last
forever,
but
so
is
the
vaccine,
it's
transient,
and
so
I'm
I'm
somewhat
disheartened,
I'm
hoping
when
the
data
comes
out
and
the
evidence-based
journals.
We're
gonna
know
that
they
looked
at
an
arm
with
people
who
had
antibodies.
L
However,
I
know
for
a
fact:
moderna
excluded
all
people
who
had
previously
been
infected.
That
is
a
very
big
concern
to
me
because
it
says
that
at
the
table,
when
the
study
was
being
designed,
folks
who
were
already
infected,
which
were
primarily
black
and
latinx
in
america,
were
not
at
the
forefront
or
that
would
have
been
included.
That's
my
comment.
L
My
concern
as
I'm
on
the
vaccine
advance
advisory
committee
with
dr
brennan
and
dr
johnson
is
the
phase
one
people
that
are
primarily
health
care
workers,
people
who
take
care
of
folks
in
nursing
homes
and
folks
that
are
65
and
up
dr
farley,
and
I
have
discussed
it
and
the
african-american
community.
It's
not
primarily
65
and
up
the
people
who
are
contracting
coronavirus
are
45
to
54
they're,
your
working
class
people,
they're
35
to
44,
and
then
we
get
into
the
65
and
up,
and
then
we
go
back
to
the
25
to
34..
L
So
again,
the
criteria
that
excluded
african-americans
and
latinxs
from
getting
tested
are
going
to
be
some
of
the
same
criteria
that
exclude
them
also
of
our
data.
Only
22
percent
of
people
who
tested
positive
had
comorbid
conditions.
So
you're
saying
I
need
to
be
old.
I
need
comorbid
conditions
that
makes
me
high
risk.
Well,
those
aren't
risk
factors
that
many
african
americans
and
latinx
people
have.
L
That
is
the
crux
of
what
I
needed
to
say
and
the
last
thing
I'll
say
about
the
restrictions,
even
with
the
vaccine
being
90
effective.
That
means
10
of
people
even
getting
the
vaccine
will
not
have
immunity
against
this
virus,
which
means
we
still
have
to
promote
wearing
your
mask
social
distancing
till
everybody
gets
it
phase
3,
it
may
not
be
till
summer
or
even
the
end
of
december
2021.
E
E
I
was
called
here
to
discuss
the
administration
of
this
vaccine
now,
as
some
people
have
mentioned
before
this
is
literally
the
largest
logistical
operation
of
our
species,
we're
all
here
talking
about
something
that
we
still
know
very
few
details
about,
but
what
we
can
do
is
create
a
preemptive
strike,
and
that
is
what
people
like
caroline
johnson,
dr
al
stanford,
and
a
bunch
of
us
are
trying
to
do
so.
We
know
that
you
guys
don't
want
to
put
your
money
into
something
that
has
previously
been
largely
behind
the
scenes,
which
is
what
this
is.
E
It's
a
highly
scientific
effort
right
now,
the
political
sentiment
behind
vaccines
behind
anything
health
care
related
is
actually
really
poor.
So
we
hope
that
these
hearings
help
you
understand
that
this
is
something
that's
extremely
necessary
now
in
terms
of
what
philly
fighting
covet
has
been
doing.
We've
been
working
for
four
months
to
ensure
that
the
logistics
of
what's
going
on
with
this
vaccine
will
not
hold
philadelphia
to
get
the
vaccines
in
the
first
place.
E
E
E
E
I'm
sorry
guys,
let's
see
if
we
can
fix
this
okay.
Thank
you.
Can
we
see
it
now,
yeah
all
right.
Thank
you
very
much.
So
population
density-
you
know
we
were
talking
earlier
about.
Where
should
we
be
focusing
our
efforts?
This
is
one
of
the
most
important
decisions
that
is
going
to
happen
because
we
don't
want
communities
to
be
missing
out
on
medical
care,
so
population
density,
highly
dense
in
south
philadelphia
philadelphia
is
also
very
known,
as
we
know
for
being
a
highly
partitioned
city.
So
you
have
little
bits
of
density
here
and
there
income.
E
So
this
is
no
surprise
to
anybody.
American
healthcare
is
awesome
if
you're
rich,
if
you're
poor,
it's
one
of
the
worst
in
the
world.
So
what
we
want
to
focus
on
is
making
sure
that
low-income
neighborhoods
have
access
to
first
off
testing
but
as
we
currently
are
doing
but
later
on
the
vaccine,
and
if
we
look
at
hospital
distribution
in
philadelphia,
it
largely
mirrors
income
right
hospitals,
don't
really
like
to
be
in
places
that
are
poor.
Poor
people
mean
uninsured,
uninsured
means
that
hospitals
cannot
collect.
E
So
what
philadelphia
is
looking
at
is
doing
this
five
main
node
model
of
drive
throughs
with
highly
mobile
sites
high
throughput
sites,
meaning
they
can
take
about
two
to
ten
thousand
patients
a
day.
The
reason
for
these
high
throughput
sites
and
the
fact
that
they're
gonna
be
necessary
is
when
h1n1
came
around.
We
had
a
huge
problem
of
pharmacies.
E
So
what
we're
currently
asking
the
council
is
in
assistance
and
guidance
in
doing
this,
so
we've
currently
budgeted
internally
for
philly
fighting
covid
2.7
million
dollars
for
constructions
of
these
sites.
The
data
requirements
are
all
custom.
It
all
has
to
be
custom
fed
to
the
immunization
software
and
the
cdc
within
24-hour
requirements
which
my
team
is
currently
building
off.
Of
my
own
personal
funding
supplies,
pp
refrigerators,
warehouses,
we're
currently
training
staff,
we're
hiring
about
500
staff
over
the
next
60
days.
E
E
The
health
department
has
been
really
good
in
terms
of
making
sure
that
all
these
parties
are
communicating
the
conversations
that
we've
been
having
on
the
big
scene.
Advisory
board
have
been
highly
productive,
but
the
the
reason
and
the
key
takeaway
of
my
testimony
is
that
I'm
sure
you
hear
this
all
the
time.
Council
members,
I'm
sure
you
have
people
coming
here
all
the
time
asking
for
money,
but
the
health
department
in
specific
really
needs
funding
and
the
reason
is
we
need
to
preempt
this
attack.
E
We
need
a
preemptive
funding
to
create
a
preemptive
strike
as
you've
seen.
Hopefully
in
my
presentation,
this
is
a
large
scale
effort.
That's
going
to
require
thousands
of
people
and
millions
of
dollars
of
moving
parts,
the
quicker
that
we
can
begin
the
setup,
specifically
the
quicker
that
the
health
department
can
start
working
on
getting
these
pieces
in
play,
which
they
already
have
been,
but
with
limited
resources,
the
quicker
that
we
can
get
philadelphia
back
up.
