(hip-hop beat) - Good morning, and welcome to today's news conference for California Ethnic Media, co-sponsored by Ethnic Media Services, California Black Media and the Division of Population Health of the California Department of Public Health.

Our focus today is on the expanded COVID treatments for beating the COVID surge this winter.

The winter holidays are expected to bring a surge in symptomatic COVID cases, but treatment is available to reduce the impact of the illness and prevent its severity; treatment that can lead people to test negative sooner.

Early evidence suggests that COVID treatment, may also lower the risk of long COVID.

Speakers will discuss COVID therapeutics, available for treating the illness in adults and some teens and the necessity of accessing treatment early in the illness for it to work.

The CDPH will also present the latest data on disparities in getting treatment in some racial, ethnic and socioeconomic groups.

Thank you to our panelists.

Now, it gives me great pleasure to turn the microphone over to Regina Brown Wilson, executive director of California Black Media, our close partner who will moderate today's briefing.

Welcome, Regina.

- Thank you so much, Sandy.

And, as like any reporter, I like to just dive right into things.

So, I think this discussion today is extremely important, but we wanna just kind of start this discussion off with Dr. Nguyen who will provide us an overview, about the therapeutics that are currently available and how they can be accessed what new treatments may be in the pipeline and new data on ongoing disparities in the treatment for some of the racial and ethnic and socioeconomic groups.

So, Dr. Nguyen?

(clears throat) - Thanks.

I just wanna start off by giving my gratitude that you all are even here paying attention to this important work as we are in the midst of our winter surge.

I can't emphasize enough that your work and your attention to this and highlighting of COVID-19 treatments is literally lifesaving, because we know the general masses are not aware of the availability of COVID treatments.

So again, just want to thank you for your attention and work in elevating the issue.

So, I just wanna take a moment to just recognize that we are in the winter surge.

We are already seeing increases in hospitalization rates for COVID.

Rates are certainly increasing especially, after the Thanksgiving holidays and we expect even more towards the Christmas holidays and as we head through December.

And, I just wanted to take a moment to really recognize that we really have an opportunity here to meet the moment.

In Vietnamese, there is a specific word that's a little difficult to translate and the word is tiêc.

Maybe stepping back a second, what I'm thinking of is this moment actually makes me very anxious and for reasons that maybe isn't apparent.

So, yes; case rates, hospitalizations?

That would make anybody anxious.

But, what really makes me anxious is that word that I mentioned is tiêc, is this concept of regret and what a shame of missing this opportunity where we can actually do something about this surge that's never before happened in the last three years of this pandemic.

This is the first winter surge of a three-year pandemic where we actually have treatments that are highly effective, readily available and free to the public.

And, we know that most folks aren't accessing it.

And, it's just that the concept in Vietnamese is one of, like, this would be terrible if folks didn't know and didn't access.

And, that's where you all come into this picture.

And so, when I reflect back on the last three years of this pandemic, early on we didn't really have much and we were scrambling to get even testing up-and-running.

So, I just wanted to call out that, masking is and continues to be a great preventative measure.

We needed to develop testing.

We then developed vaccines- this, like, amazing science breakthrough and now, treatments.

But, folks are understandably COVID fatigued and felt like they have stopped listening after vaccines.

And, that's where you all come in.

That treatments is this amazing technological advance that we were able to bring forward and now it's available to people who aren't hospitalized, which is the point: "How do we prevent you from getting so sick that you're now being hospitalized?"

When we talk about the toolbox-- Oh!

Again, I just wanna emphasize first time that we have treatments available.

So, this is a different surge.

As much as people wanna tune it out and not pay attention, there's something different about this one.

And, that although we've done this great job of informing people that when you test positive for COVID, you should isolate and you still do need to.

We need to change the narrative that it's isolate and seek treatment.

There's actually something else you can do now.

And so, if you think back to the early 2020, people were desperate for this!

They were desperate for this moment of "when I test positive for COVID-19, "there's actually something to do about it, other than sit tight and hope for the best."

Now, we can actually seek treatment.

And, just to remind folks to not forget about the rest of the toolbox, especially as some of you have been paying attention.

We have this early and fast rise in RSV and flu cases.

So, all of these viruses, once your respiratory viruses, are overwhelming our hospitals.

And, just putting a plug in for the department's five tips to prevent winter viruses, I've included links to our press release and a tip sheet around getting vaccinated, staying up-to-date with both your flu vaccines and your COVID vaccines and getting treated.

If you do test positive for COVID or getting...seeking evaluation for treatment, staying home if you're sick, testing to figure out if it's even COVID.

And, if it is, then try to seek treatment; wearing your mask, especially in crowded places, especially around young kids who can't wear masks; washing your hands; and covering your cough or sneeze.