B
Thank
you
so
much,
I'm
going
to
pause
right
here
for
some
questions.
I
know
that
members
of
the
committee
have
questions
before
I
do
that.
I
did
want
to
recognize
dr
stanford,
and
I
know
she
has
to
go
soon
because
she's
off
to
do
another
testing
in
west
philadelphia,
and
so
I
just
really
wanted
to
thank
her
for
all
of
her
work
on
this
issue
and
for
stepping
up
at
a
time
when
it
was
kind
of
you
know
in
a
lot
of
our
communities.
B
We
felt
like
well
what
to
do
what's
happening
with
what's
going
on
and
we
didn't
have
you
know
we,
we
didn't
have
the
direction
that
we
were
all
looking
for
and
without
direction
without
a
thought.
She
just
put
something
into
place
to
begin
to
do
immediate
testing,
and
I
just
really
wanted
to
publicly
say
thank
you
so
much
for
all
that
that
you've
done
for
our
communities,
because
undoubtedly
the
testing
has
saved
lives.
So
I
just
wanted
to
put
that
on
the
record
councilman
heenan.
C
C
C
N
Sure
we
want
to
give
it
to
the
give
the
vaccine
to
the
highest
risk
individuals
and
and
to
those
who
are
at
the
greatest
risk
of
transmitting
it
to
to
others
who
would
be
high
risk.
So,
on
the
one
hand,
we
want
to
administer
it
to
everyone
who
is
at
the
front
line
in
our
emergency
departments,
for
example
in
obstetrics,
where
we've
through
studies,
that
we've
done
we've
identified
that
nearly
seven
percent
of
pregnant
women,
presenting
in
labor
in
the
first
wave
of
the
pandemic
were
coveted
positive.
N
N
If
these
vaccines
are
both
safe
and
effective,
when
we
have
more
information
about
them
beyond
the
news
reports
that
have
just
come
out,
so
we're
working
with
communications
professionals
who
have
actually
done
research
on
vaccine
messaging,
so
that
we
have
the
best
content
and
methods
to
talk
about
this,
and
you
know,
address
the
concerns
of
communities
that
have
had
adverse
experiences
with
the
medical
community
with
vaccines.
Specifically.
C
E
Yes,
sir,
so
currently
an
effort
like
this
requires
a
lot
of
human
capital
with
any
medical
effort,
as
we've
seen
with
hospitals
with
sophisticated
procedures,
you
need
mostly
equipment
right.
You
need
lots
of
resources,
the
only
equipment
that
you
really
need
for
a
large
scale.
Vaccination
effort
is,
you
know
your
ppe,
your
warehouses
and
your
refrigerators
for
their
for
the
ultra
cold
chain
storage.
E
E
So
we've
been
working
meticulously
in
making
sure
that
we
could
actually
move
all
this
data
and
then
once
people
come
to
these
sites,
they're
in
and
out
within
a
matter
of
minutes
and
that's
the
whole
point,
because
this
whole
run
on
the
bank
situation,
that's
probably
going
to
happen
with
the
hospitals
and
pharmacies
and
the
sites
that
aren't
ready.
We
can't
afford
that
at.
C
E
Yeah,
so
we
started
off
as
actually
a
ppe
manufacturing
company
we
manufactured
face
shields,
we've
done
thousands
of
manufacturing
facials
and
we
continue
to
manufacture
facials,
but
we
also
work
with
mask
manufacturers
on
a
personal
level,
so
all
of
our
ppe
supply
chain
is
actually
off
the
grid.
So
we
have
access
to
a
lot
of
equipment
that
hospitals,
pharmacies
don't
have
access
to,
but
would
be
necessary
for
sites
like
this,
because
you
know
you
have
500
people
working
in
full
ppe
every
day,
every
day
for
120
days,
you're.
G
Yeah,
thank
you
so
much.
Madam
chair.
I
think
most
of
my
questions.
First
of
all,
I
again
want
to
thank
a
wonderful
panel,
including
dr
brennan
and
dr
carnes,
and
all
the
others
who
spoke
today
for
your
insights
into
this,
but
I
think
if
dr
stanford
is
still
with
us,
I
think
some
of
my
questions
would
be
directed
towards
her
experiences
and
good
afternoon.
Dr
stanford.
G
L
G
I
know
you're,
you
are
on
your
way
doing
important
stuff.
You
know,
I
guess
you
took
the
words
that
I
had
for
you
out
of
my
mouth.
You
know
my
question
is:
is
that
if
you
were
to
evaluate
the
city's
ability
to
do
covet
testing,
you
know
as
a
precursor
to
some
extent,
to
the
covid
vaccine
right
to
cova
vaccinations?
G
L
Yes,
correct,
okay
testing,
I'd,
say
probably
a
b
minus,
but
that's
better
than
it
was
so
it's
better
than
it
was
in
april
and
may.
But
I
and
I
don't
understand
this
part-
you
guys-
can
explain
it
better-
that
how,
in
california
and
even
in
delaware,
you
can
go
online
register,
you
can
go
down
to
dodger
stadium,
you
can
go
down
and
you
can
get
a
test
and
it's
open
to
everyone.
L
And
now
what
we're
seeing
is
it's
less
african-american
and
latinx,
or
it's
50,
and
now
we're
seeing
everybody
we're
seeing
all
that
we're
seeing
you
know
police
officers
coming
to
get
you
know,
tested
and
waiting
in
line.
You
know-
and
it's
just
I
don't
know
where
the
disconnect
is.
I
don't
know
why
we're
falling
short
of
being
able
to
test
folks
and
when
our
positivity
rates
are
20.
G
No,
no,
no
need
you
know.
I
think
the
the
other
question
would
be,
and
I
fully
hope
that
you
and
many
others
who've
been
doing
this
work
in
communities
are
at
the
table,
as
the
planning
rolls
out
or
the
messaging
rolls
out
on
on
the
vaccination
front,
I
think
we
heard
a
little
bit
earlier
from
dr
banku
and
you
know
I
think
this
speaks
to
a
little
bit
of
what
dr
brennan's
saying.
G
We
can't
really
rely
on
and
I
and
again
I'm
interested
in
hearing
from
you,
dr
sanford,
but
we
can't
really
rely
again
on
sort
of
the
standard
issue
kind
of
messaging
that
you
know
has
led
to
the
fact
that
whether
or
not
we
think
we're
doing
a
good
job
or
whatever
you're
seeing
covet
positivity
raises
17
to
19
you're
testing
the
people
who
need
to
be
tested.
Yes,
but
you
know
to
a
large
extent
like
we
are
concerned
about
the
ability
to
reach
people
on
masks
what's
safe,
what's
not
safe
recognizing.
G
I
think
that
dr
bunku
said
this
very
clearly.
We
know
our
elderly,
and
you
said
this
to
dr
sanborn.
We
know
our
elderly
and
our
seniors
are
more
at
risk,
so
if
they
get
covered,
they
are
in
high
danger
of
a
health
emergency,
if
not
something
even
more
serious,
but
they
may
not
be
getting
it
from
other
seniors
that
they're
around
they're
very
likely
to
be
getting
it
from
younger
people,
who've
engaged
with
them
who
fall
below
the
radar.
G
You
know
still
to
this
day,
even
though
our
coveted
deaths
less
than
half
granted,
it's
49
are
seniors.
We
still
have
no
analysis
of
the
51
of
people
who
also
die
of
covet.
Who
are
not
older.
You
know
we
don't
get
that
breakdown,
I'm
saying
you
you
have
it
I'm
sure,
but
we
don't
get
that
breakdown
in
council
on
a
regular
basis.
G
So
the
message
continues
to
be
sent
that
it's
a
seniors
primarily
high
risk,
but
seniors
are
now
less
than
50
percent
of
the
death
rate,
and
we
really
do
need
to
be
talking
about
the
fact
that
most
seniors
aren't
getting
it
from
other
seniors.
They
could
be
getting
it
from
younger
people
who
are
either
not
covets.
You
know
showing
signs
or
something
like
that.
So
I
wanted
you
to
talk
again
about
like.
G
L
Yes,
so
I
think
what's
interesting
and
what
we're
hearing-
and
I
think
dr
brennan
and
andre
could
comment
on
this
too-
is
on
the
committee.
We
were
doing
a
lot
of
things
by
occupation
for
phase
one,
and
I
remember
early
on.
We
talked
about
ethnicity,
we
talked
about
zip
codes
and
we
kind
of
steered
away
from
that
a
little
bit.
L
Their
spouse
is
a
bartender
it's
because
their
spouse
is
head
of
environmental
services
at
a
nursing,
home
right
and-
and
I
had
to
say
to
my
staff.
Well,
we
are
black
and
latinx,
so
it
doesn't
matter
that
you
are
out
here
testing
and
we're
health
care
professionals,
because
your
family,
even
if
you
don't
bring
it
home
from
work,
will
bring
it
home
to
you
right
and
those
are
younger
people,
and
so
now,
as
I
think
back
and
again,
I
was
talking
to
dr
farley
about
this
recently,
as
we've
been
evaluating
our
data.
L
Now,
is
it's
not
the
same?
It's
not
the
same
demographic
that
the
criteria
was
set
up
to
test
60,
give
priority
to
65
and
older
and
people
with
comorbid
conditions,
because
only
22
percent
of
our
folks
had
conditions,
and
most
of
them
are
younger.
Their
45
to
54
was
our
highest.
Teeth
are
most
of
our
people
who
tested
positive,
and
I
just
think
we
might
have
to
reevaluate
that
or
we're
gonna
miss
the
mark
again
like
we
did
with
the
testing
miss
the
mark
with
who
gets
prioritized
with
the
vaccine.
G
N
N
N
We
had
about
600
tests
that
we
could
do
in
our
health
system,
just
one
health
system
I'll
be
at
a
larger
health
system,
but
lots
of
people
needing
procedures
and
coming
to
the
emergency
department,
and
you
know
400
patients
across
all
of
our
hospitals.
We
had
600
tests
to
perform,
so
you
know
it
was
very
limited,
and
while
we
have
multiples
of
that
now
it
still
isn't
nearly
enough
to
to
test
everybody
that
we
want
to.
N
N
Regarding
regarding
the
communication
issue,
I
think
that
this
is
it's
challenging.
There's
a
lot
of
anti-vaccination
sentiment
to
begin
with
in
this
nation.
Just
regarding
flu
vaccine,
and
now
we
have
novel
vaccines
that
have
been
produced
very
quickly
and
have
been
highly
politicized
and-
and
so
I
think,
it's
going
to
be
a
challenge
to
get
the
message
out
there.
So
it's
going
to
be
very
important
to
me.
N
It's
going
to
be
very
important
to
see
what
the
advisory
council
on
immunization
practices
says
about
these
vaccines.
That's
an
independent
group
that
has
strongly
held
opinions
that
works
from
evidence
and
has
an
outstanding
reputation
and
and
the
expertise
to
address
the
questions,
and
their
support
should
go
a
long
way
in
the
medical
community
in
endorsing
it
and
from
there
it's
incumbent
on
the
medical
community
and
and
beyond
beyond
the
medical
community
to
to
then
message
support
for
the
for
the
vaccine.
N
This
is
across
philadelphia,
delaware,
bucks
and
lancaster
counties
and,
and
so
there's
still,
there's
still
lots
of
lots
of
disease
occurring
there.
So
I
just
wanted
to
just
wanted
to
make
that
point,
but
oftentimes,
you
know
success
in
preventing
disease
in
the
elderly.
Infectious
diseases
in
the
elderly
is
in
vaccinating
those
who
are
in
contact
with
them
like
nursing,
home
workers
and
younger
individuals.
G
G
G
You
know
in
that
senior
category,
and
so
have
we
done
enough
to
do
the
kind
of
things
that
I
think
dr
stanford
has
raised
in
much
of
her
research
and
who
she's
seeing
in
terms
of
the
individuals
who
are
testing
at
such
such
high
positivity
rates?
You
know
17
to
19
percent.
You
know
in
the
communities
that
she's
testing,
I
think,
is
it
13
city-wide
or
something
like
that.
Is
that.
G
For
city-wide
positivity
yeah
yeah
I
mean
that
is
like
a
five-alarm.
The
fact
that
you
know
for
me
I'm
just
saying
I
know
I've
been
really
consumed
with
like
the
elections
and
everything
we're
in
city
council,
but
you
know
that
should
be
like
blasted
in
our
face.
24
7..
I
do
not
necessarily
feel
like
it
has,
but
that
is
off
the
chart.
I
mean
this
is
not.
N
You
know,
I
believe,
by
you
know
the
second
quarter
of
the
year
we're
going
to
have
a
lot
of
vaccine
and
we'll
be
able
to
reach
the
entire
population.
When
I
say
equitable
in
the
first
phase.
You
know
it
shouldn't
just
be
the
emergency
room,
docs
and
nurses,
but
I
do
think
it
should
be
healthcare
workers
just
given
what
they
put
on
the
line
you
know
throughout
this
whole.
You
know
this
whole
pandemic,
where
they
were
out
there.