And, this is all for heading into this rough winter season.

So, what are COVID-19 treatments?

They are medications that can stop COVID from getting serious.

They either come in pill or IV form.

The vast majority of folks take the pill, which is great.

It's much easier than going for an infusion.

They're free; paid for by the federal government.

The pills are free.

They're widely available and they're highly effective treatment.

And, here's the key why it makes it challenging: it has to be taken within five to seven days of symptom onset.

So, that means the day you start feeling that runny nose or that cough is when you need to start counting.

And, understandably and unfortunately people wait a few days, before they think, "Well maybe this is COVID."

So, you know?

Then you gotta go get tested, then you gotta go find a clinician to then prescribe the medicine to you.

And so, the message is as soon as you start to feel sick, test right away so that you can then get evaluated for treatment.

Don't wait till the illness gets worse.

The whole point of the treatment is to prevent serious illness, hospitalization and death.

And so, if you wait too long then you might actually be outside the window of treatment.

And, in order to take the pill, it has to be within five days.

After five days it's gonna be the IV form.

And just for name recognition, the drugs that are now out there and effective.

Paxlovid is the most effective pill in most cases.

Molnupiravir is the other pill and Remdesivir is the IV medication.

They are all antivirals.

So, the reasons to get COVID-19 treatments is that they are highly effective in preventing severe illness, hospitalization and death by up to 50% to 88%.

Even among those who are vaccinated, it decreases risk by 45% to 50%.

And, this is something that's personal to me.

One of my motivators is early yet growing evidence that treatments may lower the risk of developing long COVID symptoms.

And so, long COVID symptoms are symptoms and ailments that may continue on months, weeks, years.

We're not even sure how long 'long COVID' can last.

And so, I definitely don't want brain fog!

(chuckles) And so, anything I can do to prevent that, I'll go for.

But again, early evidence and more and more trials are being done.

Antiviral treatments can also prevent the virus from multiplying in your body and infecting more of your cells, which can help you test negative sooner.

You do still have to isolate for five days, but between that five to seven day window, if you do test negative, then you can actually leave isolation.

So, those are some of the reasons.

And, when we look at published studies of how effective this has been for entire populations, even populations that are highly vaccinated, we estimate that so far for this one specific drug that Paxlovid use, in the year of 2022 so far, has averted-- There's a missing zero there!

16,000 to 48,000 hospitalizations and between 4,800 and 10,000 deaths.

Likely, California is on the lower end because we're more vaccinated than in some of the other communities.

But, we're literally talking about thousands of lives that could be saved.

And, we know that winter surges in the past have sometimes accounted for 50% to 60% of all cases that we see all year.

That's why this message is so important to get out this month as we capture the vast majority of cases that are gonna happen and potentially benefit from treatment.

Who should take COVID-19 treatments?

So, this is another huge message that I think has been missed by the public.

And, it's a remnant of us not having enough medication in the past.

But, we have plenty of supply.

The vast majority of adults are eligible.

Nobody thinks of themselves as, quote/unquote, "high risk."

The truth is most of us are!

(chuckles) So, anyone who's over 12 years old qualifies.

You have to have symptoms of COVID-19 and you have to have a positive test.

And, folks should just seek treatment.

They should not rule themselves out and think, "Maybe I'm not."

Just talk to a provider.

Let them help figure it out for you.

So, that includes populat-- So, anybody over the age of 50: even if you have no other health conditions, just your age puts you at high risk.

Just the fact that you're unvaccinated puts you at risk.

And, having common conditions like high blood pressure, diabetes, obesity- here's a really critical one- being physically inactive which I will say is the vast majority of Americans, unfortunately; smoking, even if it was past smoking.

And, the list goes on and on.

The point here being, let a clinician help you figure out whether you qualify.

And, I do recognize that it's a newer medicine for a lot of clinicians and I have some more information about that later.

So, how do they work?

The antiviral treatments, they stop the virus from multiplying and infecting more of your cells.

And, I do wanna mention rebound.

So, side effects are also minimal and they tend to be very mild like GI nausea and feeling unwell in your GI tract.

So, rebound can happen with COVID-19 even if you don't take treatment.

Most people don't have rebound and more than 99% of people who do have rebound, it's mild.

And, rebound is not treatment failure since the medications still work to prevent severe illness.

And, the risk of rebound should not be a reason to avoid treatment.

[clicking mouse] I wanna speak particularly on an area that's near and dear to me, is that we see persistent disparities in access to care.

And the Department of Public Health, we've been working very intensely over this but we need your help to help elevate the issues and communicate to these communities of what's available to them.

And so, the CDC demonstrated what we suspected would happen anytime something new comes on the market is that communities of color have disproportionately low access.