N
First,
they
were
exposed,
and
I
think
that
you
know
it's
essential
for
our
infrastructure
that
that
we
we
protect
them.
But
you
know
we
have
security
guards
in
the
emergency
department
and
they're
greeting
people
as
they
come
in
and
they
don't
know
whether
they
have
covet
or
a
heart
attack,
and
so
you
know
they
need
to
be
vaccinated
and
they're,
not
the
licensed
professionals.
N
I
G
Yeah
yeah,
no,
we
you
know
I'm,
I
won't
hold
you
too
much
longer,
but
I
just
really
appreciate
both
both
of
you
and
your
brilliance
and
expertise
that
you're
lending
to
it.
I
just
think
we're
in
a
complicated
area.
I
think
we
have
to
be
very
real
and
honest
about
what
we
were
able
to
do,
given
the
fact
that
we
had
constraints,
we
know
that
there
were.
G
You
know
we
have
a
new
president,
basically
in
part
because,
like
you
know,
it's
very
clear
that
we
have,
we
have
issues,
and
so,
but
it
doesn't
matter
like
we're
still
philadelphia.
We
are
going
to
have
to
figure
out
what
we
have
as
strengths
locally,
but
we
also,
I
think
you
know
what
I
am
interested
in
and
hearing
from
and
without
feeling
like.
G
I
have
to
be,
you
know
for
me
personally,
I
don't
have
to
feel
defensive
about
is
the
inability
to
look
back
on
what
did
not
go
as
well
and
make
sure
that
we
can
make
amends
as
we
do
the
rollout,
but
I
really
appreciate
you
know
your
expertise
in
this
and
and
to
all
members
of
the
committee.
Thank
you
very
much,
madam
chair.
B
E
I
think
that
if
I
just
made
the
suggestion,
because
there's
so
much
information,
that's
being
transmitted
within
our
vaccine
advisory
committee,
that
council
actually
has
a
bi-weekly
meeting
or
something
with
the
health
department
and
with
key
people
on
the
vaccine,
as
we
can
see
now.
This
is
such
a
large
effort.
I
think
that
everyone's
constituents
are
going
to
want
to
know
every
detail
about
this
and
have
a
say
in
what
goes.
E
C
B
B
O
O
O
There
are
a
lot
of
structural
factors
that
happen:
access,
fragmentation
to
care,
insurance
limitations,
their
social
and
cultural
factors
that
at
play
fear
the
unknown
contents
of.
What's
in
a
vial,
the
unknown
process
of
how
it
comes
to
be,
and
then
there
are
always
the
active
misinformation
and
disinformation
campaigns,
the
so-called
anti-vaxxers
and
and
others
that
you
know
will
have
us
believe
that
that
vaccines
are
scary.
O
O
It's
made
the
disparity
worse
and
so
there's
a
handful
of
solutions
that
are
out
there,
things
that
we
talk
about
here
between
the
university
and
the
health
system,
things
that
we're
ready
to
deploy
and
have
out
on
the
streets.
It's
the
use
of
trusted
sources,
credible
messengers,
whether
they
be
our
community
health
care
workers,
whether
it
be
the
community
leaders
who
partner
with
us,
whether
they
be
you,
the
elected
officials,
partnering
with
us
side
by
side
in
helping
to
educate
the
community.
O
O
We
need
to
remain
transparent
about
the
side
effects
about
the
efficacies
about
the
outcomes
and
everything
else
related
to
how
this
vaccine
process
moves
forward
and
then
the
last
thing
I'll
say.
We
really
need
to
consider
what
kind
of
framework
we're
putting
this
in.
I
would
suggest
a
trauma-informed
framework
again
that
goes
back
to
the
credible
messengers.
It
goes
back
to
the
empathy
and
understanding
of
what's
happening
and
it
really
gets
at
that
root
of
the
underlying
cause
of
fear
of
vaccination.
B
F
You
well
terrific,
so
my
name,
dr
benjamin
abella,
I'm
an
emergency
physician
at
the
university
of
pennsylvania,
where
I've
been
for
the
last
15
years.
I'm
vice
chair
for
research
and
run
a
mobile,
cobalt
copy,
testing
center
and-
and
I
think
much
like
the
previous
speaker,
given
the
lateness
of
the
hour,
I'm
not
going
to
just
read
my
testimony.
It's
a
little
a
little
on
the
dull
side
at
this
you've
had
a
lot
to
hear
today.
You
can
read
it
at
your
leisure.
F
So
one
point
I'd
make
is
I
do
think
that
whatever
philadelphia
decides
will
be
its
multi-pronged
strategy?
It
should
definitely
include
some
mobile
testing
component.
I
think
the
concept
of
neighborhood
by
neighborhood
street
by
the
street
may
be
very
important
for
a
variety
of
reasons:
access
mobility,
crowds
gathering
with
high
infectivity
rates
and
concerns
about
that
sort
of
thing.
So
I
think
the
one
thing
I've
learned
is
that
this
concept
of
bringing
testing
or
vaccination
for
that
matter
to
the
people
through
mobile
approaches
is
going
to
be
very
important.
F
So
that's
one
point
I'd
make
the
other
point
is
we've
been
working
in
partnership
with
prevention
point
and
one
of
the
lessons
we've
learned
there,
prevention
point,
of
course,
as
you
know,
is
it
does
a
lot
of
work
with
those
who
are
suffering
with
drug
addiction
and
recovery
is
that
there
are
important
reservoirs
of
potential
covet
disease
that
we
need
to
think
about
our
multi-pronged,
philadelphia
approach,
so
certainly
healthcare
workers,
nursing
homes.
These
are
all
important
places,
but
the
it's.
F
I
think
the
folks
who
are
on
the
margins
of
society
that
we
have
to
think
about
as
well
immigrants
and
poorly
documented
immigrant
communities,
the
homeless,
those
who
are
shelter
insecure
the
concern
of
course
they
could
fall
through
the
cracks
and
serve
as
an
ongoing
reservoir
for
disease.
That
could
then
impact
our
communities.
So
so
just
I
want
to
make
a
plea
that
we
keep
them
in
mind
and
any
strategy
we
come
up
with
should
include
those
communities
as
well.
F
I
also
want
to
echo
some
of
the
points
made
by
prior
speakers
that
I
think
that
to
do
this
effectively
and
efficiently
coordination
across
all
of
our
various
groups
is
so
important,
which
is
why
I
certainly
applaud
the
formation
of
the
vaccine
advisory
committee.
I
think
that
we
don't
want
to
duplicate,
limited
resource
settings
and
also
given
the
speed
and
expediency
which
which
we
want
to
approach
this
problem.
We
want
to
make
sure
that
we
coordinate
our
efforts.
I
think
there's
another
piece.
F
So
what
I
said
I
know
is
obvious
to
this
group,
but
another
piece
of
communication
is
communication
outward
towards
the
public.
I
think
there's
going
to
be
a
lot
of
trepidation
from
the
public
about
who's,
getting
it
first
who's
getting
it
second.
How
are
we
thinking
this
through,
and
so
I
think
we
can
set
a
really
good
example
of
transparency.
F
I
think
it's
going
to
be
really
important,
given
that
these
vaccines
both
a
require
another
dose,
so
we
have
to
track
who's
gotten,
the
first
dose
and
so
forth,
and
and
b
there
may
be
side
effects
and
other
issues
that
we
want
to
track
is.
Is
that
the
city
really
think
carefully
about
how
it's
going
to
collect
data,
especially
for
the
people
who
get
vaccinated
outside
of
health
care
systems
outside
of
conventional
lists,
because
we
will
want
you'll
want
to
basically
be
able
to
dashboard
that
information?
F
I
think
that'll
be
very
important
and
I
think,
along
the
lines
of
my
public-facing
comment,
a
public-facing
dashboard
showing
philly's
progress
will
be
so
important
to
engender
public
trust,
but
then
also
just
so
that
we
know
where
we
stand
from
moment
to
moment
to
to
councilwoman's
jim's
point
of
having
a
report
card.
We
want
to
be
able
to
have
a
report
card
for
our
own
progress,
so
we
know
we
can
achieve
metrics,
and
so
I
think
I'll
stop
there.
Those
are
just
some
overarching
points
from
the
things
that
I've
learned.
F
B
B
We
want
to
dispel
any
notion
that
it's
happening
and
in
terms
of
making
sure
that
the
people
are
being
treated
fairly
and
that
those
who
are
most
affected
and
who
have
the
health
disparities
and
who
have
been
adversely
affected
and
and
have
really
taken
a
hit
from
the
virus
that
they
are
at
the
front
of
the
line.
So
I
thank
you.
So
much
for
making
that
point
and
suggestion,
and
that's
certainly
something
that
needs
to
be
done.
B
C
Thank
you,
madam
chair.
I
have
a
question
for
dr
bella.
First,
I
just
want
to
thank
him
for
his
long
history
of
the
community
of
his
community
involvement
in
educating
regarding
cpr
through
the
mobile
cpr
project
and
that
project,
as
as
a
doctor
knows,
I
am
personally
committed
to.
We
worked
a
lot.
You
know
through
our
communities
in
the
city
of
philadelphia.
C
Educating,
educating
citizens
related
to
cardiac
arrest
in
some
ways
is
a
model
I
would
imagine
for
covet
19.
so
doctor.
Can
you
identify
some
of
the
ways
that
you
were
suggesting
that
philadelphia
could
educate
the
public
what
works
and
what
doesn't
work
in
terms
of
educating
people
on
health
related
issues,
since
you
have
had
that
long-standing
trusted
education,
commitment
to
the
city.
F
Yeah
and-
and
you
raise
of
course
very
first
of
all-
thank
you
for
your
kind
remarks
councilman,
and
we
appreciate
your
support.
As
always,
I
think
you
raised
really
crucial
points
about
communication
and
some
of
the
things
we've
learned
and
by
the
way
I
would
agree
with
you.
I
think
many
of
the
lessons
of
our
mobile
cpr
are
very
analogous
getting
out
in
the
community
working
with
community
groups
and-
and
I
think
partnership
is
one
of
the
keys
here.
F
I
I
think
one
of
the
themes
we've
heard
throughout
today's
testimonies
has
has
really
focused
on
partnerships
with
community
groups,
and
community
groups
are
trusted.
Community
groups
have
their
own
sort
of
spheres
of
communication
and
networks,
and
I
think
that's
going
to
be
really
important,
so
I
think
identifying
community
leads
and
then
partnering
with
them
and
making
sure
they're
part
of
the
solution.
So
that's
not
just
sort
of
like
a
you
know,
telegraphing
from
city
hall,
and
here
are
our
proclamations.
F
That
being
said,
I
do
think
there
there
needs
to
be
some
central
either
ad
campaign,
internet
campaigns,
other
sorts
of
things.
I
think
an
interactive
dashboard
that
the
public
could
access
on
where
we're
at
you
know
how
many
vaccinations
have
we
given
what
you
know.
I
can
envision
a
map
with
communities
turning
shades
as
we
sort
of
hit
those
things
where
they
can
see
progress
first
off.
F
I
think
that
would
be
a
really
terrific
example
of
transparency
and
also
accountability,
because
we
can
all
look
and
see
how
we're
doing,
but
then
also
it
brings
people
back
and
and
by
bringing
people
back,
you
can
have
messages
portrayed
there.
You
can
have
videos
and
physicians
speaking
about
the
importance
of
vaccination
or
ppe,
so
it
can
basically
become
a
resource
hub,
so
I
think
through
through
and
then
of
course,
when
you
have
an
internet
site,
you
can
build
out
apps
that
can
access
that
site
as
well.
F
So
so
I
think
using
technology
very
important
and
should
be
an
ingredient
of
this
partnering
with
community
groups
in
a
smart
way
is
very
important
and
then
letting
them
respond.
So
I
would
suspect,
for
example,
that
you
might
want
a
community
coalition
to
report
into
the
advisory
committee
with
community
opinions
and
have
them
sort
of
have
interchange
back
and
forth
would
be
important.
So
those
are
some
thoughts,
but
but
I
do
think
that
we
really
need
to
be
be
mindful
of
communication
around
this.
F
Yeah
a
couple
of
thoughts
about
cost
effectiveness.
You
know
one
thing
that
I
think
this
city
is
blessed
with
is
a
tremendous
number
of
health
institutions
with
schools
and
the
spirit
of
volunteership
in
our
medical
schools
and
nursing
schools
is
tremendous
and
I
suspect
one
could
rouse
a
volunteer
core
to
offset
a
lot
of
these
costs.
I
think
nothing
would
be
more
exciting
than
for
some
of
our
nursing.
F
Students
and
medical
students
have
been
really
been
sidelined,
largely
in
this
pandemic
and
the
ones
I
work
with
are
just
so
eager
to
get
involved
and
so
eager
to
help
to
help.
Maybe
you
know
I,
you
know,
I'm
not
an
expert
on
on
a
credentialing
for
who's
allowed
to
get
vaccines,
but
certainly
to
be
assistants
to
to
to
get
the
data
collection
to
work
with
the
people
delivering
vaccines
in
and
if
credentialing
allows
even
to
give
the
vaccines.