And so, that data came out that if you were Black or Hispanic, that you were less likely to be prescribed COVID treatment even though you were positive compared to your white and non-Hispanic colleagues.

We are also seeing this across socioeconomic status in California specifically.

So, in California we have this index called the healthy people index and it basically stratifies areas and neighborhoods into four different quartiles.

HPI-1 and -2 typically are the ones that are lower socioeconomic status.

And, on this graph it's, as you might imagine unfortunately, they are the two lowest lines here in terms of accounting for COVID-19 treatment.

So, the people who are most likely to have severe outcomes, people of color, low-income communities, they're also the ones that are least likely to be using treatment.

- [Regina] So Dr. Nguyen, are you saying that, and I know that we wanna make sure that we jump to some of the other doctors to get some of the other perspectives and so we can come back and have people ask questions about this.

But, are you saying that people of color are not accessing any of the medications or therapeutics?

- No, they're accessing but at a lower rate.

- [Regina] Okay.

(clears throat) - So, this graph for example gives you the percent of Black Americans who were treated with Paxlovid compared to white, for example.

So, just picking a spot in May around 30-some percent of white patients presenting to care were getting treated compared to Black Americans, and about 20% of them who were coming in were actually getting access to care.

- [Regina] Okay.

So, can we put a pin on that portion of the conversation so we can jump to Dr. Bains real quick?

'Cause we wanna make sure we get the reporters to be able to ask questions of you, as well.

- Oh, sure.

Is it alright if I just finish with the "how to get" 'cause it's not that straightforward in the American healthcare system and this is part of the reason why communities of color and low-income communities are having trouble accessing?

- Oh!

No, no.

Go ahead.

- Okay, I'll just finish on this.

I think I'm just skipping a slide.

Older adults more heavily impacted.

We need to make sure they hear, so-- healthcare is hard to navigate.

There's multiple options to you.

Ideally, you go to your own provider or urgent care center.

We recognize that, that can be hard especially for our communities who may not speak English and navigate healthcare.

It's difficult for people who even are well-educated and have the means.

So, if you can't reach out to your provider within 24 hours of trying, then the state has a website and a phone line that you can call and they can help you navigate test-to-treat locations.

Some of which you might have to-- well, actually-?

Anyway, gets a little complicated!

(chuckles) But, the state has support services.

The third option, which we're really trying to promote in our priority populations for us to really meet equitable health outcomes, is the state telehealth service is if you can't figure out any other way to get to a provider quickly, then the state actually has a telehealth line that can connect you to a same-day provider and it will talk to you about whether or not you qualify.

And then, they can send the prescription to your pharmacy and the website's here: sesamecare.com And then, also pharmacies like CVS and Walgreens they also have pharmacists that can be able, that are able to prescribe.

I will note that because it's a newer medicine some clinicians aren't familiar with prescribing.

And so, there are state resources to help patients' access.

Thank you.

- Great.

No, thank you.

And, Dr. Bains, let me just go straight to you.

- Good afternoon, everyone.

Thank you so much, Dr. Nguyen for that exceptional presentation.

Can you guys hear me okay?

Okay, awesome.

No, very important information being discussed.

I'm very, very honored to be a part of the new state legislature as a new sworn-in assembly member representing District 35 which is Kern County.

I work as a physician on the front lines as a family medicine doctor.

I look forward to increasing things especially like what Dr. Nguyen was alluding to is increasing healthcare access; at the same time making sure that communities especially rural areas of California have increased access to information.

The biggest problem during COVID-19 was access to information specifically in rural areas where most patients don't really have access to information like other more urban areas do.

Rural areas, it's mostly what they experience via their doctor or what they hear between each other.

The problem that we experienced during COVID-19 was the fact that there was an accelerated retirement of physicians and therefore having access to primary care doctors suffered heavily during COVID-19.

The other problem that was presented was the fact that there were a lot of jobs that were lost during COVID-19 due to the economic downtrend.

And, because of that, a lot of people lost healthcare insurance.

So, this was something that impacts rural areas quite big, especially when it comes to accessing healthcare in America.

Accessing healthcare means you have healthcare insurance and that's the first step.

The problem in rural areas, one of the biggest barriers is having access to that healthcare insurance.

The other thing was because of the economic downtrend you had a lot of people that had to switch their jobs.

Well, when you switch your job you have to lose your healthcare insurance.

And, there's a 60-minute period-- a 60-day period in between trying to switch over to your new healthcare access line.

What do we do for people so that they continue getting healthcare in that 60-day period making sure they have access to the treatments, especially what Dr. Nguyen was alluding to?

The other barrier when it comes to rural areas is language accessibility, making sure we have resources in different languages, specifically Spanish and Punjabi as well, which was not apparent during COVID-19.

That was very challenged.