F
F
Now
I
suspect
the
fire
department
would
tell
us
that
they
are
cash
strapped
and
overtapped
as
it
is
so
so,
as
I
say,
I
almost
hazard
to
to
suggest
this,
but
they
have
been
excellent
partners
with
us
in
a
lot
of
things
and,
and
certainly
they
know
the
neighborhoods
and
they
have
vehicles
and
firehouses
and
and
maybe
the
firehouses
themselves
could
serve
as
community
hubs
for
vaccinations.
You
know
and
and
have
enlist
ems
and
fire
department
help
there.
O
C
O
For
examples
I
would
have
to
do
some
research
around
the
country
to
give
you
some,
but
what
I
can
tell
you
in
the
way
we
do.
Our
flu
vaccination
campaign
is
designed
in
a
manner
similar
to
that
we
have
ten
thousand
employees
and,
in
our
first
day
of
the
campaign,
we'll
get
somewhere
near
three
thousand
done
and
that's
just
using
two
sites.
O
I
would
almost
look
towards
that
scenario
as
a
first
choice
and
an
indoor
venue
as
a
second
choice
depending
on
the
time
of
the
year
and
just
how
cold
it
is
and
how
much
snow
is
out
there.
All
of
that
said,
I
agree
with
dr
abella
you're.
Our
first
choice
by
far
and
wide
has
got
to
be
to
go
to
the
communities,
because
I
don't
think
we're
going
to
be
able
to
get
a
large
volume
of
north
philadelphia
to
come
down
to
the
liacora
center
on
set
times
on
set
days
at
set
programs.
O
I'm
not
sure
we
can
get
them
to
come
to
a
van
at
a
set
time
and
a
set
day
and
a
set
program,
and
so
I
think
we're
going
to
need
to
be
out
with
frequency
and
regularity
and
much
like
dr
capela.
We
have
that
similar
kind
of
spirit
amongst
our
students
and
we
have
vans
in
the
streets
and
work
happening
on
a
regular
basis,
and
so
I
think
any
one
of
a
number
of
those
can
occur.
G
No,
of
course
again
I
want
to
thank
dr
abella
and
dr
reed
for
your
tremendous
work,
and
you
know
I
I
don't
really
have
a
lot
of
questions.
I
do.
You
know
think
that
I'm
certainly
deferring
to
both
of
you
on
the
direction
of
which
we're
going,
but
I
do
think
dr
abella,
you
raised
a
couple
of
good
points.
I
think
there's
a
difference
with
messaging.
Clearly
internally,
we
know
where
our
private
areas
are
our
priority
areas
are.
You
know
there
was
a
question
that
dr
sanford
had
raised
earlier.
G
You
know
universality
as
opposed
to
priority,
because
I
think
in
priority
people,
especially
when
it
comes
to
like
medicine
or
things
that
seem
inconvenient
or
require
wait
times,
people
do
sort
themselves
out
like
they're,
like.
Let
me
just
take
myself
out
of
that
voluntary
flu
vaccine.
Let
me
take
myself
out
of
this
and
that
so
the
more
it
moves
towards
universality
and
like
an
implication
that
this
is
by
you
know.
We
do
you
know
you
can
do
it.
G
You
know
in
in
big
areas,
but
is
clear
that
embraces
everybody
within
that
area
and
then
of
course,
internally
you're
gonna
be
able
to
do
it.
You
know
you,
you
have
a
priority
list
anyway,
there's
no
way
to
not
have
one,
but
the
messaging
has
to
always
be
towards
universality.
I'm
curious
about
whether
and
how
you
see
schools-
and
you
know
you
know
elementary
schools
right
functioning
within
your
network
of
either
outreach
or
destination.
G
I
mean
we're
likely
not
to
be
in
session
under
you
know,
understandably,
but
you
know
I'm
curious
about
how
you
see
that,
just
because
we
know
schools
pull
in
130
000
of
our
young
people
plus
their
families,
they
will
hit
everybody.
Some
schools
have
a
100,
low-income
household
rate.
They
will,
you
know,
reach
everybody
plus
their
family
members.
So
I'm
curious
about
how
you
see
that
working
and
the
complexities
of
the
fact
that
we're
you
know
in
virtual
learning,
right
now.
G
O
Well
I'll
start
and
then
I'll
turn
it
over
to
ben.
I
before
I
was
here
at
temple,
I
was
in
delaware
and
I'm
an
adolescent
medicine
physician.
I
do
school
work
in
delaware.
Our
our
community
health
centers
were
rate
in
the
public
schools.
We
were
in
the
high
schools
in
the
middle
schools.
It
was
a
convener,
that's
also
where
the
elections
occurred.
O
My
question
and
where
I
think
it
takes
community
input
is,
is
that
a
place
of
trust
at
a
place
where
people
feel
safe?
Is
that
a
place
where
we
can
have
those
kind
of
conversations,
and
it
may
be
a
neighborhood
by
neighborhood
decision?
It
may
be
a
regional
decision,
but
I
think
that's
certainly
something
worth
exploring.
F
Much
like
schools
are
a
touch
point
for
the
fire
department
or
police
department,
around
safety
and
community
policing
and
various
things.
Schools
could
be
an
excellent
touch
point
for
family
education
and
importance
of
the
educations
that
people,
because
you
know
I
I
think
we
have
to
take
a
step
back
and
appreciate
that.
Do
we
even
know
in
a
lot
of
communities,
do
they
understand
how
these
vaccines
work
or
what
a
vaccine
it
even
is
you
know?
F
F
I've
had
people
say
I
don't
want
the
flu
shot,
because
it
gives
me
the
flu.
So
so
I
think,
if
nothing
else
using
schools
for
their
central,
what
they
do
centrally,
which
is
education
to
get
information
out
there,
that
kids
can
bring
to
their
families
that
especially
middle
school
and
high
schools
can
ask
questions
and
we
can
make
sure
they
understand.
So
we
can
use
this
as
a
as
a
teaching
teachable
moment
around
health
literacy.
G
Yeah,
absolutely
you
know
a
couple
of
things
to
keep
in
mind.
Is
that
schools
I
mean
you
know
for
what
it's
worth.
Schools
are
compulsory.
You
know
people
have
to
attend,
it's
required,
I
mean
obviously
in
a
world
of
virtual
learning.
One
of
the
things
that
becomes
really
hard
is
that
compulsory
education
is
now
very
difficult
to
to
determine
and
we
want
to
reach
all
you
know,
students
who
could
be
dropping
out
vulnerable
communities,
etc,
etc,
but
for
right
now
you
know
you
know,
schools
are
compulsory,
so
people
do
go
there.
G
G
It
would
probably
be
worthwhile
to
ask
you
know
or
be
able
to
have
a
conversation
with
the
school
district
and
the
school
district's
health
director
about
getting
information
out
there
to
the
nurses
to
be
able
to
have
a
chance
to
drop,
in
quote
unquote
to
every
virtual
classroom
that
they
have
in
their
in
their
field.