The third is making sure we have an access supply, especially in rural areas like Kern County.

We were the last to get the supplies for the vaccines, a monoclonal antibody.

This is where we need to make sure that there our lens because rural areas like Kern County are the areas that suffer to access to healthcare, period.

This is where we need to have huge focus on to make sure specifically in times of pandemic, specifically right now as we are currently experiencing a surge in hospitalizations in Kern County.

This is real.

The surge is real.

It's happening, and it is at the detriment of areas like rural California, like the district that I represent.

The other thing is the alarming rates of underlying lung disease in areas like Kern County due to the increased air pollution and bad air quality.

We have some of the worst air quality in the state, in the country.

And, things like COVID-19 things like winter surges of the flu, it hits us harder than any other part of the state because of the prevalence of underlying lung illness.

There's a lot of work that we need to do.

There's a lot of work that we need to do together to make sure that areas that are vulnerable like the district that I represent, make sure that they are properly supported and they have their proper supplies and resources that they need to continue providing care.

And, at the same time, making sure that we cover the people that don't have access to healthcare due to not having a job at the moment, due to switching jobs over.

These are key things that affect specifically rural areas of California.

Again, very honored to be here.

Thank you so much for the invitation.

I'm honored to have this opportunity to take my voice higher from physician to legislation, and I look forward to working with everyone in this room.

- [Regina] Great, thank you.

Sunita, I think you wanna come off your mute and you wanted to ask a question?

- Absolutely.

So, we've discussed Paxlovid a lot this morning but so many of the communities that we serve, our populations are ineligible for Paxlovid treatment because of underlying conditions.

What alternatives to Paxlovid would you suggest?

And, Dr. Nguyen?

I see you're shaking your head!

But, if you could address that, that would be terrific!

- It's a huge struggle.

So again, you have to be part of these "high risk" categories to even qualify.

I think what is happening is because it's a newer medicine, clinicians aren't familiar with it.

Sometimes they misinterpret a contraindication because one of the elements of Paxlovid interacts with other drugs.

And, as a quick example, I would say probably most Americans are on some type of statin.

That's a cholesterol medicine.

And so, it does affect the level of the cholesterol medicine.

But the answer to that is that you would, in the vast majority of cases, just don't take that statin for the days that you're on COVID treatment.

So, I think part of it is also not enough education yet and comfort with a new drug.

That's part of the reason why the state telehealth line was stood up.

We recognized there would be so many barriers to care.

But, to also answer your questions-- first, I wanted to address that I do think there are many cases where people are being refused care even when they should have been offered.

So, that's problem number one.

But then problem number two, in some cases, there actually is a reason why you shouldn't take Paxlovid.

And, in those cases, Molnupiravir is the other pill that can be taken and if for whatever reason you don't, you can't take that pill, then Remdesivir is the IV medication.

But, most people don't wanna have to go somewhere to get an IV medication if they can just take a pill.

Or, they might not qualify 'cause they sought care at day six or seven.

So, those are actual reasons to not get prescribed.

And then, that's when Remdesivir is the option at day six or seven.

But again, the message to the public is simpler than that.

It's to go seek treatment, and here are the options.

Especially if you go to your provider and for whatever reason they couldn't get you an appointment, or they said no.

Then, there are sort of a plan B.

- This question too, and this is for clarification 'cause I think that Dr. Nguyen talked about this.

But these treatments, are they all free?

No matter if you have healthcare, don't have healthcare, should you be getting charged for any of-- anything?

- Excellent question.

The pills, Molnupiravir and Paxlovid are free.

The IV form, Remdesivir, is not.

It did get commercialized.

In California, we have a new law as of September, this September, that obligates health insurance to pay for COVID treatment even if you get care out-of-network.

So, when you go to another clinic or a pharmacy and I'm sorry; I don't mean to confuse.

The pills are free regardless of insurance.

If you don't have insurance, you can also access state services right now.

In the future when pills do get commercialized, they will have [outro music begins] a cost for uninsured, but the insured folks will still have it for free.

- Can I just jump in real quick?

- [Regina] Yes, yes.

Go into it.

- Just wanted to add to Dr. Nguyen's comment.

The problem in rural areas is getting access to a doctor to prescribe the medication.

That is the reality of what we're dealing with, especially in rural areas.

Yes, you can get the medication covered for but trying to get in to see your doctor?

The reality is, I mean, 10 years ago if you needed to see your pediatrician?

One to two hours.

The reality of what we're dealing with in rural areas; you need to see your pediatrician?

Two to three months!

Most care is being accessed through urgent cares which are being overwhelmed.

This is the reality of what we're dealing with.

I have to leave.

But, thank you guys so much for the information and I look forward to working with you guys.

Bye-bye!

- Thank you.

Stay safe.

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