To
be
able
to
you
know,
communicate
you
know,
healthcare
needs
and
and
or
healthcare
availability
to
each
and
every
young
person
and
or
family
member.
G
Who
can
and
should
be
partners?
And
so
you
know
an
ability
to
you
know
to
see
how
that
can
be
more
responsibly,
utilized
or
aided.
You
know.
Certainly,
partnerships
or
anything
like
that
that
could
go
on
between
the
medical
community
and
other
schools
would
have
would
go
a
long
way
towards
you
know
being
able
to
build
out
a
more
universal
approach
towards
vaccination
and
healthcare
and
self-care.
You
know
overall.
G
B
B
Fantastic,
fantastic
councilman
hayden
had
some
questions
and
I'm
not
sure,
maybe
councilwoman
kim
and
maybe
thomas,
but
I
did
want
to
just
quickly
just
mention.
I
know
that
there's
a
lot
of
balls
up
in
the
air
right
now,
there's
a
lot
of
unanswered
questions
and
but
I
wanted
to
just
you
know,
dig
back
down
into
your
statement
that
all
distribution
is
really
going
to
be
managed
by
the
city
health
department.
B
I
K
B
H
So
we
do
have
some
rough
ideas
of
how
many
people
would
be
eligible
in
phase
one
and
in
phase
two
and
then
of
course,
phase.
Three
is
the
entire
city
being
eligible,
so
in
phase
one,
the
health
care
workers
that
that
are
defined
as
eligible,
and
we
have
a
very,
very
broad
definition
of
health
care
workers.
For
example,
we
include
the
people
who
are
staffing,
our
behavioral
health
treatment
facilities,
because
we've
seen
so
many
problems
with
covet
occurring
there.
So
we
have
a
what
I
would
call
as
a
generous
definition:
health
care
worker.
H
We
are
talking
about
the
possibility
of
needing
to
cover
somewhere
around
125
000
people
in
just
phase
one,
which
is
the
highest
risk.
So
you
know
doing
the
math.
The
the
problem
is
the
number
of
doses
we
expect
to
receive
for
phase
one
or
sort
of
in
phase
one
I
don't
think
is
going
to
be
higher
than
50
000..
H
I
H
And
that's:
what's
going
to
happen?
Is
people
are
going
to
have
to
make
some
tough
choices
in
in
letting
this
vaccine
be
administered
to
their
staff
and
to
high-risk
individuals?
So
anyways?
That's
the
number.
We
do
not
know
how
fast
it
will
come
in.
After
that
I
mean
I.
I
think
it
would
be
fair
to
say
by
the
summer
of
2021
we
will
see
a
very
steady
flow
of
vaccine
in
here
to
cover
the
entire
population,
but
those
first
few
months
are
going
to
be
tough.
G
B
B
C
Thank
you,
madam
chair
and
dr
johnson.
Thank
you
for
your
patience.
I
hope
you
understand.
There's
no
disrespect
intended
to
you
know
having
these
questions
at
the
end,
and
you
know
also
want
to
remind
you
and
others
that
questions
that
haven't
had
the
chance
to
get
asked.
You
know,
because
of
time
because
of
channel
64
and
us
being
available
to
broadcast
live
all
right.
C
We
will
get
questions
as
a
as
a
committee
and
as
a
council
over
to
you
as
quickly
as
we
possibly
can
you
know
you
know
I.
I
also
want
to
remind
everybody.
You
know
about
the
good
work
that
the
health
department
is
doing
and
give
you
credit,
dr
johnson,
on
the
fill
the
backs.
All
right,
fill
of
axes
is
95
accuracy
for
all
of
our
vaccinations
in
the
city,
philadelphia,
which
is
an
incredible
network,
hopefully
which
will
be
utilized
when
we
distribute
it
and
administer.
H
And
if
we
do
not
successfully
report
to
them
the
administrations,
they
don't
replace
the
doses
of
vaccine.
So
we
can
vaccinate
even
more.
So
let's
say
they
do
give
us
50
000
doses,
to
start
off
with.
If
I
don't
report
back
50
000
administrations
to
the
cdc,
we
do
not
get
our
next
batch
of
50
000..
So
this
idea
of
the
data
connectivity
and
having
the
accurate,
reliable
data
that
we
can
turn
around
quickly
is
essential
to
us
even
participating
in
this
program.
H
C
I'm
glad
we're
making
that
point
now
in
advance
in
further
conversations,
especially
when
you
talk
about
you
know
possibly,
and
you
don't
know
for
sure
only
50
000
being
released
from
the
national
cdc
now.
That
being
said,
I
guess
it
really
doesn't
matter
how
many
pharmaceuticals
you
know
have
been
approved
if
they're
releasing
you
know
in
part,
you
know
a
little
at
a
time.
Is
that
correct.
H
That's
right,
I
mean
we
will
get
a.
We
will
get
a
proportion
of
the
the
total
amount
available
on
any
particular
day,
so
I
think
it
just
depends
on
how
much
they
have
in
their
their
stockpile
and
we
get
our
proportion
of
that
now
when
they're
multiple
different
vaccines
it'll
be
interesting
to
see
if
they
choose
to
send
all
of
one
type
to
philadelphia
and
another
type
to
new
york
or
how
that's
handled.
We
don't
have
any
advance
information
on
that,
but
we're
preparing
for
the
possibility
of
having
multiple
different
products
in
this
city.
C
So,
just
to
add
to
that
in
in
some
of
my
question
is
it
will
fill
it
up?
Will
philadelphia
receive
direct
or
is
it
would
it
will
it
come
from
the
state
like
who
would
be
the
centralized,
would
philadelphia,
be
the
centralized
distribution
and
are
we
prepared
infrastructure
wise
with
with
either
storage,
freezers
and
coolers
in,
of
course,
undisclosed
locations?
C
H
So
we
are
independent
from
pennsylvania.
Our
dose
allocation
will
be
determined
based
on
the
population
size
of
philadelphia,
and
we
are
accountable
only
for
immunizing
philadelphia
residents.
The
vaccine
will
be
stored
in
at
a
national
level.
There
are
a
couple
of
major
depots
that
will
house
all
of
the
vaccine
and
when
we
submit
an
order
to
the
cdc,
the
depot
then
will
ship
the
vaccine
to
whomever
we
determine
will
receive
it
now,
depending
on
what
the
storage
requirements
are
for
that
vaccine.
H
That
might
be
the
health
department
itself.
It
might
be.
You
know
some
of
the
occupational
health
departments
in
hospitals
may
be
direct
recipients,
so
some
of
the
flow
of
vaccine
could
go
directly
to
the
person
or
groups
that
are
administering
the
vaccine
or
they
may
come
to
the
health
department
who
will
still
on
the
handle
redispensing.
H
One
of
the
reasons
it's
not
all
worked
out
yet
is
because
of
this
issue
of
the
storage
temperatures
and
the
the
size
of
the
the
distribution
boxes.
I
know
this,
I'm
probably
getting
into
way
too
much
detail
for
you,
but
some
of
the
vaccine
is
actually
packaged
in
very
large
quantities.
Like
a
thousand
doses-
and
they
will
only
ship
in
that
large
quantity,
so
we
would
not
want
to
waste
any
vaccine
by
sending
a
thousand
doses
to
a
provider
who's
only
going
to
use
a
hundred.
H
Is
the
health
department
has
just
very
recently
brought
up
capacity
to
store
the
ultra
cold
vaccine,
and
we
do
believe
that
we're
going
to
have
capacity
to
support
the
amount
of
vaccine
that
we're
going
to
get.
We
will
be
partnering
with
some
of
the
big
universities
who
also
have
these
ultra
core
cold
storage
devices,
so
our
capacity
can
be
supplemented
by
theirs
as
well.
C
Now,
doctor
that
you
know
you
know
just
going
off
of
you
know
our
cover,
you
know
this
conversation,
but
we're
we're
less
than
five
percent
right
from
our
population
on
the
amount
of
distribution
of
vaccines
in
in
phase
one.
Are
they
you
know
below
four
percent
I
would
I
would
imagine,
is:
is
that
going
to
be
universal
across
the
country
like
1.5
or
less
for
the
initial
shipment.
H
Yes,
I
mean-
I
don't
philadelphia,
is
not
going
to
be
treated
any
better
or
worse
than
any
other
jurisdiction
they're
going
to
do
this
on
a
straight
per
capita
basis,
so
I
think,
as
a
city
will
be
treated
fairly
and
and
that's
that's,
how
vaccines
have
been
handled.
Historically,
it's
always
been
done
on
a
per
capita
basis.
H
The
only
thing
that's
a
little
bit
different
is
that
the
federal
government
is
making
some
arrangements
for
federal
institutions
that
are
outside
of
our
jurisdiction,
which
I
mean,
for
example,
the
federal
prison
and
some
of
the
federal
agencies
like
the
fbi
and
the
federal
building.
They
probably
will
have
a
direct
arrangement
with
cdc
to
receive
vaccine,
and
we
will
not
be
accountable
for
any
of
their
doses.
But
apart
from
that,
where
it's
a
straight
per
capita
level,
distribution
or
assignment.
C
You
know
I
think
more
so
than
other
other
cities,
but
you
know,
I
guess
we'll
we'll
have
time
to
you
know
to
continue
to
fight
for
that,
and
you
you
mentioned
that
the
cdc
required
that
you
know
the
city,
health
department
and
other
government
agencies
to
submit
a
plan
for
distribution
of
the
vet.
Can
you
can
you
share
that
plan?
Is
that
public
or
is
that
something
that
we
could
distribute
to
to
members
offline
or
at
least
highlight
on
some
of
the
distribution
plans
that
you
submitted
to
the
cdc
sure.
H
So
that
is
actually
an
opportune
comment,
so
I
can
just
announce
that
we
did
today
open
our
first
public.
I
guess
presence
about
a
code
of
19
vaccine
on
the
city's
covet
website.
So
if
you
go
to
the
base
or
the
cova
19
website
that
we're
hosting
there
is
now
a
tab
there
for
vaccine
and
we
have
our
first
sort
of
basic
information
there
and
are
building
out
a
series
of
faqs.
H
H
We're
happy
to
share
the
full
plan
with
all
the
members
of
council
or
whoever
you'd
like
to
have
it.
The
full
plan
will
also
be
made
available
on
the
public
website
within
probably
a
couple
of
weeks.
We
wanted
to
get
more
information
built
into
the
plan
about
the
actual
vaccines,
so
that
people,
if
they
were
going
to
read
this
in
detail,
would
understand
what
products
we're
working
with
and
what
the
safety
and
efficacy
is.
C
I
mean,
I
think,
that's
that's
that's
a
great
sign
of
transparency
in
the
symbol
for
for
the
city,
you
know
of
all
the
hard
work
that
we're
doing,
and
especially
in
a
time
when
you
know
people
are,
are
you
know,
you
know
either
either
curious
and
concerned
at
the
same
time
on
what
the
vaccine
does
is
it
safe?
Is
it
going
to
be
able
to
get
out?
How
do
I
get
it
and
what
is
the
timeline?
Are
we
allowed
to
walk
outside
our
house?
C
So
I
want
to
thank
you
for
all
your
efforts
in
that
I
have
one
last
question
and
I'll
submit
everything
else
in
in
writing.
I
didn't
get
a
chance
to
ask
this
question
to
all
of
the
other
panelists
that
that
joined
us
here
today
and
is
there.
The
question
is:
is
there
a
better
benefit
of
offering
multiple
vaccines
at
the
same
time
that
we
are
vaccinating
people
for
for
covet
19?
C
H
Absolutely
I
mean
I
love
that
idea
and
I
think,
by
the
time
we
are
in
the
phase
three,
which
is
the
open
access
for
everyone
in
the
city.
We
would
like
to
see
that
providers
who
were
immunizing
with
covet
19
vaccine
are
also
taking
that
opportunity
to
update
all
of
the
other
vaccines
that
a
person
might
be
eligible
for
we're,
hoping
that
covet
19
vaccine
becomes
integrated
into
normal
medical
practice.
H
So
when
you
go
in
for
your
annual
physical,
if
there's
an
indication
to
get
this
vaccine
every
year,
every
five
years
or
whatever
it
turns
out
to
be
that
that'll
be
the
opportunity
to
do
that.
I
don't
think
in
the
earliest
phase
that
we
will
be
able
to
address
the
other
vaccine
requirements
of
the
individuals,
partly
because
of
the
timing
and
the
population
that
we're
we're
dealing
with.
H
B
Thank
you
and
you
know
what's
so
funny.
I
can't
believe
we
didn't
ask
that
question
all
along
about
boss,
I'm
so
excited
to
hear
that
there's
not
going
to
be
a
cost
associated
with
it.
You
know,
I
think
that
this
is
just
going
to
be
phenomenal
in
terms
of
making
a
difference
in
communities
where
people
just
really
don't
have,
and
and
to
be
honest
right
now.
Nobody
has
it
so
again,
we
thank
you
and
we
thank
the
health
department
for
everything
that
you're
doing
any
additional
questions
from
them.